4716 Pebble Beach Wayn? ,
? ? •_. -' ?
?f
(gexfif traft nf COrrupaMry
Citp of Cagan
Erptr#atrttt nrf IdNng Jwrrtion
T his Certi; j'rcate issurd pursuaxt mthe requir-ements of Section 306 of tlte Unijorm Auddixg
Code cer?ifYinB l/wt at the time of issWance tlis strucwre ww in compliance wl?1e the wrikus ,
o,d;nawa ol the Qy regWafing buddks conoucdon or use. For rhe fouowtn?
U. amw. SF DWG swig,r..k N,, 893
0,,? 7?1. R-3 M-1 ZigD,,;G R-1 ? C.M V-N
O...,,jsdaj,4 SONS CONST A&,w 4600 FAIRWAY HILLS DR
BO"M716 PEBBLE BEACH WAY- 2. B3, FAIRWAY HILI.S 3RD
SEP 11, 1992
?
POST IN A CONSPICUOUS PIACE
Allb
. Contr°l INSPECTIaN RECORD "o.
CITY 4F EAGAN RL?MVAMM FM BSgr YMSH 02122193 PERMIT TYPE: ?u ttrl Ne
3830 Pilot Knob Road WPEN BLDRS $88-4952 Permit Number.
Eagan, Minnesota 55123 Date Issued:
(612) 687-4675
SITE ADDRESS: 10t :2 e r. or. K: 3 APPLICANT:
47 t.6 PE60tf. BEACH WAY SIiNS COiiSI -
YA i' ItwtAY MI f. L:4 3RD (612) 4152-6466
PERMIT ?,VIRTYPE:
TYPE OF WORK: MEW
INSPECTION
f1) 1? 1 t M6 ?, .
r HANJ.Ne
•
1Nfti11lA7.IltM FINA1.
.
}1P FfriACf ?
kfMARKas RE'CC1F''r ! E+QOs'iTER PUMf' SiW Pl8R -
Permit No. Permlt Holder Date Telephone #
S/W
PLUMBING
NVAC
ELECTRIC
ELECTRIC
fnspecttorr Date Insp. Comments
Footings I
Foundation
Framing
Roofing
Rough Plbg. 7? 1 _ Z
/ ?
Rough Htg.
Isui.
Fireplace
Fnaf Htg.
Orsat Test
Final Plbg.
/ Plbg. Inspectar - Natity Plumber
Const. Meter
Engr./Plan
Bldg. Final
Deck Ftg.
Deck Final
Well
Pr. Disp.
,'c?• ?•
?,-.?J
IN5PECTION REC4RD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
i f iilil 1 1:1 fl1t'1l 1111Y I
, .. ? . . . .. f I ? ? ' . ? '
PERMIT SUBTYPE: TYPE OF WORK:
,.L,
? ? -... .. 4?"..:? . i . . ?
? ? .. . . .. . .. ? . . ? - J
Permit No. Permit Holder Date Telephone #
ELECTRIC
PLUMBING
HVAC
Inspectlon Date Insp. Comments
FOOTINGS
FQUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST II
ROUGH
HERTING
GAS SVC
TEST
INSUL
GYPBOARD I
FIREPLACE [
' Z
/ h cf /-C
FIREPLACE
AR TEST
- ?
-
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
INSPECTION RECORD
.
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
? Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS•
? l fJl : . ?il !l+ k r
1-1 0ff1 ! EiFA(:H WAv
tAIftLJAY NiLIS :3ar,
PERMIT SUBTYPE:
t,i , ,
APPLICANT:
i "i,1t 1,. i I
(C1 :' ) u!-? t .'.'Nrt
TYPE OF INORK:
fc11 1 1 1f 1 NC,
H? / i *i It
01, /*s /4F
F' 01 1 P 1 I !t
? ..
N 1 t I
F ?
L - -- - - - - - - - - - - -
, Permlt No. Permit liolder Date Telephone k
ELECTRIC
PLUMBING
HVAC
Inspection Date Insp. Commenls
FOOTINGS
FOUND
FflAMING
ROOFING
ROUGH
PLUMDING
PLBG
AIR TES'i
RQUGH
HEATING
GAS SVC
TEST
1USUL
--
16 YI>[30ARD
? -- - - - --
-
I ! fijEPLACF
? -- -
I FIREFI ACC
AIP TEST --- - -
-- --
-
-
- - - - -- -
----- --- -- -- - --
-
FINAL PL[3G
FINAL HTC:
I iFi:;.4T
! TEST
rCi! C?:, FdJ/?;
? FtCM i R.I
I ,...?AT!.""? -
- - - - ---
- - - - - - -
- -- -- I - - -
-- --- - ---- - --- ----
-- --- - --- - - -- - -- - -
- - - ---- - --- --
?: ? K r- 1
?Y • ??
I- 2 (- 47 ??IB
.C rf ? t7w.?d rw: / ['wr?11?'w
11/o-?iot
945 ol?
9
ReOUest Date
.( ['? ? Q 3 Fire No. i n paetion
R
Fe oughquir?
?iAeatly Now ? Wiil Notity Inspector
_
?/7 l Ves = No When Peatly?
I? licensed contractor p owner hereby requeffi inspection of above electrical work at
Job Atltlress ('9V/eeG Bo% or RoN¢ No.) /^
1 i ! ? 4%U/"G
?A7,- Gfly )
<5I'?
Secfion No. Township Name ar No. Range No. Coun
OccupantlPRINT)
E ?d r ?r- Phone No.
Power SuOFlier AdCress
ElecVicai ConbraJ<ror (COmpeny/ Name?l[ ?
}7N?1? ?/".c ConVaclor5 Lkense No.
/?40
Mailing Aaaress IConVacror or owner Maki g Installafion)
-
fk
l
A1
Ss
s
crd? d?
0 , ,
Auponzetl Wre (ConhactonOwner Makinq Ins?allati Phone Number
svC
?
.
MINNESOTA STATE BDARD OF ELECTRICITY U THIS WSPECTION PEOUEST WILL NOT
Grigpa-Mltlway 81Eg. - Raom $-173 BE ACCEPTED BY THE STATE B0.4RD
1831 Universlty Ave., SL Paul. MN 55106 UNLESS PROPER INSPECTION FEE IS
Gpone (612) 642-0800 ENCLOSEO.
J7/?? RE?UEST POR ELECTRICAL INSPECTION "??` EB-00001-OB
?1 /J?/?
?$ee insVat1ion5 Iw c'ompleting ihis iorm on pack 0 yellow copy. ? ior ?.7
K 44945 ,J.
"X" Below Work Covered by This Request
ew AW'1 Rep`. TypeofBuiltling AppliancesWired EquipmentWiretl
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Olher-(Specity)
Comm./Industrial Furnace
Farm Air Conditioner
Other (syenty) ComrectorB Remarks:
Compute lnspeciion Fee Below.8>m--f i"?
# Other Fee # SeniceEnlranceSize Fee # Circuits/Faeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transbrmers Above 200 _ Amps Above 100 _ Amps
Signs Inspector's Use Onty'. TQ7qIL
' Irrigation Booms ?•
0,.?
11
Special Inspection
AlarmiCommunication THIS INSTALLATION MAY BE ORDE ISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MO S.
1, the Electrical Inspector, hereby
certif that the above ins ection has
Y P
been made. Ao.qn-m
Final oare
?
Date - -?
OFFICE USE ONLY
This request voitl 18 months trom
REDUEST FOR EIECTRICAL INSPECTION ??'" ??a E&o0om08
? ? See instmclons fur coWlenng ihis lorm On back ol yellow copy. _
2410 ``
K "X" 8e(ow Work Covered by This Request q.:.
ew Ad3 Rep. ' Type of Building AppliancesWired EquipmentWired
X ' Home ){ Range Temporary Service
Duplex Water Heater Electric Heating
Apt.Building Dryer Other-(Specity)
Comm./Indus[rial Fumace
Farm ir Conditioner
Othar(syeciry) ConVactor5 Remarks'.
