4154 Pennsylvania Ave.?:• z,,, _ .
? CASH RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE c:' ( 19 ?
FnoM
AMQUNT S
& DOLLAFiS
loo
? CASH CHECK
', 'i `s 7. `:, i') -- !?. 1.) -4- 1 - // `/ 0
BY
C 1 ; 708 M.°-P.Y°`° C°°y ?
vanow--Poas?c ?r
FiNc--Fw Capy
Thank You
. . ?
RE'.''
X
DATE:
!!AY 30. 1991
4154 PENNSYLVANIA AVB (RAINB0W HOlES OF EAGAN)
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 (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 notiee.
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.
- REQUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
?. ..
` -` - CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 :. --7 " . Se"
BUILDING PERMIT
To be used for SF M/CAIR Est. Value $40,00
Site Address 4134 PF.NHSYLVANIA AYb
Lot 1ID Block I Sec/Sub. sTlIMI*D P7.AC8
Parcel No.
W Name ?IK? ?3 OF EAGAtI INC
; Address 2367 78Ti1 ST E
0 City I?? GROVE HTSPhone 43"292
o Name SAME
Z
g? Address
City Phone
?
WW Name
?? Address
?W Gity 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 City of Eagan Or)dinances.
Signature of Permitee
A Buiiding Permit is issued to: MlAOLM tgJM" Vi lALaM
on the express condition th8t all work shall be done in accordance with all
applicable State of Minnesota Statutes and City ot Eagan Ordinances.
Building Officiai
Receipt #
OFFICE USE ONLY
Occupancy ? 3 M-1 FEES
Zoning
(Actual) Const
Bldg. Permit apt ?n
?L±t]aG
(wlowable) V-N surcnar9e 43•00
M ol Stories
Length
? • Plan Review 336.00
Depth SAC, City 100•00
S.F. Total - SAC, MCWCC 650,00
S.F. Footprints -
On Site Sewage _ Water Conn 660000
On Sile Well Water Meter 951W
MWCC System =
3
0
Cily Water Acct. Deposit 0
0•
PRV Required _ SflM1I Permil 30•00
Booster Pump - SMI Surcharge • 30
Treatment PI 276•00
APPROVALS Road Unil 370•00
Planner - Park Oed.
Council
BIdg.OH. _ Copies
3
237.50
Variance - TOTAL .
' Permit No. Permit Nolder Dsta Telsphone #
WATER
SE1N@R
PLUMBtNG
H.V.A.C.
ELECTRIC
Inspeetion Date lnsp. Comments
Footings 1
Foundation
Framing ??r!/ 1
Roofing (,c,?e,
Rough Plbg. 17-
Rough Htg.
Isul. 7/3A
Fireplace
Final Htg.
Orshat Test
Final Plbg. _ v..Lj' PI6g. Inspector - Notify Plumber
Const. Meter
EngrJPtan
81dg. Final %3
Dedc Ftg.
DeCk Fnal
wea
Pr. Oisp.
. ?. _ ?
V'ert`f`ratt o4 ??rupai`ry
?Citp of (Eagan
Br}wdatrttt v# Bueing 3wntim
77rfs Cxmfuate' issued pwsuarrt to the requursxnts of SccJion 306 oj1/re unifonrt Building
Code aertiifYinS 1Jrat c11he tinu of }uuance 1lrissuuctune kas lx c»mplianm with the warious
ordinancts ojlhe City regulating building construcuon or rrse For the foQowing.
use aksdrKaooe SF UAGIQR ews. aamk rm 1 Q 148
R VN
?w?7 7Yvm _ - ---?-- --- -- ? °-imic` - ---- ? C?.,.?? --- - ---
? ?/30/q I
POST IM A CONSPoCIiOt]S PU1CE
SEWER & WATER PERMIT
CITY OF EAGAN
383Q.Pilot ftob Rd.
Eagan, MN 55122-1897
? . . '?S'!'?'?}?SSF?7!'?^r?.Nlx?T"^.'ry?'.?`7'
&AY 31. 1991
1.
SITEADDRE"'SS 4154 PENNSYU!?.NTA Ab'E
LOT i8 BLOCK 1 SEC/SUB ?-T'••r`OiD
APPLICANT:
ADDRESS:_
CITY, STATE
PHONE: -
PLUMBER: 'LbM HfiS3IAN PLUFi,IrTC;
ADDRESS: 121 RED1a00D CF
CITY, STATE APPLF VALLF.Y N;"' Zip 3`,124
PHONE: 432- )998
?,AINBOW HOME5 OF EACAN '_t•2`3
OWNER:
ADDRESS: 1367 78TH ST E
CITY, STATE tNVER GEQVE IiEIGHTS MN Zip 55.)76
PHONE: 4 50--6292
_ PRV _ BOOSTER PUMP
PERMIT REQUESTED
? SEWER - WATER _ TAPS
x NEW
PERMIT DATE /31 } .
PERMIT # 1,2022
B.P. RECEIPT #
B.P. RECEIPT DATE oy% 31 f ?1
EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be given for Deduct Meters.
/
? ?".c11u J
1 AGREE TO COMPLY WITH CITY OF
EAGAN ORDINANCES
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
SEWER & WATEFi PERMIT
CiTY OF EAGAN
3830 Pi{ot Knob Rd.
Eagan, MN 55122-1897
DATE MAY 31, 1991
METER #q7"62 Z1 PERMIT DATE 0 5/ 31 / 91
CHIP # /) d 3 3JI/ P PERMIT # 12022 ?
METER SIZE ? B.P. RECEIPT #
ISSUE DATE B.P. RECEIPT DATE n 5( 31 9]
_ PRV - BOOSTER PUMP
SITEADDRESS 4154 ['v:.,`i`Y:.VAtv'IA AVE
LOT t8BLOCK 1 SEC/SUB STAFFORD PLACE
APPLICANT:.
ADDRESS:_
CITY, STATE
PHONE: -
ZIP
PLUMBER: "fOM tIESSIAN PLUMHING
ADDRESS: 121 REDWOOD Dt;
CITY, STATE :1PPLi: VALLEY i'[N ZIP 55124
PHONE, = ' Z--6A9S
PERMIT REOUESTED
X SEWER ? WATER -TAPS
_ COMM/IND X RESIDENTIAL
X NEW - EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WIl?L NOT be givey for Deduct Meters.
?
I AGREE TO COMPIY WITH CITY OF
OWNER: RAINBOW H0nS OF BAGAN IhC EAGAN ORDINANCES
ADDRESS: 2367 78Tki ST E ?
?
CITY
STATE INVER GROVL HEIGHTS AiN Zlp 55076
, 450-62Q2 SIGNATURE WHEN METER ISSUED
PHONE:
JLPLEASE. ALL OW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
EWER PER MITS, CONTACT ENGINEERING DEPT.
ZIP
- COMM/IND - RESIDEIVTIAL
METER # -
CHIP # -
METER SIZE
ISSUE DATE
RESIDENTIAL
BUILDING PERMIT APPLICATION
I
3830 PILOT KNOB RD - 55722 `?
651-681-4675 Wg' ,r
/
v Construction ReauiremeMS RemodeUReoair Reauiremenls
3 regislered site surveys showing sq. ft. o( lot, sq. ft. of house; and all rooted areas . 2 copies of plan
(20% maximum lot wverage allowed) . 1 set of Energy Calculations for heated additions
2 copies of plan showiig 6eam & window s¢es; poured found design, etc.) • 1 site survey for extenor additions & decks
1 set of Energy Cakulations . Indicate if home served 6y seplic system for additions
3 copies of Tree Preservation Plan If lot plafled after 711193
Rim Joist Detail Optbris selection sheet (bldgs with 3 or less uniis)
4TE 1 C)_1
)B SITE ADDRESS krJ
MULTI-PAMILY BUILDING, HOW MANY UNITS?
IOPERTY OWNER
PE OF WORK ?
