4111 Prairie Ridge Rd
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INSPECTIO
' CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
' (612) 681-4675
? SITE ADDRESS:
Iif, I h t t k! lili!
?A''.. ,'NU
PERMIT SUBTYPE:
-
I ;1 11 1 I N ti
11 i Hil!
PERMIT TYPE:
Permit Number:
Date Issued:
; APPLICANT:
TYPE OF WORK:
Yli IFNAf1ifl
I 1; AW I hai;
? RI• Mp17M'S: (F'[)fiCH Fi111Nl)Aj I nN. 1 1111NllA f 1 f1N 111411t f<I' i NN 1 N[i b PA I 1[) litlf)i
,?3s. M1 . - . • . 3
? ?
?
I
Permft No. Permit Holder Date Tslephvne #
5/W
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Mspection Dete Insp. CommeMs
Footings I
Foundatian
Framing
f
Roofing P/2 ^ F
?t,Q,.
A
a1.ec
Rough Plbg. ?
?
? 7G?•
tG{
Rough Fltg. ?
? ??
?/ O
Isul. /11,r
Fireplace
Fnal Htg.
Orsat Test
Fnal PI6g. Pibg. Inspector - Notity Plumber
Const Meter
Engr./Plan
Bldg. Final
Deck Ftg.
Deck Final ae&-,41 _
Well
Pr. Di p.
%`
ON RECORD
I CITY OF EAGAN PERMIT TYPE: A" l t t' :N'-,
3830 Pilot Knob Road Permit Number: •' iH ?°?
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
? SITE ADDRESS: ' ' ' ` ' `• ? ? S `? 4' , `' 4 ? `? ! APPLICANT:
4 E?t c?? r
?. 11 u t i??.t t,?? ?i? ? ;?E ?.,ri
? • +''.'i !yI I; r f'N`. ? .'No
PERMIT SUBTYPE:
?
TYPE OF WORK:
m r ir
0f. %crr r l1r r n N i, 1* (A
INSPECTION .. . ..
?
Permit No. Permit Holder Date Telephona A
ELECTRIC
PLUMBING
HVAC
Inapection Data Inap. Commenta
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING '
'
GAS SVC
TEST
INSUL
GYP BOAFID
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FlNAL ?, zC.s',, S? %
CITY OF EAGAN
.- 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ;.? i i? 7?.''•_'
PHONE: 681-4675 , . . . , ,
UILDING PERMIT Receipt #
Site Address a111 lw
Lot k Block 4
Pafeel No.
Name wsnLA avn-MIRa iM
w?d? 9304 1,YNDAI.E ASIE S
? Cfty eI.ooNZacroa M zP
cc Naf118 SA[iL
0
Addf255
? ctY ZP
Phone
8 License #
I hereby acknowlege that I have rgad'this ap that Ih
information is correct and a e6 to com ' p i ble Slat
a
Minnesota Statutes and q' o(.Eogr e ?
5ignatura of Permiteg
L 8uilding Official
Ordinances.
ICE USE ONLY
?? ?'
Occupancy FEES
zoNng R- I eld9• Pwmn 682.00
(Actuaq Const YIR Surchaige 56.00
s
(Albwable) V? "3
00
pm RavieW •
.
* ol stories
S 1 ?
Ucem
- -
Length 100000
Deplh SAC, City
S.F. Total - MCWCC 650•00
SAC
S. F. Footprints - , 66? .oo
On Sila Sewage _ Water Conn
On Site well
x Waler Meter 95,00
rnwcc syscem
X
/?cct. Deposit sp .pp
Ciy Water ? ?•?
PRV Required SM/ Permil
Baoster Pum .50
p - g/W Surcharge
` TreatmeM PI 276.00
.,41PPROVALS Road Unit 3 70• 00
Planner - Park Ded.
Council
BIdg.Off. _ Copies
3,392.50
variance - ToTAL
r Permit No. PermN Holder Date Telephoee #
PL,?ING
WAC
ELECT'RIC
ELECTRIY" .
I„,?ion Date ln„p. Co„nwnts
Footings I
Foundation
Framing
Roofing
Rough Plbg. -? 64
Rough Hig.
Isul.
Fireplace -? -? ?
Final Htg.
Orsat Test `
Final Plbg. d,p , Plbg. Inspector - tify P mber
Const. Meter ? G
Engr.lPlan
81dg. Final ?
Dedc Ftg.
Dedc Final
Well
Pr. Disp.
'?r[? • „- s r'ny
C?tr#i#ira#t uf (Orru?aury
Citp of (Eagart
mrpmtmnrt n# wvgbimg inspertimc
This CuTiJtcate issued pursuanl [o t/re n.quirements ojSedion 306 of the Uniform Building
Cale certill'in% [lrat at the time of i.ssuanae lhisslructure was in canpliance with 11re various
ordinanaes of the G1y regrrlaling buildiq carutruclion or use For 1he foUawing.
trx cb=6-c- AB =4Cr1R eldg. Pcrnik No. t ocYx
Owupancr Trae RnJl zoms nwua R 1 ZYaX C? VN
o?ataaa* rMF EBarMq t1Q+tS'f Aeama 93M LYAIDAiF AVE S, wMr_ru
&ae;.SAea.u 4111 PRAIR7F' RTfl[E A[1AD L..rq 7 L? . B4. Oc?Ni_RY PAsS 2M
DOC 1a6/42
POST IN A CONSPICUOUS PIACE
. ?
CASH RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
? •, V
• f?
DATE 19
neeeIvEO • .
FHOM
AMouNr a
• } ; ?1
8 OOLLARS
,oo
? CASH ? CHECK
wn t i
„
BY
C 016304 While-Peyws ?,, &
Yel?Uq
??„
Pink--File Co{ry
Thank You
SEWER & WATER PERMIT
CIZY OF FAGAN '
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE NOV 22, 1991
OFFICE USE ONLY
METER# YO PERMITDATE 11/25/91
CHIP #62/6,2. PERMIT # 12399
METER SIZE ?lh 524?Sc?S B.P. RECEIPT # 1Q
ISSUE DATE a-? ? B.P. RECEIPT DATE 11 /22 f 9
X PRV _ BOOSTER PUMP
SITE ADDRESS 4111 PRAIRIE RIDGE RD
LOT 4 BLOCK 4 SEC/SUB COVLNTRY PASS 2ND
APPLICANT:
ADDRESS:_
CITY, STATE
PHONE: _
ZIP
PLUMBER: STAR PLUMBING
ADORESS: 1018 MOUND SPRINGS TERR
CITY, STATE BLOOMINGTON MN Zip 55420
PHONE: $84-4149
PERMIT REGIUESTED
X SEWER X WATER _ TAPS I
- COMM/?ND X RESIDENTIAL
X NEW - EXISTING
Lawn SpT"er Meters are to be Installed ?
Ahead of Dimestic. Metgia 9?? Water Ling. ;
1 AGREE TO COfiAP WITH CiTY OF
OWNER: DAHLE BROTHERS INC EAGAN ORDINA Eloe
DDRESS: 9304 LYNDALE AVE S ep- a
A
CITY, STATE B?MINGTON MN ZIp
PHOVE: 888-6866 SIGNATURE WHEN METER ISSUED '
i
PLEASf ALLOW TWO ?WokING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
1C'f /1
??.
n
SEYJER&iIVATER PtHMIT
ciTx oF EAcaN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
OFFICE USE ONLY
METER # PERMIT DATE 1 1/25/91
CHIP #
METER SIZE
DATE HOV 22, 1991 I ISSUE DATE
PERMIT #
B.P. RECEIPT # '--- i : : -
B.P. RECEIPT DATE 11 /2219
x PRV - BOOSTER PUMP
SITEADDRESS 4111 PFcAIRIE RIDGE RD
LOT 4 BLOCK 4 SEC/SUB COVEI3TRY PASS 2ND
APPLICANT:
ADDRESS: _
CITY, STATE
PHONE: -
ZIP
PLUMBER: STAR PLUMBING
AODRESS: lOlE M{?UND SPRINGS TERR
CITY, STATE BLOOMINGTON HN ZiP 55420
PHONE: 884-4149
OWNER: AARLE BROTHExS INC
ADDFiESS: 304 LYNDALE AVE S
CITY, STATE BLOOHINCfON MN ZIP
PHONE: 88$-6866
PERMIT REGIUESTED ?
