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4181 Countryside Dr ø þ ý þýýüëúøúûøø ÷üüýýùøøýüþ âåû øã íâ ÿ þý üûúùø÷öû õ ô ÿ öû óûÿÿ ÷ ò ñû òÿÿðûú ï ÿýüþ ÿ÷ ý ý îí ìÚ îþ ôõüû ïþ èçíçíí ô÷ üû ð èçîçî óÿÿò ñõ ÷÷ å ÷þ ïðìüòð îþ íåû øÿ åê÷ÿïôþ ïô ëâéâ ð úø ðð ðÿ÷÷ÿððæ òÿ ò÷øð÷÷úü æïÿüûÿåøæþ ä ÿç ÷÷á òü û ÿÿûøü û New Construction Reauirements • 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 L/01 ig SITE ADDRESS 1 4 I id CO X\ TYPE OF WORK LiTQ PROPERTY OWNER 161 b S M �` Energy Code Category (0I 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 S .td t_ ((Jr`, MINNESOTA RULES 7670 CATEGORY 1 • Residential Ventilation Category 1 Worksheet Submitted • Energy Envelope Calculations Submitted Air Conditioning Heat Recovery System Signature of Applicant OFFICE USE ONLY Certificates of Survey Received _ 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 9e-i9 MULTI - FAMILY BLDG _ Y KN FIREPLACE(S) 0 _ 1 2 0SRIEN ROOFING APPLICANT 4 1 4 3 M I N N E N A H A a V E STREET ADDRESS MINN M N CITY STATE ZIP TELEPHONE # f #I p ° 7 8' O3a.(1 CELL PHONE # 5 4 ° FAX # TELEPHONE # &67 'As a'Cv3 s COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Phone # l 7 7 6'02_ MINNESOTA RULES 7672 • New Energy Code Worksheet Submitted Fee: $90.00 Fee: $70.00 Pho AUG 1 3 20n? 1 hereby acknowledge that I have read this application, state that the information correct,-aFt agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Not Required Updated 4/02 ❑ 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 ❑ 35 Int Improvement ❑ 38 Demolish (Interior) ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish (Bldg)* ❑ 43 Reroof ❑ 46 Windows /Doors ❑ 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant OFFICE USE ONLY 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 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 Approved By , Building Inspector Parcel Files Cover Sheet Unique ID: 4029 4181 Countryside Dr 101827506002 BUILDING PERMIT To be used for I / CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21 -199, Eagan, MN 55121 PHONE: 454 -8100 a Est. Value Site Address 4181 COUNTRYSIDE DR Lot 6 Block 2 Sec /Sub COUNTRY NCUINI Parcel No cc w 0 0 Z V U a U� ww' F w z— oo cr_ a Name Address City PIRTSCB BUILDERS. INC 9543 BIRCH LN LAKEYIU.E Phone 461 - 33!1!1 Name Address City Phone Name Address City Phone 1 hereby acknowlege that 1 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. Signature of Permitee A Building Permit is issued to: PIETSCH BUILDERS, INC 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 $120,000 Date Receipt # _ .✓ u r OFFICE USE ONLY Occupancy 3 N-1 Zoning R -1 (Actual) Const 174 (Allowable) V.41 # of Stories Length 60' Depth 38 S.F. Total S.F. Footprints On Site Sewage On Site Wet MWCC System City Water PRV Required Booster Pump APPROVALS Planner Council Bldg. Off. Variance Bldg. Permit Surcharge Plan Review SAC, City SAC, MCWCC Water Conn Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI Road Unit Park Ded. Copies TOTAL FEES 19 0 461.00 100.00 600.00 625.©0 90.00 30.00 30.00 1.00 252.00 333.00 .50 3,314.50 Permit No. No. Permit Holder Date Telephone # WATER SEWER PLUMBING H.V.A.C. ELECTRIC ///9 /7 � f iU- 1iLe.L /3 /SG //331 ''// 2 c6tt , /16 ,,c.L *06). / ti kZ..o -V) /. if t-9 L / ; n 6' i t . 5// ° 45 26 / Inspection Date Insp. Comments Footings I / �3/9Q Foundation Framing 2 2-/ 4' SaA lizoo r S'1 Pi /Xs:" -7/40,- Roofing 4$' r si Oi�s ' /1,47 / n/ - 400 h Rough Plbg. y S f/5y�/ 't � � ,• Mr' / "+ vL - Rough Htg. if., �1f / KW /� f� 2- ?/ - %O e / /F7 _ Isul. /.2,31, Fireplace j3 / / Final Htg. /0- ?) 25# Final Plbg. y-,/62-96) Const. Meter Plbg. Inspector - Notify Plumber Engr.JPlan Bldg. Final /2,//41 Deck Fig. Deck Final • Well Pr. Disp. CONTRACT PRICE: Site Address , iii , 1 /`r / ,' Lot Block Sec /Sub m c c 3 0 Name Address City Phone Name Address " C7 1 r f,� < 7 " f City / Phone MECHANICAL PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 PHONE: 454 -8100 FEE: S /C: TOTAL TYPE OF WORK Forced Air M BTU $ Boiler M BTU $ Unit Heater M BTU $ Air Cond. M BTU $ Vent. CFM $ Gas Piping Outlets # $ Lr , Other $ r c. , BLDG..VPE WORK D RIPTION Res. New -� .. Mult Add -on Comm. Repair Other FEES RES. HVAC 0 -100 M BTU $24.00 ADDITIONAL 50 M BTU - 6.00 (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA. 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 $1,000) /r') / SIGNATURE OF PER$AITTEE FOR: CITY OF EAGAN PERMIT # RECEIPT # 7 < DATE: For Office Use Only: C 7 ONTRACT PRICE Site Address Lot 8 1. Name PLUMBING PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 ' PHONE 454.8100 `/1)3 / WUr7 �_V�1t('� pick Address J/ City f» '/Y rt SIGNATURE OF PERMITTEE FOR: CITY OF EAGAN 7 Sec / Phone Name C CA Addre °' / tic,t s, L /tom City Phone 11( FEES COMMJIND. FEE - 1% OF CONTRACT FEE APT.BLDGS. - COMM. RATE APPLIES - - TOWNHOUSE & CONDO - RES. RATE APLLIES MINIMUM - RESIDENTIAL FEE $12.00 MINIMUM - COMM.IND. /FEE $20.00 STATE SURCHARGE PER PERMIT .50 (ADD $.50 S/C PER EACH $1,000 OF PERMIT FEE) BLDG. TYPE e t**.. s Mult Comm Other For Office Use Only PERMIT # 1 RECEIPT # 9/667 3 DATE- _ / '/� 5O WORK INSCRIPTION New Add-dn Repair RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NS? FIXTURES TOTAL Water Closet - $3.00 $ Y. O0 — Bath Tubs - $3.00 U� 7 Lavatory - $3.00 Shower - $3.00 3 . UJ ..._7— Kitchen Sink - $3.00 .1• 0) _f_ Urinal/Bidet - $3.00 Laundry Tray - $3.00 Floor Drains -. $1.5O Waterldeater - $1.50 Whirlpool - $3.00 � - Gas Piping Outlets - $1.50 (MINIMUM - 1 PER PERMIT) Softener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 PERMIT FEE: STATES S /C: GRAND TOTAL: - 0a r_ -5 CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122 -1897 (612) 681 -4675 PERMIT SUBTYPE: INSPECTION RECORD PERMIT TYPE: Permit Number: Date Issued: TYPE OF WORK: INSPECTION TYPE DATE INSPTR. INSPECTION TYPE DATE INSPTR. Permit No. Permit Holder Date Telephone # S/VV PLUMBING HVAC ELECTRIC ELECTRIC Inspection Date nsp. Comments Footings 1 Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Orsat Test Final Plbg. Plbg. Inspector — Notify Plumber Const. Meter Engr. /Plan Bldg. Final Deck Fig. /�/ �t`/ 7.3 Deck Final L19 /3 l Well Pr. Disp. CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: PERMIT SUBTYPE: INSPECTION RECORD PERMIT TYPE: Permit Number: Date Issued: APPLICANT: ; 41 TYPE OF WORK: I I' 1 t I ; , INSPECTION TYPE DATE INSPTR. INSPECTION TYPE DATE INSPTR. Permit No.. Permit Holder Telephone # ELECTRIC PLUMBING HVAC Q1�3!- F�5f ` t N, rSCX.e., : /ISA 7 ti) 1 /AO7 7"V`I565 ..e.k Inspection Date Insp. Comments FOOTINGS FOUND FRAMING 6.9 ,t / ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG ./ FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL 1/18/90 GATE: 4181 COUNTRYSIDE DR1VE, L6, 82, COUNTRY HOLLOW RE: Your Sewer & Water Permit for the above property has been completed. It will be held at the yubf Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO •CALPUBLIC WORKS (454 -5220) FOR YOUR PERMANENT WATER TURN ON. Sewer & Water Permit for the above property cannot be completed for the following easons: 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. 6 C 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 a • OC'G • APPLICANT STREET ADDRESS TELEPHONE # r - r3i 6•1900 C PROPERTY OWNER M&'& -2.\ Energy Code Category (4I submission type) Sewer /Water Contractor: Certificates of Survey Received RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EACAN 3830 PILOT KNOB RD, EAGAN MN 55122 651- 681 -4675 Pella Windows & Doors. 15300 -25th Ave. N. Ste. #100 Plymouth, MIN 55447 MINNESOTA RULES 7670 CATEGORY 1 • Residential Ventilation Category 1 Worksheet Submitted • Energy Envelope Calculations Submitted Mechanical Contractor: Mechanical system includes: Air Conditioning Heat Recovery System Signature of Applicant OFFICE USE ONLY 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 0 1 l • r(-0 COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Phone # Phone # with all applicable State of Minnesota Statutes and City of Eagan Or. ances. Tree Preservation Plan Received Not Required r SITE ADDRESS 4131 CC)0(Nr ou e,.. — Dt 0.-L. MULTI - FAMILY BLDG Y _ N TYPE OF WOR FIREPLACE(S) _ 0 _ 1 _ 2 c, SJ\ %Q o?,:o•; r.9110 STATE ZIP AX # TELEPHONE# (051.45a4D3Sf ESOTA RULES nergy Code Worksh:dU : ubmitted oC i 2 3 2002 Plumbing Contractor: Phone # _ _ Plumbing system includes: Water Softener Lawn Sprinkler Fee: $90.00 Water Heater __ No. of R.I. Baths No. of Baths Fee: $70.00 I hereby acknowledge that I have read this application, state that the in ormation is correct, and agree to comply Updated 4/02 ❑ 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 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 PlbgY or _ N ❑ 25 Miscellaneous ❑ 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 7 nn I Pella Windows & Doors - Twin Cities, Inc. June 8, 2001 City of Eagan 3836 Pilot Knob Road Eagan, MN 55122 Dear Jan: Elder Jones Corporation is authorized to pull building permits for Pella Windows & Doors — Twin Cities, Inc. Please allow their representative to provide that service for us in Eagan. This authorization shall be valid until such time as the division manager expressly revokes it, in writing to the City. I request that this authorization be accepted expeditiously, so as to not delay the processing of our building permits any further. Please call me if there are any questions, I can be contacted at 763 -745 -1432. Your Munediate attention to this matter is appreciated. cerely, Bryan t . May Replacement Sales Manager cc: Kara — Elder Jones Deana Krafty — Replacement Sales Process Coordinator CATTT'I ATT11T- ,JT11.T Wd9£ :1 . 