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4334 Bear Path Tr 1 Use BLUE or BLACK Ink For Office Use I Permit I of ~I 3830 Pilot Knob Road I Permit Fee. I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I I Fax: (651) 675-5694 1 Staff: I I - - - J 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 7 Site Address: a i X33 G AatA Tenant: Suite RESIDENT/OWNER Name: I Phone: Address / City / Zip: • Applicant is: Owner Contractor TYPE OF WORK Description of work: 0 Leg r / Construction Cost: Multi-Family Building: (Yes / No CONTRACTOR Name: License l 7V Address: / - City: X V?,- alcz t ) State: Zip: Phone: ? ~~Y ~ 26 Contactii((;i Email: Leach GirtN^ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUIL 70"1 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 youprovide 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..qopherstateonecall.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. xrli S J~7 ~l Applicant's Printed Name Applica is Signature Page 1 of 2 lflt~ SERVICE DINT TER, `s` Y~.Of EAGAN NC.:. 7.3 r w .395 i+aFat' IFngli Road PERMIT .Beg¢n MM4755122, s DATE ~ e - honing TTI - No. of thi s, - Dvyner, xis ,t1„•hr, © n~,ri~ryta'r3n i~ddxess Site Address: 7 Connection Chorge: Wier No,: Lam- -k- - i Account Depo'sit• - tf '4o P#y WUh the City;vf Eagorx, . Suri urge" 5C 3>ti Mtisc. Chdrges: r _ _ Date Paid: _ - r, #94+5 Not, Khob Road PERMIT NO,: f 57 I Bogart, JMR 55122 DATE. l3 "7Arti7g, ^ Z No. uF- i nits 1 t3vyrier. _ I;I~ ~7 `tr& ''~t35'C2ttt't , Ov~ 2W ►x e -Ad*,esia r t>~ PlUmber. ti8. llrtc PZ t7L6 _ j~I;onq 100. 00 pd i j9rer, to iatmaly with the City of Ea go* Conne£tiah Charge: 4? S . iJ(? nd cles. Account Deposit; t ; r Perhilt Fee: I y x ¢ Surcharge: .,Misc. Charges: LLr z4 x r Total: - Oco Paid ,..u• ~6 o a This request void X 63 d (v 7 18 months from Date of this Request Fire No. S 941 6 9 I, as icensed Electrical Contract- 0 Owner, do hereby request inspection of the above electri- cal Wiring installed at: Street Address or Route Norte lam'' City Section Township Range County Which is occupied by / 1e,, 7/4-'v g 1,E?! (Name of Occupant) Is a roughin inspection required on this job? No ❑ Y Ready Now ❑ Will CaU Power Supplier Address Electrical Contractor/_-:~l°.e(~'-,~- Contractor's License No. (Company 'Name) Mailing Address (Electrical Contractor or Ow aking This Installation)-~' Authorized Signature ner -7 Phone No.411& ( le al motor' Own r Ma his Mstallation) +b 71. This inspection request will not be accepted by the rr7 State Board unless proper inspection fee is enclosed. Minnesota State Board of Electricity EB-00001-02 Griggs Midway Bldg. - Room N191ty " 1821 university Ave., St. Paul, Minn. 55104 - Phone 297-2111 (0 7 REQUEST FOR ELECTRICAL INSPECTION $ 94129 CHECK BELOW WORK COVERED BY THIS REQUEST Type of Building New A . Rep. Check Appliances Wired F~ft Check Equipment Wired For Home ❑ ❑ Range Temporary Wiring ❑ Duplex ~Wo ❑ ❑ Water Heater ❑ Lighting Fixtures J~ Apt. Bldg. ❑ ❑ ❑ Dryer ❑ Electric Heating ❑ Commercial Bldg. ❑ ❑ ❑ Furnace Silo Unloader ❑ Industrial Bldg. ❑ ❑ ❑ Air Conditioner ❑ Bulk Milk Tank ❑ Farm ❑ ❑ ❑ ppList List Other ❑ ❑ ❑ Herers~ Herers# COMPUTE INSPECTION FEE BELOW Service Entrance Size: # Fee Feeders&Subfeeders: # Fee Circuits: # Fee 0 to 100 Am s. 0 to 30 Amperes 0 to 30 Amperes C t) 101 to 200 Amps. 31 to 100 Amperes 31 to 100 Amperes t . Above 200 Amps. Above 100 Amps. Above 100 Amps. Transformers Remote Control Circ. Partial or other fee - 3` Signs Special Inspection Minimum fee $5 Remarks q TOTAL F a[.. tJ ~~r ~ I, the Elec c In to ° . " eb ertify e ab cltion has been ade. (Rough-in to (Final) D 1b & -kl This request void 18 months from This request void F a ~o 18 months from Date of this Request Fire No. 34933 I, as ❑ Licensed Electrical Contractor 0Owner, do hereby request inspection of the above electri- cal wiring installed at: K Street Address or Route No. t =-i City Section Township Range County Which is occupied by (Name of Occupant) Is a roughin inspection required on this job? No El Yes ❑ Ready Now t. Will Call ❑ Power Supplier' Address Electrical Contractor Contractor's License No s (Company Name), Mailing Address! _ (Electrical: ontract6r or Owner Making This Installation),,--:-, Authorized Signature j` Phone No. (Electric8l Contractor or Ownet Making This Installation) Offf STATE BOARD' L U This inspection request will not be accepted by the State Board unless proper inspection fee is enclosed. 4 Minnesota State Board of Electricity Griggs Midway Bldg. - Room N191 EB-0000 -02 1821 University Ave., St. Paul, Minn. 55104 - Phone 297-2111 ,2t~4C)~ 13EQUEST FOR ELECTRICAL INSPECTION CAECK BELOW WORK COVERED BY THIS REQUEST 34933 Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For Home ❑ ❑ ❑ Range ❑ Temporary Wiring ❑ Duplex ❑ ❑ ❑ Water Heater ❑ Lighting Fixtures ❑ Apt. Bldg. ❑ ❑ ❑ Dryer ❑ Electric Heating ❑ Commercial Bldg. ❑ ❑ ❑ Furnace ❑ / Silo Unloader ❑ Industrial Bldg. ❑ ❑ ❑ Air Conditioner Bulk Milk Tank ❑ Farm ❑ ❑ ❑ List List Others Others Other ❑ El El Here ~ Here COMPUTE INSPECTION FEE BELOW Service Entrance Size: # Fee Feeders&Subfeeders: # Fee Circuits: # Fee 0 to 100 Am s. 0 to 30 Amperes ? 0 to 30 Amperes 101 to 200 Amps. 31 to 100 Amperes 31 to 100 Amperes Above 200 Amps. Above 100 Amps. Above 100 Amps. Transformers Remote Control Circ. Partial or other fee Signs Vccerti Inspection, Minimum fee $5.00 Remarks TOTAL FEE I, the Elec Frricag, nspec or, hhat the above i nspection has been made. (Rough-in) Date (Final) ...pate This request void 18 months from CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 N2 6575 PHONE: 454-8100 BUILDING PERMIT APPLICATION Receipt #~1Z To be used for SF DWGIGAR Est. Value 52,000 Date 4-1 19._$L Site Address 4334 Bear Path Tr Erect ~ Occupancy R3 Lot 6 Block 3` Sec/Sub. MeadOWlandS Alter ❑ Zoning Rl Parcel # 10 48050 060 03 Repair ❑ Fire Zone NA Enlarge ❑ Type of Const. V W Name Win H ft mr Qanstr- Move ❑ # Stories 3 Address 11913 Highland View Cir Demolish ❑ Front 58 ft. BurnSVille 553 7 ne 890-3992 Grade E] Depth 38 ft. City ho Approvals Fees Name zp Asses J-30-81 Permit 143.50 0' Address ~ city Phone Water & Sew. Surcharge 26.00 Police Plan check 71.75 j3X:,C-' Z Name Fire SAC 525.00 Address Eng. Water Conn. 335.00 W City Phone Planner Water Meter 60.00 Council Road Unit 185.00 hereby acknowledge that i have read this application and state that Bldg. Off. the information is correct and agree to 96mply with all applicable State of Minnesota Statute and City ow, cog rdinanc APC Total 1,346,25' Signature of Permil6o A Building Permit is issue a. Hut ex COMtr=tiOn on the express condition that all work shall be done in ccordance w' alf applica a St to of Minnesota Statutes and City of Eagan Ordinances. Building Official I •b~~~ i~~` ~~~~~a ~r t~,~,~ir~f,~'y' `dal"' ~~fi - Wh_ Fy ttCitp of Cagan This Certificate issued pursuant to the •reyuirements of Section 396 of the Uniform Building ~ Code certifying that at the time of issuance this structure was in €ompliance with the various i ordinances of the City reguldting building construction or use. For the f ollouan singl Farm [~j ~jy & CuseclasnBcahon ~~tiRp~ BIdp,Permit Nu 6575 OwpaacyType R.2__-TypeCoptimcGon-_Fire Zone ---ZoniNvouict r,. - ifs "r~' ar ~,1 pvrrterof.Hutlding Wm.._Hu ,YUp'1^'_C1)118"~yddress 4923 HIKbIand-IVIew ~ . $uUngAddmss 4334 Bea Path Tom. ~ t~ lc offid.] ,bqz.. . Date' .08T N GoiV9RYCWOUe P{ACf• ail s~^~Ai:,:~:~,1~ya:~....,_~..:.a:.;.~.,.L.._z,_::,..___~• ~vw~._.,.a.~,.i, 3.~~W. w..~.a~~~?~' ~•t ivla~w ~~-,~,y~",JfF\I~ 'J1Qd)y~~,. r;,~z9' "di~~ ~,~~T6 ltp~~ ~ ~rs .~.~~~-~+vk` y +ICS+ rS1~ r t ~ ,+'3P l+y ARo M~ _ .HIRr'. ? t +q.6~~ ~ i F Ya[dY~ ~hYn ~ `tiFa" 4' ~ 'Ve ®ooes a&i ~ -J LIrHOIN us.a. CITY OF EAGAN Include 2 sets of plans, 110iff 44f Of( Z site plan w/elevations & ~j BUILDING PERMIT APPLICATION 1 set of energy calculations. To Be Used For. K Valuation - ~ Date Site Address: 1133 OFFICE USE ONLY Lot i~7 Block 3 Sec. /Sub. iile-~,4da,4wd Erect Occupancy Parcel /~i p ~J,~~ ® Alter Zoning Repair Fire Zone_ Owner: Enlarge Type of Const. Move # Stories Address: Demolish Front S~ ft. City/Zip Code: Grade Depth ft. Phone APPROVALS FEES Contractor: ~bx5(c Assessments Permit Address: 90 ~ ~ G4,el 124- c,r Water/Sewer Surcharge ~ Police Plan Check~S City/Zip Code: ~ccrx5o,~ Fire SAC Phone : t~9099z Y~~ 3~' Eng. Water Conn. Planner. Water Meter Arch./Eng.: Council Road Unit I Rs Bldg. Off. Address: APC City/Zip Coder Phone TOTAL j 3 a 3~ ~r a ~ ~ ~.o II Certificate for: Dunn & Curry m f4~f u h e r ~0l~5 1-1sV-3Y33 DELMAR H. SCHWANZ LANDSURVEYOR Registered Under Laws of The State of Minnesota 2978 - 146TH STREET W. - BOX M ROSEMOUNT, MINNESOTA 55068 PHONE 612 423.1768 SURVEYOR'S CERTIFICATE SCALE : ` 1 inch 30 feet Xl~ w 'Sto l V zy, X 04 s~\ 1 00 ~1I y Dra Vie, & Utilit easez t 0~ srs ' . I hereby certify that this is a true a0a correct representation of Iot 6, Block 3, 7- o MEADOWLAND FIRST ADDITION, according to 04 V the recorded plat thereof, Dakota County, 5 Minnesota. Dated : June 9, 1980 Approved for Dunn & Curry Real Estate Management, Inc. by: 1 $yJn/ I ~ r r -e4 MINNESOTA RE 6GISTRATION NO. 8625 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF MWM 3f830 PILOT tA~ RD - 55122 130 W" 831-881-"73 I;_a ,fit) > 3 road site survey: shw&V s% (t. of W 3% it. of hour 2 copies of plan and St xWed atom CM mcWmwn kit ggyMM 1 set of energy cal s for headed addillCn t > 2 copes of pions (show be= & window prod fad. dsdg ; etc.) 1 dto Ivey Im e odciflons & docks > 100 of energy calculations > 3 oopt" It" prosemoson pion U kit planed attar 7/1/93 DATE: CONSTRUCTION COST: DESCRIPTION OF ORIG STREET ADDRESS: LOT. BLOCK: SUBD./P.I.D. C M"A" I gyol P 6 Phone PROPERTY Lad FW OWNER Street Addie . C W, ~jj- 4~., stars: zip: ..~2,9 7 0: Mme cofr any: pl/j / (area code) CONTRACTOR Street License City ! Skde: ~ ~1t1 ZP: ARCHITECT/ E"NEER Car aarsy: Name: Telephone Il: { Street Add: Rogkkitton C City State: Zip: SVNWMUW licensed plumber phone ( 1 I hemby acknowledge that I have read Ihis application. state that the It :coffd. and agree to cornpiy wNh all applicble Sk de of tftnssota Stautes and City of Eagan Ordk►ances. Sigrnature of Applicant: ---------l-, -d OFFICE USE ONLY Ceffllcata of Survey Received Yes No Troe Preservation Plan Received Yes No Not Required CITY OF EAGAN Remarks Addition Lot 6 Bik 3 Parcel 10 418050 061) 01 Owner Y Y' f. j`~f i 1) o hb t ~,j.: Street - 4334 Rear Path '!'rail State ZkgM, NX 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREETRESTOR, mp• ' 1981 1589.99 158.99 10 ,:S/.e6 A010319 6-25-81 GRADING SAN SEW TRUNK 77.95 3.12 25 40.63 A 00 9 3-31-81 * SEWER LATERAL Q c/j A010318 -IT 6-25 - 1 WATERMAIN WATER LATERAL 1981 in WATER AREA R61 i Q7-4 qc;- 27 6.35 15 38-12' AO-10039- 3--U.-81 STORM SEW TRK / c 1971 282. 2 14-15 20 •27 38 A010039 3-31-81 * STORM SEW LAT 1981 10 CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 18.5-00 24OD9- 4-1-91 WATER CONN. 4-1-81 335 - 00 24009 BUILDING PER, 6575 SAC 5?c; - 130 24009 PARK 4-1-81 PLUMBING P~'=RVIIIT APPLICATION CITY OF EAGAN l"O)F 'GOAD "r `V'~ 'W`: N 55122 Please comp,<- e for _,,-is fic existing residen-Jai cweiii icts. Date c3 _ J 31 HAGEMAN, BLANCHE Site Street A 'r"eS 4334 BEAR PATH TRAIL EAGAN, MN 55122 Unit # (651) 454-2494 Property Owner Telephone # ( ) y ^4 A- p,..a Contractor Telephone # ( ) 'ac Address. .~y rE i_'.v City State _ Zip I The Applic;Kn`U a: O~ser,er Contractor ----Other Alterations to mst?n dwolii,~p $ 50.00 -Add fix-_ es to oor„ t,: c ng va,-r softener aria water heater ,Septic ysttiXmAban,u;;)s~ -Water a r r : qu: e~' ~ I -Other: water Scftioner r Hey "Lar $ 15.00 re :Ja em ;n,t _ adai±;Dnal _ Lawn Irrigaiicn new _ repair ----rebuild $ 30.00 i i [State Surchar_:.~ $ 50 L~'Total $ S. SD I hereby arpiy fe a "!esi untial Plumbing Permit and acknowledge that the information is complete and accura that the v,,ork -mill ! e i;-, c°onfo,rrnance with the ordinances and codes of the City of Eagan and -i aiumbl!v,] r ~"esI j± tal~d this r3cj'~ a permit, but only an application for a permit, work tc, s'; wjt`jr_u i? rn pit anc wc,,k will o,~, ~n accordance with the approved plan in the event a r' n~' approved rn Applicant's ~r oature APR 0 7 2004 try,.k CITY OF EAGAN 3795 Pliot Knob Road Eagan, MN 55122 N! 6575 y PHONE: 454-8100 _ BUILDING PERMIT Receipt - To be used for tin J,f Est. Value Date ~ , l9 ~ - Site Address Aa3 YuaL' i'c.1 r<< n Erect Occupancy Lot f Block Sec/Sub. Ater ❑ Zonings # 10, 4 '~~05 0 Parcel Repair ❑ Fire Zone Enlarge ❑ Type of Const. ~f W Name uttl= cbrist Move Q Stories W z Address #~!l3 4'Z~ t11r?~c Vi'i' ^?.Y. Demolish Q Front ft. ems„ t:n city Done w:3r Grade Depth p Name Approvals Fees vQ Address Assesste4 Permit 14 R7 r. Water & Sew. Surcharge Ci Phone Police Plan check 7 • V W Name Fire SAC L9 Address Eng. Water Conn. dW Gi Phone Planner Water Meter r Council Road Unit i I 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 r 3`- State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permittee T Tut.t r rYrii u t t ai k' J' A Building Permit is issued to; on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official Plumbing Z 317 - Z - .P/ M chanical 3 Al -/-57--,P/ Al -,1.7, Pl INSPECTIONS DATE INSP. Rough-In Final Footings ' Date Insp. Date Inap. Foundation _ Plumbing eins.Mechanical- _ - g Final Remarks: ~it .~-t-CT" / ~°o /t.QQ c~ q.~•1. ~t~✓ ci'l~J 3 iie4eip# 24022 PLUMBING PERMIT Permit No. 2317 CITY OF EAGAN Fee 20.00 Fill in numbered spaces S/C .50 Type orPrint'legibly Tot. 20.50 1. Date 4-2--81 2. Installation Cost 3. Job Address4334 Bear Path Lot 6 Blk. 3 Tract P,Uwlds 4. Owner Th- 1AUttM,-X Cranstruction 5. Contractor Russ And xscm. Phone 990-µ9533 6. Address 2012 Oak Dr 7. City Burroville State Mn Zip 55337 8. Building Type: Residential ® Commercial ❑ Institutional ❑ 9. Work Description: New 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 1 agree to comply with all ordinances and codes governing this type of work. Signed: for i Rough Final Inspections: Date Insp. Date Insp. This is your per it w1ben numbered and approved. Approved rra' ,.<:,CITY OF EAGAN 454-8100 Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C S~ Type or Print legibly Tot. } 1. Date 2. Installation Cost r 3. Job Address Blk. Tract 4. Owner f~_. ..r--4..a, ~~n.•t c 5. Contractor'- Phone 6. Address r v -~..,►t rt3 7. City M~'-~ a..., State ~a►,~,.~ ..~~.vc a.. Zip 8. Building Type: Residential CTS Commercial ❑ Institutional ❑ 9. Work Description: New [I'~ Add ❑ Alter ❑ Repair ❑ 10. Describe Fuel Typep 11. No. Equipment 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 gigoverning this type of work. Signed : for Rough Final Inspections: Date Insp.- Date Insp. l 'This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 I Reeeipt 24416 MECHANICAL PERMIT Permit No. 2480 CITY OF EAGAN e7O Fee Fill in numbered spaces S/C Type or Print legibly Tot. J ~ 1. Date 4-' 2-3- b ( 2. Installation Cost 1 3. Job Address 3 34-- Lot Blk. Tract (-':SEva6Z, ATI,~ "C`iZ 4. Owner Q^11 , 5. Contractor -rev-1 j2 Z,J QYhone 6. Address i t 7. City LA-3&t' S7- State 01-1 1 NZip 8. Building Type: Residential L~F Commercial ❑ Institutional ❑ 9. Work Description: New ❑ Add L'7 Alter ❑ Repair ❑ 10. Describe AS.. ♦ C- Fuel Type - jor 11. No. Equipment 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 ordin and codes governing this type of work. Sigped : AM for Rough Final • Inspections: Date Insp. Date Insp. This is your'perrnit when numbered and approved. . Approved CITY OF EAGAN 454-8100 -CASH RECEIPT r CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 4) AMOUNT too CASH >r ~ FUND CODE AMOUNT Y 3 - ~8Y^ NO, 4019 9/27/2015 2:39 PM FROM: Fax T0: 1-651-675-5699 PAGE: 002 OF 009 t Use BLUE o�BLACK Ink � ForOf(IceUse---------� � � „ j Pertnil�: ���� � � � . Clty of�a��� ; . . �. �� � ( Permd Fee. � 3830 Pilot Knob Road Eagan MN 55122 � oate Received: `���'�`� j Phone:�651)675-5675 I I Fax:(651)675-5694 i Staff: � � `����������������J 2015 RESIDE(VTIAL BUILDING PERMIT /�PPLICATION Date: � oZ �� Slte Address: �J f,� ��/i V'�h T!''�i�� Unit p: Name� �f Rn l�1-P ���/e�'1 Q� Phone:�/15���yGy a y�y Resident/ ,/2 / Owner Address/City/Zip: 7 J 3�! ��Q✓ ���� VG� /, Applicanl is; Owner, �Contractor Type Of Wo�k Description of work: iCl/ ei/�"1 ��/` e Co�struction Cost�' r°� ��o Multi-Family Building:(Yes /No,� companyc�T�11�/d� �,/_UG�Gl� ��77�'�7� cont,act: G1� Contractor Address: S� �3 / �1I��[g�v" ��- City: State:�YI�1Zip:� Phone:7b �-5.37�yd''VaEmail: 1'a'!i I�e�.���Gi?�'Ii.YDJl�-��''7 T-. License�: /.7�D��'S� Lead Certificate#: //�C17 a�y�y-� If the project is exempt from lead ce�tification, please explain why: COMPLETE THIS AREA ONIY IF CONSTRUCTING A NEW BUII.DING In the last 12 months,has the City of Eaga�Issued a permlt for a simila�plan based a�n a maste►plan? Yes No If yes,date and address of masler plan: Lice�sed Plumber: � Pt�one: Mechanical Co�tractor: Ptione: Sewe�8 Water Co�tractor: Phione: Fire Suppresslon Contractor: Phone: NOTE:Plans and supporting do�uments that you submit a�e considered to be public information. Portions of the information may be c/assified as non-public if you provide specJ�c rea:sons that would permlt the Clty to � • conclude that the are bade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-�002(or proteclion against underground utilily damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.ora I hereby acknowledge that this information is complete and accurate;that the work will be in con(ortnamce with the ordinances and codes o(the Ciiy of Eagan;that I understand this is not a permit, bul only an application for a permil, and work is not ti�staA without a pertnit;that the work will be in accordance with the approved plan in the ca:e of wurk which requires a review and approval of plans. E�Reriorwork authorized by a bullding permlt Issued In accordance with tl►e Minnesota Sfate Buildi�g Code must be eompleted withln 180 days of petmit issuance. x /.'S�/��(.�C1�t�l/ x � A plicant' rinted Name , App i t s i nature Page 1 of 3 I 9/27/2015 2:39 PM FROM: Fax T0: 1-651-675-5699 PAG:E: 003 OF 009 I r �; I "� � f5�`2 ����" � � < ' /�� �/� ' " J �� � DO NOT WRITE BELOW THIS LINE� , SUB TYPES � Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alte�ation(Single Family) � Single Family _ Garage _ Porch(4-Season) � Exterior Alteration(Multi) _ Multi _ Deck _ Porch(ScreeNGazebolPergola) _ Miscellaneous _ 01 of_Plex _ Lower Level _ Pool _ Accessory Building � WORK TYPES `��a�, ��c, C�uJl `�2� `� su�.°�,,� �-Fc��d�5c� �I'b -��kv-� New _ interior Improvement _ Siding � __ Demolish Building• _ Additio� _ Move Cullding _ Reroof . _ Demolish I�terior _ Alteration _ Fire Repair _ Vbindows _ Demolish Foundation _ Replace _ Repair _ Egress�ndow __ Water Damage o..a.. ..���..0 in.. ..c•:� �s..�•:�i..:u:_ �nr��.__��..a. _r _a ..�.,......::.�....�. �.............�........................y .��j::... .................w uj.M�.�.u... OESCRIPTION i' • Valuation �� Occupancy �� MCIES System Plan Review Code Edition 2otTw�.S$G Sd(:Units (25%_100°��) Zoning �� City�Water Census Code Stories Boc►ster Pump #of Units Square Feet PR\/ #of Buildings Length Fire Suppression Required Type of Construction �_ Width REQUIRED INSPECTIONS � Footings�New Building) Meter Size:__ Footings(Deck) Final/C.O.Requ�ired Footings(Addition) � Final/No C.O:RE;quired , Foundation HVAC Gas SE;rvice Test Gas Line Air Test Roof:_Ice 8 Water _Fina� Pool:_Footing;� AiNGas Tests _Final , F�aming � �rain Tile ' Fireplace:_Rough In _Air Test _Final Siding:_,Stucco Lath _Stone Lath _Brick ' Insulation Windows � Sheathing Retaining Wall:__Footings_Back611_Final , Sheetrock Rado�Control � Fire Walls Fire Suppression:_Rough In_Final I Braced Walls Erosion Control �I Othe�• I Reviewed By: ,Building Inspector . � RESIDENTIAL FEES . Base Fee Surcharge � �� � �b��/,., � � Plan Review �f'aC.�Gvi� (� �i-�,� MCES SAC � City SAC �J . .� �Z�1 Z . Utiliry Connection Charge „ . � S8W Permit&Surcharge _ _ Treatment Plant � Copies - TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA157938 Date Issued:09/16/2019 Permit Category:ePermit Site Address: 4334 Bear Path Tr Lot:6 Block: 3 Addition: Meadowlands 1st PID:10-48050-03-060 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener 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 - Timothy Tstes J Hagemann 4334 Bear Path Tr Eagan MN 55122 Haferman Water Conditioning 12142 12th Ave. Burnsville MN 55337 (952) 894-4040 Applicant/Permitee: Signature Issued By: Signature