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4389 Svensk Lane ~~AQE OF E4G4N iibe Kne6 Road fE~/ EO9on, MN SS12y ER SERVICE p rOninB: PERMIT NO.: ERMIT ~k'ner: RII DATE: 266¢ 9ddreae: No. of Units: 1 12 12 $ Site Addre88: 38 N~~mbei: He ,a - Pet rs Sk ~ne L12 B2 WR 4 ea ,comPlY with fha Villope oi Eagan ~ Connection Ch Account az'Se425.0- gY, Pe DePOSIt: Fee: nate ofl Surch~. 10. p P nap.: Se: ~nBP.: Miac. ChazBes: • 5p Pd Total: Date P~d: VILLAUE 0~ '9GAN WATER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: - 1907 Eagon. MN 55121 DATE: -T~~~~'~ _ Zaning: ~I No. of Units: 1 owner: Tilsen Homes Inc. Address: s~ce padrese: 4389 Svensk i,ane L12 B2 WR 4 Plu ber: Peters Bey roc ter No.;~~ _~_7/-3 ~L Connection Charge: 320.00 Ud S'~e' v~ Account De posit: Reader No.: Fermit Fee: 10.00 pd ~~°9~'f~ 9D~Y ~'J~~ tha V' age of Eagan Surcharqe: .$0 pd O~~(an s /~Ce 60.00 Misc. Charges: Pd Total: BY - - - Date Paid: Date of Insp.; Insp.: INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: ~ ~ ~ ~ < < ~ F ~ ~ r ~ 3830 Pilot Knob Road Permit Number. t Eagan, Minnesota 55123 Date Issued: (612) 681-4675 SITE ADDRESS: ~ ~ ~ ~s ~ APPLICANT: . ~ r1 .i i nMt ~ , ii~,~i~ ~ ~~r i iitJ I h ~li ! I~~ I.f•!! ~ Ilpl ! f ; . .1 ~ ' •I~.1 1 PERMIT SUBTYPE: TYPE OF WORK: , . ~ 4 ,tt a~, . , ~ , , , . . ~ ~ r~M i~.,. ii i . . : i~ll~~ll t N Fi I~i i I Nr~ I ~ , ._s ~t: ~ . _ . ~ ~ ~ J Permit No. Permft Holder Date TNephone # S/W PLUMBING HVAC ELECTRIC ELECTRIC Inspectlon Dete Insp. Comments Footings I Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace FIna1 Htg. Orsat Test Flnal Plbg. Plbg. Inspector - Notify Plumber Const. Meter EngrJPlan Bldg. Finel Deck Ftg. Deck Final Well Pr. Disp. • ~ii~ CITY OF EAGAN Remarks Addition Wilderness Run 4th Addition ~ot 12 Rik Z Parcel 10 84353 120 02 owner L~~~ -"y J y+ ~,ts t; Ir street 4389 Svensk Ln. State Eacian , MN 55123 Improvement Date Amount A~nual Years Payment Receipt Date STREET SURF, STREET RESTOR. GRADING SAN SEW TRUNK 1973 163.26 8. 20 122.46 003931 4-28-77 SEWER LATERAL WATERMAIN WATEF LATERAL WATER AREA ~ TORM SEW TRK 1~83. 253.71 16.91 15 27.90 C008133 12-•3- 2 STORM 5EW TRK~' 2~8. A010522 9-2-81 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. . - - ~UI~DING PER. 11-2 -75 sac 425.00 1671 11- - PARK ~ 9~"~ ~ . a . ~o ~ . ~a s . 90 E-+-- ~7• 90 ~ ~~.,y ~,c~,.~2 d' ~i ~ CITY of EAGAN N4 - 3801 BUILDING PERMIT ~ 3795 Pilo! Kaob Road Ownsx " Eagan. Minneso3a 55122 Addrass (Drecenl) 454-BI00 Su3ldes -a-~ - Dals Addreaa DESCAIPTION Slories To Be Uted For Froni Deplh Heighi Esl. Cos! Pe:mi! Feal Aemarks - ~ S--~, ~ ~ 3c s~ i~, i 6' ~ 3 N_ ,So,~~ LOCATION /u'~S~ 5lreal, Road or other Dasariplion of Locafion I Lo! Block Addilioa os Tract ~ I % ~ ~ ti~,. ~ This permi! does no! sulhorise !he use of sireeffi, roeds, alleys or sidewalks nor doea i! give ffie oaaer or hSa sgea! Yhe right !o create anp situetinn which is e nuisance oz which presents a hasard !o !ha hea!!6, eaiefp, coaveaienes aa8 general walfare !o anpone in !he communily. THIS PERMIT MUST BE K£P.T ON TH~PAEMISE WHILE THE WORK IS IN PAOGRE$3. This is 2o cerlifp. !hal----... . f°~`'~" . ~ ' ~ f ~:.---------°°°...........°--------_..........hee parmiseion !o aseet a....._. T_u.- upon 3he above described premise subjecS !o ihe provisions of all appliaable Ordinanees fos !he Ciip of Eagan. , °-e- Per ~"..~Ce G,+~-~---°-'-~-~, . . . - . ........r...._.......-~----........_...------~---............- Mayor Suitding Iaspxtor cz~ or~ ~sc~.arv %o ~d3 S3 ~30 6 2-- . " 37°S Pi~.ot I'.nob P.cad Ea~~n, ;~i_n.~esota 55122 ~ ~SL 'r?1~~T NJ.: 647 'Phe Cit;~ oP ~~~.san :lere~y p^s.nts to L. H. Petar Plwnbing Gb. _ 185d Grand Ave.. St. Paul 55105 ~ ' YLfTi~ING Fer~mit for: (Os~^~er)__~_ Tilsen ~HOmea - 4 ' Dunrovin & ~ i~ ati Twno____~ Pursu~i~ to ap?iiacati.on d~~,eci 1/5/76 'ee F~ i i: _~~n__ :.,..I:ed {;his ~_d~.y ef Jan ~ 19 ~6 1.00 e/c . Euilding Inspec~or! N:echar.icai Fern,its: ~ ~ rid Total: ~ ~ ~ 2004 RESIDENTIAL MECHAIVICAL PERMIT APPLICATION City OfEagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 ~ I ~ -a Please complete for. single family dwellings & rownhomes/condos when permits are required for each unit Date ~ ~ / ~ / ~ Site Address ~U 'l S~f eS~ .~L ~--~1 • Unit # Property Owner ~QL~Q.ttz'~ ~Q( lLl('(~J Telephone # ) S`~ ~ ~-D~ ~P ~ Contractor i~'ohlers Southside Htg. & Air, Inc. - 6950 W. 146'~ St., #106 i Street Address I Apple Valley, MN 55124 I Ciry - (952)431-7099 ; State ~ _ _ ~ Telephone # ( ) Bond ~ 'rJ ~ `7 'r1 g / Expires: U The Applicant is _ Owner ~L Contractor _ Other Add-on or alteration to existing dwelling unit $ 30.00 ~ furnace _Additional ~Replacement air exchanger ~ air conditioner _New ~Replacement other State Surcharge $ .SO i/; ~ I? ' `~~~L' ~ ~ , G $3 5 TOfff~ I ~ OV n I il.~Y I, I ~ ~ ~ ~ I hereby apply for a Residen[ial Mecttanical Permit and adrnowledge that the infor_tnat '"5 einoi 6mp1_et,e and;zccurate; that the work will be in conformance with the ordinances and codes of ffie City of Eagan and with the Mechanical Codes; Ehat 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 ~nted Name Applicant's Si ature ~ 2004 COMMERCIAL MECHAIVICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: commerciaVindustrial buildings multi-family buildings when sepazate permits are not requirod for each dwelling unit Date / / Site Street Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owoer Telephone # ( ) Contractor Street Address City State Zip Telephone # ( ) Bond Expires: The Applicant is _ Owner _ Conuactor _ Other Work Type _ New Construction _ Underground Tank _ Install _Remove *"`see below _ Interior Improvement _ Install Piping _Processed _Gas Nature of Work: "When insfalling/removing underground tank, call forinspection by Fire Marshal and Plumbing lnspecfor Permit FCes: 570.50 Underground tank instsllation/removal $50.50 inimu~n (includes Stak Suroharge) or Contract Value $ x 1% _ $ Permit Fee • If oermit fee is $1,000 or less, add $.50 ~ $ State Surchazge If oernvt fee is over $1,000, add $.50 for every $1,000 germit fee $ Total Fee I hereby apply for a Commercial Mechanical Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the Ciry of Eagan and with the Mechanical Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. App(icanYs Printed Name ApplicanYs Signature Approved By: Inspector Date: i~u,d 1 ~ 101 -~1,' ~ 7N11 ~1~i~c!ci2i~-,l~vo~ ~ I 9 z ~-s °~U ~'~'i~ ~`p~~'f I'M , ~ ~!"~p~g. Q 1O~ ~ I ~7`~y ~,~y)~ ~h ° ~i~ /F r~d ~U "`i ~ \ I ! ' ~ ~ ~Y ~ 5'~l ~ ° ~rvr~ ~ .~.~.a~do~'-d. ~ ~~~~~p ~ O ~ , ~ - ~ ~ ,o ~ U~~ , ~ ~ ~ , ( ' . ~ ~ D - ` I~ ~ I ~s ~ S i ~~Nn ~ ~ ~.l~ ~ N S o~ , . I ? ' ~ ~/H7.