4104 Prairie Ridge Rdp
r ?'.?. .
BUILDING PERMIT
Lot 2_ Block
Parcel No.
W Name
? Address :.?
o I -.. f l M
Phone 888-6866
=F Name 8A11l?
OU ` Address
? City Phone
yVj W Name
'?? Address
<W City Phon?
I hereby acknowlege that I have read this.tpp?ation- nd ihat the
information is correct and agree to compl wi I?,d -State Qf
Minnesota Statutes and City o1 Eag rdi ances. !l
? -?,.i.,:Cr•..
Signature of Permitee
A euildino Permit is issued tW DMI.E BItOTHERS INC
- CITY OF Ei
3830 Pilot Knob Road, P.O. Box
PHONE: 454
I, Eagan, ApN 55121
Receipt #
narA MAY 13 , a 91
OFFICE USE ONLY
Occupartcy RP-3 X4 FEES
Zoning 111164
(Actual) Const Ymn Bldg. Permit l..loG
(Allowabte) Y'TH Surcharge 73- SO
# of Stories
Length Plan Review 323•00
Depth ._ SAC. City 100.00
S.F. Total - SAC, MCWCC 630•00
S.F. Footprints -
On Site Sewage _ Water Conn A60.W
On Sile Weli - Water Meler 95•00
MWCC System A_
ACCt. Deposit 3o• oo
City Water _X_
PRY Required ? S/W Permit
'Booster Pump -- SMI SurChar e • 30
9
Treatment W
APPROVALS Road Unit
Planner - Park Ded.
BIdg:Off. _ Cupies
VarianCe - TOTAL
• Permit No. PermR Holder Date Telephone #
W/1TER / S/? 9
SEWER
PLUMBING 4
5U S/&
H.VA.C. ?&'?":?
ELECTRIC 9
Inspection Date Insp. Comments
Footings I 11 Z p
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg. ?i ?30 -
Isul. ?! ? 9' (?(?
Fireplace ??i
Final Htg. ?J
Orstat Test
Final Plbg. ?
''?/
Plbg. Inspector - NoGly Plumber
Const. Meter
EngrJPlan
Bldg. Firk71
Deck Ftg.
Dedc Final
Well
Pr. Disp.
tl 1 , x?
$ ..a ,. ?
Trrtt#trttte vrf O.rr?pattry
Citp of (eagatt
loppr#acrat af luitbitug 3tcwnirnt
This Cerfifioate isrued pursuant to 1he requirements oJSecAion 306 of the Uniform Building
Code oertifying thar a! the tirrre of rssuance thir.uructure ms in compliance with the various
ordinaaces of rhe at}' regulaAiaB buMn8 ovnstrucAioR or use For !he foUowing:
vse g? ?? sw? 19056
w? ,? r?.
R3 I
?? AAEIIE ? II? Adcb= 3+ L7i?IDA?Cft , N
1 z- -I' , Q/6/q)
111. POST W A CONSPICUOUS PLACE
?
CASH RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
?.
` 11 ? 1
19
FAEarvEO
FIqM 1
AMOUNT
D CASH
& DOLLARS
lm
[?CHECK
wn
C f '? A •'1 ? wn.e--PaY. CoY ?y
. .? YNlow--P-+9 CAPY `--'?
Pink-ne Copy
Thank You
BY "
SENEER & _V?JATER PERMIT
CIYY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE 6AX 13, 19'i 1
OFFICE
METER #
CHIP # -
METER SIZE
ISSUE DATE
SITE ADDRESS 41',4 : ;<. , . ;'
LOT ? BLOCK I SEC/SUB COV'-:'=:'' ,:A:;j "_'IvD
APPLICANT:
ADDRESS:_
CITY, STATE
PHONE: -
ONLY
PERMIT DATE
PERMIT #
B.P. RECEIPT #
B.P. RECEIPT DATE
k PRV _ BOOSTER PUMP
PERMIT RE(]UESTED
? SEINER _ WATER TAPS
- COMM/IND RESIDENTIAL
r? NEW _ EXISTING
PLUMBER: STA_R PL?tiLIP7G Lawn Sprinkler Meters are to be Installed
Ahead of Domestj? Mefers on Water Line.
ADDRESS: IC18 lOUh]-` ,S"RI:"S'-) "1'`•'1 n: Credit WILL NOT;beqi?enfor Deduct Meters.
...'? , -
CITY> STATE E1.(!OMINt;T,?I; 1,"N ZIP S 5420
PHONE: 884-414?'
`I AGREE TQ CaMPLY WITH CITY OF
OWNER: ,Al`[LE WtUTkEI:S ;iN EAGAN ORDIKANCES
ADDRESS: 9304 LYnP LE AYL ?
CITY, STATE BLOOKINC;TGN '_tV ZiP 55420
PHONE: ?`•?:S-6?'6 ? SIGNATURE WHEN METER ISSUED
PIEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
ZIP
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE ?`4A'C 13. 1991
UFFICE USE ONLY
METER # 374"') PERMIT DATE
cHiP # aa3 3q aY 7 pERMIT # 119'? 1
METER SIZE 514 SQ ?'tis B.P. RECEIPT # C 13408
ISSUE DATE ' B.P. RECEtPT DATE 05 14 41
k PRV - BOOSTER PUMP
SITE ADDRESS 41Q4 RIDGk- I:i;
LOT ? BLOCK 1 SEC.ISU6 CQVL,hT::??' 2idD
APPLICANT:.
ADDRESS:-
CITY, STATE
PHONE:
ZIP
PERMIT REQUESTED
X SEWER X WATER - TAPS
- COMM!IND - RESIDENTIAL
x NEW
EXISTING
PLUMBER: SfiAR PLUMBING
ADDRESS: 1018 MOUhD SPRItdGS 1'rRP
CITY, STATE ?.14 ZIP 5`420
PHONE:
be Installed
Watef Line.
