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4194 Countryside Dr41,11111 City of Eaaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Date: Tenant: Use BLUE or BLACK Ink, Permit #: V12-91 Permit Fee: Date Received: Staff: ;2010 RESIDENTIAL PLUMBING PEF MIT APPLICATION Site Address: ,CLt.P aublax- Suite #: RESIDENT / OWNER Name: S��1 h ), l 0 I Phone:1-1 5 .5 - Address / City / Zip4�`1�-A l i(i 4 CONTRACTOR CONTRACTOR I Nam - - i - 0 # 1 i Chi l Anse #: . U Qj 1 l -1J Address: .7D1A" 6 �-ve 1et1 City: A' , 1 State:` 1 \ Zip: 1.------k �0 .,P Phone: n V .--gu Can Contact: ` 1 Email: TYPE OF WORK New Replacement Repair _ Rebuild _ Modify Space _ Work in R.O.W. _ Description of work: PERMIT TYPE RESIDENTIAL Water ........... Softener Plumbing Fixtures l— Main / _ Lower Level) i Water Heater Add Lawn Irrigation (_ RPZ / - PVB) Turnaround Water Septic System New Abandonment RESIDENTIAL FEES: i $55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) (includes $5.00 State Surcharge) State Surcharge) State Surcharge) TOTAL FEES $L $35.00 Lawn Irrigation $55.00 Add Plumbing *Water Turnaround $105.00 Septic System $95.00 Fire Repair (replace (includes $5.00 State Surcharge) Fixtures, Septic System Abandonment, Water Turnaround* (add $166.00 if a 5/8" meter is required) New ($10.00 per as built) (includes County fee and $5.0q burned out appliances, ductwork, etc.) (includes $5.04 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 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 wor'9 's 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 . /ala knr- Applicant's Printed Name FOR OFFICEUSE Required lnOections: Parcel Files Cover Sheet Unique ID: 4036 4194 Countryside Dr 101827502001 City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4194 Countryside Dr Lot: 2 Block: 1 Addition: Country Hollow PID:10- 18275- 020 -01 Use: Description: Sub Type: Work Type: Description: Census Code: Zoning: Square Feet: 0 Comments: Fee Summary: Valuation: 3,000.00 Contractor: Crew2 Inc 2650 Minnehaha Ave Minneapolis MN 55406 (612) 276 -1680 e- Windows/Doors Windows/Doors-New/Replacement House 434- PERMIT City of Eaan BL - Base Fee $3K Surcharge - Based on Valuation $3K Applicant/Permitee: Signature - Applicant - Construction Type: Occupancy: $88.50 $1.50 Total: $90.00 Owner: Ronald P Trendle 4194 Countryside Dr Eagan MN 55123 Permit Type: Permit Number: Date Issued: Permit Category: Permit closed without required inspection(s). Letter sent to applicant 3/2/2010. (pi) 0801.4085 9001.2195 Issued By: Signature Building EA091225 09/21/2009 ePermit Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply of Minnesota Statutes and City of Eagan Ordinances. h all applicable State NO C/O UNTIL ENGINEERING APPROVES. (LIFT STATION) -- CITY OF EAGAN'�'� 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT To be used for Est. Value Receipt # Date sr /n/2>fre ., ,19 Site Address 4194 Lot Block Sec/Sub Parcel No. w z 0 Name Address City Phone cc 0 t- o Ucc Name Address City Phone 0w U w W w z 0— C) CC a 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 Statutes and City of Eagan Ordinances. Signature of Permittee OFFICE USE ONLY On Site Sewage Occupancy MWCC System Zoning On Site Well Type of Const City Water (Actual) (Allowable) # of Stories Length Depth S.F. Total Footprint S.F. APPROVALS Assessments Water/Sewer Police Fire Eng r. 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 A Building Permit is issued to• 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 Permit No. Permit Holder Telephone # PIgmbing ,5 1 g 'se`"��n-fh /Date yl � % H.V.A.C. Gj/ L/G, 2%2*&:.�; + �.���% Electric,// 'v, L,JL -2 E . C 9m/4/2„.1-6 Softener 6 Inspection Date Insp. Comments Footings I %/734P?(�!% Footings II Foundation Framing 77,s-47 4.77 if Roofing 4,7...4970tiii / i ,./_3 76',,,, � 4';e. io-�' ^� �5. - zet,c,, Rough Plbg. Rough Htg. ®_y Isul. O7 .fi`i OD Fireplace `.iii 4487 Lt)4 Final Htg. Final Plbg. ,..//40/4)/// P.R.V. VALVE REQUIRED Bldg. Final Cert. Occ. j,/�, f y Temp. LP f /” Deck Ftg. i Deck Frmg. Well r� c�1� ey-5CGG� (.� Pr. Disp. f j. s--g -L 4,%r57-C 644-/2- 9‘1447 - /- ! I9-069 CONTRACT PRICE: ti PERMIT # / `F Y MECHAN L PERMIT RECEIPT # "71 ` 9 CITY EAGAN 3830 PILOT KNOB R D, EAGAN, MN 55121 DATE: 9 /-,-).5/5/ PHONE 54-8100 Site Address 4/ 1"/ Lot __T Block r Sec/Sub N c Name .•W r z , ; /�N c., r,,;�10 Address i � f City c , r Phone c O Name Address City L Phone 1 , TYPE OF WORK Forced Air / 00 M BTU$) (.X) Boiler M BTU $ Unit Heater M BTU $ Air Cond. M BTU $ Vent Ah a CFM $ Gas Piping Outlets # $ Other $ FEE: SIC: TOTAL: —.; BLDG. TYPE WORK DESCRIPTION Res. ie." -New Mult Add-on Comm. Repair Other FEES RES. HVAC 0-100 M BTU - $24.00 ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU 12.00 ADDITIONAL 6 M BTU 6.00 GAS OUTLETS - 1.50 EA. COMM/IND FEE - 1% OF CONTRACT FEE MINIMUM — RESIDENTIAL FEE ' - 10.00 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 CONTRACT PRICE: Site Address tot q 1,1 6c_ PLUMBING PERMIT iN]tlfN!lr- w+ y wR FC C: 777 PERMIT # 9 c - CITY OF EAGAN RECEIPT # / 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: 9/ S/37 PHONE:.454-8100 Lot Block / Sec/Sub Name Ts Address -Si (VV c City (1.1 L `j Phone rj 1.1 4,1-1;5- m c 0 Name sr.e Address City Phone 1)1 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 BLDG. TYPE Res. Mult Comm. Other WORK DESCRJPTION New Add-on Repair RES. PLBG. ONLY — COMPLETE THE FOLLOWING: FIXTURES TOT L Water Closet - $3.00 $ I Bath Tubs $3.00 In Lavatory - $3.00 Shower - $3.00 Kitchen Sink $3.00 Urinal/Bidet - $3.00 _- _Laundry Tray $3.00 `;ta v� —Floor Drains - $1.50 4—Water Heater - $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 FEE: 4c. STATE S/C: GRAND TOTAL: o.c CITY OF EAGAN Permit No: Date: 7O Meter Na 5-3 6 Size: �C c f% P.O. Box 21199 3830 Pilot Knob Road Reader No:.1)3_471____ Eagan, MN 55121Date:%� �5 Owner. Site Address: Plumber.__ Conn. Chg: Acct. Dep: Permit Fee: Surcharge: 1 a • : e to co Tr. Plant lnply wit the City of Eagan Meter: O ances Misc.: Zoning: _ No. of Units: CITY OF EAGAN 3830 Pilot Knob Road P.O. Box 21199 Eagan, MN 55121 Owner:_ Site Address: Plumber:_ MWCC: City Chg: _ Acct. Dep: Permit Fee: Surcharge: Misc.:_ WATER SERVICE PERMIT Permit No: B/P No: Zoning.. No. of Units: Date: Date: I agree to comply with the City of Eagan Ordinances. By SEWER SERVICE PERMIT TOTAL EXPOSED ROOF/CEILING CALCULATIONS: Total exposed roof/ceiling area // 7 -, sq ft j) Total skylight area O sq ft x k) Total roof/ceiling framing area (Average 10) //7. sq ft x 1) Total net insulated roof/ceiling area / o 5 A,V sq ft x f total of ,ut, is the same as, or less than .B.C. Section 6606 (c) 1. lull C _ 0 Hull I lu, I TOTAL j) thru 1) you have met the intent of ALTERNATE BUILDING ENVELOPE DESIGN To utilize the total envelope system method, the values established by the sum of items -'3 and `14 shall not be greater than the sum of items N1 and !'2. 3. c.3 + 2. + 4. CERTIFICATI O N 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 Energy Conservation Act. RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EACAN 3830 PILOT KNOB RD, EACAN MN 55122 651-681-4675 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 /b2_ SITE ADDRESS LP `T 6 -1 -1...4d - 1S1 tWUZ. d- 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 SDv F04..00/74_, TYPE OF W RK !f92/ . APPLICANT S.L.c,oGa,-,.. MULTI -FAMILY BLDG _Y )1N FIREPLACE(S) _ 0 A 1 _ 2 STREET ADDRESS '( l dI CITY STATE,/Lu ZIP SSI 23. TELEPHONE # (05)(og3-9/7rCELL HONE # FAX # 6,50 686- 2g50 PROPERTY OWNER 14f,2' Energy Code Category (J submission type) TELEPHONE #�05/> 683 'fir COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY MINNESOTA RULES 7670 CATEGORY 1 • Residential Ventilation Category 1 Worksheet Submitted • Energy Envelope Calculations Submitted _ MINNESOTA RULES 7672 • New Energy Code Worksheet Submitted Plumbing Contractor: Phone # Plumbing system includes: Water Softener Lawn Sprinkler Water Heater __ No. of R.I. Baths No. of Baths Mechanical Contractor: Mechanical system includes: Air Conditioning Heat Recovery System Sewer/Water Contractor: Fee: $90.00 I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant Certificates of Survey Received OFFICE USE ONLY Tree Preservation Plan Received _ Not Required Updated 4/02 OFFICE USE ONLY ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-plex 0 16 Fireplace 0 21 Porch (3 -sea.) 0 31 Ext. Alt - Multi ❑ 03 01 of _ plex 0 09 07-plex ❑ 17 Garage 0 22 Porch/Addn. (4 -sea.) 0 33 Ext. Alt - SF ❑ 04 02-plex 0 10 08-plex .18 Deck 0 23 Porch (screened) 0 36 Multi O 05 03-plex 0 11 10-plex 0 19 Lower Level 0 24 Storm Damage ❑ 06 04-plex 0 12 12-plex Plbg_Y or _ N 17 25 Miscellaneous pt./MVO.