3880 Dolomite DrCity of Ea�ali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Permit #: q. Cp a —]
Permit Fee: ...73
Date Received:
Staff:
J
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 4'/2 0// 0 Site Address: 38740 - 38 78 -3 850 - 3gSY ,doe-c.,/t44-6-/7 ,'
Tenant:
Suite #:
RESIDENT / OWNER
Name: /O ,$5DC, I%../�ivc- j't1 UMT Phone: 74 3- - 37.27
Address / City / Zip: 7100 E. FISH LIC 0 M PrP LE ( &&VE MN S5311
Applicant is: Owner X Contractor
TYPE OF WORK
Description of work: gCMOVE AN0 &PtAt 44,A -
Construction Cost: / 3, 6 ao Multi -Family Building: (Yes X / No
)
CONTRACTOR
Name: 3E/ E +4 TE'fO/L #: alD? 'V// 3/
CO,e, License #:
(/04/NT,
Address: 8 /0. 607x u T City: ///! /NNA,O6G/S
�`
A
State: Al Zip: ‘..5-&111 9 Phone: (1 26/ - 625'3
r-
Contact: DA -t/19 Email: 1f1 Fo C. berg M . COr"
COMPLETE
In the last 12 months, has
Yes If yes,
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
the City of Eagan issued a permit for a similar plan based on a master plan?
date and address of master plan:
_No
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor:
Phone:
Y tformatIon portions
of
CALL BEFORE YOU DIG. CaII 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.gopherstateonecatl.orq
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 }fm the case of work which requires a review and approval of plans.
X ('-/1is-WegccO
Applicants Printed Name
Applicants Signature
Page 1 of 2
City at Evan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694.
Jti
3i
Permit #: / / l(C 1
Date Received: AUG 2 4 2009
Staff:
Permit Fee:
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: A-'-' ' Z" a 9 Site Address: 4 2, p dt. /Ii • L i w .,., „los,` E .S
Tenant:
.41
�3' go c Lc car,6 Suite #:
RESIDENT/OWNER
Name: 1/0 /93soe„47- 0 f,),4,se,44 irlIAsr61 :r.v% Phone: 743-ySV- 37A7
Address / City / Zip: V 0 , &)c-- Al / -S g ,41 PL -S .. S`Y V) e
Applicant is: Owner i< Contractor
TYPE OF WORK
Description of work: R e - 110 , t i. Q E G �Z
Construction Cost: g, C1 -?C) Multi -Family Building: (Yes X / No )
CONTRACTOR
Name: Ci £ / £x 7-2.42/02 /92/4/"):—. tO2 P License #: .'ZC,.. 4'// 3 1
Address: i -/c s' - 6 c '�i 5,--,
City: r% PL S, State: /V1 Zip: S'SV/ g
Phone: 6,4Z- g 6/- 0 21/3 Contact Person: b e4 v t 4 u dea, -5
COMPLETE
Energy Code
Category
(/ submission type)
In the last 12 months, has
If yes,
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 Minnesota Rules 7672
• Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Submitted Submitted
• Energy Envelope Calculations Submitted
the City of Eagan issued a permit for a similar plan based on a master plan?
date and address of master plan:
_Yes _No
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.':.,
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 is not to sta out 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 ans.
x �1 Lr f b ati,2,2/S
Applicant's Printed Name
Applicant's Signature
Page 1 of 3
3 tomi--e.'r
DO NOT WRITE BELOW THIS LINE CiOCi'(
SUB TYPES
❑ Foundation
El Single Family
❑ 01 of _ Plex
❑ 02-Plex
❑ 03-Plex
❑ 04-Plex
WORK TYPES
El New
Addition
Alteration
if,„' Replacement
DESCRIPTION:
Valuation
Plan Review
(25% 100%
Census Code
# of Units
# of Buildings
Type of Const.
05-plex
06-piex
07-piex
08-piex
10-piex
12-piex
❑ 16-piex
O Fireplace
O Garage
`11... Deck
O Lower Level
O Interior Improvement
O Move Building
O Fire Repair
REQUIRED INSPECTIONS
Footings (new bldg)
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Footings (deck)
Footings (addition)
Foundation
Drain Tile
Roof: _Ice & Water _Final
Framing
Fireplace:_R.I. _Air Test _Final
Insulation
❑ Accessory Building
O Porch (3 -season)
❑ Porch (4 -season)
O Porch (screen/gazebo/pergola)
❑ Storm Damage
O Miscellaneous
O Siding
O Reroof
O Windows
O Egress Window
%fitrJ2-o
Y
D
El Pool
O Ext. Alt. — Multi
❑ Ext. Alt. — SF
❑ Multi Misc.
❑ Demolish Building*
❑ Demolish Interior
❑ Demolish Foundation
❑ Water Damage
* Demolition (entire building) — give PCA handout to applicant
Sheetrock
Final/C.O.
