1767 Meadowlark Ct12/27/2010 18:10
' City oretat
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: d■Ic i1.0 Site Address: F - 169 tI1 QQdo.OLG.+^ C c,9.%ah. mt`t rJc ( c .
Tenant:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675 -5694
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III !I
RESIDENT 1 OWNER
TYPE OF WORK
CONTRACTOR
7634326391 SERVPRO
Use BLUE or BLACK Ink
Permit #:_=3..=
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Pamdt Fee:
Date Received:
MEMO
Staff:
Suite #:
Name: Q`t Qr CM t a 1 Z^1 Phone:
U
Address ! City / Zip; 1 l (D rl f;' ctdpct.1 ts- x r k CA • 4n . rn
Applicant is: Owner Contractor
Description of worl 33'��1 �[) ��]� 11 i 1 k 1 itC1 5 td r(aYYl� IX
Construction Cost 1 : 1 660 • e C Multi- Family Building: (Yes ! No )
Name.7 rULQ i �ry a,nu License #: 0 (.1? 3` (} 6
Address: Ls) 3 11 C. mbr 't , City: t) t�1 Par
state: nirt Zip: clst.4 U Phone: (D I r 0 3 i C■ 5 S
Contact: )(},'f IAKI9 ; Email:c, Sift C�a�l .1,�,tu►��1� .C. Orr `
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit fdr a similar plan based on a master plan?
_ Yes No If yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor: Phone:
Sewer & Water Contractor;
Phone:
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.90oherstateonecail.org
•
c nt'e Signature
PAGE 02/02
Page 1 0
ii
I hereby acknowledge that this information is complete and accurate; that the work will be i • nformance with the ordinances and codes of the City �f
Eagan; that 1 understand this is not a permit, but only an application for a permit. and '" Is not to stars without a permit: that the work will be n
accordance with the approved plan In the case of work which requires a review and approv
f3
SUB TYPES
Foundation
Single Family
Multi
01 of Plex
Accessory Building
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
Reviewed By:
L-/ , / 1 kl L.E'tdD JL
. e l
DO NOT WRITE BELOW THIS LINE
Fireplace
Garage
Deck
Lower Level
Interior Improvement
_ Move Building
Fire Repair
Repair
DESCRIPTION
Valuation
Plan Review
(25 %__ 100 %4)
Census Code
# of Units
# of Buildings
Type of Construction
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice & Water Final
Framing
Fireplace: _ Rough In _Air Test
Insulation
Meter Size:
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S &W Permit & Surcharge
Treatment Pliant
Copies
TOTAL
Porch (3- Season)
Porch (4- Season)
Porch (Screen /Gazebo /Pergola)
Pool
Siding
Reroof
u✓ tri(u2
Otipm
q1
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Demolish Building"
Demolish Interior
_ Windows _ Demolish Foundation
Egress Window Water Damage
*Demolition of entire building - give PCA handout to applicant
Occupancy MCES System
Code Edition SAC Units
Zoning City Water
Stories Booster Pump
Square Feet PRV
Length Fire Sprinklers
Width
Sheetrock
Final / C.O. Required
Final / No C.O. Required
HVAC
Other:
Pool: Footings __Air /Gas Tests Fins:
Siding: Stucco Lath Stone Lath __.Brick
Final Windows
Retaining Wall: — Footings _ Backfill - Final
Radon Control
Erosion Control
, Building Inspector
26
Page 2 of 2
VILLAGE' OF EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Rood PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee:
I agree to comply with the Village of Eagan Surcharge:
Ordinan es. Misc. Charges:
Total:
By Date Paid:
Date f Insp.: ` f $' 7f Insp.:
VILLAGE OF EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning:
No. of Units:
Owner:
Address:
Site Address:
Plumber:
I agree to comply with the Village of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By: L C Misc. Charges:
Date of Irk Jr � 7j Total:
Insp.: Date Paid:
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA121692
Date Issued:04/14/2014
Permit Category:ePermit
Site Address: 1767 Meadowlark Ct
Lot:017 Block: 04 Addition: Hillandale 1st
PID:10-32950-04-017
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.
Holly Flood
1408 Northland Dr #310
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 -
Peter S Bergin
1767 Meadowlark Ct
Eagan MN 55122
Sedgwick Heating & Air Conditioning
1408 Northland Drive, Suite 310
Mendota Heights MN 55120
(952) 881-9000
Applicant/Permitee: Signature Issued By: Signature
.�
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Use BLUE or BLACK Ink
�_____--____�-.__-�
I For Office Use 1
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Clt of �a a� � Permit#: �
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I Permit Fee: �
3830 Pilot Knob Road � I
Eagan MN 55122 � �
I Date Received: I
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 � I
� Staff: �
�-----------------�
2014 COMMERCIAL BUILDING PERMIT APPLICATION
Date: I �I S � Site Address:
Tenant Name: jM z �d\d v.., \�.Y� �;����� � v+ g�
Tenant is: New/ [� Existin Suite#:
Former Tenant
Name:_�c s cM.ti`n�- �, ��ei �� � !1 Phone:
Property Owner Address�Cit �Zi i �> ���� , ! �
y P� 3 � b �1, �7b'� l '� bS t '9( `3� 17b\ � 1'15 �1 l?S?
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Applicant is: Owner Contractor c�.�w�h� �,�—�
Type of Work Description of work: SF� . �.. 1��r�N 1 h���,,�z��
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Construction Cost:���.�1i�'
Name: C Kt V�vr���� ��� C o v.i�''y c���� License#: (���5.� C
COntraCtOr � Address: Z �'7`� �/�?�����i rr� Q�- City: V; c�,'1`���
State: � h Zip: �S 3 �' b Phone: G S� " d �� " �� rv b
Contact: %e �'�'� z.�. Email: .�. � .�1 �.�- �O L_�.�w�
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Name: Registration#:
Architect/Engineer Address: City:
State: Zip: Phone:
', Contact Person: Email:
Licensed plumber installing new sewer/water service: Phone#:
NOTE;Plans and supporting documents fhaf you submit are considered to be public information. Portions of'
the information may be classified as non-public if you provide specific reasons thaf wou/d permit fhe City to :
:conclude that theyare tratle secrets.
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 w rk w II be in conformance with the ordinances and
codes of the City of Eagan; that I understand this is not a permit, but only an ap c tion`for a permit, and work is not to sta�t without a
permit; that the work will be in accordance with the approved plan in the case of r whi h requires a review and approval of plans.
x `✓�e � t�� g v� � ��e•^) x
Applicant's Printed Name ApplicanYs Sig
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