4292 Pintail CtCITY USE OA'LY
iOT 4 BL RECEIPT #: I I`t b? I
SUBD. o- RECEIPT DATE: ? J' l 1
MECHANICAL PERMTT #
1999 MEcHAvicAL PERMrr (RsinENr[AL)
CCI'Y OF £i4fir4N
3930 PILOT KAOB RD
f.A1fiAN MN 551 EY
(651)6$1-4695
Date• '
Complete this section onlv if you are installing HVAC m a single family dwelling, townhome or condo under
construction and not owner /occunied.
• HVAC: 0-I00MBTU
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one required @$3.00 ea.)
State Surchazge
Total
$ 30.00
6.00
rpo
.50
Complete this secrion oitlv if you are remodeling, adding to, or repairing an existing single family dwelling,
townhome, or condo.. Please indicate if it is a new item, alteration, or repair.
New Alterarion Repair _ Other
Reminder: Call 681-4675 for inspections.
Furnace
_ Air exchanger
SIT'E ADDRESS
OWNER NAME:
INSTALLER NAME:
STREET ADDRESS:
CITY: lot?%412 .
om x?'? -Y?l AGfi
a'
_ Air condirioning
Other
$ 30.00
State Surcharge .50
Minimum Total Due $ 30.50
PHOIVE #: -
.46 -
PHONE n co?E%
_ ?
(AREA CODE)
_ STATE: ?(? ZIP• 35?a
SIGNA O II TEE
CITY USE ONLY
L BL RECEIPT#:
SUBD. RECEIPT DATE:
APPROVED BY: , INSPECTOR MECHANICAL PERMIT #:
1999 MEcHAxlcaL PERMrr (coMMEftc[atL)
crrY aF EAsArr
S$SO PILOT KNOB ftD _
E+46AN, MN 55122
(651) 681-4675
Please complete for: all commercialfindusVial buildings
multi-family buildings when separale permits are not required for each dwelling unit
DATE:
CONTRACT PRICE:
WORK TYPE: New conshvction Instal] U.G. Tank
_ Interior Improvement Remove U.G. Tank (Minunum Fee)
Processed Piping (Minimum Fee)
'*NOTE: When installing/removing underground tank, ca11 65 1-68 1-4675 for inspecrion by fire marshal
and plumbing inspector.
DESCRIPTION OF WORK:
FEES: 1% of contract price QR $30.00 minimum fee, whichever is greater.
CONTRACT PRICE x I%
PERMIT FEE
STATESURCHARGE
TOTAL
------------- ------- -°-----°
SITE ADDRESS:
OWNER NAME:
TENANf NAME (IMPROVEMENTS ONLl):
INSTALLER:
ADDRESS:
crn':
PHONE #: -
(AREA CODE)
STATE: ZIP:
SIGNATURE OF PERMITTEE
($.50 per $1,000 of nermit fee due on all permits.)
PHONE #:
(AREA CODE)
?
mj P,-k
?n?.?".ciFX?W;k:?t???.?;8c,c8cx??'d?k,i<y:A'?:;+?>;<:>Ini.>?:n;;ht?>;r,•„?:,<.r;c2 ???v
CLTY CI= =_AGAP;
Cr1iIITF.na 8 T'FF'.M:[NAi_. iJ(la 70F?
