3869 Riverton Cir . . -~..w•r+....~
GAS WORK ORDER
1072 Payne Ave. STAN DARD 410 W. Lake St.
St. Paul, MN 55101 9 Minneapolis, MN 55408
651 /772-2449 b H EAT I N GO 612/824-2656
& AIR CONDITIONING
A Blue DoC: Service Co. EQUIPMENT INFORMATION
LAST Lc (Za-c- FIRST TYPE
ADDRESS Ljoc4xaz, Cc C MAKE
CITY fdc,Q,/ ZIP T Z Z MODEL 0 r-A
HM PH 1~5 1-454"Z.Zq~WK PH SERIAL LtOO . 33 50
TECH << DATE INPUT (p
ORSAT TEST RECORD
C02 % METERED INPUT Cfh CHIMNEY TYPE - U~ .7-
02 % LIMIT SETTING w 0 FLUE SIZE n.
CO % PILOT OUTAGE S2C CONNECTOR SIZE I11.
NET STACK TEMP ~7 ~o ~ TOTAI CHIMNEY INPUT btuh
CITYOF EAGAN Remarks Sew conn. pd. on 12-29-72 Wtr conn pd.. on 5-15-73
Addition Ced.ar Grove #8 , Ldt 14 Rik 4 Parcel 10 16707 140 04
Owner C,>6u ~-I r ~c J v l~c~l1 .s.t~ street 3869 RiveI'totl Circle State £''8g271+MN 55122
~(1-t kLt.JL_
Improuement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRAOING
SAN SEW TRUNK ~S 1970 125•00 5•00 2 P -a1.d
SEWER LATERAL ~Z'^L 1 1539.10 082 Paid
WATERMAIN
3£- WATEp LATERAL 1974 5 1
WATER AREA
jF STORM 5EW TRK
# STORM SEW LAT 1974 5
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CdNN. 00.00 7989 5_1 -7
BUILDING PER.
sac 2 0.00 7989
-1 -73
PARK
h
VILLAGE OF' EAGAN
3795 Pilot Knob xoad
Eagan, Niinnesota 55122
PEI2MIT N0. 33T
The Village of Eagazi hereby grants to ;,gd&r g,.o" GgastrqpUm Cp,
°f Mvd Seoith 4t PAL
a 97imahine Permit for; (py,mer) 3~869 RiverC a Circle 14-114, 2859 & 9861 galis~ Pt~. i k2 no"
- 3
e~N~; 1T~a 1?2l> 1718
pursuant to appl3ca d a
Fee Paid: 120,00 dated thzs 15th day of ~
3.00 9--~-Building Inspector
Niechanical Permits:
Bid Total:
, 5
_ c.G.
VILLAGE OF' tkGAN
3795 Pilot Knob ttoad
Eagan, ininnesota 55122
• PEI?iM N0. 348
The Village of Eagan hereby grants to CedRS' Grave Caststruetlaa Co.
of 7343 Coaaord Blrod. ffiBt,, South 3t. Pall
a HEpTINC# Permit for: (Owner) e=0
3869 Rivertan cirole 14-4-8 2859 & 3861 Palieade Pt. 5 & - , 1727,
at111g C~~,~e 2-4-8, 4-4:~ ,18p64uant to application dated 5/11/73
Fee Paid; alpp_pp dated this 1 Zth day of MaY , 1973
3.00 syc
Building Inspector
lliechanical Permits:
Bid Total; >
YILL40E OF EA00.M SEWER SERVIGE PERMIT
3795 Pilor K"ob Road. PERMIT NO.: ju
Eaqun. MNSS112 DATE: 12~2I172 1 ~3
~~ng: R~ No. of Units:
Owner: Qedar Grove Construction Co.
Address
Site AddrBes B 3 69 River on Ul,-Q~e _
Plumber: Stelri I 5
I oqrN te comply wifh the Villoge ef Eaqan Connection Chazge260.00 pd 5/1 SI3
Ordinaneo. Account Depoeit:
Permtt Fee: 10.00 d 12 29 72
Surcharge: •50 ACZ 12T29772
gy; Miec. ChazgeB:
Dete of Inep.: Total:
Inep.: Date Paid:
/
r EAGAN TOWNSHIP
N° 3008
BUILDING PERMIT
Ownar ........_~`L.Li.-z ._~-9-6`-/'~ ~c'-•~-•-~ .
~J................................................ Eagen Township
Addxess (Praeent) Town Hall
Builder
Dete ...:5..'C.~..:.-.7 3
Addreas
DESCRIPTION
Stories To Be Used For Fronf Depfh Heig6f Esi. Cos! Permi! Fee Remarka
,y a 4-C
LOCATION b/~ s,~c .(pg-, c e
Sireei, Road or oiher Deacsipiion oi Location I Lo! loak Addition os Tree!
s/
3 7
This parmif doec noi eulhoti:e- the use oi sireefs, roada, elleye or afdewalka Aor does it give the owner or hie agent
the righ! !o ereale anp siivation which is a nuisance or whieh presenis a hasard fo the healih, tetely, eonvanSanea and
general welfare !o anyoae in the communify. ~
TfiI3 PEAMIT MUST SE KEPT ON THI~E~PREMISE WHILE THE WOAK IS IN PROGAESB.
This ia !o certify. !hal........~....1.~~.~-~..~a-..~^~...hespazmiaeion !o e~ ~,m-~+~^~ r-•-.`
..........,,,._.upoa
the ebove described premiae eubjecf !o the provieions of the Suilding Ordinence fox Eagan Township adopled April 11,
1955.
. .
. :~:r..~->.. ae:
. .
, Chairman o Tnwn Board 8uildinq I pecior
EAGAN TOWNSHIP `
BUILDING PERMIT N? 2929
,
Ownar Eagan Towns6ip
Addrecs (Presenf) '__-../.~?,-._-.--6:~.~~:u-:Q-.-.----_---.--.----__-. Town Hell
Builder '
Addreca Date
DESCASPTION
719 To Se Used For Froni Dep1h Haigh2 Eai. Ci! Fee Aemarks
i i~i
LOCATION
Streef. Roed or ofher Deaeripiion of Loaafion I Lo ock Addition os Trae!
~ T6is permii doea not auShorise the use af alreeffi, roeds, alleys or sidewalks nor doee it giva 1he ownar or his agen!
!ha tiqhf !o erea2e anp ailuatioa which ia a nuiaanee or which presenls a hazard io the heallh, safety, conveaience and
genaral welfara !o enpone in the communilp. ~
THIS PEAMIT MUST B£ KEPT ON THE pREMISE WHILE THE WOAK IS IN PROGRESS.
• ~%~-t-.= / -o-..~ • - ,
Thta is !o eerhfy. 2hal---- r~ ..............~~.has permusion 2o erect a...... p a
u o
the above deecribed premise subjec! !o the provisiona ot the Building Ordinance far Eagan To nship adop~ed April 11,
1955.
, .•.-•-.-_..~~`.:(~`...-.Z'-. :..fl--..... . - ~Per ~~~.-........?.,c-~-~-
man o T wn ist ard ~ Suildinq Inapeetor '
` C , G.
PILLAGE OF' LAGA1V
3795 Pilot Knob ttoad
Eagan, tviinneaota 55122
PIMIT N0. 337
The Oillage of Eagan hereby grants to Led&r {}rcye Canatruatian Co.
. . . of Cjnnni.rt R]! v_d- BMAto' $outh 31'.. ' PB9111
a Al~ rmi.t fors (Owner)
3869 &~.vertan Cirale t4 -8~285~ & 3861 Palie~ ap~ ,k2 seas
6-2-8; 1709, 1727,1718
a'~ t8„~„g_pursuant to applida~detd ~
-U1 iv04
rs
Fee Paid: 120.00 dated this 15th day o£ MAZ , 19_-73_,
3.00 a o
Euilding Inspector
Nechanical Permits;
Bid Total:
5
rd-4-f
. c. G •
VILLAGE OF rAGA1V
3795 Pilot Knob itoad
Eagan, Ttinnesota 55122
PERiiIT N0. ~
The Village of Eagan hereby grants to Cedar Grave Cortstructiaat Co#
of 7343 Coaaord Blvd. Faat} Sou#.h 3t. Pmll
a HEATIAIU Permit fors (Owner) e~
3869 Rivertan csrcle 14-4-82859 & 3861 Palisade Pt. - & --,1727,
at j 71 g Coahr$he 2-li-B, lt-,It-~. )Qw"ant to applic ation dated 5/1 1/73
Fee Paid:,t120,0p dated this L5thday of Mey ~ 1973
3.00 a/c
Building Inspector
Nechanical Permits:
Bid Total:
~
2005 RE5IDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date A / ~/-J of;
Site Street Address kl D-L1r-~on Unit #
Property Owner ~~'~'~-~~~C~--•~C~`r T~-~ Telephone # (~G51) ~~-do4s
Contractor TIelephone # (950) 469 ~
Address 1 I City State M Zip O`Y
The Applicant is: _ Owner Contrector _Other
Alterations to existing dwelling $ 50.00
_ Add plumbing fxtures (excludes water softener and/or water heater--complete next
section if instaliing these appliances).
Septic System Abandonment
_ Water Turnaround (add $125.00 if a 5/8" meter is required)
Other:
Water Softener X Water Heater $ 15.00
_ new ~ replacement
Lawn Imigation _RPZ _PVB _new _repair _rebuild $ 30.00
State $urcharge $ 50
Total
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the appr ve lan in
the event a lan is required to be reviewed ved.
/ / \n .
~J~ V
~n
ApplicanYs rinted Name Applicant's Signatur
2005 I
I I~ APR i 1
LI J
Bv
CI1'Y USE ONLY
LOT ~ BL "I PERMIT
SUBD. GP-d a.r GYe)oP,~ RECEIPT l JDG 7~
RECEIPT DATE:
2000 bECHA1dICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PIIAT PQROB RD
L L\ EAGAN I+II~I 55122
f~~ ~ 651-681-4675
"l~
Date: O
Complete this section onlv if you are instalting HVAC in a single faznily dwelling, townhome or condo under
construction and not owner/occuoied.
• HVAC: 0-100 M B T U $ 30.00
ADDITIONAL 50 M BN 6.00
. Gas outlets (minimum of one required @$3.00 ea.)
State Surcharge .50
Total ` $
Complete this section 9&ly if you are remodeline, addine to. or repairing an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or repair.
_ New _ Alteration ~ Repair _ Other
~ Furnace ~ Air conditioning
_ A'v exchanger _ Other
Fee $ 30.00
State Surcharge .50
Total $ 30.50
Reminder: Call for irrspections
SITE ADDRESS: Gr
OWNER NAME: PHONE
INSTALLERNAME: l~1~~o~A CODE)
~..T.....e ~racrr PHONE k: -
(AREACODE)
STREET ADDRESS: ~ti06t
CI1'Y: ST
;
` SIGNATURE OF P RM3"iTEE
l _ _ _
CITY USE ONLY
L _ BL _ PERMIT#:
SUBD. RECEIPT#:
APPROVED BY: , INSPECTOR RECEIPT DATE:
2000 MECHANICAL PERMIT (conMEitcxrar.)
CITY OF EAGAN
3830 PILOT PQ+iOB RD
LAGAN, 2+Q7 55122
651-681-4675
Please complete for: all commerciaUindustrial buildings
multii-famity buildings when separate permits ar 7ot required for each dwelling unit
DATE:
V?ORK T'YPE: New conshuction Lis[all U.G. Tank
_ lnteriorlmprovement _ Remove U.G.Taok
_ Processed Piping
Whea instatling/removing underground taxk, call 651-681-4675 for inspection by f+re marshal and
plumbing inspector.
Descriprion of work:
Fees: 1% of contract price OR $30.00 minlmum fee, whichever is geater.
Underground tank removaUinstallation = minimum fee
Contract price: $ x 1%= $ (Base Fee)
State surcharge calculate at $30 for each $1,000 Base Fee
TOTAL $
- - -
5I1'E ADDRESS:
OWNERNAME; PHONE
(AREA CODE)
TENANT NAME (MiPROVEMEN'I'S ONL1):
WAS TfERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
. ' " ..:W.Y
. .
ADDRESS: PHONE'#:.
" (AREA CODE)
CITY: STATE: ZIP:
SIGNATURE OF PERMITTEE
MASTER CARD
LOCATION
OWNER 144004.P
~
STRUCTIJRE AND
LAND USED AS
Issued To
Permif No. Issued Contractor Owner
BUIIDING
PLUMBING
~
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL HEATING
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER I
Approved
Items (Initial) Date Remarks Distance From Well
FOOTING p~ ~ SEPTIC
FOUNDATION _ ri CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL pEPTH
HEATING OF WELL
GAS WSTALLATION
i
SEP71C TANK
CESSPOOL
DRAINFIELD
PLUMBING 7
WELL
SANITARY SEWER ~b '-J
Violations Noted
on Back
COMMENTS:
I
.
COMPLIANCE INSPECTION REPORTS
' TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO. DATE OF INSPECTIQN
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE Of NON-COMPLIANCE ? NON-COMPLIANCE. BUILDER DOES NOT
OBSERVEO. INTEN? 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 RE4UIRE0 DATE OF REINSPECTION
REINSPECTION REVEALED CERTI FICATION -1 certify that I have carefully inspected the above in which 1 have no interest present or prospective, and that I have reported herein
all significant conditions oLserved to beat variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvemenxs relating to the property inspected.
F-I ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BIJILOING INSPECTOR OATE
COMMENTS:
z3 I
1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
/
3830 PILOT KNOB RDN 55122
'
651-681-4675 ~ ?
New Construction Reauiremenfs Remodel/Renair ReauIremeMs
9 3 registered ske aurveys showing sq. tt. of lot, sq. R. of house 2 copies of plan
ond olI roofed areas (20%, maximum lot coveraae allowedl 1 set of energy calculaifons for heated addNions
> 2 copies of plans (show beam 8 window sizes; pouretl tnd. design; etc.) 1 sMe survey for e)ferior addiflons 8 decks
> 1 sef of energy calculations
> 3 coples of hee presenation plan H lot platted aHer 7/1/93
DATE: S"(_o -qG CONSTRUCTION COST: q5 g~ ~ Z
DESCRIPTION OF WORK: '-ROOt C
~ p l
STREETADDRE55: 5Slsq 1~i\V2,rA-o~1 ~P C\fC.-k
LOT: BLOCK: SUBD./P.I.D. GV-U v -e~ tS
Name: ac.f~e`L LCiCage..'JC..D Phone#: ( '51
PROPERTY ?on Firn
OWNER '
StreetAddress: ~8609 -1-?jJPX-J~,tJ CX
City State: Zip:
Company: 'Z3 C.1/-c- - I-o CY, Phone (O/2 qq 7 Z27Lp
(area code)
CONTRACTOR "~U
Sheet Address: bqJ'~J !4tr~ ~i Ucense # Z0I4 ZZ85 Exp.~'31' ZCOC
ci,y 0462we uc.~, state: k7? A-/ ZiP: SS,Z q
ARCHITECT/
ENGINEER Company: Name:
Telephone area code ( )
Street Address: Registration
City Sfate: Ztp:
Sewer 8 water Itcensed plumber (reauired for new consfruction onlv):
Penalty applies when address change and lot change is requested once permff is Issued.
I hereby acknowledge that I have read fhis applieotfon, state that fhe Information Is conect, and cgree to comply with all applicable
State of Minnesota Statutes and City of Eagon Ordinances.
SignatureofApplicant: ;41b" ( itX&'
OFFICE U5E ONLY =BY.-
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.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 03 1 of _ plex ? 08 6-piex ? 13 16-plex Q 18 Deck ? 23 Porch (screened)
O 04 2-plex ? 09 7-piex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-piex ? 15 Lodging ? 20 Pool ? 25 Misceilaneous
WORK TYPE
? 39 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 Bldg.' ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
'G ivP PCA handout tn applicant for demolition permit
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowa6le) Main level sq. ft. SAC Code
UBC Occupancy sq. ft. No. of Units
Zoning sq. ft. No. of Bldgs
# of Stories 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 Waluation: $
Surcharge
Pian Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
% SAC
EAGAid TOWNSHIP
3795 Pilot Knob Rosd
St. Yaul, Mianesota 55111
Telephone 454-5242
PLRNIIT FOR WATER SERVICS CONNSCTION
Date: 5/15/73 (12/29/72) Number: 1200
Billing Name:Cedar Grove Construction Cogite Address: -4-44t-+
Owner: Saiae Silliag Address 3869 Riverton Circle
Plumber• Stein's
Location of Connection Meter Size Coanectioa Chg.300.00 pa 5/15/73
Meter No. Permit Fee 10.00 pd 12/29/72
Meter Reading Meter Dep. •50 pd 12/29/72
Meter Sealed: Yea Add'1 Chg.
NO Total Chg.
Inspected by
Date
Building is a: Remarks:
Residence xx
$25.00 R~ ~ ~-±:I~~-f crMIN a i-P F~R
Multiple xo. unic$ IMPRQF~ "O IfJSl;;LLZL Ir"
Commercial cj,J.
Industrial By:
Other Chief Iaspector
In consideration of the issue and delivery to me of the ahove permit, I
here6y agree to do the proposed work in accordance with the zules aad
regnlations of Hagan Township, Dakota County, A4innesota.
sy:
stein's
PLease aotify [he above office when ready for inepection and connection.
09r=8r'2007 08:40 ERGpN ENG+COM DEU 4 96519051745 N0.848 D02
• 2007 RESIDENTIAL SUILIIING rMffarxxsMx
City Of Eagao
3830 PiEnt KnaD Road, F:agan A'i1V 55122 ' Telephnne # 651-675-5675 FAX # fi51-675-5594
Neu~~ansv~mnRequdament~ RemadeumrmlraEautremants oifimueea+v
]~ied.sf~ su~g_s_sfimlr~e s~ft oftpt,.59. R of hase; and d mafed area5 2 coDlPS Mtllan-shr,A9 faotlngs boamsJoists CaA of Suwsy Recd _Y _N
1 $018 Repat---- ;_y-...M-
seful Ene~gy Calcu~tbns br
~~(2U'~m~tlmanla[[Ot~ealwvedl . . . _ - heatedadGPocds
' 15o$'*9i~PangP~OC6~dlulld~Bs~hepm~sdond~tm4edso~ 15kewnt^I':tmemlHWnSddnCes TfeePresP{anReu! _Y _N,
2 mps W Wan sAwMg bmm 8 Wndow skes; poured IauiM dmgn. et Atltlklep •lad'~cale N"e MAc aYstarn Yree Pies Reqpdred _Y _ N
".138TA-.~~fl~9Y,GA~ahWtw_ . . . OrFaiYSeptlrtSymem _V,_N
. .
9 mos oF,Trea Pwervafim Alan if ht plellea afiar711193
Rlm ~mtDetsl ~Options ieledion ameet {bulfSnAs olA 3 rnrese unllsj
. --.Llione~Samehaniralven67aUonkn Plans are considered ublic infarma#ion unless au sEate the are trade secref and the reason,
b7m./(a 4:3- ~ ConevuctionCast / a/,/.Z(3
blte J~ddress 1e~..O_C/ l T~ ~?7 ~~?G ~2 IInltlSte #
Deseelpttpn of Werk
~
Mulll-yoirdfy Bldg _ Y _N Firepiace(s) Property Owaer Telephoae h~pZ)
~
Canuaetar
:~ddress ~ city
Stute ZiP TelepSooe #(~aJ 7.,~ ~
COMPI:ETF. THIS AREA ONLY IF CONS7RUCTING A NEW BUII.DING
Minnesots Rulr.s 1670 Catesorv 1 Mwnes4fa_Ru1_es_7672
; EikergyGode Catagory
. ResldenHal VenYdaUon Category 1 Worksheet • New Energy Cude Werkkeheef
(JsuM+~ss~nppej sudrcutreG sutumaed
. . Energy Emrelope C31c11a90n6 Sli6rttltlBd -'dn rfiJ lasf 72 months, Yias fihe City of Eagan is#ueC p{79rmii fOt G Tlmllor pion 5asad on tl mastet pian8 Y _ N if yes, cfare ond address of masier pfan~
Gcaised ftmber Tslephone J
UAechanical Contractor Telephone I
!Sewzr/Woier Contractor Telephona #
I hereby epply far a Reaidential Buildiag Pexmit and aektwwtedge tbat the infomtatiqn is comglete and acctua.e; ~
that the wark will be ia conformance wi#h the ordinances and codes af'tbe Ciry of Eagan and the 3tate of N_N
Stakites; t understand this is not a pemrit, 6ut only an application for a pernut, and work is not to staat witlmut a
;pernit; that the work will be in accordance with the approved plan in the ¢ase of work which req ' a review snd ~
app€nval ofpYane. ~
~APFJicant's Printed Namc ;jA ican['s Signature
' '
Q~ C~ G~ ~ MC i
City of Ea~a~ p I Permit#:
. a~~ a ~ 2ons { pe,,,,,,F'
'
3830 Pllot Knob Road
Eagan MN 55122 I Oale Received:~ ~
Phone: (651) 675-5675 1 ~
Fax: (651) 675-5694 ~ StaN______~~____ J
2009 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address: J C~ llf'I ~Up,l~ i C~Y 1[,l(~.
Tenant: Sulte ri:
RESIDENT/OWNER Name: W(~MU ~fP7iiV~ ~ Phone: LD~i Lol~k llX'"IS
~.r
Address / Ciry / Zip:
CONTRACTOR Name: I'S PIIA.YYti~, /a License#: ao t
Address:~~ s
~L11A11Y1
Ciiy: <~6Y'/~&N1 State: l~ I V Zip:
Phone: IDIoZ 0~g"IIC7~ ContadPerson: _,6Cm
TYPE OF WORK XNew _ Replacemen[ _ Repair Hebuiid _Modify Space _ Work in R.O.W.
Descrl ilon of work: ' P ~
PERMIT TYPE RESlDEMTIAL
Water Heaier _ Water Softener
~ Lawn Irrigation _ Add Plumbing Frztures
C- RPZ PVB) ~ Main _ Lower Level) .
Septic System _ Water Turnaround
New
Abandonmeni
RESIDENTlAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment. Water Turnaround' (includes $.50 State Surcharge)
'Water Tumaround (add $165.00 if a 5/8" meter is required)
$100.50 SeptiC System New ($70.00 per as built) (inciudes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace bumed out appiiances, ductxrork, etc.) (indudes $.50 State Surcharge)
TOTAL FEES $
I hereby acknowledge tha[ this infortnaUon is complete and accurate; that the work will be in confortnance with Me ordinances and codes of the City of
Eagan; that I understarM lhis Is not a permit, but only an application lor a permit, and work is not to start without a perm@; that the work will be in
accordance with the approved plan in the case of work which requires a review and approvalaf"p ans. ^
X .7~, r0-,1 LA IT~., X ~
ApplicanYs Printed Name ,,'plicanY ignature
POR OFFICE USE Reviewed By: Date:
Requirect lnspeetfohs: Under Geound Rough-In APr TesF Gas Test Flnat
'~J
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA119940
Date Issued:01/03/2014
Permit Category:ePermit
Site Address: 3869 Riverton Cir
Lot:14 Block: 4 Addition: Cedar Grove 8th
PID:10-16707-04-140
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 -
Dan Brezina
3869 Riverton Cir
Eagan MN 55122
Rybak Brothers Construction Llc
2206 East 117th Street
Burnsville MN 55337
(952) 405-8871
Applicant/Permitee: Signature Issued By: Signature
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA140021
Date Issued:11/18/2016
Permit Category:ePermit
Site Address: 3869 Riverton Cir
Lot:14 Block: 4 Addition: Cedar Grove 8th
PID:10-16707-04-140
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Dan Brezina
3869 Riverton Cir
Eagan MN 55122
(651) 451-6835
Beissel Window & Siding Co
1635 Oakdale Ave
W St Paul MN 55118
(651) 451-6835
Applicant/Permitee: Signature Issued By: Signature
i
rE AG N For Office Use
•
::::
: _Dv('
DECEIVEn Date Received: 4-/9,
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 Cv
(651)675-5675 I TDD: (651)454-8535 I FAX:(651)675-5694MAY 1 0 2019 Staff:
buildinginspections ancitvofeagan.com
2019 RESIDENTIAL BUILDT - APPLICATION
Date: C— `! /( Site Address: 32'L 7 've; /111) 55'/2 Z Unit#:
Name: t o ( r e Phone: 6/ 2 470) J 7 3 Lf
Resident/
Owner Address JCity/Zip: 31'( ci 12 r �,r ~ A) 55/
2 2-
Applicant
Applicant is: (XXOwner Contractor 0/41,6/2E 2 7)/-) (OG// OGG
COM
Type of Work
Description of work: r ZJ I j��5t:, (/tifiC��_ 47;r2,'‘. t 62.C"
Construction Cost: Multi-Family Building: (Yes /Nox )
Compa • 1'"r: vH i I I f S ifs c_ Contac:--,_ lG tr.S yN-
Contractor Address: 1S J d I h �., i C S't. City: L kr 1 le
State: 14.0 Zip: - Phone:14 Z-e%e/7 , Email: - L prJei/6
License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor. Phone:
NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the Hnlb,malion may be
classified as non public If you provide specific reasons that would permit the City to conclude that they are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeaaan.com/subscribe.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
CALL BEFORE YOU DIG. Call Gopher State One Call at(661)464-0002 for protection against underground utility damage. Call 48 hours before you
intend to dig to receive locates of underground utilities. www.aopherstateonecall.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 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 appryyaktplans. .'
x l
136e 2. to t,
x ...,,...-
�C
Applicant's Printed Name Ap cant`sSignature
DONOT WRITE BELOW THIS LINE 3R tt:, `SPY C-l'l 4/ .-- .---5-,7
SUB TYPES
_ Foundation _ Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family)
Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
_ Multi — Deck Porch(Screen/Gazebo/Pergola) _ Miscellaneous
— 01 of_Plex — Lower Level 7 Pool _ Accessory Building
WORK TYPES
`74)New _ Interior Improvement _ Siding T Demolish Building*
— Addition _ Move Building _ Reroof _ Demolish Interior
Alteration — Fire Repair _ Windows _ Demolish Foundation
— Replace — Repair _ Egress Window _ Water Damage
_ Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation6.01____PO Occupancy J MCES System
Plan Review Code Edition ,k 1. 1( SAC Units
(25%_100% ) Zoning ( 4 City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction ----V-6---
Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
Footings(Deck) Final/C.O. Required
Footings(Addition) Final I No C.O.Required
Foundation Foundation Before Backfill HVAC Service Test Gas Line Air Test_Hood
—
Roof:_Ice&Water _Final _ Pool: Footings ,Air/Gas Tests ,Final
—
Framing 30 Minutes 1 Hour Drain T e
Fireplace: Rough In Air Test _Final Siding: Stucco Lath _Stone Lath _Brick_EFIS
Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression: Rough In Final
Braced Wails Erosion Control
Shower PanOther:
Reviewed By: II �Building Inspector )
RESIDENTIAL FEES16‘,60v r v
`A3
Base Fee 1
Surcharge 4 V V
Plan Review
MCES SAC
City SAC
(4 /
Utility Connection Charge
S&W Permit&Surcharge 0 0 U
Treatment Plant f
Radio Meter Read
Copies
TOTAL
Page 2 of 3
POOL PERMIT - APPLICATION SUBMITTAL REQUIREMENTS
Address: 1 1
�� v U
Applicant Name: -zJ�nG�
GENERAL INFORMATION
0 Z
❑ ❑ Applicant name and contact information
Ja' ❑ ❑ Property owner name
.0 ❑ ❑ Address of property
❑ , ❑ North arrow, scale (1" = 30' or 40')
❑ ❑ Site Plan, drawn to scale showing location of house, pool, and other existing or proposed
structures, including retaining walls and fences.
2( ❑ U Location and name of all streets adjacent to property
❑ J� ❑ Directional drainage arrows (existing and proposed)
❑ ,ef ❑ Lot Square Footage
❑ ,� ❑ Lot Coverage
ELEVATIONS
Existing
❑ ❑ House corners
❑ ❑ Property corners
❑ ❑ If applicable, ground elevation at each end of retaining walls and at wall's greatest height
Proposed
❑ ) ' ❑ Finished pool deck corners
❑ ,� ❑ Top of proposed retaining walls (if any) and at each different elevation(if it changes)
gc ❑ ❑ Pool bottom(or max. depth)
DIMENSIONS
Existing
❑ ❑ All property/lot lines
❑ ❑ All
Easements on thero ert
p p Y
Proposed
❑ ❑ Pool
❑ f� ❑ Pool plus integrated ated deck/ atio
❑ ❑ Shortest distance from outside edge of po$ deck to lot lines and house
Reviewed: I- Vii/ 9
Name Date
P
G:FORMS/PoolPermit Checklist/11-20-12
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PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA163416
Date Issued:08/31/2020
Permit Category:ePermit
Site Address: 3869 Riverton Cir
Lot:14 Block: 4 Addition: Cedar Grove 8th
PID:10-16707-04-140
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
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 -
Dan Brezina
3869 Riverton Cir
Eagan MN 55122
Standard Heating & Air Conditioning
130 Plymouth Ave. N
Minneapolis MN 55411
(612) 824-2656
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA168114
Date Issued:04/09/2021
Permit Category:ePermit
Site Address: 3869 Riverton Cir
Lot:14 Block: 4 Addition: Cedar Grove 8th
PID:10-16707-04-140
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:Fixtures
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 (miscellaneous)$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 -
Dan & Nancy Brezina
3869 River Ton Cir
Eagan MN 55122
Minnesota Rusco
5010 Hwy 169 N
Brooklyn Park MN 55428
(952) 935-9669
Applicant/Permitee: Signature Issued By: Signature