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4961 Pine LaneCity of Eaan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 RECEIVED SEP 131010 Use BLUE or BLACK Ink Permit #: Permit Fee: Date Received: Staff: �� /� 2010 MECHANICAL PERMIT APPLICATION ((^^ Date: "1 -t - lJ Site Address: t-PU. t^i ( -P) 1-)C— _ Ln Tenant: \CfLuAsLn Suite #: J RESIDENT / OWNER CONTRACTOR Name: "a_KlYdll Cf(3 v� Phone: 1 c3� as '( 9q L-( Address /City / Zip: `--C-'1t 0 l �� l i E i 1" _ License #: 1 LS 1LoT )'� Name: BURNSVILLE HEATING & A/C, INC. 3451 W. Burnsville Parkway Address: Suite 120 State: zipurnsville, MN 55337 Contact: l Phone: Email: City: c\ 2 TYPE OF WORK New Replacement Description of work: tri Additional Alteration Demolition Act Au)cl PERMIT TYPE RESIDENTIAL XFurnace X Air Conditioner Air Exchanger _ Heat Pump�► _ L Other " 1DC}t_0_ ' ! New Construction Install Piping Gas COMMERCIAL _ Interior Improvement Processed Exterior HVAC Unit Under / Above ground Tank ( Install / _ Remove) ** When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: , $50.50 Minimum Add-on or alteration to an existing unit (includes $Q State Surcharge) CO $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal $50.50 Minimum (includes State Surcharge) OR - If Permit Fee is less than $1,000, surcharge is $.50. - If Permit Fee is > $1,000, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). Contract Value $ x 1% _ $ Permit Fee _ $ Surcharge _ $ TOTAL FEE Call 48 hours CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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. Off a 1 A`1 Applicants Signature xutm4 i Applicant's Printed Name 4 cifiY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-189 (651) 681-4675 t i . ( 41 SITE ADDRESS: PERMIT SUBTYPE: APPLICANT: TYPE OF WORK: INSPECTION .• . .• ? ri, ••t f.? .1 ki MAHK',,: F??I.AN FttVlEt-3F_t1 CtY l•t?1YNt hl! t I I-l? & 41 FI UMHI F<? •?illl(FI 111, ?'NAMIi AI F : - _ .. - ? ------ ? - L INSPECTION RECURv PERMIT TYPE: Permit Number: 7 Date Issued: I f 11111INi N11 41 ?i 7 I 11- V<i Permk Hokfer Dete Telaphona k SFAWR/ `O(O? PLUMBING ? 9 yS/O- FG?/ HVAC _ Inspwtion pift Insp. Comments FOOTINGS 0 "'7GJ i? ,c) n c? 9 tf !TJ 4),?J w'Eti" TIl ? y' ?v?5 TULD Tf?E? /??D S??L LD/P/Z r003 FOUND ? FRAMING 6 vT? ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING 1-20-21 GAS SVC TEST - ? - INSUL la,?l4 Q GYP BOARD FIREPLACE FIREPLACE AIR TEST ?Q Q FINAL PLBQ ` l j? FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAiNS CONDUCTIVITY 7EST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL ? { NNrp iQd •? . ? KeL't'tfiCQt¢ Df CCCIIpQIiC? Kitv of C?agan Zeoartatettt of leuiibiag abbocction This Certificate issued pursuarst to the requrrements of the U»iform Building Code certifying thnt at the time of issuance this strurturr was in compliance with the various ordinances of the City regulating buildireg construction or use. For the following: Ux QauiCication: Ir •m eldg. Permit No. 33cn0`? Otcupancy Type R3/ U I Zaaing Districx Ri Typc Const. {N Ovner o( Building ?? Add,,n. 4375 IFMLItM LN Ws aQ?[sliu+7+n BuiWing Address 4%] P' J • Lpcaliry I•Q, BI, + . Daie- .. . _ . ? Builmo6 Ot6cial POST IN A CONSPICUOUS PLACE ? ?a . .? . ? :r : F?? ._ WRL`ttftCQ#e df CCCIipQtiC? (Fitv of Cfagan Zqartment of Zxi[bing 3n15pectiun Thes Certiftcate issutd pursuant to the riequiremenrs af the Uniform Building Code cerrefying thal at the time of rssuartce this structur+e was ia compliance with the various ordinances of the Ciry regulating building corestruction or use. For rhe following: Use Classifitation: w am Bidg. Permit No. 33804 Occupancy Type R3! UI Zoning District Ri Type Conxi. VN Ownctof8uilding = A`CLi7ca[Y7 4375 IiRLI[!t I1+i W. SiMiiLLM BuiWing Address 061 PINE LQE Lcdrtp I.4, BI• PnLrilm FUMT Date: Building Official POST IN A CONSPICl1QUS PLACE Ad'd4ss Zip 5512 3 Lot Blk ' Sub PINETREE MRESr THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECf[ON. Date: 02? q Yes No Inspector: Zze Final gtade (6" from siding) Permanent steps (garage) ? Permanent steps (main entry) v Permanent driveway Permanent gas Sod/Seeded grass TraiUcuIb damage ? Porch Basement finish I/ Deck ? Please verifv with the builder the removal of roof test caps from the plumbing system and the shutoff of water supply to the outside Iawn faucet before freeze potential exists. ContaM engineering divisiou at 681-4645 before working in rightof-way or installing underground sprinkler system. ? White - City Copy Yellow - Resident Copy Pink - Contrector Copy PERMIT # 64 RECEIPT DATE: INSTALLER NAME l"A X 1 C? I LA-JI 8002 UIS1DENTIALL PLUM$INfi PERMiT APPLICATIOA lill I Vr LAYm ? S$SO f'ILOT KROB RD El16lf1P. b!P S512E 651-881-4875 Please complete for. singie family dwellings, townhomes and condos when permits are required for each unit, backflow preventer for irtigation sysiem SITE ADDRESS: I I ? l?" OWNER NAME: : TELEPHONE TELEPHONE #: to S I 65E J` 1? STREET DDRESS I y t It Z--> ?