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4375 Pilot Knob RdINSPECTION RECORD CITY OF EAGAN PERMIT TYPE: ?839 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: .??' ;? • (612) 681-4675 ' SITE ADDRESS: I 1A 04 r APPLICANT: , 1 1 ; kNtiN frU t;•;i , 11'.1 r;i 1! ! t'fifltl ?.li1:!'.;l?M ALt? f'i It:l.'? ?f'•°4 ',lt? F- -- ? L PERMIT SUBTYPE: TYPE OF WORK: Permit Holder Date Telephone M PLUMBING H VAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLQG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HVOROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CITY OF EAGAN Remarks /? so.?5? Addition CARLSON ACRES Lot 14 sik 1 Parcel ? Owner VO-? ?Y1 E 1r ?' J-3e Y -&.G1,-- Street 4375 Pilot Knob Rosd Scate EaQan• MN 55122 ' r 1,14P Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK Z 1973 175.00 8.75 20 Paid SEWER LATERAL WATERMAIN WATER LATERAL 1972 920.00 61.33 PZt1CI WATER AREA 35 1977 160.00 66 15 P id Coo2449 7 21 76 f STORM SEW TRK V STORM 5EW LAT CURB & GUTTER SIDEWALK STREET LiGHT WATER CONN. BUILDING PER. SAC PARK CITY OF EACAN WATER SERVICE PERMIT 3830 Pilot Knoo Road - P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DNTE: ' Zonlnp: No. of Units: ? . er Zlin?e ?? 5ite lldd rrcas: Plumber. .. • r ? • (kt?r No.: 3 q ? oZ 5y 0 22i Connection Chorqe: Size: Aocourrt Deposit: 15,00 t?rReader (Vo.: /)? `3 Permit Fee: ' (1 , (in c f) ?, ? 1aOrN to oo?pl? will? !IM Cilfr *i??y?w $urcharge: = Ordieaaar. By _ Date Mtsc. Chorye:: 61QL, nd met er TotoL• n d a 1 r_ Date Paid: I nsp.• CITY OF EAGAN 1NATER SERVICE PERMIT ? 3830 Pilot Ifcnclb Road pERMIT NO.: 6097 O.Box21199 P z.l?'+1?S . Eagan, MN 55121 . DATE: 1 i` No. af Units: r+p: , Zonl P<• ? r,r Z• '?j.Tl?? f . . . Owne?: ress: - /lddress: umber lt?e?- Vin?e ?c?(1 0? vcl Connectian Chor9e: ? r No.. ?t: ? ? iit Fea: P em ;1? der No.: yiw to eowvh r?Mr eY CMp of Eqp¦ Surchorflst r,A L.ater ' Misc. CFwroes. - Totot: pate Paid: By Irap.: 'Date af Insp.: Y OF EAGAN SEWER SERVICE PERMR ) Pilot Knob Road , ^ • ? . Box 21199 PERMIT NO.: -::?... in, MN 55121 DATE: np; No. of Units: ral.ucr t'inge er; ?ess: Addrcs?'"r ri.lot iber. "aliner Cin9B ? r??/rc 5)1?0 ' • ` ? 'lfrN 1O p?y wNh 1w City Of Losem ConMCtl01f U?O/p!: - ? OM. /?10COUf1t DlD?= • - . ' t! P NII 7 Permif FM: ' Surchoroo: . Misc. C]hwrpm ? of Insp.: Totd: Dah Poid: .s......: EAC;AN TO'VIlN 5 H I P Address (present) Buildes ........ Address ...... BUILDIiVG PERMIT .............. DESCRIPTION .. v h'U 189 Eagan Township Town Hall 5tories To Be Used For Fsanf Depth Heigh! Est. Cos! Permi! Fee RemarkR 144e.04 J?o ai f'? LOCATION Street, Road or other Descriptian of Location ! Lo! Slock Additioa or '1'rac! ?'` I /y / Ccsrlson /Qc r es This pe ii does noi authorize the u oi sYree2s, roads, alleys or sidewalka nor does it give the owner or his agent the ri to creale any situaYion which is a nuisance or which presents a haaard to the health, saiety, convenience and general welfare fo anyone in the communi . • THIS PEAMIT MUST E ON TH ?EMISE WHILE THE WORK IS IN PROG . / .__ _______.__has permission to ereci a----- ?_.- _ ___________________________upoa This is !o cerlifp, fha3_. . the above desc ibed emis subject sions of the Building Ordinance for Eagan Tow?y? adopied April 11. ...... ..... ? . vr r? .............•-••-•••-.••-•._.._......•---•-•-•--•---•....... .w. _.. ..............-•-- Per .... ?--•-?--................---..._. hairman of Town Soard Buildin4 Inspecios "? 