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3925 Cedarview Dr CITY OF EAGAN WATER SERVICE PERMIT 3795 Pilot Kyob Road PERMIT NO.: Eagan, MN 55122 DATE: o-/77 Zoning: No. of Units: 7 Owner, a, Address: Site Address: Plumber: Meter No.: Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: 1 agree to comply with the City of Eagan Surcharge: Ordinances. Misc. Charges: Total: BY Date Paid: Date of Insp.: Insp.: CITY OF EAGAN SEWER SERVICE PERMIT 3795 JP?lot, Uob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: s Owner: _ Address: Site Address: - Plumber: agree to comply with the City of Eagan Connection Charge:,. ~'Y fit! Ordinances. Account Deposit: Permit Fee: Surcharge: - BY Misc. Charges: Dote of Insp.: Total: Insp.:-__ Date Paid: CITY OF EAGAN WATER SERVICE PERMIT w 3795 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner: Address: = L4' tea. _ . i - Site Address: Plumber: Meter No.: Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: I agree to comply with the City of Eagan Surcharge: Ordinances. Misc. Charges: Total: By Date Paid: Date of Insp.: I nsp.: CITY OF+fAGAN SEWER SERVICE PERMIT 3795 Pilot Knob Read PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner: r - 7; _ Address: Site Address: Plumber: agree to comply with the City of Eagan Connection Charge: f Ordinances. Account Deposit: Permit Fee: Surcharge: By Misc. Charges: Date of Insp.: Total: Insp.:- Date Paid: CITY OF EAGAN Remarks Addition Barton-MCFray Addn. Lit _ 7 k 1 Parcel 10 13700 070 01 Owner street 3925 Sibley IAem.H State IL Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK i ' 1968 113.75 3.7 O 1 75-8.5, AnmAaq 9-6-77 SEWER LATERAL A 711 1977 6744-87 674-49 10 6070 39 -04642 9-6-77 service gtubg 1977 WATERMAIN * WATER LATERAL 1977 * WATER AREA STORM SEW TRK * STORM SEW LAT 197 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 N2 4353 PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for Date 19~ Site Address Erect Occupancy - Lot Block Sec/Sub. Alter Zoning Parcel Repair Fir one _ Enlar ype of Const. W Name Mo ❑ Stories * 3 Address _ molish ❑ Front ft. 0 Grade ❑ Depth' ft. City Phone Approvals Fees Name 0 Assessment _ Permit _ oa Address U~ Water & .Sew. Surcharge City Phan - Police Plan check F W Name Fire 7 } SAC =a Address Eng. Water Conn. aW city Phone Planner Water Meter Council hereby acknowledge that I have read this applicotion,ond stove that Bldg. Off. the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. APC Total Signature of Permittee A Building Permit is issued to: on the express condition that all work shall be done in accordance with all opplicoW'e State of Minnesota Statutes and City of Eagan Ordinances. Building Official Peewit # Deb Iowa pemittee Plumbing Mechanical INSPECTIONS DATE INSP. Rough-In Final Footings Date Insp. Date Insp. Foundation Plumbing Frame/ins. Mechanical Final Remarks: INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 14 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: kAN PAl t 1 ; 1 ? 41, ft i :i PERMIT SUBTYPE: TYPE OF WORK: r Ill" f 11111! INSPECTION TYPE DDATE INSPTR. INSPECTION Permit No. Permit Holder Date Telephone # S/W PLUMBING HVAC ELECTRIC ELECTRIC Inspection Date Insp. Comments Footings I Foundation Framing Roofing Rough Plbg. Rough Hig. Isul. Fireplace Final Htg. Orsat Test Final Plbg. Plbg. Inspector - Notify Plumber Corot. Meter Engr./Plan Bldg. Final Deck Ftg. Deck Final Well Pr. Disp. e`2 ro %-,r ~ 1 V_ / - Rea st Dat Fire No. Rough-in Insp Ion S 1l Required? ❑ Ready Now N~Will Natty Inspector l Ves L No When Ready. I X licensed contractor ❑ owner hereby request inspection of above electrical work at: Job Address (Street Box or Route City / 9. S Er LJ F AC>4 ES~,on Township Name or No. Range No. County INT) : Pho ne No. c n v 41-511-90 Power Supplier Atldress Eleanc cmr ICOmpany Name ConVador5 License No. Mkuhng Atlpress ICohtracl { m Owner Making Installation ~~fo~ l (jin Ln - "J5lzz Aulhorizetl 61ure IContrector/Owner ng Installation) Phone Number -0133z MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1641 University Ave.. St. Paul. MN 55100 UNLESS PROPER INSPECTION FEE IS Phone (612) 6620600 ENCLOSED. [Q / REQUEST FOR ELECTRICAL INSPECTION EB-00001-09 ll~ See Instmdlons for completing this form on back of yellow copy, jqp? Pq6 XBelow Work Covered by This Request -i-y v New Add. Rap. 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 Other (specify) Contractors Remarks'. w o i v r,il -~.tJtJ ~FF>c~'" Ail t~ .nRtC, Compute Inspection Fee Below: Yn0-,tO'2 ---;Ek>P 1n Zwe ~JF ,BUIGlSr/JG # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps A ve 100 Amps Signs Inspectors Use Only: TOTAL Irrigation Booms ~ cF,V Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee , 30 COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rougn-in oaf c certify that the above inspection has Final _ Dater = been made. OFFICE USE ONLY This request void 18 months from CONDITIONAL USE PERMIT NO. CITY OF EAGAN 3795 PILOT KNOB Roan FAG, N, MINICESOTA 55122 The Council of The City of Eagan hereby grants toSentman Enterprises 7101 York Av. So. of Edina. MN 55435 a Conditional Use Permit pursuant to application dated 3/8/77 for the following purpose To operate . a Crown Auto Store at Lot_3„_ Barton geGray_ Addition" Dated: 4/22/77 Fees Paid: 75,00 By: hayor Attest--- Clerk CITY OF EAGAN s 3795 Pilot Knob Road Eagan, MN 55122 N2 4353 PHONE: 454-6100 BUILDING PERMIT APPLICATION $150,000. Rpt # 6266 To be used f"-.