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3818 Riverton Ave CITY OF EAGAN - s 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121N2 122 05 PHQNE: 454-8100 BUILDING PERMIT RBCeipt # To be used for SO?nWG/GAR Est. Value $115 PO00 Date JUNE 27 yg 86 ' SiteAddress -3818 RIVERTON AVE Erect 12~ Occupancy R3 Lot8_ Block I_Sec/Sub. BLACICHAWK OAKS Remodel ? Zoning Rl Repair ? Type o( Const uA Parcel No. Addition ? No. Stories a Name TOLLEFS4N BLDRS Move ? Length = 12617 FAIRGREEN AVE Demolish O Depth 48 o Address Int Impr. ? Sq. Fr , Ciry A•V• Phone 431-1100 mstalP ? ac $~jyj~ APProvals Fees o Name o< Address ' Assessment Permit $ 0. 50 ~ City Phone Water 8 Sew. Surcharge .50 ~ a Police Plan Review~~ 25 W Name S~ 00 ,W Z Fire SAC 00.00 = a Address Eng. Water Conn. 5 U i W Ciry Phone Planner Water Meter 63.50 Council Road Unit 290.00 Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe BIdg.Off. 6/27/86 Tf.PI. 156.00 information is correct and agree to comply with all applicable State of Minnesota Statutes and City Eagan Ordinances. APC Parks Var. Date Copies Signature of Permittee ~ t` ~ :c i f . Total ,347;75 A Building Permit is issued to: TOLLEFS(}N HLDRS on the express condition that all work shall be done in accordance with all applicable State qf Minnesota Statutes and City o1 Eagan Ordinances. Building Official ~ x- - \ ~ ~ - - - ~ , PrrmR Mo. Pernrt Nolder .,r Dsh TNWphons N Plumbihy - - H.V.A.C. ! l i - ENctrk c_.•_-. 2/ J C` C1 Solt~ Inspectlon Oate Inep- CommeMs FooanqsI FooHnysll Foundatlon ~ Framiny g ~ RooNny Rouyh Plby. Rouqh Hty. Inaul. r~ Finpl" FInN Htp. r Flnel Plbp. Bldy. Finsl C.d. occ. 19- « < ID*ck Fty. Dsck Frn?p. Dereribs Locatlon: WMI P?. WWp. ' PERMIT # • MECHANICAL PERMIT RECEIPT # CITY OF EAGAN "3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: CONTRACT PRICE PHONE 454-8100 Site Address . ~ gLpG. TYPE WORK DESCRIPTION ~ Lot Block ` Sec/Sub' ~ , Res. New Name Mult Add-on S Addr Comm. Repair c CityX~-~=~`" ~r Phone`~1 Other ~ Name FEES c Address RES. HVAC 0-100 M BTU - $24.00 p City Phone ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 ADDITIONAL 6 M 8TU - 6.00 TYPE OF WORK GAS OUTLETS - 1.50 EA. Forced Air M BTU 1! COMM/IND FEE - 1% OF CONTRACT FEE Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00 Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00 Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50 Vent CFM (ADD $.50 S/C IF PERMIT PRI~E C.,OES ~ BEYOND $1,000.00) ~Gas Piping Outlets # ' - Other FEE A S/Q = SIGNATURE OF PERhAITTEE TOTAL: FOR: CITY OF EAGAN PERMIT # ~ ~ • PLUMBING PERMIT RECEIPT # • CITY OF EAGAN ~ 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: CONTRACT PRICE~:. S•~ PHONE 454-8100 Site Addr~5 s 3'~' Ib I` ,?"r ~c<,,I ve BLDG. TYPE WORK DESCRIPTION Lot Block SeclSub -R@S. .~NQ.1K ~ Name ~ -I Tulutt Add-on ~ Addresd S °U • d • L- Comm. Repair c City M0 phone a Other Name T. ~~URES TOTAL ~ Water Closet - $3.00 ~ . c Address ' i ~ • ~ 'k«'" ~ ` ~-Bath Tubs - $3.00 p; City ; Phone ' - =3 Lavatory - $3.00 ~ Shower - $3.00 ~ Kitchen 5ink - $3,00 FEES COMMlIND FEE - 196 OF CONTRACT FEE Urinal/Bidet - $3.00 I I Aundry Tray -$3.00 MINIMJM - RESIDENTIAL FEE - $10.00 ~ Floor Drains - $1.50 ' MINIMUM - COMM/IND FEE - 20•00 / Water Heater -$1.50 STATE SURCHARGE PER PERMIT - ~ Whirlpaol -$3.00 (ADD $.50 S/C IF PERMIT PRICE GOES / Gas Piping Outlets -$1.50 BEYOND $1,000.00) Softener - $5.00 Well - $10.00 Private Disp. - $10.00 =Rough Openings - $1.50 `i • ' SIGNATURE OF PERMITTEE FEE y~- STATE S/C: ~ FOR: CITY OF EAGAN GRAND TOTAL• ~ ch -,0'- ~ - . . = . . . ~ . - . _ ~ ~ _ ~ _ ~ . . . .,~.n,.~4~ CITY OF EAGAN Remarks / i J. C;Addition BLACICHAWK OAKS ADDITON Lot $ Blk 1 Parcel 10 14387 080 01 Owner sveet 3818 R.iverton AvPnue scate Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK f25 1970 3.84 - 25 SEWER LATERAL WA7ERMAIN WA7ER LATERAL WATER AREA 3-38 1977 9-49 15 STORM SEW TRK `j $ 1 STORM SEW LAT CURB & GUTTER ' SiDEWALK STREET LIGHT WATER CONN. BUILDING PER. SRC PAR K This reque5t void ~'//~9J d b lJ(~ o-7 18 mpnlhs Imw . 43067L-o6 flequesl Date ' Fire o. Rouph-in Insuection qu retl? E]BeaAy Now ill NMify InsPec- es ?No ~or henNeady -1<1-icemsed Electrical ontractor I herebv request insoection ot ebava ? Owner electrical wark inslalled at Sveet AOdress, Box or floute No. Ci ` ecLOn o. Township Name or No. Hange No. Counly Occupan[IPpINT) Phone No. tF o r $upplier Atldress EI vical Contrector ICy~ any N el • Contractor's License No. - S -3 Mailinp AdJress ICOntr ctor or Owner MakinB Instailationl Authoriz ie~amre nu c or/ ne. akinB Ins[allationl J Phone Number THIS INSPECTION HEQUEST WILL NOT MINNESOTA STATE BOAND OF ELECTRICITY Griggs-MiEwey Bldg. - Room N-191 BE ACCEPTED BY iHE STATE BOARD 1821 Univarsity Ave., St. Paul, MN 55106 VNLESS PFOPEH INSPECTION FEE IS Phona 16121 297.2111 ENCLOSED. 