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4105 Blackhawk Rd PERMIT City of Eagan Permit Type: Building 3830 Pilot Knob Rd Permit Number: EA087531 Eagan, MN 55122 . Date Issued: 11/20/2008 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 4105 Blackhawk Rd Lot: 003 Block: 077 Addition: Section 20 PID 10-02000-030-77 Use Description: Sub Type: e-Reroof Construction Type: Work Type: Replace Description: House & Garage 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: Cedar Valley Exteriors LP Richard G Hanson 9145 Springbrook Drive, Suite 105 4105 Blackhawk Rd Coon Rapids MN 55433 Eagan MN 55122 (763) 755-2221 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 TY OF EAGAN WATER TSERVICE PERMIT 3830 Pilot Knob Road 4801 P. O. Box 21199 PERMIT NO.: 6/21783 Eagan; MN 55121 DATE: --Zoning: RI No. of Units: Owner: Richard G. 3:anson Address: Site Address: 4105 fflackhawk, Road (Q Q2CX50 0 sCD 'Z Plumber: Wenzel Meter No.: 2779b3(J4 Connection Charge: 50,Q0 pd Size: 5/8 Account Deposit: 15.00 pd Reader No.: -0_ 2rep Tri - Permit Fee: 10.00 pd f some to comply wide the City of Eagan Surcharge: .50 pd Ordinoneos. Misc. Charges: 60.00 pd w-tel: Total: 15.00 pd horn By Date Paid: Date of Insp.: Insp.: CITY OF EAGAN 3830 Pilot Knob Road SEWER SERVICE PERMIT 5887 P. O. Bqx 21199 PERMIT NO.: 21 83 r Eagan, MN 55121 DATE: Z'bning: 112 No. of Units: 1 - Owner: Richard G. Hanson Address: Site Address: 4105 Blackhawk Road Menzel Pluwbing Plumber: 6/21/83 36589 100.00 pd 1 Gorse to eom* with the City of Eagan Connection Charge: 425 -00 Rd Ordinances. Account Deposit: 15,E VA Permit Fee: © Rd Surcharge: .50 By Misc. Charges: Dote of Insp.: Total: Insp.: Dote Paid: a . xf CAgH R EGE I PT CITE' OF EAGAN 3795 PILOT KNOB ROAD a; EAGAN, MINNESOTA 55122. y 4: n DATE s~*4 19 ~ CBIV6D~ ! E. AMOUNT s, 11 f o -o ~ 03L~>r l', & - DOLLARS _ fou CASH CHECK FOR !J ~...-ct..r..=r..+-'-~ FV ND CODE AMOUNT f 1" q {y 4 /ITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N? 9233 86 PHONE: 4548100 i BUILDING PERMIT Receipt # To be wed for SCREENED PORC& Value $1,100 Date JUNE 27 iq $4 4135 BLACKHAWK RD R3 Site Address 77 SiT 6 Erect ❑ Occupancy Lot 3 Block Alter ❑ Zoning N/A Parcel No. _ Repair ❑ Fire Zone Enlarge ❑ Type of Const. RICHARD G. HANSON Move ❑ # Stories W Name SAM 3 Address Demolish ❑ Length b City Phone Grade ❑ Depth Sq. Ft. S Approvals Sees o Name of Address Assessment Permit UI- City Phone Water & Sew. Surcharge 1.00 Police Pion check Fw Name Fire SAC u'l Address Eng. Water Conn. <W City Phone Planner Water Meter Council Rood Unit 1 hereby acknowledge that I have read this application and state that Bldg. Off. the information is correct and agree to comply with all applicable ~20.00 State of Minnesota Statutes and City of Eagan Ordinances. APC Totat Signature of Permittee RICTUM G.-- A Building Permit is issued to: HANMN on the express condition that all work shall be done in accordance with of ropplicob State of minx totutes and City of Eagan Ordinances. Building Official ~t'~~ff=vt,°~'r`"r Permit No, Permit Holder Misc. Permit No, Holder Plumbing H,V.A.C. Well Water Disp. Sewer Electric 9 Inspection Date Insp. Other Footings Foundation Framing 2 Rough Plbg. Rough HVAC Insulation Final Plbg. Final HVAC Final Water Describe Location: Well Sewer Pr, Disp, I ~s 11 This request void (/n f7 ~ 18 t sj g~, (7 7 1 ~y~ Bent 1i! _ ♦~rVV Request Date Fire No. Rough-in Inspection Be, ired? ady Now ❑ iI Notify Ins ec- r When Ready ~-3 ❑Yes ❑No icensed Electrical Contractor 1 hereby request inspection of above ❑ Owner electrical work installed at: Street Address. Box or Route No. City 4 S A~ :L ~~=E ecUOn o. Township Name or No. Range No. County Oc upant (PRINT Phone No. Power Supplier Addre EI c C ntractor (Company Name) / CQntractor's License No. Mailing Address (Contractor or Owner Making Installation) Authoriz ignat ntract Owner Making Installation) Phone Nrynbeir F MI ESOTA STATE B RD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD 1821 University Ave.. St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS l Phone (612) 297_2111 ENCLOSED- Q t REQUEST FOR ELECTRICAL INSPECTION EBXOWI-04 }e , See instructions for comptet Chas form on bock of yellow copy. 4 -'46 0 "X" Below Worf*x f^ ed by This Request t/ [J Add Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Heating Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm other Specify Other tspecifyl then Specify Other other Compute Inspection Fee Below p Fee Service Entrance Size # Fee Feeders/Subfeeders S Fee Circuits 0 to 200 Amps 0 to 30 Amps 0 to 30 Amps Above 200 Amps 31 to 100 Amps 31 to 100 Amps 0_A~ Swimming Pool_ _ Above 100 Anps LA ve 10 Transformers Irrigation Boorut- ial, Other Fee Signs Special Inspection $ j Remarks AL F Rough /T Date 1 the Ele tr- 1 Inspector, hereby ' certify that the above Final Diinspection has been . made. This request void 18 months from 211 71 2 1 1 91 OFFIC 9L Y This request void 18 months from validation date printed i this box / n " PLEASE PRINT OR TYPE Request Date Rough-in inspection required? Yes [ No Inspection Other Than Rough-In: [R Ready Now 0 Will Call 5 - 2 - 9 6 (You must call the inspector when ready) Date Ready: I, [2 licensed contractor ❑ owner hereby request inspection of the above electrical work at: Job Address (Street, Box, or Route No.) City Zip Code 4105 Black Hawk Rd. Ea an Section No. Township Name or No. Range No. Fire No. County Dakota Occupant Phone No. Sharon Hanson 452-7520 Power Supplier Address Dakota Electric Farmington Electrical Contractor (Company Name) Contractor License No. Master Lic. No. (Plant Elect. Only) Roehning Electric CaO 1557 Mailing Address (Contractor or Owner Performing Installation) 14811 Endicott# Way Apple Valley, Mn. 55124 Authorized Sign ractor or Owner, orming stallatiow Phone No. 423-4328 EB•OOOOIA-70 6/95 STATE BOARD COPY- INSTRUCTIONS ON BACK OFYELLOWCOPY REQUEST FOR ELECTRICAL INSPECTION ay Ave, Rm. of Electricity IIIIIIN II III ~IIIIII I 1 nes 821 University St. Paul, MN 55104 FN * 0 2 Z L 1 2 9* Phone (612) 642-0800 Home Duplex Apt. Bldg. Other New Addn Commercial Industrial Farm Remod Repair Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other: Dryer Range Elec. Heat Temp. Service X' above the work covered by this request. Enter remarks in this space and on the back of the white copy only. Wire A. C. Unit Calculate Inspection Fee - This Inspection Request will not be accepted without the correct fee: Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps 20.0() Street Ltg./Traffic Sig. Above 200 Amps Above 100 Amps Transformer/Generator INSPECTOR'S USE ONLY TOTAL Sign/Outline Ltg. Xfmr. .00 20.50 Alarm/Remote Control 60 to Swimming Pool I hereby ceHi that I inspected the electrical installation described herein on the dates stated Irrigation Boom Rough-In Dote Special Inspection l . Date Investigative Fee Fina f'' '4 'rte THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS. CITY OF EAGAN O 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 9233 -y" 01 PHONE: 454-8100 BUILDING PERMIT Receipt # - ~ ~3~2 _ To be used for SCREENED PORCItst. Value $1,100 Date JUNE 2 7 , 19_8A_ Site AdIress 4105 BLACKHAWK RD Erect ❑ Occupancy R3 Lot Block 77 Sec/Sub. SECT 20 Alter ❑ Zoning R1 Parcel No. 10-02000-030-77 Repair ❑ Fire Zone N/A Enlarge ❑ Type of Const. V W Name RICHARD G. HANSON Move ❑ Stories Z Address SAME Demolish ❑ Length 18 City Phone 454-7890 Grade ❑ Depth 24 Sq. Ft. Approvals Fees o Name SAME 19.00 OU Address Assessment Permit City Phone Water & Sew. Surcharge 1 - 00 F Police Plan check FW Name Fire SAC X3 Address Eng. Water Conn. <W City Phone Planner Water Meter Council Road Unit 1 hereby acknowledge that I have read this application and state that Bldg. Off. the information is correct and agree to comply with all applicable APC Total $20.00 State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permittee A Building Permit is issued to: RICHARD G. HANSON on the express condition that all work shall be done in accordance with of pplic le State of in es -Statutes and City of Eagan Ordinances. Building Official Y~ 3 rITY OF EAGAN Include 2 sets of plans, ' ~V 1 Certificate of Survey & BUILDING PERMIT APPLICATION 1 set of energy calculations. To Be Used Fo r,r;,e C-Nd" Poxe,b valuation '4 ~ 1, 100, - Date 1p tI Site Address: -(OS 6 L A Ckhau~AgC)• A.c j rJ OFFICE USE ONLY Lot V3 Block Sec. /Sub. -ec Erect Occupancy" Parcel -0 Q 7 Alter Zoning -1 ~epair Fire Zone Owner: Enlarge ~G Type of Const. 1 C hA 1'D ~ • TI A t~] 5D1~ Move # Stories Address : Cl S 8Cf7 C ha r,je- Demolish Front ft. City/Zip Code: (Fkgo rx 5-5-f O.:2- Grade Depth s ft. Phone 7 S` 9t y APPROVALS FEES Contractor: Assessments Permit q Address: Water/Sewer Surcharge Police Plan Check City/Zip Code: Fire SAC - Phone Eng• Water Conn. - Planner Water Meter Arch./Eng.: Council Road Unit - - Bldg. Off. Address: APC City/Zip Code: Phone TO'T'AL d NUVd £8-TZ-9 6859£ 00'SZ5 ods 'aid ONIO-lIns E8--[Z-9 6859£ 00 *05tl 'NNOO a31VM 1HOIl 133HIS NIVM301S a311noR sun0 IV'l M3S INHO1S NUI M3S WHO1S uu-UUL • • $th S Zip m 41%T ~j V38V 831vm • 996$ LL6T Q 1t1831t/-1 H31VM NI` VgH3lVM S 00'00b 00'0002 T86I gnlS _ -lVU31`dl H3M3S (II T O£ £U£$ ~4 •i~0~ Q >INnul M3S NVS `JPJILt d.wa OZ ' OZ • e$t Ob'tROt TLbT - '31fi 1~ i+~3 1 'i Sans 133HIS ale0 ldlaoaa luawAed saea/, Ienuub lunowy ale(] luawanoadwl ? ale1S % laolls JauMO a LL 0£0 OOOZO OT IeoJed ~I18 10l OZ UOT-09S uolllppy s~Jewaa NVDV3 d0 All3 EAGA TOWNSHIP 143 BUILDING PERMIT Owner Eagan Township Address (present)F - - Town Hall Builder Date A Address - - DESCRIPTION Stories To Be Used For Front Depth Height I Est. Cost Permit Fee Remarks LOCATION Street, Road or other Description of Location I Lot Block Addition or Tract 72! This permit does not authorize the use of streets oads, alleys or sidewalks nor does it give the owner or his agent the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and general welfare to anyone in the community. THIS PERMIT MUST B4X T O MISE WHILE THE WORK IS IN PROGR S. This is to certify, that__{10.-___._ has permission to erect a-_- _ _ _ ____-_.___-.--._.-------__-upon the above desc .ibed premis s ect t e provisions of the Building Ordinance for Eagan T , nship adopted April 11, 1955. - Per airman of Board Building Inspector EAGAN TOWNSHIP BUILDING PERMIT N° 2102 Owner Via' - • • - Eagan Township Address (present) . Town Hall Builder ~le / Address Date _ '•-A. .,W DESCRIPTION Stories To Be Used For Front Depth Height Est. Cost Permit Fee Remarks LOCATION O , Street, Road or other Description of Location I Lo! Block Addition or Tract This permit does not authorize the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and general welfare to anyone in the community. THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. This is to certify, that ........has permission to erect a__-..==hip ~..__.~up n the above described premise subject tole p visions of the Building Ordinance for adopted April 11, 1955. 4 /t `i.....--•-- B - rd Per Ch irman of Tnwn oa / Building Inspector r e For Office Ilse a,'7J~' I City of Eapn Permit I 0-60 I I 3830 Pffot Knob Road Permit Fee: ✓f I Eagan MN 55122 j Date Rec ived: ® Y Phone: (651) 675-5675 Fax: (651) 675-5694 Staff: -----------------J 2008 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: 51a3la Site Address: Tenant: Suite RESIDENT / OWNER Name: Lit Phone: 99 D Address / City / Zip: i p n ),3 a V) ~ ~5 CONTRACTOR Name: ti t "kb, Q License no 3'x Address: 2a S". St, ~ City: 02cda ,l State: I11~Zip: Phone: E L09 ' j I Q ;r Contact Person: c 1 a S(YI TYPE OF WORK -)LNew -Replacement -Repair Rebuild _ Modify Space - Work in R.O.W. Description of work: PERMIT TYPE RESIDENTIAL Water Heater Water Softener A- Lawn Irrigation Add Plumbing Fixtures RPZ / -)c PVB) Main - Lower Level) Septic System Water Turnaround _ New Abandonment RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround` (includes $.50 State Surcharge) 'Water Turnaround (add $136.00 if a 5/8" meter is required) $100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ 0, 'EZ 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 i o o start .thout a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval pl x Xfw. fta, x Applicant's Printed Name ica Signature ig' FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground Rough-In Air Test JGas Test ----Final 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) L CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4675 New Construction Requirements Remodel/Repair Reauirements > 3 registered site surveys showing sq. ft. of lot, sq. ff. of house 2 copies of plan and all roofed areas (20% maximum lot coverage allowed) 1 set of energy calculations for heated additions > 2 copies of plans (show beam & window sizes; poured fnd. design; etc.) 1 site survey for exterior additions & decks > 1 set of energy calculations > 3 copies of tree preservation plan if lot platted after 7/1/93 41 C UCTION COST: (-A J IPTION OF WORK. -fear ff Lan ET ADDRESS: 44 I P BLOCK: ~ 7 SUBD./P.I.D. JVL e: + -Chin ~ A:C-1AQ-c-A Phone ~5 - 444 " -7,Fs" d PROPERTY Last First OWNER Street Address:-/-4105 ELc,~~ ~A, City GV~ State: ! Zip: 551 Company: _lc Phone -70 -94%~ (area code) TRACTOR nn Street Address: 11-4 E-CS ~cN V~rJ~. License # / Exp. . City C hc.\ A A State: Zip: ARCHITECT/ ENGINEER Company: Name: Telephone area code ( ) Street Address: Registration City State: Zip: Sewer & water licensed plumber (required for new construction onlv): Penalty applies when address change and lot change is requested once permit Is Issued. 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 Ordinances. Sire of Applicant: OFFICE USE ONLY Certificates of Survey Received Yes No J i2 ~g9 Tree Preservation Plan Received Yes No Not Required ` ' " OFFICE USE ONLY BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 4-plex ❑ 11 10-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 02 SF Dwelling ❑ 07 5-plex ❑ 12 12-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 03 1 of_ plex ❑ 08 6-plex ❑ 13 16-plex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 04 2-plex ❑ 09 7-plex ❑ 14 Apartments ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 05 3-plex ❑ 10 8-plex ❑ 15 Lodging ❑ 20 Pool ❑ 25 Miscellaneous WORK TYPE ❑ 31 New ❑ 35 Tenant Impr ❑ 39 Gas Line Only ❑ 43 Siding/Soffits/Fascia ❑ 32 Addition ❑ 36 Move Bldg. ❑ 40 Gas Insert ❑ 44 Windows/Doors ❑ 33 Alteration ❑ 37 Demolish Bldg.* ❑ 41 Wood Stove ❑ 45 Fire Repair ❑ 34 Repair ❑ 38 Demolish (Interior) ❑ 42 Reroof * Give PCA handout to applicant for demolition permit GENERAL INFORMATION Const. (Actual) Basement sq. ft. Census Code (Allowable) Main level sq. ft. SAC Code UBC Occupancy sq. ft. No. of Units Zoning sq. ft. No. of Bldgs # of Stories sq. ft. MC/ES System Length sq. ft. City Water Width Footprint sq. ft. Booster Pump PRV Fire Sprinklered APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Park Ded. Trails Ded. Other Copies Total: SAC Units % SAC city of eagan MUNICIPAL CENTER MAINTENANCE FACILITY THOMAS EGAN 3830 PILOT KNOB ROAD 3501 COACHMAN POINT Mayor EAGAN, MINNESOTA 55122-1897 EAGAN, MINNESOTA 55122 PHONE: (612) 681-4600 PHONE: (612) 681-4300 PATRICIA AWADA FAX: (612) 681-4612 ' FAX: (612) 681-4360 PAMELA McCREA February 4, 1992 TIM PAWLENTY THEODORE WACHTER Council Members MS. SHARON HANSON THOMAS HEDGES 4105 BLACRHAWR ROAD City AdmInInstrator EAGAN, MN. 55122 EUGENE VAN OVERBEKE City Clerk RE: Stop sign Petition Dear Ms. Hanson: In response to our recent conversation, I am forwarding to you the petition form we discussed that would be necessary for the City to formally consider the installation of a stop sign at any specific intersection within the City. Once the petition has been completed by a "significant" number of concerned residents in the vicinity of the specified intersection, it should be returned to my attention. At that point, the Engineering Division will coordinate a detailed study of that intersection which will include traffic counts, intersection site clearance evaluations, and road conditions. The Police Department will perform a speed study in addition to a historical accident survey. Further, the Parks Department will provide input regarding pedestrian movements in relationship to community trailways and/or park activities. The results of this study will then be forwarded to the City Council and primary neighborhood contact person(lead petitioner) for formal discussion at a regular City Council meeting. This process usually takes approximately 4-6 weeks from receipt of the petition. Also, when we receive the results of the State's evaluation of the City's recent request to reduce the speed limit, I will forward a copy to your attention as you had requested. If you have any other questions or concerns, please feel free to contact me at your convenience. Sincerely, Thomas A. Colbert, P.E. Director of Public Works TAC/jf THE LONE OAK TREE ...THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY Equal Opportunity/Affirmative Action Employer FOR CITY USE ONLY Date Received To Council Approved PETITION STOP SIGN I/We, the undersigned hereby petition the City Council of the City of Eagan to install stop signs on at the intersection with I/We, request this installation for the following reasons: 1. 2. 3. 4. I/We request that the City Council take this petition request under consideration at its earliest opportunity and that we be informed as to when it is scheduled so that we may appear in person if we so choose. NAME (Please print and initial) ADDRESS 1. - 2. 3. 4. 5. 6. 7. 8. 9. 10. r June 12, 1989 Re: Project 488, Blackhawk Road - Final Assessment Adjustment Parcel 10-02000-030-77 Parcel 10-02000-010-78 Parcel 10-02000-030-78 Parcel 10-02000-030-79 Parcel 10-02000-011-75 Dear Property Owner: When the improvement for Blackhawk Road was authorized as a result of the public hearing held on February 3, 1987, the feasibility report used to estimate the proposed costs and related special assessments incorrectly referenced your property as qualifying for a postponement of a portion of your proposed special assessment subject to the execution of an agreement in accordance with Special Assessment Policy 86-3. In preparing the final assessment roll, it has been discovered that your property does not meet the qualifying criteria as required by this Special Assessment Policy, a copy of which is enclosed for your information. Therefore, the proposed final assessment amount may be higher than what was anticipated by the feasibility report presented public hearing and subsequently carried as a pending assessment until the final assessment hearing scheduled for July 5, 1989. I apologize for any problems that may have resulted from this error in the original feasibility report pending assessment roll. However, staff is not authorized to waive the criteria necessary to quality for a partial reduction of the special assessment. Sincere , Thomas as A. Colbert, P.E. Director of Public Works TAC/jj Enclosure h DAKOTA COUNTY NAME / DESCRIPTION AND DELINQUENT TAX RECORD PARCEL IDENTIFICATION SCHOOL W PROPERTY OESCRIPTION JUDGMENT pIST T SLK SUBDIVISION: DISTRICT g sec~oT TOWN naNCe YEAR 10 0 010 05 1 EAG4N TCWNSHIP C 19EU S 1/2 OF NE 1%4 X C MCN TRANSFER DATE TRANSFER N LAST GRANTEE C CR E 250 FT SW 0 P ON W EXPQFSSWAY FRCF INC LIMF 450 FT S OF EEG N 4 0 FT TC 9EG FY COM NE CR F NE 1/4 S 1200 FT TO FG 10 b 78 The NW Mutual Life Ins. Co. D 1 1 R? FT SW Tr PT 0*1 -W / L 1527 FT W CF F L NE9 7 FT Tn E LTNE N T 8F x t inr parcel 2 of S -R/ plats 19-33 & 34 & 3. 10 27 23 1~, ~ r WAIVER OF HEARING REQUEST FOR UTILITY IMPROVEMENTS .I/1-e hereby request of the City Council, City of Eagan, Minnesota, utility improvements on and over property owned by me/us as follows: (Mention type of improvement, e.g. water, sanitary sewer, etc.)WATER LATERAL BENEFIT FOR WATERMAIN The location of, said utility improvements shall be generally as follows.. Section 20 Parcel 10 02000 030 77 140 feet at $6.90 FF = 966.00 I/Gie hereby waive notice of any and all hearings necessary for the installation of said improvements and further consent to any assessments. necessarily levied by the City of Eagan for such improvements, I/Ve further agree to grant to the City of Eagan any easements neces- sary for the installtion of such improvements. It is further understood that this request shall be reviewed by the City Council of The City of Eagan or its agent and I/we will-be given reasonable notice as to whether this request is possible under present utility planning as to timing, location, etc. Dated: July 27, 1976 Y equest accepted by Date 7- City of Eagan Request referred to CitY Engineer: D to Copies: 1. City 2. C-1 -tY Engineer 3. Applicant C C 0 M I D For Office Use • AUr 2 0 2009 City of EaRan Permit#: I I I Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 i Date Received: Phone: (651) 675-5675 l Fax: (651) 675-5694 I Staff: I - - - - - - - - - - - - - - - - 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address:~„~~ d Tenant: Suite RESIDENT / OWNER Name: AUML1 0~ !t /le~~t~1,1'lcr Phone: Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work:j IA,1,1, I_ e l , Construction Cost: OD . yV Multi-Family Building: (Yes / No CONTRACTOR Name: _ Budget Exteriors _ License 8017 Nicollet Ave S. Address: Bloomington, MN 55420 1-877-310-1742 City: _ F: 952-887-1659 _ State: / Zip: Phone: contact rerson: _oamA COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Category Submitted Submitted submission type) • Energy Envelope Calculations Submitted 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: MOTE: 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 the are trade secrets. 1 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. Xr~~ X A 4 4~ Applicant's Printed Name Applicant's Signature Page 1 of 3