• IC?CU {C3? I 1 V l CITY:'1,.c?..1 I IV K? STATE: V??k ZIP: s so "° O _ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100:00 • includes $40.00 County fee Note: Additfonal consultant fees may apply ? • MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING: _ Adding fiMures to lower levels or room additions, excluding water softeners and water heaters. $ 50:00 _ Abandonment of septic system, _ Water tumaround - existing dwelling unit (+ 518" meter if needed -$118) Other: o?' u T 1 0 2aD2 U _ RPZ: new installatioNrepaidrebuild 30.00 _ lawn irrigation system ReplacemenUadditional: _ water softener X water heater $ 15:00 State Surcharge $ ,50 Total $ I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applipble Ciry of Eagan ordmances: Icis the applfcanYs responsibility.to notify the property owner that the City of Eagan assumes no liability for any damages caused by Ne City duringitsnormal operational and maintenance adivifies to the facilities Constructed under this permit within City propertyinght•of-way/easement: SIGNATURE OF PERMITTEE 1l02 RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EACAN 3830 PILOT KNOB RD, EACAN MN 55122 651-681-4675 New ConsWction Reouiremenis • 3 registered site surveys showing sq. ft. of Iot, sq. 2 ot house; and all roofed areas (20°h maximum lat covelage allowed) . 2 copies of plan showing beam & windovr saes; poured (ound design, etc.J • 1 sel of Energy Calculatmm • 3 copies of Tree Preservation Plan if lot platled aRer 7fi193 . Rim Joist Detail Optians selaction sheet (bldgs with 3 or less units) ??m?r 5,c)Q?- DATE ..f?QJ1 SITE ADDRES; TYPE OF WOF APPLICANT_ STREET ADDRI TELEPHONE # ALTI-FAMILY BLDG Y FIREPLACE(S) _ 0 _ 1 _ 2 PROPERTYOWNER 4Cl3( G1 I / /lll//lV ? TELEPHONE# COMPLETE THIS SECTION FOR KNEW" RESIDENTIA713j '^ s Y ? ?? $?p S Energy Code Category _ ?IINNESOTA RULES 7670 CATEGORY 1 NN'LSO'?A9? submission type) . Residential Ventilation Cate9ory 1 Worksheet Su6mitted N?y Q o Wo• Energy Envelope Calculations Submitted ?? - Plumbing Contractor: __ Plumbing system includes: Mechanical Conhactor: Nlechanical system includes: Sewer/Water Conhactor: _ Air Conditioning _ Heat Recovery System Phone # Phone # Pce: $70.00 --°°--------°------------------°-----------------......_...--------------------------°----°---------------....------ I hereby acknowledge that I have read this application, sTate that the information is corre agree to comply with all opplicable State of Minnesota Statutes and City of Eaga f(ces. S(gnature o(Applica OFFICE U5E ONLY _ Water Softener _ _ Water Heater _ _ No. of Baths Phone # Lawn Sprinkler No. of R.I. Baths Submitted RemodellReoair Reuuirements ? . 2 wpies of plan °? {o • 1 set of Energy Calculations for heated additions . t site survey for extenor addilions & decks • Indicate if home served by septic system for additions .3CGG, Ol? VALUATION ? -1 <?? 4 -l Fee: $90.00 Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 OFFICE USE ONLY ? Ot 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 EM. 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 (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Yor_ N A 25 Miscellaneous ?ysnf ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair /9 33 Alteratlon ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDoors ? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation f?l?b Occupancy tzMC/ES System Census Code IL/? Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs ? Length Fire Sprinklered Type of Const vri_ Width REQUIRED INSPECTIONS _ Footings (new bldg) _ FinaUC.O. Foorings (deck) FinaUNo C.O. ? Footings (edditiea) _ _ Plumbing ? Foundarion _ HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Fracning _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By ZZ , Building Inspector Base Fee Surcharge Plan Review MGES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total 3/ot,7z7 _-? City of Eagan 3830 PILOT KNOB RD EAGAN, MN 55122 (651) 681-4675 PERMIT Permit Type: Building Permit Number: EA034727 Date Issued: 03/18/1999 Site Address: 4961 Pine Lane Lot: 9 Block: 1 Addi6on: PINETREE ROREST Description Sub Type: Fireplace Work Type: New Description: Census Code: Addition/Bsmt fin/Decks/Porch UBC Occupancy: Construction Type: Zoning: Sqau?e Fe?tc,.. ? Remarks: Chimney/flue must be inspected before concealing. Requires an air test. Fee Summary: State Surcharge - Fixed Permit Fee - Fixed 0.50 60.00 $60.50 Contractor: - Appi?cant - Owner: FIRESIDE COANER INC St. Lic.: Manley Brothers 2700 N FAIRViEW AVE 4961 Pine Lane ROSEVILLE, MN 551130000 ? 6126331042 Eaean, MN 55122 i I hereby acknowledge that I have read rhis application and state thaY the information is correct and ag'ee to comply with all applicable State of Minnesota Statutes and Ciry of Eagan Ordinances. ApplicanUPermitee: Signature . "/L* Iss By: Signaz re L'S7v Or F.:nc;aN NiJu 90 S BATr-_„ 03ii.r?/99 T'.LMI:.: 1506.26 II7 ;, NAt1E:: C:[F;!-,r'sSD[' Cf.?RNfR 3210 `.?QC!i. 4961 ('INCi: IAME 60,00 2155 Ons..li. 4961 PINE i_r.NE 0,50 6(].50 'rpt;n:l Rc.:craj,p+, Amns,nit e t.R :I. OFtf1k:,1. i..iSr::R tr.,.. Nnracv I `10tij!05-98 09:47 AM IT= = CO Invoiced To: 612 452 1826 Instan2•«Testins».Co. 612 452 1826 P. 01 INSTANT TESTING COMPANY 4000 Beau D'Rue Drive • Eagan, Iv1N 55122 •(612) 454-3544• Fax: (612) 452-1826 ,?, o.,.C .??.. Fu Noia t? F°' ?Rt ?Ll?a?-IY Irom ? S -T?p 5'??M1? Meniey Bros. 4375 TriAaim Lane W. Minnetnate, MN 55364 Date Sampled: Novem6er 4, 1998 Submitted 9y: G8ry 5tendish, ITCO Rentarl:s: Copics To. Raported: November 5, 1988 Peitormed By: Gary Standlsh, ITCO Standa?d Moisture/DenstN T6et Curve Number: 98-01 98•02 Visual Soil Ciass: Sliphtly Silty Sandy Loam 31ighUy PlasUc Sandy Loam Star,dard Maximum D Dens : 120.1 128.6 0 timum Moiatwe: 12.9 10.8 Re resentativa Of: Densl test 1 Densl teat 2 Charge Codes' Standard proctur . . . . . . , . 4303 . . . 2 Sample prep . . . . .. . . . . 41302 . . . 2 /c?%I/?-? `l • S ?? ? Signed Carl AndersonProlaeaionel Englnem- Reglstracion No. 70736 612 452 1826 NOV?05-98 09:47 AM Inscant?Testjne?CO. 612 452 1826 P.02 ? LC0 Involced To: INSTANT TESTING C4MPANY 4000 Beau D'Rue Dnve • Eagan, MN 55122 •(6(2) 454-3544• Fax: (612) 452-1826 MaNey Bros. 4375 Trillaim Lene W. Minnetrista, MN 55394 Prolect' Pinetree Forest Lot 9 Bloek 1 Date 7ested: November 4, 1998 Q 315 pm .. Orderqd gy; Reported: November 5, 1988 Field Technicien: Gary Stendish, ITCO Inplace DBnsity Resulte Teet Numbar: 3A 1A LoCAtlon: Gare e ele6 erea Reer W.lO footln area De n gelow Orade: 4rade Grade Vieual Soil Clasa Slighny Piaedc 5andy Loam Sliphny aieatlc Sandy Loem Practor Cun/e Number 88-02 98-01 Percent Molsture: 8.8 11.0 O "mum Mol8ture: 10.6 12.8 Relatlva Moietura: 83 85 Field Density, PCF: 124.0 119.5 3fandard Maxlmum D Density, PCF: 128.8 120.1 ReieWe Density. Percent: - 98 100 Re uired Minimum: 05 95 Remgrks: Capies To: Charge Cotles: Densityteste 3A, 1A . . . . . . 0601 . . . . 1 Charge per test . . . p306 . . . . 2 Mfleape ................. #812 .... 17 Sipned _ ?-- p, f`: [ir Cad And.rson arofssslonal EnDinear-Regiatn an No. 1 W38 , 612 452 1826 NUVlBS-9$ 09:47 AM Instanx?Testins?CO. 612 452 1826 P.03 I TCo Involced To: INSTANT TESTING COMPANY aUUU Beau D Rue Dnve • Eagan, MN 55122 •(G12) 454-3544• Fax: (612) 452-1826 Manley Bros. 4375 Trillaim Lane W. Minnetriate, Pinstree MN 55384 'ect Fo g Date Teated Novemeer 4, 1998 (o 7 45 em .. Ordered By: Reported: November 5, 1998 Field 7echnlGan: Gary Standish, ITCO fnplace Density Reeulta Test Numbec ? 2 3 Location: Reer W/p FooGng area B889ment slab aren at gerege Blap area center line Oe th Beiow Grade: Grada Orade Grede Vigu81 Soil Cless: SlighUy plasUt silty loam Sliphtly p19sGc sandy SlighUy plasGc sandy loam loam ProctorCUrvaNumber; 98_01 88-02 88-02 Perceat MaiatUre: 11.2 11.1 9 a O fimum Moisture: 72.8 10.6 10.6 Reletive Moisture: 87 105 89 Field Denaltv. PCF' 109.4 122,8 112.5 SWndard Maximum D Density. pCF: 1201 1261 128.8 Relative Density, Percent: 91 97 88 R ulred Minimum: 95 05 95 Remarks- Copies To: Charge Codes' Densitytesig 13 . . . . . . . pgol . . 1 Cnarpe pertast ..........#306 .... 3 Mileape .................p812 .. . 17 5l,ned Grr Mdenon Proteaslonel Engineer-Reglstration No. f 0736 BL / CITY USE ONLY RECEIPT SUBD.IS?w.? o?n o ?47to?i1 RECEIPT DATE: 1999 PLUI6ISINC f'EtMTP (RESIDENTIAL) crrYoF EAsnx 3830 PILOT KNOB RD E46AA, b1N 55122 (651) 6$1-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system ------------------------- ------------------ ----- - - - - - - - FIXTURES - ----------- EACH ----- -----------"---- # -------------' TOTAL Shower 3.00 x a = 3,4) Water Closet 3.00 x /2, ? Bath Tub 3.00 x 3 = L, OD Lavatory 3.00 x t _ / a• dD Kitchen Sink 3.00 x / - 3- 4?3 Laundry Tray 3.00 x av HotTuh/Spa 3.00 x ov Water Heater 3.00 x °° Floor Drain 3.00 x 1 = 3-°U Gas Piping Outlet ' minimvm- t 3.00 x 3, dz) Rough Openings 1.50 x = Water Softener ` for dwellings under construction 5.00 x = Water Softener ' forexisGng dwelling 30.00 x = U.G.Sprinklef ' for dwelling under const. 3.00 = U.G. Sprinklef ' forexisting dwelling 30.00 = Alteretion5 ' to existing residence 30.00 = Water Turn Around 30.00 = Private Disposal System " MPC iic. 75.00 = (new and refurbished syslems) Private Disposal Systems ' Abandonment 30.00 = RPZ (new installation/repair) 30.00 = STATE SURCHARGE 50 Reminder: Call 681 -i675 for inspeMions of water heaters, water softeners, alterations, etc. TOT AL ------ -------------------------------- • --.... _........ -----------------------• - •---.... ------ •-------------------------------------------- I hereby adcnowledge tha[ I have read this appiication, state that the infortnation is oorteIX, and agree to oomply with all appllpble City of Eagan ordinances. It is the applipnYS responsibiliry to no6fy the property owner that Me City of Eagan assumes no liability tor any damages caused by Me City during its normal operational and maintenance activities lo the facilities oonstructed under this pertnit within City property/righl-of•way/easement. SITEADDRESS: 79Zl? ne OWNER NAME: INSTALLER NAME: L;p77W?'? TELEPHONE #: % 7D s?la 3/ STREETADDRE : IlC??I? CITY: STATE: ZIP: ? SIGNATURE OF PERM CD/PERMIT FORMS/RPLBG PERMIT (RES) - 1999 r ._., CLAIM VOUCHER - REFUND REQUEST C[TY OF EAGAN MAKE CHECK PAYABLE TO: LOFGREN HEATING ADDRESS: 20108 CALGARY TR FARMNGTON MN 55024 LOCATION: 4961 PINE LANE P.I.D./LEGAL: I,,9,11, PINETREE_FOREST] RECEIPT #/DATE: 101936-01/21/99 VALUATION: REASON FOR REFUND: JOB CANCELLED PERMIT #: TYPE OF REFUND: 1 $ Electrical Permit 3211-900 Plumbing Permit 3212-9001 $ Mechanical Permit 3213-9001 $39.00 Building Permit Fee 3210-9001 $ Plan Review Fee 3422-9001 $ SAC (MC/WS) 2275-9220 $ SAC (City) 3866-9379 , $ SAC (Admin) 3446-9001 $ Water Connection 3865-9220 $ Sewer Permit 3743-9220 $ Water Permit 3713-9220 $ Acwunt Deposit 2252-9220 $ Water Meter 3716-9220 $ Watec Treatment 3868-9220 $ Surcharge 2155-9001 $ Utility Acct Overpayment 2250-9220 $ Curb Box Deposit Refund 2253-9220 $ Constructioa Meter Dep Refund 2254-9220 $ Water Usage Chazge 3711-9220 $ Other $ ,TOTAL $39.00 I declaze under the penalties of law that this account, claim, or demand is just and that no part of it has been paid. January 21, 1999 DATE CITY USE OIYLY LOT / BL ? RECEIPT /0 1 SUBD. .,, 0 s 1 RGCEIPT DATE: . 1999 MECHANICAL PElZMIT (RE5IDENTIAL) crrY oF eateAv ssso PI.or Kvos Rn Date: e-Aswrr suv 551 a2 (651)6$1-4675 Complete this section onlv if you are constniction and not owner /occupieyi-?' AC in single family, or condos under . HVAC: 0-100 M B T U ADDITIONAL 50 • Gas outlets (minimum of one required @$3.00 ea.) • State Swcharge: • TOTAL: $ 30.00 6.00 oa 3 .50 3 •?? Complete this section nnlv if you are remodeling, adding to, or repairing existing inJle family dwellings, townhomes, or condos. Please indic if ' is a new item, replacement item, or repa' . New Replacement _ Repair _ Othe Fumace _ ir condi ioning _ Air exchanger, i.e. Vanee system, etc. _ Other Reminder: Ca1! 681-4675 far inspections. $ 30.00 State Surcharge: .50 Total: $30.50 SITE ADDRESS: "VL7 6?'' / OWNER NAME: f%?'114A NSTALLER NAME: L c? f t L STREET ADDRESS:,Q? CITY: J`{7IC J/? ( IJCi ; PHONE #: PHONE #: STATE: ,J?;_q ?Iz JS/FORMS BLD/ML+CfI PERMfT (RES) - 1999 L BL SUBD. APPROVED BY: INSPECTOR RECEIPT #: RECEIPT D 1999 M£CfllkNlCAL P£RbI1T (CO1N113ERCIAL) CITY Of f-A6A1V 3$30 PILOT KNOB RD EA6AN, IvIN 55122 (651) 6$1-4675 Please complete for: ail commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION INTERIOR IiNSPROVEMENT DESCRIPTION OF WORK: FEES: 1% of contract price OR $30.00 minimum fee, whichever is greater. Processed piping - $30.00 CONTRACT PRICE x 1% PROCESSED PII'ING PERMIT FEE STATESURCHARGE TOTAL SITE ADDRESS: OWNER NAME: TENANT NAME (IMPROVEMENTS ONLY): INSTALLER: ADDRESS:. CITY: PHONE #: PHONE #: STATE: ZIP: CITY USE ONLY ($.50 per $1,000 of ?ermit fee due on all permits.) SIGNATURE OF PERMITTEE r / CITY USE ONLY V LOT ? IIL ? RECEIPT N: r ! 0Yr/ 7cn0;'- SUI3D?lX1?D?o. `fOn¢ ? RECEIPT DATE: I/d'?// / 1999 MECHAN1CAL gEfiMIT (REISII3ENTIAL) CITYOF ElkfitkN 3$30 P[LOT KN09 RD E,4flt}N MN 55122 (651)681-4675 Date: Complete this section ontv if yon are installing HVAC in single family, townhomes or condos under construction and not owner /occupied • HVAC: 0-100 M B T U . $ 30.00 ADDITIONAL 50 M BTU 6.00 • Gas outlets (minimum of one required @$3.00 ea.) '7' ef 0 • State Surchar.-e: .50 • TOTAL: Complete this section onlv if you are remodeling, adding to, or repairing existing single family dwellings, townhomes, or condos. Please indicate if it is a new item, replacement item, or repair. - A)f-New _ Replacement Repair _ Other 4-7 Fumace _ Air exchanger, i.e. Vanee system, etc. Renrinder: Ca11681-4675 for inspections. ? Air conditioning _ Other $ 30.OQ State Surcharge: .50 Total: $30.50 SITE ADDRESS: 4e'-7e OWNERNAME: 001?'D7`?'?-S PHONE#: INSTALLER NAME:c S, PHONE #: ?: STREET ADDRESS: // 3/? C[TY: STATE: ZIP: / .?J'/ ?-? J? ????C SIGI A E OF RMITTEE 13/FORMS I3LD/ML•CFI PERMIT (RES) - 1999 L BL SUBD. APPROVED BY: INSPECTOR 1999 MEcIIAvicAL PERMrr (eOMMExc1AL) crrY OF EAsAx 3$30 P1LOT KNO$ RD EAfiAN, MN 55122 (651) 661-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: CON1'RACT PRICE: WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEV1EiVT DESCRIPTION OF WORK: FEES: 1% of contract price OR $30.00 minimum fee, whichever is greater. Processed piping - $30.00 CONTRACT PRICE x 1% PROCESSED PIPING PERMIT PEE STATESURCHARGE TOTAL SITE ADDRESS: OWNER NAME: RECEIPT #: RECEIPT DATE: (S.50 per $1,000 of VLrmit £ee due on aU permits.) TENANT NAIVIE (IMPROVEMENTS ONLY): INSTALLER: ADDRESS: CITY: STATE: ZIP: CITY USE ONLY PHONE #: PHONE #: SIGNATURE OF PERMITTEE , , PERMIT CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 033804 (651) 681-4675 Date Issued: 10J Z 7/ 9 8 SI7E ADDRESS: P.S.N.: 10-57650-090-01 4961 PINE LANE LOTc 9 BLOCK: 1 PINETREE FOREST DESCRIPTION: Bu,i'lding°'lPermiC Type Building Wu'r;k Type ,IiEBC Occupancy f Gonstruption 7yp-e ' Zanirrg Building Length ( 6uiiding Width By3iding stories ?:• SqUare Feat ? f Cs?;C9de-- SF DW6 NEW R-3,U-1 VN R-1 71 43 2 2,449 101 1 - FAM. QEl'ACH ` 't ? ? ? f i?.- i ? :r . . REMARKS: PLAN REVIEWED BY WAYNE MILLER. S& W PLUM6ER: SOUTH MECHANICALs TELEPHONE #423-3373 FEE SUMMARY: vALua-rsnN Base Fee Plan Rsview Suroharge SAC SAC % SAC Units Subtntal $1,407.25 $914.71 $102.00 $1,000.00 100 1 $8,423.96 $204,00@ MISC. FEES $1,592.50 Total Fee $5,016.46 CONTRACTOR: - MANLEY 8R05 CONST 1:b778 ALLISON WAY IFlVER GROVE HGTS IhN (q12) 454-4933 Applicant - ST. LIC. 14544933 20054327 55077 OWNER: MANLEY BROTHERS 4375 TRSLLIUM LANE W MINNETRT57A MN 55364 (612)386-3815 L I hereby acknawledqe thaC I hava read Chis informatinn is correct and agree to epmqrlv 5tatutes and City of Eagan Ordinanees. APPLICANT/PERMITEE SI TURE appli.catian and state that the with a11 applicable State of Mn, u ?-? l? -?SSU P? EO BY: SIGTURE J i?.::nx,.?. : ?..n,$•1}:i:: ...b)4?.ai J. N) . _. ?4 1 1 - „I:.r?, ???;.. r:?.i=?V_;,..c 771.3 ?,.. ?. ?...?:• .^ i!:':.RM'.cW.f'r.. 00' „ 1610004 *ir:? .Lly'.:.11 ;Y'c..P .• J.'`/?...?.:i.......??? /e:1li 9001 4.9t,i. 'i?... (':•.flGri?, C U'?:H,Zt'?i?:^ ;?:?(1?.f'r.,46 i'•.i:;!i.l. \iAN{-Y f ? $ ' :? so f?' 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PII.OT KNOS RD - 65122 ? O' 681-4675 New Construction Reouirements RemodeVReoair Reauiremenls ? 3 registered site surveys ? 2 copies of plan ? 2 copies of plans (InGude beam 8 window sizes; poureC fnd. design; etc.) ? 2 skesurveys (exterior additians & decks) ? 7 energy qleulaNans • t energy calculations for heate0 atlCitions ? 3 copies W tree preservation plan N bt platted after 7n/93 required: _ Yes ? No DATE: ic) • aa •98 CONSTRUCTION COST; ??`a`1 g?• ? DESCRIPTION OF WORK: STREET ADDRESS: LOT: 9 BLOCK: l SUBD./P.I.D. #: Name:_mP-"L-F.y (? ??J F_.a_s ??hone #: (?/ A? 3??- 3815 PROPERTY Lasc Fvsc O WNER StreetAddress: ?-13?15 Tx-LL.L-«+? L..,a.?E. City YY1 ?w?w??YUS-+"ra State: M?1 I Zip: .5 2s6y. Company:Iy') r...tiL-e..i C?aa??sc.sCo.+a?c.a Phone#: A138C_-3g15 CONTRACTOR Street Address: t--{'J-1S 'TTtt LuL.wti L+at..l E- lJ E S7 License # ? C?C75?-13 0"?"1 City State: mN • Zip: ?'5 511i? ARCHIT'ECT/ ENGINEER Company: -c?c.o Phone #: HM a -<=r, aL-I Name: Torv? \?a?.-?'-? Regisffation #: StreetAddress:3"I3M C-'XtPvF- City F--cacr?u State: tY'N'N . Zip: STs ) aQ? Sewer & water licensed plumber (new canstruction only): Penalty applies when atldress chang and lot change is requested once permit is issued. 33 7,J I hereby acknowledge that I have read this application and state that the infortnation is cortect and agree to comply with all applica6l State of Minnesota Statutes and City of Eagan Ordinances. Signature of OFFICE USE ONLY Certificates of Survey Received X Yes Tree Preservation Plan Received Yes No ? No OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish '0 02 SF Owelling ? 07 4-plex ? 12 Multi RepairlRem. ? 17 Swim Pool ? 03 SF Addition ? 08 8-plex ? 13 GaragelAccessory ? 20 Public Facility ? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous 0 05 SF Misc. ? 10 = plex ? 15 Deck WORK TYPE ? 31 New ? 33 Alterations ? 36 Move 0 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actuaq ? Sasement sq. ft. 5714, 7S MCNVS System (Aflowable) 17 Main level sq. ft. i6-/4/,757 , City Water UBC Occupancy P3, d.2 .IJP&A sq. ft. 1544. A Fire Sprinklered Zoning Ji2 ?g sq. ft. q34 PRV # of Stories sq. ft. Booster Pump Length 7 1, s sq. ft. Census Code. Depth q-,5_ Footprint sq. ft. HN`l 5AC Code c> / Census Bldg ? Census Unit APPROVALS ` V A Planning Building v ` v Engineering Variance Permit Fee Surcharge Plan Review License MCNVS SAC Ciry SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Capies Total: °k SAC SAC Units vaiuation: S ON Bc+'.S?MGV?" ,qOg k .?. ? _ /263,ati f' l.h' x i 2= I$O bb X 1 I= 71,5 aaV1, zs 5HMFr}S.G?SE/`7BA?i lti ?H?75 uPozrR 5y-M t .95 ?,,,E ?" SykG = 31,h yz 6re = / S u su-1 gr7%S ? ,?? ?gyy56,5 ?7yx?w - aXil = 22. q3- t?jr jt ada?9/s,zs ? * * * * PIONEEFt * eng **** Certificote of Survey for I U1 ?w. 968.6 I ` 0 O O 0) .? ? a OD M r 0 z 967.5 ' l sss.o 31:00/ ' ? j ' '- Z oi -r 976.0 i°o ? 10 ?-c?iL-----?R-- ? 969. N89'41'52"E V1c? c T> 138. 977.0 97.9 0 I I 13 I NOTE: PROPOSED GRADES SHOWN PER GRADING PLAN BY: E.G. RUD PROPOSED HOUSE EL EVATION NOTE: BVILDINC DIMENSIONS SHOWN ARE FOR HORIZONTAL ANO VERTICAL LOCATION LONEST FLOOR ELEVATION: 9L, s OF STRUCNRES ONLY. SEE pRCMITECNAL PLANS FOR BUIIDING AND FOl1NDA710N DIMENSIONS. TOP OF BLOCK ELEVATION: 1 NOTE: NO SPECIFIC SOILS INVESTIGATION HAS BEEN COMPLETED ON THIS LOT BY THE 9 ? q g SURVEYOR. THE SUITABILITV OF SOILS TO SUPPORT THE SPECIFlC NOUSE GARAGE SLAB ELEVATION: ' PROPOSED IS NOT THE RESPONSIBILITV OF ME SURVEYOR. NOTE: THIS CERTIFICATE DOES NOT PURPORT TO SHOW EASEMENTS OTHER THAN X 000.00 DENOTES ExiSTING EI.EVATION THOSE SHONN ON THE RECORDEO PLAT. ( 000.00 ) DENOTES PROPOSED ELEVAnON --- DENOTES DRAINAGE AND UTILITY EASEMENT NOTE: CONTRACTOR MUST VERIFY DRIVEWAY DESIGN, ' OENOlES DRAINAGE FLOW DIRECiION NOTE: BEARINGS SHOWN ARE BASED ON AN ASSUMEO UATUM - t DENOTES MONUMENT $ DENOTES OFFSET HUB WE HEREBY CERTIFY TO MANLEY BROS. CONST. THAT THIS IS A TRUE AND CORRECT REPRESENTATION Of A SURVEY OF THE BOUNDARIES OF: LOT 9, BLOCK 1, PINETREE FOREST DAKOTA COUNTY, MINNESOTA IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCHROACHMENTS, EXCEPT AS SHOWN, AS SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 16TH DAY OF OCT., 1998. /^' ?? cl ,NFh n. / P.F?iNFFR ENGINE IER NG. 1P.A. SCALE : 1 INCH = 30 FEET ? 10 I ?a J J a I ?w I CW I ZW I Ow N89'41 2422 Enterprise Drive Mendoto Heights, MN 55120 MD SURVETORS • CML ENGWEERS - (612) 681-1914 FAX-651-94M ) PLMNERS• lANDSCME IRCMIIECTS 625 Highwoy 10 N.E. Blaine, MN 55434 (612) 783-1880 FAX:783-1883 MANLEY BROS. CONST. 4961 PINE LANE (VACANT) 8 s 1JG7. X69.3 32.33 , ICi---976_2. ,BENCH MARK ?' TOP OF PIPE .' ELEV.=976.29 . i i ? 13 , ' I o 9?6.2 i? --«_ -1 i I 10 7 969.6 i taC i 967.3 ? 968.21 n Mi a,2.oo/ 9 ° 12.00 -,...- 0 ? °} ? a ? a? ? 0? ? t, ao 976.0 1 7-r4- 30 -F i i ? V , .0 lA L ? ? 0 O O 0) 3 a OD 0 00 r, 0 0 z 976.0 976.2 ' w Z ? J Z i a i io ? ss7.s'x\ L - - - - - - - Ln 8 t 98275.1 1 LOT SURVEY CHECKLIST FOR RESIDENTIAL ? PROPERTYLEGAL: Azo?'r / &2ri1-14- ? ? DATE OF SURVEY: LATEST REVISION: ? yZ. w a m DOCUMENTSTANDARDS B' /? ? • Registered Land Surveyor signature and company [a' g. ? • Building PermitApplicant ¢- ? • Legaldescripdon ? • Address ? • North arcow and scale e' g? • House type (ramWer, waikout, spift w/o, split entry, lookout, etc.) f? ? • Directional drainage arrows with slope/gradient % Ef/ ? ? • Proposed/exdsting sewer and water services 8 invert elevation ? • Street name O? o ? • Driveway ELEVATIONS ExIstina ? • Sewer service (or Proposed) Cr?/? ? • Property comers eY ? ? • Top of curb at the driveway ?? ? • Elevadons of any existing adjacent homes P se ? • Garage floor ? ? • Frst floot , I ¢5 ? ? • Lowest exposed elevadon (walkouUwindow) 0"?? ? • Property comers 0"?o ? • Front and rear of home at the foundation PONDING AREA C?f aoolicable) ? [X? ? • Easement line ? 6" ? • NWL o [3-' ? • HWL o ?/ ? • Pond # designation ? [d' ? • Emergency Overflow Elevation DIMENSIONS .H' ? ? • lot IinesBearings & dimensions 0-l'/o ? • Right-of-way and street wklth (to back of curb) 0 O ? • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc. (i.e. ali structures requidng permanent footings) ? ? • Show all easements of record and any Ciry utilfies within those easements p' 0 O • Setbacks of proposed sWcture and sideyard setback of adjacent exdsting sUuctures ? ? ? • Retaining wali requireme?7if any ? Reviewed: ? - ,.,o / Date January 1996 CRAIC19GdBLOOPRIRT. FM SITB 7 ? 11 9$.?57 ENEI2GY COIIE? WORKSHEET FOR 1& 2 FAMILY DWELLIPIGS o0 6c? _,PIION6?11... .,.rDATS BOILDING CLASSIFICATION: ? aaCegary 1(etandarA) 'or 0 aateaorv 1 Imuet SINIM[Rq CRITERIA Fdundation Ineulatidn-Rlo ? Walla c Windowu Slab on Grade Ineulation-R10 Eoreallowa6le percentages) Floor over unheated epaces-R24 Foundation Windowe 1/2" ineulated clase, -Wood or Vinyl Frame . 9TSp 1 Wiudow 4 Door Area A. Total Window 6 Door Area in Sq, Feet - WINDOWS (Including Foundatioli Windowe); - W2NDOW MAN[IPACTURE NAM$t WINDOW HAN[]FACTORB TYP6t D.YI. WINDOW MANIIPACT(lRH Q FACTORs_ . lC/l R. O. Quantity eq.fC.A'rea Dimensions X• A4 x!to" Xj!&" 11 7 (' N X `Q M /17 2! 'e M X `t tr]H 11 '7rt Rao£ Ahtla Iueulationt' R49-With Attic No Heel R38-{Jith Attic Raieed Ileel R38 &: RS-Solid Raftere STSP 2 Calculate area ae a pazcant o£ wall C. From Step 1 divide box A(Window & poor Area) by box B(total wall area) timeu 100 eguals the window and door area aa a percenC of wall area (box C). 92X A A 7A X 100 = F 8ox U 4Z47 /s` n ro ST6P J Daeiga Featurea , ASSEMBLY EFAMING TYP6: . . ' STANDARD FRAMINd X etude 161, o.c: ADVANCEO FRNtING atude 24" o,c, CAVITY INSULATION R-M- X 9HBATHINO TYpBt .. 1 ?l X LE59 TIIAN < R-5 ? x R-5 > OR MORB x U-FACTOR Q ? . From the table, O (9 ? (reverse side) deCermine the maxlmum percent window & door area for.the X deeign optione selected and entez the k value in Box D 6elow Uased on the window mfg. U- factor: . .. ? X D Tutal Area of A- ng.Et. - Windowe & Doors ' - 8. Total Wall Area in Sq. Ft,. The t vulue from tlio table in Box D aliall 60 . equal to or greater than the t in Box C Wall To[al . Height. Aroa - Perimeter ' ? L3 s, ? 15' , ? ? 9.o Co ?d z 0,? 14 f - 1 U•V:;w '1'otal Area oE Walls 1 n?a-1 hq,ft ! ......_ _ ? _,:Y:.,_._ ?'.k.:.___ . .. . _ . .. . / dr / `Z .. I Frami ?vi[ Exterior Wlndow U-Faetor n Inaulation Sheathin 0.49 0.36 031 0.27 STANDAAD STAN R-13 Z R- 7 13.49'e 17.896 21, 24.3°/, DARD R-13 R- 5 12.4°s 16.4% 19.7% 22 5% STANDARD R-15 > R- 5 12.99fi 17.1% 20.1% . 7 3 4% S7ANDARD STA R-18-19 < R- 5 12.19'e 16.05'0 18.8% . , 22,0% NpARD R-18 _19 R- 5 14.096 18.69'o 21.8% 25 3^/ ADVANCED R-18-19 <[Z - 5 12.9% 17.1% 20.170 . e 23 4"/ ADVANCED R-18 -19 > R- 5 14.5% 19,2g'o 22.5% . 0 26 1% STANDARD R-21 < R- 5 12.8°/. 17.0% 19.9% . ?3 1a/a STANDARD ADVAN R-21 > R- 5 14.5% 14.396 22.5% . 26.1% CED lt•21 < R- 5 13.696 18.1% 21.2% I4 6°10 ADVANCED R-21 R- 5 15.09'a 19.9% 23.29'0 . . 26.9% Additionel al ulat d val m STANOARD R-1t < R -5 11.9% 15.7°o 18.4% Z3 5% STANDARD R-17 Z R• 5 13.89'e 18.4Ye 21.5°a _ 2S Q9's ADVANCCD R-17 < R• 5 12,6% 16.8% 19.69'0 . 22 9% ADVpNCED R-17 R- 5 14.346 19.0°Yo 22.29'0 . 25.79'0 Notee: Window area eqnals rough opening minus lnetallalion clearances. Wlndow U-(actor must !x delermtned by either the National Feneslration Ratfng Council standard 100-91, or ASHRAE 1993 Handbook o( Fundsmcntals, Chapler 27, Table 5. PoNdt• FoN Note 7671 , ??/ ?i/1 ( ,?- / Doo k .0Da /O? 3y = -?- 2 W? 14 ? L BL CITY USE ONLY 1 SUBD. RECEIPT #: /0fff F 7 RECEIPT DATE: As S9 1999 PLUM$INe PuiMIT (RESIDEN'clAF.) CI'fY Of EAfiAN 8950 PILOT KNOB iiD £AfiAN, MN 55] EY (e51) 661-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system -------------------'-------------------------------------- Alterations to exi tin residence ---------------`-----------------• 30.00 Water Turn Around 30.00 Private Disposal Sysiem * MPC iic. 75.00 (new and refurbished systems) Private Disposal Systems ' Abandonment 30.00 RPZ (new installation/repair) 30.00 FIXTURES Shower Water Closet Bath Tu6 Lavatory Kitchen Sink Laundry Tray Hot Tub/Spa Water Heater Floor Drain Gas Piping Outlet Rough Openings Water Softener U.G. Sprinkler _ .36• 6 D EACH # TOTAL 3.00 x = 3.00 x = 3.00 x = 3.00 x = 3.00 x = 3.00 x = 3.00 x = 3.00 x = 3.00 x = ' minimum - 1 3.00 x = 1.50 x = ' for dwellings under construction 5.00 X = ' for dwelling under const. 3.00 = Reminder: Call 681-4675 for inspections of water heaters, water soReners, alterations, etc. STATE SURCHARGE TOTAL 50 3p . 50 --------?------------ -- --------------------------------------------------------,•------.._..-------------------. I hereby acknowledge that I have read lhis application, state that the information is wrrect, and agree to wmply with all applicable City of Eagan ordinances. It is the applicant's responsibility to notiry the property owner that the Gity of Eagan assumes no tiability for any damages caused by the C'dy tluring its normal operational and maintenance activities to the facilities consVUCted under this permit within Ciry properrylright•of-way/easement. SITE ADDRESS: / o,? %?-R /? ? E ".f e `'J OWNERNAME: 0 tNSTALLER NAME. TELEPHONE #: ??D STREET ADDRESS: -5r5- CITY: STATE: ZIP: S-S37? SIGNATURE OF PERMITTEE CD/PERMIT FORMS/RPLBG PERMIT (RES) - 1999 1999 FIREPLACE PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 55122 (651) 681-4675 Date: ,.3??tT i Description of Work: ? Construct i:erv fireplace _ Alteratinns to existing _ Install gas insert on[v _ Install uas lirie oxlv Other Job address: Y Lot: L Block: I_ SubdivisionlP.I.D. #: Applicant (circle one only): Owner ontractor Permit Fee: .560.50 Name: / / lpnt4 "t- Phone #: PROPERTY ? Last First O WNER Street Address: Ciry State: Zip: Company: A0i9d FiA Phone #: FIREPLACE $ INSTALLER StreetAddress: Liceneelf200?1? 'imdaw Roseville, MN iS11S City 6s1l6'?.?-2561 State: Zip: Company: Phone #: GAS LINE INSTALLER Street Address: Ciry State: Zip: , 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 OFFICE USE ONLY BUILDiYG PERMIT TYPE ? 14 Fireplace W'ORK TYPE ? 31 New ? 33 Alterations ? 31- Additiun ? 24 R:pei-- GENERAL INFOILVIATION Census Code. 434 SAC Code 01 RE VIARKS Chimney/flue must be inspected before concealing. r>' - .3+aAs+re+•,..? , P _.. rN5C-a- 2oos RESIDENTIAL PLUMBING PERnniTaPPUCarioN CITY OF EAGAN 3830 PiLOT KNOS ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dweAings. 30. 67t7 ? , n Date?_! I ) // n Site Street Address Unit # Property Owner T'A\-U L/.. a2w C??JIV Telephone #(? Contracto 0 via ' `L • T lephone # ` ? Address City State Zip The Applicant is: Owner jContractor _Other Septic System New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee $ 100.00 Per as-buiit $ 10.00 Alterations to existing dwelling $ 50.00 _ Add plumbing fiu[ures. This fee includes installation of a water softerter and/or water heater at the same time. If you are lnstalling onl a water softener and/or water heater, do not complete this section; move to the next sec6on and ch c??t? appliance(s) you are installing. _ ?E C? I? ?? D= ,J _Septic System Abandonment JUL 2 7 2006 TWater Turnaround (add $130.00 rf a 518" meter is required) Other: Water Softener _ Water He"ater $ 15.00 _ new _ replacement Lawn Irrigation _RPZ J PVB _new _repair _rebuild $ 30.00 State Surcharge $ .50 Total ? 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 ihis is not a permit, but only an application for a permit, work is not to start without a permit and work will be in Aecqrdanct with thq)aqproved pian 1n the event a plan is req{.iteq tq be,#eyig"rdApprove?. AdplicanYs Printed Name 4¢pficanYs Signa'ture � j� �� I ll�°"' � Use BLUE or BLACK Ink �,, ��CEIVE -----------------, i. ��', �k.;�a � For Offfce Uae � �� t � � p �� I I � �� 4 �� 11� 1A� �� U 2��4 I Permit#: � Y � � Permit Fee: � ' l/V j 3830 Pilot Knob Road � �� / i I Eagan MN 55122 � I Date Received: Phone: (651)675-5675 � �, n � � Staff: r.c�c / I Fax: (651).675-5694 • � - r� 4 � ��J 2014 ESIDENTIAL PL MBING PERMIT PLICATION .� � � �� Date: `6 �� Site Address: Tenant: 3uite#: r¢ �.��,' ��,�� A��.��.; �� Y��} � .� ' � �� `�Resi e�t'lOwne�� Name: Phone: � �°j -v�� '` �;a } �+*' � � -•.�. �'��a��'�� -k,�,�' ,. ; Address+City/Zip: '��;��J��'�c �`�.��'� � Milbert ompany Inc dba Cullign Water ��,�� e ` ��6, tvame: - ��se#: �NC643176 ��,�� '�s�� rY�F�`� �: 180150t Street East ts. ��c��ntractor � ` Aaaress: c�cy: Inver Grove Hg r�� ,��,x�xs�r� , � ;'��;�G,� ':��z �'��;�� -�� state:.�M N � zip: 5 5 0 7 7 Pnone: 6 5 1-4 5 1-2 2 4 1 � r ��k�t�� .r �' � � 7�� ,� N�M� � ' • • • �;;�,s�F� ..a,� <�.a�� ,��$ co�ta�: VV i I i i a m°:R,M i I b e rt. Email: i,i'�?k t° ir�� ;.: . .. . . .. . . u�"��,j�TM�.��a��r,� . ` � T e of Wor�' —�ew �Replacement _Repair _Rebuild _Modify Space Work in R.O.W. r��,�Yp��3 ,� �,,.� . — �� a" �a r k,� �'��a��. .„t �,,.�,; ,�� Descrfption of work: � � � � r,��,��?1��4�� ,�t� RESIDENTIA�. �r{4"�`�Y"' y. �y'r .' ' '�. ��,��`�µ�,�� uf��, WaterHeater i, ;��' � �� Water Softener `��"� �'� ,�n�� Lawn Irrigation�RPZ/ PVB) � ��'� ��(�Pe I'n;it"fyp��' Add Plumbing Fixtures�Main/_Lower Level) f "�h� ��k��$�4T:�E"t . ��,��, � Septic System I �;��, ��,�` ,�2� ��,�� " � I�lew V�ater Tumarpund r ti��,;;,� G#�i. c ,3F � I _ �,�� „, �'�. < ,, ,�� . Abandonment RESIDENTIAt FEES: � �fi0.40 VVat�r Heater;:`JVater Softer,er,ar LVa#er Heater and.�oftener(includes$5.00 State Surcharge) � $60:00 Cawn`�Irrigation;(includes$5.00 minimum State Surcharge) $60.00 Add:Plumbjng fixtures, Septic Svstem Abandonment,Water Turnaround"(includes$5.00 State Surcharge) r •.. .'"Water Turriaround(add$200.00 if a 5/8"meter is required) $115 OO Septic Svstem New($10.00 per as built)(includes County fee and$5.00 State Su�charge) CJ,,, �/, � TOTAL FEES S,�Q,�_ CAL:L' BEFORE.YdU DIG. Call Gopher State One Call at(651j 454-0002 for protection against underground utility damage. Ca11.48 fiours'before you intend to dig to receive'locates of underground utilities. www.qopherstateonecall.ora I hereby acknowledge that this informa:ion is complete and accurate;that the work will be in conformance with the ordinances and codes of the Clty of Eagar�;;thaY I`understand 4his is not a permit but only an application for a permit, and work is not to start without a permit;that the work wlll be In accordance witK:the appiuved plan in the case of work which requires a review and approval of plans. x- �' /�` � x Applican.Ys ,rinted ame Applic n 's Slgnature � � �t i,�`�,'" �� .,::� _, , ,.,, �±� , rr �rrv� k �FQ� F,,I� �U S, Y e ' -, ' a '�� .� ��;��'4w�� "x: � ,r z�� i D'atetY �` n4 f�ia . �"�;,� a� , r a 4 i �.� + y Y+ r d'��q��]` �" ��,�; r^^� . !Re`quir d In p,ecti ��, n Sz'4 ''' .e.s s�'y 1,� �`!�� ,�� ., , � , �. �`��t�er ela d�lt�m te;� r� . :� � '"�'�y ��, �. �r .,..;�, ,�n � �� , � ,.� � . �._, .�.. . . . __ �� G . �, PERMIT City of Eagan Permit Type:Building Permit Number:EA147859 Date Issued:02/12/2018 Permit Category:ePermit Site Address: 4961 Pine Lane Lot:9 Block: 1 Addition: Pinetree Forest PID:10-57650-01-090 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: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Matthew W Woodcock 4961 Pine Lane Eagan MN 55123 (952) 270-5839 Garlock French Roofing 2301 E 25th St Minneapolis MN 55406 (612) 722-7129 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA161820 Date Issued:06/15/2020 Permit Category:ePermit Site Address: 4961 Pine Lane Lot:9 Block: 1 Addition: Pinetree Forest PID:10-57650-01-090 Use: Description: Sub Type:Residential Work Type:Replace Description:Tankless Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener). Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 Surcharge-Fixed $1.00 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 - Matthew W Woodcock 4961 Pine Lane Eagan MN 55123 (952) 270-5839 Bruckmueller Plumbing Inc 3992 Pennsylvania Ave Eagan MN 55123 (651) 686-6696 Applicant/Permitee: Signature Issued By: Signature