3924 Riverton Ave4°'
City of Eaall
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Tenant:
Use BLUE or BLACK Ink
Permit #: - 3
Permit Fee: co
Date Received:
Staff:
2011 MECHANICAL PERMIT APPLI ATION
i Ill -1 Ii
Site Address: 3�; `1,
Suite #:
RESIDENT / OWNER
Name: 6OiU oil/,#V/s:O Phone: 6S( -367— 613,5 7
/�
Address / City // Zip: /C/ / a Coca R /- T , ,Aeiti.s i6L� � %rni 55 3.3%
CONTRACTOR
Name: �J��Crvc! SGL License #:
Address: 46e 7/'U'S'e"I A . City: 4Sm----
State: 41/' ' p: 6 5 ia- / Phone: k -ieea 6f' 4K/
Contact: fi E7- v‘4iL Email: .1 x/78@ %)-li ao - C6sv y
TYPE OF WORK
New ) Replacement Additional Alteration Demolition
Description of work:
NOTE: Roof mounted and ground `mounted mechanical equipment is required to be screened by Crty
Code.', Please contact the Mechanical Inspector`for, information'on permitted"screening,methods ..;
PERMIT TYPE
RESIDENTIAL
�Fumace
COMMERCIAL
New Construction Interior Improvement
Air Conditioner
Install Piping Processed
Air Exchanger
Gas Exterior HVAC Unit
Heat Pump
Under / Above ground Tank (_ Install / Remove)
Other
**When installing/removing tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$55.00 Minimum Add-on
or alteration to an existing unit (includes
burned out appliances, ductwork, etc.) (includes
$5.00 State Surcharge)
$5.00 State Surcharge) $ TOTAL FEE
$95.00 Fire repair (replace
COMMERCIAL FEES:
$75.00 Underground tank
$55.00 Minimum (includes
installation/removal OR
State Surcharge)
$10,010, surcharge is $ 5.00
surcharge increases by $.50 for each $1,000 Permit
Fee requires a $ 5.50 surcharge)
Contract Value $ x 1%
_ $ Permit Fee
- If the Permit Fee is less than
Fee = $ Surcharge
- If the Permit Fee is > $10,010,
(i.e. a $10,010-$11,010 Permit
.$ TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.bonherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in
Eagan; that r derstand this is not a permit, but only an application for a permit, and work is
with the - •r• ed plan in the se of work which requires a review and approval of plans.
Applicant's Printed Name
formance with the ordinances and codes of the City of
start without a permit; that the work will be in accordance
�"
A•plicant's Signature
cy
FOR OFFICE USE
Required Inspections:
Reviewed '•
Under GroundRough In _Air Test ' Gas Service
Exterior' HVAC Screening, Inspection
CityofEaaii
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
1
Rw-tweetue
Permit#: q 7 7
55‘ DO
Date Received: 1(121 21 I I
Permit Fee:
Staff:
J
2011 RESIDENTIAL PLUMBING PERMIT APPLICATIONa�
Date: t --.t2 1t Site Address: !rV 1\tv �L. RZOt� � Jk. trZk 74 Imo g,L
Tenant:
Suite #:
RESIDENT / OWNER
Name: rt. t 4- I IZ,O Phone: (O[ 1 --.ic3^ 1 ()
Address / City / Zip: Ytz_4 tV ft. fklb M 1\1 R.' Il, kN 11\11 M S -*-I 21.
CONTRACTOR
Name: License #:
Address: City:
State: Zip: Phone:
Contact Email:
TYPE OF WORK
New /Replacement Repair Rebuild Modify Space Work in R.O.W.
_ _ _ _
Description of work:
PERMIT TYPE
RESIDENTIAL
Water Softener
JWater
Heater
/
Add Plumbing Fixtures ( Ir Main / \Lower Level)
Lawn Irrigation ( RPZ / PVB)
_
Water Turnaround
Septic System
New
Abandonment
RESIDENTIAL FEES:
$55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation
$55.00 Add Plumbing
"Water Tumaround
$105.00 Septic System
$95.00 Fire Repair (replace
(includes $5.00 State Surcharge)
Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
(add $166.00 if a 5/8" meter is required)
New ($10.00 per as built) (incudes County fee and $5.00 State Surcharge)
bumed out appliances, ductwork, etc.) (indudes $5.00 State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Cali 48 hours before you intend to dig to receive locates of underground utilities. ^ .ciopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be i
Eagan; that I understand this is not a permit, but only an application for a permit, and w
accordance with the approved plan in the case of work which requires a review and approve
xIIS 1r N Vh' Pci) l2� x /
Applicant's Printed Namel) Applicant's Sig
conform
rk is not
of plans.
ce with the ordinances and codes of the City of
start wit(iout a permit; that the work will be in
FOR OFFICE USE
Required Inspections: Under`[
nd _,_Rough -in Air Test __Gas Test _„_F
CITY OF EAGAN Remarks sew C021ri. pd. 12-29-72 Wf.2' COi12]. pd. Ori 4-25-73
Addition Cedar Grove #8 Lot 11 sik 3 Pa,c, 10 16707 110 03
a
Owner st?.,.t 3924 Riverton Ave. statt Eagan,MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF,
STREET RESTOR.
GRADING
SAN SEW TRUNK 1970 125.00 .00 2 Paid
# SEWER LATERAL Z 1974 1539.1
WATERMAIN
WATER LATERAL ~
WATER AREA
it- STORM SEW TRK
STORM 5EW LAT 1
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 300.00-1 7849 LL-25-73
BUILDING PER.
sac 260.00 7849 -2 -73
PAR K
vau?oe oF E?oaN SEWER SERV3C~F~ PERMIT
3793 Pikt Knob Read PERMIT 2%2
Eayon, MN $5172DATE:
Zoning: R-1 - No. of Units: '
owner: Cedar Grove Construction
Address• /V- ~ •
Site Ad~ <!~-3=14 -8 3924 River on venue ~
Ptumber: Stein' s
260.0o pd
1 aqrn ro wmply wHh tM Vilkgo ef Eoqon Connectlon Charge:
Ordineneas. Account Depoei[:
Permit Fee: ~
Surcharge:
gy; Misc. Chazgee:
Date of Insp.: Total:
Inep.: Date Paid:
~ C~~Cxr~al Sil`cc~ ~nci~., ~-l cG*~S
- EAGAN TOWNSHIP `
N" 2928
BUILDING PERMIT
Owner _.._...".~....=----:-^..C.._:------ Ea an Townahi
_ n 9 P
Addrats (Precenf) ?4~ .......4~....:..........._._--.... Town Hall
Suilder
nate
I DESCRIPTION
' 5lorias To Se Used For Fron! Depih Heighf Esf. Cos! Parmit Fee Aemazlca
s/G-
. LOCATION k~"c= ; s S ~
Sireel. Road or oiher Descripfion of Localion I Lo! Block Addilion os Trae!
C)
This permii does not aulhorise the use of s2reefs, roads, alleps or sidewalks nos doea if give the owaes or hfe agent
the righf2o areafe anp silualion which is a nuisance os which psesenls a hasard !o the heallh, setetp, eoavenieaee aad
general welfare !o anpoae in the communifp.
THIS PERMIT MIIST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PAOG4EPB.
Shis ie to eertiip, !hel----.Cr.-c.._7?-.*.--.----- has permissioa !o erec! -----F.`
_upon
the abore deseribed premise subjeei fo the provisiou o! the Suilding Ordinance for Eagan Tov~nship ado !ed Ayril 11,
1955. l n
Per
,.°°-°--°--------1~-..... ~.~'_:...---~1 ...._-----........_-1.C~?.-.~C.~.--°°..........Q.....----°......_~°-°..........
C Buildin InePector
ii58
c.~.
VTLLAGE Oi,' r:AGAN
3795 Pilot Knob ttoad
Eagan, Niinn~sota 5$122
PE1?i•1IT N0. 338
The Village of Eagan hereby grants to Cedar (3rwe Conatruction Co.
_ o£ 7343 CastCOrd Blvd. East, 3auth St. Paul
a ' TG Permit for: (Owner)~
390 3880 ~,tvortaui 9~9 ; 7-t5-331700 Ca~tirane 1$-61
at 1718 ![ontdellp 9-8 C6 fPB, pursuant to a ication dated 4/23/73
Fee Paid: 61110, dated this 2 Lh day of AprS1 19 73-•
3.50eo ' •
~
• ' i
Bui ding Inspector
Piechanical Permits:
did Total:
~r
1i-3-.
G.
VILLAGE OP' r'(1CAlU
3795 Pilot Knob Hoad
Eagan, Iviinnesota 55122
PERi?lIT N0. 328
The Village of Eagan hereby grasitM to Gedar 6TOVe CalstTUOLial1 Co0
of 7343 Cauicord Blvd. Eset, 3onth St. Pattl
a PLDMBIN6 Permit fcr: (Owner) 8am8
3~90, 39240 3849, 3990, 3880 xivertan 9-3 i» , 7-5, i-3J ~1770 Cochrane
3 pyp 3~, 111H Men*ie~n 9~BF~s~st ~o cation dated la/23/T3 ,
Fee Paid: $,)`n_nn dated this 250day of ADTil ,19 73
3.50 s/c
Bui 'ng Inspector 4
Mechanical Permits:
~ Bid Total: ,
I,
RES7DENTIAL
BUILDINC PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651•681-4675
Naw ConsW ction RwuiremeiAs RamodaUReoair Raauirements
• 3 registered site surveys shoxing sq. ft. of lot, sq. fi. of house; and ~II roofed areas • 2 copies ol plan
(20% maximum lot rAVerage allowed) . 1 set of Energy CalculaUons for heated adddions
• 2 copies ol plan shovdreg beam & windax s¢es; poured tound design, etc.) . 1 site survey for exterior additiore & tlecks
• 1 set ol Energy Calculetirns . Indicate if home served 6y seplic system tor additions
• 3 copies of Tree Preservatlon Plan if lot platted afler 717/93
• Pom Jaist DetaB Options seled'wn sheet (bldgs with 3 w less unils)
DATE ~6CL • O a VALUATION 9 7UT
SITE ADDRESS ?J9 01 Ll i ll~R.Vi"eU-R . MULTI-FAMILY BLDG Y N
TYPE OF WOR O. FIREPLACE(S) _ 0_ 1_ 2
APPLICANT iRenewa] By Andersen, Inc.
STREET ADDRESS 1920 County Rd. "•C" West STATE ZIP
Roseville, MN 551 13
TELEPHONE # 651-264-4777 I FAX #
,License # 20130983
PROPERTYOWNER6,(,2,PrAIA TELEPHONE4JI • I451o -T3S7-
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNGSOTA RULFS 7672
(J submission type) . Residential Ventllation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor. Phone #
Ptumbing syscem includes: _ Water Softener _ Iawn Sprinkler Fee: $90.00
_ Water Heater _ No. of R.I. Bafhs
_ No. of Baths
Mechanical CoMractor: Phone #
Mechanical system includes: _ Air Condiuoning - - Fee: $70.00
_ Hea[ Recovery System Sewer/Water Conhactor: Phone # '
I hereby acknowledge that I hove read this application, state that the info mation is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ord'n nces.
SlgnatureofAppllcanT
c
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
MASTER CARD
LOCATION
OWNER STRUCTURE AND
IAND USED AS . ) v
Issued To
Permi} No. Issued Contractor Owner
BUILDING
PLUMBING
CESSPOOL - SEPTIC TANK
V'dELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER
W I
OTHER
Approved
Items (Inilial) Date Remarks Distance From Well
FOOTI NG SEPTIC
FOU N DATION CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL ~
DEPTH
HEA7ING
OF WELL
GAS I NSTALLATION
SEPTIC TANK . ~
CESSPOOL -17
DRAINFIELD ~v f
PLUMBING
WELL
SANITARY SEWER .0e+ 3
r
Viola}ions Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPOATS
TO BE USEO ONIY IN EVENT OF OBSERVED VIOIATIONS
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE ? NON-COMPLIANCE. BUILDER DOES NOT
OBSERVED. INTEND TO COMPLY.
? ACCEPTABLE SUBSTITUTIONS OR ? COMPLETION OF CERTAIN IMPROVEMENTS
DEVIATIONS.
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
? REINSPECTION REQUIRED DATE OF REINSPECTION
REINSPECTION REVEALED
CERTI FICATION -I certify [hai I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein
all significant conditions observed to 6e ac variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPECTOR OATE
COMMENTS:
~ z3
EAGt1N TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minneaota 55111
Telephone 454-5242
PERNIIT FOR WATER SERVICS CONNECTION
Date: 4/25/73 (12/29/72) Number: 1165
Billing Name:Cedar Grove Construction CaSite Address:4-74-8.
Ocaaer: same Billing Address 3924 RiPerton Avenue
Plumber• Stein's
Location of Connection Meter Size Coanectioa Chg.
Meter No. Permit Fee 10,00 pd 79/79/72
Meter ReadingL_ Meter Dep. •50 pd 12/29/72
Meter Sealed: Yes Add'1 Chg.
NO Total Chg.
Inspected by
Date
Buildiag ia a: Remarka;
Resideace xx
Nlultiple Ko. Units $25.00 RE-!T,!c~4CT1^P! FF77 Commercial 1p"p?OPiRTY iVS{;';1LrD
Iadustrial Hy:
Other Chief Iaspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do tte proposed work in accordance with the rulea and
regulations of Eagan Township, Dakota County, Minaesota.
$Y:
.5'tOLn'8
Please aotify the above office when ready for inspection and connection.
- . ' ' -
CHICAGO TITLE INSURANCE -
4820 West 77th Street Edina, MN 55435
Phone: 835-3100
TOEAGkN DATE:02/28/78 ADDRESS3924 RIVERTON AVE
FROM: DpNNq
FILE NO.:F43127
FILE NAMEMEpD DANIEL GLRARL DIS:
PLAT:
COiJNTYfiAKDTA PLEASE CEECK TO SEE IF THERE ARE ANY
ABS,r,RACT TORRENS LEVIED/PENDING ASSESSMENTS
i.F;GAL DESCRIPTION:
L7' 1 i, HLK 3 CLIiAR GRi3VE #£3
x***~,rx,r*~R***,t*****,t******,t*,r**x***,tw,t,t,r,t,t***,r*~*,r***tr,t*f,t~*r,r,r,t,t*r:
PLEASE FURNISH THE FOLLOWIN, LEVIED ASSESSMENT INFORMATION ON THE AEOVE
D:;SCRI&ED PROPERTY:
Type of Improvement Balance Due Original Amount
none
PLEASE FURNISH THE FOLLOWING PENDING ASSESSMENTS THAT ARE ESTIMATED AT
THIS TIME:
nnnc
ALSO REQUESTING ANY ASSESSMENTS CERTIFIED TO THE AODITORS AT THIS TIME
AND INTEREST:
Signed:qssessmen lerk i~ Date.
' Marrth 7 197R
AMO[INT OF UNPAID WATER BILL, IF ANY; $
411°
CityofEaau
3830 Pilot Knob Road
Eagan MN 55122� 1 (_ Date
Phone: (651) 675-5675 4 �'! ` '
Fax: (651) 675-5694 Staff
JAN 1 2 2011 (,'9 f
2011 RESIDENTIAL BUILDING PERMIT APPLICATION 4i
Date: '—a -Z" 1 \ Site Address: i.- 1 CZ\ J(L v t\ 1\ v Nit' 5
Tenant: Suite #:
Use BLUE or BLACK Ink
Permit*:
Permit Fee: 5111e)'
RESIDENT/ OWNER
Name: l' C• -v tw 1.k.4 11.: Phone: kD1Z. 2% 9 is
Address / City / Zip: ..4 ,`\ 4 lUn 06,N \v L.,,C\- iktikk,M ,' Z"'L-
Applicant is: Owner Contractornt
TYPE OF WORK
Description of work: ` % 1 , ttc-Z1' , .,Qt.,. 1% ; ', ..1_ ``r'�i `j°i-tC \ Q
�
Construction Cost ') /t ►3 Q Multi -Family Building: (Yes / No )
CONTRACTOR
Name: License #:
Address: City:
State: Zip: Phone:
Contact: Email:
COMPLETE
In the last 12 months, has
No If yes,
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
the City of Eagan issued a permit for a similar plan based on a master plan?
date and address of master plan:
_Yes
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public kOmmation. Portions of
the information may be classified as non -pubic if you provide specifc reasons would pts the City to
conclude that they are bade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan. that 1 understand this is not a permit, but only an application for a permit, and .rk is not start without a permit; that the work will be in
acco ante with the approved plan in the case of work which requires a review and a . -1 of plans.
x I\v � J
Applicant's Printed Narhe
Applic . is Sig .5 u
Page 1 of 3
SUB TYPES
Foundation
x Single Family
(_ Multi
01 of _ Plex
Accessory Building
WORK TYPES
New
Addition
Alteration
_ Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
U6 2 44
14-(1
DO NOT WRITE BELOW THIS LINE
_ Fireplace
Garage
Deck
Lower Level
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
_ Storm Damage
_ Exterior Alteration (Single Family)
_ Exterior Alteration (Multi)
Miscellaneous
r
V-01456 (-wi 013“-/ ( Tc.if` � %�Y a f >. ► (2
— Interior Improvement _ Siding _ Demolish Building*
Move Building _ Reroof _ Demolish Interior
Fire Repair _Windows _ Demolish Foundation
—
— Repair _Egress Window _ Water Damage
(25%_ 100% k)
Census Code
# of Units
# of Buildings
Type of Construction
Y
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: _Ice & Water Final
) Framing
Fireplace: _Rough In _Air Test
Insulation
Sheathing
Sheetrock
Reviewed By:
*Demolition of entire building - give PCA handout to applicant
Occupancy 4,7)1.-CeMCES System
Code Edition j,,`,.a+f SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Zoning
Stories
Square Feet
Length
Width
Final
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC
Other:
Pool: _Footings Air/Gas Tests
Final
Siding: _Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall: _ Footings _ Backfill _ Final
Radon Control
Erosion Control
, Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
6FIS‘im6wr 1--AcoY 2o; , 00
� 2'
0, 70 919
ijoo
it0 at)
Page 2 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA121691
Date Issued:04/14/2014
Permit Category:ePermit
Site Address: 3924 Riverton Ave
Lot:11 Block: 3 Addition: Cedar Grove 8th
PID:10-16707-03-110
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 .
Kevin Shapiro
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 -
Kevin Shapiro
13112 Ct Pl
Burnsville MN 55337
Applicant/Permitee: Signature Issued By: Signature