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3683 Widgeon Way Use BLUE or BLACK Ink r I I For Office Use I Permit#: v g 1 City of Eajan I I I Permit Fee: 1 3830 Pilot Knob Road ] f~' Eagan MN 55122 I Date Received: l U 1 Phone: (651) 675-5675 I ) Fax: (651) 675-5694 L Staff: - INFLOW & FILTRATION PERMIT APPLICATION Plumbing / Sewer & Water -2-r Q -5 Date: - Site Address: 1/Ct Tenant: Suite Name: SkJJQ., 4 Phone: 6)1:;A 9 ng P RESIDENT 1 OWNER Address / City / Zip: W"51~7GWAJ Name: ~A til License CONTRACTOR Address: Z q 'Su , , City: State: Zip: ~ 7LOV Phone: G 17-24o zj g 3 Contact: AM~aq, (a Email: A ct PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope) TYPE OF WORK Sump Pump Repair Repair Other: Other: Description of work: (A_ej4i 4S~ C g {`/3 Q lac) f1i aT 5,4 2 1 DESCRIPTION FEES $60.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.cityofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd. 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 ich requires a review and approval of plans. x ke it (4fc~A~ x Applicant's Printed Nam Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground -Rough-In -Final , '` tjU��c��r� � Use �LUE or Bl.ACK tnk �_�.�..�e..�_._m..e_e.,...�_�. E gor Office Use i �lU V� �� Permit#: � � l0� S�� I • � � � C.. �� , 3$30 Pilot Knob Road f Permit Fee: J �. � Eagan MN 55122 i p� ` '� j i Phone: (651j 675-5675 I �ate Received: � ! 1 Fax: (651} 675-5694 � � { Staff: � �------------------� 2014 COMMERCIAl. BUILQING PERMIT APPLICATIC3N oate: Site Address: ��7�—3(c��1- � S3 3 "3(0$� � Tenant Name: (Tenant is: New/ Existing) Suite#: Former Tenant: Name: Phane: Property Owner Address/City t Zip: 1 — 3 r - � g - � '� Applicant is: Owner �Cantractor Type Of Work Description of work:_ ��,�'`�� Consfructian Cos� �� ' Name; 1�1��1't"�.�x +'�;��'U '��y�"1 �3'`kC.. License#._�,.��,��j f� , � Address: �^S J� �� l� ��t�.�..��' Cit Gt ' Contractor ------- Y� State:_.�ft�V Zip:_c�3�� Phane: � J e� " �"�� '" � ��,� Contact: � Ut�'{° Email: U i"�" + � �� . € Name: Registration#: Architect/Engineer Address: City: State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewerlwater service: Phone#: NOTE:Plans and supporting dvcuments that yocr submit are considered to be public lnformatlon. Aartlons of the informafion may be class�fied as non public if you provide specific reasons that woutd permi�the City to conclude fhat the' are frade 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 ta dig to receive tocates of underground utilities. www,00qhersta#eonecall.orq i hereby acknow{edge that this information is compiefe and accurate; that the work wilf be in conformance with the ordinances and codes of the City af Eagan; that I understand this is not a permit, but anly an applieation far a permit, and work is not to start without a �rmit;that the work will be in accordance with the appraved plan in the case of work which requires a review and approvai of plans. X � x ApplicanYs Printed Name Appli anYs Signa re Page 1 of 3 { '�`;� � .F«� +.i"Rs`.�-� ,,� *;�.� �. � a,� ,.;,,�:?�° ,.,..._.�,�.�.�....._�..._ �...e � ��t�� A� �� P�tan�!� ,��/ ,� � � � � �i i • 3830 Pilot}Eno&Ro�d 1 ['ermit l�ee; v S� " � f Eagan MN��122 � � Phone;(654)675-5675 # �ate Rer,�i�c3: 1 Fax:�65'Ij 675-668�t � ! { Staff: { ! � ______�_v___�___..._� ��14 �ES�CDIE��AL E�t��DfN� PE�tM[T APPL[CAT14N Date:l�-1�- 1 k.� Site Address: 'T ° Unit#: t � `�a.��,� � � �`��'� �°_�°-�°J '.�..�°[��_?��,-..�...-._.,_. rnW �k�„#��, I�.�� --��1.W.�__��,.... �`�.��r�°.. ..,��. � ��E��F_ ' o � 1a�. :'�t��s � � t : �e.�rr.p v� � �,P �c� �, �i �-�e�r,e, „� g .-..,.,...:...�. ; . . > . � �� S _ � ��t'��#��&i'� �. ` ��T, , Q q` , ,s��.._ r ,i � �Q -�_.._..._.� i� �._'""_`".�"'°'°'"._'° � r `��a�-��'-',4,��..�; � �t�Y�$�-f`�`f1��E31�t'�N7t„�:�°��C3....._.�..� �`rE7lt1��!"!�: � _ {�'�9Tl�r'3��: g��'" � C+�ntractor a�aress;�`� �;.: � �� t�� : ��n�.�-� � � s�ate: �+� z�p:g��_ F�hone:�-�31-tt-?'v7�"''Ema►1: s �1 �.+ce�se#.�C�i`� `�:,�''i p � • � Leaa Certifiicate#: �-- l : k�'�,;;,��<��° ;;:�Y�i't'�:1 �.F"; €_ �� ..,-..---...-.....,.,.�....�..,_--.._m.��_-.M._...� ..,� .� .:� ,. � . �� "P., ��r��'��f'"� �E-��`� � . :'��,S°.s��o a:3"�f��.fla,�..7°ea3 rt;�":7 c��;s'��'. y< � �'43?�F'k.��°�T'E�t� �R.�A Qs1h��Y�� C�}�5��#�C��lC� �6��4��Ui€�E?f�C� � �� ' ��t�2 r�c�rrths,,h�s t,Cie G��of Eagan issued a perrrtit for a sim�tar plan based on a master lan? P _,_„Yes �No !f yes,dafe and addr�ss of master pla�: � Licensed Pi�mber: �� Mechanlcal�onfractt�r. 3�hc+ne: Sewer&Water Contractor: ��p��. � !�t?T� Pt�ac�� s ��,�^�� ;��,��r� t��r .°.��al��i�� '�� ...�. ��_ . ��r�� ,�..��:�'��i�� i��.. �� .�►�i�,��ttir�:�: �� - �F''�� _� ` =�� - � ; ��.��Fd�'1��3`�t!�3�. ��,� r� ��± ,. � � -_.�...�,...�,.�.,.. i?��Se��u il�snd to�it�i�r��iv�}�f�S nt Ut�Gter£�tpUt3d tii#t�i3E�_�aN�a�L}�Sp�i81 f�a��s��^��sr��rs�r��rF�.,�;�iblafy�r��. �ag��j��qpts9'� t hereby a�en�wl�dge that th�in��r�n��icrn is c�rnptete and accurai�,�at the wa�wi1Y be ia��onfirsrrnance wtth the ordinancea and c�3es af the�ityy c�# Eagan;it�at i unders3and th� � rsot a permit, but only an appfiicatian for a permit, an�i work is no210 sta�t w�hout a p�rmit; that the work wi11 be in accordance with the approved plan in the case of wark which requires a rsview and approva{of ptans, • Exterior work authorized by a lauiiding permit issued 4n accardance wi#h the Minnesata State Building Code must be comptet,�r��t,��. daK�Qf�ccati.L�s�s�c+�. � w �^� ` Appticant`s Printed Na x Apptica s Sign re Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA155743 Date Issued:05/31/2019 Permit Category:ePermit Site Address: 3683 Widgeon Way Lot:13 Block: 02 Addition: St Francis Wood 5th PID:10-65904-02-130 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: 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 Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 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 - Joann Kalisek 3683 Widgeon Way Eagan MN 55123 (612) 963-8236 Murray Construction Inc 10675 Jersey Ave Chaska MN 55318 (952) 941-7075 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA171407 Date Issued:08/16/2021 Permit Category:ePermit Site Address: 3683 Widgeon Way Lot:13 Block: 02 Addition: St Francis Wood 5th PID:10-65904-02-130 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: 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 Valuation: 1,500.00 Fee Summary:BL - Base Fee $1500 $62.50 0801.4085 Surcharge - Based on Valuation $1500 $0.75 9001.2195 $63.25 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 - Joann Kalisek 3683 Widgeon Way Eagan MN 55123 Renewal Andersen 1920 County Road C West Roseville MN 55113 (641) 264-4088 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA178563 Date Issued:08/24/2022 Permit Category:ePermit Site Address: 3683 Widgeon Way Lot:13 Block: 02 Addition: St Francis Wood 5th PID:10-65904-02-130 Use: Description: Sub Type:Water Softener Work Type:Replace Description: Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after started. 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 - Joann Kalisek 3683 Widgeon Way Eagan MN 55123 (612) 963-8236 Milbert Company (culligan) 1801 50th St E Inver Grove Heights MN 55077 (651) 451-2241 Applicant/Permitee: Signature Issued By: Signature