Final/No C.O.
HVAC
Other:
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Pool: Footings Air/Gas Tests -
Siding: _Stucco Lath _Stone Lath
Windows
Retaining Wall
Reviewed By: ' 1 , Building Inspector
RESIDENTIAL FEES:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
Total
6 / (L., )0 ° l�
Final
Brick
Page 2 of 3
CITY OF ^'EAGAN
3795 Pilot Knob Road PERMIT NO •
Eagan, MN 55122 DATE.
Zoning• No. of Units.
Owner:
Address:
Site Address.
Plumber:
Meter No.: — Connection Charge•
Size: Account Deposit --
Reader No.: Permit Fee.
1 agree to comply with the City of Eagan Surcharge.
WATER SERVICE PERMIT
Ordinances.
By
Date of Insp.:
Misc. Charges.
Total.
Date Paid•
Insp •
CITY OF EAGAN
3795 Pilot Knob Road PERMIT NO •
Eagan, MN 55122 DATE.
Zoning: No. of Units.
Owner:
Address.
Site Address.
Plumber
SEWER SERVICE PERMIT
1 agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit.
Permit Fee.
Surcharge.
By Misc. Charges.
Date of Insp.: Total.
I nsp.: Dote Paid.
41'City atEke
3630 Pitot Knob Road
Eagan MN 55122
Phone: (661) 675.6675
Fax: (651)676.5694
Use BLUE or BLACK Ink
r For Qlhce dee
Perm* 6 l CI()-
Permit Fee: .. -1.-a5"
Data Received: 1
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPucATION
Date: • SIN Address: 3174,, 3 7'S, 3 eS.0, 81F,1j tZtooLork er i AQ. Unit ft:
Name: c A C 7 not; ti) r4 rb 1 E a..r i -.710 C Phone: 7401 - .s'4 3 -19 7 7o
Address / City I Zip: �St> a Z: t 4 7--u,2 ,�1.J N p 604E.-1 V+Ki *'
Ar -SrilA
Applicant is: Owner 2, Contractor
Description of work: '7"£'A,2 OFF. e• O.E - QvoF
Construction Cost 9 VO CTO Multi -Family Building: (Yes / No
Company: E J /DRlb.a , R Contact tow 12•,F. r S
Address: 90 s- 6DtiS? .
state: / i -1 zip: .5rv/ 9
City: /'h PG 5
Phone: LD'z
License #: .t y J 3 / Lead Certificate #:
If the project Is exempt from Wad certification, please explain why: (see Page 3 for additional information)
fit. 4.5 LE C- ,tr Pas;
i,,r
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW UJLDING
In the Fast 12 months, hes 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:
tt et, i
77,.rL�rtii .�.t,�y at Tr Zwsc xw
•
aaJ� :. 7 R ! �2(r�Y :�S ✓� u d^•�(f'- ''N•
�1
.. .�,. ...15♦ ...^iA,. .G� w 4:'• T��. .Int' hM.l L.� "�'.�.7�1�1,lrnn'
CALL BEF E Y DJG Call Gopher Stats One Call at (651) 4640002 for protection against underground utility damage. Call 48 hours
before you Intend to dig to receive locates of underground utilities. vnwr.00pherstateonmall.oro
I hereby acknowledge that this information is complete and accurate; that the work vriil be in conformance with the ordinances and codes of the City of
Eagan:
understand this la not a permit. but only an application for a pemlit, and work is not to start without a permit that the work vrill be In
approved plan In MG case orwork which requires a revlew and approval of plana.
days Exterior work authorixad
of permit Issuance. by a building permit issued in accordance with the Minnesota Stara Sultan Code must be completed within 180
x_ b oqv i 4__ _S
Applicant's Pri_nted Name
ZOIZO 39vd
1NIt1W 1X3 I3S
x
Applicant's Signature
Page 1 of 3
L9Z9I98Zt9 OZ:ZT ETOZ/bT/tT
CiIy of Eag,all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (551) 675.5675
Fax: (651) 6754694
Use BLUE or BLACK Ink
Far Office Um
Permit#: I I (00
Permit free:
a 73 00
Oats Received: , 042-1 13
Staff
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
/A- - /_ddtess: 3 74, 3f7S, 3580, 3E87_ MiT t unit g;
Renident/
Owner
.
Name: etc 4C`% Miml 4tbZMtE431i -7-wr C. Phone: 741 - S73— 4770
Address / City / Zip: SSC' D E e wry Q 4v, A), I A Got.d Sti t' ,42 r /x.J
~
Ss- 4'.t 7
Applicant is: Ower X'Contractor
Typ6-ofWOrk
DeecriPtiee ofwork: Pf...o:• a a- RE Pc..e-e-E-- S lJiJ 6 a p-d1G/a /4 Z7.IA 4_
Construction Cost / yC Yo0 • 0-0 _ Multi -Family Building: (Yes Z / No „_J
Contractor
•
ComPany: {as E 1 ,c r "/014 Mid, ."T . 612 Contact !NW, 6 as -a/ S
Address: 4/°s" f.4) t.o fr. City: /71 PG. S
State: /'4,3 Zip: S5'41/ 9 Phone: [o/ A - / / - !o 2 4/3
License ht: 4.3 C- 2 y/ / 3 / Lead Certificate #:
If the project is exempt
(11-4/s.
from lead certification, please explain why: (see Page 3 for additional information)
Q,-,rL�- Posr. J y759
In the Inst 12 months,
_Yes _No If
Licensed Plumber.
Mechanical Contractor:
Sewer & Water Contractor:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has lbs City of Fagan issued a permit fora similar plan based on a master plan?
yes, date and address of master plan:
Phone:
Phone:
Phone:
NOTE. and fo 9MM + ► 'J : J a•
CALL BEFORE YOU DIG,. Can 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. wwyroEhersteteonecall.orq
I hereby acknowledge that this i ernaton is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eaganaccordance that I ae w understand this la not a panne, but only an application fora permit, and work is not to sleet without a permit that the wait Wit be in
approved plan In me case of wadi whlch requires a rewewand approval of plane.
Exterior work authorized by a building permit issued in accordance with the Minnesota Stats Bufldk Code must be completed within 180
days of pest issuance.
x 4 v, 0 /24,4-/Z../.3
Applicant's Printed Name
ZO/T0 39dd
x
Applicant's Signature
77Page 1ofs
1NIVW .X3 I3>3 L9Z9198ZT9 EE:0T ETOZ/Z0/ZT
City of Eaaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office lis 67 77/
Permit #: /
Permit Fee:
Date Received:
Staff:
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: c-:-14,
Site Address: 3 e3 O
Unit #:
J
Name( e3 41 Clown Phone: S/-6`6- cfr7
Address / City / Zip: 3e80 Or
Applicant is: Owner ? Contractor
Description of work: ,fin 4/ /O r- J/;.% GLewie..1
Construction Cos194/go
Multi -Family Building: (Yes / No )
Companyr et 4- P%a.:-r S (,✓,,,c[e;,�s c., f L?,o,ts Contact: % 1) (t/nr 2
Address: Co '33 'A S'f` Al cre f Civ City: COQ L le...
State:in/I Zip: 5-' 1,2b Phone: 4S7 -4207-`/5 Email: St..✓cr4,9ya,l-ljia, p S' Ge;.--ao•..,s>G.-
License #: 2C2 -70613 k, Lead Certificate #: (/ f -1;'1 (o I Siff- (
If the project is exempt from lead certification, please explain why:
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:
Phone:
Phone:
Sewer & Water Contractor:
Fire Suppression Contractor:
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.000herstateonecall.orq
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 Minn s - State Bui in. Code must be completed within 180
days of permit issuance.
V � �.a d
plicas rinted Name
t' Si• ature
Page 1 of 3
City of Eagan
PERMIT
EAGAN
Permit Type: Building
Permit Number: EA153753
Date Issued: 01/22/2019
Permit Category: ePermit
Site Address: 3880 Dolomite Dr
Lot: 33 Block: 01 Addition: Briar Hill 3rd
PID: 10-14992-01-330
Use:
Description:
Sub Type: Fireplace Construction Type:
Work Type: Gas Insert
Description:
Census Code: 434 - Residential Additions, Alterations Occupancy:
Zoning:
Square Feet: 0
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
Fee Summary:
Valuation: 3,000.00
BL - Base Fee $3K
$88.50
Surcharge - Based on Valuation $3K $1.50
0801.4085
9001.2195
Total: $90.00
Contractor:
The Fireplace Guys Llc
680 Hale Ave N #110
Oakdale MN 55128
(612) 326-1919
- Applicant -
Owner:
Gregory Tste M Stevenson
3880 Dolomite Dr
Eagan MN 55122
(651) 402-2556
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
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA175211
Date Issued:03/21/2022
Permit Category:ePermit
Site Address: 3880 Dolomite Dr
Lot:33 Block: 01 Addition: Briar Hill 3rd
PID:10-14992-01-330
Use:
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675-5675
www.cityofeagan.com
Description:
Sub Type:Water Heater
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota
State Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 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 -
Gregory M Tste Stevenson
3880 Dolomite Dr
Eagan MN 55122
Clearwater Plumbing & Heating
19260 Mushtown Rd
Prior Lake MN 55372
(952) 440-3779
Applicant/Permitee: Signature Issued By: Signature