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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