4146 Pennsylvania Aver ?
DATE:
JUN 27, 1991
4146 PENNSYLVANIA AVE (MITTELSTAEDT BROTHERS)
X
Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (4545220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannot be completed for the following
reasons:
Your Sewer 8 Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
COMMERCIAL PROJECTS oNLY: Please pay far 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.
- REQUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
r:
0 CASH RECEIPT -
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE -7 19 c?
'?F-l0m ? IrtTF ?S4 (t P c1 i- V)-y C `-- AMOUNT S
? l ,? ?
& DOLLARS
,oo
? CASH 'U'CHECK
sap C " ? r ?? I i .• l - s ?% ?•i - ? ' 1?`'
Va ( E - ?-? 14 4 v A ??k •
_ r w . .1 r' .5 ,-7 • ?
C 14 i 97 wm---Pey- COPY
v"--aoe*,, copY ?
Pink-Fib Copy
Thank You
BY
5/21 /92 -??-- ---'"-•"•+'?-?•-r
. .? =? ,.....,? .
Bkt ANG295M -(x)454-0739(W)223r-2678 CITY OF EAGAN p, 13
? 9V3
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 `""
PHONE:454-8100
BUILDING PERMIT Receipt #__ ( t-i
To be used for s? ?/01111,1111: Est. Value $91 ,OW Date 'jun 26• 19 91
Site Address 4146 lgM4LYAi11A Alit
Lot 20 L Block I- Sec/Sub. ?AFIM PLACI
Parcel No.
W Name N1TiRI.BtwLdT W03
3 Address 785 92111SE4 D?
° City AGnH Phone 456-9125
Name g"
Address
bw ?WName
r-
?? Address
<W City Phone
I hereby acknowlege 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 Ciry of Eagan Ordinances.
Signalure of Permitee ' • .,, •• ,?*-*? ? • : ' .<r - ' ?
A Building Permit is issued to:
on the express condition that all work shall be done in accordance with all
applicable State ot Minnesota Statutes and City of Eagan Ordmances.
Building OfliCial
OFFICE USE ONLY
Octupdncy R"",_L K-1 FEES
Zoning
(Actual) Consf v*j__ _ Bldg. Permit 1 s19.OO
(Aliowahie) ?4- Surcharge 43A50
# of Stories - 389,00
Length Plan Review
DePth ?- SAC, City 100000
S.P. Total _
sAC, Mcwcc b???
S.F. Footprints -
On Site Sewege _ Water Conn b0.00
On Sde Well - Waler Meter 95000
MWCC System U_
?
?
t ?.?
Ciry Water ?_
'
??
PRV Required _ S/W Permil, 30000
Booster Pump - g(yy Surcharge • 50
Treatment PI
APPROYALS Road Unit 370.00
Planner - Park Oed.
CounCil ?
BIdg.Ofl. _ Copies
9 ?s,OO
Vana?e - TOTAL
` pKmit No. Permit Holder Date Telephone #
WATER ??O Y 7 9
S?GYER ?
PLUMBING
H.VAC.
ELECTRIC jJ 29,2
k?spettion Dste Insp. Commsnts
Footings I 7 ? ?
Foundauon l9/ tl LJi?1?
Framing 7 7
Roofing
Rough Plbg.
Rough Htg. 7f?
Is,i.
Fireplace
Final Hig.
Orstat Test
Final Plbg. , s. Plbg. Inspector - Notify Plumber
Const. Meter
Engr.lPlan /
Bidg. Futal 60-"2 2 ? ?S
Deck Ftg.
Dedc Final
Well Ow
Pr. DiSp.
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
•+ ?t+, r t WN .•r I - nFllR AVi
; l A f f Il H (.l {' L A i: i- ( b 1 ." ) .' .' :t . + : (W)
PERMIT SUBTYPE:
, ' i rii ;li . It" I'
TYPE OF WORK:
?:II I I I1 1 Nfr
0 .' 110 I I1
INSPECTION DA • DA
??f?i,Yl I iJ t' I iIl? t 1 hl?l l
Hr MnKK ti: !,t? ?AVA rI rt P?a i r•, pRE I40U ! iff 10 r oR ANY t' I IIMH 1 Wti nR t i tc ? 4?jo Ai 1.1+10
F
-J
L
PermR No. Psrmft Holder Date Telephone i
S/W
PLUMBING ,?lJ?
HVAC
ELECTRIC
ELECTRIC
Inspectfon Date Insp. Comments
Footings I
Foundation
Framing ?OS- c5-
Rooflng
Rough Plbg. PT6
Rough Htg.
r?
Isul.
Fireplace 2r''
Fnal Htg.
Orsat Test
Fnal Pibg. Plbg. Inspector - Notify Plumber
Const. Meter
EngrJPlan
Bldg. Final
Declc Ftg. ?
Deck Final 1 / E N'G E
-
n4/ /r !sr
Well ?t/?f'(? ? ? • . /
Pr. Disp.
?6
?'J .
MM-" IgViOM 5121/42
' -(H)154-073q(W)223-2678 `
gtr#tfira#e uf (Orrupattry
Cf tp of (Eagan
mqmlatptt# u# Nai(bitg Jtcsprtim
poieued pwrsuWAo 1he requir+emmbaf Section 306 of the Unifonn Bui1d&ig
GiNmiWgirt at the time ojiuumuae deis souctune xw in compliance wi11i rhe ?+cuious
aM dOrCity reguladng buiTding conmuctiort or use For the foUowing.
SF DWG2W ? ? ? 1Q338
R3 = ?
- - MITIHSDIDrT ? ? .
?ry
8/22/4j
, Z-
POST IN A CONSPICUOUS PU1CE
SEWER & WATER PERMIT
CITY OF EXGAN
3830.PiLol Knob Rd.
Eagan, N 55122-1897
JUNE 25, 1491
? . ..
METER # -
CHIP #
METER SIZE
IS5UE DATE.
SITE ADDRESS '?1t`6 nER'R?;YLIiANlt? AV!:
LOT 20 BLOCK 1 SEC/SUB STk?FQV NlliI
APPLICANT:
ADQRESS?
COMM/IfVD Y RESIDENT{AL
- PRV - BOOSTER PUMP
USE ONLY
PERMIT DATE 46J27 f 91
PERMIT # t? lc4
B.P. RECEIPT# C I4197
B.P. RECElP7 OATE 06 12 7 /()1
PERMIT REGIUESTED
X SEWER WATER - TAPS
STATE ZIP ? NEW - EXISTING
PLUMBER: MCDUNALD PLl1'.38ING SYSTEIT5 I _ti
ADDRESS: 18271 Y.LNivOCt? TR
CITY, STATE 1-1KEVILLi, i•,A Zip 55044
PHONE: 425-333w
OWNER: 1:1T1EL.QTAFfl'I BBtQ3
ADDRESS: /F,S SUNSIiT DR
CITY, STATE EAGAN ZiP ;5123
PHONE: 456-9125
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be given for Deduct Meters.
I AGREE TO COMPLY WITH CITY OF
EAGAN ORDINAPICES
SIGNATURE WHEN METER ISSUED
.EASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR {NSPECTIONS. FOR STORM
:WER PERMITS, CONTACT ENGINEERING DEPT.
SEWERA WATER PERMIT
CITY OF EAGAN
3830 Pilot 1:nob Rd.
Eagan, MN S122-1897
DATE j[JNF. 26, 1991
OFFICE USE ONLY
ME7ER # L? AIDG& (1 PERMIT DATE ??'r 27 f 91
CHIP # ? J??'? ? PERMIT # 121G4
METER SIZE B.P. RECEIPT # C 14197
ISSUE DATE B.P. RECEIPT DATE 06 27 91
_ PRV - BOOSTER PUMP
JITE ADDRESS 4146 PENNS i'LVANlA AVE
OT ' BLOCK i SEC/SUB STAFFO? ?ACS
APPLICANT:
ADDRESS:_
CITY, STATE
PFiONE: -
PERMIT REQUESTED
x SEWER )' WATER - TAPS
- COMMIIND x RESIDENTIAL
ZIP X_ NEW - EXISTING
Lawn Sp6nk4er Meters are to be lnstalled
PLUMBER: - MCDGNALD FLttl4BTNG SY3TEM5 INC Ahead of Domestic Meters on Water Line.
ADdRESS: 18271 KENG'00D TR Credit WILL NOT be given for Deduct Meters.
STATE
CITY LAYLVILLE t•lt' ZIP 55044 1.,1
•
, ?.?.?. ,..,? ?,
X ?
; PHONE: ?'s35-3334
I 1 AGREE TO COMPLY WITH CITY OF
! OWNER: °.11iTELSTAEaT B-tOS EAGAN ORDINANCES
' ADDRESS: 735 SUNSi.T DR
FAGpN 5.5123
? CITY, STATE ZlP
136
91
"' 5 IGNATURE H TER IS U
PHONE:
t -
f PLtASE ALLOW .
, • , , ;
T'1Af0 WORI(fNG DIrYS POR PROCE ;
SSING. CALL 454-5220 FaR INSPECrIONS. FOR STQRM
t SEWER PERMITS, CUNTACT ENGINEERING DEPT.
?
?'_`?
-- -- - - -
CITY OF EAGAN N2 19338
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454-8100 (a I`"?
? f1n-1
BUILDING PERMIT Receipt # ?? ? I/
Tobeusedfor SF DW6/GAR EsLValue $91,000 Date JIJNE 26, 1991
Site Address 4146 PENNSYLVANIA AVE
Lot Za Block 1 Sec/Sub. STAFFORD PLACE
Parcel No.
w IName MITTELSTAEDT BROS
0 Address 785 SUNSET DR
City EAGAN Phone 456-9125
a Name S?
Address
? City Phone
?
WW Name
LAddress
aW City Phane
I hereby acknowlege that I have read this applicalion and state that the
information is corred and agree lo wmply with all applicable Slate ot
Minnesota Statules and t of Eagan Ordinances.
Signature of Permit?
A euiiding Permit is issued to: MITTELSTAEDT BROS
on the express condition thet all work shall be done in accordance with all
applicable State of Minnesota §Ptulas and Ciry olftan Ordinances.
Building Official
Occupancy
Zoning
(ACWaI) Const
(Allowable)
X ols+ones
Length
Depth
S.F. Total
S.F. Faotprint5
On Site Sewage
On Site Well
MWCC Syslem
Ciry Water
PRV FequireC
B0o5lar Pump
APPROVALS
Planner
Cqmcil
Bldg. Off.
Varience
OFFICE USE ONLY
R-3 , M-1 FEES
R-1
Vn Bldg. Permil 59 .00
Vn" Surcharge 45.50
389.00
46 _ Plan Review
46--- SA4 City 100.00
- SAC,MCWCC 6$0.00
WaterConn 6()0.00
WaterMeter 95.00
Xx-
XX_
Acct. Deposil 30.00
_ SM/ Permit 30.00
- S/W Surcharge • 50
Trealment PI 276.00
RoadUnil 37(7-(10
- Perk Ded.
-- Copies
$3,245.00?
- TOTAL
7111,991
17? ? ?
8
ReQUest Date Flre
w Rougn-in Inspection
ReQ 'reC?
? Ready N. ?ill Nolity Inspector
Ves G No When Reaay?
I•?jlicensed conhactor ? owner hereby request inspection of above elechical work at:
?. .
JoD AtltlS¢ss (SVeel. Box or Roule No.) ?/
? .i?/tl " /'L ?//?if , //? //1? - City
'Z? , /
SecnoA No. Townsnip Name or No. Fange No. County
Ocwpant(PRINT)
?oT?%r?< PhOne NO.
--/r/?-
Power SupOlier AEtlress '
Elecmcai Convaclor IGOmpany Name, Conlratti License No.
aninq AeCress ?Comracmr or Owner Making Inslallalion,
&?.
Hmnor¢ed Ignamre iCOnvaclouowne' Making Inslallauon) Pnone Number
-P?c ?f O sS'O?
MINNESOTA STATE BOARD OF ELECTHICITY THIS INSPECTION REOUEST WILL NOT
Griggs-Mitlwey Bltlg. - RoomS-1]3 BE ACCEPTED BY THE STATE BOARO
iBPt Univarsity Ave.. SI. Paul. MN 5510G UNLESS PROPER INSPEGTION FEE IS
Phone (612) 642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL lNSPECTION ?". i'? ee-ooooi-oe
7?0/9/ ? See Inatrua?ans for aompletin91h15 lorm on beck of yellow oopy. ,?
X" Belbw V?orko Covered by This Request
„-- yt
ew Type of Building AppliancesWired EquipmentWired
Home Range Temporary Service
? Duplex Water Heater Electric Heating
Apt. Building ? Dryer Other (Specify)
• CommJlntlus[rial Fumace
? Farm Air Condi[ioner
? OtM1er (suecilyl Comractors Femarks'.
Compute Inspecfion Fee Belaw:
# Oiher Fee # Service Entrance Size Fee # Circuits/Feetlers Fee
Swimming Pool 0 t0 200 Ampi 0 to 100 Amps /?f
Transformers Above 200 _Amps Abov Amps
Signs lnspedorsUSeOnry: d T L
Ivigation Booms ? ? ??
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee - COMPLETEO WITHIN 78 S. ,ei
?
I, the Electrical Inspector, hereby Rwqn-m
certify that the above inspection has
been made. F;nai oa?e
OFFICE USE ONLY •
Tbis request voitl I8 manths irom
REQUEST FOR ELECTRICAL INSPECTION ' a+* ee.pooooi'-(/7g
Ill? See in5tructions for completing Ihis fortn on back oF yellow wpy.
61_9* ,
"X" Below Work Covered by This Request
Ne Add Rep. Y??e'bf Building Appliances Wired Equipmant Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Load Managemant
Comm./Industrial Furnace Other Specif )
Farm Air Conditioner
. ONer (specity) Con(racror's Femerks: 1
. ?SMI
Compute Inspection Fee Belaw: t/
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimmin Pool 0 to 200 Amps 0 to 100 Am s
Transformers A6ove 200-Amps Above 100 _Am s
Si nS inspecmr's Use Onty: TOTAL
?
Irrigation Booms ?
5 ecial Ins action •
AIarMCommunication THIS INSTALLATION MAV BE ORDERED QISCONNECTED IF NOT
Other Fee COMPLETED WITNIN,18, NT
I, the Elecirical Inspector, here6y Rough.in oate-
certify thal the above inspection has
been made. Finai
s oaie ?p
X
OFFlCE USE ONLY
This request vaitl 18 monihs im.
0-
0 2 7
.?0 9s
Request Dye "
?j Flre N¢ Fou h-In Insp Required
(YOU mu call n peclor when ready) Inspection Other Than 90ugh
? Feady Now 25,Will Notify Inspeclor
Ves ? No Date Rea
I C] licensed contractor Xowner hereby request inspection of above electrical work at:
i
Job Atldress (SVeeL eox or RoNe No.) Clry
?ciCC
U t?
$ection No. Township Neme or No. Fange No. County
Occupant (PFINT)
n ? c? Phone No. ".???_
?15 'D73?j '
Power Sopplier Atltlress
AaKaA-q 6 ec??? ?
Elecvical Comracbr (COmpany Name) ComractoYS License No.
BYKP?7 Lt?'??y
Mailing Adtl
re? (COnVacbr or Owner Making In51alWtion)
() J
f 1D
AWhorizetl Signature (COnlractodOwner Making Inslalletion) Phone Number
-? ysy- 073
MINNESOTA STATE 60AR0 OF ELECTRICITY
Griggs-MlOway Bltlg. - Roam 5-128
II
I
I I
I
II
I
I I
I I
I
II I
I
I
THIS INSPECTION REQUEST WILI NOT
BE ACCEPTED BV THE STATE BOAqO
I
1821 Unlversity Ave. 51. Peul, MN 55104
Phonef6121fi41?0800 ?
? UNLESS PROPER INSPECTION FEE IS
ENCLOSED.
A'tldress: 4146 PE[a]SYLVANIA AVENUE Lot Zp Blk I Sec/Sub $EAFFOPp p(ACE
,These items were/were not complete at the time of the final inspection.
Yes No ? Tnqpprtnr,
Final grade (6" from siding)
Permanent steps - garage
Permanent steps - main antry
Permanent driveway
Permanent gas
Sod/seeded grass
Trail/curb damage Ll?
Porch f
Basement finish
Deck
Please verify vith the builder the ramoval of roof tast caps from the plumbing
system and tha shut-off of watar supply to tha outside lavn faucet before
fzeeze potential exists. ca
.ecmmnr?n
White - City copy Yellow - Resident copy Pink.- Contractor copy
RESIDENTIAL BUII.DING
Permlt Applicatlon
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
4 113,"1?3
New ConsWction Rewiramenb RemodeYRaoairRaouiremenb Ofire Use OnN
3 registered site surveys showing ya. iL ol bt sq. S af house; anC ig raoled arens 2 oopies of plan _ Cert of Survey ReN
(2096 merzimum lot coverdp albxed) f aet d Frieigy Cakula5ons fa hea0ed atlditlons _ Tree Pres Plan Reod
2 coPies of pWn shoxdng Ceam 8 vrinqow sizes; Wumd found desgn, ek. 1 site suveq kr aGditlais 8deCks _ Tree Pres Nm Reqd
lseta(EneryyCalculatlans AaH'dbn-indkefaAonsYem?'csystem _OnaiEe'SepCCSyatem
3 copiea ot Tree Preservetlon Plen N bt platmd aRer 711/93
Rim JoialOemil Op6are seleCtlon sheet (bldgs wph 3 a Ims wiib
Date _f5 / / 1-1 / 2cxD -5
Site Address P2,,,, 5 t;LR"n i 9 Constructlon Cost 44-2ZX7
A/ le- UnillSte #
DescripdonotWOrk Rervtou-e Viit??
MumilyBldg _?N
7` Gq
FYreplace(s) _ 0 ? 1 _ 2
Property Owner B04o( An-'?CrSd rt Telephone #((aS1 ) `-?sy - o? 3?j
Caatractor -54?
Address
State City
Zip Telephoae ik ( )
COMPLETE TNIS AREA ONLY IF CONSTRUCTIN6 A NEW BUILDING
- Minnesota Rules 7670 Cate?orv 1 Minnesota Rules 7672
Energy Code Category . Residentlal Ventilatlon Category 1 WorksFreet . New Energy Code Worksheet
(J submission type) Su6mitted Su6mitted
• Erteigy Emrefape Calalatlons SubmilGed
r ?1? ?
Licensed Piumber p
1'? Telephone #( )
, . _
Mechanical Contractor MAR 4 Zp63 ? Telephone #( )
Sewer/Water Contractor Telephone # ( )
I hereby apply for a Residential Building Pernut and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a pernut, 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.
Brad Li, AiJe-rSDn
ApplicanPs Printed Name Applicant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation O 07 05-plex O 13 16-plex ? 20 Pooi O 30 AccessoryBldc
6'02 SF Dwelling ? 08 OB-plez ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext Alt - Multi
? 03 Dt of _ plex ? 09 07-plex ? 17 Garage 0 22 Porch/Addn. (4-sea.) O 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck O 23 Porch (screeNgazebo) O 36 Mutti Misc.
? 05 03-plex 0 ti 10-plex 0 19 LowerLevel 0 24 Storm Damage
? 06 04-plex O 12 12-plex Plbg_Y w_ N ? 25 Miscellaneous
Work Types
? 31 New O 35 Int Improvement 0 38 Demolish (Interior) C9' 44 Sidirg
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45?
- Fire Repair
? 33 Alteration ? 37 Demolish (Bidg)' ? 43 Reroof 8--
46 WindowslDoors
O 34 R8pl8Cement 'Demolitlon (Entlre Bldg) - Caive PCA handout to applicant
L12° g c9c)
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) _ FinallC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Snuco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utiiity Connection Charge
S&W Pertnit & Surcharge
Treatrnent Plant
License Search
Copies
Other
Total
RESIDENTIAL
BUILDINC PERMIT APPLICATION
r_. CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675 ?
New ConstruNion ReouiremeMS RemodellReoair ReuuiremeMs
• 3 registered site surveys stwwing sq. ft of lol, sq. R. of house; and all raafed areas • 2 copies of plan
(20% mazimum lol coverege allowed) . 1 set of Energy Calculations for heated addNons
. 2 cropies of plan showing 6eam & wintlow s¢es; poured (ound design, etc.) • 1 site survey for enterbr additions & decks
• 1 set of Energy Calculations . IMicale il hane served by septic system for additions
. 3 wpies of Tree Preservation Plan if IW platted after 7/1193
• Rim Joist Detail Options selection sheet (bldgs wiM 3 or less units)
DATE U ' O0-
VALUATION Cl! J?? G
SITE ADDRESS ?I ? l0 NV1 JCl F'1 jG 4U ? MULTI-FAMILY BLDG _ Y _ N
TYPE OF WORK ?2aV ?PdoD'FI/lndb? cE Afla& Pr) ci W'?,A,- FIREPLACE(S) _ D_ 1_ 2
SELA ROOFING & REMODELING, INC.
APPLICANT 4i98RYGRI b'I(aR $I?i'T'.
STREET ADDRESS sT• LOUts pARK, IYTN 55416 CITY STATE ZIP
TELEPHONE #61J-Ka3`ga((, CELL PHONE # FAX #
PROPERTYOWNERf3 rclc( A-"jPu So r-j TELEPHONE# foS'I-? lf^?
----------------------------------°-----------------------------°----------------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNF,SOTA RULES 7670 CATEGORY 1 MINNESOTA RUI.ES 7672
(4 submission type) . Residential Ventiladon Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor. Phone #
Plumbing system includes: _ Water Softener Lawn Sprinkler I+ee: $90.00
_ Water Heater _ No. of R.I. 13aths
_ No. of Baths
Mechanical Contractor: Phone #
Mechanical system includes: Air Condidoning Fee: $70.00
Heat Recovery System
Sewer/Water Contractor: Phone # r? ,r,
- - - - - - - - - - L? luD , J 4
_ --
I hereby acknowledge that I have read this application, state that the information is!c I?
arrect, and ag?'eetoV?amply
---------------
with ali applicable State of Minnesota Statutes and City of Eagan Ordinances.
Slgnature W Applicant 5 v[ (Y , -
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4l02
OFFICE USE ONLY
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi
O 03 01 of _ plex ? 09 07-plex O 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 LowerLevel ? 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 •Demalition (Entire Bldg anly) - Give PCA handout to appllcant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bidgs Length Fire Sprink)ered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addifion) _ Plumbing
Foundation 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
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
?13ILIIING PERMIT APPLICATION
CITY OF EAGAN
SZNGLE FAMILY DWELLINGS
2 SETS OF PLANS
3 REGISTERED SITE SURVEYS
1 SET OF ENERGY CALCULATIONS
MULTIPLE DWELLINGS
COI9MRCIAL
2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
(CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLZES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PIGKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - 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 YERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER,
? /
To Be Used For: ?t. ?L'?!' Valuation: ? Date: ' l?9lAQi
Site Address L //W,
Lot 20 Block / 19 uG.
Parcel/Sub !S?? fi?fJLg
Dwner
Address
City/Zip Code
Phone
Contractor /,?`TTEG?T.QGi1T /1,1"Er?.
Address '7g5 Cju,rrye: ,(ys. _
City/2ip Code
Phone 4{S(o
Arch./Engr.
Address
City/Zip Code
Phone #
ql, oo0--
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Foatprint S.F
OFFICE USE ONLY
R-3 M -1
Tz -(
V-N
?
On site sewage_
On site well
MWCC System ?
City water f?
PRV _
Booster Pump _
FEES
Bldg. Permit
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Acct. Deposit
S/w'Permit
S/W SurchargE
Treatment P1.
Road Unit
Park Ded.
Trail Ded.
Copies
SUBTOTAL
Penalty
Lot Change
TOTAL
4cJr
APPROVALS
Planner _
Council
Bldg. Off. L-?,'S`91QS
Variance
agrees that all work shall be done in accordance with
-' Signature of Contractor)
all applicahle State of Mi:rnesota Statutes and City of Eagan Ordinances.
.-• .
VA l.uAMoN
GQRA6?G
?----
a4 y 22 = ?Z8 x /s ?.. r7°12a
6S MT;
0? 4 k'fb=
? ? ?9yZ = 7B
IIg2 ? ?y s I6S4 a
1:-15rr FLa,rZ
1?2? 23 3y
19
Pm
i
1255 -t53= 4G515'
o)e 'Jf)000?
r
?a/ /g?
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION DATE js>
OWNER
SITE ADDRESS_
CONTRACTOA In I -r7gLS7AEA r ?/j?,.. Cn,i,sT• '
ADDRESS_?7$6 rr,u.JSFf ?A FAIsA,d YHONE Y',Sb 4% 2 S
DETERMINE WORRING SQUARE r'OOTAGE OF EACH.
1. Total exposed wall area ... 0a(o?o sq: ft. x•11 ? 2yq,3
2. Tatal roof/ceiling area ... 1?k rJ 2. sq. ft. x•026 s 2,?
Total expased wall area above floor a 2./9 2
a. Total wall window area ......................... ;l 5$
b. Total door area ............................... 3 9
c. Total sliding glass door area .................. 3!0
d. Total fireplace wall area ......• •.. .... p
e. Total wall framing area (averagelOZ).......... 21 q
f. Total net wall area abone floor ................ / y y 2
g. Total rim joist area .......................... 2 0/
Total exposed foundation area ? 17v
h. Total foundation window area ................... p
i. Total aet foundatian area above grade .......... % y
Determine "U" value of each wall segment.
a. 2.55 E ,VUll , y.6 ` i lY . Sr
b. 3q R "U" .07 2 -'7
C. 34. g ,fUll 15. !
a. o x o,pll o ffl o
e. 219 x "u„ 2N, /
f. lyy2 x ^n" .oa3y - &2.to
s- 201 g fltl,f , D'/y n B, $
h. p R "U" O ? O
L. '7N x „vlo .. O g1. - 6,1
3 . ............................. .xocai
If item 03 is the same as, or less ehan item 91,°qau°fiave met the intent
of SSC 6006 (c)2.
-1-
Page 2 of 2
Tatal exposed roof/ceiling area - I 2 8 Z
j. Total skylight area ........................... n
k. Total roof/ceiling framing area (average 109).. 17$
1. Total net insulated roof/ceiling area ......... 11?7 y
Determine "U" value for each roof/ceiling segment.
J. 0 XltITn
k. 98 x flo" .0258 ?.o
i. 117H x ItUlt 02 ig 25.?
4 ....................................... .Total.a'
If total of 44 is the same as, or less than 02, you ha•:e met the intent
OL oBC 6006(r)t. .
Alternate Suilding Envelope Design
To utilize the total envelope system meehod, the values eatablished by
the sum of items 03 and li4 shall not be greater than the svm of items
91 and #2. ,
1. + 2. ?
3. + 4. _
-2-
INSPECTION RECORD
CITYOFEAGAN PERMITTYPE: auxLoiNG
3830 Pilot Knoh Road Permit Number: 074018
Eagan, MiI1r18SOtd 55123 Date Issued: 0 6/ 3@/ 9 4
(612) 681-4675
SITE ADDRESS: APPLICANT:
LOT: 20 BLOCK: 1
4146 PENNSYLVANTA AVE ANDERSON BRAD
STAFFORD PLACE (612) 223-2678
PERMIT SUBTYPE: TYPE OF WORK:
BASEMEN7 FINISH ALTERATION
INSPECTION
FRAMING ., .
INSULATION ,.
ROUGH IN PLBG FINAL
REMARKS: SEPARATE pERMITS ARE REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK
?
-1
? ?
, PERMIT dXO
CITY Of EAGAN o
3830 Pilot Knob Road PERMIT TYPE: Bu= L ING?
Eagan, Minnesota 55123 Permit Num6er: 024018
(612) 681-4675 Date Issued: 06 (30 /94
SITE ADDRESS:
4146 PENNSYLVANIA AVE
LOT: 20 BLOCK: 1
STAFFORD PLACE
p.I.N.: 10-72500-200-01 '
DESCRIPTION:
fiul2ding`-Permit 7ype
,Bu:ilding WQrk Type
,
j.,
? l
B/ /~
\. y(
\` ? n
1t?
L ri
BASEMENT FINSSH
ALTERATZON
?F
?tl?i 71?IQ')
? . ?
REMARKS:
SEpHRATE PERMITS ARE REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK
FEE SUMMARY:
Bese Fee $35.60
3urcharge $.50
7ota1 Fee $35.56
CONTRACTOR:
OWNER: - ppplicant -
ANDERSON BRAD
4146 PENN3YLVANIA AVE
EAGAN MN 55123
(612)223-2678
f
I hereby acknowled9e that T have read Chis appl3eation antl state that tNe
infinrmation is correct and agree to comply with a11'applicable State of Mn.
StaCuCes and City af Eagan Ordinances.
L
J
nwia APPLICANTlPERMI7EE SIGNATURE ? E: S?AT? '?
14011
CITY OF EAGAN
1994 BUILDING PERMIT APPLICATION
681-4675
4X.-50
rPD0ntl 1. - 5o
-r
?
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date 2Uv) e /27. / ?9 V Yaluation of work 4 t
Site Address: G?yL ?Ennsy/Uq?,? f}?
STREET SVITE q
Tenant Name: (cammercial only)
LOT 10 BLOCK SUBD.
?i ?t.f Z P.I.D. #
Descri tion of work: f:7in? Ll (dlt5 e F ?owCr le-"C (
The applicant is: Owner ? Contractor ? Other (f7esoribe)
,A,, dersar, B,z,A D Phone 4 Y9"Y-o73g
Name .
Property ,
LAST PIRST ? aa3
Owner Address ? I?? ? nnSY Ivqn ; q Ave
STREET STE f!
City EyYG?7 State /W/t) Zip SS)
Company <5aAAC qr Phone
Go ntractor Address License # Exp.
City State Zip
Company Phone
ArchitecU
Engineer Name Registration #
Address '
City State Zip
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area has heen approved.
I hereby acknawledge that I have read this application and state that the information is
correct and agree ta comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
y,
`I.
?
Signature of Applicant: "?-??P
OFFICE USE ONLY ?`
'f ? ? ?'"
;r
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging -dt ?` 16 Basement Finish
? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 17 Swim Pool
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 19 Comm./Ind. Misc.
? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
? 31 New R'33 Alterations ? 35 Tenant Finish 0 37 Uemolish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) lst F1. sq. ft. City Water
UBC Occupancy 2nd F1. sq. ft. PRV Required
2oning Sq. Ft. total Booster Pump
# of 5tories Footprint Sq. ft. Fire Sprinkler
Length On-site well Census Code
,3y
Depth On-site sewage _
SAC Code d!
C
Und
APPROVALS ensus
t
o
Planning
Engineering
REQUIRED INSPECTIONS
?.Site
? Wallboard
Building
Yariance
? Footing
/P'Final
Assessments
,(51- Framing E' Insulation
? Draintile ? Fireplace
Permit Fee veiuacton: g
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
5/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Totat:
SAC %
SAC Units
PERMif #` ' cinr oF EAcaN M? I td Pl? s
39 1992 BUILDING PERMIT APPLICATION?
681-4675 l 1
...,, 2 3 ?
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMPIERCIAL 2 sets of architectural 5 structural plans, 1 set of
specifications, 1 copy of energy calcs.
°enalty applies when typing 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 ?I?00 ?nq-l-er;k45
Site Address: ???1?0 ?e?nS?I?Gniy ,qv?
STREET STE f
Tenant Name•
LOT C?o BLOCK I suso. ,'`jTAr'FaRD piRCC- P.I.D. Y
Descri tion of work: ?Ec K
The applicant is: Owner ? Contractor ? Other (Deseribe)
Name A Nl7C R SaN f-?Phone qsY - o73S (W)
Property IAST F1RSi
Owner 4'`i(4
A
vP
n;5
qddress
STREET STE i
City rGciState //74N Zip
Company Phone
Contractor Address License # Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer 8 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 all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant: ?? ??
vrriut u*t unLY
f? 'fY! .i .? .•4 ?? ' 9i:?n
aLRDING PERMIT TYPE
?I 1 1
? 01 Foundation ? 05 Apt. Bldg ? 09 Basement finish
? 02 Sf Dwg. . ? 06 6arage/Accessory ? 10 Swim Pool
? 03 :Two family O 07 Fireplace ? 11 Res. Add./Porch
13 04 Multi-fam. T.H. 6Y08 Deck ? 12 Comm./Ind.
woRK rrPE
d 31 New
b 32 Addition
0 33 Alterations
? 34 Repair
? 35 Tenant Finish
? 36 Move
? 37 Demolish
? 99 Undefined
GENERAL INFORMATION
Const. (Actual)
(A1lowable)
UBC Occupancy
Zoning
# bf Stories
Length
Depth
APPROVALS
Basement sq. ft.
lst F1. sq, ft.
fZ-? 2nd Fl. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
;q On-site well
i9' On-site sewage
Planning Building •'Q1?.259a
Engineering Variance
REQUIRED INSPECTIONS
13 Site bfFooting ? Framing
O Wallboard E3 Final ? Draintile
lz?
? Insulation
O Fireplace
Permit fee
Surcharge
Plan Review
License
MWCC 5AC
r.ity car
Water Conn..
Mater Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies „ sc
Other
Total:
SAC %
SAC Units
v.tuecim: s
?' ,,? ` •
:? ,• "
,
? 13 Public';.Facr
? 14 Agricultural
? 15 Miscellaneous
MWCC System
r;r; uater
PRV Required
Booster Pump
Fire 5prinkler
Census Code
SAC Code
Assessments
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMTTS ARE REQUIRED FOA EACH UNTT.
NO. FIXTURES
SHOWER
WATER CLOSET
BATH TUB
LAVATORY
KITCHEN SINK 0 ? S l?
LAUNDRY TRAY
HOT TUB/SPA
WATER HEATER
FLOOR DRAIN
GAS PIPING OUTLET • minsmum • t
ROUGH OPENINGS
WATER SOFTE?+IER
PRIVATE DISP. • Dak.Cty. lic.
U.G. SPRINKLER • home under const.
ALTERATIONS • ro acisiing
WATER TURN AROUND
STATESURCHARGE
TOTAL:
-?SITE ADDRESS:
E
EACH TOTAL
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
1.5n0/?
J.VV
20.00
3.00
20.00
20.00
.50
1a
OWNER NAME: ?A N1p e k SaN
INSTALLER: ??? I?In»cKSVN
ADDRES$:_ W??? I?? n? 5? I v? ?; 5 t1u`e
CITY: f`yST.ATE: Mti ZIP CODE:
PHONE #: ((o(2 ) IiS`i 073c7 -glrl?/ ???_
SIGNATURE OF PERMITTEE
1994 PLUMBING PERMIT (RESIDENTIAL) -
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COIvIPLETE FOR ALL
FAMILY BUILDINGS WHEN
DWELLING UNTT.
NEW CONSTRUCTION
ADD ON
REPAIR
WORK DESCRIPI?IQN:
CONTRACT PRICE4 $
rrE: r% oF coxTRAcT FEE:
STATG SURCHARGE; $.50 FOR EACH'$1,000 QF I!F&1l71'? FEE.
?EE: $ '500 ..
CUNTRACT PRICE X 1% $
STATESURCHARGE $
TOTAL $
SITEOADDRESS:
BUILD'INGS. AL-SO FOR MULTI-
NOT REQUIRED : FOR EACH
FOR: _
CITY OF EAGAN APPLICANT
1994 PLUMBING.PERIVIIT (COIVIMERCIAL).
CITY OF EAGAN
3830 PIaLOT KNOB RD
Et1GAN MN 55122-
(612) 6$14675
CITY OF EAGAN FOR CITY USE ONLY
3830 PILOT KNOB ROAD
EAGAN MN 55122 PERMIT #
PHONE: (612) 454-8100 RECEIPT # -S O
DATE:
PLEASE COMPLETE UPPER PORTIQN ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WNEN PERHITS ARE REQUIRED FOR EACH UNIT.
_-----------------°----
WORK DESCRIPTIDN ----- --------------------- ---- ----------------------
COMPLETE THE FOLIAWING: -°--
N0. FIXTURES EA. TOTAL
NEW CONST ?; ADD-ON MINIMUM 15.00
ADD ON SHOWER 3.00 T-_
REPAIR ? L WATER CLOSET 3.00 ;3=
? SATH TUB
LAVATORY 3.00
3
00
.
OWNER NAME: KITCHEN SINK 3.00
f?f? /?/
' ? LAUNDRY TRAY 3.00 -
SITE ADDRESS: i r ?
Gv, HOT TUB/SPA 3.00
? WATER HEATER
LOT: 40 BIACK ? SUBD.? / FLOOR DRAIN 3.00
GAS PIPING OUT.
INSTALLER: / (MINIMUM - 1) 3.00 3 ?
ROUGH OPENINGS 1.50 t?-"SO
ADDRESS: ? OTHER
WATER SOFTENER 5.00
CITY: ,J ??i'h??1 ZIP: PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
SUBTOTAL
ST. SURCHARGE
TOTAL
? 35-q
.50
$ 35.D:9
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND
MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
?WELLING UNIT.
-------------
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:^
LOT: BLOCK .
INSTALLER:
ADDRESS:
CITY:
PHONE #:
FOR:
ZIP:
SUBD,
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
CITY OF EAGAN FOR CITY USE ONLY
3830 PIIAT RNOB ROAD
EAGAN MN 55122 PERMIT #
PflONE (612) 454 8100 RECEIPT # ?'1
0C?ANSC2l?;??RTSI„I' DATE: 0,9/_
PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION
NEW CONST ?
ADD ON _
REPAIR _
OWNER NAME: /,;7 / TTEC s rAEV% aRoS - Ccvb'7
SITE ADDRESS; '-"G ????Nfv?Up-?v.A fhJe
LOT:?G BLOCK ? SUBD. STAPJCeoey j'cA-c?
INSTALLER:
ADDRESS: BUI'CiSVIII@ H@8tlflg & A/C InC.
12481 Rhode Island Ave. So.
ci'ty: Savage, MN 2W378-11 2
894-0005
PHONE
FEES
ADD-ON MINIMUM $15.00
HVAC 0-100 M BTU 4.0
ADDITIONAL 50 M BTU . 0
GAS OUTLETS - MINIMUM .00
OF 1 PER PERMIT
oa
SUBTOTAL: $ z-7
STATE SURCHARGE: .50
TOTAL: $ 97 ?'
SIGNATURE OF PERMITTEE
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIALfINDUSTRIAL BUILDINGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY SUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
CONTRACT PRICE:
OWNER NAME:
SiTE ADDRE3S:
LOT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE #:
FOR:
CITY OF EAGAN
FEES
1% OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
EkCH $1,000 Or PERI•iIi FEE.
PROCESSED PIPING - $25.00
$25.00 MINIMUM F'EE.
CONTRACT PRICE x 18
STATE SURCHARGE $
TOTAL: $
(SIGNATURE)
.TUN-25-191 TlE 10:23 1D:JRMES R HILL INC TEL N0:612 0M-6244 t3765 P01
lJRVEYOR'3 CERTIFiCATE
R. HILL, INC.
eaos. oowsr
NOTEs NO MUFlC SOILS INVElTtlMiON HA9 6lQJ COMPIFTED'
ON TN19 l.pT gY THH lyMypq, . 7?E SNTAmILIlY Of NOTE: SV0.DINB pWprS10NS SMOWN ARE
lOIL! 10 BUMOqT TN[ froI:IOIC NOUlE PMPOK0 IS ' ?Ipq?Tq CTIM ?f 0??LlE-
N07 THE R[SPONSIlIL?TY OF TH! fURVEYOR. ????? ?? ?WLMG
+ DENOTES PqOPOSED SURFACE DRAINAGE °??ION ongubowt
O DENOTES IRON MONUMENT SET SCALE: i INCH - 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED QARAGE f100R - 9Y/. Z FEET
X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - 92y,9 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK - 93J,0 FEET
WE kERE9Y CERTIFY TO MIT7ELSTAEDT BRO6. CONST. THAT THIS 15 A TRUE AND CORRECT
REPRESENTA710N OF A SURVEY OF THE BOUNDARIES OF:
LOT 20, BLOCK 1, STAFFORD PLACE,ACCORDING lq THE
RFCORbED PLAT THEREOFo DAKOTA COUNtYt MINNE50TA
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS
SURVEYED 8Y ME OR UNDER MY DIRECT SU?WISION THIS 18TH DAY OF JUNE , 1891.
PROPOSFO CpApEB SMQYW WEAE TAKEN
RROM THE OMpN6, OIIAINIIM & [IIDlION
CqiTROL. IK,AM 1011 • 7TA/MOMD MC!.
PIIEMNED BY HEDWND ENOR!lRINO,
LAST DAIED 8-31•87
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F'pjc;j?1n
r
JOHN C. LARSON, LAND SURVEYOR
MJNNESOTA LICENSE NUMBER 18828
James R. Hill, inc.
PLANNERS / ENGINEERS / SURVEYORS
2600 W. CTY. qD. 42 *BURNSVILLE, MN. 55337 0 612-890-8044
JUN-25-191 TLE 10z24 ID:SAMES R HILL INC TEL N0:612 890-6244
*FSURVEYOR'S CERTIFICATE _ MITTE!
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?
I INCH ¦ 30 FEET
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oz w O??
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a t0 ?
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N A O m y <
James R. Hill, inc.
PLANNERS / ENGINEERS / SURVEYORS
2500 W. CTY. RD. 42 0 BURNSVILLE, MN. 55337 o 812-880-8044
?
u76s Pez
,uRVEYOR'S CERTIFICATE
\
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-?..
?
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cp 4ib /
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:.«?io
t4N
•
James R. Hill, inc.
PLANNERS / ENGINEERS / SURVEYORS
2500 W. CTY. RD. 42 o BURNSVIILE, MN. 55337 • 812-890-8044
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4146 Pennsylvania Ave
Lot: 20 Block: 1 Addition: Stafford Place
PID:10- 72500- 200 -01
Use:
Description:
Sub Type: e - Furnace & Air Conditioner
Work Type: New
Description: Fumace & Air Conditioner
Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952)
445 -2840
Fee Summary:
Contractor:
Genz Ryan Plumbing & Heating
2200 West Highway 13
Burnsville MN 55337
(952) 767 -1000
ME - Permit Fee (Replacements)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Owner:
Brad W Anderson
4146 Pennsylvania Ave
Eagan MN 55123
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$50.00 0801.4088
$0.50 9001.2195
$50.50
Issued By: Signature
Mechanical
EA090361
07/28/2009
ePermit
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Date:
Tenant:
City of Eaftall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
RECEIVED
pub 1 2016
Use BLUE or BLACK Ink
For Office Use (� Q
Permit*: / 3 / l
Permit Fee: /0 D• v d 1 r
Date Received: 7-4
Staff:
( 2016 RESIDENTIAL PLUMBING PERMIT APPLICATION
l I Site Address: l'4t0 `'nneivvrL Ave_
j RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes State Surcharge)
$60.00 Lawn Irrigation (includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment Water Turnaround* (includes State Surcharge)
*Water Turnaround (add $280.00 if a 3/4" meter is required)
$115.00 Septic System New (includes County fee and State Surcharge)
TOTAL FEES $ "
Suite #:
J
Name: i u%r v 4—C-11- S ` Phone: (IEE 1 -454— or739
Address / City / Zip: 4 I L-ke r' Are M Al 5S1
Name: Croix Crystal Water TreatmentLicense #: 64997WC
Address: 3440 Yoerg Dr city: Hudson
State: VVI zip: 54016 Phone: 715-386-8667
Contact: Jim Email: croixcrystal@att.net
_ New Replacement _ Repair _ Rebuild _ Modify Space _ Work in Descrip of : Install Water Softener
RESIDENTIAL
Water Heater
Lawn Irrigation ( RPZ /_ PVB)
Septic System
New
Abandonment
Add Plumbing Fixtures ( Main J_ Lower Level)
Water Turnarour
CALL BEFORE YOU DIG. Call Gopher State One Cali at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www_gopherstateonecall_oro
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of pla
x Jim Schober
Applicant's Printed Name
x
Applicant's gnature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA170831
Date Issued:07/19/2021
Permit Category:ePermit
Site Address: 4146 Pennsylvania Ave
Lot:20 Block: 1 Addition: Stafford Place
PID:10-72500-01-200
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 -
Brad W Anderson
4146 Pennsylvania Ave
Saint Paul MN 55123--157
(651) 341-5226
T 10 Construction Services Llc
16754 US 10 Bldg 2
Elk River MN 55330
(612) 254-8060
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA178906
Date Issued:09/09/2022
Permit Category:ePermit
Site Address: 4146 Pennsylvania Ave
Lot:20 Block: 1 Addition: Stafford Place
PID:10-72500-01-200
Use:
Description:
Sub Type:Water Heater
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:
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 -
Brad W Anderson
4146 Pennsylvania Ave
Saint Paul MN 55123--157
Champion Plumbing Llc
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature