3872 Dolomite DrCITY OF EAGAN WATER SERVICE PERMIT
3,795 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•
1 agree to comply with he City of Eagan Surcharge.
Ordinances. Misc. Charges.
Total •
By P' Date Paid.
Date o Insp.: Insp •
CITY OF EAGAN SEWER SERVICE PERMIT
,3795 Pilot Knob Road PERMIT NO •
Eagan, MN 55122 DATE•
Zoning: No. of Units -
Owner:
Address•
Site Address:
Plumber:
agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit•
Permit Fee:
Surcharge•
By Misc. Charges•
Date of Insp.: Total•
Insp.: Date Paid•
1
1
46'City o(Eataa
3830 Pilot Knob Road
Eagan MN 66122
Phone: (661) 61$-8615
Falx: (681) 8754884
Use BLUE or BLACK Ink
Fee OOka Use
Pemrit l ee:
10r-5-35
Data Received: `T (14 -IM -
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Dat®: 1-/- 9 - /11 Site Address: 3 lr7 1L'/1 i TE Drs . Unit*:
ReSldantl
Owner
Name: e% 4i. /i%'b,.i 4 6 £ 1K 147— .� .,1 c. Phone: 763 - S-7 3'- 9 7 7
Address /City alp: /SO IS E t s97'u 2 qv, A fi A acorn, Veal r•/5,i)
S 4'L7
Applicant is: Owner 4Contractor
YTpe'aF-Work,
Cogitator
Description of work: R 4-P4 4 C r- Mat r. PL t i.J/,J tont-:'S
Construction Cost
Multi-Famly Building: (Yes / No _J
Company: {c!) £ 1 E,:cr Le,02 Mei JT . Cs,Pit Contact NW r t3 gda-Q'S
Address: 4/Ps- t..) foo . Cor: /ti! Pt-
Stets:
t
State: PI ALS Zip: 55'4/19
License #: L Z Y/ / 3 /
Phone: /Pi z 8(o-Ge?ef.3
Lead CarWicatDe #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
ibLA10,S- 11.E/L'r- Poste Js7r
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 plat?
_Yes _No If yes, dabs and address of master plan
Licensed Plumber: Phone:
Mechanical Contractor. Phone:
Sewer & Water Contractor: Phone:
NOM Ploile
r ..� -.,,_ _
CALL BEFORE Y_QU MG, Call Gopher mate One GA et (851) 454-0002 for protection against underground utility damage. Call 48 hours
before you Intend to dig to receive Locates etunderground unties. www,4oingmstateorrensll.or+q
I hereby adcnowbdge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Fallen; that r underattand t hie is not a paamit, but only an application kr a permit. and work is not to start Mthout a permit the rhe work wit bus In
accordance Met than approved pian In me case or work vrtmich molar= a review and approval or piens.
Exterior worts authoriamed by a Wilding permit Issued in accordance with the Minnesota Strew Bulld njCoda must be completed within 180
dors of permit Issuance.
x 4 a4 /2& z.Q.,f
Applicant's Printed Name
8T/OT 39vd
Applicants Signature
Page 1 01 3
1NIGW 1X3 I3g L9Z9198ZT9 9T:bI PTOZ/TT/t'0
41/k
C!tyofaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Permit Fee:
Date Rdceived:
Sta
2011 MECHANICAL PERMIT APPLICATION
Date: ' 134/ Site Address: 3F 7 Dia r 1, CD'1
Tenant:
Suite #:
RESIDENT / OWNER
Name: L r aS t. e.�, LSF / CUA -‘.12.' Phone:
Address / City / Zip: 3r%D- 06 l() n.. t - ,-t, 1
CONTRACTOR
Name: Pc, b r E a,t S4p Q..� CP License #:
e Ue
Address: L` d .' Lk, S4 City: k, �vt,
J�U(1 L4 Phone: £S' '
State: N Zip:/ -)- -` 6 ' .C.S30
M
Contact: Pe ,---e,._, Email:
TYPE OF WORK
New Replacement Additional Alteration Demolition
Description of work: //45 qict 1 3c s 1‘"tc3x1 if /Cy3 -+
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on`permitted screening methods
PERMIT TYPE
RESIDENTIAL
Furnace
COMMERCIAL
New Construction Interior Improvement
Air Conditioner
Install Piping Processed
Air Exchanger
Gas Exterior HVAC Unit
Heat Pump
Under / Above ground Tank (_ Install / _ Remove)
1
Other 0.J IG� to ,,,`t,"
When installing/removing tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$55.00 Minimum Add-on
or alteration to an existing unit (includes
bumed out appliances, ductwork, etc.) (includes
$5.00 State Surcharge)
$5.00 State Surcharge) $ TOTAL FEE
$95.00 Fire repair (replace
COMMERCIAL FEES:
$75.00 Underground tank
$55.00 Minimum (includes
installation/removal OR
State Surcharge)
$10,010, surcharge is $ 5.00
surcharge increases by $.50 for each $1,000 Permit
Fee requires a $ 5.50 surcharge)
Contract Value $ x 1%
= $ Permit Fee
- If the Permit Fee is Tess than
Fee = $ Surcharge
- If the Permit Fee is > $10,010,
(i.e. a $10,010-$11,010 Permit
= $ 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.gopherstateonecall.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.
x
Applicant's Printed Name
x
Applicant's Signature
`FOR OFFICE USE
Required Inspections:
Reviewed By.
TestGas.ServiceTest, In floor Heat
erior'; HVAC Screening inspect'
CITY OF EAGAN WATER SERVICE PERMIT
3795, Pliot 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•
I agree to comply with the City of Eagan Surcharge.
Ordinances. Misc. Charges.
Total.
By Dote Paid.
`
Da e of p.: G 0 VI 77 Insp .
CITY OF EAGAN / SEWER SERVICE PERMIT
3795 ,Pilot Knob Road PERMIT NO •
Eagan, MN 55122 DATE -
Zoning: No. of Units•
Owner:
Address•
Site Address:
Plumber•
1 agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit•
Permit Fee•
Surcharge•
By Misc. Charges•
Dote of Insp.: Total•
Insp.: Date Paid•
/ •.3974 / 35/2J. i/
r / 1
410'City otEke
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 678.4676
Fax: (651) 67566$4
Date; •
Use BLUE or BLACK Ink
imr
For Office Use /
Permit* l! ; / o0'
hermit Fee: ;7. 4)55
Data Received: 11 /I 543
3
Staff:
4,!
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Site Address: 3nJ 3$70, le72,3?79 tSo4.ow,rz Aa. Unit#:
Choler
Name::/ u9 C 7- "4 A 4. Al t v i .x+) C Phony 743 - tS 3- 9 7 70
Address / City / zip: 7S-0 zr e A 7-v Q Av A) 'a` ,2 A aaoi b E.J i//K
mss S3'ylr7
Applicant is: Owner Contractor
Description of wont: • r.412 or -F2 a 1 L -
Construction Cost 1/ 9 00, Gr°
Multi -Family Building: (Yes )C / No
Company i&! P Contest knew, Is TS. (J ' S
address: 4/0 s tc) 64).6. S7 . City: m PG S .
State:/Y%c 1 zip: .3T 9i 9
License #:.!0C .*Y!/3/
Phone: 4'11- r6' -G x Y3
Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
QtLi,I,S L L2( QuldY Porti' 197 S
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has Me City of Eagan Issued a pemnit for a similar plan based on a master plan?
Yes No If yes, date and address of master plan:
Licensed Plumber. Phone:
Mechanical Contractor. Phone:
Sewer & Water Contractor Phone:
1
CALL. BEFORE YQU DIG. Call Gopher State one Cali at (651) 454-0002 for prot cl on aga A$t underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.goaherstateonerau.org
I hereby adcnowledge that this information is complete and accurate; that the work wit be In confom ante 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 to Mart without a permit that the woi t iota be in
Beeordenne with the approved Wan In the case of work reach requires a review and approval of
Exterior work
dots of peckwitholted by a building permit Issued in accordance with the Minnesota State autldin Code must be computed within 180
x VAviN u a.i3
Applicant's pn Name
Z0 / TO 39tid INIVW 1X3 I3a
x
Applicant. Signature
777
Page 1 of 3
L9Z9T98ZT9 OZ:ZT ETOZ/tT/TT
411INF City
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 6755675
Fax: (651) 675-5694
FA
3--? _
Use BLUE or BLACK Ink
For Office Use
Permit #:
)1, W
Permit Fee:
Date Received:
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
7 4./ site Address:
Mag, 3sg70 3771, 3¥ )4f 62. Unit 6:
Resident/
Owner
Type'of.Work,
Name: eh) 4e, Aff,3 46t N<iA.3 + r
Address / City iZip: :SO b1C34-r-u2 Av, , lA
Applicant is: Owner KContractor
Phone: 7k3 - si3- 97 7
oLD£:J V L Y /QA)
spy. 7
Description of work: R£KO E a' 4.4 P °Kf - J,'' ',) /o 6 F
Multi -Family Building: (Yes 2C / No
Construction Cost / 4 Y • CN
Contractor
Company. g £ 1 E,r ER/ c 2 /Aft kr-r . &2� Contact Da✓,
Address:
YDS. w tDo# S- City: h'/ Pi 5
State: /VAS Zip: SS -y/ C/ Phone: 1pi ,Z ' b' (r' / - Lo 2 S/ 3
License It: 4 �- ZIP / 3 / Lead Certificate #:
J
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
(11-4/0s. Pos,- /77r
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 pian?
Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor.
Sewer & Water Contractor:
Phone:
Phone:
CALL BEFORE YOU DIG. Cap Gopher State One Cali at (651) 4540002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.000herstateonecap.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 1 understand this is not a pormit. 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 Build n Code must be completed within 180
days of permit issuance.
x I./
Applicant's Printed Name
x
Applicant's Signature
/ 4',x77 �)
Page 1 of 3
C!tyofEaaali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit # /07,69(
Permit Fee:
2014 RESIDENTIAL PLUMBINGI PERMIT APPLICATION
Date: \6VA\A Site Address: 3? -)-1 7 bb\b''smc,A
Tenant:
ResidentlOwner
Name: L10.\ �1CIS`C��t}`C (;( Phone: �� 1- `1 37 - n 3
Address/City/Zip: 3P12 UU,bm\li N- . .OECU�l c5c3\72
Contractor
Name: \V\c)TbanAm License #:.Pa4�FD .►.\3
Address: R0 C) t) q5 KGCity: \ A
State:') Zip: 5032 Phone: 37) (-1213-- Li'l 81
Contact: . '(\5 1X.‘a)\1 Email: bawr-\► lg. 1 • v
Type of Work
New 1 Replacement Repair Rebuild Modify Space Work in R.O.W.
_
Description of work: Vir ksc'1( l iji
_ _ _
l k) \\--h L G (XX \v-, 11.„00
Permit Type
RESIDENTIAL )
Water Heater
Water Softener
Lawn Irrigation (_ RPZ / PVB)
�+
X Add Plumbing Fixtures ( X Main / Lower Level)
T
Septic System
_
Water Tumaround
New
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater,
$60.00 Lawn Irrigation
$60.00 Add Plumbing
*Water Tumaround
$115.00 Septic System
Water Softener, or Water Heater and Softener
(includes $5.00 State Surcharge)
Turnaround* (includes $5.00 State Surcharge)
and $5.00 State Surcharge)
TOTAL FEES $ ID —
(includes $5.00 minimum State Surcharge)
Fixtures, Septic System Abandonment, Water
(add $200.00 if a 5/8" meter is required)
New ($10.00 per as built) (includes County 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.aooherstateonecall.orq
1 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.
�V un
App icant's Prints Name
x
Applicant's Signature
FOR OFFICE USE Reviewed By:
Requited Inspections: Under Ground Rough -In Air Tes
Meter Related items: Meter Size Radio Read Sty
City of Eagan
PERMIT
City of Eaan
Permit Type: Plumbing
Permit Number: EA130536
Date Issued: 04/29/2015
Permit Category: ePermit
Site Address: 3872 Dolomite Dr
Lot: 29 Block: 01 Addition: Briar Hill 3rd
PID: 10-14992-01-290
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.
Applicant: Troy Good
3670 Dodd Rd
Eagan, MN 55123
Fee Summary:
PL - Permit Fee (WS &/or WH) $55.00
Surcharge -Fixed $5.00
0801.4087
9001.2195
Total: $60.00
Contractor:
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
- Applicant -
Owner:
Dale Sanford
3872 Dolomite Dr
Eagan MN 55122
(651) 785-4787
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:EA155422
Date Issued:05/15/2019
Permit Category:ePermit
Site Address: 3872 Dolomite Dr
Lot:29 Block: 01 Addition: Briar Hill 3rd
PID:10-14992-01-290
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Dale Sanford
3872 Dolomite Dr
Eagan MN 55122
(651) 785-4787
Burnsville Heating & Air Conditioning
3451 West Burnsville Parkway, Ste. 120
Burnsville MN 55337
(952) 894-0005
Applicant/Permitee: Signature Issued By: Signature