4516 Whitetail Way
CITY OF EAGAN SEWER SERVlCE PERMIT
3830 Pilot Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 p^TE: •
Zoninp: No. of Unlts:
Ownar:
Address: _
Site /lddress:
Plumber: • .
I r/IM tO OOeIply Mkb the Cky Of a'Ow COII?NC«011 (hQ1al: r ,
"MIKM. AOODUM DQpodf:
Pllfllit FlR: Surdwrye:
By Mise. Charpes;
date of Inap.: Totah
Insp.: Dah Paid:
- _ . .a.,
' CITY aF EAGAN 1NATER SERVICE PERMIT
3830 Pllot rmob Road '
P.O. Box 21199 PERMIT NO.: 934%
Eagan, MN 59121 DATE: 1-6-87 _
Zoning: :.1 No. of Units: I
Owner. '
Address:
Site Addess: a- 51 Fi i,11, i rPr a i T TJa3, T.4 n4 zwtt P. i r' ,,P 7 T
~ Plumber. r'
Meter No.: 5' Charge: 110 _ nr-,P(I
.*.r., .
Size: oc ~ccount 0eposit: ;p",
Reader No.: 074 r V~" ~~9~leS '1~~~~?
I agree to comply wRh pthe C(ty g FCr&'rcl'e
Ordin ea. r~ E 'tU I i,.Cha~g~g; TP
~~AW _5C!n:t mr,Yar
Y Date Peid:
~ ate of Insp.: Insp.:
a- /3~ g 7
3830 Pilot Knob Roadi P.O. Bo 2G-A199, Eagan, MN 55121 ! v2 "12897
PHONE:454-8100 ; -
BUILDING PERMIT ReceiPt #
To be used tor SF DM+G/CYAR Est. Value $75,000 Date I`jOVEi•:BER 20 ~g86
Site Address 4 516 WHITETAIL WAY Erect 12; Occupancy K3
Lot-4 Block 4 Sec/Sub. FAWN R IDGE 2ND Remodei ? Zoning Ri
Parcel No. Repair ? Type of Const v
Addition ? No. Stories
cc KFI,CRIS Ii~1(; Move ? Length dA
= Name Demolish ? Depth A u
3 Address 1020 146TH ST Int Impr. ? Sq. Ft
° City 8' V ZLL~hone 4 3 2-8131 Install ?
o Name t1CAPPIsL INC Approvata Fres
~ 358.00
~ i Address SAL' "f' Assessment Permit
cc City Phone Water & Sew. Surcharge 37.50
179.00
~ Police Pian Review
F W Name 1'ROHE ENGR Fire SAC 575.00
z
Address 1000 E 146TN 5T Eng. Water Conn. 500, 00
!gc W c;ry ri' VILi.4one 432-3000 pianner Water Meter 63.50
Council Road Unit 290.00
I hereby acknowledge that I have read this application and state-Mat the gldg. Otf. 11/2 0l8 Tr. PI. 156.00
information is correct and d ' grde to comply with all applicaple State of
Minnesota Statutes and Cjt~ o Eagan Ordliria~ 440. APC Parks
'A;N.;1~ Var. Date Copie
Signature of Permittee $ 2,1 . 0 0
Total
A Building Permit is issued to: MC}1PPEL INC on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
Pwmll No. Pnmit HoWw Dde TNaphone M
Plumbiny
H.V.A.C.
EI•ctrre
r'
Softanar
Inspoclion Dab Irnp. CommeMs
Fooflrtps 1
Footinys II
Foundallon
Frsminp
Rooilny
Rouqh Plby. Y/S.
Rouph Ntq. ~
Inaul. ~
Fk.plac.
Flnd Htp.
Final Plbq. -If- T ~
Bldp. FMaI
CeA.Oca
Dsck Fty.
Dock Frmy.
WMI
Pr. Disp.
. . .Y . : +5,~ •k • . . . : ....rv . S' : ' , :S.'; . . .n .
