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647 Atlantic Hill Dr
CITY OF EAGAN Remarks Addition Lakeside Estates Loc 4 Rik 1 Parcel 10 44300 040 01 Owner ?- 5treet _ 6117 At13I1t,1C H111S Dr. State E2.g,MN_?j12 ? ? l +`0,Cf?L!t /L. di'i(?.i,'f • Improvement Date Amount Annual Years Vjf Payment Receipt Date STREETSURF. jip . 1981 1690.16 84.51 20 /.t(oq, 4,6 A O/4,61a 2 STREET RESTOR, s- 19$1 1409.71 70.49 20 057, 3/ p/'60 ya ?'ay- ?S GRADING 5AN SEW TRUNK ? 1 280.00 1. ? 0 0?11 A o« ? y? }?-c2,7 - As SEWER LATERAL 258.07 0-5 o?b o'/.,A -a94S WATERMAIN WATER LATERAL WATER AREA i9H1 280.00 14.00 ZO ?4fO, 0O A G/?vG `Ioz g- e.?q- ?-7 STORMSEWTRK 03 13.80 15 p/(orj4o2 * STORM 5EW LAT 1981 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. „ BUILDING PER. sAC 525.00 PAR K , • CITY OF EAGAN 2 "? 2 3830 Piiot Knob Road, P.O. Box 21•199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Recelat # - T. V urd iw? .•+ ?/ L%: •I : - Faf Vnluw 4' 4 1J y'. Qate _ S ? . ? 4 ,.y 1 ?, Erect L:!- Occupancv . Sits Addrex Bi L k ' S lS b Remodel ? Zoning - ot u . oc ec Repair 0 Type of Const. Parcel No. Enlarge ? No. Stories ;_'•., `?%;? ?; Move ? Length W Name Demolish ? Depth ?.; ? Addrest T : . , Grade ? Sq. Ft. CitY Phone install ? Name Addre 6- City _ Assessment Phane Woter 3 Sew. Police Fin Enp. Phone Ptanner Counci{ Plan Review. SAC Woter Conn. I hercby acknowledps thot 1 haw rcad this applicotion ond stote thot gld9, pff, `•' 1?'• 3:> tht informotion is correct and ogree to comply with oll opplicoble APC Total Stah of Minnesota Stotutes and City of Ea9on Ordinonces. Var. Date Sipnoturo of Permittes _ A Buildinp Pen»if Is issusd to: on the expross Conditlon thot o!I wo?k sholl be done in xcordonce with oll opplioable 5tote of Mlnr+esoto Stotutes ar+d City of Eapan Ordinances. 8uildi?q Offido) , Psrmit No. Permit Holdsr Dm Tsle hone ik ?umb;n9 H.VA.C. C? V,? Etictric ` s S? . 8o1tMer Impsction Date' Insp. pther Foot,ngs r Foundation s 9?_ Framinq f) W?? Rooilnq Rouyh Pibp. Rouph HVA ? Inwlation a (? Final Plbq. ?- W Final VAC ?? D?.+v yd /?d"1 ? Final Grt/Ooc. - ( , Waftr D"cribe Loestion: YYell Sewsr Pr. Oisp. CITY OF EAGAN 3a30 Pildt Knob Road P. O. Box 21199 Eagan, MN 55121 _Z i Zoning: Owner: ` e at t, << . Address: . Stte /tddrcss: 647 Plumber. `:3ke-+7 WATER SERVICE PERMlT PERMIT NO.: 6, > ;'% nc r? a r? _ _ - •, ? - G _j : L? ;'t Lakeside Est. AAeter No.: ':? •L!o Y h ! G, 22 Connection Charge: -`-, ' • v v Pu Size: ?s" R&-4- AccounY Deposit: -i -`' 00 Reader No.: C6=? /h 5 D? 02 / Permit Fee: ? n, 4 1agne to omplp wlth tM Ciry of Eagan $urcharge: 5 Oedi Misc. Charges: 132.00pd S/C TotaL• 63• n0Pd meter By Date Paid: Date of Insp.: - insp.: CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road P. O. Box21199 PERMIT NO.: Eagan, MN 55121 DATE: Za+ino: No. of Un(rs: 1 Owner, i entvrc> r;ui leers Address: Site ?? 647 Atlantic Hills ''?r. L4 ",2 I.k:.?.eside Est. Plumber: T ?'?r??i11c eter No.: AA Connection Charfle: 500. OOpd Size: llccoLmt Deposit: 15.00 Reoder No.: Permit Fee: 1 O.'? C? 1.9ne ro oown* wMh !iw Cihr of bgen Surcharge: •??- OrJiMeas. Misc. CFierpes: 132. 7pd S C Torol: meter By Date Poid: Dote of Irap.: Insp.: CITY OF EAGAN 3830 Pilot.Knob Road - P. O. Box 21199 Eagan, MN 55121 Zaninp: Ownar: Feature ?'-,; I'. i, r; 11dd?ess: Sito Addrom 647 Atlantic Hills Dr. L4 E1 Lakeside EsC. Plumber. '+L?„ i l *'?LI°{?• .r 7 .? 7 . 1Gw« te ...oy wilh eiw Gy oF EN.s Connealon Cho?pe: 42 5. 0 0 pd Ordinaoas. Acoount Daposit: Pennk FM: Surctwrps: er Mi.c. Cl,oroes: Date of Irop.: SEWER SERVICE PERMIT PERMIT NO.: 7412 D/1TE: rr . ? No. of Units: ? Totol: - Dote Pcid: CASH RECEIPT CITY OF EAGAN P. 0. BOX 21-199 EAGAN, MINNESOTA 55121 DATE '? ? /-• f 9 - AMOUNT I$ - I, C' -& DOLLARS I oa ? CASH [] CHECK FUNO COOE AMOUNT ll, --, , J l ? Thank You 52202 BY White-Payers Copy Yellow-Postinp Copy Pink-File Copy Raceipt ? I. Commercial O PLUMBING PERMIT CITY OF EAGAN Fill in numbered spaces S/C Type or Print legib/y Tot. 1. Date!? 2. Installation Cost -- ? ? 3. Job Address _ Lot 1-! Blk. i' Tract 4. Owner 5. Contractor /1 e ;.l Phone - .? 6. Address i 7. City V State •'f/ ?^ ,' Zip 8. Building Type: Residential _E] 9. Work Description: New lp 10. Describe 11. Add ? Alter ? Permit No. Fee Institutional O Aepair ? No. Fixtures Water Closet No. Fixtures Cess ool/Drainfield ? Bath tubs p tic Tank Se ? _ Lavatory p Softner ?-- Shower Well ? Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. ? Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes gpverning this type of work. Signed. -"t r` for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numhered and approved. Approved CITY OF EAGAN 454-8100 Recp- ei? MECHANICAL PERMIT Permit No. ? GV .? CITY OF EAGAN Fee Fi!l in numbered spaces S/C Type or Print /egibly Tot 1. Date 2. Installation Cost I 1 ItL.S -"i'2 i ? L/??C C 3. Jo6 Address ?TLf?M1, Lot?Blk. Tract ?. 4. Owner FF147 URF 5. ContractorURD4) trx! Phone-/--'y " L 6. Address % '??0 (.?(?E 1TWQpp T?? 7. CityE4Jr State !h AJ Zip -' -? yy8. Building Type: Residential rJ Commercial 13 institutional O 9. Work Description: New ET Add O Alter ? Repair ? 10. Describe Fuel TypetN?TT ??5 11. No. E.quiQment BTU - M. Ea. Forced Air No. Evuiament CFM Air Handling: Mfg. Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other ? Air Cond. Mfg. ? Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. ,. Signed : 4-1 /1 iC ?.7r> >>+- .J for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 BUILDING PERMIT CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121 PHONE: 454-8100 SF DWG/GAR i 86,000 SiteAddrm 647 ATLANTIC HILLS DR Lot 4 eIock 1 S&c/sue. LAKESIDE EST Peroel No. Name FEATURE BLDRS Addm3 15513 LOGARTO LN citv BIIRNSVILLEpho,e 435-8443 .?ra.•,u ? Neme Addreu ? Citv Phone Name Phone N_ 10222 Receipt # '<1_/ -W Ereet L3 Occupency xs RemOdel ? Zoning Rl Repair ? Type of Const. V Enlarge ? No. Storief Move ? Langth 70 OemolisA ? Depth 33 Grede ? Sq. Ft. Install ? Apqarah Fen Asseszment _ Woter b Sew. Polite _ Firo Enp. Plonner _ Councu _ Pertnit +' ''7i • v ? Su,d,,,ga 43.00 Plan Review 195.50 gqC 525.00 WaterConn. 50 0 Water Metar _63..9 0 Rooe un+r 290 _ np I hereby ackrowladga tFwt I haw rood this upPlication and stote that Bldg. Off. 5 14 8 S I T-. P. $2,129.5 0 tha inlormution is Wrrec d agree b comply with oll applicable A? Totel Smta of Minnewta St tas d Cil?of Eagan rdironces. a • n Var. Dete SlqnMUrc of Pem+iMn ?"'W'+.e•r?-+ A Buildinq Pannit ia lssued to: FEATURE BLDRS on fhe azpretf conditlon thot dl work shcll be dana in otmrdanee with all opplimbla Stq" Aoinneaota Srotutes and City o4 Eayan Ordinancec Bufld{np Officlal This request witl f ?a???? v A1 1:4ouJ7-ste ??LL Ia 5 im-4" 49_5a Nep te ?- /? _ C, ? fire No. IMugh-in Inspcc?ion ReQUiretl7 Wfll Notity Insoec- ?Beady Nuw? ? ?Yes ?No lo r When Peatly ?OLiwcensed ElecVical Con[mclor 1 herebv requesi inspection of above ner elae[rical work installad e[: Str¢et Address, Box or Routa No. ? ? • C?t / K ? ? ? ? ?//J ?? tron o. Townshi0 Name or No. flange No. County Occupanc(PBINT) r-v?P G' Pho e No. 3 S- ? t/ ?13 Pown,r SuDPlier Atltlress 4 O 7? Elec[/nral ConVar.tor (Company Namel ? 5' A/ t ?Y S t 7 , Contractor' Lic??n e No. D?/??9 ??- 3 . , v V ? 7 ? ?t. Yailing Address (ConVactor or Ow er Makind Instaila[ion) AuNOri ture (Conhaclor/ wner Mak ng In, tallxtionl Phone Number 7 _ S? v WNNESOTA STATE BOAND OF ELECTRICITY ? THIS INSVECTION NEQUEST WIIL NOT GriWS-Midwsy BId9. -?am N491 BE ACCEPTED BY THE STATE 60AND 7821 UnivarsitV Ave., St. Peul. MN 55104 UNLESS PROPER INSPECTION FEE IS PMny (g1Z1Zy72111 ENCLOSEO. (?? REQUEST FOR ELECTRICAL INSPECTION Ee-ooooi-w ! J D ' Sea instruetions ior completifg this form on back oT Vellow coOV. 4 265 2 ;. "X" Be/ow Work t'overed by This Request 712+j'1 6? ftrA !tltl ReO. Typg of BuilEing AOPlianCea NirW E4uiVment Wiretl Home Range Temporary Service Duplex Water Heater Lightiny Fixtures Apt Building Uryer Electric Heatin Commercial Bldy. Furnace Silo Unloader Industriah Bldg. Air Conditioner 8ulk Milk Tank -Earm [her uec' ly Other lSnocifyl t r Sueci y Other Othur Compute lnspection Fee 8elow • Fee ServicaEntranceSize # Fee Feaders/Suhfeeders k Fee Circuits / 0 to 200 qm s- 0 to 30 qm 0 in 30 Am s A6ove 200 qmps 31 ro 100 Amps / 5- 31 to 100 qm s Swimming Pool Above 100-Am - Above 100_nm - Transtormers Irtigation Boorrtis O Partfal-'Other_Eee - Signs Special Inspection / pma,? SSO TOTAL FEE - - ? - ( U9'J ? F;m' ' ?n certity [het the abov _ l if.? Y{? ? nsoection nas been ?, "°`° -) YS mt 1ro ? 1- 0 6/I ?( I d S l?_o 0 7 ibuah-in?Ir„yec?ion t// ??? Fepu retl Firu Na. ?ReaOy N. Hill Natify Inspec- ^ . ?s ?Na a [ WMn ReaAY Licensed ElecViral Coniractor 1 herebr reY?st impection M above OwueJ ueJ eleetri.l work irmtnlled al' Str i d ress, Box w Ibu(e No. y'?1?7C #/c? City / cUm Townshio Name or No. ng¢ No. Cwn1y o??uvu.t(PR,NT)-v?-? Ph.? Supplia AdAress EI v:cal Coonra'ci?p lC?onpianrv Namely-?p v J ?? IL1 G/?/??. . ConVa?cr"s Maili Addr¢ss ICoM?acto? 'Ormer IL?kinptailationl l ? ?? 1 3 ' , c2 i rsed Sipre Nre 1 [ra r Makinp InsWllation) N?m?Uer - ----------------- - - 'YINqFSOTp y7p7E gpqpp OF EIEC'INICfT11 THIS INSPECTION BEQUFST N LL NOT Griqps-tliAray BMp. - Rpvn N-197 BE ACCEPiED BY 7HE STAIE BOARD 7821 Universiq Ava.. M. Paul. YN 515104 UNlESS PROPEp IN5IECTION FEE IS Phons 1612! 297-2117 ENCLOSEO. ? REQUEST WR ELECTRICAL IPISPECTION EB'00001-04 , See i.sbiciions tor rortvleting.chis fam m baek ot yellow copY. (? ? 5 "X" Be/ow Work Covesed by This Request Appliances Witae I 1 I 1 IndmVfal Blda. 1 I Air Cwditioner 1 1 Butk Milk Tank I • F¢e ServiceEMa?eSize # Fee FewdersASu4feeders # Fee Circuita 0 tu 200 AnT, 0 to 30 Arnt? 0 to 30 Me Above 200 lamws 31 to 100 Amq?s n 31 to lOQ q Swimmirg Pool A6ove 100_ Above 700_Art4is TIdflSiOfRtCrS IR193lion BOOIuE P'drt12l,`OthE( FEC SIg15 $steGldl II15pCCCtlqt $ )A?? ? TOTRI/FEE Rouph-in ' Da4+ 1_ Ne EI ?ral r Final ? te ` ? I?spector, herebY rtify thet [he a0ove inr.pectim has seen -((7 gnmUe. 1tm cBquesl .aid 1B eKn11B 40n Clty of EapIl 3830 Pilot Knob Road Eagan MN 55122 Phone:(651) 675-5675 Fax: (651) 675-5694 -- ----------- I FAt?fficel?se ? ? I ? Pertnd #: /-? V I I Permit Fee: Z =??O _?C 0 i I ? Date Received: ? Staff: 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: .. . '(% Site Address: ?7y ?J?ffia[?bC, tTI I I 1?)Y Tenant:' ?G?l? f'?T1A ?vinsN Suite#: RESIDENT/OWNER Name:?4fu, ! '}"54_4 :?A_ Y7'1,SKy Phone: Address ! City ! Zip: &1'7 Applicant is: V*"? Owner _ Contractor TYPE OF WORK Description of work: !`LL+ OYI 0. 61? cleck Construction Cost: Multi-Family Building: (Yes No V) CONTRACTOR Name: License #: Address: 5e 'f Ciry: State: Zip: Phone: Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category t Worksheet • New Energy Code Worksheet Category Submitted Submitted submission type) • Energy Envelope Calculations Su6mitted In the last 12 months, has the City of Eagan issued a pertnit 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. PoRions of the information may be classified as non-public if you provide specific reasons ihat.would permit the Cityto , > conclude thaf the are trade secrets:" ,- I hereby acknowledge that this infortnation 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. ? X4 52?ms4 Abo App icanYs Printed Name n} A canYs Signa ure Page 1 of 3 1 IJ AUG 0 $ 2008 , SUB TYPES ? Foundation ? Single Family ? 01 of _ Plex ? 02-Plex ? 03-Plex ? 04-Plex WORK TYPES ? New 71- Addition ? Alteration ? Repiacement DO NOT WRITE BELOW THIS LINE ? 05-plex ? 16-plex ? 06-plex ? Fireplace ? 07-plex ? Garage ? 08-plex X Deck ? 10-plex ? Lower Level ? 12-plex ? Accessory Building ? Porch(3-season) ? Porch (4-season) ? Porch (screen/gazebo/pergola) ? Stortn Damage ? Miscellaneous ? Pool ? Ext. Alt - Multi ? Ext. AIL - SF ? Muiti Misc. ? Interior Improvement ? Siding ? Demolish Building* ? Move Building ? Reroof ? Demolish Interior ? Fire Repair ? Windows ? Demolish Foundation ? Egress Window ? Water Damage ` Demolition (entire building) - give PCA handout to applicant DESCRIPTION: Valuation f700 Plan Review (25%_ 100% Census Code # of Units # of Buildings Type of Const vrg- Occupancy MCESSystem Code Edition .{? I SAC Units Zoning City Water Staries Booster Pump Square Feet PRV Length Fire Sprinklers Width REQUIRED INSPECTIONS Footings (new bldg) ? Footings (deck) Footings (addition) Foundation Drain Tile Roof: Ice & Water Final ? Freming Fireplace:_R.I. _AirTest _Final Insulation Sheetrock Meter Size: FinallC.O. ? Final/No C.O. HVAC Other: Pool: _Footings _AirlGas Tests _Final _ Siding: _Stucco Lath _Stone Lath _Brick Windows ReWining Wall Reviewed By: Building Inspector RESIDENTIAL FEES: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Pertnit 8 Surcharge Treatment Plant Copies Total ? f>r Page 2 of 3 ^LAND INC. SURVEYiNG , SERVICES Eagon, Minnesoto 55121 S I T E P L A N FOR FEATURE HOMES VU -° S 80° - 07E ?--------- i 5i i i i ? r? • \? o ? ----T 1 'S I I i i i e a" Lr,° -? 2.0 0 0 24 v o i P N°`' N ' o ? ?o jO so ? s ? ? 1 I I ' I ?----------- ° N 80° - 03' , 27"W ° co ? N LC1 N Scale 1" = 30 LEGAL DESCRIPTION: LOT 4, BLOCK 1 LAKESIDE ESTATES DAKOTA COUIJTY according to the recorded plat thereof. Garage fioor shali be set 18" above the top of the curb. West side of house shall be set back 10' from property line. 100.00 4, as,aH ?w •pO ao ?b" C?:TLAf1IIC Hii I ?RLII?? - Note: Existing elevations shown. I hereby certify thot this survey, plan or report wus prepared by me or under my direct supervision ond ihat I am o duly Registered Lond Surveyor under the Lows of ihe State of Minnesola. Front line of house shall be set back 40' from property line. 8 rod le J. S wenson Mn. Req No. 15235 Dote' S?Y?BS` ? . ?5// ? 2004 RESIDEMTIAL PLUMBING PERMlT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. 15. S d Date 0 / _?3 1 e -/ ' ?.,,?.A ?//????? ( ? Site Street Address C?/?9?7?.1°i fL7L? ,l`Lo-, Unit # Property Owner L/ Telephone # 45/ )4Fk_-4419P' ContractorW5,0 a?ja.-+? Telephone# 4?Si )045--/R V Z) ? Address c36?6 [)C4m.Q. waQ City ? StateYYl6. Zip_K The Applicant is: _ Owner _ Contractor _Other Alterations to existing dweliing $ 50.00 _Add fixtures to rooms, exctuding water softener and water heater _Septic System Abandonment _Water Turnaround (add $121.00 if a 518" meter is required) Other: Water Softener Water Heater $ 15.00 ? replacement _ additionai Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00 State Surcharge ? `? ?? ? ? ? $ .50 Total ? JUN `L 9 'Z?04 $ 16.50 ? I hereby apply for a Re L a? Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accordance with the approved plan in the event a plan is required to be reviewed and approved. WI,412?4 V?ue,tL4 V2A? A_Z? ApplicanYs Printed Name ApplicanYs Si nature ************?????******************???* CITY OF EAGAN CASHIER: JS TERMINAL NO: 785 DATE: 08/17/00 TIME: 07:15:19 ID: NAME: LOREN WOLFE COMPANY 3210 9001 647 ALNTIC HL D 181.25 2155 9001 647 ALNTIC HL ? 5.00 Total Receipt Amount: 186.25 CR136021 USER ID: JAN J1 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EACAN ? lQ I'a G) ? 3830 PILOT KNOB RD • 55122 851-681-4875 New ConahucNon Reaulremenh > 3 reyistered slte wrveya showing aq. fl. ol lot, sq. B. of house and gO rooled areas (20% maximum lot covemae allowedf > 2 coples ot plana (show baam d wlntlow slzes; poured Ind. dealgn; etc.) Y 1 set of energy calculaNOns > 3 coples ol hee Preaervatlon Plan il lot plalfed alter 7/1/93 DATE: 6 '" 'b UU DESCRIPTION OF WORK: O 2 copies of plan 1 sef W energy calcWaHoru for healed pddiflons 1 site wney tor e)teAOr addiflona # decks COST: STREETADDRESS: L GA,( /'YllU_?_it?) I LOT: ? BLOCK: ` SUBD./P.I.D, i:. ??.0, ESTAAA- ? 0(0 a5 PROPERTY Lost OWNER Sheet Address: City Company: COMRACTOR Sheet Address: Cly SqMko 7 ARCHITECT/ ENGINEER Compuny: Telephone #: ( ) Sfreef Address: CHy #: A a (area code) / ucense r A??Fxa. ? Zip: s5370 Name: Regishaflon #: _ Sfate: Lp: Sewedwater licensed plumber (H installinm sewerlwaterl: Phone #: 1 hereby acknowledye ihat I have read this applicoNon, afafe Mwt 1he infomwtbn is cortect, and agree to comply wHh aA apPAcable Stafe of Minnesota Stalutea and CNy of Eagan Ordinances. Signafure of Applicanh OPFICE USE ONLY Certificates of Survey Recefved _ Yes _ No Tree Preservation Plan Received _ Yes - No - Not Required i ?. i 2/84 CITY OF EAGAN Illil APPLICATZON FOR P?'R:IIT SEWER AND/OR WATER CONNECTIODT (PLEASE PRIHi) 1) PROP= ADDRE55: a/t&-,,t? 2fjl ,/.,01 r.Fr21,I, DE.,?IFP_TCV: "-A ! -/64t,5-?a eB Y-? . (Ir?tBlock/Sutaivisicn or Ta? r 'cei? I.D. NL.?.:)er) ' I'c' =-iIS_'=:G STOL'C^.?=, DA'IE 0_° ORIGu'AI, u,ITuP,L:G =?,=l ISS?: \C.: ` •'_=. ?.,' -?? , ::^`7rr,/PF0PCSZD C'S: ? R-1 Sz?;GL:: F,?-vSLY ? R-2 CUPL`% (T,•:0 L^IITS) ? R-3 M,7%i7C(Teg (?YGW + C`]I^:S) ( L1II^_'S) ? cZ-4 T,^r1r;^,c^;rICC_.iti..,lrrlr?i ( L:%-I=J) ? COti?1E.;CL?L/RE,'^.AII?Or 'IC:: Cl ?,'C;JST?,L'?L Q L1;STI'I'[.'PIO:lAI,/GaVEPH-vE:?'T 2) APPI,=C ?;T (PiEas? PRiv) NAhE: ? (?°-.'?.?n?_e. GG?.i.?.t 4' c?? O?.,a_ ACDRESS: - CTTY, S:t,T°, ZIP: ? 737 ? PFoNE: y-3 ?- Ff S j) PLI-7,ip,En (PLEASE PflINT) i FOR CITY USE 04LY NIU"IE ] p? 44 V ..1.i" ADDRESS: ; PLJMBEAS LI- CEYSE: CITY, STATE, ZIP: h?,? PLl1MeER LFCENSE ,V Record i4 nitia v) OCC?,JPAIVT/C?NTIFSL p,? lr?ta5t NxiNI) ?--? NAi"IE: /?° ?ar.¢C ADDRESS: CI'I"L, S=, ZSP: PIiO*IE: 5} INpYCA„E ;,n;ICH PEf?NLiT IS BEING RFQUESTM: ? CONNF.C_TIQN 'IC] CZTY 5a7ER ? CONNEC'TIGN 'Ib CITY WATER ? di(ER (PLLr'LSE DF_SCRIBE) bl L^YDIG, ? C2:c: ___. --- - __- ----- - - - -- - . PI,°..??SE_ EAID APPROVID_ PIIZ'?LLT_FOR PICi;-G'r BY- ONE OE. AEC'?'E ? PL&'+SE = APP?tpVED P=LIT TrJ 1. 2. 3, 4 AACTJE i--? (Circle one) 7) SZC:;!,Tu-RE: `4 ?7?.?e+- " DATF.': ?! ?! EIiIMJY?e.i? ?? Q!l:a?aa! ? nf?.'s?a#M ?/ i s issi:? a! Y?lfla?IM? ? i 1s ?iiiQ? . F 0 R C I T Y U S E O N:. Y PE4NtIT " ?SSUED crE5: $ $ $ S $ Uv $ l.vo $ $ - $ ? $ $ S $ . s f3a. c, C? $ PE.^Z?'I= (I_`ICLliDE SU°CH?RGE) WATER PER.^4IT (INCL'uDE SliECHARGr.) WATER METER/COPPEBHDRN/OUTSID° REi,DER WATER TAP (INCLL'DE CORPORATIO:V STOP) SE'.vER TAP ACCOUNT D.F,PnSIT - WATER wac SAC TRUVK WATER ASSESS:?E.:T TRliNK Sc:'7ER ASS:.SS:•i°:iT Lt1:ERAL BENEFIT/TRU:IK SEi-R LATERrIL BENEFIT/TRU..K WATER WATER TREATMENT PLAATT SIIRCHARGE OTHER: TOT? L A1110U:vT °AID/REC°I2T ,'lr ?_U DOES i1T:LITY CON:IECTION REQUZRE EXCaVATION IN PUBLIC RIGHT OF WAY? ? YES ZF YES, THEN A "PERMIT FOR '40RK WITHIN ?- PUBLIC ROADWAY" MUST BE ISSUED BY THE ?O ENGINEERING DIVISION. LIST AS rl CONDI- TION. SUEJ$CT TO THE FOLLO;JING CONDITIONS: APPROVED BY: Avl_ ! TITLE: DATr: ? ; / V C:,,D,? ` 1985 BUILDING PERHIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS HUST BE LICENSED WITH THE CITY OF EAGAN INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET OF EMERGY CALCULATIONS To Be Used For: Valuation: ?-p?- Date: s/ $ Site Address: (0ct7_ ?s /Q--., OFFI CE USE ONLY Lot: Bloc k ? Sect/Sub ? Ereet x Occupancy Q-3 Remodel Zoning ?-1 Parcel 11 Repair Type of Const 'S[ ? Enlarge # of Stories Owner ? ?A A=?L, Move _ Length Demolish Depth 3 3 \ Address Grade Sq Ft City/Zip Code ,?,y?,tQQfl Phone Contractor Address City/Zip Code ? Phone ?3S-$tFy,3 Arch./Engr. Address City/Zip Code APPROVALS Assessments Permit eo ? Water/Sewer Surcharge ?.? Police Plan Review 14 S.Sb Fire SAC 525,°? Engr Water Conn I Planner Water Meter Co3 Council Road Unit 2 •° Bldg Off S Parks APC Treatment Pl Variance TOTAL Phone N Z4x 33 = 19zx 5-4- = 42-?cog `L-7 x 2c, - 1Oz x s¢ - 'Y7 ? oe Z- K 20 = 42so x i i ? S Z?C) 85 6(SG TRI-LAND INC. =SURVEYING SERVICES Eagan, Minnesota 55121 S I T E P L A N FOR FEATl1RE HOMES 42 100.00 y aL ° S 80° - 07E ° qy. r- ----- ----- --? ? ?S 5 i i i ? I ? i ? ? IM r o ? A0? Zb 4?' _ `Ln ? a •\ 0 \ary I? zl o vk Itp ? 10 I S I + so ? ? I ? ----- ? ----- I - ° N 80° - 03' 27"0 Qq ? N Scale t" = 30 LEGAL DESCRIPTION: LOT 4, BLOCK 1 LAKESIDE ESTA7ES DAKOTA COUIJTY according to the ? recorded plat thereof. Garage floor shall be set 18" above the top of the curb. West side of house shall be set back 10' from property line. 100.00 4f?a4 oofo? pp .b? _ TLAPIIIC Hil I S 4RLYL - Note: Existing elevations shown. I hereby certify ihat Ihis survey, plan or report wos prepared by me or under my direct supervision ond fhat I am o duly Registered Lond Surveyor under the Lows ot the Stoie of Minnesota. Front line of house shall be set back 40' from property line. 910,14 z B rod le S wenson Mn. Rep No. 15235 Date: S? /BS` . fXTERIOR ENV£LOPE AYERAGE °U".COMPUTATION OaINEA J?.e•,.???,?, ?,. - S I Tf AODRE SS 6V 7- at&,,4c, CONTR.4CTOR FA-;F TURC liLiG,Qr DATE PHONE431-84 42 OetermSne working square footage of eath. 1. Total exposed wa11 area .,.,,. L2j_?.9 Z sq. ft. x .1 ? •2? 2. Total roof/ce;lin9 area .,... f34?oDY, sq. ft, x .0?•s"• ? Total exposed rrail area above floor •_Vg_-7 J? a. Total Hall window area ........................•.. jQ 0,49 b. Total door area ............................,.... a.q/ c. Total sliding ylass door area ................... gianA ? d. Total fireplace watl area........................ e, Total wall framing area (average 10%),,.,,.....,. f. Total net wa11 area aDove floor ................. g. Total rim joist area ............................ / d gvli- Total exposed foundation area = .SS./,R _ h. Total foundation uindow area...... , .............. -? Lf i. Toal net foundatiun area above gra<ie ,,,,,,,,,,., >A.9 z Determine "U" value of each s:°c11 segment, a, t4o•??? X "V -?? D, 37 f?/ T x "u" .17 _ q-9i c._ q 0•04 X "U" ? 53? • 44-02 e. z tium ? '- e. 2z. 3-g 9 g „u" , 0 43 = 9-6Z r. JCz3.oZ x °v° •o4"i • C244 4. ?4 A,-OD X "U° , DQ- • , r-OI Z n. S'.zz ^u° , 5 i? • - Z- 60 t, 3 X "U" .-47 . 3'7.5Z 3 . ................ .,........,..... Total • If item 13 1s the sam2 as, or less than item I1, you have aet the fntent of SBC 6006(t)2. • I ? t r % ?otal exposed roof/ceiling area = ! 3 4$ De j. Total skyliqht area ..................... . . k. Totat roof/ceiling traming area (avera9e 10?)... t. Total net insulate6 roof/ceiting area.......... . .Oi,_ Determine "U" value for each roof/ceillnq segment. j X livii . k. X "U" • • ) - a 4R.vl) z "u" _bzc • .33id 4 ..............1,# No.-0.4.......... Tota1 ' ? If total of 44 is the same as, or less than 02, you have met the intent of SBC 6006(c)1. Alternate BuilGin9 Envelope Design To utilize the total envelope system method, the values established by the sum of items 13 and 04 shall not be greater than the sum of item6 #1 ind 02. I . 24&.4 2. _33,70 = ZW- 9g 3. 2.4 z.89 + a. 3t 3-7 a =Z7,f; 5 9 WEPJA CO. PLAN SERVICE ED ANDERSON ARCMITlCTUR,IL OESIONING ANO PU.NNING 5397 Upper 147th Street Apple Valley, Minnesota ResitlenCe: OTtite: 423-5658 4233775 RECORD ()F COMPLAINT Date 7- 1" 9 ( Complaint taken by Type of building S Name L »Y-.) A- Address 6,q`7P ? TLAH'TlC- W /LC..S b(2 I (,./ G-- Legal description Phone number Z156' Complaint -? ? T?> AJ6%--- 'M'? ? l Action taken r??? T K?? 4 c_ ,Z I Comments Signature -J 0 G- , BUILDING COMPLAINT GUIDELWES • When a complaint is received, get the address, name, phone number, and a general idea of what the problem is. . ? • Always have two City employees present to (1) verify the conversa6ons, (2) offer additional opinionsi and (3) lend credibility., . '• ' • Get "both sides" of the story if there is a conflict. • Ask other inspectors and City employees if they are. famititkr. with the address or the problem. • Contact other agencies or departmenis (ie. Dakota County Human Services, 431-2424; police department; fire department), if necessary. • Provide hand-out materials if they are available. • Maintain a record of inspections and conversations on a City complaint form. 4111° City of Ea�au 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit#: j i()353 Permit Fee: (i0 DJ Date Received: '317 1113 Staff: INFLOW & INFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water Date: / `i 3 Site Address: f 7 Tenant: 7/ / , Suite #: Name: `,tom- .1 tJe1so,r,�� Phone: 6 3-7 ` 6 & - Address / City / Zip: 7 71 /( fic 77s1 ✓Y` �� %c``, `i X1.1 Name: License #: Address: City: State: Zip: Phone: Contact: Email: PLUMBING (Within the building envelope) Sump Pump Repair Other: SEWER & WATER (Outside the building envelope) Repair Other: Description of work: =e. c O cG T (,' i ; jt79?/ OtkLe -("Cr j O • FEES $60.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeaqan.com/inflow, or City Hall at 3830 Pilot Knob Rd. 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 of plans. Applicant's Printed Name x Applic ature Use BLUE or BLACK Ink I For Office Use I I I CI Permit Ity of Ea V11 I Permit Fee: O ~ I 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I I j 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 7 Site Address: _ 4 4~211C~T c Unit Name: S'{/r7- Phone+1 Resident/ Owner Address / City / Zip ~Q Applicant is: Owner Contractor Type of Work Description of work: ' Te12K &a leer G(L/ W, Ttx C/^ Construction Cost: 7DD Multi-Family Building: (Yes I No Company: ✓ rprS Contact:&U;; e_ /~1 ql Contractor Address:~gsZ- Q City: ~ 1.4424.7 / oz Stater Zip: Phone: License Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) - m-~ Y 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: I Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: _ Phone: I NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of I the information may be classified as non-public if you provide specific reasons that would permit the City to a conclude that they are trade secrets. CALL BEFORE YOU DIG Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall 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 Minnesota State Building Code must be completed within 180 days of permit issuance. e e- ;e i x ~4~~~ x Applicant's Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA143661 Date Issued:06/22/2017 Permit Category:ePermit Site Address: 647 Atlantic Hill Dr Lot:4 Block: 1 Addition: Lakeside Estates PID:10-44300-01-040 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Stuart B Samsky 647 Atlantic Hill Dr Eagan MN 55123 Polar Builders Inc 1103 West Burnsville Parkway Suite 110 Burnsville MN 55337 (612) 432-1597 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA143937 Date Issued:07/05/2017 Permit Category:ePermit Site Address: 647 Atlantic Hill Dr Lot:4 Block: 1 Addition: Lakeside Estates PID:10-44300-01-040 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Stuart B Samsky 647 Atlantic Hill Dr Eagan MN 55123 (651) 688-6498 Centerpoint Energy 1240 W River Pkwy Minneapolis MN 55454 (612) 321-5597 Applicant/Permitee: Signature Issued By: Signature CenterPoint. House heating test record /F^Y( -� _tt, Fnel�/Y/�y/��)/� mmammmlmmmi AUG 1 4 2017 Owner Sctioick. Controls Conversion Address 64 c *%(,(5_ Pr Thermostat 1 Heat plug Vent Size if B City Eg Valve 1,)--e Kind of liner/size 6,j`i 1.-Heat loss Date htg.inst Limit itk Draft hood Regulator A)t Sold by CenterPoint Energy Limit setting f Filters:Size f all Number ( Installed by CenterPoint Energy Fan setting iit. Chimney locations: side Q Outside Electrical work by CenterPoint Energy Pilot type Slag.t— Chimney construction g. Heat type FA 0 Space heater Pilot make c., Wiring C c_ Test tag ycs Gas line by 6! C Pilot model Lighting Inst /U 4 Date tested 7—Z/-t J? Unit heater Other Pilot timing Company testing CenterPoint Energy Gas design Pressur /Lo fire . f. c Tester's name fes, 'Fri____ Make fi oo( Model II A(115— Percent CO2 54, F3-j l a -Z A' II Input CFH-767&t;p Percent 02,E Y Serial no. ;20 i 175`0„ Input S `zea Stack tempi?ab Percent CO 3aPi- CNP 235(11-2008) r For Office Use •�` � � ; • Permit#: /E AGA N ICJ I Permit Fee: Co b cc Date Received: 3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildinginspections(a�cityofeacian.com 2019 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: /1 0 r 1 9 Site Address: 6' 7 471/94-74;G !7i i/$ .644 an / MN 55/23 Tenant: Suite#: � er Name: SAM$ "v( Phone: Address/City/Zip: C41 Ai Z4/kw.- h`i//S £-. 6,1i 4.n, ,Mw Name: /0/► ._7;)c.. License#: Y o b 3, .3\PC177'7 596 Address: 5 7 L ASA(/e lye /V,f., City: 57.1/,'C LAA,/ Gont%act©r- y State: /4/1 Zip: 55376 Phone: ( ii ) 57, 0 ?39 Contact: A , .9L/ , Email: ,• . '� _ 9 '/'fs-rAelL New Replacement —Repair Rebuild —Modify Space —Work in R.O.W. Type of Work — Description of work: Tankless Water Heater Lawn Irrigation( RPZ/—PVB) Standard Water Heater Description Add Plumbing Fixtures( Main/—Lower Level) p Water Softener /eta Description:A t . .,41 n k10 raY/Oil 'd-71,10114o1 Septic System New Abandonment Connection to City Water from Well 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 $100.00 New Residential (fee collected with Building Permit) $115.00 New Septic System (includes County fee and State Surcharge) $60.00 Connecting to City Water from Well* +$290 for Meter and$190 for Radio Read =$540 *Sewer&Water Permit also required for connection charges TOTAL FEES$ 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.gopherstateonecall.orq 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.citvofeaqan.com/subscribe. 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 f plans. x/471110114 E. /iiaL,'SZEws ki /1 , ' r Applicant's V'rinted Name pplicant s gnature Page 1 of 2 0,-/d _ ...i . For Office Use C % y Pemfit#: / 2".- /E'''' �/� Ø' ': Permit Fee: Date Received: `i)— I 7 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 RECEIVED (651)675-5675 I TDD:(651)454-8535 I FAX: (651)675-5694 LStaff: J buiidinginspections@citVofeagan.com OCT 3 0 2019 2019 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 10/30/19 Site Address: 647 Atlantic Hill Drive unit#: I NIS Phone: , I Name: i Resident! 1 Owner Address i City/Zip: cE,4 'i , t<7., 1 L ' Applicant is: Owner Contractor Remodel kitchen- new cabinets, flooring ' Type of Work Description of work: i Construction Cost: / ./ 9`3 Multi-Family Building: (Yes_I No/4 ) t Company: TLC Remodeling Contact: Leslie Sale I 3 _ 20450 Smith Street NW City: Elk River Contractor Address. ' State: MN Zip: 55330 Phone: 952.356.4303 Email: Imsaletic©gmail.COm BC629141 NAT 117087-2 Lead Certificate#: License#: --- _ - If the project is exempt from lead certification, please explain why: , built in 1985 ---- I 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 to be public information. Portions of the information may be L classified as non- ublic ityou provide specific reasons that would ppEnit the City to conclude that the 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.cityofeagan.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 urndergro rid utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.q_opherstateonecall,c • I hereby acknowledge that this information is complete and accurate;that the work will be in onfolnanc 'ith 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 wo is n+t to t without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and ap•roval• pli.'s. x Leslie Sale \ ,� Applicant's Printed Name Applica VS 'ign•tO DO NOT WRITE BELOW THIS LINE Y /9---061-f-,-c._ 1+; JJ/2 . /..5-8& 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 Valuation9# i2& Occupancy /111/_, MCES System Plan Review Code Edition A, , A SAC Units (25%_ 100%X ) Zoning Al City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction --V6----- Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) Final/C.O. Required Footings(Addition) Final/ No C.O. Required Foundation Foundation Before Backfill HVAC_Service Test Gas Line Air Test Hood Roof:_Ice &Water _Final Pool:_Footings Air/Gas Tests _Final Ni Framing 30 Minutes 1 Hour Drain Tile Fireplace: _Rough In _Air Test _Final X Siding: Stucco Lath Stone Lath Brick EFIS )c Insulation Windows i Sheathing Retaining Wall: _ Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control Shower Pan Other: I Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee PO2, 0 0O Surcharge Plan Review ic &bx)1A7r MCES SAC � City SAC ariVir� Utility Connection Charge alf tet. S&W Permit& Surcharge + ' - 6 d x;` -- 71 o o Treatment Plant Radio Meter Read Copies 9, 0 0 TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA160262 Date Issued:02/26/2020 Permit Category:ePermit Site Address: 647 Atlantic Hill Dr Lot:4 Block: 1 Addition: Lakeside Estates PID:10-44300-01-040 Use: Description: Sub Type:Residential Work Type:Alteration Description:Stove Comments:Please call for a Rough In and Air Test, prior to the Final Inspection. Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 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 - Stuart B Samsky 647 Atlantic Hill Dr Eagan MN 55123 (763) 301-4361 Mtad PO Box 366 St. Michael MN 55376 (763) 301-4361 Applicant/Permitee: Signature Issued By: Signature