4279 Valley Forge Pl
CITY OF EAGAN WATER SERVICE PERNUT '
3830 Pilot ::ndb Road 5382
~
P. O. Box 21199 PERMIT NQ.:
Eagan, WV 55121 DATE: 4-6-84
Zoninp; R1 Na, of Unlts: i I
Ke Lan K ~
Owner.
Adlresa:
t~ress; R~44~ 79 Val_ley ,~tQ,~ ce L16 L4 Northview Meadow
Pi r: ~t~cg~T i
No.: ~ ~ J nection Chorye: 450.00 pd '
Stze: `1REG"-,aF'E-E r D--v- ri-AWnt Deposlt: 15 . 00 p d I
Reoder No.: T;z 4 .Ij TLzi, / Permit Fee: 10. 00 pd
I Nne !o oomoyr wM 11w Cihr ef Eegar Surcharge: .50 pd
Ordinaeor. ~ Miac. Charyes: 63. 00 P Teter
~ Totoi:
BY g V Date Paid: ~
Dote of Insp.: Intp,; I
i
CITY OF FAGAN SEWER SERVICE PERMIT ~
3830 Pilotl.nob Road I
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE: 4- " 4
Zoninp: I'l1 No. of Units: 1
p„r1ef; Kev I.and flomes
Addrcss: ~i
Stte Address: 4279 Valley Forste Place L15 ?4 NortiiviQi+ Xeadowe
Plumber. DC MeChA111C81 i
3-14-84 ~fI993 ' p
I pns te eo~nrhr wNl~ !b Cihr ef Eysn Conrwctton Chanas: 425.00 pd I
O~rdismnoN. Account Deposit: 15.00 pd
Psrmk Fee: Q' pd '
Su?therye: . 5 G n d I
By Miac. Charpas: I
Date of Insp.: Total: ,
1 nsp.: Doh Paid: i
- - i
I
I
I
CiTY OF EAGAN
3830 PNot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt M ~
._rob.us.aro? FIRCPLACE Est.Vaiue $2.000 pate NOVEMBER 21 19 85
4279 VALLEY FORGE PL
Site AddreaBlock Erect ? Occupancy
ot 16$ 4 Sec/Sub. NORTHVIEW MEAU%emodel ? Zonina
L
Parcel No. Repair ? Type of Const
Addition ? No. Stories
Name •TEFFRFY S. ANDERSON Move ? Length
Demoliah ? Depth
o Address S Int Impr. ? Sq. Ft
City Phone 452-6887 Install 13X
Name KFYLAND HOMES Approvals F«s
s
Address Assessment Permit
ciry Pnone 4 9 -654 6 Water 8 Sew. Surcharge i.UU
Police Plan Review
~ W Name Fire SAC
~ n Address Eng. Water Conn.
W City Phone Planner Water Meter
~oad Unit
I hereby acknowledge that I have read this application and state that the Council gldg. Off~~ r. PI.
intormation is correct and agree to comply with all applicable State of
Parks
Minnesota Statutes and v~y E~a~g~li~O~dinencea. Var. APC Date Copi
Signature of Permittee TOtAl $33.
A Building Permit is issued t:1J~ J JEFFREY S. ANDERSON on the express conditlon thet
ell work shall be done in accordance with all applicable State of Minnesota Statutes and City ot Eagan Ordinances.
Building Official _ ~ ` '
~
~
o ~
~
:
I LU
• " CITY OF EAGAN NO 88g~
3830 Pilot Knob Road, P.O. Box 21•199, Eapn, MN 55121 ?
PHONE: 4548100
RUILDING 'ERMIT Receipt
Te w wwd fe• SF Mn;'GAR Est. volue 50,000 Dore MARCH 15 , 19 84
4279 VALLEY FORG~ pLrC3, R3
Slte Address Erett Occuponq
Lot 1() elock 4 s.c/sub. NORTHV IE" .T4EADSAIter p Zoni~y Rl
Percel No. 17-52100-160-04 Repoir ? Firo Z«+• N A
Eniorfle O TYpe of Const. V
oc Name KEY-LAI1D HOMES move p # Srories
~ Addrfts 3471 W. 17 3 RD ST. per„o~~~, p Length 4 0'
City JORDAr1 phone 4 9 2- 6 6 4 6 Grode ? Depth 4 2 Sq. Ft.
~ CLA CONSTRUCTION Approvols foes
N~„e .
Addrm: W. 19 OTH ST. llsseument Permit 00
~ City P RI OlZ LAKT~hane 4 4 7- 612 8 Water a Sew. Surchorpe g g
Palice Plon check
GW Name T~ENPTIS HALQUIST Fin 5^C ~5.00
Addrest , Enp. Water Conn. 450.00
00
~W City Phone Plonner Water Metor
Council Rood Unit • 0 0
1 hercby ocknowledqe that I how recd this opplitation and stote that gldg. Off,
the Inlormation is oorrect and cgree to comply with oll opplicoble Totol 7' 5 0
Stota of Minnesota Statutes and City of Eaflon Ordinances. APC '
Sipnoture of Pern+ltteo
A BuUding Pe?mir i: issusd ro: l on rh. .xprem condirion ir,at
all wo?k sholl ba done in acoordonce with II appliwblo',5tote of Minlxsota Stotutet ond Ciy of Eopan Ordinances.
Buildinp Offitiol
1
Permit No. Permit Holdbr Mite. Pwmit No. HokNr 3
Piumbiny o2 N
H.v.w.C.
w.n
w.e.?
DiSp.
S~wsr
Ele.tric 'i 5bz c nr)t r~ -13-%f
Inspeetion Dwa Insp. ONur
Footinp
Foundation
Fnmiip
Rough Plba . . ~
Rougbh HVA
Inwlation i'
Final Plba
Final HVAC
Final
Wour CnwiM Locatlon:
MWII
Sevver
Pr. Dhp.
C1TY OF EAGAN Remarks
~ addition NORTHVIEW MEADOWS Loc 16 eik 4 Parcel J&4-52200-160-04
I Owner street 4279 VALLEY FORGE PLACE gtat@ EAGAN MW 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. Tlg 1984 76.75 7.68 10 69.08 A 014176 -7/9184
STREET RESTOR.
GRADING
SEWER LAT 5-7 1981 15.89 .79 20
SAN SEW 7RUNK 75 Xgg1 138.48 6.92 20 iV ir
SEWER LATERAL TRKB 984 275.22 18.35 15 956-88 if we
EWER LAT 57 7 1981 22.28 1.11 20 16.36 " "
WATERMAIN g41 84 70.67 4.71 15 65.96 " "
WATER LATERAI. 19$1 18.65 .93 20 13.69 It
WATER AREA 7 9$1 13$.4$ 6.92 20 110.80 to ~f
WATER LAT 51 982 29.52 1.48 3 20
STORM SEW TRK $ 1984 392.32 39.23 0 313.86 " "
STORM 5EW LAT
DRAINAGE 1984 33.97 3. 0 0 30.58 A 014176 7 9 84
CURB & GUTTER
SIDEWALK
STREET LIGHT
ROAD UNIT 260.00 1993 3-14-84
WATER CONN. 450 . 00
BUILDING PER. ARRO
s,ac 525.00 "
PARK
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: ~ h~'~ ~
3830 Pilot Knob Road Permit Number. s? 0; ,
Eagan, Minnesota 551 22-1 897 Date Issued: 0
(612) 681-4675 i
SITE ADDRESS: APPLICANT:
1 0 c 1 j, HIM r.
~ .:A11FY F(II:E1f 1-1 ; c;; ifii I i1l.rt1 1111
y,.
PERIIAIT SUBTYPE: TYPE OF WORK:
INSPECTION DA •
I~ 4ifilill t fU ~ I t•!:• I
F
~
~ ~
pertnR No. PermR Hoider Dste Telephone b
ELECTRIC
PLUMBING
HVAC
MspscNon Dm insp. Commenta
FOOTINGS
FOUND
FRAMING
ROOFINO
ROUGH
PLUMBING
I PLBG
AIR TEST I
I ROU(3H I
I HEATING
GAS SVC I
TEST I
I INSUL
GYPBOARD
FIREPLACE
FIREPLACE y/q~6
AIR TEST
I FINAL PLBG
I FINAL HTG
ORSAT
TEST
F3LDG FINAL I
f3SMT R.I. I
~ 3SMT FINAL I
I
~ DFCK FTG I
I ;'F=CK FINAL ~I
I I
i I - I
~
. . CITY OF EAGAN AT
3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121 l~l ? 8889
PHONE: 454-8100
BUILDING PERMIT Receiot #
Te be uwd for SF DT'U/GAR Est. Volue +S 50,000 pate MARCH 15 19 84
SiteAddress 4279 VALLEY FORGE PLACE Erect g) Occuponcy R3
Lot 16 slock 4 Sec/Sub. NORTHVIEW MEADS.qlrer ? Zoning Rl
Parcel No. 10-52100-160-04 Repoir ? Fire Zone N/A
~ Enlarge ? Type of Const. V
a Name KEY-LAND HOMES Move ? # Stories
z Address 3471 W. 173RD ST Demolish ? Length 4V
City JORDAN phone 492-6646 Gmde ? Depth 42
Sq. Ft.-
~ CLA CONSTRUCTION Avv~o~ab Feea
o Name
u~ Addre55 6451 W. 190TH Assessment Permit 2 8 . o 0
~ City PRIOR LAKEphone 447-6128 WaterBSew. Surcharge-~=:50
Police Plon check
WW Name DENNIS HALOUIST Fire SAC 525.00
~Z
Address Enp. Woter Conn. _-450.00
~W City Phone 831-1875 plonMr WaterMeter 63.00
Countil Road Unit 260.00
1 hereby acknowledge that I have read this aODlicotion ond sfote ihat Bldg. Ofi.
Ihe intormolion is correct ond ogree to comply with all applicable AVC Totol $1. ~4~ . 5~
Stote of Minnesota $tatutes and City of Eagan Ordinonces.
Signature of Permittee
A Building Permit is issued fo: on the exprev condilion thni
nII work sholl be done in occordorxe wit all p'co_b~ $tot of nn sota Stafutes and Ciry of Eagan Ordinances.
Buildin9 OfFlticl Gc~c-C
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N2 11322
BUILDING PERMIT PHONE:454-8100 Receipl #~.771~
,
_TObeusedlor FIREPLACE Est.value $2,000 oate NOVEMSER 21 1985
SiteAddress 4279 VALLEY FORGE PL Erect ? Occupancy
Lot 16 Block 4 Sec/Sub. NORTHVIEW MEADSRemodei ? Zoning
Parcel No. Repair ? Type of Const.
Addition ? No. Stories
a Name JEFFREY S. ANDERSON ~nove ? Length
i $AME Demoli5h ? Depth
o Address Int. Impr. ? Sq. Ft
ciry Phone 452-6887 Instau Ex
a KEYLAND HOMES Approvals Feea
o Name
$u nddress Assessment Permit $32.50
" Ciry Phone 492-6646 Water&Sew. Surcharge 1.00
~ Police Plan Review
u
F i Name Fire SAC
nddress Eng. Water Conn.
a w Ciry Pnone Planner Water Meter
Council Road Unit
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.Off. 11/10/8 Tr.PI.
mformation is correct and agre to corr! ly with all applicable Sfate of
Minnesota Statutes and iry i rdinances. APC Parks
Var. Date Copies
Signature of Permittee Total
A euildin9 Permit is issued . JEFFREY S. ANDERSON on the express condition that
all work shall be done in accordance wit pl' ble State of innes a Statutes and Ciry oi Eagan Ordinances.
Budding Official v ~
W
CITY OF EAGAN , Include 2 sets of plans,
1 Certificate of Survey &
BUILDING PERMIT APPLICATION 1 set of er.erT.! cal.culations.
'lb Be Used For - Valuation Date
Site Address: Z! OFFICE USE ONLY
IAt IZ BIOC)C ~ $2C./SUb. M a"'rtgCt QCCl1pa1'1Cy J 3
Parcel pT p c~G lter zoning /
i Repair Fire Zone
Owner: ,62t1-UFNC) !,»,n Enlarge _ Type of Const. ~e # Stories ~
Address: Demolish Front ft.
City/Zip Code: J,-~,rcoor.l fi7n, SS.~S2 Grade Depth ft.
Phone # : y9z -9,yy6 APp?~OUALS FEES
Contractor: (c Assessments Permit 93 ~
Acldress: /~p~Kj- Water/Sewer Surcharge S~ e°-
Police Plan Check ) y
City/Zip Code: (Kiorc 4.4K&- Fire SAC Se?S
Phone t/t/J- ~/Zg ~4• Water Conn. h/Sd
Planner Water.Meter -63---OT-
Arch./Fn4• : AIIrNiS lc4i 5/- Council Rc>ad Unit
Blda. off.
Address: p,pC
City/Zip Code:
Phone ZCYPAL ? c~, •7 S ~
~
~ ~ ~
~ ° ~C
.
SURVEYOR'S CkSTIFICATE ` KEYLANDWES MODEL 3256
4279 VLILLEY FORGE
PROPOSED ELEVATIONS WERE
TAKEN FROM THE DEVELOPMENT ~
PLAN FOR NORTHVIEW MEADOWS
BY SUBURBAN ENGINEERING, INC.
LAST DATED 9-29-83.
~
. ~
. - ! )
i~
h ~a\
Q \ ?'.o c~` ~
O /Q~ lJ
SO
4? . 22'3'3 \ /0
Qr v
5 / \ ~l
~ a0 \QQ ~ ~ rBa) / ~ 'x
~ ~ 2! s~ \ ~ t r
r Q /ry ?~Bg ry=:r..: ~_P~~o o 0o
0) VA L L E Y
_ ~b ` C91B3 'C.;.:r~H~vE FO
~.OT 16 wF... ~o•~~~o FORGE
, ~
pq-
ti -
^ " 45. lO 35.5! ~ P
S89°20'42"W 101.95 ~ 1p
DENOTES PROPOSED SURFACE DRAINAGE
O DENOTES IRON MONUMENT SET SCALE: 1 INCH = 30 FEET
• DEPJOTES IRON MONUPIENT FOUND PROP05ED GARAGE FLOOR = 978.3 FEET
X000.0 DEPlOTES EXISTING ELEVATION PROPOSED LOIJEST FLOOR = 97y.2 FEET
(000.0) DEtlOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = 977•N FEET
I HEREBY CERTIFY TO KEYLAND fiOMES THAT THIS IS A TRUE AND CORRECT '
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot 16, Block 4, NORTHVIEb! MEADOIJS, according to the recorded plat thereof,
Dakota County, Minnesota.
AND OF THE LOCATION Of A PROPOSED BUILDING. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS
OR ENCROACHMENTS, IF ANY, THEREON. AS SURVEYED BY ME, OR UNDER MY DIRECT SUPERVISION,
THIS DAY OF fEBRUARY, 1984.
APPROVED FOR SIENNA SIGNED: JAMES R./HILL, INC.
CORPORATION i
BY:
ROBERTS ARCHITECTS gY: ~
DATED THIS DAY OF H ROLD C. PETERSON, LAND SURVEVOR
19 MINNESOTA LICENSE N0. 12294
PROJECT NO. BOOK / PAGE JAMES R. HILL, INC.
84550
Planners / Engineers / Surveyors
FILE NO. 8200 Humboldt Avenu• South
FO L D ER BbomTnpton. Mn. 55431 812-884-3020
- _ J c
LDING AND INSPECTION DIVISI
Ok~ ON D°_PART T OF
MUNITV DEVELOPMENT $215 WE~T OLO VEE
HEAT LOSS CALCULATIONS D. BLOOMINGTON, MINf4E50TA 55431 -5811 ~-4
Weat6entrips ~ I Comhodim Mu, INSULATION Doon ReOct. WaU Int Wall Ce7mQ Roof Flaor Kind How Ayplied
Yes-~ ~ ~ - t9_ -
i i, Roem timatha?./ 1 Widch J 1/ eiahe .1 c a. Room l.angth LWidth cI Heieh:
..Q+mdows an Dooer--Eraek4se aod Area W~cdoMn aed Door*--4,nckage aad Area
Wpth Iis4M Na.n[ L~w?111. An> ' WbW Xe1{Lt Na at LeS&114 A
N w
w of 9aw. of o~~v Hfht. . d eneY ~p. ri.
Na Of MM ~ pee i4eu et enek ~p. [L
cX~.~ Z z. !g ~3
CoeE. Btu Coef. Btu
lafiltration 60uation g cf (
CJa~s CJ+y / b 7 Z
_F.zP. wall ( e )C Exp, wall X B
OL-
Net cxp. wau Na op..ra0
Int wall ' ~ !L •
Ini wa0
Cding CL Ceilin6 c- 7-v
Floor / ~ Flaor / X O
Total &u. , - Total Bm.
Required p. h. ED.R wsq. ia. W.A. Leader ana Rapdred p, (L E,p,R, m p, im, WA Leader arca ~
P)o_qsj. t~ Length 911-t, cvid?b Height F.I xom I tAMA arah x«abt
Vmaom .na aoon-c..ck.ge .na armam. .va n~,+--cn.~ .na a~.
WIELY H~I~st N11~01~ a ot Weul t~ ~m ~V wu ~ ~M ~ A~
Ne~ a[ ee~lk M. fL
~a et O~M ~t !fs tl WM K~Y ~1~1b otlfalt M. R ~ c0cf. _ iho
~hOII'sr:•-`d•. _ . . - _ _ _ _ . -
. , .
_ _ _ ' ~~bOO^:a.zN;`.y„•:r's. ~7S'~+~ ' - ,
_ ~:-..r. . . 't ' '
.
v . . . . . . . .
1~Y~:i'ZFi,._ . - - _ VI•W•=5'i~d: ' `i.~~?,;,4iza"_':." ' _ _
K
. . . .l . . . r-;....
Kaeap.w.ll . D C NeteKv..wa0 - _s;-;.~.-•-~ a 1 =::;s'~;.,._..
int wdl
~ f
Comg ~o `u't - Ceflms
f7eor = . . ti. _ cZ
F1oor
.
. . . . . .
;
Teaal &u. _ ' ~ - , . - - ~t. Twal Btn. - . , 7_7~:~:._;, z - - a - _ -
[tequired w. k. EDR m _
sq. inx WA LRader na Reqaired+4 R EDR er '
' p.-'ma WA Leader area`.
Room leogt6 Wdt6 h Hag6t Cf~ F7. Room I[.m4th Widt6 Height
=t Wmdo
Wwtb vn acdx•poc`rr-Gie1u uon~ dtpre Window~ and Doms--Cnekage and Area
w~ eewR• e1 w~. urei. •te..ei m. h. . 16t\ .iskt MR. ot uew m
f1a e: Wee u yiw Ilteu v~at p. tt ~ Z Z~ /
Coef. Btu . Coef Bm
In6leratioa In6leration
/ Glaa
Esa. watl f~ Fam. wdl •
Wet aqi. wrall / d Net am. wdl
let waU ' ' - lot. wall
CeOing arif- ' ~ Ceiling
Floor S ,,,s' Floor
Taal &w ~ Total &u.
Re4ui*cd W. ft ED.R.-m p. ios. WA Leader area R"uimd p. k. ED.R or.y. in.. WA Ie.d«.R.
3as
ING AND INSPECTION DIVISION DECA0. OF
G EE
UNITV DEVELOVMENT 2235 WESTLD P
HEAT LOSS CALCULATIONS BLOOMINGTON, MINfSESOTA 55631 ~SB31
Weathentriys I . Conatraetion No. INSULATION ~r~ngeoi
Windows J' Dooo Refermce ~ Out. WaR Int. Wa0 CeOinf Roof Flom Kind Fiow Applied
Yn-No I Y~ 19_
5~7 Fl. • - q Room Lenath 4 /)fz.Width I ~zlieieht ~ rFl /rJeaL Room (.engt6 6 /,..Qfidt6 //-Wiaht
Are~ '
Windows and Doon-Cracktge and Ana WiodeMn and Doon--Gukate and
w1atn He19na iffi- P'ICaL INIi\t & K ws
NO. ef NP I y~M Of WM 14\O[ CHCk q. [C Coef. Beo Coef. Bia
lnfiltration In6luatioa 0 Q
Glsu el 'J Glw / SL8 B/
F:v. walI + X F.xv. w.u S 6
Ne< <:p. w.u 7 lt~ 6 Nec esp. aa0 S
lnt. wall Int wall
Ceiling .5.5 S Cei1m8 S"X F.
0'Z)
Fioor e e d o - Floor .
row etu. - ~ 2 7
3 rotal em.
Reyuircd ,q. k. ED.R. w.q. ins. WA. Leader ..u ' - ReQ,med q, h. ED.R. or sa ms. WA lAader area
h CJ o. Room I.eegeL !.2 W~dt6 /rzHeight fs /3~ FLI Room I i.eu~t6 /~i Widt6 Hei~t
wiodows eoa Doors--Ciaeksgt and Arest ! WmaoM{ and DoOrs-rCRCkap and W WLL HN~ot Na ot [ie tL Atq ~yb ~k y p( 1 R AIM
TIw et preq e! pu. II~GY O[ eetet M. [1. Ne, «pM p~ P~ ~upV p{ pvtick q. (L
' . i t a4c.,, / . . .
N 6 8 0%0,. / B'
c.oeE. Btu
in6ltration In6ltratioo 17
Glaw Glau
Fsw wall S. 5 6 F:v. wafl
Nee esp. w¦ll Nd ezp.
lnt. wall 02 O O InL wall
Ceiling o2 ,rj' ~ (e ,p Ceiling /
Floor F1oor - .ur
Toul Btu. ~ Twsl Bta.
Required aq. ft. ED.R. or p. im. WA Leader area [Zequired p, k. Ep,R, or sq, ms, Q/A. [iader area
%3; Fl. M. .8 ' Room I lsnsth. "//-t..Widt6 ~ Room l lsneth / Width B/ ' t 8
Wiedows and Doon--Cnckage and Are~ ' Wipdpws and Dppn-CraekaQe and
Are~
wietn x.iset Ne. o[ ue.al e4 ia.e x.lset a ot Irew ta wr..
Ne. et of p~n~ IItlt~ e[ enek N> ef p~eo Ot pe~ Il'OY o! «~ek
C«f. Ben. Coef. Btu
InGltration ~26 D In6ltration ,s'
Glaa Cdw
E:P. wdl S fsR wall z /v /
Net esp. watl Ne[ eV. wall - /o Z
int. wall Int wn0 :
Ceiling Ceiliog e-o -Pe
Floor p -14 ~ Floor
Total B[u. Total Bta.
Rec o^. ReWired sq. k. ED.R er sq. ms. WA leader area
. PERMIT ~~~7~5
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 7 2 0 3
(612) 681-4675 Date Issued: 0 3 J 2 8/ 9 6
SITE ADDRESS:
4279 VALLEY FORGE PL
LOT: 16 BLOCK: 4
NORTHVIEW MEADOWS
P.I.N.: 10-52100-160-04
DESCRIPTION: '
( G A 5 )
uildi g,,,Permit Type FIREPLACE
$uilding W~r'k, Type NEW
/4"q CB n5,w5 Gode 43R ALT. RESIDENTIAL -..j
^^qqJ ~~yy~:~' }~.3 i1 ~ ~ i •~~-~~49,
~ ti- ~ tJ A
tr.°.. % U ;.~7
C."
REMARKS:
FEE SUMMARY: '
Base Fee $25.00
Surcharge $.50
Total Fee $25.50
CONTRACTOR: - ppplicant - ST. l.IC.OWNER:
FIRESIDE CORNER INC 16331042 0001068 WORTHINGTON DOUG
2700 N FAIRVZEW AVE 4279 VALLEY FORGE PL ROSEVILLE MN 55113 EAGAN MN 55123
(612) 633-1042 (612)683-9381
~ T hereby acknowledge that I have reed this application and state that .the
information is correct and agree to aomply with 611 applicable State nf Mn.
~ Statutes nd City of Eagan Ordinances. °
-
CANT/PERMITEE SIGNATURE ISSUED BV: IG RE
CITY OF EAGAN ffD
jLq ~ ~ 3830 PILOT KNOB RD - 55122 '4J
1996 FIREPLACE PERMIT APPLICATION
681-4675
DATE: 3 ~ 2'9 -7f, '
DESCRIPTION OF WORK: ~ INSTALL NEW FIREPLACE: _ WOOD BURNING C' GAS
_ INSTALL GAS LOG ONLY IN EXISTING FIREPLACE
_ INSTALL GAS LINE ONLY IN EXISTING FIREPLACE
OTHER:
AREA TO BE INSTALLED IN:
STREET ADDRESS: ¢ Z 7 9 VA "Cb t-~Z C, 6
LOT ~ BLOCK ~ SUBD./P.I.D.
APPLICANT: (circle one only) OWNER ONTRACTOR
I hereby acknowledge that I have read this application and state that the information is correct and agree to
comply with aIl applicable State of Minnesota Statutes and City of Eagan Ordinances.
PROPERTY Name: W 11~?"~ ~NTa'~ 1-~~07 ~A~ ~CG'~ Phone
OWNER
Signature:
StreetAddress~4-2 71 ro"(c7e RaL/
City: Q Gi A04 State: Zip:5~Q~/ Z 3
FIREPLACE Company:~cLhlP 72cfS fi ,l~ ~ rzPhone 1~ 33 '2 5 -6 J
INSTALLER
Signature:
Stre Address:276o k vI oi License LO 6 g
City ~6-&4Vr (.c~.~ State: Zip.S 6l ) ~
GAS LINE Company: Phone
INSTALLER
Name:
Signat .
Stree ddress•
City: State: Zip:
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 14 Fireplace
WORK TYPE
? 31 New ? 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Census Code.
SAC Code
REMARKS: Chimneylflue must be inspected before concealing.
FEES
Permit Fee
Surcharge
Other
Copies
Total:
7 ~
1985 BUILDING PERMIT APPLICATIDN - CZTY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED NITH THE CITY OF EAG9N
COl41ERCIAL SINGLE FAMILY Dti(ELLINGS
INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS
& STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY
SPECIFICATIONS AND 1 SET OF 1 SET OE ENERGY CALCULATIONS
ENERGY CALCULATIONS'
$2,000 LANDSCAPE BOND
To Be Used For: tjr(f Valuation: 0200d• a U Date:
Site Address 22,7~ (/AIZa ~,yzze ~L OFFICE USE ONLY
Lot AL Bloek ~ Erect _ Occupancy
Remodel Zoning
Parcel/Sub //()/'~Zl Vie.uJ MPJOwS Repair , Type of Const
Addition It of Stories
Owner p-~.~rr v•POS Move , Length
Demolish Depth
Address LZL-y q)rce koC Int.Impr. Sq Ft
Install ~
City/Zip Code
Phone 41 S,2- la S S'7 APPROVALS FEES
Contractor ~ z6zL4CQ ~ytQ'~ Assessments Permit 3Z•~
Water/Sewer ~ Surcharge
Address Police ~ Plan Review
Fire SAC
City/Zip Code Engr Water Conn
Planner Water Meter
Phone y~ ~-~y 6 Council Road Unit
Bldg Offl/.Tn-BS Treatment Pl
Arch,/Engr. APC Parks
Variance Copies
Address TOTAL
City/Zip Code
Phone ll
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
~3 p ZW City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Consirudion Reoviremenis RemodellReoair Requirements Office Use Onlv
3 registemd sde surve , showirg sq. R of lot sq. R of house; and all roofed areas 2 wpies ol plan Cert of Survey Recd _ Y'_ N
(20°A ma~num lol ~verage allowed) 1 set of Energy Calalations for heated additions Tree Pres Plan Recd Y-_ N.
2 copies of plan s,~,~~^" bg~ m 8 windax sizes; poured found desgn, etc. 7 sAe survey for additions 8 decks 7ree P2s Required _Y =N
isetofEnergy~a~CUlliah.,_ Addifion - indicafei/on-sttesepticsysfem OnsiteSeptic5ystem,N
3 oopies oi Tree P2senation Plan'rf lot platted after 711193
Rim Joist Detail Op6ais selecGon sheet (bldgs wiN 3 or less units
• .
0/ 0`1 Construction Cost lJ (o V V
A L. l- F~2CoE ~ L• ~ Unit/Sre #
S~
' e Address V
F
Description of Work 9, Pi
Multi-Family Bldg _ Y N Fireplace(s) _ 0 _ 1 _ 2
Property Owner STC, V Erj rVVD 21 Telephone t~ (~j -~02 A
prM Nkq Window 3 SWing
Contractor D&O Apple Address ph. p1.1~100 Foc (l6~) 541~0 City
State M Lim « Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code CategOry . Residential Ventilation Category 1 Worksheel • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submined
. Energy Envelope Calculations Submi d
/ .
Have you previously constructed a building in Eagan vha simllar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber Telephone )
v
Mechanical Contracior Q Telephone # ( )
v~
Sewer/WaterContractor Telephone )
I hereby apply for a Residential Bui]ding Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
1VILIF A- ~V12NS
Applicant's Printed Name Applicant's i ture
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling O 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex O 17 Garage ? 22 Porch/Addn. (4-sea.) 0 33 E#. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
. a .
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Pibg_v or _ N ? 25 Miscellaneous
~
Work Types •i hp !
; ,
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding , -
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair +
? 33 Alleration O 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 Repiacement 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. t:PRY 49 ,;;.~,~r a,:.;
t# of Bldgs Length Fiee'Spr nl ered,' 1i'3-t
pnaT.> ~ r. ~'•'iM l•iyqii
Type of Const Wldth Q. ~'P~t xEi 6.!AC-C8p MEQI i:cl
':.{sS39nOS ri a1J MI.F - REQUIRED INSPECTIONS _ Footings (new bldg) _ FinaUC.O.
Footings (deck) _ Final/No C.O.
Foorings (addition) _ Plumbing
Foundation _ HVAC
Drain Tile Other
Roof Ice & Water Final _ Pool _ Ftgs _ A'v/Gas Tests Final
_ Framing _ Siding _ S[ucco _ Stone _ Brick
_ Fireplace R.I. AirTest Final Windows
Insulation _ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date l
TT J
Site Street Address A74 AZ 7 Unit #
Property Owner Telephone #(6~/)
Contractor D Telephone #
Address S- /5-Z~f/"/~ ~d r,~7d City StateZiF S~-~s3
The Applicant is: _ Owner AContrector _Other
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures (excludes water softener and/or water heater--complete next
section if installing these appliances).
_Septic System Abandonment
_Water Turnaround (add $125.00 if a 5/8" meter is required)
-Other:
~
;
_ Water Softener ~ Water Heater $ 15.00
_ new ~ replacement V
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ 50
Total $
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved. ' ja,~L~
_ 1 ~
Appl canYs Printed Name P Ap lica Ys Signature
