4037 Pennsylvania AveCITY OF EAGAl4 ? Permit Na '?. Date:
-:7 7 i Date: I D-31-3
3830 Pilot Knob Road B/P No:
P.O. Box 21199
Eagan, MN 55127
Owner. ? 'ronL ier Yi,dwes t
:??37 Penns l?-an?+.? :`•?: ;^ 3•'; SL3ff('T;3 Place
Site Address:
Plumber: ' rar I'lumbin^
h4WCC: r `0. ClOod
City Chg: 70. !lUpd
' I
-- • 'n
Acct. Dep:
Permit Fee:
Surcharge:
CITY OF EACiAN
3830 Piloi Knob Road
P.O. Bax 21199
Eagan, MN 55121
Owner. o
S+te Address: 4Q ,;
No. 01 Units:
I agree to comply with the City of Eagan
Ordinances.
sy
SEWER SERVICE PERMIT
Meeer No: _
Reader No:
Conn. Chg: 550• Q0pd
Acct Dep:_ 15. 00P'd
Permit Fee: 10• oop"!
Surcharge:
Tr. Plant 204'?pd
Meter. lnp.? -
Misc.:
WATER SERI
Zoning: -
No. of Units:
Date: Z I-1--£tb
Size:
Date:
1 agree ta comply with the City ot
Ordinances.
CITY OF. EAGAN Permit No: Date: 1 I-1-$8
3830 pilot Knob Road
P.O
Boz 21199 Meter Na (1/y 6 .2. Size: S,?S1 oc ?
.
Eagan, MN 55721 Reader No: L 99 _ q
??--?J
?ate: la-/9-fsk
Owner. 4 ? r
Site Address: y-!Y--4-a- Ave 1 q R? c* ff,,,-,i place
Plumber
L
?.c
Conn. Chg:
Acct Dep:
Permit Fee:
Surcharge;
Tr. Plant
Mater.
AAi...
Zoning: Rl-
No. oi Units: I
I agree to comply with the Clty oi Eagan
Or
Bydlnance
/
0 P WATER SERVICE PERMIT/z),--?
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Recelpt
To be used for SF NC/GAR Est. Value $60iCOO Date OCTOBER 31 Site Address 4037 PIRAS7LY/1,2dU Al/E
Lot 9 Block 4 Sec/Sub. STAFFORD pLACE
Parcel No
w. Name FROIdTILR MID'ii'EST li0M6
3 Address ?902 {•EnARVAZ.L T+R
° City Nn.::d Phone 454-0433
-Name 8?
? i? Address
r,- Citv Phone
a
W Name _
= address
u
W City-
I hereby ecknbwledge that I have read thls application and state that the
' information is correct and agree to comply wiih all applicable 5tate of
• Minnesota Statutes and City of Eagan O?dinances.
Signature of Permittee
?A Building Permit is issued tar't.CRTI }:,'c ?iID'JEST HOffii9
• on the express condition that all work shall be done in accordance with all
appHcable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
•
OFFICE USE ONLY
On Site Sewage Occupancy R-3 X-1
MWCC System X Zoning R-1
On Site Well (Acfual) Const y'"'Y
City Water x (Ailoweble) v N
PRV Required # of Sto?ies
Booster Pump Length 58,
Depth 34 '
S.F. Total
Footprint S.F.
APPROVALS FEES
414600
Engr./Assess. Permit
Planner Surcharge 10.00
Council Plan Review 247 • 00
Bldg. Off. SAC, City 1W' 00
Variance SAC, MWCC 550•00
WaterConn. _ 550•m
Water Meter U f • ?
Road Unit Z15.00
Treatment P1 204•00
Parks
TOTAL ` ' 44T • 00
GITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55723
(612) 681-4675
SITE ADDRESS: ,
,4/03-1 ; 11W.; ?
PERMIT SUBTYPE:
, 11 , - I -;i
INSPECTION RECURD
PERMtT TYPE:
Permit Number:
Date Issued:
,, APPLICANT:
I A nvr . . , .
i:t,i.
TYPE OF WORK:
?
--------------- --------------
kf 04AI?1 ': 'A ! AI<A I f Pi IiFi t 11, Alef' Itt i.0lf 1 ki- Cl tOIR f1NY 1'1 i1M?; 1 t#rs eik fA. F i f Ir I(A1 11???K
Permit No. PermR Holder Dete Telephone #
S/W
PLUMBING
HVAC
ELECTR ? 00
ELECTRIG
Inspection Date Insp. Comments
Faotings I
Foundation
Framing
Roofing
Raugh Plbg.
Rough Htg.
Isul.
Freplace
Final Htg.
Orsat Test
Final Pibg.
7 . ?Xc?wtr
I. nspector - Notify Plumber
Const. Meter
Engr./Plan
Bldg. Final
DeCk Ftg.
Deck Final
Well
Pr. Disp.
., . . • --_ . , ,.w„+w„?..?
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21 •199, Eagan, MN 55121 PH O N E: 454-8100
BUILDING PERMIT Receipt #
To be used for S? ??/cAlk Est. Value 460s000 Date U??ORER 31 ,19
Site Address 4037 t1EMSYLVANIA AVE
Lot ' Bloek a Sec/5ub. ?AffORD pLACE
Parcel No.
oc Name
3 Addre
° City _
¢ Name
.o
? ? Addre
fK- City _
Address
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 Permittee .--
A Building Permit is issued to:__ r't''"NTZER NI034::9T !?If-'ihd3
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
OFFICE USE ONLY
On Sfte Sewage Occupancy H'3 M"j
MWCC System x Zoning R-!
On Site Well (Actual) Const Y'}l
Ciry Water x (Allowable) v"TV
PAV Required * of Stories
Booster Pump Length 51,11
Depth 34 #
S.F. Total
Footprint S.F.
APPROVALS FEES
41?. ?
Engr./Assess. _ Permit 30'00
Planner Surcharge
707'00
Council PlanReview
81dg.Off. SAC, City 100`00
550'00
Variance SAC, MWCC 550
00
WaterConn. •
WaterMeter 67•00
Road Unit 325•?
