4510 Ridgeview Dr8/3/2011
Affidavit
Terry Miller Construction LLC.
5819 Lake Elmo Ave N
Lake Elmo, MN 55042
License # 20637567
651-983-7781
To the City of Eagan, MN
Job Name: Linda & Mark Filonowich
4510 Rid2eview Dr Plz. /.74t / 00 ot5i/
Eagan, MN
Work Performed: Install maxi plank cement fiber board siding. 12 % square
I Terry Miller from Terry Miller Construction declare that I tore off 6 pieces of t-11
siding 3/ of in thick on east side of house because it had rot in it, there was Bildtr
ite underneath the t- 11 siding and it was in perfect condition to hold new maxi
plank siding that I installed. About 6 square. All the above work was performed
8/1/2011
I agree to the above statement: TERRY MILLER
Date: 8/3/2011
CITY OF EAGAN Remarks
Addition Ches Mar 2nd A.ddn. ~ot 1 Rik 1 Parcel 10 17101 01Q O1
~wner ~~'y %«T ~%-'~A~' 'st~~t 4510 Ridgeview Drive 5tate Eagan, 14W 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1973 152 6 99. 35 AC107489 3/9/79
SEWERLATERRL 3 1g78 2825,51 188 37 15 2448.79 A007489 3/9/79
WATERMAIN
* WATER LATERAL j9]H
WATERAREA j22,z2 A007489 3/9/79
* STORM SEW TRK 1978
* STORM SEW LAT 1978
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. ZSO OO I2198 10-2 -7g
BUILDING PER.
SAC
PARK
CASH RECEIPT
CITY OF EAG~4N
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122 ~
DATE f f
~es~rm
~woM
I AMOUNT $ I
ac DOLLARS
too
fC / _ ~nd~ ? CASH ~ CHECK
rm
FOR
FUND CODS AMOUNT
T~i~k You
O~ • ~ e v ~
~ VYhite-Peyers CoPY
Yeilow-Posting Copy
Pink-File Copy
~
~ ' ' CITY OF EAGAN p ^
~ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHON E: 454-8100
BUILDING PERMIT Receipt #
To be used for Est Value Date ~ - ,19 ~
Site Address ~ ~ OFFICE USE ONLY
Lot BlOCk Sec/5ub. ZyL On Site Sewage _ Occupency
MWCC System _ Zoning
PBfCeI NO. On 5ite Well _ Type of Const
Ciry Water _ (Actuaq
o~ Name (Allowable)
W - - # of Stories
3 Address ~ength
~ City Phone " ' ' Depth
S.F. Total
°C N8m8 ~ ~ ~~N Footprint S.F,
~O
Address APPROVALS FEES
~ City Phone "4 Assessments _ Permit
V a Water/Sewer _ Surcharge
y~ W Name Police _ Plan Review
~ z Fire SAC, Ciry
Address
uZ Engr. _ SAC,MWCC
~ W City Phone _ Planner _ Water Conn.
Council _ Water Meter
I hereby acknowledge that I have read this appliCation end state Bldg. Off. _ Road Unit
that the informetion is correct and agree to comply with all applicable APC _ Treatment Pt
State of Minnesota Statutes and City of Eagan Ordinances. Variance _ Parks
• Copiea
Signature of Permittee TOTnL
A Bullding Permit is issued to: on the express condition that
all work shall be done in accordance with all appliceble State of Minnesota Statutes and City of Eagan Ordinances
Building Official
' Permit No. P~rmlt Holdar Dats Telephone it
~ L
~Plumbing h ~~C ' ' - ~ " ~ ~-~~~7
N.V.AC. & J~ f :i~ ~7
ElectriC G , ~ ~ ~7
~ ~ ~"l ~r~ " i~, Y.£-~~ ~~~.1~~ ~~~~i"~~~ / ~ .
Softener '
t~apection Dat~ Insp. Commsnt~
Footings I
Footings II
Foundation
Framing 7 ~r 7 L-`. q. I`o ooe~ ~i~R c., ao~ c
Roofing
Rough Plbg. S• ~
Rough Htg.
Isul. 1 ~
FireplaCe 7 j ~
Final Htg.
Final Plbg. ~~'f
Bldg. Final Yl ~
Cert. Occ. •
Temp. LP
Deck Ftg.
Deck Frmg.
Well ,
Pr. Disp.
~ ' " PERMIT ~F ~~1 ~f C
PLUMBING PERMIT RECEIPT # ~1 ~ I ~1 '
CITY OF EAGAN
3830 PILOT KNOB AOAD, EAGAN, MN 55124 DATE: I~ 1
CONTRACT PRICE PHONE: 45~-8100
Site Address BIDG. TYPE WORK DESCRIPTION
Lot g~ock ~ec/Sub Res. ~ New
r Mult Add-on
y Name~ ~ - - Comm. Repair !