- h' . .,ti . . . . . . . . ;
PERMIT #
MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE
CONTRACT PRICE: PHONE: 454-8100
Site Address 4- '7 BLDG. TYPE WORK DESCRIPTION
Lot Block Sec/Sub
Res. ~ New ~
i r
~ Name (y~ult • Add-on
Addre
Comm. Repair
c Cily ~ Phone Other
Name FEES
c Addres? 6 /"-4-/ RES. HVAC 0-100 M BTU _ $24.00
p City Phone ~-y~ 'D ADDITIONAL 50 M BTU 6.00
AOD-OIV A4R COND. 0-24 STl! - 12.00
ADDITIONAL 6 M BTU - 6.00
T1~PE OF WORK ~ GAS OUTLETS - 1.50 EA.
ForCed Air S~~UM BTU COMM/INO FEE - 196 OF CONTRACT FEE
Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00
Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00
Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50
Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES
~ BEYOND $1,000.00)
Gas Piping Outlets #
Other -
FEE
S/C: SIGNATURE aF PERMITTEE '
TOTAL :12
FOR: CITY OF EAGAM
. . y.. ` . . . . . .M' .
PERMIT
' . PLUMBING PERMIT
CITY OF EAGAN RECEIPT ~k
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE PHONE: 454-8100
Site Address • BLDG. TYPE WORK DESCRIPTION
Lot Block Sec/Sub Res. >S~ New
Mult. Add-on
~ Name ' 1 , Comm. Repair
m Address Other
c City Phone ' RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Name ~~+~+ater Closet - $3 00 S ~
` , Bath Tubs - $3.00 ~
3 Address '2 Lavatory - $3.00
p City Phone , - irl Shower - $3.00 31
~Kitchen Sink - $3.00 %
FEES Urinal/Bidet - $3.00
COMM/IND FEE - 1% OF CONTRACT FEE Z Laundry Tray -$3.00
APT. BLDGS - COMM RATE APPLIES ~Floor Drains -$1.50 S
TOWNHOUSE & CONDO - RES. RATE APPLIES Waler Heater -$t.50
MINIMUM - RESIDENTIAL FEE -$12.00 Whirlpool - S100
MINIMUM - COMM/IND FEE -$20.00 Gas Piping Outlets -$1.50
STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMI7)
{ADD $.50 S/C IF PERMIT PRICE GOES Softener -$5.00
BEYOND $1,000.00) Well - S10.00
Private Disp. - $10.00
.
Rough Openings - $1.50
IGNATURE OF P RMITTEE FEE:
. ~
STATE S/C:
FOR CITY OF EAGAN GRAND TOTAL:
CITY OF EAGAN
3830 Pllot Knob Road, P.O. Box 21-199, Eagan, MN 55121N2 V 1 897
' PHONE: 454-8100 6 V
BUILDING PERMIT Receiptp
To be used for SF DWG/GAR Est. value $ 75,0 0 0 Date NOVEMBER 20 1$ 6
SiteAddress 4516 WHITETAIL WAY Erect 99 occupancy R3
Lot4-Black 4 5ec/Sub. FAWN RIDGE 2ND Remodel ? Zoning R1
Parcel No. Repair ? Type oi Const. V
Addition ? No. Stories
~ KELCRIS INC Move ? Lengtn aR
z Name Demolish ? Depth48
# Address 1020 E 146TH ST Int.lmpr. ? Sq.Ft
° Ciry B' VILL*hone 432-8131 Install ?
o Name MCAPPEL INC Approvals Fees
$6 nddress S~E /+ssessment Permit $ 358.00
' Ciry Phone Water&Sew. Surcharge 37.50
Police Plan Review 179 . 00
W8w Name PROBE ENGR Fire SAC 575.00
~a nddress 1000 E 146TH ST Eng. WaterConn. 500.00
Q W Ciry B' VILL$hone 432-3000 Planner Water Meter 63. 50
Council Road Unit 290.00
Iherebyacknowledgetha Ih vereadthisapplicationandstatethatthe gldg.OH.ll/20/8 Tr, pi, 156.00
iniormation is correct an a ee to comp with all applic State oF
Minnesota Statutes and ry( Eagan in nces. APC Parks
Vac Date Copies
Signature of Per e Total $ zi1$ 9. 00
A Building Permit is issued to: M APPE INC on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and Ciry ot Eagan Ordinances.
Building Official
~ RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EACAN MN 55122
E~ L+ 651-681-4675 ~
New Construction ReauiremeMs RemodellReoair Reouirementa Q.a~
• 3 reg'xtered site surveys showing sq. ft ot lot, sq. ft. o( house; and all roofed areas • 2 copies of plan O
(20%mazimum lol coverege allmvad) • 1 setof Energy CalculaUons for healed additions
• 2 copies of plan showing 6eam 8 window saes; poured found design, etc.) • 1 sife surveyfor exterior additiorta & decks
• 1 set of Energy Calculations . Indicate'rf home served by septic system for addil'wns
. 3 copies of 7ree PreservaGon Plan if lot plafled aRer 711183
. Rim Joisl Detail Oplions seleIXion sheet (bldgs wBh 3 or less unils)
DATE A a 1 6~ z.m'i VALUATION It 1`'l
SITE ADDRESS ~~5 l6 wi...4t-Vti,N w-..4 MULTI-FAMILY BLDG ,Y ZN
TYPE OF WORK ,rJ<.., a...-u- FIREPLACE(S) _ 0_ 1_ 2
APPLICANT 40Ld 81[ W~rw&'J
STREETADDRESS 3431 STATE w!~ ZIP 51081
TELEPHONE # So~ -"luy- ~z~ CELL PHONE # 612 bd' -7 a6y FAX #
~
PROPERTYOWNER Ild- k~ =ka1 TELEPHONE# ~S A 66- 0482
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULFS 7670 CATEGORY 1 MINNESOTA RiJI.ES 7672
(4 submission type) • Residential Venfilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
n V
Plum6iag Contractor. Ph
Plumbing system includes: _ Water Softener _ Lawn S 1 g 2002 F $90.00
Water Heater No. of ~ s
No. of 13aths Lc~
Mechanical Contractor:
Mechanical system includes: Air Conditioning Fee: $70.00
Heat Recovery System
SeweriW ater Conhcctor. Phone #
I hereby acknowledge that I have read this application, state ihat the information' correct, nd agree to comply
with all applicable State of Minnesota Statutes and City of Eogan Ordin
Signature of Appllcanf
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY r
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
Q 03 01 of_ plex ? 09 07-piex ? 17 Garage ? 22 Porch/Addrt. (4-sea.) ? 33 Exf. Alt - SF
? 04 02-plex ? 10 08-plex @ 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
15 31 New ? 35 Int Improvement ? 38 Demolfsh (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Z~ a60 Occupancy _`3 MC/ES System
Census Code ~3y Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Vki Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinallC.O.
~o Footings (deck) ~d FinaUNo C.O.
_ Footings (addition) _ Plumbing
_ Foundation j;ypC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Aiz/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insularion Retainiro 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 , Z S
Other
Total
kom .
~
toHSU~tiHa ~ Ha ~~Etes KE~cKis ItiC.
i~EERIN~j PLRHNEpS and tANC ~URYEYO113
JM-PANY, tNC.
.~b00 [AST 146tl~ STREET, EURNSVILLE, IIINNESOTA 6533T pN ~S2-l000
Cer~ i}'z cct~~~ ~
`~L~L ~IO~t • LOT 4, BLOCK FAWAI RlD6E PND ADD/TiON, ~
DAKOTA CO[iN7y, MINNESOTA
DENOTE5 EXISTIN6 ELEVfiTION
C9Sb.o) pEN07ES PROPOSED ELEVqTioN
INDICATE$ DI,qEC7l0111 OF SURFqCE D24/Alq6E
9SG,33 = FINISHED GARAGE FLOOR ELEVAT/DA/
~ ~P~P ye 0ti°~~ss4: s)
` 'ys
~(P~~~ ,1a y~.o. 45 3C~ F'ROiI/T gU/LD/N6
~~~~t~ D~~,? ^h SE ,6qCK L /~l/E
f
t~ 50/ °o qSbpo N~, i o0
C) / / 55 0,l'1 yo- ~ e \'F'9 x) 3R, .
A-
SO, SJ 5
Ko / N \ \ \
D. Si \ i5~o1 O ~ \
g q510 ~ ya'u o y~ q5~ /i
' ~ g~ ~ . c9g8.o,
t?*?.o
a
t1~9- \ ~ \J~ / •
~y ~ ~ q2, 2~ ~k
,e°'y~
ItilA6E AND ~ AA
lL1Ty ELEVATION h~s• g ~
,
certify thnt thie ie a true and¢corract reprasentation of a tract~ot
shc,wn'Rnd deecribed hereon.. Aa preparad by me on thit /w S"nG day ot
//=~14y
. . W ~
I
1986 BOILDING PBRIQT APPLICAITON - CITY OF EAGAN
80YE: ALL CONTRACTO&S M[TST BE LICENSSD iiITH THE CITY OF SAGAU
3INGLS FAMIILY DiiELLIAGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 7 SET OF ENERGY CALCULATIONS
MQLTIPLE DiiSLLIHGS - HESIDSNTIAL R6NTAL [INITS FOE SALS QNITS
UDE 2 SETS OF PLANS, CEBTIFICATE OF SDRYEY - CHECB WITH BLDG. DSPT.,
PILSET OENERGY CALCULATIONS
lL+RCter-
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
t SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
N.aw CoNSAnc4•N -15,000
To Be Used For: Siws7.e Aom; Valuation: ~ Date: "/7- 801i
Site Address kS` (,~k~~e•Fail OFFICE US6 OD1LY
Lot 1./ Block L/ Erect ? Occupancy ~ 3
T ~1~ I Remodel Zoning R 7
Pareel/Sub ~~?W,~_~e ~jy-Repair _ Type oF Const SL
/ Addition # of Stories
Owner Move ~ Length 4g
Demolish Depth 48
Address y/G4-S's~ Int.Impr. _ Sq Ft
Install
City/Zip Code~~s~,
Phone APPROVALS FEES
Contractor aC lJ~~ivC Assessments Permit 356.
Water/Sewer Surcharge '3-) .
Address i0~. Police Plan Review 119,
Fire S4C ~"1S•
City/Zip Code ,~N~1,~17 Engr Water Conn r~oo.
T Planner Water Meter l~3.
Phone 3 Council Road Unit 2~)o.
Bldg Off Treatment P1 1 5(a.
Arch./Engr. ~ APC Parks
Yariance Copies
Address /45 p OF/yL°~3T zoTAL ~ 15 •
City/Zip Code oAVS d~el~
Phone 0 Y 2-300d
NOTE: ADDEESSES FOR CORNER LOTS - CONTRACTOR/HOMEOi1NER IiQST DESIGNATE WHICH ADDRESS
IS D6SIRED. PO CHANGES WILL SE ALLOWSD ONCE BUILDING PERMIT IS ISSOED.
.
K6~~K~S
'aoge ~
CONSUlTIHO [NO !!IS
ENGINEERING pLaNNeas ana ~NEaHn iuavEYOns
COMPANY, INC.
L 1000 EAST 1461h STREET, EUflNSVILLE, NINHE30TA 55]]7 PH 472'9000
CeriF zccz~ Sur-Ye y
iL,4gqj I2C.jCr( 2 LO7 4, BLlJCK FAWIV RIDGE 2ND ADD/TiOti/, ~
~ DAKOTA CDUN7Y, MINNESOTA
DENOTES EXISTIN6 ELEVATI0A.1
(9sZ,,o) DENO7Es PROP05ED ELEVATloN
INDICATES DlKEC?lO1V OF SURFACE D9AIAlA6E
95G.33 = FINISNED 6A2qGE FLWR ELEVATIDiII
scacE .50'
~9s¢ eo,
'P=4~5`, 30' F'ROIV7 BU/LDIiV6
4E79ACK C/A /E
2Y, w ol
00,
0
y > sr.
ol, \~'9 S9 3S" ~
Qpr Lrbi
o io. / ~ ~ qy~. f~' iq%\ <L
211%
0
v/
(9SO s~ y / ° ~ ~
D~ `q7 % /01
Fi
QV'y
y2'~ti ~6.,0 ~ ~nX • (9fB.0)
s. ~ 9?e?. o
~
'L 2titi~ LqS~oi
l~
.
5e
ORAlIJA6E AND
UTrLITY ELEVqTION h~s• ~
1.'
(~?4~.~~
.
I??are6y certify that thie ie a true AQdp~e~ad bypmaeontthi~n /SnL daycot t
land an shown'+~nd deecribed hereon.•
p~ra~x • 19 S~ . ~J~ ~f Hinn. 1to6. No. 1<0F-s
, . .
NINIMUM "U" VALUE AND.R-FACTOR AT ROOP, WALL, RIPI AiND CONCAHTC BLOCK
~ •
Provide insulation baffles in every' ' . RODF~
rafter spacc. . CR~ VALU-
AW- F?uM .61
Q 5R GYF e~, , Sg
QQ IhSULA'{IDN yy,oo
_ _ O EXj6Rlo(~ PIR FILI`'l
(STill)
Y&TAL CR~=vsgd
. . ~ . WAIL (1`c) I/ALt:-~
~ S , • . QQ IN I~f~lof= Flf~ ~I~M , 6b~
• 9 Q~ 2' GYP. RD.
z ~ INS(JLA7?oN arz~!= 19.0t
. • ' (D do.06
(`rIA-tONIT-r- S1DIr'G .67
?,(YIf tz =:01-3 ToYAL (R) -'ANWIP
ol3.03
T~ I M . . _ . , t2 . • " Vr1lUc
i~ I11TCI'•loR AxR FluI 6e
51/z' INSULEMOia . ' ~ `J.00
i~ 10 2 Flr- R111 ~isT 3•?z
kol ,s 105 ~J~z ~~;•'~.-~'JTc , ~.ob
/ u• r,F;sor'ITE s19IrG
• I' Q Z!xTcRIDR AIR FlLC1 47
. . . ° "u'' _ (/IZ=.D? ,1 ToTA.~ (~t)=,PS7a
. ~Q . . , . .
° . ' °p • foJNDATio~~~ .
(tz) v~~u~
. iNTEV-10~ AK F~U-A
~°f~ o•, ~ O
72 , `ie n ?J `1 I'-P Cbt')G~ $l.Kr ~•a ~
OX'
, . . ~a EXjc(tlolt AIR KM .17
u,~ /T"7 ToIaL. (rO=16. 13
~ - ,
Floors over unheated spaces must have minimum R-factor o£ R-20 (tuck-under garages).
Floors over outdoor air (overhangs) must liave a minimum P.-factor of R-38. .
******#*#*******#***f*Y****#*******#
C i T Y O F E G A~i ~mD~" PA](Mf3Nr OF FF.E AT TIME OF *
* Arri.zcATzorr DoFS Nar corsriTUIE *
APPROVAL OF PERbIIT. *
C APPLICATION FOR PERMIT * *
~ . * INSPDMON oF SEWEIt ADID/OR Fgi'LE[2 *
• *E uvprraTTONS WIIL NOT SE 9Cm- ,*t
~ SEWER AND/OR WATER CONNECTION ~ U~ ~m P~~T *
~
. * APPxovID. ~
. . . *
* »
»
. *~***~**k***~***.***kx:*x*****#.****
Please Print)
1) PROPERTY ADDRESS :
LEGAL DESCRIPTION:
. Lot Bloc Tsubdivision or Tax Parcel°ID )
IF EXISTING STACCIURE, DATE OF ORIGINAL &!ILDING PERMIT ISSCANCE: "
~
_ lbbn Year
PRESENP ZONZNG/PROPOSID LSE:
? CO~~NEtCIAL/R~.'rAIL/0FFICE m' R 1 SINGLE FAMILY '
Q IPIDL'STRIAL Q R-2 DL'PLEX (Tro IInits)
f-T INSTIIL)TIONAL/GOVERAIIMEN'P ~ R-3 40WNEi0USE (Three + Units) ( C~nits)
, F-1 R-4 APARTMEE7P/CONIDOMINILTI ( Units)
2) . •
NAME:
_J~ `in. ron ~ K~-avaf n 9
• ADDRESS: 108os
CITYr STATE. ZIP:_
PHONE:
. 3) For City L~se
NAME:_ ' D. IP. M c_ f~cr rn c Tl Plumbers License:
ADDRFSS: o L Active
_[a u '.rwr~ L 4 n.e I i bcpired
i CITY.. STATE, ZIP:_ 7 . ~ Not recorded
PHONE: aS`.iZ~ MASTER LICENSE# 04).29-7(0 A'1 ~e
stayr Initial
4) Ca• • 10577 r5-
NAM:~
_ AoDRESS:~c.2v
crrx, s~rAZE, zxP:_
,
PHONE:y3.2-,?/3/ -
•5) i:~ v i u~• i • o • or4- ti~a~
' [J~ CON[~CTION 1l~ CITSC SEWFR ~CON[~CTION TO CITY WATIIt OTHER ' .
T'-
6) ~ M• C] PLEASE HOLD APPROVfD PEE2MIT E'OR PICK-L~P BY ONE OF ABOVE
~ PLEASE MAIL APPROVID PERMIT TO 1. 2. 4. ABOVE .
(Circ e one)
7) a r. u•- ' 7~~~
_ :I• '1: • Y: NI: M ~ U 1. I' •~P D Ca• ~ h YJI' • ~•i IB . • . . ~ 1
• I:n ~ 1 : S MN. •tlJ~ 1 1 I ' :A: • •~:A' ' Y 11 N . •
. FOR CITY USE ONLY PERMIT # ISSCED ,
Pd w/Bldg. Permit FEES:
$ $ ~U•S~ SEWER PERMIT (INCLUDE SL'RCHARGE)
$ $ _ WATER PERMIT ( INCLODE SC'RCHARGE )
$ IO S~ $ WATER METER/COPPERHORN/OCTSIDE READER
$ $ WATER TAP (INCLC'DE CORPORATION STOP)
- $ $ SEWER TAP
$ S_ f~UZ1 ACCOONT DEPOSIT - SEWER
$ ACCOLNT DEPOSIT - WATER
,
$ WAC
$ J /~S• 0~ $ SAC
$ $ TRLNK WATER ASSESSMENT
$ $ `TRT!NK SEWER ASSESSMENT
$ $ ' LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
457"U U $ WATER TREATMENT PLANT SURCHARGE
$ $ ' OTHER:
TOTAL
7
RECEIPT RECEIPT
DOES LTILITY CONNECTION REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY TFIE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CbNDITIONS:
APPROVED BY:
TITLE: ~
DATE :
/ '
--For----U------------
~ OHice ~ I
C ~
~ Permit I
City of Eap
I Permit Fee:
3830 Pilot Knob Road
Eegen MN 55122 j Date Received: j
Phone: (651) 675-5675 Fax: (651) 675-5694 1 Staff: ~
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
oese: sioe aaa.em: iykr .S Sl Z~
Tenant: ~ite If:
RESIDENT / WN Name: VE~~?-~ So vv1 Phorie. G 01 -G $"G -U ( 3~
Address / City / Zip: ~ SI ~o /n/~ ~ ~ i?"'~-
Applicant is: --k Owner _ Contractor
TYPE OF WORK Description af xrork: Qc?001
Construc6on Cost: y//UU Multi-Family Building: (Yes Nok__)
CONTRACTOR Name: License
Address:
Ctty: State: Zip:
Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code . Residertial Verrolatlon Categary 1 Warksheet • New Ener9Y Code Woiksheet
Category Submitted Submitted
(4 submission type) • Energy Emelope Calculatias Submined
In the last 12 moMhs, has the Clty ot Eagan issued a perm8 for a similar plan based on a master plan?
_Yes No If yes, date and address of master plan:
Licensed Plumber: Phpne:
MeChanical Contrector: Phorke.
Sewer & Water Contracta: Phone:
NOTE: Plans and wpporting documertts that you submlt are considered to be publlc lnformaiion. Porftons ot
the IniormatJon may be classffied as nonpublfc N you provlde speciflc reasons that wouM pem?!t the Clry to
conclude that the are frade secreta
I hereby eckrwwledge that this information is complete and aocurate; that the work will ba in conformance with the ordinances and codes of the Ciry of
Eagan; that{,underslarW this is rwt a permit, but onty an application for a permit, and work i not to start wi[Fwu[ a permit; that the work will be in
accordance,vim the approved p"-Me case of work which requires a review and approv . p ns.
x-x UC-E~P' '4 /`x
Applicant s Printed Name ApplicanPs Signature
Page 1 of 3
City of Eaaafl
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
retati*Iit_
Permit #: 3D D
Permit Fee: qi9 • 0 6
Date Received:
Staff:
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 3(la Site Address: (� \ �, � 1 vv (./('
it -6 �-
Tenant:
Suite #:
RESIDENT I OWNER
Name: U,IC_a�(
Address / City / Zip: Gt'Vv k4 FeJz '4
Applicant is: \/ Owner Contractor
Phone:
/- o -01
TYPE OF WORK
Description of work:
Construction Cost: _
0 O
o/k
Multi -Family Building: (Yes / No V )
CONTRACTOR
Name: ru (iyU
Address:
State: Zip: ri " Phone:
Contact: Email:
License #:
City:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Phone:
Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the informationmay be classified as non-public if you provide specific reasons that would permit the City"to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One CaII 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.dopherstateonecall.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 wor s 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 tans.
X
V'wwi so..
Applicant's Printed Name
4111111
City of Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use
//
Permit Fee: oD V (�J
Permit #:
Date Received:
Staff:
INFLOWNFILTRATION PERMIT APPLICATION
Plumbing / Sewer & Water
Date: ). - i- 0 --'Site Addre s: ej,� !�j 6"--1�9,�tC4 g !(a_( L4,u6ty
41J2P Sr, L'V
Tenant:
Suite #:
Name: Phone:
Address / City / Zip:
Name:S�1 F' 144 I V-� - 6 i4, IA 6- Okicense #: ,) C� ; /'9 3 6
Address: 6-d 4- G/ - / gA r4 -. City: l 2Y /441 /4-7
`l-2 '9�_ O le)
Email: L ,e L 1' T / tip ,` i.�6
State: /7 VII Zip: 557) 69- Phone:
Contact:
PLUMBING (Within the building envelope)
V Sump Pump Repair
Other:
SEWER & WATER (Outside the building envelope)
Repair
Other:
Description of work: C 1'
ft
FEES
$60.00 / Each (includes $5.00 State Surcharge)
)9W//ii, d('SC �1
TOTAL FEE $
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit I/I repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.citvofeaqan.com/inflow, or City Hall at 3830 Pilot Knob Rd.
CALL BEFORE YOU DIG. Call Gopher State One CaII 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.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 accordanc - • proved plan in the case of work which requires a review and approval of plans.
x
pplicant's Printed Name
!,f lit C -M -t c -V GGY1
_".. x
Applicant's Signature
Use BLUE or BLACK Ink
I For Office Use I
I I
W(
Permit
City of EaRd I s I
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received: ' 1
Phone: (651) 675-5675
Fax: (651) 675-5694 I Staff: I
I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
ul~ 1 7 (r0
Name: Phone:
Resident/ ~1~ rr
Owner Address / City / Zip: W4(
Applicant is: Owner Contractor
Type of Work Description of work: ' Vet X10' `C~l t
Construction Cost: Multi-Family Building: (Yes No )
Company: Contact. fi
Contractor Address ~~~ICX ql1/L City: [ ~l
z
State: ~-Zip: J 7~ Phone:
License #:JL .~3 I c l Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes No If yes, date and address of master plan:
I Licensed Plumber: Phone: ~
i
Mechanical Contractor: Phone: ,
1
Sewer & Water Contractor:
_ Phone:
NOTE: Plans and supporting documents thaf you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
i 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 approva of plans.
Exterior work authorized by a building permit issued in accordance with the Minneso tate Bui in Co must be 7pleted within 180
days o ermit issuance. `
x X -
App icant's rinted Name Appl Si na re
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA146260
Date Issued:10/17/2017
Permit Category:ePermit
Site Address: 4516 Whitetail Way
Lot:4 Block: 4 Addition: Fawn Ridge 2nd
PID:10-25801-04-040
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: 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 -
Veera Som
4516 Whitetail Way
Eagan MN 55123
Polar Builders Inc
1103 West Burnsville Parkway
Suite 110
Burnsville MN 55337
(612) 432-1597
Applicant/Permitee: Signature Issued By: Signature