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4080 States Ave 1 CITY OF EAGAN, Permit No: Date: ~ 3830 Pilox Knob Road Meter No: v y ~ o giZe: P.O. Boz 21199 Reader No: D -~f~ 35 17-? Date: ~ Eagan, MN 55121 I a Owner, t~ron ler ;'idwest ~ SiteAddress: 4()80 S a s Avenue L" B3 S[afford Place ; Plumber ~ Conn. Chg: _ 5 SO _0QnC Zoning: 1J- i Acct Dep:-_ ~ 5.,qp:,d No. of Units: 7 Permit Fee: - ~ n Qr)Pd Surcharge: r.d I agrea to comply with t Eagan Tr. Plant_ ~ ~`F • OO~d Ordinances. Meler. 7 Cjnpa i Misc.: er - WATER SERVICE PERMIT CITY OF EAGAN ; Permit No: Date: ~27-s 3830 Pilot Kno6 Road Meter No: Size: P.O. Box 21199 Reader No: Date: Eagan, MN 55121 I OWfl@r trnrv?iwv, ~{eiYRtt I SiteAddreSS:~+:~C G+'.tre ksems:w T_T 33 StHffOZ(~ PI8[~' ! - ~ Piumbe`rrr 21 „m},ing I Conn. Chg: Zoning: Acct Dep:~ ~T;~•y~,,~+= No. of Units: - Permit Fee: } f Tgorg ' Surcharge: , I agree to comply with tbe Clty ot Eagan ~ Tr. Plant Ordinances. Meter. Misc.: gy ~ ; WATER SERVICE PERIIAIT - CITY OF EAGAN. Permit No: Date: 7-77-8P 3830 PIle3 Knob Road B/p No: `~rf) n. ~ Date: 7-26- Fc~ P.O. Box 21199 Eagan, MN 55121 Owner. ~ront! e.- *'idw~aat Site Address: 4 080 S tate8 .A: . ; - , . ?iF e : Plumber: StBZ P?.ur!164Pn MWCC: 5 5'i. 00-Po. Zoning- n- City Chg: lno'of)Pd NO. of UnitS: ~ Acct. Dep: I agree to comply with the City oi Eagan Permit Fee: Ordinances. Surcharge: Misc.: By SEWER SERVICE PERMIT This request vo' d 18 months from Q ~ "(P6l E 45259 z~?~2c~ R" ate Fi o. Rouph-1n Inspecuon Required? ~Ready Now ill Notity. InSpec- ~ 2-2• 5?fes ? No tor When Ready [!]'~,censed Electrical Contrac[or I Mereby reQuest inspection of above ? Owner electrical work insialled et: Stre t Add s, Box or Rou No. Citv~ ~ ectinn awn5hip e No. Rang o. County D D ~ -4 Occ 1 IP~LF{J~ Phone No. ~ G 4) -7~ S Powe pplier Address kyll~ Elecirical Contractor ICompany Name) Con ar.tor' License No. O Ma o a d~c ~q~pri+yeCg Ins[ailauon) r ~.1 t'iZ Authp~jzyc~~ LS~ture r allation) Phone Number tiY VALI,EY MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILI NOT Gripgs-MidwaY Bldg. - Room N-191 8E ACCEPTED BY THE STATE BOARD 1821 Universitv Ave.. St. Peul. MN 55104 UNLESS PROPER INSPECTION FEE IS ow,...e 1a11'2 i ae2.nnnn ENCLOSED. g"/~~/E$` REQUEST FOR ELECTRICAL INSPECTION . Es-oooot-os III, Sae instructions 1or completing this form on back o1 Vellaw copv. , &&' 9 1~ E 4 5 2 5 9 "x" Below Work Covered by Thrs Request Add Rep. Type ot Bwiding Appliante! Wirod Equipmant Wired Home Range Temporary Service Duplrx Water Heater Lightui,y fixtures Apt. Building Dryer lectric Heatin Commercial Bldy. Fumace Siio lhiloader Industrial Bldg. Air Conditioner Bulk Mllk Tank Farm ojnrr vrcdv Cllnt-, IS~~~,.:~tyl t er ueci y t cr Olhi:r ompute lnspection Fee Below N Fee ServiceEntrenceSize h Fee Feeders/Subfeeders W-Above Circuita U to 200 Am s 0 to 30 qm s n 30 Am Above 200 Amps 31 to 100 Amps to 1C~0 Am s Swinvning Pool Above 100_Am s t00_Am)s Transformers Irrigation Boorns rtial, Ot Signs Suecial Inspectlon TA Rerrw rks Rouph-in Dj~a$ A. the Ele Insp9ctor, hereby certify thet the above Final D~)'')e'3`) p spection has been mede. This rspuest rold 18 monlhn Irom CITY OF EAGAN - 3830 Pflot Knob Raad, P.O. Box 21-199, Eagan, MN 55121 PH ON E: 454-8100 BUILDING PERMIT Receipt ~ To be used for SC iiWG/GAR Est. Value 4+Wo Date JULY zu ,19 ~'n Site Address 'A'~~U STA"t !:5 AL". OFFICE USE ONLY Lot ? Block 3 sec~sub. sTAFFeRr) PL±~Ci. OnSiteSewage Occupancy. R MWCC Syatem X Zoning R'-1 Parcel No. On Site Well (Actuat) Const V-N ¢ Name ~.+10WEST H04CS Citywater X (Allowable) V-N PRV Required ~ of Stories = Address 34~)E CF.GARYALE OK ~ ; Booater Pump Length 4 ° City FALtii Phone 454-043:3 Depth 71 ¢ tNt ame S.F. Total o ~ ` A~dress Footprint S.F. P Citv Phone APPROVALS FEES Engr./Assess. Permit +10.Uq yVj, ~ WW Name Planner Surcharge 37.00 Address az Cit PhOOe Council PlanReview 2~S•00 a W y 1QO.U0 Bldg. Off. SAC, City I hereby acknowlCdQe that I have read this application and state that the Variance SAC, MWCC 130•00 iniormetlon is correL't and agree to comply with all applicable State of WaterConn. SSO•W Minnesota Statutes and City of Eagan Ordinances. 4 Water Meter Signature of Permittee Road Unit 32. UO A BGilding Permit fs issued to: FYONTT EfA 111H)WES'T Treatment P1 204•00 on the express condition that all work shall be done in accordance with all Parks applicable.State of Minnesota Statutes and City of Eagan Ordinances. 538.00 Building Official TOTAL INSPECTIaN RECURD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: " (612) 681-4675 SITE ADDRESS: APPLICANT: ArFS auF PERIIAIT SUBTYPE: TYPE OF WORK: . . INSPECTION . .A ~ F ~ ~ Permit No. Permlt Halder Date Telephone N ELECTRIC PLUMBING HVAC Mspeetlon Oata Insp. CommenU FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPtACE AIR TEST FINAL PIBC FINAL HTG ORSAT TEST BLDG FINAL [i$MT R.I. BSMT FINAL DECK FTG OECK FINAI. l~lil~R~'~_r .,n . . . TSR ..r'!!R_"~T'rt,ry,,."