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4193 Countryside DrParcel Files Cover Sheet Unique ID: 4035 4193 Countryside Dr 101827509002 1) 2) 5) (PLEASE PRINT) PROPERTY ADDRESS: 4/93 , /F LEGAL DESCRIPTION: '7 IF EXISTING STRUCTURE, DATE OF ORIGINAL PRESENT ZONING /PROPOSED USE: I COMMERCIAL/RETAIL /OFFICE j I INDUSTRIAL I I INSTITUTIONAL /GOVERNMENT PEICA1r ADDRESS: CITY, STATE, ZIP: PHONE: 3) PIS ! E1213 NAME: ADDRESS: CITY, STATE, ZIP: PHONE: 4) ME M itINDI NAME: /WI OWNER NAME: ADDRESS: CITY, STATE, ZIP: PHONE: APPLICATION FOR PERMIT SEWER AND /OR WATER CONNECTION (Lot /Block /Subdivision or Tax / b' /3 3 Ge(.44` ,4 ;i J4 Al/J, 1 /3/ - vZ00/ 4PISSEE • ago Da s. 6) s- 'C22.. ka ; d 4 01 " "" Parcel ID #) BUILDING PERMIT ISSUANCE: . -R -1 SINGLE FAMILY 1 [ R -2 DUPLEX (Two Units) f R -3 TOWNHOUSE (Three + Units) ( Units) I I R -4 APARTMENT /CONDOMINIUM ( Units) 17/7 4POLA 1 ) � 2s4ch 9 A L Ae /fir -U? MASTER LICENSE # �,;��,�` :NOTE: PAYMENT OF rEE AT TIME OF * APPLICATION DOES NOT CON — STITUTE APPROVAL OF PERMIT. * INSPECTION OF SEWER AND /OR WATER * * INSTALLATIONS WILL NOT BE SCEDULED ,* UNTIL PERMIT HAS BEEN APPROVED. ******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** - CONNECTION TO CITY SEWER I4.+CONNECTION TO CITY WATER ) I OTHER (Month /Year) :2 - ir For City Use Plumbers License: Active Expired Not recorder Staff Initial * THE GOLD COPY OF THE PERMIT WTLT, 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. PERMIT # ISSUED Pd w /Bldg. Permit FEES: $ $ 1 6 SEWER PERMIT (INCLUDE SURCHARGE) $ $ / S� WATER PERMIT (INCLUDE SURCHARGE) $ $ WATER METER /COPPERHORN /OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ /C ACCOUNT DEPOSIT - SEWER $ $ /� ACCOUNT DEPOSIT - WATER $ A-"/ $ WAC $ ,.? Y7.,-) $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT /TRUNK SEWER $ $ LATERAL BENEFIT TRUNK WATER $ WATER TREATMENT PLANT SURCHARGE $ / $ OTHER: $ / �l 7 / $ 5 / TOTAL RECEIPT # RECEIPT # DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? pi YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE ENGINEERING 1 1 NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: FOR CITY USE ONLY /AkOM7 December 20, 1988 PLYMOUTH PLUMBING 9290 ZACHARY LN N MAPLE GROVE, MN 55369 Jan Severson Secretary JS RE: 740 HAVENHILL RD., L42, B7, HILLS OF STONEBRIDGE 744 HAVENHILL RD., 143, B7, HILLS OF STONEBRIDGE 731 CHESHIRE CT., L48, B7, HILLS OF STONEBRIDGE 4193 COUNTRYSIDE DR., L9, B2, COUNTRY HOLLOW 4180 PRAIRIE RIDGE RD., L13, B2, COUNTRY HOLLOW WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES — TELEPHONE, ELECTRIC, GAS, ETC. - REQUIRED BY LAW XX Your Sewer and Water Permit for the above property has been completed. It will be held at the Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO CALL PUBLIC WORKS (454 -5220) FOR YOUR PERMANENT WATER TURN ON. Your Sewer and Water Permit for the above property cannot be completed for the following reason: Your Sewer and Water Permit for the above property has been completed, however, the meter cannot be issued or occupancy allowed until further notice. S ncerely, el N4 Address i t. p° ; 'I ' r'a Y3 ,DE. DR Block Sec /Sub. COUNTRY H(;T U,; Name Address City:; ; 1C -,:a: Phone TRUCT x0 4i1-2001 S«+'lia Name Address City Phone Name Address City Phone Site Lot ,P.arQ CITY OF EAGAN 3830,Pilot Knob Road, P.O. Box 21 -199, Eagan, MN 55121 PHONE: 454 -8100 BUILDING PERMIT Receipt * To be used for 1 frr `� Est. Value i ,0 Date 00 0 o Q U cc F U ,y, W y, I 2 s° U z °C w a I hereby acknowledge that I have read ;his 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 ' ' O 1 1. 1E CCS'`1 iTIOP 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 OFFICE USE ONLY On Site Sewage Occupancy MWCC System X Zoning K -1 On Site Well (Actual) Const 4e =i City Water $ (Allowable) °? PRV Required k * of Stories Booster Pump Length # 1 t Depth 44* S.F. Total Footprint S.F. APPROVALS FEES Engr. /Assess. Permit Planner Surcharge Council Plan Review Bldg. Off. SAC, City Variance SAC, MWCC Water Conn. Water Meter Road Unit Treatment P1 Parks TOTAL ,198# 4 i4. €-0 ^J 4 247.000 100.00 550.00 550.00 u7. ©0 325.00 204.00 2,577.00 Permit No. Permit Holder Date Telephone # Plumbing /C//2@ , �f 1 %i �/ya'' I % 31 /Std ,% f . �7 H ,V,A.C. / // (` f., .. i /' ;j f y`/ a / // a - l/ - ,t'" ;, i Electric rw ''% v "�.1e, tf.. 1 , ' '//f /G ! cf ° ' Softener Inspection Date Insp. Comments Footings I if, �� Footings II Foundation GZ4u, - eQ Fc).•- 1 r - c..-/ 7 To Framing 1'2 6 C.j- Roofing Rough Plbg• /5 4.,' , " r ; � - „ 16: 3 % /2l ✓ 4 Rough Htg. if ri # 5 jot/ 04 -- S /eel- 0 V , O , i 8 Isul. Fireplace if/If 0/ J £ I Ch e Final Htg. 94/,-. Finial Plbg. 3 4 7 ,8/:, , �J 7? ' �f 3 -2-�91.Jo .F / � c , Bldg. Final / CertOcc. - , / ?/Vs , Temp. LP Deck Ftg. Deck Final Well Pr. Disp. CONTRACT PRICE: Site Add ess i Lpt Block Sec /Sub m v, (T 0 Name Address City Name Address City Phone Phone PERMIT # MECHANICAL PERMIT CITY OF EAGAN RECEIPT 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: PHONE: 454 -8100 FEE: SIC: TOTAL* TYPE OF WORK Forced Air 1' - = °M BTU $ 'Boiler M BTU $ Unit Heater M BTU $ Air Cond. M BTU $ Vent CFM Gas Piping Outlets # Other $ BLDG. TYPE WORK DESCITION Res. New V 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) SIGNATURE OF PERMITTEE FOR: CITY OF EAGAN Phone /? 07 ^ PERMIT # RECEIPT # DATE: n hex, 1 WORK DESCRIPTION New Add -on Repair FEE: STATE S /C: GRAND TOTAL: CONTRACT PRICE: Site Address Lot Block Name • J Address City Phone 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 ?ERMITTEE PLUMBING PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 PHONE: 454 -8100 BLDG. TYPE Res. Mult. Comm. Other RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO FIXTURES TOTA Water Closet - $3.00 /Bath Tubs - $3.00 °`Lavatory - $3 00 — Shower - $3.00 _Kitchen Sink - $3.00 Urinal /Bidet - $3.00 _Laundry Tray - $3.00 — LFloor Drains - $1.50 __ LWater Heater - $1.50 _Whirlpool - $3.00 i_Gas Piping Outlets - $1.50 (MINIMUM - 1 PER PERMIT) Softener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 JOE MILLER COAST 4193 eft DR.. 9. I12 - t PLYMOUTB puouniv ;550_ p4 Z ni 1 5 00 p4 Mo end I in_nn pd pd CITY^QF EAGAN 3830 Pilot Knob Road P.O. Box 21199 Eagan, MN 55121 Owner: JOE MILLER CONST MWCC: City Chg . Acct. Dep: Permit Fee $550.00 pd 100.00 pd 15.00 pd 10.00 pd Surcharge. .50 pd Misc. PRA" REQUIRED Permit N od 11323 B/P Nc( Site Address. 4193 COUNTRYSIDE DR., L9, B2, COUNTRY HOLLOW Plumber PLYMOUTH PLBG Zoning. R1 No. of Units: 1 agree to comply with the City of Eagan Ordinances. By / f/2 -. SEWER SERVICE PERMIT Dri,teFmlning "U" values at Roof, Wall, Rim, and Conc. Block l!J G 1 HUH nUu HUH ROOF /CEILING 1.) Interior Air Film 2.) 5/8" Gyp. Bd. 3.) Insulation 1.) 5.) Exterior Air Film (STILL) = 1/nn , WALL (11) VALUq 6.) Interior Air Film 0.68 7.) j" Gyp. Bd. 015 8.) Insulation MOO 9.) burcr -Prr5 Z 10.) Hasonite Siding .67 11.) Exterior Air Film .17 = 1 /11= Rill (I1) VAL E 12.) Interior Air Film 0.68 130 Insulation 19.00 14.) 2" Fir Rim Joist • 1.88 15.) Ku1Lr -P►rG 2,oq- 16.) Hasonite Siding .67 17.) Exterior Air Film .17 = 1 /11= ,al TOTAL (R)= FOUNDATION 18.) Interior Air Film 19.) • 20. g--/I 9 1 /Pf P 21.) 12" Concrete Block 22.) 23.) Exterior Air Film "U" = 1 /R= . (11) VALUF • 0.61 .56 44. c' .61 -TOTAL (R)= TOTAL (R)= 23.01 (R) VALUE 0.68 l l .00 1.28 .17 TOTAL (R)= )3.' SINGLE FAMILY DWELLINGS 1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN X5445 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 RENTAL UNITS FOR SALE UNITS # OF 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 Site Address Lot / Block Parcel /Sub Owner Address City /Zip Code Phone Contractor Address X City /Zip Code Phone 1 / 1 3 7 Arch. /Engr. Address City /Zip Code Phone # To Be Used For: / 11,) if 2- 7?'LL Valuation: C ‘2,z4„ ea ter/L_ a.d v APPROVALS FEES Date: // 09 `H OFFICE USE ONLY ?c) o OD On sit sewage Occupancy R -3 M-1 MWCC system v/ Zoning R - ( On site well Actual Const City water !/ - Allowable V- I•( PRV required ✓ it of stories Booster Pump Length Depth S.F. Total Footprint S.F. Engr /Assess Permit / 00 Planner Surcharge yf7, Ott Council Plan Review 2,44r7,00 Bldg. Off. t ) 3a SAC, City I DO, UO Variance SAC, MWCC 55O, Water Conn 550, 00 Water Meter _ ,C7C, Road Unit OG Treatment P1 ZOy ,OO Parks Copies TOTAL ,07/7,00 cc .0 z I— oQ � t- Site Lot Parc Uw W z x7. U ec w a BUILDING PERMIT To be used for SF DWG /GAR Address 4193 COUNTRYSIDE DR 9 Block 2 Sec /Sub. COUNTRY HOLLOW el No. Name JOE MILLER CONSTRUCTION Address 18133 CEDAR AVE S City FARMINGTON Phone 431 -2001 Name SAME Address City Phone Name Address City Phone cc z 3 0 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 9a ma , a Signature of Permittee A Building Permit is issued to JOE MILLER 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. --1 Building Official CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21 -199, Eagan, MN 55121 PHONE: 454 -8100 Jrrtifiratr of Mrrupan.rj Cite of (Eagan ELpartmrnt of Builbing 3nripertiim 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 DWG /GAR Bldg Permit No 15945 Occupancy Type 3 Zoning District R-1 Type C onst . V - N J oe Miller Construcgon 18133 Cedar Ave S Owner of Building ress Building Address 4193 Countryside DR. Locality L9 B2 Country Hollow Building Official Est. Value $80,000 W Date. POST IN A CONSPICUOUS PLACE Receipt * Date DEC 8 OFFICE USE ONLY On Site Sewage Occupancy R -3 M -1 MWCC System X Zoning R -1 On Site Well (Actual) Const V —N City Water X (Allowable) V —N PRV Required .___X # of Stories Booster Pump Length 51' Depth 44' S.F. Total Footprint S.F. APPROVALS FEES Engr. /Assess. Permit Planner Surcharge Council Plan Review Bldg. Off. SAC, City Variance SAC, MWCC Water Conn. Water Meter Road Unit Treatment P1 Parks TOTAL March 6, 1989 9 4,5 ,1 988 494.00 40.00 247.00 100.00 550.00 550.00 67.00 325 M 204.00 2,577.00 • CITY OF EXTERIOR ENVELOPE (To be submitted with One or Two Family Dwellin ` X All Other f �P� 1 4 Contractor -.\06EPN JV\ ILLEXZ.cJ1'. LINEAL FEET OF � 0 EXPOSED WALL 16 ��W T W►ZK5WEE OPAQUE WALL CONSTRUCTION: HUH Value x Area Detail reference from attached sheets n 1 F2ANAC rM. WINDOWS: MPH Value x Area Make & Type TWL. ",Mr • , nUn nu n nun tt nun nun rj t13 • x SQ. FT. 71(.4.4 9 c (U)(A) x SQ. FT. 9(43-115 = - 7 -33 (U)(A) HUH .0 x SQ. FT. IIR -5Z- = '1 -11 (U) (A) nun x SQ. FT. = (U)(A) MID x SQ. FT. ` ..._ _- (U) (A) ,HUH x SQ. FT. _ (U)(A) DOORS! nUn Value x Area Make & Type i7)--0.5 Hun , 14 x SQ. FT. H H Pal let nun • x SQ. FT. H H HUH x SQ. FT. n u nuu x SQ. FT. TOTALS Z16 -SS SQ. FT. AVERAGE nUn TOTAL (U)(A) VALUES Z(05,-93. DIVIDED BY TOTAL WALL AREA � 7c s r-Q .b a .AVERAGE HUI r less for 1 &2 family ROOF /CEILING: TOTAL AREA: IO6 Detail reference from attached sheets. Describe openings in roof. H UH 11 .t(p n un nun TOTAL (U)(A) VALUES DIVIDED BY 2Z.7_I TOTAL ROOF /CEILING AREA /O AVERAGE It ventilated roofs. e 4 11 BUILDING DEPARTMENT AVERAGE "Un COMPUTATION building permit application) Owner Site Address LOT ° • iIbtjt ? D1l►.h1TAA 1 W I Date I Phone ft. above grade = 77]( -‹ TOTAL EXPOSED WALL AREA SQ. FT. 4411 R lingo . x SQ. FT, ZS`i 117.'1 1 (U) (A) � ;� ' z ' x SQ. FT.= (U) (A) x SQ. FT, (U)(A) x SQ. FT. _ (U)(A) 49 _ !m• f4 (U)(&) 1 RBI = (u) (A) (U)(A) (U) (A) ViS -93 (U) (A) . [YZ I x SQ. FT, I(),af =22-2_) (U)(A) x SQ. FT, - (U)(A) x SQ. FT. _ (U)'(A) x SQ. FT. = (U)(A) S. Em.. _ (MAW) _. 7o r . zz.z) (p(A) E 85735407 G ��t� Fire No. i< (44 Rough irrTn pection RA�11uirsd? Yes ❑No �� yy 1:1 Ready Now CJ Will Notify Inspector When Ready? Request Date > 1 -9 -89 Da licensed contractor 0 owner hereby request inspection of above electrical work at: Job Address (Street, Box or Route No.) 4193 Countryside Drive City Eagan Section No. Township Name or No. Range No. County Dakota Temporary Service Occupant (PRINT) Joe Miller Construction Co. Phone No. 431 -2001 Power Supplier Dakota Electric Address Farmington, MN Electrical Contractor (Company Name) Midland Electric Inc. Contractors License No. 041610 Electric Heating Mailing Address (Contractor or Owner Making Installation) 14055 Grand Avenue So, Suite E, Burnsville, MN 55337 Authorized Signature (Contractor /Owner Making Installation) Phone Number 892 -6688 Apt. Building New Add Rep. Type of Building AppliancesWired Equipment Wired c Home Range Temporary Service / Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm. /Industrial Furnace Farm Air Conditioner Other (specify) Cont actor's Remarks: Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Circuits /Feeders Fee Swimming Pool / 0 to 200 Amps /_0 to 100 Amps Transformers Above 200 Amps Above 100 Amps Signs Inspector's Use Only:` k .�' (i OTAL 67 50 Irrigation Booms Special Inspection \ Alarm /Communication Other Fee I, the Electrical Inspector, hereby certify that the above inspection has been made. Rough -in Dat (P �� Final r D PPPP ?..410 OFFICE USE ONLY ( .,.F. 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 /,043 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 -07 967 <z<KK / !03 7 5SA _ .OX (z.s+6.5 - g5•G� . o x (z.4 44- = zz <.O 54 x (13445 +z9 tai) =. 1373. -7C0 8.83 K61- 1-31430.543D-V= MCP Z S5 A .�� x 141 = 96.48 ---- .S3 x 144 = in � . - 6A E 0 It 1 II - 6/z1560, I I 2. Z4x3c I7.5 x z - 35 WALL. � � x �14� _ ,� �� x Z. I3 L) (Ass cede,' %•`I' 1 F4 K 98 112.5XI - II•ZS R II1 1 4 x 3 . 1 = 8:75X I =x. \d = Z6525 II - ZO x coo - 33X Z = • Coto O ` 133 �- ko x3� = 0-5 x i = lo. II -zox48 - 12xzG ap•v 1 5- Z`Ix18 = 33.-)5 x I = 33.15 1 z- Z9x1 = ZZ•5X 1 s ZZ -5 1 x /18 _ 13.)4 1 13.5 255 -ZS- 6n-5m `z. v1/ PATwveXZ_ R4.0' 1330- - /r - i Lam) -4 1 Sec-' P AKI 1' 4 1 411011 CityofEaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use ~� Permit #: I 0 5 Permit Fee: 10 5. D5 Date Received: 0' L3 Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit #: Name: `A i 1t ^oLG Address / City / Zip: `i. t�) C:0 Applicant is: Owner Contractor Description of work: Construction Cost: Company. Phone: Multi -Family Building: (Yes / NoX ) Contactt, eau 3 y Address: 1 \8071 )n-00 4,1) _ , City: 14INS r1.) rS State: O A Zips5Phone: (d5 ~cfr 6 License #: c74 X11 1 Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) '66°1 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: Mechanical Contractor: Phone: Phone: Sewer & Water Contractor: Phone: ng documents a su 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.00pherstateonecall.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. 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. Applicant's Printed N App icant's Signat Page 1 of 3 PERMIT City of Eaga[1 Permit Type: Building 3830 Pilot Knob Rd Permit Number: EA126905 Eagan,MN 55122 � Date Issued: 09/16/2014 (651)675-5675 � O � (�� www.ci.eagan.mn.us (� u Site Address: 4193 Countryside Dr Lot: 9 Block: 2 Addition: Country Hollow PID: 10-18275-02-090 Use: Description: Sub Type: Single Fam Construction Type: Work Type: Day Care Inspection Description: Census Code: - Occupancy: Zoning: Square Feet: 0 Comments: Lana Orlando 612-867-7542 Fee Summary: Day Care Inspection $50.00 1221.4216 Total: $50.00 Contractor: Owner: - Applicant - ANTHONY S BIDWELL 4193 Countryside Dr Eagan MN 55123 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA133520 Date Issued:10/19/2015 Permit Category:ePermit Site Address: 4193 Countryside Dr Lot:9 Block: 2 Addition: Country Hollow PID:10-18275-02-090 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & 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 - Anthony S Bidwell 4193 Countryside Dr Eagan MN 55123 Lofgren Heating & Air 5708 Upper 147th St W Suite 102 Apple Valley MN 55124 (952) 431-5811 Applicant/Permitee: Signature Issued By: Signature City of Ea�IIII 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: l -3(10D7 Permit Permit Fee: ' D! (1 Date Received: Staff: APR 202016 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Name: Site Address: Unit #: Address / City / Zip: ,! A Vri. j' Applicant is:-- Owner Contractor Multi -Family Building: (Yes If the project is exempt from lead certification, please explain why: 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? No If yes, date and address of master plan: OLJ.s4ti70l r ct�r s(de d.to: a �i bfic' fgrmatc; Uc f yoc1. provide specifrc reasonstf a f theyare trade'ecrefs 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. vwvw.nopherstateonecall.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. Exterior work authorized bya building permit issued in accordance with the Minnesota State Building Cc de,must be completed within 180 days of permit issuance. Applicant's Printed N4me Applicant's Signature is Page 1 of 3 c341 01 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Xs Single Family Multi 01 of Piex Fireplace Garage Deck Lower Level Porch (3 -Season) _ Porch (4 -Season) WORK TYPES _ New interior Improvement _ Addition —_ Move Building _ Alteration _ Fire Repair Replace Repair Retaining Wall DESCRIPTION Valuation Plan Review (25% 100%) Census Code #of Units # of Buildings Type of Construction Porch (Screen/Gazebo/Pergola) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Roof: _Ice & Water _Final Framing Fireplace: _Rough In Air Test Final Insulation Sheathing Sheetrock Fire Walls Braced Walls Reviewed By: Siding Reroof Windows Egress Window Exterior Alteration (Single Family) _ Exterior Alteration (Multi) _ Miscellaneous Accessory Building Demolish Building* Demolish Interior _ Demolish Foundation Water Damage *Demolition of entire building — give PCA handout to applicant MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: Final / C.O. Required t( Final / No C.O. Required I HVAC _ Gas Service Test Gas Line Air Test Pool: Footings Air/Gas Tests _Final Drain Tile Siding: _Stucco Lath ,_Stone Lath _Brick Windows 146114;7m.:ice pj Retaining Wall: Footings _ Backfil Final Radon Control Erosion Control Other: 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 2of3 PERMIT City of Eagan Permit Type:Building Permit Number:EA155981 Date Issued:06/11/2019 Permit Category:ePermit Site Address: 4193 Countryside Dr Lot:9 Block: 2 Addition: Country Hollow PID:10-18275-02-090 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 - Anthony S Bidwell 4193 Countryside Dr Eagan MN 55123 (612) 232-7549 Sandau Construction 9025 Hwy 101 W Savage MN 55378 (952) 403-9100 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA168981 Date Issued:05/11/2021 Permit Category:ePermit Site Address: 4193 Countryside Dr Lot:9 Block: 2 Addition: Country Hollow PID:10-18275-02-090 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. We encourage you to retain an electronic copy of photos until the project passes a final inspection. If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 120.50Total: 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 - Anthony S Bidwell 4193 Countryside Dr Eagan MN 55123 612) 232-7549 Rji Professionals Inc 26583 Forest Blvd Wyoming MN 55092 651) 674-5158 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA168981 Date Issued:05/11/2021 Permit Category:ePermit Site Address: 4193 Countryside Dr Lot:9 Block: 2 Addition: Country Hollow PID:10-18275-02-090 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. We encourage you to retain an electronic copy of photos until the project passes a final inspection. If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any 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 - Anthony S Bidwell 4193 Countryside Dr Eagan MN 55123 (612) 232-7549 Rji Professionals Inc 26583 Forest Blvd Wyoming MN 55092 (651) 674-5158 Applicant/Permitee: Signature Issued By: Signature