1916 Shawnee RdCar of EAGAN
R 3795 pilot Knob RSA
C-1
Eagan, MN 5$125
Zoning. ?? MIT NO.:
Owner; DATE:
Address No. of Units:
;
site Address:
Plumber:
a lCQS'o 0 0 ? ` ..
l agree to comply with
ordinon... the City of Ea
• Son Connection Charge:
Account Deposit:
By Permit Fee:
Date of I Surcharge:
nsp_;
Insp,; Misc.
Charges:
?_ Total:
??- Date Paid:
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE
19
AMOUNT
& DOLLARS
+eo
CASH ? CHECK
FOR 7 1, (L?kr ?))
FUND I CODE I AMOUNT
Thank You
/,+} - B Y
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
CITY OF EAGAN Remarks
Addition CEDAR INDUSTRIAL ,PARK Lot Pt. 4 Blk 2
Owner F?`.
?tln?-r c_ °;,?r -Street
T;?.U
"tc4?? U
10 16800 042 02
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 1970 520.00 .1; 2 - 00 10
STREET RESTOR. 1972 556.00 55.60 10
GRADING
SAN SEW TRUNK 1968 505.65 16.86 30 969
75 -3-81
* SEWER LATERAL s?f ()A I
6707 18
r.7n 77
1 (1 .
6 36 47
A010060
4-3-81
WATERMAIN
* WATER LATERAL
WATER AREA 1977 2109.25 140.62 15 1406-20 A01 0060 4-3-81
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road Unit 1587.30 19588 6/26/80
WATER CONN.
BUILDING PER.
SAC 157500 195RA 196
180
6
PARK .
.
CITY OF EAGAN 1i'CATER SERVICE PERMIT
3795 Pilot Knob Road - 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:
1 agree to comply with the City of Eagan Surcharge:
Ordinan Misc. Charges:
Total:
By Date Paid:
Date of Ins .: 25` Insp.:
-r - g-
CITY o>F, faGAN 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 City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By Misc. Charges:
Date of Total:
Insp.: -` Date Paid:
te .. --�-
CITY OP EAGAN SEWER SERVICE PERMIT
3775 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
I agree to comply with the City of Eagan Connection Charge:
Ordinances. / Account Deposit:
(Qi Permit Fee:
B Surcharge:
y Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
•
Na ���1(�J-�/G�/�f oti Use BLUE or BLACK Ink
� For Office Us���� I
������ I I
���� U������ � � � Permit#: �
/� � w I
3830 Pilot Knob Road ��� �O�T I Permit Fee: �
Eagan MN 55122 j / �
Phone:(651)675-5675 ��; � Date Received: /� �
Fax:(651)675-5694 � I
I Staff: �
L-------- -------�
2014 MECHANICAL PERMIT APPLICATION
❑ Please submit two(2)sets of plans with all commercial applications.
Dat�:_l,V ' �° �� � Site Address: ����— I G��� �6������C.- h-� ' �C���6� � �`'�-�
Tenant: Suite#:
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' '" ��`� Name: �1.Q: �iLQ � Phone: �� D"1'-1' OI�
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�.: ;; ,� Address/Citv/Zip: ����lJ �� �lL�• � �d.i�LSI�I � (l. ��1.� �J�3 /
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��� � , �� Name:�Qf''�`1e� ��QC��I(�(ll�Z�-Q License#: �.��t`� h��6J�
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fy y � � Address: I�k I� e,11�'�,� �' �• City:��-br�S V l��l.Y_
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�,� �� State: �1v Zip: ����� Phone:����� �JI�OI� '�
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�,�,,� ���� Contact: I�l(i Email:Sh�C.1�. OL ��( �1 / I;� ��
{ � New �Replacement Additional Alteration Demoliti '
'."'T�pey,t7f'�i1f+DT� Description of work: � h�-�'1 C'JI -- j�
£ hi�ETE ��f tn�wc�b���r�gr�und na�unt$d rt���han�ca�equ�prr�ent i��qu�r��i to kkrGe s+creen�st�y C�y;
: ��de'. f�le��s�cnr�t���h�M��F��a�a��a`��P�r;#or�n�crrrna��n c�r�ermrit�d scr�nin���:f�iods.
�' RES/DENTIAL COMMERCIAL
� ` s
� „ ,F - ', _Furnace _New Construction _Interior)mprovement
y �� Air Conditioner Install Piping Processed
`.�_�+�Cltl���?��'� ��', — — —
� _Air Exchanger �as ✓�xterior HVAC Unit
�:� e��, — —
� �� _Heat Pump _Under/Above ground Tank �Install/_Remove)
���,z - ._ � Other
RESIDENTIAL FEES
�60.�3�J R4::s9mam Add or a!tsr�t�on to an existing unit(includes$5.00 State Surcharge)
$100.00 Residential New(includes$5.00 State Surcharge) _$ TOTAL FEE
�
COMMERCIAL FEES Contract Value$ ���v��� x.01
$55.00 Permit Fee Minimum /
$70.00 Underground tank installatioNremoval =$ �'J'�U Permit Fee
"If contract value is LESS than$10,010,Surcharge=$5.00 _$ �•�� Surcharge*
*'If contract value is GREATER than$10,010,Surcharge=Contract Value x$0.0005
**"If the project valuation is over$1 million,please call for Surcharge =$ �, QO TOTAL FEE
I herebyacknowledge 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 ptan in the case of work which requires a review and approval of plans.
x _��1Gf�G �Q�C� x
ApplicanYs Printed e App nt's Signatur
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