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1033 Beatrice St 319-945 OFFIC j~yyUSgE QNLY This request void 18 months from validation date printed inINb~1,5 X30r6a/ t~,C PLEASE PRINT OR TYPE Requestte Rough-in inspection required? Yes Q~0 No Inspection Other Than Rough-In: Ready Now . Will Call (You must call the inspector when ready) Tf~ v' Oate Ready: I, licensed contractor ❑ owner hereby request inspection of the above electrical work at: Job Address (Street, Box, r Route Not) City Zip Code= 56 Section No. Township Name or No. Range No. Fire No. Llj County Occupant Phone No. Power Supplier , Address Electricyaal` Contractor (Company No ~ Contractor License No. Tter sLic. No. (Plant Elect. Only) M4ing Address (Contractor or Owner~Pe~oaning I~tallatio/n) % 11 ,!f Authoriz/ e C mractoror w P rfornyn I stall lion) PhoneNo. _ ,lt ! 1 EB-OOO01A-10 k95 STATE BOARD COPY- SEE INSTRUCTIONS ON BACK OF YELLOW COPY lI ! J' - C~~~~~EST FOR 5 I II (I ~II I ii i t I~ III II III ~I ~I~ I~ II~ I (~~I MEOUota State Boa dEof ER cCA INSPECTION * 3 I q t $ 2 * 1821 University Ave., RW8, St. Paul, MN 55104 0 1 9 4 Phone 612) 642-00 - Home Duplex Apt. Bldg. Other. New Addn Commercial Industrial Farm Remod air 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. 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 'j G°J. 0 to 100 Amps Street Ltg./Traffic Sig. Above 200 Amps bove 100 Amps Transformer/Generator INSPECTOR'S USE ONLY TOTAL , . Sign/Outline Ltg. Xfmr. Alarm/Remote Control Swimming Pool I hereby certi thai I ins installat'on described herein on the dates stated Irrigation Boom Rough-In Date Special Inspection Investigative Fee F1O~ Date 4j THIS INSTALLATION MAY BE ORDERED IDIS ONNECTED IF NO COMPLETED WITHIN 1 M NHS. N k"A I For Office Uso 77 City ~1 Eapn Permit S~•'`i Permit Fee: r / rj 3830 Pilot Knob Road I Eagan MN 55122 I Date Received: " 5 j Phone: (651) 675-5675 I -1 I Fax: (651) 675-5694 Staff: L - - - - - - - - - - - - - - - - J 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: I C) Ir C Tenant: Suite RESIDENT / OWNER Name: Phone: 71 c" Address / City / Zip: 1(..) 3 p Tom' `c_ Applicant is: Owner Contractor TYPE OF WORK Description of work: Construction Cost: 0 CO© ` C) iz) Multi-Family Building: (Yes / No 1 CONTRACTOR Name: IkVr L 0 License C='1)_0ab_1 SS Address: City: Sta`te: Zip~J ~ Phone: ]Eontact Person: CC) 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: 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 the are trade secrets. I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances des 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 'thout a permi , that th work will be in accordance with the approved plan ' the case of work which requires a review an roval of pla x x App is rinted Name A licant' Signature Page 1 of 3 CITY OF EAGAN Remarks Addition McKee Addition #1 Lot 30 Blk 2 Parcel 10 47750 300 02 Owner[FR0C lo;r> ,tJf 5'~ Street 1033 Beatrice St. State Eagan, MLA 55121 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR.Paving 1969 $333.75 $33.38 10 GRADING p SAN SEW TRUNK 1968 $100.00 $3.33 3Q !t SEWER LATERAL _196& 2O WATERMAIN WATER LATERAL & SEW 1968 $900.00 $45.00 20 WATER AREA STORM SEW TRK V 1984 432.00 28.80 15 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. $320.00 8573 7-19-7 BUILDING PER. SAC $260.00 8573 7-19-73 PARK i EAGAN TOWNSHIP N° 884 BUILDING PERMIT Owner Eagan Township Address (present) __.__l'~-_..._._ Town Hall Builder g`t/ 2~- Address Date - Address DESCRIPTION Stories To Be Used For Front Depth Height Est. Cost Permit Fee Remarks LOCATION Street, Road or other Description of Location Lot 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, thai_. _____has permission to erect a....j4' upon the above described premise subject to the provisions of the Building Ordinance for an Top adopted April 11, 1955. 1 G4~.•- "g.......r'._...._.. Per Chairman of Tnwn Board,p Building Inspector EAGAN TOWNSHIP N 12 BUILDING PERMIT Owner . ' 4 Eagan Township Address (present) .3.. _ _ e'` A:--_____-i....... Town Hall Builder ° - - ' Address Date - - - DESCRIPTION Stories To Be Used For Front Depth Height Est. Cost Permit Fee Remarks LOCATION Street, Road or other Description of Location I Lot 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___ f__. _ _ _ _:_..__._______________has permission to erect a ____upon the above described premise subject to the provisions of the Building Ordinance for Eagan Township adopted April 11, 1955. _ Per Chairman of Town Board Building Inspector C t 5 4 PERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYrE.. BUILDING Eagan, Minnesota 55122-1897 Permit Number: 029069 (612) 681-4675 Date Issued: 10/18/96 SITE ADDRESS: 1033 BEATRICE ST LOT: 30 BLOCK: 2 MCKEE P.I.N.: 10-47750-300-02 DESCRIPTION: (SIDING) Building Permit Type SF (MISC.) Building Work Type ALTERATION Census Code 434 ALT. RESIDENTIAL REMARKS: FEE SUMMARY: VALUATION $1,500 Base Fee $48.50 Surcharge .75 Total Fee $49.25 CONTRACTOR: Applicant ST. L I C OWNER: I R C S 14550278 2000943 SAMPSON WILLIAM 710 ALLEN WAY 1033 BEATRICE ST INVER GROVE HTS MN 55077 EAGAN MN (6:12) 455-0278 it I - - - 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 Mno Statutes and City of Eagan Ordinances. ILL it APPLICANT/PERMITEE SIGNATURE ISSUED IJY. SIGNATURE CITY OF EAGAN 3830 PILOT KNOB RD - 56122 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4676 New Construction Requirements Remodel/Repair Requirements ♦ 3 registered site surveys ♦ 2 copies of plan ♦ 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ♦ 2 site surveys (exterior additions & decks) ♦ 1 energy calculations ♦ 1 energy calculations for heated additions ♦ 3 copies of tree preservation plan if lot platted after 7/1/93 required: _Yes _ No n DATE: d CONSTRUCTION COST: DESCRIPTION OF WORK: STREET ADDRESS: LOT BLOCK SUBD./P.I.D. PROPERTY Name: off-a a..__i Phone OWNER "ST FIRST Street Address: 10)3 4-0 f~~-- City: c a --r State: Zip: CONTRACTOR Company: 1"qA, Phone Street Address: "7 / a Ice V- 1 License -10 0 o ,-Pr-?.T City: r r~ Stater Zip: T-yo 2:2 - ARCHITECT/ Company: Phone ENGINEER Name: Registration Street Address: City: State: Zip: Sewer & water licensed plumber: Penalty applies when address change and lot change are requested once permit is issued. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with al applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No OFFICE USE ONLY 4 y K BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish ❑ 02 SF Dwelling ❑ 07 4-plex ❑ 12 Multi Repair/Rem. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-plex ❑ 13 Garage/Accessory ❑ 20 Public Facility ❑ 04 SF Porch ❑ 09 12-plex ❑ 14 Fireplace ❑ 21 Miscellaneous ❑ 05 SF Misc. ❑ 10 = plex ❑ 15 Deck WORK TYPE o 31 New ❑ 33 Alterations ❑ 36 Move 0 32 Addition ❑ 34 Repair ❑ 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MCNVS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Depth Footprint sq. ft. SAC Code Census Bldg Census Unit APPROVALS Planning Building Engineering Variance I Permit Fee Valuation: $ Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit SNV Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units PERMIT G 3 ~3 CITY OF EAGAN BUILDING 3830 Pilot Knob Road PERMIT TYPE: Eagan, Minnesota 55122-1897 Permit Number: 028657 (612) 681-4675 Date Issued: 08/29/96 SITE ADDRESS: 1033 BEATRICE ST LOT: 30 BLOCK: 2 MCKEE P.I.N.: 10-47750-300-02 DESCRIPTION: MAC SOUND CONTROL Building Permit Type SF (MISC.) Building Work Type ALTERATION Census Code 434 ALT. RESIDENTIAL I II REMAR~~((~~ SE1~PiRATE PERMITS REQUIRED FOR ANY ELECTRICAL OR PLUMBING WORK FEE SUMMARY: VALUATION $158000 Base Fee $224.75 Plan Review $112.38 Surcharge 7.50 Total Fee $344.63 CONTRACTOR: A p p l i c a n t - ST- L I C. OWNER: SOCON CONST INC 17846910 0008934 SAMPSON WILLIAM 9901 XYLITE ST NE 1033 BEATRICE ST BLAINE MN 55449 EAGAN MN 55121 (612) 784-6910 (612)454--8332 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 Mn. Statutes and City of Eagan Ordinances. A LICANT/PERMITEE SIGNATURE I UED : S RE r CITY OF EAGAN vq 3830 PILOT KNOB RD - 65122 a, (o 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 Na Construction Requirements Remodel/ReRair Requirements ♦ 3 registered site surveys ♦ 2 copies of plan ♦ 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) * 2 site surveys (exterior additions & decks) ♦ 1 energy calculations ♦ 1 energy calculations for heated additions ♦ 3 copies of tree preservation plan if lot platted after 711/93 required: _Yes _ No DATE: 4 a CONSTRUCTION COST: DESCRIPTION OF WORK: STREET ADDRESS: LOT BLOCK SUED./P.I.D. C PROPERTY Name: tin wtt 1 iam Phone X32 OWNER L"T FMST Street Address:-uz bmww City: Rim State: MNZip: 55121 CONTRACTOR Company: CRS c"t~_1S» Phone Street Address: D1 X~~~ NE License #:53 City: State: zip: ARCHITECT/ Company: Phone ENGINEER Name: Registration Street Address City: State: Zip: Sewer & water licensed plumber: Penalty applies when address change and lot change are requested once permit is issued. 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. Signature of Applicant: OFFICE USE ONLY T Z ~ M L. Certificates of Survey Received Yes No AAiUG ' 1996 Tree Preservation Plan Received Yes No " - - OFFICE USE ONLY y BUILDING PERMIT TYPE ❑ 1 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish 2 SF Dwelling ❑ 07 4-plex ❑ 12 Multi Repair/Rem. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-plex ❑ 13 Garage/Accessory ❑ 20 Public Facility ❑ 04 SF Porch ❑ 09 12-plex ❑ 14 Fireplace ❑ 21 Miscellaneous ❑ 05 SF Misc. ❑ 10 = plex ❑ 15 Deck WORK TYPE ❑ 31 New Ae"33 Alterations ❑ 36 Move ❑ 32 Addition ❑ 34 Repair ❑ 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MCNVS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. y Depth Footprint sq. ft. SAC Code y Census Bldg I Census Unit O APPROVALS Planning Building M i Engineering Variance Permit Fee Valuation: $ /;Lo w. Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit SNV Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units PERMIT 5(50?5 CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G P Eagan, Minnesota 55122-1897 Permit Number: 0 2 7 4 6 8 (612) 681-4675 Date Issued: 05/09/96 SITE ADDRESS: 1033 BEATRICE ST LOT: 30 BLOCK: 2 MCKEE P . I . N 10-47750--300--02 DESCRIPTION: Building, Permit Type GARAGE/ACCESSORY Building Work Type ADDITION Census Code 438 ALT. GARAGE REMARKS: A SEPARATE PERMIT IS REQUIRED FOR ANY ELECTRICAL WORK FEE SUMMARY: VALUATION $6,000 Base Fee $112.25 Surcharge 3.00 Total Fee $115.25 CONTRACTOR: - Applicant ST. LIC.OWNER: I R C S 14550278 2000943 SAMPSON BILL 7120 ALLEN WAY 1033 BEATRICE ST INVER GROVE HTS MN 55077 EAGAN MN 55121 (612) 455-0278 I 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 Mn. Statutes and City of Eagan Ordinances. J APPLI T/ RM1T ISSTIED BY: SIG ATURE ✓r CITY OF EAGAN 3830 PILOT KNOB RD - 55122 fr 11996 BUILDING PERMIT APPLICATION RESIDENTIAL at ,A 681-4675 U 4 ~ New Construction Reouirements Remodel/Repgir Requirements ♦ 3 registered site surveys ♦ 2 copies of plan 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ♦ 2 site surveys (exterior additions & decks) ♦ 1 energy calculations1 energy calculations for heated additions ♦ 3 copies of tree preservation plan if lot platted after 7/1/93 required: _Yes No 7 DATE: S CONSTRUCTION COST: C, o DESCRIPTION OF WORK: c(c~ ` d v " Gy rt' STREET ADDRESS: LOT - BLOCK v~ SUBD./P.I.D. PROPERTY Name: -o-.0- s Phone OWNER LAV FWST Street Address, 5t'Ji~ City: State: Zip: - 1 f.~f CONTRACTOR Company: , honV#: Street Address: License #~0 4y City: State: Zip: ARCHITECT/ Company: / Phone ENGINEER Name: Registration Street Addr s• City: State: Zip: Sewer & water licensed plumber: Penalty applies when address change and Ict change are requested once permit is issue . 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. Signature of Applicant: OFFICE USE ONLY E C ~ D Certificates of Survey Received Yes No APR Tree Preservation Plan Received Yes No OFFICE USE ONLY 4 BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging o 16 Basement Finish ❑ 02 SF Dwelling ❑ 07 4-plex ❑ 12 Multi Repair/Rem. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-plex &Y"3 Garage/Accessory ❑ 20 Public Facility o 04 SF Porch ❑ 09 12-plex ❑ 14 Fireplace ❑ 21 Miscellaneous ❑ 05 SF Misc. ❑ 10 - plex o 15 Deck WORK TYPE ❑ 31 New ❑ 33 Alterations ❑ 36 Move G/~a2 Addition ❑ 34 Repair ❑ 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MC/WS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Depth Footprint sq. ft. SAC Code Census Bldg Census Unit b APPROVALS Planning Building Engineering Variance w Permit Fee Valuation: $ Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit SAN Permit S/W Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Other Copies Total- % SAC SAC Units it I Q CITY USE ONLY L ~ BL RECEIPT , G SUBD. DATE: 1986 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3 _S 3830 PILOT KNOB RD EAGAN, MN 5512233- (612) 681.4675 Please complete for: • single family dwellings ► townhomes and condos when permits are required for each unit New construction Add-on furnace Add-on air conditioning Add-on air exchanger, i.e. Van system, etc. Date: 9-a2--q(, F„EES ► Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00 ► HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ► Gas Outlets (minimum of 1 required @ $3.00 each) ► State Surcharge .50 TOTAL SITE ADDRESS:--IM ?n"4Y1 C?e Lao'n w -A33Z OWNER NAME:,__ PHONE ,_..4.. INSTALLER NAME• I A 8 Mina. STREET ADDRESS: Q 1} E_ CITY: al STATE: MW ZIP: ~4 q PHONE#:(Lp)2,) SIGNATURE ~r PERMIT -EE CITY USE ONLY L BL RECEIPT M. SUBD. DATE: 1896 MECHANICAL PERMIT (COMMERCIAL.) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for. ► all c ommercialfindustriai buildings. multi-family buildings when separate permits are nW required far each dwelling unit. DATE: CONTRAU'l' PRICE: WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: FMS: $25.00 mini mm fee g 1% of contract price, whichever is greeter. Processed piping - $25.00 State surcharge of $.50 per $1,000 of i fee due on all pemft. CONTRACT PRICE x 1% PROCESSED PIPING STATE SURCHARGE TOTAL ~ SITE ADDRESS: OWNER NAME: TELEPHONE TENANT NAME: (IMPROVEMENTS ONLY) INSTALLER: ADDRESS: CITY: STATE: ZIP. PHONE SIGNATURE: SIGNATURE OF PERMITTEE CITY INSPECTOR v11.4AGE -WEAGAN WATER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: 1251 Eagan, MN 55122 DATE: 7/19/73 (12/29/72) Zoning: R- 1 No, of Unite: 1 owner: Lero W. Weiss Address: _ Site Address: 1033 Beatrice St. Plumber: Weierke Trenching Meter No.: 22757651 Connection Charge: 320.00 pd 7/19 Size: 5/8 Rockwell Account Deposit: 15.00 pd 7/19 Reader No.: Permit Fee: 10.00 pd 7119 1 agree to comply with the Village of Eagan Surcharge: .50 pd 7/19 Ordinances. Misc. Charges: 8.50 Pd 7/19 Total: By Date Paid: Date of Insp.: Insp.: 1 EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454.5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: 12/29/72 (7/19/73) NUMBER 1380 OWNER: Leroy W. Weiss Address 1033 Beatrice Street PLUMBERWeierke Trenching & Exc. TYPE OF PIPE heavy cast iron DESCRIPTION OF BUILDING Industrial Commercial Residential Multiple Dwelling No. of units Location of Connections: Connection Charge260.00.pd 7/19/73 Acct. Dep. 15.00 pd 7/19/73 Permit Fee 10.00 d 12/29472 0 pd 12/29/72 Street Repairs Total Inspected by: Date Remarks: By Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota By Weierke Trenching & Exc. Please notify when ready for inspection and connection and before any portion of the work is covered. 17:05 APN 12, 2005 FR: THERESA SCHOSTAG 016683 PAGE= 1/1 C O U N T Y ENVIRONMENTAL MANAGEMENT DEPARTMENT GROUNDWATER PROTECTION SECTION 1 14955 Galaxie Avenue • Apple Valley, MN 55124 952.891.7557 • Fax 952.891.7588 • www.eo.dakota.mn.us d MUNICIPAL NOTICE OF WELL SEALING PERMIT APPLICATION DATE: April 12, 2005 TO: Tom Colbert/Wayne Schwan (Elva Fax (651) 675-5694 RE: Well Permit 05-H232841 Well Type: Domestic Municipality: Eagan Environmental Specialist: Olsen The Water and Land Management Section of the Dakota County Environmental Management Department has received the following permit application for the well described. If you require further review of the application or if you have any questions or concerns about it, contact the Environmental Specialist listed above or our office at (952) 891-7557. If there is no response from your office within 24 HOURS (excluding weekends and holidays), we will assume that you have no objections to the issuance of the permit. Please note that permit issuance is always conditioned on the permit applicant's observance of and compliance with all applicable state, county, and municipal laws and codes. Well Contractor: Thein Well Company Date Application Received: 04/11/2005 Anticipated Drilling Date: Time: Anticipated Grouting Date: Time: Property Owner: William P Sampson Well Owner: William P Sampson WELL LOCATION: PLS Coordinates: 1/4, NE 1/4, NW 1/4, SW 1/4, Sec 02 Town 27 Range 23 Street Address: 1033 Beatrice ST PIN Number: 104775030002 WELL INFORMATION: Diameter: 4 Casing Depth: 140 Total Depth: 150 Static Water Level: Aquifer: COMMENTS: L I-lS Edit yiew jp& 8tbr+s _ 11b RK Rft ^ Id 1! i pmr O*mw JESW IEPr j EsWZorfn4 Parcel ID 104775MM Afters 10 BEATRICE ST . Owrot 1 SAMPSON VAUJAM P 1033 BEATRICE EAGAN MN 55121 3 Owner 2 I i [Mot Owner 3 E IT Owr 4 v Parcel data L datedJ ary 30.2005 4 1033 BEATRICE ST ~ C Ads{ i e .C7 T~..Fti'tl:NM- No PSH NAi"{E 1~. C 9 AQ900i :4.014 PfATRIC,E ~ " 'tab i'5, . A 4?R0 6CJ:4.4 E I PEC'T'JON RECORD CITY OF EAGAN PERMIT TYPE.. 3830 Pilot Knob Road Permit Number; Eagan, Minnesota 55122-1897 Date Issued: •+r (612) 681-4675 SITE ADDRESS: 1 30 f"I 1, 01 It" APPLICANT: 1, 01' 02 iti PERMIT SUBTYPE: TYPE OF WORK: iNSPECTION TYPE DATE INSPTR. INSPECTION TYPE DATF ' ft1 -TI146S FRA01iNii V INAI R ''NARES . A ~.VPARATV Puo#414` -I`.; tuft AN 4_I.f:~'~~~2t At oopf"; x w Perna ft Permit Holder Date Teftphone # ELECTRIC PLUMBING HVAC In"ootion Data ku"L Cmnmanta FOOTINGS FOUND FRAMING ROOFING ~S• ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT 6 TEST BLDG FINAL -^f BSMT R.I. < b BSMT FINAL DECK FTG DECK FINAL r ~'~r17 IISPETIN Rt' CORD +r CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: ~ ~ s Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 f ..SITE ADDRESS: APPLICANT: (61 IF14 --6910 PERMIT SUBTYPE: TYPE OF WORK: Dr -*I I (IN *AC S01100 f.014TROL il"I~PFUFION TYPE DATE INSPTR, INSPECTION TYPE IN Hffi Vi 14 A I. :f [ flf f "f PARA'f"f Pf:f1M1.'TS f4i`~~'~f#~'f10-0 f° 1a ANY f frh f:I _f t' ef, t)# # f fl # f3 i t l ~T Permit NO. Penv* HoIcter Date Telephone # ELECTRIC PLUMBING WAC f~d~ a9 l F3' Inspection Doe Insp. OommentE FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING R I AIRIEST f f ROUGH HEATING GAS TEST VC INSUL k GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL 1 BSMT R.I. BSMT FINAL DECK FTG DECK FINAL INSPECTION RECORD CITY. OF EAGAN PERMIT TYPE. 3830 Pilot Knob Road 0 2 9 0 6 Permit Number: Eagan, Minnesota 55122-1897 Date issued: (612) 681-4675 SITE ADDRESS: ; APPLICANT: 1033 i: t 14, E 3 t C Are PERMIT SUBTYPE: TYPE OF WORK: SIT 011 f" ACTERATTOM FRAMING f ELC-CX 3 PUMASIM WAC I"pootlon Daft • FOLMID t i FROMM FIOOFM V t ~4 V Kee~~.~+y - f foci HEATIM E GAS SW TEST NSM f GYP DOARD k FIRE t FWMACE r FINAL PM F#4AL HTG OR'W r TEST MDG F . BSMT R.L ®SMT FINAL. 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