4674 Penkwe Way
Use BLUE or BLACK Ink
For Office Use I
C*t NOR O1 Permit
f ~ Permit Fee: a
I
3830 Pilot Knob Road ~~U!,~'' 2 F I
Eagan MN 55122 I Date Received: K?`
Phone: (651) 675-5675 C I
Fax: (651) 675-5694 Staff: j
- - - -
PERMIT APPLICATION
2011 MECHANICAL
Date:,-/,, Site Address: h4q
Tenant: Suite
RESIDENT I OWNER Name: Phone: 5,g
Address / City / Zip: Lk-
CONTRACTOR Name: / d d License
Address: 12 1~C-+ City:
i < n
State: t Zip: J ~ Phone: &
Contact: Email:
TYPE OF WORK New Replacement Additional Alteration Demolition Description of work: km ~ ea- gIil d Am ee, ~ difL
NOTE:` Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
RESIDENTIAL - COMMERCIAL
PERMIT TYPE Furnace New Construction Interior Improvement
7Air Conditioner Install Piping _ Processed
Air Exchanger Gas Exterior HVAC Unit
Heat Pump Under/ Above ground Tank (_Install Remove)
When installing/removing tank(s), call for inspection by Fire
Other Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge)
$95.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $fs TOTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank installation/removal OR Contract Value $ x1%
$55.00 Minimum (includes State Surcharge)
Permit Fee
- If the Permit Fee is less than $10,010, surcharge is $ 5.00
If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee Surcharge
(i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge)
= $ TOTAL FEE
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.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with 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 u a per it. that the work will in accordance
with the approved plan in the case of work which requires a review and approval of plans.
X p iM1 ~I / ~JY WI:.kJ&'- I CJ x +
Applican 's Printed Name Applicant's $i ature
FOR OFFICE USE Reviewed By: Date:
Required' Inspections: -Under Ground _ Rough In Air Test Gas Service Test iIn-floor Heat Final
Exterior HVAC Screening Inspection
PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA087226
Eagan, MN 55122 . Date Issued: 10/31/2008
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 4674 Penkwe Way
Lot: 6 Block: 2 Addition: Johnny Cake Ridge
PID 10-39800-060-02
Use
Description:
Sub Type: e-Siding Construction Type:
Work Type: Siding
Description: House
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: When installing ventilated soffit material, remove existing soffit material (i.e. debris that could block vent openings) and
take steps to ensure maximum ventilation into attic space.
Fee Summary- BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
Valuation: 3,000.00
Total: $90.00
Contractor: -Applicant - Owner:
Eagle Siding Robert W Hall
1301 East Cliff Road 4674 Penkwe Way
Suite 117 Eagan MN 55122
Bumsville MN 55337
952 746-3046
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.
Applicant/Permitee: Signature Issued By: Signature
CITY OF EAGAN Remarks
Addition JOHNM CA,KE_RTDGE ADDTTIL7Dt Lot b Rik 2 Parcet 10 39800 060 02
owner li}4:i ;b„1 a : 1 -40 0 screet 4674 Pe7tkwe Pfay srate Eagaz?, MM[+ii 55122
improvement Date Amount Annual Years Payment Receipt Daie
STREET SURF,
STREE7 RESTOR.
GRADING
SAN SEW TRUNK 1975 323.14 - 54 15, -215 44
* SEWER LATERAL
WATERMAIN
* WATER LATERAL IaQl
1NATER AREA
7
STORM 5EW TRK ?b
* STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGH7
WATER CONN.
10500
SUILDING PER.
SAC
PARK
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE
19
AMOUNT $ 17
& DOLLAR$
1 eo
[] CASH [] CHECK
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
Thank You
?? - 8Y Iv/
: CITY OF EAGAN
8795 Pilot Knob Raod Eagan, MN 55122
PHONE: 454-8100
N4 5903
BUILQING PERMIT Receipt #k
Te ho urd ier FC}_ Vl1I11P DAYP
Site Address
Lot
Porcel # Block Sec/Sub.
oe Nome
W
3
Address
0
Ci Phone
o Nome
?
??
Address
~ Ci Phone
u?
W
Name
W
PW
_?
Address
I hereby acknowledge that I have reod this application ond state that
the informotion is correct and agree to comply with all opplicable
State of Minnesota Statutes and City of Eogan Ordinances.
Erect ? Occupuncy
Alter 0 Zoning _
Repair ? Fire Zone
Enlorge ? Type of Const.
Move ? # Stories
Demalish ? Front ft.
Grode ? Depth ft.
Approro ls Fee¦
Assessment
Water & Sew.
Pollce
Fire
Eng.
Planner
CounCil
Bldg. Off.
APC
Permit
Surcharge
Plan check
SAC
Water Conn.
Woter Meter
Rood Unit
Total
Signature of Permittee I
A Bullding Permit is issued to: ? on the express condition that
oll work sholl be done in actordance with oll applicoble State of Minnesota Stotutes ond City of Eagon Ordinonces.
Building Officiol
F*f1dt 001o IMN/ FomIMN
Plumbing - f.
Mechunicul
INSPECTIONS DATE INSP. Rpph-In Finol
FoOtings 7``? Date Insp. Dote (nsp.
Foundation Plumbing
I , f2Z ?'
