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4265 Sandstone DrDate: City of Ea�an 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit#: /� f/ d Permit Fee: Date Received: Staff: o� 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address: Unit #: RESIDENT / OWNER Name: A NS . Lt C. Phone: 6-f z- 2_9 Q ty 990 Address / City / Zip: k--(2, 6 o INI d b AN. Applicant is: K Owner Contractor TYPE OF WORK Description of work: A Ai eg r e,s lkj it 11 01 Construction Cost: 1 Z., 0 0 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 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.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x AbduRa)1 Mort A(JO Applicant's Printed Name Applicant's Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Fireplace X, Single Family Garage Multi Deck 01 of Plex Lower Level Accessory Building WORK TYPES New Addition Interior Improvement 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) Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: Ice & Water Final Framing Fireplace: Rough In _Air Test _Final Insulation Sheathing Sheetrock Reviewed By: / !' 1 L— 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 MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: Final / C.O. Required Final I 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 RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 1N SYLC,'1'lUN KEUUK1) CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: ~E7'dgan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: • ~ i , i . ~ ' ~3'. 1 ~ I ° ~ . PERMIT SUBTYPE: TYPE OF WORK: INSPECTION D. • . F J L Permft Holder Date Telephone # PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ~~ayy ROUGH PIUMBING PLBG AIR TEST FOUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIFiEPLACE - - - - - AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVIIY 7EST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CITY OF EAGAN Remarks ACqtiiS3.t10I1, CAdAY' Grove Addition Cedar Grove #2 Lot 8 Blk 2 Parcel 10 16701 080 02 Qwner l r':i., r.! • ~li%! 11 1 Z,i 4 f fi~ Street 4265 Sandstane Dr. State Eag2?1T N 551 2P ~Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 8 1 1 STREET RESTOR. GRADING SAN SEW TRUNK ~ SEWER LATERAL 1972 1 WATERMAIN # WATER LATERAI. 1972 WATER AREA STORM 5EW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK . . . . . . . . v . _ ...°'f:, 1F., p.~. . - . p. . ' . - . . CITY OF EAGAN ~ t o' oo 3830 Pilot Ftnob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING RERMIT Receipt #~r 1 t, To be used for REWpEL Est. Value Oq,300 Date JtFLY 20 , 19 ~ Site Add ss 4265 S~DS~~ pR Lot ~ Block Sec/Sub. OFFICE USE ONLY Parcel No. occupancy - FeES SXLL HI1IlAidl zoning - 31.00 ¢ Name (Actual) Const - Bldg. Permit o Address TONE DR (Allowable) - ~.pp Surcharge City AA Phone 456-9380 # of Stories - Length _ Plan Review ~ R GONBTRiICTIOFi Zo Name ~AVE NW Devtn - saG ciiy ou Q Address S.F. Total - SAC, MCWCC ~ City WASECA Ph0112 507) $35"83 S.F. Footprints - On Site Sewage _ Water Conn ~ W W Name On Site Well - Water Me1er x MWCC S stem - Addre5s y Acct. Deposit <W City Phone caywacer - PRV Fequired _ SAN Permit I hereby acknowtege that I have read this application and state that the Booster Pump - 5/w Surcharge information is correct and agree to comply with all applicable State of Minnesota Slatutes and Ci ol