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2066 Bluestone Dr E 2011-06-2413:48 33 651975 5694 P 113 Use BLUE or BLACK Ink (J" 4 For Of&* 1 f ~ 1 I Permit I City of Eagan I I 1 Permit Fee: SI-OL 3830 Pilot Knob Road j j Eagan MN 65122 ; Datelteaeired: Phorw: (651) 6764076 I Statf: I Fax: (651) 675-6894 1_-__--------- --a 2011 RESIDENTIAL PL/UMBING PERMIT APP VIC,'TIONnn Data: 1 Cf~ + She Address: a u~Q Tenants Suite 0: RESIDENT I OWNER Name: Phone: 11 Address ! City / Zip: g Q {s[db dyc r CONTRAC101% Name: l License Address: @2Is. . c`(1 l.b~ LC _ L7 L V~ City: c__) State: _ Zip: 55 Phone: L91'a 9(.D$ '410;Z Contact: 30600 Email: TYPE OF WORK ~ New - Replacement Repair _ Rebuilt - Modify Space _ Work in R.O.W. Description of work: PERMIT TYPE RESIDENTIAL _ water Softener Water Heater Lam Irrigation RPZ I okp- PVB) -Add Plumbing Fixtures ( Main I _ Lower Level) Septic System _ Water Turnaround _ New Abandonment RESIDEN7lAL FEES: $55.00 1mu"t Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $35.00 Lawn It'rig8tion (includes $5.00 State Surcharge) $55.00 Add Piumbing Fixtures, Septic System Abandonment, Water Turnaround' (includes $5.00 State Surcharge) 'Water Turnaround (add $106.00 if a 5ff' meter is required) 6105.00 Septic System Now ($10,00 per as built) (Includes County fee and $5.00 Stars Surcharge) $95.00 Fire Repair (rep" burned out 8ppiilanow, do wwork, etc.) (includes $5.00 State Surcharge) TOTAL FEES; CALL BEFM YOU DIG. Call Gopher State One Call at (661) 464-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. MM.dooherrstateonecal= i hereby acknowledge that this Wormatlon is complete and accurate; that the work will be In conformance with the ordhenm and ooM 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 titan waaaut a permit: that the work wig be in 00001`4 n with theJapproved ~plan niin~thhee cm of work which requires a review vW approval of Ohms. x[~LUJ 1 L...1 }sue x AppiicerKs Prhrbad Name Appl * "Ofm FOR OFFICE USE Revivwed BY: Dab: Required k»pec ions: Under Ground _Rough-In Air Test Caae Teat -Final I Parcel Files Cover Sheet Unique ID: 1870 2066 Bluestone Dr E 101670205007 r~ CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 tons PHONE: 4548100 BUILDING,PERMIT Receipt # N To be used for 3,-SEAM VOM Est. Value $5000 Date 2 , 19 i Site Address 2066 B OFFICE USE ONLY g Lot Block 7 Sec/Sub. C2W I 3RD Parcel No. Occupancy FEES Zoning Name 1 LL DOM0 (Actual) Const Bldg. Permit Address 20(A BLURSTOM D (Allowable) e Surcharge City Phone 452-6160 # of Stories Plan Review 100 Length o Name Depth 120 SAC, City $v AddreSS 311 = $ S.F. Total SAC, MCWCC City PhoneS.F.Footprints On Site Sewage Water Conn d Name On Site Well Water Meter Address MWCC System Acet. DDeposit city water City Phone PRV Required S/W Permit - I hereby acknowlege that I have read this application and state that the Booster Pump S/W Surcharge information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Treatment PI r c Signature of Permitee , APPROVALS Road Unit A Building Permit is issued to: 'PAMLCRIXT Planner . Park Ded. d on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg, Off, Copies Variance TOTAL Building Official Permit No. Permit Holder Date. Telephone # WATER SEWER PLUMBING H.V.A.C. ry ry ELECTRIC 33 / 0 h specoon Date hasp. Comments Foofmgs.i G-Z (e gs ~s Foundatlon Framing 