4083 Vermont Ave
CITY OF EACiAN Permit Na 041, Date: _I 21 `Q'F
3830 PYot k1nob Rwd Meter Na. y~ I L0 73 Size: oG
P.O. Box A1199 Reader No: 4412_V] Y56 Date: 0-9
Eagan, MN 55121
Owner. =ontier :`td~,-est
SiteAddreas: 40"'3 V - I juu-,jQL17 r s ^r i,ljce
Plumber S ar P1 n :~'.d
Conn. Chg:
Acct Dep: - ' tNoa.~o~lJrifts:
Permit Fee: ( ~
Surcharg~ ~ ai (o~com with Cityr of Esqan
Tr. Plant 014 •00p"d Ordln s.
Meter. A7
Mlac.:
WATER SERVICE PERMIT
~ .
N ~
y CITY OF EAG/IN Permlt Na Data 3830 PNot Kriob Road
8/P No: Datec
P.O. Box &1 t89 r' f
Eagan,"iNN 55121 l
i
G Owner.
~ 4-0F3., enaont Avenue L17 U Staffor-, ?~1FC7- ~
Site Address: ,
Plumber. StaT Plumt,tn,r, ~
j MWCC: 554.00pd Zoning•
~ Ciry Chg: ' 'No. oi Units:
'j Acct Dep: 15.11012d ~
I agns to comply wlth ft Gty of Eagan
Permit Fee: io,00pd
Ordlnances. ~
, Surcharge: • 5~~
j Misc.: Bp
SEWER SERVIGE PERMIT ~ I
i
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CITY OF EAGAN
i 3830 Pllot Knob Road, P.O. Box 21 •199, Eagan, MN 55121
PH O N E: 454•8100
BUILDING PERMIT Receipt ~
To be used for SF/CM Est. Value $$Z,Opp Date MARCll I'S ,19.$A-
Site Address 6[l83 Vi?MOHT AVIC OFFICE USE ONLY
Lot _11-Block 4_ Sec/Sub. S1'APfD1tD PI.ACE On Site Sewege Occupancy R=3
MWCC System X Zoning 1-1
Parcel No_
On Site Well (ACtual) Const V-N i
a Name ~,~"TR~ City Water (Allowable) Y-`1 ~
I Address 3902 CEDAkVALB DR PRV Required ik of Storfes ~
0 City LrAL~A[i Phone 454-0433 Booster Pump Length
Depth 301
. o Namq SAlg S.F. Total ~
o U Address Footprint S.F. ~
Ud
I.- City Phone APPROVALS FEES '
U ~ Name Engr./Assess. Permit ~
W
i g AddfeoS - Planner Surcharge 41.00
4 w w City Phone Council Plan Review i
81dg. OH. SAC, City loo.00
I her~by acknowledge that I have read this application and state that the Variance SAC, MWCC r`.~.~
in(or ation is correct and agree to comply with pII applicable State of Water Conn. SSb.110
Minnesota Statutes and City of Eagan Ordinance§. '
. WaterMeter 67.W_
i Sig''natu~re af Permittee Road Unit -325,00_
~
A Building Permit is issued to: FIAONTIER Treatment P1 204.00
, ~
on the express condition that al I work shall be done in accordance with all Parks i
' applicable State of Minnesota SYatutes and City of Eagan Ordinances. ~
TOTAL 3
Building Official ~5~0. QO i
I
. . + : . PERMiT # II~
+ MECHANICAL PERMIT T-~T-
- CITY OF EAGAN RECEIPT # --y-
3030 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE / Z S l' ` PHONE: 454-8100 J
ite Address BLDG. TYPE WORK DESCRIPTION
Lot Sec/Sub Res. New
~
Name Mult Add-on X
m
7@ Address WI5e Comm. Repair
c City Phone F ~ ~
3 7 ft Name .'~FEES
RES. HVAC 0-100 M BTU -$24.00
c Address ADDITIONAL 50 M BTU - 6.00
p Ciry Phone (R~• HVAC INCLUDES A/C ON NEW •
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PEFNIIT) - 1.50 EA.
TYPE OF WORK COMM/IND FEE - 146 OF CONTRACT FEE
Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPUES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
ent CFM STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
as Piping Outlets # BEYOND $1,000)
Other
.
FEE ~ - -
S/C: SI E
T07AL•
. FOR: CITY OF EAGAN
, ~j+.3*.: .~~~'Y:•~. 'ii . . ' - ~ . _ " . . : « . s, LD "T(J +t . n.
' PERMIT # , .
° MECHANICAL PERMIT
CITY OF EAGAN RECEIPT # e.
3630 PILOT KNOB ROAD, EA(iAN, MN 55122 DATE: 41AY188 '
CONTRACT PRICE PHONE: 454-8100
Site Addres4BLp(;, T1/pE WORK DESCRIPTION
Lot Block Sec/5ub Rea. 7IX New xx
- Mult Add-on
m Name,%
w AddresS Comm. Repair
c City 8 Phone ~er
FEES
~ Name RES. HVAC 0-100 M BTU -$24.00
c Address ADDITIONAL 50 M BTU - 6.00
p City Phone (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMIn - 1.50 EA.
TYPE OF WORK COMM/1ND FEE - 1% OF CONTWT FEE
APT. BLDGS. - COMM. RATE APPLIES
A~~ ~ BTU TOWNHOUSE & CONDO&= flES. RATE} kfPPLIES '
MINIMUM RESIDENTIAL FEE - ALL ADQ-ON &
Unit Hester M BTU REMODELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHAFGE PER PERMIT - .50
Vent CFM ---(ADEr$.50 S/C iF PERNf1T PRICE GOES - Gas Piping Outlets # BEYOND $1,000)
Other
FEE
S/C: • S SIGNATURE OF PERMITTEE
TOTAL• 26.0
FOR: CITY OF EAGAN
~c.,• r~•~-„T~.9d~7,q.),R4"+ . . . . . ~ - . ~ . . . . . . _ . . . .
PERMIT # yv` i I
~ PLUMBING PERMIT
CITY OF EAGAN RECEIPT #
~ 3830 PILOT KNOB ROAO, EAGAN, MN 55122 DATE %A
CONTRACT PRICE: PHONE: 454-8100
Site Address BLDG. TYPE WORK DE CRIPTION
Lot Block Sec/Sub Res. Z New
. ' Mult. Add-on
~ 61~ « f ~ ~ " Comm. Repair .J
m Name _
Other
Address
c Ciry Phone RES. PLBG. ONLY - CdMPLETE THE FOLLOWING:
NO. FIXTURES T TAL
Water Closet - $3.00
Name ~ ~Bath Tubs - $3.00 ~
~ Addr~ss ~ ~ ' • ~Lavatory - $3.00
p City' ` Phone Shower -$3.00
-7-Kitchen Sink - $3.00 3. nn
FEES Urinal/Bidet - $3.00
COMM/IND FEE - 196 OF CONTRACT FEE 7-Laundry Tray -$3.00 3LK`
APT. BLDGS - COMM RATE APPUES Floor Drains -$1.50
TOWNHOUSE & CONDO - RES. RATE APPLIES =Water Heater -$1.50
MINIMUM - RESIDENTIAL FEE - $12.00 Whirlpool - $3.00
MINIMUM - COMM/1ND FEE - $20.00 =Gas Piping Outlets - $1.50 ~n
STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMI'T)
, (ADD $.50 5/C IF PERMIT PRICE GOES Softener -$5.00 ~
BEYOND $1,000.00) Well - $10.00 .
Private Disp. - $10.00 s~
i • ~~Vrn --3-Rough Openings - $1.50
SFGNATURE OF P ITTEE FEE
STATE S/C: ' 0
FOR: CITY OF EAGAN GRAND TOTAL•
- - _ _ _ _ - ~ . - - -
. . _ . _ . _ . . .
CITY OF EAGAN ~i
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100
BUILDING PERMIT • Receipt ~t
To be used for , Est. Velue v<+ Date iS ,19
Site Address - .11: OFFICE USE ONLY
Lot Block a /SeC/Sub. STAFE'UR': Yl.ACw OnSfteSewaqe Occupancy
MWCC System Zoning ~
PerCel No. On SRe Well
p~4ctual) Canst
Name FPON i . City Water ~ (Allowable)
~ Address `af " ~ ^ • 'J ! . '•Y PRV Required * of Storiea ,
o Cjty f Al,A;, Phone 54-041j Booster Pump Length 4f `
Depth
, o Name ~A M." S.F.Total
v ~ Address Footprint S.F.
~ City Phone APPROVALS FEES
~ ac Engr./Asaess. Permit ~t' ~ • ' `
Address Planner Surcharfle
~ Z City Phpne Council Plan Review
W Bldg. Off. SAC, C1tY r~.
1 hereby acknowledge that I have read this application and state that the Variance SAC, MWCC infortnation is Correct and agree to comply with all applicable State of Water Conn.
Minnesota Statutes and City of Eagan Ordinances.
Water Meter
Signature of Permittee Road Unit i~ S.
A Building Permit is issued to: ~~'F
~t~ _ Treatment P1
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances. PBrks
TOTAL 44!' . X'
Building Official_
' Permit No. Pormlt HoIdK Date TeIephone s
Plumbing
H.V.A.C. 9& ~10
Eleccnc ' a
Softener
Inspoction Wte Insp.
COmmenb
~
Footings I ; r
Footings II
Foundation - ~
Framing _88
Roofing
Rough Plbg.
Rough Htg. ~ . l
isui. S--q 3-e6' c.~ c c4fl
Firepiace
Finel Htg.
Final Plbg.
Bldg. Final .,2 co.. •~:arne/ P .w cerc ocG -z,- r D I
Temp. LP
DeCk Ftg
Deck Final
Well
Pr. Disp.
