4279 Augusta Lane
Use BLUE or BLACK ink
I
I For Office Use
I
nouL
bay of Ealan Permit I I
3830 Pitt Knob Road Permit Fee:
Eagan MN 58122 I I
Phone: (661) 675.5675 1 Date Reserved. 1
i
Fax: (651) 675-5694 1 sta>fi:
2014 MECHANICAL PERMIT APPLICATION
[sate: Site Address:
Tenant: Suite
RESIDENT / OWNER Name: 1 Phone: (C_~) "
~ .
Address i City i Zip:
CONTRACTOR Name: ' nse
Address:
city:
State: Mn Phone: t(J jJ~ -V
Contact Vt_r) V r -Emait:
TYPE OF WORK New 4 Replacement Additional Alteration Demolition
Description of work:
NOTE: RW mounted and grou mounted mechanical equipment is required to be screened by City
Code. Phase contact the Mechanical inspector for information on permitted screening methods.
PERMIT TYPE RESIDENTIAL COMMERCIAL
Furnace _ New Construction Interior Improvement
_ Air Conditioner Install Piping Processed
Air Exchanger Gas Exterior HVAC Unit
-Heat Pump _ Under I Above ground Tank Install Remove)
er When installing/removing tank(s), call for inspection by Fire
Marshal and Plumbi Inspector
RESIDEN17AL FEES;
$55.00 Minimum Add-on or aAeratiion to an existing unit (includes $5.00 State Surcharge) r~
$95.00 F'e'e repair (replace turned out appliances, ductwodc, etc.) (includes $5.00 State Surcharge) $ TOTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank instaitation/rernoval OR Contract Value $ x 19fi
$55-00 i i M (includes State Surcharge)
Permit Fee
- If the EMA Fee is to" than $1010, surcharge is $ 5.00
- If the Em A fm2 is s $10,010, surcharge increases by $.50 for each $1,000 Permit Fee Surcharge
(i.e. a $10010-$11,010 Perm Fee requinas a $ 5.50 surcharge)
TOTAL FEE
CALL §CFORE YOU DIG. can Gopher stare one call at (651) 4".0002 for protection against underground utility damage. Call 48 hours
before you tend to dig to receive locates of underground utillthm www.goaherstateonecall.ora
l 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 p
x Ct~ t~ g
Applicant's Pii#ftd Name ApOka nrs lure
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground - Rough In -Air Test -Gas Service Test -in-floor Heat -,Final
Exterior HVAC Screening Inspection
IF-
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road
P. O. Bo), A 199 PERMIT NO.:
Eagan, M' 55121 DATE:
Zoning: r` 't o. of Units: 1
nor: Joe '"I'
ddress:
Site Addmu 4? _ - ~ I k ~ 1 ~k?fi ~E~ S Sun:',: t 1 s
V Plumber: ii#=FiO!k~; LE TR1 GA Eti.
Motor No.: CtnAW Charge: 470.00 pd
Size: r~L.4`• Account Deposit: 15.00 pd
Reader No.: 1") L l -16 42 Permit Fee: 1.0.00 pd
1 49me to comply with the City of Eagan Surcharge: .50 pd
Misc. Charges: 63.00 pd meter
Total:
BY Date Paid:
Dote of Insp.: Ge (.9 Insp.:
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road F
P. O. Box 21199 PERMIT NO.:
Eagan,,MN 55121 DATE:
Zoning: R1( No. of Units: 1
Owner: Joe `tiller.
Address:
Site ,arm: 4279 Augusta Lane L3 B1 Sunac,l: Ist
Plumber: NcGul.re tech
Meter No.: Connection Charge: 470.00 d
Size: Account Deposit: 15. p
Reader No.: Permit Fee: 10.00 p
1 evree to campy with the City of Began Surcharge: .50 P
Ordinances. Misc. Charges: 63.00 pd meter
Total:
By Date Paid:
Date of Insp.: Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road
P. O. Box 2119 PERMIT NO.:
Eagan, MN 55111 DATE:
Zoning; Joe , t e r No. of Units:
Owner:
Address:
Site Address: Augusta one _ iiieet: ZXV 1st
Plumber: ic(:uire Mecn
k p
1 ague to comply wleh do City of Roos Connection Charge: 425.00 pd
P
Ordinances. Account Deposit: 15.00
Permit Fee: - PT-
Surcharge: p`.
