3966 Riverton AveCity of Eaaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
MA`s
Use BLUE or BLACK Ink
Date Received:
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:
J
RESIDENT /
OWNER
Name: AI/C4/0/61 5 61a,71 -74/n/ Ph(OS%— 2%3.0-6d/G+
Address / City / Zip: -3et &6 Al ft Lryj /4V€ ' �O,5lJ-1,%`3?lil
Applicant is: X Owner Contractor
TYPE OF WORK
Description of work: lq(1L,
Construction Cost: Z -00C2, ab Multi -Family Building: (Yes / No )
CONTRACTOR
Company: I- Contact:
Address: City:
State: Zip: Phone:
License #: Lead Certificate #:
Does this project require Lead Remediation? ❑ Yes ig No (see Page 3 for additional information)
e-ielb
If no, please explain: /Vo -PS�
h, ck CRS Woo}
In the last 12 months,
Yes No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude' that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Cali 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.popherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
x AJ, Gvl D /ct
Applicant's Printed Name
Applicant's Signature
Page 1 of 3
3c((O R; ar4e�n ,fes
DO NOT WRITE BELOW THIS LINE
9899Z
SUB TYPES
_ Foundation _ Fireplace — Porch (3 -Season) _ Storm Damage
_ Single Family _ Garage Porch (4 -Season) _ Exterior Alteration (Single Family)
Multi ' Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi)
01 of Plex Lower Level Pool Miscellaneous
Accessory Building
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
Interior Improvement , Siding _ Demolish Building*
_ Reroof _ Demolish Interior
Windows Demolish Foundation
Egress Window _ Water Damage
*Demolition of entire building - give. PCA handout to applicant
Move Building
Fire Repair
Repair
(25% 100% )
Census Code
# of Units
# of Buildings
Type of Construction V 15
REQUIRED INSPECTIONS
Footings (New Building)
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Footings (Deck) Final / C.O. Required
Footings (Addition) st, Final / No C.O. Required
Foundation HVAC _ Gas Service Test Gas Line Air Test
Drain Tile Other:
Roof: Ice & Water _Final Pool: _Footings _Air/Gas Tests _Final
Framing Siding: Stucco Lath _Stone Lath _Brick
Fireplace: _Rough In Air Test _Final Windows
Insulation Retaining Wall: _ Footings _ Backfill — Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
3/
Page 2 of 3
CITY OF EAGAN
- 3795 Pilot Kno6 Road Eagan, MN 55122 N2 5925
PHONE: 464-8100
BUILDING PERMIT Receipt #
To be used for Est. Value Date lf?-? 7 , 19 78
>°65 Riverton Avenue ?
Site Address Erect Occuponcy
Lot ~ BI«k 5 5ec/Sub. CC u Alter ~ Zoning
Parcel # Repair ? Fire Zone
Enlarge ? Type of Const "
a Nome ~'ert)ert ] , tarvey Move
? # Stories
x Address iivertnn ?tve. Demolish ? Front ft.
Cit phone i. _ Grode p Depth ft.
o Ncme APprovob Fees 5110 , 1
u~ Assessment Permit , 5)
~ Ci Phone Waser & 5ew. Surcharge
Police Plan check
~W Nome Fire SAC
Address Eng. Wafer Conn.
<W Ci Phone Plonner Water Meter
Council
I hereby acknowledge that I have read this application and state that Bldg. Off.
the information is correct and agree to comply with oU applicable APC Total 'Stote of Minnesota Statutes and City o~; Eagan Ordinances.
Signature of Permittee. •L ` r ,
A Building Permit is issued to: i'erUert L. ~i,t-vey on the exPress condition thnt
oll work shall be done in occordance with oll opplicable Stete of Minnescta 5tatutes ond City of Eagan Ordinances.
Building Officiol .
Permit # Ded* lmod PuMiirw
Plumbing
Mechanical
INSPECTIONS DATE INSP• RougF-ln Firwl
Fopting5 Date Insp. pate Irup.
Foundation Plumbing
Frame/ ins. Mechcnica l
Finpl
Remarks:
CITY OF EAGAN Remarks SGW & WtP COIlri. pcl, Ori T 1-28-72
Addition Cedar Grove #8 Lot 4 Qik 5 Pa.cei 10 16707 040 05
Owner~ Street 3966 Riverton Ave. State Eagan,rrm 55122
. -
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF,
STREET RESTOR.
GRADING
SAN SEW TRUNK ~ 1970 2.00 •OO 2 Paid
#'iEWER LATERAL j,eLL 197 39. Q Paid
WATERMAIN
# WATER LATERAL 197
WATER AREA
~ STORM SEW TRK G~
STORM SEW LAT 1974
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN, 00•00 6897 11-28^72
BUILDING PER.
s,ac 260.00 6897 11-2 -7
PARK
~~y~~~ v d~_S/ -4-7G
~ ' w i•
CITY of EAGAN N2 _3926
BUILDING PERMIT
wnex ...~~G~.pS 3795 Pilo! Knob Road
Eagan, Minnesota 55122
O
Addresa (Presanl) ..~.~yfi~ 459-8100
s„tiae: ...............e-......................... -
Dale . Qw„.~..
Addrese
DESCRIPTION
Sforiesl To Be Use For Fsoa! Deplh Haigh! Eel. Cos! ~Perm_il~Fe Aema:ks
va
LOCATION
8fresf, Aoad or other Deseription ot Loeetioa I La! Bloek Addilfon os Trae!
This permii does noi aufhorise the use of slreels, roads, alleys or sidawalks nos doae it give the owner or h[s agant
the righlio creafe any s9luation which is a nuisance oz whioh peesents a hazard !a the heallh, safefy, convenienco and
genexal weltare !o anpone in the communify.
TFiIS PERMIT MUST BE EPT OIQ TH AEMISE WHILE THE WORK IS IN PR6GRE .
This is !o eexlifp. !hal....~........- -.......has pexmisaion !o erec! i....y~'"'_....... ..YpOA
the above d cribed palym ise subjecf to ihe provis' ns of all applicable O' s for the C' agan.
../..!7 Per `.'7'!i~i.Z.t....-°-9
. aYnr BuAdiag Impaetoa
Eagan Township pERMIT
• Dako2a County, Minaesota DaYe
AppGcation for Bnilding Permit
Type of building or work coniemplafed. Cirele eorrec3 deseripfions.
Aesidenlial Commercial Indusfrial Ofher........................................
8uild Ealargs Aller Repai= Install Move Wreck Olher.
Dimensions_~.2X/$ Coct ---DO.-oYr.............
Details oz remasks...--.7P ..--fZE~.. -~~......L.----
Locafion
Numbex S4rea2 Hefween whai cross slreets Sise Esi. Valuafion
,i'9loG /~'l//~'R?~~/ /)1lC= ~t`h'u/uoD¢r1oo~7~~EC~d/a;r'/g
Loi Bloeu Addition earrangemenY or Tracf
41- s C. 6.
L-~---N%(E.Y...-~-~-----~~---~-- ~'.Y.~~.._.R/d~RTaN i9/~c' E/aGfIN
Owner ' ' - - ' Addzess . .
Coniraefor Addeess
The undeesigned hexeby makes apulieation foc a permii !o
$ do work as herein specified, agreeing !o do ali work in s2ricf
Total fee collecied. accordanee wiYh !he building oxdinance adopYed Apzil 11, 1955
~ by 3he Eagan Township Soard of Supervisors.
PermiY fees are not
refundahle.
Sigaed
~ EAGAN TOWNSHIP
' N° 2898
BUILDING PERMIT
Ownex ."...pp~....._. Z. Eagan Towaship
Address (Precenf) Towa Iiall
Builder ~ .
7 Z
aate
Address
DESCRIPTION
Siorie To Be Used Fos Fron! Depfh HeighS Esi. Cos! 'Permi! Fee Remarke
~
~ LOCATION (~~6•"~'
Sieeei, Aoad or oiher DescripSion ot Loearion I Lo! Bloek Addifion or Tsac!
Alt./
Thia permit does noY au2horise the use of sireela, raads, alleys or sidewalks aor does St g3ve the ownes or Lis agent
the righ2 !o azeste axp siluaf3on whieh is a nuisance or which presenis a hesard !o the heellh, ea4efy, conveaieaee and
general wel£are !o anpoae in the eommunifp.
THIS PERMIT MUST SE KEPT ON THE PREMISE WHILE THE WOAK IS IN PAOGRES
Th[s is !o cerrifp. ....V has permission lo erect a...:3.... _upon
the above deseribed pzemise subjec! !o the provisions of the Building Ordinance !or Eagan wnship adopled April 11.
1855.
----...............:.-e4:~-.---~ :-...0``.~ par
clfairn,aa-e~~'++yua~dasd~(YH-~-y-•J auuaue tns eo:
06
i6 16-),A 2 0~)6 05
. VILI,dGE OF EAGAIQ
3795 Pilot Knob Road
Eagan, Minnesota 55122
. PEIiMIT NO.:
The Village o£ Eagan hereb,y grants to
Of .231l (:rmRnrri qlvri j'i, I."iC43th s^t n 1 r.+ .
~-~r-+*r-~o075
a _ F~[I.J~i~i3Lj({ Permit for: (Owner)_
37VV ~{~61'~iOn °nC1e
4-5-81 3~89-Patii.a
at " , pursu~an ~o ap' p1S.cation dated „,~i
Fee Paid: $4a_uo dated this --2azhday of Ncvcah.w 19
~
1.50 s/c
Building Inspecto: ~
Mechanical Permits:
3id Total•
a
4--s- r
C.
• + VILLdGE OF EAGAIQ
3795 Pilot Knob Road
Eagan, Minnesota 55122
PERMiT N0.• 287
The Village of iagan hereby grants to r
.Pd r;}rave C a. ;_.ion •o,
of 731,; r.oncora Riva. r., so. U. raul 5075
a liEATIL•TG Permit £or: (Owner) 5am8,
3966 Rivorton 4-5-8, 3889 Palisada wapr 4-7-8, & -
at 172o S °rtH31 y9 ~~_p , pursuant to application dated 11/25/72
Fee Paid: 60.00 dated this 28th day o£ Novataber , 1972
1 0 e o .
Building Inspector
Nlechanical Permi.ts:
Bid Total:
~
CITY OF EAGAN
3795 Pi1M Knob Reed Eagan, MN 55722 N2 5025
PHONF: 4548100
BUILDING PERMIT APPLICATION Receipt #
Te be uaed for prefab fireplace Est. volue 704. Dore 10-17 , 19--18_
Sire Address 3966 Riverton Avenue Erecr e Occuponcy I
Lot 4 Blxk 5 Sec/Sub. CG 8 Alter ? Zoning Rl
Parcel .fk Repoir ? Fire Zone 3
Enloige ? Type af Const. `7
W Name HerbeYt L. Harvey Move p #Stories
Z Address 3966 Riverton Ave. pemol;sh ? Front h.
~O Clty Eagan Phom 454-8409 Grade ? Depth ft.
~ Same ApPra'elf Fees
p Name §[XxXS.00
zt Auessment Permit
~ Address
i Water 8 Sew. Surcharge .50
F' Cl PFwne
Police Plan
~Z check
GW Name Fire SAC
Address Eng. Water Conn.
4w Ci phone Planner Wcter Meter
Council
I hereby acknowledge that I have read this applicotion and stare ttwt Bldg. Off.
the information Is correct end o9me 1'a comply with oll applicoble AP~ Total 5.50
Stote of Minnesota Statutes a id ' o Eagan Ord' ances
Signature of Permitte~(/ ~
A Buitding Pertnit is issued to,. H hert T ~ on the exprea eonditlon that
oll work shall be done in ac ~danc~`th~oN,~ iiwble State of Minnesota Statutes ond Ciry of Eagan Ordinonces.
Buildinp Official .L
RESIDENTIAL
BUILDINC PERMIT APPLICATION
~ CITY OF EACAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681•4675
Fre3 nstruction Reauiramants RemodellReoair Reauiremants
giste (ed d site surveys shaxing sq. fl. ot l06 sq. R. af house; aM all roofed a2as • 2 copies of plan
(20% mazimum bt coverage allowed) • 1 set ot Energy Calculations for heated addNOns
• 2 wpies of plan showing beam 8 window s¢es; poured fourM design, etc.) . 7 site survey for extenor addiGons 8 decks
• 1 5et of Energy Cakula6anb • Indicate rf home served by septic system (or addNons
• 3 copies W Tree Preservafion Plan il lol platted aRer 711/93
. Rim Jaisl Dehail OpGons selection sheet (61dgs with 3 w less units)
DATE D?i VALUATION
SITE ADDRES _ 3T~D~O Al /,lPByI ~t • MULTI-FAMILY BLDG _ Y N
TYPE OF WO~KjF'adt,.6t9'S ter ga /SO 1~'f; /SkID ' FIREPLACE(S) _ 0_ 1_ 2
APPLICANT N/G`c ~uL-~~PiY
STREETADDRESS 3`?616 1~n A`e CITY~STATEAlNZIP
TELEPHONE # 105_1-q5'a-39lo1 CELL PHONE # (oSl- 230 -601(a FAX #
PROPERTYOWNER 4/14 C9~"~Tt2~? TELEPHONE# ~e~
COMPLETE FOR KNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ VfIVNk:50TA RULES 7670 CA'IT,G012Y 1 MINNESOT:1 RULES 7672
(4 submission type) . Residential Ventilation Category t Worksheet Submitted • New Energy Code Worksheet Su6mitted
• Energy Envelope Calculations Submitted
Plumbing Confractor: Phone # _
Plumbiti, system includes: Water Softener _ Lawn 5pnnkler Fee: $90.00
Water Heater No. of R.I. Baths
_ No. of Baths
Mechanical Contractor: Phone # . .
Mechanical systein includes: _ Air CondiCioning Fce:~ $,70.00
Heat Recovery System
~ ~ ~ _ ~ 1 £1 2C: Z
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 Eogan OrdinanGes.
Signature of Applicant !"wr"~l~iv 'A • ~~'~'<1
-
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ~ 30 Accessory 81dg
? 02 SF Dwelling ? OB 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) 0 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 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-piex Plbg_Y or _ N ? 25 Miscellaneous
`Q~ 31 New ? 35 Int Improvement O 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demalish (Bldg)• ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolitian (Entire Bldg only) - Give PCA handout to applicant
Valuation ~ Occupancy U-~ MC/ES System -
Census Code ~/3y Zoning City Water '
SAC Units - Stories Booster Pump -
Nbr. of Units - Sq. Ft. /10 PRV ~
Nbr. of Bldgs - Length )o Fire Sprinklered ~
Type of Const ~ Width ~Jr
REQUIRED INSPECTIONS
Footings(new bldg) FinaUC.O.
Footings (deck) ~ FinaUNo C.O.
_ Footings (addition) _ Plumbing
_ Foundation HVAC
_ Drain Tile O[her
Roof , ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Franung _ Siding SNcco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ W indows (new/replacement)
_ Insularion _ Retanvng Wall
Approved By , Building Inspector
-
Base Fee 7O
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit 8 Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Tota I
LJ- 5 ~8
? 4 EAGAN TOWNSHIP
3795 Pilot Rnob Rosd
St, Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTTON
Date• I I10417a Number: 1055
Biliing Name:\ Pc-~Qs` 1-Al0L,g Q-OY1Cj-Site Address:3C0 (o 11)PrIQ2, Owner: \7(~Y`n 4e Billing Address7393 l...QnCDA k~W )-F~-
Plumber:
V
Location of Conuection Meter Size Coanection Chg. 300,00 dp 11/2$/72
Meter No. Permit Fee 10.00 pd 11/28/72
Meter Reading_ Meter Dep. -50 pd 11j28/72
Meter Sealed: Yes Add'1 Chg.
Id0 Total Chg.
Inspected by
Date
Building is a: Remarks:
Residence xx
14ultiple No. Units
Commercial
Iadustrial Sp:
Other Chief Iaspector
In conaideration of the isaue and delivery to me of the above permit, I
hereby agree to do tte proposed work in accordance mith the iules aad
regalations of 8agan Township, Dakota Couaty, Miaaesota.
By:\ Qk0-k-1 T~~ G~
~2 1 Qmn",.Q a
Plesse aotify the above office when ready for iuspection and connection.
z-1-5=$
EAGliA7 TOSdNSHIP
3795 PiZot Knob Road
St, Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNL+CTIOId
DATE: ~ 1 C9 q I 7r-2 N[1MBER 1221
OWNEA.LQI(` ~-ft ?Q Address`,/Iplp f'S Il4Pr'IDr~ ~TU'e,
PLUMBEIR h(> Y~ N L l TYPE OF PIPE~~'I~. (b hr
DESCRIPTION OF BUILDING
Industrial Commercial Residential Multiple Dwelling No. of unies
l
Location of Connectfons: Connection Charge260.00 nd 11/28/72.
Permit Fee 10_00 pd 11/28/72
,$0 pd 11/28/72 s/c
StreeC Repairs
Total
Iaspected by:
Date
Remarks•
By.
Chief Inspector
In consideration of the iasue amd delivery to me of the above permit, I
hereby agree to do the proposed work ia accordance with the rules arid
regulaCioas of Eagan Ta•mship, Dakota Couaty, Minne~ ta
0]
B . 1
Pleaae aotify when ready for inspection and connectioa and hefore any portion
of the work ia covered.
h
• DATE
BUILDING PERMIT APPLICATION
Include 2 sets of plans, 1 site plan w/elevations and 1 set of energy calcuations.
jasT.fLC
To be used for y,eEF4BKrc.4LEa FREP4jC6' Valuation 70 4.a'a'
Site Address: 3 96~ ~,uz~2.~o~~•'~~
Lot Slock Sec./Sub. Parcel Number
I ~J Ic -6-15t
owner /-IERG~RT L, ~tqIQUETelephone '-~-5 ?V6 /
Address 396/' Rl vE/Z7odtl '&E,
Contractor Telephone
Address
Arch/Eng. Telephone
Address
OFFICE USE ONLY
Erect L/ Occupancy ~
Alter Zoning /f~
Repair Fire Zone 3
Enlarge Type of Const. I/
Move ll of Stories
Demalish Front
Grade Depth
Date of Approval and Initial Fees
Assessment . Permit S t:fA
Water/Sewer Surcharge ~
Police Plan Check
Fire SAC
Engineer Water Connection
Planner Water Meter
Council
Bldg. Off.
D
A. P . C . TOTAL
I
, MASTER CARD
LOCATION ~tr • ~ y.s
OWNER
STRUCTURE AND
LAND USED AS qae ~j~ ~ ~DD ~~7 ~fas -
1 Issued To
Permit No. Issued Conirector Owner
BUILDMG -=C~-I-_
PLUMBING 2q/ ~ y
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING zBz
GAS INSTALLING SANITARY SEWER
OTHER /vS3 ~
OTHER
Approved
Items (Initial) Date Remarks Distance From Well
FOOTING SEPTIC
FOUNDATION 49el CESSPOOL
FRAMING TILE FIELD Ff.
FINAL
ELECTRICAL DEPTH
HEATING ~ OF WELL
GAS INSTALLATION .
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
'2C- 7.3 :2~~,___ ~ n4+(!P ~
Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS "
TO BE USED ONIY IN 6VENT OF OBSERVEG VIOLATIONS
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTIDN
? NO EVIDENCE OF NON-COMPLIANCE ? NON-COMPLIANCE. BUILDER DOES NOT
OBSERVED. INTEND TO COMPLY.
? ACCEPTABIE SUBSTITUTIONS OR
DEVIATIONS. ? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOlLOWS:
? REINSPECTION REOUIRED DATE OF REINSPECTION
REINSPECTION REVEALED
CERTI FICATION -I certify that I have carefully inspected the abwe in which I have no interest present or prospective, and that I have reported herein
all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any spacific require-
ments for off-site improvements relating to the property inspectad.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPECTOR DATE
COMMENTS:
aa
LOT: BLOCK: ~ SUBD./P.I.D C^ Y U v't°
2000 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
r ~l CITY OF EAGAN ~ c~
3830 PILOT KNOB RD - 55122
851-681-4675 00
New Construcfion Requirements Remodel/Reoair Reauirements
? 3 regisfered zRe surveys showing sq. ff. of lot, sq. lt. of house 2 copies of plan
and QII roofed areas (2017, maximum lot coveraae allowed) 1 set of energy calculatlons for heated oddilions
D 2 copies of plans (ahow beam 5 w(ndow sizes; poured fnd. design; etc.) 7 sife survey for exterfor addHions 8 decks
D 1 set of energy calculafions
? 3 copfes of free preservation plan N lot platted affer 7/1 /93
? Rim Jolsf Defail Opflons selection sheet (buildinas wffh 3 or less unksl
DATE: CONSTRUCTION COST: 4000
DESCRIPTION OF WORK: i kS~l~a.~ Rdd'p If mulH-famtly bldg., how many units?
STREET ADDRESS:
Name: rivlo% s Phone
PROPERTY Last First
OWNER "L ~
SfreetAddress: ~V~o I`~~ -
Cffy State: ~41U Zip: SSl7~Z
Company: Phone
(area code)
CONTRACTOR
Sheet Address: License # Exp.
City State: Zip:
ARCHRECT/
ENGINEER Company:
Name:
ielephone M: ( )
Sheet Address: Registratton
Clly State: Zip:
Sewer/water licensed plumber (if installing sewer/water): Phone
I hereby acknowledge that I have read this application, state that the information fs correct, and agree to
comply wHh all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicanf:
OFFICE USE ONLY
~
Certificates of Survey Received _ Yes _ No ! nOV 0 2 2000
Tree Preservation Plan Received Yes No _ Not Required i
- - L_'•-~
OFFICE USE ONLY
? Ot 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 Ent. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement O 42 Demolish (Foundation) ? 45 Fire Repair
? 32 Addition ? 36 Move Bldg. ? 43 Reroof ? 46 Windows/Doors
? 33 Alteration ? 37 Demolish (Bldg)• ? 44 Siding
? 34 Replacement 0 38 Demolish (Interior)
' Demolitlon (Entire Bldg only) permit - Give PCA handout to appllcant
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
INSPECTIONS REQUIRED
_ Footings: New Bldg _ Insulation _ Windows - new/replacement
_ Footings: Deck _ FinallC.O. _ Siding
_ Foo[ings: Addition _ FinaUNo C.O. _ Stucco/Stone
_ Foundation Fireplace: _ r.i. _ air test fmal Roof: _ ice & water _ fmal
_ Framing Pool: _ ftgs _ air/gas tests _ final
APPROVALS
Planning Building Engineering Variance
- - - - - - - - - - - - - - - - - - - - - -
Base Fee 61700
Surcharge 1.d o
Plan Review
MCIES SAC
City SAC
Water Supply 8 Storage
S&W Permit 8 Surcharge
Treatment Plant
Park Dedication
Trails Dedication
License Search
Copies
Other
Total:
MASTER CARD
LOCATION
OWNER r~
STRUCTURE AND S/
LAND USED AS
Issued To
Permit No. Issued Coniractor ~ Owner
BUILDING s~ P
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER
Approved
Items (Initial) Date Remarks DisTance From Well
FOOTING SEPTIC
FOUNDATION CESSPOOL
FRAMING TILE FIELD ' FT.
FINAL
ELECTRICAL
DEPTH
HEATING OF WELL
GAS INSTALLATION SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARV SEWER
Violations Noted .
on Back
COMMENTS:
COMPLIANCE INSPECTION REPOftTS
TO 6E USED ONIY IN EVENT OF 085ERVE0 VIOLATIONS
PERMIT NO. DATE OF INSPECTIQN
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE ? NON-COMPLIANCE. BUILDER DOES NOT
OBSERVED. INTEND TO COMPLY.
~ ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS. ? COMPLETION OF CERTAIN IMPROVEMENTS
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 REVEALEO
CERTI FICATION - I certify that I have carefully inspec2ed <he abwe in which I have no interest present or prospective, and that I have reported herein
all significant conditions oLserved to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site imprwements relating to the property inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILOING INSPECTOR OATE
COMMENTS:
sa
RESIDENTIAL
BUILDING PERMIT APPLICATION
'
3830 PILOT KNOB RDN 55122 ~
~ yy~ y3
651-681-4675 ~ ~D
New Construdion Reauirements RemodeVReoair Reauirements
• 3 registered site surveys showing sq. ft. of lot, sq, ft of house; and all mofed areas • 2 copies of plan
(20%maximum lot Coverage allowed) . 1 set of Energy Calculalions for healed addNons
• 2 copies of plan showing beam & window sizes; poured fourid design, etc.) . 1 site survey for exlerior additions 8 decks
. 1 set of Eneigy Calculations
• 3 copies of Tree Preservation Plan if lot platted after 711193
. Rim Joist Delail OpUons seleclion sheet (bldgs with 3 or less units)
DATE I-' q- D I VALUATION (EXCwDiNG LAND) ~ I SOD~ vD
JOB SITE ADDRESS ~ 4~ ro ~ii a~iY f ev~ rt y-t.
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTYOWNER /1Jii.Ao/Ac T. Gtc.Gt~t~'I~
TYPE OF WORK FIREPLACE(S) _0 _1 _2 _3
APPLICANT 4)1'dAG Iu s S ~kpiT/Ii~/ PHONE #
ADDRESS 31?66 R&~ ffWL• ZIPCODE
PAGER # CELL PHONE # CoS/- `195-q5'16 FAX #
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - ResidenGal Ventilation Category 1 Worksheet Submitted
- Energy Envelope Caiculations Submitted
_ MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumbing Contractor: Phone
Plumbing Systcm Includes: Wa1er Softener _ Lawn Sprinkler Tee: $90.00
Waler Heater No. of R.I. Baths
No. of Baths
Mechanical Contractor: Phone #
Mechanical Systcm Includes: _ Air Conditioning ree: $70.00
_ Hea[ Recovery System
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 complywith
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Appllcant
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 1101
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 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
O 05 03-plex ? 11 10-plex O 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolitlon (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Staries 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) Final/No C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile
Roof Ice & Water Final Other
_ Franvng _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Fireplace _ R.I. _ Air Test _ Final _ Siding Stucco Stone
_ Insula6on _ Windows (new/replacement)
Approved By , Building Inspector
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
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA120058
Date Issued:01/14/2014
Permit Category:ePermit
Site Address: 3966 Riverton Ave
Lot:4 Block: 5 Addition: Cedar Grove 8th
PID:10-16707-05-040
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and house wrap and leave on site.
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.
Valuation: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 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 J Guettler
3966 Riverton Ave
Eagan MN 55122
(651) 230-6016
Justkyle
3966 Riverton Ave
Eagan MN 55122
(651) 230-6016
Applicant/Permitee: Signature Issued By: Signature