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4166 Countryside DrL o2 B,q./._ SUBD. .l ' CITY OF EAGAN zbylc,0 101 MECHANICAL PERMIT (612) 681-4675 RESIDENTIAL RECEIPT # X990 DATE (oar./ 9 PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, COMPLETE FOR TOWNHOMES/CONDOS WHEN SEPARATE PERMITS ARE REQUIRED FOR EACH DWELLING UNIT. OWNER: .• w E'__r--i 0 ,J 't-`% FEES SITE ADDRESS: L\ \ LQ. Lo C --5...,.1...)-\-N-./ Sc�e_ s- . ADD ON/REMODEL (EXISTING CONSTRUCTION ONLY) $ 15.00 INSTALLER:..„..}.c.1/4_,\.\ ,®„`,, \c- .. HVAC: 0-100 M BTU 24.00 PHONE #: �s..k Lk-- k ADDITIONAL 50 M BTU. 6.00 ADDRESS:Ar� `'.l L � � .....1„.3 17...02 `( GAS OUTLETS - MINIMUM 1 @ $3 EA. a -- CITY: � c I ZIP: 3` 1 V SURCHARGE: $ .50 SIGNA 1 ' ..� ..TOTAL: $ "")...1A •t -C COMMERCIAL PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO COMPLETE FOR APARTMENT BUILDINGS OR OTHER MULTI -FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. WORK DESCRIPTION: CONTRACT PRICE: 1% OF CONTRACT¥I E. STATE SURCHARGE IS $.50 FOR EACH $1,000 OF PERMIT FEE. PROCESSED PIPING $25.00 MINIMUM ME - $25.00 FEES OWNER: TOTAL: SITE ADDRESS: TENANT: SUITE #: INSTALLER: ADDRESS: PHONE #: CITY SIGNATURE: SIGNATURE: COUNTRY HOLLOW SECOND ADDITION PRESSURE REDUCING VALVE AGREEMENT This agreement, made and entered of �f'it-c- , 1990, by and between municipity of the State of Minnesota, City), and the Owner and Developer identified The terms "Developer" and "Owner" as PROGRESS LAND COMPANY, INC. whose address Suite 235, Burnsville, Minnesota 55337. WHEREAS, the Developer has applied to 954870 into the_ S7-- ' day the CITY OF EAGAN, a (hereinafter called the herein. used herein refer to: is 14300 Nicollet Court, the city for approval of the plat or subdivision known as COUNTRY HOLLOW SECOND ADDITION, located within the City; and WHEREAS, the Owner and Developer agree to notify the proposed potential buyers of all lots within COUNTRY HOLLOW SECOND ADDITION that. Lots 1-4, Block 1, Lots 1-17, Block 2 and Lots 1-10, Block 3 are in a high water pressure zone and a pressure reducing valve shall be installed in each home below the elevation of 875 feet. All costs shall be the responsibility of the Buyer and shall be installed to prevent damage due to high water pressure. NOW, THEREFORE, the City, Owner and Developer agree as follows: 1. Recording. This agreement shall be recorded with the Dakota County Recorder so as to provide notice to the owners of Lots 1-4, Block 1, Lots 1-17, Block 2, and Lots 1-10, Block 3. The Owner shall provide and execute any and all documents necessary to implement the recording of this agreement. 2. Notice. The recording of this document shall constitute notice to all owners and future owners of property in the COUNTRY HOLLOW SECOND ADDITION subdivision that Lots 1-4, Biock 1, Lots 1-17, Biock 2, and Lots 1-10, Biock 3 are in a high water pressure zone and that a pressure reducing valve shall be installed in each home below the elevation of 875 feet. All costs shall be the responsibility of the Buyer and shall be installed to prevent the damage due to high water pressure. 3. Validity. If any portion, section, subsection, sentence, clause, paragraph or phrase of this agreement is for any reason held to be invalid, such decision shall not affect the validity of the remaining portion of this Contract. 4. Binding Agreement. The parties mutually recognize and agree that all terms and conditions of this recordable agreement shall run with the land herein described and shall be binding upon the heirs, successors, administrators and assigns of the owners and developers referenced in this Contract. IN WITNESS WHEREOF, we have hereunto set our hands. CITY OF EWN (Date: / W, OWNER AND DEVELOPER: PROGRESS LAND COMPANY, INC. mas A. Its: Mayor Attest:C1. J. VanOverbeke Its: erk BY: uArr .