Compute Mspection Fee Below:
# Other Fee # ServiceEntranceSiie Fee # CircuitslFeetler5 Fee
Swimming Pool 0 to 200 Amps 1 11 0 ro 100 Amps 47.
Transiormers Above 200 _ Amps Amps
SignS Inspector5 Use Only: OTAI
Irriga[i0n Booms ?
?
rr $65 . 50
Special Inspection ?
?r
Alarm/Communication THIS INSTALLATION MAY BE D DI ONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 M S. f
I, the Electrical Inspector, hereby
tif
ih
t th
b
i
i R0v9""" . . , ,a
cer
y
a
e a
ove
nspect
on has
been made. F;nei ? oeie L? ?,
a
OFFICE USE ONLY ?
Tnis requesl voitl 18 monihs irom
n d/
? i "L41U 'UC07°
,
? ?? 5a?
, , A&
Repuest Date '
7/Zl/C?'? Fire No. Rough?in In on
Requiretl? ?[??
GReadyNOw LT'niIlNOUtylnspector
$] Yes ^ _. No Wtien Reedy?
I E licensed contractor ? owner hereby request inspection oi above electrical work at:
Job Atltlress streeL Box or Route Noj Ciry
2?± 4716 Pebble Beach Way Eagan
Sedion No. Township Name or No. RanBe No. CouMy
Dakota
OccuOam (PRINT)
Sons Construction Phone No.
452-5355
Powar SuOPker pqpress
Dakota Electric 4300 220 St. W. Frmington
Eleclr¢a1 Comrecmr IGompany Name) ConVaclor5 Lkense No.
Joos Electric Co. AM01895
Mailing Aatlres5(COmrxlor or Owner Makmg Installetion)
2104 Great Oaks Drive, Burnsville, MN 55337
Aulnorine0 Signature ICOnVactor10vvner Making Ins lalio PM1One Num1ber
431-4755
MINNESOiA STATE BOAND OF ELECTpICRV THIS INSPECTION FEOUEST WILL NOT
GriggsMiOway Bklg. - Poom 5173 BE ACCEPTED BY THE STATE BOARD
1821 Unlve.nity Ave., St. Paul. MN 55106 UNLESS PROPER INSPECTION fEE IS
Phone(612) 8iY-0800 ENCLOSED.
Address:4716 PEBBLE SEACH WA12ot 2 Blk 3 Sec/Sub FAIRWAY HILLS 3RD
These itema were/were not complete at the time of the final lnapection.
Date; SEP 11 1992 Yas No Inspector;
Final grade (6" from siding)
Permanent steps - garage
Permanent atepa - main entry 170
Permanent drlveway
Yermanent gas
Sod/seaded gtass ?
Trail/curb damage
Porch
Basemant finish
Dack ?
Please varify vith the builder the removal of roof teat caps from tha plvmbing
system and tha shut-off of vater supply to the outaide lavn faucet bnfore
freeze potantial exists. ?
White - C1ty copy Yellow - Reaident copy Pink - Contractor copy
, $ CITY OF EAGAN
681-4675
DEPT. OF BUILDING INSPECTIONS
Correction Notice
I have inspected this structure and these
premises and have found the following
violations of city codes:
When corrections have been made, please
call 681-4675 for inspection.
Date t 2 f/a-? yU -*?-
Inspector City of Eagan
DO NOT REMOVE THIS TAG
t?e s i wa.. ?
o?
2005 RESIDENTIAL BUILDING PERMIT APPLICATION ?U •
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694 I
NewCOnshuctionReouirements RemodeUReoairReauiremeMS OfficeUseOnMl
3 reg?fered site surveys showing sq. ft of lol, sq. fl. of house; and all roofed areas 2 copies of plan Cerl M 5urvey Recd Y N
(20% maximum lot coverage allowed) 7 sel of Energy Calculations for heated additi-Sree P.res Poan Recd Y_ N,
2 copies of plan showmg heam & window sizes; poured (ound desgn, etc. t site survey for addNons & decks "Tfee PresReqmred =-= Y _N
7 set of Eneigy Calculations Add'rtion - iriditafe ilon-sife sepBc system On-slte Septic System _Y _ N
3 copies of Tree Preservation Plan H lot platled after 711193
Rim Joist Detad Options selection sheet (buldings with 3 or less units)
Construction Cost ?( ?` J+
Date ?&C4- l65-
Site Address
? ?_ ,,p
v
? (AC?1 U)C
Q. • UniUSte #
Q
Description of Work QC.,Q 1.5J `.kj? lr\.l ?S L,_J? f r, c Q PC
Multi-Family Btdg _ Y_ N Fireplace(s) 0_ 1 _ 2
O
P
t C 0.c o ( Com D 6
I I-2
e Telephone #((OSj) lO 632O
wner
roper
y .
-
RENEWAL BY ANDERSEN
Contractor 1920 COUNTY RD. "C" W.
Address ROSEVILLE, MN 55113 C'ty
State 651-2644777 Telephone # ( )
LICENSE #20130983
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Cateeorv 1
• Residential Ventilation Category 1 WoAcsheet
(Jsubmissiontype) Submitted
• Energy Envelape Calculations Submiried
A NEW BUILDING
Minnesota Rules 7672
• New Energy Code Worksheel
Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the informarion 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 without a
permi ; that the work will be in accordance with the approved p m the case of work which requires a review and
apprval of plans, ? n ,
pplicant's Printed Nazne LMplicant's Signature
OFFICE USE ONLY
Sub Types
? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex O 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01of_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.) O 33 Ext.Alt-SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvemenl ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building 0 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building• ? 43 Reroof ? 46 WindowslDoors
? 34 ReplaCement •Demalition (Enttre Bld g) - Give PCA handout to applieant
Valuation Occupancy MCES System
Plan Review 100% or 25%
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bidgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaVC.O.
_ Footings (deck) _ Final/No C.O.
_ Footings (addition) _ Ptumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas T ests Final
_ Framing _ Siding _ Stucco _ Stone _ Brick
_ 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
??••••,??••'` iu? ''c•ov rtfa tod U!1 '4460 lC?C?Lril`lSts ?Y3d'!LlSt47tflY •
.? ? .
r?na?
aune t aooi (aw of Eam -
3836 PiIcrt gnob Rond • '
EaM MN 55-122 '
. ro whom rc way eocoem:
Etaerranes is authorized to pttn buffdin
1116er Iones to ?ts forRe?tewal by tlnae?. rtease attow
prm•ide this 8' ?ccivi? forus in Bagan, `(? ?diati?atibn is valid for
. date bcyond 6/610Z; watiI a any
to theG`Ity. ?g? by ?n ??IY ?vo?es it in wiidng
I rcquest this antfiorizatian be ac?-expedi@oust .- '..
our buiidiag Pcanib auY fuxtltGt. Plcasc cxtII mc If ythctc acronnaY qtt?cFotta., t?ng ?
? coutacGed at 763-502-47Q6. .
Yonr itnmqdiate attention to Us maffer is mLmnrm ' . , .
Siuoeacly, , . .
ymoad'R &Pm
ustatlation Managcr
Rcnowai by AndcJSCn CoiRoration
C'r.: Karn-Firies 7?n? .
- --?-?- - - -?- ' -- -- - - -._. _ __._-?---- ?200.1
Received Tiha Ju?. 1. 1' 07PM
h.a ?
?
ouu
??Sfi3
,#::?o.zs
City Of Eagan _Z` . ?, ?_ `,??.?,__?
3830 Pilot Knob Road, Eagan MN 55122 t??? _..
Telephone # 651-675-5675 FAX 9 651-675-5694 1 - ?? 4 - 0 ,?
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
New Constructlan Reaui2ments RemodeN2eoair Reouirements Office Use Onlv
3 registared sBe surveys showing sq, ft. ot lot, sq. ft. of house; and all roofed areas 2 copias of plan CeA of Survey Recd _ Y _ N
(20°h maximum lot wverage allowed) 1 sel of Energy Calculations for healed additions Tree Pres Plan Recd _ Y _ N.
