4048 Pennsylvania AveCA$E',,,RECEIPT ?
•.:?;:?. , -
• CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
-,-
' DATE 19 ?.._
NECErv?o fRdM
Annourn
& DOLLARS
100
p CASH CHECK
BY
_ r`. .. - .
? White--Payere Copy
Yelbw--POSting C.opy
Pink---Fi{e Copy
Thank You
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21 •199, Eagan, MN 55121
PH ON E: 454-81 00
BUILDING PERMIT Receipt ? To be used for 5•° DWG/W+R Est. Value $749 )0ti Date %CF'f 20
Site Address 40?8 PFK-l4.,YLVwHIA A+ Z
Lot 9 Block 5 Sec/Sub. STA:'FCkD ?E.ACP
Parcel No
c Name MbRISR lilDUM HMS
3 Address 3902 G'ELAItVAI.a QR
o City CAGAH Phone 454-0433
, o ? lJame a?
? ` ? lAddress
City Phone
a
W Name _
c7 Z Address
W City -
I hereby acknowledge that I have read this application and state that the
inFormation is correct and agree to comply with all applicable State of
Mirinesota Statutes and City of Eagan Ordinances.
Signature of Permittee
A Bu4lding Permit is issued to: - FR0NTJ EK HJuLs
on Ihe express condition that all workshall be done in accordancewith all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official __ _
OFFICE USE ONL11
On Site Sewape Occupancy A 2?-1
MWCC System Zoning R_-1
On Site Well (ACtual) Conat V_r+
City Water x (Allowable) V-iq
PRV Required * of Stories
Booster Pump Length -40'_
Depth 489
S.F. Tatal
Footprint S.F.
APPROVALS FEES
Engr./ASSess. Permit 4-70+00
Planner Surcharge 37.00
Council Pian Review 235•00
Bldg. Off. SAG City 100•?("o
Variance SAC, MWCC Sso •?
WaterConn. 550•?
Water Meter 67.OQ
RoadUnit 311-?[1
Treatment Pi 204•00
Parks
TOTAL 21538. (k)
CITY QF EAGAN
•- -- • , - 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454•8100
BUILDING PERMIT Receipt #
To be used for SF y'WI1CIAR Est. Value r74s(W Date SEPT E0
Site Address 404? I'ENNSYLVAnA AllI
Lot 9 Block S Sec/Sub. ??? FLACK
Parcel No
a Name FRO*TIZg ??M NOW
; Address 3902 CEbARNAI.E DR
0 City EAW Phone 454-0433
°C
o Name 4AME
.
? ` Address
a City Phone
U yU
W W
~ Z
v
Uz
Q
Q W
Name _
address
City _
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
A Building Permit is issued to: _ FRnN'CIKR P[TA679S? H4HE$
__---
on the express condition that aliwork shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building OlficiaL_ ---
OFFICE USE ONLY
On 5ite Sewage Occupancy lt-3 d"1
MWCC System f` Zoning ?,-1
On Site Well (Actual) Const V-N
city water ` (Allowabla) V N
PRV Required * of Stories
Booster Pump Length 401
Depth 43'
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr./Assess. Permit 470'00
3740
Planner Surcharge
Council Plan Review 235•00
BIdg.Off. _ SAC,City 10C'•00
550e00
Variance _ SAC, MWCC
Water Conn. 350•00
water Meter 61.00
Road Unit 3ZS.W
204000
Treatment P1
Parks
TOTAL 2s538.00
, Parmit No. Psrmit Holder Date TNephone ?
Plumbing
v
H.G.n.c.
u
Electric
i
Softener
Inspection Date Insp. COmments
Footings I
Footings II
Foundation
Framing
Roofing
Rough Plbg. ? ?s 8
Rough Htg. pb/
IsuL
Fireplace
Final Htg. 1
Final Plbg.
Bldg. Final `A?? 'afs f ,,,..f
Cert Occ. tc L, 4c1- S i r[ wd /?
Temp. LP
Deck Ftg.
Deck Final
Well
Pr. Disp.
-..,x•.ar.ro4ta?•?f:-'-+f.^-"?•^iw-7t?-v,"4?.s; ?•-z. -.?;xvs?+rr...? .? ?-r.., . •
GTY OF EAGAN
- 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454-8100
BUILDING PERMIT Receipt #
To be used for DECK Est. Value :1,000 Date JULY 2S
Site Ad4ress • - -- - ?T- --------- --- -
lot Block SeclSub.
PafC@I No. Occupancy
Z
?IMOrP1iY 6 iIEDL?CCA SCH$NK oning
c Name (Acluaq Const
; Address (al°'"able)
° City Kim= Phone # oi Stories
th
g?? Leng
a Name Depth
.
o
?a Addf85S S.F. Total
? City Phone S.F. Footprints
i
S
ewage
On S
te
W Name on sae weu
W
=; Address Mwcc sysiem
W ciry waier
` City Phone i
PRV R
d
equ
re
I hereby acknowlege that I have read this appiication and state that the 8ooster Pump
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City oLEagan Ordinances.
Signature ot Permitee ' APPROVALS
?? ?
? M Planner
A Building Permit is issued to:
on the express condilion that all work shall be done in acCOrdanCe with all Co+ncil
applicable State ot Minnesota Statutes and City of Eagan Ordinances. Bldg_ Olf.
Building Ofticial variance
OFFICE USE ONLY
18197
- 19 ..?
FEES ?
25.00
.SO
Bldg. Permit
Surcharge
Plan Review
snc, c?y
SAC, MCWCC
Water Conn
Water Meter
Acct. Deposit
S/W Permit
SNY Surcharge
Treatment PI
Road Unit
Park Ded.
Copies
TOTAL
--23-.'-Co
Permk No. Permk Holde? Date Telephone #
WATER
SEWER
PLUMBING
H.VA.C.
ELECTRIC
k?specHon Date Insp. Comments
Footings t
Foundation '
Framing
Roofing
Rough Pibg.
