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4163 Countryside DrName JUSZPII > 11tI1.1. 16t T Address 18139 ` AVE S City Y Phone 431. 21311 Name Address City Phone BUILDING PERMI To be used for CITY OF EAGAN 830 Pilot Knob Road, P.O. Box 21 -199, Eagan, MN 5 PHONE: 454 -8100 Est. Value 1 41.000 Site Address 4163 courant= Lot l_ Block ? Sec /Sub Parcel No. 'f IO1! Name Address City Phone I hereby acknowlege that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes anifCity of Eagan Qr i des. 1 Signature of Permitee / A Building Permit is issued to: on the express condition that ' work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official Occupancy, " .1 Zoning 1 (Actual) Const (Allowable) # of Stones Length _60' Depth _! S.F. Total S.F. Footprints On Site Sewage On Site Well MWCC System City Water PRY Required Booster Pump Planner Council Bldg. Off. Variance Receipt # Date PPROVALS 6 OFFICp USE ONLY Bldg. Permit Surcharge 70 Plan Review SAC, City t2,.00 ; SAC, MCWCC Water Conn __aM Water Meter Acct. Deposit 310.00 S/W Permit - S/W Surcharge = 50 Treatment PI _MOO Road Unit Park Ded. Copies TOTAL 1 Pr. Disp. 1 Well I Deck Final I Deck Ftg. I Bldg. Final I I Engr. /Plan I Const. Meter I Final Plbg. 1 Orstat Test 1 Final Htg. 1 Fireplace I Isul. I I Rough Htg. 1 Rough Plbg.I I Roofing I 1 Framing I I Foundation 1 I Footings I I I Inspection Date I r = r m RI 0 ; A o n z c) s/L I IVS7 i Sri V,s ?f 1 7 41 /2e 1 //q5 I Permit No. C� k Insp. I k r •4 ol., A rF Permit Holder ,,,,,. 1 (:) , .i ,..z vsJ bc. zi Plbg. Inspector — Notify Plumber 1 1 r r 57 a -J1/4 / ,.t)g Comments Ft? / Date [ c ' 1 4 ,03 -/ /// 1 Telephone # CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681 -4675 SPWTION E CQR PERMIT Permit Number: Date Issued: SITE ADDRESS: 41f D140411-: PERMIT SUBTYPE: APPLICANT: i)'tNf.:Y H8! St_;F C.RF:Af IONS '2) 464-9150 TYPE OF WORK: DESCRIPTION 20'11. G4 /21 / {s::; NEW :tNCiuo•Es. 1404 DC n 0 0 CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122 -1897 (612) 681 -4675 SITE ADDRESS: 1 " I PERMIT SUBTYPE: i'1 fit P1 Ai.`t' INSPECTION RECORD PERMIT TYPE: Permit Number: Date Issued: APPLICANT: HFA C , . _ti ( :4) A- -07■U TYPE OF WORK: LAC `a INSPECTION TYPE DATE IFJSPI R iNSPEC:`T ry }'t i 1:? 11611 1 N A l _ DECK FINAL DECK FTG BSMT FINAL BSMT R.I. HYDROSTATIC TEST CONDUCTIVITY TEST FLUSH MAINS IRRIGATION METER DOMESTIC METER BLDG FINAL ORSAT TEST FINAL HTG F INAL PLBG FIREPLACE AIR TEST FIREPLACE GYP BOARD INSUL GAS SVC TEST ROUGH HEATING PLBG AIR TEST ROUGH PLUMBING ROOFING FRAMING FOUND FOOTINGS Inspection Date PLUMBING HVAC 'Wig? Permit Holder Insp. 1 Comments Date Telephone # CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 I' 1 - ilf*14 SITE ADDRESS: 4 1 t i0111.111ce' 1141 if ti111 1 ti ; 041 PERMIT SUBTYPE: !pi 1 t‘t<1. f'; t.N ir V11 1 f° 1111 1 61 1 1 INSTECTIONRECURIT PERMIT TYPE: Permit Number: Date Issued: APPLICANT: VA I . 11 1'0111 TN(' t 6 1 ) f1q4 TYPE OF WORK: Or'A'Fr11 NbPE( TION TYPE • tirw T.Nett(0 HIM tYiN(a 03,„'406 0704 /90 INSPECTION TYPE DATE iNSPTR 1;1; Pt loiilt1)1111, 11 11 i1RHll 1 PRPII ANN IN'iPECTION% DECK FINAL DECK FTG BSMT FINAL BSMT R.I. HYDROSTATIC TEST CONDUCTIVITY TEST FLUSH MAINS IRRIGATION METER DOMESTIC METER BLDG FINAL ORSAT TEST FINAL HTG FINAL PLBG FIREPLACE AIR TEST FIREPLACE GYP BOARD INSUL GAS SVC TEST ROUGH HEATING PLBG AIR TEST ROUGH PLUMBING ROOFING FRAMING FOUND FOOTINGS Inspection Date PLUMBING HVAC Permit Holder Insp. /5--Ps1 • Comments Date Telephone # 7 %§ New Construction Requirements Remodel /Repair Requirements • 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas • 2 copies of plan (20% maximum lot coverage allowed) • 1 set of Energy Calculations for heated additions • 2 copies of plan showing beam & window sizes; poured found design, etc.) • 1 site survey for exterior additions & decks • 1 set of Energy Calculations • Indicate if home served by septic system for additions • 3 copies of Tree Preservation Plan if lot platted after 7 /1/93 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) TYPE OF WORK Replace roof PROPERTY OWNER Kent & Jill Therkelsen Energy Code Category (J submission type) Plumbing Contractor: Phone # Plumbing system includes: Water Softener Lawn Sprinkler Water Heater No. of R.I. Baths No. of Baths Mechanical Contractor: Mechanical system includes: Sewer /Water Contractor: RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651- 681 -4675 Air Conditioning Heat Recovery System Signature of Ap OFFICE USE ONLY COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Phone # Phone # Certificates of Survey Received _ Tree Preservation Plan Received Not Required _ DATE Sept. 25 2002 VALUATION 7,070.00 SITE ADDRESS 4163 Countryside Drive, Eagan, MN 55123 MULTI- FAMILY BLDG _ Y X N FIREPLACE(S) _ 0 _ 1 _ 2 APPLICANT EXTERIOR INNOVATIONS, INC. STREET ADDRESS 9635 Humboldt Ave. S. CITY 111 oomi n on , STATE ZIP 55431 TELEPHONE # (952) 844 -0814 CELL PHONE # FAX # (952) 884 -5769 TELEPHONE# (651) 454 -8587 - MINNESOTA RULES 7670 CATEGORY 1 _ MINNESOTA RULES 7672 • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Fee: $90.00 Fee: $70.00 I hereby acknowledge that I have read this application, state th • - ' • orma • is correct, and agree to comply with all applicable State of Minnesota Statutes and City of E gan Ordin!. Updated 4/02 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 (bldgs with 3 or less units) DATE JOB SITE ADDRESS RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EACAN 3830 PILOT KNOB RD - 55122 651 - 681 -4675 Zf // eacoi sae, tr i tV Q. RemodeURepair Requirements • 2 copies of plan • 1 set of Energy Calculations for heated additions • 1 site survey for exterior additions & decks • Indicate if home served by septic system for additions VALUATION a7/,Y o IF MULTI- FAMILY BUILDING, HOW MANY UNITS? <J PROPERTY OWNER i 1 A e � S t'!