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4179 Countryside DrMay 1, 1996 JOE & KITTY ROBERTSON 4179 COUNTRYSIDE DR EAGAN MN 55123 Re: Lot 5, Block 2, Country Hollow Addition Sanitary Sewer Service Dear Mr. & Mrs. Robertson: It is my understanding that the house of the above - referenced property has experienced minor flooding from a back -up in the City's sanitary sewer system on two different occasions. On both occasions, the City's electrical sewer pumps incurred a power failure. In itself such a power (or mechanical) failure should not cause a sewer back -up as the City has portable generators and/or auxiliary pumps that can be commissioned to maintain continuous sewer service. Unfortunately, both back -ups resulted from a failure in the alarm system notifying the City's Maintenance Division of a problem allowing it to respond with corrective action prior to any homes being impacted. After isolating the alarm failure problem with the first sewer back -up, the City initiated an aggressive program of replacing all such alarms throughout our entire system with the most current technology that has built -in redundancy and fail safe mechanisms. Unfortunately, we were approximately five weeks away from completing the conversion to the new alarm system when the recent pump failure and sewer back -up occurred. We feel confident once this new alarm system is activated, there should be no further concerns of similar situations occurring in the future. I sincerely apology for the inconvenience you have experienced in the past and want to assure you that the City of Eagan is committed to providing a safe, dependable, and trouble -free sanitary sewer system to meet all of your needs. Sincerely, Thomas A. Colbert, P.E. Director of Public Works TAC /jj THOMAS EGAN Mayor PATRICIA AWADA SHAWN HUNTER SANDRA A. MASIN THEODORE WACHTER Council Members THOMAS HEDGES City Administrator E. J. VAN OVERBEKE City Clerk MUNICIPAL CENTER 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 -1897 PHONE: (612) 681 -4600 FAX: (612) 681 -4612 TDD: (612) 454 -8535 city of aagcin THE LONE OAK TREE THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY Equal Opportunity /Affirmative Action Employer MAINTENANCE FACILITY 3501 COACHMAN POINT EAGAN, MINNESOTA 55122 PHONE: (612) 681-4300 FAX: (612) 681 -4360 TDD: (612) 454 -8535 Date Oa / 12 Ic Site Street Address 4119 Cc/ Ir\-o SI S aO Property Owner MG( r ph l � y Contractor 1- P LAO (�s Address (0 DOOkck hCcav$ w 100 City F The Applicant is: Owner ■contractor 0 Alterations to existing dwelling fixtures to rooms, excluding water softener and water he _ Add Septic System Abandonment Water Turnaround (add $121.00 if a 5/8" meter is required) Other: Water Softener 1 Water Heater _ 1 replacement additional Lawn Irrigation System RPZ new repa _ State Surcharge Total 2004 RESIDENTIAL PLUMBING F CITY OF EAG 3830 PILOT KNOB ROAD, E 651- 675 -567 Please complete for modifications to existing residential I hereby apply for a Residential Plumbing Permit and a and accurate; that the work will be in conformance wi Eagan and the plumbing codes; that I understand this i permit, work is not to start without a permit and work wil the event a plan is required to be reviewed and approved K. 0 '10 ( Applicant's Printed Name Applice _city of =man 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 -1897 PHONE: (612) 454 -8100 FAX: (612) 454 -8363 October 10, 1990 WARREN ISRAELSON PROGRESS COMPANIES, INC. 14300 NICOLLET COURT SUITE 235 BURNSVILLE, MN. 55337 RE: T.V. Inspection of Sanitary Sewer Dear Warren: Enclosed is the invoice from Visu -Sewer for televising the sanitary sewer line between Lots 4 and 5, Block 2, Country Hollow Addition. Because of the incorrect as -built information the City received, we feel it is the developer and /or engineering firm that is responsible for at least z of this amount As I stated in our telephone conversation, the City of Eagan will pay the other Z. Please submit to the City of Eagan a check in the amount of $212.50. If you have any questions pertaining to this item, please call me at 454 -8100. Sincerely, Stanley /Lexvol• Senior Engineering Technician- Construction cc: Joe Connolly, Supt. of Utilities Michael P. Foertsch, Assistant City Engineer SL /jf THE LONE OAK TREE...THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY THOMAS EGAN Mayor DAVID K. GUSTAFSON PAMELA McCREA TIM PAWLENTY THEODORE WACHTER Council Members THOMAS HEDGES City Administrator EUGENE VAN OVERBEKE City Clerk Equal Opportunity /Affirmative Action Employer P7'Tn T nI .jF . Au mist On0g4 VISU- SEWER CLEAN & SEAL, 1I CP N59 W14397 Bobolink Avenue, Menomonee Falls, Wisconsin 53051 41 4- 252 -3203 FAX 414-252-3195 1 n n - i t ,, f 7;lc?t1 P7: T . \ . Tnspel: t i r - 1 0 ' r`t7r' t'_1 f i u1 r:al- vices I '?Y - minimum ^11)ar{_Ip T I1 t7 0 j r F !111e upon I-e -nipt of i11','r)iro A servi -f 1 1 'T'- C'p mr may Past 111P F1'T" - . .. , r 1 .. •r` - ,1 , . ■ 1 It :I r IN\J0T(77 CU`= Tr`l!FT r'jl 1 Clr.,rl .,11 member of • , DATE August 3l , 1 Ron City nf Eagan 10 ?fl Pilot Knob Road Flaq MN 55122 1/' day - minimum charge VISU-SEWER CLEAN & SEAL, INC,. N59 W14397 Bobolink Avenue, Menomonee Falls, Wisconsin 53051 414-252-3203 FAX 414-252-3195 PE: T.V. Inspection of 10" PVC to find services - 1 TIVO I C E f in() ri 1 lttIt rr tiri it 101 II INVOICE iirP ,TrIP 0 0084 CUSTOMEP 114 SU TEPMS: Due upon receipt of invoice A service charge of 1 1/2' per month may be 'charged on all past due accounts. member of _city of aagan 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 -1897 PHONE: (612) 454 -8100 FAX: (612) 454 -8363 November 6, 1991 BLILIE CONSTRUCTION 644 SUPERIOR COURT EAGAN, MN. 55122 RE: Unpaid Bill for Sanitary Sewer Service Reconnection Dear Wayne: I just heard today again that your plumber, Eagan Excavating, has not paid their share of the bill ($200.00) for the reconnection of the sewer service for the home located on 4179 Countryside Drive in Country Hollow. As you remember, the bill received was for $980.00 and I negotiated it down to $750.00. It was agreed upon that you and your plumber are responsible for each $200.00 of this amount. If Eagan Excavating is not going to pay their amount, then I ask you as the builder to pay their share now and collect from them. This work was completed in the spring of 1990 and payment is long overdue. Please take care of this matter immediately. Thank you. Sincerely, Stan Lexvold Sr. Engineering Technician /Construction SL/jf THE LONE OAK TREE THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY THOMAS EGAN Mayor DAVID K. GUSTAFSON PAMELA McCREA TIM PAWLENTY THEODORE WACHTER Council Members THOMAS HEDGES City Administrator EUGENE VAN OVERBEKE City Clerk Equal Opportunity /Affirmative Action Employer TO: THOMAS L. HEDGES, CITY ADMINISTRATOR FROM: THOMAS A. COLBERT, DIRECTOR OF PUBLIC WORKS DATE: MAY 3, 1996 SUBJECT: SANITARY SEWER BACK -UP - COUNTRY HOLLOW ADDITION INCIDENT At approximately 8:15 A.M. on Monday, April 30, 1996, the maintenance division of the Public Works Department was contacted by various residents within the Country Hollow Addition reporting sanitary sewer back -up into their homes. Maintenance employees dispatched to the area discovered that the Country Hollow sanitary sewer lift station experienced a power failure and the pumps were not working. Dakota Electric was contacted and City dispatched a portable generator to the site with one pump being reactivated at approximately 9:23 A.M.. Full power was ultimately restored at 10:13 A.M.. By Tuesday morning, the City had indications that approximately seven home owners experienced a sanitary sewer back -up into their homes to some degree. See attached map for location of impacted properties. CAUSE Preliminary investigations indicate that some type of power spike or surge created a "flash burry' at one of the connection points of the control fuse for the electrical motors. Such a power or mechanical failure should not result in a sewer back -up into residential homes as the City has portable generators and /or auxiliary pumps that can be commissioned to maintain continuous sewer service. Unfortunately, the sewer back -up resulted from a failure in the alarm system to notify the City's maintenance of a lift station malfunction allowing it to respond with corrective action prior to any homes being impacted. HISTORY MEMO city of eagan L S @a 2 (L' our►4rj AOltow) Unfortunately, a similar situation occurred on June 14, 1994. At that time, five homes were impacted. Similarly, the 1994 sewer back -up resulted from an electrical power outage and the failure of the alarm system to notify City maintenance. Due to that previous occurrence, the Public Works Department proceeded in 1995 to replace all such unreliable alarm systems with current technology of radio telemetry SCADA System City wide. Unfortunately, we were approximately 4 - 5 weeks away from completing the conversion of the alarm system at this location when the second power outage /alarm failure occurred. CORRECTIVE ACTION The Public Works Department has contracted with an Electrical Engineer to review the electrical controls and alarm system to identify any interim measures that can be taken to increase reliability. The Public Works Department will also be accelerating its efforts to complete the conversion to the new fail -safe alarm system. During the interim, the City will be inspecting the facility three times per week testing all controls and alarm systems helping to insure reliability. The City's insurance agent, League of Minnesota City's Insurance Trust "LMCIT" has already been in contact with all of the known affected home owners helping to process any claims they may have. Of the seven homes owners, two of them have indicated the back -up did not result in any damage requiring on -site inspection by the insurance agent. COMMUNICATIONS In addition to numerous phone calls and personal visits with affected property owners, attached is a letter being sent to affected property owners. As significant additional information becomes available, I will forward it to your attention. Please let me know if you would like any further action. Respectfully submitted. Director of Public Works TAC /cb cc: Eugene VanOverbeke, Director of Finance /Risk Manager Wayne Schwanz, Superintendent of Utilities Attachment: Letter dated May 2, 1996 List of Affected Property Owners Location map 05%0 :%95 14:08 MAY 2, 1996 NAME ADDRESS CITY, STATE ZIP Dear Name: MUNICIPAL CENTER 3880 PILOT KNOB ROAD EAGAN. MINNESOTA 55122 1867 PHONE. (612) 681 4600 FAX. (6 681.4612 IDO (612) 454.8535 b1,2 bbl 4.jUk EAGAN MTCE FAi_ - CITY HALL- DNSTPS City of =man RE: FAILURE OF THE COUN IRY HOLLOW SANITARY LIFT STATION ON TUESDAY, APRIL 30, 1996 THE LONE OAK TREE THE SYMBOL Of STRENGTH ANO GROWTH IN OUR COMMUNITY EcuaI Opponunity /Attlrmotive Action Employer NO.396 P001 00 THOMAS EGAN Mayor PATRtCIA AWAOA SHAWN HUNTER SANDRA A. MASIN THEODORE WACHTER Council Memoers THOMAS HEDGES CIN Administrator E. J. VAN OVERBEKE ON Clerk It is my understanding that your house was involved in flooding from the backup of the city sanitary sewer system on April 30, 1996. The cause of the backup was a failure of the City of Eagan's sanitary lift station which incurred a power failure thus preventing the sewage pumps to function properly. In itself, such a power failure would not cause a sewer backup as the city has portable generators and pumps to maintain continuous sewer service. Unfortunately, the backup resulted from a failure in the alarm system which notifies the City's maintenance division of a problem allowing it to respond with corrective action prior to any of the homes being impacted. Upon receiving the alarm at 8:17 a.m., on April 30th, 1996 the Utility Division dispatched two employees to the scene and they arrived on site within 10 minutes of being notified of a flooding problem of one of the homes in the area. They immediately requested a backup generator to be brought in which was done within an additional 15 minutes. At the same time Dakota Electric was notified that a possible power failure may be resulting in the transformer which controls the sanitary lift station. Dakota Electric dispatched a truck which arrived within 40 minutes of the initial call. The emergency crew connected the generator to the electrical bypass of the sanitary lift station and the pumps were operating within minutes. It took approximately 20 minutes to pump the system down to control any flooding that may have been taken place. Unfortunately approximately seven homes in the area had experienced a sewer back up to some degree. The entire situation was corrected and the station was back on line operating properly by 10:13 a.m. On May 1, 1996 the Utility Division contracted with Jensen Electric Company to inspect and test the control panel at the sanitary lift station. As a result of their inspection, no problem was discovered within the control panel, suggesting possibly what may have happened was a power spike being created within the power lines which may have damaged a fuse. Although a fuse was located which showed that it may have been exposed to excessive power, it was still operable. The Utility Division also traced and verified the operation of the current alarm system which has existed at the station. Further investigation will continue to determine what caused the alarm failure. MAINTENANCE FACILITY 9501 COACHMAN JOINT EAGAN MINNESOTA 55122 JWONE• (612) 6814300 :AX: (612) 68).4350 '00 (6)2( 454.8535 612 681 4300 05z0 -96 14:08 EAGAN MTCE FAC - CITY HALL- DNSTPS On June 20, 1994 this lift station experienced a similar problem due to loss of power from Dakota Electric. After reviewing this incident the Division investigated alternatives in system control and monitoring failure alarms which lead to the development of our current SCADA (Supervisory Control and Data Acquisition) system which is utilized at our Water Treatment Plants. In 1995, the city initiated an aggressive program of replacing controls and alarms in our entire system with the most current technology available which has built in redundance of a failsafe mechanism. Unfortunately we were approximately five weeks away from completing the conversion to the new alarm system when the recent pump and alarm failure and sewer backup occurred. The city will make every effort to further accelerate the completion of this alarm conversion and hope to complete the installation and testing within two to three weeks. We feel confident that once this new alarm system is activated there should be no further concerns of similar situations occurring in the future. In the meantime, the Utility Division has taken further steps to monitor the operation of the lift station. The current alarm system will be tested three times weekly and verified as to the status of its operation. Also, we will be adding a light to be installed at the station which will activate during a high sewage level situation. This light will provide a visible alarm that a problem with the station is occurring and therefore allowing the city to be notified by residents whenever the light is observed to be on. We sincerely apologize for the inconvenience you have experienced and want to assure you that the City of Eagan is committed to providing a safe, dependable and trouble free sanitary sewer system to meet all of your expectations. As the work progresses with the new alarm system, I will notify you as to the progress and completion date of that project. If you have incurred any damages the City's insurance company will work with your homeowners insurance company to process any claims and reimbursement payments. If you have any questions regarding processing your claim, please contact the city's insurance agent, Ms. Darlene Boise at 215 -4077. Sincerely, Wayne Schwan Superintendent of Utilities WS /nab I'L? t b(co untrv.124 NO.996 P002= 0n:- BUILDING PERMIT To be used for SF DWG /GAR DECK 5-8169 /19/ CITY OF EAGAN 3830 Pilot Knob Road, P.O.; Box 21 -199, Eagan, MN 55121 PHONE: 454 -8100 Receipt # �e...; Site Address 4179 COUNTRYSIDE DE Lot 5 Block 2 Sec /Sub COUNTRY HOLLOW Parcel No cc w 3 0 0 cc Ua U w F w U Z a W Name Address (fifty BLILIE CONSTRUCTION 644 SUPERIOR CT EAGAN Phone 4S4^ -1438 me SAME A &ir ess City Phone Name Address City phone I hereby acknowlege that l have read this application and state that the information is correct and,agrge to comply with all applicable State of Minnesota Statutes and Citfof arc an Ordinance: Signature of Permitee E $i A Building Permit is issued to: BLILIE CONSTRUCTION on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Est. Value .$111 *WOO Building Official Occupancy ' Zoning (Actual) Con (Allowable) # of Stories Length Depth S.F. Total S.F. Footprints On Site Sewage On Site Wet MWCC System City Water PRV Required Booster Pump APPROVALS Planner Council Bldg. Off. Variance Date DEC 12 OFFICE USE ONLY S � 48' .4$.10g. Permit „Surcharge Plan Review , 19 FEES 35.50 339. 10 0.00 575.00 SAC, City SAC, MCWCC Water Conn Water Meter Acct. Deposit S/W Permit S/W Surcharge •'`^' Treatment PI Road .Unit Park Ded. Copies TOTAL 580.00 228.00 Permit No. Permit Holder Date Telephone # WATER sc-weR4d. PLUMBING elf. H.V.A.C. ELECTRIC / / /�,L / f ' � f 1 ' , . , r �?r l,i,t l L; ( j/58 G o de . %ego 4;C,/,5 //L7' J 5 Ge- ,„_.,2 Yi; /�/? ._ ' /51. ��L -/f 0ki : % 9i z'. /7/ ,2 ,� // /g.,,/ / ;l/�l�4c'.�L"i��t,; 4C .c,..Lz : /'�/ 0 J/ �o � _(0 — 6 . a rt G., ,. /049 �,c f J Inspection Date Insp. Comments Footings I /ol/�, / /t J Foundation Framing 6-A9 4P Roofing Rough Plbg• r� .9 :.� -,l'd 7 - ?- %' / G /24 " Rough Htg. 2/7/9 , ,J f (i�e� 2 0 dZ . u,�' .(41/.6z, .aie1 'e.- Fireplace 3 III& 64 Final Htg. . / ' ' Final Plbg. s-/ 4 f' G) 4 Consl. Meter Plbg. Inspector – Notify Plumber Engr. /Plan Bldg. Final 3 , ? Deck Ftg. ,2 / / A) n ✓ #« L — Arskii /i / Deck Final it 8 – 10 65 bIte 4 ott. PG ( T "' 9� � g Well r f pm ' �14i �� Pr. Disp. / 7/4 CONTRACT PRICE: Site Address Lot 0, d c 0 Block Sep /Sub r.' Name Address City 1 fix. Phone Name Address 4 City Phone TYPE OF WORK Forced Air M BTU Boiler M BTU $ Unit Heater M BTU $ Air Cond. M BTU $ Vent r a' . = CFM $ Gas Piping Outlets # $ Other $ FEE: S /C: TOTAL: .'. MECHANICAL PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 HONE. 454 -8100 BLDG. TYPE WORK DESCRIPTION Res. New Mult. Comm. Other SIGNATURE OF PERMITTEE FOR: CITY OF EAGAN PERMIT# / RECEIPT # ���� DATE: For Office Use Only: Add -on Repair - $24.00 FEES RES. HVAC 0 -100 M BTU ADDITIONAL 50 M BTU (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMIT) COMM /IND FEE - 1% OF CONTRACT FEE APT. BLDGS. — COMM. RATE APPLIES TOWNHOUSE & CONDOS — RES. RATE APPLIES MINIMUM RESIDENTIAL FEE — ALL ADD -ON & REMODELS 12.00 MINIMUM COMMERCIAL FEE 20.00 STATE SURCHARGE PER PERMIT ' - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000) 1.50 EA. CONTRACT PRICE Site Address 1 /7 Lot *5' Block eSAe Name . e #0a Address _1) ) City / c 0 PLUMBING PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGANp MN PHONE 4548100 Name n ! ( Address Cif City •r.J/ rL? ec/Sub Phone r. FEES COMM. /IND. FEE - 1% OF CONTRACT FEE APT. BLDGS. COMM. RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APLLIES MINIMUM - RESIDENTIAL FEE $12.00 MINIMUM - COMMAND. /FEE $20.00 STATE SURCHARGE PER PERMIT .50 (ADD $.50 S/C PER EACH $1,000 OF PERMIT FEE) Phone . f7. /r7; BLDG. TYPE Res. Mult. Comm. Other NO. FIXTURES Water Closet - 3.00 Bath Tubs - $3. Lavatory - $3.00 Shower $3.00 .00 f Kitchen Sink - $3.00 Urinal /Bidet - $3.00 La rY y und Tray - $3.00 For Office Use Or* PERMIT //4 RECEIPT # 4 DATE: / 99 WORK DESCRIPTION New Add -on Repair RES. PLBG. ONLY - COMPLETE THE FOLLOWING; TOTAL 3 $ Floor Drains - $1.50 Water Heater - $1.50 / ? Whirlpool - $3.00 Gas Piping Outlets - $1.50 (MINIMUM - PER PERMIT) Softener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 1/, 5 U. G. Sprinkler System - $12.00 PERMIT FEE: STATES SIC: GRAND TOTAL: 3 0,7 c'42 4ssr•sssseAsatotos U *V; .s" = Arlsooiriik, OTY ST MOW OVMR: CITY • L S ecretary, Building 3flepi3 ATE: 12/14/19 RE 4179 COMETS1DE MINX, L5, 12, Your Sewer & Water Permit/tor the above propertyhas been coi Public Works Garage (3501 Coachman Road) unti the meter ftikLI. PUBLIC WORKS (4544220) FOR YOUR ItERMANENT,W tbur Sewer & Water Permit for the above property cannot b Freasons: lk , ------ be issued or occdpoiney Your Sewer & Water porrriit for the abov ti tov r i tti r property has C Or; ME RCIAL PRo4' crs' oritAei Pes* ' confirmed by BllrAdarfts Or O ( P b irk Houee WARNING: : I IEF it2. 1 :: - 04 '- a l t 13 1 y: 'tA",vi,"143CA,L,4 , 1 CONTACT CO0MitoRTY • s • ROOT' /CEILING 1 FIG. 115 Heat floss up FIG. M6 . vented NON — VENTED Nast flow up ptr,. 47 Construction 1. Trite ri ir film 2. .5r e ickw • Sd' 3. /0 � fea/tOIs ./X, 4. Exterior air film (rtiiI) O-GT Total 39, r 1. Interior ai film 2. 3. ,. 4. Exterior air M1m Total 1. Inside air film 0.61 2. 3. 4. 