?'?
Treatment P1
Parks
l
4k?'00
TOTAL *
Building
Permit No. Permit Holder Date TN*phone ?
Plumbing ? Ci ?? • ?,? /? ? ?'
H.V.A.C.
,
Electric 187
(
Softener
Inapection oate Insp. Comments
Footings I "??? Lt
Footings II
Foundation
Framing
Roofing
Rougn Plb9. ' jfyd
Rough Htg. "Af S'
I5ul. `
r' D
Fireplace
Final Htg. B?
Final Plbg.
Bldg. Final
Cert.Occ.
Temp. LP
Deck Ftg_
Deck Final
Well
Pr. Disp.
,a
??er#tftr?t? ?f (?rru???tr?
Citp of eagan
lgpitMrtlltPlt# Df TWbtri J Ati3pPtftDtt
This Certificate issued pursuant to 1he requirements of Section 306 of the Uniform Building
Code certifying that at the time of issuance this shzccture wrrs in compliance with the various
ordinances ojthe City regulating building construction or use. For the foUowing.•
U? aa?rio. SF DiI6/GAR eiag. Ptrinit No. 15811
o«.pan,y rype R-3 M-1 Tn,,;,,g v;str;« R-1 Tyac cAnst,. V-N
own«of a,ala;ng FRONTIER MIDWEST Add,, 3902 CEDARVALE DR
euikimg A?ren 4037 PMEYLVANIA AVE ?;ty L9, B4, STAFFORD PLACE
4 - "; ,, ,' p„e; DECEMBER 30, 1988
Building Ofticial
POST IN A CONSPICUOUS PLACE
?
t
-'IF
-.I
PLUMBlNG PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
PHONE: 454-8100
Site Address
Lot % Block Sec/Sub
Phone
Name , rr7? c L'S rr C
c Address
p Ciry Phone
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE 8 CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
OF
FOR: CITY OF EAGAN
r.'
PERMIT # `
RECEIPT #
DATE: '
BLDG. TYPE WORK DESCRIPTION
Res. ?New
M ult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
Ng. FIXTURES TOTAL
Water Closet - $3 00
?-Bath Tubs - $3.00 '
-7--Lavatory - $3.00
Shower - $3.00
=Kitchen Sink - $3.00
Urinal/Bidet - $3.00
7-Laundry Tray - $3.00
?-Floor Drains - $1.50
17--Water Heater - $1.50
Whirlpool - $3.00
-' Gas Piping Outlets - $1.50 '
(MINIMUM - 1 PER PERMIn
Softenei - $5.00
well - $10.00
Private Disp. - $10.00
?-Rough Openings - $1.50 -?
FEE:
STATE S/C: -
GAAND TOTAL-
?`?? ?
., • PERMIT # ' --
MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN 11
3830 PILOT KNOB ROAD, EACAN, MN 55122 DATE:
;.T PRICE $1704.00 PHONE: 454-8100
Site Address wva i renneylvan;
Lot 9 Block 4
Name 11h1+ZEL HEATING ?
m
? Address 1y55 Shawnee R
? Ciry ?aiz-an pt
? Name
c Addre
O CitY -
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent.
Gas Piping Outleis #
Other
80,000 M BTu
M BTU
M BTU
M BTU
CFM
FEE:
S/C:
TOTAL•
BLDG. TYPE WORK DESCRIPTION
Res. xx New `"{
Mult Add-on
Comm. Repair
Other
FEES
RES
HVAC 0-100 M BTU
-$24
00
wy • .
ADDITIONAL 50 M BTU .
- 6.00
•0433 (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PEkMIT)
- 1
50 EA
24.04
COMM/IND FEE - 1% OF CONTRACT FEE
APT. 6LDGS. - CAMM. RATE APPLIES .
.
TOWNHQUSE & CONDOS - RES. RATE APPLIES
MINIMUM RE51DEN71AL FEE - ALL AOD-ON 8
REMODELS - 12.00
MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT
50 S/C IF PERMIT PRICE GQES
(ADD $ - .50
,? .
BEYOND $1,000)
25.50 .
t:
• So SIGNATURE OF. PERMITTEE
26.OU
FOR: CITY OF EAGAN t
7//S/5/ 10
/ %
?
a 65270 ,?
At,
ReQUest e .
0
/l
i/ ire No. -'vnlnsp
e9uiretl?
S) ReatlY Nax ? WJI Notiy Inspevtoi
7
.
91 ? Ves ? No NTen Reatly7
I L$licensed contractor El-owner hereby request inspection ofabove elecVical xrork at:
Jab Mdress (Streat Bm or Roule Na.) ' Ciy
4037 P s 1 Eagan
Section No. Township Name a M. Ranga M. CouMy
Dakota
DECUpanl (PRINT) - ' Phorie No.
Power Supplier ' Pdtlress
Eln.inzal Conhaclor (Canpeny Nama) CoMractor§ Licenao No. -
Monson Electric, Inc. 0397454
rna?fing iwe,ess (comacra « owre, uwwny mslanaboa - -
1711 - 118th Avenue N.E., Blaine, MN 55434
qu1Mr¢e0 Si a1 nVector er M?tan) Phnne755 ?- 6611
ti
WNNESOT S 7E BOARD OFEIECTXICRY ' THI$ INSPECTION REOUEST WILL NOT,
GrqprM Bltly. - Neom &173 - 8E ACCEPTED 8V THE STATE BOARD
1821 UnHenlry 11w.. St.Pwl. MN'S510C . UNLESS PROPER INSPECTION FEE IS :
PMne (612) 642-0BOU' . ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION
? See insvuc[ions for comaeting [his lorm on back ol yellow cnpy.
? 65270 "X" Below Work Covered by Thrs Request
o-%,? `B.2ov / I
e Adtl Rep. ' TypeofBUiltling AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Healer Eleclric Heating
Apt. Building Dryer Other (Speciy)
Comm,llndustrial FumaCe
Farm Air Conditioner
Olher (specity) ConVaaor§ Remerks:
Compute Inspection fee Selow:
# Other Fee N ServiceEntranceSize Fee # CircuiWiFeeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformer5 Above 200 _ Amps ADOVe 700 _ Amps
SIgnS InspBCtor4 Use Onry: TUTAL
Irrigation Booms `J : ? $ 15 •?
