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4380 Woodgate Lane N
"1'i . l," Eh;jLjN . ' 3830 Pi:ot KnoE Rosd Wy?,~~ ~~RVI` pERM i P. O. Box 21189 PERMIT NO.: 5970 Eegan, MN 55DATE: 5: t ~No. of Units: r, ` t _>1i-An .y t~ Addrest: 4 3v0 {2i~ln"Ynotse: - 2~rall-~L d F~1?-l.. umber f ~ ~yy - - _ s Meftr No.: _ 3`f 7 3~o Connection Chor 5`? 0. 00 nd Sszs: Y.r . 9r /4ceount Oeptistt: 15.00 nd Reador No.: Parmit Fee: - 1 0.O`? Pd 1 NM 1e wMply vfth NN Gh ei !yr¦ Surchw OMlI~oM, ro~: .5!~ d Mlsc. Cl,a?nes: I 3 2. 00 +2ct , By --'~"/Lj TOtOl: n-~ N; r, r Dote of Insp.: DoM Paid: Irup.: CfTY OF 3830 Pilot Krtoa Road W4TER SBitVlts POtMit f~ ! P. O. Box 21109 PERMIT NO.: Eegen, MN F-5121 DATE: Zoninp: No. af Units: Owner: Stenh-Aii Ho:nes Addrosc Sih /lddroar, 4380 Yo t!oodQate Lane r23 r? ^'al.l ird Fark "i Plumber. +,'enzel '!eCh AAetrr No.: Conriectlon Cho 500. 00 vd Size: ro~. /?ooount Depostr: 15. (]0 pd Reada No.: Psrmit Fee: _ 10.00 pd ' 1"nr to sowpy MNh Nw Cih? of gqpm Surchorye: . 50 d Onil.enps. Mitc. Cho npe=; _ 132.00 Pd Total: er BY Doh Poid: Octa of Insp.: Insp.: -.--..r_-_ CITY OF EAGAN SEWER SERVICE PERMIT ~ 3830 Pilot Knob Road ~ 15 PERMIT NO.: P. 0. Box 21199 DATE: t i Eagan, MN 551,21 ~lmg: No. of Units: ~ rnr: . ten t-- t'oiues Ow 'Addrm` , o 00 ~;ate Lane L-3 F? ^;aZlard Park 4380 Slte /lddross: @11ZH =i@C 1 1 Plt1f11bQf: ~ - - 1 ~ . 1 o. 00 }~Ci 577 I I Mm to omwyr wNb !Iw G!p of VMe ConrneNon Chcroo. 41S . 00 Pd ~ ~ OrdiMwa~. ~ pormit FN: 10.00 nd ~ Surd,aro•: .50 nd By lVlisc. Charoos: ~ pots of Irop.: Total: inw: Dote Pold: I - , • CITY OF EAGAN : _ . . 3830 PNot Knob Rosd, P.O. Box 21-199, Eapsn. MN 55121 SUILDIN6 'ERMIT PHONE~ 4544100 R.ce+ar ~F d g T7 7 To M liwa fer W =Cvlm Est. Volue 97100 Doce J2M0jvffa_jR 19__M Site /Kddrea +3m ND• Y=xwm =AE Ersct ~ accuWncY RW3 Lot 23 Blxk Z Sec/Sub. ~~M PK 3 R°m°d°l 7oning So1 PacN No. Rspsir ? Typa of Const. v Enlarpe ? No. Storias Nwne Move ? Lsnpth _52_ Demolish ? Dspth 42_ Addresa 14M pIIaP xmm m Grade ? SQ. Ft. City VPZZM Phone 423-1172 Inutall O am ~??~.e..h E... ~ Nsme Address /lssessment Permit 424_00 City Phone Woter b 5sw. Surchorpe G Poliu Plan Review.2j,Z_~ Name Fiti SAC R9R._AA ~3 Addres~ Enp. Water Conn. -500,ft ~ W City Phone Plorxwr Woter Meter --63.M Coundl Rood Unft -2@0.M- 1 hercby ocknowiedys thot I hove road this opplicotion ond srote thot Bidg. OH. ~ Pariu tha informofion is tortect and Gyree to comply with all opplitoblo State of Minnesoto Stotutes and City of Ea9an Ordiooncars, V~ pou 5fpnotun of Pemaft« A Buildlny Pennit Is isswd to: mmm - an the expreu condition IFw" oll work sholl be dorw in ocoordonce with oll oppliooblo Stote of Minnewfo Statutes ond City of Eoqon Ordirwnces. BWldinp Offitiol pwmit No. PNmk Holdr Doo TeNphone s Plwnbiq H.VA.C. Ebewla softwwr Irqipeetion Dsa Insp. OthM FootieNt Foundation F..mWw 3 ~ noonrw , Roulh Plbo. _ s Rough HV / Imulatioo Find PlbO. Final HVAC Final CKdOOO. Dueribe Lotation: NNII Swor Pa Ditp. ReaiPt ' MECHANICAL PERMIT Pffmit No. , CITY OF EAGAN FN ~ ffll in numbwsd spWyr ' S/C + , - Typs ar Prlnt /epib/y { Tot J ; 1. DaLQ ~ Z. IniLallatlOfl COft • 1 1 3. Job Address Lot Blk. Tract " ~ 4. Owner Jcr,m^anr. ; iamas. ~ 5. Conusctor xlfnvp- fiF ~itirzq & - _Phone ,211 8. Address 13075 Dione< r: -_z; ' 7. Qty T.lac°;l PX?f~.T' .SUtR ZiP 8. Building Type: Raidsntial 13 Commercisl ? Institutionai O 9. Work Desafption: New Q Add 13 Altar ? Repsir ? 10. Dsscribe ^aF,.,~ rT-t1- 'i ,r FuelType r,,1 t-.,- : 11. No• EquWpepi BTU - M. Ea. No• Eauiumtnt CFM Fordd Air Air Hwdlinq: 1,1.~.13C`i.i'J'i~ J•~ r.~. Mfg. Boilsn Mech. Exhaust Mfg. ' s, r,ri i~, ~nr k_` lt'rlel UflIL HRaLOr . ~ i'. ` A•,.3 Mfg. Othsr Air Cond. Mfg. Go.PipinqOutfett ;rr:.;.~r 12. 1 hereby certify that the abovs information is true and oorrect, and I ayrea to ~ oomply with ali ordinanoes and codas qo+rerniny this type of work. Siy^°d c for Rarqh Final Inspsction:: D,te Insp. Date Insp. This is your permit when numbered and approved. Approwd CITY oF EAGAN 46"100 i Recaipt PLUMBING PERMIT Permit No. CITY OF EAGAN ~ , ~ • Fse FiJI in numbered spaces S/C 7ype or Print /e{libly Tot. 1. Date 2. Installation Cost y 3. Job Address Lot Bik. . Tract 4. Owner ' - , 5. Conuactor Phone - r 6. Addreu ~ CG - 7. City State 2ip _j~ 8. Building Type: Residential C3 Commercial O Institutional ? 9. Work Description: New ~ Add O Alter ? Repair ? 10. Describe 11. No, Fixtures No. Fixtures ~ Water Closet Cesspool/Drainfield / Bath tubs Septic Tank > Lavatory Softner ~ Shower Well i Kitchen Sink Urinal/Bidet Other ~ Laundry Tray ' --T 1; ~c•~~a/ r Floor Orains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that tfie above iniormation is true and correct, and 1 agree to comply with all ordinances and codes governing this type of work. Signed : ; f for / Rouph Final Inspectionsl Date Insp. Dete Inap. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-6100 CITY OF EAGAN Remarks Addition Lot 23 eik 2 Pe?cei_ #10 47252 230 02 Dwner Street State Eagan, NN 55122 438 North Woodgate Lane Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 7~- STREET RESTOR. GRADING SAN 5EW TRUNK ~ SEWER LATERAL .f/ 1981 4 Z 47 ()$2.50 A014 $8 10-2 -84 WATERMAIN * WATERLATERAL 1981 WATER AREA STORM SEW TRK 7~ 19laA 81 467.74 ~ 93.55 5 93.58 A014788 10-25-84 * STORM SEW LAT 1981 CURB & GUTTER SIDEWALK STREET LIGHT 280.00 49577 2 15 85 WATER CONN. 500.00 of BUILOING PER. qgcjg SAC PARK INSPECTION RECORD T CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (651) 681-4675 SITE ADDRESS: ' ' ` ~ ~ " ~ - t. t „l, f' " APPLICANT: Wf E I ANI N 0 PERMIT SUBTYPE: TYPE OF WORK: INSPECTION • DA F ~ L Permn Molder Dabs 7elephons s SEWEIV- WATER PLUMBING HVAC Napscdon Dab Nap. Conrmnb Foonrx3s FOUND FRAMINC3 ROOFlNG ROUGH PLUMBtWG PLBG AIR TEST ROIKiH HEATIN(3 CiAS SVC TEST INSUL QYPBOARD FIREPLACE FlREPLACE AIR TEST FlHIAI. PI.B(i FINAL HTQ ORSAT TEST BLDG FINAL I DOMEST{C ~ MEfER I IRRICiATION I MEfER FLUSH I MAINS I CoNOUCrnrrv TEST HYDROSTATIC I rEsT I BSMT R.I. ~ BSMT FINAL DECK FTCi I DECK FlNAL I, , This requesl wltl /1 U ~arb 3 I I/3 I~ 5 5 frOm 18 .1482 ~ H~est Ua:rs Fire No. PoupM1-in InSVection ~ Heamred? ReaAy Nuw PWill Notdv Inspec- Ycs ?No Im When fleady jp Licensed Eleclnml Contr:mmr I hereby request inspectmn ol abmo ? Ovinncr electrical work mstalleC aL Street Atldress, Boa or Rmte No. Citv 4380 Wood ate Ea an eciion o. Township Name or No. R~ngc No. Coui~ly Dakota Occvpdnt (%tINT) Phone No. Fower Supplie~ Atldress rnin ton Electriral Con[raclor ICOmpanY Namo) Contr;~c1ur's Lmense No. Petersoii Electric Co. 041192 Mailinp AdJress (Convacror or Owrrer MakmB 1.swilation) 13359 Folia e Ave A ple Valley MN 55124 AuNorrzed Signalure (Conbactor/Owner Makine Installation) Phone Numbcr 432-4022 YINNE$pTA STATE BOARD OF ELEGTRICITY THIS INSPECTION HEQl1EST WILL NOT Griggs-6lidway Bldg. - Room N-191 BE ACCEPTED BY THE STqTE BOAND 1821 Univorsity Ave., SL Peul. MN 55104 UNLESS PROPEN INSVECTION FEE IS PAnm 1021 2972111 ENCLOSED. . y U I~ REQUEST FOR ELECTRICAL INSPECTION M E9-001Do14 ' bee instructions for campletuy this form on back ot Vellow caOV. 5 ~ 23482 "X" Below Work Covered b; Thrs Request Hdd Rep. Type ol Builtling Qooii a.ces wi.ea Equiument Wire.f Home Range Temporary Service Duplex Water Healer Liyhtmy Fixtures ApT- BuilAing Dryer Electric HeaUn Commercial Bldg. Furnace Silo Unloader Intlustrial Bldg. Air Conditioner Bidk Milk Tank Farm ocnn, vec1 v ener (speuty) t r Sueuty Other Otnur ompute lnspection Fee Belaw N Fee ServiceEntrence5ize p Fee Fexders~Subleeders N Foe Clrcuits 12. . 0 0 ta Z00 qm s 0[0 30 Am s to 30 Am s Above 200 qmps 37 to 100 qmps Z 10 . Q 1 to 100 qm s Swinming Pool Above 700-Amps Above 700_/amps Transrormers Irrigation Boorr.s artial•'Other Fee S igns Suec ia l I nsNec! ion $ 42.5U TOTAL E Remarks ~ ~y O~ \ O~ floo9h-in Oate'J L I. the Eledtricaf~ Inspactaq heroby rU~y lhat ~M1e nbove Final ,DI,oi, insDe.tion has been made. 'C tt" repuesl void 18 monire Imm CITY OF EAGAN rJo g g g g 3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT rtece+Pt # Te M awd fer SF DWG/GAR Esr. Vnlue 97,000 pare FE6RUARY 15 , 19 85 Site Addreu 4380 N0. WOODGATE LANE Erect gl Occupency R-3 Loi 23 Block 2 Sec/Sub. MALLARD PK 3 Remodel ? Zoning R-1 Percel No. Repair ? Type of Const. V Enlarge ? Na. Stories Move ? Length $2 , W Neme STF.PH-AN HON1E'S Demolish ? Depth 4;k_ ~ Address 143¢0 PIi.()T IQ]O$ RD Grade ? Sq. Ft. City APP VAiT.F.V Phone 423-11 79 Install ? o Neme SAME AVVrovab Res Address A:sezzment permit 424.00 • City phone Wu1er 3 Sew. SurChorpe dR 5(1 w Police Plen Review 219-(10 ~w Neme Fira SAC 525_00 Atldress En0• Water Conn. Sflfl ()!1 ~ W CitV Phone Vlonrwr WoPor Mefar 6'i _ nn CounNl Rood Unit 280 nn I hereby ockrawledpe thot I h othis apD " hon ond store fhot Bldg. Otf. Z 14 SS Perka the inlormotion is wrrect an " ree t co ly w h oll opplicabla APC TP 132_~~ Slpnotum Stote of of Per mMinnewtaittea Stotutes Gry Eo Or inoncez. - f~ er. oace qOTps,: z,184.50 ~ A Building Permit Is iuuee to: STEPH-AN HOMES on tha ezDrcss cordiNOn ihot oll work sholl be dona in acmrda with oll opp//l~" abla State of Minnewto $tututes ond Cify of Eopon Ordinancef. Bulldinp Of/itioi r ~`~-CA .Lmti h.,~.~ j . ; For oni-Ca u5a ; City of Eapn I Pertnit I I Permit Fee~ G a~ I 3830 Pilot Knob Road • Eagan MN 55122 j Date Received. j Phone: (651) 675-5675 Fax: (651) 675-5694 ~ sian: i 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: 4130.0 /V, W Qo A GaT e-, ' Tenant: Suite RESIDENT / OWNER Name: Phone: s '(o ~ 4-0 Address / City / Zip: Applicant is: _ Owner % Contractor TYPE OF WORK Description of work: Construction Cost: U! ~`~-CvCAN ~ Multi- mily Building: (Yes No CONTRACTOR Name: License N0W LffA CODZI8Ct19go If9C. Addr~ss:. . 190249488 Pf HifMvood Orive. St. Peul, MPI 55119 State: Zip: Dffice: 651-224-3442 Fax: 851-330-8009 P606 5ontact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 Energy Code . Residential Ventilatlon Calegory 1 Worksheet • New Energy Code Worksheet Category Submitted Submined (4 submission type) • Energy Envelope Calculations Submitted < In the last 72 monlhs, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Conlractor: Phone: NOTE: Plans and supporting documents that you'submit aie considered to be public informatian. Portlons of the lnlormatlon may be classified as non-pub!!c 11 you provlde speclt)c reasons that would permit the Ciry ta conclude that the are trade secrets. I hereby acknowledge that Ihis information is complete and acwrate; Ihat the work will be in conformance wit e orcT nce and codes ol the Ciry oi Eagan; Ihat I underslantl ihis is nol a permit, bul only an application for a perm' k is nol ta ul rm' ; Ihal the work will be in accordance with the approved plan m the case of work which requires a review and roval o ns x h X Applicant's Printed Name t's Signature • Page 1 of 3 ~1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN ~ NOiE: ALL CON'IRACiORS MUST BE LICENSED F1ITH THE CITY OF EAGAN INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCULATIONS To Be Used For: Valuation: Date; ^oFj~ w Site Address: OFFICE USE ONLY Lot; ~-)j Block Sect/Sub /dU~z/ Erect ~C Occupancy R-3 Remodel Zoning 7-~ Parcel I1 Repair _ Type of Const S= Enlarge /I of Stories Owner Move _ Length S2 Demolish Depth 4'L Address Grade _ Sq Ft City/Zip Code Contractor /647c S APPROVALS Address pssessments Permit W Water/Sewer Surcharge 510 City/Zip Code ~,rQ/r U~`/lcy gelice Plan RevieN Fire SAC 25 Phone I! Engr Water Conn ~pp, = Planner Water Meter Co3 °O Arch./Engr Council R d-Unit Bldg Off Parks Address APC ~ Treatment P1 Phone I/ Variance iOiAL I ~ S d ~ h a o ~ • o~~ , Ja 0 : II V D` ~ ~ ~0 Ey,~s1 otP,c "1 9.~ 42.3:b - ~ . . , F~ W ~ o +,n2?.r.c ~ ; o i , > o:o ny ~M..l, p M~ 36 p ' o n0/ n Q t~ I ~ ~ e/ . 93°.~ ~J j" F•.'~~i O~c,n _ ~ ~ ~ti.~ 92~,3 z~.?s~f eF 1~•.~ ~ _ / . ~ ~ ~ ~ o " ~ - - - ios, I' 3n y*,v , 9t9,~. r \ c..~yi 9t~.L ~ti0-•Oe,' • , \ F-~..i q 2'1. f~ N ~•~f'1~•d ` ~ q 0 0 M M -i- I v~tuu~-~o•,t 6.oT z3, b~.oao~ z, ~JtALE 1"=3v~ MALVAQ.C PI?.R.K- ALL ~~uo AffuAftO TNia.C ADCI'T'1a~.i~ e OWe'TEf IRo1! MV1lUM6lT OAK.e T~?, c o V I~IT `f ~ MiNNefo'r~. I hereby certify that this survey was prepared by me or under my direct supervieion and that I am a duly Registered Land Surveyor under the laws of the State of Minnesota, L oy . Dohlen Registered Land Surveyor No. 10795 - - - - a , % . ` - - r::...:,, j' . , . . - - E'Ll i ~ . , . ~ - , 1a~lweo . 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I • h O Y ~ t_ O FI 9.4 e.. . c~ _ . _ '__J' Ji 111 _~1__ ~ a r ut.•'r~:~_~rt* ~ ~r. _ •en / I - 1 ~ . i1tlZ FLOOY au? . . ~ . " 1- ' ' ~/1:1•0 ' . / . . ~ 204 ' ' ' ' . , , 4 ~ _ ' . ' ' ' _ ~ _.~1.i - ' . • , e ' ' _ ~ ` :;;~.;y~.': _ . . . . . . ~ - " . !'r-,• , . . . - ~ . - ' ~ . , ,l- . : . . . - ~y_ _ . . . . ' . . . . . _ ' ` ' . ~ .i . . . . ' r " . . . ` . ' I . . . ' U. [.6...-_ ' . . . I~ J ~ i S 70 p' ri • u: • . . • ~ , ~ 3.f • . • ' • . a . Y. ~ ~ • : . . : . - a P . _ / : •I - -----,5. - - . ~~a•< ~ , t j - _ ' ~ ' . . ~ ~ . nrcwoat 9/h'3 . . E - • . - ~ ~ _ ~ "~e~e . n• I qI ' . . . u... u . . - . . :eco._ ~a •...e - . - '.~a.~irx~~-r~'i . .'-Y ~ ~ • . - ~ ~ . . )~.2"~.v ca ws~+r. • ? . eTU[ ?~)9ur . . ' ' " - . _ . _ _.%a'.r~. . O . ~ . ' . - . • ' I ~ . • , . _ : ' . - . ' _ . . . . . e . ~ . . , - ' - . nv~n wvH.• - ~ ~ .IUnr m0+ ]{r• I I I I - ~ I 1~ ~ - 1LIM . : ar - - ' ~•iJ•. _ ' ' ' f "..~.~...I .1- ~ 1-_!-T ~-.1~ '---J.' _ " - ' f I tat__ I I <..,e anv I I: ~ I I ° I I Yl~M11 IrL~vY~J,LIfp\~O\ ~ e~ . I uli~~ vu : n ~ I 4 s ~ L r - - e . P ~ ~=v7-. - • , a - I I : t ' i ~ ~ ~ ~ • M •I C2y d'I i o I ~Bn/ z' IA1 O - • ~.i ~ ~ W_N__~ __~~4~?_t';-ffT.(._iAJJ~__L'o~d, ~1 : • heoi bn ~i - . . . hw/ ba atal mn7ml .Yell oroo t~ BT~/ Wal renical heat lon Z f~. . ' . . ' - dal (loor 8 ce:linp area ~ ; atd fbor 8 wilinp hoet bu ? 97-0 . Gaa Rmd {eroed ai. L FvpsX ~ • . 1 ~ ~ - . . ~ . . . . ~ ~ ~ • _ . ~ . ~ - ' . - _ ~ . . PERMIT ~ CI''P°Y OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 0 3 3 7 8 9 (651) 681-4675 Date Issued: 10 / 2 6/ 9 8 SITE ADDRESS: 4380 WOODGATE LANE N LOT: 23 BLOCK: 2 MALLARD PARK 3RD P.I.N.: 10-47252-230-02 DESCRIPTION: T.O. & REROOP ' Buildincj,Permit Type STORM DAMAGE Building Wor.k Type REPAIR Census Code 434 ALT. RESIDENTIAL ~ A ` REMARKS: FEE SUMMARY: CONTRACTOR: - Applicant - ST. Lzc. OWNER: ERICK KALLERUP CONST 17019892 7591 NYSTUEN TOM 7406 1ST AVENUE SOUTH 4380 WOODGATE LANE N RICHFIELD MN 55423 EAGAN MN 55122 (612) 701-9892 (651)954-9594 2 hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State ofi Mn. Statutes and City of Eagan Ordinances. L ~ APPLICANT/PERMITEE SIGNATURE 436SUED BY: SIGNAT qE 00 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN S ~ pl ~ 3830 PII.OTKNO 7 RD - 55122 New Construction Reauiremmts RemodeVReoair Requirements • 3 registereC site surveys ? 2 copies of plan ? 2 copies of plans (inGutle beam 6 window s¢es; pouretl fid. design; etc.) ? 2 sae surveys (exterior addrtions 8 decks) ? 1 energy wleulations ? 1 energy caleulations for heated addrtions ? 3 copies of tree preservation plan A lot platted aRer 7/1/93 raqwred: _ Yes No DATE: I l~ f~ IAS' CONSTRUCTION COST; DESCRIPTION OF WORK: I~C( ~"C) -Pr _/6 e- r('jOf ETU f YYl (L 1/VLOn-5 ~ STREET ADDRESS: -C 2 N ~ w0~~%~ °L~ ~ n ~ LOT: ~ BLOCK: ~ SUBD./P.I.D. W e~-~Q ~,,n ~ C'~.~ f~ 3°~~ Name: f v ~dv qt n 7 O VV1 Phone PROPERTY azt Fust OWNER c StreetAddress: r, U NW~~lz~~Q, C 1-/1 ~ City ff ei C~ V\ State: M ~Zip: Company: ErIGk KGi1(e('VP C61'1s-L Phone#: 7C) CONTRACTOR Street Address: 7"4110U 15T License I? 752 ~ City L G~ u h State: M N` Zip: 5 S<l ARCHITECT/ ENGINEER Company: i Phone N: Name: Registration Street Address: Ciry State: Zip: Sewer 8 water licensed plumber (new construction onty): Penalty applies when address chang and lot change is requested once permit is issued. I hereby acknowledge that I have read this application and state that the iniortnation is correct and agree to comply with all applicabl Sfate of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant. L/' t~/~ ',;7 L~\@ OFFICE USE ONLY I Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No _ Not Requ' ed . ~ OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation O 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ? 02 SF Dwelling ? 07 4-plex O 12 Multi Repair/Rem. ? 17 Swim Pool O 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility ? 04 SF Porch ? 09 12-plex ? 14 Fireplace O 21 Miscellaneous ? 05 SF Misc. ? 10 _-plex ? 15 Deck WORK TYPE ? 31 New 0 33 Alterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MClWS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Depth Footprint sq. ft. SAC Code Census Bldg Census Unit APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License . MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit SM/ Pertnit S/W Surcharge Treatment PI. Park Ded. Treils Ded. Other Copies Total: % SAC SAC Units - ~ a - ~ 2/84 R ~ . ' J CITY OF EAGAN APPLICATZON FOR PERMIT % SEWER AND/OR WATER CONNECTIOr1 ' (PLEASE PRIHT) 1) PROPII21^! ADDRESS: _430d LN r.rrnr DESCRIPTICN: ZOT 2,'3 Z /yA(-L1.~,pD (~t/Block/St_bivision or Tax Parcel I.p, Nimmer) IF rCIS _ ~ F.=:ffT . PRESEW ::'-,`]IL~N:/P20PpSM USE: ~I R-1 SINGLE FAMILY ? R-2 DUPLF-X (7V.p UfqITS) ? R-3 TOWNII;C(fSE (TIIIiEE; + UNITS)( UNITS) 0 R-4 A^rAh"iPIENT/COPIDC{~LINILT,i ( Wi ITS) ? CCMNIERCIAL/REPAII,/OFFICE ? IIMUSTRIAL ? INSTITUTTONAL/GOVERNAENT 2)APPISCANT (PLEASE Pli Ni) NAME: _ ST~'PN-AN G~~A~MAw,~(J awoREss: O ' CITY, STATE, ZIP: _ P/~C~ /CfL(~V ' M~? •~SIZ4' f-T PHOiNE: 3? pL.7mBER NFME: PLEASE PRINT) Fpp CITY fISE ONLY m WEI~2!Et ME'e'APfl' PLIIMfiERS LICEHSE: ` ADDRESS: .36WKFNNFRFC I'1RIlJE EAGAN MINN.5517t 452•1565 ~ Active CZTY, STATE, ZIP: Ezpired ' PHO[VE: PLUMBEfi LICENSE q 001445M2 0 Not of Recor a ni ia 4) pCCCTPpNT/a.,RNgR G' (PLfASE PNIN~r)} . N71ME: ~I _740N `AR.) 4C/ 1~/fl~ 5T i+DDCtE55 : CITY, STATG, ZIP: ~ A,) PHorrE: -33 2 cs 5) INDICATE Wf1ZCH PERMIT IS BEING REQUESTEp: ~ CONNECPION 'IC) CITY SEr]ER ~ CONNECTION TO CITY WATEF2 ? 0'1'IIER (PLF115E DESCRIDE) 6) IINDIGl'1E- ONE: E] PI,Fl'1SE iIOLD APPR(TJID PERMIT FOR PICFC-UP BY ONE OF 11B(7VE ~ PLFz'LSE MAIL APPROVEp PERMIT TO 1, 2AO 4 la?OVE (Circle one) 7) =Ir`.ZURE: DATE: Z~3 O~ ~r w R~w~t~>. aw u.. ...:s.~i..+l a~f ~i ~iiia!?~%Iri "wi ii~l A iiirs~ I~!~ r Ya1.TEtT~1'! TE ~O~ i~ F O R C I T Y U S E O N L Y . I PERMIT ISSUED FEES: $ .5 U SEWER nE. RMIT (INCLUD:: SpRCt!P.R,E) O WATER PBRDqIT (INCLUDE SURCIIARGE) $ C&• a'0 WATER METER/COPPERHORN/OUTSIDE READER $ WATER TAP (TNCLUDE COP.PORATION STOP) ~ SESJER TAP $ a O ACCOUNT GEPOSIT - SEWER $ /S. ad ACCOUNT DEPOSIT - GdATF..R. $ _ y'oe, ea WAC $ ~S~S. eG SAC $ TRUNK WATER ASSESSMENT $ TRUNK SEWER ASSESSMBNT $ LATERAL BENEFIT/TRUNK SESaER $ LATERAL BENEFIT/TRUNK WATER $ OTHER $ TOTAL - . , $ ! a a•~~ ---`'AMOUNT PAID/RECEIPT # ,eZ S$ DOES UTILZTY CONNECTION REQUIRE EXCAVATION ZN PUBLIC RIGHT OF WAY? ~ YES IF YES, THEN A"PERMIT FOR WORK WITHIN ~ PUBLIC ROADWAY" MUST BE ISSUED BY THE NO ENGINEERING DIVISZOC:. LIST RS A CONDI- micy. SUBJECT TO T[IE POLLOWING CpNDITIONS: APPROVED BY: TITLG: DATE Y_=/=Cr No wi+ ~ w~ s~ w.~ ~r ~a ~ w~ w~ ra ~s4 ~~Y,'T ~!'!I ~R ~ wd~ w~,~a s~ w,+ w?~ ra s~ o Addrou P oian Da~o1..~-.j- cY~ HEATLOSSCALCULATIONS 'otaf Hr~at Loss + gg x1 ib = =Total Btu Input I All windowt & dools aro wanthentrippad Room I LOth. ~r "Wth. L • Ht. • FI. . Roam LBN " ••Wth. • Ht. ~ Wulirv N.iUhl Nu.al linedll. 11n. Witlib MeipN Naol llnolll. Aru II hu ol cu[L vl. No. ol I.en~ ol pm 114hu nl <rocL vi. II. No, ol p.n. OI Mne /L X EEL~q~~ I Z a2/ - ~bwo n~ ,doo ~ ,doo„ PK.. 3 „ Cael. BTU /tloon Cod. BTU /doon ibhntionW~nGOw~ 47 a inlilvuionWinCOwt 47 dJtnuan W/DOOn 118 ' Inlihntlon W/OOOn itB ,idlmwn5/Oaon 71 ~n111vnionS/Daon 71 .y Wa11 l Z eaV. Well as ~ 48 Gio,dDoo.i 411 Iluw b Doon I 7 y - ~ 7 ld Nst E.P. We11 i~.~~. b~ L.Ii. Wirll I i. T ~ e c.wre 2J- g 5 7 70 Floor 7 f0 r'IILI BIY. O TO1a1 BIY. "F1.~ &Le Room I L9th. "Wth. FI. Room ~ L9th~ D "Wth. T' Nt yy,atp Helptit No.ot Lineali,. Aru ~ eipnt No,ol Linaeli~. H~n No, ol Wn. ol0ana II M, of cmck W.11. N~' I Oen li ~u e1 cmc4 W. _f O Z 1 .L o \ efift /aoon /aoon Cool. BTU Itlocus Coet. BTU moo,. T ^ 47 InliHr~lion 1 47 ~_,2yy nlilvtlion WinEOw. G`~ L i 11B InlilbetionW/DOOn 118 n4hriiro W/Dna• nliuuuon S/Omn 71 Inllluetion 5/Daon 71 C• pi. V41~ E ep. W el l ~ ibu b Onw~ ~ 6 L Gma & Ooon ae L GnEin.V/NI 7 Nat EeP.WHI _ 7 ~ 1- n i- Gliina Q 6 Q Criline Q g ~ 3 5 F1~ 7 3 10 Floor 1 Tou18lu. (rrf Tou18rv. Room I LBth. • „ Wth. O• „ Ht. ' FI. Room L9th Wth. itll " Ht ' Width HuQhI No.ol Linenlli. Ane No. ~ N~~AM1~ NO.oI l~~eal Arw Nn. of Wnv of P.I. li in OI cnck W. h. of pene OI Oene li ~tf OI Cr~[\ p. h. Q ~ / - IOOOn /AOOn /doo Cont. BTU Id~o'~ Cw1, 9TV n 47 A7 I nliltnrlonwlnaows InblvninnWirWOw~ O~ - ( -718 wiooo.. tte ~ IntilvmionW/DOOn lnbiv~~ion5/DOOn 71 InL1 imtion5/L`oon 71 _ C.n. W.il ~Jp E ap. W all Q GIm~bDew~ ~ L Glen&Doon ~ b p d6 ~ Net E~o. Wall Nn E n0. 'Nall c.nina O t- Cellin9 5 O 5 J d' - 7 6 Floor ~ ~3 ps J Z~ f kiar 7 1 O Totsi tlw. Toul Bm. RIVI Dylis+.I.i.rM/ AddrecsPlan#__ Data / HEAT LOSS CALCULATIONS °Total B[u Input I All windows & doors era wanthentrippod ~ 9L:" LO55 J~rL - 66 % Q • f ~ _ I FI_~~+ Roam I Lgth, I ' "Wth FL 0j Room LBth. ' "Wth. Ht.~ An. n. Wvfin Mup~~ Ne.o~ Lmnelti. Arn. W~tlN MuOht No.o1 Lineal t. ol p~m ol pene f M~ ol necM ul. 11. Na• ot pene ol pene II htl ol crKY ul. p. ~:5 5F Z. ~eeo.. lauan /tloan C.O. BTU /COOn Cori. 6TU bhnilon Wi~WOw~ 97 Inlilvetlon Windom 47 Ynmion WlDaw~ . 1t8 ' In111ve~ion W/Doon 11B inv~uonS/D~wn 71 InNVetlonS/DOOn 71 •y. W~II EF0. Wall x i~w b Oow, 01 4B Gles. & Daon g~ 48 i E.u. Will 7 Nat E.P. Well ~ 7 B <~j c»m~, _ Floor 3 6 7it 2- 7 lo oml BN. O Totel BN. S 7 FI.~ a7 d• oom 1 LOth.f ..Wth. " Ht. ~FI. Room ~ L9tA "WN. Nt. Nn. W°Il~ fl qp~t Na.ol LinuullL Ame Witlth Nu h~ N4ot lma~qt. Ane nl pene nl pw. Il M. ol creck W.IL NO' ol p~ne al pene li hl. ol cnck p.lt. ~ ~ <,a 0 Za 30. L 177,6 n ~ - ~a " r ~doo„ 0/7,? Caal. 8TU /tloon Cl. BTU 47 Inlilvotien 4' W/OOUn 118 o nilup~ionSlDuan » IniihretlonS/Doon 2 7' rP. WNl EvO. Well Q b~a d Doon 48 Gla., & Doors ~ 48 ~ 44 6 E.p. Wall G 7 Net EsO. Well Q 7 <Jb.y 5 CeifnY 5 5 Fioo, 3 5 13 10 ~ 7 melBia ~ ToulBm. J 1Fi. Room Lgth Wth. Ht. ' FI. Foom Lgth. Wth. Ht. yy~~~M1 Heiph, No.ol LinealtL Aree Witl~~ Hupl No.af Lineialt, Am No ol punu ol pane Ilqhp o1 ttack p, h. NO' of qns ot pene tl tt OI crK4 ul, fl. L 3. lnoo,. ,aoon /tloon Coal. BTU ltlaon CMI, 9TU hlviPUn WnMuw~ - 47 ~ Q Inllltntlon Wintlow. 47 iW~m~ienWlOnp~ 118 InliltralionW/OOOrt 118 - dihu1ion5lDOan 71 Inlilvotian57DOOn 71 nn. v4ll LS E wP. W ell las~ 8 Ooor~ 48 3~-¢ GWCS & Doon 48 ~ E.p. Wall L 7 Net E.P. Wall 7 ' rd.ny 6 Ceilinp 5 7 3p6 Flow 7 3 108 vr,r '.n~l tlm. ToPIBtu. - - - - - - - - - - - - - - - - - For Office Use Permit q City of Ea a~ I u Permit Fee: ~l?. I 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 I ~l Fax: (651) 675-5694 Staff: 2009 RESIDENTIAL BUILDING PERMIT APPLICATION C~ C Date:. C61 7_ O Site Address: _ l;( GC 11 t~ Tenant: Suite RESIDENT/ OWNER NamehOfflOJ and WC IIdC kiLp LI Phone: kti ( 451-9 q° Address/City/Zip: `t Su k ubpdon e Loot- Applicant is: . Owner Contractor TYPE OF WORK Description of work: Q o 1 t cI i r g d ce k I-Ij Construction Cost: 31©00, Do Multi-Family Building: (Yes / No L" CONTRACTOR Name: CT0r(1.P_ U I r) e-(' License Address: City: State: Zip: Phone: Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted (4 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 Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. X .n _ x Applicants Printed Name cants Signature ID) Page 1 of 3 LRI AU G 2 6 Z009 DO NOT WRITE BELOW THIS LINE SUB TYPES - Foundation Fireplace Porch (3-Season) Storm Damage Single Family Garage _ Porch (4-Season) Exterior Alteration (Single Family) - Multi Deck Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) 01 of Plex _ Lower Level Pool Miscellaneous 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 _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation Occupancy .~i MCES System Plan Review Code Edition SAC Units (25%_ 100%) Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final I C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Drain Tile Other: Roof: _Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final 4- Framing Siding: _Stucco Lath -Stone Lath -Brick Fireplace: Rough In _Air Test -Final Windows Insulation Retaining Wail Meter Size: Radon Control Erosion Control Reviewed By: j 2 , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 7~( X 40 sit VP 7 -P.~ Lr}UtT q. 42 .3' !c'"'~~ s1'?<'` i { tL o t,A~k4L` o~ O _ -i (V I-so "PA 3 . \3~- ISO ~1rs.04 4r lr Tr~tt~s ` t"s 30' N~At-i-ARG PACLW - T.._....._... *A-&# AAIMh*AM LT n V. O r C DU P44 f C!ty of Eaali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 x\IVQPCLCt �1 c Applicant's Printed Na e x I&JAkcicI Applicant's Signature Use BLUE or BLACK Ink F� ;#11 *14$0 Li 9 Permit 2009 RESIDENTIAL BUILDING DING PERMIT APPLICATION Date: e j dd) OG Site Address: 4 s UV IV OcC'� G Lc in Tenant: Th f V`t1C.� 3 CE V1 C� tt V1 C.l C� L 3' T Permit Fee: &o 7' Date Received: Staff: Suite RESIDENT OWNER TYPE OF WORK CONTRACTOR Name: I Ifl OtINC 5 C.)I d I ,On odo @VU`S Phone: 1,11 1I 4�J Address City Zip: 43% 0 k l�U r.x�l- 160`0, a_ t' 1 0 n Applicant is: Owner Contractor Description of work: i OC Construction Cost: Duo c mc1 it'd r Multi Family Building: (Yes No x Name: ))f1(iDIA)5 MCA 3 r✓fex License Ads :f nc CC i)1CCn IV— City: State: Zip: Phone: Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes No If yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer Water Contractor: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered 1 the information may be classified as non public if you provide specific r conclude that they are trade secrets. c information. Portions o at would permit the Ci CALL BEFORE YOU DIG. CaII Gopher State One CaII at (651) 454 -0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA116545 Date Issued:10/08/2013 Permit Category:ePermit Site Address: 4380 Woodgate Lane N Lot:23 Block: 2 Addition: Mallard Park 3rd PID:10-47252-02-230 Use: Description: Sub Type:Reroof 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. Carbon monoxide detectors are required by law in ALL single family homes . Elizabeth Hess 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 - Thomas P Nystuen 4380 Woodgate Lane N Eagan MN 55122 Sela Roofing Remodeling 4100 Excelsior Blvd St. Louis Park MN 55416 (612) 823-8046 Applicant/Permitee: Signature Issued By: Signature