4772 Penkwe CirCITY _OF EAGAN
,-?ilot Knob Road
Eagan, Minnesota 55122
(612) 681-4675
SITE ADDRESS: I;..1!:•, f. rit , .; i ili,i
PERMIT SUBTYPE:
-189
INSY?(;'IIUN KLt?UlKlJ
PERMIT TYPE:
Permit Number:
7 Date Issued:
APPLICANT:
TYPE OF WORK:
till { i fo 1 IVf,
INSPECTION ..
a`1 °?
66 . ..
IiY ?1tIF: VnF 1
F
L
Permit Holder Date Telephone #
PLUMBING
HVAC
Inspection Date Inap. Comments
FOOTINGS ?
. .
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HVOROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
Receipt PLUMBING PERMIT Permit No.•
CITY OF EAGAN .
Fee
Frli in numbered spaces S/C ?
Type or Print legib/y
Tot.
1. Date 2. Installation Cost
?' I
3. Job Address
Lot Bik. Tract_
. ?
4. Owner / '-
,.
5. Contractor - Phone '
6. Address . ?:
7. City State Zip ' 8. Building Type: Residential El Commercial O Institutional ?
9. Work Description: New ?
10. Describe
11.
Add ? Alter O Repair 0
No. Fixtures
Water Closet No. Fixtures
Cess
ool/Drainfield
Bath tubs p
tic Tank
Se
Lavatory p
Softner
Shewer Well
Kitchen Sink
Urinal/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 cocjes 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 454,8100
CITY OF EAGAN Remarks
Addition -- jntnr?rv' rM DTT!'?B AlliITTTALT Lot 6 Blk I Parcel 10 39800 060 01
Owner U•`• Street 4777 Pgnkrrn, rirrla Stste EA,9anI MN 55122
lmprovement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
* SEWER IATERAL
WATE(iMAIN
* WATER LATERAL IgAl
WATER AREA
STORM SEW TRK j"
* STORM SEW LAT igAl
CURB & GUTTER
SIDEWAIK
STREET LIGHT
WATER CONN. 420. OO ti is
BUILDING PER. 7701
SAC
PARK
cirr oF E?GAN
' =795 Pilsf Kwob Rood Eoyan, JYIM 55122
'
PHONLs 4 S4-i100
BUILDING PER'MIT Reteipt ?j
Te be wW Mr Est. Value Dote _, 19
Site /lddreu Erect ? Occupancy
Lot Biock 5ec/Sub. - Alter ? Zoning
Porcel ?E - Repair ? Fire Zone
Enlarps ? Type of Const.
oc Name Mo i
S
,,, ve
?
tor
#
es
Z
? Addmss
`
, Demolish ? Length
G '--
phone Grode p Depth Sq. Ft.
o Na? Approvols Fees
?? F
Address
F- r-:.,.
Nome
Assessment -
Water & Sew.
Polite
Firo
Enp.
Planner
Counti I
I hereby acknowledge that I have read this opplicotion and stote that Bldfl. Off.
the intormation is correct and agree to comply with all applicable A? -
State of Minnesota Statutes ond City of Eagon Ordinonces.
Permit
Surchorpa
Plan check
SAC
Woter Conn.
Woter Meter
Road Unit
Tofal
$iynoturc of Permittee ?
/1 Building Permit Is issued to: on the exprcss condltlon thm
oll work shall be done in accordonce with all upplicoble State of Minnesoto Statutes ond Clry of Eoflan Ordinances.
Buildinp Officiol
Psrmit No. Permit Holder Mise. Parmit No. Holde?
Plumbing 3W6 Z?, l t "Z,-) -33
H.v.a.c.
w.u
wner
Disp.
Sftwr
EIeMric Wo(03?Sb ?if.l? ???4 '()-$I4
InspaMion Date Insp. Other
Footinps
Foundation
Framing F
RouYh Plbo. Y-1713
c.
)
Rouph HVA
Inwlation
Final Plbp. - g?
Finsl HVAC -J ?
Finel ?
. c eW
Water Dlmwibe location:
VYell
Sawer . ?
1
Pr. D'ap.
' ..? :9r?DR:a .-?!li.i??`'1"?,..r?.??'.K`.."!` . ?;? •'?
C?erfiffirtttr uf Orrupttury
Citp of eagan
lprpttrfinent o# 'Builbing lmwrr#im
Tbis Certificaet ia.rucd puriuant to tbc "equillcmcntt of Scaion 306 of thc Uniform Building
Code arti f ying that at tlac time of itsuance thi.r .ctrruture wat in com pliancc with t/x variou.r
ordinancct o f the City ngudarir,g building ronrrrucrion or urc. For tix f ollowing:
v„cuwrwA,m SF DWG/GAR &e4reryWi N0 7761
aww,wr'ryr. R-3 'hr croswcdm v F. zon. NA zon;na wcrici R- 1
My:
m,.: 7-6-83
roar In w cawncua» ruu
t
--
LITNU "1 U. 5 .A.