----Crown Dotqft June 8, 1977 Site Address 3925 Cednryiew 01arTy ncy Lot 7 Block 1 Sec/Sub. B t McGrai GB Parcel # ne - f Const. eo~ s Name ies z 710 York Av So,Address ft. ci Edina phone 8 5-3020 Name Approvals Fees 0 ssment Permit 9FS_ Sn Addrs - F- Pon Water & Surcharge 7 An city L Police 13/77 Plan check 1 1 47 _ 75 uW No Fir SAC i9nn_nn Fw Water Conn. Add s aw City Ph a tanner Water Meter Council I hereby acknowledge that I have read is applic do an st t Bldg. Off. the information is correct and agree t comply with a I a le State of Minnesota Statutes and City o Eagan Ordinanc APC Total 7374.-25 Signature of Permittee A Building Permit is issued to: Sentman E r riseS InC. on the express condition that all work shall be done in accord pe with all 'p lica State df Minnesota Statutes and City of Eagan Ordinances. Building Official 1ao - CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 N2 4403 PHONE: 454-8100 BUILDING PERMIT APPLICATION $150,000. Receipt # 6728 To be used for Crown Auto Store Date July 20, 1977 Site Address 3925 Cedar View Erect [JOE Occupancy Lot 7 Block 1 Sec/Sub. Barton McGray Alter ❑ Zoning GB Parcel # Repair ❑ Fire Zone _ Enlarge ❑ Type of Const. W Name Sentffian Enterprises, Inc. Move ❑ # Stories 3 Address 7101 York Avenue South Demolish ❑ Front ft. ° City Edina Phone 835-3020 Grade E] Depth ft. o Name Conlitruet4on 70 Approvals Fees Zvi Assessment 5/13/77 Permit Address 75.00 Phone Water 8 SeJv~r..7- Surcharge city Police Plan check 132.75 Fw Name Charles Novak - Fire 5/13/77 SAC 1900.00 Address 2900 Rice St. Suite 380 Eng. Water Conn. 4w City St. Paul Phone Planner Water Meter Council - hereby acknowledge that I hove read this application and state that Bldg. Off. 5/13/77 the information is correct d agree to comply with all applicable APC Total 2373.25 State of Minnesota Stotut s and City f Epgd,~neOrdi nas. Signature of PermittX,el( l/t`/'t=-t4e I A Building Permit is issi d to: $ ntman Enterprises, Inc., COIIS trnonC gnaxpreess condition that all work shall be done cor nce w h all opplica le Stote of Minnesota Statutes and City of Eagan Ordinances. Building Official - TW,%request void 18 months from /0 13700 070 01 4[. r ~a y~ 00-rIt n - MO-Jray 0 67577 Date of this Request e - 3 I, asl!~ Licensed Electrical Contractor ❑ Owner, do hereby request inspection of the above electri- cal wiring installed at: n h Street Address or Route No.~ ~~-v 1 AMT J~J~ City Section Townshi/p~ _ Range Count W y hich is occupied by J4 )C6 C6 (Name of Occupant) Is a roughin inspection required on this job? No ❑ Yes) Ready Now ❑ Will Call Power Supplier S Address g 11 Ar (era Electrical Contractor _,4 cr Contractor's L tense No. (Company Name) Mailing Address / 63 /Electrical Contractor o O ner Making This Installation) _Te_ yo Authorized Signature Phone N0 ectrical Contractor or Owns r Making This Installatlon) Minnesotaitate Board of Electricity # 1954 jlniversity Ave., S . Paul, Minn. 55104-Phone 6U-7703 4t O &467577 rr REQUEST FOR ELECTRICAL INSPECTION CHECK BELOW WORK COVERED BY THIS REQUEST Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For Home ❑ ❑ ❑ Range ❑ Temporary Wiring ❑ Duplex ❑ ❑ ❑ Water Heater ❑ Lighting Fixtures Apt. Bldg. ❑ ❑ ❑ Dryer ❑ Electric Heating ❑ Commercial Bldg. >5 ❑ ❑ Furnace ❑ Silo Unloader ❑ Industrial Bldg. ❑ ❑ ❑ Air Conditioner Bulk Milk Tank ❑ Farm ❑ ❑ ❑ List List Other ❑ ❑ ❑ Hehers} Hehers~ COMPUTE INSPECTION FEE BELOW 1 Service Entrance Size: Fee Feeder Subf Fee Circuits: # Fee 0 to 100 Amps:' :to 30 A ` 1 1, 0 to 30 Amperes o b 101 to 200 Amps. ;31 1 res ,03 31 to 100 Amperes Above 20 s. ove _Amp . Above 100 Amps. Transformers- Retnote Control Cite. Partial or other fee - Signs Special Inspection Minimum fee $5.00 Remarks TOTAL FEE 00-~2' , I, the Electrical inspector, hereby certif e ,a ve s ection Date 3' ~ (Rough-in) c P i ~SaA I (Final) Date > This request void 18 months from v + yt CITY OF EAGAN 3745 Pilot Knob Road Eagan, MN 55122 N2 4353 PHONE: 454-8100 BUILDING PERMIT Receipt To be used for Date , 19 Site Address Erect ❑ Occupancy Lot Block Sec/Sub. _ Alter Zoning Parcel # Repair Fire Zone Enlarge r Type of Const. W Name Move # Stories 3 Address Demol' h font ft. frad ❑ Depth' ft. city Phone Nome ►ovals Fees sessment__- Permit _ ~0 1 Address qr ~ City Phone oter & w. Surcharge ice Plan check uW ,,,W Name e SAC vG Address g. Water Conn. _ eter <W City Phone nner Water M Council hereby acknowledge that I have read this application and state that Bldg. Off. the information is correct and agree to comply with all applicable APC Total State of Minnesota Statutes and City of Eagan Ordinances. . Signature of Permittee i A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official - CITY OF EAGAN 3795 Pilot Knob Rood Eagan, MN 55122 N2 4403 PHONE: 454-8100 BUILDING PERMIT Receipt To be used for Date 19 Site Address - Erect ❑ Occupancy Alter ❑ Zoning - Lot Block Sec/Sub. Parcel # Repair ❑ Fire Zone 3 _ I Enlarge ❑ Type of Const. Val b• W Name Move ❑ Stories 3 Address Demolish ❑ Front ft. _ Grade ❑ Depth ft. city Phone Nome Approvals Fees 0 u< Address Assessment Permit _ F City Phone Water & Sew< - ,TT Surcharge Police Plan check ~W Nome Fire SAC x~ Address Eng. Water Conn. _ <W city Phone Planner Water Meter Council I hereby acknowledge that I have read this applicaticn and state that Bldg. Off. the information is correct and agree to comply with a!I applicable State of Minnesota Statutes and City of Eagan Ordinances.' APC Total Signature of Permittee K A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official - permit # Dote Is ed PWMIHee Plumbing Mechanical J S / INSPECTIONS DATE INSP. Rough-In Find Footings Date Insp. Date Imp. Foundation_ Plumbing Frame/ins. Mechanical Final Remarks: f- 77 d~~ ~ecl tlCa I Lys f~P C~o~ CITY OF EAGAN 3795 Pilot Knob Rood Eagan, Minnesota 55122 Phone: 454-8100 i _ PERMIT No. August r. ~7 n y Date: isft 19, 1977 Receipt No.: , 141 -117! 1 r i.vn Single Residential Site Address: Lot Block Sub/Sec. Barton Mc(wra'_ Multi Res., Comm./Ind. I Comm Name n' A•ilto Store c/o S. M. Fabian New/Alter./Repair ne?: i 1220 Court 5300.00 3 Address - Cost of Installation C Burnsville 53. 00 City _ Phone: Permit Fee Name 3ackdahl & Olson Plumb.i.ng & Fieatinq Surcharge .50 3157 Chicago Ave. A dress City Phone: Total This Permit is issued on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official City of Ea~d R Pat Geagan August 24 2005 MAYOR Peggy Carlson Cyndee Fields RANDALL J & SANDRA K QUAM Mike Maguire 3925 SIBLEY MEMORIAL HWY Meg Tilley ST PAUL MN 55122-1415 COUNCIL MEMBERS Re: Project No. 80OR Thomas Hedges Assessment Deferment Agreement CITY ADMINISTRATOR Dear Mr. & Mrs. Quam: For your files, I am enclosing a copy of a fully signed and recorded Assessment Deferment Agreement. The recorded document number is 2342786. If you have any questions, please contact the Engineering Division at 651-675- MUNICIPAL CENTER 5646. 3830 Pilot Knob Road Eagan, MN 55122-1810 Sincerely, 651.675.5000 phone 651.675.5012 fax 651.454.8535 TDD y Jenki gineeri ' ecretary MAINTENANCE FACILITY Enclosure: Agreement 3501 Coachman Point Eagan, MN 55122 651.675.5300 phone 651.675.5360 fax 651.454.8535 TDD www.cityofeagan.com THE LONE OAK TREE The symbol of strength and growth in our community. 2342786 ❑ o D O a s CD ' ❑ os~Z ~ o ° ~ W wWNO ~ b oX U N ~.D z WN w 'u ?zLL z aQ c OQ r Aso G o v = U~ N v Q Wr w Ups v = N W W= ? J Q 2 ❑ W Y rn N F-Q~o chi >9 U o o'QWU x w {{yy~ O W OU N m I ❑ 0 LL W (Z {LL C J _ LL. cWi3 ' LL U U O ASSESSMENT DEFERRAL AGREEMENT T IS ASSESSMENT DEFERRAL AGREEMENT ("Agreement') is made this f~ day of n/Li ~ , 2005, by and between Randall J. Quam and Sandra K. Quam, husband and wife (hereinafter "Landowners") and the City of Eagan, a Minnesota municipal corporation (hereinafter the "City"). (Landowners and City are collectively referred to as the "Parties.") WHEREAS, Landowners are the fee owners of certain property in the City, of Eagan, County of Dakota, State of Minnesota and legally described as: Lot Seven (7), Block One (1), Barton McGray Addition (hereinafter the "Property"); and WHEREAS, as part of Public Improvement Project No. 80OR (hereinafter the "Project") the City is proposing to assess the Property for street improvement costs in the amount of $4,924.08; and WHEREAS, the City is willing to defer the assessment for a limited time in anticipation of redevelopment of the Property; and WHEREAS, Landowners are willing to accept the deferment and pay the assessment all upon the terms and conditions contained herein. NOW, THEREFORE, in consideration of the mutual promises contained herein and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the Parties do agree as follows: 1. DEFERRED ASSESSMENT. The Parties agree that the street improvement costs under the Project in the amount of $4,924.08 shall be deferred without interest until the earlier of the following: A. The Property is sold; RECEIVED - MAIL B. The Property is subdivided; C. The Property is platted; or JUL 14 2005 DAKOTA COUNTY 'TREASURER-AUDITOR D. June 1, 2008. At such time, the deferred assessment shall be payable in equal installments over a period of ten years with interest thereon at interest of seven percent (7%) per annum. 2. WAIVER. The Landowners hereby accept the deferred assessment for street improvement costs in connection with the Project in the total amount of $4,924.08. The Landowners hereby waive the right to object or appeal the assessments pursuant to MINN. STAT. § 429.081 and further waive notice of hearing on this Agreement. 