4708 White Oak Ct ~
CITY OF EAGAN Permft Na_ 8734 p8ter 5-13-87
3830 Pilot Knob Road Meter No: 3 0 2 OV5 L~ 3 Size: ~"/~oc f'f
P.O. Box 21199 Reader No: Date:
Eagan, MN 55121
Owner. McMullen/Moselle
Site Address: 4708 White Oa Court L B2 Oa C if f t
Plumber Krumholtz Plumbing
Conn. Chg; 525. dOpd Zoning: Rl
Acct. Dep: 15, OQpd No. of Units: 1
Permit Fee: 10. O0pd
Surcharge: • 50pd I agree to compiy with the CI! ol Eagan
Tr. Plant 180.00pd Or nces.
Meter. 6.1-Qgpd
Misc- B 41L
WATER SERVICE PERMIT
I C1TY OF EAGAN SEWER SERVICE PERMIT 1
i 3830 Pilol Knob Road 9$89
~ P.O. B64-h99 PERMIT NO.:
5-13-31
j Eaq3i; MN 55121R.1 DATE:
Zoning: No. of llniis:
Owner. ullen TSoselle
; Address: ~
Site Address: ite Qa urt : ClifT t ~
` Plumber: Rrum La P vin g ;
( 4-11-87 20 . p '
4 I ayne lo comply wkh IIw~C•Mg'of Eagan Connection Charge: 525 • flQpd i
~ Ordlnancn. Account Deposlt: 15 . OOpd j
l Permit Fee: 10. 00vd ~
I Suroharge: • 50pd ;
~
By Mlac. Charges: l
~ Data of Insp-- Totai: 3
I insp.: Dsie Pald:
_ _
. ' . . . . . . . . . . , . . . . _
CITY OF EAGAN • ~ , , °
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PH O N E: 454-8100
BUILDING PERMIT Receipt ~
To be uaed for ~ I l,n.`. Est Value Date rti'!~ L 19 7
Site Addri!!~B OFFICE USE ONLY
Lot _Block ` Sec/Sub. "A" CL1FF 4 i'i, On Site Sewage , Occupancy
~ MWCC System _ Zoning
Parcel No. ell 7ype en onst
Cty Wate `
s Name U. (Alloweble) 4
w ~ HLVO * of Storiea
; Address ' , ~ Lengtn
° City Phone } ' Depth S.F. Total
. O N8m@ . Footprint S.F.
Address APPROVALS FEES
City PhOnB Assesaments _ Permit f
Water/Sewer Surcharge
~
W Neme Police _ Plen Review
F
v~ Address Fire = SAC, City
Enqc SAC, MWCC
Q= City
t PhOne Planner Water Conn.
Councfl _ Water Meter
I hereby acknowledge that I have read this applicetiOn and atate Bid4 ON• - Fioed Unlt
that the infortnatlon iscorrect and agree to complywith all applicable APC _ Treatment Pt
State of Minnesota Stetutes and City of Eagan Ordinances. Variance _ Parks
Copies
Signature of Permittee TOTAL
:._tl LL' J Mt)Sr:LL~
A Building Permit is issued to: on th9 express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eegan Ordinancea
Buildiny Ofticial
Permit Ho. Permit Holdsr pate Telephone s
Plumbing ~ • ~ ~
H.V.AC. L~-~ ~
E lectric
Softener
Inspoctlon WN Insp. Commenb
Footings t P~
Footings II
Foundation
Framing p fj~f' jrIt, $O'C'ffJ 5--iy-y7 c••~
Roofing
Rough Plbg. ~
Rough Htg. to ~Ilf/ J'
Isul.
Fireplace
Final Htg.
Final Pibg.
Bldg. Final
cerL occ. rv :
7emp. LP
Deck Ftg.
Deck Frmg.
Wel I
Pr. Disp.
. ~ .rs-+..~•~ ;,n--.. .......+~+.-n.r}~`•~7~'~;.-s-:.wu-r r . .i.. .~~.vr o•-.},~'7~~ . . • .
, PERMIT M ~ 2' ff~
PLUMBING PERMIT ~ `
CITY OF EAGAN RECEIPT # ~ ~
i 3530 PILOT KNOB ROAD, EACAN, MN 55122 DATE: 'I Y 7 _
i CONTRACT PRICE PHONE: 45I-6100
' Site Address , BLDG. TYPE WORK DESCRIPTION
Lot Block Sec/Sub Res. 't New
• ' ~ Mult. Add-on
m Name Y r~;,`~,, Comm. Repair
~ Address Other
c Ciry 3AP v~ Phone r k RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
AIQ. FIXTURES TOTAL
Name 'L C- Water Closet - $3 00 1 ~
~._Bath Tubs - $3.00
; Address -$3.00
-Lavatory
p Ciry Phone ..L-Shower - $3.00 3
-L.Ki?chen Sink - $3.00 3
FEES Urinal/Bidet - $3.00
COMM/IND FEE - 146 OF CONTRACT FEE __~-Laundry Tray -$3.00 J
APT. BLDGS - COMM RATE APPLIES ~-Floor Drains -$1.50
TOWNNOUSE & CONDO - RES. RATE APPUES ~ Water Heater -$t50
MINIMUM - RESIDENTIAL FEE - $12.00 Whlrlpool - $3.00
MINIMUM - COMM/IND FEE -$20.00 =Gas Piping Outtets -$1.50 ' S
STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIn
(ADD $.50 S/C IF PERMIT PRICE GOES SoRener -$5.00
BEYOND $1,000.00) Well - $10.00
• ~ ~ Private Disp. - $10.00
-S_Rough Openings - $1.50 • ~
I SIGNATURE OF P RMITTEE FEE STATE S/C:
FOR: CITY OF EAGAN GRAND TOTAL• •oc
"'•i'~.~'..'~ @ .'oS'.'' ~ ? f `~~;'~~ry'"` ~''~"'L'~ '~':'.~.7~',''~ "4~~~?!t ~T77: w.-r7r~?'!^!'o:. ° ""0,~ ~"'fi"`: . , y, ~ , ~!i~
. PERMIT N
MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
3890 PILOT KNOB ROAD, EA<iAN, MN 55121 DATE
CONTRACT PRICE PHONE 45"100
Site AddrQss 7 BLp(;. TYpE WORK DESCRIPTION
Lot , ~Ixk; Sub
m Na~1n8 Mu~tt AN~
dd on ~
Address ' ra-~ n
Repafr
c° City ~ IA,^~ < Phone ~//7 v C Other
Name FEEB
c Addreas RES. HVAC 0-100 M BTU -$24.00
p City Phone ADDInONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
TYPE OF WORK ADDITIONAL 6 M BTU - 8.00
GAS OUTLETS - 1.50 EA
Forced A1r M BTU L) COMM/IND FEE - 1% 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 Pfping Outleb # ~
Other '
FEE } ' ~i/~ ~ J r~•i~ L~r-~ c1
$/C. ' 6GNATURE OF PERMITTEE v
TOTAI:
FOR: CITY OF EAGAN
- I
, • ? r
fttrfiftra#p n# (Orruvanry
Y
r ~ titp of Cagatt
mPp1lbltptif Df 16atttg 3wp1ftDlt
This Certifrcate issued pursuanl w the requirements of Seclion 306 ojthe Uniforne Building
Code cerpfying that at the dme oJrssuance lhis structure ?Nas rn compliarce witli the various
orIfinances of the City regulating building construction or use. For the following:
u.e clanitio.oon 2 i7C/CvNR e~. Anm 14M 13+' S
oc-p•ncr Trvt R3 Zonint niouia lt I Type c-. v
owner a e,lwng mc M1I11M.M)97,I.F.. Ad&M 430 L*d7USIFu.Ai. BM, W[.5
Budcling A ddm 4708 ~ t]AK CT, LOCSUry 1.5, 32, C1AK Q.IIrF 4-M
DKW iX'i JWR 16, i"0
Maaing oMc.i
POST IN A CONSPICUOUS PUCE
,
CITY OF EAGAN N! 13 4 4 5
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PH O N E: 454-8100
BUILDING PERMIT Receiptu ~ayoif
Tobeusedfor SF DWG/GAR Est.Vafue $121,000 Date APRIL 8 1987
Site Address ' 4708 WI{ITE OAK CT OFFICE USE ONLY
Lot 5 Block Z Sec/Sub. OAK CLIFF 4TH MWCC Systeme X ~pn~9 ncY R3
F.1
Parcel No. _ On Site Well 7ype of Const
Gty Waler X (ACtual) V
a Name MCMIiLLEN/MOSELLE (Allowable) y
i Address 430 INDGSTRIAL BLVD x of Stones -66-
g h
° City ~'`-PLS Phone 378-3981 Deptn [.n
S.F. Total
, o Name SAME FootOrint S F.
o~ Address
APPROVALS FEES
~ City phone Assessmenls Permit 566.50
r~ Water/Sewer Surcharge • o
yujW Name Police _ PlenReview 98'3 ~5
~i Fire SAQCity lnfl (1O
x- Address -
ui Engc SAC,MWCC 575_00
a w City Phone Planner _ Water Conn. 57 S_ 00
Council _ WaterMeter 67_n0
I hereby acknowledqe that I have read this application and state Bla9- Off. _ Road Unil 'in S_ nQ
thattheinformationiscorrectandagreetocomplywithallapplicable AFC - TreatmentPt 780 np
State of Minnesota Statu s and it of Eagan Or ir nces. Vanance _ Parks
COpies ~,~5
Signature of Permittee TO7aL .
A Building Permit is issued to: r C LEN/ OSELLE on the express condition that
all work shall be done in accordance with all ap^plic,pb'le State of innesota Statutes and City of Eagan Ordinances
BuildingOfficial ~XJ`~-C.t~f /A ,pl
7
5 ~1987 BQILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
INCLUDE 2 SEfS OF PLANS, 3 CERTIFICATES OE SORVEY, 1 SET OF ENERGY CALCQL6TIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MOST DESIGAATE WHICfl ADDRESS
IS DESIRED. NO CH9NGES WILL BE ALLOWED ONCE BOILDING PERMIT IS ISSQED.
MfJLTIPLE DiiELLINGS - RFSIDENTZAL RENTAL iRiITS FOR SALE QmiITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIRVEY - CHECK WITH BLDG. DEPT.,
7 SET OF ENERGY CALCULATIONS
COLMR7ERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS, ,
$2,000 LANDSCAPE BOND .
~
~F r~,~
To Be Used For: Valuation: 121,Ckf)C) Date:
Site Address D(~ OFFICE USE ONLY
Lot ~ Block ~ On Site Sewage Occupancy
c{ MWCC System ? Zoning Iz l
Parcel/Sub On Site Well Type of Const
Owner ic City Water ? (Actual) ~
(Allowable) ~
/ Il of Stories
Address y30 Length C~Co
Depth d O
City/Zip Code S.F. Total
Footprint S.F.
Phone 9PPROVALS FEFS
Contractor StI /1' Assessments Permit 5Lo.~
/ Water/Sewer Surcharge ~p so
Address &Police Plan Review Z83. z5
Fire SAC, City IOO
City/Zip Code MP4s. ssy~~ Engr SAC, MWCC 5 ZS
Planner Water Conn S ZS•
Phone 398- q,fr/ Council Water Meter G3 '7.
Bldg Off Road Unit 3ZD.~
Arch./Engr. APC Treatment P1 IP)O .
Variance Parks
Address Copies
TOTAL
City/Zip Code
Phone
. 23 x~~-- x~=
=SSD x l 2
I ~ x ~ = 2~? ~o >c c 2 = ~17 ~j ( ~
(20~~ z
CERTIFICATE OF SURVEY
FOR McMuuxN KURTH SURVEYING INC.
I Muur uNrvr TwAr rws sMvcr,rLaN,on n[?oe? rw nanweo - 4002 JEfFER80N STREET N.E,
wmg 04 uwo[ iecw wrcMnl~ ~ ~ro w?r I ~ A puLr COLUMBIA N610MT3 MINNLOOTA 56421
COIiT[NEO M EYO YN O
i f TMt tTAT[ p/ YIMNLWTA. . ~-760'~N DAT6 3-30- 8'7 1 . , SCALE I'IN 30'~
6K-~u'P°NYa-o6` clRuRb
MINNE90TA TION NO. (b113 24.ocw-2--FytV,+.96o.q17 ONIRONNONUMENT
' 4RLWNlnS ASS41?~QO
. . , iOd ~tKfi T.BT
~ ;o1.ec~5t,~ 6~.EVk~oN
(90.0)•~ooos~o tsU6vATlo?~
' %O1CA5NA(rK A'4CROV/
N8q° 5a~ ZZ' C u3 e; 1toZ.Z.1 ~31.?~~
" a ewai~vA~ac UT1L\T`I ~~,sEr~tu- . rb a SZ'7°~~~25~E
? ~ g Z.PJ.q e>
.o ? /
.~p~_..
t - _ Cs3.o) , /
i / VJ
'(91
. I o
ay~ HouSE
. Z I. ` TS" O
~
, O t
VROPOS~D Yop b.OC.k=94io,B
, (sea .R_ O~~ `o s PRoR~~.7i c~aR. Stl4b = 9~.5
~~4 VRdPOSGt) WWr$T Fw6R-Q53•O
i
W K1T E ~s~:~~\
pc.K ~
L.err 5~ 3hocK2-, O,&.t4, CuFP uTM Abb~'clo?,?~
~~~r~, Co~~.?T Y~ l~u •
%
. . k
. EXTERIOR ENyEIAPE AVERAGE "U^ COMPUTATION
OwNER - C77A~L_l.X.lt'16..
SITE ADDRESS: . . . . . . . . . CONTRACTOR: . . . . DATEe . . . PHONE: .
DES£'.(MINE WOR]:ING SQUARE FOOTAGE OF EACH:
1. TOTAL EX?OSSD WALL AREA........ sq .`t x•.U..
2. TOTAL ROOF/C£IL":NG AR£A l~l~, sq ft x"U"
3. TOTAL £XPOSED WALL AELA CALCULATIDNS:Total exposed wall
area above floor 30 $b,Q sq,ft
a) Total wall window area:
glaze8 ~39;1 sq ft. x "U" /3!,6
glazed sq ft x "U" _
b) Total door area sq ft x"U" '',''a ' - y0•rf'
c) Total sliding glass door area:
glazed ~ sq ft x"U" . Sg
glazed sq ft.x."U"
d) Total Pireplace wall area:Z2_ sq ft x"U" , y/Q =
e) Total wall framing area
(Average 10$) L sq £t x•'II•, Oq
f) Total net wall area above
floor (insulated) ;2,sq ft x "U" .04 _ Li
q) Total rim joist area ~ sq ft x"U"
Sotal foundation
azea (exposed) sq ft h) Total foundation
window area sq ft. x•U"
i.) Total net foundation
area above grade ''/O.sq ft, x"U"
TOTAL dZ tkL:u 1)
If Item #3 is the same as, or less than Ztem rl, you have met the intent of
S.B.C. Section 6006 (c) 2.
. , ,
, TOTAL EXPOSID ROOF/CEILING CALCULATZONS:
Total exposed
roof/ceiling area..... sq ft
s8 ft. x "U"
j) Total skylight area O
k) Total roof/oeiling framinq
area (Average lOS) b sq ft, x"U"
1) Total net insulated
roof/ceiling area /0 sq ft. x "U"
TOTAI. j1 thru 1)
Zf total of #4 is the same as, or less than.#2, you have met the intent of
S.S.C. Section,fi606 (c) 1. ~
ALTERNATE BUILDING ENVELOPE DESIGN
To utilize the total envelope system method, the valuee established by the sum
of Items #3 and #4 shall not be greatez than the sum o£ Items #1 and #2.
1. + 2.
3. ~$D.S +4. Z.J e....~p ;p...
C E R T I F I C A T Z'O N
,
I hereby certify that I have calculated the "II" factors and "R" values herein
and that the building here described meets or exceeds the State of Minnesota
Energy Conservation Act. . . . ~
(S gnatur ) -
. . . . . .
(pate)
***~*****##**Y***f**********}#*!**#YOf
C I T Y O F E G A f~ PAYM~1f OF FEE AT TII~; pF *
* ArriscATioN DoFS Nvr ooNsrrmm *
~ ,*t APPROVAL OF PII2NffT. +
APPLICATION FOR PERMIT
. * INSPDCTION OF SEWIII2 ANID/OR WA2IIt *t
* II1S2ar,ramrONS WIIS, NOT BE 5(~m- *
r
SEWER AND/OR WATER CONNECTION *ui~ID UNPII. PERP4IT HAS BEQd *
r
. * APPROVID. rt
* r
~ r
»
*,t* *,t,t,r+,t w****w n.* xx: w:***x r x***
, P ease Print)
1) PROPERTY ADDRESS: ~I7rj~ azL-~p ne:~f. ~f0~
l~
LEGAL DESCRIPTION:F,
(Lot7Block Subdivision or Tax Parcel ID )
IF EXISTING SIRL'C![7RE, DATE OF ORIGINAL H[,'ILDING PERMIT ISSt'ANCE:
' PR£SIINr 7ANING/PROPOSID LTSE: (Dbn Year) -
? Ca'"AEl2CIAL/REPAIL/OFFICE cx R-1 SINGLE FAMILY
r7 IIIDC'STRIAI, ~ R-2 DUPLEX (TWp Onits)
n INSTI'I(C;TIONAL/GOVERNMg,'Nr ~ R-3 70WNIOT-ISE (Three + Units) ( L~nits)
~ R-4 APARZmENT/CONIDOMINlOM ( Units)
2) ~
NAME'_ L, . ko
ADoxESS:_
CITY, STATE, ZIP:
PHONE: ~ ,~-2 -`t ~?S~
3) • y I: NAhE. K.l~ ur~n kn f2 ~ For City Use
Plumbers License:
ADDRESS:~/0 Active
~ CITY, STATE, ZIP'. ~ H ~piTed
-I~/1 /C /Yl ! C-~~S11/ IJ. Not recorded
PHONE:~?'~'>-i/4!S'~' ^ MAST'ER LI(ENSE#
Sta Inltial
4) • • / _
NAPE:
_ ADDRESS:
CITY, Srp,TE, ZZP:
PHONE: .
'S) ' 11 V' I 1 M: • 71' l0 • 9~ A ~U
~ CONNECI'ZON TO CITY SEWEft ~ CONNEX,TZON RO CITY WATER ~ pTfglt .
6) ~ ' PLEASE HOLD APPROVFD PERMIT F'OR PICK-OP BY ONE OF }1BOVE -
PLEASE MAIL APPROVID PEEtMIT 20 1, 2 3, 4, ABOVE
(Circ one) '
7) ~
~
. ~ r r ~ ~ r
a~ • 1" J IID• q 7• Y71' • JI' 1 • 91• ~ 1
• r. r•r• -,na~ ~ ~ i :n- • ~ ~ • u. h
. FOR CITY USE ONLY
PERMIT # ISSUED
Pd w/Bldg. Permit FEES:
$ $ SEWER PERMIT (INCLODE SURCHARGE)
$ $ zWATER PERMIT (INCLODE SORCHARGE)
$ ~-.7•0-7J $ WATER METER/COPPERHORN/OCTSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ $ IS'~ z ACCOUNT DEPOSIT - SEWER
$ $ ACCOUNT DEPOSIT - WATER
$ $ WAC
$ $ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ ` LATERAL BENEFIT/TRUNK SEWER
$ LATERAL BENEFIT/TRUNK WATER
$ C•c'T $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ $ "L' TOTAL
-72 733J'~
RECEIPT RECEIPT
DOES UTZLITY CONNECTION REQLIRE EXCAVATION IN P[IBLIC RIGHT OF WAY?
~ YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
ROADWAY" MUST BE ISSUED BY THE ENGINEERI[VG
~ NO DIVISION. LIST AS A CONDITZON.
SOBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE: ,
DATE: .3
r ~
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4708 White Oak Ct
Lot: 5 Block: 2 Addition: Oak Cliff 4th
PID:10- 53553- 050 -02
Use:
Description:
Sub Type: e - Furnace & Air Conditioner
Work Type: Replacement
Description: Fumace & Air Conditioner
Comments: Questions regarding electrical permit requirements should be directed to Mar k Anderson, State Electrical Inspector,
952- 445 -2840. Brian Welke 122 W 3rd St hastings, mn 55033 651- 437 -0338 bwelke@haleycomfort.com
Fee Summary:
Contractor:
Haley Comfort Systems
122 West 3rd St
Hastings MN 55033
(651) 437 -0338
ME - Permit Fee (Replacements)
Surcharge -Fixed
Total:
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
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
$50.50
Owner:
William A Bigelow
4708 White Oak Ct
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$50.00 0801.4088
$0.50 9001.2195
Issued By: Signature
Mechanical
EA076408
01/16/2007
ePermit
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA113231
Date Issued:09/03/2013
Permit Category:ePermit
Site Address: 4708 White Oak Ct
Lot:5 Block: 2 Addition: Oak Cliff 4th
PID:10-53553-02-050
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Audrey Flattum
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 -
William A Bigelow
4708 White Oak Ct
Eagan MN 55122
(651) 895-5789
Storm Guard Restoration
1355 Geneva Avenue North, Suite 201
Oakdale MN 55128
(651) 738-1698
Applicant/Permitee: Signature Issued By: Signature
City of Eapll
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: .� gto3?
Permit Fee: 3a l �3c1°
Date Received: t/i o/ 9-
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ,4///rte Site Address: 77.3,4%w' " a x G T Unit #:
Name: 47/7/ 4?/ls //
Resident/
Owner
Address / City / Zip: t c4" /1/ 71. G'
Phone:eSr77r-r7,
Applicant is: Owner Contractor
Type of Work -`
Description of work: 47't' -f 441 Z q..7 '47'`"/t4'
Construction Cost: ,"1:7. Building: (Yes / Nok )
Company: ✓O.ti � / a•J'T/c+-�+ J ,Z'A.G
Address: .r4 ,01,114C/ -s--1
State:—r`-' Zip: XJJ. 7
Contact: 5 -,cc ‘574/ 6roi
�(/ll City: -.,--1"44111Z
Phone: 6`r/ 2 6/• 1./Y
License #: -674- ' Lead Certificate #:. "' ` t'e.-9.-71
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
PD
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:
Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are consideree
the information may be classifiedas.non-public if you provide specific reason
conclude that they are trade secret
llc information a
would:permit
toffs of
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.gooherstateonecall.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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x 5'X SCJ f�
Applicant's Printed Name
S Signature
Page 1 of 3
4 -no- WIit& a 1L c
DO NOT WRITE BELOW THIS LINE
Doo. c9
SUB TYPES
Foundation
2( Single Family
Multi
01 of Plex
WORK TYPES
New
„Addition
t leration
Replace
Retaining Wall
Fireplace
Garage
Deck
Lower Level
Interior Improvement
Move Building
Fire Repair
Repair
DESCRIPTION / Di 00
Valuation
Plan Review d
(25%_ 100% X)
Census Code
# of Units
# of Buildings
Type of Construction
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: _Ice & Water _Final
Framing
replace: 4) --Rough In k -Air Test
insulation
Sheathing
Sheetrock
Reviewed By:
5?
1
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola) Miscellaneous
Pool Accessory Building
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
A-Final
'4
Siding
Reroof
Windows
Egress Window
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building — give PCA handout to applicant
Meter Size:
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Final / C.O. Required
)(final / No C.O. Required
ye HVAC _ Gas Service Test
Gas Line Air Test
Other:
Pool: _Footings Air/Gas Tests _
Siding: _Stucco Lath _Stone Lath -
Windows
Retaining Wall: _ Footings _ Backfill
Radon Control
Erosion Control
, Building Inspector
Final
Brick
Final
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
67-1
Page 2 of 3
Date:
A Aart's & Tims
CityofEaaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
763-425-7461 p.1
r
Use BLUE or BLACK Ink
For Office Use {�
Permit #: l @BSD–
Permit Fee: (� I
Date Received: ! -6 r
Staff:
L
I 2014 RESIDENTIAL PLUMBING
GIPERMIT APPLICATION
I a`Urr�� 14-) Site Address: 1±7 b g GO h+4 -e O c( k Co tor+
Tenant:
Suite #:
Resident/Owner
Contractor
Type of Work
Permit Type
Name: 1 ] 11(7, 2 (O t.: Phone:
Address / City / Zip: 4 1-6 Lk) k
Name: —17--04\ tS Q 1.LQ 11'47 p
Address: 5 23 Cl
State:
rg ) Zip: 55 3 67Contact: I t rn �inotkO(n^ Email: 'Sf)ee'c4y p u IV\. ; ittQ� C GIY•^q 511 tke-
— New _ Replacement Repair _ Rebuild Modify Space _ Work in R.O.W
T�\5-it1l1 L. xt v•'c'es (. ) +e-i-,--ub/sha• kid r tnks5
Description of work: rr' : rs
Pho
t' Cci k Court Getty A, Iti1 N�
1ufjjLicense#: t T)Li1QT'm
f uA City: 05e c)
('/9-t-10 1 O
ne:
Art
♦ _t .
11-
•
IRESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures Septic System Abandonment, Water Turnaround" (includes $5.00 State Surcharge)
( 'Water Turnaround (add $200.00 if a 5/8" meter is required)
$115.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $ .6°C),C-2)
RESIDENTIAL
Water Heater
Lawn Irrigation ( RPZ / PVB)
Septic System
New
_Abandonment
Water Softener
Add Plumbing Fixtures ( Main f _ Lower Level)
Water Turnaround
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, :ww.aooherstateonecall.orq
I hereby ad nowledge 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.
A‘ry Be (:..&_\DC1
Applicant's Printbd Name Applicant's igna e
FOR OFFICE USE Reviewed By:
Required Inspections: Under Ground Rough -In Air Test Gas Test Final
Meter Related Items: Meter Size Radio Read Staff:
Date: