4667 Penkwe WayCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4667 Penkwe Way
Lot: 3 Block: 3 Addition: Johnny Cake Ridge
PID:10- 39800 - 030 -03
Use:
Description:
Sub Type: e- Reroof
Work Type: Replace
Description: House & Garage
Census Code: 434 -
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspec
acceptable in lieu of inspections.
Fee Summary:
Valuation: 3,000.00
Contractor:
Property Claim Solutions LLC
4655 Nicols Rd, Suite 202
Eagan MN 55122
(651) 994 -2028
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Construction Type:
Occupancy:
on prior to final, you must meet inspector with ladder and flat bar. Pictures are not
Owner:
Richard W Anderson
4667 Penkwe Way
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$88.50 0801.4085
$1.50 9001.2195
$90.00
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
Building
EA085409
08/20/2008
ePermit
CASH RECEIPT
CiTY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
RECEIVED
FROM
AMOUNT $ I
!e_,fD LL S
(xL ?
? CASH ? CHECK
M
ee?? ?? T
ROR
FUNO I CODE I AI.tOUNT
?
k You
BY
?
White-Payers Copy
Yellow-Posting CoRy
Pink-File CopY
CITY OF EAGAN Remerks
Addition JOHW CAKE R?'IMI ApnTTTONL- Lot IS Bik ? parce! 10 39800 030 03
Owner '-J'fh t( W `'I'L2: 1111i Lt•ti` street 4667 Pen]ctive 1?IaY State Eairan, NQi 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF,
STREET RESTOR.
GRADING
SAN SEW 7FiUNK
* SEWER LATERAL sJ
WATERMAIN
* WATER IATERAL
WATER AREA
STORM SEW TRK
* STORM SEW LAT
CURB & GUTTER
SIDEWALK
5TREET LIGHT
WATER CONN. 305 It it
BUILOING PER. 5, 6
910 it it
SAC -
PAR K
No. '13
cinr oF EAc,AN
3795 Pilaf Kwob Rood
Ea9an, Munnnora s5122
P6one: 45I-8100
- T• Ir'7 PERMIT
oate: L9
Site Address:
1980
+667 Penkwe VNav
Lot ; Block 3 Sub/Sec. `T1111
r. Cake Ridge
Nome lorrpaon HOrfi ?
.
Address
' '6S82`0a
O
City r Phone:
Name 11.4y N.
.
?
Address --+ "
City Phone''
This Permit i s issued on ihe express condition that oll work shall be
Minnesoto Stotutes ond City of Eogon Ordinonces.
INSPECTOR NOTIFICATION
REQUI RED BY LAW
FOR ALL INSPECTIONS
Receipt No.:
Single
Residential
New/Alter. /Repoir Cost of Instollotion
Permit Fee
Surcharge
Totol done in occordance with all appliceble Stote of
Iding Offlcial
. ' ? CITY OF EAGAN
. 3795 Pllot Kno6 Road Eagon, MN 55122 N2 5690
PHONEs 454-8100
gU1LDING PERMIT Reteipt #
To be used for Est. Value Dote , 19
Site Addross Erect E] Oocupancy
Lot Block Sec/Sub. -; -'' Alter p Zonin9
Porcel Repair ? F(re Zone
Enicr
e ? T
e of Const
g yp
.
& Nome -' '' ??,•••oT':^G??r. ' t:= r ? Move ? # Stories -
? Address Demolish p Front ft.
?
Ci
-
- -
Phone
Grode ?
Depth ft.
Approvols Feea
? Name
Assessment - , -
?? Address
Water &
Sew.
~ Ci Phone
Police
bee
W
Name
Firo
?
W
?? Address Eng.
<W Ci Phone Planner
Council
I hereby acknowtedge that I hcve read this opplicotion ond stote that gldg. Off.
the informotion is correct and agree to comply with all applicable
State of Minnesota Statutes ond City of Eagun Ordinances. APC
Permit
Surcharge
Plnn thetk
SAC
Woter Conn.
Water Meter
Total r
Signature af Permittee I
A Building Permit is issued to: - on the eupress condition that
oll work shall be done in cccordance with cll opplicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Officlcl
?@nnlf # Dah laaed P"IttM
Plumbing (F Q
Mechanical / U
o
INSPECTIONS DATE INSP.
Rouph-In
Flnd
Footings Dote Irnp. Date Insp.
Foundotion Plumbing
Frame/ins. 23' 6 d Mechanfcal
Finol 'r^ag -
Remarks:
. ]_,' ?