3. BINDING EFFECT. This Agreement shall be binding upon and inure to the benefit of the Parties' heirs, successors and assigns and shall run with the land. CITY OF EAGAN: LANDOWNE By: By: Pat Ge an 117andall J. Q m Its: Mayor y: Sandra K. Quam Maria Petersen Its: Clerk STATE OF MINNESOTA) ) ss. COUNTY OF DAKOTA ) The foregoing instrument was acknowledged before me this (~;rjn day of 2005, by Randall J. Quam and Sandra K. Quam, husband and wife. Notary Public BMW AN NOTARY PJBILIC UC -MI NN ESOTA My Om"m B$n Ja 31.2010 STATE OF MINNESOTA) ) ss. COUNTY OF DAKOTA ) he foregoing instrument was acknowledged before me this J~4-day of U 1 L-- , 2005, by Pat Geagan and Maria Petersen, the Mayor and Clerk of the City of Eag a Minnesota municipal corporation, on behalf of the municipal corporation. N tart' P bli APPROVED AS TO FORM: / P~~ 16_ /e~- 9EIEN City Attorney's Officgg Dated: -7 ~~/oS APPROVED AS TO CONTENT: A Public Works Department Dated: -7-,, - U5"- THIS INSTRUMENT WAS DRAFTED BY: SEVERSON, SHELDON, DOUGHERTY & MOLENDA, P.A. 7300 West 147th Street, Suite 600 Apple Valley, MN 55124 (952) 432-3136 (RBB: 9206-20268) Date: April 12, 1977 BUILDING PERMIT APPLICI1T20.1 LOT 7 BLOCK 1 ADDITIOI Barton Mc Gray PARCEL & SECTION HUMBER IF UIIPLATTED ADDRF.SS.OF PARCEL 3925 Cedarview Automotive Parts 701E .dG_ GB OCCUPANCY Sales/Service USE Crown Auto Store ESTIP-wnD COS.' $150,000.00 07151 HER Sentman Enterprises, Inc. TELEPHONE NO. 835 3020 ADDRESS 7101 York Avenue South Edina Minnesota-55435 - COL,PPRACTOR 4r'nae'Y Ly c r-/n w 76) TELEPHO14B 110. ADDRESS Note-, Include site plan, building plans, and energy calculations with this application Signed C;'?ICI; USE VALU71TIOE SAC seri~ic e ✓~~ys ~ooa:,~ /f 9 X17, WAT"ZIR C0.31IECTIOA WATER 11ETER 76 b e X01;rt I/ ft / HSSP.SSPA W ~ 0 A BUILDING PER1,1IT FEB' t LE f o v SURCHARGE FEE rNLE Ce:ECK FEE PARK DEDICATIOiT FEE OTf:ER TO TAL'S //~J APPROVALS. ASSESSME:C~T CLERK,r/ .BUILDING DE -,POLICE DEPT. *.9ATER & SEB79R DEPT. FIRE DEPT. ARK DEPT. . Date: f BUILDING PERMIT APPLICATION LOT BLOCK. ADDITION PARCEL & SECTION flUMIBER IF U11PLATTED ADDRESS OF PARCEL - "ZONING CCCUPANCY A1toMOLL'iO ParUsE - ore ESTIMATED COST OWNER- Ifte3p IM, TELEPHONE NO. 335 302D ADDRESS CONTRACTOR TELEPHONE 110. ADDRESS Notes Include site plan, building plans, and energy calculations with this application Signed OFFICE USE VALUATION { SAC WATER COMECTION I I FIATER METER BUILDING PERMIT FEE SURCHARGE FEE PLAN CHECK FEE PARK DEDICATION FEE OTHER TOTAL* i APPROVALS ASSESSMENT CLERK BUILDING DEPT. POLICE DEPT. WATER & SMMM DEPT. FIRE DEPT. PARK DEPT._ - PERMIT RMIT # PETE*_ 1993 BUILDNGA PERMIT APPLICATION G 1A q 1 681-4675 • SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date 2- / 23 / X73 Valuation of work '33, ®Oa Site Address: 3ci 7-5 C_iTmLvlriL✓ paivr - izA(~AN MA) S5127 STREET SUITE # Tenant Name: (commercial only) LOT aLOCY ( sUSD. ~AR~rJ - ►YkGRAS P.I.D. * - 3-00 - o?O 0I Description of work: The applicant is: 0 Owner ❑ Contractor ❑ Other (Describe) Name Qtjp m QArJQA LL Phone 41 Sy - ~Ot 3 Property LAST FIRST Owner Address ~3Q~y CHRriiaR~r1 Aono STREET STE # City State CY1/~ Zip S 5 / Z Z Company Phone Contractor Address License # Exp. City State Zip Architect/ Company Phone Engineer Name Registration # Address City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply wit11 applicable State of Minnesota Statutes and City of Eagan Ordinances. _ ~ Signature of Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE 3 ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑.16.Basement Finish ❑ 02 SF Dwg. ❑ 07 4-Plex ❑ 12 Multi. Misc. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-Plex ❑ 13 Garage/Accessory ❑ 18 Comm./Ind. ❑ 04 SF Porch ❑ 09 12-Plex ❑ 14 Fireplace R 19 Comm./Ind. Misc. ❑ 05 SF Misc. ❑ 10 Multi. Add'l. ❑ 15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous WORK TYPE ❑ 31 New 33 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish ❑ 32 Addition ❑ 34 Repair ❑ 36 Move GENERAL INFORMATION Const. (Actual) Basement sq. ft. MWCC System (Allowable) 1st F1. sq. ft. City Water UBC Occupancy 82 yy 2nd F1. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump of Stories Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code 4/39 Depth On-site sewage SAC Code fear.. B~ APPROVALS Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ❑ Site ❑ Footing ,9 Framing ❑ Insulation ❑ Wallboard ~t Final ❑ Draintile ❑ Fireplace Permit Fee 54, 0,0 vahmtSan; Surcharge J. go Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC % SAC Units ry ''PY'mt 1 .P i ~ti d?x.D yi tl :n((.. x^yyM .Y• W it y,pg 4, i ~ ' .F YI T y1W`C t r F xtl2 Ij'L~s tl I ~ ~ i .r2 ~'k A, ~ x A _ x 1 ~+r 1 8 r5~.ti t IIa'.e' } tr ~~t1 ucu nyw I~PhI Mlplt 7t4 L i { 1 I tl5 9~ 'I s I + i A'x r f a r I j G - sewn.a . ~ . __~,'c~:wu. ~3r'e%~44' ~'tt`•t5 ~ ~ n - : xumrrveo.MniW x „e., / ` N 1. A it :At ~ ~ ~ Hau NyG h~ ~sma• N ~ Phil tl A~S ]'x r{~ { ~yy ~r . +e+a xMU Po sev. r- 1 can ~ ~ r d t , lll >~i f tl, ~ ~ ~ ~ Y Y Y ~ ,~1 ~ 11 d ♦j il~r„~ ~ jai ~ i v tl a w ,tl..,>Jr ~~wM1~ / r i. a - a V y MM1M~ /tl tiro/cu. Y. • t~Y i. 6 ~1}tq * ~t"rrx- tl yx ~ x -xn tl* bcntln r•xdo ~T it ~ w Y . 1 k: ,y ~ g , i ~y a ~ /KwSxi' NC Sgpyi~tO.m✓s ~.fbRil✓f , Y i tlw ` Y ~ ~ M/NNHS 1Q 3i 77 ~ I i~.~~y • ~ ~ r _ t 33 _r L • 1 BL CITY USE ONLY RECEIPT#: C~ I SUBD. I J CLY +0 Y~ - f)l C C--) (C<- _ RECEIPT DATE: 1 C) / APPROVED BY: INSPECTOR MECHANICAL PERMIT M 1999 MECHANICAL PERMIT (COMMERCIAL) CITYOF EAGAN 3630 PILOT KNOB RD EAGAN, MN 55122 (651) 6$1-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: CONTRACT PRICE: a 'V WORK TYPE: New construction Install U.G. Tank Interior Improvement Remove U.G. Tank (Minimum Fee) Processed Piping (Minimum Fee) "NOTE: When installing/removing underground tank, call 651-681-4675 for inspection by fire marshal and plumbing inspector. DESCRIPTION OF WORK: ZP. ov So o g al . W , o , ti FEES: 1% of contract price OR $30.00 minimum fee, whichever is greater. CONTRACT PRICE x 1% PERMIT FEE 3 G ,O O STATE SURCHARGE ($.50 per $1,000 of pgmrit fee due on all pemrits.) TOTAL 3U O ~ SITE ADDRESS: 395 ~PC~Pr v. t D r - Co 3 3 OWNER NAME: C o M ~p . S p 3 PHONE (n 5-1 - G'0 (AREA CODE) TENANT NAME (IMPROVEMENTS ONLY): IZa n d Q . a INSTALLER: Z a-i5 ti;02r, evt t Co ADDRESS: PHONE Co I Z - 3 3 I - `3 T s ° (AREA CODE) CITY: STATE: ~ ZIP: _5--.5- ~~RE O PERMITTEE 41-cftoFaagan MUNICIPAL CENTER MAINTENANCE FACILITY - THOMAS EGAN 3830 PILOT KNOB ROAD 3501 COACHMAN POINT - Mayor EAGAN, MINNESOTA 55122-1897 EAGAN, MINNESOTA 55122 PHONE: (612) 681-4600 PHONE: (612) 681.4300 PATRICIA AWADA FAX: (612) 681-4612 FAX: (612) 681.4360 PAMELA McCREA TIM PAWLENTY THEODORE WACHTER Council Members April 17, 1992 THOMAS HEDGES City Adminlnstrator EUGENE VAN OVERBEKE SAM MILLER BAG CO City Clerk MILL PLACE III BOX 1125 3RD AVENUE SO MINNEAPOLIS MN 55440 RE: STORAGE - SIGNAGE LOT 7, BLOCK 11 BARTON MCGRAY ADDITION P.I.D. #10.13700-070-01 TO WHOM IT MAY CONCERN: This letter is in reference to Eagan City Code violations occurring at the property referenced above. You are listed as the owner and therefore are the responsible party for the Northstar Surplus Outlet Store located at 3925 Sibley Memorial Highway in Eagan. I do not know if Robert Rasmussen is an agent of yours or a lessee, however City staff has been urging him to bring his business into conformance over the past several months. Violations to the zoning, sign, and fire codes have been explained at length to Mr. _ Rasmussen and adequate measures have yet to be taken to alleviate the problems. Regardless of your level of involvement with this property, as owner the City will not hesitate to take legal action to resolve this situation, To gain code compliance, the following must be addressed immediately: 1. All outside storage must be removed from the site or brought inside the building. 2. Eight of the ten signs must be removed, along with flags and pennants. The two business signs-one for each major street frontage will require a sign permit. THE LONE OAK TREE THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY Equal Opportunity/Affirmative Action Employer 1 This situation must be brought into conformance no later than April 30, 1992. Please provide me a schedule of compliance and notify me of your intent by April 24, 1992. Sincerely, Mike Ridley Zoning Administrator MR/js CC: Mike Dougherty, City Attorney Jim Sturm, City Planner Donna Rollins, Sign Inspector C71" P L9 4,; twin city testing AUG 5 1x77 am enoineerl nq lahorator4, Inc. i . 662 CROMWELL AVENUE a. ST. PAUL. MN 55114 PHONE 612/645-3601 REPORT OF: SOIL INSPECTION PROPOSED CROWN AUTO STORE S y PROJECT: HIGHWAY 13 NEAR CEDAR AVENUE DATE, August 4, 1977 EAGAN; MINNESOTA REPORTED TO: Construction 70 Inc FURNISHED BY:: 1430 W County Rd C COPIES TO: ) Eagan Township St Paul, MN 55113 / Building Inspection Dept Attn: Don Motz LABORATORY No. 9-0034 INTRODUCTION This report concerns the recent inspection and compaction testing we performed on the soil conditions at the site of the proposed Crown Auto Store in Eagan, Minnesota. Mr Don Motz authorized us to determine if the exposed soils in the excavation would provide adequate support for the intended foundation loadings. We were also requested to determine if exist- ing fill in the footing areas was sufficiently compact. CONCLUSIONS Based on the results of our hand auger borings and compaction tests, it is our opinion the foundation network included in our investigation should adequately support the design unit loadings without detrimental settlement. As deep penetration borings were not placed within the building confines, we cannot warrant the conditions beneath the depths of our shallow hand auger borings. However, based on our geological data, the likelihood of encountering inferior material at depth is very remote. Most of the material removed from the excavation will not be suitable for backfi-lling and compaction with small compaction equipment adjacent to the walls. Only a small volume of select granular fill excavated at elevations above final footing grade should be reused. For the remainder of the backfill, we suggest usage of a typical pit-run sand with no more than about 15% passing the #200 sieve. PROJECT INFORMATION We understand the building will be a one-story, slab-on-grade structure with plan dimensions of 118' x 60'. Finished floor elevation will be 100'. We understand the structure is to be supported by strip footings and column pads designed to rest on soil having an allowable bearing capacity of 2500 psf. Planned top of footing elevation varied from 96'-99.3'. We understand the subject lot was recently excavated and refilled with a compacted fill by a reputable contractor. Therefore, the foundation plan was to excavate to the designated footing elevations and place the footings on either competent natural soils or compacted fill. Soil test borings were not placed in the building area prior to construction. However, avail- able geological data indicates the surficial soils in the area consist of coarse alluvium, fine alluvium, and glacial till. AS A MUTUAL PROTECTION TO CLIENTS. THE PUBLIC AND OURSELVES. ALL REPORTS ARE SUBMITTED AS THE CONFIDENTIAL PROPERTY OF CLIENTS. AND AUTHOR. IZATION FOR PUBLICATION OF STATEMENTS. CONCLUSIONS OR EXTRACTS FROM OR REGARDING OUR REPORTS IS RESERVED PENDING OUR WRITTEN APPROVAL. twin city testinq ono enau srrvio Ieoormw,J, iuw. 662 CCROMWELL AVENUE ST ST. PAUL MN SSlla `G ~ PHONE 6121 x53601 SOIL INSPECTION x REPORT OF: DATE: August 4, 1977 LABORATORY No. 9-0034 PAGE: 2 INVESTIGATION METHODS AND RESULTS We performed visual inspections of the excavation on July 25 and 26. The exposed soils were visually classified in accordance with the Unified Soil Classification System, and estimates were made of their strength properties. Numerous shallow hand auger borings were also put down to further determine local subsurface soil conditions. Several in-place moisture-density tests were then evaluated according to the moisture-density relation of soil as designated by ASTM:D698-70 (Standard Proctor). Excavation operations were initiated on July 25 at the north end of the proposed structure. As trench excavation operations in footing areas progressed southward, seams of nonorganic, black clayey sand fill having a soft to medium consistency were discovered extending below proposed footing grade. At our direction, this material was removed in the footing trench areas. The deepest subcut area was in the northern portion of the building area. In the north footing line and in portions of the east, west, and south footing lines, approximately 3' of dense, granular, select fill was exposed at or slightly below planned bottom of foot- ing elevation. This material was found to be underlain by natural soils consisting of dense: silty sands, rather stiff clayey sands or dense gravelly sands. In order to verify that compaction of the existing fill was adequate for footing support, compaction tests were taken at various locations. Examination of test pits excavated just outside the building area indi- cated the select fill over natural soil profile extended beyond the building limits by at least 8'. Therefore, it appeared that sufficient lateral oversize (1:1 minimum) was available around the perimeter of the structure. In other footing areas, the excavation was carried down to the competent natural soils prev- iously described. A sketch, attached, indicates final subcut elevations in footing areas and also shows where the select fill network was exposed at footing grade. It was agreed that additional fill should not be placed to footing grade. Rather, the footings were to be stepped down to the elevations of competent material exposed below planned footing grade. No water was encountered in the excavation at the time of our inspection. A total of six compaction tests were obtained in the select granular fill sequence exposed at footing grade. Test results indicated compaction values of 96.5% to 102% of the Standard Proctor. The project specification require a minimum compaction value of 95% of the Standard Proctor value. COMMENTS In order to properly evaluate the foundation soils at a building site, it is imperative our firm know exactly where the building will be placed, its size and the elevation of the foun- dation elements. AS A MUTUAL PROTECTION TO CLIENTS. THE PUBLIC AND OURSELVES. ALL REPORTS AMC SUBMITTED AS THE CONPIDENTIAL PROPERTY OF CLIENTS. AND AUTHOR- IZATION FOR PUBLICATION OF STATEMENTS. CONCLUSIONS OR EXTRACTS FROM OR REGARDING OUR REPORTS 10 RESERVED PENDING OUR WRITTEN APPROVAL. twin aty testing Eno enWrw,enrW rabo"EtorEL W@C. 662 CROMWELL AVENUE SL PAUL. MN 55114 8 L§ PHONE 61216453601 ~P REPORT OP: SOIL INSPECTION Y yAY DATE: August 4, 1977 LABORATORY No. 9-0034 PAGE: 3 COMMENTS - Cont. - This project data is especially critical in situations where the excavation extends below the footing grade and compacted fill will be required to attain building excavations. In these situations, the excavation would require lateral oversizing to provide suitable lateral distribution of the footing loads. It should be noted that offset batter boards were provided for our use in the field by the contractor. It must be recognized that Twin City Testing and Engineering Laboratory Inc does not practice in the field of surveying. We, therefore, must rely on the staking done by others. If the construction is redesigned or otherwise moved subsequent to our inspection, we should be informed so our firm can assess if additional inspection work is required or suggest sound engineering alternatives. We cannot be responsible for excavation subsequent to our inspection. TWIN CITY TESTING AND ENGINEERING LABORATORY INC Leonard A Rasmussen, P.E. LAR/jb AS A MUTUAL PROTECTION TO CLIENTS, THE PUBLIC AND OURSELVES, ALL REPORTS ARE RURMITTED AS THE CONFIDENTIAL PROPERTY OF CLIENTS, AND AUTHOR- IZATION FOR PUBLICATION OF STATEMENTS, CONCLUSIONS OR EXTRACTS FROM OR REGARDING OUR REPORTS 18 RESERVED PENDING OUR WRITTEN APPROVAL. i PROPOSED CROWN AUTO STORE EAGAN, MINNESOTA #9-0034 Note: Numbers shown are approximate final elevation of bottom of trench excavation. Cross hatching indicates where the excavation terminated upon approx. 3' of dense, granular select fill. ~ a'7jI 4 f Assumed North Ed Rq,~ 8's, q0' Scale: 1" = 20' f0 twin city testinq y, - .i ano emineertm laboratory, Inc. T 662 i DEV CROMWELL AVENUE ST ST PAUL. MN SS11J PHONE 612'6453661 REPORT OF: DENSITY TESTS OF COMPACTED FILL PROPOSED CROWN AUT E PROJECT: HIGHWAY 13 NEAR CEDAR AVE DATE: July 27, I EAGAN, MINNESOTA REPORTED TO: Construction nC COPIES TO Eagan Township 70 1430 W County Rd C Attn:Bldg dg Insnspec Dept St Paul, MN 55113 Attn: Don Motz LABORATORY No. 9-0034 TEST NUMBER: 1 2 3 4 DATE TAKEN: July 26, 1977 July 26, 1977 July 26, 1977 July 26, 1977 UNIFIED SOIL CLASSIFICATION: Sand, fine Sand, fine Sand, fine Sand, fine (Moisture-Density Sample grained, a grained, a grained, trace rained, brown Number) little gravel, little gravel, of gravel, ?Sp-SM)-2 light brown light brown light brown (SP)-1 (SP)-1 (SP)-1 LOCATION: NW footing 36'E of NW NE footing 10'N of SW corner corner, along corner footing corner footing DEPTH BELOW FLOOR ELEVATION:5 1/2' 5 1/2' 5 1/2' 5 112' DEPTH BELOW EXISTING GRADE: 1/2' 1/2' 1/2' 1/2' FIELD DENSITY DETERMINATION: Method Density in Place By Sand-Cone Method, ASTM: D1556-64 (-44 Basis) Dry Density (pcf) 106.5 110 105 106 Moisture Content 3.8 2.8 4.1 4.1 Plus 04 Material (y) 13 12 4 None LABORATORY MOISTURE-DENSITY RELATION OF SOIL: Method ASTM:D698-70, Method "A", (44 Basis) Maximum Dry Density (pcf) 108.8 108.8 108.8 103.5 Optimum Moisture 14.2 14.2 14.2 15.0 COMPACTION TEST RESULTS: Compaction 98 102 96.5 102 . Specified Compaction 95 95 95 95, REMARKS: The above test locations were selected by Twin City Testing and Engineering Laboratory Inc. Compaction meets specifications in the above test areas. AS A MUTUAL PROTECTION TO CWENTS.TNE PUBLIC AND OURSELVES.ALL REPORTS ARE SUBMITTED AS THE CONFIDENTIAL PROPERTY OF CLIENTS. AND AUTHOR. IZATI ON FOR PUBLICATION OF STATEMENTS. CONCLUSIONS OR EXTRACTS FROM OR REGARDING OUR REPORTS IS RESERVED PENDING OUR WRITTEN APPROVAL Twin City Teessjri and Engineering Laboratory, Inc. By dczjg 1 tuuin city testinq ana engmeennq inDmaccru, Inc. =1, 662 CROMWELL AVENUE PHONE 612/6453601 0120 ST PAULMN 55114 REPOTESTS OF COMPACTED FILL PROPOSED CROWN AUTO S ORE PROJECT: HIGHWAY 13 NEAR CEDAR AVE DATE, July 27, 1977 EAGAN, MINNESOTA REPORTED To: Construction 70 Inc COPIES TO: 1) Eagan Township 1430 W County Rd C Attn:Bldg Inspec Dept St Paul, MN 55113 Attn: Don Motz LABORATORY No. 9-0034 TEST NUMBER: 5 6 DATE TAKEN: July 26, 1977 July 26, 1977 UNIFIED SOIL CLASSIFICATION: Sand, fine grained, Sand, fine grained, (Moisture-Density Sample brown (SP-SM)-2 trace of gravel, Number) brown (SP-SM)-2 LOCATION: 15'E of SW footing 36'W & 20'S of NE corner footing corner DEPTH BELOW FLOOR ELEVATION: 5 112' 5 1/2' DEPTH BELOW EXISTING GRADE: 6N 611 FIELD DENSITY DETERMINATION: Method Density in Place By Sand-Cone Method, ASTM: D1556-64 (414 Basis) Dry Density (pcf) 106.5 105.5 Moisture Content 3.6 2.8 Plus N4 Material None 4 LABORATORY MOISTURE-DENSITY RELATION OF SOIL: Method ASTM:D698-70, Method "A", (44 Basis) Maximum Dry Density (pcf) 103.5 108.8 Optimum Moisture (5) 15.0 14.2 COMPACTION TEST RESULTS: Compaction 102 97 Specified Compaction (90) 95 95 REMARKS: The above test locations were selected by Twin City Testing,and Engineering Laboratory Inc. Compaction meets specifications in the above test areas. AS A MUTUAL PROTECTION TO CLIENTS. THE PUBLIC AND OURSELVES, ALL REPORTS ARE SUBMITTED AS THE CON PI DEN TIAL PROPERTY OF CLIENTS. AND AUTHOR- ISATION FOR PUBLICATION OF STATEMENTS. CONCLUSIONS OR EXTRACTS FROM OR REGARDING OUR REPORTS 19 RESERVED PENDING OUR WRITTEN APPROVAL Twin City Te9t' Ond Engineer' g Laboratory, Inc. By twin city testrnq ' ana enqu manes Iabo,atani,im. 1 662 CROMWELL AVENUE 1 a ST PAUL. MN 55114 p PHONE 6121645-3601 MOISTURE - DENSITY CURVE SAMPLE NO. 1 PROPOSED CROWN AUTO STORE PROJECT: DATE: July 27, 1977 HIGHWAY 13 NEAR CEDAR AVE REPORTED TO: EAGAN, MINNESOTA COPIES TO: (See page one) Construction 70 Inc LABORATORY NO. 9-0034 METHOD OF TEST: ASTM;D698-70, Method "A" TYPE OF MATERIAL: Sand, fine grained, light brown MAXIMUM DENSITY: 108,8 111. /cit. ft. OPTIMUM MOISTURE: 14.2 %p 1 110 109 w , 1 108 r t r _ a E w W a { 2 10 ~ --i - 4 , # Y i I 10 F L... 12 13 14 15 16 17 uemmri for ~+~w~TCw~r al twin city testinq ana ergfneennq mooratarµ Inc. 662 CAOMWEU. AVENUE ST. PAUL. MN 55114 k 4 PHONE 612/645 WU MOISTURE - DENSITY CURVE SAMPLEND. 2 PROPOSED CROWN AUTO STORE PROJECT: HIGHWAY 13 NEAR CEDAR AVE DATE: July 27, 1977 REPORTED TO: EAGAN, MINNESOTA COPIES TO: (See page one) Construct on 0 Inc LABORATORY NO. 9_0034 METHOD OF TEST: Sand, fine grained, brown TYPE OF MATERIAL: ASTM:D698-70, Method "A" MAXIMUM DENSITY: 103.5 Ib. /Cll. ft. OPTIMUM MOISTURE: 15.0 %p 105 - ; , , 104 y 0 . I 103 I I i N 1 Z i W 102f--, D ~ t F. L 101 i ' j.. 100 _ I E I v { f f_. 13 14 15 _16... 17 .18 urnlcTr 1nr rrr%wrrcwrr QI April 3, 2001 Bob Kirmis, AICP Planner City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 Re: Obtaining a Motor Vehicle Dealer License Dear Mr. Kirmis: Dave Goldie and I spoke with you Monday, April 2, regarding obtaining a Motor Vehicle Dealer License in Eagan. The form we received from the State of Minnesota does not pertain to what we would be doing with a Dealer License, so I wanted to clarify our intensions. We will not be having any kind of a "lot" or showing any cars outside.. We only need a Dealer License for transferring titles. There shall be no vehicles stored or sold on the premises. I have owned my own building in Eagan since 1992 and am located at 3925 Cedarview Drive. This building is currently being used for automotive repair and this license will not increase the amount of cars in the parking lot. Please call me regarding this matter or stop by if you would like to take a look around. Sincerely,// Randall J. Quam TT C6nlpetion Engines, Inc. 3925 Cedarview Drive Eagan, MN 55122 (651) 688-6351 Use BLUE or BLACK Ink i-----------------, I For office use Ab~ C~ I Permit 9: Its of Wan a3830 Pilot Knob Road Penult Fee: ~ - I Eagan MN 55122 Date Received: Z Phone: (651) 676-5675 J I Fax: (651) 675-5694 staff; 2012 COMMERCIAL BUILDING PERMIT APPLICATION Date, I~ Site Address 3 9 a it n , Tenant Name: ~ M ' (Tenant is: New / E)dsting) Suite Former Tenant: s- Name: 6 671 ~ Y'i 0 ' Phone: PROPERTY OWNER Address / City / Zip: ~0-✓~rc f~~ . /t"/y s T/p Applicant is: Owner >4Contractor TYPE-OFWORK Description of work: Q Dir, 4 - n - Iff Construction Cost 4 s) ~O S g ' Name: t 3j, license A CONTRACTOR Address: I`I k/ 6-L P)a C. City; _ ~9eyJ State: A/y Zip: S3 Phone: 6~ ' ~f9 $ 6 7 K3 Contact: -yort o~ 141u►c U v- Email-, . l+ W c 4 Lf ✓e 4uJ C Name: Registration ARCHITECT/ Address: City: ENGINEER' State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewer/water service: 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 conclude that the -are trade secrets, CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage- Call 48 hours before you Intend to dig to receive locates of underground utilities. www.aogherstateonecall,orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit that the work will be in accordance with the approved plan in the case of rh requires a taut wand approval of plans. x ML4CII v x Applicant's Printed Name Ap nt's Signature Page 1 of 3 26e-:1 100/ZOO'd W-1 epee alp e92 seluedwo0 1ieA-10108~ 1NdOO:Z1 ZIOZ-91-80 Use BLUE or BLACK Ink r - - - - - - - - - - - - - - - - For Office Use I Permit / L2 i7 City of EaV I Permit Fee: I 3830 Pilot Knob Road I Q~ Eagan MN 55122 I Date Received: I Phone: (651) 675-5675 Fax: (651) 675-5694 I Staff: 2012 SEWER AND WATER REPAIR / DISCONNECT PERMIT Date: Fee: $60.00 City Sewer City Water Repair Disconnect Description Of Work: Street Address for Proposed Work S 2--e Name: Phone: OWNER Address / City / Zip: Applicant is: Owner Contractor Licensed Pipelayer Master Plumber Property Owner ' 7 r Phone: 1Name Address / City / Zip: L~@/✓UI /a '0 . C Pipelayer Training Certification Card or Master Plumber License I acknowledge that the information is complete and accurate and that the work ill be in formance with the ordinances and codes of the City of Eagan and the State of MN Statutes. I understand this is not perrraat, only n ap 'cation for a permit, and work is not to start without a permit. Applicant (Print Nam cant's Sign re CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org