Loading...
4747 Berkshire Way PERMIT City of Eagan Permit Type: Building 3830 Pilot Knob Rd Permit Number: EA085209 Eagan, MN 55122 . Date Issued: 08/12/2008 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 4747 Berkshire Way Lot: 19 Block: 4 Addition: Berkshire Ponds PID 10-13750-190-04 Use Description: Sub Type: e-Reroof Construction Type: Work Type: Replace Description: House Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: If there is no ice protection inspection prior to final, you must meet inspector with ladder and flat bar. Pictures are not acceptable in lieu of inspections. Fee Summary- BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 Valuation: 3,000.00 Total: $90.00 Contractor: -Applicant - Owner: Gritz Construction Scott R Peterson 16138 Goodview Cir 4747 Berkshire Way Lakeville MN 55044 Eagan MN 55122 (952) 891-4208 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type: Building 3830 Pilot Knob Rd Permit Number: EA088735 Eagan, MN 55122 . Date Issued: 04/15/2009 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 4747 Berkshire Way Lot: 19 Block: 4 Addition: Berkshire Ponds PID 10-13750-190-04 Use Description: Sub Type: e-Reroof Construction Type: Work Type: Replace Description: House Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 Valuation: 3,000.00 Total: $90.00 Contractor: -Applicant - Owner: Gritz Construction Scott R Peterson 16138 Goodview Cir 4747 Berkshire Way Lakeville MN 55044 Eagan MN 55122 (952) 891-4208 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature 29502 40 9 1~ xA Request Date Fire No. Rough-in Inspection V00- C 2 Required? D Ready Now W Notify Inspector ,11 Yes G No When Ready? I Acensed contractor D owner hereby request inspection of above electrical work at: Job Address (Street. Box or Route No.) City `4.14 -7 '~j~ rt : S~; re VJQ Ga Section No. Township Name or No. Range No. County r1 Occupant (PRINT) one No. (M-it Q o-Son Power Supplier Address Electrical Contractor (Company Name) Contractor's License No. cr'C Z Mailing Add less (Contractor or Owner Making Installation) Authorized Si nature (Contractor/Owner Ma ing ins ion) Phone Numb O_35_SSS MINNESOTA S T BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midw g. -Room S-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642.0800 ENCLOSED. 7,'1 REQUEST FOR ELECTRICAL INSPECTION r ~ EB-00001-08 'L~Jr~ 9 5 0 2 10. See instructions for eomoletirig this form on back of yellow copy. ~l° ~ 115 SA"elow Work Covered by This Request New Add Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm Air Conditioner Other cify contractors Remarks: Compute Inspection Feed Below: # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fe Swimming Pool 0 to 200 Amps JA4 0 to $ Amps Transformers Above 200 Amps ove 10 Amps 1 77'00 Signs Inspector's Use Only: r(~ TOTAL Irrigation Booms 2'~1 Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. 1, the Electrical Inspector, hereby Rough-in Date certify that the above inspection has Final Date been made. (Ji OFFICE USE ONLY This request void 18 months from 'S BEQUEST FOR ELECTNCAL 11115'PECTWN Esootldt~fi b l~ See us"wctiens for conoftifing this for.a se bath of vellow copy. f A -V Below Work Covered by This Ber/ mt l ivow of aadapieg Agpfieeges wired Equipatent Wired Range T Service VA-~ Neater ling Fixtures Apt. Building Dryer Electric Heating Silo Unioader Commercial Bldg. tirptace Industrial Bldg. Air Conditioner Bulk Milk Tank Farm her MF.-itv) Ot r 1Sne6ty) e Other Compute nsEction fee Below A Fee service Eftbance Size a Fee F s Fee circuits O to 200 0 to 30 to 30 Anws Above 2 ,A 31 to 100 Amps 31 to 100 Swimming Pool Above 100 Above 100_ A Transfomer5 lit tion Boorrms r PartialP° Si" Special lnspection S errerks To FEE Rough-in f/ate 1. tke 1Vf leepecter. herobv a Finai Date ( rtifmr tltat~ above Made. 'ihi6tegtla~p YOid t$pltlplheiteta -,This request void q l b G ffrnths from fleques;kDaiSy Fire No. Ro =?InsPtction JOReady Now Yll Notify Irfspec- Yes ❑NO for When Ready 10 Licensed Electrical Contractor I bereby ragas.- inspection of above Owner electrical cork installed at= Stree Addr . Box or Flo. Ci t owns or a Occ t tPRINTI . Plrene Pb S Tier r E t m tCampaf+y N s 7F- Mail (Corr- for or R"kpw Instailationl, a/ Av Sf { Maki ng nstaifation Phone Nunn-}bar GA w MINNESOTA STATE WARD CTRICny THIS AnPECTIONMMUESf RILL NOT Griggs-iKdway SkIg. - Room N-181 BE ACCEPTED RY TIRE STAIWE BOARD UNLEM PROPER ITASPECTION FEE IS 1521 University Ave.. St. Pea{, MN 5004 phone {8121297,2111 ENCLOSED. CITY OF EAGAN M 9634 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for SF DWG/GAR Est. Value $61,000 Date OCTOBER 19 19 84 4747 BERKSHIRE WAY R3 Site Address Erect ff Occupancy Lot 19 Block 4 SWSub. BERKSHIRE PONDSRemodel ❑ Zoning R1 Parcel No. Repair ❑ Type of Cont. V Enlarge ❑ No. Stories " W Name JOE MILLER CONST Move Length 39 LU Address 18133 cedar AVE , Demolish ❑ Depth 466 City FARMINGTON Phone 431-2001 Grade ❑ $q. Ft. Name SAME Approvals Fees ,B - 0 Address Assessment Permit City Phone Water & Sew. Surcharge 30 - 50 f Police Plan check 1 58 0 wW Name Fire SAC 525 • 00 ~ VO Address Eng. Water Co.. 470.00 <Uzi City Phone Planner Water Meter 63.00 _.QO Council Road Unit 260 1 hereby acknowledge that I have read this application and, state that Bldg. Off. Parks the information is correct and agree to comply with all applicable APC Total $11822.50 State of Minnesota Statute `a City of Ep n Ordinances. j Var. Date Signature of Permittee &ri A Building Permit is issued to: JOE MILLER CONST on the express condition that- all work shall be done in accordance with op bte State n Statutes and City of Eagan Ordinances. Building Official . CITY OF EAGAN 9634 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 4548100 , BUILDING PERMIT Receipt # To be used for SF DWG/GAR Est. Value $61,000 Date OCTOBER 19 19 84 Site Addf 4747 BERKSHIRE WAY Erect CK? Occupancy R3 Lot Block Sec/Sub. BERKSHIRE DSRemodel ❑ Zoning R1 Parcel No. Repair ❑ Type of Const. V Enlarge ❑ No. Stories W Name JOE MILLER CONST Move El Length 39 Addreps 18133 cedar AVE Demolish ❑ Depth 46 I City G ON Phone 431-2001 Grade ❑ Sq. Ft. Approvals Fees ix I R Name SAME uu Address Assessment Permit Jilbutl 30 o.5 F City Phone Water & Sew. Surcharge Police Plan check 158.00 ri Ix n Name Fire SAC 525.00 Z Address Eng. Water Con 470.00 n. OZi City Phone Planner Water Meter 63 •00 Council Road Unit 260.00 1 hereby acknowledge that I have read this application and state that Bldg. Off. Parks the information is correct and agree to comply with all applicable APC Total~+~y~ State of Minnesota Statutes and City of Eagan Ordinances. Var. Date Signature of Permittee , A Building Permit is issued to: JOE MILLER CONST on the express condition that all work shall be done in accordance with op ble Stat { of ~nneso Statutes and City of Eagan Ordinances. Building Official Plumbing Permit No. Permit Holder Date H. V.A.C. 0-2-0 Electric Softener Inspection Date Insp. Other Footings 10 24 r2 Foundation Framing M Rough Plbg. Rough HVAC Insulation Final Plbg. Z Final HVAC a Final Cert/Occ. Water Describe Location: Well Y Sewer Pr. Diisp. r' Receipt Sys MECHANICAL PERMIT Permit No CITY OF EAGN , Fee Fill in numberedspaces S/C Type or Print legibly Tot. 1. Date 2. Installation Cost 3. Job Addresskl U1 IhL~ot It 1 Blk. _ Tra(c v~ .r 0 4. Owner 1 r 5. Contractors-~ Phone I lam. C 6. Address' C- 7. City State Zip _j 8. Building Type: Residential ka Commercial ❑ Institutional ❑ 9. Work Description: New 4B Add ❑ Alter ❑R~~epair ❑ 10. Describe Fuel Type P~C 11. No, Equipment~~ BTU - M. Ea. No, Equipment CFM Forced Air 7 Air Handling: Mfg. q Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with'a~I ordinances and codes governing this type of work. Signed: N~.1 . -------for Rough Final Inspectidns: Date Insp. _ Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-8100' I T- , Receipt PLUMBING PERMIT. Permit No. CITY OF EAGAN f r` ti a ^ f Fee r"T Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date i'` ` 2. Installation Cost 2 r 3. Job Address.x kt~~ Lot Bik. Tract ^ f..1zr 4. Owner 5. Contractor Phone - 6. Address 7. City State Zip 8. Building Type: Residential Commercial ❑ Institutional ❑ it 9. Work Description: New Add ❑ Alter ❑ Repair ❑ 10. Describe 11. No, Fixtures No. Fixtures ` Water Closet Cesspool/Drainfield s$ Bath tubs Septic Tank Lavatory ' Softner Shower s Well _ Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink / Gas Piping Outlets III 12. t hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. :t: , Signed for, Rough Final d' Inspections: Date Insp. _ Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 8RJi3~ O' P d. Eftan, " 'C c Ownw Zoning. of !Nits: Addmm sire Address: 4747 t re Way L1 B4 Ety V,* F PIS: Ply "*h Plb 10-19-84 47169 • . 14900610 eoe* WI& the at, of 5"" Connection 4iS.00 Account Dep oft 1~.00 Fee: 0. 50 Surcharge: • By Misc. Charges: Dtae of Insp.: Tom: • insp.. CI'tY P~ !I VON" 3830 - - 5800 P. 0. Box 21M PERMIT NO.: Eagan. MN ~1 DATE: Zoning: et Cilati No. of Units: r _ . Owner. Address: ttt Site Address: 4747 Plumber: PlyMuth 9 Motor No.: Connection Charge Size: Account Deposit:. 15• [70 , Render: Permit Fee: epee to own* w" the (2ty of Eegon Surcharge: "5 Misc. Charges: 'X° Total: By Dote Paid: Date of Insp.: Insp.: H RECEIPT CITY OF EAGAN P. O. BOX 21-199 EAGAN, MINNESOTA 5512E RECEIVED FROM.. r AMOUNT $ I I & _DOLLARS f 00 ❑ CASH VI.GHECK FDR FUND CODE AMOUNT 1 f , Thank L r1 4; a, C BY s - white-payers Copy , Yel (ow--Posting;4izpv plink-Filet (^qpy' CITY OF EAGAN Remarks Addition BERKSHIRE PONDS Lot 19 BIk 4 Parcel 10 13750 190 04 Owner Street 4747 Berkshire Way State Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1982 239.09 23.91 10 143.49 A015093 1-18-85 STREET RESTOR. 115.55 it " 1985 193-80 15 GRADING SAN SEW TRUNK 1982 176.04 11.74 15 129.12 A015093 1-18-85 SEWER LATERAL 1982 57.24 3.82 15 42.00 it " * 42 T$8_ 28.53- 15 399.36 WATERMAIN 1982 46.09 3.07 15 33.81 * WATER LATERAL WATER AREA 1982 176.04 11.74 15 129.72 A015093 1-18-85 STORM SEW TR`K 1985 385-01 25-67 15 359.37 A015093 1-18-85 STORMS W LAT CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 260.00 #47169 10-19-84 n WATER CONN. 470.00 it BUILDING PER. st w SAC ss ss PARK JNSPECTION RECORD f taa Pilot Mob! *Vpwr r (612) 681-W& LOT' *tocjs APPLICANT. ti ii it iltlb N**If$* 10 SOW,*, (012) 404-44" _ Y M e~+a~i~►r~~t riiir;4~ LIt IF" • Iii All 2 v, 7 l It i dww irtipohor+~ i Pt.MOM EI M c ! U l~' f 5 yc~ COMM" F ft. T Fft.kup*CW -NOW Pko"W Coro Meter Skfg. DWk r~. Deck F%W Y" Pr. mp. K - P. 0. PERMIT NO.: 5800 Eagan, MN ,Sjyj DATE: Zoning. i No. of Units: 6Sep Owrw: Address- w 3 to `Address: k4hire Qt t t3 I r. z s , t: 15.00 pd Eeade r No.: No.: Permit Fee: 10.-00 pd agree to CONPiy With the City of Eegen Surcharge: -50 ~,d L Ordi'ancef. Misc. Charges 63.UO nd meter:? Total: v By Date Paid; Date of insp.: Insp.: _ w~~e. ~w..~ ~ _ ,fit ,,T ~ ~ x s i= ..i~: s y , t - 2 1. _ ~ _ y ; •,~,i r PERMIT I Control No. 1113 CITY OF EAGAN ~ 3830 Pilot Knob Road PERMIT TYPE: BUILDING I Eagan, Minnesota 55123 Permit Number: 0 1 ~ 0 (612) 681-4675 Date Issued: 09/25/92 SITE ADDRESS: 4747 BERKSHIRE WAY LOT. 19 BLOCK: 4 BERKSHIRE PONDS DESCRIPTION: GAZEBO ~ HECK 6u1d:i_riq Perfn %'t "T"ype SF (MISC. GI_I-.7.d inch Work Type NEW 8 i 1.e9:I L,engt:h 12 u .1,d _L Wadt.h 12 REMARKS: ~4,~0 ~Q-1 FEE SUMMARY: VALUATION $5,000 Base Fee $72.00 COPY _..w .....__..__.___.