1543 Clemson DrCITY OF EAGAN WATER SERVICE PERMIT
3830 Piet Knob Road
P70. Box 21199 PERMIT NO •
Eagan, MN 55121 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•
Ordinances. Misc. Charges•
Total
By Date Paid•
Date of I nsp.: I nsp •
CITY OF piGAN •
38 o Knob Road
P. Box 21199
Eagan, MN -55121
Zoning.
Owner:
Address.
SEWER SERVICE PERMIT
PERMIT NO.:
DATE:
No. of Units:
Site mAddress.
Plumber:
1 agree to comply withpthe City of Eagan Connection Charge.
Account Deposit.
Permit Fee:
-- rchorge:
By Mise os:..---�—"''`
Date of Insp.: Total.
Insp.• Date Paid.
Ordinances.
54b 5413
no -re. c.�a.
_ .s b 5 Drt ve--
1 +or 1541(o
(o
BaLor C+.
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City of EapA
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675.5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use /d2Z3
Permit 0: —
Permit Fee: 1 1..O
Date Received; l ". J I"( 3
Staff:
467
2013 MECHANICAL. PERMIT APPLICATION
0 please submit two (2) sets of plans with all commercial applications.
Date: \ �-x� Site Address: c7 -34.b 4.C�Q,l(�. xx }cl ��iQ� .9,�Id�n� Y�'
n
Tenant: "\ \ A 'Q'(\
Suite #:
RESldent/Ow:f)er
Name: Q f(A, ''CA `( X� .t1.iN Phone: 1 x. - 1 - (Ct 411
1
\ .
Address / City / Zip: 'tib L.Jt �.IM&M 1) 4v' — (1)A,1- & Ea- Q(•VT' N\R. "Sl uloc
Contractor
Name.\ },01A. , 1. prft\f i-ED:tY t_C Q€f P( License #:
1 y:�eS-� .E.EI
Address:, ��-�� �`•� (fit'- . R.i i ,i Cit
State: nt\•n Zip: Phone; (.9S(-CMa-a�a6
,('3C.)(9.S
Contact -.�._ti OC A Email: , G4SQQACU.( ,r-Ulcp- t VJC 11CO -C.c
'Type of Work .
New X Replacement Alteration Demolition
_Additional
Description of work: (€QKg l0d e . /Y?' C cliS ('Act
NOTE: Roof mounted and ground mounted mechanical. equipment Is requlred.to ,be screened. by City.
Cede...please. contact the Mechanical Inspector fur information on permitted screening: methods.
:permit Type
RESIDENTIAL
yFumece
COMMERCIAL
New Construction Interior Improvement
Air Conditioner
Install Piping Processed
Air Exchanger
Gas Exterior HVAC Unit
Heat;Pump
_
Under / Above ground Tank ( histall / _ Remove)
Other
_
RESIDENTIAL FEES:
$60.00 Minimum Add-on or
$100.00 Fire repair (replace
alteration to an existing unit (includes 55.00 State Surcharge)
burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) = $ Q ii; ti0 TOTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank installation/removal
$60.00 Minimum(includes
(includes 55.00 State Surcharge)
State Surcharge)
51 million, please call for Surcharge
OR Contract Value $ x 1%
_ $ Permit Fee
if the project valuation is over
e $ 5.00 Surcharge*
= 5 TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. CaII 48 hours before
you Intend to dig to receive locates of underground utilities. www.gopherstateonerall.orq
I hereby acknowledge that thls information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Fagan; 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 t►l ► tl - ���
App'cant's Printed ame
x
wa(
WA)
Applicant's Signature
FOR OFFICE USE
Required Inspections:
Underground Rough In Alr Test Gas Service Test _..__.. In -floor Heat _,. Final HVAC Screening
Reviewed By:
Date:
TO/TO 39 d
dIt1N3dS'o IZ6SZ861S9 EZ :60 EZOZ/tE/tO
4111'
C!tyofEaftan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit#: I t tolea-1
Permit Fee: J Ol (P• 1
Date Received: (,O
Staff: 513
2013 RESIDENTIAL BUILDING PERMIT APPLICATION #
Date: kb - (1- 13 Site Address: r5'1o� la
1 ,, 15 1��3,is,<�B�Q��r�`�.- uD ��nit:
J
Name: a(-!/? �! TQ4!/�i1____ Phone: &(-2. 72/- S f "Od
Address / City / Zip:
Applicant is: Owner Y_ Contractor
Description of work: Ret$o t✓ io
Construction Cost
Multi -Family Building: (Yes _No _)
Company: - ( ec,, TgtC73d" Contact: � E12.3 e/)
Address: 3 o 3 „Z M rtelia c City: 1 1ttt 62,0Ir•s
State: /YIN Zip: 53-110 Phone: 61.2 - r22-/- 5506
License #: i^ - 19406 2-- Lead Certificate #: A/Af f — 24/?:17 — l
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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:
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.gooherstateonecall.orq
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.
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.
Applicant's Printed Name
Appiica s Signa
Page 1 of 3
City of Evan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
EWE
SEP 15 2014
r
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
MG.. 1960
Staff:
9—/5—/4-
2014 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date, ) I
Tenant:
Site Address: T. 11 l r'
lr�
Suite #:lt'430v ` �'J�'`` .
��_ )- �`�
Phone: � 911 —1 LI
_..
Address / City / Zip:\ CIO 6Y\ 1,0__
Name: (AriN Cis lt— License #: 1 0-t "I A
Address: (N Lt h v, .Iz City: X
State: tt Zip: c L l Di Phone: 77)9112_
Contact.
Email:
New \C Replacement Repair _ Rebuild _ Modify Space
Description of work:
RESIDENTIAL
Water Heater
Lawn Irrigation (_ RPZ /_ PVB)
Work in R.O.W.
Septic System
New
Abandonment
Water Softener
Add Plumbing Fixtures ( Main /
Water Turnaround
Lower Level)
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $200.00 if a 5/8" meter is required)
$115.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) (')
TOTAL FEES $J?C .
CALL BEFORE YOU DIG. Call Gopher State One Cali 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.aopherstateonecall.oro
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.
Applicant's Printed Name
City of Eagan
PERMIT
4111' CityofEaan
Permit Type: Building
Permit Number: EA133853
Date Issued: 11/05/2015
Permit Category: ePermit
Site Address: 1543 Clemson Dr
Lot: 22 Block: 02 Addition: Thomas Lake Heights 2nd
PID: 10-75951-02-220
Use:
Description:
Sub Type: Windows/Doors
Work Type: Replace
Description: Two or More Windows/Doors
Census Code: 434 -
Zoning:
Square Feet: 0
Construction Type:
Occupancy:
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
Fee Summary:
Valuation: 4,000.00
BL - Base Fee $4K
$103.25
Surcharge - Based on Valuation S4K $2.00
0801.4085
9001.2195
Total: $105.25
Contractor:
Great Lakes Window & Siding
14690 Galaxie Ave
Apple Valley MN 55124
(952) 891-3400
- Applicant -
Owner:
Ryan A Schaben
1543 Clemson Dr
Eagan MN 55122
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