4280 Trenton Tr
, CITY OF EAGAN
~ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 -1J,
~ PHONE: 454-8100
BUILDING PERMIT Receipt k ~~(617 I
ro es us.d ro. SF Arlt./GarY estvaiue 74_ppepete 12-31- 19 85
Site Address 4280 RN7Y1W TRAiiErect 03t Occupancy
LotBlock 3 Sec/Sub. Remodel ? Zoning NeWthWie" Parcel No. 10-52100-0Y1.pS Aepafr ? Type of Const V
Addition ? No. Stories
WESLEY CONSTRUC'fIOH Move ? Length 40
s Name
; Addr ss _ 9~1 XylOi! Ave. Demolish ? Depth~~
o p~o ~i t9~7~2 Int Impr. ? Sq. Ft
cit~' ~ ~one Install ? •
= F Name Approrals Fees
8 Q Address Assessment P@frtlit iS_o
~ City Phone Water & Sew. Surcharge 37.00
s Police Plan Review 177_'S0
~ = Name Fire SAC 525.00
Address
a= Eng. Water Conn. ~0. 00
< W City Phone Planner Water Meter 63.00
o
I herebyacknowledge that I have read this application and state thatthe Council Road Unit 281_11
Bldg. Off. Tr. PI. 132.00
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagr Ordinances. APC Parks
Signature of Permittee 2:4- ' I Var. Date Copies
' Totel 2QA9. %
A Buildinl Permit is issued to: WESLEY CONS('R on the express conditlon that
all work shall be done in accordence with all applyEable Stste of Min spta Statutes and City of Eagan Ordinances.
Building OHicial ~ ti~
~ PwmM Na PamM Moldw Wb TNphone N
PWmbin9 z.9' ~ - I - ~ j 7 - {S8L
X.V.A.C. ll~~ 1/ 5 j
Electrlc o6
soe.~«
Impeelbn DoM Imp. Conurowb
foomW i
Foetlnpe 11
Foundatlon
Fominp
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CITY OF EAGAN Remarks
Addition NORTHVIEW MEADOWS Lot 5 elk 5 Parcel 10-52100-050-05
Owner Street 4280 TRENTON TRAIL State EAGAN MN 55123
Improvement Date Amount Annual Years Payment Receipt Data
STREET SURF. 7 -147 7 lO
STREET RESTOR.
GFADING
SEWER T 1981 15.89 .79 20
SAN SEW TRUNK 57,5 1981 138.48 6.92 20
SEWER LATERAL R g 1984 275.22 1e.3418.5s 1$
7 1981 22.28 1,48 }-}1 g9is
WATERMAIN 07 1984 70.67 4.71 15
WATER LATERAL 7$ 1981 18.65 1.24 HIS
WATER AREA ~V 1981 138.48 6.92 20
WATER LAT 3 1982 29.52 1.4'1 1-48 20
STORM SEW TRK D 1984 392.32 e, (.39s-23 '"S
STORM SEW LAT
DRAINAGE 1984 33.97 3.'i1 3^+9 10
CURB & GUTTER
SIDEWALK
STREET LIGHT
28 0 58677 12 31 85
WATER CONN. 500.00 11 11
BUILDING PER. 11405
SAC 525-00
PARK
INSPECTION RECORD ~
CITY OF EAGAN PERMIT TYPE:
f 3830 Pilot Knob Road Permit Number.
~ Eagan, Minnesota 55122-1897 Date Issued:
~ (612) 681-4675 ~
I
~ SITE ADDRESS: APPLICANT:
tI FN10N iR RI I! IIdv9',IMI N7'a t:UN',T I
. i~l~rt~ I li\i I 1 1.1 rit 01l1tl•,
,
PERMIT SUBTYPE: TYPE OF WORK: ~
1'A1H 1
INSPECTION DATE INSPTR. INSPECTION TYPE DA
i IIitl i !!1I410l 111 7 f i'.`i
~ I+NUf;II 1N ftlt'r I In1F~l
I
I
i;tt mAL/ . ~11 Ah;Ali I'i i, Ml 1', t.l 0 itlf<114 Fl1t; 1 I F~ INIfA) Mf ~ f1AN11 AI I\I41, ('I Ii{ryt:lNO ilif"l
~
I L
~
Parmk No. PermR Holder Date Telephons N i,
ELECTRIC g0 , l /r ~Q ~ i
PLUMBING
HVAC UG 9 I 901 ~~I
Inspeetlon Dats Insp. Comm nU
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PIUMBING ~-Je Q.EJ N 5 4G
PLBG
Alfl TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
~v
BSMT R.I.
BSMT FINAL
~ DECK FTG
~
i
~ DECK FINAL I
i
~
I
J
CITY ( )F EAGAN
3WO PuYti Knob Road MrATB! SERVICB PEnMR
F;'O. Box 21189 ?ng.y '
Eapan, MN 55121 P~IT NO.: _
DATE:
Zaninp: _
Owrrr, Wesle C.onst. No. of Unlh:
/lddrssx
SNr Addren: 4280 Trenton Tr. L5 B5
PIuR,be,; rrilc Northview N;ea ovs
ue er
M.r.r No.: 36
7 S5 0 0 3
Slu:
~_rQo c/ D f xR.~~a c8~ I~: P
Reoder No.: 0/ ill ~ c/ ~r t., ~...~c r; E • P
~~rn
~"fte to smas* Mo
acp„ 1 .
rpra: • p'
By ~ Totai: 63.OOpd meter
• Pold:
Dofa of Irup.:
03 ~ 0 cp I^ap'.