No.'
(),}0
Dote:
cirY oF Er?"N
3795 Wlof Knob ReaA
Eagan, Minnesata 55122
Pbone: 464.8100
PERMIT
Site Address: ' * hc`7
Lot Block ? Sub/Sec. 'h??' • ??=`' ?'i-?re
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTtONS
Receipt No.:
$ingle
Residentia l
Multi Res., Comm./Ind. I
Na? 7r2`:.Il T:loi:!n30n New/Alter./Repair ?
. . .
; Address Cost of Instaliotion
O
Ciry Phone: Permit Fee
• E.:i ;c??_ . .'C'.n' ? Cr 1
Nome ' Surchorge
.
? Address ' -30 `:en::ebec . Tlb'?
? City Phone: - 52 -1 Total
This Permit is issued on the express condition thot all work sholl be done in accordance with oll opplicab{e State of
Minnesoto Statutes and City of Eagon Ordinonces.
Building Official
BUILDING PERMIT
To be used for act
.n.q...? ?,V -a?,;+r.:
CITY OF EAGAN 14! 17809
3830 Pilot Knoh Road, P.O. Box 21-199, Eagan, MN 551?$
PHONE:454-8100
Racaint A
$1,000
!!AY 4 19 90
Site Address ??? PMUM YAY
Lot 3 Block 3 Sec/Sub. JOHNNY CAKE OFFICE USE ONLY
P8fC21 N0. Occupancy - FEES
W Name RICt?ARO 8$U3Al? AlfDL'R90N Zoning
(p,ctua1) Corul 3s.?
- Bldg. Permft
Address 4667 PEIIKWE idAY (Allowable) - . SO
Surcharge
? City ?? Phone # oi sto?es -
, Plan Review
Length _
o Name SAMS Depth - SAC, City
Address S.F. Total -
A
M
w
Cc C,
S
C
CC
City Phone S.F. Footprints -
Waier Conn
On Site Sewage _
?
W
Name
on sice wen
- wacer Mecer
?
x= Address MWCC System _
?• ?Posit
? W City Phone Ci1y Water _
S/W Pertnit
PRV Required _
I hereby acknowlege that I ha e read this application nd state that the Booster Pump - SMf 5urcharge
iniormation is correCt and to conlply ? all i e Stale ol
f g?di
Lr f? ??
Minnesata Statutes and Cit Treatment PI
{
??
Signature of Permitee APPROVALS Road Unit
RICRARD Ot $jTS11N Planner -
A Bwlding Permit is issued to: Park 6ed.
on the express condition Ihat all work shall be done in accordance with ail Council
appiicable State of Minnesota Statutes and City of Eagan Ordinances. gldcj, pft, - COPieS --?
Building OHiciai ' °? ? - Variance - TOTAI ?
Pcrmit No. PermH Holder Dtle Telephone #
WATEfi
SEWER
PLUMBING
H.VA.C.
ELECTRIC
Inspection Date Insp. Comments
Foolings I
Foundation
Framing
Flodirg
Rough Pibg.
Rough Htg.
Isul.
Flreplace
Final Htg-
Fnal Plbg.
Corist. Meter Plbg. Inspector - Notify Ptumber
Engr./Plan
Bldg. final
Oeck Ftg.
Deck Final . /
we?i
Pr. oisp.
95 Pilot Knob Rood
Iog In °F E'°`c??N SEWER S ERVICE PERMIT
gan. MN 5512Z PERMIT NO.:
ning; DATE:
,?r. No, of Units:
dress:
e Address:
mber:
?ee !o comply wit6 the Cify of Eagon
inanees,
BY -?
Dnte of insp.;
Insp..-
-CITY OF EAGAN ?
%3795 Pilot Knob Road
gan, MN 55122
oning:
ner,
IM ite Address:
PI umber:
?!Vleter r No.:
t eader No.;
ogree fo tomply wifh tfie City of Eagon
rdinoneee.
BY
' Date of Insp.:
Conneciion Chcrge;
Account Deposit:
Permit Fee:
Surchorge;
Misc. Charges:
Totol;
Date Paid:
WATER SERVICE PERMIT
PERMIT NO.:
DATE:
No. of Units:
Connection Charge: j
Account Deposit:
Permit Fee:
Surchorge:
MisC. Chorges:
Total:
Dote Paid:
Insp.:
minnesota sca[e uoara ot tiectncity
Griggs Midway Bldg. - Room N791
1821 llAiversity Ave., St. Paul, Minn. 55104 - Phone 297-2171
<- - REflUEST FOR ELECTRICAL INSPECTION
CHECK SELOW WORK COVERED BY THIS REQUEST
/q/ / n?-EB-00o01-02
?g. 59346
Type of Building New Add. Rep. Check Appliances W'ved Foi Check Fquipment Wired Fm
Home ? ? ? Range Temporary W'ving ?
uplex ? ? Watec Heater ? Lighting Fucmies
t. Bldg. ? ? ? Dry ? Electric Heating ?
mmercial Bldg. ? ? ? Fu Silo Unloader ?
Industrial Bldg. ? ? 0 Air "? ?ti ??? Bulk Milk Tank ?
Fazm ? ? ? Lis List
Othef
?
?
? p
Heiers? p
?
Hehe 5
COMPUTE INSPECTION FEE BF.LOW
Service En[rance Size: # Fee Feeders.@Subfeeders: # Fee C'vcuits: u Fee
0 to 100 Am s. I Z, 0 to 30 Am eres 0 to 30 Am ies
101 to 200 Amps. 31 to ] 00 Amperes 31 to 100 Am eces 9,JU
Above 200_Amps. Above ]00 Amps. Above 100 Amps.
Transforme[s RemoteControlCirc. Partial or other fee
Si ns Special lns ction Minimum fee -
Remazks TOTAL FE ,F,?5
(Final)
This request void
18 months from
beenwadg. _
dG?
e J ,
r 11n- aZ 40
Thisrequest_void
18 months from
Date of this Request S I 1 a?? Fire No. S` 5934"
I, auxlicensed Electrical Contractor ? Owner, do hereby request 'ns ection of the above electri-
cal wiring installed at: K3 .63 G'.k,
et Address or Route No. P?'"?e W? ?
?t City. CAW
ion Township Range County DNIC-01-A
Which is occupied by
Is a roughin inspection required on this job? No ? Yes$__ Ready Now O Will CaIIGBI
Power Supplier Address ' W'WblCN"
Electrical Contractor Contractor's License NoJ5(q
I ?i ( mpany Name
Mailing Address IqI` v` ? ? ul
( rica on tor orowner Making This Installatlon)
AuthorizedSignature PhoneNo. gqo -
(Elec rlcal ContYaCtof or Owne1 Making Thls Initallatlon)
?('??`??? ????D ??f?$? This inspeetion requast will not 6e accepted 6y the t'J {? State Board unless praper inspection fee is enclosed.
CITY OF EAGAN Np 17809
3830 Pilot Knob Road, P.O. Box 21-1, 99, Eagan, MN 55
PHONE:454-8100
BUILDING PERMIT aeceipt #
To be used for DECK Est. Value $1, 000 Date MAY 4 , 1 g2D---
Site Address 4667 PENKWE WAY OFFICE USE ONLY
LOt 3 BIOCk 3 Sec/Sub. -TOHNNY KF.
Parcei No.RIDGE 1ST occupancy - FEEs
Zoning -
Name RIC.HARD & StISAN ANDF.RSON (acroaqconst - sidq.Pemrii 25.00
w AddtOSS 4667 PF.NKWE WAY (alaxable) e .50
- Surchar
o City Far.ax Phone 459_4881 zorstories g
-
Plan Review
Lengih _
p Name SAMF. Depth - SAC, City
,
?
AddfBSS
S.F.Total
-
C
SAC,MCWG
? City Phone S.F. Footprinls -
Waler Conn
On SiIe Sewage -
?
ww
Name
On Site Well
- Waler Meter
i? Addf95S MWCCSystem -
? Acct Deposit
ew Clty PhOn@ CiryWater -
SM' Permil
PRV Required -
I hereby acknowlege tha[ 1 have reatl this application and stale that the Booster Pump - SIW Surcharge
intormation is correcl and a e lo corvply ith all plic le State of
.
Minnesota Statutes and Ciry f ag rdin Treatment PI
?
?-
Signature ol Permitee
APPROVALS
Road Unit
A Building Permit is issued to: RICHARD OR SUSAN ANDERSO Planner - park Ded.
on the ezpress condilion that all work gnall be done in accordance with all Cancil
ity
ot Eagan Ordinances.
applicable Slale ol Minneaofa Statutes an
d
C Bldg. Oft - COP'es
y
?
y
? 25.50
Building Oflicial ? Ml ,pd,??,J-LL1eQ
\ Variance - TOTAL
?O ' . . ' CITy p?' FAGAN Include 2 sets of plans.
?\ . 1 site plan w/elevations 6
V'
BUIIDING PIItN=,APPLICATION 1 set of enezgy calculations.
Zb Be Used Fbr % y- Valuation ? 4(oTgW p o Date M A(Z l9 i Iq 9 0 '
Site Pddress: L?bL'1 QEuv.wE W A? (t`aDEL 37) ) OFFICB LiSE C1NI,Y
Lot 3 sioac a sec./sub. zwAumy cnY-e
???s( R1DGE ?'J'/
Parcel #•
O.mer:
Pddress:
City/Zip Oode:
Phorve # :
Contractor: nRRIN THnMPC(1N N(1MFe
AddreSS: a Division of U. S. Home Corporation
1712 1 IG11KfPl6 6R96SR eftB
City/ZlP COde: MINNETONKA, MINN. 55343
Phone #: Syq•1333
Arch./Ehg.:
Pddress:
City/Zip Code:
Phone #:
Erect ? Occupancy K-3
A1teY ZOning k -
gQn3ir . Fire Zone
Enlarge _ 7ype of Const. _
Nbve # Stories
De[nlish Front ft.
Grade Depth 1 ft.
Assessments
F13tET/S24.er
Polioe
Fire
Eng
lanner
Council
Bldg. Off.j.¢°-
APC
Perndt
'?-
Surcharge ,2-1
Plan Cieck 6 5 %-
SAC S ? 5' ?
Water Conn.
Water Meter O
RDad Unit
'inTAL ?
• , cirr oF Er?c,AN
9795 Wlot Knob Rand Eagoa, MN 55122
PHONF: 4548100
BUILDING PERMIT APPLICATION r ' Receipt j'
SIM Address 4667 Penkwe Way
Lor 3 ei«k 3 sec/S.b. Johnny Cake
rorcal # Ridge
w Name nrri n Thnm,ncnn HnmaA
? Address 1712 Hopkins Crossroad
p Name
?? Address SdmO
!- r:- e1 _'_
Name
Address SaIRP
I hereby ocknowledge that I have read this opplicotion ond state that
the infomwtion is correct ond agree to comply with oll applicable
SMte of MinnesoM SMtutes and Ciry ot Ea9an Ordinances.
Sfgnature of Permittee
A Building Permit is issued to: I
cll xrork shall be done in accorcfance
Building Off1Nal ?
N9 5690
/ftl, ?, s
Erect l`j OccuPOnry R l
Alter p Zoning Rl
Repoir ? Fire Zorre '
Enlorge ? Type of Conat. U
Move ? # SMries Snl i t
Demolish ? Front S f) h.
Grade ? Depth 'A R ft.
ppproveb Feea
Assessment 3 / J?1 / }{ I
Water & Sew.
Polite
Fire
Eng.
Planrrer
Council
BIdg.Off. 4.,/4 /R(1
APC
Permir 130_50
Surcharge 73 _ (10
Plan check 6 - 2 q
SAC 525.00
Water Conn. '10S_ O Q
Water Meter F n- n 0
;nar3 iTnit 1RS_Q(
Totol l 99't _ 7S
on the axpress rnndition that
Statutes and Clty of Eagan Ordirmnces.
RESIDENTIAL BUII.DING
Permit Applicution
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
?? Telephone # 651-675-5675 FAX # 651-675-5694
c?? (, - a--1
New CanstrucGon Reauirements RemodeURepair Reouirements Office Use Onlr
3 registered site surveys showing sq. R. of lot, sq. h. of house; and all roofed areas 2 copies of plan Cert of Survey Real
(20% rreximum lot coverage allowed) i setof Energy Calculations for heated additions Tree Pres Plan Recd
2 copies of plan shaxing 6eam & window sizes; poured found design, etc. t site survey for addifions 8 decks Tree Pres Not Reqd
isetofEnergyCalculations Addi[ion-inUicateilon-sResepticsystem _On-site5epticSystem
3 copies of Trce PreservaGon Plan'rf lot platted aker 711193
Rim Jaist Delail Options seleclion sheet (bldgs wifh 3 ar less units
Date e /A? /6-?
SiteAddress 7 Construction Cost /z g D U 0,)
e4--,.4 ?i UniUSte #
ell
Description oF Work •2 _-i4
Multi-Family Bldg _ Y/_-N FSreplace(s) _ 0 X, 1 _ 2
Property Owner le1 G'k Telephone # ( )
Contractor
Address v2/ v-5 G[J.
State City dJcc 2,?.r'//'./G=
Zip Telephone #( qcT"?} 999- S&a 0
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Cateeorv 1
(J submission type) • Residential Ventllation Category 1 Worksheet
Submitted
• Energy Envelope CalculatLQns Submitted
r- l?I p
Licensed Plumber li1 $ ???? ?=
Mechanical Contractor
Sewer/Water Coniractor
A NEW BUILDING
Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
Telephone # (
Telephone # (
Telephone # (
I hereby apply for a Residential Building Permit 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 permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
Z41:n
ApplicanYs Printed Name ApplicanYs Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pooi
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace Ix 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 (screen/gazebo)
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New
1?6 32 Addition
? 33 Alteration
? 34 Replacement
ar?
Valuation gGzY
Census Code ?t 3K
SAC Units r
Nbr. of Units "
Nbr. of Bldgs
Type of Const ?y
Footings (new bldg)
? Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof -J' Ice & Water X_ Final
? Framing
4 Fireplace I R.I. kAir Test )( Final
Insulation
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Occupancy R -3 MC/ES System
? 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
"Demolition (EMire Bldg) - Give PCA handout to applicant Zoning R ? ! City Water
Stories ? Booster Pump "-
Sq. Ft. A2' PRV
Length Fire Sprinklered ?
Width
REQUIRED INSPECTIONS
FinaUC.O.
? FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stuceo Stone
_ Windows (new/replacement)
_ Retaining Wall
Approved By
? 30 Accessory Bidg
? 31 EM. Alt- Multi
? 33 EM. Alt- SF
? 36 Multi Misc.
Buiiding Inspector
/C7 '?--
.?2.290 3 SK11S'oW Q ho?/?r B?Ga =
?C. R. WINDEN d? ASSOCIATES, INC.
V (J lANO SURVEYORS ToL 645•3646 '
1381 EUSTIS SL, 5T. PAUI, MINN, 33108
For:
U. S. HOME CORPORATION
PENKwE
Scale: 1" = 30'
O Denotes Iron
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E 5p o
? 69• r - ?
5? 10?eYha"g 71-2A ' \ ,
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Lot 3, Block 3, Johnny Cake Ridge
Addition, Dakota County, Minnesota
WE HERf6Y CERTIFV TFiAT iM15 IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY Of THE
60UNDARIES OF THE IAND A60VE DESCRI6ED AND OF iHE lOCATION Of All 6UILOINGS, IF ANY,
TNEREON, AND ALl V1516LE ENCROACNMENTS, IF ANY, fROM OR ON SAID LAND.
DatoA +bis 177' 4 doy eF A^QQ A.D. 1900 C. R. WINOEN 3 ASSOCMTES, INC.
- ?)
br ?iR-j'",'
Surveyor, Minnewea taqistrotion Ho. ?'?2-G
C.R. WINDEN d ASSOCIATES, INC` •
?J'?l???j•(j?/?y IAND SURVEVORS Td 645•3648 i
O I381 EUSTIS SL, ST. PAUI, MINN. 88108
For:
U. S. HOME CORPORATION
l v
Z7NXWE
P Scale: 1" = 30'
, O Denotes Iron
?
E
• O
50 ..L
? 69•
?
?Sed w
25?
? 2 PYpP ?
?
N ?oL)se -
? 10
?
.? I
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9B. 9
I
Lot 3, Block 3, Johnny Cake Ridge
Addition, Dakota County, Minnesota
WE HEREBY CERTIFY THAT TMIS IS A TRUE ANO CONRECT REPRESENTATtON OF A SURVEY OF TME
6OUNDARIES OF THE tAND A60VE DESCRIBED AND OF THE lOCATION OF ALL 6UIl01NG5, If ANY,
THEREON, AND ALl VISIBIE ENCROACMMENTS, If ANY, FROM OR ON SAID IAND.
Datad fhis 17 T"/ day ef MAe A.D. 1900 C. R. WINOEN d ASSOCIATES, INC.
Survayor. Minnewra Raqistrotiee No.??ZL
,
wi-of A.
1990 BUILDING PERMZT APPLICATION
CITY OF EAGAN
APR 2 r 1990
SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS 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 KEQUEST IS MADE.
