4929 Royale Way03/07/2011 MON 14:53 FAX 6514378831
City ef Eaaan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
a1002/003
Use BLUE or BLACK Ink
Permit #:
Permit Fee:
Date Received:
Staff:
2010 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 31/1 2011 Site Address: 1-1c)251 RQ aJe
Tenant: Ai Ie Porter
Suite #:
RESIDENT / OWNER
Name: Allen Porter
Address / City / Zip:
air) 55422.
Phone: (PS) -1-152.7 13q
CONTRACTOR
Name:
..it it . ■,'/.' x i
'cense #:
Address: I -f O4 \Jt'vrni I i; Qt`i 7i City: '}"#(,($ t flc
Vit
State: my) Zip: 65033 Phone: (,051- 4j?' 41-1-1j
Contact:( �'},)_ _ Email:
Gi ► k
:1 1 .11 I —
TYPE OF WORK
New /Replacement Repair _ Rebuild _Modify Space Work in R,O.W.
Description of work:
PERMIT TYPE
RESJDENTIAL
l Water Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
(_ RPZ / _ PV8) ( Main _ Lower Level)
Septic System Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater oil Softener (includes 8.50 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 Turnaround (add $166.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
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, wvvw,gopberstateonecall.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
Jam le VOInOLO g) A/ret,1...-
Applicant's Printed Name Appl ant's Signature
' INSPECTION RECORD
. «
CITY OF EAGAN PERMIT TYPE: ' ' + ' ~r' ~
3830 Pilot Knob Road Permit Number: " •
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: , „ ~ . i r APPLIGANT:
, , W!t'~ ~~~i~ ~ ~ i: ~
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PERMIT SUBTYPE: TYPE OF WORK:
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Permit No. PBrmR Holdsr Date Telephons #
SNV
PLUMBING ~ ~ ~l yi I p
!
HVAC ~ L 6 Zp y SSa•90 (L
ELECTRIC ~~rf~ ~ 5p ~
ELECTRIC
Inspectbn Date Inap. Comments
Footings t
Foundfldon ~Q C,L(
vt,
Framing ~
RooSng l~~C! !./J
P~~. ~ 1s 9Y ~ Q, ~
~9~ ` ~ ~l .C~J
Isul. 7 ~ ~
Flrep~ace ,
Fnal Htg.
Orsat Test
Final Pibg. Q~~~~ ~ Plbg. Inspector- Notify Plumber
U .
Const. Meter Z ~/s7
Engr.lPlan
Bldg. Fnal ~r~~
Deck Ftg.
Deck Final
Well
Pr. Disp.
9 . -
ii ~ • ~ ~ ' 1
~e~~cate n~ ~ccu~anc~
~ ~a~~
~c~a~tace~t o f ~riib~g ~u~pcction
This Certi,fieale issued pursuant to the ~q~rireinents of ~he Uni,farm Building Code
certefying that at the time of issuance this s~rrectu~ wcrs irr compliance with the various
ordinances of the City regulating building construction or use. For the following:
u~ ca~~r~u~,: SF I~~G awg. No_ 23422
~~Pa~Y ~'P~ Zoaing Distritt R~ Type Cons~. ~
o~ ~r s~aa~~ SIEV'@1 MA~IA~EK ~ 138 E ~li, B ST PAI1L
s~~a~~ naa~ 4929 ~E WAY ~;~y Lq, B3, F~AL'~li~l ~E
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POST IN A CONSPICUOUS PLACE
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: "'17`:s+~
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: ' ~ " ~ ~ " ~ APPLICANT:
1 I ~ ttl ~ir 1
. ~ , i ~~YA1 h WAY , , . E i . ,
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PERMIT SUBTYPE: TYPE OF WORK:
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Permit No. Pertnit Holdar Date Telephone #
ELEC7RIC
PLUMBING
HVAC
Inspectlon Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PlUM81NG
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL -
BSMT R.I. '
BSMT FINAL
DECK FTG ,~-96 1l1 v b_v ~l -q ~
~ ~~-1_-_D
OFCK FINAL
'~"?S-4'
p~~~ pn1 .~J~,~ No~G~O - - ,
it/`4~__ ~JSf~2 ~C~l?/ f,~'?~N~-,
t~r ~r~~t/7~ C,~ wcs
_ 1__ _
INSPECTION REC4RD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued: < t', ,
(612) 681-4675
~ ~l 1.~ ~ i
SITE ADDRESS: ~ ~ ~ Ft ~ i, r; ; APPLICANT:
. . , , ~ F~ wRV ~~~~rr~ii
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PERMIT SUBTYPE: TYPE OF WORK:
, , ~ ~ ~ , ~ . ~ , ,
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~•A~ t ~4~~ : f3qN i~E~pt~1~JN~~ rl k.r. fk)f~.At f•i I~Mi I AN1.~ tt~~;F~E~7 1~~fa~.,
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Permit Holder Date Telephone
PLUMBIN ~ 7 ~8 - 3
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
fIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG ~
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS ~
CONDUCTIVIN I
TEST I
HYOROSTATIC I
TEST
BSMT R.I.
BSMT FINAL ~ $'S {S i
DECK FTG
DECK FINAL
~ a4a 9 ~.9
s~ ~t'jr ~
Re uest Date ^ Fire o. Rough- Ins ion
ReQUiretl? ? Reetly Now ~Will NaOty Inspeclor
es ? No Wnen Reetly?
I,,'~licensed contractor ~ 1,] owner hereby request inspection of above eledrical work at:
Jo tlree/s ~(Streel. 8ox or te No.) Ciry
. ~ / ~A 4 R n
Section No. Township Name r No. ' Range No. CouMy
Da ko~"~.
Occupam ~PRINT~ Phona No.
ev~ ac~ - SY9
Power Supplier! AtlEress
!
Ele mcal Comractor ICompany Name) Conlranor§ license Na.
~V/., T. ~ ~~Cl. C}~ OIIO
Ma?ing Atltlrass IContrector o~ OWner Making nstallation)
~~t ~w~vP Cl. N• S~t%l~w~~« /'~~v .~50 ~
Au~M1Orizgo $ign3ture IGOntrac~onOwner Meking Ins[allation) ~ . Phone NumOer
Y o-3s~
MINNE5OTA TATE BOAHD O ELEGTPIGTY TMIS INSPECTION RE~VEST WILL N07
Gtlgge-Mitlwey Bltlg. - Foo 54]9 BE ACCEPTEO 6V THE STATE BOARD
1811 University Ave., St Peul, MN 55100 UNI.ESS PROPER INSPECTIDN FEE IS
Phone~612~86P-0800 ENCLOSED.
G aa/9~ REQUEST FOR ELECTRICAL INSPECTION ~`yyy~`" ee.ooooi~
~ See inSVUCtions 1or completing ~~is form on back oi yellow copy. ~~I ~
~ 4 6 9 5 ' "X" 8elow Work Covered by This Request ~,ww
~
e /Ctltl Rep. d TypeolBuiltling AppliancesWired EquipmentWired
Home Ranqe Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other-(SpeCify)
Comm./Industrial Fumace
Farm Air Conditioner
O~her (specilyl CoMractoYS Remarks'
~V~~, hoM~
Compufe Inspecfion Fee Below.~
X 01her Fee # ServiceEmranceSize Fee # Circuits/Feedars Fee
Swimming Pool O to 200 Amps ~Q~00 / 0 to 100 ps .pp 5',QD
Transformers Above 200 _ Amps ~00 Amps
Signs Inspecmr§ Use Only: \ . op~
Irrigation BoomS GV~ 7 S. SD
Special Inspection ~
Alarm/Communication THIS INSTALLATION MAY BE OH RED DI NNECTED IF NOT
Other Fee COMPLETED WITNIN 18 MO HS. r
I, the Electrical Inspector, hereby Ro~n-~~ a ~ Z~ 4, ,
certify that the above inspection has F;,~i
been made. ~
OFFICE USE ~NLV
ThiS reques~ witl 18 monlhs 1mm
Address 4929 ROYALE WAY Zip 5512 Z
L.ot 9' Blk 3 Sub ~[trntat.E
THESE ITEMS WERE / WERE NOT COMPLEI'E AT THE TIME OF THE FINAL INSPECTION.
Date: C1 ~~j Yes No Inspedor.
Final grade (6" from siding)
Permanent steps (garage)
Pennanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
TraiUcurb damage
Porch
Basement finish
Deck
Please verify wi[h the builder the removal of ro f test caps from the plumbing syscem and the shuhoff of water supply to
the outside lawn faucet before freeze potential exists.
ContaIX engineering division at 681-4645 before working in righhof-way or installing underground sprinkler system. ~
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
5a /~C' RESIDENTIAL `
BUILDING PERMIT APPLICATION
CITY OF EACAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675 Q .
New Constmction Reouiremenb RamodellReoair Reuuirements
• 7:eg~sterea ;i[e surveys showing sq, ft. of Ict, fl. of house~, and all roo(ed areas • 2 copies of plan
(20"~o maximum lot cave2ge allcwed) • 1 set ol Energy CalcWations fer heated additians
.?„ones of plan showing beam S window s¢es; pouretl found design, etc.) • 1 site survey fcr =x:enor additions 8 tlecks
. 1 aet of Ener~y Calculations . Iridicate if home serveA bY septic system for addiGons
. 3 saGizs of Tree P~eservation Plan if lot platted aRe~ 7/tl93 ~
. Rim Jois[ Cetail Options selection sheet (bidgs with 3 or less unitsl
DATE / VALUATION ~ r ~
~
SITE ADDRESS ~Z~ Y~~ ~'P"~ MULTI-FAMILY BLDG _Y ~
TYPE OF WORK ~aD<' FIREPLACE(S) _ 0~!' 1_ 2
ST~~~/ ~c~-~~. ~
APPLICANT
STREET ADDRESS _ ~~9 '40 W CITY~STATE ~+-'ZIP~/~-
TELEPHONE # ~~~~6~•23~0 CELL PHONE~ FAX # -
PROPERTYOWNER .~'~"r`° TELEPHONE#
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ ~[I\'Vi:SO'C:\ RCLES 7670 G1"f1:GORt' l 1II\~LSO"1':\ R["L1:5 itiiY
(d submission type) . Residential Ventila[ion Category 1 Worksheet Submitted • New Energy Code Worksheet SubmittzC
• Energy Envelope Calculatlons Submitted
Plumbing Contractor. Phone #
Plumbin~ systcm includes: V4'atcr Softener L~wn Sprinkler Fee: 590.00
~Vater Hea[er No. of R.I. Baths
~o. oF Baths
Mechanical Contractor: Phone # _
~Iccli.uiic.~ systccn includc,: .~ir Concliuociiiig ~ ~F ~ ( .
~[cac accovcn• systciti .II II 1 1 2002 U
Sewer/Water Conhactor: Phone #
SY
- •
I hereby acknowledge that I have read this application, state that the i or ation is correct,
a~to comply
with all applicable State of Minnesota Statutes and City of Eagan Or n ce~i~
Signature of Applicant
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Ptan Received _ Not Required _
Updated 4102
OFFICE USE ONLY
? O7 Foundation O 07 OS-plex ~ 13 16-plex ? 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? 08 O6-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext Alt - Multi
? 03 07 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 70 OS-plex ? 18 ~eck ? 23 Porch (screened) ? 36 Multi
? 05 03•plex ? 17 10-plex ? 19 Lower Level ? 24 Storm Damage
? O6 04-plex ? 12 72-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 (81dg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolitio~ (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinkiered
Type of Consi Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaliC.O.
_ Foo[in~s (deck) FinaVNo C.O.
_ Footings (addition) _ Plumbing
, Foundation HVAC
_ Drain Tile Other
Roof _ Ice ~ 6Varer _ Final _ Pool _ Ftgs _ AiriGas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ RL _ Air Test _ Fiml _ Windows (new/replacement) .
_ Insulation _ Retaining ~4'all
Approved By , Building Inspector
Base Fee
Surcharge
Pian Review
MC/ES SAC
City SAC
Water Suppty & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
PERMIT Ci~ a 333 ~
~CITYOF'EAGAN PERMITTYPE: s~ 9
sUIL0ZN6
3830 Pilot Knob Road
Eagan, Minnesota 55123 Permit Number: 0 2 3 4 2 2
(612) 681-4675 Date Issued: 0 5/ 0 2/ 9 4
SITE ADDRESS:
4929 ROYALE WAY
LOTs 9 BLOCK: 3
EAGAN ROYALE
P.I.N.: 10-22475-090-03
DESCRIPTION:
61uilding?_,Permit 7ype SF DWG
puildzng W~,rk Type NEW
<'U8C Oecupancy~, R-9 M-1
~
~ Construction Ty'pe v-N
% 2onifig
R-1
i`~ Build~ng Length ` 70
Building Width `j 48
Building stories f~~ 2
~ h.k~
-~e/L\f~j. ~
_ ` .
4
y~
l y /
t\\. t`J ll`~.~~\~~ ~`~~{-.fl i~"'1 l i r:`~
Fi `J. '7 ~,l `~:.1 ' ti~w L" ~4
a:+, c J
REMARKS:
S& W PLBR - STEVE PELTIER
FEE SUMMARY:
VALUA7ION $155,00@
Base Fee $832.00 MISCELLANEOUS ~1,$28.50
Plan Review $540.80 Total Fee $4,078.80
Surcharge $77.50
SAC~ $880.00
SAC & 100
SAC Units 1
Subtotal $2,250.30
CONTRACTOR: OWNER: - Applicant -
MACHACEK STEVEN
138 E ASH
S ST PAUL MN 55075
(612)687-2629
S hereby acknowledge that I have read this applic~tion and state that the
information is correct and agree to comply with a11 applicable State ot Mn~
Statutes and City o€ Eagan Ordinances.
~ ~
APPLICANTlPER ITEE SIGNATURE IS E~ BY: SIGNATURE
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: e u x ~ o x N ~
3$30 Pilot Knob Road Permit Number: 0 2 3 4 2 2
Eagan, Minnesota 55123 Date Issued: 0 5 J 0 2/ 9 4
(612) 681-4675
SITEADDRESS: ~or: e BLOCK: 3 APPLICANT:
4929 ROYALE WAY MACHACEK STEVEN
EA~AN ROYALE (612) 687-2629
PERMIT SUBTYPE: TYPE OF WORK:
SF DWG NEW
. .
FOOTINGS FOUNDA7ION
FRAMING ROOFING
INSULATION FIREPLACE
ROUGH IN PLBG ROUGH IN HTG
FTNAL pLBG FINAL
REMARKS: S& W PLBR - 5TEVE PELTIER
~ ~
L J
' CITY OF EAGAN ~
~ ~ 1994 BUILDING PERMIT APPLICATION
~ 681-4675 P R 1 1 15;4
~ ` r e7~.~o ~
tt'' +,+;,r;' - ~
~~SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date / ~ / ~ Valuation of work ~/zs,mo G~r
Site Address: '~9L9 ~?oz,al~ l.~~,
ST EET SUITE #
Tenant Name: (commercial only)
LOT BLOCK 3 SUBD. E~~~~ ~ q~~ P.I.D. #
Descri tion of work:
The applicant is: Owner ? Contractor ? Other C~es~ribe)
Name ~"1HCkkc~~ ~reyt~.l Phone 687-?~Z9lw ~
Property ~asT v~asr y,si-~~z C.v~
Owner qddress i38 E A~~,
STREET STE #
City -S. s'-. ~~-u~ State M~/ Zip ssa75
Company .5~~~ Phone
Contractor Address License ~~t`~~ Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registration #
Address '
City State Zip
Sewer & water licensed plumber G~ ~ Processing time for
sewer & water permits is two days once area has been approved.
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.
Signature of Applicant:
OFFICE USE ONLY ~ ~
~ ~
BUILDlNG PERMIT TYPE ~ '
~ro" --y~ yp '~i~.,.w~..+
? O1 Foundation ? O6 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
~ 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 17 Swim Pool
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace 0 19 Camm./Ind. Misc.
? 05 SF Misc. ? 10 Multi. Add'l. ? 15 Deck ~ 20 Public Facility
~ 21 Miscellaneous
WORK TYPE
31 New ? 33 Alterations ~ 35 Tenant Finish O 37 Demolish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) ~ lst F1. sq. ft. ~ 44'rP City Water ~
UBC Occupancy 1 2nd F1. sq. ft. ~y,~ PRV Required
Zoning a_, Sq. Ft. total Booster Pump
of Stories footprint Sq. ft. Fire Sprinkler
Length 7D• Y On-site well Census Code !d r
Depth ~ On-site sewage SAC Code ~
Census Bldg _L
APPROVALS Census Unit ~
Planning Building Assessments
Engineering Variance
REGIUIRED INSPECTIONS
? Site C~ Faoting ~ Framing ~ Insulation
? Wallboard Final ? Oraintile ~ Fireplace
Permit Fee vei~c;oo: S ! S5. tJdd
5urcharge ~
Plan Review /a-?~~~-p,~,,,,~
License
MwCC SAC sy k~-7 ' lysd'K 6~f = 10o,~c~a
City SAC
Water Conn. ~ ~ ~-(iv,2
Water Meter 30 =~'fOX ~ 4 = C~ S,96v
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment Pl . ~Q',!v v 1 L' y rd
Road Unit ~kl,~ - `
Park Ded. S I~,r r6 ~
Trails Ded.
Copies ~
Other
Total:
SAC Y
SAC Units
: N00~! Cs~lY~%C1l~ ~ORs
SIGMA STEVE MACHACEK
SURVEYINGi ,
3ERVICE3 INC.
f9'( l Seneea fbed •5~..~4e E•
EP N:181~-3077
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s I /s l.~ ~ r $ ~
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- - i `~LE~~ Sc.ale s l ~`I~
%-wz . ~
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p~ Denotes Iron Monument PROPOSED GARAGE FLOOR ELEVATION=
o Denotes Wood Hub Set PROPOSED TOP OF BIOCK ELEVATION=
xq9~.z Denotes Existing Spot Elevation PROPOSED BASEMENT FLOOR ELEVATION= 9a7.U al~
(x~y~ 1 Denotes Proposed Spot Elevation ~
Denotes Drainage Direction *NOTE: Verify all Bldc~, ~imensions and
Floor Heights with Final House Plans.
-PROPERTY DESCRIPTION- ''Yr"~~'
-SURVEYORS CERTIFICATION-
Lot 9, Block 3, EA6AN ROYALE, I hereby certify that this survey, plan ar
according to the recorded plat report was prepared by me or under my
direct supervision and that I am a duly
thereof, Dakota County, Minn,,:;-;;.,., Registered Land Surveyor under the laws of
the State of Minnesota.
: ~ Date: yI~31yY
Wayne 0. Cordes, Minn. Reg. No. 14675
, ~E`a4~ ; t+~•cf[`iy Cl.a..~~ti -H:~.~~a.~
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B' 0 0 • auilainq pezmit ~lpplicant '
@'~ D • L~9a1 d~scription
B~D 0 • J?ddr~ss
~O D • North anev and bar ieal•
D~'O O • 8ouse type (tamblaz, valkout, split »/o, split eatry,
lookout, ttc.~
D~ D 0 • Dis~etioaal draineq~ azrews rith slope/qradi~nt t.
S~ D 0 • pzoposed/existinp s~v~z and vater •ervicss
8~ C 0 • Stre~t name ~
D~D 0 • Dtivevey
ss.tv~rioa~e
tx3stine
1~!' D 0 • Sewer service
B~ 0 0 • Lot eorners
Dr 0 0 • Tep o! euzb at the drivevay
8~ 0 0 • gl~vetions oi any existinq edjaeenL homes
p:ebe.•e "
D~D 0 • Cnraqe ileoz .
D' 0 D • FirsL lleor
0' 0 0 • Lovest exposea alevation (velkout/winaow)
P_'~ D • property oornezs
i~ O D • Fzoat and zear o! bom~ et the ioundstien
pODiDIPO 11RT71B fii an~lle~nl~1
. L~0 D • tnsement line
~ 0 D • ~i
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~Itstxa=o~as
~O D • Lot lines
t~ D 0 , Riqht-~f-vay anE stz~et xiEth (to beek ef enzb)
proposed ~ome dimenslons ineludinq ~ny prepos~d ~~cks,
ovezhnnqs 9:eeter tAnn 2', porchcs, ste. (i.~. a11
structuses requiring permnnent tootinqsy •
@~D D • 6hev all enaements of teeord and eny City utilities vithin
those ansements
0 • Setbaeks of proposed strueture and setbnek of adjseent
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D D~ • Retainin 11 zequizements, ii ~ny
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MENDOTA HEIAHT8, MN 66120 p i6371
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~ PERMIT
CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: 8 u I ~ ~ I N~
Eagan, Minnesota 55122-1897 Permit Number: 032415
(612) 681-4675 Date Issued: 0 7/~ 2/ 9 8
SITE ADDRESS:
4929 ftOYALE WAY
L07: 9 BLOCK: 3
EAGAN RQYALE
P.I.N.: 10-22475-090-03
DESCRIPTION:
By~
d.~Y"~"`J~:',~,Permit Type BASEMENT FINISH
~~#~ltl~i~g ~~,rk Type ALTERRTION
~en~[t~ Ccsd~~`~~k 434 ALT. RESIDENTSAL
~
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v`w"~•~x.ra+ea~ #swk ~ig ^c:+v. d.r t~.e%pt
REMARKS:
PLHN REVIEWE~ BY MIKE BARCK
CflIL 445-2846 REGARDING ELECTRICAL PERMIT AND INSPECTIONS
5EPATA7E PERMIT REqUIRE~ FOR ANY PLUMBING WORK
FEE SUMMARY:
Base Fee $60.00
Surcharge ~.50
Total Fee $50.50 ~
CONTRACTOR: OWNER: - Applicant -
MACHflCEK pEBORAH
4929 ROYALE WAY
' EA~AN MN 55122
(612}688-2930
~`tr~rehy aak~~tw~,ed~.~k "CF~~~ ~ h~va ~eacl,t:h3S appitoatirskt'snd state.t~t~~ the .
'~n~cxrm~~=ia~ i~. aore~~t and' at~re~ ~o ec~mp~~i_ ~i~h a2~_appli~:~bl,~ ~~e~e a~ Mno
~ ~",~'C~'~€+~~is ~.t1d ~i~g c7"~' Eag~rF. Ordin~nGe5.'. . . ° -a . . -
~ ° o:-. _ . . ' "
a,.:; . _ . .u . . _ _ . _ _ . ~ . . _ ~ ~ . _ _ ._d . ..,.J~
.
APPL lPERMITEE SIGNATURE E~ BV: S A RE
~ BUILDING PERMiIT Aji'PLICATION (RESIDENTIAL) ~~0~~
~ CITY OF EAGAN
3830 PILOT RNOB RD - 55122
681-4675
New Construdion Reauirements RemodeVReoaii Reauireme~ts
? 3 registered ske surveys ? 2 copies of pian
? 2 copies of plans (include beam 8 window s¢es; poured fid. ~sign; etc.) ? 2 site surveys (exterior etltlitians 8 dedcs)
? 7 energy caleulations ? t energy calwlations for heated additions
? 3 copies of tree preservation plan 'rf lot platted after 717l93
required: _ Yes _ No
DATE: L7 ~ r~ A~~~ CONSTRUCTION COST;
DESCRIPTION OF WORK: T~ n+~ ~ i~-t ~D~'1e/Y~e~~~
STREET ADDRESS: I ~ ~'~-e- Q
LOT: BLOCK: ~ SUBD./P.I.D. ~
Name:~Ca!'~'~QC'P~ ~~~?~.I---~~`~l~e,~ Phone#: V~~-t333~
PROPERTY last First
OWNER ,r q
StreetAddress: I ~l 2{~llQ~c_ WCu
c~ry ~a p,_ sr~u: l~"1 zsp: ~-T' l 22
Company: fl-E~d $ ~ ~1~ Phone LO D v 3 ~
CONTRACTOR
Street Address: License #
City State: Zip:
ARCHITECTI
ENGINEER Company: Phone
Name: Registration
Street Address:
City State: Zip:
Sewer 8 water licensed plumber (new constructio~ only): Penalty applies when address chang
and lot change is requested once permit is issued.
I hereby acknowledge that I have read this application and state that the iniortnation is correct and agree Oo comply with all applicabl
State of Minnesota Statutes and City of Eagan Ordinances. ~
~ 0~~ P~~/y Signature of Appli n.
t, ~yl
,~S n 1 OFFICE USE ONLY D~~ r' 0 V~
Certificates of Survey Received _ Yes _ No I
JUN 3 p 19~8
Tree Preservation Plan Received _ Yes _ No Not Required
~
OFFICE USE ONLY ~ '
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ~ 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-plex ? 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 ? 37 Demolition
GENERAL INFORMATION
Const. (Actualj Basement sq. ft. MCNVS 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 D/
Census Bldg _L
Census Unit D
APPROVALS
Planning Building ~ Engineering Variance
Permit Fee Valuation: $ ~
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit .
5/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
~ TotaL•
°h SAC
! SAC Units ~ i:,
~ . .~..~.....~n..----°.`~~''
aTV use ow~v
L ~ BL ~ RECEIPT#: ~'T~~~
SUBD. QGt.('~?.sv I~-~. RECEIPT DATE: gJ
1998 PLtJN~ING PERMIT (RESIDENTIAL)
CITY OF *+ar_nn~r
3830 PILOT IINOS Rn
EAGAN, tAi 55122
(612) 681-4675
Please complete for: D single family dwellings
D townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
-
FIXTURES EACH # TOTAL
Shower 3.00 x =
Water Closet 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Hot TublSpa 3.00 x =
Water Heater 3.D0 x =
Floor Drain 3.00 x =
Gas Piping Outlet ` minimum - t 3.00 x =
Rough Openings 1.50 x =
Wate~ Softenef ' for dwellings under construction 5.D0 X =
Water Softener ' for axisting dwelling 20.00 X =
U.G. Sprinkler ` for dwelling under const. 3.00 =
U.G.Sprinkler "forexistingdwelling 20.00 =
AItBf2ti0ns ' to existing residence 20.00 = v.~
Water Turn Around 20.00 =
Private Disposal System ' MPC iic. 75.00 =
(new and refur6ished systems)
Private Disposal Systems ` Abandonment 20.00 ' _
RPZ (new installation only) 20.00 =
STATE SURCHARGE 50
TOTAL 2 b.~
.
I hereby acknowledge that I have read this applipGon, shate that fhe information is cortect, and agree to mmply with all applicable Cily of Eagan ordinances.
It is the applicanYs responsiGility to notiy the property owner that the City of Eagan assumes no liability for any damages caused by the City during its
normal operational and maintenance activdies to the facilities construMed under this permit within Ciry property/right-of-way/easement.
SITE ADDRESS: `r~ o~Q~ ~G'.N
OWNERNAME: ~eUC.- ~1~P~h1,~ N15~C11QC2~
INSTALLERNAME: ~}po~t~ TELEPHONE#: ~~~"a~~~
STREET ADDRESS: + ~
CITY: STATE: rn~ ZIP: SS~~ 2
IGNATURE OF PERMITTEE
CDlPERMIT FORMS/RPLBG PERMIT (RES) - 1998 ~
, PERMIT ~o~ .
CIT~( OF EAGAN ~/~3,~ ~
3830 Pilot Knob Road PERMIT TYPE: ~ u x ~ o s N ~ ~ C~
Eagan, Minnesota 55122-1897 Permit Number: 0 2 8 5 8 7
(612) 681-4675 Date Issued: 0 8/ 2 2/ 9 6
SITE ADDRESS:
4929 ROYALE WAY
IOT: 9 BLOCK: 3
EA6AN ROYALE
P.I.N.: 10-22475-090=03
DESCRIPTION:
~uilding-,Permit Type DECK
~Building I~o.r,k Type NEW
~ Ce:nsus Cade 434 ALT. RESIDENTIAL
~
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REMARKS:
FEE SUMMARY:
Base Fee $45.00 COPY $.50
Surcharge $.50 Total Fee $46.00
Subtotal $45.50
CONTRACTOR: OWNER: - Applicent -
MACHACEK STEVE
4929 ROYALE WAY
EAGAN MN 55122
(612)688-2330
I hereby acknowledge tfiat I have read this application a°nd state that tfie
infiormsti4n is carrect and agree to comply with all applioable State of Mn.
S tutes and C3ty`ofi ~aga=n Ordinances.
~ ~ ~`-t'~° ~
A LICAN /PERMI EE SIGNATl1RE ISSUED : SIGNATURE
~ CITY OF EA(3AN ~
3830 PILOT KNOB RD - 55122
~96 BUILDING PERMIT APPLICATION (RESIDENTIAL) ~
~ : rA~ ~
~ 681-4675 . " ~
~
New Conatruetbn Reauirements ~qjnodeVReoair Reauiremenh
? 3 regislered aite surveys ? 2 cropies of plan
? 2 copiee ot plana (indude beam b wirMow aizes; Rwured fid. design; eto.) ? 2 sfte surveys (ex[erior additions 8 decks)
? 1 energy calcufellons ? 7 energy celculations for fieated addflions
? 3 copie6 oT Iree p~eserwHon plen M bt platted efler 7/7/93 ~
required: ~ Yes No
DATE: O CON5TRUCTION COST: l~~
DESCRIPTION OF WORK:
STREET ADDRESS: Y ~z ~
LOT BLOCK J~ SUBD./P.I.D. ~~~I,~~~l~a,
PROPERTY Name: M~~~~ Phone ~~`~~Z~`~
OWNER . "'°y~2 ~`f '°'°w~4i
Street Address~
City: ~i~~'i'~- State: M'"y Zip. S5~ z~
coN7w4c7oR Company: S~"'f*. ~ Phone
Street Address: License
City: State: Zip•
ARCNITECTI Company: Phone
ENGINEER
Name: Registration
Street Address•
City: State: Zip:
Sewer & water licensed plumber: Penalty applies when address change and lot
change are requested once permR is issued.
1 hereby acknowledge that I heve read this application and state that the information is coRect and agree to comply with ali
applicable State of Minnesota Staiutes and City of Eagan Ordinances.
Signature of Applicant:
f~[~C~COMC~
OFFICE USE ONLY
s~~~ ; ~r~
Certificates of Survey Recsived _ Yes No
Tree Preservation Plan Received _ Yes _ No
OFFICE USE ONLY k. ~ r~* ~
BUILDING PERMIT TYPE ~
0 01 Foundation o 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
0 02 SF Dweliing ? 07 4-plex o 12 Multi Repair/Rem. ? 17 5wim Pool
0 03 SF Addition o 0$ 8-plex o 13 Garage/Accessory ? 20 Public Facility
o 04 SF Porch o 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
0 05 SF Misc. 0 10 = plex `s~15 Oeck
WORK TYPE 1
~31 New ? 33 Alterations o 36 Move
n 32 Addition o 34 Repair o 37 Demolition
GENERAL INF~RMATION
~
Const (Actuai) Basement sq. ft. MCNVS 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. fl. Census Code.
Depth Footprint sq. ft. SAC Code ~L
Census Bidg ~
Census Unit n
APPROVALS
Planning Buiiding Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SIW Pertnit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Totai:
°k SAC
SAC Units
~ ~ ~ ~~wv ~ .
F.
% SIGMA STEVE MACHACEK
SURVEYIN~
3ERVICE3 INC.
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'I o~~y~ EA G A.N ~
/ {~ter ~tEVtEWED ~
\ Sj S ~t a •
,
- s~: r-z~
~ ~cLE(iEND- , ;
I q~ y ~
p~ Denotes Iron Monument PROPOSED fARAGE FLOOR ELEVATION=
o Denotes Wood Hub Set PROPOSED TOP OF BLOCK ELEVATION= ~ 7'~-
xq9i,z Denotes Existing Spot Elevation PROPOSED BASEMENT FLOOR ELEVATION= ~~~'U ~j~~
t+~`~±'~•~ ) Denotes Proposed Spot Elevation ~
Denotes Drainage Direction *NOTE: Verify all Bldc~. Dimensions and
~ Floor Heights with Final House Plans.
-PROPERTY DESCRIPTION-
-SURVEYORS CERTIFICATION-
Lot 9, Block 3, EAGAN ROYALE, I hereby certify that this survey, plan or
according to the recorded plat report was prepared by me or under my
thereof, Dakota County, Minn, direct supervision and that I am a duly
Registered Land Surveyor under the laws of
the State of Minnesota.
_ ,1.~ Date: ~I~31kY
Wayne D. Cordes, Minn. Reg. No. 14675
~FI+S y<<i i ~G I~`~ f~.~'v.c c~, f-~~:-tfV; y~
~ ~'14~. ~`~`.:1~~~~; .
J~J•Sp
~ ~ ~ ~ ~ ~ ~ i ~~u i
I1 u MAY 2 2 2008 ; ae~man: ~Jl~%~'' i
City of E~~aIl ~ ~
~ . Permit Fee:
3830 Pilot Knob Road i i;
Edgan MN 55122 I ~ate Received: ~
Pfione: (651) 675-5675 ~ ' j
° .
Fax: (651) 675-5654 _ c. ~ Staff: r' .
2008 MfCHANICAL PERMfT APPLICATION
Date: s/$~o O~ Site Address: T C~/ o~~
Tenant: Sulte ~
RESIDENT ! OWNER Hame: ~ L L Pr+v Po27 Phone:~i5(^ t/$Z - 73 90
Address / City / Zip: T o' RL~L~ G(lr¢ ~gG MN S/ ZZ-
CONTRACTOR Name: ~ {~z~C ~{~4q-> ~ Lic~n`yse F~L~S~i~~Z.
naa~ess: /9v~{ (1~zu-tr~uo~ S~
City: 6~7~7"~MJ95 State: Zip: ~Sv~'
Phone: lnJ~~~y37~~~77 ContactPerson: ~•A~N~c4~~f--L-
TYPEOFWORK -New ~Replacement _Additional _Alteration Demolition
. . . . Description of work: 4c 1~Yi~4c a! ~ i~ ~~z° ide'h~~
. ~~~~N~*E' 8o~h4r`pQ7amounted=an~r~uod avr~~Fe~nrtec?tgnrca~"r~~n
"~t~~~K'~q~tl~to"k~
' k ~5 w t~' l~ a n .v"~ w.~` r ii ~ a~v`~ ~ ~ `Y x~5 N4"~" Rrr wY.%~ V+{, a~^4@;
~fie screerred~b}qCity Cnde~~P„l~e~se~er~~ttac~~M 1~~~ s~ec~t~, or one oE~f~r~,~~'~ ~
~.f_~,~~~.` d° '*`~~,.=P/snnersifvr~fnPorrri~6roi~cicr~ erme~fedsctdee~ei
m . et~rods ~
PERMIT TYPE RESIDENTIAL CQMMERCfAL
~ ~ Furnace _ New Construction . _ Interior Improvement
Air Conditioner _ Install Piping _ Processed
_ Air Exchanger - Gas - Exterior HVAC Unit
~ HVAC units must 6e screened
_ Heat Pump Under / Above ground Tank Install / Remove~
Other " W hen installinglremoving tank(s), call tor inspection by Fire
~ Marshal and Plumbin Ins ector
RESIDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 Fire ~epair-(replace burned out appliances, duciwork, etc.) (includes $.50 State Sufcharge) .
$ .J~ •Sd TOTAL FEE
COMMERClAL FEES:
$70.50 Underground tank installation/removal OR Contract Vaiue $ x 1°/<
$50.50 Minimum (includes State Surcharge)
_ $ Permit Fee
~ If Permit Fgg is less than $7,000, surcharge is $.54.
- If Perrnit Fee is >$1,000, surcharge increases by $.50 for each State Su~Chafge
$1,000 Permit Fee (i.e. a$1,001-$2,000 Permit Fee requires a 51.00 surcharge).
_ $ TOTAL FEE
I hereby acknowledge [ha[ this information is complete and accurate; Ihat the work will be in confcrmaoce with the ordinances ard codes of ihe Ciry of Eagan; Iha[
I understand (his is no[ a permi[, but only an application for a permi[, and work is no[ to siart without a permi[; that the work will be in accortlance vnth the approved
plan in~~th~e
.c(ase of work which requi~es a review and approval of pians. ~
x itJ ~~~v~ ~•k~..~~o~-LC; X ~,~i~ ,
ApplicanYs Printed Name QN~. ~u.~ ~ry~,~~ ApplicanPs Signature -
~a ryl>t 3 x~~ .m~bw r t tceaii3'i r t ~ ~'rS+~"," +ct ~^n~'r ~ k ""~`~'jr .
F,OROFPICEUSE ~k 4, ~iZ ~~~~`ip~..F„~~s:. q~„E ~'uReViewe,tl~y~' ~ mx~ ~ ~"M~:e,rt '~Date ~~S~ x~~§~ ~>s ~
a t~~ 1+'eJ i ~t ~ p "~s. 3 K 6 ~n ~+t fi z ~ a~`~3 °fit7'2~~~` 1E `4~~~ 1F" ~~„~j~i.~ ~"'~'a'a.~ ~~A'k~~~kt,':~? .
Reqwredlnspeetions,~a,Under,GrouncP~~r -RO~3gE~In _qir7est„* GasSeruice~`t`e~satu.~,iFn''rflaa~He,~tt ,PifiaGi~~1~~e,~~~
02/23/2010 TUE 8:33 FAX 6514378831
City of Ea�all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
a 002/002
Use BLUE or BLACK Ink
EllifirdWA
Permit #: X93
Permit Fee: £Z s
Date Received: g
Staff:
2010 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address:
Tenant Suite #:
RESIDENT! OWNER
Name: 11 Ian 'd1.t .. Phone: `'CS) --1.380
Address / City / Zip: ‘49,19a.a.
CONTRACTOR
Name: t!\ail'\ 'Piton
IILicense
Address: Vfl t tion
City:
"""" ii'
State: Mk) Zip: 55333 Phone: 431.UI1/
Contact: 0.11110.. Email: t Qr na . pi 01 47 Eft" hotly Wits C0 v -
TYPE OF WORK
New Replacement Repair Rebuild Modify
Space —Work in R.O.W.
Description of work:
PERMIT TYPE
RESIDENTIAL
Water Heater X
Water Softener
Add Plumbing Fixtures
Main Lower Level)
Lawn irrigation 11 ^
( RPZ / — PVB) (_
_ Septic System
Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water
Heater, Water Softener, or Water Heater
(includes $.50 State Surcharge)
Fixtures, Septic System Abandonment, Water
and Softener (includes $.50
State Surcharge)
$_50 State Surcharge)
FEES $
$30.50 Lawn Irrigation
$50.50 Add Plumbing
"Water Turnaround
$100.50 Septic System
$90.50 Fire Repair (replace
Turnaround* (includes
and $.50 State Surcharge)
$,50 State Surcharge)
TOTAL
(add $166.00 if a 518" meter is required)
New ($10.00 per as built) (includes County fee
burned out appliances, ductwork, etc.) (includes
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. www.gopherstateonecall orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the
Eagan; that I understand this is not a permit, but only an application for a permit, an rk is not to start wi
acc rdance with the a roved plan in the case of work which requires a review and appy ai f plans.
YtIttnirtd‘' MS I
Ap(licant's Printed Name
inances and codes of the City of
a permit; that the work will be in
Aplicant's Signature
r City of Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use
Permit #: / / / j (, 1
Permit Fee: /f1t/`
Date Received:
Staff:
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit #:
L-� -K. 51-33G3JJ �- 743f
Name: �6e") i6Phone.
side
Address / City / Zip:
t �1e
Applicant is: Owner Contractor
Description of work:
Construction Cost: '?
Multi -Family Building: (Yes / N
ntrac
:a1
Com pany.a/17- 2 (.� (64
Contact: e'L1'.
��
Address'��C
S ) Sr ��„� City: r�-C T`J
State Zip: ��' Phone: e v Email:
License -'5 Lead Certificate #: FC
G�
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:
ILS P#ansa nal Supp_ r ing doc risen#s tha#, r�u submit ar .co sidered o e p l c inforrnatio onions`
e information may ibe classified as mon public �f fou provide sP +fic reasons that would per i# # e Cit t~
concludethat they are rade ,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.00pherstateonecall.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.
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.
x
prp3
0(011 -7 -
Applicant's Printed Name Applicaryt''s'Signat
Page 1 of 3
City of Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
AUS 0 51016
r
Use BLUE or BLACK Ink
For Office Use (�
Permit #: % of_
Permit Fee: lY L'
Date Received: 3-c- / tP
Staff:
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit #:
Resident/'
Owner
Applicant is: Owner
Description of work:
Contractor
Multi -Family Building: (Yes I No
Company:f � f Web/1'rC/'/`Cre Contact: e4-r7
jj ! 'f3
Address`b, �"j (jO� �� City: -ii ii`-'
gefif
State:m~Zip: Phone: '`O Z Email:
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 thatyou submit are considered to be public information. Portions>o
the information may be classified as non-public if you provide specific reasons that would permit the Clty', to"'
conclude that the are trade 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.qopherstateonecall.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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code ust be completed within 180
days of permit issuance.
x,%�l %' = wi" G' "
Applicant's Printed Name
x
Ap
icant's
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
k (D(9,
SUB TYPES 119 aci
lei 13C
AL1 Fireplace Porch (3-Seon) L1_ 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 Pool Accessory Building
WORK TYPES
New Interior Improvement Siding Demolish Building*
Addition Move Building Reroof Demolish Interior
Alteration Fire Repair Windows emolish Foundation
Replace Repair Egress Window ✓ Water Damage
Retaining Wall
*Demolition of entire building - give PCA handout to applicant
DESCRIPTION
Valuation S'o v, a -c.) Occupancy IXL-- / MCES System
Plan Review ,�' Code Edition Zalr/W c _ SAC Units
(25% 100%_) ,/,. Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings / Length Fire Suppression Required
Type of Construction V + & Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final / C.O. Required
Footings (Addition) V Final / No C.O. Required
Foundation
Roof: _Ice & Water _Final Pool: Footings _Air/Gas Tests _Final
V Framing ✓30 Minutes 1 Hour Drain Tile
Fireplace: _Rough In _Air Test _Final Siding: _Stucco Lath _Stone Lath _Brick
Insulation Windows
/ Sheathing Retaining Wall: _ Footings T Backfill _ Final
Sheetrock Radon Control
Fire Walls Fire Suppression: _Rough In _Final
Braced Walls Erosion Control
Shower Pan Other:
HVAC Gas Service Test Gas Line Air Test
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
Lfc f
v� D
TOTAL 66. YO
Page 2 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA159638
Date Issued:01/07/2020
Permit Category:ePermit
Site Address: 4929 Royale Way
Lot:9 Block: 3 Addition: Eagan Royale
PID:10-22475-03-090
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Timothy J Soedarjatno
4929 Royale Way
Eagan MN 55122
(612) 770-7809
One Hour Heating & Air
11825 Point Douglas Rd S
Hastings MN 55033
(651) 437-4177
Applicant/Permitee: Signature Issued By: Signature
` R.ECETV.I�� rFor Office Use n
a r /6(s L/7
EAGAN
��� +� i r`� ::::e
SEB 072020 �f: /q-5-'
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD: (651)454-8535 i FAX: (651)675-5694 Staff:
buildinginspections(a�citvofeagan.com
2020 RESIDENTIAk BUILDING PERMIT APPLICATION
Date: Feb 7, 2020 Site Address: 499 Royale Way unit#:
Name: Tim Soedarjatno Phone: 612-770-7809
Resident/ 4929 Ro ale Wa Eagan MN 55122
Owner Address/City/Zip: y y' g
Applicant is: Owner ✓ Contractor
° w
Type of Work Description of work:
Roof top solar photovoltaic system
Construction Cost: 15000 Multi-Family Building: (Yes /No 1 )
Company: Mouli Engineering Inc contact: Mouli Vaidyanathan
Contractor
Address: 1230 East 115th St city: Burnsville
IState: MN Zip: 55337 Phone: 612-424-517_6Email: mouli@mouliengg.com k
BC753116
License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why:
czA
t
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:
1 Sewer&Water Contractor: Phone:
i
Fire Suppression Contractor: 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.
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(651)454-0002 for protection against underground utility damage. Call 48 hours before you
intend to dig to receive locates of underground utilities. www.qopherstateonecall.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.
Digitally signed by Mouli
X Mouli Vaidyanathan X Mouli Vaidyanathan Vaidyanathan
Dale:2020.02.07 13:18:23-06'00'
Applicant's Printed Name Applicant's Signature
DO NOT WRITE BELOW THIS LINE —1 J 0 P)ovA-le Lal /‘o/'
SUB TYPES
Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration (Single Family)
MIngle Family _ _ _ Exterior Alteration (Multi)
ulti _ Deck Garage _ Porch(4-Season)Porch (Screen/Gazebo/Pergola) _ Miscellaneous
01 of Plex Lower Level Pool Accessory Building
WORK TYPES
New Interior Improvement Siding Demolish Building*
Addition Move Building Reroof Demolish Interior
)(Alteration _ Fire Repair _ Windows _ Demolish Foundation
I Replace _ Repair Egress Window Water Damage
Retaining Wall *Demolition of entire building—give PCA handout to applicant
DESCRIPTION .--
Valuation a Occupancy ,„MCES System
Plan Review Code Edition r _ fl 5 SAC Units
(25%_ 100%k ) Zoning / I City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction ----V6--
Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final I C.O. Required
Footings (Addition) )6 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 Tile
Fireplace: /Y_` 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 Walls Erosion Control
Shower Pan Other:
Reviewed By: 11/ , Building Inspector
RESIDENTIAL FEES
Base Fee v//��
244/1
Surcharge
Plan Review 40141;7292 4.'
MCES SAC
City SAC
Utility Connection Charge
S&W Permit& Surcharge 7Cl/
Treatment Plant
Radio Meter Read /
Copies
TOTAL
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