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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