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4774 Slater Rd = INSPECTIQN RECORD ~ CITY OF EAGAN PERMIT TYPE: ~ ~ ~ t~ % N +i i 3$30 Pilat Knob Road Permit Number: r, i,,~ Eagan, Minnesota 55122-1897 Date Issued: ' (612) 681-4675 , E SITE ADDRESS: ~ „ ~ , i , ; APPLICANT: ~ A~rFR R4~ ~ r~=, ~.i rtN. ~ f,'r.,~'I i il~~rr~~ ~.y 't l l:.~. : PERMIT SUBTYPE: TYPE OF WORK: y~; . . _ , , ~ } ;~~i~•1~~n i , r~'ri ! . ~•i 1'~i~I~ 1 t1~, f(,t•,fil r~.l I flFl f 11?t r`,( i .:,ll~,~; i;1 { i f't~ 1=lIt1l~li tl~) ;i i t~ ii-~~ ~ ~ i{~, i~ r~~:~ ~'1 (~Ir1i:1 { ~ l;~~' i~1 I I ' i I1~ << it{'!tl I.1;~ { 1 I ~ ~ ~ ~ Permit No. Permit Hotder Dete Telephvne # ~ ELEGTRIC G55 , ~D rJ 9~j ~/47 ~ PLUMBING y~,, , 8'/~1 f~i a3-//~ HVAC ~ (p~ Inspectlon e f p. Comments FOOTINGS ~~/4.~ ~ c aw/s / FOUND Gv g' /S-~l!'o d~` ~u5 D.~ FRAMING lC^ ~ ROOFING ROUGH g ~ ~ - p~ PLUMBING Q-/ L'G PLBG C ~ AIR TEST ` ROUGH G/~~~ C HEATING ~ ~/d~) GAS SVC ~/~Q TEST /l INSUL fv 7 4~ f~YP BOARD FIREPLACE ~/Q gG ~ FIREPLACE AIR TEST FINALPLBG 7J~ Q~ ~ Z L FINAL HTr_, ?1L-~~ _ ORSAT TEST BLOG FINAL ~q/D/_ q 64v BSMT R.I. BSMT FINAL DECK FfG DECK FlNAL ~ _ _ _ 4 j'. ~ i a~..i - .°`a-~ ~ ~ . _ • * r . (~e~ti~.ca#e o~ ~ccu~anc~ ~~j a~ ~agatt ~~~t ~ ~~ar~~ ~~n This Certificaie issued pursuaat 1o the req~irements of the Uniform Building Cade certifying that at the tinee of issuance this structure was in compliance witle the various o~inances of the City negulating building construction or use. For the following: ~ SF DWG s~. 28436 oa~~,,.iy~ R-3 U-1 n~ R-1 7ype Consc. VN o,.~~B,,;~ JOE t~l1LLER HOMES ~ 3459 WASHINGTON DR. ~ EAGAN, !!N 4774 SLATER RD ~;,Y L5, Sl, ST CHABLES WdOD , ; , i oate: ~ ~ j BaildioaOffcpl / POST IN A CONSPICUOUS PLACE ~ 2 6 5~ J 1~ ~ ~O~~~NLY Thi}reqvesl void 18 monihs irom validalion dare pnnfed in t~ ozi~ ~ Y T P~° PLEASE PRINT OR TYPE ~ O ReQawl Dok Roigh-in inspeclion required2 BXEs ? No InspecFon Olher Thon Rovgh~ln: ~ Ready Now [L].Itl'll Call 09-30-96 (1'oum~stcoll~heinspedorwhenready) DaMReady: I, [r]'licensed conirddor ? owner hereby requesf inspedion of the above electrical work af: Jab Pddress (SVeei, Box, or Rouro Na.) Crry Zip Code 4774 Slater Road Ea an 55122 Sernan No. Township Nome or No. Range Na. Fire Na. Ca~nly Dakota Oaupam Phone No. e Mil er Homes 454-4663 PovrerSupplier "~a"" 4300 220th St. Dakota Electric Eleckiml Conhaclor (Compony Nome) Conhatlor icenu Na. Master lic Na. (Planf EIecI. Only) Mi~~ nd Electric Inc. A-01236 Mailing Pddraea (Contmclor or Owner Pedorming installanan~ 22691 Red Fox Dr. Lakeville, MN 55044 AWAoriz re(Canl vmer PeAormir~}.InsMllaXOn) Phone No. 461-1~44 EB-OOOOlA-10 6/95 ATEBOARDCOPY-SEEINSTRUC'fION50NBACKOFY0.LOWCOW Address 4774 SLATER RD Zlp SS12 'IAf ~ 5 Blk 1 Sllb ST CHARLES WOOD THESE TI'EMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPEGTION. Date: / / ~j'(~ Yes No Inspector: Final grade (6" from siding) Permanent steps (garage) Permanent steps (main entry) Permanent driveway ? Percnanent gas ? Sod/Seeded grass v TraiUwrb damage v Porch ? Basement finish c/ Deck ~ Please verify with the builder the removal of roof tes[ caps from the plumbing system and the shuPOff of water supply to the oufside lawn faucet before freeze potential exists. - . , Contact engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system. ~ White - Ciry Copy Yellow - Resident Copy Pink - Conlractor Copy I~I III II I II II I I I I I II I I~~ ~REC}~ST ~R ELECTRICAL INSPECTION Minnesota State Board of Elechicity $ zd 7821 Universiry Ave., Rm. 5-128, St. Paul, MN 5 104 * 0 2 6 5 5 7 1 0 s Pnone (st2) sa2-0eoo 1~~, Home Duplez Apt. Bldg. Other: ~ New Addn Commercial Indushial Farm Remod Re air Air Cond. Htg. Equip. Wotei Htr. Laad Mgm}. Ofher: D er Ran e Elec. Heaf Tem . Service "X' above fhe work covered by ~his reqvest. Enter remarks in this space and on the bock of fhe white copy only. Calculote Inspection Fee - This Inspection Request w'ill not be accepfed without the correct fee: Other Fce #t Service EMrance Size Fee tF Circuih/Feeders Fee Mobile Home Park Stall / 0 to 200 Amps ad 7 0 to 100 Amps $'7 Sheef Ltg./Traffic Sig. Above 20D Am Abave 100 Amps TronsformedGenera}or INSPECTOR'SUSE v TOTAL Sign/Ouiline Lfg. Xfmr. Alorm/Remofe Canfrol $wimminy Poo~ ~ henb ' Mat I ins 'ml i la' daalbed herein on ihe dalee mhd Irriga}ion Boom Roagh-In om«?/ . Speciallnspedion - Investigative Fee F~~'~ Z ~3 THIS INSTALLATION MAY BE ORDERED UISCONNE ~ ED iF NOT COMPLETED WITHIN 18 MONTHS. ~g I'~~ ~~o. o0 2005 RESIDENTIAL BUILDING PERMIT APPLICATION L e~~ n"S~ 3~~Y~05 City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Consimciion Reauiremenis RemodellReoair Reauirements ~e-~e 6fl~ Ce~4aFSu`veyR2ttl 'Y M1I 3 registered sile surveys showing sq. fl. of lot, sq. ft. of house; and all roofed areas 2 copies of plan (20% maximum iot coverage allowed) 1 set of Energy Calculations for healed additions TtBC Fres Plart;f2ectl _Y N; isilesuN foraddifions8decks FreePresRayuired ' Y N 2 copies of plan showing beam & window sizes; poured found design, elc. qddition - indicate if oo-site septic sysfem Dttsite.5eppt Syslem .~~Y _ F1 1 set of Energy Caiculalions 3 ccqies of Tree Preservation Pian if lot platted after 7/i/93 Rim Joist Detail Options selecfion sheet (huildings with 3 or less units) Date / 1 l~ / 8~ ` Construction Cost ~ ~ ~ 0 V, SiteAddress ~~-14 0.4 Q~l UniUSte # Description of Work ~'~^~rk fi~ ~ s~ Multi-FamilyBldg _ Y xN Fireplace(s) ~ 0 _ 1 _ Z G57 '~-b ~ L1mc~1~ "~7~1~m (~q~w.~?`. Telephone#('~) `6`6? -b3~r~ Property Owner Contractor ~bn~~-~_~a d At~c ~c ~ s ~1~G ~c~ 2~- ~ ~6{6~1 Address ~l~a Wa Jnv~ W°~ C:v c~ty 3~.c~~'c~~ State Mw • _ Zip s`S 3/ ; Telephone 76~ ) r~s; 23 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rul s 7672 Minnesota Rules 76'70 Cate~orv 1 - Ene~gy Code Category , Residential Ventilation Category 1 Worksheef • New Energ Cod ~ rksheet (J submission type) Submitted Submitted/U ~ ~ . Energy Envelope Calculations Submitted ~ ve ou reviousl constNCted a building in Eagan with a similar plan? _ Y _ N If So, 25%`~ ~a~ov Ha Y P Y ef ` OS V fee applies. Licensed Plumber Telephone ~ Mechanical Contractor Telephone ~ Sewer/Water Contractor 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. ~ G~~ h9~r~ l,, . ~,u~ I y, , Applicant's Pnnted Name Applicant s Signature OFFICE USE ONLY Sub Types O 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling O OB 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 OB-plex O 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex '1~ 19 Lower Level ? 24 Storm Damage ~ ? 06 04-plex ? 12 12-plex Plhg_Yor_N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ~ 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement `Demolition (Entire Bldg) -Give PCA handout to applicant Valuation dv~ Occupancy MCES System Census Code ~ Zoning City Water SAC Unfts Stories Booster Pump # of Units Sq. Ft. . PRV # of Bldgs Length Fire Sprinklered Type of Const _ ~ Width REQUIItED INSPECTIONS _ Footings (new bldg) FinaUC.O. _ Footings(deck) FinaUNo C.O. _ FooUngs (addition) Plumbing _ Foundation ~C HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final ~ Framing _ Siding _ Stucco _ Stone _ Brick Fireplace _ RI. _ AirTest _ Final _ Windows ~ Insulation _ Retaining Wall Approved By: , Building Inspector - Base Fee surcharge j Plan Review ~ `f ~~Q ~ MC/ES SAC City SAC ~ ~ Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total 3830 PILI T KNaB RDN 55122 ~ J~ ~`U ~~3 ~ ~ 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) ~ 681 ~675 New Construdion Reouirements RemodeVReoair Reauirements ? 3 registered aRe surveys ? 2 copies of plan ? 2 apies of plans (include beam & window sizes; poured fnd. design; Mc.) ? 2 siM surveys (exterfor addRlons 8 decks) ? 1 energy wiwlatlnns ? 1 energy calculations for heated addilions ? 3 coples of tree preaervation plan A bt plaflad after 711f93 . required: ~ Yes _ No - DATE: 7-,~5-/~/o C~NSTRUCTION COST: j~a r~~~ DESCRIPTION OF WORK: w r~~NS+ru c~~ u,-, STREET ADDRESS: `~~~~I s~~~~' ~0~~ LOT _,S` BLOCK SUBD./P.I.D. G~+crlCS IrJ~~ _ PROPERTY Name: Phone OWNER Street Address~ City: State: Zip: CoNTw?cTOR Company: ~Soe, r'Y) '(je,r l~irneS _ Phone ~~~3 er~ /a9 Street Address: ~~l~la sh kc~~ ~v~'~.°• License ~i~/'~-S7 City: ~rr-., State: ~ Zip: SSi~? - ARCHITECT! Company: Phone ENGINEER Name: Registration Street Address~ City: 5tate: Zip: Sewer 8 water Iicensed plumber: /~~'u/ ~'-/~G? J- LUGfI/ . Penalty applies when address change and lot change are requested once permit is issued. 1 hereby acknowledge that I have read this appiication and state that the information is correct and agree to comply with all applicabie State of Minnesota Statutes and City of Eagan Ordinances. ~/J Signature of Applicant: ~,/s~~~~/ OFFICE USE ONLY ~ ~ ~ 2 ~ ~ n ~ ~ L5 U Certificates of Survey Received Yes = No . ~ 4~~6 • 11 2 Tree PreservaGon Plan Received _ Yes No ~ OFFICE USE ONLY ~ h'' ~ y „ a : BUILDING PERMIT TYPE ~ r ? OyFoundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish m~02 SF Dwelling ? 07 4-plex o 12 Muiti Repair/Rem. ? 17 Swim Pool ? 03 SF Addition ? 08 8-piex o 13 Garage/Accessory o 20 Public Facility ? 04 SF Porch ? Q9 12-plex ? 14 Fireplace o 21 Miscellaneous ? 05 SF Misc. ? 10 _-plex o 15 Deck WORK TYPE [9'"31 New ? 33 Alterations ? 36 Move 0 32 Addition o 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. I N~~3 MC/WS System ~ {Allowable) VIV Main level sq. ft. ~~6~, 3 3 City Water ~ UBC Occupancy P-3 J-I y'"`~ sq. ft. 4 c). 33 Fire Sprinkfered Zoning I C~~ sq. ft. !o IS PRV # of Stories '7- sq. ft. Booster Pump Length sq. ft. Census Code. 1 o i Depth 3 S' Footprint sq. ft. ~ r'~ _ SAC Code ~21- Census Bidg i Census Unit ~Z APPROVALS Planning Building v~~ Engineering Varia~ce Permit Fee Valuation: $ a x Sy ~O Surcharge Plan Review 3~u _ License ~ SS ~ ~ ~ MCNVS SAC 37 , 5 yt ~ y = 5 z5 City SAC z- x~ +3. z 7° 33 Water Co~n. ~ o. Ifo =~~(~s Water Meter i_^~~ ~ S% ~ t~ ' q~S Acct. Deposit y- y,~ - 5zs S/W Pertnit a~•33 S/W Surcharge Z y' ~ 3,~G ~ Treatment PL ~~,ot 8p' 3'~ ~y ~ 7R``13$ Road Unit 5~,,„„a ~ g ~ Park Ded. Trails Ded. 7q~q ~ Other Copies Total: 3ou 2v. 5= ~iSr~S C~~22S % SAC SAC Units ~~2~i~~• ~~~ga Sdr~ 2005 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 I ! Site Street Address ~ Unit # Propeity Owner~~ i~ . Telephone #(~(p~ LZ~2-~ I~TL~ Contractor J'~~ T(Jl ~f I~~~}~~ 1/l~ I~V1/~ICJ~ ~ ~1L~ Telephone #(~(S~ 4~f~'~~1~~ . Address,~Z~U MVI~t~v1~1/l i~471. City~ ~~1~~~ State ~l/~,~. Zip~~~ The Applicant is: _ Owner Contrector _Other Alterations to existing dwelling $ 50.OD Add plumbing fixtures (excludes water softener and/or water heater-complete next ~ section if installing these appliances). _Septic System Abandonment _Water Tumaround (add $125.00 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 Total . $ V~Jv 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 only an application for a permit, work is not to start without a permit and work will be in accordance with the approved plan in event a plan is required to be reviewed and ap rr ed. ~ P~/VUV~~ e/I U~/1.~/ ` ApplicanYs Printed Name ~ ' nYs Sign ture PERMIT ~~as~~ ' CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: s u i ~ o z n c Eagan, Minnesota 55122-1897 Permit Number: 0 2 8 4 3 6 (612) 681-4675 Date Issued: 0 8( 01 / 9 6 SITE ADDRESS: 4774 SLATER R~ LOT: 5 BLOCK: 1 5T CHARLES W000 P.S.N.: 10-65870-050-01 DESCRIPTION: . Buildiriy._,Permit Type SF DW6 ~~Bui].~ding ~tArk Type NEW ~ UBC~ Ac~ltpanc~,, R-3 U-1 f' Construction Type V-N Zoning R-1 j` Building Length ~ ~ 68 Building Width 3$ ~ ~u~~~dirt4,:stor~es y-~ 2 "1~ r. ~ ~t~'~~G u a r e ~°e"e t 5. 0 5 6 C"~ `'~'~~...,,,,7 r-~..~ ' . Can's.u;s ,Go:de' 191 1- FAM. DETACH ~ ~ \ % i; ~ i~ r' n?.'~>, ~ >i/_" - .,r ~ .i1 i ~ E ~ ~ 4'k,... -u ~ . E . . . i i~. . 4 y .h nK-~~ . ~ . REMARKS: • PRV S& W PLBR - M& W SEWER AND WA7ER FEE SUMMARY: VALUATION $223e~e~ Base Fee $1,502.25 MISCELLANEOUS ~1.923.50 Plan Review $751.13 Total Fee $5,188.38 Surcharge $111.50 SAC $900.00 SAC ~ 100 SHC Units 1 Subtotal $3,264.88 CONTRACTOR: - Applicant - sT. ~zc.OWNER: HORTON INC OF MN, D R 14544663 2000565 JtlE MIILER HOMES 3459 WASHINGTON OR 204 3459 WASHINGTON DR EAGAN MN 55122 EAGAN MN 55122 (612) 454-4663 (612)454-4663 I here6y ackn.owledg-e th~t I have read' th~is application an!d state tttat the information is correct and agree to comply with all applicable State of Mn. Statutes and City of Eagan Qrdin~ances. , ~ _ ~ //1.L/'f ~.(/~~L- ~~ll,fl ~.~1 A I ~ ' APPLI ANT! ERM TEE IG ATURE ~~SSUED BV: 1 TUR~ CERTIFICATE OF SURVEY M 32-1447- 9 6 for JOE MILLER HOMES ~ 22r S, ~ ~ ~ /1,~5A ~~i~ I/~ ~ ~ ~~q~. ~ ~J ~ ryry ? ? B s. ~ °o ~ ~ ' N64 ~i`~~ ~ • 4~ Op 8 W ' 1 ~ ~ ~ ~ R N 4 0~~ ~ ~ ,~~..,7.~ w~~/~ ~ h 4~+.J~~ CT:~ ' g,: ~~b < . ~ ~ ? o b ~ \ L} ~ •y, y~ ' ~ m~ -c~q ~ ~ h o ..:'t01/JY ~y 8M ~ ~ ~ ~ ~h t~ `nd ~ ~ o °i g~ ~ ~ ~ ~ Q S ~vv ~g~`._ q p ~.~.~~`oyF ~ ~ / p o~1 t;' /Q ~ C , ~ , . ~ ~ g"~,,~oa w ~ ~ F ~ ~1 ~ - 9~ ~ 56, ~ ~ ~ ~ i ~ S6 ~ ~ zo~ 8 9~ ~ ~ ~ h / \ ~ ~~'~'~`~5'S+, 8 oc° ~ ~ ^N~~ \ / ~ ~ ~ J q~, ~ ~ ~-~~b°~ =ry ~ _ ~ .C ~ / ~ ~ ~ ~4 9`+= ` ~ ~ ~ ~ r~'~/ I ~ ~ ,PYo`~Iv~~ 3j0,. `J JS ~rys~~\ r ~ \ ~ "S I„ 8 w ~ ~ry ` rn ~ ~b~' ~ ~ ~ L ~ BY ~ Top curb to Gar slab D`' ,~~JG pEpT. Top block = ~5~~~ ~EAGI~N EN'~-~~ _ ~ , : , Lowest bsmt flr = 6Z ~ ~ ,i ~ ' I, ; ~~~1; i'~ ~s = o~ o e ~-1.~_:'•:.,s~,-%',I'1 i;1_.' . Scale: 1" = 30' 4774 Slaters Road DESCRIPTION I hereby certify that this survey, plan, or Lot 5, Block 1, report was prepared by me or under my direct ST. CHARLES WOOD supervision and that I am a duly Registered Dakota County, Minnesota Land Surveyor under the Laws of the State of Minnesota. plot bearings shown ~f~ . o Cenotes iron monument Date ZZ ~'ULY 199L Reg. No. 8140 ~ Existing~ Proposed BRANDT ENGINEERING & SURVEYING 1600 West 143rd Street, Su ite 206 Burnsville, MN 5530C (612) 435-1966 M32-1447-96 . • ~ ' LOT SURVEY CHECKUST FOR RESIDENTIAL BUILDING PERMITAPPLIC~~~ ~ ~ PROPERTY LEGAL: ~ ~ ~ DATE OF SURVEY: ~7 / Z L~ g' ~ ~ ~ LATEST REVISION: ~ ~ ~ DOCUMENTSTANDARDS < ~ ~~o ? • Registered Land Surveyor signature and company ? • Building Permit Applicar~t [3~~ ? • Legal description [~o ? • Address .0~0 ? • North arrow and scale e~o ? • House type (rambler, walkout, split w/o, split entry, lookout, etc.) ? • Directional drainage arrows witt~ slope/gradient % ? ? • Proposed/ebsting sewer and water services 8 invert elevation ~o ? • Street name ~a ? • Driveway ELEVATIONS F~ostina ~o ? • Sewer service (or Praposed) ~ o ? • Property corners ? • Top of curb atthe driveway o% ? • Elevatlons of any epstlng adjacent homes Pro s ~o ? • Garagefloor ? ? • First floor ~ ? ? • Lowest exposed elevation (walkout/window) C~ ? ? • Property comers r~ ? ? • Front and rear of home at the foundation PONDING AREA fif aoolicablel ? ? • Easement line ? d ~ • NWL ? C~ ? • HWl ? ? • Pond#designation ? t7 ? • Emergency Overtiow Elevation DIMENSIONS [~o ? • Lot IineslBea~ings 8 dimensions e~ ? ? • Right-of-way and street width (to back of curb) ? • Proposed home dimensions including any proposed decks, ovefiangs greater than 7, porches, etc. (.e. all structures requiring pertnanent footings) oi ? ? • Show all easemenls of record and any Cily utilNes within those easemenls ? ? • Setbacks of proposed structure and sideyard setback of adjacent e~assUng structures ? • Retaining wall requiremeMs, if any Reviewed: ~ ~ Na e / ate January 7996 CRAIG7 W 816LDOPRMf. FM ~ J~ y ~y , a ~ £ G Pou[a NP-15 ' . I • n f- ' 9GALE I' - ym' ! ' ~ /r 4 ` ~ __C<'_ - ' a~ 4wu~ 4 l \ _ y w ~ ~ y~ I So T. ~ . V4 . ~1..f-1..f-~1 ~ ~a-~~'J ~ - a..~wtu`nl' . ~ +~a - - 1 r°n'c"'"'°'K"m^°'~% 1~.~ ~ ` / ~~~ric s"'~."':~. ~L ~ r- ~ ~ ~.L-~PJ~i2i~~i~ . ~ _ ~ V ~ j 9CALE ~ ~~Cii~ lt.ii? ~i~;~~' ~yv~ \ ( . , Dri0u0. 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INfNIF ..3Z2P =1 x.ID..._'.150. ~ . . , =ic.~~~z ~ ~s.__ : ~ . . . . . . . : . Zo3~o ~~2. I2---.__..__... . Y . ' • •r_ . . ( 1,C~t'°D . . . ( ~ ~ _ I ~ _ _ _ . . : : . ~ . ~ '~ri~'~._.' _ t,~ . . , 1 ~ ~07 . ~~z~Ps . . `j ~1 . _ ~ Pr~ I 1 ~ i~ ~L. Z '-i ~ . ~ 3°~~c..~~~~,~Z~,~ ~.33~~~ . . . . ~ . Z~S1c, s~~c.~ ~p(Z .1 ~ . . . ~ ~ . . , . _ : . . . : . ~!r . ~ ' n ~orni. • CITY USE ONLY / r L .1 BL ~ _ - RECEIPT a Od~ SUBD. ( uJOOO~- DATE: ~g g~ 7996 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT K'NOB RD EAGAN, MN 55122 (612) 681-4675 Please compiete for: ? single family dwellings ? townhomes and condos when permits are required for each unit FIXTURES EAC_H ~Q. Shower 3.00 x / _ Water Closet 3.V0 x _ Bath Tub 3.00 x ~ _ ~ Lavatory 3.00 x ~ _ /a, . Kitchen Sink 3.00 :c _ Laundry Tray 3.00 ;c = 3 Hot Tub/Spa 3.00 _ Water Heater 3.00 :c I = ~ Floor Drain 3.00 x / _ Gas Piping Outlet' mfnimum - 1 3.00 ;c / _~r Rough Openings 1.50 ~ _ ~ Water Softener 5.00 x = Private Disposal ' Dakota Cty. license 65.00 = (new and refurbished systems) U.G. Sprinkler' homa under const. 3.00 = Alterations ` to exisBng 20.00 = Water Tum Around 20.00 STATE SURCHARGE .50 1 tJ I14L ~ SITE ADDRESS: 4774 Slater Road OWNER NAME: JoE rffr~.ER xoMEs tNSTALLER NAME• 14745 South Robert Trail STREET ADDRESS: GENZ-xYArr rLUr~IrrG CITY: Rosemount STATE: ~ Z~p; 55068 PHONE ( 612 ) 423-1144 OFFICE USE ONLY L BL RECEIPT ~ 4 SUBD. DATE~ 1996 PLUMBING PERMIT (CQMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Piease complete for. ~ all commercial/indushiai buildings. ? muRi-family buildings when separete permits are ~t required for each dweiling unit. DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION ADD ON REPAIR DESCRIPTION OF WORK: IS WATER METER REQUIRED? _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING: WATER FLOW: GPM. ARE FLUSHOMETER> TO BE INSTALLED? YES NO. FAILURE TO PROVIDE THIS INFORMATION WILL RESUL7' IN A DELAY OF METER ISSUANCE. WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM7 _ YES _ NO. IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINi:LER PERMIT. FEE: $25.00 minimum fee or 1°h of conhact price, whichever is greater. State surcharge of $.50 per $1,000 of ~ fee due on all pe~mits. CONTRACT PRICE x 1% STATE SURCHARGE TOTA4 ~ SITE ADDRESS: TENANT NAME: STE. # OWNER NAME: INSTALIER: ADDRESS: CITY: STATE: ZIP: PHONE SIGNATURE: ' APPLICANT OFFICE USE ONLY METER SIZE: DATE: INSPECTOR: CITY USE ONLY L Jr BL 1_ RECEIPT v , - / A SUBD. ,dX'. !~L/O~OC DATE: / / 9{° / 1996 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612)681-4675 Please complete for: ? single family dwellings ? townhomes and condos whESn permits are required for each unit • FIXTURES EACH NQ. TOTAL Shower 3.00 x = Water Closet 3.00 x = Bath Tub 3.00 _ Lavatory 3.00 x = Kitchen Sink 3.00 ;c = Laundry Tray 3.00 :c = Hot Tub/Spa 3.00 :c = Water Heater 3.00 _ Floor Drain 3.00 _ Gas Piping Outlet' m~n~mum -1 3.U0 _ Rough Openings 1.50 _ Water Softener 5.00 x = 5~~ P~ivate DispOSal ' Dakota Cty. license 65.00 = (new and refurbished systems) U.G. Sprinklef " home under const. 3.00 = Alterations ' to ex~sting 20.00 = Water Turn Around 20.00 STATE SURCHARGE .50 TOTAL o ~ ~ 5~; . 7a - S SITE ADDRESS: ~~r~~f ~ ~ yy~ OWNER NAME: ~/G~ c ~ J INSTALLER NAME: ~ ~~~=d-' STREET ADDRESS: ~ -~'~"u'~~l~-C~~ ~ 1~-~ CITY: o~ I~~S ~ STATE: ~7~ ZIP: ~ PHONE ) - -i ~ ; , ~ -'P ' ~'?l9~-~ r~c ~ ~ OFWCE USE ONLY L _ BL _ RECEIPT _ . , SUBD. DATE: 1996 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612)681-4675 Piease complete for: . all commerciaVindustrial buildings. ~ multi-family buildings when separate permits are D91 required for each dwelling unit. DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION ADD ON REPAIR DESCRIPTION OF WORK: IS WATER METER REQUIRED? _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING: WATER FLOW: GPM. ARE FLUSHOMETER!i TO BE INSTALLED7 YES NO. FAILURE TO PROVIDE THIS INFORMATION WILL RESULI' IN A DELAY OF METER ISSUANCE. WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? YES NO. IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINiCLER PERMIT. FEE: $25.00 minimum fee or 7% of contract price, whiche~~er is greater. State surcharge of $.50 per $1,000 of permit fee due on all permits. CONTRACT PRICE x 1% STATE SURCHARGE TOTAL SITE ADDRESS: TENANT NAME: STE. # OWNER NAME: INSTALLER: ADDRESS: C~T~'~ STATE: ZIP: PHONE SIGNATURE: APPLICANT OFFICE USE ONLY METER SIZE: " DATE: _ INSPECTOR: L ~ BL / CRIi' USE ~hNLY RECEIPT ~O'S SUBD. /._lfi• DATE: g 1996 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RO EAGAN, MN 55122 (612)681-4675 Please complete for: ? single family dwellings ? townhomes and condos when peRnits are required for each unit New construction Add-on fumace Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc. Date: - FEES ? Minimum Fee: Add-oNRemodel (existing residence only) -$39:66- ? HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ? Gas OuUets (minimum of 1 required ~ 53.00 each) G.Gb ~ State Surcharge .50 TOTAL ~ 3~ ,so SITE ADDRESS• ~7 7y S ~e~ ~ OWNER NAME: ~o+~ /l'/~-//~- ~~es PHONE y'~ f`663 INSTALLER NAME~ ~O~~~le~ STREET ADDRESS: d ~7°h CITY: ~~.c. STATE: ~')rU ZIP: ss`a~`~ PHONE#: ( ~/,z) S~(o~1-60~z CRY US~' ONLY L _ BL _ RECEIPT SUBD. DATE: x,. 1996 MECHANICAL PERMIT (COMMERCIAL) • CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 687 ~d675 Please complete for: ? all commerciaUndustrial buildings. ? mufti-family buildings when separate permits are ~ required for each dwelling unit. DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: FEES: ~$25.00 minimum fee 4I 1°k of contract price, whichever is greater. ? Processed piping - $25.00 ~ ? State surcharge of $.50 per $1,000 of p~~ fee due on all pertnits. CONTRACT PRICE x 1% PROCESSED PIPING STATE SURCHARGE TOTAL SITE ADDRESS: OWNER NAME: TELEPHONE TENANT NAME: (IMPROVEMENTS ONL1~ INSTALLER: ADDRESS: CITY: STATE: ZIP• PHONE SIGNATURE: SIGNATURE OF PERMIITEE CITY INSPECTOR , , ~ /A .,~D~ CITY OF BAIiAN 8T. CHARb88 ROOD t~oT S DBVEL08MENT CONTItACT Th~q Contract, made and entered into on the 6~ day of `.~-c t , 1994, by and between the CITY OF EAGAN, a Mi esota municipal corporation, (hereinafter called the "City"), whose address is 3830 Pilot ICnob Road, P.O. Box 21199, Eagan, Minnesota 55121, and the Owner and Developer identiPied herein. A. The term "Developer" as used herein rePers to: Joe Miller Homes whose address is 3459 Washington Drive, Eaqan, l+aT 55122. B. The term "Owner" as used herein refers to: D.R. Horton, Inc.-Minnesota, a Delaware corpozation whcse address is 3459 Washington Drive, Eagan, PII~1 55122. WHEREAS, the Developer has applied to the City Por approval of the plat or subdivision known as ST. CHARLES WOOD located within the City; and WHEREAS,. in conjunction with the granting of said approval, the City requires the installation and/or availability of streets, water, sanitary :Bewer, related services, storm sewer pipes, ponds, erosion and sediment control measures or other facilities; and WHEREAS, undar authority qranted to it, iacluding Minnesota Statutes s412 and 5462, the City Council has aqreed to approve said plat on the conditions: (1) that the Developer enter into this Development Contract, which Contract defines the work which the Developer undertakes to completa within the boundariea of said plat 7. on Lots 2 throuqh 6, the driveway connections to Slater Road shall include a turnaround on the driveways. 8. A land covenant must be recorded that prohibits outdoor storage within the turn-around area. 9. The Developer shall meet with the residents as early as possible before the item is prasanted to the City Council. 10. The Developer shall pay a cash trails dedication and provide an eight foot wide bituminous trail connection from the cul-de-sac to an existing trail just southeast of Hiqhcroft Court, through a berm designed to act as a buffer; to the park and a 30• wide easement to accommodate the trail. ~ ~ , , ' I FOP~:Office~USe ~ r ~ ~ ~ Pertnit ~OU~ J j I ~ it~ of a~a~ I pe~it Fee i ~ 3830 Pilot Knob Road ~ _ a~ ~ Eagan MN 55122 ~ Date Received: ~ Phone: (657) 675-5675 i scatt: i Fax:(651)675-5694 ~ ~ 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: L~~L~`~~ SiteAddress: ~I 5~~~'~ ~'O~ Tenant: Suite RESIDENT 1 OWNER Name: 1Kr~ ~ 5~ `--L-- /'~?I-~/~~~ ~ Phone: Address / City / Zip' ~J ~ 7~"~ S ( ~rZ2 ~ Applicant is: _ Owner /~Contractor TYPE OF WORK Description ofwork: ~ti~/` ~~`i~'- /Ci%~~` 1 Consiruction Cost: /UC/ Multi-Family Building: (Yes _ 1 No 'L) CONTRACTOR Name: ~I~~LJ-fST G~7ii'"°`'g~~s License#: c~C7 ~ S~"/~"~ 73 Address: 7"JL~6~~ Z'~~7~ ) ~?R -rr~/?L /f/~ City: N? /J7° f~- G~~ t~ State: Zip: S 5 3~~ Phone: b~Z - U r7 7 Contact Person: ~ ~G~``~~- COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 CateqoN 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Cdtegory Submitted Submitted ~ submission type) • Energy Envelope Calculations Submitted In the last 72 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 Contrector: Phone: Sewer 8 Water Contractor: Phone: NOTE: Plans and supporfing documents that you submit are considered to be public information. Portions of fhe information may be classified as non-public if you provide specHic reasons that Would peimit the City fo ` conclude lhat the are trade secreLS. I here6y acknowledge that this information is complete and accurate; that the work will be in confortnance 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 i not to start without a permit; that the work will be in accordance with the approved pian in the case of work which requires a review and approval,o~ ans. r + ~ r~~ /~9 x Applicant's Printed Name pplicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA139773 Date Issued:11/08/2016 Permit Category:ePermit Site Address: 4774 Slater Rd Lot:5 Block: 1 Addition: St Charles Wood PID:10-65870-01-050 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 - Robbie C Dohm-palmer 4774 Slater Rd Eagan MN 55122 (651) 882-6392 The Roof Guys 7630 145th Street, Suite 110 Apple Valley MN 55124 (952) 997-4777 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA140070 Date Issued:11/22/2016 Permit Category:ePermit Site Address: 4774 Slater Rd Lot:5 Block: 1 Addition: St Charles Wood PID:10-65870-01-050 Use: Description: Sub Type:Siding Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please leave printed pictures of house wrap on site for the final inspection. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. 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 - Robbie C Dohm-palmer 4774 Slater Rd Eagan MN 55122 (612) 749-3646 Builders Remodelers 3517 Hennepin Ave S Minneapolis MN 55408-3830 (612) 827-5481 Applicant/Permitee: Signature Issued By: Signature EAGAN 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 I TDD: (651) 454-8535 I FAX: (651) 675-5694 buildinginspections@cityofeagan.com RECEIVED SEP 11 2019 For Office Use Permit #: /Soa/o Permit Fee: 1.3, Date Received: L " I I —1 Staff: J 2019 RESIDENTIAL BUILDING PERMIT APPLICATION k 47 Date: 9/10/19 Site Address: 4774 Slater Rd Unit #: Resident/ Owner Name: Robbie and Nicole Dohm-Palmer Phone: Address / City / Zip: 4774 Slater Rd., Eagan, MN 55122 Applicant is: Owner t✓ Contractor -th Type of Work Description of work: Kitchen and Main Level Update Construction Cost: $10,000 Multi -Family Building: (Yes / No ✓ ) Contractor Company: New Spaces Contact: Shawn Nelson Address: 2105 W. 143rd St. City: Burnsville State: MN Zip: 55306 Phone: 952-898-5300 Email: shawn@newspaces.com License #: BC001586 Lead Certificate #: NAT -F150060-1 If the project is exempt from lead certification, please explain why: Built in 1996 In the last 12 months, Yes No 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? If yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Fire Suppression Contractor: Phone: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe classified as non-public if you provide specific reasons that would permit the City to conclude that they 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.citvofeaaan.com/subscribe. 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. 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 thenn approved plan in the case of work which requires a review and approval of plans. x 4114.4." A 444 tre-j-.ti,C x S Applicant's Printed Name Applicant's Signature DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation j Single Family Multi 01 of Plex WORK TYPES New Addition X Alteration _ Replace Retaining Wall DESCRIPTION Valuation Plan Review (25% 100% yC ) Census Code # of Units # of Buildings Type of Construction _ Fireplace Garage Deck Lower Level 4/77 V 5/ hr Rel Interior Improvement Move Building Fire Repair Repair �Y3 Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Foundation Before Backfill Roof: _Ice & Water _ Framing 30 Minutes Fireplace: _Rough In Insulation Sheathing Sheetrock Fire Walls Braced Walls Shower Pan Reviewed By: Final 1 Hour Air Test Tib 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 _� acs/S /s1A) 12es. Pr) MCES System SAC Units City Water Booster Pump PRV Fire Suppression Required Meter Size: Final / C.O. Required Final / No C.O. Required HVAC _ Service Test Gas Line Air Test Pool: _Footings _Air/Gas Tests _Final Drain Tile Final Siding: _Stucco Lath _Stone Lath _Brick _ EFIS Windows Retaining Wall: _ Footings _ Backfill _ Final Radon Control Fire Suppression: _Rough In _Final Erosion Control Other: Hood , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Radio Meter Read Copies TOTAL IAIOpot; level 6�4L. Page 2 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA161857 Date Issued:06/16/2020 Permit Category:ePermit Site Address: 4774 Slater Rd Lot:5 Block: 1 Addition: St Charles Wood PID:10-65870-01-050 Use: Description: Sub Type:Residential Work Type:Alteration Description:Fixtures 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 (miscellaneous)$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 - Robbie C Dohm-palmer 4774 Slater Rd Eagan MN 55122 Janecky Plumbing Service 720 Pontiac Place Mendota Heights MN 55120 (651) 454-9297 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA161857 Date Issued:06/16/2020 Permit Category:ePermit Site Address: 4774 Slater Rd Lot:5 Block: 1 Addition: St Charles Wood PID:10-65870-01-050 Use: Description: Sub Type:Residential Work Type:Alteration Description:Fixtures 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 (miscellaneous)$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 - Robbie C Dohm-palmer 4774 Slater Rd Eagan MN 55122 Janecky Plumbing Service 720 Pontiac Place Mendota Heights MN 55120 (651) 454-9297 Applicant/Permitee: Signature Issued By: Signature EAGAN 3830 PILOT KNOB ROAD i EAGAN, MN 55122-1810 (651) 675-5675 i TDD: (651) 454-8535 I FAX: (651) 675-56 buildinginspections@cityofeagan.com BY: 2020 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 7/8/20 Site Address: 4774 Slater Road Unit #: r For Office Use Permit #: Permit Fee: Date Received: Staff: Resident/ Owner E��ED JUL � 0 2020 Name: Robbie and Nicole Dohm-Palmer Phone: Address / City / zip: 4774 Slater Road Applicant is: Owner Contractor ? D gl a C E s J Sri P Description of work: Master Bathroom Update - Shower, Bench, Vanity Top, and Floor Construction Cost: $ 10000 Multi -Family Building: (Yes / No ✓ ) Company: New Spaces contact Shawn Nelson Address: 2105 W. 143rd Street City. Burnsville State: MN Zip: 55306 phone: 9528985300 Email: shawn@newspaces.com License #: BC001586 Lead Certificate #: NAT-F 150060-2 If the project is exempt from lead certification, please explain why: Built in 1996 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 asnonpublic if you provide specific reasons that would permit the city to conclude that they 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 Clty's website at www.citvofeaaan.com/subscribe. 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. 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.aooherstateonecallorq 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 Shawn Nelson c`i. , - 4 /tig Applicant's Printed Name Applicant's Signature DO NOT WRITE BELOW THIS LINE 1-1 �76( SIB ed. SUB TYPES Foundation __Single Family Multi 01 of _ Plex WORK TYPES New Addition Alteration — Fireplace — Garage Deck Lower Level — Porch (3-Season) - - Porch (4-Season) - - Porch (Screen/Gazebo/Pergola) Pool — Interior Improvement — Move Building — 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) Footings (Deck) Footings (Addition) Foundation Foundation Before Backfill Roof: _Ice & Water _Final Framing j. 30 Minutes 1 Hour Fireplace: _Rough In Air Test Occupancy Code Edition Zoning Stories Square Feet Length Width Insulation Sheathing Sheetrock Fire Walls Braced Walls Shower Pan Reviewed By: Tti _ 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 MCES System SAC Units City Water Booster Pump PRV Fire Suppression Required Meter Size: Final / C.O. Required Final / No C.O. Required HVAC _ Service Test Gas Line Air Test _ Hood Pool: _Footings Air/Gas Tests _Final Drain Tile Final Siding: _Stucco Lath _Stone Lath _Brick _ EFIS 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 SSW Permit & Surcharge Treatment Plant Radio Meter Read Copies TOTAL fh$Thltv 601 a Dab //?xo z. Zv Page 2 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA174130 Date Issued:12/29/2021 Permit Category:ePermit Site Address: 4774 Slater Rd Lot:5 Block: 1 Addition: St Charles Wood PID:10-65870-01-050 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) 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 - Robbie C & Nicole A Dohm-palmer 4774 Slater Rd Eagan MN 55122--236 (651) 882-6392 Genz Ryan Plumbing & Heating 2200 West Highway 13 Burnsville MN 55337 (952) 767-1000 Applicant/Permitee: Signature Issued By: Signature