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1268 Balsam Tr ECtTY OF EAGAN 3795 .^Ilot Knob Road Eoian, MN 55122 Zoning: _ Owner, _ s Address: Site Address: Plumber: _ Meter No.: Si?n• Reoder No.: 1 agree fo compiy wifh fhe City of Eogon Ordinaneea. BY - Dote of CITY OF EApAN 3795 Pilot Kno6 Rood Eagoe, MN 55122 Zoning: Owner: Address: WATER SERVICE PERMIT PERMIT NO.: DATE: No. of Units: Connection Chorge: Account Deposit: Permit Fee: Surcharge: Misc. CFbrges: Total: Dote Paid: SEWER SERVICE PERMIT PERMIT NO.: _ DATE: _ No. of Units b ttI ogroe ro oomply with fhe Citr of Eagon of Insp.: Connection Chorge; < Acwunt Deposit: Permit Fee: Surcharge: Misc. Charges: Totol: • CITY OF EAGAN ? 9745 Pilot Kwob Read Eogen, Mlnnesofa 95122 Phoee: 454-8 t 00 PERMIT Dcte: 0/78 Site Address: 1268 E. Balsam Lot " Block ? Sub/Sec No Receipt No.: $ingie I ? . Residentiol _ . .. - _, . ot- imulti Name ?r,'cbert F. ?,nder?c,: _....-j•, _? . i,c?_.. • ...,.. New/ /11ter. / Repoi r ? Aadress 621 jo. .,iit:lliny Cost of Installation ? k'dlli City Phone: Permit Fee ` Nome _ •"1f]d8T , ?jOn SurcMrge • J` 20 ?. ?3ut! ez ? Addreu e • e -, . 1 ". ? . l .? V City ?> .. . , r ,, . ? .. Phone: Totol This Permit is issued on the express condition that ell work shell be done in acwrdonce with nll opplicable Stote of Minnesota Stotutes and City of Eagan Ordinances. Building CITY OF EAGAN 3795 Pilot Knob Roed Eagaw, AAinnesoM 55122 P6owe: 454-8100 1 14.- _ PERMIT Date: - 8/15/?8 268 E. Balsam Site Address: ? _ Lot J Block 5ub/Sec. _ k;l?tii 110i:lE`S No. ? ? .. _ .. Receipt No.: Single I Residential Multi Res., Comm.llnd. I l"r Name New/Alter./Repoir. . ? Address Cost of Instollntion A. Paul CitY Phane: Permit Fee italph's I?ibr. . N°'Y'e Surcfiarge ? ? 1900 Keswick Address e 0 City Phone: Totol This Permit is issued on the express condiiion that all work shall be done in occordance witfi oll applicable State of Minnesota 5tatutes and City of Eagan Ordinonces. Building Official CITY OF EAGAN ? ? - 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100 BUILDING PERMIT Receiqt ? To be used for Est Value 4 Date ,19 Site Address OFFICE USE aNLY Lot BIoCk t SeC/Sub. On Site Sewage _ Occupancy , MWCC System _ Zoning PBrCeI NO. On Site Well _ Type of Const City Water (ActuaQ (Allowable) c Name W . . 4F O} StOf16$ z Address Length ° City Phone Depth Total S F , p Name . . Footprint S.F. ? ? Address ' APPROVALS FEES P City Phone Assessments _ Permit ? ac Water/Sewer - Surcharge w W NamB Police _ Plan Review W _z Address Fire _ SAC,City ?= ? W City Phone Engr. Planner _ SAC, MWCC _ Water Conn. Council _ Water Meter I hereby acknowledge that I have read this application and state Bldg. Off. _ Road Unit thattheinformationiscorreCtandagreetocomplywithallapplicable APC _ TreatmentPt State ot Minnesota 5tatutes and City of Eagan Ordinances. variance _ Parks Copies 5ignature of Permittee TOTIIL . 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. Permft No. Psrmit Holder Date TeIsphone 7e Plumbing H.V.AC. Electric le? ?? /? ?? ,jCZ, G Softener Inspoctlon Date Insp. Commsnts Footings I Footings II Foundation Framin9 Rooting Rough Pibg. Rough Htg. Isul. Fireplace Final Htg. Final Plbg. Bldg. Final Occ. p. LP Ftg. ?? Frmg. I S Disp. CITY OF EAGAN Addition W' lderness Run 6th Lot 11 aik 1 Parcel 10 84355 110 01 Owner •i ' iL'!'.,t'; i) ?,?Y)?,?.G' '? 1? Street 1268 East Balsam Trail State 10 84355 110 01 Improvement Date Amount Annual Years Payment Receipt Date STREET SUR F. STREET RESTOR. GRADING SAN SEW TRUNK C;Q1 1973 161.21 8.04 20 9-25-78 SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA 3 1977 162. 14 ` 5S0 *-.g{y 15 STORM SEW TRK 3 1978 280.60 _ 1$A.7 S 33 9-25-78 STORM 5EW LAT ' CURB & GUTTER SIDEWALK STREET LIGHT i WATER CONN. 250.00 10665 6-28-78 BUILOING PER. #4858 sAC 500.00 10665 6-28-78 PARK .?(0 7 -77 ?k?k*?*???******?***??***************?*** CITY QF EAGAN CASHIER: S TERMINAL Nd: 683 pATE: 07/09/99 TIMF=: 15:50:53 ILl: NqME ; MUf;F'FIY BFi05 320 9001 1268 BALSAM TC. 181.25 2i.55 9001 1268 BALSAM Tk 5-00 I To+.al Recpirt Amoun+,: 186.25 GF:i 1;30U3 tJSER I D: NANCY *?