4070 Amethyst Lanecrnr oF EaGaN
3795 P16t Knob Rocd Eagan, MN 55122
PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used for Est. Value Dote
N2 6087
-
19
Site Address Erect 0 Occupancy
?
Lot B lxk Sec/Sub. Alter ? Zoning
Porcel .# Repair ? Fire Zone
Enlorge ? Type of Consf.
W Name
-' 0 ^ ; • / M?o e-? # Stories ,
3 Address ! OT-LF I {?9IIs Front ' ft.
0G IGOW ? DePth ft-
°C Nome
0 Is Fees
6 Addreu
0
L L
UR
ssessment
Permit
45 Water & Sew. Surchorge
Ci Phone
Police Plan check
F
W W Name
?_ Fire SAC
?? Address Eng. Water Conn.
aW Ci Phone Plonner Water Meter
Council Road Unit
I hereby acknowledge thot I have read this opplication ond stote thot Bldg. Off.
the information is correct and agree to comply with all appliccble A? Totol
5tote of Minnesota $tatutes and City of Eagan flrdinances.
Signoture of Permittee
A Building Permit is issued to: on the express condition thot
oll work shall be done in accordance with all opplicable State of Minnesota Statutes and City of Eagan Ordinances
Building Official
?u # wa aw.a pernaer..
Plumbing
Mechoniccl
INSPECTIONS DATE INSP. Rough-In Finol
Footing5 Dafe Insp. Dote Irup.
Foundotion Plumbing
Frame/ins. Mechonicol
Final
Remorks:
CITY OF EAGAN
3795 Pilot Knob Road Eogon, MN 55114 N2 4438
PHONE: 4548100
BUILDING PERMIT . ReceiPt #
3, [}13( .".
Ts 6n uMd fer i1tldTl. Dnte 19-Z2
Site Address -~m'-' t1' S t Ln Ereci ? Occuponcy -"
Lot Block Sec/Sub. ???' S Alter ?p Zoning
Parcel # Repair ? Fire Zone _
Enlarge ? Type of Const.
0: Nome i.:= i.:td C. Move ? # Stories
Z
? Address Demolish ? Front ?fT.
.... i-,., ,. .,?---- A 5t, _7'i l Grode fl Depth ' ft.
Ix Name - -- --- -
0
?a Address Assessment -- Permit
w
Water & $ew. -
---
Surchorge
Ci Phone
Police Plan check
?-
W Name Fi SAC
F re
_? Address - Eng. Water Conn.
<W Ci Phone Planner Water Meter
Council
I hereby ocknowledge that I have reod this application and stote that Bldg. Off.
the information is correct Ond a gree to comply with oll applicable APC Total '• 5?
State of Minnesoto Stotutes and City of Eagan Ordi nances.
. .
Signature of Permittee y
, 1
;,{ i t ". ?es t?.a
c?t.
A Building Permit is issued to: _ on the express condition that
all work sholl be done in occordance with all opplicable State of Minnesoto SYatutes and City of Eogon Ordinonces.
Building Official
POrsM # Dofs lared hrsMtM
Plumbing
Mechanical
INSPECTIONS I DATE INSP. RougMln Final
Footings Date Irap. Date Imp.
Foundation plumbing
Frome/ins. Mechonical
Finol •
C1TY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-467'5
SITE ADDRESS:
10111
, ,?„ ,„. ,? InNa
PERMIT SUBTYPE:
,
ECTION RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
APPLICANT: noa«? ?,?- ??,[ 2
TYPE OF WORK:
- wr +v
INPPECTION •• • D
? i
- -
a
::?I{P••, ft ,- I i'Afi 6?Ih:/ vtt6Ml i I'., I41: trNl!•I:0 ! c:1N Atdl' f i S I.II:1Clil W(llib
r-
M?
?_ . <. . " .
Permit No. Permit Holtler Date Telephone #
S/W , . . ,
PLUMBING
HVAC
ELECTRI Oa6 Q
ELECTRIC
Inspectlon Date Insp. Comments
Footings I
r?
Foundation
Framing
Roofing r---?? -
WI rt /N -
Rough Pibg.
Rough Htg.
IsuL
Fireplace
Final Htg.
Orsat Test
Final Plbg. Plbg. Inspecior- lyotiiy Pfumber
Const. Meter
Engr./Pian
Bldg. Final a?
Deck Ftg. ?
Deck Final
Well *W, 7 v?J
Pr. Disp. ! LL /? ? /L. ! /j
?
9L 1
CITY OF EAGAN
? /I'7i_z
Lot 23 elk in Parcel ln 7 67Qd 10
Amethvst Lane state EaQan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 3L 1967 100.00 5.00 20 Pdi d
SEWERLATERAL 196 570.00 28.5
WATERMAIN
* WATER LATERAL (o 1972 607.00 24.28 25 P'
WATER AREA
STORM SEW TRK Z 1974 70.00 4.66 15 Pdj.d
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
s,nc 200.00 644 2-9-6
PARK
CI40256?
ReQUest Dat F e No
?/^f ? Rough-ln Inpsettan Repwra0
(Yau wll inspacmr w?en reeCy)
E Yea ? NO InsOeclron Other Than ough-In
? Reatly Now egLW,ll Nolify Inspector
Date Ready
I C licensed contractor alowner hereby request inspecllon of above electrical work at:
Job Atltlress ($treet. Box or Route N. I
A1070 A*yye_9Lrd- (}., . Gity
Sedion No Townsniv Name or No Range No County
OccuOant(PqWT)
a n ? o ? Phone No
PowarSupphar Atltlrass
Electncal Gom ctor ICampeny Name)
' ome ownp,i- ConVactor's License No
MaNng qtltlr s I/COn?Vactor opr Owner Mabng Installatron)
Av?bon iqnatwe ?COn c nOwner Making Ins?allaLOn? Phone Number
MINNESOTA STATE 60FRD OF ELECTBICITV m THIS WSPECTION REQUEST WILL NOT
Gtlggs-Mitlwey Bltlg - Room S113 ? BE AGCEPTED BYTHE STATE BOAFD
11321 Unlversity Ave. St Peul. MN 55104 ?Oh UNLESS PROPER INSPECTION FEE IS
Vhane (612) 662-0800 OLtk? ? ENGLOSED,
REQUEST FOR ELECTRICAL INSPECTION
/5 / O SBe in51NC?iOnSIOf CamplBting IhiS fOfm On bdCk M yBllow wpy.
"'X" Below Work Coveied by This Request
YdmeN?, EB-Owv. ,_
?
95 .5
ew Adtl Rep. 7ypeofBmldmg AppliancesWued EquipmentWired
Nome Range Temporary Service
6uplex Water Heater Electric Heating
Apt. Budding r Load Management
Comm./Indusirial ace
T Other (Spec'i(y)
Farm ondRione r
Air
01her (speuty) Comrector's Remarks
oovn ?dd?"f*on
Compute Inspection Fee Belaw.
> Other Fee # Serwce EntranceSiae
F Cvcui[5/Feeders Fee
Swimming Pool
TransformerS mpS Above 100 _ Amps
Signs msPector's use omy. ' TOTA¢
Irnqation 8ooms
? %? • ?'?? ?
y
Special Inspection Z
AlarmlCommumcanon THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WtTHIN 18 ONTH . '
I, the Electrical Inspectoc hereby Rouqn-in ? Daf ?/ta
certify that the a6ove inspection has
been made Finai oa?e ?
•
OFFICE USE ONW '
Tnis reauest voitl 18 manlhs irom
CITY OF EAGAN
- ' 3795 Pi1M Knob Road Eagan, MN 55122 N? 6087
PHONE: 454-5700 7
BUILDING PERMIT APPLICATION $500 Receipt #
,
Te 6o ueed Fe. 1ZT(1RdCR S17Fn Fd VnL.n Dote AUgUSt 1? 19 80
Site Address -
Lot 23 Block
Porcel #
rc iNom, Derald J Mittelstadt
; Address 4070 Amethyst
o .. ..,.,
?o Name
Erect [2 Occuponcy R 3 _
Alter ? Zonin9 Rl
Repair ? Fire Zone 3
Enlarge 0 Type of Const. v
Move ? # Stories
Demolish ? Fmnt -_ 11 ft.
Grode ? Depth 13 ft.
Approvab Fees
fill
? Address Assessment Permit :
?
Water & Sew. 50
Surcharge
? Ci p{w?e
Poiice Plon check
Ww Name Fire SAC
r
_?
Addreu
Eng.
Water Conn.
-<w Ci phone Planner - Water Meter
Council Road Unit
I hereby acknowledge that I have read this application ond state thot Bldg. Off.
the information is torrect ond agree to tomply with all applicable 6
50
Stote of Minnewta Statutes a C,ty of Eagon Ordinonces. APC .
Total
Signature of Pertnittee
A Building Permit is issued to: DEIB].d ?r 1 r.i r on the express condifion that
all work sholl be done in accordanC wiih all?applicp tote of Minnesota Statutes and Gity of Eogan Ordinances.
4070 Amethyst Ln
10 Sec/Sub. CG 5
Building Official
CITY OF EAGAN
Include 2 sets of plans,
1 site plan w/elevations &
1' '?B LDING PERNLIT APPLICATION 1 set of energy calculations.
To Be Used For Valuation ff?t S? Date GgU
Site Pddress: '7U A121cm-I Y.S'T LN OFFICE USE ONLY
?t ?_ siocx ? s?./sUu. C ??5 rE.rite V zo???? ? _
Parcel #: Fire Zone '?
owner: -n r2q i Yl T )'}') i -7TLY.jn40'T
Pddress: L{U76 6/'h[>7-14V SY (-P
City/Zip Caie: GW? /f,U .iSl ZZ`
Pnorie #: 1454- 733 0
Contractor: SLL?
Address:
City/Zip Code:
Phone #:
Arch./Eng.:
Pcldress:
City/Zip Code:
Phone #:
Repair
Enlan7e x 'iyPe of Const.
Move # Stories
Deirnlish Front ft.
Grade Depth 13 ft.
APPROUALS FEES
Assessments Permit
Water/Sewer Surcharge ?=-
Police Plan Check
Fire 5AC
glq, Water Conn.
Planner Water Meter
Council Road Unit
Bldg. Off.
APC
TOTAL G
EAGAN TOWNSHIP
N° ? 1'714
BUILDING PERMIT
Ownex ---"-"C!y".`...'--_`.".-.?.---?----'-'------ Eagan Township
Addsass (Preceni) ....................................... ._------- _................ ......_... Town Hall
BuilBer .....-"-----....-- '---. ..._ ...................
na:e ...7. ---- -i-- -.......