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION 4City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos when permits aze required for each unit oete 5 ? /? ? es Site Address y3 /75 /0i "lof Kna h 104 Uo;t « s a? Property Owner Tetephone tt 00 ?Jr Contractor ? I l Me ctianr C-n 1 Street Address 3,301 OC h U (3f Na 4), City ?! /3 State m N Zip 5 5 I 1? Telephone #( Bond #: >2L z 5? 3/ 5 9 Egp,res: aoc)5 The Applicant is _ Owner ?Conhactoe _ Other Add-on or alteration to existing dwelling unit $ 30.00 furnace _Additional _Replacement ' air exchanger air condit ioner New Replacement n ? other State Surcharge; . $ 50 Total $ ?,?(?, 5O I hereby apply for a Residential Mechanical 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 with the Mechanical Codes; that 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 o s. h??s ?< ? Qx?crl? ? ? ApphcanYs Printed Name ' icanY Signature IIn n? ?? ?av 2 0 2oa5 2005 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for. commercial/industrial buildings . multi-family buildings when separate permi[s are not required for each dwelling unit Date Site Street Address Unit # Tenanf Name (if applicable) Previous Tenant Name Propeity Owner Telephone # ( ) Contractor Street Address City State Zip Telephone # ( ) Bond #: Expires: The Applicant is ? Owner _ Contractor _ Other Work'I'ype New Construction _ Underground Tank _ Install _Remove **see below fnteriorlmprovement - InstallPiping _ Processed _Gas Nature of Work: "When insfalling/removing underground tank, call for inspection 4y Fire Marshal and Plumbing lnspector PefmiG Fe¢s: 570.50 Underground tank installatior?removal $50.50 Minimum (includes State Surcharge) or ContractValue $ x 1% _ $ PermitFee • If ermit fee is $1,000 or less, add $.50 _--:1 $ State Surcharge If ermit fee is over $1,000, add $.50 for every $1,000 pe rmit fee $ Total Fee i hereby apply for a Commercial Mechanical 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 with the Mechanical Codes; that 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 acwrdance with the approved plan in the case of work which requires a review and approval of plans. Applicznt's Printed Name ApplicanPs Signature Approved By: ,Inspector -dY?a-?Y- 3C.C 2004 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date?/:z 10 5ite Street Address Y3?J`? ?16o1r_/4t-A1od oe- Unit # PropertyOwner Telephone# ((/,t) 600 "7d73 ?&_'r `a"" Contrector tl?,6iAJ Z..%64 046Q.4 pf ?/? Telephone #((,371) c/,5Z- IJZS Address / 71o i9l.fi.r•4?A.£? -,eA City State X4AJ Zip S? /Z ( The Appiicant is: _ Owner __?Contractor _Other Alterations to existing dwelling $ 50.00 _Add fixtures to rooms, excluding water softener and water heater _Septic System Abandonment _WaterTurnaround (add $121.00 if a 5/8" meter is required) J?_Other: /4kf'L!)C-6- A[? f/ fa.C r7,_v6 le,971111 t.?.s'G2 P,E Water Softener XWater Heater g irnn ?z replacement _ additional Lawn Irrigation System RPZ_ new _ repair _ rebuild $ 30.00 State Surcharge • $ 50 SO ? Totai $ I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accordance with the approved plan in the event a plan is required to be reviewed and approved. n .a . e?gA?:, L 14-11 G4 c/ S Applicant's Printed Name Signature rr? ' RFIS ?QU? EP ?0 S 2004 . ? RESIDENTIAL BUILDINC PERMIT APPLICATION CITY OF EACAN c? 3830 PILOT KNOB RD, EACAN MN 55122 651•881-4675 New Comtruetlon Reauiramenb • 3 registered sde surveys showirg sq. fl. of lol, sq. fl. of house; and all roofed areas (20% mazimum lot coverage a0owed) • 2 wpies of plan showing beam & window s¢es; poured (ouM desgn, etc.) • i set of Enmryy Calculaliom • 3 cropies of Tree Preservation Plan if lol platteC after 111/93 . Rim Jaist Delad OOtions selection sheet (bldgs with 3 or less unila) DATE '-p / 1 4 I02 RemodaUReoair RaauiremeMs • 2 copies ol plan . 1 set of Eneyy CakaJatians for heated additions . t sile wrvey fa exleriar additiore & decks . Indicate if hame served by septic system for additions l_.D2LD? • S?-P VALUATION ?o SITE ADDRESS TE7 MULTI-FAM4ILY 9LDG _ Y _ N TYPE OF WORK T/P-\ _k'?,z)QV FIREPLACE(S) _ 0_ 1_ 2 APPUCANT STREET ADDRES3 TELEPHONE # CELL PHONE # FAX # PROPER7YOWNER 4L. _Lnrfleu TELEPHONE# ?54 CDQ)1 ?`J ----------------------------------------------------- ----°----°°-----------°----- COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ ;b(IVNESOTA RULES 7670 CATEGORY l MINNESOTA RLII.FS 7672 (J submission type) • Residenfial Ventilation Category 1 Worksheet Submined • New Energy Code Worksheet Submitted • Energy Envelope Calwlations Submitted Plumbing Contractor: P(umbing sys[em includes: Mechanical Contractor. Vfechanical system includes: Sewer/Water Conhactor: _ Air Conditioning _ Heat Recovery System Phone # Phone # Fee: $70.00 ----------------------------------------------°-------....-----------...----°---------------------------------°--°--° I hereby acknowledge that I have read this application, state that the information is correct, and a comply with aii applicable State of Minnesofa Statutes and City of Eagan Ordinances. rr ? ,YI Slgnature of Applicant OFFICE USE ONLY _ Water Softener _ Water Heater _ No. of Baths _ Phone # Iawn Sprinkler No. of R.I. Baths ZIP Fee: $90.00 JUN Certificates of Survey Received _ Tree Preservation Plan Received _ MofRequired _ Updated 4l02 OFFICE USE ONLY t . .. ? 01 Foundation ? 07 05,plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? OS 03-plex O 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex 0 12 72-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Additlon ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 WindowslDOOrs 0 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bidgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) _ FinallC.O. _ Footings (deck) _ FinaUNo C.O. _ Footings (addirion) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & W ater _ Final _ Pool _ Ftgs _ Air/Gas Tesu _ Final _ Framing _ Siding Stucco Stone _ Fireplace _ R.I. _ AirTest _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC W ater Supply 8 Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Totat L ? ? BL _0 CITY USE ONLY SUBO. c APPROVED BY: - , INSPECTOR C':ON12tt1C 1 YFUI,E: 1999 M£CHANICAL PEiMIT (COblbl£RCIAL) CITY OF EPkfiAN S$SO PILOT KNOB fiD fAfiAN. MN 55122 (651) 681-4675 Please complete for: all commerciailindustrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: WORK TI'PE: _ New conslruction _ Interior Improvement RECEIPT #: i ? ? ? ?l! a RECEIPT DATE: MECHANICAL PERMIT#: Install U.G. Tank ? Remove U.G. Tank (Minimum Fee) Processed Piping (Minimum Fee) ?**NOTE: When installing/removing underground tank, call 651-6814675 for inspecrion by fire marshal ? and plumbing inspector. DESCRIPTION OF WORK: FEES: 1% of conffact price OR $30.00 minimum fee, whichever is greater. CONTRACT PRICE x 1% PERMIT FEE 3? . G STAT'E SURCHARGE ($; SO per $1,000 of nem2't fee due omall; pemuu ),., , ? . . . .'... . . . . ?? . . , f•°..,,.,,ss : . ToTAi SITE ADDRESS: o r .4t:?Xe ., 4 't cz OWNER NAME: h.