4401 Slater Rd
CITY OF EAGAN SlWER SERVICE PE7RMR
3830 Pilot Knob Road pERMiT Np.:
~ P. O. Box 21189 DATE:
Eegan, MN 55121 1
~?II m~ No. of Unln:
.ac n
Qwrer.
Add''°w. S at er a , nn amon F e
~TM ~f°n:
Plumbee Westonicu Plb
4z5.o~ pa
' ~ Nw~ fo ~rM ~ tw Gh? ei fmN¦ Conrnction Cho~: . UT-P-J--
orainesom Ao°°unt °'podt` p
Pemnit F«:
Surd+ar0o• .
~i Mlhc. CharDts:
BY Tarol:
pob of Inap.: pate Pold:
I^sp.: -
, CITY OF EAGAN
3830 Pilot Knob Road WATER SERVICE PERl1A1T
P. O. Box 21199 PERMIT NO.: 17
Epan. MN 55121 DATE:
, Zoninp; P.TT No. of Units:
Owrnr; 7chmPn ?lonee Inc
Jlddram
Sito Addross: 4401 Slater ?:oad I?O B2 Cinnar,.on pe
; pR~-iber. Westonka P1b9
Meftr No.: Connsctian CF+orgc -L!L Od Fd
~ Stz.: Aooount Deposk: TS~?JZ3 p-
Reoder No.: Permit Fee: 10 ' p
NM hommpl!? wilb !w Cly of iass¦ Surchorpt: p
Misc. CFwrpK: 61. p0 rd nP er
Totol: _ and ?tnrn
BY DoH Paid:
Dob of Insp.: Irqp.:
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road 5937
P. O. Box 21199 ' PERMIT NO.:
Eagan, MN 55121 DATE:
Zoninp: RII No. of Unlts:
I pw,,,r; Zachman Aomes Inc
Addrosx
5it, Addma; 4401 Slater Road L28 B2 Cinnaman RITg-e
%umber Westonka Plbg
*or No.: 3 Conned(an Charfls: pd
, e 1l
ccount Deposit: • P
Rea No.• r 94 a 16 6 q Pertnit Fee: • P
1 y~w !o eorw wN6 !w Citp of Ee"w Surcharpe: • P
Mi~, p,o~; 63.00 meter
Total: and hnrn
; ey Dcte Paid:
" Date of I nsp.: Insp.:
DETACH AND RETAIN THIS STATEMENT ZACHMAN BROTHERS TNE PTTACMEO CHEGK I! IN PAYMENT Or ITEMS DESGRIBEO IOELOW.
CONSTRUC RO.` CO. IF NOT GORqECT pL,Eqgg NOTIG"! U5 PROMPTLM• NO RECEIPf DK.BIRED. I
• ~ QEIUXE - FORM 1WC4 V-2
DAT[ DESCRIPTION AMOYNT I
WATER DEPOSIT ON 4401 SLATER ROAD _ $30.00
_~y ~y' A . _ ~ ~ _ . ~
!~I . 1~ ~+.r/~,•. ~
_ ~ ~ . :
:y`~ - _ _ _ . _ , .
ti/ ~:.i ~.r' `s e:.~ e/' i'i ~c,a'~~%'- 1~ Y 1.~'
-•^~ti ~ 5-
.r'~a - .r'~"ti y /
~°r,•' r? ~/,~.,~'t/ ' \`~I '~.~y. ''1~ 1.. ~/~V~l~~
,i~ 1~. i1 ~.r"'-~.~.r+~._~ .~r.r~~ w~ ~+r ~.rA~.• ..~~~./1~~•
~ vv o~ w ~r ~,r v v~ ~r .
~'i sr'• a ~'1 /`v. . e'~. /i I\ ~ f~1 r''1 - I~,,. _
~ A A A N A A r. A A A o!~~~+
M~+ ~M~r^ V__ Y Y V r+ Y V' V' .?'V' ~V
. ~al~ ~ r~.r~' ~..f ~vi ti~ ~?.a~ s~' v,~'I~ .
~.~~~r.. 1? ti aw rc .s ~r. .w .t w .r.. . . r. w
• .yi
.W ~r• ~i~' °trv~ 7.t ~wl ~.YI 'i..~' ~V .~.r
a" r? ±I^+~. I'~~ /"4 I"O r I„~\ J~~ .r'~+ . . 1'`
A r? w w w. .rs ~ . ~ r+~~ w 'r,...
'ac
Vq 1+ ;+,_i..+~1.s~ ~'h/~ ~d'~ '~wr~ ~.y" t~~ ~w.,.~ '~O .'i 1.., .
- - - - - - ''i~~'~/''S'-~~~'Z~~-/'~"~~'.'V~`/~y_`U~~*~e'"~'°`'ti'`..r~~^\.~"t~J'~ti'~.- ,-'hl~I+~~'"'f~'?i
~ CASH RECEIPT
CITY OF EAGAN
P. O. BOX 21-199
EAGAN, MINNESOTA 55121
~ DATE 4 1gt
:
~
weecIvan /
FROM
~.AMOUNT $
, } C)
& DOLLARS
~oo
~ CASH F-I CHECK
row
FuNO - coofi arnouHT •
.
, . i .
, j
. . . , .
. . . . ..i f ~.J
Thank You
, : . . ~ •z~
BY J .
yl/~ White-Payers Copy
CJ~ Yellow-Posting Copy
Pink-File Copy
_ - -z -a•--~ ,v----~~~----- _ - . ~ - _ _ ~ ,
' CITY 4F EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eapan, MN 55121
PHONE: 454-8100 QUILDING 'ERMIT Receipf #
To k„"a fw SF D4aG/GAR Est, yalue 51,000 pate DECEMBER 12 19 E34
Site Add 4401 SLATER ROAD Ersct 12 Occupancy R-3
~S 2 CINNAMON RIDGE 3
Lot Block Sec/Sub. Ramodel ? Zoning R-1
Parcel No. Repair ? Type of Conrt. V
Enlarge ? No. Stories
~ Name ZACHMAN BROS CONST COi INC. Move ? I..ength 38
i Address 4620 W. 77TH ST, SUITE 04 oemotiah 0 Depth44
~ Crty ED I NA phone 8 9 3- 0 7 5 Grede ? Sy. Ft.
ApProvals f~es
~ Name SAi~AF.
Assessment Permit 2 6. 0 0
o~ Address
u~ City - Phone Woter b 5ew. SurcFwrye 25.00
Poliu Plon check 143.00
W Name Firs SAC 525.00
Address Enp. Water Conn. 470.00
~ W City Phone Plonrser Woter Meter 63-00
' Council Rood Unit 2 6 0_ 0 0
I hereb?r acknowledge that I hove read fhis opplicotion and state that gld9, p{{, 12/11/ 4parks .
the inlormafion is correct and ogree to tomply with oll applicn6la A~ Total ~
State of Minrxsota Stotutes and City of Eaqan Ordinanccs.
Var. Date
5ipnaturo of Permittee , - - - " ' _
A Building Pem,it is issued to: ZACIiMt-lN BROS CON ST CO., I NC . &xpress corWit~~ tha,
oll work sholl ae done in occordonce with oIl opplicable 5tate of Minnesota 5totutes ond Ciry of Eo9an Ordinonces.
' / .
8ulldinq Offlciol ' - - - - - - - -
PKmit No. Permit Holde? Dat~
~umbing
H.vA.c.
Eteetrie
Soherw
Impsction Dau Insp. Other
Footinys /s
Foundation
FnminQ
t
~
RouYh PIb9.
Rouph HVA
. ,
Inwlation
Final Plbp.
Finsl HVAC
Final
~
Grt/Ox.
Wmr Desc?ibs Location:
VYell
5wrr
P?. D'ap.
` ~
Roeeipt PLUMBING PERMIT Pe?mit No. _
CITY OF EAGAN FN
~
- fill in numbered Woces S/C
Type w Print legibly TaL ~
,
1. Date - 2. Installation Cost
~
3. Job Address - Lot Blk. Tract 7
4. Owner ~ n.,• Gr.t . '
~
! 6. Contrsctor~%~,['' Phone
i
6. Addreu
7. City t.;~' c..c State Zip
~ 8. Building Type: Residential b Commercial ? Institutional ?
;
9. Work Description: New L'7 Add ? Alter ? Repair O ~
10. Describe
11. No, Fixtures Mo. Fixtures
Water Closet Cesspool/Drainfield
, Bath tubs Septic Tank
l.avatory $o{tner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
E Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agrae to
comply with all ordinances and codes governing this type of work.
Signed : ` - ` for
Rouyh Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
ARProved CITY OF EAGAN 464-8100
,
Rsoeipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN Fee
5 !i
, Fill in numbered speces S/C ~
TYPe or Print /egibly Tot : [ ' ` •
1. Date 2. Installation Cost
3. Job Addreu ~tK~ot ~ l Blk ~ Tract
4. Owner ~ c. c! ~ /611 . ie'c' •j I
6. CQntfBCLOf r. .l' fl~C PhOIIg C ~
6. Address
7. City 111 ri,JiU..S' Stete /i) Zip ~ c:--
8. Building Type: Residential 0'_ Commercial ? Institutional ?
9. Work Description: New 0~ Add ? Alter O Repair 0
10. Destxibe t'G,•,-, li„" lr,r 6 Fuel Type ,l!n l G n 5
11. No, Eguioment BTU - M. Ea. No. Equiament CFM
Forced Air Air Handling:
Mfg.
Boilers Mech. Exhaust
Mfg.
Unit Heater
Mfg. Other
Air Cond.
Mfg,
Gas, Piping Outlets
12. I hereby certify that the above informe ion is true and correct, and I agree to
oomply wi ordinances and .ro~go ning tFiis type of work.
i
Signed :
Rouqh Finel
Inspections: Date Insp. Date Insp.
This is your permit when numbered and epproved.
Approved CITY OF EAGAN 464-8700
CITY OF EAGAN Remarks
Addition CINNAMON RIDGE 3RD ADDN Lot 28 Rlk 2 Parcel 10-17402-280-02
Owner Street 4401 SLATER ROAD Swte EAGAN NW 55122
Improvement Date Amount Annual Years i Payment Receipt Date
STREET SUFiF. 3-25-65
STREET RESTOR,
GRADING
5AN SEW TRUNK 1973 102.22 6.81 1 ~ _
SEWERLATERAL ~t 1985 2834.53 566.90
WATEfiMAIN
WATER LATERAL }
WATER AREA 7 ~
ti
STORM SEW TRK 1979 381.69 19.08 20
S70RM 5EW LAT 1( X 1985
~
~
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road Unit 26
WATER CONN. 470.00 " 17
6UILOING PER. #9786 rr r~
SAC
525.00
PARK
~
Cf 9io ~ REQUEST FOR ELECTRICAL INSPECTION . Ea-°°°°q'-°+
B17405 , Seo inshuctwns br comDleHmq tAis form on back ol Yetlow copy. ~ T~n
"x- ae,oW Work Ccvarad try This Request V~
FeO: Tyoe oi Builtling Appliames Wirs0 Equipment Wired
Home Range Temporary Service
Duplex Water Heater Ligbting Fixtures
Apt. Building Dryer Electric Heatin
Commercial Bldg. Furnace Silo Unloader
Industrial BIAg. Air Conditioncr Bulk Milk Tank
Farm Otnu, oeo v 01hm l5nedfvl
tMr Succi y thcr Othm
ompute lnspection Fee 8elaw
p Fee ServiceEntance5ize U Fee Fandars/Subleeders b Feo Clrcuits
0 m s 0 to 30 qm Z, 0 to 30 Am ps
Above Z00 q~n ~s31 ta 700 qmps ~Q 31 to 700 Am
Swinming Pool Above lOD_An . qbove 100_A
Transiormers Irrigation Boorts Partial•'O r Fee
Signs $peciallnspec!ion S
Nearks TO L F
r
re
by
flooah-in ~ D:4lec-S,
tY Ihat the oppve
Final D«tion has Ceen
a.
mb repueal voie 18 monrtp Imm
This request void -a- J
r
B,Mwrus
Request Q,;y Fire No. flnugh-in I, ?ctiNO uon
.OUnetl? ~1leatlv N ~ II Nalilv Inspec
es r When Heady
Licensed Elec[rical Conlraclor 1 hereby requast inspeclion ol ebove
? Owner olectrical wort in.Lilled at
Sveet Ad ,es 7 17 t~ O~ ~ Cftv
ecuon a. iownshio Name or No. HanBe No. Counly
0,4 e/
Or,cuV.nt IPflINT Mom No.
•
Powm Suppli AAtl ess
Da e~O f-c- E/u>` ~
Elecvi nvac~o (Co any amel Contmcwr"s License No.
Mailine Address ~ ntractor or Owner Mnking IRSlailahonl
`Of S
Authoriz ienature (COntm . r Owner MakinB l~stallation) PM1o~ Nwnber
G~~- ~9'D 355~$
MINNESOTA STATE OANO Of ELECTRICIiY THIS INSPECTION RWUEST WILL NOT
Griggs-Midwav Blde. - Aoom N•191 BE ACCEPTED BY THE STATE BOABD
PROPER INSPECTION FEE IS
1821 Univers,tY A~e.. St. Veul, M 55~~~~ ENCUNLE55L0.5EO.
o~....... lG191 94]9ttt N
~
, CITY OF EAGAN M 9786
" 3830 Pilot Knob Road, P.O. Box 21-799, Eagan, MN 55127
BUILDING PERMIT PHONE: 454•8100 ReceiPr # C1140
To ba u"d fer SF DWG/GAR Est. Value 51,000 Dote DECEMBER 12 19 84
SiteAddress 4401 SLATER ROAD Erect ~ Occupancy R-3
Lot 28 elock Z Sec/SubCINNAMON RIDGE 3 Remodel ? Zoninq R-1
Parcel No. Repair ? Type of Cons[. V
Enlarge ? No.Stories
W Name ZACHMAN BROS CONST CO,INC. Move ? Len9th 38
~ Address 4620 W. 77TH ST, SUITE 104 oemoiish ? Depth4i~ City EDINA Phone $93-0755 Grade ? Sq. Ft.
Avvroval+ Feas
O Name
Zu 2~E
Assessment Permit 286.00
Address
• Ciry Phone Water 8 Sew. $urcFarge 25, ~0
Police Plan check 143 _ 00
tw Name Firo SAC 525 _ 00
uo Address Enq. Water Conn. 470-00
'Z
City Phone Plonner Woter Meter F+3 -no
' Council Road Unit 7AI1 ~10
I hereby ocknowledge tFwt I have read fhis applicotion ond stare that Bldg. Off. IZ 11 41arks
- the information is correct and agree to comply with oll opplicuble APC Total 1, 772 .00
Stnfe of Minnesoto Statute d City of Eogan Ordinances.
• Var. Date ~lp~b
Sipnaturc of Pertnittee ~
A Building Permit Is issued fo: ACHMAN BROS CONST CO.. INC. on the expreu condition that
oll work sholl be don n a[ ordanc e th oll opplicable Stote of Minnewta Statutes ond Ciry of Eoqcn Ordinancea.
auild,no of,icia, ~a a , 4-tA A,(M
~v 1 ' i CITY OF EACA:V Inc_ude 2 seEs of plans,
1 site plan w/elevations & '
Y' BUILDING PERf4iT PP°LICATION 1 set of energy calculations.
To Be Us_r3 For Valuation Date
Site rddress: b/
51 ~oco' OFFICE USE 01U,
Aw~
ot Bloclc Sec./Sub. y~ Erect X Occupancy
L (Z-.3
Parcel ~,cqr~ A1ter Zoning R
~ Repair Fire Zone
Qwner: aNb0 ~.PrYo~kt n G Enlarge _ `iype of Const. ~
v hbve r Stories
Pddress: 4& c2Q (A) .S~u,~~ Id ~Delrolish Front 36 ft.
City/Zio Code: r(mr)~ Grade Depth 4 ft.
Phone APPEUUALS FEFS
~
Contrzctor: ~ Assessnents Pezinit
Pddress • Water/Se.~r Surcnarge 2S•
~ Police Plan Check _ l.43, m
City/Zip Code: Fire SAC
Phone = Eng-- Water. Corn. ¢-7 0.
Planr.er-" Sdater Meter c0 3. ~
Arcn./E~ng.: Council Road Unit
Bldg. Off.
F,c.'c'sess : ppC
C1t'J/Zio Cir?a-
13x~~C~ - ~~BK 5q-7 252- I 2
I~ = f 44 x 54 7 7~-7~
30Q-?x~~ ~ 12s4~
x i i = 4~g~
2~ x 22 ~490
,::)o q3 q-
w
w
~
/ 0~0
2005 RESIDEN7'IAL BUILDING PERNIII' APPLICATION ff7V i
City Of Eagan
e
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
/
New Consiruction Reamrements RemodellReoair Reauiremen4s 0
3 reg istered site surveys showing sq. @. of lot, sq. ft. oi house; and all roofed areas 12 copLs of ylan Cert of Survey Recd _ Y_ N
(20 b maximum lot cove2ge allowed) t set of Energy Calculations for heated addNOns Tree Pres Plan Recd _ Y_ N,
2 copies of plan showing beam & window s¢es; poured (ound design, etc. sAe survey for additions 8 decks Tree Pres Required _Y _ N
1 set of Eneryy Calcuiahons AddRion - indkafe ilon-sde sepfic sysfem _ On~sAe Se t~ ~
3 coDies of Tree Preservation Plan if lot platted afler7/1193 ~
Rim Joist Detail Options seledion sheet (buildings with 3 orless units)
Date OZ ConstructionCost
SiteAyd~d~ress~~ Unit/Ste #
~ '~7r-rc.iDescription of Work
%'~w-,Z NLyt.. If•NU 7-7
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2
Property Owner ~1~~ ~1~~L '~~>LN Telephone # ( )
Contractor C4 y4K ~";4V6r4ob A`le "
~~~~lz=
Address 7'~{`'J~- 709'<) F4"'i &-13 City
State p ' Zip S 1 -7"1; Telephone # (G/ 6
n 2 n , _
I ~~l P1 V n
COMPLETE THIS AREA ONLY IF CONSTRUCTING A k BULDING
- Minnesota Rules 7670 Cateeorv 1 By ~Minnsota Rules 7672
Energy Code Category , Residential Venlilation Category 1 Worksheet • N6W1Ekwjy Code Worksheet
(q submissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber Telephone # ( )
Mechanical Contractor Telephone # ( )
Sewer/Water Contractor Telephone ~
I hereby apply for a Residential Building 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.
1,14 61-,7.) e
Applicant's Printed Name Applicant's Sig e
OFFICE USE ONLY .
~
Sub Types
? 01 Foundation O 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Exl. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 EM. Alt - SF
? 04 02-plex ? 10 OB-plex ~ 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
'171 , 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolitlon (Entire Bldg) - Give PCA handout to applicant
Valuation 0 Lko Occupancy MCES System
Census Code L/ r Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings(new bldg) FinaVC.O.
~ Footings (deck) Final/No C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AirlGas Tests Final
_ Framing _ Siding _ Stucco _ Stone _ Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
Insulation Retaining Wall
Approved By: Building Inspector
Base Fee
Surcharge
Plan Review
MC1ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies • zs
Other
Total
, x 7726 Morqan Avenue South
gf L V I N 1 N H. H E D L U N D aicnri.id, Mlnneiota 55423
Phona : 866-252E
Land Surveyor Clvll Enqmeer'
~~rr~~e~nr`s G'ert~~'~cr~te
JOB NO.
SURVEY FOR: Z'achman Brothers Cbnstruction Co., Inc.
DESGRIBED AS: Lot 28, Block 2, CINNAMON RIDGE TEIIRD ADDITION, city of Eagan,
Dakota county, Minnesota and reserving easements of record. I
W 1
914.8 N44°05'!I"F 85.00 914,5 ` j
Top of ~oc~nJatFon: 9/(~•B . ~
~ - 7-- -'j ~ $asemanY Fl.er /3. 3
; Dt% n~~ C,o#,.jc Fhvr= o v.
h h Froposed E/e?ario.?t ~
Q ` O
Ex;sting LJsvnt;wns
W _ 9/6.7 K ~ I N -
Dra;naye SJ'~recsions
i I ~enetes Lot Corner 0
I \ N ~,~~eWUO / ~
10'VQ $t4Ke5 I~\b' IN~ 1~~~._ ~ ~
t i r 10: 0 5 St~Ke s
N C4 r I'
-ni
QL6D I y 30~
M
/ ti 5~vl 9i6, \ aJ 9
45 'G~i• A.Z• t-,
4\ a` ~c.56 525•3 a/
FK~v~T~ STQG-~- 5 z~
1.
F~"a~T ~.ETSaCK O~`~~¢' \
~
V G ~ r~
.
0 .
CERTIFICATE OF SURVEY
I hereby certify that on [11 7 /$4 I surveyed the property described above and ihat
the above plat is a correct represenTation of soid survey.
4">.~
Calvin H. Hedlund, Minn. Reg. No. 5942
650nc-7 A5,
2004 RESIDENTIAL PLUMBING PERMIT APPLICATlON
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date(l~/d
Site Street Address Unit #
Property Owner Telephone # ((e5/ ) h~J%D -~ia2lo9
Contractor Telephone # (kg1 ).3L5 -13 'fl>
Address,34,,?D L'~200 cicy statecln" zip 55 /-L
The Applicant is: _ Owner VContractor _Other
Alteretions 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 V Water Heater $ 15.00
~replacement _ additional
Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00
State Surcharge $ .50
Total ~ $11:r Jjo
3UN ~ 3 ZOD
I hereby apply for a Reside Plumbing Per nd acknowledge that the information is complete
and accurate; that the work ill be ' nforma e with the ordinances and codes of the City of
Eagan and the plumbing co 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.
ApplicanYs Printed Name ApplicanY Signature
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
~p1o1 3830 PILOT KNOB RD - 55122
651-681.4e75 ~ .
o~
New ConfhucHon Reaulremenh Remotlel/Reoalr Reaulremenis
> J replstered Yfe wneys showlnp fq. rt. ol lot, aq. R. ol house 2 copies ol plan
antl gp rooled areas (10% mmclmum bf eoveraae atlowed) 1 set of enerpy calculallons tor heated adtliHOns
> 2 coples o1 plans (ahow beam a wlndow tizes; poureC fnd. desipn; efc.) 1 site survey for exterlor addlNOru & tlecks
> 1 aet of enerpy calculatlons
> 3 coples of hae prefenaHon plan il lot plafled alter 7/1/93
DATE: I00 CONSTRUCTION COST: 7?4 5-00•tVV
DESCRIPfION OF WORK: Qo0i lIfc,- DE'
STREET ADDRESS: m ~
r r•
LOT: BLOCK: D_ SUBD./P.I.D.
NameliAkA UltiG kD lf(i vl2 g~l Phone
PROPERTY Laat flrst
OWNER
Sfreef Address:
Ciy state: Lp:
Company: ~ ( l 2/ ~.v
Phone A:
(area code)
COMRACTOR
Street Address:-,/ Z 2~7 Ir___~ucense a 2°669 393 Exp.
City State: ~-N zip: 5533=7
ARCHITECT/ Name:
ENGINEER Company:
Telephone ( )
Sheet Address: ReglshaHon
Clty State: Zip:
Sewer/water licensed plumber (if Instaliina sewerhvaterl: Phone
I hereby acknowledye thaf I have read Mis applicaHon, state thaf fhe informatbn is co ect, and agree to tfi-pfV'WHh atl apptlcable StafE
of Minnesota Sfatufes and Ciy ol Eagan Ordinances.
Signafure of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No i
Tree Preservation Plan ReCeived _ Yes _ No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
O 01 Foundation ? 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.) ? 31 6ct Att - Mutti
? 02 SF Dwelling ? 08 06-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Aft - 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
? OS 03-plex ? 11 10-plex Plbg _YOr_N ? 25 Miscellaneous
? 06 04-plex 0 12 12-plex ? 20 Pool ? 30 Accessory Bldg.
WORK TYPE
? 31 New ? 36 Move Bldg. ZJ:243 Reroof
? 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding
? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair O 42 Demolish (Foundation) ? 46 Windows/Doors
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code # of Stories ~ sq. ft.
No. of Units Length sq. ft.
No. of Buildings Width Footprint sq. ft.
Const. (Actual) Basement sq. ft. Census Code
(Aliowable) 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
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
ToWI:
SAC Units
% SAC
C A L V I N H. H E D L U'MD t »zs Morqan Avenue soufn
RICMieId,Mlnnesata 55423
Land Surveyor Clvll Enqineer' Phone : 866-2523
Suuler#or`s G'errmfiwte
,
{ J08 N0.
SURVEY FOR: Zachman Brotliers Cbnstruction Co., Inc.
DESGRIBED AS: Lot 28, Block 2, CINNAMON RIDGE TfIIRD ADDITION, city of Edgan,
Dakota county, Minnesota and reserving easements of record.
_9/4.8 Nqq°05'll"F $5.00 914,5 Top of Fo4.,/a<Ion: 9/6.8
: 1345lMQ/!Y F/.er ~3.3 ~
Ca/• c Fl•oY * 9 6
h h Proposed E/e?ario*t 0
v1 0~ ~Q tl; o
z ~~~67 peGK ~ Ex7ssing Ll..vae;o.~s
30 N Dra;naye 1Directions
I~~ N P;neW I~ es LoC- Cerner 0
lo'-Um StaKes ~~,b• N~~.= ~ J
~ -
wNG ~ ~ 10~0 5 St4Ke5
: C_- ! \ e L6.)
~
30'
i~ y'~ ~ 3o I 91
~c.sc ~Z 3~'*l
63' . ,.525 34 a/
va?- 5r~c~-r- 'S zz ~ P
~
FZaNT ~;E?enc K o. K. o
`b
C`No AO oN . `
O
~
~ N ~ J . m .
CERTIFICATE OF SURVEY
I hereby certify ihat on (2/7 /$4 I surveyed ihe property described above and that
the above plat is a correct representotion of said survey.
Y.,(C.~-"~---
Calvin H. Hedlund, Minn. Reg. No. 5942 ,
s
~ i 4
CITY OF EAGAN 2/8
~ APPLICATION FOR PERMIT
;
- SEWER AND/OR WATER CONNECTIOrT
(PLEASE PRINT)
1) PROPEIYPY ApDRESS:
r.Frar• oESCRIprioN: o~ OG Z C~?~~~~h l
(LOt/Block/Subdivision or Tax Parcel I.D. NLUnherl
i IF F":i~_= :G S'?'RC'CT?.I'., Drl^ OF ORIGuLAL aliiI.uL^~G P~:ffT ~cS,-~
~ \`._OC_ ar1
? R-2 DU??.E{ ('P.•,-O LtiITSj
p R-3 ZC7r7NHOLISE ('I'fTRF," + UNITS) ( UNITS)
? R-4 APA.RZma1T/CONDCMNILM ( Wi ITS)
? COitiIIMETtC7AL/RE,'PAIL,/OFFICE
? I`i'DliSTRTAi
? INSTITUTIONAL/GOVEFh',Ilv=
z) pppLICANT (PLEASE PRIN1)
NAP7E : CQe pi' p I J G .
ADDRESS: (7 L°c ~
cITY, s~ATE, ZIP: y'oL) m,-7 Ss 3~ y
PHOiVE: 7 Z - q7 S- -
3) P=,TBER PLEASE PHINT) FOR CITY USE ONLY
NAME: ~ qJG~(C 4- .
ADDRESS: ~j SQ CC) FLUyBEAS LICENSE:
~ Active
CITY, STATE, ZIP: ~rfOc~ yn/~ . Ezpired
Not of Record
PHONE: PLUMBER LICENSE H b ~F
a nttia
c]) O=pj~/Or&TER ~ (PLEA E PRINi)
N11h1E :
ADDRESS: ZQ [QJ. ~1
CITY, STATE, ZIP: 5 ~ S^
PHONE: 7 SS^
5) 7NDICnTF' F'dHlCr{ or.onnlm rS EEIP7C; F2D guTST"~:
~ ION 'Ib CSTY SE7idER
CONNECI'ION 'IC) CITY WATCR
E] 0'ITM (PLEASE DESCRIIIE)
6) NDIG,TE 0.E:
Q PI.P.ASE HOLD APPf20VID PERMIT FOR PICEC-UP BY ONE OF ItB()VE
? PLEA.SE hfAIL APPROVm PERAIIT 'IO 1, 2, 3, 4 ABOVE
/y. (Circle one)
7) SIG!vATL-RE: DATE: ~ ~ d
•awwwiwsy.i.a.e~;::~:~s+n.r.:.~a's;~.:~ai.~~;i;~s:~~r~.a~,~.:~.~i..~.~..s.s.. ,
~ssa
F 0 R C I T Y U S E O N L Y i
PERMIT ISSUED
~
F°ES: $ ia~ o SEWER nv-RMT_m (I`ICLliDE SUP.CH?RGc)
$ ia•SO WATEP. PERF1IT (I*:CLUDE SURCHr1?GE)
$_~_~~.ee ' WATER METER/COPPERHORN/OUTSIDE READER
$ WATER TAP (INCLUDE COF.PORATZON STOP)
$ SEWER T.'vr
$ ACCOUNT DEPOSZ'1' - SEWER
$ ACCOUNT DEPOSIT - WATER
$ -~-~7 Q o-'O WAC
$ SAC
$ TRUNK L4ATER ASSESSMENT
$ TRliNK SEWER ASSESSMENT
$ LATERAL BENEFIT/TRUNK SEWER
$ LATERAL BENEFIT/TRUNK WATER
$ ' OTHER -
/ $ / d dAd TOTAL .~/9a q ~
$ .G.~ °__cl AM0UNT PAID/RECEIPT 4
/
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGcIT OF SdAY?
~ YES IF YES, THEN A"PERMIT FOR WORK WITHIN ~ PUBLIC ROADWAY" MUST BE ISSUED BY THE
NO ENGINEERING DIVISZON. LZST AS A CONDI-
TION.
SUBJECT TO TEtE FOLL0:9ING CONDZTIONS:
APPROVED BY:
TITLEezlcl-l
`
DAT°:
EUM wM sM W-M IMM w ssN w.a w=wW:W wM w,a MEMwWjng wUM
Use BLUE or BLACK Ink
r
For Office Use I
Z/H
City of Ea , Permit#:
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: ,
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: tdf /~j Site Address: qLIA later Unit
Name: N&fw( Se-rpson Phone: C) %C/
Resident/
Address / City / Zip: 7 D' S lq+er M
Applicant is: Owner U Contractor
Type Description of work: Te~~ ~T J i'1't Ces fi ~ ~d0
of Work
Construction Cost: 44 4 . Multi-Family Building: (Yes / No v
Company: TW (h C1114 W0 S Contact: _7c>4 C4
Contractor Address: h Y!O Cas-~ Q.iV2r 44J City: A h
State: Zip: _ S Q 3 Phone: 7G 3_7q6 -y 6 G 0
License C0 Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
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.
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.clopherstateonecall.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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x AvI Rdt&43 x
Applic n 's Printed Name Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA179184
Date Issued:09/22/2022
Permit Category:ePermit
Site Address: 4401 Slater Rd
Lot:28 Block: 2 Addition: Cinnamon Ridge 3rd
PID:10-17402-02-280
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation. When a weather barrier is installed or
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
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 -
Melissa Kuchlenz
4401 Slater Rd
Eagan MN 55122
(715) 379-4517
Budget Exteriors
8017 Nicollet Avenue South
Bloomington MN 55420
(952) 887-1613
Applicant/Permitee: Signature Issued By: Signature