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4918 Rusten Rd44' City of EaQan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 PFCEIVFD MAY 1 1 2011 r Use BLUE or BLACK Ink Permit #: %Li Permit Fee: Date Received: Staff: 2,4 69i -t/- 201 1 -i/- 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit #: RESIDENT / OWNER Name: S A,f1 -3 NI , S, S tAz' s Phone: 6 l 2 9 (n - 6131, Li - S� p© � 5 5 1 � Address / City / Zip: 4011 I> 4NI Applicant is: / Owner Contractor TYPE OF WORK Description of work: 13ePr Ob --f_ c t ) 51-t 6+ e:mtMT - Construction Cost: ___t5a / Multi -Family Building: (Yes / No)) CONTRACTOR Company: Contact: Address: City: State: Zip: Phone: License #: Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 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 fo bepublic information. `Portions of` the information maybe classified as non public, rf you provide specific reasons that wotuld permit the City:#o conclude that they are trade secretsWre .` 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.ciopherstateonecall.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 plan AJI J4 • Sar x Applicant's Printed Name x Applicant' ature Page 1 of 3 LI I V (1`/it -RC ' DO NOT WRITE BELOW THIS LINE q9/1/ SUB TYPES Foundation ingle Family Multi 01 of _ Plex Accessory Building Fireplace Garage Deck Lower Level WORK TYPES New Interior Improvement Addition Move Building Alteration —Fire Repair Replace Repair Retaining Wall DESCRIPTION Valuation Plan Review (25% 100%_) Census Code # of Units # of Buildings Type of Construction REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: Ice & Water _Final V Framing Y Fireplace: _Rough In Insulation Sheathing Sheetrock Reviewed By: Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width Air Test Final RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Siding Reroof Windows Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Demolish Building* Demolish Interior Demolish Foundation Egress Window Water Damage *Demolition of entire building - give PCA handout to applicant Rt /p'G"f MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: Final / C.O. Required Final / No C.O. Required HVAC Gas Service Test Gas Line Air Test Other: Pool: _Footings Air/Gas Tests Final Siding: _Stucco Lath Stone Lath Brick Windows Retaining Wall: Footings _ Backfill Final Radon Control Erosion Control , Building Inspector Page 2 of 3 INSPECTIQN RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: i Eagan, Minnesota 55122-1897 Date Issued: ' {612) 681-4675 SITE ADDRESS: ~ ~ ~ APPLICANT: s i i:i ~ ~ ,~~,It N 1~1? • , . • ,iurl; • . , . i , ~ . PERMIT SUBTYPE: TYPE OF WORIC: , ~ ~ t'' ' • • . , ~ ;i:. ~ ~~iri~~i:. ~ ~ . . . ~ i r ~ . . . . ~ i , I ~ ~ i , 1 . , ! I ~ i . i. r ~ i . ~ . ~ i . r' ~ . , !t.~t i ~ . t~i ~ f tl~y~ . , ~ i ~ , t~. , ~ . ~ ~ ~ . . . . ' ' 1 ~ Permit No. Permit Holder Date Telephone M T ELECTRIC ~8 ~ ~ ~ D5 ~ PLUMBING ya3 HVAC (3 97 Inspectfon ~a 1 sp. Comments FOOTINGS '~~~/Q 7 ~ y~~J'~7~ Y ! ~ FOUND '~~g-ICI ~ (~-Q ~ 6 ` ~ ~ ~ b Cea ~l--,cE~ ~z.q FRAM WG J,~ /1' Y ~(~N ROOFING ROUGH PLUMBING . PL@G ~ AIR TEST ROUGH HEATING GAS SVC TEST ~ INSUL ~~7.-~(', GYPBOARD FIREPLACE ~ ~ FIREPLACE r~~ •-y^ AIR TEST [ ~"L FINAL PLBG _ >3 ~ L FINALHTG ~ ~ aRSAT TEST BLDG FINAL ~ ~ ~ BSMT R.i. BSMT FINAL DECK FTG DECK FINAL r~~ ~ ~e~ti~ica#e v~ ~ccu~ianc~ ~~t~j o~ ~agan ~ra~rt~cxt ~(r ~s~iag ~~ccr~on This Certificale issued purswanr ta tlre requirements of the Unrform Building Code cerrifyireg tf~at at the rin~e of issuance tleis stnecture was in compliance with rhe various o~rlinances of the Ciry rrgulating buildi?ig constructian or use. For the following: u~ c~r~ww~.~ ~ I~IG ewg. No. 246p I ~P~Y ZYP~ ~ Zaniag District V11T Type Cans~. $ ~ o.~ner a( suiwins RYI.AI~ID E~ff''.S wad~s A00 F. 7q11i S'f_ MPf _S s~w;,~ ~de~ 4918 Rtisi~'.N ~n ~ar ~ ,e~~ ~ POST IN A CONSP1CUOl1S PLACE t . . . . ~ . ~ a . ~ • . . . , n~/ ~ r ~eat~id 18 mon s hom 1 al' ~~Q iC is box. s~-~ Illlllllllllllllliillllllllllllllllllllllll o,~~v~ c~ * ~ 4 L 8 5 5 9 L* /Q s/ -PLEASE PRINT OR TYPE ~`OCJ RB1~ RougMn iropecM1On mqoiredR ? No Inspacnon OMx 7Fan RougMn: ? Reody Naw Call ~ ~You mvsl call ihe inspa.vor whan reody~ Da~e Rendy: I, icensed conhactor ? owner hereby requesl inspection of Iha above elechical work af: bb Address ~Skre~, Bmc, w Rama No.~ Cty Zip Code 9 .c_. np/) Secfion No. Township Nome w No. onga No. Fre No. Cw~ np~ / ~ LC~~ Occ m Phe.~n ~No. ~J C3 J / G!~ awer Addres:. ; ` -'f(J ` k' clor ~Cwnpo Name~ , C acro, 'cen o: Mosim lia No. ~Planr FJxr. OnFy~ ~7~~CSZ ~ Mo ntq Addeass IC w Perbrmi I~Mllalian~ ~ Aulhanmd Sg pr Owner Parfw ing Ins Ilononl ~ Egd~~A'~ , wn O MW _ RFF iNSTi1110T(1NS ON 9GCK OF YELLOW GOPY 7/1 ~/9 7 REQUEST FOR ELECTRICAL INSPECTION ~aD 4.1~ - 5 5 9 0 M827 Univ siry ABear Rm. 8 1 8c SL Paul, MN 55104 Phone (612) 642-0800 Home Duplex Apt. Bldg. Other: New Addn Commercial Industrial Farm Remod Re air Air Cond. H. E ui . Water Hh. Load Mgmt pther: Dryer Range Elx. Heat Temp. 5ervice "X° above the work covered 6y this request. Enter remarks in fhis spoce ond on Ihe back of the while copy only. /~~P Z Colculate Inspection Fee - This Inspacfion Requesl will not be accepted wiFhouf the correcF fee: Olher f-ee S Service Entrance Size Fee N Circuits/Feeden Fee Mobile Home Park Stall 0 to 200 Amps ~"0" o s Sheet Ug./Traffic Sig. Above 200_A Above 100 Amps Tronsformer/Genemror INSPECTOP'S USE O , Sign/Oudine Ltg. Xfmr. ~j"~ Alarm/RemaM Control ~ \ Swimming Pool v 1 Mre6 ni kwl I' fie n descri ota s Irrigafion Boom RoughA 4 $pecial Inspedion Fi~wl Investigafive Fee THIS INSTALLATION MAY BE ORDERED SCONNECTED IF NO PLETED WITHIN 18 MONTHS. Addreay. 491$ ?tUS~nt xc~ Zip 5512 2 L.ot 2~ Blk z Sub ~o~ut t~c~irs THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'fON. Date: ~i f~f Yes No Inspector: Final grade (6" from siding) Permanent steps (gazage) Permanent steps (main entry) i/ Permanent driveway Pertnanent gas Sod/Seeded gtass TraiUcurb damage Porch Basement finish ~ Deck ~ Please verify with the builder the removal of roof test caps from [he plumbing system and the shut-off of water supply to the outside lawn faucet before freeze potential exisis. Contact engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system. White - Ciry Copy Yellow - Resident Copy Pink - Contractor Copy ~ ~~~~y(~ 2000 BUILDINC PERMIT APPLICATION iRESIDENTIAL) r~~ CITY OF EACAN E ' 3830 PILOT KNOB RD - 55122 ~a~~R~{ ~j'pf Q~ 851-681-4875 New ConahucHon Reaulremenh RemodaVReoalr Reauiremenh > 3 reglaferetl Yte wrveys slwwlnp aq. lt. ol bt, eq. fl. of house 2 coplea of plan antl g~( roo(ed areas (20% maximum bt covemae Wbwed) > 2 coples of plana (show beam R wintlow alzes; poured fnd. deslgn; etc.) i site wrvey for extedor addiXOns 8 tfecks : 1 set ol energy calculaNOns a 7 coples W irea presenaMOn ptan II IW plaMetl after 7/1/93 DATE: "Z~l~ a CONSTRUCTION COST: DESCRIPTIONOFWORK: ~E~~n-r~cru~ofa ~~~t~ Fta~3T~o~' STREETADDRESS: ~-~L$ 1~~STC-~.~- ~or~• ~~trn,,~1- Mnl 551~2 LOT: ~L~ BLOCK: SUBD./P.I.D.#: C+~G1G1Y ~I-fl ~~~5 Nqme: ?lASa.+~A-~3- ~ANJA~. Phone@: C~S.L/ 6 ~~^QJ~~S~ PROPERTY ~ Fl~ OWNER ~L p Sheet Address: T 91$ ~5 ic~ - i~`o~*~ city Er~-c-fa+~ ~ state: M r.i Zip: 5 51 ZZ- - Company: I ~ Phone (area code) COPRRACTOR Sheef Address: lJcense # Exp. Ciy Stafe: Z~p: ARCHIiECT/ ENGINEER Company: Name: Telephone A: ( ) 5treef Address: RegishoHon ri: Cly Stafe: ~p: Sewer/water licensed plumber (it installfna sewarhvaterl: Pho~e ~_l I hereby acknowledya Ihat I have read this applfcaNon, sfate lhat Ihe infortnatbn is cortecl, and agree to comply wilh atl appiicable Stafe of Minnesota Sfatulea and City o} Eagan Ordinances. ' Signafura of Appllcant ~ OFFICE USE ONLY Certificates of Survey Received ~ Yes _ No ~ ~ Q Tree Preservation Plan ReCeived _ Yes _ No ~ Not Required ~f~J OFFICE USE ONLY ~ BUILDING PERMIT SUBTYPES ? 01 Foundation ? 07 05-piex 0 13 16-plex ? 21 Porch (3-sea.) ? 31 Ext. Att - Mufti ? 02 SF Dwelling ? 08 O6-plex ? 17 Garage ~ 22 Porch/Addn. (4-sea.) ? 33 Ext. Aft - SF ? 03 01 of _ plex ? 09 07-plex ~ 18 Deck ? 23 Porch (screened) ? 36 Mufti ? 04 02-plex ? 10 OS-plex ~ 19 Lower Level ? 24 Storm Damage ? 05 03-plex ? 11 10-plex Ptbg _Y or_ N? 25 Miscellaneous ? O6 04-plex ? 12 12-plex ? 20 Pooi ? 30 Accessory Bldg. WORK TYPE i3 31 New ~ 36 Move Bldg. O 43 Reroof ~ 32 Addition ? 37 Demolish (Bidg)' ? 44 Siding ? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair ? 34 Repair ~ 42 Demolish (Foundation) ? 46 WindowsiDoors ' Give PCA handout to applicant for demolition permit GENERAL INFORMATION SAC Code 01 # of Stories sq. ft. No. of Units ~ Length sq. ft. No. of Buildings Width Footprint sq. ft. Const. (Actual) Basement sq. ft. Census Code ` 3 (Allowable) Main level q: ft: C ty Wa e~tem UBC Occupancy Zoning sq. ft. Booster Pump PRV Fire Sprinklered MISCELLANEOUS INSPECTIONS ? ~ Stucco/Stone APPROVALS Planning Building ~ Engineering Variance Permit Fee Valuation: $ ~d~~ Surcharge Plan 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 ***************************~xxzx~xxxxxx CITY OF EAGAN CASHIER: SS TERMINAL NO: 673 DATE: O5/02/00 TIME: 08:06:57 ID: NAME: SANJAY SUJANANI 3210 9001 4918 RUSTEN RD 60.00 2155 9001 4918 RUSTEN RD 0.50 i Total Receipt Amount: 60.50 CR128759 USER ID: JAN y.y..~~~~.- - SN1~aw ~ 4 at~b Pxy~? R..~C . FOR RYLAND HOMES P L 0 T: P L A N ~Rr,-r suRV~rrnrc. r,vc. " TNIS !S N07 A HOf.PNARY SURVEY ' 4oa2 JEF~E3tSON ST. N.E. i~s~r cerrir~r nuT m~t vi.m n.µ v,~ w~~a~ er ~ rALUBIA FEI(MS. 1N. 5552~ s uoe+rr m~r avem~ia , nKr mit vc~w oara~~r PROPOSED DATE 3 ~ 7~97 ~6i2~ 7!6•Y769 fAX c6t2i '/E6-T601. ~ :ws ne a~~aert oc ~ ww~m an~ouc w n~ vro ~RADES o, I RON NOMIMENT ~ ~ oe~xi~ ,ro n~v ~ w+~ 7 LI uro y~ra u~oot vs oF ne rrA • BEAR INGS ARE PER PLAT 0 30 ~ 98S•~ • • SPIKE SEf cnn~°E Sue • EXISTING ELEYATION ~ r ToP o~ B~acx - 98~ •O AROPOSm ELEY. I MIMlESOTA UC N0.1(ol~''~ , qZ8•O E- = DRAINAGE hR$~Y SCAI.E lN FEET ~ ~ 9ASEYFNT FLOOR , I f- o~ s~ac. woKnu~t 981, ~ y ~l I C.~ q1~1 1 I O e ~ ` ~ a' ~ j o s3 / ~t~,_ ~ `F . ~ / i c _ . ~S r'~•,s' ' ~ ~ ~ o '7 / ~ j~ 67 _ - . ~ ~ :i ~O v° ~~4~ ~9~°~kr. Cqa3.Z~ - - o~m ~ , . : ~i 8`~Q ~ ~ii~9~~,, _ ` ~ „ •s~ a~Z > y4~_~_, fo o ~ .r ~ ,v ~9~9,y, . - +7 C~ c p ~ ~ ~ ~~V y ~ ~ ' 7, C ~ ~ r ~ ~L a° ~V "o. ru ~ ° n: O k ~ J~ / w~ n ~ ~ ~7:',~ ~ C m a ~ 0 0 ` ~4 ~T _ ~icj ' O~,/ ~ p ~o u / ~ a "P'~p 3~'o~\~"i P 'j ~48'+-i~ ~v R_ ~ / ~ n/ r. # n ss .a _ o _ l HSS i ~ ~~ae.~ s.~~ /a` °j ~ _ ~ - ~ ~ J3 ~ ~ oc ~i \~S ? ~ 8J \ LaonrrC.ss'. `~9~ a IGssTCU ~xpra~ + ~~C.+L OF D2~~LC SKpv~Ri~• 99~.~~ LOT 26 . BLOCK 2, o~-~~ SK~~.~~' S?~~ = 5~5 9~~ CEDAR HE I GHTS . DAKOTA CO.. MN. Gt~{3Ct~T j. Lcs~R T / :Y%~'!"„"•-".RcY,<~k~C°oKY,tY~%nXxck dcic;t5~'~kkX;~Xi•;<~t:~::;c":f;ro:~;.: 't;.°. ~ ~7Y'M ~'jc {~bry+~i . „p~_„ „'-="f; S '"E°.~'~r~A,' ~',~r n~rFe ~_ir,4,~cj~ ~r~~.. i."~1;.~°~4 f'AVEa kYLAP:~~ '?ct'~ ~7~.1 i A4i C~ ;.~1 Pry.if-vi'~..?{, ~ ~k. . . , . , - . . . - y~._" . - . - . . . _ 1.~ TT1Tr71 FiEF7C?.':r RC.C'!7~'`. ~ . •.,ibi,}..'~~. ~~cn'1:. . . 'LLC'.' J.Y;:: ~,"1i,,r;~, ~^~~''~'~'~~3Y Y (1i.mm• Mr i.1~r.:, u.4Y,..~,y,y, ~ ' ~ PERIVIIT ~ CfTY O~ EAGAN 3830 Pilot Knob Road PERMIT TYPE: g u x ~ n~ N ~ Eagan,Minnesota55122-1897 PermitNumber: m29601 (612) 681-4675 Date Issued: ~ 3/ 14 / 9 7 SITE ADDRESS: 4918 RU57~N RD LOTa 2S BLOCK: 2 CEDAR HEIGHTS P,I.N.: 10-16725-260-02 DESCRIPTION: ~ ~tt~~t73t~s~ ermit Type SF DWG ~m,'~u~.~,`{~Jt7i~,~r~ TYPe NEW ~rU~:G [Fa~cup~~t~~ R3/U1 ~ ~a~as~rl~c~3tY~ s~`~p~e VN ~ ~ ~on`i~.~} , e . R1 ~ ~ B,uil~l~Y~g ~,~r7t~~ti,. 46 " 6uA~~"S-t~,g ~~.s~'~h ° ~ A9 e..' E3 i~ud ~hB,~~,~ri es~~ 2 arin.a v Y`~.E e~'~ r~" 1, 6 0 9 101 1 - FAMe DE7ACN ~ ~ ~ ~ ~ ~ ~*~a ~ ~ ~ ~ ~ ~~`~r~ ~ ~ ~ i~ REMARKS:. S& W PLUMBER: STAR PLBG FEE SUMMARY: VALUATION $sni,~me Base Fee $1,092.25 MISCELLANEOUS $1,539.50 Plan Review . $709.96 Total Fee $4,362•21 5urcharge $70.50 SflC $95m.0m SAC ~ 100 SAC Units 1 Subtatal $2,822.71 CONTRACTOR: - Applicant - sT. ~IC OWNER: ft'YLAND HOmES 185A6363 2003544 RYLAND HDMES n00 E 79TH ST 101 900 E 797M ST 1~1 ELOOMZNGTON MN 55420 MINMEAPOLIS MN 55420 (612) 854-6363 (612)85R-6363 Z hereb a'cki?o 1~~'g^~ ~h~~;'7C ha'veq read,'~hie a~~~~cat2prr arid ~•ta`t~ ttr~~ .~~a ' in#crr `t~ap" is ~o~rt=~~~' °~n~~k~'~grve~ ta~e~p~.~~a~~~~_al~~ ~~R,~~~a~~~, S~~~e ~In- ~ . S~ u ~s ~ ~~~~-crfi ~E~9~!h ~lrcE`it~~an~~~`~; . . . _ ~ . . , _ ~ _ _ II - ~ ~ ~ ISSUED eY: GNATU PL ANTlPERMITEE SIGNA7URE ~ , CITY OF EAGAN $~.~~a.a~ e~~~~ I 3830 PILOT KNOB RD - 55122 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) %'7 ' ~ 681-4675 New Construcl'an Reauireme~ts RemodeVReoair Reouireme~ts ? 3 registered site eurvays ? 2 copies of plan ? 2 copies of plans (inGude beam 8 window sizes; poured tnd. design: elc.) ? 2 site surveys (ezterior additions & decks) ? 1 energy calwlations ? 1 energy calculations for healed additions ? 3 cop~es of tree preserva[ion plan if lot platted after 7/1/93 , required: _ Yes _ No DATE: 3- -~7 7. CONSTRUCTION COST: DESCRIPTION OF WORK: S~ ~ ~P ~ rn, I~l ~j.{~~ STREET ADDRESS: LOT ~ BLOCK ~ SUBD./P.I.D. PROPERTY Name: Yl ~ ~2r~A~'LQS Phone ~4~. OWNER n Street Address• "I~~ E ~_fth ~ ~ .~+e. Jbl City: ~i n Il 2[~,1~~ ~i~ State: Zip: -~~~L- CONTRACTOR Company: ~ rn i (.i-L,C~ L~Q ~ Phone Street Address: License ad~~y~~ City: State: Zip: ARCHITECTf Company: ~f1rn~ Q.Q Q,~t/Q~ Phone#: ENGINEER Name: Registration Street Address• City: State' Zip: Sewer & water licensed plumber. ~}t('i~.v' ~~I,l,fYt.U ~ f`~ Penalty applies when address change and lot change are requested once permit is issued. I hereby acknowledge that I have read this application and state that the inforR7ation is correct and agree to comply with all appiicable State of Minnesota Statutes and City of Eagan Ordinances. Q~ Signature of Applicant: ~~T- OFFICE USE ONLY RECEIVED Certificates of Survey Received _ Yes _,110 ~ A j~~7 Trae Preservation Plan Received _ Yes ~ No,~ A ~ 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 Pooi ~ ? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility 0 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous 0 05 SF Misc. ? 10 = plex ? 15 Deck WORK TYPE ~31 New ? 33 Alterations ? 36 Move 0 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) dn~ easement sq. ft. i~~13 MC/WS System (Allowable) JN Main level sq. ft. ~ i y~ City Water i UBC Occupancy ~-3,~-~ z~~ sq, ft, i~o4 Fire Sprinklered Zoning I C~ sq. ft. tla~ PRV # of Stories ~ ~ sq. ft. Booster Pump Length WG sq. ft. Census Code. t o I Depth ~ Footprint sq. ft. i.t~o9 SAC Code o ~ Census Bldg ~ Census Unit APPROVALS Planning Building ~ Engineering Variance Permit Fee Valuation: $ 1clf~ ooD.~ Surcharge ~~5~~ Plan Review License t3. ~s~ Zs ~ 9 ~ MCNVS SAC zo, s,~ ~ g.-» . CitySAC ~X 2~i.3~1 ,~v,~! Water Conn. 3, 5 x Z 3~~ Water Meter • Z Acct. Deposit r s+ i i 4~ ~ Sv' r S/W Permit ~ 5/W Surcharge 5°~"~ r ~~f, . 3 s tb ~~N ` 6~, ~ 4~, ~ Treatment Pt. Road Unit z~, Park Ded. Trails Ded. ivv g'~ ~ sy= s`(, ~r3a. ~ Other Copies ~ 0.,~ TotaL• ~3.s ,r z-~.s ~q4.2s iG. s ~c s.~r %SAC Z•'~vr ~t. i7 ~ ~ Z. i3 SAC Units 4 <l~~. ic{ i~ ~ « _ ~i 4~a~. r t--- i<!tl ~ ~~l / R JUL-06-1995 E78~33 FFUM RYLAIID rllG4iEST REGI01~ TO MIFW P.094/Ff~S ~ CABO MEC 92 COi~P~I~,NCE * Builder RYLAND HQMES 3ubmitted Ay R.H. TRACEY Model GILBERT Date 4/5/95 Lot/?lan/Address OPT. 295 Degree Day F~~se BoCO Minneapolis Type Single Family House valume 41900 Filename GILBERT Control No. 7748 ------------------i----p-----j---~-----, I+--Uo Totals __Pro osed Re ired Component Area Uo Total Uo ~Total I4alls 2611 .103 269 .110 285 Ceilings 1148 .026 29 .026 30 Fl.oor~ 162 .047 8 .OSC 8 Floors (Open) 0 .035 ~ .026 0 Hsmt h~all(U) 1195 .080 96 .097. 109 This House Qualifies With Total Total ~ 401 ~ I 432 U-Value Calculatiana Specificaticns Uo Calculatiane ~Walls Size O.C. Insul. Sheac. Companent Area ' U-Val Total A Frame 3.5 16 13 i.06 Frame Wall A B Frame 5.5 16 19 2.06 ~Frame Wall B 1fi66~ .052 87.7 C Fram~-Gar. 3.5 16 13 ,45 F'rame-Gar.C 296 .O&2 23.4 D Masor.ary B N/A 11 N/A f4asonary D ~ .OSD E tVtascna-ry N/A N/A Masonary E * Ring Joist 1S 24 13 9.0 Ring Joiat 350 .C56 19.6 Window A 268 .48 128. i IDoor9 Panel Glass ' s.C. window B A Meta1 .19 .62 .88 Window C ( B IWOOd .46 .62 I.88 Dcor A-Panel 38 .19 7.22 C ~Other poor A-Glass 3 .62 1.86 Door B-Panel ICeilings O.C. Ineu1. Sheat. Doox' B-Glase A w/Attic 2~ 38 N/A Door C-Panel B No Attic 16 19 .63 Door C-Glass C ~Other Totals 2611 268.6 - Uo=(Ut/ACl .103 Floors 0.C Ineul. Cover A Non Con3. 16 19 1.23 Ceiling A 114a .025 29.2 B Overhang 16 3~ 1.23 Ceiling A C Other N/A 5 Ceiling C Skyight A Windows U-Val S.C. SkylighC. B A Alum T.e. .48 .88 Skylight C I B Wood .S2 .98 Totals 11d8 29.3 C Vinyl/FG .38 .88 Uo=Ut/At Skylights U-Vall S.C. + Baeement wa11s 7 50~Ybelow grade A Standard .60 .88 B High Perf. .32 I.5 NQTICE: Users of this software are responaible C Other for the speciPicatians and dimensional data used to generate thi~ report. The devalopers of HvAC Equip Rating the software are in no way reaponsible for the i Gas AFUE .78 misrepesentation of any building due to errore, HP HSPF 6.8 omissions, or any other mieuse of the software, AC/HP SEER 1D ~ ; i~~-pE-1995 02~34 FRGM Rl'LFtJD MIDIIEST REGIUIJ TO MIF6~! P.~Si9~5 Page 2 of 3 Huildar RYLAND HO[dE5 9ubmitted By R.I-i. T1~ACEY Model GILBERT Date 4/5/95 Lot/Plan/Addrese QPT. 295 Degree Day Base B000 Minneapolis '"ype Si.ngle Family House Volume 914Q0 Filenama GILHERT Control No. 7748 _~~~.~-_"~o'-ss-c==x=--'cnv.masa=c=oac3acmmaee-aoasmeass'e~'ea~=ssaemaas~evve~s- ~i;nensions iWails ~ Frame A ~ Frame B ~ ~Gar.Com.C~ ~ Mason.D~ Mason.E ' Hasement ' Bsmt. Above Gr 608 lst Flaor i 512 1et Floor 304 Below Gr 60B 2nd Floor 1024 Crawl. 3rd Fleor Misc, Misc. Miec. Misc. Misc. Ring Area 350 IWindows ~?~luminum I z47 i I Z~ I ~'r7ood Vinyl/FG Doora (G-Glase Area q-0 a e Area) Metal G 3 ~ 2~ 18 Wood G O Other ~ O ~ Ceilings With ACtic No Attic +I Other 1 ` 1148 ` - I iStd.Skylitasl I ~ iHP Skylitea ~ Other ~ Flaors Nan Cond. I Overhang SLab 162 WindowsiQly I6068gGLASS1DOOR I~tY I DesCription IQ2y'Ij03a~scription I 4 2QZp 12 3250 Doors I4ty.l Deacription IQty.l Dea~ription ~IQtyil__-Deecription ` 1 GAR. 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I W 61 bft~ nT .bwb ~IWC ZCY MnM .tl~b: $.4r~+.w~~ mww..<~w . ~ e ~ I ~ + ' r I e e u ~ + d Np~I~Y M R MN4NYtl~vM M ~ lu~i~ ~n ~ w.~i ~~i.~M~w i ~ / , W~~ 13CC ROC~ ~0.~x(xG Sxpyy~ ~ ~ M[ OTY Y[SfR1IT[ON t41DUL LfXLIX L u~ ~ 1 l 1' a 9 12' vkac-Rn 98 t64'~ ' P t 9 VL' BCl/~7 ~ 3 3 9!/¢' YCL~9 2~' 9 9 V2• BCI/YJ C~' 9 9 9 V2' ~C Y' 6 l] 9 V2' BCII~3 Z0" ~ a e vr ecva ia• Y L 9 V2' KI/~S 6' 9 1 J VY ~ II )/B' Vvsa-Len C ~0 I J l]/~' n II ~/Y Vlffn-LN 21' • 9 I/2' BCV45 Y 192' O.G SPACING oc.'v.Tq-Ilfla MAIN LEVEL FL??R FRAMING PLAN SGaG 1/P . 1'~0' . ~ ~ Y I- A N S~ ~ q •a«..,. . . . ~ ~jrtmn WmWrCmqiry •I ~~~.rs I _ ~m.w s , . ~ ~ 16tl a< IC aG ar IH st ' pt. W~~ f/f N I~Nh n~ onMl~ I ' N 4WwA ~e 1C1 JmN w~~ JOMtpK4f KN=N[/!!n ~p{t4 I !-MMwa~v~t 1m W me a~ b~bn 1 ~ t i ~ ~ ~ - i~JNw~FI`~fu Yui d~ !/I M 4M~ ~e11sM1 { ~ ~ F ~ 0~@~ nY ~R L 0 xv¢w~rzco nom rannuc scnTw~ ~ • MR TY ?ESCR~MIDl. Np LENGTX 1 1' . 9 / V~ru-I~n 98 IfY~ L 20 9/2' DCV1 29' . . 3 ~ 1 VC' lCV~3 1 l YP 9 12' Vvfatian 2C 3 1 ! V¢' ICVP i d 9 I/2' ?CV~` 6' ' l:%4' ~ IC Verfo-LOn 20' 9 V2' HLI/1] ! 19.2' U.C. SPACING ~y,_ r.ns l ou 1W-119]0 ~ UPPER LEVEL FL?~R .FRAMING PLAN F~ Y!- A N D ; I~ ~ ~iyro.nwmwrco~wM I , , LOT SURVEY CHECKLIST FOR RESIDENTIAL ~ , , B ILDING PERMIT APPLICATION PROPERTYLEGAL: " ~ ~ DATE OF SURVEY: I.~7 / 4~ ~ LATEST REVISION: ~ ~ ~ DOCUMENTSTANDARDS ~o ? • Registered Land Surveyor signature and company P1~0 ? • BuildingPermitAppiicant f~ ? O • Legal description R~ ? ? • Address ~ ? ? • North arrow and scale ? ? • House type (rambler, walkout, splitw/o, split entry, lookout, etc.) ? • Directional dreinage arrows with slope/gradient % CY ~ ? • Proposed/e~ass6ng sewer and water services & irnert elevation ? • Streetname C9' ? ? • Driveway ELEVATIONS / E»asstina rr ~ • Sewer service (or Proposed) O • Propertycomers ~ ? • Top of curb at the driveway e~ ? ~ • Elevatlons of any e~dsMng adjacent homes ro ed a ? • Garage floor C~ ? ? • Frst floor Z~ ? ? • Lowest exposed elevatlon (walkout/window) ? • Properly comers 0% ? • Front and rear of home at the foundation - PONDING AREA Cd aoolicablel ? [3~ ? • Easement line ? O~ ? • NWL ? 0~ ? • HWL ? ~~7 • Pond # designatio~ ? m~ ? • Emergency Overflow Elevation DIMENSIONS ~ ? ? • LotlinesBearings & dimensions a'~ ? ? • Right-of-way and street width (to back of curb) ? • Proposed home dimeosions including any proposed decks, overhangs greater than 7, porches, etc. (.e. all structures requiring permanent foodngs) [3~0 ? • Show all easemenTs of record and any Cily utilitles within those easements ? • Setbacks of proposed structure and sideyard setback of adjaceM e~dsting structures ? a~o • Retaining wall requiremeMs, if any Reviewed: ~ ~ ame Dat Jamiary 7996 cruiatware~ocaai.rt.Fn~ I a ~ P L 0T P LAN ~RTi~ SURVEYING. (NC. FOR RYLAND HOMES • rfrrs !S N07 A 80U+IDARY SiJHVFY ' 4007 JffFERSpt ST. N.E. m i ie+~r cerrirY nw* nnr ~m eun wu rww~,w~ er ~ fALUBIA FEIOffS. IN. SSSZi ~ a uoei ur masr srervuia . nv.T nns at,w war~ar PROPOSED DATE 97 t6121 7BB•B76B fAX (8121 7d8-7607 ~ ~ gCVi TfE PLkBBd OF A PROPDSFD ~11LDIN6 ON Tf LMD ~ ree~+ oacaie~ leo nar i rr e r~i uro (3RADE5 0• I RON MOMJA{ENT ~ vs BEARINGS ARE PER PLAT O 30 cnan~ sus • 9$S ~1 SP I KE SET n 99C>~O ~%1STtNG ELEVATION ~ i rav oF e~ocx • PROPOSm ELEV. ~ AI1f3JESOTA UC N0. 1Ca l l-S SCALE fN FEE7 BASE1ENf FLOOR • 9~9~0 F- = DRAINAGE ARROY ! SibC~ID1GDUT g8\~'~ /U~J Q ~ . r f~ + X q.,7 m ~ \ p./ ~ ~~i .1~ ~480~Cn~ m ~ ^ 9~~ ' ~~G~a~.; n~ ~ I C ,e S 73 • ~ ~~~ESC+ I 1 ~ s ~ f ~ rs, / F ~ : , J o 3 iu~. 7, . o= F;' ~ 3?. s7 ~ 9 ' o ` f ~`~,Q" ; ~ - rc ~ ~ ~ ~ C98o; O O ~9'`~~ _ ~qa3'~_''' y C~m /u, ~ : / /or ~9?' ` 99 3 Z > - - ~ ~OIO'/~ p / ~V 9 \ 9,y~ ,a ~ ~ ~ ~ R ~ ~ ~ ~Q ~ DaTE ~ ' ~ ~ ~ he o r; ~L Q° o~ / ry BUILDIIVG I PECTIQN~ _ ~ ^ ~ n. Q J y ^ - ~ ~-Q o ~ Q C ~ ~ S 1L I~ . 'CA q6~L / D i~` ~.p 4p~ ~ ~ < ~ ~ ~~ti~O~ 3i.o \ ~i~ O~ ~ ~ z Y G1 ~484.i~ p/ / j 0 " H~~ r.~ n`// ~~u ~ ~ 1 n l HBSy~ ~?~08.~ s.~ /a~ ~ ~y ~ ~ ~ \ c ~ y ^»te ~~-,.,~~33 ` /o \~=`C ; ~ 8J ~ ~sr'1d1r T°il'~'a'r.l~.''I'e~PA I~Y ~~''i.~~i. ~loosccSS'. `~9 ~ e ~sTCu ~o,o.' ~1~.Cfa OF D2~V~. SKp~~I~• 9'9r~7.,~ LOT 2 6. BLOCK 2, ~ ~,,z,?,~ o~ s~,~„~~c ~ 9 CEDAR HE I GHTS , m - DAKOTA CO.. MN. m N . ' C~~L.QCi~T ~ 2.CAfZ T o? Cv BL CITY U8E ONLY RECEIPT 7/5~ SUBD. l /X~ll:;&at~ ~ ~ RECEIPT`DATE: '-3~~5~/9~T- : ' ~ . br_. . : - 1997 PLUMBING PERM{T {RESIDENTIAL) - ~ . ' ciTr o~ eacaN, 3830' PILOT KNOB RQ - EAGAN, MN;55122 • (612) 681 ~675 Pleas,e complete for. r single family dwellings ~ townhomes and condos when permits; are required for eaeh unrt~ ` ~ backflow preventer for underground sprinkler syStem ' FIXTURES_ ~~j ~ i0. Shower 3.00 x - ~ VVater Closet 3.00 x = ~ ' Bath Tub 3.00 x Lavatory 3.D0 x ' ~ ' : Kitchen Sink 3.D0 x ~ Laundry Tray 3A0 x Hot Tub/Spa 3:00 k = Water Heater 3.0`0 x ~ Floor Drain 3.00 x r' Gas Piping Outlet 'minimum-t 3.00 x Raugh Openiqgs ~ 1.50 x - WaterSoftener `tordweirnysunaermnstmaion 5:DD x ~u.=" _ . Water Softener ` for existing dwelling 20:00 x ! ' ` ~ U;G. Sptinkler ` fordweuing under const. 3 00 = U:G.$prinkler "torexistingtlwelling, 2D:00 : Altereti0ns ` to existing residence 20,Q0 = WaterTum Around 20 00 = Private Disposal System ' oak cty ~ic. 65.00 = . . (new and refurbishad ~~syslams) ~ ~ ~ ~ - ~ ~ ~ - ~ Private Disposal Systems'a~nanaonment 20:00 = STATE SURCHARGE- .50' TOTAL 1 ~ ~ . . j.;_ I hereby~admowledge thatJ heve read~this~~ spplication; sfate that ltle information ~is eortect, and agree to corr~py~wRh all appliea6lerCity ~ ~ ~ ~ W~Eagan ordinances. It is~tAe epplicaM's responsmility'to notity the p~operty ownerthaCthe Crty of`Eagan,essum`es no lia6il,ity forany ~ ~ damages pu5ed by the~City-0uriig ds nortnal.operational and memtenance actwi[ies~tu^iha'facilities constructed undeMhis~pertndwithim t,~ . City.propertyJright-of-way/easemenl. . . ~ - ~ . ~ . SITE ADDRESS: A -~~~n ^ OWNER NAME: ~C~~QJ~~X ~I^I ~7 - 1NSTALLER NAME: GINZ-RYAN PLUMBIfIG TELEPHONE k23:-114,4 : _ STREETADDRESS: 14745 So Robert Trl CITY: Rosemount STATE: TII`? -ZIP' S5068 - _ ~ ~ e'~ f , f' ~ _ . ? _ ~ . . . ,ar . . , NATCJ , OF P~ERMITTEE: . ~ , ' . . ~ ~ ~ .:OFFICE USE ONLY. ~ ~ . ~ ~ . . - . - . . _ _ ~ _ ~ ~ . ~ - r'"~~E . , . ~ . ? ' a~o BL o2. CITY USE ONLY RECEIPT#: 7~.1 SUBD. ~ RECEIPTDATE: ~ 1997 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681~675 Please complete for. ? single family dwellings ? townhomes and condos when pertnits are required for each unit New construction Add-on fumace ' Add-~n air candiiiorsin~, v,ud-oii air excnai~yei, i.~.'v'an~ sysiam, etc. Date: / , FEES ? Minimum Fee: Add-on/Remodel (existing residence only) $ 2D.00 ? HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ? Gas Outlets {minimum of 1 required @$3.00 each) ~ ? State Surcharge .50 TOTAL SITE ADDRESS: ~ ~ ~ OWNER NAME: 7.t-~/C~~ l_"~( //(~~Y~~ PHONE#:~,=1?'~~~ INSTALLERNAME: GENZ-RYAN HEATING PHONE#: 423-1144 STREET ADDRESS: 14745 So Robert Trl C~7y; Rosemount STATE: MM~11` Z~p; 55068 ~ /./~~~~U!/~ ~JGNAT E OF PERMITTEE 1 CITY USE ONLY ~ ' L _ BL _ RECEIPT#: SUBD. RECEIPT DATE: 1997 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681~675 Please complete for. . all commerciaUndustrial buildings. ~ mutti-Tamily buildings when separate permits are ~ required for each dweiling unit DATE: ~p~TRa~:-r Qctir.F; WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: FEES: ~ $25.00 minimum fee Qr 1% of contract price, whichever is greater. ? Processed piping - $25.00 ~ State surcharge of $.50 per $1,000 of nermit fee due on all pertnits. CONTRACT PRICE x 1% PROCESSED PIPING STATE SURCHARGE TOTAL SITE ADDRESS: OWNER NAME: TELEPHONE#: TENANT NAME: pnnPROVeMen~rs oN~t~ INSTALLER: ADDRESS: CIN: STATE: ZIP: PHONE 51GNATURE: SIGNATURE OF PERMITTEE CITY 1N5PECTOR -i99i WeSl~ooL Pr0!esliona~ $erntts. In<. \ . ~ \ / Q~ / / Ccn iB N~~urs pg~nq. / ,~(1 ,^~v¢~o~a`y/', ~ ' , oeta< a , 5 ~ ~ CONrvECT TO E% MH Br ~ r` ~4, E¢ _~OeTCnIUL 0~ S1REE~ CORE ~RiLL COnCNCiE SA'N I. I,`~ + nrv0 Ec. 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CONSTHUCTIOX SHEET FE4 NO. 19153 ~ ~ PI ~M Date: City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK InkX....., e Permit #: 4"l 0-%t Permit Fee: t s0 Date Received: Staff: 2010 RESIDENTIAL Q PLUMBING PERMIT APPLICATION Site Address: `'I l D � S7 �/V t Q A L , C� I v l\► 55(22_ Tenant: Suite #: RESIDENT /OWNER '� Name: 3 � -i-�/J � J�� - �� L( ���one: 651 gQA- 3445 'h, Address / City / Zip: 4-61 t s l &040 \ 603 • 55 (2"Z r CONTRACTOR Name:t..F License #: Address: City: State: Zip: Phone: Contact: Email: TYPE OF WORK New _ Replacement Repair _ Rebuild Modify Space _ Work in R.O.W. Description of work: PERMIT TYPE RESIDENTIAL Water Heater Water Softener Lawn Irrigation i/ Add Plumbing Fixtures ( RPZ / PVB) ( Main V Lower Level) _ Septic System Water Turnaround New _ Abandonment RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation $50.50 Add Plumbing *Water Turnaround $100.50 Septic System $90.50 Fire Repair (replace (includes $.50 State Surcharge) Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge) (add $166.00 if a 5/8" meter is required) New ($10.00 per as built) (includes County fee and $.50 State Surcharge) burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ 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.aopherstateonecall.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 ' the case of work which requires a review and approval of pla x Af a\\(7q-f 1 A� Z' x Applicant's Printed Name icant' Signature FOR OFFICE USE Required Inspection Under Ground , `Rough -Ir Test Gas' T City otEapn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Us^ Permit#: (I Permit Fee: Date Received: Staff: 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: A) a/6 Site Address: c ✓) l `� gc,5cov Tenant: Suite #: RESIDENT / OWNER Name: 9O�i'l) A / SU Cka,1 I Phone: 6 s-/—/` cef - 3 7 7"i l Address / City / Zip: < l g Ru Sr/7e Applicant is: Owner A Contractor TYPE OF WORK Description of work: -9/d( G1 Construction Cosikf RU) Multi -Family Building: (Yes / No ) CONTRACTOR Name: // Address: '7 y/ 5 way Z..v�lv07 Sui±e O City: _. 1- /-0,1-‘ ) Qar-i Phone: 7c 7 -Y3- '7027 O Contact Person: 34 so -N. gi'I.Z% 6 RAe:i 5XDen`.)rS License #: State: Zip: 57S—(775z7 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: Phone: Sewer & Water Contractor: Phone: Mechanical Contractor: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions o the information maybe classified as non-public if you provide specific reasons that wail permit the City to. conclude that they 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 t`y ithout 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 plan Applicant's Printed Name City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675-5675 www.ci.eagan.mn.us PERMIT City of En Permit Type: Permit Number: Date Issued: Permit Category: Building EA090450 08/03/2009 ePermit Site Address: 4918 Rusten Rd Lot: 26 Block: 2 Addition: Cedar Heights PID:10-16725-260-02 Use: Description: Sub Type: e-Reroof Work Type: Replace Description: House & Garage Census Code: 434 - Zoning: Square Feet: 0 Construction Type: Occupancy: Comments: If there is no ice protection inspection prior to final, the contractor must meet the Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes. nspector w/ a ladder and flat bar. Fee Summary: Valuation: 3,000.00 BL - Base Fee $3K Surcharge - Based on Valuation $3K $88.50 0801.4085 $1.50 9001.2195 Total: $90.00 Contractor: Property Claim Solutions LLC 4655 Nicols Rd, Suite 202 Eagan MN 55122 (651) 994-2028 - Applicant - Owner: Sanjay Sujanaru 4918 Rusten Rd Eagan MN 55122 I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Applicant/Permitee: Signature Issued By: Signature Date: City of Ea�all 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: Date Received: Staff: 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address: Unit #: RESIDENT / OWNER Name: Al\Va M, S . sak 1 ? l Phone: G (Z 9 6 c{- 93ct &/ I-1- CI 1 Rots ROA 6sA SS)2.?- Address/City/Zip: 1 G-.1.) -6- • Iv`,j Applicant is: V Owner ' Contractor TYPE OF WORK Description of work: i , RR_ c --Rot 1 i2 T l slep ' _ / Construction Cost: 4 %p 5 0 Multi -Family Building: (Yes / No V ) CONTRACTOR Company: Contact: Address: City: State: Zip: Phone: License #: Lead Certificate #: If the project is exempt • from lead certification, please explain why: (see Page 3 for additional information) - I 60 If 077 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 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 Buil days of permit issuance. ` Applicant's Printed Name A. plicant's Si nature g Code musk mpleted within 180 C Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Single Family Multi 01 of _ Plex Accessory Building WORK TYPES New ,,' Addition Alteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (25% 100% t4. #01111-‘C" Fireplace Garage Deck Lower Level Interior Improvement Move Building Fire Repair Repair /8649 Census Code # of Units # of Buildings Type of Construction r 7,5 REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: Ice & Water Final g• Framing Fireplace: Rough In Air Test Insulation Sheathing Sheetrock Reviewed By: RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge SSW Permit & Surcharge Treatment Plant L,,r stR-, ea, Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width Final Y,5 *1 Copies Z3 TOTAL Siding Reroof Windows /QL7 Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Demolish Building* Demolish Interior Demolish Foundation Egress Window Water Damage *Demolition of entire building - give PCA handout to applicant 007 WO 6 MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: Final / C.O. Required --ii Final / No C.O. Required HVAC Gas Service Test Gas Line Air Test Other: Pool: Footings Air/Gas Tests Final Siding: Stucco Lath Stone Lath Brick Windows Retaining Wall: Footings Backfill Final Radon Control Erosion Control , Building Inspector zioffs dig". Page 2 of 3 N n p 2 1 <D a 0 a 1N l I .D 0 a 33 _D M 033 rn (11v S3WOH QNV1A8 J3AW?S ANVO x"708 V IAN SJ S 1Hl 0 6-1 r a' N r4„w, -R3AI 1►• • A 1 N a' . . 6 N City of Eagan PERMIT City of Eaan Permit Type: Mechanical Permit Number: EA112609 Date Issued: 08/20/2013 Permit Category: ePermit Site Address: 4918 Rusten Rd Lot: 26 Block: 2 Addition: Cedar Heights PID: 10-16725-02-260 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. Holly Flood 1408 Northland Dr #310 Fee Summary: ME - Permit Fee (Replacements) $55.00 Surcharge -Fixed $5.00 0801.4088 9001.2195 Total: $60.00 Contractor: Sedgwick Heating & Air Conditioning 1408 Northland Drive, Suite 310 Mendota Heights MN 55120 (952) 881-9000 - Applicant - Owner: Sanjay Sujanani 4918 Rusten Rd Eagan MN 55122 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. Applicant/Permitee: Signature Issued By: Signature SEDGWICK HEATING & AIR CONDITIONING CO. 1408 NORTHLAND DRIVE, SUITE 310 • MENDOTA HEIGHTS, MN 55120 • (952) 881-9000 ADDRESS 99 U s / E,f`L s J in " %, i CITY En-r^G L} OCCUPANT Jin Vi J A1� JV I `& Na it I OWNER J HEATING TEST RECORD SOLD BY MAKE Lt -In SERIAL NO THERMOSTAT VALVE LIMIT of 1 I co rsc o 1 LIMIT SETTING FAN SETTING PILOT TYPE IGNITION MODEL PILOT TIMING PRESSURE INPUT CFH STACK TEMP. 1 Siam: .0 r t. e2 (5 c 1 PERCENT CO2 FORM 235 (REV 10/10) PERCENT 02 PERCENT CO C INSTALLED BY MODEL INPUT S 5u, %J u t/ 090 kv 3 ( cL VENT SIZE TYPE OF LINER LINER SIZE c-�� FILTERS- SIZE �> �--tr0 NUMBER WIRING TEST TAG //I fr DATE TESTED f [ / / , COMPANY TESTING �-/ � 1 fAA c ' f NAME OF TESTER Athl A LIGHTING INST. FORM DISTRIBUTION TE COPY - JOB FILE YELLOW COPY - CITY City of Eagan PERMIT City of Eaan Permit Type: Plumbing Permit Number: EA125955 Date Issued: 08/08/2014 Permit Category: ePermit Site Address: 4918 Rusten Rd Lot: 26 Block: 2 Addition: Cedar Heights PID: 10-16725-02-260 Use: Description: Sub Type: Residential Work Type: Underground Sprinkler System Description: PVB 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. Jason Larson 25 S Sutton Lake Blvd Jordan, MN 55352 Fee Summary: PL - RPZ/PVB/Lawn Irrigation $55.00 Surcharge -Fixed $5.00 0801.4087 9001.2195 Total: $60.00 Contractor: Jay's Plumbing 25 South Sutton Lake Blvd. Jordan MN 55352 (612) 868-4102 - Applicant - Owner: Sanjay Sujanani 4918 Rusten Rd Eagan MN 55122 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. Applicant/Permitee: Signature Issued By: Signature