4124 Prairie Ridge RdINSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
? PERMIT SUBTYPE:
i TYPE OF VIIORK:
t{O I ? r? 1 Mt,
N" 0,t;.'
0r-,/irl11d
INSPECTION .. . .•
...?i;,
?
??4
; ?
Permit No. Permit Holder Date Telephone #
S/W
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspectlon Date Insp. Comments
Footings (
Foundation
Framing
Roofing .
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Orsat Test
Fnal Pibg. Plbg. Inspectw - Notify Plumber
Const. Meter
EngrJPian
Bidg. Final
Deck Ftg. ?
Deck Finai
Well
Pr. Disp.
" NSPE"CTION RECO- - - - - - - - - - - - - - - ---
RD ? G°ntrol N; 0335
?
HUtI. NA
. CI , 4F EAGAN PERMfT TYPE: ?
3830 Pilot Knob Road Permit Number.
_ Eagan, Minnesota 55123 Date Issued: ?'? ?29 /97
(612) 681-4675
SITE ADDRESS: LOI', A H l OC K: e APPLICANT:
41?4 pRAiftIE aID(iE Rp nAHLE: flROTlIERS fNC . ,
C-O1IVMTRY pAS: 1M1D (612) aHN--6066
PERMITLPUBTYPE:
TYPE QF WORK:
NF l.l
INSPECTION
:. 1 1" 1• .. .
i e? ?., I 1 ri ?, .A
i RAM [NO .INSIlIATTON
1 lNAI FIREF*I,ACE
I RFIIARKg: tiE CE YpT I
? ??r?.?:?°?.?s? .,??:'_-• ._ :
SbW PLBN. - STAit PlUMBIMH
?,? v
0
ParmN Pw. wvmit rwld.r oar T•"lwn. k
SNV
,PLUMBING
•?.
HVAC
EL.ECTRIC
ELECTRIC
IMpmtl4n DeUa Imp. Commsnb
?? I
/./ ! ?
U)'d
Foundatlon '
Framktg y
Rocrfing
R°ugh Plbg' ?
Rough "'g- b /6
W. /Ij z
Fireoace 9s
F`".'
Omat Test
Flnal PIb9- Piby, fempec0pr - Notity PMunDer
Carisl. Meter
EngrJPten
?? FhvW
Oedc Ftg.
Oeck Flnal
Well
Pr. Disp.
a? ??C.? %33 S, ?
...?
Y
r --
???f?
?er#t#trate of (Orrupanry
titp of eaflan
firpotttcetcf a# "ding Jtcmeriwu
77ris Certificate issrred pursuarit !o tiie requirements of Section 306 ojthe (Iniform Building
Cade certifying tha[ at the time of issuance this structure wrrs in compliance wrth the mrious
ondinanraes of the City regulaling building constncction or use. For !he following:
cax a..:r.m. SF IXdG/GAR awg. ?;? cao. 383
p-jpay'rya R3/M)
Zoa;ng Mb;ct Rl Tnt rm., VN
ownaoc ewaam A? BPDniMS IlC Add. 9384 L.?,7 F AVE S. W-r; nq
4124 PRAIRIE RID(E ROAD L..S?y L4. B5, :70VfMRY PASS ti±ID
BU&Iio& ol riew Da,r 7 30 42
POST IN A COFISPICUOUS PLACE
? CITY OF EAGAN PERMIT TYPE: Ai' !I'I"G ?
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued: {'
i? (612) 681-4675
' SITE ADDRESS: d, ,; <<,, f APPLICANT:
(t t I; t! t? I f?h!- F'{)
. . ? . , ,. .•, .'Nli t ?• ? . ? ?q s •i sf?7
F-
L
PERMIT SUBTYPE: TYPE OF WORK: '
I:, F ra y R
;, , ; . .... 41-rEfi00E . t?rtass115%
Permit Holder Date Telephono #
PLUMBING
HVAC
inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
?wa
ROUGH
PIUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC TEST
INSUL GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLQG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTI4ITY
TEST
HYDROSTATIC TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
,,,,....- 3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(651) 681-4675
, ? . . .
SITEADDRESS: APPLICANT:
i . .
PERMIT SUBTYPE:
. ka
AM t ta i
1611 1:N F
f r4
IF
iL
TYPE OF WORK:
W? ui A t 1 nra
r%' F'I.AN Rh_V?ftJEp HY tRAI'il NI)VACX'iK.
?,FPf:FAIF i+UkMl T itE011fFiF1,1 Ff1R AMY i'I tIMBi
fAl l 446-2844 WF'iiAR!"liM6 f 1_Ft' Th (('A1 RF r.M
-1
?
? Permft Holder Date Telephone S
SEWER/
WATER
PLUMBING
HVAC
Inspection Date Insp. Commenta
FODTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUM8ING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FiREPLACE l/.
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IFRIGATION
METER
FLUSH
MAINS
corvoucTivm
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
CITY OF EAGAN PERMIT TYPE: I I is jH6
3830 Pilot Knob Road Permit Number: 1 a A
Ea an, Minnesota 55122-1897
9 Date Issued:
(612) 681-4675
SITE ADDRESS: ' -10 `it' APPLICANT:
I rr ?: .t t; I iic k.
' . • i , i ? ?Nt
, 1 ? . .. . .
PERMIT SUBTYPE: TYPE OF WORK:
,; .
INSPECTION TYPE D• • D•
?
I +ltXr?: f'lAN F2FViFLIFp eY .:ItIF' VwFS
??
?
?? 6,a. G°
?
?
Permit Holder Date Telephone A
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL _
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TE5T
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
?Address: 4124 pRAIgIE RmGE gpM Lot q Blk 5 Sec/Sub rppgNTgy pASS ZND
These items were/were not complete at the time of the final inspection.
Date: 7/30/92 Yes No
Final grade (6" from siding)
Permanent steps - gaiage t/
Permanent steps - main entry ?
Permanent driveway ?
Permanent gas ?
Sod/seeded grass ?/ ?
Trail/curb damage V
Porch ?
Basemant finish
Deck
Please verify with the buildar the removal of roof test caps from the plumbing
system and the shut-off of vater supply to the outside lawn faucet before
freeze potantial exists. ?
s
p[CRFDMRP
White - City copy Yellow - Resident copy Pink - Contractor copy
,?? REQUEST POR ELECTRICAL INSPECTION Es.ooooi-oa
lSe nshuqiars Por complaM1ng tM1is lorm on back ol yellow copy ..?' y
/-C v. i. `
'X" Below Work Covered by This Request a? y?
ew Ac4J Rep TypeoButldmg AppliancesWiretl EqwpmentWired
rlome Range Temporary Serwce
Duplex Water Heater Electnc Heatmg
Apt Bwlding Dryer Other (Specity)
F omm.ilndustnal Furnace
arm Air Condilloner
OtM1er lsueufy? Conttactor5 Remerks
Compute Inspectron Fee Selow
u Other Fee # Service Entrance Sae Fee # QrcmtslFeetlers Fee
Swlmming Pool 0 to 200 Amps 0 to 100 Arips
Transformers Above 200 _ Amps bove 100 Amps
Signs inspectars Use Onry TOT
?
Irnganon Booms ?
Speaalinspecllon
Alarm/CommunicaLOn THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 THS.
I, me Electrical Inspector, hereby RougM1-in ??„? oa?e
certify that the above inspechon has
been made.
-f'
OFFlCE USE JNLY
This requesl v00 13 monihs irom
ro/al? y -9-- /o 6" a 7
p l 5 2 5 '$6 1
Requesl Oate
S'??y (? r?L
"1_"?. Fre Pough-in Inspetlion
eqwretl'
es C No `'
C? Feady Now AWill NoUty Inspector
??Nlhen Reatli
IY licensed contractor ] owner hereby request inspeclion of above electncal work at:
Job Atltlress IStreet Box or e No ) l n T?
.?. -rN
I2?' ?rairia.?. '? Qry C ?
Secnon N. Townsni0 Name or No Range No Covnry
«z?0
Occupan?ligg INT)
lM •\Q PhoneqNo?A
V 6?(,J' G86(c
Power SupPL r
I co4a E LQ-c#-6 c, Atldress
trar rnm' 2 -43 n
Eiecmc Convado: (COmpany Name,
•c ? Conlrectors L¢ense No.
cA llq2
Maihng Atldres ICOnlraclo: o, Owner MaWng InsIDllaVOnl
a
Aumorzetl Siqnawre tGOm:ar.mnDwner Maki ?allanoni
e PhOnE Number
? 90
^ 3 SSS
.
MINNESOTA STAT OAflO OF ELECTqICITY THIS INSPEGTION REOUEST WILI NOT
Griggs-Mitlway B - Paom 5973 BE AGCEPTEO BV THE STATE BOARD
1811 llnrvemity Ave.. 51 Gaul. MN 55104 UNLESS PROPEF INSPECTION FEE IS
Phone (6II) 602-0800 ENCLOSED
c?..r„ O,:: Enr.a:aN
I::,4;i!-!}.LR^ „ :!i.GiMINh;i... P'I71I 875
.li>..r.:?',.1?.'J.',
LAfF11 ..L./[r' a,,? /: ???., 1I('i:: ?..4 ._?...... L...
1%
NnME,, r.;rRl. Fl :=Err::RSnN
Wr'i 9001 4:24 1-Rr?7.r<:l:i: FD °,r!.,rln
".:3i5 `?ilp'l. 4124 PfiA'iRTp. !..l17 0.5?
0
Tu ? 50.50
l.;rl. i :??.p C.??:L;?'I; Ali?C'?Ui"?.;I rr,, 10 1245
..Si''> 1L!;: t.1AiJ';r'
PERMIT
C1TY OF EAGAN
3830 Pilot Kncb Rmd`
Eagan, Minnesota 55122-1897
(651) 681-4675
PERMIT TYPE: Ru 1 Ln t NG
Permit Num6er: d3 4> 5 6
Date Issued: 1 21 ' _' l 9 8
SITE ADDRESS:
W.'I.IVe: 10-I8401-040-05
4124 PftA7R.CE RIDGF_ R?
LOT> A BLQCK: 5
L,OVE14TRY fAS`•3 :'ND
DESCRIPTION:
Et u
h id
}?da.Y1A,(?eYmit fypp_
ildinq W?Sir;k Type
?...
risus Code '?.
?
- ?
F?
r
l
l` l
F3AiEhIENT PINISH
WL7ERATIUN
134 fiLT. RF5IOEiVTIFlL
} (D ? " y ? ;."?? ?• •, {r? n? ? ,` ,?.?, •-r ? r.:; i T?... ?.- '? a." ?.. ?`i
.:.3t?4.•: ; .L.:' , 44_''.., ..?i.?'^`???? _??i ...
REM?RKSkEVrFwLa FY cRAzCi NOVflr,ZYk.
aEPERA7E f'ERMS't REQU7REU FOk HNY WLUMBIhlti WQNK.
Cf1Lt_ 445-2840 RtGAR1)IN6 EI.ECTIi:CCM. F'FRhli7 RIVt7 TNSPEC"fI0iV5.
FEE SUMMARY:
Base Fee $50.00
Surchar-qe _ te50
,
ToCal FeQ $5?i1.50
CONTRACTOR:
F; iEasQu coNsi. cHfri.
174 LAKFVIEW
F, ?RN MN
f 12) b£38-6564
- Nptal.icant - ;l'e LTC
J6886564 0000.275
CURVE
5512r
OWNER:
5f''FlliKS 6FNRV.IS
412q PRAIi57E RSD[iE RL7
EAGAN Mn1 55123
(651J4Fi6-459?
T hQreby acknowledqe Chat 7 F13ve read this aAplication and state tliat the
intormatian i,s enrrect and agree Co complY with ai1 appk<icatale State nF MrlY
Statutes and Czty ot Eaqan Ordic+anceS.
L
APPLICANT/PERMITEE SIGNATURE SUED BY: SIGNATURE
I
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
_ • " CITY OF EAGAN
3830 PII.OT KNOB RD - 55122
? 681-4675 :s L??o _?
New Construction Reauirements RemodeVReoair Reauirements /? ?., Q Q_(? ID.a( -?e
L_ l `L?fLPI
? 3 registered site surveys
? 2 copies of plans (inGude beam 8 wmdow sizes; poured fnd. design; etc.)
? 1 energy wiculations
? 3 copies af tree preservatian plan if lot platted after 711193
required: _Yes _ No
DATE: /o?- I k' 9f
DESCRIPTION OF WORK:
STREETADDRESS: ql aV P/
LOT: 14 BLOCK: SUBD./P.I.D. #: ? O I1 -1Z KLu
Name: Spq r'ks L) 2tin4 Phone#: yS?o -DS5?7
PROPERTY I Last First
OWNER
y1a y ? ?
?9 / re /, g c
Street Address:
Ciri Ea
? grs? State : /1'//? Zip: S.f'? z 3
Phone #: ? 8'B' - 6,s(o v
Company:
CONTRACTOR
Suzet Address:
W C'u r?e
License # ya 7-?
City E49
? 9n State: In? Zip: SS/ 2. Z
ARCHII'ECT/
ENGINEER Company: Phone 4:
Name: Registration #:
Street Address:
City State: Zip:
Sewer & water licensed plumber (new construction only):
and lot change is requested once permit is issued.
Penalty applies when address chan
I hereby acknowledge that I have read this application and state that the infortnation is correct and agree to comply with ail applicai
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
?,----i??
OFFICE USE ONLY ?I
Certificates of Survey Received _ Yes _ No fl? -?-/ I
? 2 copies oi plan
? 2 site surveys (eMerior additions 8 decks)
? 1 energy calculations for heated additions
CONSTRUCTIQN COST;
1
? S /09
?14e AV
Tree Preservation Plan Received - Yes - No
oFFicE uae oN6Y
SU16DING PERMlfi TYPE
El Oi ??undation (3 00 @upl?x El 11
@ 02 OF Dvolll? ? ?? 4%pW E3 12
0 03 OF Addftfl El O? 8-pIeu El 13
D 04 ?? ?atcF? E3 00 12=plaat 0 14
a 05 ap Mie@. 0 10 =ZpIax E3 9 o
W91lit TYP@
13 39 N@w X'33 Ahmtioflg
D 32 AddftiaR Q 34 R@paIP
OQNERAL INFORMAfiION
Co18t.. (A@tuaQ
(Allow?ab1e)
UsC @mpafl&y
ZoRIRg
# ot atomea
6oriotM
@epth
APPReve,La
El 30 Mav@
@ 37 DeR1oIItIOfl
? 96 B@a@m@fltFifli§h
? 17 swim PooI
Q 20 Pdblla 4@I1lfy
E3 29 Mia@@llafl@@w§
S--? @a!@fl?@Rt aq: ft:
Main I@v@l sq, #t:
8q, ft,
eq: R,
eq: ft:
Ro?t?int eq: ?:
?I?RflfR?
BdlfdlRg ?
MONV@ Illyot@m
cIty W@W
Fif@ @pflRkl@F@d
PRV
6@00tof PdfRp
Wsd@ Ced&
QAG Cod@
Wous Bidg
W§ds Uflll
IRQImeFIRQ V@ftRas
?
i
?
poFfhR p@t
PIaR R@VWW ?
L.Ia@R9@
MW3 SAAC
00 SAC
VVaf@PfeoRR:
WOt@e Mew
Aod: Dapait
WW P@fvnit
WW aurchaege
fiemNfl@Rt
??? W&
i'raila Ded:
Othor
Gopw
rolar,
V8luitl@R? ? ???
% SAC
SAAC IdRite
t.
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMITTYPE: BuzLosNe
Permit Num6er: 0 3 2 5 6 0
Date Issued: 0 7/ 16 / 9 8
SITE ADDRESS:
P.I.N.: 10-18901-040-05
FERMIT
4124 PRAIRSE RIDGE ftD
L07: 4 BLtlCK: 5
COVENTRY PASS 2ND
DESCRIPTION:
TRUSSES
S70RM DAMA6E
REPAIR
434 flLT. RESIDENTIAL
N t e
11
f/
T . ?.?
i .... .:°,l .. .1^???•?''. : i.
REROOF,
B,u`ildii5g,Permit Type
fiuS.,lding Wgrk Type
s-?Census Code
?
I
? -
?
? '•?.iD.y ....
\\ '`? _ l.
..1 . ?. d . ?.3
REMARKS:
FEE SUMMARY:
CONTRACTOR: - Applicant - ST. LIC OWNER:
QUANTUM CONSTR INC 19434357 9232 SPARKS JAYNE
10525 FLORIDA AVE S 4124 PRAIRIE RIDGE RD
BLOOMINGTON MN 55438 EAGAN MN 55123
(612) 943-4357 (651)456-6312
I
i
I hereby aeknowled9e thst I have read this application and state that the
information is oorrect and agree to comply with all applicable State of hln.
StaCutes and City trf Eagen Qrdinanaes. ,
- /7 ?
APPLICANTlPERMITEE SIGNATURE ISSUED BY: SIUNATUR
U
• 2%t LDING
?
Hew Conshuction Reauirements
PERMIT APPLICATION (RESIDEIITTIAL)
CITY OF EAGAN
8830 PII.OT KNOB RD - 66122
681-4675
? 3 registered sfte surveys
? 2 copies of plans (inGude heam & window s¢ea; poured tnd, design; etc.)
