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4968 Pine Lane. . INSYEU'1'iON Rl:(:()itl) bITY OF EAGAN PERMIT TYPE: - 3830 Pilot Knob Road Permit Number: Eagan, Minnesata 55122-1897 Date Issued: (651) 681-4675 SITE ADDRESS: APPLICANT: ? ? PERMIT SUBTYPE: TYPE OF WORK: INSPECTION .. . .. ,;.. ? f'lAN RkV[EW.-If fiY ;A?/17(; NGtifAi-1YK?. TS •;1.f3;F3FF F'I UMli 1 WO f't-I:iCJi" 0411 F L ? ? Permlt Holder Date 7elephone # SEWE-R wnff-FM' •. ? ,? y ? _ PLUMBING ? HVAC Ingpectton Dete Insp. Comments FOOTIN(3S 1o FOUND 7 FRAMING wJ ROOFING ROUGH PIUMBING PLBG AIR TEST ? ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG 7 FINAL HTG ORSAT TEST BLDG FINAL / DOMESTIC METEA IRRIGATtON METER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FfG DECK FINAL I Aps, ? i? . . s KCL'ttfiCQte 0f CCC1tpQ1iC? igitv of *agatt Zevart?cut af lftilbiug -lulapectiaa This Certificate issreed pursuant to the requirements of the Uniform Buildrng Code certifying tfeat at the time of issuance this structure was irt compliance with the various ordinances of rhe Ciry regulating buildrrtg constructron or use. For the following: u. ciirwwn: SF W eag. Peffnit No. 33758 Occupancy 7ype R3 7ming Distriu R I Type Const VN OwnetofBuildi.g ?. BFDIHER.5 /1&bress 10170 ALL1SON WAY• IQH ewmi,8 naaw 4Q68 PINE IANE LOCW„y LZO B3 PIINE IREE FCl4tEST ?ng Offocw POST IN A CONSPICUOUS PLACE Address 49r,9 arnE T.nxE Zip 5512 3 pt x Blk 3 Sub PR?E 1-PM FMEST THESE 1TEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION. Date: Yes No Inspedor. ? .. Final gtade (6" from siding) Permanent steps (gazage) Permanent steps (main entry) Permanent driveway Permanent gas X Sod/Seeded gass Trai]/curb damage Porch x Basement finish Deck y Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to the oufside Iawn faucet before freeze poten[ial exisis. Contact engineering division at 6814645 before working in rightof-way o[ installing underground sprinkler system ? White - Ciry Copy Yellow - Resident Copy Pink - ContracWr Copy 2005 RESIDENTIAL BiJELDING PERNIIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Consirudion Reauiremenis 3 reg'stered site surveys shor+ing sq. R. of lot, sq. ft. of house; and 211 roo(ed areas (20% maximum lol coverege aibwed) 2 copies ot plan showiig beam & window sizes; poured found desgn, etc. 1 set of Energy Calculalbns 3 copies of Tree Preservatlon Plan i( lot platted after 717/53 Rim Joist Detail Optians selection sheet (buildings with 3 or less units) Telephone #( Date g? tro Construction Cost r16-? &8D Site Address y 9 (?B P+ ???"*-?- Unit/Ste # Description of Work J':?2 Multi-Family Bldg _ Y I N Fireplace(s) _ 0 A 1 _ 2 liL'' 2Y PropertyOwner zbN f- a Telephone # (4S/) qZ 3 ' Z -7S L c < L /'? ,,? ? ? `? Contractor n.S t>'ti.-r(a? ?--D - Address Sm City ?a State I^) ? Zip 1 Z( Telephone #(-,;S ?) 3g9 " 3 1?-?, COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 Energy Code CategOry . Residential Ventilation Category 1 Worksheef • New Energy Code Worksheel (4 submissiontype) Submitted Submitted . Energy Envelope Calculations Submiried Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies, Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( ) Telephone # ( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a 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 require_ s a_reviw? approval of lans. ? d w,•-'? 7 2005 ??J Applic s Printed Name Applicant's Signature ? ' --__- RamodeVReoair Reouiremen4s "I Office Use Onlv 2 copies of plan CertafSurveyRecd,.. _Y_N 7 se[ of Energy Calculations for heated addNOns Tree Pres Plan Recd : _ Y-_ N. 1 site survey for additions & decks TreePres Required_ Y-_ N AddiGOn - indicafeHon-sitese ? ??? pticsys ._1?fe" `-?p6cSyste _Y Pcl OFFICE U5E ONLY Sub Types .` . ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool O 30 Accessory Bldg ? 02 SF Dwelling ? OS OB-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 6ct. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ex[. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck A 23 Porch (screenlgazebo) 0 36 Multi Misc. ? 05 03-piex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-piex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demalish Interior ? 44 Siding X 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building' O 43 Reroof ? 46 WindowslDoors ? 34 Replacement •Demolitlon (Entire Bldg) - Give PCA handout to applicant Valuation 'P"J°,v Occupancy i?-3 MCES System - Census Code y3y Zoning R- i City Water SAC Units " Stories --' Booster Pump ? # of Units Sq. Ft. PRV # of Bldgs -" Length Fire Sprinklered `- Type of Const -T13 Width / z REQUIRED INSPECTIONS _ Footings(new bldg) FinaVC.O. Footings (deck) ? Final/No C.O. j? Footings (addition) _ Plumbing Foundation HVAC Drain Tile Ottier Roof ? Ice & Water 2? Final Ftgs AidGas Tests Pool Final ? Framing _ _ _ Siding _ Stucco _ Stone _ Br ick _ Fireplace _ R.I. _ Air T est _ Final Windows _ Insulation _ _ Retaining Wall Approved By: , Building Inspector -------- -------- ------ ----- --------- Base Fee ---------------- -- -- ---- -- -------------------- - ? ?J?p?y ----------- Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search ?- Copies other Total ? L ? ** * 'k PIONI *,% ** Certificate of Survey, for: Uwo wnvc*una • uwL cnwnecrta LAND PLPNNERS. LMIDSCAPE ARC107ECT5 2422 Enterprise Drive Mendata Heights, MN 55720 (612) 681-1914 FAX:681-9488 625 Highwoy 70 N.E. Blaine, MN 55434 (612) 783-1880 FAX:783-1883 MANLEY BROS. CONST. .., 19 30 ' 976.71 WI Z i JI WI Z' al i I 30 i BENCH MARK TOP OF PIPE ELEV.=979.24 S89'41'52"W f - - oTg 10 l O a O 1.0 ; 0 I 4 °. r 30 _!, 3 OD O 0 co r 0 c Z 980. f!' I t I ? ? sao.7 r' I o? to ? o 78.0 ° i s 977. ?M XPA (?0 G(y8o3: PROPOSED DRIVEWAY S89'41'52"W 976.8 PdYCJ`- a/rfA` d ? -b g 3 /d? z« - 1 2 979.92 136.50 o ? R ?n - -- ?0 ----? ?1 10 ?79 6 978.8 x Y w . ? u I r Q ? ? - ? I J ? J I '00 $ ?w ? ? ? .6a OO ? \. O W ? %978.9 n I x GO zw i 978.6 Cra i i ow I ` --1 ` 44 979.1 y o ? I ?{° i ? 10 o i -?'r-- -----J i i o 9776 136.50 977.6 ? 791 5 O O ? ? OD O OD O 0 Z 977.5 ? / A'IS' s7s.s ._. ?-?._ ----------- -- _ SYCAMORE DRIVE NOTE: PROPOSED CRADES SNOwN PER GRnDING PLAN BY: E.G. RUD PROPOSED HOUSE ELEVATION NOTE: BUIIOINC DIMENSION$ SHOWN ARE FOR HORIZONTAL AND VERTICAL LOCATION LOWEST FLOOR ELEVATION: 971-1 OF STRUCNRES ONLY. SEE ARCHITECTUAL PLANS FOR BUILDING AND FOUNDATION DIMENSIONS. TOP OF BLOCK ELEVATION: 60`-1 NOTE: NO SPEqFlC SOILS INVESTICATION HAS BEEN COMPIETED ON iHIS L0T 6Y THE . 9?'3 SURVEYOR. THE SUITABILI7Y OP SOILS TO $UPPORT THE SPECIFIC HOUSE GARAGE SLAB ELEVATION: PROPOSED IS NOT THE RESPONSIBILITY OF THE SURYEYOR, NOTE: TMIS CERIIFICATE DOES NOT PURPORT TO SNOW EASEAIENTS Oi11ER TMnN x 000.00 DENOTES ExiSTiNG ELEVATION TFiOSE SHOwN ON iHE RECORDEU PLAT. ( 000.00 ) DENOTES PROPOSED ELEVATION NOTE: CONTRACTOR M115T VERIFY URIVEWAY DESICN. --- DENOTES DRAINAGE AND UTILITY EASEMENT ? DENOTES DRAINAGE ROW OIRECTION NOTE: BEARINCS SHOWN ARE BASED ON AN ASSUMED DANM • DENOTES MONVMENi 8 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 20, BLOCK 3, 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 30TH DAY OF SEPT., 1998. SCALE : 1 INCH = 30 FEET SWK PIONEER ENGI ERI , P.A. C. Lorson, L.S. Reg. No. 19828 . R CLAtM VOUCHER- REFUND REQUEST C[TY OF EACAN MAKE CHECK PAYABLE TO: SHERER PLUMBING ADDRESS: 4800 ADRIAN CIACLE SE PRIOR LAKE MN 55372 LOCATION: 4968 P1NE LANE P.I.D.JLEGAL: ?L20, B3, PINETREE FOREST ' RECEIPT #/DATE: 99278 -11/10/98 VALUATION: REASON FOR REFUND: JOB CANCELLED PERMIT #: TYPE OF REFUND: Elech-ical Permit 3211-9001 $ Plumhing Permit 3212-9001 $37.50 Mechanical Permit 3213-9001 $ Suilding Permit Fee 3210-9001 $ Plan Review Fee 3422-9001 $ SAC (MGWS) 2275-9220 $ SAC (City) 3866-9379 ? SAC (Admin) 3446-9001 $ Water Connection 3865-9220 $ SewerPermit 3743-9220 $ Water Permit 3713-9220 $ Account Deposit 2252-9220 $ Water Meter 3716-9220 $ Water Treahnent 3868-9220 $ Surcharge 2155-9001 $ Utility Acct Overpayment 2250-9220 $ Cur6 Box Deposit Refund 2253-9220 $ Construction Meter Dep Refund 2254-9220 $ Water Usage Chazge 3711-9220 $ Other $ TOTAL $37.50 1 declare under the penalties of law that this account, claim, or demand is just and that no part of it has been paid Date: December 8, 1998 iaz5'r ??a ? 1998 PLiJMBING PERMIT (RES CITY OF EAGAN 3830 PILOT IINOH RD EAGP.N, tIlAT 55122 (612) 681-4675 Piease complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system FIXTURES EACH # - TOTAL Shower 3.00 x ? = 3.cx: WaterCloset 3.00 x "Z = Cc,Gc Bath Tub 3.00 x I = GG Lavatory 3.00 x Z = . Go Kitchen Sink 3.00 x 3,0G Laundry Tray 3.00 x I = 3, Cc Hot Tub/Spa 3.00 x = Water Heater 3.00 x I = 31 GC Floor Drain 3.00 x ?, C?D Gas Piping Outlet * minimum - i 3.00 x 3,00 Rough Openings 1.50 x q,5o Water Softener ' for dwellings under construdion 5.00 X = Water Softener ` for existing dwelling 20.00 x = U.G. Sprinkler ' for dwelling under wnst. 3.00 = U.G. Sprinkler ' far existing dwelling 20.00 = Alterations * to existing residence 20.00 = Water Turn Around 20.00 = Private Disposal System ' MPC lic. 75.00 = (new and refurbished systems) Private Disposal Systems' nbandonment 20.00 = RPZ (new installation only) 20.00 = STATE SURCHARGE 50 x -'$ TOT AL ` ' I/ ----------------------------- ---- ----------------------- --- --------------------------------------------- ---------------------------- - I hereby acknowledge that I -have read this appliwtion, state that the informafion is correct, and egree to compty with all applicable City of Eagan ordinances. It is the applicant's responsibility to notiTy the property owner that the Ciry of Eagan assumes no liability for any damages caused by the Ciry during its normal operetional and maintenance aGivities to the facilHies constructed under this permit wi[hin Ciry propertylrigM-ot-way/easement. SITEADDRESS: ?%S ?Ine LGrip- OWNER NAME: 1' ?? v l? ? 'blQne- INSTALLER NAME: 1?_&Vnv v I UmTELEPHONE#: ?12`?-IU????'3y STREETADDRESS: q(300 Wria? ?if-C 2 5L CITY: 1 r1or LQ?Az STATE: MN ZIp: SS 30 2 v CITY USE ONLY RECEIPT #: / ?Gf' / / RECEIPT DATE: ( O 9 L aD BL C:- SUBD. CD/PERMIT FORMS/RPLBG PERMIT (RES) - 1998 ? CITY USE ONLY LOT OO BL o? RECEIPT#: /ODc?_O ? SUBD.?i?^, RECEIPT DATE: 199$ MECHANICAL PEftMIT (ft£SIDENTIAL) CITY OF gE1fiAN $$SO PILOT KNOB RD E4fiAN D!N 55122 Date: /a' -c;;t ' -,7g, (61E) 681-4675 Complete this section onlv if you aze installing HVAC in single family, townhomes or condos under construction and not owner /occupied ' • HVAC: 0-100 M B T U $ 24.00 ADDITIONAL 50 M BTU 6.00 • Gas outlets ( minimum of one required @$3.00 ea.) Y, 60 • State Surcharge: •SQ . • TOTAL: ?--'-50 Complete this section onlv if you aze remodeling, adding to, or repairing existing single family dwellings, townhomes, or condos. Note: Mechanical permit is not re uired for alteration/add-on to ductwork in existing residential units; but is required for the following: t_/ Install fumace --? Install air conditioning Instal] air exchanger, i.e. Vanee system, etc. _ Other Minimum fee applies to all remodel or add-ons of existing residences $ 20.00 State Surcharge •50 Total: $ 20.50 SITEADDRESS: ?d /'//U /Q-n'Q OWNER NAME: / / /CLII ? BI-d ?S PHONE #: INSTALLERNAME: C?D/?C? // c.cL{7LLfi/ LQ-L PHONE#: 7???dG3? STREET ADDRESS: jo??g 'SG - CI'I'Y: STATE: AZA ZIP: SIGNATURE OF PE ITTEE 15/FORMS BLD/hfECH PHRMIT (RES) - 1998 L BL SUBD. CITY USE ONLY APPROVED BY: all commerciaVindustrial buildings multi-family buildings when separate permits are not required for each dwelling unit INSPECTOR 199$ MECHANICAL PEft1HIT (COMLt£RCIlkL) CIT'Y O£ EAfiAN S$SO PILOT KN08 BD EAsArt,lrtu 55122 (612)6$1-4675 Please complete for: DATE: RECEIPT #: RECEIPT DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: FEES: 1% of contract price OR $25.00 minimum fee, whichever is greater. Processed piping - $25.00 CONTRACT PRICE x 1% PROCESSED PIPING PERMIT FEE STATESURCHARGE TOTAL SITE ADDRESS: OWNER NAME: PHONE #: TENANT NAME (IMPROVEMENTS ONLY): INSTALLER: ADDRESS: PHONE #: CITY: ($.50 per $1,000 of oermit fee due on alI permits.) STATE: ZIP: SIGNATURE OF PERMITTEE ?j ?L ?0 BL ? e CITY USE ONLY J RECEIPT#: I?07&o-- SUBD.(.?i4.e, !f/C.t4- RECEIPT DATE: 1998 PLUMSING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT i4dOB RD EAGAN, tMI 55122 (612) 661-4675 Please complete for: ? single famiiy dwellings .. ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinklersystem _ _ _ FIXTURES EACH # TOTAL Shower 3.00 x &?- Water Closet 3.00 x vo Bath Tub 3.00 x 1 = ?- cYG Lavatory 3.00 x 3 = 9- cro Kitchen Sink 3.00 x 1 _ "vf • ?'o Laundry Tray 3.00 x 1 = 3- oU Hot Tub/Spa 3.00 x I = - v c Water Heater 3.00 x I Floor Drain 3.00 x I Gas Piping Outlet ` minimum - 1 3.00 x Rough Openings 1.50 x = Water Softener "for dwellings under construction 5.00 x = Water Softener ' for existing dwelling 20.00 x = U.G. Spfinkl2f ' for dwelling under const. 3.00 = U.G. Spfinkler ' for existing dwelling 20.00 = Alterations ' to existing residence 20.00 = Water Tum Around 20.00 = Private Disposal System ' MPC iic. 75.00 = (new and refurbished systems) Private Disposal Systems ` nbandonment 20.00 = RPZ (new installation only) 20.00 = STATE SURCHARGE .50 TOTAL !ra- ?CG) ----------------------- ------------------------------------------------------------------------------------------------------------- - I hereby acknowledge that I have read this appliwtion, state that the infortnation is corted, and agree to comply with all applicable Ciry of Eagan ordinances. It is the applicant's responsibility to notify the property owner thet the City of Eagan assumes no liability for any damages caused by the City during its nortnal operational and maintenance activities to the facilities constructed under this permH within Cily property/right-of-way/easement. SITE ADDRESS: 7 ?C?k 4az/7-e /LZ /t-e OWNER NAME: S INSTALLERNAME: C?Oli1_T/? ?GLC?JCCl2%?'a-L TELEPHONE#: STREET ADDRESS: CITY: O /' LQlee STATE: SIGNATURE OF PERMITfEE ZIP: CDlPERMIT FORMS/RPLBG PERMIT (RES) - 1998 ? ? CI?K OF EAGAN 3830 Pilot F(nob Road Eagan, Minnesota 55122-1897 (651) 681-4675 PERMIT PERMITTYPE: suzLDrNs Permit Number: 0 3 3 7 5 8 Date Issued: 10 ( 7_ 2 J 9 8 SITE ADDRESS: P.I.N.: 10-57650-020-03 4968 PINE LANE LQT: 20 BLOCK: 3 PINCTREE FOREST DESCRIPTION: Bua'1Ndi `g' ,Permit Type SF DW6 B 0/3lding W$'r,'k Type NEW gC Occupency \ R-3 j ClbnstruCtiqn 7ypfe 5-N Zoning 1 R-1 ?Building Length. ? 60 f 8uilding Width ? 43 ?L Buikding stories 2 t?= Ce.FjSrus Code ./? 101 1- FAM. DETACH -- ? .i ? i • 7? f a t r .- e REMARKS: PLAN REVIEWED BY CRAIG NOVACZYK. S& W IS SCHEREF2 PLUMBING PHONE #447-6I34. FEE SUMMARY: VALUA7IQN $166,000 Base Fee P1an Review Surcharge SAC SAC % SAC Units Subtotal $1,217.25 $791.21 $83.00 $1.000.00 10@ 1 $3,091.46 MISC. FEE5 Tntal Fee $4,683.96 CONTRACTOR: - Applicant - sr. LIC. OWNER: MANLEY BRQS CONST 14544933 20054327 MANLEY BROTHERS 19778 ALLTSON WAY 10778 ALLI50N WAY INVER GROVE HG7S MN 55077 INVER GROVE HG7S MN 55077 (612) 454-4933 (612)454-4933 R I hereby acknpwle°dge that I have read this applicatitin and state that the information is correct and agree to comply with all app],iqable State of Mn. Statutes and City of Eagan Ordinances. L ? -- -- -? ??. ?? L APPLICANT/PERMITEE SIGNATURE / SUED BV: SIGNAT RE ;. . ? y ?r;(`,':x?.;>Y •a?:v: ?? i'.1T I.;.!.?Y?V l,is?,.h., L. i r,3f::iG. . ?' ,.• ,:,,{?r? r,r,?,? ,:; ,. .. 1.:.. 'r,., .,,, t::t)P?s:n`• -.-? (° ?i?.,... . J. .?. ,i S? . `.:ifa 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) » CITY OF EAGAN 2' j? ?? 3830 PII.OT KNOB RD - 55122 ? ?? 681-4675 New Construction Reauirements ? 3 registered sNe surveys ? 2 copies oi plans (InGude beam 8 window sizes; poured fid. design; etc.) ? 1 energy calalations ? 3 copies of tree preservation plan iF lot platted after 7/1/93 required: i! Yes _ No DATE: 10 " IfA -vl D DESCRIPTION OF WORK: STREET ADDRESS: ,d LOT: 42D_ BLOCK: SUBD./P.I.D. #: RemodeVReoair Reauirements ? 2 copies oT plan ? 2 site surveys (exterior addkions 6 dedcs) ? 1 energy ralculations Por hea[ed addRians CONSTRUCTION.COST; ? ? ? IFS K/v-?- La.u-j, -Tree reg Name: -I I lQ.n( U-1 &L4I vS lORS i• PLone #: PROPERI'Y ?.est eirst OWNER n! 0 r?'" ? Street Address: i0? y, 411 S((ri?` - ?/(ln,? City ??(2?'( klP Wah State: HO_ Zip: 550fl Company: I lx' T4 bl W Phone #" '"]f -0%3 " ? CONTRACTOR /?n I l v1 // StreetAddress: V? 1 I?YI ?.l/0)4 License# City -t?V U 6l W e State: 1 I?v Zip: ??7 I A,,wT'GWTCT/ ?/ E'n.}N?£R Company: ?I Phone ?1: `i",?O"on%?'/ /?3Y Name: Registration #: StreetAddress: q/ukf?lli`(1'I 'Uf , city 6Gw state: z,P: Sewer & water licensed plumber (new construction ony): ?WW ??tfiLdf:2 . Penalty applies when address chang and lot change is requested once permit is issued. 14 q ? - (o-? -J ? I hereby acknowledge that I have read this application and state that the iniortnation is con and agree to comply with all applicabl State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE OIJ?Y Certificates of Survey Received ? Yes Trea Preservation Plan Received v Yes _ No _ No Not Required D LF-3 k?? UOM uv LS OCT I 2 PA 00 f..:^T . . , .`. . BUILDING PERMIT TYPE O 01 Foundation ? 06 Duplez At 02 SF Dwelling ? 07 4-plex O 03 SF Addition 0 08 8-piex ? 04 SF Porch ? 09 12-plex ? 05 SF Misc. ? 10 = plex WORK TYPE 'p.31 New ? 33 Alterations ? 32 Addition ? 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Oeposit S!W Pertnit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: OFFICE USE ONLY O 11 Apt./Lodging ? 0 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. MC/WS System ' Main;evel sq. ft. City Water sq. ft. I? Fire Sprinklered ( ai'1,?icAf, sq. ft. %1(ct! PRV sq. ft. Booster Pump sq. ft. , Census Code. - Footprint sq. ft. '1-C SAC Code Census Bldg Census Unit _ Building Engineering Variance Valuation: $ s?`?r - ?- ,. _ ,- , ' 4U -- ?4-". / ?, j, / t °k SAC SAC Units ? m a sr'O ? w'o ? ? CY ? ? ? ? ? ? ? ? ? ? ? ? , LOT SURVEY CHECKLIST FOR RESIOENTIAL BUILDING PERMIT APPUCATION I PROPERTY LEGAL: ? -1) DATE OF SURVEY: LATEST REVISION: q?- DOCUMENTSTANDARDS • Registered Land Surveyor signature and company • Building Pertnit Applicant • Legal descripdon • Address • North arrow and scale • House type (ram6ler, walkout, split w/o, spiit entry, lookout, etc.) • Directional drainage arrows with siope/gradient % • Proposed/exdsting sewer and water services & invert elevation. • Streetname • Driveway ELEVATIONS Ebstinn V,-'p ? • Sewer service (or Proposed) ?? ? • PropeRy comers ra' ? ? • Top of curb at the driveway 57?0 13 • Elevations of any ebsting adjacent homes roosed [xY ? ? • Garage floor p?p ? • First floor , ?/p ? • Lowest exposed elevation (walkouVwindow) 3 ?12- ? • Property comers p?? ? • Front and rear of home at the foundation PONDING AREA Crf aoolicablel ? ?p • Easement line ? o?? • NWL ? C?F' ?C] • HWL ? p?? ' • Pond#designation Elevation Af O ? [3 ? • ow ve Emergency DIMENSIONS ?o ? • Lot IinesBearings & dimensions ? p ? • Right-of-way and strastwIdW-0oback of curb) / (? p ? • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc. (.e. all structures requiring permanent footings) ?p ? • Show all easements of record and any City utilities within fhose easements 2' ? ? • Setbacks of proposed structure and sideyard setback of adjacent existing structures ? ?0 • Retaining wali requirements?jf?ny / Reviewed: January 7998 CHA101 GGBIBLOGPRMf. FM y • , * * ** * PIONEEA * ang near ** ** LMID Certificate of Survey for: LMlD PLMINERS 2422 Enterprise Drive Mendoto Heights, IAN 55120 LIVR ENGINEERS (612) 681-1914 FAX:681-9488 • HDSCA?E Ap0H1hcn 625 Highway 10 N.E. Bloine, MN 55434 (612) 783-1880 FAX:783-1883 MANLEY BROS. CONST. . I I 19 ? 2 BENCH MARK TOP OF PIPE U'` ELEV.=979.24 ? 30 1?A11A. ; S89'41'52°W 979.92 136.50 977.6 .?l 78.0 34.00 44.33 976.7 -- :--- `O r- x - 0 9m9.4 - ? x 978.8 10 ° 10 ? ? ? itn 31.33 o Y 979.6 ?, I I O i a 7.0 N\o\m p ta ? . O w'w ? Ja p i O 4° 00 12.OOo ? ?W ?o ? 30 x\ ?a ? M ?2.Oi L°n a \9.00? ?Z W ? ? ,?y ?3? i 978.9 x20 zW4' ? Z? 5?? 1 980.7 ; z.'3? - ? o i 978.6 o W 3 ? ? N?}I j? GARAGE N ? U \ O 4 Z? - 00 ? F 32.33 00 a I r ? 980J i ?9go-3 979.? ? p i O ? o? PROPOSED ? oj I 10 Z i Z 10 ? °? ORIVEWAY oi 30 L---?2r------ r------- i o 978.0 x977.5 ? 010.v) 34.00 t 44.33 I s?7.s ! S89'41'52°W 977.76 136.50 975.5 , o M BENCH MARK 976.8 TOP OF PIPE -- ELEV.= 76.20 - - - - ???,?j?? ?P-- SYCAMORE DRIVE NOTE: PROPOSED GRADES $MOWN PER GRAOING PUN BY: E.G. RUO PROPOSED HOUSE EIEVATION NOTE: BUILDING OIAIENSIONS SHOWN ARE FOR HOftIZONTAL AND VERi1CAL LOCAnON LOWEST FLOOR ELEVATION: 97l-!q OF S7RUCTURES ONLY. SEE ARCHITECTUpL PLANS FOR BUILDING ANO vouNOnnon oiMEnsia+s. TOP OF BLOCK ELEVATION: q?oo'l NOTE: NO SPECIfIC SOILS INVESTICATIINJ HAS BEEN COMPLETEO qJ TNIS l0T By TME ??j•3 SURYEYOR. TNE SUITABILITY OF SOILS TO SUPPORT THE SPECIFIC HOl15E GARAGE SLAB ELEVATION: PROPOSEU IS NOT THE RESPONSIBILITY OF THE SURVEYOR, NOTE: TMIS CERTFICATE OOES NOT PURPORT TO SHOW EASEMENTS OMER TMAN % 000.00 DENOTES EXISTINC ELEVATION TNOSE SMOWN ON THE RECORDED PLA7. ( 000.00 ) OENO7E5 PROPOSED ELEVATIOP! DENOTES ORAINaGE AND U7ILITY EASEMEN7 NOIE: CONTRACTOR MUST VERIFY DRIYEWAY DESIGN. DENOTE$ DRNNAGE ROW DIREC710N NOTE: BEARINGS SHOWN ARE BASEO ON nN ASSUMED D/.TUM T DENOlES MaJUMENT -E3- 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 20, BLOCK 3, 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 30TH DAY OF SEPT., 1998. dIGNEC / PIONEER ENGI ERI , P.A. SCALE : 1 INCH = 30 FEET l . ? ? SITB AD ENEItGl' COBE WOI2KSHEET FOR 1& 2 FADiILY DWELLINGS ? ??J}n a s?7-r dDCSLr CITY i?? i? L?: E31Z0?. enoNS NDATC 352NICATION: 11 categoLy 1(otandard) or1po category 2(must incl4da voatilation) tfItiIHUM CRITHRIA Foundatlon Ineulation-R10 - Y7alln & Windowo Roof Attia lnnulationi Slab (See reverse g e on Grade Ineulation-R10 forullowable arcentaee P 9 1 R49-With Attic No ISeel Floor over unheated epaces-1129 R38-WithAttic Raised Neel Foundation Windowe 1/2" R38 & 95-Solid RaEte're Snsulated Glase. -Wood or Viayl ['rame STBP 1 Window 4 Door Area A. Total Window & Door Area in Sq. Ceet WINUOWS (Including Foundatioii WiII(j0{Jg) ; WI2SDOW MANVFACTfJRB NAMB e WINDOW MAtNPACTQRE TYpB,_ G*`lrY o, N, WINDOW MANOFACTUR6 i7 F1?CTOR: / ? ? R. O. Quantity cq.[C.Akea Dimensions ?Nx ?N OF x CO D X X X X X UW;St 'w(J > '/ ? M CoB X? /- ?- 1'utal Atea of n_ Windowa 4 Daore B. Total Wall tlrea in Sq. [`C. . Wall Total Ifeight Perimeter 7'otal Area of Walls Area Et. [c ST6P 2 Calculata area ae a percent af wall C. From Step 1 divide box A(47indow 6 poor Area) by 6ox 0(total wall area) timeo lno equale tite window and door area as a percent oE wall area (6ox C). AOX a ? j? X loo I3 ox B ST6P 3 Ueaign Peatureu P.SSEM6LY PRAMIt7G TYPE: - ? STANDARD FRAMINa ?ttida 16" o.c: ADVANCEO FRRMING rstuda 29" a c . . CP.VITY INSULATION ? 994ATHIli6 TYP6t ? LESS TIIAIJ < R-5 R-5 > OR PIORIi U-FACTOR p From the table, (reveree eidQ) deCermine the maximum peYCent window 4 door aroa for thedeeign op[iono eelected and enter the k value fn Box D balaw baoed on tlie window mEg. U- factor: ? I `n ? D ? ? j$ [? ? The t value EYOm Che Cable in 6ox D ahall be cyual to or greal-er than the k in Dox C r 9 ? ONE- &'fWp_ppmpj,Y RC$fD@N'CIqL p[m,pING pRF,rCIUM.rvE (COOK-SOOK) API'ROACIt MAXIMUM WINDOW AND DOOR AREA AS A PEI2CCNT OF OVERALL WAL[, AREA STANDARD R.17 <R , STANDA2D R-17 Z n . ADVANCGD R-17 ADVAI3CED 11•17 ? . Notea: 5 11.9% 15.7% 18.4% 21.5% 5 13.8"Yo 18.4'/0 . 21.51A 25.09'0 5 12.6°/. 16.8% 19.6°(u 22.9"/0 5 14.3% 19.0% 22.2% 25,7"/0 Wlndow erea equals rongh opening minus lnelallation clearances. Window U-factor must be determined by either the Nationa! Fenestration Rating Council slandard 100-91, or AStiRAE 1993 HOdbook of Fundamentals, Chapter 27, 'table S. Post•R• Fox Nota 78lt n FL4IILMtnn Kulee part 7670 047?,ftu l c Bly ?* ** * PION6@R L.ND * en near ng * ?...... ? ?10•` ?Wf;fcl?%Turvey for: M 2422 EntNprise Drive Mendota Heighta. MN 55120 (612) 681-1914 FAX:681-9488 625 Highwoy 10 N.E. Blaine, MN 55434 (612) 783-1880 FAX:783-1883 BROS. CONST. ? ?y,,.JI 2 1Z v 3 6.rJ0 1977.6 . \ 976.7 r N o ?-F --- - - R 0 io ?"20 10 1.33 ? LY3 O ? 978. .6 ?? ? 8 x ?.W m ° g? 1.0 p ? C5 ? ? 4 e pN .? °• p 1200 / a ? F } ??] O ? 30 0 2.0 6 / -tla J? w o? ? k I ? 97 O w 20 11 +3 •o- ? - • ? x 'y 980.7; z. o o ? o ? G 978.6 • o< '? ? ? 3 a W I Go w ? ? ARAGE - i \ ? i ?? Jp N I Q Z? ? 0 co I " \ 11 32.33 1 7 F 980 •? 8 1 4-- W I O 1 . ?9 c 979.1 ? t8.+ ? ? O 7- ? 10 ol PROPDSED o? DRIVEWAY Ip 1 e 70 Z i 30 L --?? t ? 978.0 x 977.5 (q'IS• { . ( q90•,)34.00 ? ?4.33? 977J6 ; S89'41 52 W 136.50 975.5 I 977 9 0 ? n BENCH A1ARK 976.8 TOP OF PIPE ELEV.-978.20 _ _ _ - SYCAMORE DRIVE NOTE: THIS CERTPCATE DOES NOT PURPORT i0 SNOW E>SEMENTS OiNEM TM/JI X 000.00 DENOlES E%ISnNC ELEVAnON iHOSE SHOWN ON ME RECWDEU vlAi. ( p00.00 ) OEMOlES PRWOSEO ELE-TON - p(NOlES OHNNAGE M1D UTIJtt EASEMENT NOTE: CMItRACiOP MUST V£flltY OPiVEWAY pL5tC1l. ??. Mp{[5 DflPINACE RM DIAEGTCN NOTE: BEARIwCS SHOMN ME Ba5E0 ON M ASSUMED OAIUY ? OENOIES MONUMEni -g- DEHOiES OifSET Hi1B WE HEREBY CERTIFY TO MANIEY BROS. CONST, THAT THI$ IS A TRUE AND CORRECT REPRESENTAiION OF A SURVEY OF THE BOUNDARIES OF: LOT 20, BLOCK 3, PINETREE FOREST DAKOTA fAUNTV, MINNESOTA IT DOES NDT PURPORT TO SHOW IMPROVEMEN75 OR ENCMROACHMEN75, EXCEPT AS SHOWN. AS SURVEYED BY ME OR UNOER MY DIRECT $UPERV1510N THIS 30TH OAY OF SEPT., 1998- l1 NOIE: PROPO$D qtROES SMOWN PER pfADINC PWI 8Y: E.G. RUD PROPOSED HOUSE ELEVATION NOTE: BINLDMC WNENSIONS SHOYM AFE i0R Nq1120NiAL NIp VERMAL LWATON LOWEST FLOOR ELEVATION: 97i.q ?pUNO TOxpOiMEN90N5. E ARCMIECNIiL PlANS FOR BVILO?NG u?0 TOP OF BLOCK ELEVATION: &'' NOIE: NO SVECIfIC SOILS MVESTGAnM HA5 BEEN LOMPLETED ON 1H15 LOT BY iHE L?eo,3 siaWvars. nie suirABIu.r w sais io weroar nie svcane Hwsc GARaGE SLA9 ELEVnTION: vnoPO5E0 6 xor THE HESFd+51eNiV Of lME wROEYtM. BGNED PION?R ENG? ERI , P.A. SCAIE : 1 1NCH = 30 FEET , . - . )-- ?.? 3 y 7 ao'? t?.) • 01 F(iOtUl 'UN 1 6 2009 4* D ? 3830 Pibt Knob Road Eagen MN 55722 Phone:'(657) 675a675 Fau:(6bj)s75-569a `:• 2009 RESIDENTIAL PLl Daw: 10 = 01 Sfte AW.?: 9 C0 g renaM• ? 5 1 Permit#: ??0 ? remm ree: '_ '5-D j oare Recewed: i staff' ----------------- IG PERMIT APPLICA710N Lnre Suite #: RESIDENT / OWNER Name: D i e v-, e. IJ P vtic f'? 2 J 9 e r2. PhpnO; lO Ia ' Q 7 U' S a S/ nddress/ Ciry/ zip:491o8 Q; »z Lan-e- ia4e,,. Y?i .z SS??2 CONTRACTOR Name:NeSSiar\ plr+r-b?i?$ Ser.ic;e.f ik Vcense#;OS4SlS Address: 1'• 0. Q o X a a ?? a city: ? ? g ai-. state: ri," 2jp: s s ?? a Phone: l?i - (o $ 1-$ 2 SQL Comaat Persan: Yln ?' ?(e f c? i' /? IYPE OF WORK _ New Repiacement vRepair _ Rebuifd _ Modity Space _ Work in R.O.W. Description M worlt• PERMR TYPE RESIDENTIAL H t W t f ?W S er eater tener a er a o Lawn Irtigatlon Add Plumbing Fix[ures RPZ /_ PVB) (_ b9ain _ lower Level) _ Seplic System _ Water Tumaround New AbatxlOnrnerd RES! L FEES: $50.50 Water Heater, Water Softener, or Water Heater n?d SofOerrer (includes $30 State Surcharge) $30.50 Lawn Irrigatbn (includes $.50 Shdte Surchar9e) $50.50 Add Plumbing Fixtures, Septic System AhandonmeM. Water Turnaround` (includes $.50 Smte 5urtharge) 'Water Tumarourd (add $165.00'rfa 5/8" meter is required) $100S0 SepUC Systertl New ($10.00 per as buik) (rsiudes CouMy fes and $.50 State Surcharge) $90.50 Rre Repair (replace burned out appliances, ductwork, eoc.) (indudes $.50 SYate Surcherge) To'rpL FEES $ 5 O• 5 U i nereuY acanoxneage maz crus rtnomanon ts comprete am aocuraoe: tnet me www ww oe m conrortnence w+m me aamazxes anw caoes m me um m EaBen: tlwt 1 untlersterW tlUe ie not 8 Pormh, tiut oMy 2n appikkeYtion far a PermiR arM vroAc is not to alar[ wiMou[ a pem?i? 11at ttre wak vri0 be in aocodance wkh the approvetl plan in tha case af wak whidh requfres a revfew and approvel of plarm. J x yl-? i ?'1 P SG )-). IN ) 'TZ_ . X?i?-h?. jj_,,-A tlcatN's Prldted Mlame -- __. _ A{fplii?rrt'9 SlgrreWre fOq OF'FICE USE RbVigmwW By: Date: ite9uired lnspecttons: -UnderGraarxl _Rouqh-In _,Air Test Pas Test .,_Flnal ? i For Office Use ! vI O I City Eag,aii Permit I I I Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 I Date Received: Phone: (651) 675-5675 i Staff: I Fax: (651) 675-5694 1 I 2009 RESIDENTIAL BUILDING PERMIT APPLICATION 64 Q' 7-1 Date: Site Address: Tenant: = Suite RESIDENT / OW NER Name: H `CtL N3T 4 ! Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: Construction Cost: Multi-Family Building: (Yes / No X CONTRACTOR Name: License Address: City: State: Zip: Phone: Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted ('I submission type) • Energy Envelope Calculations Submitted 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: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: 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. 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 aprplans. X Applicant's Printed Name igna ure Page 1 of 3 Jul 0 9 Z009 11. DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Fireplace _ Porch (3-Season) _ Storm Damage Single Family Garage Porch (4-Season) Exterior Alteration (Single Family) Multi Deck _ Porch (Screen/GazebolPergola) _ Exterior Alteration (Multi) _ 01 of _ Plex Lower Level _ Pool _ Miscellaneous Accessory Building WORK TYPES New Interior Improvement Siding Demolish Building* Addition Move Building Reroof Demolish Interior Alteration _ Fire Repair Windows _ Demolish Foundation _ Replace Repair Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION /Valuation Occupancy MCES System Plan Review Code Edition SAC Units (25%_ 100% ) Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) Final I No C.O. Required Foundation HVAC Drain Tile Other: Roof: _Ice & Water -Final Pool: -Footings Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath Brick j Fireplace: Rough In Air Test Final Windows insulation Retaining Wall Meter Size: Erosion Control Reviewed By: , t Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4968 Pine Lane Lot: 20 Block: 3 Addition: Pinetree Forest PID:10- 57650- 200 -03 Use: Description: Sub Type: e - Furnace & Air Conditioner Work Type: New Description: Fumace & Air Conditioner Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952) 445 -2840 Fee Summary: Contractor: Quality Heating & Air Services 12912 Ventura Ct #21 Shakopee MN 55379 (952) 403 -1110 ME - Permit Fee (Replacements) Surcharge -Fixed Total: Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - Owner: Gerald Hansen 4968 Pine Lane Eagan MN 55123 Permit Type: Permit Number: Date Issued: Permit Category: $50.00 0801.4088 $0.50 9001.2195 $50.50 Issued By: Signature Mechanical EA089559 06/05/2009 ePermit I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State f City U1 I Permit 0 7 Jr j j j� Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675 -5675 Fax: (651) 675 -5694 Staff: 2009 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: eb •Cfb Site Address: 1 1t...GS I u 4 an MN 1 N 5512 Tenant: ,.r S(� Vag Ii 1. L Suite RESIDENT OWNER Name: I_ (if/l:I Ls 4 J" ibitk 2 .2 Address City Zip: '4)16 h LX '5I CONTRACTOR Name: License Address: City: State: Zip: Phone: Contact Person: TYPE OF WORK .K New Replacement Repair Rebuild Modify Space _Work in R.O.W. Description of work:. z4 Wirticztvl It4 PERMIT TYPE RESIDENTIAL Water Heater Water Softener l Lawn Irrigation X Add Plumbing Fixtures 4�' T� u RPZ PVB) Main Lower Level) Septic System Water Turnaround lY New Abandonment RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge) `Water Turnaround (add $165.00 if a 5/8" meter is required) $100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES 5 I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and ork is not start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and ap. -1 .Ian• t l XSj 7 �WL.1 C X i. 1. Applicant's Printed Name App^III""s ignatu re FOR OFFICE USE Reviewed By. Date. Required Inspections Under Ground Rough-In Air Test .__Gas Test Final, C!tyofEaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 ple(�L& y 1-yetini r L Use BLUE or BLACK Ink/ For Office Use Permit #: 33$ Permit Fee: DC.= Date Received: Staff: 2012 RESIDENTheirPLEMEMG PERMIT APPLICATION Date: --3 — l�^ 1 2,. Site Address: 4-14( Lajj,...L C- c,�.t,L_ �y.• Tenant. �L.�t�C771.. L `3-- /'m%'/2- 19(.2 Suite #: Name: Address / City / Zip: 0? Name: 4!ll1.C?�tl� '.fes Address: -` State: jf Zip: _ "�?'�� Phone: Contact: Email: Phone: (-Pi Z. -2 t O" S -c? -S( License #: �/-4.02cp 9671( City: _7 —61171 New Replacement Repair Rebuild Modify Space J Work in R.O.W. Description of work: r" - RESIDENTIAL Water Heater Lawn Irrigation (_ RPZ / PVB) Septic System New Abandonment Water Softener Add Plumbing Fixtures (_ Main / Lower Level) Water Turnaround RESIDENTIAL FEES: $60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) *Water Turnaround (add $189.00 if a 5/8" meter is required) $105.00 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 (651) 454-0002 for protection against underground utility damage. Call 48 hours 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. x�r � x ..PJAs.•7 Applicant's Printed Name Applicant's Signature Use BLUE or BLACK Ink �_________________I I For Office Use � � �,f�� I ' � Permit#: �� "`�-" � I Clty of E���� � / � � � Permit Fee: �//�- � � 3830 Pilot Knob Road � i Eagan MN 55122 � Date Received: � Phone: (651) 675-5675 I � Fax: (651) 675-5694 L Staff: __——___ � -------� 2014 RESIDENTIAL PLUMBING PERMIT APPLICATION Date:��.J Site Address: �a.J� ��� �.i"�1`�. ��� ���Z� Tenant: Suite#: Resident/Owner ' Name: � Phone: �J'•�7'r.J� i+�� ` Address/City/Zip: I V 1 Name: License#: Contractor , Address: City: '' State: Zip: Phone: Contact: Email: Type of Work —New �Replacement _Repair _Rebuild �Modify Space _Work in R.O.W. Description of work: RESIDENTIAL Water Heater � Water Softener ' Lawn Irrigation�RPZ/_PVB) Permit Type' ?�Main� Lower Level Septic System � Add Plumbing Fixtures � _ ) New Water Turnaround Abandonment 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, Septic System Abandonment, Water Turnaround'`(includes$5.00 State Surcharge) *Water Turnaround (add $200.00 if a 5/8"meter is required) $115.00 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(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org 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, 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 p val X��' . r ' � ApplicanYs Pr�nted Name App i ignature FOR OFFICE USE Reviewed'By: Date: Required Inspections: Under Grountl Rough-In Air Test Gas Test- Finai Meter Related Items: Meter Size : Radio Read Manometer< Staff: Use BLUE or BLACK Ink r For Office Use lIt /q0--15(--/ Permit#: *2' City 0f Laall RECEWED �,,I Permit Fee: /�/7- 3830 '�"O�` Pilot Knob Road DEL Z 9 2016 // Eagan MN 55122 Date Received: Phone: (651)675-5675 Fax: (651)675-5694 Staff: 2016 RESIDENTIAL /BUILDI G PERMIT APPLICATION Date: Site Address: (Q ( 4/911 /7 6 / C Unit#: Name: 2.,. — L�S�G�.. �'''.'i7& Phone: &` - D -7, - 14S--' Resident/ I I Owner I Address/City/Zip: Applicant is: Owner Contractor I Description of work: i4' 1�e �P Type of Work I �._. Construction Cost: !< Multi-Family Building: (Yes /No ) Company: /11/2 4' c. „` ` „i..l14'kc rtiv� utiContact:�. betski0..- v-ex Address:?Pie �VI Sir41City: ) f,.Contractor ....9(7 4, -7 I State/2 Zip: 03 / PhoneelV—1 b 4/6) Email: Y4/4aK.11"+,. /9s3��' %7/-c6441 I License#: Lead Certificate#: �–/ / Of� ' 7 s i If the project is exempt from lead certification, please explain why: C L / -1-' •I 1 t, '/ / 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: Phone: 1 k Mechanical Contractor: Phone: i Sewer&Water Contractor: Phone: I t Fire Suppression Contractor: Phone: 1 NOTE:Plans and supporting documents that youssubmit are considered to be public information. Portions of I the information may be classified as non-public if you provide specific reasons that would permit the City to _,„ -.m -m ,� _ , . ,p _o, conclude that the 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.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. Exterior work authorized by a building permit issued in accordance with the Minnesota State Buildi 2 --_• must be completed within 180 days of permit issuance. x /4# 4 f04 -- I ApplicAis Printed Name A.: .-nt's S 1= ure Page 1 of 3 qq6`:-2< /)17) e Lai DO NOT WRITE BELOW THIS LINE /`'70--S`7 SUB TYPES Foundation Fireplace Porch (3-Season) Exterior Alteration (Single Family) ,, Single Family Garage Porch (4-Season) Exterior Alteration (Multi) Multi Deck Porch (Screen/Gazebo/Pergola) Miscellaneous 01 of_Plex Lower Level Pool Accessory Building WORK TYPES New Interior Improvement Siding Demolish Building* Addition Move Building Reroof Demolish Interior Alteration Fire Repair Windows Demolish Foundation Replace Repair Egress Window Water Damage Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION tor Valuation 36r.,0 Occupancy 7 t -/ MCES System Plan Review Code Edition ay/1 SAC Units (25%_ 100% Zoning a-/ City Water — Census Code 'r/ 3y Stories Booster Pump — #of Units / Square Feet PRV #of Buildings 1 Length Fire Suppression Required -- Type of Construction �'' Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) Final/No C.O. Required Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test Roof:_Ice ,Water _Final Pool: Footings _Air/Gas Tests Final ' Framing if 30 Minutes 1 Hour Drain Tile Fireplace:_Rough In _Air Test _Final Siding: Stucco Lath _Stone Lath _Brick—EFIS itk Insulation Windows Sheathing Retaining Wall:_ Footings_ Backfill, Final Sheetrock Radon Control Fire Walls Fire Suppression: _Rough In_Final Braced WallsErosion Control Shower Pan Other: Reviewed By: , Building Inspector RESIDENTIAL FEES ?* --- `� `v Base Fee F,?-. ''' Surcharge Plan Review 7 `_ MCES SAC City SAC Utility Connection Charge S&W Permit& Surcharge Treatment Plant Copies / g ,2.3 TOTAL Page 2 of 3 Use BLUE or BLACK Ink For Office Use Permit : /1/o V*-- I(� City of EaftakPermit Foe; `0 3830 Pilot Knob Road Esgan MN 55122 Date Received; C' . Phone:(651) 6756675 Stats: Fax: (651)675-5694 2017 RESIDENTIAL PLUMBING PERMIT APPLICATION • 1 Date: 1 Site Address; r / Tenant: Suite#: Resldenit/Owner Name: ( 1d)5 //u-77 `T`1"- / t:\Q Phone: Address/City/Zip: I-I ct i,pg I tor: Name:R"Q- \t ' i311-V(44.&1w1 ave.._ License#: '!" . 6 tt^8� Contractor IN-A-9") 1.04[ U r�,c6 , L City: L) le.e. ILL_C State: -1" Zip: c )L(,t( Phone: 9( -aD.9 a 1)0 T1 Contact: I VVP're- . Emit �+ Q1�1��L)�� P ?" 't LW C p(4 Type of Work —New Replacement Repair Rebuild Modify Space _Work in R.O.W. Description of work:Q ©VE-.? FA wV IA N P 6` .,__ o RESIDENTIAL Water Heater Lawn Irrigation( RPZ/ PV$) --Water Softener Permit Type Add Plumbing Fixtures L Main/—Lower Level) Septic System _New _,,,,,Water Turnaround _ Abandonment RESIDENTIAL FEES: $60.00 Water Heater,Water Softener,or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation(Includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment;,Water Turnaround"(includes State Surcharge) *Water Turnaround(add$280.00 If a 3/4"meter is required) $115.00 Se tic S stem Ant,(includes County fee and State Surcharge) TOTAL FEES$ GALL.DgFORE YOU DIG. Call Gopher State One Call at(651)464-0002 for protection against underground utility damage. Call 48 hours before you Intend to dig to receive locates of underground utilities, www.gonherstateonecall.orp I hereby acknowledge that thin 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 en 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. x 1\144.‘4, L 1E5/ItJr x ,1 t I • • Appllcent'a Printed Name Applicant's Signature FOR OFFICE 113E Reviewed By; _ Date; Required Inspections: Under Ground Rough-In Alr Test Gas Test Final Meter Related Items; Meter Size Radio Read Manometer Stetf: PERMIT City of Eagan Permit Type:Building Permit Number:EA144349 Date Issued:07/21/2017 Permit Category:ePermit Site Address: 4968 Pine Lane Lot:20 Block: 3 Addition: Pinetree Forest PID:10-57650-03-200 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - 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 - Gerald Hansen 4968 Pine Lane Eagan MN 55123 (612) 280-5725 Caliber Construction Inc 968 Ivy Hills Rd Belle Plaine MN 56011 (952) 873-6078 Applicant/Permitee: Signature Issued By: Signature To: 6516755699 From: 7637108061 _ _ . _ ____ _ 9-09-19 3:99pm R. 1 of 1 E GAN For Office Use �`E �a►� i ,i, Permit#: /sy� �� ;2.5 Permit Fee: (1/ . Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 551 22-1 81 0 (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff buildinginsoections a'�citjofeagan.com I_ J 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 4/4/19 Site Address: 4968 Pine LN Unit#: I Name: Gerald Hansen Phone: 612-280-5725 Resident/ # 4968 Pine Lane i Owner I Address/City/Zip: i 1 Applicant is: Owner X Contractor i i 3 Type of Work • Description of work: Replace existing overhead garage door on attached garage. i I construction Cost: $4000.00 Multi Family Building: (Yes /No X i I # AA Garage Door LLC Dave Sands t Company: Contact: y I , Address: 562 Lundy Lane City: Hudson Contractor i I l WI : 54016 651-702-1420 cave as arc edoor.com State: Zip_ Phone: Email: 9 9 i Nat-671642 t License#: Lead Certificate#: , I i _ If the project is exempt from lead certification, please explain why: i i i COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING t In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan? I I 1 g Yes No If yes,date and address of master plan: i E S Licensed Plumber: Phone: I i Mechanical Contractor: Phone: t i Sewer&Water Contractor: Phone: a Fire Suppression Contractor: 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 iia provide specific reasons that would permit the Ci y to conclude that they are trade secrets. 4 You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.cityofeagan.com!subscribe. 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. 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.copherstateonecall.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 app ,:I • plans. Deborah Nyasende x t� V2 /41'-,419-- ' Applicant's Printed Name Ap' icant's Signature