512 White Pine Way
r • ` 7 ~ •
C~~t~~cate v~ ~ccu~anc~
This Ctrtificate issued pursuanl to tht iequrnements of t6e Unifarm Building Code
cernifying that at tlu tinu of issuanct t6is structun wos in compliance with the various
onlinantes of the City ?tgulatrng 6uilding cainstnrction or use. For the followirtg:
un cWWW'Mim- SF ME ewb. Ptfudc r+o. 26060
o,.pwcr iYv, R3/U 1 y=M p;,,,;a RI Type ca,s,. VN
~of BW,d* MDQJATD O~1ST IINC „dm., 7601 145M ST W, APPiE VAUEY
512 WIE PIIE WAY 84, PIIf.9(= IST
• i . . ^ { DGW
Bmido~ Off aw
P06T IN A CXNSPICUOUS PLACE
INSPECTION RECORD
~ CtTY Of EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675 07,~i~ 95
. , , ~
SITE ADDRESS: ~ i r, l , APPLICANT:
{ 1111 (t f' l NF WAY la; 1!4-0:11 I, t iir4 • I 1 r7l
~
~PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION • .A
I` r(•'n?'t 1 Nti i:~?rrt 1 P4i,
I iJ',tll /1 I I ~iF{ I:1 {'1 ftI 1
1*11t,11 I N ! 1 I,r, (,i~lli~li 1 tJ I! I.
1 f 1110 ('1 Ifti f I}fi•i '
i t•. 1, tl I'1
F
~
~ J
Permit No. Pwnil HoldMr Date Tdphons •
:
ELECTRIC
~ PLUMBING
Hvnc S ~ 95 ~
kapwtlon DaU Insp. CammMb
FoonNOS
FWND
FRAMIMG ?.;IQS
ROOFlNG
ROUGH
PLUMBING
( AIR~TEST
( ROUGH
, HEATING
~ GAS SVC
TEST
INSUL
i
(iYP BOARD
f FIREPLACE
~ aR i~s~~r E
~ FlNALPLBG Z S ~GGOSS' ~ I
~
I I
~I FlNAL HTG ~
' ORSAT I
~ TEST I
BWG FINAL I
BSAAT R.I. I
I
BSW FINAL
I
DECK FTG I
DECK FINAL
I
I
Address 512 WHITE PINE WAY Zip 5512 3
L.ot 4 Blk 4 Sub PI[ES IDcE IST
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date: Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanent driveway
Permanent gas V/i
Sod/Seeded grass
TraiUcurb damage /
Porch
Basement finish
Deck 1-7
Please verify with the builder the removal of roof lest caps from the plumbing system and ihe shuboff of water supply to
the outside lawn faucet before freeze polential exists.
Contact engineering division at 651-4645 before working in righto6way or installing underground sprinkler system.
White - City Copy Yellow , Residem Copy Pink - Contractor Copy ~
2005 RESIDENTIAL BUILDING PERNIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagaa MN 55122
Telephone # 651-675-5675 FAX 9 651-675-5694
New Construdion Reauirements RemodellReoair Reauirements Office Use Onlv
3 registered si[e surveys shaxing sq. ft. of lol, sq. ft. of house; and all mofed areas 2 copies of plan CeR ol Survey Recd Y _N
(20% manimum lot coverage allowed) 1 set ol Energy Calculations lor heated additions Tree Pres Plan Rectl _Y _ N,
2 copies of plan showing beam 8 window sizes; poured found design, etc 1 site survey for addi6ons 8 decks Tree Pres Requi2d _Y _ N
lsetofEnergyCalculations Add'rtion-irMicatei/oo-sttesepG'csystem Oo-siteSeplicSyslem _V _N
3 copies of Tree Preservation Plan if lot platted ailer7/1193
Rim Joist Detail Options selection sheet (buildings wiN 3 or less units)
Date_~/_~~/ v3 ~ ConstructionCast
Site Address 72 Zt/? '7` j/?2 UniUSte #
~
Description of Work
Multi-Family Bldg _ Y~Pi Fireplace(s) 0 _ 1 _ 2
Proget(~wne r ~ Telephone tl~~ ) 3Z z`~~7ZJ
~
` C
Contractor
Address ~~r}C City
State lle~ti/ ~ Zip S?^~T! Telephone
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Enefgy COde Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitled
. Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber Telephone )
Mechanical Contractor Telephone ~
Sewer/Water Contractor Telephone )
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes o e City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an applicatio for p rmit, and work is not to start without a
permit; t the work 'll be 'n accordance with the approved p i he se of rk which requires a r ' and
ap7-- al of plans.
lq'~1 i R 200
Applicant's rinted Name Applicant's Signa e uU
By
OFFICE USE ONLY
Sub Types
Q Ot Foundation Q 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Exl. Alt - Multi
? 03 07 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 EM. Alt - SF
O 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ~ 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
I)l" ~ 46~
? 31 New ? 35 Int Improvement ? 38 Demolish Interiar ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
-pf, 33 Alteration ? 37 Demolish Building` ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolidon (EnUre Bldg) - Give PCA handout to appiicant
Valuation u Occupancy MCES System
Census Code L4_ Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaVC.O.
_ Footings (deck) Y Final/No C.O.
_ Footings (addition) 7 Plumbing
Foundation HVAC
Drain Tile Other
Roof Ice & Water _ Pinal _ Pool _ Ftgs _ AidGas Tesu Final
Framing _ Siding _ Stucco _ Stone _ Brick
Fireplace _ R.I. _ Air Test _ Final _ Windows
C~"" [nsulation _ Retaining Wall
7
Approved By: , Building Inspector
Base Fee
Surcharge 2 ~ L~-t7
Plan Review l
MGES SAC ~
CitySAC I
Utility Connection Charge
S8W Permit 8 Surcharge
Treatment Plant
License Search
Copies
Other
Total
PERMIT
CITYAF EAGAN
3$30 Pilot Knob Road PERMITTYPE: eurLorNe
~
Eagan, Minnesota 55122-1897 Permit Number: 0 2 6 0 6 0
(612) 681-4675 Date Issued: 31 / 9 5
SITE ADDRESS:
512 WHITE PINE WAY
LOT: 4 BLOCK: 4
PINES EDGE 1ST
P.I.N.: 10-57690-040-04
DESCRIPTION:
Building Permit Type SF DWG
Building Work Type NEW ,
~UBC Occupancy~. R-3 U-1
Construction Type V-N
. Zoning R-1
. Building Length 64
Building Width 34
Building stories 2
REMARKS:
S& W PIBR - FIVE STAR PLBG
FEE SUMMARY:
VALUATION $134,000
Base Fee $1,057.25 MI9CELLANEOUS $1,892.50
Plan Review $370.04 Total Fee $4,236.79
Surcharge $67.00
SAC $850.00
SAC % 100
SAC Units 1
Subtotal $2,344.29
CONTRACTOR: - Applicant - sT. Lzc. OWNER:
MCDONALD CONST INC 14327601 0002376 MCDONALD CONST INC
7601 145TH ST W 7601 145TN ST W
APPLE VALLEY MN 55124 APPLE VALLEY MN 55124
(612) 432-7601 (612)432-7601
I hereby acknowledge that I have read Chis application and staCe that the
information is correct and agree to comply with all applicable State of Mn.
L Statut and City of Eagan Ordinances. ~
~
APPLICANT/PERMITEE SIGNATURE ISSUED BY: SIGNATURE
~ ot O CITY OF EAGAN
~ 3830 PILOT KNOB RD - 55122
1995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Construc[ion Reauirements RemodeUFieoair Reauirements
? 3 registered site surveys ? 2 copies of plan
? 2 copies of plans (include beam 8 window sizes; poured fid. design; etc ) ? 2 ske surveys (exterior addkions 8 decks)
? 7 energy dlculations ? 1 energy calculations for heated add8ions
? 1 Vee preservation plan rf lot platt after 771/93
required: _ Yes No
DATE: ~I I 3 I~I S CONSTRUCTIONcCOST:
DESCRIPTION OF WORK: ~?'n `
STREET ADDRESS: S~ ~ W A
LOT ~ BLOCK ~ SUBD./P.I.D. ES EdaQ
PROPERTY Name: Phone
OWNER
Street Address•
City: State: Zip:
coNrw?cTOrt Company: IOCOonra I.A Phone
Street Address: 74OI / y,SZkA k)t License a3
~ity:Apo(e Ud(( (M ^ s'sla{/
aRCHRecT/ Company: Phone
ENGINEER
Name: Registration #Street Address,
City: State: Zip:
M f
Sewer 8 water licensed plumber. Fri/E g r9 R0( I vnm L~4 3"2. Penalty applies when address change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this application and state that the intormation is correct and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances. _
Signature of Applicant:
OFFIGE USE ONLY
Certificates of Survey Received _ Xes o
Tree Preservation Plan Received _ Yes No
OFFICE USE ONLY
. '5... .
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex o 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. ? 10 Multi (additional) ? 15 Deck
WORK TYPE
,0"' 31 New ? 33 Alterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MC/WS System ~
(Allowable) Main i vel sq. ft. City Water %
UBC Occupancy t 1 'l sq. ft. Y3 Fire Sprinklered
Zoning sq. ft. _ PRV
# of Stories : sq. ft. Booster Pump •
Length sq. ft. Census Code. ~
Depth Footprint sq. ft. SAC Code
Census Bidg
Census Unit
APPROVALS
Planning Buifding Engineering Variance
Permit Fee Valuation: $
Surcharge - r %g t
Plan Review 2e, p 6° r
License z z
MCNVS SAC >
City SAC ~
Water Conn.
Water Meter
Acct. Deposit ~
S/W Permit
S!W Surcharge ~ ~
Treatment PI. z 7
Road Unit , I 7,_
Park Ded. ~
Trails Ded.
Other ~
Copies
/Da eV, 0 r.Q-
TotaL• 3 y$ S' ; 5"3 DB"7
% SAC
SAC Units
. 2422 Enterprise Drive
Mendota Nelghts. MN 55120
(612) 681-1914 FAX:881-9486
* PIONLER W!0 SURVEYURS • CINL ENWNEERS
* UND vLnNNEM1S• aMDSCAGE MGHI7CCiS 625 Nighwoy 10 N.E.
k, ane ABOr ng 8loine, MN 55434
(612) 783-1980 FAX: 783-1 B83
Certificate of Survey for_ MCDONALD CONSTRUCTION
512 WHITE PINE WAY
- _ - WHITE PINE WAY~ _ ~ - -
O M
r7
955.4 956.1 966.4 v~
~ 957.2 S89°41'S2"W 85.00 958.3 ~
- SERVICE <I 545T
o
(QSS ~l ~ INV.=946.8 -
BENCH MARK o - - 1 °o
TOP OF PIPE ° r PROPOSE0 A 5 0 ___gENCN MA K
ELEV.-956,82~~ SI DRIVEWAY ~ ~ n
ETOP LEV~ 959~09
(
00 I 956.9 C95y.(,) 11.~ ~ 0 ' 960,9
~ ~-T(R6U' 3) PORCH o24.33 ~ 1 i956.9 0 21.6~ ~GARAGE ~ I o q No/
~ ~b h w=
~ "pJ1 I ~ ° //pHOUSED / / M I \
p W i 961.0
~ I 00 16.00 a
0 46.00 ~ 11.e0 958.5 w
Z ~---k---~- 4- x p 00 rj
3 956.4 1 957.1 (~l~0,957.11 to p
~~O i 959.4 959.1 i 0
4 42AGAN ~
I
~~DRAINAGE & UTiLI7Y EAGAN 5 EASEMENT PER PLAT-e~ - ~G DEPT•
L____----- RfY9E1MEp er ~ 9556)
N89°41'52"E 85.00 e57.5
q )ArE 8_.. ~ 7
NOTE: PROPOSED GRADES SHONN PER GRADING PLAN BY: PIONEER PROPOSEp HOUSE Pi.EVnTION
NOIE: BUILDING DIMETJSgONS SHOWN AfiE FOR HORRONTAL AND VERTICAL lOCA710N LOWEST FLOOR ELEVATION: ~
Of' STkUC7URES ONLY. SEE ARCHITECNAL PlANS POR BUILOINC AND
FouNOanon oiMEr+raas. 70P OF BLOCK ElEVA710N: 9G, l. 0
nOTE: NO SPEdFIt SOIlS MVESTICA710N HqS BEEN COMDLETED ON 1FI15 LOT BY 1HE ~ 9.9
SURVEYOR. THE SVITABII~TV OF SOIL$ TO SUPPORT THE 5PECiFlC NOUSE GARAGE SLAB ElEVA710N: 2-
PROPOSED i5 NO7 THE RESPONSIBNTY OF THE StlRVEYOR.
NOIE. TMS CERTIfICATE OOES NOT PURPORT TO SHOW EASEMEN75 OTHCR TMAn % 000.00 OtTlOTES EkiSTNC EIEVATOq
THOSE SHOYM ON TNE RfCORDED PLAT. ( 00000 ) DENOTES PROPOSED ELEVA110N
w-- OENOTES ORAINAGE ANO UTILITY E~SENENT
NOTE: CCNIRACTOR MUST YERiFY OA~`~CWAV DESIGN. - DENOTES DRAINACE fLOW OIRfCIION
NO7f BEnRINGS SHOWN ARE BnSEO ON AN ASSIMEO DATUM DENOTES MONUMENT
~8 DENOTES OFFSET HUB
WE HFREBY CERIIFY TO MCDONALO CONSTRUCTION THA7 11-11S IS A 1RUE AND CORRECT REPRESENTATON OF A
SURVEY OF TNE 80UNpARIES OF:
L07 4, BLOCK 4, PINES EDGE iST ADDITION s,
DAKOTA COUN7Y, MINNESOTA
IT DOES NOT PURPORT 70 SHOW IMPftOVEMENTS OR ENCHROACHMENTS, 6XCEPT AS SHOWN, AS SURVEYEO BY ME OR
UNDER MV DIRECT SUPERVISION THIS 6TH.DAY OF JULY, 1995. tNED: PIONEER 'ENGINEING, P.n.
SCAIE : 1 INCH = 30 FEET
975 94330.09 SYYK John C. Larson, L.S. Rag. No. 19828
• ~ LOT SURVEY CHECKLIST FOR RESIDENTIAL
\ o BUILDING PERMIT APPLICATION
W~ W PROPERTY LEGAL:
~ ¢ m DATE OF SURVEY: 7/
LATEST REVISION:
a = :
DOCUMENTSTANDARDS
rd" ~ ? • Registered Land Surveyorsignature and company
~ ? • Building PermitApplicant
? • Legaldescription
0 ? • Address
• North arcow and scale
? • House type (rambler, walkout, splR w/o, splft entry, lookaut, etc.)
xi ? • Directional drainage arrows with slope/gradient %
? • Proposed/ebsting sewer and water services & invert elevation
? ~ • . SUeet name _
w- o 0 • Driveway
ELEVATIONS
Existina
? • Sewer service
? • Property corners
~0 ? • Top of curb at the driveway
m~o ? • Elevations of any existing adjacent homes
Prooosed
&-'0 ? • Garage Floor
? • First floor
~ 0 • Lowest exposed elevation (walkouVwindow)
~ ? • Praperty comers
o% ? • Front and rear of home at the toundation
PONDING AREA fif apolicabtel
0 0~ 0 • Easement tine
? Er'0 • NWL
? 0-'cl • HWL
? Er"~ 0 • Pond#designation
? ~0 • Emergency Overflow Elevation
DIMENSIONS
~0 Cl • Lot lines/Bearfngs & dimensions
? • Right-of-way and sVeet width (to back of curb)
4V ? ? • Proposed home dimensions including any proposed decks, overhangs greatar than 2',
~ porches, etc. (.e. all sVudures requiring permanent footings)
B' ? • Show all easements of record and any Ciiy utilities within those easemenfs
? • Setbacks of propased structure and sideyard setback ot adJacent exisdng structures
• Retaining wall requiremen y
~
Reviewed:
me / ate
Juty 1995
0+05 ~ . I + wni
946.2 oo . v
- 955.2 s+ o 44.00 «
45' -BENfl'' « « «
X
'
_ r------
r ~
,
-
~
~r___ i
- ; ~ S= 0+45 g= 0+04 S= 0+86 : ; S= 1 +71 g= 2+63
iNV= 946.2 iNV= 946.8 INV= 94.7.4
I j INV= 945.7 I j INV= 945.6 : 1
CS= 956.0 ;i CS= 957.2
CS=.9i4.4 ~ i CS= 954.0 CS= 954.9
4 5
D+42 + 2 2
7 4 R~. ~
346.8
956.0 MH STA. 5+34
MH (L STA. +06 6 ~ 1 f I
1 R
,
~
-
c'
~
.
. , "
• . . ! ~ 4.. ~
_
~ •
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~ , ~ ~ - ~ ~ ~ U,~,.(la IT
PE,~_ ~ SIl
) ~ ~ . ~ ~ I I ,i 10, T~-1.. ~
MH ~ STA. 1
H, ANT
V= 947.4
» ICE
~ ' . OwX 6 T~
956.41
9,- °DIP, CL 52
S= 3+59
~ To GN ~L. 958.7 9 8 7
~ I ' ' I INV= 958.8
0+41 ~ 1
CS= 968.8
~ ;INV= 949.2 S= 1+20 I;,NV_ 951 ~ .5 INV- 954.3 I; 8"x8"T
, lCS= 959.0 ~ ;.INV= 950.3
3 g"G
45' BEND CS= 959.8 CS= 961.0 CS= 964.3 ;1
.
•
- 2+24 L -
,
~
-
IV= 947.9,.
5= 957.B'
H 1 ( ~ t a.--T~a -'"~--°0--+--
WHITE PINE WAY .
- S= 0+1 -7,
: INV= 948.3~'~
-
;et
. CS= 958. -
~ S= 1+93 S= 2+86 S= 3+55
d w , S= '0+14 ; I S= 1+05 1 ~ ~ ~ A ; ~ INV= 958.6
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•T6 MA1NTAIN• 1.6 •MIN: • • • . . . . . ; • . . . . . . . ' ' : : : . . . . . . . . _ . . . . : : :
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.
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JVL-11 iJJJ 1G•VJ ~L~91Y\,.UI 3111.• 1 V1G ~v~.// 1.V1 VJ
° 1 Sc 2 Family 1lcsidcntial "Cookbool:" Niclhon q~'.~?Jy
.
SffE ADDRE55 ' Cily
?IIII []ER ~ ~pG G ~ ~ ^ [)+~c
hfin[mum Crilcria:
Rim loist: R-19 insularicn Fo+indilnn IutulatcJ E.I.iss, IR' air space, umNl or vinyl fiauic
Enny doors: Ili Inch solid woocl }rith slnrm or bdter
STEP 1 I1 indow & noor Area SZ'Iil' 2 Calcul:~tc arc:~ ~s pcrcc~l ~f ~rnll
Total Window & Door Arca in Sq, i'cct 19ox A(window S door arta) d'IVldcd by 13ox A(IOiaI
VFRrpOWS (1ncLuding fcundaiion winJo•::s): vvz11 arz) timcs lfHl cqi:a)s thc winJow z:;d door xrc,
DimcnSions Qnry. Arca as a pctrcnt of wall arca (13nx C~.
z-b X 3,-65* /I// Z 11 ~ x A 3 R Z/ x 1()0 -
7ir 6'~' x5-!O`~ 11 13oz ]3 ~~qje I~ C
3' a x ~ ~(D~ _
„ ' ~ S"riT 3 Ilcsign Features
x Assr_1,T13i.Y
X i= RA r, rr: VIP. f.i..:
X
- $1'?.171)!.iil) I'I2 r.l.lltl(i.
x .
x AI)V.s.N(TD I'li <.l.fll7ii
X CP.Vfll' 1175UL~TIQ11 R ~
x
DOORS: 51rr_nnrnic;:
i.ess ru .4.ti u.s
b 11-5 bli 111[')1i12 I
\!'fI1D0WS (c¢r.cpl fu11nJaiiun u~inAu~.•e):
u
Tolal Arca oC
PTndow & Doors A
1=rom 16e talilc, dctenniue ilie mazinunn r-rccnl %vimtuw
ToIal \Va11 P.rca in Sq. Pi_ L door arca far ilic dc~igu npiinnz scicncd anA cnicr 06c
Wall Total Perimeier IJciglu ^,lea valne in boX A lulow:
~~07 [Sb~ ~
. ~
T1oz C: 11n110 lic Ic.c's Iham or cqiril In Ilu-, 11
Toial P.rca
of wall .
.JLJL 11 1JJJ 1G• 1V l~LI"IIV1..Uf 11~~..• 1 O1L YJG JOJJ I. VJ/ CJJ
'I . .
P: llie buildin,^, musl itol exceccl Ihe maximum lvin110W Rnd 4I00r 11•0r
rercenlage nf ovenll eKI)osed tvall area lisled Iielnw fnr 111,1 cc,ml,in,iion
. o( framinft Ieclini9iie, !t•valne oF iusulalioil Ivilliin Ihe IilaliltiteQ cak•ilxt.
slicalhinj; R-value, ancl ivlndotiv ll•factor. Olliar componuni~, „l,,,i „j,.C,i '
Ihc rerjiiircmenls of Ihis stil+pan.
TvfA XInnI n i 1VM I V A nIii) F)Onn aur:A
AS A PI:II('Ii197'(>I'(WIiItAI I, IcXP(15ItI) lY.11 I.
lVindmr I; liiciui
jiiamin~ • _Ins~~l~~linri ' Sl~co~Ling---. 0 ~~9 n 3~ i~ ll
srnrrpnnn r;-13 13'•1','. iizi.~,~
srnNnnrcn u•~ ~ zu.s 12.917.14L 20 I:
s`rn111nnun s . 1,.10" :16 00. Iu2,1 n;~
sTnNr) n[tn 13 51'. iui~°: 21 ?.;j;;,
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nnvaNCr:u ~ i;•~n .:r.-s 11 st. iD.i01: 1,;;. 10 1•::.
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' TOTRL P.05
L BL CITY USE ONLY
RECEIPT ~N
SUBD. (Zj, /O4Q. r ~ DATE:
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
Water Closet 3.00 x
Bath Tub 3.00 x
Lavatory 3.00 x
Kitchen Sink 3.00 x 3 . co
Laundry Tray 3.00 x w
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x
Floor Drain 3.00 x J_ _ ~.rn
Gas Piping Outlet ' minimum - 1 3.00 x ~ vo
Rough Openings 1.50 x -3_
Water Softener 5.00 x =
Private Disposai ` Dakota Cty. license 20.00 =
U.G. Sprinkler' home underconst. 3.00 =
Alterations ' to eXisUn9 20.00 =
Water Tum Around 20.00
STATE SURCHARGE .50
TOTAL ~ p
SITE ADDRESS: S I~, w N s~f f' .1 t/ t 1l
OWNER NAME:~ C P 1T/'q L
0
INSTALLER NAME- 0 L6EPoi6 GGZ/S7~
STREET ADDRESS: fiT 0 S i C-'
CITY: STATE: /Y(h/ ZIP:
PHONE
r~
, TT
OFFICE USE ONLY ~ .
L 8L RECEIPT
SUBD. DATE
1995 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PIL07 KNOB RD
EAGAN, MN 55122
(612) 681 -d675
Please complete for: • all commercial/industrial buildings.
~ multi-Tamily buildings when separate permits are IIQt required for each dwelling
unit.
DATE: CONTRACT PRICE:
WORK TYPE: _ NEW CONSTRUCTIOM _ ADD ON REPAIR
OESCRIPTION OF WORK:
IS WATER METER REQUIRED? _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING:
WATER FLOW: GPM. ARE FLUSHOMETERS TO BE INSTALLE09 YES NO.
FAILURE TO PROVIDE THIS INFORMATION WILL RESULT IN A DELAY OF METER ISSUANCE.
WILL YOU BE INSTAIUNG 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 pg= 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:
i/~ p~z
~ L BL CITY USE ONLY RECEIPT ~
SUBD ~ DATE:
1995 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please compiete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
New construction Add-on furnace
rdu-'v~8iiv~iuiii0iiii~ nuu-oi~aifcX~iiniiycr,i.e.VSf.2@SYSLel1,EtC.
Date:
FEES
? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
w
? Gas Outlets (minimum of 1 required @$3.00 each) L .
? State Surcharge .50
3l so
,low TOTAL
q
SITE ADDRESS: 512 GUl/'!a /)NE G(/~
OWNER NAME: IVC004194U C6-&57 PHONE y`32 ' 76~~
INSTALLER NAME: Cl~11/7~OLG~(, ~7,e
STREETADDRESS: 30 Z'vD Sr-
CITY: )~~R#71N6ro7L/ STATE: N/V ZIP: SSG7 y
PHONE (6!2 ) y60 y
'Xz l
~ -
cirr use oNLv
L _ BL _ RECEIPT
SUBD. DA7E:
1995 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please compiete for: ? all commerciaUindustrial buildings.
? mutti-family buildings when separate permits are pQt required
for each dwelling unit.
DA?E: C^NI?RACT PRlCE:
WORK TYPE: _ NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: $25.00 minimum fee pL 1% of contract price, whichever is greater.
. Processed piping - $25.00
State surcharge of $.50 per $1,000 of 2onmA fee due on all permits.
CONTRACT PRICE x 1%
PROCESSED PIPING
STATE SURCHARGE
TOTAL
SI'I t HUUttESj:
OWNER NAME: TELEPHONE
TENANT NAME: (innPROVennENTS oNLr)
INSTALLER:
ADDRESS:
CITY: STATE: ZIP-
PHONE
SIGNATURE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA126144
Date Issued:08/14/2014
Permit Category:ePermit
Site Address: 512 White Pine Way
Lot:4 Block: 4 Addition: Pines Edge 1st
PID:10-57690-04-040
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 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 -
David S Bell
512 White Pine Way
Eagan MN 55123
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA137121
Date Issued:06/16/2016
Permit Category:ePermit
Site Address: 512 White Pine Way
Lot:4 Block: 4 Addition: Pines Edge 1st
PID:10-57690-04-040
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
David S Bell
512 White Pine Way
Eagan MN 55123
(651) 335-5679
Home Depot At Home Services
6224 Lakeland Avenue N, #102
Booklyn Park MN 55428
(763) 542-8826
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA157857
Date Issued:09/12/2019
Permit Category:ePermit
Site Address: 512 White Pine Way
Lot:4 Block: 4 Addition: Pines Edge 1st
PID:10-57690-04-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 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 -
David S Bell
512 White Pine Way
Eagan MN 55123
(651) 335-5679
Boys Mechanical Inc
490 Villaume Ave, Suite 300
South St. Paul MN 55075
(651) 340-5956
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA157882
Date Issued:09/13/2019
Permit Category:ePermit
Site Address: 512 White Pine Way
Lot:4 Block: 4 Addition: Pines Edge 1st
PID:10-57690-04-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 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 -
David S Bell
512 White Pine Way
Eagan MN 55123
(651) 335-5679
Boys Mechanical Inc
490 Villaume Ave, Suite 300
South St. Paul MN 55075
(651) 340-5956
Applicant/Permitee: Signature Issued By: Signature