**?K*?K*****?K***?K?K**?*****?c***?*?K?K?**** 7 . ciTr oF EAc,AN ' 8795 Pqot Knob Road Eogen, MN 55122 N2 4858 PHONEs 454-8100 BUILDING PERMIT Receipt # 1 C6f; 5_ rt__ b,i.s% , o Site Address - ''-1 ? f?. , ,Llfl Lot Block 5ec/5ub. Porcel # oc Name W ? /4dd(eSi , .. .r.. -- -• .;??, ? lx Name an<... 0 z . . ??? Addross ?- rlti, ati.,..e Name I hereby acknowledge that I have read this application ond stote that the information is correct ond agree to comply with all opplicoble State of Minnesoto STotutes and City of Eagon Ordirances. Signature of Permittee _ ,1 Building Permit is issued all work shall be done in a Building Officiol Erect ? Alter ? Reppir ? Enlnrge ? Move ? Demolish ? Grode ? Assessment _ Water & 5ew. Pol ice Fire Eng. Plonner Council Bldg. Off. - APC Occuponty ' ; Zoning Fire Zone " Type of Const. .# Stories Front Depth ft. Fees Permit Surcharge Plon check SAC Water Conn. ' Water Meter on the express condition that all appliwble State of Minnesota Statutes and City of Eagan Ordinances. PawM # OeM Isswd PerwMt" Plumbin9 -,;07 Mechcnical /„151-6 INSPECTIONS DATE INSP. Rouqh-In Final Footings Dote Irnp. Dafe lerp. Foundation Plumbing $'-/?ag Frome/ins. r'-?/d-7? Mechanical Final ? Remarks: ?l. ?- /A - 2 r ?-? @s,,? CITY OF EAGAN N2 14 5 7 7 3830 Pilot Knob Road, P.O. Bax 21-199, Eagan, MN 55127 BUILDING PERMIT PHONE: 454-8100 Aeceipt # o p 0?1 1 I 7o be used for DECK/BAY WINDO'Jst. Value $4, 000 Date JANtiARY 29 19 88 Site Address 1268 SALSAM TRAIL E Lot 11 Block 1 Sec/Sub. WILDERNESS RUN Parcel No. 6TH ADD. a Name TIM & BARB CALLISTER 3 Address SAME ° City Phone ao Name NEW SPACES HOME CRAFTSMAN ?? Address 15025 STEVENS AVE , City B'VILLE phone 435-3478 a F w Nan x ? Add <w City OFFICE USE ONLY OnSiteSewage _ Occupancy MWCC System _ Zoning On Site Well _ Type of Const City Water _ (Actuap (Allowable) it ot stories Length Depth S.F. Total FootOrint S.F. APPROVAIS FEES Assessments _ Permit $$8.00 Water/Sewer _ Surcharge 9_ nn Police Plan Review Fire SAC, City Engc _ SAC, MWCC Planner Water Conn. Council WaterMeter I hereby acknowledge ihat I have read this aOPlication and state I Bldg. OH. _ Roatl Unit thattheinformationiscorrectandagreetocomplywithallepplicable APC - TreatmentPt State of Minnesota Statute,W?nd Clt f Eaga{1 Ord' anc s Variance _ Parks ///C?/ ?? Copies Signature of Permittee??/ TOTAL 60.00 A Building Permit is issued to: NEW SPACES HOME CRAFTSMAN on the express condition thet all work shall be done in accordance with all_?*icable State ofyinnesota Statutes and City of Eagan Ordinancea Buflding Official This request void?? 18 mmhsCfromt 9 C /' I?I t !7 0 Oc)1_O6?_//.1?! :,.,.s.vi, i(%>__ flequest Dale Fire No. Rouph-in Insuec ion RanurteA? tify Inspeo- ?Heatly NowMW?ll Nn -? ?Yes ?NO Io, Wh.n Readv ???/ LicenseA Elecvic I Con raclor I hareby request inspection of above ,?yOwner elechical work installad at: Stree[ Atldress, Box o? Route No. C°v I Y.l d7 r-4 ecuon o. me Townsn ip Na or No. Ranpe Nn. County ? A O OccaVant (PNINT) Phone No. Power Supo??er 1 A.dd?ess .. y.? ? ? ItGI R I Q 1 N C1h' ? Electrical C tractor ICOmpany Namel Co rtract r's License No. MailinB J ess ICunhactor or Owner Makiny Instatlationl / --? ? ? ? • _ C? ,o/sarr, S.. Authorh d SiBnT IConha [ wner M< iny Ins[allatioM Phone Nm r , I )/f / MINNESOTA STpTE A OF-ELECTHICITV THIS 1 SPECTION flEQUEST WILL NOT GriBBS-Mitlwav Bld .- Poom N•197 BE ACCEP7ED BY THE STqTE BOARD 7821 Universilv e.. St. Peul. MN 55104 UNLE55 PNOPEP INSPECTION FEE IS Ph?one(612) 642- W ENCLOSED. -- REQUEST FOR ELECTRICAL INSPECTION epe.oooo/t-?o7s See instructions lor com=leting [his lorm on Dxck ot yellow eopV. p II ?f / X" Below Work Covered by This Request ? J 6166 AAtl Rep. Type of Builtling Apolioncea Wired EqaiVment Wire•] Home Runge Temporary Scrvice DUplex Water Heater Liyhtiny Fixtures Apt. BuilAing Dryer Electric Heatin Commercial Bld,y. Fumace Silu Unloader Industrial BIAg. Air Conditioner Bulk Milk Tank Farm +ne, oeu v OinnrlSnecirvl t e Succity Other O?hi?? Comnuie Insoection Fee 8elow p Fee Service Enbence5ize fl fee Feeders/Subieedars N Pee Circuits 0 to200Am 5 0 ro30qm s 0 tn30An n Ahove 200 qmps 31 to 100 Amps 31 to 100 Am s Swinming Pool Above 100_Amps Above 700-Amps Transformers Irngation Booms Partial.'Other Fee Signs Speciallnspection TOTAL Ne`marks Nough-in -i . D:?te I, the EIecU nspector, nereby C? cenify Ihet the nbove 1 Final U' e inspection hes been m. '' made. ; i TMe request vold 1B montlre from a uu.7?-- ?? zi This rVquest voi 18 months from !i/87 - =' R 4439 Date of this Request 8-3-1978 I, ac'yff Licensed Electrical Contractor OOwner, do hereby request inspection of the above electri- cal wiring installed at: ig/ /.?i( ol Ll//C ?? Stieet Address or Route Na. 1260 East Balsan CityE??_ Sectlon Township Range County Dakota Which is occupied by Tilson Hottoe (Name af Occupanl) Is a roughin inspection required on this job? No ? Yes n Ready Now ? Will CaIPM Power Supplier T1Akn+a (`t$_ Address Far?.i ngtnn Electrical Contractor O.B. Thonpscn Blectric Cc. Contractor's License NoA=3J` (COmpany Name) Mailing Address 12201 Ktka_ Blyd. , ?Ttka 5"43 Authorized (Electrical ContracYor'or Own, NOE MOmD Qopw Phone No. 933-2521 This inspection request will not he accepted by the State Board unless proper inspection fee is enclased. ? Minnesota State Board of Electricity `l53 Unie+oSity Ato., St. Paul, A9inn. 55104-Phone 645-7703 i .FLEOUEST FOR ELECTRICAL INSPECTION CHECK sELOW WOKK COVERED BY THIS REQUEST i// 8r 4439 Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wirdl Foi Home ia ? ? Range 10 Tempotary Wiring ? Duplex ? ? ? Water Heater ? Lighting Futures @{. Apt. Bldg. El ? ? Dryer ? Electric Heating ? Commexcial Bldg. ? ? ? Fumac Silo Unloader ? Industrial Bldg. ? ? ? A"u Co p e'?M Bulk Milk Tank ? Farm ? ? ? List L List Other ? ? ? p Herer ?. ? p HeheIS? COMPUTE INSPECTION FEE BELOW Service Enhance Size: it Fce Feedera&Subfeeders: # Fee Ctrwits: # Fce 0 to 300 Am s. 0 to 30 Am eres 0 to 30 Am eres 0 101 to 200 Amp .? G 31 to 100 Ampeies 31 to 100 Am eres Above 200 Amps. Above 100 Amps. Above 100 Amps. 7ransformers Remote Con[rol Cire. Partial or other Cee Signs Specia( Ins ection Minimum fee S5. Remazks 7.3a11 TOTAL FE sp. 40• 50 I, the Electrical Inspector, hereby certify (Final) This request has ,-. „ _ ? 1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 ? -681•4675 /` 9Q/, New Consfruction Reauiremenh 651 RemodeVReoair Rea?Irl? `o 3v D 3 regisferetl sHe wrveys showing sq. R. of lof, sq. H. of house and all rooled areas (20% maxlmum lot coveraae allowed) ? T copies of plans (show beam a window sizes; poured Ind. destgn; etc.) ? 1 set of energy calculations ? 3 copfes ol tree preservWfon plan N IM platfed alfer 7/1/93 DATE: lj? 0-S?/q q DESCRIPTION OF 1 STREEf ADDRESS: LOT: ? BLOCK: I_ SUBD./P.I.D. #: 2 capies of plan 1 aet of energy calculaflons lor heafed addkions 1 sMe survey for exterlor addMtons 3 decks CONSTRUCTION COST: ?/o, oQ0 Name: l?alt4skA/ 7 lwli Phone #: PROPERTY Last Fint OWNER 12??y ? -??sra-t? 7??u.? Street Address: City ?CfiYt/ state: MA' Zip: Company: M(.{4 ??1? Phone &12-- _790"3 24- 2-- (area code) CONTRACTOR Street Address:_ LCf.w, N5 license #.?/!o Exp. ?u City State: Zip: ARCHITECT/ ENGINEER Telephone #: area code ( ) Name: Sheefi Address: RegishaHon #: City State: Zip: Sewer 8 water Iicensed plumber (reaulred for new tonstructlon onNl: PcnaNy applies when address change and lot change Is requested once permff Is issued. i hpreby acknowledge fhaf I have read this application, state that fhe Informafion is conecl, and agree to comply wRh all applicabl Sttite of Minnesota Statutes and Cfy of Eagan Ordinances. Signature of Appllcant: OFFICE USE ONLY i`' ? ?i Certificates of Survey Received _ Yes _ No ' ,? 2- ? ?? t ' ?^ (? Tree Preservation Plan Received _ Yes _ No _ Not Required i!1l.J_`v.Ykd? , ° 1 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 _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened) ? 04 2-plex ? 09 7-piex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage ? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool D' 25 Miscellaneous WORK TYPE ? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia ? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair O? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof • Give PCA handout to applicant for demofition permit GENERAL INFORMATION Const. (Actuai) (Allowable) UBC Occupancy Zoning # of Stories Length Width APPROVALS Planning Permit Fee 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: Basement sq. ft. Main level sq. ft. sq. ft, sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building tg" I . a? Census Code SAC Code t=T? No. of Units ? No. of Bldgs ? MC/ES System City Water Booster Pump PRV Fire Sprinklered 14 Engineering Variance Valuation: $ t 5AC Units % SAC E r i ' 1988 UILDING PfiRMIT APPLICATION - CITY OF EAGAN SO SINGLE FAMILY DWELLINGS ?e) ? INCLUDE 2 SETS OF PLANS, 3 CERTIEICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR CORNER LOTS - CONTAACTOR/HOMEOWIdER MUST DESIGNATE WIiICH ADDRESS IS DESIRED.' NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS # OF UNITS INCLUDE 2 SETS OF PLANS, CERTIEICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS ? -`l ??'a`r'? r?i %;?:•? o ?:" To Be Used For: Ae»'.Ae.{ Valuation: A° ?;sroQ- Date: I- Zz Site Address IZ' (p13 P)A IS?m %r_ ?. Lot ?I Block ? ? . • u ' j ? ? _ Parcel/Sub owner'fimPJ (3ur6 Go/lisfer Address City/Zip Code ?G,qqr, ?T Phone Contractor LPU)-SpY1CeS_f ?urne CfC?FisMur Address I Sb2 S S'fc_.tx,n s City/Zip Code 6u{Y6uilM2., 65'?3-7 Phone ,:1 3 S- 3 L-} -) (9 Arch./Engr. Uew Snr?ees -? Address ? ?UZS ?}??enS lave. 1Q SS 331 City/Zip Code YJU^rt-,sv??l-e.. ?lv? Phone 11 qooo ^ - On site sewage_ MWCC system _ On site well _ City water _ PRV required _ Booster Pump APPROVALS Oecupancy 2oning Actual Const Allowable li of stories Length Depth S.F. Total Footprint S.F. FEES Engr/Assess Permit Planner Surcharge Council Plan Review Bldg. Off. ?25 SAC, City Variance SAC, MWCC Water Conn Water Meter Road Unit Treatment P1 Parks Copies TOTAL S8, ob DD cITr oF EacnN 3795 PiIM Kno6 Road Eagen, MN 55123 N2 4858 ? PHONE: 454-8100 BUILDING PERMIT APPLICATION Receipt # _-1Q665 To be used for SF d4KJ. 8 Gar. Est. Volue 419000.00 pate 6/22/78 _ ly__ f Slte Address 1268 E. Balsam 7rai1 Erect ? Occupancy j 11 1 '?fildorness Run 6th Lot Block Sec/Sub. Alter ? ? Zoning parcel 10 84355 110 Ol Repoir ? Fire Zone 3 Enlarge ? Type of Const. v rc Nome ?bert F. Anderson Move ? # Stnries i 1356 Sargent Ave. Addreu Demolish ? Front ft. ? ? a? 690-5652 Ci Phone Grade ? Depth ft• lsen Homes, I(1C. ? APPrevals Feet Name z? 27 Sile ling AVe. Assessment 6 21 78 permit 118.00 8? Addra ? Water & Sew. Surchorge 20050 phme ~ CI police . Ploncheck G? ?W Name Fire SAC 500.00. _?? Address Eng. Woter Conn. ?•Q? <w C phone planner WoterMeter 60•00 Council 1 hereby ocknowledge that I have read ihis apPlicotion ond state that gldg. Off. the informotion is torrect and ogree ta comply with all applicable APC 9??r? Totol Stata of Minnesom Smtutes nnd City of En9on Ordirwnces. $ignature of Pertnittee A Buildirg Permit is issued to: -. Tilsen HomeS IIIC . on the express condition that oll work shall be done in rdanc with a plicable State of Minnesota Statutes and Cify of Eogan Ordinances. Building Officiul ??CP? ovi/ : q.Ks? } .. nnTE -6- -19-V BUILDING PERMIT APPLICATION Fnclude 2 sets of plans, 2 site plan w/elevations and 1 set o£ energy calculations. To be used for 41 ?? 4 C.'a-r ,z 9 D j Site AddresE; 8R.&?a...a. L'e*t 00 4/o0 ° Valuation a?I Lot Block Sec. SuD. Parcel Number 1,4 g,fl,3g5 110 0) Owner o,,. . 'WAJCTI"V Address 13.? ?Ir2 C'C.ltC . , Contractor Address (/'ra7 ?t [ic> ? _ Q.tt? %Y1n? SSN? Arch./Eng. AddreSs Telephone ??? ?-?' `?-Q-? Telephone Telephone OFFICE USE Erect Alter P.epair Enlarge Move nemolish Grade OFF2CE USE Date of A pproval & Initial nssessment Water/Sewer Police Fire Eng. Planner C7ouncil ` Rldg. D/ ff. _ A.P.C :-? Occupancy Z? Zoning K Fire Zone ? Type of Const. ft of Stories Front Depth _ FEES -- ? Permit / J?T ? Surcharge RD ? Plan Check SAG JY. pp . OD i9ater Conn. ?,ro , o0 Water Meter TOTAI, I L ae,AL p- to u e Lcrr 11 St-out. 1 , w 1 i. ? 1?ORT11 Y ti +} ? ? ?2 /?J _ __ • I ?? 