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