3728 Woodland Tr
Contral No.
INSPECTION REC4RD ~
, CITY OF EAGAN PERMIT TYPE: r#ll jI
3830 PilOt KCIOb RO8d Permit Number: #*I f" 4
II Ea9an, Minnesota 55123 uate Issued: 116f i3i9z
~ (612) 681-4675
I SITE ADDRESS: tor. I; oRock; APPLICANT;
97~?8 1iUt7L11,AMlJ I~+ ~A11l11 J~l~'ItlY
TtiE iiR00LAM08 (~i~) et~-~1~!
PERY
flT PWBTYPq. 3~ N TYPE OF WORK: A L T 1~ R A? 1(IM I
DAVE I
~RA~II~1t~ fI1IA1..
,
1I
•
~
C'
PWnNt No. Pwmlt Fbld~r DMW TNepF?ons 0 >
~ stw
~ F'LIJMBIN(3
i HVAC . ~I ELECTRIc ov
ELECTRIC
j p p4am Date bwp. CM~
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PAN* ~-Z/- ~2 D S
PAUM P". ~
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aw.
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. , . - -f-.,r'~v~r - . .._....w:,~••- r '~~C.// ~(Jc1~ . . r
~ Io~ l A~/
SEDGWICK HEATING 8 AIR CONDITIONING CO.
HOUSE HEATING TEST RECORD 1 ?
ADDRES&~~~~~ ~ i ~ CITY ~ ~Grt~
OCCUPANT OWNER
HEAT LOSS DATE HTG. INST.
SOLD BY u~«- INSTALLED BY
Electrical Work gv ^I Hid _ Gas Line By - Sz!~i~ ! `
TYPE OF HEAT GA_ FA_ HW_ STEAM SPACE HTR. UNIT HTR. OTHER
G S DESIGN CONVERSION
MAKE L ~ N ~ MAKEOFBURNER
Model (3, Model
Serial Max. BTU Rating
INPUT ~ MAKE OF FURNACE
Model
/ CpNTROLS ~ i ~
THERMQ~T T7 t Plug . Vent Size -
Valve K~ ~ KIND OF LIN~ r_ SIZE NONE
Limit Draft Hoad-i U~ r- Regulator I
Limit Setting Filters Size N ber
Fan Setting i(v Chimney Location Inside~ Oy;side
Pilot Type Chimney Construction
Pilot Make ~ S+4
Pilot Model Smoke Bomb Wiring
Pilot Timing =N5 ~ Draft Test Tag
L.W. Cut Off Door Pressure Lighting Inst.
Pressure -7 percent COZ Date Tested
Input CFH ~ Percent 02 Company Testing
Stack Temp i~ ~ Percent CO - Name of Tester k'~ ~
Form 235
--_,CITY OF EAGAN
3830 Pflot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454-8100
BUILDING PERMIT Receipt # To be used for 5F ~}WC/ LA.L Est. Value Date 1 x` . 19
Site Address -1723 W~ij"ND ZP
Lot BIOCk % SeC/Sub. TiiE KO3DLAND5 OFFICE USE ONLY
Parcel No. Occupancr FEEs
Zon;,,g R-1
W Name "f> tt' ~^?`!'~(!~1 ~:~~:STriIl~'~Zuiti (actual) const V--N Bldg. Permit . 90•
9 Address t~ 14 i: S:.L? Ifi' i'.^, (Albwable) ~j~ 80.00
o Surcharge City S': i.:v5"r`ILI F~ Phone 89111-22E+2 # ot stories
Lergth 67' Plan Review 400
~ Name ~~•=r Dev?n sAC, city 100.00
89 Address S.F. Total = SAG MCWCC ~ 7 R• aG
Clry PhOn@ S.F. Footprints
On Sde Sewage _ Water Conn
W W Name On Site well Water Meter
Address Mwccsystem X~ 30•00
Ciry Phone ciri waier X ~ ~~sii
PFiV Required _ SNV Permil 20+00
I hereby adcnowlege that I have read this application and state that the Baoster Pump - S/yy Surcharge 1•00
infortnation is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances. Treatment PI 223•00
Sigrk3ture of Permitee APPROVALS Road Unil 340•0C
A Building Permit is issued to: 'AAr 00sNOW GOilST Plenner - Park Ded.
on the express condition that all work shall be done in accordance with all Cou^cil
applicable State of Minnesota Statutes and City of Eagan Ordinances. gldg, pry. _ CoPies
B,ilair,g onicial Variance - TOTAL
' Pnmk No. Permk Ho{dsr Dats Telsphone #
1yATER
sEwER 113 9
aLuMainG Z iv ltq
H.V.A.C. IL'O / 3 ~
.
ELECTFIC ' fo1L L ' ~ <_n.~" • ,,,~dv
Inspnctbn Do" kap. ~ ConMtW?ts
Foobrigs I w~-
Foundabon
Frw" 3
P""
R.0 Pft-
Faeplace 1f f~
c
FR?al FIOg.
Final Plbg. -
Cpnst. Me1er Plbg. Inspectpr - Notify Plumber
EngrJPlan
eiecj. Fnal .S Lfl l'~~df S Car~C~ f%r.
oix* Fig.
Deck Fnal
VYeM
Pr. Oisp.
tJ OS A 2 O .(S II!,',AAC
J
w a ~ 1 ~
• • • ~ ' - I
(Itr#if{ra#r of (Orrupaury
~
-Citp of Cagan
_ lupm'tqlptil Df 'Wowo Jt'lS}iPtttDtt
This Certi; ficale issued pursuant to the nquiremenls of Sectlon 306 of the Uniform Brdlding
Code certifying rhar at the time of issuance 11u's structure n,as in con?pliance with che various
'draihanres o1 the Cuy regulating building construction or use. For the following.•
r U. sF DWGr('~AR aft. % rb. 16083
~ O-UPB-Y T"C R3/M1 zooing D;,~ R) Tym COML VN
o,,~or maa~e MARK .AiM0N OCNSf. Ad*. 1614 E~'~,IFF RL1AD. BURNSVIIIE
.,A, 3728 WDOUAD IliAM L'CatityL12, B5, IlHE G10CQAND5
oam:Oc o 1489
&nld6g OffiM
POST IN A CONSPICUOUS PLACE
---•------,.~r- . T
;
- •f. PERMIT # " .
PLUMB{NLi PERM{T RECEIPT # ' ' - 'T_
CITY OF EAGAN 777) 7rV
3630 PILOT KNOB ROAD, EAGAN, MN 55131 DATE
CONTRACT PRICE: PHONE: 4544100
Site A~i¢~ess F vjo,774P7; BLDG. TYPE WORK DESCRIPTION
Lot Bloc~ Sec/Sub ~
Res. ~ New
Name f 7' ca ' p f ~ 1' ' Mult Add-on
m
- Addr Comm. Repair
~
c Ciry ~ Phone 7`P~ - 1 6' C Other
FIXTURES
~ Name Water Ctoset - $3.00 ~
~Bath Tubs - $3.00 '
~ ~ity Phone '~%Q 1- y~- Lavatory -$3.00
00
Tsnower - $3.00
~-Kitchen Sink - $3.00
FEES
COMMiIND FEE - 1% OF CONTRACT FEE Urinal/Bidet - $3.00
~~undry Tray -$3.00 ~U
MINIMJM - RESIDENTIAL FEE -$1•~•~ Floor Drains -$1.50 ' v
MINIMUM - COMM/IND FEE - 20•00 =yyater Heater -$1.50
STATE SURCHARGE PER PERMIT - •50 / Whirlpool -$3.00
(ADD $.50 S/C IF PERMIT PRtCE GOES TGas Piping OuUets -$1.50 j `
BEYOND $1,000.00) Softener - $5.00
Well - $10.00
Private Disp. - $10.00
~-Rough Openings - $1.50
SIGNATURE OF PERMITTEE FEE `I ~U O
STATE S/C: • s G
FOR CITY OF EAGAN GRAND TOTAL•
_ , ~ r... . ....Y.._. ~
- , • ~ ~ PERMIT # J , MECVA"Ar PERMIT RECEIPT #
CITY OF EAGAN
~ 3430 PILOT KNOB ROAD, EAGAN, MN 55122 DATE
CONTRACT PRICE: ~l~I I PHONE: 454-8100
Site Add~gss t! 6 Li gLpC,. TypE WORK DESCRIPTION
Lot - ~ Block ~ Sec/Sub
~ . , _ Res. Ll/- New
Name Mult Add-on
?
Address . Comm. Repair
c City ~ i Other
Name : ~ • ' ' ~ ~ / FEES
~ . RES. HVAC 0-100 M BTU -$24.00
c AddreS3 ~ ADDITIONAL 50 M BTU - 6.00
p City Phone (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PENMIT) - 1.50 EA.
TYPE OF WORK ^ COMM/IND FEE - 1% OF CONTRACT FEE
Forced Air M BTU APT. BLDGS. - COMM. RATE APPUES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
Unit Heater M BTU ' REMODELS - 12.00
Air Cond. ~ M BTU MINIMUM COMMERCIAL FEE - 20.00
Vent CFM STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping OuHets # t l~-~U BEYOND $1,000)
Other
FEE
~ ~,.i r)L J'. % .'v~-" .~%.;c~•~'
S/C: 'L v SIGNATURE OF PERMITTEE ~
TOTAL•
FOR: CITY OF EAGAN
! CITY OF EAGAN .
, 454-8100 .
DEPT. OF BUILDING INSPECTIONS r
Correction Notice
Located at 3
.
I have this day inspected fhis structure and
these premises and have found the following,
violatiogs of city codes governing same:
704
•a;
~J / , g~.•r .s~l~rnC ~ i0... ~ /~0..0~
When corrections have been made, please
call 454-8100 for inspection.
Date < I;; b ~
Inspector City of Eagan
DO NOT REMOVE THIS TAG
SEWER & WATER PERMIT OFFlCE USE ONLY
CITY Of EAGAN I' ! ~t':
3830 Pilot Knob F~d. PERMIT DATE ~
SEWER PERMIT # i-13~'?
P.O. BOX 21199 VI?ATER PERMff # n~ =
Eagan, MN 55121 FETEA # g/ B.P. RECEIPT # 9t~ !
R~ G~ o~~`~71 B.P. RECEIPT DATE 28 9
SIZE
ISSUE DATE _ PRV _ BOOSTEFi PUMP
SITE ADDRESS % = 'r' ' ~ % ~ PERMR REOUESTED
LOT .~LOCK SEC/SUB - ` ~ • ~ S
-SEWER ~ WATER _ TAPS
APPUCANT:
A E
DDAbS: ~ • t' d` 2~ • _ COMM/IND _ RESIDENTIAL
CITY, STATE r.^4 v'%~Se ,•'s ZIP r'
PHONE: NEW _ EXISTING
PLUMBER:
ADDRESS: ~•^`~r. I AGREE TO COMPLY WITH C(TY OF
CITY, STATE ~ f~---E ZIp r- c EAGAN OHDINAMCES:
PHONE:
OWNER:
ADDRESS: SIGNATURE WHEN METER 13SUED
CITY, STATE ZIP C~~
PHONE:
PLEASE ALLOW TWO WORKiNG DAYS FOR PROCESSING. FOR STORM SEWER PERMtT3, CONTACT
ENGINEERING DEPT.
SEWER & WATER PERMIT OFFICE USE ONLY -
CITY OF EAGAN 1 i' 1;=
3830 PIIOt K?lOb Rd. PERMIT DATE
P. O. B ox 2 1 1 9 9 NNATER PERMIT # 1`-)2`4 SEWER PERMIT # I i 3's
METER # B.P. RECEIPT # 907 7 7
Eagan, MN 55121 READEFI # B.P. RECEIPT DATE 1 7 f 3
METER SIZE
9 ISSUE DATE _ PRV _ BOOSTER PUMP
SITE ADDRE96 - 22 7. PERMIT REQUESTED
LOT i 2 LOCK 5, SEC/SUB 13 cd 'cl•
APPUCANT: ' ~ ~ o ~ . • ~ La..a ~ = SEWER -X-WATER - TAPS
ADDREft: IV k`j _ COMM/IND k RESIDENTIAL
CIIY, STATE -1, r.•; L ,1\e rr : ZIP 1~' 7 `I
PHONk: 13 L) NEW _ EXISTING
PLUMBER: A.
ADDRESS: 1 I AGREE TO COMPLY WtTH CITY OF
CITY, STATE - r • ' ' - ZIP EAGAN OROINANCES:
PHONE: OWNER: ~ . ~ . l , • '
ADDRESS: SIGNATURE WHEN METER ISSUED
CITY, STATE ZIP
PHONE:
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. FOR STORM SEWER PERMITS, CONTACT
ENGINEERING DEPT.
I
e~ASH RECEIPT
,
CITY QF EAGAN
. ,
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
l /
DATE 19
FFIOM~
AMOUNT t% L
6 DOLlJ1AS
~ro
0 CASH <CHECK
i
,
, wn ~`f, . ~ ~ ~+'L (U• /Z
~,~~T?~ ~ ~~~1~~~--d~~L;~l<~/ ~
FUND OBJECT AMOUNT
~
Ttank You
ev
1, P„
Yellm~ Covr
~ PWc--Ffle Copy
Y .
BLDG. PERMIT NO. ~ ` -
,01-3210 Bldg. Permit
01-3422 Plan Check
01-3445 Surch./Adm. ~ 01-3446 SAC/Adm. -
. ~
+ 01-2455 Surcharge ~ l
75-3$60 Road Unit
~ 20-2275 SAC Cs '
l-. ,
20-3565 Water Conn. ~
20-3868 Water Trmt. -7
20-3716 Water Meter
20-2252 Acct. Dep. - -
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn. ' -
28-3855 Park Ded.
TOTAL
CITY OF EAGAN 16083
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, NIN 55121
BUILDING PERMIT • PHONE: 454-8100 Receipt #
~
To be used tor 5F DWGIGAK Est. Value $160,000 Date z 19~
Site Address . 37 2 B ii00DI.AND TR
Lot 12 Biock _5 Sec/Sub. TtiE SiQODI.ANDS OFFICE USE ONLY
Parcel No. O-+uWr 2"3 ~ ~ES
. Zoning
W Name ~OHNSM CONSTBUCTION COrkSt Y-N BkJg, Pe,rt,;t 850,00
o Address 1614 E CLIFP' RD (awWabie) V-N sura,arge 80.00
City BUWiVI1.1.E Phone 890-2242 r or swries
Length 67• PlanReview 425•00
o Name oeQCn ~ snc, cny 100 •00
Address S.F.Total - gqC,MCWCC 575•00
~ City Phone S.F. FootpriMs _
On Site Sewage Water Conn 580.00
6,W Name on site well - wa?er Meter 90•~
iL' Address tirvvccsystem xx
j0•~
~ W City Phone c~y water IX A.W. ~n
1 PRV Required _ S/W Permit ZO•~
I hereby acknowlege that I have read this applicatlon and state that the Booster Pump - ~~rcharge 1.00
inlorrnation is conect and agree to comply with all applicable State of
Minntqota Statutes and Clty of Eagan Ordinances. 7reaWmi pI 228.00
Signature of Permftee APPROVALS qpad Unit 340.00
n euikkrg Permd is issued ro: MARK JCHSNON CONST Pla"^ef - Park pad.
on tt?e express condition tfiat all work shall be done in accordance with all Council -
applicable State ot MinnesoW Statutes and City of Eagan Ordinances. gidg. pry, _ copie8
3+ 319.Oa
suilding onicial v~~ - roraL
' DATE: 1 / 31 / 89
RE. 3728 ii00DLAtiD Tx., L12, bS. WOODI.ANDS
Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CA%. PUBUC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Yot~; Sewer & Water Permit for the above property cannot be completed for the following
reasons:
- r
Your Sewer 8 Water Permit for the above property has been completed, but the meter cannot
be Issued or occupancy allowed until further potice.
r
ti COMMERCIAL PROJECTS ONLY: Please pay fc;r meter at City Hall. Meter size must be
~ confirmed by Bill Adarns or Dirk House (Plumbing Inspectors - 454-8100) before issuance. i
WARNING: BEFORE DIGGINC, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REOUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POUCY.
i
Sec
ptary, Building Inspections Dept. ,
--f DATE: 1/31/89
RE. 3728 il00DLAPID TR.. L12, ES, WOODLAM3
XX Your Sewer & Water Permit for the above property has been campleted. It will be held at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CA4 PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit tor the above property cannot be oompleted for the following
. reaj;ons:
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
J be issued or occupency allowed untll further notlce.
? w
1
- COMMERCIAL PROJECTS ONLY: Please pay far meter at City Hall. Meter size must be
S confirmed by Bill Adams or Dirlc House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL U7ILITIES - TEIEPHONE, ELECTRIC, GAS, ETC.
- REDUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLJCY.
Secretary, Building Inspections Dept.
~ CITY OF EAGAN N? 16083
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
-7
BUILDING PHONE: 454-8100 Q~j 7~ ~
PERMIT Receipt # / ~
Tobeusedfor SF DWG/GAR Est.Value $160,000 Date , 7982
Site Address 3728 WOODLAND TR
LOl 12 BIOCk S SeC/Sub. THE WOODLANDS OFFICE USE ONLY
Parcel No. acuPancy R-3 b_I FEES
Zoning R=1
a Name MARK .IOHNSON CONSTRIICT70N (ACtual) Const V=N Bltlg.Permit 850.00
o AddreSS 1614 E CLIFF RD IAllowable) V=N 5wcnarge 80.00
City RJRNgVTT-T-F Phone 890-9947 #ofStories -
Lengih 671 Plan Review 425.00
, o Name SAMF. Depin ~i8 ~ SAQ Gry 100.00
g¢ Address SP.7olai - SAC,MCWCC 575.00
CIIY PhOfl@ S.F. Footprints -
On Srte Sewage _ water Conn 580.00
~
ww Name On Sile Well _ Water Meter 90.00
i~ AddfeSS MwCCSystem ~'7L
o~ xX_ AccLDepOSt 3~.~~
<w City Phone atywaier PRV Reqmred _ SrW Permit 20 • 00
I hereby acknowlege that I have read this apphcation and state iha[ the Booster Pump - SIW Sumharge 1.00
information is correct and agree to comply wrth all applicable State of
Mmnesota StaWtes and City oi Eagan Ordinances 7reatment PI 228 • 00
Signature olPermitee APPROVALS RoadUnil 340.00
A Bwlding Permit is issued to. MARK JOHSNON CONST Planner - park Ded.
on the eapress condition that all work shall be done in accordance with all Council -
applicable State of Minnesofa Statutes and City of Eagan Ordinances. gld9 pff, _ Copies
b~f -M~ Variance - 707AL 3,319.00
uilding ONicial
e
K 4 5131
, ; ~ 9/92- /a? ! 3 ~K
Request ~a fire Na, Rough-in Inspearon
q , ~J Reatly Now Will Notity Inspector
, O I ` ili'1 s G No hen Reatly't
I J licensed contractor wner hereby request inspection of above electncal work at:
Job A ess 1S el. Box or R ute no ~ Ciry
vV
Se<lmn No Township Name or No Range No Counly
Occupanl IPRWTI ~ PM1OnGS '8, ^ (0?
~
Power Su Adtlress
Elecmcal Conhactor (Company Name) _ Conl~ense No
Matling Atl s ICon[raclor or Owner Making InslallaLOnl
T
III uthonze aNre ICanVactoriOwner Making Inslallalion, PM1One Number ~
s , L
MINN OT STATE BOANU OF ELECTRICITY THiS WSPECTION REQUEST WILL NOT
Grigga- Ewey Bltlg - Room 5-173 BE ACCEPTED BY THE STATE 80ARD
1811 Univeniry Ave. St Peul MN 55106 UNLE55 PROPER INSPECTION FEE IS
Phone(61]~6C3-0800 ENCLOSED
REOUEST FOR ELECTRICAL INSPECTION ee-ooom.oe
('7 ? See mSVUCUOns for compieung tNS lorm on Oack ol yeliow copy
~n` I 1
~ `i 31 ~ "I" Below Work Covered by This Request
e a ep TypeolBudding ApplianceSWired Equipmen[Wiretl
Home Range Temporary Service
Duplex Water Heater Electnc Heatmg
Apt. Bwlding Dryer Other (Specify)
Comm /Indusirial Furnace
Farm Air COntlRioner
Uhar ayxily) Gonvactor5 Remarks
Compute Mspechan Fee Below: N Olher Fee # Service Enirance Srze Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 700 Amps
Transformers Above 200 _ Amps Above-100 AmOs
ISignS inspxtor'sUSeOnly/ UJ OTAL
Irngation Booms
Special Inspeciwn
Alarm/Communicanon THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WI7HIN 18 MONTHS. _
I, the Eledrical Inspecror, hereby Rougmm ^ a` oaie
cenify that the above inspection has F,,,ei , / ik oete r.~
been made. ' ti /rz d
OFFICE USE 9NLY
This request voitl 18 monfis imm
LJ ~ ~
oye'-!:f/,y~
E 9 3 0 U 2
Request Data Fi No Rough-in InspecLOn
Feqmretl7 ? Reatly Now Will NotityInspector
s ? No When Reatly
I licensed contractor ? owner hereby request inspection ot above electrical work at
J b Atldress (SVeet, Box or Raute No Ciry
• 'z ~ /
Seclion No Township Name or No. Rarga No Caunry
Occupant~P 'f . f/ Plwne N.
Iu~ LY~
Power Supplier Pdtlress
Elecbical Contr (COmpsrry Nam Contrector4l.icense No
9 f f:it(i
Mali g Atltlress (C ractor or Owrrer Making InsWllatwn)
~ / I' L
AuffMraetl Si vre (nt ctor/Ownei Makrtg InstalWLOn) Ptane NumDer
M "ZfK M?
MINNESOTA STATE BOAHO OF ELECTRICITY THI$ INSPECTION REQUEST WIIL NOT
Grigga-Mldway BIUg. - Room 5113 BE ACCEPTED BV THE STnTE BOARD
1821 Univeralry Ave., SL Peul, MN SStOC UNLE55 PflOPEfl INSPECTION FEE IS
PM1Ona(612) 662-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION eeooomo7
? See instmctiore lor compieung tnis form on bflck ol yelbw copy C~Oy'Qi~
/
E Q 2 ~ 'X*Be/ow Work Covered by This Request
e Add Rep. 7ypeoBmldmg App6ancesWued EquipmentWired
Home Range 7emporary Service
Duplex Water Heater Elecinc Heating
Apt. Bmlding Dryer Other (Specity)
Comm./Indusirial Furnace
Farm ' Air Conditioner
Dlher(speaty) Contractork Remarks:
Compute /nspection Fee Below:
# Other Fee # ServiceEntranceSrze Fee M CircmcsiFaetlers Fee
Swimming Pool 0 to 200 Amps ' Q(J 0 to 700 Amps
Transformers Above 200 _ Amps A6ove Amps
Signs Inspeclw5 Use OnN: ~A/~ T TAL
Irrigation 8ooms
Special Inspection
Alarm/Communication
Other Fee (
I, the Electrical Inspector, hereby Rough-in Vate
certify that the above inspection has Finel i ~ Date
been made.
OFFICE USE ONLY ~ ` ~ - -
This request voitl 18 rtwnths Imm
RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
'-C Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauiremenfs Remodelrtteoair Reauirements Office Use OnN
3 registe2d sile surveys shavirg sq. fl of IoL sq. ft of house; and all roofed areas 2 copies ol plan CeR of Suney Real
(20°k maximum lot coverage albwed) 1 set of Energy CalculaLons lor heated additlons Tree Pres Plan Recd
2 copies of plan showing beam & window sizes; poured lound design, etc. 1 sde survey for additions & decks Tree Pres Not Reqd
7 set of Energy Calculafions , Adddion - indicate Bar-sfte septic system _ Oo-site Septic Syslem
3 copies of Tree Preservation Plan if lot plaried after 711193
Rim Joist Dehail Options selecGon sheet (hldgs with 3 ar less un'hs
Date Construction Cost
Site Add~ V
I I.ECLych 11 UniUSte #
i
Descripiion of 'Yerk
Multi-Family Bldg _ Y~ N Fireplacc(s) _ 0 1 _ 2
Property Owner Telephone # (0S)) ll J U' - I ~ )
Contractor
Address City BVII-RSV7
~
State Zip Telephone#5v (3 - D'I~ ~
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventllation Category 1 Worksheet . New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber Telephone )
Mechanical Contractor , Telephone # ( )
Sewer/WaterContractor Telephone#( r
~
i„iv
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the Stafe=of MN
Statutes; I understand this is not a permit, but only an application for a pennit, and work is not to start without a
permit; that the work will be in accordance with the approved plan i e c of work which requires a review and
approval of plans.
Applicant's Prited Name phcant's S(gna re
OFFICE USE ONLY
Sub Types
? 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 EM. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex 0 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Pibg_V or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Inl Improvement ? 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) - 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
_ Footings (new bldg) _ FinaVC.O.
_ Footings (deck) _ FinaVNo C.O.
_ Fwtings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & W ater Final _ Pool _ Ftgs _ AidGas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ \Vindows (new/replacement)
Insulation _ Retaining Wall
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
1989 BOILDING PfiRHIT APPLICATION - CTTY OF EAGAN •
SINGLE FAMILY DWELLINGS IINCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTEs ADDRFSSFS FOR CORNER LOTS - CONTRACTOA/HOMEOWNBR MOST DESIGNATE riHICB ADDRFSS
IS DFSIRED. NO CHANGES WILL BE ALLO{iED ONCE BIIILDING PERMIT IS IS30ED.
M[TLTIPLE DWELLINGS RENTAL QNITS FOR SALE U9ITS t OF iTNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIRVEY - CHECH WITH HLDG. DEPT.t 1 SET OF ENERGY
CALCULATIONS
COPAIEACIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
To Be Used For: Valuation: ~CpC Date: /gG'/
Site Address Tm; l 0, aoa ' OFFICE [ISE ONLY
i 6
Lot 1;2 Block ~ Occupancy R-3 M-1 FE&S
k Zoning R-1
ParcelT/Sub ,,,.,~/o,,js Actual Const V-N Bldg. Permit 860.00
Allowable V-N Surcharge 00,00
Owner li of stories Plan Review qZSiO0
Length ~ SAC, City MQr DO
Address Depth y 8' SAC, MWCC OD S.F. Total Water Conn DD
City/Zip Code Footprint S.F. Water Meter qD,p0
Acet. Deposit 30,0
0
Phone On site sexage_ S/W Permit 20,00 I
On site well S/W Sureharge i,pn I
Contractor ~n~v~sarCs,..C-7L MWCC System 4-~ Treatment Pl. 22 .LY7
City water ? Road Unit
Address /(ol PRV required _ Park Ded.
~ Booster Pump _ Copies
City/23p Code Ru~ns,,,'!lp . S5'33'7 TOTAL 31319.00
APPROV9LS
Phone li3~/ p-- Planner
Council ~ , ~s g w
Mch./Engr• Bldg. Off. `~i~2to
Varianee
Address Couneil
City/Zip Code
Phone # 1~70
NOTE: Sewer & Water Permit fees and account deposit fees xill be included in the building
permit fee. Processing time for sexer and water permits is txo days onee a licenaed
plumber has applied Por a permit at City Hall.
VA LUATIoN
1 `l x Z~ = 45~
I1 x z2 - Z42
6ys
Ls rn
iayZx3o = tios
zy"zx 1G = 39 2.
Z3XZg = l~yy
o-
1 ~41 x 13= igr33
IZX,z - ~Nw X ~+a = s?~o
I~r r~vo~
P~mT = J 4 4 I
12xz = 2y
~y88x149 _ ?z9 i2
z Na oofZ
Z`6X Z5~2= ~~L~
~ ~'~t X 3 O = ~_r_
IOSq, Xyq -5~
I 5`~ O68
4. SURVEYOR'S CERTIFICATE MARK JOHNSON
cn)
By F-S
Date i-z6-g-~------
Er4GA1V ENGIIVEERING ~
f- DENOTES PROPOSED SURFACE DRAINAGE DEPx
O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FIOOR - 904-7 FEET
X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - 89103 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK - 905. J FEET
WE.HEREBY CERTIFY TO MARK JOFNSON THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
LOT 12, BLOCK 5, THE WOODLANDS,ACCORDING TO THE
REGORDED PLAT THEREOF,DAKOTA COUNTY,MINNESOTA.
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS
SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 9TH DAY OF JANUARY , 1989
SIGNED: JApA5 ILL, INC.
D
BY:
HAROLD C.PETERSON,LAND SURVEYOR
MINNESOTA LICENSE NUMBER 12294
11
T
co ~ James R. Hill inc.
m p r= m~ O N O ~ p L >
- r mOD " v~ m Z PLANNERS / ENGINEERS / SURVEYORS
~
~ m
m ~ 0 N D z l0 W
N m ' 0 (n m ~n {
9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 • 612-884-3029
m
N
O
SURVEYOR'S CERTIFICATE ' MARK JOHNSON
V
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v
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LOT 12
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. By f' Fr~ D~6
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Date i-z~-8`~ ` '(3 a~-b6
lENGINEERI ~ iZI3EPT~8a '904
~ soi.e •
o ~
P ~
~po9o,.7
z
I INCH = 30 FEET
cn
~
~ oF amo°ro°o < ~ o~~ James R. Hi , inc.
m pD m-l C ln (0 D
o°m o w~ N D Z ao m m Z PLANNERS / ENGINEERS / SURVEYORS
N A,' ~ 01 m N~ < .
9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 • 612-884-3029
EYTiEtIOR ENVEIQPE AVERAGE "0" COMPQTATIODI
OWNIIt PLAN N0.
SITE ADDRFSS LGT I~ '.VL'G+C ~ -T~O W-`~o'~LA?JX DATS y/~.C/ IO ~ I/V~
CONTRACTOR MAaK- ~41LA~~LT..~ ~&WT• PHQNE
Determiae working square footage o4 each
1. Total exposed wall area..... . ~~•J sq.Yt. x~_
2. Total roof/ceiling area...... sq.ft. x~=
3• Total floor/CdT1t• 8I'98.... oo• BQoft• x•ig
Total ezposed srall area above Yloor 3455 ~ U
8• TOt.81. W8U WiF1dOW area.............. o O~l7
b• Total door 8l98..... 0 0.0.0 0..."• ~
c. Total sliding glass door araa P~~04
d. Total Pireplace wall area
e. Total Wall framing area (average 1096)........
~ • C7 r
Y • TOf.31 [19t. W81I. 8P98 8}JOV9 YlOOT 9o,-*
g• Total rim joist STeS.o o . a 0 . . . . o ~C7
Total exposed foundation area 2~73.J
h. Total foundation windrnr area
i. Total net toundation area above grade........ 3.a
Determine "II" valus of each wsll segmeat
a. ,1 z "II"
b. ~1S7- x "U" l12.Pa
o. 80, z "II" 4ts = 3(0+03
d, x °B" _
e. x ^II" '
f . ~ x "0' _ o
g. 'Sl c~ x "II"
h. x nIIv
i. x "II"
~
4 . Tatam 414,cro
If item $4 is the same asv or less than item $19 e met
the intent of SHC 6006(c)2.
~
Total exposed roof/ceiling area ~53 O i0
j. Total skylight area
k. Total roof/ceiling framing area (aver.
(.0621W4"o/c)...
l. Total net insulated roof/ceiling area
Determine "U" value for each roof/ceiling segment
x "U"
k. (a~ x "u" , 07-4- 2
x 'lpll .021 = _2u, ~a
5 . Tocal - 32, 5
I£ total of #5 is the same as, or less than #2, you have met the
intent of SBC 6006(c)1,
Total exposed floor/cant. area
m. Total floor/cant. framing area (average .10%)..........
Il • To{;al net insul#.ed £loor/cant • 3k'08 9
Determine "U^ value for each floor/cant. segment
m, x "U" -
n, x
6 . Total
If total of #6 is the aame as, or less than ~3, you have met the
intent of SBC 6006('c)3.
xLTNMNATE BUILDING aVELOPE DESIGN
To utilize the total envelope system methodt the values established
by the sum of items #4, #5 and $6 shall no be greater than the sum
of items #1, #2 and #3,
1 . 2. -A 49 3.
4. 6.
Preparad by
Date l2"r - ~
TEIltU 'sTUD int. Air ,68 TE~tO INS, wALL Int. Air .68
I x/ S.R. & SIDING 1/2^ S,R. ,45 v/ SR. & SIDING 1/2" S.R. .45
I' Stud (~,¢6 6~) ° Ins. 19,0
i25/32° Bild. 2.06 ~ 25/32" Bild. 2.06 i
i ~
3131ag .1g7 sidinB 78 ~
i Ekt. Air .17 C Ext. Air •17
~
; Total "R" Total "R" 144- i
;i
,
1/R = "U" _ 1011 1/R = "II" _ .0415 ~
-
~ ==..~a,--- _ -
' THRU RIM Int. Air .68 I THRQ CONC'BLOCS Int. Air .68
' JOIST (a Zns. 161,0 C.B. ('IZ") I'Z& ~
~ Opt. Styro. Opt. Ins. 5.0
; i i/a^ wooa 1.89 brt. nsr .17
=f-
I
25/32" Bild. 2.06 Opt. S.R.
~SidiIlg i~gj i p Opt• $id.
~I Fct. Air .17 Total "R" _ ~ I 3
1~ I
s Opt. Brick 1/R ="U" _
Total "R" = 24,~ II
i
1/R = "A" _ .D`rl
4 - - = - - _
I THRU CLG. Int. Air .61 THRU CL(3. Int. Air .61
~ MEPIDIIt S.R. INSUTATION S.R. .5- ~I
I '
~ Clg. Memb. 435 Ins,
In5. 35,~ , stul air .61 ~j
j ' Still Air .61 Total "R" _ 4(o.7b> I
i , ~)I ll
~ Total "R" _ 'j- 1/R = nQ'r =
1
~ 1/R = "U" = r62 i
~ I
I
~
CIT#Q- EAGAN PERMIT c°"t`°' 1176
~
3830 Pilot Knob Road PERMIT TYPE: e u r Lo z rv G
Eagan, Minnesota 55123 Permit Number: 001624
(612) 681-4675 Date Issued: 10 / 13 / 9?
SITE ADDRESS:
3728 WOODLAND TR
LOT: 12 BLUCK: 5
l'HE WOODLANOS
DESCRIPTION:
%Suild3ng Permit T,ype BASEMENI' FINISH
' Building'Work Type ALTERATION
UBC Occupan'cy R-3
/
( \
~
REMARKS: 71
FEE SUMMARY:
Base Fee $35.00
Surcharge $.5o
Total Fee $35.50
CONTRACTOR: OWNER: - Applicant -
BAUER JEFFREY
3728 WODDLAND TR
EAGAN MN 55123
(67.2)688-7189
I h.raby acl<nowLedge that I have read this application and staCe that L'he
in or ation is correct and agree to comply with al.l. applicable State ofi Mn.
St.it tes and City ofi Eagan Ordinances.
~ J
U~
~'hJ(
APPUCANT/PERMITEE SIGNATURE ISSUED V: IGNA 1RE~-
INSPECTION RECORD Controi No. 1176
CITYOFEAGAN PERMITTYPE: sulLotNc
3830 Pilot Knob Road Permit Number: e 016 2 n
Eagan, Minnesota 55123 Date Issued: 1 m/ 13/ 9 2
(612) 681-4675
SITE ADDRESS: Lo T: 12 B L 0 C K: 5 APPLICANT:
3728 WOODLAND TR BAUER JEFFREY
THE WOODLANDS (612) 688-7189
PERMIT SUBTYPE: TYPE OF WORK:
BASEMENT FINISH ALTERATION
INSPECTION .
FRAMTNG FINAL
~
PERMIT N CITY OF EAGAN
REACTIVAl`% _ 1992 BUILDING PERMIT APPLICATION
~ X-24 681-4675
SINGLE 8 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energ;y
calcs.
COMMERCIAL 2 sets of architectural 6 structural plans, I set of
specifications, 1 copy of energy calcs.
Penalty applies when typin9 of permit is requested, but not picked up by last working day
of month in,which re uest is made or lot chan e is re uested once ermit is issued.
Date 04' / '92 Valuation of work
Site Address: 3rJZQ lq-
STREEi SUITE t
Tenant Name: (commercial anly)
LOT 11 BIACK ~ SUBD. -jke U/ r, ~ L.fJ I~~IV P.I.D. M
'a
Descri tion of work: iNI S ASD-{vjJr
The applicant is: V"lowner ? Contractor ? Other (Deacrlbe)
Name ~"FIzey Phorie. ~`d~
Property LAST FIRST
owner Address 312g I,J9odlaw?4 -"Ir,
STREET STE R
City State MtJ Zip 55~23
Company Phone
Contractor Address License # Exp.
City State Zip
Architect/ Company Phone
Engtneer Name Registration #
Address
City State Zip
Sewer 3 water licensed plumber . Processing time for
sewer 8 water permits is two days once area has been approved.
I hereby acknowledge that I a e read this application and state that the information is
correct and agree to comply w th all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant: '
~
BUILDING PERMIT TYPE OFFICE USE ONLY
~
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging 046 Basement Finish
~~.32 SF Dwg. ? 07 4-Plex O 12 Multi. Misc. ? 17 Swim Pool
',J 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory O 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace O 19 Cormn./Ind. Misc.
0 05 SF Misc. ? 10 Multi. Add'1. O 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE ~1 New ? 33 Alterations ? 35 Tenant Finish O 37 Demolish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) lst F1. sq. ft. City Water
UBC Occupancy ~ 2nd F1. sq. ft. PRY Required
Zoniny SQ. Ft. total Booster PumP
~l of Stories Footprint Sq. ft. fire Sprinkler
Length On-site well Census Code U3
Depth On-site sewage SAC Code
Bld ~
APPROVALS Cetisas a H ~fs C.),
Planning Building (o !3 9.pJ Assessments
Engineering Variance
REQUIRED INSPECTIONS
? Site ? Footing bkTraming ? Insulation
? Nallboard ""gj inal ? Draintile O Fireplace
Permit Fee pO Yslmtim: $
Surcharge , 3-0
Plan Review
License
MWCC SAC
City SAC
Nater Conn.
Water Meter ~
Acct. Deposit
S/M Permit
S/W Surcharye
Treatment Pl.
Road Unit
Park Ded.
Trails Ded.
CoPies
Other
Total:
SAC % SAC Units
/a B~ -CITY OF EAGAN CITY USE ONLY
PLUMBING PERMIT
SUBD. (612) 681-4675 RECEIPT li C0-)/ 3
DATE i01l9 /°i r
RESIDSNTIAL
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION COMPLETE THE FOLIAWING:
N0. FIXTURES EA. TOTAL
NEW CONST _ REPAIR/ADD ON 15.00
ADD ON SHOWER 3.00
REPAIR WATER CIASET . 3.00
BATH TUB 3.00
tNOWNER NAME: KITCHENYSINK 3.00
~SITE ADDRESS: 2 s ~ a ~ 1 OfNTITB/SPAY 33.00
.00
_ WATER HEATER 3.00
FLOOR DRAIN 3.00
5 m"ti GAS PIPING OUT.
INSTALLER: OL
_ (MINIMUM - 1) 3.00
_ ROUGH OPENINGS 1.50
ADDRESS : pTl{ER
WATER SOFTENER 5.00
CITY: ZIP: PRIVATE DISP. 15.00
~PHONE~~: (n ~7 ~ • ~ ~ ~ ~ = U.G. SPRINKLER 3.00
W. TURNAROUND 15.00
(1 STATE SURCHARGE .50
-jo SIGNATURE OF PERMITTEE TOTAL:
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
CONTRACT PRICE: ~
SITE ADDRESS: 1% OF CONTRACT FEE. .
STATE SURCHARGE - $.SO FOR
TENANT NAME: EACH $1,000 OF PERMIT FEE.
SUITE $25.00 MINIMUM FEE.
INSTALLER: CONTRACT PRICE x 1% $
ADDRESS: STATE SURCHARGE $
CITY: 2IP:
TOTAL: $
PHONE
FOR: (SIGNATURE)
CITY OF EAGAN
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PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA110615
Date Issued:05/17/2013
Permit Category:ePermit
Site Address: 3728 Woodland Tr
Lot:12 Block: 5 Addition: The Woodlands
PID:10-75875-05-120
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Diane Moyer
Home Energy Center
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Jon E Borgstrom
3728 Woodland Tr
Eagan MN 55123
(651) 456-0730
Home Energy Center
2415 Annapolis Lane N #170
Plymouth MN 55441
(651) 766-6763
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
�-------------------
� For O�fice Use �
' c�^�► C I �ermit#: /��l '°/ j
���� ������� G V���G � Petmit Fee: (!/�. � i
3830 Pitot Knob Road i /� i
Eagan MN 55122 JUN 2 3 2014 � Date Received; �'OS�'���
Q����:��sy�s�s=s��� � j �
FaX: (651)675-5694 E�Y: Staff:
� I
�----------- -----�
���� ������Ir��� ������������ ������i����
Date:
� ���1 Site Address: � �`�� �'�"�/``�� "��'�*�
Tenant: Suite#:
r �
K
� � � t11�ma: .�0 �i.n �c7!'�L:�'7�/"�.,-(sl Phnne� � �� ��
����!�� � �.�.- -s �`��Y
` r_ '. ^ Address i City i Zp: 3 ���' W�' ��`'�� �r``I�
�? N�tfile: �t�e'�' ��'^ry�,�'�q o� /j�.e.41��ry Li�Ei����: �� ���6��
` Address: /�� /� � ��!^ �v-e- .�G�� City: �yM� �I1�
�����'
Y State- Zi ��y 7 Phone: ��� ��° -3 ���
t ' -� P�
<' ;
Contact: -� ��� �`^ ��^ Email:
� ���� New �Replacement _Repair _Rebuild _Modify Space _Work in R.O.W.
�
� � Desc�ip�ian ofi work:
�
�f ��
� ° � ; �f���� �Water He c-�
Water Softener
� „�, Lawn Irrigation�RPZ/_PVB)
���� Add Plumbing Fixtures�Main/_Lower Levef)
,
t f� _New Water Turnaraund
�, ;���' �� Abandonment
- _ - - _
TIAL FEES:
ater Heater,Water Softener, or WBter Neater and SoftEner{includes$5.Ofl State Surcharge}
��AB�La����#���ttades$�:i�a�ir�r�taraa����ar�e�
$60.00 Add Plumbing Fixtures, Se�tic System Abandonment,Water Turnaround*(includes$5.00 State Surcharge}
'�Water Turnaround{add$200.00 if a 5/8"meter is required}
$995.AA SeAtic�vStem New{�10,Ofl per as bt�ilt)(i►acl�des Gour�t�r#ee and$5,00 State Surcharg�� /�Q
TOTAL FEES$ '��
CALL BEF�,l�Y�DIJ�,1G. �u-�r�te�Gatt,at.(�5��4�t�.2#ru�r�tic�ra.�fi uraaier{�-ou�d�i�_
Cali 48 hours before you intend to dig to receive locates of underground utilities, www.qopherstateonecail.org
t hereby acknowledge that this information is complete and accurate;that the wa�k 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 woric will be in
��rri�n�v�It»tti��pprov�+d p�an in tti�+c�s�nf work vuP�i�h r�ir�s�r�vfew�,n�J�pptuv�i�f��n�.
x ��'�/ L1! li`/�n /1 X � �.
�lpp�icanCs P�inted�ame App n�s�gnature
� �
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA126424
Date Issued:08/25/2014
Permit Category:ePermit
Site Address: 3728 Woodland Tr
Lot:12 Block: 5 Addition: The Woodlands
PID:10-75875-05-120
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
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 -
Jon E Borgstrom Tstes
3728 Woodland Tr
Eagan MN 55123
(651) 456-0730
Home Depot At Home Services
656 Mendelssohn Ave N
Golden Valley MN 55427
(763) 542-8826
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA137461
Date Issued:07/06/2016
Permit Category:ePermit
Site Address: 3728 Woodland Tr
Lot:12 Block: 5 Addition: The Woodlands
PID:10-75875-05-120
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Jon E Borgstrom Tstes
3728 Woodland Tr
Eagan MN 55123
(612) 805-4864
Home Depot At Home Services
6224 Lakeland Avenue N, #102
Booklyn Park MN 55428
(763) 542-8826
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA151012
Date Issued:08/03/2018
Permit Category:ePermit
Site Address: 3728 Woodland Tr
Lot:12 Block: 5 Addition: The Woodlands
PID:10-75875-05-120
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Jon E Borgstrom Tstes
3728 Woodland Tr
Eagan MN 55123
(612) 805-4864
Home Depot Usa Dba The Home Depot
2455 Paces Ferry Rd
Atlanta GA 30339
(763) 852-1044
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA168062
Date Issued:04/08/2021
Permit Category:ePermit
Site Address: 3728 Woodland Tr
Lot:12 Block: 5 Addition: The Woodlands
PID:10-75875-05-120
Use:
Description:
Sub Type:Reroof & Windows/Doors
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site. We encourage you to retain an electronic copy of
photos until the project passes a final inspection.
*Roof permits issued between December and March will be inspected in the spring or when weather warms up.
Valuation: 10,000.00
Fee Summary:BL - Base Fee $10K $191.75 0801.4085
Surcharge - Based on Valuation $10K $5.00 9001.2195
$196.75 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 -
Jon E & Catherine A Tstes Borgstrom
3728 Woodland Trl
Eagan MN 55123
Highmark Restorations/platinum Restorations
8720 Eagle Creek Pkwy
Savage MN 55378
(952) 641-3519
Applicant/Permitee: Signature Issued By: Signature