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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