CITY OF EAGAN
3330 Piiot Knob Road SEWN SQVICE PERNT
P. O. Box 21199 PERMIT
Eagan, MN 55121 NO.: ` Zaninp: 't'_ Do1TE:
Owrrr, No. of Unih: i
;e
/lddress:
Site Addross: G ^ f r
Plumber. iecLr,,.11eZ ~I
~ M~w h
•~Nf~ wiN~ N. _ : 100. On
SN11 COfwwtl0n ~~I~O~rpe: ' 75. C;)6G'
~ O{~wf: •
PsTih FM: ? ( ) „l t
gy Surchorp~;
DcN oi AAitc. Cfqrpy;
I,yp,; Totol:
Doft Pold:
~~i~- 9 ,c~~ 7if F10 ~ 4o a ~S~o
0 0 7 ~ 8
,
Request Date Fi e No. Rouc~stInspection Reqwretl Inspaction Othar Thgp pough-In ~
(f_~ _'/n (You 19 call inspector when reatly) ~ Ready Now ~~~`Will No4ty Mspector
Yes ? No Date Reatl
I)~licensed contractor ?owner hereby request inspection oi above ele rical wor
Job Address (StreeL eox or Route No.) City
4 o1g0 ~c'~ En+pn 1 ~
Secbon No. Township Name or No. Range No. Coumy
Occupant(PRINT) Phone No.
5~ IL'/\ :
POrver Supplier Address
IJ,S j°
Electncal Contracwr (Company Name) s( Contractor's License No.
~ ~ 9D f"110
Mailing Atltlress Contracbr or Owner Making InstallatioN .
1~~3~ So S~-~~ 1~.•• 6s1r3
Authorizetl Signat e( n dOwn r mg Instaltation) Ph ne Number
JV IL~ ~
MINNESO A STATE BOARD OF ELECTRICITV II~~I IIIII IIIII III~~ IIIII nl~l Illn IIIII Illn IIIII THIS INSPECTION R OUEST WILL NOT
G8299 Unive51Iy Ave., Room
Pau1S MN 8 55104 II II II ES EP~ROPER NSPECTION FOEE RS
I
Phone (612) 642-0800 ENC
REQUEST FOR ELECTRICAL INSPECTION
EB-00001-09
10, See inslrucUOns tor completing this form on 6ack of yellow copy
;,.~a,,~=, !oa ~
0 071 888 "X" Below Work Covered by This Request
Ne Add Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Electric Heating
Apt. Building Load Management
Comm./Industrial Other (Specify)
Farm AOther (specify) Contractor's Remarks: ,
2 ~hp ct,et.
Compute Inspection Fee Below: (3t_~
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transtormers Above 200 Amps ove 100 _Amps
SIgnS Inspecrors Usa Only. TOTAL
Irrigation Booms W. 50
Special Inspection L
Alarm/Communication THIS INST LA O ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED HIN 18 MONT
I, the Electrical Inspector, hereby Rough-in Date C
Yo
certify that the above inspection has Final
been made.
OFFICE USE ONLY
This request voitl 18 monihs lrom
CITY OF EAGAN N 2 114 0 5
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 .
PHONE: 454-8100
BUILDING PERMIT Receiptu 007
Tobeusedfor SF Dwlg./Garg Est.Value 74,000.Date 12-31- 19 85
Site Address 4280 TRENTON TRA7 i. Erect C~ Occupancy
Lot5_ Block 5 Sec/Sub. Remodel ? Zoning
Parcel No. 10-52100-050-05 Repair ? Type of Const. V
Addition ? No. Stories
Q WESLEY CONSTRUCTION Move ? Length 40
W Name
o A ess 9401 Xylon Ave. Demolish ? Depth 40
~oom ngto 944-7092 Int Impr. ? sq. Fc.
Ci y Phone Install ?
= o Name Approvals Fees
nddress Assessment Permit 355_O(1
~ City Phone Water & Sew. Surcharge 37.00
I-Q Police Plan Review 177. 50
F W Name Fire SAC 525.00
Address En Water Conn. 500.00
a W City Phone PI nner Water Meter 63.00
Council Road Unit 280.00
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe BIdg.Ott. Tr.PI. 132.00
information is correct and a ree to com ly with all applicable State of
Minnesota Statutes and C' f a ~ n idinances. APC ParkS
Signature of Permittee Var. Date Copies
Total 2069.50
A Building Permit is issued to: WESLEY CONSfR CT4.bN / on the express condition that
all work shall be done in accordance with all ap ~e/,able State of, /M/in~~e~s~o~ta Statutes a~nd City,~f Eagan Ordinances.
Building Official ~V~ ~ / ~e~GCi'?J~~'~
~
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
HOTE: ALL CONTRACTORS MUST BE LICENSED YITH THE CITY OF EAGAN
COMMERCIAL SINCLE FANZLY DWELLINGS
INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS
& STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY
SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS ENERGY CALCULATIONS'
$2,000 LANDSCAPE
To Be Used For: ID.F• DWC-t ~LP4- Valuation: Date:
Site Address AOFFICE USE ONLY
Lot 15- Block j Erect ~ Occupancy .3
Remodel Zoning
Parcel/Sub/.,~2&1 vr.Cr.~ Repair ~ Type of Const "V-
I ~J Addition ~f of Stories
Owner L,/ •~'C~, L - Move ~ Length ¢o
Demolish Depth d
Address /"~~ie, Int.Impr. Sq Ft
Install
City/Zip Code .
Phone APPROVALS FEES
Contractor Assessments 1 Permit 35S,
Water/Sewer Surcharge 3 ,
Address Police Plan Review
Fire SAC S S,
City/Zip Code Engr Water Conn sco,
Planner Water Meter (,3, Phone Council Road Unit ? gp,
Bldg Off Treatment Pl
Arch./Engr. APC Parks
Variance Copies
. Address ~ TOTAL
City/Zip Code
,~/~y' •
Phone
~
, G,~,.'~'"~
~
.1
0
2~x 20 = 48o x s8 = Z-7 B4 o
6 J -2e)o x 44 ? (23'z-0
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- 4-5 4 x ~ 2- = .SS oa
ZZx22
-72o
0
~36~8
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Approved for Northvi'
~yf
Ir Atwci&tes as per, llrchitectural tontr
ol Couittee by
9 _ t' ' • ' . . _ . :
n.ce - ~y- ~s • "'':'`s~
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Aor4oy eortitr,that tbis survey. Olan er Poport ru Orapred by u er under my diNCt sYOorYI~lon
~"s and tAat I 02 s.duly Ae91atoisd Lanl Surveyor under the Lar• •f the Stat• •f Ni'amusta
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~ Rof. No. 10l~l,`
Cities Di i._~ tal Quality Control
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,ie: ^•"IiL1 S;(e: °.'j ! F," .:1 ••1~41 ~1 { , y' , : ( , . .~L::j
'
D'etermine ;wo'r.k'iing ;squar,e, foota,ge, of ea. ch:
„
,
~all area sq. ftz~
..~R
~y' :';,~~u i ~ ~ = ° ~ . ~ . ' ' i , ) • ' ' ~ a~S
k~.jnpdf:/ce~il~n'g,!.a"rea, sq. ft.
i1~.1 : • 'L•, Sy ~y,,~ u'r ,i
;i~ 1` r i a ~ F ` . • , , ' . ~ r
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`.To.te.l~:epx'`'osed~ aall are.a bo
, : . ~ y:•:~ , , a ve floo'r = . ~0`j,~y F • i;~.
'4 ,7~~ :~t , • 1 '~r'' , ' 1 , . , .1-. ~ , : . ~ ~
Tptall" wal'l wi.ndow. area.
. • . I.. . . . . . . . , . . _1:2~?:;. . . ; ,
~~.door area-. . . i~ ~~"~.,a:;$5~~
. . . • ~ . . . . . . . . . . 7~;i' i I~,lv " . '~:jt ,1;.')!•1
S1',i'd: gl:ass door area .
erea'...:.....
:i~.~ • •
1 ~ ~~l'~r ~ ~ 1 `i~.~~~~C~'~ yafl
p'.tp wall.'fpaming area (average 10%)...:..... ~~Y..[~r1.'3~•4 •'t'.r ^ai`~;~~;
Wa1~1 'area above floor
8~.l~'3
: 'TC)tal rim.,]ot'arca ?
Total, exposed foundation area = "C7;
ip,
4.1pundaflon' window area......
~i
~~,.:r~?~,.,~: • , ~Td~:~.~;~i~;~ fou,t~da~tion area above gr~~de
~~.i~*~ ~ . , • ~..1',;! ..~i~ll_.`y j..~'~~. ~ . ' •r ~ ~ ~ . . . ,
',;"Defermine,.U" value: cf each wall segment.
~ µ . . . . . . f • . , ' iE'.
y'fr
a. ,1•.~ .•1 y 11~11 ry = ! ~'7,~, . 1 ~ .L +i
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: I '
. ~
k:. Total roof/ceiling fri~#ng area (av,~a9e; 1
Tota1!'net lnsulafed roof/cefiing area ~
R
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Oet6~'Ni1ne "U„ value for each `rooffcellinQ
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Alternate BuilGing Enveiope ~Oesign~~
To ut.ilize thq total envelope system m$thod, the values,established by the
sum of items 03 and #4 shal l not be greater than the: suni' af' itemS 01 land 42.
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PERMIT
CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: Bu x Lo IN s
Eagan, Minnesota 55122-1897 Permit Number: 0 2 8 5 4 7
(612) 681-4675 Date Issued: 0 8/ 2 7/ 9 6
SITE ADDRESS:
4280 TRENTON TR
LOT: 5 BLOCK: 5
NORTHVIEW MEflDOWS
P.I.N.: 10-52100-050-05
DESCRIPTION:
FIRE REPAIR
~Building-_Permit Type SF (MISC.)
,Building W'or~k Type REPAIR
Census Code 434 ALT. RESIDENTIAL
i ~
/
j
i
t ~
\ ~s
• ~1\ ~ T_~ T-.~ 1 : i L, • N`
J` ~~S,\` , ~ i ~ • , i ~ . f ` f j f ~ I .
REMARKS:
SEPflRATE PERMITS REQUIRED FOR ELECTRICAL, MECHANICAL AND PIUMBING WORK
FEE SUMMARY:
, VALUATION $75,000
Base Fee $731.00
Surcharge $37.50
Total Fee $768.50
CONTRACTOR: - Applicant - sT. Lxc.OWNER:
VALLEY INVESTMENTS CONST 14545191 0004241 HOLMDAHL MICHAEL
2401 LEXINGTON AVE S 4280 TRENTON TR
MENDOTA HTS MN 55120 EAGAN MN
(612) 454-5191
I hereby acknowledge that I have read this application and stete that the
infiormation is correct and egree to comply with all applicable State of Mn.
Statutes and City ofi Eagan Ordinances.
- ~
~11
APPL AT/PERMI£E SIGNATURE ISSUED B: SI ATUR
. . .
G _
CITY OF EAGAN
CASHIER: S TERMINAL N0: 541
DATEe 08/27/36 TIMEe 1500e31
ID :
NAMEa VALLEY INVCSTMENTS CONST CO
3210 90(]1 4280 TRE:idTON TR 731.00
205 3001 4280 TRF_N70N TR 37.50
To+.al Receipt Amoun+,e 766.50
CR06333i
USE..R ID : NANCY
-I - ~ CITY OF EAGAN 7~~• S-ZJ
3830 PILOT KNOB RD - 55122
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Construdion Reauiremenls RemodellRepair Reauirements
? 3 regis[ered site surveys ? 2 copies of plan
? 2 copies of plans (include beam 8 window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior additions 8 decks)
? t energy calculations ? 1 energy calculations for heated additions
? 3 copies of tree preservation plan if lot platted after 7/1193
required: _ Yes _ No
DATE: CONSTRUCTION COS :
DESCRIPTION OF WORK: 'A s
ST EET ADDRESS: ~ag0 (R~? ;~VN / RA-f L
LOT 5 BLOCK S SUBD./P.I.D.
PROPERTY Name: ~l-VY~D~tf L A/C4f9~c- c- Phone
OWNER ""S` '
Street Address: %R4W-fll~ /r` 2A~L
City: fi~47 64-n-j State: Zip:
CONTRACTOR Company: 1A~:"-~-+'kJL)-~r&!"hone
Street Address: c7"/OI k,6-3. License
City: lhe-A]1,00-n - i6ff-is State: Zip: ~C)
ARCHITECTI Company: Phone
ENGINEER
Name: Registration
Street Address:
City: State: Zip:
Sewer 8 water licensed piumber. k~LJ 2:25~:L Penalty applies when addiess change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this application and state th e' formation is correct agd agree to comply with a{I
applicable State of Minnesota Statutes and City of Eagan Ordinance. ~
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes No
Tree Preservation Plan Received Yes No
OFFICE USE ONLY ' •
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging o 16 Basement Finish
0 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. 0 17 Swim Pool
? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
0 04 SF Porch o 09 12-piex o 14 Fireplace ~ 21 Miscellaneous
0 05 SF Misc. ? 10 = plex o 15 Deck
WORK TYPE
31 New eI' 33 Alterations ? 36 Move
? 32 Addition /0 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. fl. 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
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
% SAC
SAC Units
CITY USE ONLY
L S BL RECEIPT
SUBD. C'-c `^''J DATE:_ W b
1996 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
New construction Add-on fumace
~ Acid-on air conditioning Fidd-on air exchanger, i.e. Vanee system, etc.
Date: qU/
EM
? Minimum Fee: Add-oNRemodel (existing residence only) $ 20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required @ $3.00 each)
- Sta*.s Surchargo- .50
TOTAL sn, 5C7
SITE ADDRESS• ~ ~ '~6'n ~V '
OWNER NAME: M k QSL k0c, \1 ~ PHONE
VOGT HEAl1NG i AIR CONDITIONING
INSTALLER NAME•
ST LOUIS PARK, MN 55426
STREET ADDRESS: saI Fs a9Q.ar67 S6RNI6E 689
CIIY: STATE: ZIP:
PHONE (
,
~TGR~ Rt ur ~R~ ~
CITY USE ONLY . , .
• L BL RECEIPT
SUBD. DATE:
-..1996 MECHANICAL PERMIT (COMMERCIAL)
• CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 6814675
Piease complete for. ? all commerciaUndustrial buildings.
? multi-family buildings when separate permits are ~ required
for each dwelling unit. -
DATE: CCNT°.ACT PRICE:
WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: ?$25.00 minlmum fee pt 1°h of conVact price, whichever is greater.
? Processed piping - $25.00
? State surcharge of $.50 per $1,000 of pgnjjj fee due on all permits.
CONTRACT PRICE x 1 %
PROCESSED PIPING
STATE SURCHARGE TOTAL
SITE ADDRESS:
OWNER NAME: TELEPHONE
TENANT NAME: (iMPROVennerrrs oNLY)
INSTALLER: VOGT HeanNQ a eIa r_nuDtfl0MIW6 3260 GORHAM AVE. ADDRESS: ST LOUIS PARK MN 55426
-SAL S 929•8787 SERVICE 928401 i"' '
CITY: STATE: ZIP•
~ PHONE
SIGNATURE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
CITY USE ONLY
L ~ BL J~ RECEIPT 6VZ;2 5
SUB . DATE:
1996 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
FIXTURES EACH TOTAL
Shower 3.00 x
`Natsr C!oset 3.00 x
Bath Tub 3.00 x
Lavatory 3.00 x _
Kitchen Sink 3.00 :c
Laundry Tray 3.00 ;c =
Hot Tub/Spa 3.00 :c =
Water Heater 3.00 ;c =
Floor Drain 3.00 _
Gas Piping Outlet " minimum - 1 3.00 ;c =
Rough Openings 1.50 :c =
Water Softener 5.00 x =
Private Disposal ' Dakota Cty. license 65.00 =
(new and refurbished systems)
U.G. Sprinkler " home under const. 3.00 =
Alterations ' to existiny 20.00 =
Water Turn Around 20.00
STATE SURCHARGE .50
TOTAL o`~DSo
SITE ADDRESS: ~WO ;L012~ ;r/
OWNER NAME: U6(.~.eL~- LP1I211 INSTALLER NAME:
STREET ADDRESS:
CITY: STATE: 1Yl fil ZIP:
PHONE (6la. ) q6a -l5(o 5
OFFICE USE ONLY
L BL RECEIPT
SUBD. DATE-
1996 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 6814675
Please complete for: ? all commerciaUindustriat buildings.
? multi-family buildings when separate permits are pgs required for each dwelling
unit.
DATE: CONTRACT PRICE:
~~^v^~: T'; rr: _ yE'vJ CvNS i FiiG i iG~i ADD GN IttPAIR
DESCRIPTION OF WORK:
IS WATER METER REDUIRED? _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING:
WATER FLOW: GPM. ARE FLUSHOMETER:i TO BE INSTALLED? _ YES _ NO.
FAILURE TO PROVIDE THIS INFORMATION WILL RESULI' IN A DELAY OF METER ISSUANCE.
WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? _ YES _ NO.
iF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINi:LER PERMIT.
FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge of $.50 per $1,000 of pgrmit fee due on all permits.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL
SITE ADDRESS:
TENANT NAME: _ STE. #
OWNER NAME:
INSTALLER:
ADDRESS:
CITY: STATE: ZIP:
PHONE SIGNATURE:
APPLICANT
OFFICE USE ONLY
METER SIZE: " DATE: INSPECTOR:
vE•a
?EC~IPT DATE
DA'I'E
:'0
.7oH
OWND 57
h7~~
?I.cJISL 9E ADVMe,D ZS Ar
EE 3Fi0R':,1Gq^, OH n
X ABOVE
MECTRIGL i?STAL'.ATIpx rH M AMOfJIPT OF $
~
SHaRTACa !SL'ST 3E ?AiD ~HI:}tIN 14 ,7AY5.
c~~.ARl6
l ti = =o 20 amv -u- -s• / ~
=1 "o 100 amo. ci:c;sitsa
0 co 100 amc se.-vicem
'_OI c0 300 amo. serv:ce-
'CTAL F= ° DUE=
LcSS FEE REC.-F,VED C
T ~ZC SMORTAGE. I
~ERMIlr~
ORZG. RECE2PT*
RECEI?T DA2E eIR~ ~
REN?L'V CDPY OF THIS FORM WITH REMITTr1NCE.
PERMIT # RECEIPT DATE:
MIDENTIlEL PLUMSIftfi PEfiM1T APPI1Ci4TI0N
crrYoF KAsM
S$SO P1LOT KNOB EtD
, . . . . . . : • EAfiAN.1NN 55122
- , - - ~ - - - • - - - 651-6$1-4675
' ; , „ . • , , . .
Please complete for: ? single family dwellings •
? townhomes and condos when permits are required for each unit
? backflow preventer for irrigation system
SITE ADDRESS: HOLMDAHL, MICHAEL
- 4280 TRENTON TRAIL
OWNER NAME: : EAGAN, MN 55123 TELEPHONE
- (651) 688-0274 (AREA CODE)
INSTALLER NAME: TELEPHONE
(AREA CODE)
STREET ADDRESS:
CITY: STATE: ZIP:
Place a check mark next to the ermit work t e
_ New residential dwelling unit under construction and not owner/occupied $ 90.00
V Add-on, modification or alteration to existinct dwelling unit, including: $ 50.00
• abandonment of septic system
• new installation/repair/rebuild of RPZ D~~ 1~,~
• lawn irrigation system
• water tumaround ~ I JUL ~ 6 l0( 1
Nature of work: rP~I (a C P) ~hea~e.~' ~
Septic System, new/refurbished - $ 225.00
• inciudes County & Consulting Inspector fees
• requires MPC license
State Surcharge $ .50
Total $f5D_
Reminder: Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc.
I hereby acknowledge that I have read this application, state that the information is correct, and agree to complywith all applicable City of Eagan ordinances. It
is the applicanYs responsibility to notify the property owner lhat the City of Eagan assumes no liabiliry for any damages caused by the City during its normal
operalional and maintenance activities to the facilities conslrucled under this permit within City property/right-of-way/easement.
Tl/ry~
/
SIG A RE OF PERMITTEE
Updated 1/01
(G RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construction Reauiremenis RemodeUReR81r Reaulrementa avc) •7?
• 3 registered sae surveys showing sq. fl. of lot, sq. tt. of house; and all roofed areas • 2 copies oi plan
(20% maximum lot coverage allowed) . 1 set of Energy Calculatbns tor heated additions
• 2 copies of plan showing beam & window sizes; poured }ound design, etc.) • 1 site survey for exterior addRbns 8 decks
• 1 se1 oi Energy Calculations . Indicate if home served by septic system for add'dions
• 3 copies of Tree Preservation Plan A bt platled after 7/1/93
• Rim Joist Detail Options selectbn sheet (bkigs with 3 or less units)
DATE 6' 14`o Z- VALUATION
SITE ADDRESS ~ Zk(-) 1:12er``Fu7n _tr4~_1 1 MULTI-FAMILY BLDG _ Y IiIV
TYPE OF WORK Qa•S~ cl-i tn S o~~~ I 5~ • FIREPLACE(S) _ 0_ 1_ 2
/
1 ~ ~v-,,,'}~<<C=7'~?~ ~~P~IC•
APPLICANT ~ ?y?~Y I < _c~ I> 1),
STREET ADDRESS 111)~? • Sv CITO~t.YY~VI~~~ lc2 STATE M1-)ZIP SS 3 3 7
- r--
TELEPHONE # L---~CELL PHONE # FAX # C~tZ'QX,_(b
PROPERNOWNERRD6~Jv~r`L~C~hevN TELEPHONE# 6;~V- J-SL 965'
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RUI.ES 7670 CA1'EGORY 1 MINNFSOTA RULES 7672
(4 submission lype) . Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: Phone #
Plumbin
g system includes: Water Softener _ Lawn Sprinkler Fee: $90.00
Water Heater 1Vo. of R.I. Baths
No. of Baths
Mechanical Contractor: Phone #
Mechanical system includes: Air CondiUoning Fee: $70.00
Heat Recovecy System
Sewer/Water Contractor: Ph t
L~ ~ c
;
I hereby acknowledge that I have read this application, state that the informa F is.~re~ci~aagto comply
with all applicable State of Minnesota Statutes and City of Eagan Ord' _ ces. V
Signature of Applicant B i
i OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY , . .
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
O 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex O 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck O 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition O 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuatlon 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) _ Final/C.O.
_ Footings (deck) _ FinallNo C.O.
_ Footings (addition) _ Plumbing
Foundation _ HVAC
Drain Tile Other
Roof _[ce & Water _ Final _ 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 & Storage
S&W Permit 8 Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
RESIDENTIAL
51 9 S(.0 BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
NewConstructionReaulrementa RemodeVReoalrReauiremeMS
• 3 registered sfle surveys showing sq. tt. of lot, sq. fl. of house; and ~II roofed areas • 2 copies of plan
(200/6 maximum lot coverage albwed) . 1 set of Energy Calculations lor heated additions
• 2 copies of plan showing beam 8 window sizes; poured found design, etc.) • 1 sRe survey for exterior addRions 8 decks
• t set of Energy Calculations . Indicate it home served by septic system for additbns
• 3 copies of Tree Preservation Plan H lot ptatted atter 7/1/93
• Rim Joist Detail Options selection sheet (bldgs with 3 or less unfts)
DATE VALUATION 222
~
SITE ADD ~-`'~'Q-~`+~1 MULTI-FAMILY BLDG _ Y ?~V
r(~'('
NPE OF ItK*~Rex) FckSqS FIREPLACE(S) _ 0_ 1_ 2
APPUCANT Ari/1 e-Y (C-,c.vv
STREET ADDRESS I a-/VIC6/l27- 4X. SD CITY(!~4- STATE A41J ZIP
TELEPHONE # "~(SJ_-I 767 _1~4 CELL PHONE # FAX #
PROPERNOWNER TELEPHONE#C~--9 6'4f6Sc/
COMPLETE THIS SECTION FOR %,NEW,-, RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672
submission type) . Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Workshee[ Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: Phone #
Plumbing system includes: _ Water Softener _ Lawn Sprinkler Fee: $90.00
_ Water Heater _ No. of R.I. Baths
_ No. of Baths
Mechanical Contracfor: Phone ti
Mechanical system includes: _ Air Conditioning Fee: $70.00
_ Heat Recovery System
Sewer/Water CoNractor: Pho Ul~ f s
~,--~~~'.--~-°ft
I hereby acknowledge that I have read this application, state that t informati ~~~is correct, ar o comp
ly
with all applicable State of Minnesota Stotutes and City of Eagan(9rd a~
BY
Signature ot Applicanti
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06plex O 16 Fireplace ? 21 Porch (3sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New O 35 Int Improvement O 38 Demolish (Interior) O 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories • Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation _ HVAC
Drain Tile Other
Roof _[ce & Water _ Final _ 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 & Storage
S8W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total '
RESIDENTIAL BUILDING
j • - 5Kq3 Permit Application ~
City Of Eagan C~~ ~/ra3 ~~.3
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauirements RemodeUReoair Reouirements Office Use Onlv
3 registered site surveys showing sq. ft.:if lot, sq. fl. of house; and all roofed areas 2 copies of plan Cert of Survey Recd
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd
2 copies of plan showing beam 8 window- sizes; poured found design, etc. 1 site survey for additions 8 decks Tree Pres Not Reqd
1 set of Energy Calculations Addition - indicate if on-site sepGc system _ On-site Septic System
3 copies of Tree Preserva6on Plan if lot Fdatted after 711193
Rim Joist Detail OpGons selection sheet+(bldgs with 3 or less uniLs
Date /17/ UJ Construction Cost C5 V Uvi U U
Site Address T/` P/1 /(1n 72I Unit/Ste #
E • ~ .~J~/~ .3 6,4
Description of Work A/ e w ~ Q L(7
Multi-Family Bldg _'i' X N Fireplace(s) _ 0 _ 1 _ 2
Property Owner ~(Ijciln_ &2j Telephone # ( 6S/ ) --nS` r
Contractor 13yf "StG/) e-
Address Kja !jk'L} N, City LGfre C/
State Zip ,sSU~fL Telephone #
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Energy Code Category - Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
(J submission type) ' • Residential Ventilation Category 1 Worksheet . New Energy Code Worksheet
Submitted Submitted
• Energy Envelope Calculalions Submitted
Licensed Plumber Telephone # ( )
Mechanical Contractor Telephone # ( )
Sewer/Water Contractor Telephone
~ ~ . .
1 !
I ~ . .
I hereby apply for a Re:,idential Building Permit and acknowledge that the informa }4n is co rp Zand ac~urate;
that the work will be in conformance with the ordinances and codes of the City o4-ffr=1 the State-~f MN
Statutes; 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 wiil be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
l3, !l (rvld-e-n
Applicant's Printed Nar;rie , pp icant's Signature
OFFICE USE ONLY
Sub Types i
? 01 Foundation ? 07 05-plex O 13 16-plex ? 20 Pool ? 30 AccessoryBldg
? 02 SF Dwelling ? 08 06-plex O 16 Fireplace ? 21 Porch (3-sea.) 0 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage 0 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex X 18 Deck ? 23 Porch (screen/gazebo) O 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
~ 32 Addition O 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement 'Demolition (Entire Bldg) • Give PCA handout to applicant
Valuation ~L90 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 VWidth
REQUIRED INSPECTIONS
Footings (new bldg) FinaUC.O.
~ Footings (deck) ~ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (newheplacement)
Insulation _ Retaining Wall
Approved By Building Inspector
Base Fee
Surcharge n
Plan Review L
v
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
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MnMp04~. Mmmfou o'-132
~ Cui7. Muna ippl tl tm•~.unmtneaf £ngmnnng Fa3m*.u1..'1Ue.350 O}Ht1 • feed Swqtring • InnJYlannin Rwer R-tl4e ei. i 8 Sw/ Mmnewb DSi:i I I
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~ Approved for Norlhvior Atsociat*s a• per Architectural Control Committee by
• t,;
' • ' Date /y- fS
•
1 AlrsOY esrttfy tAat thts •urvo
~~f'11 ~,~,e •up.~.i.iea
•ftd that 1 as a duly Reoisterod laed 1SurreyorPrnder ,tAe 'Lars 'oibth- •State
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day of . 19~• bl
Gary R. Pis. Aeqlstere1 Lan1 rrviror
Niam. Ret. No. I0643
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RESIDENTIAL MECHANICAL
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675
Please complete for. Single Family Dwellings & Townhomes and Condos when permits are required for each unit
Date ~ / q 1 104
Site Address ~~(~"b'1 ( • Unit #
PropertyOwner hc)eflC(1 Telephone#(
Contractor _Wohlers Southside Htg. & Air, Inc.
' 6950 W. 146' St., 9 106
Street Address Apple Valley, MN 55124 City
State (952) 431-7099
Telephone # ( )
sond ~1 Z d~jL-1 7 q~ Expires:
The Applicant is _ Owner ~ Contractor _ Other
Add-on, modification or alteration to existing dwelling unit $ 30.00
furnace replacement
air exchanger
~ air conditioner _ New ~4,Replacement
other
State Surcharge r j~$ .50
fl ~ 11 t:
I1
Total U $
~v -
I hereby apply for a Residential Mechanical Pernvt and acknowledge that the information is complete and accurate; that the work will
be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a
pemrit, but only an application for a pernvt, and work is not to start without a pernrit; that the work will be in accordance with the
approved plan in the case of work which requires a review and approval of plans.
D cz-fll e.l -:R, • l-~k.'6'1 ler~ CC_Q.L~Q l,U~)UW~
ApplicanYs Printed Name ApplicanYs ignature
COMMERCIAL MECHANICAL
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675
Please complete for: commerciaVindustrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
Date
Site Street Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor
Street Address City
State Zip Telephone # ( )
Bond Expires:
The Applicant is _ Owner _ Contractor _ Other
Work Type
New construction _Install _Remove Underground Tank
Interior Improvement Schedule inspeclion during installation or removal of tank
Processed Piping
Nature of Work:
Permit Fee $50.50 Minimum Fee (includes Sta[e Surcharge)
Contract Value $ x 1% _ $ Pernvt Fee
• If pernrit fee is $1,000 or less, add $.50 $ State Surcharge
If pernut fee is over $1,000, add $.50 per
$1,000 Pemut Fee
$ Total Fee
I hereby apply for a Commercial Mechanical Pernvt and aclmowledge that the information is complete and accurate; that the work
will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is
not a pernut, but only an application for a pernut, 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 approva] of plans.
ApplicanPs Printed Name Applicant's Signahue
Approved By: , Inspector Date:
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675 Please complete for modifications to existing residential dwellings.
Date
Site Street Address Unit #
PropertyOwner ~U~LQr? Telephone# ql q
Contractor Telephone# (6la)W1-6c-4L0Q
Address (Siy 3R° NUf 5\,,1 city KU,~CV\ + v1SCr~ StateN%-~%J zip 553,0
The Applicant is: _ Owner ~ Contractor _Other
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures (excludes water softener and/or water heater--complete next
section if installing these appliances).
_ Septic System Abandonment
_Water Turnaround (add $125.00 if a 5/8" meter is required)
Other:
Water Softener Water Heater $ 15.00
_ new _ replacement
V'Lawn Irrigation _RPZ ?PVB ?ew _repair _rebuild $ 30.00
State Surcharge $ .50
Total $ ?,p , 50
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be_in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
~1\\~\\)n,^, 1\~7 \ S
Applicant's'Printed Name Applicant's Signature
May, 17. 2012 7:49AM Champion Plumbing 1-651-365-1332 No. 0154 P. 1
Date:
City of Eag.all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675.5694.
Use BLUE or BLACK Ink
For Oce• Use
/L/
t.
Permit #:
Permit Fee;
D°f
Date Received: c- 1712-,
Staff:
INFLOW & INFILTRATION PERMIT APPLICATION
Plumbing / Sewer & Water
6-1 0- ( - Site Address: 6a$0 7re nfo
1
Tenant; Suite #:
RESIDENT I OWNER
Name: k 05 ' £11 , — VZ 2 * Phone: (61 1 1 q -- b
Address / City / Zip:O,
, , , . NI Nt • I -
CONTRACTOR
Name: C4v I OP
0 L(4 3(Ifr1 License /k I 1 -1O t" )
Address: U� - N. I
3
City: Cf irN
Slate: ,��•Zip: � Phone(
t5I )J �t - .14;6-.-1 0
r�,,,, r,�,
Email: k -r I L.l 1(i(r ohyi.(.�VIK ��!j
Contact: ')'-+ I -S
TYPE OF WORK
PLUMBING (Within the building
— Sump Pump Repair
envelope)
SEWER & WATER ((Outside the building envelope)
Repair
Other. 11Lti.t J / 'Ari! Other.
_
DESCRIPTION
Description of work: RQf(ia..ie. `(pril ,(rl0 tiVTC )
FEES
566.00I Each (Includes $5.00 State Surcharge)TOTAL
6,0,"---
0"-$55.00
.
FEE $
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit I/1 repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.cltyofeagan,comlinflow, or City Hall at 3830 Pilot Knob Rd.
CALL BEFORE YOU DIG, Call Gopher State One Call 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.00pherstateonecall,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 Fagan; 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.
Applicants Printed Name
x
Applicant's:*ature
FOR OFFICE USE
Required Inspections:
Reviewed By: Date:
Under Ground _Rough -In Final
akiP r C,fe di carri
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA139279
Date Issued:10/18/2016
Permit Category:ePermit
Site Address: 4280 Trenton Tr
Lot:5 Block: 5 Addition: Northview Meadows
PID:10-52100-05-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Rosemary D Koenen
4280 Trenton Tr
Eagan MN 55123
(651) 994-7056
Appliance Connections Inc
12850 Chestnut Blvd
Shakopee MN 55379
(952) 445-4803
Applicant/Permitee: Signature Issued By: Signature
!"
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA172885
Date Issued:10/20/2021
Permit Category:ePermit
Site Address: 4280 Trenton Tr
Lot:5 Block: 5 Addition: Northview Meadows
PID:10-52100-05-050
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
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.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Rosemary D Koenen
4280 Trenton Trl
Eagan MN 55123--195
(651) 994-7056
Restoration Builders Inc
PO Box 8043
Scottsdale AZ 85252
(612) 804-1189
Applicant/Permitee: Signature Issued By: Signature