- y+ -P TENANT NAME (IMPR VEMO?ENTS ONL17: v INSTALLER: &? f',nr lf -?A s rs, "- y'e .S F i!+ G/ d L J ADDRESS: 9Gr/ e- i5L-,4 x.x"?z PHONE #: 3"2 --2 22 ^-??27 ? (AREA CODE) CTI'Y: S?i _'? .P ? L STATE: sy, s? ZIP: PxoxE #: 6j,-, (AREA CODE) SIGNATURE RMITI'EE L^T BL SUBD. CITY USE ONLY RECEIPT #: RECEIPT DATE: MECHAlVICAL PERMIT # ,. . .-? • - 1999 M£CEANICAL PEiiMIT (RESIDENTWIa crrY oF EwsM S$SO PILOT KNOB iiD SAIfiAN MN 551 EE (651)6$1-4675 Date: Complete this section onlv if you are installing HVAC in a single family dwelling, townhome or condo under construction and not owner /occunied. . uvqf`_ . n. i.nn M g.T . . ? SU.iN dT1T1T"I'fllN T $fl M RT'f T . (_.,nQ • Gas outlets (minimum of one required @$3.00 ea.) State Surchazge Total $ .50 Complete this secrion onlv if you are remodeling, adding to, or repairing an existing single family dwelling, townhome, or condo. Please indicate if it is a new item, alteration, or repair. New Alteration Repair _ Other Reminder.• Ca11 681-46 75forinspections. _ Furnace _ Air conditioning _ Air exchanger _ Other $ 30,00 State 3urchazge .50 Minimum Tota] Due $ 30.50 SITE ADDRESS OWNER NAME: INSTALLER NAME: STREET ADDRESS: CITY: PHONE #: (AREA CODE) PHONE #: (AREA CODE) STATE: SIGNATCTKE OF PERMITTEE r , ?*XcX?*??t?.'??hk?kC&?FXtX??k*X?:kYCkc?K?k:X??%tXcW. W.kc?Fk???k?k?kXt r...r.rv nr _r.n.r..,AN casri.r.Er,: r.?.r.?rE ? :; r-r_RrtaNFli.. NO: n8i?.??i9?? rrnF:, ? s ].:I.:(77: 55 IL? a PlAME: AMER:'CAN I-fOt11= YMPfitJtlNT f-•Ri7Cr5 3210 9001 21.`'.:5 90O1. 4275 PTL_OT h•:NT+ 43'5 F'7L_ ?1 i I!Nk'S i3i?? .c.? 4.00 7ohat F:ecei.p# Amnurti+,: CRp3614F3 10.2`; I.15.F..R :[D: NANCY FERMIT f:ITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (672) 681-4675 PERMITTYPE: aurLozNs Permit Number: 0 3 2 S 9 7 Date Issued: 0$ / 12 / 9 $ SITE ADDRESS: 4375 PILOT KNQB RD LOT: 141 BLOCK: CARLSON ACRES P.I.N.: 10-16400-141-00 DESCRIPTION: REPLACE ermit Type krk Type WINDOW SF (MISC.} REPAIR 434 ALT. RE6LOENTIAL ?. - ' ffia'E g? S ._ `ry10Nr ?LL cv. ? vra 5 7? ??'?? ..,? d ?`§ oiw, 3? . =J .? REMARKS: FEE SUMMARY: VALUATION $8,000 Base Fee $137.25 Surcharge $4.00 Total Fee $141.25 CONTRACTOR: - Applicant - sT. I.IC. OWNER: AMER HOME IMPROVEMENT PROD 13154516 20090017 VIN6E HARRY 8823 ZEALAND AVE N 4375 PILO7 KNOB RO BROOhtYN PARK MN 55445 EAGAN MN 55122 (612) 315-4516 (651)454-1231 t z . 3°'h'e'rtb:y' dCfirraWkB#f?e that I heuf3. i'ead this? appliCation and! staCe tMat tho -'- ' Jnfar"=rn?tion, It doreect arr$ agreo-to c?rmply wi.th 's11apPlics(?Ie S.Cafi? o?.A1nr : ? Statute s, at!d.?ityt txf. Eagan ardlnanpes,,. L APPLICANT/PERMI7EE SIGNATURE %JSSUED BY: SIGNATUR . ' 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PII.OT KNOB RD - 55122 I ? 681-4675 New Construction Reauirements ? 3 registered site surveys ? Z copies of plans (inGude beam 8 window saes; poured fitl. design; etc.) ? t energy cakulationa ? 3 copies oi tree preservetlon plan 'rf fot pWtted after 7l1/93 required: _ Yes _ No RemodellReoair Reauirements Sr ? 2 coPies o( plan , ? 2 site aurveys (exterior adddions & decks) ? 1 energy calculations Por heated add'Rions DATE CONSTRUCTION COST; DESCRIP ON OF WORK: U?/? A/?-o -??_ ?_=-'?-s ST ET DRESS: 237L LOT: BLOCK: C? SUBD./P.I.D. #: ? PROPERTY OWNER Name: V t? r?1c',-? ? Y?? Phone #: Latt First Street > ? ??CJ (} City ? C.?l State: Zip: Company: ''?c ? 1?Phone #: 3 CONTRACTOR ?? / Street Address: ?/GU License # ? d c) ?6U City State: .?