Receipt -? MECHANICAL PERMIT Permit No. ?
CITY OF EAGAN Fee
Fi!l in numbered spaces S/C
Type or Print legib/y
Tot
.
1. Date -" ?` --- 2. Installation Cost
3. Job Address ?-?%?•? -`?rl?'? ---- tot ? Blk. ? TractT?
4. Owner
5. Contractor Phone 5?67
6. Address • - ? , - - •'?? •
7. City -' State _ Zip 6%Q7
8. Building Type: Residential ? Commercial ? Institutional ?
9. Work Description: New El Add O Alter O Repair ?
10. Describe '-': -- - ; Fuel Type --`?
11
No.
? Eauinment 8TU - M. Ea.
Forced Air No. Equipment CFM
Air Handlin
:
Mfg. g
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg, 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
? j • 1 i
Receipt PLUMBING PERMIT Permit No.
CITY OF EAGAN Fee
Flll in numbered spaces S/C
Type or Print le+yibly Tot.
?-
1. DatelI18I83 2. Installation Cost
3. Job Address ? i% ? Petl k;?; e C 1 t1mic, r.fl ? Blk. Tract
4. Owner JRRIN Ti-iOi+iPSON ti01-145
5. Contractor ''ENZEL MECH
6. Address I E«,,: ._ Y 1Ve
7. City State ''in Zip ? ? 1? `.'
8. Building Type: Residential Cl Commercial O Institutional ?
9. Work Description: New 0 Add ? Alter O Repair ?
10. Descri be
11.
No.
? Fixtures
Water Closet No. Fixtures
Cess
ool/Dr
i
field
i Bath tubs p
a
n
Se
tic Tank
Lavatory p
Softner
Shower Well
i Kitchen Sink
Urinal/Bidet Other -
l.aundry 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 454-8100
Phone 452-1565
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN. MINNESOTA 55122
DATE
AEceivec
t9
AMOUNT ? I
IN DOLLAR4
ioo
F]CASH ? CHECK
White-Payers Copy
Yellow-Posting Copy
Pink-Fite Copy
Than You
? BY
cIn oF EAsAN WATER SERVICE PERMIT
3795 Pilr± Yinob Road
Eagan, MN 55122
Zoning:
Owner:
Address:
Site Address:
Plumber:
Meter No.:
Slze:
Reader No.:
1 agree to wmvh with eha City of Eagan
Ordinanees.
By
Dcrte of I nsp.:
PERMIT NO.:
DATE:
_ No, of Units:
- ?
- Connection Charge:
- Acoount Deposft:
_ Permit Fee:
Surcharge:
Misc. Ctwrges:
7otal:
_ Date Paid:
- Insp..
OF EAGAN SEWER SERVICE PERMIT
Piloe Knob Raad PERMIT Nd.:
MN 55122 DA7E:
No. of Units:
fe canpFY wIM !he Clty of Eagon
Connection Charye:
AcCOUnY Deposit:
Permit Fee:
5urcharpe:
Misc. Chnrgas:
Dote Po1d:
Dote of Insp.: Totol:
Thisrequestvoidi?l? 3y`ITo
18 month5 irom ?J
W063450
Fequey st ate Fire No. Rough-in Insoection
He uired7 ?Ready NowaWill Koflly. Inspec-
?" ? ? ?yes ?No ror When Reatly
2kLicensed Electrical Contractor 1 hereby reouest inspaction of above'
70wner electricel wark installed aC
S[reet A
ress, Box or Route N
o
.
A
d Ciry
??,? ?
(
`
-
1-
?
ecUOn o. Township Nama or No. ange o. Co?untv ?p
V/V rv iv
Or,cupant(PRINT) Phone No.
,.
?4 ?A[.?"_
Powe
r S
upplier Adtlress
?
?
p
f?-?v
q?4wirlo171J
Eiectrical Conhactor ICompany Namel
B Contractor"s Licanse No.
R39Szs-Z
C?-?
MailinB AAdress
IConvacmr or Owner Makina Instaiiationl
y
Authorized SiBna[ e l ctodOwner Making Inslallationl Phone Number
MINNESOTq STqTE BOARD OF ELECTNICITY THIS INSPECTION NEQUE3T WILL NOT
Grigps-Mitlwey Blde. - poom N-191 8E ACCEPTED BY THE STqTE BOARD
UNLESS PNOPER INSPECTION FEE IS
1821 UnivarsitY Ave., St. Paul, MN 65104
PA..ne (RV1197.91N ENCLOSED.
