3833 Riverton Ave
CITY OF EAGAN 1117Z
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt ~qt
Te be wnd fer Est. Vclue Date , 19
Site Addreas Erect El Occupancy
Remodel ? Zoning
Lot Block Sec/Sub.
Parcel No. Repair ? Type of Const.
Addition ? No. Stories
Move ? Length
Z Name Demolish ? Depth
~ Address Int Impr. ? Sq. Ft.
City Phone Install ?
Name Apa.ovob F•ss
~
u- A~~ Assessment Permit
1- City Phone Woter 8 Sew. Surcharge
Police Plan Review
oc
~Z Name Firo SAC
uo Address _ Erg. WaterConn.
~ W City Phone ' Planner Water Meter
Council Road Unit
I hereby acknowledge that I have reod this opplication ond state thot gldg. Off. Tr. PI.
the information is Correct and ogree to comply with oll opplitable APC
Stote of Minrxsota Statutes and City of Eoyan Ordinonces. Parks
Var. Date Copies
Sipnature of Permlffea
Total
h Building Permit Is issued to: on tha exprcst conditlon tlwt
oll work shoil be done in occordwrce with oll appticabla Stete of Minnesota Stotutes and City of Eaqan Ordinonus.
Buiidlrp Offidul
Pwmit No. Permit HoWw Date Telephone #
Plumbiny q ( 8~ ~
H.VA.C.
EML-Wc M c 4 ~ 3~ I. G r• do
Inspsction Date Insp• Other
Footings 1
Footings 11
Foundation /X/-Y/ff iAl
Framing
Roofing
ilouyh
Rouyh Htp. ~ ya -1-4 o44 P'
Insul.
Flroplsce
Final Htg Ff,(/,e}[. lWeaeo 13 QeCU~
Final PI ,Q laft~
Final
CIs t/O . ~ S •l S- ~5"l ~ ~ '
Water ~•iba L ion1
WAII J
Sewer
Pr. Disp.
# '
;
PERMIT # CITY OF EAGAN FEE 06
MECHANICAL PERMIT ~ f
RECEIPT 454-8100 S/C
MINIMUM RESIDENTIAL FEE - $10.00 + $.50 TOTAL
DATE ~ MINIMUM COMMERCIAL FEE - $20.00 + $.50
1. Bldg. Type: R~s Comm Inat 2. New Add Alter Repair
3. Total Bid Price 4. Job Address
I ~-i..e"'a W
Lot Block 2- Se Il
c S5.Owner"
7
6. Contractor j~-J : r ~•l i ? !:.t.~~ i!~ / ~~7~1~i'!_J '~7) `_~-1 f?~Lt~i" i~9LJ ~~`•C'
(Name) {Streeq (Citl') RiR}
7. Contractor Phone #
~ RESIDENTIAL HEATING - 01-100,000 BTU's -$24.00. Each additional 50,000 BTU's or fraction -$6.00
RESIDENTIAL COOLING - 01-24,000 BTU's -$12.00. Each additional 6,000 BTU's or fraction -$6.00
MODIFICATIONS/ALTERATIONS -$10.00 minimum fee
/ HEATING VENTILATING HOT WATER STEAM ~ AIR COND.
e1R PIPING PROCESSED PIPING AIR HAND. EQUIP. RtFRIG.
RES. GAS PIPING OUTLETS -$1.5U TANKS: LP. UNDERGROUND OTHER
COMM./IND. RATE - 1% OF TOTAL BID PRICE PLUS $•50 STATE SYRCHARGE FOR EACH $1,000 OF FEE.
Signed: for
Approved Inspections: Date Rough Insp. Date Final Insp.
CITY OF EAGAN Remarks 1 J'?
Addition BLACKHAWK OAKS ADDITION Lot 11 Blk 2 Parcel 10 14387 110 02
owner Street 3833 Riverton Avenue scace Eagan. MN 55122
Improvement Date Amount Annual Years 5 Payment Raceipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK /1112 9 1970
p - 3-84
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA D~aZ
STORM SEW TRK 7 - -
STORM SEW LAT
CURB & GUTTER '
SIDEWALK
STREET LIGHT
Roa Unit -
WATER CONN. .
BUILDING PER.
SAC •
PARK
Receipt PLUMBING PEHMIT Permit No.
CITY OF EAGAN
Fee
~ Fill in numbered spaces S/C
' Type or Print /egibly Tot.
` 1. Date 2. Installation Cost
3. Job Address - Lot Blk. Tract
4. Owner .
5. Contractor Phone
6. Address
7. City State Zip
8. Building Type: Residential 0 Commercial ? Institutional ?
9. Work Description: New ~ Add ? Alter ? Repair ?
10. Describe
11. No, Fixtures No. Fixtures '
Water Closet Cesspool/Drainfield
Bath tubs Septic Tank
~ Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outleis
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and cades governing this type of work.
Signed :
for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-6100
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 PilOt Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675 '
SITE ADDRESS: APPLICANT:
. 11N A1/F . :
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION .
, ,
~ ~
Pertnk No. Portnk Holder DaM TNephona A
ELECTRIC
PLUMBING
HVAC
Mspectlon Dete Insp. Commenb
FOOTINGS
FOUND
FRAMINQ
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTO
ORSAT I
TEST I
BLDG FINAL I
~
BSMT R.I.
BSMT FINAL I
DECK FTCi
DECK FINAL
l bfN -Z~-tii~ ~
• ` RESIDENTIAL
BUILDINC PERMIT APPLICATION
CITY OF EAGAN 130• 56
3830 PILOT KNOB RO - 55122
7?~~9 / 651-681-4675
NewConstrucfionReauiremeMS RemodeVReoatrReouiremenis -
• 3 registered site surveys sMxirg sq. tL ot bl, sq. fL ot Muse; and ail roo(ed areas . 2 copies of plan
(20% mazimum bt cweaage alimxed) . 7 set of Eneigy CalcuWtions tor heated additions
• 2 copies ol plan showing beam 8 window sizes; poured found design, etc.) . 1 sde survey for exterior additions 6 dedcs
• 1 sel of Eneigy Cala:ations
• 3 capies of Tree Preservatlon Plan if bt platted alter 717/93
• Rim Joist Detail Options selettion sheet (bklgs wilh 3 a less unAS)
~
DATE ~e~2 °UI VALUA~TIO,/N(EXCLUDINGIAND) f-IC.~PD
~JB SITE ADDRESS 01 Ye, ~~~,LYJ I~YJ J7 ~
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWNER G~JZ-~~
TYPE OF WOR(K~ FIREPLACE(S) _0 _1 _2 _3
APPLICANT fVJ (`i (_9- t;t' rn n PHONE # CO (2`^I 21-~o f~o 2,P
ADDRESS?)~Vwk SYtO 1 i 1f16 6SI)• MQI C~Jf~I ZIPCODE5~
PAGER # CELL PHONE # FAX #
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULFS 7670 CATEGORY 1
(check one) ' - Residential VentilaGon Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
_ MINNESOTA RULES 7672
- New Enetgy Code Worksheet Submitted
Plumbing Contractor: Phone
Plumbing S}'stem Includes: _ Water Softener _ L1wn Sprinkler Fee: $90.00
Water Heater 1Vo. of R.I. Baths
Nu. of naihs
Mechanical Contractor. Phone #
b4echanical Sys[em Includes: _ Air Conditioning Fee: $70.00
~ Heat Recovery System ~~(1;241
lSewer/Water Contraetor: Phone # ~
191
All above information must be submitted prior4o processing of application. By
I hereby ocknowledge ihat I have read this application, state ihat the information is conect, and agree to comply with
all applicable State of Minnesota Statutes and City of Eagan Ordicances. `
Signature of Applicant ~~l_OV=A3N ~ ~ _
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 1101
OFFICE USE ONLY
0 01 Foundation ? 07 OS-alex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
O 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) t] 36 Multi
? 05 03-plex ? 17 10-piex ? 19 Lowar Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interiar) O 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FoundaGon) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuaiion Occupancy MC/ES System
C~rcuc -cde Znninn City Watei
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bidgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Foorings(new bldg) _ FinaUC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundarion HVAC
Drain Tile
Roof Ice & Water Final Other
_ Framing _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Fueplace _ R.I. _ Air Test _ Final _ Siding Stucco Stone
_ Insulation _ Windows (new/replacement)
P,pproved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC1ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Piumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Thiz request vaia
18 mon ths (mm ~i3-3rQ/_0 . [;'/5
~
C• 2~22 ~Ia~k~~wk 6in Ks ~(p~.av
Request Oate Fire No. Rough-in Insyection ~
J fl ired? Ready Now Will Notify InsPec-
Ves ?NO [or When Heady
Licensed ElecVical Contrector 1 hereby requeat insoection ot above
Owner electrical work installed at:
Street Address, 9o ar Paute No. City
3~'33 r rfv r) 4~ Qk'1
ection o. Townshlp- ame or Na. Fange No. Cou Ity
' OccuGa t WRINT) Phone No.
rn e ~sa - 36
Po r5uppli r yAddre~+s5
IJ/1~~~4i / f.f{~rn/~4t4
Ele~ th ical Conhector (Compap y Namel 1 Conuaclor's Liconse No.
/VII[~IQi1d ~lPC'~V~C.
Mailing Address (Convactor or Owner Making Insiailationl
36 Qerr ia( e ol. EOqaki
Auxho ed Signatur ntractor O er Making In~ allaiion) Phon Number . •
, ~sa - s~ao
MINNEbOTA STATE BOApD O CTflICITV THIS INSPECTION REQUEST WIIL NOT
ari99s-Midwey 91tlg. - Boom N-191 BE ACCEPTED BV THE STATE epqND
1821 Universily Ava., St. Peul, MN 55104 UNLE53 PHOPEN INSPECTION FEE IS
Phnne 16121297-2111 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ee•ooooi.oa
v'
~ See instrvctions for comoleling this brm on beck oi vellow copv-
-`N`Z 2 "X" Below Work Covered by 7his Request
MVwIAddj ReO. Type o1 Builtling Applioncee WiroA EpuiVmenl WireA
Home Range Temporary Service
Duplex Water Heater Lightiny Fi#ures
Apt. Building Dryer Electric HeaUn
Commercial Bldg. Fumace Silo Unlonder,
Industrial BIAg. Afr Conditioner 8ulk Milk Tnnk
farm Other per.i y ,her ISper,ityl
~ er uccify Other Omer
ompu[e Inspection Fee 8elow
N ServiceEnVancaSixe d Fae Fexders/Subleeders 4 Fee Circuits
0 to Z00 Am s 0 l0 30 Am s a 3. 0 m 30 An~ s
Above 200 qmps 37 to 100 Amps /O d) 31 to 100 Am E s
Swimming Pool Above 100_Am s Above 100_Am
Transformers Irrigation Boonts Partial.'Other F e.s
Signs Specialinspection / '
nem9.ks S6I. Sd TOTAL ffE( W I
U '
flouph-in Ont^r~~ \ /
I, eha ElectrieeY
Inspector, heraby
certily thet the above
Final O~'~ ~77 insDection hes ~aen
J mede.
fMa repuest voltl 18 monlha trom
CITY OF EAGAN N°_ 1 1 17 2
' 3830 Pilot Krwb Road, P.O. Box 21-199, Eagan, MN 55121 1
S 6~~
BUILDING PERMIT PHONE: 454-8100 rteceiot # ~
Te y. md y, SF DWG/GAR Est. Value $103,000 Date OCTOBER 28 , 1 9_85__
SiteAddress 3833 RIVERTON AVE Erect ~'[l Occupancy R3
Lat 11 Black 2 Sec/Suh. BLACKHAWK OAKS Remodel ? Zoning R1
Parcel No. Repair ? Type of Conat. V
Addition ? No. Stories
KOZY ENERGY HOMES Move ? Lenyth 64
w Nme Demolish ? Depth 4 ~
z AddresW 5850 TOWER DR ~nt Impr. ? Sy, Ft,
~
City OODBURY 459-1163 Phone Instflll ?
SAME 452-3692 Apyrorols Fees
o Name
u~ Address Asussment Permit 440.50
l- City Phone Water d Sew. Surcharge 51.50
Police Plan Review 220.25
GW Neme DONN ANDERSON Fira SAC ~00
!'z 13426 FLORIDA CT 500.00
I~ Address Enp. WaterConn.
~W CityA'V• phone 432-5461 plonner waterMeter 63.00
Council RoadUnit 280.04
I hereby otkrqwledge that I hove read this opplicotion ond ztote thaf gldg. Off. lO/Z H/H T, pI 132 . 00
the inlormution is rnrrecf and ogree to wmply with oll applicable APC
State ot Minnewta Statutes and City of Eayan Ordinances.. n Parks
Var. Date CoPies
Sipnaturc of Permifroe , 212 . 75
A Bulldin Permit is issued ta: KOZ •R W on tha etal
9 xprcss conditlon thot
ull work sholl be done in occordante wi a icuble Stat f ewta Statutes and Ciy of Eapan Ordirances.
Buildirp Officlol
0 *Y6**:i.* *SC:YY,t>%%"K >a*
rr.rv t:iF rAt:;nNI
!-;AS4w1E!;: 3 7E:=;rsiNAt_ Nr.i: 7219
DEt7F_c 04f2'"r'!93 7'!i'il::: 16s0028
tLi .
NAi'iL;; f'ANF..t..CFti*T :]F ASN I\!C
32:10 3001 7"23 CAEiIE;OII I...R l`.39,75
205 9001 72::; c,nr.t:Br.,U LN 6.50
3210 900:!. 3833 Fi:CVF'.I+:TOsv P, i'6i2.c^_5
205 9001 3833 I't7:UEF;.7QN :?.OD
.
cF;ca ao ;r;,~
USI?R iD;: NANCY
I--~ PERMIT CITY OF EAGAN
' 3830 Pilot Knob Road PERMITTYPE: euzLosNG
Eagan, Minnesota 55122-1897 PermitNumber. 031766
(612) 681-4675 Date Issued: 0 4/ 2 7/ 9 8
SITE ADDRESS:
3833 RIVERTON AVE
LOT: 11 BIOCK: 2
BLACKHAWK OAKS
P.I.N.: 10-14387-110-02
DESCRIPTION:
Buiiding-Permit Type SF (MISC.)
~Suilding Work Type REPAIR
,z
CensUS Code y 434 ALT. RESIDENTIAL
: E--~
i~ ~k" ~
' t\(.....3'jUrs t_•~/.s
€
~ y n y,
1(`~~ r~_, ~
a
REMARKS:
SIDIN6 50FFIT FASCIA TRIM DOWNSPOUTS
FEE SUMMARY:
VALUATION $18,000
Base Fee $262.25
Surcharge $9.00
7ota1 Fee $271.25
CONTRACTOR: - Applicant - sT. LIC OWNER:
PANELCRAF7 OF MM INC 17216628 0002179 LEASE DAVID
3118 SNELLTNG AVE S 3833 RIVERTON AVE
MINNEAPOLI3 MN 55406 EAGAN MN 55122
(612) 721-6628 (612)456-9735
S hereby acknowledge that i have read this application and etate that ths'
information i,s correct and agree to comply with all appliceble State qf Mn.
~Sta-tuteg and Gity atf Eagan drtlitf,ances.-' ~
-
APPLICANT/PERMITEE SIGNATURE ISSUED Y: IGNP-TfURk
311c(e 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) $jqj.jK
cirY oF eacaN
3830 PILOT KNOB RD - 55122
681 at675
New Construdion Reauiremen% RemodeVReoair Reauirements .
? 3 registered sRe surveys ? 2 copies of plan
? 2 copies ot plans (include beam 8 window sizes; poured fnd. design; etc.) ? 2 sde surveys (exterior additions & decks) ? 7 energy calculations ? 1 energy calculations for heated additions
? 3 copies of tree preservation plan if lot platted aRer 711193
. required: _ Yes _ No - ' DATE: CONSTRUCTION COST: a~ S 6•~
DESCRIPTION OF WORK: S I d 1nQ ~SDF F f T FQ SGI Q
STREET ADDRESS: 3 3 'K.I V QX'f"U n ~11uQ.
LOT BLOCK ~l
SUBD./P.I.D.
PROPERTY Name: lP_CLSe. DGl.uid Phone L456 - q 73S
owNeR A~~
Street Address: K`t ~ I' ~D(1 .tt'~~Yl (.i
City: F- QG1 Cl.n State: mn Zip: SS(2Z
CONTRACTOR Company: ~fIP,ICXCL.F-F D1= M(1 Phone#: D21
~Sot) Street Address: _5t te ,~Y1P,~ License
OD33g City: MP15 state: /Yl N ziP: 557d0(0
ARCHI_TECTI,,,, , Company: Pho
ENGINEER . . .
Name: Registration
Street Address:
City: State: Zip:
Sewer & water licer.^ed plumber (new construction only): Penalty applies when address change
and bt change am , equested once permit is issued.
I hereby acknowledge that I have read this application and state that the information is orrect and agree to com I with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
iLPR OFFICE USE ONLY
91938
Certifcates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Require
OFFlCE USE ONLY ` ~ ~
ak.- ir . •..y ;
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging o 16 Basement Finish
? 02 SF Dwelling 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-piex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch ? 09 12-plex ? 14 Fireplace ?`21 Miscellaneous
? 05 SF Misc. ? 10 = plex ? 15 Deck
WORK TYPE
? 31 New ? 33 Alterations ? 36 Move
? 32 Addition ? 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MC/WS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code.
Depth Footprint sq. ft. SAC Code
Census Bidg
Census Unit
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $ , ~oS6. ~
5urcharge
Plan Review
License
MCNVS SAC
City SAC
Waier Conn.
Water Meter
Acct. Deposit
SIW Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total: a 8y a~
% sAc
SAC Units
1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL11 IZ5. 25
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651•681•4675
New Conskuction ReauhemeMs - Remodel/Renalr Reaufremenfs
? 3 registered stle surveys showing sq. R. of lot, tq. N. of house 2 copies of plan
and all roofed areas (209e maximum lot eoverace allowedJ 1 set of energy calculaifons for heafed addBions
? 2 coples of ptans (show beam S w(ndow sizea; poured tnd. destgn; etc.) 1 sife suney for extertor addMions 3 decks
? t sei of energy caleulaf(ons
? 3 copies of kee preservaflon plan B lot plaHed aker 7/1/93 od
DATE: D- 3- ~g CONSTRUCTION COST:
DESCRIPTION OF WORK~~'
STREETADDRESS:
LOT: ~ BLOCK: ~2- SUBD./P.I.D. ~
Name: Phone ~'S~1' u s~' 7 3 f
PROPERTY tasf F+n?
OWNER ~
Street Address: L 0W~0~
City ~'<-o O..--L- State: Zip:
Company: Ck l.-C.-O- ~-~`°r-r vrC Phone 6) S 1, Z{ ?
(area code)
CONTRACTOR /~I^ °
Street Address: y-t C C ~ License #9 Exp. ~ o 0
CffY&,62,~ Sq State: Zip:
ARCHITECT/
ENGINEER Company: Name:
Telephone area code ( )
StreeR Address: Regisfration
City State: Zip:
Sewer 8, water Ilcensed plumber (reaulred for new conshuction onlvl:
Penalty applies when address change and l01 change is requested once permN Is Issued.
I herehy acknowledge that 1 have read this applicaflon, state thaf the informaN I e e n a to comply wRh ail applicabl
5tate of Minnesota Statutes and City of Eagan Ordinances. I
,
Signature of Appllcant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
D 02 5F Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage 0 22 Porch/Addn. (4sea.
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-piex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damago
? 05 3-plex ? 10 8-piex ? 15 Lodging ? 20 Pool O 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bidg.' ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
" Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code
UBG Occupancy sq. ft. No. of Units
Zoning sq. ft. No. of Bidgs
# of 5tories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MC/ES SAC City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
5/W Surcharge
Treatment PL
Park Ded. Trails Ded.
Other `
Copies
Total:
SAC Units
% SAC .
• ~ ~ •'r ~ • i • i • • u r. a.
~ . s • a~ i • • • r• • • ~ • t ~ ~ ~ ~ •
. ~
CITY OF Ed1GAN
APPLICATION FOR PIItMIT SEL9ER ANID/OR WATER CON1,1ECTION
(Please Print)
1) PROPEE2TY ADDRESS: _ S~
r.Fr_ar. DFS(RIPTION: II !•~i 7~// ~
(Lot Block Subdivision or Tax Parcel I.D. Number)
IF EXISTING STRCC'IqJRE, DATE OF ORIGINAL BL'ILDING PERNffT ISSL'ANCE:
(Nbn Year)
PRESENT ZONING/PROPOSID USE: R-1 SINGLE FAhffLY
R-2 DL'PLEX (2t,o L'nits)
R-3 TOWNHOLSE (Three + Units) ( Units)
R-4 APARTh1ENT/CODIDOMINIC'M ( Units)
C0NA1EF2CIAL/RE"TAIL/0FFICE
INIDCSTRIAL
INSTI1i; TIONAL/GDVERNMENT
2 ~ NAME: I~( .
i r
ADDRE55:
CITY, STATE, ~.ZP: 6~1g)t~ ~-uv-;-P~.MiU
PHONE: ~2~t^C9<Ce~Cv
3) • r~• For City/L'se
NAME: ~
Plumbers Licenst
ADDRESS: p f`e 4 c ti-P tlve
CITY, STATE, ZIP:
8JU ired
PHONE: MASTER LICENSE ~ V~' t Recor,
Staf Initial
4) ~r.y :.~r ~ ia•
NAME: G~ LI ~n,S't t V G l ~ l 1 Ci1MtA C
r ADDxESS: 4(n i c, c Ro a
CITY, STATE, ZIP:
PHONE:
5) u ~ • y~
Q( COIV['.CTION TO CITY SEWER QQ CONNECTION 'IO CITY W11TER
Q 0'PHER (Please Describe)
6) u • ~ i
? PLEASE HOLD APPROVID PEEtIffT FOR PICK-L'P BY ONE OF AHpVE
~ PI,EASE MAIL APPROVED PERMiT TO 1Q~ 3, 4, AHC7VE
(Circle ane)
7) ~
- _
FOR C ITY U SE ON:,Y r ~
pE°`".IT ISSUED
F~rs' $ ~/i,5 i~ SE::c:2 °ET{t1T^i' ~I~IC~L'JL~. jU~~~?~Gc~)
S ~(J. l~r~ W?TEZ PERP4IT (INCL'JDE SIIRC?:A~GL)
$ f~•~~G WATER ~1ETER/COPPERHORN/OUTSZD~ REP,DE.'.
5 WAT°R TAP (INCLUDE CORPORATZ0~1 STO?)
$ S~:JE4 T~P
~ ~r.., r-~~'1.-."T_~ ....=.ri~i_ - a_:.~'^.~
S_% S ~c~ ACCOUNT ?..F,POSIT - P7ATE4
S _S ~o. ~ wac
$ ~3~.~.~ SP.C
$ TRliVK WATER ASS%SS??E.`7T
$ TRu;~K SE~vER ?SSES5~~IE:TT
$ L:,TE?,aL BENEFIT/TRUNK Sc:~:E~c
$ L.'~TERAL BENEFIT/TRU:IK SVAT°R
$ WATER TREATMENT PLANT SURCHARGE
$ OTHER:
$ TOT~L
Ar10U:~T PAID/gECEIPT ; S~aU
DOES UTZLITY CONNECTION REQUIRE EXC.aVATION IN PUBLIC RIGiiT OF WAY?
~ YES ZF YES, THEN n"PERMIT FOR ~RORK WITHIN
PUBLIC ROADWAY" MUST SE ISSUED BY THE .t
C] NO ENGINEERING DIVISION. LIST AS A CONDI-
TION.
b
SCEJECT TO THE FOI.LOS4ING CONDZTIONS:
APPROVED BY: :^~9
TITLE:
i
DAT~ •
CITY USE ONLY
L BL ~1- RECEIPT
SUBD. .~"atJ Ak DATE:,
1996 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
, 3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
New construction Add-on fumace
~ Add-on sir conditioning Add-on air exchanger, i.e. Vanee system, etc.
Date: ' 3 9 (o
FFCC
? Minimum Fee: Add-oNRemodel (existing residence only) $ 20.
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
~ Gas Outlets (minimum of 1 required @$3.00 each)
? State Surcharge .50
TOTAL 0•S
SITE ADDRESS• 3 ~ 13 Av-er 7on
OWNER NAME: 6tc-u i d 4 P, C1. ~-e- PHONE " 73S
INSTALLER NAME ~ekg -5Q-&A5LCC0- ff~4'f~c 1'Hc
STREET ADDRESS: -7~ 3 0 (.c) /cf5 C-A S-t- A
C1TY: e STATE: ZIP: S~/a y
PHONE ( f~/~-) y3 ~ - 7C7 ~I ,n~ • ~ ,
MZ`AA"TQRF6FV
CITY USE ONLY
L _ BL _ RECEIPT
SUBD. DATE:
1996 MECHANICAL PERMIT (COMMERCIAL)
• CITY OF EAGAN ,
5830 PILOT KNOB RD
EAGAN, MN 55722
(612) 681-4675
Please complete for: ? all commerciaVindustrial buildings.
? multi-family buildings when separate permits are M required
for each dwelling unit.
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: ?$25.00 minimum fee QC 1% of contract price, whichever is greater.
? Processed piping - $25.00
• State surcharge of $.50 per $1,000 of pgmk fee due on all pertnits.
CONTRACT PRfCE x 1%
PROCESSED PIPING
STATE SURCHARGE
TOTAL
Ei ir- X)DRCJJ. - - -
OWNER NAME: TELEPHONE
TENANT NAME: (IMPROVEMENTS ONLY)
INSTALLER:
ADDRESS:
CITY: STATE: ZIP•
~ PHONE
SIGNATURE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
~
~
~
7985 BUILDING P£RMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MLST BE LICENSED StSTH THE CITY OF EAGMI
COMMERCIAL SINGLE FANILY DWELLINGS
INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS
& STRUCTURAL PLANS, 1 SET OF 3 CERTIFZCATES OF SURVEY
SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS
ENERGY CALCULATIONS' ~
$2,000 LANDSCAPE BOND 103,000
To Be Used For: ~XFIDW6 Vatuation: /~p'r~ Date: ZZ-, ~s
Site Address 3~'33 /c 1?e?LTo Pi,Qr/. OFFICE US£ ONLY
Lot Block Erect ~ Occupancy R~3
Remodel Zoning ,1
Parcel/Sub fiC-ACK/{AyvK QA/4J' Repair Type of Const
Addition ~ It of Stories
Owner j-c~ o x.. y fL rI r,2 G~ ,r~a;~i~s Move ^ Length (o
Demolish Depth
Address ,5 3`Sa 7-OLc1L./L O!L - Int.Impr. , Sq Ft
Install
C i t y/ Z i p Cod e i.00?J O 13 rlGtz
Phone APPROVALS FEES
, -^7--
Contractor 'L ~/F/LG pNigj Assessments Permit
7z'~-, ~
'Aater/Sewer Surcharge 51!-
Address Police ~ P1an Review 22p.
Fire SAC ZS,
City/Zip Code 4_ Engr Water Conn Sp6.
Planner Water Meter (03,
Phone Council Road Unit O.
Bldg Off ?7e2k,
:4)1'reatment Pl (3'L.
Arch./Engr. .06t/r/ A,.../Qg7,Jt.S" UW APC Parks
Variance Copies
Address TOTAL ?s
City/Zip Code AAQL,F- i/%{- e,L-
Phone It ~/,J 2- -'.S Y 6 /
2~ K ~2 t ~e~zx ~8 = 4€~2s~ ~
.
24 K 20 6co x t 2= 5-7 (o c)
~2~ ~ iz r lisZ
7ec)
Io 2(cg E,
SOLAR HOMES OF AMERICA
4651 Nicols Road
Eaqan, Minnesota 55122
(612) 452-1148
EXTERIOR ENVELOPE AVERAGE " U" COMPUTATION
Owner: L/ o/= r/ /C_. r, 14 o NI e-~ J /t/c::- -
Site Address: y~ x--Ta A v,-
Contractor: eO L;/ F_,4 I-IGMaJ Date: /e - zL -gs Phone: y,;- y- //G.1
~I52 - 3 G 9
Determine working square footage of each.
1. Total exposed wall area Sq. Ft. x .11 = / °o 'L
2. Total roof/ceiling area 3~ Sq. Ft. x.026 = d
Total exposed wall area above floor
a. Total wall window area
b. Total door area Z/- o
c. Total sliding glass door area 61ri, ~
d. Total fireplace wall 5~_6
e. Total wall framing area (average 10%) /6' 5
f. Total net wall area above floor q q~
a.: Total rim joist area Total F.xposed foundation area
h. Total foundation window area / (fD
i. Total net foundation area above grade ~
Determine " U" Value of each wall segment.
a. x u • A~ 7 = 4- s- 0 -7
b. z~ . o xu~~ 3s-I'{ = Z• YS:
c. X u~~
d. xu„ ,o ~ = 3• Zo
e. J . C) x u
f. qC~ .I.o Xu„ .v4101" = 3~.y6
9. ,s-d Xu~, ord~
n x„u~,
O•C~ x u,~ d = a
3. cv O•~T _TOTl1L
If item #3 is the same as, or 1?ss than item #1, you have met the intent of Sec. 6006 (c) 2
Total exposed roof / ceiling area = /p
j. Total skylight area
k. Total roof / ceiling framing area lOq / p y
1. Total net insulated roof / ceiling area q/ 2, ey 1~
Determine " U" value for each roof / ceiling segment.
J. p,/- oY X„ u „ , 30 = 6-~'~----
K . Z'p ~ x u , a 3 = 3 .
L. ~iz,qz X„ u„ . o1..,
4. TOTAL
If total of 4 is the same as, or less than #2, you have met the intent of SBC 6006
(c) 1. To utilize the total envelope system method, the values established by the
sum of lines #3 and #4 shall not be greater than the suni of lines #1 and #2.
. 2~
1. /1 3- Z +2. 2? ' d = 2-/0
s. i~ a-~ +u. 2~- _ ~ 8'~• ~
\
~IOMA House Certificate Fo?~
SUFIVEYINA
9EAVICEB
3908 Sibley Memorial Highway ENERGY HOME~, IIYC.
Eagan, Minnesota 55122
Phone: (612) 452•3077
eiU+.t.E : I" =0>o'
0 I . ` ~i~E
0
s~ 90 0 ~
N, ~csr I I ~ S 9
I 1
010.
O 1 ~ Il
L.oT 10
0
~
N J }Q o~'~ I
%q(p0
7 ~
Lt1 ~ U €a5er~ 34.0 30.0 ~ $`if•
~ I 10.0
~~WAYNE
LO'' 12 I s; CORDES _
/ _ `•-9~675-f~`
s<''tt
:
~
~
_LEGEND_ PROPOSED GARAGE Ftj&L.~BS !}EVATIdIU=
O lknotes Iron Yonment PIdOPOSED Top of Ply4e EZEVATIOM! 900•8
m Denotes N'ad Nu6 Set PROPOSED BASEYENT FLOOR ELEVAT ION- $9Z.8
xRoo-5 Llsnotes Existirg Spot Elevalion Verify all ilavr heiqhts with Firel House Plsrs~
(„=N) Aenotes Proposed Spot Elevatian
'.~Glsnotes Drainege Directian _qUSyM COffiFt
1 hereby certify thet this swvey, pran or report
-PRYEK1Y WSCRIPrIW- was prepared by me or wder my diroct supervisian
LOT,! ,BL.LYK 2 srd thet I am e duly Registered LeM Sunreyor
P.1,AGK.MAWK OA~G`i ~~~ITION urder the lews of fhe State of Yiroiesota.
accordirg to tM rxcrded plat thereot, G~ ~te;
DPKc1TA Canty. MimesWa Wayne D. Cordes. Yinn. Reg. No. 14675
• - -•
Road „, • ;. • -
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_:,-,„:;',;.-4,..-,:,: -4:::--„::,-,:::-•,,-:,:i'q,,,,,,i,7;'::::,-...:::--,,c'tL----'0".'''''
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA118778
Date Issued:11/07/2013
Permit Category:ePermit
Site Address: 3833 Riverton Ave
Lot:11 Block: 2 Addition: Blackhawk Oaks
PID:10-14387-02-110
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Kelly Meyer
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 -
Nicholas Ward
477 Golden Trout Way
Bozeman MT 59715
Hause Construction, Jg
P O Box 206
Bayport MN 55003
(651) 439-0189
Applicant/Permitee: Signature Issued By: Signature
CityofEaall . sEe
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit*: 1-.9Gto4
Permit Fee: ( O
Date Received:
Staff:
2015 RESIDENTIAL PLUMBING ERMIT APPLICATION
j �
Date: 11 T Site Address: 33r3 4�, y�•--
Tenant:
Name:
Address / City / Zip:
Tg3? e
Suite #:
Phone: �LJ I ?
ave_.. �✓71 " " � y1/j�'t�
Nare: *1.?ert. Company Inc dlia Culligan Water. License #: WC6413 76
Address:
1.$01 50`h St East City: Inver Grove Hgts.,
State: Mn55077 Phone: .651-451-224r' •
Zip:
Contact: William R Milbert Email:
_ New Replacement _ Repair _ Rebuild _ Modify Space _Work in R.O.W.
Description of work:
RESIDENTIAL
F`. Water Heater
Lawn Irrigation (_ RPZ / _ PVB)
Septic System
_ New
_ Abandonment
XWater Softener
Add Plumbing Fixtures L Main / Lower Level)
Water Tumaround
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
"Water Turnaround (add $200.00 if a 5/8" meter is required)
$115.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) (DO, O O
TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One CaII at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig'to receive locates of underground utilities. wvok.aooherstateonecail.oro
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; tha I understand this is not a permit, but only an app cation for a permit, and work is not to start without a permit that the work will be in
accoranc w h he approved plan int e case •f irk which r .ulres a review and approval of plans.
x /311(1 , it-fil;(1a6/751--Applicants Signature
x
Applicant's Printed Name
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA178194
Date Issued:08/04/2022
Permit Category:ePermit
Site Address: 3833 Riverton Ave
Lot:11 Block: 2 Addition: Blackhawk Oaks
PID:10-14387-02-110
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation. When a weather barrier is installed or
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Brendan Yourczek
3833 Riverton Ave
Eagan MN 55122
(651) 252-7807
Krech Exteriors Inc
5866 Blackshire Path
Inver Grove Heights MN 55076
(651) 688-6368
Applicant/Permitee: Signature Issued By: Signature