3034 Pine Ridge DrDate:
City of Eago
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Tenant:
Use BLUE or BLACK Ink
ForOfficeUse
Permit #:
Permit Fee:
Date Received:
Staff:
(2011 RESIDENTIAL PLUMBING PERMIT APPLICATION
/ Site Address: T f/' �= ' c r' / --
1
Suite #:
RESIDENT / OWNER
Name: U %3 (77 l Z:t.J ' I�`E Z Phor e: /2_, --1 4.., a- -----/d6-----/d65s
Address / City / Zip: ,) 0 3 L'/ /ZJc E '". ;� )' 6-A-64A-ii.MIIJ 2 I
'
CONTRACTOR
Name: License #:
Address: City:
State: Zip: Phone:
Contact: Email:
TYPE OF WORK
_ New .Replacement Repair Rebuild Modify Space Work in R.O.W.
_
Description of work:
PERMIT TYPE
RESIDENTIAL
Water Heater v Water Softener
Add Plumbing Fixtures ( Main / Lower Level)
Lawn Irrigation (� RPZ / PVB)
Water Turnaround
Septic System
New
Abandonment
RESIDENTIAL FEES:
$55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation
$55.00 Add Plumbing
*Water Turnaround
$105.00 Septic System
$95.00 Fire Repair (replace.burned
(includes $5.00 State Surcharge)
Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
(add $166.00 if a 5/8" meter is required)
New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
out appliances, ductwork, etc.) (includes $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.qopherstateonecall.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
accordithlhe approved pi in these of work which requ' es a review and approv Mf plans.
x
c
A Jplicant's Printed Name
icant's Signature
FOR OFFICE USE
Reviewed By: Date:
Required Inspections: _Under Ground Rough -In Air Test Gas Test Final
City otHapll
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
1C4-
Permit
Permit #: /60
Permit Fee:
Date Received:
Staff:
2011 MECHANICAL PERMIT APPLICATION
Date: eit/ � Site Address:3 / �
Tenant: Suite #:
J
RESIDENT / OWNER
Name: -"42771--f.-`. (/t /,4A-'7 C t G Phon6/ Z Z----16 65
-/
Address / City / Zip: 3 J 7 `1 e. 111- 6"--17-64/3/1`.-1A-j,, � Z/
CONTRACTOR
Name: License #:
Address: City:
State: Zip: Phone:
Contact: Email:
TYPE OF WORK
New ,Replacement Additional Alteration Demolition
Description of work:
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
PERMIT TYPE
RESIDENTIAL
Furnace
COMMERCIAL
New Construction Interior Improvement
Air Conditioner
Install Piping Processed
Air Exchanger
Gas Exterior HVAC Unit
Heat Pump
Under / Above ground Tank ( Install / Remove)
Other
** When installing/removing tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$55.00 Minimum Add-on
or alteration to an existing unit (includes $5.00 State Surcharge)
burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ TOTAL FEE
$95.00 Fire repair (replace
COMMERCIAL FEES:
$75.00 Underground tank
$55.00 Minimum (includes
installation/removal OR
State Surcharge)
$10,010, surcharge is $ 5.00
surcharge increases by $.50 for each $1,000 Permit
Fee requires a $ 5.50 surcharge)
Contract Value $ x 1%
= $ Permit Fee
- If the Permit Fee is less than
Fee = $ Surcharge
- If the Permit Fee is > $10,010,
(i.e. a $10,010-$11,010 Permit
_ $ TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.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, 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 /Ze j(7t , 4,4v YiT eZe-:,
Applicant's Printed Name
App'licant's Signature
FOR OFFICE USE
Reviewed By: Date:
Required Inspections: Under Ground _ Rough In Air Test Gas Service Test In -floor Heat Final
Exterior HVAC Screening Inspection
2011-07-2516:06
411/`1City otes
» 6519755694
3830 Pilot Knob Road
Eagan MN 56122
Phone: (651) 675.5675
Fax: (651) 675.8694
P1/2
UM BLUE or BLACK ink U"
ti
Far Of Uar
Permit Si:
Parmrt Fee:
Orb
Stet
`') r�
2011 RESIDENTIAL PLUMBINGQPERMIT APPLICA` ION
Daft: ` r_X 1 Sits Address: 30324 ! ' r.
Tenant Suits 6:
RESIDENT I OWNER
Name: &V Anklinbere3 Phone Ii13 8T, O tti
Addr+sss l City I Zip: SairjRJ LCIteliCate__.
CONTRACTOR
.
Name: A, I P /
. 1 A A e. L.idenee I: a tt%
Adm: ta5 SglifiVn 14b _ %tut Cit
State: M NI Zip:55 35.1 Phone: LQ Ida Rtig 2410_
Contact 5St sate Email:
TYPE OF WORK
_ New Replacement RerpauRebuild Mydify Space Wort in R.O,W.
_ _
`
Description of worst:. 1r r% �`
PERMIT
taE TYPE
l
RESIDENTIAL
Water Softener
Water Neater —
— Add Plumbing Fixtures L. Main / - Lower Level)
Lawn IrrigationRPZ / PV9)
Sept System Water Turnaround
New
_Abandonment
.._. -.
RESIDENTIAL FEES:
$55.00 M)n)tr imi Water Heater, Water Softener, or Water Heater and Softener (Includes $6.00 State Surcharge)
$35.00 Lawn irrigation (includes $6.00 State Surcharge)
$55-00 Add Plumbing Fbtbures, Septic System Abandonment Water Turnaround" (Includes $5.00 State Surcharge)
'Wafer Turnaround (add 9188.00 if a 5/8" meter la required)
$105.00 Septic System May (moo per as bull) (incudes County tee and $5.00 State Surcharge)
$95.00 Fire Repair (replace burned out appliances, ductwork. etc.) (includes $5.00 State Surcharge)
TOTAL FEES $
;ALL..BEF_ YOU 1:49. tall Gopher Stets One Can at (1161) 464.0002 for protection against underground uti r damage.
Call 48 hours before you intend to dig to receive locates of underground uti iaas. www.aooherstateonecall.orq
I t*mby v m edge that this Irtomietlon is complete and accurate-, that the work will be In conformance with the ordlnences and codas of the City of
Eagan; that I underetend this is nota permit, but only an rppfinYon fora permit, and wok is riot to shut a permit that t he work will ba in
Scoordenca with the . . , plan In the case of work which requlros a review and epprrivai of piens.
FOR OFFICE USE Reviewed By: - Date: ..
Requited Inspections: Under Ground Rough4n 4n _pdr Test Gas Test _Final
411°'
City of Evan
3830 Pilot,Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Date:
Tenant:
Use BLUE or BLACK Ink
Permit*: C% ?W[6.
P�,uil
Fut. s vim. 0 C)
Cate Received: 7—,—/
Staff:C-
2010 MECHANICAL PERMIT APPLICATION
0 Site Address: 0 r • *'!
Suite*:
J
RESIDENT / OWNER
CONTRACTOR
News,
Name:
Address:
State:
Contact: " O /_
Phone: 11712 b 1Ja t 619-
44
.L
t r �V
411 1i► D41 tt- �.J 1101 License #:
. ra. Cir. 1tJ1,, City;
5&33 tPhone:-7
_ LC!!34D-33"'
Email:
TYPE OF WORK
New Replacement _AdditionalIteral' r, i Demolition
r ids ltit6S f--0,
17g,WE-
Description of work:AM
SMR
•
FTE: RQOf`mgyrited and •gr,.pisnd mouri!ted:re
• • dianical*qulp4nt is'cequired•to.b.scceenedby Citybode: •caritMeoanicatsg• •Infaraatiopotparmitted seteering method6.,• . . • • • •h •• •..
PERMIT TYPE
RESIDENTIAL FEES:
RESIDENTIAL
_ Furnace
Air Conditioner
w Air Exchanger
_ Heat Pump
(✓Other
Caw i &Mo
COMMERCIAL
New Construction Interi
Install Piping
Cas
avement
Exterior Unit
Un • _ •t.ove ground Tank Install / Remove)
hen Instaiungiremoving tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
$55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge)
$95.00 Fire repair (replace burned out appliances, ductwork. etc.) (includes $5.00 State Surcharge)
COMMERCIAL FEES:
$75.00 Underground tank installation/removal OR
$55.00 Minimum (includes State Surcharge)
55, O b TOTAL FEE
Contract Value $ x 1%
$
- if the Permit Fee is less than $10,010, surcharge is $ 5.00 Permit Fee
• If the Permit Fee is > $10,010. surcharge increases by 5.50 for each $1,000 Permit Fee = $ Surcharge
Um, a 510,010-511,u10 Permit Fee requires a $ 5.50 surcharge)
r. $ TOTAL FEE
CALL BEFORE YOU DIG. Gall Gopher state One Ceti at (651) 454-0002 for protection against underground utility damage. Call 4$ hours
before you intend to dig to receive locates of underground utilities. www.gopheratateenocail 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
Cagan; that I urrdcrstune this Is not a permit, out only an application for a permit, and work Is not to start without a permit; that the work will be In accordance
wi•
th the approved plan in the case of work which requires a review and approval of plans.
Applicant's Printed Name pplica is Signature
FOR OFFICE USE
Required, Inspection
E0/Z0 39Vd
r+ roue
reviewed By::
O. 17r tri .. • , , Air Pests: _ •.,,Gas Se)'ifice Te : -tl
at :._.,,., ... Irr Dort: Heat. ^•...F'tnaE..
_. xtartor•HVAC.Screenirkltispecdon:
1000 193H avo HJIH
BEEELLPE9L
LZ:60 0TOZ/80/L0
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued: a'l ;..? ;•.
(612) 681-4675
SITEADDRESS: ` 1" """
i: t r.
!!1 F I IFli4 IIR
PERMIT SUBTYPE:
I`'" APPLICANT:
fi 1, (t ? t
TYPE OF 1N4RK:
?
NI"
x---"`-- __----?
Pertnit No. Permit Holder Date Telephvne #
ELECTRIC
PLUMBING
HVAC
Inspectfon Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAS
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
eK(i?
DECK FINAL
CITY OF EAGAN Remarks
Addition 0 lund Timberline Lot 16 Rik 2 Parcel
Owner a /f' st.eet 3034 Pine Ridge Dr. State Eagan, MN 55121
W A•-?tt?tf ; _ t,?
Improvement Date Amount Annual Years Payment Receipt Oate
STREET SUR F.
aq STREET RESTOR. 1 1 1024.22 102.42 10
GRADING
0 SAN SEW TRUNK 1968 100. 00 3.33 30
EWER LATERAL 1970 . 2 1 .37 20
* WATERMAIN 1970 ZO
WATER LATERAL
WATER AREA 33 1977 160.00 10.66 15 -35:7 7
• STORM SEW TRK 1970 ZO
STORM SEUV LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATERCONN. 320.00 2$]] 5-11-7E7
BUILDING PER. #392 $129.50 2877 5-4-76
S-I1-76
PAR K
T
V
CITY of EAGAN
BUILDINC3 PERMIT
/.j..?J..
own.: Z9 ....... ..W?y./.../.J. ....... ... .J. .................................
Address (nresani) .0.!!1?! ..............,...,?<?e?..............................
Bu5ldes
Address
DE3CAIPTIOIQ
A ia
N2 3924
3795 Piloi Kaob Road
Eagan. Minneso2a 55122
954-8100
Dels7/7...?.?...??..yl.?-•....
- Ramulu
Slories Be Used For Froni Deplh HeiBb! Eal. Coo! Parmit F
qJ1L
I.4?I b? 73ao? i g°°
LOCATION `/ 29 %
or
!6
or
This permit does not aulhorize the use of dreels, roada, alleps or sidewalks nor does ft g{ve the ownes or hls aqent
ffie righ! !o create anp situation whieh is a nuisanee oz whieh ptaseals a hmard !0 the heallh, sa£elp, coavenlenee and
geaeral weltace !o anpone in the commwnity.
THIS PEAMIT MUST / THE' E WHILE THE WORK IS IN PA01M?
............ ? ?L.r..._upon
Thls is 3o ceriifY, lha??L. .?. ....- ---..0f!4 Lr. ..frl.......has peraussioa !o ereat e. W*7-.
the above described pre ' e u'eat fo ihe provuions ot all applicaLl?inance for ! ......................... Par ....... .............
......?......
."""_..?.._-"- """..or
? 0 55.3? 0 /!r d a?\-
Qslccr7d 7:m
C TIi'1' OF E.4GAN
1795 ?i3ot Knob Road
Eagan, Minnesota 55122
PE.sNIIT NO. ; 687
The City of Eagan hereby grants to Project Plumbina Oo.
oY 9743 Fiwnboldt Ave: So. hWls. 55431
a PLUMBiNG Pexmit for: (Owner) Tollefson _
at 3034 Pine Ridqe Drive , pursuant to application dated 619/76
Fee Paid: $20.00 dated this 14 day of JLne ? 19 76.