// ��f�'ar TYPE OF WORK M - c4, � ( rt GAS ko ct l/P14 P✓ lace Ct ktair FIREPLACE(S) ' 0 v 1 — 2 APPLICANT 'r i ‘t e s /Se cop-J4 PK /.%I//eJ <�✓' e S/ sz, PHONE# 95,2 ,1 025 ADDRESS 3 3 1)), t/1,f1' t�i 1 Ito c'sv i RN( ZIP CODE 377 PAGER # CELL PHONE # FAX # Energy Code Category (check one) NEW RESIDENTIAL BUILDING ONLY FILL OUT COMPLETELY MINNESOTA RULES 7670 CATEGORY 1 Residential Ventilation Category 1 Worksheet Submitted Energy Envelope Calculations Submitted MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Plumbing Contractor: Phone #: Plumbing System Includes: Water Softener Lawn Sprinkler Fee: $90.00 Water Heater _ No. of R.I. Baths No. of Baths Mechanical Contractor: i es a t erner Phone # .95;P fV-o26 Mechanical System Includes: _ Air Conditioning Fee: $70.00 Heat Recovery System Sewer /Water Contractor: Phone # All above information must be submitted prior to processing of application. I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordi•• nces. / Signature of Applicant .�� .�;i' Certificates of Survey Received r Tree Preservation Plan Received _ Not Required Updated 2002 CITY OF EAGAN 3830 Pt*}fndb Road Eagan, Minnesota 55123 (612) 681 -4675 SITE ADDRESS: 4163 COUNTRYSIDE 06 LOT: 6 BLOCK: 2 COUNTRY HOLLOW 2N0 P . I ., N.: 10- 18 76-- 060._02 DESCRIPTION: REMARKS: FEE SUMMARY: INCLUDES Permit Type ;rk Type PERMIT Base Fee $135.00 Plan Review $87.75 Surcharge $6.00 Lic. Search Fee $5.00 Total Fee $233.75. • CONTRACTOR: -- Applicant -- ST. LIC WHITNEY HOMES CREATIONS 14549150 0008344 4160 LANTERN 1. N EAGAN MN 55123 (612) 451. ) 0 PERMIT TYPE: 13 LI I Permit N tuber: 0 2 0 ' 1.1� Date` Issued: 0&,/21/93 . . 4x14 DECK SE PORCH NEW R1 V -N VALUATION $12,000 ocqg THERKELSEN KENT.: 4163 COUNTRYSIDE Dft EAGAN, (612) 4 4 -8 "87' EllinffilE EMI= 7 � SINGLE & MULTI - FAMILY COMMERCIAL 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. 2 sets of architectural & structural plans, l 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 issu d. Date / / Valuation of work _ n eta I � 9e Site Address: Tenant Name: 4 0 (2 3 l ,.�, :v I_ .eL (4 STREET (commercial only) \ c� SUITE # LOT BLACK C, SUBD " I %r� �+ �� fr. P.I.D. M - Description of work: c-c- v S .• 0' The applicant r El Contractor is: ■ Own e • Other (Describe) Property Owner Name , & wV tk e: & JJ ( Phone '& Z & 7 LAST FIRST Address 1 . 4 4 J STREET _ k �� State STE 0 '� + `v / +3 . Zip 3 City Contractor Company tic U L a. AS ( -- : Phone 4s / - > Address41W L1 L ,v t- License #O003,344 Exp.J City ' N. State o Zip S / ,9, Architect/ Engineer A_ ^ Company Phone Name Registration # Address City State Zip Sewer & water licensed plumber sewer & water permits is two . Processing time for days once area has been approved. I hereby acknow correct and ag Eagan Ordinance Signature of edge tha have read his ap lication and state that the information is ee to comply ith 1 a li a e S ate o nnesota Statutes and City of . Applicant: et. c... REAC JVATE 'PERMIT # CITY OF EAGAN 1993 BUILDING PERMIT APPLICATION 681 -4675 BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 02 SF Dwg. ❑ 03 SF Addition a04 SF Porch ❑ 05 SF Misc. WORK TYPE 'C 31 New ❑ 32 Addition GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Building Variance ALs , REQUIRED INSPECTIONS iq 14 .t). Planning Engineering O Site ❑ Wallboard Permit Fee Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC % SAC Units ❑ 06 Duplex ❑ 07 4 -Plex ❑ 08 8 -Plex ❑ 09 12 -Plex ❑ 10 Multi. Addl. ❑ 33 Alterations ❑ 34 Repair f 3. Footing E ':. Final OFFICE USE ONLY Basement sq. ft. 1st F1. sq. ft. 2nd Fi. sq. ft. Sq. Ft. total Footprint Sq. ft. On -site well On -site sewage ❑ 11 Apt. /Lodging ❑ 1 Basement Finish ❑ 12 Multi. Misc. - -O-17 Swiregol ❑ 13 Garage /Accessory ❑ 18 Comm. /Ind. ❑ 14 Fireplace ❑ 19 Comm. /Ind. Misc. ❑ 15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous ❑ 35 Tenant Finish ❑ 37 Demolish ❑ 36 Move I • Framing 0 Draintile MWCC System City Water PRV Required Booster Pump Fire Sprinkler Census Code SAC Code t LA.44 Assessments Insulation ❑ Fireplace SITE ADDRESS: CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122 -1897 (612) 681 -4675 1.827- -_060- DESCRIPTION: FEE SUMMARY: CONTRACTOR: VALLEY POOLS INC 651 C L I F F R D SURNSVI L. L E:. MN ( 7612) 894- 4' 4 "J6 COUNTRYSIDE DR LOT; 6 BLOCK COUNTRY HOLLOW 2ND Base e Fe $1137 >r'_Ea Surcharge C 0r Total Fee $ 1.. r 5 APPLICANT /PERMIT IGNATURE VALU0 i "10N AF,r l.ic;ant -- 1.8 ?41.480 PERMIT PERMIT TYPE: Permit Number: Date Issued: INGROUND POOL rlT t Type SWIM POOL rk Type NEW 329 NONELDG +' RtJCT REMARKS: PLAN REc,.t1:E!4L0 BY MIKE. 308CK CALL 445-' REGARDING