~la~d~0 ~b~d' ~ . _ ' ` ~ ~ / ~ MASTER CARD LOCATION 4~j/PK t ~~J ~Z '.l • 4 OWNER ~ h, STRUCTURE AND LAND USED AS j~.Jp_ y Q w? ,rO~ !p r•°_'~ Issued To Permit No. Issued Contracfor Owner BUILDING 3~0/ ~y„~.7~ PLUM8ING G~l ~f I IG~ ~G CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING ~ ~ GAS INSTALLING SANITARY SEWER OTHER OTHER Approved Items (Initial) Date Remarks Distance From Well rOOTING SEPTIC FOUNDATION H-7p CESSPOOL FRAMING J-/~ TILE FIELD FT. i-~ FINAL ELECTRICAL DEPTH HEATING ~_L1~~~ OF WELL GAS INSTALLATION ~ SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING J-/y-)L ' WELL SANITARY SEWER r ~ ~ Violations Noted on Back COMMENTS: COMPLIANCE INSPECTION REPORTS TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS PERMIT NO. DATE OF INSPECTIQN CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ? NO EVIDENCE OF NON-COMPLIANCE ? NON-COMPLIANCE. BUIIDER DOES NOT OBSERVED. INTEND TO COMPLY. ACCEPTABLE SUBSTITUTIONS OR DEVIATIONS. ? COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYED BY CONDITIONS BEYOND CONTROL. NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. ITEMIZED AND DESCRIBED AS FOLLOWS: ? REInSPECTION REQUIRED DATE OF REINSPECTION REINSPECTION REVEALED CERTIFICATION -1 cenify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein all significant conditions ohserved to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require- ments for off-site improvements relating to the propeny inspected. ~ All IMPROVEMENTS ACCEPTABLY GOMPLETED . BIJILOING INSPECTOR DATE COMMENTS: ~p z3 PERMIT C~~ ~j j~ , ~ ~`CITY OF EAGAN PERMir rvPE: f~~ 3830 Pilot Knob Road B U I L D I N G Eagan, Minnesota 55123 Permit Numher: 024624 (612) 681-4675 Date Issued: 0 9/ 2 8/ 9 4 SITE ADDRESS: R389 SVENSK LANE LOT: 12 BLOCK: 2 WILDERNESS RUN 4TH P.I.N.: 10-84353-120-02 DESCRIPTION: (ROOFING) B,uilding-.P,ermit Type SF (MISC.) Building Work Type REPAIR r \ ~ ~ ~ - ~ i , ~ J / . ~ a, /~~y ll r~_~ ~ `~`~~~~~~j/ ~J~F ~~`~jL~~~V~~\~~~:~ ;i ,i ~ ~ r-\ 2l REMARKS: FEE SUMMARY: VALUATION $4,090 Base Fee $63.00 Surcharge $2.00 Total Fee $65.00 CONTRACTOR: - Applicant - ST. ~IC. OWNER: TWIN CITY QUALITY CONTR 12254611 20018451 JANARD PAULETTE 651 S SMITH AVE 4389 SVENSK LN ST PAUL MN 55107 EAGAN MN 55123 (612) 225-4611 (612y454-6736 I hereby acknowledge that I have read this application and staYe that the information is correct and agree to comply with all applicable State of Mn. Statutes and Gity of Eagan Ordinances. ~ IL !~`~~r+^~ 7`~, flCN~l1. ~ o ~ APPIICANT/PERMITEESIGNA~ E - ~ ISSUED Y: IGN URE 1 1 INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: a u x ~ o i N ~ 3830 Pilot Knob Road Permit Number: 0 2 4 6 2 4 Eagan, Minnesota 55123 Date Issued: g g ~ 2 g~ g q (612)681-4675 SITE ADDRESS: APPLICANT: LOT: 12 BLOCK: 2 4389 SVENSK LANE TWIN CITY QUALITY CONTR WILDERNESS RUN 4TH (612) 225-4611 PERMIT SUBTYPE: TYPE OF WORK: SF (MISC.) REPAIR DESCRIPTION (ROOFING) . „ . FRAMING ROUGH IN PLB6 ROUGH IN HTG FINAL ~ ~ ~ J CITY OF EAGAN ` ~ ~ 1994 BUILDING PERMITAPPLICATION ~~t,.~.{~~ 681-4675 SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, i copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last workinq day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date ~I /~~9 _ Valuation of work 3,~oO.oo Site Address: 4~g9 5 vensk LaN~ SiREET SUITE ~ Tenant Name: (commercial only) LOT ~ SLOCK ~ SIIBD.," ~ P.I.D. # lu~;~~.~~ l~u~v ~~,~v Descri tion of work: o~ Ex•~~r ous~ TPflR The applicant is: ~ Owner Contractor O Other (Ueseribe) Name 3flNARD '~~1~^~~'~'~ Phane 454-67~6 Property LAST FIRST Owner qddress q~S9 S ur~sF LflN~ STREET STE p City FA~~ArJ State ~K~ Zip Company Tw;~ [~un~~~v ~onfetrc~o[S Phone ~~.~-4~6/I Contractor Address 6~~ $~p~ P~ License #~.Dfl1S451 Exp. 3?( ~l5 City 1'AUL State ?rlh' Zip O Company Phone Architect/ Engineer Name Registration # Address ' City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. 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 Ea9an Ordinances. ~ Signature of Applicant: I OFFICE USE ONLY ~ - BUILDING PERMIT TYPE ~ ~ ~ m^'. r, .r~" ? O1 Foundation ? O6 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ~ 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 17 Sw9m Pool ? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind. ? 04 SF Porch ? 09 12-Plex O 14 Fireplace ? 19 Comm./Ind. Misc. ~ 05 Sf Misc. ? 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility ? 21 Miscellaneous WORK TYPE ? 31 New ? 33 Alterations ? 35 Tenant Finish ? 37 Demolish ? 32 Addition ? 34 Repair ? 36 Move GENERAL INFORMATION Const. (Actual) Basement sq. ft. MWCC System (Allowable) lst F1. sq. ft. City Water UBC Occupancy 2nd Fl. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code Depth On-site sewage SAC Code Census Bldg APPROVALS Census Unit Planning Building Assessments Engineering Yariance REt~U~RED INSPECTIONS ? .Site ? Footing O Framing ? Insulation ? Wallboard ? Final ? Draintile ? Fireplace Permit Fee vei,~t;p,: g Surcharge Ptan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit 5/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC % 5AC Units i , ~ t RESIDENTIAL BUILDING Permit Application 5~ ~Q~C~ City Of Eagan t~p`l~ ~ j 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 New ConsWCtion Reauirements R~nodeUFteoair Reauiremerns Oifice Use OnN 3 registered sile surveys shaxing sq. ft of Wt sq. R of house; and all roofed areas 2 capies of plan CeR of Survey ReW (20% mazimum bt coverage apaxed) 7 set o( Eneqy Calamtions for heated additions Tree Pres PWn ReoJ 2 copies of plan showing beam 8 window saes; poured faund design, ek. 7 site survey for additions 8 decks T2e Pres Not Reqd 1 set of Energy Calcu~ations Additian -'uMicate if on-sife sepfrc system _ On-sRe SepUC System 3 copies of Tree Preservation PWn if lot plalled after 7l7193 Rim Joist Defail Optbns selection sheet (bldgs with 3 or less unils Date 1 / / ~ Construction Cost ~Q! ~J(p o7 / Site Address y?~Q~(' rJ~(~.Y1SK• Lb.9~~ UnidSte # DescriptionofWork ~ ~Q~.Q ,a 1J.31(~.(,S ~j L~ .QJ1Ci (`a ~~r`~C7• Multi-Family Bldg _ Y_ N Ftreplace(s) _ 0_ 1 _ 2 Property Owner ~CC1U,~~2~ ~GY~p~~'d Telephone # ((G$~ ) y~ ~ ~~3~ i RMA HOME SERVICES INC Contractor ~ Home Depot Installed Sales ~~I Address I3z00 Cobb Galleria Pkwy., Ste. Sl200 l~! i!~ l, I I I IAClanta, GA 30339 i,~ ~~F J 8,Cr~ I II State 763-542-8826 e#( ~ j, BG20268257 `J J - - ~By-- COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv I Minnesota Rules 7672 Energy COde Category . Residential Ventilation Ca[egory 1 Worksheet • New Energy Code Worksheet (J submission type) Submitted ~ Submitted . Energy Envelope Calculations Submitted Licensed Plumber Telephone ) Mechanical Contractor Telephone # ( ) Sewer/WaterContractor Telephone#( ) I hereby apply for a Residential Building Permit and aclmowledge 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 perntit, 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~ ~SOt~~ - A icanYs Printed Name Appli ant's Signature ~ OFk~CE U5E ONLY } ~ . Sub Types ? 01 Foundation ? 07 05-plex ? 13 i6-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Aft - Multi O 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 EM. Alt - SF ? 04 02-plex O 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-piex ? 19 Lower Level ? 24 Storm Damage ? O6 04-plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New . ? 35 Int Improvement ? 38 Demolish (Interior) ~ 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ?'45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof O 46 Windows/DOOrs ? 34 Replacement ~ ~Demolition (Entire Bldg) - Give PCA handout to applicant . , 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) FinallC.O. _ Footings (deck) FinaVNo C.O. _ Footings (addition) _ Plumbing _ Foundation HVAC _ Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insularion _ Retaining Wall _ Approved By , Building Irtspeclor Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total , • . , , _ , . ~ ~ > Installed I , , ~ ~ Siding and~~sPOWER OF ATTORNEI~ - - ~ , ~c . ~ _ , , . . , , ' ' OUNTY OF COBB . ~ STATE OF GEORGIA KNOW ALL PEOPLE BY THESE PRESENTS: THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania ("Principal"), and a licensed contractor of AMA Home Services, Inc., DBA Home Deoot Installed Sales located a± 5601l~Iendelsse!zn Ati~enue No:th; Go13en Valley, N~i 55427, havin$ a license n~Zmber of BG 2026&2~7, do hereby appoint, name and constitute Elder-Jones Building Permit Service, Inc. ("Agent") as my true and lawful attorney-in-fact and do authorize and grant said attorney-in-fact for me and in my name, place and stead the power to execute, acknowledge, sign and deliver (in such form as may be required by the municipality) a permit application, or any other instrument(s) which may be necessazy and appropriate, in order to obtain the proper permit(s) from the City of Eagan, Minnesota for the installation, maintenance and repair of windows and siding (the "Work"}. The powers conveyed ta tfieAgeriYby this Liinited Power of Attorney aze limited solely to the express powersdelineated herein and apply solely to the Work: This Limited Power of Attorney shall expire and automaticaliy be revoked on the 30~' day of May, 2003, which date is one year from the execution hereof. Further, the powers conveyed by this Limited Power of Attorney may be revoked by Principal at any time by express revocation and shall also be revoked by the Principal's death, disability, incapacity or incompetence. IN WITNESS WHEREOF this Limited Power of Attomey is executed this 3n~ d.ay of tVt /t`p , 2002. David . z SWORN TO AND SUBSCRIB~D BEFORE ME hy David N. Katz on this 30`h day of May, ~ . . . . „ r~ Notary blic in for the Stat of eorgia My Commission Expires: Januazy 21, 2006 396816.v3 Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor. 3200 Cob6 Galleria Parkway, Suite 200 • Atlanta, GA 3D339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800J 79-DEPOT 4~ ~ ~ ds 2004 RESIDENTIAL BUILDING PERMIT APPLICATION C „ ~ i~ City Of Eagan ~ e'd`~ 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New ConsUUCtion Reauirements RemodaVReoair Reauirements Office~~.USe~OnIJ 3 registered sHe suNeys showing sq. ft. of lot, sq. ft. of house; and all roofed a2as 2 wpies of plan ~Ced of Survey Recd Y~, _ N (20% mazimum lot mverege allaved) 1 setof Energy CalculaGons for heated addilions Tree Pres Plap Recd _:Y _N. 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for addilions & decks Tf~ Pr@s Required .;,rY N isetofEnergyCalculations Addifion-irMicateilon-sitesepticsystem ~[I-~Ae9epllcSy`slam _Y _N 3 copies of Tree P2servation Plan H bt platfed after 711~J3 Rim Joist Defail Optlons selection sheet (bldgs with 3 or less unib ~ Date ~ / ~ / 2~y ConstructionCost ~{~~Q Site Address -f ZC3°I SV E NSk ~A N{ UniUSte # Description of Work ~ECk ~`D1~IT 1~1 Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 2 Proper[yOwner {~liVLE?TE ~lfWl~~ Telephone#(~~j~ ) ~~~"~~7~ Contractar C~ ~A1 ~ L1'-~j12 ~ortn ol1 N7 Address ~ ~'(KRG~ f<v~ ~ City ~ Al ~E2 GQGVC F~ ~-t6` f~ State M,~ Zip ~~G7~ Telephonell(CE"j~ )~22-~{`l~ TX7~ IG3 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan2 _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Telephone # ( ) Mechanical Contractor Telephone # ( ) Sewer/Water Contractor Telephone # ( D I hereby apply for a Residential Building Permit and acknowledge that the info ahon is co` J curate; that the work will be in conformance with the ordinances and codes of the City @~ Eagan and the Stat of MN Statutes; I understand this is not a permit, but only an application for a permit, and wor is no ithout a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval oFplans. ~l~ kt ~vn~~ ~`z- Applicant's Printed Name ApplicanYs Signature OFFICE USE ONLY ~ , Sub 7ypes ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 O6-plex ? 78 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 (screenlgazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or_ N? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interiar ? 44 Siding 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish 8uilding" ? 43 Reroof ? 46 Windows/Doors ? 34 ReplaCement •Demoli[ion (Entire Bldg) - Give PCA handout to applicant Valuation t~l3t7 Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) FinaVC.O. ~ Footings (deck) ~ FinaVNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final _ Framing _ Siding _ Stucco _ Stone _ Brick _ Fireplace _ R.I. _ Air Test _ Final _ Windows _ Insulation _ Retaining Wall Approved By: T 7i" , Building Inspector Base Fee Surcharge Plan Review ~l MC/ES SAC City SAC ~ Utility Connection Charge 7~ S&W Permit & Surcharge Treatment Plant License Search Copies - ? ~ Other Total ~ _~.__~1 ~ ~ f ~ ,G_E'~~ ~ieoo~ery LwE ~ I I ~ I ~ \o ~ ~ ~ ~ ~ L1NE' i , D~k 6 ~d " I ~ ~ ~ . ~ ~ , ~ ' 1~n~~c~ ~ ~ I ~ \ ~ ~ n ~ , u o - ~ ~ ~ ~ ~ GK u ~t~~ V . ,~~~~~~o~' ~ ~~oP~ery ' ~ LiN~ " l ~~5~ ,~tt f~~ ~,~'~'t;~~,S~ ~"C~ ~ ~ ~ -~-~~'K:~~, I o !".s*~''' / ° I ~i LaT ~ 13~.OCk ~ ~ ~ S /~,w {~~~~1 i~m''-:~ ~4,+r1'~.~ Y ~ n9o ~ s~ 2 6 i ~ ~oN~t"_.~ao~F~.rY ..~iN~ ~ , 1~- L~T ~4 L A~1 PERMIT City of Eagan Permit Type:Building Permit Number:EA113904 Date Issued:09/09/2013 Permit Category:ePermit Site Address: 4389 Svensk Lane Lot:012 Block: 002 Addition: Wilderness Run 4th PID:10-84353-02-120 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes . Jason Bunes 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 - Paulette Janard 4389 Svensk Lane Eagan MN 55123 Custom Creations Remodeling Inc 1321 Andover Blvd NE Ste 112 Andover MN 55304 (763) 441-5907 Applicant/Permitee: Signature Issued By: Signature