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
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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'
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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
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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 - ; , ,
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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