4286 Sunrise RdCity of Eaall
3830 Pilot Knob Road '
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
r �
For Office Use
Permit #: q / ! / 7
Permit Fee: 1 L471 ✓3
Date Received:
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION tnC.
"7 -7 -II
Date: COP -L4 I Site Address: 142-8(0 51414 r L. Unit #:
RESIDENT /
OWNER
Name: F'A✓1 SGl SSS /i Phone: (OSI -6,8'o -9e
Address / City / Zip: 92167 Sµ i rt5e. Rot.
Applicant is: )( Owner Contractor
TYPE OF WORK
Description of work: Dei -k-.
Construction Cost: t 7r®va Multi -Family Building: (Yes / No2C )
CONTRACTOR
Company: Contact:
Address: City:
State: Zip: Phone:
License #: Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
Yes No If
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?
yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
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.
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 the approved plan in the case of work which requires a review and approval of plans.
X ciAK.
SANK-ss)er
Applicant's Printed Name
x
App cant's Signature
Page 1 of 3
SUB TYPES
Foundation
Single Family
Multi
01 of _ Plex
Accessory Building
WORK TYPES
✓ New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25% 100% V )
Census Code
# of Units
# of Buildings
Type of Construction
StiviLt
Fireplace
Garage
✓ Deck
Lower Level
T WRITE BELOW THIS LINE
Interior Improvement
Move Building
Fire Repair
Repair
3
� 00
yes
REQUIRED INSPECTIONS
Footings (New Building)
✓ Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice & Water Final
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Siding
Reroof
Windows
Egress Window
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building — give PCA handout to applicant
Occupancy )'/
Code Edition .V4,a7 ,Mrs'/e.-
Zoning?/'
Stories
Square Feet
Length
Width
Framing
Fireplace: Rough In _Air Test Final
Insulation
Sheathing
Sheetrock
Reviewed By:
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
✓Final / No C.O. Required
HVAC _ Gas Service Test
Other:
Pool: Footings
Siding: Stucco Lath
Windows
Retaining Wall:
Radon Control
Erosion Control
Building Inspector
Gas Line Air Test
Air/Gas Tests Final
Stone Lath Brick
Footings Backfill Final
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
app Pit, /5- = 00 0
Page 2 of 3
,99
For: R.M.C. DEVELOPMENT CORP.
NOTE:
4284 .uNRISE RaAD
C. fit. WINDEN Ii ASSOCIATES, INC.
tAND SURYEYOtS Tat $45-5148
13111 EUSTtS $T., ST. PALA, MINN. MOS
e Denotes Wooden Stake
Proposed Garage Floor E1.9c41•0.•
( 903.7) Denotes Proposed
Finished Ground El.
-mg- Denotes Direction
Of Surface Drainage
Vertical Datum - N.G.V.D. 1929
Scale: 1" == 30'
O Denotes Iron
Monument
Lot 6, Block 4, SUN CLIFF FIRST
ADDITION, Dakota County, Minnesota.
WE HERESY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURvEY OF
BOUNDARIES OF THE LAND ASOVE DESCRISED AND OF THE LOCATION OF ALL MOLDINGS, IY
THEREON, AND ALL VISIBLE ENCROACHMENTS, IF Amy FROM OR ON SAID LAND.
Dowd thii..1.i dol of duly
_ieviied- 657-
1 0
S10 - 4-
-
-- 'Revised - 'f•-8�
. , r TW r. . . s v ~ .f ri~ . . . . , . . PERMIT #
PLUMBING PERMIT RECEIPT #
CITY OF EAGAN -
3830 PiLOT KNOB ROAD, EAGAN, MN 55121 DATE:
CONTRACT PRICE PHONE 4544100
Site Address BLDG. TYPE WORK DESCRIPTION
l.ot Block Sec/Sub
~ Res. New ~ Name Mult Add-on
~ Address 'i`~ v ~ Comm. Repair
J. L
Me- _ Other
c City _ "i iFab
NO. FlXTURES TOTAL
~ Name ' Water Closet - $3.00 $
c Address Bsth Tubs - $3.00
p City Phone , F Lavatory -$3.00
Shower - $3.00
FEES Kitchen Sink - $3.00
COMMlIND FEE - 1% OF CONTRACT FEE Urinal/Bidet -$3.00
MINIMiJM - RESIDENTIAL FEE _$10,00 Laundry Tray -$3.00
MINIMUM - COMM/IND FEE _ 20_00 Floor Drains - $1.50
STATE SURCHARGE PER PERMIT _ ,50 Water Heater - a1•50
(ADD $.50 S/C IF PERMIT PRICE GOES 1Nhirlpool -$3.00
Gas Piping Outlets - $1.50
BEYOND $1,000.00) Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
51GNAtURE'dF PERMITTE15~ FEE '
STATE S/C
FOR: CRY OF EAGAN CaRAND TOTAL: -
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used tor SF D~yV/CAR Est. Value $65, UOO Date FEaRUARY 27 , 1g 66
Sife Address 42b6 SUNRI S h ;2D Erect d( Occupancy i~3
Lot 6 Block 4 Sec/Sub. 6UN LLIFF IS'T Remodel ? Zoning RZ
Parcel No. Repair ? Type of Const. V
Addition ? No. Stories
::,;C DF:Vx.I,UP~~IEI'JT C0:1P Move ? Length 40
w Name d k
3 Address 3209 V+ 7 fiTH S'r., STr ~k 2 p 5 Demo~ish ? Depth
Int Impr. ? Sq. Ft
° city LDINH phone 835-3773 Instau ?
= o Name ~~''SiT'' Approvats Fses
Address Assessment Permit $ 34 0•~' ~
City Phone Water & Sew. Surcharge 34 . 50
Pofice Plan Review 170.00
t-ilNNL:`I'ONKA DESIGN
W W Name Fire SAC 575.00
31.R s~r
¢ W Cddres~},y C ET.. 474- 59 9 1 Eng. WaterConn. 5 63.50
< tY ~ Planner Water Meter
Council ' Road Unit 290.00
f hereby acknowledge that f have read this application and siaie that the 2 156.00
information is correct and agree to comply with all applicable State of Bldg. Off. Tf. PI.
Minnesota Statutes and Cit ot agan lOrdinances. APC Parks
' Var. Date Copie
Signature of Permittee I J Total 2~ 1 9-~V
A Building Permit is issued to: RMC DEVELOPt•jENT Ct)RP on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Of(icial- r ~
PsrmN No. PsrmH 1loidsr Dete Telsphona R
P1urmb1n9 7 7 H.V.A.C. eiocuic ' y -
Soflaner
Inspeclion Dab Insp. Commenb
FooNngs I
Foodnqsll
Foundatlon
Framfng
Rooflnp
Rough Plbq. - -W . `'0-
Rough Hty.
lnsul.
Ffnplace
Flnal Hty.
Final Plbp. -
Bldp. FMal -40
Cert. Occ.
Dock ity.
Dack Frmy.
WNI
Pr. Dlsp.
~ . ~ . . - r - . . . . - • ~ ~ ~ - ~ . . r~ ~ , .
• PERMIT # CITY OF EAGAN FEE
PLUMBING PERMIT sd
RECEIPT # 454-8100 S/C '
MINIMUM RESIDENTIAL FEE - $10.00 + $.50 TOTAL
DATE 3 ~ MINIMUM COMMERCIAL FEE - $20.00 + $.50
1. Bldg. Type: Res X Comm Inst 2. New X Add Alter Repair
3. Total Bid Pi'!ce 4. Job Address
Lot Block Sec 5. Owner
6. COrltfBCtOf 36bu
(Name) 4 5 L-1 S(i 5 csc?~ (city) (zip)
7. Contractor Phone #
NO. FIXTURES NO. FIXTURES NO. FIXTURES
Water Closet - $3.00 -L-Laundry Tray - $3.00 -Well - $10.00
_7~13ath Tubs - $3.00 E Floor Drains - $1.50 _Private Disp Syst - $10.00
=Lavatory -$3.00 /-Water Heater -$1.50 -Rough Openings w/o
/ Shower - $3.00 Whirlpool - $3.00 Fixtures - $1.50
TKitchen Sink - $3.00 iGas Piping Outlets - $1.50
-Urinal/Bidet - $3.00 / Softener - $5.00
COMM./IND. RATE - 1% OF TOTAk BID PRICE PLUS $.50 STATE SURCHARGE FOR EACH $1,000 OF FEE.
5lgned: for
?
AppTOVedJ Inspections: Date Rough Insp. Oate Final Insp.
. . . . ~v.-I' v _ .~-c~ ~.Ra.s. ~y •.+vaR:r-.r. _ . . , , . ^ .
. 4G /
. PERMIT # b? CITY OF EAGAN FEE 2`3 ~
/ 0 ~ ~S MECHANICAL PERMIT 5iC A~)
RECEIPT # 454-8100 ~GI
MINIMUM RESIDENTIAL FEE - $10.00 + $.50 TOTAL
DATE M MINIMUM COMMERCIAL FEE - $20.00 $.50
1. Bldg. Type: Res ° Comm Inst 2. New Alter Repair
3. Total Bid Price Job Address ~'~~1°~~
i . `
Lot~ Blocli- 5. wner y~/~
41
s. Contractor
(Name (Street) ICitY1 (ZiP)
7. Contractor Phone #
iH6'
RESIDENTIAL HEATING - 01 -100,000 BTU's -$24.00. Each additional 50,000 BTU's or fraction -$6.00
RESIDENTIAL COOLING - 01-24,000 BTU's -$12.OU. Each additional 6,000 BTU's or fraction -$6.00
MODATIONS/ALTERATIONS -$10.00 minimum fee _
A,l~ i ,~1 _ ~~u ~3t~ ~~t;, i,~«
EATING ~VENTILATING HOT WATER STEAM AIR COND.
IR PIPING PROCESSED PIPING AIR HAND. EOUIP. RrFRi(3.
RES. GAS PIPING OUTLETS -$1.50 TANKS: L.P. UNDERGROUND OTHER
COMM./IND .RATV - 1% 0f7 T L ID F~ICE PLUS $.50 STATE SURCHARGE FOR EACH $1,000 OF FEE.
Signed: for
Approved i Inspections: Date Rough Insp. Date Final Insp.
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: ~
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: i., f t„r r , APPLICANT:
PERIVIIT PUBTYPE: TYPE OF WORK:
, •~t ~i ~,ni i~~ri
INSPECTION DA • D•
t ~ ~ ~~t~? i I :•1" 1 f:. 1 ~a f i 1 ~ ir .~r ; . ~ i~7: ~ l N~.
~ J
Permit Holder Date 7elephone N
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
RpUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE ~ Jh
o~
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
coNDucrivirv
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
CITY OF EAGAN Remarks-
Addition SUN CLIPP 1ST Lot 6 Rik 4 parcel 10-72975-060-04
owner rJ,.y, 5treet 4286 . ST3NRISE ROAD state EACAN hlN1 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. C 1
STREET RESTOR.
GRADING
SAN SEW TRUNK
• SEWER LATERAL 1989 3547.94 7~9 .59
WATERMAIN
• WATER LATERAL •
WATER AREA
STORM SEW TRK 105 1971 --322-29 16- 11 --2D--
• STORM SEW LAT 1985 "
* Service 1985
-
CURB & GUTTER
SIOEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
i CITY UF EAGAN WATER SERVICE PERMR
3830 PBot Knal, Road ,
P. O. 66x 21199 PERMIT NQ.:
,
' Eegan, MN 56121 DI1TE: '
' Zoninp: No. of Un1ts:
Owrwr: T:evclopers
"
Addross:
Site llddress: SunriBe F.oad jAgj4 5un Cliff Ist
Plumber. a' IeV F1 _
3 70 /S/ 76 act: 50i) : Of?~u
Meter No.:
Sim: T
. . .&v%jv
L p~rmit, F~'~tLf
Reode No.: N
I .,m ro ea.d„ ,.NU oft p~+o~13., p
OAtM~a~. Misc. CY+orpes: ,
r• c~e a_r
Totol:
By Dor. Poid:
Date of Insp.: ~ Insp.:
CiTY OF EAGAN WATER SERVICE PERMIT ~
3830 Pilot Knob.Road
P. 0. Box 21199 PERMIT NO.: ;
Eagan, MN 55121 D^TE: '
Zoninp: No. of Units: ~I
r•!(~ LeVfllOPE'-'S 1
OwrMt:
Addross: ~
Stt. Address:'':"E- Si:nrise Roa,-'
Plumber: T'i-,' l.eq Plumb3ng _
Mlbr NO.: COrIr1ECt{O/1 Q1arQl: r"^~ f1 V.J
Siu: Acoax+e Oeposit: . . „s .
Readsr No.: Permit Fee:
1 yme h aompir wMh !M Q!p of Empa Surcho?9e:
Ou11MseM. Mlsc. Choryss:
Totol:
By Doce Paid:
Dote of Insp.: In106: ,
CITY OF EAGAN SEWER SERVlCE PERMR
3830 Pilot Knob Road
P. O, Box 21199 PERMIT NO.:
Eagan, MN 55121 pATE;
Zoninp: No. of Units:
Owner, ~ , _
/1dd?ess:
Site /lddress: _
Piumber.
I Gym h esr*b whh Iw Cif of B"Pa Conrnctian Chorps: '
OrdhNepm Aooourrt Deposit:
Pormk Fes:
Sureharys: '
BY Misc. CM?pss: :
Dote of Insp.: Total: °
Insp.: DoM Pald:
~
E'
~ CITY OF EAGAN N 0 115 51
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 ` )BUILDING PERMIT Receipt# (~~'~7C1
Tobeusedfor SF DWG/GAR EstValue $69,000 pgte FEBRUARY 27 1986
SiteAddress 4286 SUNRISE RD Erect ~ Occupancy R3
Lot 6 elock 4 Sec/Sub. SUN CLIFF ST Remodel ? Zoning
Parcel No. Repair ? Type of Const. V
Addition ? No. Stories
~ RMC DEVELOPMENT CORP Move ? Length 40
Name
W 3209 W 76TH ST., STE #205 Demolish ? Depth 48
o Address Int. Impr. ? Sq. Ft.
Ciry EDINA phone $35-3773 Install ?
i o Name SAME Approvals Fees
$ ¢ Address ' ASSeSSment P¢rmit 0 • 0 0
~ Ciry Phone Water 8 Sew. Surcharg~' S0
E"i= MINNETONKA DESIGN Police Plan Review 170.OQ
~W Name Fire SAC 575.00
x~ Address 337 WATER ST 500.00
aw ~i EXCELS~~ 474-5991 Eng. WaterConn. 63.50
< tY Planner Water Meter
Council~ RoadUnit 290.OQ
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.Off. `/"z'/" Tr.PI. 156.00
information is correct and agreelo compl with all applicable State of
Minnesota Statutes an a O di c s. APC Parks
Var
Si nature of Permittee ~ . Date Copie
9 Total ~.00
A Building Permit is issued to: RMC DEVELO ENT CORP ~ on the express condition that
all work shall be done in accordance with all pplicable Siste of innesota Statutes and City of Eagan Ordinances.
Building Otticial
~
This request void
18 mo ~ -I
nths Irom
a f~y5315 Bq ~U~ eCI~F ~ St ~~7
Re ~st ~ate Fire No. RouOh-in Insueaion
Requir ? ~Ready Now ~]J4'rYf NotifY InsPec-
~ es ?Nu ~or When Ready
censed Elearical Convactor
1 hareby repuest insoection of ebove .
? Owner ' electrical work insiallad eL'
Street ddr ss, x~floute N Cit~~ ~
e1 o ownship Name m No. Range No. Counly
Oc ent IPqINT) Phane No.
Iti 'V 3 -~7~
Pow S~p01i Atldress
Electrical ConVacmr (COmpany N rt~l*r1 . Contracmr's License No.
: ryF.C. ~nf~, L62
M~~; ~ lasi 9~~ a 51ftsiLLaV I on)
Authorize $jpn~w W r ner Making InslallutioN Ph Number
'
MINNESOTA STATE BOAPO OF ELECTRIGITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midwey Bldg. - Room N•191 BE ACCEPTED BY THE STpTE BpqRD
1821 University Ave., St. Peu1, MN 66104 UNLESS PROPER INSPECTION FEE IS
Phona (812) 297-2711 ENCLOSED.
Q'g (40 REQU~ FOR ELECTRICAL INSPECTION ea-ooooi-oa
instructiens tor comoleting this /arm on beck o/ yellow coov. 4// J /''i
953 - S '"X" Below Work Covered by This Request ~ y
Home Range Te porary Service
Pompute :.''TyDe of-Builtling Aooliancas WireE Equiumenc Wired
Duplex Water Heater ightin,y Fixtures
Apt. Buildine~ Dr er Electric He2tin
Cominercial Bldg. urnace Silo UNoader
Industrial Bldg. Air Conditioner Buik Milk Tank
Farm O(he.M Peci y Other fSUecity)
t er neci y o[ er Other
pectio n Fee Below
pFee ,SarvicaEntrenceSiza k Fae Fentlers/Subfeeders k Fen Circuits .
0 to 200 Am s 0 to 30 Am s 0 to 30 Ain s
Above m ps 37 [0 100 Amps / 31 to 100 Am
Swimming200 q Pool Above 100-Amps Ahove 100_Am e
Transtormers Irrigation Booms Partial%Oiher
Signs Speciallnspection
Nem,~.ks TOTAL F
f 67 7.
Nouph-in D:11e I, cheElect '
~ nspector, hereby
certily that the abave
Final ~ O "te~~ ingpection hes been
made.
ThISrequastvalGlBmontluirom "
1985 BUILDINC PERNIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED NITH THE CITY OF EAGAN
COl4fERCIAL SINGLE FAMILY DiiELLINGS
INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS
& STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY
SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS
ENERGY CALCULATIONS
$2,000 LANDSCAPE BOND L !vl/ ~
.P/ Kf IE //7K.~ ODCJ /
To Be Used For: fJ~//„ro Valuation: Date: ~F-d ~yf;R~'G
----t-7---
Site Address OFFICE USE ONLY
Lot jr Block ~ Erect k Occupancy 3
Remodel Zoning
Parcel/Sub ~~7~ fRst Repair , Type of Const
Addition # of Stories
Owner zfz6c Move ~ Length qo
Demolish Depth 4 6
Address ,3.?Q J W zi rnt.Impr. ~ sq Ft
Install
City/Zip Code Z~ GL~tV'y------------- -
Phone LT5 = 3 22J APPROVALS FEES
Contractor S,yf i¢s ~j~vo,s Assessments Permit 3410
Water/Sewer ~ Surcharge
Address Police Plan Review j p.~
Fire SAC "75.
City/Zip Code Engr Water Conn SDC?.
Planner Water Meter lp3.
Phone Council Road Unit 29p.
Off~ ,~jTreatment Pl Sc~.
Areh./Engr. Bldg
APC Parks
Variance Copies
Address 33~ /v~fisie y TOTAL
City/Zip Code ~~~s~~SiOQ4/11AA1 ~2S331
Phone 11 ~ J~ _„~Ypf
3C9xZCo - ~3CnK ~ " ~4.Z~n ,
~2 K 12
= SZ~n
1,o44oK 12
(o
vb~~
.
4284e SuNRrse Ro•?a
C. R. WINDEN & ASSOCIATES, IN[.
~ ~iAND bUfvEtl0t5 tal 046•3446
1381 EUSTIS SL. ST. FAUIS MINN. 6610$
FOr: R.M.C. DEVELOPMENT CORP.
v N
NOTE:
o Denotes liooden Stake
L Proposed Garage Floor E1.9014-0..
903.'j) Denotes Proposed
Finished Ground El.
~ f--- penotes Direction
Of Surface Drainage
Vertical Datum - N.G.V.D. 1929
q op / Y\
o+~ 90 y ~ Scale: 1" = 30'
qoq 'L'~ ~ 'OJ p Denotes Iron
Monument
3
Q ~
tYo~9
729„ ,S-
`90
r S~~ ~ lq~l \ ~Rr
ss .~s \
/A • \ \
41. ~
c,
,
Lot 6, S1oCk 4, SUN CLIFF FIRST
ADDITION, Dakota County, Minnesota.
b~yb
r 0 56 ~p• y N t0
~
O
WE NERElY CERTIfY TFIAT iM15 IS A TRUE AND CORRECT lEiRESENTATION Of A fURVEY Of TNE z
{pUNDARIES Of TME LAND A?OVE OESClI&ED AND Of TME IOCAiION OF Atl WILDINGS, li ANT,
iMEREON, ANO All VISISIE ENCROACMMENTf, li ANr, • fRpM Olt WN SAIO IAND. . . OeNJ 1Ais pltco day o1 J4~..o. 1+84 C. 1' WINOEN i ASSOCIATES, IMC.
--~itvisnd--2-~0-BS- ~~il~ •
~eviseJ !O-{-65 • ~@VLSId .:~~'$~i'- 11'
. SurvMr..MieMNle tpiarofi~w ~N.Q~t~,L .
. ....Yb4N . _ . . . . . . . . . ' .
r 5; '
t
kLRltait i ri r I.U! U" tql,r•t1lnl lOra d 7i~
-
(~dNER , ~ a ~ . 11A7 C : -
4
_ _ _ - - -
SITE.ADQi:E55:
- ~
CONTRACTUR:_~'-~~
. Determine rrorkirg s,uarc fooLage of each
. ,
, 1~.:•jOLdl sekpOSCd Ndll dPEi1.....20 ~.4-',-~~-----...sn.. ft• r.__??_._°---=-~ Z?. -]~j
2. Total rooflceil9ng area....._ ft. x_._02G
~ . , _ ~
~
ii)till @X(%:'SC'd WiiiI ;li)0'il' fl0oY:.:.i~'
i-. ..L. l. _
a. Total wali iv•indow area O-'-C°~--
b. Tota? daur area
C.. r0td2 sitdinJ y1a55 i!ppr ai^Ca . ~CJiUZ
-
d..-Total fiirep;a ce r•all arer
e.' Total wall frami!;g r:rea 0tv,ra?c . . . . . .
. . . . . . .
f. Total rim Joi5t al-ea
g. _ net wstl areA abooe oer...... -
'
h.. wall are'l ahove f'oor
i. wail Area nUove f'luor
3.:; frame wa11 area ai fc>wiciatior Total expcied fuund.,t ior aroa-
k. Total tottndnt:io^ wiridow ar?r
1. Tc*ai net fou^iaticn area abcve qra,ir..............
Uetermine "u" value of cach wall seynlen!
(e.g. Andow, deor, each ;eparatr v:al' sr.ct
a._~_: k°~;~~_. 2-~
~ . _
t---
r ~ ,
I„LI'I
c~_._ X ~ -_j~~~-~,~1
J
~•-_.~_-~`-JU ~ ~ ~p .
h.
:
~ If item N3 is the samE
"Li,~ , as, ur i^ss trian item
h,) e
meJ the
~ ~ .~...1 1- -...--II---' ~in.e0t Gf SeC o~C-b (G)
~...Y.. . ' ~ , ~
'~'J.......
~ y' 1 1~ ' ~
:(14'
''4:'
.
,
~
1 Ll_.j---
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CITY OF EA(;AN
CASH7Eh: 5 TERM?NFll_ n0; 91.8
DFt'TE;: 9.0/01198 TLt1L-'.u 15-59:1.7
N(-tHF_s ALL.IE:Li F'1R'L-'.STDF INC
329.0 9001 428E, 51.1NRISE RA 50.00
21.55 3001. 4286 SUNF.T.SE. fiLJ 0.50
;
7or,:i7. Rereipt Amnunt _ 50.50
CR09'i9"i1.
USE:R ILt: NANCY
>k1C n~>'FX~~F~WY,cYkyFkc'MX~XC?XYF#X+!X>X~M M~k787XM7,°.X~MY,<.~M~'n~Xi(~k
PERMIT
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road B U I L D I N G
E p,gane Wnnesota 55122-1897 Permit Number. 033521
(612) 681-4675 Date Issued: 0 9/ 3 0/ 9 8
SITE ADDRESS:
4286 SUNRISE RD
LO'C: 6 BLOCKo 4
5UN CLIFF 1ST
P.I.N.: 10-72975-060-04
DESCRIPTION:
Gas INSERT
B4„i?ld~i~`g- ,~Permit 7ype FIREPLACE
L~,~t~.1d3 Y5~ 0b,¢-k Type AL7ERATION •
Aensus,Cot]e434 ALT. RESIpENTIAL
~
~ .
&~e
e .tK e .~3~z^^
~ 6n
h Sj ig,
REMARKS Ev(FLuE MUST BE INSPECTEp BEFORE CONCEALING.
FEE SUMMARY:
Base Fee $50.00
Surcharge "D
Tntal Fee $50.50
FA~~T&CTOI~• - Appricant sr. L zc. OWNER:
CO IVER INC 16331042 20090911 PETERSON MARK
2700 N FATRVIEW AVE 4286 SUNRISE RD
RQSEVILLE MN 55113 E A G A N MN 55122
(612) 633-1042 (651)687-9270
2 hes-ela~ ~r~l~"r~~+w~edg~ that ;L havv read t!hig appJ.l~atz:on and stato tfraltR Vi e
' Jftfarmatlasn~ !`s borroct and agreo to compXY ~aithi a5.1 aPpjicable State ,ofi! Mn= '
e . _ .
. ~ f
APPLIGANTIPERMITEE SIGNATURE SUGNATURE
;
~
3c,-9N
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
1998 FIItEPLACE PERMTf APPLICATION
7:~ D- J 681-4675
DATE: S-e ~,-l ' PERMITFEE: $50.50
DESCRIPTION OF WORK: T Constuct new fireplace _ lt tions to existing
Install pss insert onlv Install ¢as line onlv
Other
JOB AIPRESS: d /Sl,
i,OT: yr~ Bi;OCK: SL73DM53'JN/P.I.D. ~ lK tn
APPLICANT (circle one only): OWNER CONTRACTOR
I hereby acknowledge that I have read this application and state that the information is coaect
and agree to comply with all applicable State of Minnesota Statutes and City of Eagan
Ordinances.
Name: ~we-v5 Q h Phone ?970
PROPERTY Last First
OWNER
Signature:
Street Address:
City State: Zip:
Company: 11 Q S I l i ePhooc
FIREPLACE ~ r
INSTALLER Signature: r
Street Address: ,3g-5 0 ~,11 f?~t1 F i~~License # Jo
n
ciri ~~~rr~ f Il A- state:~v. Zip: -!C5 -3,3~
Company: Phone
GAS LINE
INSTALLER Signature:
Street Address:
~
Jtl~ 'L 9 1998 ~
. ~
OFFICE USE ONLY
BUILDING PERMIT TYPE
? ]4 Fueplace
WORK TYPE
? 31 New ? 33 Afterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Census Code. 434
SAC Code Ol
xtEMARKS
Chimney/flue must be inspected before concealing.
• t ~ • i •s ~ • n •a~.
. ~ •a~ • ~ ~ ~ • ~
•C ~
CZTY OF EAGAN
P.PPLICATION FOR PERMiT SEWEE2 ADID/OR WATII2 CONNECTION
(Please Print)
1) PROPE[tTYADDRFSS: 4-/~gG
r.Frn.r. DFSCRIPPION: C(P
(Lot B1OCK/Subdivision or Tax Parcel I.D. Ntunber)
IF EXISTING STRL'CTURE, DATE OF ORIGINAL HC?ILDING PERNIIT ISSC~ANCE:
Nlonth Year )
PRESENT ZOATING/PROP0.SID USE: R-1 SINGLE FAMILY
R-2 DL'PLEX (Rtao C'nits)
R-3 'IC)WNFiOUSE (Three + Lnits) ( Units)
R-4 APARTMENT/CObIDOMINIL'M ~ Units)
CONA9ERC IAL/RETAIL/OFf'ICE
IDIDC'STRiAL
INSTI'PL T I ONAL/GOVE.RL~NT
2)
~ NAME:
ADDRESS: ~ ~~pl (N S~T /(e S7 l.UP4~~
CITY, STATE. ZIP:
PHONE: 2 2-7
3) • i;~• For City Use
N~' Plimbers License
ADDRESS: ro~ G L-. Cl Yl ~ C:t1 Active
CITY, STATE, ZIP: 5 Q I"~ d~ /"1_,. G7 Expired
PHONE: MASTER LICENSE # C= Not Recorc
St f Initial
4) 4F20
NAME:
ADDRFSS:
CITY, STATE, ZIP:
PFiONE:
5) io • • r~ a~~
4PCONNECTION TO CITY SEWECt ~CONNECTION 'PO CITY WATEEt
Q OTHER (Please Describe)
6) •
~ PLEASE HOLD APPROVFD PERmIIT FOR PICR-L'P BY ONE OF ABOVE
PLEASE MAIL APPROVF9 PERMIT 7.U 1, 2, 3, 4, ABOVE
~i (Circle one)
7 ) ~ r{~ ??N°r/GC~ ~ ~ ~ ~ ~-P ~ d
I
- _ • , "1~
F O R C I T Y U S E O N L Y
PE?2MIT ISSUED
t ' 1
. FF...r'..57 s SE:'iLP. PER?1TT (INCL'?DL SU7C=GL)
.
$ ~C~ S-0 WATE.2 PERP4IT (INCiDDE SliRCHARGL)
$ 3 `S-U' WATER METER/COPPERHORN/OUTSZDE READER
$ WATER TAP (INCLUDE CORPORATZON STOP)
$ SE:dE3 TAp
$ =C-Q:..?GSi= -
S ACCOUNT D.F.PpSIT - pIATER
$ C9 0 . cJ ~ WAC
$ -?c ~ S - U`d SP_C
$ TRGNK WATFR ASSESSifE:VT
$ TRliNK SEWER ASSESS.IE:IT
$ LATEP.AL BEiNEFIT/TRUNK SES• tiR
$ LATERrIL BENEFIT/TRUNK WATER
WATER TREATMENT PLANT SURCHARGE
$ OTHER:
$ TOTAL
$ AI~IOII::T PAID/RECEI?T # 40O ~O
. ,~~?•p0 0 a7 s.Y
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
C] YES IF YES, THEN A"PERMIT FOR T40RK WITHIN
PCIBLIC ROADWAY" MUST SE ISSUED BY THE
Q NO ENGINEERING DIVASION. LIST AS A CONDZ-
TIDN.
SUSJECT TO THE FOL.LOWING CONDITIONS:
APPROVED BY:
TI:LE:
DATE:
, CASH RECEIPT -
' -CITY OF EAGAN
P. 0. BOX 21-199
EAGAN, MINNESOTA 55121
DATE 19
RtCtiYtD
FIwoM
AMOUNT $ ~
6 OOLLARS
+oo
E]CASH ? CHECK
row
FUNC CODE AMOUNT
Thank You
BY
White-Payers Copy
Yeilow-Posting Copy
Pink-File Copy
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4286 Sunrise Rd
Lot: 6 Block: 4 Addition: Sun Cliff 1st
PID:10- 72975- 060 -04
Use:
Description:
Sub Type: e- Reroof, Siding & Windows/Doors
Work Type: Reroof, Siding, Windows /doors
Description: House & Garage
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 9,000.00
Contractor:
PERMIT
City of Eaan
Construction Type:
Occupancy:
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Building
EA086472
09/30/2008
ePermit
Pictures are not acceptable in lieu of inspections.
Smoke detectors are required in all sleeping rooms prior to final inspection. When wall studs or ceiling joists are exposed,
hard -wired detectors are required. Battery operated types are acceptable if the wall/ceiling finish (i.e. sheetrock) has to be
removed to install a smoke detector.
BL - Base Fee $9K
Surcharge - Based on Valuation $9K
Total:
Applicant/Permitee: Signature
$177.00
$4.50
$181.50
Owner:
Franklin 0 Schussler
4286 Sunrise Rd
Eagan MN 55122
0801
9001
Issued By: Signature
- Applicant -
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.