SEDGWICK HEATING & AIR CONDITIONING CO.
8910 WENTV?ORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000
ADDRESS '{ -72- 0x1vL1ING Cil 4'Z CITV-
OCCUPANT I/ r??,,J CgAIY_ OWNER
SOLD BV INSTALLED BY
MAKE
SERIALNO.
HEATING Jpg N0_52
.
TEST RECORD
MODEL ? CO I tr -p V
INPUT "L'? ? ?16?
THERMOSTAT 4 `-) ?V VENTSIZE * -2
VALVE PE OF LWEfl ? -v
LIMIT ?77'-7--?-? IJ'?NER SIZE 2l ?
LIMIT SETTING V?' `?zubo FILTERS: SIZE NUMBER
FAN SETTING ? •~'? WIRING SL'
?
PILOTTVPE TEST7AG
IGNITION MODEL _S -4u VL7y?-?'
PILOTTIMING
PRESSUFE PERCENT COz ?
INPUT CFH PERCENT Oz
STACKTEMP. PERCENTCO v ?
FORM 235 (REV. 11189)
LIGHTING INST.
DATETESTED /V-` ( ^V
COMPANYTESTING ?NAME OF TESTERz
FORMDISTRI9UTI0 : EC E VELLOWCOPY-CITY
r ( CITY OF EAGAN
BUILDING PERNNLIP APPLI I?1
ER
6aK-- .?; ?d-oo
7b Be Used For -- Valuation L1site Pddress
oFFzcE USE OMY
Lot (c Blodc 1 Sec./Sub. 3G-IL )-'i Erect ? Occupancy J'?' 3
Parcel #: I b 3Ct ?-D O o to o CJ ? Alter Zoning c
Repair Fire Zone
??: Enlarge _ Type of Const. r
Nbve # Stories
Address: Deimlish Front
City/Zip Code: Grade Depth
Phone # : APPROt1AL.S F'EFS
Contractor:
Address: a Division of U.S. Home Corp.
I/LZ op ins rossroa
C].t17/Zlp COd2: Minnetnnkay Minn_ 55349
Phone #: S" - I3s3
Arch./EEIng.: _
Pddress:
City/Zip Code:
Phone #:
Assessments
Water/Sewer
Police
Fire
Eng.
Pezmit a /
Surcharge 3 O -'W
Plan Check 1,5-6 '?
SAC S?S ZY
Water Conn. rO
Planner Water ^1bter -09
Council Road Unit ?
Bldg. Off. ,-
APC
TOTAL
Include 2 sets of plans,
1 site plan w/elevations &
1 set of energy calculations.
Date \ - \O- 8s
CITY OF EAGAN _
3793,Pibf Knob Raod Ee9an, MN 53141 N9 7761
PHONFs 431•8100 1 - -
BUILDING PERMIT
re 6s wad fee_ SF DWG/GAR Est. Value $60,OOC
Siro Address 4772 Penkwe N Circle
l.ot 6 ei«k 1 Sec/Sub.Johnny Cake Ridge
Parcel # 10 39800 060 01 lst
m IN.,,o Thomnson Lake Division
; Addres' 1712'Hopkins Crossroad
b
o I Name Owner
?
Address
r r?.,, w......
Ncme _
Address
I hereby ackrqwlodge that I have read this applicatian ond state thot
the inlormotion is correct and ogree to wmply wiih oll opplicoble
Stote of Minrresoro Stotutes and City of Eagon Ordirances.
$f0nature of Pertnittee
Receipt # ?17
M.e .Tnnnorv i 7 ,0 83
Erect
Alrer
? Occuponcy K-S
Zoning PD R-1
Repoit ? Fire Zone NA
Enlarge D TrPe of C,onst. V
Move 0 # Stories
Demoiish ? Length 66
Gmde ? Depth 28 Sq. Ft.-
ApOrwola Fees
Assessment -
Water 8 $ew.
Police _
Fire
Enp.
Pianner _
Council _
Bidg. Off: _
APC
Permit 010.VV
Surcharge 30.00
Plon check156.50
SqC $25.00
Water Conn420. 00
Water Meter 60. 00
Road Unit 240.00
Tor,i $1744_50
A euudiny vem,+t is issmd to: Thompson Lakes Divis' n of U. S. Homeon tha express condition that
oll work sholl be done in occordonce wifh oll opplicap Sto e r?ewtg,$tatutes on ity of Eagen Ordinonceo.
Buildirg Official
?
23333
a
Reques Date Fire W. Rougb-inlnspection
/ Requi d?
? Ready N. ill Notily Inspecta
n Reetl
7
H'h
CT ,2 9Q AVes G No e
y
I icensed contractor O owner hereby request inspection of above electrical work at:
Job AOOress (Street, 9ox or Rou??eng )
77a r?l wz e;.- Ciry
?i? A cj
Sectlon No. Township Name or No. Raige W. County
l
10
4.
Occupent(PFINT) !
?-AN/? Phone No.
PowerSuppiier Atltlress
Elec1mal Conlretlor (Co pany Name) ConVactor's Licanse No.
¢ Rw[nt'.a e IYG+? .?d9f ?`??lob
Mailing AOtlres ConVaclor or Owner Making Installation)
/
i
?
,
S F 44OU ,
.a
Aulho?ize0 ig re Vado wne king Install o ? Phon'e /Number ?
MINNESOTA STATE BOARU OF ICITY THIS INSPECTION REOUEST WILL NOT
GrlggoMlOway Bidg. - Room S- 6E ACCEPTED BV THE STATE BOAFD
1821 Unlverslty Ave., St. Paul, MN SStO< UNLESS PROPER INSPEGTION FEE IS
Phom (612) 6024800 ENCLOSED.
1 p 9/5 J REQUEST FOR ELECTRICAL INSPECTION Ee-onoo -oe
? See insttuclions tor completi=g this lormon EaCk of yellow copg
M23333 X" Below Work Covered by This Request
eiv ABd Hep. TypeofBuiltling AppliancesWired EquipmeniWired
Home Ranqe Temporary Service
Duplex Waler Heater Electric Heafing
Apt. Building Dryer Othei (Specify)
Comm./Industrial ' Furnace
Farm Air Contlitioner
Other (speciy) Cantracbr§/qp.y(?arks: `
r?/LVA1 ?J46?'a5°
Compute lnspection Fee Belaw:
N Other Fee # ServiceEniranceSize Fee N Cirouits/Feeders Fee
Swimming Pool 0 ro 200 Amps o to 700 Amps
Translormers A6ove 200 _ Amps Above 100 _ Amps
Signs inspectors usa Ony: TOTAL
Irrigation Booms
/ ?
U'
Special Inspection ?
?
Aiarm/Communication THIS INSTALLATION MAY BE ORDERE SCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby R°ughin oaie?O ?
cenity that the above inspection has
been made.
?
OFflCE USE ONLY
Tnis request mid 18 manths tran
REQUEST FOR ELECTRICAL INSPECTION EB-00007-04
? p ' See instruc[ions for comPletin9 this form on back ol Yellaw coOV.
?+ p r/?Y? ?/-
"X?" Be1oWWo? CoUeYed by This Request
r
l
e AAd R.P. TYpa of Builtlin9 Apoliancns Wired Eqaipmant WireA
Home
Duplex Range 6p5
Water Heater Temporary Service
Li,yhtin,y Pixtures
Apt Building Dryer Electric Heatin
Commercial Bldg. Fumace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm tner Pnci v mi erl5ner.ifyl
1 e uecify Other Other
Compute lnspection Fee Below
k Pee ServiceEnlrenceSize d Fea Fenders/Subtaeders k Fee Circuits
Q 0 to 200 Am s- 0 to 30 Am s 03 0 tn 30 Am us
Above Z00 qm s 31 to 100 qmps 31 to 100 qm s
Swimming Pool Above 100_Am s Above 100_Amps
Transformers Irrigation &ooms ?tC . o Partial.'Other Fee
Signs Special Inspection S•? nl
`?
T
Remarks ? 5? .,n
1. -tF7e'-ElecVic?l
Inspector, hereby
certify tha[ tha ebove
inspection hes been
rtrede.
TNe renueat
`--Sb RESIDENTIAL
BUILDINC PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651•681-4675
New Construefion Reouiremenb
. 3 regislered site surveys showing sq, ft. of lot sq. IL of house; and all roofed a2as
(20°k macimum lot coverage allowed)
. 2 copies of plan showirg Geam 8 vnndax sizes; poured found desgn, etc.)
. 1 sel of Eneryy Calculatlons
. 3 copies of Tree Preservation Plan H IW platted after 711193
. Rim Joist Oetad Optlons SelecUOn sheet (61dgs wAh 3 orless uniLs)
DATE
StTE ADDRESS
TYPE OF WO
ULTI-FAMILY BLDG Y Ze
FIREPLACE(S) L8'_ 1 _ 2
APPLICANT? l L f UL? 00M
STREETADDRESS ly(a?o/rla.cA 4v4 imAl'-'s CITY J k STATE.Z&tZIP.4,<YW
TELEPHONE # 91 -0ELL PHONE # PAX #
PROPERTYOWNERfleRJ1MI NPLU TELEPHONE# 651-1,KI670,926
........... -............................. -------- ------ -.................... --'-°------°----
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RUI.ES 7670 CATEGORY 1 MINNES07'A RULES 7672
(d submission rype) . Residential Ventifatlon Category 1 Workshee[ Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations SubmiUed
Piumbing Contractor: ___
Plumbing system includes:
Mechantcal Contracfor:
Mechanical system includes
Sewer/Water Conhactor:
_ Air Condiboning
_ Heat Recovery System
Phone #
Phone #
--------------------------------------------------------------------------------------------------
I hereby acknowledge that I have read this application, state that the information is correct
with all applicable State of Minnesota Statutes and City of Eagan Ordin.9nces.
