4681 Penkwe WayCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4681 Penkwe Way
Lot: 4 Block: 3 Addition: Johnny Cake Ridge
PID:10- 39800 - 040 -03
Use:
Description:
Sub Type: e- Windows/Doors
Work Type: Windows/Doors - New/Replacement
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
New Windows for America
609 W County Rd E
Shoreview MN 55126
(651) 203 -0149
4/30/08 Notification letter sent regarding expired perm
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Construction Type:
Occupancy:
pf
Permit Type:
Permit Number:
Date Issued:
Permit Category:
A framing inspection is required when installing a Bay or Bow window or if the opening is altered
required in all sleeping rooms prior to final
Owner:
James E Schmidt
4681 Penkwe Way
Eagan MN 55122
$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
EA080575
10/19/2007
ePermit
Smoke detectors are
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4681 Penkwe Way
Lot: 4 Block: 3 Addition: Johnny Cake Ridge
PID:10- 39800 - 040 -03
Use:
Description:
Sub Type: e- Windows/Doors
Work Type: Windows/Doors - New/Replacement
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
New Windows for America
609 W County Rd E
Shoreview MN 55126
(651) 203 -0149
Applicant/Permitee: Signature
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
- Applicant -
Construction Type:
Occupancy:
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.
$88.50
$1.50
Total: $90.00
Owner:
James E Schmidt
4681 Penkwe Way
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
0801
9001
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
EA090754
08/20/2009
ePermit
CITY OF EAGAN Remarks
Addition o,A(:&U }?IDGIR ADrj==n*_Lot 4 alk 3 Parcel- 10 39800 040 03
Owner l}1' iif)Af t. I Street 4b81 pLlt1'kYR NAv State???- MN 55122
Improvement Date Amount Annual Years Payment ReceiQt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TFiUNK
* SEWER LATERAL 23-
WATERMAIN
* WATER LATERAL
WATER AREA
STORM SEW TRK a
* STORM SEW LAT 1981
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILOING PER.
sAC 525.00 20604 8 25 80
PARK
? . - crnr oF Eac,AN
3795 Pilof Keob Rocd Eagan, MN S5122
PHONE: 454-8100
BUILDING PERMIT ReceiPt .i#
Site Adc
Lot -
Porcel #
e?xk Sec/Sub. s'j-1v. Cske P.dff
W Nome n?'r'in 'i'?icxrt?Rnn Hcymep
; Address ?.?2 r;r,r,' {rtA rrsY`d.
b ,..... "ntka, P:Ir.. „?--_ 544-7333
? Nome _
Zo
?? Addross
?- r:r,.
Name
I hereby acknowledge that I have reod this applicotion and state that
the Information is correct and ogree to comply with oll applicable
State of Minnesoto Statutes nnd Ciry of Eagan Ordinonces.
Ng 6113
Ered ,, fl Occupancy
Aiter ? Zoning
Repoir ? Fire Zone '
Enlorge ? Type of Const.
Move Stories
Demolish ? Front ff.
Grade ? Depth ff.
Approvals Fees
Water & Sew.
Pol ice
Fire
Eng.
Planner
Council
Bldg. Off. ^
APC
Permit Surchorge
Plon check '
SAC
.-
Woter Conn. 5.
'
Water Meter ?
Road Unit -
Total
Signature of Permittes ?
A Building Permit is issued to: on the express tondition that
all work shall be done in accordunce with oll opplicoble State of Minnesota Statuces ond City of Eagan Ordinonces.
Building Official
?annlt # oe% Iwo.A ??ewNtw
Plumbing f ] 9- /5-- 64)
Mechonical O (o
.7
INSPECTIONS DATE INSP. Roiqh-In ? Final
FOOtings Date Insp. Date (ntp.
Foundotion Piumbing g6_
Frame/ins. Q -.21-6C MecFwnical
Final " ?
Remorks:
No. , `),r7
cirir oF EAGAN
3795 Pilof Knob Read
Eegen, Minnesota 55122
Phone: 454-8100
Pltlmbil'L,? PERMIT
Dote:
Site Address:
Lot
4681 Penkwe Way
J'r-nv. r r., t., . rI --r
Block Sub/Sec.
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
Receipt No.:
$ingle
Residentlal
SF r1, r,
Nome Jrr1!] 1'rOrrp90ri t'.O?':i?^ New /Alter./ Repoir new
? Address
Cost of Instcllation
Ciry tOr:.. . . Phone: 3 Permit Fee ' ?t •
Name 'iQnZ61 1:!@ChAiLlCal Surcharge '
.
? nddress 3600 Kennebec Dr.
? City Phone; Totol .
This Permit is issued on the express condition thot oll work sholl be done in attordnnte with al) appliCOble State of
Minnesoto 5tatutes and City of Eagan Ordinances.
Buildinp Official
. cirY oF EAcwN
3795 Pilot Knob Road
-,: - -, Eogan, Minnesoto 55122
"°. Phone: 454-8100
PERMIT
Dote: _
Site Address:
4581 Penlcwe way
Lot Block Sub/Sec.
Thi1y. C8kA Ridg@
„-••in 'r1i0i.Irr;OT. ,10i'F^3
Name
? L`iZc l10p1;iI1: CTSTul.
; Address
O
City Phone:
Nome , , ?1.±•?'•:' ;ie£t't1?? .
.
? . 37 ' '._' 11v:?
Address
e
City . Phone,
This Permit is issued on the express cor+dition that oll work sholl be
Minnesoto 5totutes ond City of Eegon Ordincnces.
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
7'1 't7/
Recetpt No.:
5ingle . I
Residential
Multi Res., Comm./Ind. I
New/Alter./Repair. Cost of Instollotion
Permit Fee
Surcharge
?^•S?
Toto I
done in occordance with all opplicable State of
Building Offlcicl
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE
19
AMOUNT $ I
b DOlLARS
loo
? CASH ? CNECK
FOR Gi a
f
White-Payers Copy
Yellow-Postinp Copy
Pink-File Copy
Thank You
?? BY
1CITY AF EAGAN
? 795 Pilot Knob Road
qan, MN 55122
` oning:
ner:
s,Address:
;Site Address:
Plumber:
Meter No_:
Size:
Reader No.:
I og? to Comply with tho Ci?r of Eagan
Ordinonaes•
By -----
Date of i nsp.:
GTY OP EAGAN
3795 Pilot Knob Rood
Ec *an, MN 55722
Zoningt
Owner: •
Address:
Site Address:
WATER SERVICE PERMIT
PERMIT NO.:
DATE:
_ No. of Units:
Connection Charge:
Account Deposit:
Permit Fee:
Surcharge: '
Misc. Char9es:
Total: ,
Dote Poid:
Insp.•
SEWER SERVICE PERMIT
PERMIT NO.:
DATE:
No, of Units:
Plumber
I agree to eompiy with the City of Eagan Connection Charge:
Account Deposit:
Ordinances.
Permit Fee:
Surchorge:
Misc. Charges:
Y
ote af Insp.: Total:
Date Paid:
?sp.: .
- - ?? -
'
.?.
,
Y
- S i '.1??. sis•'??
:]EI^ ? - ,. ._ .;,,?." "
.r. . -.;'i+.
i _ - .
minnesote Sta? 9oard of Electricity
-Griggs Midwa Bldg. - Room N191 EH•00001-02
1821 UniversiN Ave., St. Paul. Minn. 55104 - Phone 297-2111 , 71 '
- REOLIEST FOR ELECTRICAL INSPECTION ?`' ?? S 99307
CHECK BEL(iW WOftK COVERED BY THIS REOUEST
Type of BuOding New Add. Rep. Check Appliances W'ved Foi Check Equipment Wired For
Home ? ? Range ? Temporary W'ving ?
Duplex ? ? Water Heater ? Ligh[ing Pixtures ?
t. Bldg. ? ? ? Dryer ? F,lectric Heating ?
mmercial Bldg. ? ? ? Fumace co Silo Unloadei ?
Indusirial Bldg. ? ? ? A¢ Conditionec ? Bulk Milk Tank ?
Farm
° List
) List
Other o o ? p
Hehelsl } p
s?
Herer
COMPUTE INSPECTION FEE BELOW
Service Entxance Size: e Fee FeedecsBSubteeders: Cixcuits: # Fee
0 to 100 Am s. 0 to 30 Am eres 0 tu 30 Am cres
101 to 200 Am s. 31 to 100 Amperes 31 to 100 Am eres
Above 200 Amps. 100 Amps. Ti Above I00 Amps.
Transformers m"? Control Circ. Pattial or other fee ?
Signs " ci ? ns ction Minimum fee $5,00
Remazks ' "
TO'IALF ..7a ?
,Q
I, the Electrical Inspector, hereby certif the specti has been made.
(Rough-in) • .--5 Date
(Final) /7 f Date
This cequest void ? ?'L?%2=_i;11
18 months from
This requeat void
0
2'? . SD ?
] 8 months fcom
-
I13
? ? I
7
I ? -?
? ? ? ? , 7
Date o this Request
{
Fire No.
1
as
CLicensed Electrical Contractor 0 Ow
e
eb
ues
d
h
re t i
s
ction of th
abov
le
t
i
,
(
er
q
n
r,
o
y pe
n
e
e e
c
r
-
cal wiring installed at:
eet Address or Route No. `LN k-j,,C- Atj
?t
ion Township Range County Otltt-a
Which is occupied by Om? ??(`1 Pf c?v )
?lY`1Ltr
(Name of OccuPant)
[s a roughin inspection required on this job? No ? YeIAI Ready Now ? Will CaK
Power Supplier F-?N Address MP-h 1A)
Electrical Contractor ?K+C_ Contractor's License Nb:
(COmpany Name)
Mailing Address ? Lj ff p_
(Ele,
Authorized Signature Ycal C ntrattor or Owner Makin9 Thls installatlon)
4_ ? c' Phone Nu. V"55`?
(EleCtrlCal Contractor or Owner aking Tnls Installatlon)
This inspectian request will not be accepted hy ffie
State Board unl ess proper inspection fee is enclosed.
CITY OF EAGAN
9795 Piloe Kno6 Rond . Eagun:, MN 55122
PHONE: 454-8100
BUILDING PERMIT APPLICATION
_
Site Address 4681 Penkwe (43)
Lot 4_ Block _i_ Sec/Sub. Jh'nV. C3ke Rde
Parcel # 10 39800 040 03
w Name OTrin T}]oI4pGon HnmBs
Z Address 1712 Hopkins Crsrd.
9 ..,_. Mntka. Nn. 544-7333
o Name _
?
0? Address
Name _
Address
I hereby ucknowledge thot I hcve read this application ond stote that
the informotion ia correct and agree to comply with all applicable
State of Minnewta Statutes and City of Eagan Ordinances.
Signature ofi Permittee _
A Building Permit is issued to:
oll work sholl be done in occo
Receipt #
N? 61 3
R'3
Erect gfJ Occupancy
Alter ? Zoning - PD
Repoir ? Fire Zone _
V
Enlerge ? Type of Const.
Move ? # Stories
-b!'
Demolish ? Front - Ft.
Grade ? Depth
Approvala Fees
Water 8 Sew.
Police -
Fire
Eng.
Planner _
Council _
Bldg. Off. _
APC
Permit 133.00
Surcharge 23.50
Plon check 66.50
snc 525_no
Water Conn. 3015 - oQ
Water Meter hn _ nn
Road Unit -IB5-00-
7oml 1.298.00
Orrin Thompson Homes on the express condition that
with olj.6pplicable State of Minnesota Statutes and City of Eagan Ordinances.
Buildirg Official
?? CTTy pF' EF?GAN Include 2 sets of plans,
1 site pIan w/elevations &
BUILDING PIIRMPP APPLICATIOf1 1 set of energy calculattons.
To Be Used For R c%u H e Valuation Date P -I YP,
?
Site Address: I PE,.i r- ? v3 )_ OFFICE USE OTII,Y
Lot Ll slock3 Sec./sub. souNNY cAk.e Erect Occupancy
Alter Zonirng
Parcel #: /D ?9?i90 /?//3
,- Repair Fire Zone
Owner:
Pddress:
City/Zip Code:
Phone #:
Contractor: (1RRW THnMPCflN NfMFc
Ad[1L255: a Division of U. S. Home Corporation
}7}2119PIKINS 6f1055RB! B
City/Zip Code: MINNETONKA, MINN. 55343
Phone #: Sy1A•1333
Arch-/fh9.:
Pridress:
City/Zip Co3e:
Enlarge _ 'Iype of Const.
Move # Stories
DeJCnlish Front ft.
Grade Depth ft.
APPI2CNAL5 FFFS
i
/
Assessments
Pennit ?-
Water/Seuer Surcharge
Police Plan Check !.,v °-
Fire SAC
gng, Water Conn.
Planner Water Meter
Council Road Unit ) g.s ?
Bldg. Off.
APC
Phone #: rMTAL
City of EapIl
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 6755694
?- -----------
i For Otfice Use I
I
i Pertnit #: ?' `5 ?`!7 O I
? Permit Fee:
? /1 C? I
? Date Received: (
I staB: ----___--
? --- Q- r y _ __GI
2008 RESIDENTIAL BUILDING PERMIT APPLI
Date: l7(S site Address: ? (? ?61 ?P,? ?t9 e I,l)a -r-
renant-
cANC, 2 5 zoos
RESIDENT / OWNER Name: -? Phone:6 C, f-o`r7 q ' q(4-11
Address / City I2ip: ? n 617VCA, tl W M, i6(4" GS2
.1
Applicant is: _ Ownei _N?_Contractor
TYPE OF WORK Descriptlon of work: TfO AC n?
Constructan Cost: Multi-Family Building: (Yes _ I No ?
CONTRACTOR Name: 1` A .4'l .cL License #: Z DI M ILi 10
nddress: l b-1 ?-10 Ll?l Vl QA-? G
S?
? ,
V? State: l? Zip: G-/
City: l
Phone:1 92 Contact Person: ur krj(
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Errergy Code . qesideritial Verblalion Category 7 Worksheet • New Energy Code Worksheet
Category suaniaed suwnmed
(4 SubTiSSiOn lypB) • Energy Ernebpe Calculations Submitted
In the last 12 moMhs, has the Gty ot Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of mas[er plan:
Licensed Piumber: Phone:
Mechanical CoMractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plens and supporting documents that you su6mft are considered to be public in/ormaTion. Portions o/
the in/ormation may be classif'?ed as non-public H you provide specific reasons that would permit the City to
conclude that the are trade secrets.
1 hereby aCknowledge that this infortnation is CAmplete and accurate; that the work will be in conformance vrith the ordinances and codes of the City of
Eagan; that f uMtletstentl ffiis is not a permR, but onty an application for a permit, and work is not to start without a permH; that the work will 6e in
a"n'ts with the app lan in the rase oi vrorlc which requires a review and appval of plans.
?x ?Gtit1?i Cc ??IC?V'e??`
PNM
ed e e ApplicanYs Signature
Page 1 of 3
2005 RESIDENTIAL BUILDING PERMTT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
ofl
New Constructbn Reauirements RemodeVReoalr Requirements Oflice Use Onlv
3 registered site surveys showing sq. k. of lol, sq. R. of house; and all roofed areas 2 copies of plan CeA of Survey'Recd _ Y_:N
(20%maximum lot coverage allmved) 1 set of Enertgy Calculatbns for heated addNOns Tree Pres PIanRecd Y _?N.
2 wpies of plan showing beam 8 window saes; poured found desgn, etc. 1 site survey for additions 8 decks Tree'PresRequired Y_ N
1 set of Eneigy Calculalians Adddion - indicate don-sRe sepfic sysiem Onaite Septic System . _ Y_ N
3 copies of Tree Preservation Plan'rf lot platted aher7/1/93
Rim Joist Detail Oplions seledlan sheel (buildings wHh 3 orless units)
Date 1o 1 1MO.LN 6CJ ConstructionCost P•0W ?-
Site Address
v
y(Pg ?T-Q 11Y-1,u2. (.t901lA
UniUSte #
Description of Work ? olac-e1 ?`1?41uW C.J?iV-\ a1'(''S??\ T(2Q.Y1?? '
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2
PropertyOwner Telephane#(&51)
Rn4A HOME SERVICES
INC
Contractor ,
.
Home Depot Inshalled Sales
Address , 3200 Cobb Galleria Pkwy, Ste. #200
Atlanta, GA 30339 Cjty
State • 763-542-8826
BG20268257 - Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv I Minnesota Rules 7672
Energy Code Category . Rasidential Ventilalion Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submifted Submitted
• Energy Envelope Calculalions Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone #( J
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 perrrtit, 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 approve plan in the case of work. which requires a review and
approval of plans. E, ?
v
pplicant's Printed Name plicant's Signature f '' "' ? I ? J'
°-- OPFICE USE ONLY
Sub Types
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-plex
? OB 04-plex
Work Types
? 31 New
? 32 Addition
? 33 Alteration
? 34 Replacement
Valuation
Census Code
SAC Units
# of Units
# of Bidgs
Type of Const
_ Footings (new bldg)
Footings (deck)
Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
_ Framing
_ Fireplace _ R.I. _ Air Test _ Final
_ Insulation
Occupancy MCES System
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
Width
REQUIRED INSPECTIONS
FinaUC.O.
FinaUNo C.O.
_ Plumbing
HVAC
Other
Pool _ Ftgs _ Air/Gas Tests
_ Siding _ Stucco _ Stone _ Brick
W indows
_ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
? 07 05-plex ? 13 16-plex ? 20 Pool
? 08 OB-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 08 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.)
? 10 OS-plex ? 18 Deck ? 23 Porch (screenlgazebo)
? 77 10-plex ? 19 LowerLevel ? 24 StormDamage
? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
? 30 Accessory Bldg
? 37 Ext. Alt - Multi
? 33 Ext. Alt - SF
O 36 Multi Misc.
? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 37 Demolish Building* ? 43 Reroof ? 46 WindowslDoors
'Demolition (Entire Bldg) - Give PCA handout to applicant .
Installed
Siding and Windows
LIMITED POWER OF ATTORNEY
UuuN i Y ur c:uBB
STATE OF GEORGIA
KNO W ALL PEdPLE BY THESE PRESENTS:
THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania
("Principal"), and a licensed contractar of RMA Home Serviccs, Inc., DBA Home
Depot Ins?alted Sales loca±ed at 660 Mendetssohn Avenzie North, Gnldon Valley, MN
55427, having a license number of SG 20268257, do hereby appoint, name and
constitute Elder-Jones Building Permit Service, Inc. ("Agent") as my true and lawful
attorney-in-fact and do authorize and grant said attorney-in-fact for me and in my
name, place and stead the power to execute, acknowledge, sign and deliver (in such
form as may be required by the municipality) a permit application, or any other
instrument(s) which may be necessary arid appropriate, in order to obtain the proper
permit(s) from the City of Eagan, Minnesota far the installation, maintenance and
repair of windows and siding (the "iVork").
The powers conveyed to the Agent by this Limited Power of .Atterriey are
limited solely to the express powers delineated herein and apPly solely to the Work.
This Limi,*ed Power of Attomey shall expire and automatically be revoked on the 21 st
day of May, 2004, which date is one year from the execution hereof. Further, the
powers conveyed by this Limited Power of Attorney may be revoked by Principal at
any time by express revocation and shall also be revoked by the Principal's death,
disability, incapaciry or incompetence.
1??.T WT•_'INESS WHEREOF Lhis Limited PoNver of qrrorney is ?;;ec,rtcd thic
21 st day of May, 2003
( ,
David N. Katz
SWOAN TO AND SUBSCRIBED BEFORE ME by David N. Katz on this
21st day of May, 2003.
Notary P ic in for the State o eorgia
h'Iy Commission Expires: January 21, 2006
396816.v3
Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor.
3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPOT
MECHANICAL (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX 4 651-675-5694
C? lJ Sa
Please complete for: Single Family Dweliings
Townhomes and Condos when permits are required for each unit
Date F? / 4:9?? / b"),
Site Address -41CDR? _P
C
N Unit k
-
Property Owner Te,eP,,ane #( t.,,sJ >L-I
Contractor Wohlers Southslde Htg. & Air, inc.
6950 W. 146' St., #106 ?
Street Address Apple Valley, MN 55124 i City
(952) 431-7099 ?
State Telephoue # ( )
_ l
The Applicant is _ Owner ? Coniractor _ Other
Add-on, moditication or alteratio¢ to eaisting dwelling unit $ 30.00
?
fumace replacement
air exchanger
? air conditioner I? -
?(u S Jlu? - - ? _
other
??%? 4 ? 7;:?3 III?
?
I
State Surc6arge -?
$ .50
$ w?
Total
I hereby apply for a Residenrial Mechanical Permi[ and aclmowledge that the information is complete and accurate; that the work will
be in conformance with the ordinances and codes of the Ciry of Eagan and with the Mecbanical Codes; that I understand this is not a
pemut, but only an applicarion for a pemrit, and work is not to start without a pernut; that the work will be in accordance with the
approved plan in the case of work wluch requires a review and approval of plans.
?E1 ?.??er5
ApplicanYs Printed Name ApplicanYs Signature
MECHANICAL (COMMERCIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephoue # 651-675-5675 FAX # 651-675-5694
Please complete for. commercial/industrial buildings
multi-family 6uildings when separate permits arc not required for each dwelling unit
Date
Site Address Unit #
Tenant Name (if applica6le) Previous Tenant IYame
Property Owner Telephone # { )
Contractor
Street Address City
State Zip Telephone # ( )
The Applicant is _ Owner _ Contractor _ O[her
Work Type
New construction Underground Tank _Install _Remove
Interior Improvement Call for inspection during installation/removal of tank
Processed Piping
Nature of Work:
Permit Fee $50.50 Minimum Fee (includes State Surchurge)
Contract Value $ x I% _ $ Permit Fee
. If permit fee is $1,000 or less, add $.50 ? $ State Surcharge
If permit fee is over $1,000, add $.50 per
$1,000 Permit Fee
$ Total Fee
I hereby appty for a Commercial Mechanical Permit and acknowledge that the information is complete and accurate; that me work
will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that 1 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.
ApplicanPs Printed Name
Applicant's Signature
Approved By: Inspector Date:
RESIDENTIAL
BUILDING PERMIT APPLICATION
5_j.f 9 / _ '1 CITY OF EAGAN
< <f? ? 3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New ConsWction ReauiremaMs
• 3 registered site surveys showing sq. ft. of l06 sq. ft. of house; and all roofed areas
(20% mazimum lot cwerage allawed)
. 2 copies af plan showing heam & window s¢es; poured found design, etc.)
• lsetofEnergyCalculations
. 3 copies of Tree Preservation Plan if lot platled after 711193
• Rim Joist Det2il Options seleclion sheet (bldgs with 3 or less uniLa)
DATE ? ZT- d Z
SITE ADC
TYPE OF
APPLICANT
SELA ROOFING & REMODELING, IPJ!
4100 EXCELSIOR BLVD.
RemodaUReoair Reauirements
. 2 copies W plan
• 1 selof Energy Calculalions for healed additions
• 1 50e survey Wr exterior additions & decks
• Indicate'rf home served 6y septic system foradditions
ULTI-FAMILY BLDG _ Y _ N
FIREPLACE(S) _ 0 2
STREET ADDRESS in gnnninin CITY STATE ZIP
TELEPHONE # C2L2-4f2 3--$6 eCCELL PHONE # FAX #
PROPERTYOWNER ?rvn?? S?Vh?JJ- TELEPHONE# _?FSq - 9y-7?
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Ener Code Cate o 2 rn 1
9Y 9 rY MINNESOTA RiJLES 7670 CATEGORY 1 ?? I C, ?M1 ' A RULES 7672
(+lsubmissiontype) • Residential Ventilation Category 1 WorksheetSu edAUG 2 8 ZOOZE Code Worksheet Submitted
• Energy Envelope Calculations Submitted I Il
Plumbing Conhactor: ___
Plumbing system includes:
Mechanical Contractor:
Mechanical system includes:
Sewer/Water Contractor:
_ Air Conditioning
_ Heat Recovery System
Phone #
Phone #
(;? 4)j, 02 .?
Fcc: $90.00
`
Fee: $70.00
1 hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Slgnature of Applicant
----------'----------°----°°°------.._____--------._.._______.°----°-_________.---------
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
Water Softener
Water Heater
No. of Baths
4,tu rv.' vicj ,•vL
VALUATION , `? ( -?so •
Lawn Sprinkler
_ No. of R.I. Baths
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex O 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 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 (screened) ? 36 Multi
? 05 03-plex ? 11 1 D-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex PI6g_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/DOOrs
? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to appllcant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
_ Footings(new bldg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final Windows (new/replacement)
_ Insularion _
_ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
46tl1
C. R. WtNDEN 3 ASSOCIATES, INC.
lANO SURVEYORS TtL 645-3646
V 1361 EUSTIS ST., ST. PAUt, MINN. $SIOB
For:
U. S. HOME CORPORATION
N
Scale: 1" = 30'
O Denotes Iron
41. 62 98. 89 ?
0
r- ?? - ----
y? . ? 10
A \ I O
?
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A
w
,
?c NA prop? d4 ? pna
?
? D e?N
5? O 54.ZD
J PE
Lot 4, Block 3, Johnny Cake Ridge
Addition, Dakota County, Minnesota
WE HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENIATION OF A SURVEY OF THE
60UNDARIES OF THE IAND A60VE DFSCRI6ED AND Of THE LOCATION OF ALL 6UILDINGS, if ANY,
TMEREON, AND All VISIBLE ENCROACFfMENTS, IF ANY, FROM OR ON SAIO IAND.
Dotad rAis 13th doy oF flucA.D. 19R0 C. R. WINDEN 6 ASSOCIATES, INC.
6Y _ .?..rA? ?1'"` " '"`°? •-'t?.T'..,?"kn''
Surrarer, Minnewto Rapistrorien No.77Z6
CITY USE ONLY
L BL J7- RECEIPT #:
SUBD(?? DATE:
1995 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PtLOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
FIXTURES
Shower
Water Closet
Bath Tub
Lavatory
Kitchen Sink
Laundry Tray
Hat_Tuh/.
e-?Vlater Hpat
Floor Drain
Gas Piping Outlet ' minimum - 1
Rough Openings
Water Softener
Private Disposal "' Dakota Cty. license
U.G. Sprinkler' home under const.
Alterations ' to existing
Water Tum Around
EACH NO. TOTAL
3.00 x =
3.00 x =
3.00 x =
3.00 x =
3.00 x =
3.00 x =
3.00 x =
3.00 x =
3.00 x =
3.00 x =
1.50 x =
5.00 x =
20.00 =
3.00 =
20.00
20.00
STATE SURCHARGE
TOTAL
SITE ADDRES:
OWNER NAME
INSTALLER Nfi
STREET ADI
CITY:
GuhiN i E
.50
5O
ao !
STATE: ZIP:
PHONE #: ( )
SCHMIOT
4681 PENY4IF 61f!''r'
EfiGftN
H 454-94?9 W
OFFICE USE ONLY
L BL RECEIPT
SUBD.
DATE-
1995 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 6814675
Please complete for: ? all wmmercial/industrial buildings.
? multi-family buildings when separate permits are M required for each dwelling
unit.
DATE: ? CONTR,4CT PRICE:
WORK TYPE: NEW CONSTRUCTION
DESCRIPTION OF WORK:
ADD ON REPAIR
IS WATER METER REQUIRED? _ YES _ NO. IF SO, PLEA5E PROVIDE THE FOLLOWING:
WATER FLOW: GPM. ARE FLUSHOMETERS TO BE INSTALLED? _ YES _ NO.
FAILURE TO PROVIDE THIS INFORMATION WILL RESULT IN A DELAY OF METER ISSUANCE.
WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? _ YES _ NO.
IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINKLER PERMR.
FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge of $.50 per
$1,000 of , ep rmit fee due on all permits.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL
SITE ADDRESS:
TENANT NAME:
OWNER NAME:
INSTALLER:
ADDRESS:
ciTV:
!t'p`r
PHONE #:
TVJl ?•.. •
)MAiJ11f. ..` 'i , .. - .
LItc A STATE:
SIGNATURE:
APPLICANT
OFFICE USE ONLY
,1] ?1Nq
STE. #
ZIP:
METER SIZE: " DATE: INSPECTOR:
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4681 Penkwe Way
Lot: 4 Block: 3 Addition: Johnny Cake Ridge
PID:10- 39800 - 040 -03
Use:
Description:
Sub Type: e- Windows/Doors
Work Type: Windows/Doors - New/Replacement
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
New Windows for America
609 W County Rd E
Shoreview MN 55126
(651) 203 -0149
4/30/08 Notification letter sent regarding expired perm
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Construction Type:
Occupancy:
pf
Permit Type:
Permit Number:
Date Issued:
Permit Category:
A framing inspection is required when installing a Bay or Bow window or if the opening is altered
required in all sleeping rooms prior to final
Owner:
James E Schmidt
4681 Penkwe Way
Eagan MN 55122
$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
EA080575
10/19/2007
ePermit
Smoke detectors are
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4681 Penkwe Way
Lot: 4 Block: 3 Addition: Johnny Cake Ridge
PID:10- 39800 - 040 -03
Use:
Description:
Sub Type: e- Windows/Doors
Work Type: Windows/Doors - New/Replacement
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
New Windows for America
609 W County Rd E
Shoreview MN 55126
(651) 203 -0149
Applicant/Permitee: Signature
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
- Applicant -
Construction Type:
Occupancy:
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.
$88.50
$1.50
Total: $90.00
Owner:
James E Schmidt
4681 Penkwe Way
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
0801
9001
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
EA090754
08/20/2009
ePermit
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA108105
Date Issued:11/16/2012
Permit Category:ePermit
Site Address: 4681 Penkwe Way
Lot:4 Block: 3 Addition: Johnny Cake Ridge
PID:10-39800-03-040
Use:
Description:
Sub Type:e - Water Heater
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Renae Freinwald
2200 Hwy 13 W
Burnsville, MN 55337
952-767-1870
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
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 -
James E Schmidt
4681 Penkwe Way
Eagan MN 55122
Genz Ryan Plumbing & Heating
2200 West Highway 13
Burnsville MN 55337
(952) 767-1000
Applicant/Permitee: Signature Issued By: Signature