UA'T"E:; 0500199 'iIP1;'4 09:5007
=Li ^
NAt?!_: hS h I-iECsF.i.iil' °. A59Cf7I(i'i1=3 l.NC
i'i5Sr 9220 4292 F''f.i4'((37:i. C'(' 30..00
32:L0 9001 4292 i"7t•ll"f+f.i_ CT t,316.55
^,:,,;,6 9379 4292 f'•lfidi'nl!_ r'i LC1n.40
3422 ':a(..i.,:l. 7292 F'?H7P,?I_ C'1' I375.26
^i;:id' 9(]fli, 4?92 I'lN'Y'A"f.L. CT 0.50
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3743 :)?;?i.] hr92 I'7.i•7-IA1:l. C"i b0„00
f':I.55 (:)001 03i? P'TN''(;SL CT 3:t.50
3868 9:?r'.?C) 4292 f'}.i1'TFill.. r;1 4b8. ;(]
CR'.08319 xM CC1:Q" ;.P1L!lE
LISER TD: NANC`r' u C[JN7:f.NUF_
,{r11.(vty.:Y,'7Fr,;.K%` . . .c:#.,<00 ,'i :ct;:>$`'.?hd1 ,^ V,C$tof* 1 *#
['UNT1'I`!I.IE
CtTiY Cq'' L7:GA3J
C!?SH1:F:Fia '.'i i'f.'Rt51:NAL N0: 708
DF'il'i- ll 7 t7°:i/'I.q/9[3 "i'i:M', n 08:50:98
.
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NnM.; Vi r FiEt:n,:r f, ns50c:_niGS zNr,
27:1b 9220 4292 f'lAi'iA:fL i,Y I.ifi.OU
371.3 `_=)'cR(:) 4292 F'TNTi4'i.l._ CT 50.0q
3965 9?cJ 4292 r-irarAi:i. cr 825.00
?ni:a:1. fir_.,c?ipt A,nQnt:: 4.990„81.
C4i Hi3'319
UcFr. 'rDg N1tJCV
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
+ CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675 9Q
New Construction Reaviremenfs Remodel/Reoair Reaulrements
? 3 registered site surveys showing sq. fl. of lot, sq. R. of house
and alI roofed areas (209 maximum iot coveraae ailowed)
9 2 copfes of pians (show beam 8 window sizea; poured fnd. design; etc.)
? 1 sef M energy calculatlons
> 3 coples of tree preservatlon plan M lot platled aHer 7/1/93
DATE: y- 7 e - 1?
DESCRIPTION OF WORK:
STREEi ADDRESS:
2 copfes of plan
1 set of energy calculaHOns for heated addfllons
1 sMe survey tor exterior addflions & decks
CONSTRUCTION COST:
i' L e- /-fftircL-(-?
/-7-T /c- C/1I19 CL c
/0 'F, 92 S
LOT: `I BLOCK: I SUBD./P.I.D.#: W,?( 1-.-m.0 y?
PROPERTY
owNee
Name: /? ? C
r
Lasf First
Street Address: /y 3
Phone#: / f 3- 3e, City T/j°p? ? ??? ??"i State: Zip: 2 L?
Company: S') C Phone #: G ,'Z' 2 E- 2
(area code)
CONTRACTOR
Sfreet Address: '
Ciiy
State:
License # Exp.
ARCHITECT/
ENGINEER Company: < !D Name:
Telephone #: area code ( )
Street Address: Registration #:
City
Sfate:
Zip:
Z-a7 z`-/
Zip:
y-µ?? ?? ,L i ??k. ?/ie-?[
Sewer & watet licensed plumber (reoulred tor new consfructlon oniv): C FJ
i"
,_ Pr?aly applies when address change and lot change Is requested once permft ts tssued. ?
t hdreby acknowledge thaf I have read this applicatlon, siete that the information is conecf, and a ee to
Stafe of Minnesota Stafutes and Clty of Eagan Ordiaances. ? -4
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received ? Yes _ No
(rS` ?-
?CS-?
with all applicable
- - -?
`? .
Tree Preservation Plan Received - Yes !% No '? Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
,
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
A 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
;( 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bidg.* ? 41 Wood 5tove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
" Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. 014• Census Code 101
(Allowable) 5?l Main level sq. ft. I 4-7G SAC Code ol_
UBC Occupancy ZIPu( sq. ft SZ6 No. of Units L
Zoning 7z-? GNe . sq. ft. No. of Bldgs ?
# of Stories 2 sq. ft. MC/ES System
Length 5-1_ sq. ft. City Water
Width 3-3 Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS ,
Planning Building CAA-? Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
b< ?S =
/AC 14? )C s??' ? 79
`1
City SAC
9 ?0x??F' ,
WaterConn.
Water Meter a - ? 3 t rl L0
Acct. Deposit
SMI Permit T? = l62, 2B?'
S/W Surcharge
Treatment PI.
Park Ded.
?
Trails Ded.
Other
?
Copies
Total:
SAC Units
% 5AC
LOT SURVEY CHECKLIST FOR RESIOENTIAL
PROPERTY LEGA
/
67
4
?-
,
L:
1
^
DATE FSURVEY'
? LATEST REVISION:
-
?
d 3 ?
m --
a o DOCUMENT STANDARDS
?
¢ z° f
0 ? Registered Land Surveyor signature and company
?
Building Permd AppGcant
/:3 ? .
Legal descrip6on
_
Q ? ? • Addreu
?y?- c • North arrow and scale
?? o • House type (rambler, walkout, splR wlo
spfR entry, lookoA etc.)
? ? ,
• Dvectional drainage aROws with slope/gradlent %
??
'
' ? • Proposed/epsting sewer and water services & invert eleva6on
O
- ? • Street name
aa o . Driveway
er-c o • Lot Square Footage
Q--C' ? • Lot Coverege
ELEVATIONS
ExIstina
a-'a ? • Sewer service (or Proposed)
a-'c ? . Property comers
a-'[] ? • Top of curb at the driveway
t '-' ? • ElevaEOns of any ebsGng adjacent homes
Prooosed
13-,o ? • Garege floor
2f' ? ? • First floor
'=l ? ? • Lowest exposed etevation (walkouUwindow)
25, a o • Property comers
0' ? ? • Front and rear of home at the foundaGon
PONDINCa AREA (it anodcade)
? d' ? • Easement line
0 0' ? • NWL
? a/? . HWL
? d ? •
? Pond # designaUon
? a
a • Emergency Overllow Elevatlon
OIMENSIONS
0- o a • Lot Gnes/Bearings & dmensions
CT' ? ? • Right-of-way and straet width (to back of curb)
Cr-?? ? • Proposed home dimensiorm induQmg any proposed decks, overhangs greater than 2', parches, etc.
(i.e. ap structures requiring permanent footfngs)
o' ? o • Show ap easements of record and any Cily utNes within those easementa
??? • Setbacks of proposed sWCture and sideyard setback ot adjacent epsting sVUCtures
? m' ? • Retaining vrall requiroments, if any _
Reviewed:
March 19BB
caucikoovaMr Fle
ENERGI' CODE WORKSHEET FOR 1& 2 FAMILY DWELLINGS.
. ,
•COMpLETE? BY:
6IIILpIL7G CLA55IFICATION: ? cat
HZNIMUM CRITBRIA
Foundation Inaulation-R10
slab on Grade Inaulation-R10
Floor over unheated epaces-R29
Fouhdation Windowe 1/2"
inaUlated Glass.
-Wood or Vinyl Frame
1 {ee
Walle @ Wiadowa
(See table on reveree sjde
for allowable percentagee)
STSP 1 Wiadow & Door Area
A•, Total Window & Door Area in Sq. [`eet
WLNDOWS (Including Foundation Winc3owe):
WINDOW MANi7pACTURB NAMB:
WIM10W MANOFACT[TRE TYPS:
WINDOW MA2QQFACTUR6 U gACTOR:
R. O. Quantity eq.EL.Area
Dimensians
S!-o" X 4 0" ,?f /
71
_2?X ?ON II
'e?t%0 X 7.,c ?? (1
X l k ? l
1 ? CON x 3 L wn (1
" 3 ! o" 7
x
X
X
DOOR?S
'is 1 Gi
Zg "(08 !
G° x G ?/,
1'utal Area of
Windowe & Doore
B. Total Wall Area in Sq. Et
Wall Total k{eight
Perimeter
Total Area of Walls
0
V
18
r7?
P7-
A_ og.ft.
3(olD
ArQa
?
ZO
?857
Off,
CZTY
DATS
1
lation
Roof Att1c Ineulatioh:
R44-With Attic No ffeel
R38-With Attic Raised 11ee1
R38 & RS-Solid Raftere
STBY I Calculate area ae a percent of wall
C. From S[ep 1 divide box A(Y7indow 4 Door
Area) by box D(total wall area) timea 100
equals the window and door area as a
percent oE wall area (box C).
BOX A _5eje?e X 100 =
aoX t? Z2.9 3 ???Jf
STEP ] Deeiga Peatureo
P.SS6MBLY
PRAMItVG TYPE:
STANDARD FRAMING otuds 16" o.c.
ADVANCEO FRN1INa ctude 24" o.c.
CAVITY INSULATION R?
9H6ATHIL7G TYPH;
LESS TFIAN < R-5
R-5 > OR MORE
Il-FACTOR p
Prom the ta61e, (reverse side) determine the
maximum percent window 4 door area for the
deaign op[ione eelected and enter [he t valiie
in Box 0 below Uased on the window mEg. U-
facGor:
??//J ?D
?{?JL.J
The ! value from tlie table in Box D shall be
equal to or greater [han the k in Hox C
•
.
ONE- & 7W0-p,4A,QLY RFSIpEN'l74,t pLlIyDING PRESCWp77yE (COOK-HOOK)
ArrROncri
MAXIMUM WINDOW ANb DOOR AREA A5 A PEI2e[NT OF OVEftALC WALL
naEA
Notea:
Window area equals rough opening minus Inatallatlon clearances.
Window U-factor must be determined by either Ihe National Fenestrat(on Rating
Councii etandard 100-91, or ASHRAE 1993 Handbook o[ Fundamcntals, Chapler 27,
7'sble 5.
Post-It' Foz Note 7671
rt
Prom Mlnn R?les nart 7670 0:?5 0bsAuZj,_M r
A"It14na1 ealcula?ed vaWes
1 L BL CITY USE ONLY
SUBD.
RECEIPT #:
RECEIPT DATE: ?
PERMIT #
1999 PLUM$INfi PEftblTl' (fiESIDENTIAL)
crrYof EAs"
3$30 PILOT KNOB RD
EA6M, MN 55122
(651)6$1-4675
Please complete for: ? singie family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinklersystem
FIXTURES
EACH #
TOTAL
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
GeS i in outl0t ' minimum - t 3.00 x $
Hot tub/s a Sae 3.00 x = $
Kitchen sink 3.00 x = $
Laund tra 3.00 x = $
Lavato 3.00 x = $
Minimum fee alterations to existin dwellin 30.00 x = $
Private Dis osal S stem newlrefurbished ` re uires MPC iic. 75.00 x = $
Private Dis osal S stem abandonment 30.00 x = $
RPZ new installation/re air 30.00 x = $
Rou h o enin 1.50 x = $
Shower 3.00 x 2 = $
Under round s rinkler if dweliin is under construction 3.00 x = $
Under round s rinkler if existin dwellin 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
Water softener if dwellin under construction 5.00 X = $
Water softener if existin dwellin 30.00 x = $.
Water tumaround 30.00 x ----
State Surchar e .50 --> ----> ----> $ 50
Total ----> S
53 °-=
Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc.
--------------- •- •-------- ? ---------------------------------------• •------------------------• •------------------------------------ •-----
I hereby acknowledge that I have read this application, state that the informatlon is correct, and agree to comply with all applicable City of Eagan ordinances.
It is the applicanYs responsibility to notify the properry owner that the City of Eagan assumes no liability for any damages caused by The City during its
normal operational and maintenance activities to the facilities constructed under this pertnit within City property/right-of-wayleasemenf.
SITEADDRESS: qz9Z A/I4e" ( C ?
OWNER NAME: : Ik6r4 '(-4S50c- TELEPHONE #: S.3 - 3
(AREA CODE) ?I
INSTALLER NAME: ? ?O LR ?-r.- (r I?g TELEPHONE #: /- 5/ Y (o o ' ? YZ Z
STREET ADDRESS: TARIA CODE)
cirv:
ATE: A?
25?'
ZIP: O2
JATURE OF PERMITTEE
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EACAN
? 3830 PILOT KNOB RD - 55122
1??. 651-881-4875
k? ? CR!lPOl 5-io-av
New Conshuctton Reaulremenh ? 5/1?Au Re /Reoalr Reauiremenis
n 3 reglatered slte wrveys Owwlnq sq, tl. of bt, sq. B. of house 2 copfes ot plan
and gU rooleC areaa (4016 mmdmum lot covemae alloweN 1 set ol energy cdculcillans lor heated adtllHOna
> 2 coplea of plans (show beam R window slzes; poured Ind. dealgn; efc.) 1 site wney tar extedor addlflona a decka
> 1 set o1 enerpy CNCWatlons
> 3 copies of hee prefervaMon plan If lot PlaHed aRer 7/1/93
oArE: 5-°I -6 o CONSTRUCTION COST: $-1 ? S 0 0. 0 O
DESCRIPTION OF WORK: Cf d a r d,e c K-
STREET ADDRESS: '} 2 q 2 Pi t-ii0.l I to (,Lv}
LOT: . ?' BLOCK: ? SUBD./P.I.D. #: NlA V? ?V Ih LI ??%
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Name: S a n k C v r t. g?! t Phone u: l? S l- In 61v - to 4!"7
(qst First
Sheet Address: 4" Z q 2 P? h+i.t l[ t0 I,t v-f-
aty _ C- Gt p a vn state: M i.! zlp: S S I 2,z
Company: ?bYl'?l tr ? bV? S?n,l. L?'t 61"-' : ?Y1C • Phone M: q 5 2
(area code)
Sheet Address: b la lo Vj,,iG?(4 f wCL?I-LV Dv• License i 2-o2i U 1 l p Exp, 3 3 ? o i
Cly V!A f Stafe:
Mnj
Company: ? I A Name:
Telephone #: (
Sfreet Address: RegishaBon N:
Ctty
Sfate:
SewerAvater licensed plumber (if installina sewerhvater): Phone #:
zip: ? 5 3 '10
ZiP:
I herebY xknowledge ttwt I have read lhis applicalbn, state thaf the InfortnaHon is cortecf. and agree to comply with a0 apPIcable Sfate
of Minnesoia Stafirtes and Ciy of Eagan Ordinancea
Signalure of APplicarN:
OFFICE USE ONLY
Certiflcates of Survey Received ? Yes _ No
Tree Preservation Plan Received Yes No _ Not Required
- - ??
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.)
? 02 SF Dwelling ? OS 06-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.)
? 03 01 of _ plex ? 09 07-plex .bc-- 18 Deck ? 23 Porch (screened)
? 04 02-plex ? 10 OS-plex ? 19 Lower Level ? 24 Stortn Damage
? 05 03-plex ? 11 10-plex Plbg _YOr_ N ? 25 Miscellaneous
? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Aa:essory Bldg.
WQRK TYPE
?K 31 New ? 36 Move Bldg. O 43 Reroof
O 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding
? 33 Alteration O 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code 0( # of Stories sq. ft.
No. of Units D Length yo sq. ft.
No. of Buildings ? Width +s. s Footprint sq. ft.
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. MC/ES System
UBC Occupancy sq. ft. City Water
Zoning sq. ft. Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning Building Engineering Variance
? 31 Fxt. Alt - MuRi
? 33 Ext. AR - SF
? 36 MuRi
y 3y
Permit Fee fi 6 0. S d
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total: 1ti D . S a
Valuation: $ 1,100
SAC Units
% SAC
I 0? A D?
2007 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reouiremenis
3 registered site surveys showing sq ft of lot, sq. ft. of house; and ali roofed areas
(20% maximum lot coverege allowed)
1 Soils Report if proposed building is to be placed on disturbed soil
2 wpies of plan showing beam & window sizes; poured found design, etc
1 set of Energy Calwlations
3 copies of Tree Preservation Plan'rf lot platted affer7lll93
Rim JoisiDetaif Options seiedlon sheet (buildings with 3 orless unds)
Minnegasco mechanical ventilation form
RemodeVRePair Reawrements Office Se ONy
2 copies ot plan strowing footings, beams, joats CeA of Survey Recd _ Y_ N
1 set of Energy Calculations for heated additions Soiis RepoA _Y _ N
lsitesurveyforaddNOnsBdecks Tree Pres Plan Recd _Y _N
Addrfion - indicatei(on-sitesephcsystem TreePresRequired _Y _N
OnsleSepticSystem _Y ,N
ofn.,e zro rnncirlcrcrl nnhlir i.,fnrr„a+inn iiniPczcz unu state thev are trade secret and the reason.
Date O /?/ /? .r?
Construction Cost ?5DCJ
/
Site Address v2q,? ?"f?"lA? 4tE UniUSte #
tion of Work ;Fr //?'/ 2
Descri ??? ? ?'???? ?/?? ? - /j?02T"?'F?
p
Multi-Family Bldg _ Y_?RN Fireplace(s) _ 0 2
! ?/,
t
O Telephone # (65/ ) 33 ?? Cpa- 8"?
i
-
Property
wner
Contractor ?{ ?77"E"-? ?C????G"
Address ?-3la jqfi? C/OlC '?{
0''r CitY ???l?5T%?[?
State / !-,` Zip ,SS-i 3 7 Telephone #(?rl?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv ] _ Minnesota Rules 7672
Energy Code Category
. Residential Ven[ilation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) • , Submitted Submitted
` . Energy Envelope Calcwlations Submitted
In ihe last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
i herebv annlv for a Residential Building Permit and
Telephone # (
Telephone # (
Telephone # (
that the information is complete and accurat
e;
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
perxnit; that the work will be in accordance with the approved plan in the case of wo which requires a review and
approval of plans. ?
g7
JZ?
Applicant's Printed Name ApplicanYs ignature
DO NOT WRITE BELOW THIS LINE
Sub Tvqes
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alf - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo/pergola) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvpes
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Altera6on ? 37 Demolish Building* ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement 'Demolitian (Entire Bltlg) - Give PCA handout to applicaM
DBSCriPtion: WaterDamage_Yes
Valuation Occupancy MCES System
Plan Review 100% or 25% Code Edition
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bidgs Length Fire Sprinklered
Type of Const Width
Footings (new bldg)
Footings (deck)
_ Footings (addition)
Foimdauon
Drain Tile
Roof Ice & Water Final
Framing
_ Fireplace _ R.I. _ Air Test _ Final
_ Insularion
Approved By:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
REQUIRED INSPECTIONS
_ Sheetrack
_ FinaUC.O.
_ FinaUNo C.O.
HVAC
Other
Pool Ftgs Au/Gas Tests Final
_ Siding _ Stucco Lath _ Stone Lath _Brick
_ Windows
_ Retaining Wall
Building Inspector
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ADDRESS Ft2 - 4292 PPNTA,L GO,,Rr
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Bearings are assumed
Sub,?ect to eaeementa of record Lf any
Q Donotes aet or tound lron pipe monuments
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Denotee direction of surPace drainage
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I hereby certify that Lhis ie a true and corract representation oi e survey of the boundaries
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of Lot4-, Block County, Minnesota as on file and of record
in the Oflice of the County Recorder Sn and for eaid County? also showing the proposed location
of a house as etaked thereon,
.
That I am a duly Ragiatered I.and Surveyor undar the Lawa of the State of Minnesote.
Dated: hpQ{L 1-/1 IJ-/ /
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' Allan R. Haetinge
idinneaota Regietration No. 17009
212 &sat First Avanue,
Suite No. C
Shakopee, Minnesote 55379
Phone 612 445 9027
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0 Denotea set or found iron pipe monuments
$ Danotea set wood hub end tack
"Jgqp Denotee exieting elevetion
9p Denotes proposed finish grade elevation
qn-5.I Propvsed Denotes direction of surface drainage
?? lowest iloor elevation ?