__.....a .w, . Surcharge $2.50 Total Fee $80.00 Lie. Search Fee w. _ $5.0.0 Subtotal. $79.50 CONTRACTOR: - Applicant - ST. L 1 s OWNER: HENJUM & ASSOC, STEVE J 14546199 000606° PETERSON SCOTT 426; SUNRISE RD 4747 BERKSHIRE WAY EAGAN MN 55122 EAGAN MN 55122 (612) 454-6199 (612)688--6728 T herehy aeknow e that I have road thi a'on_Li < tJ,on and ~,t 3t w that t:he, i,itormat:ion (x rr~>,ct and ~~~r4-e t;o c: r,rnply al.J_ cq-,)plicablea .~t,aLe o1' P1rl~, t a t u t e s ar of F:ac~_an 0rdi.rianc,c-s now APPLICANTlPERMITEE SIGNATURE -TSSUED Y: IGNA U E INSPECTION RECORD I Control No. 1 3 CITY OF EAGAN PERMIT TYPE: BUILDING 3830 Pilot Knob Road Permit Number: 001509 Eagan, Minnesota 55123 Date Issued: 09/25/92 (612) 681-4675 SITE ADDRESS: L OT > 19 BLOCK: 4 APPLICANT: 4747 BERKSHIRE WAY HENJUM & ASSOC, STEVE J BERKSHIRE PONDS (612) 454-6199 PERMIT SUBTYPE: TYPE OF WORK: SF (MISC.) NEW DESCRIPTION GAZEBO & DECK; INSPECTION TYPE .DATE INSPTR. INSPECTION TYPE DATE INSPTR. FOO1ING FINAL PERMIT # r CITY OF EAGAN REACTIVA*1E 1992 BUILDING PERMIT APPLIC-- i 0o T~ 681-4675 SINGLE & MULTI-FAMILY 2 sets of pTans 3 registered site surveys, ~-,-copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, I set of specifications, I copy of energy calcs. Penalty applies when typing of permit is requested, but not picked up by last working day of month in which request is made or lot change is requested once ermit is issued. Date c / I / q z- Valuation of work ` 7 • b Site Address: `_r k' !A r-e J v STREET SUITE S Tenant Name: (commercial only) LOT BLOCK C N Ir; SUBD. P.I.D. i Description of work: ;,t The applicant is: 11 Owner OContractor ❑ Other (Describe) Name S a Pholie,,,,. -49 Property LAST FIRST Owner Address 7 A'e'-k5M1-'e L~ STREET STE # City✓ State Zip -SS~Z~Z-- ' r`t Company . J Phone fS4f -6I rg zz01 c,y Contractor Address "12- License # 6004--0(4_Exp. City E t~q a'L) State 01AJ Zip SS Company Phone Architect/ Engineer Name Registration # Address City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read-th- s application and state that the information is correct and agree to comply with_al'1:app~l,able State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant K~,_~_ OFFICE USE ONLY x s, BUILDING PERMIT TYPE , ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish ❑ 02 SF Dwg. ❑ 07 4-Plex ❑ 12 Multi. Misc. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-Plex '0.13 Garage/Accessory ❑ 18 Comm./Ind. ❑ 04 SF Porch ❑ 09 12-Plex ❑ 14 Fireplace ❑ 19 Comm./Ind. Misc. 05 SF Misc. ❑ 10 Multi. Add'l. ^Q 15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous WORK TYPE K31 New ❑ 33 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish ❑ 32 Addition ❑ 34 Repair ❑ 36 Move GENERAL INFORMATION Const. (Actual) Basement sq. ft. MWCC System (Allowable) 1st Fl. sq. ft. City Water UBC Occupancy R-3 2nd F1. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code 3 ~f Depth _ On-site sewage SAC Code APPROVALS Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS CA-ZC-BO ALS« T>E c K ❑ Site Footing ❑ Framing ❑ Insulation ❑ Wallboard Final ❑ Draintile ❑ Fireplace Permit Fee , D D valuation: $ ,57000 Surcharge Plan Review 6A e-S License MWCC SAC City SAC, Water Conn. e-> Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Copies ,So Other Total: SAC % SAC Units .S ROBE CONSUI_TINO. lNO~NtlAt~UAVlYOAS ANO PLAN !AS and f ENGINEERING 1 i COMPRNY, INC. , ~ ~ q00 WT 146IA 37ALL?, 8tJ1tNSVILLL~ MIMN[sOTA 55337 PH 432,-~3 QtXt ~Cl"~~_._ 41L l-OT 19 Roc.K. 4, 5E"6*Vz pONOS t ►KCT~► GouN-t'Y, M~Nu~so~ 3d ~RoNT P1ltLD1Al(s LC Y N 88~Z J~ vV ~ •ZS 7oQg O o c t t.. VAN ~ 1 j0 d o ►.toRT+1 ~ ~ - y SCALE: ►,r=3o' o LOTS ril rlecl I~r ~l 1 r I I• r I i ~ c~S , n, . iii I ,l i l Ir• L~"' (~I ~ 2S.w N gym, I Y1 -4 0 tL 3 10 ~ - 0 33s 138.00 . _ r • M ;,-9 sP= OT>:,5 EXtsTtw (s- agvArno 1 ~300~ Diu oT~S PlzoPtiSED F.4& ATI 0 J iND►tk s plRrfGTON 471: tv9K#?z ' DR4~nt!4V~ ' FI►J tSi~~l) . VA~I~ ' Ft.~OR ELE.t/~o~rt OnJ . s 933.63 .hereby certify that this is a-true and correct representation of a tract of and ' as shove' and described hereon... As prepared. by.xe on this day .of ~T , 1l8~• 1 f 1r" ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN r INCLUDE © SETS OF PLANS, CERTIFICATES OF SURVEY S.fi, DWU. ` lta~~, © SET OF ENERGY CALCULATIONS To Be Used For: Valuation: Date: Gp Site Address: 1 " 1, Off. • • Lot: Block:` Sect/Sub rect: Occupancy: Parcel , Remodel: Zoning: -f Repair: Type Of Const: Owner: Enlarge: # Stories: Move: Length: Address: Demolish: Depth: 4619 City/Zip Code: Grade: Sq. Ft.. Phone Contractor: Address: Assessments: Permit: City/Zip Code.. Water/Sewer: Surcharge: W.a Police: Plan Rev.. S0 Phone # 7 Fire: SAC: 525 Engr.: Water Conn: c~~p Arch./Eng: Planner: Water Meter (n3.°° Address: Council: Road Unit: Bldg. Off.. T,'~ .-4 Parks: City/Zip Code: APC: nh.,,,P - Variance: / l ° . r- ~Niz!Aq.4 j ROBE As COkSULTINO. CH01144445 ENGINEERING PLANNlAS and AND il,IAMOas COMPRNY [NC. r : NEWUMNEW0000 EAST 1431A STAEETs BLVINSVILLE ~ MINNESOTA 30337 PH 432'30047. rt ~ G..~....Z` .tea. ~S~ ~'~u.~''-z'-!~„zy • 1 r crLp.-~: w-r Iq Sc,oc K 4, > 5~krz€ ~N05~ L1~K41FA GOVN'Ty, MINA1~Sa30 ' RWNT 5VU.DW&, I scrW r wNE n11` l~ N8~s'2 o zs 1 t _ - rte- - - 7I N "~,v N N ! Q 11 Ju V1 _ o is 3 i . -U1 1E 385' !p bP.,4t~lAt,E VTILIT`/ 138.00 /1 _ . qtr Fad ~u-r N 88°710' 48' vV' 46 ZS S~:P. ? ~l~OTb$ Ells ST I tJ fs - C~t/~'f10N 53D•o) MQ Or&el PWPWACD fj.&A"'m cIJ I nt D l c aTi~S DpM cT1 oN Vp SUC Kf••CE • F ~ ►J ~ s~+~~ _ coA¢A!~ FteavR ~t.EVa-r1 and . = 9 33.83 herrby certify that this is a•true and correct representation of a tract of and ; as shown' and described hereon As prepared. by.s►e on this day#;ot _ri• • 2~c.T ~ ll,~+ j r - - 2/84 CITY OF EAGAN l1 APPLICATION FOR `PERMIT SEWER AND/OR WATER CONNECTION (PLEASE PRINT) 1) PROPERTY ADDRESS : ? ~,I, jti , c e.d LEGAL. DESCRIPTICN: /4 9 cIle- (Lot/Block/Subdivision or Tax Parcel_ I.D. Number) IF '-1 X'ISTM-.G STRUCT[UITIRE, DATE OF ORIGINAL B ILDDING Pz :I,. ISSUA.:NCE: PPWSM7r Z^•1IN<;/P??0POSED L7ZE: 14 R-1 SD;GLE F AIMILY ❑ R-2 DUPL~..z'Y (TWO UNITS) ❑ R-3 W,-RR HMJSE (TREE 1 U NITS) ( WITS) ❑ R-4. APAR', Mfr/CC~MCA-,1INILT%1 ( WITS) ❑ CQMNERCI.AL/R=T-/OFFICz- [3 INDUSTRIAL (3 INSTITUTIONAL/GOVEf2rDT-%r 2) APPLICA',1T (PLEASE PRINT) NAME :e i- ADDRESS : l8/ 3 3 Cc ~P.¢r. /Q~ S, CITY, STATE, ZIP: Fist MM. &0 /eA10 616-Az 51 PHONE: X13I- .too 3) P=,IBER PLEASE /PRINT) FOR CITY USE ONLY NAME :1 PLUMBERS LICENSE: ADDRESS: /Y3.28 o'Z3#,c12 lac, A.), ~ Active CITY, STATE, ZIP: Expired MAS it Q „ Not o Reco d PHONE: S,f9 36 ~J PLUMBER LICENSE #,2065-N3 a nitia +4) OCCUPAN'T'/OWNER NAME: (PLEASE PRINT) : ADDRESS: CITY, STATE, ZIP: Sl~,rec PHONE: S) INDICATE WHICH.PERMIT IS BEING REQUESTED: ~J CONNECTION TO CITY SESr7ER ❑ CONNDC i'ION TO CITY WATER ❑ 0-111ER (PLEASE DESCRIBE) 6) INDIGNTE O:+I;: PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE ❑ PLEASE MAIL APPROVED PERMIT TO 1, 2, 3, ,4 ABOVE (Circle one) 7) SIG:ZL'RE: tv DATE: C~c ~'~~Sl 1 y~ 2/84 CITY OF EAGAN 111u APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION (PLEASE PRINT) 1) PPOP= ADDRESS : LEGAL DES=PTIC`1: (Trot/Block/su division or Tax Parcel I.D. Nu7ber) ..T 2_ IF S'?"'CTL:E Da'? OF O?-TG-"!AL parer 2"II:~~/p~OPOS US=: ❑ R-1 Ste; - FAMILY ❑ R-2 DUPT{ (TTtiO L^:ITS ) ❑ R-3 TC.%.T-?CL'SE (TT=- + LNITS) f UNI='S) ❑ R-4 UN,1T ❑ CCi-n1E ZC=aL/REIAIL✓Cr'FICE ❑ INSTI -TICMU/=v'=,?%T;T 2) APP=-=r (PLEASE PRINT) NAP1E : ADDRESS: CITY, STATE, ZIP : PHONE: 3) nu-= (PLEASE PRINT) FOR CITY USE ONLY NAME : PLUMBERS LICENSE: ADDRESS: Active CITY, STATE, ZIP: L] Expired MASIL r Q Not of Record PHONE: PLUMBER LICENSE Staft initial 4) O=j ANT/CF.yTjm NAME: (PLEASE PRINT) ADDRESS: CITY, STA'L'E, ZIP: PHONE: 5) INDICATE Ldmcli PERIAIT IS BEING REQUESTED: ❑ CONNECTION TO CITY SaM ❑ COI. ION TO CITY I'7ATER ❑ 071ER (PLASE DESCRIBE) 6) 11MIC=, z. ONE : - ❑ PLE.'%.SE HOLD APPROVED PEPMIT FOR PICK-L'P BY ONE OF ABOVE ❑ PLE~~SE :1ffAIL APPROVED PEP, LIT TO 1, 2, 3, 4 ABOVE (Circle one) 7) SIC-TUBE: DATE: w /tol,~+ti, it as see amm-ma-ma:sm "I map" r F O R C I T Y U S E O N L Y PERMIT " ISSUED FEES: $ ea , ~ SET11ER PERMIT (=CL ;DE SURC_ARGE) $ WATER PERDIT'" ( INCLUDE SURCHARGE) $ e-:f¢--~~ WATER METER/COPPERHORN/OUTSIDE READER $ WATER TAP (INCLUDE CORPORATION STOP) $ SEWER TAP $ / e-c:5 ACCOUNT DEPOSIT - WATER $ WAC $ SAC $ TRUNK WATER ASSESS LENT $ TRUNK SEWER ASSESSMENT $ LATERAL BENEFIT/TRUNK SE;'7ER $ LATERAL BENEFIT/TRUNK WATER $ OTHER $ TOTAL $ °~G AMOUNT PAID "RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE NO ENGINEERING DIVISION. LIST AS A CONDI- TION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: ?e~, TITLE: DATE: _ us Am wwM W& Mso spun w-mM ow W4 WILL pq w pa 40406 wsm ~mw"m@&w W~pv owarkwrESpm w.. J