4174 Pennsylvania Ave_? . . .
CASH RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN. MlNNESOTA 55122
DATE ? -J r 19
nccerveo fnoM
?
AMOUNT
i
& DOLLARS
too
O CASH ?J CHECK
n
FOR 41-
? 12664 w"`?'e',? `°p,
Yelbw-Posting Copy
Pink-Fib CqPY
Thank You
BY
CITY OF EAGAN ?'•?? # 6818
-.?
3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121
PHONE: 454-8 f OQ
BUILDING PERMIT Receipt #
To be used for SF DK/GAR Est. Value $124'000 Date MM 27 1g 91
i.ST,t nvvvcvIIv•*lT A .vr
Site Adgress
Lot Block SeclSub.
Parcel No.
- -- - - --- -- -- -
W Name
3 Addres?
a Citv t? FpLT
' Phone
Name _
Address
Phone
?
W W Name
?
? ; Address
a? City Phone
I hereby acknowlege thaVl have read
information is correct ar agree to c
Minnesota Statutes and ?v.of Eaqap 1
Signature of Permitee -"
TU
A Building Perrnit is issued to:
on the exoress condition that all work s
Building Olficial
of
one in accordance wit
ol Eagan Ordinances.
OFFICE USE ONLY
R"-3 M-1
Occupancy FEES
Zoning TZ j?.00
(Aotuat) Const .?? 8ldg. Permif
62' ?
(Allowable) _ Surcharge
# af Stories 470.00
Le ih
? Plan Review
1?loo
Depth - SAC, City
S.F. Total - ??•?
SAC, MCWCC
S.F.Footprints - 660.00
On Site Sewage _ Water Conn
93' ?
on site welf Water Meter
MWCC System -? it
t
A
D 30.00
Ciry Water - epos
cc
. 30.00
PRV Required _ S/W Permit ?
.
Boosler Pump - S/W Surcharge
276.00
Treatment PI
APPROVALS
Road Unit 370.00
Planner - Park Oed.
Council
BIdg.Off. _ Copies
-?
Variance
. -
. . TOTAL
. . _ ? ._. . ._ ...._ _.v..?.? ... . _ ?
" Permk No. Permit Holder Date Tekphone #
WATER 9 u?o `3 ?/9
SEWER
PLUMBING Q • ??g 9? ?? "3???
H.v.n.c. p 9 9/ 4423
ELECTRIC
Inspectioo Date Ins Comments
Foo6rgs 1 7',Z,B Ll1e
Faundation
Framing
Raorny
Rough Pibg. Vv/
Rough Htg.
[S,l.
Freplace
Final Htg.
Fnal Plbg. ri 7,
Consl. Meter Plbg. Inspector - Notity Plumber
Engr./Plan
81dg. Fina1 ?2 Sfyl t?
Qeck Ftg.
Deck Final
Well
Pr. Disp.
? ?t b « ?
?
f??exfi#ir?x?e ?# (?r?ru?rttnx?
Citp of Cagatt
, loroftetct of iuning itwnian
`?7rts Ceriificale issuM, pwsuant to the requirmentr of Section 306 ojthe Urrijorm Building
Code anijying rhal at 1ir?r. tlme ojissuancr this ancxrue ms in comptiance with lhe mrious
,
ardinarcces of tlre Ci1y regulctturg but7dirtg rnnsdudion ar usa Far the fallowing.
,
?
the C62dfimdw SF DWG/GA]! B4 ftns& Nm 18818
- M- R- V-N
d? THE WINDWOO 0? INC P O BO'r24329
4174
&Adiag ?? P NNS VA?1I •A?? L, B, STAFFORD PLACE
JUNE 25, 1991
o?
Bwldina OtScW
Posr aN A coriswcuous Puce
hkh? - 4
SEWFP & WATER PERMIT
CITY QF E. GAN
- METER # -
3830
Pil6f Knob Rd.
Eagan, MN 55122-1897 CHIP # -
METER SIZE
?
DATE MAfi 27• 1991
ISSUE DATE
SITE ADDRESS 4174 PEiNNSYLVAIVIA AVE
LOT (' BLOCK 1 SEC/SUB STAFFORD PI,ACi:
APPLICANT
ADDRESS:.