Special Inspeclion ?
Alarm/Communication THIS INSTALLATION MAY BE ORD EO DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 78 MONTHS.
1, the Electrical Inspector, hereby flO1g"'
D8?
cartify that the above inspection has
been made. F?nal oate 7,
(
OFFICE USE ONLY -
This mquesc wb 18 moMhs Irom '
18 mpnths from Id Iq6/?/d !// UA-
D 2 Q 2 81 ?.9 13!{ /?.??2lrtsCGl1?? ?1Jn nt
Y-95? -?
e-D
Requesr Date
r. .\ Fire -./ RouPh-in Insper.iion
Re rtetl?
?Heady Now Will Notify Insoec-
Ves ?NO r When fleady
Lice:fsed Elechical ConVactor - I hereby requast inspection oi ebove
ner elocirical work instelled al:
Sv Y'Address, Boz o Route No. f City
H
04
e t n o. Town iP am o. Ranqn No. C n Y
Occvpt IPfi NTI
? v?e/
.rwB.S Phone No.
f v 9
Power Suv/q? lier Addre
d
M
RI?a / /O
Eleclrical Convactor ompan Na el
` Co?t acmr's Li ense No.
??
MailinB Atldress Contractor or O
er Ma in/qI/nst Ilationl ' ?
/ L D . ?YK V Lp Ir '
AuMor' ed 5?9? ? e ( Mea or Owner Making Instnllationl Phone Nu ber
[
MINNESOTA STATE BOANO OF ELECTflILITV THIS INSPECTI(SN REUUEST WILL NOT
Grig9s-Mitlway Bld9. - Noom N-181 BE ACCEPTED 6Y TME STpTE BOARD
1821 Universitv Ave.. SL Paul. MN 55104 UNLESS PPOPEP INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
..,.u(JEST FOR ELECTRICAL INSPECTION - ee-ooooi-oe
I0 See insROCtions for complating this torm on beck o1 Valiow copy. ? f?9Js?
"X" Below Work Covered by 7his Request
F'lea4Nddj Pap.1 Type ol Huiltling 1, . Appiiancea WireE I Equiyment Wired I
Fix
Buik Mil
p Fea Service Entrence Size b Fae Fexders/5ubfexders IX Fee Cir.uits
0 to 200 qm>s 0 to 30 Am s 0 tn 30 Am
Above 200 qmps 37 to 100 Amps 31 to 100 Am s
Swimming Pool Above 700_Ain s Above 100_Amps
Transrormers Irri ation Booms Pdrtial."Other Fee
Slgns Special Inspection
Remarks ? ?
I Final
1. the c??- 00
Insoecbr, hereby
rtify thni 1he nbove
naVeetion hes been
-Zja ff 9 9G el
M 46 18
Repuesl Date
(? ? re . gh-in Inspeclbn
I
?? NOTICE: You Muat Call Elecirical Inspec[or
H A Rough-In I?speclion
` es ? N. Is Requiretl.
Xlicensed contractor ? owner hereby request inspection of a6ove electrical work at:
Job Addreas (S e?et, Box or Route No.) 14
f? ^
City
?
Sedbn No. Township Name ar No. Range No. Gounry
Occvpant (P Phone Ny
G2" t4
o
Pawer SuFylier Atldress
ElecVical Co recror (COmpeny Name) Contrdclor5 Licanse No.
c n " e?f h °
Mailing Atltlress (Contrector or sO/wner Making instelletwn1 p
?
?`7' O V'r'i7 /t77?L^' dL//'? Op1D?7'
AWhor¢eA Signatu king ati 1 Phone N mber
_...
MINNESOTA STATE BOA OF ELECTPoCRY THIS INSPECTION REQUEST WILL NOT
Griggs-Mldway Bldg. - Raam 5173 BE ACCEPTED BV THE STATE BOARD
1621 University Ave., SL Peul, MN 55104 UNLESS PROPEfi INSPECTION FEE IS
Phone(612) 812-0800 ENCLi
RE4UEST FOR ELECTRICAL INSPECTION ee-oooo,-oe
SeB inslmctions for completing ihis form an beck ai yellow copy 9
ji,
M ,!? b t51 t5 `X" Belauv WodrCovered by This Request T-"W
e d Rap. TypeoiBuilding AppliancesWired EquipmentWired
Home Range iemporary Servica
Duplez Water Heater Electric Healing
Apt. Building Dryer Load Managemem
d Comm./Industrial Furnace Other (Specify)
Farm Air Conditioner
. Other (speciry) Cortlradot5 Peerkg:
/ . /
-?
Compute Inspection Fee Below: mwerl? vG
# Ofher Fee # ServiceEntranceSize Fee # Circuits/Feeders Fee
Swimming Pool D to 200 Amps o to 100 Amps
Transformers Above 200 _ Amps 10 Amps
Siyns InspeclorS Use Only: TOTAL
trrigation 8ooms
i
Special Inspection
Alarm/Communiration THIS INSTALLATION MAV BE OR DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN ONT (
I, the Electrical Inspector, hereby Rough-in ? oaie ?
certif y that the above inspection has
been made. F;nv
44 oaie
-j
OFFICE USE ONLV ?
This request wid 18 monihs trom
CASH RECEIPT
;
?
CITY OF EAGAN .
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
.
` ,
DATE 19
•?ce+reo ? • '
._i : ? •;?`? ==l__ i .' ., ? t, i , ? • ..l _
AMOUN7
8 DOLLARS
?m
? QASH f?CHECK
? _,-
Fur+o 08i?CT
Thank You
sv
Wnim--PaYm CoPY
?
ekdo ?
Pv?
Copy
BLDG. PERMIT NO.
01-3210' Bidg. Permit
01-3422 Plan Check
01-3445 $urch./Adm.
01-344f " SAC/Adm.
01-2155 Surcharge
753860 Road Unit
20-2275 SAC
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn.
