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1565 Red Cedar RdDate: City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Tenant: Use BLUE or BLACK Ink =961 t5S_cd Permit Fee: Date Receiv Staff: J 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION • ( Site Address: /565- P e- c C4- •1- t QL Suite #: RESIDENT / OWNER Name: CT 4 " z vS5 R e f Phone: Address /" City Zip: so— CONTRACTOR ^/ L' OCG Name: (74/ C/ r l" c Our. License #: 11 r'* Address: ` �0 r'' at 0C_ City: hoe t41 C%''�71 State: kW.- Zip: 5-,0j--0 Phone: 1t t('� '- C v)- Q State: Contact: t�/�V'e— Email: d A. VC o/ i G k GGk7 p eot f "- C TYPE OF WORK New Replacement Repair Rebuild Modify Space Work in R.O.W. _ _ _ _ _ Description of work: SkdW tot -TV Tv • L e fj �--+Gt.v rep (4 C z_-.. PERMIT TYPE RESIDENTIAL Water Softener Water Heater Add Plumbing Fixtures ( Main / Level) _Lower Lawn Irrigation (_ RPZ / PVB) _ Water Turnaround Septic System New _ Abandonment RESIDENTIAL FEES: $55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $35.00 Lawn Irrigation $55.00 Add Plumbing *Water Turnaround $105.00 Septic System $95.00 Fire Repair (replace (includes $5.00 State Surcharge) Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) (add $166.00 if a 5/8" meter is required) New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge)i TOTAL FEES $ CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.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 pl- ns. Applicant's Printed Name FOR OFFICE US equired ;Iris x Applica ion; City of Eaaali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 MAY 3 1 2011 Use BLUE or BLACK Ink F �,/ Permit #: 9 (poo 0O Permit Fee: 2) -6 7 Date Received: Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Cath Date: /4)/ 3/-// Site Address: /S-6.5-- Re Cc ( Unit #: 6— J RESIDENT / OWNER Name: Rcr.CS cfr .SIGs 'U.-4-. 4 (' Phone: CIS -2 - 4/42 -2) 7 9 Address / City / Zip: /6"- C iee,d eech/ Rcacs di ICL/1./ .,1747‘‘C -5.22i Applicant is: Owner X Contractor TYPE OF WORK Description of work: %e,,ac '/ ,&,i4,'ad�/ Construction Cost: ,2 d® a Multi -Family Building: (Yes / No , X ) CONTRACTOR Company: /✓, I-, %c'ctLrfe- ec.,e2d"tritche., Contact: L ' '/ C7 j - Address: 00OS- /Gr, c 4 •1e- 441.1 City: /:),/)/m 1-4 State: ./90fir Zip: �c `// Phone:../.,2 - ,.2le, -- . o,ci--'a License #: 2063,2 410 Lead Certificate #: 4417- 94/c1- % If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) In the last 12 months, Yes If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: _No Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classifirmiclassified as non-public if you provide specific reasons that would permit the City to conclude that they 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. gopherstateonecal I.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. x W / %'cs�a L Applicant's Printed Name Applicant's Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE lad arbitEd, SUB TYPES 'Foundation Fireplace Single Family Garage Multi Deck 01 of Plex Lower Level Accessory Building WORK TYPES New Addition Alteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (25%_ 100% x ) Census Code # of Units # of Buildings Type of Construction Porch (3 -Season) _ Porch (4 -Season) _ Porch (Screen/Gazebo/Pergola) Pool Interior Improvement Move Building Fire Repair Repair n0PD REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: Ice & Water Framing Fireplace: _Rough In _ Insulation Sheathing Sheetrock Reviewed By: Final Occupancy Code Edition Zoning Stories Square Feet Length Width Air Test Final Siding Reroof Windows _ Egress Window _ Storm Damage _ Exterior Alteration (Single Family) _ Exterior Alteration (Multi) Miscellaneous — Demolish Building* _ Demolish Interior Demolish Foundation _ Water Damage *Demolition of entire building - give PGA 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 Other: Pool: _Footings Air/Gas Tests _ Siding: _Stucco Lath _Stone Lath Windows Retaining Wall: _ Footings _ Backfill _ Final Radon Control Erosion Control , Building Inspector Final Brick RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL het C61/40)0'- Page 2 of 3 CITY OF EAGAN Remarks Addition Oslund Timberline Lat 15 Bik 4 Parcel ? Owner .P.,ed..CBd3x._RoAd State Eagan, M C 55121 4 or Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 1968 $100.00 $3.33 30 * SEWERLATERAL l 1970 1210.00 60.50 ZO WATERMAIN WATER LATERAL WRTER AREA STORM SEW TRK * STORM SEW LAT 1970 ZO CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. ? 5AC ' 77 PARK CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-189 (612) 681-4675 SITE ADDRESS: ! ? „ t i't h f;t- hFitr i1'.l 1???li ! tF?lt1 tl{ !N!L ? INSPECTIaN RECORD PERMIT TYPE: Permit Number: 7 Date Issued: ,w»._.e:,w w4 t'+ ff ? t1 C M APPLICANT: ir.l.'? 4t Mr, I= 1 1 fl 11 1 1 i I l!il? 1-.Ht, 7 PERMIT SUBTYPE: TYPE OF WORK: ri r i.i I?i .I:Ti'Tlf.1N i ItE f'1 ACFM! Nf 1 Permit No. Pertnit Holder Date Talephone iF ELECTRIC PLUMBINa HVAC Inapection Date Inap. Comments FODTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FlNAL HTG ORSAT TEST eLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK Fit!=,? -T - rJ4/Ar/ , - I Control INSPECTI4N RECORD I No. CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (612) 6$1•4675 SITE ADDRESS: LOT APPUCANT: 1566 RED CCuw? F:A, LQOM BUILDEl1$ A9lU"p TIMBERL.IME (6I2) 6At-o'$t -- ••':...? - PERMIT SUBTYPE: SF ( M.[ ;?' . } NI''NARKS- RECF. IFT # TYPE OF WIIDRK: At,TEttAT1'ON Perrrtlt No. PermR Holeer Date Telepharn N S/VN PLUMBING HVAC ELECTRIC ELECTFIIC hkepection (]ate lnep. Comments Faotings I Foundatlon Freming ? Roofing S, r ?Q Rough Pibg. Roaigh Hlg. Isul. Fireplace Flnal Htg, Orsat Test Fnal Pibg. Pibg. Inspector - Notify Plumber Const. Meter EngrJPian Bldg. Final Dedc Fig. Deck Finai Well Pr. pi9p. ? CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 PHONE: 454-8100 BUILDING PERMIT 53,000 . Receipt # N4 4433 To be used for Dote ' • , 19 ' ' $ite Address Erect ? Occupancy Lot Block ? Sec/Sub. ?'?'r i"'`- `?a?` ° Alter ? Zoning ?-( i Parcel # ac Name 0s; - ?' ::'nstlCUCtfoII Co. 3 Address I _`"• ' :'''??T'thy Rd. o __ 454-3336 ? Name 0 ?Q Addre ? ?- r«., Name I hereby acknowledge thot I have read this application ond state that the information is correct and agree to cornply with a!I applicable Stote of Minnesota 5taY:jtes and City of Eagon Ordinonces. Repair ? Fire Zone Enlorge E] Type of Const. Move ? # Stories Demolish ? Front it. Grade ? Depth ft. Approvals Fees Assessment _ Water & Sew. Polite Fire Eng. Planner Council Bldg. Off. _ APC Permit Surchorge Plon check SAC Water Conn. Water Meter Total Signature of Permittee I A Building Permit is issued to: on the express conditian that oll work shall be done in accordonce with all applicoble 5tate of Minnesata Statutes und City of Eagon Ordirwnces. Building Official Pernit # Dats Issued Pe Miss Plumbing Mechunical --7 a - 7' INSPECTIONS DATE INSP. Rough-In Fhal Footings ? Date insp. Date inap. Foundation Plumbing -?) -,f' Frome/ins. _ Mechanical Finul ? Remarks: OF EAGAN 3795 Pilot 1(nob Roed Ea9on, MN 55122 Zoning; Owner: ^ Address: Site Address _ t hy ;. _ Plum6er: 1 ugrce M oanPly wIth N,e C• SEWER SERVICE PERMIT PERMIT NO.: _ DATE: No. of Units: ¦ 'tY °f Ca9an Connection Charge: ' 75. !1() pi Ordinonees. Account Deposit: Permit Fee: gy 5urchorge; . Date of fnsp. : MiK• Charges: Insp.: Total: - Dote Paid: ? CM OF EAaN 3:95 Pilot Knob Roed WATER SERVICE PERM?T Eo9an, MN 5S1??2 PERMIT NO.: Zoning: ___ DATE: • _ -- Owner; - Na- of Uniis: Address: - Site Address: L,-. • . Plumber. - ?Meter No.. Size: Connection ?ar$e: eader No.: Account Deposit: a9? ? ?m P?' w'? the City of Eogon Permit Fee: . dinanees , , Surcharge: Misc. Chorges: • ?•,? gy Torol: Dote of Ins P e Paid: DOt I nsp.. I I z/ ?? RESIDENTIAL J`-Y BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 55722 yd, 7C 651-681-4675 ?J New Conetruction Reauiremenb RemodeVReoair Reaufremenb • 3 registered sde surveys shawirg sq. ft. of lol, sq. R. of house; and all roofed areas • 2 copies of plan (20% max'unum lot coverage allowed) . t set of Eneigy Calculations Por heated addNans • 2 copies of plan sfawirg beam 8 window s¢es; poured found desgn, etc J • 1 site survey for exterior additions 8 decks • t set af Energy Calculations • Indicate if home served by septic system far additbro • 3 wpies at Tree Preservation Plan i( IM qaHed after 711/93 • Rim Joist DetalOpGons seleclion sheet (bldgs with 3 or less wils) DATE 9/I1'0I n p VALUATION ? /?odo JOB SITE ADDRESS 15?o S ICpLI ????1/1/ ILGC . IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER Ke,h TVii6rs0n TYPE OF WORK liardf-i . ? FIREPLACE(S) _ 0_ 1_ 2 APPLICANT 14ZM124 ?"1 -`? I?X??WF D/1/'(Q CM40. PHONE# ADDRESS'liSOB LI.A"YIAGi? AUQ, 547. ZIPCODE5r2qao PAGER # CELL PHONE #6 12 -, 3610 -791gD FAX # 9SoZ'cY(PcP' NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category MINNFSOTA RULES 7670 CATEGORY 1 ---- _ ?' (check one) - Residential Ventilation Cate9orY 1 Worksheet Sutimitted l"-- ? _ • ? ??' ( - Energy Envelope Calculations Submitted _ MINNESOTA RULES 7672 20? - New Energy Code Worksheet Submitted t Plumbing Confractor. Phone #: Plumbing System Includes: _ Water Softener Lawn Sprinkler Fee: $90.00 _ Water Heater _ No. of R.I. Baths No. of Baths Mechanical Conhactor: _ Mechanical System Includes: Sewer/Water Confractor: _ Air CondiRoning _ Heat Recovery System Phone # Phone # Fee: $70.00 All above information must be submitted prior to processing of application. I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordi n s? Signafure of AppUcant --?,I Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 1I01 OFFICE USE ONLY ? 01 Foundation ? 07 05-plex O 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - MuIG ? 03 Ot of _ pfex ? 09 07-plex ? 17 Garage O 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Muiti ? 05 03-plex ? 11 10.plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous 0 37 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Additlon ? 38 Move Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 WindowslDoors ? 34 Replacement •Demolltion (Entlre 61dg only) • Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Unfts Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) Footings(deck) FinaUNo C.O. Footings (addition) Foundation Drain Tile . Roof Ice & Water Final Other Franring _ Pool _ Ftgs _ Air/Gas Tests _ Final Fueplace _ R.I. _ Air Test _ Final _ Siding Stucco Stone Insulation _ Windows (newheplacement) Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total FinallC.O. _ Plwnbing HVAC , cIrr oF encaN 3795 Pilot Knob Read Eogan, MN 53722 ' PHONE: 454-8100 BUILDING PERMIT APPLICATION $53,000. Receipt # _ for Site Address 17ojy viCtBriny na Lor 15 st«k 4 sec/sub. Timberline Addn. Porcei # z Ncme Oslund Construction Co. z Address 1547 McCarthy Rd. o E Esn 454-3336 p Name _ ? ?? Address ? Name _ Address I hereby acknowledge that I have read this apDlication and state thot the infortnation is correct and agree to comply with ail applicable Stote of Minnesota Stotutes and City ot Eagan Ordinances. Signature of Pertnittee M,,.,, Jul N°_ 4433 6899 Erect E Occuponcy I Alter ? Zoning Rl Repair ? Fire Zone Enlarge ? Type of Const. jL Move ? # Stories ? Demolish ? Front ? Grade ? Depth 2$ ft. Approvala Fees - Assessment Permit 1,.45 _ OT (f Water & Sew. Surcharge 26. S? Police Plan check Fire SAC 475.00 Eng. Water Conn. g30.00 Planner Water Meter _bQ..Q.O Council eldy Off . . APC Total 706? 5(1 A Building Permit is issued to: 0s1UII4II[L i pR CO. on the expreu condition that all work shall be done in acc ? nce with all ble State o Minnesota Statutes and City of Eagan Ordinances. Building Official / 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos whrn petaiits aze requ'ved for each utrit Date -7 / 5 Site Address I 5(pcJ PA C? Q( ` r I'1 O a d Unit # PropertyOwner f ) USS jU Q cr'T Telephone#(Q?ja) QG,?- P"6-', COOITaCtOC ?0 /) 1 r O I/ 2? ? f 1e- Street Address a 101 ! c GAD n CitY State f`n lv Zip ???LA Telephone# ((p5 ) ) 14660" (?6a? Bond #: Espires: The Applicant is _ Owner ? Con[rador _ Other Add-on or alteration to existing dwelting unit $ 30.00 -Z furnace _Additional ZReplacement _ New , 1 air exchanger ? -Z air conditioner heat pump other E? E G-?-Uni C !- tt r- C?CGr,.er ? ?-_ - State Surcharge $ .50 Total $ '12n.50 I hereby apply for a Residential Meclianical Peanit and acknowledge [hat the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the MecLanical Codes; tttat I understand this is not a permit, but only an applicadon for a pemtit, 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 wivch requires a review and apprwal of plan. c s A w L , ?- Applicant' 'nted Name p icant s Signature 2005 COMNIERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knoh Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for. commerciaVindushial buildings multi-family buildings when sepazate pennits are not reqirired for each dwelling unit Date 1 I Site Street Address IInit # Tenant Name (if appticabte) Previous Tenant Name Property Owner Telephone # ( ) Contractor Street Address City State Zip Telephone # ( ) Bond #: Espires: The Applicant is _ Owner _ Contractor _ Other Work Type New Construction _ Underground Tank _ Install Remove "see below _ Interior Improvement _ Instali Piping _ Processed _Gas Nature of Work: *"When insfaflmg/removing underground fank, calf for inspecSon by Fere Marshal and Plumbing lnspec tor P¢im11 FCCS: $70.50 Uadaground tank ins[allatiodremoval $50.50 M'wimum (includes Stefe Surcharge) or Conhact Value $ x I% _ $ PermitFee $ State Surcharge'' ` If pe 't fee is less t6an $1,000, add $.50 If pmmit fee is more than 51,0110, surcharge --- : is $.50 for every $1,000 owed $ Total Fee 1 hereby appty ibr a C:ommercial Mecbanical Pemut and aclmowledge tliat the information is camplete and accurate; that the work will be in conformance with the ordinances aod codes of the City of Eagan and with the Mecbanical Codes; that I undeishand this is not a permit, but only an application for a permit, and work is not to start without a permiY, that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. ApplicanYs Printed Name Applicant's Signature Approved By: Inspector Date: Required Inspections: _ U.G. _ RI. _ Air Test - Gas Service Test - Infloor Heat _ Final ,- ? .. 69*133 Da'.e : 7 7 _ ---? SUILD2SIG PERMIi APPLiCAT30^i LG^z ?? BLOCI{ A7DITIO,17 ??` ??°?° :'!?.;::rT, E SF,r"PXOP3 P'![TI4IIER IF U'i1PLATTED ': _'2 ^:7Tid? j OCCUPAAdCY USE yq? / ?S U x.?'? , C/-U U0 TELEPHOIYTE A70._::?'-'f? l C(i_?'i?*CTOF lj¢js.-a-s Lr' TELEPHONE Y]O. :'_ ;:'RE5S tv`ote: Inclade site p2an, bui.Iding plans, and energy calculations vith '.h.i.: application Signeci OFFICE USE op ? '7.{LUALIOM 3 U o 0 `T:. ?;R `i£TER `IIITJJSDIG PET$3IT FEE ;r7Rtlt*r.P.GE FEE 31.21ii CS-:LCZ FEE P.c?.RK DEDIGATIQ?4 FLB OT,,cR ?G n.I• - li h?a. ? a? ?Q_ ? ... ? ? ::^?"C?Yl T S .: ;S°•i$u:?TP CLERK BUILDING DEPT. POLICE DEP'P. ".;"^rR E Sh'kJF,R DF.PT. FIRG I]RPT, PIlRK DEPT 6ob;'0s1und ' • ` F. C. JACKSON . LAND SURVEYOR R[618TQN[O UND(R LAWS Or 6TAT6 Or MINNlWTA LiC[NYfG BY OROlNANCi OF CITY 0/ MINN[AlOL1S 3E18 EAST SSiN STREET 727-3484 $IIL11tpOC'g ?tCflflCBtt , ? ? .? ?e J ? \ c L i 4 ?., i? 1ti , r ? ,?1 • ? y,? Q a - SCAIE: 1" = 40' 305& a DonoCes Iroo M ? ?'2rf?y 1 s= ,&.0 103,70 ' ? - ? °v ,aH ? ? \ ? ? ? ya ? x \ Cl \13 v - ? o v' - ! ? f Q ICI a? I hereby certify that thi• is a erue and correct plat of asurvey of: Lot 15 81ock 4. Oaluad T1W6erline Addition. Dakota County, tiinoasota. Ai SURVEYEO BY ME TNIS_2OCh _DAY Of'_.TU Or. 10700 181-68A xk 1977 / SIGNED y-?- ' F. C. JACKSON. M?co7w R[msrewrwN. Ho. 3600 CITY USE ONLY LOT ? BL SUBD.ISLA4J RECEIPT #: UQ 9/9 RECEIPT DATE: y/°79-,7 1997 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOS RD EAGAN MN 55122 (612) 681-4675 nete: 9- a-97 Complete this section onlv if vou are installing HVAC in sinLyle family, townhome, or condos that are under construction and are not awner /occupied. • HVAC: 0-100 M B T U $ 24.00 ADDITIONAL 50 M BTU 6.00 • Gas outlets (minimum of one required @$3.00 ea.) • State Surcharge: .50 • TOTAL: Complete Uus section only if you are remodeling, addina to, or reoairin¢ egisring single familv dwellines, townhomes, or condos. _ Add-on fiunace X Add on air conditioning _ Add-on air exchanger, i.e. Vanee system, etc. Other Minimum fee applies to all remodel or add-ons of existing residences $ 20.00 State Surcharge Total: $ 20.50 SITE ADDRESS: 1565 ReaC G ecY a r,Pcr • OWNERNAME: 1UQY'12 II/-E'1'S'Oh PHONE#: ¢-5- O4--? INSTALLERNAME: N0til21^C Sau-{hcide f}`lAf RlC Inc. pxorrEa: 431-7D99 STREET ADDRESS: I¢7 31 /?E h h/a" aC f?V? • CITY: &1212I,6 Va l Fev STATE: NN ZIP: SSIJ'F' ll`?a'q7 rf7a.17? h? ? SIGNATURE OF PERMITTEE / ??J .? CITY USE ONLY L BL SUBD. RECEIPT #: RECEIPT DATE: 1997 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? all commerciaUndustrial buildings. ? mulG-family buildings when separate permits are not required for each dwelling unit. DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: FEES: ?$25.00 minimum fee or 1% of contract price, whichever is greater. ? Processed piping - $25.00 ? State surcharge of $.50 per $1,000 of eo rmit fee due on all permits. CONTRACT PRICE x 1% PROCESSED PIPING STATE SURCHARGE TOTAL SITE ADDRESS: OWNER NAME: TELEPHONE #: TENANT NAME: (InnaROVenneNrs ONLV) INSTALLER: ADDRESS: CITY: STATE: PHONE #: ZIP: SIGNATURE: SIGNATURE OF PERMITTEE CITY INSPECTOR CITY USE ONLY L BL ? RECEIPT #: ? ? - SUBD. V4?uj DATE: ?/29// 1995 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55722 (612) 681-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit FIXTURES E/rCH NO. TOTAL Shower 3.00 x = Water Closet 3.00 x = Bath Tub 3.00 x = Lavatory 3.00 x = Kitchen 5ink 3.00 x = Laundry Tray 3.00 x = Hot Tub/Spa 3.00 x = Water Heater 3.00 x Floor Drain 3.00 x = Gas Piping Outiet * minimum - 1 3.00 x = Rough Openings 1.50 x = Water Softener 5.00 x = Private Disposal * Dakota Cry. license 20.00 = U.G. Sprlnklel' * home under const. 3.00 = Alterations " to existing 20.00 = Water Turn Around 20.00 STATE SURCHARGE .50 TOTAL ? SITE ADDRESS: ?-J10 -) dC-A?fX A a`' ' OWNER NAME: kerine--?A -E-v-ei-56 '? zzu INSTALLER NAME: STREET ADDRESS: e- ? ?- CITY: STATE: ZIP: PHONE #: 52-' ??Za-? SIGNATURE l?? F P OFFICE USE ONLY L BL RECEIPT #: SUBD. DATE: 1995 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Piease complete for. . all commerciaVindustrial buildings. ? multi-family buildings when separate permits are = required for each dwelling unit. DATE: ? CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION ADO ON REPAIR DESCRIPTION OF WORK: IS WATER METER REQUIRED? _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING: WATER FLOW: GPM. ARE FLUSHOMETERS TO BE INSTALLED? _ YES _ NO. FAILURE TO PROVIDE THIS INFORMATION WILL RESULT IN A DELAY OF METER ISSUANCE. WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM9 _ YES _ NO. IF 50, YOU MUST APPLY FOR A SEPARATE U.G. SPRINKLER PERMIT. FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge of $.50 per $1,000 of oermit fee due on all permits. CONTRACT PRICE x 1% STATE SURCHARGE TOTAL SITE ADDRESS: TENANT NAME: OWNER NAME: INSTALLER: ADDRESS: cirr: PHONE #: SIGNATURE: OFFICE USE ONLY I METER SIZE: ' DATE: STE. # STATE: ZIP: APPLICANT INSPECTOR: PERMIT ` CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT TYPE: Permit Numlaer: Date Issued: e,eo??sa-q BUILDING 027505 05/89/96 SITE ADDRESS: 1565 RED CEDAR RD LOT: 15 BLOCK: 4 05LUND TIMBERLINE, P.I.N.: 10-55300-150-04 DESCRIPTION: (REPLACEMENT) SF /VK'°'v e r m i t T y p e 4YEE'1F ??, s?k T y p e N?EbR ?`t'? 434 flLT. RESIDENTIAL REMARKS: "?ca,u.?, j'?^' ?? ? FEE SUMMARY: Base Fee $45.00 Surcharge $.5e Tptal Fee $45.50 CONTRACTOR: OWNER: - flpplicant - IVERSON MARIE 1566RED CEDAR RD EAGAN MN 55121 (612)452-6042 ??er?tiy grue rs4d, this appl.ioation ant3 state that tfie Fs ii *p,or?r,?"?? ,ai?tl:°ag.r.es`t?t eomply w3th alk applicahle State af lfn_ ' -f?ag an in onc Y ? __ _._. ,......,f,?.. F_ ... , r „?? ,v.._ }"+:....... _ ... . _ . . ? APPLICAM/PERMITEE 5 GNATURE IS UED B. ' CITY OF EAGAN 7"" 3830 PILbT KNOB RD - 55722 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) '`?' ??•?l? 681-4675 m2f i z- Naw Construclion Reaulremenls RemodellReoair Reauirements ? 3 regislered sita surveys ? 2 copies of plan • ? 2 copiea of plans (indude beam 8 window sizes; poured fnd. design; atc.) ? 2 site surveys (exterior additions & decks) ? 7 energy plculaNans ? 1 energy plculations for heated additions ? 3 copies of iree preservaNon plan if lot platled after 711193 required: _ Yes _ No ?. DATE: CONSTRUCTION COST: r- DESCRIPTION OF WORt STREET ADDRESS: ? LOT BLOCK PRUPERTY OVIlNER CONTRACTOR Name: Phone #: T Wi YIRBT ?. . . _.. r Street Ad City: Company: _ Street Address: Citv: ARCHI7ECT1 Company: ENGINEER Name: Street Add City: Sewer & water licensed plumber: change are requested once permit is issued. State: ? Zip? 5 Z Phone #: License State: Zip* State: Zip: Penalty applies when address change and Ic± 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. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received _ Yes No Tree Preseroatian Plan Received _ Yes _ No I 715C;C ???E -0 .?Y n 3 1996 I Phone Registration -?L- SUBD./P.I.D. #: '?0 S/& n (v :1, M W V/C ho BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 02 SF Dweliing ? 07 4-plex ? 03 SF Addition ? OS 8-plex ? 04 SF Porch .? 09 12-plex ? 05 SF Misc. ? 10 = plex WORK TYPE ? 31 New ? 33 Alterations ? 32 Addition ?334 Repairf tL.L PL A« GENERAL INFORMATION OFFICE USE ONLY ? 11 Apt:/Lodging ? ? 12 Multi Repair/Rem. ? ? 13 Garage/Accessory ? ? 14 Fireplace ? ep" 5 Deck ? 36 Move ? 37 Demolition _?, ? * • ?? . . n . ? ^??. ..,a,.. 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscelianeous Const. (Actual) 8asement sq. ft. MC/WS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. R. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. -13 y Depth Footprint sq. ft. SAC Code o i Census Bldg I Census Unit o APPROVALS Planning Building Engineering Variance Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit SlVN Permit SNH Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: Valuation: $ % SAC SAC Units ' . . .? f . • <.^ } J .d 7?b -2o aa- 1, ? "' / . .-..?,!^r?z?.Y?*.?,/jG'?/?s'?- r:i`..rx':.i; . ..•,..,`,:? !':?f. ? ? \ PERMIT Control No. 13?J 7 , x aCfT?( OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: p u z G u z tv c Permit Number: Eagan, Minnesota 55123 001875 (612) 681-4675 Date Issued: 12J p? /.9; SITE ADDRESS: 1S85 RED (7ECtAR RIJ LOT: 15 [3LOCK: ?? (75LUND -iIMBERLINE DESCRIPTION: ' 6u:ilal?.n9 Permit l"YPe SF (MTSC.) ' ! Bualding'ltiWork Type HLTERATTqN ? l ri \ , . - i .: ?. i. ? 7,C'i ? REMARKS: ftEC ECP , ? Coars?9 FEE SUMMARY: VALUAI'IC1N $6.6e0 Esase Fee $90,00 5urcharge $3.30 I.ic, Search Fee $5v00 ? Totel Fee g98.30 CONTRACTOR: - Appli.cant - 51'. t. cQWNER: LOON BUS:LL7ER5 18816030 000577 6 IVERSON KEN 4816 W 110TH 5T 1565 RED CEDAR Rl7 BLOOMTNIiTON MN 55437 EHGAN MN (612) 881--6038 (512)452-5042 I heretiy acknowJ.adge that 't haave rsad this applicaCaotc and MCate that the ' infarthaCion is aorreet and agree to ccsmpJ.y wi.t'h a11 app l3cable State nf htn. 5tatutes anrl City af Eagan Owdi.nances. L ? LICANT?PITEE SIGNATURE ISS?ED ? Y'I SIGNATURE PERMIT # . CITY OF EAGAN REACTIVATE _ 1992 BUILDING PERMIT APPLICATION 681-4675 SINGLE 8 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 when typing of permit is requested, but not picked up by last working day of manth in which re uest is made or lot chan e is re uested once ermit is issued. Date /2- /?Z ,_, /4,1- Valuation of work ?S 7,9r Site Address: JQP,.,? 6,06i1 AC ? SiREET SUITE ! Tenant Name: (commercial only) LOT BLOCR SUBDq P.I.D. iF lv .v?r?G Descri tion of work: ? The applicant is: O Owner Mf C ntractor ? Othe (Deseribe) Name Pho??e 4?So1`SL?f.Z Property , `ASr FIRST Owner 2 2 1 ,J , Address JSf? 4 .,r / STREE7 STE N City State Zip SS Company Afasn t Phone - 40_/d Contractor Address 10? 144 *J?fLicense #5 77? Ex A19_1?- City Statevi-7-11-1 Zip .r, 51V7 Company Phone Archltect/ Engtneer Name Registration # Address City State Zip Sewer 5 water licensed plumber . Processing time for sewer 8 Nater permits is two days once area as been approved. I hereby acknowledge that I have read this application and state that the infarmation is correct and agree ta comply with all applicable State af Minnesota Statutes and City of Eagan Ordinances. S ? ignature of Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./lodging ? 02 SF Dwg. ? 01 4-Plex ? 12 Multi. Misc. 0 03 SF Addition ? OS 8-Plex ? 13 Garage/Accessury ? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 05 5F Misc. ? 10 Multi. Add'1. O 15 Deck WORK TYPE ? 31 New O 33 Alteratians O 35 Tenant finish ? 32 Addition ?34 Repair ? 36 Move GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning / of Stories Length Depth APPROVALS Planning Engineering REQUIRED INSPECTIONS 0 Site 0 Mallboard Basement sq. ft. Ist F1. sq. ft. 2nd F1. sq. ft. Sq. ft. total Footprint Sq. ft. On-site well On-site sewage Building Variance O Footing O Final .- ? 16 Basement Finish ? 17 Swim Pool ? 18 Comm./Ind. ? 19 Comn./Ind. Misc. ? 20 Public Facility [1 21 Miscellaneous 0 31 Demolish MWCC System City Water PRU Required Booster PumP Fire Rrinkler Census Cod`v ?S! SAC tode 7?'? (J "T U F Sc a PE. Assessments ? Framing 0 Insulation ? Draintile ? Fireplace Permit Fee Surcharge Plan Review License MWCC SAC City SAC Mater Conn. Nater Meter Acct. Deposit 5/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: v.itmc;a,e $ SAC % SAC Units City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 1565 Red Cedar Rd Lot: 15 Block: 4 Addition: Oslund Timberline PID:10- 55300- 150 -04 Use: Description: Sub Type: Work Type: Description: Census Code: Zoning: Square Feet: 0 Comments: Fee Summary: Valuation: 3,000.00 Contractor: Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264 -4777 e- Windows/Doors Windows/Doors-New/Replacement House 434- Applicant/Permitee: Signature PERMIT City of Eaan BL - Base Fee $3K Surcharge - Based on Valuation $3K - Applicant - Construction Type: Occupancy: Carbon monoxide detectors are required by law in ALL single family homes. $88.50 $1.50 Total: $90.00 Owner: Russell P Jubert 1565 Red Cedar Rd Eagan MN 55121--191 Permit Type: Permit Number: Date Issued: Permit Category: Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. 0801 9001 I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Issued By: Signature Building EA089048 05/05/2009 ePermit City of Eagan PERMIT Permit Type: Building Permit Number: EA106629 itDate Issued: 08/30/2012 of jjft Site Address: 1565 Red Cedar Rd Lot: 15 Block: 4 Addition: Oslund Timberline PID: 10-55300-04-150 Use: Description: Sub Type: e-Windows/Doors Work Type: Windows/Doors-New/Replacement Description: House Census Code: 434 - Zoning: Square Feet: 0 Construction Type: Occupancy: Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: Valuation: 4,000.00 BL - Base Fee $4K Surcharge - Based on Valuation $4K $103.25 $2.00 0801.4085 9001.2195 Total: $105.25 Contractor: Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 - Applicant - Owner: Russell P Jubert 1565 Red Cedar Rd Eagan MN 55121--191 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA117659 Date Issued:10/22/2013 Permit Category:ePermit Site Address: 1565 Red Cedar Rd Lot:15 Block: 4 Addition: Oslund Timberline PID:10-55300-04-150 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door 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, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes . Valuation: 500.00 Fee Summary:BL - Base Fee $500 $40.00 0801.4085 Surcharge - Based on Valuation $500 $0.50 9001.2195 $40.50 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 - Russell P Jubert 1565 Red Cedar Rd Eagan MN 55121--191 (651) 452-2179 Crew2 Inc 2650 Minnehaha Ave Suite 100 Minneapolis MN 55406 (612) 276-1680 Applicant/Permitee: Signature Issued By: Signature Jul 02 14 02:57p American Wateiworks 5073563312 p.2 Use BLUE or BLACK ink � Forofficeuse---------� ' �a �� ' � � Permit#: � C�ty of �a�aIl �-�v�� Pe��F�: r��a� � 3830 Pilot Knob Road .�� (�� j s � Dale ReceiveQ: � Eagan MN 55122 � � Phone: (65'i)675-5675 I Staff: � Fax: (651)fi75-5694 i � _ 2012 RESIDENTIAL BUILDING PERMIT APPLtCATION �JJ� Date: � Z-1 � SiteAddress: �S�J fLQ� �C101r' 11U Unit#: / f � �e.� ('�S 1-Z_1 Z-�za3 � Name:�IJ�S� �u ,(" Phone: � � RESiDENT 1 � �1 l� � OWNER � Address/City/Zip: � Applicant is: Owner �Contrador ' TYPE OF WORK Description ofwork: ""i�1 C1�Gin ��'C �' Sl-�v�t ��,�Yv1�� Construction Cost:�� Z-� Multf-Family Buiiding: (Yes /No_� ; 9 Company: YY10I'i t_G1 n ��L'nl�('�t Contad:LJII�� ln/l� � GONTRAC � Address: ��-�� • l(ir� 1��' S City: �J� �S�G� � TOR ` � State: 1 ' �� Zip: .�Y' C.�� Phone: ��1 Z� � 3 License#: JJG �� l�� Lead CertificatE#: lil �� F � If the project is exempt from lead certi�cation, please explain why: (see Page 3 for additional information� � ; � 1�1 I'�� COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING i � In the last 12 months,has the City oi Eagan issued a pennit for a similar plan based on a master plan? � +., Yes _No If yes,date and address of master plan: i � Licensed Plumber. Phone: � � Mechanical Contractor: Phone: � � Sewer 8 Water Contractor: Phone: � IYOTE:Plans and supportlrtg documents that you submit are considered to be public informatiort. Portions of � the information may be dassi�ed as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. CALL BEFORE YOfI DIG. Call Gopher State One Call at(651)454-0002 for protection againsl underground utility damage. Call a8 hours before you intend to dig to receive locates oi underground utitities. wvvw.gooherstateonecall.org I hereby acknowledge that this infom3ation is complete and accurafe;that the work wi II be in confortr�ance with the ardinances and codes of the City of Eagan; thai I undersland this is not a peRnit, bul only an application for a pertnit, and work is not to start without a pem►i[; tha[the wock wiU be in accordance with the approved plan in Ihe 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 oompleted within 180 days of permit issuanee. X ►✓�Jr�f W'Q12.��`� X�� ApplicanYs Printed Name ApplicanYs Signature Page 1 of 3 Jul 02 14 02:57p American Waterworks 5073563312 p.3 r y , ,� �� /� Cr�� /a�'��'S� DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Fireplace Porch{3Season} _ Storm Damage '`� Single Family _ Garege _ Porch(4Season) _ Exterior Alteration(Single Family) T MuEti Deck Porch(ScreenlGazebolPergola) _ Exterior Alteration(Multi} 01 �f Plex Lower Level Pool Miscellaneous Accessory Building — ,r WORKTYPES '..f�'' ",3��'�.. r�-°I� I�'�' �°`"/�t` _ New _ Interior Improvement _ Siding _ Demolish Building" Addition _ IlAove Building _ Reroof Demolish Interior � Alteration _ Fire Repair _ Windows _ Demolish Foundation _ Replace � Repair _ Egress Window _ Water Damage Retaining Wall `Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation 'r!, m s Occupancy � ,� MCES System Plan Review �� Code Edition � SAC Units �� '�� (25°/a_100%� Zoning �_ City Water i Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings(New Building� Meter Size: Footings(Deck) Final/C.O. Required Footings(Addition) Final!No C.O. Required Foundation � HVAC Gas Service Test Gas Line Air Test � Drain Tile ��t �� Other. Roof:_1ce&Water _Final Pool:_Footings Air/Gas Tests _Final Framing Siding:_Stucco Lath _Stone Lath _Brick Fi�eplace:_Rough In AirTest _Final Windows Insulation Retaining Wall:_Footings_Backfill_Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: ► �-- , Building Inspector RESIDEIVTIAL FEES Base Fee /"��I�,�� St�rcharge I J �' Plan Review �(�-�� MCES SAC � City SAC Utility Connection Charge - �/ � S�W Permit 8�Surcharge � l � Treatment Plant Copies TOTAL , Page 2 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA155515 Date Issued:05/20/2019 Permit Category:ePermit Site Address: 1565 Red Cedar Rd Lot:15 Block: 4 Addition: Oslund Timberline PID:10-55300-04-150 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door 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: 1,500.00 Fee Summary:BL - Base Fee $1500 $62.50 0801.4085 Surcharge - Based on Valuation $1500 $0.75 9001.2195 $63.25 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 - Russell P Jubert 1565 Red Cedar Rd Eagan MN 55121--191 (952) 212-9203 Home Depot Usa Dba The Home Depot 2455 Paces Ferry Rd Atlanta GA 30339 (763) 852-1044 Applicant/Permitee: Signature Issued By: Signature