%) ❑ 31 New 0 35 Int Improvement 0 38 Demolish (Interior) 0 44 Siding O 32 Addition 0 36 Move Bldg. 0 42 Demolish (Foundation) 0 45 Fire Repair ❑ 33 Alteration 0 37 Demolish (Bldg)* 0 43 Reroof g 46 Windows/Doors 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Census Code SAC Units Nbr. of Units Nbr. of Bldgs Type of Const Occupancy MC/ES System Zoning City Water Stories Booster Pump Sq. Ft. PRV Length Fire Sprinklered Width REQUIRED INSPECTIONS Footings (new bldg) _ Final/C.O. Footings (deck) -i( 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 f , Building Inspector 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 IA -4000k) / VO gi/ 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 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND To Be Used For: ,c/n541 tc„?1,7/ Site Address / ) LI L„� Valuation: Lot J Block Parcel/Sub Owner COu4 I1/7/// no se_/4 Address r/3d 1hc, / s /r/rr/ /3L City/Zip Code NLf S S y/.3 Phone 3%f/ Contractor MP//..:-' , i.;/J3o t/L Address City/Zip Code Phone Arch./Engr. Address City/Zip Code Phone # PLANS, Date: OFFICE USE ONLY On Site Sewage MWCC System On Site Well City Water APPROVALS Assessments Water/Sewer Police Fixe Engr Planner Council Bldg Offs' APC Variance Occupancy Zoning Type of Const (Actual) (Allowable) # of Stories Length Depth S.F. Total Footprint S.F. FEES Permit J -]e. Surcharge GZ.5� Plan Review 2_69,t§ SAC, City (6c3. SAC, MWCC 25, Water Conn Water Meter 07. Road Unit Treatment P1 Parks Copies TOTAL c.r J 12. It P.R.V. REQUIRED CITY OF EAGAN N° 1 4 0 41 MODEL HOME — >`?aarav-Piloturruiob Road, P.O. Box 21-199, Eagan, MN 55121 PLANNING APPROVES. PHONE:454-8100 BUILDING PERMIT Receipt # To be used for SF DWG/GAR Est. Value $125,000 Date AUGUST 12 9 87 Site Address 4194 COUNTRYSIDE DR Lot 2 Block 1 Sec/Sub COUNTRY HOLLOW Parcel No. cc w z 0 Name MCMULLEN/MOSELLE Address 430 INDUSTRIAL BLVD City MPLS Phone 378-3981 cc .0 z 00 Ucc t - Name SAME Address City Phone Uw 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 Statutes and City of%Eagan Ordinances. Signature of Permittee p. On Site Sewage MWCC System On Site Well City Water APPROVALS Assessments Water/Sewer Police Fire Eng r. Planner Council Bldg. Off. APC Variance OFFICE USE ONLY Occupancy X Zoning Type of Const X (Actual) (Allowable) # of Stories Length Depth S.F. Total Footprint S.F. FEES Permit Surcharge Plan Review SAC, City SAC, MWCC Water Conn. Water Meter Road Unit Treatment P1 Parks Copies TOTAL $2,632.25 R3 R1 V V 54 38 $ 578.50 62.50 2R9 25 100 GO 525.00 525 00 67.00 305.00 180.00 A Building Permit is issued to: MCMULLEN/MOSEL1 E on the express condition that all work shall be done in accordance with all appli le State of Miu pesota Statutes and City of Eagan Ordinances. �'` `��{ / ((c : U � Building Official 1hrtifiraIr of (!rrupanrq QCitp of Cagan Er}rttrtrnrnt of Euilbing Jna,prriion 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 ING/GAR Occupancy Type R3 Zoning District Owner of Building MICMLEWMDSELLE Building Address 4194 COUNTRYSIDE DRIVE Building Official ,d!� Bldg Permit No. 14041 R 1 Type ConstV Address 430 MISTRIAL BLVD • , Locality L2, B1, OCUNIRSC HOLUNI Date. NUMBER 2gt, 1989 POST IN A CONSPICUOUS PLACE OWNER: EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION SITE ADDRESS: CONTRACTOR: DATE: PHONE: DETERMINE WORKING SQUARE FOOTAGE OF EACH: 1. TOTAL EXPOSED HALL AREA 2. TOTAL ROOF/CEILING AREA 3. TOTAL EXPOSED WALL AREA CALCULATIONS: (Dr). J sq ft x "U" Total exposed wall area above floor a) Total wall window area: glazed sq ft x "U" 3..?oo,i sq ft .2 92, sq ft x "U" glazed sq ft x "U" b) Total door area [i g sq ft x "U" c) Total sliding glass door area: glazed b1 sq ft x "U" glazed sq ft x "U" d) Total fireplace wall area 90 sq ft x "U" 0.2 = o _454gc = 3. e) Total wall framing area (Average Mt.) »/). sq ft x "U" '0? f) Total net wall area above floor (Insulated) g) Total rim joist area �SJ / sq ft x "U" . .p4 sq ft x "U" , o'f Total foundation area (Exposed) (7) sq ft h) Total foundation window area sq ft x "U" i) Total net foundation area above grade sq ft x "U" TOTAL a) thru 1) If item `3 is the same as, or less than item fl, you have met the intent of S.P.C. Section FOOT, (c) 2. This request void/X.14/7"v 18 months from D 36913 zoz 4/ c-7 Request/ Date /` 2 Fire No. V Rough -in Inspection Required? ,. .� jgReady Now 111 Will Notify Inspec- XHome tor When Ready Licensed Electrical Contractor ❑ Owner 1 hereby request inspection of above electrical work installed at: Street Address, Box or Route No. 1 CO 01 A.+ Sec ion No. Township Name or No. 5—¢1 IRange No. Occu ant IPjiI,JcJT) aupe,i/ vii / // /�N s Address Powerpull Qr 1-a. E ! r c City 0c7C74/ County 12q !("-er Phone No. Elecal Cont -ctor (Com any Name c / �t �; C !t� Mailing Address (Contract or Owner Making In tails ion) Iv/ / 7 - �� cry � ,t) 37 cri Siontractor's License No. Authorizey, ignature (Contractpr/�� Making Installation) a°`-) 3 MINNESOTA ST :OARD OF ELECTRICITY Griggs-Midwa dg. — Room N-191 1821 University Ave., St. Paul, MN 55104 Phone (612) 642-0800 5/14//5"17 ; OUESTSee instrUctions FOR ELECTRICALfor r/Owne this formMak D 3613 £JSFe 15)//)* .51-5-r3,) RF�one Numt�er THIS INSPECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS ENCLOSED. TIon of yellow copy. X" Below Work Covered by This Request EB -00001-06 New Ada Rep. Type of Building Appliances Wired Equipment Wired XHome Fee. Circuits 4' 1 Z- Range Yi I Temporary Service 0 to 30 Amps 31 to 100 Amps Above 100 Amps Duplex Water Heater Above 200 Amps Lighting Fixtures Swimming Pool Apt. Building Transformers Dryer Electric Floating Partial -"Other Commercial Bldg. Furnace Silo Unloader Special I/;lc`i - $j .�Y L F� Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Other (Specify) Other (Specify) Other (Specify) Other Other Compute Inspection Fee Below # Fee Service EntranceSize # Fee Feeders/Subfeeders # Fee. Circuits 4' 1 Z- 0 to 200 Amps Yi I D6, s 0 to 30 Amps 31 to 100 Amps Above 100 Amps 0 to 30 Amps 31 to 100 Amps Above 100_Amps Above 200 Amps Swimming Pool Transformers Irrigation Booms Partial -"Other Signs Special I/;lc`i - $j .�Y L F� �� Remarks r1/ Rough -in `G ( ,,^ � Di 7e Ele‘c%rfir , hereby certify that the above has been made. Final • .ry Date 1/ s request void 18 months from CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION XZXXAZXXXxfl XXccWfl araaaaa a+cxcxxc c c c * NOTE: PAYMENT OF Yht. AT TIME OF * APPLICATION DOES NOT CONSTITUTE * APPROVAL OF PERMIT. * * INSPECTION OF SEWER AND/OR WATER * INSTALLATIONS WILL NOT BE SCHED- ULED UNTIL PERMIT HAS BEEN * APPROVED. * * * ************************************ 1) 2) 3) (Please Print) PROPERTY ADDRESS: 4/i t./ c Ati-ye y L � LEGAL DESCRIPTION: (Lot/Block/Subdivision or Tax Parcel IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: PRESENT ZONING/PROPOSED USE: Q COMMERCIAL/RETAIL/OFFICE Q INDUSTRIAL ❑ INSTITUTIONAL/GOVERNMENT ID # ) (Nbnth/Year) C R-1 SINGLE FAMILY R-2 DUPLEX (Two Units) El R-3 'TOWNHOUSE (Three + Units) a R-4 APARTMENT/CONDOMINIUM Units) Units) NAME: AI ota. i 1 - : ' t -fir ADDRESS:3l0 7 / ; CITY, STATE, ZIP: AIPLE 4711' PHONE: 71y36/1-4/ NAME: ,eUM IriCL_ZZOl , I /1 ), ADDRESS: 3/0.7 / Y�%� i( CITY, STATE, ZIP: /�rr/2Lgm .. PHONE: 7(- ( MASTER LICENSE# X23 For City Use 'Plumbers License: Active Expired Not recorded Staff Initial 4) .5) 6) 7) OCCUPANT OWNER NAME: I1C MULL -VA) HOS ADDRESS: CITY, STATE, ZIP: PHONE: •INDICATE= WHICH"iPERMIT"ISa BEING+ • • 'ESTER':, E CONNECTION TO CITY SEWER ISq CONNECTION TO CITY WAIF ❑ OTHER INDICATE ONE: PLEASE HO L -APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE APPROVED PERMIT TO 1, 2, 3, 4, ABOVE (Circle one) ITI r 1. «:, •, a o- r DATE:' • ' SEWERi.AND: WATER+ PERMI . PERSONS REQUIRING • $ • OOd•FEw •! i• i FOR CITY USE ONLY PERMIT # ISSUED Pd w/Bldg. Permit FEES: $ SEWER PERMIT (INCLUDE SURCHARGE) $ WATER PERMIT (INCLUDE SURCHARGE) $ WATER METER/COPPERHORN/OUTSIDE READER $ WATER TAP (INCLUDE CORPORATION STOP) $ SEWER TAP ACCOUNT DEPOSIT - SEWER $ /; ACCOUNT DEPOSIT - WATER $ tr ? S ' 7) $ WAC $ S -6 $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ $ / TOTAL RECEIPT # RECEIPT # DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? El YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: city of cagcin 3830 PILOT KNOB ROAD, P.O. BOX 21199 EAGAN, MINNESOTA 55121 PHONE: (612) 454-8100 Special Assessment Search Date: November 30, 1987 Requested by: First Security Title Re: 10-18275-020-01 L2 Bl, Country Hollow BEA BLOMQUIST Mayor THOMAS EGAN JAMES A. SMITH VIC ELLISON THEODORE WACHTER Council Members THOMAS HEDGES City Administrator EUGENE VAN OVERBEKE City Clerk On the attached form is the City's response to your search request on the identified property. The information includes the original amount of the assessments and the payoff amounts of the assessments. on the parcel. In addition, pending assessments are included for improvement projects that have been ordered to be installed by the City Council as they may affect this parcel. The City's policy is to levy assessments based upon the current zoning or existing use of the parcel (whichever is higher) as reflected in the above assessments. If, and when, the parcel is rezoned or developed to a higher use, a condition of development approval will require that this parcel assume any additional assessment obligations that have not been previously paid for existing public improvements. The City Engineering Division can provide further clarification.of this policy if you desire. WAIVER/DISCLAIMERz Neither the City of Eagan nor its employees guarantees the accuracy or completeness of the information provided which was requested by the person or persons indicated. Nor does the City or its employees assume any liability for the correctness thereof. In consideration of receiving and using information on the attached form and for all other consideration of any nature whatsoever, any claim against the City or its employees rising therefrom is hereby expressly denied. Pending assessments cannot be paid until levied. Levied assessments can be paid to the CITY OF EAGAN. Very truly yours, SPECIAL ASSESSMENTS Attachment THE LONE OAK TREE...THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY 114 TRANSACTION ID: R768 PROPERTY. I.D. SF EC 1 AL.