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4210 Valley Forge Pl CITY OF EAGAN 9 37lf MM? Knob RM1 4gen, MN U12= • ~ ~ ~ PHON[s 454-8100 eUILDINO PERMIT Rece+at # To M wmd fer SF DWG/GAR Est. Vclw $68,000 pote Au ust 16 19 83 SiTM Addrou i 421 Valley ForRe E P.-3 Lot 23' Blotk 2 Sec/$ub. Northview Mesdowe Aiter M~ ? ~ Zaoniny ~u~o~`y • ~ ITN_ Parcel i Repoir Q Flro Zone ames R ese E^lOrge ? Type of Gonst. oc Non-a ~e O # Srorla I ~ 13755 Shirleq Drive Addron Demotish ? Length I G Eutnsville Ph" 890-3076 Grode ? Depth ti Sq. Ft. ~ Name rau a s eve opmen o. Appe.o1s F.•s PPer lb/th . es Aasessmenr Pem,ir ~ Addreo ' 345 ~ Ci Lalceville Ph" 432-656I Water 6 Sew. Surcho?9e.~'~ Polia Plon check 5~ W Nams Fin $AC Addnst Enp. Water Conn. 450.'JO <W G pFqr» Plonner 6-21-83., Wcter Meter (3•00 Council Rood Unit 250. 0U I hercby ocknowledpe thot I how road this applicotion ond stote thot Bldy. Off.~~ - fhe Informafion Is torcect and a9rce to comply wlth oll appiitobl* Stote of Minnesoto Stotutes ond City of Eayan O?dinonces. ^PC Total ~ Stgnatun of Permitt" ent Co. A Bulldinp Penmtt is issued to: on tiH oxprea tondition tlxai oll work sholl bs done in ocoordanc: wlth all o icoblo Stote of _Mianpta-.Sfaontes-ond City of Eogan Ordinances. Buildinp Offlticl ~ PKmit No. Pwmit Holder Misc. PKmit No. Holdsr ff5a7q ~7 3 bOA Q 44 Q 7'~ + 6 Skt~.a w.n Watfr EMctrk dQ Ig I lA'WSrttTE(Ct • 14643 Irdpetion Dm Irnp. Othe* Pooein¢ 3 Foundttion FnminO Cw Rouah Pitq. . 7. Rouph HV Inwlation Final Plb¢ . i find HVAC Final r Wmr Dac?ibo Loeation: ' YWII Sw"r • • Pr. Dbp. • ~ Rewipt MECHANICAL PERMIT' Perntit No. CITY OF EAGAN . ~ Fae Fill in numbeied spaces . S/C ' Type or P,rint /egiWy Tot. i . t. Date 2. Installation Cost ~ , 3. Job Address Lot Blk. Tract 4. Owner Q 5. Contractor~,,:'f Phone - G• ~f • , ' 6, Address r t' ~ - 7. City, , . State Zip , 8. Building Type: Residential 0 Commercial O Institutional O •r 9. Work Description: New O Add ? Alter ~ Repair ? 10. Describe ' • FuelType 11. No. Eauioment BTU - M. Ea. No. Equiqment CFM Forced Air Air Handling: Mfg,- Boilers Mech, Exhaust Mfg. Unit Heater Mfg. Other Air Cond. Mfg, ' Gaa, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to oomply with all ordinances and codes governing this type of work.- Signed : for - • • Rough Final Inspections: Oate Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-8100 Reoeipt CC c ci `A- PLUMBING PERMIT Permit No. -7 ~ s CITYOF EAGAN Fee a(J C~ U, j Fill in numbered spaces • S/C S v I Type or Piint /egibty Tot. 1. Date " 2. Installation Cost 3. JobAddress Lot~Blk. Tract'iU,.,(rv,iA 4. Owner 5. Conuactor Phone 6. Address 7. City ' . State Zip 8. Building Type: Residentia~0 Commercial O Institutional O 9. Work Description: NevyO' Add ? Alter O Repair ? 10. Describe 11. No, Fixtures No. Fixtures Water Closet Cesspcol/Drainfield ~ Bath tubs Septic Tank ~ Lavatory Softner ~ Shower Well _L Kitchen Sink Urinal/Bidet Other ~ L.aundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. ' 'i Signed : i~ 4 for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CfTY OF EAGAN 464$100 ' - ~J Reeeipt ~ PLUMBING PERMIT Permit Na. CITY OF EAGAN Fse Fill in number+ed speces S/C Type or Print /egibly Tox ' ! ~ • 1. Date .~y 2. Installation Cost 3. Job Address •..c~`Lota_Blk. ~ Tract - ~ 4. Owner ~ ~ 5. Conuactor 6. Address 7. City State ~ Zip 8. Building Type: Residential ~ Commercial ? Institutional ? 9. Work Description: New O Add ? Alter ? Repair O 10. Describe 11. No. Fixtures No. Fixtures Water Closet Cesspool/Drainfield Bath tubs Septic Tank Lavatory -T Softner Sh0mr Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. - ~ /I Signed : - , for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-8100 lr OF EAGAN Remarks Addltion NORTHI/IEW MEADOWS Lot 23 Rlk 2 Parcel Owner ~~~~L~ ~ ~ ` . ~ : r ~ ~ ~'~i • : ! ~ Street 4210 VALLEY FORGE pI,AC$ State EAGAN MIIV55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. Sl'g 1 76.75 7.68 10 STREET RESTOR. GRADING 1y 1981 15.89 .79 20 -83 SAN SEW TRUNK 1981 138.48 6.92 20 110.80 " " /f SEWERLATERAL TRK y 1984 275.22 18.35 15 5? 1981 22.28 1.11 20 it ' WATERMAIN 1984 70.67 4.71 15 65.96 A013299 " WATER LATERAL 7 19$1 1$.6$ .93 20 of ' WATER AREA 570 19$2 13$.4$ 6.92 ZQ I t WATER LAT 5731 1982 29.52 1.48 20 3.64 i? STORMSEW TRK 1984 392.32 39.23 10 313.86 A013299 " STORM SEW LAT DRAINAGE 1984 33.97 3.40 0 30.58 A013299 12-13-83 CURB & GUTTER ' SIDEWALK STREET LIGHT I ROAD T 250.00 38073 8-16-83 i WATER CONN. 450.00 11 11 BUILOING PER. 8369 r~ n SAC 525.00 PARK CITY OF EAGAN SEWER SERVICE PERMIT 7830 Pilot Knob Road , P. O. Box 21199 PERMIT NO.: C,1741= Eagan, MN 55121 DATE: 9- zo^i^o: R L No. of units: 1 Owner: Graatl Oaks Dev Address: . 5ite Address: 4210 Vallev Po ge L23 a2 t+wrthviww Meadawa i ; Plumber: Pri or Lake Facc , t3-16-83 38D73 100.T0 rd I.lro. re aenyy wleh er. C1ly .i tye. Connscrron Chary.: _ 42 S. O0 rd ~ Orlimaam Acaount Depcsit: Pertnit FN: - 1 fi n;1 n.i SurcFwroe: > 8Y Misc. Chorqm Dofe of Irisp.: Total: ~ I^sP.: Doh Paid: ~ CITY OF EAGAN WATER SERVICE PERMlT 300 Pilot Knob Road P. O. Box 21199 PERMIT NO.: 5 C) ) 7 Epan, MN 5512i D11TE: -Zanirg: RNo. of Units: pM,Mr; Grand Oak Uev Addresa: 5ite Addro,s; 4220 Valley ForQe L23 B2 Northview 2teadova qumb,r; Prior Lakc F:xc Mehr No.: Connsction Cho?ye: 450.00 vG Siu: Acaount Depoalt: Reade? No.: Pemilt Fee: 10.00 ~cl 1e!m h aoly wY61w City oi Eqpo Surdwrpe: ~ Misc. Charyes: 60.00 pd meter Total: BY DaM Paid: Dote of Insp.: lewp.: CITY OF EAGAN N. ~ 8389 9795 Pllot Knob Road Eagan, MN 55722 BUILDING PERMIT PHONF: 434•8100 R¢ceipt # To ba und fo. SF DWG/GAR Est Value $68,000 Dare Aueust 16 1983 Sire Address • 4210 Vallev ForQe Erecr 11 OccuPancy R-3 Lot 23 Block 2 Sec/Sub. Northview Meadows qlter ? Zon;,,q R-1 Porcel Repair ? Fire Zone NA Enlurge 0 Type of Const V ~ Na~„e James Kissel Move ? # Srories 3 Address 13755 Shirlep Drive pe,,,oush ? Length 50 ° Burnsville 890-3076 Gmde Ci Phone ? Depth 48 Sq. Ft.- g Name Grand Oaks Development Co. Aovro.ats Foes z~ 7623 Upper 167th St. West u~ Address /~ssessment Permit 337.00 r Clt LakeVille phone 432-6561 Woter 8 Sew. Surchorge 34.50 ~ Police Plon check 168.50 FZ Nome Fira $AC 525.00 ~ W Address Ena. Water Conn. 450 _ 00 < Ci Phorro Planner WoterMeter Fin_(ln Council 6-21-83 Road Una 29fl nn I hereby acknowledge fhat I hove read this application ond sfate that eid9. otE. $-9-83 fhe intormohon is mrrect and agree to comply with all opplicoble $1$2$.Q~ State of Minnewto Statutes ond Gty of Eagan Ord7rwnces. APC Totol SiOnoture of Germiffro ran a s eve opment Co. A Building Permit Is issued to: 1 ~ 1 on the express condition tho, oll work sholl be done in accordarxe with oll op oto 5 ty of Eagon Ordinances. Building Ofilciol ~ Nu'//'' S ~ ~•'K'/? 1Ca+:'~:~<.g1 " . : • . ~ X E`d"'!~~.<~,~,...~ ~p~,~°'!~ggq:+q!~y.~-'::,~a, ,~~p'. ,rv, '~i'F` ::s.q'4~y`j~~~P,`,,;e~a, .~$•~~i°,F , ~ ~-g'`~i'.,,~-,_-~~~-~c,~ti-_-~•~_-_.-'~_~•"-•_~_"_•.~~3.-~a.v~.~T~+^^ ;.s'u~~fs,~'s~~mvii.'~A'~x..ste,~tr,;.R°~P r~a2~°4~'i~.'ndy'w; .~:U/~''`-~s'. ' fs9 i•_ . _ _ _t''";a-`ti~~`~a:g.rncz ,-_..rx.n.. -c=-°zvi:.,~c .~~.Sa~ rrtifirttte~of (~rru ttnr ~ f o~ o (EAgan "rVttrlmPnt nf iguilitittg Jnil;tertiim P Tbif Cnli(irutt ittued purruaru to tbt nquiremenet of Setrion 306 oJ the Uniform Building Codt crrlifpng tbat at 1hr timr of irtuantt tbit rtrnaure wai in romp(iana wirb ihe vanou.r 7~ ordinunrrtofthtCity>rgularingbwlJinBtonttrtrttionor utt. Fwthtfo(/ouvrtg; SF DWG/GAR nme e«~,r+o 8389 ; 591"Rl ~W^~YTYR R3 'IYpeCownucyon V Firt 2on NA R , o.M.ore~ua.sJames Kissel 13755 Shirley r.~<g ..m naa.~ Dr., Burnsvill[a-~ e,aw,onea~ 4210 Va11ev For L~„YI,ot 23,Block 2 Northview A ey: Meadows fl~Iv A October 18, 1983 o,w BUILDER 7~s : GRAND OAKS DEV. C0. ' , • +1 . ~~D" ~ v~~,~. ~t d .~~-'R.~ 1. ~•t ~ ~ ~a~~.~~.~,~~, ~j~;',~ ~..r'~.~,~AA~ < , RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 '7 ~ 651-681-4675 ~ New Construction ReauiremenU RemodeUReoair Reauiremants • 3 registerec sile surveys showmg sq k of lot, sq A. ol house; and all roofetl areas • 2 copies ol plan (200'o maxunum lol coverage allowed) . 1 se1 ol Energy Calculations for heated aadihons • ? copies of plan showing heam 3 window vzes; pouretl found design, etc ~ . 1 site survey for exterior aaditions 8 decks • 1 sel of Energy Calculaaons . IMicale d nome served by septic system for additiore • 3 copies of Tree Preserva0on Plan J b[ platteA after 711193 . Rim Joist Detad Options selecUOn sheet (61Cgs wdh 9 or less wits) p L Cp DATE D~~~ p Z VAIUATION ~ ~~~JI)D • SITEADDRESS aIb Ucw- Ilev oti' C' ~I MULTI-FAMILYBLDG _Y L--R TYPETA"OR *F00 H FIREPIACE(5) _ 0_ 1_ 2 APPLICANT 11 STREETADDRESS 1a-7-47 nflc.c>lle-1 A-0c. -S~ CITY rnS~illeSTATE MAJZIP 5-S33? TELEPHONE # SJ- 7U7 0 CELL PHONE # FAX # PROPERTYOWNER K(2Uik. ~CC~1'~"-^! TELEPHONE#6-rl 6Q-oo73 COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ y[[NyE:50"C,1 RGLES 7670 C:A"CNG0121' I Y([VNLSOT:A Rl;L1•:ti 7(i72 (i submission type) . Residenhal Ventilation Category 1`NOrksheet Submittetl . New'cnergy Cotle Worksheet SuCmittec • Energy Envelope Calculations Submitted Plumbing Contractor: Phonc ~ Plumbing system includes: _ Wa[er Sokener _ LaNm Sprinkler I'ee 590.00 Watcr Hcater No. of R.I. Baths No. of Baths Mechanical Contractor: Phone lk ~ - r~ N[cchanic>l s}stcm includc,: :\ir Condiuonin, ~ l~['t;~:U ~"i0~.f)qp ~ E[eat Rccoccn' Systrm ~ AUG 2 3 2002 11, Sewer/Water Confractor: Phone # By I hereby acknowledge that I have read this application, siate fhat ihe information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordi__ nances. l. _ SignatureofAppl(canf ~U/YJ(~ OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Upaated 4102 OFFICE USE ONLY ? Ot Foundalion ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg ? 02 SF Dwelling ? 08 06-plex ?16 Fireplace ? 21 Poroh (3-sea.) ? 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 ? 78 Deck ? 23 Porch (screened) ? 36 Multi ? OS 03-plex ? 11 10-plex ? 79 Lower Level ? 24 Storm Damage ? 06 04-plex O 12 12-plex Plbg_Yor_N ? 25 tifiscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) 0 41 Siding ? 32 Addition 0 36 titove Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Altera[ion ? 37 Demolish (Bldg)' O 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 Staries Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const W idth REQUIRED INSPECTIONS _ Footings(ne« bldg) _ FinaLC.O. _ Footings(deck) _ FinaljNo C.O. _ Footings (addicion) _ Plumbing Foundacion H V AC Drain Tile Other Roof Ice & Wacer Final Pool Ft_s Air,Gas Ttsts Fmal _ Framing _ Siding Stucco _ Stone _ Fireplace _ R.I. _AirTest _Final _ Windows(new'replacement) _ [nsulanon _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total / C.I'PY OF I?%C,71N Include`2 sets o[ plans, ~ 1 site plcin w/eleva:ions & .mo 3UiIJD7';X; PEFb1I7' IPPL,]CNTION 1 sct o,: ener.qy calai]ations. Tb Be Used For [e t,j v 1 cn , I Inate Site Tddress oFt'I.CE USL 0[Jri rAt Z 2JIIlock Sec./Sub. N~~I.v~EwM~.~,°I,re wsc r ~ O~cupancy ~ Parcel elitei: ZonincJ - Repair C'ire 7.one Owner: F:.rlargc _'iWpe of Const. _ / hbve ti storics AcYlress: /~Y S~t~~"l2vr Dr. [~,inlish irvnt ft-. City/'Lip Code: d~,Ji t . GLade Depth y~ ft. Phone # : 40 -3 0 `7 71['f'[YJVAC S Contract0r: i~~R,QVVD QM<~S Tssessrr_nts PeL~itit Pddress: ~(9 Z3 l~~pa.v~r (b'7~St. IVatcr/Sc~ver _ Surchar.ce 3y UJ' Policc Plv, checY. City/7,ip Code: LdKt ?i i,ir.e _ S.~' so2S Phone 3a taater Conn. ~o e;v I i'lanner I-dat:cr hleter (.:ounci.l Po<ul Un.it Arch. /F.ng . : l3lcig . 0 [ f ~~=-~---{-1~- - Fc?dress : Pd~ City/7.ip Cale: ~ n - Phone 9: ' J 9C71'AL Ji ~aS' d 0 ~ . , ~/~p cl E ~ ~ v\. . ~ d / s • SURVEYOR'S CERTIFICATE " GRAND OAKS DEVELOPMENT CONPANY ' I •~i3S~ N 00 07'49E 111.43 1 Cv'~ORA/NAGE B VTILl7Y £ASEM£N7S PER PLAT ~ ~ LOT 23 1:~ 4, t} o \ a 46•00 m I N ~ ~ ~0~ , 'n~ ro ~pOSE F o ~ \a, NouSE g00 I °n 4.0o N N . C \ N ~ (o I ^i rpF. o ~-•i o i-_ 2 W ~ II ; ~ \ w 00 ~ \ .ZZ',,..:+LCI'I . p f1~/ \ I . g• ; vd Q m w -J ~ ~15.00 NO°07'49"E 9 ` ~ o,°`o ; VALLEY /000 ° ~ FORGE . , ~ DENOTES PROPOSED SURFACE DRAINAGE O DENOTES IRON hiONUMENT SET SCALE: 1 INCH = 30 FEET • DENOTES IRON MONUMENT fOUND PROPOSED GARAGE FLOOR =~9-13•8 FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR = 9 70 •g FEET (000.0) DENOTES PROPOSED ELEVATInN PROPOSED TOP OF BLOCK = 01-74.1 FEET I HEREBY CERTIFY TO GRAND OAKS DEVELOPMENT COPiPANY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 23, Block 2, NORTuI':Ei4 MEAD0! 1 5, accordirn to the recorded plat theFreofL, Dakota County, f":innesota. (TO~iH1'~G~LrjQREb}i0N ViLL B' VAL:U UPO:•i IHE FiLiN'= OF THE °LAT, AND OF THE LOCATION OF ALL BUILDINGS, IF ANY, T4EREON, AND ALL VISIBLE ENCROACHMENTS, IF ANY, FROM OR 0N SA1D LA14D. A5 SUP.VEYED BY ME THIS 25T4 DAY OF JULY, 1983 . SIGNED: JAh+ P,. FIILL, INC. BY: HAROLD C. PETERSON, LAND SURVEYOR PfINNE50TA LICENSE N0. 12294 PROJECT NO. BOOK / PAGE JAMES R. HILL, INC. ~33Z y . Planners / Engineers / Surveyors FILE NO. 8200 Humboldt Avenu• South m - Bbomington, Mn, 55431 812-884-3029 T`/ P L, -0 P 6~-~m'D~~ LOAD CENTE k cl i 1. Summer tlesign deyrees _ n i n ~ ' (90, 95, 100, 105, 710 or 115) (II 90, 105, 110 or 115. Iteni 2 N A.) 2. Dailyrango(0°-35°) . ~ ~ 3. Wintertlesigntlegrees (Precede a minu5 num6er wilh M) 4 Numherofwintlowpanes ( 1, 2 or 3 II 2 or 3, Item 5 N.A ) 5. Storm wintlows? (Y or N) 6. NAndows weathersinppetl? (YOr N) 7. Four wintlow areas stafbn9 wnh N or N[Orientation . (Ex: Np25N30N20N25pn. ldaz per sitle 999 sy II.) 71 N or NE 72EOrSE 73 S or SW 74 W Ot NW 8. Shatled wintlow area . (0 or 5q Il Enter 0 d nol applicaUle . Max~ 999 sq. It.) 9. Door area . . . . . . (0 or sp. It. Ma+. 999 sq. tt. I I 0. ` Items 10 8 11 N.A.) 10 DoOrweeiher5trippe4?(YOrN) y q ~ n ~ 11, Slorrndoors?(VOrN) N NN f~ ku qp 12. Fustsloryperimetei 13. Secontlslory perimHter 14.Thickne5sof wallin9ulaUOn 1~I N (0, 2, 4 0f 6" Ii6ergla5. ENer MA f or masonry; R values, enter R, Ihen value. [x: R79) 15 Basemeniperimeter . . (OOr linear It. II 0, Items 16, 17 828 N.A.) 16. Basement heatetl7 (Yoi NJ ~ n ~ (II N, Item 17 N.A.) 17. Percentubovegratle(Ea.S%=5) 18, Area of r0o1 with exposotl beams or sWtlioceiling . . . N.A. pp pn aa (0 or sq. H II zoro, Ilcros 19, 20 8 27 N.A.) 19 orFlortiber.ll \N,Ifem20NA.,~ W fur wootl II F, Item 21 N A.) 20. Thicknessofliber . ~ Op (1.5, 2 or 3" or R vatues) 21 Insulfllion (Y, N or R values, V assumes 1.5") --~-r-- ~ , . , 01M0C,1 A OG°)4OOG:l U E 22 Area ol ceiling under venied roof or uncontlilionetl sPece . (0 or 5q. It If O ltem 23 N.A.) ° 23. Thicknessollnsulaiion (0, 3. 6, 12 or 18" of hbergias or R values ~ # Ex: RJO) 24. AreaOlfl0or50veruncontlibonetlspace u (0 w sy. 11. It O lrem 25 N.A.) 25. Thicknessolmsulalion f0. 3 or 6" liberglas, ot R volues) ° 26. Area ol floors over open or ventetl space, m 9arage (0 or sq. It It 0 Ilem 27 N A) ~ np 27. Thicknessolinsulation (0. 3 or 6'" ol liberglas or R values) a 2e. easement area . (0 or sp. ft. It Item 15 ia 0 skip ihie entry.) 29. Total heateU area (sa. 11 ) , 30. Porimelerolconcretesleb (0 or iinear It ) (II 0, Item 31 NA ) 31 ThicknessolslaUinsulation............~ (0. 1 or 2") 32. Desiretl summer mtloor temperaiure swing ~ na ~ Pn pn (Value between 7 antl 6 inclusrve.) ~ 33. Desiretl winterinsitleiemperature 'J C a 'J r u p 34. Ductlocation (AT = muc, BA = basemem, SL = slab, CR = crawl space. CO = conaitioned :pace) (It BA, SL. or CO, Item 35 N A.) ~ l 35. Thucknessofinsulauon (0, t or 2". Use 2 br t" ngi(I.) ' REPEAT DATA4" Y or N .'CORRECTIONS7" It Ihure are no eorrCCUOns iequne0 enler uu II thete are cortecuons to ihe daln. enler quesuon number, P. thc new tlu1., and aa EY: 190WqN P pN ? N Pp ? G Pp It 00IUIIhC! COlf2CI10115. COIBf NN Oflly. p4 aq pp COOLING B.T.U.H. EOUALS•? 1~ 1-0 1 AT °F B.T.U.H.~~/ qT 0°F B.T.U.M. AT °F MEATING B.T.U.H. EOUALS f~•l .~~/Y AT °F B.T.U.H. q7 °p B.T.U.H. AT °F "REPEATTHEANSWERS"(YOrN)..,...,.. un pp , pp 44SAVEYOURDATA7" nn pp ~ Y or N; or YRaa will save youi tlata antl goes to be9immng for new Analysis: or NR++u wdl nol s:rve Aata bul goes bnck lo beginninG foi new anaiysis JOBNUMBER ~ C- 11 you want lo save your tlata CLIC assigns Job Number "STRUC7URE CHANGES?................. II there are no changes reqwretl enter roM It lhtlltl erC ch9nge5 i0 VtC U31B. enlCi yue5uon number. P. the new Uala. antl 4u n uu c cn E.-25aR90np ~ roa II no furlher changes, enter un only. a a R C~~I~~GJ ~Vllf~nl~ss . OPPORTUNIN HOME 3.7e aunWa 1„ u s n e3e-039 . . 1999 BUILDING PERMlT APPLICATION (RESIDENTIAL) CITY OF EAGAN p O'S~ 3830 PILOT KNOB RD - 55122 e_~'> l0 651-681-4675 New Cons}ruction Reauirements Remodel/Repair Reoufremenis > 3 registered site surveys showing sq. N. ot lot, sq. R. of house 2 coples ot plen and all roofed areas (20%moximum lot coveraae allowed) i set of energy calculatlons for heafed addNions > 2 coples of plans (show beam 8 window slzes; poured fnd. design; eic.) 1 sMe survey for exterior addMlons 8 decks 1 sef of energy calculatlons : 3 coples ol free preservation plan H lot platted aHer 7/1/93 , DATE: J/~'Y/GJ9 CONSTRUCTION COST: ~~O~• p6 DESCRIPTION OF WORK: GQ /!.t ~e_ ~ STREET ADDRESS: ~a IG LAIIe, v7 4!~o ~ ; ~ pG • ~ LOT: BLOCK: ~ SUBD./P.I.D.#: /~J82~G~GIIJ ~2 k Uo~s Name: ~°5 D rG Gob Phone #:~6 Sl ~ 6 -~r6 -LF151? PROPfRTY Last First OWNER 1/ CG 1 ~f ~6 ' oZ~S,f Street Address: `~a'/o ~ City rA) State: V2A-A) Zip: 5 5/~ 3 Company: Phone (area code) CONTRACTOR Street Address: License # Exp. City State: Zip: ARCHITECT/ ENGINEER Company: Name: Telephone area code ( ) Street Address: Registration City State: Zip: Sewer 8 wafer Ilcensed plumber (required for new consirucTlon oniv): P2nalty applfes when address change and lof change Is requested once permtt Is Issued. I hereby acknowledge thaf I have read thls applicaflon, state thaf the Informatton is correct, and agr e fo comply with all appltcable Slute of Mlnnesota Statutes and C1ty of fagan Ordinances. Slgnature of Applicant: G~ G 3 , OFFICE USE ON I~ Il1 v I-. - Certificates of Survey Received I/ Yes _ No , JUN I s,.^,q 11 Tree Preservation Plan Received _ Yes _ No _ Not Required , OFFICE USE ONLY ~ BUILDING PERMIT TYPE ? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 03 1 of plex ? 08 6-plex ? 13 16-plex A 18 Deck ? 23 Porch (screened) ? 04 2-plex 0 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 El 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 GENERAL INFORMATION Const. (Actual) Basement sq. ft. Census Code 4/ (Allowable) Main level sq. ft. SAC Code 0/ UBC Occupancy sq. ft. No. of Units O 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 Rl~ Engineering Variance Permit Fee Valuation: $ 110(~ 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 'SURVEYOR9S CERTIFBCATE ~ GRAND OAKS DEVELOGMENT COMPANY (~35~ yalo ?a(!ey ~'oa~c p~, I EaSa.til r`h~l SS1~3 I IV 00 07'49E 111.43 h ~ h ~ C=> ORAINAGE 9 UT/L/TY £AS£MEN7S P£R PLAT-- ~ ~ LOT 23 ~ N h ~i A600 ~ _O_ R°~ ED . • I 0 ~ 'o,/ NOuSE • 60 - tAi a \ 0 400 N ~ ' N o ~ iv / •o 'l t~ i GpF./o 22.0 ~ Lq~3•5)' . Ib OD ~ i (n Vi • " A ~ q-~r \ I p _ 5 ~ r wy0, _ _ ~ W a c • ;c,~.,. O % / \ r.. . m ; o NO°07'49'. ; VALLEY aaoooo r--- - - FORGE 1 ~ DENOTES PROPOSED SURFACE DRAINAGE O DENOTES IRON MONUMENT SET lE: 1 INCH = 30 FEET • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE EET X000.0 DENOTES EXISTING ELEVATION oROPOSED LOWEST FLOOR = 9 70•9 FEET (000.0) DENOTES PROPOSED ELEVATInN PROPOSED TOP OF BLOCK = ~-7 4.1 FEET I HEREBY CERTIFY TO GRAND OAKS DEVELOPMENT COPiPANY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 23, Block 2, NORTLIV:EW PIEADOI:S, accordire to -the recorded: plat_ thereof, Dakota County, Ninnesota. %.~$H~,EG~LriQk~~~;°`i0?•! ~~iLL B~ V^.L:: UPO:i TH- FiLi~~!= OF THE PLAT, AND OF THE LOCATIOM OF ALL BUILDINGS, IF ANY, TNEREON, AND AlL VISIBLE ENCROACHMENTS, IF ANY, FROM OR 0N SAID LAND. AS SUP,VEYED BY t+E TNIS 25-14 DAY OF JULY, 1983 . SIGtdED: JAh~ P.. 11ILL, INC. BY: HAROLD C. PETERSON, LAND SURVEYOR PfINNESOTA LICENSE N0. 12294 PROJECT P10, BOOK / PAGE JqMES R. HILL, INC. ~33 Z ~ Planners / Engineers / Surveyors FILE td0. • 8200 Humboldt Avenuo South ~"~-~F= P Bbomington, Mn, 55431 812-884-3029 13a, RAND KS DEVELOPMENT COMPANY (ctober 31, 1983 Dale S. Peterson City of Eagan 3795 Pilot Knob Road Eagan, MN 55122 Dear Sir: This serves to make notification that the deck at 4210 Valley Forge has been penta treated as agreed. Sincerely, F. Vincent Dale GRAND OAKS DEVEIAPMQJT mrw 7623 Upper 1671h Street West Lakeville, MN 55044 (612) 432-6561 '•f3 kio4Vw 0~-to P-ta..~ w3 ~ La3;L. ~ . , w~vixnrrrr,i; ~risiIi.~:riu~! , C3~ ~,-t k su...!,,~~:.~~,~~ r:rnnr: 1'h~~nr.: (hm) T---- Pcicliess: (wk) D1.i:;tcr: Yee; tJ~i . tiut+~•anli ~ictor .7 t ('in i ~ ~-~-`,~'-Z~---- r^'_c_~-~u~= d2 U , . . ~ o ' L . ' _ _ II.iLi;: 4' ' - - PERMIT City of Eagan Permit Type:Building Permit Number:EA107045 Date Issued:09/25/2012 Permit Category:ePermit Site Address: 4210 Valley Forge Pl Lot:23 Block: 2 Addition: Northview Meadows PID:10-52100-02-230 Use: Description: Sub Type:e-Windows/Doors Work Type:Windows/Doors-New/Replacement Description:House 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, 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 $105.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Kevin C Tegantvoort 4210 Valley Forge Pl Eagan MN 55123 Window Concepts MN 990 Lone Oak Rd #114 Eagan MN 55121 (651) 905-0105 Applicant/Permitee: Signature Issued By: Signature �( �� ��� �1�"' Use BLUE or BLACK Ink ----------------i ��� � For Office Use � C�� VI !J� �i! ������ ' I Pertnit#: /����Q I � � I ��\ � E J 6 S�p, ,y � �0�� i Permit Fee: �� . (J!/ � 3830 Pilot Knob Road � � � 1 agan MN 55722 � Phone:(651)675-5675 � � I Date Received: �' '�l Fax:(651)675-5694 ���� �--.,.,�_ \� � Staff: j -----------------� 2014 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2)sets of plans with ali commercial applications. Date: �-- 2��S� Site Address: �� Z'� �� �c., '�L�c �� A � Tenant: �� , � V ,r Suite#: ����.�5►�ttT����" :�� Name: ��e..-��n ��o. �.� �v c��'�C � Phone: �1 Z- FS 1 Z-�?�� Address/City/Zip: 1.iU �ot,�\ �ce, �a a� Name: �S t c�..��.c�� �"���"��� � !'��r License#: Gti�t��cfc►�: ' r Address: 1�15 �_ `-'�1 S` S� - J�v.�� 'i City: � .� -��u r�v l�S State: 'l�r� Zip: S 4�� (;'Z Phone: � �2�^l2�- l$�oj Contact: f�n�r �C_ Email: �r, nc. . `L d�rLC Q. t^��r�•c.�\ • Ct��, New �_Replacement Additional Alteration Demolition jZ���a.ts_ '��irt�A �t ��.'w'¢ 5G.1�°l�uraaT� 'TOpot7 �`� I ,�'y�2�;pf1�1�'t'�'Jc � Descriptionofwork: � g,,x.c� ,4.z - �n.-,�;�r ,y,��,cvz� z.c�TOn zy oaa�3 'S � <� ;, ��t�'}'�,�IR�o�rnb�t�'�4�&�o�er�s��tr��r��P���i�`��,�s � � ��� � ���� � , . , . �� �'�s������s�ila�cfran���#t����?r i�f�ar��i'�� .,����` �9i��s �, � �_ � �� .�� n . .. , . .. ��N .. . ..�. � . <,,,� r. RES/DENTIAL COMMERC/AL '?� Fumace New Construction _Interior Improvement ���,���*�• � l"� Air Conditioner _Install Piping _Processed � �� �� Air Exchanger Gas Exterior HVAC Unit _Heat Pump Under/Above ground Tank (_Install!_Remove) Other RESIDENT/AL FEES $60.00 Minimum Add or alteration to an existing unit(includes$5.00 State Surcharge) a $100.00 Residential New(includes$5.00 State Surcharge) _$ (S�� � TOTAL FEE COMMERCIAL FEES Contract Value$ x.07 $55.00 Permit Fee Minimum $70.00 Underground tank installation/removal =$ Permit Fee `If contract value is LESS than$10,010, Surcharge=$5.00 =$ Surcharge` "*If contract value is GREATER than$10,010, Surcharge=Contract Value x$0.0005 ***If the project valuation is over$1 million, please call for Surcharge =$ TOTAL FEE I hereby acknowledge that this information is complete and accurate; that the work will in conformance wit e 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' not to start it ut p rmit;that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. � �/ a X 1/6�. .. 3.._ p��c�f X ApplicanYs Printed Name Appl a s Sig tu �`t3R��0Ef�GE�iSE �� � , � � 's� �� ���� s ��" �a���,��� �� � � r ; c - �' .�.# »+' �� '� n' ,�%x �aa�'�� �@G��lT@���',�B.�IC�1fl.�s` �.� � �. 4�� " �. �.�r�r ,��.�'a* r"�` t� ��'. �`�..��.��" �'� �''a�� � ', r� � �.. �� p i . :. y; s } �r.n* � "* 3t i�?�t'��"�'���� . lJr1t�EC'c,�rol'�r�Li R�r�.1f,�lT JCt ,,;�,,,�,�'�"�k ` t��+s�v'�.�����&i,,e..,,,,,+����i`a� '�::�;,u���', �x�. � (,� �� PERMIT City of Eagan Permit Type:Building Permit Number:EA132741 Date Issued:09/01/2015 Permit Category:ePermit Site Address: 4210 Valley Forge Pl Lot:23 Block: 2 Addition: Northview Meadows PID:10-52100-02-230 Use: Description: Sub Type:Siding Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please leave printed pictures of house wrap on site for the final inspection. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Kevin C Tegantvoort 4210 Valley Forge Pl Eagan MN 55123 (651) 687-0073 Eagle Siding 1301 East Cliff Road Suite 117 Burnsville MN 55337 (952) 746-3046 Applicant/Permitee: Signature Issued By: Signature  !" #$%&'()'*+*, -./$%'"&0-123$45$,+ -./$%'63/7-.189:;??K =*%-'!>>3-519?@A:@?A9B -./$%'#*%-+(.&1--./$% C$%-'855.->>1'';?9A''O*44-&'E(.+-'4''  'H"#$% &&'())**+ &&Z/N1*-C&T-.)C; 234 567V'56676'7'H6& :;- =->D.$0%$(,1 <=>&?@A- B*+)C;D4/;,+;/=$*+&?@A- B/%&?@A- E-A#.$- 4-;$/*A*+ ?C&/&T/-&B*+)C;D4/; ,-+;=;&,)- GHG&7&F$$=A.+$@ I+*+J <K=./-&L-- 6 3MA/1-M-+;&&N-&NM-&/-K=*/-&;M%-&)--$/;&*+&.##&>-)/M;O&3P&.#-/*+J&C*+)C&A-+*+J;&/&*+;.##*+J&".@&/&"C& #(//-,%>1 C*+)C;Q&$.##&P/&P/.M*+J&*+;A-$*+O&,.##&P/&P*+.#&*+;A-$*+&.P-/&*+;.##.*+O ,./>+&M+R*)-&)--$/;&./-&/-K=*/-)&C*N*+&56&P--&P&.##&;#--A*+J&/M&A-+*+J;&*+&/-;*)-+*.#&NM-;&ST*++-;.&<.-& "&7&".;-&L--&WG^W56HO'V&6!65OG6!V E--'C3//*.&1 <=/$N./J-&7&".;-)&+&U.#=.*+&WG^W'O66&X665O'5XV U.#=.*+ &&GQ666O66 "(%*41F9ABG?B' #(,%.*D%(.1HI,-.1 7&&(AA#*$.+&&7 Y.J#-&<*)*+J^-1*+&,&?-J.+1/ 5H65&Y.;&,#*PP&E.)G'56&U.##-@&L/J-&2# <=*-&559Y.J.+&TZ&&VV5'H "=/+;1*##-&TZ&&VVHH9S8V5\\&8!97669H SXV'\\&9G87H6G8 3&N-/->@&.$%+C#-)J-&N.&3&N.1-&/-.)&N*;&.AA#*$.*+&.+)&;.-&N.&N-&*+P/M.*+&*;&$//-$&.+)&.J/--&&$MA#@&C*N&.##&.AA#*$.>#-&<.-& P&T*++-;.&<.=-;&.+)&,*@&P&Y.J.+&F/)*+.+$-;O (AA#*$.+D2-/M*-- &<*J+.=/-3;;=-)&"@ &<*J+.=/- Use BLUE or BL.ACK Ink �---- - ---------, � For Off+ce Use � � ' �3� ��� i ��}� n� ����� � Permit#: � I it t% j b � � Permit Fee� � I 3830 Pitot Knob Road � � Eagan MN 55122 1 Date Recebted: � Phone: (651) 675-5675 � i � StatF: Fax: (651)675-5694 L________________� 2015 RESIDENTIAL PLUMBING PERMfT APPLICAT{ON Date: �b�T��� ) Site Address: �"�a-�� v�.Q.QQ���Z�i�.- �� Tenant: Suite#: � p�7 3 � ' � Name: � �Jw T�(��Vl..'tVl�'i��'"�" Phone: ��� �Qg / "_ � �@�����'�1llt�� ; . � Address/CitylZip: ��.�� � ��Q'�' � � . � � Name: �'� �-� �'C. �Q �/I�C��il T1�!�' . .1G`ce�: �y"qC1`� 1N G � � ' � �/' � � Address: 3��� r �'e�- "1 ���"' City: �� � ����� � � State:�_Zip: S`t��Y Phone:�i �r 3��- � ��� � I�L.Q kJ PX (�Y` �'E�i.rQ � C��"���7` � c�� �vC � , Contact: Email: � � , _ �Replacement _Repair �Rebuild _Modify Space _Work in R.O.W. � �-���� � New � H Description of work: �'Y�'��'Q- w a'�/I /�t^��l-Q/� � ; RESIDENTIAL � � � � � Water Heater ; § � � Water Softener � � Lawn Irrigation(_RPZ 1_PVB) � ����� � Add Plumbing Fi�ures�Main/_Lower Level} � � Septic System � � New Water Tumaround � � � � � � Abandonment � ..; ..._.; — � � RESIDENTIAL FEES: � $60.00 Water Heater,Water Softener, or Water Heater and Softener(includes State Surcharge) � � $60.Q0 Lawn Irriga#ion (includes State Surcharge} � $60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround`(includes State Surcharge) � 'Water Tumaround(add$210.�if a 5l8"meter is required) � $115.00 SeDtIC SVstem New(incfudes Caunty fee and State Surcharge} /� � ' IIL.� � ��.�,,,�_b.�,� � TOT/�L FEES; CALL BEFORE YOU DIG. Call Gopher State One Cal!at(651j 454-0OQ2 for protectio�against underground uti6ty damage. Call 48 hours before you intend to dig to receive locates of underground utilities. �v�r,rw.qflphersiateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in confortnance writh the ardmances and codes of the City of Eagan; that I understand this is not a permit, b�t on{y an ap�ication for a permit, arn4 work is not to start without a permit;that the work wi1{be in accordance with tt�approved plan in the case of work wrhich requires a review and approval of plar�,s. X �. �CR'10�j�r X , c�C�Q�. Applicant's Printed Name Applicarrt's ' nature �`E��'��E�� ' R+��i+�r�l��"` �:! , ; , .; . � , � . , �� ��#�i�i�r��or��. , �����t�t�t�` ���� �'�`�� �„�,�,,,��� ,�.,�.�:,���.` PERMIT City of Eagan Permit Type:Building Permit Number:EA155702 Date Issued:05/30/2019 Permit Category:ePermit Site Address: 4210 Valley Forge Pl Lot:23 Block: 2 Addition: Northview Meadows PID:10-52100-02-230 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. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). 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 - Kevin C Tegantvoort 4210 Valley Forge Pl Eagan MN 55123 (612) 812-9737 Advantage Construction Inc 18563 Vermillion St Wyoming MN 55092 (763) 354-8441 Applicant/Permitee: Signature Issued By: Signature r For Office Use r�j l ("C a '' i i�, Permit# ( ✓ 7 ifir .. .° . E A N REf GET- A_'✓R PeftTllt Fee. D E C 1 ® U Date Received: i'?,--to -/I 3830 PILOT KNOB ROAD EAGAN, MN 55122-1810 (651)675-5675 I TDD' (651)454-8535 I FAX. (651)675-5694 Staff buiidinginspections(acitipfeagan com / h J /‘?-.42°--/( A ? 2019 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 12/10/2019 Site Address: 4210 Valley Forge PI unit#: '';,, ,,,,J.. „, Kevin & Sheri TeGantvoort 612-812-9737 Name' Phone: E Address/City/Zip 4210 Valley Forge PI, Eagan, MN 55123 - Applicant is: Owner ✓ Contractor II'.'; ' Description of work Bathroom Remodel _:_ . Construction Cost 7000 Multi-Family Building: (Yes-I No J ) ” ' Great Lakes Window & SidingDerek Company_ Contact: ,� Apple Valley 14690 Galaxie Ave Cit YI: � : Address. y. _..._.. State: MN Zip: 5a5124 Phone 952-891-34C. Email derek.glwsco@gmail.com 80060427NAT-23297-3 y License# Lead Certificate#_ 1 If the project is exempt from lead certification, please explain why COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan? Yes __No If yes date and address of master pian Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: NOTE:. and r tents thiliou-suimitire cwt to be public info ti4ti . *0004'of the me may k ., „ :.el nonpublic if j evil►specific NIOSOOS that would hornet the City to conclude concludethat theyare tiedite ., -''"'-., ,7,,,,:`,',-cti'''.t. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. 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- ,{dww.00therstateonecail 21-2 I hereby acknowledge that this information is complete and accurate that the work will be in conformance with the ordinances and codes of the City of Eagan, that I understand this is not a pet or'. but only an application for a permit, and work is not to sidrt 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 pians i x Derek Brouillet x Applicant's Printed Name Applicant's Signature r7 ?i O A l/e Ail rri e /9/ /� `a DO NOT WRITE BELOW THIS LINE• J SUB TYPES Foundation Fireplace Porch(3-Season) Exterior Alteration(Single Family) v Single Family Garage Porch(4-Season) _ Exterior Alteration(Multi) r Multi Deck Porch(Screen/Gazebo/Pergola) Miscellaneous 01 of_Plex Lower Level Pool Accessory Building WORK TYPES New Interior Improvement Siding Demolish Building* Addition Move Building Reroof Demolish Interior 4,Alteration _ Fire Repair Windows Demolish Foundation Replace Repair Egress Window Water Damage Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION ttt��� 01) Valuation Occupancy MCES System Plan Review Code Edition AN qf SAC Units (25% 100% ) Zoning ( D City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction � I Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) Final/C.O. Required Footings(Addition) 1,Final/No C.O. Required Foundation Foundation Before Backfill HVAC_Service Test Gas Line Air Test_Hood Roof:_Ice&Water _Final Pool:_Footings _Air/Gas Tests _Final Framing 30 Minutes 1 Hour Drain Tile Fireplace:_Rough In _Air Test Final Siding: _Stucco Lath _Stone Lath _Brick_EFIS Insulation Windows Sheathing Retaining Wall: _Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: , Building Inspector RESIDENTIAL FEES 1 v Base Fee Surcharge ..q) Plan Review est t / tia ir MCES SAC cidti ei City SAC :t Utility Connection Charge s` S&W Permit&SurchargeViil t, I Treatment Plant ,{� Radio Meter Read t f"/ t Copies ^1 A.,i .d-i- 1 10-0 TOTAL Page 2 of 3 r For Office Use Permit* E AG N Permit Fee: Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildinciinspectionsc cityofeagan.com 2020 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: !—/ 3— `"1 ZJ ' Site Address: 2 I 0 ///e i ( P/ - C Tenant: T6 (y---Fli )Ot �-- / Suite#: Name: c.J, ✓"- /C 60n—/-7jPhone:4 Z 8/2— 5737 ReSidentigainer Address/City/Zip: `7 Z 10 /&//e,, ky /9/c-e -67,1 41A1 Name: �r'e,�- y/tet yld.v�� r License#: P(c 7 albs Contractor Address: < s5 /Pee a,4/( ye6/ City: c e✓ L J e State:M/t Zip: 55'37 Z Phone: 2— 4A4 7-(O 7.7V Contact: iC r1 -'�1-ere-'r. Email: .SG, rev 7092 4oL, 6 New ,•Replacement —Repair —Rebuild —Modify Space Work in R.O.W. Type of Work ,,((�� / // Description of work: /T"GM,0 J iv" ?-1.i 6 u dl C� ©cJCr/N, moi. c�&ve Tankless Water Heater / Lawn Irrigation( RPZ/—PVB) Standard Water Heater Description Add Plumbing Fixtures( Main/—Lower Level) Water Softener Description: Septic System New Abandonment Connection to City Water from Well RESIDENTIAL FEES $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation (includes State Surcharge) $60.00 New fixtures, adding or removing piping (includes State Surcharge) $60.00 Septic System Abandonment $100.00 New Residential (fee collected with Building Permit) $115.00 New Septic System (includes County fee and State Surcharge) $60.00 Connecting to City Water from Well*+$290 for Meter and $200 for Radio Read = $550 *Sewer&Water Permit also required for connection charges TOTAL FEES $ 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.aooherstateonecall.orq You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaoan.com/subscribe. I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. ,y)� x ///7'1 x Applicant's Printed Name Applicant's Signature Page 1 of 2 FOR OFFICE USE, Reviewed By: Date: Required Inspections: Under Ground Rough-In Air Test Gas Test Final Meter Related Items: Meter Size Radio Read'.- Manometer Staff: • 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 TDD: (651)454-8535 FAX: (651)675-5694 buildinginspections(a)citvofeagan.com Page 2 of 2 PERMIT City of Eagan Permit Type:Building Permit Number:EA167821 Date Issued:03/30/2021 Permit Category:ePermit Site Address: 4210 Valley Forge Pl Lot:23 Block: 2 Addition: Northview Meadows PID:10-52100-02-230 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door 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: 1,500.00 Fee Summary:BL - Base Fee $1500 $62.50 0801.4085 Surcharge - Based on Valuation $1500 $0.75 9001.2195 $63.25 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 - Kevin C & Sheri J Tegantvoort 4210 Valley Forge Pl Saint Paul MN 55123--195 (612) 812-9737 Custom Choice Inc. 3384 S Coon Creek Dr Andover MN 55304 (763) 208-1259 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA171264 Date Issued:08/09/2021 Permit Category:ePermit Site Address: 4210 Valley Forge Pl Lot:23 Block: 2 Addition: Northview Meadows PID:10-52100-02-230 Use: Description: Sub Type:Fireplace Work Type:Gas Fireplace (new) Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to concealing. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 3,000.00 Fee Summary:BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 $90.00 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 - Kevin C & Sheri J Tegantvoort 4210 Valley Forge Pl Saint Paul MN 55123--195 (612) 812-9737 The Fireplace Guys Llc 680 Hale Ave N #110 Oakdale MN 55128 (612) 326-1919 Applicant/Permitee: Signature Issued By: Signature