28-3855 Park Ded.
?
7
v
?-O cO
f? co
' -7 6o
a
v
TOTAL
PERMIT #:
`55yb?
CITY USE ONLY
RECEIPT DATE:
? /17/6Z
EOOE M1WIWTilkL M£CEMICAI. PERMIT APPLICATIOft
crrYoF cAexx
3930 eaor Kxoe sn
ElkHAtA EiN 55122
65i-6814675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date: LJ ? / (.P / G Z
SITE ADDRESS:
OWNER NAME: ??12 ,
INSTALLER NAME:
STREET ADDRESS:
s+1-\
TELEPHONE #: 1575 ?"" 4C7 4??
_ TELEPHONE #: (0 J 1-,3?Z?FI Z.?o
A- <..? _. 1?. G - ??X ?,[SS
cirv: STATE: ziP: 55G -o4F?S
Place a check mark next to the permit work type
Lel?' Add-on, modification or alteration to exfstina dwelling unit $ 30.00
• fumacereplacement n 2 r
i
r', f,.
? r
• air exchanger
I ?
: a
ireonditioner • I r? $_P 1_ ' ?P57
0
Nature of work:
Y - -
State Surchar e $ .50
T
t
l $ ?()
o
a
URE OF PERMITTEE
SI AT
?
1roz
CITY USE ONLY
PERMIT #:
APPROVED BY:
INSPECTOR
RECEIPT DATE:
8008 COMbIEitCIlkL MECHAN1CAI. PEiiM1T lEPPLICATION
CTfY OP E4fiAA
S$SO PILOT KftOB itD
ElkGA1V, b!ft 5518E
651-6$1-4675
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
SITE ADDRESS:
OWNER NAME: PHONE #:
TENANT NAME (IMPROVEMENTS ONLY):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
STREET ADDRESS:
CIT'Y:
TELEPHONE #:
STATE: ZIP:
WORK TYPE: New construction Install U.G. Tank
_ Interior Improvement _ Remove U.G. Tank
_ Processed Piping
SpecifyNature of Wotk:
When iustallixg/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and
Plumbing inspector.
Fees: 1% of contract price OR $50.00 minimum fee, whichever is greater.
Underground tank removaUinstallation = muilmum fee
Contract price: $ x 1%= $ (Base Fee)
State surcharge calculate at $.50 for each $1,000 Base Fee
TOTAL $
SIGNATURE OF PERMITTEE
Updated 1/02
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Ea9an, MN 55121 N? 1rj811
PH O N E: 454-8100
BUILDING PERMIT Receiptu 01?' .N ?/ (-
To be used for SF DWG/GAR Est. Value $60, 000 Date OCTOSER 31
Site Address 4037 PENNSYLVANIA AVE
Lot 9 8bck 4 Sec/Sub. STAFFORD PLACE
Parcel No
a Name FRONTIER MIDWEST HOMES
w
3 Address 3902 CF.DARVAi.F. DR
0 City F.ARAN Phone 454-0439
,o Name SAME
? a Address
m? CityPhone
i-m
Address
City_
I hereby acknowledge that I have read this application nd state that Ihe
inlormafion is correct and agree to comply ilh all a Olicable State )t
Minnesota Statutes and City ot g Ordi ces.
a
Signature of Permittee _ 10 _
A euilding Permit is issued [o:__FRQHTIER_MIDWEST HOMF.S
on the express condition that all work shall be done in accordance with all
applicable Slate of Minneso[a StaW(es and City of Eagan Ordinances.
8uilding Official_J L"?.J_?1--
OFFICE USE ONLY
On Site Sewage _ Occupency R-3 M-1
MWCCSyatem X Zoning R-1
On Site Well _ (ACtuap Conat V-N
City Water _ X_ (Allowable) V-N
PRV Required _ # of Stories
Boosier Pump _ Length 58 '
Depih 34'
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr./ASSess. Permit 414.00
Planner Surcharge 30.00
Council PlanReview 207.00
Bldg.Off. SAC,City 100.00
Variance SAC, MWCC 550.00
Water Conn. 550_00
Water Meter 67.00
Road Unit
O
325-0
7reatment Pt 204.00
Parks
TOTAL 2,447.00
?
1988 BOILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS 1 6 1 11
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
' .?
.
NOTEs ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDAESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BIIILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL ONITS FOR SALE UNITS
# OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SUAVEY - CHECB WITH HLDG. DEPT.o
1 SET OF ENERGY CALCULATIONS
COhMERC2AL
INCLUDE 2 SETS OF ARCHITECTURAL & STAUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
r 000
To He Used For: NEW CONSTRUCTIOWaluation: ?52?86- Date: 10/21/88
Site Address 4037 PENNSYLVANIA AVE
Lot 9 Hlock 4
Parcel/Sub STAFFORD PLACE
Owner LAVIN. JOHN & DIANE
Address 3925 PLEASANT AVE S 4k3
City/Zip Code MPLS. 55409
Phone 822-4389
Contractor FRONTIER MIDWEST HOMES
Address 3902 CEDARVALE DRIVE
City/Zip Code EAGAN. 55122
Phone 454-0433
Arch./Engr. pHILLIPS PLAN SERVICE
Address 14530 PENNOCK AVE
City/Zip Code APPLE VALLEY 55124
Phone U - 432-2044
On site sewage_ Oecupancy IQ-3 N/-1
MWCC system -? Zoning (Z - /
On site well Aetual Const VA/
City water =./ Allowable V,d?
PRV required _ ll of stories
Hooster Pump _ Length
Depth 3 t/ 3 3
S.F. Total
Footprint S.F.
APPAOVALS FEES
Engr/Assess Permit
Planner Sureharge 30
Council Plan Review Zo 2
Bldg. Off. ?a/21 SAC, City /D 0
Variance SAC, MWCC SSe
Water Conn SSo
Water Meter (o)
Road Unit 3?s
Treatment Pl 204/
Parks
Copies
TOTAI. , :Z <??7 l •
?+-
/
/4o
a<v k ?, ? ?,, s,
C,
? • •?