I hereby certity Lhat thie ie a true and correct represantation oP a survey of the boundaries
M t?Q? I7?1I Dwora
of Lot4-, Block A-M?Q°O?jyV?l, County, Minnesota as on file and of record
in the Office oi the County Recorder in and ior eaid County, also showing the proposed location
02 a house as stakad thereon,
That I am a duly Regiatered Land Surveyor under the Laws oi the State of Minnesota.
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I&qt Allan R. Haetinge
Mlnneeota Ragiatration No.
212 East First Avenue,
Suite No. C
Shakopee, Minneeota 55379
Phone 612 445 4027
17009
.
PERMIT
Permit Type: Building
City of Eagan
Permit Number: EA106077
Date Issued: 08/08/2012
Permit Category: ePermit
Site Address: 4292 Pintail Ct
Lot: 4 Block: 1 Addition: Mallard Park 4th
PID: 10-47253-01-040
Use:
Description:
Sub Type: e-Reroof
Construction Type:
Work Type: Replace
Description: House & Garage
Census Code: 434 -
Occupancy:
Zoning:
Square Feet: 0
If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are
Comments:
not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes.
BL - Base Fee $4K $103.25 0801.4085
Fee Summary:
Surcharge - Based on Valuation $4K $2.00 9001.2195
Valuation: 4,000.00
Total:
$105.25
Contractor: Owner:
- Applicant -
Legacy Restoration LLC MARK A SCHAEFER
10650 Cty Rd 81, Unit 101 4292 Pintail Ct
Maple Grove MN 55369 Eagan MN 55122
(763) 354-7660
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA115274
Date Issued:09/25/2013
Permit Category:ePermit
Site Address: 4292 Pintail Ct
Lot:4 Block: 1 Addition: Mallard Park 4th
PID:10-47253-01-040
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Jeff Pelant
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 -
Mark A Schaefer
4292 Pintail Ct
Eagan MN 55122
(651) 452-3287
Legacy Restoration Llc
14000 25th Ave N
Suite 110
Plymouth MN 55447
(763) 354-7660
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA124977
Date Issued:07/16/2014
Permit Category:ePermit
Site Address: 4292 Pintail Ct
Lot:4 Block: 1 Addition: Mallard Park 4th
PID:10-47253-01-040
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Mark A Schaefer
4292 Pintail Ct
Eagan MN 55122
(651) 452-3287
Legacy Restoration Llc
14000 25th Ave N
Suite 110
Plymouth MN 55447
(763) 354-7660
Applicant/Permitee: Signature Issued By: Signature
. � .. r . ��.. . � . �.
' .. +y�,.� �, './`� 7 �i.i�� tti,r'C�. � ,' � . .
' �, t .yf..{ . .
. '� .
, . � : ," . '• '.,' '. . • • --- Use BL.UE or BI.ACK ink
. . . � . , . i FOf�}(ICY ViY ��.____._.-I
Clt of � � . � . . � �,��� . ,
. � ��j�n � . . . . I PeRnil�: �
�ill � �
3830 Pilot Knob Road �
i Permlt Fee: °'�� i
Ea9an MN 66122 . . � ' ' . � �
j Date Received: �� � � �
Phona: (661) 676-b676 . � � �
Fax: (6b1j 6T6�6684 � s�an: i
� � , ;'' �--------- ------_�
20� 1 RESIDENTlAI: 6UIL`DIN.G,PERMIT APPLICATfON
Date; 3{te Addre�s, � � �• �i'�' ' �'-�� •
UNt p;
Name; �ie�i� ' � �{}.� . ,'` .. �—
RESIDENT I , ,!�:�.� , '��R�� Pho�e:��r� ����-��o
OWNER • Address/Ci�y I Zip;_ �(�.�',Z' � ��;tJ7`-�i�G� �-���
, ��`'��Z
Appilcant Is: .Ovrnar. •.Contractor• , � .. � .
