4139 Pennsylvania Ave0 CASH RECEIPT J ;
CITY 4F EAGAN I
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE i 19
PECErvEO . ,i , .
ffiOM AMOUNT S - -'
J 1 -
O CASH
P( CHECK
Fon
BY
& DOLLARS
,ro
C t ? s?E? Wh,,e-Pa,ers ?„ 4
rauow--?osn? cocr
PirAc-File Copy
Thank You .
?
DATE
JUL 24, 1991
4139 PENNSYLVANIA AVE (KELCRIS INC)
x
Your Sewer & Water Permit for the above property has been completed. It will be heid at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannot be completed for the following
reasons:
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or accupancy allowed until further notice.
COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REGIUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
, .
BI)ILDING PERMIT
To oe used for 5F 1
CITY OF EAGAN
3830 Pilot Knob Road, P.O. 8ox 21-199, Eagan, MN 55121
PHO N E: 454-8100 ,
Receipt #
GAIt Est. Value S136.000 Date
SitaAddress 4199 p=t11NSYL_Vmla AY8
Lot 16 - Block -2 Sec/Sub. STAFTOBD ptACL?
Parcel No.
W Name KEICgiS It,fC
? Address 1000 E 146TN ST STB lol
° cit auxHSVi . . .
y Phone 454-0161
A Name ' SAME
$04 Address
F- City Phone
Name
City Phone
I hereby acknowlege that I have read this application and state that the
intormation is correct and agree to comply with all.'Applicable State ol
Minnesota Statutes and Gitv of Eaaan Ordinances. /
t0M I'S 4 4 0
; -, ,
' OFFICE USE ONLY
Occupan.Cy R-3 -H--1 FEES
2oniny?
(ACtual) Const
00
Bldg. Permit 766,
(Allowable) Y? gurcharge ?-?
N of Stories _
Lerkgth -609 Plan Review 498_AA
oePm 3?! sac, cicy 100 -ee
S.F. Total - SAC, MCWCC 650-00
S.F. Foolprinls -
On 5ite Sewage _ Water Conn
On Site Well Water Meter 9S-?
MWCC 5ystem x-
City Water Acct. Oeposil 30-00
PRVRequired _ SiW Permit 310-00
Booster Pump - SNV Surcharge ?
t ! ;? APPROVALS
Signature of Permitee 1 -* -••r?_4,
A Buildmg Permil is issued to' " /KZLdIS I NC Planner
- on Ihe express condition that all work shall be done in accordance with all Council
applicable State of Minnesota Statutes and City of Eagan Ordinances. gldy. pn.
Building Official Variance
00
Treatmenl PI 276,
Road Unit 370•?
- Park Ded.
? Copies
- TOTAL ? 3,543.
?
Parmit No. PermR Holdef Date Telephons #
WATER oZ?JO?
SEVYER '
PLUMBING `' 9 9/ ? ?l0 - 90S
H.VAG /
ELECTRIC
Inspection Date Insp. Comments
Footings I 2-2+ -9/ s
Foundation ?
Framing ?i' • 2 p/ D
Rooting ?S' ?(f/
Rough Plbg. .(?
Rough Htg. ?'d
ls,l. 9/i3 f i.?t
Fireplace
Final Htg.
Orstat Test
Final Plbg. Plbg Inspeclor - Notify Plumber
Const. Meter
EngrJPlan
Bidg. Final `I 2 Z -9 S
Dedc Ftg. Jr/? 9oZ ? U
Dedc Final IZ?.S 9 ?'f C?- _? ?..t; i,? 3 O/?•?.? -.3 ?".?
weu
Pr. Disp. 1 c)K .
16 l -9
1N SYLC:'1'lUN i11:UUK1)
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
. ?, . .,.? . .
SITE ADDRESS: APPLICANT:
VAN I A AVs A a I l=fi ,
+4 A 4
PERMIT SUBTYPE:
. „ TYPE OF WORK:
?,; , i , , ri
1_ttF t t 0 t MI I
cs-t .'t4!.
li? J2 3/eIR
141 PA rR
m I t:(' RFPA f!
INSPECTION DA . DA
.,?!',,, ? t • ? . , t:? ?i !,i f;F:
: ! Nr+l I; 11?
f'MA?tK`:! PIAH dtFVIFl.1FD F3Y Ctil I. Et{rl)f-S'ti_f . MT:;CF'tlRhlFfrllti REPAIK"; trtl(' 1 f1 ':i iitFtM IiAMA ltl
.. , ....- . ... ....
d
M
??