04 Roofing Rough Plbg. Rough Htg. Isuk. Fireplace Final Htg. Final Plbg. Coast. Meter Plbg. Inspector- Notify Plumber EngrdPlan Bldg. Final Dock Ftg. Deck Final Well Pr. Disp. CITY OF EAGAN Remarks Cedar Grove A c g6ition Addition Cedar Grove 3 Lot 5 I` Rlk 7 -ParceI~ 10 16702 050 07 2066 Bluestone,D 55122 Eagan,MN Owner Streat State Improvement Date Amount Annual Years Iayment Receipt Date STREET SUR F. STREET RESTOR. i, GRADING SAN SEW TRUNK # SEWER LATERAL 9 , • 938 A006442 8-'1T-78 30400 ---5 WATERMAIN WATER LATERAL 1972 WATER AREA STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT l WATER CONN. I3UILDING PER. SAC PARK F X13/3 71 _ - ~ ~ ~ ga9,~ ac- Request Date Fire No. Rough-in Inspection e ' ed? ❑ Ready Now Wil Notify Inspector Yes ❑ No an Ready? I Cil ensed contractor ❑ owner hereby request inspection f above ele work at: Job Address (Str I, Box or Route No:) City 4 L a~ W"_1 ) '-IE~ a_v__J~ Section No. Township Name or No. Range No. County 91- Occupant (PRINT) Phone No. Power Supplier Address Electrical Contra Company Nam) lContractortLicense No. Mailing Address (Contractor or Ow r ing Installation) PRY T- o JC~ J ~ Authorized Sig lure ( ontractorlOym aking Install n) > Phone NumbePO' MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Btdg - Room S-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. ~(1 Qj REQUEST FOR ELECTRICAL INSPECTION ~ • EB-00001-07 ►Seeinstruc?Ibns for completing this form on back of yellow copy. x/90' 9 9 F 13371 `X" Below Work Covered by This Request New Ad(Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm Air Conditioner Q/ r (s cify) Contractor's Remarks: Compute Inspection Fee Below: ¢,m # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps A Amps Signs Inspectors Use Only: TOTAL Irrigation Booms Qr~ r Special Inspection Alarm/Communication Other Fee I, the Electrical Inspector, hereby Rough-in Dalfi' certify that the above inspection has f ' Final Date - been made. OFFICE USE ONLY This request void 18 months from EAGAN TOWNSHIP N.o 1401 BUILDING PERMIT Owner =e_d Eagan Township Address (present) Town Hall Builder Date y'..'=--.~~1 EGG------- Address DESCRIPTION Stories To Be Used For Front Depth Height Est. Cost -Permit Fee Remarks LOCATION Street, Road or other Description_ of Location I Lot ' Block Addition or Tract This permit does not authorize the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and ` i general welfare to anyone in the community. THIS PERMIT MUST BE KEP O THE PREMISE WHILE THE WORK IS IN PROGRESS. I This is to certify, that has permission to erect a._tv/upon the above described premise subject to the provisions of the Building Ordinance for Eaga ownship a opted April 11, 1955. Per ---•--------a~,~IJ s Chairman of T nwn Board Building Inspector 2007 RESIDENTIAL BLTILDfNG PERMrr A,PPLICATIIO'N City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5575 FAX # 651-675-5694 Neva uonsruction Reaumnentri ri$lLodet R bait Reguuemenl9 Oifioe Ot fY 3 ragisterea sde swvays shoving eq_ ft. of Id, sq. R. of house; and,LN roofed erase Z co os of plan showlloa beams, " 'sts It-of tags. la £itrirey Recd Y N (20% maximum lot coverage atlnuredl 1 set of {rnsrgy Oalculati tiony for healed adWorrs SoItS mart ' ti y ;.y i Soils Report 9 proposed building is to bo placed on disturbed soil 1 sM axvey for additions & decks Tres.t?t~s .Rtrrd Y = 2 copias of plan showing beam & Mndov, aizes: poured found dcsiyn, sic. AciAft -h *w&-7onroita sWO, byafem 7x9+9PlpS Y.-....A1 I set of Energy Calculations 3 Ors sitB Selii: Syst~iis Y .:.:i copses of Tres Preservation Plan 6 lot platted after 711x33 Rh Joist Detail Options salsction sheet (buildings with 3 or less units) Minnegaaca nreehaaical ventitation farm `x it 'g,> aw : ~8, r at ;S «'a~ Yiuk)iic `af* f"€!r'afl n yrqo ~s x w n Mate t:.:-:^~ ~ are t~~et3.e ~&~.mt ard !he r~;asxeP:°>. Date 1.1 / -1 07 V 4. cdlkstruction Cunt o d Site Address r O (o auk57b"c. a+.A L2. a SAS Z Unit/ste # Ues4cription of Work Multi-Famil, lsldg _ Y X IN F;retiaccKa) - 0 - 2 Property Owner 2 rTR-t~ Teltphone 7 9Y& Contractor ~ :Jt~ ~/C~Y~S ~ arl5-rytaGTZ'JPJ Address Ito W tq" 9'"i-, city IV e4i V41 State 1,..4 iJ zip S-6al r Ttlephone # OSI) COMPLETE THIS AREA ON~.Y IF CQN$TRUGrNG A NBUILDING Energy Cods Category - l Msttita Rules 7670 ruatewc)ti I - M irg esoM aples 7672 RSSid9htia! Ventilation Gateftoty 4 YVorksfreet New Energy Code WerkSheat E~ submission type} Submitted Submitted • Energy Eovetope CalcuiaBons Submitted In the last 12 months, has the City of Eagan issued a perrnit for a similar plait based on a roaster plan? Y _ N If yes, dat9 and address of rr,osler plan, Ucensed Plumber Te4ephone # ( j Mechanical Contractor Telephone ] Sewer/Water Contractor Telephone # I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; l [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 plat->:.in the case of work which requires a review and approval of plans. Appliullies Prime ed Name Applicant's ignature i CITY OF EAGAN N~ 16 6 8 8 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE: 454-8100 Receipt # C~' z C-C z- To be used for 3-SEASON PORCH Est. Value $5,000 Date JUNE 21 1989 Site Address 2066 BLUESTONE LN Lot 5 Block 7 Sec/Sub. CEDAR GROVE 3RD OFFICE USE ONLY Parcel No. Occupancy R-3 FEES Zoning W Name DARRELL DEWALD (Actual) Const Bldg. Permit 72.00 o Address 2066 BLUESTONE DR (Allowable) Surcharge 2.50 City EAGAN Phone 452-6160 # of Stories Plan Review Length 1Q o Name PANELCRAFT Depth 12' SAC, City ua Address 3118 SNELLING S S.F. Total SAC, Mcwcc City MINNEAPOLIS Phone 721-6628 S.F. Footprints On Site Sewage Water Conn w w Name On Site Well Water Meter Address MWCC System ~Z Acct. Deposit aw City Phone City Water PRV Required S/W Permit I hereby acknowlege that I have read this application and state that the Booster Pump S/w Surcharge information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan O,rdinances. Treatment PI Signature of Permitee APPROVALS Road Unit A Building Permit is issued to: PANELCRAFT Planner Park Ded. on the express condition that all work shall be done in accordance with all Council .50 applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies Building Official Variance TOTAL 75.00 1989 BUILDING PERMIT APPLICATION CITY OF EAGAN l ) Y 4 11 SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS A STRUCTURAL PLANS 1 SET OF ENERGY CALCS. (CHECK WITH BLDG DIV.) 1 SET OF SPECIFICATIONS i SET OF ENERGY`CALCS. 1 SET OF ENERGY CALCS. !MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS # OF UNITS NOTES ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED SEWER A WATER PERMIT FEES AND ACCOUNT DEPOSIT FEES WILL BE INCLUDED WITH THE BUILDING PERMIT FEE. PROCESSING TIME FOR SEWER AND WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED INDICATING A LICENSED PLUMBER. PENALTY APPLIES WHEN: PERMIT IS NOT PAID FOR IN SAME MONTH IT IS REQUESTED. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. JUN 19189 To Be Used Forte A)ec / Valuations Dates Site Address 2-66 &06Si~F- OFFICE USE ONLY Lot Block _ Occupancy 12- FEES Zoning Parcel/Sub Actual Const Bldg. Permit Allowable Surcharge 2.50 Owner p,&4Eze ®e7✓/jza # of stories Plan Review Length 0' SAC, City Address 20 dK DA Depth Z' SAC, MWCC S.F. Total Water Conn City/Zip Code, Footprint S.F._ Water Meter Acct. Deposit Phone X17On site sewage S/W Permit- On site well S/W Surcharge Contractor , Q*AECC efp- MWCC System Treatment P1. City water Road Unit Address 3IIA*SA E4~1_/4,k5 :";4 PRV required Park Ded. Booster Pump Copies City/Zip Code "Z-S 1-tAJ is `1~6 SUBTOTAL APPROVALS Penalty Phone C ~G24111 Planner TOTAL 9 5-- Council Arch./Engr. Bldg. Off. !~"~2D Variance Address ` City/Zip Code Phone # C4yy^ 7 ~ ~ J NOLtSE RPY~NT 1 I EXIST. 1401-1 SE 1 GAh1k~E NLW 2~ SE(.L,Q N I _ _ -rt-=EXIST POl1~CN I PAT 10 4 ~ ~=1 I LOCbT ION ON S I T. CONTRACTOR OWNER SHEET NO. IRATE DRAWN BY REVISIONS 'PANELCRAFT - 3118 SNELLING AVE.SO ZZZo u (10 " Act D)qv25'-.. tMPLS MN 55406 p,nN~ tisz- ~5 r ► ~w f v s'1 w CITY of EAGAN N© 3334 BUILDING PERMIT Owner 3795 Pilot Knob Road Eagan, Minnesota 55122 Address (present) ...0. G. G..... 454-8100 Builder ......r........................ ~7 Address Date ......2... . DESCRIPTION Stories To Be Used For Front Depth Height Est Cost 'Permit Fee Remarks LOCATION Street, Road or other Description of Location I Lot Block Addition or Tract -7 7q This permit does not authorise the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and general welfare to anyone in the community. THIS PERMIT MUST BE JAEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS This is to certify, that....... .....has permission to erect a.... ~ p the above described premi a subject t the provisions of all applicable Ordinances for the City of Eagan. , ~1.......... Per Mayor Buil 'ng Inspector 333X PHONE 454-SIOG VILLAGE OF EAGAN 8795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 MAC Ti l ree 1 fi 1 i t Q MASTER CARD LOCATION OWNER STRUCTURE AND LAND USED AS Issued To Permit No. Issued Contractor Owner BUILDING tj[ U3.5 3r.3G PLUMBING CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING GAS INSTALLING SANITARY" SEWER OTHER OTHER Approved Items (Initial) Date Remarks Distance From Well FOOTING SEPTIC FOUNDATION CESSPOOL FRAMING TILE FIELD FT. FINAL ELECTRICAL DEPTH HEATING OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING WELL SANITARY SEWER Violations Noted on Back COMMENTS: COMPLIANCE INSPECTION REPORTS TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS PERMIT NO. DATE OF INSPECTION CONDITIONS OF CONSTRUCTION AT THIS INSPECTION NO EVIDENCE OF NON-COMPLIANCE NON-COMPLIANCE. BUILDER DOES NOT OBSERVED. ~ INTEND TO COMPLY. a ACCEPTABLE SUBSTITUTIONS OR COMPLETION OF CERTAIN IMPROVEMENTS DEVIATIONS. WILL BE DELAYED BY CONDITIONS BEYOND ❑ NON-COMPLIANCE. BUILDER WILL COMPLY CONTROL. WITHOUT DELAY. ITEMIZED AND DESCRIBED AS FOLLOWS: REINSPECTION REQUIRED DATE OF REINSPECTION a REINSPECTION REVEALED CERTIFICATION-1 certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require- ments for off-site improvements relating to the property inspected. F] ALL IMPROVEMENTS ACCEPTABLY COMPLETED BUILDING INSPECTOR DATE COMMENTS: f 23 l PERMIT City of Eagan Permit Type:Building Permit Number:EA117019 Date Issued:10/14/2013 Permit Category:ePermit Site Address: 2066 Bluestone Dr E Lot:5 Block: 7 Addition: Cedar Grove 3rd PID:10-16702-07-050 Use: Description: Sub Type:Reroof & Siding Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Valuation: 8,000.00 Fee Summary:BL - Base Fee $8K $162.25 0801.4085 Surcharge - Based on Valuation $8K $4.00 9001.2195 $166.25 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 - Hai P Le 2066 Bluestone Dr E Eagan MN 55122 Hartland Builders Corporation 2000 Old West Main St, Suite 346 Red Wing MN 55066 (651) 327-2071 Applicant/Permitee: Signature Issued By: Signature 5 Use BLUE or BLACK Ink � r————————————————� � I For Office Use � I // � C�t of�a aIl [ ; Permit#: ���`7� � � � � t�������Cu 1 Perm�tFee: r�(��,� 1 3830 Pilot Knob Road 1 Eagan MN 55122 �UN � �J 70�5 � Date Received: f l� " l' i Phone:(651)675-5675 � Fau:(651)675-5694 � Staff: I I � �����������������J 2015 RESIDENTIAL BUILDING PERMIT APPLICATION Date: t�`I�" �� Site Address: 40t�J�O �V'� � � 1 1t � ' Unit#: ht �� ` � e � Name: ��� � �Q��� ���'�, Phone: ���'�� ��� t����� � Address/City l Zip:��1�b��r,� V L,�rD�'e I.�(� � ,', �� rr �x � y�x � ,� Applicant is: �6 Owner ConVactor ������, Description of work:��,�)C ��fi ` (�1 [�f��/'1 � ` � s F i � Construction Cost:� � Multi-Family Building: (Yes /No� f ; � �f � � Company: Contact: ,� � � r � '�J � � k �� k- � �2 ` ���� Address: City: �� x � State: Zip: Phone: Email: x �� � License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDIRIG In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan7 Yes No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer 8 Water Contractor: Phone: Fire Suppression Contractor. Phone: � � � �`���+��. �� �� ` � ����� �!� i �� ��� `� �� ` � � � �� � � � ��c��_�� �.�;����' q �- �. . z� , n g r., -;� f,.7�'a" t^z°+�'�s� � �t+�: -, €.a s� '�: .-},,. -' � �" •G,x� " t+ �.�� a �,`��a � e"`����'��' �.� �� � � � � �:' �, '3, CALL BEFORE YOU DIG. Call Gopher State One Call at(651)4540002 for protection against underground utility damage. Ca1148 hours before you intend to dig to receive locates of underground utilities. www.aoqherstateonecall.org 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 E�qan; 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. E�cterior work authorized by a building pertnit issued in accordance with the Minnesota State Building Code must Ne completed within 180 days of permit issuance. � � X � � �i X Appl�cant�s Printed Name Applicant's Signature Page 1 of 3 ��. ♦ � Y Vf4. � � I �, �j Cu,��r��✓1..�, �.�F� DO NOT WRITE BELOW THIS LINE ,��� C��� SUB TYPES _ Foundation _ Fireplace Porch(3-Season) _ Exterior Alteration(Single Family) _ Single Family Garage � Porch(4-Season) Exterior Aiteration(Multi) _ Multi _ Deck _ Porch(ScreeNGazebo/Pergola) _ Miscellaneous _ 01 of_Plex _ Lower Levei _ Pooi _ Accessory Building WORK TYPES New T Interlor improvement _ Siding _ Demolish Building* �Addition _ Move Building _ Reroof _ Demolish Interior _ Alteration _ Fire Repair _ Windows _ Demolish Foundation _ Replace _ Repair _ Egress Window _ Water Damage _ Retainfng Wall *Demolition of entire building—give PCA handout to applicarrt DESCRIPTION Valuation `� �� � Occupancy MCES System � Plan Review Code Edition t , � SAC Units (25%_100%� Zoning �_ City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction Width � REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) Final/C.O. Required � Footings(Addition) � Final i No C.O. Required � Foundation HVAC_Gas Service Test Gas Line Air Test Roof:_Ice&Water _Final Pool:_Footings _Air/Gas Tests _Final � Framing Drain Tile �Fireplace:,�Rough In �Air Test �Final Siding:_Stucco Lath Stone Lath Brick Insulation Windows � Sheathing Retaining Wall:_Footings_Backfiii_Final Sheetrock Radon Control � Fire Walis Fire Suppression:_Rough In_Final Braced Walls Erosion Control �y� Other: Reviewed By: � , Building Inspector RESIDENTIAL FEES y � Base Fee :������ �� � � � Surchar e ���� �� �� 9 Plan Review ' MCES SAC �;� ��1 �1'I.�11�,l�t��R ' City SAC �I Utility Connection Charge � ���=• ��,���J� �� �i � / �, S�W Permit+&Surcharge i Treatment Plant ��,�'` � / �I Copies �/ ���t �1 �`I� T�TAL � Page 2 of 3 � � � � � ���� I �'�, _ � � � � � � � � ' .-s�.o � : � ;�.X :-�. � . .- : .- : . --� / . _ , �� -�m�0 Z� � vm --io �� DnC�v13�� \ \`e/ � (Q� o � ?S� o o �.o-o s,.o -, ao o a�, w � •o N � N � �� �' ° a� a��f °°� \ \ �� ' ' ,o � m -, � �Nr°naimm �z � 000 --... � � ��� cn �Mam�'�> > ��-mN-° o ooN�.'c°> > \ / O� '� � S—m m � � �^ \ �- n O n y LT O`G O O (A � y � � $ �. 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CEDAR GROVEkNO. 3 ['IVII.FN[ii\FAR$ ,.,,Hp,.�� yp[�InSU&VEYOR$ �����.-� Certificate of Survey for: according to the recorded plat thereof 2422EnterpriseDrive « ^n Ph_(651)bA1-1914 Dokot❑ County, Minnesota Iritegll� DeSlgri & Use BLUE or BLACK Ink � r---------------- I For Office Use I ���� C�� �� �� �� j Permit#: � � ����� I Y � � � J`� � � Permit Fee:1 �`�Ls' � 3830 Pilot Knob Road � i Eagan MN 55122 � Date Received: � Phone: (651) 675-5675 � � Fax: (651) 675-5694 I Staff: I �-----------------� 2015 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: IG c��r �� Site Address:bC��(A /���l�'�7`GYI ��, �' Tenant: Suite#: #tesidet�tJ+(�a�1/tler Name: Phone: ' Address/City/Zip: ' Name:� ��Q.i�,(����.� �pn5 `P�� �OL�License#: G�t�tt'a�fOt' �� Address: ����+�� ��f���� �� City: �..0 f1S�� � State:_� Zip: .�,sp�� Phone: c��v`Z" ''jc�� �7 O ( Contact: �- EmaiL• � V1'10.i 1• LO� �New _Replacement _Repair _Rebuild _Modify Space Work in R.O.W. T�pe o#V11ork — Description of work: �; — ` �'�E� RESIDENTIAL Water Heater � � �� �� Water Softener � Lawn Irrigation(_RPZ/_PVB) ����������� � �� � � Add Plumbin Fi�ures Septic System 9 ( X Main/_Lower Level) New Water Tumaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation(includes State Surcharge) $60.00 Add Plumbing Fixtures, Seqtic Svstem Abandonment, Water Turnaround*(includes State Surcharge) "`Water Turnaround(add$210.00 if a 5/8"meter is required) $115.00 Septic SVstem New(includes County fee and State Surcharge) TOTAL FEES$ ' 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.qopherstateonecall.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 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 ����6�.� �y IC►,Y\d x Applicant's Printed Name Applicant's Signa ure FOR C�FFICE l�SE Rev9ewed By: Da#e: Required Inspections: Under Grbund Rough-In Air T�s# Gas Test - Fir�ai Meter Reiated Items: Meter Size Radio Read Manometer Staff: