3926 Worchester DrPERMIT
City of Eagan Permit Type:Building
Permit Number:EA128768
Date Issued:12/03/2014
Permit Category:ePermit
Site Address: 3926 Worchester Dr
Lot:17 Block: 1 Addition: Hills Of Stonebridge
PID:10-32990-01-170
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Donna M Geyen Tste
3926 Worchester Dr
Eagan MN 55123
(651) 687-0287
Pella Northland
15300 25th Ave N #100
Plymouth MN 55447
(763) 355-1300
Applicant/Permitee: Signature Issued By: Signature
- ~r
~ ~ • CITY OF EAGAN .42 18809
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 1 7
BUI~DING PERMIT Receipt #
To be used for sr ~/GAR Est. Value =79'000 Date HU ZS 19 91
$T6R DS
Sit@ AI"S OFFICE USE ONLY
Lot y Block Sec/Sub. R-3 !l-1
Parcel No. OoCUpanCy re-iFY FEES
INC Zoning 345.00
W Name t~uaq consi Bldg. Permit
Amdress (aiowebie) _ 39.50
Surcharge
° Cit Phone +e of stones 354.00
Y Plan Review
Length ~ ;
$AM
a Name oevu+ - saC. Ciry ,
OU2 Address S.F. Total - gAC, MCWCC
~ City Phone S.F. Footpnrns - 660.00
On Sile Sewage _ Water Conn
ww Name On sile well waler Meter 90.00
w
x = Address MWCC System Acct. Deposit ~ ~ ~
City ' Phone C'ty Wate` - 30.00 PRV Required _ S/W Permit ~
I hereby acknowlege that I hav reatl thi ocation and state Ihat the Booster Pump - ~yy c~r~~~ ~
inlormation is correct and a e tb~c m with all applicable State of
Minnesota Statutes and City F,dylfn O inances. Treatment PI
Signature ol Permitee APPROVALS Road Unit
TNB RO1TLUlID CO IMC Planner -
A Building Permft is issued to: Park Ded.
on the express condition that all work shall be done in accordance with all Council
applicable Slate of Minnesota Statutes and City of Eagan Ordinances. gldg, p}f, _ Copies 3,14~ '
Building Otficlal ' Variance - TOTAL •
~ w.mx ao. wrmn Maa.r o.ft Td.phorw ~
WATER
.
SEWER
PLUbIBI1J(3
H.VAC. 4 a 9 7 9/ 5s~?- G
ELEcraIc 7 • ~ °Q
r"p.euon ooa kop. comm.na
FooMp I y~19 u~
F*undab«,
Framirg
Roo(m
Po-O Plbg.
~ ~ a
Fk*pWe
FwW -Z/
F:+ a~s~ -
co~+. ~ Pbg. inspect« - nbwy Pi,mbe?
EngriPlan
eldy. F" S
Deck Flg.
Deck Final
Wep
N. Dap.
SEWER & WATER PERMIT • ~~~C,
~ I ~ OFFICE USE ONLY
i~ CRY OF EAGAN METER # I 21) ~ PERMIT DATE 04 / 01 I91
I 3830 Piiot Knob Fd. - •
~ Eagan, MN 5k122F~897 CHIP PERMIT # 11893
METER SIZE B.P. RECEIPT # C 12671
DATE 2-19--91. ISSUE OATE G B.P. RECEIPT DATE 03..1271 ~ 1
~!pRV - BOOSTER PUMP
SITE ADDRESS 3926 Worchester a&M DR PERMIT REQUESTED
LOT LLBLOCK 1 SEC/SUB S~ T~ R GE X
SEWER x WATER - TAPS
APPLICANT: l'ha rnt-t 1 nnr3 Cn Tnn
COMMlIND X RESIDEMTIAL
ADDRESS: 5201 Riv Rnar?
CITY, STATE Fridley, Mn ZIPSS4~~1 X NEW - EXISTING
PHONE: 571-0304 _
Lawn Sprinkler Meters are to be Ins#alled
PLUMBER: VS1J.ey Pltunbi ng Ahead of Domestic Meters on Water Line.
AQDRESS: 610 C1^eek T ane • Credit WILL NOT be given for Deduct Meters.
CITY, STATE }Tar :~sn o.Mn ZIP 55352
PHONE: 492_2121 ,..uc
I AGREE TO COMPLY WRH CITY OF
OWNER; '1'he RoCtlund Co Inc EAGAN ORDINANCES
ADDRESS: 5201 E. River Road
CITY, STATE ~~dOeY+ Mn Zip55421
PHQNE: 71-03D4 NATURE WHEN METER ISSUED
' /
PL~ASF3''I~I.LbW7WO ~WORKING DAYS 'FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STOHM
SEWER PERMITS, CO~"JACT EKGINEERI~G DEPT. ,
' "•_c6~?f <; . !r_..- r`'~-_
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: 14 Fi
Eagan, Minnesota 55123 Date Issued: !I N/q-4
(612) 681-4675
SITE ADDRESS: ~t, i I, ~ APPLICANT:
41uH1 1tf 1 I• ft i~li tii:I It I I i i1141 ,
PERMIT SUBTYPE: TYPE OF WORK: . i
INSPECTIOPJ
~ ~
Pormft No. Permft HoNlr Dete Telephoiw !
W
PLUMBING
HVAC
ELECTRIC
ELECTRIC
In.p.ctlon o.a aap. commK?ts
Footings i
Foundetion
Frartxnp
Rooflng
Rough Pibg.
Rai9h Htq.
Isul.
Freplace
Firrel Htg.
OBet Test
Final Plbg Plhg. Inspeaw - Notihr Plumber
Const. Meter
EngrJPlan
Bldg. Flnel
oaak Ft9.
~
won
Pr. Disp.
- ^
INSPECTION RECORD ~
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, MinneSOta 55122-1897 Date Issued:
(612) 681-4675
SITEADDRESS: I, Hl.f?i APPLICANT:
• ; ~ , fFR 01?
PF~MIT ISUPTYPE: TYPE OF WORK•
'
INSPECTION .A . D•
I
~
~ J
Psrmit Holde? Date Tetephone N
PIUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FpUND
FRAMING
ROOFING
ROUGH
PLUMBING I
PIBG
AIR TEST
ROUGH I
HEATING
GAS SVC ' I
TEST
~
INSUL I
GYP 80ARD i
FIREPLACE /O-Q~
(J
FIREPLACE I
AIR TEST ~W
FINAL PLBG I
{
FINAL HTG I
I
ORSAT
TEST
BLDG FINAL I
DOMESTIC I
METER
IRRIGATIDN
METER
I
FLUSH
MAINS i
CONDUCTIVITY
TEST I
HYDROSTATiC I
TEST I
BSMT R.I. I
~
BSMT FINAL I
DECK FTG I
DECK FINAL
- - - - ~
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number.
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675 ,
SITE ADDRESS: -APPLIGANT:
PERMIT SUBTYPE: TYPE OF WORK:
y
INSPECTION • DA
t^; :1M 1 Ili~ ! I Pi~1~
I ~
~ ~
.
1
,
wrmn No. POnnR Nom.. " w" ibNphor» r
S/W
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspwtbn Dde Imp• Commnnts
FootifW I i
FOU11ddtlW1 ~
F"""
ROCOV
Rough Plbg.
Rough HV. ~ ~
lsul. <<
FirqMm I
Flnel Htg. I
Orsat Test
Flnel Plbp. Plbg. Irspsctor - Nofily Plurber
Const. Mefer
EnWJPlan I
eag. Final 'N"4 v
°ock Ftg- 7, 36 vo,- -
oeck FWmi Z ~
I
weli I
ar. oisp. '
I
? • , ,
.
(grxtiftra#t uf (Orruaanry
citp of eagan
~r}~~ n# ~iuildiag ~Jn,~prrxint~
~
T7ets CeWj'raQte tmd pursu"lo the rnqwrmm& ojSecnon 306 of llre Unijorm Building
Code c+A~rjyfiig rlrat e111ie time of iuuanae rlrts gnctur+e xns In oompJia= wi11i rJre rarious ~
ondina~raa~ o. j~lre ('.up ~guladnS bufldin8 oonstrxction ar usG Forlhe following:
uWa.=TwkdGG 4qp TW,!= em& F - xo. 18809
0-va-7 'iRC R3/M h,,... ~ PD/R I VN
ow.~~~ Tm R=ttnm m- Ttar'• 5201 E. RIVFR IiD.,FRIIIlY
L 17, B 1. HMS OF S1IINMIDCE
o„C 6119/91
f
POST IN A OONSPICxJOUS PLACE
~
CITY OF EAGAN NO 18809
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454•8100 C ('ZllJ7
BUILDING PERMIT r_ '
Receipt #
Tobeusedbr SF DWG/GAR Est.Value $79.000 pate MAR 25 , 1991
Site Address 3926 WORCHESTER DR
OFFICE USE ONLY
Lot 17 Block 1 Sec/Sub. HILLS OF
Parcel No. oauPancy R-3 M-1 FEES
Zoning PD R-1
w Name THE ROTTLUND CO INC (Actuaq Const V-`1 Bldg. Permil 545.00
; AddrBSS 5201 E RIVER RD (Aliowable) V-N Surcharge 39.50
0 Cit FRIDLEY phone 571-0304 kolStories
Y Length 45' Plan Review 354.00
, o Name SAME oePm 44' snc, ciiy 100.00
ga Address S.F.TOtal - SAC.MCWCC 650.00
x City Phone S.F. FoalDrinis -
WSi~e Sewage _ aler Conn 660.0
On 0
r
ww Name On Sile Well _ Water Meter 90.00
w
sz Address MwcCSysiem X 30.00
~i Attl. Oeposil
:w City Phone Cnywaier 30.00
PRV Required _ S/W Permit
I hereby acknowleqe Ihat I hav e Ihis ap ication and state that the Booster Pump - Siw Surcharge .50
information is correct and a e t co I pplicable State of
Minnesota SlaNtes antl City E Or ances. APPROVALS 7rea1menl PI 2 7 6. 00
SignaWre of Permi[ee Road Unn 370.00
A Building Permit is issued ta THE ROTTLUND CO INC Pianner - park Ded
on the express contlition that all work shall be tlone in accordance with all CmMiI
applicable Slate ol Minnesota StpaNtesI arndC,it~y. of Eagan Ortlinances Bitlg OfL _ Copies
~
).N(q V\OllA.y ~I Ill,c~ Vananca - TOTAL 3,145.0
Bmlding OHicial
Addness: 3926 WPUESTIIt DRIVE Lot 17 Blk I Sec/Sub HILS,S OF SPONORIDGE
These items were/were not complete at the time of the final inspection.
6 I9 9] Yes No '
Fina1 grade (6" from siding)
Permanent steps - garage ~
Permanent steps - main entry f
Permanent driveway
Pexmanent gas
Sod/seeded grass ?
Trail/curb damage ~
Porch ~
Basement finish
Deck
PLease verSfy vith the bullder the removal of roof test caps from the plumbing
system and the shut-off of water supply to tha outside lawn faucet be£ore
freeze potential exists. ~
White - City copy Yellow - Resident copy Pink - Contractor copy
l oe/
~/o' ~ 94
Repuest Dale ~ Fre No gRin InspecLOn
S Q v ? Reatly Now ill Nolify InSpecftor
~ _Yes C No Whan ReaCy7
I] 6censed contractorp<owner hereby request inspection of above eleclricai work aY.
Job Atltlress (SlreeL Bor or Pou NO ~ Qty
3~a~ Gc~ore~Es~cl~ Seclion No Townshi0 Name or No Rarga No. Counry
Occypawh.'RIFIT) Phone No
--jRn'I£' S r e
Powar SuOPlier AOErass
EiecmcaiGOmracrorlGOmpany Namel ConVa<IOrS ~cense No
o wh
Maning Adaress iCOmracmr or Owner Makinq instanaoon~
r--
ApmOniptl S ~w¢ ICOnIrdClOnOwner M ny InSndlldlionl Phone Numper
r ba(c -es~$y
MINNE50 STATE BOARD OF ELECTHICITY THIS INSPECTION REOUEST WILL NOT~/
Gdgge-MiEway BIEp. - Room 6.193 BE ACCEPTED Bv THE STATE BOARD
1821 UnlvenHy Aro.. SL Peul. MN 551pC UNLE55 PFOPER INSPECTION FEE IS
PMne (612) 64I-0B00 ENCLOSED.
-ooom-oe
REQUEST FOR ELECTRICAL INSPECTION ~
945082 See mslmctions lor complehng Ihis lorm on back ol yellow wpy
/~-~0.L~
~"X" B?low Work Covered by This Requ 1~
,r , J
ew Add Rep Typeo/Bmldmg AppliancesWired EqwpmenlWued
Home Range Temporary Service
Duplez Water Healer Electnc Heatmg
Apt. Building Dryer Other (Specity)
~ Comm./Industrial Fumace
Farm Air CondRioner
Omer syecily) Convac ks.
Compute Inspechon Fee Below:
a Other Fee # ServiceEntranceSae Fee # Cirwits/Feeders Fee
Swimming Pool ~ 0 to 200 Amps 0 to 100 Amps
Transformers Above20D_Amps Abovel00, Amps
SignS Inspecmrs Use Only: TOT~
Irrigahon Booms
Special Inspecuon
Alarm/Communicanon THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MO
I, ihe Electrical Inspector, hereby RO°9n-'" °S i
certify that the above inspecllon has F,,,ai
been made. ~
OiFICE USE ONLY
TM1is requesl voitl 15 montns Imm
~ For Office Use ~
City of Eapn ; Permit#
I Pertnit Fee.
3830 Pilot Knob Road
Eagan MN 55122 Date Received: j
Phone: (651) 675-5675
i ~
Fax: (651) 675-5694 I Staff: I
I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: 3~z ~O wOe e~P?'~~~ 6~
Tenant DdN N A L9 2 y(~- a Suite
RESIDENT ! OWNER Name: Phone' G SI- 2 06 - 3 37/
Address / City / Zip. 39z Wo,~~ ~QS~2 /6,2
Applicant is. 'OK Owner x Contractor
TYPE OF WORK Description of work: ~e °Pccor
Construction Cost: 26 6• e3G Multi-Family Building: (Yes No 1~
CONTRACTOR Name: 7~~ ~GNS~Ru~~id.? G'2e~~ License#: .067, Zo33//Z/
Address: 3 3 M ~ C/e `/i9, a s~
City: P State: ZiP:
Phone: GS/- 7 S7- 0 3 S'L Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy COde . Residenhal Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
(4 submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a pertnit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master planLicensed Plumber: phone:
Mechanical Contractor: Phone:
Sewer 8. Water Contrector: Phone:
NOTE: Plans and supporting documents thaf you submif are considered fo be public information. PoRions of
the information may be classified as non-public if you provide specific reasons that would permit the Cify to
conclude that the are trade secrets.
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit: that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
x ~LV/~CNCC ,J 5-1~ISG X e
ApplicanYs Printed Name A icant's Signa re
Page 1 of 3
'7(/.)- 7 6 30 , s~
2004 RESIDENTIAL MECIIANICAL PERMIT APPLICATION
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. single farttily dwellings & tovmhomes/condos when pemvts are required for each unit
Date ( Z / 2-6
Site Address 3`i2c, l..J U T- ~I c Unit #
Property Owner l-s c- c" Telephone E5 1) f~ g 1- O 2.9-i-
Contractor
Street Address Air Conditionang, YYAC. City
1815 East 41 st Street
State Minneapolis MN 55407 Zip Telephone )
(612) 7241899
Bond`#: 6 G S "A`L9-S Expires: °1 ~ t"I I O~-
The Applicant is _ Owner ~ Contractor _ Other
Add-on or alteration to existing dwelling unit $ 30.00
? furnace _Additional t/Replacement
air exchanger
? air conditioner _New __t,,Replacement
other
State Surcharge 5 50
Total $ ~--J
I hereby apply for a Residential Mechanical Pemut and acknowledge that the info tion is complete and accurate; that the work will
be in conformance with the ordinances and codes of the City of Eagan and with Mechanical Codes; that I understand this is not a
permit, but only an applica[ion for a pemvt, and work is not to start without a p 't; that the ork ' e in accordance with the
approved plan in the case of work wtuch requ'ues a review and approval of plans.
~ ~C, l ~e r
Applicant's Printed Name Ap ic t's Sign ture
RESIDENTIAL
BUILDING PERMIT APPLICATION
G CITY OF EAGAN
3830 PILOT Kg68RD, 1- 675 N MN 55122
651
New Construction Renuirements RemodellReoair Recuirements
• 1:egisterea sde surveys showing sq. Y. cl lcl, sq. 9. of house: anA all roolea areas • 2 copies of plan
(20°'o mawmum lot coverage allowea) . I set of Eneryy Calculations for heated aCCi6ons
• 2 copies ol plan showug beam 3 window sizes; poured found design, ztc.) . 1 site survey for eztenor additions 8 decks
• 1 set of Energy Calculations . Indicale d home servetl by seplic syslem for adailions
• 3 copies of 7ree Preservation Plan d lol platted after 71153
. Rim Joist Detail Oplions selecuon sneet (bldgs with J or less units)
DAiE -1 ` ((-U _Z_ VALUATION
SITE ADDRESS (31 2(O (_,VG'~GG~S-~~.-? ~ MULTI-FAMILY BLDG _Y _N
TYPE OF WORK RlLxpsV P KlgailC,0 FIREPLACE(S) _ 0_ 1_ 2
SELA ROOFING & REMODELING, INC.
APPLICANT
4'.,90 EXGE684AFl136V9.
STREET ADDRESS ST. LOUIS PARK, MN 55416 CITY STATE ZIP
TELEPHONE #Cs~Z'o~23' o`/S2 CELL PHONE # fAX #
PROPERTYOWNER L.ezf:~~ TELEPHONE# C=9-'7- aZg
COMPLETE THIS SECTION POR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Cate9orY >fINN F:S( )"I':A RULL:S 7670 C.1'I'L:GOR1' f 'M IN: ri ~'12[LI~ ~tfIp~ (J submission rype) • Residential VenGlation Category 1 Worksheet Submitted Ne d orkslree uetl
• Energy Envelope Calculahons Submitted U( 1 1 2002
Plumbing Contractor: Plionc n B
Plumbing systcm includes: _ Wa[cr SoEtcncr [awn Spnnkler Pec: $90.00
Watcr Hcatcr No. of R.I. Baths
\o. of Baths
Mechanical Contractor: Phone #
Mcclruucal svstcm indudcs: .1ir CondiUOning Pcc: $70.00
Hcat Rccoccn• $ystcm
Sewer/Water Contractor: Phone #
I hereby acknowledge that i have read ihis application, state that ihe information is correct, and agree to compiy
wiih all ppplicable State of i'vlinnesota Slatutes and City of Eagan Ordinonces.
Signature ot Applicanf
OFFICF. USE ONLY
Certificates of Survey Received Tree Preservation Plan Received _ Not Required _
Updated 4102
OFFICE USE ONLY
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 76 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (a-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08•plex 0 18 Deck Q 23 Porch (screened) ? 36 hiulti
? 05 03-plex ? 11 70-plex ? 19 Lower Level Q 24 Storm Damage
? 06 OA-plex ? 12 12-plex Plbg_Y or _ N 0 25 Miscellaneous
? 31 New 0 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteretion ? 37 Demolish (Bldg)' ? 43 Reraof ?.i6 WindowslDoors
? 34 Replacement •Demolition (Entire Bldg only) • Give PCA handout to applicant
Valuation Occupancy MClES 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
_ Foocings (new bldg) _ FinaL C.O.
_ Footings (deck) _ FinaLNo C.O.
_ Foocings (addicion) _ Plumbmg
Foundation H V AC
Dram Tilz Other
Roof _ Ice &\Varer _ Final _ Pool _ Ftgs _ Air,Gas Tests _ Final
_ Framing _ Sidinq Smcco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windo«'s (nea•'replacement)
_ Insulation _ Retaining Wall
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
1991 BUI~~~ ao tLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS LNLT PI LE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PIANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
OF RENTAL UNITS
OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLAWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
" 2 S RECD
To Be Used For: T~Amie_y Valuation:~-- Date:
~ r.
Site Address 3qzc- OFFICE USE ONLY
Lot Block ~ HJLLS 4~4-- FEES
Occupancy -R 3 M_I Bldg. Permit Sy5,00
• Zoning pD V_-) Surcharge 3940
Parcel/Sub Actual Const V-(y Plan Review &;'y,6a
Allowable V-N snc, cicy /OD,pv
Owner 7zmTTu~NO cm. INC # of stories SAC, MWCC (.JSbL OD
Length Water Conn. 1~, A p,0D
Address y7,,~/. E. ;Ri?~~ pnar=) Depth yy' Water Meter W,pJ
S.F. Total Acct. Deposit 30,00
City/Zip Code =yZ~ Footprint S.F. S/w Permit 30,D0
S/W Surcharge ~ SO
Phone S~v_ c~4 On site sewage_ Treatment P1. DO
On site well Road Unit 3?01OJ
Contractor MWCC System Park Ded.
City water Trail Ded.
Address PRV _ Copies
Booster Pump _
City/Zip Code SUBTOTAL
APPROVALS Penalty
Phone Planner Lot Change
Council TOTAL 3~n
Arch./Engr. Bldg. Off. QS 3-7~_9/
Variance
Address ?
City/Zip Code I
Phone #
agrees that all work shall be done in accordance with
L/(Signafure of Contractor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
'
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2422 Entcrprise Drive
* PIONEER unosunvevows•CIVILENWNEERS Mendota Heights, MN 55120
~ehf7 neerin9.. L1INOPLANNCR3•lAND5Cl1PEARCHITECTS I (612) 681-1914
lf .K I
Certificate of Survey for: TNE ROT T L UND COMPANY
~ WC-SCOT7 ROAD ~
~ ~•89°59`Z5'C. NoR7N
9 85. o0
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w4rZCHcsrER, s. 9~5y Ls w~ -
~
7ELe0NoNE fjo~( '
IN ~RNE y~A~'
. 900.a Dmp/es exisl(nQ flFVarlon PROPUSEO NouSE E[EVATIONS
. yoo.o Dtnofes propaNd Elevotion IowestFloor~levafion = s9S~ 2~
------Denofes Drar'naej util~ fj Easemenf
benofes Orama eFlaw Arrows Top ot'8/oek f/evafiori : 8`18.z~
o Dmofrs monumen} (7ara4e 5/ab E/evafron = 89?•93
BeariI's shown orQ assurned
LOT 11 , BLOCK 1 ~ NILLS oF STOAIEBRldCE
DQKOrA CouNty, M/NNESOTA $UBIECT 7D EASfMENTS OFRffORD
1 herebY certl/y thet thie furvey, vlan or report M
was ~Or~~f ar by me or und my direct supervision and Ihal I am Auly fiegistered Land Surveyor
under Me lews ol the State of Mlnnesole. Dated this_$' ~1av of A.D. tg-V-
SCQle: 1 indT : 40 , re( C--Z-
8 11~~'~QI ORERT R. SIKIOI L5. REG.IJO. 14891
V
131 '
M,~t iT
FY7'F.(iioR FNVrLOi•F. nvh:ICnGI: °U" CWT'IPPr1I'Int7
. o4m ER R~TT L(1 !Jd c.o .
. ~ .
SITE ADD?tESS k_ ( IT~~ I~t-c:cic I {-~'r i~S c'l--~1'1Tn~~
CONTRACTOR DhTF. P}{c)NE
Deterain vorkini; square footar,c o1' each.
1. Total exposed vall area r$ 2b sR. ft. x 0.11 = ZO ~i~8
- 2. Total roof/ceiling area f 2+"jr sq, ft. x 8,026 = 23
•
Total exposed wall area nbovc floor = 1~ zX
a. Total vall vindow area
r b. Total door area 1117fj. i
c. Total slidine glnss door area 3 q,9']
d. Total fireplace wall nrea Z o
e. Total wall framing area (average lOP)
f. Total net wall area nbove floor Z(r ~
g. Total rim joist area JZ a-,f~
Total exposed fnumdation arca = (qZ,
h. Total fcun3et?on vindow a:ea ~
' i. Total net foundstion a:-ea above grade
~ . Deterrr,ine °U" value o; each wall ;ec;ment.
~ a. 1 a X„u„ G, 42 = 67•
b. 38, -7( x.,U„ Q, r 3~
~ C. X „u„
d 2o X,~~„ 2.-
e.. I4G, X.,.U„
f. ~ zq9, 2c, x„U,, p, o~~ = 55.84
. s• r Z4. 8 X.,t,,, p, c~4 ~ = b~ 1 I
h. ~ X
X .,U„
3 .
.
~
If item N3 is the same as, or iess :.h:ln item Nl, you nave met the intent
of sBC 6oo6(c)2.
Totnl exposed roof/ceilinG arel
Total gross roof'/ceilinf, are:+ _
Total skylieht area _
k. Total roof/ceiling framing area..............
~Z¢' 1. Total net insulated roof/ceiling area
Determine "U" vnlue for cnch ruuf/ccilini; scb~ncnt.
X nUn
J. •
Ct- O 2 7 = 3 •
k: X ~~~~l t2
1. I(~~.Cv x„u„ 0.022 = 24,~3 4 . Total
If total oP N4 is the same as, or less than N2, you have met t e intent of
saC 6oo6(c)1. . .
To utilize the total envelope system method, the values establi:hed by the
sum of itens N3 and M4 shall not be 6reater.thKn the sum of iten:s N1 and N2.
1. + 2.
' T. • +4.
• ~
.
. .
~
- o
~ ..-V~F~U~ GAl-GU1-ATIDt~ (GcNr).
rf'AMtl- WAu. (k'I NLi L,AjjoN
LOMPON~-'Ni . . R-~lALUE
aa.{Te~(M AI(z- Fit,M
~
1 2 •J
~U =-.~}gATHIN~ 2; oc~ ~ -
3
~
- 5~2 lNSIlLA'(~cT4 I q. G '
G
u= = G.c43
RraJ~'L
-FFAMO' wAu. ~ 6-T09 .
LoMPON~NTS ~ . - F--VALUL
o_UT.A?10E RdlZ pt,A.
?
~ 2 2 hIDIN~..
3 3 hH5A"jHINb, 2 ,OC.? _
4 c~ h1~.lD(r- 9~,m Fli)
J^ 5 Q~`2:~~P• P~D• 0,4~
_ • ~ C' INSi D~ Aip RLA~1.
- - • ~T~f~.=._II, I C~-
_ p1.~1~• v?eInt.
~1~f3~L
1 `
X o.0b9) t~o,Sb X 0•043> = O, 04-7
-~1 N1 ~Olh I -
~J_•
O p
~ ~'L-F~~
5 -
,J•.; ~2:G: .
Gtz'~ ' ~ ZG %7'i
/
03
~
.
. ~
~ ~
j . ~ i '
I
_t.; = o . I G
L =
: '.~v~rx~~--~uu?~~7T~~ _ ,
,
-~1-~ - - C~ ~G~11~. I N ~uL.:: _2~i • Cp
• ~ ~b . 3,' 'L~_~-~'rGNOl=D. _ .'r~_~ o.. .
O Iha--pcF- -FI~M. -
I
3 4 5 R= 35.-g3
~ = 0, 027
3
\4,• , ~ = p,p22
~ ~
INSPECTION RECORD
CITYOFEAGAN PERMITTYPE: eurLoirvs
3830 Pilot Knob Road Permit Number: 021482
Eagan, Minnesota 55123 Date Issued: 0 7/ 2 0/ 9 3
(612) 681-4675
SITE ADDRESS: Lo r: 17 B L 0 C K: 1 APPLICANT:
3926 WORCHESTER DR ORCUTT JAMES
HILLS OF STONEBRIDGE (612) 298-7871
PERMIT SUBTYPE: TYPE OF WORK:
DECK NEW
INSPECTION .
FOOTING FINAL
F-
L J
, PERMIT /a ?s
~ CITY OF EAGAN '/1' 2 /S~
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55123 Permit Number: 021482
(612) 681-4675 Date Issued: 0 7/ 2 0/ 9 3
SITE ADDRESS:
3926 WORCHESTER DR
LOT: 17 BLOCK: 1
HZLLS OF STONEBRIDGE
P.I.N.: 10-32990-170-01
DESCRIPTION:
B.uilding Permit Type DECK
Building Work Type NEW
: Building Length 24
~ Building Width10
i
~
/ j,.~ ~ '
REMARKS:
FEE SUMMARY:
Base Fee $25.00
Surcharge $.50
Total Fee $25.50
CONTRACTOR: OWNER: - Applicant -
ORCUTT JAMES
3926 WORCHESTER DR
EAGAN MN
(612)298-7871
I hereby acknowledge that I have read this application and state that the
infiormation is correct and agree to comply with all applicable State of Mn.
Statutes and City of Eagan Ordinances.
- J
~APPLICANT/PERMITEE S Rl7 E iSSUEDI RY.iGNATU IE ~
REALTIVATE _RECE~~E ~ 1 s3 BUILDNG EA
PERMIT.~• RMIT AP LICATION
~
I~ J U L 0 6 1993 681-4675 ~
a 49
SINGLE 8 MULTI-FAMILV 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural 3 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 / lv / l253 Yaluation of work
Site A dress: 39~~ 0 nRC,HES"TCfZ,
STREET SUITE M
Tenant Name: (commercial only)
IAT 1-7_ BIACK ~ SIIBD. P.I.D. N
L
Descri tion of wark: E LK
The applicant is: )3f Owner ? Contractor ? Other coeserrba>
Name L2P,lfi T ::5 f°VJE, S Phone (oS'G;
Property LAsT FIRST
-Owner Address29oZ6 f.c)o,~~_~rF s-rc 2
STREET STE /
City G An) State /0 i&J,t,) Zip
Company Phone
CO ntf8Ct0r Address License # Exp.
City State Zip
ArchitecU Company Phone
Engineer Name Registration N
Address
City State Zip
Sewer 8 water licensed plumber . Processing time for
sewer 8 water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the infor~:iation is
correct and agree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
urrwc uat W141..
BUILDING PERMIT TYPE ~ •
O 01 Foundation ? 06 Duplex 0 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. 0 17 Swim Pool
O 03 SF Addition ? OS 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind.
? 04 SF Parch ? 09 12-Plex ? 14 Fir.eplace O 19 Comm./Ind. Misc.
0 05 SF Misc. O 10 Multi. Add'1. I-gt 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
$ir31 New ? 33 Alterations ? 35 Tenant Finish ? 37 Demolish
O 32 Addition ? 34 Repair 0 36 Move
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) lst F1. sq. ft. City Mater
UBC Occupancy ~ 2nd F1. sq. ft. PRV Required
Zaning Sq. Ft. total Booster Pump
N of Stories Foatprint Sq. ft. Fire Sprinkler
Length ~ On-site well Census Code ~
Depth On-site sewage SAC Code
~
APPROVALS °
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
? Site a footing D Framing O Insulation
? Wallboard 6d Final ? Oraintile ? Fireplace
Permit Fee M v~ v.iu.cton: S _
Surcharge , Sv
Plan 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 %
SAC Units
~ * 2422 En~erprise ~rive
FEq LAHDSVPV[Y01MJ•CIVILENGINEERS Mendota Heights, MN 55120
* PG~N OSC
~Qng ~Q~rl n~1-. LI1NOPlANNCR3•L1IN11pE11RCNITEC~3
* ~ ~ I (612) 681-1914
CertificateofSurveyfor:_ rl7E ROTTLUND CQ/NPQnIY
o Wc-sCaTfi 9oA0
89°59'25'E. No4714
89 85. o0
5~ ------------i ,
i ~
i '
i
~ ~ ~f I as.e o~ ~J' .
8 N ~ Ils a r 44 0
i N
PRoPosaot,
~ M I ~ Na~sa I M o
f .
~ S.o-
I ~ i2,;3 I
o UAR' . it.;3 I 896.g~' is.o ~zo.3s~ 899.1
I zc_oo~ ~ yLy~
o I 1 f T ~ o
oO
v
°~c ,•22- 1 yttaicE o , ~{b ~
89[. o raveQ c31~~ / C~
W01Z,CH~STER-~5 ,~5~° w ~ n 1 vc
TECevao,vE go~
fN aarvE' !J~ • 900.o Dtna/es exislfnQ fleVarlOn PROpOSEO NOUSf E[EVATNS
• soo.o Deno{es propo.}~d Elevotion IO
------Denofes Oriarhajufrl~{~ Eas[menf lowest Floor ElevaIion = s9s. Z~
denafes DrrJina ~fe
F
low Arrows Top oi'e1oe4 E1eva11'6f7 _ s98.-z~
o Omoles monumtnf qvrage 51ab E/evafioi7 = g9"7.93
8 e4rin~s shown are assu m ed
LOT lI , BLOCK 1 ~141[L5 OF $TONEBRlaGE
DAKOTA COUNTY, MiNNESpTq SUBlECT 7D EASfMENTS OFQfCOqD,
1 hereby certify thet thin eurvey, plan or report wae Dr arM hy me or und my direct supervisioa and tha; em dul R
w,der 1he lev~n ol the Staee of Minnesote. DatM thh~ ~~g~stered Lend Surveyor
dayof A.D.1g-f/,
/
SCnle : j'"6 _ 4pi2d
OHERT f1.51K1U11.S. REG. Nq. I,sE91
CITY~OFmEAGAN
CASHIER: S TEFMINAL N0: 733
DATE: 09/23/98 TIME: 15:09:25
ID:
NAME: GAS LINE FLUS INC
50.00
3210 9001. 3326 WaRCHESTEk O.gO
2.1.JJ 3o01 3326 WOFCHES7Ek
50.50
To+,al Feceipt Amoisnt:
CF037825
USEF ID: NaNCY
PERMIT
`CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 033506
(612) 681-4675 Date Issued: 0 9/ 2 8/ 9 8
SITE ADDRESS:
3926 WORCHESTER DR
LOT: 17 BLOCK: 1
HILLS OF STONEBRIDGE
P.I.N.: 10-32990-170-01
DESCRIPTION:
Building Permit Type FIREPLACE
Building Work Type ALTERATION
-Census Code 434 ALT. RE3IDENTIAL
REMA~~k'EY/FLUE MUST BE INSPECTED BEFORE CONCEALING.
FEE SUMMARY:
Base Fee $50.00
Surcharge $.50
Total Fee $50.50
CONTRACTOR: - Applicant - OWNER:
GI~1S LINE PLUS INC 12266220 • GEYEN DONNA
4806 RUTIEDGE ST 3926 WORCHES'i"ER DR
PRIOR LAKE MN 55372 EAGAN MN 55122
(612) 226-6220 (651)687-0287
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 ot Eagan Ordinances.
ha~
APPLICANTlPERMITEE SIGNATURE ~SUED BV: SIGNATURE
~ CITY OF EAGAN ~j
s. 3830 PILOT KNOB RD - 55122
1997 FIREPLAC 68 4
ERMIT APPLICATION
DATE: Iq J PERMIT FEE: $50.50 ,
DESCRIPT'ION OF WORK: _ CONSTRUCT NEYV FIREPLACE ALTERATTONS TO EXISTING
_ INSTALL GAS INSERT ONLY
_ INSTALL GAS LINE ONLY
OTI-IER:
STREET ~DRESS: (99 00 rGkP.S )p r OV \ , l C--
LOT BLOCK l SUBD./P.I.D. S
V
APPLICANT: (circle one only) OWNER CGNTRACTO
I hereby acknowledge that I have read this application and state that the information is correct arid agree to comply with
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
PROPER7'Y Name: G e `(-e ~1 ~ 6 Y-\ Phone L g 2
OWNER
Signature:
Street Address:
City: State: Zip:
FIREPLACE Company: Gs, l.t..o pl"., joC Phone
INSTALLER
4806 Eutledge Street
Signature: Mer Lake, AE?i 66e79 SVeet Address: License
City: State: Zip:
GAS LINE Company: Phone
INSTALLER
Name:
Signahue:
Street Address:
City: State: Zip:
J
. a
OFFICE USE ONLY
BUILDING PERNIIT TYPE
? 14 F'ueplace
WORK TYPE
0 31 New o 33 Alterations
? 32 Addition ? 34 Repa'v
GENERALINFORMATION
Census Code. 434
SAC Code Ol
REMARKS
Chimney/flue must be inspected before concealing.
p PERMIT
CITY OF EAGAN ~/7/
3830 Pilot Knob Road PERMIT TYPE: i i n r 111
Eagan, Minnesota 55123 Permit Number:
(612) 681-4675 Date Issued:
SITE ADDRESS:
3926 WORChItSTtR DR
LOT: 37 BLUCI<: 1
HIILS OF SiONF_BRIDGE
P.I.N.: 10-32990-170-01
DESCRIPTION:
,u..iding Permit. Type BASEMENT FINISI-I
:,ij 1('i- i? W o r k lype NEW
IWC f`r.~up.:nr.y R-3
.
~
i
REMARKS:
FEE SUMMARY:
Basc Feo A3S.00
Surcharye --1_50
rotal Fee $35.50
CONTRACTOR: OWNER: Appt~~~nt
oHCUT r I ail i ;
3926 WORCHCSiER UR
EAGA' MIV SS l''i
(612)927-7131
h.vr r;.irl Shi.~ili.Yni' i i:•
ifuiin,.i.iun ca,-r•.c. .,nd , nr.o lo cun.) l~• wl l' oli.,1 I,.h' c.' . i t ,...~li •ii.,I; .
L ~
APPLICAM/PERMITEE SIGNATURE ° ISS ED B GNATURE
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: B u r i n i N c
3830 Pilot Knob Road Permit Number: m;' 0.o Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
i o r: 17 gLOc K,
0^36 WORCHESTER UR ORCUTi JAM`_:;
iilll5 OF STONEBR]DGE (617) 927-7131
PERMIT SUBTYPE: TYPE OF WORK:
RASEMENT FINISH NEW
INSPECTION D. .
FR/1MING FINAI
F
~ -
REACTIVATE, CITY OF EAGAN S,/ c~
PERMIT lf 1993 BUILDING PERMIT APPLICATION
BM6 681-4675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural 8 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 ~ 1993 Valuation of work
Site Address: 39Z<o Worc4erS~'
STREET SUITE N
Tenant Name: (commercial only)
IAT iq_ BIACK ~ SUSD. r ~?~J' , Q~~"~~J,,,, P.I.D. k
~1 tp 1!~1~
Descri tion of work: I~ASem«'~
The applicant is: IM Owner ? Contractor ? Other (Deccribe)
Name OrSar1eS Ppone b86
Property LAST FIRST ~W~Cfo17~~l3f
Owner qddress 3T 2~ CoorcLe-54.C Df.
STREET STE M
City f- oL!~N o,~n State wJti Zip 5-5IZ3
Company Sq m L Phone
Contractor Address License # Exp.
City State Zip
Architect/ Company Phone
Engineer Name Registration N
Address
City State Zip
Sewer & water licensed plumber . Processing time for
sewer 8 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
Eagan Ordinances.
Signature of Applicant: l
OFFICE USE ONLY
BUILDING PERMIT TYPE ~
~
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging -6 BasemenkkFinish
? 02 SF Dwg. ~ 07 4-Plex ? 12 Multi. Misc. 17 Swim Pool
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind.
O 04 SF Porch ? 09 12-Plex ?]4 Fireplace O 19 Comm./Ind. Misc.
0 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
31 New ? 33 Alterations 13 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 Mater
UBC Occupancy i7l3 2nd F1, sq. ft. PRV Required
Zoning Sq. Ft. total Booster Pump
k of Stories Footprint Sq. ft. Fire Sprinkler
Length On-site well Census Code ti 3•/
Depth On-site sewage SAC Code
APPROVALS ~r5«l b«~,. ~
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
? Site ? Footing ~ Framing ? Insulation
? Wallboard ~ Final ? Draintile ? Fireplace
Permit Fee 3:5,v,iuac;on: $
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
LOT L'~- BLOCK L SUBD. d&
RECEIPT # aJ~ / DATE 411A/Y~l
1996 CITY OF EAGAN
IRRIGATION PERMIT (FOR BACKFLOW PREVENTER)
COMMERCIAL INSTALLATIONS: FORM MUST BE COMPLETED BY LICENSED PLUMBER
Date: Commercial GPM
Residential (boulevards) GPM
~ Existing residential
Area/address to be irrigated: 6-) 0 trc-ei~S?"~•~ `~~c~~
Installer: XPo6, &J~
, ~rs Owner ? Plumber`~KD
Street address: 2B & ' 1"7
City, state & zip code: llro . i ~ Alu. Phone
Owner Name• ~s Or c u Q7`
Street address 39d6 Lb /'cG~'~,r Ff r- ,/7e^c
City, state & zip code: flr,/l~< «5~ r~1~ 3 Phone ~o y d rj.Z Z
irrigation contractor, ii di'rferent than installer. ALU u 405y,:~
Telephone ( qi~
I hereby acknowledge that I have read this application, state that the information is correct, and agree to
comply with all applicable City of Eagan ordinances. It is the applicant's responsibility to notify the property
owner that the City of Eagan assumes no liability for any damages caused by the City during its normal
operational and maintenance activities to the facilities constructed under this permit within City
p roperty/right-of-way/easement.
~ /z/ 5- 2L
Applican 's signature Title .
Approved by: Date:
PRV ? Yes ? No New service 0 Yes ? No
Meter Size & Cost
Fees due: Calculated by:
R,;,~ ~ 2 G-
PROCEDURE FOR IRRIGATION SYSTEMS - 1996
An irrigation permit j-a required - please contact Protective Inspections at 681-4675.
Fees
Commerciai project: $25.50 irrigation permit to cover installation of backflow preventer.
• $50.50 water permit fee only if new service is installed.
$300.00 per tap if installed by City.
Residential project: $20.50 irrigation permit to cover installation of backflow preventer.
$50.50 water permit fee if new service is installed.
$760.00 per connection - WAC.
$396.00 per connection - water treatment facility.
Existing residence: $20.50 irrigation permit to cover installation of backflow preventer -(not
required if backflow preventer previously installed).
Meter charge: If gallons per minute are less than 25, a 1" meter will be required at a cost of
$182.00. if gallons per minute are more than 25, a 2" turbo with strainer will
be required at a cost of $822.00. This information is to be supplied by the
designer of the system.
No meter will be sold before all sewer and water inspections are complete on a new service. If new
service lines are not reai i~ red, one check may be written for meter and permit costs. Receipt will be coded
to 20-3716 (meter portion only) with pink copy forwarded to Utility Billing Clerk.
The installer is to contact Protective Inspections at 681-4675 for inspection of the inside water line and
backflow preventer. The Public Works Department may be reached at 681-4300 for water turn-on and set
and seal of the meter. Inspection hours are 8:30 a.m. to 3:30 p.m. Monday through Friday. Requests for
A.M. inspections should be made on the preceding work day. Requests for PM inspections will be accepted
until 12:00 noon.
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA164277
Date Issued:09/24/2020
Permit Category:ePermit
Site Address: 3926 Worchester Dr
Lot:17 Block: 1 Addition: Hills Of Stonebridge
PID:10-32990-01-170
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Paul D Hoyer
3926 Worchester Dr
Eagan MN 55123
Minnesota Restoration Contractors Inc
12252 Nicollet Ave
Burnsville MN 55337
(612) 280-4807
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA165050
Date Issued:10/15/2020
Permit Category:ePermit
Site Address: 3926 Worchester Dr
Lot:17 Block: 1 Addition: Hills Of Stonebridge
PID:10-32990-01-170
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. When a weather barrier is installed or
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 -
Paul D & Karen K Hoyer
3926 Worchester Dr
Eagan MN 55123
(608) 330-2048
Minnesota Restoration Contractors Inc
12252 Nicollet Ave
Burnsville MN 55337
(612) 280-4807
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA169555
Date Issued:06/01/2021
Permit Category:ePermit
Site Address: 3926 Worchester Dr
Lot:17 Block: 1 Addition: Hills Of Stonebridge
PID:10-32990-01-170
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 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 -
Paul D & Karen K Hoyer
3926 Worchester Dr
Eagan MN 55123
Minnesota Restoration Contractors Inc
12252 Nicollet Ave
Burnsville MN 55337
(612) 280-4807
Applicant/Permitee: Signature Issued By: Signature