4876 Richard LaneCASH RECEIPT
? 1 • ?,
CITY OF EAGAN
P. O. BOX 21-199
EAGAN, MINNESOTA 55121
DATE 19 ?..'
. -r?--"?' • ,/
R<G<lYlD
/IROM L",
AMOUNT $
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? CASH ? CHECK
12Z41 J J / ;4
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FUND COD6 AtAOUNT
or ?• ? 37y d;' .?
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Thank You
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Nfiite-PaYe?i ODPY
Yellow-Posting CopY
Pink-File Copy
CASH RECEIPI' -'
CITY OF EAGAN P. O. BOX 21-199
EAGAN, MINNESOTA 55121
?
DATE ? 19 J
wsceivsn
lrROM .
AMOUNT $
!k DOLLARS
oo
7
[D CASH ? GHECK
White-Payers CopV
Yellow-Posting Copy
Pink-File Copy
Thank You
. •aYr
. - ._....o
. ?,
BUILDING 'ERMIT
CITY OF EAGAN
3830 Pilot Knob Rosd, P.O. Box 21-199, Eagsn, MN 55121
PHONE: 454-8100
Site Addrea L'N
Lot elock ? se'/Sub.
Perce! No.
NBTB tiMl. . fT•.,i.il:iJ? C''NS'.
? Addreas
City Phone
Name ,,,,,.>.i;
? Address
City Phone
Name _
Address
Phone
I hercby ocknowledqe thot I have rcad fhis applicution ond state thot
thr informotion is correct ond ogree to comply wifh all applicable
SlaN of Minnesota Stotutes and City of Eaflon Ordinontet.
Siqnoturo of Pemwfta
/1 Buildiny PeRnif Is issusd fo:
oll wo?k sholl be dorw in otoordanct with oll nppliaoble Stote oi Mlr
10778
Receipt #
M?. - • :;.??,. .. . ?a ? i
Erect
Remodel
Repair
Addit(on
Move
Demotish
Int Impr.
?
?
?
a
?
Type of Const.
No. Stories
length -
Depth 4.;
Sq. Ft.
Assessment
Wuter d. Sew.
Police
Fin
Enp.
Plonner
Council
BIdg.Off. 6 /)3:?8 5,
APC
Var. Date
on
sota Stotutea om City o;
Permit
Plan Review
SAC
WeterConn. 0 •'JO
Weter Meter G? • 00
Road Unit Z ft f)• 00
Tr.PI. 132.00
Parka
CoPies 1 . 0
Totel
tFN expnsf Conditlon Ihot
Ecpon Ordinoncts.
Buildinp Offidol
I Inweetion Dsta I Insp. I Othar I
Rouyh Htg.
Final Htq.
Flnal Plbg.
Final
Water Dftcribe
We11
P?.
Rocaipt MECHANICAL PERMIT Pennit No. '
CITY OF EAOAN FN
F Fill in numbered apscet S/C
Type or Print /epfbly TOL
. ? .
1. Data Z. Installation Cost `c" • •
3. Job Addrass Lot? ? Bik. ? TraCt
4. Owner
,. -
5. Contractory.????•?•• Phona -- _ ,
6. Address
7. City i.-!2.a+,,.- ? State ?'?? ,?• r 2ip
8. Building Type: Residential 181 Commercial ? Institutional ?
9. Work Description: New 0 Add ? Alter D Repair ?
10. Desa'ibe L Fuel Type
11.
.
No. Ep1iinmBni STU - M. Ea.
Foroed Air No• Equiament CFM
Air Handling:
.
Mfg.
Boilers F
E
Mfg. nwst
Mech.
x
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed :
for
Rough F Inal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-6100
Receipt PLUMBING PERMIT Permit No.
CITY OF EAGAN
FM
Pill in numbered spaces S/C . .
Type or Print legiblY Tot .
, .
1. Date 2. Installation Cost
3. Job Address Lot Blk. ? Tract -
?
4. Owner - ', • tf7v`?' '`- ?_ C'i: - 2 I
,
5. Contractor ? ??='• '!?: 'r - ! '-r ; _'r: C ?? ?- Y - Phone ' ? • , .?
6. Address .,`? - % : ?• . . ? • . ? ? ,
7. City State 1', ZiP
8. Building Type: Residential Commercial O Institutional ?
9. Work Description: New M Add ? Alier 11 Repair ?
10. Describe
11.
No. Fixtures
Waier Closet No. Fixtures
Cesspool/Drainfield
?
? Bath tubs
Septic Tank
? Lavatory Softner
Shower Well
? Kitchen Sink
Urinal/Bidet
Other
L Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby aertify that the above information is true and correct, and I agree to
comply with all ord inances and codes governing this type of work.
Signed: for
Rough F inal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8700
Receipt PLUMBING PERMIT Permit No.
CITY OF EAGAN
Fee
' FiII in numbered spaces S/C
Type or Print legibly Tot.
1. Date 2. Installation Cost -"'
3. Job Address ' Lot Blk. ? TracE
4. Owner
5. Contractor Phone
?
6. Address ? 1 ` " ` ' ? ' • t-
,
7. City r State Zip
8. Building Type: Residential Commercial ? Institutional O
9. Work Description: New ? Add ? Alter ? Repair ?
10. Describe
11.
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield I
Bath tubs Septic Tank
Lavatory ? Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
?
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : I for
Rough Final
Inspections: Date Insp. _ Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
CITY OF EAGAN Remarks r?,!'J' T ' `' 2(,5 ' ` ` " -
Addition HILLCRE`4'T ADDITION Loc 10 Bik 1 Parcel 10-32975-100-01
owner street 4876 RICHARQ LANB state ElIGlW IrIIV 55122
Improvement Oate Amount Annual Years Payment Receipt Date
STREET SURF, ?9(p Q, /Z O I(p,3 ? /O / S
STREET RESTOR.
GRADING
SAN SEW TRUNK 3044 1976 183.08 12.21 15 ?• ? o/? 3P1. ?o i? ?s?
*6EWER LATERAL 3 X 9. O o /G 381- /O / ? ?
WATERMAIN
*WATER LATERAL 1999
WATER AREA a 1982 19.62 15 o,? /S+S 0 163-F' i /a i7 k-4-
*
STORM SEW TRK ' 1954 804.56 160.91 5 3X /o i-7
*.STORM SEW lAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
280.00
wat R coruN. ,t „
BUILDING PER.
10778
SAC
PARK
CITY OF EAGAN
3830 Pilot Knob Road
P. O. Box 21199
Eagan, MN 55121
Zoninp:
Owrwr. ';s ? 4 ,.r .. _ •.
Address:
Site Address: 'Z] Ct1;:irC1 l,rl
Plumber: - r ,•`,,.•"^.? _
I iw" !a asrply whh fIN Ciyr of Eqp¦
CnnMOCM.
By
Date of Insp.:
Insp..
SEWHt SERVICE PERMR
PERMIT NO.:
DATE:
- No. of Unita:
Ll'' i -iallc<<a._.;,
c«,rAwcron aorge: 4 - 5
/,COOUI7F DCpOlIt2
PdR1'llt FN: `snli
SUfd'IO/pe: •'
_ MIsC. Chq/om
_ Totof:
_ DaM Poid:
CITY OF rAGAN WATER SERVICE PERMIT
3830 Pitot Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 5512l. ? DATE:
Zoninp: No. of Units:
Qwner: i!'•`'- t
Addross:
?.1?.
Slh Address: • - :.r1.. .
. _ , i. .
Plumber. ?
Meftr No.: Connection Charye: ?')O•Qr?•.i
Size: ilcoount Depasit:
Reader Na.: Permit Fee:
1a0m h eoaPlp whh iw Cihr of E*pn Surcharga:
OaiMnoM. Mlsc. Charges: -
Total: '
BY Dota Poid:
Dote of Irisp.: ;
Insp
,
CITY OF EAGAN
3830 Pilot Knob Rosd
P. U. Box 21199
Eagan, MN 551?11
l6 Cifp ef Eagew
WATER SERVICE PER1ylR
.. ?,-.
PERMIT NO.:
dATE:
BUILDING PERMIT
Te M med fer SF
gite Addrm 4876 RICHARB LId
Lot 10 Bbck 1 ?ec/Sub. HILLCREST ADD
Psrcal No. . .
CITY OF EAGAN N_ 10778
38?4 Pilot Knob Road, P.O. 8ox 21-199, Eagan, MN 55121
PHONE: 454-8100 y
Receipt Af ?
DWG/GAR Est, Volue $$2, 000 Date AUGUST 12 10 85
W Name WM HUTTNER CONST
? nddre?s 960 WATERFORD DR W
Citv EAGAN Phone 452-3088
c
0
3u
?
Name SAME
Citv .
Name
Atldre
City .
Phone
Phone
I hereby ocknowledga Ihat I hove reod this npplication ond stoM tFaf
the inlormation is cornct ond ogree toAmply w ble
Stata of Minnemro Statutes and Ciry q!f/Eagon?Q" 1A Buildin9 Permit Is issued fo: ? WM HUTTNER CONST
dl work sholl be done in atcordanee wlih a pplicobla St of 'n
Buildinp Officiol -r?G.-P -
Erect [l Oteupancy - ?-
Remodel ? 2oning RI-
Repair ? Type of Const. {7
Addition ? No. Stories
Mova ? Length 61
Damolish ? Depth 44
Int Impc ? Sq. Ft.
Install ?
AVOrovalt i"s
Assessment permit $ 379.00
Water 8 Sew. Surcharge 41, 00
PoNu Plan Review 1 S 9_ 50
Firo SAC 525.00
Enp. waterConn. 500.00
Plonnar WatarMeter 63.00
Council RoadUnit 280.00
Bldg. Otf. $$$ 5 Tr. PI. 132. 0 0
APC Parks
Var. Date Copies
2
109
50
.
.
Totai
on tha axp,ea canditlon tFqt
aota Statutes ond City o7 Enqan Ordinancaa
T
18 his request wid
B`?°??°33?
Bequest Uate Fre No. ItauBh-?n Incpect?on
Fepwred? .
O?MeaAy N. ?1 Notity. Inspec-
/ - //_ $ C
r ?? l ?s ?NO ' or When ReadY
aticensed Eleclriwl Contrnc[a j hyreby repuast inspection of abova
ner electriol wvk imtalled ac
SVeet AOdress, eox or Rou[e No. . Citv
ecUOn o. Toenahip N. or No. . IUaqe No. CwntY
?
Occupanl lNi1NT) No.
wt
Power pplier Atltlress
I riral
Conhact
or (COrtipairy Name) Contractor s Liccnse No.
/
r
` C d'?
ilinB Address IContractor or Owrer Makin Instailaiionl
?
0( ? 1' ^?
AuMoriz '9 re ICOnbac[ /Owner MakinB lostallation) ?M1one N1mber
6
'YINNESOTA STATE BOAqD OF EIECTRICT' TNIS INSPECTION REpUEST 111111 NOT
Grigps-Yidrey BMp. - Room N-791 BE ACCEPrED B1 7HE SfAIE BOARD
1821 UniversiiY Ave.. St. Paul. YN 55104 UNI.ESS PROPEq IMSfECT10N FEE IS
pM? 16,121297??111 ENCLOSEU.
IEQUEST FOR ELECTRICAL INSPECTION EB'°°°°I '04
, Sae instrmrions br coWlatirg this torm on back o7 yail. capY- ?
B1-9 2„d 3 ..X.. 8elow Wnrk Covered by This Request /?-/ - L(
tlA Rao. Troe ot Buiisinn . ponliaaea Wird Equiomem iired
Water
p Fee ServieeEMmMeSiza N Fee FaeCers/SUbteeders tl Fee Circuits
Oto AnWs 0 to30A 9 0 to30Am
Above 201) Amps 37 to 100 qmps 31 to 700 Antlis
Swimming Pool Above 100_ Above 100_ArtWs
Tre?fonners Irtigation Booirs Partial•'Other-Fee
Signs Speciallnspeclion /
Renarks $ 3gpn TOTRL F?E Jv
Bovph-in 174j
. the E10cvical
?. ?.aw
?..?r? ?.:? a?„a
Final incpectim lus bean
aside.
THatepuesinaWMmOntlBban V "
PERMIT # G!+ (O I ? RECEIPT DATE:
5008 finIDENTIlEL i'LUM$lAfi PEftMIT APPLiCATION
crrY oF EAsLAx
3830 Pnor xxos ftn
EnstN, Uv ssi as
651-6$1-4875
Please complete for: single family dwellings, townhomes and condos when permits are required for each unit,
backflow preventer for irrigation system
SITE ADDRESS:
OWNERNAME:: 11c?-tl?-y ?vtJe? TELEPHONE6 `r-/"
(AREA CODE)
INSTALLER NAME: J TELEPHONE
(AI?EA CODE)
STREET ADDRESS: _ I 6 7Vv 21 ?
CITY:
STATE: ZIP:
?-?
_ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00
includes $40.00 County fee
Note: Additional consultant fees may apply
• MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
_ Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00
_ Abandonment of septic system.
_ Water tumamund - existing dwelling unit (+ 5/8" meter if needed -$118)
Other:
_ RPZ: new installation/repairlrebuild $ 30.00
_ lawn irrigation system
ReplacemenUadditional: `?water softener _ water heater $ 15.00
State Surcharge n ry?
II U 1 .50
I
)
rotal p AUG 2 0 200 _
g
I herebyacknowledge tliat I have read this applicatlon, state thatthe information is coved, and agre comp ??vith all appli E?yo -?rdinances. It
Is the appliranYs responsibility to notlfy the property owner that tFie City of Eagan assumes no lia ty for a amages ?the City during its normal
operetional and maintenance activities to the fadlities constructed under this permit within C' p rty t-gfavay/ ment.
NATURE OF PERMITTEEv 1I02
, -Date:08/22/2002
Installer ..: TONY
Install Date: 08/16/2002
Time ........ -
M
Client .....: SEARS
Order Number: 011321429998
Department..: 46
Customer.... : BUCK, GREGORY
Address..... : 4876 RICHARD LN
City........ : EAGAN, MN 55122-
Phone....... : (651)452-8742 Work Phone
Item:
WATER TREATMENT Naw Installation - Softener
WATER TREATMENT Permits
Special Instructions:
ONIT AT HOUSE
Amount Received :
Comments ........
Pick up at:
NOTICE TO CUSTOMER:
Do not siqn this statement until the installation is satisfactorily completed.
The installation of the above has been completed satisfactorily.
011321424998
SALES CHECK NUMSER
CUSTOMER SIGNATURE
INSTALLER NOTE: Return this form with your invoice.
I have inspected merchandise and found no damage. (X)
I have inspected my home and £ound no damage. (X)
I have checked a11 water lines and found no leaks. (X)
Customer Siqnature
Appliance Installers of MN
I
. a
1985 BUILDING PERNIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTHACTORS NOST HE LICENSED IiITH 'fHE CITY OF EAGAN
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
?' r eZ. cY?o. °-
To Be Used For: 1I / Valuation: Za,-eeo Date• F-7-Fs
Site Address: 7 G.y? OFFICE USE ONLY
Lot: 1 v Block ? Sect/Sub iErect • X Occupancy ?-3
Remodel 'F Zoning t
Parcel U Repair _ Type of Const -?
Addition fl of Stories
Owner Move , Length (D?
Demolish Depth 44-
Address Int.Impr. Sq Ft
City/Zip Code
Phone
Contractor yer (_,,z",r S/
Address _ ?(pC/ W 4
City/ZSp Code La 2w , {?„?,
? .?_.__?..?.. .?
Phone 'T?2"3 0 50
Arch./Engr.
Address
City/2ip Code
Install
9PPROVALS FEES
Assessments
Permit ?
Water/Sewer _ Surcharge
Police plan Review I8q :Lo
Fire SAC ty. 02
Engr Water Conn 50010?
Planner Water Meter `°
Council Road Unit Z20,°=
Bldg Off - . reatment P1 =
APC Parks
Variance Copies
TOTAL a )= Q
Phone #
?
? 2 Y? Z? - f C?12 ? S Q- =?Y ? CD g .
4 _< 1
2? I4 ? 2g x 4( -( ? 4?
2.2,? ?3 P Z?? x S?" (5444
22 x z4 ? S zg x?( = S??
8 1 -?(06
, • • CertiPXcate far:
' Huttner Conabruction
960 WaterPord Dr. weat
F,agan, Mn. 55122
DELMAR W. SCHWANZ
1AN0.^+11RVi tNC
RM91PrM Untlw lM nl Tne SItlP n/ MinnPBnla
, 117$p 9pNTM 406p7 TRAN. RQ88YOUNT. M1MNE80TA 55068 P110NE !tY 123-1769
- SURVEral1'S CHRTIRICATE
d ?
t0 Qq1°? ??b
J? ? ??.Q.'?
44g-
?
, zr
t a
'?°"> „?o? , •.?. h
.,n,"a" ?
N?
/,0191,10
?
/V
_ % !
Drainage ?
and utility ?
easement
?
I
4,
'`,?
1?`
I
?
. T..??-.24 _ 09?
Proposed garase P}oor elevatlah . U . ,
?J
0
N
?
?
?
h
SCALE:
1 inch - 30 Peet
p Tlevations ahown
0 are exiating
M
M
\
'N3.0
I i7ieTebg aert3Py that this 1?S s??te and correct repreeentation of
I,ot.10, Blnck I, HILIGR?T, aa+s+Od3ng to the recorded plat thereof,
Da3rota Cour?ty, Mlnnesota.
Alao shcwlsg the loaation of a 10opased house as ataked thereon.
Datied: Aiaguet 6, 1985
I
:. .
' j
(Fom Dcvcloped by the StaLC of Hinncsota Luilding Codc 171clsio11)
TO EE SU34ITTED L7I2R BUILDIIIC PL•RMIT AS'PLICATI0:1
EXTEP.IOR E;IVF.LOPE AVERACE "U" CO:tF'UiA'IION
OS,'9ER:
sira nnnxESS: r,r d L?
CONTRACfOR: LU ? h`til7NatY (?o?t ? DATE: p- 7- 85 PIIONE: -?(SZ-3o oT
1.
-\2.
S.
_• , Determina vorking aquare tootage of each
j
Total exposed wall area......... sq.ft. s%?'?. t-
Total roof/ceiling area........... /`/oG eq?ft• x'
Total exposed taall area calculationa: :
total exposed wall area above floor
a. Total wall window•area .............. ............
....??•
b:?- Total door area........................
....:.........
e. Total sliding glasa door area..:.......... ............. LOd. Total fireplace wall area........... ................ -- '
' e. Total vaLl framing area (averagelOZ) ...............
. f+ Total net s?all area above floor ................... ..?
g. Total riai joist area....:..........................: !z& '
? • Total expoaed foundatioa area + . /`{Y
b. Total foundation window area.............. ........... 3
i: Tatal net foundation asea.above grade...............1/? Determine "B" value of each wall segment
?. . . .
' a. 1 L? ` x nD..
' b. 39 . R
• c. ?'? . x u?. ,_55" ? .y?l ao
d. -'-- x Stn„
. e. %4o X $lull
f. 11 4 g x „u„
x glUts ; n-4
. '. h• ' 3... r x IIUh? J?a ?r f60.. . .
i. X 'lUll ,10 se 13;90
3.
•
Torni.':, . ? / , y
It item 03 is the sama as, or less than item 91, you havo mci the intent of
.
" 4. Total exposed' roof/cciling ealculations:
Total e:tposed roof/ceiling area
j.-Tatal skylight area ................................... ^
k.'Total roof/ceiling fruming area (averap,e 107.)......... '/'qp
1. ToCal net fnsulated roof/eeiling area..... :........... /L'G 6,
Determine "U" value for each roof/ceiling segaent
? • .,.. .. . . X nvu
.
x,ou.l
x I.Uff ,'oy . zS,3Z
.
?
4. ;Torta. -. Z8, I t
If total of C4 is the.same as, ot•less than 02. you have aet the intcnt
of SSC'6006(c)1.. '
? Alternate Hailding Envelope Design.
. ti?l:, . ' .. . . • - . . .
To utilize the total envelape system method, the values establislied by •
the sum of items 03 and 04 shall not be greater than the sum of items 41 .
aad 02. • .
, 1? • + 2. ?
3. + 4. ?
. .
:
_ C E R'f I F I C A T I O N
I hereby eerttfq that I have calculated the "U" factors and R values
heteia and that the building hera described meeta o= exeeeds the SCata oF
Hinnesoia Energy Coaservation Ace. ? ? ??,.? ? • `;??
? (sisriawre).
• ? 7, V-0"
. ? (Aate) .
7;+r .
.
?.
FRT.t:E h•ALL
Construction R-Valuc
?h" +7t7 :..Ait .-F? •
1, Tnterior air film 0.6f1
2.
3, ? nches soft wond
i
' 1) t:1
4?. ?'=ai 2 ?.=%.?,?? il • ? D!o
s. 5, ??;?U ' I.csS
6. Exterior air film = 0.17
TCSCal t?,° 13 Zct
l,L'. 1„? LL , . U= O 7
Vz"
1. InCcrior air filrr ' 0.68,
z. k?` o
f
3. `
a_,' 1 .
.,
4
. ?
5
. St Dln (s_ I . a5
6. ExCerior air filn O
.13.
?
2'otal I"Z
Z?M .
? • .
1. -I tcriar .:i.r film ' 0.63.
2. `? " ?A1 1 R. U p
3. ' 1 L?" SOF1(,v0019
9. ?'/1L 6'-1r':-47ia '(10jn
5. ?,1 k?? ?(Z .0 5
6. Exterinr air film 0.17
. Total
1. Interior air film 0.68
2.
• 3. I Z"
. a,
5.
' G. ExL-erior air film 0.17
'!'ota]- =f. 6 ;
sr.ns o:a crauQ
?IG. 93
.
, • n . ? ,IS •
• •• ? • :
P' •. . ,? , ?' ? .
' . .• ? : . ,. .
f??r ?? :[ ? ,• ? ..
?? ?l? ? " • ? . • • ??i i, ??
?rr ?- . . • ' •
?!t " ? ' • • ' ? ilr =
-
./[I ? . ' . .. . . ..= ??l
• /?/
FIG. 94 ?!1 k .d• •, o Y/
• (cr?J? = Irr =.j /ir ?
NOTGs thdicatr_ Cyno, "r" Valuq, dapth and
placenent of insulattoa. .
1:07`E~Usc l0':. of ti•a11 arca for
, fr.:amc constructiun •
"R001'/CEILTt7G ? . ?
? .
. ,
? :..,?.
. %; ?
ante3
z
t<
D r:
L'cac i•luw
uP
FIG. ?S ?
I lieat flow up
„FIC. $G' .
Constr.uction R-Valtte
1. Intcrior ai.r film 0.61
z. ? +?ALL. - I =!
3. IP.` IiJiVL. 16.GU
4. Txtcrior nir film (still) , O.t,I
?rotal
? : • U7r,at
, .
• ???..
l?l?/?" IIww..r !NS•,i?. 36; o
2. Int•crior air film 0•E2
2.
s. T.h.•• 4?rL-udO
q. £r.terior air film sY.iI3) LTf
' Total
. .J -7J
1, incide air_film _ 0.61
2.
3.
4.
5. Outsidee air film .0.17
Total
Note: U::e .,aaitiol,3i ::hects if more sFare i
nceded for.detsils and cnlculut•ion..
? • ?'
? .vencea
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CITY OF EAGAN
APPLICATION FOR PEtZLMIT
SEWER AND/OR WATER CONNECTIODI
1) PROPE.R?'Y ApDRp,SS:
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PDDRESS:
CITY, S'IAT'E, ZIP:
PHONE:
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ADDRESS:
CITY. STATE, ZIP:
PMNE:
FOR CITY USE O,yLY
PLUHBERS itSE:
Attive
Expir
Q of Record
,ce
.+i uvulu'?i?; WHICH PERAIIT IS BEING RF7QUES'I'Lp:
[3 CO.1NF'.CTIODI TO CIT1' SEVIER
aCONNDC.TZCN 'IC) CZTY S9ATER -
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7) SIGaTL-RE:
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Q. PIFiaSE_.TAIL APPROVm PMtIT TJ 1,M 3, 4 ABOVE?
(Circle one) '
DATE:
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F 0 R C I T Y U S E
PE4:+1IT '-` ISSUED
F°ES: $ A t 0
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WATEit: PERS4IT (Ir1CL`uDE SuRCHARGn)
WATER METER/COPPEFfIORN/OUTSZDE REi,DE2
WATER TAP (INCLUDE CORPORATION STOP)
SEE:dER TAP
'ACCOUNT DEPOSIT - WATER
WAC
SP C
TRtiNK WATER ASSESS?+E::T
TRli:IK SEjvER a55ES5'-_ENT
LATEP.AL BE:IEFIT/,TRUDIK SE:-l=--R
LATERAL BENEFZT/TRUNK TVATER
WATER TREATMENT PLANT SURCHARGE
OTHER:
TOTAL
AFSOL':7T PAID/RECEI?T n ??/J
DOES UTILZTY CONNECTZON REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
YES IF YES, THEN A"PERMIT FOR WORK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
Q NO ENGINEERING DIVISION. LIST AS A CONDI-
TION.
SUBJECT TO TAE FOLLOS9ING CONDITIONS:
APPROVED BY:
TI':LE:
G/
DATE: 1 / S 1r
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1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
ew Construction Reaulremenis
> 3 registered sHe surveys showing sq. R, of IoT, sq. X. o( house
and II roofed areas (207, maximum lot coveraae allowedl
> 2 coples of plans (show beam 8 wlndow slzes; poured ind. design; eic.)
: 7 sM of energy calculations
> 3 copies of hee presenallon plan H IW plaNed affer 7/1/93
DATE: J_".3 -q /
Remodel/Repalr Reauirements
2 copies of plan
7 set of energy calculatfons for heated addifions
1 sNe survey for exterior addBions 8 decks
?
cosr: `737C,,2
DESCRIPTION OF WORK: '7'K?imOJa IA,-'
STREETADDRE55: ?j J
LOT: -L-D BLOCK: 1 SUBD./P.I.D. #: I-VI
Name: ?ezo Lla ^jj Phone#: CoSI 4,$7-gq7V
PROPERTY Lan First
OWNER f?7? ?/-/ /
Sfreet Address: `? _ C?Gcz'=? C/..1
City C-?SG^j State: I"Y Zip: S? ',/2 Z
Company: ??-??e • LO C/5 Phone #: GP/ Z qq 7• Z 2-7 Cp
(area code)
CONTRACTOR \
StreetAddress:? 955 /?Ca?' Sl" W License# ZUlqz?s Exp.Z•31 ZCCO
City 2F:f :'1e- State: 127N Zip: J`~sI &`
ARCHITECT/
ENGINEER Company: Name:
Telephone #: area code ( )
Street Address: Registration #:
C(ty State: Zip:
Sewer & water Iicensed plumber (reauired for new construcHon onlv):
Penalty applies when address change and lot change Is requested once permit is issued.
I hereby acknowledge thaf I have read thts applica}lon, state that the Informafion is conect, and agree to comply with all applicable
State of Minnesota Statutes and Clty of Eagan Ordinances.
Slgnafure of
Certificates of Survey Received _ Yes
OFFICE USE ONLY
_ No
?I MAY ni
?
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 Apartmenis ? 19 Lower Level ? 24 Storm Damage
? 05 3-piex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? . 33 Alteration ? 37 Demolish Bidg.` ? 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
Booster 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
SNV Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
Valuation:
% SAC
L ? O BL I CITY USE ONLY
sueD. i I ? C YP,?
RECEIPT #:
RECEIPTDATE:_ 10-2-3-00
PERMIT# ?
2000 PLUNlBING PERMIT (RESIDENTIAL)
CITY OE EAGAN
3830 PILOT KNOH RD
EAGAN, MN 55122
651-681-6675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIXTIJRES
EACH /f
TOTAL
Alterations to existing dwelling - minimum fee
Describe: $ 30.00
Sath tub $ 3.00 x = $
Floordrain 3.00 x = $
Gas pipin outlet ' minimum - t 3.00 x = $
Hot tub/spa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tray 3.00 x = $
Lavatory 3.00 x = $
Septic System newJrefurbished • requires MPC lic. 75.00 x = $
Septic System abandonment 30.00 x = $
RPZ new instauationlrepaidrebuild 30.00 x = $
Rough opening 1.50 x
Shower 3.00 x = $
Underground sprinkler if dwelling is under construction 3.00 x = $
Underground sprinkler rf existing dwelling 30.00 x = $
Water doset 3.00 x = $
Water heater 3.00 x $
Water softener If dwelling under eonstruction 5.00 x = $
Water softener if existing dwelling 30.00 X = $
Watertumaround 30.00 x -- = $
State Surcharge 50 --> --> --> $ .50
Total --> --> -> ----> $
Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc.
-
----------••--------- -- ------ •--------- ---- •-- • •-----------•-•-- ----- ----- ..-------------•----------?-•--
-
-
- .
-nces-
-
- Aity of Eagan oNina-
- is - wrc - eG, - and agree - to - compty . with - all - applicable -
- application - , s - Wte - that - tbe - intormation -
I hereby adcnuwledge that I -have- read - this -
It is the appliwnPs responsibility ta notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during Rs
nortnal operational and maintenance adivities to the facilities construded under this parmit within Ciry propertylright-of-way/easement.
SITE ADDRESS: `i'?S No K-ECrNAJP-D L41-)kr'D'51?
OWNERNAME::Glezo 6L!-C-K. TELEPHONE#:Llsl?
- (AREA CODE) . . . . .
INSTALLER NAME: { / ll? • ??> l .P- TELEPHONE
. . . L , n ? (AREA CODE) ' . .
STREET ADDRESS: A/n PI.IS ?< <.c-r i?
_ •_? ' ZI P.?
3 2000
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA118925
Date Issued:11/12/2013
Permit Category:ePermit
Site Address: 4876 Richard Lane
Lot:10 Block: 1 Addition: Hillcrest
PID:10-32975-01-100
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Arnold Lawson
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Gregory A Buck
4876 Richard Lane
Eagan MN 55122
(763) 444-0405
Northern Hideaway Homes Inc
2472 Bridgewater Place SE
Cambridge MN 55008
(763) 286-9870
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA170090
Date Issued:06/18/2021
Permit Category:ePermit
Site Address: 4876 Richard Lane
Lot:10 Block: 1 Addition: Hillcrest
PID:10-32975-01-100
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 -
Patricia Bradash-buck
4876 Richard Ln
Eagan MN 55122
(612) 849-0958
Warner Stellian Co Inc
550 Atwater Circle
St Paul MN 55103
(651) 222-0011
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA175590
Date Issued:04/08/2022
Permit Category:ePermit
Site Address: 4876 Richard Lane
Lot:10 Block: 1 Addition: Hillcrest
PID:10-32975-01-100
Use:
Description:
Sub Type:Fixtures
Work Type:Alteration
Description:Multiple
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.
All tiled shower bases require a water test.
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 -
Patricia Bradash-buck
4876 Richard Ln
Eagan MN 55122
Preferred Plumbing Inc
6400 High Point Trail
Prior Lake MN 55372
(952) 447-5761
Applicant/Permitee: Signature Issued By: Signature