CITY, STATE
PHONE: ZIP
PLUMBER: ? ; .
ADDRESS: 1 5lE'? t Afi0U5EI. iiA':
CITY, STATE
PHONE
- •. ? ZIP- -
OWNER: THE WINPWOOD CO INC
ADDRESS: P 0 BOX 24329
CITY, STATE
PHONE: APPJ-E V?LLEY MN
`-, 1.°f+605 ZIP 55124
USE ONLY
PERMIT DATE 03? 213?
PERMIT #
B.P. FIECEIPT # ` B.P. RECEIPT DATE k'j3/27 91
PRV - BOOSTER PUMP
PERMIT REOUESTED
7. SEWER - WATER - TAPS
COMMIIND X RESIDENTIAL
_X_ NEW - EXISTING
Lawn Sprinkler Meters are ta be Instalied
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be given for Deduct Meters.
.
. A ?---
I AGREE TO COMPLY WITH CITY OF
EAGAN ORDINANCES
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 4545220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT. SEWER_4 WATER PERMIT
CITY OF E GAN
3830 Pilui Kriob Rd.
Eagan, MN 55122-1897
4 QATE "'p :.- 27, 1991
OFFICE USE ONLY
METER #??a g 70 PERMIT DATE 03/'L1.
7/ ?_ tiE?,l9
CHIP # .fLra../ ? ?D -S?? PERMIT #
METER SIZE a`'r-%.P. RECEIPT #.. I-= ?• ?f `;
ISSUE DATE S-? -?? B.P. RECEIPT DATE 03/27I S S
_ PRV - BOOSTER PUMP
SITE ADDRESS 4174 PENtVSY1.VANTA AVE PERMIT REOUESTED
LOT ' BLOCK 1 SEC/SUB STAFFOItD PLACii.
X SEWER X WATER - TAPS
APPLICANT:
_ COMM/IND x RESIDENTIAL
ADDRESS:
ClTY, STATE ,. ZIP X NEW - EXISTING
PHONE:
' Lawn Sprinkler Meters are to be Instailed
Li
i
W
PLUMBER• ne_
er
a
Ahead of Domestic Meters on
ADDRESS: 151$5 CAROUSEL WAY Credii WILL NOT be given for Dedyct Meters.
. . ? liti • __ . C_
CITY, STATE L i
? -
? ;. , i i,
? - ?
? 3 ev
PHONE:
?
IjAGREE TO COMPy'Y WITH CITY OF
OWNER: T1i;L' WINDWOOD CO INC EAG ORDINAN,- S
ADDRESS: P 0 BOX 24329 `
STATE APPL.E VALI.EY MN Zlp 55124
CITY
,
PHONE:. 8q1-4605 SIGNATURE WHE ETER ISSUED
PLEASE ALLOWTWO WORKING DAYS FOFi PROCESSiNG. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
?. ?? '
CITY OF EAGAN Np 188 18
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 ?
BUILDING PERMIT Receipt #
) beusedfor SF DWG/GAR Est.vaiue $124,000 Date MaR 27 . 192L_
Site Address 4174 PENNSYLVANIA AVE
Lot 6 Block 1 Sec/Sub. STAFFORD PLACE
Parcel No.
w Name THE WINDWOOD CO INC
? Address P O BOX 24329
° City APPLE VALLEY phone 891-4605
,o Name SAME
oa Address
U? City Phone
UQ
ww Name
xz Address
aw City Phone
I hereby acknowlege tha ave read Ihis ap cation an ? ate that the
information is correct a gree to co ith all li ble State of
Minnesota Stalutes and ' y ot Eaga O f a ces.
Signature ot Permitee 00
A Building Permil is issued to: THE "DWOOD CO INC
on the express condition thal all work shillf be done in accordance with all
applicable State of Minnesota Statules and Ciry ol Eagan Ortlinances.
Building OHicial j 1M 11.P.1
OFFICE USE ONLY
Occupancy R-3 M-1 FEES
Zoning R-1
(AcWapConst V-N BIdg.Permil 724.00
(Allowable) V-N
Surcharge 62.00
Y ol slories
Length 52' PlanReview 470-0
n
DeDth 50 ' SA4 City 100.00
S.F. Total - SAC, MCWCC 650.00
S.F. Footprints -
660
00
On Site Sawage _ bVater Conn .
On Site Well Waler Meter 95.00
MwCC system X
'
Acct. Deposil 30.00
City Water _
?
PRV Required _ SIW Permil 30.00
Boaster Pump - S/VJ Sumharge .5
?
TrealmenlPl 276-0
n
APPNOVALS Raad Unit 3 7n _ nn
Planner - park Dad.
Council -
BItlg.Off. _ Copies
Variance - 707AL
0
3,467.5
,'?9/ ? REOUEST FOR ELECTRICAL INSPECTION ?`? ?aq EB-00001-OB
.? eE:inSMw?iens br compkting ihis brm on beck of yelbw CopY. ?OD(?? _
? 6 4 2 Q 7 'X" Below Work Covered by This Request wr• ? tG ?, (g a?..
e tl Rep. TypeolBuilding AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heate: • Electric Heating
Apt 8uilding Dryer Other (Specity)
Comm./Industrial t if urnace
Farm Air Conditioner
Olhar(speciry) GonVactork Remerks'.
Compute Inspectian Fee Below:
# Other Fee # ServiceEntrenceSize Fee # Circuits/Feeders ee
Swimming Pool 0 to 200 Amps 0 to 100 Amps 410.12
Transformers Above 200 _ Amps Above 100 _ Amps
Signs Inspecrors use Only: T AL S+Q
Irrigation Booms ?QS ?
?
(:?
Speciallnspection
-
"Q .
Alarm/Communication THIS INSTALLA770N MAY BE ORDER CON?CTED IF NOT
Other Fee COMPLETED WITHIN 18 MO THS.
1, the Electricsl Inspector, hereby
certify that the a6ove inspection has
been made. Roupn-In
Final Da
?? r
OFFICE USE ONLY
Th5 uesr vob 18 months firom_ ?
?
/! 5 9/ e'67`11V/ ?v1sv.? ?/ood'SLd
RI16 2 0 7
--- - 5??
Repu Da1e F Rou9h-iRlnspeclion
. . ReQui
? N.
? Raedy Now &1'MI No6N Inapec[or
When ReaO
It;;,ensed contractor' O owner hereby request inspection oT above elechi ork .$ Iro
Ciry
F.n . Tow 'w Nage a No. Nange M.
.
CouMy
om .V O./
r
Ppwer Su /?
?0 • Atl
EI n al CoMractor (GOmpany Neme)
• • Conbeciur§ lkanse No.
MaiNng
1
4 or Ow i Maki? Inatallation)
ss(
AulMrixed ?$igna?twe( ?(C?OnVx''QQ r Makiig IrMaAalionjy t ` r(I NumCa?
MiNNE5014S11CfE BOAND Of ELECTNICITY l\I • ' TNIS INSPECTION REQUEST WILL NOT
6rlyy?•NWway BWy. - Xoom &173 V - BE ACCEPTED BY THE STATE 80ARD
7lt1 UnNxaly Aw., St. Poul, MN 55101 UNLESS PROPER INSPECTION FEE IS
PhoM (812) N2-0800 ENCIOSED.
A3dress:4174 PENNSYLVANIA AV1;,ot 6 Blkl Sec/Sub STAFFORD PLACE
These items vera/were not complete at the time of the final inspectlon.
dUNE 25 1991 Yes No
Final grade (6" from siding) ?
Permanent steps - garage
Permanent steps - main entry
Permanent driveway ?
Permanent gas /o
Sod/seeded grass VII"
Trail/curb damage ? a[p7,t?
Porch
Basemant finish ?
Deck
Please verify with the builder the removal o£ roof teat caps from the plumbing
system and the shut-off of vater supply to the wtsida lavn £aucat before
freeze potentiel exists. ?
R[LIRFDMfEM
White - City copy Yellow - Resident copy Pink.- Contractor copy
?? ?U'
Clty of ?ap
3830 Pilot Knob Road
Eagan A1N 55122
Pfione: (651) 675-5675
Fax: (651) 675-5694
a uq3;?
