4748 White Oak Ct
CITY'OF`EAGAN ~ 12588
; tx=~-~ •r 3830 Pllot Kno6 Road, P.O. Box 21-199, Eagan, MN 55121 ~
, PHONE: 454-8100
` BUILDING PERMIT ReCeipt #
To be usedt'or 3F DWG/GAIrZ Est Value $114,000 Date SEPTLtkfBER 8 .19 86
SiteAddress 4748 WHITE OAK CT Erect C~ Occupancy R3
Lot4 Block ~1Sec/Sub_ OAK CLIFF 4TH Remodel ? Zoning pn
Repair ? Type of Const Va
Parcel No.
Addition ? No- Stories
Name SUNSHINE CONST Move ? Length 6
3 Address 5985 125TH ST DemoHsh ? Depth 38
~ lnt Impr. 0 Sq. Ft
o City A,v• Phone 431-2200 Install ?
o Name SA!'1E Approvab Fees
~ Q Address Assessment Permit . 00
~ City Phone Water & Sew. Surcharge 57.00
S Police Plan Review-~~ 0 ~
, ~
= Z Add ess 82~ HU~IBULDT AVE SO Fire SAC ~
o n Eng_ Water Conn.
~9 City BL14GTNPhone 8$4-3029
Planner Water Meter-~ 5U
Council Road Unit T' 0 0
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gidg. Off. 9/8/86 Tr. PI. 0 U
information is correct and agree to comply with all applicable State of
Minnesota Statutes and _9ityitif Eagan Qr:~~a ea. ~ APC PBrkS
/ . r. aate Copies
Signature of Per ' ee TO~l
A Buildin Permit is issued to: ~~NSHi;Vi; Ci~i~iST~ZUC`~ZOt~i
9 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 Olficial
_ ~
P«mll No. PNmll NoIdK DaN TNwphom A
PlumWnq
H.Y.A.C.
EIlCtr(C
I
~ Sa11~n~r
I
~I
I. Insp~tlon DaM Inap. Commwb
~ Foollng. 1
Foodng. ll
FouedNion
F?"""g
Roolinq
no"n Pew• •io g~- fi • j-~y-9G -
Rouqh Htq. IL'n .
IMd.
FNrplse~
Final Nlp. 40/1914' Ai~
Flnal FMllq.
Bldp• ftM ~
. C«t Ooc.
D~ck Ftp.
Dsck Frrtp.
' Wop
Pr. Dfap.
J
~ PERMIT #
MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: 11191-66
CONTRACT PRICE . PHONE 454-8100
Site Address TT Y p~ WORK DESCRIPTION
LotBlock Sec/Sub e
7ves/ ^ New
m Name Q O Mult Add-on
AddrgM
' R ir
c C i t'~ Phone C Other
~ Name -W / . FEEg
# Add RES. HVAC 0=100 M BTU -$24.00
p City Phone '-~-~00 ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
TYPE OF WORK ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA
Forced Air 600 M BTU ' COMM/IND FEE - 196 OF CONTRACT FEE
8oiler 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
Gas P(ping Outleffi # BEYOND $1,000.00)
Other ~
~ S, 50
FEE ~'t
s/C. . SIGNATURE OF PERMITTEE
TOTAL• v~ b• D D
FOR CITY OF EAGAN
. ..kv'7' ;.~r1fT ~i ` 1
i i~e ~
j PERMIT # t ?
. . PLUMBING PERMIT RECEIPT # ~
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 56121 DATE ~
CONTRACT PRICE PHONE 454-a100
Site Address BLDG. ME WORK DESCRIPTION
LotBlock ~ SeclSub
. Res. New
m Name Mult Add-on
~ Address Comm. Repafr
c City Phone ~ Other
NO. Fll(TURES TOTAL,.
~ Name - Water Closet - $3.00 $
c Address Beth Tubs - $3.00
- $3.00
p City Phone Lavatory
Shower - $3.00
FEES Kitchen Sink - $3.00
COMM/IND FEE - 1% OF CONTRACT FEE Urinal/Bidet - $3.00
Laundry Tray -$3.00
MINIMUM - RESIDENTIAL FEE -$10.00 Floor Drafns -$1.50 -
MINIMUM - COMM/IND FEE - 20•00 Water Heater - $1.50
STATE SURCHARGE PER PERMIT - •50 Whirlpool -$3.00
(ADD $.50 S/C IF PERMiT PRICE GOES Gas Piping Outtets -$1.50
BEYOND 51.000.00) Soitener - $5•00
Well - a10.00
Private Disp. - $10.00
Rough Openings - $1.50
31GNATURE OF PERMITTEE FEE;
STATE S/C:
FOFt CITY OF EAGAN GRAND TOTAL:
I CITY OF EAGAN
WATER SERVICE PERMIT
~ 3830 Pilot Knob Road 812 6
' P.O. Box 21199 PERMIT NO.: ~
Eagan, MN 55DATE ~
~ Zoning: uns e net. No. of Units: ~
~
Owner.
~ Addreas: ~
Site Addess:
~ Plumber.
~ Meter No.: Connection Charge: ~ Stze: Account Deposit: ' p
Reader No.: Permit Fee: ~ j
~ I agrss to complr wtth !he CMy of Eayan Surcharge: ' ~
Ordlnances. Misa Charges: 63. 54pd meter "i
ToffiI:
By Date Paid:
~ Date of Insp.: Insp.: I
' CIn of EAGN WATER SERVICE PERMIT ~
3890 Plld Knab Rosd 8126
~ P.O. Box 21199 PERMIT NO.: ; Eagan, MN 55121 DATE t
~ Zoning: R~' No. of Unita i
~ Owner. Suns ine Const.
Addreaa: a ur a ~
$fte Addess: Number.
. 'P
iAeter No.: ocK ~6~!'on•~, ~ . p ~ze: " , ~ o a
Reader No.: ' 0 p
I aqrw to complp wNh the Clty M c P
.OOpd TP
dinances. R~a1.LA010-` r~63. SOud meter
otai:
~ Date Paid:
'9 of Insp.: ^ ~ Insp-
CITY OF EAGAN N 0 12588
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt#
7o be uaed ftor SF DWG/GAR Est. value $114,000 Date SEPTEMBER 8 19 86
SrteAdd:ess 4748 WHITE OAK CT Erect L~ Occupancy R3
Lot 4 Block 1 Sec/Sub OAK CLIFF 4TH Remodel ? Zoning pD
Parcel No. Repair ? 7ype ot Const 1.7n
Addition ? No. Stories
a Name SUNSHINE CONST Move ? Length 60
z S9~S 12STH ST Demolish ? Depth ~R
o Address Int. Impi. ? Sq. Ft.
city A.V. Phone 431-2200 Install ?
¢ SAME Approvals Faes
o Name
$a Address Assessment Permit 468.00
~ Ciry phone Water&Sew. Surcharge 57.00
234.OC
~ Q Police Plan Review
~ W Name JAMES R HIL Fire SAC 575.OC
~a nddress 8200 HUMBOLDT AVE SO Eng. WaterConn. SOO.OC
a W ciry BLMGTN pnone $$4-3029 planner Water Meter 63. SC
Council RoadUnit 290.OC
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.oR. 9/8/56 Tr.PI 156.OC
inlormation is corred and agre~ to comply with all applic ble State of
Minnesota Statutes and o( gan Ordjn~xces. APC Parks
~ Date Copies
r
Signature of Per ttee l~ Total ~~4~ 54
A Building Permit is issued to: NSHINE CONSTRUCTION on the express condition that
all work shall be done in accordance wtlh all applicable te of nesota Stato-es-arlc~ C-7iry- ~of Eagan Ordinances.
8wlding Official- L. 1T! .qAlA~~~
~ ~
1986 BQILDING PERKIT APPLICATION - CITY OF E6G9N
NOTE: ALL COATRAC?ORS MOSY BE LICENSED iiITH THE CITY OF EAGAN
SIAGLE FANIILY DAELLIPGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
MOLTIPLE DiiELLINGS - RESIDENTIAL RENTAL IRiITS FOS SALS QNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SQROEY - CHECB WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
C02RMERC71L
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFZCATIONS AND 7 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
CYO
To Be Used For: AjEccy (ZESelJ. Valuation: Date:
9a'
Site Address loFHTe ppKG'T OFFICE OSE ONLY
Lot ~ Bloek ( Erect ~ Occupancy ~
Remodel Zoning
Parcel/Sub b~.~ GLi pF I~QI~ . Repair _ Type of Const ~
Addition li of Stories
Owner -Su Af s H iAjc (3"S l Move Length ~
Demolish Depth ~
Address SlBs 1Z.S~ ~ S T Znt.Impr. Sq Ft
Install
City/Zip Code ~ppc.c~/aC1,6y sS~L~
~
Phone ~3i'2'246 APPROV6LS FEFS
Contractor Sq md: q,s ,Q B0UES Assessments Permit ry~p8
Water/Sewer Surcharge 7
Address Police _ Plan Review 2 jZ
Fire SAC f 7,`~
City/Zip Code Engr Water Conn
Planner Water Meter
Phone Council CLAP Road Unit Z jb
` ~Bldg Off WIV Treatment P1
Arch./Engr. 'A Mc.S APC Parks
Variance Copies
Address BZ~o ~~.,,QOC„p F~Qc:~$ • ?pTAL l;g =0
City/Zip Code OOM IAU-ObN 6T431
Phone lk agQ~Q2C7
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOANER MDST DESIGNATE WflICH ADDRESS
IS DESIRED. NO CH9NGFS iIILL BE ALLOiiED ONCE BQILDING PSRMIT IS ISSIIED.
~ ~~3~~~ .
SURVEYOR'S CERTIFICATE SUNSHINE CDI•lSTRUCTION,c,o. N
I I 7- I
30
N 89036118" E 136.63
qlb~' 9&L.9r i30A0 - - 3833
~ ro ~ ~>ra.oo 14.00< i 5
O I p ,
co
co LOT ~ ~
t i rn o 2.0 o- W I
~ 1 N u~ ~ 4 W
O
aR P \
osEO~ ~ N a ~ m N
4sYsJ•V ~t ;orrrve~r....~ o Nt
LU 14.67
\ ~ N I ~ W
3.66 ~QiX97G.~- py~
~ Z 914~' Z
f0 i~>14.00 14.00~' 5 I
~x9BS,t, ~ ' R&z.R 9i3,
30.00 - - 38.33 '
I~ N 89036118° E 136.63
30
I
--4- ' DENOTES PROPOSED SURfACE DRAII4IIGE
p DENOTES IIiUN MONUhIENT SET SCALE: 1 IIiCH = 30 FEET
0 DENOTES 11i0N MONUhIENT FOUNU PROPOSED GNiAGF. FI.OUR = 9F~ 3 FEET
XD00.0 DENOTES EXISTIF1f ELEVATION PROPUSED LOWEST FLOUR = 978.G FEET
(OOU.U) DENOTES f'RUPUSEU ELEUI1T10PI I'RUPOSED TOP Of ULOCK = 4PG•? FEET
1 HEREBY CERTIFY TO SUNSHINE CONST. C0. THAT TH15 IS A TRUE APIO CORRECT
REPRESENTATIUN UF A SURVEY UF THE UOUNDARIES UF:
Lat 4, 61eck 1, QAK CLIFF 4TH,AGDITION, acccrdiro to the recerded
plat thereof, Dakcta County, V.inr.eseta.
ANU OF THE l.Of,ATIUN OF A PROPOSED BU1LUlNG. IT DOES NOT PURPORT TO SHOW IMPR(1VEMENTS
OR ENCRUACHMENIS, IF ANY, THEREUN, AS SURVEYED BY,ME, Ufi UNUER MY UIR[CT SUPERVISION,
THIS 5TH I)AY (1F AUGUST , 19E16.
SIGNEU: JAMES R. HILL, fI1C.
BY:
AROLD C. PETERSON, LAND SURVEYUN
MINNESUTA LICENSE N0. 12294
PROJECT NO. UODK / PAGE JAMES R. I-{ILL, INC.
85850 -7
y Planners / Engineers / Surveyors
FILE NO. 0200 Ilumboldt Avenue Soutti
FOLDER plootTilnpton,?Am 65431 612-e84-3029
CITY OF ~~[Qf~/~{ ' BUZLDINa DEPARTldEIJT
X . EXTE;RIOR ENVE3,OPE AVERAGE l'Utl COIdPUTATION
(To be submitted ivith building permit appllcAtion)
One or Two Family Dwollina Ov+ner
All Other SS.te Addresa •
Contractor Date Phone
LINEAL FEET OF Q EXPOSED WALL ft. above grade =
, TOTAL EXPOSED WALL AREA 3Q. FT,
OPAqUE WALL CONSTRUCTION: "U" Value x Area '
Detail af4tME x SQ. FT.ZZZiIrl ~ 9CJ,q~j U y
reference L ~~O x SQ. FT.~(U) (A)
from ~ ~iUn x SQ. FT. /~4•~=~~~U)(A)
attached ~~UII X SR• F"1'. = U) (R)
sheets x SQ. FT. _ (p) (A) .
nU~~ x SQ. FT. _ (11)(A)
YlINDOWS: "U" Value x Area~
Ptnke & Type ~It/~I/L'
x SQ. FT. Z,(o(o= D7, OZ
it „ (U) (A)
~'U" x SQ. FT. _ (U)(A)
n u
It ~~p~~ x 8@. FT. _ (U)(A)
nUn
X FT. - ,
SQ. - (U)(A)
DOORS: "U" Value x Ares .
Eiaice & Type op S „_L L~
v m ~ npn ; x SQ. FT. -7~~•84"- ~U)~A)
ii n Q-~ X SQ. FT. ~ = '~1't~r (U)(A) . iful: u n upn X SQ. FT. = (U)(A)
_ x SQ, FT. (U)(A)
TOTALS Z~ D SQ. F'T.--_y_.27L(U) (A)
A(3E ~~U~
TOTAL (U) (A) VALUES S~ _ AVER
DIVIDED BY TOTAL 14ALL AREA ZfjL~7j~p ~ ' •
AVERAQE °U11(/,1'15,"br leos for 1&2 family dwellinge
ROOF/CEILIN4 - ' TOTAL AREA: • 2 ~ '
Detail reference flUfft 0 23 x SQ. FT. 335'0 = 0,717(p)(p)
from npn x Sq. FT. w (U)(A)
attached sheeta. °UII x SQ. FT. ' (p)(p)
Describe onenings itUu x SQ, FT.
in roof, „U„ _ (U){p)
x SQ. FT. _ (U)(A)
TOTAL (U)(A) VALUES DIVIll1sD BY Z2O.7g 7= T7"~tL~j /339 N.~ 6,'7/7CU~r~\
~
. -TOTAL ROOF/CEIL N(3 AREA
AVERACiE "U" .025 or vontilntad roofe. ' ~ d ~
!w°~'~ ~'1'E~T" - - - - •
- ~ - ~
z~_
- - - - ?-P~}-3. DZ~7.-~.----------. x.`-------- - '
~ - - _
---I :?8 = g c~ , 4-a - _ - -
- ~s.4 , 38~- - - -
-
_W.i N ~ov.~ ~ _ - - .
= 4- X z . _ £3~ a~ . - - - - . .
Zo yc = zo x s' . - G~tZoSf- ~K~aS~_~1P_.4,1-_ ~ 8~~, o!~;
_ZoX 48 ~~o~q X 7 = 41-P- (ob - - -
-?,Q.~
-z4x48 = g x c~ = 4--a° v?~ ~s4~~-- - _
~=~5 - - :
STL b'~ Z SL = 775 QO - - :
--~-=sn- S5p- ~ Zr, aa - - - - - -
i u w _ : zl , o ~ . . . _ _ - - - - - - -
oo - -
- - - - - - -
~oY
z - _
~~c ~s= I 35 - - -
- . Z8X ~l = g Co - i-- - -
; 32q
~
, . . --VlAI,L SECTEON-- . . Determining "U" valuee at Roof, Wallp Rimp and Conc. Block
I •
, ROOF/OEILINq , R VALUE
1.) Interior Air F'i1m o.61
• 2.) 5/810 (Iyp. Bd.' .56
3.) Ineulation
4.) 4O,oo
59) Exterior Air Film .61
~ 2 3 , (BTILL)
. /n ~IU° a 1/Ra OZ?j TOTAL (R)=41. 78 ,
g YlALL . R VALU
6.) Interior Air Film 0,68
}n aYP. Hd. ' .45
, 80 inaulation J9,o~
9•) Bu1LT•1-'?TE
10.) Masonite Siding .57
' 11.) Exterior Air Film ,17
• °pn ~ 1/R~ ~b4'3 TOTAL (R)=Z3 D' .
~ • •
~
12 RIM R VALUE .
. 0~---- ~3 12.) Interior Air Film 0.68
. 13.) Inaulation ~Q,o 0
14•) 2ll Fir Rim Joiat 1,88
S 160 NaueonTiteRsidin6 Z,6~
. 170 Exterior Air Film -17
. o ' Ue ' ' . . . upn o 1/Ra iU10 TOTAL. (R)e
po
' ' •
_ FOUtIDATION R VALU
'189) Interior Air Film 0.68
tl ; . . ~g 19.)
'
, .
~6 e . y 20.)
n . 8 n 21.) 12" Conarete Block 1.28
e . 10 22.) F-)Kh W~VI., $,oO
. ~3 230 Exterior Air Film ,17 "
e '
L~° (go • nUn e Il/R= TOTAL (R)= 7
_ t.
~
~
• . . . -
.........w._..._
1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
c~
651-681-4675
New Consfrucfion Reaulremenh Remodel/Reoair Reaulrem~ti
? 3 registered sRe surveys showing sq. fl. of lot, sq. tt. ot house Z coples of plan
and all roofed areas L20%maximum lot coveraae allowed) 1 sef of energy calculations for healed addNfons
? 2 copies of plans (show beam 6 wlndow skes; poured ind. deslgn; eic.) 1sHe survey lor exterlor addHlons 3 decks
? 1 set ot energy calculatlons
? 3 coples ol hee preservafion plan H lot plaMed aNer 7/1/93
DATE: 'Qi 7(i -CONSTRUCTION COST: 15-~i9U
DESCRIPTION OP WORK: 0 Lo70
STREET ADDRESS:
T
LOT: ` BLOCK: ~ SUBD./P.I.D. V 01
Name: A//kY 729, PhoneM:
PROPERTY ~a~ Ftrs1
OWNER SheetAddress: lil~J~`~~ C~
Ciy 6~4c.,"A State: Zip: ss~7i~
Company:Phone
(area code)
CONTRACTOR `
Sheet Address: de Lieense 1k `Z0/,0387 Exp. 3`z0vG
city &.,l„t cv,state: zlp: -~3 S37
ARCHITECT/
ENGINEER Company: Name:
Telephone area code ( )
Streel Address: Registratfon (k:
City State: Zip:
Sewer 8 wafer Iicensed plumber (reciuired for new construction onlv):
Penclfy applies when address change and lof change is requested once permR Is Issued.
I hereby acknowledge that I have read fhis applicaflon, s}ate that the informaflon Is cortect, and agree to comply wRh all applicabl
Statg of Mlnnesota Stafutes and City of Eagan Ordinances.
Signature of Applicant: /
. OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea.
? 03 1 of _ plex ? 08 6-plex O 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex 0 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool O 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg.' ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code
UBC Occupancy sq. ft. No. of Units
Zoning sq. ft. No. of Bldgs
# of Stories sq. ft. MC/ES System
Length .x sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MC/ES SAC City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PL `
Park Ded.
Trails Ded. ~
Other
Copies
Total:
SAC Units
% SAC
*xxxxxxxxrxxxzxxrR..........RR:xR~
C i TY O F E A A i~ PAYMFN'C OF FF.E AT TIME OFn *
APPLICATiON DOES NOT COIISTINiE
• ,*f APPROVAL OF PIItN4T. *
APPLICATION FOR PERMIT * *
, INsrncrrox oF sEWx Arro/ox c+u{TEt *
r *f I~Ar.ra'PIONS WIIS. NOT BE SCI~- *t
SEWER AND/OR WATER CONNECTION ~ ULED UNnL PmMIT HAS BEEN ~
* APPR(Jt7ID. r
* •
. ? *
• ~
r
* ***+*i r+**w+*r*:*+,rr,r,r,rt*,r~t+~x****
~ P ease Print
1) PROPERTY ADDRESS: 7~E pQ~ CT-, •
LEGAL DESCRIPTION: _ Q ~ ~~i~ GL,iFF 4.'('n '
Lot Block Subdivision or Tax Parcel ID )
IF EXISTING STRLY.Z[.R2E, DATE OF ORIGINAL BL'ILDZNG PERMIT ZSSL'ANCE:
~ (Nbn Year)
PRFSENf 7ANING/PROPOSID LSE:
~ COb'MERCIAL/REPAIL/OFFICE 'jRr'0`R-1 SINGLE FAMILY
~ INJ~'STRIAL 0 R-2 DL'PLEX (1wo Units)
~ INSTITLTIONAL/GOVERNmENr ~ R-3 70WPII-IOUSE (Three + Units) ( [Inits)
~ R-4 APARTnaPf/CONIDOMINZUM ( Units)
~ .
2)
NAME= 56WS "rF /NE
Sr..
ADDRESS: 5c7 Lu5,S /2~57~
CITY, STATE, zIr: ,q i'N/lG
PxONE: .43 [ -ZZVG
• 3) i: NAME• s726a L~LM - For City Ose .
_ q- (~in( P1LUnbers License:
ADDRFSS: /C7 Mr,t ,.r i S PO inCc c TEP 2 Active
E7cpired
~ CITY, STATE, ZIP:_ g GOO m.~IL...f'O•1/ m K_ ssQ 2a rbt reco=aea
Pxorrs:~gc~ - 41qr-s MASTII2 LICIIVSE# 332SM smit~ai
4) . i~•
NAME: S4/niff A-s ~2
ADDRFSS : .
CITY. STATE, ZIP:
PHONE: 5) n v r: : a • o~ -
CONNF.CTION TO CITY SEWII2 JR[-Cp[.`TION 2U CITY WATER Q OTFET2 .
6) 'o `F713~ PLF.ASE HOLD APPROVFD PERMIT EY)R PICK-UP BY ONE OF ABOVE
PLEASE N1F1ZL AP ROVFa PERMIT TO 1, 2, 3, 4, ABOVE
(Circle one)
7) _ • r • r r. ~ • r ~ • r • • o- i~• u r • • ~ . • ~ ~
• r. • ~ M:I• •,H?~ 1 1 1 ' BI" • • 1, 1 ^
/
.fOR -CITY USE ONLY - ,
PERMIT # ZSSUED
t
/Z~ .
Pd w/Bldg. Permit FEES:
S /c^- S z~ $ SEWER PERMIT (INCLODE SURCHARGE)
$ M-,SU $ WATER PERMIT (INCLUDE SURCHARGE)
$ D'.~j 12> $ WATER METER/COPPERHORN/OOTSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ JS~OZ' $ ACCOLNT DEPOSIT - SEWER
$ ~ SC r $ ACCOONT DEPOSIT - WATER
$ ; j7` • C) $ WAC
$ S 7S-C r> $ sAc
$ $ TRUNX WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TR[)NK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ $ TOTAL
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
F___j YES IF YES, THEN A"PERMIT FOR WORK LVITHIN PUBLIC
ROADWAY" MUST BE ISSC)ED BY THE ENGINEERING
13 NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY: t~: ~-o
TITLE:
/
DATE: I1-7 ~
~
Cit 0! Ea�all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use ,A,
Permit #: ff /p2� W
Permit Fee:
Date Received:
Staff:
Z-312-
2012 MECHANICAL PERMIT ,/
APPLICATION/
Date: a V1( f!� Site Address: 1-1-7 U )h L Oa L-.-!
Tenant: om m,1
Name: /614 _LUX
Address / City / Zip: LI "7'41 14.) 1.C. t- Ori L
Suite #:
Phone/2 -g 7-33-7)
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Name: BURNSVILLE HEATING & JC, INC.
3451 W. Burnsville Parkway
Address: Suite 120 City:
State: %ffnsville, MN 55337 Phone: q'S-2kW-- 0066—
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Contact: t [ V 111.
License #: 14 / 6S8U6c�7/ 3
New Replacement
Email:
Additional Alteration Demolition
Description of work: Lt -e9 �u,ci e /9C, et)
RESIDENTIAL
Furnace
Air Conditioner
Air Exchanger
Heat Pump
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Other fK�JL�
COMMERCIAL
New Construction _ Interior Improvement
Install Piping Processed
Gas Exterior HVAC Unit
Under / Above ground Tank ( Install / _ Remove)
RESIDENTIAL FEES:
$60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge)
$100.00 Fire repair (replace bumed out appliances, ductwork, etc.) (includes $5.00 State Surcharge) =
ao6
TOTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ x 1%
$60.00 Minimum (includes State Surcharge) = $ Permit Fee
- If the Permit Fee is less than $10,010, surcharge is $ 5.00 = $ Surcharge
- If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee
(i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) = $ TOTAL FEE
CALL BEFORE YOU DIG. CaII Gopher State One Cali at (651) 4544002 for protection against underground utility damage. Call 48 hours before
you intend to dig to receive locates of underground utilities. www.aouherstateonecall.orq
1 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 Ian in the case of work which requires a review and approval of plans. u
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Applicant's Signature
cants Printed Name
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA158640
Date Issued:10/23/2019
Permit Category:ePermit
Site Address: 4748 White Oak Ct
Lot:4 Block: 1 Addition: Oak Cliff 4th
PID:10-53553-01-040
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: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Thomas G Miller
4748 White Oak Ct
Eagan MN 55122
Shelter Construction Llc
7040 Lakeland Ave N
Brooklyn Park MN 55428
(612) 849-8082
Applicant/Permitee: Signature Issued By: Signature