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4695 Penkwe WayCITY OF EAGAN Remarks Addition -7010?NY CAKF? RTnf;F AI1nTTT(]N Lot 7 elk Parcel Owner I:i)?,rl!if ?`. h1r r)u 1 n_ lii ?Iaid streec 4695 Penkwe WaY state BaBan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK ..1975 2 * SEWER LATERAL .S D WATERMAIN * WATER LATERAL -1981 WATER AREA a 7 is 0 STORM SEW TRK a 1981 670.68 134-14 670.68 C005860 10 15 80 * sraRnn sew Lar 1981 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. of it BUILDING PER. SAC PARK CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DAT6 19 nacciveo FROM AMOUNT & w 3 ?e ? CASH ? CHECK - ? FOR 7T- White-Payers Copy Yeliow-Postinp CoPY Pink-File Copy Thank You C?? ?. sY , CITY OF EAGAN ' 3795 Piler Knob Road Eogan, MN SSIZ'l R 1 PHONEs 454-8100 BUILDING PERMIT Receipt # N! 5686 To be wsd for' Est. Value Dote , 19 Site Address ; ?j •J'- ?, -? • ? Erect ? Qccupancy - Lot Block ? Sec/Sub. `T??j?",''' Alter p Zoninfl Repoir ? Fire Zor?e Porcel EnlarQe ? Type of Const. ? W Narne n 'T`il0niPSnn 11 ar1PG Move ? # Stories = o Address Demolish ? Front ft. Cit phone _ Grade ? Depth ft. °C 0 Name APV?ovob Fees ?? Address `- I Nome _ Address I hereby ocknowledge thot I have read this application and stote that the information is correCt and agree to comply with cll opplitable State of Minnesota Statutes and City of Eagan Ordinonces. Assessment _1" ?. ; / Water & Sew. Police Fi re Enfl. Planner Council Bldg. Off. APC Permit Surchorge Plan check . '? SAC ` - Water Conn. - : Water Meter Total Signature of Permittee I A Building Permit is issued to: on the expreu condition that oll work shall be done in aaordonce with cll applicuble 5tate of Minnesota Statutes ond City of Eagan Ordinances. 8uilding Officiol Pumit # peH IsireA PMS11toe Plumbing Mechanicol SC95_/?5'_s INSPECTIONS DATE INSP. Raugh-In Fir?ol Footings ?9% 2$-gv Date Insp. Date Insp. Foundation Plumbing - Frome/ins. Mechonical ? Final Remarks: . . No. Date: Site /lddress: Lot Nome Blxk 5 Sub/Sec. ILr;, Orrin Th,.om--)ecm ;'orp-:: $ Address 3712 1iorkinu Crns"roar, ? `jrLnetor.?:F City Phone: Nome :rPT1Z@I. . ? :oT:nebec: ?7r'.v? ? Address V C;ty Phone: - This Permit is issued on the expreu condition thot oll work sholl be Minnesota Stotutes and City of Eagon Ordinances. a.? CITY OF EAGAN 3795 Pilot Knob Reed Ee9an, Minnesota 551 Phoee: 454-3100 PERMIT ? INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIONS Receipt No.: Single . I Residential I Multi Res., Comm./Ind. I New /Alter. / Repai r Cost of Installation Permit Fee Surcharge Total done in atcordonce with all appliwble Stote o# Buildirg Official • crrY oF E?CP?N , 3795 Pilot Knob Road No. Eogae, Minwesota 55122 Phone: 454-e100 PERMIT Dote: IAay 20, 1980 Site Address: 4695 Penkitve Way .? Lot 81ock Sub/Sec. Jbn.y. Cak@ Ridi Name ')TZ'iri T}]ompSOIl Address i(-,- )1dns Crossron.d J City Phone: :?r r Nome ?. ':tielter '.3eat3ri, g Address e City Phone: This Permit is issued on the express condition that all work sholl be Minnesota Stotutes ond City of Eagan Ordinances. INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIONS Receipt No.: $ingle I Residential Multi Res., Comm./Ind. I New/Alter./Repair. - Cost of Instollation Permit Fee Surchorge ToTal =-?• i? done in accordance with oll oppliaoble State of Building Official CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHO N E: 454-8100 BUILDING PERMIT Receipt# To be used for a Est. Value S i" ')(' Date ,19 Site Address Lot ' Block ? Parcel No. Y,AY iUNNirTYY a Name 'UN PRINi?.",.1 z Address • f, ' `4Y 3 L54-iS?l 0 Ciry ' Phone . o Name N:. ,•F. ? < Address ? City Phone ?31-0? yC a W Name_ Z Address ? W City_ 1 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. Signature of Permittee A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City ofi Eagan Ordinances. Building Official__ OFFICE USE ONLY On Site Sewage Occupancy MWCC System Zoning On Site Well (Actual) Conat City Water (Allowable) PRV Required #of Stories Booster Pump Length Depth S.F. Total Foatprint S.F. APPROVALS FEES Engr./ASSess. Permit Planner Surcharge Council Plan Review Bldg. Off. SAC, City Variance SAC, MWCC Water Conn. Water Meter Road Unit Treatment Pt Parks TOTAL 24. 541, Permit No. Prrmit Nolder Dste Tslephone #t Plumbing H.V.AC. ElectMc Softener Inspection Date Insp. Commsnts Footings I Footings II Foundation Framing Roofing Rough Plbg. Rough Htg. Isul Fireplace Final Htg. Final Plbg. Bldg. Final Cert Oca Temp. LP Deck Ftg_ -?? ?6)z /! Deck Final l We11 Pr. Disp. INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: IA 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date issued: (612) 681-4675 SITEADDRESS: APPLICANT: 4695 ? i Iit i?; ?tr{y .?? ? , ii?,'t ,1i?i? I•i . ?. ??;a ., . ;1::- . .,. . Ftlf?iiF (ti1.?) A!-,4-l?1.?1 PERMIT SUBTYPE: F L TYPE OF WORK: Permit No. PermR Holder Date Te{ephone N S/1N PLUMBING HVAC ELECTRIC ELECTRIC Inspection Date Insp. Commerrts Footings I Foundetlon Framing Q t? ,fl1?ry /j? " G Roofing / Rough Plbg. ? Rough Fltg. Isul. Rreplace Rnal Htg. Orsat Test Flnal Plbg. Ptbg. Inspecta- Noti(q Plumber Cortsi. Meter EngrJPlan Bldg. Final Deck Ftg. Dedc Flnal wen Pr. Disp. 3 1Piloe Knob Road Ium r oF E,?c??M •- n, MN 55122 ng: er: ress: Address: b@r: I agree to wn+ply with the City of Eagon Ordinanees. BY ? Date of I nsp.: I nsp.. 95 Pilo? Knob Raad Iu Y OF EA6AN an, MN 55122 ning: ner: dress: Address: mber: Connection Churge: Account Deposit: _ Permit Fee: Surchurge: Misc. Charges: - Total: Date Poid: PERMIT NO.: DATE: No, of Units: ii.ea t ?`" ? ?'' '?• -`-' - eter No.: Connection Charge: • i=e; ? Account Deposit: eoder No.: Permit Fee: agrea to eomply with the City of Eagan Surcharge: rdinanoes. Misc. Charges: Total: gy Date Paid: Date of Insp.: Insp.: SEWER SERVICE PERMIT PERMIT NO.: DATE: No. of Units; RESIDENTIAL BUILDING PERMIT APPLICATION ? ? ? ? ? CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4675 New Construction Reauirements • 3 registered site surveys showing sq. ft. of lot sq. ft. of house; an?tl roofed areas (20% mazimum lot coverage albwed) • 2 copies of plan shawing 6eam & window sizes; poured tound design, etc.) • 1 set of Energy Calculations • 3 copies of Tree Preservation Plan if lot platted after 711/93 • Rim Joist Detail OpUons selec6on sheet (bldgs wiN 3 or less units) DATE JO`;?"O JOB SITE IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY TYPE OF APPUCA ADDRESS _ PAGER # _ ? ? 8?. --7 5 RemodellReoairReauirements ? b- 3- d J . 2 copies of plan • i set of Energy Calculations for heated additions • 1 site survey for exterior additions & decks • Indicate if home served by sepfic system lor additions VALUQION Z.;4,06 . d 0 Z_ Z 61 REPLACE(S) _ 0 _ 1 _ 2 PHONE# lS/ /!/I/(/ z/ ZIP CODE SS/ z U CELL PHONE # Gs/ `7 75-4 7Y? FAX # 9sa7SV-1r;"3 NEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY Energy Code Category _ VIINNESOTA RUI.ES 7670 CATEGORY 1 (check one) - Residential Ventilation Category 1 Worksheet Submitted - Energy Envelope Calculations Submitted MINNLSOTA RULES 7672 - New Energy Code Worksheet Submitted Plumbing Contractor: Plumbing System Includes: Mechanical Contractor: Vlechanicail System Includes: Sewer/Water Contractor. Watcr Softencr Walcr Heater No. of Battis Air Conditioning Hea[ Rccovery System All above information must be submitted prior to processing of application. Fee: $90.00 Phone # Fce: $70.00 PhW4V# "_ ' I I I hereby acknowledge that I have read this application, state that the information is correct; an e to comply with all ppplicable State of Minnesota Statutes and City of Eagan grjdiraagces. SignatureafApplicant Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 1/O7 Phone I.awn Sprinkler No. oF R.I. Baths OFFICE USE ONLY ? 01 Foundation ? 07 OS-plex ? 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 ? OS 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement •Demolition (Enttre Bldg only) - Give PCA handout ta applicant 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) Footings (deck) Fina Footings (addition) Pl Foundation Drain Tile Roof Ice & Water Final Other Framing _ Pool _ Ftgs _ Air/Gas Tests _ Final Fueplace _ R.I. _ Air Test _ Final _ Siding Smcco Stone Insulation _ Windows (new/reptacement) Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC W ater Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other FinaUC.O. _ Wio C.O. _ umbing HVAC Building Inspector Total `1 c 47 N ?,521,C??? Fepuest ?ate - Fir o, Pou h n Inpsection FaOUir . nreatly) sicall pBCta?wN (YO u Inspectian Other Than Rough-ln qeaGyNOw ? Will ' InspedOr 1 ? ? Oa Pead 13 Ig licensed contractor D owner hereby request inspection of above electrical work at: Job Adaress (StreeL Box or Roule No.) Ciry 4b S Fziojil Secbon i Townsnip Name or No. Range No. County n Occul IPRINT? Phone No. ??att'9 qg' PowerSuppher Adtlress J ' Electncal Convaaor IGOmpany Nadi CqnVaqorS License No. =al, k\tii 1 l = t-7 Mailing Aparess ICOnttaclor or Owner Making Inslallation) LL^ ,J 5? 3 , Amhonze0 Siqna?ue Co . acmnOwner Mak:ng Insa?a^ila?rory / K? ?J?1 ?? _ Phone Number y ? `-+-+ MINNESOiA STATE BOARD OF ELECTHICITY THIS INSPECTION REQUEST WILL NOT Griggs-Mitlway BICB. - Foom S-173 V 6E ACCEPTED BY THE STATE BOARD 1821 University Ave.. St. Peul. MN 55104 UNLESS PROPER INSPECTION FEE IS Ppone(612) 642-0B00 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION q?7 ? Sae insVUCtians lor completing this torm on beck ot yellow copy. Vv ( 521 . •"X° Befow Work Covered by This Request EB-0001-08 1S9 ew Atld Re . TypeoBuitding AppliancesWired EquipmeniWired Home Range Temparary Service uplez Water Heater Electric Heating Apt. Building Dryer Loetl Management Comm./lndustrial Furnace Othef (SpeciTy) Farm Air Conditioner Olher(syecilyl ConVactor's Remarks' Compufe Inspection Fee Below: R 'c # Olher Pee # ServiceEniranceSize Fee # Cimuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 _ Amps Above 100 _ Amps SignS , Inspecmrra Use Only: ) 7pT Irrigation Booms GC 4 O?O Special Inspection Alarm/Communication TNIS INSTALLATION MAY BE RED DISCONNECTED IF NOT Other Fee COMPLETED WITMIN 18 MONTHS. I, the Electrical Inspector, hereby Rough-in ? Date certify Ihat the above inspection has been made. OFFICE USE ONLY This requesl void 18 momhs fram mmnesoca awte aoara or ciecviciry , Griggs Midway Bldg. - Room N191 . 18^y^ Universiry AJe.. SL Paul, Minn. 55704 - Phone 297-2117 ' REQUEST'FOR ELECTRICAL INSPECTION CHECK BELOW WORK COVERED BY THIS REQUEST iy,?-.wooo 0 S 64355 pe°of Building New Add. Rep. Check Appliances Wired For Check Fquipment Wired Fm me D.plex ? ? ? ? ? Range ? Water ? t ? Tempocary W'ving LightingFixWfes ? ; t. Bldg. ? ? Dryer k; , ? Electric Heating mmeicial Bldg. ? ? ? Fuma ? Silo Unloader dustrial Bldg. ? ? ? A'v C-?ditio Bulk M0k Tank m ? ? List Lis[ hec ? ? ? p Hehe?s? Heiers? ) COMPUTEINSPECTION FEE BELOW Sewice Entrance Size: # Fm Feedus&Subteedeia: it Fm C¢cuits: # Fm 0 to 100 Am s. 0 to 30 Am eres 0 ro 30 Am eres 101 ta 200 Amps. 31 to 100 Am res 31 to 100 Am eres Above 200_Amps. Above 100 Amps. Above 100 Amps. Transfoimers RemoteConvolCuc. Partialocotherfee J Si ns Speciai Ins ection Minimum Cee S Remarks _ d TOTAL FEE ?'• ? r . J 0 I,the ElectricalInspec[or,hereby (Final) This request void 18 months from has been made. Date S - , JYa[e /v - o't -9 O _ .,yuest void 18 months from Date of this Request Fire No. S "435v I, as 0-kicensed Electrical Contractor 0 Owner, do he by request inspe o of the above electri- cal wiring installed at: ? 7 6 3 - Street Address or Route No. PEN" Wlay City ??W 0- on Township Range County ?Afe?a Which is occupied by Is a roughin inspeciion required on this job? No ? Yes&&, Ready Now ? Will CalkK Pawer Supplier ,Ed Address Electncal Contractor 6ELV azG mfC' Contractor's License No.@519 (C mpany Namea Mailing Address Iq(l ?---I? l?fl. Authorized 7h16 Installatlon) Phone No. gqa ?S?OS (eletnlcal Concracior or ownar Makln9 TMS InstalNtlon) ?( r' ?VN ,? ??R? ???? This irnpeetian request will not 6e accepted hy ffie otJ u?'a uu State Board unless proper inspection fee is enclosed. CITY OF EAGAN ' Na 14 6 4 5 3830 Pilot Knob Road, P.O. Box 27-199; Eagan, MN 55121 BUILDING PERMIT PHONEr454-8100 Receipt # ?I (o D-e Tobeusedtor DECK Est:Value $1,000 Date MARCH 2, ,19-8&__ Site Address 4695 PENKWE WAY Lot 7 Block 3 Sec/SubJOHNNY CAKE RIDGE Parcel No. a Name DON PRIHODA z Address 4695 PENKWE WAY a City EAGAN Phone 454-7991 o Name AMRE ?a Address 1935 CO RD B-2 ? City ROSEVILLE phone 631-0458 ? ww w M Name iz. Address a W City Phone I hereby acknowledge that I re thi ap ? ion antl st 'Ihat the information is correct and gree to o I it all appltate of Minnesota Statutes and ty of E r na ? Signature of Permittee . A Building Permit is is ed to: A ontheexpressconditionthatallworkshall tloneinaccordancewithall applicable State of M[i?nnesota StatutesQand City ofE//agan Ordinances. BuildingOfficial_?CYlg? OPFICE USE ONLY On Site Sewage _ Occupancy MWCC System _ Zoning On Site Well _ (ACtuaq Const City Water _ (Allowable) PRV Requiretl - # of Stories Booster Pump _ Length DeDth S.F. Total Footprint S.F. APPROVALS FEES Engr./Assess. Permit 24.00 Plenner Surcharge . $0 CounCil Plan Review 81dg. Off. SAC, City Variance SAC,MWCC Water Conn. Water Meter ROad Unit Treatment P1 Parks TOTAL L4.,.$g- _ cITr oF Fa"N 9795 Pilot Kno6 Road Eegan, MN 53122 PNM[: 454-6100 BUILDING PERMIT APPLICATION sire address 4695 Penkwe Wav l.or7_ Biak3_ Sec/Sub. Johnny Cake Parcei # Ridge w iName nrri n ThmmPTCnn $npL-c 3 Address 1712 Hopkins Crossroad ---- c r Nome Address same Name i hereby acknowledge that I have read this opplicotion and state that the information is correct and agree to comply wlth all applicuble SMte of Minnesata Statutes and City of Eagan Ordirwnces. Receipt # 5686 ? e.ecc ?j occupa.rc.y R3 Airer ? Zoning Rl Repoir ? Fire Zone I Enlarge ? Type of Const. V Move ? # Stories Dertwlish ? Front fr. Gmde ? Depth ft. Approvale Feea Asse55ment {,? -1 k5 ? H' Wnter & Sew. Poliw Fire Eng. Planner Gouncil Bldg. Off. AIAISO APC % Permit 1 -4-4 - nn Surchorge 73- Sn Plcn check ti A - 50 5qC S95 _ f1f1 Water Conn. 3 ()5_ fl f1 Woter Meter.6 0..11.Q Total 12 9 8. 0 0 Signoture of Permittee I A Building Cermit is issued to: ?lri T on the express condition that all work shall be done in acm th II h4e of Minnesota Statutes and Ciry of Eagan Ordinances. Buildirg Offiefal ? ? Zb He CFTY VF.-EAGAN BUILDING PERNIIT APPLICATION ? ,?" i;T -'ro 0.es%oeNCe Valuation Site Address: licoqs Qc-1,3wWb Wkl IDt B10Ck ?j 52C./SUb. So?ANrty CqKE R1?Dl+E Parcel #: Address: City/Zip Code: Phone #: Contractor: nRRIN TH()MPG(1N I-1O1MRc Address: a Division of U. S. Home Corporation }7}.2 +{g(yf,IN6 6R9SSf2BnB Clty/ZlP COCle. MINNETONKA, MINN. 55343 Phone #: S44-1333 Arch./Eng.. Address: City/Zip Oode: Pnorie #: \ „?V Us? For Include 2 sets of plans, 1 site plan w/elevations s 1 set of erpsgy calcuPations• Date OFFI(E USE ONi.Y Erect Occupancy AItEr ZOT11I1g ? - gepair Fire Zone 3 Enlaxge _ Type of Const. Move # Stnries Demolish Front ft. Grade Depth ft. APP%)UAIS FEES Assess?nts . Pennit Water/Sec,er Surcharge Police Plan Check !o!A ? Fire SAC gng: Water Conn. 2 0 5"-°-v planner Wdt2T MEt2L council Road Unit Bldg. Off. APC -- To T;?L ? l2 9 /?/3 4695 ?I C.R. WINDEN a ASSOCIATES, INC. V ? V!?" LAND SURVEYORS TfL 645•3646 For: 1381 EUSTIS SL, ST. PAULO MINN. 55108 U. S. HOME CORPORATION / / Ig38? ??/ O / \l L- ? \ P . 4 \ G `q _ `y \ \ ¢ \ ? X J? Scale: 1" = 30' O Denotes Iron O ?P? / O \ \ \ ? \ O N \ ?9 \ '6 \ ?a k 02 C tOC gPl /? ? Q pJ / ? ? Gy,?oc•? ? ? ?A/ n? E P Lot.7, Block 3, 3ohnny Cake Ridge Addition, Dakota County, Minnesota WE HEREBY CERTIFY THAT TMtS IS A TRUE AND CORREGT REPRESENTATION OP A SURVEY Of TME 60UNDARIES OF THE LAND ABOVE DESCRIBED AND OF TXE LOCATION OF All 6UItDINGS, IF ANY, TMEREON, ANO All VISIBIE ENCROACMMENiS, If ANY, fROM OR ON SAIO IAND. Datad this 20 TH doy oF MAQ A.D. 1980 C. R. WINDEN b ASSOGIATES, INC. ,Or 6" ..4? kl-? . Surryror, Minnowra RayiNrotion Mo. 77Z6 ? 19$8 BUILDING PERMIT APPLICATION - CITY OF EAGAN l? .? SINGLE FAMILY DWELLINGS V' INCLUDE 2 SE'PS OF PLANS, 3 CERTIFICATES OF SURVEY, 7 SET OF ENERGY CALCULATIQNS NOTE: ADDRESSES FOA CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS ZS DESIRED. NO CHANGES WILL BE 9LLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNTTS Il OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CAECK WITH BLDG. DEPT., 1 SET OF ENENGY CALCULATIONS COMMERCIAL INCL[1DE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 7 SET OF ENERGY CALCULATIONS To Be Used Por: Site Address 'PECL Valuation: '744?i) Date: q(-IS RLL?-' cIJaT Lot I B1oek -3 Parcel/Sub 1.d6.L ` Owner Ql.) f a Address '"J bq5 City/Zip Code 51 Phone ?y ? Contractor Address City/Zip Code f1. ?54.1?1?1rv -?S 1?? Phone L-35Y' Arch./Engr. Address City/Zip Code /0oo -- ur r . - On site sewage_ NIIdCC system ` On site well _ City water , PRV requ3red _ Booster PumQ _ APPROVALS Dccupancy Zoning Actual Const Allowable al of stories Length ?epth S.F. Total Footprint S.F. FEES Permit Surcharge Plan Review SAC, City SAC, P7WCC Water Conn Water Meter Road Unit Treatment P1 Parks Copies TOTAL Engr/Assess Planner Council Bldg. Off. ?3/1 Variance _ z o0 y,- , So Phone # INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: e u t t - o I N G 3830 Pilot Knob Road Permit Number. ? 7 0,t's i Eagan, Minnesota 55123 Date Issued: 02 J 1?/ v 3 (612) 6814675 SITE ADDRESS: APPLICANT: i.o7?: 7 aL ??c??? i 4695 PENKWE WAY VALLEY .[NVESTMEIVTS COP!SF J('iHNIVY L'AKE f2I0CE (612) 454-5191. PERMIT SUBTYPE: TYPE OF WORK: t3A5EhlE14T F7:NI'SFI ALTEN.N7IUN ? ? CITY OF EAGAN PERMIT 3830 Pilot Knoti Road PERMIT TYPE: Bu I Lc! r_ N e Eagan, Minnesota 55123 Permit Number: 020337 (612) 6814675 Date Issued: G?': / 17 J yj SITE ADDRESS: 4695 PGIVKWE Wfl'Y LO'ie 7 3l[1CK: 3 JOFiNIV,1' fFKi; RT7CiE P_S.h!<, 10-39800-070-03 DESCRIPTION: ' BuiidA9 Perm:i*. 'i'Ype ? BttiTcJingAaJnrk TYPe '" IF?C t?ecup?nVy i ir _ p BFl5'EhIGN i P:[NISH AITFRATTUN !?-3 ??\i L;. ? / ? n r- t ? I ^- ? -??l '? REMARKS: FEE SUMMARY: E3ase Fee „asoeo-) 5 u r c I'i ary U ?._....._._._...._.._._?._.5_0 rot:al r-esa $35.50 ? CONTRACTOR: - Fipp l.iaanr - s-r. i-jcOWNER: VHLLLY IPdVESTMLIVT"l CpNS'(" 14545191 0001241. PRTHOI!R UQN 2401 LEk]:NClOiti Fd'V,= 5 4635 pEMKWE WR'! ME.NGt5T7a NTS mN 55120 EAGAiV MfV 5512' ( 612) 1.54_.51c17- (6i2)4: q_.; ^91 T iiereby aclzravwled'ge th7L- I kravice rea8 this app:t.icatiran and staee that the infor^matiarr Is cUrrecG and agree r:v ec,mply w5th ;:l.i spplicable ,;tate vf Mn. IStatute.s and Caty bf Caqan Orr1S.nanc,es. I A ? r ? ? ??1 ?APPLICANT ERM EE SIGNATUFE ISSUED Y: IGNA RE REACTIVATE _, PERMIT # koNA fl CITY OF EAGAN 1993 BUILDING PERMIT APPLICATION 681-4675 SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architecturat & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month- in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date /Z / ?L Valuation of work Site Address: 4/!o STREET SU1TE / Tenant Name: (commercial only) IAT BLOC& SIIBD. 7 ? P.I.D. ?P U5 2 Descri tion of work: i?kFLac N ? Aw ?-J W& The applicant is: ? Owner Contractor ? Other (Deseribe) Name P_,t+vYJPr noni Phone ?110-7%W Property usr F1R5T Owner Address 4/6 Prywy- +.0 6 l,tA4? STREET STE N '?5?? ? YVI ? yC Zip "? State City V Company I/AiL F-'`? 'C,vv?S i rti ,n, f S LppyS ?, Phone Contractar Address Lv(-)z i?(?i.??? .Si?. License #11,)Y1 Exp.ci 5 City lU wt9t)ir4 /? i 1, Ni 5 State G'11h/ Zip ? Company Phone Architect/ Engineer Name Registration # Address City State Zip Sewer & water licensed plumber . Processing time for sewer & water permits is two days once area has been approved. 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. Signature of Applicant: 9 11? y OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 02 SF Dwg. ? 03 SF Addition ? 04 SF Porch ,0.05 SF Misc. WORK TYPE ? 31 New O 32 Addition ? Ob Duplex ? 07 4-Plex ? 08 8-Plex ? 09 12-Plex ? 10 Multi. Add'1. 933 Alterations ? 34 Repair GENERAL INFORMATION ? 1 10 ? 11 Apt./Lodginy : ? 12 Multi. Misc. ? 13 Garage/Accessory ? 14 Fireplace _ ? 15 Deck ? 35 ienant Finish ? 36 Move 1.I6 &asjement Finish ? 17 Swim Pool ? 18 Comm./Ind. ? 19 Comm./Ind. Misc. ? 20 Public Facility ? 21 Miscellaneous ? 37 Demolish Const. (Actual) Basement sq. ft. MWCC System (Allowable) lst F1. sq. ft. City Water UBC Occupancy 2nd F7. sq. ft. PRV Required Zoning 5q. Ft. total Booster Pump #i of 5tories Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code y c Depth On-site sewage SAC Code t APPROVALS Planning Building Assessments Engineering Variance REGtUiRED INSPECTIONS ? Site ? Footing )R?Framing ? Insulation ? Wallboard Cg Final ? Draintile ? fireplace Permi t Fee 36, 0a v.iuas;on: Surcharge so Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: ? SAC % SAC Units t CITY OF EAGAN EARLY UTILITY CONNECTION PERMIT 4695 Penkwe Way L7 S3 Johnny Cake Ridge Address Subdivision/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 turned on until the City utility system has been declared operational by the City Engineer. Signed by - Plumber: WENZEL MECHANICAL -tL?- Owner • .? ?.., ? Developer• Suilder Dated: 5/27/80 6 L1L14i 1 PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND COND05 WHEN PERMITS ARE REQUIRED FOR EACH UNTT. NEW CONSTRU ION _?` ADD-CaN .4/C ?t?c SL,1 A?Tx o 1Ll oL? ADD-ON FURNACE FIREPLACE INSERT DATE 7-0-4+-f FEES HVAC: 0.100 M BTU $ 24,00 ADDITIONAL 50 M BTU 6.00 GAS OUTLETS (MINIMUM 1 @ $3.00 EACH) ADD-ON/REMODEL (E)asrnvc CoNSntucrtoN) $ 20.00 STATE SURCHARGE .50 TOTAL cl?_ Sii'E OWNER NAME:4g24 grzhh" V TELEpHONE #: L1Sd- 7541 INST. HEqiING 8 AIR CONDfiIONING C0, ADDRESS: 8910 WE iH 71VE . MINNLAPOLIS, MN 55420-2853 Cj'I'y: 881•9000 STATE: ZIP CODE: TELEPHONE #: 9ivi?AT'JFcEOr ?ERIvf7l7EE ?Y?2« 1994 MECHANICAI, pptMlT (RESIDEIVTI;aII,) CITY OF EAGAN 3830 PILOT HNOB RD EAGAN MN 55122 (612) 681-4675 1994 MECHANICAI, pHtM1T (COMMERCIAL) C1TY OF EAGAN 3830 PIIAT HNOB RD EAGAN MN 55122 (612) 681-4675 PLEASE COMPLETE FOR ALL COMNIERCIALdIINDUSTRIAL BUII.DINGS. ALSO COMPLETE FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMII,Y BUILDINGS WEEN SEPARATE PERMTTS ARE NOT REQUIRED FOR EACH DWELLING UNTf. t'?* ?r nn T?. ? L.4in: ... ?3'? ..,4 ?._...,.,. NEW BUILDING INTERIOR IlAPROVEMENT WORK DESCRIpTION: FEES 1% OF C9]? FEE PROCESSED PIpING: MINIMUM FEE: STATE SURCHARGE ?'nT l? r $ $25.00 $25.00 ;.,? $.50 FOR EACH $1,000 OF ..9.:.:.U'... FEE. ? SITE ADDRFSS: OWNER NAME: TELEPHONE #: TENANT NAME: (IMPROVEMENTS oNLY) INSTALI.ER: ADDRESS: CITY TELEPHONE STATE: ZIP CODE: SIGNATURE OF PERMITTEE CITY INSPECTOR ? 2004RESIDENTIAL BIIII.DINCPERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 9? Telephone # 651-675-5675 FAX # 651-675-5694 ,5`70 .0 0 New Cons4vction Reauiremen5 3 registered sife surveys shaving sq. ft o( lot sq. fL ot house; and all roofed a2as RemodeURepair Reouirements 2 copies of plan UsE?tjrj Ce?t,gFSUn?? 0MA A 3'1 (20%maximumlotcoverageallowed) etc beam & windax sizes; poured found design lan showif ies of 2 co lsetofEneyyCabulaGonsforheatedaddNOns 1 site survey for additions 8 decks , . g p p m t d ti t ddN i dk 'rf 1 set of Energy Cak,ulaGons a ons e sep c sys e A On - n e 3 copies of Tree Preservation PWn if lol platled aRer 777/93 Rim Joist Defad Options selecUon shcet (bldgs with 3 or less units Date al/ mc.v v Construction Cost ?y Site Address n1!, ?'J 5-e)(?Y-kl?Q. x-"\ UniUSte # • , Description of Work w ? Multi-Family Bldg _ Y>< N Fireplace(s) _ 0_ 1 _ 2 i l- Property Owner -- _t ??_Yl ?1f?1 ?QYnS ? nG( v, Telephone #(j 6 O O' -V ? RMA HOME SERVICES INC. Contractor ? Home Depot Installed Sales i 3200 Cobb Galleria Pkwy., Ste. #200 City Addrese Atlanta, GA 30339 State 763-542-8826 Telephone # ( ) BC-20268257 ? COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (4 submission type) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan ?` fee applies. Fn T?? Licensed Plumber II? At'R Mechanical Contractor Sewer/Water Contractor By plan8 _ Y _ N If so, 25% plan review ? Telephone #( ) _ Telephone #( ) TelephoneffF&?T? Fjg1qR I h it 0. APR 2 1 'uu4 a?e I hereby apply for a Residential Building Permit and acknowledge that the info tion is complete anaccurthat the work will be in conformance with the ordinances and codes of the Ci of Eaganand the of N1N Statutes; I understand this is not a permit, but only an application for a permit, zii o s without a permit; that ttte work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. 1 ?N,::) s, ICLAa ApplicanYs Printed Name pplicant's Signature OFFICE USE ONLY _, Sub Types ? 01 Foundation ? 02 SF Dwelling ? 03 01 of_plex ? 04 02-plex ? 05 03-plex ? 06 04-plex Work Types ? 31 New ? 32 Addition ? 33 Alteration ? 34 Replacement Valuation Census Code SAC Units # of Units # of Bidgs Type of Const _ Fookngs(new bldg) _ Footings (deck) _ Footings(addirion) Foundation Drain Tile Ronf Ice & Water Final _ Framing _ Fireplace _ R.I. _ Air Test _ Final Insulation Approved By: 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 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous ? 30 °ACCessory Bidg ? 31 Ext. Alt- Multi ? 33 Eut. Alt - SF ? 36 MultiMisc. ? 35 Int Improvement ? 38 Demolish Interior ;? 44 Siding ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 37 Demolish Building• ? 43 Reraof ? 46 Windaws/Doors `Demolition (Entire Bldg) - Give PCA handout to applicant Occupancy MCES System Zoning City Water . Stories Booster Pump Sq. Ft. PRV Length Fire Sprinklered W idth REQUIRED INSPECTIONS _ FinaUC.O. _ FinaUNo C.O. _ Plumbing HVAC Other _ Pool _ Ftgs _ Air/Gas Tests Final _ Siding _ Stucco _ Stone _ Brick _ Windows _ Retaining Wall Building Inspector l,1? 3 1-t q ? %`-Io,c) i 2004 RESIDENTIAL BUII.DING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 NewConsVUCtlonReauirements RemodeVReoairReauirements ceceUseN _ 3 registered sde surveys showing sq. ft of bt sq. R of house; and a0 roofed amas 2 copies of plan £eArofSur`vey ReW 4 _Y, ?L N e (20%mazimumblwveregeallawed) isatMEnergyCalculaGonsforheatedaddiAOns ir ePrgsPlanRecd L _Y N 2 copies of plan slwwing beam 8 window s¢es; poured found design, etc. 1 site survey for additions & decks Tree P2s Reqared .?_V N, ' N isetafEnergyCakuhdons AddNOn-irMicateHon-sdesepticsystem On-sifeSephcSysfem;„„;==? 3_.- 3 wpies of Tree Preservation Plan if bt plaCed aNer 711193 Rim Joist Detail Options seleqion sheet (bldgs wiUi 3 ar less unils Date I (? / 1' `OA /0_ Construction Cost 1 ? J U UIn SiteAddress [n95?} .Pnk,W -Q? ? Ocw UniUSte # Description of Work 1\DYkaC.Q p? 1?J1 G?U W J L_4_j11 Y t__l' Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2 PropertyOwner Tx'l,q`(\{rhalft ??'MS•t1\G?h Telephone#((OJru RMA HOME SERVICES INC. Contractor 'Home Depot Installed Sales 3200 Cobb Galleria Pkwy., Ste. #200 Address AUanta, GA 30339 State 763-542-8826 BG20268257 City lephone # ( COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeory 1 _ Minnesota Rules 7672 Energy Code Category , Residential Ventllation Category 1 Worksheet • New Energy Code Worksheet (4 submission type) SubmiUed Submitted • Energy Envelope Calculations Submitted Have you previously consTructed a building in Eagan with a similar plan? _ Y _ fee applies. Licensed Plumber Telephone #( ( Mechanical Contractor 'k" r?' Telephone # • ? 6 Sewer/WaterContractor Telephone #( N If so, 25% plan review I hereby apply for a Residential Building Pemut 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. I/ ? ApplicanYs Printed Name A13"plicanYs Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 O6-plex ? 16 Firepiace ? 21 Porch (3-sea.) ? 31 6ct. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? OS 03-plex ? 11 10.plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding 0 32 Addition ? 36 Move Building ?.42 Demolish Foundation ? 45 Fire Repair ? 33 Alteralion ? 37 Demolish Building` ? 43 Reroof ? 46 WindowslDoors ? 34 Replacement 'Demolitlon (Entire Bltlg) - GWe PCA handout to applicant Valuation Occupancy MCES System Census Code Zoning City Water SAC Units Stories ' Booster Pump # of Units Sq. Ft. PRV # of Bidgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) _ FinaUC.O. Footings(deck) _ FinallNo C.O. Footings (addition) _ Plumbing Foundation _ HVAC Drain Tile Other Roof Ice & Water Final _ Pool _ Ftgs _ Air/Gas Tests Final _ praming _ Siding _ Stucco _ Stone _ Brick Fireplace _ R.I. _ Air Test _ Final _ Windows Insulation _ Retaining Wall Approved By: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Building Inspector Installed Siding and Windows LIMITED POWER.OF ATTORNEY. , - CUUN'1'Y UF COBB STATE OF GEORGIA KNOW ALL PEOPLE BY THESE PRESENTS: THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania ("Principal"), and a licensed contractor of RMA Home Services, Inc., DBA Home Depot Installed Sales located at 660 Mendelssohn Avenue North, Crolden Valley, MN 55427, having a license number of BC- 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 and appropriate, in order to obtain the proper permit(s) from the City of Eagan, Minnesota for the installation, maintenance and repair of windows and siding (the "LVork"). The powers conveyed to the Agent by this Limited Power of tlttcmey are limited solely to the express powers delineated herein and apPly solely to the Work. This Limited Power of Aftorney`shall expire and automatically be revoked on the 21st 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, incapacity or incompetence. IN WITNESS WHEREOF this Limited Power of A±torney is eaecutcd this 21 st day of May, 2003 t ' David . Katz S WORN TO AND SUBSCRIBED BEFORE ME by David N. Katz on this 21st day of May, 2003. X. Zga. Notary PQlic in for the State o eorgia My Commission Expires: January 21, 2006 3968I6.v3 Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor. 3200 Cob6 Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toli free (800) 79-DEPOT installed Siding and Windows LIMITED POWER OF ATTORNEY cOiJNTY OF COBB STATE OF GEORGIA KNOW ALL PEOPLE BY THESE PRESENTS: THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania ("Principal"), and a licensed contractor of ItMf1 Home Services, Inc., DBA Home Depot Installed Sa1es loca±ed at 660 Mendelssehn Avenue North, Golden. Valley, MItiT 55427, having a license number of BC- 20268257, do hereby appoint, name and constitute Elder-Jones Building Permit Service, Ina ("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 sequired by the municipality) a permit application, or any other instrument(s) which may be necessary and appropriate, in order to obtain the proper permit(s) from the City of Eagan, Minnesota for the installation, maintenance and repur of windows and siding (the "Work"). The powers conveyed to the Agent by this Limited Power of Attorney are limited sotely to the express powers delineated herein ancl app?y solely to the Work. This Limi*,ed Power of Aftomey shall expire and automaticaliy be revoked on the 21st day of 1b1ay, 2004, which date is one year from the execution hereo£ Further, the powers conveyed by this Limited Power of Attorney may be revoked by Principal at aizy time by express revocation and shall also be revoked by the Principal's death, disability, incapacity or incompetence. IN WIT'NESS WIIEI2EOF this Limited Power efAttorne-y is e._3ecutcd this 21 st day of May, 2003 M ? David . Katz SWORN TO AND SUBSCRIBED BEPORE ME by David N. Katz on this 21 st day of May, 200? .n Notary P ic in for the State o eorgia My Commission Expires: January 21, 2006 396816.0 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 Use BLUE or BLACK Ink For Office U6@ I I I city of Eajan ~ Permit I Permit Fee: 0 ' 3830 Pilot Knob Road D C 3 2009 Eagan MN 55122 I ' I Date Received: 1 Phone: (651) 675-5675 1 Fax: (651) 675-5694 I` Staff: l - - - - - - - - - - - - - - - - - J 2009 MEC~ _H(~ANIC L PERMIT APPLICATION Date: G V c7 Site Address: IC l1-D .ln Tenant: Suite RESIDENT I OWNER Name: rl f~' ie4v Phone: Address ity/ Zip: r-~ CONTRACTOR Name: r 4 ` License Address: City:, r~ State: M-~44 Zip: 4 1 Phone: 4" l -001IContact Person: L~s~ l!V tMJ& r~, TYPE OF WORK New Replacement Additional Alteration Demolition NOTE: Roof mounted and ground mounted mec anical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. PERMIT TYPE RESIDENTIAL COMMERCIAL Furnace New Construction _ Interior Improvement Air Conditioner Install Piping ^ Processed Air Exchanger Gas _ Exterior HVAC Unit Heat Pump -Under/ Above ground Tank L- Install / _ Remove) When installing/removing tank(s), call for inspection by Fire Other Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ b TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ x1% $50.50 Minimum (includes State Surcharge) = $ Permit Fee - If Permit Fee is less than $1,000, surcharge is $.50. - If Permit Fee is > $1,000, surcharge increases by $.50 for each = $ Surcharge $1,000 Permit Fee (i.e. a $1,00142,000 Permit Fee requires a $1.00 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.nooherstateonecall.orn I hereby acknowledge that this information is complete and accurate; thf1he 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 rmit, 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 ap roval of plans. x N \ P, x Applicant's Printed Name ppli ant' gnature FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground _ Rough In ___,.Air Test -Gas Service Test -In-floor Heat -Final Exterior HVAC Screening Inspection 01/12/2010 13:03 JEFFERSON HOMES + 6516755694 NO.824 9002 bn 1 b'(5 nby4 01/12/2010 11:38 ERGPN ENG+COM DEV 4 94296351 NO.011 901 Use BLUE or BLACK IRK i i Perm* 4 f City of Eajan ; Permit Fee' 3830 Pilot Knob Road ~ gate RecGi,►ca: 1 I 1 Eagan MN 65122 Phone: (651) 076.66751 I Slate 1 Pax: (651) 676-66Si4 _ / - mo RESIDENTIAL BUILDING PERMIT APPLICATION Date= .-1/12/09. Site Address: 4695 penkve Way, Eagan, MAT Tenant_ Sulls RESIDENT I OWNER Name. Kent Je eKson Construction Phone: (612) 670-3686 Addmss r city J zip: 4530 Highway 61, White Bear Lakes 14N Appacant is' X Owner X Conva0wr TYPE OF WORK Description of work: Replace sheetrock in Lower Level Conevuetion Cost" $ 51000-00 Multi-FamNy Building: (Yos i No CONTRACTOR Name: Jefferson Romes t_icensee 2090 Address'. 4530 Highway 61 City: _ White Bea-c_Lake,_ state:- MN Zip! 55110 phone: (612) 670-3686 Contact Kent Jefferson Email: tjefferson4530@aol.com COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING in the tact 1 Z months, has the City of Fagan Issued a permit for a s4rdlar plan based on a master plan? YPg __No If yes, data ana address of master plan: - Licensed Plumber; Phone, Mechanical Comactor Phone: severer 6 Water Contractor. Phone: MUTE.- Pfans and supporting documents That you submit eerie conskWed to be lvubffc information. portions of the information may be classifled as non-public NY" pt'ovide speefflC r"Sons that would permit the City to conclude dwt are trade secrets. CALF. BEFORE YOU DID. Call Gopher Slats One Cali at (651) 4544002 for protection against underground utility damage. Call 48 hours bolors you intend to dig to receive lutes of underground utilities. M=-_QoVtMMt&teon9cali.om i Hereby acknowledge that this in[wmMlon is complete and accuma. UW the v wil be in contormenoa V* on trances and codes of the City of =agar: that I unders16-4 this is not a permit, but only an application for a permit, and wont Is not to steel vKlhout a permit: that the work vAl be In acmaance with the apprc;xd plan 0 ine case of work which requires a review and approval of plans. >c Beverly Osborne, Controller Applicant's Printed Name Appt n s to for: Kent Jefferson Construction Page Iof2 ABA: Jeffersun.11Hmmes 01/12/2010 13:03 JEFFERSON HOMES 4 6516755694 NO.824 P003 01!12/2010 11:38 EAGAN ENG+COM DEV 4 94298351 Nfl.071 ~We~ DO NOT WRITE BELOW THIS LINE SUB TYPES Stann Damage _ _ Flrepiace Porch ("Own) Foundation - Singes tionily Garage Posh (4-Season) Sxtorior Alteration (Single Family) Multi Deck Porch (ScreenlGazebolPergofa) , Exterior Alteration (MuIt1) 01 of _ Plex _ 1_awsr Level _ Poo! Mlscellarieous A06e6Sory Building WORK TYPES V' Demolish Wlding• Now _ Interior knProvemOnt _ Siding _ Addition _ Move Guliding lteroof Demolish Interior VAndows pernotlsh Foundation y[ Alteration _ Fire Repair T Replaco Repair _ Egress Window Water l3amays Retalning Wall *DoenoNdon of entire building - >itv& PGA handout to spp>iciint DESCRIPTION- Valuation 4 00 Occupancy MCES System Plan Review Code Edition SAC Units (25%-100°k-~) zoning City Water ~-T-- Census Code Stories Booster Pump N of Units Square Feet PRV # of Buildings Length Fire Sprinklers. Type of Constriction V Width SQUIRED INSPECTIONS Footings (New Building) Sheatrack Footings (Deck) Fined I C.O. Required Footings (Addition) Final I No C.O. Required Foundation HVAC Drain Tile Other: Roof: -lee & Water Final Pool, Footings ~AIrIGas Tests -Final Framing Siding: Stucco Lath ___,Stone Lath -Brick Fireplace: Rough In Air Test Final Windows Insulation Retaining Wall: Footings 6ac"ll _ Final Meter Size: Radon Control Erasion Control Reviewed By: suilding Inspector k RESIIaENTI& FEES Bass Fee Surcharge f .1.s Plan Review MCES SAC City SAC f Utility Connection Charge / S&W Permit & Surcharge Treatment Plant Copies , TOTAL Page 2 of 2 Use BLUE or BLACK Ink µ~R 10101'1 i Ica i City of Ea ian ; Permit* 1 Uv 1 3830 Pilot Knob Road i Permit Fee: Eagan MN 55122 1 Date Received: Z ; Phone: (651) 675-5675 Fax: (851) 6754694 I State ; 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: Slta Addreaa m ~ Tenant: suite 1f: RESIDENT I OWNER 'Name: 0. Gt dA Phone: J - 3-3c3 Address I City I Zip. Cil L Ulm MIN ID- OF C;L CONTRACTOR Nave:.NMERT COMPANY INC.dba CUWGAN % TER Address: 1801507" ST EAST city, ' INUEIt GROVE'~i= statb• MN _Zip;_ 55.077' Phone: 65,1 '45t-2241 Contact BILL.MILBE~tT` Email: TYPE OF WORK _ New' replacement _Repair Rebuild _ Modify Space _Work In.R.O.W. Descrl Ion of wo . rk• PERMIT TYPE RE§IDENTIAL Water Heater Water Softener Lawn Irrigation L_ RPZ I_ PVB) Add Plumbing Fixtures Main / _ Lower Level) Septic System Water Turnaround _ New -Abandonment RESIDENTIAL FEES. $55.00 Minimum Water Hoter, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $35.00. Lawn Irrigation anckldes $6.00 State Surcharge) $55.00 Add Plumbing Fixtures, Septic System Abandonment. Water Turnaround' (Includes $5.00 State Surcharge) 'Water Turnaround (atld $166.00 Ifa 518" meter is required) $105.00 Septic System hm~ ($10.00 per as built) (includes County fee and $5.00 State Surcharge) $95.00 Fire Repair (replace fumed out appliances, ductwork, etc.) pncludes $5.00 State Surcharge) ZOO TOTAL FEES $ CALL BEFORE YOU Did. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before yott intend to dig to receive locates of underground utllities.• www.oopherstateonecall.oro I hereby acknowledge that this h$rmation is complete and accurate; that the work will be in conformance with the ordinances and codes of ft City of Eagan; that I understand this le riot a perms. but only"an application 'tor a permit, and work Is not to stag a permit; that the work will be In accordance with approved pla In the case of work which requires a.nvlew and a pla x h l-m ' -t? 10 Applicant's Printed Name cant's•Signature FQR OFF . S F~ev ewe $,y >f Req~r rei ` nape I.... ` .og n