;4
Smmcllords Certificate
SURVEY FOR: 171-c,,tici riidwest Ilomcs Corp.
OESCRIBED AS: 1,ot 9, Rlock n, S'I'AFl'ORll PI,ACIi, (:ity of Gagan, IlAot'l
County, P•linnesota aiid reserving easements oP recorcl.
v
R r 9e `p ??
?a, a p Op,.
---? Op App
%° 4F, ac,? SFR \
• ry ? \ ??? V 4OC
ds -oo„ 4 nO"
0
a• 86+s ? e ?s ' ,?
M !S
\ catily? ? aa
0.?p 6''' \ H?j 7 1
.i 1 tiT? ! I F?^(d1' ' C'idn * /
, ? ? / \ `\ Shl J N ..
O? ? S 34 Z) o?'? ry 9`' ro ?h
?
?
f\` / ? \y w? i
N
6 ? \\ -
g?3 \ b6
M
Ns9e °
o° k?\ ,tio
\ 5 2
9q ?
98
• ??\ ` •
v ?i
By
-•--?.,_.. _
Dat
EACAN ??GT? `4'1D.
PROPOSED ELEVATIONS ? 1015 bc7 81AL?KouALS
Tov or Founaot+on 'g7o.o4'
Garage Floor ? Sc .'•.S .
Bosemenl Ftoor : ec. 1,0 i MIN. SETBACK REOIREMENTS
Approx. Sawer 3errice Elev. • e57.5'- 1
propoesd Elsvotlone ? Q Fronl -*30 House Slde -I?
Eaietlnq Elavolians ?
Oroinopa Direellons '....... Rear -15 Oarape 81M- 5
DenoteeOl/sat Stahe I O SCALE: tlnch • 30 Feef , -- I Mrgly arllry tuet Mb wrwr, Oron a npert wes PnPanA M ma JOB NO.:
IAIEDLUND er uoe.r my einn supervldon anA Inel 1 sm a Aulr RsOi+ifnd $8P - 53G
lanA 8urvoya une.r mf lans •r ms emn d Mlnnewta. 8OOK.
Planninp Errglneeting Surveying
?»ie.xnevM?nonn«w eiaemhqmn.wx.w.a.tHx D PAdE:
t.iwxa+??inwmw pebt lot \0, 06
? a ?ran, Llcanda Na14379
! ZJ(Ip STLIDS EXTERIOR ENVELOPE_AVERAGE '.U"__COMPnlllliUn
OWNER: LAVIN, JOHN & DIANE f1ATf :_
S?TE ADDRESS: 4037 PENNSYLVANIA AVE PNONE: 454-0433 FRONTIER
CONTRACTOR: FP1Ji..ITlr`c?L l?oi`1kS PLAN # WI t,S+-Ik (Zc
Determine working square footage of each
1. Total exposed wall area..... sq. ft. x.11
2. Total roof/ceiling area..... g12- sq. ft. x.026 = ZZ.1
Total exposed wall area above.floor=_ Ils 2- S
a.
b. Total
Total wall window area .............................:.............
door area .................................................. 1Z-1
SCo
c.
d.
e.
f.
g. Total
Total
Total
Total
net sliding glass door area ....................................
fireplace wa11 area ........................................
wall framing area (average 10%) ............................
................
rim joist area .............................
wall area a6ove floor ...............:..................... ?
Zl?
I Z q Z
h. wall area a6ove floor ..........:..........................
i.
j. wall area a6ove floor ...............:.....................
frame wall area at *oLnndation ...................................
Total exposed foundation area=
k.
l. Total
Total foundation window area .......................
net foundation area above grade ..............
Determine "u" value of each wall segment
(e.g. window, door, each separate wail section) .
a. izt X „U„ ,4? = S`?.3
b. Jr? X '°U"
C. X „V Jt0,J .
d _ X liu.,
e. 1'1S X l.ull
f. iZlo Xliul.
9. lZ4z X liuii ,04 = q`1,1
n. X ,tuii
i. X ltuii _
lll
X u
•
J
f item p3 is the sar
r X„u„ = as, or less than iter
nl, you have met the
1, X"U" = intent of SSC 6006
3. .....
.....................Total
.......
C
Total exposed roof/ceiling area = E31 Z-
? m. Tbtal skylight area ............................
n. Totzl roo`/ceilin,.framing area (zvcrayc 10?)-•-
o. Total net.i.^.sulate3 roof/ceilinq area...........
Determine "U" value for each roof/ceiling segment
m . X "U" _
n. 6?_ a ?.Ull OZ •-- - 2, ?
?. `I85 X .1U.. oz = is?l
a........................... TOtal = !-1• S
total cf T4 is the same as, or less than N2, you have met the intent of
SBC 50Q5 ;r_1
rlternate Building Envel.ope Des'ign
2b utiiiza tne total enyelope'system method, the values established by the s'.un of
items.;:3 and =4 shall not be 9reater than the sum of items $1 and #2.
1. ?c1Z, V + 2. Z2.? = ZZScP
3. ?103; l + 4. ?1,g
PLAN # \.4 I L-5 N i R.S
* LINFAL Fff.T EXPOSID WALL
BLfJCK:
KNEE: 38+36fi1q+7-1 -.:-iz...?
w.o.:
fuId. 1: 38 ?38 ? zS+ ZS = ? Zco
FtJLL 2: •
FIREPLACE:
RIM:
* SQUARE FEET EXPOSID WALL ARFA
BIACK: x .5 =
iQ1EE: IZ9 x 5 =lpZD
W.O.: x 8 =
FULL 1:11(q x 8 =)006
FULL 2: x 8 =
FIREPLACE: x =
RIM: 1Z(-P x 1 = 17.(p
I?',?
* SQUARE F'EE'P F.XPOSID CEILING glZ
Ly 3 cP 59
Ilu Z498 = 3ti
14 -zo t, o : 25
'?
? ni5_3to
1° ?20
PATIO DOORS
s`=34
* aasEIarr urrrrs
wou ?e?..?-+?-?o
V)se 156z, of opaque Wa! 1 area for
' fYar+?e ccx?struCf?oi. R- VAUJE
CONSTRUClIOIS -- FRAMING - -
1. INfERIOR AIR FILM 0.68
2. 2 BD .45
3. 5 1 2 SOF!' WOOD 6.