; ---------------- ;
,? ?
; ,a?: `??
?,, i
i Perma Fee:
I
1
? Date Received: ?
i Staff:
i----------------?
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date• o a? C)z $ite
Sui6s
Tenant:
RESIDENT / OWNER I Name::
p,,one: ka -ysy-8?0a?
Address ! Ciq' / Zip:
Applicant is: _ Owner _Y_ ConhatOr
TYPEOFWORK Omcripfion of work: 1kA2 oc-c- ? i2Elq-(X)F oL33 Scx
ConsWcGonCost: SCfI,? gA
CONTRACTOR
Multi-Family Building: (Yes_! Nok,_,)
Lkense s:
c•fty:?1f ?`Y?t-e3' _Stats:_ MN zw._ 550w
Phone:Gru 'L1'AI•q3d0 ContactPerson:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDtNG
Minnesoha Rules 7670 Caieaorv 1 Mirtnesota Rufes 7672
Energy Code • pes;denmd venaiacon.careaen i worksneec • New 5,ersr caae wo*~
cgltegory Subrnqted
(J submission type) • E? EnveWpe Calwtatiom Su6mined .
In the last 12 moMhs, has the City ot Eagan isaued a pertnit for a 9lmilar plan beaed on a master Ptan4
_Yes _,No If yes, dats ard address W mester plan: -
Lkensed Plumber:
Meehanical Contractor:
PhOne:
PhOne:
Sewer 8 Waur COntraMOr PhOOe:
I nereby aqknowledge that tl* IMOnnalgon is comosteantl aoeureDw, tlo the xak wW bs in Confwnlarwe witlf tln ordfna= entl catlee OT tlie q!y at
Esgan; that 1 understa'W this is not a pormtt hd oNy an appiics6ori tor a permh, aruf work ic not to:start witlrout a pertnik tlat Oro vrork wi8 Be m
accwdance with the approved pan In ttre ease ot wak wMch requires a revievr aritl appoval W planc. .
X M- CAMMUcA x`M.C?
ApPlicant's Printed Name Applicartl's Sigmture
Pege 1 of 3
? tttit mrw
1991 BIIILDING PERlSIT APPLZCATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
2 SETS OF PLANS
3 REGISTERED SITE SURVEYS
1 SET OF ENERGY CALCULATIONS
MULTIPLE DWELLINGS
COMRSE
RfERCIAL
2 SETS OF YLANS 2 SETS OF ARCHITECTURAL
REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
(CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCUTATIONS 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.
LbT CNANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALIAWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT M[JST SHOW A LICENSED PLUMBER.
To Be Used For: Single Family Valuation
Site Address 4174 Pennsylvania Ave.
Lot 6 Block 1
Parcel/Sub Stafford Place
Owner The Windwood Company, Inc.
Address PO Sox 24329
City/Zip Code Apple valley, MN 55124
Phone 891-4605
Contractor The Windwood Company, Inc.
Address PO Box 24329
City/Zip Code Appple Valley, NIN 55124
Phone 891-4605
Arch./Engr.
Address
City/Zip Code
48 ; 69?
Date: 3/22/91
lZy, 00,1 - OFFICE USE ONLY
Occupanc
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F.
FEES
R3M-I
Y
R- ?
V-N Bldg. Permit Wq.oO
V-N Surcharge z;T0
.r2
SU
On site sewage_
On site well
MWCC System ?
City water ?
PRV
Booster Pump _
APPROVALS
Planner
Council
Bldg. Off.
Variance
Plan Review y90,0
O
SAC, City /DO, DO
SAC, MWCC GSO,JO
Water Conn 660. Dv
Water Meter ,D C
Acct. Deposit D,J O
S/W Permit 3D,v0
S/W Surcharge 52
Treatment P1..?76, Do
Road Unit 3 D, ou
Park Ded.
Copies
SUBTOTAL
Penalty
Lot Change
TOTAL .??
Phone #
agrees that all work shall be done in accordance with
(SignatiAri of Contractor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
IWW va?-uA?nby
. N
GARA GE
Z2 X22= Ll SU
? ? ! = (4)
___----
y'1f3 x IS= 7170
$SMT
I5-r f?-ooW,-
-lSxa4=: ?oo
i X
-?Xc,
ay X???z= G?4
?--
I.'S2'2- xs3 _ ?oo??
Ztip
F-Lo02
_?---
xs3 = 3 S?o7
-- .. ._
d?3 -7 y3 0? ti??,?c> o
CITY OF EAGAN
3830 PIIAT RN4B ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
ot
FOR CITY USE ONLY
PERMIT #
RECEIPT # /O
DATE:
PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS 6
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH IINIT.
WORK DESCRIPTION
NEW CONST _
ADD ON _
REPAIR
OWNER NAME:
SITE ADDRESS:
LOT:44_ BLOCK J SUBD.
INSTALLER:
ADDRESS
CITY: / A4'?"YldJJLi/Y(.t" ZIP:
FEES
ADD-ON MINIMUM $15.00
HVAC 0-100 M STU 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS - MINIMUM 3.00
? OF 1 PER PERMIT
SUBTOTAL: S>U. ?
?1G??• STATE SURCHARGE: .50
? TOT
?(./ji[ •
IGNATURE PERMIT ^E Vi'
PHONE # : -,o? -5-767
E4?YtCIALjTN1??TR?A?.`.: PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS,
_ .._.._,....... .
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
IAT: BIACK _ SUBD.
INSTALLER:
ADDRESS:_
CITY:
PHONE
ZIP:
TOTAL:
( S IGNAT[JRE )
FEES
1% OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
EACH $1,000 OF PERMIT FEE.
?ROrESSED PIPING = $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $
STATE SURCHARGE
FOR:
CITY OF EAGAN
' CZTY OF EACAN
3830 PILOT KNOB AOAD
EAGAN, MN 55122
PHONE: (612) 454-8100
FOR CITY USE ONLY
PEkMIT # 0
RECEIPT #?
DATE: / I
RESUENT'XlIL:PLEASE COHPLETE ' UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS' &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. - ------
-------------------
WORK DESCRIPTION ----- ------------------- ----------° -----------------
COMYLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
NEW CONST X .' ADD-ON MINIMUM 15.00
ACD ON SHOWER 3.00 3.Go
REPAIR WATER CLOSET 3.00 Co,[Xl
? BATH TUB 3.00 300
I ?a. LAVATORY 3.00 G?.0.1
OWNER NAME: 1 KITCHEN SINK 3.00 300
LAUNDRY TRAY
? 3.00 300
SITE ADDRESS: LIIqy P 5VIU(pl?IGL HOT TUB/SPA 3.00
? WATER HEATER 3.00 3 OU
LOT:6P BLOCK SUBD. ? FLvOR DRAIN 3.00 3..6,a
GAS PIPING OUT.
INSTALLER: nd? ? )m)'IS (MINIMUM - 1) 3.00
ROUGH OPENINGS 1.50
?
ADDRESS: 3.5- _OTHER
? WATER SOFTENER 5.00
CiTY:
??L/YACI//'r "LIP: PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
PHONE tF: ya3" ,.l??b
SUSTOTAL S 3?? SD
z ST. SURCHARGE .50
SIGNA.URE 0 PERh:ITTEE -
TOTAL: S 3 g?oz)
COMMEEtCIALJ2NbU5TR3AL:?.: PLEASE COMPLETE THIS PORTZON FOR ALL GOMMERCIAL/INDUSTRIA L BUILD INGS AND
MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
-----------
------
-------
------------------
CONTRACT PRICE: -----'---^___------------- -------------
FEES .
OLitiEli NtiltiE: 18 GF COIvTkHGT FEE.
STATE SURCHARGE _ $.50 FOR
SITE ADDRESS: EACH $1,000 OF PERMIT FEE.
LOT: SLOCK SUBD. $25.00 MINIMUM FEE.
INSTALLER: CONTRAGT PRICE x 18 $
ADDRESS: STATE SURCHARGE $
GITY: ZTP:
TOTAL: $
PHOVE #:
(SIGNATURE)
FOR:
CITY OF EAGAN
Alhh?