Aaa:e:s .... -......................................... .. - -- --- -_.._.. - -- --
5lories To Be Used For Front Depih Heigh! Esl. Cos! Permi! Fee Remarks
LOCATION
This plrmit does noi aufhorize the use of sSreefe, roads, alleys or sidewalks nor does i2 give the owner ot his aqen!
the righf !o create anp sifvaiion which is a nuisance or which presenls a hazard !0 the healfh, safety, convenienae and
generaI welfare !o anpone in the eommunify.
THIS PERMIT MUST BE pKEPT ON THE PREMISE WHILE THE WORK IS IN PROGAESS. ?
This is fo eerfi4y, ihaf......... ................... hespermission !o erect a....... 3..:....._.. ...........upon
.' ' ........... ..
the abore described premise subjecf !o the provisions of the Building Ordinance for Eagan Townahip adope
April 11,
IA55.
,1??'-'??'?^..... . ci ......................_......._
...-._....._._...? _E?...._- ?---_-...??..-.._...L?...?...`.".f Per .._.... ..... .( ........ lCc.-M---
C erd Buildin9 Iaapeclor
?' ,Ci
CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 55722 N2 4436
.- ' PHONE: 454-6100
6907
BUILDING PERMIT APPLICATION Receipt # _
$3,000
.
Te be used for Garage AddII. Date 19
Site Addreu 4070 AI0. SL LII Erect ? Occuponcy
Lot 23 Block 10 Sec/Sub. ?' S- Alter f?7 Zoning Rl
Parcel # Repair ? Fire Zone _
Enlarge ? Type of Const.
w Nome Derald Mittelstadt Move ? # Stories
3 Address _1?7(1 A rh?g?{ Demolish ? Front 22 4t.
° Ci Eagan Phone 454-7330 Grade ? Depth fr.
ADOrovals Feea
w Name c .ma
0
?
Address Assessment Permit +0_
? Water & Sew. Surchorge 50
~ Ci Phone Poiice Plon check
F
?w Name Fire SAC
uZz Address Eng. Water Conn.
aw Cit Phone - Plonner Water Meter
Council
I hereby acknowledge that I hove read this application and state that gldg. Off.
the information is correct ond agree to comply with all aDPlicoble 13
5?
State o4 Minnesoto Statutes and City of Eogan Ordinances. APC .
Total
Signoture of Permittee
A Building Permit is issued ko: . Dei81a Mit[LESCBd i on the express condition that
oll work shall be done in accordance with II oppli ble of Minnesota Statutes and City of Eagon Ordinances.
Official
Buildin
g
EAGE;PI 1'TA?^aRZP
3795 Pilot Knob Road
SC, Paul, Minnesota 55111
Telephone 454-5242
PEPS$IT FOR SE?41ER SI;RVICF. CON:'d,s.^,iI0P1
DATE: February 7, 1968
23-10-5
NDKB-P4 /0'?
0W^1LF: Cedar Grove Const. Co. pddress 4070 Amethyst Zane 6yn C,6. -5-
PLL^"BER TYPE OF PIPE Cast Iron
OF BUILDING
Inc?ustriaii Co?merr.ial l Residential i Multiple Dca=lling I Ivo, of u-its
i I X I { One
Locaticn of Conr.nctions;
o;
Cor.nectfon Charg..?2 'F-w;_,_,.__?°? ?
SL ; .
PermiY Fee 7•
Street Repeirs
,
Total ol V 7"
Inspected by: ?
Date
Remarke:
$y -
Chief Icwpeceor
in cozci:?erat_ien of the issue a.r.d c?a14117ery to me ef the abo-:s pe:Rml.t, I
he*eby agrae to 3o the pr^a^•se3 w.rk in accordn.r_Ae vyith the rules aad
re?uletious oi Eu;an Tot7rsi:ip, Dal:ota CouaCy, NLanesoCa
Stein, Inc.
sy
Q)P.asP. ;!ntz¢y S7}'?71 X??dy far iZ?.Speci.ion 8A(: CO:n.GY.7.OC 2E'.i: :72L'n!•e an!J pn:-t?U?1
ei rba cr;rtt is cov,raQ.
, g4A4431
Date: 7???/ /7 7
BUILDI ?G PERtti4Ii APPLICATTO!I
LOT oC 3 gLOCK 1fi?DTTTOtd Jf.V
PARCEL & SECTIOi7 PUFIBER IF UiIPLATTED
AnllRESS aF PaRcEL
20iII.TG- /f/ / OCCUPANCY C/ USE lb X a7 Z UU/2 L?,??i?'.u?L??
7---
ESTIbiAii:D W51 y+ t?JQ
T??nTTEr.Erxois ivo. 454- 7 3,3 d
aDuxrss 4D 7/) fl irJ ?T r/ " 5T L ti/
COr:1TRACTOR / 'TELEPHONE TTO.
?
AllDs2ESS
tiotes Include site plan, building plans, and energp calculations oaith this
application
Signed
? OFFICE USE
VALUIITIOF'
Se1C
S'?:1'?'h':2 COiTi1?EC:IOi] `
C•IATEIi ! S:.TER
BU2LDIPIG PEPSiIT FEE
SJkCIiAFtGE FLF;
PLrL3 Ct.ECIf F="
PAAIC DEDICIITM:T FEE
OT wR
%
TOTAL*
APPF.OVP,LS :
ASSESS,>LENT CLERI< BUILDING D PT. POLICE DEPT.
