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4202 Valley Forge Pl ; ~ ~ _ • . • CITY OF EAGAN ~ p 3830 Pflot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ~ 12919 PHONE: 454-8100 BUILDING PERMIT Receipt # To b "br SE' DWG/GF1iZ Est Value $57, 000 Date DECEMBEZ 2 ,19 86 ssed Site Address 4202 VALLEY rOFtGE Erect Of accupancy R3 Lot 2 1 elock 2 Sec/Sub. 14ORTHVIEW MF,ADOWrwnodel ? 2oning R1 Parcel No. Repair ? Type of Const u AddiUon ? No. Storiea ~ Name BU?R OAK BLDRS INC Move O Length 38 ~ Address 11461 GOLDENROD S'I' BW Demolish ? Oepth d d ° int.lmpr. ? Sq. Ft City COON R)WAPS 452-2906 Install ? o Name SAMF' ApprovNs FMs ~ i Address Assessment Permit •0 I ~ City Phone Water & Sew. Surcharge ~ w~~'00 ~ W Name CK~YT & ASSOC Police Fire Plan SAC Revie00 ~z Address 9`P}I b MISS RIVLR Eng. Water Conn. • ~ Ib City r1-E'LS Phone 379-4947 Planner WaterMeter~'30 Council Road Unit 290.00 I hereby acknowledge thai d this application and state thatthe j 2 2~ 6 Tr. PI. ~0 0 I Bldg. OH. ~ ~ information is correct and ag ta o ply with all applicable State of I Minnesota Statutes and Ci o rdinancea APC Parks Slgnature of Permittee Var. Date Copie Total ~ , ~ A Building Permit is issued to: BURR OAK BLDR5 INC on the expresa condition that atl work shall be done in a ence with all appticable State of Minneaota Statutes and Clty of Eegan Ordinances. Building Oificial PwmM No. Pw nAt Holder Ddm TNphonw • PI1t111(lIf19 H.v.n.C. ~o-7 ) -44,11'147 sonm.? Impeetlon Oab Imp. ComnNnh F°au'9`' Foounp. n FoundNlon FnnMnq RoWkq Rouyh Plbq. Rouyh IMq. Inwl. ~ 4L Fkrplm Fkul ft FkW Paw• FMM s,7 c.lt oa. Doek Ftg. D9c* Fmq. YYM M. OMp. . , . _ , , , PERMIT M ' PLUMBING PERMIT CITY OF EAGAN RECEIPT p 3830 PILOT KNOB ROAD, EAGAN, MN 55124 DATE: CONTRACT PRICE: PHONE: 451-8100 /Li BLDG. TYPE WORK DESCRIPTION Site Address Lot Bock „Z-SeclSub Res. New ~ - ~ . Mult. Add-on m Name G~ ~ L Comm. Repair ~ Address Other c Ciry Phone RES. PLBG. ONLY - COMPLETE THE FOLLOWING: N FIXTURES Name ~n Water Closet -$3 00 S ~ Bath Tubs - $3.00 3 • cry 3 Address Lavatory - $3.00 • &J9 p City Phone Shower - $3.00 =Kitchen Sink - $3.00 FEES Urinal,8idet - 53.00 COMM/IND FEE - 1% OF CONTRACT FEE Laundry Tray -$3.00 APT. BLDGS - COMM RATE APPLIES Floor Drains -$1.50 ~ TOWNHOUSE 8 CONDO - RES. RATE APPLIES Water Heater -$1.50 S^ MINIMUM - FiESIDENTIAL FEE - $12.00 Whirlpool - $3.00 MINIMUM - COMM/IND FEE -$20.00 ::7--Gas Piping Outiets -$1.50 STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIn (ADD $.50 S/C IF PERMIT PRICE GOES Softener -$5.00 BEYOND.$1)000.00) Well - $10.00 Private Disp. - $10.00 ZT :TRough Openings - $1.50 SYGNATURE OF PERMITTEE FEE: ~ STATE S/C: FOR: CITY OF EAGAN GRAND TOTAL• - . `r'°rJRr_'+'~~., '~''Tri't~•F~~y,,~~•.;~"~S'+~.'~',~".r::!'~, -r., .,c,,~ C:;T~.'V~~,' ';''y>,r;.,.:' .`!'v"'~' a+• :r~r'~"~4r ~ , . ~ PERMIT # MECHANICAL PERMIT RECEIPT # CITY OF EAGAN - , 3830 PILOT KNOB ROAD, EAGAN, MN 65121 DATE r-- CONTRACT PRICE: PHONE 454-8700 , Site Address BLpG. T1fPE WORK DESCRIPTION Lot B1ock ~ 5ec/Sub ' Fies. New 7 m Name r Mult Add-on ~ Addresa ~ Comm. Repair c City Phone ~pmer Name ~ FEES c Address RES. HVAC 0-100 M BTU -~24.00 - p City F~ , Phone ADDITIONAL 50 M BTU - 6.00 ~ ADD-ON AIFi COND. 0-24 BTU - 12.00 ADDITIONAL 6 M BTU - 6.00 TYPE OF WORK GAS OUTLETS - 1.50 EA. Forced Air M BTU COMM/IND FEE - 196 OF CONTRACT FEE Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00 Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00 Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50 Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES ~ BEYOND $1,000•00) Gas Piping Outlets # Other , FEE g/C. SIGNATURE OF PERMITTEE TOTAL• - FOR: CITY OF EAGAN = CITY OF EAGAN 3830 Pilot Knob Rcad, P.O. Box 21-199, Eagan, MN 33121 PHON E: 454-8100 BUILDING PERMIT Receipt ~c ~ To be dsed for I1ECK Est Value -OC'C Date 1`T L 7 ,19 ~ Site Address 4202 VALI.E; FORGF nL OFFICE USE ONLY Lot 11 81xk 2 Sec/Sub.N'4ZXV1EW- MgAMMS On Ske 3eways Occupancy MWCC 3ystsm Zoninq Parcel No. On Site Well (ACtuel) Const e Name $l,(YWjA[( Clly Water (Allowable) ; Address 4202 VA1.L!'X ?OkCE Yi. PRV Required ik of Storles o c;ry F.Ac:Ai phone 68-0S74 BoosterPump LengtA Depth .o Name S.F. Total °C . ~ ~ AddreSS Footprint S.F. City Phone APPROVAl3 FEES ~CC Engr./Asseas. Permit 24' , W W Name -,TaC ~ W Planner Surcharge ~ g Address a= City Phone Council Plan Review ~ W Bldg. Off. SAC, City I hereby acknowledge that I have read this application and state that the Variance _ SAC, MWCC informetion is correct and agree to comply with all applicabie State of Water Conn. Minnesota Statutes and City of Eagan Ordinances; Water Meter Signature of Permittee • Roed Unit A Building Permft ia iasued to: 1 J 5lAh1iAK Treatment Pt on the express condition that all work shall be done in accordance with all applicable State ot Minnesota Statutes and City of Eagan Ordinances. Parks G- Y, TOTAL Buildiny Official Vermit No. Permlt Holdor Date ToIopAone J~ Plumbing ' H.V.A.C. E lectric Softener Inspsctlon Da% Insp. Commsnte Footings I Footings II Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Final Plbg. Bldg. Final Cert. Occ. Temp, LP Deck Ftg. / Deck Final `Well Pr. Disp. CITY OF EAGAN Remarks Additfon NORTHVIEW MEADOWS Lot 21 Rik 2 Parcel 10-52100-210-02 Owner 5treet 4202 VALLEY FORGE PLACE State EAGAIV hW 55123 Improvement Amount Annual Years Payment Recaipt Date STREET SURF. T Date 1 STREET RESTOR. GRADING 5741 1981 15.89 79 20 SAN SEW TRUNK 575 1981 138.48 6.92 20 SEWER LATERAL 15 ~i ~$-!5 WATERMAIN 1984 70.67 4.71 15 WATER LATERAL ,Z } WATER AREA 513 .+z STORM SEW TRK Sp 1984 392.32 7 39-.-t3 10 S STORM SEW LAT 3 3-gtA 10 CURB & GUTTER ' SIOEWALK STREET LiGHT WATER CONN. 6UILDING PER. SAC PARK INSPECTION RECORD CITY 4F EAGAN PERMIT TYPE: 'MII f) INo 3830 Pilot Knob Road Permit Number: 0.109 44 Eagan, Minnesota 55122-1897 Date Issued: I o f o , / " ~ (612) 681-4675 SITE ADDRESS• ' ' 4 fl APPLICANT: t V A! LEY F'liRGF Pi I :t i 11 1111: MIf+ I liV lt 141 /11tnlt V. jf, I.' ) F;ic:-i PERMIT SUBTYPE: TYPE OF WORK: D• • D• ; I FJ 1 I II ~ - - - ~ ~ ~ Permk No. PwmB Hokiar Date TelephorN # ELECTRIC , PLUMBING HVAC - a?sp.ctlon o.a insp. comm.na FOOTINGS I FOUND FRAMING ROOFlN(3 i ROUGH PLUMBINO I AI~R~TEST ' ~ ROl1GH I HEATINO I GAS SVC I TEST I INSUL ~ I GYP 90ARD I I FIREPLACE I FIREPLACE I AIR TEST I ~ FINAL PLBG I ~ I I FINAL HTQ I I ORSAT I I TEST I i BLDG FINAL i I BSMT R.I. ~ ~ I BSMT FINAL I I DECK FfG I DECK FINAL I ~ I I ~ I - - - INSPECTION REC4ItD ( COntrol No ~ ~ CITY OF EAGAN PERMIT T1fPE: ` 3830 Pilot Knob Road Permit Number. 4410001? ~ Eagan, Minnesota 55123 Date Issued: b 1'~ ~ (612) 881-4875 i SITE ADDRESS: APPUCANT: ~ 1VAl L! Y Ft?Rft! f'! M`F Ni t3 [ONL f Ims Rt PAj fr ` NOWtleVr[W Of Anuus 1f~~~! 4?.~-y~?~t i PERMIT SUBTYPE: TYPE OF WORK: ~ r i si F s=t At 4 REPAtN r ~ I t tHt'.1'~n~.k I I ~ ~ NOMARIES: R10R YPT ! C 019F149 i . . ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ n~~ ~ ~ ~ ~ _ ~ ~ s ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ I ~ ` I ~ ' ~ ~ ~ ~ ( ' I w ~ INSPECTI4N RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: A 4't Ea an, Minnesota 55122-1897 49 I i•~~. 9 Date Issued: i (612) 681-4675 } SITE ADDRESS: I'~t, ~f j i f~ IO(. r. . APPLICANT: 'A1 I I Y F0Rfif F^i ',pi-l'tAI 1"; 1 il~~h I ti`.' f t ti MF i1it1111 I PERMIT SUBTYPE: TYPE OF WORK: ~ INSPECTION . I I ~ ~ ~ Permft No. Permk Holdar Oete Telephone M ELECTRIC PLUMBING HVAC InspecUon Dab Inap. Comments FOOTiNGS FOUNO FRAMING ROOFINC3 ROUGH PLUMBING PL8t3 AIR TEST ROUGH HEATING QAS SVC TEST INSUL GYP BOARD FIHEPLACE FIREPLACE ~ q AtR TEST / FiNAL PLBG FINAL HTG i ORSAT TEST BLD(3 FINAL ' BSMT R.I. ~ ' I I BSMT FINAL J DECK FfG _ , i UECK FINAL ' f - - - , I I f -I--- - - m i CIn OF EA(#AN' WAFER SERVIGE PER"'~ 36:w PNot knob Road pERMIT NO.: F4 1-( ~ P.O. Box 21199 { Eagan, MN 55121 DATE 4 Zaning: No. M Unlta: I . i Owner. ' Address: Site Addess: ' 4 202 ~ Plumber. ~nn nn 1 ~ Meter No.: r O ion Charge: SizA: ~sp?~1~Wa": 1 S (](1 j ~~p, ~~r• ~ ~ Read No.: ~ I pne to complY with th~~~~,t . E~- ~nyarg : Ordlnancss iSV`~„$ 6 65.5(1 utitc~. uti ToffiI: BY , Date Pald: { Date of Inap.: Inap.: 4 ca~~/Z 'p7 ~ - - , - . - . ~ i' CITY OF EAGAN SEWER SERVICE PERMIT 9830 Pitot Knob Rood 4 5F 7 P.O. Box 21199 PERMIT h10 : 5 R 7 } Esgsn, MN 55121 DATE: ~ ZoNng: No. of Units: Owner. Aux`I' Qak R Idrs ; Address: Site Address: 42n2 Val le,y For e T. ~ Plumher. 12/3/86 68801 100.On , 1 agne to eomphr with the City ot Eagan Connection Charge: -47 ~ ~.-~.-n- ACCOUnt Deposit: --45 . "Q • Ordlnances. Permit Fee: , Surcharge: . , BY Misc. Charges: ' Date of lnap.: j°w' ' , InsP- Date Paid: ~ CITY OF EAGAN p 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55721 N 12919 BUILDING PERMIT PHONE: 454-8100 Receipt N ft) _ 7obeusedtor SF DWG/GAR Est.value $57,000 Date DECEMBER 2 7986 SiteAdtlress 4202 VALLEY FORGE Erect IN Occupancy R3 Lot 21 Block Z Sec/Sub. NORTHVIEW MEADOW5rnodel ? Zoning R1 Repair ? Type of Const. v Parcel No. Addition ? No. Stories BURR OAK BLDRS INC Move ? Length 38 w Name Demolish ? Depth dd o Address 11461 GOLDENROD ST PW lnt Impr. ? Sq. Ft Ciry COON RI~~S 452-2906 ~nstall ? a Approvals Fees o Name SAME nddress Assessment Permit $ 304.00 " City Fhone Water&Sew. Surcharge 2$'50 r Police Plan Review 152 . 00 rw Name CRADIT & ASSOC Fire SAC 575.00 x a address9TH & MISS RIVER Eng. WaterConn. 500.00 iw Ciry Mpr.S phone 379-4947 planner WaterMeter 63.50 Council Road Unit 290.00 Iherebyacknowledgetpat+he~*e edth'sapplicationandstatethatthe gldg.OK12/2/86 Tr.PI. 156.00 informahon is correct and a e/ e o ply wilh all applicable State of Minnesota Statutes and Ci o a Ordinanc ~ APC Parks 9 . Var. Date CopiesJ~ O Si nature ol Permittee TOtal A Building Permit is issued to, BURR OAK BLDRS INC on the express condition that all work shall be done in ance wnh all applic State of mn sota Statutes and Ciry ol Eagan Ordinances. Building Ofticial h , • (gtr#i#irtttr of (Orrupttriry Citp of eagan IDepttrtmrnt of NutlD'mg AgpQimi This Cer7rficate issued pursuant to the requiremenu of Section 306 oJ1he Unijorm Bui(ding Code certifying [hat at the time ojissuance this structure war in compliance wilh the various ordinances of the City regu/afing building coutruction or use. For the jollowirtg: U. C1wJn~on T- 61d8. Rrmit N. 1;'-•:i V OccuparicY Type Zon'nB ~Intt TYpe Conv OwncolBuildm8 1•:1,. I v:e.. ~Y` Addrm 11~'CIl M '~'d.''" BwidingAddrm '\N v%i'~._~l Walny "i')I_ Bmldmg Oflirial POST IN A CONSPICUOUS PLACE CITY OF EAGAN N2 14 8 91 3830 Pilot Knob Road, P.O. 8ox 21-199, Eagan, MN 55121 BUILDING PERMIT PH ONE: 454-8100 Receipt#g ZZO 7o be used for DECK Est. Value '$1, 000 Date APRIL 27 ,1988 -i Site A'ddress 4202 VALLEY FORGE PL OFFICE USE ONLV Lot 21 Block 2 Sec/SubNORTHVIEW MEADOWS OnSiteSewage _ Occupancy . MWCC System _ Zoning Parcel No. On Site Well _ (ACtuap Const a Name THEODORE-J SLOWIAK Ciry Water _ (Allowable) w PRV Requiretl # of Staries z Address 4202 VALLEY FORGE PL ; ° City EAGAN Phone 681-0524 Booster Pump - Len9th Depth , p Name SF 7otal o a Address Footprmt S.F ¢ City Phone AppROVALS FEES ~w Name Engr/nssess Permit 24.00 w F- i Planner Surcharge .50 z - I Address Q w City PhOne Council Plan Review Bldg. OfL SAC, City I hereby acknowletlge that I have read ihis application and state that the Vanance SAC, MWCC mforma4on is correct antl agree to comply wrth all applica6le State of Water Conn. Minnesola Statutes antl Gty ot Eagan Ordmances Waler Meter Signature of Permittee W~0.9"L Road Unit A Building Permit is issued o: TH •ODOREJ SLOWIAK Treatment P1 on the ezpress condrtion that all work shall be done in accordance wrth al I applicable State of Minnesota Statutes and City of Eagan Ordinances Parks Building Otficial - tN.ll R~la 1 1~P TOTAL 24.50 2005 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/wndos when permits aze requ'ued for each unit Date /0 l / l 0'WO5 /I^ Site Address H~ol0o2 YAl / le_? r'0 Y'Q E Unit # Property Owner Moni ka Vn~QY)11e5 Telephone #((PS/ > 345' q~q7 Contractor AQ.; 1p Street Address ~~p(0J City ~5~ MOL(yl ~ AA'1 State ! ' \ /U Zip 6501o f~ Telephone # (&5/ > 321- S'914 Bond Expires: The Appticant is _ Owner ~ Contracror _ Other Add-on or alteration to eaisting dwelling unit $ 30.00 ~ furnace _Additional _LReplacement _ New air exchanger air conditioner heat pump other State Surcharge $ 50 Total $ ,30 50 I hereby apply for a Resideotial Mechanical Pemtit and acknowledge iliat the informafion is complete and accurate; tltat the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a permit, but only an application for a pemuL and work is not to start without a peraut; that the work will be in accordance with the approved plan in the case of work which requires a review and apprwal of ans. rine./ 5evtrSOnFf~ViQC~. CoorAinaAor Applic nt's Printed Name Appli nt' ignature 2005 COMMERCIAL MECHANICAL PERMTT APPLICATION City OfEagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: commerciaUindusma] bmldings multi-Camily buildings when separate permits are not requued Cor each dwelling unit Date ; . ; Site Street Address ~ Unit # . ; c• , . _ . Tenani Name (if appGcable) Pre-vious Tenant Name - • ~ n,,. ' Property Owner Telepfione k ) Contractor StreetAddress ' ~City'~~~~>'. State Zip.•" Telephane# ( ) ~ Bond Ezpires: The AppGcant is _ Owner _ Contractor _ Other Work Type New Construction _ Underground Tank _ Install _Remove `*see below Interior Improvement _ Install Piping _Processed _Gas Nature of Work: *'When instafling/removing underground tank, call for inspection by Fire Marshal and Plum6ing lnspecfor FCR111t FCfS: 570.50 Undcgroundlank inslallation/removal 550.50 Afinimum (includes State Surcharge) or Convact Value $ x 1% Permit Fee S State Surcharge ICoelmit tee is less thae $1,000, add $.50 If oe it fee is more than 51,000, surcharge is $.50 foi every $1,000 owed $ Total Fee I hereby apply for a Commercial Mechanical Pertni[ and acknowledge that ihe information is comple[e and accurate; iha[ the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that i understand Uus is not a permit, but only an application for a permit, and work is not to stazt without a pemti[; ihat the work will be in accordance with the approved plan in the case of work which requ'ves a review and approval of plans. ApplicanPs Printed Name • , r • , ~ ti , f. . Applicant's,Signazure, Approved By: Inspector Date: Required Inspections: - U.G. _ R.I. - Air Test - Gas Service Test - Inf]oor Heat _ Final / ~ **OAKWOOD I** ~j / 1986 BOILDING PEA!!IT APPLICATIOH - CITY OF EAGAN 60TE: ALL CONTRACfORS HQST BE LICENSED UITH THE CITY OF EAGAN SINGLE FAlIILY DHELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SUAVEY, 1 SET OF ENERGY CALCULATIONS MOLTIPLE DHEI.LINGS - RESIDENTIAL RENTAL i1NITS FOR SALE ONITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SORVEY - CHECH WITH BLDG. DEPT., 1 SET OF 6NERGY CALCULATIONS COi9lERCIAI: ~ INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, ~ 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND Sl, ~x-ro To Be Used For: Single Family Valuation: Date: 12/01/86 ao a- Site Address Valley Forge OFFICE OSE ONLY Lot 21 Block 2 Erect Oceupaney Q•3 Remodel Zoning IZ•I Parcel/SubNorthview Meadows I Repair _ Type of Const SC i Addition @ of Stories Owner Burr Oak Builders, Inc. Move _ Length 138 Demolish Depth 4 ~ Address 11461 Goldenrod St. N.W. Int.Impr. _ Sq Ft Install City/Zip Code Coon Rapids, Mn. 55433 - Phone 452-2906 APPROVAIS FEES Contractor Same Assessments Permit 30 4. Water/Sewer Surcharge 28.50 Address Police Plan Review 151 . Fire SAC 5"I5 City/Zip Code _ Engr Water Conn Sa0. Planner Water Meter (o3.5D Phone Council Road Unit 7_9 O. Bldg Off Treatment P1 1 Slo• Arch./Engr. Cradit & Assoc. APC Parks ~Jr,y Variance Copies Address 9th & Miss. River qpTAL ~ City/Zip Code Mpls., Mn. Phone 379-4947 NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MDST DESIGNATE AHICH ADDRESS ZS DESIRED. NO CHANGFS 1iILL BE ALLOHED ONCE BIIILDING PERMIT IS ISSDED. ~ r: =s Bao,~ 57, R4LE 76 4. , ~ m - ~k ~ ~ BUze O~ BUIL~ COHSllLT1H6 EN61HEf9S, pIANHEAS nnd lANO SURVEYOftS ar ,r ~ PANYr QNC. o 1000 U57 146L1 57REE7, BURNSVILLE ~ tlINHE=G7A 56337 PH 4=2'!000 , fT C'e *-°Zz~'~: LOT 2t. BLOC'rC 2, NORTHVIEW MEAD"vWS, DAKCTA GOVUT'( , MIIVNE SOT.~ •.i~ ~ • _ . _ _ 1:~q k . . . . . l . ~rst ~ E • ' DRAINAGEME ~~*JT' S 89 135~72 UT-ILI-FY EA ~ / 7L, 2~ ~ LOT 21 SCAIE I':70' i sp r~ I iS} ' I.,~ DENOTES EXISTING ELEUF+TiON ~ f.;.. ;i~ _ ~)Z3~ 11~~0~ / p •'d_..r sv,~ c 974-,0 ; DENOTcPROFJSEG ELEV4TIC PROP~ o°I ENDIG~1TcZ OF E~ npi ~97¢ / O' ~ i . :.U~A•..'~ UP/•,~i~•; ~r~~ • Ao 97433 - r;•j;c;;c~ FLCUR ' . ~3 b_ 'G a G4Ra~ Et_:VATION E 0 (7~~ ~ 22.p_ C974,3g , o 30' FRONT BUILOlNG EA GAN SETBACK LINE ' R E V E ~ [Yrz,9) ' BY f. ~C ~71_9: 9 6?7z.4) DATE,~I ./qLLEY F PLACt ~a~F r.c. I heraby cartify that thia ie a t:ue and carrect repmaentatioa of A tracY o ;:.land aa nho+m'und described heraon.• AQ prepared by me on 4his _1111V day of A~'w..,,t~? , 19A-" ~ Hinn. Plsg. Ho. 1(-685 4~' X e.., 3• ~ - PERMIT ` Control No. 0638 ~ CITY OF tAGAN PERMIT TYPE: 3830 Pilot Knob Road BUILDING Eagan, Minnesota 55123 Permit Number: 000809 (612) 681-4675 Date Issued: 0 6/ 15 / 92 SITE ADDRESS: 4202 VALLEY FORGE PL LOT: 21 BLOCK: 2 NORTHVIEW MEADOWS DESCRIPTION: ~Building Permit Type FIREPLACE ' Building Work Type REPAIR \ Q-;_i~, . REMARKS: RECEIPT N C 019399 FEE SUMMARY: Base Fee $25.00 Surcharge $.50 Total Fee ;25.50 CONTRACTOR: - Applicant - S7. I.I OWNER: KENCO CONST INS REPAIR 14229901 000517 KLEPETKA SANDY 16200 JASPER ST NW 4202 VALLEY FORGE PL RAMSEY MN 56303 EA6AN MN (612) 422-9901 (612)452-6770 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 Mn. Statutes and City of Eagan Ordinances. ~CU4 ~.~,71_ ~ n1 APPLICANT/PERMITEE SIGNATURE ~I SUED Y: IGNATURE PERMIT # CITY OF EAGAN 4Q~atw C01y?`m' REACTIVATE 1992 BUILDING PERMIT APPLICATION 681-4675 SINGLE S MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies when typing 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 cJvl"ly- yaluation of work Site Address: ~-5se- rJL~ STREET SUITE M Tenant Name: (commercial only) IAT ~L BIACK Z. SUBD.y~~~L~~~, P.I.D. B i ~ A~ ~ i ~ C(ifA.04, Descri tion of work: CLW K` t zr~£ The applicant is: ? Owner Contractor ? Other (DeacriEe) Name h 1£ if 4£ka ' /q /"111() Phone Property LAsT FIRST oor Owner pddress `/aaa l+'joLLy fo~&t2 STREET STE N City _ h?`J State Zip Company .`K£.ulGo Q- vJS f r NSU~'~UCe~ rc Phone `~1a2 9~1d I Contractor Address 100"0 ~ws,/~~~2 S,cw~/ License p&QD5/~Q ~Exp.. 3 9 City rarn,S`4~ State !/11rt/ Zip:S.S.?ca Architect/ Company Phone Engineer Name Registration # Address City State Zip ` Sewer 6 water licensed plumber Processing time for sewer 8 water permits is two days once area has been approved. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply w' h all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY ~-~.,y. • . - BUILDING PERMIT TYPE ~.c f ~ O 01 Foundation ? 06 Duplex O 11 Apt./Lodging ? 16 Basement Finish ? 02 Sf Dwg. ? 07 4-Plex ? 12 Multi. Misc. 11 17 Swim Pool ? 03 SF Addition ? OB 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind. 11 04 SF Porch ? 09 12-Plex ~ 14 Fireplace O 19 Comm./Ind. Misc. ? 05 SF Misc. O 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility O 21 Miscellaneous WORK TYPE O 31 New ? 33 Alteratlons 11 35 Tenant Finish ? 37 Demolish ? 32 Addition 10 34 Repair ? 36 Move GENERAL INFORMATION Const. (Actual) Basement sq. ft. MWCC System (Allowable) lst F1. sq. ft. City Nater UBC Occupancy 2nd F1. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump ~Y of Stories Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code Depth On-site sewage SAC Lode APPROVALS Planning Building Assessments Engineering Variance REDUIRED INSPECTIONS ? Site ? Footing ? Framing ? Insulation ? Wallboard ? final ? Draintile Ig Fireplace Permit Fee 5~ . Velwtion: S Surcharge , S o Plan Review License MWCC SAC City SAC Nater Conn. Water Meter ~ Acct. Deposit S/W Permit S/W Surcharge ' Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total : , 50 SAC % SAC Units ~ CITY OF EAGAN PERMIT BUILDING 3830 Pilot Knob Road PERMIT TYPE: Eagan, Minnesota 55122-1897 Permit Number: 028449 (612) 681-4675 Date Issued: 0 B/ 01 / 9 6 SITE ADDRESS: 4202 VALLEY FORGE PL LOT: 21 BLOCK: 2 NORTHVIEW MEADOWS P.I.N.: 10-52100-210-02 DESCRIPTION: (GAS INSERT) Building Permit Type FIREPLACE /Building, Work Type ALTERATION /'Census Code 434 ALT. RESIDENTIAL \ ' . / ~ • REMARKS: FEE SUMMARY: Base Fee $25.00 Surcharge $.50 Total Fee $25.50 CONTRACTOR: - Applicant - OWNER: FIREPLACE SPECIALIST 14511970 KLEPETKA RICHARD 1200 9TH AVE 4202 VALLEY FORGE PL S ST PAUL MN 55075 EAGAN MN (612) 451-1970 (612)452-6770 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with ell applicable State of Mn. Statutes and City of Eagan Ordinances. APPLICANT/PERMITEE SIGNATURE ISSUED BY: IGN URE k - ~ CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1996 FIREPLACE PERMIT APPLICATION 681-4675 DATE: '~76 DESCRIPTTON OF WORK: _ CONSTRUCT N W FIREPLACE: _ WOOD BURNING _ GAS DLINSTALL GAS INSERT ONLY IN EXISTING FIREPLACE _ INSTALL GAS LINE ONLY IN EXISTING FIREPLACE OTHER: ROOM TO BE INSTALLED IN: STREET ADDRESS: 41 V ~ ~ 1,e ~ ~ ~ ~ Y ` • LOT ~L BLOCK ~ SUBD./P.I.D. 1 I~? A 1~`~n.~,~ ! I I D!i/~/I•(r)Y l APPLICANT: (circle one only) OWNER CONTRACTOR 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. PROPERTY rrame: h L P~e t JTA, c4 c, k~ Phone `20 OWNER ~.n Signature: Street Address: 41 0 a' vq fJ~ QOZ, City: C4 Q n/ State: rn y Zip: FIREPLACE Company: r~Q-eLe ce 5 C~ C /'Srs Phone INSTALLER Signature: Street Address: 0c) ve S. License City:.S 5-P- lT c1-J State: rY Iv Zip:c-550 GAS LINE Company: Phone 4: INSTALLER Name: Signature: Street Address: Ciry: State: Zip: OFFICE USE ONLY BUILDING PERMIT 7'YPE 0 14 Fireplace WORK TYPE ? 31 New o 33 Alterations ? 32 Addition o 34 Repair GENERALINFORMATION Census Code. SAC Code REMARKS Chimney/flue must be inspected before concealing. PERMIT CITY OF EAGAN ~ ~3830PilotKnobRoad PERMITTYPE: auzLoxNs Eagan, Minnesota 55122-1897 Permit Number: 0 3 0 9 3 4 (612) 681-4675 Date Issued: 10 / 0 7/ 9 7 SITE ADDRESS: 4202 VALLEY FORGE PL LOT: 21 BLOCK: 2 NORTHVIEW MEADOWS P.I.N.: 10-52100-210-02 DESCRIPTION: ~ . SIDING/SOFFIT/FASCIA . Buiiding Permit Type SF (MISC.) Building Work Type REPAIR Census Code 434 ALT. RESIDENTIAL 1 ~ ! . . . ir REMARKS: FEE SUMMARY: VALUATION $8,000 Base Fee $137.25 Surcharge $4.00 Total Fee $141.25 CONTRACTOR: - qpplicant - ST. LIC OWNER: WREN BLDRS INC 18884952 0004360 KLEPETKA DICK 9218 11TH AVE S 4202 VALLEY FORGE PL BL90MINGTON MN 55420 EAGAN MN (6l2) 888-4952 (612)452-6770 I hereby acknowledge that I have read this application and state that the inPormation is correct and agree to comply with all applicable State of Mn. L Statutes and City of Eagan Ordinances. ~ ~ I~~ APPLICANT/PERMITEE SIGNATURE ISUED B: SI U E O 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) 4jqI• ff ciTV oF EAcAN 3b4 3830 PILOT KNOB RD - 55122 681-4675 New Construction Reauirements RemodeVReoair Reauircments ? 3 registered sde surveys ? 2 copies of plan ? 2 coDies of plans (indu0e Deam 8 window sizes; poured fid. design; etc.) ? 2 site suneys (extenor aCditions 8 CeGcs) ? 7 energy calculations ? 1 energy wlculations for heateC additions ? 3 copies of tree presarvation plan if lot platted aRer 7I7193 repuired: _Yes _ No DATE: 7 CONSTRUCTION COST: DESCRIPTION OF WORK: s*~Iv~(¢ ~~ii.ccc^ STREETADDRESS: ~Z~ Z (~/L~~GJ ~iu d~~~ LOT BLOCK ~ SUBD./P.I.D. r ~ utnr~INDl~) ~OAPI(t/LW ~ PROPERTY Name: z9,4Z4'C Phone _ yTZ OWNER Street Address. Z ~JCL~ ~~u~ ~-~r~ City: Q?;%= State: Zip: coNTRnC7oR Company: ,SC~,/.~A.~'/ _"'g, Phone ef~~ y9.3- 2 Street Address: //4t / .s v License Y 360 City: State: Zip: f-S-'l~-2 v ARCHITECT/ Company: Phone ENGINEER Name: Registration Street Address: City: State: Zip: Sewer 8 water licer.^ed plumber (new construction only): Penalry applies when address change and lot change are,equested once permit is issued. I hereby acknowledge that I have read this application and state that the intormation is corre t and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. ~ Signature of Applicant: ~ OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received - Yes No _ Not Required OFFlCE USE ONLY R t I . wfto~~~ ~ • BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging o 16 Basement Finish ? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool ? 03 SF Addition o 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility 0 04 SF Porch ? 09 12-plex o 14 Fireplace ? 21 Miscellaneous ? 05 SF Misc. ? 10 _-plex ? 15 Deck WORK TYPE ? 31 New o 33 Alterations ? 36 Move ? 32 Addition ? 34 Repair o 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MC/WS 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 Bidg Census Unit APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MCM/S SAC City SAC Water Conn. Water Meter Acct. DeFosit S/W Permit SNV Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units r,L g Ocj(~ 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) J CITY OF EAGAN 3830 PILOT KNOB RD • 55122 651-681•4675 New Conshueflon ReaulremeMS Remodel/Reoalr ReaulremeMs D 3 reglslered sMe surveya showing sq. R. of lot, fq. H. of house 2 coples of plan and QII roofed areas (20°/< maxlmum lot coveraae allowedJ 1 fet of eneryy talculaHont for heated addRlons D 2 coples of plana (show beam 3 window slxes; poured Ind. deslgn; Mc.) 1sRe survey for exferior addlHons i decW ? 1 sef M energy calculafions D 9 coples W hee preservatlon plan tl bt plaMed afler 7/1 /93 DATE: CONSTRUCTION COST: ~ 9o v_ a~ , UESCRIPTION OF WORK: STREEfADDRESS: 7~vt~' LOT: _a_ BLOCK: d~ SUBD./P.I.D. M: r`H'1V I Pi,:I .A 61n~s Name: Phone/~: GS/- YS2^ C 770 PROPERTY ~ Ln First OWNER Yd a~ U~ Street Address: ~ ~ City ~r arate: ziP: S`s ~ a 3 ~;rold Company: Phone k: 6/ 2 ~A:f Z (area code) CONTRACTOR Sfreet Address: 4`^- S ~ lieense N 4 3 6 Exp. a Cify /,d4~~ State: Zip: ARCHITECT/ ENGINEER Company: Name: 7elephone area code ( ) Sfreei Address: RegistraHon Ik: City State: Zip: Sewer 3 water Ilcensed plumber (resulred for new consfrucflon onN Penally applles when address change and lot change Is requested once permfl Is Issued. I,hereby ocknowledge fhat I have read thls appllcaNon, stafe that fhe InformaNon Is conect, and agree to compty wHh all appllcabl State of Minnesota Stafutes and CMy of Eagan Ordinances. Signafure of Applicant: L' OFFICE USE ONLY Certificates of Survey Received _ Yes _ No 5EP Lq Tree Preservation Plan Received _ Yes _ No _ Not Required ji,n Y" OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) 0 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea. ? 03 1 of _ plex O 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened) ? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage ? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous WORK TYPE ? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia ? 32 Addition ? 36 Move Bldg. ? 40 Gas insert ? 44 Windows/Doors ? 33 Alteration ? 37 Demolish Bldg.' ? 41 Wood Stove ? 45 Fire Repair ? 34 Repair ? 38 Demolish (Interior) 0, 42 Reroof ` Give PCA handout to applicant for demolition permit GENERAL INFORMATION Const. (Actual) Basement sq. ft. Census Code (Allowable) Main level sq. ft. SAC Code UBC Occupancy sq. ft. No. of Units Zoning sq. ft. No. of Bldgs # of Stories sq. ft. MC/ES System Length sq. ft. City Water Width Footprint sq. ft. Booster Pump PRV Fire Sprinklered APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge , Treatment PI. ~ Park Ded. ' Trails Ded. ' Other Copies Total: SAC Units % SAC 1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN~ 4~4 ~ ly$Q I a SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTEs ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WfiICH ADDAESS IS DESIRED. NO CHANGES WILL HE ALLOWED ONCE BUILDING PEAMIT IS ISSUED. MULTIPLE DWELLINGS RENTAL ONITS FOR SALE UNITS 0 OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT.t 1 SET OF ENERGY CALCULATIONS COh4lERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTUAAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS To Be Used For: DE~ Valuation: J a Date: ~y Z/ / d~ Site Address -'IZUZ M&E-7 FM6E I ~D ~ OFFICE USE ONLY / Lot 2 Block Z On site sewage_ Occupancy 1~-H r-,~/~~LMWCC system Zoning Parcel/Sub ~~~h~v`~ On site well Actual Const f City water Allowable Owner 7/r~/~~,f 7 SL-04 )l~ K PRV required _ If of stories Booster Pump _ Length Address ~IZOZ V.qLLE`r F0e, 6E PL• Depth S.F. Total City/Zip Code Fr°iGAA) 55-17- 3 Footprint S.F. Phone 6S-1 - U APPROVALS FEES Contractor - Engr/Assess Permit Zy ~O Planner Surcharge . So Address ~ Council Plan Review Bldg. OfP. 7/T4/ZZ SAC, City City/Zip Code ~ Variance SAC, MWCC Water Conn Phone - Water Meter Road Unit Arch./Engr. Treatment P1 Parks Address Copies ~ I City/2ip Code TOTAL Phone 7l (O /z) - 66/ ~ b Sz-L{ • • . ~ _ *i*##ti*#~t******#*#!*f**i**t*****# C I T Y O F E A G A f~f *~E' PA~r OF FEE AT Z7ME OF * APPISCATION DOFS Ncyf OoNSTIZ[7IE APPROVAL OF PER241T. APPLICATION FOR PERMIT * . * INSPDC.TION oF SEWEIt ANID/OR WATEft . ,*F asv;Lr_aTtONS WIIS, Nl7T HE S(HED- SEWER AND/OR WATER CONNECTION ~III UWn PmMIT HAS BEEN . * APPROVID. * r ~ . *:****,r.,rt*x~+•*.•+..,rt.t**x*,r**x:vr- • P ease Print 1) PROPERTY ADDRESS :~f~ v fy//~" - LEGAL DESCRIPTION: m~A~ ~Lot Block Subdivision or Tax Parcel ID ) IF EXISTING SZRCCZ[]RE, DATE OF ORIGINAI, BUILDIDIG PERNIIT ISSL'ANCE: : ~ PRFSENP 7ANING/PROPOSID C'SE: (hbn Year) ~ C0i11MERCIAL/1EPAIL/OFFICE IK-R-1 SINGLE: .FAMII,Y. 0 IDIDL'STRIAL r-I R-2 DC'PLEX (ZG,o C~nits) . ~ INSTIZL;TIONAL/GOVIItt~,'NT C] R-3 TOWNHOUSE (Three + Units) ( Units) q R-4 APARZ'hIEN'P/CONIDa~LLNIL^i1 ( Units) 2) NAME: 1-19k C ~SiGZ-v_ ~S', ADDRESS: f,,?.4 fA7 Zii,rA,. ~ ciTY, szATE, zzP:.S~s~~c. rxorE: ~7~-i - 7.d o a 3) • u c a• For City Use NAME:1 Plumbers License: ADDRESS: Active /a ~/6 9 z` n r- .4-ri c Ekpired CITY, STATE, ZIP:~;9i,,~, p ~ m„~ - ss-37Q Not recOrded r ~ PHONE:p'r'/~i-7-dov MASTEft LICENSE# C}o~387 /rI(D Sta~itial 4) ...4•:,i ~,n.i~; DU1ME: . ADDRESS:-7 CITY, STATE, ZIP: <:f0a,., Afa/hA/- PHONE: 7ur'~ = /PBC~ ' 'S) ~ 7 i'i r' . • n~1 • U' -9Ya~ ~CODIig'.CTION 'Ib' CITY SEWER E-,r CONNFX.`TZON rM CITY WATE2 C] (YTi-gR ' . . 6) PLEASE HOLD APPROVID PERMIT FOR PICK-C~P BY ONE OF ABOVE _2'PLEASE MAIL APPROt/ID PERf4iT TO 1. 2, Q4. ABOVE . (Circle one) 7) r r u• • ~f)'14~/C~X ~ A~~~ - q 7: ~ Y' ~'I' Y ~ 1~' • I" ~I Y? I.A D ! Y~1 JI 1 ~1 • 1 ~ i 1 •~I I.i. 1 1 .l M.I. .l1~~ I 1 1 . :1: ~ :A • 11 ' . . .-FOR -CITY USE ONLY ~ PERMIT # ISSUED Pd w/Bldg. Permit FEES: $ $ /p Sv SEWER PERMIT (INCLUDE SURCHARGE) $ $ ~p 5 d WATER PERMIT (INCLUDE SC'RCHARGE) WATER METER/COPPERHORN/OUTSIDE REaDER . $ $ WATER TAP (INCLC'DE CORPORATION STOP) $ $ SEWER TAP $ $ ACCOUNT DEPOSIT - SEWER $ $ ACCOUNT DEPOSIT - WATER $ $ • WAC $ r) 0 $ sAc $ $ TRUNK WATER ASSESSMENT $ $ TRCtiNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRC'NK WATER $ $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: s 9 y 50 $ Jl /•0U TOTAL ,,~Rol 704/~ RECEIPT ' RECEIPT ; DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PIIBLIC RIGHT OF WAY? ~ YES IF YES, THEN A"PERMIT FOR WORK WITHIN PC~BLIC ROADWAY" MUST BE ISSCED BY THE ENGINEERING ~ NO •DIVISION. LIST AS A CONDITION. S[iBJECT TO THE FOLLOWING CONDZTIONS: APPROVED BY: TITLE: DATE: ~ - j òî ÿþ ÿÿ þýý üþþÿÿûé ø õ äô í ÿù ýüûúùø õ ø ô ýóô úùøôüòü ý õüñû ðñõüñû ýó Ü â ÿ ìð ÿþñíí ìíìíå ñ÷è ýßà æííéëéåë øü ýü ÿ÷öæíéîéîí ÷ö ùõô øø ã ñøüñûÿýñÖ ìðéþØåêù÷ ÿ ÿôõíí ÿôõíí èìíçìíå ûùÿ ä øø ò ñ ÿ ñøù øøûý òô ýü ãùò ÿâ é øøà ñýÿü üùýÿü