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4259 Valley Forge Pl CITYOFEAGAN 1087)3 3830 Pilot Knob Road, P.O. Box 21-199, Epan, MN 55127 PHONE: 454-8100 eUILDINO PERMIT Receipt ~ To M w~ fer '1 t~1 : i; Esf. Volue E~~ r~';" ' Dote , I 9 R. SiteAddren. VRi,IJ?Y FOltl : ! EreCt Oxupancy Remodel ~ Zoning Lot Block Sec/Sub. Repalr ? Type of Conrt. Psrcel No. Addition ? No. Stories Move ? Length ~ F. Name Demollsh ? Depth _ Addrass Int Impr. ? Sq. Ft. City V"Phone Install O ~ Name APpovob F.•t ~ Addrass Assesunent Permk > ' . i o City Phone Water b Sew. Surcherpe ••uo: ~ Pollu Plan Rsview Z 5~} •5 0; Name .l Fin SAC c :l, GO Address Enp. water Conn .00 OCW Cicy Phone Plonnsr Water Mstsr •fi 0 ~ Countil ROad Unk I hemby acknow0edys that I hove raod this opplicotion ond state fhat g[dg. Off. Tr. PL fF~e information Is torrect and ogree to tomply with oll opplicAble APC Sfah of MinnesoM Statufes and City of En9an Ordinances. Pe~ Var. Date Coples Sipnotum of Pemniftee 7ota1 A Butldlny Pe?mit Is iuued to: on the expross conditb+? ihoo all wo?k shall be done in accordance with oll applicqble Stota of Minnesofo Statufes ond City of Eopon Ordiranus. , BuildinQ Officiol " ~ - - - - , PrrNo. hrmk IioWW Dea TehpAon~ ~ ~urnwno Y 1.~~ ~ ~ ~ c cJ. `~l ~ 6 Y~ I - , - , H.vA.c. e~~ 7 z(o 'O $ yY. ~ aaft..». Irapfttion Dste Insp. OthN FooNnps l Footlnps 11 Foundetlon Fnming Roofiny Rough Plbp. ~ RoWh ~ 6 : I-. L InsuL Flnplaa II Flnal Ntp. Flnal Plbp. r W4T.E12 Aj) c .CdL= . Flnal CWOcc. 3 ~ Co ~ W~~ Daaibe Location: WNI I S~w~r I~ Pr. Disp. _ ~ ~ . I . 1 Ruipt MECHANICALPERMIT PermitNo. C1TY OF EAGAN ' F« I Fi!/ in numberod tpacas ' S/C ~j Type ar Prira /piWy Tot " I 1. Data 2. Inataila,tion Cost ~ ~ ~ 3. Job Addrest Lot 81k. Tract ~ 4. Owner - 5. Contractor Phone 6. Address , 7. City State " Zip 8. Building Type: Residential ~ Commercial 0 Institutional ? 9. Work Deacription: New ~ Add 13 Alter ? Repair ? 10. Describe Fuel TYPe 11. No. Fquipment BTU - M. Es. No. Eauiament CFM Forced Air Air Handlinq: Mf9• Boilers Mech. Exhaust Mfg. ' Unit Heater Mfg• Other Air Cond. ~ AAfp. Gas. Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ardinances and codes governing this type of work. Signed' for Rou¢+ Final Inapections: Date Insp. Date Inap. This is your permit when numbered and approved. Approved C1TY OF EAGAN 484-6100 _ i ~ PWMBING PERMIT Permit Na Repipt - CITY OF EAGAN , Fes fili in numbered spaces S/C /J Type oi Prinf JegiWy Tot. -=~e- 1. Date 2. Installation Cost 3. Job Address LotBlk. _4 Tract 4. Owner t ~ 5. Contractor ~ Phone • - , r 6. Address ` • ` ~ ' 7. City State Zip _ 8. Building Type: Residential ~ Commercial O Institutional ? 9. Work Description: New El Add ? Alter ? Repair ? 10. Describe 11. No. Fixtures No. Fixtures Water Closet Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner Shower Well ' Kitchen Sink Urinal/Bidet Other ' Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. 1 hereby canify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rouqh final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454$100 CITY OF EAGAN Remarks Addition NORTHI/IEW MEADOWS Lat 11 glk 4 Pefoei 99-52100-110-fy OAA Owner Street _ State EAGAN MN 55123 4259 VALLEY FORGE pj,4ZE IOQJ Improvement Date Amount Annual Years Payment Receipt Dete STREET SURF. .(O 7.68 1 , 7 D/ be -76 STREET RESTOR. GRADING 15.89 .79 20 O/ (0 7 ' SAN SEW TRUNK 515 1$1 138.48 6.92 ZO / li . lO O/~v~ 74 SEWER LATERAL [9L 27$ z2 ~15 a O.,,Z D /~}d (p '7 ? 22.28 i.+a +-.ft "Is 14 o ~ 7 4Q--.7-4k. WATERMAIN 'gql 1984 70.67 4.71 1$ ~ R-V /G 6 7& / -.2 49- WATER LATERAL 1981 18.65 .Z4' -'95 tvIS IA ~z~ -ju WATER AREA S 1981 13$.4$ 6.92 20 (r •f 6 O 166 -y 2 1982 29.52 0-1 1-. 4,6 20 a~• 70 #,9-0 / 6 G y,S' STORM SEW TRK 1984 392 . 32 761649-.Q3 -74 R 10 /6 G 4 STORM SEW LAT DRAINAGE I 1984 33 . 9 7 3T40~ 10 . p p/ ~ CURB & GUTTER SIDEWALK STREET LIGHT F . BUILDING PER, SAC 25-00 PARK INSPECTION RECORD ~ CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: ' Eagan, Minnesota 55122-1897 Date Issued: ~ - ~ ~ ' ' • (612) 681-4675 SITE ADDRESS: 1 f, 1. 1,,1 , APPLICANT: .'M 1 FY F(tF?fil f,i r;i t I , MI IiI, iII I Iqtil " .f 1~ I Idi+i' 1 iI'.fI I f! f+ll 111 tN.J'. 1e.o 1. I PERMIT SUBTYPE: TYPE OF WORK: a t; r t'n tR INSPECTION • rA ~ ~ 1 Psrmlt No. PormR Holder Dabs Tilephorn # i ELECTRIC ~I I PLUMBING HVAC InspacUon Dib Insp. h Commmnts FOOTtNGS FOUNO FRAMING ROOFING ROUGH PLUMBING F'l8G AIR TEST ROU('H HEATING GAS SVC 1'EST INSUL GYPBOARD FlREPLACE FlREPLACE ~ AIR TEST FINAL PLBCi FlNAL FfT'G ORSAT I TEST BIDG FINAL I BSART R.I. BSMT FINAL DECK FT(3 DEqC FlNAL I I J CITY OF EAGAN WpTU SERVICE PERNIIT ' 3830 Pilot Knob Rosd i P. d' Box 21199 PERMIT NO.: EsWn. MN 5,9121 . • - DIITE:' - • - ~ - _ ~ ~ ~ z°'^i^D fVa. of Uniti: . Owrwr, Addnu: i Add,.m 42! ,^JoVl '~a ~h i bws ' Plumber. • s ;~lec. ~8' ] - ~ 1 l-, ~ ~ Mmw No.: ~ 36 l ..16 0 r,,........l.,., r-~....,.._. 500. 0 Jtxt: . Siu: z " Aooount Deposit: • P Reoder No.: ~~/1'J SI 9 c! Permlt Fes: P i 1sMM Hown* ri1b ty CNp of sopm 5urcharge; • P Mi,c. Chorpm 1 32. i10o;: ToTOi: 63 - ' Doh PoM: - of Irqp.: Insp.: ~ T D Z 5 8 5` CITY OF EAQAN SEWN SmVm PEmff 3830 Pilot Knob Rosd P. O. 9ox 21189 PERMIT NO.: Epan, MN 55121 p,,TE: Zani 1 ~ No. of Unlts: A Owrnr. ~,uY'x Odk ~}1 i t;i . Ilddross: Shr Addnss: 4259 Val I eY F3z`q-- L I.t 114 i--, ,<~x~r • - Plunber. ' I owm h«.Nr wkh er. aer .r ie@" Conn.djon CJ,ap.; 4 2 5. D O;x: ~NAOM. AOC01N'It Depait, S` ~i ~ s Pome FYf: 8 $Yf'Cf~pfa: ` - Y MhC. dIC/Q!{; Dotr of Irop.: Total: ; Dotr PWd: CITY OF EAGAN nf ° 10 8 5 3 3830 Pilot Knob Road, P.O. Bo: 21•199, Eagan, MN 55121 PHONE: 4548100 J BUILDING ~ J/~ PERMIT ReceiPr # Te M uwd fer SF DWG/GAR Est. Value $62,000 pate AUGUST 22 1985 Site Addreu ' 4259 VALLEY FORGE Erect ~ Occupancy 11 4 NORTHVIEW MEADSRemodet ? 2oning Lot Block Sec/Sub. Repair ? Type of Const. V Vercello. Addition ? No. Stories SURR OAK BLDRS INC Move ? Lenyth 38 Nme Demolish ? Depth 46 z Address 11461 GOLDENROD ST Inl lmPC ? Sq Ft ~ Crcy COON RAPIDSphone 757-8157 instau ? °C SAME AvDrorals Feet o Neme =u Addresa Assessment permit 00 o u~ cit~ Phone H'ater 8 Sew. Surcharge 31 . 00 Police Plan Raview 159.50 CW Neme CRADIT & ASSOC Fire SnC 525.00 `-z 63.00 x~ Address Enp. WaterConrL ~Z CitY MPLS phone Plonner WaterMeter 280•00 t"' Council RoadUnit 132.00 I hereby ockrwwledge tfaf I have read this opplication and stote fhat Bldg. Off. $ 19/85 Tr. PI. tho inlormation is correct and agree to camply with oll opplicoble APC State o4 Minnewla Sta u e nd rty of Eogan Ordirances. Parks Q var. Date Coples ~_50 $i nofure of Permittee A Building Permil Is iss o: BURR OAK BLDRS INC Totel on the exDrcss cordition thai oll work :holl be done in occordonce wirh all oDDli e Stnte of qlnnew Slptutes ond City of Eoqan Ordinonces. 8ulldirp Oflldol SEDGWICK HEATING & AIR CONDITIONING CO. r+eanNC JOBNO 5~~6 8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000 TEST RECORD &4 AODRESS I "I+ 7 "~~'~7 1 v'~-VV ~L CITV OCCUPANT OWNER IRDn1 - M?4R~f J p / V/ VCSJC~ ~l SOLD BY INSTALLED BV 45~4 ±J-L/~l4:H:: MAKE Le' ' MODEL fApV3 (oCSd?lD SERIAL NO. QWM-3 INPU7 ~bD2L, , THERMOSTAT N-Z ?'~v NTSIZE VALVE D ~~f}yPEOFLINER C`~t,SS B LIMIT ~~e• MAY 0 2 2007 LINER S2E LIMIT SETTING FILTERS: SIZE 6k2>Ir NUMBER ~ZLkYL FAN SETTING WIRING SW w?~ "1, PILOT TVPE TEST TAG IGNITION MODEI 4-:~i LIGHTING INST. ? PILOTTIMING ~H~ A= Cti ~ DATETESTED PRESSURE PERCENT COz INPUTCFH PERCEN70z ks COMPANYTESTING STACK TEMP. PERCENT CO ~ NAME OF TESTER • FOqM2]5(REVll/89) FORMDISTRIBUTIONWHITECAPY.JOBFILE YELLOWCOPV - CITV . . ' ~ /C/53 1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS MUST BE LICENSED ifITN THE CITY OF EAGAN INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCOLATIONS T(o2,f7CJb. !2 To Be Used For: Snc;fle~~,.i, Valuation: y~sBO~ Date: $ ~ Site Address: OFFICE USE ONLY iKFJowS Lot: If Block ~ Sect/Sub /1(arErect x pecupancy (Z-Oj Remodel Zoning (Z-I Parcel ll Repair _ Type of Const 'SL Addition I1 of Stories Owner M,% ynctprMove _ Length 3s Demolish Depth 4ln Address Int.Impr, Sq Ft n Install City/Zip Code 1Nrr"jPzSlej2, Al h. r Phone APPROVALS FEES Contractor b?kO Assessments Permit 3 lot. Water/Sewer Surcharge 31 Address police Plan Review 159.S-° 1 Fire SAC E52-S. City/Zip Code Engr Water Conn 150t~" Planner Water Meter Phone '74~T)- 5-'15 ~ Council Road Unit J Bldg Off Treatment Pl 132.= Arch,/Engr. ~ra~, .7'yl A-'60c, APC Parks Variance Copies Address A ?er TOTAL ,~200 y~ Cj L City/Zip Code -T Phone I! 24x 3~: & 4 K 5 ¢ ~ a( q~ y J 4 ` Z I co 0 ~K ~l -,~Q6 North 7~$~NOhwlsy No. 571 DUQUROAN I M 65 Naf o . 'r ~ NUINYt1~IN~ I lpOM~. M~NMWI~ S~~J1 ~ .~~I~ ' I BWIIWYI . I(~ sooin oino.. esaeaio ' lClvil. A/umciPul tl f.ncvunrnrnia! f'nxinrrnnK 12750 Rrvn Rmye B,rd r~~ land5w~~n~mX'IunJYlunnmy.SuJl'nunx ~.Mimtfo4S5]JI LJ i , - Cewii.°cco& Wqurv~V ror Alarlhtliow Agooc. „ . . •Pi+' .I I _ YoRKYoww . PLACe . . - . 0. S 8905 2 I I" E 120.00 Ai ~ ro Z I ; . m Z o. • - - Ao[ d QTiLiTY ' ~SEMEelT lo , IO I . pe 0 0 -4 I " M I • ~ '•ti: ,4. rn :r. 03 , O I ~if+ O ~ . . . , "f:~,.;. :'t ~ O 6L ;<tv' ~t'm:nl~v~l ~ .If J I m V ~ V1 5 ~ F{ 7i F F d 9.. f~-FF, Jio ,v~ 3O . • . ~ S 09° 52' 11" E 120. oo' ; . . . . . . . . . . . . . - - :,r~~~, : ;:i; • ~ , . i'' ~;I:,.. Y~' .:1 . V. ' , ' ~'~j`i k ~'~C 30 Lvr sc.ocg A1o,e7w,~~1,:"w l4,6aOoW,0, ,~~'a~,~ ~'OU~~Y, ~i~vVE;orq . Approved for Morthview Associates at per Architectural Control Couittee by ~ • ~ 1 herebt cartify that thii wrroy. Olan er repart ras.prePared br as or rnder ey dif-at wpsrvisioo and that 1as a duly`NopittvN land Surreyor uader tM Lws of tb• Staj$ of [eaqott. ~ Dated tliii ~46y of Or GsrY p. N rrls, Aeglstars/ Lu1 irrvelor Me. 10943 ? Q `i ,.i 3794947 . . k~ L7L'Q$ a OSwcbtDfl. II1C. ~ :l'~.;f';j' . ~ t M e 4eNr n~ mW., nim. ~ W u 1J e A ~t. 'e tlY 'li~,. .crcn!bCturaldatAprar6ol0u1nL~ ne~4 , . ' , EXTe-AZOR EtNGLOPE AVERAGE pi1" CCL'dPOTATION owsm PIJLa Voe ~3 03 OG• r j li SITG ADDRESS DATZ MA~~ f i I9p7~ • ; ' COHTItACTOR PA f~-R Dr'iL PJtJIL-UC.R`7 ' PfiQHE Datarmine iaoricing 'square footngo of eaoh ' 1. Total axposed wnll AP813.....b4.ft. xA='~''~ 2. Total roof/coiling arou.,.. sq.ft. x~~rs`} 3. Total f].oor/cant, area>,..... n4•ft• z~_ 'i ';r . ~ ; ~ Q Total exposed wall area abovo floor 151 ~I. o ' I19, • i ' 8• TO'f81:w8ll windOL1 8T'08.......eo....... D ' ~ ~ 17. Total door LiPOA...eeeee. e.e.e.... e........ao• ~ c. Total slidin3 glass door aroa.o...a.....o.... d. Total fireplaca cJall aroa.........aeseo..o.ae q e, Total wall frm]ng eroa (average 10%),,..avoo >>d ; fe Total not G1311 IIPO3 LtJ074 flOOPeoeaoo.a. os-ae ~ . . ~ ~f.raiC7 } f: ge Total rim j01.9~. 8P01oo..e......o.e...ae..... t Lp ~ ' Total exposed foundation area tl• Total foum3u'tioza orindrna aT90soeee~•eeee~eoeoe ; ,i. 1, Total not foun3atlon area abovo grade ~ k' llatercdne "II" value of each wall segment ~A' x4i; a. R arQn G7 i bo x "Ua , y b v a, D, 7C aU~° a i de X roIIn c . . e e g „Q" P. y`~0 7C apn ge x °II" ~ ho x eaQn z 7C nUn i 4. Totab ;r If item #4 is the same as, or less than item f1, you have met 4J the intent oP S13C 6006(o)2. <,fo~ , . . . - . : ~C:' : i . _ i~?,~e~~ tA t.'. . . . . ,.J . . c.~. t 'ti: ~.e.aR's......~...u..AI: _<.VC . r~'~~ i': ~~:~,,,~°`r'cI`~ <--E=i~-ma,{`.~ • , F,t~..y.~~• Total exposed roof/ceiling arou , , Total ekylight uras Total rocf/coiling f1•r<ning arers (avor. (>10516"o/c), (.062y914"o/c)... le Total not insulut@CI roof/cailing area................. e ~ . ~I Dotermino "U" value far each roof/ceiling sagment u~a = J. X ko Gr /rJ x ::U" -'.v ~ 1^_~.~G, ~j g Uv -c~: 5 . •e..e..eeeoe.ao..eeaas~aeaaseseesa~eooee~~~~~sa~• TOta1 If total of $5 is tho same as, or less than #29 you have mot the ' intent of S3C 6006(c)i, Tetal ezposod floor/cant. aroa , m. Total floor/cant. frraming area (uvorrage .10%) o~ fl• ToCaI r.et insulL•ed £loor/CSRte 81°06ooeoaoeoeeeeeeesoeoo . : z~ , t IIetercatne "U" valve for sach floor/cant. segment 1~- jA p~ a X ~ 11 B n. x , • P x: 6. ...•.....11•...,•0...•...e0...•..•.O..•.•.•..... Total 1 If total of 1~6 is the an.Yne as, or less than ¢39 you hmvo met tha ? ~intont of SBC 6006("c)3, ' LL AI.TL3tNATL BUIIAING ENVELOPE DESIGN ~I " To utilize the total envolapo system method9 the nalues estmblishod I by the sum of items ~41 '~5 and '~`b shall ~ be greater than the sum of iter3s #1, 02 and'$3o 2• 15,~,`1 3. J I n (~~iOL Y 7~ Ya S> O• i~.~. Proparod by • D8te 5:; . Y.~ . r-. . , ~.i ~A{. ~ ~V ' 1..':..! . .r 9 ?UD Int. Air e69 '1HiII ZNS. blAI.L Int: Gir e68 S.R. & SIDINO 1/2^ S.R. ,45 v/ 3Ro & SIDIPdG 1/20 S.R. ,45 . , (,.bb Ci p Ins. 19v { 25/32^ Bild. 2,06 ~ 25/320 Bild. 2.06 Jiding tU~ V gJf.1ing I1O I T ,4.'•, . ii, X I~f 6 ~ Ext.s L!12' el'f ~ E7'.to I,lI' .17 k u . Tottsl "'R" _ Totnl nRn = Q--~? . ' l/g = aQn _ , OG1~ 1/R = "lJ°" _ •04'~j `1; r: L ~ , - - ~y THRU R7M Int. Air .68 I THP.O CONC' HIRCS Int. Air o68 f i : JOIaT Ins. C.B. (12 n) I•Z~5 - ; Opt, Styro. Opt. Ins. "7,c-~ ~ ~ i i /2,1 Wood 1,II9 ~ Exto lt11' .17 ~ , . ra 25/32" Bildo 2,06 e. opt. S.R. _ . ~ II; I v~~ (c~ G, ~a S~e L3:t. Air ,17 , Totnl "R" _ r; Opt. Srick ~ 1/R"um _ ,I1 , I s ; Total pRn = 24 ofl ~ ` 1 /R = "A" _ I. ~ : THRU riLGs II'lte ~'ai3' • a61 ' THRQ CiLG• ZIlte AiT e01 MDMraR S.R. nvscrLnTaox S.R. cig. Memb. Ins. ( q,?D,o ' ; U'S. st111 air n li Still Air ..61 ~ Total "R" ; Total 'R" = 4'I I" J 1/g c v0" o ,(7`li • I j'• 1/R _ ieIIp = ,D~-- t e a; i . . ' i.. PERMIT C.12o~70~~ CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 0 2 6 2 5 6 (612) 681-4675 Date Issued: 0 8/ 18 / 9 5 SITE ADDRESS: 4259 VALLEY FORGE PL LOT: 11 BIOCK: 4 NORTHVIEW MEADOWS P.I.N.: 10-52100-110-04 DESCRIPTION: Building Permit Type FIREPLACE Building Work Type REPAIR REMARKS: FEE SUMMARY: Base Fee $25.00 Surcharge $.50 Total Fee $25.50 CONTRACTOR: - Applicant - ST. LIC. OWNER: VALLEY METRO CHIMNEY SPEC 14601233 00003810 KOLTUN JANIS P 0 BOX 240295 4259 VAILEY FORGE PL APPLE VALLEY MN 55124 EA6AN MN (612) 460-1233 (612)452-2449 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State ofi Mn. Statutes and City of Eagan Ordinances. /e/ (l_.P u~ APPLICANT/PERMITEE SIGNA7URE ISSUE Y: SIGNATURE _ CITY OF EAGAN ~ S Sj 3830 PILOT KNOB RD - 55122 1995 FIREPLACE PERMIT APPLICATION 681-4675 DATE: DESCRIPTION OF WORK: _ INSTALL N.lp( FIREPLACE: _ WOOD BURNING _ GAS _ INSTALL GAS LOG ONLY IN EXISTING FIREPLACE _ INSTALL GAS LINE ONLY IN EXISTING FIREPLACE OTHER: /LEPiR12JAJL 14 0 5ordRy ~LI~jDl~t:4/.AMRbvD CLAy - F~L uEr~LF,S #l~OStA~..L~Nb "V~lv7'lniDX S7q)NLP'.53.Ft~ L~,v1~/6 AREA TO BE INSTALLED IN: SYSTSWI (u.t-• LS7eD 9AD02"O STREETADDRESS: 42SY ALLEv)6'y2te,PLAr.E LOT ~ BLOCK ~ SUBD./P.I.D. AbL'0~ APPLICANT: (circle one only) OWNER CONTRACTOR I hereby acknowledge that I have read this appiication and state that the information is correct and agree to comply with ail appticable State of Minnesota Statutes and City of Eagan Ordinances. da~,-ropi 14RRIAN~,l605 Phone#: 452 -244`I PROPERTY Name: OWNER Signature: Street Address- VAL'L'~ k646E PGACI", City: State: M^J Zip: FIREPLACE Company: ALL~yfV'~1'2D('}liMAPC'`l SF~L, phone#: -460-1233 INSTALLER Signature: klil-m J Street Address: P D, 6ax 240295 License 3B1D 3~3~I City: f)PPI.r.Vfl LLEY State: M0 Zip. S5{Z4 GAS LINE Company: Phone INSTALLER Name: Signature: Street Address- City: State: Zip: OFFICE USE ONLY BUILDING PERMIT TYPE ? 14 Fireplace WORK TYPE 0 31 New o 33 Atterations ? 32 Addition o 34 Repair GENERAL INFORMATION Census Code. SAC Code REMARKS: Chimney/flue must be inspected before concealing. FEES Pertnit Fee Surcharge Other Copies Total: I Zblo 2000 BUILDING PERMIT APPLICATION (RESIDENTIA ) CITY OF EAGAN 3830 PILOT NNOB RD - 55122 651-681-4875 New CoruhucHon Reaulremenh ~ 1-6 Remodel/Reoalr Reaulremenh > 3 reqlatered sIfe wrveys thowMO fq. % ot bf, sq. N. of hane 2 coPlen ol plan and g0 roofeC areas (20% rtwxlmum Iot coveraae albwetl) 1 eat ol eneryy calcWaHOns (a treatsd additlons > 2 coples of plans (ahow beam & wlntlow slzes; poured fnd. deslyn: etc.) 1 sife wney for exleAOr admNOns # Uecka > 1 set of eneryy cdculafloru > J coples W hee preservaHOn plan If lot platletl after 7/1/93 DATE: CO rl* DESCRIPTION Of WORK: STREETADDRESS: LOT: BLOCK: ? RSUBD. P.I. . S: VTIO LVt)rlhv;PVV Anendovr(c Name: A Az Lf\,-~ Phone o „~/,,~~'68 iL2U PROPERTY Wst First OWNER Sheef Address: f/ q ZlT~-~ ~~C1 Cp City Z~g_/i~o Stafe: 4Y1 t-,/ Zip: Company: SELA ROOFING & REMODELING, INC. phone q: ~ v U y 4100 (area code) COMRACTOR ST. LOUIS PARK~ N 55416 S~ Sa'3/ Sheet Address: ~ 00001009 License a F~tp. City State: 2ip: ARCHITECT/ ENGINEER Company: Name: Telephone ( ) Sheet Address: Reglshaflon tY: City State: Zip: Sewer/water licensed plumber (if Installina sewer/waterPhone L I hereby acknowledye fhat I have read this applicaNon, state fhat Me (Mortnation one 7onda ree to eomply with aU applicable State of Minnesota Statutes and CMy of Eapan 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 SUBTYPES ? 01 Foundation ? 07 OSplex ? 13 16-plex O 21 Porch (3-sea.) ? 31 Ext. Att - Mutti ? 02 SF Dwelling ? 08 06-plex ? 17 Garage 0 22 Porch/Addn. (4-sea.) ? 33 Ext. AR - SF ? 03 01 of _ plex ? 09 07-plex ? 18 Deck ? 23 Porch (screened) ? 36 MuRi ? 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage ? 05 03-plex ? 11 10-plex Plbg _Vor_N O 25 Miscellaneous ? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bidg. WORK TYPE ? 31 New ? 36 Move Bldg. ? 43 Reroof ? 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding ? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair ? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors • Give PCA handout to applicant for demolition permit GENERAL INFORMATION SAC Code # of Stories sq. ft. No. of Gnits Length sq. ft. No. of Buiidings Width Footprint sq. ft. Const. (Actual) Basement sq. ft. Census Code (Allowable) Main level sq. ft. MC/ES System UBC Occupancy sq. ft. City Water Zoning sq. ft. Booster Pump PRV Fire Sprinklered MISCELLANEOUS INSPECTIONS ? Stucco/Stone APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Ptan 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 , , ~ • ~ ~ • i i~• • u n 4Em •71• • • • •bi a • • iwwo) • 7~~ 1 11 71 • • : • CITY OF EAGAN APPLICATION FOR PERMIT SEWER ADID/OR WATII2 CONNECPION (Please Pr1nt) 1) PROPERTY ADDRFSS: ~ /l / c T.FY;AT DFSCRiPTIori: ~ w'~' b~c (Lot Block Subdivision or Tax Parcel I.D. Number) IF EXISTING STRI;CT[.'RE, DATE OF ORIGINAI, B[JILDING PFS2N1iT ISSUANCE: (Mbnth Year) PRESENT ZONING/PROPOSID L'SE: R-1 SINGLE FAMILY . R-2 DOPLEX (T%vo Units) R-3 'IOWDIHOL'SE (Three + Units) ( Units) R-4 APARTMENP/CODIDOMINICM ( Dnits) COMME2CIAL/RETAIL/OFFICE IPIDLSTRIAL INSTI'IL TIONAL/GOVE.RAAIENT 2) ~ / ~-I NAME: J h .5 G/l !f !S /17 Y e ~ ADDRESS: S``~ /!5'7 TTh Ak, c N: w.Uw d/lA CITY, STATE, ZIP: P9; r N 3 5-34 3 PHONE: i'-5- 3 -3 :2c~ 3) i: [ f For City Cse N~ : 4-,&-? ~ f S/! C uPlumbers License ADDitESS: 33 S`~ Th Fi-c y~w ~tive CITY, STATE, ZIP: '09a, a/! NN S C~ 30 3 ?~i / ired PHONE : rJ.~'3 37 C G LICENSE # pp 3?O„^ I ~ ft Reorc f Sta f Initial i ~ • i~• 4) NAME: Qv/Z~ da.f' ~u;~L7crrc <6 rwDxFSS: 111173 ~o4C.N AeQ W. CITY, STATE, ZIP: dlOa ±,{s ni s s~/ 3 3 PHONE: 73'7 - ~/S7 5) i~ « •a~• • • 10 CONNECTION TO CITY SEWER R1 CONNDCTION 'Ib CITY WATII2 Q OTHEEt (Please Describe) 6) u • • i ~ PLEASE HOLD APPROVID PFT2MIT FOR PICK-UP BY ONE OF AEOVE PI,EASE MAIL ARPROVID PERNLiT 'IC) 1, 2, 3, 4, ABOVE (Circle one) 7) ~ /O S) J- F 0 R C I T Y U S E O N L y y PE2MIT ISSUED rrr.s: $ SEWc.°. °ER]+.rT IINC,T.;DL .JUP.Ct';~RGGJ $ ~ (L' WATEiZ PERPtrT (ITICiuDc Sii?CHArZG'a) $ ~ ~ cG WrITER METER/COPPE4HORIV/OUTSIDE REe,DER $ WATER TAP ( INCL[.'DE CORPORATION STOP ) $ SE;vER T.a? / S LO =r'~^,-••-•P ~r.c-._. ~ $ ~ l._:. 1_ - : ' $ /~uu ACCOUNT D.F,p(1SIT - Wr`,TE3 $ WAC $ SP.C $ TRU?1K WATER ASScSS:!E:iT $ TRuNK SEYiER :ySSESSbLNiT $ LATER;`,L BEi1EFIT/TRU`:K SEt:~R $ LaTE;2t\L BEVEFIT/TRUNiC I•IATrR $ WATER TREATMENT PLANT SURCHARGE $ OTHER: $ TOTAL c ~ AMOL'NT PAID; QEC°IPT DOES UTZLITY CONNECTION REQUIP.E EXC?.VATION IN PUBLIC RIGiiT OF WAy? YES IF YES, THEN n"PERb]IT FOR :dORK WITHZN PUBLIC ROADWAY" MUST BE ZSSUED BY THE ~ NO ENGINEERIrIG DIVISION. LIST AS A CONDI- TION. SGEJECT TO THE FOLLO:•7ING CONDITIONS: ~ APPROVED BY: ` TI:LE: t ~ DAT°: //S / \ : 612 822 5408 01/30/20 OS WE015:10 PAX $12 822 $608 A1'Q M6btOY plumbimq m001/001 . . : . C.' of EakaIl ~ ,3,530 Pllot Knob Road ereC)'~ Q~rd~ I Pertnit Fee: i ~ EdganMN55122 r / 1 DateReceived: Plione: (651) 675-5675 (,:w - 4/.D8sl Fax:-(651)675-5694 Lstarr:_7- -i ,~;.,,u.o- . 2008 RESIDENTIAL PLUMBING PERMIT.APPLICATION . Date: Site Address: ' 5/ Tensnl; $uite RESIDEMT'/'OWNER Name: Rcs-n 1- e-h Y'rjCS!^, Phon ~ 6Q1P- J Y70 1 Adtlress / City / Zip: tTeZc~/G ~qe T( Q(',~G CONT,RqCTOR Name!"ie ii" Y -~7X V~~.K License#03 dOI / M . ' Atldress: ~ 54 3 ~ S't' ~ iia.•.. Ciry:State:A4/V Zip:75~~ Phone.C9~ 93/ - 9~7~ Contact Person: TYPE 4'FWORK _ New _ Replacemont, _ Repaif _ Rebuiltl _ Nbtlify Space _ Work in R.O.W. ' y ~Descrlptlonofwork: PERMI;riYPE RESlDENTIAL Water Heater _ Water Softener ^-:i~:.,,• ; LawnlrrigaGOn AdtlPlumbingFixtures RPZ / _ PVB) ~ Main _ Lower Level) Septic System _ Water Turnaround New . _ . , _ Abendonment RESIDEI11714L FEES: $50.50 MiWmum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) . ; $30.50 LBiv.fi Irfig82ioTt (includes $.50 State Surcharge) $50.50 Atld: RJumbing Fixtures, Septic System Abandonment, Water Tumaround` (indudes $.50 State Surcharge) 'Wate(Turnaround (add S136.00 if a 5/8' meter is requlretl) . $100.50 S2ptic Sy518m New ($10.00 per as built) (includes Counry fee and $.50 State Surchange) $90.50 FiCARepail' (replace bumed out'appliances, duclwork, etc.) (includes $.50 State Svrcharge) " ' • TOTAL FEES $ I hereby acknpWletlpe fhat thm infortnalion is canplete and accurate; that ihe work will be in confOrcnanCe wHh the ordinance5 and codes ot the City of Eagan; 1haC~l.~ypderslantl this is not a pertnii, but only an appllwtlon fa a permlt, a oAc is not to s[~lqfhout d permll; Nat Ihe work will be in ac tl nc~ ~iRh"ikie apprplan In the case of work whlcb requlres a revlew antl a o M. x ~ X. ApplicanYsRrihted, Neme AppliCant's Slgnature n ?FO$lOF.F CE: ~~~~iY.~•~t:~;;'i:i'`~!~,i?;,jyY'~i r~ i,""~'~,':?.~1ta "N~'',~ . ~~Y1F1ul b ~~,r ~F~. ~i' .,TJ.`.~>%~:", y 1 Z~t'',~"~,tis,n"''~s7:'~A;" ~ ,,..l~~~,•w~i1r'~a~ { ' %R guiCeJ• L~ ~ng'~~' ull ~r~y/ ~~J ~1 z ~r, f.^7eg ~y . [..:F:~.:~`,•Si..: r'.~~Y.'r.'rrC~u:Lt.el•~x,~l~uWffi~rns:~vij.i.m. °i::~r~?.G~S~14 H.m ?r. SiYSw.i. A i •r.N~.~sc . , . . ~ - - - - - - - - - - - - - - - - - I For Office Use Permit City of Ea ft~li I Permit Fee: 3830 Pilot Knob Road I Eagan MN 55122 Date Received: 1` 15 Phone: (651) 675-5675 I ` Fax: (651) 675-5694 Staff: 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: L Tenant: Suite 147 e- Y-t RESIDENT/ OWNER Name: 2 -r\ G Phone: 9sa~n.ga5_ 31y S.' Address/City/Zip: s9 _L e) rf'1_ 5 S1 2a Applicant is: Owner Contractor TYPE OF WORK Description of work: 54, e7 Construction Cost: I ' Multi-Family Building: (Yes / No Z3 CONTRACTOR Name: License Address: City: State: Zip: Phone: Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted submission type) Energy Envelop Calcul ins Submitted In the last 12 months, has the City Eagan iss ed a e t for a similar plan based on a master plan? Yes _LNo if yes, date and ress of ma ter pl Licensed Plumber: FPhone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. 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 wor of to start wo a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approv of plan X I), X Applica 's Printed Name Applican s ignature Page 1 of 3 City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4259 Valley Forge P1 Lot: 11 Block: 4 Addition: Northview Meadows PID:10- 52100- 110 -04 Use: Description: Sub Type: e - Fumace & Air Conditioner Work Type: Replacement Description: Fumace & Air Conditioner Comments: Questions regarding electrical perm 952- 445 -2840. Fee Summary: Contractor: Sedgwick Heating & Air 8910 Wentworth Ave S Minneapolis MN 55420 (952) 881 -7739 ME - Permit Fee (Replacements) Surcharge -Fixed Total: Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - equirements should be directed to Mark Anderson, State Electrical Inspector, $50.00 0801.4088 Owner: Ronald G Peteson 4259 Valley Forge P1 Eagan MN 55123 $50.50 Permit Type: Permit Number: Date Issued: Permit Category: $0.50 9001.2195 I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Issued By: Signature Mechanical EA077385 04/19/2007 ePermit PERMIT City of Eagan Permit Type:Building Permit Number:EA115315 Date Issued:09/25/2013 Permit Category:ePermit Site Address: 4259 Valley Forge Pl Lot:11 Block: 4 Addition: Northview Meadows PID:10-52100-04-110 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes . Audrey Flattum 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 - Ronald G Peteson 4259 Valley Forge Pl Eagan MN 55123 (651) 484-5470 Storm Guard Restoration 1355 Geneva Avenue North, Suite 201 Oakdale MN 55128 (651) 738-1698 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA130583 Date Issued:05/01/2015 Permit Category:ePermit Site Address: 4259 Valley Forge Pl Lot:11 Block: 4 Addition: Northview Meadows PID:10-52100-04-110 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 500.00 Fee Summary:BL - Base Fee $500 $40.00 0801.4085 Surcharge - Based on Valuation $500 $0.50 9001.2195 $40.50 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 - Ronald G Peteson 4259 Valley Forge Pl Eagan MN 55123 (612) 209-7365 Wellington Home Improvement 3938 Meadowbrook Rd St. Louis Park MN 55426 (952) 933-6300 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA157546 Date Issued:08/26/2019 Permit Category:ePermit Site Address: 4259 Valley Forge Pl Lot:11 Block: 4 Addition: Northview Meadows PID:10-52100-04-110 Use: Description: Sub Type:Fireplace Work Type:Gas Insert 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 - Ronald G Peterson 4259 Valley Forge Pl Eagan MN 55123 (612) 209-7365 The Fireplace Guys Llc 680 Hale Ave N #110 Oakdale MN 55128 (612) 326-1919 Applicant/Permitee: Signature Issued By: Signature