8 °unp 8Wil peApoed 15300 25TH AVE. N. STE. #100 PLYMOUTH, MN 55447 763/745 -1400 WATS 1- 800 -462 -5359 FAX 763/745 -1401 Windows, Doors, & Skylights i� /bT CTS / 7TO VVT /TCt'T TN.T TA /OA /Ofl CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122 -1897 (612) 681 -4675 SITE ADDRESS: P.I.N.: 10- 18275 -060 DESCRIPTION: REMARKS: FEE SUMMARY: Base Fee Surcharge Total Fee 4181 COUNTRYSIDE DR LOT: 6 BLOCK: 2 COUNTRY HOLLOW (NO BEDROOMS) ermlt Type BASEMENT FINISH Type ALTERATION 434 ALT. RESIDENTIAL $50.00 $.50 $50.50 PERMIT PERMIT TYPE: Permit Number: Date Issued: BUILDING 029414 01/16/97 CONTRACTOR: -- Applicant — ST. LIC. STEPH -AN HOMES 16819777 0001457 4130 BLACKHAWK RD 114 E, GAN MN 55122 (612) 681 -9777 ICANT /PERMITEE SIGNATURE OWNER: SMITH 4181 EAGAN MIKE COUNTRYSIDE DR MN 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) � CITY OF EAGAN 0`0 2i4 3830 PILOT KNOB RD - 55122 DATE: 681 -4675 New Construction Requirements • 3 registered site surveys • 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) • 1 energy calculations • 3 copies of tree preservation plan if lot platted after 7/1/93 required: _ Yes _ No DESCRIPTION OF WORK: STREET ADDRESS: LOT i.7 BLOCK 1 SUBD. /P.I.D. #: C,NIAth /1 11-4 1/Y PROPERTY OWNER City: State: CONTRACTOR Company: cam/o // -� Street Address: 175) License #: City: State: Zip: ARCHITECT/ ENGINEER CONSTRUCTION COST: nfri e 4 Name: / l.' inn ✓ 7 Street Address: Company: Name: Street Address: City: State: Zip: Sewer & water licensed plumber (new construction only): and lot change are requested once permit is issued. I hereby acknowledge that I have read this application and state that the State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No RemodeUReoair Reauirements • 2 copies of plan • 2 site surveys (exterior additions & decks) • 1 energy calculations for heated additions cak1�� -�R Not Required 5L/ Phone #: Zip: Phone #: 1/G 57 Registration #. /y53 Phone #: . Penalty applies when address change information is correct and agree to comply with all applicable R ECEIVED JAN 1 0 1997 BY: BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex ❑ 02 SF Dwelling ❑ 07 4 -plex ❑ 03 SF Addition ❑ 08 8 -plex ❑ 04 SF Porch ❑ 09 12 -plex ❑ 05 SF Misc. ❑ 10 = plex WORK TYPE OFFICE USE ONLY ❑ 31 New la 33 Alterations ❑ 36 Move ❑ 32 Addition ❑ 34 Repair ❑ 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MC/WS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. it Depth Footprint sq. ft. SAC Code c 1 Census Bldg 1 Census Unit v APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit SAN Permit SAN Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units ❑ 11 Apt. /Lodging d 16 Basement Finish ❑ 12 Multi Repair /Rem. ❑ 17 Swim Pool ❑ 13 Garage /Accessory ❑ 20 Public Facility ❑ 14 Fireplace n 21 Miscellaneous ❑ 15 Deck REMARKS: FTY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681 -4675 SITE ADDRESS: 4181 COUNTRYSIDE DR LOT: 6 BLOCK: COUNTRY HOLLOW P.I.N.: 10-18275-060-02 DESCRIPTION: FEE SUMMARY: Base Fee Surcharge Total Fee CONTRACTOR: — Applicant -- ST. LIC. WHITNEY HOMES CREATIONS 14549150 0008344 4160 LANTERN LN EAGAN MN 55123 (612) 454 -9150 /PERMITEE SIGNATURE Permit Type rk Type $25.00 $ .50 $25.50 DECK NEW R -3 vo f PERMIT TYPE: Permit Number: Date Issued: 021028 05/26/93 SINGLE & MULTI - FAMILY COMMERCIAL 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month - in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date -, / . ( / 1 s Valuation of work Site Address: Tenant Name: 4 ct std 6/2/v 8 STREET (commercial only) SUITE Si LOT BLOCK SUBD . ,� �.ik1 _i 1 - (t 1 L ;,t P.I.D. # Description of work: _ 1— 1 /c9 The applicant i s : • Owner ISI Contractor • Other (Describe) Property Owner Name Vi"w«I1c -- Phone LAST FIRST Address 44e i &et( ; � 5. '©e' 0 f -irts- ( STREET STE # City e State " Zip ��- Contractor Company l: lki f ic (4 S Phone , tS - 1 -* sv r I Address 'x/4%0 j 747 £ mot License #tio 3"Vi Exp. 3f'1C Ci ty 1 -A • State " + ;`" Zip C 2- Architect/ Engineer 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 