'I AGREE TO COMPCY WITH CITY OF
OWNER: DAIiLE BF20THERS I1'?C: ?-? EAGAN ORDINA ES
ADDRESS: 9304 LYNDALE AVL
CITY, STATE BL,UC?Mi,'•3GTUf, T•iN ZIp 551:-20
PHONE: :'F °-?t •?., SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKIMG DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FQR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
A`ndress: 4104 pRAIgIE PJDGE PjaAD Lot Z Blk I Sec/Sub OUvW1gy pp,s$ 2AID
These items were/were not complete at the time of the final inspection.
9/6/91 Yes No ? -
Final grade (6" from siding) ?
Permanent steps - garage ?
Permanent steps - main entry
Permanent driveway
Permanent gas ?
Sod/seeded grass ?
Trail/curb damage ? ?y?gyzc?¢?
Porch
Basement finish ?
Deck ?
Please verify vith the builder the removal of xoof test caps from the plumbing
system and the shut-off o£ water supply to the outside lawn faucet be£ore
freeze potential exists. ,?"-?)
?r
aMEO.Ra
White - City copy Yellow - Resident copy Pink - Contractor copy
CITY OF EAGAN Np .19056
3830 Pilat Knob Road, P.O. Box 21- 199, Eagan, MN 55121
PHONE: 454-8700
BUILDING PERMIT Receipt # C/ vq /j t?
To be used for SF DWG/GAR Est. Value $147, 000 Date MAP 13 , 1g 91
Site Address 4104 PRAIRIE RIDGE RD
Lot 2 Block 1 SeclSub.COVENTRY PASS 2N OFFICE USE ONLY
Parcel No. occupancy R-3 PL-1 FEES
Zoning JL--1
s Name DAHLE BROTHERS INC (ACtuap Const ?
N 81dg
Permit $??+. ??
w . .
o AddreSS 9304 LYNDALE AVE S (qllowabie) V=N 73
5
City BLOOMINGTON Phone 888-6866
+v of stories .
0
Surcharge
66, 523.00
Plan Revi
?ngiry ew
? Name $AME Depth ?? 100.00
SAC
Cit
i
00a Address S.F.7otal _
_ y
,
65
0
? City Phone S F. Poolprinis _ 0.
0
SAC, MCWCC
660
00
W
C
? On Site Sewage .
ater
onn
'
w Name on sne wen
95
00
?
w - .
WalerMeter
? ; Address Mwcc sysiem ?L
3
a W City hOf1 Qty Waler -(_ 0. 00
Acct. Deposil
10
00
e PRVRequired ? -
SM Permit
I hereby acknowlege that I hav
read thi a' atio nd iha steT6ump - 50
mlormauon is corred and agiee to pl i tate SM! Surcharge .
MinnesoW Statutes and City of Eag rd c Treatment PI 276.00
$iqnature Of Permitee ROYALS ROad Unit 370 - 00
A Buddmg Permrt is issu d DAHLE BR HE INC Planner - park Dea,
on the express conditio ' at all work shall be done in ccordance with all Council
apphcable State oi Minnesota Statules an
d
City ol Ea an Ordinances. BIdg.On. _ Copies
-y
?
BuildingOfficial ?.??PI ol ? f? 2 variance - TOTAI 3,612.00
MAY 14, 1991
DATE:
N
RE:- 4104 PRpIRIE RIDGE RD (DAHLE BROTHEBS INC)
x Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman 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
Vour Sewer'& Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
COMMERCIAL PROJECTS ONLY: Please•pay for meter at City Hall. Meter size must be
confirmed by 8ill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
? 59850 - ?30 59
?
R
tD y
?
ques
ate Frz¢ No Roug Inspeceon
S //
? ? Re ire ? ? Reatly Now ?OGII Notity Inspectm
s ? No When fleaOy?
I?.licensed ntractor ? owner hereby request inspection of above electncal work at-
r ( eet, eox or Route No 1 Ciry
i ? /
d ?
SecLOn No Township Name or No qan9e Na ?unry
Z_
Oec.PanilP fJrl Phone No.
Pawer Su001ier
R'
El Atltlress L_
ec? I ConVacror (ComOany Name) ConlractorB LicBnse No
Mai6ng Adtlress COnVactor or p.vner Maki9q Installation)
,
?
/
?7
Aut
Q S? naI ?ConVa ner Mak n Inst IlaLOn) S
none Number
_
n
w aJwi e nuwHU OF ELECTRIQTY 10i THIS INSPECTION qEQUEST WILL NOT
Gr19psNlJwey BIOg. - qoum S-n3 BE PCGEPTED eV TME STATE BOARD
1821 Univeralty pve, SL Peul, MN 55106
PIwM UNLE55 PROPER INSPECTION FEE IS
?6?2? 60Z-pBOp ENCLOSED
C?/? REQUEST FOR ELECTRICAL INSPECTION ee-ooom-oe
VM ?? Ill See inatmctiana torcompletinq this (arm on back of yellow copy
In1 598,50 "X" 8elow Work Covered by This Request ?18?`? ?
ew Abd Rep TypeoiButlding AppliancesWired EqmpmeniWired
Home Range Temporary Service
Duplex Water Heater Electric Hea6ng
Api. Building Dryer Other (Specity)
CommJlndustnal ' Fumace
Farm Av Conditioner
Other speaN) Contactor§ Femarks
Compute lnspechon Fee Below1.5V
# Other Fee # ServiceEnirance Size Fee is/Feeders Fee
Swimming Pool D to 2D0 Amps ,y' mps O(J
Trensformers Above 200 _ Amps _ Amps
SignS Inspecmrs Use Onry
g TOTAL
Irrigation Booms
Special Inspection
Alarm/Communicauon --CONNECTED
THIS INSTALLATION MAY BE ORIF NOT
Other Fee COMPLETED WITHIN 76 ONTHS.
I, the Electrical Inspector, hereby
cerhty that the above inspection has
6een made. Ro°9n"" oa?e
,
OFFICE USE ONLY
This request void 18 moNhs imm
J/r 4'/yr c /s Vs ?;
C? 5 9 8 4 9,?
Reqyest Date Fre No h-in Inspection
e rtetl? ?/?
y.*qea0y Now, ? Will NoLiy Inspector
?
? Yes o When Reetli
1nsed niractor ? owner hereby request inspection of above electrical work at:
Jo0 essI eL Bo Route No?
? Ciry ?
LS
? r ?- ' Lt'•ti
Sectmn No Township Name or No Range No County
E/4Kd
OcFuPant(P)MWT) l
' ? Phona??
G
? /
G-
Power up0lier /
/<, Atldress?Jw??,
Elech al Con?redOr (COmpany Neme) ContrecM?5 License No
?'G . L?n CG ? C
Mailing Atltlress (Con[ractor or Owner Making /In? allaLOn)
?
'
d - Tqr .3 7
--:5
Awhonzed Si r.aWre (COnlracto
rlOwner Making Insta
llation ) Phone N mber
/
y 10 ° Gi C? Z
MINNESOTA STATE BOARD OF ELECTRICRY ?
Grlggs-MlAway BIEg. - poom S413
1821 Universlty Ava.. SI. Peul, MN 55104
Mne (612) 642-0800 THIS INSPECTiON REOUEST WII.L NOT
BE ACCEPTED 8V THE STATE 60ARD
11NLES5 PFOPER INSPECTION FEE IS
ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION
l ? See inslmqionvlor completing this form on ba<k oi yellow copy
a 5 9 8 4 9 "X" Be/ow Work Covered by This Request
E6-00001-08
eCv Adtl kep" - Typeofewlding AppliancesWired EqmpmentWired
Home Range Temporary Service
. Duplex Water Heater Electric Heating
Apt Buddinq Dryer Other(Speafy)
Comm/Industrial ' Furnace
Farm Air CondiUOner
Other (specity) ConMacrorg Remarks
Compute Inspecfion Fee Below'.?
# Other Fee # ServiceEntrance5ize Fee # Circurts/Feeders Fee
Swimmmg Pool 0 to 200 Amps f.?O f 0 ro 100 Amps ,617 "Ill
hansformers Above 200 _ Amps Abova 100 _ Amps
$I JOS inspecmr5 U5e Only TOTAL
Irrigation Booms
Special Inspection
Alarm/Communicanon THIS INSTALLATION MAY 8E ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electncal Inspector, hereby Rough-in oate
certrfy ihat ihe above inspec[ion has
been made. oa?p^
OFFICE USE ONLY
TTis request vortl 18 monms irom ?
CITY OF EAGAN FOR CITY USE ONLY
3830 PILOT ICNOB ROAD '/
EAGAN, MN 55122 PERMIT # 'Y
'
PHONE: (612) 454-8100 RECEIPT # 90
AWil DATE: - 0-
PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
-------------------
WORK DESCRIPTION
NEW CONST
ADD ON _
REPAIR
OWNER NAME:
SITE ADDRESS :
LOT:?I BLOCK ? SUBD. n?
INSTALLER: ???ii'L/Ea1P? S?
ADDRESS:
CITY: ZIP: 5 ?7 /Z 2
?
S ?
PHONE #: b?? - 6?2
Z5;;?.4 " _=r?
SIGNATURE OF PERMITTEE
COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
ADD-ON MINIMUM 15.00
/ SHOWER 3.00 4Qo
? WATER CIASET 3.00 L,00
? BATH TUB 3.00 _J,Pv
? LAVATORY 3.00 a0
KITCHEN SINK 3.00 .e O
? LAUNDRY TRAY 3.00 3oP
HOT TUB/SPA 3.00
-7 WATER HEATER 3.00 1,067
/ FLOOR DRAIN 3.00 i.D ,-)
GAS PIPING OUT.
L (MINIM[IM - 1) 3.00 2,02
? ROUGH OPENINGS 1.50 _ OTHER
WATER SOFTENER 5.00
_ PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
SUBTOTAL q3, S 0
ST. SURCHARGE .50
TOTAL: ?l eJ
oOMM$g?rNDC{$T,&IAL;' PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL SUILDINGS AND
MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLZNG UNIT.
-------------
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: BLACK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE #:
FOR:
CITY OF EAGAN
------------ ________
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $
STATE SURCHARGE
TOTAL:
( S I GNAT[IRE )
$
? CITY OF EAGAN
` 3830 PIIAT KNOS ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
?q4N
WIS3
---------------
----- -----'---------------------------------------
WORK DESCRIPTION
NEW CONST '??
ADD ON ^
REPAIR ^
OWNER NAME: _ , cxW.;_'_ P-lcc.S ?- t l? .
SITE ADDRESS:_?-I?Ciy
IAT:x9,_ BLOCK ? SUBD.
INSTALLER:
ADDRESS:
CITY: `-t?..-•_ ZIP:
PHONE 'a?'3 c) \
ADD-ON MINIMUM
HVPC 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OUTLETS - MINIMUM
OF 1 PER PERMIT
SUBTOTAL:
STATE SURCHARGE:
TOTAL:
DWELLINGS &
$15.00
24 .i_
6.00
3; ,QQ__
$?
.50
$m• ?o
?
5IGNATURE OF PERMITTE
??MPdER?IAT.j?NT?ASTK?AI.l: PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDIISTRIAL BUILDINGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
------------
CONTRACT PRICE
OWNER NAME:
SITE ADDRESS:
LOT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PNONE #:
FOR:
FOR CITY USE ONLY
PERMIT
RECEIPT
DATE: '
PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE ]
TOWNHOMES/CONDOS WHEN YERMITS ARE REQUIRED FOR EACH UNIT.
FEES
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING = $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1% $
STATE SURCHARGE
TOTAL:
$
(SIGNATURE)
CITY OF EAGAN
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
FOR CITY USE ONLY
PERMIT #
RECEIPT
DATE: l ?-
PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMZLY DWELLINGS &
....:. .... ..... ..._,. .,:: .'.
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH IINIT.
------------------------ -----------------------------'
WORK DESCRIPTION
N0.
NEW CONST _
ADD ON clll? _
REPAIR
OWNER NAME: 24 .y A
SITE ADDRESS: ?a
LOT: BLOCK ' SUBD.
INSTALLER: ?l //"¢fi z-0
?
--------------------
COMPLETE THE FOLLOWING:
FIXTURES EA.
ADD-ON MINIMUM 15.00
SHOWER 3.00
WATER CLOSET 3.00
BATH TUB 3.00
LAVATORY 3.00
KITCHEN SINK 3.00
LAUNDRY TRAY 3.00
HOT TUB/SPA 3.00
WATER HEATER 3.00
FLOOR DRAIN 3.00
GAS PIPING OUT.
(MINIMUM - 1) 3.00
ROUGH OPENINGS 1.50
OTHER
WATER SOFTENER 5.00
PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
SUBTOTAL
ST. SURCHARGE
TOTAL:
TOTAL
?
SO
CiI??RGTAlifiNDUST&IAL:, PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND
MULTI-FAMILY BUILDINGS WkiEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
CONTRACT PRICE: FEES
OWNER NAME:
SITE ADDRESS
LOT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE #:
FOR:
CITY OF EAGAN
18 OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18
STATE SURCHARGE
TOTAL:
(SIGNATURE)
ADDRESS: /19/1I 1'1 /??cv Aqi/Le So
CITY: ?-?f.: d? ? ZIP: 5??a 2 J
p • .?
804•00+
7s•so+
523•00F
21 211•50+
3, 612•OU?
804•00+
73•5U+
523•00+
21 211•50+
3,612•00*
J?
l?a3C? .
1991 BUILDING PERMIT A PLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
2 SETS OF PLANS
3 REGISTERED SITE SURVEYS
1 SET OF ENERGY CALCUTATIONS
lNLTIPLE DWELLINGS
COMMERCIAL
2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
REGISTERED SITE SURVEYS - & STRUCT[IRAL PLANS
(CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCUTATIONS 1 SET OF ENERGY CALCS
_# OF RENTAL UNITS
_# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER M[JST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: V?'J? Valuation. 4@9r,-eev-- Date:
Site Address
Lot Z^ Block
?c K? OFFICE USE ONLY
1y9, oov'
Parcel/Sub
Owner
Address
City/Zip Code
Phone
Contractor Dx\?
Address `?wic ??'-+? N,-)°
City/Zip Code?`vir?- SSdc-o
Phone Vb$ ` G' SL, (".
Arch./Engr.
Address
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F
? 314-f
R-?
?/ •1`?
?
38,
On site sewage_
On site well
MWCC System ?
City water ?
PRV
Booster Pump _
APPROVALS
Planner _
Council
Bldg. Off. I?S S /D.9/
Variance _
FEES p I1
Bldg. Permit OD'I+OQ
Surcharge T??,SO
Plan Review ?" OA
SAC, City 100i00
SAC, MWCC 0100
Water Conn. 60i00
Water Meter 95,00
Acct. Deposit 30,00
S/w Permit ?
S/W Surcharge iso
Treatment P1. 00
Road Unit a10
?
Park Ded.
Trail Ded.
Copies
SIIBTOTAL
Penalty
Lot Change
TOTAL
agrees that all work shall be done in accordance with
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
City/Zip Code
GA 2,4& e
3z y z2 ? ?04
x 15= la-zoo
135 tv? T,
2-'A3b = ?136
a ,? ?i = aa
6 x I 2= n 2-
!
/ Z26 X Iy= IQl by
15 ? F.,aak
I X i2 - i2
6syn r ? ( Z?
1 252 x53 = G ?3s-?
2,?D L) Pz
.?r?2 X 36=?j170 x S3 = S2u??
?`-l6,1 ta
o r? I 47, ooo ,
,,
?
CERTIFICATE OF SURVEY ,c'wHy R.
Ceu?sc. Pua.
? 8713 OUPONT?AVENUE SOUTH
010.ft=BIOOMINOTON, MINN. 86430
? 888-2084
LANDSURVEYORS
0
Gi
,I? ?83Z
5urvey for: oy??3? ?
DAHLE BROS., INC. fj 09 D0
c Y
I ?O'I
DESCRIPTION:
Lot 2, Block 1, COVENTRY
PASS 2ND ADOITION
?
S / ` y ?S'?-•, ?
Scale: 1"=30'
?
E11?A?? ?i E Id? DIsPT
siz7-° /?
b •ai o , . ?? ? ?J p???1 '+ c n
??? l???l; ', F
Proposed Grades:
Top of Blocks ,?SSy
85z- o 'Pr? / a '?•'r?? i s-
?`°?, Garaye r"loor gs
Basement floor 5s-'7L
?S/ 9 ,e !. / ? /? gs S
3G?
A„
/ Circled elevations are proposed, others are
Lc 4 existing.
Arrows denote direction of drainage.
9d
' 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 land.
Oated this 7th day of May 119 91 .? //) ---)
2f 74- ~(
EXTERIOR EkVELDPE AVERAGE "U" LOMPUTATION
OWFIER: ' D?.I"FLE. t?R?S. I1.iG.
SITE ADURESS: Li L1 (P 1'r4+v ?e..
