3669 Ashbury RdCITY OF EAGAN Remark????
Addition Rlackha?r?Len 1st Lot 3 sik Z Parcel 70_14350_030_02
Owner Street 3669 Ashbury Road 5tate
n
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. 1076 1986 253.48 50.70 5
STREET RESTOR.
GRADING
SANSEWTRUNK SIM 1970 6.70 25 Pd prior to division
SEWERLATERAL$n1074 1986 112.09 22.42 5
WATERMAINBTI 1075 1986 92.80 18.56 5
WATER LATERAL
WATER AREA 1072 1586 309.40 61.88 S
gtorm Sew Trk 1073 1985 110.91 22.18 5
STOFM SEW TRK 732 1983 32.57 15
STORM SEW LAT
CURB & GUTTER '
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
CITY OF EAGAN Permit No:
3830 PIIqI Knob Road Meter No: 3 22 --5-.3 5? 9J?
P.O. Box 21199 Reader No: 0!7 1?? 7 a S S
E&gan, MN 55121
Date: 7. 20-&7
Size: o C/
Date: i o - la2- g7
? Owner. Lundgren i3ros.
669 f?l::ury 1:oa' 2:?!_r?c!":a;.rc G en
? SiteAddress:
Plumber --ur_c;;ren Bros. r:Lu;n :i.i?
? Conn. Chg: '''' ? Zoning:
? Acct Dep: ?-r •' 0 u?yf&Units: '
i Permit Fee: .? E3C.
Surcharge: ??v - FLEC ? a ro comply with the City af Eagan
Tr. Plant ??•?
ces.
6.431 1
Mater.
iKr-v
Misc.:
WATER SERVICE PERMIT
GTY OF EAGAN Permit No: 8900 Date:
3830 Pllot Kneb poad Veter No: Size:
P.O. Box 21199 Reader No: Date:
Eagan, MN 55121
I Owner. Lundgret Bros.
Site Address: ' ''? ??
' Conn. Chg: 525.00r-?
Acct Dep: 15. JOpd
Permit Fee_ 10. (?Opc?
Surcharge: • 5 0 pu
Tr. Plant 1 ` . 00 p('
Meter.
Zoning: ?
No. of Units: 1-
I agree to comply with the CNy of Eagan
Ordinances.
By
WATER SERVICE PERMIT
CITY OF EAGAN SEWER SERVICE PERMIT
3830 PNot Knob 4lwd '+A,3 ,? ?4
P.O. Box 21199 PERMIT NO.:
- I,-r, i
Eagan; MN 55121 DATE:
Zoning: Rl No. of Units:
Owner. TjundF ren B ro s.
Address:
Site Addr
Plumber.
I agree to comply wlth fhe City of Eayan
Ordinances. "
By
Date of Insp.:
Insp.:
ConnectionCharge: 525•0011d
Account Deposit: 15. 0()pd
Permit Fee: 1.0. OOpd
Surcharge: • 50pd
Misc. Charges:
Total:
Date Paid:-
+--- . ?
, .
(tertifira#p uf (Orrupariry
titp ot Cagan
arpartrnmt of Suilding 3wrrtinn
Thu Certificate issued pursuant to the requirementr of Sectron 306 of the Uniform Building
Code certifying that at the time of issuance this struclure was in coruplionce with the various
ordinances of the City regulating building conrtruction or use. For the following.•
7 ? Dfn1G/CAR
Uae Qasei6atian B4. Rcmit iVo. ?.; =.. .:
acuWaY Tw M
Zorrinp Dislrict ?Typt (`onn
Ownerofewlding ':.l:?iN ? ?r??Al:j?
Bm7diogAddreas ?lity i i, 1'•L., 1?.h?;?k.t'?t?l'u'? '.? i?i,j I
Datc
Bwldmg Offinal
POST IN A CONSPICUOUS PLACE
CASH RECEIPT
, .
4 " CITY OF EAGAN ` 3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
.
DATE 19
RQCPJVCD
FROM/? w'LL/ l...l
aMOUNr $
- - ,
. 'f?
?
& DOLLARS
7aa
? CASH ? CHECK
- , i
roR ._G ? F ?
''/ 4 1 - '?I L?l.u/.24sG /! i ?-~cv . ?? - ? •
i40 , -L.
FUNC COOE AMOLIMT
Thank You
B Y 1'1.iA
? . White-Payers CoPY
Yellow-Posting Copy
Pink-File Copy
, $LDG. ? PERMIT N0. 1c? ? ?_•? ? ?G' ?'?! ???, • fi' ??. ! ? ? ?i ? Lr??/r' ,t:?? , ? _.?j?+!C.E,?' "
01-3210' Bldg. Permit
01-3422 Plan Check
01-3445 Surch./Adm.
01-3446 SAC/Adm.
? ?
01-2155 Surcharge ?'? ?
1F-3860 Road Unit
20-2275 SAC ? r
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTAL -,7, -??
CITY OF EAGAN .?. 64
3830 Pilot Knob Road, P.O. Box 21 -199, Eagan, MN 55121 .
PHONE: 454-8 100
BUILDING PERMIT Receipt #
To be used for °?L01' Est. Value ? 1, r co Date MAY 1$ 19 84
5ite Address 1639 A54$L'°Y
Lot 3 Block 2 SeciSub. 81 G?I'y
- OFFICE USE ONLY
P8fC21 N0. IZT Occupancy FEES ?
W
Name BR?-LE & 'S?'?Ei, Zoning
(ActuaqConst
Bidg.Permit ? fj C?
? •
o Address 3669 A=+4$?Fr' =4% (Allowable) - Surcharge ?
City EAGAN Phone ? 7Q-65U1 # or scories -
Plan Review
Length _
Zlo' Name 5AME DePin - sAC, ciry
LO)Q Address S.F. Total - SAC, MCwcC
? City Phone S.F. Footprints -
?Nater Conn
On Site Sewage _
?
W
Lu'
Name
On Site Well
- Water Meter
W
i?
Addf@SS
MWCC System
- ?
UZ Acct. Deposit
a W City Phone City Water _
PRV Required _ S'W Permit
I hereby acknowlege that I have read this application and state that the Booscer Pump - S/W Surchacge
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances. Treatment PI ?
Signature of Permitee
APPROVALS
Road Unit ?
BRl1CE C!'. FL7ti K:;1,vEL
A Building Permit is issued to: Planner
- Park Ded.
on the express condition that all work shall be done in accordance with all Council
applicable State of Minnesota Statutes and City of Eagan Ordinances. EMdg pry, _ Copies
''4' ?
Building Official Variance - TOTAL a
?
Permk No. Permit Holder date Telephone #
WATER
SEWER
PLUMBING
H.V.A.C.
ELECTRIC
Inspsction Date Insp. Comments
Footingsl
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
lsul.
Fireplace
Final Htg.
Fnal Plbg.
Const. Meter Plbg. Inspector - Notify Plumber
Engr.lPlan
Bidg. Final
Deck F19.
Deck Final
weu
Pr. Disp.
?
iL CITY OF EAGAN •? ,? ?? ? .??
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHON E: 454-8100 .
BUILDING PERMIT Receipt
To be used for Est. Value Date ,1 g '
Site Address '
Lot Block Sec/Sub. •.:L?, ,. 1
N o.
c Name
; Address ?
0 City Phone 1,731
, o Name "
? 1 Addrias
P City Phone
City Phone
that 1 have read this application and st8te
of
Signature of
A Building Permit is issued to:
all work shall be done in accordance with
Building Official
OFFIC E USE ONLY
On Site Sewage , Occupancy ?_
MWCC System _ Zoning
On Site Well Type of Conffi I,
C(ty Water = (ActuaQ
(Allowable)
* of StoriBs
L
th
eng
Depth _
S.F. Total
Footprint S.F.
APPROVALS FEES A,
'
J12.54
Assessments Permit
Water/Sewer _ Surcharge ?-?'?
Police _ Pian Review •= 5
Fire _ SAC, City
`F
Engr. _ SAC, MWCC
Plenner _ Water Conn.
Council _ Water Meter
81dg, aft. _ Road Unit
APC _ Treatment Pt
Veriance Parka
V.UNiaa 3 i
TOTAL
on the express condition that
Minnesota Statutes and City of Eagan Ordinances.
M
a Permit No. Permit Holder Dats TeISphone ?t
Plumbing .?v?
?
H.V.AG
Electric
Softener
Inapaetion Dats Insp. Comments
Footings I
Footings II
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg. ?
Isul.
Fireplace
Final Htg
Final Plbg.
Bldg. Final
Cerk Oca
Temp. LP
Deck Ftg.
Deck Frmg.
Well
Pr. Disp.
CONTRACT PRICE:
Site Address
tot -? . Block
m Name
-ii
c Address
Cit
?=
y -- -
? Name
c Address
? p City ' ?,ti .+ _
MECHANICAL PERMIT RECEIPT # 71!' lo ??'
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: ?/8 7
'UQ PHONE: 454-8100
0
Phone -
TYPE OF WQRK
Forced Air M BTU
Boiler M BTU
Unit Heater M BTl7
! Air Cond: M BTU
' Vent. CFM
IGas Piping Outlets # ?
FEE:
S/C:
TOTAL•
BLDG. Tl(PE WOAK DESCRIPTION
x
Res.
New
? Mult Add-on
Comm. Repair
Other
FEES
RES
HVAC 0
100 M BT
$24
00
.
-
U -
.
ADdITIONAL 50 M BTU - 6.40
, (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS O
TL
T
INI
UM
PER PERMI
0 EA
<?•:_ S (M
n - 1.5
. ?
U
E
M
-1
COMM/IND FEE - 1a/o OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES - j
TOWNHOUSE 8 CONDOS - RES. RATE APPLIES ?
MINIMUM RESIDENTIAL FEE
ALL ADD-ON 8 i
-
REMODELS - 12.00 ?
MINIMUM GOMMERCIAL FEE - 20.00 ?
STATE St1RCHARGE PER PERMIT - .50 ?
(ADb $
50 S/C IF PERMIT PRICE GOES {
.
aFVntin iti nnrn y
;'-
' ? SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
: ? .? • .t .. . ? , . . y. . ._... , . . ...,ti . _ , "" . • , __ - ., , . « . . .. . . .. _ , . . . ;ai , .
PERMIT # kX??
PLUMBING PERMIT RECEIPT # 2 L''D c2-1
CITY OF EAGAN l )
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: ?r?
CONTRACT PRICE PHONE: 454-8100
Site Address
lot Block; ? Sec Sub
7 , i
m Name S f C T
? Address
c Ciry f
?. Phone fit
,
Name
3 Address
p City Phone
FEES
COMM /IND FEE - 1% aF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE 8 CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.40
STATE SURCHqRGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
'? / ..? ?f' i ??A? ?/??. '? I a /
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
BLDG. TYPE WORK DESCRIPTION ;
Res. i--- New " - ?
?
Mult Add-on ?j
Comm. Repair ' j
Other ?
RES. PLBG. ONLY - COMPL.ETE THE FOLLOWING: ?
NO. FIXTURES
_I-Water Closet - $100 TOTAL ?
-a2--Bath Tubs - $3.00
-,,L-Lavatory - $3.00 y `?1
?5hower - $3.00
_LKitchen Sink - $3.00 -?
UrinaliBidet - $3.00
/ Laundry Tray - $3.00
? Floor Drains - $1 50 • JG
?Water Heater - $1.50
Whirlpool - $3.00 ?
? Gas Piping Outiets -$1.50
(MINIMUM - 1 PER PERMIT)
Softener - $5.00 • r
Well - 510.00 ?
Private Disp. - $10.00
Rough Openings - $1.50
FEE:
STATE S/C: , 5 0
GRAND TOTAL: 3 g
q,cj J
? Name
m Address
N
C Cilry
Name t ?a
? 3 Address
O CitY
I.
TYPE OF WORK
Forced Air
, Boiler
Unit Heafer. - -
MECHANICAL PERMIT
CITY OF EAGAN REGEIPT # 1?9998
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
• PHONE: 454-8100
BLDG. TYP?. WORK DESCRIPTION
J /Sub
Res. ? "'New ?
74-75-
Mult. %Add-on
Comm. j / Repair
Other
FEES
RES. HyAC 0-100 M BTU '
+' 7 r- La ADDITfONAL 50 M BTU
?Irone (R HVAC WCLUDES A/C ON NEW
NSTAUCTION)
'GAS OUl'1,?ETS (MINIMUM - 1 PER PE
, COMM/IN[j,FEE - 1% OF CONTRACT
M BTU 'L APT. BLDGS. =,GOMM. RATE APPLIE
M BTU TOWNHOUSE & GONDOS - RES. RA
MINIMUM RESIDENTIAL FEE - ALL ?
- %A ori A e? ncu
Vent. CFM
Gas Piping Outiets # -4_ /
Dther
0FEE:
S/C:
TOTAL:
IF PERMIT PFi1CE GOES
0)
- $24.00
- 6.00
- 1.50 EA.
?
,a
51GNATURE OF PERMITTEE
. ?.?,>
This revuest voitl p
18 mpnths Irom O/W/p O 7 7691L
D 2 5.0 2 5 1.3 4/v
Aequesf Dale
?J??I? Fire No. Houph-in InSVec?lon
Raquiratll
?
-
?Reatly Nuw e!FV{NI NoGfV Insper.-
to
Wh
R
[
}M?.
?ryo r
en
eadY
'(*'Gcensed Eleo[rical Contraclor I Fereby reOuesl inspection of above
? Owner aleclrical work installed at:
Street AdAress, Box Rome No.
3G6ry s.v?u.ey ?o?D C ??
'.4g'q.?
ecUOn o. Township Name or No. Ranpe No. 'ow"tY
?-i A-60`J?
DccuVent (PpINT)
N
LBwisr
°
G
? /?1
?
d Phone Nn.
os
,
`
c52s
.
.
t?,rJ
Power SupDlier 'A/ddress p ?
Elecbical Con[ractor ICompany Namel Canha,toFs License No.
Standard Electric Co. 40837
MailinB AdJress IConhacmr or Owner Makine Installationl
2672 wood Dr. Ma w , Mn 55109
Authorized S- n re IConNactor/ wn a- n allationl Phone Number
484-8044
MIN ATE BOAND OF ELEC NICITY TMIS INSPECTION FEQUEST WILI NOT
Griggs•Midwev Bldg. - Poom N•191 BE ACCEPTED BY TME STqTE BOAflU
1827 Universitv Ave.. St. Paul, MN 56104 VNLESS PHOPEP INSPECTION FEE IS
Phone(612?642-0600 ENCLOSED.
81-311Y 7 ?; SQUESTuFOfl.ELECTRo eA^L? INSP?ECT?IONck ol yellaw coov. EB-00001 -O6
?Co 9/v
D'Z 11?0 2 5 "X" Below i4eck Covered by Thrs Requesf
NM ,Add Nep. Tyoe of OuilUine Apvlionces Wiretl Equipmenl Wired
Home Fange Temporary Service
Duplex Water Heater Lightiny Fintures
Apt. BuilAinq Dryer Electric Heabn
Commercial Bidg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tenk
Farm OmH. oe,tv in,,, Isnc?:?rvl
L P,! IIC[:IIV O1hC! nlhll
Compute lnspection fee Below
N Pee ServiceEnManceSize tt Fee Fanders/Svbtextlers N Fn Circuits
0 to 200 qm s 0 to 30 qm s ? 0 tn 30 Anip?j
A6ove 200 Amps 31 ta 700 Ainps / 'O 31 to 100 Am s
Swimming Pool Above 100_Am s Above 100_P.m s
Transtormer5 Irrigation Booms o Pertial.'Other Fee
Signs Special Inspection $,/'/`p T
E
pemqrks
????? OTAL FE
)
?(/
/. J
i?i •
Rooph-in / D'1yy./?-br I, Me Elect ' cat/ '
saeclor. herabY
certifV that Ne xbove I
Final ins0ectim, hes been ?
maee. ?
Tliis rapuest roid 18 montM Irom
This reauest void
18 monlhs Irom
0 66225??3.
Request Daie
/L,t1o
?-
? Fire No. Rouph-in Inyueciinn
RequireA?
?Reatlv Nam"?,Will Notify Inspee-
O O
` J ?Yes ? lor When NeadY
?&licensea EIecVeCal CunltaclOr I her0 Y ?BquBSt inspa ion of abov0 ?
? Owner electrical work instal d aY
Street AtlAress, Boa or Route No.
36 S' City -/ ?
y
ecUOn o. Townshi0 N;ame o No. panfle Nn. Counly
Occupant (PflINT)
a
' Phone Nn.
-ea
S/e /.s 6
Power Supplier Addeess
00 220 .a
v
Du o ? «?„?? .
?
Ele
1 ConVactor ICOmpany Namel
Cnntractor's l.icense No.
r
< ?e
L° i77 / 4
!`
l
i
/h .C
C G /
/h li i1 {..i 7 v'-
Mailing Address ICOntractor or Owner Makine Ins1aila1io I
/
Authorized i nature IConVactor/Owner Making Insullationl Phone Number
WINNESOTA STATE BOARD OF ELECTRICITV ? THIS INSPECTION pEQUEST WILL NOT
GrigBS-Mitlwey 91tlg. - floom N•191 ? BE ACCEPTED BV THE STATE BOAflO
1821 Universitv Ave.. 51. Peul, MN 66104 UNLESS PHOPEH INSPECTION fEE IS
oi....... m-m uo nonn FNCI OSFl1
REQUEST FOR'ELECTRICAL INSPECTION . ea-ooooi-os
?
, See inatruct ions tor complet ing [his form on beck ol yellow copy.
U'b 2 2 5 X-" Below Work Covered by 7his Request q? y? 3
add Rep. Type ti awmine nuanoncae wi,ee Equiumem Wired
Home Range . Temporary Service
Duplax Water Heater Lighfiny Fixtures
ApL BuilAing Oryer Etectric Heatin
Cominercial Bldy. Furnace Silo Unloader
InAustrial Bldg. Air Conditioner Bulk Mllk Tank
fgrm Othnr 77P y ther ISUnrifvl
t .r Syecify thnr Other
Compute lnspection Fee Below
p Fea SelvicaEntrenca5i¢e k Fae Feeders/Subfeeders N fee Cirwits
0 to 200 qm s 0 tu 30 qm s 0 to 30 C.n >s
Above 200 qinps 37 to 100 Amps 31 to 100 'Am s
Swinming Pool Abave 100_Am s Above 700_Amps
Transiormers Irrigation Booms Partial."Other Fee
Signs Special Inspection S q,? '?J ?
ro
emarks pt,(?r
,?? Gd
N
Foueh-in
ZF ?te I, vhe
"?. Inspector, hereby
?
Fin
l cartily that the above
a inspecllon hes Eeen
made.
fhiereyuest voitl/Bmonlhalrom - To,u?/ T (J
!
This requesl voitl
18 monlhs (mm 7/'?.'r//g'
D-24952 i :? A_-.2
?coOc) l
;Z?/ .? O'[7
-
Hequest Date _ .
Fife No. ?,,,' .,
RouAh-in InspeUion'
?J? A/J?l7/f
? Q Requiretl? /
?, eady Now [] Will Nntity Insaec-
/
? ?yes
?Np tnr When ReadV
?censed Elecvwal Contractor 1 herahy repaest ingpection ol ebove
DOwner electricBl wark insuliwA wt?
Svget Address, Bos or RoWe No. -
3?? ..s?.ov.e ??i
ecLOn o. Township Name or No. Hange No.
101
Upant PqINTI Pho ne No,
E
,
'7'J?} ?+d ress
',kV.. S7-
EleGtncal ConVador (COmpany Name) Contractor's License No.
Standard Electric Co., Inc. 40837
Mailine.4dJress (Contrac[or or Own¢r Making InStailation)
2672 Ma lewood Dr. Ma lewood, Mn 55109
Authorized 5n ure IConhactor/Ow Ins[allation? Phone Numr
484-8044
MINNESOTq STATE BOAflD OF EL GTRICITY THIS INSPECTION REQU[ST WILL NOT
Griggs-Miawey Bltlg. - Noom N•197 BE ACCEPTED BY TME STATE BOAHD
1827 Universitv qve.. St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone 1612) 642-0800 ENCIpSEU.
' REQUEST FOR ELECTRICAL INSPECTION ee-ooooi-os
1 See instructlons tor completing this lorm on beck o/ Vellow copy.
D 24 qS? "X" 8elow Work Coveied by 7his Request
pve4pnaj neo.l ryoe of Buuaine 1 P.aolinncea wirea 1 Euuiumant wiree I
ectriC
umaCe
Fi
# Fee Service Enhance5ixa b Fee Fextlers/Subleeders fee. Circuifs
°O
...? 0 to 200 qm s 0 to 30 Am s ? 0 tn 30 Am
A6ove 200 q?»p5 31 to 100 qmps h 31 to 100 Am s
Swimming Pool Above 100_Amps Above 100_Amps
Transiormers Irrigation Booms O Partia6Other Fee
L I ? Signs ? ? - Special Inspection jS J? q'0
Me?+arks /?] e?. TOTA ? ' '? /
certilv that tM1e abov
inSpBCt ion has bean
meAB.
0// 2 va- io.sess
J 260884,5, ? -k 1184 s ril°
Raquest0ale ?J /
M
r
Q Fire No. Rough-inlnapac?ion
equi
?'
R y?
Notty
/?Ready Now Q Wilh
dyT?or
R
R 7
L
'/ L G Ves
o en
ea
IXicensed conhactor ? owner hereby request inspection ot above electrical work at:
Joa Atldress iSlr9et Box or Route No.) City
36 6 9 AsN a EA(eAAJ
Setlion No. Township Name or No. Rarge No. County
Occupant(PFINT)
T
B
1 Plipne No.
7
? q
q,
i? c
11l +?c .
-7yo
Power $upplier AOEress
Electncal Conlractor (COmpany Name) Conhactor's License No.
A ETA FcEC, i cqo0 '
Mailing AEtlress ICoMractor or O.vner Making Installalion)
7zy.rc-4 Ni « v EE sdH s o??
Awnonzetl SignaWre IComr oe?Owner Making Installa n? Phone NumDer
.+7?..?.-?- yJ:f -7d1
MINNESOTA STATLBOAHO OF ELECTRICITY THIS INSPEGTION REQUEST WILL NOT
Griggg-Midway Bltlg. - Room S173 BE NCCEPTEO BY TME STATE 80ARp
1821 Unlversity Ave., St. Paul. MN 5510G UNLESS PROPER INSPECTION FEE IS
PFwne (612) 862-0900 ENCLOSED.
J/? 69088
REQUEST FOR ELECTRICAL INSPECTION
? See Insimctions for completing ihis form on bdck ol yellow copy.
X" Below Work Covered by This Request
s'?'?'aEe.oooo,-0e
?+Y yJ
ew dOtl Rep. TypeofBUilding AppliancesWiretl EpuipmenlWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial Fumace
Farm Air Conditioner
Other(sVecily) Contractor5 Remarks: 04 7-p pa*e?CC" G/oKIC
Compute Inspection Fee Below:
# ' Olher Fee # ServiceEnlranceSiza Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps / 0 to 100 Amps
Translormers Above 200 _ Amps Above 100 _ Amps
Signs Inspecror5 U. Onry: TOTAL
?
- Irrigation 8ooms (J . S
Special Inspection
Alarm/Gommunication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Elechical Inspector, hereby
certify that the above inspedion has
been made. Rough-in
Final oate
OFFlCE USE 3NLY
This request voitl 18 months irom
2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION
L?1 N C) City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. single family dwellings & townhomeslcondos when permits aze required'for each uni[
13 3U,??
Date-za/-/-q--/ c20M
3 D,-- L
?
Site Address
tC1 1
v I(iU V?JO? Unit #
Property Owner (6 rxf ? Telephone #(?..71 )(?Oo -!,3,3)
Contractor
AQ I ha
- Y:h Sr ' Ci
StreetAddress ,,.)
. w
tY
State Zip sCS.5 0Q Telephane # ( ?! ) /
Bond #: Expires:
The Applicant is _ Owner -V---eontractor _ Other
Add-on or alteration to existing dwelling unit $ 30.00
? furnace _Additional _k-ITeplacement
air exchanger
lr- air conditioner _New eplacement
other
State Surcharge $ .50
Total NOV 1 j 2004
L
?J
I hereby apply for a Residential Mechanical Permit and acknowledge that
be in conformance with the ordinances and codes of the City of Eagan ax
, ut only an applicarion foi a pemut, and work is not to start wif
res review and approval d
ap ov plan in the case o?rygrk vluh 7,6
t .?? ? 1 z is
Y
complete and accurate; that the work will
;hanica] Codes; that I understand this is not a
that the worieq11 be i# accord4ce vtiith the
ApplicanYs Printed Name
2004 COMMERCIAL MECHAIVICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: commerciallindustrial buildings
mul[i-family buildings when separate permits aze not required for each dwelling unit
Date
Site Street Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Confractor
Street Address City
State Zip Telephone # ( )
Bond #: Expires:
The Applicant is _ Owner _ Contractor _ Other
Work Type
New Construction , Underground Tank _ Install _Remove'*see below
Interiorlmprovement ` InstallPiping _ Processed _Gas
Nature of Work:
"`When installing/removing underground tank, call for inspection by Fire Marshal and Plumbing lnspector
Permit Fees: 570.50 Underground tank installatioNremoval .
550.50 Miximum (includes State Sumharge)
or
Contract Value $ x 1% _ $ Permit Fee
• If permit fee is $1,000 or less, add $50 ? $ State Surcharge
If Rtrmit fee is over $1,000, add $.50 for
every $1,000 permit fee $ Total Fee
I hereby apply for a Commercial Mechanical Permit and acknowledge that the information is complete and accurate; tha[ the work
will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; 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 accortlance with
the approved plan in the case of work which requires a review and approval of plans.
Applicant's Printed Name
ApplicanYs Signature
Approved By: , Inspector Daze:,
CITY OF EAGAN N? 16491
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454-81QQ l1
BUILDING PERMIT Receipt
# ?? ti? a
Tobeusedfor DECK Est.Value $1,000 Date MAY 18 , 19 $9
Site Address 3669 ASHHURY RD
Lot 3 Block Z SeGSub. BLACKHAWK GLEN OFFICE USE ONLY
Parcel No. iST Occupancy - FEES
Zoning -
w Name BRUCE & RUTH HEi.SF.i. (qcmai) cor,sc BIdg.Permit 26.00
o pddreSS 3669 ASHBURY RD (Anowable) - S
5n
h
City EAGAN Phone 870-6601 # of Smries urc
arge ,-
-
Plan Review
Length _
F Name SAME Depth SAC
City
z
0
¢ Address S.F.TOtal ,
-
,
?
City Phone
S.F. Footprints SAC,MCWCC
Water Conn
On Site Sewage _
?
w
Name
On Site weu
- water Meter
F
z Address MWCCSystem -
¢
aW
City Phone
cirywater qcct.Deposit
SMf Permit
PRV RequiTed _
I hereby acknowlege that I have read this application and state that Ihe eooster Pump - SM! Surcharge
information is correct and agree ro compty with all appiica6le State of
Minnesota StaWtes and Ciy
f Eag?n O?an s. Treatment PI .
L
??
?1 1- /?J
SignaNre of Permitee l L ?f. V
APPROVALS
Roatl Unit
A 8uiiding Permit is issuetl to: BRUCE OR RUTH HF.L.SEL Planner - park Ded.
on the express condition that all work shall be done in accordance with all Council
applicable State of
Minnesola StaWtes and City of Eagan Ordinances. gidg. pry, _ Copies
..
Building OfliCial Variance TOTAL 26. 50
_ 1989 BUILDING PERMIT APPLICATION - CITY OF EAG6N
SIlIGLE FAMILY DWELLINGS
I (..qGI
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTEs ADDRFSSE4 F08 CORNER LOTS - CONTR9CTOR/HOMEOWDIER MDST DESIGNATE iiHICH ADDRESS
IS DESIRED. NO CHANGES WILL BE AL,LOWED ONCE BIIILDING PERMIT IS ISSOED.
MQLTIPLE DWELLINGS RENTAL DNITS FOR SALE UBITS • OF ONIT3
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SUR4EY - CHECg WITH BLDG. DEPT., 1 SET OF ENERGY
CALCULATIONS
CObAERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET_ OF SPECIFICAT70NS AND 7 SET_ OF ENERGy CaLCULATIONS
- ;;i???op AIAY 1 5 1989
( ?ieti 14-u)
S/1 S ?8?
To Be Osed For: j? p_ Valuation? te:
Site Address 36b? f}S?l?vv? iec-I OFFICE OSE ON[.Y
Lot ? Block I
Parcel/Sub ?1 w'"04 ??,?f- ---
Owner Vvl2 d' 1?iJ? 4P/4P l
Address 3b6? /i S Zr ?'vi ?fU ,
City/Zip Code SqGQ 0
Phone
Contra
Addres
^,ity/Z
Phone `i S S-3S?Z7
Arch./Engr.
Address
City/Zip Code
Phone #
Occupaney
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F.
On site-sewage_
On site well _
MWCC System _
City water _
PRV required _
Booster Pump _
WLIA.
Bldg. Permit
Sureharge
Plan Review
SAC, City
SAC, MWCC
Water Conn
Water Meter
Acet. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Copies
TO'!'AL
26,
, S-d
APPROVALS
Planner _
Council
Bldg. Off. tiLS//fLn
Varianee
NOTE: Sewer & Water Permit fees and aecount deposit fees will be included in the building
permit Pee. Processing time for sewer and siater permits is tvo days onoe a licenaed
plumber has applied for a permit at City Iiall.
?????'hul ('evyoi'l- ?vwbPj,' i3q36
l;VEYOR'S' CERT1FICATE sIENN}i CORPORATION . . .
6.6
_-
ASH UB?jq'y R ADB X.e
?M
i .$ 827.1 828.6
??gZa.oj d=?36`20" ?R
71 ? R`620.69
\-?l
B 2 9.56
Z j' o
EklSTI `?
HOUgEG
0 ?
?
^ t-I 1
S-I n -
g f?-
? M 83l. J-)
1M ? ? 7
1?--_
PROpOSED P 20.0
MbUSE /G41R
( 8 3 l.4 -?
(8?l. ?
)6
LOT 3
,ieao.c?l
,
8302
5 ?
?
,?
N
?
T
? B33,fi
V
c
0 O N \
! N M ljj m EXISTING
? Aq x HOUSE
s
I `` III1I I
\ J I
? I
\ v)
s ? ORA/NAG
?EryT p?'Uf'!„q? TT ` -?
82e 1 ?
N
a?
?
n
V,
1? 1
` J
7
S 1 B?22 • 01•,
-+- DENOTES PROPOSED SURFACE DRAINAGE
O DENOTES IRON MONUMENT SET SCALE: 1 INCI1 = 30 FEET
0 UENOTES IRON MONUMENT FOUtaD PROPOSED GARAGE FLOOR = 1331,3 FEE7
X000.0 DENOTES EXl5T1NG ELEVATION PROPOSED LOWEST FLOOR = 9'23•6 FEET
(000.0) DEPIOTES PROPOSED ELEVATION PROP05ED TOP OF BLOCK = 3347 FEET
41E IIEREBY CERTIFY TO SIENNA CORPORATION TtiAT THIS 15 A TRUE AND CORRECT
REPRESENTA7ION Of A SURVEY OF T}iE ROl1NDA(IIES OF:
Lot 3.91ock 2. BLACKNAWK GLEN 15T ADDITION, according to the recordetl plat
thereof, Dakota County, hlinnesota.
IT DOES NOT PURPORT TO SfIOb! IMPROVEt1ENTS OR ENCROAC}Ih1ENTS, IF ANY. AS SURV[YED 6Y
ME OR UNDER MY DIRECT SUPERVISION THISi'"rN DAY Df N oV. , 19857
REVISED 7-7-e7 ro sr+ow SI?P?ED
A PROPOSED HOUSE FOR
LUNDGREN SROS. CONST,
DY
PROJECT 140. BOOK / PAGE
,IAMES-R/HILI, INC.
? /rri?.??;r?r?j ? , ? ;-?
?
IIAROLD C. PETERSON, LANQ SUItVEYOR
MlNfa[SOTA LICENSE NUh14ER 12294
Pianners / Engineers / Surveyors
JAPViES R. HILL, INC.
8200 }lumboldt Avanue Soutli
Bbominelorti Mn, 55431 012-Bt34-3029
85618(973ay)
FILE NO,
FOLDER
CITY OF EAGAN N° 13 9 3 6
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PH ON E: 454-8100 /
BUILDING PERMIT Receipt# 5-
To be used for SF DWG/GAR Est.Value $105,000 Date JliLY 17 19 87
SiteAddress 3669 ASHBliRY RD
Lot 3 Block 2 Sec/Sub. BLACKHAWK GLEN 1 OnSiteSewage
MWCC System
Parcel No. On Slte Well
Giry Water
a Name LUNDGREN BROS CONST
w
Address 935 E
WAYZATA BLVD
° City WAYZATA phone 473-1231
a 0 Name
?Q Addre
' CitY-
f¢
w W Name
f
x? Addre
U
aW City_
I hereby ecknowledge that I hav? read thia applicalion d state
thaltheinformationiscortect?ndr'e,greetoco ply,Cvitha applicable
State ot Minnesota Statutes a? 6itv of E ?rdin ces.
Signature of Permittee
''?-?.
? LUNDGR^N BROS CONST
A Building Permit is issued to:
all work shall be done in accordance with all applicable St t?;qf M
Building Official 6?'?'
APPROVALS
Assessmen[s
WateUSewer
Police
Fire
Engr.
Planner
Council
BICg. Olf.
APC
Variance
OFFICE USE ONLY
?_. Occupency
_ Zoning
Type ot Const
X_ (ACtuan
(Allowable)
# of Stories
Length
Depih
S.F. Total
Footprint S.F.
FEES
R3
RL
?
?-
$ 512.50
_ Permit
_ Surcharge
_ Plan Review
_ SAQ City
_ SAC, MWCC
_ WaterConn.
_ Waler Meter
_ Road Unit
_ Treatment P1
_ Parks
Copies
TOTAI
51.50
75Fi_95
100.00
525.00
575_00
67_?0
3(15 _ (lQ
1R0.00
?T? 52?2 5
on the express condition that
f City of Eagan Ordinances.
.
1987 BDILDING PERMIT 6PPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
INCLIIDE 2 SETS OF PLANS, 3 CERTIFICATES OF SOHVEY, 1 SET OF ENERGY CALCOLATIOHS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOiiNER MQST DESIGHATE WHICH ADDRESS
IS DESIRED. NO CHANGES NILL BE ALLOWED ONCE BOILDING PERMIT IS ISSIIED.
MOLTIPLE DWELLINGS - RFSIDENTIAI. RENTAL OAITS FOR SALE i111ITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIRVEY - CHECK iIITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COPM6RCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
t SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: 5"14)6 V/a?luation:?-?
Site Address 3?06 /""?"_" ?i v` OFFI
Lot ? Block ""2-- On Site Sewage_
MWCC System ?
Pareel/Sub On Site Well
Owner City Water ?
???• /
?-
Address
City/Zip CodeS/1'9'`f?
Phone 473"Iz 9PPROYAI.S
Contractor Assessments
Water/Sewer
Address Police
Fire
City/Zip Code Engr
Planner
Phone Council
Bldg Off
Arch./Engr. APC
Varianee
Address
City/Zip Code
Date: 17 ?Sr 4?
Oceupaney l< ?5
Zoning 12 • (
Type of Const
(Actual) IZ
(Allowable)
1/ of Stories
Length S 4
Depth 3Z
S.F. Total
Footprint S.F.
FEES
Permit
Sureharge
Plan Review Z5(o ??
SAC, City ?fx).
SAC, MWCC 5Z5
Water Conn 52S"
Water Meter (D'( .
Road Unit 305
Treatment P1 1E30.
Parks
Copies ?
TOTAL ?' , >„! ,_,1
4S`--
Phone #
?; ? X 20 -?o f rO ? J c? - ?S `7 2 P?
20 ?, 2Z = q.qo x ?Z =?Z? ?
2? ? 3 q- ' ?3 g? x q-,I- = S 3 g?0
io2 (76
?SURVEYOR'S
, .
CERTIFICMTE SIENNA CORPORATION
6?
AS BH URY?- 82X.8 - -
? M ROqD
s.s 827.i
! 828.6
,(8"L9.6) 4=6°3620° ?
c
82' 7 f ao =620.89
o s a "' ° ,
(1 I - ? 'i=?p , .
aMD/
\-829.56 M83/.o?
' .83 Z eH0sT1NG \?
Q)i,
3. N? N /21.17
PROPOSED p 20.0
i 15 HOUSE /GAR.O
? 8 N N
? -' x830.8 54.0
e ? ry ?831.0? 63?/.J
n ~ LOT 3
Z I
1 I I
. f g ? ORA/NACE' a
L ?
`?'S??
82a.T
5
, 1lJ'? ?? i? ?- BB Q
i . 63
S 1B°22'01., W --
-i- UENOTES PROPOSED SURfACE DRAINAGE
O DENOTES IRON MONUMENT SET
• UENOTES IRON MONUMENT fOUtID
X000.0 DENOTES EXISTING ELEVATION
(000.0) DE!IOTES PROPOSED ELEVATION
41E HEREBY CERTIFY TO SIENNA CORPORATION
IiEPRESENTATION OF A SURVEY OF TFIE 40UNDARIES OF:
- -
? ?
I
833.11 CV
i ?
V
a
O ? N \
M
?
EXISTING
N x HOUSE
?
.
CD
m N
^
^
?
I
•?g??
- ?
?
SCALE: 1 INCH = 30 FEET
PROPOSED GARAGE FLOOR = P,30 FEET
PROPOSED LOWEST FLOOR = 9'23.G FEET
PROPOSED TOP OF BLOCK = 331.7 FEET
TfiAT TfIIS IS A TRUE AND CORRECT
Lot 3,81ock 2, BLACKHAWK GLEN 15T AUDITION, according to tlie recorded plat
thereof, Dakota County, Minnesota.
JAMES R. HILL, INC. (
;I
:??,??4.9??
IIAROLD C. PETERSON, LAPID SURVEYOR
h1INN[SOTA LICENSE NUFIBER 12294
JAPViES R. HILL, INC.
Planners / Engineers / Surveyors
8200 tlumboldt Avonue South
Bbominelort, Mn. 55431 012-084-3029
IT OOES NOT PURPORT 70 SHOW. IMPROVEP1ENTS OR ENCROACHMENTS, IF ANY. AS SURVEYED 4Y
ME OR UNDER MY DIRECT SUPERVISION THIS i3TN pAY OF NoV. , 1985?
REVISED 7-7-87 TO SHOW SIGNED:
A PROPOSED HOUSE FOR
LUNDGREN BROS. CONST,
[3Y:
PROJECT NO. BOOK / PAGE
85618(9739y)
F1LE N0.
FOLDER
Cities Di ital uality 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.
••'• +? ???.,' S • . ??? ?? ? ? ? ? ?`?
? CONSlRUC1101?--__-- ----
. IIJC.
EOULEVkRD • ?VhYZATA, rrndr,!ESOTl; 55391 ` (012) <7=%?1231
935 EAS7 ?•VNYZHTA
Ey,1EP.I0P, EIIVELOPE F.VEP.kGE U C0:'?PUTATI0f4 ?/?,
LG?
Lot -? Bloch')
Site Addres
3GG j? ? . R u
R & -
_058
ppaoue 4lalls _ .117
41a11 Framing Freas 023
;
Ceiling Insulation Area -
.027
Ceiling Framing Area
, _04
Rim Joist -
_le
1•Sasonry Wall
.26
;lindows Double Hung = ,4E
Doors ?
Patio Goors 1!
Sidelites
1) Lo«er Level (Sasement)
7ota7 exoosed wall area
Opaoue IJall Area
IJood Frame Area
Rim Joist
Exposed block
. Window Area
$liding Glass Door
Door Area
C
CzsemenLs
.18
_46
_47
?
?x (u) -058 = _?-
- x
_ (U) -117 = ?-
- X
(U)
.04 = -
?-
io x (u) .14 =
? . 4 6
Casement ?-X ??? .26
Double Hung
-x (U) -46 = = --
. ? x ' . (U) -18 --
/?" ? ?
Total -
2)
L 6
c, oJCT RUC110IJ ----
. VJNYZNTl,, t?INN[SOTA 5S391 • (6?2) 473-1231
9'?5 EAST vJHYZAT<. BOUIEVkRO
lst or r,ain floor
Total ex.posed wall area
ppaoue 1:4all area
biood frame area
Rim joist
ldindow P•rea ;
Sliding Glass Door
Door area
Casements
Double Nung
Sidelites
;3) 2nd ?loor if 2 s'?ory
' lotal exposed wall area
' Ooaoue wall area I
wood frame area
I•lindow area
Sliding glass door
Door area
4) Total ceiling area
Wood frame area
ppaque ceiling area
Skylight
C
Casements
Double Hung
/a L-:?
8?2X (u) -oss = ?8 OS!
?X (u) .iv =
04
(u) .
(U) _46
-26
=
ax
,?O x
(U)
•46 L
=
,.3Y_.x (U) .la
1-3x (U) .47
= ?-?-- -
m? 2,
Total
i ?8a
?X
9 (u) .ass
(u) -117
?
X
?
?X ?
?U3 . 4 6
.26
=
= ?
fX (U) _46 = ?-
_x (U) -18 = ?-
Total
ax (u) _027 = _7
?iLL-x ?u) .023 = P D
---x (u) -55 =.- ---
Total ? ?
? iA
-r ? -
COJCIRUCIIOIJ -
? , I!iUJI?FSOTA 5539; • (612) 473-1231
?- -
°_35 EH57 VJl,YZNTA EOULEVARD • l?Jf,YZhTN.
X
?-5 O_
Hinn. U Factors Total er.posed viall zrea
y, .020 = a-s
hinn. U Factors iotal expos°d ceiling area??-
(A) Total
,?,+ Item 2J?O+ Item 3 ?'" I?em 4o?a
I tem 1?1,Se? --If total of I-Lems 1- 4 is less than Item (A), building
comolies witn SBC o006 (C)s
?
GOLD COPY-PERPIIT RELEASE FORM
PERMIT ll
?c-o cc?q
ADDRESS
PICKED UF
?
?, ?
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*UTr,: PAYMEKS OF FEE AT TIME pF
APriscAMorr noEs Nor CONSMMM
APPR(7f71,i. OF PERMIIT.
INSPFXTION OF SM'I2 ADID/O2 FiATIIt
Tni.STAiSATTpN$ WIIL NOP BE SQ'lED-
ULID [JDTFIL PII2MLT HAS BEHg
APPROVID.
?. P ease Print
1) FROPERTY ADDRESS: '-
---?R,?
LEGAL DESCRIPTION:
Lot Block Subdivision or Tax Parce ID )
IE' E}QSTING S1RLMME, DATE OF ORIGINAL BC'ILDING PII2MZT ISSOANCE: '7 B?
PRFSENr ZONING/PROPOSID LSE: (Nbnt eaz
0 COhW[2CIAL/REfAIL/OFFICE
F7 IbIIK.'STRIAL
n INS"I'I=ONAL/GOVERDA=
2) ?
NAME:
ADDRESS:
? R-1 SINGLE FAPIILY
? R-2 DOPLEX (24,o Units)
? R-3 'IOWNHOUSE (Three + Units)
? R-4 APARTMENP/COAIDOMINILTM
CITY, S'!'p.TE. ZIP:
pxoNE: 'f 73 - /2 3 /
3) • i: m• rAME:
ALIDRFSS :
CITY. STATE, ZIP:
PHONE: q2? - /2 3 ! ru+sTER isCEvsE#
( Units)
( Units)
rlumoers liicense:
? Active
Expired
Not recorded
st?' initia].
41
NAPE:
_ ADDRESS:
CITY, STp,TE, ZIP:
PHONE:
. ,
5) . i? a• • ?• : a • • • ??
? CONNEC.TION S0 CITY SEHM ? CpNNIDC,'TION M CITY WATII2 ? OTIm '. .
6) P7,F1ASE HOID APPROVID PEREIIT FC)R PICK-UP BY ONE OF ABOVE
? PLEASE MAIL APPROVID PERWT TO 1. 2. 3. 4. ABCnIE .
? e ? A / ? (Circle one) '
- : FOR :CITY USE ONLY '
PERMIT # ISSLED
?a
Pd w/Bldg. Permit FEES:
$ $ SEWER PERMIT (INCLLDE SURCHARG?:)
$ WATER PERMIT (INCLUDE SL'RCHARGE)
$ 67$ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLL'DE CORPORATION STOP)
$ $ SEWER TAP
$ ACCOUNT DEPOSIT - SEWER
$ $ / $'o-o ACCOUNT DEPOSIT - WATER
?
$ WAC
$ 1= ZSa? s sAC'
$ $ TRUNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRLNK WATER
$ I X ?'?Ta $ WATER TREATMENT PLANT SORCHARGE
$ $ OTHER:
$ --7?5 139 2??C7 S TOTAL
-7',SZ 7 ?
RECEIPT IRECEIPT
DOES UTILITY CONNECTTON REQUZRE EXCAVATION IN PUBLIC RIGHT OF WAY?
? YES VIF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MLST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CO[VDITION.
SUB.7ECT TO THE FOLLOWING CONDITIONS:
APPROVED BY: ZL_? PA?
TITLE:
DATE : ( /2? Z 07
CLAIpf VOUCHER - REFIIND REQUEST
CITY OF EAGAN
CLAI14ANT FT.ARF. HF.ATTNG
ADDRESS 664 MENDELSSOHN AVENUE NORTH
GOLDEN VALLEY MN 55427
Location
Receipt No./Date
Reason for Refund
Type of Refund
3669 ASHBIIRY ROAiI LA R9 RT.ACKHASdK EN 1
- Z999R?19-IR-R7
DUPLICATE PERMIT Electrical Permit
Plumbing Permit
Mechanical Permit
Surcharge
Water Connection Permit
Sewer Connection Permit
Account Deposit
Utility Account Over-Payment
Other:
01-3211 $
01-3212 $
01-3213 $ 25.50
01-2155 $
20-3713 $
20-3743 $
20-2252 $
20-2250 $
$
$
TOTAL $ 25.50
I declare under the penalties of law that this account, claim or demand is 3ust and
that no part of it has been paid.
i
*SignDECEMBER 22. 1987
ature Date
/3 y/3 1?
L 3 BL 2? GITY USE ONLY RECEIPT #: I
SUBD. wALLCwW lc am RECEIPTDATE: 00
PERMIT # "1 I 1 O 7
2000 PLUMBING PERMIT (RESIDENTIAL)
CITY OE EA6AN
3830 PILOT IQNOH RD
EPaGPN, TSi 55122
651-661-4675
Please complete for: D single family dwellings
? townhomes and condos when permits are required for each unit
? 6ackflow preventer for underground sprinkler system
FIXTURES
EACH #
TOTAL
Alterations to existing dwelling - minimum fee
Describe: $ 30.00
Bath tub ? $ 3.00 x = $
Floor drain 3.00 x = $
Gas iping outlet ' minimum - 1 3.00 x = $
Hot tub/spa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tray 3.00 x = $
Lavatory 3.00 x = $
Septic System newireturtisned " requlres MPC lie. 75.00 x = $
Septic System abandonment 30.00 x = $
RPZ new installation/repaidrebuild 30.00 X = $
Rough o ening 1.50 x = $
Shower 3.00 x = $
Underground sprinkler if dwelling is under wnstruction 3.00 x = $
Under round sprinkler if axisting dwelling 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
Water softener If dwelling under consVUCtlon 5.00 x = $
Water softener if existing dvrelling 30.00 x = $
Water turnaround 30.00 x $
State Surcharge 50 --> --> -> $ .50
TOtal --> --? --? ---? $
Reminder: Caii for inspections of alterations, i.e. water heaters, water softeners, etc.
-------------------------------- -------------------------d ----------------- compty with -- all - a-----------------• --------------
-
- appli - cation - , - sGte - that the iMOrmation is wrtect, an agree to ppliwble Ciry of Eagan ordinances.
I hereby- ------- acknowiedge -
- that I - have -
- read - this -
It is the applicant's responsibility to notity the property owner that the City of Eagan assumes no lia6ility for any damages caused by the City during its
nortnal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement.
SITE ADDRESS:
OWNER NAME: :TPYPQa EJIC?? v TELEPHONE #: L.9CJ I 0 O`
(AREA CODE)
INSTALLER NAME: 1" 1r ?VUI?.f TELEPHONE #:
STREET ADDRESS: ` LO 1, ) l LL Y Y"1 1f?1? 1.i) L-r ?J?_>-` 3 v *T t v
?,
CITY: ST TE: ZIP: ff::? It
. . -q.;^.
SIGNATURE OF RMITTEE
2007 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWctian Reouiremenfs
3 registered site surveys showing sq. ft. d lot, sq. tt. of house; and all roMed areas
(2D%maximum lot coverage allowed)
1 Soils Report if proposed buildirg is lo be placed an disWr6ed sal
2 wpies of plan showing bemn 6 vnndow sizes; pouretl found desi9n, Nc.
15etMEneryyCalculations 3 copies N Tree Preservation Plan if lat plattad after 711793
Rim Jast Deqil Options selectian sheet (buildings with 3 or less units)
Minnegasco medianical ventilation foim
RemodeVReoair Reauirements
2 copies of plan showing fmtlngs, beams,joists
i set N Energy Calalations fa heated additions
1 site survey far additions & tlecks
AddN'on -irMicata if an-site septic system
Dffice?UseOnlv
CeM1OfSurveyRecd _Y N
SoilsReport _Y _N
Tree PTes Plan Rectl _Y _ N.
7ree Pres Required, Y 'N
Ortsde Sep6c System Y '. N
Plans are considered nuhiic information unless vou stafe thev are trade secret and the reason.
Date 10 / 22
SiteAddress 3U(pc( AS4-,? kx)rtA ?-6
Construction Cost
Ucx-iig] Unit/Ste #
Description of Work I bK>tZ d?F t ?- ??oc-? (7
Multi-Family Bldg _ Y-
'2( N
Fireplace(s) _ 0 _ 1 ^ 2
Property Owner }os?l {4 p P. 1 T Telephone #(U IZ) E?L72 4 N 30
Contractor w?,?TE}? yL Gv C'? ?2?'j C o -SYfivC t`?i?a?J
Address '5(-9 H-1 lYl ?-M ?l (Li r'?1?
State MN f?Aj. lQ • City 5{-+ I,LVnl F4 T??'-
Zip 55c??fZ. Telephone#(los{) '-l39 '-437=o
COMP4ETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
-- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Enefgy COde Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submisslan type) Submitted Submitted
- . Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit For a similar plan based on a master plan$
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone # (
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is wmplete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; 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.
CAssyan; D 244 Wi?-,ict lc-
Applicant's Printed Name
ApplicanYs Signatu er
Cllyof Eaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675=5694
Use BLUE or BLACK Ink
Permit 1r:
Permit Fee:
I
Date Received: CiI I�a'��
J
r� 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 12 ✓ 1 � t)- SIta Address: Qj 1 Wou f Gin �l -s-3----/Da
Tenant
�1i0`�J G Suiten:
RESIDENT / OWNER
CONTRACTOR
Name:
Phone: / D ,2 - )
m
Addiees / City /Zip:
Name; MILBERT COMPANY INC.dba GAN W_A
Address: 1801 50Th ST EAST
City: '. • INVER GROVE 'IGTS
State: • MN • Zip; 55077.Phone: 65.1 •;:45]:-2241 •
Contact BILL.MILBE` j ,
TYPE OF WORK
PERMIT TYPE
Email:
__New Replacement — Repair _ Rebuild _ Modify Space Work In.R.O.W.
Description of Work:
RESIDENTIAL
• • Water Heater
' Lawn hrlgatl n (.__ RPZ/PVB)
Septic System
_ New •
—Abandonment
,[Water Softener
Add Plumbing Fixtures L. Main / Lower Level)
Water Tumaround
RESIDENTIAL FEES:
355.00 MlntmumWater Heater, Water Softener, or Water Heater Softener (Includes 35.00 State Surcharge)
$35.00 Lawn Irrigation (nclddes 35.00 State Surcharge)
355.00 Add Plumbing Flxtutes, Septic System Abandonment. Water Turnaround* (Includes 35.00 State Surcharge)
'Water Turnaround (add 5166.001fa 5/8' meter Is required) •
3105.00 Septic System liele (310.00 per as built) (Includes County fee and 35.00 State Surcharge)
385.00 Flre Repair (replace burned out appliances, ductwork, etc.) (Includes 35.00 Stats Surcharge)
TOTAL. FEES
CALL BEFOREYOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utiltty damage.
Call 48 hours before you intend to dig to recelva locates of underground utilities: yrww.000herstateonecall.orhi '
1 hereby acknowledge that this Inti matron N comphte and accurate; that the work will be In conformance with the ordinances and codes of the alit d
Eagan; that I understand this N a penult, buy •an application fora permit, and work b rtot to start without a permit: that the watt WIbe It
accordance with pproved pia In the ca d work which requires a raNew and approval • ans.
• X f 111-144_ 14( lif-.7— 11 ./(1
Appllcan s
• Applicant's Printed Name •
Cit of Eaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: 1/(01q5 -
Permit
I(Vg9.
Permit Fee:
10 has
Date Received: 10 hit
T /'L
Staff: _IV
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
J
Date: /D //q J i 3 Site Address: 36,6 y hsA .&4 r yged Unit #:
Resident/
Owner
Name: Te.' -c 14 n Sen Phone: 65/ - 22. 4 - 7V sks-
Address / City / Zip: 3664 A s A 4 w r, I?d
Applicant is: Owner Contractor
Type of Work`'
Description of work: R e ra o 11
Construction Cost: _j d 0 0, oh Multi -Family Building: (Yes / No tom)
Contractor
Company: _ Dr e a m s c' 4/ , .1 :Til G Contact Ce r y 6 A o
j
Address: 9/ O a ,i/ 6J 66#4* S f O -S. /41 ,e0#1,4 -f,../
2 City: f
State: /4/ 1/ Zip: S50yel Phone: SO 7 --‘ ys6 -/d g 1
License #: eC - th03.5'(0 0 Lead Certificate #:
If the project is exempt
from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
Yes _No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents that you submit are, considered to be public information. Portions of
the information may be classified as non-public if you provide speck reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. CaII 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.ora
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that 1 understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x oAr'y Cool
Applicantl Printed Name
Appiicant'Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA178570
Date Issued:08/24/2022
Permit Category:ePermit
Site Address: 3669 Ashbury Rd
Lot:3 Block: 2 Addition: Blackhawk Glen
PID:10-14350-02-030
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
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 -
Ava Teresa Pait
3669 Ashbury Rd
Eagan MN 55122--125
(612) 802-9430
Builders & Remodelers Inc
5301 East River Road
Suite 110
Fridley MN 55421
(612) 827-5481
Applicant/Permitee: Signature Issued By: Signature