1077 Beatrice St 14:23 SEP 20, 2004 FR: THERESA SCHOSTAG #6103 PAGE: 1/1
C O U N T Y 1111
ENVIRONMENTAL MANAGEMENT DEPARTMENT
GROUNDWATER PROTECTION SECTION
14955 Galaxie Avenue - Apple Valley, MN 55124
952.891.7557 - Fax 952.891.7588 - www.co.dakota.mn.us
MUNICIPAL NOTICE OF WELL SEALING PERMIT APPLICATION
DATE: September 20, 2004
TO: Tom Colbert/Wayne Schwarz (EM) Fax (651) 675-5694
RE: Well Permit 04-H227560 Well Type: Domestic
Municipality: Eagan Environmental Specialist: Rutten
The Water and Land Management Section of the Dakota County Environmental Management Department has received the
following permit application for the well described. If you require further review of the application or if you have any
questions or concerns about it, contact the Environmental Specialist listed above or our office at (952) 891-7011. If there is
no response from your office within 24 HOURS (excluding weekends and holidays), we will assume that you have no
objections to the issuance of the permit. Please note that permit issuance is always conditioned on the permit applicant's
observance of and compliance with all applicable state, county, and municipal laws and codes.
Well Contractor: Thein Well Company
Date Application Received: 9/9/2004
Anticipated Drilling Date: Time:
Anticipated Grouting Date: Time:
Property Owner: Richard Ouradnik
Well Owner: Richard Ouradnik
WELL LOCATION:
PLS Coordinates: 1/4, NW 1/4, NW 1/4, SW 1/4, Sec 02 Town 027 Range 23
Street Address: 1077 Beatrice ST
PIN Number: 104775019002
WELL INFORMATION:
Diameter: 4
Casing Depth: 142
Total Depth: 111
Static Water Level:
Aquifer:
COMMENTS:
{
Ve Fdt Riew Dols 6pplicatiom tielp
i
x It VIA
nn ion €:onnnente
Eagan Building Eagan Development Permits
Owner Eagan Assess5ales Eagan Property Eagan Zonin
KENNUH.ST
-,a Parcel ID 104775013002
Address PF7-
BEATRICE ST
Owner 1 OURADNIK RICHARD
1077 BEATRICE ST
EAGAN MAN 55121.1402
Owner 2
4"RIMST Owner 3
Owner 4
. Parcel data updated August 27, 2004
i
ID Search Harm 1077 A `Ria ST
K 2,
Request Date Fire No. Routh-in Inspection
Req red? Ready Now .J Will Notify Inspector
,94(4- ~ ves N. When Ready?
I icensed contractor owner hereby request inspection of above electrical work at:
Job Address (Street. Box or a No.) Ci
l G C,-,~
Section No Township Name or No. Range No. A
CZ-cu-patlN PRINT) Phone No.
nUj,~ t
Power Supplier Address
EI ncal tractor ICo any Name) Co ctor5 License No.
0--kir I
Mailing Ad ss_ onlractor caner Making Ins1a11
l
AUIh n tl Si ature I ntr ctor%Owner Making Installation) P Number
MINNESOTA STATE B AR EL TRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. R 17 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., Bt AR
ul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED
y o7S 9~ REQUEST FOR ELECTRICAL INSPECTIONEBaoo 1-oa
jo. See instructions for completing this form on back of yellow copy.
/K X" Below Work Covered by This RequestL
ew Add Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
1 Other (specify) Contractor Remarks: rt ( T n N
Compute Inspection Fee Below: U I , Ill!
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps Above 100 Amps
Signs Inspectors Use Only: TOTAL
Irrigation Booms l J DU j~
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORD ED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rough-in Date
, go
certify that the above inspection has Final r Date
been made.
OFFICE USE ONLY +
This request void 18 months from
CITY OF EAGAN Remarks
Addition McKee Addition #1 Lot 19 Blk 2 Parcel 10 47750 190 02
Owner3(3-" 'R OVrQc~rl~kt Street 1077 Beatrice St. State Eagan, MN 55121
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR. Pavin 1969 $311.50 $31.15 10 PAID
GRADING
SAN SEW TRUNK 1968 $100.00 $3.33 30 PAID
* SEWER LATERAL 1968 20
WATERMAIN
WATERLATERAL& SEW 1968 $850.00 $42.50 20 PAID
WATER AREA
STORM SEW TRK 1984 403.00 26.87 15 403.00 0008338 8-4-83
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. $200.00 432 1 -1 - 7
BUILDING PER. #3622 494 6-75
SAC $200.00 43 10-19-67--
PARK
CITY of EAGA N N° . 3622
BUILDING PERMIT
3795 Pilot Knob Road
Owner .....G~. .......Vjqr.A&.1.A Eagan, Minnesota 55122
Address (present) IA2.7 ail.. ~ -.L-~!1.e.e 454-8100
Builder le f.ei°_F,4......lka.w.welftf n- --C , fm:rL.t , Address ~IiC..........,C,~~IJ,F....~b Q Date . .....~Z~~t......E... s/.DESCRIPTION Stories To
Be Used For Front Depth Height Est. Cost ermit Fee Remarks
~O~oo _
LOCATION
Q
Street, Road or other Description of Location Lcff Block Addition or Tract
This permit does not authorize the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent
the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and
general welfare to anyone in the community.
THIS PERMIT MUST BT ON ,iE PREMISE WHILE permission WORK IS IN PROGRESS.
This is to certify, that _4..............!Z!~ alt trS..._ .!~C.has to erect^alh f..Q t~~ .!t1....k.~.l upon
the above describ premise subject to the provisions of all applicable Or ces for the Ci f agars.
...d = L....Z Per
.
Mayor Building Inspector
y
EAGAN TOWNSHIP
N.o 589
BUILDING PERMIT
Owner Eagan Township
Address (present) Town Hall
Builder
Date.. ~
Address
DESCRIPTION
Stories To~LB`e Used For
j % Front Depth Height E/'st. Cost Permit Fee Remarks
-z~' 1-?~/ ~ L-e~
LOCATION
t Street. Road or other Description of Location I Lot Block Addition or Tract
t
permit does not authorise the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent
ight to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and
al welfare to anyone in the community.
PERMIT MUST BE PT Nr PRE S RILE THE WORK IS IN PROGRESS.
zs to certify, that.. i : •---has permission to erect a. p
u on
e above described pre 'se subject to pro on_.__f the Building Or 'na Eagan pted April 11,
1955.
a- r
-••--••••-•••--•----••...r Per .
Chairman of Town Board _ Building ctor
EAGAN TOWNSHIP
NO. 964
BUILDING PERMIT
Owner pa4-'46 a4-'- -•--ia r ...1 . Eagan Township
Address (present) f__Q_7-7----- . - . Town Hall
Builder e-•-
Address Date
DESCRIPTION
Stories To Be Used For Front Depth Height Est. Cost_ Permit Fee Remarks
LOCATION
Street, Road or other Description of Location Lot Block Addition or Tract
::C
4,,.-~ `
This permit does not authorise the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent
the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and
general welfare to anyone in the community.
THIS PERMIT MUST BE KEP ON THE PREMISE WHILE THE WORK IS IN PROGRESS. r
This is to certify, that' JV ..................................has permission to erect a.-.. _ upon
the above described premise subject to the provisions of the Building Ordinance for Eagan Township adopted April 11,
1955.
Per... -
Chairman of Town Board Building inspec_ for
A-& ~
- PERMIT 6k3 4i q~
CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55123 Permit Number: 0 2 5 0 4 5
(612) 681-4675 Date Issued: 02/06/95
SITE ADDRESS:
1077 BEATRICE ST
LOT.- 19 BLOCK: 2
MCKEE 1ST
P.T.N.: 10-47750-190-02
DESCRIPTION:
(MAC SOUND PROGRAM)
Building-Permit Type SF (MISC.)
Building Work Type ALTERATION
REMARKS:
A SEPARATE PERMIT IS REQUIRED FOR ANY ELECTRICAL OR PLUMBING WORK
FEE SUMMARY
VALUATION $8,000
Base Fee $99.00
Surcharge $4.00
Total Fee $103.00
CONTRACTOR: - Applicant - ST. LIC. OWNER:
JOHNSON CONST, LYNNE MARIE 15531983 20012133 OURADNIK ANASTASIA
6272 YUCCA LN N 1077 BEATRICE ST
MAPLE GROVE MN 55311 EAGAN MN 55121
(612) 553-1983 (612)454-4587
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 Mn.
Statutes and City of Eagan Ordinances.
t n L
APPLICANT/PERMITEE SIGNAT ISSU BY SIG U^ REI
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: B U I L D I N G
3830 Pilot Knob Road Permit Number: 0 2 5 0 4 5
Eagan, Minnesota 55123 Date Issued: 02/06/95
(612) 681-4675
SITE ADDRESS: L O T : 19 BLOCK: 2 APPLICANT:
1077 BEATRICE ST JOHNSON CONST, LYNNE MARIE
MCKEE 1ST (612) 553-1983
PERMIT SUBTYPE: TYPE OF WORK:
SF (MISC.) ALTERATION
DESCRIPTION (MAC SOUND PROGRAM)
INSPECTION TYPE .DATE INSPTR. INSPECTION DATE INSPTR.
FRAMING ROUGH IN PLBG
ROUGH IN HTG FINAL
REMARKS: A SEPARATE PERMIT IS REQUIRED FOR ANY ELECTRICAL OR PLUMBING WORK
L
CITY OF EAGAN E0033
44 4f 11I5 BUILDING PERMIT APPLICATION (RESIDENTIAL.)
681-4675
New Construction fto ltements
♦ 3 registered site surveys ♦ 2 copies of plan
♦ 2 copies of plans (include beam & window saes, poured fod. design, etc.) ♦ 2 site surveys (exterior oddilklOns & decks)
♦ 1 energy calaulstions ♦ 1 energy coloulations for healed additions
♦ 1 tree preservation plan if lot platted after 7/1/93
required: _Yes _ No
DATE: January 15, 1995 CONSTRUCTION COST: 17,828.00
DESCRIPTION OF WORK: Misc. Alterations - MAC Sound Program
STREET ADDRESS: 1077 Beatrice
LOT_ BLOCK SUBD. P.I.D. #
PROPERTY Name: Phone
OWNER FMT
Street Address
City: State:
CONTRACTOR Company: LYNNE MARIE JOHNSON CONSTRUCTION, I'Phone 5.53-1983
Street Address: 6272 Yucca Lane North L.imnse 20012133
City: Maple Grove, MN 55311
.
ARCHITECT/ Company: Pone'
ENGINEER
Name: Registration
Street Address,
City: State: Zip:
Sewer & water licensed plumber: _ Penalty applies it address change or lot change
are requested once permit is issued.
I hereby acknowledge that I have road this application and state that the information is correct: and agree to comply with all
applicable State of Minnesota Stathtes and City of Eagan Ordinances.
Signature of Applicant:
4ne Lerberg
OFFICE USE ONLY
Certificates of Survey Received Yes No
Tree Preservation Plan Received Yes No
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
OFFICE USE ONLY
BUILDING PERMIT TYPE
o 01 Foundation o 06 Duplex o 11 AptJLodging a 16 Basement Finish
0 02 SF Dwelling a 07 4-plex o 12 Multi (Misc.) 0 17 Swim Pool
0 03 SF Addition o 08 8-plex a 13 Garage/Accessory a 20 Public Facility
0 04 SF Porch a 09 12-plex o 14 Fireplace o 21 Miscellaneous
o 05 SF Misc. a 10 Multi (additional) a 15 Deck
WORK TYPE
a 31 New ❑ 33 Alterations o 36 Move
o 32 Addition ❑ 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MCNVS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. Census Code
# of Stories sq. ft. SAC Code
Length sq. ft. Census Bldg..
Depth Footprint sq. ft. Census Unit
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SJW Permit
S/W Surcharge
Treatment Pl.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
% SAC
SAC Units
a CITY USE ONLY
LOT BL PERMIT
SUED. RECEIPT n
RECEIP'1" DATE, f a
2001 >Cn=CAL VWXMfi.
Cm 4w now
3830 ITLOR XWOB MD
P 55122
651~~i-4675
Dater
Complete this section ggh if you are iastallm" g HVAC in a single fwnily clwel townbome, or condo
~n-and-not o~mert,i®d. .
H"VAC: 4.100 M O T U S 30,0
ADDMONAL 50 M STU f+.l
w Gas outlets (minimum of one rewired @ $3.00 ea.)
State Stew.
R.
T01W
Complete this section tl if you are ama adding o: t ity-
townhome, or condo. Please indicate if it is.a new item, aeration, or repair.
New Alton ~ Repair Other
Furnace Air dooditiming
Air e=hanW Oar
Fee $ 1F
St
Tel
Remsnder: Call,jbr impyerdow
srm ADDRESS:'
OwNEIttvAME: C6 e
INSTALLER NAME: PHCM -7 L 1% tiI a - « ) b
STREET ADDRESS:
CITY' P A-h 6 +
ji
27
.3
CITY USE ONLY
L BL PSS , .
SUBO.
APPROVED BY ` TOR AECEPT, i TE~„r ~,,r.._.......I..r:.r~r
1430. A .
"amf' u
Pte
DATE:
WORK TYPE: ATe W_._. ewWt U.G. Tmk
gn"W'U.0. TW&
Demotkm ofw nn ~r wple.l4 ...'Jlue~+r,yY r.rrr..r.rgnll•"
Few: I% of co nt un I gg duo fie,.
Co t pim $ K l%.*s (Bw P O
Std sur*wv akdft*t $,SB firm& s
TOTAL•
SrM ADDIM:
pfio
' :
OWNERNA1 -
TENANT AtAME
(IMPROVE
_e
WAS THERE A PREVIOUS TER , ' ' ,THIS SPACE? Y- "Ali.
INSTA LLW-
q{ V .
ADDRESS. i M
8IGNATU OF Pm[A i,i,rc
r .lrq i f r r ,r.:,,•. a. I; w~r,.! •.4 a, is •I ,'.,l:.". -b p: v: ~b,y °.L'rt'k
CITY iOF OWN
UATE, to/01/93 Tim Q9426:30
NAME; SUSSEL CORPORATION
::k['_ID 900i W77 BEATRICE S
K55 9001 1077 YEATRICE 'S OW)
0
r'P 7-C.5
KER ID; IAN.
;,at .a. y ° 1 .q.:r Q(';k 4 I:-:: a I'i,: ~4,.r+! I: d:,a
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF RACAN
3830 PILOT KNOB RD - 55122 t
651.681-4675
Now cgnstruction Iteautrements - a $ -
> 3 registered site surreys showing s% ft. of lat. sq. ft. d house 2 copies of plan
and all rooted areas (20% mazirman lot coverage alkmed) 1 seed energy cakulalions for heated additions
> 2 copies of plans (show beam i wM+dow :lees: poured Ind. design; etc.) 1 site survey for exterior odditm L decks
> 1 set of energy cdculallons
> 3 copies of tree preservation plan N lot plaited after 7/1/93
4l9
DATE: CONSTRUCTION COST: 1 I
DESCRIPTION OF WORK: _
STREET ADDRESS: )6-7-7 &-L40 UC-0- 0 r~►t~ r 5-121
oE,SS: ~
LOT: 1 1 BLOCK: SUBD./P.I.D. 4t:
Name: OU e-0-c'-m.? Lc A Yl Phone F: St ;f S~ S~~
PROPERTY Last First
OWNER
Street Address• ~6 7
City ra n State: 1~~1 Dp:I2./
5~I - G S = 03 3 /
Company. Phone*
(area code)
CONTRACTOR
Street Address: License * "9: f EW.
City ~~-•..Q State: H,~\ - zip. 5-5-1 O
ARCHITECT/
ENGINEER Company: Name:
Telephone area code ( )
Street Address: R*q tratton
City State: Zip:
Sewer i water licensed plumber (feauked for new construction anlv):
Penblly applies when address change and lot change Is requested once permit Is issued.
1 hereby acknowledge that I have read this application, state that the information Is c d comp!y with aN appfkabi
Stare of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received Yes No
Tree Preservation Plan Received Yes No 'NotRgquifod
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 jt 17 Garage ❑ 22 PordVAddn. (4-sea.
❑ 03 1 of _ plex ❑ 08 6-plex ❑ 13 16-plex ❑ 18 Deck ❑ 23 Porch (screened)
❑ 04 2-plex ❑ 09 7-plex ❑ 14 Apartments ❑ 19 Lower Level ❑ 24 Storm Damage
❑ 05 3-plex ❑ 10 8-plex ❑ 15 Lodging ❑ 20 Pool ❑ 25 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
❑ 34 Repair ❑ 38 Demolish (Interior) ❑ 42 Reroof
* Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code
UBC Occupancy sq. ft. No. of Units
Zoning sq. ft. No. of Bldgs
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump _
PRV
Fire Sprinklered
APPROVALS
Planning Building Engineering Variance
Permit Fee g ( Valuation: $2
Surcharge _U C
Plan Review
License
MC/ES SAC s
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment Pl.
Park Ded.
Trails Ded. r
Other
Copies
Total: 1
SAC Units
SAC
WORK ORDER
GAP mwlnwwmw~ MES Ms. Ann Ouradnik #9932 ZONE:
1077 Beatrice Ave.
1852 COMO AVENUE Eagan, MN 55121 LONE:
♦ ST. PAUL, MN 55108 H 651-454-4587
Permit by Legal Description
Lot.
Blk 22x26 Det. Allilt W/Conc. f
Add'n 9/15/99 Mike Russell -SIZE ZZ"zso
Value Builders License #1934
Type Const.
SLAB:
gBy SUSSEL
❑ By Owner Approx.
❑ I n t.0[ t•~`~
2-STARTING POINTS ONLY S.P.L. S-
S.S.P.L. 1 - - - + _ - -
R.P.L.
Alley S.
House
F. Street
Other - -
'Square With
910 Sod Rem By U-2- Ci~
`
A.B.U.
~jq
Grade Point
❑ Con i _ WEf~
Blocks: ❑By Owner gTBy_Sussel
Wtr.proof: ❑BY Own. ❑By Sus.
❑ Backfill: ❑By Own. ❑By Sussel 910CIC-
'QMaintain 8' Total Wall Height
Including Blocks OR
❑ Maintain 8' Wall Height on
cl -V w
Top of Blocks
Block Size (Top course) - -
❑ 81, 6,. ❑ 4,. -
Wall Height other than 8' - - _
04 _ t
Existing garage: No ❑
ize Ketached D Attached Yes ❑ - - - - - - - - -
of existing: ZZ x Z4• - _ iCtS+l-'k - - r -
Existing garage will be: 10A tv
❑ Left as is t
❑ Converted to L.S.. By owner
❑ Removed By: Owner ❑
Sussel
Junk Must Be Removed By Owner - _ _ _ _ _ _ - - _ _ - -
Stakes visible Yes ❑ No EXis_
Survey available Yes ❑ No n a✓ L~+3 BA+I - - ! _ _
❑Special instructions from -l s ~W
Cement Man
ACCESS
11 Good ❑ Fair ❑ Poor DIRECTION
PURCHASER'S INITIALS:
WESTERN REMODELERS
2529 NICOLLET AVENUE
MINNEAPOLIS, MINN., 55404
PHONE: 823-6172
COMPLETE REMODELING ALUMINUM & STEEL SIDING
ALUMINUM WINDOWS & DOORS ALUMINUM TRIM
C _
e w
~
r
1
cc ~fop
"OVER 30 YEARS EXPERIENCE SERVING THE PUBLIC"
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE: r6 19,1967 NUMBER -16.
OW-TER: &U R. au rarirfi Address 107? , W : IXMst
PVERIBER TYPE OF PIPE u. M
DESCRIPTION OF BUILDING
Industrial Commercial ResidentiA l Multiple Dwelling No. of units
IL
Location of Connections: Connection Charge
Permit Fee
Street Repairs
Total
' Inspected by:-_ fL1
Date t 'c'
1 Rema rks : a. BY
Chief Inspector
In conr.'3eration of the issue and delivery to me of the above ppr.:.;it, I
hereby agree to do the pronc-sed work in accordanne !ith the rules and
regulations of Sagan Township, Dakota County, Minnesota
Pleess notify when ready for inspection and connection ansi before any portion
of the work is covered.
.
EAGPX TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
Date: oa&qkur 196M Number: 7
Billing Name: „ ik Site Address:. fl'l7 u .riua 'Areat
Owner: same Billing Address sm
Plumber:
Location of Connection Meter Size Connection Chg. • ~c~.
Meter No. Permit Fee
Meter Reading Meter Dep. $15000
Meter Sealed: Yes Add'1 Chg.
33 / = NO Total Chg.
1 Inspected by
CD&' 46~ ,
~ Date
Building is a: Remarks:
Residence
Multiple No. Units
Commercial
Industrial By:
Chief Inspector
Other
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota. '
By:
Please notify the above office when ready for inspection and connection.
MASTER CARD
LOCATION tool /P- 7
OWNER
STRUCTURE AND
LAND USED AS Q
Issued To
Permit No. Issued Contractor Owner
BUILDING r R rit~f~ r
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER
Approved
Items (Initial) Date Remarks Distance From Well
FOOTING SEPTIC
FOUNDATION CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL
DEPTH
HEATING OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
a NO EVIDENCE OF NON-COMPLIANCE ❑ NON-COMPLIANCE. BUILDER DOES NOT
OBSERVED. INTEND TO COMPLY.
❑ ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS. ❑ COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
❑ NON-COMPLIANCE. BUILDER WILL COMPLY CONTROL.
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
❑ REINSPECTION REQUIRED DATE OF REINSPECTION
REINSPECTION REVEALED
CERTIFICATION-1 certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein
all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property inspected.
ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPECTOR DATE
COMMENTS:
2 7
~2g~I 4[S o
2006 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
iDate
Site Street Address t C U
Vafrl I (,e S+ ' Unit #
Property Owner ~I Ckekj d C~Ltt'< c( ti i Telephone # 4-ffl 1~~+ s
i
Contractor Ir Iff Telephone # (1;~~t) S 240
Address - [VIL ~W6 City 4n Stat RAJ Zip 0510
The Applicant is: _ Owner '4Contractor -Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
Alterations to existing dwelling $ 50.00
Add plumbing fixtures. This fee includes installation of a water softener and/or water
heater at the same time. If you are installing only a water softener and/or water
heater, do not complete this section; move to the next section and check the
appliance(s) you are installing.
-Septic System Abandonment
-Water Turnaround (add $130.00 if a 518" meter is required)
Other:
_ Water Softener- Water Heater $ 15.00
_ new Yreplacement
Lawn Irrigation _RPZ _PVB new -repair -rebuild $ 30.00
State Surcharge $ .50
Total
I hereby apply for a Residential Plumbing 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, o is not to start without a permit and work will be in
accordance th the approved plan in the event a plan is required t b revie,#ed ar)q approved.
E f,
Applicant's Printed Name Appli nt' Signature
/f ~
III~ No. Pwmlt "Older Delta TelapNow #
S1W
PLUMBING
HVAC
ELECTRIC
ELECTRIC
hopecdon Data Map. Commute
Foo*W I
Foundation f
Framing
Roang
Rough Ptbg.
Rough
taut.
Fireplace
Fhal Hig.
Omv Tae
FMW PlIv. Pt S. hWedw - Na ty Plumb w
Coral mew
MWA%n
I. Fqnd ,
tc~ealll
t~ Diep. _
INSPECTION RECORD
Crff OF FAGAN PERMIT TYPE: ~ 4 ~ + 1 r r ~ t rt
Pilot Kkk Road Pemrrt dumber: at `t
EaW, Mictnesata 55123 Date Issued: 0
(612) 681-4675
WE AWIRESwS: 1 to r : 19 ~ t Ie ~ ~ 1 APPLICANT:
I e.r ~ HF A l k (cl if IcINN:,[1N VONS 1, I YNNI MAa' 11:
H3
PERMA ISTYPE: TYPE OF WORK:
Dv ~'IfAi I p I ) ON (MAC ~r_~UNU 1 1.'t1ti1~ AM )
RAI'1 N( ki)001( l N Fit 8b
.11)41H 1
RC'.MAttV A 'SEPARAII I -RMI I I REi)IIII? 0 t IW A14Y F i FLI-F11►;A1. 011 PI IIMIs.INi; U~Wt
~j t .4~ h j 1fi te
' -dap
J
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SINER SERVICE CONNECTION
DATE: October 19.1967 NUMBER ~G
OWNER: Paul R_ (MradMk Address 1077 Beatrice Street
PLUMBX11 TYPE OF PIPE t X r• H.1 y, e.+,t r T 'Z'o
DESCRIPTION OF BUILDING
Industrial Commercial Residential Multiple Dwelling No. of units
x
Location of Connections: Connection Charge 1200.00 Od '1"07
Permit Fee s°
"Ilk Street Repairs
Total ao7.s'a
333 G Inspected by: SteLttiE~1-
Date oI3 G _
Remarks:
By.
Chief Inspector
In conciieration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordenre with the rules and
regulations of Eagan Taraship, Dakota County, Minnesota
By_(2 )t-' e~Ld
Please notify when ready for inspection and conaection and before any portion
of tha work is covered.
Use BLUE or BLACK Ink
I For Office Use I
I Permit
41 City of Ea a~
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 I Date Received:
Phone: (651) 675-5675
I I
Fax: (651) 675-5694 1 Staff: I
I I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit M
Name: red, P X~'-c Prbrev~,o Phone: 17 S'i - `ZZf - 7G~
Resident/
Owner Address / City / Zip:(o 77 5- SV, - - c
17
Applicant is: Owner - Contractor
Type of Work p Description of work: t
Construction Cost: 6(900Multi-Family Building: (Yes / No
Contact: Company: Al-c") 4 v '{~e✓r~--r_
Address: 150&4 ~~~~P rz ~ccSC~ /q/,-/ City: + ~ a ~ ✓ Contractor V_
State: h "_J Zip: Phone:
License ID to ~~l 2rS 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.: Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
w. n..w 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.oor)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 Minnesota State Buildi Code must be completed within 180
days of permit issuance.
x~ki 6L-t (4r61 x
Applicant' Printed Name Appli ant's gnature
Page 1 of 3
Date:
City otEayn
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
10 2 7 2016
Use BLUE or BLACK Ink
For Office Ute
Permit #: t 37 7: 1
Permit Fee:
o°'1"
Date Received:
Staff:
2015 RESIDENTIAL PLUMBING PERMIT APPLICATION
Site Address:
Tenant:
Phone: ia`' -660ez
Address / City / Zip:
Name:se #:
'Hilbert Company Inc Oa Culligan Water' se .
gan
Address: 1:8.01 5(`h St East City: Inver Grove Hgts..
State:: Mn Zip: 55077 Phone: .651-451-2241 •
Contact: William R Milbert Email:
_ New _ Replacement _ Repair ^ Rebuild _ Modify Space _ Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
Lawn Irrigation ( RPZ / PVB)
Septic System
New
Abandonment
Water Softener
Add Plumbing Fixtures Main / _ Lower Level)
Water Tumaround
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
"Water Turnaround (add $200.00 if a 5/8" meter is required)
$115.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) '
TOTAL FEES $ 100 t O O
•
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.aopherstateonecall.oro
1 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 permlt; that the work will be in
acjordance w th the ePproved plan intheca)Selof work whit» requires a review and approv,I of plans.
Applicant's Printed Name
x
cant's Signature