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4879 Richard Lane*. City of Eagan Date: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 JUL Flu Use BLUE or BLACK Ink I For Office Use Permit #: sS 7 Permit Fee:! ate Received: I Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION CA 6 , Site Address: Unit #: �✓ RESIDENT OWNER , Name: e+ /4. VI:r 124&4't e...Z. r ? Phone: (3) 6-Y-7. 9 Y/.J� Address /City /Zip: y ..../...4...0...-e__ ,r-/�� L%// 2 Applicant is: Owner L Contractor TYPE OF WORK r r / / r Description of work: ,r/ ✓�c,�, � 9 S.71) -/-0e v er/ Construction Cost: _ Multi -Family Building: (Yes / No v CONTRACTOR Company: eA,,, it/ /0,,, (. i.i tir jjn Contact:�h cc Address: /Jc)`f /.S 74)f �a City: /444.5 -41/r// -E'' State: Zip: 5,70‘ Phone: 9 �2 V„.2.5�- l-' 67T (.4,--/7 y/ 9 ^/6 ,5' License #: 06? 6S 7 2_ Lead Certificate #: /U// If the project is exempt J/ r from lead certification, please explain why: (see Page 3 for additional information) ��; /a//�r�/.6 2d4t tv�eet hese M-1 5 iz'N ,6%,;:i J24.�/r /e rr �� ^fir In the last 12 months, No 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: _Yes 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 classified 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.gopherstateonecall.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 plan . x Applicant's Printed Name Applicant's Signature Page 1 of 3 L) DO NOT WRITE BELOW THIS LINE tOCXE 57 SUB TYPES Foundation Single Family Multi 01 of _ Plex Accessory Building WORK TYPES New pf Addition Alteration Replace Retaining Wall Fireplace Garage j' Deck Lower Level Porch (3 -Season) — Porch (4 -Season) Interior Improvement Move Building Fire Repair Repair DESCRIPTION Valuation 134119 Plan Review (25%100%_Zr Census Code # of Units # of Buildings Type of Construction x/ 2.05 REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: _Ice & Water _Final Framing Fireplace: _Rough In Insulation Sheathing Sheetrock Reviewed By: RESIDENTIAL FE Air Test Porch (Screen/Gazebo/Pergola) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width Final Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL 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 PCA handout to applicant 14,? R-1 5-39 MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers mama_. 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 _ Radon Control Erosion Control , Building Inspector Final Brick 539 al& rily0 Final ?DV - Page Page 2 of 3 4 •_ JUL 2 8 21 dagi DELMAR H. SCHWANZ LAND SURVEYOR% 1 Registered Under Laws of The State Of Minnesota 2978 - 146TH STREET W. - BOX M ROSEMOUNT, MINNESOTA 55008 PHONE 612 42314709 SURVEYOR'S CERTIFICATE 9,'t9,1114 cr. '4% v g cd 0) ' vtg4 /,/c0,9/11 DATfl: 0 so El f2 0 c4 43 cd c) 0 4.) ta tb CO **4 • r-1 ..td $4 0 CD 0'4) 0 0 H ▪ cv cri 0 0% 0)('J 6)0 cd t4 r1 0 o 4: 0 .0 r -I 9, EAGAN My/ IL 7-- A?•• - DING N—,t--.CTIONS DIVISION /147Zt MINNESOTA REGISTRATION NO.8625 ? CASH RECEIPT t ? CITY OF EAGAN P. 0. BOX 21-199 EAGAN, MINNESOTA 55121 DATE ? 19 ReceIvcn J'--? FROM AMOUNT Is I, ` & DOLLARS I oo ? CASH CHECK r- FOR ?? '? • \ ?,j r? ?-- ? J __ { !LC /,-) ?JL "- / //. O As t . _ '4- FUND CODE AMDUNT (' ri -2 4/o] J yc 01.07 _i ? r; :, •? •_,- i .1 ? ' , ?_. b? /OC y ,, O O o ?'' rR--U Than u . s,r _ . z ? YVhite-Payers CoPy Yellow-Posting Copy Pink-File Copy , r BUILDING PERMIT Ts V rmed fet ..:1' ' CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E : 454-8100 50,000 N°' 894 r Receipt # ??? ? ? f%-_ APRIL 6 ,,, 84 site Address 4879 R ICHIIRD LN. Erect a =3 ?cu?? 1 HILLC ?ES'' Lot Block Sec/Sub. Alter ? Zonin9 Parcel No. 10- 3 i'. 9 7;-1 2U- C 1 Repatr ? Fire Zona N Enlarpe ? Type of Corut. V W Name '•• : U'I"l'(\i:fi COi•iS`I`. Move ? * Srories ? Address 9 6 0 ,,1R'1 i; f-z k ORD DR.W. pemolish ? Length 4 - City j' AGF'r' Phone 4 5 2- 3 0 ti 3 Grode ? TT1 sq• Ft. Depth ? S t 1i., T: Approvals Fees Zo Name O Address Assesunenf ? ? Permit ? u? City Phone Water & Sew. Surchorge '-' '??Q 1 a 50 Police . Plan check W Name Firo SAC 525.00 P _? Address Enp. Water Conn. 4 7 0. U 0 u ? W City Phone plan?r Woter Meter 03.00 Council Road Unit 260.00 I hereby acknowledge that I hove read this appiicution ond state that Bid . Off. the inlormnfion IS Correct and cgree to comply with nll op l itable $ ? ) • 50 Stota of Minnesoto Stotutes ond Gt? pf Eagan Ordio6n ^PC Tota) , i Sipncture of Permittee ; r. -?'T-Tr?TFn orlFT. A Bu{Iding Pertnif Is issued to: on tM ezprcss tondiHon thnt oll work sholl be done in acco?donce with oll oppliau of Minnesota Statutes orkd City of Eapon Ordi?wnces. Buildirp Offlciol Permit No. Permit Holdsr Misc. Parmit No. HoFder Plum6inp J H.V.A.C. y4j C? ? ? ?-b 7 w.u W?ter Disp. Sawer Elect.ic tiJoS3 D ?,• S??Z(? .S? Inspection Dats Insp. Other Footingt Foundation FreminQ Rou? Plbg. ?2 ? Rouph HVAC 4 ? 4Plbg. jd R Final HVAC Fi nal /W f L(J? Water W?cribe Location: YVell ? Sewer Pr. Disp. Receipt ' 1O rl JIECHANICAL PERMIT Permit No. ` CITY OF EAGAN Fee Fil/ in numbered spaces S/C Type or Print legibJy Tot. 1. Date 2. Installation Cost 3. Job Address '. Lot Blk. ? Trect 4. Owner - ' Ph 5. Contractor one 6. Address 7. CitY State +- Zip 8. Building Type: Residential ? Commercial O Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 10. Describe r Fuel Type 11 No. Eauinment 8TU - M. Ea. Forced Air No. Equiament CFM Air Handlin : Mfg, g Boilers Mfg. Mech. Exhaust 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 Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 ? Receipt PWMBING PERMIT -Permit No. CITY OF EAGAN Fee , ?- Fill in numbered spaces S/C Type or Print /egibly Tot. . ate 2. Installation Cost 3. Job Address Lot Blk. Tract ?! . i'- , 4. Owner 5. Contractor Phone ., ? 6. Address 7. City State Zip 8. Building Type: Residential 0 Commercial ? Institutional ? 9. Work Description: New 12 Add ? Alter ? Repair ? 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner Shower Well ; Kitchen Sink l3rinal/8idet Other ' Laundry Tray Floor Drains Drinking Ftn. SIoP Sink Gas Piping putlets 12. I hereby certify that the above information is true and correct, and 1 agree to comply with all ordinances and codes governing this type of work. Signed : - ' for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt r PLUMBING PERMIT Permit No. ? CITY OF EAGAN ( ' D 7 Fee !? 7 Fill in numbered spaces S/C Type or Print legibly Tot. ?- 1. Date ? 2. Installation Cost ? 3. Job Address ?l Lo?Blk. ?,L1T Tract/-/' 4. Owner _L2Z? ? 5. Contractor d:? /,-, Phone 6. Address _ ' e-7 " j k` 7. City State Zip 8. Building Type: Residential ? Commercial O Institutional ? 9. Work Description: New ? Add 0 Alte,? Repair ? 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield 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. 5igned : Hough Inspections: Date Insp. for Final Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 CITY OF EAGAN Remarksi --' ? Addition HLLCRESZ' IIDDITIbN Lot 12 aik i Parcel +10,52975-12-??k3 owner street 4879 RICHARD [.IWE siate EIIG/W MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. S 1985 2450.15 490.03 2450.15 C00 20 10-18-84 STREET RESTOR. GRADING SAN SEW TRUNK 1976 183.08 12.2 1 Zs 73-28 A 014266 7117184 *SEWERLATERAL 1985 4361.74 872.35 5 4361.74 C00 820 0-18- 4 WATERMAIN ATER LATERAL 1985 WATER AREA ip 19.62 2 *Services 1985 STORM SEW TRK 5 1984 804.56 160.91 5 'tiSTORM SEW LAT 1985 CURB & GUTTER SIDEWALK STREET LIGHT ROAD UNIT 260.00 #42387 4-6-84 WATER CONN, 470.00 i' 11 BUILDING PER. 8945 s,ac 525.0 PARK CITY OF EAGAN SEyVER SERVICE PERMR 3830 Pilot Knob Road P. O. Box 21199 PERMIT NO.: Eagan, MN 55VI pATE; Zoni I`1 ?? Na. of Untts: .r?? u ner ons - Owner. /lddress: Site Address: 4679 Richaris Lane L12 b c.reet Plumber: ar PIFp 4-6-84 423>' . , Ioe+. eo .ewpy wNU Nu CNy .i fq.. Cor,nwcrton O,arQs: 425.00 pcI Ordl..sea. Accaxit Depodt: 5.00 pd Pennit Fee: 10.00 pd Suniwrpe: • 50 pd BY Misc. CharpeR Dote of Irop.: Totol: CITY OF EAGAN 3830 Pilot Knob Road P. O. Box 21199 Eagan, MN 55121 Zoniny: ? .! pM,ner_ FhI. f,uttner Con.1 Addross: Site Addmss 4879 Richarda Lr Plumber: Star Plbe Meter No.. Stze! Reoder No.; 1aynse ro canolp wqb 1iN Cify ei Faqan Ordinanees. By Date of Insp.: Connection Charpe: 4 I U. UO pd Aooount Deposit: 15. 00 pd Permit Fee: 10.00 pd Surchcrge: .50 pd Mlac. Cha?yes: meter Totnl: Date Poid: CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knr,b Road P. O. Box 21199 PERMIT NO.: Eegan, MN 55121 DATE: Zoninp: j' l No. of Units: 1 ayner. WTf't Ihl COI15 t fE53: ? S ite Mdress• Z?ek??,?:l?crw L 12 L l t' i 1 1_ ,- r e s t ,?Plumber: ?teter No.• otl?tion Charye: 47?.00 r;il Siu: r P AomLy,t Depcsrt: 15. 00 pd Reoder No.: I??irh't Fee: 10. Ol? Dd 1 pm te aomPly wilh !iw Ciryr ei Ee"¦ Surcharpe: .50 pd Misc. Chorpes: 63.00 p dr, :. ;er Totol: By Paid: Dote of Insp.: 4-11 Insp.: WATER SERVICE PERMIT PERMIT NO.: DATE: :'S F.4 No, of Units: _ CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121 PHONE: 461-8100 BUILDING PERMIT N° 8945 Recelpt # 4" -7 Te M wed For SF DWG/GAR Esr. Volue $ 50,000 pOfe APRIL 6 1 q 84 SiteAddress 4879 RICHARD LN. Erect a Occuponcy ? R3 Lot 12 elock 1 Sec/Sub, HILLCREST Alter p Zoninq Rl ParcelNo. 10-32975-120-01 Repolr ? FireZone N A E I T t C a V Name WM. HUTTNER CONST. Address 9 60 WATERFORD DR. W. City EAGAN phone 452-3088 ? Neme _ su Address r City - Name Address City _ SAME Phone Phone n orge ? ype o nst. Move ? * Stories Demolish ? Length 4 7 6mde ? Depth 4 6 Sq. Ft.- Approvala Feea Assessment _ Woter & $ew. Police - Fire Eng. Planner - Councii _ 1 hereby acknowledge that I hove read this opplication and state that BId9. Off. the inlormalion is correct and n9 e to wmply with II ap licoble - State of Minnesota $tatutes di f Eagon }d' ??an APC c°? Sipnature of Permittee WM TTNER CONST Perrnit +S 283.00 Surcharge 2 5. 00 Plan check 141. 50 snc 525.00 Water Conn. 470 . 00 Water Meler _63 00 Road Unit 260-00 7oeal $1,767.50 A Building Permit Is issued ta: ?,? • HU • on the express cordition thnt oll wark sholl be done in acco{aar/cq with, nll p?g?fonblo-State of Minnewfo Sfalutes ond City af Eogon Ordinancea. Buildinp Officfal ?ne.?' ?a?c. Sa.r?e. as . ?.y / ?S ? ?P?a'lioas - ?? ? '?? L,? A?!/e?j??? ?xN. , • f?e 'n?HTY oF EacAN Include 2 sets of plans, / ??%ot?/o?IQ?' Certificate ofo:Survey & P"0 "SP e"' i gUILpING PERMST APPLICATION .l set o.`_ energy cal.culations. 'Ib Be TTSed For Site Pddress: `fe7y KiC?a? Lot / 2- Block Sec./Sub. Parcel #: ? n- 3 a9 7 5 Owner: Pddress: City/Zip Code: Phone #: ? Valuation Date -/7" 3 -? ?..k OFFICE USE ONLY Contractor: 61 44 #' Pilr eCw?ll Address: 96 o G(l? rd . Dr< o. City/ZiP Code: E.d? SS 12 Z Phone #: qSL -30rr Arch./Fng.. Adclress: Gity/Zip Cocle: Erect ? Occupancy Alter Zoning Repair Fire Zone .?I Enlarge Type of Const. Nbve # Stories Demolish Front ft. Grade Depth ?v-ft. APPRDUALS F'EE6 _ ¢3 Assessments Pexinit 8L Water/Sewer Surchame Police Plan Check / Fire SAC sc Eng, water Conn. y; Planner Water Meter ? Council gy Road Unit 5;?4 Bldg. Off. P.PC nYi'AL ?? 7 l 7 /S7) - ? v 1yIq S REQUEST FOR ELECTRICAL INSPECTION EB-00001.04 ' See instruetions for completinq this torm on back ot Vellaw coa.,. g? zzr? ?y ?? j , '"X1 " Be???o??red by This Request ov4 Add Nap. Type ol Builtling APOliances Wired Equipment Wiri Home Ronge Temporary Service Duplex Water Heater Lightiny F(xtures Apt. Building Dryer Electric Heatin Commercial Bldg. Furnace Sito Unloader Industrial 81dg. Air Conditinner Bulk Milk Tank Farm omer oer,i v 1ne:, lsned(vl L 9! pCCI(y QLhCf 01F1Cf omUUte lnspection Fee Se/ow M Fee ServlcaEntreneeSize p Fee Featlars/5ubfneders # Fee Circvits I 0 to 200 qm s 0 to 30 Am s 4 0 to 30 Am s Above 200 qmps 31 to 100 qmps / 31 to 100 A s Swimming Pool Above 100_Amps Above 700_Amps Transformers Irrigation Booms Partia6`Other Fee Signs Speciallnspection S 3 TO Remarks 8.a, ? ? Roueh-in '- j , th rical I Inspactoq hereby Final D? / 7/?made.?tion,hesbeen. I Thla reuueat vold 18 monlhs irom Thisraqueslvoid y3y59 10mo nths w tm IA! 0$3225 ua- 6 5lzz-ISy 3? .5 0 Request Date Fire N7 kouBh-in InsOec[ion epu etl? ?Ready Nu ?Will Notifv InsPec- S? s ?NO ?or When Ready C3 Licensetl Elecuical Contrector I herebY request insoection oi ebova ? Owner elactricel work inslelled at: ? Sireet Address, Box or Roqte No. L CitY E a??. 7 /??cf?a'd , std- ac ion o. Township Name or Nn. R,,nBc o. unty Co 1 H G // •T Occvpa t IP I R N T) ' Phone No. ` / {? . _ s.C • / h4 ? Power SupDlier ? ??• _ 'G Address EI cvical Convactor (COm any Name) Comractor's License No. ling Address ICOntra tor or Owner Makinp Ins ilatlonl C.?0e7 Making Install io Authoriz Signatur I Phone Number ? Gv-G t MINNESOTA STATE BOARD OF ELECTHICITY THIS INSPECTION HEQUEST WILL NOT Gri98a-MidweV Blde. - poom N•791 BE ACCEPTEO BV THE STATE BOAHD 1821 Vniversity Ava.. St. Peul, MN 55104 UNLESS PNOPEH INSPECTION FEE IS PAnna IB'121291.2111 ENCLOSED. t r?? RESIDENTIAL BUILDING ?d?/? Z PermitApplicatiou City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 fI??q:i S ?y nLe•?, /b/Z?Jps New ConsWctiai ReouiremenCS RemotleVReoair Requirements Office Use Oniv 3 registered site surveys showing sq. R af bt, sq. ft of Irouse; and all raofed areas 2 copies of plan CeR of Survey Recd _ Y _ N (200h maximum bt coverage allaxed) 7 set af Eneigy Calculations (or hpated additions Tree Pres Plan Recd _ Y _ N 2 copies o( plan showing beam & wirMow sizes; paured found design, etc. 7 site survey for additions & decks Tree Pres Reqd Y N lsetofEnergyCalalatlons Addition-indicafei/on•sitesepGcsysfem OnsdeSepdcSystem _Y _N 3 copies af Tree PreservaUan Plan if IM platted after 7l1193 Rim Joist Defail Options ulecWn shcet (bidgs with 3 or less unBs Da[e LfL l/S l 03 Construction Cost Site Address a 4/ Unit/Ste # DescriptlonofWork '4d'Q,'2,L ;.., 7v rr fi?A v/?G- wwr ir?ry I , 61 Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 1 _ 2 Property Owner J, oC d- I uuH n ? fr ? r? h Telephone #. ( 6J-/ ) 6,y1 - 97 7? ? Contractor cJC v h Address //0 ?4 /S ,7- ?1 J-/, ? City State Zip S 5 70 6 Telephone # (qSZ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Cqde Ca[egory , Residen6al Ventitatlon Category 1 Worksheet • New Energy Code Worksheet (4 submission type) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously consiructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber ----- - -• - Tele hone #( Mechanical Contractor Telep'hlbne # ( 1. 3 cD03 I Sewer/Water Contractor ? Telephone #? IF I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ardinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name Applicant's Signature OFFICE U5E ONLY Sub Types .- 1 o ? Ot Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 AccessoryBldg K 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multl ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4- sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screeNgazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Yor _N ? 25 Miscellaneous Wo rkTypes 1?L1ti? Awr-a ?'?G}y")"L`til ?yIlbl ?r?..v,-q-i& .tlV77rY?, ? 31 N ?ZL? ? ew ? 35 Int Improvement ? 38 Demolish (Interior) l1 ? 44 Siding ? 32 Addition O 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair /K 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors ? 34 ReplaCement 'Demolition (Entire Bldg) - G ive PCA handout to applicant Valuation ?C7 Census Code 14 -1' SAC Units Nbr. of Units Nbr. of Bldgs Type of Const VK/ _ Occupancy MC/ES System Zoning City Water Stories Booster Pump Sq. Ft. PRV Length Fire Sprinklered Width _ Footings (new bldg) Footings (deck) ? Footings(addirion) 7Y Foundarion Drain TIle Roof Ice & Water Final X Framing X Fireplace ?C R.I. :? Air Test -?S, Final ? Insulation REQUIRED INSPECTIONS FinallC.O. FinaUNo C.O. _ Plumbing _ HVAC Other _ Pool Ftgs Air/Gas Tests _ Final _ Siding Stucco Stone _ Windows (new/replacement) _ Retaining Wall Approved By T Z , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge 5&W Permit 8 Surcharge Treatment Plant l.icense Search Copies Other Total fjv? QkJ - ? rI.vLy°iAe,?vhF'"r' ?JU?S?L / ? vcra ?( lS" = l 9j5?Oc7 X sy? 7a, ??? YW A-kl-l J c ? ?L) MNcheck COMPLIANCE REPORT Minnesota Energy Code MNcheck Software Version 3.0 i i i ? Permit # " I I _I I Checked by/Date I COUNTY: Dakota STATE: Minnesota ZONE: 2 CONSTRUCTION TYPE: Single Family DATE: 10-14-2003 DATE OF PLANS: 8/28/03 TITLE: CONTRACTOR PROJECT INFORMATION: APPROX. 1,300 SQ. FT. ADDITION TO EXISTING HOME WITH UNFINISHED WALK OOUT LOWER LEVEL, INCLUDING APPROX. 330 SQ. FT. OF ADDITION TO EXISTING GARAGE AND CONVERSION OF EXISTING KITCHEN & LIVING ROOM TO A MASTER BEDROOM/BATH. PROJECT ALSO INCLUDES REPLACEMENT OF EXISTING HOUSE WINDOWS. JOB LOCATION: 4879 RICHARD LANE EAGAN, MN (LOT 12 BLOCK 1, HILLCREST ADDITION) OWNERS: DAVID & SUSAN PETERSON COMPANY INFORMATION: CHAD MILLER CONSTRUCTION 1104 157TH. ST. E. BURNSVILLE, MN 55306 PH. (952) 435-4049 LIC.