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4176 Meadowlark Way
City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 Date: ✓ Tenant: 2009 MECHANICAL PERMIT APPLICATION ? �/ °Site Address: / / 76 Cr / y RESIDENT / OWNER CONTRACTOR TYPE OF WORK PERMIT TYPE Name: /47.9'?1 > %� Phone: 6.57— c; Address / City / Zip: A /77 e au, fr Name:P,f1€ lt K License #: Address: "!/ 17-r City: p Phone: /— t/- / t 97 Contact Person: /, %/ Zip: ,53 New Replacement Additional Alteration Demolition Description of work: NOTE: Roof mounted and ground mounted mechanical equipmen Code. Please contact the Mechanical Inspector for information is require to be screened by C n permitted screening methods RESIDENTIAL �rnace 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) ** When installing /removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add -on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) �j S—v ✓ O TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation /removal OR $50.50 Minimum (includes State Surcharge) - If Permit Fee is Tess than $1,000, surcharge is $.50. - If Permit Fee is > $1,000, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $1,001 - $2,000 Permit Fee requires a $1.00 surcharge). Contract Value $ x 1% = $ Permit Fee = $ 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.or I hereby acknowledge that this information is complete and accurate; that the work will be n con Eagan; that I understand this is not a permit, but only an application for a permit, and work is of with the approved plan in the case of work which requires a review and approval of plans. (0-LL - Applicant's Printed Name x Appli nt's Si Use BLUE or BLACK Ink Eof Permit #: '-3'S CS Permit Fee: - l 6 Date Received: w Staff: Suite #: ance with the ordinances and codes of the City of wit, • ay mit; that the work will be in accordance _•'" ure Reviewed By Under Ground R ough In Air Tess Gas, Service Test _In-floor Heat Final Exterior HVAC Screening Inspection FOR OFFICE USE Required Inspections: CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 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: Ordinances. Misc. Charges: Total: By Date Paid: Date of Insp.: 7?fp" Insp.• CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Road P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: 1 agree to comply . �^ g ply with the City of Eagan Connection Charge: Ordinances. Account Deposit: rF Permit Fee: ter _ - Surcharge: By r� vf ! Misc. Charges: Dote of Insp.: _ Total: Insp.• Dote Paid: Use BLUE or BLACK Ink I For Office Use rr Permit* City of Eap 1 14 1 Permit Fee: 1 3830 Pilot Knob Road i I Eagan MN 55122 I Date Received: 01113)13 1 Phone: (651) 675-5675 1 I Fax: (651) 675-5694 I Staff- c I I ___--_J J 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address:1 A/yel,((~,U./~ Name: _L.a4wccd h YIfJ//1~~ Phone: Resident/ Owner Address / City / Zip: Applicant is: Owner OW Type of Work Description of work: OCo &-A22E yn)yv r sid / Yi (Wks Construction Cost: Multi-Family Building: (Yes Y Company: !V u 44er i © rs Av S A 4 f ~k- Contact: 562 Affe-C I Contractor Address: )Q /01 City: hook l9'1olfL ~~~y j Zip: I~~2~...) t/0 Phone: ~~0 /3 -3 1s _ pqQ State: %r (J ~ - - O I License Sr 3~ Lead Certificate fV 1 / (J 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 A the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are bade 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.goaherstateonecall.oro 1 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 Idin o st completed within 180 days of permit issuance. Applicant's Printed Name Applicant's Signature Page 1 of 3 Date: City of Eaaan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 RECEIVED MAR 2 0 2014 Use PL or BLACK Ink For Office Use Permit #: Permit Fee: Date Received: Staff: 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Resident/ Owner Type of Work Contractor / �vt� t �1 3 L! Site Address: 1/ 7 �' ` Y / ` 0 i t% ! r" Unit #: Name: P fry S.v Address / City / Zip: 1 / 7 L -12 14^26 L / 0--14? 1�..� Applicant is: Owner •%nb�ctor Description of work: (�� 5%� vJ 4 /wt Construction Cost G',, &O 0 Multi -Family Building: (Yes .../r/ No ) Company: 0l -(f' e C�7' d°'h *Jo e„1i i, pi r�` Contact /J 4"1-1 .e_ �,11 „1 Address: 5 i. 17 ” 3 , Cj(jr. J ,C <;.; �"°"/'h •. State:ry / I'1 Zip: � 5 0 U1 Phone: G 404 - 7, 3 `" 7 0 "1 r/ Phone:' _ 6;/—;4l. S~e)4 License #: et- 2470I-7 ,� 7�� v 3 7 Lead Certificate #: R -J - 303;1-10-X/ Q� If the project is exempt from lead certifia tioii; pleaWaxplain why: (see Page 3 for additional information) i t y4-5 / q 7 1(21c i 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. 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 l./ t/ .e 6--0 r41 X Applicant's Printed Name A plican 's Signature Page 1 of 3 y1141 ;Mtaciowlaki�7 DO NOT WRITE BELOW THIS LINE 07/3 73 SUB TYPES Foundation _ Fireplace Single Family _ Garage _ Multi _ Deck t- 01 of # Piex _ Lower Level WORK TYPES New _ Interior Improvement _ Addition _ Move Building Alteration _ Fire Repair _ Replace _ Repair _ Retaining Wall Porch (3 -Season) Porch (4 -Season) _ Porch (Screen/Gazebo/Pergola) _ DESCRIPTION Valuation Plan Review (25%_ 100% Y ) Census Code # of Units # of Buildings Type of Construction 4.111 Pool Occupancy Code Edition Zoning Stories Square Feet Length Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Roof: Ice & Water Final 4t_ Framing Fireplace: Rough In Air Test Final Insulation Sheathing Sheetrock Fire Walls Braced Walls Siding Reroof Windows Egress Window Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Accessory Building Demolish Building* _ Demolish Interior _ Demolish Foundation _ Water Damage *Demolition of entire building — give PCA handout to applicant ZA4 - 3 MCES System o t 7 SAC Units R-3 City Water Booster Pump PRV Fire Sprinklers WINNON Meter Size: Final / C.O. Required Final / No C.O. Required HVAC _ Gas Service Test Gas Line Air Test Pool: _Footings Air/Gas Tests _Final Drain Tile Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wall: _ Footings _ Backfill _ Final Radon Control Erosion Control Other: Reviewed By: L17 7) , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL 7373 ( � 03 O* 2o" ,2oGodie- Page 2 of 3 I— For Office Use :::t:: t it / /67•___ E AG N C� } I Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 Jf vE (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-569 ? MAR Staff: buildinginspectionsr'a�citvofeagan.com 1 2019 2019 RESIDENTIAL BUIL r IT APPLICATION Date: -57iii/9 1 Site Address: 41 171‘) ���/� �'�E` f C Unit#: Name: Phone: Resident! �Cr C , Owner Address/City/Zip: Applicant is: Owner Contractor T e O pry Description of work: Pet k I�LCn-e, YP f W 1� Construction Cost: P-Li 7 005- Multi-Family Building: (Yes /No ) Company: Contact: /{A IL //,..) Address:_ 7/L73 S;/(1 , l` City: Contractor _ State:MA) Zip:6-5-/- hone: (t7 S 7--Z/v/Ot OEmail: / I fil--)414"-)11). C,Ur��. 4"‘ License#: 627-00 / (i Lead Certificate#: If the project is exempt from lead certification, please explain why: .tox 4-ern-If-- 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? Y---Yes No If yes, date and address of master plan: 5P Zoig rG ��t v✓i� �/� Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression 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. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaaan.com/subscribe. 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. 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.aopherstateonecall.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 accor laipV/ik.) e wite approved plan in the case of work which requires a review and appro al f pl . x l Applicant's Printed Name Applicant's Signature •DO NOT WRITE BELOW THIS LINE L(1 7(G fei4Aocaltqa 10 /6'w/ , SUB TYPES Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi) Multi x Deck — Porch(Screen/Gazebo/Pergola) _ Miscellaneous — 01 of_Plex _ Lower Level Pool _ Accessory Building WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building ` _ Reroof _ Demolish Interior _ Alteration _ Fire Repair _ Windows _ Demolish Foundation x Replace _ Repair Egress Window _ Water Damage Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION UOD____ Valuation Occupancy 11 MCES System Plan Review Code Edition A, I 5-'1 SAC Units (25%)( 100%_) Zoning MS City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length '2- Fire Suppression Required Type of Construction V r V 5 Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) X Final/No C.O. Required Foundation Foundation Before Backfill HVAC_Service Test Gas Line Air Test Hood Roof:_Ice &Water _Final Pool:_Footings Air/Gas Tests _Final 1( Framing 30 Minutes 1 Hour Drain Tile Fireplace:_Rough In _Air Test Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS Insulation Windows Sheathing Retaining Wall:_Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control — Shower Pan Other: Reviewed By: 17/ , Building Inspector RESIDENTIAL FEES Base Fee Surcharge 006 Plan Review / /3/ t� O MCES SAC AffiV3 ;� I V City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant Radio Meter Read Copies TOTAL Page 2 of 3 r , * For Office Use 1 I ' ° o f' Permit#: �� Iqa 53,164? $w'o y.4 Ps P.✓ I A.-, DearrtenitReceiFee:ved: �?0 , EAGA �Qt "�� CEI EvE0 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675!TDD:(651)454-8535 FAX(651)675- HAY 1 0 2019 stiff: I buiidinginspections aOcityofeagan.com J 2019 RESIDENTIAL BUILDING RMIT APPLICATION Date: 5-10-2019 Site Address: 4176 Meadowlark Way Unit#: Name: Patricia Mikrut Sever Phone: 651-452-2396 I Resident/ 4176 Meadowlark WayEagan, MN 55122 owner Address f City/Zip: Applicant is: Owner Contractor '. `J I It'6 _4 :--' • if Type of Work Description of work: I would like to replace my deck floor boards with composite material Construction Cost: $200. Material ✓ Multi-Family Building: (Yes /No ) Self I Company: Contact: Contractor Address:City: State: Zip: Phone: Email: License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: Note: I am only going to replace the deck floor, deck is new. I will be replacing floor with composite materail. 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: Fire Suppression Contractor: Phone: NOTE:Plans and supporting documents that you submit are considered to be public infonnatlon. 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. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at wuwv.citvofeaaan.com/subscribe. Exterior work authorized by a building penult Issued In accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. CALL BEFORE YOU DIG. Call Gopher State One Call at(851)454-0002 for protection against underground utility damage. Call 48 hours before you Intend to dig to receive locates of underground utilities. www.dooherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in ., ormance f°th the ordinan and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, an. . is not to s rt without a permit; that the work will be in accordance with the approved plait in the case of work which requires a review and a. ::.arts x Patricia Mikrut Sever Applicant's Printed Name A A. Applicant ' 'ignatu l DO NOT WRITE BELOVV THIS LINE I-111(p 141U-100)04t. 1/36i SUB TYPES Foundation _ Fireplace Porch(3-Season) Exterior Alteration(Single Family) Single Family Garage Porch(4-Season) Exterior Alteration(Multi) - Multi i .4._ Deck — Porch(Screen/Gazebo/Pergola) Miscellaneous t4 01 of Lt Plex Lower Level — Pool Accessory Building WORK TYPES New Interior improvement Siding _ _ Demolish Building* Addition Move Building Reroof _ _____ _ _____ Demolish interior Alteration Fire Repair Windows Demolish Foundation )< Replace _ Repair Egress Window Water Damage _ Retaining Wall 'Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation 49 513t9• --- Occupancy --1- 113 MCES System Plan Review Code Edition m0 2'3/5- SAC Units (25% 100% Yi) Zoning D City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction kig Width REQUIRED INSPECTIONS Footings(New Building) _ Meter Size: Footings(Deck) ____ Final/C.O. Required Footings(Addition) >0 Final/No C.O.Required Foundation Foundation Before Backfill HVAC Service Test Gas Line Air Test Hood Roof: ice&Water Final Pool: Footings Air/Gas Tests Final Framing 30 Minutes 1 Hour Drain Tile Fireplace: Rough in Air Test Final Siding: Stucco Lath Stone Lath Brick EFIS insulation _ Windows Sheathing ____ Retaining Wall: Footings Backfill Final Sheetrock Radon Control _ Fire Walls Fire Suppression: Rough In Final Braced Wails Erosion Control Shower Pan _ Other: Reviewed By: "I.OM /77:(C./7,1 , Building Inspector RESIDENTIAL FEES 09in;',/)/-)4-7 /---- -'e--- Base Fee Surcharge Plan Review De 4- 73 Doig P.S all /1 MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant Radio Meter Read Copies TOTAL Page 2 of 3 1 E AG A NFor Office Use �f "� �, Permit#: 1 S 1 -2 J ) ,, Permit Fee: !,D I' 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 Date Received: (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Email: buildinginspections ccityofeacian.com Staff: Commercial Plan Submittal: eplans(c�citvofeagan.com L 2020 RESIDENTIAL MECHANICAL PERMIT APPLICATION Date: I 1` ZC Site Address: 9 76 ep-ei u� 0 w C Tenant: r3./ / C��✓C * Suite#: --- Name: r -ems Phone - qS`—- 3 ci S� Resident/Owner �/i i �///moi /aç Address/City/Zip: / - CA) e• c Name: GZ •2 / / 'gti- cG �Ll�ense#: L Uc-iC/ Contractor Address:. � S / ? ,`�1 `( /pity: i G/� State:AA/ 53 Phone: 6 ✓ 6 Contacts(f2 EC Email: re-iC55L@ 0 .1'tZe_i 14(74-0 R,IDENTIAL _/Furnace _Air Conditioner Permit Type Air Exchanger Heat Pump Other New R lacement Additional Alteration Demolition Type of Work 4/471----Pt Description of work: e03,- RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit, includes State Surcharge $100.00 Residential New, includes State Surcharge =$ TOTAL FEE You may subscribe to receive an electronic notification from the City of proposed •rdinan -s by signing up for an email update on the City's website at www.citvofeacian.com/subscribe. I hereby acknowledge that this information is complete and accurate;that the wor will •e in o •r ance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application far - per -,d ork is not to start without a permit; that the w k will bei accordance with th approved plan in the case of work which r •'fres r-v'-w .nd approval of plans. II x )(LIE-- 111111...��/ � Ap icant's Printed Name A••I' a O`ature FOR OFFICE USE Required Inspections: Reviewed.By: Date: Underground Rough In Air Test Gas Service Test In-floor Heat Final PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA174367 Date Issued:01/20/2022 Permit Category:ePermit Site Address: 4176 Meadowlark Way Lot:1 Block: 3 Addition: Hillandale 2nd PID:10-32951-03-010 Use: Description: Sub Type:Furnace Work Type:Replace Description: Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 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 - Patricia Sue Sever 4176 Meadlowlark Way S Eagan MN 55122--177 (651) 452-2346 Wenzel Heating & Air Conditioning 4145 Old Sibley Memorial Hwy Eagan MN 55122 (651) 894-9898 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA174829 Date Issued:02/22/2022 Permit Category:ePermit Site Address: 4176 Meadowlark Way Lot:1 Block: 3 Addition: Hillandale 2nd PID:10-32951-03-010 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 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: 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 - Patricia Sue Sever 4176 Meadlowlark Way S Eagan MN 55122--177 Property Claim Solutions Llc 2005 Pin Oak Dr Eagan MN 55122 (651) 994-2028 Applicant/Permitee: Signature Issued By: Signature