2 copies ot plan showirg beam 8 window saes; poured fourM design, etc. 1 site survey for additians & decks Tree Pres Requlred Y _ N
lsetofEnergyCalculations AddHion-indicefei(onsNesepticsystem On-siteSepticSysfem _Y _N
3 copies ot Tree Preservation Plan if lot platted after 711193
Rim Joisl Detall Opfions seledlon sheet (buildings wilh 3 orless unils)
Date
SiteAddress
'{7i4 iemE Ara j Cons[ruction Cost "? ?e e v
Unit/Ste #
Description of Work (vDCa-Pz - ?lu+
Multi-Family Bldg _ Y? N Fireplace(s) _ 0 _ 1 _Y 2
Property Owner T?«'? ?i¢u+??cc? Telephone #(bri ) 617 a 39 i'
Contractor D'?1
Address
State City
Zip Tetephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv I Minnesota Rules 7672
Enengy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code worksheet
(Jsubmissionlype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan8 _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Coniractor
Telephone #(
Telephone #(
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the informat n rate;
that the work will be in conformance with the ordinances and codes of the Ciry o MN
Statutes; 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.
.?I'r?/G'/( ('??vYr?34 Gc,
Applicant's rinted Name
?
V`
L,jv
Applicant's S* na re
p (?T OdC?
DEC 3 0 2004
is comp e d acc
OFFICE USE ONLY
Sub Types
? 01 Foundation O 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex A 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 EM. Alt - SF
? 04 02-plex ? 10 08-plex ? 16 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower L evel ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_ Y or_ N? 25 Miscellaneous
WorkTypes e;jef
? 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` ? 43 Reroof ? 46 Windows/Doors
? 34Replacement "Demolition (Entire Bldg) - Give PCA hantlout to applicant
Valuation Occupancy MCES System
Census Code Zonin
g
R -1 City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
'
Type of Const
Width
REQUIRED INSPECTIONS
_ Footings(new bldg) FinaUC.O.
_ Footings (deck) Final/No C.O.
_ Footings (addition) _ Plumbing
Foundation H V AC
Drain Tile Other
Roof Ice & Water F inal Pool Ftgs AidGas Tests Final
X Framing _ Siding _ Stucco _ Stone _ Bri ck
_ Fireplace _ R.I. _ Airi'est _ Final Windows
_ Insulation _ Retaining Wall
Approved By` n- A , 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
? z SI
RESIDENTIAL
BUILDING PERMIT APPLICATION
? CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New ConsVUCtian Reouiremenh
• 3 registered site surveys showing sq. ft. of lot, sq ft. of house; and all roofad areas
(20% maximum lot coverage allowed)
. 2 copies of plan showing 6eam & window sizes; poured found design, etc.)
• 1 set of Energy CalculaGons
• 3 copies of Tree Preservation Plan if lol platted after 711193
• Rim Joist Delail Options selection sheel (bldgs with 3 or less units)
DATE ?y-NOV -O?
SITE ADDRES.
TYPE OF WO
?
APPLICANT _ Renewal By Andersen, Inc
RemodeVRepair Requirements
• 2 copies of plan
• 1 set of Eneigy Calculations kr heated additions
• i site survey for extenor additions & decks
. Indicate H home served by septic syslem for addNOns
VALUATION lSlI OOS(:T
ULTI-FAMILY BLDG _ Y _ N
FIREPLACE(S)
J U
- 0 _ 1 - 2
STREET ADDRESS ; 1920 County Rd. "C" West CITY STATE_ZIP
Roseville. MN 55113
TELEPHONE # I 651-264-4777 FAX #
? License # 20130983 ?
PROPERTYOWNER??f.LW.WYJbC.II TELEPHONE# (1051-
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RUI,ES 7670 CATEGORY 1 MINNLSOTA 12ULLS 7672
(4 su6mission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submilted
Plumbing Contractor:
Plumbing system includes:
Mechanical Contractor:
Mcch:unical syslem includes:
Sewer/Water Contractor:
1{ee:
Phone #
Phone #
$90.00
?t
Fee: $70.00
I hereby acknowledge that I have read this application, state thaT the info mation is orrect, and agree to compiy
with all applicable State of Minnesota Statutes and City of Eagan Ordin nces.
Signafure of Applicant
OFFICE USE ONLY
_ Watcr SoPtencr
Watcr Heater
_ No. of Baths
Phone # _
Lawn Sprinkler
No. of R.I. I3aths-
_ Air Condilionuig
Heat Recoveiy Syslem
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
OFFICE USE ONLY
? 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 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-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 Windows/DOOrs
? 34 Replacement 'Demol(tion (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy _ MG/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr, of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS ,
Footings (new bldg) FinaUC.O. '
_ Footings (deck) FinaVNo C.O.
_ Footings (addition) _ Plumbing
_ Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final Pool Ftgs Au/Gas Tests Final
_ Framing _
_ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaunng Wall
Approved By
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
Building Inspector
??.??erv•.c tuv ti.oV Cpp IOJ pll +i400
xnruseru. nrenun?sn
re al
,? .
. amet zoal
Cuy of Ham
3836 Riicrt gacb Road
Eagen, MP1 55122
To Whom It May Conoarn:
Elder ]ones tA audkorized to putl buiidtng peMIts pbr geamW bY Andeism piease atlow
Pwvidc ttus ses"vzCC for tts in BaSan. 'ntis andirAizetion is valid for eny
date bayond 616101: uutil aftnewal by AndGrsen manaM ezp=etY mvolaas it ta aviitlag
to the City-
oar?bu? this sudiodzation be acoeP'tad-expedlt3onsly. as to not detay in thn af
?S Po?ta any furthcr. Elcaac call mc If ihct? aro a" questtona.. I i.?m ?? .
ooIItacted at T63-Sf12-4706.
Your immqdiate att,eatiott to ft matter is
sinoeavly,
.
ond R Rau
ostallation Manager
Ranowal by Andeasan Corporation
('r.: Karn-F.1de.r 7?ne.a
A,;?`?Ma`
?col?
;
Wuu2
Received Time Jun. 1. 1:07P4d
RESIDENTIAL
5-(o 9 q BUILDING PERMIT APPLICATION
cirv oF eacnN
3830 PILOT KNaB RD, EAGAN MN 55122
681-681-4675
NawCanetnx.Mlon BeaufremaMe
• 3 registered stte surveys showirq sq. M. of bt, sq. N. ol house; anA ig roofed areas
(20% meximum bt COVereOe allOw9d)
. 2 copies of plan strowNg beam & window s¢es; poured tound design, etc.)
• 1 aetolEnergyCalCUl9tlons
. 3 copies of Trea Presenation Plan d bt pletled atter 711/93
. Rim Joisl Detail Optbns salectqn sheet (bldgs wMh 3 or less unils)
DATE 5-1 1' 0Z
7' lCVt ?/--+,)
SITE ADDRESS ?7IC., ?f gg? ???h-r-k r.?,a-l MULTI-FAMILY BLDG _ Y ? N
TYPE OF WORK XCI o? FIREPLACE(S) _ 0 _ 1 _ 2
APPUCANT
STREET ADDRESS 3 a?`! T-fg /L ;? f` ?O I CIN ce' 'STATE? 21P S r( )-/
TELEPHONE #402 -S?2 ( P Z`LCELL PHONE # &f Z`f 96 9161- FAX # 612 ?Srz- ?LV"Lq
PROPERTY OWNER TELEPHONE q6Sf a 7() Q 3E/E
-------------------°---------------------°----------------------------------°---------
COMPLETE THIS SECTION FOR -NEW° RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672
(4 submission type) • Residential Ventilation Category t Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contracfor:
Plumbing system includes:
Mechanical Contracfor. _
Mechanical system includes:
Sewer/Water Conhacfor:
_ Air Conditioning
_ Heat Recovery System
Phone
Phone
Fee: $90.00
MAY 3 1 2002
-°-----°--------°-------------------------------------------•--------------°-----°----°-----------------------------
I hereby acknowledge ihat I have read this application, state that the informatlon is correct, and agree fo comply
with all appllcable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant
OFFICE USE ONLY
_ Water Softener
_ Water Heater
_ No. of Baths
)«--7 is-
BemodeUHeoah Neaulrements
• 2coplesWplan
• lsetofEnergyCalculatansforheatetladAMbns
• 1gflBSllrvey }OfB%tBf10f8ddA10113&d8Ck3
• Indicate if tame seNed Dy seplic system for add7tlons
VALUATION
Phone #
_ Lawn Sprinkier
_ No. of R.I. Baths
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 76-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Ak - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garege ? 22 Porch/Addn. (4sea.) ? 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
O 06 04-plex ? 12 12-plex Plbg Yor_ 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 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolitlon (Erkire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MClES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQl11RED INSPECTIONS
_ Footings (new bldg) _ FinaVC.O.
_ Footings (deck) _ Final/No C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AidGas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Av Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
5&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Capies
Other
Total
Building Inspector
,_
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT
Control No. 0724
BUILDINO
000893
06/29/92
SITE ADDRESS:
. ?.
?BuildYng Permit 7ype
Building Work 7ype
U8G Oacuparrcy
Construction 7ype
Zoning
euild3ng Length '
Building Width ?
DESCRIPTION:
?
?.?.
4716 PEBBLE BEACH WAY
LOT: 2 BLOCK= 3
FAIRWAY HILLS 3RD
\. ?
?... ?::y..
PERMIT TYPE:
Permit Number:
Date Issued:
SF DWG
NEW
R-3 M-1
VN
R-1
49
44
C r_
REMARKS:
RECEZPT NC-OIq?,J / BOOSTER PUMP 5&W PLBR -
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
SAC
SAC 8
SAC Units
Subtotal
vnLuaTioN
$161,000
$853.00
$554.45
$80.58
$700.00
100
1
$2,187.95
MISC FEES $1.610.50
Total Fee $3,798.45
CONTRACTOR: - RPPlicant - sr. Licp?yNER:
SONS CONST 14525365 0082608 SONS CONST
1091 TIFFANY DR 4600 FAIRWAY HILLS DR
EAGAN P9N 55123 EAGAN MN 55123
(612) 452-5355 (612)452-5365
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 Mn.
Sta utes and City of Eagan Ordinancas.
L -
APPLICANUPERMI 'IT IGNATURE IS??V: ? NAT?' ??
.. .
? t'3
SINGLE FAMILY DWELLINGS
2 SETS OF PLANS
3 REGISTERED SITE SURVEYS
1 SET OF ENERGY CALCUTATIONS
1991 BIIILDING PERMIT APPLICATION
CITY OF EAGAN
MULTIPLE DWELLINGS
?U K 2 2 ftECO
COZffiERCIAL
2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
REGISTERED SITE SURVEYS - & STRUCTURAL PIANS
(CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLZES WHEN: TYPING OF PERMIT IS REQUESTED, SUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT 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.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMSER.
To Be Used For: OYj'/Z Valuation:Date: (r?f?
?e Address `J?2/4 f%b/jCe /Seti?S *.z(
/
Lot y Block ?
Parcel/Sub FAJ/Lwu?n '3
?
Owner -SdhS C"'tis-?
Address yrdOQ WLzf DiL
i
City/Zip Code ??y? ?., YJ??? 5 j/Z}
Phone
ContractoY 50o f don'F7
Address 7/o1911 City/Zip Code ?? s4„ YJ7N i 1%L?
Phone L3 - T
Arch./Engr
Lee is,rcL
OFFICE USE ONLY
FEES
Occupancy Bldg. Permit
Zoning Surcharge
Actual Const Plan Review
Allowable SAC, City
# of stories SAC, MWCC
Length Water Conn.
Depth Water Meter
S.F. Total Acct. Deposit
Footprint S.F. S/w Permit
S/W Surcharge
On site sewage_ Treatment P1.
On site well Road Unit
MWCC System _ Park Ded.
City water _ Trail Ded.
PRV _ Copies
Booster Pump _
SUBTOTAL
APPROVALS Penalty
Planner _ Lot Change
Council TOTAL
Bldg. Off.
Variance
agrees that all work shall be done in accordance with
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Address F/tl/2??? /YLLr ?h
City/Zip Code ?S%2-3
PERMIT 1 CITY OF EAGAN
1992 BUILDING PERMIT APPLICATION
681 -4675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural 8 structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
af month in which re uest is made or lot chan e is re uested once ermit is issued.
Date Valuation of work
Site Address:
STREET STE f
Tenant Name:
LOT ? BLOCK ? SUBD. rA I{Z(-1j U-S P. [.D. f
Descri tion of work:
The applicant is: .? Owner O Contractor ? Other coe.«ix>
Name Phone
Property LAST FIRST
Owner
qddress
STREET ' STE Y
City State Zip
Company Phone
Contractor Address License M Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State 2ip
Sewer & water licensed plumber . Processing time for
sewer & water permlts is two days once area as been approved.
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.
Signature of Applicant:
urri%ot uaC urvLY
BUILDING PERMIT TYPE
? 01 Foundation ? 05 Apt. Bldg ? 09 Basement finish ? 13 Public Fac.
V 02 SF Dwg. ? 06 Garage/Accessory ? 10 Swim Pool ? 14 Agricultural
? 03 Two family O 07 Fireplace ? 11 Res. Add./Porch ? 15 Miscellaneous
O 04 Multi-fam. T.H. ? 08 Deck ? 12 Cortm./Ind.
WOR K TYPE
? 31 New ? 34 Repair ? 37 DemoTish
? 32 Addition ? 35 Tenant Finish ? 99 Undefined
? 33 Alterations ? 36 Move •
GENERAL INFORMATION
Const. (Actual) V-n? Basement sq. ft. MWCC System YE?
(Allowable) v-N lst F1, sq. ft. City Water YES
UBC Occupancy -Q 3 M-1 2nd F1. sq. ft. PRV Required
Zoning Sq. Ft. total Booster Pump 77- Z7
i of Stories Footprint Sq. ft. Fire Sprinkler
Length yqTT' On-site well Census Code
Depth -174-7- On-site sewage SAC Code vl
APPROVALS
Planning Building Assessments
Engineering _ Variance
REQUIRED INSPECTIONS
? Site " ? Footing ? Framing ? Insulatian
? Wallboard ? Final ? Draintile ? Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1..
Road Unit
Park Ded.
Trails Ded.
Capies
Other
Total:
SAC % 100
5AC Units I_
wtios;on: s
GA? 41 C1
z/K qv2?
B_ st?Ts g I b= 7000
32X 3 o= `J6 ?)
1o%n/S = 157
?zo
IsTF 'k
F??rt1lc ! Z a Y-
2?,r?
rz?,cS3 %
?NC??u?t ??x i°z•" 9'6c
i (/z x -2 ,_ ) ?,
c6,03?.
?Sfl? p
I
a
?
?
*
?
**? d
Certificate of Survey for: !5OR5 CONST^ uCT?0A1
House Address: Pefable 8each Way, E49an" Me'nn.
Model Name:
i
.;O
Q
? 3o
?
/
e*
? .M V.
b ?
/'r I
`\^v /e A2r ?? 'SC• -u
i
\? 'Sg6
:
s
S .
? ;s io;g,8 ? 'FIO36.os
`+ / o ? 3 /0 00?
yS M ? b Z'o '??? ry
,o o ?o' o•}•
r.
4O
pRwEWpy i, Q 'p
/ 38,' R L ? p •
h$0???I Nzp/oso t031.8
31 z('J? / Op ?YO`? KIo34.1 ?i i
2 ? o 0 8
? ° T k/o3q o /
Y s! •o\ N/ 1 ? ? O
/ ?c"o ¢0M
S !?? ,?•Y ?:-'..i ° '" • {? , q {( .'' ,ca f .
r
60•
{
?????? ???P
,?_EQUORED
E??VT
• 000.0 Denotes Existing Elevation PROPOSED HOUSE ELEVA110N
•(g?) Denotes Proposed Elevation Lowest Floor Elevatiom:. I031
Denotes Drainage k Utility Eosement jI, Top of 81ock Elevation: Io 9.6
- Denotes Drainage Flow Directlon
-o- Denotes Monument ' Garage Slab Elewtlon: Io3 ?