9/<29I~~ REQUEST FOR ELECTRICAL INSPECTION ft ea-ootwt-oa II, See instructions br comDletin9 thie form on back o1 yellaw copy. / I O~ ~ 43067 "X"' Below Work Covered by 7hrs Request ~ ada aeo. Tvoe oi suuaine nooiioncas wnaa Equiument Wired Home Range Temporary Service Duplex Water Heater Ligh[iny Fixtures Apt. 8uii<11ng Dryer Electric Heatin Commercial Bldg. Fumace Silo Unloader Industrial BIAg. Air Conditioner Bulk Milk Tank Farm ome. peci y otner (SnerHV) > >r Vecify Other Oth,,r ompu[e Inspection Fee Below p Fea $erviceEnVenceSixe H Fee Faeders/5ubleetlars N iee Circultg ~ 0 to200 Ams 0 to30Ams 0 to30Am Above 200 qmps 31 to 100 qmps 31 to 100 Am s Swimming Poal Above 100_Amps Above 100_AmUs Transiormer5 IrrigatiOn lboms Partial.'Other Fee Signs Speciallnspection $ TOTA ~FEE Hemarks Noueh-in Date 140 ~ - I, the Elecirical Inspector, nereeY certilV that the abova Final ~°~-~/I G ins0ection has been ( i N meee. tlils reQUasl voiE 1B moniha Irom CITY OF EAGAN t 3830 Pibt Knob Road, P.O. Box 21-199, Eagan, MN 55121 N2 12206 BUILDING PERMIT PHONE:454-8100 Receipt# 7 To be used for SF DWG/GAR Est. Value $115,000 Date JUNE 27 .19 86 SiteAddress 3818 RIVERTON AVE Erect 99 Occupancy R3 Lot 8 81ock 1 Sec/Sub. BLACKHAWK OAKS Remodel ? Zoning RI Parcel No. Repair ? Type ot Const Addition ? No. Stories Name TOLLEFSON BLDRS Move ? Length 48 W 12617 FAIRGREEN AVE Demolish ? Depth dR o, Address Int. Impr. ? Sq. FI City A.V. Phone 431-1100 Install ? ¢ SAME Approvals Fees o Name ~Q nddress Assessment Permit $ 470.50 ~ City Phone Water & Sew. Surcharge 57 . 50 ~Q Police PlanReview 235.25 Fw Name Fire SAC S7S•00 i Address Eng. WaterCOnn.500100 a w Ciry Phone Planner Water Meter0 Council Road Unit 290.00 Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.Off. 6/27/86 Tr.PI. 156.00 Information is correct and ag e to comply with all applicable State of Minnesota Statutes and City Eagan Ordinanc s. APC Parks Var. Date Copies SignatureofPermitt ee Total $2.347.75 A euilding Permit is issued to: TOLLEFSON BLDRS on the express condition that all work shall be done in accordance with all applic G ta4 pl Minnesota S utes ~ Ordinances. Building Oflicial . ~ 2006 RESIDENTIAL BUILDING rExMiT nrrLicaTioN City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone 4 651-675-5675 FAX 9 651-675-5694 NewConsWctionReauiremeMS RemodeVReoairReauirements Officellse0nlv 3 reqistered site surveys showing sq. tt. of IoL sq. R of house; and all roofed areas 2 copies oi plan showing footings, beams, joists Ced o( Survey Reo] _ Y_ N (20% mazimum lot cove2ge allowed) 1 set of Energy Calculations for heated adddbns Tree Pres Plan Recd _ Y_ N_ 2 copies of plan shovring beam 8 window sizes; poured found design, etc. 1 site survey for add'Aions 8 decks Tree Pres Required _ Y_ N 1 sel of Energy Caiculations Add'rtion - ind'aate r(on-sde septic system On-sfle SepUc System _ Y_ N 3 copies of Tree Preservation Plan if lot platted after 711/93 Rim Joist Dehil Options selectlon sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form Date~/~_/ ~b ConstructionCost Z4J SiteAddress w A,i.2 UniUSte # Ehi;fej % ZZ Description of Work Ul ~ r•b h w &VL~ ~ C'20 Multi-Family Bldg _ YC. N Fireplace(s) _ 0 _ 1 _ 2 / Property Owner Ses m0 K Telephone #((~S )q-!S:~f - Ki ~ Z Contractor Address 47 b . );K vt(L1<4t,c.. City EA&tr..J Zip 123, Telephone#(o1 L) r,~l d State _im l%) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (4 submissiontype) Submitted Submitted . Energy Envelope Calculations Submilted In the lasf 12 months, has ihe City of Eagan issued a permit for a similar plan based on a masier plan? _ Y _ N If yes, date and address of master plan: Licensed Plumber Telephone ) Mechanical Contractor Telephone # ( ) Sewer/Water Contractor Telephone # ( ) 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 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. G ~ Applicant Printed ame Applicant' Signatur ~ DO NOT WRITE BELOW THIS LINE Sub Tvpes ? 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 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garege O 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage O 06 04-plex ? 12 12-plex ? 25 Miscellaneous Work Tvpes ? 