X SEWER X WATER - TAPS ?
- COMM/IND x RESIDENTIAL ?
-X- NEW - EXISTING ?
1
Lawn Sprillker Meters are ta be Installed .?
Ahead of D, mestic, Metpra_or( Water LiW. j
I AGREE TO COMP}CY WITH CITY OF
EAGAN ORDINAMLES
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
ndd,ress: 4111 pRAIgJE rup? Rppp Lot 4 Blk 4 Sec/Sub r,p?Ry p[Sg uqp
, .?
These items were/were not complete at the time of the final inspection.
ate: 2/26/92 Yes No (,wj ?
Final grade (6" from siding)
Permanent steps - garage ?
Permanent steps - main entry
Permanent driveway
Permanent gas
Sod/seeded grass ?
Trail/curb damage (j
Porch ?
Basement finish
Deck
Please verify vith the builder tha removal o£ roof test caps from the plumbing
system and the shut-off of vater sapply to the outside lanm faucet before
freeze potential exists. ?y
xecaEOwren
White - City copy Yellow - Resident copy Pink - Contractor copy
? . CITY OF EAGAN ?I
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 1 906
BUILDING PERMIT PHONE: 681-4675 Receipt u ??
/Y O 0Tobeusedtor SF DWG/GAR EsLValue $112,000 Dete NOV 22 , 192L-
Site Address 4111 PRAIRIE RIDGE RD
Lot 4 Block 4 Sec/Sub.COVENTRY PASS 2ND
Parcel No.
Name _
W Address
0 Ciry _
9304
MN
Zp
rc Name SAME
? Address
? City Zp
? Phone
ucensa?
1 hereby acknowlege at 1 have a is app a s[e-NreYiFi
intormanon is corre and 9r L m i ble S"
Minnesota Statute nd y?6 r es
Signature ot Per ite
A Bwldm9 Per is issued toDAHLE BROHERS INC
on Ihe express condition that all work shall be done in accordance with all
applicahle State of Minnesola Stat.uqtes and Crtyyy o?f Eagan Ordinances.
Budding Official Il.li , ? I I I?
OFFICE USE ONLV
FEES
occupancy R-3 M=1
Zoning R- &tlg. Pertnd 682.00
(AcNaq Const SL-N Sincharge $6.00
(Allowable) V=N Plan Review
Q
443.o
# afStories _
Lengih 51 ' Licerse
Depih 1r8-' SAG City 100.00
S F Total - SAC, MCWCC 650.00
5 F. Footpnnls _
660
00
On Site Sewage - ti'ater Conn .
On Sde well - Water Meter
0
95.0
MWCCSystem X
AccL DeP°sit 3D.00
Cny Water X
PAV Reqwrad X S/W Permit 30.00
Booster Pump - S/W Surcharga • 50
? TreatmeM PI 276.00
PPROVALS RoadUnil 370(1f1
.. Planner - park Ded.
I Council _
BIdg.Off _ COpies
Vanance - TOTAL 3.392.50
. • - DATE: NOV 25, 1991
RE 4111 PRAIRIE RIDGE RD (DAHLE BROTNERS INC)
Y._ Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3507 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 foliowing
reasons:
_ Your Sewer 8 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 Bill 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.
J
3
0
? ? ? ?? 5°75
1
1
5
..?
Repuest Date Fire No R g?-in Inspection
Re iretl,
? ReaOy Now ?JlNill No01y InspectOr
Wnen Reatly,
Ves G N.
I?glicensed contractor p owner here6y request inspec4on of above elecirical work at:
Job AtlEress ISireet Box or Route No I /?
/1
. Gty
r
` Q % Gfe\
SMion No 161 Name or No Range No County /
h leOJ''t
Occupanl?PRiNTI Phoire No q
Pow"AerSuppher 1
f?'i LA/' Adtlress 1
•A./N1
Elecmc onhactor (COmDany Name)
?t?+,u?
?-, ?.
,w?. Con[racloYS Gcense No
Dy2 3< -
Maiting Address (GOnVacror or Owner Mak ing Ins Ilalion)
Autbor¢e0 5? atere (GOntectonOwne? Makin IIaO ) P one Number
?-
MINNESOTA STATE BOAND OF ELECTflICITY
Grigga-Midway BICg - ROOm 5-173
1821 University Ava., SI Paul, MN 55104
hone1612)6CY-0B00 THIS INSPECTION REOUEST WILL NOT
BE AGGEPTED BYTHE STATE BOAHD
UNLESS PROPER INSPEQION FEE I$
ENCLOSED
°nn eeoaom-oe
;
REQUEST FOR ELECTRICAL INSPECTION
q nL ? See inslmctions lor compieLng this brm on back of yellow copy ?' /-a /?3 75
q
I 111 1 1- X" Ralnw Wnrk f:nvaro!/ hv This Ranuacl +?,"! , i O fi P
ew Adtl Rep' " Typeo?BUtltling AppliancesWrted EquipmentWired
Home Range Temporary Service
Duplez Water Heater Electnc Heating
Apt Budding Dryer Other (Specify)
Comm.llndustnal Fumace
Farm Air Condilloner ? z
Other (specityl Comractors RemaMs
Compufe Inspechon Fee Below.
A Other Fee # ServiceEnirance Sze Fee k Circwis/Feeders Fee
Swimming Pool 0 to 200 Amps /P? e10 / 0 4 l0 100 Amps 8rC0
Transformers Above 200 _ Amps Abov Amps
$I(jn5 InSpecror5 Use Only AL
Irrigahon Booms ??7 S?
Speciallnspection T
3N
Alarm/Commumcation EC
IED
THIS INSTALLATION MAY BF-QRDER D ISCIF NOT
Other Fee COMPIETED WITHIN 18.IU?idNiHS. ?
I, the Electrical Inspector, hereby
ti
t ROUgh-in c.i c >
cer
ty
hat the above inspection has
been made Fuai ( Date
OFFICE USE ONLY
This request wi0 18 monlhs imm
???.. ??a4--
Z
INSPECTION RECORD
CITYOFEAGAN PERMITTYPE: BuzLoiNG
3830 Pilot Knob Road Permit Number: 022066
Eagan, Minnesota 55123 Date Issued: 0 9 I29/ 93
(612) 681-4675
SITEADDRESS: Lor: a BLOCK: q APPLICANT:
4111 PRAIRIE RIDGE RD MAAS DON
COVENTRY PASS ZND (612) 456-5969
PERMIT SUBTYPE: TYPE OF WORK:
SF (MISC.) ALTERATItlN
INSPECTION .. . .•
FOOTZNG FRAMING ?
FINAL
REMARKS: (pORCH FOISNDATIDN, fOUNDRTION UNDERpINNING & PATIO DOOR
-? PERMIT
CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55123 Permit Number: 022068
(612) 681-4675 Date Issued: 0 9/ 2 9/ 9 3
SITE ADDRESS:
4111 PRAIRIE RIDGE RO
LOT: q BLOCK: 4
COVENTRY PASS 2ND
P.I.N.: 10-18401-040-04
DESCRIPTION:
? -w
BiYildirig?Permit Type
9uilding W"ork Type
UBC Occupancy,,
?
i ?
ti
` J
i
-?-' ?
