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4065 Amethyst LaneCITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt# To be used for =^'•?1`1? Yt` Est. Value 115,00) Date ' ,19 Site Address 4ft5 LN OFFICE USE ONLY Lot 'a Block kI 5ec/Sub. c:k;;-AR Cf'OVE STH On Site Sewage Occupancy MWCC System Zoning Parcel No. l C On Site Well (Actua onst ) a Name TIN P&"'€R5UP citywater (Allowable) i 4C1b5 lu'KSTkIti!S. L• AddreSS T PRV Required # of Stories 0 Cit LA?-N PhOne '???????? Y Booster Pump Length Depth 0 Name 4:%ii'MAti f0!3STRL'CTI0i4 CQ S.F.Total . o i 43.i0 LiN AVE S Address Footprint S.F. U? City ?'PtIS Phone APPROVALS FEES V W Name Engr./Assess. Permit 00 ? ? ? Z Address Planner Surcharge ? ? ? Council Plan Review ? W City Phone Bldg. Off. SAG City I hereby acknowledge that I have read thfs application and state that the Variance SAC, MWCC iniormation is correct and agree to comPly with all applicable State of Water Conn. Minnesota Slatutes and City of Eagan Ordmances. ? Water Meter Signature of Permittee • ' "` Road Unit ^'f?? ?[c_.._ i?:?.,..:<;,.? `'ti;? - A Building Permit is issued to: oti Treatment P1 on the express cond ition that all work shall be done in accordance with all parks applicable State of Minnesota Statutes and City of Eagan Ordinances. ? ? TOTAL Building Official__ Permit No. Permit Holdsr Date Telephone ?k Plumbing H.V.A.C. E lectric Softener Inspaction Date Insp. Comments Footings I Footings II Foundation Framing 2 i" - ?. , -? / ,!Z tcc;G ? t ^-ti- %?. t Roofing Rough Plbg. ? Rough Htg. Isul. Fireplace Final Htg. Final Plbg. Bldg. Final jr,ji f Cert. Occ. Temp. LP Deck Ftg. Deck Final Well Pr. Disp. Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 1967 100.00 dd SEWERLATERAL AIN AT ERAL M REA A STORM SEW TRK 237 1974 70.00 4.66 15 Pi STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC 200.00 679 3-12-68 PARK *****?********************************* CITY OF EAGAN CASHIER: JS TERMINAL NO: 764 DATE: 05/03/00 TIME: 15:00:01 ID: NAME: PREMIER HOME ENHANCERS, INC. 3210 9001 4065 AMETHYST L 153.25 2155 9001 4065 AMETHYST L 4.00 Total Receipt Amount: 157.25 CR128971 USER ID: JAN ?. . • ' CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N?? 15880 BUILDING PERMIT PHONE:454•8100 Receipt o} u p To be used tor FIRE REPAIR Est. Value $15,000 Date V/o ,19 0 d Site Address 4065 AMETHYST LN Lot 6 elock 11 Sec/Sub. CEDAR GROVE STH Parcel No w Name TIM PETERSON I 3 Address 4065 AMETHYST LN 0 City EAGAN phone 448-4848 OFFICE USE ONLY On Site Sewage - Occupancy R-3 MWCCSystem _ Zoning On Site Well _ (ACtual) Const Ciry Water _ (Allowable) PfiV Requiretl _ # ot Sturies 8ooster Pump _ Length Depth S.F. Total Footprmt S.F. UQIName IINGERMaN CONSTRUCT70N 0 I o? Address 4330 IIPTON AVR S ? City MPI R phone 097-7R00 1- a uw wW ?i xa ui aw Name _ Address C itY _ I hereby acknowledge thal 1 have read ihis apphcation antl state that ihe mformaUOn is corre agree co with all ap licable State ot Minnesota Statutes nd Ci olEa an O n es' µ/ 4•'*?-" Si9nature of Permitte A Bwlding Permit is iss to: UNGERMAP]_CQN$TRII4TTON on the express condihon that all work shall be done m accordance wrth ali applicable State of Minnesota Statutes and Ciry of Eagan Ordinances BuJdingOfficial?QA(???__ APPROVALS Engr./ASSess. Planner Council Bldq. Off. Variance FEES Permit Surcharge Plan Review SAC,Ciry SAC, MWCC Waler Conn. Water Meter Road Uml Treatment P1 Parks TO7AL ] 4(z,90 7-50 153.50 Xa/ia/87 ? Y'r141 ?2Z; 15,10 ? 76963 0 ,> ReQUest Date _ ?? Frte No Rough-in napeceon Re,_ q??? ? ? Ready Now Will NoVly Inspec{or R '? Wh 1 ? - res ?NO IE en earh I licensed contractor ? owner hereby request inspection of above electrical work at: Job Address (SVeel, 8m or Roule No.) ff nti o.¢4 5 t Law e, dry r a, a?J Sectwn No Townshi0 Name or No Range No County / Occupant (P ??.???Sa,? Phonv Power Supdier QLlke{o. c00 Atltlresa o.rw??'.v o?..J ElecVlcal Conirador (Comparry Neme ComractoPS Licenee No -f T W z rvi .e r M9nirg Atltlress (Comractor or Owmr Makng InstellaOOn) z 7 r°l ?l 01 4 k 4 au , 7 2& ?c 9- 1 13 ?_ ) Aullwrizetl SignaNre (CoMraclor/Owner Making Installatlon) Phone Number MINNESOTA STATE BOARD DF ELECTRICffY THIS INSPECTION REOUEST WILL NOT Griggs-Mldway Bldg. - Raom 5173 BE ACCEPTED BV THE STATE BOARD 1821 UnivBrsity qve., Si. Peul, MN 55100 UNLESS PROPEfl INSPECTION FEE IS Plqne (612) 642-080p ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION eea0001 o7 Op / Sae inslrucilons br mmpletmg this torm on back of yellow copy. ?:?G ?// 7 D 7,69 6 3 `X" Below Work Covered by This Request e Add Rep. TypeofBuilding AppliancesWired EquipmeMWired Home Range Temporary Service Duplex Water Heater ElecVic Heating Apt. Building Dryer Other (Specify) 4 Comm.Mdustrial Furnace Farm " Ai7Conditioner "- - Olher (spacity) CoMractar§ Remarks ? -j- kr- P. Compute Inspection Fee Below: p ? ) (Z 1' j"7)19G 7- - # ONer Fee # ServiceEnhanceSize Fee # Circwts/Feeders Fee Swimming Pool 0 to 200 Amps a to 100 Amps Transformers Above 200 _ Amps Above 100 _ Amps Signs tnspeaors Use Ony: ? ` p7q? Irngation eooms (;10 a ? S p Special InspecYion -" Alarm/Communication ? Other Fee I, the Electrical Inspector, hereby rtif th tth b RO°gh-in DareI y &.? ? ce y a ea oveinspectionhas been made. Final o e 1 OFFICE USE ONLV v This request voiG 18 months (rom CITY of EAGAN BUILDING PERMIT Owne= Address (Precant) ..:.jL/.f7?......6/.l...f?,.?...4..?(!?..r?..J.?? / Builder ......{y?(.l.c?y.e ../ ............. . ea..?............'--................ Add:ase ....... If......... dOm.o....... .... a/.l..:l ............... L' ? ,• N? 4063 3795 Pi1oY Knab Road Eagan, MinaesoYa 55122 454-8100 Dafa ..l...?._?....<.•-4?...... _....... To Sa Used Fos Fsoai DepSh Haigb! Eel. Coe! - Perm!! ea Aamaeks 7 Q ?ci ?0 ?B 30 ja or 46?.S' 4,4jo '??,,r 7 _ 6/ i/ ?'eo/'r G?ro dP S`. This permit doea not auShorise fFie use of streels, roads, alleys or sidewalka nos does !t give ths/ownas oi Lis sgeat !he righffo cseate anp situation which is a nuisance or which prasents a hazard fo the healfh, aafelp, eoavenisnee aad general weliare !o anpone in the eommuniip. THIS PERMIT MUST BEPT ONHE P EMISE WHILE THE WORK IS IN PROGAESS. / .40 This is !o cexlifY. !hal... ..,I..f?..._--.......?.V ...................hasPermiasion !o ereet a-/q--°.....1?....a ..,(_. ..L??........._upon the above described pxemise 7e i fo the provisions of all appliaabl r inance for e Ciip f . ..............?....._..................... Per ............ ... --- --- - • ... .. .... ..........•_--............... Mayor HuSlding Impeelor EAGAN TOWNSHIP BUILDING PERMIT owoe: -- _ ................ Address (Presenl) ....-'-- ..... ?L?.<:s?zc.:..[ld?r . ................................................ Huilder ...... Address _.....--...._......?'?-?"...?C! :........ .._...---------- .............'----........ N°. 1859 Eagan Township Town Hall ne:e ----9.1..e ...................... Sfories To Be Used For Fron! Depth Heighi Esl. Cos! Pesmi! Fee Aamarka ? ._t.- LOCATION Sireei, Road or olher DesaripSion of Location I Lo! Slock Aqdition or Traci This pexmit does not authozize the use of slreeSs, roads, alleys oz sidewalks nor does it give the ownes oe his agenf the cigh2 to creafe any situation mhich is a nuisance or whieh presenis a hazard to the healfh, safefy, convenienee and genesal welfare to anpone in the eommunify. THIS PERMIT MUST SE KfPT ON THE PREMISE WHILE THE WORK IS IN PROGAESS. This is So cerlifY. Shai_....:?':???:r'`.•?? ?:-',................ ....has permission !o eneet a__- -.....-_?..- y.°? _.........................._upoa the above descTibed premise subjec! !o the p/?OVisiona of the Building Ordinanae for ...,gen Tbwnship adop2ed April 11. xsss ?:................(?,?.°.. ...... ? -........ ;% . . ...._......_... ........ ....._... ................ rer ..................... `?-?- Chainffan of Tnwn Board f Suilding Inspef2.or 'i ! w EAGAN TOWNSHIP BUILDING PERMIT N° 1724 Eagan Township 1'own Hal] Dale ...:?/!.-- '.Ae ................... Sforiesl To Be Used For _ Fron! Depih Height Ssi. Cosi Permif Fee Remarks - ? .? r'v _ -- Sireei, Road or oiher Ueserapiion oi Locanon Lot -n1ocB ACtl3fion or Trae! - ? -, L I?9r.Ru ?7 This permii does not auihaxise 16e use of slreeSs, roads, alleys or sidewalks nor does it give the owner or hia agent !he riqht !a ereafe any sifuafion which is a nuisence or which p:esenSs a haxerd io the health, safe2y, convenience and ganeral welfare to anpone in 36e community. THIS PERMIT MUST BE K?E?P?T ON? T?HE PREMISE WHILE THE WOAK IS IN PROGRESS. This is fo ceriify, lhai...? e ? .w.....,5lI?_:.............hasParmisaion !o ereei a...... j ----- .......? .. upon ?....... the above described premise subjeei !o the provisiona of the Building Ordinance for Eagannship ado !ed April 11, 1855. ? ' .._ . ........... .. ... .. . ........{.-'..- .- G !9. ----"----.....--..... Per ....... _.._.... '? e.c ..---....?.-.__?4.if?.......... C ?rman of nw Board Huildin Ins ecfor 6-11-5 EAGEIq TOWNSHIP 3795 Pilot Knob P,oad St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT POR SEWER SERVICE CONNECTIOPI DATE: March 5, 1968 OWNER: Cedar Grove Const. PLUMBER Stein, Inc. DESCRIPTION OF BUILDING Industriall Commerciall Residential ` Multiple Dwelling ' No. of units ! I x + I 1 Location of Connections: Permit Fee 7, SD " Street Repairs Total ,2t,7, S? ?n°?' Inspected by- DaCe Remarks NUMBER I,Z C7 Address 4065 Amethyst Lane ?-// ('?',,? TYPE OF PIPE Cast Iron Connection Charge cZ ?' ?' ? °' •' 9`? 3?? z"/? ? By Chief Iospector In consideration of the issue and delivery to me of the above permit, I hereby agree Co do the proposed work in accordance with the rules and regulations of Eagan Tormship, Dakota County, Minnesota Stein, ]nc. By PZ=_aQe r.otif.y e,hen ready for inspection and cor.n--ction ar.d befn:e any portica or tha wcrk is covered. /?sy . si 1 ? ? , -IS- ? a ? .y r V I ?? ?5 f}rvIE 7?G?ysf ?av?? ?a`nes Cha?c/?Er MASTER CARD TION y?6? OWNER STRUCTURE AND ir ,?/ LAND USEO AS O ?/ ?? Permit No. Issued Issued To Contractor Owner BUILDING PLUMBMG '(/?` Z ?sri?J'- j „ .r , CESSPOOL - SEPTIC TANK V'JELL EIECTRICAL HEATING GAS INSTALLING SANITARY SEWER I OTHER I OTHER I Items Approved (Initial) Date ` Remarks Distance From Well FOOTING SEPTIC FOUNDATION ?-~`? 1? AZOVW CESSPOOL FflAMING TILE FIELD FT. FINAL ELECTRICAL HEATING DEPTH OF WELL GAS INSTALLATION SEPTIC TANK _ CESSPOOL DRAINFIELD PLUM8ING WELL ? SANITARV SEWER ?. Violations Noted on Batk COMMENTS: j p • ??"- ?{, ?Ji(G- COMPLIANCE INSPECTION REPORTS TO BE USED ONIY IN EVENT Of OBSERVED VIOLATIONS PERMIT CONDITIONS OF CONSTRUCTION AT THIS INSPECTION NO EVIDENCE OF NON-COMPLIANCE OBSERVED. ? ACCEPTABIE SUBSTITUTIONS OR DEVIATIONS. DATE OF INSPECTION NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. ITEMIZFD AND NON-COMPLIANCE. BUILDER DOES NOT INTEND TO COMPLY. ? COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYED BY CONDITIONS BEYOND CONTROL. ? REINSPECTION REQUIRED DATE OF REINSPECTION REINSPECTION REVEALED CERTI FICATION - I certify that 1 have carefully inspected the ahove 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- menu for off-site improvements relating to the property inspected. F-I ALL IMPROVEMENTS ACCEPTABLY COMPLETED ?g :? ? ? 1 ? ? ? ? ' 9 ? , a ? s ? ? 1,„ /,? REQUEST FOR ELECTRICAL INSPECTION d)?? ? See msVUChons for completirg this tortn on Mck ot yellow Wpy E--M9 6 3 X" Below Work Covered by This Request ? 1 ? •• •• 11 J . ??4 lb • EB-00001-0] F y ?i/,/ e Add Rep. TypeofBwlding AppliancesWired EquipmenlWvetl Home Range Temporary Service DUplex Water Heater Electric Heatinq Apt Buildinq Dryer O?her (Specdy) Comm./lndusirial Furnace Farm Air ndinoner Dlher (speGty) Comraclor5 Femarks. p yK)s P 4 Compute Inspecaon Fee Below: ?- A Other Fee # SernteEntranceSize Fee # Circuftsffeetlers Fee Swimming Pool 0 to 200 Amps o to 100 Amps Transformers Above 2( 0 _ Amps Above 100 _ Amps Signs I nspecYOrg use ony TOTAL ircigation Booms a 0-S V Special Inspection Alarm/Communication Other Fee I, the Electrical Inspector, hereby R°ugh-in os?e certiry Mat the above inspection has been made. F,,,ai oa?e OFFICE USE ONLV _ This requeet wM iB months fmm E 7 6 9 6 3 Rtquest Date 1y G o l I? ?!? O O Fire No. Rough-in nspedan o ?? ? Na ? ReaOy Now W-II Notdy InspeUOr Whan ReflOYv 1 Qdlicansed coniractor ? owner herehy request inspec6on of aCove electrical work at: Job AdCreas (Sheel. Box w RMe No.) 1/b?? f1 n.? e-(-ti 5 t Lcuv z CM ^ ? c?, a?.J Seceon No. Townshlp Nerre a No. Rerge M. Coun?ty 1 / 1 .(,/!l,.F F) T 6- Occupem (PRINn T?„ ?'?,??.?Sa?? %arre No v7y-is??y Ppxer Suppliar Lt ko{o. c p D ?r? I o. r M i',v e,J Electnral Coritmclor (COmpenY Namni Cantractor9 LkeAU No. 6nn A/'.a.r-fL MaiLrg Address (Cantraqw w Umer Melung InstelleM1On) ? /y3 z7 -L,?5IL_4 PlacQ ?°l a j Aulhorizetl Sgnature (Cantractor/Owner Makirg Inalella4on) 11 Number ss3 MINNESOTA STRTE BOAflD OF ELECTPICRY Grigpa-Mltlway BWy. - Noom &1T3 1821 Uniwnlry Aw., SL Gaul, MN 55100 Phoeie 18121 6012-0110o THIS INSPECTION REOUEST W ILL NOT BE qCCEPTED BV THE STATE BOARD UNLESS PROPERINSPECTION FEEIS ENCIASED . 1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NO'fEs ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WIiICEi ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENT9L QNITS FDR SALE UNITS # OF UNITS INCLUDE 2 SETS OE PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS CONII•IERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS To Be Used For: '' r?' Rep`"'r Valuation: 1.5. 00 Date: Site Address HUO'w Lot -j?z- Block 11 Parcel/Sub ??A& (??pgoue ST" p,t?n ? Owner Z2?YJ ?27°G???oo'1 Address qo City/Zip Code &e-h Phone 2? y? p" yU '7 g Contractor VhQ err,,an C062 5Y . C.. Q. Address y-3 3 C7 City/Zip Code &,Q1 S ?.SyfO Phone 922 - a0 o a Arch./Engr. Address City/Zip Code On site sewage_ MWCC system ` On site well _ City water _ PRV required _ Hooster Pump _ APPROVALS Engr/Assess Planner Council Bldg. Off. Variance occupancy 1Z-3 Zoning Actual Const Allowable _ 0 of stories Length Depth S.F. Total Footprint S.F. FEES Permit Surcharge Plan Review SAC, City SAC, MWCC Water Conn Water Meter Road Unit Treatment P1 Parks Copies TOTAL 1y6.? 1S3,5o Phone # 41? MEMO - ciiy of eagan T0: DIANE DOWNS, UTILITY BILLING CLERK FROM: ED KIRSCHT, SR. ENGINEERING TECHNICIAN DATE: AUGUST 23, 1993 SUBJECT: STREETLIGHT ENERGY COSTS-CEDAR GROVE NO. 5(208 LOT5) This memo is to inform your departmerrt to begin to invoice the energy costs at the single family rate effective August 1, 1993 to the property owners in Cedar Grove No. 5 Addition. Block 1, Lots 1-22 22 Biock 2, Lots 1-19 19 BloCk 3, LOts 1-11 11 Block 4, Lots 1-16 16 Block 5, Lots 1-25 25 Block 6, Lots 1-22 22 BloCk 7, Lots 1-25 25 Block 8, Lots 1-5 5 Block 9, Lots 1-2 2 Block 10, Lots 1-23 23 Block 11, Lots 1-14 14 Block 12, Lots 1-9 9 Block 13, Lots 1-15 15 4?7= The City is currently being billed by Dakota Electric for streetlighting in the above listed subdivision. Edward J. irsc t Sr. Engineering Technician cc: Mike Foertsch EJK/je 2000 STORM DAMAGE PERMIT APPLICATION (RESIDENTIAL) cb CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4675 Reauirements ? 2 copies of plan DATE: I?S oo CONSTRUCTION COST: DESCRIPTION OF WORK: 51-°L i)-e-W to If multi-famity bldg., how many unlfs? IWDI?TE THE FOLLOWIfiIG EQUI. P}WEiYf TO BE REPLACED AND BY WHOM: ? Plumbing 7? Homeowner or Contractor Name Mechanical ? Homeowner Q Contractor Name ? '*NOte: If somebody oTher than the homeowner is performing plumbing or mechanica( work, they must apply for appropriate permit. Only licensed plumbing contractor or homeowner may complete plumbing work. STRfET ADDRESS: ( r S Af'Yl P`M V ?-f IL(D.YI 'tf, LOT: ? BLOCK: I l SUBD./P.LD. f C3 VC) \1-e PROPERTY OWNER ?m o /r Name: I-OwY?'lGl-V? M?UiCn'rie- Phone#: (PSI `TQS-9(a-7 ? Last FI t Sheet ? City Stafe: l/w 2ip: ? CONTRACTOR Sheef Clty Phone #: (area code) License # Sfate: Zip: v-a.r6 5-?-tLUU? - uarS°f- V1Yk ? (uorIYtC I hereby acknowledge thaf I have read this opplication, state thaf fhe intormation is correcf, and agree to compty wiih all applicable State of Minnesota Slafutes and City of Eogan Ordinances. r, Signature of auc 18 2000 OFFICE USE ONLY BUILDING PERMIT SUBTYPES ? 01 Foundation ? 07 05-plex ? 02 SF Dwelling ? 08 06-plex ? 03 Ot of _ plex ? 09 07-plex ? 04 02-plex ? 10 08-plex ? 05 03-plex ? 11 10-plex ? 06 04-plex ? 12 12-plex WORK TYPE ? 31 New ? 32 Addition ? 33 Alteration ? 34 Repair ? 13 16-plex ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 18 Deck ? 23 Porch (screened) ? 36 Muki ? 19 Lower Level ? 24 Storm Damage Plbg _Y or_ N ? 25 Miscellaneous ? 20 Pool ? 30 Accessory Bldg. ? 36 Move Bldg. ? 43 Reroof ? 37 Demolish (Bldg)* ? 44 Siding ? 38 Demolish (Interior) ? 45 Fire Repair ? 42 Demolish (Foundation) ? 46 WindowslDoors * Demolition permit - Give PCA handout to applicant GENERAL INFORMATION No. of Units No. of Buildings Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Width Basement sq, ft. Main level sq. ft. sq. ft. sq. ft. sq.ft. sq.ft. Footprint sq. ft. Census Code MC/ES System City Water Booster Pump PRV arr use oNLv L ? BL RECEIPT#: SUBD. l7 `( W"??' ? RECEIPT DATE: PERMIT# 2000 PI,UMBING PERMIT {gESIDENTIAL} CITY OF EAGAN 3830 PILOT KNOS RD I EAGAN, MN 55122 5-?-? JVA/? 651-661-4675 ? Please complete for: D single family dwellings ? townhomes and condos when pertnits are required for each unit D backflow preventer for underground sprinkler system CIYTI IQFi EACN N TATAL Alteretions to e sting dwelling - miniQ? rp-fe .? ,^ Describe: ?C?-O?I.YV?1L ? ?C ? i ?" \ $ 30.00 Bath tub $ 3.00 x = $ Floor drain 3.00 x = $ Gas piping outlet " minimum -1 100 x = $ Hot tub/spa 3.00 x = $ Kitchen sink 3.00 x = $ Laund tray 3.00 x = $ Lavatory 3.00 x = $ SeptiC System new/refurbished • requlres MPC Ilc. 75.00 x = $ Septic System abandonment 30.00 x = $ RPZ new installationlrepaidrebuild 30.00 x = $ Rough opening 1.50 x = $ Shower 3.00 x = $ Underground s flnklef if dwelling is undar construction 3 00 X = $ Underground sprinkler if existing dwelling 30.00 x = $ Water closet 3.00 x = $ Water heater 3.00 x = $ Water softener If dwelling under construttlon 5.00 x = $ Water softener if exisGng dwalling 30.00 x = $ Water tumaround 30.00 x $ State Surcharge 50 -> ---> --> $ .50 Total -> -> ----' °-' $ Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc. --------------wledge that I have -°-------------read ---- this a pp l -, s--t ate ----t hat ----t he in••---fo------ rmatio n i---s -co--rt----ect, ----and ----agree--to----comply-----w@h---a l•l --- appli-•-w --bleC----ity ---of--Eagan--•------ordinan----ce--s .- I hereby adcnoi cation It is the applicanPs responsihility to notrfy the property owner that Ne Ciry of Eagan assumes no liabiliry far any damages caused by the City during its normal operational and maintenance activities to the facilities construded under this pertnit within Ciry propertylright-of-way/easement. SITE ADDRESS: OWNER NAME: :--?L1 VVv LC1 W VVv' G- ?^ J TELEPHONE #: (° ?, y US-eI L--l (AREA CODE) tNSTALLER NAME: STREET ADDRESS: TELEPHONE #: (AREA CODE) Crr+(, STATE: ZIP: SIGNATURE OF PERMITTEE t- y070 q 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) cirr oF eacaiu 3830 PILOT KNOB RC - 55122 651-681-4875 RLS'••'_'=]I137'.•?CL :?? ; ? ?] n 3 regiafered alte wrveya ahowing sq. ft ol bl, sq. lt. of houae and Q jl roofed areas (20% rmxlmum lol coverocie Wbwed) * 2 coplea of plana (atww betan & window sizes; poured fnd. design; etc.) n 1 set of anergy caIculaHaru > J coples W hee pr6servaMOn plan il lot plattetl afler 7/1/93 DATE: ?I I I C) d DESCRIPTION OF 1 STREET ADDRESS: 2 copies W plan 1 se1 of energy calculaNons tor heafed adtlitlons 1 site survey for axteifor atldiHOns & decks CONSTRUCTION COST: T 7 0 0 U, 0U LOT: b BLOCK: / I SUBD./P.I.D. #: NaY 6l'(JVf. -96 Name:mQ,?1 l?C. N`1 ? PhoneJf: (?? •??'?(O 7? PROPERTY l.ast Flrst OWNER sneetaaaress:4olo5 hkyftvea?IV Lajl?.% aty srate: zip: . Companr ?'C W,-ta( Phone i: ] ; 15t,3 ' Ott (area code) COMRACTOR r? ?,,o SheetAddress:Cl?(?i? {?C? .lV • IJCense# Xj?k>3361 ExP• Ciy??? ?mt?,- Stafe: Iip: ARCHITECT/ ENGINEER Comparry: Name: Telephone ti: ( Shset Clly Regishatlon Ji: State: Sewedwater licensed plumber iif Installina sewer/water): Phone #: 2ip: I hereby acknowledge fhat I have read thls application, sfate fhaf Ihe InfortnaNon is correct, cnd agree to comply wilh a0 applicable State bf Minnesota SFaNtes and City of Eagan Ordinancea `&Ap SignaTure of ApplicanY. 6? ?d 4. 4 ?- OFFICE USE ONLY Certificates of Survey Received _ Yes _ Na Tree Preservation Plan Received - Yes - No - Not Required OFFICE USE ONLY BUILDING PERMIT SUBTYPES ? 01 Foundatian ? 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.) ? 02 SF Dweiling ? 08 06-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 03 01 of plex ? 09 07-plex ? 18 Deck ? 23 Porch (scraened) p 04 _ 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage ? 05 03-plex ? 11 10-plex Plbg _Yor_N ? 25 Miscelianeous ? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bidg. WORK TYPE ? 31 New ? 36 Move Bldg. ? 43 Reroof ? 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding ? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair ? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors • Give PCA handout to applicant for demolitiort permit GENERAL INFORMATION SAC Code # of Stories sq. ft. No. of Units Length sq. ft. No. of Buildings Width Footprint sq. ft. Const. (Actual) Basement sq. ft. Census Code (Allowahle) Main level sq. ft. MC/ES System UBC Occupancy sq. ft. City Water Zoning sq. ft. Booster Pump PRV Fire Sprinklered MISCELLANEOUS INSPECTIONS ? Stucco/Stone APPROVALS Planning Building Engineering Variance ? 31 Ext. Att - Mutti ? 33 Ext. AR - SF ? 36 Mufti Permit Fee $ I sq.39 Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W 5urcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: a'? valuation: $ `b,Y)CO-OD SAC Units % SAC 1004 STORM DAMAGE PERMIT APPLICATION (RESIDENTIAL) CITY UF EACAN 3830 PILOT KN06 RD - 55122 651-681-4675 /?- Vi X? ReauiremenTs ? 2 copies ol plan DATE: &.1140/ CONSTRUCTION C05f: f'-EPLOA'cE H'+Acw/?o +.c02+v6, DESCRIPTION OF WORK: )2V-P(R<e- S4$M*4C-!J iL-LtC*Z40C If mulH-family bldg., how many unlts? WP-4r4G INDICATE THE FOLLOWIPdG EQUIPPAEPJT TO BE REPLACED AWD BY WHOM: _ Plumbing _ Homeowner Q ConTractor Name _ Mechanical _ Homeowner Q Contractor Name "Note: If somebody otherThan ihe homeowner is pertorming plumbing or mechanical work, mey mustapplyforappropriate permit. Only licensed plumbing contractor or homeowner may complete plumbing work, STREET ADDRESS: lI dGS AME?r4?irSr LhKi5 LOT: BLOCK: SUBD./P.I.D. #: Name: t-OwM'ti`4 T M ?5' ,/ntZy AW Phone #: G.?(- y05"46:7I PROPERTY Wr ' Firr OWNER STreet Address: q06S f;l'ltw'Jys? L?Axll? clTy state: MN zip: 6V41--t'4- 6S/ Z?JB-coa2 Company: F?f'???+t'? ?5??? Phone #: SY (area code) CONTRACTOR Street Addreu: 3'(-?? C??` License #ZOZI -1G 91 Exp. 3 5rl City 15?44^1 state: 11'1il! zip:?5"/23 Z2ZZ 1 MAR 1 4 1001 I hereby acknowledge lhaf I have read this application, siate that the information is correct, aridlagree tcLCOmpty wilh adapplicable State of Minnesota Statutes and Ci1y of Eagan Ordinances. "` Signaiure of Applicant: c/?L'?'.??- r` ""•°"`"••? ?u? l?.o? cna ro.r DIl '4460,KC1YfSllfila ?k°k1VlJtilG7lS!@ wuu funo 7, 2007 e4tY Of Ea$an .. 3836 Pi;ot &wb goaci • EaM MN 55-122 To Whom It May Goncern: Eldes 7ones ia suthorized to pttll bniidiug permits Par Renewel by AttderserL Ptease allow dElder Jones to provide this ServiOc for us ia Hagsm. IRtIR 9titItQFI?8tiblt lR vBlttl fpr 8T1y ate bcyond 6/6l01; uutij a?awaj by And? ??y ?a? it in wiiting to the City- i rcquest this auttiovzation be a-coeptedc Y m ? thP?Cs+ng of our baildiuS P?an-its aay fnxtficr.Plcaa call mc?LFythcto acc nnY dele e cotttacted at 763-502-4706. 4ReuEona. , Ican (ie _ 8, Your immqdiaOC attcat[on to fhts maticx is arsmated. 9 Sinoeiely, ond R Rmz astatlation Managar Renowal by AndeJS3r.n Carporatiou ('r.: Ksm?-Fiiti? 7anea Received Time Jao. 1. I,01PM PLUMBING(BESH)ENTV&) - Permit Application ? City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 sz) ? Please complete for: Single Family Dwellings Townhomes and Condos when pemuts are required for each unit Date U ?- Si[e Address Vv, E-?V( L0.Y`.? Uni[ # Property Owner --rv?-o vv? cxS Telephone #(ld51 ) '-f o S -`t (e `i ? Contractor Address City State Zip Telephone # ( ) The Applicant is ? Owner _ Contractor _ Other Septic System New _ Refurbished Submit 2 sets of plans and MPC license $ 100.00 Includes County fee. Additional wnsultant fees may apply. Alterations To Esisting Dwelling Unit, Including $ 00 50 _ Adding fiMures to lower levels or room additions, excluding water softener and water heater . _ Abandonment of septic system _ Water turnaround (+ 5/8" meter if needed -$121.00) Other: _ RPZ _ new installation _ repair _ rebuild $ 30.00 _ Lawn irriga[ion system Vo? Water sottener Water heater _ $ 15.00 _ replacement _ additlonal $ .50 State Surcharge T l ^' ota $ I hereby apply for a Residential Plumbing Permit and aclmowledge tLat the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that I understand this is not a pem¢t, but only an applicauon for a permit, and work is not to start without a pemut, that the work will he in accordance with the approved plan in the case of work wYrich re uires a review and approval of plans. ') 5 Se?? ?U ??a? ApplicanYs Printed Name ApplicanYs Signature 2003 STORM DAMAGE PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN C. y C9 5 f 3830 PILOT KNOB RD - 55122 J:;i - 3 1-a ? 651-675-5675 Reauiremenfs ? 2 copies ot plan DATE: D!E,G 6/St 0?L CONSTRUCTION COST: DESCRIPTION OF WORK: lacqf` If multi-family bldg., how many unifs? INDICATE THE FOLLOWING EQUIPMENT TO BE REPLACED AND BY WHOM: ? Plumbing Homeowner or Contractor Name Mechanical ? Homeowner or Contractor Name **Note: If somebody other than the homeowner is performing plumbing or mechanical work, they must apply for appropriate permit. Only licensed plumbing contractor or homeowner may complete plumbing work. STREET ADDRESS; A? o t' 5 L A/ LOT: BLOCK: SUBD./P.I.D. #: PROPERiY OWNER CONTRACTOR Name: ! 7in nl APhone last firot Street Addre ctty E?4A Street City s a vn -e- I hereby acknowledge that I have read this applicction, stqte that the of Minnesota Stqtutes and City of Eagan Ordinances. State: ////?? Zip: 55/c?d_--- State: Phone #: (area code) L(cense # Zip: correcf, and agree to comply with all applicable StaFe Signature of OFFICE USE ONLY BUILDING PERMIT SUBTYPE ? 24 Storm damage WORK TYPE ? 33 Alteration ? 37 Demolish (Bldg)* *- Give PCA handout to applicant ? 38 Demolish Interior ? 42 Demolish Foundation ? 43 Reroof ? 44 Siding ? 46 Windows/Doors Lof luO RESIDENTIAL BUII.DING ? Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 NewConsWctionReauirements RemodeVReoairReauiremenGS OfficaUseOnN 3 iegistered site surveys showing sq. ft. of lot, sq. 8, of house; and all roofed areas 2 wpies of plan Ced of Survey Real (20% maximum lot coverage allowed) 1 set of Energy Calculatlons for heated additions Tree Pres Plan Recd 2 copies of plan showing beam & window srzes; poured found design, etc. 1 site surrey tor additions & decks Tree Pres Not Reqd 1 sel of Energy CalculaGons Add'Non - mdicafe Aon-site sepfk system _ Oo-site Septic System 3 wpies of Tree Preserva6on Plan if lot platted after 711/93 Rim Joist Dehail Oplions selection sheet (bldgs with 3 or less unifs Date O! ? / Q? Construction Cost Gf?O ' Site Address 40('05 LCLN-Q- Unit/Ste # Description of Work nQ C5..C4 1? 1 n`(V?l?s ?? 1`S1.0lY.iST?1 aQFIYI+??k? Multi-Family Bldg _ Y_ N Fireplace(s) _ 0_ 1 _ 2 Pr rt O ner WY Tele hone #tos}) ^ ope y w p rl RENEWAL BY ANDERSON Contractor 1920 COIJNTY RD. "C" WEST Address ROSEVILLE, MN 55113 City State 65 ] -264-4777 Telep6one # ( ) LIC # 20130983 - 4rd Yq ZS-- COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Energy Code Category - Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 • Residen6al Ventilation Category 1 Worksheet • New Energy Code Worksheet submissiontype) Submitted Submitted • Energy Envelope Calculations Submitted, '^! l? Licensed Plumber Mechanical Contractor Telephone #( Sewer/Water Contractor Telephone #( ? Telephone # ( I hereby apply for a Residenfial Building Perrnit and acknowledge that the inforxnation 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; I understand this is not a pernut, but only an application for a permit, and wark is not to start wiYhout a pernut; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. ?su.,i?e.nsar.? ApplicanYs Frinted Name ApplicanYs Signature OFFICE dTSE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg ? 02 SF Dwelling CI 08 06-plex ? 16 Fireplace Q 21 Porch (3-sea.) Q 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Eut. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex q 12 12-plex Pibg_Y or_N ? 25 Miscellaneous Work Types ? 31 New ., O 35 Int Improvement C] 38 Demalish (Interior) ? 44 Sidirig , ? 32 Addition ? 36 Move Bldg. ?. 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration 0 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors ? 34 ReplaCement •Demolition (Entire Bldg) - Give PCA handout to applicant Valuatian Occupancy MC/ES System Census Code Zoning City Water SAC Units. Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bidgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. _ Footings (deck) FinaUNo C.O. _ Footings (addition) _ plumbing _ Foundarion HVAC _ Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Pfant License Search Copies Other Total Building Inspector Use BLUE or BLACK Ink r----------------- I For Office Use I I I City O1 Ea MR Permit#: l,, b I a~ I Permit Fee: t ~ I 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit Name: D r,-\ Lo W N Phone: q01 Resident/ Owner Address/ City/Zip: yob LA VC= Applicant is: Owner Contractor S Type of Work Description of work: Z 1- l U9 6 t`' ( Construction Cost: 2- J 00 1 Multi-Family Building: (Yes / No - Company: _ YY~ R U MI C k- ~C 7"T. C-6, Contact: Contractor Address: l City: t'`l A IV 6 l~'>~ State: Zip: J J "l ( Phone: 7 7qo License g G 00 SS 2 Lead Certificate r 1 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: I Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to. conclude that they are trade 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 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. 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. X_ (--A fZ 12 tip KUS x Applicant's Printed Name Applicant' ignature Page 1 of 3