4236 Sandstone Dr3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
/-7171 * q -
Use BLUE or BLACK Ink
For Office Use
Permit #:/A�`7 o1
Permit Fee: rO e a.)
Date Received:
Staff:
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 3P..-41 I 1 Site Address: t -f" Sal ` l S4O M`e .
Tenant: Suite #:
RESIDENT / OWNER
Name: 071,0aYi • Phone:952-' 14614 '(o162
Address / City / Zip: 1493l ild �S � Q
. ,
Applicant is: Owner t/ Contractor
TYPE OF WORK
Description of work: A 1 /-6111 01,6V
wi cvv5 w a '1— 1�1 - h k no KQadil/ay,
Construction Cost: . Multi -Family Buil ng: (Yes / No )01,
o?`�3GI`-va
CONTRACTOR
Name: License #: /o �a%tt
Budget Exteriors
Addres 8017 Nicollet Ave S. City:
Bloomington, MN 55420
State: 887-1613
, PH: (952)
Contac F: (952) 887-1659
COMPLETE
In the last 12 months, has
Yes No If yes,
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
the City of Eagan issued a permit for a similar plan based on a master plan?
date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor:
Sewer & Water Contractor:
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 .gopherstateonecali.arc)
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 f 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 approvaiof plans, I
x ct,4�' 5�.� t I t [rel
Applicant's Printed Name
x
Ap . icant's
nature
Page 1 of 2
CITY OF EAGAN Remarks Gedar Grove Acquisition
Addition Lot 1)i aik 1 Parcel 10 16701 140 01
, 42 Sandstone Dr. Eagan, rflt 55122
Owner ' Street
' Y• ' ~ State
Improvement Date Amount Annual Years Payment Receipt Date-
STREET SURF. 19
STREET RESTOR.
GRADING
SAN SEW TRUNK
* SEWER LATERAL 1972 13 .00 2. ~ 2 Pa7.d
WATERMAIN
* WATER LATERAL 1972
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. I
BUILDING PER.
SAC ~
PARK
}
~
~ FoiOfficejJse I
~ PermR# ~
, n~~ CltY ~ of Eaan
~ Permit Fee: ~ ~
3830 Pilot Knob Road -
Eagan MN 55122 I Date Received: j
Phone: (651) 675-5675 ~ ~ ~
~-~I Statt:
Fax: (651) 675-5694
2008 RESIDENTIAL BU/ILDING PERMIT APPLICATION
Dafe: ~ 1- Site Address: 5 g tiJ S+6 h E lz~r
7enant: Suite
RESIDENT / OWNER Name: A (3 h Phone:
Address / Ciry / Zip: ::0,zAen
Applicant is: _ Owner 11 Contractor
TYPE OF WORK Description of work:7cu~
Construction Cost: Multi-Family Building: (Yes No I
CONTRACTOR Name License
, •
Addres~2esidBnHel MN liC.~20249486
C2478 Hillwood DriVe. St. Paul, MN 55119 State: zip:
PhoQovo Johnson - Cell: 651-274-09A&ct Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Cat890n1 Submitled Submifted ,
(4 submission lype) • Energy Envelope CalculationsSubmitted
In lhe last 12 months, has ihe 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:
NOTE: Plans and supporting documents that you_§ubmft are; consldered to be publlc information. : Portfons of
the information may'be, classified as non-public if"you provide speafio reasons that wou/d permft the City to
conclude ihat the are t'rade:secrets:-
I hereby acknowledge that Ihis information is complete and accurate; that the work will be in conformance with the ordinances and codes ot the City oi
Eagan; Ihat i vnderstand this is not a permit, but only an application tor a permit, and work Is not to staA without ermit; that the work will be in
accordance with the approved plan In ihe case of work which requires a review and appro f plans ~
X ~0. jo~,nSoN x
Applicant's Printed Name Applicanfs Signature
Page 1 of 3
~ . 1
2006 RESIDENTIAL BITILDING PERMTT APPLICATION ~ v
City Of Eagan
3830 Piiot Knob Road, Eagan NIN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
NewConsWctianReouirements - RemodeVReoairReouirements -
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan showing footin9s, 6eems, joisis