SF (MISC.)
ALTERATION
R-3
c?
?fi ?k [?) C' ?r' ?Q -,?S?Jti
REMARKS:
(PORCH FOUNDATION, FOUNDATION UNDERPINNING & PATIO DOOR
FEE SUMMARY:
VALUATION $3,000
Base Fee $54.00 COPY $.50
Surcharge _ $1.50 Total Fee $56.00
Subtotal $55.50
CONTRACTOR:
OWNER: - Applicant -
MAAS DON
4111 PRAIRIE RI06E RD
EAGAN MN 55123
(612)456-5969
I hereby acknowledge that I havs read th3s
information is correct and agree to comply
Statutes and City af Eagan Ordinances.
APPLIC NT ERMWFEI?.IIAT11111
-`----- '? _
application and state that the
with all applicable State nf Mn.
,& C
ISSUE BY: S G RE
-i
I
REACTI1111TE _ rE-Ci'???? ITY OF EAGAN
PE?I7 ?'' §Ep Z' ? 9 3 BUILDING PERMIT
??? -- - - 681-4675
APPLICATION
('p 0 Q?"l, q -?(I
SINGLE h MUL7I-FAMILY 2 sets of plans. 3 registered site surveys, i copy of energy
calcs.
COMMERCIAL 2 sets of architectural 8 structurat plans, I set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by ltst working day of month.
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date `1 / 2 4 /93 Valuation of work sey
Site Address: wlll IF 9-A.1F-i1?-, V-1V-164g?-_ 9-c>p-L?>
fTREET W1TE N
Tenant Name: (comnercial only)
IAT 4 BIACK 4 SUBD. ?? PQ% Y.I.D. M
Descri tion of work kfui{S oui" w?e In ssta-Sen er'cII
The abplicant is: C'fOwner 0 Contractor ? Other (Deocrlbe).
Name r?a r.t Pho ta 8'6- 9 3 $`7
Property LAST F1R51 ti/) 45(o' SSGQ _
Owner pddress ?-1 rr g-tte, tZt??a FTz? t__2
STREET sT¢ r
City State ZiP
wi1t be ?XQ
b!d e?ce
Company Phone
Contractor Address License # Exp.
City State Zjp
Company Phone
Architect/
Engineer Name Registration M
Address
City State ZiP
Sewer & water licensed plumber . Processing time for
sewer 6 water permits is two days once area has been approved.
1 hereby acknowledge that I have read this apPlication and state that the information is
f
d C
t
y o
i
correct and agree to comply with all applicable State of Minnesota Statutes an
Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
O 01 Foundation
? 02 SF Dwg.
? 03 SF Addition
O 04 SF Porch
,U 05 SF Misc.
WORK TYPE
X7 31 New
? 32 Addition
? 06 Duplex
? 07 4-Plex
? 08 8-Plex
13 09 12-Plex
? 10 Multi. Add'1.
,W33 Alterations
? 34 Repair
GENERAL INFORMATION
0 11 Apt./lodging
? 12 Nult1. Misc.
O 13 Garage/Accessory
O 14 Fireplace
O 15 Deck
? 35 Tenant Finish
? 36 Move
Const. (Actual) Basement sq. ft.
(Allowable) ' lst F1. sq. ft.
UBC Occupancy ? 2nd F1. sq. ft.
Zoning Sq. Ft. total
i of Stories footprint Sq. ft.
Length ,
On-site well
Depth On-site sewage
APPROVALS
Planning Building
Engineering Yariance
. M .
? 16 Besement iinish
0 17 Swim " Pool"-
? 18 Comm./Ind.
O 19 Cowm./Ind. Misc.
? 20 Public Facility
? 21 Miscellanecus
? 37 Demolish
MWCL System
City Mater
PRY Required
Booster Pump
Fire Sprinkler
Census Lode
SAC Code
Assessments
T
0
REOUIRED INSPECTIONS PO? FOUND?oTJON, ?rouwc??ndN uNDEXp,NiNa ?
O Site ,?L footing Framing ? ? Insulation
O Mallbaard V, Final O Draintile ? fireplace
Permit Fee jY,vd aiuana,:
Surcharge
Plan Review
License
MWCC 5AC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Cooies sn
Other
Total:
S 3000 =
SAC %
SAC Units
??^•?? ?v??? Vr JVRYL 1
utuw
_ h LANDSURVEYORS
rs ? ? • aca
Survey for:
DAHIE BROS., INC.
DESCRiPTION:
Lot 4, Block 4, COVENTRY
PASS ?_ND ADDITION
a'
?
0????
Scale: 111=3p,
?
I
/ ? „1 \X1
?
ol
°
?
i?
,.
?
Z" R. eftwea, ;VWs.
8713 DUPONF AVENUE BOUTH
BLOOMINaTbN, MINN. 68420
888-4080
8yto?' 3y? 10
a C?
y ?`, I Yw w 13 33
/
? ?
N
? ?.-
?
mV,
i?
1+?93
"\n 8
Proposed Grades:
y2?03 ? Top of Blocks g,?'?,lS
y76arage floor?j?°-,Bbsement';floorN?, -?
MOT[: Circled elevations are rop" ???"°' -••?
p os _ ,, others/,a? ---
f(
Arrews.-denate-v.i.rection of=?9i?aIaije. --?r '.?--4
'dio'AN. REQC1I ED _...r.?r_...?-
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.
Dated this 20th day of November ,19 91. /) --I 11??
27¢ -S8
1 4•=
7, 7 10
•?
? 0•*
? 68G•?
Al 56•+
Q?? ?z.. 443.+
1oo•+
65u•+
XV 66 o•f
y; . +
? Y r so•+
n, 3 0 . +
? o•5+
o- zrf•+
, 37U•+
?' 3, 391•?*
1991 BUIL1N6 PIItM10T APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS ?NLTIPLE DWELLINGS C0144ERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 5ET OF ENERGY CALCUTATIONS (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 AYPLIES i1HEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY IAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER HUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALIAWED 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: Valuation: OGU' Date:
Site Address 7yw-? OFFICE USE ONLY
Lot Block FEES
Occupancy IZ-3 M-I Bldg. Permit "Z.00
/ Zoning R-i Surcharge iSb,QO
Parcel Sub ?•Actual Const V-N Plan Review °?/ 3iv0
Allowable V-N SAC, City 100 , 0&0
Owner # of stories SAC, MWCC 50i00
Length 51, Water Conn. ?aD.Oo
Address Depth S$' Water Meter qi 00
S.F. Total Acct. Deposit 0,00
City/21p Code Footprint S.F. S/w Permit 3o•vo
S/W Surcharge 15D
Phone On site sewage_ Treatment P1. a7r16•00
On site well Road Unit 370,00
Contractor \^^^"^? ?? ? MWCC System ? Park Ded.
` C City water ? Trail Ded.
Address PRV ? Copies
Booster Pump _
City/Zip Code\ SUBTOTAL
APPROVALS Penalty
Phone E)P'bb ` LP E) c¢Planner _ Lot Change
Council TOTAL
Arch./Engr. Bldg. Off.
Variance
il
Address
City/Zip Code
Phone #
Se" r.erar LihLd Contr. T? ?
agrees that all w'64 shall be done in accordance with
(Signatu of Contractor)
all applicable State of Minnesota Statutes and City of Eag?an Ordinances.
I
-• - V?tt:u?` ? ??
cBSMT,_
650
s%2x?os SS
zX ?= C6?
(,so u IA*- ql o0
c?l R a-??'
?
z2X22 = y8y X IS = 726?
I sT -Fc.oa?
S" 7:
2)K% ?-
I X10=
z2-Xsn?
2r-p F?
?aX3??=
6sb
i(P
!o
Gba x 23
?-
I 336 ? S'3 = ?OS oS
r) y8 'A 53= 39,6 y'l
F c?1E'A ) T u N l=/N 1,5ktm +41z?,+4-
?11?63Z-
CERTIFICATE OF SURVEY
? ?MlOM `
•iktox? ?
LAND SURVEYORS
y Ib ' • 1Ca
Survey for:
DAHIE BROS., INC.
DESCRIPTION:
Lot 4, Block 4, COVENTRY
PASS 2ND ADDITION
,y
Scale: 111=30'
?
W
\AW
o ° ? X
10•
S?
Y
e5or 3N? '? \
\
?h b
? ? 2ti 3
? a
\ o ?: 3p
,
?
? \ , , / ?•
` /
ry ? \
\ y
r/
nA? ? \'?
?v
.?e?r R. (,?eaArori, Pua,
8713 DUPONF AVENUE 90UTH
BLOOMINOTbN, MINN. 85440
888-4084
Q -'
9
1
? Q
? m
/
i\
8
/
/
Proposed Grades:
? v3 v7Top of Blocks
,._
Garage floor' BS ?°,1?asgment?,lf,loorj,
f+?,'1 i;
•( `
PJOT[: Circled elevations are propas o, other
n
ArrAw-s--denote-d.i•r-ect-i on --ofT? ?d#a5,iaage.Ei
r
ro No REQURED
??
?
\ ?
a
DEPT
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.
Dated this 20th day of November ,19 91. ,/) Z-?2 ,
Z7¢ -S8
•; :? -; ?
. .
;' .
'OWCkR
?
EXTERIOR ENVELOPE AVERAGE "U"'COMPUTATION
L7AlaVE. 6CLOS. Ir?G.' ._._. . '
, -?
SITE ADDRESS
.. _ . _.:?. ... . - ? _
CONTRACTOR ' DATEC? 11-u =1 PHONE e)20
Detezmine vorkinq square footage of each. '
1. 'Total exposed wall area ..... Zo 1 2 sq, ft..X -? ? -_ 2 2 I, 3 2
]. Total roof/ceiling area ...... I232 aq, ft. X-02` -? 32,03
_ , . .
A. Total wall window area ......................... ?Q-G
B. Total door area ................................. 40
C. Total sliding glase door area ................... q-O
D. Total fireplace wall area .......................
E. Total wall framing area (average 10t)........... f4.4 ?
F. Total Rim joist area............................ l 44
G: Total Net wall area above floor................. 1418
' yo ?2
Total exposed foundation area -
$. 2ota1 foundation window area .................... '
1. Total net,foundatiori area above grade........... .
Determine "U" value of each wall segment.
a. 1 44 x^p^ .158 ? 84. (.8
b. C? G X"U" i 2.Ti a 1.2 Q ' ,
c. 4° x ^v^ 23.60 -
d. X °UN a
C. b' wU^, . ? O a 14-9'0
f. 144 x "u" .04 m 5,"1G
q, 14'18 X»p. 5r-l.17-
Z1. X ^1J" s
i. X "u" ?
3 ...................................Tota1 = 19 8 ?
If item 43 is the same as, or less than item # u hav met the intent of
SHC 6006(c)2.
1.
,• ? ( ?
. .. ,
, Total expoaed roof/ceiling area ? I 2 3 Z ^_" • j. Total skyliqht area ................................
k. Total roof/ceiling framing area (avezage 10%)...... ? 2 3
1. Total net insulated roof/ceiling azea .............. 11 09
Determine "U" value for each roof/ceilinq segment.
J• • X '"U"
k. 12 ?j x •Uw . 02T 6 ? 3. 3 y
1. • ? ? d9 ]C-"Un • OZr'J a 2.7.? 3
a ...............................:.....Tor.al ? 31 • Z '
If total of #4 is the same as, or less than #2, you have met the intent of
SBC 6006(c)1. '
Alternate Suildinq Envelope Deaign
To utilize the total envelope system method, the values established by the
sum of items p3 and #4 shall not be greater than the sum of items 41 and p2. '
S• + 2, ' C
+ 4. ?
15%, of opa uo
q aall area for .•.. .. . '`
frame, construction Conatrucclon , R-Value?
?
_ . '
,,1. .; Interior air film 0.68
... _.Z.: I/z" flRY1NAl1- ,q5
3. 5I/L inches soft ++ood G.IL
- •_, - :T•;;4, eyNEPTH?NG Z?OG
•n*::':; 5. SIt71uG .G7
SIC `°- 6. Exterior air film : D.17
ALL •_ _ 4bta1 { o. i S
? , . . ' U=•lo
Fzc.
FRAHE Wl\LI.
• ?.
.
FIG. i2 ?
. ' •?• ,
, •; •,,? •
SeA C;
e.al
siox
?
"0'. a
. • Q 'µ
4?'i' '-'T•
C? _? w
.:?. a •Q?
• : ti ?..
1.. Interior air film 0.68
„.' .
. 2• •'/7." S7LYWALL .45
? • .. 3. c,11L" 1us1) L. ty.oo
4. SHEGT411NG 2.oG
4:?? %viw4 G .Gl
6. Exterior sir film, 0.17
Total -a,;,03
? • . ., , t) =.04
-0 • ' 1. Interior air film 0.68
"-? 2. lu=?uL. . t 9, 00
-?j • 3. 1 I/z" woov 1.88
4. SNEAT4t11J G ?.oG
--Q S. SIpIWG • .G1
_?• 6. Exterior air film
Total 0.17
2- 4.4G
• U= .04
?
1. Interior air film 0.68
1 ? 2. 111SUL. .AIJv DR.yWALL . B'Ofe
•
''
' 3. J2" bloc.? 1,28 -
? •
S.
6. Exterior air film 0.17
. . • Total 10.111
• l1:.la
SL11B ON GRADE
• • , - //(
?••' ?
i3
. , ? o _ • ,? .
' • .
i• ? ' - 1
. ,? ? . ? . . .
.??9?? r? k • «; ' ;? ' .` _ . ' ? .
.
?r? _- . . . .
/rf " • . • _
? ? a • ??i =
FIG. $4
, , /fl ?t • o ?
NOTEt Indicate type, "R" value, denth and
' olacenent of incniMt.,.,_ -
.Y
f? i?<^a'• ? , -RGOF/CEILIt?G , "?
.., ., Conetrvctio» (Use for Item L) ?`naiue -a , ,
4 •??:,??1. Interior air film 0.61
2. `56SHEE72oc? ,Sb
I -.W
?1? ? ?'Stv°'l?3• 1"SU{.. T 38.00
':..4. Extcrior air film (still O.fiI
• VEbTT Totai 39 .'1 S
..? ? . .
? ? , .. . U c.07-5
• ? ??1?! . • ' .. • y ,
G'LG. FRAMING (Uae for Ztem K)
Tenced geat flow - '
uP .•. ''°''"= 1. Interior Air film. 0.61
. •; f : ,; ,-.
. ' . . • 2. SIB" SIMF--TR.oclG .S?
3. Inches soft wood 31/7-" 4-.3 8
FIG. p5 • 4. Inches insul above framina 30.00
-• •, 5. Air Film 0.61
. ' ' - • .• ?6#?? 'SG.1G -
?n?/ .• :+1`ti•':.. /ft`.,?,An?CJOtLA . . . .. . '" ' • ' v z, dZTG
"?? " --- •
' ?.
l. Interior air film ' 0.61
2• ,
3.
4. Exterior air film (still) 0.61
Total
.
• '
! tieat flost up . ? ; vented•
a
1. Inside air film -' 0.61
2.
3.
9.
'S. Outside air film 0.17
Total
: .? NUV-VENT'p.p . ?
. }fcat ' .
. , flov up ?
' .
PLr,, 07
Notce Usc additional slicuts if more spacc ia
reeded ior dr.tails and calculations.
r
. .FIG... #6' . .
CITY OF EAGAN
" 3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
W"gm
---------------
---------y---------___------------_---___-----------__.
WORK DESCRIPTION
NEW CONST ?
ADD ON _
REPAIR _
W
NAME
& Ll ?
:
O
NER
?
el
Cl I
l
'
`U
?
A
SITE ADDRESS:
I t ?>! /? /
?
Z/ 05? 2,1
BLOCK
LOT: SUBD.
? (/P
INSTALLER: /YC / (
.
ADDRESS :
CITY: zGt?-_ot'! ZIP: S S Ile) >
PHONE #: GAi? `r`? S d
FOR CITY USE ONLY
PERMIT #
RECEIPT # G 01 lv'I 7GI
DATE: '7-5-q9?
SIGNATURE OF PERMITTEE
DWELLINGS &
COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
ADD-ON MINIMUM 15.00
? SHOWER 3.00
WATER CIASET 3.00 G O/J
? BATH TUB 3.00
? LAVATORY 3.00
KITCHEN SINK 3.00 3_gZo
? LAUNDRY TRAY 3.00 I00
HOT TUB/SPA 3.00 3,&?4:2
? WATER HEATER 3.00 4 Di7
FIAOR DRAIN 3.00 3-420
GAS PIPING OUT.
? (MINIMUM - 1) 3.00
? ROUGH OPENINGS 1.50 f6 S?2
_ OTHER ? '
WATER SOFTENER 5.00
_ PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
SUBTOTAL $ 14. 3c?
ST. SURCHARGE .50
TOTAL: $ YY,Oa
C024T?F€C3??iHDiIST?TA2:? PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND
MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: BLDCK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE
FOR:
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY
TOWNHOMES/CONDOS WHEN PERMITS ARE REQIIIRED FOR EACH UNIT.
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:
$
(SIGNATURE)
CITY OF EAGAN
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
t3?C.FIANICAI:`??lt?'?
FOR CITY USE ONLY
PERMIT #
RECEIPT # /? LO
DATE: /
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: LAk I` C.??
'/
LOT: BLOCK h` SUBD.
?
INSTALLER:
ADDRESS: ??1\ `Q Ca(?-E-(n ST
CITY: ZIP: ?'q g
- ?
PHONE #:
FEES
ADD-ON MINIMUM $15.00
HVAC 0-100 M STU 4.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS - MINIMUM '?..?'0
OF 1 PER PERMIT
SUBTOTAL: $ +1.cu
STATE SURCHARGE: .50
TOTAL: $__ n.?v
J? _ )
SIGNATURE OF PERMI EE ?
.0QMMEuIAI.ITNDUST?Tl4l:; 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: FEES
OWPIER NAME:
SITE ADDRESS:
LOT: BLACK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE #:
1% OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING = $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $
STATE SURCHARGE
TOTAL:
(SIGNATURE)
FOR:
CITY OF EAGAN
CITY OF EFlGAN
f:AaM7EI"c S TI_ICM.T.NAL Nt], 32
DATF^ C1t:,/09197 TIMI:e 140?f1'31
ID :
NAMEa LiR:tAN L_ BOFL_TI'F:
32.1.0 '9001 4111 F'RAIF::I:E'. F'CI 50.00
21.55 3001 4111 I'-'RFlIRIt: RU 0.50
?
To+.a:l. C;erer.pi; Arciauni;, 50.50
CRO i'..`47 i k.
lJSFfi TLi: NANCY
, .
? CITY OF EAGAN PERIVIIT
3830 Pilot Knob Road PERMIT TYPE: s u z Lo z ra G
Eagan, Minnesota 55122-1897 Permit Numher: 0 30 19 a
(612) 681-4675 Date Issued: 05 J 09/ 9 i
SITE ADDRESS:
411 i r-RAsRrE R1r,Gs_ Ro
LOT: 4 HLOCK: 4
COVENTR1` PFiS ; 2ND
P.I. IVa : 10-184 01--040--04
DESCRIPTION:
D E C K
U.4;;? l`., Pe r m i t T yps.
Y P e .
F
Ili ECK
NE6J
434 AI.T. 12ES`IDEPJT:i^4.
F6 t 3;
m k }{? ?g ??
Y
2,us V
p^C:°`,c.IR1?'@` $'€?'r?'-r ?,?i?i.' y?
sry? ? ?Q?? ? R
Z?'n
REMARKS:
FEE SUMMARY:
Base Fee
Swrcharge
Tota1 Fee
;sSm.mE?
$50e5P,
CONTRACTOR: OWNER: - Applicarit --
Bt7Cl_1'rR BRIFlN
4111 PRAZRIE RTDGE RD
f
? Ef1CiAM MN 55123
(612)454-2202
_
77
., 4Lwtw` ,tiII?tv lsil?`
la...... liz-,6te at
z
.
Z?ta?t'at)?-??.?? o? 5'a 4 6cr pr 'a e,
s
'3/P'1JlAJl.l, T •
?1?`?PPIICANT,PERMITEESIGNATURE ED Fft.SIGNA E
1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)
??//?? ? ? CITY OF EAGAN
3830 PILOT KNOB RD - 55122
681-4875
0S'o. sc
? 3 registered sita surveya ? 2 copies of plan
? 2 copies of plans (Indude beam 8 window saea: Pourad ind. design; eta) ? 2 site wrveys (exleAor atltlidoos 8 tleeks)
? 1 energy catwlatlons ? 1 energy plwlatlons for heated additions
? 3 copiea of tree praservedan plan if lot platted after 7/1l93
required: _ Yes _ No . "
DATE: C-P J ?I I cI -l CONSTRUCTION COST: ,;;7- '"-7 6°
DESCRIPTION OF WORK:
STREET ADDRESS:
LOT ?I BLOCK
? SUBOJP.I.D. #: 0,6 Ue-n-tf ?-( PaSS Zn `? Gl?cl ??1 dY)
PROPERTY Name: iz Phone
OWNER
Street Address: 14111 City: F??AqAj State: ? Zip: SS f 2,?s ,
CONTRACTOR Company: u oM'F-:? Phone #:
Street Address: License #:
City: State: Zip:
ARCHITECT/ Company: ?JnkT)F-? Phone #:
ENGINEER
Name: Registration
Street Address:
City: State: Zip:
Sewer 8 water licensed plumber (new construcfion only):
and lot change are requested once permit is issued.
Penalty applies when address change
I hereby acknowledge that 1 have read this applicatlon and state that the information is correct and agree to compry with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
i
Signature of Applicant:
OFFICE USE ONLY RECEIVED
CertiflcatesofSurveyReceived _ Yes _ No ??? 51997
Tree Preservatlon Plan Received _ Yes _ No _ Not Required B
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation o 06 Duplex
0 02 SF Dwelling o 07 4plex
? 03 SF Addition a 08 8-plex
0 04 SF Porch o 09 12-plex
? 05 SF Misc. ? 10 = plex
WORK TYPE
? 31 New o 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
? 36 Move
0 37 Demolition
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
APPROVALS
Planning
Pertnit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatmerrt PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Building 11
Total:
0 11 Apt./Lodging o
a 12 Multi Repair/Rem. o
? 13 Garage/Axessory o
? 14 Fireplace ?
,K 15 Deck
16 Basement Finish :
17 Swim Pool
20 Public Facility
21 Miscellaneous
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
Engineering Variance
Valuation: $
?
?L
?-
?
% SAC
SAC UnRs
,
ERTIFICATE OF SURVEY ,, -
? 6717 DUPONF. AVENl1E 8OUTH .
BLOOMIN6TbN, MiNN. ElA70
. ?, ?, . . 99 0-2091
LANO SURVEYORS
'5urvey for:
, DAHIE BROS., INC.
64?'of ?'?^ ?o
)ESCRiPTION;
: Lot 4, Block 4, COVENTRY N
? r ^
PASS ?.ND AtiDITION
TUn eFfc.k' hbb /
J7'?14
ot
8?{Q _
W W-
3 p
?
oot ?-
r 5.y ? ?' ? \ ?? a
°
%
ZIS
? 5y w `
a/ o_ •
Scale,.1_II=30I?
v+ 3
?? %?Z3 g5 -
\d? _
Proposed Grades:
0oo ??C,
? '1 ? i'" Top of Blocks ?
5-71
sarage floor BS 6! Basement floor 8&!2s
? ?{a
s
0
{? ? ?5•° NOTE: Circled elevations are proposed, others are existipg.
Arrows denote direction of drainage.
y!,Ne hereby certify that this is a true and correct representatSon of a survey of the
boundarles of the land ebove described and of the location of ail buiidings, lf any, •
' thereon and all visible encroachments, if,any, from or on said land. Oated this 20th day of November ,19 91. -
- , - -
bY !
inneso icense o.
., 7¢ -_ss
?k:i?X(YF9Fk?3X`KksW%lt?'?k?W?kN(?KSku<%Y•:YYFYFYf.??X ?N:?kW„Y6'+k?'<.W.y.(dt?Y?1:
C;TTti' [)FEAGAN
C/d iH.lER ` JS TLRMTN(§L NOn 62,
rA'rEi r. 06/24/97 7.T.Mfi:s 000a27
'.D ?;
0?1?`fEn f"[E?Tf3C;hl Lt1..1:L1_D['FiS :(N.f.;
,,..iQ 9001 621 CUVFNT'FiY F'R 50„00
:_c`.
205 9001 621 C:OVGNTFtY I-'I' 0.50
7oi,;il kerr,i.pi a,rnou;','4.e •_Si].SO
fF.!)75i':?;L
lJ"-iiif' l:li: ,l(1tJ
:k:!:>'nXt•Y.1FW ?FY,tur.?>k1}""h1;:K;k9f.?R;i.?F?,gxY;v?SW?k?9d'7F%F.%C'.Y>M>#?W,.
? PERMIT
,.A)CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: e u.r G. o z rv G
Eagan, Minnesota 55122-1897 Permit Number: 030305
(612) 681-4675 Date Issued: 06/24/97
SITE ADDRESS:
szl coveNrRr r>Kwv
LUT: ?G BLOCK,: 3
CGV[M7RY PH9S A'TN
P.T.N.: 10-18403-260--03
DESCRIPTION:
Type
guilding Wta,rk 'I"ype
r'Cvns.tis C 6 d
.>
y,
„
EiASEMENT FINSSH
AL7ERATSON
434 ALT. RESIDEPITItaL
'&
REMARKS:
SEPARA7E PERPIIT^ ftEQUIi2E0 FUR ANY E.l.EC7ftLCAl_ OR PI_UI"i6IIVG WGI?K
FEE SUMMARY:
,
t3ase Fee $50.00
Surchacge $.58
Total rce $50.50
COiVTRACTOR:
PIET5C11 BLDRS IIVC
20830 HOLT AVE
I.AKEVJLLE MN
(612) 469-3E44
- Appli-car,t: - sr. Llc
I4G9304A 0002358
55044
I hereby ackrtowledge tiiat T
infor-maCian is ccrrreot and
I SL'atutes and City o'F Eagan
L?
OWNER:
PZETSCH BUILOEftS
28830 HOL1' AVE
I„RKEU'ZLLE MN 56091
(612)469-304A
havs rtad 'thie appliaatiarz e?n-d stdte that the ,
agrpb t"tr car'up1y w'i'th a1,1 d}ipri.;raL?lP gtate? of'Mn.
qrdinancef,,. e
.. . _ . . ? ' . ' ..
. . . .. . ._. <. ?_ . .. ?
PLICANT/
?? , ERMjTPEE IGNATURE
?
ISSUED : IGNATURE
7 3830 PIL' T KNOB RDN 55122
t996'BUILDING PEaMIT APPLICATION (RESIDENTIAL)
6814675
New Construction ReauiremenGa RemodeVReoair Reauiremen
? 3 registered sRe surveys ? 2 eoples of plan
? 2 copies of plans (inGude beam 8 window sizes; poured fnd, design; ete.) ? 2 ske surveys (exterior addkions & decks)
? t energy wlculations ? 1 energy caiculelions far heated additions
? 3 copies of tree preservation plen if lot platted aRer 7/1f93
required: _ Yas No ?
DATE: ?? I?I TT7 CONSTRUCTION COST: ??? On ?2
DESCRIPTION OF WORK: IN 15 +4 '?86 ? 1q EN 1 P?ALY
STREEJ ADDRESS: ??? PalrK k2d?A
LO? BLOCK ? SUBD./P.I.D. #: ?S
P h o n e #: 4??"{1-
CONTRACTOR
Zip-
Name:
Street Add
City:
State:
Phone
Registration #:
Zip:
Sewer 8 water ficensed plumber: . Penalty applies when address change and lot
change are requested once permit is issued.
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. J?
Signature of Applicant: ? ?zT Q LM4
OFFICE USE ONLY
Street Address:
Company:
ARCHITECTI Company:
ENGINEER
Certificates of Survey Received _ Yes No
Tree Preservation Plan Received _ Yes _ No L,
Street Address: aQ??D 4Cr 1Wj? License #: S?66
City: .[?Qke v I (--L-E State: `?J?? I Zip: ??
OFFICE USE ONLY
BUILDING PERMIT TYPE
:3 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
:i 02 SF Dwelling ? 07 4-plex ? 12 Multi RepaidRem. ? 17 Swim Pool
?i 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
-1 04 SF Porch o 09 12-plex ? 14 Fireplace o 21 Miscellaneous
:3 05 SF Misc. ? 10 _-plex o 15 Deck
WORK TYPE
- 31 New ? 33 Alterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
3ENERAL INFORMATION
?onst. (Actual)
(Allowable)
JBC Occupancy
Zoning
" of Stories
_ength
D=pth
4PPROVALS
:1lanning
_ Basement sq. ft. MCIWS System
_ Main level sq. ft. City Water
_ Sq, ft. Fire Sprinklered
_ sq. ft. PRV
sq. ft. Baoster Pump
_ sq. ft. Census Code.
_ Footprint sq. ft. SAC Code
Census Bldg
Census Unit
Building Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
5NV Permit
51W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Totai:
Valuation: $
% SAC
SAC Units
rzrv a= rFlGr-,N
T:AiiH:l:!-'Fi°. .Is 1"i"'riFSlid(•1l. N(i: FSivS
IlA'iE,; 00i17/99 'Y:I:M;:; 0E3a50:14
Til."
PJ61N:EI-1QWtai'CL"S EiMfaL.E. C(IPJ;iTI?:I?(.:llf:li'!
32i.p 9(701 411.1. f-'F;:A:LP1:1'c fiCi i25.25
2:i..:;:, 9001 40 F'RAJ.IiIE. FiS.i .;.OO
I'o?:,'t Rt>c:c:aiF?;, Amnuni,. 0E3.25
CR :1.1.5:,39
ilgER 7D,". .?PA'4
?F'?Pn k'k?k? FYF?F:?'.:i?sK:{;V:? #k:'r'p%k%kW `^kMYX'%F'k%? X?k#? ?3kY6' F 'M'? ?Y
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
3830 PILOT KNB RDN 55122 ?l a-Q?j •a ?
'
651-681-4675 q
New ConshucHon ReaulremeMs Remodel/Reoah Reaulremenrts
? 3 registered iBe aurvey> >howing sq. tt. ot lot, sq. H. ol house 2 coples of plan
and all roofed areas [40% maximum loi coveraae allowed) 1 sM of energy calculaNom for heated cddlNons
D 2 eopies of plans (show beam a wtndow sixer, poured (nd. deaign; etc.) 1 sffe suney tar exMrlor addBtons 3 dec W
? 1 set W energy calculaHona
Y 3 copies ot hee presenaHon plan M bt plalfed affer 7/1/99
DATE: ?I, ? 1 Io 1 go
DESCRIPTION OF WORK:
CONSTRUCTION COST: 48 STREET ADDRESS:
LOT: ? BLOCK: ? SUBD./P.I.D.
Name: e`a.n Phone #: 6 S ! - ?'l 5?d ? ? 0 ?
PROPERTY Last FW
OWNER /-i , n _,
Street
Ci1y ?•v, StaFe: lYlil/ Zip: SS I?,?
Company: G.?h Phone #: sV 0 3?/ S' ?
(area code)
CONTRACTOR
Sheet Addreu: License #4 J 12 Exp.
CffY j /? ?0 State: /qJ\)'1 h . Zip:
ARCHITECT/
ENGINEER Company: Name:
Telephone #: area code (
SireaR Address: Regisfration Ik:
City
Sewer 3 water Ilcensed plum6er (reauired for new eonshuellon onN):
StaFe:
PenalFy applies when address change and lot change Is requested once permB is issued.
Zip:
? t hereby acknowledge fhal I have reod this appllcaNOn, siate thal the IMormafion Is correcl, a d a e to comply wRh all applleabl
? StaFe o( Minnesofa Sfafufes and CIFy of Eagan Ordinances. ?
? Slgnafure of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
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.)
? 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 0 24 5torm 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/SoffitslFascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
Basement sq. ft.
Main level sq. ft.,
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building Engineering
Census Code
SAC Code
No. of Units
No. of Bldgs
MC/ES System
City Water
Baoster Pump
PRV .
Fire Sprinklered
Variance
Permit Fee
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
?-5-
3. U c?
Valuation: $
SAC Units
% SAC
2007 RESIDENTIAL BUILDING rExMiT nrrLrcaTioN
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Consiruc6on Reauiremenis RemodeUReoair Reauiremenls Oifice Use Onlv
3 registered site surveys showing sq. ft of lot, sq. fl. oihouse; and all roofed areas 2 copies of plan showing footings, beams, joists Cedof Survey Recd Y_ N
(20%maximum lof cwerage allowed) 1 setof Energy Calculahons kr heated additions Shcs Report Y_ N
7 Soils Repat if proposed building is to 6e placed on disturbed soil 1 site suney kr adddions & decks Tree Pres Plen Recd Y_ N,
2 copies oiplan showing beam &window sizes; poured found design, etc Adddion ? mdicete' ifesepfic system Trce Pres Required _Y _ N
1 set of Energy Calculafions
3 copies of Tree Presemahon Plan if lot platted atter 711193 Onsite Septc System _Y _ N
R
im Jdst Dehail Opbons selection sheel (buildings wiN 3 or less units) I
Minnegasco mechanical ventilation form ?r?Q Q? p ti t?C.J ?v
E
es
s(?ou state t e are trade secret and the reason.
Plans are considered oubo l
Date BY u' ost h` Z Op0
SiteAddress 4I11 PRa„eiE RrOGF Rtl UniUSte #
6 . ss/
Description of Work p EC,f' K'lA?.d (aC'?(? G1f7??
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 2
7 - Jty- o 47 7- L1-
Property Owner Z ;rEpa JO-CX =?y Telephone #( 65) ) - NOME
65! 2 Wo
Contractor
Address City
State Zip Telephooe # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTIN6 A NEW BUILDING
Minneso[a Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category , Resitlential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(d submission type) Submitted Submitted
. Energy Envelope Calculations Submitted
In The last 12 months, has the City of Eagan issued a permit for a similar plan based on a masTer plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
I herebv anolv for a Residential Buildine Permit and
Telephone # (
Telephone # (
Telephone # (
that the information is complete and accural
e;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; ] understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case ofwork which requires a review and
approval of plans.
-? EpN Tc K?TlT' + "
Applicant's Printed Name Ap C n' S' ture
DO NOT WRITE BELOW THIS LINE
Sub Tvoes
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ezt. Alt-Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
O 04 02-plex ? 10 OS-plex x 18 Deck ? 23 Porch (screenlgazebo/pergola) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plez ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvqes
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundalion ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building" ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement *Demolition (Entlre Bldg) - Give PCA handout to applieant
D@SCfIptI0I1: WaterDamage_Yes
Valuation -70V Occupancy R-? MCES System
Plan Review 114- 100% or _ 25°/a laoG rAC
Census Code ?/ 3 y 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 [ce & Water Final
Framing
_ Fireplace _ R.I. _ Air Test _ Final
Insulation
Approved By: _
Base Fee U Y
Surcharge
Plan Review
MCIES SAC
City SAC
Utility Connection Charge
S&W Permit 8 Surcharge
Treatment Plant
License Search
Copies
Other
Total
REQUIRED 1NSPECTIONS
_ Sheetrock
Final/C.O.
? Final/No C.O.
HVAC
Other
Pool Ftgs Air/Gas Tests Final
Siding _ Stucw Lath _ Stone Lath _Brick
Windows
_ Retaining Wall
Buiiding Inspector
RbN `
• ??L?
LAND SURVEYORS
Survey for:
DAHIE BROS., INC.
DESCRiPTION:
l.ot 4, Block 4, COVENTRY
PASS ?ND AGDITION
B
3
,y
0
, ? S n
Scale: 111=30l
W
?
7'?0
?
a`
??.
\ ?? Q
'0 ' .9
V?
? N \
? ?
3
t3h? /' `/ ', ,?.
V
. . . ? lI" R, [i4w&w. ;)4td.
8713 DUPONf AVENUE 80UTH
6LOOMINpTON, MINN. 65420
eae-2oea
, ?.-
,
\ I?
s c? /y9 ?
/
Proposed Grades:
?
v-
?? Top of Blocks gs'?1S
Garage floor' ?Basement; fioor,..
r C A
PlOTE: Circled elevations
We hereby certify that
boundaries of the land
thereon and all visibli
Dated this 20th day of
J
S
's
are pro?os ,, other s ?r -
Arraws?eno-t-e-d.irection of-?dra?a?age ° ? ya? ?q •=,... _.._._ -/•r,.r, ?:: : ,
d?3a?. R {EOUN Fe 0
this is a true and correct representation of a survey of the
above described and of the location of all buildings, if any,
? encroachments, if,any, from or on said land.
November ,19 91, n I',?
by
cense
'74 -S8
? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ -
? Fo%Q_ffi_ce'Use ?
? Permit #:
? Permit Fee l?• v?/ I
I I
? Date Received:
? Staff: ?r I
I I
--------------___
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:
Tenant:
Site Address:
Suite #:
RESIDENT/OWNER Name: 2o4tkL-,5f. 3 t,?c?_C4T j_ Phone: y-?`+' 77A?
Address 1 City! Zip: t{ltt ?tr.' A/?.1•/ /?
Applicant is: _ Owner ? Contrador
TYPE OF WORK Description ofwork: ?IR
Construction Cosk ? gdo Multi-Famity Building: (Yes _ I No `
CONTRACTOR Name: License #: adlU
?
Address: 1?3-73 1?4(LlQ-614Cy ?-?
City. r4 0,1--li t1.u40C,1 State1 .1 Zip: Od-
Phone: ?5'?' a?(v S3d? Contact Person: ?LJeQ? -(
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
COtegOfy Submitted Submitted
(4 submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a pertnit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan.
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer 8 Water Contrector: Phone:
NOTE: Plans and supporting documents thaf you sbbmif are considered,to be pubhc information.' Por6ons of'.
? the information may be classified as non public if you provide specific ieasons that would permif the City to: `
`concluiie that the `are trade secretsi
I hereby acknowledge that this information is complete and accurate; that the work will be in confortnance with the ordinances and codes of the City of
Eagan; that I understand this is not a permd, but only an application for a permit, and work is not to start wRhout a permi[; that the work will be in
accordance with the approved plan in the case of work which requires a rewew and approval of plans.
x
ApplicanYs Printed Name
X7:0--?? ? -?--
ApplicanYs ' re
Page 1 of 3
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Date:
Cly of Eaaaa
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: ( 1 99 13
Permit Fee: 39549°
Date Received:
Staff:
g`,
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
L/19 1-5 Site Address: 411 L Pro, t e R o
Unit #:
Name: aC OC 11 Phone: (6'5)) 4 '7) 0
Address / City / Zip: 4111 P Ar { 10 dieeJ e J F4 SS 12 5
�
Applicant is: Owner Contractor
Description of work: LC9 L✓e r L 14. :e
Construction Cost: 45i ®n® Multi -Family Building: (Yes / No
Company: 1-- n)t 1, l'e5; fJK
I„ — ; ie Contact: Alex &c 4 --e.,-
Address: 710 C DHS'+ V7 e /CC r. City: `'VO OA '-..r>
State: A47 Zip: 5 512 5 Phone: (G/) «41- Z — 9/6 %
License #: 15( (, Z7 7 Z Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor:
Phone:
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.gooherstateonecali.orq
hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota StatpjB!ding Cj'u • e completed within 180
days of permit issuance.
x Ai geeL-
Applicant's
X
Printed Name
x
Applicant's Signature
Page 1 of 3
Lf f// /, Vk1
DO NOT WRITE BELOW THIS LINE
1/99/L5
SUB TYPES
Foundation
Single Family
Multi
01 of _ Plex
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100% )
Census Code
# of Units
# of Buildings
Type of Construction
Fireplace
Garage
Deck
V Lower Level
Interior Improvement
_ Move Building
Fire Repair
Repair
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
kiTILLO Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Roof: _Ice & Water Final
Framing
Fireplace Rough In \/ Air Test Final
Insulation
Width
Sheathing
Sheetrock
Fire Walls
Braced Walls
Reviewed By:
72
_ Siding
Reroof
Windows
Egress Window
_ Exterior Alteration (Single Family)
Exterior Alteration (Multi)
_ Miscellaneous
Accessory Building
Demolish Building*
Demolish Interior
Demolish Foundation
_ Water Damage
*Demolition of entire building - give PCA handout to applicant
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC Gas Service Test Gas Line Air Test
Pool: _Footings _Air/Gas Tests Final
Drain Tile
Siding: _Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall: _ Footings Backfill _ Final
Radon Control
Erosion Control
Other:
, Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
la t(SPv 2-o = //ov
Page 2 of 3
Jan, 6. 2014 11:23PM A. J, Alberts Plumbimg
*City of kali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
No, 5734 P. 2
Use BLUE or BLACK Ink
For Office Use.
Permit #:
Permit Fee:
Date Received:
Staff:
t 2014 RESIDENTIAL PLUMBING PERM
IT APPLICATION
Date: /Mg p f My Site Address: ij{ j7 /r °_ Pie
Tenant;
Suite #:
Name: u c e 147 Phone:
Address / City / Zip: $n.4^
Name:
Address:
Az. Ag -em
State: , Zip: SSldS�
Contact: .5Cd r+Y &
License #: SS 1105.)
City: (4,100447
Phone: 1 7;tvra c)
Email: _*(0 /4-- 4 k/1,- 5. Ae-b-
New lerpttement Repair _r Rebuild JModify Space _ Work in R.O.W,
Description of work: (w6 (44 1 %/'/' t �
RESIDENTIAL
Water Heater
Lawn Irrigation (_ RPZ / PVB)
Septic System
New
Abandonment
Water Softener
Add Plumbing Fixtures (, Main / Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Sematic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
'Water Turnaround (add $200.00 if a 5/8" meter is required)
$115.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Cail Gopher State One CaII at (651) 454-0002 for protection against underground utility damage.
CaII 48 hours before you intend to dig to receive locates of underground utilities. www.gooherstateonecall.orq
I hereby acknowledge that this information is complete and accurate: that the work will be in conformance with the ordinances and codes of the City of
Eagan: that 1 understand this is not a permit, but only an application for a permit, and work Is not to start without a permit; that the work wilt be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
,41- etc
Applicant's Print dfd Name
x
Applicant's Si
eters
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA120042
Date Issued:01/13/2014
Permit Category:ePermit
Site Address: 4111 Prairie Ridge Rd
Lot:4 Block: 4 Addition: Coventry Pass 2nd
PID:10-18401-04-040
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Insert
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 4,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Joseph Jocketty Jr
4111 Prairie Ridge Rd
Eagan MN 55123
Hearth And Home Technologies
2700 N. Fairview Ave
Roseville MN 55113
(651) 638-3309
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
. - r————————-————
---�
I For Office Use �
I
. � Permit#: � � � i
, U16� Ol ����11 I Permit Fee: ' L �� a �
3830 Pilot Knob Road j I
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 � �
Fax:(651)675-5694 I Staff: �
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
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If the project is exempt from lead certification, please explain why:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
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CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
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Applicant's Printed ame Applicant's Signa ure '
Page 1 of 3
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3830 Pilot Knob Road I I
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I I
Fax: (651)675-5694 i Staff: i
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
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' License#: ��(�,3� a2�S� Lead Certificate#: �� ����S �"lv 'd�3�
If the project is exempt from lead certification, please explain why:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer 8 Water Contractor: Phone:
Fire Suppression Contractor: Phone:
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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.aopherstateonecall.or4
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permft; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
,
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Applicant's Printed ame Applicant's Signa ure
Page 1 of 3
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA164375
Date Issued:09/28/2020
Permit Category:ePermit
Site Address: 4111 Prairie Ridge Rd
Lot:4 Block: 4 Addition: Coventry Pass 2nd
PID:10-18401-04-040
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 -
Joseph Jocketty Jr
4111 Prairie Ridge Rd
Eagan MN 55123
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA166044
Date Issued:12/08/2020
Permit Category:ePermit
Site Address: 4111 Prairie Ridge Rd
Lot:4 Block: 4 Addition: Coventry Pass 2nd
PID:10-18401-04-040
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:Fixtures
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087
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 -
Joseph Jr Jocketty
4111 Prairie Ridge Rd
Saint Paul MN 55123--162
(612) 849-0472
Window Concepts Mn
291 Eva St
St Paul MN 55107
(651) 905-0105
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA170565
Date Issued:07/09/2021
Permit Category:ePermit
Site Address: 4111 Prairie Ridge Rd
Lot:4 Block: 4 Addition: Coventry Pass 2nd
PID:10-18401-04-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
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 -
Joseph Jr Jocketty
4111 Prairie Ridge Rd
Saint Paul MN 55123--162
Haferman Water Conditioning
12142 12th Ave.
Burnsville MN 55337
(952) 894-4040
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA177010
Date Issued:06/13/2022
Permit Category:ePermit
Site Address: 4111 Prairie Ridge Rd
Lot:4 Block: 4 Addition: Coventry Pass 2nd
PID:10-18401-04-040
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 -
Joseph Jr Jocketty
4111 Prairie Ridge Rd
Saint Paul MN 55123--162
(612) 849-0472
Krech Exteriors Inc
5866 Blackshire Path
Inver Grove Heights MN 55076
(651) 688-6368
Applicant/Permitee: Signature Issued By: Signature