~ Address - Other
y " ~
c City Phone ` RES. P~BG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
L Name -Z~Water Closet - ~3.00 ~ t-~•
; Address _ ' - -~Bath Tubs - $3.00 '
_~Lavatory - $3.00
h ~ ~ Phone
O Ci - _~Shower - $3.00
~ Kitchen Sink - $3.00
FEES Urinalleidet - 33.00
COMM/IND FEE - i~No OF CONTRACT FEE Laundry Tray -$3.00
APT. BLDGS - COMM RATE APPLIES Floor Drains -$1.50
TOWNHOUSE 8 CONDO - RES. RATE APPLIES Water Heater -$t.50
MINIMUM - RESIDENTIAL FEE - $12.00 Whirlpoal - $3.00
MINIMUM - COMM/IND FEE -$20.00 Gas Piping Outlets -$1.50
STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMI'~
(ADD $.50 S/C IF PERMIT PRICE GOES Softener -$5.00
BEYOND $1,000.00) Wel~ - $10.00
Private Oisp. - $10.00
_ - 1,1~ " Rough Openings - $f.50
SIGNATUfiE ~F'PERMI / E ` FEE: ~
STATE S1C:
FOR: CITY OF EAGAN GRAN~ TOTAL: ~ '
~r f}~~5 ' ~ . • . _ _ . ; • PERMIT # ~s'',~f 7 `J ~ "'~h
MECHANICAt 1'~RM T
' CITY OF EAGAN RECEIPT # ~ ~
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE 7
CONTRACT PRICE 7 ~ PHONE: 454-8100
Site Address ~ BLDG. TYPE WORK DESCRIPTION
tot / Block !~_~~ec'~,5ub Res. ~ New
Name • • Mult Add-on
` Addre ~ ' „ ' Comm. Repair ~
H • Other
c Ciry oo~~~
FEES
L Name RES. HVAC 0-100 M BTU -$24.00
c Address ADDITIONAL 50 M BTU - 6.0~
O C~ty Phone {RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMI~ - 1.50 EA.
TYPE OF WORK COMM/IND FEE - 14~o OF CONTRACT FEE
Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE 8 CONDOS - RES. RATE APPUES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Neater M BTU REMODELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # BEYOND $1,000)
Other
~
f ~i,~~ ,[~~~{~EVi~K FEE: ~ ~ ~
'~'1'-.~P.tXJ.C~~(c .
/h~z~i
~~1 ~X`~/t.~s~-C~ S/C: SIGNATURE OF PERMITTEE ~7'~.~E~
~/,l~~'yC ~.0~- TOTAL• .1 S .
; ~
,I ~ir~f ~~.r ,~,li,l,v FOR: CITY OF EAGAN
~ ~
s T, r, , CITIf OF EAGAN
~ 8795 Pilot Knob Rood Eagan, MN 5S1ZZ N~ _ 5~ 4 3
PHONls 454-8100
BUILDING PERMIT Receipt ~ ~ ~ ~ `
Te ba wed for 1'' y'~. Z re~,_ ~ Est. Volue ! a1 ~ 00f1. Dcte 1 R-~F 19 7~
Site Address i ~ i RiC R,_~i ;~-W DriVe Erect Occupancy I
~
Lot ' Block Sec/Sub. Alter ~ Zo~ing ~ i
Pa~~ ~ 17i~~1 020 ~1 Repair ? Fire Zone ~i
a,t~lo ..a eon Enlorge ? Type of Const. '
s Name Move p # 5tories
~ Address r~ S 1~1 t.i~3!?.e~?i.ew r?riv~ Demolish ? Front ^ r' ff.
`jO~n Grnde ? Depth ~ ft.
Ci Phor?e
~ x'tiii3iJ t, I~C. Avpravab Fees
p Name
o~ ~d~ 9~:s:^..1 F.''~7 oar,in~ton T'rwy. Assessment Permir '
"?.nomin~tn-; ~~~~-33f~5 Woter&Sew. Surcha~ge
Ci Phone
Police ~ Plan check
~W Ncme Fire SAC
, r ,
Address Eng. Wcter Conn. r'
a'Z" Ci Phone Plonner ~Q.~ ~i~r ~*~~1
Councif
I hereby acknowledge that I hove read this application ond stote that g~d9. pff.
the information is wrrect and agree to comply with oll applicable APC Total l~~ ~
State of Minnesota Statutes and City af Eagan Ordinances.
$ignature of Permittee
A Bullding Permit is issued to: J~" ~~-t • I~C , on the express condition that
all work shall be done in accordance with all opplicoble State of Minnesota 5totutes ond City of Eagan Ordinances.
Buifding Officioi ~ . `
ParmM # out~ larad P~nnktN
Plumbing ~oZ c~ ~ / - ' 7 8 ~~p-L.'Le(~
Mechaniccl /~G f~ / - y
~~t ~~L~ _ S~(~ 1 1' l S- 7~S n.c rn.e~
INSPECTIONS DATE INSP. Rouglh-In Final
Footings Dofe Insp. Oote Iro~.
Foundotion Plumbing ~ ~
Frume/ins. ~ Mechanicol .sp~ _
Finol
Remarks: ~YIfC: ~O~tfd /"~6~ ~n ~ ,7td ~~o~7Q- ~OuJ •
~~a~{ ~.n. ~~c rt~pn~ C~t~6~
r
SEIMER SERVICE PERMIT
CITY OF EAGAN pERMIT NO.:
9795 Pi~:~t Kweb Roed ~ ~ ~ '
DATE:
Ergon, MN 55122 No. of Units: _ ~
Zoning: , : . _
QVl1'IEf: '•~ll'~: ZI':C:. i~!.,. -ti~~.i-~.
14f~fC55: r~~ i .i T
-.1(7 Ridu~vie~ Dr. Ll l?~.
Site Address: ~-------f ^ -
. ..1 /~.if~ ~ Sl ~ i.~.Y S ~ I~f rv~ D'~Jll
Plumber: .
. ~ . ~ . ~t '1(~ T",? _
1 agree fo eo~'ph' w~' N'° City of FA9on Connection Charge: =
Account Deposit:
Ordinan~et. + '
~(1 r+'~
permit Fee:
Surcha rge:
Misc. Chorges:
By _ Total:
Dute ot Insp.: _ ~e paid:
Insp.: ~
WATER SERVICE PERM~T
C~TY OF E/?C'd?M pERMIT NO.:
3745 Pilot Knob Rosd DATE:
E°g'"' M~ 55122 No. of Units:
Zoning: -
Owner: ~ , . - ~ - -
Address:
Site Address: , , . -
Plumber: ~ r ~ x
Connection Charge: ~
Meter No.: Account Deposit:
Size: .
permit Fee:
Reader No.: : ~ -
wiN+ tl+e Citp of Eagon Surcharge: t~r
1 agree to eompir Misc. CFwrges:
Ordinanees. Totol:
Dote Poid:
By
Insp.:
Date of Insp.:
, , , CITY OF EAGAN
' 379b Pilot Knob Roed
Eagan, Minnesota 55122
Phone: 454-8100
PERMIT No. ~3~
Date: ~ 14 ~ 1978 Recei pt No.: 12692
Single I
4510 Ridgavie++ ~liV~e Residential X
Site Address:
Lot 1 Biock 1 Sub/Sec. _ II Multi Res., Comm./Ind. I
Name ~~ilt InC. _ New/Alter./Repair n~
~ Address ~001 8. A200~1.ZSQtUT1 i°'Wy
Cost of instollation
zo.oa
City 8100~~.Aq'~On Phone: Permit Fee
Nome ~a~IIal COl1tS01 Inc• Surcharge .50
.
~ Address 7620 Lyndale Ave. So,
~ City Plco~inaton ~542f) Phone: Total Z~''"`~
' This Permit is issued on the express condition that oll work shall be done in accorda~ce with all applicab~e State of
Minnesota Statutes ond City of Eagan Ordinonces.
Building Official
• '
, , . CITY OF EAGAN
' 3795 Pilot Knob Road
Eagan, Minnesota 55122
P6one: 494-8100
:~*~~c L?8z
~ PERMIT No.
Date: ~~~~r~~ Receipt No.: ~?~~7
Single I
Site Address: 45~ ~A~i D~iV~ Residential X
1 I
Lot Block ~ Sub/Sec. 2 Multi Res., Comm./Ind.
Chi.~ilt ~ IT~ .
Name New/Alter./Repoir
- 9001 E. rLoaa+i.rx~t~
; Address Cost of Instollction
O
~~loanir*_~*tr.~z, 55~?~ "3e_??FS ?.~.~J(1
City Phone: Permit Fee _
i2.}CGnTIZ:Q PZ~~!'~'~SSY-J F- ;ii~~"'X' . ~
Nome Surchorge
.
~ ?'t. ~
~ ddress
e
't:',C3^.^i1.:• j~f?~!~1 .~;5~~ ?:1,~;"
City Phone: Total
This Permit is issued on the express condition that oll work shall be done in occordance with all applicable Stote of
Minnesoto Statutes and City of Eagon Ordinances.
Building Officiol
This ~equest witl /
18 mon[hs fmm 7 ~
D 1672_1_ ~.r /3.1. C.~~>„ yY,~,~.
Reqoest U tc ' Fire No. flouPh-in InSPec~~on
1 Re~ ired7 ? [~flea6y Now~] Will Nniify, inspac-
~ Yes No ~or When Feady
~ Liw~sed Electrical Cmnractor 1 hereby re0uast inspectlan ot ebova
? Owner ' electrical work ~ns~alled et
Sv¢at Address, Bo. or Rou~e No. C~tV
~S/O ~(DG~UI~ GAi.~
iion o. Township Nema or No. anpe o. Cowtyy .
~ ~-E9 T~fl
Occupa~t IMIINT) Phone N~,
~A~s~~ w -~3~-1~11a
Power Suppli¢r Atltlress
Elechical Convactor ICOmpany Name) ~ Corttrar.tor's L~cense No.