(20%maximum lot coverage allowed) 1 set of Energy Cakulations fa heated addidons
2 copies of plan showing 6eam & windav sizes; poured (ound design, etc. 1 site survey foradditions & decks
1setofEnergyCalculafions - Addfion-indicafei/on-srfesep6'csysfem
3 copies of T2e Preservafion Plan'rf lot platted after 711193 -RimJoistDelailOptionsselec6onsheet(buBdinqswith3orlessunits) Minnegasco mechanical ventilation form
DateConstructionCost~~T-/ /
Site Address - Li 2 (0~ ) \ l ~Q Unit/Ste q -
~
Description of Wark ~
Mulri-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2
PropertyOwuer _c~. A Telephooe#(~6 ((J~~" ~~I O~ ,
RENEWAL BY ANDERSEN
Contractor 1920 COUNTY RD. "C" WEST
Address ROSEVILLE, MN 55113 c'n'
5tate 651-264-4777 _ 7'e[ephone # ( )
LICENSE #20130983
COMPLETE TFIIS AREA ONl.Y IF CONSTRUCTlNG A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Mirmesota Rules 7672
Energy Code Category , Residenlial Ventilation Category 7 Worksheet • New Energy Code Worksheet
(4 submission type) Submitted Submitted
. Energy Envelope Calculations Submitted •
In ihe lasi 12 monThs, has The City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of masier plan:
Licensed Plumber Telephone J
Mechanical Contractor Telephone # ( )
Sewer/WaterContractor 7elephone#( )
I hereby apply for a Residential Building Permit and aclmowledge 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 State of.MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
pe rt; that the work will be in accordance with the approved plan in the case of work which requires a review and
ap oval ofplans.
~
4~
App ican 's Printed Name pplicanYs Signature
DO IVOT WRITE BELOW THIS LINE
Su6 Tvpes
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling q 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01of_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.) ? 33EM.AIt-SF
04 02-plex 10 OS-plex 18 Deck ? 23 Porch (screen/gazebo) ? 36 MWEi Misc.
?05. 03-plex ? 11 10-plex ? 19Lower Level ? 24 Stortn Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvpes
? 31 New ? 35 Int Improvement ?3S Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building" ? 43 Reroof ? 46 WindowslDoors
? 34 ReplaCement `Demolition (Entire Bldg) - Give PCA handout to applicant
, DCSCiiD110f1: Water Damage _ Yes . Valuation Occupancy MCES System
Plan Review 100% or 25%
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQiTIItED INSPECTIONS
_ Footings (new bldg) Sheetrock
_ Footings(deck).. FinaUC.O. _ Footings (addition) - - Fhial/No C.O. -
_ Foundation HVAC _ Drain Tile Other' - Roof - Ice & Water Final _ Pool Ftgs Air/Gas Tests Final
_ Fr~B _ Siding _ Stucco Lath _ Stone Lath _Brick
_ Fueplace _ R.I. _ Air Test _ Pinal _ Windows
_ Insulation _ Retaining Wall Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
SRW Permit & Surcharge
Treatment Plant
license Search
Copies
Other
Total
vv~vdr 4v-i1 zuv .c4.oo Ctf6 (OJ U71 ''&4tS8 '
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' - • ~¢1Vu
re _ - - - - -
zooa - - - . - ,
3836 PiIcsf Kaob goad - '
Eagen, MN '5.5122
To ?Ghom It May Conoera; .
EIder7ones is aufhOd2ed • '
Elder Joncs to PraviBe tWs~ ~h~~g P~ts forltene~vsl {~y, Andexsen. pteasc alIow
. date bcyond 616101: imti[ a~~~ I~~ 7Ttss amhotizatibn is veIid fvr
w any
the Ctry ~aEeraxpctsslY ~vokes ft in writfag
I reqnest this auiio~iaa bc - ' . .
oar bailding P~aaita aa ac~~-expedTBously. as t0 aot de[ay in tke
Y fuz~ct: Efcaac caIl mc if tltctc ~~B of
r contacted at 763-5(Y1-4706. ~mY qQationa., I can Ua -
Your immpmaft Wention to ~ m~ter is 1 atett.
Slnoefely, . .
ymonci'R '
ostallation &AzZnag'_C_r
•
Rcn
awa[ bY Attdersctt Cotporatiott . .
C'.c:: Tiarn_~?~PrSnnec . .
y oH o.
~a"m°"°°~,,,,,nZpq~ .
Recsived Time Jun. 7- l~OIPld
C:1:7Y f1F CA(.,AN
CAShl7:E'.fte S 1I-RMINrIi_ Npr. M
DATE;; 07/19/99 '1TML. 080D:41
II),
tdANE~ AAAMF.fiICAci B4:ST :I:NC
3210 3001 4236 5r-lhlT)STi]NE M.25
2155 9001 4236 SANl'STC7NI' 2.50
.
~
Tota1 Fiecei.pt, Nna.ini;: 1:13.75
Gfi:ll:3528
l.lSF::R :!:Ii a NANCY
lN/
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
~ ~ ~ ~ CITY OF EAGAN
3830 AILOT IiNOB RD - 55122
(651) 681-4675 n
~ - ~ ~ • ~ ~
New Constructian Reauirements RemodeUReoair Reauirements
? 3 registered site surveys ? 2 copies af plan
? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ? t sfte surveys (eMerior additions & decks)
? 1 enargy calculations ? 7 energy calculations far heated additlons
? 3 copias oi tree preservation plan if lot platted after 7/t193 required: Yes No
DATE: Z/ ff CONSTRUCTION COS7: ~~~UD•~~
DESCRIPTION OF WORK:
STREET ADDRESS: 7GY
LOT: BLOCK: SUBD./P.I.D.
Phone
Name: L qlal,61fl,
PROPERTY Lasi First
OWNER c ~ & 'Ikw ,
Sheet Address: c,.~
City State: - Zip: L~J l~-'~O~
Company: C' Phone
CONTRACTOR /
Street Address: (V License # 6M3094xp.
City State: r( Zip:
ARCHITECT/
ENGINEER Company: Phone
Name: Registration
Street Address:
City State: Zip:
Sewer & water licensed plumber (new construction only); . Penalty applies when address
change and lot change is requested once permit is issued.
I hereby acknowledge that I have read this application, state that t information i correct, d agree c ply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances. ~
~
, Signature of App oant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
OFFICE U5E ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex 0 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 0 15 Deck
WORK TYPE
? 31 New ? 33 Alterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
CENERAL INFORMATlON
Const. (Actual) Basement sq. ft, Census Code
(Allowable) Main level sq. ft. SAC Code
UBC Occupancy sq. ft, Census Units
Zoning sq. ft, Census Bfdg
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building Engineering . Variance
Permit Fee Valuation: $
Surcharge S,
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SNV Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies • •
Totah
% SAC t
SAC Units
EAGAN TOWNSHIP N0 1105
BUILDING PERMIT
Owner .....Yr......
Eagan Tawnship
Address (present) Town Hall
~ Builder
Daie _3!11.7A.x
Address
. _
.DESCRIPTION '
Stories To Se Used For FronS Depih . Heighf Esi. Cusf Permif Fee _Remarks
oc..C ~L 5,.r , _
7 i/ ?
-
LOCATION
S1reel, Road oz oiher Descripiian ot Locaiion Lo! Black Addilion or Trac!
~i~- ~ ~-r- ~ 3 .--,6E ~f . r7 - ~ 9 ._-a s
27
This permii does not au3horise the use of sireals, zoads, alleys or sidewalks nor doea ii qive the owner or his agent
She righi !o czeale any sifuaiion which is e nuisanae or which presenls a hasard !o the healih, safety, convenience and
general welfare So anyone in the community.
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGAES5. ~This is So cerlify' lhaf A _ C0 -..........._--haspermission !o esect a---~........_... - upon
2he above described premise subject io the provisions of the Building Ordinance for Eagan wnship adopl~'d Apzil 11,
1955. a4 .._..._..........._.STi?'rir......,C?./.._..lC....--.""."?,-------_..._..... Per ...--.....~`Jc
Chair`man of Tnwn Soard~ Building Inspeclor
6.
EA[3AN TOWNSHIP
N° 1356
BUILDING PERMIT
Ownez Eagan Township
Address (preseni) . ...-~µJ...... Town Hall
Builder..a~-v~^~.'y`~~.1--... 0.!........................
/-~J ~laS~GSJ
Address _'-T~'~7---~~ _ Dale
...~...lCN".
l%
DESCAIPTION
Siories To Be Used For F:oni Dep1h Heighi £s1. Cosf Permii Fee Remarke
.7-0 Z 1 / 3~~- 1-0
LOCATION
Sireef, Aoad or ofher Desesipiion of Location I Lo! Block ~ Addifion or Tracf
I /d/ a-
Thia pesmit daes aof auihorise the use of sireeis, roads, alleps or sidawalks nor does if give the owner os his agenS
the righi !o creaie anp siiuafion which is a nuisanee or which presents a hazazd !o the healih, safely, eonvenience and
general welfare to anpone in the communilp.
THIS PERMIT MUST BE ~g/E~PT ON THE PREMISE WHILE THE WORK IS IN PROGRESS.
~ ---------------...has permission !o erect a_..-_....--- upon
This is Yo cextifY. ihal---,.../....- _
!he a6ove desesibed premise subjec! !o ihe~rovisions of the Building Ordinance for Ea Tow ip adopied April 11.
-
19 . 55. -
..~..Y--.-": ..T-..._... Per ° --."&7
--.ll ~ ac
Chazrmaa of Tmmn Boerd Builing Incpeetor
cl -/.3.
, . , .
zv
~
~
.~ernar~r ~drSan ~
Sdh~sfon
~uo j
004 RESIDENTIAL BUILDING PERMIT APPLICATION
. City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Consirucfion Reouirements RemodeVReoair RequiremenLS ONice Use OnN
3 registered site surveys showing sq. B. of lot, sq. fl. of house; and all roofed areas 2 copies of plan CertotSurvey Recd _Y., N
(20°k maximum lot coverage allowed) 7 set of Eneryy CakuWtions for heated addNons Tree Pres Plan Recd YN
2 wpies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions 8 decks Tree Pres Required 7N
i sel of Energy Calculatlons Addifion - iMicate iI on-site sep6c sysfem Oi~sile Septic System Y' _ N
3 copies of Tree Preserva6on Plan if lot platted afler 711193 -
Rim Joist Defail Options seleclion sheet (bldgs with 3 or less units
Date rt ~ O
V 1 Z/ OS Construction Cost 6&o
SiteAddress eAw m ~jtS4k~te #
! h ~
Description of Work
Multi-Family Bldg _ Y ? N Fireplace(s) _ 0 _ 1 _ 2
II'4
Praperty Owner Telephone # ( &5! ) Si~5-50Z,3
Contractor (,n.ubUTIJ' ~yt,t.)60, ~y'7llc' •
Address 5~8 5 CA,Lmt., City
State Zip 5S3'73 Telephone #(g5Z)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Calegory 1 Worksheet • New Energy Code Worksheet
(4 submissiontype) Submitted Submitted
• Energy Envelope Calculatlons Submitted
Have you previously constructed a building in Eagan with a similor plan? _ Y _ N If so, 25% pian review
fee applies.
Licensed Plumber Telephone )
Mechanical Contractor Telephone )
Sewer/Water Contractor Telephone # ( )
I hereby apply for a Residential Building Permit and aclmowledge 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 State of MN
Statutes; I understand this is not a permit, but only an applicarion 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 ofplans.
I1jad? IM.S
Applicant's Printed Name Applican's Signahu
OFFICE USE ONLY
Sub Types
D 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex O 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement `Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tesu Final
_ Framing _ Siding _ Stucco _ Stone _ Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
_ Insufation _ Retaining Wall
Approved By: Buiiding Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
2006 RESIDENTIAL BUILDING rERMiT arrLIcaTiorr d,_ b
City Of Eagan ~
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construdion Reouiremenk RemodeVReoair ReauiremenLS Off~ce'llseANv
3 registered sAe surveys shaving sq. tt. of lot, sq. h of house; and all roofed areas 2 oapies of plan showing foobngs, beams, Jolsis CeR o( Survey,ReM ~ ~Y -N
(20%mauimum lot coverage aliowed) - 1 set of Energy Calculations for heated additions T2e Pres Plan Reoi =Y _N, .
2 copies of plan showing beam & window sizes; poured found design, etc. 7 site survey fw additions & decks Tree Pres Required Y=N
1 set of Energy Calculalions Addition - indicate ilon-sife sepfa sysfem - On-site Sep4c;System 'Y - N
3 copies of Tree Pmservafion Plan'rf lot platted after 711/93
Rim Joist Defail Options selectbn sheet (buildings with 3 or less unifs)
Minnegasco mechaniql ven6lation form
~ h 2/ DO
Date ~
Construction Cost Jb
'
Site Address En~ UniUSte #
Description of Work _ ~
Multi-Famity Bldg _ Y_ N 6 Fireplace(s) _ 0 _ 1
Property Owner ,61& Telephone ff (FiSI ) d SS "f LE 8.2
Contractor )40~
Address `YLp City
State Zip •55 K a p Telephone # (763 ) S s`
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submission rype) Submitted Submitted
• Energy Envelope Calculations Submitted -
In fhe last 12 mon}hs, has the City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, daTe and address of mosier plan:
Licensed Plumber Telephone )
Mechanical Contractor Telephone # ( )
Sewer/WaterContractor Telephone#~ )
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that tfie work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; 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'c> LE ~7" -y~-
ApplicanYs Printed Name Appli~cant's Signature
DO NOT R'RITE BELOW THIS LINE
Sub Tvoes
? 01 Foundation O 07 05-plex 0 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Firepiace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 EM. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvues
? 31 New ? 35 Int Impravement O 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 Replecement 'Demolition (Entire Bidg) • Give PCA handout to applleant
DeSGfiptlon: WaterDamage_Yes
Valuation Occupancy MCES System
Plan Review 100% or 25%
Census Code Zoning City Water
SAC Units Stories Booster Pump .
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ Sheetrock
_ Footings (deck) _ FinaUC.O.
_ Footings (addition) _ FinaUNo C.O.
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Fina] _ Pool Ftgs Air/Gas Tests Final
_ Framing _ Siding _ Stucco Lath _ Stone Lath _Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
_ Insularion _ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge Treatment Plant
License Search
Copies
Other
Total
~j~'$. • ' ~
2006 RESIDENTIAI. BUII,DING PERMIT APPLICATION
1S1 City Of Eagan ~
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-695-5694
3 registwad si0e swveys showitg s9. ft of bt s9. it of hase; and d roo(ed a , I? 4aP~ of ~=bwMalt
(2114:madmumbtcoveraHeallwied) ' torh2 copies af p6n show6g hwm dviindaw sl: paved kwd des1An. ek. ded1setMEne~gyCalaAafirns Ptlc.
3 croPles of T2e Preswvation Plan tl Wt platled afler 711193 JA ~I Y 8 2007
Rtr .
n Jdsl Detall Optlats selecilon sheet (Mutdinps.witli 3 or less unlLs) y
IvHmegasco mec6mmcal veatilatlon fmm
Date l6Z Constraction Cost ~ 4~ 3~v
Site Address qj Unif/Ste #
1?escription of Work (3 v ' - -
Multi-Family Bldg _ Y_ N Ftireplace(s) _ 0_ 1 _ 2
y
, Property Owner 'F Telephone # (65`)
.
Contractor .
Addres4 Cfty 'c/
State -`'bW Zip by6 Telephone #(~y
, COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING .
- Minnesota Rules 7670 CaGegg)ry 1 Mimesota Rtiles 7672
Enel'gy CodO CatOgOry . Residentiel VentllaHOn Cfltegory 1 Worksheel • New EnergyCode Worksheat .
(Jsubmissionlype) Su6mitted Submitled
. . Eirergy Envelope Calwlations SubmiHed In the last 12 months, has The City of Edgan issued a parmit for a similar plan based on a master pldn2
_ Y _ N If yes, date and address of master plan:
Licensed Plumber Telephone # ( )
Mechanical Contractor Telephone )
Sewer/Water ConTractor Telephone )
I hereby apply for a Residential Building Permit and aclmowledge that the infortnarion is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the Sffite of MN
Statutes; 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 whioh requires a review and
approval of plans. '
4 ARb s o IU
Applic 's Printed Name Applicant's Si
DO NOT WRITE BELOW TffiS LINE
J • '
Sub Types
? 07 Foundation ? 07 05-plex ? 73 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling O 08 06-plex ? 16 Fireplace O 21 Poreh (3-sea.) 13 31 Ext Aft- Multi '
? 03 01 of _ plex ? 09 07-plex 13 17 Ga2ge ? 22 PorcFVAddn. (4-sea.) ? 33 Ext. Ak - SF
? 04 02-plex ? 10 08-plex ? 18 Dedc ? 23 Porch.(saeeNgaze6o) ? 36 Muw Misc.
? 05 03-plex ? 11 10-plex ? 19 Lover Level Q 24 Storm Damage ? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvues
? 31 New ? 35 Int Improvement O 38 Demolish Irrterior ? 44 Siding
? 32 Addfion ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteretion O 37 Demolish Building" ? 43 Reroof . ? 46 Windows/Doars
? 34 Replacement `DemolPoOn(EntlreBltlg)-GIvePCAhandouttoapplicant . DCSCriDNOO: WaOerDamage_Yes , Valuation Occupancy MCES System
Plan Review _ 100°h or _ 25°k
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units . Sq. Ft. PRV
# of Bldgs Length FireSprinklered
Type of, Cbnst Width
REQUIRED INSPECTIONS
_ Footings(¢ewbldg) Sheetrock ^ Foo4ngs (deck) _ FinaVC.0.
_ Footings(addition) _ FinaVNo C.O.
Foundation _ HVAC
Drain Tile Other
Roof Ice & Water Final _ Pool Ftgs _ Air/Gas Tests Fic~l
_ p~~ _ Siding _ Stucco Lath _ Stone Lath _Brick
_ •Fireplace _ R.I. AirTest Final Windmus
Insulation _ Retaining Wall
Approved By: . Building Inspector
Base Fee
Surcharge
Plan Review
MClES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatrnent Plant
License Search
Copies
Other
Total
Sep. 9. 2013 9:20AM All Elements Inc. No.0766 P. 2
411/` CityofEaaall
Date:
3830 Pilot Knob Road
Eagan MN 66122
Phone: (661) 676-6675
Fax: (661) 676-6694
Use BLUE or BLACK Ink
For Wilco Use
11345
Permit #:
Permit Fee: C15-5
Dale Received:
Staff:
Q 2013 RESIDENTIAL BUILDING PERMIT APPLICATION
1 13 Site Address: LI 2- 3 6 SandJt0rt, Or• Unit #:
Resident/
Owner
Name: A .1.„, (l v y Phone: 9 5-2 - Lr ry -610
Address / City / Zip; W 2 3 6 .5 n►,, dstor c or- E O3 f'W .c.5-12. L
Applicant Is: Owner Contractor
T e of Work
Yp
Description of work: rr - roo f 4- 9 v+Ft e S
_
Construction Cost: IO 3 (5, Fc Multi -Family Building: (Yes / No�,)
Contractor
Company: fill e(ent's Zeit, Contact: t_ jj - 3 rr[,
c�
Address: 13'4/ pto/NJ ni Glrek City: non f;reify
State:. ! JA/ Zip: 5-Y36 2 Phone; 76 3 - 202 - 6 3 416
License #: 6C-3 2 3 S4/0 Lead Certlflcate #: R-1- Xi' d y -/D -1)2 C606)60 I)
If the project is exempt
from lead certification, please explain why: (see Page 3 For additional information)
In the last 12 months,
No !ryes,
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?
date and address of master plan:
_Yes
Licensed Plumber:
Mechanical Contractor;
Sewer 8 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, Cat Gopher State One Call at (651) 454.0002 for protection against underground utility damage. Cali 48 hours
before you Intend lo dig to receive locales of underground utilities. www.Qopherslateonecall.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 or work which requires a review and approval of plans.
Exterior work authorized by a building permit Issued In accordance with the Minnesota Stale Building Code must be completed within 100
days of permit Issuance. 11,,
x
Jufrr
� �%irtIN
Applicant's Printed Name
Applnt's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA159139
Date Issued:11/22/2019
Permit Category:ePermit
Site Address: 4236 Sandstone Dr
Lot:14 Block: 1 Addition: Cedar Grove 2nd
PID:10-16701-01-140
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 -
Adam J Ray
4236 Sandstone Dr
Eagan MN 55122--202
(952) 454-6108
Home Depot Usa Dba The Home Depot
2455 Paces Ferry Rd
Atlanta GA 30339
(763) 852-1044
Applicant/Permitee: Signature Issued By: Signature