Frame/ins. %0 -,?z -. Mechanical
Final //- ;L6-t
?
f D
Remarks:
- cIrr oF EAGarr
3795 Pilot Knob Reed
No, Eagae, Minnesota 55122
Phene: 454-8100
PERMIT
Dote:
Site /\ddress:
9-12-9
4674 Penkive Wsj
Lor ?'' Block -, Sub/Sec. Jh?T•Calce :'irl:'e
Name ?.'2'rin Thompson 'Iom, i
g Address -:7i2 ` op}:ins Crsrd.
?
CIfy t' 4:. Phone: 544-7333
Ncme
?
g Address ChiC9F_'O AY° .
e
0
V City `• ?a • ';`n• Phone:
This Permit is issued on the express condition thot all work shull be
Minnesoto Statutes and City of Eogan Ordinonces.
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
Receipt No.:
Single . I
Residentiol
I
Multi Res., Comm.!Ind. '
New//11ter. / Repoit
Cost of Installotion
Permit Fee Surcharge '
Tota I '
done in accordonce with oll appliooble State of
Buildinp Official
No.
'=liuabii?.
Date: ?- i
Site /lddreu: ' -?Z i'e'7i;we W.
Lot BI«k Sub/5ec. JIMY• Ck• Rd?" .
Name Orrin Thompson HomeS
? Ilddress 1712 Iiopkllss Crs1•::.
?
Clty . .i.ririetOllka, ?fil Phone: 544-7a-
Nome l'Jenzel ',Meehanical
.
g Address i`'' -jO Kennebec JT .
e
3 City Phone:
This Permit is issued on the expreu condirion that oll work shull be
Minnesota 5totutes ond City of Eagan Ordirwnces.
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
Receipt No.:
Single I
Residential
Multi Res., Comm./Ind. ?
New /Alter. /Repoir
Cost of Insfallation
Permit Fee 20.
Surcharge L r
Totol
done in accordance with oll applicable 5tote of
crnr oF E?GAN
3795 Pilet Keob Rood
Eoqen, Minnesota 65122
Phene: 454-8100
PERMIT
Buildinfl Official
CITY OF EAGAN ?r
3830 Pilot Knob Road P.O. Box 21-199, Esgan, MN 55121 1?1 Q 9139
PHONE:454-8100 / -
BUILDfNG PERMIT
T. A. .d ier DF"?C
Receipt
250. ,ti..e JUNF 6 84
Site Addr s
?
JOHNNY
-
1
D
??t parxy -."
??u
Lot C
?I Ok? __ c0 JO b 02
6
1 3 9 8 0 0 ?KE RI
G
ter
? `
Zoninp
-
Percel Mo, Repair ? Fire Zone
Er,lorge ? Type of Const.
ROBER'P W. P.ALL
?e Name Move O # Stories
Z Address SAME Demolish 0
?
Length 10
? City Phone 4 54 - 5 9 6 3 Grode ? Depth L8 S
Ft
q.
.
;;A;,]L ApProvola Fees
? Name
?? Address
? City Phone
Name _
Address
City _
Phone
1 hereby acknowledfle thot I have reod this cpplicotion ond state that
the inlormotion is correct ond ogree to comply with oll applicoble
Stote of Minnesoto Stotutes and City of Ea9an Ordinonces.
Slqnoture of Permittea
ROBERT W. !1
A Buildiny Permit is issued to:
oll work sholl be done in accord6n6 wkth oll appliooble Stote, of Mir
Buildinp Official ?l-? e--?
Asseument Permit "`T?
Water & Sew. ?
Surchorge
Police Plon check
Firo SAC
Enp. Warer Conn.
Planner Water Meter
Council Rood Unit
Bldy. Off.
/1PC Totol 2 3. 0 0
on the express condition thnr
wM Statutes and City of Eoyon Ordinontes.
Permit No. Permit Holder Misc. Permit No. Holder
PlumWnq
H.V.A.C.
WNI
Wmr
Di"p.
Sftwr
Elsctric
Irapection Dats Insp. Other
Footinp •?-
Foundation
Fnminp
Rouyh Plbq.
Rough HVA
Inwlation
Final Plbg.
Final HVAC
Final ?j
Water Dssaibe Location:
WeU
Sower
Pr. Disp.
ctrY oF EAGAN
3796 PIlot Keob Raed Eoyan, MN SS12!
PHONE: I54-8100
BUILDING PERMIT
Sife Addrcu `+fliy renicwe wav
Lot 6 Blxk g 2 Sec/Sub. Johnny Cake Ridge
Parcel # 1CL34EOA 460 02 let
ix Na,t„ Robert Hall
au Add,ou 4674 Penkwe Wav
A Norne raciiic rvvt a r
Addren 6922 55th SC. No.
? r55109 0,,,,,,_
Name _
Address
I hereby acknowledge that I hove read this application and state that
fhe intormation is torrect ond ogree to wmply wifh oll (ipplicoble
State of Minnesoto Stotutes ond Ciry ot Eoflon 9rd'nwnces.
Receipt #
Erect ?
111ter p
Repair Q
Enlarpe ?
Move ?
Demolish ?
Grode ?
Apororals
•° 8141030
Occuponcy
Zoning (Pil) r-1
Fire Zone NA
Type of Const.
# Stories
Lengthl6
Depth.32 Sa. Ft.
Assessment
Water & Sew.
Police
Firo
Eny.
Plonner
Councfl
Bldg. Off.
APC -
Permit t$U•,-I) to
Surcharye 5•0(}
Plen check
SAC
Water Conn.
Water Meter
Road Unit
Totol $85.50
Sipnature of Permittee ' ,i - • -/ - ?
C' 00 S O ?
rx6f A Building Permit Is issued to: - .1 on tha express tondiNon tlxat
oll work shall be done in occordance wlt pll epplioaksle Stote of Minnesota Statutes ond Ciry of Ea9on Ordlnances.
8ulldiny Official
Psrmit No. Permit Holder Mise. Permit No. Holder
[
E
W
Disp.
S?vrer
Ekctrie t00$03oq r?tP?ta a m?
Irnpection Date Insp. Other
Footinyt
Foundation
FnminQ
Rough Plbp.
Rouph HVA
Inwlation
Final Plby.
Final HVAC
Final y
Watsr Do,"ibe Location:
YVell
Sawer
Pr. D'aP.
L / ? ? ?
Raceipt ? .? 7 ?? --- MECHANICAL PERMIT
CITY OF EAGAN
Permit No.
Fee
Fill in numbered spaces S/C
Type or Print /eg/Wy Tot. ?• 5('
1. Date 2, installation Cost 140 0.W
3. Job Address? t74 ' erLk"' -? • LotV--?)Bik. .,2 Tract...,
r _
4. Owner 3.?.'.'!' H.'.i?:.
5. Contractor . Phone S25=!?£:67
6. Address 1k37 C3]iCSgO FiYe. S0•
7. City
State . ?'' •
zip `~1+o7
8. Building Type: Residential KI Commercial ? Institutional 0
9. Work Description: New t) Add ? Alter ? Repair ?
10. Describeln-stal air COt1d.1'tlOn1_^ - FuelType ?lectric
11.
No. Eqyuipment BTU - M. Ea,
Forced Air No. Euuipment CFM
Ai
dli
H
Mfg. r
an
ng:
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
? ? -,
Air Condr
Mfg.
Gas, Piping Outlets
12. I hereby certify thatt?e above information is true and correct, and I agree to
comply with all gr6nances ?nd codes governing this type of work.
Signed : - • • .
for
. Rough Flnal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved . CITY OF EAGAN 454-8100
Receipt
1 D te ? "
PLUMBING PERMIT
CITY OF EAGAN
Fill in numbered spaces
Type or Print legibly
6 2 I 11 t' Co
r
, -
Permit Na.
Fee
S/C
Tot.
. a . nsta a ion st
3. Job Address Lot Blk. Tract
4. Owner
5. Contractor Phone
6. Address
7. City
8. Building Type: Residential El
9. Work Description: New O
10. Describe
11.
State
Zip
Commercial ? Institutional ?
Add tl Alter 11 Repair ?
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs $e
tic Tank
Lavatory ? p
Softner
Shower Wel I
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough F'nal
Inspections: Date Insp. Dateftp. ?
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Or EAGAN
Pilot Knob Road
MN 65122
SEYVER SERVICE PERMIT
PERMIT NO.:
DqTE:
. No, of U
e nits:
'ess: 4
Address:
ber:
°a to CO-PIf' M'ith Nie City of Eagon Connedion Ch
By
Date of insp.:
I nsp.:_
CITY QF EAGAN
3795 Pilot Knob Rood
Eoqan, MN 55122
Zoning:
Owner;
Address:
ite Address:
lumber:
eter No •
arge.
Account Deposit:
Permit Fee;
Surcharpe:
Misc. Chorges;
Total:
DoYe Poid:
WATER SERVICE PERMIT
PERMIT NO.:
DATE:
No. of Units:
" Connection Chorge:
Size:
Reader No.: Account Deppsit:
Permit Fee:
'I QgrO° b??p? M'i? ? CitY of Eagon Surchorge:
?????' Misc. Charges:
ToYol:
' Y Dute Patd:
, ote of Insp.:
Insp.:
1 Copy: Office
2 Copy: Crew Chief Pacific Pool & Patio
3 CopY:-Me7nicipalify _
4 Copy: Customer A Minnesota Package Products Company
6922 55th St. North 9913 Lyndale Ave. So. 4321 68th Ave. No.
North St. Paul, MN 55109 Bloomfngton, MN 55420 Brooklyn Ctr., MN 55429
770-1313 888-1998 560-6442
CREW CHIEF
Equipment Needed
El Back hoe ? Bob Cat
O Cat ? Truck
? Snow Fence ?
Inspections Contract
? Walls
? Plumbing
El Foating
? Before Backfill
? Other
ACCOIlNT NUMBER POOL S12E DATE
NAME HOMEPHONE
STREET WORK PHONE
CITY f STQTE ZIP COOE
DIRECTIONS I
Diagram pool site in relation to house, garage, property line, and wires. (Allow 3" variance)
---7' F 1
_. . ?? _ . 1 . ...
' ? ?•
i
,.
j 1
? Mark location of filter anlor heater by (#2).
O Indicate deep end by (X).
? Does Customer wish to retain any or all dirt from pool
excavation: _
D Will any abstructions be encountered - such as trees,
clothes poles or power/phone lines
._ ?-- , ? - _
-?
•
0 Elevation from location marked "A" in diagram:
? Show type and location of slide if applicable: _
? Location for disposal of dirt:
? Pacific Pool & Patio recommends that customer irtstall
(As soon as possible following pool construction):
1. Rain gutters adjacent to pool
2. Retaining wall where diagramed
3. Run off control ar drainfield
"'' CUSTOMER ALSO UNDERSTANDS & ACKNOWLEDGES THE FOLLQWING '''
Some damage may be done to the yard and/or driveway entering and leaving the yard during construction: Intial
Customer assumes responsibility for electrical wiring and grounding of the pool (including permit if required): Initial
Cusomter assumes responsibility for the gas installation of heater if applicable (including permit if required): Initial.
If debris, structures, or substance foreign to normal soil should be encountered while excavating which requfres abnormal
handfing andlor disposing - Customer shall assume responsibility if any extra costs are incurred. Intfal .
If you wish to change: filter position, slape of land, or anything else stated in this outline, please call our office - 770•1313.
Crew chiefs are not authorized to change anything on the job or make any promises for work to be done by them. Any Changes
that are not authorized by the office will be charged at a standard rate - no exceptions.
Pacific Representative Signature - Customer Signature
minrresota atace uoara or tiecvicny
Griggs Midway Bldg. - Room N791
Q 1 University Ave.. St. Paul, Minn. 55104 - Phone 297-2111
?E'QUESj fOR.ELECTRICAL INSPECTION ?
CHECK BELOW WOAK COVERED BY THIS REQUEST
EB-00001-02
84977
Type of Building New Add. Rep. Cheok App(iances W'ved Foc Check Equipment Wired Foi
Home lp? ? ? Range ? Temporaxy Wixing ?
Duplex ? ? Water Heater ? Lighting F'uctuies
t. Bldg. ? ? ? Dryer ? ElecVic Heating ?
mmercial Bldg. ? ? ? Fumace ? Silo UNoader ?
Industrial Bidg. ? ? ? A'u Conditioner Bulk Mtlk Tank ?
Fazm List
J List
Other
_
?
?
? p
y
Hehe`S1
re p
Heie15?
COMPU'I'E INSPECTION FEE BELOW
Se?vice Entrance Size: # Fee FeedersBSubfeedeis: # Fee Circuits: # Fee
0 to 100 Am s. 0 to 30 Am eres 0 to 30 Am eres
101 to 00 Amps. - 31 to 100 Ampeces 31 to 100 Am res
Above 200 Amps. Above 100 Amps. Above lO_Am s.
Transfor ?? RemoteControlCitc. Partial or other fee - L
S? ns
? Special Ins ection Minimum fee $5.00
Remarks TOTAL FEE
I, the Electrical lnspector, hereby certify
(Final)
This request void
18 months from
hasbeen ma
bate
Date /
This request void L? z ? ?c 31 Z? So ??
18 months from S 84977
Date thu Request ( Fire No.
I, as ?Licensed Electrical Contracror ? Owner, do hereby request inspection of the above electri-
cal wiring installed at:
et Address or Route No. _qGt 1 i v PW1-1
" WN City---
mn Township Range County ph&!?g4
N'hich is occupied 6y oNlit-i ?Fw
Is a roughin inspection required on this job? No ? Ye4K1, Ready Now ? Will CallIEC
PowerSupplier RiCk Address f PUP4UNVJ?d
Electrical Contractor 4EK-ECL i? ( C? Contractor's License No T'?sj 4
C lco/m?pany rvamel p
Mailing Address C. p• ?...,? ??' (v b.
Authorized
,',,,a??a.,,.??,
Phone No. IF* -_<Za?ff
(Electrical Contrutor or Owner Making Tnis Installatlon)
^i '? I? ? l/?ln, This inupectian request will not be aecep[ed 6y ffie
Q'/?L?S `?`?? ? State Board unless proper inspeetion fee is enciosed.
,,. REQUEST FOR ELECTRICAL INSPECTION ee-ooooi-oa
?.,
' Sea inspuctiona lor completing this form on back ot Vellow copy. .
'X Re? w Por?Cbvered by This Request 37? 7 b
Ness AAtl Nep. Tvpe ol Buildinq APPliancxs WirBd EquiUm¢nt Wired
Home Range Temporary Service
Duplez Water Heater Lightin, Fixtures
Apt. Building Dryer Electrlc Heatin
Commercial Bldg. Fumace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tnnk
Fafm the,r aeci v [he, ISncrityl
t er Speufy Other Other
Compute lnspection Fee Below
t! Fee ServiceEntrencaSize b Fee Feeders/Subfexders # Foe Circuits
0 to 200 qm s 0 to 30 Am s 0 to 30 Am.
Above 200 qmpy 37 to 100 Amps 31 to 700 Am
o Swimming Pool Above 100_Am s Above 100_.4mps
TransPormers Irrigation Booms Partial.'Oth Fee
Signs Special Inspection
$
RemTrks .?. ? ?REEGG
Roueh-in D
the IecVicel
? nspec[oq hereby
Final
Date certify that the nbove
f ingpaction hes been
med
? e.
Thlareeuesivoltll8monlhvfrom ? `
This reqerfcc void
18 monNs from
w080324
37a-7 o
.71,06
Re.quest Date Fire No. Reoqgfed?InsVer,tlon ?Reatly Nuw?Will Notify, Inspe??-
- Yes ?No tor When Ready
? LicenseA Electrical Contractor I heraby raquest insoection of above
Ownef elecVicxl work installed at:
Screee Address, Box or Rou2e No.
P Citv
e
ecuon o. ownship Name or No. Ranpe No. Counry
? Q.
Occu n11PR NTI
? 0 e,,f,7` 14 2 [. Phone Ne.
kl?,t Y- J'S
Pawer Su?pplier
a /
0 /J /
?
` Address ?
o4'
i
G i
-
C
b- C i
sJ%
Ele rical ConVactor (Cy mpany Na a) C [ractor"s Licef se No.
7Z
?
G ?lC.So.c/ lC LJ `u: -
C
Mailinq Address IContrnctor or Owner Makine lnstailationl
?
U
,
"
Z
,c
o 41) L ,tz`
l
?t
u SJ
Auth ' e igna[.re (CO vactodOw MakinB Installatinn) Phone umber
2
?
2-
?
Z
MINNESOTA STpTE BOARD F ELECTNICITY THIS INSPECTION HEQUEST WILL NOT
Griggs-Midwey Bidg. - Raom N•191 BE ACCEPTED BY THE STATE eOAHD
1821 UnivarsitY Ave.. St. Peul, MN 55704 UNLE55 PPOPEP INSPECTION FEE IS
..... ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION
T_7 M71 ' See insiruc[ions tor cmnplalinS this form on hack ol yellow copy.
.?
"X''Belaw Wark Covered by This Request
K_w EB-00001-Us
u I
Ne Atld Rep. Type ot Building Anulinnces Wirea Euuinmant Wirea
Home Range Temporary Service
Duplex Water Heater Lightiny Fixtures
Apt. BuilAing Dryer Electric Heatin
Commercial Bldg. Furnace Silo Unloader
Industrial Bidg. Air Conditioner Bulk Milk Tank
Farm oNer oecify tnei (SUeciry)
_ ihee Suocify OMer Other
Compute lnspection Fee Below
d Fea Service Entrence5ize # Fen FAxtlers/Suhteedars # Fee Circui!s
0 to 100 qm is 0 to 30 Am>s 1s0 ? to 30 Am s
101 to 200 Amps 31 to 700 Amps 31 to 100 qrn
Above 200 qmps qbove 100-Amps Above 100_Ajnns
Transionners Remote Control Circ. ?. Partial:Other Fee
Si gns Spec ia l I nspect i on
' ?
$
T
Renarks
?7 ? ncns..?•L:1i„n S ? OTAL FE
cf6 • 7
. Y t
eouen-it,
? o:,t c
the Elechic
al
?
? Inspectaq hernby
c
ti(
<h
h
??<
final
/ wLl/
D,11e
`
?? /
P e n
ove
e.
Y
i ection has been
?d
?r- / a.
7hls renuesr void
18 ??ion,n, rroni
. rJ?? CoP wL ?? }Xt?c? 3/a??v?
;z Eq,a ad
18 momhs tmm -T.,71071 F4,<lucst Date Fire No. Rou ?fteaAy Nuw
?
?
I ???` ph-iiin? Insul-r.tion
Hequ re
"
I
Will Nntity Inspec-
IorWh
nR
d
J
?
Yes ?Nn
2
e
ea
V
u Lir,ensed ElecVical ContrTCtor I heraby repvest inspection uf above
VOwner electrical work installed et:
Street AAdress, Pox or floute No.
y671-1 tOcnkwc c.,1A City
Ea ah
ecLOn o. Township Name ur No. Range No. Caumy
Da ko fa
Occuuent(PRINT) 'P
Ro beet Phone No.
ys y- 596 g
Power SupPlier
f?ssac
l E`/
a Aedress
+`A d?'`0n
n
/?Jl
.
e,
m, ,
n
i
Elech' I Cnntractor ICompany Namel ConVar.tor's License No.
?
Mailinq AAJreIAs?s IConVac[or or Owner Makiny Instailationl
Authoriz ipna[ure ICOntractor/Owner Making Installauionl
cJ, ,P Phone Number
4/6' 4/-s9'
MINNESOTq STqTE BOAND OF ELECTflICITY . TMIS INSPECTION NEQUEST WILL NOT
Griggs•MidwayBldg. - Poam N•191 BE ACCEPTED BY THE STATE 80AHD
UNI.ESS PROPEfl INSPECTION FEE IS
1821 UniversitY Ave., St. Paul, MN 55104 --
n?.....e fa12I 947_7Nl ENCLOSED.
? CITy pg EAGAN Include 2 sets of plans,
*?'/?? {? ?? G 1 site plan w/elevations &
3UI111ING PERMIT APPLICATION 1 set of energy calculations.
/O. o-o-v J e?
Zb Be Used For ?Va?on,, - Date
Site Pddress ?, OFFICE USE ONLY
Lot lY slocx cZ sec./suU.--Y'k"`n ? grect accupancy
Parcel # :
Ormer:
Address
City/Zi
Phone ?