�, ZseAC iARA Its: PP.i f 1-Y.Pv r By: Its* STATE OF MINNESOTA ) ss. COUNTY OF DAKOTA On this c=2/.-?/ day of . ,1 a , 1990, before me a Notary Public within and for said County personally appeared THOMAS A, EGAN and E. J. VanOVERBEKE to me personally known, who being each by me duly sworn, each did say that they are respectively the Mayor and Clerk of the City of Eagan, the municipality named in the foregoing instrument, and that the seal affixed on behalf of said municipality by authority of its City Council and said Mayor and Clerk acknowledged said instrument to be the free act and deed of said municipality. g; •!iI!!tC°Se: 410INillftit :k 4. STATE OF MINNESOTA COUNTY OF I''_ Public within appeared personably own, -ety 4t E ) ss. day of and for Notary 1?ublic who being-aa,c11- re3pcctivcl, foregoing instrument, St 1990, before me a Notary said County, personally -ate- to me by me duly sworn, each did say that the E_ --t d; t -t of the corporation named in the , and that said instrument was signed __&1 -d on behalf of said corpora ion, k>y authority of its Board of Directors and said rre s i cicift..r -end— acknowledged said instrument to be the free act and deed of the corporation. 4 Notary Pubic APPROVED AS TO FORM: City Attokney bated: /: APPROVED AS TO CONTENT: ge4ett'd t Public Wor4s Department Dated: Al hi / i° THIS INSTRUMENT WAS DRAFTED BY: SEVERSON, WILCOX & SHELDON, P.A. 600 Midway National Bank Bldg. 7300 West 147th Street Apple Valley, MN 55124 (612) 432-3136 MGD , o L 5'1153 RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas (20% maximum lot coverage allowed) 2 copies of plan showing beam & window sizes; poured found design, etc. 1 set of Energy Calculations 3 copies of Tree Preservation Plan if lot platted after 7/1/93 Rim Joist Detail Options selection sheet (bIdgs with 3 or less units Remodel/Repair Requirements 2 copies of plan 1 set of Energy Calculations for heated additions 1 site survey for additions & decks Addition - indicate if on-site septic system vL 3s Office Use Only Cert of Survey Recd _ Tree Pres Plan Recd _Tree Pres Not Regd _ On-site Septic System Date 5— / i3 / a2°&' 3 �p n Construction 4. Cost ! g 6W //�� Site Address /6t L1Crt/7 A'C /dc Unit/Ste # /,yeti, ;7J sS/g3 Description of Work go /-/A/C Si.P Multi -Family Bldg _ Y _ N Fireplace(s) 0 _ 1 _ 2 Property Owner Si/ i✓ 6 x Telephone # ( ) Contractorre)11/-5e1- r /' --,v U/2-,9F/Z S. Address /2C -5S /,,o/d' %/i✓.1 City 4S6/1-ilJllt/ State AIN Zip -C-�e6 i �y Telephone # ( Gsl) y,.3` 2 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Energy Code Category (' submission type) Licensed Plumber Mechanical Contractor Sewer/Water Contractor Minnesota Rules 7670 Category 1 • Residential Ventilation Category 1 Worksheet Submitted • Energy Envelope Calculations Submitted Minnesota Rules 7672 • New Energy Code Worksheet Submitted Telephone #( Telephone # ( 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. X72,4-7" Applicant's Printed Name PERMIT CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 PERMIT TYPE: Permit Number: Date Issued: dk SITE ADDRESS: 1„CrTN.". t333:: L02: .i33:1 COUNTRY HOLL01./„! 32NU 10-18216-020-01 DESCRIPTION: 6N PWC. ••••• 40:77, OPN.,,,n004%h4.2.Qiig! REMARKS: 1 1B 1 FEE SUMMARY: / PA 1 l'AN'•31. .3„. ,11 0 01 13, .3•31 „ y31 „! f3N-N. (2) U ;133. '1' •.: •"3. :•"33 I. 3: • , .333, 1 0 ':313)0. UniL6 CONTRACTOR: SEVC:RSON HOMEN8 INC 540 BURNSVTi 6 1 MN ••••• .1. (3: a ill:. , :4 7 :1,• OWNER: 6.3, E t'34 H 0 F:N33.3 (!. 1:3', C ''•,1 EN. N 1•3•3“.N•13N\ Pr:.3 c6i1-!...1606 -3'4/10 APPLICANY/PERMITEE SIG URE f)oGNAT 'ISSUED GNAT E 4 ,ertikicate n tccnpmsc ma * wagon 'q'* sago This Certificate issued pursuant to the requirements of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following: Use Classification: SF' 11 Bldg. Permit No. VN Occupancy Type Zoning Distract R) =MAY T Coast. B Owner of Building . 1' Address 540 �'�'+`i VD, 'V ,E Building Address 4166 DRIVE 20344 Building Official Locality L2, B 1 s WU1:M 2�ID 05/13/93 POST IN A CONSPICUOUS PLACE Address 4166 COUNTRYSIDE DRIVE Zip 5512 3 Lot 2 Blk 1 Sub COUNTRY HOLLOW 2ND THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: 05/13/93 Yes No Inspector: C.fJ Final grade (6" from siding) ;.,/ Permanent steps (garage) Permanent steps (main entry) Permanent driveway Permanent gas 1- Sod/Seeded grass i./ Trail/curb damage Porch V Basement finish V Deck y% Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to the outside lawn faucet before freeze potential exists. Contact engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system. White - City Copy Yellow - Resident Copy Pink - Contractor Co REACTIVATEta 3 PERMIT # CITY OF EAGAN 4,03i 13 1993 BUILDING PERMIT APPLICATION 681-4675 FEB 1 8 REca SINGLE & MULTI -FAMILY COMMERCIAL 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date *''(%cs r -) / C3 / Valuation of work 11010°° Site Address: Tenant Name: X11 Lk CvN i( ' 5 106, aLi STREET (commercial only) SUITE # LOT a BLOCK I SUBD. T 14°4-(-7W 2`'2 P.I.D. # Description of work: F to HOM7r The applicant i s : • Owner M Contractor • Other (Describe) Property Owner Name Phone LAST FIRST Address STREET STE # City State Zip Contractor -'� -S<I� ° I�c _ 'S 'i c- Phone 9 S" <411.) Company � �` �' Address 5-W3 F AQ! (BLVD License #00000'6 Exp. 1 q City %0,12._ \it 1-4—C, State In)►.) Zip 5x337 Architect/ Engineer Company 5EJMI= 'NS CO1ZAc-T Phone Name Registration # Address City State Zip Sewer & water licensed plumber sewer & water permits is two Sites 144)) )r-4: . Processing time for days once area has been approved. I hereby acknowledge correct and agree Eagan Ordinances. Signature of that I have read this application and state that the information is to comply with all applicable State of Minnesota Statutes and City of Applicant: BUILDING PERMIT TYPE ❑ 01 Foundation 02 SF Dwg. ❑ 03 SF Addition ❑ 04 SF Porch ❑ 05 SF Misc. WORK TYPE 0.31 New 0 32 Addition OFFICE USE ONLY ❑ 06 Duplex ❑ 07 4-Plex ❑ 08 8-Plex ❑ 09 12-Plex ❑ 10 Multi. Add'1. ❑ 33 Alterations ❑ 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Engineering (o(' 36' REQUIRED INSPECTIONS ❑ Site ❑ Wallboard er° ❑ 11 Apt./Lodging. ❑ 12 Multi. Misc. ❑ 13 Garage/Accessory ❑ 14 Fireplace ❑ 15 Deck ❑ 35 Tenant Finish ❑ 36 Move Basement sq. ft. 1st F1. sq. ft. 2nd F1. sq. ft. Sq. Ft. total Footprint Sq. ft. On-site well On-site sewage Building Variance ❑ Footing ❑ Final ❑ Framing ❑ Draintile 1. 1:116 Basemenefinish ❑ 17 Swim Pool ❑ 18 Comm./Ind. ❑ 19 Comm./Ind. Misc. ❑ 20 Public Facility ❑ 21 Miscellaneous 0 37 Demolish MWCC System `/S City Water YES PRV Required yii5 Booster Pump Fire Sprinkler Census Code o/ SAC Code 0/ d Assessments ❑ Insulation ❑ Fireplace Permit Fee Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC % SAC Units / Valuation: $ I70,0D' 6AczAc.,e', 32x 22 r204, Xlo = Hca 13SMT;74/ /44'= / Z ---- 34 x zg s 2 3 x II 31 / i 22 = 308 1293X /S ST FL 'o 44 sin -r: 1293 52 ?Na FLovv2 56 '2,3:7 1566 3X ►►: 11/7 LI .11.2, x/ cl (3 0l 13►t4X.51" 19395 ,s,621 LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILDINp.PERMIT JPPLICATI PROPERTY LEGAL: DOCUMENT STANDARDS 0S D• Registered Land Surveyor signature and company • Building Permit Applicant [�'o� • Legal description 0 ©" ❑ • Address Er0 • North arrow and bar scale FJ 0 0 • House type (rambler, walkout, split w/o, split entry, lookout, etc.) VD 0 • Directional drainage arrows with slope/gradient %. 