4075 Prairie Ridge Rd
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o CITY OF EAGAN 1865?
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ?PH,pNE: 454-8100
BUILDING PERMIT Receipt #
Tn ?,o i icari fnr SF DWC/G,AR F?t V,i"o $146,000 n,tq 3AN 1 S Ia 91
Site Addre
Lot 8
Parcel No
RD
OFFIC E USE ONIY
R-3
Occupancy ?? FEES
Zoning ?1 ??
(Actual) Cons1 ? Bldg. Permit
(Albweble) - Surcharge 73.00
# ot stories 3T 520.00
Length Plan Review
i???
Depth SAC, City
S.F. Total - 630.00
SAC, MGWCC
S.F. Footprints - 660.00
On Site Sewage _ Water Conn
On Site Well Water Meter 90.00
MWCC System
Acct. Deposit 30 Qo
'
Ciry Water 30.00
PRV Required SNV Permit
Booster Pump - S/W Surcharge .50
276.00
Treatment PI
APPROVALS Road Unit 370.00
Planner
Co
il - Park Ded.
unc
BIdg.Off. ?
_
Copies
?
VarianCe
- r
TOTAL •
Sec/Sub.
W Name ` "r` & ` `.'..
? Addres AW a
0 City Phone 5515-6566
?o Name _
Address
Clty _
W W Name
?? Address
<W City Phone
I hereby acknowlege Ihat I have read this application and state that the
information is correct and agree ro compty wdh all applicable State of
Minnesota Statutes and Ci.W pf Eagan Ordinances.,:
?r . „? '" ?!? : _-?--?• ? • ! .
Signature of Permitee
1tOT?3E?S It?DC
A Building Permit is issued to: DAkLE E
on the express eondition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City ot Eagan Ordinances.
Building Official , ? k' i
' Permft No. Permit Holder Dale TeNphonO #
WATER
SEWER
PLUM8ING
H.V.A.C. 8D a 9? Q" ?
ELECTRIC ? .1[.GC.,• l? 9?
Inspeetion Date Insp. Comments
Foolings i
Foundatan
5r8ming ? ,?
Roofi^9
Rough Pibg. -
Flough Htg.
is,i.
Rreplace
Fnal Htg.
Final PIb9.
Const. Meter Plbg. Inspector- Notify Plum6er
Engr.lPlan
Bldg. Fnal 1) ' k. 6-t.'4t ,
VGLk Fig.
Deck Final
weii
Pr. Disp.
x _.
? - Y
r.
(ger#i#ira#t uf Mrrupanry
titp. of (tagan
ioppwfiatetci of %antg jwPrti.on
This Ceru'ficate itsueod pursuam to tlre requirements of Section 306 of the Unifornt Bu!lding
Code certifyurg lhat at rlre time of issuance tlus strucwre wns in compliance with the Nurious
N%l ordinances of tlie City negulating buildireg constrrrction or ux For 1he following:
yF ?/? 18659
u? a.??au? ?/1'ql RI ew?. R?? No.
?? 11AHM Bt?06. Ig4? ? ,, 9304 L?A . S., H[PG1N.
? 4075 PRAIRIE RID(? ? IB, B4, OWHIIRY P
7(? D.n.. 3/28/9 f
POST IN A CONSPICUOUS PLACE
SEWER. 4LWATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE Jp+N 22. 1941
METER #
OFFICE USE ONLY
CHIP # -
METER SIZE
ISSUE DATE
PERMIT DATE 02/12191
PERMIT # 11e"
B.P. RECEIPT # C 11713
B.P. RECEIPT DATE 011161 ?1
x PRV _ BOOSTER PUMP
SITE ADDRESS 4075 Vi,A I R I E 8I DGB RD
LOT BLOCK 4 SEC/SUB COVEMfRY PASS 2ND
APPLICANT:
ADDRESS: _
CITY, STATE
PHONE: -
ZIP
PLUMBER: gTAjt PL[RiBING
ADDRESS: 1018 MUND SPRINGS-TERR
CITY, STATE BLOOM ?NGTON MN Zip 55424
PHONE: E84-414?
OWNER: DAHLE HRO?HERS INC
ADDRESS: 9304 LYNDALE AVE S
CITY, STATE 8LrOA9TFr'f0?? 1,,vi Zlp s442n
PHONE: .u,',-(
PERMIT REQUESTED
x SEWER h WATER - TAPS
- COMMIIND RESIDENTIAL
x NEW
EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Cxeqit WILL NOT be giyen for Deduct Meters.
AGREE TO COMPLY WITH CITY OF
:AGAN ORDINANCES
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW T1N0 WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
, SEWER PERMITS, CONTACT ENGINEERING DEPT. A
'i„ .'`r?%
DATE: FEB 12, 1991 wv
RE: 4075 PRAIRIE RIDGE RD (DAHLE HxOTHERS INC)
X Your Sewer & Water Permit for the above property has been completed. It wiil be held at the
Public Works Garage (3501 Goachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannot be completed for the following
reasons:
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed,until furtfier notice.
/
COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by Bitl Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQU{REO BY LAW.
CNTACT CO?MUNITY DEVELO?MENT DEPARTMENT FQR WATER 7URN VN PqV5y.
P ease su mi[ a cop o your master plumders lfcense or
licensing with the ?icy of Eagan.
Secretary, Building Inspections Dept.
r
CASH RECEIPT
CITY OF EAGAN '
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
D„E ,9? l
WMWO ? 1'y _?:J?r.! ? L'?'[.t _J? i . `•.r? ? ? .
AMOUNT S f ?"71
8 DOLLAHS
'm
O CASH XCHECK
C 11715 ??
Pink-Fle GOIYV
Thank You ^
BY ,?"
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE JAN 22, 1991
SITE ADDRESS 4075 PRAIRIE
LOT $ BLOCK 4 SEClSUB -
APPLIGANT:.
ADDRESS:_
C1TY. STATE
PHONE:
ZIP
PLUMBER: STAR PLUMBING
ADDRESS: 1018 MGUATQ SPRINGS TE:'.R
CITY, STATE BLOOhTNGTON MN Zlp .? 20
PHONE: b84-4149
OWJNER: DAHLE BROTHERS INC '
ADDRESS' c?304 LYNDALL' AVh S
PERMIT HEQUESTED
x SEWER X WATER _ TAPS
_ COMMlIND x RESIDENTIAL
X NEW - EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
(:,c it WILL NOT be 0en for Deduct Meters.
TO COMPLY WITH CI7b OF
CfTY, STATE BLOQMINGTpN MN ZIP 5542n 14_._.)J.)-
PHONE: 366 SiGNATURE WHEN METER ISSUED
PLEASE ALLOW TWOWG DAYS' F?ORcPROCES?S?NG. CALL 454-5220 FOR INSPECTIONS. FbR STORM
' SEWER PERMITS, CONTACT ENGINEERING DEPT.
OFFICE USE ONLY
METER # T?! 1U 2 g? PERMIT DATE 02112I y7.
cHiP# D.?D 3/7 77 PERMIT # 11806
15
METER SIZE B.P. RECEIPT # C 117
ISSUEDATE B.P.RECEIPTDATE 011161 91
-1 PRV - BOOSTER PUMP
RIDGE BD
CQVEhTRY PASS 2ND
INSPECTION REC4RD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITEADDRESS: APPLICANT:
i ?? .?1 ?? ? ? ? I rti ,. rat? ?. { , , ,?.•cr .
PERMIT SUBTYPE: TYPE OF WORK:
:1 , s? t 41
F -1
L ?
Permtt No. Psrmk Hoider Date Tslephone #
S/W
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspectfon Dste Inap. Comments
Footings I
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Freplace
Flnal Htg.
Orsal Test
Fnal Plbg. Plbg. Inspector - Notify Plumber
Const. Meter
EngrJPlan
Bldg. Final
Deck Ftg.
??
Deck Final ? S
weli
Pr. Disp.
, . . •-,.- . : t. , , ._ ,, .s •.; ,.r, _ . . . • y-, ,, , .
- CITY OF EAGAN Page 1 of 4
PERMIT
WORK WITHIN CITY ROADWAYS L?' dJ L?? G e` (? '''?
_Lr
1. Location dinCG /ecl.
2. Nature of Work Ui71„ ?, ,.? ?1? ?? ? 7 E-, •\
,
3. A construction sketch or plan shall show the location of the proposed work. A copy of
the sketch or plan shall be provided with permit application.
4. Method of Installation or Construction
;
5. Work to start on or after 3`f and shall be completed by approximately ?
A , V DATE
6. Will detouring of traffic be necessary? U If necessary to detour traffic,
describe suggested route:
DETOURS: The Director of Public Works shall be notified in writing at
least 72 hours in advance of any detour being established,
changed or discontinued. -.
NAME OF APPLICANT CtirE
ADDRESS ? c,
1,N I16I( -e
PHONE ?O ?
? I.11T ainir r cir
NAME OF PARTY OR ORGANIZATION PERFORMING WORK 1eET
ADDRESS PHONE &)'
b[Alt fZ
?
The undersigned herewith accepts the terms and conditions of the regulations by the
City of Eagan as herein contained and agree to fully comply therewith to the satisfaction
of the Eagan City Council.
Fvr:
i
?
Signed:
Title: ?\t i`•'' r L, 1? I` t??r
Date:
IFOR CITY USE ONLY? AUTHORIZATION OF PERMIT
Fee: $ Receipt No. ,/ `??(? ?, e- I Permit No
In consideration of agreement to comply in all respects with the regulations of the
City of Eagan covering such operations, and pursuant to authorization duly given
by said Eagan City Council; permission is hereby granted for the work to be done
as described in the above application, said work to be done in accordance with special•
provisions as hereby stated:
.
: `,?BPT. PUS ` WORKS '
Ir? l
?
ALL LEGAL REQUIREMENTS SHOWN ON REVERSE SIDE AND ON "SPECIAL PROVISION5" TO BE COMPLIED
WITH! THE DATE WHEN WORK IS COMPLETED MUST BE REPORTED TO THE EAGAN CITY ENGINEER.
Page 3 of 4
c. Except for the negligent acts of the City, its agents and its employees,
the permittee shall assume all liability for, and save the City, its agents
and its employees, harmless from any and all claims for damages, actions
or causes of action arising out of the work to be done herein and the
continuing uses by the permittee, including but not limited to the placing,
constructing, and reconstructing, maintaining and using of said utility
under this application and permit for construction.
5. Existing Facilities--The utility facility and installations shall not interfere
with any existing utility facility on the City's right-of-way.
6. Private Property--The work permit or permit for construction as issued does
not in any way imply an easement on private property.
7. Quality of Work--Finished surface, base and suh-base of road upon completion
of work: shall be at least equal to or better than specifications of original
road in 'accordance with City Standard Specifications. Surface shall be finished
within 48 hours upan completion of backfill.
8. Cutting Trees--The permission herein granted does not confer upon the permittee
the right to cut, remove or destroy trees or shrubbery within the legal limits
of the roadway or relieve permittee from obt.aining any consent otherwise required
from the owner of the property adjacent thereto.
9. Drainage--All waterways and lines of drainage shall remain operative.
10. Pale Anchors--iVo pole anchors, anchors, braces or other construction to be
put on roadway shoulder, except by permit authorization.
?
11. Driving Limitations--No driving onto highway from ditch or driving on shoulders
or over curbs.where darnage will occur.
12. Lugs on Equipment--No lugs shall be used on equipment traversing road which
will damage the raad surface.
13. Clean-Up--Street surface and roadside shall be cleaned after construction
is completed and left in a neat and presentable condition.
14. Trees and Vegetations--Burning or disking operations and/or the use of chemicals
to control or ki11 trees, brush and ather vegetatian is prohibited without
prior approval from the City.
15. Replacement of Sod--Wherever top-soil and sod are disturbed, they shall be
replaced and maintained satisfactorily until the turf is established.
The undersigned hereby declares he/she
the PERTINENT REGULATIONS as stated abave
/,;..
DATE : SIGNED : V
has read and will comply with all
V
RESIDENTIAL
BUILDING PERMIT APPLICATION
GTY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681•4675
New Construcdon ReauiremeMs
• 3 registered site surveys showing sq. h of b4 sq. R W house: and all rwfed areas
(20% maximum bt coverage albwed)
• 2 mpieaa d plan showing beam & window sizes; poured touM Gesign, ete.)
• 1 selof Energy Calalallons
• 3 copies of Trce Preservation Plan H lot plaped alter 71153
. Rim Joist Detail OpHons selecfion sheet (bldgs with 3 or less unils)
DATE J"`D '
.;JB SITE
IF MULTI-FAMILY BUILDING, HOW MANY l
PROPERTY OWNER 67-E
TYPE OF WORK ?J " ? -
APPLICANT OQ„(' ?
ADDRESS G
PAGER #
CELL PHONE #
'JYV'
EPLACE(S)
IY?0 _7 _2 _3
PHONE #
ZIPCODE
FAX #
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COM
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Sut
- Energy Envelope Calculations Submitted
_ MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumbing Confractor: _
Plumbing System Includes:
Mechanical Contractor: _
blechanical System Includes:
Sewer/Water Contractor:
Phone #
Phone #
Fee: $90.00
.
Fee: $70.00
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the information is cOrrect, and agree to comply with
ail applicable State of Minnesota Statutes and City of Eagan Ordinanc . ??
Signature of Applicanf
Certificates of Survey Received _ Tree Preservation Plan Received _ Nol Required _
_ Water Softener _
_ Water Heater _
_ No. of Baths
Phone #:
La«m Sprinkler
No. of R.I. Baths
_ Air Condiuoning
_ Heat Recovery System
RemodeVReoalrReauirements -
. 2 capies of plan
. 1 sel of Emqgy Calculations tor heated additions
. 1 stle wrvey far ez[eriar additions 8 decks
VAIUATION (EXCLUDING LAND)
?0, o D
Ca [led 3'b-b I
Updated 1101
OFFICE USE ONLY
0 01 Foundation ? 07 OS-plex ? 13 16-piex ? 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 16 Firepiace ? 21 Porch (3-sea.)
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
O 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened)
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
O 36 Multi
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 AddiGon ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
0 33 Alteration ? 37 Demolish (Bldg)• O 43 Reroof ? 46 Windows/DOOrs
? 34 Replacement •Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy le-3 MC/ES System
Census Code zoning /e-/ City watei
SAC Units ?L Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr, of Bldgs l Length Fire Sprinklered
Type of Const S-? Width
Footings (new bldg)
Footings (deck)
Footings (addition)
Foundation
Drain Tile
Roof Ice& Water Final
Framuig -
Fireplace _ R.I. _ Air Test _ Final
Insulation
REQUIRED INSPECTIONS
FinaUC.O.
11P' FinaUNo C.O.
Plumbing
?j HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tesu _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
P,pproved By?,a , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply 8 Storage
S&W Permit 8 Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
CITY OF EAGAN NO 18659
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUILDING ? PERMIT PHONE:454-8100 Receipt p (0 `1'7f?
? ?
To be used for SF DWG/GAR Est. Value E146, 000
Site Address 4075 PRAIRIE RIDGE RD
Lol 8 Block 4 Sec/Sub. COVENTRY PASS
Parcel No. ZND
w Name DAHLE BROTHERS INC
o Address 9304 LYNDALE AVE S
City BLOOMINGTON phone 888-6566
F Name SAME
f
Address
City Phone
u?
ww
Name
w
?;
Address
?a W City Phone
I hereby acknowleqe thatl have read this application and state thatihe
information is correct and agre emp ith all ppN le State ol
Minnesota Statutes and Ciry agan Ordinances.
SignaWre of Per ee ?
n euilding Permi is issued to: DAHLE BROTHERS INC
on the express condition that all work shall be done in accordance with all
applicable State ol Mi(n?ne?s,o?ta Statutes and City oi Eagan Ordinances.
BuildingOfficial
T
OFFICE USE ONLY
Occupancy R-3 PL-1 FEES
Zoning R-1
(AduaQ Const .1!---N Bldg. Permit 801 • 00
(Allowable) V-N 73.00
Surcharge
N OfStories -
Length 57' Plan Review 520 _ n0
oeom 4' snc,cay ion_nn
S.F. Total - SAC, MCWCC 650.00
S.F. Foolprinls -
On Site Sewage _ 'Nater Conn 660_ on
On Site Well - Water Me1er qn _ nn
MWCC Syslem x
City Water x Acct. Deposil 3n _ nn
PRVRequiretl ? S/4VPermit 30-00
Booster Pump - S!W Surcharge - Sn
TrealmentPl 276-00
APPROVALS qoaA Unit
Planner - park Ded.
Council --
BIdg.Oft _ CoOies
Variance - TOTAL
3,600.50
AddRss: 4075 PRAIRIE RIDGE J;MD Lot 8 Blk 4 Sec/Sub !:OVENfRY PASS 2NID
These items were/were not complete at the time of the final Lnspection.
Date: 3 28 9] Yes No .? S
Final grade (6" from siding) t/
Permanent steps - garage VI"
Permanent steps - main entry ?
Permanent dtivaway ?
Permanent gas
Sod/seeded grasa ?
Trail/curb damage
Porch
Basement finish .
Deck
Please varify with the builder the removal of roo£ tast caps from the plumhing
system and the shut-off o£ water supply to the outside lawn faucet bePore
freeze potential exists.
R[l0.[DN1f11
White - City copy Yellow - Resident copy Pink - Contractor copy
. an/9t
////Qn/.
a ?21?9?8
ReQUesl Daro Fire No. aug?-in Inspection
ReqWretl7
? ReeOY Now ?Yill Notity Inspeclor
- 30 - ?es ? ? W? ?MY,
IWficensed contractor ? owner hereby request inspection of above electrical work at: .
JoC Aderew (Sheel. 6ox w Roure .) Ciry
y0.?a
Section M. Township Name or No. J Pr," No. CouMy
?ifS 6
Ocrupant (P
l
• Phone No.
? ?
,e a s
Powe. sucvr naaress
EIecV' I Comracror (Cwnpany Name) . Conlrec?aS License No.
,r r v" i
Mailing Ndtlras8 (GMVaciw or p.mar Makirg Instell
aM1On)
S
"
Q ? R. SS.3
a
Aumor¢etl gn re (COnVector/pwigr Meking Installalpn) Phone N
um
7ar .
o
y
MINNESOTA STATE BOARD OF ELECTRICITY TXIS INSPECTION REOUEST WILL NOT
GtlpprMMway BNIp. - Noom S173 - BE ACCEPTED BV THE STATE BOARD
1821 UnHerslry Aw., St Paul, MN 55106 ' UNLESS PROPER INSPECfION FEE IS
Plnrw (817) 64I4800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ? N" EB-00001-08
? ?$¢e insimclions for com0leting Ihis fov?el yellow wpy. /?
121-7 g 'X' Below Work Covered by This Request
ew Adl? Hep.- TypeafBuilding AppliflncesWired EqulpmeniWired
Home Range Temporery Service
Duplex Water Heater Electric Heatinq
Apt. Building Dryer Olher (Specify)
Comm./InduStrial Fumace
Farm Air Conditioner
Otherapeciy) Coniractar5 Remarks:
Compute Inspection Fee Below: i
# Other Fee # Service Entrance5ize Fee # Circuits/Feeders Fea
Swimming Pool 0 to 200 Amps ?„?CO 0 to 100 Amps .0c
Transformers Above 200 _ AmpS Above 100 _ Amps
Signs Inspector§ Use Ony: / TOTAL
Irrigation Booms
?y q-O
Special Inspeclion
Alarm/Communication THIS INSTALLATION MAY B DE DDISCONNECTEO IF NOT
Olher Fee COMPLETED WITHIN 78 MO
I, the Electrical Inspector, bereby flOUqn-in Data ???
r
certify that the above inspection has
been made.
F;,,W777 ?em v
40 ? l
OFFICE USE ONLY
This requasl witl 18 monihs hom
CLAIM VOUCHER- REFUND REQUEST
CITY OF EAGAN
MAKE CHECK PAYABLE TO: GREGORY POWERS
ADDRESS: 4075 PRAIRIE RIDGE RD
EAGAN MN 55123
RECEIPT #/DATE: 50693 7/08/03
REASON FOR REFUND: CUSTOMER REQUEST PERMIT #: 59612
TYPE OF REFUND:
Plumbing Permit 9001.4087 $
Mechanical Pernilt 9001.4088 $ 30.00
Building Permit Fee 9001.4085 $
Plan Review Fee 9001.4222 $
SAC(MC/WS) 92202275 $
SAC (CiTy) 9379.4681 $
SAC (Admin) 9001.4246 $
?
Water Connection 92203865 $
Sewer Pemut 9220.4532 $
Water Pemvt 9220.4507 $
Account Deposit 9220.2252 $
Water Meter 9220.4509 $
Water Treatment 9220.4685 $
Water Supply & Storage 9220.4680 $
Surcharge 9001.2195 $
Overpayment 9001.2250 $
Curb Box Deposit Refund 92202253 $
Construction Meter Dep Refund 9220.2254 $
Other
TOTAL $ 30.00
I declare under the enalties of law that this account, clavn, or demand is just and that no part of it has been paid.
7/21/03
SIGNATURE DATE
RESIDENTIAL
4?f- yf ?13 a? BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
New Construdlon Reauirements
• 3 registered sile surveys show(ing sq. ft of lot sq. ff. ot house; anr911 roofed areas
(20% macimum lot wverage alDwed)
• 2 copies of plan shaving beam 8 window sizes; poured found design, etc.)
• i set of Energy Cakulations
. 3 copies ot Tree Preservation Plan'rf lot platted after 711193
• Rim Joisi Dehail Options selection sheet (bklgs wiM 3 ar less units)
DATE
JOB SI
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWNER Gr e ?
TYPE OF WORK
APPLICANT .
ADDRESS `7U
PAGER # CELL PHONE #
PHONE# 497I-hl57304
_ZIPCODE S5I a?
FAX #
NEW RESIDENTIAL BUILDING ONLY- FILL OUT COM lY ? H T ? [
Energy Code Category MINNESOTA RUI.ES 7670 CATEGORY MAR 1 8?002
(check one) - Residential Ventilation Category 1 Worksheet Su i ed ?
- Energy Envelope Calculations Submitted s
MINNESOTA RULES 7672 By - New Energy Code Worksheet Submitted
Plumbing Contractor: _
Plumbing System Includes:
Mechanical Conhactor:
Mechanical Syslem Includes:
Sewer/Water Contractor:
Air Conditioning
_ Heat Recovery System
FIREPLACE(S) X 04" _ 2
Phone #
Phone #
Fcc: $90.00
Fee:
$70.00
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the informati n i correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Or irfdl?ces.
Signature of Applicant
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 2002
_ Waeer Softener _
Water HeaCer _
No. oF Baths
RemodeUReoairReau irements
. 2 copies of plan
• 1 setof Energy CalculaGons forheated addiUons
• 1 site survey for exterioradditions 8 decks
• Indicate'rf home served by septic system for addi6ons
Phone
Iawn Sprinkler
No. of R.I. Baths
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 07 05-plex ? 13 16-plex
? OS 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 08-plex ? 18 Deck
? 11 10-plex (?r19 Lower Level
? 12 12-plex PIbg?Y or _ N
? 20 Pool
? 21 Porch (3-sea.)
? 22 PorchlAddn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bldg
? 31 Eut. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition
( ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
33 Alteration
5 ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuatfon ??- v o Occupancy 3 MC/ES System
Census Code 43?f Zoning R- f Ciry Water
SAC Units vf Stories Booster Pump
Nbr. of Units ? Sq. Ft. PRV
Nbr. of Bldgs ? Length Fire Sprinklered
Type of Const y 11 /,^/ Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaUC.O.
_ Footings(deck) ? FinallNo C.O.
_ Footings (addition) _y Plumbing
_ Foundation ? HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
?l Framing _ Siding Stucco Stone
Fireplace _ R.I. _ Air Test Final Windows (new/replacement)
? Insulation _ Retaining Wall
Approved By 5 P , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
PERMIT# tl -I 32q
RECEIPT DATE:
8008 MIDENTIAL PLUMBINfi PEiMIT APPLICATION
cmt og EAsM
3890 PILOT KAOB RD
Sk6N1Y. MlV 85] EE
e51-e81-4e75
Please complete for. single family dwellings, townhomes and condas when pertnits are required for each
backflow preventer for irrigation system
SITE ADDRESS: ? "
OWNER NAME: :
INSTALLER NAME:
STREET ADDRESS:
CITY:
?7
_ SEPTIC SYSTEM, new/refurbished (requires lwo sets of plans and MPC license) $ 100.00
includes $40.00 County fee
Note: Additional consultant fees may appiy
• MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
? Adding fixtures to tower levels or room additions, excluding water softeners and water heaters. $ 50.00
_ Abandonment of septic system.
_ Water tumaround - existing dwelling unit (+ 5/8" meter ff needed -$118)
Other:
_ RPZ: new installation/repair/rebuild $ 30.00
_ lawn irrigation system
ReplacemenUadditional: _ watersoftener _ waterheater $ 15.00
State Surcharge $ .50
Total S sp .so
I hereby acknowledge that I have read this application, state that the informetion is correct, and agree to com???ppply with all applirable Ciry of Eagan ordinancea. It
is the applicanYs responsibiliry to notify the property owner that the Cily of Eagan assumes no IiaDiliry for mages caused by the City during its nortnal
operational and maintenance acGvities to the facilfties constructed under this permit wit ' Ay pro erry/righ o?f•,wa?yQ/e?ast?emeM. /q
<ln/l" ?
SI ATURE OF PE MI7TEE 1/02
p(???111
MAR 18 2002 D
By Sp
TELEPHONE #: (n F?i-?7 O--O ?
(AREA C DE)
PERMIT# I I 5U;-
RECEIPT DATE:
MIDENTIAL PLiJM$IRfi PERM1T APPIICATION
CITYOF £AfiAN
3$30 PII.OT KNOB RD
SAfiAA, MP 55122
651-681-4675
Please complete for: i single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for irrigation system
SITEADDRESS: k-7P?(n I f 1 LA`i CCi 'P & ?
OWNER NAME: :
TELEPHONE #: ??? 3U TO ?
(AREA CODE)
INSTALLER NAME: ? Iil'V1?P TELEPHONE #:
(AREA CODE)
STREET ADDRESS:
CITY:
Place a check mark next to the oermit work tvoe
STATE:
ZIP:
New residential dwelling unit under construction and not owner/occupied $ 90.00
T Add-on, modifcation or alteretion to existina dwelling unit, including:
ti
t
b
d
f 50"OD? ?
?
onment o
sep
c sys
em
• a
an
• new installation/repair/rebuild of RPZ 0 5
. lawn irrigation system F
• waterturnaround
Nature of work: ': _
Septic System, new/refurbished - $ 225.00
• includes County & Consulting Inspector fees
• requires MPC license
State Surcharge $ .50
Total $-SP??
Reminder: Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc.
lU
J
I hereby acknowletlge that I have read Ihis application, sWte that the informalion is correcl, and agree to wmplywilh all applicable Ciry of Eagan ordinances. It
is lhe applicanPs responsibility to notify ihe property owner that the City of Eagan assumes no liability f any damages caused 6y the City during its nortnal
operational and maintenance activities to lhe facilities cons[ructed under Ihis permil wiN' . ity prop rty rightof-wayleasement.
SIGNATU E OF PERMITTEE
150!50
Updaled 1101
t T
LA,a.?'1
.* -
.?
I Y Xb
?136 K +5=
?-
26xz? = r7oz-
3 y I I = 57
N X z 2= saa
i `l y G = g??
1!
I IS'I X ly =
15T i,nu?'L
$Sm^? ? ? ?.S ?
llo (-le
1611?
I I r1`? X ?'I = c?ol2°?
Z
3X?5 =
Z ? 13'12_
?
?l5"1
(5
27
12
?
---
) NS` 5-2- Z?'
JrZ
.?
.
)'-l6 ,cx,a-
o•*
801•00E
'73•00?
520•U0+
2)ZO6•so+
31600•50*
soi•oo+
73•00+
520•00+
2,200•50+
3?600•50*
?
' 1991 JILDIN?IRMITCLICATION
CITY OF EAGAN
SZNGLE FAMILY DWELLINGS
2 SETS OF PLANS
3 REGISTERED SITE SURVEYS
1 SET OF ENERGY CALCULATIONS
MiJLTIPLE DWELLINGS
t 11-0-
COMMERCIAL
2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
(CHECK WITH SLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT I0 REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH TN WHICH REQURS'!" :CS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALIAWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWD DAYS ONCE A PERMIT HAS BEEN COMPLETE?.
PERMIT MUST SHOW A LICENSED PLUMBER.
Rtcg
To Be Used For: C?°s??•.._,?. Valuation: -Aih-t:ft04"- Date:
Site Address
Lot rU' Block 4
Ce„??ws5 2"`?'
Parcel/Sub _
Owner
Address
City/Zip Code
Phone
ContractorG??+-
Address Co'o'\
City/Zip Code w? SS?Lo
Phone &e;'& f6 `?
Arch./Engr.
Address
City/Zip Code
Phone #
(Signature of Contractor)
N - i% -'`1\
ly?? ODO?
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F.
R-3 M-I
R-1
V-N
V-N
?-
On site sewage_
On site well
MWCC System ?
City water ?
PRV ?
Booster Pump _
APPROVALS
Planner
Council L
Bldg. Off. ? 1hS
Variance
FEES
Bldg. Permit (,OU
Surcharge 3,oc?
Plan Review 520,00
SAC, City /OO.Oo
snC, MwCC 650,00
Water Conn. TIOO
Water Meter 10,00
Acct. Deposit 30,00
S/w Permit 30100
S/W Surcharge ,5'D
Treatment P1. Z 7 6,00
Road Unit 3 o,oa
Park Ded.
Trail Ded.
Copies
SIIBTOTAL
Penalty
Lot Change
TOTAL t?nn•R0
agrees that all work shall be done in accordance with
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
CERTIFICATE OF SURVEY
, asox ?, f
r •
? LANOSURVEYORS
? AV
pr?
V
o ?
.?
0
DESCRIPTION:
Za"# R. cautciu. Psea.
8713 DVPONT AVENUE SOUTH
BLOOMINGTON, MINN. 55420
6883084
Survey for:
DAHIE BROS.., INC.
?a o \
?
V u>
?X ,3i,
?Q1/ \ ?? ?.. .
1? ? ? ? / • ? ?
/
[^ Y X
\ '\ /
1
s?
?
Lot 8, Block 4, COVENTRY
PASS 2ND ADDITION
?
•, ___ .
c
Scale: 1"=30'
?
?
/ . '
7- '7"?.
Proposed Grades:
Top of Blocks 85 °- Garage floor 853'S Basement floor BS-?G= •
NOTE:
Circled elevations are proposed, others are existing.
Arrows denote direction of drainage.
N ?
N ?
h
\
P,:ReVo ??OURED
We hereby certify that this is a true and correct representation of a survey of the
boundaries of the land above described and of the location of all buildings, if any, thereon
and all visible encroachments, if any, from or on said d. Dated this 14th day
of January , 1991 ; ?
1 Z68-68
? .:
; .
EXTERIOR ENVELOPE AVERAGE "U" LOHPUTATION
QWPIER: '
SITE ADURESS:
CONTRACTDR,????? DATE : PHONE :659rW9(06
DETERMINE NDRKING SOUARE FOOTAGE DF fACH:
1. TOTAL EXPOSED uALL AREA,,,,,,,, 2(y(o2 gq ft x"U" & I f - 292,
2. TOTAL ROOF/CEILING AREA,,,,, „ 10(01(5 -tO sq ft x"U" 0 001-&
3• TOTAL EXPOSED t1ALL AREA LAICULATI0N5:
Total exposed wall
rea above floor,,,,,,,, 2 sq ft
:
a) Ttal wall window area:
0DQP,A-E- 4lazed...... sq ft z „ull I`-t
?
.
glazed...... sq ft x "U" _
b) Total door area ,,,,,,,,, ? sq ft x "U" •Z?J ? ?,2-?
c) Total stidtng glass door area:
owb glazed...... '/ sq ft x ??U" .59
a glazed.....: sq ft x "U" _
d) Total flreplace wall area sq ft x "U" ?
e) Total wall framing area
(Average Fog) ..........
236,q0
sq
ft
z
"U"
•I? 2 a
Z?. V?
f) Total net wall area a6ove
floor (fnsulated)....... I gqT 11) sq ft x "U" •?`i =-7rj165
g) Total rfm Joist area.... ?ZG5.8Z sq ft x "U" •o4
Total foundation
area (Exposed).......... sq ft
h) Total foundatlon
window area............. 9 sq ft x "U" .56 _ "'rj.ZZ
i) Total net foundation
area above
r
d
11 D
f
"
"
10
q
a
e........ sq t x U -
3• TOTAL a) thru 1) ? 27??Sb
If It em N3 ls the same as, or le ss than Ttem P1, yo u hav e met the inten t of
2 PfCAR 1.16008 A and O.
Page 1
4. TOTAL EXPDSED ROOF/LEILING CALCULATIDNS:
Total exposed
roof/cetling area........ 10(,0'5-9Q sq ft
,i) Total skylicht area......
.
sq ft x•"U" u
k) Total roof/ceflTnq framing 1 / pZ-?? e 2 9?,
area (Averaqe 1f19,),,.... 4??0.c-JQ 1 sq ft x"U"
1) Total net insulated n , a OI 8
roof/celling area....... sq ft x"U" 0Zc) Z?.
/ l
? TOTAL j) thru 1) Z?•?
If total of #4 is the same as, or less than s2, you have met the lntent of -
2 MCAIt 1.16008 A and 0.
ALTERNATE BUILDING EnVELOPE DESIGN
To utillze the total envelope system method; the values established by the sum
of items N3 and ?4 shall not be greater ihan the sum of items dl and N2.
3.
+ 2.
+ A.
?
3
C E R T I F i C A T I 0 N
I hereby certify that I have calculated the "U" factors and "R"
values herein and that the buildinq here descri A meets or e? e?is the State
of Ninnesota Enerqy Conservation Act. ?? '? ?? ?
qnature
(Date)
Page 2
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
16121681-4675
INSPECTION RECORD
PERMIT TYPE
Permit Number:
Date Issued:
SITE ADDRESS:
LOT: 8 BIOCK:
4075 PRAIRIE RIDGE RD
COVENTRY PASS 2NO
PERMIT SUBTYPE:
DECK
?
4
APPLICANT:
POWERS
(612) 683-0209
TYPE OF WORK:
BUILDING
024399
08/18/94
GREGORY
NEW
7
I_ J
? CIT.Y OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
4075 PRAIRTE RIDGE RD
LpT: 8 BLOCK: 4
COVENTRY pASS 2ND
P.I.N.: 10-18901-080-04
.3,A3?
LO!NGlr
024399
@8/18/94
DESCRIPTION:
- ?
BCiilding-Permit Type OECK
Building Wbr_.\ Type NEW
/
?- ?
ii
?
i
r
..
REMARKS:
FEE SUMMARY:
Base Fee $30.00
Surcharge $.50
Total Fee $30.50
CONTRACTOR:
I hereby acknowledge that I have read th3s
information is correct and egres to comply
L Statutes an C ty of Eagan Ordinances.
li6P'70 .
APPLICANT ERMITEE SIGNATURE
OWNER: - npplicant -
POWERS GREGORY
4075 PRAIRIE RIDGE RD
EA6AN MN 55123
(612)683-0209
application and eCate that the
with all applicable StaCe of Mn.
-i
I E SI ATU
CITY OF EAGAN
14309 1994 BUILDING PERMIT APPLICATION $30•_?O
681-4675
rn 0?'a.1?-17
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, W
specifications, 1 copy of energy calcs. ON 1
Penalty applies: 1) when permit is typed, but not picked up by last w '-
in which request is made, 2) address is changed or 3) lot change is requeste once permit
is issued.
Date / / Valuatian of work
r'
7
'
L(
' rz'"
SiteAddress:
V& ??
1
iP
6
5 _ I<<Cic,p
G
STREET SUITE #
Tenant Name: (commerc9al only)
LOT ___?_ SLOCK ? SUBD. PL Z
- .I.D . #
.
Descri tion of work: QG
The applicant is: Owner ? Contractor ? Other (Describe)
Name iwalvS 4 /'?n/jY'u Phone ?o ?i-O?Q9
Property LAST f- IRP 1
OWn@I' ?
?U
< v i
'
Acidress
?
f .?
!
i N.
STREET STE p
City C., Gt h 5tate Zip
i
Company
Phone
Contractor Address License # Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registration #
Address '
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to camply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
BUILDING PERMIT TYPE
? 01 Foundation
? 02 SF Dwg.
? 03 SF Addition
? 04 SF Porch
? 05 SF Misc.
WORK TYPE
OFFICE USE ONLY
? 11 Apt./Lodging
? 12 Multi. Misc.
? 13 Garage/Accessory
? 14 Fireplace
0115 Deck
? 06 Duplex
? 07 4-Plex
? 08 8-Plex
O 09 12-Plex
? 10 Multi. Add'1
f
31 New ? 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Engineering
REGIUIRED INSPECTIONS
?.Site
? Wallboard
? 35 Tenant Finish
? 36 Move
Basement sq. ft.
Ist fl. sq, ft.
2nd F1. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Building
Variance
q Footing
ET Final
? Framing
? Draintile
?,_ W
Z
? Insulation
O Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Traits Ded.
Copies
Other
Total:
vatuac;on: g
g
? 16 Basement Finish
? 17 Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
? 37 Demolish
MWCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code
Census Bldg
Census Unit
Assessments
SAC %
SAC Units
?`t'R Y?1r {?'9 h l'Gc) yt??`l a'12 -. (
?° t?- Ft?" s.C 1i` 4t° y< 093x? R? (i4..
i?1as .? ???a.w? ???y ??? }??^?v i
4, t R.y ?.? h y %r j :(.r ? yr ? C r• Y ?_.4?:
? Ny . ? 4 ? { }- ? - ••?
4 ,F ? i I Ry `
? y `
. ? 1
i. }
'ii?.SX ?,y 1i. :Q 1.'•
_ ,.?'•t _ -. .
o t r y
i
? f
?
'? ?t ,[ 4 t rr q
? Y .?tiY 5' 1 l t -. .
??r\
?? ' ?. _ . ..
r
A:: r
v
5 4?1 p y NJ..k 2 S{' ]tl Yy .
' ? t F Y 4 '? `a CG
a
33 N r r 5 . 1 ? ?S J
) fNe t q ?`?{ 41 W l Y 1 ..' ? t? .
r7
3Y?.
UNDERGROUND SPRINKI.ER SYSTEM
PLUMBING PERMIT
Date: -7-:?5- q I
Permit #
Date
,
Receipt #
_ Commercial: $25.50 + water tap if required. (City installs all taps up to 1"). If
adding new service, a water permit will be required, as well.
? Eavsting residential: $15.50 (Plumbing permit not requued if backflow preventor was
previously installed).
_ Residential develoQments: Fee to be determined by building inspections department.
May require payment of water permit, plumbing perm t, WAC, and water treatment
plant fees. k8; a 4" 6Z2?
0 ? covv
Homeowner/Plumber:
Phone #:
Street Address:
City, State, Zip:
Owner Name:
Street Address:
Phone #:
Irtigation Conuactor:
-C?
Phone #: ?? u -t?)L SS?4
ro -2'7Z TO?"U /?o PU? P°1rSC.rrs /y/°? ?
1/a? u U „n ,6i•,ra f ??' ,3
I hereby acknowledge that I have read this application and state that the information is
correct 9,nd agree to coippiy with all applicable City of Eagan Ordinances
?
LCc?.
(Address to be sp ' . ered)
f 9 S?3 O?) O°J
??J (? ??d?Gr?'(?E YC(CY2 ?Z? .
cc: Engineering Department
?l(S?C Pi/? !1"I t I
CITY OF EAGAN
3830 PIIAT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
MMXGAiRM
FOR CITY USE ONLY
PERMIT # /02 8a (?,
RECEIPT # /?? O
DATE: d 9
mgmM PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE ]
TOWNHOMES/CONDOS WNEN PERMITS ARE REQUIRED FOR EACH UNZT.
------------°-----
WORK DESCRIPTION
NEW CONST X_
ADD ON _
REPAIR _
---?----------
OWNER NAME: N-??1?--
SITE ADDRESS:
v %
?nT• d BIOC:C ? SUBD.
INSTALLER: s- w-ADDRESS:
CITY: ZIP:
PHONE #: g? C7 ?3 U ?
FEES
:LY DWELLINGS &
---------------
ADD-ON MINIMUM $15.00
HVAC 0-100 M BTU 24.00',
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS - MINIMUM 3.00 x
OF 1 PER PERMIT
SUBTOTAL: $ 7Lo-c>
STATE SURCHP.RGE: .50
lU`fAL: $.5?r?a
SIGNATURE.OF PERMITTE
C?1?1ERL`iA?JThlDITS'?fiTA?:.; PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
------------ ___________________ ------- -__-__-°______
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
IAT: BIACK _ SUBD.
INSTALLER:
ADDRESS:
CITS[: ZIP:
PHONE #:
FOR: _
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE a $.50 FOR
EACH $1,000 OF PERMIT FEE.
PROcE3SnU PIYING _ $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18
STATE SURCHARGE $
TOTAL:
$
(SIGNATURE)
CITY OF EAGAN
MECHANICAL (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Please complete for. Single Family Dwellings
Townhomes and Condos when pertnits are required for each unit
X 30 .-?
?
Date?/?/_? .
Site Address Unit #
Property Owner (17i?t- ` ????u ?!/ / Telephone #( G s l) "-? C)
Contractor
Street Address City
State Zip Telephone # ( )
The Applicant is C? Owner _ Conuactor
? _ Other
Add-on, modification or aiteration to existing dwelling unit $ 30.00
furnace replacement
air exchanger
air conditioner (
other Gl5 t ? I^
?
State Surcharge _ `_ $ .50
II Sj 1) 7^nn? I,,II
Total $
I"1-
I hereby apply for a Residential Mechanical Perxnit and acknowledge that the information is complete and accurate; that the work will
be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a
pemut, but only an application for a permit, and work is not to staR without a permit; that the ??qrk will be in accordance with the
approved plan in the?spse of work which requires a review and approval of plans. ? ?, ?
Applicant's p nted Nazne ' Applicant`§ Signature
MECHA1vICAL (COMMERCIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Please complete for: commercial/industria] buildings
multi-family buildings when separate permits are not required for each dwelling unit
Date
Site Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
ContracWr
Street Address City
State Zip Telephone # ( )
The Applicant is _ Owner _ ConRactor _ Other
Work Type
_ Newconstruction UndergroundTank _Install _Remove
_ Interior Improvement Call for inspection during installationlremoval of tank
Processed Piping
Nature of Work:
Permit Fee $50.50 Minimum Fee (includes Sta[e Surcharge)
Contract Value $ x t% _ $ Pemut Fee
• If pernilt fee is $1,000 or less, add $.50
If permit fee is over $1,000, add $.50 per => $ State Surcharge
$1,000 Permit Fee
$ Total Fee
i nereny appty tor a Commercial Mechanical Pernut and acknowledge that the information is complete and accurate; that the work
will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is
not a pertnit, but only an applicauon 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.
Applicant's Printed Name
ApplicanPs Signature
Approved By: , Inspector Date:
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA130453
Date Issued:04/24/2015
Permit Category:ePermit
Site Address: 4075 Prairie Ridge Rd
Lot:8 Block: 4 Addition: Coventry Pass 2nd
PID:10-18401-04-080
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
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 -
Gregory Powers
4075 Prairie Ridge Rd
Eagan MN 55123
(651) 683-0209
Scherer Brothers Lumber Company
9401 73rd Ave. N
Suite 400
Brooklyn Park MN 55428
(952) 277-1600
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA164747
Date Issued:10/07/2020
Permit Category:ePermit
Site Address: 4075 Prairie Ridge Rd
Lot:8 Block: 4 Addition: Coventry Pass 2nd
PID:10-18401-04-080
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 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 -
Gregory & Elizabeth Powers
4075 Prarie Ridge Rd
Saint Paul MN 55123--393
(651) 269-9276
Walker Roofing Company
2270 Capp Rd
St Paul MN 55114
(651) 251-0910
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA169557
Date Issued:06/01/2021
Permit Category:ePermit
Site Address: 4075 Prairie Ridge Rd
Lot:8 Block: 4 Addition: Coventry Pass 2nd
PID:10-18401-04-080
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
210-0754.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Gregory & Elizabeth Powers
4075 Prarie Ridge Rd
Saint Paul MN 55123--393
Genz Ryan Plumbing & Heating
2200 West Highway 13
Burnsville MN 55337
(952) 767-1000
Applicant/Permitee: Signature Issued By: Signature