Contrac
O 3-tg00 0(ap 62 ? A1ter ( Zoning
Repair Fire Zone
Enlarge _ Type of Const.
Nbve # Stories
r,daress: /,y'aa
City/Zip Cocle: /?R.(¢f? ?,y . ?17n. SS/n G
Phone #: 77n /?/ ?
Arch./En5• v»// e r,? 71P?... .
Address: /n 4,)-a- 6T-4'2.4'//U-
City/Zip Code: C/a
Phone # : ,-7 7d - / yX-?
Delmlish Front ft.
Grade Depth . ? ft.
APPFtOVALS FEES
Assessments Permit D ?
l4ater/Sewer Surcharge
Police Plan Check
Fire SAC
Eng, Water Conn.
planner Water Meter
Council Road Unit
Bldg. Off.
APC
'iOPAL
cirr oF FA"N 8230
9793 Pilof Knob Raed Eogen, MN 55172 . ?To
PHONEi 454-8100
BUILDING PERMIT Receipr # ?y4-?
T. 6s usad fer POOL & FENCE Est,yalue $10,000 Dete .Tuly 11 10 83
Site Addreu 40/4 renKwe way
Lor 6 Black g 2 Sec/Sub. JOhnny Cake Ridge
parcet # 70 39800 060 0 lst
W 1140m. Robert Hall
z qdd,ea 4674 Penkwe Way
p Name raciric rooi & ratlo
Addreu 6922 SSth St. No.
Oakdale 55109 770-1313
Nome _
Address
I hereby ackrwwtedge that I have read this opvlicotion ond state thot
the inlormotion is correct ond agree to comply witA all opplicoble
Stote of Minnesota Statute: ofd City of Eagan 9 rAir?nces. ,
Sipnctura of PermiMee ?
aci oo E
A Building Permif is issuEd fa:
oll work ahall be done in accordonce wi a ._? e ?Statc
Buildinp Officiol ??L,f't6s'
Erect ? Occupancy R-3
Alter ? Zoning (PD) R-1
Repalr ? Fire 2one NA
Enlorge p Type af Const.
Move ? .# Stories
Demolish ? Length 16
C,rode ? Depth 32 Sq. Ft.-
Approrals Feea
Assessment _
Water 8 Sew.
Police ?
Fire
Erp.
Planner -
Councll _
Bldg. Off. _
APC
Permit _
Surcha rge -
Plon Check _
SAC _
Water Conn.
Water Meter
Road Unit _
Totol $85.50
on the ezpress caditlon thm
Statutes ond City of Eagan Ordirwnces.
CITY OF EAGAN Include 2 sets of plans,
,L?7?,{'+? ?/ ?? •, •. 1 site plan w/elevations 6
y1? BUIIDING PII2[?P I,PPLICATION 1 set of energy calculations.
'ib Beisd For R!S\DEticf Valuation '41-ty,a00-00Date 4,-a..?i-$Z)
SitFr'Pddress: lb a Mo06? ?? OFFICE USE OHI'Y
Lot ?o
Parcel #:
Qaner:
Bloclc 2 Sec. Sub. -rect 0 ccuPancY
AItET ZOn111CJ ?
pair . Fire Zone ;
' ?Enlarqe _ 'Iype of Const.
Pddress:
City/Zip Code:
Phone #:
Csontractor: QRRIN THf]MPC(1N HO1MFC
Pdclr2s5: a Division of U. S. Home Corporation
-1=1 iOPKINS G.:SSGrteae
Clty/Zlp COd2: MINNETONKA, MINN. 55343
Phone #: S4q•1333
Prch./Eng.:
Pddress:
City/Zip Code:
Phone #:
Move # Stories
Denolish Fmnt Gp ft.
Grade Depth
APPI3?VALS FEES
Assessments
water/Sewer
Police
Fire
En4 ?
Planner
Council gaj?
Bldg. Off. yd
P,PC
PernLit
Surcharge
Plan Check Co:+ ?
sAc
Water Conn. 3oS
Water Meter --
Road Unit / ?s
TOTAL ia85. 91 5
Model 38 CITY OF EAGAN
3795 Pilo! Knob Roefi'' Ea'gan, MN 55122
PHONE: 454-8100
BUILDING PERMIT APPLICATION Reteipt #
To 6e uaed for SF .Dwlg/Gai'age Est. Value 44, 000.00 Date _
Site Address 4674 Penkwe Wa.y
Lot 6 Block 2 Sec/Sub. JlmV.Ck. RidEe
Parcel # riOt recorded _
m Nome Orrin ThomDeon
Z Address 1712 Hopk3ns Crossroad
o Minnat.nnka_ 55141
p Nnme _
?
?u Address
Nome _
Address
I hereby acknowledge thot I have read this application ond state thot
the information i5 Correct ond agree to comply with all oppliwble
State of Minnewta Sfatutes and Ciry of Eagan Ordirwnces.
Signoture of Pertnittee -
A Building Permit Is issued ta:
all work shall be done in acw
Bullding Officioi
N? 5903
/9,c 3/
June 30. ,., 80
Erect ?C] Occuponty
Alter . ? Zoning R
Repoir ? Fire Zone III
Enlarge ? Type of Const. V
Move ? # Stories
Demolish ? Front 60 ft.
Grade ? Depth 26 ft.
Anormals Fees -
Assessment
Water & $ew.
Polite
Fire
Eng.
Plonner
Counci I
BId9. Off6/30/80
APC
Permif 125- 5n
Surcharge 22-00
Plun check 6.2. 75
5qC 525_OD
Water Conn. 305"00
WoterMeter 60.00
Road Unit 185 _ 00
Total l P785 _ 25
pGOn HomeS _ on the express condition thot State of Minnesata Statutes ond City of Eogan Ordinances.
CITi, OF 1?1C'?AN
1 l BUILDING PERMLT APPLICATICN
To Be used For 0e c/r valuation ?/ 7 SO °°
Site Addx'ess: 1-167 ?1 Pe-n ?wc Oce
Int 6 Bloclc Q- Sec./Sub. ,6 R iErect X
Parcei #: ? o alter
Repair
ONmer: ?Ok eYf ? ?a ?? Enlarge -
Nbve
Address: ?671/ Q`,,k?,c (,Jay Demolish
City/Zip Code: Grade
Ptwne #: S's y? 5' 96 g APPRavAr.s r-EEs
Contractor: VuJner
AddL'255:
CityjZip Cocle:
Phone #:
Arch • /Eng. ?c?J n c Y
Address:
Cityjzip Cocle:
Phone #:
Include 2 sets of plans,
1 Certlficate of Survey &
1 set of enerqy cal.culations.
Date u
OFFICE USE ONLY
Occupancy _ R-3
zoning Q -1
Fire Zone N ,4
Type of Const. ?
# Stories
F'ront 10 ft.
Depth I Pj ft.
Assessments
Water/Sewer
Police
Fire
?
En9 •
Planner
Council
Bldg. Off.
APC
Pennit 22, eF
rJLLYCtY7YCJe I , ua
Plan Check -?
SAC
Water Conn. -
Water.Metex ?
Road Unit ?-
TOTAL a,?, o-a
fi
T
- . , - 1 ?? ? i ,
7 ?lf,,'JcSf 6h ?nD?:ri?5
s_u
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CITY OF EAGAN ?
3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121' l?l? 9139
PHONE: 454-8100
BUILDINd PERMIT Receipt #
To bs wsd far DN7CIC Est. Value $1250. Date JUNE 6 , 19 84
Site Addresa 4674 PENKWE WAY ? R3
Erect Occupanty
Lot 6 elock 2 ?ecfSub. JOHNNY CAKE RIDGTxiter Zon!
?-
10-39800-06D-02
Parcel No. Repelr ? Fira Zone ?_
Enlarge ? Tyce of Consf.
w Neme ROBERT W. HALL Mova ? # Stories
Z Address SAME Demolish ? Length 10
6 Citv Phone 454-5968 Grade ? Depth 18 Sq. Ft.-
9; SAyE Approrals Fees
O Nama
?? Address
? City _
Phone
Name
?
zQ Address
mW City Phone
I hereby acknowlcdge thot I hove read this epplication and state that
fhe intormaffon is correct and agree fo wmply with oll applicoble
Sfate of Minnesoto Statutes and City of Eu9an Ordinances.
Sipnoture of Pertnittee _
A 8uilding Pertnit is isiuad to:
all vrork sholl be done in acco
Assessment Permit
Water & Sew. Surcharge 1. 00
PoNce Plon check
Hre SAC
Enp. Water Conn.
Plannar WaterMeter
Council Rood Unit
Bldg. Off.
APC Totol $23.0?.
ROBERT W. HALL on tha ezpren condtHon that
qth all applicpMeAtate of Minnewto Stotutes and Clty of Eapcn Ordinonces.
Bulldinp Offfcial
4674
lw? 0/? ? t. R. WINDEN b ASSOCIATES, INC.
lANO SURVEI'ORS T1t 846-3648
1381 EUSTIS SL, ST. YAUI, MINN. 53109
Foz:
U. S. HOME CORPORATION
JY
Scale: 1" = 30'
O Denotes Iron
ctl??' I
Sem
E°
? ?A9•63
/ I
p?a?n°9P /
/
\ / I
Q??, ! zz.s
w
?0\` o 0
-v
?
U
46 I
,? _ ?r ' •,;T ,-I ??_, ?i
101 - Z? 3 ilo
? $ o - o
< . .
I /3 0, 03 I
Lot 6, Block 2, Johnny Cake Ridge
Addition, Dakota County, Minnesota
WE HEREBY CERTIiY THAT iH15 IS A TRUE AND CORRECI REPRESENTATION OF A SURVEY OF TME
60UNDARIES OF TNE LAND ABOVE DFSCRIlEC AND Of TME IOCATION OF All lUItDINGS, IF ANY,
THEREON, AND ALL VI516LE ENCROACMMENTS, IF ANY, fROM OR ON SAID LAND.
Dotad thi& 3dur oFMok A.D. 19$0 C. R. W?NDEN 3 ASSOCIATES, INC.
br &?
Survayor, Minnesofa Rapisfrotion No.7726
-? s?Z/ ?
2006 RESIDENTIAL PLUMBING PeRnniT aPPUCarioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
/?-, GD
Date _4_ 1 _L3_ 1
Site Street Address Unit #
PropertyOwner V)OY )?? TVA 2U Telephone# (?? j ?'P?J?'?IGIb
V?v
Contractor ?
Address ? City
Telephone # ?OS( ) ?j?j`?3?
f?-&q&n State)AN Zip 5 3
The Applicant is: _ Owner 6eContractor _ Other
New _ Refurbished Submit 2 sets of plans and MPC license
Septic System Includes County fee
_ $ 100.00
Per as-built $ 10.00
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee includes installation of a water softener andlor water
heater at the same time. If you are insta0ing onlv a water softener and/or water
heater, do not complete this sectiori; move to the next section and check the
appliance(s) you are installing.
_Septic System Abandonment
( _ Water Turnaround (add $130.00 if a 5/8" meter is required)
Other.
Wat_r Softener vWater Heater
_ new replacement $ 15.00
Lawn Irrigation _RPZ _PVB _new ^repair ,rebuild $ 30.00
D
State Surcharge
$ 50
?
Total r?ov 2 0 2oos
s
I hereby apply for a Residential Plumbing Permit and acknowiedge that the information fs compiete and accurete; tnat tne
work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing crodes; that I
understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in
accordan,cel with the approved plan in the event a plan is required to be reviewed and approved.
KY 1 S ??`Qilr'? ?? ?
ApplicanYs Printed Name ApplicanPs Signature
?
.,,, .
2007 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsW ction Reouirements
3 regislered ste suneys showing sq. ft. of lol, sq. fl M houu; and all roofed areaz
(20%mazimum lot coveraqe allaved)
1 SoJS Report i( propose0 6uilding is to be placed on disNr6ed sdl
2 copies oiplan shovdng beam 8 window sizes; poured found dasign, etc.
1 set ot Energy CalculaGons
3 copies N Tree Preservaton Plan if lot plalled atler 711199
Rim Joist Detail Optlons sNec6an sheel (6uildings with 3 or less units)
Minnegasco medianical ventilation form
RemodeVReoair Reauiremenis
2 copies of plan shaxvig loo6ngs, beams, jois5
1 set of Energy Calculatlons fw healed additlons
1 site survey fa addidons 8 decks
Adtlif'ron - indicafe if on-sife sepll'c system
o?
?r
?
Ofrice Use OnN
CeAOfSurveyFtecd _Y _N
Shcs Repat _ Y _ N
Trce Pres Plan Recd _ Y _ N,
Tree Pras Requiretl Y _ N
On-siteSeptlcSystem _ Y _N
rians are consiaerea puonc intormation umess vou state tnev are traae secret and tne reason.
Date __?/;? 3/ a, Constructiou Cost J'zl 7 '
Site Address Y(,, ? v q? hr,J etZ6 V UniUSte #
Description of Work
Multi-Family Bldg _ Y 7?.`. N
r-"
Property Owner
Fireplace(s) _ 0 _ 1 _ 2
i LAKEWOODS REMODELING, INC.
Contrac[or , 9001 E. Bloomington Freeway Address i Suite 144
- Blooming[on, MN 55420 .
State
City _
Telephone # (`/3_3)
1r-SSS o
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Cateeorv 1
Resitlential Ventilation Category 1 Worksheet
(4 submission type) Submitted
• Energy Envelope Calculalions Submitled
In ihe last 12 monfhs, has ihe City of Eagan issued a permit for a similar plan based on a masier plan?
_ Y _ N If yes, date and address of master pian:
Licensed Plumber
Mechanical Coniractor
Sewer/Water Contractor
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.
'
S=?m,) A??,n L A
Applicant's Printed Name Applicant's ign . ure
Telephone # (
PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA087226
Eagan, MN 55122 . Date Issued: 10/31/2008
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 4674 Penkwe Way
Lot: 6 Block: 2 Addition: Johnny Cake Ridge
PID 10-39800-060-02
Use
Description:
Sub Type: e-Siding Construction Type:
Work Type: Siding
Description: House
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: When installing ventilated soffit material, remove existing soffit material (i.e. debris that could block vent openings) and
take steps to ensure maximum ventilation into attic space.
Fee Summary- BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
Valuation: 3,000.00
Total: $90.00
Contractor: -Applicant - Owner:
Eagle Siding Robert W Hall
1301 East Cliff Road 4674 Penkwe Way
Suite 117 Eagan MN 55122
Bumsville MN 55337
952 746-3046
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.
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA108247
Date Issued:11/27/2012
Permit Category:ePermit
Site Address: 4674 Penkwe Way
Lot:6 Block: 2 Addition: Johnny Cake Ridge
PID:10-39800-02-060
Use:
Description:
Sub Type:e-Windows/Doors
Work Type:Windows/Doors
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Kara Benson
9533 - 367th Street
North Branch, MN 55056
651-674-1766
Valuation: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 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 -
Robert W Hall
4674 Penkwe Way
Eagan MN 55122
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA166004
Date Issued:12/07/2020
Permit Category:ePermit
Site Address: 4674 Penkwe Way
Lot:6 Block: 2 Addition: Johnny Cake Ridge
PID:10-39800-02-060
Use:
Description:
Sub Type:Fireplace
Work Type:Free-standing Stove (new)
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Derek Cable
4674 Penkwe Way
Eagan MN 55122
Applicant/Permitee: Signature Issued By: Signature