? t errergy calwlations
? 3 copies of tree preservation plan 'rf lot plattad after 717193
required: _ Yes _ No
DATE: 6I 3 a ? ? g-
RemotfeURenair Requiraments
? 2 oopies of plan
? 2 sfte surveys (exterior adEkions & dadcs)
? 7 errergy calculationa for heatetl addkions
CONSTRUCTION COST; ?J, GY?I, _
DESCRIPTION OF WORK: _&&M D4m4ff - 7?,sre s, "i? A???grlf
STREET ADDRESS: _ LI ?a ?I pl-G( ; /'r
LOT: BLOCK: F SUBD./P.I.D. L an,? I r ? i 7 S1 ?- ?? ?
r
Name: ?WeS Phone #:
PROPERTY .. 1.est First
QWNER e•
Street Address: y(Z`? Pf??• f K.ccQ, /
City kmyz State:
/VPV
zip: SS/z3
Company:_ niva_{d._ Phone #: q L-,I ? ?I ? ? ? -
CONTRACTOR
Street Address: 1052S /f.,.,a License p -Y 2 3 z?
?
city a/o,n,,?,4v,• srata:
ARCHIT'ECT/
ENGINEER Campany;_IV ,4 phone #;
Name:
Street
City
State:
zcp: SSY3 3 .21
Zip:
Sewer & water licensed plumber (new consbvction only): . Penatty applies when address chang
and lot change is requested once permit is issued.
I hereby acknowledge that I have read this application and state that the infortnation is nd agree to comply with all applicabl
5tate of Minnesota Statutes and City of Eagan Ordinances.
5ignature of Applicant
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Registration #:
Tree Preservation Plan Received - Yes ! No - Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
? 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. ? 10 _-plex
VN'ORK TYPE
'J' 31 New ? 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
2oning
# of Stories
Length
Depth
A?PROVALS
Planning
? 11 Apt.lLodging ?
? 12 Multi RepaiNRem. ?
? 13 Garage/Accessory ?
O 14 Fireplace , ?
? 15 Deck
0 36 Move
? 37 Demolition
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq.ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
Engineering
Variance
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment Pi.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
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 81dg
Census Unit
.
°k SAC
SAC Units
INSPECTION RECORD
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMITTYPE: auzLozNe
Permit Number: 0 2 3 5 8 2
Date Issued: 0 5/ 12 / 9 4
SITE ADDRESS:
LOT: 4 BLOCK:
4124 PRAIRIE RIDGE RD
COVEN7RY PA55 2ND
PERMIT Sl1BTYPE:
OECK
5 APPLICANT:
PETEf250N CONST, CARL
(612) 688--6564
TYPE OF WORK:
NEW
INSPECTION „ . DA
FOOTIN6S FINflL
? ?
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT
PERMIT TYPE:
Pertnit Number:
Date Issued
S? (3-Ciy
BUILDIN6
029582
05(12/9q
SITE ADDRESS:
P.I.N.: 10-18401-040-05
4124 PRAIRIE RIDGE RD
LOT: 4 BLpCK: S
COVENTRY PASS 2Np
DESCRIPTION:
- .,
8,6ild.ing'Permit 7ype
building Work Type
't
r ?l
ti
i
?
DECK
NEW
C7 ?
ZL
u?-Ll
?
REMARKS:
FEE SUMMARY:
Base Fee $30.00
Surcharge $.50
Lic. Search Fee $5.00
Tvtal Fee $35.50
CONTRACTOR: - Applicant - 5T. LTC. OWNER:
PETERSOM CONS7, CARL 16886564 $004275 SPARKS DENNIS
1574 LAKEVIEW CURVE 4124 PRAIRIE RIDGE RD
EAGAN MN 55122 EAGAN MN 55123
(612) 688-6564 (612)456-0597
?
I hereby acknowledge that I have read this appl,ieatiqn attd stats that the
' inforrnation !s correct and agree to comp,ly with all app?l3.aable State af Mri,•
SCetutes and City o'f Eagan• prdinances.
APPIICANT/PEIiMITEE SIGNATURE I ED B SI NATUR 1
z
CITY OF EAGAN
1994 BUILDING PERMIT APPLICATION
681-4675 Aj_?ZD
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date s / 1L /'/ I/ Valuation of work
Site Address: S//aY P?a.'e R.d I.e Ad
STREET SUITE #
Tenant Name: (commercial only)
LOT _L- BLOCK SUSD. L7T P • I • D. #
Descri tion of work: oIfeK
The applicant is: ? Owner ?Contractor ? Other (Deseribe)
Name Sparks ,l7-1 '? '7 /'s Phone ?s6 -oS97
Property LAST FIRST
Owner Address
STREET S1E #
City EaQ?n 5tate Zip
Company aPef2fsv„ 60•.sPhone o8g' ?S?O y
Contractor Address /S'7v ?aKe?•?:a C????^? License # Exp
City Lc?!!?e., State Zip S_S/Z Z"
Company Phone
Architect/
Engineer Name Registration #
Address "
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with all applica6le State of Minnesota Statutes and City of
Eagan Ordinances.
f A
l
pp
S
icant:
BUILDING PERMIT TYPE
? 01 Foundation
? 02 Sf Dwg.
? 03 SF Addition
11 04 SF Porch
? 05 SF Misc.
WORK TYPE
0 31 New
? 32 Addition
OFFICE USE ONLY
4?"'`a
?? 06 Duplex
? 07 4-Plex
? 08 8-Plex
? 09 12-Plex
? 10 Multi. Add'1
? 33 Alterations
? 34 Repair
? 11 Apt./Lodging ? 16 Basement Finish
0 12 Multi. Misc. ? 17 Swim Pool
? 13 Garage/Accessory ? 18 Comm./Ind.
? 14 Fireplace ? 19 Coimn./Ind. Misc.
a 15 Deck ? 20 Public Facility
0 21 Miscellaneous
? 35 Tenant Finish
? 36 Move
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
q of Stories
Length
Depth
APPROVALS
Planning
Engineering
REQUIRED INSPECTIONS
? .Site
O Wallboard
Basement sq. ft.
lst F1. sq. ft.