Tam rnFrt~ E ~cTv,e y
Mailing Address (COnvactor or Owner Making Installation)
1 i-z8~ p e n~5~l~I
Auth~d 5-e^ature (Convactor/Owner Making Ins[a latinn) Phone Number
~--~va-rs~ct,o Lu • ~
MINNESOTA STATE BOARU OF ELECTN V THIS INSPECTION HEaUEST WILL NOT
Grig9s-Midwey Bldg. - Poom N•191 BE ACGEPTED BY THE STATE BOAflD
1821 Universitv Ave.. 51. Vaul, MN 55106 l1NLESS PROPER INSPECTION FEE IS •
Phane1672)842-0800 ~ ENClOSED.
7~/l:/,~ 7 ~QUEST FOR ELECTRICAL INSPECTIQN ~ ~e7a-~~o"oi-os
1 See instruetions for completing this form an baCk o7 Vellow cooV. tp
D~~ 6~ ""X"' Below Work Covered by This Request
Atld fleD~ TVOe ot BuilEing ApO~iOncea Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Liyhtiny Ffxtuies
Apt. Buildinc~ Dryer Electnc Heatin
Commercial 61dg. Fumace Silo Unloader
InAustria~ B~Ag. Air Conditioner Bulk Milk Tnnk
Farm Otne~ veu v ~her Isncr~ivl
t ar Succi y ther p~he.
ompute lnspection Fee Below
p Fee ServiceEnimnce5ize tt Fee Fanders/SUbfeeders # Fee Circults
0 to 200 Am s 0[0 30 qm s 0 tn 30 Am s
Above 200 qmps 31 to 100 Amps 37 to 100 A
Swimming Poo~ Above 700_Amps A6ove 100_~1m s
Transrormer5 Irrigation Booms Partial~~Other Fee
Signs SUeciallnspection S 5(„)
Rem9.ks t ~ TOTAI F E
I 2 A~C .G~D 8: F'12E" ~j•aG
p°~a^-,^ r~ t~%6 ,~a E~a a~
~ Insp¢ctor, he~eby
certi/y lhet ~he abovo
Final ~ ~'te inspection hes been
p~'... Y
matle.
mla repueat voltl 18 montle Irom - C../- ,
1~' (is requ~est void 18 months from ~~t~~~
Da~e of this Request 7~ ~ 5 2 61
I, as ? Licensed Electrical Contractor Owner, do hereby request inspection of the above electri-
cal wiring installed at: ~o~ ~ ~ ~y ~
e
Sireet Address or Route No. s~ / a~~ ~'-~'r~ Cit~~-.~J
Section Township Range County o~cG.c~st
Which is occupied by o~ ° J~-~~~
(Name ot OccuDanq ~ /
Is a roughin inspection required on this job? No ? Yes ~ Ready Now ? Will Call ~7'
,_~o~ -5!
PowerSupplierc~(.L ~~Addre~
Electrical Contracto~J Contractor's License No:
~ (COmvany Name) ~~`~~}-C~
Mailing Address.~
i
(Ele cal C tfa or I Ownal Making Thls InStallatlonJ~
j,SL~~~
Authorized Signature Phone No:s 3~"-`'
(Elecblcal Cont actor o ner Making Tnls Installatlon)
(~~7 ~~~p This inspection request will not be accepted 6y the
-~J" ~J ~ U State Boerd unless proper inspection fee is enclosed.
a Minnesota State Board of Electricity
. 1554 University Ave., St. Paul, Minn. 55104-Phone 645-7703 ~~S LP / CS
~ REQUEST FOR ELECTRICAL INSPECTION 5261
CH£C'IC BELOW WORK COVERED BY THIS REQUEST
Type of Building New d. Rep. Check Appliances Wired For Check Fquipment Wired Fo~
Home ? ? Range ? Temporary Wiring ?
' Dwplex Watec Heater ? Ligh[ing Fixmres ?
Apt. dldg. ? Dryer ? Elec[ric Neating ?
Commercial Bldg. ~ Fumace ? Silo Unloader ?
Industrial Bldg. qir Conditioner ? Bulk Milk Tank ?
Fazm ? ? ? pList I} List "
Other ? ? ? HeietSJ ~[hers~
ere
a COMPUTE INSPECTION FEE BELOW
~ Service Entcance Size: u Fee Feede~ bf ers: iC Fee Circuits: # Fee
0 to 100 Am s. 0 to 0 ta 30 Am eres
101 to 200 Amps. 31 to. ~ e- 31 to 100 Am ies
Above 200_Amps. Abov 00 Above I00 Amps.
L Transformers RemoleControlCirc. Partialorotherfee
Signs Special lns ection Min"unum Cee S5.
Rema~ks
~ TOTAL FEE d "
I, the Electrical Inspector, hereby certifi+ t the ~ ovEinapection has been made.
(Rough-in) Date -
(Final) ~ Date 3_
Ttus request void ]8 months from :J,
CITYOFEAGAN N° 13692
3 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 ~ O
BUILDING PERMIT Receipt#
Tobeusedfor FIRE DAMAGE EstValue $50,000 Date_ MAY 29 ,19__,$Z .
Site Address 4510 RIDGEVIEW DR OFFtCE USE ONLY
Lot 1 Block 1 Sec/Sub. CHES MAR 2ND OnSiteSewage _ Occupancy
MWCC System _ Zoning
Parcel No. - On Site Weil _ Type of Conat
City Watef _ (ACtuap
e Name DAVE LARSON (Alloweble)
w n of Stories
= Address Length
o City Phone 452-4719 oeptn
S.F. Total
, o Name UNGERMAN CONSTRUCTION Footprint S.F.
~a Address 4330 UPTON AVE SO APPROVALS FEES
~ City MPLS Phone 922-2800 qssessments _ Permit '~328.50
r WateqSewer _ Surcharge 95-f)(1
~ Police Plan Review
w W Name -
iZ Address F~re _ Snc,ciry
pt7 . Engc _ SAC,MWCC
aw City Phone Planner _ WaterConn.
Council _ WaterMeter
I here6y acknowledge that I have read this application and state B~d4. Off. _ Roetl Unit
thattheinformatianiscorrect dagreetocompl withallapplicable APC _ TreatmentPl
State of Minnesota Statute n y ag r inan s. Variance _ Parks
Copies ~-C-~
Signature of Permlttee 707aL ~
A Building"permit is issued to: ~LP~ on the express condition that
all work shall be done in accordance with ~all appli le tate of M' esota S tu es and Ciry of Eagan Ordinancea
BUilding ONicial
crrr oF eacnN
8795 Pilot Knob Raod Eagan, MN 55721 N~ 5043
PHONB: 4548700
BUILDING PERMIT APPLICATION Receivt # ---~~'l~~
To bs usad fo. SF Dwlg & Garage Est. Va~ue 60,000. pate 10-26 , ~g_78
5i~ q~,eu 4510 RidQeview Drive Erea {g 0«uvo~cy 1
Lot 1 Block 1 Sec/Sub. ~ Z Alter ? Zoning Rl
pa~~ # LO 17101 O10 ~l Repair ? Pire Zone 3
Enlorge ? Typa of Const.V
Davi Larson
z Nome Move ? #'Stories
Z Address4510 RidQeview Drive Demolish ? Fro~x 54 ft.
~ Eagan pha~e Grade ? DepN, 40 rr.
o Nane Unihllt Inc Approvals Feea
o~ Address9001 E, Bloomington FYwV. Assessment Permit 5 F•5~ _
C~ Bloomington phone $$4-3365 Wuter & Sew. Surcharge 30.00
~ Police _ Plan check
w Name Fire SAC 500.00
u~ q~d~ ~g_ Water Conn. Z50.00
<w C pho~ Planner Water Meter 60.
Wuncii Road Unit 75.00
I hereby acknowledge that I have read this applicotion and state that Bldg. Off.
the informotion is rnrrect and ugree to comply with oll applicable APC Total 1 069.50
State of Minrcesota Sfatutes~~ Eagun Ordinunces. '
$ignoture of Permittea~ J2
A Building Permit is issued t 1ln~hi 1 on the express condition tfiat
oll work shall be done in once with II a icabie State of Minnesota Stotutes and City of Eagan Ordincnces.
Bulldirg Officiul ~ j~~Q`
RESIDENTIAL
~ '~~1 ~a3 BUILDINC PERMIT APPLICATION ~ ia~.as~
~ CI7Y OF EAGAN
3830 PILOT KNOB RD - 55122
651-68'1-4675
New Canatructlon Reauirementa RemodellReoair Reauiraments
• 3 regislered sAe surveys showing sq. ft. of lot, sq, ft. of house; and ,~II roofed areas . 2 copies of plan
(20°h maz'unum lot coverage allowed) • 1 sel of Energy Calculatbns for heated additions
• 2 copies of plan showing beam 8 window s¢es; poured found design, etc.) . i site survey for exlerior additions & decks
• 1 set oF Ene~gy Calculalions . Iridicate if home served by sepfic system for add'Aiore
• 3 copies of Trae Preservation Plan if lot platled afler 1/1/93
• Rim Joist Detail Options selecUon sheet (61dgs wiU 3 or less uniLS)
DATE ~ ~-S "U~ ' ~~u-J VALUATION~~j ~S ~ ' ~B
JOB SITE ADDRESS ~ fC ~ ~?F •
IF MULTI-FAMILY BUILDING, HOW MANY UNITS? ~
PROPERTY OWN A ;
TYPE OF WORK I PL C S)~ 0_ 7_ 2
APPLICANT - N~ - PH E# g3~'~I-S ~q~
ADDRESS I/ A/2 I~ ' ` L M ZIP CODE _~~3~
PAGER # CELL PHONE # FAX #~S~' b 9S - 7y~~
NE1V RESIDENTIAL BUILDING ONLY - FILL OUT COMPLE C~' L~ 0 C~I L~ ~
Energy Code Category MINNFSOTA RULES 7670 CATEGORY 1 APR 1 8 2002
(check one) - Residential Ventilation Category t Worksheet Su6mi ~
- Energy Envelope Calculations Submitted B ~
Y
_ MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumbing Conhactor: Phone
Plumbing System Includcs: Water So$ener _ L,awn Sprinkler Pee: ~90.00
_ Water Hcater _ No. of R.I. Baths
No. oP Bariis ~
Mechanical Contractor: Phone #
Mechaziical System Icicludes: _ Air Condilionii~g P'ee: ~70.00
_ Heat Recovery Systein
Sewer/Water Contractor: Phone #
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 Stpte of Minnesota Statutes and City of Eagan Or c
Slgnature of Applicant K.,~ "1
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 2002
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ~
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt - Muiti
? 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 (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level O 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Impravement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bidg. ? 42 ~emolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDOOrs
? 34 Replacement 'Demolition (Entire Bidg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundarion HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Au Test _ Final _ Windows (new/replacement)
_ Insularion _ Retaining Wall
Approved By , Building Inspectar
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
RESIDENTIAL
~ ~ BUILDINC PERMIT APPLICATION
CITY OF EACAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-687-4675
NeW Canstruetion Reauirements RemodellReoair Reauirementa !'7 ~
• 3 registered sRe surveys sfiaxiriq sq. ft of VM, sq. ft. M house; and aif roofed areas • 2 coples at plan ~P ~
(20% maximum lot coverage allowed) • 1 set of Energy Calalations for heated addNons
. 2 copies of plan showing beam & window saes; paured faund design, etc.) . i site survey (or exterior additbns 8 decks
. 1 set W Energy Calculations . Indicate'rf home served by septic system for additions
• 3 copies af Tree Preservation Plan H lot plaUed after 7/1193 _
. Rim Joisl Detail Options selection sheet (61dgs wifh 3 or less units)
DATE ~n-~~~` ~0~~ VALUATION • ~U
r~
SITE ADDRESS 1 C"vt/ ~ ~ l~ MULTI-FAMILY BLDG _ Y C,~~N
TYPE OF WORK FIREPLA E S) ~0 _ 1_ 2
. t 1..1 hf'1~'~~~ ~ J
APPLICANT ' ~ p~~
STREET ADDRES ~ ' ~ CI~,1~J'L(~esTATE~ZIP~~
TELEPHONE # ~ LL PHONE # ~ FAX # ~Sr~'F~S~-~7//
PROPERTYOWNER~'~C ~Ldv~~~%~i9altJ (~11~~G~ ~ TELEPHONE# (.dJ~ C~~ - 71~
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULFS 7670 CA1'EGORY 1 MINNESOTA RULES 767`l
(J submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculalions Submitted
Plumbing Contractor: _ Phone # _ ~2 n nn ~
Plumbing system includes: _ Water Softener _ Lawn Sprinkler U.~~ 00 ~
WaCer Heater _ No. of R.I. Baths Q$ 2~~2
No. of Baths
Mechanical Contractor: Phone # B
Mechanical system includes: _ Air Conditioning ' Fee: $70.00
_ , Heat Recovery System
Sewer/Water Contractor: Phone #
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 ~ances.
Signature of Appllcant '
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg •
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 D&plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex PI6g_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 ~emolish (Foundation) ? 45 Fire Repair
? 33 Alteration Q 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement "Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units 5tories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaUC.O.
_ Footings (deck) FinallNo C.O.
_ Footings (addirion) _ Plumhing
_ Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ FIaxnin8 _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insularion _ Retaining Wall
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MGES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
~ J
r ' ~ ~
7987 BDILDING PERMIT APPLZC9TION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
INCLDDE 2 SETS OF PLANS, 3 CERTIFICASES OF SQItVEY, 1 S6T OF ENERGY CALCULATIOHS
NOTE: ADDRESSES FOR CORNER LOTS - COliTR9CTOR/HOME04iNER MIIST DESIGAAYE WHICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BQILDING PERMZT IS ISSIIED.
MOLTIPLfi D{iELLINGS - RSSIDENTIAL RENTAL QIVITS FOR S9LE O~iTS
INCLUDE 2 SETS OF PLANS, CERTIFIC9TE OF SIIRVEY - CHECK HITH BLDG. DEPT.~
1 SET OF ENERGY CALCULATIONS
CO[~RCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,.
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For:l [~e ~r~ ~ Valuation: ~G o~o,~ Date; S-a 6-
Site Address y s/O y~ (~~'e u Dr2 • OFFICS USfi ONLY
. ~
Lot ~ Bloek ~ On Site Sewage_ Occupancy 3 ,
°y,~""'l MWCC System Zoning q'-1
Parcel/Sub l./lQ~ / r~-a~~ o` On Site Well Type of Const
City Water (Actual) Tr-
Owner I~f}~e L/~~,~' a~.J (Allowable) ~
n Il of Stories
Address N S /o ~;~re c~~"eu ///2, Length
„ Depth
City/Zip Code C fjr~ S.F. Total
Footprint S.F.
Phone 4~~ -`f 5~ 9PPROVALS FEFS
Contraetor ~(Wq e/L/y1Ac-~ ~~wJ' T/~U=7:~„J Assessments Permit ,p.~~, So
Water/Sewer Sureharge ;s:oO
Address y.3,3 0 ~//~~o„~ /}v~ 1~~ Police Plan Review
i~/ Fire SAC, City
City/Zip Code p SS y! O Engr SAC, MWCC
Planner Water Conn
Phone %02;~- ~Z ~U~' 0 Council Water Meter
(ZI M/{/AM1 Bldg Off Road Unit
Areh./Engr. APC Treatment P1
Variance Parks
Address Copies
TOTAL
City/Zip Code
Phone 1l
F
. , . s~~~
' ' DATE ~O ~~.~f
BUILDING PERMIT APPLICATION
Include 2 sets of plans, 1 site plan w/elevations and 1 s t of energy calcuations.
' ~~000~
To be used for ~/NGC~ ~.q-~iG? .~S' Valuation ~
Site Address:
Lot Block Sec./Sub, d Parcel Numher ~7/D/ D/D p~
l / Gf1~S M/h2 z f1D~irieN
Owner (~Ru~;D L~¢~.SO~ Telephone
AddTOSS 3/D ~i~sQui<i~ ~~li~ivi
Contractor (~Nig~~T , T.~~, . Telephone ~ - 3~6.~i
Address ~Do/ ~ GgLenr~i:Jl~7r.YJ ~t?Y~,~oa~ni.Lldro,rJ
Arch/Eng. Telephone
Address
OFFICE USE ONLY
Erect J/ Occupancy J
Alter Zoning ~ ~
Repair Fire Zone -.3~
Enlarge Type of Const. l~
Move ~l of Stories
Demolish Front u~`'~/
Grade Depth "y~
Date of A roval and Initial Fees
Assessment ~a 6
~
r Permit % S'~/ -
a~2
Water/Sewer Surcharge ~
Police Plan Check
o-O
Fire SAC +~i 00
Engineer Water Connection o°~~SO ~
as
Planner Water Meter Gr0
Council ~ J,~~;
V ~S ~
Bldg. Off.
A.P.C. TOTAL ~ ,S~
7 /S~ . .
g a
s~ ~ ~
~ ~ ~ '
~
0 /G c~ ~r
> D
3 ~ ~6 5'
i ~ ~
W.O.• 256-78 54/6 Survey For: MR. DAVE _ S~_ ~J~
.
SUNDE LAND SURVEYING INC. EDWARD H. SUNDE
~ N[G18T{R6D LAMO SURV[YOR
9001 EAST BLOOMINGTON FREEWAY (35WI . BLOOMINGTON, MINNESOTA 55420 . 812•881•2455
Surveyor's Certificate
~ I .~Oa9
( ~OP OF iqON Dip[: i051
ee~ ~o~" 76.0 ~o~'' , 205.80
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Li I ~O I ys \
~TOP Ol IXON PIPE • 102 B / I
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~ 30 , ~
•~oa~ pROPERTY DESCRIPTION ~
NOTES & LEGEND
Lot 1, Block 1, CHES MAR SECOND ADDITION,
* Proposed Garage floor elevation = according to the recorded plat thereof,
101.6 . Dakota County, Minnesota. J
* Proposed Front house entry elevation =
102.5. I hereby certify that this
* Proposed Top of Foundation elevation = survey, plan or report was v
101.4 . prepared by me or under my LL
* Proposed Basement floor elevation = direct supervision and that o
93.8 . I am a duly Registered Land ~
* The proposed elevations and proposed house Surveyor under the laws of
location are subject to review and change by the State of Minnesota. ~
the City Engineer, Building Dept., developer ~
and owner. Proposed grades and house location ~ K•~---~'
which are approved by the City are final. Edward H. Sunde, R.L.S.
~ Date September 21, 1978 v
Cj~g n"~"""- Re9. No. 8612 ~
~e~,~.,., 9s$ ~
.23 G~•w dw.~~C~-~
a~.-.~ a~-c''r'_' ~"n.~.
Cities Di~ital Quality Control
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David W. Larson Prop: 4510 Ridgeview Drive
SFECIAL IMPROVEMEN'LS
Show 1_viPd E p~r.clin~
on
All ttiat tract or Dakota
parcel of land lying and being in fletaRx~ta County, Minnesota, described
as follws, to-vit:
Lot 1~ Block 1, Ches Mar Second Addition
Plat E parcel - 10-17101-010-01
Thie is to certify that I have examined the records in the office of the Village Clerk,
Village of...~r~K~P..........4?kRS@,~3e~onaDd~pxCoUnty, Minnesota, and find that the
above-described tract or parcel of land has the following improvements ae indicated by
CHECK MAR1S5:
Weter Main Sidewalk Street Paving
Main Trunk Sever Curb & Gutter Alley Paving
,Iateral Sewer Street Crading Garbage Collection
Storm Sewer Alley GradSng _Tarring Street
Street Sprinkling
I furt.her certify that according to the records of said office, the folloving assessmente
appear unpaid:
Kic~i of Impv't. Runs Beginnings Original Total Amt. Unpaid
Amount subsequent to
current year
Sewer Trunk 20 Yrs. 1973 152,76 99.35
Water Area 15 Yrs. 1977 152.76 122.22
Sew $ Wat Lats 15 Yrs. 1978 2825.51 2448.79
I further certify that acce-ding to the records of said offlce, the folloving improvements
are contemplated or pending after having been approved, and are nw in the process or ,
planniog or eompletion:
Kind of Imprv't. Approx. date of Approx. Cost of
Completion Improvement
NONE I
~
Dated this 26th day of Jan. 1979 •
)
Clerk
Assessment
Village of Eagan
FF 1444
M-a~%~.-~- ~~s ~ ~ so . s~
: 200~ RESIDENTIAL MECHANICAL rExivnT arrLicnTiorr
~ ~ City OfEagan //Y`Y~~
Y 1 3830 Pilot Knob Road, Eagan MN 55122 ~
Telephone # 651-675-5675
. Please complete for. single family dwellings & townhomes/condos when permits are required for each unit
oate 8~ 2°~ ~ o~
Site Address L-1-5 I(~ 1' ~C~A-~ U 1~) ~r i ls-C. u~~t a
i i
Property Owner l=( ~'~,Q~~ ~l I ~Yl~l,v( C;h Telephone 335- ~ 8~ g
Contractor J u V1 5 C ~ ~G~-~~ ~ ~
Street Address ~ 5 t g S ~Y ~ UU. $L + w~ C~h, 1'1 ~5~~ (SLl-V~.~
State 1_ `1..V1 Vl"[. S(~ Tl/~ Zip "~J J U ~D ~ Telephone # ( ~95 ~ ) ~ "~3 ~ 5 `l 5'~
Bond b~~-1" 5~ ~ 3~°~ Expires: 8~1 °1-O~
The Applicant is _ Owner ~ Conhactor _ Other _
Fire repsir (replace burned out appliances, ductwork, e[c.) $ 90.00
This fee applies when extensive mechanical repairs are made to a building. '
Add-on or alteration to ezisting dwelling unit 50.00
~ fumace _Additional ~Replacement _ New
air exchanger
~ air conditioner
heat pump
other
~ ~Ca ' N
State Surcharge 5 E P 0~ 2007 $ 50
Tote~ $ ~ ~
I hereby apply for a Residential Mechanical Permi[ and acknowledge [hat the infortnation is complete and acwrate; that the work will
be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a
pertnit, but only an application for a permit, and work is not to start wi[hou[ a pe mit; that the work will be in accordance with the
approved plan in the case of work which requires a review and approval of plans
Jud k~~~ s a-.~
Applicant's Printed Name ApplicanYs Sig ture
~ G ~'/5~
~l ~
2oa~ RESIDENTIAL PLUMBING PeRMir aPP~icarioN ~
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings. Do not combine insicfe and outside
plurr~bin en the same a Iication; seperate a lications and ermits are re uired.
Date ~ I ~ I v ~
Si[e Street Address - [ ~ ~ ~ ~ ~ ~ ~ ~ ~ Unit #
PropertyOwner C~IY~ Telep one#"(~) 77 "
Contractor Telephone # ( )
Address City State Zip
The Applicant is: Owner & Occupant _ Licensed Plumbing Contractor
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
' Per as-built $ 10.OD
Fire Repair (replace bumed out fixtures, etc.) S 90.00
This fee a lies when extensive lumbin re airs are made to a 6uildin .
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures to main level lower level. This fee includes
installation of a water softener and/or water heater at the same time. !f you are
instalJing onlv a water softener and/or water heaTer, do not complete this section;
move to the next section and place a checkmark next to the appliance(s) you are
installing.
_Septic System Abandonment
_ Water Tumaround (add $136.00 if a 5/8" meter is required)
Other:
Water Softener ~ ~ ~later Heater 15.00
_ new replacement
i
Lawn Irrigation _RPZ _PVB _new _repair _rebuild 5 30.00
State Surcharge $ 50
Total $ ~ S ~
I hereby apply for a Residential Plumbing Permit and acknowledge 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 the plumbing codes; that i understand this is not a permit, but
only an application For a permit, work is not to start without a permi nd work will be in accordance with the approved plan in the event
j a plan ,igs re~quire~ be reviewed and approvgd ~
f~ l~ Vl.(.t-!~ T( I~'l U"?~ ~ G~ L C~~l
Applicant's Printed Name ApplicanYs Signature
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