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1444 Balsam StCITY Of EAGAN 3795 Pilot Keob Road Eogan, MinnesoM 55122 Phone: 454-8100 WATER SOT' i _ PERJ+AIT Dote: ' 33y 25, Z?' Site Address: ?-" ' a 1:3 a i. St, Lot '...?- Block Sub/5ec. ?-??..>'v?'_ ?=-i - ?•f? _ Receipt Mo.: Single Residential No. '10 X Multi Nnme LeROy iCugel c,n /Repair New/Alter . . ? ? Address `14 Ba 15 am St. Cosr of Installarion City ?3`; an 5512Z Phone: Permit Fee Name L1ridS3y W1tL-',Y' CO. Surchorge ? ? ? Address e 0 u City Phone: Tota I " This Permit is issued on the express condition that all work shall be done in accordance with oll opplicable Stote of Minnesota Stotutes and City of Eagan Ordinances. V Buiiding Officiol CITY OF EAGAN Remarks Addition Evergreen Park Lot- 10 B,k 5 Parcel 10 24880 100 05 owne?.PV61 Street 141?BaldamSt. scate Eagan,MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SUR F. STREET RESTOR. GRADING SAN SEW TRUNK 1973 175.00 $.75 20 Paid SEWER LA7ERAL 19714 2 0 d0 8.00 WATERMAIN WATER LATERAL WATER AREA STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 26O.OQ 3250 2-19-71 BUILOING PER. SAC PARK CITY OF EAGAN PERMIT TYPE: fil+?? ?N6 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: ct?lf?"??' ?1 (612) 681-4675 SITE ADDRESS: APPLICANT• II • 1 ? ;,, ; t rii,r f? ??. ; rit ? ' (,?,i 1 : fd i rll F ? r, f . ? ?!'?. {•41:.'? ?y PERMIT SUBTYPE: I;AMINW TYPE OF WORK: ?i ?, , ,: ? i ??rr i?: ,? ; ti ?????a t? ?? i r t ii i????? i I Nti# I Mr11:h •. A',1 1 t1tm A 11 t'f 1:C11 1 f'; I;c 911 1 t?l 1? I #)I: ANY 1 1I t, 1 F2 1 I R1 4I1: ='1 111I41? 1 Wli llU2+F Permit No. Pertnit Holder Date Telephone N ELECTRIC PLUMBING HVAC Inspectlon Date Insp. Gommants FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FfG DECK FINAL E, 6---e{'1,) A-r /C TOWId OF EAGAId 3795 Pilot Knob 2oad St. Paul, Minn. 55111 PEPS4IT N0. 94 The Board of Supervisors hereby grants to Neil d Hubbard for Tilsen . of 99 North Bnelling_Ave.. St. Paul a HE TING Permit for: (Owner) Tilsen Construction at 44 Balsam, 4233 d 4372 Sequoia, EaQan, Minn. , pursuant to application dated Ilarch 24. 1971 Fee Paid; 60.00 (20.00 ea.) Dated this 26th day of March , 197_ 1. Building Inspector ? /o ??S"a% /oo a5 ?U-6ree? ?/-/(? TpFi21 OF EAGAiJ 3795 Pilot I'nob 2pad SL. Paul, Minn, 55111 P!?Pk1IT IdO. -9*'• 'p'1 The Board of Supervisors hereby grants to i _ Farrn d S_on. of 990 Sdest Montana, St, Paul 55117 PLUPtDING Pe*wi_t £or: (Gcaner) Tilsen Homes £t 4372 Sequoia 7-6, 4233 Sequoia 5-11 ?Balsam 10-5? 1438 Balsam 9-5 , p4rsuanY to application dated March 249 1971 _ ._ ?.... , .,e..??..._. Fe? Paid. S80.40 , Dated this_ 24thday o£ , March _,__._) 15; _1_ - &:i7.ding Znspector ? , ? 0 o1-0 2 8 0 °n ? ?- 5 Requ s? Oat J?/? ?` Fire No. Rou h-In Inspectaild Requiretl (VOU mujif call inspector when reetly) Insp9clion Olher Than ough-In [] qeatly Now ill Notily Inspeclor ? ???? Ves N. Da[e Reatl I? licensed contractor wlwner hereby raquest inspection of a6ove electrical work at: JobAtlys,teox?a.l CitY s??,. Settion No. Township Name or No. Range No. County 3 nt(PFINT) I / + Phone No. ' f? V n lIl 2r) Powe? Supplier Atltlress Electncal ont2clor (COmpany Name) o n,. o w n 7777 Mailing tlress (COnvactor or Owner Making Insiallation) 0 V Autho ized SignaNre (ComractoriOwner Making Insfallation) Phone Number ?-c.. ?- ..._.aQn-t' ? ?s2 ^? 0 2 MINNESOTA STATE BOAPO OF EIECTpIGTV THIS INSPECTION FEQUEST WILL NOl Griggs-Mitlway Bltlg. ? Room 5-128 1 1111 111 111 11111 1111 1111 1111 111 11111 1 ( 1 1111 1111 1 BE ACCEPTED BV THE STATE BOARO 1821 Unlversity Ave., SL Peul, MN SS10C UNLESS PROPER INSPECTION FEE IS Phane 16121 6C2A800 . FNCI ORFI) / REQUEST FOR ELECTRICAL INSPECTION W4 ee-ooooi-os qp, pp 10- See instmctions for completing this lorm on back ot yellow copy. "X" 8e7ow Work Covered by This Request Ne Ad Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building l ryer Load Management Comm./Industrial umace Other (S ecify Fartn Conditioner Air Other (specify) ConMacror's Femarks: 175 Compufe Inspection Fee Below: r' ?V e 0 u I'? X Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 -? Amps 00 -Amps Si ns insPeciors use oniy: TOT L $ Irrigation Booms ( fG"O U Special Ins ection . Alarm/Communication THIS INSTALLATION,MAY BE ORDERED DISCONNECTED IP NOT Other Fee COMPLETED WITHIN18 MONTHS. I, the Electrical Inspector, hereby dif th t th b i i h Rou9n-in ce y a e a ove nspect on as been made. F??ai a?e OFFICE USE ONLV Y- This request void 1 8 months iram EAGFN TOWNSHIP 3795 Pilot Knob Road St, Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR WATER SERVICE CONNECTION Date: Februarv 19. 1971 Billing Name: Tilsen Construction Co. 2/19/71 Owner: same Billing Address Plamber: Lueckea Excavatin¢ Connection I Meter G3G .l aS Meter No,if a v Permit Fee tn_no pd 5/13/71 Meter Reading Meter Dep. Meter Seaied: Yes_ lAdd'1 Chg. NO ' Total Chg. Building is a: Residence 2MX& IRulCiple no, Units Commercial Iadustrial Other Inspected by Date Remarka: Number: 541 Site Address: 1444 Balsam Street 10-5-Evergreen P1 r^_ _ I +c Cu1i!PrCrini'r` ED iviETERS. By: Chief InspecYOr Ia cansideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accorda ce with the rules and regulations of Eagan ToFmship, Dakota County in'nesota. B a Luecken Excavating Please notity the above office when ready for inepection and connection. EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEW$R SERVICE CONNECTION DATS: Februarv 19. 1971 OWNER: Tilsen Construction PLUMBERLuggkea Excavatine NOMBER 700 Address s1444 Balsam Street 10-5 Everbreen p ark TYPE OF PIPE cast iron DESCRIPTION OF BUII1)ING Industrial Commercial Residentiai Multiple Dwelling No, of units xxxx Location of Connections: Conaection Charge Permit Fee 10.00 pd 5/13/71 Street Repairs Total Inspected by: DaCe Remarks• By. Chief Inspector In consideratioa of the issue acui delivery to me of the above pexmit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Toc•mship, Dakota County, 90C8 By Luecken Excavatiag - Lorne L. Gal ati Jr, 2861 Minot Ave.. Nm St. Paul 55109 Please notify when ready for inspection and connection aad before any portion of the work is covered. ? CITY EAGAN 3836'Pilot nob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: P.I.N.: 10-24880-100-05 DESCRIPTION: PERMIT 1444 aALsam sT LOTr 10 BLOCK: 5 EVERGREEN PARK PERMIT TYPE Permit Number: Date Issued: (LIFT CEILING) ermit Type SF (MISC.) 7ype ALTERATION ? ,T rY + a , 1 wr,...yt ? vF? 3s v` i^wsi, -a„'MK.' s$? ca (.f I,???J B ILDIN6 025786 06f09/95 REMARKS: A SEPARATE PERMIT IS REQUIRED FOR ANY ELECTRICAL OR PLUMBING WORK FEE SUMMARY: VALUA7'IQN 6ase Fee $34.75 5urcharqe $.50 Total Fee $35.25 $i,e0e 1N5YE(;'1'IUN llE(:Ullll CITY OF EAGAN PERMIT TYPE 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITEADDRESS: P.x.H.: 1e-2488e-100-05 APPLICANT: LOT: 10 BLOCK: 5 1444 6ALSAM ST VANDERLINDEN EVERGREEN PARK (612) 452-5029 PERMIT SUBTYPE: TYPE OF WORK: sF troxsc.? DESCRIPTION BUILDIN6 025786 06/09/95 BRENT ALTERATION (LIFT CEZLING) ?' .a?,a ?" ? rw s t ? ._._... .. ._ ., ...,.. _. , .?..?.... _ ..__..<.._ . . , . ? r.... . .,.... .. _. _?,.. ?._ . . ,.. . . _ r ,.,.?... ......... REMARKS: A SEPARATE PERMIT Z5 REpUIRED FtlR ANY ELECTRICAL OR PIUMBING WORK 26 li CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681 -t675 New Constr!etion ReouiremerMS . RemodetlRen v R.auirements ? 3'registeretl ske wneY$ ? 2 copiea ot ptan ? 2 popW of plens (indude beam & window saea; poured tnd. design; etc.) + 2 site surveys (erierbr addilions 8 decke) ? 1 energY eeiCUlatinns ? 7 eneigy alalations for heated addidon: ? 3 copiea of troe pruervation plan if la plattetl afler 7/1/93 requfred: _ Yes _ No DATE: t'---y 2, cT S- CONSTRUCTION COST' 14P,10r6 x. Z o U=° DESCRIPTION OF WORK: STREET ADDRESS: rl. .3 ?2.. / K /0 't9Dr0tvan 19 `( -1 i3A ITKµ, Sf LOT I ? BLOCK S SUBD./P.I.D. ! ?? / y S?. ,? ° 2 q PROPERTY Name: I/c? ? ?t f•' A Phone #: a°f 6;-/9 0°I OWNER Street 9 4 City: ??°? •• Stafe: /"I IV' Zip: coNrw?C7oR Company: WA Phone #: , Street Address: City: License #• Zip: State: ARCHITECTI Company: /V IA ENGINEER Name: Phone #• Registration #• Street Address- City: State: Zip• Sewer & water licensed plumber. &/?" . Penalty appUes when address ehange and bt change are requested once pertnit is issued. I hereby acknowledge that 1 have read this application and state that the infortnation is correct and agree bo comply with all applicable STate of Minnesota 5tatutes and City of Eagan Ordinances. 5ignature of Appliqnt ?^-- OFFICE USE ONLY EENE'D Certifiqtes of Survey Received _ Yes _ No ,f U l [J 5 1995 Tree Preservation Plan Received _ Yes ^ No _ _ _ _ _ _ . ,... ..... _ OFFICE USE ONLY BUILDING PERMIT TYPE a 01 Foundation o 06 Duplex o 11 Apt./Lodging ? 0 02 SF Dweliing o 07 4-plex ? 12 Multi RepaiNRem. ? o 03 SF Addition o 08 8-plex o 13 Garage/Accessory ? 0 04 SF Porch o 09 12-plex ? 14 Fireplace ? (4-05 SF Misc. 0 10 = pfex ? 15 Deck WORK TYPE a 31 New jp;?3 Alterations o 36 Move o 32 Addition ? 34 Repair o 37 Demolition GENERAL INFORMATION . y ... . 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous Const. (Actuaf) 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 ? Census Bldg i Census Unit v APPROVALS Planning Buiiding Engineering Variance Permit Fee Valuation: $ l J°O - Surcharge Plan Review License ' MClWS 5AC City SAC Water Conn. Water Meter Acct. Deposit 5/W Pertnit SNV Suroharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units EAGAN TOWNSHIP BUILDING PERMIT Owaex '-.._.. ?p- ---'--------------- ? Address (Preseni) .---??te.:----°---.._----°-°°.._. ........ . Buildax Address DESCAIPTION $SOrie To Be Uced For Frant Depth Height Esl. Cos! Pesmi! F ee Aemarka ? I d'7 e-a-d I '3d. a-- Eagan Township Town Hall Dale ,;??¢: ..................... ' N° 2385 `3SSBef, rioBG os oINB! DesCiipflon of LoCailoll I Lot I l31oCk I Addtil0n DY 7YfiC! /?q C/ R-?? This permit doee not auihorise the use of slreels, roads, alleys or sidewalke nor does it gfve the owner or his agen! the righf So creale anp siluation which is a nuisance or whieh presenis a hasard !o the healih, safeip, eonvenieaee and general welfare !o anyone in the eommunilp. THIS PERMIT MUST BE EgT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. This is !o certify, tbal.-.-=--+-c?_ca,.-_.-,-,-.-._..bespermission !o ereei a...... -.---_? . . . . ..... ........... _.._upon !he above described premise subjec! !0 the provisioas of the Building Ordinanea for Ee?Townshipled Apr?1 11, 1955. L . .................... ------------•-.}..t-..!`:?._:: ?:._..-?- . Pe: ...................... ??Cl .?.,,,._?„i,,.,'`'^`.,_:'..-?...................... Chairmaa of Tnwn Board Buflding Inspeolor ? MASTER CARD • LOCATION g,C?a f s a r,? /`? OWNER ? /srK ?o STRUCTURE AND LAND USED AS /a-t- 19.10 Permit No. ? I Issued _- Issued To Contractor Owner BWLDING •? S t?? ? _ PIUMBING CESSPOOL - SEPTIC TANK 3.24.71 r?R?eEL l i VJELL ElECT21CAL HEATING GAS INSTALLING I SANITARY SEWER I OTHER O7HER 40 . Items Approved (initial) Dafe Remarks Distance From Weil FOOTING FOUNDATION FRAMING FINAL ELECTRICAL -F? ? ?_ . .' y.? -??I SEPTIC CESSPOOL TILE FIEID FT. NEATING P OF WELL GAS INSTALLATION i SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING WELL SANliARY SEWER y 0 r-ly. Violations Noted on Batk COMMENTS! . 1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL) o ? CITY OF EAGI4N 3830 PILOT KNOB RD - 55122 ? 851-681-4875 a ? New Construcilon Reaulremenh Remodel/Reoalr ReautremeMs ? 3 registered sRe surveys showing sq. k. of lot, sq. tt. ol house and all raoled artas (20% maxknum Iot coveraae allowed) D 2 copies of plans (show beam a window skes; poured fntl. deatgn; efc.) ? 1 set of energy calculWlona ? 3 coples of hee preservaNon plan B IM platted aHer 7/1/93 DATE: I v ' Z- /, -? at DESCRIPiION OF WORK: ?w 1?? Srl'O STREET ADDRESS: 14 -T ? d;, LOT: --?9 BLOCK: SUBD./P.I.D. #: 2 coples of plan 1 set of enetgy calculallons for heafed addHiom 1 sMe survey tor exTerlar addNlons A. decb 00 CONSTRUCTION COST: S?-O( r w 4- • o.?--- Name: (/^ K/-Ctf'-?. /'/?O^'?? Phone #: PROPERTY last ' First OWNER Street Address: j-w"`` . Ctty StaFe: Zip: S.S I? Z? Ic?'.S'S Company. Phone (area code) CONTRACTOR Sfreet Address: license # Exp. City State: Zip: ARCHIiECi/ ENGINEER Company: Name: Telephone #: area code ( ) Stree7 Address: Regishation #: Ciiy _ Sfate: Zip: Sewer 3 water Iicensed plumber [reauhed for new construction onlv PenaNy applies when address ehange and lof change Is requesfed once permN Is issued. I I hereby acknowledge that 1 have read this appllcaflon, state that the IFvformaHon Is cortecf, and cgree to camply with aN appNcab! State of Minnesota StafuMs and CHy of Eagan Ordinances. Signature of AppllcarM: OFFICE USE ONLY Certificates of Survey Received ?/BS _ No Tree Preservation Plan Received _ Yes - No ,_ Not Required ? _ .y 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. (4sea. ? 03 1 of _ piex ? 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 Misceltaneous 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 - Code C Const. (Actual) Basement sq. ft. ensus (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 VVidth Footprint sq. ft. Booster Pump PRV Fire Sprinkfered APPROVALS Planning B uilding Eng ineering Variance Permit Fee Valuation: $ l ? 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: SAC Units % SAC - . A 0' IX a "" N 11 _ I I I I ' SO w ?r -- ---- ?TN ? - - ! o ? N --`-- ? k .? 10 ? ?• .? ? ? .. ?o 4 ? N - :, - - Iso ? ?N 4 R T N-` ? ? o - A - ? ? ? ? ? ? ? ? 3 - ? ? ? ? . . ? .1 . . . ? I 2001 STORM DAMAGE PERMIT APPLICATlON (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55722 - L?-rz-7 651-681-4675 _4z:7?_ lp lJ Reaulremenh ? 2 coples W plan DATE: Name: !/ ?' "`4_-' l/,?lp(G? , Phone #: b S? S 0 Z C] Las+ ? FInT -c)? o a J- DESCRIPTION OF WORK: f4'?''I( mulTi-famity bldg., how many unlts? INDICATE THE FOLLOWING EQUIPMEfdT TO BE REPLACED APdD BY WHOPA: _ Ptumbinq _ Homeowner or Cantractor Name _ Mechanical _ Homeowner or Contractor Name "Note: If somebody other than ihe homeowner is performing plumbing or mechanical work they mustapply for appropriate permlt. Only licensed plumbing contractor or homeowner may complete plumbing work. STREET ADDRESS: _Lj?4 4_ ji? / SC? j`? S? , r G " o\ h LOT: BLOCK: SUBD./P.I.D. N: PROPERTY OWNER CONTRACTOR Street CONSTRUC710N COST: City STafe: Company: ziP: ?S / a 2 Phone #: (area code) Street Addreu: License # City State: Zip: JUN 0 7 2001 i? I hereby acknowledge thpt I have read fhis application, sfate thaf the informolion is correct, and agree to comply wHh all appGcable Sfafe of Minnesofa Siatutes and Ci1y of Eagon Ordinances. Signalure of Applicant: : _ _ , _ _ , . _ _ . _ _ r % , o ~ i~,... ~ . . . . . . . . . ~ . . . . . . ~ ~ . . ~ . . . ~ - . ~ . ~ . ~ ~ ~ . . . . . ~ ~ . . . . ~ . , . . . . ~ . ~ . . . , I _ . . - - 4 54.92 ~ ~ ~ ADDITION . ~ - . _ - - _ ~s5 r C ` ET ARE~A ~ , _ . _ _ i \ ~ 1~- 45 _ ~ EAGAN 70WNSHIF DAKOTA C aKOTA COUNTY , MINNESOTA ~ ~ ,4 ~oo_~ ? ~i ~ ~ , ~W ~ ~ - ,IOp i \ ~ : ~ I j ~ d ~0~~~.~.. 2399,92 _ 1 ~ ~ 2 ~ i 3 ~ ' ~ - I00 ~ NA7 ° 08' S5"E ~ ~ I.N --Ip ~ ~ , o ~ o ~ ~ ~ ~ ~ ~ o ~ I r o ~ o; I ~ ~ 100 - , ~ o ~ ~ 26 ~ I , ~ ~ a ~ -,o LE0 B. SHAW LAND SURVEYORS, INC. ~ N'ET AREA a~ ^ Z ' a pi i ~ l I `~I I'"-~0 I 0-_ i a I ~ f ~ 1 _ IOp : SAVAGE. 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OZ , ~ Z z _ o ' (Q ~ -/y , ~ The We~t Half, (W''z) of Lo~ ~tine (9) i Dt Na.ne (9) Carlson Acres, according to N Y. ~ ~ ~ 1 ~ ~ \ ~ / , / ` ~ I ~ ~ ' O ~ ~ O . 0 ~ . ~ . ~ . ~ ~ 1 _ / ' \ ` ~ ~ ~ I 1 O ' p . p _ - . . 1 1~ ~ J- - . Che 1aC th~reof now on file and of 1 file and of recoxd in the office of fihe ' ~ ` _ ' - ~ ~ ~ I a ~ P ~ , 1 , _ `..i ~ ~i ; ~I - 3 0 zao ~ 3 _ 1'~~ f ^i _ _ _ ^ _ _ 20 - - - - - - , Register o~' Deeds within and for sa; - - - NoATH I- NORTH n and for saicl County and State a KNOB - - - - - PiLOT - ~ _ - _ ~ - - - - - - - _ _ _ _ _ ^ ^ _ - . ~ a,L . . i NORTH - 2Sv~3_-r ~ Use BLUE or BLACK Ink For Office Use~1 t/ I olc~ T 7 I I City of Eajan I Permit I s.. -I~ I ~ v .,j t .0 I Permit Fee: 1, 0 1 I 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 I 1 Fax: (651) 675-5694 I Staff. I I 2014 RESIDENTIAL BUILDING PERMIT APPLICATION a 3 Date: Site Address: Unit Name: /1 ~G ~-n f'l s G Phone: Resident/ Owner Address/ City/ Zip: Mq'l ~6~ SG-- Applicant is: Owner Z-Contractor Type of Work Description of work: U, ~~rti+4GSi~i /'per g(ja' (~t.~ Cam' *Construction Cost: Multi-Family Building: } i (Yes I No-v Company: A *C, Contact: Dckt- w Address: 2-1 G f i et city: ®e if e- Contractor , State: h Zip: .S gt) Phone: 17,® 'Yq' t'V License /0340 7 u14 Lead Certificate (V °'®~i ~2-` l 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: Z~ 27s ' 91 Z Mechanical Contractor: C-4J Phone: 6'-L- Rg ©-761 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. 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.ooi3herstateonecall.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 1 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. x ~LG n x v1,. J' Applicant's Print Nam Ap icant's Signature Page 1 of 3 / ` YY alm -V- ~V DO NOT WRITE BELOW THIS LINE SUB TYPES _ Foundation _ Fireplace _ Porch (3-Season) _ Exterior Alteration (Single Family) _ Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Multi) _ Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Miscellaneous 01 of - Plex Lower Level Pool Accessory Building WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior Alteration Fire Repair Windows Demolish Foundation Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation ' + Occupancy MCES System Plan Review Code Edition SAC Units (25%_ 100%) Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC _ Gas Service Test Gas Line Air Test Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: _Rough In -Air Test -Final Windows 41- Insulation Retaining Wall: _ Footings _ Backfill _ Final Sheathing Radon Control ` Sheetrock Erosion Control Reviewed By: , Building Inspector Laj~,.j RESIDENTIAL FEES 0j Base Fee Surcharge Plan Review ` MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge 6/ Treatment Plant x;73.. Copies TOTAL 71 Page 2 of 3 1 A 41 -•.i'',.• osl A N o l o.~ tZ MMWM-\\ of C Use BLUE or BLACK Ink --------------, � For OffiCe Use I ��� n{��� � j Permit#: �°� "T fOC. 7""" � � ul � � / � 3830 Pilot Knob Road � Permit Fee: �/��� � Eagan MN 55122 I / r� � Phone�(651)675-5675 � Date Received: l��/�3-�� I Fax:{657)675-5694 � I � Staff: � ������______��_��J 2014 MECHANICAL PERMIT APPLICATION ❑ Piease submit two(2)sets of pians with all commerciai applications. Date:�' °��"i Site Address: �y-''1'� �C�I�(.(.��'� ��"�-�� `�• Tenant: �,�� �� �)% �� � � r� Suite#: � � �� Name: 'V !% `��..•- �I� �� Phone: �; � ; � �J y� �, , r �� �_ � Address/City/Zip: � 3 � ,�� � � �°�1-�Ce� il l i �G�� '� Name: nse#: ; 'R ,? K- ^ - .� � .. ' '� i r / (' �� y�l � # ���� ����� Addres��l � l.��� 1�. , .. � 1 City: T�!l�'�'1/�'� �/� '� �: , � � �� �.- F ``` � � � State� ' ��ip: �74�"�� Phone: �� `" — c=� ��j � o� � �1 S" �> �' � �, �� . , _ - � . � � � . , + / /( / ` , � Contact: �Ci Email: ���,�� Y I �C,�i) ��� l�� .l`, `/ � 1 't �, ,�,�:�7 � � � � { � j�� � 3 z , New Replacement Additional �Alteration Demolition ,, : k , , , , , � � � '�`�������: ��„ Descript�on of work ��/? `r ��, j �,� �t,. J� 1 # � � � ���� } � � � � � _ � ;�`� ��4�� ���'�� � � � x � � . �� � r.�. � h � ��� , �� � "��� RESIDENTIAL COMMERCIAL � 4 '` � � � LL Fumace New Construction _Interior Improvement � � �f — — _� ' �x; Air Conditioner Install Piping Processed ����� ��' — — ��` � � Air Exchanger Gas Exterior HVAC Unit <, � , �;� � � — — — , _Heat Pump Under/Above ground Tank �Install/_Remove) , y — " ` , �� �° ,v Othe�•�L� t� h ,,..._ii...c. � . a.•,,.,: .r ,�.sZi�:x..a..,.. RESIDENTIAL FEES ��`u°��'CI�J '� ��-- �v'11J $60.00 Minimum Add or alteration to an exis6ng unit(includes$5.00 State Surcharge} j'� $100.00 Residential New(includes$5.00 State Surcharge) _$ � •U� TOTAL FEE COMMERCIAL FEES Contract Value$ x.01 $55.00 Permit Fee AAinimum $70.00 Underground tank installatioNremoval =$ Permit Fee "If contract value is LESS than$10,010,Surcharge=$5.00 =$ Surcharge" ""If contract value is GREATER than$10,010,Surcharge=Contract Value x$0.0005 "*•If the project valuation is over$1 million, please call for Surcharge =� TOTAL FEE t hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the Ciry 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 plar�ss. � , �r : x �1 .�r \..� : , l. ?.�V g /�°`' � ApplicanYs Printed Name App icant's Sig re y���� � z � ,� F � � � u � ��. � a � � � �TM"`���i� ;� � r���tr� 1 i A i,t '� .-�, �y d,,.�, �.f ��. ..- s e. c v .± A ��' s�i �� i�b�' � �1�^'£�Y � z � v ? €� i t ' ���; ,��°'�g 7 s a �F'� : r�� .��. � -h �i �s� ,i�- �a��r � 2� ,?q' ; L. � ,�� ����.� �s..�,^,��'�,,,,',�,,��` � �,�: �`,� *� .. t s�` ������ s�'� �'� � , . t � �'��� `�a +� �,.�;-J `� � � z k ,� ✓ & t �. 7 3x r ,� � .. u�° . �c ,?c t�s-""��n. �. �.,� �� �a � t < '�`�r s '`r' . t ., '� y Tr�' ..•. ;s��3 f k z e ��` :.,, '���rc`,`� �.��� .r '�} , `�,`�f ,� �.�,� �;:-r Y, s u u,��, ,.:.a�i�,�t! ,e,,. Use BLUE or BLACK Ink r————————————————� I For Office Use � � �� � ) ��a(� Permit#: � � '1���( I Clty of ���a� ; . � ; I Permit Fee: - � 3830 Pilot Knob Road � Eagan MN 55122 i Date Received: �� � Phone: (651) 675-5675 i I Fax: (651) 675-5694 L Staff: ___—_ _—_�_———I 2 14 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: d"� l Site Address: �d G � ��- S'�}-I'� � �� Tenant: Suite#: ��-; ��� ���ti� � � �� �� L Phone: R�SIdG',�1�%C�W�IE�.���� Name: � ��� Address/City/ ip: � �.�(�� � ! Name: "�' l License#: Address: � City: � � - ���f��c���?� � State� �� Zip: . ��r/ � Phone: Cl�l ���r� � �o� Contact: C�� Email: lJ ��C��-- ��'ta �G � � ' � New Replacement _Repair _Rebuild _Modify Space Work in R.O.W. Ty�?���W�xt� : - - - ' Description of work: : RESIDENTIAL Water Heater Water Softener Lawn Irrigation�RPZ/_PVB) R�rmi�'fy�pe ,� Se tic S stem �Add Plumbing Fixtures�" Main/_Lower Level) p Y �., a����� i�9 �,r � t �j ��;. .,� NeW Water Turnaround � Yn.. — . ,,;��_ '. ` � Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes�5.00 State Surcharge) $60.00 Lawn Irrigation (includes$5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround*(includes$5.00 State Surcharge) "Water Turnaround (add$200.00 if a 5/8"meter is required) $115.00 SeptiC System New($10.00 per as built) (includes County fee and$5.00 State Surcharge) TOTAL FEES $ 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.qopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conf ance 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 wor � t to start with ut a permit; that the work will be in accor ce ith the approved plan i the case of work which requires a review and approva f ns. t X Ap icant's Printed me p ic n 's i re F{)f��?�FICE USE R�view�d B� �,. '�: . ;t�a��:: � Rec�uired Mns�r�ct�otts ��lnd�r£`�,�r�;�r��'` �����„��€��i-Tn ������;��t; ,�„`���T��f ,;�;,�;_�inat � ; b � =Meter:Relatec�w�[�terns r����q�.��er Sy`'��,._.,��,���„��Radic�FZ�ad��"�� lVl�nciri����r,�,w ��;�'`�. Date: City otEtan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 JAN 1 5 2016 r Use BLUE or BLACK Ink L For Office Use Permit #:16"'1 (1 a Permit Fee: too • 0(3 Date Received:1— 15 — 1 L9 Staff: y2016 RESIDENTIAL PLUMBING PERMIT APPLICATION ['al I It Site Address: 1 41-1 e3Oki-S(1-4'k Ct • Tenant: Suite #: Resident/Owner Contractor Type of Work Permit Type Name: 601.00(. Address / City / Zip: ) L4 4 (4 ( Name: Address: State: Contact: O+-dw-GA}efiu4 (4-'40 `i'm-vt5 Dr. Y v ( Zip: 5 t t1 Phone: Email: Phone: q 5 - log 5 - 5q? 0- Ki , M' s 1 a a License #: `f O 1 \ L City: 915-5%1/46127 CrC b 6 cc i+, f e+ New y Replacement �Repair _ Rebuild _ Modify S)pace��__ Work in R.O.W. Ui r Description of work: " W RESIDENTIAL Water Heater Lawn Irrigation ( RPZ / — PVB) Septic System New Abandonment Water Softener Add Plumbing Fixtures ( Main /_ Lower Level) Water Turnaround RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener (includes State Surcharge) $60.00 Lawn Irrigation (includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes State Surcharge) *Water Turnaround (add $280.00 if a 3/4" meter is required) $115.00 Septic System New (includes County fee and State Surcharge) TOTAL FEES $ 0 L, CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 45440002 for protection against underground utility damage. CaII 48 hours before you intend to dig to receive locates of underground utilities. 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. - f? x /1 x K 1'VI SCHo13E , Applicant's P ted Name Applicanrs Signature FOR OFFICE USE Required Inspections: Reviewed By: Date: Under Ground Rough -In Air Test Gas Test Final Meter Related Items: Meter Size Radio Read Manometer Staff: , For Office Use tLQ\ O' Permit#: (."4- Permit Fee: Date Received: 3830 PILOT KNOB ROAD i EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 L Staff: J buildinainspectionsi city2feagan.com 2020RESIDENTIAL PLUMBING PERMIT APPLICATION h Date: # - Site Site Address: i; i U J,,,' i .1' `.. .. Tenant: �, . ._w._a. Suite#: �.. ._ �._ ... _ ne Resident/Owner Name: k3_ :1i).-1 t i C t i �, Phone: L( i - Address/City/Zip: .,)i. f' t > "'' Name: )cr L1 J'' 1(t i (1I)l, License#: t.1 i v _> Address: , U.. ),--1 ...,/:\.1. i . i .t.-/c City: )C. i t)Lt.t 1 Contractor State: )l '} 1' Zip: > . 7 Phone: L I 0 >, =i,,,,,, : i ' c ) \ Email: Contact: �' )� k � '' Type of Work >—New _Replacement _Repair _Rebuild _Modify Space ___Work in R.O.W. Description of work r It i,t l i t ',) v'i " Id- 4 3{ 1 t' Ci l i G.1 r' Tankless Water Heater— Lawn Irrigation( RPZ i)` PVB) 6 Standard Water Heater Add Plumbing Fixtures( Main/—Lower Level) Description Water Softener Description: Septic System Connection to City Water from Well New Abandonment RESIDENTIAL FEES $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation (includes State Surcharge) $60.00 New fixtures, adding or removing piping (includes State Surcharge) $60.00 Septic System Abandonment I $100.00 New Residential (fee collected with Building Permit) 1 $115.00 New Septic System (includes County fee and State Surcharge) $60.00 Connecting to City Water from Well*+$290 for Meter and $200 for Radio Read = $550 *Sewer&Water Permit also required for connection charges TOTAL FEES$ r L. _., _ .._.. .. CALL BEF ,.- �__ ORE 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. ;:^vzv o+herstateonecall.a You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.cityofeagan.comtsubscribe. 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. XI t '�- f,.. - x )0-S ) (-a.1 ) l / Applicant's rinted Name .c...- -- Applicant's Signature Page 1 of 2