31 New ? 35 Int Improvement ? 38 Demolish Interior 0. 44 Siding O 32 Addition ? 36 Move Building ? 42 Demolish Founda5on ? 45 Fire Repair 0 33 Alteration ? 37 Demolish Building` ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entfre Bldg) • Give PCA handout to applicant . DBSCrIptioO: WaterDamage_Yes Vatuation Occupancy MCES System Plan Review 100% or 25% 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) _ Sheetrock _ Footings (deck) _ FinallC.O. _ Footings (addition) _ FinaVNo C.O. Foundation HVAC Drain Tile Other Roof Ice & Water Final Pool Ftgs Air/Gas Tests Final _ Framing _ Siding _ Stucco Lath _ Stone Lath _Brick _ Fireplace _ R.I. _ AirTest _ Final _ Windows Insulation Retaining Wall Approved By: , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Totai 2005 RESIDENTIAL BUILDING PERNIIT APPLICATION . . City Of Eagan ` 3830 Pilot Knob Road, Eagan NIN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reauirements RemodeVRepair Reauirements (7tfice UseOnlv 3 regisfered site surveys shaxing sq fl. of lot, sq. fl. of house; and all roofed areas 2 copies of plan ~ CerEai Swvep Recd X~ y (20%maximumlotcoverageallowed) iset afEnergyCalculationsforheatedadditions TEe¢41'e9PIa~RCCd _N. 2 copies of plan shaxing beam 8 window sizes; poured found design, etc. 1 site survey for additions & decks T~¢e Pres f~eqwred YN isetofEnergyCalculations Addition-irdicateifonsitesepticsysfem 4ft-sit95ep6cSyslem , _Y=N 3 copies of Tree Preservafion Plan if lot platled afler 1!1l93 Rim Joisl Detail Options selection sheet (buildngs with 3 or less units) Date Construction Cost SiteAddress UniUSte # ~?~p~ECri ~CT~ Description of Work ~ Muld-Family Bldg _ Ytl/N Fireplace(s) xjrt1 _ 2 Pmperty Owner ~JP~(9cCK '4 f'( Gt{~4r-- 54!"4.5~1>z Telephone #(''s/ Contractor r Address 3~'W / i',j~0n 7T V'e. City Ce v-;t State o1 iu( Zip Z Z. Telephone #(&i Y) q- s4 - crS ~2;~ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Categorv 1 _,~bnnesota Rules 7672 Enefgy Code Category , Resldential Ventilation Category 1 Worksheet • New Energy Cade Worksheet (J submission type) Submltted Submitted . Energy Envelope Calculatlons S b,mitt€d Have you previously constructed a buildiirrEa9h a similar plan? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber / 7~ 1T~I~p e#( ~ Mechanical C actor 2 2~&p e#( ) Sew aterConhactor Te pho e#( ) By 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 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 pernut, 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 app/rJoval of plans. 1~ Vl 11 L'`W l rsGLYI4 S 1)VI L)~z Applicant's Printed Name Applicant's Signature OFFICE USE ONLY . Sub Types . ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 AccessoryBldg 0 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3sea.) ? 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 DB-plex X 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. O 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Yor_N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish IMerior ? 44 Siding )kT 32 Add'Rion ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building" ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement •Demolition (Entire Bldg) - Give PCA handout to applicant Valuation ~ Occupancy 3 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 REQUII2ED INSPECTIONS Footings (new bldg) FinaUC.O. Footings (deck) ;~e Final/No C.O. _ Footings (addition) _ Plumbing Foundation HVAC Dnin Tile Other Roof _ Ice & Water _ Final _ Poo] _ F[gs _ Air/Gas Tests Final _ Framing _ Siding _ Stucco _ Stone _ Brick _ Fireplace _ R.I. _ Air Test _ Final _ Windows _ Insulation _ ~~ining WaR Approved By: , Building Inspector ~ Base Fee ?O Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other . Total aooE E~IGINEEt~ING CoNSULTIHa cI+aIHEEl1S PIANNEHS add IAHP jUAVEYCOMI~(~NY, INC. 1000 EAST 1461h STREET, BUflNSVIILE, AIINNE30TA 6S33T CerIZZ,~Z CGi~ SLC7'Y~ y K kgggl Ihacr4p2icn: LOT 5LOCtL f, BLAC.KN~wk - oak5 ~DDITtoN i'(~AK-J~A GOUKT(,M~NNC,~SS'D N B9° S9A6" E aez_sJ ~ h3 . 6 5 !s ea.-~ (aaz. s) ~eas.a) \ _ ~ ^ S ~ L4 T 8 ~ r ca O , O 6 ' ~ -1e r0 ~ V V. V _ ~ pRnPaSED o •@si.o p 'a- ~ '(i i yo~SE ' ~;Z' N A b r-- 9.0 sz 6 ~l`: R. (892.0~ ~ 89%.dj g 00 \ 2f• (B9Z.33) srzP S(~F~IrE ~ 3~ , z [ s_9: 'o_ ~gBRb) . . O,ZZ . ~806 ^tiMi~ ,ti ~~vENVE ..8~ ~ 89io; 'DEt~1oTG~S ~XtSTIt~1Ca ELE~(l~T~ot~ ~892.0 1 DEt~OTES ~oP~SE~ Gt...E,~IATON S~~FAc.E. Diz-A<<NAC-~E ~ y~,~ 6*eAP~ Y01!~77 ~.TD G4M66 iv I hartby certify that this in a true aad correct repreeantation of a tract of l+nd as shown'and deecribed heraon.. Ae preparad by me on this ~1$nl day ot ~'~a~- ~ 198G . ICcvi3¢P 6 1181P4 movEA /%uSE ~Q p A.....~.. - Mn?c.~ UmiSC :•~-;,h__~Zjlinn. ,1lea• A~~ RESIDENTIAL BUILDING PERMIT APPLICATION cinr oF eacAw ~ U 3830 PILOT KNOB RD, EAGAN MN 55722 651-681-4675 Naw Constructkn BeauhnmeMe pamotleUReoeh Heaulremanle • 3 repisfered sile surveys slmwinp sq. ft of bt, sq. ft. of house; and Ap roafetl areas • 2 coples ol plan (209% maxtrnum bt coverage allowed) . 1 set of Energy Calculelions for neate0 adtltlions • 2 copies of plan showing beam & window sizes; poured found design, etc.) • 1 site Survey for eMeibr etltlftions 8 tlecks • 1 set ot Energy Calculatbns . Indiate ii home served by septic syslem ror addNOns • 3 coples of Tree PreservatWn Plen X bt plafted afler 7/1f93 • Rlm Jo'st Detall Optbns seleclbn sheet (hldgs wNh 3 or less units) DATE 1040 VALUATION O v SIT ~D~DRE 3~ I~s 1 Ve r'~? ~ MULTI-FAMILY BLDG _ Y~ N NPCfF WM f e- rD a-F 3~k sC(~ FIREPLACE(S) _ 0_ 1_ 2 APPLICANT STREETADDRESSjld~&`fl IVifAe4- A*A-- So CITY lwLk_ STATEMIL)ZIP `33'7 TELEPHONE # R.'St~ ~707-1ah55 CELL PHONE # FAX # 6I Sa -7d rl - `)ia-S PROPERTY OWNER ~ 1un ~6 Y?1C7 ~ TELEPHONE # InS I-14S t-{ 'gI .3 a COMPLETE THIS SECTION FOR -NEW,• RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672 (4 submission type) • Residential Ventilatian Category 1 Worksheet Submitted • N o~ V~prk~he~ y¢ itted • Energy Envelope Calculatfons Submitted D 1r~ JUN 1 0 Z~02 U ~umbing Conhactor: Phone # Plumbing system includes: _ Water Softener _ Lawn Sprinkler gy Water Heater No. of R.I. Baths No. of Baths Mechanlcal Conhacior. Phone N Mechanical system includes: _ Air Conditioning Fee: $70.00 _ Heat Recovery System Sewer/Water Conhactor: Phone # I hereby acknowledge ThaT I have read this applicatton, state ihat the information is correct, and agree to comply with all appllcable State of Minnesota Statutes and Cliy of Eagan Ordinances. Signalure of Applicanf ~ I OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 OFFICE USE ONLY ? 01 Foundation 0 07 OSplex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg O 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) O 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4sea.) ? 33 EM. All - SF ? 04 02-plex ? 10 08-plex O 18 Deck ? 23 Porch (screened) ? 36 Multi O OS 03-plex ? 11 10.plex ? 19 Lower Level ? 24 Storm Damage O 06 04-plex ? 12 12-plex Plbg_Yor_N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. O 42 Demolish (FOUndation) ? 45 Fire Repair ? 33 Afleration ? 37 Demolish (Bldg)' O 43 Reroof ? 46 WindowslDoors ? 34 Replacement 'Demolltion (Entire Bldg only) - Give PCA handout to appllcaM Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units , Storles Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) _ FinallC.O. _ Footings (deck) _ FinaUNo C.O. _ Footings (addition) _ Plumbing Foundarion HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AidGas Tests _ Final _ Framing _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insulation _ Reta'ming Wall Approved By , Building Inspector - Base Fee Suroharge 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 4268. x 2. _ B536•DO r r 470•50 + 57•50 + 235•25 + 575•00 + 500•00 + 63•50 + ` 29•00 + 156•00 + 2066•75 * 470•50 + 57•50 + 235•25 + ' S75•00 + 500•00 + 63•50 + 290•00 + 156•00 + 2347•75 * o• + 1986 BIIILDING PERMIT APPLICATIOH - CITY OF EAG9N NO'PS: ALL CONTRACiORS MUS'! BE LICffiNSED IiITH THE CITY OF EAGAN SIBGLE FA[nLY DWELLINGS INCLODE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS MULTIPLS DSiELLINGS - RESIDENTIAL RENT6L DeiITS FOR S9LS QNITS INCLUDE 2 SETS OF PLANS, CERTIFICAT6 OF SIJRVEY - CHECg KITH BLDG. DSPT., 1 SET OF BNERGY CALCULATIONS CctmRCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SE'f OF SPECIFICATZONS AND 1 SET OE ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND To Be Used For: Valuation: 115, ~ Date: Site Address OFFICE USE OHLY Lot ~ Bloek Erect X-- Oecupaney 1~3 e Remodel Zoning Parcel/Sub Repair _ Type oF Const gkl Addition # of Stories Owner Aei.n. L 'A-VD , 2414 . Move _ Length 4/R Demolish _ Depth Address .-Int.Impr. Sq Ft - ? Install _ City/Zip Code Phone APPROVALS FSS3 Contractorr-/~Assessments Permit _ Water/Sewer Sureharge Sz,5-0 Address Police Plan Review Z 55, Z$r Fire SAC -5 -2 City/Zip Code rj E1_ Engr Water Conn 'S Planner Water Meter 45,~.Sv Phone Council Road Unit 070 _ Bldg Off -2 Treatment Pl ~ Arch./Engr. 9PC Parks Varianee Copies Address TOT9I. L~. 7 City/Zip Code Phone 4 NOTE: 6DDRESSES FDR CORNfiR LOTS - CONTEACTOR/HOMEOiiNER MIIST DESIGNATBiiAICH ADDRBSS , IS DBSIEED, NO CHANGFS W'iLL BE ALLOjiED OACS BIIILDING PERMIT I3 ISSDED. ~3 X ~6 = 3~U x 5~ = GZ(i~ ~ , , t /J n Z7 ° 29?' ~ sg = 17ZU76 > < e 2X ra ~ iHn x ~g - 92~ ' ~ zz~ X5~ ° `Z99Z 16 7 = 70 ~ ~GI = .~o~Q -7,K lV- VL/ yq = G~77~0 /V= V Y AO sE ~ plpf+NEA1 odd6~AHp SiURVEYOIIS B~~~orRs ENGINEEAING . COMPANY, INC: L1000 EAST 1461h STREET. EUNNSVILLE, IAINHElOTA 56337 PH 432'3000 cer-~~}'i cc~~ Sa~r-ey iLggg .Dkacrt,eZian: LoT BLocV, l, BLAC.K4-I4w+4- OAY,S ADDITioN , pAv--~rA N Bq° 5946' E (&ez. s) (8a9.o) _ f ~ H S F ~ D2Ana Acv~r(; E r( r, \ ~~`~r \ \ iSe^'n' s9~'7 \P . ~99 i6) _ O \ w 1 ~ ~se A' ~mosE r- e-O~ 1 C, o j S3, ~ ibo ~ GFlR NO~TF~ ~ W 1 ~E o I R ~ C~Z~~j/.7 ~ 24'~ A ~4 ` q.e (gq2' C892..33~ . 7 Sc~NLE I^= 3~ 0 ~ ~J' ~gB9.oSJ - Ot, `06 ooov A\4 ENoE R- ~ . ~0b•, i 89/.O ~ ~Et~10T~S ~XISTIN(a EC._EVI~T~ON 1 ~Et~1o`fES P~oQc~S~P E~E,~rA'r~oN ( B92.0 D~No~'~S `D12EG.T~ON QT° Sv2GAC.E ~rzF~~~aA(ae _-~'t9~ 89Z. 33. I hereby certify that thie ie a true and correct repreeentation of a traet ot land as sho+m'and deecribed heraon.. As praparad by tnn an thii L&2L. daY o! _'1-u aE ~ 19~G . ~CGV~s¢v 6 ~i8~9~ .,oveo //ovsE .,rtHinn. 1le6. No. CITY OF BUILDINIi DEPARTMENT , EXTERIOR ENVII,OPE AVERAGE "U lt COMPUTATION v~ (To be su6mitted with building permit application) ~ One or Two Family Dwelling Owner All Other Site Addresa Contractor T ~LanotJ Date Phone - LINEAL FEET OF I 8~, O p~ EXPOSED WALL EF, ~jt~t--ETft. above grade TOTAL E}L°OSED VVALL AR'r',A SQ. FT, 0?A(~,,UE WkLL COD:STRU-ITIOti: "Ull Value x Area Detail VRAolig "U" •C43 x S2. FT. / .D . (o . U)(A) ret'erence GaAJe, nU" . 0919 x Sq. FT. /e4.5z= o. Z(U) (A) Yrom QIIW ~V/ST "UII , p¢D x SQ. FT. l29.48= 547(U)(A) attached "U" x sQ. FT. _ (U)(!~) sheets "UII x SQ. FT. _ (U)(A) "Ull x SQ. FT. _ (U)(A) WINDOWS: "Ull Value x Area ' Make & TYAe IAK04. ,eWT u0'v .4g x SQ. FT. z. b= S8• (0)(A) u n nUu x SQ. FT. - (U)(A) n n nUn x SQ. FT. _ (U)(A) n n uU ll _ X SQ. FT. _ (U)(A) DOORS: "Ult Value x Area t<Ia1-ce & Ty_oe S7 e.C.. 11U11 ./4 x SQ. FT. ,00 = , (U)(A) ti PdM n $lUll_ .48 x Sq. FT. 4Z`bD =(U)(A) n n nUu n n x 3Q. FT. _ (U)(A) nUu _ _ x SQ. FT. _ (U)(A) ToTALS I135Z.00 Sq, t'T. 1&1•07 (U)(p) AVERACiE IOU" TOTAL (U) (A) VALUES I(pI• 07 = DIVIDED BY TOTAL SiALL AREA /$SZ.Op a AVFRA(}E "Utl ,11 r lesa Yor 1&2 family dwellinga ROOF/CEILINQ: TOTAL AREA: 13Z3.OlJ Detail reference 11Ult •OZ~ x SQ. FT._/3z3 = 7.7 (U)(A) from flUit x S@. FT. . (U) (A) attached sheete. ilUto x SQ. FT, - (U)(A) Describe openings 1rUit x SQ. FT. _ (U)(A) in roof. rrUlt x SQ. n. - (U)(A) TOTAL (U)(A) VALUES DIVIDED BY z7~78 = T'iAl.4j i323 27.7$ CuYa> t~ TOTAL R00F/0EI JG AREA 13 Z AVERAGE 11 .025 for ventilated roofa. . c~a~K 5~~r,~ GK~ EXPcSoD t,Jrlt_c-- 9• Sb X(48+48 t 30-t 3-0) _ 1¢8Z • oo X( 24 -?'2Q' + z(o) ~ 37a, o0 18SZ. r o Co~Ve, . ~7 x (4 St-48t- 3o t;a~ _ /py~; ~Z ~ L$,T . S3 X ~48fi¢8t 3or3o, _ /Z.9-48 W~x~LbwGi ~(oX5-(c> = 4.0 x Z z S.oo Zvx 36 = S.o x 4= Zo.oo /Z.oo Z~Xfoo = 8•3 x 4 z4X48 = 9.0 X /z/• zo-~' STC • W f SL, ; Z8•oo Z~ S'n-• sEn, = Z/, 00 (n ~ Po k- ri o ~ 4z.o 0 ~eT EXpe5-=-b wpU- E-c?opc.S oaJ~ wAL- /8sz.ot~ Z~}~c zlo = (oZ4 G.Ess ev,vc ~o~sZ Zg~( Z8 ~ Cv7 Z. ri !Z1 Z=27 h l.upw'S /v. Zo „ tx~~~5 9i.oo - l, 3z3.oa~. 1,40~•o8-~E' --WALL SECTIOB-- ~Determining "0" values at Roof, Wall, Rim, and Conc. Block ROOF/CEILINCi (R) VALUE S 1.) Interior A1r r'i1m 0.61 2.) 5/81, Gyp. Bd. .56 3.) Insulation 45.00 4.1 5.) Exterior Air Film .61 (STILL) ~ 2 3 ~ nUn = 1/R= . OZI iOTAL (R)= 16.7$ l ~ WALL (R) VALUE L°J q 6.) Interior Air Film 0.68 7.i i" GYp. Bd. .45 8.) Insulation I q',oo 9. ) ~'i" wrc~-~1e z•Q4 10, ) Musonite Siding , 07 11.) Exterior kir Film .17 l l "IIn = 1/R= .OQ'3 TOTAL (R)=Z3.0~ 1-t RIM (R) VALUE 12.) Interior Air Film 0.68 13.) Inaulation MoD 1 14 14.) 2" Fir Rim Joist 1.88 is 15• ) h" Fvv7- R1TE" Z• 16.) Masonite Siding 66t 170 Exterior Air Film .17 . o , • . . flIIn o 1/R= TOTAL (R)=ZT.~ c D. FOUNDATION (R) VALIIE 18.) Interior Air Film 0.68 19. ) z~ ~e 20. ) n ~j°• 9 21,) 12" Concrete Block 1.28 ' e n 11> 22.) f[olA l,WVG. $.vv 23.) xterior Air Film .17 n ' i> ° , (g~ . npn = t/R= . 09B TOTAL (R) = 10.I77 L Y(7 F E A A I~ ~",o~ Ynm,1~,s.V OV ~u •l1r~: Or ~ . *F APPLICAIZON DOFS NOT CONS'PI7VIE * APPROVAL OF PER[YIIT. ~ ~ APPUCATION FOR PERMIT * 6• . * INsPnMorr oF sUM r,rro/ox M= * rNSTULAzzoNS wna, Nar ss sa-gn-- * ' SEWER AND/OR WATER CONNECTION ~Mm UNTIL PEF2NIIT HAS BEE8 *t , . . ' . * APPR(3VID. s . * w ~ **~***~******~,r**~****t*:*****s*~*** ease Print 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: 407- Lot Block Subd vision or Tax Parcel ID ) IF EXISTING STRCCIL~RE, DATE OF ORIGINAL B[.'ILDING PERMiT ISSL'ANCE: . - (hbn Year - PRFSENr ZpNING/pROPOSID LSE: COPRMMCIAL/RETAIL/OFE'ICE R-1 SINGLE FAMILY . ~ IDIDC'STRIAI, ~ R-2 DOPLEX (7t,o C~nits) C] INSTI'IOTIONAL/GpVERi'NT ~ R-3 'IOWDII-IOL~SE (Three + Units) ( L~nits) . R-4 APARTMEN'p/CObIDOMINI[JM ( Units) 2) ~ NAME: TOLLEFSON BUILDERS, INC. ADDRFSS: 12617 Fairgreen Avenixe' CITY, STAT'E, ZZP: Apple Valley, MN 55124 PHONE= 431-1100 3) • For City Use . NA`'E: GENZ-RYAN PLUMBING & HEATTNG COMPANY Plumbers License: 7 ADDRESS: 14745 South Robert Trail ~ Active CITY, STATE, ZIP: Rosemount, MN 55068 ExPlred Not recorded ' PHONE; 423-1144 MASTII2 LICETISE# 1849M Staf£ Intial 4) oqau•:.~~o,.il' D1AME: _ ADDRESS: . CITY, STATE, ZIP: ' PHONE: • 5) ~ w• i i a• : a ~o - ~ CONNECTION T0 CITY SEWER ~p( CpNNFX~X'TION 7U CITY WATER C] pTHER . On~' 6) • o r ~ PLEASE HOLD ApPROVID PEE2MIT FOR PICK-UP BY ONE OF ABOVE ~ PLE7aSE MAIL APPROVID PERMIT TU 1, 2 41 ABOVE . • (Circ e one) ' 7) c r• u• • ^ I~44~ 7z 16 . a 7- ~ v• ~ r ca a .•,o u• e i- uo ~~a• n r• u~• Y ~ '•e • 1:•. 1 ::r 4:/. •,tlP~ 1 1 1 : pl" • !e' ;a' . • ~ . 00~ ` . . fOR CI1"Y USE ONLY PERMIT # ISSLED Pd w/Bldg. Permit FEES: $ $ ~D `5SEWER PERMIT (INCLUDE SURCHARGE) $ $ rD ' SZ~ WATER PERMIT (INCLUDE SURCHARGE ) $ $ WATER METER/COPPERHORN/OL'TSIDE READER $ $ WATER TAP (INCL[.'DE CORPORATION STOP} $ $ SEWER TAP $ $ _ % S• D-r7 ACCOUNT DEPOSIT - SEWER $ $ ACCOUNT DEPOSIT - WATER $ ~ D • Cl'Z> $ WAC $ $ SAC $ $ 'TRONK WATER ASSESSMENT $ $ TRCNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ $ WATER TREATMENT PLANT SURCHARGE ° $ $ .OTHER:, , $ _ A 77-/, G(~ TOTAL . , . . 4 .-6 Z/ ~ RECEIPT RECEIPT DOES UTILITY CONNECTZON REQUIRE EXCAVATION IN PC'BLIC RIGHT OF WAY? F--j YES IF YES, THEN A"PERMIT FOR WORK L4ITHIN PUBLIC Q ROADWAY" MLST BE ISS[JED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CpNDITIONS: APPROVED BY: TITLE: . DATE: Q~ CITY USE ONLY 5 • ~ ~ B~ _,L_ RECEIPT#: ~a . SUBD. ~Y~e~cur-i'L RECEIPTDATE: 1997 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 85122 (612)681.3675 Please complete for. ~ single family dwellings o townhomes and condos when pertnits are required for each unit New construction Add-on furnace ~ Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc. Date: 4~ 1 ZZ Z& FEES ? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00 ? HVAC: 0-100 M BTU 24.00 Additionai 50 M BTU 6.00 ? Gas Outlets (minimum of 1 required @$3.00 each) ? State 5urcharge .50 TOTAL SITE ADDRESS: 141 ZZZ13~3 OWNER NAME: y I D~ ~l ~LI.L~L~ PHONE#: INSTALLERNAME: I'PrefefC2d Fl@8tlflg $c 811' PHONE#: 7643 Logan Avenue South STREETADDRESS:_ Richfield, MN 55423 i Bus:866-7611 Fax:866-0125 CITY: ZIP: SIGN URE F R ITTEE ,t.~ arr use oNLr , L _ BL _ RECEIPT#: SUBD. RECEIPT DATE: 1997 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681 -4675 Please compiete for. . all commerciaUndustrial buildings. 0 multi-famiy buildings when separate pertnits are = required for each dwelling unit. DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: FEES: . $25.00 minimum fee gl 1% of contract price, whichever is greater. • Processed piping - $25.00 • State surcharge of $.50 per $7,000 of nermit fee due on all permits. CONTRACT PRICE x 1% PROCESSED PIPING STATE SURCHARGE TOTAL . • • ~ SITE ADDRESS: _ • • :OWNER.NAME: , 7LEPHONE ' .,TEIJANT NAME: (innPROVEnnera7'S ONLY) , _ . INSTALLER: ADDRESS: CITY: STATE: ZIP: PHONE . SIGNATURE: SIGNATURE OF PERMITTEE CITY INSPECTOR ' I.wW OPPICES TELEPHONE STALLAND Sc STALLAND (012) 836-6677 ONE CORFORA'IE CENTF.R PINANCIAL PLAZA 72dl OflMS LAN6 MINNEAPOLIS,MINNH90TA 66436 LUTEIER M. STALLAND K. YEiER SI'ALI.ANll November 11, 1986 Mr. Gary Tollefson Tollefson Builders, Inc. 12617 Fairgreen Avenue Apple Valley, MN 55124 i Re: Lot-8, B3ock 1, Blackhawk Oaks Addition i Dear Mr. Tollefson: This fall I have received two bills from you regarding the above described property. One is for $275 for a water shut-off adjustment and the other is for a grate and curb replacement in the amount of $600. As I have indicated to you on the phone several times I will pay for the water shut-off adjustment since this was my responsibility to have this corrected at the time of closing on the lot with your company, however, I reiterate my position that the grade and curb replacement is not my responsibility and I will not pay this bill. The grate and curb was damaged and apparently needs to be replaced as a result of the placement of the driveway. When I had my engineers desiqn the lots and the placement of the grates and curbs within the subdivision I had no idea of course where people would put their driveways relative to the width of the lot on Riverton Avenue. I have told you that this is the responsibility of either yourself or the property owner. In regard to the water shut-off adjustment I would like to see evidence from your subcontractor in writing as to what was done, when, and by whom. When I receive that informa- tion I will then forward you a check. . ~ Mr. Gary Tollefson November 11, 1986 Page Two I hope that this clears up some of the confusion related to these two issues as I understand that there are problems in regard to the closinq of the now completed house with Mr. David Lindquist, the buyer. If you have any questions, please feel free to call me. Yours very truly, Peter Stalland PS/JJ cc:' le Peterson Building Inspector City of Eagan onre TOLLEFSON BUILDERS, INC. Se tember 25, 1986 NUMBEfl ~~yi/1TWY `IALY.Wl6d 12617 Fairgreen Ave, ~.e ,v I 55124 Appl~i4l`~°fxX 431-1100 Peter Stallin c/o Norse Development 7261 Ohms Lane , Edina, MN 55435 , TERMS: eL[Ase o[incH Ano n¢iunn wrtH rwp weNN-cE { DATE•_ . , y ~4:H/aitGE6~;AN? CRE,bIT'S' ,,-e'~ . . BALANCE BALANCE FORWARD ' 9/25/86 Grate and curb replacement for the property located at Lot 8, Block 1, Blackhawk Oaks Addition $ 600 00 PMV LAST AMOUNT IH TNIS COLUMN TOLLEFSON BUILDERS, INC. TOLLEFSON BUILDERS, INC. NK4W"5WM Nov. 7, 1986 yy~y~qRyy~y~YfIlYa61 M}npp~~~nPQ~ qg NUMBER nmpin.~~r~d'Y 12617 Fairgreen Ave. Apple V(MIU45-7355124 Peter Stallin c/o Norse Development 7261 Ohms Lane , Edina, MN 55435 , TERMS: aLeAst ec- wwo warvnw wnw roun xeMirrwwc[ § DATE... . . . , CHAI~QES AWD Cf2EDit5 t . . 6ALANCE BALANCE FORWARD i- Water shut-off adjustment for the property located at Lot 8, Block 1, Blackhawk Oaks Addition $275. 00 PqY LqST AMOUNT TOLLEFSON BUILDERS, INC. IN THI3 COWMN V RESIDENTIAL BUILDING Permit Application / City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New ConsWCroon Reauirements RemodeUReoair Reauirements Office Use Onlv 3 registered site surveys showirg sq. ry. of lot, sq. ft. of house; and all roo(ed areas 2 copies of plan Cert of Survey Recd (20°k maximum bl coverage allowed) 1 set of Energy Cakulations for heated addi6ons Tree Pres Plan Recd 2 copies oi plan showing 6eam 8 window sizes; poured found design, etc. 1 site survey for addibons 8 decks Tree Pres Not ReQd 1 set of Eneryy Cakulatbns Additbn -i/Micate i/on-s8e sepfic system _ On-sde SepGc System 3 copies of Tree P2servafion Plan if lot platted after 711193 Rim Joist DetaJ Op6ons selectlon sheet (bldgs with 3 or less units Date ? S Construcriou Cost Site Address P Y' ~ I/1 A/ P Unit/Ste # Description oC Work ~~tS7 (q„ I I Q G(]~ S GY Cf 1`i fP.t~ ~Gyl~ Pl Y~~ I"'Gl!2r Multi-Family Bldg _ Y~ N Fireplace(s) _ 0x 1 _ 2 Property Owner r1 l`71'~ ~ c~~~ !9 k Telephone #(tU.~I ) OtaC 2- Contractor /ld'o Le / ~{n~ /~d~l Address ~n'~~n j/1 , Zl~ f/ Z 3 CitY ^ ~p_~~(~~~- State M Zip Telephone #(j~'~) r'{ 2'J ^ 6 -2 S-~ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 Energy Code Category , Residentlal Ventllation Category 1 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope CalculaUons Submitted Licensed Plumber Telephone ) Mechanicat Contractor i7Mt2- Telephone 9301) - ~ Sewer/WaterContractor I - I ~I li j~I J LI i,(',jJ I' i I hereby apply for a Residential Building Permit and acknowledge that the information is aomplete and accurate; that the work will be in conformance with the ordinances and code°of"tfie 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 lans. a W~,~ nko ApplicanYs Printed Name ApplicanYs Signature ' OFFICE USE ONLY Sub Types ? 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 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage O 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding 13 32 Addition ? 36 Move Bldg. ? 42 Demoiish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors ? 34 ReplaCement •Demolition (Entire Bldg) - 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. _ Fooangs(deck) FinallIvo C.O. _ Footings (addition) _ Plumbing _ Foundation HVAC _ Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ F[gs _ Au/Gas Tests _ Final . _ Framing _ Siding Srucw Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (newlreplacement) _ Insularion _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review - MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Capies Other Total : $V- ArS aoOe El'GINEEAING . COHSU~T~HO EI161HEElIS ~~,i~,~oc-Q-S PIAHNEBi cAd IAHD 3LRVEYOf15 COMPANY, INC. ~ 1000 EAST 1461h STpEET, 6URNSVILLE, YINHESOTA 55337 PN 44332-3000 Cer~Z}~z ccz~` Sut-Y~ c~ Jaaal I.~e~cri z,~io~z: LoT BLock l, BLAC.KNAwK. O/~,k5 ~DDtTioN ,~Av~n.~~tiTc,nnw,a~,~p, N 601° 50.` 4a" E ~ee`z_sJ e e_e , (aaz. s) (eas.a) ~D~Aiti1A(~ E UTi~ts+~ ~~61~nt,a~' LOT 8 ~ 1,7 ~ is' uur. L9/.o7 \ (d9L.o) ~ C69Z•~) ~ - p ~ / ~ rPR PasED °L~9z. ~ ~ ( r~ 4~,~c w ii.c i ~y,e~ o I~ By 5. ,6 \ (89z.o~.o g N~~T~ `y~~dj p¢,ao CBqz.33~ sszs SC~AIlE ~ 1= 3 C), i.-i' _i ~y • . _ . s ~ ~ !ee9. ~ m`k{ 1 X 5 Y Q~.\bf , z c. geb3 6 p`b 1889'~~ - / ~ 89/0, ~ENOT~ ~~ST11~1(a ELEVG4TiON (dqZ.o ~ 9EiaoT~s P~opc>SE~ E~E.~rA~oN ~ . pr- Su2FAc.E. 7D C74M66 I heriby certity that thie in a true and corract rapreeantation ot a tract of land at shown'and described hereon.• Ae praparad by me on this ,I-Fr4 , day ol 198 . . KGViseP b ~/8~9~ movep p/ouS6 ~ Reviseo 7/n/e6 AlovE'o frousE ou lC~~•. H171n. 20c7 RESIDENTIAL PLUMBING PeRnnir aPPLicaTioN CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please com lete for modifications to existin residential dwellin s. Date ___U-f 145 ! o Site Street Address ;Sg Vg R-1 V'PX tD rl &9 Unit # ...,.,~_hE*Q_ UesM(7k~ _ Telephone# ( PropertyOwner, )i ohYj:3 _,kl Ctimpion Contractor gq7 3F,S_1340 Telephone ) I Address 3670 Oodd Rd. #100 City State Zip The Applicant is: _ Owner & Occupant V! Licensed Plumbing Contractor Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee $ 100.00 Per as-built $ 10.00 Fire Repair (replace burned out fixtures, etc.) $ 90.00 This fee a lies when extensive lumbin re airs are made to a building. 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 . installing only a wafer 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 Ahandonment _Water Turnaround (add $136.00 if a 5/8" meter is required) Other: Water Heater $ 15.00 Water Softener V new replacement Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00 State Surcharge $ .50 Total $+=Y=- I hereby apply for t, Reaiciential 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 wi[hout a permit and work will be in accordance with the approved plan in the event a plan is required to be reviewed and approved. ApplicanYs Printed Name ApplicanPs Signature A-f~5 K~ 4b nr ; . • a' rY Qty' of - —+ a e 1411ILL14. 7 11-86 sr j fi ' A e 7 47A;;.001)4 PERMIT City of Eagan Permit Type:Building Permit Number:EA112546 Date Issued:08/16/2013 Permit Category:ePermit Site Address: 3818 Riverton Ave Lot:8 Block: 1 Addition: Blackhawk Oaks PID:10-14387-01-080 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes . Joseph Smith Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - John C Jesmok 3818 Riverton Ave Eagan MN 55122 (651) 454-8132 Frank Fabio Company 6510 Jocelyn Road North Stillwater MN 55082 (612) 741-9640 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA126638 Date Issued:09/04/2014 Permit Category:ePermit Site Address: 3818 Riverton Ave Lot:8 Block: 1 Addition: Blackhawk Oaks PID:10-14387-01-080 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: 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 by law in ALL single family homes . Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - John C Jesmok 3818 Riverton Ave Eagan MN 55122 (651) 454-8132 Home Depot At Home Services 656 Mendelssohn Ave N Golden Valley MN 55427 (763) 542-8826 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA136544 Date Issued:05/19/2016 Permit Category:ePermit Site Address: 3818 Riverton Ave Lot:8 Block: 1 Addition: Blackhawk Oaks PID:10-14387-01-080 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). 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 - John C Jesmok 3818 Riverton Ave Eagan MN 55122 (651) 238-0810 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA158730 Date Issued:10/29/2019 Permit Category:ePermit Site Address: 3818 Riverton Ave Lot:8 Block: 1 Addition: Blackhawk Oaks PID:10-14387-01-080 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. Please call Building Inspections at (651) 675-5675 to schedule a final inspection. 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 - John C Jesmok 3818 Riverton Ave Eagan MN 55122 Minneapolis St. Paul Plumbing Heating Air 640 Grand Ave St. Paul MN 55105 (651) 228-9200 Applicant/Permitee: Signature Issued By: Signature