4299 Wexford WayCity of Eapll
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Permit #. 9(7 z7_
Permit Fee: ��
Date Received:
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit #:
RESIDENT /
OWNER
Name: 324,v ,. -Li fit / Phone:
/
Address / City / Zip: t/ Tq(1.9ex 4, W' -j7
Applicant is: .-owner Contractor
TYPE OF WORK
Description of work: 404 ce- 'IJr,-.5 Witli t/QJrt 5a0) , 40 cr1u '-i-
14-7e4-
''''
it
Construction Cost:' 3� Multi -Family Building: (Yes / No K )
CONTRACTOR
Company: 5�./4 Contact:
Address: City:
State: Zip: Phone:
License #: Lead Certificate #:
If the project is exempt
from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
Yes If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
_No
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE; Plans and supporting documents that y04.'a' Oiitare considered td be public information "Portions of
the information' maybe classified' as non=public rf youprovide specific reasonsthat would 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.gopherstateonecall.org
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.
✓ l' ( e - Cif x kkt c% t
Applicant's Printed Name App icant's Signatkf-
Page 1 of 3
!r -
y ~ ~Y
~~e~~.ca#e o~ ~ccu~anc~
~m Of sum"% 3notctioM
This Certificate issaed pursuant to the nquirrnrents oj the Uniform Building Code
certefying that at the tinu of issuance lhis srrNCtuir was in compliance with the various
oidinancts of the City rrgWating brtilding caRStruction or use. For the follawing:
.
Uw Cbudka6w SF jDGiG/GAR em& pemit N,. 27396
O-P-Y Type R-3 U-1 7w:g Dw;a R-1 Tya co~. V-N
omm d~dn LIFESTYLE NOMES 1NC Ad6. 1489 I.AKE PARK C1RCLE, EAGAN, MN
g,,;W&g Ad&m 4299 HEXFORd WAY Local;y L14, B1. WERFORD ?ND 55122
i Do= ,
4wiam offi -.i
P06'T W A OOWSPK,UOUS PLACE
INSPECTI4N RECORD
CITI'•OF EAGAN PERMIT TYPE: '
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued: 1 N f 1 r,h
(612) 681-4675
SITE ADDRESS: APPLICANT:
~)t. xt t)hU 44 HY
~
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION DA . D.
t t~n 1 I id~~ r,~~+tlf+i, ! I~~t.t
t R4 1?'d!.
! r1".UI i! ~iI`d I I I.1 f1~ 1
i iY~~i~ i I ~:i~ ~ !!l:•,!
~ ~
Permit No. Permlt Holder Date Telephone #
- ELECTRIC AW
~
~ • PLUMBING OVo74:71
HVAC <j
Inspecdon Date Insp. Comments
FOOTINGS
FOUND sX17(/-f
FRAMING ~F
ROOFING
ROUGH ~ O
PLUMBING ,y
PLBG
AIR TEST ,
ROUGH
HEATING
GAS SVC
TEST
12
INSUL
! [ wc.~
GYP BOARD •
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
' FINAL HTG
~ ORSAT
TEST
4 BLDG FINAL
i BSMT R.I.
BSMT FINAL
DECK FfG _
DECK FlNAL
- - _ i
i
L__.. _ . .
~
Address ~ 4299 WEXFORD WA1 Zip 55122
IAt 14 Blk 1 Sub WEXFORD 2ND ,
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date: 916? 41F (v Yes No Inspec[or:
Final grade (6" from siding)
Permanent steps (garage) f/
Permanent steps (main entry) V
Permanent driveway ~
Permanent gas ~
Sod/Seeded grass UO
TraiUwrb damage ~
Porch
Basement finish vl~
Deck ?
Please verify with the builder the removal of roof test caps from the plumbing system and the shuhoff of water suppty ro
the outside lawn faucet before freeze potential exists.
Contac[ engineering division at 681-4645 before working in righFOf-way or installing underground sprinkler system. ~
White - Ciry Copy Yellow - Resident Copy Pink - Contractor Copy
2 7 O- O/~ ~ ~ OFFIC USE O LY This raquest.oid IB monihe Imm volidabon dme pnnted in Ihis bo:.
r ~ 1~~9/p.
Hd
PLEASE PRINT OR TVPE
L'it
Reqoes Da Roogh-in inspadian reqwmdi Yes ? Na Impeaion Olher Than kaogh-la ~ Raody Now Will Coll
f0 Q~ ~Yov m~a~ mll ihe mspedor wA reody~ Date Read~.
I, $Jicensed mnfmclor 0 owner here6y request inspedion of fhe above electrical work af:
Job /ddress (Streel, Bo~, o~ Rauro Na.) Gry Zip Code
yZ g 9 C(,QX 16;fx;
Seaon No To..nship Nome or No. Range No. Fire Na Coun
~~0 ~
p«~p ni Phone No.
Irr«- 716 4
Powe/r'y pplier Pddrea
~(//!-Kc i7a L~T•~°! ~ ~fh2m iivl~ ~D N
EIMn Connaaor (Cqmpony Nome~ Comratlor licenve N. Mmror Lc No (PIan1 Elen. Only)
//i~,j~ ~,CECT•e.e ~i~c. C~Ao/f/3Z
Mailing Mdress (Conimdo, or Owner PedorminB smllanon~
~yd / Jy{/o~'m~J vK o• '~~.~0 Loo~.N c~t N.~'Ss'.~/
Aulhonxed nmure (Ga clor er Pedormng InsMllabon) P~
JLe~-.~j~
Ee-00001A-10 6/95 STATEBOAfiDCOPY -SEEINSTNUCTIONSONBACKOFYELLOWCOPY
REOUEST FOR ELECTRICAL INSPECTION~?Z~9.
IpI Miryiesota State Board ot Electriciry
I I~ 11 1821 University Ave., Rm. S-1 8, St Paul, MN 55104
* 0 7 0 0 3 6 7* Phone (612) 642-0800 'j
Home Duplex Apf. Bldg. G!+er. New Addn
Cammercial Indusfrial Farm Remod Re air
Av Cond. H}g. Equip Water Hfr. Load Mgmt Ofher:
D er Ran e Elec Heat Tem . Service
"X" obove the work coveied by fhis request. Enter remarks in ihis space ond on the back of ihe whRe copy only.
Calculate Inspection Fee - This Inspechon Request wJl nof be accepfed wdhouf fhe cortect fee:
Other Fee # Service Enhance Size Fee Circvits/Feeders Fee
Mobile Home Park Stall 0 to 200 Amp #
s ~ 0 to 100 Amps Q
5}reef L}g /TraHic $ig. Above 200 Amps Amps
Tmnsformer/Generafor INSVECTON'SUSEONLY OTAL
Sign/Outline Lig. Xfmr. /~D ~ 0 ~
Alarm/Remofe Con}rol ~
$wimming Pool I here6 cem 1hat I ms ened me insiall o d h e dme, smmd
Irrigotion Boom kough-in • ~7~~
$pecial IativenspeFee dion '
Final aro ~
Invesfig '
THIS INSTALLATION MAY BE ORDERED DlSCONNECTED IF NOT COMPLETED WITHIN 1 B MONTHS.
~ CITY OF EAGAN PERMIT
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 2 7 3 9 6
(612) 681-4675 Date Issued: 05/ 01 / 9 6
SITE ADDRESS:
4299 WEXFORD WAY
LOT: 14 BLQCK: 1
WEXFORD 2ND
P.I.N.: 10-83851-140-01
DESCRiPTiON:
,Building-Permit Type SF DWG
'6uilding Work Type NEW
UBC Occupancy R-3 U-1
Construction Type V-N
' Zoning R-1
Building Length 67
Building Width ~ 42
~ Building stories . 2
'$qua.re Feet . 2,059
eens+us-'Code~ 101 1- FAM. OETACH
REMARKS:
S& W PLBR - VALLEY PLBG
FEE SUMMARY:
VALUATION $149,000
Base Fee $1,132.25 MISCELLANEOUS $1,923.50
Plan Review $566.13 COPY $.50
Surcharge $74.50 Total Fee $4,596.88
SAC $900.00
SAC % 100
SAC Units 1
' Subtotal $2,672.88
CONTRACTOR: _ Applicant - sT. LrC.OWNER:
LIFESTYLE HOhIES INC 14547866 0001288 LIFESTYLE HOMES INC
1489 LAKE PARK CIR 1489 LAKE PARK CIR
EAGAN MN 55122 EAGAN MN 55122
(612) 454-7866 (612)454-7866
I'
I hereby ecknowledge that I have read this applicaCion e'ind state that the
infiormaCion it correct and agres to comply with all appliicable State of Mn.
~ Statutes and City,of Eagan Ordinances. ~I
i I
~o~.~.~°~ R.
APPLICA T/P RMITEE SIGNATURE ISSUED BYIGN RE
CITY OF EAGAN 4 'r -nL r7 (1
3830 PILOT KNOB RD - 55122 `Ti y 1ti b
14.39L996 BUILDING PERMIT APPLICATION (RESIDENTIAI:)
6e14675 New Construdion Reouiremenls RemodeVReoair Reauirements
? 3 registered eRe surveys ? 2 cropies of plan
? 2 copfas ot plana (include beam 8 window sizes; poured (nd. design; elc.) ? 2 site surveys (e:terior additions & decks)
? 1 energy ealculations ? 7 energy caleulations for healed addilions
? 3 copies of tree preservetion plan H lot platted efter 711l93 required: _Yea _ o
DATE: 7 v CONSTRUCTION COST:
DESCRIPTION OF WORK:
STREET ADDRESS: L4
LOT BLOCK SUBD./P.I.D.
PROfPERTY Name: Phone LIs(A-29p(o
OWNER ~ f~ •
Street Address-Cl"~
City: State: ~ Zip: 651 Z2-
CONTRACTOR Company: c~tJVl.11(1R n c, aPhone 4 sA -lflb6
Street Address: License ntvc-~M
City: State: Zip:
ARCHITECTI Company: Phone
ENGINEER
Name: Registration
Street Address- I
City: I State: Zip:
',~•Jn(~ ~
Sewer 8 water licensed plumber: 1JJl~A Penalty applies when address change and lot
change are requested once permit is issued. l
1 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 Applicank
OFFICE USE ONLY FECF- ~ D jCertificates of Su rvey Received Yes o ~ Tree Preservation Plan Received Yes No
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
"n' 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
0 03 SF Addition o 08 8-piex ? 13 Garage/Accessory o 20 Public Facility
? 04 SF Porch o 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. 0 10 = plex ? 15 Deck
WORK TYPE
` 31 New ? 33 Alterations ? 36 Move '0 32 Addition ? 34, Repair , a 37, Demolition
GENERAL INFORMATION ' • • ,
Consk .(Actual) !a-- /y Basement sq. ft. ~OSZ MCNVS System OC
(Allowabte) Main le'vel sq. ft. '27 City Water
UBC Occupancy 2-714-i, 2~ sq. ft. 4Yy Fire Sprinklered
Zoning 110-1 sq. R. PRV
# of Stories 24t35,,r. sq. ft. Booster Pump
Length , '/l.s sq. ft. • Census Code. Ol
Depth S~/-s" Footprint sq. ft. yi os'T SAC Code
Census Bldg ~
APPRONALS ~I Census Unit
9 ~ ~
- ~s
Planning Building Engineering Variance
Permit Fee Valuation: $ dC%O ~
Surcharge A yi,y
Plan Review
License 2 x G -1 z
3xZ~.ss-79 --/,279
MCNVS SAC z
= U ~
City SAC Z z yo.1J ~ 4/ y~ 6
Water Conn. /zf~ SG-11 ~ 7°y
Water Meter 1rx S. -zs ° SY ,o
Acct. Deposit 4 s~ 3s- = z Z~ ~Yxzs)
S/W Permit c~ ° - • . , $py y)
S/W Surcharge s--
Treatment PI. 3•rr 9's ` i
Road Unit z = ~s '7fJO
Park Ded. G-BI = 9 lj/l4 -
Trails Ded. ~ Z?X sy= ~ S
Other ' , fx i~ ~ "
Copies e5v P~/,06G 3se z~.yz _ 1~7
Z~&0-
rotat:
Ylx zGS
°k SAC /3z37-~` ,c ~ /
SAC Units
~roFG r L6~ oo
'
.
' 2422 Enterprise p,„^
A;,erid0'o Fiei9ht5, MIN jJ12U
* PIONEEFI (812) 881-1914 FAX:681-9488
LAVD SbR~TCfiS • CIV4 [hqNEEiS
~ enginc:er n-~ g Lu+c oi.YN_RS• ~.Nc;cn^c Arsnlr_crs 625 Highway 10 N E.
BlOine, N,N 55434
(612) 783-1880 FAX:783-1883
Certificate of survey fol,: _LiFESTYLE HOMES
4299 NEXFORD VJAv
.
rn
' N
~ °Q S89°43'31"E 63.68
,.N89°4331°WNQ o
, 18.44•-
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5
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ul ~ - - - - -
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r
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940 7 (1 416, ~
9a3.9 5.~J2 9at.4 11.
94-2.9
o~ ~ r16.00 ~
i DtCK FOSED o I
945. HOUSc ~
D M/Z4'17 L //O I ~ W
? ~ o 4 ~ N
EAGANEIVGI~TEER.INGY~P'1 f N' ~ncE n~'~.~~Q •a.t' I~aSi .i
Z 12.00,~
BENCH N.ARK ",;.[0 UUo; 12.'9
T0P OF PiFE 5 / --/i- ~ - - 1---~- -
945.9
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ORiVE4'dAY ~
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p-- - - 56.11 wAY
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NOTE. RhUPOSEC Gl.'~ES SHOWN PEA CFIA7~NC PLA:J 2Y, aia~EER PRGPUS_O HS!,ll`ir ELEVATISZN_
NO".' °UIl01NC O;%IENSICNS $HOWN ARE FOR HOR4CNTA~ A'JJ 'lEB71CAL LOCATI01! ~ ~ Q
CF ST~2VCTURES ONLY. SEF ARCHIlEC7UAL PLANS fUZ 6UIi.DINC AIJD LUF/E~T FLOnR _LEVA i;O;:'
~OUNDATCN 01-nENS10NS~ C
TUP OF Bi_UCK ELt~'~'~~0'~.
NOTE: `'0 SPECiFIC $OILS INVESTIGATION HA5 BEF.N CONPLF_7ED ON Tw, LU7 BY T4g
SuRVE.vO;. iHE SUiip3iUTY 0° SCn_5 i0 Sut?CF.i iNE 5"Eri,'C HOUSE GARA'uE SLA9 ELLVATfOIJ:
FROPOSEP IS ItOT 1TiE RESPONSiBiL;TY OF 'InE SUiVE'fOn.
!:pYE: THIS CERTIFI[al!; DOE3'N01' PURFJRi TO SHOW ENSEVCNTS OTHEH THAN % ODOAJ DENO?=5 EX~StING KLE'~AiiO`V
TNOSE 5410N'N CN rNE'RECCF?EG PLnT. ( DOO.co ) GEnUtES %RO°OSC0 EL:.'i^Ti^':
7EN0'ES OR4INAUE f~0 uTI,17Y Ea,SEU[~'i
CO~ITRAC'+94 MUST 'dER~FY [7PodEwAY DE~~LN. pE`:+)TES CRRINhCE =1.0'N DinECi,V;
NO7E, BEARINGS SHO,YN xRE:8 A5t0 CN PN ASSUVEO UATUU GENOTE.`. ~~ONU!~ENS
I OENOTES 0'SET 4'U6
WF N"cRtBY CERTIFY TO LIFESTYL_ HOMES i!'Ai THIS I; N TRU` Fli\D GORRtCi RtfRESEN'"A'I;OP: OF a
SURvEY Of 1NE CfO'JN"uARIES OF:
LOT ,14, BLQCK 1, WEXFORD 2NU AQDI710(V
DAKOTA COUNTY, MINNESOTA
I'; DOi 5 ~;OT ~URPOrT TO SHOW I!1PROVESGcNTS OR =NCHROACHMENTS, cXCE°T AS SHOVIN, P.S SURVaI't~,7 6„ V_, Oi?
Uh'DER 6dY'11f1CCT SIiF?rRVS10id THIS 15SH DAY OF P,PRIL. 1996-
G~vEp~~'.ONEEr: ENG:;v~Ertird~J F'.a.
8
SCALE : 1 1NCH 30 FFE f ~ c
CJII/~. JJJTL.O) JWK
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
~ PROPERTY LEGAL:
DATE OF 96RVEY/
LATEST REVISION:
o ~ DOCUMENTSTANDARDS
z
• Registered Land Surveyar signature and company
a-'o ? • Building PermitApplicant
M--'[] ? • Legal description
El,~o a • Address
&-'o o • North arrow and scale
B~~ ? • House type (rambler, walkout, splft w/o, split entry, lookout, etc.)
~o ? • Directional drainage arrows with slope/gradient %
2~ 13 ? • Praposed/exdsting sewer and water services 8 invert elevation
B-O O • Street name
4,-,0 ? • Driveway
ELEVATIONS
Edstlna
• Sewer service (or Proposed)
z'o 0 • Property comers
' 13 ? • Top of curb at the driveway
13 d11 • Elevations of any ebsting adJacent homes
rosed
4~ ~ ? • Garage floor
cp~ • First floor
ar- 13 ? • Lowest exposed elevation (walkauUwindow)
~ ? • Property comers
~ ? • Front and rear of home at the foundation
PONDING AREA fif aoolicablel
? Q--~ ? • Easement line
? d ? • NWL
? Llr ? . HWL
? ~ ? • Pand # designation
? p,-' O • Emergency Overflow Elevation
DIMENSIONS
• Lot lines/8earings 8 dimensions
a • Right-ot-way and streef width (tn back of curb)
Kl~ ? ? • Proposed home dimensions including any proposed decks, overhangs greater than 2',
porches, etc. (i.e. all structures requiring pertnanent footings)
2-,? ? • Show ali easemenLs of record and any City utilitles within those easements
e" ? ? • Setbacks of proposed structure and sideyard setback of adjacent existing strudures
? z`o • Retaining wall requireme~ if any
Reviewed: z `
me / ae
January 1998
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15+00 16+00 17t00 ' 18t00 19t00 20t00 21+% 22t00 23t00 24t00 25-E00-ES~'REET STATIONINGI~ /I O I 0
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CITY USE ONLY j
L~ BL ~ RECEIPT 56260 9
SUBD. DATE: 5111219lo
1996 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN I
3830 PILOT KNOB RD I
EAGAN, MN 55122 ;
(612) 681-4675 I
Please complete for: ? single family dwellings 'i
? townhomes and condos when permits are required for each unit
~
FIXTURES EACt( TOTAL
Shower 3.00 x
Water Closet 3.00 x 3 q-
oeih TiiS 3.00 ii
Lavatory 3.00 x 3
Kitchen Sink 3.00 x
Laundry Tray , 3.00 x
Hot Tub/Spa 3.00 x
Water Heater 3.40 x t = 3-
FloorDrain 3.00 x L 3-
Gas Piping Outlet ' minimum -1 3.00 x I = I 3-
Rough Openings 1.50 x =
Water Softener 5.00 x =
Private Disposal " Dakota Cty. license 50.00 =
(new and refurbished systems)
U.G. Sprinkler " home under const. 3.00 _I
Alterations ' to existing 20.00 - ,
Water Turn Around 20.00 I
STATE SURCHARGE j .50
~c, ~0
TOTAL
ll
SITE ADDRESS: n
,i
OWNER NAME:
~
INSTAILER NAME:
I
STREET ADDRESS: (o A ~~"N
CITY: STATE: vU- Zip; i s s 3s ~
~
PHONE (
~
.5fU F'LKMI Tr I
~
i
~
OFFICE USE ONLY
L BL RECEIPT
SUBD. DATE:
1996 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681 -4675
Please complete for: - all commerciaUindustrial buildings.
p multi-family buildings when separate permits are pgs required for each dwelling
unit.
DATE: CONTRACT PRICE:
VJOnK iYPE: tiEVJ CONSTRUCTION ADD GiJ RcFAIR
DESCRIPTION OF WORK:
IS WATER METER REQUIRED? _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING:
WATER FLOW: GPM. ARE FLUSHOMETERS TO BE INSTALLED7 YES NO.
FAILURE TO PROVIDE THIS INFORMATION WILL RESULT IN A DELAY OF METER ISSUANCE.
WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? YES NO.
IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINKLER PERMIT.
FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge of $.50 per
$1,000 of pQrmit fee due on all permits.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL
SITE ADDRESS:
TENANT NAME: STE. #
OWNER NAME:
INSTALLER:
ADDRESS:
CITY: STATE: ZIP:
PHONE SIGNATURE:
APPLICANT
OFFICE USE ONLY
METER SIZE: DATE: INSPECTOR:
CITY USE ONLY
L BL ~ a RECEIPT
SUBD. hd'l ~ N~ DATE: ~ 5 y~
1996 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 furnace
Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc.
Date: ~ m
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)
? State Surcharge .50
TOTAL ~~-'0
SITE ADDRESS:
OWNER NAME: ,I'FP , S41P. k-)}'V)cQ.n PHONE
INSTALLER NAME: ~ ?
STREET ADDRESS:R~ nO 1 Y/.0,
CITY: IrLVP.V AlY[SV2 STATE: l/Y!/IJ ZIP: 55077
PHONE#: (IjclZ) L4 ~n(4 " 'RL9lsl4
~
CITY USE ONLY
L BL RECEIPT
SUBD. DATE:
1996 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? all commercial/industrial buildings.
? muiti-family buildings when separate peRnits are ~t required
for each dwelling unit.
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: o $25.00 minimum fee g_r 1% of contract price, whichever is greater.
0 Processed piping - $25.00
State surcharge of $.50 per $1,000 of pffmit fee due on all permits.
CONTRACT PRICE x 1%
PROCESSED PIPING
STATE SURCHARGE
TOTAL
S!TE P.DQRESS:
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#: ~T77/r/S
SUBD. l.l ~ WG~O/C.ol ~N~ RECEIPT DATE: 7--~/q 7
1997 PLUMBING PERMIT (RESIDENTIAL)
ciTr oF encaN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: . single family dwellings
• townhomes and condos when permits are required for eacfi unit
• backflow preventer for underground sprinkler system
FIXTURES EACH NQ, TOTAL
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 Outlet ' minimum - 1 3.00 x =
Raugh Openings 1.50 x =
Water Softener ' for dwellings under consWCtion 5.00 x =
Water Softener ' for existinq dweiunq 20.00 x =
U.G. SQrinkler ' kr dwelling under wnst. 3.00 = O
~ O.G. Sprinkler\' for existing dwelling 20.00
Alter2tlOnS ' to existing residence 20.00 =
Water Turn Around 20.00 =
Private Disposal System ' Dak Cty lic. 75.00 =
(new and refurbished systems)
Private Disposal Systems'ntandanmenc 20.00 =
STATE SURCHARGE SOo
TOTAL
aC s~
I hereby achnowledge that I have read this appliptbn, sfate that the informafion is correct, and agree to compty with all applicable City
of Eagan ordinances. It is the applicanPs responsibility to notify the properry owner that the City of Eagan assumes no Iiability for any
tlamages caused by the Ciry Ounng its normel operetional antl maintenance aetivities to the facilities constructed under this permit within
Ciry property/right-of-way/easement.
SITE ADDRESS:
OWNER NAME:
INSTALLER NAME: TELEPHONE
STREET ADDRESS:
cin: fi~-f~/~'/ STATE: ziP: S512- 2
(Ji L bi 7-c 225-fi
/ S NATURE OF PERMITTEE
J~ ~
S00'd iVy01
3220 Denmark Avenue • Eagan, MN 55121
(ss1) 452-2323 • Fax: (551) 994-9416
~
Apri128, 2009
Subject: Inspection of Exterior poor by, City of Eagan refused by Customer Prnnit ~
#L"A86710
Jofin Avery
4299 Wexford Way .
Eagan, MN 55122
To whom it may concern:
Our 'vistallers have tried to get customer to schedule inspection since Novembcr of 2008
for Pecmit #iEA86710 to no avail. We coniacted customer and asked him to call the Ciry
of Eagan and told us he was not going to schedule the inspection. Thank you for yow
help on this matter.
Tharilc you,
Home Depot Eagan Store #2813
USA
~
I00i100'd LT46466T59 ESBZ ,LOd3a 3WOH BS:Zi 600Z-8Z-2IdV
Lib6b66tS9
Cities Di ital Quality Control
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Aihernatr Buildlnl; knretope Cesoqn
+ 9.
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4299 Wexford Way
Lot: 014 Block: 001 Addition:
PID:10- 83851- 140 -01
Use:
Description:
Sub Type:
Work Type: Reroof & Siding
Description:
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 6,000.00
Contractor:
Sela Roofing Remodeling
4100 Excelsior Blvd
St. Louis Park MN 55416
(612) 823 -8046
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
Wexford 2nd
e- Reroof & Siding Construction Type:
Census Code: 434 - Occupancy:
BL - Base Fee $6K
Surcharge - Based on Valuation $6K
- Applicant -
$132.75
$3.00
$135.75
Owner:
John W Avery
4299 Wexford Way
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
0801
9001
Issued By: Signature
Building
EA082361
03/26/2008
ePermit
Reroof: If there is no ice protection inspection prior to final, you must meet inspector with ladder and flat bar.
Siding: When installing ventilated soffit material, remove existing material (ie: debris that could block vents) and take steps
to ensure maximum ventilation to attic. Call for final inspection after installation.
Jen Ulick
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply
of Minnesota Statutes and City of Eagan Ordinances.
h all applicable State
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4299 Wexford Way
Lot: 14 Block: 1 Addition: Wexford 2nd
PID:10- 83851- 140 -01
Use:
Description:
Sub Type: e- Windows/Doors
Work Type: Windows/Doors - New/Replacement
Description: SEE COMMENTS
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Crew2 Inc
2650 Minnehaha Ave
Minneapolis MN 55406
(612) 276 -1680
PERMIT
City of Eaan
4/28/09 Received a letter from Home Depot (Crew2 Inc
inspection on his windows. pf
Permit closed without required inspection(s). Letter sent to applicant on 4/15/09. (pf)
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total:
Applicant/Permitee: Signature
- Applicant -
Construction Type:
Occupancy:
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Building
EA086710
10/08/2008
ePermit
s the subcontractor) stating that the homeowner refuses to have an
$90.00
Owner:
John W Avery
4299 Wexford Way
Eagan MN 55122
$88.50 0801.4085
$1.50 9001.2195
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4299 Wexford Way
Lot: 014 Block: 001 Addition: Wexford 2nd
PID:10- 83851- 140 -01
Use:
Description:
Sub Type: e- Windows/Doors
Work Type: Windows/Doors - New/Replacement
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Crew2 Inc
2650 Minnehaha Ave
Minneapolis MN 55406
(612) 276 -1680
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
- Applicant -
Construction Type:
Occupancy:
$90.00
Owner:
John W Avery
4299 Wexford Way
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Permit closed without required inspection(s). Letter sent to applicant on 2/2/2010. (pf)
Building
EA090681
08/17/2009
ePermit
Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
$88.50 0801.4085
$1.50 9001.2195
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply
of Minnesota Statutes and City of Eagan Ordinances.
h all applicable State
Issued By: Signature
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PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA129339
Date Issued:02/02/2015
Permit Category:ePermit
Site Address: 4299 Wexford Way
Lot:014 Block: 001 Addition: Wexford 2nd
PID:10-83851-01-140
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Applicant: Heather Winn
21210 Eaton Avenue
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Peter A Davich
4299 Wexford Way
Eagan MN 55122
(651) 357-8361
Controlled Air
21210 Eaton Ave
Farmington MN 55024
(651) 460-6022 X253
Applicant/Permitee: Signature Issued By: Signature