City of Eapn
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (657) 675-5694
?n 2009 ME
Date: Site Address:
Tenant;
e..:- y.
RESIDENT / OWNER Name: a' (}? ?,tn,?,(,, Phone: 4 ` plYAP
"R
Address / City / Zip: ?
eV') ayi C?„
CONTRACTOR Name: ? .vosQ ?L?ng ?V? 4 yyrlfin/y Lic? es aA ^?.-rR? yG Z
r-
,
Address: IYO?f //G/?Miuio ,5r'
City: 5 ;H?S StatelfAl
Zip:53a33
_
Phone: c// -7-7 Contact Person:
TYPE OF WORK -New I-?placement _Additionql Alteration _Demolition
Description of work: A11, lrl(.11'f iiNf r
NOT6: Bofh}roof mounted andrgrourid mounted rilechanloa! eq*&eritirsn"ieqafr?d fo
be scre?netl8y City Cotle.Pleas?: cdK1i¢t the,J??echanl?`-'1?s?i8?toY.:Dr'ene srftl?e
Planners for In/ormatlvn on? e?mitted,gcreeriln riretfioci?
PERMITTYPE RESIDENTIAL COMMERCIAL
Furnace
Const
Tv
ruction Interior Improvement
Air Condifioner ail Piping - Processed
Air Exchanger _ Gas _ Exterior HVAC Unit
Heat Pump
- _ Under / Above ground Tank (_ Install / Remova)
" When installing/removing tank(s), call for inspection by Fire
. Other Marshal and Plumbing lnspecta
RESIDENTIAL FEES:
$50.50 Minimum Add-on or•alteration to an existing unit (includes $.50 State Surcharge)
$90.50 Firg repair (replace bumed oul appliances, ductvrork, etc.) (includes $.50 State Surcharge) ?"7s
v
?
$
_ TOTAL FEE
COMMERClAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x 1°k
$50.50 Minimum (includes State Surcharge)
- If Permit F-qg is leso than $1,000, surcharge is $.50. Permit Fee
- If P rmi En is > $1,000, surcharge increases by $.50 tor each =$ StBte SurCharge
$1,000 Permit Fee (i.e. a$1,001-$2,000 Permit Fee requires a$1.00 surcharge).
$ TOTALFEE
i nereby acknaMedge that this information is complete and accurate; thaUhe xark will be in conformance with the ordinances and Codes ol the City of Eagan; that
I untlersland this isnot a permN, bul only an application for a permit, and work is rwt m start with t a permA; thal l rk vrill be in accoNance with the approved
plan in case ol work whi equires a review antl approval of plans.
X X ;
AppU anYS Pnnted Name An licant's Sianature ,
i --- -----------,
i ?Df??B?? /n i
Permit #: ??L?' ? I
JUN 1 1 2009 ? i
? Permit Fee:
. j Date Received:
? Sta1f'
------------------'
:HANIICAL PERMIT APPLICATION
r?nalrr?oC'VJC ' -. '
Required'Inspecti6ns: _Unde'r=,Ground .. Rough 4n _qir
IN/NDWOOA yo({ Q 8 c
CNGINCOING `p?RN`rIERS u daIAND x?uRVEYOHS Brc iSS
P6 ?f8
CoMPA[dv, lIVC.
?.. ?IUUU CABT 14811t BTflEET, dURNBVILLF:, MINNE90TA 6633T PH 432-30U0
Certifica#e of 5urvey
Legal Description :LoT 6, BwCK l, STAFGORD P[AC??
DAKpTA CGYJN7Y, M/NNESOTA.
(9iE5 ) DENOTC-S EXISTING ELEVATION
(915, 5 ) DENOTES PROP05ED ELEVATION
? INDICATES DIRECTION OF SURFAC[ DRqINAGE
9/5,83 = pINISHED GAFIAGE FLOOFi ELEYATION
°9• = BASEMENT FLOOR ELEVATION
917.90 = TOP OF BLOCK ELEVATION
SCALE e 1• m 30'
EN `=,?
?,N s Ia
3a',:?W
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PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA125623
Date Issued:07/29/2014
Permit Category:ePermit
Site Address: 4174 Pennsylvania Ave
Lot:6 Block: 1 Addition: Stafford Place
PID:10-72500-01-060
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:Stove
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Eric Bruckmueller
3992 Pennsylvania Avenue
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 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 -
Patrick M Rondeau
4174 Pennsylvania Ave
Eagan MN 55123
Bruckmueller Plumbing Inc
3992 Pennsylvania Ave
Eagan MN 55123
(651) 686-6696
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
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Permit#: � I
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3830 Pilot Knob Road i i
Eagan MN 55122 I Date Received: I
Phone: (651) 675-5675 � i
� Staff:
Fax: (651) 675-5694 �_________________i
2015 RESIDENTIAL PL�BING PERMIT APP ICATION
Date: � J v <S Site Address: L�I / L� / �/�,�1�"I �VGn ��. C�
Tenant: � � �<.--- Suite#:
����"� AY Name: Phone:
F2es���nt�t���� �
� � ���- u Address/City/Zip:
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: ��� £ Name: �✓�C-'C� V�� License#:
A � `F ���, '. � Address: /�� � 6�'1 ✓ '�tL � City: ��' /E?// .. !��
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n� �� � �� ,�,1/ �s��� �1 -� �lsGi- ��� �
�� State: Zip: Phone:
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�������>w' £ Contact: EmaiL•
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Type of.l�l` � ��# —New Replacement _Repair _Rebuild _Modify Space _Work in R.O.W.
i��.
���� � � �-����� Description of work:
��# ���� � RESIDENTIAL
� ; ,�,f ��� �
������
����° �., �Water Heater
� �.. Water Softener
�� �� Lawn Irrigation(_RPZ/_PVB)
�����#�� � #�� Add Plumbing Fixtures(_Main/_Lower Level)
� xf Septic System
��� ��
� �� �� New Water Tumaround
���� ���� � —
� " ����%,
Abandonment
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 Rdd Plumbing Fixtures, Septic Svstem Abandonment,Water Turnaround"(includes State Surcharge)
''Water Turnaround(add$210.00 if a 5/8"meter is required)
$115.00 Septic Svstem New(includes Counry fee and State Surcharge)
TOTAL FEES$
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.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 wor ' not to start witho t a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approv of pl s.
x � �vt e C � x
ApplicanYs Printed Name Ap ant's Signature
x.ax '. ��'�#�'��� :� ,� '� � . r > -,'��..,�g � raf;,
F�3���5F�IC����� � � � ��� � � ��� � � �� �;�#� � � �
� � � �
� �� � �� � � �
� � �� � � � � #� ����� ����
�2equired�n�pections �J����Cfc�und;� ��� �������������Tes# #�Gas�Tes � � �� inal�
� ; � �� � � �� � � w
� ,.r � ;: x ���"�� �� �� � ��� ���tr "�����'
�#���er R��ated I#ems '��leter��z�� �=#�-�� _ � �� ��� �, iM�n� #�r ���' � ������� ����
�v. = k�:... �� � � �r
r , .����..... -.�-.�_ ���... , � � �.��..: . �.. r.r ' �
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA156955
Date Issued:07/26/2019
Permit Category:ePermit
Site Address: 4174 Pennsylvania Ave
Lot:6 Block: 1 Addition: Stafford Place
PID:10-72500-01-060
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 -
Patrick M Rondeau
4174 Pennsylvania Ave
Eagan MN 55123
Ralow's Roofing & Remodeling Inc
8609 Lyndale Ave S
Bloomington MN 55420
(952) 210-4988
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA174180
Date Issued:01/04/2022
Permit Category:ePermit
Site Address: 4174 Pennsylvania Ave
Lot:6 Block: 1 Addition: Stafford Place
PID:10-72500-01-060
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:Fixtures
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
All tiled shower bases require a water test.
Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
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 -
Justin Bruce Noll
4174 Pennsylvania Ave
Eagan MN 55123
Mad City Windows & Baths
5020 Voges Road
Madison WI 53718
(651) 500-0514
Applicant/Permitee: Signature Issued By: Signature