? ..?? i€"?£`??f
Permit Holder Date Telephone N
PLUMBING 8V-i9
HVAC
Inspection Uate Insp. Comments
FOOTINGS
FOUND
FRAMING
g
zxe,
?
ROOFING
/ ?
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
9 3 s'
BA ?? ??
GYP BOARD
FIREPLACE
FIREPLACE
AI R TEST
FINAL PLBG
FINAL HTG ?
ORSAT
TEST
BIDG FINAL /Z .15% c?
?
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONUUC'fIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FiNAL
r f
1
.:.? .
(Itrfifirate uf (Orru?attry
titp of Cagan
loPpa1't11tP1t# IIf l11tlbtttg jwPtftDtt
This Cp.rCi`ficate issued pursuant to the requirements of Section 306 of the Uniforni Buelding
Code certifying that al the nme of rssuance this structure was in compliance withW van"
ordinances of rhe Crty regulating building construclion or use. For the foTlowing.•
use CYassifinuon elea. Rrmit No. I?0
OccuP+-Y TYPe R3/m' 2ooing District Type Coe.sL VN
Owner of 8wlding MUM5 RE Address 1000 E 146IN ST. W-MVILiE
BAddress 413q_PF?SYLVAN?A AVMIE,om,;ty L16, B3, ST07ORD P11KE
10/22/91
Bwiding ,O&cial •
POST IN A CONSPICUOUS PLACE
4 .ti
?
Rd.
22-1897
DATE 3uI 19 1991
SITE ADDRESS 41 30 '' ' 'J 4NI A AvF
LOT 16-BLOCK -3 SEC/SUB STAFFOF:u PI_a(*F
nr r uvnl I I . --
' ADQRESS:
CITY, STATE ZIP
PHONE:
PLUMBER: t'i.DFI I 01-1 F'LLMBI'+G
ADDRESS: 12350 F.TYLR RIDGI: F',
` CITY, STATE BURNSVILLI: I?;•! ZIP 5'3_0
? PHONE: 890'9084
- OWNER: KELCRIS INC
ADDRESS: 1nM £ 146'rh ST JT:: 1(11
CITY, STATE BURNSVILLE MN ZIP 55337
METER # PERMIT DATE 07/z4/91
CHIP # PERMIT #
METER SIZE B.P. RECEIPT #
ISSUE DATE B.P. RECEIPT DATE 07 124 yl
- PRV - BOOSTER PUMP
SIGNATURE WHEN METER ISSUED
INSPECTIQNS. FOR STORM
, , , .T. .. .. .?_ .- . - . _ , ?
; SEWER & WATER PERMIT
CITY OF EAGAN
30 Pilot Knob Rd.
agarr, MN 55122-1897
ATE .7UL 19 1991
USE ONLY
PERMITDATE 07/24/91
CHIP #
METER SIZE 151? PA)S K
ISSUE DATE 'f1
SITE ADDRESS 4139 PENNSt'' '4AN'
LOT 1? BLOCK_3_-SEC/SUB STArr'0?<1)
i APPLICANT:
ADDRESS:
CITY, STATE ZIP
PHONE:
PLUMBER:k ry_;,DERitOTT PLUMBING I[aC
ADDRESS: 12350 kIVI:T RIDGE BLV[-
CITY. STATE BJR1+:5ViLI,E '::: ZIP IJ5337
PHONE: 890-9Qf14
PERMIT REQUESTED
?L SEWER WATER - TAPS
COMM/IND ? RESIDENTIAL ?
X_ NEW
EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be given for Deduct Meters.
?
I AGREE j0 COMPLY WITH CITY OF
EAGAN dRDINANCES
PERMIT # 1917n B.P. RECEIPT # ) . I -! ' ?.
B.P. RECEIPT DATE 07/2491
_ PRV - BOOSTER PUMP
PERMIT REOUESTED
_ SEWER _ WATER - TAPS
_ COMMlIND
X NEW
X RESIDENTIAL
_ EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be given for Deduct Meters.
. v" 1 li?inG?f v 'OWNER: ` c?.CRIS E ORD
ADDRESS: 1000 E 146', i: ;`. :: Tr. ]•_ i
CITY, STATE BURN;;VTi,LF. VN ZIP >`,337
,
i-po'LEAgE ONE: SIGNATU E
ALLOW TWb WORKING DAYS FOR PROCESSING. CALL 4545220 FOR
?ON?LY CITY OF
VAN S 7_?? _
VH ETER ISSUED
INSPECTIONS. FOR STORM
$EWER PERMITS, CONTACT ENGINEERING DEPT. or
CITY OF EAGAN N2 19440
3830 Pilot Knob Road, P.O. 6ox 21-199, Eagan, MN 5512
PHONE: 454-8100
BUILDING PERMIT Receipt # + 144
Site Address 4139 PENNSYLVANIA AVE
Lot 16 Block 3 SeGSub. STAFFORD PLACE
Parcel No.
ed for SF DWG/GAR Est. Valu$136,000
OFFICE USE ONLY
Occupancy R-3 -H--1 FEES
Zaning
(Actual) Const V=N Bldg. Permit 766.0
0
(Allowable) -V-- N Surcharga 68• 00
M ol Stories
lengN 60 ' PIan Review 498.00
Depth '18, SAC, Cily 100_ nn
S.F. Total - SaC. MCwCC 650.00
S.F. Foolprints -
OnSiteSewage _ waterConn 660.00
On Sila Well - Walar Meter
0
95.0
MWCC System X
Ciry Water ? Accl Deposit 30. nn
PRV Required - 5/W Parmil 30_ nn
Bopster Pump - 5/W Surcharga . 50
Treatment PI 276.00
APPROVAL9 Road Unil 3 70 _ 00
Plannar - park Detl.
COUncil
BIdg.Otf. _ Copies
Variance - TOTAL it/ j. 543. 5C
w Name KELCRIS INC
o Address 1000 E 1415TH ST S7'E 101
City BURNSVII LE phone 454-0161
A Name SAME
p?a Address
? City Phone
I?WIName I
w
? ; Address
a W City Phone
I hereby acknowlege ihat I have read this application and state Ihat Ihe
information is correcl aVA wilh all pplicable Slate of
Minnesota Stalutes and ces.
SignaNr
e of Permitee A euilding Permit is issued to: KELC IS INC
on ihe express condilion that all work shall be done in accordance with all
applicable Stale of Minnesota Statutes and Ciry of Eagan Ordinances.
Building Oflicial
6-;
isos.?
?
62
p
385
Feduest Date Fiva No. ough-in Inspection
equiretl?
? Feady Now )i(Will Notity Inspecror
g - xVes C No When ReatlyP
I;K licensed contracior ? owner hereby request inspection ot above electrical work at:
Job Hatlress (SUeet. Box or Route N94 ? Clry
?s v « ?
Sec on o. ownship Name or No. Ranqe No. Couni ik/c
occopant(PRINT)
C
1 Pnone No.
a?l.S7
7
C S
Power Suopl,er Atltlress /
Electn<al Co?cfacto? ICOmpany Name)
K Conhaclor5 Licenu No.
Mailing Add:ass (COmrador or Owner Making Inst lalio
?
' L
i.
o J d
Authorrzetl Sicnawre 1 onhacrorrOw aking Installa!i A
` ), Phone Number
.3S-3?b
MINNES TA STATE BOAPU OP CTRICITY THIS INSPECTION REOUEST WILL NOT
Griggs-Miaway BIEg. - Room 5-173 BE AGGEPTEO BY THE STATE BOAFD
1821 University Ave.. St. Paul. MN SSIOC UNLE55 PROPER INSPECTION FEE IS
Phone(612)6<Y-OB00 ENGLOSED.
REQUEST FOR ELECTRICAL INSPECTION ee-ooom-oa
,
lil? See insiruqions lor com0leting brm on back o( yellow mpy
k
?? ? C' /sos 3
"X" Below Wo?rk Covered by This Request ?• "-k`
e 9dd Rep., Typeof8uilding AppliancesWired Equipmen[Wired
Home Range Temporary Service
Duplex water Heater Electric Heating
Apt Building Dryer Other (Specity)
Comm./Industrial Furnace
Farm Air Condilioner
Othar (syeatyl
Compute Inspection Fee Below: CanVaororS Remarks:
x Other Fee # ServiceEniranceSize Fee # Circuits/Feeders Fee
Swimminq Pool 6Ja-7B9-Pcmps f/1 4 t0 100 Amps ?
hanstormers Above 200 _ Amps Above 100 _ Amps
SignS inspecior's Use Only. TOTA/L 5-?
Irrigation eooms
Special Inspection
Alarm/Communication THIS MSTALLATION MAY BE ORDERE DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 1 NTH f
I, the Electrical Inspectoc hereby R009"-'" Date w? R
certity that the above inspection has
been made.
? a?a
OFFICE USE ONLV
Tnis request voitl 18 monNS imm
.,
Address:4139 PIIVPISYLVANIA AVFN[JE Lot 16 Blk 3 Sec/Sub gTApFpgp prAC:E
These items were/were not complete at the time of the final inspection.
]0 22 A1 Yes No
Final grade (6" from siding) w w(I hm?
Permanent steps - garage ?
Permanent stepa - main entry ?
Parmanent driveway ?
Permanent gas i/
Sod/seeded grass ?
Trail/curb damage ?
Porch
Basement finish ?
Deck
Please verify with the tuilder the removal o£ roof test caps £rom the plvmbing
system andthe shut-off of water supply to tha outside lavn faucet before
freeze potential exists. ?
acmEO?n
White - City copy Yellow - Resident copy Pink.- Contractor copy
, ?
1991 BUI S P I APPLICATION
CITY OF EAGAN
J
SINGLE FAMILY DWELLINGS
2 SETS OF PLANS 3 REGISTERED SITE SURVEYS
1 SET OF ENERGY CALCULATIONS
MULTIPLE DWELLINGS
COMMERCIAL ?
2 SETS OF PLANS 2 SETS OF ARCHITECTURAL ?
REGISTERED SITE SURVEYS - @ STRUCTURAL PLANS
(CHECK WITH BLDG. DEPT.) 1 SET OF SBECIFICATIONS
1 SET OF ENERGY CALCULATIDNS 1 SET OF ENERGY CALCS
_# OF RENTAL UNITS
_# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MUST DESIGNAT$ 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: SirosfC Valuation
Site Address 11131 p^'V?f„a,?)1 ?tl. I
Lot ZCr Block 3
Parcel/Sub jfA CC, j {/-?i?
Owner A-,1..4C2e5 r(Tlr
Address / DDO wz'I04
Cit Zi Code?(y/ p J,f /e. .(;?&732
Phone 4S +-/ O /(o /
Contractor
Address
City/2ip Code
Phone
Arch./Engr. 4, 1 pdtun/J
Address
City/Zip Code Lycroia,.v?
Phone # 4vy25 Da 8%
f3??
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F.
Date: . 7''1 ` ?Z_
OFFICE USE
FEES
` 3 /z'J-/ Bldg. Permit 2(1(1
Surcharge <?-
? Plan Review
? SAC, Gity /O 6
SAC, MWCC 41SD _
S9,3ro Water Conn. 60
3 2,a7 Water Meter
Acct. Deposit 371
S/w Permit 3?1
S/W Surcharge ,Sa
On site sewage_ Treatment'YI. z?G
On site well Road Unit 3 2p
MWCC System Park Ded.
City water ? Trail Ded.
PRV _ Copies
Booster Pump _
SIIBTOTAL
APPROVAIS Penalty
Planner Lot Change
. Z10
Council '
TOTAL 'S `) `' ) r
Bldg. Off
Variance
agrees that all work shall be done in accordance with
(Signature of Contractor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
b
QSkwF
7 3,t- 2?,s ? ?so•?s ?g , .dAli ?
/12
?
-2?-3 k 28l?x lY =
. 266
jo
?-
2y,?
Ss/yr.2
?---
f
, ?
_,.,?..
.• , :?: CITY OF BIIILDIN4 DEPART?MENT
I;XTERIOR ENVF3,OPE AVERAQE IIUII COMPUTATIUK
(To be submitted with building permit application)
one or Tiuo Family Dwelling 4 Owner , C
All Other ?S NG
Contractor /< , p _I Gprs --T. )
LINEAL FEET OF
EXPOSED VlALL
Stte Addreae
Date ln/-°J / Phone
fte above grade = ',(,p ? 2 S
1Y1TAL i;XpOSED ",YALL ARr^.A SQ, FT.
OPAQUE WALL CONSTRUCTIOtd: "U" Value x Area :.
Detail "p" • b?? x S
reference _
x .
s2
from ' U
: Job0 x SQ.
attached '
"U g gQ-
sheets X S?,
upn
x
Sq,
WIND01Y5: " UP' Value x Area
Make & Type ? v
w?c_, c?.? ?r„U?,
?
;, u ,
X
- SQ.
it if ??U?? x SQ.
„ IIUI
sQ
.
np n X SQ.
DGORS: "Ut' Value x area
Malce & Tyne o U r.. a?
Ulf 114
ii ::
) U u0u
% Q
3'
n n npu
o „
itUal x 34Z.
_ x SQ.,
TOT ALS 7?Q
AV
TOTN. (U) (A) VALUES ERAc3E Ulf
DIVIDED BY TOTAL S7/LL AREA 25
?T
AVERA(iE IIU9 _i+s-a leas for 1&2 family dwellinge
C?-:''..
RoOF/CEILINas
TOTAL aREA: LbZ/
__ _
FT.'L7SZi2.5l?f(U)(A)
?
.
FT 113?F (U) (A)
FT. a??= rD,? D (U)(A)
FT. _ (U)(R)
- (U) (A)
FT. _ (U) (A)
FT. , ?i.(U) (A)
FT. _ (U)(A)
- ?U)(A)
FT. _ (U)(A)
FT. -42
,0
0 _ Z,S 6c (U) (A)
.,
-
? ?A)
:
_ (U) (A)
FT. _ (U)(A)
r,T. 7i77 r (0 $ (U) (A)
Detail reference
froos IIUII / 0 2. 11 x 8
R.
FT.
attached sheets. nUte
IIUII x
Sq.
FT•
? (U)(A)
Describe oaenittge „U,? x SQ. FT, F (U)(A)
in roof. upn Y sQ. FT. ? ?d)(A)
x 9Q. FT. ? (II)(A)
TOTAL (II) (p) VALUE3 DIYIDED BY 24 1? I Z ' 're, 714V2 I 17? kftZQ '(01L
L (t1
TOTAL ROOF/CEILIN(3 AREA j' 7,7?
AVERA(3E "IIL ventilated roofe.
.1
A WOR4 ,Z(?, ?v3 x( 4? ;{-- (z-+-
1?. 157, 494- i?o-f- iQ-)
?r7l 2*4
?
x
_
o (0, 7x
-?s
An
?'
C49 -t i-z-- 14) s" ? p?-r??
ZfA?f ? )? (ikl- 1 p =
W I N s.
2 ?la,?-28 =? Z X6?5"P IIXz. = Z2 103,??
1?A-,X 2a = '
Z,s x4 = IoXI ? I ? ?' ??n?
[Lo L
Ioi?xl^" ?
4-,vX Z2,nx I = 22,vo
4, p?t- 4,5 8,ox1= o
z
2G-
ZBx14;????Z?
. i ' : •
Detormining 1,U" values at Roofo Wall$ Rims end Conc, Blocls
ROOF/CEILINQ
1.) Interior Air P'ilm
2.) 51e11 ayp. Ba.
3.) Insulation
4.l .
5.) Exterior Air Film
, (6TILL)
It VALUE
0,61
.56
`I4,00
.61
. up?l a I/R. ! ?ZI '1bTAL ( R) ? ?.? ?7g
WALL R VALUE
60 ..Interior Air Film 0,68
7.)
8.)
' P aYP. Hd.
Insulstlon ?E5
. J9,o O
9.) ?'?vrtT {_',17'E Z.o q.
10.) Ftaeonite Siding .67
11.) Exterior Air Film 117
upto TOT1lI, (R)= r
.5. O ?
RIM R VALUE
12.) Interior Air Film 0,68
130 Insulstion 17pp
14•) 211 Fir Rlro Jo1eE 1,88
15. ) .P?1LI"- P17'F oq
16.)
MasoniCe siding z
,
67
170 Exterior Air Film ,17
upn a IIR? ?/?d? TOTAL ($)= z,/,I??
. L. 7
FOUIiDATION R VALUE
18.) Interior Air Film 0,68
19.)
20. ? g-li sr?rrr?? ?l
oo
21.) 12" Conarete Block .
1,28
22.)
23.) Extarior Air Film ;17
upu = 1/R= a, 07(o TOTAL (R)
PERMIT
CfTY OF EAGAN
3FJO,P.iIcQKnob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
P.I.N.: 10-72500-160-03
DESCRIPTION:
x.
s '
.
i
?.?
, ,. . ?
- - -r _ -
PERMIT TYPE:
Permit Number:
Date Issued:
4139 PENNSYLVANIA AVE
LOT: 16 BLOCK: 3
STAFFORD PLACE
F--? MISC REPAIR5
Building,Permit Type STORM DAMAGE
,building Wark Type REPAIR
Census Cade '?, 434 ALT. RESIDENTIAL
BUILqING
0326 5
07/23/98
REMARKS:
pLAN REVIEWEO BY BILL BRUESTLE.
FEE SUMMARY:
MISCELLANEOUS REPAIRS DUE TO STORM DAMAGE.
CONTRACTOR: - Applicant - sT. I.IC
ROIVEL RESTORATIONS 14351992 0002158
P 0 BOX 240744
APPLE VALLEY MN 55124
(612) 432-3444
OWNER:
CIHLAR BRENDA
4139 PENNSYIVANIA AVE
EAGAN MN 55123
T hereby ecknowledge that I have read this applicet'ion and state that the
anfc7rmatio;n ,iS oorrect and pgree to flpmply with all applicable Stats of Mn.
Statutes and City of Eagan Ordi;nences.
L __
APPLICANT/PERMITEE SIGNATURE
ISSUED BV: SIGN TURE
I
' 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
'• ?.' _ CITY OF EAGAN
3830 PII.OT KNOB RD - 55122
l0 `-Y 681-4675
New Canstructian Reauirements RemodeVRenair Reouirements ?
9
? , 3 registerod sde surveys
? 2 copies of plans (inGude beam 8 window s¢es; poured fntl. design; etc.)
? 1 energy calcuWtions
? 3 copies of tree preservation plan 'rf bt plaCed aRer 7!7/93
required: _ Yes _ No
DATE: / -
OESC TION OF WORK:
S ET ADDRESS: ?
LOT: I ?v BLOCK:
? 2 coPies oi plan
? 2 site surveys (exterior additions 8 decks)
? 1 eneigy calculations for heated additions
CONSTRUCTION COST;
-1 a e-loo-) ?
?
J?nv .? a-3
SUBD./P.I.D. #: SkGk, ?- ? () f CQ ?? cc c- -'?j
PROPERTY
OWNER
CONTRACTOR
Name: Cl jjL/1,?2 eK'y?? Phone #:
I.est First
Street Address:
City r/'"i State: /n- Zip:
ie tt:
License # V/
city ?A00?? / State: /W,"- zip:
ARCHITECT! I/p
ENGINEER Company: ? v d Phone
Nazne: vrb , }{i/.?? / ? Registration k: ? ClISl ?
Street Address: A-y-e
City State: ?V(,v Zip:
Sewer & water licensed plumber (new construction ony): . Penalty applies when address chang
and lot change is requested once permit is issued.
I hereby acknowledge that 1 have read this application and state that the
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
is)tortect and agree to camply witti ali applicabl
IL 21 MB
Tree Preservation Plan Received Yes Na Not
OFFICE USE ONLY
BUILDING PERMIT TYPE
.? ..
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dweliing ? 07 4-plex O 12 Multi RepaidRem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory 0 20 Public Facility
? 04 SF Porch ? 09 12-plex ? 14 Firepiace ? 21 Miscellaneous
? 05 SF Misc. ? 10 = plex ? 15 Deck
WORK TYPE
? 31 New ? 33 Afterations ? 36 Move
O 32 Addition PP 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building j
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code. Y. 7 el
SAC Code
Census Bldg ?
Census Unit 0
Engineering Variance
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 "
Total:
Valuation: $
% SAC
SAC Units
PERMIT #
CITY OF EAGAN
1992 BUILDING PERMIT APPLICATION
681-4675 >>
,rAY 14. RECO
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural.•b structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typin? of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date ? Valuation of work
5ite Address: yI3? Za'I??_-'?rfli1,-W [-4? - 144
STREET 8TE !
Tenant Name: (commercial only)
l0T _ IlD BLOCK SUBD. U_ P.I.D. ?
Descri tion of work:
The applicant is: 14 Owner Contractor O Other coescr;be>
Name % el.a Phone a F5i-(ciql7
Property LAST FlRS7 ,i, cf?_ ?g(,d
owner qddress
. STREET STE M
City a'V\ State Zip Z3
Company Phone
C011tr8CtOf Address License # Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registration Ii
Address
City State Zip
Sewer S water licensed plumber . Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with ali applicable Sta e of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applican : -4? ?.
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 05 Apt. Bldg O 09 Basement Finish
? 02 Sf Dwg. O 06 Garage/Accessory ? 10 Swim Pool
? 03 Two family O 07 Fireplace ? 11 Res. Add.
? 04 Multi-fam. T.H. JC 08 Deck ? 12 Res. Porch
woRK rrPE
%,31 New ? 33 Alterations ? 35 Move
? 32 Addition 0 34 Tenant Finish ? 36 Demolish
GENERAL INFORMATION
Const. (Actual)
(A1Towable)
UBC Occupancy ?
Zoning
t of Stories ?
Length
Depth
APPROVALS
Planning
Engineering
REDUIRED INSPECTIONS
? Site
? Mallboard
Basement sq. ft.
lst fl. sq. ft.
2nd F1. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Building
Variance
E% Footing
JK Final
? Framing
? Draintile
? Insulation
? fireplace
Permit Fee ? veiuatia,: s
5urcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Mater Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment Pl.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC X
SAC Units
,
Y?
13 13Co? ?
? 14 Co?d Adtl
...O 15 Comn/Ind Rem
0 16 Public Fac.
? 17 Agricultural
MWCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler ?
Census Code
SAC Code
Assessments
I(? /? BL CITY USE ONLY RECEIPT #: ( ,,S7
L J? n
SUBD. ? RECEIPT DATE:
1998 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, D4d 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground spr'inkler system
------------------
FIXTURES -----------------
EACH ------------------------------------------
# TOTAL
Shower 3.00 x =
Water Closet 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x =
Floor Drain 3.00 x =
Gas Piping Outlet * minimum - t 3.00 x =
Rough Openings 1.50 x =
Water Softener ` for tlwellings under construction 5.00 X =
Water Softener " for existing dwelling 20.00 x =
U.G. Sprinkler " for dwelling under const. 3.00 =
U.G. Sprinkler ' for existing dwelling 20.00 =
Alterations " to existing residence 20.00 = f7r96
Water Turn Around 20.00 =
Private Disposal System " MPC lic. 75.00 =
(new and refurbished systems)
Private Disposal Systems'nbandonment 20.00 =
RPZ (new installation only) 20.00 =
STATESURCHARGE .50
TOTAL c, SD
------------------------------------•----- --------
------------?--------------------------------------------
I hereby acknowledge that I hava read tl?is application, state that the infortnation is correct, and agree to comply wdh all applicable Ciry of Eagan ordinances.
It is the applicanPs responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the C8y during its
nortnal operational and maintenance activitias to the facilities constructed under this permit within City property/right-of-wayleasement.
SITE ADDRESS: '// 3C) APHi7 YP?,Vr/1 l7`G /
OWNER NAME: /1?10 N ? r yf Ew
INSTALLER NAME: eel
j TELEPHONE#: G???' CCS?
STREETADDRESS: 375-0 A?,-?// &
CITY: k-GYril STATE: ?y h ZIP: ;>
SIGNATURE OF PERMITTEE
CO/PERMIT FORMS/RPLBG PERMIT (RES) - 1998
CITY OF EAGAN
3830 PIIAT RNOB ROAD
EAGAN, 1N 55122
PHONE (612) 454 8100
#E?sarrzc??:: A"x:
ZIP:
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS S7HEN PERMITS ARE BEQUIRED FOR EACH UNIT.
WORK DESCRIPTION
NEW CONST
ADD ON _
REPAIR ?
OWNER NAME: /f7O.mA S /1 C I 14 LA ?
SITE ADDRESS: -7] 39 q-"l/U& ?14
LbT:1& BIACK ,3_ SUBD.
INSTALLER: cfCC)a'?L-IE'.
ADDRESS: 1147 4Y4'rl- 94-
cirY: ?? pex,.-F ziP: S?l b ?
PHONE #: 77yr 326o w yE??_ ^I
FOR CITY USE ONLY
YERMIT #
RECEIPT #
DATE: T? a 4
FEES
ADD-ON MINIMUM $15.00
HVAC 0-100 M BTU 4.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS - MINIMUM c/ - 3.00 I'7-
OF 1 PER PERMIT
SUBTOTAL:
STATE SUftCHARGE: .50
TOTAL: $ 3GS?
? ?.4? K
SIGNATURE OF YERMITTEE
TIIS£RCiAL?iNbVSTRTALi'? PLEASE COMPLETE THSS PORTION FOR ALL COMMERCIAL/INDUSTRZAL BUILDINGS,
? ..... . .
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDZNGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH Dti1ELLZNG IINIT.
------------------------------- _____----------------- _____________-________-_---_
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
IAT: BLUCK _ SUBD.
INSTALLER:
ADDRESS:
CITY:
PHONE
FOR:
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING - $25.00
$25.00 lfINIMIJM FEE.
CONTRACT PRICE x 19
STATE SURCHARGE
TOTAL:
$
(SIGNATITRE)
CITY OF EAGAN
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
FOR CITY USE ONLY
PERMIT #
RECEIPT # /O / S
DATE: 177 9 IV
PLEASE COMPLETE IIPPER PORTIDN ONLY FOR SINGLE FAMILY
TOWNHOMES/CONDOS WNEN PERMITS ARE REQUIRED FOR EACH UNIT.
---------?--------------------------------------------
WORK DES,ERIPTION
NEW CONST 1?
ADD ON _
REPAIR _
OWNER NAME
Kelcris Inc.
SITE ADDR6S5: 4139 Pennsylvania Ave.
LOT:1j/ BLOCK f SUBD. ?
INSTALLER; McDermott Plwnb Ync.
ADDRESS: 12350 River Ridae Boulevard
CITY: Burnsville ZIP: 55337
PHONE #
PERMITTEE
DWELLINGS &
COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOT6L
ADD-ON MINIMUM 15-98
? SHOWER 3.00 13_
3 WATER CLOSET 3.00 44?_9°a
? BATH TUB 3.00
? LAVATORY 3.00 y_
L, KITCHEN SINK 3.00 ..o
L LAUNDRY TRAY 3.00 3?oa
HOT TUB/SPA 3.00
WATER HEATER 3.00 ,em
? FLAOR DRAIN 3.00 ,o>
GAS PIPING OUT.
? (MINIMUM - 1) 3.00 3•ee
? ROIIGH OPENINGS 1.50 ?rv
_ OTHER
WATER SOFTENER 5.00
PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
.j9• So
SUBTOTAL $ ST. SURCHARGE 50 0 ? .50
TOTAL: S 34'?
COMMSEfCiAL?i?1J7T?S?`R?lAL:` PLEASE COMPLETE THIS PORTZON FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND
MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
-------------
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE
FOR: _
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $_
STATE SURCHARGE $_
TOTAL: $
(SIGNATURE)
CITY OF EAGAN
Sur?ve?or? L'ert?f?cate
SURVEY POR: Kelcris
DESCRIBED AS: Lot 16, Block 3, STAFFORD PllACE, City of F,agan, Dakota
County, Minnesota and reserving easements of record.
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EAGAN F
PfiOPOSED ELEVATIONS
Top ol FvundeUons = 930. i ?
Garage Floor = 9L8•?
BasemenlFloor
Approx. Sewer Servica Elev. ?
Pmposed Elevalions e ?
Exlsling Elavellons
Dralnags Direcllons
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VEVEDBYMEORUNOERMYOIRECT6UPENVISIONANDDOfiSNOiPURPORT TO SHOW IMpqOVEMENt6 OR EMCROACHMENTS, EXCEPT A8 6HOWN. BOOK: PA(
Deie 713 i9j? Llr1F7t"^'a C)•
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MIMNE90TALICEN9@ NUM9ER 1?)18 t6b- I6
b6
?
Use BLUE or BLACK Ink
I For Office Ussep~/
Permit#:/ 4~U (Io
City of EaRd l I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I I
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ~ Site Address: H 1 (I~ L I Y / X 9-/ L 1111941119 &it
Name: Phone:
RESIDENT /
OWNER Address / City / Zip:
Applicant is: Ownerontract~o}r
TYPE OF WORK Description of work:
Construction Cost to 66b Multi-Family Building: (Yes No )
Company: c(2 6(U QV/9 j) (,6P U _13y 125 /61Q Contact: `J I r/,-,-
CONTRACTOR Address: [ 7Y I AIX Wd~ WLL5 77'~d kcity: L6 V E Z U
State: MN Zip: 51'n 9k Phone: 25-2 - 21 ' G 3
License M 13 c 36 q ( Lead Certificate M
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
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.gopherstateoneGall.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 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.
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.
x H V IEs V~1 i~ ~z H y
Applicant's Printed Name App ' ant's Signature
Pag 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA176800
Date Issued:06/02/2022
Permit Category:ePermit
Site Address: 4139 Pennsylvania Ave
Lot:16 Block: 3 Addition: Stafford Place
PID:10-72500-03-160
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
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: 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 -
Michael J Reinders
4139 Pennsylvania Ave
Eagan MN 55123--158
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-7052
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA179794
Date Issued:10/19/2022
Permit Category:ePermit
Site Address: 4139 Pennsylvania Ave
Lot:16 Block: 3 Addition: Stafford Place
PID:10-72500-03-160
Use:
Description:
Sub Type:Fixtures
Work Type:Alteration
Description:Bathroom(s)
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
All tiled shower bases require a water test.
Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
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 -
Michael J Tste Reinders
4139 Pennsylvania Ave
Eagan MN 55123
Boevaag Plumbing Inc
P.O. Box 1257
Prior Lake MN 55372
(952) 292-1511
Applicant/Permitee: Signature Issued By: Signature