Signoture of
Fee: $70.00
'.1I7 f_ -
a ree to comply ?
P 2 0 2002 ;
OFFICE U5E ONLY
Water Softener
_ Water Heater
_ No. of Baths
_ Phone #
Larvn Sprinkler
No. of R.I. Baths
RamodellReoair Reuuiraments
. 2 copies of pWn
. 1 set M Eneqy Calculations for heated additbns
. 1 sde survey fir extenor addiUons & decks
. Indicate if hane served 6y septic system for additlons
VALUATION ct
Fee: $90.00
Certificates of Survey Received _ Tree Preservafion Plan Received _ Not Required _
Updaled 4102
OFFICE USE ONLY
? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS OB-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ' ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
CJ 05 03-pfex ? 11 10-plex ? 19 Lower Levei ? 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 81dg only) - Give PCA handout to applicant
Valuatioo Occupancy MC/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 W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) Finat/C.O.
_ Footings (deck) FinaUNo C.O.
_ Footings(addirion) _ Plumbing
Foundarion 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 (newlreplacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge R. fi ?1
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Building Inspector
Total p2 $' 7. 7 _,?
•i i
9qCJR7Y•*Xt7?7k:k:V.?k?CW:i?K?t7K'KWMCMN:l,o"?K*?1k'? ?xCkC?K?w ?"?'?ks?'
CITY OF EPGAN
CASHTE'fi: S
PA'T'E: 06/26l98
iz .
TERMSMAL h!C)a 759
TIMFa 15n'1.'_:24
iipfitE: VFF<N NEINE
'.32j0 9001 4772 F'ENKM!E C?R `OoOQ
?..iJS 9CI:]'. 4772 I'F_W142 ('?R 0. 5o
?.
TO`al. Receipt Amovnt: 50.50
CR09435Z :
U5EFf ?Li: 'MAN!:Y
C ITbz.z --
? RESIDENTIAL 517_40?
? BUILDINC PERMIT APPLICATIO
CITY OF EAGAN
3830 PILOT KNOB RD, EACAN MN 55122 ---
??? ?- I 651-681-4675
New Construetion Reauirements
• 3 registered site surveys shmving sq. ft. of lot, sq. ft. of house; and all roofed areas
(20% maicimum lot coverage allowed)
• 2 copies of plan showing beam & window s¢es; poured found design, etc.)
• 1 set of Energy Calculations
• 3 copies of Trce Preservation Plan if lot platted afler 711193
• Rim Joist DeWB Optbris selection sheet (Wdgs with 3 or less units)
DATE C300;9--
SITE ADDRESS
MULTI-FAMILYBLDG _Y _N
TYPE OF WORK UJtflCkPt-t-) f1R?IQ.P'.PiY1(..e?c?i (6 (d-tal I FIREPLACE(S) _ 0_ 1_ 2
WINDOW LITE Home Improvements ?iQ? 1
APPUCANi Crosstown North Business Ctr. # 4 )
wte 460-8400-89th ve. North cm STATE ziP
STREET ADDRESS " _
TELEPHONE 3 CELL PHONE # FAX #C742?i37J - (p 36 6
?QIYK._ 61 (1 ( _C?
PROPERTYOWNER \)0(Y1 d Cd YISfle1 vtE. TELEPHONE?CPJ?' I? cRi?o- 0975
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESO'1'A RLII.ES 7670 CATEGORY I MINNF.SO'CA RULES 7672
, -
(d submission type) • Residen6al Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Suhmitted
Plumbing Contractor: ___
Plumbing system includes:
Mechanical Contractor:
Mechanical system includes:
Sewer/Water Contractor:
_ Water Softener
_ Water Heater ,
No. of Baths
Air Condirioiung
Heat Recovery System
Phone #
I hereby acknowledge that I have read this application, state that the information is
with all appiicable State of Minnesota Statutes and City of Eaga9,0Trdk)ances. ?
Signature of Applicant
ree: $90.00
P'ee: $70.00
and agree to comply
OFFICE USE ONLY
Phone #
RemodellReoair Reouiremenis
• 2 copies of plan
• 1 set of Energy CalculaNons for heated add'Aions
• 1 site survey forexlenoradd'Nons & decks
• Indicate if hane sened by septic system for add@ions
VALUATION 1? ? . c%
Lawn Sprinkler
No. of R.I. Baths
Phone #
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 6ct. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinallC.O.
_ Footiugs (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundarion HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MGES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Building Inspector
Total
FERMIT
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMITTYPE: gffi$?NO
Permit Number:
Date Issued: 0 6 /2 6/ 9 8
SITE ADDRESS:
P.I.N.: 10-39800-060-01
4772 pENKWE CIR
LOT: 6 BLOCK: 1
JOHNNY CAKE RIDGE
DESCRIPTION:
PermiC Type DECK
,?.nc? ?rk 7ype NEW
?errSUS C0 dq34 ALT. RESIDENTIAL
f. ?
?p
n?
M1 " ? bX
X
.. , x .f ¢
f.'? t? i? ?fl ^t???
?( t^,.
REMI" P:REVZEweo BY ,70E VQELS
FEE SUMMARY:
Base Fee $60.00
Surcharge $.50
7ata1 Fee $50.50
CONTRACTOR:
I
OWNER: - Applicant -
HEINE VERNON
4772 PENKWE CIR
EAGflN MN 55122-2725
(612)686-0915
? h?he?y°acl??rta?,r,???g? tha? 3 Mave?read thi.s ap}rlieati;an arrs#etate'tbpt t'ha
. 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) $-1:5c) C?-)o
CITY OF EAGAN ?
asao pnar xiNos Rn - 55122 lff?-
681-4675 ? ?m cSS
New Constmc[ion Reauirements RemodeVReoair Reauirements
? 3 registered site suneys ? 2 copies of plan
? 2 copies of plans (inGude beam 8 window saes; poured fitl. design; etc.) ? 2 stte surveys (axterior etlditions & decks)
? 1 energy calculMions ? 1 energy calculations for heatededditions
? 3 copies of tree preservatian plan if IM platted after 7l1 J93
required: _ Yes _ No
DATE: to- Jf -900 CONSTRUCTION COST; 0 `?,Dov
DESCRIPTION OF WORK: Deck
STREET ADDRESS:
Al S-sfzz
BLOCK: I SUBDJP.I.D. #:
PROPERTY
OWNER
CONTRACTOR
Name: NESAIE I?erna,? ? chri5 Phone#: 086 oY75-
Lsst Fint
Street Address: 4 I7 Z oocrr kwc C;t rcle
City ?? µn State: /h ? Zip; 55lZZ- Z7zS
Campany: Phone #:
kw?
Street Adc
City
ARCHITECT/
ENGINEER Company:
' --«
License # _
State: Zip:
Phone #:
Registration #: _
Street Address:
City
Sewer 8 water licensed plumber (new construction only):
and fot change is requested once permit is issued.
Zip:
Penally applies when address chang
I hereby acknowiedge that 1 have read this application and state that the intortnation is correct and agree to comply with all applica6l
State of Minnesota Statutes and Ciry of Eagan Ordinances.
Signature of Appficant: ?o.Q,t/Vl,trvt
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
Statc:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
O 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 .8-piex
? 04 SF Porch O 04 12-p)ex
? 05 SF Misc. ? 10 = plex
WORK TYPE
?? 31 New ? 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
A' of Stories
Length
Depth
APPROVALS
Planning
? 11 Apt./Lodging 0
? 12 Multi RepaidRem. ?
? 13 Garage/Accessory ?
? 14 Fireplace ?
,o? 5 Deck
? 36 Move
? 37 Demolition
Basement sq. ft.
_ Main level sq. ft.
_ sq. ft.
sq. ft.
_ sq. ft.
_ sq. ft.
Footprint sq. ft.
rt.
V,
16 Basement Finish
17 5wim Pool
20 Public Facility
21 Miscellaneous
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bltlg
Census Unit
Buiiding _jVEngineering Variance
?
? Valuat+on: $
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
7otal:
?
O/
/
0
% 5AC
SAC Units
? ? .
? N 79'q?W '
io
o" ? .
C7 !1. ?1 ???
e s ?; 1
%ll
/ Zl,S
/ VT/? ?J?•
I . rt?
In?
Q0 Q ?-' ?l\>?+` .
ti
Lot 6, Block l, Johnny Cake
I / Ridge Addition, Dakota County,
g Minnesota
?fol/,_ ,o
WE NEREBY CEROY TNAi TMIS IS A TRUE ANO CORRECT REPRESENTA110N Of A SURVEY OF iMf
DOUNDARIES OF iME UND AlOVE DFSCRISED AND OF TME LOUiION OF ALL EUIIDINGS, IF ANY,
THEREON, AND AlL VISISIE ENCROACHMENTS, IF ANY, fROM OR ON SAID LANO.
i
Oorad rAis -30L"- day of n.cgm « A p 1962 C. R. WINDEN 3 ASSOCIATES, INC.
4//L
, . 0 .. . . ? 91"
U. S. HOME CORPORATION
C. R. WINDEN d, ASSOCINTES, INC.
lANO SURVEYORS TOL 843•3646
1381 EUSTIS ST., Si, PAUI, MINN. 55I08
/ '
N79
42'W
?? -
? 223
vo ; b
? \ / A O
? O
n
/ a
Scale: 1" = 50'
O Denotes Iron?
b
?
?
?
W n
c m
\\
£
I/A
f?2
52
b? • ?'
?'o
p? I / R
Lot 6, Block 1, Johnny Cake
Ridge Addition, Dakota County,
Minnesota
?
Ia id , :./O
WE MEREBY CERTA TMAT THIS IS A TRUE AND GORRECT REPRESENTATION OF A SURVEY OF TME
BOUNDARIES OF THE IAND A60VE Df5CR1EED AND Of THEIOCATION OF All BUItDINGS, IiANY,
THEREON, AND Atl VISIBIE ENCROACFiMENTS, IF ANY, FROM OR ON SAID LANO.
Daead ehis 30u day oF necwmhsr A.D. 198d C. R. WINDEN 3 ASSOCIATES, INC. -b? je-..?
, Svrrvroq Minnewta Roqiftrolion Ne.772G
CITY USE ONLY
LOT -CA BL / RECEIPT#:
SUBD. RECEIPT DATE:
1998 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PIIAT KNOB RD EaGAN NA7 55122
(612) 681-4675
Date:
Complete this secrion onlv if you aze installing HVAC in single family, townhomes or condos undei
construction and not owner /occupied
• HVAC: 0-100 M B T U $ 24.00
ADDITIONAL 50 M BTU 6.00
• Gas outlets (minimum of one required @$3.00 ea.)
• State Surchazge: .50
• TOTAL:
Complete this section onlv if you aze remodeling, adding to, or repairing existing single family dwellings,
townhomes, or condos. Note: Mechanicai pemvt is not reauired for alteration/add-on to ductwork in
existing residential units; but is required for the following:
_ Install fiunace IX Install air conditioning
_ Install air exchanger, i.e. Vanee system, etc. _ Other
Minimum fee applies to all remodel or add-ons of existing residences $ 20.00
State Sa*charge .5^v
TotaL• $ 20.50
S[TEADDRESS: 4-I-7;? ?rL.N?KIlJ? C??rC??
OWNER NAME: VcG?NC7 o PHONE #: (n R? " C7 (q `7 IS
INSTALLERNAME: WNIT?TPc1l_. Nfp"r\IJC-, ? QT71iAXPHONE#: qq,4",g3q5
STREET ADDRESS: aR (n cI a PNSJ4- c,,MC l?3 tJ W
c[rY: --T-- -SAn?s srnrE: rn?N 2.1 r: 5,?c?uG
SIG ANRE OF P TTEE
15/FORMS BLD/MECH PERMIT (RES) - 1998
?
cirv use oNLv
L BL
SUBD.
RECEIPT # _
RECEIPT DATE:
3ANICAI, PERMIT (COI+MRCIAL)
CITY OF EAGAN
3830 PZLOT lINOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE: CONTRACT PRICE:
yVpgX TYP_F_: NEW COIVSTRTJCTTON INTER[OR IMPR.OVF.MENT
DESCRIPTION OF WORK:
FEES: 1% of contract price OR $25.00 minimum fee, whichever is greater.
Processed piping - $25.00
CONTRACT PRICE x 1%
PROCESSED PIPING
PERMIT FEE
STATESURCHARGE
TOTAL
SI1'E ADDRESS:
OWNER NAME:
TENANT NAME (uviPROVEMENTS oNL1):
INSTALLER:
($.50 per $1,000 of cermit fee due on all pemiiu.)
PHONE #:
ADDRESS: PHONE #:
CITY:
SIGNATURE OF PERMITTEE
STATE:
ZIP:
CITY INSPECTOR
?
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4772 Penkwe Cir
Lot: 006 Block: 001 Addition: Johnny Cake Ridge
PID:10- 39800 - 060 -01
Use:
Description:
Sub Type: e - Furnace
Work Type: Replacement
Description: Furnace
Comments: Quesetions regarding electrical permit requirements should be directed to Ma rk Anderson, State Electrical Inspector,
952- 445- 2840Crystal Gemuenden 8910 Wentworth Ave S Bloomington, MN 55420 952- 881 -9000 Crystal.Gemuenden @Se
viceExperts.com
Fee Summary:
Contractor:
Sedgwick Heating & Air
8910 Wentworth Ave S
Minneapolis MN 55420
(952) 881 -7739
Surcharge -Fixed
ME - Permit Fee (Replacements)
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
$0.50
$30.00
$30.50
Owner:
Vernon H Heine
4772 Penkwe Cir
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
9001
0801
Issued By: Signature
Mechanical
EA075412
10/10/2006
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
For Office Use
'it, Fav Permit#: Aii.. � I/ill\ D
Permit Fee:
EAGAN /S-7, 4., I
E C EIVE :
Date Received / b
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 . (c___
(651)675-5675 I TDD:(651)454-8535 I FAX: (651)675-5694 APR 2 7 2020Staff:
buildinainspections( citvofeagan.com L
2020 RESIDENTIAL BUILYING-PERMITPPLICATION
Date: 4-24-2020 Site Address: 4772 Penkwe Circle, Eagan Unit#:
Name: Vernon Heine Phone:
Resident/ 4772 Penkwe Circle, Eagan
Owner Address/City/Zip: i -
Applicant is: Owner V Contractor — , ( ' C—
Type of Work
Description of work: repair existing deck footings and beam, repair handrail
Construction Cost: $3000 Multi-Family Building:(Yes /No )
Company: Masberg Inc Contact: Joe Masberg
Contractor
Address: 26850 Naylor Ave City: New Prague
State: MN Zip: 56071 Phone: 612-382-7256 Email: masberginc@bevcomm.net
License#: BC585990 Lead Certificate#:
If the project is exempt from lead certification, please explain why:
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 ou •rovide scific reasons that would•=rmit the Ci to conclude that the 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.citvofeagan.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.00pherstateonecall.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.
xJoe Masberg x
Applicant's Printed Name Applicant's Signature
DO NOT WRITE BELOW THIS LINE ti-7 -7- k}E �
7 iii- . / 7// r 0
SUS TYPES
*
— Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)
Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration (Multi)
_ Multi X Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
01 of_Plex Lower Level Pool Accessory Building
WORK TYPES
New Interior Improvement _ Siding Demolish Building*
Addition _ Move Building _ Reroof _ Demolish Interior
Alteration _ Fire Repair _ Windows Demolish Foundation
_
XReplace _ Repair _ Egress Window Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation -3,UGc., Occupancy TP—c— I MCES System
Plan Review Code Edition 209,0 SAC Units
(25%_ 100%_) Zoning R 1 City Water
Census Code 2/3q Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction �/3 Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
X Footings (Deck) Final/C.O. Required
Footings (Addition) y Final/ No C.O. Required
Foundation Foundation Before Backfill HVAC_Service Test Gas Line Air Test_Hood
Roof:_Ice &Water Final Pool:_Footings _Air/Gas Tests _Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace: _Rough In _Air Test _Final Siding: _Stucco Lath _Stone Lath _Brick_ EFIS
Insulation Windows
Sheathing Retaining Wall: _ Footings_Backfill_ Final
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_Final
Braced Walls Erosion Control
Shower Pan '' // Other:
Reviewed By: �;- /V�/Sd^ , Building Inspector
RESIDENTIAL FEES )2</.7/..e e_ -;,..5sAe,-.44-.3<�tIe,v1r,., i
Base Fee �;ts
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit& Surcharge
Treatment Plant
Radio Meter Read
Copies 3P4166/4 70- b )
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA161588
Date Issued:06/03/2020
Permit Category:ePermit
Site Address: 4772 Penkwe Cir
Lot:6 Block: 1 Addition: Johnny Cake Ridge
PID:10-39800-01-060
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 - Residential Additions, Alterations
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 1,500.00
Fee Summary:BL - Base Fee $1500 $62.50 0801.4085
Surcharge - Based on Valuation $1500 $0.75 9001.2195
$63.25 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 -
Wendy C Barnum
16680 Eagleview Pl
Lakeville MN 55044
Masberg Inc
26850 Naylor Avenue
New Prague MN 56071
(612) 382-7256
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA162915
Date Issued:08/05/2020
Permit Category:ePermit
Site Address: 4772 Penkwe Cir
Lot:6 Block: 1 Addition: Johnny Cake Ridge
PID:10-39800-01-060
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Wendy C Barnum
16680 Eagleview Pl
Lakeville MN 55044
(952) 646-8293
Appliance Connections Inc
12850 Chestnut Blvd
Shakopee MN 55379
(952) 445-4803
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA178447
Date Issued:08/17/2022
Permit Category:ePermit
Site Address: 4772 Penkwe Cir
Lot:6 Block: 1 Addition: Johnny Cake Ridge
PID:10-39800-01-060
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation. When a weather barrier is installed or
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Jeffrey Devich
4772 Penkwe Cir
Eagan MN 55122
(952) 649-8293
Shelter Construction LLC
7040 Lakeland Ave N
Brooklyn Park MN 55428
(612) 849-8082
Applicant/Permitee: Signature Issued By: Signature