4462 Whitetail Way
CITY OF EAGAN SEWER SERVICE PERIWT
3830 Pilot Knob Road
P. O. Box 2 i;89 PERMIT NO.:
Eagan, MN 55121 pATE;
• ~
IO^ing `~3.
No. of Units: ~
Owrnr Lfiil.~et;e City C~ir,..~~t:.
/lddrcss:
sia Aad.on: - 4462 Whitetai.l WT<-rr Lt 33 Fawn 11.~d~.c -
Plumbew. _ ?`::rr Plixxhtr.p - A!)^Ie VaI: p iLC
?;7--25•-rt~ 56464 ~ 100.00pd
I Nm t+ anMlp wo 1M Cihr oF gqp. Connsctton Chorge: 4 25 QQ,z _1
0?~iMeen. Aocaw+t DrPait: 00~n
lil Pomdt Fee : t n s'a c7~_
Surel,orpr.
I BY Mise. CF+oegm
~ Dote of Intp.: Total:
l^w: Goft Poid:
Y OF EAGAN WAIU SERVICE PEIGAR
.d30 PilotVnob R6W
P. O: Bbx 21199 PERMIT NO.: '
Ea"n, MN 551~ bATE: - '
ZO^i^o: - 1Na. of Uniri:
~ Owner: ge utty oIIe .
~ Mdrrsr:
i Slts Addnss: 4462 e a ay awn ~•e
' P1unber ~,,zirr plum ev, Inc.
i
i M.t.. No.: o a,arge: • r
Size: (NA6W*Wt: 15•0 F'-(-
Reoder ~W"16r- - • P
1 pm *s @W* ~rleli ii N! .
o~~..a.. REC~~ r%~~ ,
~ ~ Total: . p me er
I /
er ava Paw:
oaro of I rqp.: I„W;
II
I
. ~
CITY OF EAGAN 11167
. 3830 Pilot Krab Rosd, P.O. Box 21-199, Eapn, MN 55121
PHONE: 4548100
SUILDING ~ERMIT Re"ipr #
To Mqa,@d fa 1: tt'i ;%+R Est. Vclue $ u 1,'D0 G pme
Site Address 4 i, F, L+.r) 1 TI. TM1 ,.'-l 'f Erect }O Occupsncy
Lot I~ Block ~ Sec/Sub. 'r•`.,,Ii•: 'l ~,1; Remodel ? 2oning
~ Repair ? Type of Const.
Parcel No. Addition ? No. Stories
Move ? Length
~ Name ' , . Demoliah ? Depth .
Addross % Int Impc ? Sq. Ft.
City ~ I'kone Install ?
APprorab FNs
Name
A~~ Asseument Pertnit , ? f -
9 City Phone Woter 3$ew. Surcherqe ~ f _
Polite Plan Review
G~ Name Fin SAC . `
W
~~i, nda?es: Eng. weter c«,n
tW City Phone Planner WaterMeter
Cour+cil Road Unit
I her~eby acknowledpe that I hove road this opplication and stote that gldg. Off. ~i 2 ~~n Tr. PL 2 '
fhe inlo?motion is totrect and ogree to tamply with all opplicabls
Srote of Minr+esoto Stctutss ond Gty of Eoflon Ordinances. '4PC Pa?ks
Var. Uate C~~~
Siynoturc o( Permitteo
Total 1 . _ .
A 8uilding Permit Is issued W: on the expross conditlon thot
oll worlc shnll be dorw in ocaadanu with atl oppliooble State oi Mlnnesoto Statutes ond City of Eopon Ordinonces.
Buildinp Officiol `
Pwmk No. Pwmit Ho1dK Date TNepAone ~t
wumbh-W ?~r~c ~ F ~
H.VA.C.
Ebctrie
So(tww
Impeetion Ds" Imp• OthM
Footlnps 1
Footlnys II
Found&tlon
Fnminp L97'L
Nootln9 k1,~
ROUyh Plbp.
Rough Htp.
Inwl.
Flnplaa
FInalFftp.
Flnal Plbp. Final
CWVOcc.
w~ Wsaibo Location:
WNI
SMMK
Pr. Disp.
Rnwpt MECHANICAL PERMt7 Pwmit No.
CITY OF EAOAN '
FN
Flll in numbwrd *rcw S/C
' 7ype a A?!nt Aplb/y Tot
1. Da" Z. Installation Cost
3. Job Addrat , Lot Blk.~ Tract
T
4. OwMr _
5. Contractor Phone
~
8. Addr"s
7. pri 9aa Zip -
8. Buildiny T
yps: Rosidential O Comrmrdal 0 In:titutional O ~
9. Work Description: New ? Add ? Alter O Repair ? ~
~
10. Dpcribe Fuel Type ? : i '
11. No• FQujpaant STU - M. Ea. No, Equiprttent CFM
Forced Air Air Handliny:
Mfg.
Bollen Mech. Exhaust
Mfg.
Unit Hester
Mfg. Other
Air Cond.
Mfg.
Gas, P'iping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
oomply with all ordinances and codes governing this type of work.
5igned : ~ for
Rouyh F inal 1
Inspections: Date Insp. Date Insp. 1
i
This is your permit when numbered and approved.
Approved C1TY OF EAGAN 454$100
Raoeipt 1 ' PLUMBING PERMIT Permit No.
CITY OF EAGAN
FN
Fi!l in numbered spaces SIC - ~
Type or Prirrt legib/y Tot. _
1. Date 2. Installation Cost . ~
1
3. Job Address Lot • Blk. Tract I ~
i
4. OWnBf ~
~
S. Contractor, ~ Phone ~
6. Address 1 • j
i
a
7. City State Zip ~
~
;
8. Building Type: Residential ? Commercial ? Institutional ? ;
j
9. Work Description: New ? Add O Alter O Repair O ~
,
~ 10. Desaibe ~
~
~ 11. No, Fixtures No. Fixtures
Water Closet Cesspool/Drainfield
~ Bath tubs $eptic Tank ,
_ Lavatory Softner ~
Shower Well
1 Kitchen Sink ~
Urinal/Bidet Other
1
Laundry Tray ~
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
~
12. I hereby certify that the above information is true and correct, and 1 agree to
oomply with all ordinances and codes governing this type of work.
Signed : ~ -
for"' Rouyh F inal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
I CITY OF EAGAN Remarks
Addition FAWN R= ADDITICIJ Lot 1 pik 3 Parcel 10 2S$AQ 8Ig 03
Owner Street ktrIVE ~ State-Eagan ! MV 99129
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. 57.2 1981 229,35- 11.47 20 T D, C'DII / ~-~-.2 6- S
STREET RESTOR, r 1984 499.4 - 49.95 10 3AIII. e0 ~ IL
- S
GRADING - 19$1 E)Z.ZFi 4.08 ZS . C~O rI / /L-IL
SAN SEW TRUNK IUS 1981 205 44 10.27 20 . 2-- CO 1141 a-o~ S
SEWER LATERAL 77 1951 3 - 1.65 /-,Z -S'o
1981 23,57- 18 2 . eO ? /j -lb -6 yy
WATERMAIN
WATER LATERAL 1981 43 67~ 2.18 2 L4 O
WATER AREA - 19$1 905,44- 10.27 2 S 2"1G 4S
Water Lateral 1981 27 - 1.38 c o ~~~1.j` 12 -a& d s
STORM SEW TRK 1985 557.79 • 37.19 15 eO
'Ebkjj&jge kar- 1984 222,51, 22.25 10 t? i i 1.2 -a -
CURB & GUTTER
SIDEWALK
STREET LIGHT
Tba-d DiTt 280.00 56964 25 85
WATER CONN. 500.00 "
BUILDING PER. 11197 „ of
SAC
PARK
, CITY OF EAGAN N° 1 1 16 7
• 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 ~
BUILDING PERMIT Rece+Pt #
Te be uwA br SF DWG/GAR Est. Value $$1,000 pO1e OCTOBER 24 1985
SiteAddress 4462 WHITETAIL WAY Erect Occupancy R3
1 3 FAWN RIDGE Aemoeel ? Zoning R1
Lot Block Sec/Sub. Repair ? Type of Const, V
Parcel No. Addition ? No. Stories
6 Name COLLEGE CITY CONST Move ? Length 51
z BOX 309, HWY 3 SO oemolish ? oepth 50
~ nddressNORTHFIEL7~ 507/645-6648 l^tlmpc ? ~.pt.
City 7hone Install ?
$AME ADVrorals Fees
Name
Zo u ASSessment Permit $ 376.00
nddress
~ City Phone ~?aler 8 Sew. Surcherge 40. SQ
t Police Plan Review 1 88 _ 0 Q
Name Firo SAC 52 5 . 00
x~ Address Enq. WaterConn. 500.00
u
'3 City Phane Vlnnner waterrneter 63.00
Council RoadUnit 280.00
I hereby ockrawledge thotreI have re this apDlicotion ond state thaf gldg.Off. I0/23~$ Tr.PI. 132 . 00
the inbrmation is corct and oe to wryryry~~~yyyI ieh all opplicoble APC
State of Mmnewm Statutes a Ciry of 6gbn rduwnces. Parks
Var. Date Copies
$Ipnoture of Permittee 104.50
LLEGE CITY CONSTRUCTION Total $2~
A Building Permif Is issued to: on the exprcss caditlon iho,
ofl work sholl be done in accordance with oll opp icoble Sfate Min soto 5latutes ond Ciry of Eoqon Ordinances.
Bulldirq Of/iciol r7_~
~
CITY OF EAGAN N~ 19352
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
, ' PHONE: 454-8100 I ~,~5~
BUILDING PEJRMIT Receipt a ~ /t~
To be used lor • POOL Est value $10,000 Date JUL 1 1991
Site Address 4462 WHITETAIL WAY
Lot I- Block 3 Sec/Sub. FAWN RIDGE OFFICE USE ONLv
P8fC01 NO. Occupancy -M_2 FEES
Zoning _
w Name JIM & GLORI HIBBARD (qctual)COnst _ BIdg.Permil 117.00
3 Address 4462 WHITETAIL LN (Allowa6le)
n
0 City EAGAN Phone 683-0218 +v of Stones Surcnarge 5-0
Lenglh 361 Plan Raview
~a Name pRESTIGE POOL & PATIO Deplh 18' snc,cny
ou 245 E ROSELAWN AVE
AddfB55 S.F. Total
Um City ST PAUL Phone 488-6726 SF.Foolprints _ SAC,MCWCC
.1 On Site Sewage _ Water Conn
Name on siie wen
Ww - Waler Meter
iz AddreSS MWCCSysiem
iw Cit PhOnB Gry Walar _ AccL Deposit
Y
PRV RequireC _ S/VJ Permit
I here6y acknowlege lhat I have read this applica and state that Ihe Booster Pump - Siw Sumharga
information is correct gree comply wit all apphcable State ol
Minnesota Statutes d City of E Ordin s. Treatmenl PI
Signature of Permite eez- APPROVALS Road Unii
A Building Permit is issued lo: P~STIGE PO A PATIO Plannar - park Ded.
on Ihe express condition that all work shall be tlone m cortlance with all Council
apphcable Slate of Minnesota Statutes and Ciry'/ ot Eagan Ordinances. Bidg. Ofl. - Copies
Building Olficial AP1ZITC~I TI~~I Varience - TOTAL 122.00
SEDGWICK HEATING & AIR CONDITIONING CO. HEAriNC JOBNO 5-6S `1-l-
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 861-9000 TEST RECORD
ADDRESS ~ `bl ~~~•1~ \ y•\ ~~N CITV
OCCUPANT OWNER
SOLD BV WSTALLED BV
MAKE 40MODELLTS~MP' 3166^ 0-70-0-7
SERIAL NO. ? / Q S M t~,( ~ ~ ~ ~ INPUT
THERMOSTAT f I v~ VENT SIZE
VALVE k TVPE OF LINER
¦ C
LIMIT ''X er"I JAN 1 LINER SIZE Oq / e
LIMITSETTING ;Iv FILTERS: SIZE ~ grXy NUMBER
FAN SETTING WIRING Y!x ( r d' P
PILOT TYPE J/~. %_,_l Tna A : C TEST TAG
IGNITION MODEL G/ G.I f/G-Q LIGHTING INST.
1
PILOTTIMING ~?vY
PRESSURE ~•~/~JC ~ pERCENTCOz (1 DATETESTED
INPIJTCFH (~/if/fl_ PERCENTOp COMPANVTESTING
STACK TEMP. PERCENT CO NAME OF TESTER
FORM2&S(REV.i1R9) FORMDISTRIBUTION:WHITECOPY - JOBFlLE YELLOWWPY-dTY
C~ 2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
l~ CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
~ - - - - -
Date ~ l 31 / OS HIBBARD, LAURIE ~
4462 WHITETAIL WAY I
Site Street Address I EAGAN, M19N 55123 ~ Ulllt #
. (651)633-0758 , I
Property Owner ~ -'Telephone # ( )
contractor NORBLOM PLUMBING CO. Telephone )
Address City State Zip
MINNEAPOUS, M~N~5540~ _
The Applicant is: Owner ontrac or Other
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures (excludes water softener and/or water heater--complete next
section if instaliing these appliances).
_Septic System Abandonment
_WaterTurnaround (add $125.00 if a 5/8" meter is required)
Other:
Water Softener X Water Heater $ 15.00
_ new ~ replacement
Lawn Irrigation _RP2 _PVB _new _repair _rebuild $ 30.00 '
State Surcharge $ .50
Total 5 I S. 50
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be,.in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
ApplicanYs Printed Name A n's igna ure ~11 ~ JUN 0 6 2005
. ,
RESIDENTIAL
c BUILDING PERMIT APPLICATION C1 C
c) CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681•4675
New Construction Reauiremente RemodellReDair Racuiremenis
. 7 registere0 site suneys showug sq. fl. of lot, sa, k. of house; and all roofed areas • 2 coDies of plan
(20°'o maxunum lot coverage allowea) • 1 sel o( Eneryy CalculaUOns for heated adddicns
• 2 wvies of plan showing beam 8 vnndow ;aes; poured found aesgn, etc.) • 1 sde survey for extenor atldNons 8 tlecks
• 1 set of Energy Calculations • Indicate A home served by seplic system for atltlinons
• J copies of Tree Preservatian Ptan d Io1 platte0 after 711193
. Rim Joist Oetail Options selechon sheet (blCgs wiN J or less uni45)
DATE Ad L; 2VALUAiION
SITEADDRESS MUITI-FAMILYBLDG _Y _N
TYPE OF WORK FIREPLACE(S) _ 0_ 1_ 2
APPLICANT
STREET ADDRESS Zile -Y/ CITY ~ STATE~? ZIP
TELEPHONE # CELL PHONE FAX #
PROPERTYOWNER~J/~I TELEPHONEAIZ~ ~d?2~1d
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Cate9orY - lI[\'NL•:50T.1 RCL1:5 7670 G\"fECOR}' l MI\\ESO"f.l RCL.ES I672
(J submission type) • Residential Ven6laGOn Category 7 Worksheet Submitted . New Energy Code Worksheet Submitted
• Energy Envelope Calculalions Submittetl
Plumbing Contractor: Phonc # _
Plumbing system includes: _ Water Soltener _ L.1wi Sprinkler Fee: 590.00
Water Heater _ No. of R.I. Baths
No. of I3a[hs
Mechanical Contractor: Phone N
XIcch;mical ,vstcm includc,: :1ir Conditioiung F«: S/'O.l)O
I-[r.u Rccovci} Sy'stcm
Sewer/Water Coniractor: Phone #
I hereby acknowledge fhat I have read ihis applicafion, state fhaf the information is correct, and agree to compiy
with all applicable State of Minnesota Statutes and City of Eaga r i a ces. nn
SlgnatureofApplicanf wz~-~~""'-_'
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
OFFICE USE ONLY
? 01 Foundation ? 07 OS-plex ? 13 18-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Owelling O OB 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? OS 03-plex ? 11 10-plex ? 19 Lower Level 0 24 Storm Damage
? 06 04-plex ? 12 12•plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New O 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move 81dg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)• O 43 Reroof ? 46 WindowslDoors
? 34 Replacement 'Demolidon (Entlre Bidg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
_ Foorings(new bldg) _ FinaVC.O.
_ Footings (deck) _ FinalNo C.O.
_ Footings (addition) _ Plumbing
Foundarion HVAC
Drain'I'ile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Smcco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining W'all
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S8W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
RESIDENTIAL
~ BUILDING PERMIT APPLICATION
CITY OF EAGAN l
3830 PILOT KNOB RD - 55122
651-681•4675
New Construction Reauiremenls RemodellReoair Reauirements
• 3 registered site surveys showing sq ft of bt, sq k. of house; and all mofed areas . 2 copies of plan
(20%maximum bt coverage allowed) . 1 set oi Energy Calculations lor heated additions
• 2 copies o( plan showing beam & window sizes; poured found design, etc.) . 1 site survey (or eztenor addi6ons & decks
• 1 sel of Energy Calculations . Indicate rf home served by septic system for addiM1Ons
• 3 wDfes of Tree Preservation Plan il lot plattetl after 7l1793
• Rim Joist Detail Options selection sheet (bldgs with 3 or less units)
DATE VALUATION I&C.J0-00
JOB SITE ADDRESS CUII,.4e~~ W u~/
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTYOWNERJ i m ~6) uLkr;C A'66cJ
TYPEOFWORK~IJS~u~~ GccS Kre(.'IaC9_ FIREPLACE(S) _Odl _2
APPUCANi PHONE#
MAST~~ CAS FITTERS INC.
ADDRESS ZIP CODE
2263 IVV ~NI-tlTll . SUITE2 PAGER # N(1 $T PAI li , nflN , ~&G~1pHONE # FAX
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Ener9y Code Category ~ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
_ MINNESOTA RULES 7672
- New Energy Cade Worksheet Submitted
Plumbing Contractor: Phone
Plumbing System Includcs: Walcr Softener _ Lawn Sprinkler Tce: $90.00
W.dcr I-Icatcr No. of RI. 13aths
No. of 13atlis
Mechanical Contractor: Phone #
Mechanical Systein Iticlueies: _ Air Conditionitig Pcc: $70.00
_ Heat Recovery Systcm
Sewer/Water Contractor: Phone # 7F),
All above information must be submitted prior to processing of application. Jl
I hereby acknowledge that I have read this application, state that the information is corrlect, and agree to compll
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applican ( LCL c • lzz,_U
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 2002
OFFICE USE ONLY
? 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
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) O 33 Ex[. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) O 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
? 31 New ? 35 Int Improvement 0 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings(new bldg) _ FinaUC.O.
_ Footings (deck) _ Final/No C.O.
_ Footings (addi[ion) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Fracning _ Siding SNCCO Stone
_ Fireplace _ R.I. _ Air Tes[ _ Final _ Windows (newlreplacement)
Insulation _ Retaining 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
Other
Total ^ U,UU
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675 J
New Conekuclbn Heauiremenu HemodeVNeoalr iieaulrements
• 3 registered stle surveys showing sq. fl. of bt, sq, tl. ot house; aM gll roofed areas • 2 copias of plan
(200A mazimum bt coverage allowed) • 1 set of Energy CakuYdlbns tor heatetl adtlttions
• 2 copies of plan showing Deam & window sizes; poured tountl design, etc.) • 1 site survey for exlerbr addAbns & decks
• 1 set ol Energy Calculations • Indicate tl home saned by septic syslem for atltlAions
• 3 cOpiBS of Tree PreSetvatbn PI3n tl bt pl2tled atter 7/1/93
• Rim Joi51 DeI211 Optbns selection sheet (bWgs willi 3 or less unAS)
DATE 61 a VALUATION 72 ~l1
SITE ADDRESS L~ C~07 1~n~,, ~ ~ MULTI-FAMILY BLDG _ Y _ N
_ . _
NPE OF WORK FIREPLACE(S) _ 0_ 1_ 2
APPLICANT
STREETADDRESS CIN STATEAt_dl/ZIP
TELEPHONE rie,1:2- L 3ai2CELL PHONE #72S -.2 ~ 3-2, FAX #
PROPERN OWNER TEIEPHONE #
aT o
COMPLETE THIS SECTION FOR ^NEW- RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7692
(q submission lype) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calcuiations Submitted
Plumbing Conhactor: Phone #
Plumbing system includes: _ Water Softener _ Lawn Sprinkler Fee: $90.00
_ Water Heater _ No. of R.I. Baths
_ No. of Baths
Mechanical Conhacior: Phone k
Mechanical system includes: _ Air Conditioning n M ~$70.00
_ Heat Recovery System I~ U
sewer/waterContractor: eiPR 2 6 2002
I hereby acknowledge ThaT I have read this application, sTate that the inform rrecT, and agre To comply
with all applicable State of Mlnnesota Statutes and City of Eagan Ordin nces.
Signature of Applicant
OFFICE USE ONLY
Certiflcates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
? 01 Foundation ? 07 OSplex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Mulli
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.) ? 33 Exl. Alt - SF
? 04 02-plex O 10 OB-plex ? 18 Deck ? 23 Porch (screened) O 36 Multi
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Stortn Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndalion) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings(new bldg) _ FinaUC.O.
_ Footings (deck) _ FinaVNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Watcr _ Final _ Pool _ Ftgs _ AidGas Tests _ Final
_ Framing _ Siding Stucco Stonc
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MGES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
~
1985 BUILDING PERhIT APPLICATZON - CIiY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED YITH THE CITY OF EAGAN
C014IERCIAL SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS
& STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY
SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS
ENERGY CALCULATIONS
$2,000 LANDSCAPE BOND ~j1~00u
q Cw
To Be Used For: HQbS'C; Valuation:~ Date:
~ ~•-~r-
Site Address y y~" 2Act< OFFICE USE ONLY
Lot ~ Block -3 Erect X, Occupancy fz•'>
Remodel Zoning •I
Parcel/Sub Dai,i„3 Repair , Type of Const y
Addition II of Stories
Owner Cl rv lS)»S-f2,)2jiaJ Move _ Length S
Demolish Depth So
Address '(by 3,99, 1,W`1 .3 So,rnA Int.Impr, , Sq Ft
Install
C i t y/ Z i p Cod e~ Z^y LS~~'i L cY , Jv~ w SSQ$
Phone S~!]- ~ys~ ~i,~y~ APPROVALS FEES
Contractor 5Aytnr~ A6001=, Assessments Permit
Water/Sewer ^ Surcharge 40-a
Address Police ~ Plan Review f}.
Fire SAC SZS.
City/Zip Code Engr Water Conn Sc~.
Planner Water Meter G 3.
Phone Council Road Unit
Bldg Off/jD-23_ reatment Pl 13Z
Arch./Engr. Snr?~~ j~ A)504JG APC Parks
Variance Copies
Address TOTAL
City/Zip Code
Phone 0
~
2~ x~,~ = I 24 z n s8 ° 7zo~~
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•
2-~z2 - 44 ~44 ` icl 3G .
22 ~ 22 - ~ o° 4 x I 2 ' S80B
= 12U r U ` ~6~
I 2 x io
~o~ao
TRI-LAND C0. SITE PLAN FOR:
SURVEYING
SERVICES COLLEGE CITY CONST.
4655 NICOLS ROAD
EAGAN, MINNESOTA 55122
S,.a~~N
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PROPERTY DESCRIPT~E q~~ wa
LOT--L, BLOCK3, ~
Fawro Riooe
accordinq to ihe recorded plat ihereof
DAKOTd CouMy, Minnesota
LEGEND
o DENOTES IRON MONUMENT PROPOSED GARAGE FLOOR ELEVATION= l06-00
o DENOTES WOOD HUB SET PROPOSED FIRST FLOOR ELEVATION = Ioti.so
DENOTES EXISTING SPOT PROPOSED BASEMENT FLOOR = 96-33
ELE VATION E LE VATI ON
DENOTES PROPOSED SPOT
ELEVATION NOTE' VERIFY ALL FLOOR HEIGHTS WITH
DENOTES DRAINAGE DIRECTION
FINAL HOUSE PLANS
I hereby, certify,thaf this survey,plan or
report was prepared by me or under my direct supervision and ihat I am a duly Bradley wenson, Mn. ReQ. No. 15235
o. Reqistered Land Surveyor under ihe
Laws of the State of Minnesota. Date •~ohB/HS"
~
, .
. EXTERIOR ENVELOPS AVERAGE "U" COMPUTATION
BUILDING: _ LEROY'& ALICE AOYBAL
SSTE ADDRESS: IAt 1 B1oCk 3._F`dwn Rldge
ANALYSIS BY: JLV-µ(TFU~ SD~- DATE 7-19- COMM. N0. :?•5 ,
As required by Code: Code "U" = Minimum: 1. To[al exposed wall area (0 33 Sq.Ft. x 11 = 179,63 er::6j
2. Total roof/ceiling erea 13 D Sq.Ft. x.0 = 29.64 F.7L)LJ
a. Total wall window area It`o O.D Sq.Ft.
b. Total door area 40,0 Sq.Ft.
c. Total glasa door area . 4S 5 Sq.Ft.
d. Total wall area ~..:Y........... O Sq.Ft.
e. Total wall area ..JL6214:FA ;R ;,F-ccl.TP.(PWA ¢l03,0 Sq.Ft.
f. Total wall area - Sq.Ft.
g. Total wall area - Sq.Ft.
h. Total foundation wall window area 0.0 Sq.Ft.
i. Total ne[ foundation area above grade $o. o Sq.Ft.
("U" value of each wall segment calculated on a[[ached sheets.)
a. I(CIo s~ X..o" p. 4q = '18.4 aTUx
b. 4p X..U" 0. O(n BTUH
C. QS S 5c x"U° 0,.4 S 20, ~ g BTUH
d. a33,0 SF x•'U'• O. 05~>Z 62,43 BTUH
e. 5f X••U•• U50'L 2(o. Gt BTUH
f. -x "U" _ - BTUH
g. - x "U.. - BTUH
h. - x "U" - BTUH
i. , D. S~ x"U" U. 6011 (e ° "1, 4 I BTUH
3. Building Walls: Total BTUH
If Item fi3 is the same as, or less than Item fll, you havemet the intent
of SBC 6006(c)2. _
Total skylight area ~o(r-ME(L ir~,Vt,o7oN) Sq.F[.
k. To[al roof/ceiling framing area•(average,l0%). -1E- Sq.Ft.
1. Total net insulated roof/ceiling area Ito o Sq.Ft.
Determine "U" value for each roof/ceiling segmen[:
J. 40 5~ x"o" o.ns~z 2.24~ sTUx
k. x "U" - - BTUH
1. I1 0 0 5F x"U" o, 2'~.R44 BTUH
4. Building Roof/Ceiling Total = 2L, lq L BTUH
If total of iF4 is the same ae, or lese than 112, you have me[ the intent of
SBC 6006 (c)1.
Alterna[e Building Envelope Design
To u[ilize [he total envelope system method, the values established by [he
sum of Items D3 and ll4 ehall not be greater than [he sum of Items lll and 112.
Code: 1. 710,3 R~rv" + 2. 44; f10 P 355A BTUH
Building: 3. 1167, 5 BTvH + 4. 24,1 B7vu 213,? BTUN
DSfference: ~ 142.z- ~uLi LE'S:
T1=M1 RE62lD .
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. . . . . . SLV = I.00/11 TCLL- 10.0 PSY '
a0. A70593 , TYPES _.,100 TaP
' a OF IS SPAI' N'00-00 tlUtT CUT = 0-00•04 TCOLG CLI' '0,0 PSF
~NT= 4-01-15 SPCL. 7-00-00 a tlCOL= IO.U PSV '
' . t071a 60.0 PSY
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t,;tl PEP tV(-78 7-1b-02
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Ff-lu-S% /17 Ltl5 IN-L0 L65 '
6-04-14 4.00 C l- -3779 3tl01 Y 1= -616
f- 5-07-02 4.00 C 7= -7057 1tl01 M'l= B!0
7-05-09 0,00 C e= 7175 170
i= a-03-0+ 0.00 c7_ ]uo nai
,UMtlEp DESIGN SUMMAPY='°°<0lSIGNCUMe1NEDCUpoANCE MI'IN 7YI-79 AND N05-797-=
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NO SPLICES-SLOTSPANA i0 CND(16fS. NA% LIIMBlR)= -==IS(PLA'IE RAiINGS)====
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Y. STRUCTURAL COMPONENT SUPNLY 0.
80X 338
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CANN 65009
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1 Design Information 5 Plating Infortnatidn
TC(U•L)= SU,U PSi TOt-
dC(D•L1= 1U,0 PSF
UfrG N0. R19-5010-'[P!P- 7Go TL(u•L)= 6V,0 FSF JT. nAd-SPANS(F'i-In) FYLHU-hwIL LUCdI:Or.tIL)
SMT N0. 12 D47E 1/ 9/79 5'lNE55 If+C = 1,15 60. SYY OF/HF PLA'I6 SIZC --t--
2 MaximumChordSpans (Ft.•In.) ~ i es• e z~-io ~ 10 a o vr
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LUMBER GRADE ?UP CnOHL 'dOiT.OM CHOHC 31- ~ 3'!- 5'i 1/2 % e V7
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4 Force Information L=Span (FL) SfHUCTURAL COMPONENT SUPPLY C0.
CMURD F00.C65 +IE9 FUaCE3 JOItiT LGA05 BOX338
c I_ -vi.<L M 1= -22.1L d 1_ . i6,56 CANNON FALLS, MN. 65009
C 2= -84,3L N l= iJ,hL J l= 'LS.OL 607-263-3311
C e= 59.01, J 'e4.01L
C 7= 81.21, MlAr7= -eC.OL J 7= 6.6L .
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07 CND 4 1650Y-1.5C' 11 SPC'•' 0,695 = 0,177 ? 0,413 7elJ 1070 1320
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" 1991 BUILDING PEiT7"PLION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PIANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - 6 STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCUTATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY IAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LATS - CONTRACTOR/NOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLAWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER 6 WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
~ i .
To Be Used For: '~'Valuation: Date:
/ 8'!C aG oc~ " aY
Site Address 2Tt OFFICE USE ONLY
Lot ~ Block ~ FEES
Occupancy M-2+ Bldg. Permit 171 00
r A Zoning Surcharge ,$;DD
Parcel/Sub rAW~ Rlj)4E hV~O~~ Actual Const Plan Review
Allowable SAC, Cit
Owner~~j~l~9~/ /~/BBA~iJ # of stories SAC, MWCC
/ Length , Water Conn.
Address 1,4i~ ~/7/&7 J Depth i g Water Meter
S.F. Total Acct. Deposit
City/Zip Code GAG-,ffdJ .67~-(a -9 Footprint S.F. S/w Permit
S/W Surcharge
Phone - On site sewage_ Treatment P1.
On site well Road Unit
Contractor eEST/4~ MWCC System _ Park Ded.
a?/r/-,5 ^ - O n City water Trail Ded.
Address pSQfit'atJ `~7/ PRV _ Copies
Booster Pump
City/Zip Code ,qct- SUBTOTAL
APPROVALS Penalty
Phone 7 Z~ Planner Lot Change
Council TOTAL L:2Q
Arch./Engr. Sldg. Off. bSGZl,9!
Variance
Address
City/Zip Code
Phone # 17
G~r agrees that all work shall be done in accordance with
(Signature of Cont ctor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
1 Copy: Office
2 Copy: Crew Chief PRE5TiC1EIkOI.&I '1O
3 Copy: Municipality
4 Copy: Customer
t• St. Paul Business Center
245 E. Roselawn Ave. • Suite 29
St. Paul, Minnesota 55117
CREW CHIEF
Equipment Needed ACCOUNT NUMBER POOL SIZE DATE
❑ Back hoe H Bob Cat HOME PHONE
NAME
❑ Cat H Truck
❑ Snow Fence H — ___T - WORK PHONE
STREET
Inspections Contract CITY STATE ZIP CODE
❑ Walls
DIRECTIONS
❑ Plumbing
❑ Footing
❑ Before Backfill
❑ Other
Diagram pool site in relation to house, garage, property line, and wires. (Allow 3" variance)
, .,,,,,,,„,,,,",, ,H3t S , /JP." \'- - -
U
t
1T1
rM j�
\ ‘,' '''
11"...'''''.""'"""D
* Alai
U)46C X ICS
tfilit4t4 Seer
13 111°
��_ 4114 Av ,,, I
60 Feetik
, 44. 06,11.44
I _
Re',
PIA*
.............. ....___________,
_....., , NA-
D , is'r
1)60.44 PK,
1 - iv ciii
c.e c- ., ice t4 Z'!' ?
O Mark location of filter an/or heater by (#2). ❑ Elevation from location marked"A"in diagram:
❑ Show type and location of slide if applicable:
❑ Indicate deep end by (X).
Ll Does Customer wish to retain any or all dirt from pool ❑ Location for disposal of dirt: _
excavation:
[1 Will any obstructions be encountered — such as trees, L Prestige Pool & Patio recommends that customer install
clothes poles or power/phone lines etc.: (As soon as possible following pool construction):
1. Rain gutters adjacent to pool
2. Retaining wall where diagramed
3. Run off control or drainfield
CUSTOMER ALSO UNDERSTANDS & ACKNOWLEDGES THE FOLLOWING ' ' •
Some damage may be done to the yard and/or driveway entering and leaving the yard during construction: Intial •
Customerassumes responsibility for electrical wiring and grounding of the pool (including permit if required): Initial .
Cusomter assumes responsibility for the gas installation of heater if applicable(including permit if required): Initial .
If debris, structures, or substance foreign to normal soil should be encountered while excavating which requires abnormal
handling and/or disposing — Customer shall assume responsibility If any extra costs are Incurred. Intial .
If you wish to change: filter position, slope of land, or anything else stated in this outline, please call our office —488-6726,
Crew chiefs are not authorized to change anything on the job or make any promises for work to be done by them.Any Changes
that are not authorized by the office will be charged at a standard rate — no exceptions.
Prestige Representative Signature Customer Signature
CITY USE ONLY
L BL RECEIPT
SUBD. / W RECEIPT DATE: " 1 I 7'-I -1
~~I go t
PERMIT #
1999 PLUM$INfi PERMIT (RE.SIDENTIAL)
crrY oF ErtsArr
3530 PILOT KN08 RD
EA&AN, MN 55122
(651)6$1-4675
Please complete for. : single family dwellings
: townhomes and condos when permits are required for each unit
: backflow preventer for underground sprinkler system
FIXTURES EACH # TOTAL
Bath tub $ 3.00 x = S
Floor drain 3.00 x = $
Gas i in outlet ' minimum - i 3.00 x = $
Hot tub/s a 3.00 x = $
Kitchen sink 3.00 x = $
Laund tra 3.00 x = $
Lavator 3.00 x = $
Minimum fee alteretions to existin dwellin 30.00 x = $
~ Private Dis osal S stem new/refurbished ' re uires MPC iic. 75.00 x = $
Private Dis osal S stem abandonment 30.00 x = S
RPZ new installation/re air 30.00 x = $
Rou h o enin 1.50 x = $
Shower 3.00 x = $
Under round s rinkler if dwellin is under construction 3.00 x = $
Under round s rinkler if existin dwellin 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
er softener if dwelling under wnstruction 5.00 x = $
Water soften r if existin dwellin 30.00 x = S f7. l7
; ater turnaround 30.00 x $
State Surchar e 50 $ 50
Total $ . i O
Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc.
- - - - -
I hereby acknowledge that I have read Ihis application, state Nat the intormafion is correct, and agree to wmply with all applicable City of Eagan ordinances.
It is the applicant's responsibihry to nohfy the property owner that the City of Eagan assumes no liability for any damages caused by the City during rts
normal operational and maintenance activities to the facilities constructed under this permit within City propertyfnght-of-way/easement.
SITE ADDRESS: I/lxdf
OWNER NAME : ~?+l ~fj' ~ q,. ,L TELEPHONE
(AREA CODE)
INSTALLER NAME: /"/Gtryj~?/,LTELEPHONE - 7l r' L'~
STREET ADDRESS: 3 t/ (AREA CODE)
CITY: ~ ~ ~ ~_uv nm, STATE: "L "
ti SEP I 31999 , .01
SIGNATURE OF PERMITTEE
2/84
CITY OF EAGAN
APPLSCATIOV FOR PERZ-SIT
SEL4ER AUD/OR WATER CONNECTIODI
(PLEASE PRINi)
1) PP.OPEPL1' ACDRESS: l 7, z Wi~Y
rFrs=+L DESGRI°TZCV: ~ ~ - J'-i51 A/ /r 6
(Loc/B1oGc/Sl..,aivisicn or Tac Parcel 1.9. Nts:~-zr)
, T'r ~•;I~:'=:G ST:.CC^ :v°., Drli; 0F C.cIGl^.Ai, cuILDL`:G
I _=_t .
P.F-ESLT --n=zX;/^'?OPCS=--D L7,S: 61't-1 S--'=- FP~+SLY
? i2-2 CUP= (T.iO C,SIZTS)
. ? c2-3 :CT%N1?rZ.rcr ~•rr.o^ ~ L-IT~) ( ?Iv-_s) ? i:-4 tirA=:T/CC1mC11.tr:1IL~1 ( LTNi=Si
? CCi•ME.°.CZAI,/RETF,II,/OF:'ZCE
? mDliSTu:%L
? LITSTI:LTIC~IAL/GG~'~~~~,~I`
2) A?P*TC-:~.NiT (PLEASc PFtM1T)
rr~~: C'~~~ES F C.'Tv C'o.vs~
ADDIRESS: J , u
CTT'_', STI~."-_', ZIP:
P?:G'ZE: - d 7 -
3) pl17.T, ~o IPLEASE PR1Ni) FOR CITY USE 04LY
I~ALF :
PDC3ESS: !l~lUflH Uf!iBING - APPE VA YlN(;. PlMERS LIC:ASE:
Ac[ive
CITY, STATE, ZIP; APPLE VALLEY, MN 55124 Exvired
M"" L" / / Not of Record
PHOVE: PLU,'7BEA LICENSE_ q
sr in~.elal
4) CCC[Jpp,D]'P/Cr,vi7ELt NAI`-SE: (PLEASE PR111I) I
AJDRFSS:
CITY, ST;,'I'r-, ZIP:
PEiONE:
5) IIVpIC1~TE :4FIICH PERi•LIT IS BEI\CC FtE7QUESTLID:
2-C-CIION 2q CITY SETr7ER
/
rotv'VEx,TIC:] 'IO CZTY WATEF2
~ U.'IER (PI.ZAI-ZE DPSCP.IBE) 6) IiDIG, C:ic.: .
• ?PMASE I?OID r1PP ,PGVm PER.'~LiT FOR PICi:-UP BY ONE OF AEl'VE
P=-.SE 2*.-UL APPROVED PERMtT 'I`'J 1. 2.(p 4 ABOVE
(Circle one)
7) sic.'~TLM: ~ DATE:
lwa:t~,~rsi~rQ~~:aar.a~~•.+e~.a '
F 0 R C I T Y U S E O N L Y
PE=MIT ISSL'ED
$ SL:':LR PE3Mrm
$ //G•~II WATER PEZbt?T (IiiC:.uDE SiiRC?ilRG:)
$ Wi{T°R METER/COPPERHOrZN/OUTSiD: cZ :nD: R
$ H;pmrR TAp (IyCLi;D° C03PORATZQN STOP)
5 5=i:c4 T~?
$ ~ ~ . c~u = _,.Ci;:i•r _:i'.ci^ $ / `UU ACCOliD'T DF.POSIT - NAT°_3
S <,-DO . Wr,C
SAC
$ TRGcIK fdAT°R ASSESS;!E:iT
S TRi.i::?C SE?iE:2 ASSZSS:i=:•iT
$ LATE?,.,L BE:•iEFIT/T°U.`liC SEii'=
$ LAT'cZrlL BLNt,FTT/`rT,?UN~ S•:ATrR
$ WATER TREATtIEAT PLAATT SURCHARGE
S OTHER:
$ TOTaL
$ AMOU::T PAIJjRECEZ?T n ~"~~cl'7
DOES UTI:,ZT'! CON.IECTION REQUIRE EXCaVATION Iv PUBLIC RIGHT OF [dAY?
~ YES IF YES, THEid A "PERt]IT FOR :JORS WITEIa7
PUBLIC ROADLJAY" MUST BE ZSSUED BY THE
C NO ENGIPIEERZAIG DIVISION. LIST AS A CONDZ-
TION.
SCBJEC_ TO THE FOLL0WING CONDITIOD:S: •
/
APPROVcD BY:
TZ:'Lc: '
DAT_ : /-ji
D_ .L/64vl 630.50
2005 RESIDENTIAL M H~'ICAL PERMIT APPLICATION
--7 ~ City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: single family dwellings & townhomes/condos when permits are required for each unit
Date~/
Site Address Unit #
Property Owner , <2VI Telephone # ( )
Contractor
Street Address 8910 Wentrnrorth Ave. city
State (952) 881-9000 Zip Telephone # ( )
Bond Expires:
The Applicant is _ Owner __Ll Contractor _ Other
Add-on or alteration to existing d Iling unit $ 30.00
A l /7Jp J(o Q 0,70
a' furnace _Additional _&ZPteplacement _ New
air exchanger
air conditioner
heat pump
other
State Surcharge $ .50
Total
I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that the work will
be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a
permit, but only an application for a permit, and work is not to start withou[ a permir, that the work wi be in accordance with the
approved plan in the case of work which requires a review and approval of plans.
L
Applicant's Signature
Ap"MYVW
8910 WeMworth Ave.
Minneapolis, MN 55420
(952) 881-9000
2005 COMMERCIAL MECHANICA&FRERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Pleue complete for: commerciallindustrial buildings
multi-family buildings when separate permits ve not required for each dwelling unit
Date
Site Street Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor 'A1 e y... .3.: X~n.~~n~3
StreetAddress af!h.~i~l9tiyOre8
a)toct rn;
State Zip Telephone.°#i~.'~~} )
Bond Expires:
The Applicant is _ Owner _ ConVactor _ O[her
Work Type
New Construction _ Underground Tank _ Install _Remove "see below
Interior Improvement _ Install Piping _Processed _Gas
Nature of Work:
"When insfalling/removing underground tank, call for inspection by Fire Marshal and Plumbing /nspector
PeI'mit Fe¢5: 570.50 Underground tanA ins[allation/removal
550.50 Minimum (includcs Statc Surcharge)
or
Contract Value S x 1% _ $ Permit Fee
$ State Surcharge
If rmit fee is less than $1,000, add $.50
If oermit fee is more than $1,000, surcharge
is 5.50 Cor every $1,000 owed.
$ Total Fee
I hereby apply for a Commercial Mechanical Permit and acknowledge that the information is complete and accurace; that the work
will be in conformance with the ordinances and codes of the Ciry of Eagan and with the Mechanical Codes; that I understand [his is
not a permit, but only an application for a permit, and work is not to start without a permir, that the work will be in accordance with
the approved plan in the case of work which requires a review and approval of plans.
ApplicanYs Printed Name ApplicanYs Signature
~
, _ :<~r..• r~
Approved By: , Inspector Date: (1.'~C ~'Bft iW ~ i"7
Required Inspec[ions: - U.G. _ R.I. - Air Test _ Gas Service Test - Infloor'Heat _Final
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4462 Whitetail Way
Lot: 1 Block: 3 Addition: Fawn Ridge
PID:10- 25800- 010 -03
Use:
Description:
Sub Type: e - Air Conditioner
Work Type: New
Description: Air Conditioner
Comments: Questions regarding electrical perm
952- 445 -2840.
Fee Summary:
Contractor:
Sedgwick Heating & Air
8910 Wentworth Ave S
Minneapolis MN 55420
(952) 881 -7739
ME - Permit Fee (Replacements)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Permit Type:
Permit Number:
Date Issued:
Permit Category:
equirements should be directed to Mark Anderson, State Electrical Inspector,
Owner:
Laurie G Hibbard
4462 Whitetail Way
Eagan MN 55123
$50.00 0801.4088
$0.50 9001.2195
$50.50
Issued By: Signature
Mechanical
EA084425
07/17/2008
ePermit
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
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA122229
Date Issued:04/30/2014
Permit Category:ePermit
Site Address: 4462 Whitetail Way
Lot:1 Block: 3 Addition: Fawn Ridge
PID:10-25800-03-010
Use:
Description:
Sub Type:Reroof & Windows/Doors
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Windows/Doors: If altering the opening size, a framing inspection is required.
Valuation: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 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 -
Laurie G Hibbard
4462 Whitetail Way
Eagan MN 55123
Property Claim Solutions LLC
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA123322
Date Issued:06/04/2014
Permit Category:ePermit
Site Address: 4462 Whitetail Way
Lot:1 Block: 3 Addition: Fawn Ridge
PID:10-25800-03-010
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
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 -
Laurie G Hibbard
4462 Whitetail Way
Eagan MN 55123
Property Claim Solutions LLC
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature