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Paul, Minnesoto ~ ~ATE: ;~J.v,~ r~ t~sy coi~M, ~'3~;~~- For Office Use Permit L3 I City of Eap nn Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 I Fax: (651) 675-5694 Staff: 2009 RESIDENTIAL PLUMBING PERMIT APPLICATION II-01 r Date: Site Address: Tenant: Suite RESIDENT / OWNER Name: AAE, S yof p Phone: Vim, f - C23 tom- 41S 77 Address / City / Zip: title- 55 1 Z3 CONTRACTOR Name: License (2 1 [ 7 0 Champion Address: 651-365-1340 3670 Dodd Rd. #100 City: ESWn MN-5512313-3( State: Zip: Phone: Contact Person: S TYPE OF WORK _ New V Replacement Repair R build Modify Space -Work in R.O.W. Description of work: PERMIT TYPE RESIDENTIAL Water Heater Water Softener Lawn Irrigation Add Plumbing Fixtures RPZ PVB) ( Main - Lower Level) Septic System Water Turnaround New Abandonment RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge) *Water Turnaround (add $165.00 if a 5/8" meter is required) $100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ 50 QQ 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. Applicant's Printed Name Applicant's FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In Air Test Gas Test Final City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675-5675 www.ci.eagan.mn.us PERMIT City of En Permit Type: Permit Number: Date Issued: Permit Category: Building EA076302 12/29/2006 ePermit Site Address: 4186 Countryside Dr Lot: 4 Block: 1 Addition: Country Hollow PID:10-18275-040-01 Use: Description: Sub Type: e-Windows/Doors Work Type: Windows/Doors-New/Replacement Description: House Census Code: 434 - Zoning: Square Feet: 0 Construction Type: Occupancy: Comments: If altering the opening size, a framing inspection is required. Smoke detec tors are required in all sleeping rooms prior to final inspection. When wall studs or ceiling joists are exposed, hard -wired detectors are required Bat tery operated types are acceptable if the wall/ceiling finish (i.e. sheetroc k) has to be removed to install a smoke detector. Tim Schenk Elder -Jon es Building Permit Service 1120 East 80th Street, Ste. #211 Bloomington, MN 55420 952-345-6040 Fee Summary: Valuation: 2,000.00 BL - Base Fee $2K Surcharge - Based on Valuation $2K $69.00 0801.4085 $1.00 9001.2195 Total: $70.00 Contractor: Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 - Applicant - Owner: Bruce C Sharp 4186 Countryside Dr Eagan MN 55123 I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply with all applicable State Applicant/Permitee: Signature Issued By: Signature Parcel Files Cover Sheet Unique ID: 4032 4186 Countryside Dr 101827504001 CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199 BUILDING PERMIT To be used for PHONE: 454-8100 Receipt * Date . ,19 Est. Value , Site Address �. Lot Block Sec/Sub. Parcel No. cc W z 0 Name = Address City Phone ` " "" ) 74a cc zo 1- oQ Ucc Name Address City Phone WW W z v5 �z aW Name Address City • Phone 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. Signature of Permittee A Building Permit is issued to: „t.aa73 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 On Site Sewage MWCC System On Site Well City Water OFFICE USE ONLY Occupancy Zoning Type of Const (Actual) (Allowable) # of Stories Length Depth S.F. Total Footprint S F. APPROVALS Assessments Water/Sewer Police Fire Engr. Planner Council Bldg. Off. APC Variance `f t FEES Permit Surcharge Plan Review SAC, City SAC, MWCC Water Conn. Water Meter Road Unit Treatment P1 Parks Copies TOTAL Permit No. Permit Holder Date// Telephone # Plumping c :ta; ,o y 4'4. /.,% a H.V.A.C. � • .,':1",-,%; ie. , '/.��82 Electric /"95 ✓f/(, ? t i (x .F 70/ '% 3-U _ Softener Inspection Date Insp. Comments Footings I 9 4777 C.S. Footings II Foundation Framing /rcr/ ?.% �� Roofing `` l !// Rough Plbg. ids i%•.? fit.7 Rough Htg. /Ow (� Isul. 141-07 A° Fireplace /0//�J ��/ Final Htg. �//4, 4 Final Plbg. .fg fb rf PRV Bldg. Final f c Cert. Occ. f_ Temp. LP Deck Ftg. Deck Frmg. Well Pr. Disp. CONTRACT PRICE: Site Address Lot r Block PERMIT # `),/ 9 / fy. MECHANICAL PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: PHGNE: 454-8100 / Sec/Sub is c Name Address City Phone Phone 0 Name Addreps, City 'c • Phon TYPE OF WORK 1 , Forced Air 1 1- , ' M BTU S''-' .! ' i ' t ' Boiler M BTU $ Unit Heater M BTU $ Air Cond. M BTU $ Vent. CFM $ $ .2 Gas Piping Outlets # Other FEE: SIC: TOTAL: BLDG. TYPEWORK DESCRIPTION / Res. New L.-- Mult Add-on Comm. Repair Other 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) 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) - $24.00 - 6.00 SIGNATURE OF PERMITTEE CONTRACT PRICE: Site Address Lot �% 1if n7) PLUMBING PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 PHONE: 454-8100 B4ock Se /Sub Name Address ? City Phone g -"7 0 Name Address City J 71 Phone -/r, FEES COMM/IND FEE — 1% OF CONTRACT FEE APT. BLDGS — COMM RATE APPLIES TOWNHOUSE & CONDO RES. RATE APPLIES MINIMUM - RESIDENTIAL FEE - $12.00 MINIMUM — COMM/IND FEE $20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) SIGNATURE OF PERMITTEE FOR: CITY OF EAGAN p �saat:,•� b PERMIT # 1 --%1 RECEIPT # DATE: BLDG. TYPE Res. Mult. Comm. Other WORK DESCRIPTION New Add-on Repair RES. PLBG. ONLY COMPLETE THE FOLLOWING: NO. FIXTURES TO AL .T Water Closet - $3.00 $ 1 Bath Tubs - $3.00 - Lavatory - $3.00 Shower - $3.00 —LKitchen Sink - $3.00 Urinal/Bidet - $3.00 —L—Laundry Tray - $3.00 _Floor Drains - $1.50 / Water Heater - $1.50 LWhirlpool - $3.00 - 1 Gas Piping Outlets - $1.50 (MINIMUM- 1 PER PERMIT) Softener - $5.00 Well - $10.00 Private Disp. $10.00 _,Rough Openings - $1.50 FEE: C:4.• STATE S/C: GRAND TOTAL: j. C.10 INSPECTION RECORD CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT TYPE: Permit Number: Date Issued: SITE ADDRESS: PERMIT SUBTYPE: APPLICANT: TYPE OF WORK: INSPECTION TYPE DATE INSPTR. INSPECTION TYPE DATE iNSPTR Permit No. Permit Holder Date Telephone # ELECTRIC PLUMBING HVAC Dpocz, a,„ 0405?ie Inspection Date Insp. Comments FOOTINGS FOUND FRAMING 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 CITY OF EAGAN 3830 Pilot Knob Road P.O. Box 21199 Eagan, MN 55121 Owner: Site Address: Plumber. Conn. Chg: Acct. Dep:_ Permit Fee: Surcharge: Tr. Plant Meter: — Misc.:— Date: Permit No: �� �,e Size: Meter 54111-0221--r--, Reader Reader No: d Date: �-- Zoning: -- No. of Units: I agree to comply with the City of Ea • • n Ordi .! ces. B WATER SERVICE PERMIT CITY OF EAGAN Permit No: 3830 Pilot Knob Road B/P No: _ P.O. Box 21199 Eagan, MN 55121 Owner Site Address: Plumber____ MWCC: — City Chg: _ Acct. Dep: Permit Fee: Surcharge: Misc.:—.— Date: Date: Zoning. No. of Units: I agree to comply with the City of Eagan Ordinances. By SEWER SERVICE PERMIT AR FLO* VENTED VENTED CEPUM6 SECTION (INSULATED) (1 letttrior air film (2 !'' (3 5;4.4p....6.,4 h-15. ►5. (4 szteriar air film (OM) CEILING FRAMING SECTION (L iaterlor air film (3 it t a•a J ►-�s 0.61 .540 41-•c' 0.61 TOTAL R 4.7g U s 1/R .G'ZZ 0.61 (4 intsrior air film (5 5'1z.ttlohos of soft wood .TOTAL y s I /R•�fd CEIUNG SECTION (INSULATED) (1 interior air film 0.61 (2 (3 (4 eiferior air film (still) 0.61 TOTAL R 1) is 1/R CEIUNG FRAMING SECTION (1 Interior air film (2 (3 0.61 (4 inferior air film {5 fnthes of soft wood _TOTAL R y = I/R EXPOSED BEAM CEILING SECTION (j Inferior air Sllm (3 0.61 (4 (S exterior air film 0.17 TOTAL R y = L!10-- PERMIT CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT TYPE: Permit Number: Date Issued: c,k4 413 te BUILDING 025861 06/26/95 SITE ADDRESS: 4186 COUNTRYSIDE DR LOT: 4 BLOCK: 1 COUNTRY HOLLOW P.I.N.: 10-18275-040-01 DESCRIPTION: ermit Type rk Type BASEMENT FINISH ALTERATION REMARKS: A SEPARATE PERMIT IS REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK FEE SUMMARY: Base Fee Surcharge Total Fee $35.00 $.50 $35.50 CONTRACTOR: OWNER: - Applicant - SHARP BRUCE 4186 COUNTRYSIDE DR EAGAN MN 55123 (612)686-4577 PLICANT/PERMITEE SIGN -4 RE 15SUED SIG UREI di CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) Ad 681-4675 New Construction Requirements Remodel/Repair Reauirementg • 3 registered site surveys • 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) • 1 energy calculations • 3 copies of tree preservation plan if lot platted after 7/1/93 required: _ Yes No DATE: 6 - /a 95 DESCRIPTION OF WORK: 46),c1-5S-/NC/V7- STREET YJg,VT • 2 copies of plan • 2 site surveys (exterior additions & decks) • 1 energy calculations for heated additions CONSTRUCTION COST: STREET ADDRESS: '/8�vU/ZJg'i'ST 2L LOT BLOCK I SUED./P.ID. #. &f1,nhq----Pfine PROPERTY Name /9 A/t'CE Sg�9/66th r -Phone #: S -& -5'5-i OWNER Street Address. LAST FIRST 9/ ?Y'-6 c©o/ir )Sz,9L Ili City: T,7l91v State: /%2/1,2 Zip: 3 CONTRACTOR Company: `rZ/ Phone #: 108 /5% Street Address: /Sr License #: City: State: Zip: Company: Phone #: Name: Street Address. City: State: Zip. ARCHITECT/ ENGINEER Registration #. Sewer & water licensed plumber: . Penalty applies when address change change are requested once permit is issued. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply applicable 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 „s/ a-(7) w ECEI G lig J W'i 1 2 1995 BUILDING PERMIT TYPE a 01 Foundation ❑ 02 SF Dwelling ❑ 03 SF Addition o 04 SF Porch ❑ 05 SF Misc. WORK TYPE ❑ 31 New O 32 Addition ❑ 06 ❑ 07 ❑ 08 ❑ 09 O 10 Duplex 4-plex 8-plex 12-piex plex 33 Alterations O 34 Repair GENERAL INFORMATION OFFICE USE ONLY O 11 ❑ 12 ❑ 13 ❑ 14 ❑ 15 Apt./Lodging -- - 16 Multi Repair/Rem. 0 17 Garage/Accessory 0 20 Fireplace 0 21 Deck ❑ 36 Move o 37 Demolition Const. (Actual) Basement sq. ft. (Allowable) Main level sq. ft. UBC Occupancy sq. ft. Zoning sq. ft. # of Stories sq. ft. Length sq. ft. Depth Footprint sq. ft. APPROVALS Planning Building Basement Finish Swim Pool Public Facility Miscellaneous MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit Engineering Variance O Permit Fee Surcharge Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units Valuation: $ /52--529 MoDE 1987 BUILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS - RESIDENTIAL RENTAL UNITS FOR SALE UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND To Be Used For: 60141 r'tiM11t,/ Valuations Co4M4t 5(4 Dr. Site Address Lot 4 Block 1 Parcel/Sub, v Vis'' f 1"�U(t .1 Owner 13 4d0bwud hi,NNALS ''tvl o OS Address City/Zip Code Phone Contractor Z rj d\kj(,Q Address ?3b1 19l',T' City/Zip Code .X JU4fL t vont. tflt5, 444) Phone 4 . s7Zq Arch./Engr. Address City/Zip Code Phone # trot Date: //4f97 OFFICE USE ONLY //9000,-° On Site Sewage MWCC System ✓ On Site Well City Water _L Occupancy Zoning Type of Const (Actual) (Allowable) # of Stories Length 69,3 3 Depth 3y 00 S.F. Total Footprint S.F. 3 F-1 v -N v -N' APPROVALS FEES Assessments Permit S3'7.50 Water/Sewer Surcharge 57.649 Police Plan Review ar79.7.5 Fire SAC, City /00, 00 Engr SAC, MWCC 5/5-.00 Planner Water Conn 525.00 Council Water Meter 0.00 Bldg Off 4,rg 9114 Road Unit 305.00 APC Treatment P1 jgp,c0 Variance Parks Copies TOTAL a 59y, n NO C.O. UNTIL PLANNING OK' S CITY OF EAGAN N° 1416 6 MODEL HOME 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PRV REQUIRED PHONE: 454-8100 �ti 5 it BUILDING PERMIT Receipt # To be used for SF DWG/GAR Est. Value $118,000 Date SEPTEMBER 14 1 g 87 4186 COUNTRYSIDE DR OFFICE USE ONLY Occupancy R1 X Zoning Type of Const Vn Parcel No. x (Actual) (Allowable) c` 2367 78TH ST E # of Stories z Length 67 o Depth S.F. Total Footprint S.F. Site Address Lot 4 Block 1 Sec/Sub. COUNTRY HOLLOW On Site Sewage MWCC System On Site Well City Water R3 RAINBOW HOMES Name Vn Address City I.G.H. Phone 450-1724 cc .0 ow Ua a Name Address City SAME Phone I— cc WW FW z X UZ W Name Address City Phone 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 Statute nd +ityof gan na es. Signature of Permittee A Building Permit is issued to: RAINBOW HOMES on the express condition that all work shall be done in accordance with all applic le State of Min -esota Statutes and City of Eagan Ordinances. Building Official (- ,t'�-e-2.4` s APPROVALS Assessments Water/Sewer Police Fire Engr. Planner Council Bldg. Off. APC Variance FEES Permit Surcharge Plan Review SAC, City SAC, MWCC Water Conn. Water Meter Road Unit Treatment P1 Parks Copies TOTAL 34 $ 557.50 59.00 278.75 100.00 525.00 525.00 67.00 305.00 180.00 X25 QJi rtifiratt of (orrupanrg ettp of Qgagan fppnrtmrnt of Building Jnnpprtinn 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: Use Classification SF LW/GAR Occupancy Type Zoning District Owner of Building iit 141474 richrS Building Address 4186 C )IrTR S1DE DRIvF Building Official Bldg. Permit No. 14166 F.1 Type Const t!ll Address .3617 7132E ST 7, TM �j .."! cis fflTV `l(. LL(�'v' Localityt}, t;x)z Date. /Ij JS. 31. 1968 POST IN A CONSPICUOUS PLACE John Bradley orchitecturoJ consultants inc. •OQE fly IT. $ E. OSSEO, Vii. Sits M. flit} -414.4771 XT_ROR N L'PE AV RA E" " OM= TAT Pion ©11-S-1 Date 1- 4-8F7 Owner, g$.iv bou) -ovvv S Contractor: I.d`i•--i 1 �� - - Site Address: x kx x C©wrlry1Yd4 012,• , `Ianr Ler 4 etc, / Cowwf'y /low Z46C7 fjTOTAL EXPOSED WALL AREA 2)TOTAL EXPOSED ROOF/CEILING AREA WALL AREA CALCULATIONS: TOTAL WINDOW AREA GLAZED TOTAL DOOR AREA TOTAL GLASS DOOR AREA 1704 -AW -11 GLAZED TOTAL FIREPLACE WALL AREA TOTAL WALL FRAMING AREA NET INSULATED WALL AREA TOTAL RIM JOIST AREA TOTAL FOUNDATION AREA (EXPOSED) TOTAL FOUNDATION WINDOW AREA tt4Co io5 PHONE ft " ",11 :=1”/(is (17 sq. ff U � 34 ft. %'ir u=1 t 01. 1- sq.ftii'U"•_ Sit s4e, 'Z b sq.ft.xtU",o'7 = t.e040. 40 38 Zmas t't44 If item 3 is the some as, or less than item 2 MCAR 1.16006 A and 0. ROOF/CEILING CALCULATtONS� TOTAL SKYLIGHT AREA TOTAL ROOF/CEILING FRAMING AREA NET INSULATED ROOF CEILING AREA sq.ft x"U"moi = Vao ,40 sq.ft x rU"! = (3. 11 sq.ftxU"•lQ Z1,4.0 s .ff.x'U" .424= 57,4l sq.ft.><U" °043 = sq.ft.x"U" .ICs = 4 sq.ftisir •" = I*44/4. 3) TOTAL 1, you have met the Intent of 1o3 t sq.ftz'U" ' = 1.44). sq.fta tr = ' ci sq.ftx U"sgre==1'L4 4j TOTAL . to,ed t If item 4 is the same os,or less then item 2, you hove met the intent of 2 MCAR 1.16008 A and 0. ALTERNATE BUILDING ENVELOPE DESIGN To utilize the total envelope system method, the sum of items 1 and 2 ahol be greater than the swn of items 3 and 4. 1) t2) a) +4) IIIC 1 hereby certify 'bat the building here described meets or exceeds the State of Minnesota Energy Conservation Act. 0®0 Cep ®026 95 Rep. 3 ��0 14)''?. di Request Date/���jj c GP O`�/�5 Fire No. Rough -In Inspection Requ' d (You r}y [ call inspector wh ady) Yes ❑ No Inspection Other Than ugh -In ❑ Ready Now ,Will Notify Inspector Date Ready I • licensed contractor ',:.wner hereby request inspection of above electrical work at: Jobress1Street, Box or to No.) r/ 8-6' uh ircG,sI e ]:f- City Sectiorr No. Township Name or No. Range No. County O PRINT) rtkce Sh4rp Phone No. Power Supplier Address Electrical Contractor (Company Name) 'M&.' wri et" Contractor's License No. Mailing Address n actor or Owner Making Installation) JC/ Authorized Signature (Contractor/Owner Making Installation) Phone Number — i<577 MINNESOT ATE BOARD ELECTRIC! Gr Griggs -Midway Bldg. - Room S-128 1821 Unlversity Ave., St. Paul, MN 55104 Phone (612) 642-0800 - Dryer II II III II II BErACIC�EPTEDI BY THIS THE STATEWILL NO BOARDT UNLESS PROPER INSPECTION FEE IS 7'4g°(9 REQUEST FOR ELECTRICAL INSPECTION R See instructions for completing this form on back of yellow copy. "X" Below Work Cover New Auld Rep. Type of Building I Appliances Wired Equipment Wired Home It Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial Furnace Other (Specify) Farm Air Conditioner Other (specify) Contractor's Remarks: 0 Compute 'VSA 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 A..ve 100 Amps Signs Inspector's Use Only: TOT Irrigation Booms L SO Special Inspection THIS INSTALLATION Alarm/Communication Other Fee MAY BE OR. RED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTH I, the Electrical Inspector, hereby certify that the above inspection has Rough -in �f / t Dat G f been made. F nal 9/�(/ �C/'�" Date OFFICE USE ONLY This request void 18 months from Z.Neto ***tic*, ve att# ex &mom . 1211181&121 L MAIMS MS *CTMON 0 wit 4� 00 • _ekes of sof' .aoe (4 e"'Ar- (5 ($ sootily t." • 4,1A1- •cam MILL SECTION (INSULATED) {1 j/Iferr sir tam tt ►� s1IE { 3 V % { 4 k'c•c D (5 *Pork" $ aatNior of film 0,t? TOTAL It u • 1/11 •to • 45 i9 .n •bI 0.1? TOTAL R • • 77 U a int 0.6e • 19 •co . 0.17 TOTAL A Z Y s sm • ___ 0 ea 'o 1•3b' TOTAL Rg This request void /„ 18 months from D 41895 // J?/ .‘)/ Request;te / Fire No. Rough-in Inspection Type of Building Appliances Wired Equipment Wired /0-- l2 Fee R qj�'lied?• 1 Ready Now Will Notify Inspec- tor When Ready Temporary Service Licensed Electrical Contractor ❑ Owner I hereby request inspection of above electrical work installed at: Street Address Box or Route No 41/0141-61:0<4.s,1— /t IL" Section No. Township a or No. Range No. City Occupant (PR NT) A%- 2/0/k9er Co,< /e 7-/`0/4/ Power Supplier ;47/1®r4,9 ff/ctA, oun D� Phone No. Address ASV— /%)-4 Electrical Contractor (Company Name) ak Mailing Address (Contractor or Owner Making Installation) rif NNESOT '/ATE BOARD OF ELECTRICITY riggs-Midway Bldg. — Room N-191 1821 University Ave.. St. Paul, MN 55104 Phone (612) 642-0800 Contractor's License No. ®41/6:l f 0— �� Cd fld '/ •,) 5UPNSL'i/14. ized Signature (Cy tractor/Owner Making Installation) / .3-337 Phone Number / S7' D 41895 THIS INSPECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION 10 See instructions for completing this form on back of yellow copy. Below Work Covered by This Request EB -00001-06 New Add Rep. Type of Building Appliances Wired Equipment Wired XHome Fee Circuits 1 )C Range Temporary Service 0 to 30 Amps 31 to 100 Amps 951.33,00 / ':00 Duplex Water Heater Above 200 Amps; Lighting Fixtures Swimming Pool Apt. Building Commercial Bldg. ) Dryer Furnace Electric Heating Silo Unloader TranstormerS Irrigation Booms Industrial Bldg. ,.0 Air C nditi ner Bulk Milk Tank Signs Farm X Wr 6 Remarks Other (Specify) Other (Specify) Other Other ee [seiow as Fee Service Entrance Size 8 Fee Feeders/Subfeeders 8 Fee Circuits 1 4:4-0O 0 to 200 Amps 0 to 30 Amps 31 to 100 Amps 951.33,00 / ':00 0 to 30 Amps 31 to 100 Amps Above 200 Amps; Swimming Pool Above 100 Amps Above 100_Amps TranstormerS Irrigation Booms ,.0 Partial.'Other Fee Signs Special Inspection S Ja,S0 / •-•'-',.•-•'-',.� TOTAL F 4r Or) Remarks Final This request void 18 months from Date 0.- 31'). the Electrical Inspector, hereby certify that the above inspection has been made. 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION :NOTE: PAYMENT OF FII. AT TIME OF APPLICATION DOES NOT CON- STITUTE APPROVAL OF PERMIT. * INSPECTION OF SEWER AND/OR WAl'tR *. * INSTALLATIONS WILL NOT BE SCEDUUD * UNTIL PERMIT HAS BEEN APPROVED. ************************************** * (Lot/Block/Subdivision or Tax Parcel ID ##) IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: PRESENT ZONING/PROPOSED USE: I COMMERCIAL/RETAIL/OFFICE I l INDUSTRIAL INSTITUTIONAL/GOVERNMENT (Month/Year) 1R-1 SINGLE FAMILY 1 [R-2 DUPLEX (Two Units) f R-3 TOWNHOUSE (Three + Units) ( Units) R-4 APARTMENT/CONDOMINIUM ( Units) 2) "RLICAND NAME: ADDRESS: CITY, STATE, ZIP: PHONE: 3) s¢ PL► ' �. 24 NAME: ADDRESS: CITY, STATE, ZIP: PHONE: 14t / / .P,✓ B:m16,„ T2, 0 ci • ', } 2 s MASTER LICENSE # For City Use Plumbers License: _ Active Expired Not recorded Staff Initial 4) OWNER I NAME: ADDRESS: CITY, STATE, ZIP: PHONE: 5) DiVisAe.oy ° .I 2 �+�• T TIS+ BEINGIk CONNECTION TO CITY SEWER FA,C,ONNECTION TO CITY WATER ) J OTHER 6) • /7, ;j ************************************************************************************************ THE GOLD COPY OF THE PERMIT WILL BE SENT DIRECTLY TO PUBLIC WORKS TO FACILITATE METER PICK-UP. PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. SOMEONE FROM THE CITY WILL CONTACT YOU IF THERE * ARE ANY PROBLEMS. * * * * **************************************************************************************************; FOR CITY USE ONLY PERMIT # ISSUED Pd w/Bldg. Permit FEES: $ $ /D - S L) SEWER PERMIT (INCLUDE SURCHARGE) $ $ /Ch - .5-2).5-2).5-2)WATER PERMIT (INCLUDE SURCHARGE) -7 $ / 'LIC"' $ WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ /T-0-6 ACCOUNT DEPOSIT - SEWER $ $ /5, lr1) ACCOUNT DEPOSIT - WATER $ S 2 .', - .6 $ WAC $ 2- • ( $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ /ef. '(' (1 $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ /39 // ' G' C" $/ ` 4-"v TOTAL 7-7 3 7 •-- 7 T 7 RECEIPT # RECEIPT # DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE ENGINEERING DIVISION. LIST AS A CONDITION. NO SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: 7f2// .S-/�1' t == _______===========___ =-x===-==-== =-s==============_________ MEMO ========________________________________===========:____=====sa==ss====__=======. TO: File FROM: Jerry Bourdon DATE: June 30, 1989 Re: House Settlement Lot 4, Block 1 Country Hollow Addition Contract No. 87-30, Project 505 file no.: 49424 This memo summarizes the findings of our investigation into the cause of the cracked floor slab and walls of the house located on lot 4 of block 1 of the Country Hollow Addition. BACKGROUND On June 8, 1989, Craig Larson and I met with Warren Israelson (developer), Charlie Brown of Rainbow Construction (the home builder) and the owner of the house to inspect a cracked house floor slab and walls. We were requested to inspect the crack because one of the potential causes of the cracking is the storm sewer trench which was constructed under city contract. FINDINGS The general locations and dimensions of the cracks are presented on the attached sketch. To better understand the situation we plotted the cross sections at select locations to show the geometric relationship between the original ground, proposed grading, actual grading, the storm sewer trench and the findings of the soil borings. Attached is a copy of that drawing. CONCLUSIONS / OPINIONS From this drawing it is somewhat inconclusive as to the cause of the cracking. The cracking that has occurred close to the north wall may be the result of settlement of the trench backfill. However the crack running completely through the floor slab is located significantly farther back from the probable edge of trench than expected for the storm sewer trench to be the cause. Perhaps there are two separate contributing causes to the cracking. For instance it is possible that settlement of the site grading could be a contributing factor to the cracking since the house sits upon several feet of fill. Assuming that a primary cause of the cracking is settlement of the storm sewer trench backfill is not unreasonable because the crack parallels the storm sewer. This tends to support the theory that settlement of the trench backfill was a primary cause of the cracking. In addition the soil density shown by the split tube borings indicates less than desirable compaction. The information at hand is sufficient for the city to consider the trench settlement to be a possible cause of the cracking and therefore the project retainage will be held pending resolution of the matter. However the current information is not sufficiently conclusive to cause the city to force the contractor to be financially responsible. Perhaps the next step could be to find a negotiated settlement acceptable to developer and contractor. If this can not be accomplished perhaps additional study by a structural and soils engineer would be in order. MISCELLANEOUS Incidental comments: The house across the street also cracked. In that instance the utility contractor contends that he left the trench partially unbackfilled for site access reasons and someone else filled the trench prior to his intended backfill. I thought that Allied Test Drilling Company previously did split tube borings on this segment of the storm sewer trench and concluded that the compaction was acceptable. In addition, based upon recent experience, 1 have become skeptical of split tube findings. Also, note that the elevations used by Allied in the report differ from the findings of our field surveys. cc Warren Israelson Frank Jedlicki Tom Colbert Mike Foertsch Pat Wilcox z. 3v V 0) ,. I V c, .� -4- n V W . S . ; L y V 3 g J vy V y �Ap .1 44. �Zs ; , 144 ,r\.c Y .J OZ VD/ fre-l— J -- .r 0) w TO) L > i) ..i C L 3 0 ED 0 c0 Ll Q >� C �ti ..r. z 0 1L O 01 C O Z C C 0 ..r .., _Ne P 03 t0 0 L U) U < 0) C T 3 C L 0 -4 C X' o 10 0 (0 z T Tc L 3 (1) 4 0 ui C ci 1C 3 0 CO H 0 4 U O) .Y O J U < 0 ^ -� C 0 m 1- U) (.3 V 0) 4-3W Q 1— 0 (A _I Project 87005E 5"191{5 PLUMBING (RESIDENTIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 Please complete for: Single Family Dwellings Townhomes and Condos when permits are required for each unit Date 1 /42.0 / D3 # Site Address 4 i P)(0 ent,u4-tie ,S j C h( mo_ t Unit Property Owner S h U r" ; % ,ta,;rei aft -17 Telephone # ((I l) j 1 �''' kL(� + t Contractor I-', P . P <AA,C (Ks 1-' Address ] L.v 1 () fib 1) b RA) City E61 n State '010... Yl Zip S J 12 4- Telephone # 6 0 .S US — I 4?) The Applicant is Owner Y Contractor Other Septic System New Refurbished Submit 2 sets of plans and MPC license $ 100.00 Includes County fee. Additional consultant fees may apply. Alterations To Existing Dwelling Unit, Including Adding fixtures to lower levels or room additions, excluding water softener and water heater Abandonment of septic system — Water turnaround (+ 5/8" meter if needed - $121.00) Other: $ 50.00 PJZ new installation repair rebuild $ 30.00 — Lawn irrigation system n rP fT,(r I 1 U1 Water softener s. Water heater F E 6 4 1003 �I �J replacement additional $ 15.00 State Surcharge $ 50 Total $ I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; 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. L19v Hikvou Applicant's Printed Name cant's Signature 2006 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. .Sa Date `J / 2. / / v �O Unit # Site Street Address y /g( c ,, S,'de_ a . Property Owner,` &71e -e. _ Telephone # (o6") ) CSS -'/ / / �� Contractor L / /.� r'!�' Telephone # (Z7) 7W—Y ' Address (/ Pd/."4\i' 5/ 5" City L ri- L - State/Wii Zip `c`'S-Oce:‘, The Applicant is: = Owner Contractor _Other Septic System New Refurbished Submit 2 sets of plans and MPC license Includes County fee $ 100.00 $ 10.00 _ _ Per as -built Alterations to existing dwelling Add plumbing fixtures. This fee includes installation of a water softener and/or water $ 50.00 _ _ heater at the same time. If you are installing only a water softener armor water heater, do not complete this section; move to -the next section and check the appliance(s) you are installing. System Abandonment _Septic _Water Turnaround (add $130.00 if a 5/8" meter is required) Other: Water Softener Water Heater $ 15.00 new replacement _ _ / Lawn Irrigation 40(PVB new _repair rebuild $ 30.00 _RPZ State Surcharge $ .50 Total $ 3 0.5 0 I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accordance with the approved plan in the event a plan is required to be reviewed a r roved. r'/ f - 4 Applicant's Printed Name Date: Tenant: City of Eaafl 3830 Pitot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 RECE `V ED MA0 032016 r Use BLUE LUE or BLACK Ink L For Office Use 13 Permit Fee: ©fes Permit #: Date Received: Staff 2016 RESIDENTIAL PLUMBING PERMIT APPLICATION to Ca k f?. c2/ < //b Site Address: Resident/Owner Contractor Type of Work Permit Type Suite #: Name: ail Phone: IP SI— 10 ' ip " L4sr77 Address / City / Zip:: J 18 ct? ✓(.. S1.6 I> a 4,14,, M lir 'j 5 (a 3 344 0 avA d- Thr State: l t Zip:c 5 Li 01 (.47 Phone: 7 15 — 3' b� 7 Contact: SCh(C.:i Email: C tOu , /7'± Name: Address: License #: to (4 6161 "i W C City: i - `Zv New I Replacement Repair Description of work: \11A, (> .t RESIDENTIAL Water Heater Lawn Irrigation ( RPZ / PVB) Septic System New — _ Abandonment Rebuild _ Modify Space Work in R.O.W. WG ±k't ci{"TU' "�-`1 Water Softener — Add Plumbing Fixtures ( Main / _ Lower Level) Water Turnaround 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. 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. TIM 6c4-oBeA Applicant's Printed Name x Applicantd Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough -In Meter Related Items: Meter Size Radio Read Air Test Manometer Gas Test Final Staff: PERMIT City of Eagan Permit Type:Building Permit Number:EA173043 Date Issued:10/26/2021 Permit Category:ePermit Site Address: 4186 Countryside Dr Lot:4 Block: 1 Addition: Country Hollow PID:10-18275-01-040 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 - Bruce C & Margaret M Sharp 4186 Countryside Dr Saint Paul MN 55123--162 Renewal Andersen 1920 County Road C West Roseville MN 55113 (641) 264-4088 Applicant/Permitee: Signature Issued By: Signature