4955 Rusten Rd ~ . INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: rr t.
3830 Pilot Knob Road Permit Number:
~ Eagan, Minnesota 55122-1897 Date Issued: ' '
(612) 681-4675
SITE ADDRESS: ~ ~ ~ ~ ! , f;, , APPLICANT:
,f~, ! I N E?n ~
, ~ ~ , ~i
PERMIT SUBTYPE: TYPE OF WORK:
z;
. . .
. . . ~
~ ~
I ~
Permit No. Permit Holdar 6ato Telephona ~f
ELECTRIC
PLUMBING
HVAC
Inapectlon Date Insp. Comme~ta
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOAHD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG _ 9_ Cf~ ~
!
DECK FINAL ~~7 - MS
-Z
INSh'ECTION RECORD ~
C11 ~Y OF EAGAN PERMIT TYPE: ' ~ '
3830 Pilot Knob Road Permit Number: 'S''
Ea an, Minnesota 55122-1897 43 ~ ! ~ ~ `
9 Date Issued:
(612) 681-4675
, ,
SITE ADDRESS: , p r, t, ; APPLICANT:
'I~~ . . I:11'tilf°N H[I i .'~r;~` flt~fii •
~ f fi:~r !II 1 ~~I i • ~ ~ t ' i ;1'.,t r. ,
PERMIT SUBTYPE: TYPE OF WORK:
! ~~1 r~, Nt ! I
• •
• i~ii i I IV~~', I r~11Wt~,t.~
: t';1M 1 Nst 1 ~It~I 1 N~~
ir+ ~Ul Al li.?N t TRI I~I A~`F
1: ~~lI~~FI t N f I{~~~ ~ I~+ii1,,ll ~ ~d !I 1~,
i 1 f~~ (i i 1 1; 1 I h~ !1 I
' r~~~l~1 ft~~it', 1 F t< f 111+11 6_! I•I i{f~ , I Alc I'I iJ~,
~ ~
L~ J
a Pertnit No. Permit Holder Date Telephone !1
ELECTRIC ~a'r~~ Q N
PLUMBING ~1 l~~j 3~ 3~
HVAC 7 (j 3~~ 5
Inspection ate Insp. Comments
FOOTINGS b _ . ~j
cr~3
FOUND /~/jy~
7
FRAMING j~ /~/~I
n`~~~
FOOFING
ROUGH ~
PLUMBING
PLBG
AIR TEST
FiOUGH ~ ~
HEATIMG L ~
GAS SVC
TEST
INSUL ~
v
GYPBOARD
FIREPIACE ..~~/6 ~r
FIREPLACE
AIR TEST
FINAL PLBG `r d 6~ g ~
FINAL HTG
ORSAT °
TEST _
BLDCi FINAL 6
BSMT R.I.
BSMT FINAL .
DECK FTG
DECK FINAL °
~ ? ~ . ~
~ r ~ ~
C3';erti~icate o~ ~ccu~a~c~
~it~ o~ ~aga~t
~artiaexr e~ ~~iliiNg ~~yectisK
This Certifecote issued pursuant to the r~quirements of the Uniform Building Code
certifying thai at the time of issuance this structur~e was in compliance with the various
orrlinances of 1lu City regu[ating 6uilding construcrion or use. For the following:
u~ a~~r,~oo: SF r~iG swg. r~. y 1
pcpiponc,y 'Iype ~,'~~J ~ Zonina pisuict A 1 lype Cons~. ~
Oweer d Buil~inE BYI.AI1~ Addresa QfY) F 7Q7S7 CT i~C
au~w~g naa~ 4455 gq.S'tFat T~[1An ~.«~?;n L 1~, R2, (1~iNR ~I(~~t'S
~ ~ /"~.~,"~yC~
r-.--~ Date-
POST {N A CONSPfCUOUS PLACE
Address 4955 TzUSffi~1 RoAD Zip 5512 2
I.Ut' ' 45 $]~C 7 SUb !'F71AR HF'TfSTI'.S
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPEGTION.
Date: ~~J` ~j Yes No Inspector:
Final grade (6" from siding) t~
Pennanent steps (garage)
Pernianent steps (main entry) ?
Permanent driveway r
Permanent gas
Sod/Seeded grass
TraiU~rb damage
Porch ~
Basement finish 1~
Deck
Please verify with the builder the removal of roof test caps from ihe plumbing system and the shuhoff of water supply to
the outside lawn faucet before freeze potential exists.
Contad engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system. ~
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
2 5 2- 7 5 9 U E ONLY This rcqmst.oid 18 monihs fmm volidotion dak pnnkd in fils bax.
S/~8'~9~a 5~059
~
PLEASE PRINT OR TYPE ,G~ OS
Requat Dofe~ Rwgh-in inspxtion roquired2 es ~ Na pecnon Other Than Rough.ln: 0 Ready Now ill Call
~You m~s~ coll ~M inzpedor wh reody) ~ote Ready:
I, censed contracior ? owner hereby requesf inspedion of }he above eledrical work at:
Job Mdw~s ~Sfieel, Box, or Roub No.) Ciry Lp Code
~ ~
SMion No. Township Nome ar No. Rnnge No. fire Na. Cau
OrcuP P g y// /_~~J'
Q /~1 GfC
~l~/
Pov.ar Su Pddre
Elacfiml CoMracmr (Company Nome~ Contmtlor Gan ' N MasHr Lic. Na (Plant EIM. Only)
, O y
MoiGng Pddroes (Conhatlo~ or Owner Pedorminp Inslalletion~
~r ~ l M I N
AWhonz SigmNm (Comrador or Owmr Per(artnirg ImblloPOn) Phone Na. G
U - O ~ O
EB- 1A-10 STA7E90MDCOVV-SEEINSTpUC710N50NBACKOFVELLOWCAPY
I~I I I I~II REQUEST FOR ELECTRICAL INSPECTION~S 9
~
Minnesota State Board of Elechicity 4_.~,
4921 t)nhersity Ave., Rm. S-128 St. Paul, MN 55704
* 2 5 2 7 5 9 6 * Phone (612) 642-OS00 .~L 9
Home Duplex Apt.6ldg. Other: New Addn
Commercial Indushial Farm Remod Re air
Air Cond. Hig. Equip. Water Htr. Load Mgmf. Other:
D er Ran e Elec. Heot Tem . Service
"X" above the work mvered by ihis request Enter remarks in this spoce ond on ~he back of ~he white copy only.
Calculate Inspection Fee - This Inspectian Request will ~of be accepted wifhout the <onecf fee:
Olher Fee # Service Enhance Size fee # Circuils/Feeders Fee
Mobile Home Park Siall 0 ~a 200 Amps to 100 Amps
Sheet Lt9./TraHic Sig. Above 200 Amps A6ove 100 Amps
Transfortner/Generator INSPECTOR'SUSEONLY ; O Toyg~S`J_
Sign/Outline Ltg. Xfmr. /(Jf
Alarm/Remofe Confrol
Swimming Pool i her~b am mm ~ m. ened ~ha ~n:wli d ' ed'erem ~ a dores:wred
Irngafion 8oom Ro~gh-In ~ ~.Z~
Special Inspeciion ~
Firwl
Invesfigalive Fee
THIS INSTALLATION MAY BE ORDERED DISCONNECTED OT COMPLETED WITHIN 18 MONTHS.
i~, PEIZIVIIT
CITX OF EAGAN
383D Pilot Knob Road PERMIT TYPE: B u z ~ 0 7 N s
Eagan, Minnesota 55122-1897 Permit Number: ~7 z 9 g
(612) 681-4675 Date Issued: @ 5/ 0 9 j 9 7
SITE ADDRESS:
4955 Rl1STEN RD
LOT: 1.5 BIOCKa 2 .
CCUAR HEIGHTS
P.I.N.: 10-16725-1.5m-m2
DESCRIPTION:
FkJTUftE PORCH FT6S
~3A~ tj~.~~ Pehmit Type DECK
.w~6uila~z~~ ~~1"„~ TYP~' NEW
, ~$~~"p~ ~~y~~ y~ 4~A AL7. RESTDENTIAL
t
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~
~
~
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"''~ia"-~.a~~~~s~," ci ''"x ~;.~''L~
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~ °t~'"re ~ x:aa ~~~r ' ~ . €x ~4
~`F~,~,ky~4~`"~."c 6~
REMARKS:
FEE SUMMARY:
~ase ~~e ~sm.m0
Surcharge $.50
Total Fee $50.50
s
CONTRACTOR: - rapplicant - s7. ~rc.OWNER:
FRONTIER CONST 18914359 2006031 TAYLOR GATHRO[
141m1 FRONTIER LN 4955 RUSTEN RD
BURNSVILLE ~ MN 55337 ERGAN ~N
(61,2) 891-A359 (612)890-6931
Z ti~r~;'k~y ~~~naw.L~~(~1-~ ~Frait, ~ .Mav~ t~~md =~~~€iS~~~~~r~ ~an~ ~~a~.s :~~e
r•;
, a'rrfiQ~°rn:a~~a ~~~~~~~.~°~t~~r.~~r~~ ~.~prk~,"ra~~h<.~~~`~p~s~~~~~~~-°.~~~~~ s?f rtn =
' ~~attt~~° ' C~~yf s~f ~~g~~ CStd~~r~~~t~es,~ a.;: ~ ~ „ .
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I`~'~`~Y
APPLICANT/PEFiMITEE SIGNATUFIE ISSUED BY: ATURE
-j `~fq~~ 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) S(~ . S~
~~ti~ / CITY OF EAGAN
3830 PILOT KNOB RD - 55122
681~d675
dew Constructlon Reauirementa ~ RemodeURenefr Reauiromeota
? 3 registered ske surveys ~ ? 2 copica of plan
2 copies of D~ans pndude beam & window sizes; poured fid. design; etc.) ? 2 site surveys (exterior atldkions & dedcs)
? 1 energy calwlations ? t ene
igy calalaUona for heatetl addftions
? 3 eopies af tree pieservetion plen if lot plaltetl aRer 7N/93
required: _Yes _ No . ~
DATE: S~l 1~~ CONSTRUCTION COST: / ~ SrC~. CJ~
DESCRIPTION OF WORK: y~/G`Srm ~eav ~If ~,t ~ rN /s~d C'~~ C
STREET ADDRESS: y~ss ~v~~ ~~ct
LOT ~ BLOCK ~ SUBD./P.I.D. `
PROPERTY Name: (~v~t~.~-o~ ~~ay~ Phone ~4v-~ I
" OWNER I
Street Address: ~~55 17~~„-. d
City: State: Zip:
CONTRACTOR Company: -~-r~e~ ~~,~c r~ktr~?~ Phone 84 ~
Street Address: 1`-( I ~l tvu~,c r~r~ License ~ti
Ciry:~„~cA ~ I-2_ State: 1/ z~p:5533?