0} 1 A I , y `'? u? , ? ?I ? ? I £s`-t \ ? i ??oP?e ry LINE ? ? M =i .pEFl,2 ARvOERTY LwE ? ? NovsE \ \? \ ?i uN?? ? I i ?) J c -, a" '?\ \ ? ? I LoT ? ?onfT".,r?ROi?F(LTY ,_LIIVE ? ? q5?j - fCOT V?LAN ities Di i? tal Quality Control The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. Qc1a L`0 ??2tC?, vflRFl ?0E14kd4t?; }?g ? 5 P?.+'87011?F ? £Jffao ??r? ,?::• ?..- '. ? --- - . _? Pk320R Qy YMAs EMU= Qbj? f7A&5. ct•-,Y.MZ2%9:7; vclao ; cr?a ' OQo , .:qo E20 o ? ffa,-?o ?'$'.?] a-..? . `. ?; •( `? ._l ?.?._._ ?-??Cb ??- tt co, ^ _' ? QB, o 05w4L` _ , _ ?. ? 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F I ,1p?r F •"Y??y. )M1" ? ??Y x Use BLUE or BLACK Ink F--------------- I For Office Use I I I City of Ea ER I Permit I I ~ Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: /yl I I 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ~ I Site Address: IZb~ 6JUnit J Name: I vi„~~ C I I ) 5`~-Ir` Phone: fry I '151 - 360YS Resident! ~ . _ j Owner Address / City / Zip: I I t lv~ r,. ilN~t/ ~t/ i Applicant is: Owner Contractor _ 4-,~ a- Type of Work Description of work: ii Construction Cost: l r Multi-Family Building: (Yes / No Company: ~1,~ tide 1.8h5~ ~brti Contact: t?PCK U, Contractor Address: 9371 City: State:, Zip: Phone: License $CZC7~3 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. Portionsof 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.gor)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. Exterior work authorized by a building permit issued in accordance with the Minnes Building Code must be completed within 180 days of permit issuance. X_ J), ~ -5, i~afllf py-c!,s, X_ Applicant's Printed Name t Applicant's Signature Page 1 of 3 C!ty of Eapn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink r For Office Use Permit #: Permit Fee: (22-1 Date Received: Staff: 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit #: Resident Owner Contractor'' Name: 1 Phone: 6c)--�,,s �dt1 Address / City / Zip: 1 X GPS\ Cc' Applicant is: Owner i< Contractor Description of work: Construction Cost: Multi -Family Building: (Yes / No ) Company: /'?_ Address: l 15 e Contact: City: State: Zip: Ss3�- Phone: `1s_ a -.,cry" 3Gi Email: wave �v�l (r License #: 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: Mechanical Contractor: Sewer & Water Contractor: submit are considered to u provide specific rea hey are trade Phone: Phone: Phone: CALL BEFORE YOU DIG. can Gopher State One CaII 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.orq 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. 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 Applicant's Printed Name x Applicant's Signature Page 1 of 3 Date: City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use Permit #: 7 Lf c0Y Permit Fee: Date Received: 7)1 I I Staff: 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address: l Ltag�Unit #: Name: esiden' Type ofaai Address / City / Zip: Applicant is: Owner ;X Contractor k Description of work: /2 a Phone: 6 (/ Y5 2- Construction Cost: Company: ®.sc7 ractor Address: 77 ! 31111a-/ /5,1) State: Zip: 5c0cP7 Phone: (Oi r 7224 / )��' �., License #: N Lead Certificate #: Multi -Family Building: (Yes IS0,,A / No Contact: ✓F CO r City: C-74�.vw'o1-- icat3 , q�mail: dshchrc c)-A/LM/ 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: Phone: Phone: Mechanical Contractor: Sewer & Water Contractor: NOTE: Plans and supporting documents that you submit are considered to be public information. Portionsof 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.gopherstateonecali.orq 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 Miresota,State Building Code must be co 2 leted within 180 days of permit issuance. ,kr IPS Applica t s Printed Name x Applicant's Signature Page 1 of 3 City of Eagan PERMIT 411' CityofEaan Permit Type: Mechanical Permit Number: EA134022 Date Issued: 11/17/2015 Permit Category: ePermit Site Address: 1268 Balsam Tr E Lot: 011 Block: 001 Addition: Wilderness Run 6th PID: 10-84355-01-110 Use: Description: Sub Type: Residential Work Type: Replace Description: Furnace Comments: Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary: ME - Permit Fee (Replacements) $59.00 0801.4088 Surcharge -Fixed $1.00 9001.2195 Total: $60.00 Contractor: Sedgwick Heating & Air Conditioning 1408 Northland Drive, Suite 310 Mendota Heights MN 55120 (952) 881-9000 - Applicant - Owner: Timothy C Callister 1268 Balsam Tr E Eagan MN 55123 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature SEDGWICK HEATING & AIR CONDITIONING CO. 1408 NORTHLAND DRIVE, SUITE 310 • MENDOTA HEIGHTS, MN 55120 • (952) 881-9000 ADDRESS 114" e' OCCUPANT SOLD BY MAKE SERIAL NO Awousk. �S THERMOSTA y -/ VALVE r` -k ^ &gib- LIMIT map U LIMIT SETTING FAN SETTING PILOT TYPE Y� V CITY HEATING TEST RECORD JOB NO'? OWNER 77 l'/C INSTALLED BY MODEL INPUT �9ezeill-o�kV 31013 b440190 O ` l NT SIZE t9 � � IGNITION MODEL -5 PILOT TIMING CA 5 4•_^d, 11 l PRESSURE : `' INPUT CFH -7 0 STACK TEMP. 1)7 di I --- FORM 235 (REV. 10/10) PERCENT CO2 PERCENT 02 PERCENT CO 1 r TYPE OF LINER LINER SIZE Pm c REc 11140, DFL 18 2015 FILTERS: SIZE V St.? NUMBER 19 `o WIRING TEST TAG LIGHTING INST. DATE TESTED t % �i d4 IL COMPANY TESTING Sed NAME OF TESTER FORM DISTRIBUTION: WHITE COPY - JOB FILE YELLOW COPY - CITY Cit of Eaaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 %16 r Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: 66 q.---7& Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 8/9/2011 site Address: 1268 Balsam Tr. E. Eagan, MN 55123 J Unit #: Name: Tim & Barb Callister Phone: 651-452-3848 Address / City / zip: 1268 Balsam Tr. E. Eagan, MN 55123 Applicant is: Owner ✓ Contractor Description of work: Retaining Wall Replacement Construction Cost: 19400.00 Company: Ecoscapes Multi -Family Building: (Yes / No ✓ ) Address: 25755 Zachary Ave. Contact: Craig Stark State: MN Zip: 55020 Phone: 612-965-0848 City: Elko New Market Email: craigstark@ecoscapes1.com License #: NA Lead Certificate #: If the project is exempt from lead certification, please explain why: 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: Mechanical Contractor: Phone: Phone: Sewer & Water Contractor: Phone: Fire Suppression Contractor: Phone: 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.gonherstateonecall.orq 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. 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. re-1/4 Applicant's Prinleki Name Applicant's Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE * 'SUB TYPES Foundation Fireplace _ Single Family _ Garage _ Multi _ Deck 01 of _ Piex _ Lower Level — Porch (3 -Season) — Exterior Alteration (Single Family) — Porch (4 -Season) Exterior Alteration (Multi) Porch (Screen/Gazebo/Pergola) Miscellaneous — Pool_ Accessory Building WORK TYPES _ New _ Interior Improvement Addition Move Building _ Alteration _ Fire Repair _ Replace _ Repair 4, Retaining Wall DESCRIPTION Valuation '2, 0 MO Plan Review yr - (25% 100% Census Code Ai 3i( #of Units # of Buildings Type of Construction Occupancy Code Edition Zoning Stories Square Feet Length Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Roof: Ice & Water Final Framing 30 Minutes 1 Hour Fireplace: _Rough In Air Test Final Insulation Sheathing Sheetrock Fire Walls Braced Walls Shower Pan _ Siding Reroof Windows _ Demolish Building* — Demolish Interior _ Demolish Foundation _ Egress Window _ Water Damage *Demolition of entire building - give PCA handout to applicant .74c- / i .1110 MCES System SAC Units City Water Booster Pump PRV Fire Suppression Required Meter Size: Final / C.O. Required Final / No C.O. Required HVAC _ Gas Service Test Gas Line Air Test Pool: Footings Air/Gas Tests _Final Drain Tile Siding: _Stucco Lath _Stone Lath Brick Windows $" Retaining Wall: 1 Footings Backfill Final Radon Control Fire Suppression: Rough In _Final Erosion Control Other: Reviewed By: (�`-�f( , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Pian Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 ❑❑❑❑❑❑❑❑❑ Add/Change 3070 I LOT SURVEY CHECKLIST FOR RETAINING WALL / BUILDING PERMIT APPLICATION Address: 248 5 ,/27� Zcc.1� / - Applicant Name: PY) f 8a440ead.�dV Wj]] ldht4.en1t' DATE OF SURVEY: 8/19% LATEST REVISION: **Permits required for Retaining Walls 4 feet high or greater. DOCUMENT STANDARDS • Registered Engineer signature and company • Building Permit Applicant • Address • Legal description • Lot lines/Bearings & dimensions • North arrow and scale • Street name • Show all easements of record and any City utilities within those easements • Setbacks of proposed structure and side yard setback of adjacent existing structures ELEVATIONS ❑ fd 0 • Property corners O 2'' ❑ • Top of curb at the driveway and property line extensions (only if wall is within 30 ft. of curb) ❑ ❑ • Elevations of any existing adjacent homes 0 0 • Adequate footing depth of structures due to adjacent utility trenches 2' 0 0 • Waterways (pond, stream, etc.) O 0 • At the foundation of the building and/or nearest structure PONDING AREA (if applicable) O yf 0 • Easement line ❑ ,B° ❑ • NWL ❑ 7 ❑ • HWL O -Fr 0 • Pond # designation O JZ' 0 • Emergency Overflow Elevation 0 ,e 0 • Pond/Wetland buffer delineation • Shoreland Zoning Overlay District 1, • Conservation Easements RETAINING WALL INFORMATION )2` 0 0 • Location of Retaining Wall on property ,rf 0 0 • Top & bottom elevation at each end of wall and any change in elevation in between X 0 0 • Type of material (i.e. modular block, boulder etc.) 0 0 • Directional drainage arrows with sI•pe/� .dient Reviewed By G:FORMS/Building Permit Application -Retaining Walls Rev. 5-4-09 Date //‘ � M is (. "' p ,.� _ •a-� - ' - car ��, O/ gOl 9nV aeaA/sql 6Z'0 :peo-j dl (aniap/jooa = oe L•p) sa.ioe £'0 :da 3 I1eal weSlee 89ZL eaegae8'8 know!i `aa;s!lle3 -1 For Office Use et/24z /500'7j' 0 Permit#: " 0 EAGAN /...kp,.. ..... . . '''' Permit Fee: a?,i•grO 0 .„.......,.., REcEIVI---;.--) Date Received: 6 -il- /8‘ 7 3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 (651)675-5675 I TOD:(651)454-8536 I FAX:(651)675-5694 JUN 11 2018 Staff: buildinginssections-thoit ofpagan.corn 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 6/11/18 Site Address: 1268 Balsam Trl E. Unit#: , i Tim & Barb Callister 1 Phone: 651-452-3848 1 1 Resident/ ' Address/City/Zip: 1268 Balsam Trl. E., Eagan, 55123 owner =, i 1 ; Applicant is- Owner Contractor I 1 Type of Work Demo existing lower deck and build new deck i Description of work: $20 i 173.00 Construction Cost: ' Multi-Family Building: (Yes 'No x ) ' Contac Company: Outdoor Spaces Jon Hassenfritz t: ; 5378193rdSt. W. . Farmington Contractor i .Address: City: .:: . , State: MN Zip: 55024 Phone: 952-457-0597 Email: jhass415@gmail.com I License4: BC689582 NAT-F168253-1 = Lead Certificate#: _,,,,,,,,_ If the project is exempt from lead certification, please explain why: 1 Built after 1978 1-- - 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: 1 , f Fire Suppression Contractor: Phone: NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information may be ,classiffedas non if euRrovide specific reasons that wouldyrnit the City to conclude that they are trade secrets. 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 wwwcitvofeeoen.Comisubscribe. 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. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Calf 48 hours before you intend to dig to receive locates of underground utilities. www,gonherstateonecalLorg I hereby acknowledge that this information is complete and accurate:that the work will be in contort nceie.lth 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 yk is no o. ''...-, 'thout a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and appro al f p x Jon Hassenfritz , • • x Applicant's Printed Name Appi i ant's -"gnature , . \ ~- � ^ /3 L�7 � -�� \ � �� /�� / �� (�^��p/� � � ` `~ �� - ^~ f8 DO NOT WRITE BELOW THIS LINE ' SUB TYPES _ Foundation ___ Fireplace � Porch(3-Season) Exterior Alteration(Single Family) __ Sin8|eFumUy Garage Porch(4-Season) E�mdorA�menmn(Muiti) ___ Multi °� �p�h 01nf P|=^ Lower�ove| Pool Po,x�(�c,een/�o�w�uPnmg��) --' Miscellaneous --- ___ __ __ 4comosoryBuUding WORK TYPES NI,New Interior Improvement _ Siding Demolish Building* Addition Move�ui|�inQ Reroof --- °o Demolish Interior ___ Alteration Fire Repair Windows Demolish ___ Replace Repair Egress Window --' Water Damage ___ Retaining Wall .00mo/monor*vu�uunu/"n— give PCA handout uvapplicant DESCRIPTION tt Valuation ` ^--0 Occupancy m MCES System Plan Review Code Edition ` 1,0 1 SAC Units (25% 100% �`) Zoning LCity Water ---- Census Code Stories Booster Pump -- #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction Width REQUIRED INSPECTIONS Footings(Nem Building) Meter Size: ~( Footings(Deck) __ Final/C.C>. Required ' Footings (Addition) --- �� Final/NoC.<�. Required Foundation Foundation BeforeBackfill ` __ HVAC Gas Service Test Gas Line Air Test Roof: Ice&Water Final Pool: Footings Air/Gas � Fina| � � Fnnming_ 8Oxxinv�s1 Mo"r Orm|n Ti|o -- --- Fireplmcm: Roogh |n Air Test Final Siding: Stucco Lath Stone Brick EF|S Insulation --' --- --' Windows --- Retaining Wall: Footings Backfill Final Sheetrock --- --- __ _ Radon Control Fire - - Fire Suppression: Rough Final Braced Walls --- --- Erosion Control Shower Pan Other: Reviewed By: ^~\le , Building Inspector RESIDENTIAL FEES Base Fee Surcharge - Plan Review \\J K8CES SACii611/4))k/jd)"..11 City SAC �Uti|ity Connection Charge S&VVPermit& Surcharge ) / 15 _, _. y � / 1 Treatment Plant Copies m 0 �� - �' � q ` �. °~^- TOTAL Page 2 of 3 P. • M6k" 6,,/..S4..41--7 7r-/ L._ Lac.AL. 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Yw� , ,_q11 /1� i'iiA !I!I ' " //41110!!!!! _ 1331 /4 ti \� ) /f ,/j1 For Office Use Z.1/°'�JI y I Permit#:,� � RE�EI�TED /-5.1/3 .9- EPermit Fee: / MAR 12 2019 Date Received: —4.1 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff: buildinoinspections(ilcitvofeaoan.com L 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 3/7/19 Site Address: 1268 Balsam Trl. E. Unit#: Name: Tim & Barb Callister Phone: 651-452-3848 R+ s cl+Ilnt! ` 1268 Balsam Trl. E. Filmer. Address/City/Zip: Applicant is: Owner X Contractor tz` / TO0 ofWork Description of work: Re-Deck & Re-Rail (upper deck) - Construction Cost: 10,594.36 Multi-Family Building:(Yes /No X ) Company: Outdoor Spaces Design and Build Co. Contact: Jon Hassenfritz contractor Address: 19205 Harappa Ave City: Lakeville State: MN Zip: 55044 Phone: 952-457-0597 Email: jhass415@gmail.com License#: BC689582 Lead Certificate#: NAT-F168253-1 If the project is exempt from lead certification, please explain why: 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: • Fire Suppression Contractor: Phone: NOTE:Plans and supporting documents that you submit are considered ifo be public infortnation. Portions of the"itf ation maybe classified as nonpublic.if you provide specific reasons that would permit the City to conclude that they are trade secrets. 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.citvofeauan.com/subscribe. 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. 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.gopherstateonecall.orq 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 oflans. Jon Hassenfritz Jon l-�assenfritz pae'zo;9o3o°o839 -06 Applicant's Printed Name Applicant's Signature , / 6 EA-Ls/i-44 1 l 12 . / (7 - -- 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 2$ Repair _ Egress Window Water Damage Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION pie4li. ^ Valuation ' Occupancy 7.1/CdMCES System Plan Review / Code Edition 20/5-- SAC Units `. (25%_100% ✓ ) Zoning 12.`1 City Water Census Code If 314 Stories -- Booster Pump -- #of Units / Square Feet PRV #of Buildings i Length Fire Suppression Required Type of Construction Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) Final/C.O. Required Footings(Addition) ,t Final/No C.O. Required Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test — Roof:_Ice&Water _Final Pool:_Footings _Air/Gas Tests _Final Framing 30 Minutes 1 Hour Drain Tile Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick EFIS Insulation Windows Sheathing Retaining Wall:_Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls - ion Control — Shower Pan Other: i Reviewed By: �7 , Building Inspector I RESIDENTIAL FEES F.'p' Os /5--745r4'33,,oBase Fee 7 3 � Surcharge Plan Review 1/ 7 MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant Copies TOTAL Page 2 of 3