--.&- Denotes Offset Hub Bearings shown are assumed '
LOT 2 BLOCK 3
FA IR WAY HILlS 390 A DDITIDA
,
,
DA kDTA CAUNTY. YINNESOTA
1 herebY c*rtllY thel lAb wrvsy. Plan or nport wnyp?rpaad Ay m? or under my dine[ fupavhien ad llqti un dWp RphtvM Lmd MmMa
'
??
undx ths lews ol the Stetool MlnnsqG. Dotad thh
'"` dry ol A.D. 19
A? .
e-to. 6-IS-92: AAd Er;s1 El?vs. . /, .
Scale: 1in-ch-30f2o'
W-11
_,
EXTERIOA.SNVBLOPS &NBAGY CODB COMPUTATtON;WORlLSHW?
Z+o Determine Oa?ipliance with tha Minneaota Szergy Oode
(Section 502 of the State Amended 1983 !lodal SnarW 'Code)
PCO)2Ct T1t1E E1der Home Block 3, Lot 2, Fairwav Hills 3rd Addition
S1tE AddLeSS$ 4716 Pebble Beach Way, Eaqan Mn. 55123
I. EXPOSED WALL CALCULATiONB
AM 'V Wim ARFA x "U"
A. Opdque Wall .
1. Masonry/Corrcrete
a. x ?
b. x •
c. x ¦
2. Eoundat rn Wa Grade)
a. t4. Z-5 x. . O°l so s 4,11
b. _
x
,?
3. Wodd Frame
W&U
a. Insulated Area x • O4-
b. Framicg Area (Ave. 15$ at 16" x) _
i x . i t? ;n
C. Framing Area (Ave. 10i St 24" oc)
4. Peript?eral 81oor Edga/Aim JoiBt
d. 2Z0 Y .04 a b.FS
_ b. Y ?
8. Glazing
1. Wirr7ows
a. •
= . .
x
.36
b. _
4o x 47 a tR.Pi
2. Doors x. •
C. Doors
l. Woad
a. Solid ?p x(o a 1.71
b. With stocm door x a
2. Meta1 x • .
3. Overhead x .
4. Other x =
D. Z+OPAL FWI. ARFA, sq. ft .....
.::.............
211?
E. TOTAL of AREA x"U" ................................................... Z(oZ .) G
II. $OOF/CTsIl.ING CALCULATiONB
A. itoof/Ce iling Insulated Area 11014A, x ? D L ? 32• Z?
B. Iioof/Ceiling Framirg (AVe. 158 at 160 x) x ¦
C. Rmf/Ce ilirg Framing (Ave. 10% at 24" x) 1"19 • 4 x . o Z ¦-?
D. Skylight Y .
E. TDTAL 3i0oF/CEI7.iNG ARFA sq. ft .............. 179 4
F. TDML UF A[iFA x"U" .................................................. ?
. ,
qY.J .
Ili. BUILDING ENVELOPS 88QUIR8MEHTB • • '
TQP11L ARFA ALIAW.ASLB
(Frcm I.D i II.L) (P'tom V.I (Areo X'I7')
A. Ecposed Wa]1: ?.? i x . 1 I t?
B. Roof/Ceilirg: I1fJ4 Y__---0rt? _._ m..
• ?, s
. ,. ,
C. TOrRt ALT.DWmaLE BuILDING WiEiM (lbtal of A a B abwe)... e.4
' - a 4
IV. ACTUAL BUII.DINCi BNVBLOPB
ACTUAL
(,71C?da.X O0")
A. E4XGOd Wall (FIUR I.E) . Uo Z. ti6
B. RoOf/Ceilinq (FtCm II.F) Ar.,-5. i:? I
c. TOZAL ACIuPw WMIM EWvUM (Totai oF A& 8) .. ....... ...
•(IINLi COft PpY1?Li IT llif Lhim III.C) . -?
Y. REQUiRED "U" VALUES
RXF/CEILING
Detache] one arr] two Eami]y dwellings .11 .026
* Multi-Family Fesidential Buildings •238 •033
(3 stories oc less in height)
* All Other Ounstruction Zypes (3 stories or Less) .238 .06
* All Other Constructicn zypes (MOre than 3 staries) .28• .06
* Based on 8007 beatiny dayree dsYS (Ipls/St. Ytul)
Adjust 'Y• valuss acuidtayly for otMr locatioas
CERTIFICATION
I hereby certify that I have
Minnesota State Energy Code.
Signatute
ihe above lnbormatiort atd ttat Jt<9[qFUqB with L-
6-18-1992
HCSD 3-89
CC/SN'1/6574
? CITY OF EAGAN
3830 Pilot Knob Road Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
P.I.N.: 10-25602-020-03
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
4716 PEBBLE BEACH'WAY
LOT: 2 BLOCK: 3
FAIRWAY HILLS 3RD
C2?S?s?a?
BUILDING
027755
06/09/96
DESCRIPTION:
B'u3lding..Permit Type
8uil:ding 43'o.rk Type
Census Code '\
i
".?
r
. ??
-',
j
`?? ? ? ?? •? ?
DECK
NEW
434 ALT. RESIDENTIAL
REMARKS
FEE SUMMARY:
Base Fee $45.00
Surcharge $.50
Totel Fee $45.50
CONTRACTOR: OWNER: - Applicant -
CAMPBELL PATRICK
4716 PEBBLE BEACH WAY
• EHGAN MN 55123(612)851-2208
Z hereby acknowledge that i have read th3s
information is eorrect and' agree to comply
? Statutes and City pf Eagan Ordinanoes.
PLICA /PERMI EE SIGNATURE
application and state that the'
witN a31 applieable State of Mo.
I
Jm? <o?.j,?- ?
ISSUED B SIG URE
CITY OF EAGAN
lqq!ff 3830 PILOT KNOB RD - 55122
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
RemodeVRepair Reauirements
? 3 regislered s8e surveys ? 2 cropies of plan
? 2 cropies of plans (Include beam & window sizes; poured tnd. design; etc.) ? 2 site surveys (exterior addkions & decks)
? 1 energy calculattons ? 1 energy caleulations for heated additions
? 3 eoDies of tree preservation plan it Wt platted efter 7/1/93
required: _ Yes _ Na
DATE:
DESCRIPTION OF WORK:
STREETADDRESS: 'i 0/
LOT !2-- BLOCK ?
PROPERTY
OWNER
Street
CONSTRUCTION COST:
SUBD./P.I.D. #:
3
L1odf-- ?a 1 - ar?o g?
Phone #: 7-D3
U
City: State: ? Zip:
coN7w?cTOR Company: '
Street Address:
City: State: _
ARCHITECTI Company:
ENGINEER
Name:
Phone #:
License #:
Zip:
Registration #-
Street Address-
City:
Sewer & water iicensed piumber:
change are requested once permit is issued.
I hereby acknowledge that 1 have read this application and state that the
applicable State of Minnesota Statutes and Ciry of Eagan Ordinances.
OFFICE USE ONLY
Certificates of Survey Received
Tree Preservation Plan Received
Signature of Applicant:
_ Yes No
_ Yes _ No
State:
Phone #-
Zip:
Penatty applies when address change and lot
corcect,hnd Wree to comply with all
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
? 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? OS S-plex
0 04 SF Porch ? 09 12-plex
n 05 SF Misc. ? 10 _-plex
WORK TYPE
? 31 New ? 33 Alterations
0 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Pianning
? 11 Apt./Lodging o
? 12 Multi Repair/Rem. ?
0 13 Garage/Accessory ?
? 14 Fireplace 0
eu?:? 15 Deck
? 36 Move
? 37 Demolition
..
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
Basement sq. ft. MC/WS System
Main level sq. ft. City Water
' Sq, ff, Fire Sprinklered
sq. {{. PRV
sq. ft. Booster Pump
sq.
ft. 3
Census Code. /
Footprint sq. ft. SAC Code o/
- Census Bidg '
Census Unit d
Building Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
SN1l Surcharge
Treatment Pi.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
% SAC
SAC Units
oo?
r
. w
?
., •'.•.? ?.:'4?t(! : . ? .. .
Dtlw
i, MN 66120
?., -n?a.. IPI'??qi?r..I'vin
},; ? * * ** , ,: '
Certificate of Survey for: ?DIVS CON`JTIKUCTIOM
House Address: Pefable 8each WQy) E09an" Minn.
Model Nome:
V,
?
? 30
P ?4
M
r? # o 0?? b
(/I M
``/\v /e a ,r `002'
0 / ? .
0 IVor
(V• ? .
S`i?.? ro;g,8
30
Y
}'cE ?S
???
., -
4y
h ?
h?\
?O3
)
l1
v
s
Sg6s?rF
?
o36A5
. .,? \
K?o34.1
` (?`Y
,o3s L 2
? Yo
-?
S??Z? '?'Yo \
h,o
\
f
1
BoosTER PuMP
L REQUIRED
p?PT
• 900.0 Denotes Existing Elavation PROPOSED HOUSE ELEVATION
•(gO Denotes Proposed Elevatlon Lowest Floor Elevation: 1031.5
--- Denotes Drainage AC Utility Easement a Top of Biock Elsvatlon: lo3q•6
- Denotes Droinage Flow Diroction
-o- Denotes Monument ' Garage Slab Elevation: l03 ,
E3-- Denotes Offset Hub Bearinga ahown are assumed '
LOT Z, BLOCK 3,FAIRWAY N11,L5 3919 ADDITION
IPAkOTA CWNTY, YINNESOTA
1 here6Y eerllly ihq lhls wrwY, Olan ot rppt Mfp?-rpnod by m? or umNr mY dlt?el wpuYlHon ud tlrt 1 un duly Rp1stuW 4nd WrveYa
under the Iew? ol lh? SHN ol MlnnHOtL MIM lhN IIy"` d?y oi S°wc A.D. IB'IZ .
Ke". 6-IS-9Z: pdd Er;s{ Elovs.
aoa[at . . nEO. No, 14491
Scale: 1kl;h-30im,
M Qo
l? .7"
?O\4 y'0
C'rd ! o9/`?c
. . .'.???•,..
\ O
8
I?
?,o
CO
r??,? 7:
REACTIVATE ?
PERMIT S
CITY OF EAGAN
1993 BUILDING PERMIT APPLICATION
681-4675
fEe
_*DO
1 q REGD.
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date 12 / %-J Valuation of work -0?57 s"-! ?
Site Address: / 7?? ?lz?-4 Ql f 13.?o <_ h`
STREET SUITE M
Tenant Name: (commercial only)
IAT BLOCK ?
I
SIIBD.?? n,V a
JX/ J li
P.I.D. *
Descri tion of work: A S f /ti L-- f--% d___ SYY
The applicant is: ? Owner L7 Contractor ? Other (Deseribe)
a 0 A Phone6?S-V- 2 3 S/
Name ?,FL D F
Property ,
LxST FIRST
Owner pddress I7' 7/ C II" 13 ?3 1 A i
STREET SiE N
City /- A GG /d s? State Zip
Company Wl?E ? /3L 19 I'2 S .,C?' Phone
Contractor Address S License #ZI361 d Exp:3?3L`/9y
City /_7 L/ c2 '0 '?- 2'.--? 5tate 1-f-9 _1 Zip 5?5 `fZv
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber . Processing time for
sewer & water permits is twa days once area has been approved.
I hereby acknowledge that I have read this aPplicatian and state that the information is
correct and agree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
f
l
Gt
Signature o
App
icant:
v
OFFICE USE ONLY
BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex O 11 Apt./Lodging
? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc.
O 03 SF Addltion 0 OS 8-Plex ? 13 Garage/Accessory
O 04 5F Porch ? 09 12-Plex ? 14 Fireplace
? 05 Sf Misc. ? 10 Multi. Add'1. ? 15 Deck
WORK TYPE
? 31 New ? 33 Alterations O 35 Tenant Finish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
I
w
:
;?If,6,Ba"eement Finish
p 11 Swlm Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
? 37 Demolish
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) lst F1. sq. ft. City Water
UBC Occupancy 2nd fl. sq. ft. PRY Required
Zoning 7?7_73 Sq. Ft. total Booster PumP
#1 of Stories Footprint Sq. ft. Fire Sprinkler
Length On-site well Census Code
Depth On-site sewage SAC Cade
G.r• ,.,, bld? .
APPROVALS
Planning Building Assessments
Engineering Var9ance
REQUIRED INSPECTIONS
? Site
? Wallboard
La3V
i
0
?
? Insulation
? Fireplace
? Footing
E;X- Final
1?r Framing
? Draintile
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
Oc) I valuatim: $
•SD
SAC X
SAC Units
SiJBD. B 3 • ? I Q.? 3 ME HANICAL PERMIT RECEIPT # ? b? 0 3
(612) 651-4675 DATE
RESIDEIV'I7AL
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMII,Y DWELIdNGS. ALSO, COMPLETE FOR
TOWNHDMES/CONDOS R+HEN SEPARATE PERMII'S ARE REQUIRED FOR EACH DWF.LLING UNIT.
OWNER: f F M
5 ADDRFSS•
? ADD ON/REMODEI. (EIIISTING
CONSTRUCTION ONL7) S 15.00
INSTALLER: GENZ-RYAN HEATING 67, AVAC: 0-100 M BTU 24:
PHONE #: 423-1144 ADDITIONAL SO M BTU 6.00
ADDRESS: 14745 South Robert Trail Gpg pUTLETS .KUJEWUM 1 @S3 EA. ( ll'
crry0 Rosemo t ZJP-' 55068 SURCAARGE: $ .50
SIGNAT[IRE: J TOTAL: $ 7, -Q
COMMERCIAL
PLEASE COMPLET'E THIS PORTTON FOR ALL CQMMERCIAIJINDUSTRIAL BUILDINGS. AISO COMPLETE FOR
APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE PIItMITS ARE NOT REQUIRED FOR
EACH DWELLIIVG UNTT.
WORK DESCRIPTION: CONTRACT PRICE FEES
196 OF CONTRAGT FEE.
STATE SURCHARGE IS $.50 FOR EACH
$1,000 OF PERMTT FEE $
PROCESSED PIPING - $25.00
$
MINEMIIM FEE • ,?'e25.00
OWNER: TOTAL: $
SI1'E ADDRESS:
TENAIV7':
3UITE #:
INSTALLER:
ADDRFSS:
CTI'Y: ZIP:
PHONE #: CI1T SIGNATURE
SIGNATURE:
CITY OF EAGAN
3830 PILOT KNOS ROAD
EAGAN, MN 55122
PAONE (612) 454-8100
MNx"AM
FOR CITY USE ONLY
PERMIT #
RECEIPT # O O
naTE: S a--
PLEASE COMPLETE UPPER PORTION ONLY FOR 5INGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION
NEW CONST X
ADD ON _
REPAIR
owlvEx NAME: Sons Construction
SITE ADDRESS: 4716 ebble Beach Wav
IAT: ? BLOCK ? SUBD. /" ??
INSTALLER: R C Plumbing
ADDRESS: 5910 Chester Ave
CITY: Northfield 2IP: 55057
rxorrE 461-2096
SIGNATURE
COMPLETE THE FOLLAWING:
N0. FIXTURES EA.
? ADD-ON MINIMUM
SHOWER 15.00
3.00
WATER CLASET 3.00
BATH TtIB 3.00
? LAVATORY 3.00
? KITCHEN SINK 3,00
1 LAUNDRY TRAY 3.00
HOT TUB/SPA 3.00
? WATER HEATER 3.00
_ FLOOR DRAIN 3.00
GAS PIPING OUT.
? (MINIM[JM - 1) 3.00
_ ROUGH OPENINGS 1.50
_ OTHER
? WATER SOFI'ENER 5.00
PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
TOTAL
?
3_ -
3 -
3- -
SUBTOTAL
? ST. SURCHARGE .50
TOTAL: S 46?,SD
CI?MMEiCGIALftF3DU5TRM j PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BIIILDINGS AND
MULTI-FAMILY BUZLDZNGS.WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
------------ °_- -----------------------------------------------°--°________-__-
CONTRACT PRICE:
OWNER NAME:
SITE P,DDRESS:
IAT: BIACK _ SUBD.
INSTALLER:
ADDRESS:
CITY:
PHONE #:
FOR:
ZIY:
18 OF CONTRACT FEE.
STATE SURCHARGE _ $.50 F'OR
EACH $1,000 OF PERMIT FEE,
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $
STATE SURCHARGE $
TOTAL:
(SIGNATURE)
FEES
CITY OF EAGAN
CITY OF EAGAN
? 3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT TYPE:
Permit Num6er:
Date Issued:
?tl(4 4L
BUILDING
029691
@4/07/97
SITE ADDRESS:
P.S.N.c 10-25602-920-03
PERMIT
4716 PEBBLE BEACH WAY
LOT: 2 BLOCK: 3
FAIRWAY HILLS 3RD
DESCRIPTION:
( s A s )
m f SU11??ng Permit Type
? ??-2ci`1?Work Type
Cet'1si.}m^e
%
FIREPLACE
NEW
434 ALT.'RESIDENTIAL
o ? ?Qa £
P*wF? zr, ="{4rt?"""???A ';i
. 2
? ?'t
? "?.?
REMARKS:
FEE SUMMARY:
Base Fee $50.00
5urcherge $.50
Tntal Fee $50.50
CONTRACTOR: - Applicant - sT. PMNER:
FIRESIDE CQRNER INC 16331042 000 068 CAMPBELL PAT
2700 PJ FAIRVSEW AVE 4716 PEBBLE BEACH WAY
ROSEVILLE MN 55113 EAGAN MN 55122
(612) 633-1042 (612)687-0398
I Kereb)r aZKn,atisS?dg? ?hatnT: ta?v? r"vari-'`Gh?s app.liratiorr ,a?ircl st' te tFr the'
?srtr?rsct 4?#d,a9:res X? %ctsqpl? ?9.th011? aPpl*&able Stste nf MrI
? . Statu`tes ?nd cltsf; ?agarr n?nce,0.. .. _ .. . .. _ :.:?
APPLICANTlPERMITEE SIGNATURE
L .?J ?? f?.DllA1 17L?
ISSUED W. SIGIATU}iiE V
CITY OF EAGAN
Iq 3830 PII,OT I{NOB RD - 55122
? ? 1997 FIItEPLACE PERMIT APPLICATION
681-4675
DATE: 44 ,? / PERMIT FEE: $50.50
DESCRIPTION OF WORK: ? CONSTRUCT UM ? _
F PLACE A,LTERATIONS TO EXISTING
_ INSTALL GAS INSERT ONLY
_ INSTALL GAS LINE ONLY
OT'EIER:
STREET ADDRESS: -Y-116 /`eL3/3 L- 1E- ZS a--A?
LOT BLOCK DL SUBD./P.I.D.
APPLICANT: (circle one only) OWNER CONTRACTOR
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with
all applicable State of Minnesota Statutes and City of F,agan Ordinances.
PROPERTY
OWNER
FIREPLACE
INSTALLER
Name: eA Wbt" 010MAYLvC_ Phone#: 6 8 7 -0 3
Signature:
Street Address:
Ciry: ?A 4]O o? state: zip: Z Z
CompanYzVLLf[EbPhone #:8A--dTa' 60-2C$,Q-?
GAS LWE
INSTALLER
Citya?Z'1A35 Sl( C-'--C State: Af AJ
Companv:
Name:
Signat
IVED 5treet
?e iq
City:
License #: L ? 4 -8
ziP: 63^3? 7
Phone #:
A M•? ?
OFFICE USE ONLY
BUILDING PERMIT TYPE
a 14 Fireplace
WORK TYPE
0 31 New ? 33 Alteradons
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Census Cade.
SAC Code
REMARKS
Chimney/flue must be inspected before concealing.
RESIDENTIAL BUII.DING
? Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construdion Reauirements RemodeVReoair Reouirements
3 registered site surveys showing sq. ft, of l06 sq. ft. of house; and all raofed areas 2 copies of plan
(200% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks
1 set of Eneyy Calculations Adddion -indicafe i(on-site septic system
3 copies of Tree P2servaGon Plan if lot platted after 7/1193 Rim Joist Detail Opdons selection sheet (bldgs with 3 or less units
14a,
-I 5?
Oifxe Use Onlv
Cert of Suney Recd
Tree Pres Plan Recd
Tree Pres Not Reqd
_ On-site Septic System
Date / onstru/ction Cost
Site Address 71 L [h UniUSte #
Description of Work
Multi-Family Bldg _ YN Fireplace(s) _ 0 _ 1 _ 2
Property Owner ?ri?{L Telephone # (ek zw7- D ?J I S
Contractor
Address ' City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF
Energy Code Category Minnesota Rules 7670 Cateeorv 1
. . Residential Ventilation Category t Worksheet
(J submission type) Submltted
. Energy Envelope Calcu '_ Subm t(?d
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
A NEW BUILDING
Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
Telephone #(
Telephone #(
Telephone #(
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 without a
permit; that the work will be in accordance with the approved plan in the case of work woch requires a review and
-appr a plans.
&0"/ , (i ?/?i'?-C- C?
Applicant's Printed Name Applic t's Si ature
OFFICE USE ONLY
Sub Types
,
? 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 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext: Alt - SF
? 04 02-plex ? 10 DS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
O 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 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
D 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MC/ESSystem
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaUC.O.
Footings(deck) ? FinaWi o C.O.
X, Footings (addition) _ Plumbing
ZC Foundation _ HVAC
Drain Tile Other
Roof )!d Ice & Water ? F inel _ Pool _ Ftgs _ Air/Gas TesCS _ Final
? Framing _ Siding Stucco _ Stone
Fireplace _ R.I. _ Au Test _ Final
Windows (new/replacement)
)O Insulation _
_ Retaining Wall
------------------------------------------
----------- r
Approved By
----
----- -----------------------------------
, Building Inspector
------------
BaseFee ??aC? y? 7- °c.?`C6
Surcharge
y
''?`2 ? rt, c7 ? ? ?c
Plan Review y 1 ?
MCIES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
M
MECcheck Compliance Report
2000 Minnesota Energy Code
MECcheck Software Version 33 Release lb
Data filename: Untitled
TITLE: 03-111
COLJNTY: Dakota
STATE: Minnesota
ZONE: 2
CONSTRUCTION TYPE: Single Family
DATE: O 1/10/03
DATE OF PLANS: I-10-03
PROJECT INFORMATION:
PAT & CAROL CAMPBELL
COMPLIANCE: Passes
Maximum UA = 44
Your Home = 36
18.2% Better Than Code
Pemut Number
Checked By/Date
Gross Glazing
Area or Caviry Cont. or poor
Perime[er R-Value R-Value U-Factor UA
Ceiling 1: Raised or Energy Truss 72 44.0
Wall 1: Wood Frame, 16" o.c. 309 19.0
Window 1: Above Grade, Wood Frame, Double Pane with Low-E 9
Door 1: Solid 18
Basement Wall 1: Masonry Block with Empry Cells, 3.5' ht/2.9' bg/3.5' insul
108 11.0
Proposed and Maximum U-Factor Averages
Proposed
Average U-Factor
Above-Grade Windows and Glass Doors
Includes Foundation Windows > 5.6 fr2
0.0 2
0.0 17
0.310 3
0.350 6
0.0
Maximum
Allowed U-Factor
0.310 0.370
COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans,
specifications, and other calculations sub ed with the pemvt application. The proposed building has been
designed to meet the 2000 Minnesota Ene?y Code requirements in MECcheck Version 33 Release lh and to
compiy with the mandatorreyuirements? stedf4 the MECcheck Inspection Checklist.
Date ? lCp 03
'..i:<Wiu_ :., ...:. ' .:.., ??. ... ...
I . I
. .... i?i.iilCi?i?•:.? • '
* 2447'EnUrprlse Orlvo
NEER LIINOWI1V[YOHf.CIVIL[IqIN[LM Msnd0ls FjsIphli.MN66120
Ing eer ng.. LANO K111N4IM • IANOWA?t AI101179CT/
1612p??1.19t4
,1 ?I .f
Certificate of Survey for: SOtV?J CO/V ST? uCTI01V
House Address: Pelable 8each Woy, Ea9an ,, M;nrt.
Model Name:
V
?V
V?
Q
i
`o,?? 7
30
v
U?
/
I
IV
C. pGA"
?'?`( ?- Z'-
,?.'-r
30 ; ' ?, ?ll?PEC;11? .•
dAC M
w
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M
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IV
(j?
el = n /?? ss.g
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03 ° M ti-
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EW 4413ly-0 ?
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P ??
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S? ••
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5? Sz3.,
6S ?
? ?Io36.os
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lt?yo ?
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lo
BOOSTER PUMP ' X?.?.c?N
?
L_ REf?lliRED
?
DE1'.?,
• 900.o penotes Exfsting Elevation PROPOSED NOUSE ELEVATION
• g Denotes Proposed Elevatlon Lowest Floor Elevation: 1031
5
--- Denotes Dralnage Ac Utility Easement Top of Block .
Elevatlon: l0 9.6
Denotes Drainage Flow Dlrecilon ?
-o- Denotes A?onument ' Garage Slob Elevatlon: Io3 ,
-a- Denotas Offsat Hub Bearings shown are assumed
LOT 2 FIRW
BLOCK 3 AY NlL1.s
3KD A001TIDi
,
,
VAKOTA CWNTY, 1AINNESOTA
1 hoahy <aJly IMt lhlt surny, plen or qpwl wn prpned Oy " m under m y d6ecl supervldon and IMI I am du1Y Rplnued Lad furv+yw
undof iM Iavn al tht 9 uu ol MlnnewtL Daled thls II ilN d*Y ol 3owc
KeJ
i 6 A.O. I9 9Z .
Pt/S
. 6-1&-9L: Add EK;S .
/
plavo'
Scal 1Ingh_3ptat RODEATOO. .
.pEO.N0.1.1f1
\ o /
\ h
? /o /ojz B
o0
!n' OM
IpO qg L PLiJMBING (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
Please complete for: Single Family Dweliings
Townhomes and Condos when pemuu are required for each unit
Date Zf / /Z- / 0 3
Site Address 14a/G Z.Oeee"0+ 44y Unit #
Property Owner ???-4/1w/ Telephone #(`Si ) 617 " 03
! Q
Contractor Dln/vS
Address 7.016 City A" Iz -
State Zip ...??? Telephone # ?j?;7 7 3 ?S'7Yd
The Applicant is _ Owner _ Contracror _ Other
Septic System New Refufbished Submit 2 sets of plans and MPC license $ 100.00
Indudes County fee. Additional consultant fees may apply.
Altera ' To Existing Dwelling Unit, Including ?~^? t 'r"?"a°'''?) $ 50
00
_ Adding fiMures to lower levels or room additions, excluding water softener and water heater .
_ Abandonment of septic system
_ Water turnaround (+ 5/8" meter if needed -$121.00)
Other:
_ RPZ _ new installation _ repair _ rebuild $ 30.00
_ Lawn irrigation system
_ Water softener _ Water heater
r ? ? II U ? p
$
15.00
_ replacement _ addilional AUG i 3 2GC3
State Surcharge .50
Total
I hereby apply for a Residential Plumbing Permit and aclrnowledge that the information is complete and accurate; that the work will
be in confonnance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that 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 x.
C? ew"'1 e-jlNl ?S
Applicans Printed Name A canYs Signature
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4716 Pebble Beach Way
Lot: 2 Block: 3 Addition: Fairway Hills 3rd
PID:10- 25602- 020 -03
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:
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264 -4777
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Construction Type:
Occupancy:
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Permit closed without required inspection(s). Letter sent to applicant on 9/29/09. (pf)
Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
Owner:
Patrick J Campbell
4716 Pebble Beach Way
Eagan MN 55123
$88.50 0801.4085
$1.50 9001.2195
$90.00
Issued By: Signature
Building
EA088911
04/27/2009
ePermit
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Use BLUE or BLACK Ink
For Office Use
I
I
aan
1V. I
b1l't~ of E *,d11 I Permit
Permit Fee: 1
3830 Pilot Knob Road
Eagan MN 55122 1 Date Received: _
Phone: (651) 675-5675 1
Fax: (651) 675-5694 1 -Staff.
2013 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address: '4-11 u Yei iqf/Ki &A&h
Tenant: Suite
Resident/Owner Name: M 1rI~ ~I Phone: (,f"8-[" 0
Address / City / Zip: b
Name: Wenzel-Plymouth Plumbing, LLC License 061555
Contractor Address: 1710 Alexander Road City: Eagan
State: MN Zip: 55121 Phone: 651-452-1565
Contact: Carl Michels Email: cmichels@wppmn.com
Type of Work -New _Replacement -Repair _Rebuild - Modify Space -Work in R.O.W.
Description of work: Demo Pressure Booster
RESIDENTIAL
Water Heater
Water Softener
Lawn Irrigation C_ RPZ PVB)
Permit Type Add Plumbing Fixtures Main Lower Level)
Septic System
New Water Turnaround
X Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $200.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $ N/A
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.oro
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 pi
x Carl Michels x
Applicant's Printed Name A icant's ignature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
Use BLUE or BLACK Ink
r————————————————�
I For Office Use �
I �t� ��
Cit of �� aIl ; Permit#: /�
y � �,__�
� � ,
I Permit Fee: �
3830 Pilot Knob Road j �
Eagan MN 55122 � Date Received: �
Phone: (651) 675-5675 � �
Fax: (651) 675-5694 L Staff: ______________�
2015 RESIDENTIAL PLUMBING PERMIT APP�IC�TION
Date: � �� Site Address: ` �C � ���j� �r���"\ ��' �
Tenant: Suite#:
Kf� ¥
' � ���; '' Name: 7C�.�' ��,/W�p �C'/! Phone: �l� "1��' �a�/ 3
Resident/Cl��i��r
�� ����
A �r ' Address/City/Zip: � �N—�--
� ���� h `f� Z,�'�^
�� ��������� �, Name: � (' 1 l,l„M i License#: � / lo�l�
� � ����� .��.,:, _
x'` Address: � � S���` City: �c7G�^�
COI`���'�Ct4�1' �:
� �}� $' State:,/��/Zip: � � Phone: .�." � � J
�, " '.��:
���°� �
���w t � : Contact:
Email:
:� ;s
Type OY ���C �ew �Replacement _Repair _Rebuild _Modify Space _Work in R.O.W. �
� ��; (
� -� Description of work: �t� Vl3 j L S�`n� Gw,� (/�Sfv-ll /S t fiGG�ec. S�'n� � � ���
��� ���; ��� =: RESIDENTIAL i
�� � � �,� � _�� r 64�� �G�.� j � ,� pr G�(J��.{�,-�� J
� ��r��j � Water Heater
����, � :�� ����� Water Softener
> Lawn Irrigation(_RPZ/_PVB)
R�t"r'11�������; ��� �
�����.�' ` Septic System �Add Plumbing Fixtures(�Main/_Lower Level)
r �� *�.:
������` _New Water Tumaround
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� ° Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic Svstem Abandonment,Water Turnaround*(includes State Surcharge)
"'Water Turnaround(add$210.00 if a 5/8"meter is required)
$115.00 SeptiC SVstem New(includes County fee and State Surcharge)
TOTAL FEES$
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.goqherstateonecall.org
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 wi hout a 't; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of pl .
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ApplicanYs Printed Name Applicant's Signature
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