4363 Sequoia Dr
CITY OF EAGAN Remarks
Additio ~ergreen Park ~at 1 Rik 5 Pa~cei 10 21~880 010 05
Owner ~ Street ~363 SeQUOia Dr. State Eagan,r~r 55~ 22
L
Improvement Date Amount Annual Years t". ~ Payment Receipt Date
STREET SURF,
STREET RESTOR.
GRADING
SAN SEW TRUNK ~
SEWERLATERAL
Sew Conn c. 1 74 0.00 .00
WATERMAIN
WATER IATERAL
WATER AREA
STORMSEW TRK „ 983 360~15 2k.01 288.12 C010184 3-14-85
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN, 26O OO - -
~UILDING PER.
SAC 2 Q.QQ - -
PARK
INSPECTION REC~RD I Control No.
CITY OF EAGAN PERMIT TYPE: Rt~t ~ a Y Ne
3830 Pilot Knob Road Permit Number: ~ r
Eagan, Minnesota 55123 Date Issued: L r f~ g/~~'
(612) 681-4675
SITE ADDRESS: R p~ ~ 2 ~l.Of.k a~ APPLICANT: ~
~363 SEQUOIA pPt ~:ELA Rt14FIM8 ~ REMOh~LIN9
EVFRAR£~'N PARIt ( 612) 82~-8l~6
PERMIT SUBTYPE: TYPE OF WORK: ~
r t M 1~+[' . 1 f~E PAIR
[~E~C:~tTPTl01V R~~ROO`
1'INAI
y~y " ~~,y~yrS ~+•°1 a~- ~ ~ - . _ ~~~~t~a . v'.
, - ~ r~ s- t ' fi 5 - - ~ i 1-~ SI~i~' • ~ - . ~ri~,."~ .
Y.~
~ ~ i_ ~ 1- _ ~ ~ S-c ~ v~~ ~3 - ~ t .~w ~ r' 7. r~~^%~ : R. ~ '
i Fs.~y~ ~ - ~Y : ~ - F K l; , '7t- ~ .Ji j.: , t - ~ ~
r r t ~,i - i~ z f-
! ' -~c ` ~t d } ~ { ti t , 3,-"~si-
~3g?~y__...: .s~ . . ~is-~~~.._~,_.~ _ ti~ ~ - . . _ -
P~rtnH No. Parmft Mlold~r Deb Tilepl~oM 1
S/V1~
PLUMBING
HVAC
ELECTR{C
ELECTRIC
Irtspectlon Osbs inap. CommsMa
Footings I
Foundation
Framiny
.
~/~~/s3 ~ ~a / o~ 4 ~ 06
.,Z.y3 ~s ~~i~~d~c~h~
~h,~. f~
c~ Q~
~W.
+~9.
Orsat Test
Final Plbg. Plbg. Inepedor - Notily Plumber
Cor~et. Meter
EngrJPlan
Bldp. FineJ
Dedc Rg.
Deck Finel
Well
Pr. Diep.
~70 =4'
~~~q 2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Requirements RemotlellReoair Reauirements Office Use Onlv
3 registe2d site surveys showing sq. ft, of l06 sq. ft. of hause; antl all roofed areas 2 copies ot plan Cert of Survey Recd Y_ N
(20°~ maximum bt cove2ge allawed) ~ 1 set of Eneqy Calculatans for heated adtli6ons Tree Pres Plan Recd Y_ N,
2 copies of plan showing beam & window s¢es; Poured found design, etc. 1 site survey fir additions & decks Tree Pres Required. Y_ N
1 set of Ene~gy Calculalions Addfion - i/Micate if on-sife septk system On site Septic~System. _ Y_ N
3 cupies of Tree Preservaiion Plan rf lot platled after 7/1193
RimJoistDefailOptionsselectiansheet (build'mgswitlr3orlessuniGS)
Date 2- I 1'~-l n S Coostruction Cost ~ a
Site Address ~'3 ~ 3 ~e 6t f~, UniUSte #
a cvt~v
Description of rk re b 1 a Ge vv~ e wt CJ r j S w ~ ~l ~G D W~
i~uiti-Famiiy Bidg _ Y_ H Fireplace(s) _ 0 _ 1 _ 2
Property Owner ~~h SG~ uYVI GL Telephone lp 5~) ~ g ~ V~O 5
Contractor ~I/~ j~ / G~ 0 W~ l ~ ` ~p
Address ~j P p~~ l~ ~p {~O 0 ~ City ~7 . Lp GC / $ ~
State M N zip S 5 Z~o Telepnone k(°~`jr~j R 3 3- 6 3 oD
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cate¢orv 1 Minnesota Aules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissionrype) Submitted Submitted
. Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan8 _ Y _ N If so, 25% plan review
fee applie:.
Licensed Plumber Telephone # ( )
Mechanical Contractor Teiephone )
Sewer/Water Contractor Telephone ~
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that tlie 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 w requires
2'i~evie, - d
approval of plans. ~ ~ 1 ~
(J 111 1~~,5 ~D~S es ~ ~g-y,~ ~ iY'.K ~ ~ Z0o5 D
ApplicanYs Printed Name Ap ic nt's Signature
~
OFFICE USE ONLY "
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS O6-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Eut. Alt - Multi
? 03 01 of_ plex ? 09 D7-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ent. Alt- SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch(screenlgazebo) ? 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 ~ Demalish Interior ? 44 Siding
? 32 Addition O 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof p 46 Windows/Doors
? 34~. ReplaCement ~ "Demolitlon (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
REQLTIRED INSPECTIONS
_ Footings (new bldg) _ FinallC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AidGas Tests Final
_ Framing _ Siding _ Swcco _ Stone `Brick
_ Fireplace _ R.I. _ AirTest _ Final _ Windows
_ Insulatio~ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
5&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Tota1
PERMIT ~°"t 12 4 4
fdT~Y OF EAGAN
' 3830 Pilot Knob Road PERMIT TYPE: ~ u z ~ o z N ~
Permit Number: 017 16
Eagan, Minnesota 55123 Date Issued: y~ J~ 9/ g 2
(612)681-4675
SITE ADDRESS:
4363 5EQUOIA DR
LOTc 1. E3LOCK: 5
EVER6REFN PAfti<
DESCRIPTION:
HE-ROOF
'"8uildin_g Permit Type SF (MT5C.)
Efuilding`~Work Type ftFPA.T.R
i~
.
~
~
j
~rt ,
~ - , ~
...~t%i
~ . ~r j-~/~~. i~,-I~
1 ,J L,"/ ~ i i s
~ l .-J ~
_ . ~
REMARKS:
~ L z l ~ ,~j
FEE SUMMARY:
VAIUATION $4,000
Base Fee $63.00
Surrharge ~ ^,~2.00
Total Fee $65.00
CONTRACTOR: - Applicant - sT, ~z~OWNER:
SELA ROOFING & REMODELING 1823$046 an~D1.050 GRIFFITH DAVID
3233 MENNEPIN AVE 5 4353 SEQUOIA DR
MINNEAPOLIS MN 55404 EAGAN MN 55122
{612) 823-8846 (612}688-7999
~ hereby acknowlsdga that I have re~d Zhis ~pplication and state that the
infiormation is correr.t and agree to comp).y with all ap~li.cable State of Mn.
Stat'utes and Gity of Eagan Ordinances.
L -
~ C,.~ 1~~ ~Ik~3~ f YYl„~
~ APPLICANT/P RMI E SIGNATURE rISSUED V: IGNATURE
INSPECTION RECORD ~~°"t 2 4 4
CITY OF EAGAN PERMIT TYPE: e u z ~ o t N c
3830 Pilot Knob Road Permit Number: 0 c~ 171 e~
Eagan, Minnesota 55123 Date Issued: 1~/ 2 9 J 9?_
(612)681-4675
SITE ADDRESS: ~ o T: 1 ~ ~ o c K: 5 p`PPLICANT:
~363 SEQUOIA DR SELA ROOFING & REMODELING
EVERGftEEN PARK (612} 823~-Sp4fi
PERMIT SUBTYPE: TYPE OF WORK:
SF (mISC.) REPAIR
DESCRIP7ION RE-ROOF
. .
FINAL
~
L
PERMIT N CITY OF EAGAN
REACTIVA?E _ 1992 BUILDING PERMIT APPLICATION
~ 681-4675
~ 11
SINGLE 8 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date l~ / a~ / g~_ Yaluation of work ~~3mo, ~a
Site Address: y363 ~~be,T ~2~v,~
STREET SUITE I
Tenant Name: (commercial only)
LOT ~ BIACR ~ SUBD. ~~1~ P.I.D. M
~S
Oescri tion of work: ~~,/Lr~~~
~
The applicant is: ? Owner 0-Contractor ? Other coesc~in~>
Name -p~~fl G~ Fr~,i-1~ Phone G~~ ~F9g
Property ~~5~ FIRST
Owner Address ~ ~ 3 ~g~, ~o i~ ~(Li v
STREE7 StE ~I .
City ~?~9 uti+~ _ State ~N Z;p ~S~'/ zd
Company SFZ l~ ~c~F~.~.~-e, Phone ~23 Boy~
COntf8Ct0~ Address ~Z3 3 t4'~~ni' n.~ License 5'~
~L, Exp.
City /"iO~S State~~ Zip
Company Phone
Architect/
Engineer Name Registratian ~
• Address
City State Zip
Sewer 8 xater licensed plumber . Processing time for
sewer 8 water permits is two days once area as been approved.
I hereby acknowledge that I have read this application and state that the information 9s
correct and agree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant: ~
OFFICE USE ONLY
BUILDING PERMIT TYPE ~ ~ ~ '
? O1 Foundation ? 06 Duplex O 11 Apt./Lodging ~16~~iement Finish
? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. 0 17 Swim Pool
? 03 SF Addition ? 08 8-Plex O 13 Garage/Accessory O 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 19 Comm./Ind. Misc.
? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
? 31 New ? 33 Alterations ? 35 Tenant Finish O 37 Demolish
? 32 Addition ? 34 Repair ? 36 Move~
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) lst F1. sq. ft. City Water
UBC Occupancy 2nd F1. sq. ft. PRY Required
Zoning Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft. Fire Sprinkler
Length On-site well Census Code
Depth On-site sewage SAC Code
APPROVALS ~
Planning Building Assessments
Engineering Yariance
RE~UIRED INSPECTIONS
~
O Site ? Footing - ~ Framing ? Insulation
? Nallboard ? Final ? Draintile ? fireplace
Permit Fee Val~mtim: $
5urcharge
Plan Review
License
MWCC SAC
City SAC
Mater Conn.
Mater Meter .
Acct. Deposit
S/W Permit
S/W Surcharge -
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
CoPies
Other
Total:
SAC %
SAC Units
EAGAN TOWNSHIP
BUILDING PERMIT Ne 22~4
Ownex ..~-~.!...._...~°z:°.-"_p~k~+r~ ...........,~.p.--°~~~ Eagan Towaship
Address (present) ..G..8:6~.....~.?:~-~:°.<4_.-.~6-u-<...~_ d-~-""~" Town Ha11
r.
Builder ~ ~-P-~r~-~'~ . .
- Dete ~~~::r.-2~---......._.......
Address .
DESCRIPTION
Slosiee To Be Uaed For Front Depih Ha3gh! Esl. Cos! esmi! Fee Remarlu
~ . ~ G I oz d~ .-b-n ~ ~3. e= .3• i ~-,.,c'~oK.,[-e-~
s~ .a_ ~1 /e ~ ,a.e~Zc.G-C ~.-1._
LOCATION
Slrae2, Road or oihee Deacriplion of Localion I Lo! Block Addilion o= Tseo!
~!3 6 3 ,I _ • J S ~R-~.C~
,d`~~-d-~..~
This permi! does ao! aulhoxiz !he use of alreels, roada, alleys or sidewalka nor does i! glve !he owaer or hia agen!
!he xigh2 !o create anp siluation which is a nuisanee or whieh preseaffi a hesard !o the heal2h, safelp, convenience aad
geaeral welfare !o aapone in the eommuniSy.
THIS PERMIT MUST SE KEPT ,Or-N. TOH-E PAEM7I SE WFIILE THE WORK IS SN PAOG SS.
This is !o cerlifY. !6al--:7.2.?. .`^.~:-~J..-.-.---_....._has permisaioa !o eree! d.. ~ ~ f ~f/~~.._._~.J_upoa
!he above deseribed premise eubJec! !o !he provisions of the Building Ordinanee for Eag n Tom~ adoplAE Aps[1 11,
1855.
c n
. ...h..~....'_........ Per .........--'........--._!~-~:e:4.....(l.....9 ."p"""-•• ~
Chairman f Tnwn Board~, Buildin Ias acios
I'~'~k ~ ~
a -
~ ~
4
\ y
~
. ~ ~
' ~ k ~~6~
~ j~ ~ ~
r~ ~ .
0
. ~
~ a2
va. ~I'~ ~ 30'
~ ?
~3 0
~
~
. ~
~ ° ~i,.~-~°~'`~. r ~f
~~!.~~..,A
~.~-'1'`~-f, ~X, .
_ ~ t~~
MASTER CARD
• LOCATION „ e o A ~`/36 3 ~
OWNER yp/ /y~ ~h _
SAND US D ASD G
Issued To
Permit No, Issued Coniractor Owner
BUILDING 2 2 l y 6_~,~
PLUMBWG ~ ~ ~f.
CESSPOOL - SEPTIC TANK
WE« N3? y-y- ~o w-~~«/a~
ELECTRICAL n .
HEATING `7 ~ ~-7'.](~ Q.U-P (3~j !-~l ~ww" /1'
GAS INSTAIIING
SANI7ARY SEWER ~ Z L
OTHER I
OTHER I
• Approved
Items (Initial) Date Remarks Distance From Well
FOOTING ~ ~`I~~D SEPTIC
FOUNDATION CESSPOOL
FRAMING ~I~ TILE FIELD FT.
FINAL
- ELECTRICAL -~7-~ DEPTH
HEA7ING V I~ O OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL I
DRAINFIELD ~
PLUMBING ~ ~ ~ ~
WELL ~Q- ~t'~
_-Y _
SANITARY SEWER
~ b ~ ~ ~ J ~C/~
~ V V
U~ o s NMted
~ Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
~
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OP NON-COMPLIANCE NON-COMPLIANCE. BUIIDER DOES NOT
OBSERVED. ~ INTEND TO COMPLY.
? ACCEPTABLE SUBSTITUTIONS OR
DEVIA~ONS. ~ COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
i
? REINSPECTION REQUIRED DATE OF REINSPECTION •
REINSPECTION REVEALED
CE RTI FICATION -1 certify that I have carefully inspected the aba?e in which I have no interest present or prospective, and that I have repotted herein
all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site impravements relating to the property inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETE~
BUILOING INSPECTOR OATE
COMMENTS:
~
~
s
TOWN OF EAGAN
3795 Pilot Knob Road
St. Paul~ Minn, 55~>>
PERMIT NO.: 49
The Board of Supervisors hereby grants to ~g~p~bii3U d Heatin~~Inc.
~f ~~Q55 `~hn~.+++nn RpaA~ S~nu]„_55111 S Plumbina ~
4363 /e ~
Permit for: ~OWR2S'~ 4)pnc~nann ,on~~u~t{nn Ge at Se uoia DzivG~Evergreen Parl~
purauant to application dated Aygp~~_4'~97~
Fee Paid: _$qn nn Dated this ~t~piay oP Aueust ~ 197 0
Building Inspector
~
TOWN OF EAGAN
3795 Pilot Knob Rcad
st. Paui, Ntinn. 55~>>
PERMIT NO.: 44
The Board of Supervisora hereby grante to Kleve Neat4na d Air~nditioaiag~ ~c.
e,f 13075 Pioneer Trail, Eden Prairie a Heating___,____~.___~~ -
~ /
JS
Permit for: (Owner)Riphuth d Crothe _ at _ 4363 Seauoia Drigg~vezgreen Park
i_, pursuant to application dated Au~ust 6t_ 1970
Fee Paid: $ZC.00 Dated this llth day cf Ausust , ~91Q.•
-
Building Inspector
: ~
EAG~N 1~DWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SIIRVICB CONNECTION
Date: Oetober 2. 1969 Number: 334 S~~P'
Billing Name• Wensman~Construction Site Address• 4~ Sequoia - EvergreenPark
Owner: Billiag Address
Pl~ber: Wenzel Plumbing & Heating, Inc.
Location of Connection Meter Size~ Connection Chg. ~30..00 ~d. 10/2/6g
Meter No. ~ o S Permit Fee 7.5o Pd 11/~8/6g
Meter Reading Meter Dep.
Meter Sealed: Yea Add'1 Chg.
NO Total Chg.
Inspected by
Date
Building is a: Remarka:
Residence
22ultiple I~o, Units
Commercial
Iadustrial ' By:
Other Chief Inspector
In conaideration of the isaue and delivery to me of the above permit, I
hereby agree to do tt~e proposed work in accordance with the rules aad
regulations of Hagan Township, Dakota Count}a~, Minneso~a.
By: ~ ~r~T-P~ /.J. t,.~ Y/u
Wenzel Plumbing & Heating, c.
1955 Shawnee Road, St. Faul
Please aotify the above office when ready for inEpection aad connection.
EAGPN TDWNSHIP
3795 Pilot Knob Road
SC. Paul, Mianesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNSCTION
Date: June - July 10, 1970 Number: 457
Wens[nann Construction Co. equo a rive
Billing Name: Mihhael Heilman Site Address: Lot 1 Block 5 Evereeen Park
Owner: Michael Heilman Billing F.ddress 4363 Sequoia Drive
Plumber; Wenzel PLumbinQ & Heatine~,Inc.
Location of Connection Meter Size " Connectioa Chg.260.00.nd
Meter No. Permit Fee 10.00 pd 8/4/70
~y,,c~. .~a Gi 6 ~ s 7G
Meter Reading~ Meter Dep.
`Zu a~ 9
~y ~O Meter Sealed: Yes Add'2 Chg.
~~v~~- NO Total Chg.
Inspected bq
Date
Building is a: Remarka:
Besidence ~
Multiple t~o. Units
Coamiercia 1
Ibdustrial Sy;
Other Chief Iaspector
In consideration of the isaue and delivezy to me of the above permit, I
hereby agree to do tt~e proposed work in accordance with the rules and
regulatioas of Bagan Towaship, Dakota Coun~nnes ta.
sy. „ ~ ~
Wenzel Plumbing d Heating, Inc.
Plea3e aotify the above office when ready for inspection and connection.
EAGlaN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE: June - July L0, 1970 NUMBER 609
Wensmann Construction 4363 Sequoia Drive
OWNER: Michael Heilman Address Lot 1 Block 5 Evergreen Park
pL~gggWenzel Plumbing d Hearing Inc~,pE OF PIPE Cast iron
DESCRIPTION OF BUIIDING
Industrial Commercial Residential Multiple Dwelling No, of units
x~c
Location of Connections: Connection Charge
Permit Fee 10.00 pd 8/4/70
Street Repairs
Total
Inepected by:
DaCe
Remarks;
By
Chief Inspector
In consideratioa of the issue aad delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulationa of Eagan Tocroship, Dakota County, Minneaota
BY a
Wenzel Plumbing d Heating~ Inc,
1955 Shawnee Road. St. Paul. Minn. 55111
Please notify when ready for inspection and connection and before any portioa
of the work is covered.
62/24/2005 20:50 6512289201 ST PAUL PLUMBING PAGE 02
DEPARTMEIYT O~ FIRE AND SAFETY SERVIC~S
FIRE PREVENTIUN'D1V1SIDIV
700 EAST 77th STREET, SAIWT PAUL, MH 55101
EXISTING FUEL BURNING EQUIPMENT SAFETY TEST REPOR7
Nse separate form fa eaeh appfianee) ~ a~~
y 3 63 ~[-9' k~la~ ~ Ea~s.. ~/N/f/ Date..
Address:
Owner•
TYPE OF HEAT: y
Gravity Air~ Forced Air V Gravity Hot Water_ Forced Hot Water
Steam Unit Heater Space Heater _ Other
TYPE OF FUEL: Gas ~ Oil _ Other
GAS DESIGN CONVERSIOM
Make of Burner Cp /~flN1 Make
ModAl G l OQ (I 8/~~ Model
Seria! w~~ M~~O14/ Max. B ating
Input ~~0 ~TG Make o urnace
Equipment venting type: Atmospheric ~nduced Fan r Other
Total BTU input of all vented gas appliances per chimney: ~/,,,yOT OPCS~
Type of Chimney: Masonry ~ Class B Other
Type of Liner: None T Metal ~ C3ay Tile~
Combtrstible Air Supply: Yes~ N/A~ Recommended_
5aferi & Oneratina Gontrol 'fests: Yes No Fuel Analvsis !ue O~s Analvsis: Yes No
Pilot/Flame Safeguard Operating Properly ~ _ Vents Properly Without Spillage ~ ~
Limit(s) Operating Properiy ~t Flame Stays Inside/Doesn't Roll Out~ _
Operator(s) Qperating Properly r~ Burner Lights Smoothly ~
Low Water Cut-Off Operating Properly
All Controls Operating Properly ~
In iat Final Visuallnsaection Yes Plo
Stack Temperature F/Net 3 ya F/Net Fuel Piping System--Okay a' _
Oxygen ~ % ~ g % Vent Systems--Drafthood,
Carbon Dioxide % 6_~f % Connector, Vent Chimney--Okay
Carbon Monoxide °.U/ppm 32 96/ppm Heating Unii-Okay ~ _
Carbon Monoxide Detector (tube typel Pnsitive~ Negative~'
Look At 7ota1 Heating System Before You Leave:
Does system operate safely and properlyl Yes d' ~o_
COMMENTS:
Wave above corrections been made? Ye~s~ No E~.~
Name of ~icensed Contractor: aRr ~//Qg, ~'.,n, Phone #o7vZ g
S3ot` aa
Address: ~j y~ (r ~G G ~t/ , j
Person Doing Test:
Iprin~r~ $7er,~ Is~gnacuref -
C~rtrtfC~te nf ComoatPncy Number From City of Saint Paul for App priate Fuel: N• RHt f9/951
nnino v
G~~~`3 ~ s~
2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. single family dwellings & townhomes/condos when permits are required for each unit
Date / /
Site Address UO ~r' Unit #
Property Owner V ~ ('C~~ ~h~m~ n n Telephone # ( (~j ~ ) (~~S l -C~)U[~7~~
Contractar ~ 1~Gc~+ !'I (/mb! ?1Q I~7~~~ nG
Street Address ~Gl r U ~e- Cit}' S+ 1- Ci U~
State 1~ Zip ~71~5 Telephone# ((p~~) O~C7"~a~~
Bond Q~031 35 Expires: 7~3 ~-US
The Applicant is _ Owner ~ Contracror _ Other
Add-on or alteration to existing dwelling unit $ 30.00
~ furnace _Additional ~Replacement
air exchanger
~ airconditioner _New ~Replacement
other
State Surcharge $ .50
Total $
I hereby apply for a Residentia] Mechanical 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 with the Mechanical Codes; 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 acwrdance with the
approved plan in the case of work which requires a review and approval of plans.
~IL~~L' ~~Cx~l(1 ~ L~' ! ~ ~ 5
Applicant's Printed Name Applicant s Signature ~ l I~
FEB 1 5 2005 U
ay
2005 COMMERCIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephane # 651-675-5675
Please complete for: commercial/industrial 6uildings
mulci-family buildings when separate permi[s are not required for each dwelling unit
Date / /
Site Street Address Unit ~i
Tenanf Name (if applicable) Previous Tenan[ Name
Property Owner Telephone # ( )
Contractor
Street Address City
State Zip Telephone # ( )
Bond Expires:
The Applicant is _ Owner _ Contractor _ Other
Work Type
New Construction _ Underground Tank _ Install _Remove "`see below
fnterior Improvement _ Install Piping _Processed _Gas
Nature of Work:
*'When ittsta!ling/removing underground tartk, call for inspection by Fire Marshal and Plumbing lnspector
Pert111Q F¢¢S: $70.50 Underground [ank installa[ion/removal
~ 550.50 Minimum (includes Stare Surcharge)
OC
Contract Value $ x 1% _ $ Permit Fee
• If ep rmit fee is $1,000 or less, add $.50 ~ $ State Surcharge
If en rmit fee is over $1,000, add $.50 for
every $1,000 permit fee $ Total Fee
I hereby apply for a Commercial Mechanical 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 with the Mechanical Codes; 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 wil] be in accordance with
the approved plan in the case of work which requires a review and approva] of plans.
Applicant's Printed Name Applicant's Signature
Approved By: , Inspector Date:
~7SS~~ ~ 1S S~
2aos RESIDENTIAL PLUMBING PERnmr aPPUCaTioN
CfTY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date~(~Z ( Olm
Site Street Address _ Karen Schumann Unit #
4363 Seqoia Drive
Property Owner_ Eagan, MN 55122 Telephone )
Contractor ! `~~r b~ (5}'Yl ~l,l,(,Y}~ ~7l 1'? G} Telephone # ((p~z) ~d2'7-tf0~'3
Address 2qD5 C~LLrff~[C.~ _~?^SD. c~cy ~als scate rYl t~ . z~p~+-tDg
The Appiicant is: Owner ~Contractor _Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
Alterations to existing dweiling $ 50.00
_ Add plumbing fixtures. This fee includes installation of a water softener and/or water
heater at the same time. !f you are installing onlv a wafer softener and/or water
heafer, do not complete this section; move to the next section and check the
app{iance(s) you are installing.
_Septic System Abandonment ~ CT I 9
_ Water Turnaround (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
State Surcharge $ 50
Totai S ~ ~ .5~
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 cod i the i'of Eagan and the plumbing codes; that I
understand this is not a permit, but only an application for a p t, wor ' ot to start without a permit and work will be in
accordance with the approved plan in the event a plan is requ' to b r i wed and approved.
~ef~r~~ Nor,hlorvi,
ApplicanPs Prin d Name p ant' Si nature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA116560
Date Issued:10/08/2013
Permit Category:ePermit
Site Address: 4363 Sequoia Dr
Lot:1 Block: 5 Addition: Evergreen Park
PID:10-24880-05-010
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
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 by law in ALL single family homes .
jackie terrell
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 -
Karen Lynn Schumann
4363 Sequoia Dr
Eagan MN 55122
Walker Roofing Company
2274 Capp Rd
St Paul MN 55114
(651) 251-0910
Applicant/Permitee: Signature Issued By: Signature