LONTRACTOR: LIE, Fjeoof,,?JL„?ATE: 5 '1 -"' ? PHONE: e1B8'(0
DETERMINE NORKING SOUARE FOOTAGE OF EACN:
1. TOTAL EXPDSED 41ALL AREA,,,,,,,, 2S?'?j sq ft x"U" •? I
2. TOTAL RDOF/CfILING AREA,,,,,,.._ 11 z-rj sq ft x"U" • Q
3• TDTAL EXPOSED WALL AREA CAICUlATIONS:
Total exposed wa11
area above floor,,,,,,,, 2 522 sq ft
t
a) Total wall window area:
p?BLE. 9Tazed,,,,,, 190.q 5' sq ft x"u" • SS • 11015
glazed......
Sq ft X "U" _
b) Total door area ......... 3$ sq ft x"U" . 23 ? 5-14
c) Total sliding glass door area:
LiPLAI? 9lazed...... r?o 54 ft fc ??U" •59
Glazed...... sq ft x „U" _
d) Total fireplace wall area
e) Total wall framing area
(Averaoe 104)......... 252 . 2 sq ft x"U"
,010 = 25.22
f) Total net wall area above
floor (Insutated)....... 195825sq,ft x"U" _04 _niU•w
g) Total rim Joist area......, e?.??...q sq ft x"U" •04 , = 852
Total foundatTon
area (Exposed).......... _55,$Z sq ft
h) Total foundatlon
window area...........
sq ft x "U" ?
sq ft x "U"
?
t) Total net foundation S
area above grade....... C?S.sz sq ft x"U" •?? _
3• TOTAL a) thru i) m •?
-7
if item #9 ls the same as, or iess than item #1, you have met the intent of
2 11CAR 1.16008 A and 0.
Page 1
4. TOTAL tXPOSED ROOF/LEILING CALCULATIOR75:
Total cxposed
roof/ceiling area........ 1125 sq ft ?
J) Total skylTaht area....... sq ft x"U" '
k) Total roof/cellinq framing .O,Z7D a 3.11
area (Averaoe 1?9,)..... 112.? 5q ft x"U"
1) Total net insulated ??,,?, SO
roof/celiinq area....... • sq ft x"U" •? 2 5 ? 25•3?
TOTAL j) thru ) L.V•4Z
if total of B4 Is che same as, or less than N2, you have met the lntent of
2 MCAR 1.16008 A and 0.
ALTERtIATE BUILDING ENVELOPE DESIGN
To utilize the iotal envelope system method, the values established by the sum
of items 93 and #4 shall not be 9reater than the sum of items F1 and 02.
a
1. + 2.
3.
+ 4. . °
t E R T I F I C A T 1 0 N
I hereby certify that 1 have calcutated the "U" factors and "R"
values herein and tfiat the buildinq here descr ets /r ex4ee? the State
of Minnesota Eneray Conservation Act. ?/
(Date)
Page 2
r- -7- 11
Cor,structian R-Value
1.
2. Oft•' vevwAL-L- .45
3. St/t inches soft vood Ce.lt
1. '.5WEpTNiNG Z.oG
S. ,5 ifliNG .67
6. Exterior air film : 0.17
Total 10.19
' Qa.lo
1. Interior air film 0.68
2. ?/2" pLYWQLL •45
3. SyLl tusu1-. 19,00
4. 'SNCQTN ING 2.oG
S. °J1D1?1Cn .41
6. Extezior air film 0.17
1bta1 -=,;,03
1. Znterior air film 0.68
2. 1!,! 5u 1. . 19.00
3. ? l/z'• wooP 1.88
4. 45 HEC74 11.lG 2.oG
5. SI DtW G .G7
6. Exterinr air film 0.17
7btai Z4.46
V_ .04
, ?•.'. , ??' ?
` u `,•
•._ ? :? (?(
•" r
1.
2.
3.
4.
5.
6.
Interior air film ' 0.68
INSUL, /1UC> DCyWALL 8.0(e
12" bLoGr__ 1,28.
Exterior aiz film 0.17
Total + 0. 19
• Us,lO
SLAB ON GRADE
-
43
Y.. . ?
. o . . ? „ ,
. ?
-_??m.. ...,-._?..,.......'? ,----. .. _ . ? ..._._.?
• - .? • • ?
. ? r
?/ ? V • .
/fl . '? . . • /(!
. . , ?i
ti1
FIG. A4 /II 1 ?
6• • O /
• , // / ?
(!! ? ?c K ?l >? /?/
/l? _ llf = li? ?
NOTE: Indicate type, "R" value, denth and
placenent of insulation.
;xa?,e coustruction
_ „?. . .
•••? .' '-?T•..?OF/CEILIHG
YEliT ??.?1?-?I^
Vented flea[ flow
up
FIG. 05
?- .
1 }Ieas flov vp .•vented
.FIG. #6 . '
?
Constrvction(Use for Item L) R-Valuc
1. Interior air tilm 0.61
2. KI6 SNEETQecr- ,5L
3. 1WSVL. 38,00
4. Extcrior air film (still 0.61
Toul ;9.'I S
' U =.oz5
GT.C;. FFiA.*iSNG(USe for Item 1C)
1. Znterior Air film, 0.61
2. 518" 544L,E.1F.ocr .5?
3. Znches soft vood ?I/L" •?-,3 E
4. Znches insul above framina 30.00
5. Air Film 0.61
?0?1 '.S G . 1 L
. •- -. ?1c.o2TL
1. Interior sir film - ' " 0,61
2. 3.
4. £xterior air film (still) 0.61
Total
1. Inside air film ' 0.61
2.
3.
4.
5. Outside air film a•17
Total
Notc: Usc a9ditional shects if more tF,)ec ia
i.ceded for drtailt aud ealcul:,tions.
rTr,, i7
: _ NU.`i-VII?I'E? • ?
. Heat '
. , Elov up '
?--?-
MECHANICAL (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Raad, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
Please complete for: Single Family Dwellings
Townhomes and Condos when permits are required for each umt
_5% 30.C-?-o
Date?/\ '70 /b"_
Site Address ? 1 ??-( ?'( Q1 ? 1? l?\ C7.q 2 K3 Unit #
PropertyOwner ??Q r?ul l2 Ki ec,k er Telephone #( )
Contractor kjL',
StreetAddress City S• 5'?QWI).,`
State dYVN Zip ?'1 "``J Telephone # ( (oS l
The Applicant is _ Owner ? Contractor _ Other
Add-on, modification or akeration ro eaisting dwelling unit -%rjQ,Se,vQQk-?- 30.00
fumace replacement
? air exchanger
air conditioner
-
?
other ? .
State Surcharge D ? ?
U $ 50
Towl JUN $ ?p
?
I hereby apply for a Residential Mechanical Permit and acknowledge that the inforxnation is complete and accwate; that the work will
be in conformance with the ordinances and codes of the Ciry of Eagan and wiih the Mechanical Codes; that I understand this is not a
permit, but only an application for a permit, and work is not ro start without a permit; that the work will be in acwrdaace with the
approved plan in the case of work wlvch requires a review and approval of plans. A _
'R?%c.koxd M. B i?c?u r 8A,e.J" 4 &4
ApplicanYs Printed Name App icanYs Signature
MECHANICAL (COMMERCIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
Please complete for. commercial/mdustrial buildings
multi-family buildings when sepazate pemvts aze not requued for each dwelling unit
Date
Site Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Pre;^+e*Yy Owner Telepho :e # ( )
Contractor
Street Addresa City
State Zip Telephone # ( )
The Applicant is _ Owner _ Contractor _ Other
Work Type
New construction Underground Tank _Install _Remove
Interior Improvement Call for inspection during installationlremovai of tank
Processed Piping
Nature of Work:
Permit Fee $50.50 Minimum Fee (includes State Surcharge)
Contract Value $ x Al% _$ Permit Fee
• If pemiit fee is $1,000 or less, add $.50 => $ State Surcttarge
If permit fee is over $1,000, add $.50 per
$1,000 Pemut Fee
$ Total Fee
I hereby apply for a Commercial Mechanical Permit and aclrnowledge 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 tlus is
not a pemut, but only an applicarion 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
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date 6_ I ?q 1 C? '
Site Street Address
?
?, :
Unit #
?
Property Owner DGi.YLr? 6? re, ckP-r Telephone # ( bYn 6?
Contractor L/?c;,:'';•,: Telephone# (`t$Z..) 443-e)53
Address 7
-- l? ` City StateMj? Zip ; S_355G, "
?-
The Applicant is: _ Owner ? Contractor _Other
Alterations to existing dweiling $ 50.00
_Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_Water Turnaround (add $121.00 if a 5!8" mete
r is re
q
uired)
xOther: }?
I
/
3??. ?v?,TV?
Water Softener Water Heater $ 15.00
_ replacement _ additional
Lawn Irrigation 5ystem RPZ_ new _ repair _rebuild $ 30.00
State Surcharge $ 50
JUN 2 3 2004
Total
OBY ?
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work wili be in conformance with tne ordinances and codes of the City of
Eagan. and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be i ordance with the approved plan in
the event a plan is required to be reviewed and app v.
ApplicanYs Printed Name ApplicanYs Signature
???55
GO
2004 RESIDENTIAL BUII.DING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone 9 651-675-5675 FAX # 651-675-5694
7?
New Construction Reauire mants RemodeVReoair Reauirements
3 registered site surveys shovnng sq. ft of lof, sq. ft ot house; and all roofed areas 2 copies of plan
}a. ?
(20%maximumlotcoveregealbwed) isetofEnergyCalculetionsforheatedadd'Nons T'ee.P n
1x(-N
2 coples of plan showing beam & window saes; poured found design, elc. 1 sile survey for addMons & decks T";Pi u`uad,'?"?.?`lznr2:Y,
1 set of Energy Calculetions AddiGon - indicefe il onsde septic sysfem ??-;{le??9 ?l;a''?f;C
3 copies of Tree Preservation Plan if bt platted after 7l1193
Rim Joist Detail Options selecfqn sheel (bldgs with 3 or less unils
Date ?L l 1_ l D
Construction Cost
/
Site Address ?l ?j?3g??6?- ?? ?1?E /•-? Unit/Ste #
Description of Work RG?S'iGtt t+? I`?``?Kd ?
Mulri-Family Bldg _ YA N Fireplace(s) _ 0 -<1 _ 2
PropertyOwner r14- r&;rz- fv' Telephone # (69 )?P(O- g6
Contractor ? 1a;-? ?44 ?
Address
Z Z -S?•
I City
I?,
?
State ,(/yJs'/ Zip 3 3 Telephone #(6/L )
COMPLETE THIS AREA ONLY IF CG
Energy Code Category - MiDTlesota Rules 7670 Cateeorv 1
• Residen6al Ventilation Category 11
(Jsubmissiontype) Submitted
• Energy Envelope Calculations Subi
Have you previously constructed a building in Eagan with a
fee applies. A
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
D.
A NEW BUILDING
Minnesota Rules 7672
• New Energy Code Worksheet
Submilled
8 ZaQ4
If so, 25% plan review
Telephone # (
I hereby apply for a Residential Building Pemut and acknowledge that the infortnation is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a peimit, 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
appro ans.
?
?-?
A s Printed Naipe
/ J
?y rdP
1 I ?? % 1
Apphcant s Signature
OFFICE USE ONLY
Sub Types
? Ot Foundation ? 07 05-plex ? 73 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 76 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garege ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex O 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New 13 35 Int Improvement ? 38 Demolish Interior O 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
'?c 33 Alteration ? 37 Demolish Building` ? 43 Reroof ? 46 Windows/Doors
/O 34 ReplaCement 'Demolition (EnUre Bldg) - Give PCA handout to applicant
Valuation oa 0 Occupancy MCES System
Census Code 4-/l.? Zoning City Water
SAC Units ? Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
REQUIRED INSPECTIONS
FinaVC.O.
)C FinaUNo C.O.
T Plumbing
HVAC
Other
Pool = Ftgs =Air/Gas Tesu
Framing Siding Stucco Stone Brick
Fireplace A? R.I. -VAirTest ?[Final Windows
Insulation ?` _ Retaining Wall
7-.
Approved By: I L? , Building Inspector
Base Fee
Surcharge
Plan Review
Mcies sac
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
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Oct 061511:50a Niederkorn's Construction 651-459-2091 p.1
,
� RECEIVED Use BLUE or BLACK Ink��\
�-----------------{� \
Or� O C �O�c ; For OHice Use ! �
� ii U J 1 � �
��4Ol L� �11 �VE� j Permit#: �� �� ����.,
� � RECE - � Permic Fee: r �� �lU, l�
3830 Pilot Knob Road � �(��
Eagan MN 55122 0�,� a �� � Dale Received: ��"1� I� �"l J�
Phone:(651)6755675 � �� i ��
Fax:(651)675-5694 � Siait
I I
2015 RESID�NTIAL BUILDING PERMIT APPLICATION
� � r� 1� /,
Date:��,1���/S Si1e Address- ��� ��a.-�+c. /� ,��C ,Cdr�c, Unit#:
�.r.�.�.,�..�
y Name: _I LG�.1 e. Yt-� ��.�--,i PF�one: �5�- �y3-- Go�,,3
j Reside�f!
� OW11Bf Address/City I Zip: ��D�/ %�-�,'� >�'J�,�c ��, �g�� vzc� .s 5�a 3 ;
r
� ' Applicant is: �Owner Coniractor 3
� .�. Descripfon of work: /SE'��l /r/rt✓re. -�r-��5�- <hu'fG�S �
� y�of wa�
� ;
� _ _ � ConsEruction Cost: �S S� Mulii-Family Building:(Yes 1 No_) s
_ ;
� � - - - �
{ � Company: ��v-ri ��'�- �-�S�rcC.�'+��,..�'11Contacl: �G!n /V/�c�.w'GC� � n �
� ^ �
�
f i
' Contracto� ' Address: V�I /j'l�w.c �z� �u.r fe.�� c;�y: � • �'� .P�.t �
� � Sta#e: 1 y'�''Zip: So i Phone:�.5/-�{,fy-GG�y'Emai[: d'cUh%t��.� .s a�/•t c�r �
� � �
� License#: �� 6��' 3 f 7 Lead Certificaie#: �+'� T' �o� ��R- I �
�
"�
� If the project is exempt from lead certification, please explain why: �
� �"��� �Jr .;c;�� �, ��'r 9/ � '� �
,•
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING �
� In the lasi 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan? �
Yes No 1f yes, daie ared address of master plan: �
�
,
Licenaed Plumber: Phane• �
. �
� Mechanical Corrtractor: Phone: j
#
�
Sewer&Water Contractor: Phone- '
�
� Fire Suppression Contraclor: Phone: �
NOTE:P/ans and supparting documents that yvu sub►�it are considered#o be pu6lic intormation. Portions ot �
the infermation may be classitied as non public if you provide specific r+easons Nrat would permit the City to (
conclude that they are trade secrets. �
CALL BEFORE YOU DIG. Call Gopher State One Call at(65��454-0002 ior protection againsE underground ulili#y damage. Call 48 hours �
befo�e you intend to dig to receive locates of underground utilities. rNvw.qophe�siateonecall.ora
I hereby acknowledge that this infarmafio�is complete aod accurate;that Ihe work will be in oonfortnance witM the ordinances and codes of Ehe City of
Eagan; thai I understand this is not a permit, but anly an applicatlon fior a permit, and work is not to stari wilhoul a permt�; thal the work will be in
ac�rdance with ihe approved plan in the case ofwork which requires a review and approval of pla�s.
Exterior work aulhorized by a building permit issued in acco�0ance with the Minnesola State 8uilc6ng Code must be completed within 78Q
days of permit is5uance. �
X ,y� Jtf r �C��.r.'6Cd-�/! x � �`.�1�,/r.�=��-�-
Applicant's Printed Name Appl nt's Signature
Page 1 oF 3
� � � ( �� � l
�"/���_ __ �I�""(RI� �I L.1l�rC I���DO NOT WRITE BELOW THIS LINE ������
.
SUB TYPES
Foundation _ Fireplace _ Porch (3-Season) _ Exterior Alteration (Single Family)
� Single Family _ Garage _ Porch (4-Season) _ Exterior Aiteration (Multi)
_ Multi _ Deck _ Porch (Screen/GazebolPergola) _ Misceilaneous
_ 01 of_Piex _ Lower Level _ Pool _ Accessory Building
WORK TYPES
_ New _ Interior Improvement _ Siding _ Demolish Building*
_ Addition Move Building Reroof Demolish Interior �
�Alteration _ Fire Repair _ Windows _ Demolish Foundation
_ Replace _ Repair _ Egress Window _ Water Damage
_ Retaining Wall *Demolition of entire building—give PCA handout to applicant
DESCRIPTION � , 1
Valuation �`� � Occupancy � MCES System
Plan Review Code Edition , ��,,� ,� SAC Units
(25%_100%�) Zoning � City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings(Deck) Final/C.O. Required
Footings(Addition) � Final/No C.O. Required
Foundation � 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 WaIL•_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression: Rough In_Final
B�aced Walls Erosion Control
��� Other: ��
�"� r �J'.,.
Reviewed By: �� , Building Inspector ,�
RESIDENTIAL FEES
��� �
Base Fee � � ' ..�� �"'
Surcharge `"�•� �
Plan Review I" '�� �.��t
-���
MCES SAC ���
City SAC
Utility Connection Charge � � � �� � /� �
S�W Permit�Surcharge f ('�
Treatment Plant
I ,�j'"` �
Copies
TOTAL
Page 2 of 3
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Use BLUE or BLACK Ink
RECEIVED For Office Use -1City O f Ea�$u DEC 2 7 2016 Permit#: b
3830 Pilot Knob Road
Permit Fee: `
Eagan MN 55122
Phone:(651)675-5675 Date Received: /a'Ai-//6
Fax:(651)675-5694
Staff: ..7
J
2016 MECHANICAL PERMIT APPLICATION
❑ Please submit two(2)sets of plans
�with all commercial applications. y�,
Date: Site Address: c110Lf pro.....e,„,.. cit.,.1 d c t,icli
Tenant: Suite#:
Resident:'' /
Owrter ,, Name: to tJ� /<,1L//J4 Phone: (L' [ 2-' 703 —; 614,
Address/City/Zip: q 0 Li Pra_44..e_wft. /!X zic._ /Qq/
. IA.)G.t. �12_ (biles, icense#: ji(3,06 3 S-94,2
Address: 3 l ID CAI I'/'iz z'11 G City: I. J� [:a�g"r
Contractor �,
State`f 1(,/Zip: ,5< / -7 Phone: 15i"`e/ --.e9 /4/6
Contact: Email:
New ) Replacement Additional Alteration Demolition
Type of Work Description of work: 4/ (' et
NOTE Roof mounted and ground mounted mechanical equipment is required to bye scree ed by City
1 odch
Ce. Please contact the Mechanical Ip c
n tor far information on permitted screening methods
RESIDENTIAL COMMERCIAL
XFurnace New Construction Interior Improvement
Permit Type Air Conditioner Install Piping Processed
Air Exchanger Gas Exterior HVAC Unit
Heat Pump Under/Above ground Tank ( Install/ Remove)
Other
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit, includes State Surcharge /. ,r{
$100.00 Residential New, includes State Surcharge =$ Ct; TOTAL FEE
COMMERCIAL FEES Contract Value$ x.01
$60.00 Permit Fee Minimum
$75.00 Underground tank installation/removal, includes State Surcharge =$ Permit Fee
Surcharge=Contract Value x$0.0005 =$ Surcharge
If the project valuation is over$1 million, please call for Surcharge =$ TOTAL FEE
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 i -•. •start without a permit;that{/he work will be in accordance
with the approved plan in the case of work which requires a review and approval of plans'." f
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A.• is nt's Printed Name -• icant's : '1 re.. , Ar_ge . .8•1W
• OFFICE USE . - > �� p -.., � �
Required Inspections: eviewed,By Date:
Underground :=Ro-ugh In 'Air Test ,�Gas Service Test In-floor Heat "' `'F nal v .:: HVAC Screen g
Use BLUE or BLACK Ink
RECEIVED
For Office Use
it
DEC 2 7 2016 Permit#: I�fOSO
City 01 bats Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received: /0?-.27- 7k
Phone: (651)675-5675 Staff: 7Fax: (651)675-5694
2016 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 12//3/162 Site Address: I Oil Prajuu.— d
Tenant: ()Q IUCD, Y'�7�t�u it * !/ )I"� 1e••,,2L. Suite#:
Resident/Owner Name: 0...../0‘,...-1- ,Ti)fifes. /4/eU�+Cone: / —7O3 fir" 7 4,
Address/City/Zip: �/ O ,rG �,
Name: / ( 1' unse#:
Address: I tf 6 Couun'-i 1! if— City 1.,� L f (Ll ,,,,,,,264.....l
Contractor �` J / �-
State: Zip: Phone: Cd! L!J
Contact: �' j /1' Email:
l.1
Type of Work —New ,)(Replacement —Repair —Rebuild Modify Space —Work in R.O.W.
Description of work: 14 �� CAZ {Lt [ /2
RESIDENTIAL
/Water Heater
Lawn Irrigation( RPZ/ PVB) Water Softener
Permit Type SAdd Plumbing Fixtures(—Main/—Lower Level)
Se System
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge)
*Water Turnaround(add$280.00 if a 3/4"meter is required)
$115.00 Septic System New(includes County fee and State Surcharge) 1.��• C.�A
TOTAL FEES$
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance d codes of the City of
with
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to startwithouttheordinances a permit;
anthat the work will be in
accordance with the approved plan in the case of work which requires a review and approv f plans.
/960 IIIIIP
r IQ (ck)/te)iliC---
Ap icant's Printed Name App' ants Signature
FOR OFFICE USE :' I Reviewed B ' Date
s a .tit.Y Airy*st ,' ^' ,, ;t
Re uired Ins ections: Under Ground
q p Rough In �. Air Test .. .... Gas Test `� , __. Incl .. ..:
Meter Related Items , •MeterSize " .-4,14.4.,• Radio Read Manometer, Staff ,.
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA163659
Date Issued:09/09/2020
Permit Category:ePermit
Site Address: 4104 Prairie Ridge Rd
Lot:2 Block: 1 Addition: Coventry Pass 2nd
PID:10-18401-01-020
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 -
Dana E Kiecker
4104 Prairie Ridge Rd
Eagan MN 55122
(612) 703-5186
Krech Exteriors Inc
5866 Blackshire Path
Inver Grove Heights MN 55076
(651) 688-6368
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA172701
Date Issued:10/12/2021
Permit Category:ePermit
Site Address: 4104 Prairie Ridge Rd
Lot:2 Block: 1 Addition: Coventry Pass 2nd
PID:10-18401-01-020
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Dana E & Julia A Kiecker
4104 Prairie Ridge Rd
Saint Paul MN 55123--162
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature