4424 Wilderness Run CtPERMIT
City of Eagan Permit Type:Building
Permit Number:EA127536
Date Issued:10/06/2014
Permit Category:ePermit
Site Address: 4424 Wilderness Run Ct
Lot:016 Block: 002 Addition: Wilderness Run 1st
PID:10-84350-02-160
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and house wrap and leave on site.
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.
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 -
Ashraf H Eldomiatti
4424 Wilderness Run Ct
Eagan MN 55123
Brand Company
6806 Faricy Lane
Prior Lake MN 55372
(952) 447-4488
Applicant/Permitee: Signature Issued By: Signature
N'JMERICAL F1LE
~ CITY OF EAGAN ~
3795 PILOT KyOB ROAD
EAGAN, MINNESOTA 55122
CASH RECEIPT
DATE 19 '
kcCEIVED
FROM ~
AMOUNT ~ I .
DOLLARS
ioo
? CASH ? CF'ECK
Foa ' - „
~
FUND CODE I AMOUNT
I
I . .
I .
I
I
4 7 4 E By
~
CITY OF EAGAN
3795 Mid Knob Roed Eagoe, MN 551=2
?HONL: 4S4-i100
BUILDING PERMIT Receia #
Te M aed Me Est. Volue Date 19 l
Site Addreu >
. Enct Q OccuponcY
Lot Block Sec/Sub. u'' Alter ? Zonirq
Porcel # Repolr Q Fire Zone
Enlarqs ? Type of Const. ~
ac Name
~ Mow ? # Stories
/lddress Demolish ? Length I
Ci ptone - Grode ? Depth $q. Ft. I
I
ac Nam i'()ol S r 1T1 C: . AVProvals fees
Addross - ~'-t'C • llssessment Permit I
u
l C~ Phone Woter a Sew. Surchorpe
~ Police Plan check
°C N. FZ Fin SAC
_g Addross EnO. Water Conn.
u
<W CI phcne Plonner Woter Meter
Council Rood Unit
( heroby acknowledpe that I hove road this applicotion ond stote thot Bldy. Off.
the intormation is correct ond ogree to comply with oll opplicoble
Stah of Minnesoto Statutes ond City of Euflen Ordinonces. APC Totol
Sipnatum of Permittee
A Buildiny Pemiit is luued ro: . on tFw express condition tMn
oll work shoil be dorw in occordonce with all appliooble State of Minnesota Statutes ond Gty of Eapon Ordinonces.
Buildinp Official
Pumit No. Pwmit Holder Misc. Pamit No. Ho1dN
Plumbiny
H.V.A.C.
YWII
w.:..
oan.
s.,~..
Ewetr~e t~~~sv~ /o -zt-~ Cd~-,_~bl~
IrMpeetion Doa Irap. OMM
Footina
Foundetion
Fnmino
Rough Plbo.
Rou¢~ HVA
Imul~don
Find Mbo. •
Fi~al HVAC %
Flnd ~ .
Woa DNeribe Loeation:
NNII
Srmr
Pr. DMp.
~ Roaipt ~ FIIECHANICAL PERMIT Permk No.
CiTY OF EAOAN _
FN -
.,1 fill in numbevvd s,rlwer S/C •
Typs w Print /pldy Tot
1. Date < x 2. installation Cost
3. Job Address ' Lot Blk. Trect
4. Owner
' 5. Conuactor Phone
8. Addroa -
7. Gty State Zip
8. Buildiny Typa: Rssidential E3 Commercial ? In:titutional ?
9. Work Description: Nsw ? Add ? Alter 0 Rspair ?
10. Dascribs Fuel TYpe
~
11. No• Equlpmeni BTU - M. Ea. No• Eauiomsnt CFM j
~ Forced Air Air Handlinp: 'I
Mfg. . ,
Boikn Mach, Exhsun
Mfg.
Unit Heater
Mfg. Othar
Air Cond.
Mfg.
Gas, Pipln9 Outlets
12. I heroby certify ftt the abovs information is true and wrract, and 1 sprae to
oomply with all ordinanoet snd codes governing this type of work. I
S9^ed: for
Rouqh F1nd
lnspections: Date Insp. Date/"" $p.~_ ,
This is your permit when numberod and approved.
Approwd CITY OF EAOAN 4648100 I
CITY OF EAGAN Remarks
Addition Wilderness Run lst Addition Lot 16 pik 2 Parcel 10 84350 160 02
owner ` t~eet- 4424 Wilderneas Run Ct. state EaAan, MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SUFIF.
STREET RESTOR.
GRADING
2 SAN SEW TRUNK 1973 175.00 $8.75 ZO PAID
SEWER LATERAL
WATERMAIN
WATER IATERAL
WATER AREA 1 149.34 A003850 -11-77
STORM 5EW TRK 1981 33.66 Z 333.66 A009461 9/23/80
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT 19$1 107.94 2]..59 $
WATER CONN. . 12-7-76
9UILDING PER. 54 4/46 - 12-1-76
5AC 450.
~ - -
PARK
Thi;:reiluestvviA(t'}/h~ L1~I ~ Isr ~Q~~v
~ei, 5~86~74 Q>Ouuf FE on ~oot W ~ 2~3~ o
F~quesl Uate Fui; Nn. Rouph-~n Insoecnon
Re~uneA~ HeatlY Nnw [}341'ill Nubiy L~;;ner
Yus ?Na Wr Whon RcatlY
? Lic;enseA Eluctncal Convncro, I herehy requast inspeciron al abovo
KxOwnei elucbm.ll wmk insialleJ at.
Simet Address, Bos or Route No. Oty
4424 Wilderness Run Ct. Eagan
ecuon o. Tuwnvhip Noino or No, li~nr~c No. County
Dakota
Occuuani (PRINT) Phuue No.
Roger Erickson 454-712J1
Power Suppliw Atltlless 3000 Maxwel 1 RU.
Newport, Mn. 55055
EI„cbical Convactor ICUmuanv Nanm) Conmmmr's Licr.n::c No.
C+71'vE5-
Muilmp Addiess (Conimr,ror or Ownor Mnkin, Instailnnon)
Au ra ignalur tmc wner Ainy Inslallalionl Phunt> NumLei
' ~ 9;4....iIIIIIIi-
MINNESOTA TATE BOARD OF ELECTflICIIV THIS INSPCCTION flEOUESI WILL NOl
G,iggs-Midwny Bldy. - Room N-191 BE ACCCPlEO BV THE STAT[ 80l+flD
1821 University Ava., SL Peul, h1N 55109 UNLFSS PROPER INSPCCIION FEE IS
o1 - 11 oov o... ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION EB-00001-03
T' ~ 6 j# See inshuctions br complabny this tmm on bnck oi yellow copy.
vJ}~
V ~~320
"X" Below Work Cavered by This Request
New AAd ReO. Typa oi Bwlding AoPlinnces Wiretl Equqlmenl Wiretl
Home Ranye Tempoiaiy Service
Duplex Water Heater Lightiny fixtines
Apt. Bwiduig Dryer Electric Heabn(Comnt¢rcial 61dq. FurnaCe Silo Unlunder
Indusbial Bldy. Air Conditioner Bulk Milk Tanl<
Fflrm Othei .uuci v) ihci ISUOeifv)
7 t. Gecily Othci Othee
Cmn uie lnsper.uan Fee Below
M Fee ServicoEntronceS,ze tt Foo Fontless/Sublentlers tl Feo Cvcwls
0 to 100 Amps 0[u 30 AmPS 0 to 30 Arnps
101 to 200 qnips 31 to 700 Ainps 31 to 100 Amps
Flbave 200 Amps Above 100_Amps Above 100_ninps
Transiormers RemoteControlGrc. Ptvtial'
Signs Special Inspection s 60.50
Rearks TOTA FE~Q.m
Wiring of Swimming Pool
Rouyh-in . " Date I, thn Cl~ctnr.nl
? 0,77 I"suectm, hureby
cx~tilv that tM1y nbova
Final ( n;'t': ~nspeebun M1ns ba"n
mnde
Ihis wqvest vmd
18 momhs hnm
?
.
CITY of EAGAN N2 4154
BUILDING PERMIT
3795 Pilo! Knob Road
Ownas ....'--.....pEiIAiS..IKQF.L Eagen. Minnesofa 55122
Addresa (Prasenl) 454-8100
Sullder ....Tilsen Homes. Inc.
627 So. Snellin Ave St Paul Minn Dett ...~ecemb.er...fi~...1.Q7.6.....
Addrate ............................................&.........~.r.........e.............a.........
DESCRIPTION
62oriec To Be Vaed For Fronf Depih Heigh! Ed. Coaf Perm!! Fea Romarln
Sing. Fam Dwl,g d Gari. 52' 48' 46p000 1~3:05 c
LOCATION
Slraef, Aoad or other Deaeripiion of Localion I Lo! BlodiO Addi!!on or Tree!
4424 Wilderness Run Ct, 16 2 Wilderness Run lst.
This permit does not auihorise the use of aixeefs, roads, alleys or eidewalkc nor does it glve the owasr or Lis ngent
the righ!!o create enp situation which is a nuisanoe or which presenls e ha:ard !o the haelth, safelp, eonvsalsaee and
general welfere !o anyone in the eommunily.
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PAOGRESS.
This Ie !o carlify, lhei.... Ti.lsen. HQme~.~...I.r{~.. ................has permksion !o eraVa.S.A.ihe•abe e desc ~bed to !he provisions of all applic ances 1y of Eagan
~~~wL..............................~.....................
.
Mayor C. Suildinp Impaetor
CITY OF EAGAN N~ - 6872
` 1793 Vllo? Knob Road Eagan, MN 53112 _
PXONEs 434-8100
BUILDING PERMIT Receipt
re ee u.ea rer POOL & FENCE Esf. Value $9,000 p,te September 11 ly 81
Sire Address 4424 Wilderness-Mm 11I't E"a R3
16 2 Wildernesa Run lat 7g o«~~~cY~
Lot Block Sec/Sub. Alrer ? Zoning
Parcel # 10 84350 160 02 Repoir ? Fi.e Zone
Roger Erickson E^i°ree ? Type of Const.
e Nome Move ? # Storie
; Address 4424 Wilderaess Rim Court pemoi;s, ~ 0063' t per~meter
U ? Length_
C; Fa~an 55123 pr,o,,, 454-7121 Grade ? DePCh sq. F<.-
p Nome Continental Pools, TS1C. AvV~orala Feaa
o'~' Address 2050 Whtte Bear Ave. Assessment Permit $~+.50
ci St. P8111 `J5123 phone 777-~g6 V?ater 8 Sew. Surcharge 4.50
Police Plon check
Gw Nome
Fite SAC
vU Addreu Erq. Water Conn.
iW Ci Phone Plonner WoterMeter
Council Rood Unit
I hereby ocknowledge thof I have read this npDlicolion ond stote that Bldg. Off.
the informofion is wrrec n ogree to comply with oll opplicoble APC Total $~_nn
State of M.nnesota 51 utes o City f Ea m~rOrd' nces.
Sipnoture of Permitt
~
A Building Pertnit Is issued fo: on the express mrdiNOn Ihat
oll work sholl be done in occordunce with /opn oppliwble St 1 ~oft ~Minnesota Stotutez and City of Eagan Ordinances.
Buildin9 OHiciol
CITY OF EAGAN Include 2 sets of plans,
1 site plaz w/elevations &
BUILDING PERNIIT APPLICATION 1 set of energy calculations.
To Be Used For. y- Valunation f~ UJ CO U Date A'/
Site Pcldress: yy'~~_G Ji~~ErHP•55(~v.e C't'~ OFFICE USE ONLY ~
L~otk~_slocx~-sec./sub~ ~Erect Occatancy ~-3
Parcel (0 ~E >-,S O -Alter Zoning
Repair Fire Zone
Qaner: ~o~e-i- ~~e -T~ of Const.
Nbve # Stories
Address: SG.~ e Dernlish Front ft.
City/Zip Code: Ss / 2~ Grade Depth 4(Q ( ft.
Phone # : Z4~41 APPROVIII-S FEES
Contractor: (fo vA~r.,T2/ /oo 111, --;t:, Assessrents Pesmit 2 y-rO
Water/Sewer Surcharge ~f, $D
Address: ac~ S~Q!(9~,~t Polioe Plan Check
CitY/Zip Code: .i~, Fire SAC '
Phone 7 7 7- g/ g-G Eng• water Conn.
planner Water Meter
Council Roacl Unit
Arch./~h5•: Sa~u ~ Bldg. Off.
Pddress: APC
City/Zip Code:
Phone n7fAL ~ • o
D
~G f~350 a 0.-)
Z
CITY OF CkGAN
3795 Piiot Iv:ob Road -
Eagan, PIinnesota 55122
PEStivIIT N0. : 831
The City of Ea.gan hereby grants to A. Ainder s Son. Inc.
of 120 E. Butler. .
Tilsen
a HEATING permit forc f Construction Co.
4424 Wildernese Run_C:£:, Trail, and
at4236 N. carlson r,ake vnPursuant to application dated 12/2/76
Fce Paid: $60.00 dated this 8 da,y of necember ~ 19 7F
1.50 s/c
Building Inspector
Mechanical Permits:
Bid Tota.l:
~
VILLAOE OF EACAN SEWER SERVICE PERMIT
7795 Pilot Knob Road PERMIT NO.: -2084
Eagan, MN 55122 DATE: 10/5/73
ZoNng: R-1 No. of Unils: 1
Owner: Wensmann Construction
Address:
Site AddresQA24 Wilderness Run Court
Plumber: Wenzel Plumbinq S Heatinq ZNC.
1 ag.aa fo comply wiM tAa Viiloga o{ Eagan Connection CharRe: 37 5.00 9/5/73
Ordinances. Account Ueposit:Permit Fee: -I4-00_010/5/_73_
Surcharge: -5Q-gtl_10J5/73
By: Misc. Charges:
Uate of Insp.: Total:
Insp.: Date Paid:
YILLAGE OF EAGAN WATER SERVICE PERMIT
379i-V:lct '{eob Road PEHMIT NO.: 1316
Eagan, MN 55127 DA"1'E: 10/5/73
"Loning: R=1 No. of Units: 1
ow,ec Wenemann Cnnatruction Co.
Address: Aq--a-[/,
Sire nddress: 4424 Wilderness Run Court
Piumher: _Wenzel_Plumbing-&_Seating_I-c.
Meter No.: Connection Charge: 320.00 9/5/73
Size: Account Deposit:
Reader No.: Permit Fee: 10.00 pd
I agree fo complr with tba Villoge of Eoyan Surcharge: •$0 pd
Ordinaneaa. Misc Charges:
7'otal:
By Date Paid:
Ua[e ol' lnsp.: Insp.:
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EACAN
1_5?X~ 3830 PILOT KNOB RD, EAGAN MN 55122
~ 651-681-4675 a ~ ~Naw Construction Reauiramenta RemodellReoav ReQUirements
• 3 registered sire surveys showmg ;q tl. cr iot, sq ft of house: and all molea areas • 2 copies of plan
(20 % maximum lot coverage albwed) • 1 set ot Energy Calalauons for heated atlaroons
• 2 copies ot plan showing heam 3 wmdow ;aes, poured fcund design, etc ) • 1 site survey for zxtenor addrtions 8 aecks
• 7 se[ u( Energy CalculaUOns . Indicate d home served hy seplic sys[em for additions
• 7 copies af Tree Preservatwn Plan rf lof FlaCed after 711193
. Rim Joist Detail Options seleqion sheet (cldgs with 3 or less umtS)
DATE 7'30 - 0 Z VALUATION
SITE ADDRESS qL ZO L'1 C-~_ MULTI-FAMILY BLDG _ Y _ N
TYPE OF WORK ~ f 7_ cd~ FIREPLACE(5) _ 0_ 1_ 2
APPLICANT SELA ROOFING & REMOI"~°=',+,~-
STREET ADDRESS ST. LOUIS PARK, M• CITY STATE_ZIP
TELEPHONE CEL~PHONE # FAX #
PROPERTYOWNER &4'c-(d EL.eL r-P TELEPHONE# ~-FS -
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category RUI.ES 7670 G1"1'EX;(Jltl' I Nflv\'ESO"C.1 RULES 7672
(J submission type) • Residential Ventilation Category 1 Workshee[ Submitted • New Energy Code Worksheel Submitted
• Energy Envelope Calcula[ions Submitted
Plumbing Contractor: Plionc ~
Plumbiug sys[eni includcs: Watcr Sollcner _ l.am Spnnl:lcr Pec: $90.00
Watcr Hea[cr \o. of 2.L Ba[hs
No. of t3atlis -
Mechanical Contractor: Phone #
X[cch.mical ststcm indudc,: :Air Condiuonma C'cc: S70.00
[-[cat Rccovcn St:stcm
~nri
Sewer/Water Contractor: Phone # I II I
II~~ AUG ~ G 7,S2
I hereby acknowledge that I have read this application, state that the information is correct, nd agree to comply ~
with all applicable Sfate of Mmnesota Statutes and City of Eagan Ordi ances. gy '
Signature of Appllcant
'
.
----------•-----------OFFICE U5E O(VLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
UpOatetl 4r02
OFFICE USE ONLY
? 01 Foundation ? 07 OS-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 0 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OB-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? OS 03-plex ? 11 10-plex 0 19 Lower Level ? 24 Storm 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 (Foundation) ? 45 Fire Repair
? 33 Alteration [3 37 Demolish (Bldg)' ? 43 Reroof ? 46 Wintlows/Doors
? 34 Replacement 'Demolition (Entlre 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) _ Fina]No C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain 1'ile Other
Roof _ Ice & Water _ Fina] _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply 8 Storage
S8W Permit 8 Surcharge
Treatment Plant
Plumbing Pertnit
Mechanical Permit
License Search
Copies
Other
Total
nat~_~3o
P.II''")Z:iU PiR:1:IY iP.L'CAT'IO_d
FT-O~..N 4 a [...D1~iA^1'J
=:,~3?CZL 6 3v-^TI0U Idl`+i".iiP.. SI' L7j3?=TA'iTED
OCC-Ji'r71Nc- S
x' US^//- x~t------'----'
0 f~ 4 !
r:71'11"Ir;1112ll COSi U
mEL.^s?=EpIvY iC0•.--`.---..._.___._.__.._.__..__..
co?lm=:i,c,vn ,i!~~Qi „Q17~. TELrxorn: rta.
anvti,ss_~'~7~,~.,~.~~ ..~'usP 1/, ~i~~ _ ~5_`_~lv
Ylot_• 7.cici»~ ^.1zn, hni7.0.ing plar.s, and energy calculac~u^s :r.i.th i:his
anpi i.c a i:inn
Signed
OPrICE USE
V_ALUiii'i.0"S-_~~.~~~ ~
SFC ---5SJ~2-=---.
v;FMLR !,:':TI:R
rtiY?:D:CYG FPPJ:i.T_'~' F-;Z SCPIci a-'1F'4 sF. ~23 fw
PIa1Ii Cci: CK Fi:r. ---'----PAFK D,^'.DiCl1TIO7.4 FEE
07.'H.uR
.G`'t1L*
FynoROpALS:
A^uSES:;17~,'T CLF.rSC BUILDITVG DEFT. PQLIC£ llF.^-T.
LI[a:'T'R crFtiR D:'PT. FI?ZE MPT. PZ1RK DE'_'T.
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P.P~PE.PTY ~~~e~i''l/1'L(AJ ~ ?.5~4/ ~
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I~LOT -PL AN
• ~ ' MASTER CARD
LoCATION 4424 Wilderness Run Ct. ~l ~a LUK ~
OWNER Dennis KbOtr
STRUCTUR: AND
IAND Useo nS Sin¢. Fam Dwl¢ b GaraQe
Issued To
Permii No. issued Coniractor Owner
BUILDING 4154 12/6/76 Tilsen Homes Inc.
PLUMBING ?epR
CESSPOOL - SEPTIC TANK
V?ELL
ELECTRICAL
HEATING 93 / ~ I • G~C~1L~,J.
GAS INSTALIING
SANITARY SEWER
OTHER
OTHER
Approved
Items (Inifial) Date Remarks Distance From Well
FOOT I NG ~ SE PTIC
FOUNDATION CESSPOOL
FFAMING TILE FIELD FT
FINAL
ELECTRICAL
DEPTH
HEATING /
OF WELL
GAS WSTALLATION /
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING L2(e-77
WELL
SANITARY SEWER
/9 7
Violations Noted
on Back
COMMENTS: yG~ f/a?
s11
cldpe,t' ~~a ~~o.~
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON{OMPLIANCE ? NON-COMPLIANCE. BUILDER DOES NOT
OBSERVED. INTEND TO COMPLY.
? ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS. ? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DEIAYED BY CONDITIONS BEYOND
CONTROL.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZFD AND DESCRIBED AS FOLLOWS:
? REINSPECTION REQUIRED DATE OF REINSPERION
REINSPEC710N REVEALED
CERTIFICATION - I cenify that I have care(ully inspected the abova in which I have no interest present ar prospettive, and that I hwe reponed herein
all significant conditions observed to be at variance with ordinancas of the Town of Eapan, approved plans ond specifications, and any specific require-
ments for oft-site improvements relating to the property inspected.
F-I ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPEGTOR DATE
COMMENTS:
s'
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1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
J` 3830 PILOT KNOB RD - 55122
651-681-4675 ~r ~
New Construc6on Reauirements Remodel/Reoair Requvements
? 3 registered site surveys showing sq. If. oflot, sq. ft. o/house ? 2 copies of plan
and all roofed areas (20% maximum lot coverape allowed) ? 1 set of energy calculations for heated atltlitions
? 2 wpies of plans (show beam 8 window sizes; poured fntl. tlesign, etc.) ? 7 site survey for exterior additions 8 decks
? 1 set of energy wlculations
? 3 wpies of tree presenation plan if lot platted after 7/1793 ~
DATE: CONSTRUCTION COST: ,S~p O o
DESCRIPTION OF WORK: 46O ~J y~
STREET ADDRESS: L~ 1I z ~I Lk- S S V,.i C- 7,
LOT: BLOCK: SUBD./P.I.D. (JJ ~A~.EA 1L t':LO 1. l,k Vi~
L W~i C ~
Narne: P1lo„e 4: P'j s ~
PROPERTY lasi First
0N1'NER I
- • i a C~ w[~ f_ e` V~ C-% ,
Strcet Address:---~q ~
-
Ciic - - - State: AA Zip:
-
Compann':_a~2A1__C___L- Phone N: ~ J? _ Y T 7 y°
COVTRACTOR 7p~ -
Strcct Address'LC ..~ti7'_
ciii state: _tl ? ' -i,,: SSd -
ARCHITECT/
ENGINEER Comp:mc: _ Phonc
Nainc:--- - - - - - - Rcgistrauon k:
Sveci Address:
Citl' Slale: Zip:
Sewer 8 water licensed plumber (reauired for new construction onlv):
Penalty applies when address change and lot change is requested once permit is issued.
I hereby acknowledge that 1 have read this application, state that the information is correct, and agree to comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Appiicant: ~
LI
OFFICE USE ONLY Dil
Certificates of Survey Received _ Yes -No ViAR 2 Q, J,9
~ i
Tree Preservation Plan Received _ Yes _ No _ Not Required ~ ? I
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-ptex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 PorchlAddn. (4-sea)
? 03 1 of _ plex ? OB 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
O 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Levei ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging O 20 Pool ? 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 O 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg. ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
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 Bidgs
# of Stories sq. ft. MC/ES System
Length 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/VU Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
-
~ ,F,or;t~ffiBe,USe~7 ~
C7ty OT L'Q~Qn ;a a~~ j Permit#
~ ~ I
I Permit Fee*
3830 Pilot Knob Road
Eagan MN 55122 j Date Received ~
Phone: (651) 675-5675 i Statf i
Fax: (651) 675-5694 i i
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: [~7/ Site Address: 44v4- cz- •
Tenant: ^ Suite
RESIDENT ! OWNER Name: i~"f M L~L1 e, r' Phone:65 ~S~,Z-,,?04
Address / City! Zip. ¢ . YL '
Applicant is: _ Owner _ Contractor
TYPEOFWORK Descnptionofwork. lZ/o&'?L i%LoU,7-t (ScIG../I GYDl-L Gi.vlLrn LiN/i
T- ~
Construction Cost: 0 Multi-Family Bwiding (Yes No~ )
CONTRACTOR Name. License#
Address: 5<D_5__ tU ~..~~1-'~l'~~l ~-~h-
City. ar p(iGLlil S[ate:N") Zip:
Phone: Contact PersonZ r''_
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Cate9Dfy Submitted Submittetl
(V submission type) • Energy Envelope Calculations Submitted
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 Contrector: Phone:
Sewer & Water Contrector: Phone:
NOTE `Rlans and supporGng.'docyments fhat, you "submii are,consideied to,tie'public.inforrriationPortions of `a
the mfo`AmiaUon may be.classified as non pub6c if you.provide spe`cific reasons that would permitfhe Cify.to
_$~.,..=x ~ conclade.that the arestiade;sec
I hereby acknaMedge that Ihis infortnalion is lete and accurate; that the vrork will be in conformance vnth lhe ordinances and cotles of Ihe City ot
Eagan; that I understand this is not a mit, t only an application for a permil, and work is nol to stah vnlhout a permit, that the work will be in
accordan pproved pl " thecw of work which requires a review and approval of plans.
x x
01c ted ame Ap canY Sy
/ Page 1 of 3
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DO NOT WRITE BELOW THIS LINE .
SUB TYPES
Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage
~ Single Family _ Garege _ Porch (4-Season) _ Exterior Alteration (Single Family)
_ Multi _ Deck _ Porch (ScreeNGazebolPergola) _ Exterior Alteration (Multi)
01 of Plex Lower Level Pool Miscelianeous
Accessory Building
WORK TYPES
New Interior Improvement _ Siding _ Demolish Building'
_ Addition _ Move Building _ Reroof _ Demolish Interior
_ Alteration _ Fire Repair _ Windows Demolish Foundation
Replace Repair _ Egress Window x Water Damage
Retaining Wall . 'Demolition ot enlire huilding -give PCA handout to applicant
DESCRIPTION
Valuation pccupancy MCES System
Plan Review CbdeEdition 2GO~1 MS9L SAC Units
{25%= }99%-=7) Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings . ~ length Fire Sprinklers
Type of Construction V 8 Width
REQUIRED INSPECTIONS
Footings (New Building) Sheetrock
Footings (Deck) Final / C.O. Required
Footings (Addition) ? Final I No C.O. Required
Foundation HVAC
Drain 7ile Other:
--yRoof: Ice 8 Water Final Pool: Footings _AirlGas Tests Final
v Framing _ Siding: _Stucco Lath Stone Lath _Brick
Fireplace: _Rough In _Air Test _Final _ Windows
Insulation Retaining Wall
Meter Size: Erosion Control
Reviewed By: Building Inspector
RESIDENTIAL FEES ~
Base Fee -78.75~-
Surcharge ~0
Plan Review D• B~
MCES SAC
City SAC
Utility Connection Charge
S8W Permit 8 Surcharge
Treatment Plant
Copies
TOTAL -I-1
Page 2 of 3
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