ARCHITECTI Company: Phone
ENGINEER
Name: Registration
Street Address:
City: State: Zip:
Sewer & water licensed plumber (new conshuction onty): . 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 infortnation is co a a comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant
OFFICE USE ONLY 'RECEIVE+ D
Certificates of Survey Received _ Yes _ No ~'AY 0 i 1997
Tree Preservation Plan Received _ Yes _ No _ Not Requi Y'=_
OFFICE USE ONLY .r1
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex o 11 Apt./Lodging o 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex n 12 Multi RepaidRem. ? 17 Swim Pooi
0 03 SF Addition o 08 8-plex o 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch o 09 12-plex o 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. 0 10 = plex 15 Deck .
~A~IFj' i-a~~.tU 51z65 ,oF f~vvR.e f-t:ZX,
WORK TYPE
0 31 New o 33 Alterations o 36 Move
~ 32 Addition o 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MC/WS 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
Census Bldg ~
Census Unit 0
APPROVALS
Planning Building ~1 Engineering Variance
Pertnit Fee Valuation: $
Surcharge
Plan Review
License
MCNVS SAC
City SAC .
Water Conn.
Water Meter
Acct. Deposit
S!W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
% SAC ~
SAC Units
3~-~
2oos RESIDENTIAL PLUMBING PeRnnrraPPUCnrioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651~75~6675
Please complete for modifications to existing residential dwellings.
Date 1 I
stce saeec aaaress _ y95S :~u s d;h u~n #
Property Owner r- Telephone # ~'cSl ) ~7-~077
Contrador D~~N~.S V~ E.~~j~ Telephone Sa ~D~
Address _ ~D ~ ~J VQ. c5 City ~U.,~h~~~l~ State ~ Za~
"
~
The ApplleaM is: T Owrrer Contractor _Ofher
SepUc System _ New _ Refurbished Submit 2 sets of plans and MPC license Indudes County fee
S 100•00
Peras-buitt $ 10.00
Alterations to existing dwellin9 $ 50.00
_ Add plumbing fixtures. This fee indudes installation of a water softener and/or water
heater at tt~e same time. ff you are lnstalling ~ a wa~ so(tener and/or water
heater, do not complete tliis section; rtwve to the next section and checlc the
appliance(s) you are insta0i~.
_Septic System Abandonment
_Water Tumaround (add $130.00'rf a 5/8' meter is required)
other. ~
Water Sottener _ Water Heater $ 15.00
_ new _ replacement
~ Lawn Irrigation _RPZ ~PVB ~new _repair _rebuild $ 30.00
State Surcharge $ .50
T~~ $3t~,5U
1 hereby apply for a Residendal Plumbing Permit and adcnowledge that tlie inTortnation is complete and accurate; that ihe
work will be in coniortnance with tfie ordinances and codes of ttre City of Eagan and the plumbing cpdes; ttiffi I
understand this is not a pertnit, but only an application for a pertnit, work is not to start without a pertnit and work will be in
accordance wiTh the approved plan in the event a plan ' ui to be reviewed and approve
` c ~
~-Q'~`~~ a \ .1.~ 2 c~. ~ ~
ApplicanYs Printed Name ApplicanYs SignaWre
L '
City of E~~~Il ClaimYouchcr
Make Check Payable to: GATHROE TAYLOR
Address: 4955 RUSTEN RD
EAGAN, MN 55122
Permit # 77726
Receipt 127439 ! 5/14/2007 Site Address: 4955 Rusten Rd
Reason For Refund: charges added to water bill
TYPE OF REFUND
Buildin Perntit Base Fee 0801.4085 $
Conshuction Meter De Refund 9220.2254 $
Curb Box De osit Refund 9220.2253 $
Fire Su ression Permit 0801.4096 $
Mechanical Pemut 0801.4088 $
Plan Review Fee 0720.4222 $
Plumbin Permit . 0801.4087 $ 50.00
SAC (MCES) 9220.2275 $
SAC (Ci 9379.4681 $
SAC (Admin 0801.4246 $
Sewer Pemvt 6201.4532 $
Surchar e 9001.2195 $ .50
TreatrnentPlant 6101.4685 $
Water Permit 6101.4507 $ ~
A~
Water Meters & Radio Read 6101.4509 $ 174.00
Water Su 1& Stora e 6101.4680 $
Co ies 020t.4230 $
$
Total $ 224.so
I declaze under the penalries f law that tlus account, claim, or demand is just and that no part of it has been paid.
~ ~ June 14, 2007
SIGNATURE DATE
`777~ ~ 02~ ~
~
200~ RESIDENTIAL PLUMBING PeRnniT APPUCarioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please com lete for modifications to existin residential dwellin s.
Date 'J~ / ! ~
SiteStreetAddress ~-~'S~ Rt.Si~n ~~d ~ Unit#
Property Owner -f y e- l 2 p Telephone #(~,sl Q~ `3C4 77
Contracfor ~ ~ Telephone # ( )
Address City State Zip
The Appiicant is: Owner & Occupant icensed Plumbing Contractor
Septic System _ New _ Refurbished Submit sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
Fire Repair (replace bumed out fixtures, etc.) $ 90.00
This fee a lies when extensive lumbin re airs re rttade to a buildin .
Alterations to existing dwelling ~ $ 50.00
_ Add plumbing fixtures to main level / lower Ievel. This fee includes
installation of a water softener and/or watef heater at the sair+e time. lf you are
insfalling onl~ a water softener and/or w ter heater, do not cot~iplete this section;
move to the next section and place a ch~ckmark next to the appliance(s) you are
installing.
Se - System Abandonment I
ater Turnaround (add $136.D0 if a 5/8" mqter is required)
Other: '
_ Water Softener _ Wa4~ r Heater $ 15.00
_ new _ repiacement'
awn Irrigation _RPZ _PVB _new ~repair _re6uild $ 30.00
State Surcharge $ 50
Total $
I hereby apply for a Residential Plumhing 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 witMout a permit and work will be in
accordance with the approved plan in the event a plan is reqwred t revie dand approved.
~a~~voe ~-~~~f i'~
Applicant's Printed Name Applicant's Signature
2004 RESIDENTIAL MECHANICAL PERNIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
/ 4 ~ Telephone # 651-675-5675
~v
Please cornplete for: single family dwellings & rownhomes/condos when permits are required for each unit
Date ~ ~ ~ ~1 ~ C~~--~
Site Address 1~4. 1,~~ Unit #
Property Owner ~'3~~~ r~ d~xx~` 1 v4 Telephone ~ ~)~~=~c~ Cl~~
Contractor ~
~ii~g g qIC LLC
12481 Rhode Island Ave. So.
Street Address SgVage MN 55378-1122 City
~-7 rr~y~~~ C-~
State Zip Telep6one #'~._~L_) ~~1` l~_~I.J J
Bond ~V`1W ~c~~-f~~ Expires: ~ . ~ .
The Appticant is Owner ~ Contractor _ Other
Add-on or alteration to ezisting dwelling unit ' $ 30.00
furnace _Additional Replacement
air exchanger _
air conditioner _New TReplacemen `S
~ other ~ ~~Z~ YlQ.~ T7~ ~
State Surcharge O~ r 2; I; .50
i'.,~ I c, i ~
Total ~J
By
I hereby apply for a Residenrial Mechanical Permit and acla~owledge that the information is complete and accurate; that the work will
be in eonformance with the-ordinances and codes of the City of Eagan and with the Mechanical Codes; t1~atT understand this is not a
permit, but only an application for a permit, and work is not to start without a permit; tUat the work will be in accordance with the
ap roved plan in the case of work wlqch requires a review and approval of pla
~ .r~- ~e~~~c~ ~~CT
~.~~.4~C~~c~
Apphcant s Pnnted Name Apphcant s Signature
2004 COMMERCIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: commerciallindustrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
Date / /
Site Street Address Unit #
Tenant Name (if applicahle) Previous Tenant Name
Property Owuer Telephone # ( )
Contractor
Siraet auuc ess L{~y
State Zip Telephone # ( )
Bond ` Expires:
The Applicant is _ Owner _ Contractor _ O[her ~ ~ ~ ~
Work Type
New Construction _ Underground Tank _ Install _Remove **see below
Interior Improvement _ Install Piping _Processed _Gas
Nature of Work:
'"'When installing/removing underground fank, call for inspecfion by Fire Marshal and Plumbing lnspector
Pel'mit FeeS: $70.50 Underground tank installa6onfremoval
$50.50 Mir.unum (includes State SrrchargtJ
or
ContractValue $ x 1°/a = $ PernutFee
• If nernvt fee is $1,000 or less, add $.50 ~ $ State Surcharge
If ~ermit fee is over $1,000, add $.50 for
every $1,000 nermit fee $ Total Fee
I hereby apply £or a Commercial Mechanical Pernut and acknowledge that the information is complete and accucate; tliat the wo~k
will be in conformance with the ordinances and codes of ihe City of Eagan and with the Mechanical Codes; [hat I unders[and this is
not a permit, but only an application for a permit, and work is not to start without a pemvt; [hat the wock will be in accordance with
the appxoved plan in the case of work which requires a review and approval of plans. ,
ApplicanYs Printed Name Applicant's Signature
Approved By: , Inspector Date:
"'•.,r~ 96 11: 30 7887602 KURTH SURVEYING INC PAI~ tll
~ '
• ~
- !C ~ ~ 1l 1~ ~ L111V
• ' 7H15 1S NOT A 80UNDARY SURVfY -
FOR R`~`~.tio 1-lorlcs KURTH SURVEYING, INC.
PROPOSED 1007 JEFFERSON ST. N.E.
I FfFAE1Y cfAilfY iW~7 1ryIS YLOT pLIiN yA1 pR¢p~pEp gy NE GRADES COLlA1BIA HEIOHTS. MN, 55~7i
ER UO9~ 1ft OIRECf fUYFAVISIQI . 11N7 7HIf p~µ COpqEttlY 16191 )pE-g76L FAX 18171 7BB-)90~
WWi 7HE PLACB/4!i OG A PYOVOim 7ryg Lk.p
~Q ~ lA7N~T I~ A oULY~1Y1111E OARAOE SLAB . )030~0
DATE 1~2'1/9~
Tov OF BLOCK . ~oDO~3 0• IRON MONUMENT
BASEerENT FLOOp 02t • ro BEAR I NGS ARE PER PLAT
MINNESOTA lIC E . ~ ~ ~ ' • • SPIKE SE7
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. . _
I PERMIT ~'s~`°2O~
CITY OF EAGAN
3830 Pilot Knob Road . PERMIT TYPE: B u z ~ o s ~v ~
Eagan, Minnesota 55122-1897 Permit Number: 027123
(612) 681-4675 Date Issued: 0 3/ 12 / 9 6
SITE ADDRESS:
4955 . RUSTEN R~
LOT: 15 BLOCK: 2
CEDAR HEIGHTS ~
P.I.N.: 10-16725-150-02
DESCRIPTION:
, ~~3`_~Ix~Permit Type SF OWG
~~c3~.1d~Tlg,~rk Type NEW
° ~~.3C -~'3~er~~r~~~ R-3 U--1
~ns~~u~`C•~~#fr ~,~e V-N
- ~~~~ng ° ~t-i
` ~.icri~•d~~1€$ L~~nq"~fl 66
~ ~ 8~5.~1~~f3n~° ~7~,si~~t ~ 39
i'~ ~u~3~~~` `~,~or~i$s:;~``~ 2
~€f ~ ~"~a~=~ 2. 0 6 2
° c~e°"~ ~ 101 1- FAM. DETACH
tr
~ ~ 6~ut ~ ~°~,s ' ~ , r~~ ; ~
~.a ~ ~ ~~-~2 `
~
REMARKS: ~
BOOSTER PUMP S& W PLBR - 3TAR PLBG
FEE SUMMARY:
VALUA7ION $197,000
BaSe Fee $1,372.25 MISCELLANEOUS $1,923.50
Plan Review $686.13 Total Fee $A,980.38
Surcharge $98.50
SAC $900.09
SAC g 100
SAC Units 1
Subtotal $3,056.88
CONTRACTOR: - Applicant - sT. ~zc.OWNER:
RYLAND HOMES 18546363 2003544 RYLAND HOMES
900 E 79TM ST 101 906 E 79TN ST 101
BLpOMINGTON MN 55420 MINNEAPOLIS MN 5542@
(612) 854-6363 (612)854-6363
3 .m ~ ti h . 94 ~ e . . - . ~ '
~ her~;~'try a~E£7~r~t,~Y~~~~e~ tf~~t;7~ h~ue r`Ract tha.~ ~pp~~,~~~ivr~ ar~d ~tiate #h~C tk1~
~ii~fiar~~~€,~m raai~~F~~t:a~rt+~ ~g~r.~s ~~+s~ co~npl~t, w3,~ al~ ~~Splic~i~~e' ~1t~~e ~ ~~f Mn,
S'~~:~u`C~~ ~rrii F~~,~~+, ~~a~Ea,~~Fi t3r,`~9'i~awwces.: _
~
~
. , . .~~~~~""~-ir~~' e , . ~ _ e._ . ~ .
APPUCANT/PERMITEE SIGNATURE ISSUEO Y: IGN URE ~
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: s u z ~ o x H ~
3830 Pilot Knob Road Permit Number: 827123
Eagan, Minnesota 55122-1897 Date Issued: 0 3/ 12 / 96
(612)681-4675
SITEADDRESS: ~•~•ti.: 1e-16~zs-15e-ez APPLICANT:
LpT: 15 BLOCK: Z
4955 RUSTEN Rq RYLAND HQMES
CEDRR WEI6M75 (612) $54~6363
PERMIT SUBTYPE: ~ TYPE OF WORK:
5F pWG NEW
. .
FOpTINGS FOUNDNTION
FRAMING RpOFING
INSULATIpN • FIREPLACE
ROUGH IN PLBG ROU~H SN HT6
FINAL PLBG FINAL
REMqRKSe BpQSTER PUMP S& W PLBR - STAR PLBG
n, ~ _w
~ Y' 3 F ~
i
.a ~ v nx € n `S r „ ~i
,
a=
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~
.
~ 5 ^ , Nt t~ ' : . _ Y
k...... . ~ w._..... _ .....~.,u s,ewse,v. .s,m a,. e n . _ _ .,,~,e- . .H ' .
` t CITY OF EAGAN 11 ~~1 ~ a
3830 PILOT KNOB RD - 55122 T~ `i l!, ~
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Constnution ReqWrements QQmodel~epair ReauiremeMs
? 3 regbtered site surveys ? 2 cropies of plan
? 2 copies of plens (indude 6eam 8 window sizes; paured fid. design; etc.) ? 2 site surveys (extarior addttions & decks)
? 1 ener9y celculationa ? 1 energy calculations (or healed edditions
? 3 oopies of tree preaenetlon^Wgn N lot pleded after 7/7/93 ~
requlred: _ Yes _~Y No '
DATE: 3~ CONSTRUCTION COST: ~ n, n
DESCRIPTION OF WORK: s
STREET ADDRESS: ~
LOT ~ BLOCK O~ SUBD./P.I.D. l
D~ IG~~
PROPERTY Name: ~ I f~ 11 1'I 0t~1 U,S Phone ~~3 ~ J
OWNER ~Ob G~ ~ I~ (1 `W T. SI P. IOI
Street Address•
City: ~-T~ State: Zip: ~-~"J`~~ Q
CONTRACTOR Company: ~L I liCl i'IomPS Phone
7,
Street Address: ~~LL1Y19 License Q ~~~~1
City: State: Zip:
ARCHITECTI Company: 1"1(J _ _ Phone
ENGINEER
Name: ~ Registration
Street Address•
City: State: Zip:
Sewer & water licensed plumber. STQ~ 4' IU f"Yl C~ 111~- Penalty applies when address change and lot
change are requested once permk is issued.
I hereby acknowledge that I have read this application and state that the information is correct and ree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY / G~[~ CC~,I~OMI~~
/
Certificates of Survey Received ~ Yes No ;,:'.;i ij ~ j9~~
Tree Preservation Plan Received _ Yes l/ No -------_____o__
OFFICE USE ONLY " " ` ~
a r ~ .
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
a 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch o 09 12-plex o 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 _-plex o 15 Deck
WORK TYPE
~1 New o 33 Alterations ? 36 Move
0 32 Addition ? 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MClWS System
(Allowable) ~ Main level sq. ft. iF,yi~ City Water oc
UBC Occupancy 3 / Z~ sq. ft. I~ ~ 2~ Fire Sprinklered
Zoning ,e-/ sq. ft. PRV
# of Stories Z~Bs•~ sq. ft. Booster Pump S~GS
Length /°(o sq. ft. Census Code. lv~
Depth 3~ Footprint sq. ft. z, a~z SAC Code 6/
Census Bldg /
Census Unit i
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $ ~G/ 7• O°O
Surcharge
Pian Review
License ~ Z
MCNVS SAC ~ LD G f,~
~
c~t,, sAC / 6 f- r` l 4~~ ~~f
Water Conn. ~
Water Meter
Acct. Deposft ~
S/W Pertnit ~ / GS
SM! 5urcharge (i ~
Treatment PI. n
Road Unit ( /
f
Paric Ded. rr \
Trails Ded. ' ~ ~S ~ 1
Other ~
Copies
S~M4.-
To~,:
sAc
SAC Unfts
02/,27/1996 11:30 7887602 KURTH SURVEYING INC PAGE bl
i
y
' 7H1 S f S NO7 A 80IYJDARY SURVEY -
FOR R~L~~1D ~"`on-~Cg pROPOSED '1001hJEFFERSOEIVYSTJN.E'NC.
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CN uoFA Yr DIPER suvplYiilOn . tw,T 7NI4 ?t,w topRCt7tY 16141 700•8769 FAJ( {gll) 78E•JBO~
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~~1'~M ~FR 7XF 7ME 51 7E OF YINrE OARAOE SLAB . 1030 • O DATE 1~ LL / 9~°
TOP Of BLOCK • 103~' 3 0- I RON MONUMEM
aAS~exr FLOOR 02t ~6 BEARINGS ARE PER PI.AT
MINNESOTA UC E~, 3 SPIKE SET
• EXISTING ELEVATION
f 1 • PROPOSED ELEV,
b~ O- DRAINAOE ARROu
S T 8o i
•3 SCALE IN FEET
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, lOT SURVEY CHECKLIST FOR RESIDENTIAL
, BUILDING PERMIT APPUCATION
~ PROPERTY LEGAL:
~ DA F SURVEY:
~ ~ LATEST REVISION:
~
~ „ ~ QOCUMENT STANDARDS
~
9 ~ • Registared Lend Surveyor aipnature and company .
O • Butiding PermitApplicant
L~'~ O • Legal descrfpdon
e~ O ~ • P~ddress
~o ? • North arrow and scale
e~ O ? • House type (rambler, walkout, splR w/o, split entry, lookout, etc.)
0 • Directional drainage artows with slope/gradieM %
o ? • Proposed/e~sting sewer and water'servicea & InveR elevatlon
~ ? • Street name
? ? • Driveway
ELEVATIONS
C~ ~ -
~ o • Sewer service {or Proposed)
~ ? • Property comers
Ca' • Top of curb at the driveway
~ O • ElevaUons of am e~ostlng adjacent homes
Prooosed
~Cy ~ • Garage floor
~/j~ 0 • First floor
0 • Lowest exposed eleva~on (waikouHwindow)
~ ? • Property comers
~l ? ? • Front and rear of home at the foundation
PONDING AREA Cd aoolicable)
? [3' o • Easement Ifne
? 0~ ? • NYVL
O • H4VL
? • Pond # desipnatlon
O 6' ? . Emergency Overfiow Elevatlon
DIMENSIONS
q/~0 0 • LotlinesBearings 3 dimensioms
? • Right-of-way and street width (to bedc of curb)
? ? • Proposed home dimensions includinp a~ry praposed decks, ovefiangs greater than 2',
/ porches. eDc. Q.e. all strudures requtring pertneneM fooMnps)
C9' ~E] O • Show all easemeMs oi record and arry C~y utqitles wflhin tlaee easemeMa
R~ • Setbacks of proposed structure and sideyerd aelbadc ot adJecerd e~atinp structures
? C9~ ? • Retainlnp wall requiremerna,
Reviewed:
Na e / te
.Mwary /COe
auq+aos~etDOPn?rt.rw
i ~ ii ~ 1: z.. f; UII' w;
- - . - _ - - _ . . . `
r~' i1 1/4' BENf.)
~4
IUIE: J___._ ~ 15' ESMT.
:OMP~CTIQN EFFpR7S INSIDE _ g"_22 ~~2• gEND ~±7 1~
nRp AR[ns SF+qLL MEET SPECS ~ ~
nLI.ED rOR UNDER STREETS wYE-2~09
95~ ST~NDARD PROCiOR) 5' FSMT. ~ ~
' ~
' , ~015.0 WYF.-1 + 27 WYE-O+J2
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6"x6° TEE ~16.0 1013.9 1011 0)
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1017.1 LWYE=1 E81~ IWYF=0+94_l
/ fWYE=0+0~
h L---
j ~ ~ WYE=2 F59
NntE: , 7 , ~ ~ ~ ~l~
• ALL S~NITARY SEWER SHALL BE --HYDRANT
SDR 3..5 UNLESS OTHERWISE NOTEO _ 49'-6". DIP_~ . SERVICES TO EXT
DENOTES SANITARY SEWER SERVICE INVERT ~ 'i : _ 5 -45',BEN ~ ' ~ ~ ` ~ ~ PROPERTY LINE (
PROPFRTY LWE. SERVICE SHALL BE EXTFNDED 6~>> ~%4.~ FND~ 1( I ~ CURB STOP IOCA
15', PIPF S~IAIL ~E CALCUTATED ~ 2.U~ , GROUND, IEL =[07F.9j,";;,~, w/ 15' PIG Tnn
, , PII' :~^"t^~;~ n..~~~ p,.~, ;
~ tn pBTnIN STUB INVERT. ~ .
, - ~ Il' ~r~CU!_L . .~,c
~ C!FNOTES SANIIARY SEWER SERVICE OiV 7I-~~ ~I t~.
'NVF I.OCATION ON MAINLINE FROM ALL WATERMAIN PIPE SHALL ~E
pr_~WN STRF.AM M.N. CIASS 52 UNLE.;~ 01HERWISE NOTfD
. ~ ~ ~ I ~ ~ ~ I
~
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.
ti . _ . . . . _ . .
'•GRADE' - FINISHED C/L GRADE:
~
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i i i _ ,'.~i' MIP. C(1VFR i i i
~ ~ ~ ~ ~ ~ 30U' pVC ~ ' ' ~
180, !
~ ;
' MI~--6 - ~
i ~ I ~$(A. 12+76 ,
; i J ~RE = 1026.~5
; i IIE - ip15.0C I .
~ ~
- . ~ j "
~ I _ _ . I~H-S
~ STA. 9+ 76
~ Dlf' (f3'Y OTI±IERS) ' RE = 1017.5~
i i IE S= 1006 61
I IE. N= l0U 51
_ _ _ _ _ _ _ _ _ _ . _
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* CABO MEC 92 COMPT~IANCE *
Huilder RYLAND HOMES Submitted By R.H. TRACEY
Model MUIRFZELD C LOW E GLA Date 2/3/95
Lot/Plan/Address BONUS ROOM ~ Degree Day Base 8000 Minaeapolis.
Type Single Family House Volume 41400
Filename MUIRFBR Control No. 5925
Uo Totals ~ Proposed ~ Required
Component Area Uo Total Uo Total
Walls 3572 .108 386 .110 390
Ceilings 1719 .026 45 .026 45
Floors 345 .047 16 .040 19
Floors (Open) 30 .035 1 .026 1
Bsmt Wall(U) 1374 .080 110 .091 125
This House Qualifies With Total
Total ~ 559 ~ ~ 574 U-Value Calculations
Specifications Uo Calculations
Walls Size O.C. Insul. Sheat. Component Area U-Val Total
A Frame S.5 16 19 2.06 Frame Wall A 2222 .052 117.
B Frame 5.5 16 19 2.06 Frame Wall B
C Frame-Gar. 3.5 16 13 .45 Frame-Gar.C 324 .082 26.6
D Masonary 8 N/A 11 N/A Masonary D * .080
E Masonary N/A N/A Masonary E *
Ring Joiet 15 28 13 2,06 Ring Joist 442 6.28 27.7
Window A 531 .38 201.
Doors Panel Glase S.C. window B
A Metal .19 .62 .SB Window C
B Wood .46 .62 .88 Door A-Panel 46 .19 8.74
C Other poor A-Glass 7 .62 4.34
Door B-Panel
Ceilings o.C. Insul. Sheat. Door B-Glass
A W/Attic 24 38 N/A Door C-Panel
S No Attic 24 30 Door C-Glass
C OtheY Totals 3572 386.3
Uo=(Ut/At) .108
Floore O.C. Insul. Cover
A Non Cond. 16 19 1.23 Ceiling A 1581 .025 40.3
B Overhang 16 30 1.23 Ceiling B 138 .035 4.96
C Other N/A 5 Ceiling C
Skyight A
Windows U-Val S.C. Skylight B
A Alum T.B. .38 .88 Skylight C
B Wood ,52 .88 Totals 1719 45.3
C Vinyl/FG .48 .88 Uo=Ut/At .026
Skylights U-Val B.C. * Sasement walls > 50% below grade
A Standard .60 .88
B High Perf. .32 .5 NOTICE: Users of this eoftware are responsible
C Other for the specifications and dimensional data
used to generate this report. The developere of
HVAC Equip Rating the software are in no way responsible for the
Gas AFUE .78 misrepesentation of any building due to errors,
HP HSPF 6.8 omissions, or any other misuse of the software.
AC/HP SEER 10
L00i200'd NNIW Ol NOI~J3Li 1S3MQiW QNd'1,12! WOa~ 4S:ZT S66S-S0-a3Q
, ..ti
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Page 2 of 3
Suilder RYLAND HOMES Submitted By R.H. TRACEY
Model MUIRFIELD C LOW E GLA Date 2/3/95
Lot/Plan/Address BONUS ROOM Degree Day Base B000 Minneapolis
Type Single Family House Volume 41400
Filename MUIRFBR Control No. 5925
Dimensions
walls ~ Frame A ~ Frame S ~ ~Gar.Com.C~ ~ Mason.D~ Mason.E
Basement Bsmt. Above Gr 600
lst Floor 1287 lat Floor 342 Below Gr 800
2nd Floor 1376 Crawl.
3rd Floor Misc.
Misc. 99 Misc.
Misc. Misc.
Ring Area 442
Windows
Aluminum 505 I I I I I 26 I
Wood
Vinyl/FG
Doors (G=Glase Area - 0=0paque Area)
Metal G 7
o • as ie
Wood G
0
Other G
0
Ceilings I Wi1581ttic I Ni38ttic I Other
Std.Skylitesl I (
HP Skylites
Other
----------------------------------g----------------
Floors I Non Cond. I Overhan I Slab
345 30
~indows Qty. Description Qty. Aescription Qty. Description
5 2820 25 Misc.(Enter Area) 1 4010
8 3260 12 3250 1 3062
1 3040 1 2852 1 2060
1 2052 2 1052 1 5 FT HP.LF ROUND
1 6080 GLASS DOOR
)oors IQly IGAReBWALLtDOOR I41Y ENTRY9W/DSL1SDLITE 4ty.l Description I
L i
306 YII Q ~
L00i~00'd NNIW Ol NOI~J3?J 1S3rIQIW QNli~1.21 WO?1~ 7S:2L 566S-S0-~3Q
CITY USE ONLY
L ~ BL ~ RECEIPT#:'i~~JLv
SUBD. l ~.~i DATE:-~~~'L~
1996 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 5512?
(612)681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
~ New construction Add-on fumace
Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc.
Date: ~f- -qlr,
FEES
? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
a`7
? Gas Outlets (minimum of 1 required @$3.00 each) ~J ~ca7
? State Surcharge .50
TOTAL CP • Sv
SITE ADDRESS:~~~ ~ ~tQn
OWNER NAME: YICI 7` t PHONE
INSTALLER NAME: ~ }h ~ ~ '
STREET ADDRESS~ q~`~~ J~ nn -~~c1 (~"G_
cinr: J~rc~~,1~,1~n 'l~k STATE: T1'lYl ziP: ~-~ya~
--r
PHONE (tc,la ) r~.~S~'~I.~ ~
Ji-.!~/1~
CITY USE ONLY
L BL RECEIPT
SUBD. DATE:
1986 MECHANICAL PERMIT (COMMERCIAL)
• CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612)681-4675
Please complete for: ? all commercial/industrial buildings.
? multi-family buildings when separate permits are ~ required
for each dwelling unit.
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: ~$25.00 minimum fee 4~ 1% of contract price, whichever is greater.
~ Processed piping - $25.00
~ State suroharge of $.50 per $1,000 of Rermit fee due on all permits.
CONTRACT PRICE x 1%
PROCESSED PIPING
STATE SURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME: TELEPHONE
TENANT NAME: (IMPROVEMENTS ONLY)
INSTALLER:
ADDRESS:
CITY: STATE: ZIP:
PHONE
SIGNATURE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
L L_ BL CITY USE ONLY RECEIPT 55~OD
SUBD. t~d DATE: ~ ~
1996 PLUMBING 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 permits are required for each unit
FIXTURES ~ACH ~ TOTAL
Shower 3.00 x ~ = 3-
Water Closet 3.00 x 3 = R-
Bath Tub 3.00 x Z = 6-
Lavatory 3.00 x S = ~ S-
Kitchen Sink 3.00 x ~ = 3-
Laundry Tray 3.00 x ~ = 3~
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x ~ = 3,
Floor Drain 3.00 x 1 = 3-
Gas Piping Outlet " minimum -1 3.00 x 1 = 3-
Rough Openings 1.50 x 3
Water Softener 5.00 x =
Private Disposal " ~akoca cry. iicsnse 5~.00 =
(new and refurbished systems)
U.G. Sprinkler * home under const. 3.00 =
Alterations ` to existing 20.00 =
Water Turn Around 20.00
STATE SURCHARGE .50
TOTAL 53. W
SITE ADDRESS: ~SS ~5-EJ~1
OWNER NAME:
INSTALLER NAME: ~~~~N~
STREET ADDRESS: 6a~~ W W~~~
CITY: STATE: ZIP: 5~~~
PHONE ( ~ ~3~4 3S"7
tt
OPFICE USE ONLY
L BL RECEIPT
SUBD. DATE:
1996 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PIL~T KNOB RD
EAGAN, MN 55122
(612) 681~675
Please compiete for: ~ all commercial/industrial buildings.
~ muki-family buiidings when separate permits are ~g1 required for each dwelling
unit.
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION ADD ON REPAIR
DESCRIPTION OF WORK:
IS WATER METER RE~UIRED? _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING:
WATER FLOW: GPM. ARE FLUSHOMETERS TO BE INSTALLED7 YES NO.
FAILURE TO PROVIDE THIS INFORMATION WILL RESULT IN A DELAY OF METER ISSUANCE.
WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? YES NO.
IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINKLER PERMIT.
FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge of $.50 per
$1,000 of permit fee due on all permits.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL
SITE ADDRESS:
TENANT NAME: STE. #
OWNER NAME:
INSTALLER:
ADDRESS:
CITY: STATE: ZIP:
PHONE SIGNATURE:
APPLICANT
OPFICE USE ONLY
METER SIZE: " DATE: INSPECTOR:
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA110691
Date Issued:05/22/2013
Permit Category:ePermit
Site Address: 4955 Rusten Rd
Lot:15 Block: 2 Addition: Cedar Heights
PID:10-16725-02-150
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Amber Beard
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 -
Gathroe Taylor
4955 Rusten Rd
Eagan MN 55122
(651) 387-3677
Craftsmans Choice Inc
26219 Fremont Drive
Zimmerman MN 55398
(763) 633-1390
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA160966
Date Issued:04/27/2020
Permit Category:ePermit
Site Address: 4955 Rusten Rd
Lot:15 Block: 2 Addition: Cedar Heights
PID:10-16725-02-150
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
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: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Gathroe Taylor
4955 Rusten Rd
Eagan MN 55122
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA168352
Date Issued:04/19/2021
Permit Category:ePermit
Site Address: 4955 Rusten Rd
Lot:15 Block: 2 Addition: Cedar Heights
PID:10-16725-02-150
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
210-0754.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Gathroe & Gauthra Taylor
4955 Rusten Road
Eagan MN 55122--402
Gv Heating & Air Inc
5182 West Broadway
Crystal MN 55429
(763) 535-2000
Applicant/Permitee: Signature Issued By: Signature