.50 s/c
Building Inspector
Nechanical Permits:
Bid Totai:
/a 55300 /c,o oy
ioslnOd T,mF?er??na
Cl:'i'Y CF E:'fGAN
37g5 Pilot Knob Road
Eagan, Mir.nasota 55122
PEFNIT NO.: ,}iaf;
The City of Eagan hereby grants to Fredrickson ttPat-ing c n/r-
of 4030 Beau d'Rue nriva
xeating Tollefson Builders
a Air con. Permit for: (Owner) i wa?-diov -
3034 Pine Ridqe Dr.
at ' r. , pursuant to application dated FIIA17r,
Fee Paid: $25.00 dated this 17ba day of TyinP ,.19-a&_
1.00 s/c
Building Inspector
Nechanical Permits:
Bid Total:
« _----
- rIL60E oF eacnx WATER SERVICE PERMIT
3795 Pilot Knob Rood PERM[T NO
: 1997
Ea9on,MN 55122
Zoning: RI .
DnTE: 6/14/76
Owner: T?jje__fSOn Bui],deiS No. of Units:
Address:
Site Address: 3.034_Ping_gid,.
P]umyr: ProjectPlwnbing Co = __ ?-.
_l??
F
o. Lonnection Charge: ?50_[f?
Reader No.: Accaun[ Deposit; _
10.00 pd
P
_
I ogree fo comply wifh tAe Villoge of Eogan
O
7 ermit Fee:
Surcharge: • 50 Pa
rdinwnces.
/' j .
Misc Charges: 60 00 pd
? i
Total:
By
Date of Irisp.: - lla[e Paid:
Insp.:
VILLpqE OF E40AM
3795 Pilof Kno6 Rood
Ea9on, MN SSl$Z
Zoning; RI
Owner: Tni I pfs
Address:
Site Address: in9
Plum6er. _
SEWER SERVICE PERMIT
PERMIT NO.: _
DATE: -? 614/7_6?_
No. oF Umts: _ 1
5/11/76 02877
1 ogna fo ?o1nPlY wif6 Ny Village ei Ea on 100. QQ pd
OrA{na??„ 9 ConnecunnChazge350•00 pd
Account Deposit:
Permit Fee: 10.00 pi -
gy; Sumhazge: .50 pa
Dateoflnsp. Misc. Charges:
:
Insp.; Total: -
. Date Paid: _
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
BUILDING
@25436
04/24/95
$ITE ADDRE$$:P•I•N.s 10-55300-160-02
LOT: 16 BLOCK:
3034 PINE RSDGE DR
OSLUND TIMBERLINE
PERMIT SUBTYPE:
DECK
?
?
APPLICANT:
2
THE DECK & DOOR COMpANY
(612) 451-3192
TYPE OF WORK:
NEW
?
?
y CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMITTYPE: BuYLozNG
Permit Number: 0 2 5 4 3 6
Date Issued: 0 4/ 2 4/ 9 5
SITE ADDRESS:
P.T.N.: 10-55300-160-02
PERMIT cu4M
3034 PZNE RTDGE DR
LOT: 16 BLOCK: 2
05LUNp TIMBERLINE
DESCRIPTION:
BSU3ltlirsdl Permit Type DECK
v%Iding 6J&rk, Type NEW
?
z
• . . ..3
r^
?+v
?
REMARKS:
FEE SUMMARY:
Base Fee $30.00
Surcharge $.50
Total Fee $30.50
CONTRACTOR: - ppplicant - 57. l.IC. QWNER:
THE DECK & DOOR COMPANY 14519192 0005457 WANBERG BOB
11632 AKRpN AVE E 3634 PXNE RIDGE DR
INVER GRQVE HTS MN 55075 EAGAN MN 55121
(612) 451-3192 (612)454-8464
T hereby ackriowledge ttsat I have read this appl3caCian artd state thOt the
informatictr* Is barreetr andagr??? to comply,uith al3.=,applir;able 5tate o€ Mri.
? 5tatute:s and Gity raf Eagan Ortlirrances.
.. . . ' APPLICANT/ITERE ----S ?U?D B1 SI???? ? ??
3830 PIL'OT KNOB RDN 55722 $3D ?O
1995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Conshuetion Reauirements RetnodeVReeair ReQutrements
? 8 registeretl ske aurveys ? 2 copbs of plan
? 2 copies of plens (include beam 8 window sizes; poured ind. design; etc.) ? 2 site surveya (ex[erior edditions 8 deeks)
? 1 energy celaletbna ? 1 anergy ealculetions for heated additions
? 3 wpies of tree proservaEon plan if lot platted after 711/93
required: _ Yes _ No -
DATE: /7` 2;L CONSTRUCTION COST: ??vv 6J
DESCRIPTION OF WORK: v?4e
STREET ADDRESS: '
LOT I (P BLOCK ?-s -,/N `
SUBD./P.I.D. #: I l 'I d =
d
PROPERTY Name: /..?ol? 61AN411zK6- Phone #:
OWNER
StreetAddress-
Cliy: f= 4 6AN State: Nrl Zip: . 5-\.5 d- /
CONTRACTdR Company%NrZ V- Roofz Phone #: z-
3 3? S`b
Street Address: Av'?`z fi License #• ? y`s7 ?J
City:LniYdk State: )"%r'/ 2ip•?ss?a?.3?
ARCHITECTI Company: Phone #•
ENGINEER
Name: Registration #*
Street Address*
City: State: Zip:
Sewer 8 water licensed plumber:
change are requested once pertnit is issued.
Penalty applies when address change and lot
I hereby acknowiedge that I have read this application and state that the information is correct and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received
Tree Preservation Plan Received
_ Yes _ No
_ Yes _ No
APR 17 1995
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation o 06 Duplex
0 02 5F Dweiling o 07 4-plex
0 03 SF Addition ? OS 8-plex
0 04 SF Porch ? 09 12-plex
0 05 SF Misc. 0 10 _ plex
WORK TYPE
j!f--31 New o 33 ARerations
n 32 Addftion o 34 Repair
GENERAL iNFQRMATION
Const. (Actuaq
(Aliowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
? 11 Apt./Lodging ?
? 12 Multi RepaidRem. o
0 13 Garage/Accessory o
? 14 Fireplace ?
,0-15 Deck
? 36 Move
0 37 Demolition
!
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
Basement sq. ft.
Main fevel sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Planning Building
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
ACCt. Deposit
S/W Permit
SNV Surcharge
Treatment PI.
Road Unit
Park Ded.
Treils Ded.
Other
Copies
Totai:
MGWS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code. ?
SAC Code ?
Census Bidg /
Census Unit O
_ Engineering Variance
Valuation: $ t200
?
,
% SAC
SAC Units
Cities Digi
itv Control
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from the original page.
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Lot_?_ Bloc?r Ar1?=. 1,?.;;-; ..,.- /.;z1JP? i1 3°
j'id seu?iari number
Stre:t
; L 5?
Zosie-Ord3nzxcs ??2
Loc SizA X
Fla,ted
Total , arca
IIn.pJ.atte3
Bz::i:,ce Size ?.? X Z? JTc':;al area
0 CC'31; ui:.i;?r
Tfj]2 Ofl C;C?'a5tY't;.^ i•rC:1 .. . V .._ _
Se,,`.baCks: S ti r4t sldes Reax' ?,?p
Sides ? -O?-Parkir..ve To'la7_ axe.a _?
c
Par?:zrc area setbackp:
S'tr-et side q`2-k?
Landscape app?^oval
Spec?a.7. Assea...:wnts:
o??? /
?_:.., charge
?
tidater areas
Assessed
_ Bond PEC,'ri:iPEd
U
...? ?
? ?4-50.00 Ur.sssessed ?- j(?6. /??e?„!z? C1????,?.?
Sr asse:saef?: Conncation charg.>
If unassessAd: Conne;t-on ciuarge
Lot di.-S.sions
Adci_tional assessments needed
Total spaces
- ? q .-
:tear Si:ies
Not neaded t!
Lateralse
Assessed Not asse3sed
iaai:-er of hearin :
Neeoed Dlot ne-3ed
Assessmexzt clk Water & SEwe: Dept F3uilding Dept
Police Dept Fire Dept (Co^.m & Ind only)
«
Type of building or wark i
(Ikesidential) Commercial
? uild Enlarge A1ler
Dimensions_ q .. /z .. .........
Details or
Locaiion
Eagan Township
DakoYa Counfy, Minnesofa
Applicatioa for Bnilding Peemit
oalemplaYed. Circle corzect descripfians.
Indusf rial Olher...............................
Repeis Inslall Move Wreck
S S?
,......'..'._.' . Cosi.:... °O U
.._._
........... ......
piher ...............
PEA$TY//N .......
d ?
aate ........ ....-..
N umber 5tree! Between whaY cross streels Size Est. Va_ luat??
Pr.?l 2ioe'? ?r', 1 973 ?
Loi Bloelc
Addii?on Rearrangemeni ar Tsae1
I / > dv1 hP i' Zr n P
owner ?-5 °r ?A?/3CRG ?? S?'
, .._ """"_'-""' ---------------- " -"-_"-'_
-------------'--'-----"'---'._..."""-"-'-""""""--"----------- .-_'-....... . Addrass -------- _"---'-'-'_'_-----'
""'
-'-'..._ Addxess/--'..2_.1.....:?`.. .1.?.:........'
y
Coniracfor --??k-----' '-?------- ""
The undersigned heseby makes apnli ?@afion for a permi! !o "
$ do work er specified, agraeixg Yo do all work in stric!
Total fee eolleeied. accord ce wiih he building ordinaaee adopied April 11. 1955
by the aga ? owaship oax o -
PermiY fees are noi ? ?
refundnble. -
---------------------- .............. --------- .......................... ." gn -------"
5i ed
Carl Tollefsou Ur.10470
17ti-11
. F. C. JACKSON
u,NO suixvErort
? R[G13T[REp UNp[R LAWS OF STAT6 OF MINNLiQTA ?
n) LIG[N![D BY OROINANCC 6F GITY N MINN[AlOLIf ?
121-3484
9616 EAST 55T11 S7REET55417 ?
1 I
Sburbcpor'g QLtttificatt
L ?
,
?
M
^? I I N ??? !
,
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N 3 j .= 1roh
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•? I?F d?
IN Ni
_ ---_.._ _ - -- - - -- - _- _ ?
1 N[RHCY ClpTIrV T AT TN[ "OV[ 18 A TRU! ANO OORRCCT PLAT Or A BURVEY Or
Lot Lo,Block 2,09luod Timberlioe Additiow,
Dakota Couoty,Miamuota.
ws 9UNVEY[O er Ni THI! 23rd-__CAY ov -?urch. p_ 1976
7th: Apzil 1976
F. C. JICCKSON. MIHN[sa7A ,K[61sirtArlon. No. 3600
l ?
MASTER CARD
P-`.? ?g 3 o??I /b - A
OWNER
STRUCTURE AND
LAND USED AS
Permit
No.
Issued Issued To
Coniractor Owner
BUILDING
PLUMBING 168 7 ?
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAI
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER I \
OTHER I
Items Approved
(Initial)
Date
Remarks '
Distance From Well
FOOTING SEPTIC -
FOUNDATION ? ESSPOOL
FRAMING TIIE FIELD FT.
FINAL
ELECTRICAL
HEATIN6 DEPTH
OF WELL
GAS INSTALIATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUM8ING
WELL
SANITARY SEWER ,
go,
224 4914 AZE?'`?a2
?
?
-•-
- Violations Noted
on Batk
COMMENTS?
...
??
90,
COMPLIANCE INSPECTION REPORTS
TO BE USED ONIY IN EVENT OF OBSERVEG VIOLATIONS
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
? ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
? NON-COMPIIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
? REINSPECTION REQUIRED
REINSPEGTION REVEALED
DATE OF REINSPECTION
CERTI FICATION - I cenify that I have carefully inspected the abwe in which 1 have no interest present or prospective, and that I have reported herein
all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site imprwements relating to the property inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
COMMENTS:
BUILDING INSPECTOR
23
'QW
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONUOS WHEN PERMITS ARE REQUIRED FOR EACH UNTT.
?? ??Od•
^
EACH
TOTAL
NO. FIXTURES
SHOWER 3•00
WATER CIASET 3.00
BATH TUB 3.00
LAVATORY 3•00
KTTCHEN SINK 3•00
LAUNDRY TRAY 3.00
HOT TUB/SPA 3.00
? WATER HEATER 3.00
FLOOR DRAIN 3•00
' GAS PIPING OUTLET • m+nimum - 1 3.00
ROUGH OPENINGS 1.50
WATER SOFTEi.iER 5 M
PRIVATE DISP. • oek.cty. iic. 15.00
U.G. $PRINKLER • nome under consc.
ALTERATIONS • to adstin 3.00
15.00
g
WATER TURN AROUND 15.00
STATE SURCHARGE .50
TOTAL: _ '15. 5 0
SITE
OWNER
WSTALLER:. 14-1 AO7e??I?s ag,^
ADDRESS: ? S`O a- /Ve?14s 1);,,
crrx:?? STATE: ZIP CODE: SSoZ
PHONE #: ( 6/,a)
2- za -y'z 4? ,Se
1993 PLUMBING PERNIIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
l1'y/-23 Ael
1993 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN D'IN 55122
(612) 6814675
PLEASE COMPLETE FOR ALL COMRMRCIALJINDUSTRIAL BUILDINGS. ALSO FOR MULTI-
FAMILY BUILDINGS WHEN SEPARATE PERMTfS ARE NOT REQUII2ED FOR EACH
DWELLING UNIT.
_ NEW CONSTRUC110N
ADD ON
_ REPAIR
WORK DESCRIPTION:
CON'I'RAC'I' PRICE:
FEE: l% OF CONTRACT FEE.
SI'ATF SURCH,li2CF• 5.50 FOR FACA $1,000 OF Y?tJY#T',?' FE&
MINIMUM FEE $ 25.00 '
CONTRACT PRICE X 1%
5TATE SURCHARGE $
TOTAL $_
SITE ADDRESS:
TENANT NAME
OWNER NAME:
INSTALLER:
ADDRESS:
CITY:
PHONE #:
STE. #
STATE:
ZIP CODE:
FOR:
CITY OF EAGAN
APPLICANT
4,11
City of Eaall
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Permit#: 'q30£ 6—
Permit
Permit Fee: 6' 3//"�
6 /6
Date Received:
Staff:
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
C1 Site Address:
Tenant:
Suite #:
RESIDENT / OWNER
Name: /'7c7L ,4-- - (i(,/i4 \J,?''Z.- ,Phone: ./Z a 2_ --"/
5
Address / City / Zip: - p 7 L% PSE'' 1 6e` 2> rt._
Applicant is: Owner Contractor
TYPE OF WORK
Description of work: l " LA -e (--7--4-__ . t 41 -2P A---A—C__.
Construction Cost: V--/ c c) u Multi -Family Building: (Yes / No)
CONTRACTOR
Name: License #:
Address: City:
State: Zip: Phone:
Contact: Email:
COMPLETE
In the last 12 months, has
Yes No If yes,
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
the City of Eagan issued a permit for a similar plan based on a master plan?
date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor:
Phone:
E7, Plans a d Si, ..ort1ng hoca encs that r �b € + Ile
the information nag aclass ifies as no -1 li Yo vie pew ifs sons at u�r .
,conclude; ha 5ea
q
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
x /,j crk r %" - L --444\),r c7,6
Applicant's Printed Name
App licanis Signature
Page 1 of 2
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Use BLUE or BLACK Ink
�-----------------
� For Office Use �
C• ; P@�,�#: i�a��c� s ;
�d� Ol ����il � PermitFee: �� 1� 5� I
3830 Pilot Knob Road RECEIVED
Eagan MN 55122 i Date Received:��� � �
Phone:(651)675-5675 ���- � � �01& i I
Fax:(651)675-5694 � Staff: I
I I
V������ ��������J
2014 RESIDENTIAL BUILDING PERMIT APPLICATION �
Da�: 7/z 1/l�l Si�nad�s$: 3�3'� ���� Rl'c�9e dr �'qq��, ✓�d,�✓ Unit#• � ��
' Name: P�O�'�C"7;' l•✓�n b��tq Phone:
Resi��nt!
��� Address/City/Zip:
' Applicant is: Owner V Conuactor
.1•�/p�8 4�,V�Qrk Description of work: �QGk
Construction Cost:_�`����� Mulb-Family Building:(Yes /No )
Company: lT�� $���+SaraS ��1��In�J Gay�?PAl?L�J Contact: Tu��Y Z✓,i��]
Cc�ntractor:
Address: (Z2,7 O�l ca�i�e f-- �v�, S- c��: �U rr�,s��'i//�-
` State: �� Zip: 5�3 3 ? Phone: `�✓� 73� ��maii: Tu I��r @ U�1 y�ec�,Go�
' License#:_J�C Jc 700�5 Lead Certificate#: �,
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
� ��
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months,has the C1ty 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:
M�TE:Pleas antt serppot�i'n�aloct�ments'tha�yo�r subrn#t are consid�rreal ta be petbli��rtxt�ita�t�. Por#ions:o�
�re fi���tfo�r�t�y be cf�l�ed�S no;n-p�tblfc ff yoe�proVide spec/fic raa�v»s tlta#wot�l p�r�tft the�lly tfl
concfucf�that the �rs trsde secrets. `
CALL BEFORE YOU DIG. Cail Gophe�State One Call at(651)454-0002 for protection against underground utitity damage. Call 48 hours
before you intend to dig to receive locates of underground utliities. www.00aherstateonecail.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 Ciry of
Eagan; that I understand this is not a perm�, 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 authotized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
X .�u I-e v'" (e✓,'th� x t�'�y��i �����
Appli nt's Printed Na e Appl nYs Signature
Page 1 of 3
. , . ���� I�i �+ }��� �� ( � � ��l�
DO NOT WRITE BELOW THIS LINE
SUB TYPES
_ Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Familyj
_ Single Family _ Garage _ Porch(4Season) _ 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 _ Re�oof _ Demolish Interior
_ Alteration _ Fire Repair _ Windows _ Demolish Foundation
_ Replace _ Repair _ Egress Window _ Water Damage
_ RetAining Wall *Demolition of entire buiiding—give PCA handout to applicant
DESCRIPTION
Valuation � � Occupancy �+� MCES System
Plan Review Code Edition 1�/ 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) Meter Size:
� Footings(Deck) Finai/C.O. Required
Footings(Addition) y Final/No C.O. Required
Foundation � ~ HVAC Gas Service Test Gas Line Air Test
Roof:_Ice&Water _Final Pool:_Footings _Air/Gas Tests _Final
Framing Drain Tile
Fireplace:_Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick
Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Erosion Control
Braced Walls Other:
Reviewed By: � , Building Inspector
RESIDENTIAL FEES
Base Fee �J
Surcharge 1^���� �
Plan Review
1
MCES SAC
City SAC
Utility Connection Charge � �"� � �" � �� ��
S�W Permit 8 Surcharge � �
Treatment Plant
Copies
TOTAL
Page 2 of 3
Carl Tslltfsou Uz. l047U
� � ` � 17u-71
: ,. �� � F. C. JACKS[]N /�S(c�/S
L.A�i� �URVEYOR , /
' N
� � R[Ca16T�REp t�MpgR LAWf OF STAT6 CF MINHLiQTA •
� � LtC[HSlD �1f ORCiPtANCE CSF C1TY O� MINNYAr01.1!
� �z�-��sa �
� , � 4 se�a Ewsr ssrH srR��r55G11 �
�
' � ` &�urbcper'� QCert{ficatc
Y 4
� � `�_- -- __.i--�7 .�9-' ......r....,__.__ __ -
,
I
�
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�_` .____.._._...%� __.. .. -- ___ ��, o _ ----- - - ---
I HERHIlY CERTIFY T AT TNi 11�OVi li A TRt7E ANp OpRRCCT PLAT OF A BURYEY OF
Lot 16,Block 2,Oaluad Timberline Additiox,
Dakota CouatyfMia�saots.
23rd l4rch I97b '
AS SURVEY[b LY F�t[ THIS—,_-- –.�CAY CF •.D.-- �
7th: April 1976 �
SioK�a - � ,..f. '
F. C. J CK30N. MtNNCSOI"A IsTRATtC�i. NO. 'J600
�
�f
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA140067
Date Issued:11/22/2016
Permit Category:ePermit
Site Address: 3034 Pine Ridge Dr
Lot:16 Block: 2 Addition: Oslund Timberline
PID:10-55300-02-160
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 -
Robert A Wanberg
3034 Pine Ridge Dr
Eagan MN 55122
Heartland Roofing Siding And Windows Llc
1192 McAndrews Rd E
Bumrsville MN 55337
(800) 681-4169
Applicant/Permitee: Signature Issued By: Signature