4. -
5. SIDING .6
6. EXTERIOR R IIM .17
TOT&L R= 10.8
U= .09
NET
i,
1. INTERIOR AIR FiIM 0.68
3:'_` 2 BD . 5
3.
4. 25/32 SHEA'IHING 2.06
5. SIDG .6
6. R 0.17
U= .04
s, tt I Se-4LeR
{ti.rrDhT7cm
WhLL
1. INTERIOR AIR FILM 0.68
2. 6 INSIJL. 19.00
3. x JO
4. 25/32 G
5. S G
6. OR AIR LM
U= .04
BLACK
1. INTERIOA AIR FILM 0.68
2, i
3. STYRO S.
4. PROTECfIVE BARRIER
5.
6. EXTMOR A R
TOTAL R= 7.1
U= .14
r ? . A3 ??.?,..,.
?
L ?
i.. ?
FZ.G. a4
0 - ? 1
`r
1??
!F? ? ? ? D a
fl3 , , °
?L S. ?l•_ a
1« 1(I ? fil = It( ?
1 r 1
i r3c.
?
w `{
.,• lfl
;o , NOTE: INDICATE TYPE, "R" VATI7E. DEPTH AAID
IV, ? PLACIIMENi' OF INSULATION.
SLAB ON GRADE
RCOF-CEILING
CONSTRUCPION ' R-V.ALUE
_i
JF? 4
_ 4-- ?
}l ?
yII1i'Ep ` A FEAT FLX)W
'uUP
FIG. #5 .
1. INZ'ERIOR AIR FTIM 0.61
2, b/a° uzr. nu. •--
3.
4. U.bi
45.80
TOTAL
U = .02
MP,ME
1, INT'ERIOR AIR FILM 0.61
'l. S/tl" IiYY. CL.
4.
U = 0.024
CONSTRUCI'IOId
f I HFAT FLOW UP
Ll
FZG. #6
4
. .. ' :
...?•";?
. ? • ? ? i ? ? i?N .
-?• - •••' ?
'A •
? NON-VEMI'ED
HFAT FIAW
UP
FZG. #7
5 ,,.•;`
?
1. INSIDE AIR £ZLM 0.61
2.
3.
4.
5. 0.17
F'WE
1. INSIDE AIR FILM TOTAL
U =
• 0.61
2.
3.
5. U.11
1. INSIDE AIR FILM u _
0.61
z.
3.
4.
5.
TOTAL
U -
NOTE: USE ADDTTIONAL S=S IF' 14ORE SPACE IS
NEEDED FOR DEI'AILS AND CALOUL.ATIONS.
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: LOT : 9 g L 0 C K: q APPLICANT:
4037 PENNSYLVANIA AVE BENDZICK BLIJRS
STAFFORD PLACE (612) 496-0553
PERMIT SUBTYPE:
BASEMENT FTNT5F1
TYPE OF WORK:
BUILDING
022924
F72/08J94
ALTERATION
INSPECTION .. . ..
FRAMIN6 7NSULATION
ROUGH IN PLBG FINAL
REMARKS: SEPARATE PERMIfS ARE F2EQUIRED FOR ANY PLUMBING OFt ELECTRTCflL WtlftK
?
?
L ?
f .?
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT ok- i 71
? ?f
PERMIT TYPE: ? i. pN r,
Permit Number: 022924
Date Issued: 0 2/ 0$/ 9 4
SITE ADDRESS:
4037 PENNSYLVANIA AUE
LOT: 9 BLOCK: 4
STAFFOK20 PLACE
P.I.IV.: 1.0-72500-090-04
DESCRIPTION:
Bpilding'.Permit 7ype
Building Wbrk 7ype
?
i ?
%
\ J
BASEMENT FINI5H
flLTGRATTON
?,.
???,?i?
?3
REMARKS:
SEPNRRTE PERMITS ARE REQUIRED FOR ANY PLUMBING OR ELFCTRICAL WORK
FEE SUMMARY:
Base Fee
Surchargc
Lic. Search Fee
ToY.al Fee
$35.00
$.50
. 0 0,
$40.50
CONTRACTOR:
BENOZICK BIDRS
%31 W 96TN ST
CHANHASSEN MN
(612) 496-0553
- flpplicant - ST. L7C
14960553 0005884
5531"!
OWNER:
AVIN JOMN
037 PENNSYLVAN]:A AVE
AGHN MN
612)687-0618
2 hereby acknowledge that I havs read this applir.ation and state that the
information is correct and agree ta cumply with all applioablo State ot Mn.
5tatutes and City of ragan Ordinances.
L
APPLICANT/PERMITEE SIGNATURE
? 1(N I1.D1 ? ieCl
?EDB :S
I
.-r? . r?
; ?-a,,?.??01?ED
tq CITY OF EAGAN ?
1994 BUILDING PERMIT APPLICATION 1 •J?a
681-4675 F E B 0t1994
L-2.-L
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & 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 Valuation of work Ao, od-d "°
Site Address: 11037 1?eKnry/?.n;w If?1e,
?
STREET
SUITE #
Tenant Name: (commercial only)
LOT SIACK ? SUBD. ?Tb? P.I.D. #
Descri tion of work: se.?
The applicant is: ? Owner 9 Contractor ? Other (Describe)
Name _l-qv j a J '4n Phone 0'7'64/Y
Property LpsT FIRST
Own2r pddress Wo37 ?enKS.j I'J"HIc?
STREET STE #
City I? State A3 Zip
Company Phone
Contractor Address -731 W`j4? Sf • L9cense #Sb'ff, Exp.33i-?,K
City State -*1?7 ti/ Zip sY317
Company Phone
Architect/
Engineer Name Registration q
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:
? rT y
OFFICE USE ONLY
BUILDING PERMIT TYPE
O 01 Foundation ? 06 Duplex ? 11 Apt./Lodging
? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc.
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace
? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck
WORK TYPE
? 31 New U 33 Alterations ? 35 Tenant Finish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Engineering
REGIUIRED INSPECTIONS
? Site
? Wallboard
Basement sq. ft.
lst F1. sq. ft.
2nd F1. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Building
Variance
? Footing
0 final
0 Framing
? Draintile
y3
o/
?
B
0 Insulation
? Fireplace
Permit Fee
5urcharge
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:
vawac;m: g
?
r ,
4 I ?
,f8'16 Basement Finish
0 11 Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
? 37 Demolish
MWCC System
City Water
PRY Required
Booster Pump
fire Sprinkler
Census Code
SAC Code
Census Bldg
Census Unit
Assessments
SAC %
SAC Units
s-
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
NEW CONSTRUCTION
?.BB-ON ?JC
? ADD-ON FURNACE
FIREPLACE INSERT
DATE
FEES
HVAC: 0-100 M BTU $ 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS (MINIMUM 1 @ $3.00 EACH)
ADD-ON/REMODEL (ExisTtNG coNSTxucrloN) $ 20.00
STATE SURCHARGE .50
TOTAL ZD6t>
SITE
OWNER NAME: TELEPHONE #:
.
INST
- ----- --•--.. .,...?...
ADDRESS: i????•??•??f22
CITY: STATE: ZIP CODE:
TELEPHONE #:
'UR1994 MECHANICAL PERMIT (RESIDENTIAL)
?FPERMITTEE
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
1994 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO COMPLETE
FOR APARTMENT BUII.DINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE
PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
uraTE:
CGiv`PkAI;T YKl(:E:
NEW BUILDING
INTERIOR IMPROVEMENT
WORK DESCRIPTION:
FEES
1% OF CC7N1",C?C."F' FEE $
PROCESSED PIPING: $25.00
MINIMUM FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF PF?,RIVII"? FEE.
TOTAL $
Sri'E AUDRESS:
OWNER NAME: TELEPHONE #:
TENANT NAME: (IMPROVEMENTS ONL1)
INST
ADDRFSS:
CITY:
TELEPHONE
STATE: ZIP CODE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
PLEASE_ COMPLETE FQR SINGLE FAIvIILY D.WELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS .W<HEN PERM'ITS ARE:REQUI'RED FOR EACH UNTT.
----------------- -- -------=- --------- --------
? ----=------------------------- ----------------
NO.. ,
FIXTCI•RES
EACH TOTAI,
SI=IOWER 3.00 _3, nc,
? VJATER CLOSET 3.00 3, oD
BAT,H _TUB 3,00
= LAVA`FORY 3.00
' KITCI-iEN SINK 3.00
LAUNbRY TE€AY 3.00
HOT TUB%SPA 3:00
WATER HEATER: 3.00
. FLOOR DRAIN 3.00
GAS P'I'PING QUTLET • minimum - 1 3.00
ROLJGH OPENINGS 1.50
WATER SOFTENER 5.00
PRIVAT'E D`ISP. •bek.cry. iic. 20:00
U.G. SPRINKLER 1 nomevnder;oonsr. 3.00
ALTERATIONS • to gusting ZO:OO
WATER TURN AROUND 20:00
STATE SUR'CHARGE .50
TOTAI 50
P1D
.:
CITY: QL\kJ?+?I-"?? STATE'; j(Ylt? ZIP CODE:5?4L
PHONE #:
SIGNATURE OF PERMITTEE
". lYY9YLUMIf'liVlrYL'K'lY1?1Y"(1(L'JlUr.N11AL)
CITY OF,EAGAN
3830 PILOT KNOB RD
EA'GAN MN 55122.
(¢12) 68I4625 .
SI^TE AD.DI2ESS: !A:1-C)'I ``F't!21')5t /l UQ.YtfQA-
OWNER NAlv1E: ?3??n '4'b(Xti1e.. l.u.V i r\
PLEASE, COMPI:,E'TE``FOR, AL:L' CQMMFRCIAL/INDL7STRiAL. BUILD,INGS;> ALSO?F'OR Mi
FAMILY BUILDTNGS WHEN SEPARA'TE PERIvIITS ARE NOT RE`IJIRED' `FOL3 E
DV?ELLING UNIT.
_ NEW CONSTRUClION ? ADD *UN `
REFAIR <
"vJOkit DESCRI-PTION:
....,. .; ..:.:.
STATL SURCHARCrE $.50 EOR EACH E1,000 OTi 3!ERM?f'tFEE.
11fINIAtU11't FEE $ 25.00
CO'TRAGT PRICE X 10/c $
STATESURCHARGE
TOTAL
$
e
1994 PLUMBIN;G:;P.ERMTF a(COMIVIERCIAL) -QE? F.?1GA1?T ?:3830'PIIAT'KNUB RD
FAGAN MN 55;1;22
(612)K,6814675
APFL=TION FOR PERMIT
SEWER ANQ/QR WATER CONNECTION
. . , , . .. .. ..
,
i N01•E: PAYhII?TNr OF FEE AT TIME OF
? APPLICATION DOFS N7P CON- .'t
• SPi7V1E APP3K°idAL OF PFRFIIT. i
y IISSPHCi'ION OF SEFR'R ACD/OR WA1ER .*?
? II1STNdATIIX1S WIIJ. N(7f' HE S'nnn.vri ?
? [![dl'IL PBtFIIT HAS BEIS] APPROVID. ?
•x+»xx+?+e?x? trf ? ??wxRrt,e?:?3y+?xivrfwe:
OF eClgai9
(PLEASE PRINT
1) PROPERTY ADDRESS: 4037 PENNSYLVANIA AVE
T,Fl:AT• DFSCaIPTION: LOT9 - BLOCK4 - STAFFO-RD - - - - - Lot B oc S ivision or Tax Parce ID
IF EXISTING STRUCTLIRE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: N/A
Nbnt Year
PRESENT ZONING/PROPOSID L'SE:
Q .CONA"JERCIAL/RETAIL/OFFICE
Q INDOSTRIAL
Q INSTITUTIONAL/GOVEE2PA'IENT
ED R-1 SINGLE FAMILY
? R-2 DUPLEX (3WO Units)
Q R-3 TOWNHOLiSE (Three.+ Dnits) ( Lnits)
Q R-4 APARTMENT/CODIDOMINILM ( Lnits)
21 ? NA&E: FRONTIER MIDWEST HDMES CORP.
ADDxESS: 3902 CEDARVALE DRIVE
CITY, STATE, ZIP: EAGAN. MN. 55122
PHONE: 454-0433
3) NAME: STAR PLUMBING
ADDRESS: 1018 MOWND SPRING TERRACE
CITY, STATE, ZIP: BLOOMINGTON. MN. 55420
PHONE: B84-4149 MAS'PIIt LICENSE # 3329
I? Active
i FSxpired
Not recordec
St Initi
? .. • a??
4)
NAME: LAVIN. JDHN & DIANE
ADDRESS: 3925 PLEASANT AVE S. #3
CITY, STATE, ZIP: MPLS. MN. 55409
PHONE: $22 4389
5)
FX7 CONNF.CTION TO CITY SEWM X? CODII9ECTION TO CITY WATER O OTHII2
6)
*****???******+**?***+***+*****,?*******?**?*****,?****?*******.?***,r*********???*****?*****?********,
*
THE GOLD COPY OF TfE PII2NIIT WILI, BE SENf DIRF7C.TLY TO PUSLIC FARKS ZU FACILSTATE MEPER PICK-OP. ;
?*. PLEASE ALLOW 7W0 WORKING DAYS FOR PROCESSING. SONIDONE FROM TM CITY WILL CONPAGT YOU IF THERE .'y
* ARE ANY PROBLENIS. y
?*«*****+**,?***??******??#**,r**?**?**x****?*?+***?*?**??******?*****?****??******?r*****?*+**,r*?***;
FOR CITY USE ONLY
PERMIT # ISSOED
I ml e? S U I
Pd w/Bldg. Permit FEES:
$ S? $
$ S 2) $
$ C' L' $
$ $
$ $
$ $
$ 0-?d $
s -?`"?S?c • c ? $
$
?• S?'' _- C* 7,
$
$ $
$ $
$ $
$_ $
$__ $
S /-5 Z $
RECEIPT RECEIPT
SEWER PERMIT (INCLLDE SURCHARGE)
WATER PERMIT (INCLDDE SL'RCHARGE)
WATER METER/COPPERHORN/OL'TSIDE READER
WATER TAP (INCLLDE CORPORATION STOP)
SEWER TAP
ACCOUNT DEPOSIT - SEWER
ACCOLNT DEPOSIT - WATER
WAC
SAC
TRLNK WATER ASSESSMENT
TRUNK SEWER ASSESSMENT
LATERAL BENEFIT/TRUNK SEWER
LATERAL BENEFIT/TRliNK WATER
WATER TREATMENT PLANT SLRCHARGE
OTHER:
TOTAL
DOES UTILITY CONNECTION REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN A"PERMIT FOR WORK LQITHIN POBLIC
Q ROADWAY" MUST BE ISSL'ED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SLBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE : ? ? ? ? ??
?? ?"??7.?dl?i?l?" .
Cus?ortwr'c Name _? ? LS YI ? 1? C
Gty
I/K 44??
Hesidenti:d
Who% House Worksheet
? ? . , . . .?,., ,?,. ,...y... .
AdOruu . . . . .. _ _... ? .
SWtB 4TelapAotyNUmber
WINTER: Inside Drsipn Amp . . _.. .. .? . .
F-Outsitla Design Tamp •?U °F . Mestinp Tsmp Diflennce 17 g ... - p
SUMMER: OuUitle Desipn Temp . ?? 'F-InniCa Deeid n Tem • ` .. .. ... .. .•
P CuotinpTomp•Di:• N.er:
: .encs ••.1!. F '
HEATING . .. . . . . ...... - - - . __ .
TAIIIE A-11EATING- _ -• ?•• ?vJ'? "'
IPER 10°FI . DOOHS b WOOD FRqME WINOOWS
Fw aLJin;1yy» d,ors . ucn Iactors lor Ih, Wme Jl'Pa window
?l-atn111 .un. . .
W?nduw b -- Framu s
Oanr Types
5rt?ylu VanO _ Wond
_'_ TIM Matal • A'sO . Btub Lois
Clesi 9.90 10.45 11.55 '
Wnn 5?orm ? 5.2
5
6
GoULk Yu?
- .
,
N__
6.o?
7.25
? s'S
6 3
t 3
8
5
4
90
.
.__ .
. ?•?.?? ? 3.:i0 4.35 5.46 ?
- - 11.0
iWrT
_?
y?nglf I1.07 1I.69 12.82
?
- ----
- 7 35
bJ5 - -
i,,.oi -_
WuoqUn!Y 4.li(1
iM_Sln.>Ioim I- I - 1 1.70
TOTALS l?l I /O $3
1Pi???t C - ADJUStM1.NTfACTORS .- INFA'fINGI
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?
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA108149
Date Issued:11/19/2012
Permit Category:ePermit
Site Address: 4037 Pennsylvania Ave
Lot:9 Block: 4 Addition: Stafford Place
PID:10-72500-04-090
Use:
Description:
Sub Type:e - Furnace
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to Mark Anderson , State Electrical Inspector,
952-445-2840
Lisa Skogen
5660 Memorial Avenue North
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Betty M Schofield
4037 Pennsylvania Ave
Eagan MN 55123
Hoffman Refrigeration & Heating
5660 Memorial Ave. N
Stillwater MN 55082
(651) 439-5770
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA162958
Date Issued:08/06/2020
Permit Category:ePermit
Site Address: 4037 Pennsylvania Ave
Lot:9 Block: 4 Addition: Stafford Place
PID:10-72500-04-090
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Carrie L Roseth
4037 Pennsylvania Ave
Eagan MN 55123
Window Store Home Improvements
2924 Anthony Lane #115
St Anthony MN 55418
(612) 353-5780
Applicant/Permitee: Signature Issued By: Signature