IAT 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.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: 446ew?r L'
Site Address 4&7 k-?`IKWc-
L/00 r?
valuation: Date: 2-7 919
Lot b-'?O slock 03
Parcel/Sub JU`'A'wv CT'IA?e le1-P49z---
Owne r L' ! Ci-FA 2D
Address 4wl All.lKUle WA-y
City/Zip Code GA&A"-J M,[ s$I L7-
Phone
Contractor ?l161-1
Address
City/Zip Code
Phone
Arch./Engr. ??leF
Address
City/2ip Code
Phone #
OFFICE USE ONLY
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F
On site sewage_
On site well _
MWCC System _
City water _
PRV _
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CITY OF EAGAN
EARLY UTILITY CONNECTION PERMIT
4667 Penkwe Way L3 B3 Johnnv Cake Ridga
Address Suhdivision/Parcel
I hereby request permission from the City of Eagan to connect to the
sanitary sewer and water lateral line in the public right-of-way. I
understand that the City has not yet completed, inspected and/or accepted
the sewer and/or water lateral. I agree not to use, test, or connect these
individual services to any interior plumbing and understand the require-
ment to cap the sewer service to prevent any unauthorized use.
In accepting this permit, it is agreed that I will hold the City and its
agents harmless from any damage that may occur due to this early connection.
It is understood that no Occupancy Permit will be issued or water allowed
to be tumed on until the City utility system has been declared operational
by the City Engineer.
Signed by - Plumber: r..cr,ZFr ,.+Erx?nNrr7a . ?.
Owner ?
Developer•
Builder
Dated:J; 97/ao --
RESIDENTIAL BUILDING
Permit Application
City Of Eagau
3830 Pilot Knob Road, Eagan Mo 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construdion Reouirernents RemadeVReoair Reauiremenls Office Use ONv
3 registered site surveys shaxing sq, ft of lot sq. ft ot house; and all roofed areas 2 capies of plan Cert of Survey Recd
(20% mazimum lot wverage albwtd) 1 set of Eneigy Calala6m for healed addi6ons Tree Pres Plan Reod
2 copies ot plan showing beam & window sizes; poured found desgn, etc. 1 sRe survey for addifmns & decks Tree Pres Not Reqd
lsetofEne(gyCalculations Addifion-indicateifon-sfesepticsysfem _On-siteSepGCSystem
3 wpies of Tree Preservation Plan if lot platted aker 717/93
Rim Jois1 Detzil Op6ons ulecllon sheet (61dgs wiN 3 or less units
Date -2/1?5/1 -?92 Construction Cost J 6,90 Uo
Site Address y& ?, p
7 c4 UnidSte #
Description of Work 1Z
Multi-Family Bldg _ Y Fireptace(s) _ 0_ 1 _ 2
Property Owner Le c4, Telephone # ( )
Contractor /v cc-- S
Address v?/ ?•5 lnJ, ?Yc? ?`? s? City
State Zip Telephane #(
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category . Residentlal Vantilation Category 1 Worksheet • New Energy Code Worksheet
(J submission lype) Submitted Submitted
. Energy Envelope Calculations Submitted
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone #
JUL 1 5 2003 I??I
I hereby apply for a Residential Building Pemut and acknowledg ?at the information?t complete and accurate;
that the work will be in conformance with the ordinances and co es of the City of Eagati and the 3tate of bN
Statutes; I understand this is not a permit, but only an application Y a perntit,=arid- s 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.
1__?
l'
/ o ? ?d, s-
Applicant's Printed Name
?
Applic St ?san ?ature
OFFICE USE ONLY
Sub Types
O 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace 0 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Founda6on) ? 45 Fire Repair
? 33 klteration ? 37 Demolish (Bidg)* ? 43 Reroof ? 46 WindowslOoors
? 34 Replacement •Demalition (Entire Bldg) - 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. af Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSYECTIONS
_ Footings (new bldg) _ FinallC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addirion) Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Au/Gas Tests. _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ InsulaHon _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review -
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatrnent Plant
License Search
Copies
Other
Tvtal
Building Inspector
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4667 Penkwe Way
Lot: 3 Block: 3 Addition: Johnny Cake Ridge
PID:10- 39800 - 030 -03
Use:
Description:
Sub Type: e- Reroof
Work Type: Replace
Description: House & Garage
Census Code: 434 -
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspec
acceptable in lieu of inspections.
Fee Summary:
Valuation: 3,000.00
Contractor:
Property Claim Solutions LLC
4655 Nicols Rd, Suite 202
Eagan MN 55122
(651) 994 -2028
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Construction Type:
Occupancy:
on prior to final, you must meet inspector with ladder and flat bar. Pictures are not
Owner:
Richard W Anderson
4667 Penkwe Way
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$88.50 0801.4085
$1.50 9001.2195
$90.00
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
Building
EA085409
08/20/2008
ePermit