WTER & SEF,1ER DEPi. FI?ts MPT. PARK DEPT.
q3?
?
M
19
00
?
Z
?
?
?
-?
?
In
? yrNu?l?fNpp?? i?
?.'
;u
-city of eagan
MEMO
TO: DIANE DOWNS, UTILITY BILLING CLERK
FROM: ED KIRSCHT, SR. ENGINEERING TECHNICIAN
DATE: AUGUST 23, 1993
SUBJECT: STREETLIGHT ENERGY C05TS-CEDAR GROVE NO. 5(208 LOTS)
This memo is to inform your department to begin to invoice the energy costs at the singie
family rate effective August 1, 1993 to the properry owners in Cedar Grove No. 5 Addition.
Block 1, Lots 1-22 22
BloCk 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
208
The City is currently being billed by Dakota Electric for streetlighting in the above listed
subdivision.
Edward J. irscht
5r. Engineering Technician
cc: Mike Foertsch
EJK/je
? CIT'f( OF?EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT CR w13
PERMITTYPE: BuzLoxNs
Permit Number: 0 2 3 6 3 9
Date Issued: 0 6/ 0 6/ 9 4
SITE ADDRESS:
P.I.N.: 10-16704-230-10
4070 AMETHYST LANE
LOT¢ 23 BLOCK: 10
CEDAR GRtlVE 5TH
DESCRIPTION:
?. ?
Building.Permit Type SF PORCH
/Building Work Ty pe NEW
.
?
?
; -
?
/J
• ,V!?' ("lu.- '
?
C
?
REMARKS:
A SEPARATE PERMIT IS REQUIRED FOR ANY ELECTRICAL WORK
FEE SUMMARY:
VALUATION $9.000
Base Fee $108.00
Surcharge $4.50
Total Fee $112.50
CONTRACTOR: - Applicant - S7. l.IC. OWNER:
CUSTOM HANDYMAN 15521599 0007765 GEftMOND WAYNE
1317 SOUTHVIEW BLVD 4070 AMETHYST LN
S S7 PAUI MN 55075 EAGAN MN 55122
(612) 552-1599
S hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable State ofi Mn.
L Statutes and City of Eagan Ordinances. ?
APPLICANTlPERMITEE SIGNATURE ISS D BY' : ATURE
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
LOT: 23 6LOCK: 10
4070 AMETHYST LRNE GUSTOM HANDYMAN
CEDAR GROVE 5TH (612) 552-1599
PERMIT SUBTYPE:
SF PORCH
TYPE OF WORK:
?
?
NEW
BUILDSNG
023639
06/06/94
?
I
REMFlRKS: A SEPARATE PERMTT IS REQUZRED FOR ANY ELECTRTCAL WORK
59 CITY OF EAGAN
? 1994 BUILDING PERMIT APPLICATIO
681-4675 it 3 1?59'?
?Si9/ % ? ?c?ssa,?/? rnJQ?rl ???? ??'?•Jr? - ---
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set af
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date Valuation of work
Site Address: 402Q
SLJITE #
STREET
?
Tenant Name: (commercial only)
LOT BLOCK SUSD. L
t P.I.D. #
,Wt
e_,
Descri tion of work: c40 4,!
The applicant is: ? Owner Contractor ? Other (Describe)
Name L?.?.. e a »C?/ Phone
PrQ?ertS/ LAST ? FIRS'
Owner ys4 'gel'on ,f
Address 7 o 4? _-0/1
_
STREET STE #
City State Zip S-r-/JL
Company ?? ?s?r• ??? ?y---?-? Phone
Contractor Address License # 40a 774, ?Exp.
City State d~?? Zip ,5-?r-o 7?
Company < Tr7/-c Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once ar a has been approved.
I hereby acknowledge that I hav read this application and state that the information is
cnrrect and agree to comply wi a 1 applicable State of Minnesota Statutes and City of
Eagan Ordinances.
"
? ?
?
Signature of Applicant: ?
^
?-? ??^?
OFFICE USE ONLY
BUILDING PERMIT TYPiE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dwg. ? 07 4-Plex 0 12 Multi. Misc. ? 17 Swim Pool
E.03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind.
I?G 04 5F Porch ? 09 12-Plex ? 14 Fireplace ? 19 Comm./Ind. Misc.
b 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
? 31 New ? 33 Rlterations ? 35 Tenant Finish ? 37 Demolish
? 32 Additian ? 34 Repair ? 36 Move
GENERAL INFORI4+IATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
P3a7r?ng
Engineering
REGIUIRED lNSPECTIOMS
? Site
? Wallboard
Basement sq. ft.
lst F1. sq. ft.
2nd F1. sq. ft.
Sq, ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Ruilding
Variance
,0 Footing
51 Final
P Framing
? Draintile
v" Y
o/
?
,R Insulation
? Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SJW Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
TraiTs Ded.
Copies
Other
Total:
vatuatim: $ n
/,(0- l6 =a,2Y? Yo ' 89G6 °o
I
MWCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code
Census Bldg
Census Unit
Rssessments
5AC %
SAC Units
1999 BUILDING PERMIT APPLICATlON (RESIDENTIAL)
CfTY OF EACAN
/ 3830 PILOT KNOB RD - 55122 .r
3 ?L 651•681-4675
New Conskuctlon Reaulremenh Remodel/Reoair Reaufrements
? 3 regisfered sRe suneys showing sq. k. of lot sq. lt. of house 2 copies of plan
and gg tooted ateas {20% maximum lot coveyaae ollovretl) 1 aet oF energy calcuiafions for heafed addNions
? 2 coples of pians (show beam 6 window siZes; poured fnd. deslgn; eTC.) 1 sNa survey for exterfor addffions d decb
? 7 set of energy calculations
? 3 coples of free pre:ervatlon plan H lot platted aNer 7/1/93
DATE: / " p ~ ( ? CONSTRUCTION COST:
DESCRIPTfON OF WORK:
Sl46J
STREET ADDRESS: -951O 17 0
LOT: ? BLOCK: 10 SUBD./P.I.D. #: C, & C, 4-(1 o -c '?'
Name:???Pdr/p l/`?'4'?N??-5 14 Phone #: 1?5,rl- e) ?fo
PROPERTY Last First
OWNER
Street Address: 4 0? ? zFtWy S T ZOnc
WN zip: z Z
city state:
Compan,,OEFF? ? 124AV?Pn' Cs -?c Phone #: 6/?-- .5-if d-V 2- 7 -7
(area code)
CONTRACTOR 3 ,/ Sheef Address:47 N??C1Al0 License # 3-3? Exp. 2-4'+'v
ARCHITECT/
ENGINEER
Street
City
Sewer 8 water licensed plum6er (reauired for new constructlon onlvl:
"&/!/ Zip: 5-C5eG~ Z
Name:
Registratton C.
_
State: Zip:
PenaNy applies when address chonge and lot change Is requested once permH ts
I hereby acknowledge that I hwe read lhis appiicatton, state fhat the
Stafe of Minnesota STatutes and CNy of Eagan Ordinances.
Signature M
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No v
Tree Preservation Plan Received _ Yes _ No _ Not Required
wflh all applicobl
? ...,..
1? ?------- .-? 1
Telephone #: area code (
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? dZ SF Dwelling Q 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea.
? 03 1 of _ plex ? OS 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
O 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35
? 32 Addition ? 36
? 33 Alteration ? 37
? 34 Repair ? 38
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia
Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair
Demolish (Interior) ? 42 Reroaf
" Give PCA handout to applicant for demolition permif
Basement sq. ft.
Main level sq. ft.
sq, ft.
sq. ft.
sq, ft.
sq. ft.
Footprint sq. ft.
Building
Engineering
Census Code
SAC Code
No. of UniYs
No. of Bidgs
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
SAC Units
% SAC
411""'citVioFicagan
Z7-
PATRICIA E AWADA
Mayor
October 20, 2000
Lisa Germond
4070 Amethyst Lane
Eagan, MN 55122
Dear Lisa:
PAULBAKKEN
BEA BLOMQUIST
PEGGY A. CARLSON
$ANDRA A. MASIN
CounalMembers
THOMAS HEDGES
City Atlminisirator
Enclosed please find copies of the documents distributed at the last City Council meeting,
Tuesday, October 17. If you need further inforxnation, please feel free to call the City.
Thank you for giving me the telephone number to call regarding the mold on my
daughter's dolls.
Sincerely,
( l ?.
Thomas L. Hedges
City Administrator
Enclosure
MUNICIPAL CENIER
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122-1897
PHONE (651)681d600
FN( (651)681-4612
TDD(651)454-9535
THE LONE OAK TREE
THE SYMBOL OF STRENGTH AND GROWIH IN OUR COMMUNIN
Equal Opportunity Employer
W W W.CItyOf@OgOf1.COT
MAINTENANCE FACILIiY
3501 COACHMAN POINT
EAGAN, MINNESOiA 55122
PFIONE' (651) 681-4300
FAX. (651) 681-4360
TDD: (651) 454-8535
r
2000 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PI851-681-48 5- 55122
?
5 - a-?,Uu
> 3 reglsfared stte wneys showlng eq. ft ot bf, sq. B. of house
arxl gff rootetl areaa C1096 mmdmum lot coveraae allowa?
D 2 copies ol Pkmu (ahow beam 8 window slzea: Poured Mtl. deaipn; atc.)
n 1 aet of enerpy catcWaMOns
? 3 coples of hae preeenaHon plan fl lof pkdfetl alfer 7/1 /93
DATE: ?
DESCRIPTION OF WORK: <,
STREET ADDRESS: 0 Z 0
LOT: D_-?Z BLOCK: I a SUBDJP.I.D.
PROPERTY
OWNER
CONiRACTOR
ARCHITECT/
ENGINEER
RemodeL/Reoalr Re4tilremenh
?
7s
-aa_Oc)
2 copies W plan
1 set OI energy cdcWalions lor tWfed addtlona
1silo wrvey for exlador adtliHOns R decks
CON5TRUCTION COST:
1.? ??,
G?C)?? ?
Name: G?f-f0 iCl /) LS ? Phone #: a l M?3 06 7 G
las+ flrs?
Sheet Address: it I / i 1av
cuv srat.: /'Y) Ai zIa: S-12,77-1
Company: Phone N:
(area code)
StreeY Address: License # Exp.
City
Company:
Telephone #: ( )
Slreef Address: Registrarion f1:
citY
SMte:
SeweMxater Ifcensed piumber (H IrnWlilna sawerMratarl: Phone #:
Zip:
I herebY acknowledye fhat I hwe read Ihis applicatbn, state Nwt Ihe IMomwtlon is cortect and agree tc cc?1W wNt+ atl apppcable State
of Minnesota Slatutes and Cily of Eagan Ordinances.
Signalure of AppUcanY.
OFFICE USE ONLY
State: Zip:
Name:
Certificates of Survey ReCeived _ Yes _ No ViAY 2 z
Tree Preservation Plan Received _ Yes - No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 08 06-plex ? 17 Garage ? 22 Poreh/Addn. (4-sea.)
? 03 Ot of _ plex ? 09 07-plex ? 18 Deck ? 23 Porch (screened)
? 04 02-plex ? 10 08-piex O 19 Lower level ? 24 Storm Damage
? OS 03-plex ? 11 10-plex Plbg Y or _ N ? 25 Miscellaneous
? 06 04-plex ? 12 12-plex ? 20 Pool o 30 Accessory Bldg.
WORK TYPE
? 31 New O 36 Move Bldg. ? 43 Reroof
? 32 Addition 0 37 Demolish (Bldg)' ? 44 Siding
? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair 0 42 Demolish (Foundation) ? 46 Windows/Doors
• Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
5AC Code # of Stories S9• ft•
No. of Units Length sq. ft.
No. of Buildings Width Footprint sq. ft.
Const. (Actual) Basement sq. ft. Census Code
(Allowabie) 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 ExL Alt - Multi
? 33 Ext. Alt - SF
? 38 MuiG
Permit Fee CS 3 ?
Surcharge I. ?
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S!W Permit
5Ml Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
SAC Units
% SAC
2000 STORM DAMAGE PERMIT APPLICATION (RESIDENTIAL) ?..-,
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
If I 657-681-4675
Reaulremenh
? 2 copies ot plan
DATE: ? 6 J G?C.IY, CONSTRUCTION COST: 36) ccx)
DESCRIPTION OP WORK: j&j:ACr-
1 _ If mulH-famlty bldg., how many untts?
IPlDICAiE THE FOLLOWING EQUIPFAEPSTTO BE REPLACED APfD BY WHOPA:
_ Plumbing _ Homeowner cZr Contractor Name
_ Mechanical !?Iomeowner gr Contractor Name
"Note: If somebody other Than the homeowner is pertorming plumbinq or mechanical work, ihey must applyfor appropriate
permit. Only licensed plumbing confractor or homeowner may complete plumbing work.
STREET ADDRESS:
?40-70
Ar, W v-, 551 ZZ
LOT: _=J BLOCK: I ? SUBDJP.I.D.#: GY-' ?Yvoe' S
PROPERTY
OWNER
Name: GE-12 V0000 LlS A- Phone q:
Last Fint
stree?
-4v-7b
r o
ciy srare: ziP: 5?`-12Z
Company: Phone #:
(area code)
CONTRACTOR
Sheet Address: License # Exp.
Clty
State:
Zip:
I hereby acknowledge }hat I have read this applicafion, state that the informafion is correct, and agree to comply with all applicable State
of Minnesota Stafutes and Cify of Eagan Ordinances.
Signature of Applicant:
JUL 2 8
?j
2000 STORM DAMAGE PERMIT APPLICATION (RESIDENTIAL)
CITY OF EACAN
3830 PILOT KNOB RD - 55122
651-681-4675
Reaulremenh
? 2 copies of plan
DATE: ?f zZI?I CONSTRUCTION COST:
DESCRIPTION OF WORK: ?2 Lekrd- Ct?i2Ai11/G 9-kM4321f mWti-family bldg., how many unifs?
INDICATE THE FOLLOWIPIG EQUIPMEFIT TO BE REPLACED APlD BY WHOM:
? Plumbing _ Homeowner Qr Contractor Name ?F?KY
_ Mechanical _ Homeowner Ql Contractor Name
"Note: If somebody other ihan the homeowner is pertorming plumbing or mechanical work, they must appry for appropriate
permit. Only Iicensed plumbing contractor or homeowner may complete plumbing work.
STREET ADDRESS: 70 10 AMi5TVS7- L-f{/11?
\
Lor: Z 3 eLocK: ? suaD.ir.i.o. #: Ce <a' (t n6r 611,-; IP q
a? ? u5-1 Phone
Name: 6e-4?IWND , W
PROPERN Last ' Firsr'
OWNER ?l
Streef Address: 70?G M!?YST 44"e-:
Gty SfaTe: M(J Zip: 55/;07-
(rlsl - Z11(5 - 0oZZZ
Company:eA/?V25FM ,Z'?55&';Kj LLC • Phone a: S/ l-OOZ-2-
(area code)
COMRACTOR
StreefAddress: License#20z/-769/ Exp. 3! o
City State: ?? Zip:
I hereby acknowledge lhaf i have read this application, staTe that fhe information is correct, and agree fo comply wilh allapplicable State
of Minnesofa Staiutes and City of Eagan Ordinances.
Signaiure of ApplicanT:
yFb3?
??? 'as
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN ?
3830 PILOT KNOB RD - 55122 ?
651-681-4675 ?
Naw Conatruc6on Reauiremanb RemodeURaoair Reauiremenb
• 3 reg'sMred site suneys showing sq, ft o( lot, sq. ft af house; and all roofed areas . 2 copies M plan
(20% maximum lot coverage aliowgd) • 7 set of Erergy Calwlations for heated addibons
• 2 capies of plan shovnng beam 8 window saes; poured found design, etc.) . 1 site surrey for ezterior additions $ decks
• i set ot Energy Cakulatlans . IrMimte'rf home served 6y septlc syslem for additlom
• 3 copies of Tree Preservatlon Flan it lot platted aXer 7MR3
. Rim JoislOefail Optbns selactbn sheet (bldgs wilh 3 ar less uniLg)
DATE / ^a;? - a a`
JOB SITE ADDRESS _ Z74 0 '?
IF MULTI-FAMILY BUILDING, HOW MANY
PROPERTY
TYPE OF WORK Y,'
APPLICANT E,14
ADDRESS 7/0o
PAGER #
VALUATION 54`0I?! a c--'
5? ?
Pc.g? pr
FIREPLACE(S) _ 0 _ 1 _ 2
?, - f Heeu.n5_,?/r{Ol
CELL PHONE #
PHONE# 4'S a-RX! -/2 3
_ZIPCODE 53-2f-
FAX #
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumbing Conhactor: Phone #:
Plumbing System Includes: _ Water SoFtener _ Lawn Sprinkler Fee: $90.00
_ Water Heater _ No. of R.I. Saths
_ No. of Baths
Mechanieal Contractor: Phone #
Mechanical System Includes: _ Air Conditioning Fee: $70.00
_ Heat Recovery System
Sewer/Water Contractor: Phone #
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Or inances
Signature of Appiicant ?;' 7. a??
Certificates of Survey Received _ Tree P2servation Plan Received _ Not Required _
Updated 2002
OFFICE USE ONLY
? Ot Foundation ? 07 0''rplex ? 13 16-plex ? 20 Poal ? 30 Accessory Bidg
? 02 SF Dwelling ? 08 Ofrplex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex O 17 Garage ? 22 PorchlAddn. (4-sea.) O 33 EM. Alt - SF
? 04 02-plex ? 10 08-piex 0 18 Deck ? 23 Porch (screened) ? 36 Multi
? OS 03-p4ex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage
? 06 04-plex O 12 12-plex Plbg_Y ar _ N ? 25 Miscellaneous
? 37 New O 35 Int Improvement ? 38 Demolish (Interiao ? 44 Siding
O 32 Addition ? 38 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)` ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement `Oemolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zaning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
Footings (new bldg)
Footings(deck)
Footings (addition)
Foundation
Drain Tile
Roof Ice 8c Water Final
Framing
Fireplace _ R.I. _ Air Test _ Final
[nsulafion
FinaVC.O.
_ FinaVNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ AidGas Tesu _ Final
_ Siding Stucca Stone
_ Windows (new/replacement)
Approved By , Building Inspector
Base Fee
Suroharge
Pian Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Searoh
Copies
Other
Total
,
SEVERSON,SHELDON,
DOUGHERTY & MOLENDA, P.A.
SIDTE 600
7300 WEST 147TH STRBET
APPLE VALLBY, MINNESOTA Si 124-7580
(952) 432-3136
TELfiFAX NUMBER (952) 432-3780
E-MAIL bauerrou seversonsheldon.com
TO: Jolm Gorder, Assistant City Engineer
FROM: Robert B. Bauer, City Attoxney ?
DATE: July 13, 2004
RE: Lot 23, Block 10, Cedar Grove 5
Drainage and Utility Easement - No. 933
Wayne D. and Lisa A. Germond
Our File No. 206-19117
John,
Enclosed for the City's records, please find the origina] Drainage and Utility Easement dated
June 20, 2001 and recorded with the Dakota County Registraz of Titles on December 9, 2003, as
Document No. 05237560.
?
• ,)_r?aJ F ja.?z ? !"
? F k !
?ly 1 ?t.
1/0%6
?YMPt????.? w
s!
O
i
? ?a W ? 0 0523760 ?
? z r ? tJ,,
O
OCO ¢O ` U LL ? ? W ?
O W? U ¢Q y? U W W ? 10
? ?j= 21i Q N cc
o y x
c, Q g ?V
Z W
L \
N ? O I=- ? O N j U
P
O V Q a W c.?--'
LL '? CL Z ? ? ?
F? pm Z Y 0 G
? ? W 5? rygp c?p? 7 l
?-? w? Z 0
? Q N Q Y?iF R:+?.3?eCIY^E?P p./
LL U a ? O W fn O D U IFY??y??n ?i.?iV I Y
0 3 0? a¢ z TFiEA.S°URE: R-:2i..lDBTOR « vv ?
DRAINAGE AND UTILITY EASEMENT
I
THIS EASEMENT, made this 2J? day of v?? a , 2001, between
WAI'NE D. GERMOND and LISA A. GERMONI??@-RHMN ef`eff ed to as "Landowner"),
and the CITY OF EAGAN, a murucipal corporation, organized under the laws of the State of
Minnesota, (hereinafter refened to as the "City").
WITNESSETH:
That the Landowner, in consideration of the sum of One Dollaz ($1.00) and other good
and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, does
hereby grant and convey unto the City, its successors and assigns, a perxnanent drainage and
utility easement, over, across and under the following described premises, situated within Dakota
County, Minnesota, to-wit:
A permanent drainage and utility easement over the east 10' of Lot
23, Block 10, Cedaz Grove 5.
The grant of the foregoing permanent easement for drainage and utility purposes includes
the right of the City, its contractors, agents and servants to enter upon the premises at all
reasonable times to constnzct, reconstruct, inspect, repair and maintain pipes, conduits and mains;
and the further right to remove trees, brush, undergrowth and other obstructions. After
completion of such construction, maintenance, repair or removal, the City shall restore the
premises to the condition in which it was found prior to the commencement of such actions, save
only for the necessary removal of trees, brush, undergrowth and other obstructions.
And the Landowner, its successors and assigns, does covenant with the City, its
successors and assigns, that it is the Landowner of the premises aforesaid and has good right to
grant and convey the easement herein to the City.
F2ECEIVED - MAIL
NQ!' 0,5, 2003
DAKOTA COUN7Y
TREASURER-AUDROR
IN TESTIMONY WHEREOF, the Landowner has caused this
as of the day and year first above written. _
WAY,N& D. GERMOND
A.
STATE OF MINNESOTA)
)ss.
COUNTY O ?-oTtj
The foregoing instrument was
12001, by WAYNE D.
and wife.
APPROVED AS TO FORM:
?-?--- ,? . ?.-
to be executed
aclaiowledged before me this ?-b day of
GER?IOND and LISA A. GERMOND hu band
?'
Notaf,v Public
q
m
RES g @
iw
City Attorney's Office
Dated: g1(W4
APPROVED AS TO
orks
Dated:
THIS INSTRUMENT WAS DRAFTED BY:
C SEVERSON, SHELDON, DOUGHERTY &
? MOLENDA, P.A.
7300 West 147th Street, Suite 600
Apple Val]ey MN 55124
(952) 432-3136
(Eesement #973)
(20fi-19117)
6S09
2005 RESIDENT'IAL BUILDING PERNII'T APPLICAI'ION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX 4 651-675-5694
Telephone #(
New Construdion Reauiremenis RemadeUReoair RenuiremenGs Oifice Use Onlv
3 registered si[e surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Cert of Survey RerA _ Y_ N
(20%mazimum lat coverage allowed) 1 setof Energy Celculations forheated eddlCrons Tree Pres Plan Recd _Y _ N.
2 copies of plan showing beam & window s¢es; pourad tound design, etc. 1 site survey for additions & decks Tree P2s Required _ Y_ N
lsetofEneigyCalculations Addifion-indicatedon-sitesepficsysfem On-siteSeptcSystem _ Y _N
3 copies of Tree Preservation Plan if bt plattad afler7/1N3
Rim Joist DefaB Oplions selectlon sheet (bu0d'uigs Wrfh 3 or less untts)
uo
Date Construction Cost
SiteAddress S f" L G, 2 UniGSte f/
l.? O\ A? v Y
Description of Work ?
S I?i t v?
Q
Multi-Family Bldg _ Y-,K N Fireplace(s) _ 0_ 1 _ 2
Property Owner
d-
? r .?, '
L1i) c.? C'f r vri 0 +?111 Telephone #( G',' G a -b 0_??
?
Contractor ? Xf e_ rI
w1 -r
Address C?( Q O ' 'Yl City
- O n'l 1?1
State 1-n L/\ ?
Zip Ss y3, Telephone #( Q
G? ?-U?? -!SU ?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minneso[a Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Vantilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan8 _ Y _ N If so, 25% pian review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
0 7 va
0,
Telephone # ( )
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; 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 asSig# case of work which requires a review and
approval of plans.
Applicant's Prin d Name Applicant e
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 78-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex O 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair,
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 48 Windows/Doors
? 34 Replacement 'DemollGon (Entire Bid g) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width -
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaVC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water Final Pool _ Ftgs _ Air/Gas Tests Final
_
_ Framing _
_ Siding _ Stucco _ Stone _ Brick
Fireplace _ R.I. _ Air Test _ Final _ Windows
_
_ Insulation _ Retaining Wall
Approved By:
Base Fee
5urcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
5&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
• EAG TOWNS
3795 Pilot Kno 51 2340.5
St. Paul, Minnesota _+11
Telephone 454 -5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE: Xabs+rrsy -3, 1S6R NUMER /a .Y
OWNER : P.A., n...... P .. e^ Address dn7n ...,.riy ■r +...
PLUMBER TYPE OF PIPE 0...1 lees Dula. LOC.
DESCRIPTION OF BUILDING
Industrial Commercial Residential Multiple Dwelling No. of units _
1 Y Oa
Location of Connections: Connection Charge
Permit Fee 9. J ,I
Street Repairs
J
� �} Total
V Inspected by: /,�
Date 0 (6 /
Remarks: 0 f (
36'2 OtC1 )en's
By
Chief Inspector
In consideration of the issue and delivery to me of the above rnrmi.t, I
hereby agree to do the prcposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota
Stein, loc.
By
Please nnrify when ready for inspection and connection at::: becre any portion
of the work is covered.
Use BLUE or BLACK Ink
r
I For Office Use 1
~ Permit
City of Ea ~aii
3830 Pilot Knob Road I Permit Fee: 105
Eagan MN 55122 Date Received: h
Phone: (651) 675-5675
I i
Fax: (651) 675-5694 I Staff:
I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: \ , t Site Address: Unit
Name: a~n~ . ~'GC-MOB Phone: ~U _4 l~~y
Resident/
Owner Address / City / Zip: o V h
Applicant is: Owner Contractor
Description of worker c~ ho~S~
Type of Work o0
Construction Cost: Multi-Family Building: (Yes / No )
Company: Contact:
Contractor Address: City:
State: Zip: Phone:
License Lead Certificate
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:
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. `
1~
x
Applicant's Printed Name Applicant' Signature
Page 1 of 3