4396 Tofte Lane , ~ ~~.~~r''. `~'~i"~+9.'afi~~ "~•r. 9
V ~ ~ ' . .
B~ r ~1 ~ , . 1 • 4. T.
&ftiftcate of ccc"anc~
~ilh) o~ ~"an
1 ~t~urtatcxt ~ 8xiti~g ~a~ycction
Tius Certiftcate issued pursuant to !he rieqyirrments of 1he Urtifornr Building Code
certifying that at the tink of issuance this stnectwe was in co?»pliance w+th the various
T ordinancts of tlee City rrgulattag buelding construction or use. For the Jollowing:
ur cLMir,aoon: SF t~ sws. ramit rb. 21536
Ooa.prw.y iype R3M1 ?ming Disuict RI Type Const.
o..etoreo;wirs ICEYIAM EM Adckrws 14450 B'VIIZE PiW,B'V=r
ene&m 4396 1 LANE ~ity L2. B3, AVitJW R]IIGE ZNID
'
D.: 421i/V/ /
P06T IN A CONSPICUOUS PLACE
INSPECTION RECORD
' CiT Y OF EAGAN PERMIT TYPE:
3830 Pilot Knab Road , Permit Number:
~ Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
~ a; i rfh~i , i~~,~~f~~ ii~~r~it
~ , ~ r~~~ ~ ~ ~t~,~~ ; PERMIT SUBTYPE: TYPE OF WORK:
~
~
i
INSPECTION
; It',I~I ~ti !!I rp~
I~ 1 1{,1 I'~ 11~ i
~
. . . . . ` ~
~ ~
r Plrlnit No. P9Rnlt HoIdM oate Telephone a
S/1N
~ PLUMBING
HVAC ~ ~ •~i~~f'- l I
ELECTRI Q,t1 ~f 9~ Q ~
ELECTRIC
Inapsctlon Dats Insp. Commenb II
Footm9s i ~--(I. ~3 'QS' I
Foundation ~~53 t-m 6e 6 ~
Framing 23 - ~ 3
Roofing
Rough Plbg-
Rough Htg.
ls,l.
Fireplace
Final Htg.
OBat Test L( Cr
Rnal Plbg. Plbg. or - Notity Plumber `
cW
Const. Meter
Engr./Plan
Bfdg. Final li, I I
Deck Ftg.
DeCk Final
J
Well
Pr. Disp. ~ II
J
! INSPECTION RECORD ~ !
~ CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: • t N`, ~ f;
Eagan, Minnesota 55122-1897 Date Issued: ' i` • ' ' • , ; '
I (612) 681-4675
SITE ADDRESS: ; 0 W' . APPLICANT:
10 r~ , r~l0c'F
rif'1'f ( AN1=
' ~ il~j•1 ~ i I~:~ i'.'.!' 1 S y'~ + r~~. i
I •
i PERMIT SUBTYPE: TYPE OF WORK:
RAi"inN
• • DA
I
~ W1,
~
I
~
Portnft No. ParnR Holder Date Telephona #
ELECTRIC
PLUMBIN ?
HVAC
Inapectfon Dsb Insp. Commenb
FOOTINGS
FOUND
FRAMING
0 2 ' 7RA
ROOFING
ROUGH
PLUMBING Q l7-5
PLBG
AIR TEST
ROUGM
HEATING
GAS SVC
TEST
INSUL
GYP BOARD 1
FIREPLACE
FIREPLACE
AiR TEST
FINAL PLBG
FlNAL HTG i
ORSAT I
TEST I
6LDG FlNAL I
E3SMT R.I.
BSMT FlNAL G, ,MCJ /Q xAzd' I
_ I
DECK FTG I
DECK FINAL I
I
I
I
WV 0~166 `
a ~
ReQUest Dale Fve No. Rough-in InspecLOn NOTICE: You Mus1Call Eleqncal Inspecmr
RequireE~ II A Rough-Inlnspectron
r' es ? No Is Reqwretl.
I licensed contractor ? owner hereby request inspection of above electrical work at:
Job Addre traet, Bax or Faute No
~ 9lP ~'o ~ Cny
Sedwn No TownsM1ip Name or No pange N. Coun
Occupam (PRI Phone No.
PoweZ Atltlress
Eledncal Co tor (COmpany Name) l Convector Acense No
7
Mailing Atlaress (CO Vador or Owner Making Insaallalion~
' ,
Aulhonzetl n re(GOnirndw/Owner aWng Ins Ilelion) Phone Number cz'
MINNESOTA STATE BOARD OF ELECTHICITY THIS INSPECTION REOUEST WILL NOT
Griggs-Mitlway Bltlg. - Room S173 BE ACCEPTED BY THE STATE BOARD
1821 Unlverslty Ave., 51. Paul, MN 55tp4 UNLESS PROPEfl INSPECTION FEE IS
Phone (612) 602-0800 ENCLOSED.
V REQUEST F(YR ELECTRICAL INSPECTION ""eemooi-oe
/ d? See inS~dbns foreompleling this lorm on back ol yellow mpy 16 6 X" Below Work Covered by This Request .i,,.
e Ad ' ep i TypeoiBmlding ApphancesWiretl EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Bwldmg Dryer Loatl Management
Comm./Indusirial Fumace Other (Specity)
Farm Air Conditioner
Olher (specity) Conhacbr5 Remarks'
Campute Inspection Fee Below: "
# Other Fee # ServiceEntranceSize Fee # Qrcuits/Feeders Fee
Swimmmg Pool 0 to 200 Amps - 0 to 100 Amps
Transformers Above 200 _ Amps IL-A
Above 100 _ Amps
$iCJnS Inspector5llse Only: TOTAL
Irrigation Booms 'yd O O ~ J
C '
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE DE
FIE ISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MO
I, the Elecirical Inspector, hereby RougRin oaie
certify that the above inspection has Final 'J ~
~ate
been made.
OFFlCE USE ONLY
This requesl void 18 months Imm
Address 1,14F mFrF raNE Zip 5512 3
Let • 2, Blk 3 Sub RIDGF Z0
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPEGTION.
Date: Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanent driveway ?
Permanent gas ~
Sod/Seeded grass ?
TraiUcurb damage ~
Porch I/
Basement finish ?
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shul-oH of water supply to
lhe oufside lawn faucet before freeze potential exists.
Contact engineecing division at 6514645 before working in rightof-way or installing underground sprinkler system.
White - City Copy Yellow - Resident Copy Pink - Contractor Copy ~
PERMIT
6ITY.IOF EAGAN ~1i
3830 Pilot Knob Road P E R I T T P E: e u r Lo N e
Eagan, Minnesota 55123 Permit Number: 021536
(612) 681-4675 Date Issued: 0 7/ 3 0/ 9 3
SITE ADDRESS:
4396 TOFTE LANE
LOT: 2 BLOCK: 3
AUTUMN RIDGE 2N0
P.I.N.: 10-12301-020-03
DESCRIPTION:
Bu"i.lding Permit Type SF DWG Building Glo,rk Type NEW
~ UBC Occupancy-, R-3 M-1
% Construction Type V-N
j 2oning R-1
Building Length 68
Building Width 36
.
,
REMARKS:
S& W PLBR - D C MECH
k%feE SUMMARY:
VALUATION $156,000
Base Fee $835.50 MI3CELLANEOUS $1.744.50
Plan Review $543.08 Total Fee $3,951.08
Surcharge $78.00
SAC $750.00
SAC 8 100
SAC Units 1
Subtotal $2,206.56
CONTRACTOR: - Applicant - sT. LIC. OWNER:
KEY LAND HOMES 18942636 0001553 KEYLAND HOMES
14450 BURNSVILLE PKWY 14450 BURNSVILLE PKWY
BURNSVILLE MN 55337 BURNSVILIE MN 55337
(612-)-894-2636 (612)894-2636
2 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.
A PLICANT/PERMIT E SIGNA7U ISSUED SIGNATURE
~ i
, ~
REACTIVATE,_ CITY OF EAGAN '1!
PTRMiT C 993 BUILDING PERMIT APPLICATION 211 . JUL 16 1~93 681-4675
XIA _
I
SIN6LE 8 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 c)ULq /it-o/ 93 Valuation of work 105~
Site Address: 4'2-:~SCe ToF"T:%F LArtAE
SiREET SUI7E N
Tenant Name: (commercial only)
IAT 2 BIACK ?7 SIIBD.NNpMIA R~Dc~E P.I.D. 0
Z A9D1"Clot1
Descri tion of work: ~Fyl St LE FAML "T ED A0mE
The applicant is: ? Owner ;E(Contractor ? Other (Describe)
Name Phone
Property LAST FIRST
OW112f qddress
STREET SiE M
City State Zip
Company E S Phone
Contractor Address )44S0 g7UR?-IS0LI.E WWY. License p 1f~3 Exp3 31-95
City I? ;;,,1RIJSViILE State Mkl Zip oCo
Architect/ Company Phone
Engineer Name Registration N
Address
City State Zip
Sewer & water licensed plumber 7. L• MECA Aa1tGAL- . 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 app icable State of Minnesota Statutes and City of
Eagan Ordinances. ~
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
O Ol Foundation ? 06 Duplex ? 11 Apt./Lodging 0,16 Basemer~k Fin~,~,b
.
.
~ 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. O 17 Swim~.Pool'-
? 03 SF Addition ? 08 S-Plex ? 13 Garage/Accessory ? 18 Comn./Ind.
0 04 SF Porch ? 09 12-Plex ? 14 Fireplace O 19 Corton./Ind. Misc.
? 05 SF Misc. ? 10 Multi. Add'1. 0 15 Deck O 20 Public Facility
? 21 Miscellaneous
WORK TYPE .
g 31 New ? 33 Alterations ? 35 Tenant Finish ? 37 Demolish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual) V- N Basement sq. ft. MWLL System ye-S
(Allowable) v- N lst F1. sq. ft. City Water yL-s
UBC Occupancy R-3 M-1 2nd F1. sq. ft. PRV Required
Zoning R-1 Sq. Ft. total Booster PumP
~Y of Stories Footprint Sq. ft. Fire Sprinkler
Length C. On-site well Census Code / b 1
Depth 361 On-site sewage SAC Code ~L
1
APPROVALS j
Planning Building Assessments
Engineerin9 Variance
REQUIRED INSPECTIONS
• Site 0 Footing ? Framing ? Insulation
? Wallboard O Final ? Draintile ? Fireplace
Permit Fee v.iuac;o,: S 1•rd 09Pd
Surcharge GARaGE;
Plan Review - 3o XZ2= 6~o x/G ~ fB56o
License '
MWCC SAC 28 k 3$ ~ I0644
City SAL
Water Conn. x ~0a
Water Meter ~~yc IS~ l~~~~~
Acct. Deposit IST Fi..ooA;
S/W Permit ~
S/W Surcharge gSrn7: I'1- y"
Treatment P1.
Road Unit
Park Ded. 125~ x sy_ $ 2~
Trails Ded. ~
Copies 2m,p Fl_ooR,
Other
Total: 38XZg.;~ /064
SAC % 100 ~ Y-Lx 13= 2~
SAC Units I lo8yX5r~.
I55 Ss-0
~ 66i17i93 97:45 602
7
aSURVEYOR'S CERTIRICATE KEYLANO HOMES
HoTe: nv srecric sou.s inves nrion nne
,
ON THIffi LOT BY TME SUQR. T ~
40i14 TO BUPAOR7 TNE R!C ' 1S
NOT TNF RE6PON6181LITY Of TNfi
n
33A'
`Nso` 'f,4pg/
0o~~,t. (9a1.~~
' / f SI ~ / . I
~
Li ~ LOT 2 9;A- IL_10T 3
LLJ
N
o
0
951.4 ~
s,~ 942.7
N~ ~ 947.1 94
383 1 1
HOUSE
510 ~ I gi'
~
7p K
6AR. ~ i ECH47•6
- ~isa.0
~
4 1
~gp~p ~p~qpp~K sz ,
E~EV~95'1.P9 j; PROPO D
6 ORIVEWAY c,y II
J
C4so_a~~ . Q_
~ h15J0°42 {{"W~ Aa 1'p 1~5511 ~9
v96AA ~ a 2 . 54 I3R~C~3IRl EldRTCa F)EE'~'
o R 24eo,,'e
M M~
TOL~ANE
yQ>Q
.NOTC: Ett.DIN6 qMCpHSIONyS~ SMOIYN ARC
A t10~~~r T~RUCTUliEOHLY S E•
DENOTES PROPOSED SURFACE DRAINAGE a~FpuwpAfioH D MES? ~i No gl~IN
O DENOTES IFON MONUMENT SET SCALE: 1 INCH = 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = 9S2- ~ FEEf
X000.0 DENOTES EXISTING ELEVA710N PROPOSED LOWEST FLOOR -~?y¢ (a FEEf
(000.0) DENOTES PROPOSEp ELEVATION PROPOSED TOP OF BLOCK - q5 Z. j FEET
WE HEREBY GERTIFY TO KEYLAND MOMES THAT THIS IS A TRUE AND CORRECT
REPRFSENTATInN OF A SURVEY OF THE BOUNDARIES OF:
tof 2~ Bbck 3, AUTUMN RIDfdE 2ND ADDIT1bN, occording to the reoofCeG plaT
thereof, Dakoto County, Mlnneeola. - IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS. OCCEPT AS SHOWN. AS
SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 9TH OAY OF JUNE , 1993.
PfiOPOSfiO ORADES snovrN w2BE SIG : J R. HiLL, INC. ~
TAKfiN FRON iilE OeVMPM' CRY
r
-PpDbTIO~ ~ ~ H Ai~YG6pfONE~
E'Ffli LA T 5-11-92. B.
JOHN C. LARSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 19828
o~w~ o
~ m m° ~°)ames R. Hill, inc.
o m o~" D Z PLANNERS / ENGINEERS / SURVEYORS
o m ~ utva w j
2500 W. CTY. RD. 42 ~ BURNSVILLE, MN. 55337 • 612-890•6044
LOT BURVEY,CHECRLIST FOR RESSDENTIAL
-J BOILDING PERMIT APPLICATION
m y_~
pROPERTY LEGAL: ~~t^
N Date of 8urvey:
~ M
2 DOCUMENT BTANDARDS
0~ ? 0 • Registered Land Surveyor signature and company
Q" ? ? • Huilding Permit Applicant
0~ ? ? • Legal description
0 D" D • Address
B-~? 0 • North arrow and bar scale
91-0 0 • House type (rambler, walkout, split wyo, split entry,
lookout, etc.)
e~ ? 0 • Directional drainage arrows with slope/gradient
0 C3" ? • Proposed/existing sewer and water services
~_~o ? • Street name
O O 0 • Driveway
£LEVATIONS
Existina
0 [3-~? • Sewer service
D^ 0 ? • Lot corners
6-0 0 • Top of curb at the driveway
~ 0 0 • Elevations of any existing adjacent homes
procosea
? • Garage floor
0r ? ? • First floor
~ 0 ? • Lowest exposed elevation (walkout/window)
P~j9 0 • Property corners
• Front and rear of home at the foundation
PONDZNO AREAB (if aoolicnble)
0 d ? • Easement line
0 ~ 0 - NWL
O 6^ ? • HWL
0 C'~ ? • Pond # designation
0~ 0 • Emergency Overflow Elevation
AIMENBIONB
0-~ ? 0 • Lot lines
0~ 0 0 • Right-of-way and street width (to back of curb)
@~ D 0 • Proposed home dimensions including any proposed decks,
overhangs greater than 21, porches, etc. (i.e., all
/ structures requiring permanent footings)
? 0? • Show all easements of record and any City utilities within
those easements t~'~ ? • Setbacks of proposed structure and setback of adjacent
/ existing homes
? C3" 0 • Retainin 1 requirements, if any
Reviewed•
Na / Dat
October 1992
~ EXTERIOR ENVCLOPE AVCRAGE '.U" cUririiniivn._ zv~
~ ' - -
oW ~v E e nnrr 'z
: -
S?T~ ~DDRESS:~1~(O Ph!ONE: 9j94 "Z~3Cv
C01T2AC?OR: ~~LAIJ~ P~ ~ J ~y ~ ~
Determine working square foota9e of each
i. Total exoosed wzll area..... '3 f Zv ~s s9• ft. x .11 = 3 y 3•~I /
IZ`-k O sq. ft. x .026
2. Total roof/ceiling zrea.....
Tctal exposed wall area-above,floor=__ Z-7Zd
a. Total wzll window area . . . . . . . . . . . S ro
b. Totzl door area .
c. Total sliding olass door area }7'4
s• Total `ireplace wall area Z7Z
e. Total wall framing area (average 10% . . . . . . .
S
iotal rim joist area 3/
'Z
g. ne~ wall area a6ove rloor . . . . . . . . . . . . . . . . . . . .
h. wall area a6ove i'loor
i. wall zrea above floor
j. frzme wall area at _'oundation
Total exposed foundation area= 1~1
Totzl foundation window area ~ L (CV _
1. Total net foundation area above grade S$,7
Determine "u" value of each wall segment
(e.g: window, cioor, each separate wail seciion)
a. ZI'7 X "u"_ '-f7 = 107.~~1
b. s-6 X„u„ . 3! = 1 -7~ 3(,v
c. 3Z~Lq X 'lull
d. - X t,u..
e. Z7 Z X l.u., Ao7 = I`1•04
r. -5 I 5-' Xl.ul, ~ Q-4 i2,Co
g. Zq q~ x „u„ ~-7.Rz
h X .1 u 1. _
.
i.
j. X"U" - If item ,"3 is the szr.
• r X "U" as, or less than iter.
:1, you have met the
X L( (,V i ntent of SBC 6006 (c
3 . .................................Total = Z-~,
Total exposed roof/ceiling area =
m. 'bta1 sl:yli.c,ltt zrea .
?otzl roo</ccilin, .g_-acning arr_a (;rvcraqc 108)
o. ^otal nCt i.^.s_latc3 roof/ceilin9 area..,...... • ~ U(p .
Determine "U" value for each roof/ceiling segnent
m. X ~V,
r.. ~ Z. x„Ul. ~°17
0. 11 ~ cp X„U„ !07 = 'zz''~Z
- Zutal
`o=z1 c° is the same as, or less t:han 02, you have met tne intent of .
SaC 5025 ic) 1. . ,
ellter, ate Building Enve?.ope Desigz .
^o _ a iize the total envelone'systeJn method, the values established by the san of '
items 43 and 44 sha11 not be greater than the sum of itens ,l and n2.
+ 2. 3Z,Zy = 4111
> "
3. z UO. Z!i - 4. ~+S ~VI = ~~O 5• SS'
~
wAu ~~.T+un
t,lse ftg O~ ~o9ue Wa 1 1 area i~~r R- VALUE
. ' fv'ame ct.~'truCtlo~ CONSTRUCfION-- FRAMING - -
T- ~ 1. INTERIOR AIP. FILM 0.68
~ 2. 2 D .45
3. 5 1 2 SOFT kK)OD 6.87
' 4• ~~UIDjiHF1YfH~N[.n WSuE~ S•'4-
~ S. SID NG .8
6o5=C ~ 6. OR IR FILM 0.17
l~.si.l. TOTAL R= ~ iq
U= v7
FSG. 'Skl TUtvTEtj Cf
PF~4ME NALL NET
T-.
1. INTERIOR AIR FTLM 0.68
2. ' i2 GYPBD .45
~ 3. . ,
u. :5-"
- 5. ~I ING .6~
~ 3 6. _ r=IOR A R IM
0.17
MTAL o2Co. 30
~ U_
1. INTERIOR AIR FIIM 0.68
~I 2. 6 INSIIL. 19 . 00
5~~~ 1SfhLsR 3. 2x1 R JO 1.89
4.
5. IDING .62
6. EXTERIOR R F LM 0.
U=
e Q .i
~
" ~ BIACK
WALL 1. INTERIOR AIR FZI1d 0.68
2.
3. 0 . 0
' ~ 4. PROTECfIVE EARRIER
6.
TOTAL R= 7.13
U= .14
1 1 SLAB ON GRADE ~
~ .
~ ~ _ :
- - Ill~
• ~ ~ , ~
, D~°~,
~
~ ' . f ~ /fl _ ' °t• , ~ tl - A1
LLL
~
'r3G . 43 = •E,7r.
~
~ c~•' o 1 NOTE: INDIG4TE TYFE, "R" VAWE. DEP'I'fi AND
PLACIImENI' OF INSUiATION.
ROOF-CEILING
~
• CONSTRUCTION ' R-V.4liJE
INTERIOR AIR FILM 0.6&
-
2. SIS" 61
--3. iNtMlAllUfq
•
TOTA1. •
VENrT U = .02
o,
~
' FRAME
v.ENI,.~ I A NEAT FDOI 1. INTERIOR AIR FI'LIM 0.61
I I 2. 57gT`-
I - I I 3. 2z +NSO
? l..! 4. - L • -
_ P!. .
FTG. rS -
U _ 0.024
' CONSTRUCTION
INSIDE AIR FILM 0.62
I ! / v 1 • : • -I \ • r . u I ? r lF ~ 1 ,
- - - 3.
4
5. o '
=°T =
FRAME
I i L L nILO 1. INSIDE AIR FILM 0.61
~ J 2.
~NEAT FL:JW U?' ' VIN'i'Eil 3. .
4.
5. OUT
TO'?'PL
FIG. #E . U _
3 r 4 ~ ~ 1...INSIDE AIR FILM 0.61
I I 3.
'
i._ : S.
, „ , =;==-•-1 ~r ~ ?rri'Pt-
i~'- /~~_/_~.....f U _
r~ NQN-VEMI'ED NOTE: USE P,DDITIONAL SHEEI'S IF i".ORE S?F.C-' IS
NEEDED FOR DETAILS AND CA?CIJLATIO?vS.
H£AT FLOW
UP
rIG. #7
..~..~:''('td~'n'..~ :7k::>kPo'WTF7;)X'::Y„XCy6~'t~:...;:i°.8:)':;JY,[:YY(~O~t::(•kY,<
CITY _ACAN
f'l1SR" Si i'F'I;Ni:CNAt_ Ni);
IA'1'4la /97 'rTN'lra ~.5cA _:r33
-ri
irrivzI-r BLIOR.3
i27A 900? 4:496 'iUlrTl:= L.PI 5d1,0'J
?155 4336 'rU' 'TF t..N ~.,50
~
~
Tc r,'I. '4c -,ai rt An -rurr: : `O,.:F;O
~C!lpi?036
wAND,
~
PERMIT
GIT~f UF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 030908
(612) 681-4675 Date Issued: 10 / 13 / 9 7
SITE ADDRESS:
4396 TOFTE LANE
LOT: 2 BLOCK: 3
AUTUMN RIDGE 2ND
P.I.N.: 10-12301-020-03
DESCRIPTION:
Building Permit Type BASEMENT FINISH
Building Work Type ALTERATION
Census Code 434 ALT. RESIDENTIAL
~ .
~ .
r'
. - - . . ,~~1. .
~ . -
REMARKS:
FEE SUMMARY:
Base Fee $50.00
Surcharge $.50
Total Fee $50.50
~~`C"""ONTRACTOR: - qpplicant - sT. LIc OWNER:
~RY2ER BLDRS 14501653 0006781 BOEH JOSEPH
316 BACHMAN CIR 4396 TOFTE LANE
NVER GROVE HTS MN 55077 EAGAN MN
012) 450-1653
Z hereby acknowledge that I have read this application and state that Che
inPormation is correct and agree to comply with all applicable State of Mn.
L Statutes and City of Eagan Ordinances. ~
~
V4IkPPLICANT/PERMITEE SIGNATURE ISSUED B. RE
1997 BUILDING PERMI'T APPLICATION (RESIDENTIAL)
Lt ~ e~ CITY OF EAGAN
3830 PILOT KNOB RD - 55122
681 ~4675
New Construction Reauirements RemodeVReoair Reauirements C
? 3 registered ske surveys ? 2 copies ot plan
• 2 coDies of plans (inUUde beam 8 windaw s¢es; poured fid. design; etc.) ? 2 sRe surveys (exterior adtlitions & decks)
? 1 energy calculations ? 1 energy ealculations for heated atlditions
? 3 copies of tree preservation plan H lot platted after 7/1193
required: _ Yes _ No -
DATE: IO-I - n7 ~ CONSTRUCTION COST:
DESCRIPTION OF WORK:
STREET ADDRESS: y~ %le -fol ' L Lo5tF-,fL_
L T BLOCK SUBD./P.I.D.
T
PROPERTY Name: 8
Phone _
owNeR
StreetAddress: 324 T~%~`'
City: State: Zip: SSl-23
CONTRACTOR Company: KJZyZcA, Phone
Street Address: 63,16 ,Qi46-l~J'J/,W License
City: lo-'C N State: Zip:
ARCHITECT/ Company: Phone
ENGINEER
Name: Registration
Street Address:
City: State: Zip:
Sewer 8 water licer.ned plumber (new construction only): . Penalty applies when address change
and lot change are equested once permit is issued.
I hereby acknowledge that I have read this appiication and state that the information is correct and agree to comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No OC'( i ~o
Tree Preservation Plan Received _ Yes _ No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ~ 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
0 03 SF Addition ? 08 8-plex o 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch ? 09 12-plex ? 14 Fireplace o 21 Miscellaneous
? 05 SF Misc. ? 10 _-plex ? 15 Deck
WORK TYPE
0 31 New 33 Alterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actuat) Basement sq. ft. MC/WS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump ~
Length sq. ft. Census Code.
Depth Footprint sq. ft. SAC Code 01_
Census Bldg 1
Census Unit 0
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
i~
Total: : ' , ; • ~x'1
% SAC .
SAC Units
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675 (
New Conshuction Reaulrements Remodel/Reoair Reaulrements
? 3 registered sMe surveys showing sq. fl. of lot, sq. tt. 01 house 4 coples of plan
and gl roofed areas (207, maxlmum lot coveraae allowed) 7 sef of energy calculaNons lor heafed addNlons
? 2 coples of plans (show beam 3 wlndow slzes; poured ind. design; efc.) 1 sMe survey for exterlor addMlonf 6 decb
? 1 set ot energy calculatlons
? 3 copies of hee presenaflon plan fl lot plaffed affer 7/1 /93
DATE: CONSTRUCTION COST: I ~"IO U
DESCRIPTION OF WORK: Y~ v c-,
STRER ADDRESS 3`! ~ -)-,n 9 'j-c Z-- A-~-e
LOT: BLOCK: 3 SUBD./P.I.D.
1r C,,~. ~Y~a-a~~
Name: ~<7 c) e Phone
PROPERTY Last Fint
OWNER
Streei Address:
City ~ p•~--- State: Z(p:
Company:Vll e0 vt~ \ G~ C~ Phone * 701a-
(area code)
CONTRACTOR 1
Sheet Address: U Z, 4 License # 3 3 Exp, - a o
Ci1y State: 1i1 - Zip: 1~1
ARCHITECT/
ENGINEER Company: Name:
Telephone N: area code ( )
Sfreet Address: Registration
Ctty State: Zip:
Sewer 3 waler Ilcensed plumber (reaulred for new conshucHon onlvl:
Penalfy applies when oddress change and lot change Is requested once permH Is Issued.
1 hereby acknowledge thaf I have read this applicatfon, sfofe fhat the informatlon is cortecf, and agree to comply wifh all appiicabl
State of Minnesota Statutes and Cify of Eagan Ordinances.
Signature of Applicanf:
OFFICE USE ONLY
CeRificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
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 O 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
woRK nrPe
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/SoffitslFascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Blcig.' ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
" Give PCA handout to applicant for demotition permit
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 Vaiuation: $
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
' _ « ~'Y'
;
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1993 MECHANICAL PERMTT (RESIDENTIAL)
CITY OF EAGAN
3830 PII,OT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
- - - - - - - - - -
V"" NEW CONSTRUGTION
ADD-ON A/C
ADD-JN .L''JP.NRCE
DATE 7/a3/93
FEES
HVAC: 0-100 M BTU $ 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS (MINIMUM 1@$3.00 EACH) ~-00
ADD-ON/REMODEL (Exts'rtNG CoNSTaucnorr) $ 15.00
STATE SURCHARGE .50
TOTAL ,3a. So
SITE ADDRESS: 73 9 ~
OWNER Iv'AME: TELEPHONE 36
INSTALLER:~4~
ADDRESS: ~'1 t~4
CITY:STATE: ZIP CODE:
TELEPHONE Y~17 - $~a 7
SIG ATURE F tERMITTEE
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1993 MECHAPIICAL PERMTT (COMIIERCIAL)
CT1Y OF EAGAN
3830 PILOT KNOB RD
FAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR ALL CO]vIIvIERCL4IJINDUSTRIAL BUILDINGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OF; OTHER MULTI-FAMII.Y BUILDINGS WHEN SEPARATE
PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNTT.
- - - -
DATE: _ ^ivti tciji'I' PKI CE: $
NEW BUILDING
INTERIOR IMPROVEMEN'I"
WORK DESCRIPTION:
FEES
1% OF CONTRAGT FEE $
PROCESSED PIPING: $25.00
MINIMUM FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF PERIvIiT FEE.
TOTAL $
SITE ADDRESS:
OWNER NAME: TELEPHONE
TENANT NAME: (IMPROVEMENT'S ONLY)
INSTALLER:
ADDRESS:
CTI"Y: STATE: ZIP CODE:
TELEPHONE
SIGNATURE OF PERMITTEE CIT'Y INSPECTOR
~ PTTTUSE:sONLY
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1993 PLUMBING PERMIT (RESIDETVTIAL)
CTI7' OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMTTS ARE REQUIRED FOR EACH UNTf.
- - -
N0, FI S Encs ToTni.
3.00
~ SHOWER 3.00
WATER CLOSET 3.00
BATH TUB 3.00
LAVATORY 3 pp 3, ~p
KITCHEN SINK 3~ 3, up
LAUNDRY TRAY 3 ~
HOT TUB/SPA 3.00
WATER HEATER 3.00 3• ~
FLOOR DRAIN
~ GAS PIPING OUTI.ET • minimum -1 13.00
. 0
ROUGH OPENINGS 5 ~
WATER SOF'I'ENER 15.00
PRIVATE DISP. • Da~.cry. lic. 3~
U.G. SPRINKI.ER • nome unaer wnu. 15.00
ALTERATIONS • to aisting 15.00
WATER TURN AROUND
STATE SURCHARGE .50
TOTAL:
SITE ADDRESS: a _~In ~a?fi"~ ~e'
OWNER NAME: LGin~ me ~
INSTALLER:
.l~
ADDRESS: `
SG1-~J ~ STATE: ZIP CODE:. ~ 3 ~
CTI'Y:
PHONE ~~L
SIGNATURE OF PERMITTEE
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1993 PLUM[BING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR ALL CON[MERCIAI/INDUSTRIAL II.DINGS. AISO FOR MULTI-
FAMILY BUILDINGS WHEN SEPARATE PERMTI'S NOT REQUII2ED FOR EACH
DWELLING UNIT.
_ NEW CONSTRUCI70N
_ ADD ON
_ REPAIR
WORK DESCRIPTION:
CONTRACT PR1CE: $
FEE: 1% OF CONTRACT FEE.
STATE SURCHARGE $.50 FOR FACH $1,000 F PERMP(' FEE
MINIMUM FEE $ 25.00 `
COIv'TRACT pRICE X 1% $
STATESURCHARGE $
TOTAL $
SITE ADDRESS:
1'ENANT NA114E: / STE #
OWNER n'A111E:
INSTALLER:
ADDRESS:
CITi': STATE: ZIP CODE:
PHOIVE J
FOR:
CITY OF EAGAN APPLICANT
CITY USE ONLY
PERIMIT I~ ~~J I RECEIPT DATE:
PXSIDEN'I7i4L MECHAeNICAL PEftMTP APPLICATION
crrYoF E?sM
3830 Pu.oT [cNoe gn
EAsnx ME ssiEs
e51-681-4675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date:
SITEADDRESS: ~13~1Cr ~C~T~~- L-L•
OWNERNAME: '-'~(IES~,1 V~OVEL_{1 TELEPHONE#:
(AREA CODE)
INSTALLERNAME.__~9Li"~\51.~~`S? TELEPHONEnSo), ~SGi~(CC~J
(AREA CODE)
STREET ADDRESS:
CITY: C~.C_ STATE: MG~ ZIP:
Place a check mark next to the ermit work t e
~ _ New residential dwelling unit under constructionand not owner/occupied $ 70.00
~ Add-on, modification or aiteration to existin dwelling unit $ 50.00
• furnace replacement
• air exchanger
• air conditioner
• other
Nature of work: V V1
State Surchar e $ 50
Total $ -S
Reminder: Call jor inspections.
~
SIGNAqURE OF PERIMITTEE
Updated 1/01
CITY USE ONLY
PERMIT RECEIPT DATE:
APPROVED BY: , INSPECTOR
CiOMMERCiULl. M$CiH"CiAL PEPJET 1~PIICiATION
CITYOFEAGAR
3830 Pu,oT xxoa Rn
Eaeax, auv ssi sa
651-6$1-4675
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
SITE ADDRESS:
OWNER NAME: PHONE
(AREA CODE)
TENANT NAME (IMPROVEMENTS ONLY):
WAS THERE A PREVIOUS TENANT I;J THIS SPACE? Y N. NAME:
INSTALLER:
ADDRESS: PHONE -
(AREA CODE) p
I
CITY: STATE: Z1P: ~
WORK TYPE: New construction Install U.G. Tank
_ Interior Improvement _ Remove U.G. Tanl:
_ Processed Piping
SpecifyNanue of Work:
When insla!ling/removing underground tank, call 651-681-4675 for inspection by Fiie Marshal and
P/umbing linspector.
' Fees: 1% of conRact price OR 550.00 minimum fee, wlvchever is greater.
Underground tank removaVinstallation = minunum fee
Connact price: 5 x 1%= $ (Base Fee)
State surcharge calcula[e at $ 50 for each 51,000 Base Fee
TOTAL $
SIGNATURE OF PERMITTEE
Updated 1/01
?L ~ n BL ~ CITY USE ONLY RECEIPT gO1 C9S2
/ e
SUBD. f r~~vwvu RECEIPT DATE:» I'~" ~rJ
~ 3
1997 PLUM$INfi P£RMIT (RUID£NTIAL)
crrY oF Ens,qri
S$SO PILOT KROB RD
ElkfiRN, M1V 551EE
(61E) 6$1-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? 6ackflow preventer for underground sprinkler system
FIXTURES EACH ~ # ~ TOTAL y
Shower 3.00 x =
Water Closet 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x =
Floor Drain 3.00 x =
Gas Piping OuNet ' minimum • t 3.00 x =
Rough Openings 1.50 x =
Water Softener ' for dwellings under consWCtion 5.00 x =
Water Softener ' for existing awelling 20.00 x =
U.G.Sprinkler 'fordwellingunderconst. 3.00 =
U.G. Sprinkler ' for ezisting dwelling 20.00 =
A a to ezisting re e~- 20.00 = 2.c
Water Tum Around ~ 20.00 =
Private Disposal System ' Dak Cty lic. 75.00 =
(new and refurbiahed systems)
Private Disposal Systems'nbandonment 20.00 =
STATE SURCHARGE .50
TOTAL ~?L,, 5"b
I hereby ecknowledge that I have read this applicatian, state that the iMOrtnation is cortect, and agree to wmpty Nrith all applicable City of Eagan ordinances.
tt is Me applicanPs responsibility to notiTy the property owner that the Ciry of Eagan assumes no liabilily for any damages caused by the City during its
normal operetional and maintenanca adivitfes to the facilities constructed under this permit within City Aroperrylright-of-way/easement.
SITE ADDRESS: LI 3 $ 6 `tD I'a LA-n/c
OWNER NAME:
INSTALLER NAME: J AwRFnlc r "1L un TELEPHONE ~/S 9^a o
STREET ADDRESS: 9yo2 4 1(jM4Ro
CITY: ~o `TTY1~ E i/~~ STATE: 1''r~? ZIP: SSa /-6
SIG ATUR OF PERMITTEE
CD/FORMS/PLBG PERMIT (RESIDENTIAL) 1997
C!ty of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use 2
Permit#: t{(03j3
Permit Fee: (Jai))
Date Received: 5i 11
Staff:
1
2013 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: •-5-/t3 [ / t 3 Site Address:
Tenant: Suite #:
Name: Fele /U -47-.1(1W Phone:) -3c9 7
Address / City / Zip: /3'
Name: 444 P-6 y /1/ 4) -ST A
Address:
License #:
City:
State: 444.) Zip: ,.<',6---z;.725 Phone: 651-5(5/ -3g6 /
Contact: fb a9X-�`.� Email:
New Replacement Repair Rebuild Modify Space _ Work in R.O.W.
Description of work: WTD f �"r %2
RESIDENTIAL
1 Water Heater
Lawn Irrigation (_ RPZ / _ PVB)
Septic System
New
Abandonment
Water Softener
Add Plumbing Fixtures (_ Main / _ Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $200.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $
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.orci
1 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 1 4) r b 10010 '? Lt
Applicant's Printed Name
x
Applicant's Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA132130
Date Issued:07/27/2015
Permit Category:ePermit
Site Address: 4396 Tofte Lane
Lot:2 Block: 3 Addition: Autumn Ridge 2nd
PID:10-12301-03-020
Use:
Description:
Sub Type:Reroof
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
David J Mcmahon
4396 Tofte Lane
Eagan MN 55123
(651) 307-7723
Intelligent Design Corp
4009 103rd Ave N
Brooklyn Park MN 55443
(612) 919-2596
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA147258
Date Issued:12/20/2017
Permit Category:ePermit
Site Address: 4396 Tofte Lane
Lot:2 Block: 3 Addition: Autumn Ridge 2nd
PID:10-12301-03-020
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
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 -
David J Mcmahon
4396 Tofte Lane
Eagan MN 55123
(651) 307-7723
Croix Crystal
3440 Yoerg Dr
Hudson WI 54016
(715) 386-8667
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA157128
Date Issued:08/06/2019
Permit Category:ePermit
Site Address: 4396 Tofte Lane
Lot:2 Block: 3 Addition: Autumn Ridge 2nd
PID:10-12301-03-020
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 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 -
David J Mcmahon
4396 Tofte Lane
Eagan MN 55123
(651) 307-7723
Krech Exteriors Inc
5866 Blackshire Path
Inver Grove Heights MN 55076
(651) 688-6368
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA179016
Date Issued:09/14/2022
Permit Category:ePermit
Site Address: 4396 Tofte Lane
Lot:2 Block: 3 Addition: Autumn Ridge 2nd
PID:10-12301-03-020
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.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
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:
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
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 -
David J & Cheryl M Mcmahon
4396 Tofte Lane
Eagan MN 55123--305
(651) 307-7723
Solaris Roofing Llc
1324 Forest Cir
Burnsville MN 55306
(651) 675-8486
Applicant/Permitee: Signature Issued By: Signature