• ASSESSMENTS •SF'EC I AL ASSESSMENTS iSMEN'TS SEAl t'C 1 SUMMARY TODAY S•l_)A1 r...." 11/27/87 FLAGS ----7 • 10-18275-020-01• • S."A. ## ASSESSMENT DESCP. `YR YRS RATE TOTAL •ANN. -F :1 N. •PAYOFF COMMENT 1.01.473 STREET W199 87.;}0i'e 112.62 .4_ti_.`_'�: 10F'491 UTILITIES 00 0 .00% 1255.84 1265.84 10P505 UTILITIES 00 0 .00% 1331.31 13 1 _1 ****** SUMMARY OF ACTIVE 112.52 22.53 *. **..* THIS YEAR'S y .... _ j 34.3,L- ****** SUMMARY OF PENDING 2h 7,.15 •1265,84'PEND 1331.31 PEND 2597.15 Pres ENTER (Comrents) , FA ar F2 (Hte d er. Form) or •F7 (Restrt R768.) 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4675 New Construction Requirements A 3 registered site surveys showing sq. ff. of lot, sq. ff. of house and all roofed areas (20% maximum lot coverage allowed) A 2 copies of plans (show beam & window sizes; poured fnd. design; etc.) A 1 set of energy calculations A 3 copies of tree preservation plan if lot platted after 7/1/93 //' / DATE: DESCRIPTION OF WORK: rl C STREET ADDRESS: 11-19 LOT: � BLOCK: Remodel/Repair Requirements 2 copies of plan 1 set of energy calculations for heated additions 1 site survey for exterior additions & decks CONSTRUCTION COST: ) SUBD./P.I.D. #: . C) v X 5 i3r °= 4,6°6 d PROPERTY OWNER CONTRACTOR Name: Last Street Address: f l /"! ti� Zip: State: S5l23 Company: Phone #: 6 57 J %S First Phone #: (area code) Street Address: License # Exp. City State: Zip: ARCHITECT/ ENGINEER Company: Name: Telephone #: area code ( ) Street Address: Registration #: City State: Zip: Sewer & water licensed plumber (required for new construction only): Penalty applies when address change and lot change is requested once permit is issued. I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicabl 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 _ Not Required BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 02 SF Dwelling ❑ 03 1 of _ plex ❑ 04 2-piex ❑ 05 3-piex WORK TYPE ❑ 31 New ❑ 32 Addition ❑ 33 Alteration ❑ 34 Repair ❑ 06 ❑ 07 ❑ 08 ❑ 09 ❑ 10 4-piex 5-piex 6-piex 7-piex 8-piex OFFICE USE ONLY ❑ 11 10-piex 0 16 Fireplace ❑ 12 12-piex 0 17 Garage ❑ 13 16-piex 0 18 Deck ❑ 14 Apartments 0 19 Lower Level ❑ 15 Lodging 0 20 Pool ❑ 35 Tenant Impr 0 ❑ 36 Move Bldg. 0 ❑ 37 Demolish Bldg.* 0 ❑ 38 Demolish (Interior) 0 GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Width APPROVALS 39 Gas Line Only 40 Gas Insert 41 Wood Stove 42 Reroof ❑ 21 Porch (3 -sea.) O 22 Porch/Addn. (4 -sea. ❑ 23 Porch (screened) ❑ 24 Storm Damage ❑ 25 Miscellaneous ❑ 43 Siding/Soffits/Fascia ❑ 44 Windows/Doors ❑ 45 Fire Repair * Give PCA handout to applicant for demolition permit Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Planning Building Engineering Census Code SAC Code No. of Units No. of Bldgs MC/ES System City Water Booster Purnp PRV Fire Sprinklered Variance Permit Fee Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit SIW Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: SAC Units % SAC Valuation: City of aaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink Permit #: C\jC1 \C:)'"fj Permit Fee: • Date Received: Staff: 2010 MECHANICAL PERMIT APPLICATION \ Date: 1-3-1 0 Site Address: L\ t9L-1 (611fthyy tic Or, Tenant: �( TC1I le - Suite #: J RESIDENT / OWNER Name: Address / City / Zip: Li 1CqFopi e'357d.3 CONTRACTOR Name: Address: 3URNSVILLE HEATING & A/C, INC. 3451 W. Burnsville Parkway Suite 120((';;City:/ y::: � State: g rnsville, MN 55337 Phone: QS L O "t `f a.,j Contact: -_( Email: Phone:l.(' S /- J 7"- a W Y License #:1-1ji 3. 3Ei 1c) 7/3 TYPE OF WORK New Xi Replacement Description of work: Additional Alteration �2c�yJu�/, Staff Demolition PERMIT TYPE RESIDENTIAL Furnace Air Conditioner Air Exchanger Heat Pu , X- ^p Other New Construction Install Piping Gas COMMERCIAL Interior Improvement Processed Exterior HVAC Unit Under / Above ground Tank ( Install / Remove) ** When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $55 TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal $50.50 Minimum (includes State Surcharge) OR Contract Value $ - If Permit Fee is less than $1,000, surcharge is $.50. - If Permit Fee is > $1,000, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). x1% = $ Permit Fee = $ Surcharge = $ TOTAL FEE 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.gopherstateonecaliorg 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. xE 1',c k Applicant's Printed Name PERMIT City of Eagan Permit Type:Building Permit Number:EA114776 Date Issued:09/18/2013 Permit Category:ePermit Site Address: 4194 Countryside Dr Lot:2 Block: 1 Addition: Country Hollow PID:10-18275-01-020 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes . Merl Jensen 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 - Ronald P Trendle 4194 Countryside Dr Eagan MN 55123 (651) 683-9175 Jensen & Jensen Construction Llp 21143 115th Ave NW St. Paul MN 55119 (651) 600-4497 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA125145 Date Issued:07/18/2014 Permit Category:ePermit Site Address: 4194 Countryside Dr Lot:2 Block: 1 Addition: Country Hollow PID:10-18275-01-020 Use: Description: Sub Type:Siding & Windows/Doors Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of house wrap and leave on site for 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. Valuation: 8,000.00 Fee Summary:BL - Base Fee $8K $162.25 0801.4085 Surcharge - Based on Valuation $8K $4.00 9001.2195 $166.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Ronald P Trendle 4194 Countryside Dr Eagan MN 55123 (651) 683-9175 Jensen & Jensen Construction Llp 21143 115th Ave NW St. Paul MN 55119 (651) 600-4497 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA131421 Date Issued:06/18/2015 Permit Category:ePermit Site Address: 4194 Countryside Dr Lot:2 Block: 1 Addition: Country Hollow PID:10-18275-01-020 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)$55.00 0801.4088 Surcharge-Fixed $5.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Ronald P Trendle 4194 Countryside Dr Eagan MN 55123 Haley Comfort Systems 122 3rd St W Hastings MN 55033 (651) 437-0338 Applicant/Permitee: Signature Issued By: Signature Receipt:#395607 3088509 Attested Copy AT P $$2.00 �IIIIII IIIII IIIII IIIII I��II IIIII III���III IIII Recorded on:9f4/2015 9:23 AM Return to: RONALD TRENDLE By:STG,D2pUiy 4794 COUNTRYSIDE DR EAGAN MN 55723 Office of the County Recorder Dakota County,Minnesota Jcel T Beckman,County Recorder CERTIFICATION OF PURPOSE OF SECONDARY KITCHEN FACILITIES WITHIN SINGLE FAMILY DWELLING I, Ronald Trendle, duly sworn and under oath, certify that I am the Owner of the one-family detached dwelling as defined in Section 11.30 of the Eagan City Code located at 4194 Countryside Dr legally described as Lot 2, Block 1, Country Hollow, PID# 10-18275-01-020. A building permit application has been submitted on my behalf to the City to enlarge, alter, improve, remodel, and/or finish the above-referenced dwelling, or a portion thereof, to include the installation of facilities for a secondary kitchen within the dwelling. The secondary kitchen facilities to be installed under the building permit are for the sole purpose of providing cooking and food service facilities for private entertainment of guests by the property owner at the dwelling. I acknowledge that the Eagan Zoning Code prohibits the existence of a second kitchen facility within a dwelling unit to serve a complete, independent and secondary living or housekeeping use within the dwelling. I certify that the installation of the secondary kitchen facilities under the building permit is not for the purpose of providing a second complete, independent and separate living and/or housekeeping unit within the dwelling. Dated: September 3, 2015 �� � Owner's Signature � Subscribed and sworn to before me this�day of � (/1� , 2015. ' JULIE AN1TA STRID Notary Publio-Minnesota Nota ublic ;�� MYCommisalonExpires,1an91,�o I hereby verify that the above said Certification of Purpose of Secondary Kitchen Facilities within Single Family Dwelling was recorded at the County Recorder's Office on , 2015. By: Its: THIS INSTRUMENT WAS DRAFTED BY: City of Eagan Community Development Department 3830 Pilot Knob Road Eagan, MN 55122 G:\Building Inspections\FORMS\Certification of Kitchen . � VJC�LVG V� �LMVn��11N i_���_ _1 � For Offlce Use --- -- I �N� ' ' 1��� �s 7 �-- � ��, City of �a �� ; Perrnit#: � � ,�,�. � Pertnit Fee: i 3830 Pilot Knob Road i ��in � Eagan MN 55122 � �ate Received: � �,���� Phpne:(651)675-5675 � staff: Fax:(65y)675-5694 !----------------� �j. 2015 RESIDENTIAL PLUMBING PERMIT APPLICATION N �� , _� . Date: . ..'J1' ..�I� Site Address:��'�'"���i'�-�/��b� � �+�."�P`�t 1`�1N �)�Z� ,.,� T Tenant: Suite#• Resident/�+vner Name: �N�j' �U�1 f�l ���-1 fl� Phone:(�)'�7,t`�."�,3' `'1 ��� Address/City/Zip: a`� �--�✓� �� �"�-� Name: License#: C411t�aCt01' Address: City: State: Zip: Phone: Contact: Email: Ty�Of WOPk —New _Replacement _Repair _Rebuild _Modify Space `Work in R.O.W. Description of work: �L�►1�(� K�"T`G�--��%.��� 1 •-1-L�J � �el'��.,._" RESIDENTIAL � Water Heater Water Softener Lawn Irrigation(_RPZ/_PVB) Permit Type �A�d plumbing Fixtures(_Main/ Lower Level) Septic System New Water Tumaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation (inGudes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Tumaround"(inGudes State Surcharge) `Water Tumaround(add$210.00 if a 5/8"meter is required) $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$ CALL BEFORE YOU DIG. Ca1l Gopher State One Ca11 at(651)454-0002 for rotection against under round utility damage. Call 4$hours before you intend to dig to receive locates of underground utilities. wvwv.caopherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start arithout a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans_ ,- —. �_ ,� �_. _ . � ,,� .:�, X xy�.: l}-�_.� � � � ,(� " t�i..�__ �''� ,� �,, �-�..^di x � E�...�,.i. Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date:� Required lnspec�ions: Under Ground Rough-tn Air Test Gas Test Final ' Meter Retated ltems: Meter Size Radio Read Manometer Staff: . Use BLUE or BLACK ink i � For Office Use � ��k-V ' � P rmit#: � � � Cit of Ea�)�� , _ � e � c� � f .�`'�� � b 9�;� . � Permd Fee: � � � , 3830 Pilot Knob Ro� � I Eagan MN 55122 �f'"' � ;;�,� j Date Received:����� � r�f � Phone:(651)675-5675 �.a t r ���� I Staff: �J`-`1 I Fax:(651)675-5694 � � � V����������������J 2015 RESIDENTIAL BUILDING PERMIT APPLICATION __ � Date• f� Site Address•�'�� ����I���f� Unit#• ('� F • Name: 1�U i�t� �US;�� ���L:� Phone:��.���� �7 'J ResidenU � � � � Owner aaaress i c�ty i z�p: �-� - U ') �' �� .,�-�. Applicant is: Owner �Contractor <�( �y �''� , ���,.��,r� '" ���,r --�y�,�� Description of work:�_C�i.�� —�.'�-� t���� �� ������^� '� ����� l��'� ��� Type of Work � �.,�� Construction Cost:$L'�O O O� o'D Multi-Family Building:(Yes /No� - �f` f��� � � �� Company:���d•.l��J�h1�=i�1 L E�t�Si����Contact: 1� � �' 1� Contractor Address: �1�'`� �� �'T City: �1 f� �`1� �' � State: l�Zip: - �. U Phone:�1�Z �Z�2�mail: `�J��'145�-'�'1,��:h.�n51T'c�`�#t�'�t ��z.�' . � License#: � G - Lead Certificate#: If the project is exempt from lead certification, please explain why: � . �v� �._T� N p �'-f-�-{ t_.fJ.. _,_ -� COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 morrths,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 documerrts that you submit are considered fo b�public intom►atian. Portions of the informazion may be ctassifi�l as nonpublic it you provide specif�c r�svns fhat wou/d permit the Crty to conclude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at 651 454-0002 for rotection against underground utility damage. Catl 48 hours before you intend to dig to receive loCates of underground utilities. www.aooherstateonecall.ora f 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. Exterlor work authorized by a building permit issued in accc�rdance with the Minnesota Building Code must be completed within 180 days of permit issuance. x � _�k�-( ��1� V�� x Applicant's Printed Name Applicarrt's Signatu ' Page 1 of 3 � (� y�C� ��1,��,1��5t���- U�` 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 _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior �(, Alteration _ Fire Repair _ Windows _ Demolish Foundation T� _ Replace _ Repair _ Egress Window _ Water Damage _ Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation � Occupancy �• MCES System Plan Review Code Edition �;����� SAC Units (25%_100%� Zoning � City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final I C.O. Required Footings (Addition) � Final/No C.O. Required Foundation � HVAC Gas Service Test Gas Line Air Test Roof: _Ice &Water _Final Pool:_Footings Air/Gas Tests _Final � Framing Drain Tile Fireplace: _Rough In _Air Test _Final Siding: _Stucco Lath _Stone Lath _Brick � Insulation � Windows ��,,��"�,,� Sheathing Retaining Wall:_Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control Other: Reviewed By: '�` , Building Inspector �� RESIDENTIAL FEES �' , x Base Fee � �".� � Surcharge � � � ��� Plan Review � � s�� MCES SAC � ;�,;'� � City SAC Utility Connection Charge ' ,,l � � ✓�`= � � � S8�W Permit$Surcharge � Treatment Plant Copies TOTAL Page 2 of 3 Dale Schoeppner From: Sent: To: Subject: ARROW LIFT ACCESSIBILITY: Bjorklund, Gary (DLI) <Gary.Bjorklund@state.mn.us> Thursday, July 14, 2016 1:44 PM 'permits@arrowlift.com'; Dale Schoeppner; DU.EIevator.ETrakit Final Approval for Permit Work at 4194 COUNTRYSIDE DR, EAGAN The ELV INSTALL permit work has been completed and approved for the following project: Permit Number: ELV1509-00078 Project ► . e: Ron Trendle Sit= Location: 4194 COUNTRYSIDE DR, EAGAN The Departm- •..Industry is required to inspect and provide approvals on elevator related devices prior to allowing them to be placed into service. An Inspector from the Elevator Safety Section recently performed an inspection of the work performed under the permit listed at the site above.The new installation is in compliance with the Department rules for elevators. NOTE: Compliance with Minnesota Rules and the ANSI/ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. CONSTRUCTION CODES & LICENSING DIVISION Elevator Section 1 PERMIT City of Eagan Permit Type:Building Permit Number:EA138141 Date Issued:08/11/2016 Permit Category:ePermit Site Address: 4194 Countryside Dr Lot:2 Block: 1 Addition: Country Hollow PID:10-18275-01-020 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - 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: 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 - Ronald P Trendle 4194 Countryside Dr Eagan MN 55123 (651) 683-9175 Home Depot At Home Services 6224 Lakeland Avenue N, #102 Booklyn Park MN 55428 (763) 542-8826 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA142973 Date Issued:05/25/2017 Permit Category:ePermit Site Address: 4194 Countryside Dr Lot:2 Block: 1 Addition: Country Hollow PID:10-18275-01-020 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 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 - Ronald P Trendle 4194 Countryside Dr Eagan MN 55123 (651) 683-9175 Appliance Connections Inc 12850 Chestnut Blvd Shakopee MN 55379 (952) 445-4803 Applicant/Permitee: Signature Issued By: Signature For Office Use / v • , Permit#:E AG N zzz---- Permit Fee: / 52 Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildinainspectionsc citvofeagan.com 2019 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: Name: c9 ti ( (2-�1�Ia t-C' Phone: f `� Rowne►� Lk\C� Coo s t ►4- t�7111/netr Address' /City/Zip: 1 `f �0 Applicant is: )(--- Owner Contractor Type of Work Description of work: !i9((/1 �1,�(��(!'S S�/�?F �� v I `�`6- yp__ Construction Cost: Multi-Family Building: (Yes /No X) Company: � ( Contact: Contractor Address: City: State: Zip: Phone: Email: License#: Lead Certificate#: 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? 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 may be classified as non-public if you provide specific reasons that wouldpermIf 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.citvofeaoan.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.goaherstateonecall.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 ap (� led),N Pr1/4— S R—VuV Applicant's Printed Name Applicant's Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA158655 Date Issued:10/23/2019 Permit Category:ePermit Site Address: 4194 Countryside Dr Lot:2 Block: 1 Addition: Country Hollow PID:10-18275-01-020 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 - Ronald P Trendle 4194 Countryside Dr Eagan MN 55123 Home Depot Usa Dba The Home Depot 2455 Paces Ferry Rd Atlanta GA 30339 (763) 852-1044 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA160481 Date Issued:03/12/2020 Permit Category:ePermit Site Address: 4194 Countryside Dr Lot:2 Block: 1 Addition: Country Hollow PID:10-18275-01-020 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 1,500.00 Fee Summary:BL - Base Fee $1500 $62.50 0801.4085 Surcharge - Based on Valuation $1500 $0.75 9001.2195 $63.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Ronald P Trendle 4194 Countryside Dr Eagan MN 55123 (651) 587-7884 Home Depot Usa Dba The Home Depot 2455 Paces Ferry Rd Atlanta GA 30339 (763) 852-1044 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA167305 Date Issued:03/09/2021 Permit Category:ePermit Site Address: 4194 Countryside Dr Lot:2 Block: 1 Addition: Country Hollow PID:10-18275-01-020 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 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 - Ronald P & Susan J Trendle 4194 Countryside Dr Saint Paul MN 55123--162 (651) 683-9175 Bettin, Inc 3208 1st Street South Waite Park MN 56387 (320) 251-2505 Applicant/Permitee: Signature Issued By: Signature