0 D'f0• Proposed/existing sewer and water services 0 ' x 0 • Street name I1 0 0 • Driveway Date of Sury PLEVATIONS Pxisting D e0 • Sewer service 0' D 0 • Lot corners �0 0 • Top of curb at the driveway 0 0 0 • Elevations of any existing adjacent homes D rip0 Er • D 0' 0 • D �/ 0 • D a0 0 • Provosed Garage floor First floor Lowest exposed elevation (walkout/window) Property corners Front and rear of home at the foundation PONDING AREAS Iif applicable) � 0 0 • Easement line • NWL fr 0 ❑ • HWL D" 0 DD 0 • Pond * designation ▪ Emergency Overflow Elevation DIMENSIoxs 0'0 D • Lot lines D ' 0 0 • Right-of-way and street width (to back of curb) or 0 0 • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc. (i.e. all structures requiring permanent footings) DSD 0 • Show all easements of record and any City utilities within those easements IT 0 • Setbacks of • •••-ed st ture and setback of adjacent D • ' • existing 0 Retain' ents, if any Reviewed: Na October 1992 1 01 96 -f- / �'e� .5//079 0- J ' - al ,0 ,-. � (�[/J/�` / 1 � �� Request Date 3 ,rte E3/ / G/•/ 3 Fire No. Rough-' nsp coon Re uir d? Yes No ❑ Ready Now Will Notify Inspector When Ready? ly licensed contractor 0 owner hereby request inspection of above electrical work at: Job Address (Street. Box or Route No.) it--/ 64 CaUrrbryside.. Dr. City ""-ct y4'r) Section No. Township Name or No. Range No. County DAkS Occupant (PRINT) ��+�►1� ��+ �. a YVr 'C ♦ 1-4cr (ICS L , ,cam.. PhoneneNo. ' J/y a / S- T I / (O Power Supplier� NSF S/ Address A 3vo o /t �// , d(c.ktip, r + Al") Electric ontractor � Ole (Company Name) iFii lac -ri'c- or Owner Making Installation) R j V ,4 o L0 /In41 L /V„rnsvi7/e (Contractor w yA" g Installation( IIP - Contractor's License No. c Ao 17 q 1 Phone Number 8Yi4 ^ 0el3 Mailing Addr ss (Contractor /11 .: Authoriz-. Si..- ure 1 i minnESOTA STATE BOARD OF ELECTRICITY Griggs -Midway Bldg. — Room S-173 1821 University Ave., St. Paul, MN 55104 Phone (612) 642-0800 THIS INSPECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS ENCLOSED. 67/40/f, REQUEST FOR ELECTRICAL INSPECTION 10. See instructions for completing this form on back of yellow copy. 01296 X" Below Work Covered by This Request FCe�., EB -00001-08 5780 44„1. New Add Rep. Type of Building Appliances Wired Equipment Wired �[ Home )( Range Temporary Service �°' Duplex Water Heater Electric Heating Apt. Building k Dryer Other -(Specify) Comm./Industrial K Furnace Farm Air Conditioner Other (specify) Contractor's Remarks: Compute Inspection Fee Below: Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool / 0 to 200 Amps a / 0 / 0 to 100 Amps Transformers Above 200 Amps Above 100 Amps Signs Inspector's Use Only:(5-33 THIS INSTALLATION MAY BE ORDERED COMPLETED WITHIN 18 MONT DISCONNECTED TOTAL ie -r rtIrrigation 7Special Booms Inspection IF NOT Dat --.:0•93'5.2 Alarm/Communication Other Fee I, the Electrical Inspector, hereby certify that the above inspection has ben made. Rough -in Final Data 2"..) _y OFFICE USE ONLY This request void 18 months from • J EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION OWNER: '✓%� � N\ SITE ADDRESS: 24R2(9 Cv t3 -52i (-)CLVV CONTRACTOR: 1- ore DATE : c9. 1 b - iJ PHONE : 9S -1C Determine working square footage of each. • Total exposed wall area %2 sq . f t . x .11 = 1-4:2,/t, ] ▪ Total roof/ceiling area: t C.•c2 k sq. ft. x.026 = [ Lfrh L, Total exposed wall area above floor = %1 a. Total wall window "area ..... ......... 37.2.: b. Total door area....... ...... .... ......... . c. Total sliding glass door area... .... ..... d. Total fireplace wall area................ .• : e. Total wall framing area (average 15%)........ f Total net wall area above floor..:........... g. Total rim joist area.. .. .:.. ... ..... Total exposed foundation area = D7 h. Totalfoundation 'window area........... i. Total net foundation area above grade.. • Determine "U" value of each wall segment. a . , x "U" 4f b. "U" �? 11, l 1 C . Lot, x "YT. �{ t (4-67 d. x "U" .-�., _ e. IPte,� , x �"U,� ► 0'7 _ (1, f. 2�� I x "U" 1 t.9 = 110, $ , -"74<e› x "U" , 1., _ r + h x „Uy, i. 2-7� x "Unw = (-1-L{- . .. . . . . . . " ..Total = 'it -'''017-1.9 If item #3 is the same as or less than #1 you have met the intent of SBC 6006(c)2. 6� REQUEST FOR ELECTRICAL INSPECTION ► See instructions for completing this form on back of yellow copy. X" Below Work Covered by This Request EB -00001-08 96 g9 New Add Rep. Type of Building Appliances Wired Equipment Wired Job Address (Street. Box or Route No.) �.. if/ 6 C N e/CC/ .5C % 1v "A' City 1:' if -"— Home Section No. Range Range No. Temporary Service Occupant (PRINT) Y.1.i1G1/ Cox: Phone No. Duplex Power Supplier dir Water Heater Electric Heating Contractor's License No. Mailing Address (Contractor or Owner Makingnln t9llat q ) 12.. t + t.z4+1 i "t 1 ,t'atti, Yt .3.LE (y 1t'1ti Apt. Building Authorized Signature (Contractor/Owner Making Installation) _ r� ( Dryer Load Management Comm./Industrial Furnace Other (Specify) Farm Air Conditioner Other (specify) Cont actor's Remarks: 14 . e' i/ Compute Inspection Fee Below: # Other Fee # Service Entrance Size r Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Above 100 Amps Signs Inspector's Use Only: r 1 C( f THIS INSTALLATION MAY BE ORDERED DISCONNECTED COMPLETED WITHIN 18 MONTHS. TOTAL Z ° , 5 Irrigation Booms Special Inspection IF NOT Alarm/Communication Other Fee I, the Electrical Inspector, hereby certify that the above inspection has been made. Rough -in Date Final r r Date 7 -d(� 7' r� OFFICE USE ONLY This request void 18 months from N 5667 4,ta -- QD Request Date Fire N... Rou -In Inpsection Required (Yo st call inspector when ready) 0 Yes '.No Inspection Other Than Rough-ln FeReady Now ❑ Will Notify Inspector ate Ready l9licensed contractor D owner hereby request inspection of above electrical work at: Job Address (Street. Box or Route No.) �.. if/ 6 C N e/CC/ .5C % 1v "A' City 1:' if -"— Section No. Township Name or No. Range No. County - #®- Occupant (PRINT) Y.1.i1G1/ Cox: Phone No. Power Supplier dir _ Address f Electrical Contractor (Company Name) -. Contractor's License No. Mailing Address (Contractor or Owner Makingnln t9llat q ) 12.. t + t.z4+1 i "t 1 ,t'atti, Yt .3.LE (y 1t'1ti 124 Authorized Signature (Contractor/Owner Making Installation) _ r� ( Phone Number 431-6364 MINNESOTA STATE$OpRe b!1 tL1GVrtTICITY Griggs -Midway Bldg. — Room S-173/91C- 1821 ��_ ///1--1821 University Ave., St. Paul. MN 55104 Phone (612) 642-0800 THISINSPECTIONREQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS ENCLOSED. Total exposed roof/ceiling area = j. Total skylight area k. Total roof/ceiling framing area (average 10%) (Cof3, I c 1. Total net insulated roof/ceiling area• • .., 14 -/.4e -D, e r Determine "U" value for each roof/ceiling segment. xr..._. -- k. f L -of In x "u" 6-0'1(4'0 1.' 11449 t'7x "un , CO. - 2 , 4 ...Total =[ .7-17--Z•• .71 i 3 If total of #4 is the same as, or less than #2, you have metthe intent of SBC 6006(c)1 Alternate Building Envelope Design To utilize the total envelope system method, the values established by the sum of items #3 and #4 shall not be greater than the sum of items #1 and #2. 1 +2. 4'"IL/Zj•(J'�� 14627 +4. PERMIT CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT TYPE: Permit Number: Date Issued: BUILDING 033130 0 9 /0 4 /98 SITE ADDRESS: 4166 COUNTRYSIDE DR LOT: 2 BLOCK: 1 COUNTRY HOLLOW SECOND P.I.N.: 10-18276-020-01 DESCRIPTION: BV114WO, Permit Type Buildlrig Work Type ftentus-Cod , . - . , 4 44 49 1 a as -; • DECK NEW 434 ALT, RESIDENTIAL REMARKS: PLAN REVIEWED BY BILL ADAMS. FEE SUMMARY: Base Fee Surcharge Total Fee $50.00 $.50 $50.50 CONTRACTOR: OWNER: COX 4166 EAGAN (612)727-6318 - Applicant - JON COUNTRYSIDE DR MN 55123 hereby acknowledqe that 1 have read this appllcation appendstate that nformatian is, correct and agree to c,:)mply',, with all applicable ' State'. of - ,14 tetut:es and City of Eagan .Ordinances., .‘ iPPLIC T/PER EE SIGNATURE ezy SUED BY: SIGNA URE CITY OF EAGAN CASHIER: S TERMINAL NO: 809 ID: NAME!: JON R COX 3210 9001 4166 COUNTRYSID 50.00. 2155 900i 4166 C8|]NTRYSID 0.50 Total Receipt Amount: CR096964 USER ID: NANCY 50.50 ****************** ******** 1998 BUILDING PERMIT A,PPLICA CITY OF EAGAN • 3830 PILOT KNOB RD - .D 1 D V 681-4675 New Construction Requirements Remoc • 3 registered site surveys • 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) • 1 energy calculations • 3 copies of tree preservation plan if lot platted after 7/1/93 required: _ Yes _ No DATE: Oq"O/ '7F ♦ 2 ♦ 2 ♦ 1 CONS" DESCRIP NOF WORK: CONS T R WC/ TTA-CNED DEC+ STREET ADDRESS: 166 COtNTRySIDE DRIVE, EAG LOT: L BLOCK: SUBD.IP.I.D. #: CP/VTR Name: COX ) TON PROPERTY Last First OWNER CONTRACTOR Street Address: 4_166 COW IU TR y S I DE DRI VE City EIl 6 A N State: Company:-' FG F Street Address: City State: _ ARCHITECT/ ENGINEER Company: S f L F Name: Street Address: City State: Sewer & water licensed plumber (new construction only): and lot change is requested once permit is issued. I hereby acknowledge that I have read this application and state that the inforr State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No BUILDING PERMIT TYPE O 01 Foundation 0 06 Duplex O 02 SF Dwelling 0 07 4-piex ❑ 03 SF Addition 0 08 8-piex ❑ 04 SF Porch 0 09 12-piex ❑ 05 SF Misc. 0 10 = plex WORK TYPE pi 31 New O 32 Addition ❑ 33 Alterations ❑ 34 Repair GENERAL INFORMATION OFFICE USE ONLY Apt./Lodging 0 16 Basement Finish Multi Repair/Rem. 0 17 Swim Pool Garage/Accessory 0 20 Public Facility Fireplace 0 21 Miscellaneous Deck ❑ 36 Move ❑ 37 Demolition Const. (Actual) Basement sq. ft. (Allowable) Main level sq. ft. UBC Occupancy sq. ft. Zoning sq. ft. # of Stories sq. ft. Length sq. ft. Depth Footprint sq. ft. APPROVALS Planning Building MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit Engineering Variance Permit Fee Surcharge Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units Valuation: AEsnalTI CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MN 55122 PHONE: (612) 454-8100 ?Mai IT FOR CITY USE ONLY PERMIT # RECEIPT # .3 3 DATE: 3fl 7/73 PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION NEW CONST ADD ON REPAIR OWNER NAME : Sev@ r s4- !-acme SITE ADDRESS: 4 t L (, CUb t.At C- LOT LOT : it BLOCK / SUBD . INSTALLER: ADDRESS : 418(-10 CITY : Of , nt k -e PHONE #: 44-7-(0%34 ZIP: COMPLETE THE FOLLOWING: NO. FIXTURES EA. TOTAL ADD-ON MINIMUM 15.00 SHOWER 3.00 3- WATER CLOSET 3.00 3- i -i BATH TUB 3.00 3 LAVATORY 3.00 KITCHEN SINK 3.00 3 - / LAUNDRY TRAY 3.00 HOT TUB/SPA 3.00 WATER HEATER 3.00 3_ ± FLOOR DRAIN 3.00 3 - GAS -GAS PIPING OUT. (MINIMUM - 1) 3.00 3- ROUGH OPENINGS 1.50 4-S® OTHER WATER SOFTENER 5.00 PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 SUBTOTAL $ 3i. 'S 0 ,LGO.cca� ST. SURCHARGE .50 ITTEE TOTAL: $ iMMERCIAIWTNDMISIAL PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND MULTI -FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: FEES OWNER NAME: 1% OF CONTRACT FEE. STATE SURCHARGE _ $.50 FOR SITE ADDRESS: EACH $1,000 OF PERMIT FEE. LOT: BLOCK SUBD. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 1% ADDRESS: STATE SURCHARGE CITY: ZIP: PHONE #: TOTAL: $ (SIGNATURE) FOR: CITY OF EAGAN m z -o m > 0 m :)11:10M AO 3dAl :penoo ele] Permit No. Permit Holder Date Telephone # S/W PLUMBING HVAC ELECTRICXO�62/% ELECTRIC 1 (0.41 Q2ti'Q : 3,l%3 7 G?3 . 0 I '7� &/ r g940 -443,9i , � � r 5/O 57 6 Inspection Date nsp. Comments Footings I .3 /92 46 Foundation Framing , /)- f3 7� PPf7{ Roofing Rough Plbg. V" -,7/(:),...g? ,'(J('l j_747.,...? '247%,3,ye1:11 i"" Rough Htg. 3/243 i© Isu1. 3/25 ;* /P Fireplace Final Htg. fO<Ci3 Orsat Test 1 Final Plbg. 5------t3 J% /� u N ��bg. Insitor 211Z.Plumber Const. Meter Engr.%Plan Bldg. Final 343 Ie Deck Fig. Deck Final Well Pr. Disp. 3-z4 e1 .� arn fUliWrill1111 m z -0 E Cl) :NHOM AO 3dAl , :ssmaav 31IS aNtraliddli 4[11/ City of EaQali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 FEB 232010 Use BLUE or BLACK Ink For Use �J Permit#: Permit Fee: L-00, -7 2010 RESIDENTIAL BUILDING PERMIT APPLICATION C it: Date: 02-23-10 Site Address: L1-1° Tenant: Suite #: RESIDENT / OWNER Name: -JOS COX Phone: 651- LI52 _ 15 91 Address / City / Zip: '916 v\+ rN S i` Ci e. Di-- , E �q a v, j `5 1 L 3 Applicant is: X Owner Contractor cJ TYPE OF WORK Description of work: Fi k iS tl'r q BaSe O^ e- kv+ Construction Cost: Multi -Family Building: (Yes / No i‹. ) CONTRACTOR Name: license #: .{.) Address City: State: Zip: Phone: Contact: Email: COMPLETE In the last 12 months, has Yes No 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: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Partlonrs of the information may be classified as nonpublic if you provide specific reasons that would permit tie Gity to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Cali at (651) 454-0002 for protection against underground utility damage. Cali 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.ora 1 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 Joy\ 2 . Cox Applicant's Printed Name Applic>fnt's Signature Page 1 of 2 I DO NOT WRITE BELOW THIS LINE 47//6& eviatf2_4(I;( C16 SUB TYPES Foundation _ Single Family Multi 01 of Plex Accessory Building WORK TYPES New Additlon Alteration _ Replace Retaining Wall DESCRIPTION Valuation Plan Review Fireplace _ Garage Deck Lower Level Interior improvement _ Move Building _ Fire Repair Repair Ivo (25%_ 100%'1,) Census Code # of Units # of Buildings Type of Construction REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width Roof: _Ice & Water Final Framing Fireplace: _Rough In Air Test Final Insulation Meter Size: Reviewed By: RESIDENTIAL FEES Base Fee Surcharge Pian Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Siding Reroof Windows _ Egress Window Storm Damm _ Exterior Alteration (Single Family) _ Exterior Alteration (Mufti) Miscellaneous Demolish Building* _ Demolish interior _ Demolish Foundation Water Damage *Demolition of entire building — give PCA handout to applicant pv yvjni loo MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Sheetrock Final / C.O. Required _t Final / No C.O. Required HVAC Other: Pool: _Footings Air/Cas Tests Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wall: — Footings _ Backfill _ Final Radon Control Erosion Control , Building Inspector 1/\7,14_1, er,ipv,A GQ/CpY?-o = /7O y � ful Page 2 of 2 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink Permit #: Permit Fee: .-46 `-tom Date Received: Staff: 2010 RESIDENTIAL PLUMBING PERMIT APPLICATION j Y/€ �ydry- j 5 � e Dr , � �. 55 I2 3 Date: G2-- 2 3 - 1 G` Site Address: Tenant: Suite #: o0 —/0 RESIDENT /OWNER 3-o C$ 651- `(52—(5 . 1 Name: Phone: ° Address / City / Zip: ! t C16 C .' ...,_ J J I-� ►^ et. -cr fr, 5 J 1-23 CONTRACTOR Name: License #: Address: City: t/t243'ki ' State: Zip: Phone: 14" 11 Contact: Email: TYPE OF WORK New _ Replacement Repair Rebuild _ Modify Space Work in R.O.W. _ _ Description of work: PERMIT TYPE RESIDENTIAL Water Heater Water Softener �� MAR 0 3 2010 "-1 D Lawn Irrigation >( Add Plumbing Fixtures ( RPZ / _ PVB) ( Main X Lower Level) Septic System Water Turnaround New Abandonment RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) State Surcharge) FEES $ $30.50 Lawn Irrigation $50.50 Add Plumbing *Water Turnaround $100.50 Septic System $90.50 Fire Repair (replace (includes $.50 State Surcharge) Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 (add $166.00 if a 5/8" meter is required) New ($10.00 per as built) (includes County fee and $.50 State Surcharge) burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL CALL BEFORE YOU DIG. Call Gopher State One CaII 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.00pherstateonecall.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. x Al cO, x Applicant's Printed Name Applicaryt`s Signature - /0 FOR OFFICE USE Required Inspections: Reviewed erGroun ough-In Gas Test 41,11* CityofEaQall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r L Use BLUE or BLACK Ink For Office Use Permit #:/047. J �j Permit Fee: Date Received: Staff: 2012 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: Off- 12 Site Address: Lu V c(atir,€',st0/ 9QIvv) tAZ'/d � M/'/ 5-57 ,X Tenant: Suite #: Name: SO N COX Phone: a - 2 4 7- Address / City / Zip: 1`4O. eaot rRrij' IDO vt) E A J/1) J'-4/` S. -S-7 Name: License #: Address: City: State: Zip: Phone: Contact: Email: 4, --New Replacement Repair Rebuild Modify Space Work in R.O.W. 774 Nh 4-krf LA -41-1.0? //&Fa4 i Eirei Description of work: l2 i i LA -,4 y RESIDENTIAL Water Heater Lawn Irrigation (_ RPZ / _ PVB) Septic System New Abandonment Water Softener Add Plumbing Fixtures (_ Main / _ Lower Level) Water Turnaround RESIDENTIAL FEES: $60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) *Water Turnaround (add $189.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) TOTAL FEES $ CALL BEFORE YOU DIG. Call Gopher State One CaII 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.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. x 1 -ON gr Cak Applicant's Printed Name Appli ant's Signature City of Eagan PERMIT City of Eaan Permit Type: Mechanical Permit Number: EA139117 Date Issued: 10/11/2016 Permit Category: ePermit Site Address: 4166 Countryside Dr Lot: 2 Block: 1 Addition: Country Hollow 2nd PID: 10-18276-01-020 Use: Description: Sub Type: Residential Work Type: Replace Description: Furnace Comments: Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary: ME - Permit Fee (Replacements) $59.00 Surcharge -Fixed $1.00 0801.4088 9001.2195 Total: $60.00 Contractor: Holmin Heating & Cooling Llc 3432 Denmark Avenue, #228 Eagan MN 55123 (651) 405-3853 - Applicant - Owner: Anand Raghu 4166 Countryside Dr Eagan MN 55123 (651) 247-4615 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