.;,.s
TYPE OF WORK OascrlpUonotwo�c:' �:;��.�Gi�-�v �i��tr� ��J�
�
Constructlon Cost; �,� �' G� � � Muld•Famlly B ilding: (Yes i No
Company:�'?—i✓!N����q,¢�}1,t� �� �,� co�c��c:�..S��e�� S'7`/?0 l-l�.�4y��tZ
CONTRACTOR Address:_��I �I3�,t/L�LIL�',�Q; � ' • ' City: _ �f�LS
� Stata:,,,�_..,Z�p�„�S�•�`2¢� . 'Rhona .�. . �� Q O '
� . ; ... ,;.�Yti ;'
� � u�e�$•#; .30 35'oogz.._ .' i.oad c�r�nc�c��: iti'��'= 3�.3 7 I
�r
If tha project Is exempt.from lead certlflcatlon, please exp aln� � y;(
� �+I ,. Wh~� sea Pase 3�for addit(onal information)
�1G lL'C�._ . . : `: ,. . � �° + . � 3i� � ��
H '^'rtir;�.
r �r'�t.:r��?:�i'� , .
COMpLETE THIS AREA�N���_CQNgTR�lCTjN(3 A NEVII BUILDING
In the tast 12 montha, has tha City�of Ea�an ls�ued a po►m!t for.a slmllar�plan based�on a master ptan?
,_Yes _No If yes,data and�ddress of master plan: ' • �' • .
;�
t;7censed Piumber:
_. Phona:
Machanical Contractor, _ , : i
. Phone: ,
Sewer b Water Contractor; • , . , .;' . '
� ; : : 'Phone: I
IYOTE:P/ans and supportlnq documants tha�•yq,�,subm,It$rp cpnsl�/�recl,to�be publlc Intormado�. .Portlons ol
. the lntormaUon may ba�class�f/�tl:as:�qt�:RU�'/C l�you .
/ Y "'s �.. ,.
• . � ,�Y � �,• � ,,. �,.1�9 ��''.�,l�lQ raasvns that wou/d pe.rm�it'the City to
. . �., � ' : '.�•'. . � ;.t�'Ct7t�CludA'�fatri�e .ar�'fxad�,seQrets �
CALL BEFORE YOU OIO, Cap Qopher 8.t�� �,n�.��,;�.. �,`,,`` �.. `:'`''° ' : .•:'r' ` .,,. . .
� $ (4b, )4�000=IOf P�0�9CUOn 8981ns1 underground uQlfty damage. CeU�8 houn
oeror..you IntenO a dJy to recelve localo,o(uMer�rnund,vUllU.w�� � s .
,?�..U�•rf i 5�..,.y.1,;:4�at�t:fM /��I;K�r�O;S�rJS.�i fr��� . ', .
I hereby acknowted9e thal thls Informallon Is Corr��l��n a�acCUral9;(I'1e{(hpµptk j,y(p'pg'h'pp�(pRpBnc,e with!h� wdlnances end cpdos ol tne Ciry o�
Eagan; that I undcrstand th1� b no! e pqrmll, bul cr�h� en eppucaUon (or e pomUt, and,;wpiic Is nol to atart witnou� e pam,l�; lhal (he wpAc ydll ba in
accordance with lhe approved pla�!n lha'c�se o(µ.�;;;�,�,�1��quiras e raviow�erid�opprovai ot,p{ens,• •
:� ,'� , ; , ,
Fxtarlorwork authortzed by�bulidinp permit Is 1,'• (n accordanco wlth the Minnosota$tato 8uflding Code�muat be completed withtn t80
days ol permlt Issuance. . .
x Sf���= ,S�RD�/�i�-y� t � ,
,� , ,
App11cant s Printed Name ��'"—' x \
Ap cant's Slgnature
. Pa9e t or �
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA177816
Date Issued:07/19/2022
Permit Category:ePermit
Site Address: 4292 Pintail Ct
Lot:4 Block: 1 Addition: Mallard Park 4th
PID:10-47253-01-040
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.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Mark A & Michelle R Schaefer
4292 Pintail Ct
Eagan MN 55122--224
(651) 494-8402
Legacy Restoration Llc
15350 25th Ave N, Suite 114
Plymouth MN 55447
(763) 354-7660
Applicant/Permitee: Signature Issued By: Signature