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4147 Pennsylvania Ave ùûë þýü ÿþþ ý ýüûû úþþùûùðþïï íûôô í ÿ ÿþö ûúùø÷öò îúø÷ö òø÷öò ñ ñõöè öðú îúîíéúö÷ ìý ûëúê èö è èëúèùèçôý öýüôôèý þ öçîôôöôç îùèæëúù÷ ýôè÷ èç êáíàáßßçßçß ÷ú ûú ýãúáíàáçâç â ãúíüç õô öòñ öö õ úõ úô â îú÷õîò÷ õ íþý í åÞä Þ ù÷ ý öö ôèýèö÷ ööùû ô ûúî÷ôþýéç ööñèûýúú÷ûýú . . C°ntr°' INSPECTION RECORD I "°. ' CITY OF EAGAN BEA(.'TIVATED FOR HSMr F7NI..SH 12/18/92 PERMIT TYPE: DOti n t No 3830 Pilot Knob Road BRLICE MLWLF 946-3868 Permit Number. 669693 Eagan, Minnesota 55123 Date Issued: (612) 681-4675 SITE ADDRESS: UOT, 14 81.00 ; APPLICANT: 4147 FENNSYLVAN[A RVF SEASOMAI. BLDNS 1Nf • StAFFQRn PLACF _ (612) 454-6971 PERM4T ? ,,qPTYPE: TYPE OF WORK: MFu RfMAKk'.: RFr:E1PT 9 364/ PIbR. + REQENCY PIS4. , Prrma No. Fermlt Hokd.r aats Tibphon. # S/IN PLUMBING ,?y ??f/ HVAC ELECTRI ELECTRIC tnspectlon Dete lnsp. Commenh Footings I /?P a?- Foundation Freming (? ? ? ??L ' G Jf L' ?? Roofing ? Rough Plbg- ...,5 Rough HEg. 1 'SI'', G Fire;gaoe Flnal Fttg. z .f?l "?? 114 Orsat Test L ? ?. Finai Pibg. Pmo. Inspector - Notnr Pk-ftr Const Meter ErqrJPlan Bidg. Fnel C 2 /N 5 ? 40 Deck Ftg. DBCk FinHl we+i Pr. Diap. ? ?Z -v ?? •• ? 4 .? . • • :: ?,F-ra?.r?+-? . .""7"1",1?„,,•?rt?.`?'... ?n. ,..?,?e•,•. ??e?#i#ir?te uf (?rru???tr? titp of eagan WpOWMd o# wufilding iwPrtim 77ds CertffiQate issucd pursuant to 1he nequrnments of Secrion 306 of ike Uirifarnr Buiddisg Code certifying tJrat at the time ojissrrance tJds stracturr was tn compliance w*li lhe Narious arkWcnoes of 11re C(ty regulaft building construction or use For the following: SF DWG/GAR 593 tie M.?snum BW?. Pamit No. ?"PS°`'7 TYv? - - - - M - - ? ? R-1 7M con. J?Cli?lif L1?Y LZ1? LJ? VLA ?a JUNE 24, 1992 POST IN A CONSPICUOUS PU1CE REQUEST FOft ELECTRICAL INSPECTION ? ??q_ eooooioe ? See inSimeJns for c?pleting ihis form on back ol yellaw copy. n ??6a` •,'?0 e??'G ?p 45104 T "X" Be/ow Work Covered by This Request ?• e ??tling AppliancesWired EquipmentWired home Range Temporary 5ervice Duplex Water Heater Electric Heating Apt Building Dryer Other.(5pecify) Comm./Indusirial Furnace Farm Air Conditioner Otner (syecity) Comracfor5 FBmarks / SG?- Campute Inspection Fee Belaw: # Other Fee # ServiceEntranCeSize Fee M CircuitsiFeetlers Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps 7ransformers Above 200 _ Amps ove 100 _ Amps Signs Inspecmr§ use onry: o TO7AL ,SC) ? ' Irrigation Booms (25 - ? Special Inspection - Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IP NOT Other Fee COMPLETED WITHIN 18 MO HS. I, the Electrical Inspector, hereby flO1g""" ? f Oe? certify that ihe above inspection has been made. ? OFFICE USE JNIY ? TNS request void 18 monms Imm Request Dat? a? Fi No. r-in Inspection ire0? ? ReaOY Nax ll Notity Inspector 1 s ? NO VJhen Reatly9 I El licensed contractor ,Kowner hereby request inspection ol above eledrical work et: Joo add?es?isrreeveoxu?aome rioj A ay af . Section No. t Township Neme or No, Range No. County ant (PRIM? 1 u F M oW PhOne No. Vower SuoCher nGtlress & ectncal ontrattor (GOmpany Name) ' ' i, n ConVaclorY Llcense No. J4 /h EU u// Mafling Aoare Omrector o, Owr?er Maxinq Insiailation) ? ?? AuIDOriEe?ature ICOnVactor?Qwner Making Insta ation) Phone Number -}Sz -sss5 MINNESOTp STFTE BOAHD OF ELECTNIGITY THIS INSPECTION REpUE$T WILL NOT GrIgga-MWway Bltlg. - Room Sl73 BE ACCEPTED BY THE STATE 60AFD 1821 Unlvneity Ave., St. Peul. MN 55106 UNLE$$ PFOPER INSPECTION FEE IS Pho. (612) 64E-0800 ENClOSEO. ?/$ 594? 0 REQUEST FCi? ELECTRICAL INSPECTION '?a ee-ooom-oa ? 4 9 See insYUCtions tJhompleting Ihis lorm on back ot yellow wpy. J ??.` ? • "X" Below Work Covered by This Request ,?• .166 77 Njrw tltl. Rep. Type ol Building AppliancesWired EquipmeniWired Home Range Temporary Service Duplez Water Heater Electric Heating Apt. Building ryer Olher (Specify) Comm./Industrial Furnace Farm Air Conditioner Otner(syeciry) ConVactor's Remarks: Compute Inspection Fee Below: # . Other Fee # ServiceEntrance5ize Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps IKOO 0 to 100 Amps Transformers Above 200 _ Amps Above 100 _ Amps Sigf15 Inspectarg Use Only: TOTAL ' Irrigation Booms GrAl- l?lj• J v P 5 Special Inspection it 3J = .-4l Alarm/Communication THIS INSTALLATION MAY 8E ORDEFiEO'DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 1$ MDNTNS,-, / I, the Electrical Inspector, hereby ROUgh-in oae-y --F '2- certify that the above inspection has been made. F;nai r o ??? ? OFFICE USE ONLY This requesl voitl 18 months Irom £ ? ?4? !DG 775?` / ? ? `t 0 ? j ,Q3 ? a (p Feques[ Date n V Fire N Rough-in Inspection qeq ' tl? ? Reatly N. ill Notiy Insrief.mD '{!? Wl j o Yes ? No re e y i l k Iffl li d i f b l ? [I cense contractor owner herehy reque st inspect on o a ectr ove e ca at: JoE Ado s s (SlreeI BO x ooowe Na) _ City ? Sedion No. Township Nam¢ or No. Rarge No. Caun ? Occupa SPRINT) mw)&'l Ph n No. Power Supplier . ? ' Atltlress EI ViI onhacto (COmpar?y Na a ) ,? Vect S C n Mai -n tlres (CO Imctor or er Mak'mg Installation) Av?h rze S naWre ( WwIr/a?doriOwner Ma(y?yp' GIyt el ti _\ IY'?_ 0_Y U P on b - M NI NESOTA S1AiE BOAPD OF ELECTRICITY TMIS INSPECTION REOUEST WILL NOT Griggs-MlUwey Bltlg. - Noom S173 BE ACCEPTED BV THE STATE BDARD 1821 Universfry Ava.. 51. Paul. MN 55100 UNLESS PROPER INSPECTION FEE I$ Phone(612) 662-0800 ENCLOSED. Address: 4147 PENNSYLVANIA A?t 14 Blk 3 Sac/Sub STAFFORD PLACE These items ware/were not complete at the time of the final inspection. ate: JUNE 24, 1992 p Yes No TnqPPcfnr, Final grade (6" from siding) Permanent steps - garage Permanent steps - main entry Permanent driveway ? Permanent gas ? Sod/seeded grass r? Trail/curb damage ' Porch l? 8asement finish Deck Please verify vith the builder the removal of roof test caps from tha plumbing system and the shut-off of watar supply to the outside lawn faucet before £reeze potential exists. oa ML1G[OARR White - City copy Yellow - Resident copy Pink - Contractor copy ?J RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Constructbn BeaulremeMs • 3 reglstered slte surveys ehowing sq. k. ol lot, sq.lt. of house; antl IU rooled arees (20% maotlmum bt coverage albwed) • 2 copies G plan showing heam 8 window saes; poured found design, etc.) • lsetofEnergyCakuYatbns • 3 copies ot Tree Preservation Plan il bt ple8ed aker 711/93 . Rim Joisl Detail Optbns selectian sheet (bldgs wAh 3 or less untts) DATE VO ' 'Z) "Q _ Water Softener _ Water Heater _ No. of Baths SITE ADDRESS `W-kl Pr?NNSy Lt/AWt k 6 J MULTI-FAMILY BLDG _ Y ? N NPE OF WORK T( AQ OFF ? R,oOf;:? FIREPLACE(S) _ 0_ 1_ 2 ? APPLICANT AµCv@xc..,,s P,?.,,?o.av ?-t?"?R-nc--rtrn-S STREETADDRESS Nec.ob-LGC' CITyg„QNSo,,.?r- STATE?ZIP TELEPHONE # 952-"I,o"z- 6159 CELL PHONE *90NOWIM FAX # qM??? bf6lf(D PROPERTYOWNER R9-0Z-k- K,,, g 1 '- F TELEPHONE# 651- Li 52,- SS t- Ii COMPLETE THIS SECTION FOR -NEW- RESIDENTIAL BUILDINGS ONLY Energy Code Category ? MINNESOTA RULES'16'70 CATEGORY 1 MINNESOTA RULES 7672 (4 submission type) • Residential Ventilation Category 'I Worksheet Submittetl • New Energy Code Worksheet Submitted • Energy Envelope Calculatlons Submitted Plumbing Conhactor: Plumbing system includes: Mechanical Contractor: _ Mechanical systexn includes: Sewer/Water Conhacfor: _ Air Conditioning _ Heat Recovery System Fee: $90.00 Phone ri ' Fee: $70:00 F,Tn^? ? Phone 0 l hereby acknowledge that 1 have read this applicatlon, state ihat the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan rdinances. hlL? Signature of Applicant '-?` Po? °------°-----------_._._..°---° OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updatad 4l02 Phone # pemodeVNeoeU Reaulrements • 2 coples af plart • 1setMEnergyCakulatbnsforheatedaddHlans • ts0esurveylorez[efioratltlttbns8decks • Indicata d home served by septic system for addilbns IJ ? VALUATION $ _ Lawn Sprinkler _ No. of R.I. Baths OFFICE USE ONLY ? 01 Foundation ? 07 05-plex ? 13 tEplex O 20 Pool ? 30 Accessory Bldg O 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) 13 31 Ext. Alt- Multi O 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF 13 04 02-plex O 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex 13 11 10.plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex 13 12 12-plex Plbg_Yw_ N ? 25 Miscellaneous [3 31 New ? 35 Int Improvemant O 38 Demolish (Interior) ? 44 Siding ? 32 Addition O 36 Move Bidg. O 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bidg)" O 43 Reroof ? 46 WindowslDoors ? 34 Replacemant 'Demolitlon (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fi2 Sprinklered Type of Const W idth REQUIRED INSPECTIONS _ Footings (new bldg) _ FinaVC.O. _ Footings (deck) _ FinaUNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice 8c 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 8 Storage S&W Permit & Surcharge Treatment Plant Plumbing Permif Mechanical Permit License Search Copies Other Total Building Inspector IAL BUILDING PERMIT APPLICATION CITY OF EAGAN Qc) U 3830 PILOT KNOB RD - 55122 v 651-681-4675 -k43- d" New Conatmctien Reauirements RemodallReoair Reouirements • 3 regisiered site surveys showing sq. k. of lot, sq. ft of house; and all roofed areas • 2 copies of plan ?' ? (20%maximum lot coverage allowed) • 1 set of Energy Calculalions for heated additions • 2 copies of plan showing beam 8 window skes; Doured found design, etc.) • 7 site survey for exterior additbns & decks • 1 set of Energy CalcNations • Indicafe'rf home served by septic system tar additions • 3 copies of Tree Preservation Plan if lot platted after 711193 . Rim Joist Delail Oplions selection sheet (61dgs with 3 ar less units) DATE 'q "9 ' G-Z- VALUATION JOB SITE ADDRESS :I 147 PENAI cYy14NI? &F F46ooy, NlN, 55'I 2-- 3 IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER [312VCE MUfGL ff TYPE OF WORK dl,JWIZGKIYI 7I Al l,iV FIREPLACE(S) x 0_ 1_ 2 APPUCANT 1312C/CF MU?aL? PHONE# 65hqSZ'SS?SADDRESS 5QmE ZIP CODE PAGER # CELL PHONE # Phone # NEW RESIDENTIAL BUILDING ONLY - FILL OUT CO ? aT m? Energy Code Category MINNESOTA RULES 7670 CATEGO (check one) - Residential Ventilation Category 1 Workshee b0 4 2?02 - Energy Envelope Calculations Submitted h S(V _ MINNESOTA RULES 7672 By - New Energy Code Worksheet Submitted Piumbing Contractoc Phone Plumbing System Includcs: _ Water Softener _ I.awn Sprinkler Fee: $90.00 Water Heater _ No. of R.I. Baths No, of Bakhs Mechanical Contractor: _ Mechanical SysLem Includes: Sewer/Water Conhactor: FAX # Fee: $70.00 Phone # All above information must be submitted prior to processing of application. I hereby acknowledge that i have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Stgnoture of Applicant?.uu..? Acov/z Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 2002 Air Conditioning _ Heat Recovery SysCem OFFICE USE ONLY ? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? OS 03-plex ? 11 10-plex X 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 30 Accessory Bidg ? 31 Ext. Alt - Multi ? 33 Ext. AR - SF ? 36 Multi ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ?<' 33 Alteration ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 WindowslDoors ? 34 Replacement *Demolition (Entire B ldg only) • Give PCA handout to applicant Valuation Occupancy !( f?, "?? MClES System Census Code ? Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs ? Length Fire Sprinklered Type of Const vf+T.? Width REQUIRED IN SPECTIONS _ Footings (new bldg) FinaUC.O. _ Footings(deck) FinaUNo C.O. , _ Footings (addidon) 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 (newheplacement) ° Insulation _ Retaining Wall Approved By T! ^2r , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage 5&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total ? .._--. /'7'c PERMIT # ! ? ? A ok RECEIPT DATE: 200E MIDEPTIAL PLUM$ING PEiMiT ihPPLiCATtON c1rY og EA?I S$SO P1LOT [{AOB RD $1lHAA. MlY 561 SE 657-6$1-9675 Please complete for: SITE ADDRESS: single family dwellings, townhomes and condos when permits are required for each unit, 6ackflow preventer for irrigafion system =0n OWNER NAME: : I?ILU.CN ? (L,(Q y TELEPHONE #: S S6•(p (AREA CODE) INSTALLER NAME:0AaPaWs Plho. t M67 TELEPHONE #: J 1- N Jd -?$BO STREETADDRESS: / 31?)- t-GKQ A'e , (AREA cooe) CITY: 1/aUrt-&Q? 4k''P STATE: oqu ZIP: SS J u?- / _ SEPTIC SYSTEM, new/refurbished (requires rivo sets of plans and MPC license) $ 100.00 includes $40.00 County fee Note: Additional consultant fees may apply • MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING: ? Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00 _ Abandonment ot septic system. _ Water turnargnd - existing dwelling unit (+ 5lEmeter if needed -$118) Other: QAJ? VU,.?a.? _ RPZ: new installation/repair/rebuild $ 30A0 _ lawn irrigation system ReplacemenUadditional: _ water softener _ water heater $ 15:00 .? State Surcharge APR 19 ZQOZ ' $ .50 ? $ ? Total By I hereby acknowledge that I have read this application, state that the informatlon is correct, and agree to complywith all applicable Ciryof Eagan oMinances. ttis the applicanYs responsibility to noti(ythe property owner that the CiTy of Eagan assumes no lia6ility for any damages causedby the City duringils normal operefional and maintenance activities to the hacilitles constructed under fhis permit within Ci eRy/?-o ../easement. SIGNATURE OF PERMI7TEE 1l02 *************************************** CITY OF EAGAN CASHIER: JS TERMINAL NO: 014 DATE: 04/04/00 TIME: 14:22:14 ID: NAME: BRUCE R MUSOLF 3210 9001 4147 PNNSLV AVE 60.00 2155 9001 4147 PNNSLV AVE 0.50 Total Receipt Amount: 60.50 CR125574 USER ID: JAN ? 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) ? CITY OF EAGAN 36o' Sb 3830 PILOT KNOB RD - 55122 4 0 ?.27/ 651-887-4875 CGlltd 413100 New ConshucHOn Reaulrertynh RemoCel/Reoalr ReauiremeMs ? 3 reglitered sIle aurvaya ahowlny 2% R. of bt, eq. ft. of house antl 20 rooletl areoa ('{Q% mmdmum lot coveraae albwedl > 2 coplea ot plcna (strow beam & wMdow slzes; poured Ind. design; etcJ > I aer a enerpy caicugatbns > 3 coples d hae preaervallon plan il lot plattetl alter 7/1 /93 DATE: -7 - 3 I - (-/ d 2 copiea W plan t set of energy cdculaMOns ta neated addlHOna 1 alte wrvey for exteAOr addtHOns & deCks coNSrRUCnoN cosr: 3 r a n_ n o DESCRIPTION OF WORK: D E G K STREETADDRESS: 41A7 PF'NNCY'Lv/JAJ DA ?C/ U+E ?=-.?f CA^/ ?!Y?/?i_ SSl Z? LOT: 14 BLOCK: -3 SUBDJP.I.D. t: S1•?'ord Placv PROPERTY OWNER CONTRACTOR ARCHITECT/ ENGINEER W o C I? (? l 2- ??-I O 3-?s (?`?S Name: ? u,?-o L 1 1? RuCE Phone #: last Flrst Sheet Address: .54 rn F: CMy Company:, Telephone #: ( ) Stafe: LP: " ne 1: (area code) License # ExP. Lp: Name: Sheef Addtess: Reglshatlon 4: ay State: Sewedwater licensed plumber (N installino sewer/water): Phone #: Zip: I heroby acknowledge IhaT I have read fhis apPlicaNon, atale lhat ihe InfomnaHon is cortecf, and agree to compty wNh aq applicable S1afe of Minnesota Statutes and Cify of Eagan Ordinances. i Signalure o( Apptlconh ?/?.?u?+?-•-'?//.!? Certificates of Survey Received _ Yes Tree Preservation Plan Received Yes OFFICE USE ONLY No _ No _ Not Required ?.? City State: OFFICE USE ONLY BUILDING PERMIT SUBTYPES ? 01 FoundaGon ? 07 OS-plex ? 13 16-plex ? 21 Porch (3-sea.) O 02 SF Dwelling ? 08 06-piex ? 17 Garage ? 22 Poroh/Addn. (4-sea.) ? 03 01 of _ plex ? 09 07-piex ?18 Deck p 23 Porch (screened) ? 04 02-plex ? 10 08-plex O 19 Lower Level ? 24 Stortn Damage ? OS 03-plex ? 11 10-piex Plbg _Yor_N ? 25 Miscellaneous ? 06 04-plex ? 12 12-plex O 20 Pool ? 30 Accessory Bldg. W9 RK TYPE X 31 New ? 32 Addition ? 33 Alteration ? 34 Repair ? 36 Move Bidg. ? 43 Reroof ? 37 Demoiish (Bldg)' ? 44 Siding 0 38 Demolish (Interior) ? 45 Fire Repair O 42 Demolish (Foundation) ? 46 Windows/Doors ' Give PCA handout to applicant for demolition permit GENERAL INFORMATION SAC Code ol_ No. of Units CJ No. of Buildings t Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length W idth Basement sq. ft. Main level sq. ft. sq.ft. sq.ft. MISCELLANEOUS INSPECTIONS ? Stucco/Stone APPROVALS Planning Building 66 ? Engineering sq.ft. sq.ft. Footprint sq. ft. Census Code MC/ES System City water Booster Pump PRV Fire Sprinklered Variance ? ^ O 31 Ext. Alt - Mutti 0 33 Ext. AR - SF ? 36 MuRf i-/ 3 N Permit Fee -t? A 0 .S ?J Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: J 0. 5 Valuation: $ 1,2GG SAC Units % SAC INSPECTION RECORD I C°n °"° 0 495 CITY OF EAGAN PERMIT TYPE: BuzLoINe 3830 Pilot Knob Road Permit Number: 000593 Eagan, M in nesota 55123 Date Issued: 0 5/ 2 2/ 9 2 (612) 681-4675 SITE ADDRESS: LoT: 14 4147 PENNSYLVANIA AVE 3TAFFORD PLACE PERMIT SUBTYPE: SF DW6 BLOCK: 3 APPLICANT: SEASONAL BLDRS INC (612) 454-5971 TYPE OF WORK: NEW INSPECTION FOOTINO .. . FRAPIING D• INSULATION FINAL FIREPLACE .. REMARKSs RECEIPT • ? S&W PLBR. m REGENCY P166. ? ? CITY"UF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 PERMIT PEf{MIT TYPE: Permit Number: Datelssued: Control No. 0495 BUILDINB 000693 06/22/92 SITE ADDRESS: 9147 PENNSYLVANIA AVE LOT: 19 BLOCK: 3 .. 5TAFFORD PLACE - DESCRIPTION: ?. --Building Permit Type , Suilding',Work Type U8'C. Occup•er+vy Canstruction Type Zonirtq,, s _ Building tength j • 9uilding yJidttr ? f 4 / 1 . f ,r \ t?? SF DWO NEW R-3 pl-1 . V-N PO R-1 48 _...._,50r .,. \ 'i `7f? f `? r y J ?? r' `r.., ? I ? 4=J1 1 in .- REMARKS: RECEIPT p CUJ B'?1.5^J 3SW PLBR. s REDENCY PLBG.... FEE SUMMARY: Base Fee Plan Review Surcharge . ... SAC SAC $ SAC Units Subtotal VALURTION $563.00 ;365.96 , $41.50 ;T08.60 108 1 $1,670.45 $83.000 MISCELL,ANEOUS... >.._. $1,610.50 _... Total Fee $3,280.95 CONTRACTOR: - APPlicant - sT. LI pWNER: SEASONAL BLDRS INC 14545971 000165 SEASONAI BIDRS INC 4580 SCOTT TR 212 4580 SCO7T TR 210 EAOAN pk 56122 EA6AN MN 65122 (612) 454-6971 (612)454-5971 I fiereby acknowlodge tRat Z have read this application and state Chat the intcrmation is earrect and agree ta comply with all applieable stste of An. 5tatutes and i y af Eagan Ordinances. L ,?7 /? - /?-??L?' APPLICANT! ERMITEE SIGNATURE ISSU 8Y: SIGNATURE 1992 BUILDING PERMIT APPLICATION CITY OF EAGAN :? ?+Y ; ? RECO ? SINGLE FAMILY 2 SETS OF PLANS, 3 REGISTERED SITE SURVEYS, 1 SET ENERGY CALCS. ' MULTlPLE DWELLINGS 2 SETS OF PLANS, 3 REGISTERED SITE SURVEYS, 1 SET OF ENERGY CALCS. # OF UNITS RENTAL FOR SALE COMMERCIAL 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SEf OF SPECIFICATIONS, 1 SET OF, ENERGY CALCS. PENALTY APPLIE$ WHEN TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING QAY OF MONTH IN WHICH REQUEST IS MADE JQB 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. To Be Used For: l¢) ValuaUon: Date: ,?j- lff-/z Site Address Lot IL Blxk Parcel/Sub Owner City/Zip Address CitY/Zip. Arch./Engr. I Address LO City/Tip Code PFwne. # ? Sewer/1M1laterl for sovyar/wati ?Q `• JF= Oxupancy Zoning Actual Const Allowable # of storiss Length. Depth S.F. Total Footprirtt S.F. Bldg Permft Surcharge ? Plan Review = License Fee SAC, City r C, MWCC . . - ffier Conn. "'- Wffier Meter - Acct. Deposit - S/W Permit - SJW Surcfiarge -' Treatment Pi. - Road Unit - Park Ded. - Trail Ded. Copies - SUBTOTAL - Peneity Lot Change - TOTAL _ a.? ( On-site sewage :1?? ?IV1C_- On-site well ? MWCC System ( I ?0 City water PRV ? ?- Booster Pump Licensejta5?L- APPROVALS Planner Council I IX4 Bidg. Off. r A „ Variance two Processingtime agrees that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. N L , PERMIT, N' CITY OF EAGAN 1992 BUILDING PERMITAPPLICATION • 681-4675 SINGLE 8 MULTI-FAMILY 2 sets of plans, 3 register.ed site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural 8 structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies when typing of permit is requested, but not picked up by last working day of.month in which re uest is made r lot chan e is re uested once ermit is issued. Date Yaluation of work Site Address: . STREEi STE i Tenant Name: LOT Li_ BLOCK P.I.D. M Descri tion of work: The applicant is: ? Owner O Contractor 11 Other (Deseribe) Name Phone Property uST FIRST Owner qddress STREET ' STE i City State Zip Company Phone Contractor Address License N Exp. City State Zip Company Phone Architect/ Engineer Name Registration M Address City State Zip Sewer & water licensed plumber ." Pracessing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this applicatian and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature af Applicant: urris..;t uac unLY BUILDtNG PERMtT TYPE ?"O1 Foundation ? 05. Apt. Bldg ? 09 Basement Finish W02 5F Dwg. ? 06 Garage/Accessory ? 10 Swim Pool ? 03 Two family ? 07 Fireplace ? 11 Res. Add./Porch ? 04 Multi-fam. T.H. ? 08 Oeck ? 12 Comm./Ind. WORK TYPE Eg 31 New ? 34 Repair O 37 Demalish ? 32 Addition 0 35 Tenant Finish ? 99 Undefined ? 33 Alterations El 36 Move - GENERAL INFORMATION Const. (Actual) v-T! 8asement sq. ft. (Allowable) V- N lst fl. sq. f.t. UBC Occupancy R•3 M-? 2nd F1. sq. ft.. Zoning pn tiz-k Sq. Ft. total M of Stories Foatprint Sq. ft. Length _?? On-site well .. , Depth ,gp On-site sewage APPROVALS Planning Building Engineering Variance ? 13 Public Fac. % ? 14 Agricultural O 15 Niscellaneous MWCC System YF-S City Water YEs PRV Required Booster Pump Fire Sprinkler Census Code Ti SAC Code oi Assessments REGIUIRED INSPECTIONS ? Site ? Footing O Wallboard ? Final ? Framing ? Draintile ? Insulat9on ? Fireptace Permit Fee 3,00 vetL.c;on: S. 000'?- Surcharge Plan Review yi,sp 3(25195 ,?4K244 ? S'16 n y K /o'iz: (e-/z) MWCC SAC City SAC 160,00 1o01oo lac= E3,Su4 Mater Lonn. (0 ,oa a6x 40 ? I DW ? Water Meter 4,oa yy, ioyz.- y2 Acct. Deposit 30,00 ,..,--. S/W Permit 3D.0o )o`b2 X b0 ='?3,574 5/W Surcharge , 5v -------? Treatment Pl. 30o, 00 I 2c.? Road Unit p,o.oo Park Ded. Trails Ded. Copies Other Total: 3 1 SAC % o0 SAC Units ? 'I" " - _ :..:, ??? J?;?C. E;(TERIOP. EPJVELOPE AVF_RAGE " ------------------------------ U" LOMF'UTRTII7N ---------------- ---- ----------- Plan # 91Oi?i paLe -- _-6-°1 - ------ --------------- Owner ?t?t???.? __----- ?. _?-Ae'? Cantractor Seasonal_E;uild ers r.. .. --..... .. . ....... 5ite addres=. . 17Tota1 e;:posed wall area 2)7ota1 e::posed roof!ceiling Wal l cal ct.ilati on Total window area _ __199__ __ Total door area i8 - Tutal giass duor area - --- ---qii Total fireplace area na Total wall framirty area 157 Net insulated wall area __ __ Total rim joist zrea Total foundation area 22 2gm±im =14f l2-9 Total foundation windoo-l Rn__ _ __sg_ft__ _ _! = f 3)Total ? If item 3 is the same asT or less than item 1, you have met tne intent of 2 MCAFt1.16008 A and 0 Roof/ceiling calculation Total sFr,ylight area Total roof/ceiling framing Net insulated roof area ----no ----sg_ft_-?--_---?--- ---11i8---- --- 977---- g=ft_ON=-=10- 4) 7ota1 I f i tem 4 i s same as, or 1 ess than 2, you met Lttl.e-i n-?efit of' 2 hICAR 1.16008 A and O Alternate huilding en•relope design to utilize the total enve2ope system method the suun of iteins 1 and 2 shall be greater than the sum of items 3 and 4 1) ------ °------- ------- 3) ---+4) - I hereby certitfy that the building here described meets or e;;r_eeds the state of minnEsota energy conservation act. Signed t . ,- . WALL COIVSTFtUC'TIOhI ?%:h w/ Etildrite CEILING CON5TRUC7IOP1 F- 42.!i 61awn ins. Framing section Frzmino section 1. Interior air film .68 1. Interior air 2. 1!2" gyp, bd. .45 5J8" qvp 6d. 3. 5 1/2" of so7t wood 6.87 r 1i2" wood 4. =5/32 trildrite 2.irg 4. 10" ins. 5. Siding .81 Tot21 R 6. e:;terior air film .17 U= 1..'Fc Total R U = 1iR Insulated section i. Interior air film 2. 112" 9YP. bd. 3. S 5/8 batt ins. 4. 25/32 6ildrite 5. siding 6. e;;terior air film Total R U = liFi Rim ioist section 1. Interinr air film =, 5 1•,'2" ba.tt in=, _. 1 if2" wood 4. 25i3: 6iidrite 5. siding 6. e;;terior air film Total fi U = ifR Foundati on 1. i.nterior =. 1" stvro 3. 12" conc 4. e:;terior secti. an air film ins. b14c, air film Total R U = 1 /R 1 1 _06 _09 .68 .45 19.0 ?. 08 .91 .17 23.19 0.043 .68 19.0 1.89 2. pg .81 .17 2 4.63 .04 .68 5.0() 1.28 .1? 7,13 .14 film .b8 .56 a. 37 '3.24 38.85 , 026 Insulated section 1. Interior air film .68 2. 5/8" gvp bd. .56 77- 14" insulation 42.00 Totzl R 43.24 U = 1 /R .023 SQecial condition n/a PERMIT N REACTIVATE M-3 CITY OF EAGAN 1992 BUILDING PERMIT APPLICATION 681-4675 PEC 1 F REd, 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 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 ( Z /1.S / Valuation of work Site Address: 1:-ENWSyL.-VAMA AUF-- STREET SUITE R Tenant Name: (commercial only) IAT ?_ BIAC$ ?_ SUBD. I? P.I. D. M Descri tion of work: F'INISAI?S t?AS"iaM1E1? The applicant is: j$I Owner ? Contractor O Other (Deseribe) Name ('() USOLP 13 9 u0= Phoii2 ?SZ-'SSC'C Property usT ?IRST 'WIJIZW q'q6_3S4C9 Owner Address _? Idlr? PENQSYl.VA1.11A AVE STREE7 STE N City FA 6? N State Zip 551 Z-3 Company Phone COf1tr8CtOf Address License # Exp. City State 2ip Company Phone Architect/ Engineer Name Registration # Address City State Zip Sewer 3 water licensed plumber . Processing time for sewer & water permits is two days once area as been approved. I hereby acknowledge that I have read this application and state that the infarmatlon is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Appli,cant: OFFICE USE ONLY B UILDING PERMIT TYP E ?1 • ? O 01 Foundation p 06 Duplex ? 11 Apt./Lodging R(I6 Basement Finish O 02 SF Dwg. El 07 4-Plex O 12 Multi. Misc. ? 17 Swim Pool O 03 SF Addition ? 08 8-Plex 11 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 EX 31 New 0 33 Alterations ? 35 Tenant Finish O 37. Demolish ? 32 Addition ? 34 Repair ? 36 Move GENERAL INFORMATION Const. (Actual) Basement sq. ft. MWCC System (Allowable) lst F1. sq. ft. City Water UBC Occupancy ?Ea 2nd F1. sq. ft. PRV Required Zoning Sq. Ft. total Booster PumP N of Stories Footprint Sq. ft. fire Sprinkler Length On-site well Census Code t? Depth On-site sewage SAC Code APPROVALS C445ms' y?? f ? Planning Building Assessments Engineering Yariance REGIUIRED INSPECTIONS O Site O Nallboard ? Footing `;kFinal WFraming ? Draintile O Insulation ? Fireplace Permit Fee v.imti,,,: g Surcharge Plan Review License MWCC 5AC Cify SAC Mater Conn. Mater Meter . Acct. Deposit 5/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC % 5AC Units ' CITY OF EAGAN L-- B MECHANICAL PERMIT RECIIPT #/O (v? SUBD. (612) 6814675 DATE !v ? .5- RESIDENTIAL PLEASE COMPLETE UPPER POR1'fON ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, COMPLETE FOR TOWNHOhiES/CONDOS WHEN SEPARATE PERMITS ARE REQUIRED FOR EACH DWELLING UNTT. OR'NER: COMMERCIAL PLEASE COMPLETE THIS PORTION FOR ALL COMMERCWIINDUSTRIAI. BUILDINGS. ALSO COMPLEI'E FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDiNGS WHEN SEPAItATE PERMTfS ARE NOi REQUIRED FOR, EACH DWELLING UNIT. WORK DESCRIPTION: 11 CONTRACf PRICE: I 1''EES LFn OF CONTRAGT FEE ? STATE SURCHARGE IS $.SO FOR EACH S1,000 OF PERMIT FEE. S PRQCFSSED PIPING - $23•011 r MIIVIMUM FEE - $25.00 If CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MN 55122 PHONE: (612) 454-8100 mox FOR CITY USE ONLY PERMIT # RECEIPT # DATE : C/ -5 ?- m TOWNHOMES/CONDOS WHEN PERMITS ARE REQIIIRED FOR EACH UNIT. -----------------° ------------------____----------------------------- WORK DESCRIPTION COMPLETE THE FOLLAWING: NO FIXTURES EA. M?,? PLEASH COMPLETE UPPER PORTION ONLY FOR SINGLE FA4IZLY DWELLINGS 6 NEW CONST ADD-ON MINIMUM 15.00 ADD ON SHOWER 3.00 REPAIR WATER CIASET 3.00 / BATH TUS 3.00 ??? ???L`' ? LAVATORY 3.00 OWNER NAME: s? • ? KITCHEN SINK 3.00 ? LAUNDRY TRAY 3.00 SITE ADDRESS: HOT TUB/SPA 3.00 ? 3 ? WATER HEATER 3.00 SUBD. '?G?• BIACK LOT: FIAOR DRAIN 3.00 / GAS PIPING OUT. INSTALLER: 14 Enl "1--f (MINIMUM - 1) 3.00 /f 3 ROUGH OPENINGS 1.50 ADDRESS : /14a .?T/?. • _ OTHER M SSP 9 N WATER SOFTENER 5.00 CITY: ?/ // ZIP: PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 TOTAL 3 •3 ' ? •3 '? 3 PHONE #: /? (J- ' /J77 ? SUBTOTAL S a 5 ? ST. SURCHARGE .50 I ATURE OF PERMITTEE ^?G TOTAL: S Oc / m PLEASE COMPLETE THIS PORTION FOR ALL COMMERCZAL/INDUSTRIAL BUILDINGS AND MULTI-FAMILY BUILDINGS WNEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. ------------- CONTRACT PRICE: OWNER NAME: SITE ADDRESS: R LOT: BLOCK _ SUBD. INSTALLER: ADDRESS: CITY: ZIP: PHONE #: FOR: CITY OF EAGAN 1 FEES 18 OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR EACH $1,000 OF YERMIT FEE. $25.00 MINIMUM FEE. CONTRACT PRICE x 1$ STATE SURCHARGE $ TOTAL: (SIGNATURE) , - €'AST METRO SURVEYORS 2112 SNALE LANE / NC ' EAGAN, MN 55122 Certificate of Survey for: (612) 452-0134- SEASONAL BUILDERS LEGAL 'DESCRIPTION: LOT 14,BLOCK 3, STAFFORD PLACE ACCORDING TO THE RECOROED PLAT THEREOF DAKOTA COUNTY,MINNESOTA 7G 9? f 9r6 ` ? ? o? S V? P? ?o „ `S-.a tK-o PJ Iz- ,? IDRA/NAGE B UTfLITY \ O? 9i7// EASEMENT ?h ??• /i LOT 14 ? /t(6) L = 31.42 R=20 q? 3 • ?? \ ti Soo o <L,92 °o ?y rq ?F . ?F SCALE : I" = 30'" LEGEND o DENOTES IRON MONUMENT a DENOTES WOOD HUB SET 12e DENOTES EXISTING SPOT ELE VATION DENOTES PROPOSED SpOT ELEVATON DENOTES DRAINAGE IOIRECTION ? /'+6POSED i j , Ilnu??w ? ; d? ?r s . - yco .? i s? y ?og OO ? ? ? ; /?p• 10 CD ?;?a , L Or I z5) I hxsby csrtify tAat thit survsy,plon or rsport wos prepared b'y me or under my direct supxvision and ihat I cm a duly o ReQistered Lond Surveyor under th• : l.aws o} the Stata o} Minnesota * ;' 9? ¢ Z> s 9,T 3 k1at.r.-«,rr r.t-", s azs.o P?oposE-c SP4.T ?" V_AtKaLrT- INVERT ELEVATION AT SERVICE EXTENSIONa PROPOSEO GARAGE F100R ELEVATION • 918•7 PROP05ED FIRST FLOOR ELEVATION = 1.0 PROPOSED BASEMENT FLOOR = 5.0 ELEVATION NOTE ' VERIFY ALL FLOOR HEIGHTS WITH FINAL HOUSE PLANS Date : ? EAST METRO 2112 SHALE LANE SURVEYORS EAGAN, MN 55122 INC ' (612) 452-0134 Certificate of Survey for: SEASONAL BUILDERS LEGAL DESCRIPTION: LOT 14,BLOCK 3, STAFFORD PLACE ACCORDING TO TNE RECORDED PLAT THEREOF DAKOTA COUNTY,MINNES07A V? P? C.) ? o 45 ? i L = 31.42 R-2o.o,Q 92? ? op 9?/ 9.T 3 LOT 14 TG 9r6 e- J S !v co? lb J??J 8 g g ?''??0 ,D// \\\3e ? P ? IORAlNAGE 8 UTILITY \ 6./ EASEMENT 9z7 s \ ?/sr ?O J,D . * 0O !y ? .3 ?? ?j• i j . , ?o ?v? '? . ?? ;?- ` `?? Wr1?/? ? r U1! BY ??- -f? ?_ 9Z> s V•{GAtlT , F scaLE Dt;Y< WALIZ.a? SA-W , - 9z,5.0 PRpgDSE-C SPL?t (arYTF-`t LtAtx0oT LEGEND INVERT EI.EVATION AT SERVICE EkTENSiON= ' o DENOTES IRON MONUMENT PROPOSED GARAGE FLOOR ELEVATION =`126•7 o DENOTES WOOD HU8 SET PROPOSED FIRST FLOOR ELEVATION = i.o DENOTES EXISTING SPOT PROPOSED BASEMENT FLOOR = 92-5•o o ELEVATION ELEVATION DENOTES PROPOSED SPOT ELE VAT I ON ? DENOTES DRAINAGE DIRECTION NOTE, VERIFY ALL FLOOR HEIGHTS WITH FINAL HOUSE PLANS I hxsby certify ihat this survsy,plan or rsport wos prepared by me or under my direct supervision and that I am a duly Repistered Land Surveyor undar ths Laws of the State of Minnesota. Date ? City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4147 Pennsylvania Ave Lot: 14 Block: 3 Addition: Stafford Place PID:10- 72500- 140 -03 Use: Description: Sub Type: e - Furnace Work Type: New Description: Furnace Comments: Fee Summary: Contractor: Standard Heating & Air Conditioning 130 Plymouth Ave. N Minneapolis MN 55411 (612) 824 -2656 Quesetions regarding electrical permit 952- 445 -2840 Ashley Orman 410 W Lake St ME - Permit Fee (Replacements) Surcharge -Fixed Total: Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - Permit Type: Permit Number: Date Issued: Permit Category: equirements should be directed to Mark Anderson, State Elec Owner: Brace R Muslof 4147 Pennsylvania Ave Eagan MN 55123 $50.00 0801.4088 $0.50 9001.2195 $50.50 Mechanical EA084952 08/05/2008 ePermit cal Inspector, 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 Issued By: Signature û ú þýý üûúûøú ÷ýý ú ùýéé ëë ÿã ýü þýõ ôóüòüðü ø÷ö ôø÷öôóüòüÞóòßö ê üöñ ü ðü í ö ÷ ï êöìêüê üêü ùêüèë óóö üú ëë ê ý üöèð ëë üö ëü è ð ùêü ù÷ óü ë ê÷êüè üîåäåþþè þèþ ô÷ üæ åè âèãâ æ úè óñ õðï öö ßó ü ßá üë âãð ÿü÷ì ì ßüìáÞ û áÞ ã é çãÿÿÿ ù÷ ó ì ü öö ü ëê ü êö÷ó öö ù ëáü ü ð÷ëû í üè öö òê üü ÷ ì þ ê ÿÿ þýüëüûû úþþÿÿýýòÿ íí Þÿóóù Þ ÿù ÿþýüû ïùþüû úùüû úöêù÷ öê û ò øþ ï þï Þâþû Û ÿßþù í òûùã ò ð ðò ù ßþù ò ùý ùòçó ù ööû óùóùò ÿ û çïóùóû ó ùç ïùýòå ùù ù ßþù ýö óòðò ç í èÞçæçæ øú ÿþùðù èçäçä Ýþ îæç ÷öû ùõô ûû ö ù ùþ õþó äïþ ïú ãã ã õ÷Þ ìîéî ð ù ýö ððã ù ðûû ðð óùòùù ù òûöðûûý ÿ óõ ÿþ ïó âù ç ûûê ùò ÿ þù þ ÿ þù Use BLUE or BLACK Ink For Office Use City of EaQail I Permit #: J J Permit Fee- ( 3830 Pitot Knob Road I'1 ' (2 Eagan MN 55122 i Date Received: Phone: (651) 675-5675 1 Staff: 1 Fax: (651) 675-5694: I RESIDENTIAL PLUMBING PERMIT APPLICATION Date: 2 Site Address: rI-/(212./A-__Syl•feLNI0\'' Tenant: r Suite #: c t $D( - Phpne: U51 (,i S>.. j5 RESIDENT / OWNER CONTRACTOR Name: Address / City / Zip: LI i1- %�J'Ji L�L1ikk, Q'` 1)- yr, it , -�� Name: License #: OSS 2. J I -49t'_ 1 Appliance Connections Inc, Address: _ 12850 Chestnut -mrd: city: Shakopee, M 55379 State: --- Zip: 952=445- 61: Contact: Email: TYPE OF WORK PERMIT TYPE New Replacement _ Repair_Re�builld "1,,/M' odify Space ___ Work in R.O.W. Description of work: ' ' .. �' `�'�' ` r � � RESIDENTIAL Water Heater Lawn Irrigation (__ RPZ / _ PVB) Septic System New Abandonment ater Softener Add Plumbing Fixtures l-_ Main /;___ Lower Level) Water Turnaround RESIDENTIAL FEES: $60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) *Water Turnaround (add $189.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) TOTAL FEES $ CALL BEFORE YOU DIG. Cali Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig, to receive locates of underground utilities. ` www.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved n in the base of work which requires a review and approval of plans. Applicant's Printed Name Applica Signature FOR OFFICE USE Required Inspections: _Under Ground _Rough -In _Air Test _,Gas Test Final Reviewed By: Date: PERMIT City of Eagan Permit Type:Building Permit Number:EA166050 Date Issued:12/08/2020 Permit Category:ePermit Site Address: 4147 Pennsylvania Ave Lot:14 Block: 3 Addition: Stafford Place PID:10-72500-03-140 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. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). 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 - Bruce R Musolf 4147 Pennsylvania Ave Saint Paul MN 55123--158 (651) 452-5566 Lindus Construction 879 Hwy 63 Baldwin WI 54002 (715) 684-4647 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA172917 Date Issued:10/21/2021 Permit Category:ePermit Site Address: 4147 Pennsylvania Ave Lot:14 Block: 3 Addition: Stafford Place PID:10-72500-03-140 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 - Bruce R Musolf 4147 Pennsylvania Ave Saint Paul MN 55123--158 (651) 452-5566 Norblom Plumbing 1465 Selby Ave St Paul MN 55104 (612) 827-4033 Applicant/Permitee: Signature Issued By: Signature