3871 Gold PtCity of Eaaali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
FQr.Ofce tl54 �/,�C/
Permit #: �1 l iJ(L/
Permit Fee: 9.0
GO
Date Received:
Staff:
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ,° l 0 I Site Address: 3Vst I GO I,1 po )
Tenant Gk k'C_- I ..01 Pero
Suite #:
RESIDENT / OWNER
Name: Ck c)( e_ C,-PAS' e rE o v�
Address / City / Zip: -7)(V-1 l Cr o I3Jt\(1.
Applicant is: Owner Contractor
Phone:
TYPE OF WORK
Description of work: G Place,mokt
Construction Cost: Sj 000
Multi -Family Building: (Yes >( / No
CONTRACTOR
Name: SO y ,€± C,o f lS • OOP rile License #: 0375 o�
Address: S I o I s"
City: C 1 01tx, 10 4,r) ( State: 1ti Zip:
• Phone: iD " Co,�gco Contact Person: yov I Yl ' 6-tn-
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Pia nsand supporting:documents that you submit are considered to, be public information. Portions o
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 plans. 7_7
x 54--" A)
Applicants Printed Name Applicants Signature
CITY OF EAGAN WATER SERVICE PERMIT
3795 Pil at '
Knob Road PERMIT NO.:
Eagan, MN 55122
Zoning,: DATE:
Owner: No. of Units:
Address: Site Address:
Plumber: — Meter No.:
No.: _
Size: Connection Charge:
Reader No.: Account Deposit:
1 agree to comply with the City of Ea Permit Fee:
an
Ordinances. g Surcharge:
Misc. Charges:
By Total:
Date of Ins Dote Paid:
p : Ins p..
CITY OF EAGAN SEWER SERVICE PERMIT
3795 Prot
Kno
b Road
Eagan, MN 55122 PERMIT NO.:
Zoning: DATE:
Owner: _ No. of Units:
Address:
Site Address:
Plumber:
1 agree to comply with the City of Eagan
Ordinances.
Connection Charge:
Account Deposit:
Permit Fee:
By ` " Surcharge:
Dote of Ins Misc. Charges:
p.:
Insp.:
Total:
Date Paid:
Use BLUE or BLACK Ink
Date:
Oily of Eaaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
J
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
43 Site Address•crl I Gob 1 Unit #:
nnai co`A /
Name:�i �a(le K�IM'1'4'S<' � pr. U►r► Sl�l. � t � 'hone: -1, q0%l L° g,
l
Address/City/Zip: ~n(613 Coolcl P4-., E.,ctrAcu,,, (/J ss(aa
Applicant is: Owner ]S_ Contractor
Description of work: 1!c7 O"c- I d -e.
Construction Cost: d p►D *tit) Multi -Family Building: (Yes / No) )
Company: v" cX C ' i ontact: P cl Yk (J
b1-
Address: • (� . 2- city: S i Nca Li
State: r'` Zip: -r7-14 Lf Phone: tO ra. .
License #: SZC3 TLP 1+ Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes _No If yes, date and address of master plan:
Licensed Plumber:
Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
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.cioi herstateonecall.oru
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x luive f�V
Applicant's Printed Name
x
Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan
City of Eaan
Permit Type: Building
Permit Number: EA119389
Date Issued: 11/26/2013
Permit Category: ePermit
Site Address: 3871 Gold Pt
Lot: 116 Block: 01 Addition: Countryside Villa
PID: 10-18350-01-116
Use:
Description:
Sub Type: Fireplace
Work Type: Gas Insert
Description:
Census Code: 434 -
Zoning:
Square Feet: 0
Construction Type:
Occupancy:
Comments:
Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary:
Valuation: 3,000.00
BL - Base Fee $3K
$88.50
Surcharge - Based on Valuation $3K $1.50
0801.4085
9001.2195
Total: $90.00
Contractor:
Hearth And Home Technologies
2700 N. Fairview Ave
Roseville MN 55113
(651) 638-3309
- Applicant -
Owner:
Juel E Casperson
11101 France Ave S
Bloomington MN 55431
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature
Issued By: Signature
\'\\0 \OS�s
Use BLUE or BLACK Ink
41,1/' City of Eau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
For Office Use
Permit #: C �% ,S 9�
Permit Fee: /� J
Date Received:
Staff:
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 5
Site Address: ,c -\ \ isv,\c Q \
Unit #:
J
Resident/
Owner
Name: Sv►e\ 44 cncnt'SNi \ CuS c‘ Phone: C1Sa, - ifiSiS - . to1a,
Qecse.
Address / City / Zip: .5$i1 Gv\c Qlt . F. cA.c\ Mr% SS \a..
Applicant is: Owner X Contractor
Typeof Work
re. ccsc.we CA,e,d ce Q\cnce \\ w'mc.N.ow% vr,4so Sc.A,ttie_
Description of work: ex� s\\�,o, rotke3c1 oQ ' e%‘ IN c,
oo
Construction Cost: t(o\(o Multi -Family Building: (Yes / No X )
Contractor
Company: Fjtt \ EXIte.c cm. g Contact: V%'3U C110tvs C) n
Address: 4s0\'1 t1Icv\\C-\ cue S City: VD\ cocci \ac'1%c:t1
State: Mn Zip: SS \aC� Phone: ciSd-F54S1- \b\3
License #: tbG.00 65 iaH Lead Certificate #: fU q S - , 1''N45 - C.
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
Yes 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:
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. Cali 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 plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building de mugj.be pmpleted within 180
days of permit issuance.
x `1c Ch0ttSrC1
Applicant's Printed Name
9
Sewer & Water Contractor:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 I TDD: (651) 454-8535 I FAX: (651) 675-5694
buildinoinspections ancitvofeaoan.com
EAGAN
JUL r s 2020
For Office Use /� G (�
Permit #: L 4 C�
Permit Fee: ' °-O 90
Date Received:
Staff:
2020 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: '1 • `t ' Z"'v Site Address: 3871 fo ° 14 ?ma* ,fioar&q, MN 4 S S f t 2_ Unit #: 3111 1
Resident/
Owner
Name: R•al.d a t 1 a►... rtie-
Po:e-
Address / City / Zip: 3g'11 coo Id ' r.elt(-- ea,' 4" M ail , Ss 2 Z
Phone: CO12-7.11-3t3o
Applicant is: Owner IA Contractor
Description of work: PCIace •1 wanleas 4 1 Dear M eaac7314.6, oetw,:`01 S
Construction Cost: o;i030
Multi -Family Building: (Yes / No )
Company: (3c rj Earc4-V or Contact: 3o Z?+2 /°
Address: S1MS rnl .s4-rpa.( I'et4- 544*e1City: N►e41e P(.4: ti
State: Pi ik) Zip: sS 3 5 1 Phone: 7de 3 r 2 8 4 - Email: J a4►..ar b ee'sa..+ertse$ mi cap".
3 %'12-
License #: S E- 3 Z'i 21 " f Lead Certificate #:
If the project is exempt from lead certification, please explain why:
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:
Phone:
Fire Suppression Contractor. Phone:
NOTE: Plans and supporting documents that you submit are considered to be public Information. Portions of the information may be
classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeanan.comisubscribe.
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.
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.goaherstateonecall.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 wii out 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 John .- Ofii"r
Applicant's Printed Name
ican
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA169833
Date Issued:06/10/2021
Permit Category:ePermit
Site Address: 3871 Gold Pt
Lot:116 Block: 01 Addition: Countryside Villa
PID:10-18350-01-116
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
210-0754.
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 0801.4088
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 -
Buffie Investmentgroup Llc
1561 Rustic Hills Dr
Eagan MN 55122
Genz Ryan Plumbing & Heating
2200 West Highway 13
Burnsville MN 55337
(952) 767-1000
Applicant/Permitee: Signature Issued By: Signature