Eagan Dr¢enance Treatmenl PI - ' - G~~ APPROVALS ~ignatura of Permitee Road Unit A 8uilding Permit is issued to: M R CQiYSTRUCTION Planner - Park Ded, on Ihe express condition that all work shall be done in accordance with all Council applica6le Slate of Minnesota Statutes and Gity ol Eagan prdinancas. g~. Off. _ Copies 32.W Building Official y' •Variance - TOTAL Permit No. Permit Holder Oats Telephone # WATER SEWER PLUM&G H.V.A.C. ELECTRIC Inspecilon Date Insp. Comments Footings I foundation ' Framing Roofing Rough Plbg. Rough Htg. Isul. Freplace Fnal Htg. Fnal Plbg. Const. Meter Plbg. Inspector - Notify Plumber Engr.lPlan Bldg. Final 4 G - c 'r Decic Fi9. ~l H / P ~ L</4 Dedc Final < IeZ - Well Pr. Disp. ~ CITYQFEAGAN ~ 3830 Pflot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100 BUILDING PERMIT Receipt # To be used for `Est. Value 1~Date ,19 Site Address OFFICE USE ONLY Lot Block ` Sec/Sub. On Site Sewege accupancy MWCC Syatem Zoning Parcel No. On Site Well (Actual) Const e Name City water (Allowable) W PRV Requlred # of Stories 3 Address p Booster Pump Length City Phone Depth , o Name S.F.Total o ~ Address Footprint S.F. d U~ City Phone APPROVALS FEES Engr./Assess. Permit yU W Name ~ g Address Planner Surcharge `W City Phone Council Plan Review Bldg. Off. SAC, Ciry I hereby acknowledge that I have read this application and state that the Variance SAC, MWCC information is correct and agree to comply with all applicabte State of Water Conn. Minnesota 5tatutes and City of Eagan Ordinances. Water Meter Signature of Permittee Road Unit A Building Permit is issued to: Treatment P1 on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Parks Building Official_ TOTAL ' Permit No. PermR Holdar Date Telsphone ~t Plumbing H.V.A.C. Electric Softener Inspaction Data Insp. Comments Footings I Footings II Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Final Plbg. Bldg. Final Cert. Occ. Temp. LP Deck Ftg. Deck Final Well Pr. Disp. L ~ C . G • ~ ,~j This request void l 7 18 moniiis from 00447 Date ~of ~t Request Fire No. S 1 I, as Y7Licensed Electncal Contractor OOwner, do hereby request inspection of the above electri- cal wiring ins[alled at: Street Address or Route No. Section Township Range County,[r~~t~s Which is occupied by (Nama of OcCUDant) Is a roughin inspection required on this job? No ? Yes ? Ready Now ? Will CaA§~-_ Power Supplier Address - y .~,~~6~ Electrical Contracto~~/'t>Ga ~ontractor's License No. s Addre ~ ~'d. Mailin W-17 ~~m(Elye tric tr ctor or O n Making Thls Installatlon) Authorized Signature ~fJ~~z Phone No~.~i~s~- - (Electrlcal Contnctof or Owner M ng Thls InstallBtlOn) / ~~~Q~ j ~ rJ` This iiupectian request will not be acceptad 6y the ~ State Baard unless proper inspeetion fee is enclosed. • c.:am o- uBC[l1CR Griggs Midway Bldg. - Room N791 ng EH-00001-02 ~ 1821 University Ave.. St. Paul, Minn. 55104 - Ptwne 297-2111 !$EQUEST FOR ELECTRICAL INSPECTION ~ I CHECY BELOW WORK COVERED BY THIS REQUEST S100447 Type o( Building New Add. JR111111ep. Gheck Appliances Wved For Check Equi pment Wired Fm Home ? ge Temporary W'ving ? Duplex er Heater ? Lighting Fixtuies ? APt. Bld8. ec ? Electric Heating ? Commercial Bldg. ace ? Silo Unloader ? ]ndus[rial Bldg. ??Conditioner ? Bulk Milk Tank ? Farm List Othec ~ ~ isOthers~ ) Eiere 7 COMPUTE INSPECTION FEE BELOW Selvice Envance Size: # Fee Fceders&Subfeeders: x C"ucuits: # Fee 0 to 100 Am s. 0 to 30 A s to 30 Am eres 101 to 200 Amps. ~ 31 to 100 ' s.] to 100, m eres Above 200_Amps, Above 100 u.~Amp~; • Above 100 Am s. Transformers RemoteCon ICi . Panialorotherfee S' ns S ecial Ins ection Minimum tee $ Remazks TOTAL F Q . I, the Electrical Inspector, hereby cer ' at e ifispection has been e. (Rough-in) (Final) Date .-A% Date This request void 18 months from ~ ~ HM . IY° ].061 BL91LD9Nrm PERM1T ~ -:Ownex C~ ~ . . + ~ Eagan Township ' Addres4 (PresenS) ~~r~'1~ Town Hall I Builder~ V > Addres . . . . Date . DESCRIPTION 3tones ~ To Be Used For ~ Fronl. Depih Heigh! Esf. Cost Permif Fee Remasks 0 - LOCATION - ~ ~ Sireef, Road or other Descnphon of Locahon LoS Block Addition or Tract 17 .,/Gf - ;;~.tl- 3.' _24 ' .-3 - . This permit does nof - auShorise- the use of sireels, roads, alleys or sidewalks nor does if give the owner or his agenf , the rigkii !o cieaie any siiuafion which is a auisance ar which presenfs a hazard 30 the heallh, safely, convenieneC and generali welfare !o anyone in the communi2y. - - ~THIS PERMIT MiTST SE KEPIT, Og/y THE PREMISE WHILE THE WORK IS IN PROGAE55. ~ This is'to cerSify: iha1...L? haspermission !o erecl e-~/.L? p~ t. ...........y7~...... upon ~ the ahove desaribed premise subjed So the provisions of-lhe Suilding Ordinanae for Eagan T wnship adopie@' April 11, ; .......i..:IdS.~-la~a.N~i1."---... Per ........-----(/+YLd'.^.~~`'. ...'P.~!:'`.fR .p . Chairman'of Tnwn Board . 0 Su_' in Inspector ~3.isf;~;:3';.•s4:i~~~czczcr,aac~n;ct~'axcr~r~r~~c,:~;a,~czc~cr.cz'~;u<ro;;~c CITY OF EAGAN CASHIER: S TERHIi+tAf_ NDa 782 iWTE: 06/22/98 TIM=: 14:ii:''c7 m~ KAME: CHRISTQ°HEF C SKA\SQ?t 3210 9003 4265 SANDSTONE 23.E10 2155 9001 4265 SANDSTQNE 0.50 Total Receipt Amoilnt: 21.50 CR033i40 USEF SL: NRNCY ic:tY,cY,cY,:Y,cY,c$:x:>:ng~CY,;r;7,c~tYcrc%:S~t;~:cX•~;:ti;Sc~c~ r~c~SY~%>>:G~>.a.c>;.xc PERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 0 3 2 2 9 2 (612) j81:4fr75 Date Issued: 0 6/ 19 / 9 8 SITE ADDRESS: 4265 SANDSTONE DR LOT: 8 BLOCK: 2 CEDAR GROVE 2ND P.I.N.: 10-16701-080-02 DESCRIPTION: RESHINGLE Btr3ltliit`_Permit Type SF (MISC.) Building Work Type ALTERATION f!`Census Code 434 ALT. RESIDENTIAL ~ _ ( . ~.-~.t~-. = - ~ REMARKS: FEE SUMMARY: VALUATION $500 Base Fee $21.00 Surcharge $.50 Tatal Fee $21.50 CONTRACTOR: OWNER: - Applicant - ~ SKANSON CHRIS 4265 SANDSTONE DR ; EAGflN MN 55122 (612)452-2752 2 hereby acknowledge that I have read this appliaation snd state that the _ information is correct and agree to camply with a11 applicabl.e S te of Mn. StaCutes and City of Eagan Ord'inances. , PLICANT RMITEE SIGNATURE ISSUE B. AT 322a ~1 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) - ~ ` CITY OF EAGAN 3830 PILOT KNOB RD • 65122 681-4675 1 New Construction Reouirements RemodeUReoair Reauirements ? 3 registered sfte surveys ? 2 copies of plan ? 2 copies of plans (inGude beam 8 windav aizes; poured ind. design; etc.) ? 2 sRe eurveys (erzterior addkions & dedcs) • 1 energy calwlations ? 1 errergy celculetions for heated addftions ? 