5. Outsid .ir. film 0.17 Note: 0.61 Use additional sheets if more space is needed for details and calculations. New Construction Reauirements • 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and III roofed areas (20% maximum at 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 51z °% z . SITE ADDRESS t i ( TYPE OF WORK 1 -c APPLICANT e �+� STREET ADDRESS 1 TELEPHONE # 6s( 2 (-o CELL PHONE # FAX # PROPERTY OWNER SA, -,�i Energy Code Category (1 submission type) Plumbing Contractor: Plumbing system includes: Mechanical Contractor: Mechanical system includes: Sewer/Water Contractor: Certificates of Survey Received RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651 - 681 -4675 s ��P� oz P r(vicc� � 0 rr �R t u COMPLETE THIS SECTION FOR -NEW- RESIDENTIAL BUILDINGS ONLY L q � S - MINNESOTA RULES 7670 CATEGORY 1 • Residential Ventilation Category 1 Worksheet Submitted • Energy Envelope Calculations Submitted Water Softener Water Heater No. of Baths Air Conditioning Heat Recovery System Signature of Applicant OFFICE USE ONLY Tree Preservation Plan Received Remodel/Repair 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 T- 100 . Phone # Lawn Sprinkler MULTI - FAMILY BLDG _ Y N FIREPLACE(S) _ 0 < 1 _ 2 CITY 7T P---0 STATE ZIP 55 - i0 J TELEPHONE # MI No. of R.I. Baths Phone # Phone # Not Required _ Fee: $70.00 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 Ordinances. Updated 4/02 OFFICE USE ONLY ❑ 01 Foundation ❑ 07 05 -plex ❑ 13 16 -plex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06 -plex ❑ 16 Fireplace ❑ 21 Porch (3 -sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of _ plex ❑ 09 07 -plex ❑ 17 Garage ❑ 22 Porch /Addn. (4 -sea.) ❑ 33 Ext. Alt - SF ❑ 04 02 -plex ❑ 10 08 -plex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 36 Multi ❑ 05 03 -plex ❑ 11 10 -plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04 -plex ❑ 12 12 -plex Plbg_Y or _ N ❑ 25 Miscellaneous ❑ 31 New ❑ 32 Addition ❑ 33 Alteration ❑ 34 Replacement Base Fee Surcharge Plan Review MC /ES SAC City SAC Water Supply & Storage S &W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total ❑ 35 Int Improvement ❑ 38 Demolish (Interior) ❑ 44 Siding ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair ❑ 37 Demolish (Bldg)* ❑ 43 Reroof ❑ 46 Windows /Doors *Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC /ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) Final /C.O. Footings (deck) Final/No C.O. Footings (addition) Plumbing Foundation HVAC Drain Tile Other Roof Ice & Water Final Pool _ Ftgs _ Air /Gas Tests _ Final Framing Siding Stucco Stone Fireplace _ R.I. _ Air Test _ Final Windows (new /replacement) Insulation Retaining Wall Approved By , Building Inspector to Address Parcel /Sub Owner Address SINGLE FAMILY DWELLINGS 2 SETS OF PLANS 3 REGISTERED SITE SURVEYS 1 SET OF ENERGY CALCS. MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS NOTE: ADDRESSES FOR CORNER LOTS — CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT I3 ISSUED.. SEWER & WATER PERMIT FEES IND ACCOUNT DEPOSIT FEES WILL BE INCLUDED WITH THE BUILDING PERMIT FEE. PROCESSING TIME FOR SEWER IND WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED INDICATING A LICENSED PLUMBER. PENALTX APPLIES WHEN: PERMIT IS NOT PAID FOR IN SAME MONTH IT IS REQUESTED. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. Itt To Be Used For: Z-Si Block 2---/ r crut,—tr City /Zip Code Phone Contractor Address Co ` City /Zip Code — A 4x�� Phone Arch. /Engr. Address City /Zip Code Phone • 1989 BUILDING PERMIT APPLICATION CITY OF EAGAN I/3/9 MULTIPLE DWELLINGS 2 SETS OF PLANS REGISTERED SITE SURVEYS — (CHECE WITH BLDG DIV.) 1 SET OF ENERGY CALCS. Valuation: 1 11 O®O Occupancy Zoning Actual Const Allowable # of stories Length Depth S.F. Total Footprint S.F. On site sewage On site well MWCC System City water PRV required Booster Pump OFFICE USE R -3 M--1 R-I V -N V -N y 5 a' 8' APPROVALS Planner Council Bldg. Off. ",�7 1242 'Variance Date: COMMERCIAL 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCS. 12 - 7 -8 ? ONLY 1 OF UNITS FEES Bldg. Permit ( Surcharge 55.50 Plan Review 337, 00 SAC, City 100,00 SAC, MWCC 5'7_5, Water Conn 5s Water Meter 9 Acct. Deposit 3o,00 S/W Permit .240,0 S/W Surcharge ,Po Treatment Pl. 228,00 Road Unit 3 Na, spa Park Ded. Copies SUBTOTAL Penalty TOTAL BUILDING PERMIT To be used for SF DWG /GAR Site Address 4179 COUNTRYSIDE DR Lot 5 Block 2 Sec /Sub COUNTRY HOLLOW Parcel No cc w 3 0 r- O V c)a cc ww w (JO ¢ Z a w Name Address City BLILIE CONSTRUCTION 644 SUPERIOR CT EAGAN Phone 454 -1438 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 an. -e to comply with all applicable State of Minnesota Statutes an.j► agan erdinan. Signature of Permitee A Building Permit is i ued to: BLILIE CONSTRUCTION on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official ,).�i> ! cL 1 I1It.11 r - - 1 CITY OF EAGAN N2 17379 3830 Pilot Knob Road, P.O. Box 21 -199, Eagan, MN 55121 PHONE: 454 -8100 Est. Value $111,000 Receipt # Date OFFICE USE ONLY Occupancy R -3 M -1 Zoning R -1 V —N (Actual) Const (Allowable) # of Stories Length Depth S.F. Total S.F. Footprints On Site Sewage On Site Well MWCC System City Water PRV Required Booster Pump APPROVALS Planner Council Bldg. Off. Variance DEC 12 V—N 50' 48' XX XX XX Orrtifiratr of O rrupaurll eitp of Qagan Erparfntrnf of iiuilbing 3ttoprrtion 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: Bldg. Permit No 17379 VN Occupancy Type R3/M1 Zoning District RI Type Const 3 Owner of Building ` I . A ddress SUPERIOR , EWAN 4179 , • ., • r4 II DRIVE L5, B2, 03UNI Ida Building • ••ress WAIF LLocality Y Date: Use Classification S rhIG/GAR Building • POST IN A CONSPICUOUS PLACE MAY 22, 19 FEES , 1989 Bldg. Permit 678.00 Surcharge 55.50 Plan Review 339.00 SAC, City 100.00 SAC, MCWCC 575.00 Water Conn 580.00 Water Meter 90 - 00 Acct. Deposit 30.00 S/W Permit 20.00 S/W Surcharge 1.00 Treatment PI 228.00 Road Unit 340.00 Park Ded. Copies TOTAL 3,036.50 DNNERK' SITE ADDRESS CONTRACTOR 3 TE.OPRTIENVELOPt AVERAGE " " COMPUTATION . Total DATE e,/ Determi'ne working square footage of each. Total; exposed `gall area . .7252.33 sq. ft. x .. , d24 Total roof/ceiling area ' . /...340 sq. ft. x .94- Total exprised wall aria above floor a. Total wall widow area. b. Total door area c. Total sliding glass door area d. Total fireplace ?wail-. area= e. Total wall 'framing are r,- (average 10 %) Aa3rZ f, Total net wall area above floor ............. ... /415 / 3 g. Total. r. mr jai st area Total exposed foundation area = ?0.33 h. Total foundation window area i, Toal net foundation area above grade Determine "U" value of each wall segment. a. X24 X I , t;/� / = 43 b. 37,77 X 11U" , /.223 = y, 6.5 c: Ve x "u , 4/6 = : `g- C• d. X "U" '77_, /4/, y& e. - 03•2 X „U11 to 9 = le -29 f. /50S.03 X 11011 , efT _ 60 -.9 g. /.:30 x 11 . IW = 5. Of h X 11. 1J1/ = /] 1 . f 433. X " 43.4 .5" 1 )27, 35i If item :3 is the same as, or less than item 11, you have met the intent of SBC 6006(c)2. - /..2/a?G/90 H 42727/ 5 kga/ SO4 . Add cl5 Type of Building Request Date / ..._,q0 Fire No: Rough= nspection R equir ? ❑ uir ? ❑ Ready Now Will Notify Inspector When Ready? ,,,,,,,;,/ I 'censed contractor El owner hereby request inspection of above electrical work at: (Stree Box or ute No.) Job dress ham' ` '� r City _ _ Section No. Township Name or No. Range No. County U Occup nt PFj1NT) Phone o Paw Su I Address�- ���f�v' -^� Electri ntractor Company Name) Contractor's License No. _. l � -e— 0 3 3 Mailing Address (Contractor or • n er Making Installation) � V -5� _ _ SS 3 7 Authorized Signature ct.r /O ` .t Phone Number New Add step. Type of Building Appliances Wired Equipment Wired 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 THIS COMPLETED Use Only: r !i INSTALLATION MAY BE ORDERED DISCONNECTED WITHIN 18 MONTHS. TOTAL 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 / ( Date 1 i�, / s r' OFFICE USE ONLY 1/ „iv �i -.0 r .-is This request void 18 months from MINNESOTA S D OF ELECTRICIT Griggs - Midway Bldg. - Room S -173 1821 University Ave., St. Paul, MN 55104 Phone (612) 642 -0800 /W626110 REQUEST FOR ELECTRICAL INSPECTION See instructions for completing this form on back of yellow copy. `X" Below Work Covered by This Request THIS INSPECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS ENCLOSED. EB- 00001 -08 987.5 Total exposed roof /ceiling area = Total skylight area k. Total roof /ceiling framing area (average 1O%) y 1. Total net insulated roof /ceiling area h173,4 If total of 04 is the same as, or less than. "2, you have met the 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 04 shall not be greater than the sum of items 01 and 02. 1. 3. .227, TS Determine Determine "U" value for each roof /ceiling segment. Total j . _ X "U" k. 150, X „U„ . 0 .24 3 3, 1: 1 /,' 236 x "u1 . I25 = , .9 -34/ C 7 1 1 :se al, lit 4 + 2. + 4. 33.96 32,73 1 32 73 F 14757/ .3- °% 6 = t � '� Request Date / 1� � Fire No. /- t ough -in Inspection equired? ❑ Yes ❑ No �/ 1�Fteady Now ❑Will Notify Inspector / When n Ready? X ' contractor ❑ owner hereby request inspection of above electrical work at: Job Address (Street Box or Route No.) 7 City /' Section No. Township Name o o. Range No. County Occu t(MINT) /„.. Phone Phone No. 45 - 1 y sc' PQwetSupplie \) E 94 Address / 1 , Electric ntra r (Company Name) — Y Q.-el :L. c It • tractor's License No. D 3 ...ss - 7 Mailing Address (Contract. or Owner Making Installation) Water Heater Authorized Si.' • ure (C. tractor/Owner Making t tion) C°. L A. ) L..., Phone Number / &"9 (9 - 3 l d S New dd Rep. Type of Building Appliances Wired -, Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm. /Industrial Furnace Farm Air Conditioner Other (specify) Contractor arks: 1 ' Compute Inspection Fee Below: # Other Fee # Servi. - ntrance S' a 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: ,/-- (� ,t' TOTAL ''.--- Irrigation Booms Special Inspection Alarm /Communication Other Fee 1, the Electrical Inspector, hereby certify that the above inspection has been made. Rough -in Date Final / Dat_ OFFICE USE ONLY y This request void 18 months from MINNESOTA STATE BOARD OF ELECTRICITY Griggs - Midway Bldg. — Room S -173 1821 University Ave., St. Paul, MN 55104 Phone (612) 642 -0800 F 14757 /� REQUEST FOR ELECTRICAL INSPECTION / See instructions for completing this form on back of yellow copy. "X" Below Work Covered by This Request THIS INSPECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS ENCLOSED. EB- 00001 -07 T Uee 15% of e rraIi" i!r$t frame c;onst ;uct On BASIC WALL WALL FIG. #1 FIG. M2 r AA S. TOPV I EW Qf' FRA2tE . WALL • SLAB ON GRADE 2. _ 3. �,� i ti soft 1410 pQ+ 4. L ;144 5. /` a - , iserc •62 6. Exteri 'r ;at' film 1. Interior air film 2. 3. . a'G 1- /9 4. 2 2 4%41 .2 44 5. _.r /" Lori -Er 47 6. Exterior Sir film 0.17 23 ar , of 1. Interior air film 0.68 2. • e", sf Psi' "00 3. */' • I: 4. J7 % Ar 1"fr AS s. ?24, r'Z ptrD /NYC t t 6. faterior iir film 0.17 Total ,7 96 1. Interior air film 2. /y flQF' 1' 3. /2" "f-'f /_P 4 . 5 6. Exterior air film r film 4 .t 0.68 .3 Total Total 0.68 q= 0V 0.68 j 24 0.17 739 a= rat /t/ tlf = /44 NOTE: Indicate type, "r" value, depth and :., placement of insulation. Section No. Township Name or No. Installation) Range No. Pow_:.. ..tier r (Address Electri ., Contractor (Comps Name) Mailing Address (Contra.. or Owner Making Ins Ilation) 1 r Aut nzed y . '.nature (r ontra.` ki�, 1. J. , cal wor ontractors License No. 1478,� Request Date Job Address (Street, Box or Route No.) Compute Inspection Fee Below: I, the Electrical Inspector, hereby certify that the above inspection has been made. OFFICE USE ONLY This request void 18 months from Fire No. actors Remarks: Rou. • i Inspection ❑ No 1 ❑ licensed contractor ❑ owner hereby request inspection of above elec T / C REQUEST FOR ELECTRICAL INSPECTION l iv See instructions for completing this form on back of yellow copy. F 14758 "X" Below Work Covered by This Request New Add Rep. Type of Building 9G6 73 e ' ❑ Ready Now [rill Notify Inspector hen Ready? 0 Number MINNESOTA STATE BOARD OF ELE TRICITY Griggs - Midway Bldg. - Room 5 -173 THIS INSPECTION REQUEST WILL NOT 1821 University Ave., St. Paul, MN 55104 BE ACCEPTED BY THE STATE BOARD Phone (612) 642 -0800 UNLESS PROPER INSPECTION FEE IS ENCLOSED. Duplex Apt. Building Comm. /Industrial Other (specify) Other Swimming Pool Transformers Signs Irrigation Booms Special Inspection Alarm /Communication Other Fee Appliances Wired Range Water Heater Furnace Air Conditioner Service Entrance Size Above 200 Amps Equipment Wired Temporary Service Electric Heating Other (Specify) to 200 Amps Abo ! � Amps Inspector's Use Only: Circuits /Feeders 0 to 100 Amps Date / G/ EB- 00001 -07 9S16 :)- ntk 73 SINGLE FAMILY DWELLINGS 2 SETS OF PLANS 3 REGISTERED SITE SURVEYS 1 SET OF ENERGY CALCULATIONS PENALTY APPLIES WHEN: To Be Used For: C Site Address quiet coc,Ntr d, Lot 5 Block G.» Parcel /Sub COLS -ITA I H O V- - O Owner TT R b t C t& Address L k n C t CLL.K;t,\J ,5 ; City /Zip Code G ` sCLN 05 02 2 ) Phone V)'0 ( .0 e-,cr" \ ck, �;z, ` Ge •tractor \\- hOltStiP Address p 3 CO -,e c -c_ C City /Zip Code Phone — l 3.51S1 t,'\ Arch. /Engr. Address City /Zip Code Phone # (iq5q) k � -� 1990 BUILDING PERMIT APPLICATION CITY OF EAGAN MULTIPLE DWELLINGS 2 SETS OF PLANS REGISTERED SITE SURVEYS - (CHECK WITH BLDG. DEPT.) 1 SET OF ENERGY CALCULATIONS # OF RENTAL UNITS # OF FOR SALE UNITS 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. Valuation: Date: f « C( 0 COMMERCIAL 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCS Occupancy Zoning Actual Const Allowable # of stories Length Depth S.F. Total Footprint S.F. On site sewage On site well MWCC System City water PRV Booster Pump APPROVALS Planner Council Bldg. Off. Variance OFFICE USE ONLY 35' `y ' 19 FEES Bldg. Permit Surcharge Plan Review SAC, City SAC, MWCC Water Conn Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Road Unit Park Ded. Copies SUBTOTAL Penalty TOTAL N�� Parcel Files Cover Sheet Unique ID: 4028 4179 Countryside Dr 101827505002 STORM SEWER EASEMENT IN CONNECTION WITH EAGAN CITY PROJECT 4541 AND CONTRACT 488 -36 W ITN ESS ETH: 895390 Trastslor t s day of 1; liL. County Audi tor . L& Co THIS STORM SEWER EASEMENT, made this 2?,i /day of 1989, between NAME L. JOHNSON and DARLENE E. JOHNSON, husband and wife, herein referred to as "LANDOWNER" and the CITY OF EAGAN, , a municipal corporation, organized under the laws of the State of Minnesota, hereinafter referred to as the "CITY". That the LANDOWNER, in consideration of the sum of One Dollar ($1.00) and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, does hereby grant and convey unto the CITY, its successors and assigns, a permanent easement for storm sewer purposes, over, across and under the following described premises, situated within Dakota County, Minnesota, to -wit: The South 33.80 feet of the East 20.00 feet of Lot Six (6) , Block One (1), Country Hollow, according to the recorded plat thereof. Together with a temporary construction easement over, under and across the south 53.80 feet of the east 40.00 feet of said Lot Six (6) . See also Exhibit A attached hereto and incorporated herein. Said temporary construction easement to expire upon completion of construction of storm sewer but no later than December 1, 1990. The grant of the foregoing temporary construction easement and permanent easement for storm sewer purposes includes the right of the CITY, its contractors, agents and servants to enter upon the premises at all reasonable times to construct, reconstruct, inspect, repair and maintain pipes, conduits and mains; and the further right to remove trees, brush, undergrowth and other obstructions. After completion of such construction, maintenance, repair or removal, the CITY shall restore the premises to the condition in which it was found prior to the commencement of such actions, save only for the necessary removal of trees, brush, undergrowth and other obstructions. And the LANDOWNER, its heirs and assigns, does covenant with the CITY, its successors and assigns, that it is the LANDOWNER of the premises aforesaid and has good right to grant and convey the easement herein to the CITY. Date: 12 — Date 12 CITY OF EAGA1 N x 3830 Pilot Knob Roaa B/P Na Sin. P.O. Box 219 Eagan, MN 55121 Owner Pietsch Bldrs, Site Address: 4178 Countryside Drive L6 Sl Coun try lollow Plumber Mattltew Daniels, Inc. MWCC: 1V.00pd City. Chg: r00.00pd Acct Dep: 15.00pd Permit Fee: 10 . 00 Pd Surcharge: . 50pd Misc • Zoning No. of Units: I agree to comply with the City of Eagan Ordinances. By 4,11)`° C!ty of aau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use 7 / Permit#: /r�% -7 Permit Fee: Date Received: Staff: 2012 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial,,applications. Date: \ 0 I 1 k% Site Address: ! // 7g Cott S, cp e Tenant: Suite #: 'RESIDENT ,% OWNER., Name: Dfit,CM : 1 Phone: t 65 a3 0- 7.2 67,6 Address / City / Zip: Name: `(► PCh.it i Address: I %g 3' State: (-4 Zip: Contact: (rz C //, De -Sr e #: A1 0 ®D f 41/ie City: C (614\) -Lk 57-(3 Phone: (/) cc -7( -&;L. New X Replacement Email: Additional Alteration Demolition Description of work: NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL )(Furnace Air Conditioner Air Exchanger Heat Pump Other COMMERCIAL New Construction Interior Improvement Install Piping Processed Gas Exterior HVAC Unit Under / Above ground Tank (_ Install / Remove) RESIDENTIAL FEES: $60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $1 00.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) = $ TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ $60.00 Minimum (includes State Surcharge) = $ Permit Fee - If the Permit Fee is less than $10,010, surcharge is $ 5.00 = $ Surcharge - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) = $ TOTAL FEE x 1% CALL BEFORE YOU DIG. CaII 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.qopherstateonecall.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 Applicant's Printed me x Applicant's Signat FOR OFFICE USE Required Inspections: Underground Rough In Air Test Gas Service Test In -floor Heat Reviewed By: Dater HVAC' Screenin r City of Eapll 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: ( )9 Permit Fee: ltu V : JO Date Received: q I //)L Staff: 2014 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: `'-1/ Site Address: Tenant: ` /7P —1- i7' -2z ek, ResidentlOwne Name: Phone: Suite #: Address / City / Zip: Contracto Name: z^. 7 l U -1-C/ 1-26-• u C ' License #: 7 /©"7 Address:S 'L3 7°9 -5-7` e-3 City: 7---'1s-1-r'`'`A'`'M State: M A) Zip: S75--3 Phone: Contact: Email: Q%U,,,,,‘u Type. of Work _ New _ Replacement Repair _ Rebuild _ Modify Space _ Work in R.O.W. Description of work:6h-- Permit Typ RESIDENTIAL Water Heater Lawn Irrigation ( RPZ / _ PVB) Septic System New Abandonment 1 Water Softener ter`' Add Plumbing Fixtures ( Main / _ Lower Level) Water Turnaround RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) *Water Turnaround (add $200.00 if a 5/8" meter is required) $115.00 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 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.orq 1 hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x Applicant's Printed Name x Applicant's Signature FOR. OFFICE USE Required Inspections Meter Related Items: Meter dio. Rea C!ty of kap 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use 1 a►wa 62o," Lf/90 Permit #: Permit Fee: Date Received: Staff: 2014 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Date: " j "'l /yi Site Address: 91?? Clu 477-71 -5 d (. Tenant: Name: Phone: Suite #: Address / City / Zip: Name: P/U -(/t2 G `4-GLG , Address: 0253T l a ? r4.T. State: /Al° Zip: ,3-3 Contact: Phone: Email: License #: 7-3 b fil City: 21 i41 -11-1z"—" A 'i J New Replacement Additional Alteration Demolition Description of work: — r(sJ/LQ fie, (t) .-,U Qe,J Piro NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL Furnace Air Conditioner Air Exchanger Heat Pump Other New Construction Install Piping Gas COMMERCIAL Interior Improvement Processed Exterior HVAC Unit Under/Above ground Tank ( Install I_ Remove) RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit (includes $5.00 State Surcharge) $100.00 Residential New (includes $5.00 State Surcharge) COMMERCIAL FEES $55.00 Permit Fee Minimum $70.00 Underground tank installation/removal *If contract value is LESS than $10,010, Surcharge = $5.00 **If contract value is GREATER than $10,010, Surcharge = Contract Value x $0.0005 ***If the project valuation is over $1 million, please call for Surcharge TOTAL FEE Contract Value $ x .01 _$ _$ =$ Permit Fee Surcharge* TOTAL FEE 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 Applicant's Printed Name x Applicant's Signature FOR OFFICE USE Required Inspections: Underground Rough In Air Test Gas Service Test In -floor Heat Reviewed By: Date: Final HVAC Screening PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA126114 Date Issued:08/13/2014 Permit Category:ePermit Site Address: 4179 Countryside Dr Lot:5 Block: 2 Addition: Country Hollow PID:10-18275-02-050 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. Rick Kramer 7860 Fawn Lake Dr Ne Stacy, MN 55079 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 - Us Bank Na Tste 3476 Stateview Blvd Fort Mill SC 29715 Kramer Mechanical, Plumbing & Heating 7860 Fawn Lake Drive Stacy MN 55079 (651) 462-2194 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA126119 Date Issued:08/13/2014 Permit Category:ePermit Site Address: 4179 Countryside Dr Lot:5 Block: 2 Addition: Country Hollow PID:10-18275-02-050 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Rick Kramer 7860 Fawn Lake Dr Ne Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088 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 - Us Bank Na Tste 3476 Stateview Blvd Fort Mill SC 29715 Kramer Mechanical, Plumbing & Heating 7860 Fawn Lake Drive Stacy MN 55079 (651) 462-2194 Applicant/Permitee: Signature Issued By: Signature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ity of Eagan Permit Type:Building Permit Number:EA162551 Date Issued:07/20/2020 Permit Category:ePermit Site Address: 4179 Countryside Dr Lot:5 Block: 2 Addition: Country Hollow PID:10-18275-02-050 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 - Richard Collins 4179 Countryside Dr Eagan MN 55123 Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 Applicant/Permitee: Signature Issued By: Signature