Fiough Htg.
Isul.
Freplace
Final Hlg.
Final Plbg.
Const. Meter Plbg. Inspec,?ta - Notiry Plumber
Engr.IPlan
81dg. Fnal
Dedc Ft9• O q D
oa* Finai /
wea
Pr. Disp.
? ,.... ......?:?,.:b:.:i-?..: : ..:. .. . . .. . .. ?. . :;. . . . . .
? PERMIT #
' MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: ?
CONTRACT PRICE: $1700. 00 PHONE: 454-8100
Site Address 4048 Pen? Vu
Lot 9 Block 5
Name W.IZEI, HEATII+
m Address 1955 Sh awnee
c City E•apan
? Name PIZUNTiKK caPU
c AddresH08 Sihlaa Mi
o City E89Can
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond_
80, OQd M BTU
M BTU
M BTU
M BTU
CFM
Gas Piping Outlets #
FEE:
S/C:
TOTAL•
BLDG. TYPE WORK DESCRIPTION
Res. xx New ?
Mult Add-on
Comm. Repair
Other
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PEkMIT) - 1.50
COMM/IND FEE - 1% OF CONTRACT FEE
APT BLDGS. - COMM. RATE APPLIES
TOWNHOUSE 8 CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
REMODELS - 12.00
MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000)
25.50 ,? " ' .50 ".??- . ???.• ? ;
SIGNATURE OF PERMInEE
FOR: CITY OF EAGAN
. • PERMIT # ?
CONTRACT PRICE:
Site Address 1' k' A? "' e'5
Lot Block ?- SeclSub
Name
2 ,
`
m J)
Address
c City Phone ' - /S ? `V
Name ' f??
L
3 Address ? c 6 t= v
p City 1+?fv' /? Phone
FEES
COMM/IND FEE - 196 OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE 8 CONDO - RES. FiATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMiT PRICE GOES
BEYOND $1,000.00)
SI(3NATURE OF PERMI EE
FOR: CITY OF EAGAN
PLUMBING PERMIT RECEIPT ?i ?
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAH, MN 55122 DATE: /"?? ??? ?
PHONE:454-8100 -x ?
'-? ' r/': ;•+ V BLDG. TYPE WORK OESCRIPTION
Res. New
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
FIXTURES ?TOTAL
%
Water Closet - $3.00 S. ? • ? =
Bath Tubs - $3.00 r'
Lavatory - $3.00
i
Shower - $3.00 • ? '?
Kitchen Sink - $3.00 ? • ???f?
Urinali8idet - $3.00
?Laundry Tray - $3.00
Floor Drains - $1.50
=
Water Heater - $1.50
Whirlpool - $3
00
.
=Gas Piping Outlets - $1.50
(MINiMUM - 1 PER PERMIT)
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
=
Rough Openings - $1.50
FEE: ?.3• l?-C;
STATE S/C:
GRAND TOTAL• ?3- -1r
INSPECTION RECURD Control No. 0222
?
CITY OF EAGAN PERMIT TYPE: , i m -A
Q?, 4 1
3830 Pilot Knob Road • Permit Number. p?? i? J q h
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: L 0 T a 4 810(K: ?. APPLICANT:
4049 PENNSYtVANIA AVt SCHENK TIMaTNY
SrAFFoRp PLACf (612) 680-8542
PE"p1Tm§4qTyp&,.,I i TYPE OF WORK: ALrrRAsIoN
\
PermR No. Permit Holder Mte TNephone Ik
S/W
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Irtspeedon Dsbe Insp. Commerm
Footings 1
Foundetion
Framing Z A
y ?
Rooflng
Rouph Plbg.
Rough Hig.
IsW. I f '-1 Y-
Feeplece
Flnal Htg.
Orsat Test
Final Plbg. Plbg. lnspector - Notify Plumber
Const. Meter
EngrJPlan
Bk1g. Final
Declt Fty.
Deck Feiel ?
Well
Pr. Oiap.
?
?. .,?
.
f?t r#i#iratp uf Orrupanry
Citp of (Cagan
arwwrttl of %Qing 3wrrfinn
This Certificate rssued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying thal at 1he trme of issuarue tlus structure was in compliance with lhe tinrious
ordinances of the City regulating building corrstrucdon or use. For the foUowing.•
ux Clusi6auoe Bidg. il.mit rlo.
pc-W-1Y TYM RJ l Cl 1 Zooing Dietricy .K ; T?I* COML
Owuerot&nld'mg ^'-'VR 4:1'??•ca Addm'aLii_hrttElk DR, EAGAN
El,illi,W Ad&.. ,,,; ,: ,: ? - .,.,?..;? , ? :: A _?'•1'?'???:. 4.9, B5, STAF'FM PI.4M
7. l9oF
euaa;ns offic;,i
POST IN A CONSPICUOUS PUCE
CITY dF EAGAN Permit No: 11,1100 Date:
3630 Pilot•Knob Road B/P No: Date: -- '
P.O. Box 21199, .
Eagan, MN• 55121
Owner. Frontier Midwest CarpOrstion
SiteAddress: '" PennBy vFZJ.'r. :!v-a L9 BS $L2FrC7rL rlace
Plumber.
MWCC: SSQ.OOp<' Zoning,
City Chg: ' No. of Units:
-'•-
Acct. Dep: I ayree to comply wRh the CNy of Eagan
Permit Fee: P
Ordinances.
Surcharge: SEWER SERVICE PERMIT
,
CITY C:F EAGAN Permit No: ASs Date:
38,30 Pilot Knola Road Meter No: Size:
P.O. Box 711§9 . Reader No: Date:
Eagan, MN,55121
, SiteAddress: k0 48 Finasvlva::ia kye l•'? .-15 Staffor' °1l1Ce
I Plumber._ St 'r p1 tttahin?
Conn. Chg: `5 n_ 00vd Zoning: -Z
Acct Dep: 1
` 5_OOed No. of Units: ?
?_'.; ., Permit Fee: - 1
?
'
0_!u?•+?'
"? ?
-? ? • Surcharge: _ .54-W 1 agree to comply with 1he City ol Eagao
Tr. Plant 0(3y-d Ordinances.
Meter. ,
, Misc.: gy
.,_ i
f}? ? WATER SERVICE PERIIAIT
- --- ----
CITY OF EAGAN Permit No: Date: 10-3-$8
3830 Pilot Knob Road Meter No: Z14 7 ya a Size: ocA
P.O. Brix 21198 Reader No: (Lu 3 7'A3 S Date:
Eagan, MN 55121
SiteAddress: 4Q 48 vonncvlvania Ave L9 BS Stafford Plare
?
Plumber.
Conn. Chg: 2aning: Rl
Acct Dep:? ?? QQ?'4 No. of Units: ?
Permit Fee: 1 ?) QgTd
Surcharge: , 5Q? ? I agree to comply wi ihe Clty ol Eagan
Tr. Plant ? ? ?? ??QQ,-A
Ordlnanc
Meter.
Misc.: .*
B
y
WATER SERVICE PERMIT
CITY OF EAGAN N? 18197
3830 Pilot Knob Road, P.O. Box 2 1-199, Eagan, MN 55121
PHONE: 454-8100 ?QOs$
BUILDING PERMIT Receipt N ?
To be used for DECK Est. value $1, 000 Date JULY 25 , i g 90
Site Address 4048 PENNSYLVANIA AVE
Lot 9 Block 5 Sec/SubSTAFFORD PLACE
. OFFICE USE ONLV
Parcel No. oaupancy - FEes
Zoning -
Name TIMOTHY & REBECCA SCHENK (Actuap Const - Bldg. Permit 25.00
w
3 Address 4048 PENNSYLVANIA AVE (Allowable) - Sumharge
O
.5
° City EAGAN Phone 688-8562 xof stories -
th Plan Review
Leng _
a Name SAME Oepth - SAC, City
,
?a AddfBSS S.F.TOIaI - SAC
MCWCC
¢ Cl1Y Phone S.F. Footprints .
-
Si
S Water Conn
ewage
On
ia _
W w Name On Site Well - Water Meter
s? AddreSS MWCCSystem -
Q ? Acct. Deposit
aw City PhOne CiryWaier
i -
S!W Permil
red
PRV Requ _
I hereby acknowlege that I have read ihis application and state Ihat the Booster Pump - SNJ Surcharge
intormation is correcl and agree to comply with all applble State of
n Ordinances. _
Minnesota StaWtes and Ci[y
ga
?9
Treaimem PI
?
,
??5
?v'vi.i..?+ % ?•R?'% G
?
Signawre of Permilee ? e.? - y APPROVALS
Road Unit
A Building Pefmit is issued to: TIbfyM OR 10? SCHEW Planner - park Ded.
on the express condilion Ihat all work shall be done in accordance with all Council
iry of Eagan Ordinances.
applicable Slate of Minnesota
StaWtes and C BItlg.Off. _ Copies
?
?Q
BuildingOflicial? ??? "? g Gy : Variance - TOTAL 25.50
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 NO 15625
' PH ONE: 454-8100 ?-7 77
n?
BUILDING PERMIT Receipt# ?1)
To be used for SF DWG/GAR Est. Value $74,000 Date SEPT 20 7g 88
Site Address 4048 PENNSYLVANIA AVE
Lot 9 Block S Sec/Sub. STAFFORD PLACE
Parcel No
a Name FRONTIER MIDWEST HOMES
W Address 3902 CEDARVALE DR
3
° City EAGAN Phone 454-0433
o Name_
? Q Address
a City_
r?
w W Name _
zza Address
aw CitY_
1 hereby acknowledge Ihat I have read this application and state that ihe
information is correct and agree to comply with al applicable State of
Minnesota StaNtes and City of ag n O inanc ----
Signalure of Permittee _
A euilding Permit is issued ta:_ FRONTIER MIDWEST_HQME$.
on ihe express condition that all work shall be tlone in accordance with all
applica6le Slate of /M?in?n??e?sota Statutes and City ot Eagan Ordinances.
Building Olficial _- ? ? I1??
11TWJ 1 '\
OFFICE USE ONLY
On Sne Sewage _ Occupancy R-3 M-1
MWCCSystem X Zoning R-1
On Site Well (ACtual) Const V-N
Ciry Water X (Allowa6le) V-N
PRV Required - # of Stories
Booster Pump _ Length 40 '
Depth 48'
S.F. Total
Foo[Orint S.F.
APPROVALS FEES
Engr./Assess. Permit 470•00
Planner Surcharge 37.00
Council Plan Review 235.00
Bldg. Off. _ SAC, City 100.00
Variance SAC,MWCC __5 5D?09
Water Conn. 550.00
Water Meter
o
67.0
FoadUnit __32.5.,,.00
Treatment P1 204.00
Parks
TOTAL 2 .538.00
NO.
iyJ
01-321QV Bldg. Permit
01-3422 Plan Check
r
01-3445
Surch./Adm.
01-3446 SAC/Adm.
01-2155 Surcharge
75-3860 Road Unit
20-2275 SAC
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn.
28-3855 Park Ded.
C)
/
TOTAL
RE?QUF, POR ELECTRICAL WSPECTION
? 52e
r, In51mCti0ns 10r cOmpl8ling Ih15 falm an b2ck at y¢IIOW ropy.
1434 0 °X" 8elow Work Covered by This Request
4 EB-00001-08
F* ' C U/8YSC7
ew? Add Rep. Typeof6uilding AppliancesWired EquipmentWired
Home Range Temporary Service
? Duplex Water Heater Elec[ric Heating
Apt. Building Dryer Other (Specify)
Comm./Indusirial Fumace
' Farm Air Conditioner
Ofier(syecity) CoNractor5 Remar45: ?
Compute Inspection Fee Below:
# Other Fee # Service Enirance Size I Fee # CircuitslFeeders Fee
Swimming Pool 0 to 200 Amps 0 ta 700 Amps
TranSformers Above 200 _ Amps Above 100 _ Amps
SiJnS inspeclor's Use Only: , TOTAL -
Irrigation Booms
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORD EB-B CONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 M NTHS.
I, the Electrical Inspecror, hereby Ro°9n-'" r °i
certify that the above inspection has
been made. F,nai
?
9 oa?e
y?(??
?
OFfICE USE ON W
f
Tnis reQuesl voitl 18 monins Irom
?
43470
p
9 45
Request Dale
y
? Flre Roughin Inspection
Re ired9
YReatly Now ? WIII NoFify Inspecror
When Reatl
?
_ J
r? Ves C N. y
I='?censed contractor )(owner hereby request inspection of a6ove electrical work at:
JoD AaCress ISVeeI. Bov or Route No.I
WS 6111R10. AVE Clly
9 y
Sectmn No. Township Name or No. Range No. Counly k.afa
OccuOam (PRINTI
-ripqorN R Scff&vk Pinone No. ..
Power Supplier
?7af???c. Atltlress
?ci?«,c? ?iN
ElecVicai Convactor (Company Name) Convactor's license No.
Mdiling Atltlre551ConV2qOr of Ownel MBking In5td112LOn)
e4 /e,?ns ld ' 4vi ' fhd Ssjz
Authorrze .?gpal re ?C nUacl r M mg Installation?
p ? Phona NumOer ?
f?/Z??GP?'?f6
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPEGTION REOUEST WILL NOT
Grlggs-MlEway BIEg. - Room 5-173 ' BE ACGEPTEO BY THE STATE BOAFD 1821 Universlty Ave. St. Paul. MN 55106 UNLE55 PROPER INSPECTION FEEIS
,,,none (612) 602-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION . es-ooooi-os
See instrucqons lor comoietins tnis form on back o/ y¢Ilow copy.
D '3 O O 94 "X" Below Work Covered by This Request
1 Add Nep. Type of BuilEing ApPliancae Wlred Equiumenl Wired
Home Range Temporary Service
Duole.x Water Heater lAeT Liohtinu Fixturec
?-H ? Corrunerclal Bldy. Fumace Silu Unlonder ?
Industrial Bldo. Ai Air Co?itioner Bulk Milk Tank
athi:r
p Fae Service EntraneeSize H Fee Featleis/Subieeders IX e Circuits
0 to 200 qm 5 0 to 30 Am ,s 0 tn 30 Am Ds
Above 200 qmps 31 to 100 qinps 31 to 100 Am s
Swimming Pool Above 100_Amps Ahove 100-Amps
TransPOrmers Irrigation Boortis Pdrtia6"Other Fee
5pecial Inspection
Final
, I, the ElachiGaJ?
4Insuect
? ?t-or, he.eby
cert thet xhe above
.- .^ ?^? L?. Pection hes been
This reque5[ void
18 monlhs ISro?mn
D ? rt l1 lJ :3 4
. xg g s?s?
flequespOate..... Fir R?ouPh'? ??Inspection 08eadv Nuw pQWill Notifv InsPec-
? ?NO
es ? ?r Whr.n Ready
0J??? L censeA Electrical ConVactor I hereby request inspection oi ehova
I I Qwner electrical work installed at:
Stree Address, Bon r Raute No.
S City
ectmn o. Townshlp Na e or No. Fange Nn. ??1V
Occu (Pql )
,on Phone No.
0 5?3
Power SuuV?? /
/
/ ?}•- AAds
?
Elect?al C.nt a or IC wa Nu I
.?u G , ??r c'r?s Li ense No.
%
MailinI ess (Contractor or Owner Makin?sta'latio
4 V
Authorizeatur ontrxGOr Owner Making Installaeion)
?. P N?ber
O
MINNESOiA STATE BOARD OF ELECTqICITV THIS INSPECTION NEQUEST WILL NOT
GriB9s•Midwav gldg. - Noom N-191 BE ACCEPTED BV THE STATE 60AN0
1821 Universitv Ava.. 5i. Paul. MN 56104 UNLESS PflOPER INSPECTION FEE IS
Phone(6t21642-0800 ENCLOSEO.
PERMIT # ,J"' O w
RECEIPT DATE:
2002 RESIDEPTLAL PLUM$INfi PERM1T APPLICATIOR
crrY or KAsJkx
3$30 fILOT KftOB iW
£a4814A, bIN 55122
651-661-4675
Please complete for:
SITE ADDRESS:
OWNER NAME: :
INSTALLER NAME:
STREET ADDRESS:
TELEPHONE #: p t '
TELEPHONE #:
(AREA CODE)
CITY: l?6IA? U?l Y v STATE: ZIP: qatfl
_ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00
includes $40.00 County fee
Note: Additional consultant fees may apply
• MODIFICATION/ALTERATION TO EXI5TING DWELLING UNIT, INCLUDING:
_ Adding fiutures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00
_ Abandonment of septic system.
_ Water turnaround - ebsting dwelling unit (+ 5/8" meter if needed -$118)
Other:
RPZ: new installation/repair/rebuild $ 30.00
n
(?
