4240 Valley Forge Pl
3830 Pilot Knob Road! P.O. Bo 2G-A199, Eagan, MN 55121 N2 12314 G PHONE: 454-8100
BUILDING PERMIT Receipt k 1/1
To be used ior SF DWG/GA.~ Est. value $62 0000 Date JULY 23 yy Sb
240 VALL~ FORGE R3
Site Address Erect ~ Occupancy
Lot 27 Block 2 Sec/St_4 NORTHVIEW MEADQW~'idel ? Zoning p1)
Percel No. Repair ? Type of Const Vin
Addition ? No. Stories 44
~ Naroe RICK JOHNSTON Move ? Length
Z Demolish ? Depth 4 a
o Address~ Int. Impr. ? Sq. Ft
City Ptione Install ?
o Name GRArID OAKS DEVEL CO Approvals Fees
1881 R Assessment Permit $ 316.00
Addre
~ City AGAN 452-8934 30
Pnone Water. & Sew, Surcharge .50
Police Plan Review 158.00
IU LU Mame Fire SAC 575.00
= a Addrass 500.00
~ = Eng. Water Conn.
~a W City Phone Planner Water Meter 63.54
Council Road Unit 290.00
I hereby acknowledge that I have read this application and state that the Bldg. 0 ff~16Tr. PI. 156.00
in(ormation is correct and agree to comply with all applicable State of
Mlnnesota Statutes and City Ea an 0 in ces. APC Parks
Signature ot Permiriee `g ` < Qate Copies
A Building Permit is issued to; ~G~ND OAR~ DEVEL CO on the ex'press , • 00
condiTion that
all work ahall be done in accordance with all applioable 5tate innesota Statutes an ' Qity of Eagan Ordinancea
Building OfHcial
~
~ Pamk No. PermN Neldm DMm TNmpiwne M
Plurnbin9
H.v.A.c. '7 ~ - S
~ 10- 3
sdtNU.
Impectlon Daq Inup. Commola
FooUngs I ~ a-3 i+J
roonng. u
Foundatbn
Fnminq ~
RooMny
Rouph wbp. ' S • ,l~
R°uph Hty j- - - 1..C.J
IMW. ~~J~b(o
FI?"iacm
Flnal Nty.
Final Plbp.
FNal
C.L cim Zr-~
Dock Fty.
Dock Frmp.
OpCr" L.oCaMon:
WOM
P?. Wsp.
a ' PERMIT #
• ' PLUIYIBING PERMIT RECEIPT M
dTY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
CONTRACT PRICE PHONE: 454-8100
Site Addr]gs 10 ° I (y F`• ~ BLDQ. TYPE WORK DESCRIPTION
Lot d' ~ &ock Sec/Sub
p iZ V: c w r} r,. c.. Res. New x ~
m Name Mult Add-on
9 Address Comm. Repair
c Ciry Phone Other
NP• FIXTURES _TOTAL
~ Neme Water Closet - a3.00 $ ~
c Address T-Bath Tubs - $3.00 O City F ~ Phone Lavatory - $3.00 '
Shower - $3.00
FEES ~-Kitchen Sink - $3.00 '
COMM/IND FEE - 196 OF CONTRACT FEE --7-Urinal/Bidet - $3.00
MINIMUM - RESIDENTIAL FEE - a10.00 Laundry Tray - $3.00
Floor Drains - $1.50
MINIMUM - COMM/IND FEE -20•00 ~ Water Heater -$1.50
STATE SURCHARGE PER PERMIT - •50 ~ yyhirlpool - $3.00
(ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlats - $1.50 BEYOND $1,000.00) ' Softener - $5.00
Well - $10.00
1 Private Disp. - $10.00
~ Rough Openings - $1.50
SIONATURE OF PERMITTEE FEE
STATE 8/0. FOR: CITY OF EAGAN GRAND TOTAL: Z~`
117-
PERMR # %
MECHANICAL PERMIT
` GTY OF EA(iAN RECEIPT ~ ~ ~
3830 PILOT KNOB ROAD, EAQAN, MN 55121 DATE:
CONTRACT PRICE ~.JC_t r•~ PHONE 454-8100
Site Addresa < ~ , , r ~ • ' ; BLDG. TYPE WORK DESCRIPTION
Lot Block ~-~i Sec/Sub
~ Name Res' New A
Mult Add-on
~ Addreas ' Comm. R r
c Cityt. iCi c, t ~ i F y Phone ` - ~
Other
J I
~ Name FEE8
c Addrees RES. HVAC 0-100 M BTU - a24.00
p City - ~-a'~ • , Phone ADOITIONAL 50 M BTU - 6.00
' ADD-ON AIR COND. 0-24 BTU - 12.00
TYPE OF WORK ADDITIONAL 6 M BTU - 6.00
Forced Air > M BTU GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00
UnR Heater M BTU MINIMUM - COMM/IND FEE - 20.00
Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50
Vent CFM (ADD a50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # BEYOND $1,000.00)
Other
FEE ~ i~ • ~ ~ < ; ~ . ~ r ~1
S/C: SIGNA7URE OF PERMITTEE
TOTAL:
FOR: CITY OF EAGAN
CITY OF EAGAN Remarks Addition NORTHVIEW MEADOWS Lat 27 Rlk 2 Parcel 10-52100-270-02
Owner street 4240 VALLEY FORGE Pj,AZ$ State EAGAN MN 55123
Improvement Date Amount Rnnual Years Payment Receipt Date
STREETSURF. J 1984 76.7$ 7.6 -7-.-~ 10
STREET RESTOR.
GRAOING
SEWER LAT 51 1981 15.89 .79 20
SAN SEW TRUNK 7rj 1981 138.48 6.92 20
SEWER LATERAL 'j'Rj( 9 1984 27$.22 1eL3¢iS:"55 15
SEWER LAT 5-77 1981 22,28 269iS
WATERMAIN g 1984 70.67 4.71 15
WATER LATERAL 1981 1$,6$ I.2¢ •'r If
WATER AREA 57f 19$1 138.48 6.92 20
WATER LAT 5) 1982 29.52 1--4-& 20
STORM SEW TRK p 1984 392 . 32 4(,49-.-2'3' S
STORM SEW LAT
DRAINAGE l 1984 33.97 3•39
CURB & GUTTER '
SIDEWALK
STREET LIGHT
WATER CONN.
' BUILDING PER,
SAC
PARK
I CITY OF EAGAN PERMIT TYPE:
, ~ 8 3 0 Pilot Knob Road Permit Number.
~ Eagan, Minnesota 55122-1897 Date Issued: ~ ' • • (651) 681-4675
.
SITE ADDRESS: i: ir APPLICANT:
'r1I ! ! , I r1R017 f'l
PERMIT SUBTYPE: TYPE OF WORK: ~
INSPECTION DA • D'
L J
. PemiR Holdw DoM TiNphone III
r WATER
PLUMBING
' HVAC
~ Inspectlon Dsb Insp. Commsrrts
- FOOTINGS
FOUND
FRAMING
ROOFINQ
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
I GYP BOARD
FIREPLACE
I FIREPLACE
I AIR TEST
FINAL PLBfi
I FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
coNOUCnvm
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
- -
CITY OF FAGAN WAlM SERVICE PERJIAIT
3830 rflqt Knob Rwd 7.
P. ~ Bax 21198 PERMIT NO.:
Eapan, MN 55121 DATE: - -
Zoninp: _ P.1 No. of Unlts: 1
p„rwr; ('ran^ ()aks
Addmss;
Site Addron; ? Lev For-e Placc~ .27 D2 t3orthview Meadows'
u^L in- 'i
Plurrbor. T'l
Meftr No.: '3 500.11~1,;ci
Sis4: & oc Ik .n.pJS.; 1~.-~ n n c i
Reo No.:
~ M.w h~M wM er. . 50pd
p„dlishomms, Q~ t,Cha,rom 156. 00pd '!T ,
RE ~ Totnl: 1 Qnd r I
By n-~- Doc. Pow: ~
I
Dah of Imp.: IrMp.:
9- Z
; CITY OF EA(3AN Sgvm SERyWX 'ERM
j 3830 Pilot Knob Road
~ P. O. Box 21799 PERMIT NO.: -
Epan, MN 55121 DATf: Zonlnp: Na of Units: 1
r
Owrn. : rand Oa;it:3
I Addrtss: ~
~ Stt, Addnm- 4240 %'a11ep Far~,,e ?'1 ace L~"-
p4,,ber Va;.Iey Plttmbiatg
i 7 <,SOfin
1 Mm Msomm* wMb 1M Clhr d iopm Connoctlon Oharpe:
Orfi~ne~s. AoeourM Qepwth
~ P*nnlt Fw. i ~ 5und+orp:
i ' By Miac. Chorpa:
Dah of Irnp.: Totol:
I rop.: Daft Poid:
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N2 12314
/.vo5
BUILDING PERMIT PHONE: 454-8100 Receipt # e~-~
Tobeusedfor SF DWG/GAR Est.Value $61,000 Date JULY 23 1986
SiteAdCress 4240 VALLEY FORGE Erect ~J Occupancy R3
Lot 27 Block z SeciSub. NORTHVIEW MEADOWBodel ? Zoning pD
Parcel No. Repair ? Type of Const.Vn~
Addition ? No. Stones
RICK JOHNSTON Move ? Length 44
Name
w
i Demolish ? Depth 48
o Address Int.lmpr ? Sq Ft.
Ciry Phone Install ?
Name GRAND OAKS DEVEL CO APprovals Fees
a
o
$a nddress 1881 SUNRISE CT Assessment Permit $ 316.00
~ City EAGAN phone 452-8934 Water&Sew. Surcharge 30.50
Police PlanReview 158.00
Fw Name Fire SAC 575.00
Address 500.00
Eng. Water Conn.
iw City Phone Planner WaterMeter 63.50
Council Road Unit 290.00
IherebyacknowledgethaNhavereadthisapplicatwnandstatethatthe gldg.ON. 7/23/$ Tr.PI. 1$6.00
information is correct and a9 ee to comply with all app6cable State oi
Minnesota Statutes and Cry f Eagan i ces. APC Parks
Signature of Perminee CC- ~ 7Le ~ V. Date Copies 2,089 . o0
Total $
A Building Permit is issued to. GRAND OAK~ DE L O on the express condition ihat
all work shall be done in accordance with all applicable State Minnesot Sta u es a ity of Eaqan Ordinances.
Building Oflicial
RESIDENTIAL
Cl9 ~ BUILDING PERMIT APPLICATION
CITY OF EAGAN ~y
3830 PILOT KNOB RD, EAGAN MN 55122
651•681-4675 1
NewConsVuclfonReauirements RemodeUReuairReuuirements
. 3 registered si[e surveys showing sq, ft. of lol, sq. 0. of house; and all roofed areas • 2 cnpies af plan
(20%maximum lot coverage allowed) . 7 set of Energy Calculalions for healed additions
• 2 copies of plan sMwing beam 8 window s¢es; poured found desgn, etc.) . 1 site survey for ecterior additions & decks
• 1 set of Energy Calculations . Indicate if home served by septic syslem for addidons
• 3 copies of Tree Preservation Plan if bt platted afler 7!1193
. Rim Joist Detail Options selecfion sheet (bldgs wiU 3 or less unAs)
DATE VALUATION ~l~U~IU • O V
SITE ADDRESS NdLlh n MULTI-FAMILY BLDG Y XN
TYPE OF WORK~ 1 V~ FIREPLACE(S) _ 0_ 1_ 2
APPLICANT
~ I Y . VnSul STATEV`1n ZIP S533
STREET ADDRESS I A '
TELEPHONE # -2015 -q-MCELL PHONE # FAX # 953-%95
PROPERTYOWNERL!~~ L-\-1'l 01i TELEPHONE# 8 10,TI-LI0 5
"
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category MINNISO'CA RULLS 7670 CA"1'GGO12Y I MIN~I:SOTA RULES 7672
(d submission type) . Residential Ventilation Category i Worksheet Submitted .~ew Energy Code Worksheel Submitted
. Energy Envelope Calculations Submitted \P~lOIIC
Plumbing Contractor:
PlwnbinK systcm iiiclu<]cs: _ ~V1tcr Soltcncr _~1wn inklcr j P'cc: $90.00
Watcr Hcatcr _\i~ vf R.I. Ballis~
No. ol' Batlis
Mechanical Contractor: ~ Phone #
Mechanicil system includes: _ Air Conditioning Fee: $70.00
Hcat Recovcry Systcm
Sewer/Water Contractor: Phone #
I hereby acknowledge that I have read this application, state th information is correct, and agre to comply
with all applicable State of Minnesota Statutes and City of Ea an O dinance . ~
Signature of Applica ~
OFFICE USE ONL
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex O 13 16-plex ? 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (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 OB-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex 0 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDoors
0 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zcring 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) _ FinaUC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Founda[ion HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ F[gs _ AidGas Tes[s _ 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
MCIES SAC
City SAC
Water Supply & Storage
S&W Permit 8 Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
C/C -
, 7986 BIIILDING PEEM 9PPLICATION - CITY OF E6GAN
HOYE: ALL COBTR9CT09S MOST BE LICENSID WITH THE CITY OF EAGAN
SffiGLE FA4ffLY DWELLIIiGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
HOLTIPLE DWELLINGS - RfiSIDENTI9L RENT9L DBITS FOH SALS QNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SQRVEY - CHECH iiITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COHIIERCIAI:
ZNCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: U~ Valuation: Date:
Site Address o 0 yR, OFFICE OSE ONLY
Lot D-1 Hlock ~ Erect ~ Occupaney
Remodel Zoning PO-RJ
Parcel/Sub ~QL~4/2Repair _ Type of Const -zV
Addition 4 of Stories
Owner )dt-~ 124, Move - Length ~
T ~ Demolish Depth
Address Int.Impr. Sq Ft
Install
City/Zip Code
Phone 9PPROVALS FEFS
Contractor Assessments Permit 3IIO
~ Water/Sewer Surcharge ~
Address Police Plan Review / SR
Fire SAC S 7r
City/Zip Code _ Engr Water Conn
Planner Water Meter e:;;3. 5-0
Phone Council jIioad Unit IP-940
Bldg Off //,q .1'Treatment Pl
Arch./Engr. / APC C / " Parks
Variance Copies
Address TOT6L ~
City/Zip Code
Phone ll
NOTE: ADDBESSES FOR CORNER LOTS - CONTR9CTOR/HOMEOWNER MOST DESIGN6TS WHICH ADDRESS
IS DESIRED. NO CHANGES AILL BE ALLOifED ONCE BDILDING PERMIT IS ISSOED.
1 - '~JURVEYOR'~'J, CERTBFICAITE ~ GRAND OAKS DEVELOPMENT C0. : . 3
5
I • . I / ~ I r'J
L_ l 1 I L_ I r,~ ~
N
•I -
30
~ 0 - J
J)
W ~ S 89052'1I"E 120.74. .
0 ~ 30.00 48.00
N O ~ I,, >1o.00 10.00\
Y 0 \ /
~ ~'0 ~ k-"--•' ~ 26.0
U' N W W\ 'v
,W I 1 N\~N c~O~~~I W
~ p) °o aI p~ j- -
27
~ O PROP03~`C~"V~s".,V~ o a a ^Q
W o .QR I,
~ z..~ 10-` ~.~s^'=4Y \ 33 a 25.67 5 z
J -----,~I -
Q vo ~;'6.00 6A0`=, u•
`
30.00 48.00 i
~ S89052'11"E 120.74
30 ~
i~
- J
- DENOTES PROPOSED SURFACE DRAINAGE
O DENOTES IRON MONUh1ENT SET SCALE: 1 IPICH = 30 FEET
m UENOTES IRON MONUh1ENT FOUND PROPOSED GARAGE FLOOR =FEET
.XOOU.O DENOTES EXISTING ELEVATION PROPOSEU L041EST fLOUR = 97 fEET
(000.0) DENOTES PROPOSED ELEVATION , PROPOSED TOP OF BLOCK = 47c,-7- FEET
• ' ,
I HEREDY CERTIFY TO GRAND OAKS DEVEI.OPMENT C0. THAT TNIS IS A TRUE APlD CORRECT
REPRESENTATIUIJ OF A SURVEY OF THE I30UNDARIES OF:
Lot 27, Block 2, PlORTHVIEW MEACQIdS, accordina to the recorded plat
thereof, Dakota County, Minnesota.
ANU Of TIIE LOCATION OF !1 PROPOSED 6UILDING. IT DOES NOT PURPORT TO SIIOW IMPROVEMENTS.
OR ENCROACIIMENTS, IF ANY, TiI[REON. AS SURVEYED 4Y ME, OR UNDER P9Y UIRECT SUPER4ISION,
TIIIS 12TH DAY OF MARCH , 1986.
SIGNED: JAMES R. HILL, INC.
DY: v
AROLD C. PETERSUN, LANU SUfZZVEYUR
PIINNESOTA LICENSE N0: 12294
Pf10JECT N0. BOOK / PAGH JAMES R. t„~ILL9 0NC.
86427 pianners / Engineers Surveyors •
FILE N0. 8200 flumboldt Avonuo Soulti.
FOLDER Bloomington, Mn. 65431 012-004-3029
' , . • ,i. . ' ',:5:. . ' .
o : . . . , - . EXTERIOR ENVELOPE AVGFAGE 'U' COMPUTATTON
GkAND 0AKS DEVELOPMENT COh1PANY
- MODEL AREA U, U X AREA
ti
FEC]tJIFED
1. TOTAL WALL AREA 1800 X'.I1 ~ .
2. TOTAL ROOF ARF:A . 1196 X.026 1.0 6
ACHIFVED AREA U U X AFFFI
A. W I NDOW AREA 186.66 • 5 9'
Eq. nocR AREA --.9. 5 .077 3.06,16
C. 5LIDE GLASS AREA 13.44 .40 6.11-512
U. FIREPLACE A'riLA ' 0 0 t)
F. WF:LL FRAP7C' AREA 1E30 .041 7. __~EJ
F. NFT WALL AREA 1164.1 •049 57•0110"
L. RiM JOIST AREA 119.52 .04_~6 5.2110'2
H. f-OUND WINDOW AREA ' U C) 0
1. FOUND AEOVE GRADE 96.48 .135 13.024E1
3. TOTAL•, WF1LL AREA i80C 026 J. SKYLITE 0 0
IC. RODF FRAME 119.6 .032 3.0=72
L. NET ROOF AREA 1076.4 .025 26.91
4. TOTAL Ft00F AREA 1146 ~O• 7 ~2
SUM 1 . *2. . u96
SUM 3.+4. ~~C.2398
q8/p 13 V
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3 r I/ 3830 PII,OT KNOB RD - 55122
`t" b (651) 681-4675
9G 1 13-~5
New Construction Reauirements RemodeVReoair Requirements 3 n
? 3 registered site surveys ? 2 copies af plan
? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ? 1 site surveys (ezterior additions 8 decks)
? 1 energy calculations ? 1 energy wlculations for heated add'Rions
? 3 co0ies of tree preservation plan H lot platted after 7/1/93
required: _ Yes No
DATE: ~nAoI 1 "i o I!qg CONSTRUCTION COST: y,SUU. ~
DESCRIPTION OF WORK: Iffic L L h~r
STREETADDRESS: `1~LI~ ~/(.~ILC.~.I rl 1Tn~ Y IG C1z-
LOT: BLOCK: ~ SUBD./P.I.D. ~~~-onV 1 f.~'J
Name: S C. l l .1 ~Lh 0, T-±,k_ Phone ("l lIS--
PROPERTY Last First
OWNER ~
Street Address: ya~-1D V(..(.l I~,U I LJ r~I C.~
Ciry E~aomn State: Zip:
Company: Phonek:
CONTRACTOR
Street Address: ~ License #,Qnj xp.
City `~`7~ ~ ~~~(J 1 1 State: Zip:
ARCHITECT/
ENGINEER Company: ~ Phone
/
Name: R e,oistration
Street Address:
City State: Zip:
Sewer & water licensed plumber (new construction only): Penalty applies when address
change and lot change is requested once permit is issued.
I hereby acknowledge that I have read this application, state that the informati is correct, 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
OFFICE USE ONLY
BUILDING PERMIT TYPE
f
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-plex O 13 Garage/Accessory ? 20 Public Facility
O 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 _-plex ? 15 Deck
WORK TYPE
? 31 New ? 33 Alterations ? 36 Move
? 32 Addition ? 34 Repair 0 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code
UBC Occupancy sq. ft. Census Units
Zoning sq. ft. Census Bldg
# 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 Hl Valuation: $
Surcharge `D
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
SAC Units
~ ~v L »1AxYRRA'YYt?~fiXYtnYARF4~YFR#}AYk*6~
' C I TY O F E A A i~8 ~oN ~E-°,F~ ~ TIME oF
,*t APPROVAL OF PERMIT.
APPLICATION FOR PERMIT *
~ . • * INSPDCPION OF SEWFR ArID/OR WA1gT2
4 ZIISPAIS.ATIONS WILL NOT BE S(SED--
SEWER AND/aR WATER CONNECTION +*r 1), URM PERMIT HAS B~
. ~ APPFtovFn.
.
4-1,
*:F*kF *f 4*Yr*!Y` * 1r* *f f Y*tf ****!flrf Y
P ease Print
1) PROPERTY ADDRESS: y a O V ~
LEGAL DESCRIPTION: a, 7 a d~ -
Lot lock Subdivision or Tax Parcel ID )
IF MSTING SIRCCIL'RE, DATE OF ORIGINAL BPILDING PERMIT ISSL'11NCE:
~ (hbn Year
PRFSENP 7ANING/PROPOSID CSE:
/
C0,',NE2CIAL/f2ETAIL/0FFICE ~ R-1 SINGLE FAMILY
Q IPIDL'STRIAL ~ R-2 DLTLEX (Tleo Lfiits)
n ZNSTITCTIONAL/GOVERM~g,'blr ~ R-3 10WN[IOUSE (Three + Units) ( Units)
R-4 APARTbgS7'p/COAIDOMINZL'M Units)
2) ~
NAME: ~»-rn 5 L!Io~~FR (G c-OrlS~
• ADDREsS:_
CIT"1, STATE, ZIP:
PFIG.IE: `y5 oZ -J93jl-
3) ~ y NA[`'1E=~1~LL~ For City Use
Plumbers License:
. ADDRESS: 5~7~'?1 Active
ired
~ CITY, STATE, ZIP: Exp Not recorded
PHONE: MASTFR LICEP]SE# o?&17 /12 {O St Initial
q) • ~ i~• /f
NAME:~/~C
_ r,DoREss:_
CZTY. STATE, ZIP:
PHONE: •
-S) t ~ v , ~ r• • : o~ • a~ o-i
~ CON6IECTION TO CITY SEWIIt CONINfCI'ION ZU CSTY WATER ~ pT(1EF2
T ~
6) t'' T"-•'• PLFA.SE HOLD APPROVID PERMIT FOR PICK-CTP BY ONE OF FBOVE
PLEASE MAIL APPROVID PERMIT RD 1, 2, 3, 4, ABOVE . .
(Circle one) '
7) r r. ,
~
''1: ~ 'I: M 1 I~ ~ I' N' ' ? 1:~' ~ h Y:V' • ~I' 1
UI: ~ • J~ ~ ~
~ i. •~1' 1+. 11 1 : i c•I 1 1::e' • ' 1 Y" O~~
. FOR CITY USE ONL ~ PERMIT # ISSUED
[-7 P6 z
Pd w/Bldg. Permit FEES:
$ $ SEWER PERMIT (INCLUDE SCRCHARGE)
$ WATER PERMIT (INCLODE SCRCHARGE)
0
$ 6: 3'S-D $ WATER METER/COPPERHORN/OC'TSIDE READER
$ $ WATER TAP (INCLL'DE CORPORATION STOP)
$ $ SEWER TAP
$ 45- 1 Cl-D S J~6~ ACCOUNT DEPOSIT - SEWER
$ /S o-7 S ACCOUNT DEPOSIT - WATER . •
$ ~p c9c`> $ wac •
$ •.S 7 S ' $ SAC
$ $ TRL'NK WATER ASSESSMENT
$ $ TRC'NK SEL9ER ASSESSh1ENT
$ $ LATERAL BENEFIT/TRONK SEWER
$ LATERAL BENEFIT/TRUNK WATER
S $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ $ 0I• 0Z0 TOTAL
(o S_SW
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PL'BLIC RIGHT OF WAY?
~ YES IF YES, THEN A"PERMIT FOR WORK WITHIN P[JBLIC
ROADWAY" MUST BE ISSUED BY THE ENGINEERING
~ NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY: /-B-rC-cJ
TITLE:
DATE: /3 Z(p
RECORD OF COMPLAINT
Date Y" 3 0 "
Complaint taken by
Type of building sf-b,
Name ~jck ,T 1,nsto„
Address yz y0 Va 1, 1,--arGc
Lega] description - 2 ~2- Z
Phone number yZ v`~ 6,4/" o y&s
Complaint l.Uc,fev zea k;MIJ inlo xaare
ACilOII tflkCil -_r C~P" fi fa tlie S'/f~ O/~ el- 30-f/ an6' 0 DServ&7
10"ie vni('Frr t/,e ca44¢q~9FsfeUC 7~4f le C~eck 413 k-s'41"7
_(!vi AP YooT. I- f"~e19 C'a~~Q/ f~B~,f9os,.erv~eS,an c•,A/ io~,El1~ f2:
A0.ff/ /T!'In C~..~/ SRi~ ~~P ~uo~/~ ('I°?P SomG/~OKy fd~c{ CnrP Oj' /l,
Comments
Signature
I
BUILDING COMPLAINT GUIDELINES
• When a complaint is received, get the address, name, phone number, and a general idea
of what the problem is.
• Always have two City employees present to (1) verify the conversations, (2) offer
additional opinions, and (3) ]end credibility.
• Get "both sides" of the story if there is a conflict.
• Ask other inspectors and City employees if they are familiar with the address or the
problem.
• Contact other agencies or departments (ie. Dakota County Human Services, 431-2424;
police department; fire department), if necessary.
• Provide hand-out materials if they are available.
• Maintain a record of inspections and conversations on a City complaint form.
,
' L c~L1 f~ Q.- o-F ~
HEAT tOSS CALCULATION 2_° YEMP. DIFF,
cWwW wwal eA 1110 da tC1 L)W I Tyo. Mm,,W, M Q
CNV - wbwo,. aw.m a.++
c.lw Nmm.. w.u. . d..
Strm GNiq Iti.
ckY fba
Fi.l miL wwin lre s I> I.I aoomlL o Widti b Nwedv,
windows rw ooo.rcndup~ ane ao w+ndom ane ooon-trae,tW one am
wo wmn rNM~ Me. W lWN N.
A"g
Mlw%
N 01 M l ~1M~ . N.
(0
5)0 lo
r.0st. 0(Y C.Ow. 01U
In}sItration Q Infihntion
Gwa p GWt I co
EMO. wall 13 e,- c E:p. wa11 949
NN e:D. wall 3 !Mt oap. wll
Int. wall IM. wNl
Gilirg K 0 Z. Q Gilirq O ( .20 Fba Fba 160 Z,p
Toul Btu. Total Btu.
jXFI.I O ?poornjUn hg 1NidM 10 INi ht JtiTIF1•IRoomI Lw h 10 Wideh ~O INi t
Windo wW Doon-G+dap and Arw Window~ Mhd Doat-Crackapstnd Arr
Me an~M Ms Nry LM.DN h. ArM ~ M 1~n MN~O~ I`N. M L1~1 R • n
~t
r 1 ?
ZJ v .
ftu Cod.1 ou
~nnnr.[wn 1 !oo indironion o O
G~ / 00. G4s
Eap.vnll x Y Erp.wNl ~j
Nd eaP. wall IMI uR wMl
Int. wall IM. wdl
c«lMo 49A o o a c.~lim a x oa 3 0CM2
?lo,. Figa? o0
Total 8tu. TeW Btu.
(An i K omtL wkkn D IftaftWOW0 I y'fl.I L' I w~sm 1
wmerwus anA ooon-tr.ck &e Mu _ wY+eow, ooas-a.du .ne M.
w. ~wr a A. or ?wr n. ~i.
0 3l.
~
!tu ow
Inhlrratan Infibnan
G4,s / ,~-rp U(J Glm
Emp. wall Esp. wll
Nrl fzP. will Nat a0. MMI
In1. wll IM. wMl
Gilmg ~qxjp O G11inq l,;-X . Fkpo, 9
Teul Btu. c7ir TOW Btu. eZ fr4
. ~z~:2-
HEAT LOSS CALCULATION ~Lv ° TEMP. DIFF,
,.tan. wT. ~ vr~ v~A f.lo?~C c~ QcJ~ Tr„o conpue,bn MQ
~ - IMbdowt Stami SM
;/o.N. wm.. wNa . ~n..
y'
:1 chv Fbor
1 Length Wkkh t FI.I Roanllw h WWM INi t
wiroorw.iw oc«.-a.auo uw a. wWao" «w ooo..-awup n,e M.
IM M L1~IN. Y~.
h
ca.r. ecu ca.~. em
Inliltratien Inlikntion
G4o G4r
Eso. wau g, X Exp. %w11
N!t oap. wall NR ocD. well
Inl. wall IM. well
Gilinq i 1
a(o Gilirq
Fba 1 1-2- •J Floor
ToulBtu. Toul Btu.
Fl.~y~ RoomlLw h I WidM Jlp 1NI t FI.I RoomlL A MIid1A /Mi t
- w"Wom ma ooo..-c..i*ao. we w'a~.. «,e ooon.na n?..
Me Wmn w~1 1`1e. N ?Mrl M. • h. 1N. M y~ MMM~ Ih. o1 L;rl h
I 2 y a-
~ Cod. lku
Inlihrstion ;t. 7- IMilUtlion
Gwa Ghs
E¦p. w.u o? E,p. wNi
Nn aao..wu S. Ntt «o. well
-Ing, wsll Im. wNl
CeiiNm 5;L 3 c.il„q
_?b,,, M26 2-1 -3 fkio. -
-Toul Btu. 0 Toul Btu.
F1.11V 2 b oanfLw A MlidtAll•S IMi t FI.I Roanl~ MIfd1A IIM t
' W.wkws aM Ooat-Godcso and A?r WNdowt wd Doat-Craet~ od Arr
_ yn w ' M MI Na M Li~M h. .x. MO. M~ ~tiMh IM. M 1Y~1 h.
Al
07
COW. bu Cow. ay
II~Illifitan „qA
G4.s GVr
Esp. wNl 'S .Z Eta. wdl
Nrt emP. wlll 93 No stP. MII
Int. wall IM. well
Cwilwg / X ( ; 3 Gilirq
ibnr ao7 Fba
foul Nlu. TpN !w.
43,,V9 C~~,~~,e~fed< <o~
1&esll Q;v iv?-k,l~
Tvtcil heftd~- kss
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA150685
Date Issued:07/18/2018
Permit Category:ePermit
Site Address: 4240 Valley Forge Pl
Lot:27 Block: 2 Addition: Northview Meadows
PID:10-52100-02-270
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Includes Skylight
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: 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 J Trautman
4240 Valley Forge Pl
Eagan MN 55123--195
(612) 209-4280
Advantage Construction Inc
18563 Vermillion St
Wyoming MN 55092
(763) 354-8441
Applicant/Permitee: Signature Issued By: Signature