I
CITY OF EAGAN N2 14 6 91
~ 3830 Pilot Knob Road, P.O. Box 21-195, Eagan, MN 55121
BUILDING PERMIT PHONE: 454-8100 Receipt 4k~ ~ o--7 -7
To be used for SF/GAR Est. Value $$2,000 Date MARCH 15 ,19$8
Site Address 4083 VF.RMnNT AVF. OFFICE USE ONLY
Lot 17 elock 4 SeC/Sub. STEtFFOIZD PL.ACE On Site Sewage Occupancy R-3
MWCC System x Zoning R-1
Parcel No. On Site weu
(Actual) Const V-N
cc Name FRnNTTF.R City Water X (Allowable) V-N
y PRV Required !k of Stories
= Address 3902 CEDARVALE DR
3 Boaster Pump Length 46'
0 City EAGAN Phone 454-0433 ~
Depth 3
, o Name SA1KE S.F. Total
~ 4 Address Footprint S.F.
m
City Phone APPROVALS FEES
Engr./Assess. Permit 502.00
~
w W Name
Planner Surcharge 41.00
Address
Council Plan Review 251.00
~ W City Phone Bldg. OH. SAC, City 1.00,_00-
I hereby acknowledge that I have read this application and state that the Variance SAC, M WCC 550.00
intormation is correct and agree to comply with II applicable State of Water Conn. MD-.OQ_.
Minnesota Statutes and City of gan O ina
„ waterMeter 67-00
Signature of Permittee - `z"'• Road Unit 32-5..00_
A Building Permit is issued to: FRONTIER Treatment P1 204.00
on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan 4rdinances. Parks
Building Official TOTAL 2,590.00
~~r#i#ir~t~ ~f (~rru~ttnr~
Citp af Cagan
13marhnrtct n# %oing jmwprtwn +
Thu Certificate issued pursuant to the requiremenls of Secrion 306 of the Urdjorm Building
Code certljying that at the time of irsuance lkis structure was in conrpliance with the various
ordinances of !he City regularing building construction or use. For the following:
I~,L;/:~R ~
ux ci.~sne. ~ eWe. ftrrnit xo. 146:
O-VPMX7 ~ ~ Zoning Digriet R 1 T,e Caa Vn
oww or a,~~ PBXIF,R M]MST MIFIS Addrm 3902 MP,RVALd'. DR, EAC'M
R„IdM Addmis 400 [TF~M' AVMAJE Lmaty L 17. B4, STAFF'atD PIhff,
n,W. J'JW- 21, 1 gM
POST IN A CONSPICUOUS PLACE
~
~
, CASH.RECEIPT ~
CITY OFEAGAN ~
. ~
• 3830 PILO'f KNOB ROAD
, EAGAN, MINNESOTA 55122 ~
~
DATE 19 L
aEcervEO , ~ ' .
Fnw
~
A6AOUNT S i
1 1 r ~
a Douaas ~
? CASH / l~\CHECK
~ 1 ~
- l
~ FUND OB,IECT ~AAOUNT
ti
i ~
~
I
~I
{I
Thank You
eY
8 1 077 `w Ccr
SLDG. PERMIT Nb. ~ 2,1
~ -
01-321(f~-Bldg.,~ermit
01-3422 Plan Check - I r-~ I
01-3445 Surch./Adm.
01-3446 SAC/Adm. '
01-2155 Surcharge
-1-7-3860 Road Unit
20-2275 SAC
20-3865 Water Conn. ,
20-3868 Water Trmt. C_.
20-3716 Water Meter 1 C_:(`;
20-2252 Acct. Dep.
20-3713 Water Permft 1 CU ~C%
20-3743 Sewer Permit ' C. C)C)
79-3866 Sewer Conn.
I
; 1-4-3855 Park Ded. '
I
TOTAL - --~---%~-=a
, Ly l C .
RESIDENTIAL
BUILDING PERMIT APPLICATION
% / ! ( CITY OF EAGAN ~ ~9 as
3830 PILOT KNOB RD - 55122
651-681-4675
Iow ConsWefian RwuiwmenU RemoddlRenair ReauiromaMt
3 rep'sterad sNe sirveys shawig eq. X. W bl, sq. ft. of Muse; antl II roofed aieas • 2 copies of qan
(209L maximm Id coverage allwrod) . 1 sel of Enaryy CalcWadom for heated atlditWns
2 coples ot plen shmwvg beam 8 window s¢es; poured tound design, etc.J . 1 sRe survey for exterior additbre & decks
1 set of Energy Calculations . Indirate H lame served by septic system tor additions
3 copies of Tree Preamatbn Plan'rf lat pkdled aftx 711193
Rim.bist Defai Optias seiadion sheat (bldps wilh 3 or less wWS)
)ATE q/~//0/ VALUATION M 38lO,ao
IOB SITE ADDRESS W83 {4rnv,,r/ Auc.
F MULTI-FAMILY BUILDING, HOW MANY UNITS? ~
'ROPERTY OWNER IIls iY4/en
r
1(PE OF WORK eo/acr R..-f FIREPLACE(S) _0 _1 _2 _3
kPPLICANT 7am:.~, Lr. PHONE # 1%S'&77
kDDRESS blva 07•.3ea Cf I~oh ZIPCODE SSVry
'AGER # CELL PHONE &'j) z~9 -o8~i FAX #
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Gategory _ MINNFSOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
_ MINNFSOTA RULFS 7672
- New Energy Code Worksheet Submitted
Plumbing Contraetor: Phone
Plumbing System Includes: Water Softener _ Lawn Sprinkler Fee: $90.00
Water Heater No. of R.I. Baths
No. of Baths
Mechanlcal Contractor: Phone #
Mechanical System Includes: _ Air Conditioning ree: $70.00
Heat Recovery System
Sewer/Water Contraetor: Phone #
kII above information must 6e submitted prior to processing of application.
hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with
sll applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature ot Appllcant
:ertificates of Survey Received _ Tree Preservation Plan Received _ Npt Required _
uPaaced vo1
itya
OFFICE USE ONLY
7 Ot Foundation ? 07 05-plex O 73 16-plex ? 20 Pool 0 30 Accessory Bldg
] 02 SF Dwelling ? 08 06-plex O 16 Fireplace O 21 Porch (3-seaJ ? 31 Ext Alt- MuMi
7 03 01 of _ plex ? 09 07-plex O 17 Garage O 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
] 04 02-plex ? 10 08-plex ? 18 Dedc ? 23 Porch (screerred) ? 36 Multi
] 05 03-plex O 11 10-plex O 19 Lower Level ? 24 Storm Damage
7 06 04-plex O 12 72-plex Pibg_Y or _ N 0 25 Miscellaneous
] 31 New O 35 Int Improvement O 38 Demolish (Interar) O 44 Sidinp
] 32 Addidon O 36 Move Bldg. O 42 Demolish (FOUndation) O 45 Fire Repair
7 33 Nteralion O 37 Demolish (Bldg)' O 43 Reroof 0 46 WindowslDoors
] 34 Replacement 'Demolltion (Entlre Bldy only) - Give PCA handout to applicant
/aluation Occupancy MC/ES System
:ensus Code Zoning City Water
iAC Units Stories Booster Pump
Jbr. of Units Sq. Ft. PRV
Jbr. of Bldgs Length Fire Sprinklered
"ype of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ FinaVNo C.O.
_ Footings (addiaon) _ Plumbiag
Foundation HVAC
Drain Tile
Roof Ice & Water Final Other
_ Framing _ Pool _ Ftgs _ AidGas Tests _ Final
_ Fireplace _ R.I. _ A'v Test _ Finel _ Siding Stucco Swne
_ Insulation _ Windows (new/replacement)
Approved By , Building Inspector
-
3ase Fee
iurcharge
Nan Review
dC/ES SAC
;ity SAC
Nater Supply & Storage
i&W Permit 8 Surcharge
-reatment Plant
Ilumbing Pertnit
dechanical Permit
_icense Search
:opies
>ther
'otal
Th~SlYQUC51 VOI(I~~j~O
IB IIVn~hS IlOT O ~ C' MV
R~nu ft Uate I A~ ~Fire No. `
67 uph'in nsUec~ion
° ~RendY Npw ~fll Nplriv InsPec-
• ~s ?NO Ior Whnn Nead
Y
icensed Electrical Conlractor
? Owner I hereby repvest inspectron ol ebove
olectncal work instelled ec
Sveet ~1r¢SS,~O. or Rovte o.
ecu n o. Tow sh~o Namc or No. ~
Hange No. CovnlY
Occvpdnt (P 7)
`
Pllonn No.
Power lierr
Adtlress
Electncal Convactor IComUainY Namel
KEIVDRICK yE~LFC'rRiC Lmense No.
M. d ina ps~I~G1V1~VL1~k LL-L1~2tioN ,
1 ~t7
Author
. Y'q iM ki' 'n) Phum: Number
MINNESOTq STATE BOAflO OF ELECTflICITY THIS INSPECTION REQUEST WILL NOT
Griegs-Midwey Bltle. - Hoom N-191 BE ACCEPTEO BY TNE STqTE BOqqp
1821 Univarsitv Ave.. 5t. Pnul, MN 55104 UNLESS PpOPER INSPECTIpN F
Phone 1612) 642-0600 EE IS
ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ~~U
~ .06
1 Seo instructiens log comoletieq this lorm on beck o1 rellow cocv.
D • 94105 "R"' Below Work Covered by Ihis Request •
Nep. iv0e ot BmlEme Aoalmncm WueC Equipmen, Wired
Home Ranye Temporary Service
Duplex Water Heater 7yhtiny Fixtwes
apt. euiiains Drye, Eleclrvc Healin
Commercial Bldy. umace Silo Unloader
Industrial BIAg. Air Condrtioner Bulk Milk Tank
F3Irt1 vbr, pe0v dhcr ISOCr,~tvl
T r,r uculy ther O1hi;r
ompu[e Inspection fee Below
P Fee ServiceEmrence5¢e n Fea fePtleis/SvEleaders u Fnp Cvcmts
0 to 200 Am ps 0 to 30 Am s 0 in 30 !~m ~
Above 200 qmps 37 to 100 Amps 1 to lU0 Am
Swimming Pool Atwve 100_Amps Above 100-AmPs
Transtormers Irrigation 8oortis P~rtial- Othe
v Signs Special inspection S
Pe„ks YOTA 'OG
aauan-~~ o;ne i. me e~e ~
Z r ~ZT ~ Insoecto.. neroby
Final ~ D:~~e cxrcify Nx~ ihe above
inspection has been
rrede.
Thia reduest vold 18monllu bom
This reques~ void
18 nwmhs from
E 27556 8/
,
Requcst Date Fire N. Rouu Y h-in InsVar,uon
.
~ J7 Req rted~ Aeady Nuw ? Wfll No~dy InsUer
O! ?es No tor Wh~:n NeatlY
~~.L~censeA ElecteiWl ConUac~or I hereby request inspection ol above
~ OwnFr elecvicel work installed at:
Sveet Atldress, Ban or Foute No. City
Yo-?3 ?"inovui IFG/h.3
ecu(vt o. Townsh,p Name or No. RanB~, No. Coumy
{~/t/Cr 1iq
Occupant WNINTI Phone No.
c"r~~Ik
Power SupVlier Adtlress
Electncal Convacmr (ComVany Neme) Comrar.mi's Licenye No.
fuAc.Hx4rC ~~~QiC j ac, 0`1~a6I
~.l..8 AtlJress (COnbactor or Owner M kinp Instailation)
Y 30 PvIC4 wiWv ~~Q e-RGH+,) 14n; 5's7a :2,
Autho .tl S~ alu e (C nvaE /O r M;ikiny Installauon) Phnne N mber
YS-a 3'
MINNESOTA STATE 80AflD OF ELECTHICITY TMIS INSPECTION qEOUEST WILL NOT
Griggs.Midwey 91de. - Aoom N•191 BE ACCEPTEO BV TNE SiATE BOAHD
1821 Universilv Ava.. SI. Pnul, MN 55100 UNLE55 PROPEN INSPECTION FEE IS
ow....., m.or c11 nonn ENCLOSED.
REQUEST FOR ELECTHiCAL INSPECTION ee-,oGo~oai-os
~y ~ Sec instructions br completmB tnis form on Dxck of yetlow coov.
~
E L 7~"5 6- "X" Below Work Covered by Ihis Request
ana x,o. rvoa oi auiwine Applioncna Wvea ea.unu,aia wi.en
Horne Fanye Temporary Service
Duplex Water Hea[er Liqh(inp Fixtures
Apl. BuilAing Drye, Elecvic Heaiing
Cornmercial 81dy. Fumace Silo Unloader
Industnal BIAy. Air Condiuoner Bulk Milk Tank
Farm OtneT aeu v Mth, Itiuecrtvl
~~nr Succ~fv 1 er Oth.,
ompute Inspectian Fee 8elow
p Fee SarviceEntmnceSixe tt Fae Faxders/5ubleetlers b Frtn Circurts
0 to 200 Am ps 0 to 30 Am s 0 m 30 Am D
Above 200 qmps 31 to 100 Amps 31 [0 100 Am s
Swimming Paol Above 100-Amps Above 100_Am{n
TransiormeB Irriga[ion Booms Pdrtial.0ther Fee
Signs Special Inspection S
TO AL FEE
Nemarks
.a
flough-in ~ I. t Ele al
- Inspecto~. heroby
cer~ily ~hxt ~he ahova
Final D~' msDection hes been
, /l~~ rriede.
fhis reQUest voiC 18 monttu irom
LEwy&T0r4 MODEL'
1988 HUILDING PERMIT APPLICATION - CITY OF EAGAN
. -jvtI
SINGLE FAMILY DWELLINGS
INCLUDE L\SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNEA LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WEiICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL QNITS FOR SALE UNITS fl OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITA HLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
CONMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
SiN~LE FA~jL-y -DwEtuNG
To Be Used For:-fr.((,() PQ j(.~L Valuation: Date:
Site Address yd n`3 !~~?/~1/l!~- 82~000- OFFICE USE ONLY
Lot P/ Block ~ On site sewage_ Occupancy R- 3
MWCC system ~ Zaning R -f
Parcel/Sub ~ SyZt ~~~'GQ >01C( On site well Actual Const V-N
City water ~ Allowable V-N
Owner
~~/f/( PRV required of stories
Booster Pump Length y(o'
Address Depth 30 ,
S.F. Total
City/Zip Code Footprint S.F.
Phone ryJ l~ y U.Z- APPROVALS FEES
Contractor ~/Zd~Ilf(~/~ Engr/Assess Permit 502.00
4 Planner Sureharge ~/1, Oo
Address O y~~. Council Plan Review 25/, 00
! Bldg. Off. SAC, City 166100
City/Zip Code J,/,(G,LL/l ,?ZlU ariance SAC, MWCC StiO, 00
Water Conn ~ OU
Phone Water Meter G1).ov
Road Unit 2 , 00
Arch./Engr. Treatment Pl ZOy,Op
Parks
Address Copies ~
TOTAL
City/Zip Code Aw ~ .
Phone # F98-az8~
I
UA LU.AT It~N .
G AR At=E
Zoxz2= Llk) uxi4 = ~/60
i3AScnn~r~T
Z~xZ6= 6~~
11~/zK 2 = ~2 3)
653 Xl3° ~yg9
~N'D F~uvR
'--.ra---`
29f XZG_ 97
~
'f X li~/z= CU
6 `~Z X 4`t = 334 i ~
ISr
r)zg
Z ~c t I '/-L _ (2
z
3
z~
~i<6
1
%
Hedlun7d Engineering Services ~OlEatt&cominQfonfreeway ~
Bbominpton,Minrnsolo 55420
lond Surreyors Clvll Enqineers Lond Planners PAons: 898-0289
sumi qor"s G'ert~j~cate
IAVIZ 800K _ PAGE -
JoB No. 88R-(-7
SURVEY FOR: Prontier PIidwest Homes Corporation
OESCRIBED AS: Lot 17, Block 4, STAFFORn PLACG, City of Eagan, Dakota County,
riinnesota and reserving easements of record.
TOP OF FOUNDATION = 8931
GARAGE FLOOR = 9J3•N
BASEMENT FLOOR =~5.2
SEWER SERVICE ELEV. =E;~,y~,n
PROPOSED ELEVATIONS : C~'
EXISTING ELEVATIONS :
DRAINAGE DIRECTIONS o
DENOTES LOT CORNERS : o
DENOTES OFFSET STAKE: o I~~
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LERTIFICATE OF SURVEY
I henDy certify thaf ihis survey, ploo or report wos pnpand by me or under my dirai
supervision and tAot I am o duly Re9fstertd Laod Surveyor under fhe lars of tA•
Slafe of Minnesoto.
Date: Z /z6 /88 Z)
Je e . L dpren, Licenie o. 14376
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APFLICATION FOR PERMIT :NDTE= pAYhENf OF Fg AT TIME OF'
nre[aCATIcea ooFS Nar mN- ;
Si'I7(TIE APPR6JAI. OF PFFPIIT. ~
SEWER AND/OR WATER CONNECTION : INSPEcTION oF m-ER nrDiOR wk'ER .
irsrnuaTioNS wII.r, rior ee SCEDn.E, ;
~ ITIPIL PII2PIIT HAS HFIM APPRUVm. y
~ ' . H~ff~effe~~lrf~Maf:~»~~eeft~ftr~~~f.
city oF eagcan
(PLEASE PRINT
1) PROPERTY ADDRESS: . .'7D0z .I/eI'/7~Of~-'~'
T,F];AT• oFSCazprioN: . Le).f /7
Lot B ock S vision or Tax Parcel ID
IF EXISTING STRC'CT(JRE, DATE OF ORIGINAL B[!ILDING PERMiT ISSUAIJCE:
Nbnt Year
PRESENT 7ANING/PROPOSID CSE:
Q COMMERCIAL/RETAIL/OFFICE I]~/R-1 SINGLE FAMILY
Q INDUSTRIAL ~ R-2 DL~PLEX (3tvo Units)
Q INSTITVTIONAL/GOVERPA'IENT Q R-3 TOMOUSE (Three +,[Jnits) ( Units)
Q R-4 APARTMENT/CODIDOMINIUM ( Units)
2) NAME:
ADDRESS : 90 ~L-
CITY, STATE, ZIP:
PHONE :
3) NAME: S:&i For City Use
Pl rum es License:
ADDRESS: Active
Expired
CITY, STATE, ZIP:
S;s 2 O I Not recordec'
PHONE: << MASTER LICENSE 3~Z g St Initla
' .
4) ~ " •
-NAME= ~i~~c~-~ ~ ~~-!z
ADDRFSS:
CITY, STAT'E, ZIP:
PHONE:
5) + ' a a~•~3 i : •a'~~ .iia~
CONNECTION 'IC) CITY SfiWFd2 CONNECTION TO CITY WATEI2 O QTHER
6) M euh %Le7~
**ir*ir**:Fkrtit#***:t*k*+*Yri! ir#i**ie#it**ik+*k4#***#***k*+****k***i*+*#*/r*#ii****ir*+*k**F***it4kilir*+**#rt*i
~
* THE GOLD COPY OF THE PII2I•IIT WILL BE SENP DIRECI'LY TO PUBI,IC WORKS TO FACILITATE MEPF12 PICK-DP. a'
,*t PLEASE ALiAW 1W0 WORKING DAYS FOR PROCFSSING. SOME0NE FROM TfIE CITY WILL CONPALT Y00 IF THERE *
* ARE ANY PROSLf3•LS. *
*
*t****~**,t**~*s****,tr,***+*,t*~r*****r+.***+*******t****,r**w**,t**+*,r~*,t++t,t*t*r*,t*,r***+*~*,t+****,t****+y
.-FOR -CITY USE ONLY " .
PERMIT # ISSUED
Pd w/Bldg. Permit FEES:
$ $ SEWER PERMIT (INCLODE SURCHARGE)
$ WATER PERMIT (INCLDDE SURCHARGE)
$ ~ 7•i C' $ WATER METER/COPPERHORN/OC'TSIDE READER
$ $ WATER TAP (INCLC'DE CORPORATION STOP)
$ $ SEWER TAP
$ /i c^ $ ACCOUNT DEPOSIT - SEWER
$ / j ~ $ ACCOUNT DEPOSIT - WATER
$ ~F t" $ WAC
$ S r L$ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRC7NK SEWER
$ $ LATERAL BENEFIT/TR[1NK WATER
$ t, $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ $ TOTAL
7 7
RECEIPT RECEIPT
DOES C}TILZTY CONNECTION REQUIRE, EXCAVATION IN PUBLIC RIGHT OF WAY?
~ YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
ROADWAY" MUST BE ISSUED BY THE ENGINEERING
~ NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY: r ~ -
TITLE:
DATE: /•F w
(92-14"7 PLUMBING (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mu 55122
Telephone # 651-675-5675 FAX # 651-675-5674
Please complete for: Single'Family Dwellings •
TbwnLomes and Condos when permits are required for each unit ;
Date 10 l / a3 Site Address KINNEY, KATHY
4083 VERMONT AVENUE Unit #
EAGAN, MN 55123
(651) 456-9402
Propertv Owner Telephone # ( ) .
Contractor N ^B`d7Rf PLVMpINV yO.
(s1z)a27-ao~
Address City
e
State _MINM ip "Pelephone # ( )
The Applicant is _ Owner 4/, Contrac[or _ Other
Septic System New Refurbished Submit 2 sets of pians and MPC iicense $ 100.00
Includes County fe"e. Adtlifional consultant fees may appty.
Altera[ions To Existing Dwelling Unit, Inciuding $ 50.00
_ Adding fixtures to lower levels or room additions, excluding water softener and water heater
_ Abandonment of septic system
_ Water turnaround 5/6" meter if needed -$121.00)
Other:
_ RPZ _ new installation _ repair _ rebuild $ 30.00
_ Lawn irriga[ion s}stem
_ Water softener X Water heater
~ $ 15.00
X repiacement _ additional D
~T 2 9 2003
State Surcharge $ 50
joy
Total
I hereby npply Yor a Residenrial Plunwing Pernut and acknowledge that the information is complete andaccurate; that dhe work will
be in confonnance with the crdinances and codes of the City of Eagan and with the Plumbing Codes; that I understand this is not a
permit, but only an appLcation for a permit, and work is not to start without a permit that the work will be in accordance Nrith the
approved plan in the case of work which requires a review and approval of plans.
Applicant's Printed Name A c nt's Signature
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122 ll V~/
651-675-5675 ~ j
I ~ ~1
Please complete for modifications to existing residential dwellings. ~
Date~/~~/
Site Street Address Unit #
Property Owner Telephone
~3s-~z v
Contractor Telephone # V
Address City - ateZ2;UL Zip ~3
The Applicant is: _ Owner Contrector _Other
Alterations to existing dwelling $ 50.00
_Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_Water Turnaround (add $121.00 if a 5/8" meter is required)
Other:
~ Water Softener _ Water Heater $ 15.00
replacement _ additional
_ Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00
State Surchar9e $ 50
Total g
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 requir d to be reviewed and approved. ~
(
0
App icanYs Print d Name A' {5licanYs Anature /
RESIDENTIAL MECHANICAL
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675
Please complete foc Single Family Dwellings & Townhomes and Condos when pemv[s are required for each unit
Date /1 / / -J l (D 3
Site Address "i V p 3 ~C/Y WZAJ Unit #
Property Owner Telephone #
Contractor
urnsvi e ea ing c.
Street Address 12481 Rhode Island Ave. So. ~ity
Stivtige, Mil •
State Zip Telephone #(`S~ ) v~7 OZ~ZI S
Bond I o t-I vS a s o cJ Expires: <7,11I O 1
The Applicant is _ Owner _A Conh'actor _ Other
Add-on, modification or al[eration to existing dwelling unit $ 30.00
X furnace replacement
air exchanger
air conditioner _ New _ Replacement
ather
State Surcharge $ .50
Tota, o u~ $ 30, sa
Nov I 7 2003
D
I hereby apply for a Residenual Mechamcal Permit and acknowledge that Xuform~tion is complete a I d accurate; that the work will
be in conformance with the ordinances and codes of the Ciry of Eagan and wi e ec amca odes;'that I understand tlus is not a
permit, but only an application for a permit, and work is not to start without a pemut; that the work will be in aceordance with the
approved plan in the case of work which requires a review and approval of plans.
,lu.,lre P I A~=e Q ~ vv__~
Applicant's Printed Name A p icant's Signa
COMMERCIAL MECHANICAL
Permit Application
City OfEagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675
Please comple[e for. commerciaVindushial buildings
multi-(amily buildings when separate permits are not reqmred for each dwelling unit
Date f /
Site Street Address Unit #
Tenant Name (if applicable) Previous Tenaut Name
Property Owner Telephone # ( )
Contractor
Street Address City
State Zip Telephone # ( )
Bond Expires:
The Applicant is _ Owner _ Contracror _ Other
Work Type
New construction _Install _Remove Underground Tank
Interior Improvement Schedule inspection during installation or removal of tank
Processed Piping
Nature of Work:
Permit Fee $SO.SU blinrmum Fee (includes State Surcharge)
ConnactValue $ x 1% _ $ PemutFee
• If pemrit fee is $1,000 or less, add $.50 $ State Surcharge
If permi[ fee is over $1,000, add $.50 per
$1,000 Peanit Fee
$ Total Fee
I hereby apply for a Commercial Mechanical Petmit and aclrnowledge that the information is complete and accurate; that the work
will be in conformance with [he ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is
not a pertni[, but only an application for a permit, and work is not to start without a permit; that [he work will be in accordance with
the approved plan in the case of work which requires a review and approval of plans.
ApplicanPs Prin[ed Name ApplicanPs Signahue
Approved By: , Inspector Date:
41011
City of EaQall
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Tenant:
Use BLUE or BLACK Ink
For Office Use
Permit #: /fl/ ` " /
Permit Fee: /t / ` C
Date Received:
Staff:
2012 MECHANICAL PERMIT APPLICATION
Site Address:
Suite #:
Name: Il CL -HA ") L1;v1 vA vi Phone: Ca l 7'� 7 c 1- b`r 3'
Address / City / Zip: 4 D i33 v2.ti' iviz,v�, .
tq-V
Name: atic9 er _f Li c( -foul ~b License #:
Address: 2j2S'S 13+ Sd
City: G.. rvt.e , t.
State: 1 ki Zip: ,cso '. Phone:('O.S ( Li 2 -3 `- 'O ---
Contact:
J"' 1 ettEmail: /11.4Jd:")4 /`/` 6Zyet. dv,C.CM.
New Y Replacement Additional Alteration Demolition
Description of work: / e. f la
= NOTE: Roof mounted; and ground mounted mechanicalequipment is required to be screened by Cit
'Code. Please contact the Mechanical Inspector for information on permitted screening methods.
RESIDENTIAL
Furnace
Air Conditioner
Air Exchanger
Heat Pump
Other
COMMERCIAL
New Construction Interior Improvement
Install Piping Processed
Gas Exterior HVAC Unit
Under / Above ground Tank (_ Install / Remove)
RESIDENTIAL FEES:
$60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge)
$100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) = $ TOTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ 20 x 1%
$60.00 Minimum (includes State Surcharge) = $ Permit Fee
- If the Permit Fee is less than $10,010, surcharge is $ 5.00
- If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee = $ Surcharge
(i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) = $ TOTAL FEE
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.gopherstateonecall.org
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. _
x 44,/e) r) 67 re
Applicant's Printed Name
x
Applicant's Signature
FOR OFFICE USE =
Required Inspections:
Underground Rough In
eviewed E
Gas Service Test In -floor Heat Final HVAC Screenin
City of Eagan
PERMIT
City of Eaan
Permit Type: Building
Permit Number: EA123243
Date Issued: 06/02/2014
Permit Category: ePermit
Site Address: 4083 Vermont Ave
Lot: 17 Block: 4 Addition: Stafford Place
PID: 10-72500-04-170
Use:
Description:
Sub Type: Reroof
Work Type: Replace
Description:
Census Code: 434 -
Zoning:
Square Feet: 0
Construction Type:
Occupancy:
Comments:
Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes.
William Krech
Fee Summary:
Valuation: 4,000.00
BL - Base Fee $4K
$103.25
Surcharge - Based on Valuation $4K $2.00
0801.4085
9001.2195
Total: $105.25
Contractor:
Krech Exteriors Inc
5866 Blackshire Path
Inver Grove Heights MN 55076
(651) 688-6368
- Applicant -
Owner:
Kathleen M Kinney
4083 Vermont Ave
Eagan MN 55123
(612) 791-0937
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.
Applicant/Permitee: Signature
Issued By: Signature
City of Eagan
PERMIT
City of Eaan
Permit Type: Building
Permit Number: EA123255
Date Issued: 06/03/2014
Permit Category: ePermit
Site Address: 4083 Vermont Ave
Lot: 17 Block: 4 Addition: Stafford Place
PID: 10-72500-04-170
Use:
Description:
Sub Type: Reroof & Windows/Doors Construction Type:
Work Type: Replace
Description:
Census Code: 434 - Occupancy:
Zoning:
Square Feet: 0
Comments:
Please print pictures of ice and water protection and leave on site.
Windows/Doors: If altering the opening size, a framing inspection is required.
Fee Summary:
Valuation: 8,000.00
BL - Base Fee $8K
$162.25
Surcharge - Based on Valuation $8K $4.00
0801.4085
9001.2195
Total: $166.25
Contractor:
Krech Exteriors Inc
5866 Blackshire Path
Inver Grove Heights MN 55076
(651) 688-6368
- Applicant -
Owner:
Kathleen M Kinney
4083 Vermont Ave
Eagan MN 55123
(612) 791-0937
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.
Applicant/Permitee: Signature
Issued By: Signature