~ °F , T"!F"r 'y~?Zl"'"~,.j7-`. ,'FC r -v--'.~s.~ ~ .r ~,i~F,'~,"~ . vw±~:a a CITY OF EAGAN ~d 17816 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # - To be used for BE~ Est. Value $1'~ Date ~Y 4 19 90 Site Addiess 4M sXATSB AY! Lot Block Sec/Sub. OFFICE USE ONLY P8fC21 N0. Occupancy - FEES uUCE (L8ti? zo"'"9 - =23.00 W Name (Ac1ua1) Const - Bldg. Permit SAM (Albwable) - Surcharge ~ ~ AddfBSS City Phone # or stories - Plan Review l~ABlC S!!AY - ` ta Name oePin - sac, City 015 Address FRIULLFY ~ S.F. Tolal = SAC, rncwcc City Phone S.F. Footp?ints On Site 5ewage - W~~ Conn ~ W W Name On Site Well - yVater Meter i= Address MwcC System - c, ~ Acct. Deposit 5 W City Phone Ciry Water - PRV Aequired _ S/W Permit I hereby acknowiege that I have read this application and state that the 8ooster Pump - SNV Surcharge intormation is correct and agree to comply with all applicable Sta1e o( Minnesota Statutes and Ciry f Eag Ordin~^ce5,- - Treatment PI Signature of Permitee 41~"--- '"`740'w'- APPROYALS Road Unil - A Building Permk is issued to: NlIItK SAAW Planner Park Ded. on the express condition that all work shall be done in accordance wilh all Cou^cil - applicable State of Minne a Statutes and City of Eagan Onances. g~j, pry. _ Z.A'- t-'e-~~~ Variance - TOTAL ~ Building Official 1` yt PermH No. Permit Holder Date Telephone # WATER SEWER PLUMBING H.V.A.C. ELECTRIC Inspection Date insp. Commeerts Footings I Foundation Framing Roofing Rough Plbg. Rough Htg. Is~d. Fireplace Rnal Htg. Fnal Plbg. Const. Meter Plbg. Inspecta - Notify Plumber Engr.IPlan Bldg. Rnai Dedc Ftg. Deck Final ~ S Well Pc Disp. . PERMIT # MECHANICAL PERMIT CITY OF EAGAN RECEIPT # 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE: PHONE: 454-8100 Site Address 10 r gLpG, TypE, WORK DESC ION Lot a Block Sec/Sub Res. New ~ "n1ZE~' t~~7;,,~ Mult Add-on ~ Name` Ale, Address S' NAw~~ ~LL Comm. Repair c City ki Phone '~-15& s Other Name PU NT j rr ~ 1 N~ r FEES 5 RES. HVAC 0-100 M BTU -$24.00 c Address-4'7e_,5 qKoj ADDITIONAL 50 M BTU - 6.00 ~ r'- ' 3 (RES. HVAC INCLUDES A/C ON NEW p Ciiy FA Phone v CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PEhMII) - 1.50 EA. TYPE OF WORK ,I COMM/IND FEE - 1% OF CONTFiACT FEE Forced Air ~C M BTU ~ APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE 8 CONDOS - RES. RATE APPLIES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMODELS - 12.00 Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 Vent CFM (ADD $.50 S/C IF PERMIT PRIGE GOES Gas Piping Outlets # ~v BEYOND $1,000) Other r r.. FEE: S/C: SIGNATURE OF PERMITTEE TOTAL: FOR: CITY OF EAGAN , , . PERMIT # . PWMBING PEtiM1T RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE: PHONE: 454-8100 Site Address BLDG. TYPE WORK DESCRIPTION Lot Block Sec / Sub R es. N ew Mult. Add-on m Name 'U ci..I) iic.~.i Comm. fiepair Address iluwcif'•e K°4d Other m : c City Phane RES. PLBG. ONLY - COMPLETE THE FOLLOWIMG: vO. FIXTURES TOT,AL 1'rU~tCi_ei Water Closet - $3.00 $ Name ~ I.-Bath Tubs - $3.00 '3 Address ~yt)~i J3L L~. HWX I_Lavatory - $3.00 ~ - . p Ciiy LtiF'~dn Phone ? Shower -$3.00 I Kitchen Sink - $3.00 J., Lli<.- FEES Urinal/Bidet - $3.00 COMM/IND FEE - 1% OF CONTRACT FEE , Laundry Tray -$3.00 APT. BLDGS - COMM RATE APPLIES ! Floor Drains -$1.5a TOWNHQUSE 8 CONDO - RES. RATE APPLIES 1_Water Heater -$t.50 MINIMUM - RESIDENTIAL FEE - $12.D0 Whirlpooi - $3.00 MINIMUM - COMM/IND FEE -$20.O0 1 Gas Piping Outlets -$1.5U - STATE SURCHARGE PER PERMIT - .SU.1 (MINIMUM - 1 PER PERMIn (ADD $_50 S/C IF PERMIT PRICE GOES Softener -$5.00 BEYOND $1,000.00) Well - $10.00 Private Disp. - $10.00 =Fough Openings - $1.50 SIGNATURE OF PERMITTEE , , A . ~'Y \ c FEE: ' • ~~`ti STATE S/C: FOR: CITY OF EAGAN GRAND TOTAL: . w`•~~*e ~ . Terfif iratt nf Mrrupanry Citp of (Eagan Erpartmmt of NuOing JWtrtinn This Certil7cate issuedpursuant ta the requirements of Section 306 of the Unifonre Buifding Covafe certifying that at the time of issuance this structure was in compliance wuh the various ordinances of the Crty regulating building construction or use. For the following: Ux Clsssi6nuon Bldg. ]trmit No. pocupa-Y Tya R3IM I 7vning pisuict R t TYPe Coost. owou ot Bnila;ng . t?~' •~1~ I"~iiX1£.~.: : Addras 3 , Lxm ~n, ~.L+ 2ii} J~~r~~1J r:.~•_ Bw7dingAddr= 7r5'~"i AVENJE aaw - ~ 3 - Budding Offirial POST IN A CONSPICUOUS PLACE CITY OF EAGAN r!~.~, ~ 3830 Pilot Knob Rosd, P.O. Box 21-199, Eegan, MN 55121 PHON E: 454-8100 BUILDING PERMIT Receipt # To be used for Est Value Date ,19 Site Address OFFICE USE ONLY ~ On Sfte Sewege Occupan y l Lot Block Sec/Sub. MWCC Syatem Zoninfl PerCel No. On Site Well (Actuag Conat - City Water (Allowable) a Name z AddreS3 PRV Required ~ of Stories 3 Booster Pump Length ° City Phone ;4 % ~ , ~ , Depth ¢0 NBme i ' S.F. Total ~ 4 Address Footprint S.F. ~ City Phone APPROVALS FEES ~ a Engr./Assess. Permit • 1 v.:1 Ly W Name ~ Planner Surcharge ~ n Address `W City Phone Council , PlanReview Bldg. Off. ~ SAC, City Variance ' SAC, MWCC I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all appllcable State of ~ Water Conn. ' Minnesota Statutes and City of Eagan Ordinances. Water Meter Signature of Permittee - Road Unit A Building Permit is issued to: Treatment P1 on the express condition that all work shall be done in accordance with all Parks applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official TOTAL - Permit No. Permft Holder Dats Telephona it Plumbing L?i)/) H.V.A.C. Electric Softener Inspection oate Insp. Comments Footings 1 Footings II Foundation ~ S Framing i C Z? Roofing Rough Plbg. - ~ ~ Rough Htg. Isul. Fireplace Final Htg. 3 f/ ~0 Final Plbg. Bldg. Final + Cert OcC. D 8 ~ Temp. LP i:%.~ 't•f'. ~ . /G~_~.3=; Deck Ftg. Deck Final Well Pr. Disp. CASH RECEIPT v C'TY DF EAGAN - 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 7 DATE ~19i~7" _ ~c'veo 1 1 i ' -~'T'~ ~+1 i:' ~'V'~1(I! f AMOUNT 8 DOLLARS m ? CASH ~CHECK .ex-' %G~ `.~.r~f<_;`'~~,•; i -`~...i -1~;~,.,, ~ FUND OBJECT q~qpU Thank You ev<---.L!-~'rtc-~ wmes-veyers covr Yallo-Pmfi,g CoPY ' ' , Fnk-FlleCOpy BLDG. PERMIT NO. 01-3210 Bldg. Permit ,01-34,22 *Plan Check 3S bLl 07-3445 Surch.lAdm. 7oc ~ 01-3446 SAC/Adm. ~ SO ~ 07-2155 Surcharge ~ 75-3860 Road Unit ' S CK:-' ~ 20-2275 SAC ~ 20-3865 Water Conn. ~ 20-3868 Water Trmt. CO 20-3716 Water Meter c, 20-2252 Acct. Dep. 203713 Water Permit ~ 203743 Sewer Permit D ~ 79-3866 Sewer Conn. 28-3855 Park Ded. TOTAL CITY OF EAGAN N0 1781s 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE:454-8100 i6 1I „'3X BUILDING PERMIT Receipt # ~y U To be used for DECK Esl. Value $1, 000 Date RAY 4 1990 Site Address 4080 STATES AVE Lot 2 Block 3 Sec/Sub. STAFFORD PLACE oFFICE uSE oNLY P3tC01 NO. Occupancy _ FEES Zoning $ 25 . 00 p Name BRUCE KENT (ACtuaq Const - Bldg. Permit W o Address SAME (Allowable) - Surcharge • SO City Phone # of srories _ Length _ Plan Review o Name MARK SHAW pepth - SAQ Cily 0' Address 1351 66TH AVE S.F.TOtal - SAC, MCWCC ~ City FRIDLEF phone 571-3814 S,F,FOOtprinis - On Sile Sewage _ Water Conn ri Name on sne wan - waier Macer Address rnwccsysiem Acct Deposit Ci1y Phone CityWater _ PRV Required _ SNJ Permit I hereby acknowlege that 1 have read this application and state that Ihe Booster Pump - S/yy Surcharge inlormation is correct and agree to comply with all applicable Slate of Minnesota Stacutes and City of Eag Ordin} nce~~//s Treatmenl PI Signature ot Permitee'! APPROVALS Road Unit A Building Permit is issued to: MARK SHAW Planner - park Ded. on me ezpress condition ihat all work shall be done in accordance with all Council % applicable State of Min^nespla Statutes and City o Eagan Ordinances. gld9, pry, _ Copias /~Variance - TOTAL 8uilding Official CITY OF EAGAN No 15 3 8 4 3830 Pilot Knob Road, P.O. Box 27-199, Eagan, MN 55121 k PHON E: 454-8100 BUILDING PERMIT Receipt# 7oheusedfor SF DWG/GAR Est.Value $74,000 Date .IULY 26 ,1 g 88 Site Address 4080 STATES AVE OFFICE USE ONLY Lot 2 Block 3 Sec/Sub. STAFFORD PLACE on site Sewege _ Occupancy R-3 M-1 MWCC System X_ Zoning R-1 Parcel No. _ On Site Well _ (Actual) Const V-N a Name FRONTIER MIDWEST HOMES Ciry Water _]L_ (Allowable) V-N i PRV Required # of Stories 3 Address 3902 CEDARVALE DR - 0 City EAGAN phone 454-0433 eooster Pump _ Length 43' Depth 47' , o Name SAME S.F.TOtal Footprint S.F. ~ a Address 0~ City Phone APPROVALS FEES ~w Engr./ASSess. Permit 470.00 ww Name ~Z Planner Surcharge 37.00 Address ~z Cit Phone Council PianReview 235.00 a W Y Bldg. ON. _ SAQ City 100.00 I hereby acknowletlge that I have read ihis application antl state that the Variance SAG, MWCG 550.00 information is correct and agree to comply with all ap ' a61e $tate of Wa[er Conn. ~`50.00 Minnesota Staiutes and Ciry of Eag Or in c ~Z.00 Waler Meter Signature of Parmittee Road Unit ._32$,Qfl_ A Building Permit is issued to:_FRONTIFI~2_~IIIZ Treatment Pt 204.00 ontheex0ressconditionihatallworkshallbetloneinac ortlancewithall applica6le State of Minnesota Statutes and City ot Eagan Ordinances. Parks TOTAL Z,538.00 BuildingOtficial~~RLI[~.J - PERMIT# 5 I I c) ~ RECEIPTDATE: ' 2002 liESIDENTli4L PLUMBINfi PERMIT !lPPLICATION C1TY OF EAfiAN 9$30 PII.OT KNOB RD E46AA, MN 851 EE 651-6$1-4675 Please complete for: single family dwellings, townhomes and condos when permits are required for each unit, backflow preventer for irrigation system SITEADDRESS: -fm) 5A-Q kS OWNERNAME:: SIiISQI.YI KIV'l~ TELEPHONE (cei -lRq'O6o'rj (AREA CODE) INSTALLER NAME: TELEPHONE -7(O?'~ -I~-(P<RQ~ GAVIC & SONS PLUMBING (AREA CODE) STREET ADDRESS: 1279c nr„ht.,,,~io c¦ nnu COON RAPIDS, MN 55448 CITY: STATE; ZIP: _ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00 includes $40.00 County fee Note: Additional consultant fees may appfy • MODIFICATION/ALTERATION TO EXISTING DWELLING UYIT, INCLUDING: _ Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00 _ A6andonment of septic system. _ Water tumaround - existing dwelling unit 5/8" meter if needed -$118) Other: _ RPZ: new installation/repair/rebuild $ 30.00 _ lawn irrigation system ReplacemenUadditional: _ water softener wate^r hea r I n ~n L $ 15.00 ~,~SI hl~.V 2, )U I State Surcharge .50 rotal $ I S I herebyacknowledge Nat I have read lhis application, state thatthe informatlon is wrtect, and agree to com all applicable City of Eagan orUinances. It is ihe applican['s responsibility to notlfy the propeAy owner ihat the City of Eagan assumes n li ny damages caused by ihe City during its normal operetional and maintenance activities [o the facilities constructed under this permit within ' propertylright-of-way! emenL &av. ~au.~ i c SIGNATl1RE OF PERMITTEE 1/02 RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN ~0 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 NawConetructionReauiramenM RemodeVReoalrReauirements • 3 registered site surveys showing sq. R. oi IoL sq. ft. of house; and ~II raofed areas • 2 copies of plan (20% maximum lot coverage allowed) • 1 sel of Energy Calculations for heated additions • 2 copies of plan shmvirig beam & window sizes; poured (ound design, etc.) • 1 site survey for exterbr addiGons & decks • 1 set of Energy Calculations . Indicate if hame served by sep6c system for additions • 3 copies M Tree Preservation Plan if IW plaqed after 7l1193 • Rim Joist Detail Options selection sheet (bldgs wBh 3 or less unils) DATE ~/d~/ VALUATION ~ SITEADDRESS 40 ~ MULTI-FAMILYBLDG _Y _N TYPE OF WORK~R-~- FIREPLACE(S) _ 0_ 1_ 2 APPLICANT~a-01, Cerrt3d-n..fQ,s,n I~.~ STREETADDRESS Jf0,51, &A 0211~ fJ*1a6 ''-°tL CITY STATE ZIPSS'3142' TELEPHONE # ~O Q 0 CELL PHONE #FAX FCR" gbc~ 7 ' PROPERTYOWNER ~C)~ TELEPHONE#C3,/~~~f COMPLETE THIS SECTION FOR KNEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RUL.ES 7670 CATEGORY 1 MINNESOTA RULES 7672 (4 submission type) • Residential Ventilatlon Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted . Energy Envelope Calculations Submitted Plumbing Confractor: Phone # Plumbing systcm includes: Water Softener _ lawn Sprinkler Fee: $90.00 Water Hcatcr _ No. of R.I. Baths No. of Baths Mechanical Contractor: Ph Mechanical system includes: _ Air Conditiocung - ~ D 0.00 _ Heat Recovery System Mq y 2 2 2002 Sewer/Water Conhactor. P ne # Y_ I hereby acknowledge that I have read this application, state hat th 'nform tion is correct, and ree to comply with all applicable State of Minnesota Statutes and City of Ea an O nan Signature of Applica ' OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 OFFICE USE ONLY ? 01 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. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 6ct. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous O 31 New ? 35 Int Improvement ? 38 Demalish (Interior) ? 44 Siding ? 32 AddiSon ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 WindowsfDoors ? 34 Replacement *Demolition (Entire Bldg only) • Give PCA handout to appiicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. _ Footings (deck) FinaUNo C.O. _ Footings (addition) _ Plumbing _ Foundarion HVAC _ Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final - FrammS _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insularion _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MGES SAC City SAC Water Supply & Storage S&W Permit 8 Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total I . • , ~ , ' 1988 BDILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS 15 5 1 • INCLUDE 2 SETS OF PLANSt 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATZONS NOTEs ADDRESSES FOR COANER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WI3ICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BOILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENT9L QNITS FOR SALE UNITS # OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SORVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COFIIMEACIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS To Be Used For: l7E O asrou 7in~aluation: Date: 6 7-13-5-5 Site Address O6`6b SrRTES Qc>57 fV pO C OFFICE USE ONLY Lot ~ Block On site sewage Occupancy J<'~ ?I•I MWCC system ? Zoning JZ-/ Parcel/Sub ,STRY'Fo2,p P(}}LjE- On site well Actual Const V/? City water ~ Allowable V/'? Owner , a c ~ PRV required _ 1F of stories I Booster Pump _ Length Address rjL ( CJ'~'~ S(". ~buHEwsT Depth . 33 S.F. Total City/Zip Code "~=pJ_p~IJ. UN 55La I Footprint S.F. Phone 5'I~~I APPAOVALS FEES Contractor Frontier Midwest Homes Corp. Engr/Assess Permit Planner Surcharge 3) Address 3902 Cedarvale Drive Council Plan Review 2 3S Bldg. Off. ~'j/ig SAC, City L? City/Zip Code Eagan, Minnesota 55122 Variance SAC, MWCC SSb 1 Water Conn Sf 0 Phone "~¢~3 d~33 Water Meter 4-9 Road Unit -3 ZS Arch./Engr. Phillips Plan Service Treatment P1 zoH Parks Address 14530 Pennock Avenue Copies TOT6I. . . City/Zip Code Apple Va11ay, MN 55124 Phone U 432-2044 . ~ surve~r~r`s G'~rt!}'~c~te Frontier Midwest Homes Corp. D SURVEY FOR: DESCRIBED A5: - _ ~ Lot 2, Block 3, STAFFORD PL1(E, Cit of Ea an, Dakota Coumt?', a9='S t::iniesota and reserving easement a STArE~GAA I1~G DEPT of record. e 6'z9c~• EA st- IZO.co J ev~.~ 894.s o ~ M. T ' 4s ~ i I n aT`~ f 5 1 8a4.a' ~ 20, ~lo fl / 4. B9f.r ~8 IQi I Q,i°_ LCa.i n ' I ~ 'S.31 f Cn..~ ~a 1 I N .Q E., sc „ ~ ~ 3^ z ~ • O--_ ta "lo , ~ a : a 1 ~ 0 ! Q m ` M I ~ B91.i lo ~ r o a46,q n ~-f~ ~ 0 N I ~ 7 rN Z ~ ~ 8T4q b w0 I • ~ ~ V• ( ~ f Fn'o. /44 / I l I I I 1 S ~ ~ 1 PROPOSED ELE4A710N5 869.5 BENCNMARK : ~ T.N. MYD. ~ ~NTER oP 7op of foundation 65 41 ~`I•' 3Ts~TES 1 PEnlN3YLVANIq Garaqe Floor • 9O°. z N. aZ' 34 pa,. w ~huC = 903. 41 Basemant Floor • aq'4 MIN. SETBACX REOIREMENTS AoVroa. Sewer Serviee Elav. • 38e.4 , Proposad Etevations ~ Q Froni - 30 Houaa Slde -10 Existinq Elevations Orainaqe Direetions Raar - I5 GaraqeSida-5 Denores Ofiser Stake ~ O SCaLE: 1 Inch = 30 Feet _ I hartOY eortlfY thaf IhIs wrveY. Dlan u raDert ras OtepalM EY ins JOB N0. . w uneer my Olnct wwrrbion ana tnat 7 am a awy ReOis4r~a 88R- 3bS LanO SwvGYa un0ef Me lawa of fM Staf• of Mlnn•wra. 800K Planiring Engineering Surveying ^ rwqwn irM~N. Bb~wrvwn. N nwwH sv<0 . F J. 1'lul Eau tlMw ~ ' I PQGE '+.wu.nlanru:eV D DOf~: n ] l ?S wMr y0.;' aa n, l,lcros~ 4 a14376 I'~iuC . U( ~i . ` . Zu~y awvER:7~knir 6kue,E fiav -J~Ll`t D.,I I: ' `1080 ST!-17~S ~1 UEa! ur ri:o!,c : `-0433 SITE AOCRESS: COY i RACTuR: :ROVTIe.3 WTDS -ESi EMHES CO?POPUTZO:i ° Oet:rnine ++urking squarc iooca,je uf each 1. Totai exposzd wall area..... sq. zz~ 2. Totai rooP/ceiling area..... ft. x.025 Total expcsed wail :irr.a absvc Ciour= .la~ ~ a. 7otal wall •dindcw area - b. Total door ares c. Total sliding alass door arra -X 7-, ~r d. ICL21 rll'°rl2C^ iJ2ll dr?= E. TOi3i w1l1-,^2:^.;.^.ci Zfcg (3:°:'3S° 11~;:1 - f. 70td1 rin Jois: area g. ne: ara11 area zbcve ''joor - h. wall ar=~i zhove riocr i. wzll zr=_a abnve `lucr j. fram e wali zre: a. iut31 zx,ceed icur,datiun arca=-1 k. Tota] founda'ian windo« area - l. Total net 'ounGztion area abcve qrade Deteraiir.= "u" value of eacn ka?] segment (e.n. window, door, each sep-rate e+ail section) X ~ b. 7 C „u„ 1,7 8 c. =.2 =1 Y v "ul. ! - 17 • ~ ~J e. I Y~ _ X .,U„ f. iL I c~ X„U,. ~ - ' = fo 5~. 9' g. Co •7 X "U" h. X nL.. . i. C ~.U.._ , j X ~.U.,_ _ lf itp!n is ' y. X.U« s as , or 1 ess t' dl, Yau hzv~ rt 1'--7 ' x "u"- 0 z', inCZ.^., nf SoC 3 . .................................Total = I<CL .l{ .--+~tn=_c= --ye_cge .lverac,e "Q" C.apua:?on zge _ c: P 4 :otal ex_osed zeo:/cei=ir., area = l;Ti i M. :btal skyl?cht area . n. Total rco./cc:l_r.g ==u.i_ny area (ricra,c 10E) ~ ~ , -7 . o. Total r.eL i:snla:ed roo:/ce:ling a:ea........... G=:e . 3 • • Deteraine "U" value for each rcof/eeilins sec:ent M. 1 L X^ua n. 1 1 C•7 X"U" C Z`~ = Z~(oC~ o. Gi ~1 G,? X„U" . O Z _ r c ~.i, 7 , 4 To tal :otal c-z ;4 is t`:e sa-me as, or Zess than #2, yau have ae= :a i: t=-= o= SBC 6005 (c) 1. ?.'te^ te 9uild'.^.c M.-Ivel^ce Des>c^ To za the a:al eaveloge'sys:em methcc, t':e salnes es:_^lishe2 by .:e o: itecs n3 a^.c -4 s: a1I no: be a_eat_- thaz t.::e saz o_ items =1 aac =2. r 2. Z ry• _ i 3. I Y'v.~l +4. Z%•~;~ - . 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' ' ~ ' ' . . . •"t . , . • - ~ ^ ~ • .(.1':n'i?~ _!ii'~ ; . ~ - ~ ° iIl !~t y ~ . ~(!~r! 1~~~ f'•'•, ~ ' ~r~ ' ~ • • ~ . ~ ' t!( • F c. 64 rrt } s •'~~il1.: ` . ) _t:--::-' ji( : . !cr ~ .""in ~ q•• raloc, ° tndlcltw L1'^~•, ~ \ ina. v Ir ~ n. ° ~ ' • : ~ . . • Gcnst'^etl on ~ • ~ 1. • a' _ : :lz 0. (5:_11) ' CG C 4. Extcrior=ir ToZZ: r. , c,- . . . . • pt,.+rt ~ • . ~ . ~ . • 1. I~n'^ca-iar a~ir- f:l^ ~ 0. r._t? B_LLC f>>'J A ~ "p Z• . ~ , 3. ~j- GL - I/.15U1.. ' • ' . 4. Estc_icr P ir (s •:i1 L~ ' , • . ' . . . ';ota1 2 . < . rc. ;s' . • • . . ~ • ' U = . ~ . ' ' : ~ . GoA.:rR?Gri aq~ In'.ec -f::m ~ ' ~ ~ - - 3 _ . . .t{~ ~ 4. •n t . g. GL•:sidc :il:n ~ - . - ~ . . . . . . ~ f 1 r; Lol--~4 Sx-; iac z:= =i=m ~ . . . ~ ~en~ :lov cp ~ . , ' .-veacaa • ~ a. , . . . . 5~ Cti:tsizc a:r :-1:a ' ' • • . ~ Tot~1 96. . . _ . . , ' . . -3 ~ I 0 .v 1. Insidc aj^ :ilm • • y- , 2 - ' ' • .~~^lV~,~~ • C. ~ 3' ~,..~~j?~.f.~,~•~_ • , 5. Gtic~idc aiz fi2:n ~ . ~ / Tota1 . Y' : , , ' . • , :Ld2 ~ • • 2.'_n _tc: U~o aZ3l:ian~1 ~SeeGS i- ro=: • - • bc`:-T~`'"•= • • aeec?eci for cietsilr assd caleu . ' . ~ ~ienL ~ . • . . . . . • - ' . • . . flcv up • . . • . • • aI._ •47. . , ~ . . . . . _ . ^ ? ~:i • . :r : ~ r~ 1 r , p~ a. . . ~ •l • ~ C) r F~ r ~ Cl ± ~ \ ^C,~\•.~~i,~•:~~:r-7:~I f I . . C. ~ :.0 '~Z • ' _ ,c /i~; l I • I 1 '.p'.I:'•'. - - ~ . ~ C E ~ ~ s. 'i. 1.•: j\ • ~ 7.~~- .la.'•`~0 1: `~,I.y~`1~ I ~ ~ ~ ~ ~I - ; ; ~ _~t: - 1, ~ I• ~_A\~~1't~~:l __~~!^iJ I~ - r _-t_...:~ - - = ~'-I, ~ ; ; ; ~ ' I ~ ~ j £ n _ ~.fn i ` I ~ i I ~ ~ ~ ~ (2U 0 . ~J 10 It ` , . . i $ - ~ '7 ~ ~ G~ ~n A v u .i . c . . a ~ . . . y~ . . • • . . ~ f 't ~ IT . . . . . . • . . . . : ;y ~vl 1 { I ~ I I^ it? • 1 I~.J lYI i 1 i ii > ~3~ ! i 1 ~ • x ~ ~ . ~ ~r I _~1 i . i ~ tr I ~ I ~ :o ~ ~ ' 70 ~ ~ `~~•'`.l 1 ( ~ ~ { i ~ j ~ I ~ ~ , ~ C ~ i , I - I ' . : y' '.1I= ~'I:_ I11-~ 1'1 i:'' ~ ~ ~ i j I,~ ~ . 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W'"1;` (i. _ ~ ~ti) 51 I ' t . . .1•1 ~ t • • Wu~ J ~ ~ * ~ _c' • " { ~ .Y~ ~Jl ~ y (1 ~ O Ll O I~ ~ CS~ ~ ~ v~ U ; -o , m ~t ?I ~I ~t U ; -"c U? r d ~ , e,~ o t o ~ O J ~ C4 ~ . . > r ~ ?U ~ = d rn 'k (-1_ r ~ . lJ •t . • i j ~ , ~ j ~ _ _ - . , . - • ~ 1 ~ 1990 BUILDING PERMIT APPLICATION CITY OF EAGAN SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS # OF RENTAL UNITS # OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED. PERMIT MUST SHOW A LICENSED PLUMBER. &y 0 2 RECo To Be Used For: ~FC Valuation: ~a)- Date: ~ Site Address 190$0 OFFICE USE ONLY Lot ~ Block FEES Occupancy Zoning ~ Parcel/Sub J~ifl{!;~0",/,~ T'J. Actual Const Bldg. Permit ~ Allowable Surcharge S~ Owner Ay~~ e- Zeg-~7Z- # of stories P1an Review Length SAC, City Address ~We- Depth SAC, M41CC S.F. Total Water Conn City/Zip Code Footprint S.F. Water Meter Acct. Deposit Phone On site sewage_ S/W Permit On site well S/W Surcharge Contractor MWCC System _ Treatment P1. City water Road Unit Address /,3,j /~(o QuG PRV _ Park Ded. / Booster Pump _ Copies -417 City/Zip Code i?~/r . 5 SUBTOTAL APPROVALS Penalty Phone Planner TOTAL ~ Council Arch./Engr. Bldg. Off. =5/Z Variance Address City/Zip Code Phone # k::%Y. ;C?k~t:kKi:'K ~N:1i~FW:kri:~'"6?k>'7:~~?k~k.y('R?X!;?~~k:~'rs~i?YFY,cYhY,: C?1'Y Cii= LAi~ANI CA`.31..111F_Tt: :1}i 7tii:F:MilJfiii. ?v{):: ::'>"r' Dt`ilF-a 08/20/97 1:1:MIF.:: 0.5029 I:) s h!ANE„ ST?:Itl'r." ix F':l:P'IiiT'L.1C;l`-.: f:,:41...1_!Ef;:Y 3219 9001 40£30 S3iA?F:S AVL 50,.00 205 9004. 4090 fiiT!171:_S :11.!fi 0,50 , i I o!:-i:t Fiec: r_,i prF (ainnu+ti1; c Sfl. ;O CI :O+3t:lOC79 IISc:,ei B:t ::Iktv or . PERMIT `\1 CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: e u z Lo z N G Eagan, Minnesota 55122-1897 Permit Number: 030657 (612) 681-4675 Date Issued: 0 8/ 2 0/ 9 7 SITE ADDRESS: 4086 3TATES AVE LOT: 2 BLOCK: 3 STflFFORD PLACE P.I.N.: 10-72500-020--03 DESCRIPTION: (GAs) Buildfng--.:Permit Type FIREPLACE ;Buikd3ng 4F6,rk Type NEW Census Cale 434 ALT. RESIDENTIAL 1 _ . 4 y 7 lillk 3 ~ e r~ 1.`.~ REMARKS: FEE SUMMARY: Base Fee $50.00 Surcharge $_50 . Total Fee $50.50 CONTRACTOR: - Applicant - OWNER: STOVE & FIREPLAGE GALLERY 18981174 KENT BRUCE a278 COUNTY ROAD 42 4080 STA7ES AVE BURNSVILLE MN 55337 EAGAN MN 55122 '(612) 898-1174 (612)688-7618 I hereby acknowledge that I have read this application and state that the infiormat3on 3:& correct and agree to comply wi„th all applicahle State of Mn< Statutes 'attd City af Eagan Orda:narfces. . _ . ` - _ - APPLICANT/PERMITEE SIGNATURE ISSUED B: SF ATUR 3830 tEPLI C $EN RMIT APPLICATION ~~/O• 3OL61 1997 FII DATE: / PERMIT FEE: $50.50 DESCRIPT'fON OF WORK: ~ CONSTRUCT N W FIREPLACE _ ALTERATIONS TO EXISTING _ INSTALL GAS INSERT ONLY INSTALL GAS LINE O\I~ Y 1 OTHER: Pnn. ~SrnAJ STREET ADDRESS: LOT ~ BLOCK SUBD./P.I.D. APPLICAN'T: (circle one only) OWNER CONTRA I hereby acknowledge that I have read this application and state that the information is conect and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. PROPERTY Name: Phone OWNER ..n A.n Signature: Street Address: t-~~~ 4kA- City: Gr~~C,,,._ State: ~ Zip: FIItEPLACE Company: ~"&g,_'~~ ~~`c.c Phone INSTALLER Signature: Street Acidress: ~Z~ ~~n l4x ~Z Ce~~ Licenie State: ~ Zip: GAS LWE Company: Phone INSTALLER \ Name: . Signature: Street Address: CnLod(~At) ~ City: State: Zig~~ a y OFFICE USE ONLY BUILDING PERMIT TYPE ? 14 F'veplace WORK TYPE ? 31 New ? 33 Alterations ? 32 Addition G 34 iceNau GENERAL INFORMATION Census Code. 434 SAC Code 01 REMARKS Chimney/flue must be inspected before concealing. X ~P~ a o, g 3 J RECORD OF COMPLAINT S~`• ~Jj~,,, p~ D6TE: COMPLAINT TAKEN HY: ~~?~c--/ N9ME: 6DDRESS: PHONE NO.: COMPLAINT: 1C~ - ACTION TAKEN: )6 ' Z-1cGCc<~.LC L( ~+-u~~ ~ /YY~Y~~~Z~~ • COFASENTS: 4-' //u/?'2~*-'r'~v{ N~" r.c'."2-„ ~ /r. TYPE OF BOILDZNG: LEG9L DESCRIPTION: • SIGNED: _ ~ . CLAI11 VOUCIIFR - REFUND Rf,QUEST CITY OF FAGAt1 CLAIPSAN WIITLEL FIEATIING & AIR OMITIONING ADDRESS 1955 SHAWNEE ROAD EAMN, MN 55122 ],ncation 4080 STATES AVQNUE L2, B3, STAF'FORD PLA.,E RerriPtNo./Date 7/5/90-i197776 Reasnn fcr ReEvnd PLIZffTUNA]ECESSARY T}•re of Refund Electriral Fermit 01-3211 $ FlumbinR Fermit 01-3212 Nechanical Permit 01-3213 S 12.00 _ _ Surcharge 01-2155 $ Wlter Connection Permit 20-3713 $ , Sewer Connection Fermit 20-3743 Account Deposit 20-2252 $ Utility Account Over-rayment 20-2250 $ O[her: S TOTAi, $ 12•00 I declare under the penalties of law that [his account, claiin or demand is just and that no part of it h2s been naid. 1 / nn_Y 5. 1990 ignature Date V . R.+~.d.~.., 54 n' a WhoJe Nou.se Warkshet Co. 4 tYMIME p~wMM ~-~'i Or~MNCMIMl~M - -J~~ ~ ~WwrNw~WS ~ry" Tiw~ '-~_..e.'/-pw~. pww 1rM ~.Z~•i .~w j~1 aMMw~~ NEATINO . C-m TMM nNIwMy ` COMMON pATA SECTION• ' ~n~.»nqr MuAra ~ . p • . . IY~~r' , p . M ' ~ ..GROSSWALL t • wr+c"."' ' ooops 4 anN oowsrrwrw«s1 ~ U NET WAIL - •_.l~,..~ ` i 5 a ~ - ~ CEIUNG y , •O ~ . v7 7S FIDORS . w.n. • ¦1~¦ 1,1/~Y ¦ WMy O f ~ . y a 0./839(1 r a t y` M G T Mc ~ w..~.... a a OOtft13 t ! ¦ • Sb!&IOfAL BTUM LDSS Ipw t0OF1 • d • I ti~,~ q A H SJUSTMENT Re?CTpq 1711p4 C) 70lA1 BTUM IOSS . . ~fM ti0D9TUMGAIN W~•w f APPl1AqCES BTUM ~ o u SU&70TA1 BTUM GAIN ~rcpe ~~y~ ~ f~pp . ~ OUCT LOSS/GAIN FAC70R (Td+M FI . . SU&70?Al BTUN IS«ripU Gainl _ ~ 7 MbISTUNE REINOWI Iw0 wW r 1.31 'P"~.A7AS BYUiY LOSS/OAIM . . ¦ 1.3 ~~fATMW -DOORi i Yqpp F'E w~n S Ih111 lY~fl TMLE S- Qppy~p „ ppOlli k W1Npip1N~ 1 "Y'n%Uft~bnINNrYMS'vMhCMrs IN 11MWhlprlwppw ' ~Ia~awny~Mqpw,~~MMwW , ~IO~pIdYl4ipWMtdOaqqy ~M M1d~4~n M4M~OMr . s . . . AYW dmwmmrrl ~Ywr . Sw~ ~ . ¦ AfY • OlY~1 LML Mwrl 1wY:ow. -i.~0 10~6 tl.i~ orr yr r w ~ Nw~ l~wwi s r+ s s ~wy'~w, ` • e a r~ r u y ~ , . .6.61 &li 7.76: row o r • ¦ n a s N.rSM~~~ ~ 3 S ~~w a ~ • • ~ ¦ ~ • 6.w hM 3.80 • .M~~. • • rr M r ~ w • ~ . 4.a 6.46 r ~ • r s N ~ .~~.Q. . YM~~ ¦ ~ M~ IA YO w~l MI N ~ - . 6.0' r± u ra ua u w u y~ CD ti...rr.~,~ r+~.....ew~ww~ .T~T~ ~WO~OFI?~' ~.O ~ , F':~~: ~l1 !~~~'r`rrrw LVLEO..IMNL7RA'hONIiWITI/4yft idarA~ Wlmr AM C7rnWy hr Ilo~r - , IM 71 yiMMn1 . ~ aM ~OO0 W { IrM YODIEYI ~~YY]WO 114l . sYw . TmALi A`~p~ I.t ~p Y 7 . . - . . / ~ ~ ~ 72 . OA 0.1 . . . ' . _ 1•41 h11rm 50.014. 1; 1 0 sM: ~~t/~i~ ' . . - . 0.~ y~~_ WifMENf iAC7OAS _ ~~1 q~ ~wiw4AYLbwftrpMMEr ~ GII. ]Y ~p 7m p " ~ ~ ~ wse~r eYaIND Mia1i ~wlq Hloo u ~ ~ ll - i~4wn. r. SI~d. Mk 19tl[ ~ w y u a~ Wa u tie w 22 +01e4 . APFLICATION FOR PERMIT iNpTE= PP'YMI7r OF M AT TSME OF ~ ArPLIcaTTaN noFS cor cau- ; * SfI1[7PE AFPi~V AL OF PFR6IIT. : + e SEWER ANQ/OR WATER CONNECTIQN t IrM=au oF sEMM Ann/ox wr+Tm : i.,. •y I[E7'ALi.ATIONS WIIJ. NOT HE SCCm[[A.EO ~ x ' • ,'t UPII'IL PFT26IIT AAS BEFSI APPROVID. ~ fPi4fielrf#/!+~ltS4yrYMiefie*ffff#/kRfAf*ft l ity oF (zcigcan - + (PLF.ASE PRINT 1) PROPERTY ADDRFSS: 'iQgC) STf vw-S 'AUEflul: F"Y~C~1F~~1~ t-AIU `"v5Ia3 T•FY;AT• DESCRIPTION' . L.pT ~jlocJk.- 3 - ~ Lot B oc Subdivision or Tax Parcel ID ) IF EXISTING STRL}CZY7RE, DATE OF ORZGINAL BLILDING PM T ISSUANCE: Mont Year PRESENT ZONING/PROPOSID DSE: Q,COPM'IERCIAL/RETAIL/OFFICE I:Rj R-1 SINGLE FAMILY Q INDL'STRIAL ~ R-2 DLPLEX (7Wb Cnits) a INSTITUTIONAL/GOVERNA7ENT ~ R-3 TOWPIIi0U5E (Three Onits) ( Units) Q R-4 APARTMENT/CODIDOMINICfi1 ( Units) 2) ' ~'i" _~iY~ NAMEc P[)DRESS: 3WC~3- C~Daw~rau~ D2• CITY, STATE, ZIP: L&,p~, 4,Ao• 551o,2a- PxoNE: For City Use 3) i:x• NAME: ~`YLUmf3ir~~ Pl erumLicense: •Active ADDRESS: Expired CITY, STATE, ZIP: Not recordec PHONE: MASTII2 LICENSE # 33 a~f St Ia nf~'itia~ 4) a.~~a~e.lT~i~e7s NAME: ~i Yuar~ zL ~ArUR `R~ AwDxEss: s~CL, ~ CITY, STATE, ZIP: 'fQ_j D~`~/ / Al~~'} 55"~-tcot I.. PHONE: S 7 a 3 S`~ ( 5) s ~ ' w 15 513 •an ~ CONNECTION 'IY) CITY SEUlER Floj CONNECTION TO CITY WATII2 ~ O= 6) ~ . x**********,r*****~~~*******~**********~*****+*~*~~***~**~*~***+**,~********+*y ,*k 74IE GOLD ODPY OF 7HE PERNIIT WIIS, SE SE[di' DIREGTLY TO PUBLIC WORKS DO FACILITATE METER PICK-UP. * PLEILSE AI,LDW TWO WORKING DAYS FOR PROCESSING. SOME'ONE FROM 7m CITY WILL COIdPACf YW IF TfERE ~ * ARE ANY PROBLF.NLS. ."1 ~***,~*,~*+******~***+**x*x****~~~+«**+*,r******~+****~*~,r*~~+*+*~*~~*,~****xx*,r*~*********++**~****,r**; ' . FOR -CITY USE ONLY , PERMIT #.ISSDED ~ Pd w/Bldg. Permit FEES: ~ $ /0 •5-Z) $ SEWER PERMIT (INCLLDE SURCHARGE) $ $ WATER PERMIT (INCLUDE SL'RCHARGE ) $ $ WATER METER/COPPERHORN/0['TSIDE READER $ $ WATER TAP (INCLL'DE CORPORATION STOP) $ $ SEWER TAP $ $ ' ACCOUNT DEPOSIT - SEWER $ ACCOONT DEPOSIT - WATER $ S-SD C~ $ wAc $ (O S~ e-7D $ SAC $ $ TRLNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRONK WATER $ --,70 $ WATER TREATMENT PLANT SLRCHARGE $ $ OTHER: $ I~ z z' U~ $ TOTAL RECEIPT RECEIPT- DOES LTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? F--j YES IF YES, THEN A"PERMIT FOR WORK WITHIN POBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: 1-~~ TITLE: DATE : ]12- 71 ~ ~ C,tD -rs, 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New ConsWction Reauirements RemodeVReoair ReouiremenGS Office Use Oniv 3 registered site surveys showirg sq. ft of IW, sq. of house; and all roofed areas 2 oopies oF plan Cert of Survey Recd _ Y_ N (20%maximum lot coverage albwed) 1 set of Energy Calculaiions for heated addNOns Tree Pres Plan Recd _Y _N. 2 copies of plan showing beam 8 windax sizes; poured found desgn, etc. 7 site survey (or additlons & decks Tree Pres Required _ Y_ N 1 set of Energy Calailations Addlfron - indicete il on•site sepfic system On-siie Septic System _ Y_ N 3 copies ot Tree Preservation Plan if lot platted after 7l1193 Rim Joist Detail Options selection sheet (buiMirgs wRh 3 or less uni5) Date Gr ^ ConstructionCost ~~7000 ,OQ SiteAddress YO$Z~ ~~.#5 ~T'vf- YtJt-I UniUSte # Description of Work PC 5 r-d c- Multi-Family Bldg _ Y XN Firepiace(s) _ 0 _ 1 _ 2 Property Owner S ~ 5C.-. K i KS Telephone ) Contractor go Y 1-1'A /-~0 n+c 1'- Address r,617- 246t-~- 1J. ~ City State /l4ll/ Zip 8BEet- 5-5-6 5 Telephone # ( 6 ) Z) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv I _ Minnesota Rules 7672 Energy Code Category . Residen6al Ventilation Category 1 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _ Y _ N If yes, date and address of master plan: 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. ApplicanYs Printed Name Applicant's Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 EM. Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gaze6o) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storrn Damage ? 06 04-plex ? 12 12-plex Plbg_v or_ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Impmvement ? 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 Occupancy MCES System Plan Review 100% or 25% Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings(new bldg) FinaUC.O. _ Footings (deck) FinaUNo C.O. _ Foo[ings (addirion) _ Pluxnbing _ 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 S8W Permit & Surcharge Treatment Plant License Search Copies Other I Total PERMIT City of Eagan Permit Type:Building Permit Number:EA122621 Date Issued:05/14/2014 Permit Category:ePermit Site Address: 4080 States Ave Lot:2 Block: 3 Addition: Stafford Place PID:10-72500-03-020 Use: Description: Sub Type:Reroof & Windows/Doors 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. Windows/Doors: If altering the opening size, a framing inspection is required. Valuation: 8,000.00 Fee Summary:BL - Base Fee $8K $162.25 0801.4085 Surcharge - Based on Valuation $8K $4.00 9001.2195 $166.25 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 - Kyle D Jenkins 4080 States Ave Eagan MN 55123--159 (651) 285-5176 Reroof America 10740 Lyndale Ave S Suite 10W Bloomington MN 55420 (952) 888-8440 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA126873 Date Issued:09/15/2014 Permit Category:ePermit Site Address: 4080 States Ave Lot:2 Block: 3 Addition: Stafford Place PID:10-72500-03-020 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes . 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 - Kyle D Jenkins 4080 States Ave Eagan MN 55123--159 Renewal Andersen 1920 County Road C West Roseville MN 55113 (130) 651-2644 X777 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA131826 Date Issued:07/09/2015 Permit Category:ePermit Site Address: 4080 States Ave Lot:2 Block: 3 Addition: Stafford Place PID:10-72500-03-020 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 500.00 Fee Summary:BL - Base Fee $500 $40.00 0801.4085 Surcharge - Based on Valuation $500 $0.50 9001.2195 $40.50 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 - Kyle D Jenkins 4080 States Ave Eagan MN 55123--159 Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA163595 Date Issued:09/08/2020 Permit Category:ePermit Site Address: 4080 States Ave Lot:2 Block: 3 Addition: Stafford Place PID:10-72500-03-020 Use: Description: Sub Type:Reroof Work Type:Replace Description:Includes Skylight Census Code:434 - Residential Additions, Alterations 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: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 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 - Kyle D Jenkins 4080 States Ave Eagan MN 55123--159 (651) 706-3353 T. Dunham Construction 831 Ventnor Ave Eagan MN 55123 (612) 819-0480 Applicant/Permitee: Signature Issued By: Signature