3 wpies of tree presenation plen if lot platted a@er 717f93 ' required: _ es No DATE: CONSTRUCTION COST; DESCRIPTION OF WORK: i a(`n STREET ADDRESS: Qr, ~ LOT: C BLOCK: SUBD./P.I.D. Name: I~or~Sc?1 C6 r6% Phone PROPERTY Lest First OWNER Street Address: s„ rl .t -P 0! Ciry rq state: zip: 'S 5 ! ~ c~-- Company: Phone CONTRACTOR Street Address: License # City State: Zip: ARCHITECT/ ENGINEER Company; !Y ' 7 Phone Name: Registration Sheet Address: City State: Zip: Sewer & water licensed plumber (new construction only): Penalty applies when address chang and lot change is requested once pertnk is issued. i hereby acknowledge that I have read this applicaGon and state that the information cortect and agree to comply with all applicabl State of Minnesota Statutes and City of Eagan Ordinances. Signature of Appliqnt: OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No _ Not Required OFFICE USE ONLY BUILDING PERMIT T1fPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ? 02 SF Dwelling ? 07 4plex O 72 Multi RepaiNRem. ? 17 Swim Pool ? 03 SF Addition O 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility ? 04 SF Porch ? 09 12-plex ? 14 Firepiace , O 21 Miscellaneous ? 05 SF Misc. ? 10 = plex ? 15 Deck WORK TYPE ? 31 New ? 33 Alterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (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 APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W 5urcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: °k SAC SAC Units , CITY OF EAGAN Np ~ 8 ~ 80 . 4 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE:454-81D0 BUILDING PERMIT Receipt # / To be used for 1tEMODEL Est. value $1, 300 Dale JULY 20 , ~g9~ Site Address 4265 SANDSTONE DR 8 2 CEDAR GROVE 2N0 OFFICE USE DNLV Lot Black Sec/Sub. P2fCEl NO. Occupancy - FEES Zoning _ w Name BILL MADANI (ACiual) Const - Bldg. Permil 31. 00 . ~ Address 4265 SANDSTONE DR (Allowa6le~ - Surcharqe ~_nn City EAGAN Phone 456-9380 soisiodes - , Lenglh _ P~an Review , o Name M R CONSTRUCTION Depth - SAC, Ciry Address 421 14TH AVE NW s.F.TO~ai c°~< ~ - SAC,MCWCC ~ CISy WASF.CA PhOnB (507) 83L~9 S.F.FOOtprints - On Sile Sewage _ Water Conn ~ W w N8m8 On Si~e Well - Water Me~er ~ MWCCS stem Address Y - Acct. oeposi~ aw City Phone c~rywaier - PRV Required _ 5/W Parmit I hereby acknowlege that I have read this application and state that the Booster Pump - g/yy Suroharge information is correct and agree to comply with all applica6le State ol Minnesota Statutas and C~ of Ea n Or ~ ance Treatmant PI (~SignaWre of Permitee APPHOVALS qoad Unit A Buildinq Pertnit is issued to: M R CONSTRUGTI ON Pianner - park Ded. on the ezpress condition ihat a~l work shall be done in accortlance with all Council applicable State ol Minnesota StaWtes and City of Eaga,an Ortlinances. Bltlg. Olf. _ Copies ~fl R~1 ~}l Yl Varianca - TOTAL 3Z.00 Building OHicial z ~f-j-h I--"~' 1990 BUILDING PERMIT APPLICATION CITY OF EAGAN SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGISTERED SITE StIRVEYS - & STRUCTURAL PLANS 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS # OF RENTAL UNITS # OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF P$RMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE~ ADDRESSES FOR CORNER LDTS - CONTRACTOR/NOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALIAWED ONCE BUILDING PERMIT IS ISSUED. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWD DAYS ONCE A PERMIT HAS BEEN COMPLETED. PERMIT MUST SHOW A LTCENSED PLUMBER. ~aWS To Be Used For~~n0 de, Valuation: ~3 Date: l I~ X Site Address OFFICE USE ONLY Lot ~ Block FEES Occupancy Zoning Parcel/Sub Actual Const Bldg. Permit ~I• 0 Q Allowable Surcharge d ~ Qianer # o£ stories Plan Review Length SAC, City Address ja~~o~ Depth SAC, MWCC S.F. Total Water Conn City/Zip Code Footprint S.F. Water Meter Acct. Deposit Phone 545 9.32-0 On site sewage_ S/W Permit ,p On site well S/W Surcharge X Contractor MWCC System _ Treatment P1. ~ ^ /City water Road Unit Address (~,cr2 , /~y.UV. PRV Park Ded. Booster Pump Copies City/Zip Code SUBTOTAL APPROVALS Penalty P h o n e 70 7 -.2- 3 S~ Z390 Planner _ TOTAL Council Arch./Engr. Bldg. Off. Variance Address City/Zip Code Phone # . . ~ ~ ~ ~ t ~ ~ ~ ~ EAGAtV 'T'OWNSHIP N~ lsso BUILDING PERMIT Owuec Ea9an Township '4--~-<__--- Town Hall Address (presenf) Huilder (1.[ -'-'-c / Dale ~ l.314.I . Address DESCRIPTION Siosias To Be Vsed For Fronf Depih Heighi Esf. CosS Permii Fee Remazks ~i d2 z , 2 LOCATION Sireei, Road or olhex Descripiion of Locafion _I Lo! Block ~ Addition or Traei This permit does nof aulhorise the use of sizeels, roads, alleps os sidewalks nor does iY give the ownes or his agenf the rig'a2 Yo ereaSe anq sifuaiioa which is a nuisance oz which presenis a hazard fo the health, safe2y, convenieace and general welfare io aayone in the eommuniiy. THIS PEAMIT MVST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. - . This is io ceriifp, ihai.......... -"-'--'.........has permsssioa to ereci a . . upoa the above described premise subjee! !o the pzovisions ot the Building Ordiaance for E n Towns ip adopfed April 11, 1955. Per _ , .:......__"..:...'.'_K. ._Q_..._..._"'..... Chairmad of Tnwn Board Suil~in InsPecior „ • 8T' G!"~,vP -D.75 t, . "O . ~ . ~ . ;:J e~ _ _ f c - ~r•-. - ~ F. C. JACKSt3N _~z~ ~ LAND ii1RMlYOR f+ . ~ ...a . •.~....~:...r. - - 1 Ri~1wT~REO 4N0[R LAWL OI tTAt= QF Y!lMf=W=A r~ LtCW~iD EY ORDINl.MCS OF C1TY OI MiMN6AM0106 ,i ~ 3614 EAfT 587N 5TR[ET PA. 4-4681 . ~ • ' 'L A" .r • i `x` * . 'X~~N~• ~ . • ~ ~ , 120 - _ ~ ~I ~ ~ ~ ' ,F~~• kY ~ 7V ~ n , ; . ~ , S t P ~ 120 1 z4 1 HLRiSY CEATIFY 7MAT Ttlt AiOYt 1! A TpU[ AIdD CO1MMfGT RAT OI? AWLIRMRY QW . t mortgass Sv te'T ~ : ~ ~ Lot 8,Bloak 2Oodar Oro" Na, E, Ee.gtn `~b~rnulaip.L' akot?s Got~ttl?xicmsot,A?. < ~ 4t.h. Oot. 19~5 ~ J : _ . , , _ A• •URVtYtD BY Mt ?M1B--.- owv w ~ F. C. Jemoo"• Mw1lwM*A CITY OF EAGAN N! 14 617 „ ^ . 3830 Pilot Knob Road, P.O. Box 21 •199, Eagan, MN 55121 . PHONE:454-8100 O ~ BUILDING PERMIT Receipt# d To be used for FIREPLACE INST. Est. Value $1, 000 Date ,19~ Site Address 4265 SANDSTONE DRIVE OFFICE USE ONLY Lot 8 Block 2 Sec/SubCEDAR GROVE 2ND On Site 5ewage _ Occupancy . MWCCSystem _ Zoning Parcel No. On Site well - (Actual)Const a Name BILL MADONI Ciry Water _ (anowable) ; 4265 SANDSTONE DRIVE PRV Required _ # of Stories Address Booater Pump _ Length ° City EAGAN phone 688-0977 Depth , o Name HEAT--GLO FIREPLACE S.F.TOtai ~Q Address 3850 W. HIGHWAY 13 FootprintS.F. m Ciry BURNSVILLE phone 890-0758 pppppVALS FEES ~ ~nn ~ W Engr./ASSess. Permit ~=_vv_ W W Name ~ i Planner Surcharge .50 i- Address aw City PhOn@ Council PlanReview Bltlg. Off. SAC, City I hereby acknowledge that I have read this application and state that the Variance SAC, M WCC intormation ia correct and agree to comply with all applicable State of Water Conn. Minnesota Statutes and City of Eagan Ordinances. Water Meter Signature of Permittee - Road Unit A Building Permit is issued to:. _ ' Treatment P1 onlheexpressconditionthatallworkshallbedoneinacc*0m.rces. wdhall applicable State of Minnesota Statutes antl Cityof EagaParks ~ / TOTAL 24.50 BuildingOflicial y r ~ L 1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS INCLUDE 2 SGTS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTEs ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESZGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS Ik OF UNITS INCLUDE 2 SETS OF PLANS, CEHTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COtMIERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS / CTI To Be Used For: daluation: Date: Site Address OFFICE USE ONLY Lot ~ Block Z ~ On site sewage= Occupancy ~j MWCC system Zoning Parcel/Sub jdfD!St On s3te well _ Actual Const n City water Allowable Owner ~ILL [/~zv1 PRV required _ It of stories Booster Pump _ Length Address ~7/o Depth S.F. Total City/Zip Code Footprint S.F. Phone L(~d 7 7 APPROVALS FEES Contractor ' I ~ Engr/Assess Permit Planner Surcharge .ria Address ~r> Council Plan Raview Bldg. Off. SAC, City City/Zip Code~iil~lil-~h~-2~ Variance SAC, MWCC Water Conn Phone Water Meter Road Unit Areh./Engr. Treatment P1 Parks Address Copies ~ + TOTAL City/Zip Code I Phone ll As sz) zoos RESIDENTIAL PLUMBING PeRmiT aPPLicaTioN CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. ' Date 1 1 Site Street Address ~ z Unit # Property Owner ~ Telephone # ((W)~9i~• /6.2f 7 Teleph Contrector / one# (~-1~.~2~)~"3~ 2~'D ~-m ~iviJ l.(~iT~~' e P2 Address 1''4^•ffS~& City 1:;~/sLLP_ State)724)_ Zip~ The Applicant is: _ Owner iContractor _,Other Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Include$ Co0~nt~fee Per as-built $ 10.00 Alterations to existing dwelling $ 50.00 Add plumbing fixtures. This fee includes instailation of a water softener and/or water heater at the same time. !f you are installing only a water softener and/or water heater, do not complete this section; move to the next section and check the appliance(s) you are installing. _Septic System Abandonment WaterTurnaround (add $130.00 if a 5/8" meter is required) Other: ~ Water Softener _ Water Heater $ 15.00 new ~ replacement Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00 $ 50 State Surcharge $ T$ / I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I understand this is not a permit, but oniy an application for a permit, work is not to start without a permit and work will be jn acco dance with the approved plan in the event a plan is required reviewed and approved. ~ p ticant's Printed Name Ap lic s ~----------------i ~ ~,•flH_'ice°;Cise Pe City of Ea~aIl j rmd # I Permit Fee: I 3830 Pilot Knob Road Eagan MN 55122 ~ Date Received: ~ j Phone: (651) 675-5675 i Stafr: i ~ i Fax: (651) 675-5694 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: O,3 Site Address: i 1- 415- J a nci J~ on Ltbr Tenant: Suite RESIDENT I OWNER Name: 6 Phone: Address / City / Zip: Applicanl is: _ Owner ~ Contractor TYPE OF WORK Description of work: /'S ~ R Br) Construction Cost: nn Multi-Family Building: (Yes _ / No ~ z~9~t8~o CONTRACTOR Name: ' ~ n~ 'j ~ License zb , Address: 1 D ddI WCV N City: ~ State:~^^~ Zip: C S ~ Phone: ZZ. -1 aLNZ Contact Person: 5tCJZIe., V JJ~ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category t Worksheet • New Energy Code Worksheet Category Submitted Su6mitted (4 submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a pertnit 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 documen_ts ttiat you submIt aie considered to be public ~nformabon; Portions of :i the mformatron may be dassrfied as non publ~c'~f you provede specirlc reasons that would permit 6the Ctty to ts ~ 4` . . ~ , ° _ . __-concludethat iFie are trede secre 1 hereby acknowledge that this information is complete and accurate; that the work will be in conform ' t ord an d c des of the City of Eagan; that I understand this is not a permit, but only an application for a permit, work is no to s witho t a R; th he work will be in accordance with the approved plan in the case of work which requi2s a review and a va f~ lans x ApplicanYs Printed Name ApplicanYs Signature Page 1 of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ri CityofEaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 MAY 202016 r Use BLUE or BLACK Ink For Office Use 1 Permit #: /_3670 0 1( Permit Fee: _,`/ 7-. 6 0 Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit #: eSl@trq Owner l Name: 6A/S L$$ LLL Phone: _ Address / City / Zip: Y21' S sal& I �i i/2/ ) f �i2 'f.�� Applicant is: Owner Contractor .$ '�It>'1�C �$ Description of work: r�J,^ ,S t%✓71(.}7 Eil �%d '` LI /7%(% ®t !� 71//061/99-7-4001 ilk (Yes / Na)( ) Construction Cost: 500 Multi -Family Building: *,r Crttr C £ ` Company: ^Mikc_(Lt)$6-4.;/(6/ d %) Cofl) Contact: 74:11 - C / 6-4 �If:) /<677{V (-k C -E /1 City: ArooId- /i7 4. ow Address: S17/163–/'2 _ ��// C_ State: 41 Zip: rJ %l/l Phone: 6/ 2 2?6 3 Email: f& 0/J/?, 1W5 er(% i, /%69)7' License #: iSGG 9 1/7 Lead Certificate #: If the project is exempt from lead certification, please explain why: In the last 12 months, Yes No COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUDING has the City of Eagan issued a permit for a similar plan based on a master If yes, date and address of master plan: Plan? Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Fire Suppression Contractor: Phone: Phone: Phone: Phone: N+DTL. submit are ® tiered fo be p • , the 1 ®v n y ® ie�d a o» public if you provide circ seasons a concludeat theare trade re.• x tion.0 4 s ®= it th Citi CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground itility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that 1 understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. Applicant's Printed Name x Applicant's Signature Page 1 of 3 `7c 6S 4 2s7/26 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation �i )Single Family {{ Multi 01 of _ Plex WORK TYPES New Addition '4 Alteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (25% 100% ) Census Code # of Units # of Buildings Type of Construction Fireplace Garage Deck Lower Level 15191 Interior Improvement Move Building Fire Repair Repair Va REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Roof: Ice & Water Final Framing 30 Minutes 1 Hour Fireplace: Rough In Air Test Insulation Sheathing Sheetrock Fire Walls Braced Walls Shower Pan Reviewed By: Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width Final Siding Reroof Windows Egress Window Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Accessory Building _ Demolish Building* Demolish Interior Demolish Foundation Water Damage *Demolition of entire building — give PCA handout to applicant yiiikV013 MCES System SAC Units City Water Booster Pump PRV Fire Suppression Required Meter Size: Final / C.O. Required Final / No C.O. Required HVAC _ Gas Service Test Gas Line Air Test Pool: Footings Air/Gas Tests Final Drain Tile Siding: _Stucco Lath Stone Lath _Brick Windows Retaining Wall: _ Footings _ Backfill _ Final Radon Control Fire Suppression: _Rough In Final Erosion Control Other: , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL o-� Page 2 of 3 4,1111' CityofEaaii 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651 ) 675-5694 Use BLUE or BLACK In 4\LII For Office Use I. Permit #: 7._-_- 71" > Permit Fee: LSC " °i I� Date Received: C Staff: L 2016 RESIDENTIAL/PLUMBING PERMIT APPLICATION Dale: �I z 7!)�/ ) fc Site Address: 71;5- 5 /kv' Sra it,r 1-��• Tenant. • Resident/Owner r / C- k Name: A- (tel/ h"e--g- A- 4,15.- I ` Phone: ms) Z - Z-90 -4/1'9 s� Address / City / Zip: ContractorAddress: Name: - j E R TY �L a i' 13 ; p'I) c License#: 3/11 b 3C)C) 9 Zr 2_Z 7 f- 14110- City: r5 6 -1- (-- State: /1-1 Pi Zip: 5-50 cis" Phone: 76 7 .' 2 6 - 2 /8 S Contact: k 2 `% Sk P -k- Email: Type of Work — New _ Replacement Repair Rebuild Modify Space Work in R.O.W. — — — — Description of work: r>i}-r&V'lel. r\ -- C 13rrl 7(t s .1- 0 0 tic:- 2=RESIDENTIAL Permit Type RESIDENTIAL Water Heater Water Softener Lawn Irrigation ( RPZ! PVB) Add Plumbing Fixtures ( Main / Lower Level) Septic System _ Water Turnaround New Abandonment RESIDENTIAL FEES: $60.00 Water Heater, $60.00 Lawn Irrigation $60.00 Add Plumbing "Water Tumaround $115.00 Septic System Water Softener, or Water Heater and Softener (includes State Surcharge) Turnaround" (includes State Surcharge) TOTAL FEES $ (includes State Surcharge) Fixtures, Septic System Abandonment, Water (add $280.00 if a 3/4" meter is required) New (includes County fee and State Surcharge) 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.gooherstateonecall.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 pJ9ns. x Applicant's Printed Name x Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough -In Air Test Gas Test Final Meter Related Items: Meter Size Radio Read Manometer Staff: i. d 17ZZ l. -Z11 -£9L Auedwo0 6ulgwnld AJegll d06: LO 96 6Z unr PERMIT City of Eagan Permit Type:Building Permit Number:EA140408 Date Issued:12/19/2016 Permit Category:ePermit Site Address: 4265 Sandstone Dr Lot:8 Block: 2 Addition: Cedar Grove 2nd PID:10-16701-02-080 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). 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 - Answer Llc 211 Lake St W Minneapolis MN 55408 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA140706 Date Issued:01/17/2017 Permit Category:ePermit Site Address: 4265 Sandstone Dr Lot:8 Block: 2 Addition: Cedar Grove 2nd PID:10-16701-02-080 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Answer Llc 211 Lake St W Minneapolis MN 55408 (608) 516-5566 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA149895 Date Issued:06/13/2018 Permit Category:ePermit Site Address: 4265 Sandstone Dr Lot:8 Block: 2 Addition: Cedar Grove 2nd PID:10-16701-02-080 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. 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 - Jacobson T Mcdade 4265 Sandstone Dr Eagan MN 55122 Lofgren Heating & Air 5708 Upper 147th St W Suite 106 Apple Valley MN 55124 (952) 431-5811 Applicant/Permitee: Signature Issued By: Signature