/? Zip: je ARCHITECT/ ENGIIVEER Company: Phone #: Registration #: Street City Sewer & water licensed plumber (new construction ony): and lot chartge is requested ortce permit is issued. Zip: Penally applies when address chang I hereby acknowledge that I have read this applicatlon and state that the infortnafion is correct and agree to comply with all applicabl State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates af Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes - No State: . BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 02 SF Dwelling O 07 4-plex ? 03 SF Addition ? OS 8-plex ? 04 SF Porch ? 09 12-plex ? 05 SF Misc. ? 10 = plex WORK TYPE ? 31 New ? 33 Alterations ? 32 Addition O 34 Repair GENERAL INFORMATION Const. (Actuai) (Allowabie) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning OFFICE USE ONLY ? 11 Apt./Lodging ? ? 12 Multi Repair/Rem. ? ? 13 Garage/Accessory ? ? 14 Fireplace ? ? 15 Deck ? 36 Move ? 37 Demolition 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous Basement sq. ft. MCNVS System _ Main level sq. ft. City Water _ sq. ft. Fire Sprinklered _ sq. ft. PRV _ sq. ft. Booster Pump _ sq. ft. Census Code. _ Footprint sq. ft. SAC Code Census Bldg Census Unit Building Engineering Variance Permit Fee -?) Surcharge ? C) Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit 5/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: 24 Valuation: $ % SAC SAC Units I '• ! ? ?. ? 2/84 CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION (PtEASE PR[Ni) 1) PRO°ET7I^I ADDrZrSS-.-d/-.-APW?? r.Frai. DES='PICN: (Iot/Block/Su?division or Tax Parcel I.D. Nisnber) ^:I?T=i,, ST=CCP'RE, DAT:.' 0F ORiGi AL ,'-,i72i.=:G P;?:•ST ISS:?_NG: ? PR=SL? ? ^ ?1T : ' , , .?F /P?S)POS?J L'S: [9 R-1 SitiGL: FP^nSLY . ? R-2 CUPL...t"{ ('Pti10 LT!ITS) Q R-3 ZC:v'DII?Ci?SE ?+ L^]2T5) ( Wi I^_'S) ? R-4 APA:Z:`E-'NT/C=Ci•!ILIIr-7,M ( G:VITS) Q CCl`2'SE.°.CLu/RE"•AS7;/OF:'IC ? I1i'DL'STRIrZL ? NSTI:'LTIO:IAL/GOVE,qPL?'^.E.,^T 2) ApPI.I= (PLEASE PR 'i _ ._IE, ADDRESS: CI'I'Y. SmT;', ZIP• .•- ? ?t ??'-?J ?7 PI?0: 3) pu?sm PLEASE N ? NP_ : FOR CITY USE ONLY PDDRESS: ? PLUMBEAS LICENSE: = Active CITY, STATE, ZIP: Expired - PHOD]E: ?IL?? PLU^IBER IICE SE Q Not of Record Y arr initia 4) CCCL'°PP1T/CT.;?m NAME(rLLnyt Nxir?F) : ADDRESS: CIT`!, STATE, ZIP: PfiU:VE: 5) INDIGATE Iv'HICH PER%II BEING REtUESTID; IO.7 'IO CITY SLTAZER O[TO CITY SVATER Q C!i'IER (PLPIASE DESCRIBE) 6) P;:DIG?,77- C::n: . [I PIEaSE i?OID APPRWID pg2+1IT FOR PICF:-UP BY ONE OF AHGVE ? PL£A.SE b*AIL APPRC7VED PEPLIIT T'J 1, 2. 3, 4 AEOVE (Circle one) 7) SICZ,72L,E / DATE: c ' ." N..,. ?! R OI?.Mi?JO:f? i ii l?g?j ! S IY ?.?f:i?i Y i S?ssi :a 1? R ?! ??RYi?.? 1r f? t?iOCigY sF 0 R PERMIT y ISSUED I C I T Y U S E O N L Y F°ES : S Q . ?0 $ $ S $ +S S S $ $ 5°W'ER ???RMrT (I_`ICLuB: SURC`.i?RGc) WATER PERMIT (IrdCLUDE SiiRCHARGc) WATER METER/COPPERHDRN/OUTSIDE READER WATER TAP (INCLUDE CORPORATION STOP) SE:vER TAP ACCOUNT DF,POSIT - WAT°R WAC SP.C TRGVK WATER ASSESS?4E2dT TRliiQK SELJER ASSESS.IENT LATF..RAL BEiVEFIT/TRUNK SE?'TER LATERAL BENEFIT/TRUVK SJATER OTHER $ TOTAL $ AR AMOIINT PAID/qECEIPT ,yr DOES UTZLITY CONNECTION REQUIRE EXCAVATION ZN PUBLIC RIGHT OF WAY? = YES IF YES, THEN i: "PERb7IT FOR 'AORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE NO ENGINEERING DIV:SION. LIST AS A CONDI- TION. SUSJECT TO THE FOLLOWING CONDZTIONS: APPROVED BY ???1 DATE: am smIWs s?MAN am •wv EAGAN TOWNSHIP BUILDING PERMIT oWna= ---Y -.?. ..- ' .n............... .......... .... Address (Presenl) ..--. - ,--:--A1..4??.... !1................ Builder Address N° i'792 Eagan Towaship Town Halt Dale ._?ZkIG..P......................... forias To •Be Used For Front Depih Heighi Esi. Cosi Pezmif Fee Remarks V 61 " LOCATION Slreei, Road or olhex Deseripiion of Loeafion I Lo! Sloek ndaition or 't'raei This permii dces aot aufhozize the use of sizeefs, roads, alleps or sidewalks nor does it give !he owner or his agenf the righ! !o creafe any silvation which is a nuisance or whieh presenls a haserd !o the healfh, safely, conveaience and general welfare fo anpone in the eommunify. THIS PERNIIT MUST BE KEPT7 ?ON THE PREMISE WHILE THE WORK IS IN PROGAESS. y.s r ... ..................................has Permissioa !o ereet a......... .._______.... _........................_upon This is !o eerlifY, lhai.... X--..- the above described premisa subjee !o !he provisions of the Suilding Ordiaanee far gan T nship adapfed April 11. 1855. .""""'.......... ......... .....I?^?'-'_............. Per .--`-----'-? ..?t........J.sy°.`-:-.`"-----."-•.......----.........-'_'_'_'...... ?ha?men o! Tnwn Soard ? Building Inspecloz C «» /?c- J b a?<i-.-L'A'.4w.NtiXI?+Ir??fi}e.^r4+w+?..wi•!A2+?.!!.Te'?l`+'34h'.T`?!TMYy'.'S?R[.:••••, n•.+"••. ? j ? 7 { .. L`?wnYx?:w4?x?v`?oW4cPSraYVin`Rau.Yin'..a.u.V.nnura'Jrnirm_?at]nfMaYw+?+.K??uvu.? ? «?. PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA108842 Date Issued:01/16/2013 Permit Category:ePermit Site Address: 4375 Pilot Knob Rd Lot:141 Block: 0 Addition: Carlson Acres PID:10-16400-00-141 Use: Description: Sub Type:e - Furnace & Air Conditioner Work Type:Replace Description:Furnace & Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to Mark Anderson , State Electrical Inspector, (952) 445-2840 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 W Darnell 4375 Pilot Knob Rd Eagan MN 55122 Wenzel Heating & Air Conditioning 4145 Sibley Memorial Hwy Eagan MN 55122 (651) 894-9898 Applicant/Permitee: Signature Issued By: Signature C!ty of Eaaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use //^ Permit #: 1 o 1 1 (, 5 Permit Fee:.� Liz/g Date Received: v(" 11 — 1 3 Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION 10:4:5) .31 Date: Site Address: Unit #: Resident/ Owner Name: J% -e,4 1DOkr e 1 Address / City / Zip: Lj ;— I40+ Y1 Pb "e_8 Phone: 4 /2-- 4, 00`- Z4 Applicant is: Owner Contractor Description of work: YNA.CM0- h t S\ -N Construction Cost: I -) Multi -Family Building: (Yes / No e.) Company: L -TS Ex+e'r Y'S LLC Contact: 'EPi K_ N i M �- Address: �,Z LI St C ^ , P P e it A City: "F' r h 5 'l State: / ") Zip: SS 0 Z-- ` J Phone: 65 1- D�(iJZ n J License #: tP y d g Lead Certificate #: :i 7 t / / /95 f the project is exempt from lead certification, please explain why: (see Page 3 for additional information) prItehe "y Gjfot wivi/f f rep/pc=t PG ryc`a+a.1 41iev d 'r ri p4 i,J•:✓rc+rotAtS� r`e-1 iaa reins COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. 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.gooherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the 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 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. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. Applicant's Printed Name APS' •r' ��- Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Single Family Multi 01 of Plex Accessory Building WORK TYPES New Addition ?c. Alteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (25%_ 100% )6) Census Code # of Units # of Buildings Type of Construction Fireplace Garage Deck Lower Level Porch (3 -Season) Porch (4 -Season) Interior Improvement Move Building Fire Repair Repair 76 o 11,6 REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: Ice & Water Final Framing Fireplace: _Rough In _Air Test 7( Insulation Sheathing Sheetrock Reviewed By: Porch (Screen/Gazebo/Pergola) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width Final Siding Reroof Windows Egress Window Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Demolish Building* Demolish Interior Demolish Foundation Water Damage *Demolition of entire building - give PCA handout to applicant /V9 -0j) �fL MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: Final / C.O. Required -)C., Final / No C.O. Required HVAC _ Gas Service Test Other: Pool: _Footings _Air/Gas Tests — Siding: _Stucco Lath Stone Lath - Windows Retaining Wall: _ Footings _ Backfill Radon Control ZErosion Control , Building Inspector Gas Line Air Test Final Brick Final RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL /'9‘) c\T .vv 2-O7- /9",760 Page 2 of 3 NEW SINGLE FAMILY DWELLING - BUILDING PERMIT REQUIREMENTS Site Address: Applicant: i..�"75 File j--- rob y, LL -C Phone Number: (t6i-;L{ Check ✓ Appropriate Box One (1) signed and completed building permit application including a current contractor license number. ❑ Two (2) copies of detailed plans, drawn to scale including but not limited to; foundation plan and wall design including foundation wall insulation, radon control system, floor plan(s), cross section(s), elevation plan(s), beam size(s), joist size(s) and spacing, label window and door openings with the manufacturing U -value, and label all exterior wall and ceilings with the R -value Three (3) copies of a scaled Certificate of Survey prepared by a Minnesota registered land surveyor complying with City approved Survey requirements (maximum size 11 x 17). ❑ One (1) copy of energy code design criteria labeled on the plan, verifying that the building envelope meets the provisions of Table N1102.1 and/or Table N1102.1.2. Exceptions would include one of the following calculations that must be submitted for approval: o R -value computation method per N1102.1.1. o Total UA alternative per N1102.1.3. o Engineered systems alternative per N1102.1.5. ❑ One (1) copy of calculated heat loss / gain and calculated cooling load verifying HVAC sizing in compliance with the Minnesota Energy Code. ❑ One (1) copy of IFGC Appendix E, Worksheet E-1 calculating combustion air size, AND One (1) copy of IMC Table 501.3.1 calculating makeup air quantity. OR One (1) Centerpoint Energy Form completed by a HVAC contractor, including size of mechanical room.* One (1) copy of New Construction Energy Code Compliance Certificate (N1101.8). ❑ Two (2) copies of the individual lot tree preservation plan, if required by the development contract, shall be in accordance with the Eagan City Code. 11 11 * Please contact (651) 675-5675 if you are experiencing problems with the Centerpoint Energy software. REMODEL / REPAIR REQUIREMENTS Check ✓ Appropriate Box ❑ Two (2) copies of plan showing footings, beams and joists, label window and door openings with the manufacturing U -value, and label all exterior wall and ceilings with the R -values [1 One (1) copy of energy code design criteria labeled on the plan verifying that the building envelope meets the provisions of Table N1102.1 and/or Table N1102.1.2. Exceptions would include one of the following calculations that must be submitted for approval: o R -value computation method per N1102.1.1. o Total UA alternative per N1102.1.3. o Engineered systems alternative per N1102.1.5. ❑ One (1) site survey for additions and decks Addition — indicate if on-site septic system LEAD CERTIFICATION EXEMPTION Check ✓ Appropriate Box ❑ The applicant is not a Minnesota licensed residential contractor, residential remodeler or roofer. ❑ The building was constructed after 1978. ❑ The structure is not residential housing or a child occupied facility. /V The renovation will not disrupt 6 square feet or more of painted surface per room for interior activities, or 20 square feet or more of painted surface for exterior activities, and does not involve windows. Page 3 of 3 02/28/2013 08:51 Doc Date; C!ty of Eau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Tenant: FAX)9524923392 P.002/004 Use BLUE or BLACK Ink For Office Use Permit it; ' 1)1 3() BUJ Permit Fee: Date Received: 0 -DK -15 Staff: 14 2013 RESIDENTIAL PLUMBING PERMIT APPLICATION Site Address: �l' ��75 /0e/7o J Restdent/Qwner:' ;Contractor ,= Suite #: Name:A/ Phone: 6'42 • y.F3 _G.24PC Address / City / Zip: VS '73--.011A= fr ' h "I'd Name: �'� /4 .e e-7 License #: Address; .2C /Y8 /lie vim, c . 44/p.-4" '1`// City: G//fid State: %%lam Zip: 5-62) �G Contact: • Type of 'Work New Description Permit::Type:. Phone: g52' Email: C4. 4/.,5a v i/aie t�� i®s.>Ac./ Cobs, g Replacement Repair _ Rebuild Modify Space _ Work In R.O.W. of work: RESIDENT AL Water Heater Lawn Irrigation L<RPZ /_ PVB) Septic ystem New _ Abandonment Water Softener Add Plumbing Fixtures (_ Main/ _ Lower Level) `Water Turnaround RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures Seritic System Abandonment, Water Turnaround' (includes $5.00 State Surcharge) "Water Turnaround (add $200.00 if a 5/8" meter is required) $106.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) TOTAL FEES $ CALL BEFORE YOU DIG. Call Gopher State One Call at (661) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopt . tateoneca►I.org I hereby acknowledge that this information s complete and accurate; that the 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 permit, and work Is not to start without a permit; that the work will be in accordance with the approved plan in the c se of work which requires a review and approval of plans. X CLQ-"/ tJ c,..n fit- u e— x 1- Applicant's Printed NameAppllcan ture FOR OFFICE USE Required Inspections Reviewed By Under Ground • • c '::..Air T'est. :`Gas.Test _Flnat, ate:. City of Eagan PERMIT City of Eaan Permit Type: Building Permit Number: EA126316 Date Issued: 08/20/2014 Permit Category: ePermit Site Address: 4375 Pilot Knob Rd Lot: 141 Block: 0 Addition: Carlson Acres PID: 10-16400-00-141 Use: Description: Sub Type: Reroof Work Type: Replace Description: Census Code: 434 - Zoning: Square Feet: 0 Construction Type: Occupancy: Comments: Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required by law in ALL single family homes. Reinaldo Cintron Fee Summary: Valuation: 4,000.00 BL - Base Fee $4K $103.25 Surcharge - Based on Valuation $4K $2.00 0801.4085 9001.2195 Total: $105.25 Contractor: Ralow's Roofing & Remodeling Inc 11995 County Rd 11 #220 Burnsville MN 55337 (952) 210-4988 - Applicant - Owner: Betty W Darnell 4375 Pilot Knob Rd Eagan MN 55122 (952) 465-1145 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature