4813 Weston Hills Dr41'
C!ty of Ea�all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
,iA^, _ 4 2011
Use BLUE or BLACK Ink
Permit #:
Permit Fee:
Date Received:
Staff.
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
`V//
Date � � Site Address:
�if1/3 Gi/s%Yi
J
Tenant: Suite #:
RESIDENT / OWNER
Name: ff��< =u` ice'/ daf- Phone: 6-(.5-7- Y�3 J X36-
Address / City / Zip: 0/1 1497 /W6 ---
Applicant is: Owner Contractor
TYPE OF WORK
/Y 7 74 i44,10,1,5--72 J g,i/�1 !`/
Description of work: �llPr�"
Construction Cost/ (( vf-/a Multi -Family Building: (Yes / No ( )
CONTRACTOR
Name: �f��o,r/4/1'117/.z( License #: o���ot�U/
//"Yen4Se/e,r
Address: 65 U ' 'Z 4 ZlS City: , vel (/�'of7 //4.--
'
State:./1"-/;. = Zip: �Q7j(l Phone: 6/x71 O ,8b 7 9
Contact: /`7( /rahnV 11Email:%c@ ekviieetiegy c y74.f_ G
COMPLETE
In the last 12 months, has
No If yes,
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
the City of Eagan issued a permit for a similar plan based on a master plan?
date and address of master plan:
_Yes
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classifiedas non-public if you provide specific reasons that wouid Permit the City to
conclude that they are trade secrets::_ ... -,
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.cgopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
x ,i aMx
Applicant's Printed Name
Applicant's Signature
Page 1 of 3
%,ertiftcate vf ccc"anc4
Wit4 vf Cfagan
sc;lartllccut of Zri[iiMg 3x60ectinn
This Certificate issutd pursuaRt to the requireneersts of the Uniform Building Code ~
certifying that at the time of rssuance this structun was in compliance wirh rke various
ordinances of tlie Ciry regulating building constnuction ar use. For the following:
Use Clusificmion: SF DW Bldg. Pcrmi[ No. 249%
oa,M,,,,Cy rype R3/M I zmm p;mw, R 1 rra con%i. VN
owow or su;wft 7601 145TR ST W. APPtE VAiIEY
swmft amm 4813 W$S'lLJN FQIZS IJEtIVE LowKy B2. FM MYF. lST
Dam
R M69ding Officia' / .
i POST IN A (bNSPICUOt1S PLACE
INSPECTION RECORD
CI°fY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
PERMI, . T SUBTYPE: TYPE OF WORK:
INSPECTION .
1 PI•-1II l1 t 1I?hl
,'~111:~11 I I'J 1 I i.•, ~t')~~li ~ li ~I I!;~t 1'1 f:7, ~ t1et1
c
i11 hl(1t; i ; I ~ 1 } 1~~, ~ i i ~ 1 It!,
L~ ~
Permft No. Permlt Holder Date Telephons #
, S/4V
PLUMBING ~f9 .~1$Q
HVAC
ELECTRIC • 1 ~~9 9~' 'f
ELECTRIC
Inapectlon Date Insp. Comments
Footings 1 A6
Foundation
Framing i&-,q" 2A,~47
Roofing
Rough Pibg. I 17 ~
Rough "t9
Isul.
Flreplace
Final Fltg. Z-'/` 15,
Orsat Test
Final Plbg. „71-t5 ~ Plbg. Inspector - Notify Plumber
Const. Meter
EngrJPlan
Bidg. Final
Dedc Ftg.
Deck Final
Well
Pr. Disp.
INSPECTION REC4RD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: ,
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: ' APPLICANT:
H S'r 3 . ; t ~ ~ , . , ~ ~,r~ ~ ~ ta•
PERMIT SUBTYPE: TYPE OF WORK:
. . .A
^ ~
ro
, ' ` . . " . . . . . ' f- . , . ~~P iq
ti
~IN
. : - ~ . . . . . , ~
t,. ' - - . ' ~ ~ . . .
~f 4 ~
,s3d .33 3~~t ~ 4 £ l 21, E>
Permit No. Pormit Molde? Date Telephone M
ELECTRIC
PLUMBtNG
HVAC
Inspectfon Date Insp. Coinments
FOOTINGS
FOUND
FRAMING
HOOFINC3
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TES7
BLDG FINAL
BSMT R.f.
BSMT FINAL
DECK FTG ~ j
DECK FlNAL
7
.
Requ st Da[e Fire No. "R ugh nInspection Requiretl Inspection O[her Than Rough-In
(You u t call inspeclor when ready) ~ Reatly Now ~ Will Notily Inspectar
Ves ? N. Date Reatly
I~licensed contractor ?owner hereby request inspection of above electrical work at:
Job dress (Sireet, Bo. ar jioua No.) Giry \
~ Ve~? ~j `,~S
Seclion No. Tavnshlp Name or No. Range No. CouNyDA
Ocwpan~ (PRINT) Phon No
tled ~r 5$- t58'
Power Supplier Atltlress
~
EI r I Conlracl r(COmpany Name) ConVactor's Llcense No.
,~r , c.c~ c~ ~ C S
MaOin Ada ess (COnlracl r Owner Making Installaiion
.QiYVYIrDC~C..
Au orizetl 'gnaN~e Contr o~/Owne~ Making Installation) Pho Nu ber
4~ ~ N. a-so3~
MINN p STATE BDAqO OP CTRICITY THIS INSPECTION REQUEST WILL NOT
Gtlggs-MiEway Bltlg. - Noom S42 BE ACGEPTED BV THE STATE BOARD
1821 Univerelly Ave., St. Paul, MN 55104 I UNLESS PROPER INSPEGTION FEE IS
Phone(61])642-0800 . ENCLOSED.
G~ ;~S REQUEST FOR ELECTRICAL INSPECTION ea-ooooi-os
f'•- 10- See insimctions for compleling this form on Cack of yeltow copy. ~~D 9
X" Be/ow Work Coverea' by This Request
Ne A d Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heatin
Apt. Building Dryer Load Management
Comm./Industrial Fumace Other (SpecNy)
Farm Air Contlitioner
othar (specify) con actor's Remarks'.
Nt c
Compute lnspection Fee 6elow.# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fse
~ Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200_Amps ove 00-Amps
SIgnS Inspeclor's Use Only. T~ AL ~
Irrigation Booms f .r • O
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE D DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Ro.9n-~q oace
certify that the above inspection has F,nai
been made.
OFFICE USE ONLY
This repuest void 18 mon[hs fmm
0=10 5m94 9~
R uest D9 ~ Fir No. Foug In Inspection Requiretl Inspeclion Other Than gh-ln
(YOU mus all inspedor w0en reatly) ~ Reatly Now Wiil Notity Ins~
es ? N Dale Reatl
-ot ~O
I licensed contractor ? owner hereby request inspection of ahov lectrical work
Job=Addrsae (9[reet. Box or Raute Na.) Clry
Sec ion No, Townsni ame or No, Fflnge rvo. Coupy~
Occupant (PRIMF Pho e No.
C
Power S pller Atltlres
~V
^
ElecMC ConVaclor (Company Name) ~ Conhatlor's License No.
` ~ /l H
M iling Atltlress (COntractar or~]Eyner Making Inslallation)
! f . yJ
~L I
Aulhorizetl Slgnatvre (COnVado00wner Mflking Installalion) Ph Number
A, -YX/\L- . s~ ?a - ~
e
p INSPECTION EE D
r 1 ONVOrsty AIe. St ~Pau SMN 55104ICITM II ~I I I II 1 I I I I I I I I I I Ilf THIS UNLESS OSEDOPI T
B F
Phone (612) 842-0800 ENC ~ ~
REQUEST FOR ELECTRICAL INSPECTION ~ ee-ooooi-Tos
- ' 10, See instmctions tor completing this lorm on back of yellow copy. V
10AT "X" 8e/ow Work Covered by This Request
Ne Add Rep. Type of+Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heatin
Apt. Building ryer Load Managemenl
Comm./Industrial umace Other (S ecify)
Farm Air Conditioner -
Other (spxify) ConVactor's Femarks: -
Compute lnspection Fee Below.•
# Other Fae # Service Entrance Size Fee J! Circuits/Feetlers Fee
Swimming Pool 0 to 200 Am s 0 ta 700 Amps
Transformers Above 200_Amps A 100 -Am s
$I f15 Inspector's Use Only: , ~'Q '
Irrigation Booms '~)o
S ecial Ins ection [
AIarMCommunication THIS INS7ALLATION MAY BE ORDERED% CON , IF NCZ
Other Fee ' COMPLETED WITHIN 18/MONTHS.((/
I, the Elecirical Inspector, hereby Rouyn;n - r Date,I
certi that the above ins eCtion has N
been made. P 77nei C i 1" 1v ~,osie
OFFICE USE ONLV
This raques[ voltl 18 monihs imm
0- - 71 ~a q ~aL
Reque Date 1 ~ Fire No. Rau -In Inspeclion ReQUiretl InSpeMian Other TTan ugh-In
(VOU musl call inspecto n reatly) ~ qeatly Now ill Nolify Inspector
Yes No Date Read
I icensed contractor ?owner here6y request inspection of above electrical work at:
Jobhtl ss (SVeel. B. or Rout o.)` City
V 1
Seclion No. own" ame or No. flange No. Counry
0.
Occupant (PFIM) Phone No.
Po upplier Atltlress .
Eleclri oMractor (C pany Name) ~ I • C IrIS L~nse~o~.~ /
/ ( 7 1/ 4
S
V CJ ~
Mailin tltlress Conlraclor r Owner alting Installe~jpp~ , ~07
I~If
/ I V
AuVio' Signature (COmmclonOw Maki g Inslallation)~ Ph e Number
MINNESOTA STATE AH OF ELECTRICITY TNIS INSPECTION AEQUEST WILL NOT
Griggs-Mldway 91dg oom S128 I I I, 11111111111111 I I 1111111111 BE ACCEPTED BV THE STATE 00AFD
1821 Universlty Ave., St Paul, MN 55100 ~ UNLESS PROPER INSPECTIDN FEE IS
Phom (612) 602-0800 1111111 ~ ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION _ .Pe_00907-09
00. See instructians for campleting this form on beck oi yellow copy
d "X" Below Work Covered by This Request
Ne Ada Rep. Type of Builtling Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater EleCtric Heatin
Apt. Building Dryer Load Management
Comm./Industrial Fumace Other (Specify)
Farm qir Conditioner I
O[her (specify) Contraclors Remarks
Compute Inspecfion Fee Belaw.~,P~' ~05r
# Other Fee p Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps Clul 0 to 100 Amps
Transformers Above 200 Amps 100 -Amps
Signs mspector's use Oniy TO Q~
Irrigation Booms ~:1SCO Special Inspection L6~~
AIarMCommunication THIS INSTALLATION MAY BE N
NECTED IF NOT
Other Fee COMPLETEO WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rough-in oate
certify that the above inspection has Finai
6een made.
OFFICE USE ONLY
This request voitl 18 monihs irom
Addtess Z-uiI c,FcmN xrrTS nurvF Zip 5512 3
I.of '2 Blk z Sub PINEs EDGE 1sT
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: 7ps Yes No Inspector:
Final grade (6" from siding)
Permanent steps (gatage) ?
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
TraiUcurb damage
Porch
Basement finish
Deck
Please verify with the builder the removal of roof fes[ caps from the plumbing system and the shut-off of water supply to
the outside lawn faucet before freeze potential exists. Contact engineering division at 681-4645 before working in right-0f-way or installing underground sprinkler system. ~
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
r
PERMIT ce3%11
CITY'OF EAGAN 1;~-Aq -9 L(
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55123 Permit Number: 0 2 4 9 9 0
(612) 681-4675 Date Issued: 12 / 2 9/ 9 4
SITE ADDRESS:
4813 WESTON HSILS DR
LOT: 2 BLOCK: 2
PINE5 EDGE 1ST
P.T.N.: 10-57690-020-02
DESCRIPTION:
Btr
ilding),Permit Type SF DWG
BuildS.ng Wo.rk Type NEW
jjjUBC Occupancy`~, R-3 M-1
/ ConsCruction 7y"p.e V-N
r Zoning R-1
Building Length ( 66
Building Width 36
~ Buildin9 stories ~ 2
-5,~'uare Feet 1,914
;
Cc~"i;~~~i`
REMARKS:
PRV S& W PIBR - FIVE STAR PLBG
FEE SUMMARY:
VALUATION $157,000
Base Fee $839.00 MISCELLANEOUS $1,828.50
Plan Review $545.35 Totel Fee $4,091.35
Surcharge $78.50
SAC $800.00
SAC % 100
SAC Units 1
Subtotal $2,262.85
CONTRACTOR: - Applicant - sT. LIC. OWNER:
MCDONALD CONST INC 14327601 0002376 MCDONALD CONST INC
7681 145TH 5T W 7601 145TH ST W
APPLE VALLEY MN 55124 APPLE VALLEY MN 55124
(612) 432-7601 (612)432-7601
I hereby acknowledge that I heve read this application and state that the
~ 3nformation is correct and agree to comply with all applicable State of Mn.
i Statutes and City of Eagan Ordinances.
L J
p, v~
~ (Na /1
APPLICANT/PERMITEE SIGNATURE (-I55 ED SIG 11TUR
CITY OF EAGAN
I~ 1994 BUILDIN E-467I5 APPLICATION
681 ~ r~, Qq I, 33
oD,l
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site survey , ~y=~tt'~en~j
calcs. CEC 1 5 lggy
COMMERCIAL 2 sets of architectural & structural pla , 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 Valuation of work' Q5, 0 0
6
Site Address: (K)esL,n P,
3 STREEi SUiTE #
4e
T.enant Name: (commercial only)
, LOT Z BLOCK ~ SUBD. ~ ~ P.I'D. #
a
Descri tion of work: "73 J i v. - eA viAN% I o Wt9-
T+he appl i cant i s: 0 Owner ,K Contractor ? Other (Describe)
Name Phone
Property Lnsr F1RST
Owner qddress
STREET SiE k
City State Zip
Company C Co c, Phone /43.~t -7(v01
Contractor Address 7601 IyS~~` s~ ~o License #6oiO237(~ Exp.
City ltOf~~c ~~a~l~v . State 91 Zip S
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 proved.
~ 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. c `
Signature of Applicant:
OFFICE USE ONLY BUILDING PERMIT TYPE ~ ~
~ :
? 01 foundation ? 06 Duplex 0 11 Apt./Lodging O 16 Basement Finish
K 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 17 Swim Pool
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind.
? 04 SF Porch 13 09 12-Plex ? 14 Fireplace ? 19 Comm./Ind. Misc.
? 05 Sf Misc. 0 10 Multi. Add'1. ? 15 Deck 0 20 Public Facility
? 21 Miscellaneous
WORK TYPE
JZ 31 New ? 33 Alterations ? 35 Tenant Finish ? 37 Demolish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION Const. (Actual) Basement sq. ft. (S/ MWCC System ~ •
(Allowable) -rr lst F1. sq. ft. City Water
UBC Occupancy 2nd F1. sq. ft. ~ PRV Required ._x
Zoning ~L Sq. Ft. tatal re Booster Pump
# of Stories Footprint sq. ft. Fire Sprinkler
Length ~ On-site well iv " Census Code _V_57
Depth ~ On-site sewage SAC Code oi
Census Bldg i
APPROVALS Census Unit i
Planning Building Assessments .
Engineering Variance
REGIUIRED INSPECTIONS
? .Site 0 Faoting Z3fFraming iff-Insulation
? Wallboard ElFina1 ? Draintile ? Fireplace
.o
Permit Fee veiuaesoo: 7 000 ~
Surcharge Sf
~T-
Plan Review n z 17
MWCCSAC ' s.13 ° ~ x z _~1L
City SAC /Yx (v7Z ~yK Yfy - YjL
Water Conn. 'L x 3~ " y3L is X av '
Water Meter 's"W 0 - 1 7- 79
Acct. Deposit 6K
S/W Permit 1.5r'
S/W Surcharge ~ ~,s 9ts~s
Treatment Pl. ~ yyz (7 q/v
Road Unit Z Ad~o t-----~
Park Ded. l~~
Trails Ded. Z,~.~3 = 17
ZoK3o -~oo
Copies iyf ~b = b~z zF ~f ° 3~
Other izx 3~ ' ysa ° ~
Total:
SAC % ~•sx/z.6s = /S ~y' ~ =
SAC Units
' -
L ~TftG = /5-l0~ 3 72-
.
P.02
*;c ~ 2422 FntOrprise prlve
* Mandota Haights. MN 55120
*POUMNOM u+w wR.cmns . qNL ENCwEOa (812) 681-9914 FAX: B81-9488
w
* 0 p unD PLANIa19. uxosenne .aaat" 825 Highway 70 N.E.
* * * * 6laine, AAN 55434
(612) 783--1880 F'AX:783-1883
Certificate of Survey for: MCDONALD C()NST.
4813 WESTON XILLS ORIVE
_ WESTON HILLS DRIVE
(UNDER CON31'RUCTION ) ~
~
rPROP09ED CURB
~(987.3) ~(986.9) [(95&A) ~
95r.B 88.00 54° 18'08°E 97.s
BENCH MARK 6 ~5
lUP OF PI PE ~ PROPOSED ~ 9
ELEV.=96752---. M ORIVEWAY BETtCH MARK
700.0 856.6 P---_TOP 4F PIPE
, R 1934o (~6,lT-Trv N ELHV.=95657
1.0 a~' v 12.830 856. 21 81 vi M
° cy; M BARAaE i ~ 22.83 ~ o0
ff) ~ q 9 IBA PROPa6H0 4 Q M~
o'~qI 57.0 ~ SE N~I 1U)
co' 48.0 / Tyy,,~ 3
Y x --I 96A.28
954.96 954,3 CqSS,o) 954.2 ~
9 64.6 ~4.4 953.9'~ 953.9ri~+~Vio t ~LT
F~
g ~~DRAINAiCE 9 x UTILITY g
~ASEMENT PER PLAT~~ (p
N
C - o$ 1 949.2 ~
~
c.,i
POND LP 27.4
]EAGAN E GINLERI&-G DE . (u ~nWLFc9os~wUON)
H W L~9SQ0 ~
\ / (°I 4A•2)
fq42.o) 8a00 SO°08'28°E
- ~a~ol/o ~ U~'l~iLl U~1J
ptOPOSED CRADES SHOV&J PER GRAMa pLAN gy; FIONEER
um¢: alm owc auOaed+s SHM uE Fae Hoazatirw um VOncAL nus CBnFM7E oaes Not qwrant m Suow EASEMP+8
IMA710N OP 51RIlOTRM Ot0.Y. SFE AROifIECNAL PLANS FOR BUADIN{i OIMQt 7XAN 1M08E 910YR1 ON 1FE REOONRD MT.
AID Pd4mA7M OWFN610NS
NU'IE aNmQI0N WSr L+BFJFY tlNVEWAY CEpL SCALE : 1 INCH - 30 F'EET
1107F1 Iq WE(M 591L8 IMYE5bCATlpi XA5 BM COYPLEIEA ql 11tlS 9EAfWIBB BFftlM ANE AM=
wr ev nw sunym. M swrAWn aF goo.s m affaRr me
aMW xwM rqavacw is NO na RCONOGBLtt oF nff suaYEwe.
PRDPOSED FIOU5f F Fl~. AnoN
x auom Denotes ExieUng Elevatbn 95 e, 1
( ooo.w 3 Denotes Propaaed Elevation Lowest Ftvar Qevntion:
Denotes Drainage k Ut01fy Easement
Denotes Dralnage Flow Dtrectton Top of 91edc E1ew?luc 60,0
Denotes Monument c~ ~c~ -y
.--fi- Denotes OHeat Nub Garoge SI~ Elavatlvn:
WE HEREBY CERTIFY TO MCDONALD CONST. THAT T1iIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE SOUNDARIES OP:
LOT 2, BLOCK 2, PINES EDGE l57 ADDIT'lON
DAKOTA COUNTY, MINNESOTA
IT OOES NU7 PURPORT TO SFtOW iMPROVEMENiS OR ENCHROACHMENSS, EXCfPT AS SHOWN, AS
SURI/EYEU BY AIE OR UNDER MY DIRECT SUPERVISION THI 3"AY 0F NOU. , 1994.
RLVl3ED 12-23-94 qNW: p40NEER EtJdN IN
8.
John Lareon 4,S. . o. 19828
9T5 94330.01
R=96% 12-23-94 08:13AM P002 #43
•ia LOT BIIRVEY C$ECRLIST FOR RESIDENTIAL
~ BUILDING ?ERMIT 11PPLICATION
pROPERTY LE6ALS
" eys 9_
~ Date of 7elrl-
ic 1 DOCUMENT BTANDARDB I z~Z-T/
0 • Reqistered Land Surveyor signature and company
Do-1A 0 • Building Permit Applicant
f3~ 0 • Legal description
8' 0 0 • Address
D 0 • North arrow and bar scale
L~
~D 0 • 8ouse type (rambler, walkout, cplit w/o, splft entry,
lockout, etc.)
~ 0 0 • Directional drainage arrows wlth slope/qradient t.
H~ n 0 Proposed/existing sewer and water services
0 • Street name
~ D 0 • Driveway
ELEVATIONB
Existiac
0 • Sewer service
Zr 0 0 • Lot corners
Z~ 0~~C7 • Top of curb at the driveway
D H" D • Elevations of any existing adjacent homes
PIOD09lQ
~D 0 • Garage floor
D~0 0 • First floor
13 13 • Lowest exposefl elevatfon (walkout/window)
0 • Property corners
O 0 • Front and rear of home at the foundation
PONDING AREAS !if aDDlieable)
• Easement line
0" D 0 • NwL
0 0 • HwL
0/0 • Pond # desiqnation
D V 13 • Eaergency Ovetflow Elevation
DIMENSIOIQ6
PI~D D • Lot lines
[~~~,0 D • Right-of-way and street width (to back of curb)
H~ 0 D • Proposed Aome dimensions includiag any proposed decks,
overhangs greater thah 21, porches, etc. (i.e. all
structures requirinq permanent fcotings)
H~z3 D • Show all easements of record and any City utilities within
those easements
lr-13 0 • Setbacks of proposed structure an8 setback of adjacent
existing homes
,3 0 • Retaining requirements, if any
Reviewed: ~
Na e / ate
OCtober 1992
8"=11 f}` B~ND L5= ybti.~ Va- auu. i ; I l~J- JJ.J.J ,
• ~ `t , _ ~ ~ ~
1 1 I."__________'__. 1._.."_'
• 1
1 '
5 p2_E 7+-00
N»--H1L
,
,
g,
~ - ~ - _ ~ ~
~r•`, ~ I 1 I ; ! ' ~
8"X6"TEE
" S= 0+35 S= 1+25 S= 2+12
6 9v 0+24 INV= 946.9 INV= 946.2 INV= 945.5
INV= 947.8 ~1 CS= 956.9 ~ j CS= 956.2 CS= 955.5
CS= 957.8 ~ O;
"cv 1 2
8"-11 BEND
fY5 ~ ' _ ' ~ -
MH ~ q STA:--2~ 32.36 - 4H - ~.--5 A. -3±~,2
.
~ 3
. ~ ,
,
"
~ ~
°CAP
NOTE:
~ WM BY OTHERS LOTS 2,3,4,5,..8~9Ci~-~!-t~WE$. COPPER
SEf2VIC€S~ TO MAINTAIN 2' SEPAI2A710N
,.--FROM STORM SEWER A1 CROSSING.
. ~1.,
' .i / \ _
ELEMENTRY SCHOOL #18
.
a_F
-~kLS DRIVE
~r...... . . . . . . . .
, ,.1~~. ; . : . : : . : ' : . . . . : . . : ~ . . : . : . . . . : ~ ' . ~ : . . : .
THc CI i YC;?FcAGAN DOES NQ? GUARANTEE . :
=f, : TIiE AGCkIRACY OF :UTIUTY LOCATIOUS :
. : : . . . : . . . . .,4r,`„J./na: .7I:FVAT10N$.: TN.IS. DATa; IS . rOR . . . : . . : . . . . . .
.
?Nt='~3'n;."Af ;OiJ PURPOSES Or:L:Y AND :
: : Pc~ R,5C?:«:U1DING IT $HOULD "E("rV ThEE, :
'~L;;. . . . .
[f~ ~_I'C<Rf.1,, r,-,,~d.i .
. . : O;U ON THE SITE.. .
. . . . . . .
.qY:. . . . . . . . . . . . . . . . . . . . . . . .
5.53.:: ; . . . . .
. : . . . : . : : :
. . . . . . . . . . . . .
REr 957.82
' S1:D=15.53 : : . . . . .
. . . . . . . . . •
. . . M}{ RE=957:03• . . . . . :
. . . .
. . .
. . . . BtD= t4.~3 : . . . . . . . . . . . . . .
.
: . : . MH RE=953.86 ~ • : .
rvM: To 951.75 BLD=9:36
TORM: CRO55tNG EXISTlNG: GROUND : ~ . . .
LAtE WTH 64 L.F.• FINISHED GRADE
4'x 8`• RIGID STYROFOAM . . . . . . . . .
. . . ~ : ' _
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:
. . : 7.5' MfN.
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. CO •5¢8.85 ~ .
_ / : • ~12 RC~
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. . I_ . . . . 5~ f . . ,
~ . . . . . .
~ 4DC}'=$"PVG SDR 35 0 0.40%
'vC .SRR: 35. : . . . . . .
. .
. . . . , .
. . . . . .
. . .
: . . : : : : . ; . . TEi= AGCJPiACY , OF- UTILiV LbGATlONS. . : : : . . . : : . : . . . .
. .
. . AivGf071 LLE`'t'TION(v. THIS DA7r\ !S aOR -
. : : . . . . . . : . : . EP'E a~, ~~i`O~d• RUR~OSE~: : r+,'Ly : qP~b : . . • : • . • ~.y. . . . . : . .
.........o.a a
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HIN}JRS%...A STATE RNERGY CODS CALCULePION9
- BASED ON CIIAPTEA 5 OF TIIE
HQDEL ENEflGY COD,F - 1983 EQITjQj(
Ndoption Effective
Owner PLAE S /Y!/J P 1 T- Phone Date
site ?.ddress
,Contractor ~wNSr F ne
Bullding Classitications Type A1 (9ingla Famlly 6 Duplex)
Type 112 (Residential, 3 etories or leee) (Over 3 etoriea) (Other)
a0'1'6: Complete peges 3 anot4 d 4 Piret. , 9.EHL$8j_jbFORHA'j'70d N
. 4 ,,(~~,J
1. Buildinq Perimeter Dl'--rJ''& ft,
N
2. Wall height (ground to eave) ft. 7. 1. X Z. (above) gross wall area ZS~7 eq.ft.
4. Bulldinq dlmensions (L) - X(W) -IoOT sq.lt.rooE i floor area .
5. Sq. foot area of rim joist - F ooT joIigt size 2 X',L )
% ~
.10 ~ (Perimeter) = ZZ4 eq.[t.
12
6. poors - Arga / ( ~
Thickness in U. Yeator , ~
Type o[ Conetruction • Perimeter Lt.
. Manuiacturer
7. Total doorte perimeter !t.
~
e. Windowss Hanufac urer liAr~ ~ 3tate approved
U factor .3 ~
, TYPE BIZE 1RE11 (3q.Ft.) NLMBER OF " TOTAL
BACiI UNI't3 9Q FSET
9. Totel sq.ft. Glaee 71210
10. Flreplace atea: Nidth X lteight - X a eq.ft. ,
- 11. Exposed foundation: iteiqht R Perimater•RL14=q sq.ft.
COMPLETIOti OF THIS FORH IS REQUIRED FOR ALI. NEH CONSTRUCTION, HAJOR
• AENODELING AtID BUILDINGS BEING HOVED WIIERE ENfiAGYO OTIIER TIIAN TIf6 IiINTHAL
CODE ALLOWATICE, IS USED.
-1- .
04 zq4
li. Framinq area = lo$ grose wall erea.
13. Gross Nall area O eq.ft. .
Window area a vZ-[/ eq.ft. U windows ~ .NO UxA A.~
Rim joist area A_jZ-7 A
4;~_sq. ft. U iim joiat= , o~ 1 UxA m
Door area A sq.ft, U door area= UxA ~
other doors area A_4L_?_sq.ft, U other doore=_L~ UxA =
' Exposed fndit A-- I q8_sg,pt. U foundation-.sQ4o UxA =
Framing area eq.ft. U framinq srea= UxA -
' Net wall area AI~4Z3~ aq.ft. U wall= (A7 UxA
_ (178) TOTAL . . . . . . . . . UxA = Z~
14. Gross wall area x 0.11 (A-1 single family & duplex) = allowable UxA/Code
(13. abcsve )
x 0.23 (A-2 other reeidential) ' •
. x .27 (other buildinga)
x .28 (over 3 etoriae)
ZS'D~ 1/ ~W (d BTUii muet be larger than or eame
A x U Code ~ °F. ea 138 aCove
15. Ceiling fraininq area (Af) equnls lOt of ceilinq area
15A. Grosa ceiling area = (L) x (W) jQ~sq.ft.
258. Joiat area (Af) A 10% ceiling area ~ 1C.(Jl4 Bq.ft.
~
15C. Net ceiling area (Ac) (15A - 15B) ~(99 6q.ft.
u ceiling x Ac _~L~ x•D7/I
D ftaming x A f -_f~'_x . Z e Z
.15D. TOTAL U x A ZZ
16. Ce111ng area (15A) x 0.026 (]1-1 eingle family & duplex)
• a sllowable UxA/ 9ode
x 0.033 (A-2 other residential)
x 0.05 (other)
x BTUH must be larqer than or same
A(15A) U Code ~ u OF. es 15D above
NoTS: Use U aml A vslues obtained from pages 2, 3 and 4.
QE[iTIF.IjQB,'Tj_Qb: I hereby certify thak x have calculated the "U° Pactors and
°R" values hereLn and that the buildinq hare deeoribed meeta or exceede the
State of Hlnnesota 8nergy ConBervntion Ack. .
Date 9lgnature
-21
*1dtV oF eegan
THOMASEGAN
Mayo[
PATRICIA AWADA
SHAWN HUNTER
SANDRA A. MASIN
THEODORE WACHTER
CITY OF EAGAN CouncilMembers
PINES EDGE ADDITION THOMAS HEDGES
CONDITION OF BUILDING PERMIT CityAdministra}or
E.J. VANOVERBEKE
City Clerk
I, (3,,b I~c i J n~. \ cl~ , am the permittee and/or owner
of Lot Two Cz) , Biock 2, Pines Edge Addition, located in the City of Eagan, County
of Dakota, State of Minnesota. I acknowledge and agree that Eagan Public Project No.
673R is necessary for proper and sufficient drainage for Lots 1-6, Block 2, of Pines Edge
Addition. Further, I acknowledge that prior to the completion of Public Project No. 673R,
a potential for flooding and/or water damage to Lots 1-6, Block 2, Pines Edge Addition,
or any structure thereon exist.
Based on the foregoing, I acknowledge and agree that the permittee and/or fee
owner releases and holds the City of Eagan harmless from any liability, claims or
obligations of any kind or character, whether arising out of the City's failure to issue the
Certificate of Occupancy until Eagan Public Project No. 673R is complete and any
flooding or water damage to the property prior to the completion of Public Project No.
673R.
Dated: a 1994
G,/!
By:
Its:
MUNICIPAL CENTER THE LONE OAK TREE MAINiENANCE FACILITY
3830 PILOT KNOB ROAO THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNI7Y 3501 COACHMAN POINT
EAGAN, MINNESOTA 55122~7897 EAGAN, MINNESOiA 55122
PHONE: (612) 681-4600 PHONE: (612) 681-4300
FAX: (612) 681-4612 EqUpl OppoftUnliy/Afflrmdtlve ACilon Employer FAX: (612) 681-4360
iDD:(612) 454-8535 TDD:(612) 454-8535
CITY OF EAGAN ~ 3
~ 3830 PILOT KNOB RD - 55122
1995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
, 681 -4675
ii New Construdion Reauirements RemadeVRepair Reauirements
? 3 registered site surveys ? 2 copies of plan
? 2 copies of plens (include beam & window s¢es; poured fid. design; etc.) ? 2 slte surveys (eMarior addiiiona & decks)
1 energy calculations ? 1 energy calculations Por heated additions
1 tree preservation plan it lot platted after 7/7193
' required: _ Yes No
, DATE: ~5 3~ q.S CONSTRUCTION COST: ~ S ~ ~ • ~
~ DESCRIPTION OF WORK: Iv F~ Dec-~ -
j STREET ADDRESS: h.
- LOT c~ BLOCK SUBD./P.I.D.
i
PROPERTY Name: Phone
. • OWNER
Street Address-
City: State: Zip:
CONTRACTOR Company: A 1d C o~.~.~ S ke.- Phone 1432 - 7GO (
` Street Address: )6pf /NS~~ st W License 0 cD 0 2 3
Clt~/: A AD n I e UA11 e~1 V~I S.S
ARCHITECTI Company: Phone
ENGINEER
Name: Registration
Street Address*
City: State: Zip:
Sewer & water licensed plumber: Penalty applies when address change and lot
change are requested once permit is issued.
I' 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:
OFFICE USE ONLY
Certificates of Survey Received ? Yes _ No MAY 2 5 1R95
Tree Preservation Plan Received _ Yes _ No
. ~
OFFICE USE ONLY 1
BUILDING PERMIT TYPE , .
0 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex ? 12 Multi (Misc.) ? 17 Swim Pool
0 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. 0 10 Muiti (additionallW- 15 Deck
WORK TYPE
,zK 31 New o 33 Alterations ? 36 Move
0 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MCNVS 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 Census Bldg
Census Unit
APPROVALS
Planning Building Engineering Variance
~
Permit Fee Valuation: $
Surcharge
Plan Review
License
MCM/S SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SNV Permit
SNV Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
% SAC
SAC Units
P.02
ww~mi. '
~C 2422 Enterprise qrlvs .
19!ndota Haights. MN 65120
* Mie~'~p ~M~~ A1RKWfl5 • qNL EnCmlNC~ (512) 681-191 M1 FAX: 681-9488
* 0/1g-ftewp uxn ru.~. iu,oscere MnancIs 025 Hl9hwoy 10 N.E. '
glaine, MN 55434
~ (612) 783-1880 F'AX:783-1883
Certificate of Survey for: MCDONALQ CQNST.
4813 WESiON HILL3 DRIVE
_ WESTON HILLS DFtiVE
{VNDER CONS7RUCTlON~
t ~PFtOPOSED CURB
F0 ~ (9873) ~(956.9) ,,j(956.A) M
esa.e 813.00 $O°I$'08"6 9~8
(95111 ~ww~c~o 1~ tA S4a,'?~
BENCH / 00 5 - .ti. iM6~H4B.9 ~ ~g ~ 1
lUP OF PIPE ~ pROPOSED ~
QEV.-987.62-~. ORIVEWAY ) BENCH MARK
~ 57.OfRS4.~~ 856.6 ' ~~rTOP OF PIPE
, 419.340 C'0"iN a-EV.=956,57
. V
V~ 1.0 N/ a 12.B3p 96& 21 In
~ q OARAGE I ~
Q
fN dl m ~ 22.03 -I o0
- 9 IB.O PROP ED ol M~
M
o I 967.0 ~tI0U3E N~! tn 3
I ~
U,1 ~8.o i~ 1964.28
954.46 954.3 q 55, 954.2~
954.6 L 954!1 s53.9X 993.~ ~~t_.° V ~ b t f~T
g1~,vD`RA1NNGE 8 UTILI7Y g~ ~tr L~-
I EASEMENi PER PIAT-,-,,,.
cV
saaz a
~ K 2 /
sy ~ ~n
~ ~ PONb l.P 27A p
'1` (UNbEfl CON37RUC ION)
~i~i's/L~''1 Ll'VTGiIJ~!;i:i{f1'k1V1T'i 'T. HWL,05Q0 '
\ / (q 4p.z.)
fq42,o) SS.W 5U°06I28E
1J•S [N0 0 ~ 1;~ Q
raoro9Fn cnAO6s aHOVM PER atNHNO MM BW. _ PIONEER
NOIEt S1RDMC CIIAH9W9 910MN ME Fdl H0111Za17TAl ANO VA71CAL 01I9 CF77T61CATG DOE+" NOT {'URPdtT TO SHOW EA4111RJi5
IOGMIH OF 54M1CN11F5 OMY, gE AR6111ECNAL PLM13 FOk BU0.DIH13 •7111172 THIW iH09E SNOYM ON 1FIE RECOROED FUt.
NKI FdltilAllON W1FNgONS
NOtFi tYP.:7RA0ia11 Ytlsr VFAIfY DItl1£WAY OEStCIL SCALE : 1 INCH = 30 rEE7
H01F1 NO S'EQFW 97118 ?7VESUCATIO!! HAS BEFN COMPLElEO OH h113 0EMN09 94011IN ME A591AAFD
LOY BY 1HE SUHILYpi. 711E sUtT18N1TY OF YOd4 t0 BUPPaRT 111C
srEaFlC NoUS6 PfidroSiD 14 NOT hl[ RCSPOH961Utt OF hi[ ARIVEvai.
oononCm Hl]IICF FLEVAl10N
x ooo.oo Denotes Exlsttng Elevatlon 9$ Z, I
{ cao.oo y.A6notaa ^rcpaadCievuiiw :.oiHSSt ^acr E16rGL'cn: ,
- - - Denotes Oramage k Utility Easement
Denotee Dralnaga Flow Directlun Top of Block Flevatlon:
--9T panotes Monumen! 2 ~~9 _7
-a- Denotee Olfsat Nub Gamge 51ab Elevatlon:
WE HEREBY CERTIFY TO MCDONALD CONS7. 'lHAT TNIS IS A TRUE AND CORREC7
REPRrSENTATION OF A SURVEY OF iHE BOUNDARIES OF:
LOT z, QLOCK z, PirvES EdGE 15T ADDCfiON
DAI<OTA COUNIY, MIN14E507A
IT DOE5 NO7 PURpORT TO SHOW IIAPROVEMENIS OR ENCIIROACHMEN7S, EXCEPT AS SHOWIJ, hS
SURVEYED BY ME OR UNDER MY OIRECT SUPERVISlON 1}il -23 AY OF NOV. , 1994 •
~REVI3ED 12-23-94 IGNED: PIONEER ENG1N ING. A.
/f o C. anon L.S. eg. o. igBIW
978 94330,01 R=96% 12-23'94 08:13A1A P00.'. 114J
PERMIT 01119196
0
~ CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Num6er: 025745
(612) 681-46Z5 Date fssued: 0 6/ 0 8/ 9 5
SITE ADDRESS:
4813 WESTON HILLS OR
LOT: 2 BLOCK: 2
PINE5 EDGE 15T
p.I.N.: 10-57690-020-02
DESCRIPTION:
~ .
$~ildin~;~~Permit Type DECK
e,~ui.ldinc~ ad,rk 7ype NEW
~
fz
s4~M1
41 •4t. . -•-i4wv':u 3. ~td':'ab jP3.
Cd w ~ R ~r
Y ~
'0y~,..°
V2 ~e
DI
`w ~S f
v a ,W,,d ~A ~l ':r t'~
c
REMARKS:
FEE SUMMARY:
VALUATIpN $1.2N0
Base Fee $30.00
Surcherge $.50
Tatal Fee $30.56
CONTRACTOR: - Applicant - 5T. l.xC OWNER:
MCptlNALD CONST INC 14327601 0602376 MCDONAID CONST
7601 145TN 5T W 7601 1 145TH 5T W
APPLE VALLEY MN 55124 APPLE VALLEY MN 55124
(612) 432-7601 (612)432-7601
i, . I hereby icknow7:edi7;e that Y have read this ap;Rlitr$t#an and atate that th'O
' informatzvn is cvrt-set and agree to ccrmplY with a17.aPPlzcahle si'Cat~ pf Ptn.
t ~
; statutas ansl Ci.,ty vf Eagan Ordinc:anc'69
. .
~
APPLICANT/PERMITEE SIGNATURE ISSUED B: SI ATUR
,
CITY USE ONLY
L a BL a RECEIPT#:
SUBD. oi~ a., C2G~. DATE: ~ 9 9S
1995 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
New construction Add-on fumace
Add-on air conditioning Fireolace canversion (to existing fireolace)
Date: ~ - 12 - i~
FEES
" ? Minimum Fee: Add-on/Remodel (existing residence only) $20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
.
Gas Outlets (minimum of 1 required @ $3.00 each) CFO
? State Surcharge .50
TOTAL 39,60
SITE ADDRESS: yY13 ~~STDN ~r I LL~ ,
OWNER NAME: 11)0A1V41-Q 6N67- . PHONE y~ '760 j
INSTALLER NAME:
II
_ STREET ADDRESS: ~D9 ZND ST
cin: ~y,~miNGrnN STATE: AN ZIP: 5~~2
PHONE#:(6l2 ) 1&0 2t- ~ ~ -
,
STG ~ 1'r
I
CITY U3E ONLY L BL RECEIPT
SUBD. DATE:
1995 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 687-4675
Please complete for: ? all commercialfindustrial buildings.
? muiti-family buildings when separate permits are nDi required
for each dweiling unit.
DATF: GONTR,ACT PR1CE-
WORK TYPE: NEW CONSTRUCTION INTEFtiOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: ~$25.00 minimum fee gE 1°k of contract price, whichever is greater.
• Processed piping - $25.00
• State surcharge of $.50 per $1,000 of Dermft fee due on all permits.
CONTRACT PRICE x 1%
PROCESSED PIPING
STATE SURCHARGE
TOTAL
SITE ADCRESS:
OWNER NAME: TELEPHONE
TENANT NAME: (IMPROVEMENTS ONLY)
INSTALLER:
ADDRESS:
CITY: STATE: ZIP:
PHONE
SIGNATURE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
~ CITY USE ONLY
L ~ BL ~ RECEIPT
SUBD. v DATE: / 9 S
1995 PLUMBING PERMIT (RESIDENTIAL)
` CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
' (612) 681-4675
Please complete for: ? single family dwellings
, ? townhomes and condos when permits are required for each unit
, FIXTURES EACH NO. TOTAL
Shower 3.00 x 3,00
Water Closet 3.00 x y. 00 ,
~ Bath Tub 3.00 x -3 00
Lavatory 3.00 x = l~. do
Kitchen Sink 3.00 x = Uo
Laundry Tray 3.00 x ~ = 3 Oa
Hot Tub/Spa 3.00 x ~ _6~
Water Heater 3.00 x = z! Dr)
Floor Drain 3.00 x
Gas Piping Outlet * minimum -1 3.00 x
Rough Openings 1.50 x \ S'"
Water Softener 5.00 x =
Private Disposal " Dakota Cty. license 20.00 =
U.G. Sprinkler ' home under const. 3.00 =
Alterations * to existin9 20.00 =
Water Turn Around 20.00
STATE SURCHARGE .50
, TOTAL
SITE ADDRESS: ) , rv ~~~~~h
OWNER NAME: lI~~ ~0 n a l CY ~ v~ ~C rv'U.G ~ OVi hC .
INSTALLER NAME: S Q 1^ U`h ~ i h ~hG
STREETADDRESS: ~ To-1i/c, L7
' CITY: C)Ad Ly J STATE: ZIP:
PHONE
CITY USE ONLY
L _ BL _ RECEIPT
SUBD. DATE:
1995 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Piease complete for: ? all commercial/industrial buildings.
? multi-family buildings when separate permits are mQt required
for each dwelling unit.
DATE: CONTRACT PRICE:
WORK TYPE: _ NEW CONSTRUCTION ADD ON REPAIR
DESCRIPTION OF WORK:
FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge of $.50 per
$1,000 of permit fee due on all permits.
CONTRACT PRICE x 1%
STATE SURCHARGE I
TOTAL I
i
SITE ADDRESS:
TENANT NAME: STE. # ~I
OWNER NAME: INSTALLER:
ADDRESS:
CITY. STATE: ZIP:
PHONE I
SIGNATURE:
APPLICANT CITY OF EAGAN
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA133504
Date Issued:10/16/2015
Permit Category:ePermit
Site Address: 4813 Weston Hills Dr
Lot:2 Block: 2 Addition: Pines Edge 1st
PID:10-57690-02-020
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 -
Bradley P Haus
4813 Weston Hills Dr
Eagan MN 55123
(651) 315-9584
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
!"
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