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4836 Shevlin Ct4111' City of bin Date: 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: Date Received: Staff: INFLOW & :INFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water 7-13 - JO Site Address: qr3 6 jjvVI %47 C -1- Tenant: Suite #: RESIDENT / OWNER Name: c". j-(-)g-\i /l/4s'Phone: Address / City / Zip: CONTRACTOR Name: 14 e % S s qv\ pi 6 013 Str v ie.- S License #: 0 5 9 S i -5 PA Address: P , 0 , B 0 "( I 1 a City: Z. q tA.. eS.ci State: r ti \ N Zip: ssiaa- Phone: (I, .S) ^ (0 g I — g -- S Contact: IT\ ; 'A &- Email: (v Ke 6 11 es sign p) TYPE OF WORK PLUMBING (Within the building envelope) SEWER it WATER (Outside the building _VI_ Sump Pump Repair Repair envelope) Other Other: DESCRIPTION .....—„, Description of work: g 1' i V13- -2 4--- v--- p ps-, i--9,9 4. 3s Hicals t -A p to c.,I..k. FEES 0 te,- $55.00 / E h (includes vl e_ -r- c_,A, r‘ p c 1 -.1 I-Csi +0 $5.00 State Surcharge) (Rev. 6-30-10) TOTAL FEE $ 5.5 0° *Permit fees will NOT be reimbursed by the City of Eagan. if you plan to submit I/I repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeauan.com/inflow, or City Hall at 3830 Pilot Knob Rd. 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.clopherstateonecalLorg 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. x r\t\ ‘1‹-t 1,1 ) Z - Applicant's Printed Name x71---2;410 Li& A licant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough -In _Final M* xEd **** xEd **** xEd x**M xEd **** XEd **** xEd **** xEd M*** xEd ** •[{aogs uT sT bu-rt-{gel.T Aa 'a [TW : abEssaW NVAH aavd : woad 90£8 -T89 -Z59 = #wea EXIW = oZ ** XEd AtM** XEd M*MM XEd *M*M XEd MMMM XEd *M** XEd *M*M XEd *M** XEd MM xej 4UtZ.ISp-10S . Xed.6bG8-LZ£-BLZ. Z056-tSir-LOS ZZE€=LtE- LZ: euuotemo - spideti Net xe-j 859E -LLL- I S9 4001.-LLL-LS9 alepmlto xe j 4994 -48L -£9L xej 685£ -56Z -£9L xej SL££ -5£6-Z56 8L4P-1713L-£9L 885E -56Z -£9L OLSS-886-ZS6 olla)guoW Uois!AI❑ NNAN' ae� weH 999L-5£6 {Z56) :Xe3 StrMO-S£6 (ZS6) EiESS'NW sui)IdOH gnnoS aAv 4191 ON uiew ‘1" '3Nriadii 3S-.. J f0 SZfiaLh* Z Jo T abed hrddng auriadrd 103 NV 8Z:00 0T11O160 ~ CITY OF SAGAN 3$30 Piloc Knob Road s~~ SERVIGE PERMIT J :f~' i P. O. Box 21199 PERMIT NO.: r ' Eagan. MN 55121 DA7'E: `-'-''-s-~ F I Tollefson 31dr9 No, of Unlts; ' Ownsr. l~ddrcss: Site Address; G836 Shevlin Court L16 R 1 Eritte-~v ~itl: Plumbe~: "@ A~:'~ - - . ~ F° w~' ~ Gh of E~pa Connxtion C'~~; 42 ~0 Ordtnesws, Ikeount Depo~it: P~rmit Fas: ' - B Surcitorpe; - - Y Mise. Cho~ Date of Ir~p,; Totol: Insp.: Dats Pa1d: CITY OF EAGAN WATER SERVICE FERMlT 379b Piloc k~~ob Rood PERMIT NO.: . Eogee, MN 551 ~2 DATE: " : ; Zoning: No. of Units: ' Owrrer: ~ :,tt , . . Address: ~tie~.*1i-t • . ~ . Slte Address: Piumber. ~ Meter Afo.: Connection Charge: ' Size: Acoount Deposit: Reader No.: Permit Fee: I~gree fe compl~r witF~ tha Ciry of Eagan Sureharge: Ordinanees. Mlu. Cfiur9es: Total: By Dote Paid: Date of Insp.: cin oF ~r?~aN SEWER SERVICE PERMIT 3745 Pilot iGs,ob Roe~ PERMIT NO.: Eogsn, MN 551~3 DATE: Zoning: No. of Units: Owner: ~ Address: . . ; . ` • ~ ' Site Address: Plumber: , ~ ~ . . . 1 agrea M aomPh w~b t`s Cil~!? ~~9on Connection Char~pe: . Oedinaeees. Account Deposit: perrn#t Fee: Surchar9e: g Misc. Char9es: y Total: Date of Insp•: Date Pcid: Insp.: - - WAT~t SERVICE PERMIT ' C17Y OF EAGAN p~RMIT ?~10~ i;-~3-`-`~ 3g30 yi~e~ K:~.nb Road Box 2'1199 p/?TE: E g n, MN 55121 r I NQ. of Units: zontn~; ':ollefgoa ~l~t~ 4th p,h,ner: ~~rt ~lf~ B1 ?',titCB~n ~ l+~d~~~~ 4E36 Sheti' 45Q.'=~~ ` Stte Address: Geaz ~Y~ ~,~~on C1+ar9e: p~u~ber: q~unt DePosi~ 0 P~~ No.: Permit Fee: `>0 P3 Sixe: Su~d+a~' F,O,.~;~ ~e r,~~et Reader No.: of Ee9~a Misc. ~1Or~' ~ 1 ao~ ae~4h ~~n~ Total: p~e Paid: lnsp•: By p~g of tnsv~- , INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: ~ ~ " ~ ' ~ ~ ~ ~ ~ 3830 Pilot Knob Road Permit Number: "i's~}•`~ Eagan, Minnesota 55122-1897 Date Issued: t~>~' ~ (612) 681-4675 ~ , ~ , SITE ADDRESS: ; „ ; ~ i r , APPLICANT: , , , vl 1'N C t , , • ~ . ~ , „ ~ ~ ~ ( t , 1 1 ; . i . i ~ , . PERMIT SUBTYPE: TYPE OF WORK: ~ . , ;~r~.. , . . i i, .i . . ; ~ ~i~ , ~ . ~1 I ~ , ~ , ~ ~ ~ ~ Permit Hoider Date Telephone It PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL ' GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FiG DECK FINAL , CITY OF EAGAN ~ ~ . T ~ 37lS 'ilef Kwe~ Roed Ee~en, MN SS112 H ' PHONE: IS4-i100 - BUILDING PERMIT Receipt # ' ' ' Te b~ ua~d for ~.F DWG/GAR Est. Value $56,OU0 Oate ~,pril 4 ~ Iq~~ SiM Mdress 4,33n Shevl in Court Eratt ~ Occuponty R"3 Lot BI«k __1___ Sac/Sub. Brit tany 4 th 111ter p Zonlny Fti- ~ Porcel # 10 I5Q03 160 Ol Repoir ? Firo Zone +jp, Enlarpe ? Type of Const. y ~ N~ Tni 1 f san r~ l~ rs ~ I~c . ~ Stvries W ~ Address 1655 Noraood Drive Demoliah p Lengthl~.~_ C~ T' ph~ 45~?-6873 Grode ? Depthl~i-Sq. Ft. ~ N~e nc~.n~r Approrol~ Fees llddreu Assessment Permit _~'.L11,. nG- C~ Wcter 8 Sew. Surchorpe Police Plan check ~n~~ W W Name Fin 5NC ~ n~ Addroas Enp. ~ warer ConK~~ i W Ci phona Planner Wotar Meter g~_ Councfl Rond Unit ~ • ~ ~ I hereby ocknowledye thot I hove read this opplicotion ond state that Bidq. Off. the intormation is oorrecf cnd ogree to comply with oll opplicoble APC T~a~ Si764.~0 Stote of Minr?esota Stotutes and City of Eogan Ordira~ces. Sipnaturc of Permittee A Building Permit Is issued to: Z~ol~e£son Ruil~pr$ on the .~ress co~d~t~o~ ~h~~ all worlc sholl be dane in xcordance wfth all appUEobla State of 1~4~nnesota Statutes and City of EaQan Ordinonte~. Buildinp Officlol ~ / P~rmit Na Permit Hold~r Misc. PKmit No. Holder PlumbfnY ~j 2~"~ ~H 2- ~'l S_Z H.V.A.C. S I'l S-~$'3 W~tsr W~11 Disp. • S~wer E~~ u~o73~ ~ ti ~(~c ~ S-f7-Fr3 ~ Inspsdion Date Insp. Other Footinyt $3 ~ Foundstion Framinp ~ RouYf+ P~~ cJ Rauph HVA Inwlation ~,~J J'r--/~'F~ trY ~ Finat Plbg ~J - Final HVAC F~~~ P-~- ; . Water De~cribe Location: YII~II . Sevwr Pr. Di~p. ''~~!'1~.~ : w~. - ~`I'"~.,1~F'r' m~ ~ `S~~ ~ ~ ~ ~ ~~~~Yr~°!!r~"°~A.~~-r'~ ~ , ~ r ~ ~ s ~ ~ r ~ ~~r ' . " 4 , < : , ;="_l ~r { r' ~ :[iF'~+`~.(~.'c~t r~~i"~_3_~1=~'~"~'.'~"QCti~L.4.~i~• >°~r~~"_~~iT~`,._.a~"ss`Si~"`x~""~T_r.~{i7-~%. r. f ~ ~ a~ ~~.~s y' (~~e~#tftrttt~ ~f (~rr~t tt~cr ~ ~ r~ ~ ~ _ ~ ~ ~ ~ ~t: ~itp of ~agan ~ ~ ~ ; ~ ~p~rttrhnrni o# ~utl~ing .~n~.~pr~irri ~ ~ ' , ~ . Tbis Cc~ti ~cate i.rsued urrrr~ant ~o tbc s rdr~mcrua o Sertime 306 o t!x Uni ornt Br~ildin ~ h P ~ f f f g; !'r' Codr artif ying that at the lime of itsrea~uc tbit nracturc wat in co~ri pliancr uritb tbc vasiorrs ~:;i ordinancu o f thr Cit y sc g xlatioo g btrildia g cmtrtruction or utt. For t{x f ollou~in g: ' ~ ~~I SF DWG/GAR ~ • 7892 I' ; ~ u~. c~~~ eua~. r.mr~ No. ' ~ y~ o~w~r~Yw R3 bwc~m. V r~~~~. NA z~+~n~~ ~ ~ 1. ~;1 'r . , p,,,,w~~„y~„a Tol lPfcon RldPra_ ,we~.1655 Norwood Dr. , EaQan ~F 4836 Shevlin Court ~nLot 16,Block 1,Brittany 4th~~~~ ~ ~ ~ ~ ~ ~d,~ ~ August 11, 1983 ~ ~otHcW Q,~r~~ D~a: ~ ~a~ i ~c. ` ~ ~:I i~ rr7~ .c.. ~M w ew~ncuu,,. ..,,c. - ~ . ~ !:_I ~~~=i ~a`~~~~~_.,~:~ ~'`.b~..`aiL~a..~~~.~ ~Siq~a~ y ~ ~ ~ ~ ~ '~~D r~ a . . . , . " " . , . ~ ~-,o~ \ -.~~:i~~<,~~,•~1~~.-,~. ,Lr -r,~,..~~~i.~rt?~~i.'.~-~~- ".n,~~ ~Iv.;~ ~ .e~ - _ ~ ~ ~ ~ - . ' . . n Reoeipt L'''- ~ MECHANI~AL'PERMIT Permit No. ~s r • CITY OF EAGAN F~ J - ~ Frll in numbered spaces S/C Type or Print legib/y Tot 2 ~ 1. Date " ` ' 2.InstallationCostL'-J } y' ~ ` ~A~ f j~; ~ ~*'rt~~t 3. Job Address ~ ~ , ` ~ ' ~ot~~Blk. ~ Tract ~ 1 4. Owner ~ ~ 5. Contractor ~ ~ Phone 2 ~ " 6. Address " `7 h'~ f ' ~ ~'tiM-'f ~ ~ c 7. City 1~~~ State Zip r 8. Building Type: Residential C~' Commercial O Institutional O 9. Work Description: New Q~ Add O Alter ? Repair ? 10. Describe Fuel Type 11. No. Eauioment STU - M. Ea. No. EQUiament CFM Forced Air - l ~ Air Handling: Mfg. Boilers Mech. Exhaust Mfg. Unit Heater Mfg. Other Air Cond. Mfg. ~ Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinancys and codes,gover~ng this type of work. Signed : ' Y ~ ~ . for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 i ~ Receipt ~_->r' PLUMBING PERMIT , Pe~mit No. ~~LC J~ ' CITY OF EAGAN s F~ c, ! t' T- . Fill in numbered spaces S/C Type nr Print /egib/y ToL 1. Date ` ~ " " ~ 2, Installation Cost f ! i ` ' ~;i ?l~ ~ 3. Job Address i - ~ ~ r~ Lot~~Blk. y' Tract, ' , ~ ~ . . • 4. Owner ' ~ / / r " i-~'~/ ' ~ /Ji~ s I 5. Contractor ' L % / /l i7 iT v _ Phone ' ~ ~ % / ~ f 6. Address f~ t/ _ r~ ~ L/': F r'f i ' .~1 7. City ~ c- State /1~ ' it~ Zip 8. Building Type: Residential ~1,~~ Commercial O Institutional ? S. Work Description: New Add ? Alter ? Repair ~ 10. Describe 11. No. Fixtures No. Fixtures Water Closet Cesspool/Orainfield Bath tubs Septic Tank ~ Lavatory Softner Shower Well / ~r~~ f Kitchen Sink Urinal/Bidet Other ~ Laundry Tray ~ ~ / Floor Drains Drinking Ftn. Slop Sink Gas Piping Outleu 12. I hereby certify that the above information is true and correct, and I agree to oomply with all ordinances and codes governing this type of work. Signed : ~ = - ~ ~--for , . . Rough Final Inspections: Date Insp. Dete Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 R@C61V6D FROM AMOUNT $ I 6 DOLLAR$ ~oo ~ CASH ~ CHECK FOR I~UND CODE qMOUNT Thank You ~ ~ BY ~ White-Payers Copy Vellow-Posting Copy Pink-File Copy CITY OF EAGAN Remarks Rddition BRITTANY 4TH ADDN ~Qt 16 R~k 1 Parre! 10-15003-160-01 owne? Street 4836 SHEVLIN COURT 5tate EAG11N MN 55122 Impro~ement Date Amount Annual Years Payme~t Receipt Date STFIEET SURF. Sp 1982 452. 94 90.59 5 A 263 8-23-83 STREET RESTqR. GRADING p 1981 23.82 1.59 15 19.08 A012636 8-23-83 SAN SEW TRUNK 1976 173. 90 11.59 15 81.18 A012636 8-23-83 ~'e SEWERLATERAL 19$1 246.3Z 16.4Z Z~ 147.Q6 « « Sewer Lateral (trk) 1983 133.33 8.89 15 lOb,67 " WATERMAIN 19$Q 629.2J 62.93 ZO ~ WATERLATERAL 1981 15 WATER AREA / 1981 229.95 23.OQ 10 160.95 A01263b 8-23-83 STORMSEW TRK 1981 596.40 39.76 15 477.12 A012b36 8-23-83 * STORMSEW LAT 19H1 IS CURB & GUTTER SIDEWA~K STREET LIGHT RO 250.00 143 ~-k-83 WATER CONN. ~150.00 n ~UILDWG PER. 8 SAC n n PARK This .e4uast void ~ ' ~ ~ ~ ~ ~ ~ ~ !g rl / ~.~.h 3~g s6 18 rtwnihs iwm Lr.--. ~ ~ @~073941 ~ ~E4 ~s~ Requesf Da~e ~ Fire No. Repuliedl nsUection ~Ready Now ~W~II Notify Insoec- .~'/3-b3 Ves ?No ~orWhenReady Lice~sed EIeC[rical Contractor I hereby request inspection of above ~ Owner ~ alectrical work instalied ar. Streat A~tlf ress, Box or Route No. City "P ~if ~U,L ~.J CSJ- ~s3 ~n~ ecLOn o. Township Name ot No. enge o. County OccuD'a IN71 Phone Nn. ~9 Z Sa.J Power S pli r Address ,E'e-~r~ Electr~ ontracmr ICOmpany Namel Convactor's License No. C`i/-1 _ ~i.r2~,u ~~/(oD3- ~ Mailinp Ad ess IConlractor or Owner Making Instailationl / °L~- /V~~~r6f/~ Author' ed S~B~~ture ICOntractor Owner akinB 'tallafionl Phone Number p G~• , cF0 MINNESOTp STpTE BOAPD OF ELECTNICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midwey Bldg. - Poom N•791 BE ACCEPTED BV THE STATE BOAN~ 7821 University Ave.. St. Peul, MN 5610q UNLESS PNOPEP INSPECTION iEE IS ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION „ EB•00001-04 ~ ' See instmetions for completin0 [his torm on beek ot Vellow eopy. ~ ~?~94~ '"X"-z?elow Wak Covered by Thrs Request ~S gSd Add Rep, Tyoe of Builtling AOaliences Wiretl Equipment Wired Home Range Temporary Service Duplex Water Heater Ligh'tiny Fixtures Apt. Buildin~ Dryer Electric Heatin Commercial Bldg. Furnace Silo Unloader industri2l Bldg. Air Conditioner Bulk Milk Tenk Farm ther Oea y Otherl$Per.i}yl t ,r Suecily Oiher Orher Compute Inspection fee Be/ow p Fee ServicaEntranceSize q Fea Fexdars~5ubfeeders ~ Fow Gircuits O 0 to 2D0 qm s 0 to 30 Am 5 0 to 30 Am ~s Above 200 qmpy~ 31 to 700 Amps 31 to 100 Am Swinming Pool Above 100_Am s Above 700_Am s Transformer5 Irrigation Booms yL Pdrtial~bther Fee Signs Speciallnspection Remerks S~ ~ TOT -.f~ Roueh-in ~ Oat^ J`~ , e E cel nspec~oq hereby certify thet the abova Final ' ~^I~e inaoection has baen v tl ~a made. la ranuast voitl 1B manths ~mm _ ~ ' ~r~ CITY qF FIiGAN Inclucle 2 sets of plans, ~ ~ 1 site plan w/elevations & B[JILDING PEPMiT APPLICATION 1 set of energy calculatians. 7b se sea For ~jy~(a~~- Fq~_ Valuation~<5`~ilSOO Date I~lf.ll,~(.~~ .3C7: ~~g~i I Site Address _'~j~ ShpVflVi l C1LLV-~ ~ pFFICE USE ONLY Lvt 1~ slocx sec./sub. ~ grect ~ occupancy ~ 3 ~ Parcel fSp~ ~ 1~DC~ Alter Zoning Repair Fire Zone ' Oumer: S~P, P~.~In 1 Enlarge _ Type of Const. ~ Address: Abve # Stories , Demolish Front y3 ft. ' Gity/Zip Code: Grade Depth y~ ft. Phone APPR(7VAL.S FEES Contractor: Ic"~[IP-F°f~~1L~!'~P TL~i. Assess~nts Pexmit .30/ Pddiess: ~jh~'i~i f.~'Tb'iAl(~ ~4'I~JQi Water/Sewer Surcharge ~ . Police Plan Cltieck So : City/Zip Oode: Fire SAC ,g`~3"+~" Phone ~,4~-- ~ 7~ ~9' Wates Conn. ~,/c5-p Planner Water N~ter ~ ~g_; Council ~ Unit Bldg. Off~j Address: APC ~ City/Zip Code: Phone 7C]TAL l~ ` sd , ( . V\ ~ ~ / ~ ~ ~ o V" ~ ~ ~ CITY OF EAGAN 9795 Pilot Knob Reed Eegan, MN S512t • ~ ! N° 7892 PHON[: 454-8100 ~ - BUILDING PERMIT Rxeipt # Te bs aaed for SF DWG/GAR Esr. Valua $56,000 Date April 4 19 83 Site Addreu 4836 Shevlin Court Erect ~ Occuponcy R-3 16 Block 1 $ec/Sub. BTittany 4th Alrer ? Zoning R-1 pa~~ # 10 15003 160 Ol Repuir ? Flre Zone NA Enlarge ? Type of Const. V c Name Tollefson Builders, Inc. ~~e ? # Srories ~ Address 1655 Norwood Drive . Demolish ? Length~ " Eagan 55122 p~,o~ 454-6873 Grade ? Depth 46 Sq. Ft.- p Name DWi1eT Aovrowls Fees ~o" Addreu Assessment Permit 301.0~ V~ Cit ' p~e Woter & Sew. Surcharge 28.00 M~~ . . Police Plun check 150.50 ,'~'„w Nome Fire SAC 525.00 ~ Address Eng. Wafer Conn,4,~Q,.Q~, <W C~ pha~ Planner WoterMeter 60"~~ Counc7! Road Uni~ 250.00 1 herc6y acknowledge thut 1 have read this opplicotion and stare that g~dg. Off. the in(ormation is corrett ond agree to comply with all opD~~~able APC Totul $1764.50 State ot Minnewta Srotutes and Qty of Eogan Ordirances. ~ Sipncture of Permittee Tollefson B~yilders A Building Permif Is issued to: on fha express condiNon Ihat all work shall be done in acwrdance with all aDVN le StotU~~ ne a..5tatutes ond Cfty of Eagan Ordinances. Bullding Official Lk/ (~I ~ ~ ~ ' U °i ~ 2005 RESIDENTIAL BUILDING PERMIT APPLICATION ~ ~ City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Conslruction Reauiremanfs RamodeVl2eoalr ReauiremenGa ONice Use Onlv 3 registe2d site suneys showirg sq. fL of lot sq. R of house; and ~II roofed ereas 2 coples of plan Cert of Survey Recd _ Y_ N (20% mazimum lot coverage allowed) t sel of Eneyy Calculations kr heated addNOns Tree Pres Ppn Reo~ ~ _ Y~_ N 2 copies of plan showing beam & window sizes; poured found desgn, etc. t site survey kraddiUons 8 decks Tree Pres Required ~_Y _ N t set of Ene~gy Calculations Add'dion - indicefe ilon-site sepflc sysfem On•site Septic System ._Y N 3 copies of Tree Preservation Plan'rf lot platted after 711193 Rim Jolst Depll Optbns selectbn sheet (butdings with 3 or less uniLs) Date ~ J /~O` / c Constructioo Cost ~ 6~~~l ~ Site Address ~ ~ c~ ? l"e V ~ 1 + UnitlSte # Description of Work 3~'L~(, J11~-e. J~JI ~ 1~ l~ ._Q ~S~ ~Y~ C~ Multi-Family Bldg _ Y_ N Fireplace(s) _ 0_ 1 _ 2 Property Owner l [MLA l ~J~.,~~ Telephone #~qs ~ ) ~ The Home Depot A.H.S. Inc. Contractor 3200 Cobb Galleria Pkwy. Address Atlanta, GA 30339 Ciry State 763-542-8826 _ Telephone # ( ) License #20268257 _ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 Enefgy Code Category , Residentfal Ventilation Category 1 Worksheet • New Energy Code Worksheet (Jsubmissiontype) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan2 _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Telephone ) Mechanical Contractor Telephone # ( ) Sewer/Water Confractor 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 appxoved plan 'n the case o ork which requires a review and app al of p ~ ~ CG~ , ,^^5 Applicant's Printe Name Ap c t's ignature j~ , L - " - - ' ~FFICE USE ONLY Sub Types ? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. AR - Multi ? 03 01 of_ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) O 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gaze6o) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? O6 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 'Demolif3on (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 _ Foo[ings (new bldg) _ FinallC.O. _ Footings (deck) _ Final/No C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final _ Framing _ Siding _ Stucco _ Stone _ Brick _ Fireplace _ R.I. _ Air Test _ Final _ Windows _ Insulation _ 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 I ~ . . . . . . V . . . . . . . ~ ~ Installed Siding and Windows ~~ane Ser',~~~' IA LIMITED POWER OF ATTORNEY , , . ~ COUNTY OF COBB STATE OF GEORGIA KNOW ALL PEOPLE BY THESE PRESENTS: THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania ("Principal"), and a licensed contractor of RMA Home Services, Inc., DBA Home Depot Installed Sales located at 660 Mendelssehn Avenue North, Go',~'en .'a!ley, T~IRT 55427, having a license num6er of BG 20268257, do hereby appoint, name and constitute Elder-Jones Building Permit Service, Inc. ("Agent") as my true and lawful attorney-in-fact and do authorize and grant said attorney-in-fact for me and in my name, place and stead the power to execute, acknowledge, sign and deliver (in such form as may be required by the municipality) a permit application, or any other instrument(s) which may be necessary arid appropriate, in order to obtain the proper permit(s) from the City of Eagan, Minnesota for the installatiog, maintenance and repair of windows and siding (the "Work"). The powers conveyed to the Agent by this Limited Power`of t?~ttemey are limited solely to the expzess powers, delineated herein and apply solely to the Work. This Limi*ed Power of Attomey shall expire and automatically be revoked on the 21st day of Iv[ay, 2004, which date is one year from the execution hereo£ Further, the powers conveyed by this Limited Power of Attorney may be revoked by Principal at a~iy time by express revocation and shall also be revoked by the Principal's death, disability, incapacity or incompetence. I!~T WI'L'NESS WHEREOF this Limzted Po~a~er ofA±torney is ?_,ec~rtcd this 21 st day of May, 2003 . David N. Katz SWORN TO AND SUBSCRIBED BEFORE ME by David N. Katz on this 21 st day of May, 2003. ` C~ Notary P ic in for the State o 1~ f'~C'eorgia My Commission Expires: 7anuary 21, 2006 79681S.v3 ~ Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor. 3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPOT Cities Di ital ualitv Control ~ The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. , , _ , , 'S~Ilefaon Euildere` Inc' } ` ' : ~ ~ ` ~ flI.11395 . i. . ~ . . ~ ; %E 183 ~7A _ . , ~ ~ , . JACKSON ==Sf.~RY~Y~'3RS ~ ,~c~~~-~ ~ 1'! 3O`~~; F , . , ' ' ~b.Et~,tA~?~ 4R~ € ~ ,yy" ° x.. ~ ~ ` ~ . - . ~ +eaa~sraneo uMUR uw~ o~:~rrwn or rie~marK~ . ~ ~ : ooo-°~` .~7(I,STlNC~ r:, . . ~ ~ ~ . ~ - ~ ~ . - . . , . . . . ~M~. . ~ . . 3616 EAST 65M ST~tEET. 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" • o ~ r~ fti N,C1 ~ ~ft u'C+~~ ~ I..l.'~.i'. a~~_at:~~•T1_a2i?":~~~'.~:~=.7 h~~a~~~~~.E~sS.l~`~.e~r.~~d.~_sw.2,_-".'.w:~IL~Y~Sfu.7'~u~~..u,~.'_°~-.~1~~ ~u;.J) 1'h~ FERMIT CI.TY OF EAGAN 3830R'ilot Knob Road PERMIT TYPE: a u z ~ o z N c ~ Eagan, Minnesota 55122-1897 Permit Number: 0 3 3 0 8 5 (612) 681-4675 Date Issued: 08 / 31 / 9 8 SITE ADDRESS: 4836 SHEVLTN C7 LOT: 16 9LOCK: 1 BRITTANY 4TN P.I.N.: 10-15003-169-0] DESCRIPTION: ~ REROOF/STORM DAMAGE By~,~t#~' ~~Permit Type STDRM DAMAGE . B,~°~,~,~d.3Gnt,j 4Id°~k Type REPAIR a,~en~r~~ C~sd~ 434 ALT. RESIDENTIAL ~ f 9 i. „~t ~ 'm4 ~az ? ~'~z ~ v, s",. ~ ° P ~ ~ '*_3~..v;3~~",?"m... 5 r W"` ~`>xi c ~y~:;c"`-~'$ ~„,k "~y` 5~yu'"z~~iw~r.iA~~w g Y ~a ~ flg ~ ` T' e ~ r r• .?~.,x:p`~2Fx~ ~ ~ k ~F ~at gF~Y ~ S L`` Cd.s~~ ~ ~ ~ ~ } ~ ~~2 ~~~.f. L' a ~i+d"fi u4''~~~~ar. '+5m..n~i~d'$'~ ~a' ~ ~wSL~~ ~ ~:~°^~.t ~s:: q:`y ~ .HV .,.w d ti~. 4(tIPN• E°t2u~.. REMARKS: FEE SUMMARY: CONTRACTOR: - Applicant - sT. ~IC. QWNER: WE$TURN CEDAR SUPpLY 1541030Q 20014207 DUNCAN MARY ' 705 N HWY 169 4836 SHEVLIN CT , PLYMOU7H MN 55441 EAGAN hIN 55122 i (612) 541-4207 (651)686-5574 i ~ I~ar~tr~ ~~Itr~vw~eci~~ ~h~t ~ have :reacl th,~~ ~p~p7~~.cata"~ar~ ar~d; s~a~e ~t~~~ Ch~ ° ~~rtf~r"m~'~idp ~~.s ,~~s~r~~~t °arrd, ~gr~~ `to aomply wi~l~ a,i ~ppli~db~e 5~~te irtn_ `x~ ° ~~~u~~s a~n~1 G~t~ ~~'~~g~n`• irr~iir~~nces. ~ . . ~ ~ o. ~ _ ~ ~ ~ _ . _ . . . . ~ J APPLICANT/PERMITEE SIGNATURE (}~SUED B~ /RE 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN , ~,~0 3830 PII.OT KNOS RD - 55122 ~ l `Q, ~ 681-4675 ~ New Construction Reauirements RemodeUReoair Reauirements ? 3 registered site surveys ? 2 wPbs of plan ? 2 copies of plans (inGude beam 8 window saes: poured fid. design; etc.) ~ ? 2 site surveys (e~ctenor atlddiona & decks) ? 1 energy calwlationa ? 1 energy calculations for heated add'Rions . ? 3 wpies ot tree Dreservation plan if bt platted after 7/1/93 ~ . required: _ Yas _ No ~ DATE: ~ CONSTRUCTION COST; c~Zc~U ~ DESCRIPT N OF WORK: U ,/n S -2~J~ i Y~ S E ADDRESS: ~7"6 3~n (17U~ LOT: ~ ~A BLOCK: , SUBD./P.I.D. 1 ~Y ~ ~Q-U~.u - Name: 1 1[~lV ~i~/" ~~~"-~-f _ Phone lC~lJ ~ PROPERTY ow~R ~4~~310 ~ S~~l~ ~ ~,e.~ Street Address: City State: ~/v ~ Zip: l1J f ZZ Company( ~t ~'C~~U~ ~1~ Phone ~ ~3Q ~ CONTRACTOR ~OS ~ j i 1 ~ / p ~7 Street ess: /VI ri l.~y (X 1 License # l_r~ U~~ Z-0~ City ~ State: /r Zip: S / ~ ~ _ ARCHITECTI ENGINEER Company: Phone Name: Regis~ation Street Address: City State: Zip: Sewer & water licensed plumher (new conshuc6ion only): . Penalty applies when address chang and lot change is requested once permit is issued. I hereby acknowledge that I have read this application and state that the in ation is co t and agree to Compiy wittl all applicabl State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: ~ ? ' DC~GG - OFFICE USE ONLY i ' II Certificates af Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No _ Not Requ red OFFICE USE ONLY " ~ BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish 02 SF Dwelling ? 07 4-plex O 12 Multi RepaidRem. O 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. ? 1 ~_-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 Pian Review License MClWS SAC City SAC Water Conn. Water Meter Acct. Deposit SNU Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: °.6 SAC SAC Units ~ ~ CITY USE ONLY SS L BL RECEIPT#: I35 ~ SUBD. k~Tl~ Q11V N7y~ RECEIPT DATE: S'~' D ~ PERMIT# "IZI~'~ 2000 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PIIAT IQd08 RD EAGAN, IRi 55122 651-681-G675 Please complete for. ? single family dwellings ? townhomes and condos when pertnits ere required for each unit ? backflow preventer for underground sprinkler system FIXTURES EACH ~ TOTAL i Alterations to existing dwelling - minimum fee $ 30.00 ~ Describe: I Bath tub $ 3.00 x = $ ~ Floor drain 3.00 x = $ GaS ipin outlet " minimum - 7 3.00 X = $ ~ Hot tub/spa 3.00 x = $ i Kitchen sink 3.00 x = $ Laund tray 3.00 x = $ ~ Lavato 3.00 x = $ Septic System new/refur6iahed • requlrea MPC Ilc. 75.00 x = $ ~ Septic S stem abandonment 30.00 x = $ RPZ naw installation/repeir/rebuild 30.00 X = $ Rou h o enin 1.50 x = $ Shower 3.00 x = $ Underground s rinkler if dweliing is under construction 3.00 x = $ Undergrounds rinkler itexistingdwelling 30.00 x = $ Water closet 3.00 x = $ Water heater 3.00 x = $ Water softener if dweilln9 under conscructton 5.00 x = $ Water softener IT existing dweiling 30.00 x = $ Watertumaround 30.00 x _ $ State Surcharge .50 $ .50 Total Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc. • I hereby admow~edge that I hava iead Mis appliwtlon, state that the infortnation is wrtect, end egree ta wmply wRh all applicabla Ciry of Eagan ordinances. It is the applicanCS responsibility to notity the proDerty owner that the CBy of Eagan assumes no liability for any demages caused by the City during its nortnal operetionat and malntenance activities to the facilitles construGed under this pertnit within City property/righbot•wayleasement. SITE ADDRESS: Mccau~EV, MAav 4836 SHEVLIN COURT EAGAN, MN 55122 OWNER NAME: : ~ssi~ sss-ae~a TELEPHONE (AREA CODE) ' INSTALLERNAME: ~~,~OK[1iLOYT~ 1 LlJMP2J 11~( l_o TELEPHONE#:~ ~27' TU3~ c (AREA CODE) STREETAD~RESS: _Z.i~O J~ ~f}Q~= I ~LIS ~fJ~ JO CITY: M/iUAI El~}POL.f `J STATE: ZIP: 5 V - ~~~~~~i~,~-- SIGNK7URE OF PERMITTEE ( ~g f MECHANICAL (RESIDENTIAL) ~,ja Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Please complete for. Single Family Dwellings Townhomes and Condos when permits aze required for each uni[ ~ Date U / ~ / ~ ~ Site Address ~~3h ~1 /c I/L/~ Unit q Property Owner Telephone # ( 6s~ ) ~ ~~b ~ Contractor Street Address City State Zip Telephone # ( ) The Applicant is ~Owner _ Contractor _ Other Add-on, modification or alteration to existing dwelling unit $ 30.00 ~j fumace replacement ~n~ ~ ~ , ~ air exchanger D~ P,~ Q 9 air conditioner - M ~ J other o - 6`1 ~ ~ State Surcharge $ 50 Total $ ~ ~ I hereby apply for a Residential Meckianical Permit and acknowledge that the information is complete and accurate; that the work will be in conformauce with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a pernrit, 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 approv d plan in the case of work which requires a review and approval of pl . A/~o c~ ~~or,J,c~ ~ ApplicanYs Printed Name ApplicanYs 5ignature MECHANICAL (COMMERCIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Please complere for. commercial/industrial buiidings multi-family buildings when sepazate permits are not mquired for each dwelling unit Date / / Site Address Uni[ # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) Contractor Street Address C~~, State Zip Telephone # ( ) The Applicant is _ Owner Contracror Other Work Type _ New construction Underground Tank Install Remove _ Interior Improvement Call for inspection during installation/removal of tank Processed Piping Nature of Work: POrlrlit F0¢ $50.50 Mintmum Fee (includes Stace Surcharge) Contract Value $ x 1% _ $ Pernut Fee • Ifpernvt fee is $1,000 or less, add $.50 ~ $ State Surcharge If pemut fee is over $1,000, add $.50 per $1,000 Permit Fee S Total Fee I hereby apply for a Commercia] Mechanical Pemut and acknowledge that the information is complete and accurate; tl~at the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand tlris is not a permit, but only an application for a pemut, 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 Approved By: , Inspector Date: PERMIT City of Eagan Permit Type:Building Permit Number:EA117563 Date Issued:10/21/2013 Permit Category:ePermit Site Address: 4836 Shevlin Ct Lot:16 Block: 1 Addition: Brittany 4th PID:10-15003-01-160 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 . Nathan Corbin 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 - Tory A Nelson 4836 Shevlin Ct Eagan MN 55122 Corbin Exteriors Llc 1115 Southview Blvd South St Paul MN 55075 (651) 760-3116 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink --------------, � For O�ce Use I • � �. �� [�� I Permit#: � � � �� I � Permit Fee: � I 3830 Pilot Knob Road i � Eagan MN 55122 I Date Received: � Phone: (651)675-5675 � I Fax: (651)675-5694 � Staff_________ ��J 2015 RESIDENTIAL PLUMBING PEFtMIT APPLICATION Date; Site Address: �� '�/��' �� Tenant: Suite#: �� _ � � � ' Name: � �� cS��. Phone: � � ��i��CI�`I�W�1'' � � =�� 'D � ��.� ��-Sl Icw � �S�� —`� �R F µ Address/City/Zip: � ,�- � � � v / _ ",� � � � � ,�� '-�.�-i ,F��`��'I�I'� = � Name: � ,� �[��S' � License#: ��L} D ��...�� y��i,�i�� ;�� t��s �i��#' .� Address: �(�i � � D `C�- c�' �Gc3 _City: ��"�,�,.-"µ.Q.�, on, � �� , � �� State:�Zip: �5�� Phone: �/�-�-" d"'l��'��/��` �� ,) _ - �� Contact: V'�'�-T3'�� Email: � lu��„�-( c� � ' ;C � � � � � � � '� � New � Replacement _Repair _Relbuild _Modify Space Work in R.O.W. � 'N� � P ��f 1�fl�t� '��s r — — � — � � ,�� !��ti � � � � 6�'�`�� ' �� Description of work: � � �� i�,�� ba� RESIDENTIAL � � � �� a'!�� Water Heater � � � � � �� r� " �'�� ,� =�� Wate��r Softener � �4��r�� ""�� Lawn Irrigation�RPZ/ PVB) � � �� E� ,�; 5 i� d�� Add I�lumbing Fixtures�Main/_Lower Level) ��!�,i�,�,; ��,�. SepticSystem ��II�� '�Pla�� ' Water Turnaround �y� � ��r�� —New � �I��: � "i��,�� "_ ' Abandonment .� . At RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge) $60.00 Lawn Irrigation (includes$5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures, Septic Svstem Abandonment,Water Turnarc�und*(includes$5,00 State Surcharge) "`Water Turnaround(add$210.00 if a 5/8"meter is required) $115.00 SeptiC System New($10.00 per as built)(includes County fee and$5.00 State Surcharge) TOTAL FEES$ 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.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 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 ��,�-l� �� X�/�� ApplicanYs Printed Name ApplicaM.'s Signatu e � . '�.- dyi� ��"`'�—"°�e�§�':ia� �`�n�� > ia��;y��Idii iq�na�`�'� : ' ��r�� '� a :; � � `�;�?F�"„��FI�� I�E ;�� ,�F ��7,i� ;��Y(@V{€�C� NS ��r�`[��ru.. �_��?��II .��@, . ' I�IJ�� h;Np a n� �'_�� MxiP,��,� � ��'^� ��'�) �1�'�"" '^ + �6i N�� N�� -�'s,;�i iiP�, i5,�ry" �. I IhH � y.�I .. -. ' : ��'�IG�n i�l�N�� ., s� �� ( � i��' � R��d�Ins�. t�c�n�� '�r�� tlr�der � �:.:: r,�d �_ � :Rr�u�l�-1n,� ��l �1�r..:'T�s# �,,' ,� ,'� � �ry, 1 �$ ��». :��.-.� �' . G� �I I'lry'�i( ��' ' � ' p: �'�� 'm I�i �I�� ,�� , ��.��.� '� �y : �� L'S�� r i �- �' M *lll _kl+G�� `; k �� _ t,� a`�"• . . .� �,i.x ,. 'a�rs .a_ .. --�, . ��: . �:., sz . _ : -: . ' .. �' .,� � v 4 i Y _ -�'.,�:.. Use BLUE or BLACK Ink For Office Use, I L-ib 1.516 ity ::: 6-1� Eaali .._„ : J 411/ 4/3 3830 Pilot Knob Road C`' `u �$ Eagan MN 55122 Date Received: f i fie Phone:(651)675-5675 Fax:(651)675-5694 Staff: teYJ I 2016 RESIDENTIAL BUILDING PERMIT APPLICATION tv' LP Date: Site Address: Unit#: Name: -104—( ) ?%1Ei_ c%/4 Phone: Resident/ Owner Address/City/Zip: 4,51 Ce moi-I��/t GT r 't-444 Applicant is: Owner Contractor Type of Work Description if work: /GS I- /��Crr -Z /411./AL.4-7 Construction Cost: �� Multi-Family Building:(Yes /No Company: /ice 7`0 °fir Contact 57&-116 C' Contractor Address: /ill'l 0D7/0�e-- G/ Ci . lP�urc�.vl-- State: __'44 Zip: S-S-V 9G+ Phone: 055 72Z 14 ail: S/ V tt "if' tri r c'`<�/i'�, License#: (�C 44 3 `� Lead Certificate it: ,(7/2 If the project is exempt from lead certification, please explain why: I. / g1--- f 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: Fire Suppression Contractor. 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. Cali 48 hours before you intend to dig to receive locates of underground utilities. www.00aherstateonecalLorq 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 I pproved plan in the case of work which requires a review and approval of plans. Exterior by a building permit Issued In :--• -.• co with the Minnesota State Buil• . Code must be completed within 180 days of • ,/,f uance. Applis Printed Name Appii Signature +' 5'�c�V&-?T4Tfp Page 1 of 3 1—f 3 5v i C DO NOT WRITE BELOW THIS LINE (4/01)-8 SUB TYPES — Foundation — Fireplace _ Porch(3-Season) — Exterior Alteration(Single Family) Single Family _ Garage )c Porch(4-Season) _ Exterior Alteration(Multi) Multi — Deck _ Porch(Screen/Gazebo/Pergola) Miscellaneous 01 of_Plex Lower Level Pool Accessory Building — WORK TYPES (,, New off Interior Improvement _ Siding _ Demolish Building* Addition r _ Move Building _ Reroof _ Demolish Interior _ Alteration _ Fire Repair _ Windows _ Demolish Foundation Replace Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION � /I Valuation 4 Occupancy MCES System Plan Review Code Edition prti)--pjr SAC Units (25% 100% X) Zoning D00 City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction Vr✓ Width R QUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) Final/C.O. Required Footings(Addition) Final I No C.O. Required Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test Roof:_Ice&Water _Final Pool:_Footings _Air/Gas Tests _Final `f., Framing i 30 Minutes 1 Hour Drain Tile Fireplace: Rough In Air Test _Final Siding:_Stucco Lath Stone Lath _Brick_EFIS �( Insulation Windows Sheathing Retaining Wall:_Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: /0V , Building Inspector RESIDENTIAL FEES Base Fee [//vc) -6/ i°r4/ Surcharge Plan Review Pell- MCES SAC y Co City SAC ( 7 -.:•cr /1 q I Utility Connection Charge S&W Permit&Surcharge 06/Lilt Treatment Plant / 0 :2 Copies TOTALif 01 IZQ 51: U' ( ' ge2of3 I � Yollefxon builders Inc.. ; I'.. A, r „ ",3+ys yiaya» *;; z• RARISTERP.D UND.R LAWS Or STATl Of MJIHME OTA ;`: +.� ►` •t •' • Doo-6'' .• X I ST I LIC,.' 3616 EAST 55th STREET•MINNEAPOLIS,MN 55417 727-3484 ....• DIA) EA�J, , �, • :. L7F?PkjN}} E '• • . *ut tpar'0 Certificate . . �.. • .�. . L... yam ! i_��+ �};/ 'r • tri ' .'I ,� ;'; s�I KE / ` • . 9 tsit a • U �d - az. :•., . 2 . a i\---. NI.'•-4 /4.4,5$44, PL I r . 1 ' s`$ r Foye M"l('W^ �L . OT _....i \• t.c. i ... .. ... ,. . . I `#,,�‘'' N GARAGE n • (-10, - - . 30,00 - - `BIKE. •• : . .. • • • ,-� }IBJiPLAT . , i ^ EPCr•1' Y CRTiTHAT Tib[ ABOY[ ttl A TRUE AND CORRi CT OF �NRYt'r dI . "+ • " ,, ..r t • - Lot6,BIock 1,Brit ny -4 . Mdttiaa, ,, tau F . = Dakota -County ILL wets v F• :&. , • ,��s; �,. t 1. , -*ty _ '; f . . x :, • ' '�• e3t�. • ,• ' .,..F. ,�' •, t,...-.1.,..•,,m, , \r• x n po $f•r' ..:• '•,il1s*,'1:01P,24.--''':..4 :7.,4+1{ • • q • ' "-W.' :,•' "c• •r_� ro ... Z »i iapo .1i :4100 3.0W Al.// 97.3 d•'. +'1/ yt + it .• • n -;:-'4'.;.t,.,,. - .� r- r,, ,,,,;.1F �r t - ; �`7 4�, 7 r i' ; /�n,"�• Y'ti,�y�w • C r> K + ,'4 '..t. ..7,-;'.4...• ya'....%1;.....‘..: I. y ."r v�,„6`?.t11 43.1,`'x} , ,.•., w,i i 4 a, .1{1 t .1N ',44''', •29 t'M r• .i ..,:mP , 1vr Y i.s, ` 3 !..0. �i. •L+Y' v zW x" .e • >t' � ..`^i} }A•yxj - a AsTimiRytiYRD7Y iit"'iM 'Y OI •11 -3 t+: f' " ., k At,• c. `+ x,z t "•y� . t`, } •. '` t • f+ 4 Y l�C ',";"` F,t ,/ ..• �t rtit; + t•.-:'t,,.:"{'• ti� \ ky .r ^ } }'3"tlf :''':"":‘0.i. } } .� *tw ori . .,',W �siri�, I A.+A�'�t+�" ,v'y,^ ?,‘1/4';-;....4 •6,t x rtr -"',-' 1� v'a x '. e.';'•`:;;•.+t''9• y� r .;e4:16 •-1.e .n , Z -.7.:5A14 ••4; t:-},d r4. •.! ,C' T�7 n. . 1,_ ,v%. t i• 5'y� �.„ •>,.• `., ..,4,-„,.,' 1 , �I+ °'' • ..„ 011/61-?41 .1116-PXr. ;: a• ,,;` ' i,.t t •w:i f r R�'• : ':E,;,,',';'\41.'4!•,.;,',...;• rK4 7T - ,t,t• 1 i • .F ";e �:Pa " t -� ,r ,r• ,� . sc3'•..'r n; ',t %'i ' 4«,. r r x%.4 1 : •*r v a ti }mow- • . J ,t„ ; ry:a • i. , • 7,,,''..b.'7'.,%-:;,'...s �* �• r r +..\?+ t •'Y t ,. k -r rr� ,r 'iv r�"• t+•' 1 ny ;r i cit,.� >.._ t Y �'rtlsha YQ�,t�' •- tom, • �Si Tx•. + . . ')• 1 .✓ �� .1.4.,..• •t- A"• t. ;v : ``r,+..+ ~ _' i rt � r . ,fx' -x4.�.' ; -',...,•; � 7 t , h� y. Pa ti - . Y � i 4� 1`.:.'9,,+.+ : 'G ', t;'.77,71:.1.' ` Gr'L, `27 ,v "3.t, , . . ! ♦ � rt4. . 4 . * �: ;.y� �� f �' � �y + ,r., 5 'l'" ox :A '�F:• r ., x• - ...:1•• .,..•••• , :,,,,,,...0.:. �II.,J . s 4. . l.a. . ..•••7k+x Je5w4, •✓: ti • • • Use GLUE or BLACK Ink For Of ice(kap• j 1 EaaiiCity of , I Pa�rnit#: / • I; 3830 Pilot Knob Road RECEIVED 1 Penns Fee Eagan MW 55122 ' Date Recetvea `/ Phone:(651)675.5676 MAY 1 Fax:(651)675.6694 i c� 7 2017 f StafiF l I 2017 RESIDENTIAL BUILDING PERMIT APPLICATION I Date: Site Address: f-1h g3 6 S e v11,t c7 unit# • Name: 1 vgy a 3.Ane, e. Aleison phone: f S-7 Igo- 1/44)2 • Oigir Address/City I.Zip: 0'3& SSA v 1 s n C 7^ Ea jtm, Applicant is: Owner Contractor Description of work: wA erl 4 Conatnietlon Cost: Multi-Family Building:(Yes /No X ) • } Company / ►'117r• •1 a► •Mact • Mks. 4-t,rs l kldress: I�3(6 l lk� City te,;dl; Lake stat,:OW Zip: 37.71 Phone:6.0-0/ 1-Wa?Ernaitm Kt e Auccivi g er1sL Nei License#: &661/4/0 7 Lead Certificate#: If the project is exempt from lead certification,please explain why: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEV 'BUILDING In the last 12 months,has the City of Eagan issued a permit fora similar plan based on a Master plan? Yes No if yes,date and address of master plan: Licensed Plumber Phomas • Mechanical Contractor. Phone. • Sewer&Water Contractor: Phone: Fire Suppression Contracts: Phone: 0+�+ + 4i dF iv* " ef. .. $ t. . i CALL BEFORE YOU DIG. Can Gopher State One Call at(651)454-00o2 for protection agglilit u before you intend to dig to receive locates of underground utilities. wwwgoot stateonecaliora 9 u^d Witty damage. Cali 48 hours I hereby acknowledge that this IMomration Is complete and accurate;that the work wig be in con Eagan;that I understand this is not a permit,butanIntense rt Wthoordinances and codes work the CRY Ior n accordance with theonly application for a Pend approval Without Permit; wiltbe InInofwhichrequires of plans,• Exterior work authorised by a building permit issued in accordance with Um Minnesota State Building days of permit Issuance. Ned within 1f0 X rrfr Applicant's Printed Name x Ap licant's Si. , re Page 1 ant • zi .--__.-42 tiliil i4e- " ' DO NOT WRITE BELOW THIS LINE / - 70'7 •SUB TYPES _ Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi) — Multi — Deck — Porch(Screen/Gazebo/Pergola) _ Miscellaneous 01 of Plex Lower Level Pool Accessory Building WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior Alteration _ Fire Repair _ Windows _ Demolish Foundation Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION 111 Valuation 3-0— Occupancy pMCES System Plan Review Code Edition yvivv -t?faF' SAC Units (25%_100%_) Zoning City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction v-6 Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings(Addition) Final/No C.O. Required Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test Roof: _Ice &Water _Final Pool:_Footings Air/Gas Tests _Final Framing 30 Minutes 1 Hour Drain Tile Fireplace: _Rough In Air Test _Final Siding:_Stucco Lath Stone Lath Brick_EFIS Insulation Windows — Sheathing Retaining Wall:_Footings_Backfill Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: '7---- , Building Inspector RESIDENTIAL FEES Base Fee I Vl6tVi firj pet- Surcharge ' vItliti Plan Review MCES SAC City SAC 5/2 Utility Connection Charge � ,;S&WPermit& Surcharge Treatment Plant Copies TOTAL Page 2 of 3 • RECEIVED For Office Userr dj , i s Permit f:: /J (/! ., ,..... ,,,,, EAGAN JUN112019 apt) �� Permit Feet gat, Date Received: 3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810vi (651)575-56751 TOD:(651)454-8535 I FAX:(651)675-5694 Staff buildinainsper tionstp'2citvofeaoan.com L. // 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: (.Y"-1/"—/ / Site Address: Unit#: Name: ilQ-yt2.f=4� N/g/ T0•1_ •_ Phone;�P.7�/— ,7l 67 a Resident/ ,'p' / ,;; T--..4•V.•rnef., t Address/pity l Zip:, y 0�_-7// S'Afl'///J l�f 1 1 i Applicant is: _Owner X Contractor d • • Description of work: )3— l /41s/Gr� k�Gnl d )(kW-en�1� /�1 Type of Work 11 c7� f i V • 'i Construction Cost i fi /' Multi-Family Building: y i _ (Yes_/No•� v /y Compan� _49 .e2�� g� .r0 ontAact ( ' Address:/id33S as h� /a city: ' Contractor , C fx�l -d� l.Q� i, State Zip:55315 Phone: 5 I77/Emt 40 T �Xlz119ed .all-y) 1 License#,gC/i7L 91? Lead Certificate w'v, /66.Aa'a—a If the project is exempt from lead certification,please explain why: i • COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUI • • = In the last 12 • • .as the City of Eagan issued a permit fora similar plan base• - master plan? • Yes _No If yes,date and a.• - •- ter plan: t Licensed Plumber. Phone: . • Mechanical Contractor. Phone: i ' Sewer&Water Co •r: Phone: j • 9 Fire - •pression Contractor: Phone: • i NOTE:Plans and supporting docuni'ents that you submit are considered to be public information. Portions of the information may a classified as non-•ublic if -u•• -vide • 'tic reasons that would• It the C' to conclude that th are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.cnyofeagan.comfsubscribe. Exterior work authorized by a building permit issued In accordance with the Minnesota State Building Code must be completed within 18D days of permit issuance. CALL BEFORE YOU DIG. Call Gopher State One Call at m51)4544002 for protection against underground utility damage, Call 48 hours before you intend to dig to receive locates of underground utilities. www.dooherstareonecatl.orq I hereby acknowledge tnat 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 piens. , /� x hi -i:-�d Sm/44x - lGdALY;<., Applicants Printed Name Applicant's Signature Z 'd 6L9C '°N wd81 : 1 6106 'l Hun(' DO I(OT WRITE BELOW THIS LINE 43 I0 ,..51)e l/// ? Ci- /.5-40/9 ,SUB TYPES _ Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi) _ Multi — Deck — Porch(Screen/Gazebo/Pergola) _ Miscellaneous 01 of Plex Lower Level Pool Accessory Building WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior Y Alteration _ Fire Repair _ Windows _ Demolish Foundation Replace — Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation ir 2i moo.^ Occupancy 'C - I MCES System Plan Review Code Edition lib A ZtO% J SAC Units (25%_ 100% 1°) Zoning R -I City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction U 3 Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) )( Final/No C.O. Required Foundation Foundation Before Backfill HVAC_Service Test Gas Line Air Test_Hood Roof:_Ice &Water _Final Pool:_Footings _Air/Gas Tests _Final Framing 30 Minutes 1 Hour )L Drain Tile Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS Insulation Windows Sheathing Retaining Wall:_Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: ) n VN tn.,'d 1 )IA , Building Inspector RESIDENTIAL FEES F7,4," f-4 e Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit& Surcharge Treatment Plant Radio Meter Read Copies TOTAL Page 2 of 3 //2;11, i r / PROPERTY Appearance Thickness 2 Weight per 1000ft Construction 3" Load at Break Flame Spread Index Smoke Development Index Mold/Fungus Growth Water Vapor Transmission (perms) EM [COL.[ P.O. Box 7486, Romeoville, IL 60446 800-844-2713 815-372-2493 www.emecole.com EMESEAL 90 MIL LINER TEST METHOD Visual ASTM D-2103 ASTM D-751 ASTM D-882 ASTM E-84 ASTM E-84 STD -810 D ASTM E-96 RECEIVED OCT 09 2019 SPECS Foil/White 90 mil 53 Lbs. Aluminum Foil Closed Cell Urethane Polyethylene 140 Ibf, 2100 psi NEPA: Class A NEPA: Class A None <0.002 Note: To the best of our knowledge, these are the typical property values and are intended as guides only, not as specification limits. FMFSFAI 9(l MII I INFR Pan' 1 of 1 a t For Office Use ti. t to Permit#: �.... . , .r �� 630 C—. Permit Fee: - ECEIVE Date Received:3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694Staff: buildinginspections NOV 01 Ca?cityofeaoan.com 2019 2019 RESIDENTIAL PLUAR6itte-PERIVULT APPLICATION Date: 1 /3/) VI Site Address: L.( $36 Sty ,1 . CA et Tenant: � t �i n u\ a. L.S I Suite#: Resident/Owner Name: l , w�•f .�,,meg �. A( U ", Phone: [,a Sl --l0 75_-532)7 Address/City/Zip: /r3(..-et 5 i..,.,,,l A C.t- 0F2 , r, 11 ✓ie fri e /167 - COM Name: License#: Contractor Address: City: State: Zip: Phone: Contact: Email: Type of Work — New Replacement t Repair Rebuild Modify Space Work in R.O.W. Description of work: q-E--�v,-9k-Gti l i t ,to g t �j .c 5 L /1 Tankless Water Heater Lawn Irrigation( RPZ/_PVB) Standard Water Heater DeScri tlOn )( Add Plumbing Fixtures( Main/, Lower Level) p Water Softener Description: Pa.. /4 5)-.,7/< ,<. x,s . <, 5(q.:L... Septic System -' `J New bindonrnent Connection to City Water from Well RESIDENTIAL FEES $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation (includes State Surcharge) $60.00 New fixtures, adding or removing piping (includes State Surcharge) $60.00 Septic System Abandonment $100.00 New Residential (fee collected with Building Permit) $115.00 New Septic System (includes County fee and State Surcharge) $60.00 Connecting to City Water from Well" + $290 for Meter and $190 for Radio Read = $540 *Sewer&Water Permit also required for connection charges TOTAL FEES $ 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 You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.cityofeaoan.com/subscribe. 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 aP ermit; 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 A e ..x _ 5 c n x Applicant's Printed Name AP Signature Si nature Page 1 of 2