acknowledge correct and agree E ?::t:::icant: Ordin. that I have read this application and state that the information is to comply with all applicable State of Minnesota Statutes and City of 4 REACTIVA PE # EGGED CITY OF EAGAN V 2 1 1993 1993 BUILDING PERMIT APPLICATION 681 -4675 BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 02 SF Dwg. ❑ 03 SF Addition ❑ 04 SF Porch ❑ 05 SF Misc. WORK TYPE 31 New ❑ 32 Addition GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length le Depth )2_ APPROVALS Planning Engineering REQUIRED INSPECTIONS ❑ Site ❑ Wallboard ❑ 06 Duplex ❑ 07 4 -Plex ❑ 08 8 -Plex ❑ 09 12 -Plex ❑ 10 Multi. Addl. ❑ 33 Alterations ❑ 34 Repair , Footing ip Final OFFICE USE ONLY Basement sq. ft. 1st F1. sq. ft. 2nd F1. sq. ft. Sq. Ft. total Footprint Sq. ft. On -site well On -site sewage Building Variance ❑ 11 Apt. /Lodging ❑ 12 Multi. Misc. ❑ 13 Garage /Accessory ❑ 14 Fireplace ❑ 15 Deck ❑ 35 Tenant Finish ❑ 36 Move ❑ Framing ❑ Draintile Assessments ❑ 16 Basement Finish ❑ 17 Swim Pool ❑ 18 Comm. /Ind. ❑ 19 Comm. /Ind. Misc. ❑ 20 Public Facility ❑ 21 Miscellaneous ❑ 37 Demolish MWCC System City Water PRV Required Booster Pump Fire Sprinkler Census Code SAC Code L/ ❑ Insulation ❑ Fireplace Permit Fee Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC % SAC Units Valuation: $ SINGLE FAMILY DWELLINGS 2 SETS OF PLANS 3 REGISTERED SITE SURVEYS 1 SET OF ENERGY CALCULATIONS PENALTY APPLIES WHEN: NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR /HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. To Be Used For: /2/h//y Valuation: / .2v Site Address '<// / rovi4 $wCp, pp/v Lot [(J Block 2 Parcel /Sub (?:, C),v7 ' // // %tO -` - Owner Address City /Zip Code Phone Contractor / A4,/ es 9vC. Address 9sr/'3 / /,EroC, V-.) City /Zip Code 41i/fa/E / SOUL// Phone 4//-- 33F/ Arch. /Engr. Address City /Zip Code Phone # 1990 BUILDING PERMIT APPLICATION 11 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 COMMERCIAL 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCS 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 PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED. PERMIT MUST SHOW A LICENSED PLUMBER. JAN 1 ` RECD Q Date: 4 ///// 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 .44!" Booster Pump APPROVALS Planner Council Bldg. Off. Variance OFFICE USE ONLY R M -I R- I v- N V -N GO' 38' /11 FEES Bldg. Permit Surcharge Plan Review SAC, City SAC, MWCC Water Conn Water Meter 710.00 (7()• 1 - f (-11, 00 IOa. -D0.00 00 q 0 Acct. Deposit : S/W Permit S/W Surcharge Treatment P1. aa2,00 Road Unit .155 , OD Park Ded. Copies .50 SUBTOTAL Penalty TOTAL C BUILDING PERMIT To be used for SF DWG /GAR Site Address 4181 COUNTRYSIDE DR Lot 6 Block 2 Sec /Sub. COUNTRY HOIdOW Parcel No z z 0 0 V o U cc t— ow W F W U z ¢z a W Name PIETSCH BUILDERS, INC Address 9543 BIRCH LN City LAKEVILLE Phone 461 -3381 SAME Name 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 dinancesq Signature of Permitee A Building Permit is issued to • PIETSCH BUILDERS, INC 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 A t9 AA 1 r y Fix r Use Classification CITY OF EAGAN N° 17431 3830 Pilot Knob Road, P.O. Box 21 -199, Eagan, MN 55121 PHONE: 454 -8100 Receipt # Est. Value $120,000 Date JAN 17 , 1990 SF N /GAR Occupancy Zoning (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 60' 38' XX XX XX &rtif irate of Mrrupaurq Citp of Cagan Et purblind of iluilbing 3Juaprrtinn Occupancy Type R3Mt Zoning District Owner of Building Bi1TTI Building Address 4181 DIVE POST IN A CONSPICUOUS PLACE ' 6 1 y OFFICE USE ONLY R -3 M -1 R -1 V —N V —N Bldg. Permit Surcharge Plan Review SAC, City SAC, MCWCC Water Conn Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI Road Unit Park Ded. Copies TOTAL 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 17437 RI Type Const. VN Address 9543 BIRCH LANE, LAKEVILLE Locality L6 B2, COUNTRY TRY Ii(LD301 APRIL Date 27, 1998 FEES 710.00 60.OQ 461.00 100.00 600.00 625.00 90.00 30.00 30.00 1.00 252.00 355.00 .50 3,314.50 hn.L Ltcltltc LLV V hi.,Urh AV hhabh " u UUHt'ULJ LJULV ' OWNER: SITE ADDRESS: � /�/ ( re1io c6sir. /2J 'Y CONTRACTOR: 0 644 /» f 7 DATE: DETERMINE WORKING SQUARE. FOOTAGE OF EACH: 1. TOTAL :, EXPOSED WAI :,I :, AREA 296'1 J SQ. FT. X 2. TOTAL :, ROOF /CEI] :,ING AREA 1 ,0 SQ. FT. X t/ 3. TOTAL :, EXPOSED WAIL :, AREA CALCULATIONS: f) Total exposed wall area above floor a) Total wall window area b) Total door area c) Total sliding glass door area d) Total fireplace wall area e) Total wall framing area (average 10 %) Total net wall area above floor (insulated) g) Total rim joist area Total foundation area (exposed) h) Total foundation window area i) Total net foundation area above grade 2[�3 / 27 'f,9 PAGE 1 2112.0 107,g X7,8 4PrO i17Z. 220,5 Z17 SQ.FT. X "U" SQ.FT. X "U" SQ.FT. X "U" SQ.FT. X "U" SQ.FT. X „U" SQ.FT. SQ.FT. X "U" ., SQ.FT. X "U"_117 TOTAL :, a) thr ough i) If item #3 is the same as, or less than item #1, you have met the intent of 2 MCAR 1.16008 A and 0. PHONE: 1 271,7 1 1677. 