4595 Oak Pond Rd? CITY OF EAGAN
` 3795 Pilot Knob Rood Eagan, MN 55122
? '-PHONE: 4548100
N2 4539
- BUILDIN,?"a PERMIT Receipt #k --i I <)?
0 t, ? 000 .
To be ured for ''.t:.;i? tD house Dote
Site Address f kd. Erect ? Occuponcy
,
Lot Block Set/5ub. T-ak-iar;nd 11111s Alter [,.] Zoning -
'?/?. ; `;•„ 17){) {;.) Repoir ? Fire Zone ?
Parcel # - -
Enlarge ? Type of Const. V
oc Name a....Y • r: .. . .._ :, _ . Move
W . . '. , , ? tories
3 Address ??:1 i f f Demolish ? Front ft.
0City Phone ?'+- Grade ? Depth ft.
p Name a1 ter Lhrs+s+in APVrovolr
Address Assessment
Water & 5ew
~ Ci Phone
Police
F Name
Fi
?w re
Address Eng.
Q W Ci Phone Planner `
Council _
I hereby acknowledge thot I have read this applicaYion and sta;e that gldg_ pff. _
the informotion is correct and agree to comply with all opplicable
State of Minnesoto Stotutes ond City of Eagan Ordinanc?' APC
Signature of Permittee
A Building Permit is issue
oll work shall b= done in
Building Official
Surcharge ?-
Plan check
SAC
Water Conn.
Water Meter
Total 24.?0
Aa jgen on the express condition thot
Stote of Minnesoto Stotutes and City of Eagon Ordinances.
?MSk # Deh Iswed PmEMIN
Plumbing
Mechanical
INSPECTIONK ? DATE INSP. Rough-In Fkwl
Footings Date Insp. Dote Irop.
Foundotion _ Plumbing
Frome/ins. MecFanical
Finol i [?i7
CITY OF EAGAN Remarks? A-SO "
Addition Lakewood Hills Lot 15 Rik 1 Parcel 10 44354 150 00
Owner VcF,u + I n - Street --&7$ No: -LakewOot-- -Hi1,18-"&:-State Eagan, MN 55123
? Improvement I Date I Amount I Annual I Years I Payment I Receipt I Date
SA N
WATERMAIN
WATER LATERAL
WATER AREA
STORM SEW TRK
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
EAGAN TOWNSH' P
BuILDIf`!G PERMIT
Ownex.-?,/-_.L???
Addre (presenf)/ ---- ?.`.....?..??.P"t?..<!XR!--'-Y?/ ?
_._
----------- ----------------
Builder _._.....-[?!!'a,- ------------ -
Address _----------- -----....._.._--........---__.___------------`---
DESCAIPTIOPT
182
Eaqan Township
Town Hall
Da3e%!{.??^J??.:
Sioxies To Se Used For Front Depih Heighi Esi. Cos! Permi! Feel Remarks
/ ??1Sta%?r?!?2 ?d I ? ?
LOCATION '
This pefrnA does no2 aufhorize the use of s3reels, roads, alleys or sidewalks
the righi !o create any siiuation which is a nuisance or whiah presenis a 6azard
general welfare !o anyone in ihe eommunity.
THIS PERMIT MUST BE KEPT O PR MIS ?WHILE THE WORK IS IN
This is !o ceriify, ihai.. ?. }.y.'.'?..? . . . .....lr_. .--------- haspermission !o eree
the above descrihed ?reudse ' the
pxovisions of the Building Ordinance
1955. .,?
Chairman ef To ard or
................... . .. _.- - ... .......__..---.-' . . '-----......_... Per ........... _--
nor does iYgive the owner os his agenf
Yo the heellh, safeiy, convenienae and
PROGR 5.
f e---. _ -- --------- ?-----'-"-----....__...._upon
for Eagan To ip adaaled April 11,
Suilding Inspeeios
E/AGAN TOVt/N SHI P
BLlILDIiVG PERMIT
a i 9f /,
Ownex ?/T._.
Address (preseni) ....:?.".'" d
Builder ?/' .. " . -l_YP?d1.[.
-- -?./
Address ----- _--'------ .T..
DESCAIPTION
183
Eagan Township
Town Hall
Da!
SYOries To Se Vsed For Fron! Depih Heighl Esf. Cos! Permii Fee Remaska
LOCATION "
sf.ve+ n..oa ... ..a?,e. ne...;.,?;.... .,f T..cAr;on I Lof I Slock I Addifion or Traci
/p_ I _ I 4 //??,- ?
ThisAmil does noi aulhorise the usa of streefs, roads, alleys or sidewalks no: doerit give the ownar or his agen!
the righ2 Yo create any sifuafion whieh is a nuisance or which presenls a haaazd fo the heellh, safety, conveaienae and
general welfare to anyone in i? commuaiYy. „
A .
THIS PERMIT MU5T BE ?g{g, PT,ON THE P IS ,WHILE THE WOAK IS IN PROG
This is !o cerfifp, ihai.__'!'x??.?.__has permission io ereet fl....,%? -- -'--?. -....__........._."..upon
the ebov described e7t?ise sub'e " rovisions of the Building Ordinance for Eagan Towns adopled Apsil 11.
1955. ? i
_....._......._.._.......'...'..'._".___.._.... ._'._......_."'......._'.__......
.......-----......-- -- ?? . _ ?Per
hairm an of Huilding Insp_eclor
EAGAN TOWNSHIP
BUILDING PERMIT
Ownei ..... )U:.*.!p?-.... ?......." .._........°? _'?--------....-'-`-'--
.....
Addsess (Preseni) .....Q..?.S.... ? .... G4...-?-.? .....................
Builder .../..CE.4.A..:iu.`:!?.------....... _..
l' g -
........ -
Addzess
??-:`+?G.........._?.?..?'.? ..............a?4................................
DESCRIPTION
N° 2876
Eagan Towaship
Town Hall
Dale..10.-3d
..----`
5taries To Be Used For Fron! Depih Heigh! Esf. Cost armi! Fee Aamasks
,at..ce
LOCATION 4 1/1 Sn 5ireet, $oad or ofher Description of Localion I Lo! Block Addition or Trec!
/o
Thls permi2 does aot aufhorise the use of slreefs, roads, alleys or sidewalks aor doec it give the owaer or !us agen!
the sfght io ereafe anp silualion whieh is a nuisanee ox whieh psesenfs a haaard !o the healih, eafely, convenieaee 8ad
geaeral melfare !o anyone ia the community.
THIS PERMIT MUST BE,{CEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS.
Thia is to certifp. !hal---l? ...... ...... . .?.. . --
_??1?-.._'?._6aspermission !o ereei a_.-_?'??:..?'_?................-----.._.._upon
the above deseribed premise ubjeci fo the provisions of the Suilding Ordinance for Eagan Township adopted April 11.
1 . 955 .
. ,?7"`,,--z?
.^.?. . . ft.-. .`.'.'? ._.._ ?`?.^?..........." - Per "- .....-"•i:?-'--'_
....-- --....1.^.
... ...............
Cheirmaa of Tnwn Board Building Inspeefor
??
viLLacr: or Eacata
379$ Pilot Knob Road
Eagan, rtinnesota 55722
PEAMTT NO.: 306
TYie Village of Eagan hereby granta to Robest E. ForgiueoA
of 8,55 C11PP Road,y,Eagatt 55123 _
a DTIIMRTN(} , Permit for: (Owner) Fergusoa's edditim an home
at _ 855 (114fr gnsd , pursaant to applicat:ton dated
?
Fee Paid: $5_00 dated this 11 th day of Jatiuars , 19 73
.50 s/a
Building Inspectar
'riechanical Permits:
Did Total:
VILLAGE OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
_ PERI4IT NO.: 299
The Village of Eagan hereby grants to Robert E. Ferguson
of 855 c1ift xoaa, Eesan 55123
apATINQ Permit for: (Owner) Eergueaai addltion au home
at 855 C11Yf Road , pursuant to application dated .
Fee Paid: ffi5,0 0 dated this 11th day of JenuarY , ?9??•
.50 s/c
Duilding Inspector
-Ntechanical Pexmuts:
Gid Total:
CITY OF EAGAN
3795 Pilot Knob Rand Eagen, MN 55122 N2 4539
• PHONE: 4548100
BUIIDIN
fa PERMIT APPLICATION Receipt # 7790?
, $6,000.
To 6e used fer AddA t0 hOISE Date n..t..l.e.- lo , 79__a7
Site Address
- Q
?lif€ Rd. -- Erect ? Occupancy I
Lot1r2 Block_ L Sec/Sub-LgkEwpp?iLil],S Alter [a Zoning Rl
10 44350 150 00 ReDair ? Fire Zone 3
parml #
E
l of Con
T t
V
n
orge ? ype .
s
a Name Ro be.r-t E=Ter-gtiygR Move ? # Stories
; R
Add SS Cliff Rd Demolish [] Front 14 ft.
ress
b Ci EeRBII Phone 454-3909 Grade ? Depth 18 ft.