# 20044247 NOTES: ALL AREA NUMBER TOTALS INCLUDE EXISTING HOUSE AND NEW ADDITIONS COMPLIANCE: PASSES Required UA = 968 Your Home = 698 27.9% Better Than Code Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA CEILINGS: Raised Truss 2349 38.0 0.0 59 WALLS: Wood Frame, 16" O.C. 4791 19.0 4.0 244 BSMT: Conc. 9.0' hU8.5' bg/9.0' insul 628 10.0 0.0 38 GLAZING: Windows or poors, Above Grade 422 0.350 148 DOORS 28 0.350 10 SLAB FLOORS: Unheated, 40.0" insul. 289 10.0 199 HVAC EQUIPMENT: Furnace, 85.0 AFUE COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirerrl? of the Minnesota Energy Code. BuildedDesigner6&&ZL9 Date /o v 1 ? ?. L '~ 2/84 y I 1' CITY OF EAGAN APPLICATION FOR PEF2MIT SESdER AND/OR WATER CCNNECTIO.T (P ASE INTJ 1) PF.OPER'PY ADDRFSS: >,. r_FraI, DES=I'IC.I: ? 67' /„z V ' (Ir?t/Block/Subdivision or Tax Parcel I.D. NL=ber) lc EtI ;ST:?L'CP :2E, Drl 7-- 'E GF ORIGi :AL :=L.^,L`iG ZcSU?.`;C:: iS=: SLiGL:: cP-M.I:Y ' -?- -- --" . ? R-2 DUPLEY ('IiCO L'NITS) ? R-3 'ICistiNII-iCYJSE (TILFE""' + WITS) ( Wi I';'S) [I R?4 APAR=`:S/CC:IDCi°LIIUM ( CNZTSj ? CCYMME.T2CI;L/^2EfAII,1OFFT_CE p IINDos-L-RLAs ? IbISTI2L'PSO.V?L/GGV7EFL\fi= 2) AppLSG?NT PLEHSE PRINi) ? ? NFu?lE: .? ADDRESS: (.? CITY, STATF.', ZIP: ? - PHONE: 3) PjrxBER (P PRINi) FOR CITY USE ONLY NF4ME: ADDRESS: 0 ? T !O PLUN&ERS IICENSE: Attive CITY, STATE, ZIP: Qyn??-Ywe? C] Expired PHODIE: uSca y?yPL11MBER LICENSE It.232 2 Q Not of Record 1 arr nttla 4) OCCUPp17r/a'7NER tME: tYLtFJtYX1N1f ADDRFSS: CITY, STATE, ZIP: PHONE: 5) INpIGyTG WHICII PEPhLiT IS BEZ\G RDQUESTID: 19 CC:u"VECTZON 'ID CITY SE.TrIE.R E[ CC:I[VECrION TO CITY WATER ? di'f'.ER (PLG'1SE DESC2IBE) 6) C:z: 7) SI=4L.'RE: ? ? PLP.ISE F?OID APPT.2GIED pgt,11IT FOR PICi:-UP BY ONE OF ABMIE °LEaSE tifAIL APPROVD PER.titIT TC) 1, 2xL--V 4 ABGVE (Circle one) DATE: ?` ? MO M! OIil??A:OWM A!l?JE?s ON a! il?:r?'? 41 f? !! s??tt n F O R C I T Y U S E O N L Y PERMIT ° ISSUED I I rT`SC $` .. Q r'.;?J DrA\(T^+ T`i ?lrr. ?-- C:.:.vL $ /n . S- U WATER PERP4IT (INCLUDE SURC:?ARGr.) $ WATER METER/COPPERHORN/OUTSID° READE3 $ WATER TaP (INCLUDE CORPCRATIC:; STOP) $ SEWER T=_? $ ACCOUNT DEPOSIT - SEWER $ /S- d-d ACCOUNT DEPOSIT - WAT°_R $ ?7lG. i-D WAC $ sac $ TRUNF WAT°.°, ASSES52•?E:IT $ TRli:1K SEWER ASSESSMEVT $ LATERAL BENEFIT/TRUNK SEWER $ LATERAL BENEFIT/TRUNK S9ATER $ OTHER $ TOTAL , $ AMOUNT PAID/RECEIPT DOES UTILITY CONNECTION REQUIRE EXCi1VATION ZN PUBLIC RIGHT OF WAY? ? YES IF YES, THEN A"'PERMIT FOR WORK WITHZN PUBLIC ROADWAY" MUST BE ISSUED BY THE NO ENGZNEERING DIVISZON. LIST AS A CONDI- TION. SUIIJECT TO THE FOLL0:9ING CONDITIONS: APPROVED BY: c???. Q -- DATE : M+w-mww_ow w=sm skow ucm am Ww?w wtw wm RS-aa wwOaaMaawWrfONwcM V*WMasM wM ?. ItV OF 89-15Q0 3830 PILOT KNOB ROAD T 2 4 9 2 4 9 EAGAN. MINNESOTA 55122-1897 PHONE: (612) 454-8100 FAX:(612) 454-8363 Special Asaessmeat Search Datfl: November 14, 1989 RequeateQ By: Re: 10-32975-120-01 Lot 12, Block 1 Hillcrest Addition First Security Title VIC ELLISON Mvy« THOM0.5 EGM1 DAV1D K. GUSTAf50N PAMEL4 McCRFA THEODORE WACHIER CouncilMembars 7HOPMS HEDGES Cify Pdminishofor CUGENE VAN OVERBEKf CM C?? On the attached form is the City's response to your search request on the identified property. The information includes the original amount of the assessments and the payoff amounts of the assessments on the parcel. In addition, pending assessments are included for improvement projects that have been ordered to be installed by the City Council as they may affect this parcel. The levied and pending assessments may or may not reflect the complete assessment obligation based upon the parcel's current use or zoning. Certain parcels have not been assessed at the appropriate rate per their zoning/use. The City's policy is to review the assessment obligation of parcels at platting, replat- ting, rezoning, waiver of platting, and prior to the issuance of conditional and special use permits and certain building permits and in other unique situations. A condition of approval requires the parcel to assume its additional assessment obligations that have not previously been levied for existing public improvements. The City's Engineering Division can provide further clarification of this policy, if you desire. WAIVER/DIBCLAIMER: Neither the City of Eagan nor its employees guarantees the accuracy or completeness of the information provided which was required by the person or persons indicated. Nor does the City or its employees assume any liability for the correctness thereof. In consideration of receiving and using information on the attached form and for all other consideration of any nature whatsoever, any claim against the City or its employees rising therefrom is hereby expressly denied. Pending assessments cannot be paid until levied. Levied assessments can be paid to the CITY OF EAGAN. Very truly yours, SPECIAL ASSE5SMENTS Attachment THE LONE OAK TREE...THE SYMBOL OF STRENGTH AND GROWfH IN OUR COMMUNIN Equal Opportunity/Affirmative Action Employer SPELIAL FSSESSMEhIl' SEAhCH SLJMh9AF;Y AS OF; 11/14!1989 F'FlOF'F_RT Y]: U A5SESSMENT TYF'E 10-12975-120_01 **** CLOSEU ?*** S-fa # ASSG:SSt-1EPJ-t DESCRIPT. RFaTE TO"TAL ANN.F'kIN. PAYOFF 100=04 S(aN Sld l R 8. UC!OUI 163. Ct6 0.00 0.00 YEAR: 15 OF 15 Y'E•r`,RS 100668 W TF;-264 11.0000/ 294.33 U.O(i 0.0U YEAR: 04 0(= 15 vEIzF:S 100E65 S S'iR;:: 10.0000"! 804.56 C>.C>U U.Ui) YEAR: t;it:r Of 05 V'I"cAkS 100434 :_bJSBI_AT.??y ]0.50t00°f. 4361.74 0.00 0.00 YEAR: 00 OF 05 YEHRS 100935 ST ;?c 7 r]_ 5000°!. 2450. i5 0.00 0.00 YEAR: 00 7 l.lP 05 YEtiRS ------ sur•7is7Far:Y oF cLosEn e093,$s 0.00 0.00 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) cIrr oF eacaN 3830 PILOT KNOB RD - 55122 651-681-4875 New Cornfiuetlon Reaulrementa Remodel/Reoadr Reaulrementa > 3 reglatered Ate wrveys alwwinp t% ft d bf, a4 fl. Ot house ontl ga roofed areaa 12096 maxlmum bt coveraae allowed) ? 2 coples of plans (stww bedm 8 wintlow ahes; poured Ind. tlealgn; etc.) > 1 set ot energy calculaHons > 3 copies ol hee presenaHon plan B lot pialterJ aRer 7/I193 DATE: DESCRIPTION OF I STREET ADDRESS: LOT: /)- 4 14z5 ..?? 2 coples W plan i set of energy calcutoHOns for heated additlons 1 site wrvey tor exteda addlNana d tlecks CorisrRUCnoN Cosr: ? S-s' Sd - ? Name: V ?56y-? °-?a/e- Phone#: PROPERiY tast Flrst OWNER Street Addresa: ? 5-4-? City Siafe: ZiP: SELA ROOFINQ & REMOQELING, fNC: company: 41[K7 EXCELSIOR BLVD. Phone t: 9SZ ? z 3-?a ST. LOUIS PARK, MN 55416 (area code) Corrrw4CTOR iD soooio5o Street Address: ucense #/?D 'QO Exp. Cffy State: ARCHITECT/ ENGINEER Company: Name: Telephone tl: ( Shee1 Address: Re9istratio^ #: Cly State: Sewer/waterlicensed plumber (i} InsWllino sewer/watarl: Phone #: Zip: Zip: I hereby acknowledge ttwt I have read thfs applicatbn, state Nwt the infortnalion is cortect, and agree to comply wiM ap aPPUcable SfatF of Minnesoia SMlutea and City of Eagan Ordinancea Signalure of OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Yes No Yes _ No - Not Raquired 11 BLOCK: ? SUBD./P.I.D. #: Y71 II ('YP C7 OFFICE USE ONLY BUILDING PERMIT SUBTYPES ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.) ? 02 SF Dwelling ? 08 06-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 03 01 of plex ? 09 07-piex ? 18 Deck ? 23 Porch (screened) ? 04 _ 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage ? 05 03-plex ? 11 10-plex Plbg _Yar_N ? 25 Miscellaneous ? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bidg. WORK TYPE ? 31 New ? 36 Move Bldg. ? 43 Reroof ? 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding ? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair ? 34 Repair O 42 Demolish (Foundation) ? 46 Windows/Doors ` Give PCA handaut to applicant for demolition permit GENERAL INFORMATION SAC Code # of Stories SG. ft• No. of Units Length sq. ft. No. of Buildings Width Footprint sq. ft. Const. (Actual) Basement sq. ft. Census Code (Allowable) Main level sq. ft. MC/ES System UBC Occupancy sq. ft. City Water Zoning sq. ft. Booster Pump PRV Fire Sprinklered MISCELLANEQUS INSPECTIQNS ? Stucco/Stone APPROVALS Planning Building Engineering Variance ? 31 ExLAIt-Muw O 33 Ext. AR - SF ? 36 Mum Permit Fee Surcharge Plan Review License MC/E5 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: $ SAC Units % SAC PLiIMBING (RESIDENTIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 Please complete for: Single Family Dwellings Townhomes and Condos when pemvts aze required for each unit 1% ts"O . SV Date /I 1 .C3 l ?(, 3 Site Address V$79 Unit # -? ? Property Owner )/Uu? / JVN • ? ?5Lf L f?? Telephone # (667 ) 6?, 13 - 9API.3 Car.t:acia: WaALL?? LW?iiQ?4 ?n • -- - ? Address ,L?i'p ('4 Lk_.±vric_ 4_ .1t'o L Ujn City State ? yi Zip s567Yo$' Telephone # (i6J) h?3 7i • L3'y.30 ? The Applicant is Owner Conhactor _ Other Septic System Mew _ Refurbished Submit 2 sets of plans and MPC license $ 100.00 Includes County fee. Additional consultant fees may apply. Alteratio s To Existing Dwelling Unit, Including $ 50.00 Adding fixtures to lower levels or room additions, excluding water softener and water heater _ Abandonment of septic system Water turnarou nd (+ 518" meter if needed -$121.00 _ n , A / ? > n ? A Other: , ?C.()(,?,t,c.? ?/,P.t9LC. _ RPZ _ new installation _ repair _ rebuild $ 30.00 _ Lawn irrigarion sys[em _ Water soFtener _ Water heater $ 15.00 _ replacement _ additional D? $ .50 State Surcharge 17 2003 Total $ 'a-6D I hereby apply for a Residential Plumbing Pemut and aclnowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the CiTy of Eagan and with the Plumbing Codes; that I understand dus is not a pernut, 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 requues a review and approval of plans. • Ekme M. ku.kowi'ex? &.,,,`h(. Apphcant's Printed Name Appli t's Signa e ( fI a?S S' 2004 RESIDENTIAL MECHANICAL PERMIT APPLICATIOPi City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 c y- ? aqw34 Please complete for: single family dwellings & townhomes/condos when permits are required for each unit Date )_ / aD / 04 s<<e Address 4279 ?i chQd ?R_ Uo,t # PropertyOwner PeiQrs01't Telephone#( ) Contractor ------------------- Street Address o2 ? ?3L4 G ? ffpyl Qe? v 2.i City ?! State fn1?1?? Zip 0a Telephone# ( f,p`?'JI )qb "'7gc2? Bond #: Eap3res: The Applicant is _ Owner ? Contractor _ Other Add-on ar alteration to effisdng dwelling unit ' $ 30.00 ? fumace ?Addltional _Replacement ? ~ - -- _ ? air exchanger air conditioner _New _Replacement ?Uu JAN 2 2 l 20Qq np (?(?l other VwL '? 1) ecs.? QCXCK, 't i0?_? lo ?i _ State Surcharge $ .50 Total $ a,5 I hereby apply for a Residential MecUanical Permit and aclmowledge that the information is complete and accurate; that the work will be in oonformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a pernvt, but only an application for a permit, and work is not to start without a pemut; that ffie work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. ?I lC'A vli Pl TY' elP(il ? i1 1 O QX1,P y ir.. c-- Applicant's Printed Name ApplicanYs Sign? 2004 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please compiete for. commerciaUindustrial buildings multi-family buildings when separate permits are not required for each dwelling unit Date0q Site Str [ Addre ? p 1? I C Y?& Lzx ? Unit # Tenan Na e(if ap licable {ef ` Previous T ant Name Proper y Ow er Telep one #( l i ? T I i i ?/ 1 I 4 r 1? (.'Ollt!'eC?01' ? }.,,? 1 rn i n ?'!I UL(- 17 Q/ ?LX i r j _'- Street Ad ess ?v City ? r ? ? { I Stat i n Zip 5S Telephone # t ^? 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 installing/removing underground tank, calf for inspectron by Fire Marshal and Plumbing lnspector Perlnlt Fees: $70.50 Ondergound tank instailafionhemoval $53.50.".fittimum !incLdes Stz[e Rurobargel OC ContractValue $ x 1% _ $ Permi[Fee + If uermit fee is $1,000 or less, add $.50 ? $ State Surcharge If nermit fee is over $1,000, add $.50 for every $1,000 aemut fee $ Total Fee I hereby apply for a Commercial Mechanical Pemut and aclmowledge that the informarion is complete and accurate; that the work will be in conformance with the ordinances and codes of the Ciry of Eagan and wi[h the Mechanical Codes; that I understand tlils is not a pernilt, 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 and approval of plans. ApplicanYs Printed Name ApplicanYs Signature Approved By: , Inspector Date: 2004 RESIDENTIAL BUII.DING PERMIT APPLICATION (p City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construcfion Reauirements RemodelfReoair Reauirements ?ce i 3 registered site surveys showing sq. ft. of bl, sq. (L of house; and II roofed areas 2 copies ot plan ?' ?,..,.1- , (20% maximum lot cove2ge allowed) 7 set of Energy Ca?ulations tor heated addNOns '^°m•?1 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey (or additions & decks TFee?Pf"eq"Wreed 1 setof Energy Calculations Add'Aion -indicate 8arsile sepfic system -rtsJ(e 3 wpies of Tree Preservation Plan if lot platled aftaz 711193 Rim Joist Depil Options selection sheet (bldgs with 3 or less unAs Date Construction Cost Site Address UniUSte # Description of Work ? J,N er / c / L-e? 1? ? ???? S`? Multi-Family Bldg _ Y _ N Fireplace(s) _ 0 _ 1 _ 2 / J, ;I d 4- 5 p f hone #( 4? 5 n ? r?l i-9yu Tele Property Owner i J?: 6t i. .rc, v / P -l p Contractor ?-/I en m C hV/'//r?' ( i C 1 J' /^ v t// U t/ Address C7 L/ / 5` ..f'JL" C? City ??' S v,?vt S c-; ' e State hi/ ? Zip S J 10 L Telephone #(?S ? y 3 1` -?G? 1;4 y COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesob Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 Energy COde Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (d submission type) Submitted Submitted . Energy Envelope Calculations Submilted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Telephone # ( Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( I hereby apply for a Residential Building Permit and acknowledge 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 the State 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 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. (? /,-/z -'- JZzv? //?Z'- Applicant's Printed Name Applicant's Signature OFFICE USE ONLY Sub Typea ? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 Otof_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.) ? 33 Ext.Alt-SF ? 04 02-plex ? 10 OB-plex ? 18 Deck ? 23 Porch (screen/gazeho) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex PI6g_Y or _ N ? 25 Miscellaneous Work Types ? 31 New O 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building• ? 43 Reroof ? 46 Windows/Doors ? 34 Repiacement •Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings(new bldg) _ Final/C.O. _ Footings (deck) _ Final/No C.O. _ Footings (addifion) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas T ests Final _ Framing _ Siding _ Stucco _ Stone _ Brick _ Fireplace _ R.I. _ Air Test _ Final _ Windows _ Insulation _ Retaining Wall Approved By: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Building Inspector ? ? DELMAFt H. SCHWAN2 1.AND 6URVE1tORS, INC. 14665sourHaoesRrrMI. wosrawuKr, rnInNssarn swee 651-nS.17M. suRVeror+??-ITe 4 '?1.?+? ?'? 9 F fi ?s .+ w ? p :n Z t toe• v< o r? _..i e? •??? SI ? t LU f LL l ., ? -? ? I 05 oSB'tSµO WrA N "r' r ? 0 0 _j ? ? ? Lo eu ? ? ? ?a Q? ? -, ? ? ., ? o? J 1 hoh6Y a*Ally 9hat tlfis suWIrY. a", of nPtlA wu propenld bY rM 6un WIW ?? d? ? I? ? teu er n1 nn:wai P6i°1sanw und oslmrH. De1W lANvwwNe Uearms No. 8l26 a•.? 3S@b?b°i.SE++Ci 6c69`w??LS'3 Jns'21?F ',Plb'1 ?NNMf-?S?:Ulti? 9b?1, E60Z-bl -S?0 e For: Construction ? . +. DELMAR H. SCHWANZ LANDSURVEVOR'3 4 ' I%!Ky ReqisterW UnCef Lawf Of Th! Spte OI Mlnnefola 2978 - 146TH STREET W. - BOX M ROSEMOUNT, MINNESOTA 66086 y JT?? c ? v,v co ? ? ? _ --- - -?==r-.-:- -_--? C M q `. ? VJ C ,N If n p. ? U U C") 1 i C1 N\ V'x O i I SURVEVOfi'S CERTIFICATE i? !) ? O! Q N ? 1 m ?' ? G ? S ? V^ ? L1 ? ' ? oM \n VI I O a ? I ?`t Jr I ? -- _-- ? ? ? d E N ? ? N a N .-i ri ri ? ? m bo es C A l PHONE 813129-1789 MO a is O 0 ? m .° ? N Y N Cd ? ? ? 4) o ? t m + m 43 V 0 W f+ U N U 4.3 Q O ' A d ca m . d H 43 94 cd A as mE ? .C 2 o -1-2 g y ? ? O 4.) x ? -ri +3 1-4 41.19 N O z c U ri rl N PQ 3 C ? p w . C 6 . 0) N t0 O ai 0 ? A C ? Ci m Hr7 4y ?. . . r , ; ?_. ; V f i4w MINNESOTA REGIS PERMIT City of Eagan Permit Type:Building Permit Number:EA167860 Date Issued:03/31/2021 Permit Category:ePermit Site Address: 4879 Richard Lane Lot:12 Block: 1 Addition: Hillcrest PID:10-32975-01-120 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. We encourage you to retain an electronic copy of photos until the project passes a final inspection. *Roof permits issued between December and March will be inspected in the spring or when weather warms up. Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - David P Peterson 4879 Richard Ln Saint Paul MN 55122--278 (612) 202-3694 Ashton Mcgee Restoration Group Llc 5555 W 78th St, Suite J Minneapolis MN 55439 (952) 426-3736 Applicant/Permitee: Signature Issued By: Signature