'PUCANT l\IJ\
)DRESS Il?$
VALUATION 44l w ` ,;D
FIREPLACE(S) _0 _7 _2 _3
?T PHONE #
\GER # CELL PHONE #
ZIPCODE 5 I -4
FAX#
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
=_nergy Code Category _ MINNE30TA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Suhmitted
Plumbing Contractor: _
Plumbing System Includes:
Mechanical Contractor:
Wechanical Sys[em Includes:
Sewer/Water Contractor:
Phone #
Tee:
$70.00
above information must be submitted prior to processing of application.
ereby acknowledge that I have read this application, state that the information is correct, and agree to comply with
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature ot Applfcant
:rtificates of Survey Received _ Tree Preservation Plan Received _ V Not Required _
_ MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted ? I
Water Softener
Water Heater
No. of Baths
Air Conditioning
Heat Recovery 5ystem
Phone #:
Iawn Sprinkler
No. of R.I. Batlis
Phone #
Updated 1101
OFFICE USE ONLY
01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
02 SF Dwelling ? OS 06-plex ? 18 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)
05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
31 New
32 Addition
33 Alteration
34 Replacement
iluation
;nsus Code
kC Units
ir. of Units
rc. of Bldgs
pe of Const
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
*Demolidon (Entire Bldg only) - Give PCA handout to applicant
Occupancy
Zoning
Stories
Sq. Ft.
Length
W idth
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ PlumbitUc
Foundation HVAC
Drain Tile
Roof Ice & Watei Final Other
_ Fraxning _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Fueplace _ RL _ Air Test _ Final _ Sid'mg Stucco Stone
_ Insulation _ Windows (new/xeplacement)
Approved By
ise Fee
ircharge
an Review
:/ES SAC
ry saC
ater Supply & Storage
?W Permit & Surcharge
eatment Plant
ambing Permit
;chanical Permit
:ense Search
)pies
her
ital
Building Inspector
RESIDENTIAL
???115 BUfLD1NG PERMIT APPLICATION ?? D ? ?
CITY OF EAGAN --
J(l???r O?
3830 PILOT KNOB RD - 55122 rq I'??I
651-681-4675 Lr
IawConsVucfionReauiremenb .
3 registered site surveys showing sq. N. of lot, sq. ft. of house; and all roofed areas
(20 % maximum lot coverege allowed)
2 copies ot plan showifg hearn & window sizes; poured found design, etc.)
7 set of Energy Calculations
3 copies of Tree Preservation Plan if lot platted after 711193
Rim Joist Detail Options selection sheet (bldgs with 3 or less units)
)ATE %'"
IOB SITE
RemodeUReoalr Reauiremante ?
. 2 copies of plan
• 1 set of Energy Calculatlons forheated additions
. 1 site survey for extenor additions & decks
• Indicate if home served 6y septic system for additlons
VALUATION
A AYG.,
F MULTI-FAMILY BUILDING, HOW MANY UNITS? (
'ROPERTYOWNER e'oVa/4 a m?'?LyAx' 11.4?"^
YPE OF WORK FIREPLACE(S) _0 _1 _2 _3
4PPLICANT J, .nw HA,DRcr Co A6P?vvo^r%oou ywC- PHONE# (0V 106`4
'?DDRESS ???y RL?L`?- ?2d y,tJ Ucn' qYU?.Gr 1?j?? ZIPCODE ?5??b
'AGER #
CELL PHONE #
OV6 d, FAX#
NE1V RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
_ MINNESOTA RULES 7672
- New Energy Code Worksheet Suhmitted
Piumbing Contractor:
Plumbing System Includes:
Mechanical Contractor:
Meclianical System Includes:
Sewer/Water Contractor:
Phone #
kII above information must be submitted prior to processing of application.
hereby acknowledge that I have read this application, state that the information is
A applicable State of Minnesota Statutes and City of Eagan Ordinances.
Fcc: $90.00
Fee: $70.00
-??zr?2nnnr?f?1
I l
(? .,A ,: A 7?? A6 1
Signature of Applicanf i 1-cr l"; dr--!
;ertificates of Survey fteceived _ Tree Preservation Plan Received _ Not Required _
Phone #:
Water Softener
Water Heater
No. of Baths
Lawn Sprinkler
No. of R.I. Batlis
Phone #
_ Ali COIldlhOlllRg
_ Heat Recovery System
Updated 1101
OFFICE USE ONLY
] 01 Founda5on ? 07 05-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.)
7 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened)
] 05 03-plex ? 11 10-plex ?0 19 Lower Level ? 24 Storrn Damage
] 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscelfaneous
°? 31 New
] 32 Addition
] 33 Alteration
7 34 Replacement
? 30 Accessary Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
? 35 Int Impmvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) 0 45 Fire Repair
? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDoors
*Demolition (Entire Bldg only) - Give PCA handout to applicant
D
-
/aluatian o&a 0 ? Occupancy
;ensus Code `i ? Zoning
iAC Units 15?L Stories
Jbr. of Units l Sq. Ft.
Jbr. of Bldgs ? Length
"ype of Const Width
_ Footings (new bldg)
_ Footings(deck)
_ Footings (addi6on)
Foundation
Drain Tile
Roof Ice & Water Final
y Framing
Fireplace _ R.I. _ Air Test _ Final
tYJ Insulation
/?` 3
_k /
REQUIRED INSPECTIONS
FinaUC.O.
? FinaUNo C.O.
_ Plumbing
HVAC
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Other
_ Poo] _ Ftgs _ Air/Gas Tests _ Fina]
_ Siding Stucco Stone
_ Windows (newheplacement)
Approved Byae, , Building Inspector
3ase Fee
iurcharge
'lan Review
AC/ES SAC
:ity SAC
Nater Supply & Storage
i&W Permit & Surcharge
-reatment Plant
Ilumbing Permit
Aechanical Permit
.icense Search
;opies
)ther
fatal
CITY OF EAGAN Np 19148
3830 Pilot Knoh Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 ? % 3? TtU
?
BUILDING PERMIT Receipt # V
To be used (or SF DWG/GAR Est. Value $90, 000 Date MAY 31 ,1g9J
Site Address 4154 PENNSYLVANIA AVE
Lot i$ Block 1 SeGSub. STAFFORD PLACE
Parcel No.
= IName RAINBOW HOMES OF EAGAN INC
? Address 2367 78TH ST E
CityiNVER GROVE HTSphone 450-6292
?F Name S?
g? Address
City Phone
?W Name
?? Address
iw City Phone
I hereby acknowlege ihat I have read ihis applicalion and slate that the
inlormation is correct and agree to comply with all applica6le State of
Minnesota Statutes and CitY of E,aqan OWinancas") /?
Signawre of Perrnitee
OFFICE USE ONLY
Occupanty R-3 M=1 FEES
Zoning R=1
(ACtuaq Gonst V=N BIOg. Permit 595.00
(Allawable) V-N
Surcharge
45.00
x ol Sbries
46 '
Plan Reviaw
386. 00
Lenglh
Deplh 4'8 ?. SAC, City 100.00
S.F.TOtal - SAC,MCWCC 650-1
S.F. Faotprints -
Water Conn
660.00
On Sne Sawage _
On Sita Well - Waler Meter 95. DO
MWCC Systam X
30
City Water x_ Acct Deposit
.00
PRV Required _ S!W Permil 30•00
BDDSIer Pump - SNJ Surcharge • 50
Traatmant PI 276 - 00
APPROYALS RoadUnit 370.00
A Building Permit is issued to: R1INBOW HOMES OF EAGAN I Pianner Park Ded.
on the express condition that all work shall be done in accordance with all Council -.
applicable Slate of Minnasota YSftatutes and Cily oi Eagan Ortlinances. gUd9. pry_ Copias
Building Official ItMq R.OA! ., V Variance - TOTAL
O 9/ /o/ 97 x
0 3 5;6
Requesl D ?
? J ?? j re Na. Raugh-in Inspecfian
Pe uiretl?
? Ready Now ? Will Notily Inspechor
?
{O ? es G No When ReaOy?
I?censed contractor ? owner hereby request inspection of above electrical work at:
Job ACtlress IStreet. Bax or Rovte No
y City
?h? .4
Seclion No. Townshlp Name or No. Pen9e No. County
OccuOa ( PRINTI
?9-Gh ? e c:dJ ? ? .Zf'+C. Phone No.
'?So ? r'v 2 ?i Z
aaw4)unierK??9/?!/ `.
r? ntlares/s=?21??/r1 ?h
Eleqncal Comronor ( COmpany Name) ,
?'
?
f
f°
`
A ConVac?or's Llcense No
.t
/?c
C
2c ?/
i
/
Motlipq?uare¢s?COnlracmr or Owne? Makin Installe?ion)
1 Y ??t?ri leI? A,
AWnor reICOnvaclo?:o er Mak in alla?on
? /? Pnone Number
4/Z..3
MINNESOTA STATE BOARD OF ELECTPICITY THIS MSPECTION REQUEST WILI NOT
Griggs-Mltlway BICg. - Room S-173 6EACCEPTED BV THE STATE BOARO
1821 University Ave., St. Paul. MN 55104 ' UNLESS PROPER INSPECTION FEE IS
Phone (612) 662-0800 ENCLOSED.
REQUEST FOR ELECTRICAL lNSPECTION
? See instmctions for completinq thi=_ lorm on back ol yelbw copy.
"X" Below Work Covered by This Request
d G'^ EB-OOD01-D8 I
L.?
w .Adtl ep. )fypeofBUilding ApplianceSWiretl EquipmeniWired
Home Fange Temporary Service
Duplez Water Heater Electric Heating
Apt Building Dryer Other (Speciry)
Comm./Industrial Furnace
Farm Air Conditi0ner
Olherlspecily? Convaclor's Remarks:
Campufe Inspection Fee Below:
k Other Fee # ServiceEntrance Size Fee N Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps ??.?D 0 to 100 Amps
Transformers Above 200 _ Amps Above 100 _ Amps
Signs Inspeclors Use onlg TOTAL
Irrigation Booms
Special Inspec[ion ?
AlarmlCommunication THIS INSTALLATION MAV 8E ORDE ED DISCONNECTED IF NOT
Other Fee COMPLETED WITHI ONT f
I, the Electrical Inspector, hereby Roupn-m oac
certify that the above inspection has
been made. F;rai ( Date
OFFICE USE ONLV
ihis repuest voi0 18 montps Imm
'Add'ress:4154 PENNSYLVANIA AVI1,Pt ]$ Blk I Sec/Sub STAFFORD PLACE
These items wera/were not completa at the time of the final inspection.
Date: 7 30 91 Yes No
Final grade (6" from siding)
Parmanent steps - garaga ?
Permanent steps - main entry L?l
Permanent driveway Ll?
Permanent gas
Sod/seeded grass
Trail/curb damage
Porch ?
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plumbing
system and the shut-off of water supply to the outside lawn faucet before
freeze potential exists. 4
uaaEOruex
White - City copy Yellow - Resident copy Pink - Contractor copy
, 1991 BUILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS MULTIPLE DWLLLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (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 APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED 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 - CONTRP.CTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be IIsed For: 51?21r ?/J' Valuation: Date
Site Address °?` 57 ! -E ""'Sy/vW^'(q
Lot I- Block /
Parcel/Sub
Owner ( _Ravi? Y ' ` ??4?1 /"lwYray
Address
City/Zip Code
Phone
Contractor ??tl
s
Address ?719A
City/Zip Code '71?IeL` G?°'ep
Phone
Arch./Engr. h,L.
Address
-v-u
City/Zip Code
Phone #
99/-V?? 9 3
AS-AY 2 Reco
"r• A0, vDa ? OFFICE USE ONLY
J
FEES
Occupancy 2-3 M-I Bldg. Permit
Zoning R-1 Surcharge
Actual Const V-iq Plan Review
Allowable SAC, City
it of stories SAC, MWCC
Length ? Water Conn.
Depth ?/a' Water Meter
S.F. Total Acct. Deposit
Footprint S.F. S/w Permit
S/W Surcharge
On site sewage_ Treatment P1.
On site well Road Unit
MWCC System Park Ded.
City water ? Trail Ded.
PRV _ Copies
Booster Pump _
SUBTOTAL
APPROVALS Penalty
Planner _ Lot Change
Council TOTAL
Sldg. Off.
Variance
I Lao agrees that all work shall be done in accordance with
(Signature of Contractor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
+r?- . .. y .
V4LuA-rioN .. ,?
GAtzaC7E
z z x2? = `/Sy
13SMT
__-----
aLl X?/b ' iloy
1 o X6 - ?,o
?f
12a i3 X !4= I (???-?
1?zag = Z(
`&5mT : I 2 0 3
..----'
I229 X53= 6 5-1 37
bgcI 3o? 002 C10/
- -- ,
?- ,
CYTY OF `?'" BIIILDING DEPAF?141EMT
4:',CPERIOR ENV}Z. PE AVERAC}E l'U 'l CAMPUTATIOH
(To Le submitted with building permlt application)yy
One or Tuo Faeal.ly Dwelling Owner
411 Other S3te Addrese e Nvq,viR
Cotttracto2` Date-s? ?hone 2`?Z
GINEAL FnET OF
EXPOSiD YtALL _?E? ??Gt.?U?.':... f?t???•?', fte ahove grade = Z?'?,'=<•-, ,
TO'PAL ,`s.?..°OSE? S7ALL ARe.e1 SQ, IFT.
OPAQUi VlALL COHSTRUCTI01a: "Ut' Value x Area
Uetail -?'? ?rl -' "u" •?'a x Sq.
reference lL'
.D7(O x
"U" 2•
S
fsom glyF? "U" .o4C? x SQ.
attached "U" x BQ,
aheets "U" x Sq.
IIUII x S z.
l"iiNDOWS: "U" Value x Area
S Q.
Make & Type llUll- ,4?') x SQ. E'T. ?rn.?oD=
n u
a n uun x SQ. FT. _ (A)
nUx 5Q. FT. (II)(p)
u n =
X SQ. FT.
_ ?U)(A)
DOORS: "U" 1,'alue x ATea _
,-l?Lse & Tyne':: Ulr Sq.
n ????? •47 x sQ.
n nUu x$ .
n uUn x SQ.
TOTALS
TO`'AI. (iJ)(A) VALUES
JIVIDED SY TO •rpI,L AREA
AVERA(3 ?
Z377-, o0
E .115 or leas for 1&2 family
RCOs/CEILIN ?
TOrAL aREA:
,o
Detail referenca IIUII • O? r x
isom uUn Y
attached sheeta. I'Ull x
De:;cribe oneninga IIUII x
in rooY. rrQir
x
TOTAL (II)(A) YAE.UE3 DIVIDED BY
7.'OTAL ROOF/C Ci AREA
AVERAaE •025
,/ for ventilated roofe.
FT. W(A)
FT. 4 s14 = I1,3?> ('J)(A)
FT. IZ .?; _ (U) (A)
F"P.
FT. _ (U)($)
FT. '__
(U) (l,)
FT. 9,00 = ?9r!?? (•,i)(A}
FT. 0 3 °(u)!A3
??(Ui iA)
FT. _ (U)(A)
?J?]•,iL ,_(J) (k)
s4. FT. 125fo = ZCp.38 (u)(A)
S4. FT. (U)(A)
S@. FT. =?M(9)
sR. (Q)(A)
- (D)(x)
?pz,?
,
? , . , ------ --- -
.. . .
--21AZL SECTION--
Determining "U" valuea at RooY„Wall, Rim, and Conc. Block
ROOF/CEILINQ R VALUE
10) Interior Air F'ilm 0.61
2.? 5/81, Gyn. sa. ,56
3.) Insulation.-` ?trf
-
4. J Qo
TT
5.) Exterior Air Film .61
(STILL)
°Uu = tIR= 00-1 TOTAL
? (R)= 4j.7&
WALL (R VALIfE
6.) Interior Air Film 0.68
7.) 1" GYP. Bd. .45
8.) Insulation
9.) Fvu,'r F-rrE z• af-
10. ) Masonite Siding .67
'
il.? Exterior Air Film .17
upu _ 1/R=TOTAL (R)=13.01
RIM R Uk?UE
12.) Interior Air Film 0,58
13.) Insulation " 19•00
14.) 211 Fir Rim Joist 1,88
15.) lSvN.T- 1:t7:r Z• ?4
16.) Masonite Siding .e7
1700 Exterior Air Film .17
uUn = 1/R= , p4.ip ... TOTAL
__-- (R)= zT 44
1OU2dDATION R VALTJE
18.) Interlor Air Film 0,6$
19.)
zo. ) JP /l W1PFEt> 11 • o?
210 12" Concrete Block 1.28
22.)
23r). Exterior Air F11m .17
nUII _
- 1/"11= TOTAL 9,7Zj
(R)= 1
? --- -
.
i/ WoR?-. Sf??T ?1
I?-.? x(,4d-r4?f 3co?-3?) - 2 za¢ ?
4.? x (6plcP)
.607
J.oo
z?7Z.??
C40t,W-?
?n1 ?,sr
(4-0 -t90 fi3?o +3?? _
,
w,?:?Ws
ZD
74x ;?,(o =
z4 X45 =
Zo)< 48 =
4.o
Co.oX 7 =
s,oxc?=
ta.7 X v ?
?.oo
149 •
" 8-00
5.00
n ?z,on
?$, o0
S3, r?o
z g.oo
z1 •op _
133•00?
?S
__.-..•
z?7z.oo
14q.gq?
?s(v,(op -.5(O,?r.?n0
I3?,oa r g ?
ov
ZloXl}lo
?oX(? - coooco
1 ?Z5CQ ? - ?
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
??
FOR CITY USE ONLY
PERMIT #
RECEIPT # O q/
DATE: ?o
PLEASE COMPLETE IIPPER PORTZON ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WNEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION
/
NEW WNST
ADD ON _
REPAIR _
OWNER NAME: ? y?i-Trtci T?C?G? rYJ?
SITE ADDRESS: -g--
LOT:_Iy_ BLACK ? SUBD.
INSTALLER:
ADDRESS: 121 pEDWOODDRIVE
APPLE ", ?
CITY: ZIP: -
PHONE #
COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
ADD-ON MINIMUM 15.00
SHOWER 3.00
-7-7 WATER CIASET 3.00 3
! SATH TtIB 3.00 3
? LAVATORY 3.00 3
KITCHEN SINK 3.00 J
LAUNDRY TRAY 3.00 -?
? HOT TUB/SPA 3.00
WATER HEATER 3.00 ?
FIAOR DRAIN 3.00 ?
GAS PIPING OUT.
? (MINIMtIM - 1) 3.00 ?
ROUGH OPENINGS 1.50
_ OTHER
WATER SOFTENER 5.00
_ PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
SUBTOTAL $ ?kl
ST. SURCHARGE .50
TOTAL: $ t1g
?%pMMF?RCIALfIHTSII$T?IAT.;: PLEASE COMPLETE THIS PORTION FOR ALL COMMERC IAL/INDUS TRIAL BUILDINGS AND
MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: BIACK _ SUBD.
INSTALLER:
ADDRESS:
CITY: 2IP:
PHONE #:
FOR:
FEES
18 OF CONTRACT FEE.
STATE SIIRGHARGE - $.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
3830 PILOT RNOB ROAD
? ? "--• EAGAN, MN 55122
PHONE: (612) 454-8100
?
PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
-------------------
WORK DESCRIPTION
NEW CONST ?
ADD ON _
REPAIR _
OWNER NAME:
SITE ADDRESS: °`C l?D E"t'_1 'R i V G CA_
LOT: IP> BJL?OCK ? SUBD,` ? G• ` C? l?"Y.Q?-?
INSTALLER: \ ?'GIvO 1 \e
ADDRE55 : ?, V • 1 rt ? L ? ? CI C) A,? ?
CITY: ZIP:
PHONE
FOR CITY USE ONLY
PERMIT # /i $ `7? i
RECEIPT # /
DATE : (0119191
FEES
ADD-ON MINIMUM
HVAC 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OUTLETS - MINIMUM
OF 1 PER PERMIT
SUBTOTAL:
STATE SURCHARGE:
TOTAL:
&IG ATURE OF PERMITTEE
DWELLINGS &
$15.00
24.00
6.00
3.00
$ 2q.OU
.50
$ 2?.50
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS,
APARTMENT SUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
CONTRACT PRICE:
OWNER NAME: _
SITE ADDRESS:_
LOT: BIACK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE
FOR:
FEES
18 OF CONTRACT FEE, t
STATE SURCHARGE _ $.50 FOR
EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING = $25.00
$25.00 MINIM[JM FEE.
CONTRACT PRICE x 1%
STATE SURCHARGE $
TOTAL:
(SIGNATURE)
CITY OF EAGAN
uno
Certfflc^te of ::urvey for:
Ancwir[crs
?A/A11,30C/ /-IoMES
2422 Entcrprise Drive
Mcmdota Ileiglits, MN 55120
(612) 681-1914
-cJ
91 b.7b R ??$ ??lq
o
4M
/
/
\
m?
e:
? /g Y6? `? ?
hK 4
N,
OSS?? a?b
92 ?
20
.g
N?\?
q3b?7?
m \ / Z6
?
<?L>
NORTH
0 9i
M'? I.
/ / ?'hG?
?
o?
¦ 9oa.o Denofes Exislin Elevofion Pr?
\ oeosEa NousE EI?VA
? vo.o Uermfes Prop?ocd flevahar? Lowes -7oor Eleva ion 914,0
- --- OenotesDroina efUli/i?1y £ase.ment TopoV''Blocl?EleuaJion 9zZ•7
-?---- Denales Diai F/or?'DirPClion Garzx?fieS/aG E/evation 9 zz. 3?
o(?nales Mvnu enf BPOrir& sftown are assumfd n Denoes q e hEib
LOT i8 BLGCk i, STAFFORD PLACE
Oi?KOn4 [t7tlNry, M1NJVTsorA
1 hereby cerdty Ihal thb survey. Olen or rnpart wef pr prqd hy me of undnr my dLer.t supnlvV:inn nnd Ihat I mn •hdy Prqisln d lend Swveyar
under ehe tevn of tha Stete of Minaesotn. bated thll dny of rn? A.D. in--T._ ./J -LOC S'cale :1 orb , 40/e "
c3// Ti2 rton11_.S.nFr,. NO.I en?
U
?
•li:::?GAN 10+vVIN.GtLIING P •
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA108776
Date Issued:01/09/2013
Permit Category:ePermit
Site Address: 4154 Pennsylvania Ave
Lot:18 Block: 1 Addition: Stafford Place
PID:10-72500-01-180
Use:
Description:
Sub Type:e-Windows/Doors
Work Type:Windows/Doors
Description:House
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
LYNN A RATHBUN
4154 Pennsylvania Ave
Eagan MN 55123
Property Claim Solutions LLC
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA109615
Date Issued:03/22/2013
Permit Category:ePermit
Site Address: 4154 Pennsylvania Ave
Lot:18 Block: 1 Addition: Stafford Place
PID:10-72500-01-180
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Lisa Nyberg
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Lynn A Rathbun
4154 Pennsylvania Ave
Eagan MN 55123
Property Claim Solutions LLC
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA109853
Date Issued:04/09/2013
Permit Category:ePermit
Site Address: 4154 Pennsylvania Ave
Lot:18 Block: 1 Addition: Stafford Place
PID:10-72500-01-180
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Lisa Nyberg
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Lynn A Rathbun
4154 Pennsylvania Ave
Eagan MN 55123
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA177805
Date Issued:07/19/2022
Permit Category:ePermit
Site Address: 4154 Pennsylvania Ave
Lot:18 Block: 1 Addition: Stafford Place
PID:10-72500-01-180
Use:
Description:
Sub Type:Air Conditioner
Work Type:Replace
Description:
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
210-0754.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Dean Charles
4154 Pennsylvania Ave
Eagan MN 55123
Gv Heating & Air Inc
5182 West Broadway
Crystal MN 55429
(763) 535-2000
Applicant/Permitee: Signature Issued By: Signature