4295 Sandstone Dr
CITY OF EAGAN
3795 Pila Knob Roed
Eagan, Minnesots 55122
PAone: 434-8100
Water 5aftener pERMIT No. 29~
16296,
Dote: Receipt No.:
Singie I x
Site Address• ~4205 ',andstone Pr-_?ve Residential
C ~ t
Lot ~ Block ---:-~ub/Sec. / ' Multi Res., Comm./Ind. I
; ~._,,:,ei~n `1itr_hell
Name New/Alter./Repoir
~ Addreu 4295 Sandstone Drive Cost of Installation
Ciry Eagan , b'~N Phone: Permit Fee S. r-r
~ Name _Zlilbert CO. CSW Surcharge '
g Address ' qDl Marie Ave.
~ City Phone: Totol .
This Permit is issued on the express condition that all work sholl be done in aaardance with all applicoble Stote of
Minnesota Statutes and City of Eagan Ordinonces.
Building Official
CITY OF EAGAN Remarks- Ced3T' Grove Acquisition
Addition Cedar Grovb #2 Lot 13 aik 2 Parcel 1 O 16 TOl 130 02
Owner,~O,ti`-- ~ ' Zi/l._'_.- ~~L'Street 4295 S3t1d8tpri8 DY'. state Eagan,MtV" 77122
Improvement Date Amaunt Annual Years Payment Receipt Date
STREET SURF. 8g 1985 1266.95 84.46 15 11 2• 49 C0102 4 -3- 5
STAEET RESTOA,
GRADING
SAN SEW TRUNK
# SEWER LATERAL 1972 1304.00 52.16 2 30-11,
WATERMAIN
# WATER LATERAL 1 2
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STAEET L1GHT
WATER CONN.
BUILDING PER.
SA C
PARK
.
,
, .
. EAGAN TOWN S HI I P
].061
BUILDING PERMtT
1 Owne: C5.,-s9~:l~~ Eagan Township
; Address (preseni) Town Hall
auiiae:, /v~ IG`T
Date
~ Add:es9
,
i DESCRIPTION
Sfories To Be Used For Froni Depih Heighi EsY. Cos! Permi! Fee Remarks
LOCATION
5ireel, Road or other Descripfion of Laeation Lot Black Addition or Trac!
~ ~ . •v ~S~ !7 ~ .~c~-s~-3 _~cf- ~ ~ ~
This permii does not suihorize the use of sireets, roads, alleps or sidewalks nor does it give the owner or his agent
' the right to creale any situation which is a nuisance or which presenis a hazard fo the health, safely, convenience and
, general welfare :a anyone in the communi2p.
; THIS PERMIT MUST BE KEPT O THE PREMISE WHILE THE WORK IS IN PROGRESS:
; This is 3o ceriifp. lhai._.L?_.... ihst has pezmisaion 2o erect a-/-? .4_ . . upon
the abo: c descrihed premise subjecY io the provisions of the Building Ordinance for Eagan '~7wnship adopte April 11,
; 1955. ~
~ . ) Per .'•`f.~-~.,~~+'°@_~{-F- -~~-L~~_
, Chairman of Tnwn Board L' 6 Buildinq Ir,sp~_,c+c_
2007 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
• 3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Consimction ReauiremenGs RemodellReoair ReouiremenGs Office Use Onlv
3 registered site surveys showing sq. ft. of lot, sq. H. M house; and all roofed areas 2 copies of plan showing footings, 6aams, joists Cert o( Survey Recd Y_ N
(20% mmimum Iotcoverage aliowed) t se[ otEnergy Calculations for heated addi[ions Soils Repod Y_ N
1 Soils Repon i( proposed building is to be placed on disturbed soil t site survey for additions 8 decks Tree Pres Plan Recd Y_ N,
2 copies of plan showing beam & window sizes; poured found design, etc. Adddion -indicafe ifomsAe seplic system Tree Pres ftequired Y_ N
1 set of Energy CalculaAons On-sfte Septic System _ Y_ N
3 copies of Tree Preservation Plan if lot planed atter 711193
Rim Joist Detail Oplions ulection sheet (6uiltlings with 3 or less unils)
Minnega5co mechaniral ventilation form
Plans are considered public information unless you state they are trade secret and the reason.
Date 9 / /.Q1__ ConstruMioo Cost / / / • Z~
SiteAddress ~g.7 V/ftUd,STOAJP,4?k'_ Unit/Ste ik
p p.oJQ S .~9/Nc,G
DescriptionofNVork Q d+ d° f~0~/~CE kiZA00- A.Vili ljii r- 4 dO(v
Multi-Family Bldg _ Y)( N Fireplace(s) _ 0 _ 1 _ 2
Property Owner JOjl/fI/'fGl Telephone #*,j'l
Contractor A-e_rv0 SIGt~ tiry
• Address _z~r736 /U.~_ Lrl) City J~IVMOGa7-~, pl
State /~'7 F~ Zip S'S Telephone #(X3 )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category , Residential VentilaGon Category 1 Worksheet • New Energy Code Worksheet
submission type) Submitted Submittetl
• Energy Envelope Calculations Submitted
In the last 12 monihs, has ihe City of Eagan issued a permit for a similar plan based on a masier plan6
_ Y _ N If yes, date and address of master plan:
Licensed Plumber Telephone )
Mechanical Coniractor Telephone )
Sewer/WaterContractor Telephone#( ]
I hereby apply for a Residential Building 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 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.
Applicant's Printed Name Applicant's Signature
DO NOT WRiTE BELOW THIS LINE
Sub Tvpes
? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory BIo
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo/pergola) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvaes
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteretion ' ? 37 Demolish Building* ? 43 Reroof . ? 46 Windaws/Doars
? 34 Replacement *Demolition (Entire BIdg) - Give PCA handout to applicant -
DBSCfIptlOfl: Wate~Damage_Yes
Valuafion ' 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 Sprinkle,red
Type of Const Width ~
REQLJ[REA INSPECTIONS
_ Footings (new bldg) _ Sheetrock
_ FooCings (deck) FinaUC.O.
_ Footings (addition) FinaUNo C.O.
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water Finaf _ Pool Ftgs Air/Gas Tests Final
_ Framing Siding _ Stucco Lath _ Stone Lath _Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
_ InsiJation _ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MGES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search •
Copies
Other
Total
PERMIT# 1'~ `-l RECEIPTDATE: I"C/ ~
(
MIDEPTIi4L PLUM$INfi PERM1T APPI1CATIOR
crrY oF EAsM
3$30 PD.OT KPOB RD
Kn?s,4x, huv 5512$
651-6$1-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for irrigation system
SITE ADDRESS: I ~ Y-\
AYU Yl e--
OW NER NAME: : O G TELEPHONE / I a
(AREA CODEj
INSTALLER NAME: d S'c o- S ELEPHONE
(AREA CODE)
STREET ADDRESS: 12- ~ Z{ 1 vi5 r~ ~
CITY: ( C~c-„? i2:al;, tClS STATE: ~7n ~ ZIP:
Place a check mark next to the ermit work type
Add-on, modification or alteration to existina dwelling unit, including: $ 50.00
• abandonment of septic system
• new installationlrepairlrebuild of RPZ
• lawn irrigation system
• waterturnaround
Nature of work: i
Septic System, new/refurbished - $ 225.00
• includes County & Consulting Inspectar fees
• requires MPC license
Water turnaround - existing dwelling unit, including: $ 50.00
• 5/8" meter 115.00
$ 165.00
State Surcharge $ .50
Total 1 ~ ~DD ( $ . So
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply6wf1p'all applirable Cilyof Eagan ordinances. It
is the applicanPs responsibility to notify lhe property owner that the City of Eagan assumes no IlabiliTy for a~t~y damages caused by ihe City during its nortnal
operational and maintenance activities to the facilities consWcted under this permit within City property/r~ght-/of- ay/easementy
SIGNATURE OF PERMITTEE voz
%
2000 STORM DAMAGE PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
q~71 b 3830 PILOT KNOB RD - 55722
651-681-4675
Reauirements
? 2 copfes of plan DATE: Cl -7 "DO CONSTRUCTION COST: ~I,o OOD
DESCRIPTION OF WORK: W Q<<S 4- 0w u- ~ na j V-Q If mulfl-famiry bldg., how many unlfs9
loo
INDICATE THE FOLLOWING EAUIPMEPfT TO BE REPLI0.CED AMD BY WHOhA:
_ Plumbing _ Homeowner g Contractor Name
_ Mechanical _ Homeowner gj Conhactor Name
"Note: If somebody other than the homeowner is performing plumbing or mechanical work, they mustapply for appropriate
permit. Only Ilcensed plumbing conhactor or homeowner may complete plumbing work.
STREET ADDRESS: ~I a~S ~2n~s~l~ Dv-jV,e- ~Q.c?
LOT: BLOCK: ~ SUBD./P.I.D.#: e(JGIr Gf0jt. ~T2:f
Name: Ab-PA JO Phone tD J 1-~v $ LS - 3( p~
pROpERTy Lasf First
OWNER Street Address: 44 aq 5 Ja4,IG~ S7'D vtie- b ri v<--
CNy r-' J'a'I'q State: %Yl N Zip: 55/ a~---
Company: S0-wi e- a S Qc-0 Vtn-C Phone
(area code)
CONTRACTOR
Sfreet Address: Llcense # Exp.
City State: Zlp:
7 REC~
SEP 7 - 2000
BY:._------
I hereby acknowledge that I hwe read this applicafbn, stafe that fhe infortnafion is cortecf, and agreeto compy wBh ail appGcable StaYe
of Minnesofa Sfaiutes and City of Eagan Ordinances.
~
Signaiure of Applicant: ~Z~~ D ~
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.) ? 31 Ext. Alt - Mufti
? 02 SF Dwelling ? 08 06-plex ? 17 Garage O 22 Porch/Addn. (4-sea.) ? 33 Ext. AR - SF
? 03 01 of_ plex ? 09 07-plex ? 18 Deck ? 23 Porch (screened) 0 36 Multi
? 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage
? 05 03-plex ? 11 10-plex Plbg _YOr _N ? 25 Miscellaneous
? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bidg.
WORK TYPE
? 31 New ? 36 Move Bldg. ? 43 Reroof
? 32 Addition ? 37 Demolish (Bldg)* ? 44 Siding
? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors
* Demolition permit - Give PCA handout to applicant
GENERAL INFORMATION
# of Stories sq. ft.
No. of Units Length sq. ft.
No. of Buildings Width Footprint sq. ft.
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. MC/ES System
UBC Occupancy sq. ft. City Water
Zoning sq. ft. Booster Pump
PRV
12/39/13 16:21:44 ET TO:16516755694
FROM:
12673599288 99Z
Citi of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
1(Pp 5
Date Received: 19-)3 /13
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Site Address: �..� _. a d1, 1 Vit... :,w_." .. ,. .
Name: MitirGttis 1-16tU St +� Phone:915" 2&4--7-76)(:)
Address / City i Zip 13470 _1 v \/ &-4
fi
wner /Contractor
Date: 15
r�.
Unit #:
Applicant is:
Description of work: rho 4 r1 eg �^. t A tc
Type of Werk..:# �+� �- .,,,J
Construction Cost: bO() Multi -Family Building: (Yes / No
< f
Company
Address:.3+. mu City: e, t C
State .Zip: 5 i v Phone:
Sc�-
License #: le -316141 Lead Certificate #:ANT -1416 ) 143
`roLc+tar Coviref vtr _ :...
Conte
3
1 if the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes, date and address of master plan:
Licensed Plumber:
Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor:
Phone
NOTE Plans and'suppor�ting documents chat yroei subs It are consrdereci tc ire pulrtic inforrrration Portions of
the information maybe classified as non-public if you provide specfrc reasons that would per*ii the Crtyr to
conclude Brat the .:are trade secrets
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. 5.41WW. gophestateon caU 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 e Stat B dingoe m Code ust be completed within 180
days of permit issuance.
App licant`s Printed Na
ifrkos
x�_
Applicant's Signature