LLLECTRICOL E:PSM1: AND INSPECTIONS $12,000 SSUED BY: SIGNAT BUILDING 032406 07/14/98 OWNER: THERKELSEN KENT 4163 COUNTRYSIDE DID EAGAN MN 55123 (612)454-8587 ackr�owlecic th at I rea i;h app l lo'at on anti ' th he in orrr, tlot� i� c,. car °r of nd 1 P wi th a'11 ppllcab1 State of Mn • 502110( 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL CITY OF EAGAN 3830 PILOT KNOB RD - 55122 itttwt 681 -4675 YY U New Construction Requirements Remodel/Repair Requirements • 3 registered site surveys • 2 copies of plan • 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) • 2 site surveys (exterior additions & decks) • 1 energy calculations • 1 energy calculations for heated additions • 3 copies of tree preservation plan if lot platted after 7 /1/93 required: _ Yes _ No ® `_„t ff DATE: la " o? / CONSTRUCTION COST; // DESCRIPTION OF WORK // ; 2I /v � J /10 `4/ /1,/wj r iliQr.--1Q STREET ADDRESS: `1 / Co 3 C..O u rv- r y 5 t b t= b r. .A , V.,-&1 1 fM it), £ S/ 2 3 .COT: BLOCK: SUBD. /P.I.D. #: (, 7 4/4 �` x/� PROPERTY OWNER CONTRACTOR City AG IN State: Zip: ARCHITECT/ ENGINEER Company: Phone #: Name: Registration #: Street Address: Sewer & water licensed plumber (new construction only): . Penalty applies when address chang and lot change is requested once permit is issued. I hereby acknowledge that I have read this application and state that the information is correct and agree to co State of Minnesota Statutes and City of Eagan Ordinances. Certificates of Survey Received Tree Preservation Plan Received Name: T}-1 E R K E L 5.1■J ►i FN T a- t l Phone #: 9 5 t1 $ X8 7 Last ) First Street Address: Li t(o 3 Coo KIT e `( S 1 D e Company: VA- L L e Y 'Pao L N c Phone #: 9 H l 4 g 0 Street Address: t License # City U ekiSV 1Ie- City State: OFFICE USE ONLY Signature of Applicant: Yes No Yes No State: V\A 1 ■.1 Zip: -C$' 3 3 ly with all applicabl BUILDING PERMIT TYPE • 01 Foundation • 02 SF Dwelling ❑ 03 SF Addition ❑ 04 SF Porch ❑ 05 SF Misc. GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning ❑ 06 Duplex ❑ 07 4 -plex ❑ 08 8 -plex ❑ 09 12 -plex ❑ 10 = plex WORK TYPE jzt 31 New ❑ 33 Alterations ❑ 36 Move ❑ 32 Addition ❑ 34 Repair Permit Fee Surcharge Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit SAN Permit SAN Surcharge Treatment P1. Park Ded. Trails Ded. Other Copies Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. OFFICE USE ONLY Valuation: Apt. /Lodging Multi Repair /Rem. Garage /Accessory Fireplace Deck ❑ 37 Demolition Building ilete Engineering MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit 2 43040 ❑ 16 Basement Finish $. 17 Swim Pool ❑ 20 Public Facility ❑ 21 Miscellaneous Variance Sig r - =X33 °t-A- o S QM CERT /F /CATS OF SIAM / / 5 do I T/ S 9'3i C- /00,00 30,00 9 *38' COU J4Tt2V Sl 0E / HEREBY CERTIFY THAT THIS SURVEY, PLAN OR REPORT WAS PREPARED BY ME OR UNDER MY DIRECT SUPERVISION 70,7 )4°16' s711 2&i,S3 Dmu / V I -� (r J L- J - / ICJ M 0 Scale: 1" = 30' DESCRIPTION Lot 6, Block 2, COUNTRY HOLLOW SECOND ADDITION Dakota County, Minnesota CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122 -1897 (612) 681 -4675 SITE ADDRESS: P.I.N.: 10- 18276 - 060 -02 DESCRIPTION: FEE SUMMARY: Base Fee Surcharge Total Fee PERMIT 4163 COUNTRYSIDE DR LOT: 6 BLOCK: 2 COUNTRY HOLLOW 2ND Blct Type FIREPLACE rk Type NEW 434 ALT. RESIDENTIAL REMARKS: CHIMNEY /FLUE MUST BE INSPECTED BEFORE COVERING $50.00 $.50 $50.50 CONTRACTOR: — Applicant - ST. LIC. HEAT- -N -GLO FIREPLACES 18900758 0002960 1850 W HWY 13 BURNSVILLE MN 55337 (612) 890-0758 PERMIT TYPE: Permit Number: Date Issued: OWNER: THERKELSON JILL 4163 COUNTRYSIDE DR EAGAN MN 55123 (612)454 -8587 APPLICANT /PERMITEE SIGNATURE ISSU Y: IGNATURE BUILDING 032413 07/01/98 DATE: tt DESCRIPTION OF WORK: JOB ADDRESS: LOT: ( APPLICANT (circle one only): PROPERTY OWNER FIREPLACE INSTALLER Signature: GAS LINE INSTALLER CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1998 FIREPLACE PERMIT APPLICATION 681 -4675 91 (2 (;arn "1 �J BLOCK: 2 Construct new fireplace Install gas insert only Other OWNER ( CONTRACTOR 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. Name: YY �`P /SIQ J l Last First Signature: Street Address: City Company: City q s Lo`lit Laqc icte66014r Street Address: Company: Signature: Street Address: SUBDIVISION/P.I.D. #: State: State: /2) D Ci PERMIT FEE: $50.50 Alterations to existing Install gas line only On aartj /NW ? Phone -5� J) ji Zip: Phone #: 9 W"I /+ �0 W i 1j ° License # � G� o c' Q7/ Phone #: PROPERTY OWNER New Construction Requirements CONTRACTOR Certificates of Survey Received 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651 -681 -4675 • 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 plans (show beam & window sizes; poured fnd. design: etc.) • 1 set of energy calculations • 3 copies of tree preservation plan if lot platted after 7/1/93 //' DATE: 3 /3� DESCRIPTION OF WORK: (1'A "F( m STREET ADDRESS: L i 1( C PIA 1/1 i'f`i4 LOT: C., BLOCK: SUBD. /P.1D. #: Name: f l 'LQ:L JKe! 50 v ) Ken1- 11 Last /j First Street Address: Set/ 13'1 e 10b0(- Remodel/Repair Requirements • 2 copies of plan • 1 set of energy calculations for heated additions • 1 site survey for exterior additions & decks CONSTRUCTION COST: A. ' 7 -1L-i J fi () Phone #: City State: Zip: Company: I p (/L C aY14 (ri Gi n C Phone #:� - s %r b l C ! Street Address: V.C l �i�-' e rm License # 0 1 Exp. � City 4 rJe un / Iv ARCHITECT/ ENGINEER Company: Name: Registration #: Street Address: OFFICE USE ONLY Yes No Tree Preservation Plan Received Yes No Not Required Stat JV Zip: 5 U� Phone #: City State: Zip: Sewer & water licensed plumber (required for new construction only): Penalty applies when address change and lot change is requested once permit is issued. I hereby acknowledge that I have read this application, state that the informatio is cojr d agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: NEW CONST ADD ON REPAIR OWNER NAME: JOE MILLER CONSTRUCTION CO. INC. SITE ADDRESS: Y./L LLeL 1 I r7{Ntc/ A L`1-4.3''`k LOT: tv BLOCK ar SUBD. INSTALLER: GENZ -RYAN PLUMBING & HEAT NG CO. ADDRESS: 14745 South Robert Trail CITY: Rosemount, MN ZIP: 55068 r: :ONE #: (612) 423 - 1144 COMER_ ''.3NDU.STRIAI CONTRACT PRICE: OWNER NAME: SITE ADDRESS: ?HONE #: FOR: WORK DESCRIPTION CITY OF EAGAN PLEASE COMPLETE UPPER PORTION ONLY FOR TOWNHOMES /CONDOS WHEN PERMITS ARE REQUIRED FOR SIGNATURE Q1F PERMITTEE CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MN 55122 PHONE: (612) 454 -8100 LOT: BLOCK SUBD. INSTALLER: ADDRESS: 2ITY: ZIP: COMPLETE THE FOLLOWING: NO. FIXTURES EA. ADD -ON MINIMUM 15.00 / SHOWER 3.00 3 WATER CLOSET 3.00 ff ri BATH TUB 3.00 LAVATORY 3.00 / KITCHEN SINK 3.00 r' LAUNDRY TRAY 3.00 HOT TUB /SPA 3.00 _-- WATER HEATER 3.00 L FLOOR DRAIN 3.00 GAS PIPING OUT. (MINIMUM - 1) 3.00 ROUGH OPENINGS 1.50 OTHER WATER SOFTENER 5.00 PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL /INDUSTRIAL BUILDINGS AND MULTI- FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. FEES 1% OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR EACH $1,000 OF PERMIT FEE. $25.00 MINIMUM FEE. CONTRACT PRICE x 1% STATE SURCHARGE TOTAL: FOR CITY USE ONLY PERMIT # /4/ RECEIPT # A DATE: / ✓3/9/ SINGLE FAMILY DWELLINGS & EACH UNIT. SUBTOTAL $ ST. SURCHARGE .50 c/2 TOTAL: $ (SIGNATURE) TOTAL 1 7.» AE$ IDEANT] ........................... WORK DDESCRIPTION y NEW CONST n ADD ON REPAIR OWNER NAME: SITE ADDRESS: LOT: � BLOCK SUBD. INSTALLER: AiIY' ADDRESS 3 o V (U pyr_ 1\3(, CITY:)i V/>-' ZIP:`"1 1. PHONE #f) — h 1 7 3') C()R CONTRACT PRICE: SIGNATURE OF PERMITTEE CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MN 55122 PHONE: (612) 454 -8100 LOT: BLOCK SUBD. $25.00 MINIMUM FEE. INSTALLER: ADDRESS: STATE SURCHARGE CITY: ZIP: PHONE #: FOR: CITY OF EAGAN FOR CITY USE ONLY PERMIT # RECEIPT # DATE: PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES /CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. COMPLETE THE FOLLOWING: NO. FIXTURES EA. TOTAL ADD -ON MINIMUM 15.00 _ SHOWER 3.00 _ WATER CLOSET 3.00 _ BATH TUB 3.00 LAVATORY 3.00 KITCHEN SINK 3.00 LAUNDRY TRAY 3.00 HOT TUB /SPA 3.00 WATER HEATER 3.00 FLOOR DRAIN 3.00 GAS PIPING OUT (MINIMUM - 1) 3.00 ROUGH OPENINGS 1.50 OTHER 1 WATER SOFTENER 5.00 SERITE PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 TOTAL: FEES OWNER NAME: 1% OF CONTRACT FEE. STATE SURCHARGE a $.50 FOR SITE ADDRESS: EACH $1,000 OF PERMIT FEE. CONTRACT PRICE x 1% $ SUBTOTAL $ 5.00 0 ST. SURCHARGE .50 (SIGNATURE) TOTAL: $ $ `- COMMERCIAL /INDUSTRIAL PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL /INDUSTRIAL BUILDINGS AND MULTI- FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. SINGLE FAMILY DWELLINGS 2 SETS OF PLANS 3 REGISTERED SITE SURVEYS 1 SET OF ENERGY CALCULATIONS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR /HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED. PERMIT MUST SHOW A LICENSED PLUMBER. To Be Used For: Site Address Lot Block Parcel /Sub ,tt' . , Owner Address City /Zip Code Phone Contractor �..�� °.� �� � '1 l l- - ,i • ,r,, Address City /Zip Code Phone -r Arch. /Engr. Address City /Zip Code Phone # ALA /- Ili/9 1991 BUILDING PERMIT APPLICATION CITY OF EAGAN MULTIPLE DWELLINGS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL REGISTERED SITE SURVEYS - & STRUCTURAL PLANS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS # OF RENTAL UNITS # OF FOR SALE UNITS Valuation: Date: 000 APPROVALS Planner Council Bldg. Off. tTi,vV Variance On site sewage_ On site well '`MWCC System _ - 7 City water PRV Booster Pump OFFICE USE ONLY Occupancy K'3 M - 1 Zoning R t Actual Const V- t.4 Allowable N, # of stories Length Depth S.F. Total Footprint S.F. 38 FEES Bldg. Permit Surcharge Plan Review SAC, City SAC, MWCC Water Conn. Water Meter Acct. Deposit 30,(20 S/w Permit 330,00 S/W Surcharge ,50 Treatment P1. ]6„ G 7 Road Unit 370,00 Park Ded. Trail Ded. Copies SUBTOTAL Penalty Lot Change TOTAL 763,00 5©9,o Joo } S r o' it } (Signd ure of Contractor) f all applicable State of Minnesota Statutes and City of Eagan Ordinances. COMMERCIAL agrees that all work shall be done in accordance with )4. 2 7. *-;;? 6, ) 1 S7 I 3 7 a ‘ 5 3 b 1 3 Ocar:2,. Ak V 4.:Titr NEW CONST ADD ON REPAIR WORK DESCRIPTION CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MN 55122 ONE: (612) 454-8100 OWNER NAME: ` `'Q "' @ Cn . SITE ADDRESS : Ai VcY LOT: k BLOCK PHONE #: INSTALLER: ,,}}��d ADDRESS : V . \ - oC 1 CITY: coo ZIP: 'SS be CONTRACT PRICE: FOR: CITY OF EAGAN PLEASE COMPLETE UPPER PORTION ONLY FOR SIN TOWNHOMES /CONDOS WHEN PERMITS ARE REQUIRED FOR EACH SUBD ( `Cv� ia0`,O PERMIT # RECEIPT # 4 DATE: FEES R CITY USE ONLY AD D -ON MINIMUM HVAC 0- 100 ADDITIONAL 50 M BTU GAS OUTLETS - iINIMUM OF 1 PER PERMIT SUBTOTAL: STATE SURCHARGE` .50 TOTAL: $ ( ALIN O r a 4 Ilt. 11111.4111L.4 NATURE OF PERMITTEE PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL /INDUSTRIAL BUILD APARTMENT BUILDINGS, AND MULTI- FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED, FOR EACH DWELLING UNIT. FEES FA T. OWNER NAME: 1 % OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR SITE ADDRESS: EACH $1,000 OF PERMIT FEE. PROCESSED PIPING -'.'$25.00 LOT: BLOCK' SUBD. $25.00 MINIMUM FEE. INSTALLER: ADDRESS: STATE SURCHARGE CITY: ZIP: PHONE #: CONTRACT PRICE x 1% TOTAL: SIGNATURE) Y D NGS 1 5.00 24.00 6.00 3.00 Address: 4163 COUNTRYSIDE DRIVE Lot 6 Blk 2 Sec /Sub COUNTRY HOLLOW 2ND These items were /were not complete at the time of the final inspection. Date: 5/1/92 Yes No ITiRpPt tPr: rJ,� Final grade (6" from siding) �'" Permanent steps - garage Permanent steps - main entry Permanent driveway Permanent gas Sod /seeded grass �. Trail /curb damage Porch r Basement finish / Deck i 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. RECYCLED PIiPEN White - City copy Yellow - Resident copy Pink - Contractor copy U0TE: Complete pages 3 and 4 first. • G. • • TYPE SIZE 111IIIIESOIA SIAIE ENERGY CODE CALCUL.AI IONS BASED ON CHAPTER — 5 OI' 711E MODEL ENERGY CODE - 1983 EDITION Adoption Effective I/118r' )wncr Site Address Contractor Building Classification: Type Al (Single Family C Duplex) (11 (Other) Doors - Ai-ea 9 1 1 .0 lhlckness T'yp'e of Construction Manufacturer ], Total door's perimeter ft. B. Windows: Manufacturer /d U factor AREA (Ft. • EACH A Phone Phone b GENERAL INFORMATION I W 1. Durld ing Per Imeter7E VOP•V'_j\ �'ft. • ft. 2. Wall height (ground to eave) V. Ft2 3, 1. x 2. (who've) gross wall area ),3`) I �. ft. i Building dlmens1ons (L) .-----. X (W) '5.. Square foot area of rim joist - Floor , olst slze (2 x (. !) j X P e r l m e t e r RIm ]olst area 12 16(O • In. U [actor ``! I Perimeter Type A2(ResIdentlal) (3 stories or les s (Over 3 stories) • (79, f t. roof c floor area NUMBER OF UNITS Z Date' State, approved (rn 5 ft TOTAL FEfT 2 ft. G� C 9. Total ft. Glass 2 Ft. 10. Fireplace' area:" ' Width X height = X / _ � � Ft. Ex osed found.atlon Height r eight X Perimeter t ( X k LL.. InJUIi I1E�10DEL7fIG t BUILDINGS DEIII( C P ll OF THIS FUN 1S,'REQUIRED FOR ALL 1I C�fistRhcrl , COUPLET i o MOVED WHERE ENERGY, OTHER JUAN THE MINIMAL CODE ALLOWANCE, IS USED. 12. •framing area = 10x of gross wall area 13. Gross wall area Vlndo) area A Rim Joist area A Door area A t r z, `� �pejil aae�:area A Exposed foundation A i Framing area A Ilet wall area A (13. above) I5.• Celling framing area /U ft. 2 ft. 2 ft. ft. ft. ft. 151, (o ?7 ft. (138) 14. Gross wall area x 0.11 (A - single family & duplex x 0.23 (A -2 other residential) x ,23 (Other buildings) • x .L3 (Over 3 stories) . • 2 ) x U Code 1 (AO equals 10% of ceiling area _- --- 15A. Gross telling area = (L) x (W) ' / a 158 Joist area (AO. _ ,1.03: ceiling area = (15A - 158) _ � 1 15C. U ceiling area 0 • Z . x e r • [, 11 (Pr.-1 0 ceiling x A c 1� A 0 x - - 1 _ a " l f U framing x A f= ISO. TOTAL 0 x A (n area ( 15A) x 0.026 (A - single family & duplex - code allowable U x.A • IG. Ceti 9 x 0.033 (!l -2 other residential) x 0.06 (other) OZC4 J x U code ft. U windows U riot joist = allowable 0 x A /Code ft. 2 >, I r (j U •x A a ll x A =___5_1 (�- U . x A = (1•"r� e.: U door area C 'l— U pl ate• = I L J • 0 x A = -- - --- Id • U x 1 y -716161- O foundation ' � U framing area I5 0 x A 2 — . --- ---- -- � ,{ 0 x A K Z)SZ U wall =____ � � - ] �.�� � �`` U xA`c t TOTAL ' 2DTUl1 t be 1 arger than �Gi i33�° above ( or the. same as) /c 2 ft. r 8 011 Must be . largo . than .15D (above) I' I• (or the sameNas) A 15.n NOTE! Use U and A values obtained from pages 1,•3 and 1 1.. IF1CAT1011: 1 hereby certify that I have calculated the "U" factors and "R " values cEftT li - creln and that the bul lJln9 here descr46ed Inc'ets or exceeds the State of Fllnneso a • Energy Conservation ,Act. Date • i Signature 1 L • • p:-M, � � � Y .1v - - I,I y 1 ____\_,1111 I vixk0 i A II— ._. 17,-x.5 . ( \..1/)?c(.0.------,,.1.!e_ A1.77. 7b..q.................... _ _ _21 LI_i1i`. l ;cco - .iJ i, Y.?<0... I P. �?- • : :ID. P1 ~ Z -10 I •1 . 0.61 tLAI !tour- OR C11111EIR1L CEILIIIG . `JALIIE h Vilire CE1L111G f It /\f I I I IG 0.61 llnJotl Int 11 tratlun .5 cfni/l I►ieal tout of crack lesIdentlal door infiltration 0.5 cfm /square toot or door and minlmum'code lion- Iesldentlal door 1nf11trat.lon 11.0 cfm /lineal foot of crack Jb 12' Concrete block ''no Insulation .41 R 2.1 Jb 12" tor►crele block •insulated cores .2G It 3.0 Jb • 12 l lglrt.delght block X32 It 3.1 ib 12 llylrtielyl►t block 1nsulated'cores 112 It Ord Sing 16 glass = 1.131 i► i th storm window .54 . double glass = .55 J triple glass = .41 4. ,1 • Air Film insulation Joist Ceiling Air FIInt lotal R 1 total Il U 111 bderior walls and ch111n s musl 1 v;llror harrier (0.10 perm mAk. ilror barrier must be on the inside (heated side) of wall: fapor barriers of the polyethelene thin film Irate no it value. r z o0 .2 o Inside air filnl 0.61 Culling Joist tsEttd) insulation Air spacd Roof decking insulation 1111 l l t-Up root Outside fir f1111 0.1] requirement ► COUNTRY HOLLOW SECOND ADDITION PRESSURE REDUCING VALVE AGREEMENT 954870 This agreement, made and entered into the c7? - day of (.f.f'� � , 1990, by and between the CITY OF EAGAN, a municipality of the State of Minnesota, (hereinafter called the City), and the Owner and Developer identified herein. The terms "Developer" and "Owner" as used herein refer to: PROGRESS LAND COMPANY, INC. whose address is 14300 Nicollet Court, Suite 235, Burnsville, Minnesota 55337. WHEREAS, the Developer has applied to 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, Block 1, Lots 1 -17, Block 2, and Lots 1 -10, Block 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 OWNER AND DEVELOPER: PROGRESS LAND COMPANY, INC. (Date: ' . Th mas A. Its: Mayor By: i...v3?960. J; .rs ACt',S;A Its: P,.'Cs r Attest: C'l. J. VanOverbeke By: Its: erk Its: STATE OF MINNESOTA ) ss. COUNTY OF DAKOTA ) / On this v S% day of LC- /Z�iLG�i , 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. signed Board ?; •Nttpre=tc,.eCttNllttttt:tt t L YL._ '.'.., 7 NN a C ] • • Notary/public STATE OF MINNESOTA ) ss. COUNTY OF n,, t " 'z ) I 1990, before me a Notary this � - day of !- �4� _ , , , y Public within _ and for said County, personally appeared ( r ; " . ; _, 1- (1. !' : % r and-- to me personally k own, who being as# ch by me duly sworn, e did say that thcy .ee rc3pcctivcly the II t ',s ( i 11 -ate- of the corporation named in the foregoing instrument, and that said instrument was d aeQl on behalf of said corporation by authority of its of Directors and said { , d u2 ' -- acknowledged said instrument to be the free act and deed of the corporation. i /ALA- C i � '11 Notary Pubic f APPROVED AS TO FORM: City Atto /bated: : APPROVED AS TO CONTENT: lam' / (`t/ i/1 Public Worlfs Department Dated: A.. 6 / ?o 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 ( Act, - 595'1 /r _ SEPTIC SYSTEM, new /refurbished (requires two sets of plans and MPC license) includes $40.00 County fee Note: Additional consultant fees may apply $ 100.00 • MODIFICATION /ALTERATION TO EXISTING DWELLING UNIT, INCLUDING: $ 50.00 _ Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. Abandonment of septic system. Water turnaround - existing dwelling unit (+ 5/8" meter if needed - $118) Other: — RPZ: new installation /repair /rebuild lawn irrigation system $ 30.00 Replacement/additional: softener water heater $ 15.00 _ water State Surcharge $ .50 Total $ /S 6-0 PERMIT # Please complete for: SITE ADDRESS: 4913 y/6 3 (0 u RECEIPT DATE: 800E RESIDENTIAL PLUMBING puma APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD ((� MN 5512 65'1 -6 675 8 • nit v MAR 0 1 ?OO ?_ single family dwellings, townhomes and condos when permits are required for ea , backflow preventer for irrigation system By 1/02 J � � ► Th .rK OWNER NAME:: l5 TELEPHONE #: 6s1- 75 y Rcc 7 (AREA CODE) INSTALLER NAME: fl/� J / // (1 TELEPHONE #: 9 4.5 - d 4 /61 9 -7 W I / s ? 19h V/ e �� (AREA CODE) STREET ADDRESS: // i / Y inn/ CITY: LQ� ,t �,V/ /! e STATE: in/ v ZIP: ( 5 - 5o ,/ V I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any dama! caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within Ci p gerty/right of -w.- ement. cicl 3(9 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 (bldgs with 3 or less units) DATE 02/18/02 JOB SITE ADDRESS APPLICANT Exterior Tnnovatinnc, Inc ADDRESS 9635 Humboldt Ave. S . , 111 onmi ngton MN PAGER # CELL PHONE # Energy Code Category (check one) RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651- 681 -4675 VALUATION 4163 Countryside Drive, Fagan, MN 55193 IF MULTI- FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER Kent & Jill Therkelson TYPE OF WORK Replace sPam1PRB steel siding MINNESOTA RULES 7670 CATEGORY 1 - Residential Ventilation Category 1 Worksheet Submitted Energy Envelope Calculations Submitted NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Remodel/Repair Requirements • 2 copies of plan • 1 set of Energy Calculations for heated additions • 1 site survey for exterior additions & decks • Indicated home served by septic system for additions $16,982.00 FIREPLACE(S) _ 0 _ 1 _ 2 PHONE# (952) 884 -0814 ZIP CODE 55431 FAX # Plumbing Contractor: Phone #: Plumbing System Includes: — Water Softener _ Lawn Sprinkler Fee: $90.00 Water Heater _ No. of R.I. Baths No. of Baths Mechanical Contractor: Phone # Mechanical System Includes: Air Conditioning Heat Recovery System Sewer /Water Contractor: Phone # All above information must be submitted prior to processing of application. t By I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan 0 Certificates of Survey Received _ Signature of Applicant Tree Preservation Plan Received _ Not Required _ Updated 2002 r ■ DATE 11 K/" 199/ CERTIFICATE OF SURVEY' S 9 9"38'31 E 100(00 7 17 0 5 89038‘314,6•A it) 4 :0,/07 X33 Q M COU / t — D E Dn HEREBY CERTIFY THAT THIS SURVEY PLAN OR REPORT WAS PREPARED BY ME OR UNDER AIY DIRECT .5X.PERVISION AND THAT I AAI A DULY REGISTERED LAND SURVEYOR UNDER THE LAWS OF THE STATE OF MINNESOTA. .A r R.". M- ? - - Szs 9) ' . 1 L4 Plat bearings shown o Denotes iron monument LExistinq; Pr; - (Tgcc Scale: 1" = 30' DESCRIPTION Lot 6, Block 2, COUNTRY HOLLOW SECOND ADDITION Dakota County, Minnesota Brandt engineering 8 surveying 2705 woods !rail burn villa, ininnasola 55357 (612) 435-1966 .03a SZ5 -9) 4432 - S25 -9) DATE 11 K/" 199/ r- -13 t o S 89p4 4 004 4 7D l6'51 ( ; CQuu 9, klue- / HEREBY CERT/FY THAT THIS SURVEY, PLAN OR REPORT WAS PREPARED BY ME OR UNDER MY DIRECT SWERV/S/OM AND THAT I AM A DULY REGISTERED LAND SURVEYOR UNDER THE LAWS Of THE STATE OF MINNESOTA. /AEA No 8140 CERTIFICATE OF SURVEY S 9 9 C -- 14ot oo ate CE G-KT S ©, LIJ ° � OD M CU o Plat bearings shown o Denotes iron monument (Exi sti nq) (Propose�c Scale: 1" = 30' DESCRIPTION Lot 6, Block 2, COUNTRY HOLLOW SECOND ADDITION Dakota County, Minnesota , i brondt anginaaring a surveying 2705 woods trail burnrvilla, minnarola 95337 (61R) 435-1966 /1432,-Ca 5-9) New Acid Rep. - Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial 'curnace Farm Aft 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 , 0 to 100 Amps Transformers Above 200 Amps Abe 00. Amps Signs Inspector's Use Only: THIS INSTALLATION MAY BE ORDERED COMPLETED WITHIN 18 MONT.S. TOM Irrigation Booms Special Inspection IF NOT Alarm /Communication DISCONNECTED Other Fee I, the Electrical Inspector, hereby certify that the above inspection has been made. Rough-in R t Da ,,,, 4 te .. 4 C�''�^ / I % .I _ 1"q Final OFFICE USE ONLY This request void 18 months from INSPECTION Hack of yellow copy "X" Belc."17c,K Covered by This Request Nev Aaa Rep. Type of Building Appliances Wired EquipmentWired A Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm. /Industrial Furnace Farm Air Conditioner Other (specify) Cont actor's Remarks: Compute Inspection Fee Below: # Other Fee # Service Entrance Size 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: ' b° THIS INSTALLATION MAY BE ORDERED DISCONNECTED COMPLETED WITH! ONT -. / r L ` E '� TOTAL . V 3i ,,... Irrigation Booms Special Inspection IF NOT Alarm /Communication Other Fee 1, the Electrical Inspector, hereby certify that the above inspection has been made. Rough -i Dat f � % , Final ` 7 f t--(.. / Date- ..„L« .f i,4„,. OFFICE USE ONLY This request void 18 months from REQUEST FOR ELECTRICAL INSPECTION ► See instructions for completing this forrn on back of yellow copy. `X"`Be/' v Work Covered by This Request E 0,0x0.01 -08 — � Re q uest'nate -- 1 1 ✓ Fre No. Rough-in r Intspecton Required? t No Yes` :7 No �d� p Ready Now Will Notify Inspector /� When Ready? 1 licensed contractor D owner hereby request inspection of above electrical work at: Job A (Street. Box or Route No.) �i City 4.6 + Section No, To Nang or No. Range No. County t ry <t 1`\ Occupant (PRINT) Phone No. Power Supplier 'iJcJck C ° 1'e4' ' c. Address Elec ical Contractor (Company Name) rV(cF.,t4 tie r,'c_ Contractor's License No . CA A CA-6 A iAI Mailing Address (Contractor or Owner Making Installation) / 76 ? C R - , , i 1 5 -' � y- ) y �. L l A 1 1 f r t.) on iii N. 63330 Phone Number Authorized Signal +Contractor /Owne.Maki Installation) ..4 MINNESA STATE BOAR OF C RI CITY 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. MINNESOTA STATE BOARD OF ELECT 6TiCITY 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. Request Date 6-12-91 Fire N. Rough -In Inspection Requ red ‘U` - No =} Ready Now L.1444 Notify Inspector When Ready? I incensed contractor ❑ owner hereby request inspection of above electrical work at: Job Address (Street. Box or Route No.) 4163 COUNTRYSIDE DRIVE City EAGAN Section No. Township Name or No. Range No. County DAKOTA Qccupant�P,(iET) MILLER CONSTRUCTION Phone 6 12- 431 -2001 Power Su DAKOTA ELECTRIC ASSN Address FARMINGTON, MN Ele�th�a�nt�oA N Il LEC T R I C, INC. contra 0 41610 Mailing A 76 5t 0 14 S WEST #214, APPLE VALLEY, MN 55124 Authorzgd rS 1gr Lure (Contractor-,,rrt "'Matt no Installation) Phone Number 612- 432 -6688 MINNESOTA STATE BOARD OF ELECT 6TiCITY 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. RE: DATE • APR 29, 1991 4163 COUNTRYSIDE DR (JOSEPH M MILLER CONSTRUCTION INC) Your Sewer & Water Permit for the above property has been completed. It will be held at the Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO CALL PUBLIC WORKS (454 - 5220) FOR YOUR PERMANENT WATER TURN ON. Your Sewer & Water Permit for the above property cannot be completed for the following reasons: Your Sewer & Water Permit for the above property has been completed, but the meter cannot be issued or occupancy allowed until further notice. COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be confirmed by Bill Adams or Dirk House (Plumbing Inspectors — 454 -8100) before issuance. WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES — TELEPHONE, ELECTRIC, GAS, ETC. — REQUIRED BY LAW. CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY. Secretary, Building Inspections Dept. Qi rtifirntr of (!rrupanrj QCitp of Cagan Etpartment of % tang Jttaprtth m This Certificate issued pursuant to the requirements of Section 306 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. SF Imo /Gt\R Oaupancy Type zoning District owner of Bolding JOSEPH M MILLER 'SST. 4163 OCatI RYSIDE DP,TVE Building Address Use Classification Building (Bridal RI POST IN CONSPICUOUS PLACE Bldg Permit No 19965 VN 18133 U AR A VE S, FAR MIGNON Address L6, E2, COUNTRY HOIXOW 2ND Locality 5/1/2 Date: BUILDING PERMIT - To be used for SF DWG /GAR CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21 -199, Eagan, MN 55121 PHONE: 454 -8100 Site Address 4163 COUNTRYSIDE DR Lot 6 Block 2 Sec /Sub COUNTRY HOLLOW 2NED Parcel No cc w z 0 U¢ w Fw w o mZ aw Name JOSEPH M MILLER CONSTRUCTION Address 18133 CEDAR AVE S City FARMINGTON Phone 431 -2001 Name SAME Address City Phone Name Address City Phone I hereby acknowlege 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 OrdiVances. Signature of Permitee 7� A Building Permit is issued to OSEPH M MILLER CONST on the express condition that alt work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. 1 Building Official Receipt # Est. Value $141,000 Date APR 26 N2 18965 , 1991 OFFICE USE ONLY Occupancy R - 3 M - FEES Zoning R - (Actual) Const V — N Bldg. Permit 783.00 (Allowable) V —N Surcharge 70.50 # of Stories Length r Plan Review 509.00 Depth 38' SAC, City 100.00 S.F. Total SAC, MCWCC 650.00 S.F. Footprints On Site Sewage Water Conn 660.00 On Site Well Water Meter 95.00 MWCC System X City Water X Acct. Deposit 30. QO PRV Required X S/W Permit 30.00 Booster Pump S/W Surcharge - 50 Treatment PI 276.0 APPROVALS Road Unit 370. Planner Park Ded. Council Bldg. Off. Copies Variance TOTAL .3, 574.00 'APPI ANT 3os p1 M .., �i1 C nt ADDRESS 1$133 Cedar Ave .So CITY, STATE r + M E: 431- -20; ;1 CITY, STATE App1 J 1. I *t` ZIP 4 ,, PHONE: 43 2- IIf9 OWNER: ADDRESS: CITY, STATE PHONE: PLEASE ALLOW TWO. WORKING DAYS OR N° :CALL 454 -5220 SEWER PERMITS, CONTACT ENGINEERING o ' OPFICE 41 ON Y ' 7 PERMIT DATE fl / 41 ' PEit {MT # ,., 119 ;r MI iER$ZE "e � l s u 5 8P RECEIPT# C 13107 E E °'` 1 8 P, RECEIPT DATE 4/26/ V_ BOOSTER PUMP PERMIT REQUESTED X" SEWER X , WATER `API 5 COMM /IND IRESIDENTIAi Q� 4 NEW XIS x' Lawn Sprinkler Meters are to be Ahead of Domestic Meters on Water Cre WILL NOT be given # Deduct M I A+'EE TO`CQMPLY WITH Y OF EA AN ORDItCES SIGNATURE WHEN METER ISSUED SITE ADDRESS 4 16 3 C p u n t �r s ts'C a 1) LOT 6 BLOCK 2 SECISUB Co fl:t - r y . H ZIP NSPECTIONS, FOR STORM PERMIT Permit Type: Mechanical City of Eagan Permit Number: EA106134 Date Issued: 08/13/2012 Permit Category: ePermit Site Address: 4163 Countryside Dr Lot: 6 Block: 2 Addition: Country Hollow 2nd PID: 10-18276-02-060 Use: Description: Sub Type: e - Air Conditioner Work Type: New Description: Air Conditioner Questions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952) Comments: 445-2840 Janel Behrends 122 West 3rd S ME - Permit Fee (Replacements) $55.00 0801.4088 Fee Summary: Surcharge-Fixed $5.00 9001.2195 Valuation: 2,431.00 Total: $60.00 Contractor: Owner: - Applicant - Haley Comfort Systems Donald Downey 122 West 3rd St 4163 Countryside Dr Hastings MN 55033 Eagan MN 55123 (651) 437-0338 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:EA126945 Date Issued:09/17/2014 Permit Category:ePermit Site Address: 4163 Countryside Dr Lot:6 Block: 2 Addition: Country Hollow 2nd PID:10-18276-02-060 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. Tony Boerner 2090 County Road 42 W Burnsville, MN 55337 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 - Donald Downey 4163 Countryside Dr Eagan MN 55123 Tony's Appliance 2090 County Road 42 West Burnsville MN 55337 (952) 435-2442 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA144067 Date Issued:07/11/2017 Permit Category:ePermit Site Address: 4163 Countryside Dr Lot:6 Block: 2 Addition: Country Hollow 2nd PID:10-18276-02-060 Use: Description: Sub Type:Reroof & Windows/Doors Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Windows/Doors: If altering the opening size, a framing inspection is required. Valuation: 8,000.00 Fee Summary:BL - Base Fee $8K $162.25 0801.4085 Surcharge - Based on Valuation $8K $4.00 9001.2195 $166.25 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 - Donald Downey 4163 Countryside Dr Eagan MN 55123 (651) 681-9848 Builders & Remodelers Inc 3517 Hennepin Ave S Minneapolis MN 55408-3830 (612) 827-5481 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA161748 Date Issued:06/11/2020 Permit Category:ePermit Site Address: 4163 Countryside Dr Lot:6 Block: 2 Addition: Country Hollow 2nd PID:10-18276-02-060 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 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 - Donald Downey 4163 Countryside Dr Eagan MN 55123 (651) 681-9848 Builders & Remodelers Inc 3517 Hennepin Ave S Minneapolis MN 55408-3830 (612) 827-5481 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA168282 Date Issued:04/15/2021 Permit Category:ePermit Site Address: 4163 Countryside Dr Lot:6 Block: 2 Addition: Country Hollow 2nd PID:10-18276-02-060 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door 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: 1,500.00 Fee Summary:BL - Base Fee $1500 $62.50 0801.4085 Surcharge - Based on Valuation $1500 $0.75 9001.2195 $63.25 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 - Donald & Marilynne Downey 4163 Countryside Dr Eagan MN 55123 (651) 402-7169 Builders & Remodelers Inc 5301 East River Road Suite 110 Fridley MN 55421 (612) 827-5481 Applicant/Permitee: Signature Issued By: Signature