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3681 Widgeon WayRESIDENT / OWNER Name: Phone: Address / City / Zip: Applicant is Owner 4 Contractor / /COST 3Ck/ TYPE OF WORK ,DECK POS / Description of work: ((JZ /f & TTe s cv "code e' ''%`' 60 // , Construction Cost - q5D ,S f Multi- Family Building: (Yes / No ) CONTRACTOR Name: )/ p jZ C Z7'7 .4 L. C,, License #:.20- -5662 i' i3 Address: 3 %O 6 'isiuv)/7 A / City: Oc> es() / e State: /7,/y Zip: SS /2A Phone: 60/2 .8 5 c23c6 Contact: /J - "// 0/S0/7 Email: Q�dt`Y /! g II: . COj 7 7 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 consigered 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. *' City of Eapil 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 x f,QYC I, 6V co Applicant's Printed Name o E©LB \L AUG ;J uiJ r A plican Signature Use BLUE or BLACK Ink Permit #:'=:\ Permit Fee: N �� Date Received: Staff: 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Cople,Si(.SO Date: f, 3O�Ol® Site Address: (� g p/ / Tenant: Suite #: 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.oro ifrra‘e76,/ 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. Page 1 of 2 SUB TYPES Foundation Single Family Multi 01 of _ Plex Accessory Building WORK TYPES New Addition Alteration Replace Retaining Wall Fireplace Garage Deck Lower Level DESCRIPTION Valuation Plan Review (25 %_ 100 %_e( Census Code # of Units # of Buildings Type of Construction Reviewed By: Interior Improvement Move Building Fire Repair X Repair REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: Ice & Water Final Framing Fireplace: Rough In Air Test Insulation Meter Size: Aim RESIDENTIAL FEE Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S &W Permit & Surcharge Treatment Plant Copies TOTAL DO NOT WRITE BELOW THIS LINE 67- _ Porch (3- Season) Porch (4- Season) Porch (Screen /Gazebo /Pergola) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width Final Siding Reroof Windows Egress Window Joe " 107 R� 3 MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous _ Demolish Building* _ Demolish Interior Demolish Foundation Water Damage *Demolition of entire building — give PCA handout to applicant Sheetrock Final / C.O. Required Final / No C.O. Required HVAC Other: Pool: Footings _Air /Gas Tests _Final Siding: _Stucco Lath _Stone Lath Brick Windows Retaining Wall: _ Footings _ Backfill _ Final Radon Control Erosion Control , Building Inspector Page 2 of 2 4111 City of Eapil Date: Tenant: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 II$ r Use BLUE or BLACK Ink For Office Use /0 Permit #: Permit Fee: Date Received: 1 t 0 �f Staff: L INFLOW & 1 -INFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water 1 L'Site Address: % (A \MA tAV �� A Suite #: Phone: C,y 75O 'KA Address / City / Zip: Name: )4(7,- 110-14/:4.1/) Address: T�^ SColonr�, State: Zip: SC0611 Contact: /4t',, t (-Ts(" Phone: P.LU BING (Within the building envelope) OF ORS Sump Pump Repair Other: SEWER & WATER (Outside the building envelope) Repair Other: FEES $60.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit I/I repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd. 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.gooherstateonecall.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 yocich requires a review and approval of plans. 47x (11 ctrUU'IVIOLCA' tar\ tn. Applicant's Printed Name LiApplicant's Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA112252 Date Issued:08/05/2013 Permit Category:ePermit Site Address: 3681 Widgeon Way Lot:14 Block: 02 Addition: St Francis Wood 5th PID:10-65904-02-140 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Dean Kamrath 13791 Jonquil Ln N Dayton, MN 55327 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 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 - Dana Mckenzie 3681 Widgeon Way Eagan MN 55123 (612) 750-4684 Adam's On Time Plumbing & Water Heaters Llc 13791 Jonquil Lane N Dayton MN 55327 (612) 205-6060 Applicant/Permitee: Signature Issued By: Signature , '` tjU��c��r� � Use �LUE or Bl.ACK tnk �_�.�..�e..�_._m..e_e.,...�_�. E gor Office Use i �lU V� �� �� � Permit#: � � l0� S�� I • � � � C.. �� , 3$30 Pilot Knob Road f Permit Fee: J �. � Eagan MN 55122 i p� ` '� j i Phone: (651j 675-5675 I �ate Received: � ! 1 Fax: (651} 675-5694 � � { Staff: � �------------------� 2014 COMMERCIAl. BUILQING PERMIT APPLICATIC3N oate: Site Address: ��7�—3(c��1- � S3 3 "3(0$� � Tenant Name: (Tenant is: New/ Existing) Suite#: Former Tenant: Name: Phane: Property Owner Address/City t Zip: 1 — 3 r - � g - � '� Applicant is: Owner �Cantractor Type Of Work Description of work:_ ��,�'`�� � Consfructian Cos� �� ' Name; 1�1��1't"�.�x +'�;��'U '���y�"1 �3'`kC.. License#._�,.����,��j f� , � Address: �^S J� ��� �l� ��t�.�..��' Cit Gt ' Contractor ------- Y� State:_.�ft�V Zip:_c�3���� Phane: � J e� " �"��� '" � ��,� Contact: � Ut�'{° Email: U i"�" + � �� . € Name: Registration#: Architect/Engineer Address: City: State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewerlwater service: Phone#: NOTE:Plans and supporting dvcuments that yocr submit are considered to be public lnformatlon. Aartlons of the informafion may be class�fied as non public if you provide specific reasons that woutd permi�the City to conclude fhat the' are frade 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 ta dig to receive tocates of underground utilities. www,00qhersta#eonecall.orq i hereby acknow{edge that this information is compiefe and accurate; that the work wilf be in conformance with the ordinances and codes of the City af Eagan; that I understand this is not a permit, but anly an applieation far a permit, and work is not to start without a �rmit;that the work will be in accordance with the appraved plan in the case of work which requires a review and approvai of plans. X � x ApplicanYs Printed Name Appli anYs Signa re Page 1 of 3 ��. �':.° �,..�� � .�. �,.� �.���. _�,�: � ��ar�iri���'v._...r_ ,__,_.,,__.-�., � �� �� � �� � � F��s�sa��:��--�7�� � � � � 1 • 3830 Pilo#tCna�b Rra�d � Permit Fee; �Q�E�� d Eagan N!N 559?2 # 1 Phone:{651}675-5575 � �ate Recei�d: 1 �ax:�65�i)675-5694 � � { Staff: } I � _____._....._�__�___...__..� 2414 RL5��E3E�l'�'�AL BU�LD�[1[� P�RMtT APPL[CATtC}t� Date:_�- ` ��'�1-'�SiEe Address: `� Unit#: S� k ' w'"' . --......��,__ ���.d.w���,._ . . .""�. � �v� ' � . . . °r--�.,« !'}-y:#'µ, ���e.��"v�, - � '�„ �'.r�'a��������e�_.� g �`� � .. � �� S 5���. �. ��v � ���, cr� � ; 6�C'.rh Lj�1 E� � � � � �� W rvll t=d'c.rr.e. ..�,�n, �ws �v�._v. , ��� ��:: �� � ° '���� o. ti, .i�z_..�.,�.�o�` I .� — �._ ; ,: $ _, � ��:�`$���.��: � �:��-���iy�r��rng:�es ��dt�,..�...� 4 g Gorrapany: ° 1 . ��ni�ct: ���' � � CUrf#Tactoi` Address:�`� � �t� La.��'�- �ity: ��,+�ttr,���,. � State: �'�} Zip:�.J�'��� Phone:��'g.�-i�° 7CJ7�mai�: t'r�lLaar��r°t� rrr.g�r'� ^, � CS)v��I r'� • l.�cet�se#���..,�"���.� �ead Certifiicate#:_,��l�$�.�°, . `; YH�=.Tgl f��'a"+r;.�.��.^",�� �� g � �°*�^—..,a=.a.,,_�ew.,.,,....::......:.....Y �� � F. '� -+_ ���� r.w��t � � �+ a.,� � _ ? _ . i'� .� . ��R�...��*cw��"��.��,1P°v��F.� 4€£�R y� w�4s�_. .�.���-4�£�."m :��witi:�a��:�� � 'E. �..'�' t h�r:��;=�° � ��'�f'�.�TE�"l�t� �eR�A��L.� i� �CC��[��Rt.lG�`t�fG� �f��f B�3i�E�tl�G � ��� ' 4�st�2 mc�r�fhs,F�as t�i����y+sf Eagan issuec!�permit f4r a si�til�r pfan based+an a rrsaster 1 p an? _,.._,Yes �t�o [f y�s,dete and addre�s of master plan: Licensed Plumber: P�• Mechanica��ontrac#c�r. Phane• Sswer 8�Water Contractor: Phane: hOZ'E ,PI����������r������r������.���r��-, '_���' = v��� ���� : �<,a � ,,�a��t��i��rz�t�t�c�z�. ��� �ti�_.� : .., ��` ��� ".����;������#�c��r�€� ° -����_ �����F. ��;���t��.�� ��� �,� � �s����s{ =���� � . � � �,e��L���'���'��'�, t��r����r�����t��� � � .,..�.�. ��f�re y�v�stt��d 1�a d%�Y�rer�ive#rri�fes at ur�ier�rau�at!utsl�##es.�v�r.�t�Dh�f&l�f�n€a��,�a����i���,�,��������y�����. ��i����a�tasr5 1 heret�y a�n�wladge t3�at thz,ini�mta#i�n'�s c�mp6ete a�sd a�csra�,�+a1 the war�t�nl!be in can€trrman�e with the ordsnances arrcS aatles of the Gi#y�f Eagan;ihat t understart� 4his is not a permR, bufi oniy an application for a perm�T, and work is noi to stari�v"�out a permit; that#he work wit!b� in acco�dance with the approveci ptan in the case of work which requires a review and approval of ptans. • Exteriur work authorized by a buiiding permit issued in accardance with the RAinnesota State Building Code must be com�atetsd�ecit,kt�x+'l� ti.ays.n�p�cm��,i�s�r��. y � �"�= x Ap�SiicanYs Printed I�a App(ica s Sign re Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA155744 Date Issued:05/31/2019 Permit Category:ePermit Site Address: 3681 Widgeon Way Lot:14 Block: 02 Addition: St Francis Wood 5th PID:10-65904-02-140 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 - Dana Mckenzie 3681 Widgeon Way Eagan MN 55123 (612) 750-4684 Murray Construction Inc 10675 Jersey Ave Chaska MN 55318 (952) 941-7075 Applicant/Permitee: Signature Issued By: Signature