2nd F1. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Building
Variance
@ Footing
t? Final
? Framing
? Draintile
v 3y
o/
?
O
? Insulation
? Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded..
Copies
Other
Total:
vstuac;on:
0 37 Demolish
MWCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code
Census Bldg
Census Unit
Assessments
SAC %
SAC Units
- .?
?;.
.
Z" R. ee4f&w. ;Dw.
8717 DUPONT°AVENUB SOUTH
BIOOMIN070N, MINN. 86430
889.2o..
" CERTIFICATE OF SURVEY
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LAND SURVEYORS
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om
We hereby certify that this is a true and correct representation of a survey of the
boundaries of the land above descrlbed and of the location of all buildings, if any,
thereon and all visible encroachments, if.any, from or on said land.
Dated this ??Zday of ,.; ,199z.
??-
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Jt 1
lBL J~ CITY OF EAGAN
PLUMBZNG PERMIT
SUBD. e??xr (612) 681-4675
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
CITY USE ONLY
RECEIPT # D 19053
DATE W/o'L
ALSO, FOR TOWNHOMES AND CONDOS
WORK DESCRIPTION
NEW CONST _
ADD ON _
REPAIR _
OWNEA NAME: ?DGt114 oll?
SITE ADDRESS: ??? P ??
?
INSTALLER: !'?/'{/C/4'hu
ADDRESS: ?iU f?r2?l? !/r?clqo /J.i
CITY:?GfoJGYr ZIP:
PHONE J/: ?lY6 - ?? 5 v
COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
REPAIR/ADD ON 15.00
? SHOWER 3.00 3,c3c
? WATER CIASET 3.00 ti •
? BATH TUB 3.00 .G v'
? IAVATORY 3.00 G),62
? KITCHEN SINK 3.00 1,0o
/ IAUNDRY TRAY 3.00
HOT TUB/SPA 3.00
7 WATER HEATER 3.00 r?
T FIAOR DRAIN 3.00
3. m.:
GAS PIPING OUT.
? (MINIMUM - 1) 3.00 3. B J
ROUGH OPENINGS 1.50 ?
_ OTHER
WATER SOFPENER 5.00
_ PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
_ W. TURNAROUND 15.00
STATE SURCHARGE .50
TOTAL:
CODIIdERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COM4fERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
SITE ADDRESS: _
TENANT NAME: _
SUITE #:
INSTALLER:
ADDRESS:
CITY:
PHONE #:
FOR:
CITY OF EAGAN
CONTRACT PRICE:
1% OF CONTRACT FEE. .
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONIRACT PRICE x 1% $
STATE SURCHARGE $
TOTAL:
$
(SIGNATURE)
L? B CITY OF EAGAN
,? 01 MECHANICAL PERMiT REcEEPT # C o ? 9? rn ?O
SUBD. Sr aa.a-?? (612) 681-4675 DATE L
RESIDEIVTIAL
PLFASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DR'ELLINGS. ALSO, COMPLEfE FOR
TORNHOMFS/CONDOS R'HEN SEPARATE PERMITS ARE REQUIRED FOR EACH DWELLING UNTT.
owxEt: FEEs
SI1'E ADDRFSS:
14 \'Z ADD ON/REMODII. (E?IISTING
CONSTRUCI'ION ONLl) $ 15.00
INSTALLER:'?G\ ? AVAC: 0.100 M BTU .00
PHONE #: SZ?qm, ADDITIONAL 50 M BTU 6.00
ADDRESS: 'll\\ GAS OUTI.E1'S -MINIMUM 1@ $3 EA.
CI1'Y: zIP:°1 SURCHARGE $ .SO
SIGNA TOTAL: $
COMMERCIAL
PLEASE COMPLEl'E THIS PORTION FOR ALL COMMERCIAUINDUSTRIAL BUII.DINGS. AISO COMPLETE FOR
APARTMENT BUILD[NGS OR OTHER MiTLTI•FAMILY BUII.DWGS R'HEN SEPARATE PERMITS ARE NOT REQUIRID FOR
EACH DWELLiNG UNTC.
WORK DESCRIPI'ION: CONTRACI' PRIC&
1% OF CONTRACf FEE. FEES
STATE SURCHARGE IS $.50 FOR EACH
$1,000 OF PERMTI' FEE.
$
PROCFSSED PIPING - $25.00
MIivn?iuht FEE - $25.00
a
OWNF.R: TOTAL: $
SITE ADDRESS:
TENANf:
,.
INSTALLER: :.. .. ::..
, ._. _., :.:.. :. ..:,
ADDRESS:
CI1'Y: ZIP:
PHONE #: CITY SIGNATURE:
SIGNATURE:
' INSPECTION RECORD Control No. 0335
CITYOFEAGAN PERMITTYPE: suiLDiNG
3830 Pilot Knob Road Permit Number; 000383
Eagan, Minnesota 55123 Date Issued: 04 /29 /92
(612) 681-4675
SITEADDRESS: LoT: 4 BLOCK: 5 APPLICANT:
4124 PRAIRIE RIDGE RD DAHLE BROTHERS YNC
COVENTRY PASS 2ND (612) 888-6866
PERMIT SUBTYPE:
SF DWG
TYPE OF WORK:
NEW
INSPECTION
SITE D. .
FOOTING .•
FRAMIN6 INSULATION
FINAL FIREPIACE
REMARKS: RECEIPT #
?
?
SSW PLBR. = STAR PLUM8IN6
7
I
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
BUZLOING
000383
04J29/92
SITE ADDRESS:
4124 PRAIRIE RIDGE RD
LOT: 4 BLOCK: 5
COVEN7RY PASS 2ND
DESCRIPTION:
Building Permit Type SF DWG
8uildin9 Work Type NEW
UBC Occupani R-3 M-1
Construction 7yp_e VN
Zoning R-1
Buiiding Length 54
Building Width 40
?` ?w_. •?, ?',+ _i'u ?_, ?L, ??a i . :?.; .,
REMARKS:
RECEIPT NC,Q/$SS`? S&W PLBR. = STAR PLUpIBING TK v
FEE SUMMARY:
8ase Fee
Plan Review
Surcharge
SAC
SAC 8
SAC Units
Subtotal
VALUATION
$776.00
$509.40
$69.50
E700.00
100
E2,049.90
$139,000
p1ISC FEES
Total Fee
$1,610.50
$3,660.40
CONTRACTOR: - Applicant - sr. Ltc. OWNER:
DAHIE BROTHERS INC 18886866 0001647 DAHLE BROS INC
9304 IYNDALE AVE S 9304 LYNUALE AVE S
BLOOMINGTON MN 55420 BLOOMIN6TON M,{V 55420
(612) 888-6666 (612)868-6866
I hereby acknowledge that I have read this applictUQn;,and state that the
information is correct and agree to compl?y ^?ell applicable 3tate of Pln.
Statutes and City oEa an Ordinances.
% APPLICA /P@ MIT SIGNATURE ? ISSUED BY SIGNATURE
Control No. 0335
L
PERMI7 CITY OF EAGAN
1992 BUILDING PERMIT APPLICATION
681-4675
??66b? ? 0
?ja
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural 8 structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lat chan e is re uested once ermit is issued.
Date Yaluation of work
Site Address: y/,2 y Pru ? r e A ' ? 11?d
STREET STE t
enant Name:
LOT ? BLOCK S SUgp, V.I.D. i
Co19'r
Descri tion of work: e-„? ome C' s rI:- i?
The applicant is: 0 Owner Contractor O Other too.«ree>
Name ,G / /-r /.3,rus_ ?-, , Phone
Property LAST FIRST
Owner pddress 93 o y ?,lh '_4 le-
STREET STE /
City State Zip SS `??-U
Company 7, 17 lr /3ro s Phone
Contractor
Exp:23/-
Address 930 V le License MD ak?
City Zl orn ;n 11 State lfl
Company Phone
ArchitecU
Engineer Name Registration N
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been agproyed.
I hereby acknowledge that av read thi ap ' tion and state that the information is
correct and agree to comp wi 11 p ca tate i esota Statutes and City of
Eagan Ordinances.
Signature of ApplicanU.
urrwe uae unLr
BUILDING PERMIT TYPE
? 01 Foundation O 05 Apt. Bldg ? 09 Basement Finish
4 02 SF Dwg. ? 06 Garage/Accessory 0 10 Swim Poal
? 03 Two family ? 07 Fireplace ? 11 Res. Add./Porch
? 04 Multi-fam. T.H. O 08 Deck 0 12 Comm./Ind.
WORK TYPE
)? 31 New
? 32 Addition
? 33 Alterations
? 34 Repair
? 35 Tenant Finish
? 36 Move
GENERAL INFORMATION
? 37 Demolish
? 99 Undefined
? 13 Pablic Fac.
? 14 Agricultural
? 15 Miscellaneous
Const. (Actual)
(A1Towable) Basement sq. ft. %3
l
t F1
f MWCC System
i
W ?
UBC Occupancy
-/ s
. sq.
t. 3
2nd F1. sq. ft. C
ty
ater
PRV Required ?
Zoning _ Sq. Ft. total Booster Pump
f of Stories 2 Footprint Sq. ft. - Fire Sprinkler
Length 5_9, On-site well Census Code
Depth
.33
On-site sewage
SAC Code ?
APPROVALS
Planning Building Assessments
Engineering Yariance
REGIUIRED INSPECTIONS
Site Ea Footing ,Lk] Framing 0 Insulation
Nallboard 0 final ? Draintile ? Fireplace
Permit Fee 2p Maluatim: f 3 mO0
Surcharge Ps»t o?(rt
Plan Review Sov. ?io ?3?. = 89?
License
MWCC 5AC
')00
2%g.3& .
City SAC 160 _--
water Conn.
Water Meter ?e7s
?
Acct. Deposit
_
30 zn
?
5/W Permit.
5/W Surcharge ao
,,Sp 3/,E- 3Z.r53 =
S Z5')6
Treatment Pl. 2 00 ?
Road Unit 320
? - -
Park Ded.
Trails Ded.
Copies
?
Other V
Total:
? ?
Zz,3?zz.3xl?
_ ?9sG,6?/
SAC %
SAC Units
?
r;Ei. / ? ? ?C ,??• ??' ? ,
''E ADDRESS??? ? ? ? --
-
?
';TPAC7'pA ? /
C ?=' ! ? t DATE - - ^HONF_,??
Deteraine workino aquare fooiaoe oi each.
?otnl exposed ?a11 area ..... Z 'q, St. X•I I ? 9?c•? Z
Total zocf/ceilinc area ..... I 29 sa. fi. X•???'
A. Total wall window• area
............ ...... 144
• .......
B. Total door area............ ..................... 4 C
C. Totel slidino glass door area ............. . ??
D. 7ota1 fireplace wall area.......................
• •.
E. Total wall fra^:inc ezea (averaae 10%)........... I¢ I
F. Totel F1r., joist ezea............ •.•••••••..... 1??
G, Tctel t;et ?.•all area above Sloor.••••••••••••••• 1 tt.5
I ? ? z
Total exposed ioundation area
-
H. 70ta1 foundation window area........
2. Total net foundation area aDove grade...........
Detezr.ine "U" value o:f each wall sevmcnt.
a. _ 14? x ^u"
a. 4o x ??• .23 .. ?.Zo
c.
_ 3. x
2
^o
? .4"I
d. _ x . p•,
e. 1?F I x ?u•, • la . 1?I.I 0
1. IS? x o(I" ,04 w G?•2?
9. I 2l0?} ){ •V" .04 r rj 0.7(?
n. x . L., ?
i. x "u^ . ................................Tocai - 18 .2 5
tem 43 is the same as, or less than item M1, you 1iave met the intent of
6006(c)2.
. ? '
• 1
Totel expoaed roof/ceiling azea ? 12 q ?
j. Total ekylight aren........
k. Total roof/ceiling framing azea•(average•10%).....
l. Total net insulated zoof/ceiling area .............. _ I I G g
Determine "U" value for each zoof/ceiling segment.
k. ? 2cl X"U" .02TG a 3. S?p
l. • 1i?3 X•U" ,oZ5 ? 21
.os
..............................:.....T'Otal _ a 2 .? 4
total of 04 is the same as, oY less than #2, you have met ihe intent o£
C 6006(c)1.
Alternate Building £nvelope Design
utilize the total envelope system tnethod, {he valves established by the
T?;;of items q3 and #4 shall not be greatez than the sum of items N1 and 42. ?
1. + 2. •
r
3. + 4.
- ?
. ??,
? ? •- f.?JF/CEILING
r
'? .. A 3 R
VI,T • ?.?. ?1' - lli l l
ented Eeac flov
yp
FIG. 115 ?
Heat flot up .vented
. Hcat '
. , flov Up •
TTr, 07
r ? ?
Constructioii(Use for Ztem L) k-VElue
1. Interior air iilm 0.61
2. Sfg" SHEET4ock SL
3. NsuL . 3E,00
4. Extcrior air film (still 0
Total 39.'! 6
. v=.oz5
C14;. FRAMING(Use ior Item K)
1. Interioz Air film, 0.51
2.
3. $18" SHE.E_,fR.ocr
Inches soft Wood .3 ?/Z" S(..
4,38
-0. Inches insul above framina 30.00
S. Air Film 0.61
1. ?etal
' -- '
Intezior air film ' 3G .1 L
?J c , 8zT G
O 61
2.
3.
4. £xterior a3s film (still) 0.61
Total
1. Inside aiz film ' 0.61
2.
3.
4.
' S. Cvtside aix film 0.17
Total
Note: U?c n3ditionalaFhects if mnre zparo i?
reeded ioz drYa31s and calculations,
:-` - - • ,
'n'1 f:'v},?_,.'V1:T`'?:,:_r /,t•.,?,1."?cJet.CA/
_ ?• _? ?_'?_??_?
. FIG. 16
. r.? ?
ti" 151 cf nPtquc wall area Sor
Sraroc cq-vttruction
C
s
FIG. A1
.
.
-IG. i2
eC;
al
JN
_ ?•?
.. ? ?'
.1 I O
.•? ??
f ~ ?
--
v. p r??.. .
•? v f-"'
j e.
?•?'
• p , `n0 C.
. , ., .
_• : ?,
?
4 • !'
.•. r.
)
? .
) ?.
3 . •
ConstrucNon
R-Value
1. Intcrior air iilm 0.65
2. 112' ARY WPLL 45
3. St/L Inches aof+. wood (e ?L
4. 4b HEPT++IW G Z p?
S. 1> Ifll?iG G?
6. Exterior air Silm r 0.17
Tbtnl ti e. IS
U:.lo
1. Interior air film 0.68
2. 7W PL`/WGI.L .45
3• r?yz" i?ssuL, 1 q o0
a. ?SFIEGT4l IHG oG
5. %vi0 G Gl
6. Extezior air film 0.17
Total -2,;,03
V=.o4
1. Interior air film 0.66
2. lu=>uL. . 19,00
3. Woov 1 8B
4. SHEnTHi?!G ? oG
5. 51D11JG • .G7
b. Exterior air film
7bts1 0.17
24.4G
V c .-04
1.
1.
3.
4.
S.
6.
Intezior air film 0.68
J11SUL. AUv DCyWALI 45.0 L
-121, 6lOGt 1 28.
Exterior air film 0.17
Total ? O. 19
' U :.10
• SLAB ON GRF?DE
?
. , .
o . ' .
" ' • ? ' "
? ? l• - -?ra
? U
?
;711
T'/. ii
y-- •? -r'. '. ?i'_= _ „ .
.. ?. :.,6 ? • ?IJ _
• ' '' ?? __ NOTE: Zndicate•type, °It^ value. deorh and FRAtg HAt.T
CERTIFICATE OF SURVEY
.c'" ,. 0e4CtWea, ,aua.
?nbx , 8713 DVPONT AVENUE SOVTH
BLDOMINOTON, MINN. 65420
888.20e4
, V
LAND SURVEVORS
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¢ --- 8z7g
534 ( ,. -
.+ N ?VATE' ON , r?6G?tl 1:??????0
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 ail buildings, if any,
thereon and all visible encroachments, if,any, from or on said land.
Dated this Z,.1_Jday of ,.; ,199z, ???innen"license Ro 018
2'7? - 79
G q99,3
2004 RESIDENTIAL BUII.DING PERNIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
qol DO
NewConstNdionReauiremenfs RemodeUReoairReauirements
3 regiate2d sne surveYs showiri8 sQ. R of lot, sq. fL M Muse; and all roofed areas 2 copies of P ?a- lan ??
(20%ma?cimum lotcoverage allo?xed) 1 setof Energy Calaulations forheated additbns T?e'
2 copies of plan shaving beam & window sizes; poured found design, etc. 1 site survey for edditions 8 decks
lsetofEneigyCakuhtions Add'dion-ind'rcateilon•aReseptksysfem (?.s'?,9P?C_ aw'r;?L ¢4ak"
3 copies of Tree Preservation Plan'rf bl plaHed aiter 711193
Rim Joist Detail Options selection sheet (bltlgs wilh 3 or less unAs
Date (6_ Construcdan Cost
Site Address UniUSte #
Description of Work D' C? ro ?S ? ?T ? ?b ?e- t.I.I (? O
1 ? 2
Multi-FamilyBldg _ Y VN Fireplace(s) _ 0 _
Property Owner D -e-n n S0.y 1'1 &_ SPOr LS Telephane #(?o? U Sr7 ?
Contractor b G(`?1l t ?.lp ir ? S -
Address CitY
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
TvIinnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Cffiegory . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan?
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Y_ N If so, 25% plan review
Telephone #(
Telephone #
Telephone p m)" T 0
I hereby apply for a Residential Building Permit and aclrnowledge that the inf)ation is co ete and accurate;
that the work will be in conformance with the ordinances and codes of the Cit e of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
pertnit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
?l T zt"i p" 1 '
pplicanYs Printed Name App 'canYs Signature
OFFICE USE ONLY
Sub Types
? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
13 03 01 of_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 04 02-plex ? 10 OS-plex x 18 Deck ? 23 Porch (screen/gazebo)
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-piex ? 12 12-plex Pibg_Y or_ N? 25 Miscellaneous
Work Types
? 31 New
? 32 Addition
? 33 Alteretion
? 34 Replacement
or('Aa
Valuation
Census Code ?
SAC Units
# of Units
# of Bldgs
Type of Const VIV
Footings (new bldg)
? Footings (deck)
Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
_ Framing
_ Fireplace _ R.I. _ Air Test _ Final
[nsulation
Width
REQUIRED INSPECTIONS
FinaVC.O.
? FinallNo C.O.
_ Plumbing
HVAC
Other
_ Pool Ftgs _ AidGas Tesu Final
_ Siding _ Stucco _ Stone _ Brick
_ Windows
_ Retaining WaII
Approved By: ^ , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
? 30 Accessory Bidg
? 31 EM. Alt - Mulli
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 37 Demolish Building• ? 43 Reroof ? 46 Windows/Doors
`Demolidon (Entire Bldg) - Give PCA handout to applieant
Occupancy MCES System
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
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?7 1,2
?
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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 ail visible encroachments, if.any, from or on said land.
Dated this Z2?-,?day of ,.; ,199z•
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Llsqua
2004 RESIDENTIAL MECHA1vICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: single family dwellings &[ownhomes/condos when pertnits are required for each unit
Date oN I
Site Address 4 1 a/ -( 1?c-+? : ? ? e. '?? t' .6 •, ? Uo,t #
Property Owner Telephone #( (05 1) 4j,j] b"G S`? 1
Contractor t
?
Street Address ?- "V CitY 'Dzs???
State \ " r 1? Zip A55Q62F-j Telephone # ( (051) ,32,Z-89 2. ?
Bond #: Expires:
The Applicant is _ Owner _ Conkacror _ Other
Add-on or alteratlon to eristiug dwelling unit $ 30.00
furnace _Additional _Replacement
air exchanger
? airconditioner _New _Replacement
other
State Surcharge .50
Total
By ?
/
Y apply for a Residential Mechanical Pemut and acknowledge that the information is complete and accurate; that the work will
nformance with theordinances and codes of the Gtty of Eagan and ' echanil Codes; that I understand this is not a
but only an RIOW n f r a pe work is not to start wi out a pe that work vidi be in accordance wiW the
d pla
? ?c ?r?areview and approval of pla !'VV ?/; ii
ApplicanYs
2004 COMMERCIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: commerciaUindustrial bLildings
mulri-family buildings when separate pemtits are not required fin each dwelling unit
Date
Site Street Address Unit #
Tenant Name (if appticable) Yrevioas Tenant Name
Property Owner Telep6one # ( )
Contractor
Street Address City
State Zip Telephone # ( )
Bond #: Expires:
The Applicant is _ Owner _ Contractor _ Other
Work Type
New Construction _ Underground Tank _ Install _Remove'"see below
Interior Improvement _ Install Piping _ Processed _Gas
Nature of Work:
"When lnstalling/removing underground tank, caff for rrtspection by Flre Marshal and Plumbing lnspector
Permit Fees: S7050 Underg`ound mnk insmllation/rertrovai
$SOSO ' Mudmum (inciudes Sfate Sutcharge)
or
ContractValue $ x 1% _ $ PeraritFee
. If permit fee is $1,000 or less, add $.50 ? $ State Surcharge
If permit fee is over $1,000, add $.50 For
every $1,000 necn 't fee $ Total Fee
I hereby apply for a Commercial Mechanicat Peimit and aclmowledge that the informarion is complete and accurate; that the work
will be in conformance with the ordinances and codes of the City of Eagan and with the MecLanical Codes; that I understand this is
not a permik 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 wluch requires a review aad approval of plans.
ApplicanYs Printed Name " ApplicanPs SignaNre
Approved By: . Inspector
Use BLUE or BLACK Ink
r
For Office Use I
Clt EaV non Permit#: J Ol I Permit Fee: ° u I
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received: ~P
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
I
2014 RESIDENTIAL BUILDII l ERMIT APPLICATION
Date: S~ ly Site Address: 7 V`r~ ~r C ~of Unit
i
Name: A 1 S s Phone: t,
Resident/ yJ
Owner ` Address / City / zip: of t`/ r~d1 gc /\O/
Applicant is: Owner Contractor
I Description of work: ~C ✓cc
Type of Work ;
Construction Cost: Multi-Family Building: (Yes / No
_.n._..
Company: r~r2~ Lit Contact: ^_Xkd
Contractor - Address: City: Pt/fiik X11,_ State: /1-t-Zip: S //L Phone: 91G-3114m ai1:
License <G 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:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
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.ora
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.
X le e x
Applicant's Printed Name App iiccant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA123067
Date Issued:05/28/2014
Permit Category:ePermit
Site Address: 4124 Prairie Ridge Rd
Lot:4 Block: 5 Addition: Coventry Pass 2nd
PID:10-18401-05-040
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Dennis M Sparks
4124 Prairie Ridge Rd
Eagan MN 55123
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(130) 651-2644 X777
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA135950
Date Issued:04/14/2016
Permit Category:ePermit
Site Address: 4124 Prairie Ridge Rd
Lot:4 Block: 5 Addition: Coventry Pass 2nd
PID:10-18401-05-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
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 (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 -
Dennis M Sparks
4124 Prairie Ridge Rd
Eagan MN 55123
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
Applicant/Permitee: Signature Issued By: Signature