3914 Thames AvePERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA128502
Date Issued:11/17/2014
Permit Category:ePermit
Site Address: 3914 Thames Ave
Lot:6 Block: 2 Addition: Coventry Pass
PID:10-18400-02-060
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Ann Hoffman
505 Randolph Ave
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 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 -
Timothy K Iverson
3914 Thames Ave
Eagan MN 55123
(651) 442-2890
Bonfe's Plumbing & Heating
505 Randolph Ave
St Paul MN 55102
(651) 228-9071
Applicant/Permitee: Signature Issued By: Signature
F _ _ .
~ INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Perrnit Number: '
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
, SITE ADDRESS: APPLICANT:
, I IIAMC 1. AVF 1~~~~~id A•,
li r, r~.5. . f~• i~..' 1:s'~ 1'. ~ NH
~
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION DA • DA
~ . ,
F
L_ ~ i
I Permit No. PermYt Holder Date ' 7elephone # i _
I S/W
I PLUMBING
I i
' HVAC I
ELECTRIC I
! ELECTRIC I
~ Inspxtbn Date Msp. Commenb
Footings I I
~ - - I I
i I
- -
Fourxlation ~ I
~ Freming I
I I
RoOtmg I
Rough Plbg.
i - ~
Rough Htg.
Isul.
1
I Firepiece I
I Final Htg. I
i ~ Orsat Test i
~ Final Plbg. Pibg. Inapector - Notity Plumber I
i Const. Meter I
Ir I
Engr.IPlan I
I
' Bldg. Final ~
Deck Ftg.
DeClc Fnal
Well
Pr. Disp.
INSPECTION RECORD ~Control No. 0451
'
'Ai11 I11M(i
~ CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: 4 Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
~ S{TE ADDRESS: APPLICANT:
,:!nMES AvF
ht 1 i i' t w.'. {,i: ! i tl.iff h
PERMIT $UBTYPE: TYPE OF WORK:
~ . ; Nr i.f
INSPECTION .
{ {+liM 1 Nl;
I rt~ All.~uN (•INAI
r?i:i~•i;~~t
h l t : c) N t V fN1'1 I1p \l A I i t. Y F' 1 N 1-~
F
J
L
i
Permft No. Permit Holder Uate Telephone N
S/W
PLLIMSING
I
HVAC 7 1k~ o _ I
ELECTRIC Jk~ `ro I
ELECTRIC
Inspectlon Date Insp. Comments '
I Fooungs I
Foundetion
r
Framin
~ g b,15
Roofing
Rough Plbg.
/
I I
Rough Htg.
Isul. G ~
I Fireplace
I
I Final Htg.
I Orsat Test
I s~!(dtiL L;3,
I Final Plhg. Plbg. InSpeCtor - Noti~ Plumber
I Const. Meter
I
Engr.IPlan
Bldg. Final 1J l Z-/~Z D~
Deck Flg.
I
Deck Final
(
Well
Pr. Disp.
, . L , ,
l
(Itrftftrate af (Orrupanry
titp of (Eagan
JOppariatrni of ]iui[aing Jnsppr#inn
This Ctrlifrcale r:tsuMpursuanl ro tlre requirernenls oJSection 306 of [he Unijorne Buildiag
Code ceNijying 1ha1 at 11re time oJiuuance thir structure was in eorrpfiance wilh 11re various
ordinances of the City regulaling building conrlruc[ion or use. For llte followtng.•
U,ab,&,iw sr nwc?JtaR B,ds.K-m„,ia 554
O-Wd-7 TyPe Zoniai Diwia p I Type Camt VN
owa« ot euia* -n fF. t&T'iT ITNm ('11 7N!: Add„m 1 L!tIVHR RD, FF.IUIEY
B„b;a Aea. 3914 Il-IXMES AVEMB Local;h t.E , fi29 rJOR'F.M?Y PASS
n.e 8/12/q2
Buddog OMcW
POST IN A CANSPICUOUS PLACE
Address: Lot 6 Blk 2 Sec/Sub CpVENTgy pASg
These items were/were not complete at the time of the final inspection.
Yes No s
Final grade (6" from siding)
Permanent steps - garage
Permanent steps - main entry
Permanent driveway
Permanent gas
Sod/seeded grass
Trail/curb damage
Porch '
Basement finish
Deck
Please veri£y with the builder the removal of roof test caps from the plumbing
system and the shut-of£ of vater supply to the outslde lavn faucet before
freeze potential exists. ~
waK«n nr~n
White - City copy Yellow • Resident copy Pink - Contractor copy
K 1 1 2 02
Repuest Oala F a No RougRi ns ecuon
Re rt~ d Reatly Now ~^an'R~cl~
' Yes LNo eetly
I licensed contractor p owner hereby request inspection of above electrical work aC
Job AOtlre55 ISVeel. BOx Oe Flout No 1 C'tY
3 / `f eo CL(~
SMion No. TOwnsnio Name or No. Ran9e No COyr~'~
Occupant PINTI Pbone No
Pawer Su er Atldres5
~ vl(i~/
Elecmcal nh~c r IC~ompany~ COnlractor5 Lmense No,
C Db ~
MaiLng A r9ss IConlraclor or Q.vner Maimg Installalion,
Awtronrec Sgoamre (Convacmr. wner aki Instaliaoonl . Phone Number
- b - /o
MINNESOTA STATE BOARD OF ELE RICITY THiS WSPEGTION REOUEST WILL NOT
Gngge-MiCway BIEg. - Room S-173 BE ACCEPTEO 9Y TME STATE BOARO
1821 UmversHy Ava.. SL Peul. MN 55101 UNLE$$ PROPER INSPECTION FEE IS
PM1One(61]) 6624)800 1 ENCLOSED
li~ aTM'".
g~ L REOUEST FOR ELECTRICAL INSPECTION ~q ee~ooom-oe
1080 ~e instmclions lor complating ihis lorm on back ol yellow copy ~E/ /2-
-'7C" Be/sw Work'Covered by rhis Request ~ ~o
ew Adtl Rep TypeoiBwlding ApphancesWiretl EqwpmenlWrted
Home Range 1 Temporary Service
Duplea Water Heater Elecinc Heahnq
Apt Bwlding Dryer Other ISpecify)
Comm./Industrial Furnace
Farm Av Conditioner
Olher(syealy) Conhaclor5 RamaBs
Campufe Inspection Fee Below:
d Other Fee # ServiceEntranceSrze Fee # CircuitslFeeders Fee
Swimming Pool 0 to 200 Amps Q 0 to 100 Amps 0
Transformer5 Above 200 _ AmpS Abov Amps
Signs inspector's Use Only: /TO AL
Irrigauon Booms S r0
V~
Special Inspecnon
Alarm/Communication THIS INSTALlATION MAY BE ORDERED DIS NNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MO T. /1? f
I, the Electrical Inspector, hereby Aou9^-i^ .~y y
ceridy ihat the above inspechon has -1ii;Z`p
been made. /
OFFICE USE ONIV
Tnis request voq 18 moncns Irom
L029QV 2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122 d,v> c-i o p Q
Telephone # 651-675-5675 FAX 4 651-675-5694
New Construc6on Reowrements RemodeVReoair ReauiremenLS OHice Use Onlv
3 regatered site surveys showing sq. it. of lot sq. ft. of house, and all roofed areas 2 copies of plan Cert of Survey Recd _ Y_ N
(20°h maximum lot coverege allowed) i set of Energy Calcula6ons for heated addifions Tree Pres Plan Recd _Y _ N.
2 copies of pian showing beam & wintlow sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Required _Y _ N
lserofEneigyCalculations Addr6on-indicafeNonsftesepfksystem On-siteSepticSystem _Y _N
3 copies of Tree Preservatlon Plan M bt platted after 711193
Rim Joist Detail Options selecuon sheet (bld9s with 3 or less units
Date~/~2~ /,,2 , ConstructionCost
Site Address (2f UniUSte #
Description of Work (~L~ ~ a n('&
Mulii-Family Bldg _ Y~. N Fireplace(s) _ 0 _ 1 _ 2
Property Owner 1142~2_ oyV Telephone # f ) ~ ~ D(/~
t
Contractor
Addressp-) "~esL City
State /'74,r? Zip S-'3-0 3 / Telephone !1((yS~ ) -2`IC, yLp~-/S
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
(Jsubmissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously consiructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber Telephone ~
Mechanical Contractor Telephone
Sewer/Water Contractor Telephone AM 0 c 9fi114
V
'
I hereby apply for a Residential Building Permit and acknowledge that the informatiol3~ 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 lan in the case of work which requires a review and
approval of plans.
Applicant's Printed Name Applicant' gnat
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 OS-plex ? 13 16-plex O 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 Ext. All - SF
? 04 02-plex ? 10 08-plex O 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex O 19 LowerLevel ? 24 Storm Damage
? 06 04-p10x ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demalish Interior ? 44 Siding
O 32 Addition ? 36 Move Building ? 42 Demolish Foundation O 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 WindowslDoors
? 34 ReplaCemBnl 'Oemolition (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ Final/No C.O.
_ Footings (addition) _ Plumbing
Foundation _ HVAC
Drain Tile Other
Roof _ Ice 8 Water _ Final _ Pool _ Ftgs _ AidGas Tests Final
_ Framing _ Siding _ Stucco _ Stone _ Brick
_ Fireplace _ R.I. _ AirTest _ Final _ Windows
Insulation _ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC1ES SAC
City SAC
Utility Connection Charge
S&W Permit 8 Surcharge
Treatment Plant
License Search
Copies
Other
Total
• -PERMIT Control No. 0451
CITY OF EAGAN
3830 Pilot Knob Road pERMITTYPE: euiLoInc
Eagan, Minnesota 55123 Permit Number: 000554
(612) 681-4675 Date Issued: 0 5/ 18 / 92
SITE ADDRESS:
3914 THAMES AVE
LOT: 6 BLOCK: 2
COVENTRY PA3S
DESCRIPTION:
~-8uilding Permit Type SF DWG
Building Work Type NEW
i UBC Occuparicy R-3 M-1
Construction Type V-N
Zoning R-1
" Build3ng Length 66
.
Building Width . 44
~
REMARKS: 01iMS3
S& W CONTRACTOR - VAIIEY PLBG
FEE SUMMARY:
VALUATION $124,000
Base Fee ;723.50 MISCELLANEOUS $1,610.50
Plan Review ;470.28 Total Fee $3,566.28
Surcharge =62.00
SAC ;760.00
SAC 8 100
SAC Units 1
3ubtqtal ;1,955.78
CONTRACTOR: - Applicant - ST. LI pWNER:
THE ROTTLUND CO INC 15710304 000133 THE ROTTLUND CO INC
5201 E RIVER RD 5201 E RIVER RD 301
FRIDLEY MN 55421 FRIDLEY MN 55421
(612) 571-0304 (612)571-0304
I h'ereby acknowledge that I have read this application and state that the
information is correct and egree to comply vith all applicahle State ofi Mn.
Statutes and City of Eagan Ordinances.
~l r±r R ot ~
AP LICANT ERMITEE SIGNATURE I UED, n Y' 16NA RE
INSPECTION RECORD I ControlNo. 0451
CITYOFEAGAN PERMITTYPE: auzLoiNG
3830 Pilot Knob Road Permit Number: 000554
Eagan, Minnesota 55123 Date Issued: 05 / 18 / 92
(612) 681-4675
SITEADDRESS: LoT: e eLocK: z APPLICANT:
3914 THAMES AVE THE ROTTLUND CO INC
COVENTRY PASS (612) 571-0304
PERMIT SUBTYPE: TYPE OF WORK:
SF DWO NEW
INSPECTION .
FOOTING FRAMING
INSULATION FINAL
FIREPLACE
REMARKS: S S W LONTRACTOR - VALLEY PLBG
F
~
L
PERMIT_ A54 CITY OF EAGAN T~eb~~ GYool
1992 BUILDING PERMIT APPLICATION
681-4675 JVpy A Reco
SINGLE 6 MULTI-FAMILV 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural 5 structural plans, 1 set of
specifications, 1 copy of erlergy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date -7/ C' ~Z_ Valuation of wara 1gy.~~Ov
Site Address: S9 14
STREET STE r
Tenant Name__T~e IZo4Iv,nol cz'-Zy<.
Lor ~a eLaK ~ sueo. P.I.D. r
,cs „ ~Descri tion of work: S~ L? u-•`
The appl icant is: Owner ~ Contractor O Other (oosortbe)
~030
NameT[n~,jo,J Cn. :P-hc. Phone S'71
Property LAST FIRST
Owner Address 5201 E. ~,ver Rd1. ~1
STREE7 ' STE #
City-~+~L~I~v State Mv~ Z;p SS(-{2(
Company sa v~~ Phone
3-3i -ay
COntrBCtOt' Address License Ncc=01335- Ex0_!_=Q;-4
City State Zip
Lompany Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber olywhl'nQ . Processing time for
sewer & water permits is two day once area has bee 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
Eagan Ordinances.
Signature af Applicant: ~ tetll~
1 vrrit.t uae unLtr
' , .
BUILDING PERMIT TYPE 7
? O1 Foundation 0 05 Apt. Bldg ? 09 Basement Finish d=13 Publitc-Fac.
fZ 02 SF Dwg. ? 06 Garage/Accessory ? 10 Swim Pool O 14 Agricultural
O 03 Two family O 07 Fireplace ? 11 Res. Add./Porch ? 15 Miscellaneous
? 04 Multi-fam. T.H. ? 08 Deck O 12 Comm./Ind.
WORK TYPE
IX 31 New ? 34 Repair ? 37 Demolish
O 32 Addition ? 35 Tenant Finish ? 99 Undefined
O 33 Alterations ? 36 Move •
GENERAL INFORMATION Const. (Actual) V- N Basement sq. ft. MWCC System YES
(Allowable) N lst F1. sq. ft. City Mater ~rt~
UBC Occupancy -3 Mi-1 2nd F1. sq. ft. PRV Required
Zoning Q.1 Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft. Fire Sprinkler 1bl
Length -z-6-7- On-site well Census Code 01
Depth y 4• On-site sewage SAC Gode
APPROVALS Planning Building Assessments
Engineering Variance •
REGIUIRED INSPECTIONS
? Site 9 Footing ? Framing ? Insulation
? Wallboard 0 Final ? Draintile O Fireplace
Permit Fee 123-5o v.iu.ctm: s IZ~I~oOJ~
Surcharge ~
Plan Review G4RA`Q
y o 3JX2o=6o0
License 2 X In : (2 o)
MWCC SAC rJoO, oo I-
City Skt 1 001 oc r3snnT SSo ~c i6; 9 290
Water Conn. 1e75, oo ~ 1
Water Meter 90,0a 24K52 s ~Zyg -
Acct. Oeposit 30.00
~pK25= .
S/W Permit ?o,oo SOo
S/W Surcharge So !ox 13= ('1'3)
Treatment Pl. 300;00 2'S'
Road Unit 380,0o r
Park Ded Isi FLooR
~
.
Trails Ded. Ixq_ 9
Capies 6x
Other
Total: tqdsMTLL Ib~
5AC % ~oa I64~aXS3~ 89Y6y
SAC Units
2422 Enterprise Drive
* Mendota Helghls, MN 55120
* PIONEER (s~z) sei-~s~a•Fa. sa~-saae
LAND SURVEYDRS - GNL ENGINEERS
~ P+ngneer n uND pLANNERS • lANOSCAPE ARfYiIlECTS g 625 Highwoy 10 Northeasl
* Blalne. MN 55434
1(612) 783-1880•Fax 783-1883
Certificate of Survey forThe Rottlund Company, InC.
House Address: Thames Avenue. Eagan. MN
Model Name: Cypress Customer: Tieben
~'C 'P G• ~ /p~h~O,r,~~1 ~+aeo.
~ i i ,p, p'~ BBo,'!
i ~j61 • .~h ~ ~ri o~
g~.¢ Gl ~ g~ ~ ry~ Jt \ JV ls
{1b AY.
q) a
/ 7e. o 97
y,j ~q•-
~ ~ ~ F e OIB / Y''~ Q,§' O y~ ~ Qj(pa.1
> \ 974, Z 5 \
~ . \ e~} \
10Y \ ~ \y
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8
~
6t \ ~ i
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O
Y -7---- ~ O
a ~
ENGINEE .~G DEPT y
EAGAII
• 900.0 Denotes Existing Elevation PROPOSE HOUSE ELE ATION
= Denotes Proposed Elevation
- Denotes Drainage & Utility Easement Lowest Floo Elevatio :874.45
Denotes Droinage Flow Direction Top of Block evatio :882.56
-o-- Denotes Monument Garage Slab EI atio :882.23
-a- Denotes Offset Hub Bearings shown are qssumed
LOT 6, BLOCK 2 COVENTRY PASS
DAKOTA COUNTY, MINNESOTA
I hareby certily tha[ thb lurvey, plen or raport waf propared by me or under my direct wpervidan end thet I em duly Reglpered land Survayor
undar the lawf ot iha Slete ol Minnesote. Oated thli54~1 day of M q~ A.D. 19 9 Z
~
Scale: 1 Lnch=30,eet
. ROBER4` , Sli ICH .5. REO. NO. I4991
• y
~ 89102.09
F'C1'F.:tiOR i•:t+vr•.t,rn'ti: nvi•:i;nrr: CoMT'II'fA'I'I0u -TV-S
0WN c'.R
• sTTE annsESS Lor ~SLOGK 2, Co~~rr, RY P~~ss "
CONTRACTOR pATF: PHOtiE
DeterMin vor;cini; square footar,c of ench.
1. Total exposed vall a:eA ~`pca, o, 0.11 _
sn. ft. x - 1 Q'.8G
• 2. Total root/ceiling area I lD sq, ft. x 6,026
• -
iotal erposed uetl aren nbavc flocir
a. Total r•xll vindow a-ea 1(0
c b. Totel door aree •
.¢'L "JI
c. Total slidine 6:ess door area ?jy,~f~
d. Total fireplece va,ll area
e. Total wa11 ;ram+
-ng a-ea (average 10A)
f. Total net vell area above floor . . . . . . . . .
6• Total rim joist area
Z, Z •
~ .r .
Total exposed foUndation arc•a = tj
h. Totzl foun9e:?on vindc•: a:ee pr 3
• i. Total net faundst:on e-=a above grade .
. Cete^r,ine "U" vzlue o; eech Lall ;FC;ment.
b. x.,U„
~ • C. 3q, 9$ X.,u„
d. - x
e.. x „U„ FJ'.v7q
.
r. /I52.7Z x ,,u„
, 8. x„Li„
h. q,73 X .,U„
X,.Ll,
3.
. . . . .
If item q3 is the s2me as, or iesa !.ti:,n .ileta .Nl, you have met the inter.~
or ssc 6006(c)z.
f
Total exposed roof/ceilinG nren = ~(04
' ~ ~ . .
. TotaZ gross roof/ceilinr arc:i = J. Totel skylight area
k. Total roof/ceiling framina area
1. Total net insuleted roof/ceilinF area Z 4~~~~ .
Detezmine "U" vnlue for encli ruof/cei I int,. sc~,ment.
, X "U.1
,
k: 2, 3 x„U„ d.o z-7
7 X„U„ r~, 02 L= 3 Z.13 '
a . Total 3 (A I -0/4-7.
If total of N4 is the same es, or less than N2, you have met ttLe intent of
sBC 6oo6(c)i. _
. To utilize the total envelope syste= method, the values establizhed by the
stm of iteas N3 and 94 shall not be sreater.thKn the sum of items A1 and X2.
1. + 2. _
~ • 3'. ' + 4. - •
• ' ,
a
_ O ~ s
1 1
tr-VAC~1:~=G~LG
~
,
~ -a;~~.----
- ~ 3 4 5 I. _ I? = 3-5.-8 3~---:- -
0, 027
u 5.83
~ -r - - ~
I 2
~ ~ ~~1~1~=FicM. -0,?7_-_-_._.:_..
- - - 0:-45
0 ;2 6YP'- P.5 L?
a
' i
~
`E' I 0~~Hrr!'~11 Nla : 2, O L
i
~T-A-IF: ML~M. _ _..o; / ;
c~;1 . ~ ~...,.1 _ . 0•,04~
' ~~~NDP~11oN .
/
12
3
" I 7j,-
I
_ , ~ ~
-1z.I3
. . .-vk~u~ ~Al~u~.AT~ar~?~ (~~Nr),
- AMr- WAu• @ ~ I Nxl ~A~I~N
-
o~~DE AI~ f~I.M .----011
3
'
19.0
4 ~2u 407P, I~ o. 4S '
G
• ~~,c 23,0( -
-14
ll~ F~"L.
. :-fFAMG WAu. G ~lUD .
GoMPaNLNTS F--VALU5
- 1 o_Ur~IoE Rl(~ f~l.J~. ---....0,1'1.
~hI~INl~.
3 hNER'(HINli. 2.0(~ _
hP.ln(FPA1aIG) ' "1.-1
~vJ 5
aD..
-~v • ~ C' ~NSiv~ MR- RL-M..
~ ~T~'(~t.---~~• ~
_ pLr~N. vi~k?. . u^.: ~ o. 08~.
PERMIT c R 29003
~ CITY OF EAGAN 4 I21I4q
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55123 Permit Number: 023389
(612) 681-4675 Date Issued: 0 4/ 2 0/ 9 4
SITE ADDRESS:
3914 THAMES AVE
LOT: 6 BLOCK: 2
COVENTRY PASS
P.I.N.: 10-18900-060-02
DESCRIPTION:
Building'PermiC Type DECK
Building Wo,rk Type NEW
~
~
~
%
~ /~~i,~', \C~ ~..,'p; , ;t~l
f/ _ , .
REMARKS:
FEE SUMMARY:
Base Fee $30.00
Surcharge $.50
Total Fee $30.50
CONTRACTOR: OWNER: - Applicant -
TIEBEN DOUGLAS
3914 THAMES AVE
EAGAN MN 55123
(612)891-5100
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 Mn.
Statutes and City of Eagan Ordinances.
- J
PLIC T/PEfiMITEE SIGNATURE 18SUED BY SI~ATURE I ~
INSPECTION RECORD
CITYOFEAGAN PERMITTYPE: euzLozNs
3830 Pilot Knob Road Permit Number: 0 2 3 3 8 9
Eagan, Minnesota 55123 Date Issued: 0 4/ 2 0/ 9 4
(612) 681-4675
SITE ADDRESS: Lo r: 6 B L 0 C K: 2 APPLICANT:
3914 THAMES AVE TIEBEN DOUGLAS
COVENTRY PASS (612) 891-5100
PERMIT SUBTYPE: TYPE OF WORK:
DECK NEW
INSPECTION
INSPTR. .
FOOTINGS FINAL
F- ~
L ~
CITY OF EAGAN
19 1994 BUILDING PERMIT APPLICATION
23~ 681-4675 : APR 15 9994 I
M POoP~ ~-~n ~3 0~50 ~
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, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date 1.5- Valuation of work ro
Site Address: Th'AmEFS J9 v~- EfiGArJ Mnl
STREET SUITE
Tenant Name: (commercial only)
LOT ~ BLOCK SUBD. CCUi'XIJ ~„Q~~(J P.I.D. a
Descri tion of work:
The appl icant i s: JZ1,Owner ? Contractor ? Other (Describe)
Name -7-/ z-d',~J 7ouC,,cAS Phone ll5`1-R2° Ck
Property LAST FIRST IS-/ oo ~a
Owner Address Tl1flm-cS
STREET STE if
City ~F"t~f1n~ State /"v),J Zip 55/D's
Company Phone
Co ntractor Address License # Exp.
City ~ State Zip
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 ' nesota Statutes and City of
Eagan Ordinances. ~
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
{.A /O~ ~ YI•{~yr~4j~~7/~
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dwg. O 01 4-Plex ? 12 Multi. Misc. 0 17 Swim Pool
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 19 Comm./Ind. Misc.
0 05 SF Misc. ? 10 Multi. Add'1. a 15 Deck ? 20 Pub19c Facility
? 21 Miscellaneous
WORK TYPE
,Er 31 New O 33 Alterations O 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 F1. sq. ft. PRV Required
Zoning Sq. Ft. total Booster Pump
k of Stories Footprint Sq. ft. Fire Sprinkler
Length On-site well Lensus Code 7_3Si
Depth On-site sewage SAC Code o/
Census Bldg /
APPROVALS Census Unit o
Planning Building Assessments
Engineering Yariance
REQUIRED INSPECTIONS
O .Site ?O Footing ? framing ? Insulation
? Wallboard El Final ? Draintile ? Fireplace
Permit Fee veim:;on: S
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC %
SAC Units
PIONEER I, (s12) 681-1914•Fox 6f31-9hF18
~ND SURbEYOR5 • G`AL ENG;NEERS
~on~aneerinc,~- UND PLANNERS • Lµ05CAPE M:UIIlECiS 62~J Hi9hwOY 70 NOfLhC05t
Biaine. M1',N 55434
~ .)K I(612) 783-1880•Fax 783-1883
Cer'tificate of Survey forThe Rottlund Company, ItlC.
~ House Address: Thames Avenue, Eaqan, MN
CD ~ Model Name: Cypress Customer: Tieben
~C~
i , ~1 ~aeo,•1
/B~~yS
iji~o..>
Fj5 \o 00 ~
~
~ 41 5~ ~ IT~
D~ ~ J° ~~9~~y~~'`.f \ ~\'e' ~
't \ ~\3
R`,~ JJ ~ • 'S 'b~ s 57
V.
'
6'j~0
~ J~ J• 0',J < •~p ' F Z~, _ . n ~ 0
~ 878.3 '~r ~o .F''~*c#-i°,: .}'~~a~~.~~~,a~p~`~~~ Y 8~y_~~.• '6'~.9•. .
p ~,~Z PS Fs ~ \ \ (P
a~ \
~ 09\ O•e; - f „ f; .
~ ~ ' \rM ~ h~p9 {8~ ~
. , o,
873.Z 5~~~}9 R
VMS
i ~
9. > \ ~ 5 p2oi
~ o
~P_ 0
~
i F
0
F,~l
\ ~o
o
~
. eco.o Denotes Existing Elevation PROPOSE HOUSE ELE ATION
x 9~o Denotes Proposed Elevation Lowest Fioo Elevatio :874.45
Denotes Drainage & Utility Easement TaP of 81ock evotio 882.56
Denotes Droinage Flow Direction
Lot Block o4-'
Subd. aa.o-
UNDERGROUND SPRINKLER SYSTEM
PLUMBING PERMTT
Date
Receipt # C Oa D83 9
_ Commercial: $25.50 + water tap if required. (City installs all taps up to 1"). If
adding new service, a water permit will be required, as well.
~ E3osting residential: $15.50 (Plumbing permit not required if backflow preventor was
previously installed).
_ Residentia] developments: Fee to be determined by building inspections department.
May require payment of water permit, plumbing permit, WAC, and water treatment
plant fees.
(Address to be sprinklered)
Homeawner/Plumber: l~ L"qfP~~6
Phone _ 43 o-7 I
' Si
Street Address:
City, State, Zip:
/
Owner Name:
Street Address:
Phone
Irrigation Contractor: L £ a f- j 2-A 1\/
i
Phone
Zz8 73 /0Y~
I hereby aclmowledge that I have read this application and state that the information is
correct and agree to comply with all applicable City of Eagan Ordinances
~,1~..~ cc: Engineering Department
L67 eL 12- CITY OF EAGAN CITY USE ONLY
PLUMBING PERMIT
SUBD. \ (612) 681-4675 RECEIPT #
DATE
REBZDENTIAL
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION COMPLETE THE FOLIAWING:
N0. FIXTURES EA. TOTAL
NEW CONST X- REPAIR/ADD ON 15.00
".DD 4N _ i GHO[:ER 3.00 -3-
REPAIR WATER CIASET 3.00 S-
1 BATH TUB 3.00 J"
~ IAVATORY 3.00
OWNER NAME: 1 KITCHEN SINK 3.00 3'
SITE ADDRESS: .)q1~ ~ Y W~ '~J{ T HOTNTUB/SPAY 3.000 0
WATER HEATER 3.00 3 -
~ FIAOR DRAIN 3.00 3=
l f~
INSTALLER: lQ,\~A~y_~ l q1 C t7 GAS PIPING OUT.
(MINIMIJM - 1) 3.00 7^
( ~ ~ ROUGH OPENINGS 1.50
ADDRESS: l 0 1 i> ~C C1L C L^' _ OTHER
` WATER SOFfENER 5.00
CITY: ~1d i'~A-- ZIP: PRIVATE DISP. 15.00
PHONE O- cri~~` 1 = U.G. SPRINKLER 3.00
W. TURNAROUND 15.00
c VIII. STATE SURCHARGE .50
S ATURE PERMITTEE TOTAL: S`)~ v
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
CONTRACT PRICE:
SITE ADDRESS: 1% OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
TENANT NAME: EACH $1,000 OF PERMIT FEE.
SUITE $25.00 MINIMUM FEE.
INSTAiLER: CONTRACT PRICE x 1% $
ADDRESS: STATE SURCHARGE $
CITY: ZIP:
TOTAL: $
PHONE
FOR: (SIGNATURE)
CITY OF EAGAN
CZTY OF EAGAN FOR CITY USE ONLY
, 3830 PIIAT KNOB ROAD
EAGAN, MN 55122 PERMIT #
PHONE: (612) 454-8100 RECEIPT # /O l0 .3
r~ • °~I MECH,ANIC%ll:;:',.YEItM~~' DATE: LO y
RESSDENTIpI:c' PLEASE COMPI.ETE IIPPER PORTION ONLY FOR SINCLE FAMILY DWELLINCS &
~ TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION FEES
NEW CONST ~ ADD-ON MINIMUM $15.0
ADD ON HVAC 0-100 M BTU :00
REPAIR ADDITIONAL 50 M BTU
GAS OUTLETS - MINIMUM ~
OWNER NAME: OF 1 PER PERMIT
O ~
SUBTOTAL: $ c>27 o 6
SITE ADDRESS: 3 / ~ S STATE SURCHARGE: .50
o~ 7 SL
LOT: ~e B;ACK,. ~ SL'3D.- OQ~ T4'_'P.L: $
INSTALLER: fCARE HTCf. Et A/ rNC• sVV~
9303 Plymouth Ave. o.
ADDRESS: 69~Ae1Fva~~P~~-MN 5.,ri427 SIGH URE OF PERM~T ~E
CITY: ZIP:
PHONE lP
C,OMM$$GTAIi%rNDIISTRIAT.t: PLEASE COMPLETE 'iHIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS,
. . .
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACN DWELLING UNIT.
CONTRACT PRICE: FEES
OWNER NAME: 18 OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
SITE ADDRESS: EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING = $25.00
LOT: BLOCK _ SUBD. $25.00 MINIMUM FEE.
INSTALLER: CONTRACT PRICE x 18 $
ADDRESS: STATE SURCHARGE $
CITY: ZIP;
TOTAL: $
PHONE
(SIGNATURE)
FOR:
CITY OF EAGAN
CITY OF EAGAN FOR CITY USE ONLY
)fP U~7 3830 PILOT KNOB ROAD
~ EAGAN, ?SN 55122 PERMIT #
- PHONE: (612) 454-8100 RECEIPT # /D 7
' MECHANICAY PERMIT DATE: -)r/O
RSSID$NTIAI,.`: PLEASE COMPLETE UPPER PORTZON ONLY FOR SINGLE FAMILY DWELLZNGS 6
. . .
TOWNHOMES/CONDOS WfiEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION FEES
NEW CONST ADD-ON MINIMUM $15.00
ADD ON ? HVAC 0-100 M BTU 24.00
REPAIR _ ADDITIONAL 50 M BTU 6.00
GAS OUTLETS - MINIMUM 3.00
OF 1 PER PERMIT
OWNER NAME: OOV9
SUBTOTAL: $
SITE ADDRESS: STATE SURCHARGE: .50
LOT: C/ BLOCK ~ SUBD. }C, \ TOTAL: $
INSTALLER: e-,ot46 , .
ADDRESS: ~9Sr~~i u~/?,~~/10- IGNAT RE 1 PERMITTEE
CITY: , /~l"" 2IP: SJ %2-Z--
PHONE ,r~~y.rv-~99~ ( I
~/"S/a0
~
COMARp3AS:%iNDUSTRTAL~i PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDZNGS,
APARTMENT BUZLDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
°
CONTRACT PRICE: f FEES
OWNER NAME: 18 OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
SITF? ADDRESS: EACH $1,000 OF PERMIT FEE.
anCCESSED °I°IlIG = $25.00
LOT: BLOCK _ SUBD. $25.00 MINIMUM FEE.
INSTALLER: CONTRACT PRICE x 19 $
ADDRESS: STATE SURCHARGE $
CITY: ZIP:
TOTAL: $
PHONE
(SIGNATURE)
FOR:
CITY OF EAGAN
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
-3'S -D~ 3830 PILOT KNOB RD - 55122 L~ _'~C) 9
651-681 -46'75 ~
New Construdion Reouiremenls RemodeVReoair Reouirements
? 3 repistered site surveys showing sq. h oflot sq. ft o/house ? 2 copies of plan
and l roo/e0 areas (20% maximum lot eoveroae allowed) ? 1 set of energy wlculations for heated additions
? 2 copies o( plans (show beam 6 window sizes; poured fnd. design; etc.) ? 1 site survey for eMerior additions & Aecks
? 1 set of energy caleulatians
? 3 copies of tree Dreservation plan if lot platted after 7I1/93 ~
DATE: o/7" ~ CONSTRUCTION COST:
DESCRIPTION OF WORK:
STREET ADDRESS:
LOT: Co BLOCK: ^a~ SUBD./P.I.D. C1 U aG'~ VjzV V)L/a-1~
,
Nazne: Phone q:
PROPERTY Fint
oNi',ER ~ 4 i~
Street Address:_
city L~G.4 N state: zp: S,S
Compan}JPo.fERrsA~ s10j5~171 aZ /~~iJo,v~ Phone#: '2~ ~J~O
COA'TRACCOR / Qry
Street Address: Z~ license #(JO O~ Ex 3 3//~a
C;ry stace:_~~~ Zip: sv ~~T
ARCHITECT/
ENGINEER Company^ Phone k:
harne: Regisaarion
Street Address:
Cip• State: 7Zp:
Sewer & water licensed plumber (reaufred for new construction onivl:
Penalty applies when address change and lot change is requested once permit is issued.
I hereby acknowledge that I have read this application, state that the infortnation is correct, and agree to comply with all applicabte
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
- -
Certificates of Survey Received _ Yes No , L O
Tree Preservation Plan Received _ Yes _ No _ Not Required
L~---
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea.)
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex 0 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only O 43 Sidi ng/Soffits/Fa scia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg. ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ~ 42 Reroof
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code
UBC Occupancy sq. ft. No. of Units
Zoning sq. ft. No. of Bldgs
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
% SAC
EldeI'-JOneS
! Building Permit Service, Inc.
1120 East 80th Street
Bloomington, MN 55420
' Phone: (952) 345-6047
Fax: (952) 854-4909
To whom it may concern:
We at Elder-Jones Building Permit Service, Inc. are acring as an agent for Renewal By
Anderson. If there are any questions, or if the permit has to be picked up in person, please give
us a call at the number above. If the permit can be mailed back to us, we have enclosed a
self-addressed envelope for your convenience.
Thank you,
Kara Benson ext. 147
Elder-Jones Building Permit Service, Inc.
1120 East 80th Street ' Bloomington, Minnesota 55420-1498
952-854-2854 4 FAX: 952-854-4909
ioo ~ii aeoa =vrrtnl. nxlftvVCxZntv ' yyuu[iuuz
Te, al
BYAND8A5&N' ' '
7une 7, 2001
City of Eagan
3836 PiIot Knob Road
Eagan, MN 55122
To Whom It May Cancern:
IIder Jones is authorized to pull buIIding permits for Renewa] by Andersen_ Please allow
Elder Jones to provide this service for us in Eagan. 'I'his authorizaticm is valid for any
date beyond 6/6/01; un4d a kenawal by Andersen manager expressly revokes it in writing
to the City_
I reqnest llus authorization be accepted exgeditiously, as to not delay in che processing of
our building pcimits any furthcr, plcasc cail mc if thcs-c arc any questions. I can Ue
contacted at 763-502-4706.
, .
Your immcdiate attention to this mattcr is appreciaced.
Sincerely,
#ymond R. Ratt
ion Manager
Renewal by t#ndeJSen Corporadian V:MGHADAM.
O~N F'u01c
o nESOtB
. E~vvq.hn.97, 2pp5
Received Time Juo. 7. 1:07PM
25 ti~~~
2007 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauirements RemoOeUReoair Reouiremems Oflice Use OnN
3 regBfered site surveys showug sq. ft. M lot, sq. iL of house; an0 all mofed areas 2 copies M plan showiig foofinqs, beams, joisls Cert o1 Survey Recd _ Y_ N
(20%maximum lol coverage alloxed) 1 sel af Energy CakuWLms far healed aOdNOns Sa'Is Report _ Y_ N
1 Soils RepoA rf proposed Cuilding is ta 6e placed on disWr6ed soil 1 sile wrvey tor addi6ons 8 decks Tree Pres Plan Recd _ Y_ N.
2 copies of DWn shvxmg beam 8 window sizes; poured found design, etc Adi - indcafe tl an-siYe sep6"c system - Tree Pres Requued _ Y_ N
1 set of Enefgy Calalatima Oo-site Septlc System _ Y_ N
3 coryes of Tree Preservatlm Plan d lat platle0 after 711193
Rim Joist Oetal Optlprs selection sheet (6uildYgs xnth 3 or less wits)
Minnegasw medianipl venOlatim fortn
PIaP1S aPe CO(1SId:°7@d pU41tC IPiYOP7Y1a4iOP1 UIlIE55 pU SCa4@ tG1ev 8P0 4PadC 52CPe$ 21P1d @h@ Fe3SOPt.
Date I/ /_2 Construc[ion Cost 9 Od
Site Address c~~ ~~"l L'rlGt/y~Q_S )Q UniUSte #
Description of Work -tgx,r
Multi-Family Bldg _ Y~ N Fireplace(s) _ 0 _ 1 _ 2
PropertyOwner 1~~,p, Telephone#(~Sk)
Contractor
Addres~s/~ City
T_n~e.s- oile
State ~ V In Zip GS6_7 ~ Telephone#(lcSl Co
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 CateQOrv 1 Mincesota Rules 7672
. Energy Code Category . Residential Ventilation Category 1 Worksheet . New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitled
• Energy Envelope Calculations Submitletl
In ihe last 12 months, has the City of Eagon issued a permit for a similar plon basetl on a master plan2
_ Y _ N If yes, date and address of master plan:
Licensed Plumber Telephone ~
Mechanical Coniractor Telephone # ( ~
Sewer/WaterContractor 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 Ciry of Eagan and the State of MN
Statutes, [ understand this is not a permit, but only an application for a pertnit, 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.
" l ! L,57 Lu,C>
ApplicanYs Prin ed Name ApplicanYs tture
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA137325
Date Issued:06/29/2016
Permit Category:ePermit
Site Address: 3914 Thames Ave
Lot:6 Block: 2 Addition: Coventry Pass
PID:10-18400-02-060
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
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 (WS &/or WH)$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 -
Timothy K Iverson
3914 Thames Ave
Eagan MN 55123
(651) 329-4163
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA169812
Date Issued:06/10/2021
Permit Category:ePermit
Site Address: 3914 Thames Ave
Lot:6 Block: 2 Addition: Coventry Pass
PID:10-18400-02-060
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
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. We encourage you to retain an electronic copy of
photos until the project passes a final inspection.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
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 -
Cristie Myers
3914 Thames Ave
Eagan MN 55123
Northland Construction
4389 Malmo Circle
Eagan MN 55123
(651) 274-9777
Applicant/Permitee: Signature Issued By: Signature