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4105 Countryview DrCity of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675-5675 www.ci.eagan.mn.us PERMIT City of En Permit Type: Permit Number: Date Issued: Permit Category: Building EA091738 10/23/2009 ePermit Site Address: 4105 Countryview Dr Lot: 4 Block: 4 Addition: Coventry Pass 4th PID:10-18403-040-04 Use: Description: Sub Type: Work Type: Description: Census Code: 434 - Zoning: Square Feet: 0 e -Fireplace Gas Fireplace (new) Construction Type: Occupancy: Comments: Improvements to the home may requ concealing. e smoke detectors in all bedrooms. Chimney / flue must be inspected prior to Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: Valuation: 3,000.00 BL - Base Fee $3K Surcharge - Based on Valuation $3K $88.50 0801.4085 $1.50 9001.2195 Total: $90.00 Contractor: Hearth and Home Technologies 2700 N. Fairview Ave Roseville MN 55113 (651) 633-2561 - Applicant - Owner: Scott W Broders 4105 Countryview Dr Eagan MN 55123 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 Applicant/Permitee: Signature Issued By: Signature Date: City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink Permit #: q/ a 7(/ Permit Fee: / Date Received: Staff: 2009 RESIDENTIAL BUILDING PERMIT APPLICATION / A � ?Site Address: gin 5— 004)10-041/1/e-, / Tenant: r'7Cz77 7 'if% Z, p 07/49‘217ERI. Suite #: RESIDENT / OWNER Address / City / Zip: zJT(J1t/C/ � ��f Name: Cfa7 7 ted- Z3, b2?EA s Phone: �< 'vrv� "J�/crs" Address /City /Zip: �j'¢(� ,/� ��6 Applicant is: Owner Contractor TYPE OF WORK Description of w&k: M.p.5 * ezz., �(/ C,r� �I Ek ,549.4125' Construction Cost: IZ ele9e) Multi -Family Building: (Yes / No X ) CONTRACTOR Name: Mor' (3e.Y%5 7-, 9?5 trC /,, LLAY 1.1i24- City: ,1i'GCity: f V e State: Zip: 5i ?-7 Pherr: aid '-�6�`-? ontact Person: Address: License #: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: )TES Plans and supporting documents that you submit are considered to be public information. ' Portions e information may be classified as non-public if you provide specific reasons that would permit the City conclude that they are trade secrets.._ 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 accord ,*; approv=e/% la in the case of work which requires a review and approval plans. A. •licant' Printed a Applicant's Sigfiature Page 1 of 3 roto DO NOT WRITE BELOW THIS LIN 942 -7.‘, SUB TYPES ❑ Foundation 0 05-plex ❑ Single Family ❑ 06-plex ❑ 01 of _ Plex ❑ 07-plex ❑ 02-Plex 0 08-plex ❑ 03-Plex 0 10-plex ❑ 04-Plex 0 12-plex WORK TYPES ❑ New 0 ❑ Addition 0 ❑ Alteration 0 O 16-plex ❑ Fireplace ❑ Garage Deck ❑ Lower Level Interior Improvement Move Building Fire Repair Replacement ,r)g Nti o/rh y DESCRIPTION: Valuation 3oGlia' Plan Review /fj/ (25% 100% ) Census Code # of Units # of Buildings Type of Const. � 3y REQUIRED INSPECTIONS Footings (new bldg) Footings (deck) Footings (addition) Foundation . Drain Tile Roof: Ice & Water _Final Framing Fireplace:_ R.I. _Air Test Insulation Reviewed By: ❑ Accessory Building ❑ Porch (3 -season) ❑ Porch (4 -season) ❑ Porch (screen/gazebo/pergola) ❑ Storm Damage ❑ Miscellaneous ❑ Siding ❑ Reroof ❑ Windows ❑ Egress Window Occupancy 3 RG ^ 1 Code Edition .2_ Zoning i Stories Square Feet Length Width Final RESIDENTIAL FEES: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies Total ❑ 0 0 0 Pool Ext. Alt. —Multi Ext. Alt. — SF Multi Misc. ❑ Demolish Building* ❑ Demolish Interior ❑ Demolish Foundation ❑ Water Damage ' Demolition (entire building) — give PCA handout to applicant MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Sheetrock Final/C.O. Final/No C.O. HVAC Other: Pool: _Footings __Air/Gas Tests _Final Siding: _Stucco Lath Stone Lath _Brick Windows Retaining Wall , Building Inspector 120 Page 2 of 3 401' City or6aQau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use % Permit #: Jj ` " %� Permit Fee: Date Received: Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit #: Name: Ar" �f ' f, S Phone: Address / City / Zip: / V/05 Ce t4 'iffy {erg,e lA Applicant is: Owner ^Contractor Description of work: ZAsht1 E9res3 GS/— aO0-3a/ S SII / c✓+ndO� Company: Multi -Family Budding: (Yes r� Neifa )(1"I�tsv Contact: /yi � 4 City: 1oSe,i0 State: i4At-) Zip: 557)6 Phone: C/ 1 — 6 yy' fy P-"( License #: 3 L t'o1 ?..5-5 Lead Certificate #: kr- % b? lZ— If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: Phone: CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. CalI 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.orq 1 hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x'42^ Nelson Applicant's Printed Name x Applicant's Si • ure Page 1 of 3 L//05 ou: Vim Dr DO NOT WRITE BELOW THIS LINE 1//o15 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 Interior Improvement Move Building Fire Repair Repair (9(70 REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: _Ice & Water Final Framing Fireplace: _Rough In Air Test _Final Insulation Sheathing Sheetrock Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width Reviewed By: Storm Damage _ Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Siding _ Demolish Building* _ Reroof _ Demolish Interior Windows Demolish Foundation Egress Window _ Water Damage *Demolition of entire building - give PCA handout to applicant MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: _ Final / C.O. Required y Final / No C.O. Required HVAC _ Gas Service Test Gas Line Air Test Other: Pool: _Footings _Air/Gas Tests _Final Siding: _Stucco Lath _Stone Lath _Brick Windows 1i 5 Retaining Wall: _ Footings _ Backfill Final Radon Control Erosion Control Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 City of Eagan PERMIT City of Eaan Permit Type: Mechanical Permit Number: EA120120 Date Issued: 01/17/2014 Permit Category: ePermit Site Address: 4105 Countryview Dr Lot: 4 Block: 4 Addition: Coventry Pass 4th PID: 10-18403-04-040 Use: Description: Sub Type: Residential Work Type: Replace Description: Furnace Comments: Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Dayna Gardner 505 Randolph Ave Fee Summary: ME - Permit Fee (Replacements) $55.00 Surcharge -Fixed $5.00 0801.4088 9001.2195 Total: $60.00 Contractor: Bonfe's Plumbing & Heating 505 Randolph Ave St Paul MN 55102 (651) 228-9071 - Applicant - Owner: Mary A Broders 4105 Countryview Dr Eagan MN 55123 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 City of Eagan PERMIT City of Eaan Permit Type: Mechanical Permit Number: EA137228 Date Issued: 06/23/2016 Permit Category: ePermit Site Address: 4105 Countryview Dr Lot: 4 Block: 4 Addition: Coventry Pass 4th PID: 10-18403-04-040 Use: Description: Sub Type: Residential Work Type: Replace Description: Air Conditioner Comments: Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary: ME - Permit Fee (Replacements) $59.00 Surcharge -Fixed $1.00 0801.4088 9001.2195 Total: $60.00 Contractor: Bonfe's Plumbing & Heating 505 Randolph Ave St Paul MN 55102 (651) 228-9071 - Applicant - Owner: Mary A Broders 4105 Countryview Dr Eagan MN 55123 (651) 285-4299 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 City of Eagan PERMIT IP1' City of Eaan Permit Type: Building Permit Number: EA139886 Date Issued: 11/14/2016 Permit Category: ePermit Site Address: 4105 Countryview Dr Lot: 4 Block: 4 Addition: Coventry Pass 4th PID: 10-18403-04-040 Use: Description: Sub Type: Windows/Doors Work Type: Replace Description: Two or More Windows/Doors 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 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 Fee Summary: Valuation: 4,000.00 BL - Base Fee $4K $103.25 Surcharge - Based on Valuation $4K $2.00 0801.4085 9001.2195 Total: $105.25 Contractor: Window Concepts Mn 291 Eva St St Paul MN 55107 (651) 905-0105 - Applicant - Owner: Steven C Vetter 4105 Countryview Dr Eagan MN 55123 (651) 285-4299 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:Plumbing Permit Number:EA168720 Date Issued:04/30/2021 Permit Category:ePermit Site Address: 4105 Countryview Dr Lot:4 Block: 4 Addition: Coventry Pass 4th PID:10-18403-04-040 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Steven C Vetter 4105 Countryview Dr Eagan MN 55123 Bonfe's Plumbing & Heating 455 Hardman Ave South St. Paul MN 55075 (651) 228-7140 Applicant/Permitee: Signature Issued By: Signature