_
t
?J
l
i
i
ti
rr
em
_
awn
ga
on sys
? h'OV 1 3202
0
Iu u U
Replacement/additional: ? water softener _ water heat?r ?_
?. $ 15.00
State Surcharge $ .50
$ 1 S - 5°
rotal
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable Cityof Eagan ordinances. It
is the applicanPs responsibilityto notlTy the property owner that the City of Eagan assumes no liabi?'ty for any damages caused by the City during its nortnal
operational and maintenance activitles to the facilities constructed under this permit within City pro lrigl t-of-waylea ? nt. i f I ?
l{,`
SIGNATURE F RMITT E 1/02
single family dwellings, townhomes and condos when permits are required for each unit,
backflow preventer for irrigatlon system
, RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OP EAGAN
5 I LI ? L? 3830 PILOT KNOB RD, EAGAN MN 55722 I Z D' 2
651-681-4675
New ConeVUCtlon Reauiremants
• 3 regWered sfte surveys showing sq. fl. of bt, sq. k. ol house; and gII roofeC areas
(20% maximum bt coverege elbwad)
. 2 copies M plen showYig beam & window s¢es; poured fouM design, etc.)
• 1 set of Energy Cakuletions
• 3 copies ol Trea Presenation Plan H bt plalled atter 111/93
• R'un,bist Deteil Optbns seleclion sheet (bWgs witti 3 or less uniLS)
DATE O?U 2
SITE
NPE
_ Water Softener
_ Water Heater
_ No. of Baths
# Swa:°-°
AULTI-PAMILYBLDG _Y XN
FIREPLACE(S) _ 0 _ 1 _ 2
APPLICANT t Ll U/ CON
STREET ADDRESS A[) COL Lr A'Ll F- CITY k4kUNUISTATE .d. NZIP S'S33 7
TELEPHONE #'M-7o7-(,9J 7 CELL PHONE qFAX #?
PROPERTYOWNERhEA+J? AIJ (S LA ZIZS?V TELEPHONE# I??SI'4QS
COMPLETE THIS SECTION FOR uNEW,• RESIDENTIAL BUILDINGS ONLY
Energy Code Category MINNESOTA RULES 7670 CATEGORY 1 MINNESOT '
yRo?
M?
(J aubmisaion type) • Residential Vantilation Catepory 1 Worksheet Submitted F7?Ttl
• Energy Envelope Calculations Submitted UN 10 2002
Plumbing Conhacfor:
Plumbing system includes:
Mechanical Conhactor: _
Mechanical system includes:
Sewer/Wafer Conhactor.
_ Air Conditianing
_ Heat Recovery System
Phone #
Phone #
Submitted
Fee: $70.00
-----------°---------------------------------------------------
I hereby acknowledge that I have read this application, staTe ihat The information is correct, and agree to comply
wilh all appllcable State of Minnesota Statutes and City of Eagan Ordlnances. ?
Signalure of Applicant
OFFICE USE ONLY
Phone #
pamodeVNeoelr HeaulremeMe
• 2 copies of plan
• 7 set of Energy CaM:ulatbns for heated addilbns
. 1 sAe survey tor extarbr ad0ilions 8 decks
. Indirate tl home served by septic system ror addltions
VALUATION
_ Lawn Spri:
_ No. of R.I.
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY . , ,
? 01 Foundation ? 07 OSplex ? 13 16rplex ? 20 Pool O 30 Accessory Bidg
? 02 SF Dwelling ? 08 06plex ? 16 Fireplace ? 21 Porch (3-sea.) O 31 Ext. Alt- Multi
? 03 01 of _ plex 0 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Poroh (screened) ? 36 Multi
0 OS 03-plex ? 11 10.plex ? 19 Lower Level ? 24 Storm Damage
? 06 04plex ? 12 12-plex Plbg_Yor_ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement O 38 Demolish (Interior) O 44 Siding
? 32 Addition ? 36 Move Bldg. O 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Afteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (EMire Bldg only) - Give PCA handout to applicaM
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 W idth
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 _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fueplace _ R.I. _ Air Test _ Final _ Windows (newlreplacement)
_ Insulation _ Retauilng 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 5earch
Copies
Other
Total
Building Inspector
? ?.
1988 BUILDING PERMIT APPLIC9TION - CITY OF EAGAN !.?.
SINGLE FAMILY DWELLING3 16 u ?.§
INCLUDE 2 SETS OF PLANS, 3 CERTIEICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTEs ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WFiICH ADDRESS
IS DESZRED. NO CHANGES WILL BE 9LLOWED ONCE BQILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL ONITS FOR SALE UNITS
0 OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COhAtERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS; SEP 14 1988
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
r> OO ?
To Be Used For: NEW CONST. Valuation: Date: 9/13/88
Site Address 4048 PENNSYLVANIA AVE
Lot 9 Block 5
Pareel/Sub STAFFORD PLACE
Owner SCHENK. TIMOTHY & BECKY
Address 1445 SALEM CHURCH RD #109
City/Zip Code INVER GROVE HEIGA?575
Phone 455-3854
Contractor
Address 3902 CEDARVALE DRIVE
City/Zip Code EAGAN. 55122
Phone 454-0433
Arch./Engr. DICK CHARLIER
Address 14103 GARDENVIEW DR.
City/Zip Code AppLE VALLEY, 5,194
Phone # 432-5492
OFFICE USE ONLY
On site sewage Occupaney 3
MWCC system _
? Zoning Z`1
On site well Aetual Const 1/lY
City water Allowable 1/N
PRU required _ lk of stories
Hooster Pump _ Length YO
Depth 5'8• 3
S.F. Total
Footprint S.F.
IAPPROVALS
iEngr/Assess
Planner
Council
Bldg. Of f. 4y1?? 9
Variance
FEES
Permit %'JD
Surcharge 39
Plan Review 23.3'
SAC, City /00
SAC, MWCC -TT0-
Water Conn SS'0
Water Meter Z72-
Road Unit 32 S
Treatment Pl 2?
Parks
Copies
TOTAL ?
Cities Digital
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O41N£R SCHENK TTMOTHY & aFCkv
SI7E ADORESS 4
CONTRACTOR Cttn„k.t.e%t DA7E YL/?V PHONE
Deternina working square footage of each.
1. Total exposed wall ares ...... 7 288.&4o sq. ft. X .I 1
2. Total roa{Jceiling area .... I US /3 sq. ft. x .?- I =
Total expaszd wail area ahove floor =AL2 gL&.(eCo
a. Total wa1T windaw area ........................... 1215 .';
b. Total door area ................................. :5 9. C.a
c. Total sliding giass dcor area .................... . ya
d: Total fireplace wall area........................ 418
e. Total wall framing area (average 1QA)...:........ 4 Q S,Rfa
f. Total n=+.Na'1 area above f7oor ................ 11..5L.88
g. Total rim jaist area ............................ 1#4 8
Total exposed foundation area = '15.3 3
.
h. Totai foundation window area.....................
i. ToaI net fioundation area a6ove arade ............ 15.m?3
Deterr.sine "U" value el each wait szgrtserst.
a. I'ds.S X °uti ,3 = Y1 SS
b. 39.?a X ltu° ..y5 = ? ?.83
c. y? x ??U„ , <lj
d. ?18 x "u"
e. X IOU's
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Lr. ??a Oi X uUn
9. I ?I $ g„u.l ? 0 3(o = • 37S,
h. X "U"
33 x°U" .1 ?{ = b. 5
3 ...................................... Total = t-'-1i•{„??
If item #3 is the same as, or less.than item @1, you have met the intent
of 5BC 6006(c)2.
Total exposed raof/ceilina ar=_s =1013S
Total grass rcof/ceiling are3 =
j. Total skylight area ..................
k. Total raoflceilinq framinq area ....10?9,,,.?
1. Tota7 net insvlated roofJceiiing area.......
Deternine °U" value far esch roof/ceiiiag seement.
J
X toua
k. ?hS .$ x°U" o Z. 1 = 2.7-5
?. 9-7 Ot.Z X1,u^ .o?q = I 8, 6
4 ..................................TataT = 2 .S
If totat af #4 is the same as, or less than 472, you have met the intent of
S8C 6006(c)i.
Ta utilized the total envelope systm-n methad, the values-estabtishad 6y the
sum af items a3 and 14 shail not be greater than the svm af iteas 11 and n2.
+ 2`30,a:8
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CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675 ,
PERA4IT ? C°"t °"°. 0222
PERMITTYPE: auiLoiNa
Permit Number: 080241
Date Issued: 04 / 14 / 92
SITE ADDRESS: 4048 PENNSYLVANIA AVE
LOT: 9 BLOCK: 5
STAFFORD PLACE
DESCRIPTION:
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REMARKS:
euilding„ Permit Type
8uilding Work Type
UBC Occupancy,
?i
• \
'd- s-
BASEMENT FINZSN
ALTERATION
R-3
L: f
FEE SUMMARY:
Base Fee $35.00
Surcharge i.50
Total Fee =35.50
CONTRACTOR:
?
OWNER: - Appl3cant -
SCHENK TIMOTHV
4046 PENNSYLVANIA AVE
EAGAN IAN 55123
(612)688-8562
I hereby acI knowledge that I have read thie application and state that the
information is correct and agree to comply with all applicable State of Pin.
Statutes and City of Eagart Ordinances.
? /APPLICANT/PERMITEE SIGNATUR?
I n R:?,L I Yh ?1
? ISSUE e : SIGN TUR?
INSPECTION RECORD C°nt °"°. 0222
CITYOFEAGAN PERMITTYPE: auiLoiNG.
3830 Pilot Knob Road Permit Number: 000241
Eagan, M innesota 55123 Date Issued: 0 4/ 14 / 9 2
(612) 681-4675
SITEADDRESS: LoT: 9 BLOCK: 6 APPLICANT:
4048 PEIVNSYIVAMIA AVE SCHENK TIMOTHY
3TAFFORD PLACE (612) 688-8562
PEPHIMYTyghSH TYPE OF WORK: pLrERArioN
INSPECTION
FRAPIINO D. .
IN9ULATION ..
FINAL FIREPLACE
F-
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(i"i Jt 1 A0 ? k: t'
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? 111 r ?.i Iti" ? ?
? ± ? 1 ?? •,, ;, •.
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PERMIT N ,
cinr oF EAGaN
1992 BUILDING PERMIT APPLICATION
681-4675
A P R ti RErD
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 er?ergy calcs.
Penalty applies when typing of permit is requested, but not picked up by last xorking day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date 9 7-_ Valuation of work
Site Address: PZ0nShcVtHtq 4v-c
STREET STE •
Tenant Name: 0Y1107'V PSCFi en'K
/
?oT BLOCK ? ?. 5+q{(?d Place o.I.o. .
Descri tion of work: hudeo?
The applicant is: ?Owner O Contractor ? Other (DeserTbe>
Name tifh=-'N? Trart HY Phone /nd'g-mz-
Pa'operty LAST FIRST Q? (o 71 -srq v
Owner Address u6?tuuUiq Ave-
STREET STE M
city Caw state zyp ?SlZ3
Company Ph9ne
COntrBCtOf kddress License # Exp.
City State Zip
Company Phone
ArchitecU
Engineer Name Registration B
Address
City State Zip
Sewer 8water licensed plumber . Processing time for
sewer & water permits is two days once area has been appraved.
I hereby acknowiedge 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.
Si
f A
l i
-
gnature o
pp
cant:
vrriLrt uae UnLY
BUILDING PERMIT TYPE
? 01 Foundation ? 05 Apt. Bldg 009 Basement Finish
? 02 SF Owg, ? 06 Garage/Accessory O 10 Swim Pool
? 03 Two family ? 07 Fireplace ? 11 Res. Add./Porch
? 04 Multi-fam. T.H. ? 08 Deck ` O 12 Comm./Ind.
WORK TYPE
? 31 New
? 32 Addition
7 33 Alterations
? 34 Repair
? 35 Tenant Finish
? 36 Move
GENERAL INFORMATION
? 37 Demolish
? 99 Undefined
Const. (Actual
? Basement sq. ft.
(Allowable lst F1. sq. ft.
UBC Occupancy ? 2nd F1. sq. ft.
2oning Sq. ft. total
# of Stories Footprint Sq. ft.
Length On-site well
Depth On-site sewage
APPROVALS
Planning Building
Engineering _ Yariance
REGIUIRED INSPECTIONS
? 5ite Footing ? Framing
? Wallboard tFinal ? Draintile
3?_
? Insulation
13 Fireplace
Permit fee °
Surcharge ? o ?•??ti?:
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment Pl.
Road Unit
Park Ded.
Yrails DAd.
Copies
Other
Total: -
SAC %
5AC Units
s
_?..?..
? 13 Public Fac.
O 14 Agricultura7
O 15 Miscellaneous
MWCC System
City Water
PRV Required
Booster Pump
fire Sprinkler
Census Code
SAC Code
Assessments
S o- ob o- ooS Z L' a l
• 5oE
.. - /J
. 6?-tkt--- ?N
Wp??A <E my fa???
14144
1990 BUILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
QSETS OF PLANS
( ,Y-EEREtf SITE SURVEYS
1 SET OF ENERGY CALCULATIONS
MULTIPLE DWELLINGS
2 SETS OF PLANS
REGISTERED SITE SURVEYS -
(CHECK WITH BLDG. DEPT.)
1 SET OF ENERGY CALCULATIONS
_# OF RENTAL UNITS
_# OF FOR SALE UNITS
COMMERCSAL
2 SETS OF ARCHITECTURAL
& STRUCTURAL PLANS
1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PIGKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: yQCk Valuation: ? ? 8 Date:
Site Address 14 04 Pe?n,s yl cafiia xre-
Lot q Block 5
Parcel/Sub S jAt??-CQ? A-A??
Owner '77N1D7T!-'/ Y 4iC1fF7UL of
Address ?foo Pzohsy(uapia 4V-,P- ?y
City/Zip Code /hN .s-sr23
c?LI-
Phone
Contractor VLZYCO Ca„SrvUC%7'L
Address
City/Zip Code /ClUQ.V F4N5, W L
Phone 7f5 -'f2S-97?5
Arch./Engr. 5ot ai GO+ti??V'
Address
City/2ip Code
OFFICE USE ONLY
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length
Depth IZ'
S.F. Total
Footprint S.F.
On site sewage_
On site well _
MWCC System _
City water _
PRV _
Booster Pump _
APPROVALS
Planner
Council
Bldg. Off.
Variance
FEES
Bldg. Permit o? ,'00
Surcharge .,$a
P1an Review
SAC, City
SAC, MWCC
Water Conn
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Copies
SUBTOTAL
Penalty
TOTAL
Phone #
APFLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
. , , . .
,
? DR7fE: PA]R4a?f OF FEE AT TIME OF
; nrr:.icaxIoN ooEss rCfr coN- ;
? S1Z1S71E APPR('iJAL O£ PERDIIT.
?
r
? INSPkI.'PION OF SESd'R MD/OR WATER
f
; irsrni.v.TTOCas wnL r,vr ee SCMnM ;
y UN1ZL PII26IIT HAS Bffi4 APPROVFD.
dtV !t#1ilrieie#leffi4**flkYe*>ff+fyiif Y1\fF*4!}'/
OF CCIcjton
(PLEASE PRINT
1) PROPERTY ADDRESS: 4048 PENNSYLVANIA RVE
T.FY;AT, DESCRIPTION; LOT? BLOCK 5 T FFO D P?LACE ? Lot ffioc subc1 ivision or Tax Parcel ID
IF EXISTI[VG STRCCTLRE, DATE OF ORIGINAL BUILDING PII2NIIT ISSUANCE: N A
Nbnt Year
PRESENT ZONING/PROPQSID DSE:
Q COPM7QtCIAL/RETAIL/OFFICE
Q INDUSTRIAL
Q INSTI74.PI'IONAL/GOVFRNA']ENT
1XXI R-1 SINGLE FAMILY
F=]R-2 DOPLEX (3'wn C'nits)
? R-3 4'OWNHOL?SE (Three + Onits) ( Units)
Q R-4 APARTMEN'P/COAIDOMINILM ( C'nits)
Z) NAME= FRONTIER MIDWEST HOMES CORP.
ADDRESS: 3902 CEDARVALE DRIVE
CITY, STATE, ZIP: EAGAN. MN. 55122
PHONE: 454-0433
3) NAI`7E: STAR PLUMBING
ADDRESS: 1018 MOUND SPRINGS TERRACE
CITY, STATE, ZIP: gLDOMINGTON MN. 55420
PHONE: 884-4149 MASTER LICENSE #3329
I? Active
Expired
Not recorded
Sta In£itia-f-
4)
NAME: SCHENK, TIMOTHY & BECKY
ADDRESS: 1445 SflLEM CHURCH ROAD 4k109
CITY, STATE,.ZIP: INVER GROVE HEIGHTS, MN. 55075
PHONE: 455-3854
5)
EK] CONNECTION TO CITY SEWER XX CONNECTION TO CITY WATER O OTfIER
6)
9/13/88
****?************??* ************?**W?*********+*******+******?.***?****?+*?****??**?****?*********?
?
* THE GOLD COPY OF PII2MIT WILL BE SENP DIRDCPLY TO PUffi,IC WORIGS TO FACILITATE ME?E'ER PIC[C-UP. ?
* PLEASE ALIAW 'ISVO WORKING DAYS FC)R PROCFSSING. SOMEONE FROM TfJE CITY WILL CONTACT YOL IF THERE *
* ARE ANY PROBI,ENIS. +
?#*******?*?******??***,??,r*****w***+*+******??+**?********?*******?****???******+??********+r**+***«*?
FOR CITY USE ONLY
PERMIT # ISSDED
Pd w/Bldg. Permit FEES:
$ /G $
$_. /.^ / • G22 $
$ $
$ $
$ /.c $
$ g
$ .? S D r.'-0 $
$ $
$ $
$ $
$ $
S ?L(" `? • c, Cl $
$ $
$ /'S-ZZ•c%? g
SEWER PERMIT (INCLGDE SURCHARGE)
WATER PERMIT (INCLUDE SC'RCHARGE)
WATER METER/COPPERHORN/OtiTS2DE READER
WATER TAP (INCLUDE CORPORATION STOP)
SEWER TAP
ACCOUNT DEPOSIT - SEWER
ACCOL[VT DEPOSIT - WATER
WAC
SAC
TRUNK WATER ASSESSMENT
TRUNK SEWER ASSESSMENT
LATERAL BENEFIT/TRC'NK SEWER
LATERAL BENEFIT/TRL'NK WATER
WATER TREATMENT PLANT SDRCHARGE
OTHER:
TOTAL
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
ED YES IF YES, THEN A"PERMIT FOR WORK WITHIN PC?BLIC
Q ROADWAY" MDST BE ISSUED BY THE E[VGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE:
,
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SURVEY FOR:
DESCRIBED AS:
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PROPOSED ELEVATIONS
Slirrcyor"s ecrtifitate
Prontier Miclwest Fiomes Corp.
I.ot o, [31ock S, S'I'Al'PORD PIJ!CE, City of Iiagan, I.Takota Coimty
Minnesota and reserving easements oP rewrcl.
Top of Foundation . 094.0
Ooroqe Floor ' . 889. 4
Bosament Floor : 0 8 1. 6
AvFroa. Sewer Servtce Elav. . 869 .0
ProDesed ElsroHons . Q
ERiflinp Elevoflont
Drainaqe Olrsetlons ? ?.....-.
Oenotae Otfesf 3foke ? O
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IAIEDLUND
PlannJng Engineerlng Surveying
Vane.na:a?la?rn« oeem*na.ww..a.ee.A
rr?M??'?nsmn
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SCALE: ! lnch e 30 Fsst
DEPT.
BENC?
T. N. 11v?d. f? le* l. va
6? 16LK SPe?nsy. qvt.
E?eo. e 8-?0. oq
MIN. SETBACK REOIREMENTS
rmo?
Front - 30 Houss 91d* - 1O
Rour - Is OoroOe SWe -5
I nrney egIllly Ihel ihlg surroY. Otan w reOert wao Onpof eA br me JOB NO.;
er unler my Alretl st"rvlglen and tnet i am a eury q401+for0d gaR-49l
lan0 Surveyar unAer the Iaws el 1he Slate el Mlnoesole.
BOOK:
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PDeht ? i12 • Q8
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SURVEY FOR:
oESCaieEO As:
1
SurvcIIor"s CCrtifiCite
('rontier DlidwesY Ilomes Corp.
lAt S, Dlock 5, Srnrr•oiW MnCe, City of Liagan, UakoCa CoLmty
A1iiuiesota and reserving easemeiits of recorcl.
899
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t.e..e1?o?5
PfloPO5ED EIEVAr10NS BENCHMARK,
top of foundotlon? ¦ 084.0
QoraQeFloor
8a9,4
Basemenf Floor : 0 81.6
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t.N, Hyd. ? e? L
6?u 5, Pc.,„ab. a..e,
s-o.oq
MIN. SEtBACK REOIREMENTS
Apprex. StNer Ssrrla Elav.. 8 69,5
Propoted ElarollbN I Q
Eenllnq Elwollah? ?
Orotnepe Olrsetkno ?..-..-.
trsaotes Offsal glok• . O
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Fronf - 30 Noulli Sld@ - 10
• Roor - ?S 4ora0s Slds-5
9CALE7 1 Ineh ? 30 Faet ,
t her.ey nrnrp eeet mb iwwr. Otan a rtOert wes OnOereA !y me
ar under my dlnN supurlden end thol 1 am s duly n.oist•t.a JOB N0.7
g8Q'-0-91
N sf Mlnnuela
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lanA 9urroYer undn IM Mua e
BOOK:
Plenning Errg/ne ering Surneylnq
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA110652
Date Issued:05/21/2013
Permit Category:ePermit
Site Address: 4048 Pennsylvania Ave
Lot:9 Block: 5 Addition: Stafford Place
PID:10-72500-05-090
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Jeanie Kusie
4048 Pennsylvania Ave
Eagan MN 55123
(651) 207-4585
Home Depot At Home Services
656 Mendelssohn Ave N
Golden Valley MN 55427
(763) 542-8826
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA171448
Date Issued:08/17/2021
Permit Category:ePermit
Site Address: 4048 Pennsylvania Ave
Lot:9 Block: 5 Addition: Stafford Place
PID:10-72500-05-090
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
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 -
Chad S & Shannon T Moore
4048 Pennsylvania Ave
Eagan MN 55123
Corbin Exteriors Llc
1115 Southview Blvd
South St Paul MN 55075
(651) 760-3116
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA173380
Date Issued:11/09/2021
Permit Category:ePermit
Site Address: 4048 Pennsylvania Ave
Lot:9 Block: 5 Addition: Stafford Place
PID:10-72500-05-090
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Chad S & Shannon T Moore
4048 Pennsylvania Ave
Eagan MN 55123
Hero Plumbing Heating & Cooling Inc
10900 Hampshire Ave S
Minneapolis MN 55438
(612) 827-4674
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA173381
Date Issued:11/09/2021
Permit Category:ePermit
Site Address: 4048 Pennsylvania Ave
Lot:9 Block: 5 Addition: Stafford Place
PID:10-72500-05-090
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 -
Chad S & Shannon T Moore
4048 Pennsylvania Ave
Eagan MN 55123
Hero Plumbing Heating & Cooling Inc
10900 Hampshire Ave S
Minneapolis MN 55438
(612) 827-4674
Applicant/Permitee: Signature Issued By: Signature