'---- ''
p Name Wal tar niinnlng
?
?u Address -
F ,.,- Rosemount p,,
Nome _
Address
I hereby ocknowledge that I have read this application and state that
the informotion is correct ond agree to comply with all applicable
$tate of Minnesota Statutes onj/City of Eagan Ordinance
Pssessment _
Woter & Sew.
Police -
Fire
Eng.
Planner _
Council _
Bldg. Off. _
APC -
Surchorge 3.00
Plan check _
SAC
Woter Conn.
Water Meter
Total 24.w
Signature of Permittee • ?YC7- I
A Building Permit is iss d to' '110b8Ft E b'g?' U8?H on fhe express condition that
oll work shall be done in accord ce with II able Stote of Minnesota Stotutes and City of Eagan Ordinances.
Building Officiol / -'., x _.?/ -
/ 5-
SUBD.
C)
CITY USE ONLY
L
ir?P
RECEIPT #: ? 01
RECEIPT DATE: -
PERMIT #
1999 PLU14IBINC PER14ITT (RE5IDE1N'fIAL)
C1TY OE' f.ElfiRN
S$SO i'ILOT KNOB RD
gAfiAN, MN 55122
(651) 681-4675
Please complete for: ? single family dwellings
Y townhomes and condos when permits are required for each unit
• backflow preventer for underground sprinkler system
FIXTURES
EACH #
TOTAL
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
G2S i in oUtlet ' minimum -1 3.00 x = $
Hot tub/s a 3.00 x = $
Kitchen sink 3.00 x = $
Laundr tra 3.00 x = $
Lavato 3.00 x = $
Minimum fee alteretions to existin dwellin 30.00 x = $
Private Dis osal S stem new/refurbished " re uires MPC iic. 75.00 x = $
Private Dis osal S stem abandonment 30.00 x = $
RPZ new install2tion/re air 30.00 x = $
Rou h o enin 1.50 x = $
Shower 3.00 x = $
Under round s rinkler if dwellin is under construction 3.00 x = $
Under round s rinkler if existin dwellin 30.00 x = $
Water closet 3.00 x = $
Waterheater 3.00 x = $
Water softener If dwelling under wnstruclion 5.00 X = $
Water softener if existin dwellin 30.00 x = $
Water turnaround 30.00 x ---- _ $ 30,00
State Surchar e .50 --> ----> ----> $ 50
TOtal -->
--> >
---- .... > $
Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc.
---•------------•----------------•• -------------- -
---- ---------- ------------------------------------------
I hereby acknowledge that I have read fhis application, state fhat fhe infortnation is correct, and agree to comply with all applicable Cityof Eagan ordinances.
It is the applicanPS responsibility to notify the property owner that the City of Eagan assumes no liabiliry for any damages caused by the Ciry during its
normal operational and maintenance activities lo the facilities constructetl under this pertnit wilhin City property/right-of-way/easement.
SITE ADDRESS: S S S M.?a ,
OWNER NAME: : [Z(t,(,P,oi? ?jy?????p?? TELEPHONE #:
?? ? (AREA CODE)
^
INSTALLER NAME: TELEPHONE #: G51/ C11S9" 15_6-5
p A
STREETADDRESS: (AREA CODE)
?i1L/?'yJypL??CITY: _ rSTATE: /77 /L/ ZIP:
(?[t?m ?e- .n e o?.e,?-rr7
V^
SIGNATURE OF PERMITTEE
$ L,ot IS_ IIlock,(-.)0 PID k
Plat 1--akf wa)? 1?n 1?5
Sewer /water permit # ?7
Date ?'?? - l 1 Receipt#
CITY OF EAGAN
1999 SEWER AND WATER CONNECTION AND AVAILABILITY CHARGES
EXISTIPIG RESIDENTIAL PROPERTY
Sewer
Lateral chazge @ $21.85/ff $
Trunk @ $880/connecdon
City SAC 100.00
Base SAC 1,050.00
Date paid
Receipt #
Account deposit 15.00
Sewer permit & s charge 50.50
Subtotal S
g Total
Sewer and Water
permit & surcharge
Lateral charge @ $22.10/ff
Trunk @ $920/connection
Water supply & storage
Date paid
Receipt #
Treatment plant
Water meter "Inspec ' ns req'd prior
to issuing
Accountdepo
Water pe X& surchazge
Sewer ]ateral chazge @$21.85/ff N? Pat 6?,,
Water lateral chazge @$22.10/ff
Sewer trunk @$880/connection Y C(rS V
Water h-unk @ $920/connection { D T
cicy snc 100.00
Base SAC
Date paid Receipt #
Water supply & storage
Date paid Receipt #
Treahnentplant
Water meter "Inspections req'd prior to issuing
Account deposit
Sewer and water permit & surcharge
Subtotal
Plumbing permit & surcharge
Total
1,050.00
Water
825.00
468.00
114.00
15.00
50.50
S
30.50
$
me?
38r?-93?g
38 11-q378
Sco N N
51}?ol-IU50
sACq1-103950
825.00 WGog N
468.00 WTR-M-F
114.00 W M ETEOL
30.00 ACGDEV
100.50 50-5aRM 5o-wP£CM
. SO Sw'ay`Ag
$ L4 KA $-I -SC)
30.50
$
OFFICE USE ONLY
Propertyowner
Address ?0 Cl-(Q
Phone number r`C? G V?ff I ??
Plumber ?0.??
PRV required:
R-O-W Permit:
Unpaid
Permit Fees:
City financed:
y?s
City/* Counry 'v/+
C%:T4' 4F f::A!;Ah?
t.',A.`i;F:f.?R^ lS tE:FiMIP.lfil_ fdCi: `.-?,-3`i
ilATEli 08i27/99 i.Till'.i.e f)^d'ci':lic:I.Ct
.%
i.!A:•,f"o K,11F:T A? t_AkSWd
CI_.Cl:rF R(i 800.00
.'.iE:I..?.l. `_'.'.?N:; F"_?.`:? ':.I._:[F?'f' '?iJ1 .`:`c.'.0.1.]f.)
CI.:.;:rr; ?;:C? I.UC1???0
,"-_?:P:,i c;r@s;tn
,
3t'S°i t;I...Ii:G: p?Y? 1y?'i3`.J.So
,?,?.,;..,, .?.
3446 ..1?_?:.. :,, ?-
o...lJ ?, ? ;r_
.I....I I pi :
.I. 1.0...`.;C?
'..''_
3F,:::,.., 920J
ti:.
.
?_:-...,...i .
...?.
'i.....r.r. ? ?
.? n.. tlri?`J.C)I.)
3668 9i..'2L 855 C:!...:Ci i= i=]:i 468,.00
3714 'i)'r'20 055 CJ._IFF' R.i.t 1.WOt7
,?••"; 9220
ac, ??
ti;i:"i
C'I....i.f F
I?l?
30,.00
3743 9220 t>55 c,...rr T .r,,n 50.00
CF`.i1E60Si6±' Y;* i::Ou*;'INUS:
I..fS.'i.Fi ...;i::
Jfiih: +•-
'm'>k .,'?.)Ni'TiJUlr..
?k?:t?{y/,Yn:'?'t>;t'l,? y?i*:?F?k X<Yr:Y,:lisk:?n ?.?;4:yi:?'Y•:?F:F>F :??F?ra..?,:?F>X:?YF. ??k
::f.'rY nr !:Ar::n=,
:.:ASHlEi!;, 38 -rri;Ms.NAt_ rJtJ: 905
,,..,...:, , t:li3, c_.,._.',,.. _
:,i:t*t?::.:
?
„!1 k..
I%
NnMe:a VUr:r A., LAi;S"Ir:
3; ;.,;,,., ?,. f3;??::; c_.r.r:F ;:;r. sr.?.no
;? : ?.?_,.
2155 9001 SS;; ;a..:i.r-F rn o.sr.r
Ti71;;d'.. fi.h2ile?7.;J1', Aprt'uY',,I:C
Gf':I.i606;2
.
t.!Sli::f? I':i r, :''. N
.
PERMIT
City of Eagan
3830 PILOT KNOB RD
EAGAN, MN 55122
(651) 681-4675
Permit Type:
Permit Number:
Date Issued:
Plumbing
EA037607
09/OU1999
Site Address:
855 Cliff Rd
Lot: 15 Block: 01
10-44350-150-00
Description:
Sub Type: Residential
Work Type: Water Tuuiaround
Description:
Meter Size
Remote Number
n F.. .,;_.
Remarks:
Fee Summary:
Addition: Lakewood Hills
Fee
State Surcharee
30.00
0.5o
$30.50
Contractor: - nPpi«ant - Owner:
Wenzel Mechanical St. Lic.: RANDEL W SYKES
1959 Shawnee Road 3438 GARFIELD AVE
Eagan, MN 551220000
612-452-1565 nenrc rm.r ssanu
I hereby acknowledge that I have read this application and state tha[ the information is correct and agee to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
ApplicanUPermitee: Signature Issued By: Signature
CLAIM VOUCFIER - REFUND REQUEST
CITY OF EAGAN
MAKE CHECK PAYABLE TO: NIAIN LINE PGUMBING
ADDRESS: 5851 MEADOWLARK LN
PR[OR LAKE MN 55372
LOCATION: 855 CLIFF RD P.LD./LEGAL: L15, B00, LAKEWOOD HILLS
RECEIPT #/DATE: 115880/08-2599 VALUATION:
REASON FOR REFUND: JOB CANCELLED PERMIT #: 37462
TYPE OF REFUND:
Electrical Perntit 3211-9001 E
Plumbing Permit 3212-9001 $30.00
Mechanical Petmit 3213-9001 $
' Building Permit Fee 3210-9001 $
Plan Review Fee 3422-9001 $
SAC (MC/WS) 2275-9220 $
SAC (City) 3866-9379 $
SAC (Admin) 3446-9001 $
Water Connection 3865-9220 $
SewerPermit 3743-9220 S
Water Permit 3713-9220 $
Account Deposit 2252-9220 $
Water Meter 3716-9220 S
WaterTreatitent 3868-9220 $
Surchazge 2155-9001 S
Utility Acct Overpayment 2250-9220 $.50
Curb Box Deposit Refund 2253-9220 $
Conswction Meter Dep Refund 2254-9220 $
Water Usage Charge 3711-9220 $
Other $
TOTAL $30.50
I declue under the penalties of law that this account, claim, or demand is just and that no part of it has been paid.
September 1, 1999
SIGNA URE DATE
o \ 7 . ?? ?
1
CITY USE ONLY
L ? 8L t-
SUeo. L-k?,UJoaA kbllS
. e..
"V
Please complete for:
q
'Rc.rni 1.
5;1 q W1.1
?'I!1!P!rT?4Y1;
RECEIPT DATE:
QFDRP WF » 1
1999 PLUMSINC PEfu411T (ftUIDENTIAL)
CTI'YOf EAfiAN
? $$$0 PILOT KNO$ RD
g 9 EAfiAN,UN 55122
(651) 6$1-4675
? gle family dwellings
? tow omes and condos when permits are required for each unit
? backf preventer for underground sprinkler system
FIXTURES EACH /f
TOTAL
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
G85 i in oUtlet ' minimum - 1 3.0 x = $
Hot tub/s a 3. x = $
Kitchen sink .00 x = $
Laund tra 00 x = $
Lavato 3.00 x = $
Minimum fee alterations to existin dwellin 30.00 x = $
Private Dis osal S stem new/refurbished ' re uires MPC rc. 75.00 x = $
Private Dis osal S stem abandonment 30.00 x = $
RPZ new installation/re air 30.00 x = $
Rau h o enin 1.50 x = $
Shower 00 x = $
Under round s rinkler if dwellin is under constructio 3. x = $
Under round s rinkler if existin dwellin 30.0 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
Water softener If dwelling under constructi 5.00 = $
Water softener if existin dwellin 30.00 x = $
Water turnaround 30.00 x ---- _ $ 30
State Surchar e 50 --> ----> ----> $ .50
Total --> --> - -> ---> $
Reminder: Call for inspe/eth lterations, i.e. water heaters, water softene\agsed ------------------?----------- ---------------------- -------------------
I here6y acknowledge thal I have read state that the -information- is wrrect, and agree to comply with all Ciry of Eagan ordinances.
It is llie applicanPs responsibility to ny owner thal the City of Eagan assumes no liability for any daby lhe City during ils
normal opera[ional and mainte nce ??es cor?s?id under this permit within Ciry prop erty/righbof-way/easement.
_Oi SITE ADDRESS: ?S ? ,
OWNER NAME: : U??
INSTALLER NAME: 4?11'
STREET ADDRESS:
CITY:
Jr'
AUG 2 3
? ? `-'
ss?7P
SIGNATURE OF PERMITTEE
TELEPHONE #:
(AREA CODE)
TELEPHONE#:
? (AREA CODE)
/
Date e -77
.
v SUILD237G PZIit4Ti P,PPLICATIO_T
LOT ? BLOCK / 11DDITI0o
PARCEL &^uECTIOtd fNi4BER IE UiIPLATTED !D - g9350- /6'0 - op
.ADDRE3S OF PARCEL fSS ? l/ f? ?I.CC i
zo0s.1c_ _ /P ? OCCUPAhTCY ?
ESTIy1ATEA COSTQo
orrsMR
/. ?t
COEdTRACiOR
TELEPHOATE 10. -f 51[- 7 709 d FF,«
.
TELEPHONE ;!O.
tiote° Include site plan, buildinq plans, and energy calculations with this
application . ?
Signed
?
6 OP'FICE USE
vru.unTxoL=
5AC
WA:ER CO'.pi7EC'.'I02T ?
C1IATCF. SYETER
IIUILDIPiG PF.EtI3IT FEE
50RCHARGE FEf:
?
PLi1t: C%ECIC FEr
PARIC DEUICATIOi.I FEE ?
OT..s.R
TOTfiL*
APPROVALS.
ASSPsSMEI•2T CL£t2iC?BUILDIIdG
!•lAR'ER F. SET:BR DEP3. FIAE DrPT
DEPT.
PAItK DBP:.
.
t??E.
zG a.
C?
D
? ? nF-c,?1
v
?
- ?--?1 y
'C 5
NFW Abl?l? W
C?3
i/
CZTY OF EAGAN
3830 PIIAT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454 S1Q0
Mt?HWIC,41..
FOR CITY USE ONLY
PERMIT a
RECEIPT #
DATE: ? 9 9
R,MSIAEN'`TAT.<i PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMII
?TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
---------------
- °------- --------------°-------------------------
WORK DESCRIPTION FEES
NEW CONST _
ADD ON _ ,2$ ?
REPAIR _
OWNER NAME: ?C', G?.e_rr E?-til-? GrSo?
SITE ADDRESS: 9S S G'(?"FF el'
LOT: '^ BLOCK OO SUBD.( ?tiRk?CMV2? ??Da
INSTALLER: S?
ADDRESS:
CITY: ZIP:
PHONE #: .37C0? _
ADD-ON MINIMUM
NVAC 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OUTLETS - MINIMUM
OF 1 PER PERMTT
SUBTOTAL:
STATE SURCHARGE:
DWELLINGS &
$15.00
24.00
6.00
3.00
$.n2
.50
TOTAL:
$ (3??
? SIGNATURE OF P ITTEE
A"
C4R4ERCIAL ItV?iTSTRTAT.: PLEASE COMPLETE THIS PORTION FOR ALL COIIERCIAL/INDUSTRIAL BUILDINGS,
?.::.
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
------------
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: BIACK SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE #:
FOR:
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE 5 $.50 FOR
EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING - $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $
STATE SURCHARGE
TOTAL:
(SIGNATURE)
CITY OF EAGAN
MASTER CARD
TION
OWNER
STRUC7URE AND
LAND USED AS
t c?- - L°A?(-EwoeD I-h115
Permit
No.
Issued Issued To
Contractor Owner
j
BUILDWG
PLUMBING _
CESSPOOL • SEPTIC TANK
V'JELL
ELECTRICAL
HEATING
GAS INSTALLING
SANI7ARY SEWER
OTHER I
OTHER I
Items Approved
(Initial)
Da4e
Remarks
Distance From Well
FOOTING SEPTIC
FOUNDATION CESSPOOi
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL
HE,4iING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRA W FI ELD
FLUMBING
WELL
SANITARY SEWER
Violations Noted
on Batk
COMMENTS:
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA155851
Date Issued:06/05/2019
Permit Category:ePermit
Site Address: 855 Cliff Rd
Lot:15 Block: 0 Addition: Lakewood Hills
PID:10-44350-00-150
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
James Tstes D Williams
855 Cliff Rd
Eagan MN 55123
(651) 775-7017
Archer Exteriors
324 Concord Exchange South
South St. Paul MN 55075
(651) 775-7017
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA168502
Date Issued:04/22/2021
Permit Category:ePermit
Site Address: 855 Cliff Rd
Lot:15 Block: 0 Addition: Lakewood Hills
PID:10-44350-00-150
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 -
Zachary S Zeilinger
855 Cliff Rd
Eagan MN 55122
(651) 983-2578
Window World Twin Cities
2106 11th Ave E
N St. Paul MN 55109
(651) 770-5570
Applicant/Permitee: Signature Issued By: Signature