BY Misc. Charges:
Dote of Insp.: Total:
Insp.: Dote Paid:
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
` PHONE: 4548100 7 c~
BUILDING PERMIT Receipt
Ta be aed for DWG/GAR Est. Value $67,000 Dote JULY 17 , 9 -BA 4279 AUGUSTA LN R3
Site Address Erect ~ Occupancy
1 R!
Lot Block 1 Sec/Sub. SUNSET I Remodel ❑ Zoning
Parcel No. Repair ❑ Type of Const.
Enlarge ❑ No. Stories
It Name JOS MILLER CONST INC Move ❑ Length 6
Z Address 18133 CEDAR AVE Demolish ❑ Depth 24
City FARMING hone 454-4753 Grade ❑ Sq. Ft.
same Approvals Fees
,g Name
Assessment Permit S 334.00
OU Address
U~ City Phone Water a Sew. Surcharge 33.50
Police Plan check 167- 0 0
W Name Fire SAC 525 _ 00
1Z Address Eng. Water Conn. 410- 00
iW City Phone Planner Water Meter 63- n0
Council Road Unit 260, 0
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 $1,852.50
State of Minnesota Statutes and City of Eagan Ordinances.
Var. Date
Signature of Permittee
A Building Permit is issued to: ~JOS MILLER CUNT INC on the express condition that
all work shall be done in accordance with all applicable Stf_of Minnesota Statutes and City of Eagan Ordinances.
Building Official
mom
Permit No. Permit Holder Data
Plumbing ~e a rnC k i U g`(
H.VA.C. y7~1 6c,K yb iol6
Electric Ja I ip I h c1 16„~ a y 5 o Z
Softener
Inspection Date Insp. Other
Footings FT
F
oundation
Framing
Rough Plbg. ~
-z5i=8'
Rough HVAC B'_/z_ i
Insulation . /z. r. -
Final Plbg
Final HVAC
Final '
Cert/Occ.
Water Describe Location:
Well
Sewer
Pr. Disp.
Receipt ' - ,4 MECHANICAL PERMIT Permit No.
< < CITY OF EAGAN
. 1 Fee
1 I I
Fill in numbered spaces S/C
Type or Print legibly Tot. r~ "7-
1. Date 2. Installation Cost
3. Job Address/ Lot~ BIk. i Tract
r
4. Owner
b. Contractor Phone I,.
6. Address f
7. City / State Zip
8. Building Type: Residential 40 Commercial ❑ Institutional ❑
9. Work Description: New C1 Add ❑ Alter ❑ Repair ❑
10. Describe Fuel Type,
11. No. Eau'ioment BTU - M. Ea. No. Equipment CFM
Forced Air Air Handling:
Mfg.
Boilers Mech. Exhaust
Mfg.
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 all ordinances and codes governing this type of work.
Signed : -r-Q
for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-6100
Receipt i % PLUMBING PERMIT Permit No. b G
CITY OF EAGAN J
Fee
Fill in numbered spaces S/C
Type or Print legibly Tot.
1. Date 4 2. Installation Cost
3. Job Address ~i 2. 7 ° P UC
U S tc-lLot 3 Blk. I` Tract
Lane %
4. Owner GG t'illcr Constrllc h i c
5. Contractors r,.- i i - c- ' C c-, ( - ~1 Phone 4 -
6. Address r . c . i_ 1 c
7. City State Zip
8. Building Type: Residential Commercial ❑ Institutional ❑
9. Work Description: New C!k Add ❑ Alter ❑ Repair ❑
10. Describe
11. No. Fixtures No. Fixtures
Water Closet Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. 1 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.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
CITY OF EAGAN Remarks
Addition SUNSET FIRST ADDITION Lot 3 Rlk 1 Parcel 10 72985 030 01
Owner street 4279 Augusta Lane state Eagan, MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1981 168.57 8.43 20 134-89 A014514 9-6-84
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA 571, 1981 168.57 8.43 20 134-99 A01 4914 -
STORM SEW TRK 1985 547.79 36.52 15
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road Unit 260.00 44779 7-17-84
WATER CONN. 470.00 IT IF
BUILDING PER. #9314
SAC 525.00 "
PARK
This request wid
18 mon1. fnin W-J ✓r ^J I Y
A 066167 ~3 G i 35.
fle mst Date Fire No. tugh-rn?inspection
/ fleq redReady Nom WFBI Mptity. Inspec-
Yes o lu,, whim Ready
Licens Electrical Contractor 1 herabY request inspection rd above
Owner eleetrical wmk irrstalled all
Suet Address. Boa m flnrrte o. City
71 6cga
ecbmr M. I Towrshrp Name 27o.- nge No. C
Occupant IPRINTI Plnere No.
mllivv ~J .3
A/ 2
ctllr ICmrmany Ne ttacmr's Liceeise MP.
ned
Mall ma actm m Owner Makirp Installation)
VAu""zed ss
SS ~3
turli j on ctm/Owner in, Instal )anon ) ! t Pharr Nlvntras
CJ sa -
MINNESOTA STATE BOARD OF E C ICITT THIS INSPECTION BEQUEST WILL NOT
Griggs-Mid"v Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE Is
1821 Ph Univar9 Aw.. St Paul, MN 55104
Pis IB12/297 211t ENCLOSED.
L46- 4 S REQUEST FOR ELECTRICAL INSPECTION ED-00001 -04
rw , Sea imbmtions for completing this farm m back of velioe cepy_
nui R7 ""X". Below Work Covered by This Request
A
Add 1tep. Type of Bum Wine Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater 4- -fighting Fixtures
Apt Building Dryer b Electric Heats
Cormrlercial Bldg. rouse Silo unloader
industrial Bldg. Air Conditioner Bulk Milk Tank
Farm er (Smcifyj Other USpecerwU
t r Sppct y Other other
Compute Inspection Fee Below
q Fee Saryiee Fadranee Size q Fee Feeders/5abfee"m A Fee circuits
0 to 200 0 to 30 Am 0 to 30 Amos
Above 200 Am s 31 to 200 Aetgts 31 to 100
Swimmi Pool Ab0Ve 100_ Abmte 200
Transformers Ini tion Booms 935~c Partial'O kwns Fee
Signs Special inspection
mrerks T
31=02)11
Rough-in 77o-1, 1, a` ppr, hereby
certify that Tire above
Final • D'te t - .m has been
ilss request gold t8 me aft hmn
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
New Construction Requirements Remodelliteoair Requirements
• 3 registered site surveys showing sq. ft. of lot sq. ft. of house; and all roofed areas • 2 copies of plan
(20% maximum lot coverage allowed) l set of Energy Calculations for heated additions
• 2 copies of plan showing bears & window saes; poured found design, etc.) 1 site survey for exterior additions & decks
• 1 set of Energy Calculations • Indicate If home served by septic system for additions
• 3 copies of Tree Preservation Wan if lot platted after 711/93
• Rim Joist Detail Options selection sheet (bldgs with 3 or less units) n
DATE .3 _ 13 _OJ 42-7 1 VALUATION D ` 5
JOB SITE ADDRESS
IF MULTI-FAMILY BUILDING, HOW MA Y UNITS?
PROPERTY OWNER 4
TYPE OF WORK ~lJ FIREPLACE(S) _ 0 _ 1 2 r
APPLICANT faAft-M r PHONE* 65-1 7 S_-J
ADDRESS 7 j
ZIP CODE
PAGER # CELL PHONE # FAX # 3:'_.1 U.7 (J
NIEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPL D [ n
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MAR 1 5 2002
(check one) - Residential Ventilation Category 1 Worksheet Subm
- Energy Envelope Calculations Submitted
_ MINNESOTA RULES 7672 By 7JI
- New Energy Code Worksheet Submitted
Plumbing Contractor. Phone
Plumbing System Includes: _ Water Softener _ Lawn Sprinkler Fee: $90.00
Water Heater _ No. of R.I. Baths
No. of Baths
Mechanical 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 O ante
Signature of Applicant
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required
updated 2002
OFFICE USE ONLY
❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg
❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Parch (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 08-plex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 36 Multi
❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage
❑ 06 04-plex ❑ 12 12-plex Plbg_Y or- N ❑ 25 Miscellaneous
❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish (Interior) ❑ 44 Siding
❑ 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair
❑ 33 Alteration ❑ 37 Demolish (Bldg)* ❑ 43 Reroof ❑ 46 Windows/Doors
D 34 Replacement "Demolition (Entire Bldg only) - Give PDA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning 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) _ Final/C.O.
Footings (deck) _ Final/No C.O.
- Footings (addition) _ Plumbing
_ Foundation _ HVAC
_ Drain Tile Other____
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
Framing - Siding _ Stucco _ Stone
- Fireplace _ R.I. -Air Test -Final - Windows (new/replacement)
- Insulation _ Retaining Wall
Approved By Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
WAN
~j, pLJCa. BLnlzdwl PEAMTT APPi.ICJk!EN sst of aesw ca/Lma&t;"w-.
'!b Be Used Fbr / Valuation lo7,(J. Deb S ~la"'D 7
Site Address: a OrF= um Cwx
wt S Block sec./Stab. root X ~ooot envy fZ_3
Parcel i s ~~►►li Fire Say
Oansrt1s _ VIPs of
Non # a"""
Address:
city/zip Code: ~ ` both
Phone
Oontraa6or • !l efi~ (%Ul Assest mats Peoait 3 ~J4 -o
33.5=
liater/8wter Sw4w
Addresa: Police Plan Chscic 1Co
Fire SAC
City/Zip Code. Zll 5'd -r-
Phone S y73 Ov• Water x„"70. am. Plattner NOW slater ro'~
Arch. /EM. ODtnxdl Abed mdt 2C0,
Bldg. Of
Address: APC
City/Zip Code:
Phone
CITY OF EAGAN " v tY
ti 3830 Pilot Knob Road, P.O. Box 21.199, Eagan, MN 55121
PHONE: 454.8100
BUILDING PERMIT Receipt #
Te be wed for SF DWG/GAR Est. Value $671000 Date .TUL.V 17 19_$4
Site Address 4279 AUGUSTA LN Erect ❑X Occupancy R3
Lot 3 Block I cec/Sub. SUNSET I Remodel ❑ Zoning ~Kl-
Parcel No. Repair ❑ Type of Const. V
Enlarge ❑ No. Stories
Name JOS MILLER CONST INC Move ❑ Length 66-
Address 18133 CEDAR AVE Demolish ❑ Depth 24
D City FARMINGTONphone 454-4753 Grade ❑ 5q. Ft.
Name Sit' Approvals Fees
O
Address Assessment Permit S 334.00
City Phone Water 8 Sew. Surcharge -13 . 50
Police Plan check 167- 00
FZrc
Name Fire SAC -)95.00
Address Eng. Water Conn. 470 _ 00
Z City Phone Planner Water Meter A 4- N 0
'z
Council Road Unit 260.00
1 hereby acknowledge that 1 have read this application and state that Bldg. Off. Parks
the information is correct and agree to comply with all applicable APC Total $1. $52.50
State of Minnesota Statutes and City of Eagan Ordinances.
Var. Date
Signature of Permittee
A Building Permit Is issued to: JOS MILLER CON&T INC on the express condition that
all work shall be done in accardanc it ll opplicabl Star to Statutes City of Eagan Ordinances.
Building Official A -77
11'(1_ 1L.A111 U IF1ko. %Woll 1111GU IC UT Jul Vvy TUr
SURVEYING
• SERVICES joe miller const.
Eagan, Minnesota 55121
.1 N~1 •narF
~ ~ ~ vo.w • w ay
: - 2S
C
4
<3 I ~ J
'o 'D I i •e e ' V
2 m2 7
A I ~
I N
SI 3e I S~AtE: ~"~?o•
'O.
I'va -1W
w N -.Tf Ali'
LEGAL DESCRIPTION: Lot 3,151ock 1 Sunset let ADD.
930 Denotes Finished Elev..
9.u ..Denotes. Garage Floor Elev..
I hereby certify that this survey, plan
or report was prepared by me or under Bradley J. S-Wenson Mn. Reg No. 15235
my direct supervision and that I am a
duly Registered Land Surveyor under the Date'
Laws of the State of Minnesota.
M
i
2/84
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
(PLEASE PRINT)
1) PROPERTY ADDRESS: LOT 3 BLOCK 1 4279 AUGUSTA LANE
LEGAL DESCRIPTION: ,z_<1 /
fftT/3o'k' ud 1fvision or Tax Parcel I.D. NuTber)
IF EXIE72--G STRUCICJiRE, DATE OF ORIGINAL BUILDLIG P=,:IIT ISSUANCE:
'o
PRESET zn'TI`_X;/P-RC) OS]ED UZE: ~<R-1 SINGLE FAMILY
❑ R-2 DUPLE{ (TFO UNITS)
❑ R-3 TOQECUSE (THREE + UNITS)( UNITS)
❑ R-4 APARTPj1E!:T/CONDamINIUM ( UNITS)
❑ Ca,1MERCIAL/Rh7AII/OFFICE
❑ I%MUSTRIAL
❑ INSTITUTIONAL/GOVEUNMENT
2) APPLICpV'I' (PLEASE PRINT)
NAME: JOE MILLER CONSTRUCTION
ADDRESS: 18133 CEDAR AVE SO.
CITY, STATE, ZIP: FARMINGTON, MINN. 55024
PHONE: 454-4753
3) PLUMBER PLEASE PRINT) FOR CITY USE ONLY
NA1,1E: McGUIRE MECHANICAL SERVICES, INC.
PLUM RS LICENSE:
ADDRESS: P n RnX 719 ~ Active
CITY, STATE, ZIP: LAKETILLE, MINN. 55044 0 Expired
PHONE: L. Not of Record
nyg_agr:a PLUMBER LICENSE N 002751M7
a initial
4) OCCUPANT/a%,,,TEt2 NAME: (PLEASE PRINT)
ADDRESS:
CITY, STATE, ZIP:
PHONE:
5) INDICATE WHICH PERhIIT IS BEING REQUESTED:
CONNECTION TO CITY SEWER
Nr CONNECTION TO CITY WATER
❑ OTHER (PLEASE DESCRIBE)
6) IdDI= 0.E:
❑ 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!~=--RE: DATE:
■RN:iAW1EJO =01M M1!~~tA_!:aaMfa 70 W W WW Wt~a!rt Wt~FaF '4Mzl ~M!M*Mil~ci es
F O R C I T Y U S E O N L Y
PERMIT ISSUED
FEES: $ r o 5 r Ep%ER ox-D%Trm LUDE SURCHARGE)
(I_ C$ i O _ WATER PERMIT (INCLUDE SURCHARGE)
$ l WATER METER/COPPERHORN/OUTSIDE READER
$ WATER TAP (INCLUDE CORPORATION STOP)
$ SEWER TAP
$ ~ Lam. ACCOUNT DEPOSIT - SEWER
$ / o ACCOUNT DEPOSIT - WATER
$ -l-Z ~7O, WAC
$ SAC
$ TRUNK WATER ASSESSMENT
$ TRUNK SEWER ASSESSMENT
$ LATERAL BENEFIT/TRUNK SEWER
$ LATERAL BENEFIT/TRUNK WATER
$ OTHER
$ TOTAL
AMOUNT PAID/RECEIPT #/~~'~~d 9
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:r~D
TITLE:
DATE:
tsrws~a~se~aaa wtawt~~~ww"m wmslum m igwI"SUMj*wmaW=mNEL" mmoitwims mm
Use BLUE or BLACK Ink
r-----------------,
I For Office Use I
Permit D ACID
z
City of Ea b - hermit Fee.
___3830_ Pilot-Knob-Road _ I I
Eagan MN 55122 Date Received: j
Phone: (651) 675-5675 I 1
Fax: (651) 675-5694 I Staff: 1
I I
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
Name: 5r~ T//s'ez Phone4~2
RESIDENT / .
OWNER Address / City / Zip: 'V2
~9 /Tl/g~j %GJ GC!/JC
Applicant is: Owner __X_ Contractor
TYPE OF WORK Description of work: Ile IyaI fjpy!!c°
Construction Cost: ~a0= a49- Multi-Family Building: (Yes / No-)
Company: ~'tC(/gdJG'e /
ontact:
CONTRACTOR Address: 13 O6 Rewe- 67- City: V_1917R_l~ wl-Zeg ~
Stater l)/l Zip:. ,r//o Phone: & -
License L7C~j Cz 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.gol)herstateonecall.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.
Exterio zed by a building permit issued in accordance with the Minnesota State B g Code must be completed within 180
days f permit issuance.
9_21kze~_
x x-~ LcY( ~f
Applicant's Printed ame Applicant's Signature
s/er yA~~e~'i Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA141194
Date Issued:02/27/2017
Permit Category:ePermit
Site Address: 4279 Augusta Lane
Lot:3 Block: 1 Addition: Sunset 1st
PID:10-72985-01-030
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 Total:
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.
Contractor:Owner:- Applicant -
John C Tuset
4279 Augusta Lane
Eagan MN 55123
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA157400
Date Issued:08/19/2019
Permit Category:ePermit
Site Address: 4279 Augusta Lane
Lot:3 Block: 1 Addition: Sunset 1st
PID:10-72985-01-030
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
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.
Contractor:Owner:- Applicant -
John C Tuset
4279 Augusta Lane
Eagan MN 55123
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
Applicant/Permitee: Signature Issued By: Signature