24 ;39 = /S 11,7 SQ.FT. X "U" r043= .i SQ.FT. X „Un. 80 = f f X / 1 11 * 0 3 �r J IIfl 4 3 7 1 1 II 7 3 111111 9 8 L* ( I OFFICE USE ONL This request void 18 months from validation date printed in this box. 6 y4,33 / 802/ deril /611—" d° PLEASE PRINT OR TYPE Request Date 1 / 03 / 9 7 Rou -in inspection required? l t'es ❑ No (You must call the inspector when ready) Inspection Other Than Rough-tn: ❑ Ready Now gi Will Call Date Ready: 1, E licensed contractor • owner hereby request inspection of the above electrical work at: Job Address )Street, Box, or Route No.) 4181 Country Side Lane City Eagan Zip Code Section No. Township Name or No. Range No. Fire No. County Dakota Occupant StephAn Homes Phone No. 681 -9777 Power Supplier Dakota Electric Address 4300 220th St. W., Farm;jl tnn Electrical Contractor (Company Name) Joos Electri c Co . Contractor License No. CA 00961 Master Lic. No. (Plant Elect. Onh,r) Mailing Address (Contractor or Owner Performing Installation) 3980 Beau D' Rue Drive, Eagan, MN 55122 Authorized Signature (Contractor or Owner Performing Installation) �,- Phone No. 688 -6180 X Home Duplex Apt. Bldg. Other: x New Addn X Remod Repair Commercial Industrial Farm Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other: Dryer Range Elec. Heat Temp. Service "X" Calculate above the work covered by this request. Enter remarks in this space and on the back of the white copy only. Inspection Fee - Th's Inspection Request will not be accepted without the correct fee: Other Fee # Service Entrance Size Fee # Circuits /Feeders Fee Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps Street Ltg./Traffic Sig. Above 200 Amps /eve Amps Transformer /Generator INSPECTOR'S USE ONLY ` TAL � $40.50 AMP Sign /Outline Ltg. Xfmr. I hereb certi that I ins„"J ns : oto descn erein on the dates state Alarm /Remote Control Swimming Pool Irrigation Boom Rough -In " " Final / Al Special Inspection Investigative Fee THIS INSTALLATION MAY BE ORDERED DIS %! NNEC D IF NOT CO PLETED WITHIN 18 MONT S. EB-00001A-11 8/96 ///-x/9 437 -398 STATE BOARD COPY - SEE I RUCTIOIfl; ON BACK OF YELLOW COPY REQUEST FOR ELECTRICAL INSPECTION Minnesota State Board of Electricity 1821 University Ave., Rm. S -128, St. Paul, MN 55104 Phone (612) 642 -0800 4. TOTAL :, EXPOSED ROOF /CEILING CALCUI:,ATIONS: Total exposed roof/ ceiling area j) Total skylight area k) Total roof/ceiling framing area (average 10 %) 1) Total net insulated roof/ceiling area 1. +2. 3. +4. CERTIFICATION (Signature) (Date PAGE 2 1 3. p' SQ.FT. /0/1 SQ.FT. X „U„ _ c � l 1 2 J,Cr SQ.FT. X "U" , �` = L c 1 SQ.FT. X „U„ OZZ. 7 ' TOTAL:, j) through 1) 411111111] If total of #4 is the same as, or less than #2, you have met the intent of 2 MCAR 1.16008 A and 0. �M.7 D ALTERNATE BUILDING ENVELOPE DESIGN To utilize the total envelope system method, the values established by the sum of #3 and #4 shall not be greater than the sum of items #1 and #2. idze7EM I hereby certify that I have calculated the "U" factors and "R" values herein and that the building here described meets or exceeds the State of Minnesota nergy Conservation Act. t v G � x = ` k y Add / , e > �� EquipmentWired Wits Request Date — // QCs Fire No, ugh -in Inspection equved? ❑ No El Ready Now 1 Notify Inspector When Ready? 1 blicensed contractor D owner hereby request inspection of above electrical work at: Temporary Service Job Address (Street, Box or Route ) ..) City ' Water Heater Section No. Township Name or No. Range No. Coun f, Dryer Occupant (PRINT y�y.,- Other (Specify) Phone No. Comm. /Industrial Power Sup.lier Address Electrical n actor (Company Name)) �/ /' Farm Contracto 'ccennsse No J Mailing Address (C ntractor or Owner Making Installati ) 6 E 7 6�.� , \ L,,— y / / '— ‘,v.yfi GF . , Other (specify) ...J Authorized ture(Conttractor /Owner king Installati / on) // ' -y/ # Other Phone N ber Service Entrance Size New Add Rep. Type of Building J Appliances Wired EquipmentWired X Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm. /Industrial Furnace Farm Air Conditioner Other (specify) Contractor's Remarks: Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Circuits /Feeders Fee Swimming Pool 0 to 200 Amps Z5 "' I 0 to 100 Amps Transformers Above 200 Amps Ab Amps Signs I nspector's Use Only: THIS INSTALLATION MAY BE ORDER COMPLETED WITHIN NT TOTAL r ft Irrigation Booms Special Inspection ' DISCONNECTED IF NOT f Alarm /Communication Other Fee 4 .5 - ,e) I, the Electrical Inspector, hereby certify that the above inspection has been made. Rough -in 6i f Date ' -/ !/ Final D OFFICE USE ONLY 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 , ; , 2/;15/90 REQUEST FOR ELECTRICAL INSPECTION ► See instructions for completing this form on back of yellow copy. "X" Below Work Covered by This Request C 1993 THIS INSPECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS ENCLOSED. EB- 00001 -07 MIL) L) 001 -4010 Please complete for: • single family dwellings • townhomes and condos when permits are required for each unit OFFICE USE ONLY L BL RECEIPT #: SUBD. DATE 1996 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681 -4675 Please complete for: • all commercial/industrial buildings. • multi- family buildings when separate permits are not required for each dwelling unit. DATE: CONTRACT PRICE WORK TYPE: NEW CONSTRUCTION ADD ON REPAIR DESCRIPTION OF WORK IS WATER METER REQUIRED? _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING: WATER FLOW: GPM. ARE FLUSHOMETERS TO BE INSTALLED? YES NO, FAILURE TO PROVIDE THIS INFORMATION WILL RESULT IN A DELAY OF METER ISSUANCE. WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? YES NO. IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINKLER PERMIT. FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge of $.50 per $1,000 of permit fee due on all permits. CONTRACT PRICE x 1% STATE SURCHARGE TOTAL SITE ADDRESS TENANT NAME: STE. # OWNER NAME INSTALLER ADDRESS: CITY: STATE: ZIP PHONE #: SIGNATURE' APPLICANT OFFICE USE ONLY METER SIZE: " DATE: INSPECTOR. MEMO city of eagan L to 6 2. C 6 � h TO: THOMAS L. HEDGES, CITY ADMINISTRATOR I4° 1 lam) 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 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. 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 0%03/95 14:08 MAY 2, 1996 NAME ADDRESS CITY, STATE ZIP 1=1.2 b81 4LUb EAGAN MTCE EC -. CITY HALL- DNSTPS NO.996 P001 CO city of eagan RE: FAILURE OF THE COUNTRY HOLLOW SANITARY LIFT STATION ON TUESDAY, APRIL 30, 1996 Dear Name: MUNICIPAL CENTER 3830 PILOT KNOB ROAD EAGAN. MINNESOTA 55122 1897 PHONE. (612) 681 4600 FAX. (612) 081.4612 100 (612) 434.8535 THE LONE OAK TREE THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY Equal OpponuniTWAtfIrmatIve Action Employer THOMAS EGAN Moyor PATRICIA AWAOA SHAWN HUNTER SANDRA A. MASIN THEODORE WACHTER Counci Members THOMAS HEDGES City Administrator E. J. VAN OVERBEKE Clty 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 3501 COACHMAN POINT EAGAN MINNESOTA 55122 PHONE: (612) 681.4300 :AX: (612) 681 -4350 TOO (612) 454 -d535 612 681 4=00 05 0=/S6 14:08 EPGPN MICE FPC - CITY HPLL - 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 the 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 Schwanz Superintendent of Utilities WS /nab 1:12 t bkcountry. l 24 NO.996 P002 /fr PERMIT City of Eagan Permit Type:Building Permit Number:EA118166 Date Issued:10/29/2013 Permit Category:ePermit Site Address: 4181 Countryside Dr Lot:6 Block: 2 Addition: Country Hollow PID:10-18275-02-060 Use: Description: Sub Type:Reroof 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. Carbon monoxide detectors are required by law in ALL single family homes . Luanne Yang Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Michael J Smith 4181 Countryside Dr Eagan MN 55123 New Life Contracting Inc. 814 Grand Avenue St. Paul MN 55105 (651) 224-3442 Applicant/Permitee: Signature Issued By: Signature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`'-M+O G(64'3**'C*PQ'a!44F!X!'/.,B=9+*:'3B YDID,'E\[''WW!"GYDID,'E\[''WW!"G S(W!\\'G(W5!GF4S(W!\\'"GX56G6" 2'O:B:;='D%&,@$:*I:'OD'2'ODN:'B:D*'O+9'D>>$+%D+,'D,*'9D:'OD'O:'+,0BMD+,'+9'%BB:%'D,*'DIB::''%M>$='@+O'D$$'D>>$+%D;$:'-D:' 0'E+,,:9D'-D.:9'D,*'/+='0'YDID,'LB*+,D,%:9P )>>$+%D,A1:BM+:: '-+I,D.B:299.:*'#= '-+I,D.B: Use BLUE or BLACK Ink For Office Use I , City of Eaall Permit#: Permit Fee: C 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 Staff: Fax: (651) 675-5694 � 4 2017 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: / ar i 7 Site Address: /T l i f k N' iw y'r[ d/z I)' • Tenant: Suite#: Resident/Owner Name:4 - £a r4. Phone: Address/City/Zip: >!G"`''*-"t_ �— Name: 34 K e C `" P4,1 License#: 1 -��--(2/11 Contractor Address: 7 I v L City: �'K9� State: "'^'i Zip: cr •-d Phone: c4 re i-cr-9Zc-) Contact: 04 - Email: Type of Work —New _Replacement —Repair _Rebuild Modify Space —Work in R.O.W. Description of work: RESIDENTIAL Water Heater Water Softener Lawn Irrigation( RPZ/—PVB) �/ Permit Type Add Plumbing Fixtures( Main/ !`Lower Level) Septic System New Water Turnaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation (includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround*(includes State Surcharge) *Water Turnaround (add$280.00 if a 3/4"meter is required) $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$ 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.ciopherstateonecall.org 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. 041/1j t)}tiec Applicant's Printed Name Applicant's Sig g re FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-1n Air Test Gas Test Final Meter Related Items: Meter Size Radio Read Manometer Staff: Use BLUE or BLACK Ink For Office Use * CityOA 't f Eaan / 1 c / 1�� O! Permit#: / n,�/ I Permit Fee: /, !J`/g-7 � 3830 Pilot Knob Road r //f Eagan MN 55122 Date Received: "j6/ 7 �/1 Phone:(651)675-5675 J I buildinginspectionst citvofeagan.com Staff: e I ` $ 82017 .. .I J 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: /0 it" /7 Site Address: 4/f')/ 6W / Pn 1-g--- Unit#: rMg''s - Name: 6 'Y r � Phone: Reelder t/ / '''' ,1- 1/1 ...-- -Kfilyo' i-y.; A2A) OWrler Address/City/Zip:` CA..)k) t t. / / t ,/e Applicant is: Owner X Contractor �; D• escription of work: _ " .� _ ._ "' " Type of Work = , iii'/ 7 oti Construction Cost: 1,� 3 4L Multi-Family Building: (Yes 4/ / o ) i% i : �// �� ;rNA* Company: ,. _-_._ Contact: I II// i/f Address: !Z- ....� 6-' vL .- '' i vi 1Contractor 1� Y / ///,' �/%/: S• tate:�� /"��iZip: /.�i5 7Phon . -7_9/"?- Email: A;/+E:�'1/), &divl; i�1Lic f'i -'-,L1 4):14 Li qqq 3' j, .�.s % i L• icense#: -15C-'4e-55/40 Lead Certificate#: /� ( '` 4: '-.- If the project is exempt from lead certification, please explain why: a� : '.�._ ,,.rte COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression,Contractor: Phone: iNOTE Plans and su f]o�,sym documents that`'ou submit are considered to be �ubhc informationaPa`rtions of the/0.4,4(0,„ i ,i,%!/�: ,p�%%rFJ.,i,�y,.: ,Flu��ifi%/////�/G!iirr 1 J, f.r`.. //, ,. 1.,'i%oo,ogovA,f fif1yi�i�,�,,�", .FN,04./ ,�.r, ,i.. nformation maybe classified as non7POI, cif ouprovide s ecific reasons Bial would n_ermif flie'C ,to conclude that theV /F/fi , ,r ,/'//A/�/ ,� p. p�', r/�.f^ ,��I-fl�!J/aaA ff ,',,,,�✓ /fir te��,{. i',i'lf// N .//,;/„%,ter ; >//,�''��V/, .',.'/, `i///`./`V% ,''� : / i,�.:.,' ` 'are trade.,, ii,//% //�//,� �,�'�/,�%,�,�//f / /ii,f rr�f,``.,!�/��/`f �?r � F .fF` � secrets. .,,�s,,:r �/%/,. r�/ %��•,��!^o/% ";., „ „ ��i!/✓/6,///f/��,r'�/��/�//i.� ,.f�:�F,'`,�� You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in ,,,nformance with e ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and word is not to start ithout a permit; that the work will be in accordance with the approved pi.an in the case of work which requires a review and approv. :f pr:ns. i / //i Applicant's Printed Name . .p. `c.nt's Signat Ile r°l� Page 1 of 3 6iiia I9/3 #-- , 4,4 /91. 1 / �IIO NOT WRITE BELOW THIS LINE // S I _ SUB TYPES Foundation Fireplace Porch(3-Season) Exterior Alteration(Single Family) 24 Single Family Garage Porch(4-Season) Exterior Alteration(Multi) Multi Deck Porch(Screen/Gazebo/Pergola) Miscellaneous 01 of_Plex Lower Level Pool Accessory Building WORK TYPES New Interior Improvement Siding Demolish Building* Addition Move Building Reroof _ Demolish Interior Alteration Fire Repair Windows Demolish Foundation Replace Repair Egress Window ' Water Damage Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION Valuation �, / b 5 Occupancy „3.-.1e C-l MCES System Plan Review Code Edition jNtyt 26)y c SAC Units (25% 100%/C) ) Zoning i .- ) City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction V 3 Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) Final/C.O. Required Footings(Addition) Final/No C.O. Required Foundation Foundation Before Backfill /10 HVAC Gas Service Test Gas Line Air Test Roof:_Ice&Water Final Pool: Footings Air/Gas Tests Final 2(4 Framing 30 Minutes 1 Hour Drain Tile Fireplace: Rough In Air Test _Final Siding: Stucco Lath Stone Lath _Brick_EFIS A Insulation Windows Sheathing Retaining Wall:_Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression: Rough In_Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: 41""` i/ / jam( - , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant Copies TOTAL Page 2 of 3 Use BLUE or BLACK Ink ,OF fi ^For Office Usei rn AzkA, , , ;, /� g/� G...... Permit#: ✓c 7 Permit Fee: ee. / e,, . . to 4@4l6Ho�, Date Received: 3830 Pilot Knob Road I Eagan MN 55122 Ste ' �� Phone:(651)675-5675 I Fax:(651)675-5694 r , bulidinalnspectIonsOcityofeagan.com / 2017 RESIDENTIAL BUILDING PERMIT APPLI A TION Date: 116 17 Site Address: A. Iii. 'f J 2' 'f i •nit#: Name: 4..)�i� ,A3 (k Q_, ! Phone: . Resident! Owner Address/City/Zip: 41 �/" `� (9) l 1)011rf" L). De. a•vA J 4)— Applicant is: Owner 7 Contractor Type Of WOrk Description of work .:.r. r,' ilo '411h,'+r CA S r i )2Z) 11J •r a Id j Construction Cost: ( Multi-Family Building:(Yes__/No_) Company: _Mb •' Contact: .�. ' VV\ • Contractor Address: `-.ilii f r. Ei�l`. )`0Y: .r ,l� r State: I1 Zip: ✓],S hone: 0/ ail: 6711 /7472/ �ret2-( I, " 4 2)/1"r' License#: 1Q3a Lea Certificate#: v/• —23a54—&-- If the project is exempt from lead certification, please explain why: 1 eArt_11 - COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: { NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaaan.com/subscribe. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. CALL BEFORE YOU DIG. Call Gopher State One Call at(651}454-0002 for protection against underground utillt damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in co formance with ).ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a.permit, and wo• - not to start w out permit; that the work will be in accor ance with the re gdiplan in the case of work which requires a review and a•,r' of,•la •, M., iiiila'Alia, Applicant's Printed Name Ap' r Signatur f` Page 1of3 z-Igt at/Lek/rick-- beLs, IL76°ILI DO NOT WRITE BELOW THIS LINE " SUB TYPES Foundation _ Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family) $ Single Family _ Garage — Porch(4-Season) _ Exterior Alteration(Multi) Multi _ Deck Porch(Screen/Gazebo/Pergola) _ Miscellaneous 01 of_Plex _ Lower Level — Pool _ Accessory Building WORK TYPES _ New _ Interior Improvement Siding T Demolish Building* Addition — Move Building _ Reroof Demolish Interior fc Alteration _ Fire Repair _ _ Windows _ Demolish Foundation Replace _ Repair A Egress Window _ Water Damage Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation c.,211 7, 000 �. Occupancy J-ge- I MCES System Plan Review Code Edition Mill 2°IS SAC Units (25%_100%!` ) Zoning 1Z-) City Water Census Code y3 4 Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction V5 Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) Final/C.O. Required Footings(Addition) Final/No C.O.Required Foundation Foundation Before Backfill (4' HVAC Gas Service Test Gas Line Air Test Roof:_Ice&Water Final Pool:_Footings Air/Gas Tests Final )C Framing 30 Minutes 1 Hour Drain Tile Fireplace: Rough In Air Test Final Siding:_Stucco Lath Stone Lath Brick_EFIS jcl Insulation >l Windows Sheathing Retaining Wall:_Footings Backfill^Final Sheetrock Radon Control Fire Walls Fire Suppression: Rough In Final Braced Walls Erosion Control Shower Pan '/ ) Other: Reviewed By: C OM "If� H 414_ ,Building Inspector RESIDENTIAL FEES J Base Fee EG-k.-e,sS rnD Ou`/ .2) 8D`U , Surcharge Plan Review ,6 e�a.0 a vi" 13 erYi einT) MCES SAC 2 Co 3 . "Y-- City SAC Utility Connection Charge 0c7A-"'D ` C9 o S9 , S&W Permit&Surcharge 4/ C 0 00 , — Treatment Plant Copies TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA149441 Date Issued:05/22/2018 Permit Category:ePermit Site Address: 4181 Countryside Dr Lot:6 Block: 2 Addition: Country Hollow PID:10-18275-02-060 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. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Andrew Carey 4181 Countryside Dr Eagan MN 55123 (651) 503-8384 Standard Heating & Air Conditioning 130 Plymouth Ave. N Minneapolis MN 55411 (612) 824-2656 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA161418 Date Issued:05/22/2020 Permit Category:ePermit Site Address: 4181 Countryside Dr Lot:6 Block: 2 Addition: Country Hollow PID:10-18275-02-060 Use: Description: Sub Type:Siding Work Type:Replace Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please leave printed pictures of house wrap on site for the final inspection. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. When a weather barrier is installed or 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 - Andrew Carey 4181 Countryside Dr Eagan MN 55123 All Around Roofing & Renovations 701 Decatur Ave N Suite 201 Golden Valley MN 55427 (763) 447-3944 Applicant/Permitee: Signature Issued By: Signature