1078 Beatrice St
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
. City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
7d ab
New ConstrucOon Reciulrements RemodeUReoair Reouirements Use Q ?4v
3 registered site surveys showing sq. ft of Eot, sq. ft. of house; and all roofed areas 2 vopies of plan C?rE?af?unr?? ?[ ` Y A!
(20°k maximum lot coverage al Iowed) 1 set of EnMy Calculations for heated additions Tre? aPr?s P'l-a?
2 copEes of plan showing beam & window sizes; poured iound design, etc. 1 site survey for additions & decks Tr9e
1 sef oi Energy Calculatians Addition - indicefe if on,site septic system
3 copies of Tree Preservation Plan 9 lot platted after 711193
Rim Joist Detail Options seleclion sheet (bldgs with 3 orless uniis
Date !0k? 16 p ro
Construction Cost ??
5ite AcEdress Unit/Ste #
?
?i
Description of Work .
r F t 41 /?
Multi-Family Bldg _ Y _ N Fireplace(s) _ D 2
r
Property Owner QL"
CLZ?? Telephone # ( R 1 °7 ) & 72 -8`DO (
?`
" ??
'?"o •??`?'°
Contractor
' ?d
Address City
State Zip Telephane # (16a) ?51; '? 7- `? ?46'
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Categorv 1 Minnesota Rules 7672
Energy Code Category • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) Submitted 5ubmitted
• Energy EnvaVope Calculations 5ubmitted
Have you previnusly constructed a building in Eagan with a similar plan? _ Y _ N ff so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # ( }
Telephone # (
Telephone # T 6 2004
I hereby apply for a Residential Building Permit and aclnowledge that the informatiCftYis-,-?t?id accurate;
that the work will be in canformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is n4t a permit, but only an application for a permit, and work is not to start without a
permit; that the wark will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
App icant's Printed 1Vame Applicant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundat3on
? 02 SF Dwelling
0 03 01 of _ plex
0 04 02-plex
? 05 D3-plex
? 06 04-plex
Work Types
? 07 05-plex ? 13 16-plex ? 20 Pool
? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
0 09 07-plex ? 17 Garage ? 22 PorchiAddn. (4-sea.)
? 10 08-plex ? 18 Dsck ? 23 Poroh (scresnlgazebo)
? 11 10-plex ? 19 Lawer Levef ? 24 Storm Damage
? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 30 Acoessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
13 36 Multi Misc.
0 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Additian 0 36 Move euilding C] 42 Demalish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Buildirrg* ? 43 Reroof ? 46 Windows/Daors
O 34 Repl2Cement "Demolition (Entire Bld g) - Give PCA handout ta applicant
Valuatian Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ Final/C.O.
_ Footings (deck) ? FinallNo C.O.
_ Footings (addirion) _ Plumbing
Foundation HVAC
Drain Tile
? ? Other
Roof _ Ice & Water _ Final _ Fool _ Ftgs _ Air/Gas Tests Final
_ Frarning Siding _ Stuccv _ Stone _ Brick
_ Fireplace _ R.I. _ Air Test ?
_ Final Windows
_ Insulation _
_ Retaining Wall
Approved By:
Base Fee
Surcharge
Plan Review
MCIES SAC
City SAC
Utility Connection Charge
5&W Permit & Surcharge
Treatment Pfant
License Search
Capies
Other
Total
Building Inspector
CITY OF EAGAN
CASHIER: JS TERMINAL NO: 765
DATE: 08/14/00 TIME: 14: 55:24
ID:
NAME: ABC SEAMLESS NEWPORT
3210 9001 1078 BEATRICE S 139.25
2155 9001 "1078 BEATRICE S 3.50
3210 9001 3984 BERYL RD 335.25
2155 9001 3984 BERYL RD 10.50
3210 9001 4733 COVINGTON 223.25
2155 9001 4733 COVINGTON 6.50
Total Receipt Amount: 718.25
CR135742
USER ID: JAN
***************************************
41-im
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
C,TY oF ??? V-15
3830 PILOT KNQB RD - 35122
??
851-681-4875
R
? 3 nqistaied dta survoys 3E1owirly tq. R ot lot, sc1. R. of fouse 2 Copios ot PlM
and go rootod arqas QQ`6 maximur IoE covercKm allowadl 1 sgt at onarQy cokxalEons lor heaftd adcflilans
D 2 coplds d' Plms (thow bOCm & wlndow sites; Pourod fnd. dedpn; 91C.) 1tle awoy for qxiedor qdcliiOns & deGka
D 1 wt at onergy oaltxdations
D 3 ooples d irea praservc3llon plpn it bt pldtFed aAkar 7/1/93
DATE: CONSIRUCTION COST: 4V,,9 4??
DESCRIPTION OF WORK: ?.51c&. ------
STREET ADDRESS: b ?,4 rc
LOt: I? BLOCK: SUBD./P.LD. #: hAC VeCJ
PROPERIY
OWNER
GoNTRAcroR
ARCHITECT/
ENGINEER
N0mA: -7'o h ai.!5 PhOne i:
Last Fimt
Street Address: /D k :EZ-1 a rI cit 9?
City 5#ate: Zip:
CamPQny:A -R_g., S?a m Iz s s Phona C ?a - o'K Y y
(area catle) .
sfrevt acldress: 55 -a ucense # 1786 Exp. c, )
4'Ify Sfote: air 2ip:
Company:
t
Telephone #: ( 3
Name:
! Sireel Address: itegistraflan #:
city
Stats?: Zip:
SeweNwater iicenssd plumber (if installtr?a sWverMraterl: Phorse #: {-
I hereby aclcnowledqe 4hat I hava read lhis appficaHcn, alate itxg Ihe Infcmtatbn ic correct, and agrae to oomphr wHh ol appliooble State
vf Minneaota StahtFes and City o( EoQan Ordiruances.
SiprKturs of Appticdnt
OFFICE U3E ONLY
Gertiflcates of Survey Received Yes No
Tree Preservation Plan Received Yes No
Not Required
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
0 01 Foundation a 07 05-pleX
0 02 SF Gwelling p 48 06-plex
13 03 01 af plex 0 09 07-pfex
0 oa az-p? ? 10 os-plex
? 05 03-plex ? 11 10-plex
13 06 04-pleac O 12 72-pfex
woRK rYPE
0 31 New
O 32 Additian
E3 33 Alteration
? 34 Repair
0 93 16-plex O
? 17 Garage O
17 18 Deck C]
O 19 Lower Level p
PIDg Y or _ N 0
['J 20 Pool p
f ?
? r
0 34 Fxt. A!t - Muld
? 33 Ext. Aft - SF
O 36 MutU
29 Porch (3-sea.)
22 Pvrch/Addn. (4sea.)
23 Porch (screened)
24 Storm Damage
25 Miscsllaneous
30 Accessary Bldg.
13 36 Move Bldg. [] 43 Reroof
? 37 Demalish (Bldg)t ? 44 Siding
E3 38 C)emolish (Interior) 0 45 Fire Repair
13 42 Demolish (Foundation) p 46 WindowslUoars
' Give PCA handaut to appi[cant for demalition permit
GENERAL INFORMATION
SAC Code
No. of Units
No. of Buildings
Consi. (Actuai)
(Allowable)
UBC Occupancy
Zoning
# of Stories
LenSth
INidth
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
MISCELLANEOUS INSPECTIONS
E3 Stucco/Stone
APPROVAtS
Planning Building
Permit Fee
Surcharge
Rlan Review
License
MC/ES SAC
cicy sAc
Water Conn.
Water Meter
Acct. Depasit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Qed.
Other
Gopies
Total:
sq. ft.
sq. ft.
Footprint sq. ft.
Census Cade
NlCfES System
City W ater
Booster Pwmp
PRV
Fire Sprinklered
Engineering Variance
Valuatian: $
I
?
SAC Units
96 SAC
? GITY (JF EAGAN
3830 Pilot Knob Road
Eagan, Mlinnesota 55123
(612) 681-4675
SiTE ADDRESS:
1078 g?ATRxcE sT
LoT: 13 sLocKe 3
MCKEE 1ST
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
P.I,N.: 10-47750-130-03
DESCRIPTION:
Bu3.i r1q::fe1i
8uijd1 ng..,?
(MAC SAUIWD INSUL)
ermxt Type 5F (MISG.)
b,r,k Type ALTERATIQN
BurLDxr?G
025104
02/09J9S
?
s ? &
.. W ?•n
REIU'IARKS:
A SEPHRATE PERMIT TS REQUIRECI FQR ANY PL.lJMBING OR ELECTRTCAL WORK
FEE SUI'VlMARV:
VALUATIQN $11,000
Base Fee $126.60
Plan Review $81.90
Surcharge $5.50
Total Fee $213.40
CONTRACTUR: - AP P L i ? ? ? t - ST . LIC- O1rNNER:
hICQUIS7AN C[1N5T CCt INC 19480884 0003304 Tt16IAS I.ORRAINE
11551 ZIqN FiD 1078 BEA7RICE 5"C
BLqOMIPJGTC)N MN 55437 EAGAN hIN 55121
(612) 948--0884 (612)454-4186
4e appl?t4ft,ion ;ff"hs.tat e tli
Ly W?.,th A'?.I ap?aI ic6 EJA?;
Paw, RIPIJ I
IS ED B: SI AT R
INSPECTION RECOR.D
CITY C)F EAGAN PERMIT TYPE: a?ILDING
3830 Pilot Knob Road Fermit Number: 025104
Eagan, Minnesota 55123 Date Issued: 02}09 p 9 5
(612) 681-4675
SITE ADDRESS: L tl T: 13 BLa c K: 3 i°?PPLICANT:
107a eE,arRIcE sT McauzsTAN Gorrsr co TNc
MCKEE 1ST (612) 948-0884
PERMIIT SUBTYPE:
sF (MISc.)
TYPE QF VWORK:
ALTERATInfV
DEscRrPTIoN (Mac souNa IeasuL)
INSPECTiON
FRAMING ,. .
RQUGH ZN PLBG ..
ROUGH IN HT6 FINAL
REMARKSs A SEPARATE PERMIT IS REqUZRED FOR APIY PLUMBING Ofi ELECTRICAL WORK
..
? .
_ ., . .
e
? ., ,
. = -- ciTr vF EaGatu
3830 PILQT KNt)B RD - 56722
1995 BUILDlNG PERMIT APPLICATIi3N 1RESIDENTIAL)
.
6814676
+ ? ??ere, ? ?? ? ? ??? of plm
* 2 copies of plars (itm{ude bearn 8 windaw aizes; pourecl fnd. deaign; W.} ? 2 site eurMs *ftr1a' adtkions & decks}
? i energy cskulaffm ? 1ernergy t:afc.ufOt?ns iar Ieatect addftns
? i h8e preservaion plm if lot platted aRer 711193
requind: _ Yes _ No
ZQ. ?....`?? . .?
QATE: CONSTRWCTiOM COST: - - - ? ?
DESCRIPTi4N OF WORK:
S"TREET AUDRESS:
?Z'?o
GGt lfskA
r
Z-4zp- JL
!GT ? BLOCK ?5SUBD.fP.I:D. #:
PROPERTIf
OVVVNNER
CONTRI4CTOR
ARCHlTEGT!
ENGlNEER
Name: Phone #:
Street Address• /4 ? 9
Cityy. g? State: ,.?.._ zip:
Company: ML`„ 42&A4AI!t? Phane #:
Street Address:
4
t9 -- ' LICBfiBe
City- ?
Company:
Name:
Phone #-
Registratiort #'
Street Address• . ?.-
City. S#ate: ? Zip'
3ewer 8 water licensad plurnber: Penatty applies Swhen aftm change ond lot
change are requested once permit is issued.
I hereby ac?€nowfedge thafi 1 har+e read this appkaWnr and stabe that ft iMormation is tornect and agnee to compty with stll
appiicabie &tate ot Minnesata Statutes and Ci€y of Eagan Ordinances. ,M` / 1-1
OFFlCE USE DNLY
Certificates of Sunrey Recaimd
Tree Preservativn Plan RecohAed
Signature of Appficant:
Yer Na
Yes „,_ No
BU1LDlNG RERMIT TYPE
t')FFtCE USE ONLY
Y$ar40"tp
v 01 Faundation o 86 Dupiex o 19 Apt:fLodging o 16 Besement Finish
o' 02 SF Dvuelling o 0? 4-plex ? 12 N'lulti (Misc.) ? 17 Wm C'ool
0 43 SF Addi#cm ? 48 $-plex o 13 Garage/Awessory ca 20 PubUc Facility
o 04 SF Porch o 09 12-plex ? 14 Fireplace 0 27 Miscellanecus
t,?5 SF Misc. a 10 AAufti (additional) o 15 Qeck
WflRK TYPE
0 31 Wew 6563 Aiiterations ? 38 Move
0 32 Addititm o 34 Repair 0 37 Demcrlition
GENERAL INFflRMAT1ON
Ccnst. (Actual) Basemmnt sq. ft. ? MCMlS System ?
(ADowable) Main 1e"l sq. ft +City Water ?
UBC Occupancy sq. ft. ? F?re SpriralEWed ?
Zoning sc!• ft PRV
# a# Sturies ?sq. ft. ? Sooster F'utip
Lergth sq. ft. ? Cenm Cocle. y
Depth ? Footpritrt sq. ft. ? SAC Code v/
Census Bldg
?
Census Urdt
APPROVALS
Planning ? Building ? E?gineering ? Varisnce
Permit Fee tlaituation: $ 11400 Surcharge
Pian Review
Licxnse
MCAAlS SAG
Gity SAC
Vlfater Cann.
Water Meter
Atx#. t7epoeft
SJIAf Perrnft
S/UV Surcharge
Tre2ktmerrt PI.
Road Unrt
Park Ded.
Trails Ded.
Other
Gopies
Total:
?
% SAC
SAC Units
CITY USE ONLY r?o
LOT ? BL ? RECEIPT #: a?
SUBD. AA - RECEIPT DATE:. OU ' -
MECHArTICAL PERMIT #
MECH4NICAL PERMIT (RMIDEN1'IAL)
crrY of Esu
S$SO PILOT KNOB iiD
EltfiFtN b!N 551 ES
(651) 6$1-46?5
Date: ,..-
.
Complete this section onlv if you are installing HVAC in a single family dwelling, townhome or condo under
construction and not owner /occu ied.
. ,
? H'dr1C: 0-100 MB i U $ 30.00
ADDITIONAL 50 M BTU 6.00
? Gas outlets (minimum of one required @$3.00 ea.)
State Surchazge .50 '
Total $
4
Complete this section on if you are remodeling, adding to, or repairing an existing single family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or repair.
New X Alteration Repair ? Other
Reminder: Ca11681-4675 for inspections.
_4- Fumace
Air exchanger
STTE ADDRESS: 1 ic;'
Air conditioning
Other
$ 34.00
State Surcharge .50
Minimum Total Due $ 30.50
_r
OWNER NAMb• • PHOIVE #:
INSTALLER NAME: ?.: - ' " ? .-._i r`?1 (aREA ODE) "
PHONE #:
.
(AREA CODE)
STREET ADDRESS:
?
CITY: 4?Y-} ?- ? STATE: ZIP:
? SIGNATURE OF PE9M[ITTEE,_-;`
..' . f ,
CITY USE ONLY
L BL RECEIPT #:
SUBD. RECEIPT DATE:
APPROVED BY: , iNSPECTOR MECHANICAL PERMIT #:
1999 MECiii4NICAI. PERMTT (COMM£EtCIAI.)
CITY OF E4fiAN
S$SO PILOT KNOB gD
EAW, biN 55188
(651) 6$1-4675
-,
Piease complete for: all commerciaUndustrial bui(d(ngs
multl-famlly buildings when separate pennlts are = required for each dwelling unit
DATE: CONTRACT PRICE:
WORK TYPE: New construction Install U.G. Tank
Int?e ior 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.
4
DESCRIPTION OF WORK:
FEES: 1% of contract price QA $30.00 minimum fee, whichever is greater.
CONTR.AGT PRICE x 1%
PERMIT FEE
STATE SURCHARGE
TOTAL
SI'TE ADDRESS:
($.SO per $1,000 of m tu fee due on all permits.)
OWNER NAME: PHONE #: -
(AREA CODE)
TENANT NAME (IIvIPROVErTENTS ONL1):
INSTALLER: ?
.
ADDRESS: ' PHOIVF, #: -
(AREA CODE)
CIT'Y: STATE: ZIP;
\
SIGNATURE OF PERMITTEE
sE# zooa Raoe:10 ss-so-eo Xvs-x
. ,
?'-
?
MUNZCIPAL NOTICL 010 WELL PSRMIT APPLICATION
DAKCTA COUNTY BNVIRQNMENTAL MANAGONROT DEPARTMgNT
WATSR AND Id4ND MANAGEMSNT 3$GTION
14955 G1alaucie Avenue West, Apple Valley, MN 55124
Tel (612) 891-7011 Fax (612) 891-7031
DiAT8: March 09, 95
T0: Tom Colbert/Wayne Schwana
Municipality s Eagan Pax #t (612) 681-4512
PROM: Water and Land Management
ItS: Well Psrmft # e 95-9445
Well Type: Sealing
Reviewer : Luehrs
NQTiCE:
The Watex and Land Management Section of the Dakota Caunty Erivironmeneal
Management Department has reaeived the following psrmit applfcatian for
the are 11 desaribEd. If you require futher revfew of the apglication or
if you have any queeCions or concerns about it, ccntaat the 8nviranmentaX
specialiat listed above or our office at (612) 891-7011. It there in no
response fxom your o#fice within 24 HOUR9 (excluding weekende and
hol3dgys), we will aasume that you have no objections to the isa?uar?ce of
fihe permit. Pleaae note that permit issuance is always conditioned pn
the permit appl.icanvs obeervance vf arid aamp liance wlth all applicabie
iaws and codas. A aopy ot the weii permit will be forwarcted to your
office when completed.
wsLL comr= cToR zNPoRrrmTioN :
Johnson and 8ons Drilling
Agplicatian Received: 03(p8/95
Anticipatec3 Drilling/Sealing Date if knawn: 03/10/95 Time: .
LOCATION 4F WELL:
PL3 Coordinatee U. SW W, $W 'g, NW U, Sec 2, Town 27 , Range 23
We11 Location 1078 Beatrice St
Prop erty owaer Riak Tabias
We].1 Owaer Rick Tobias
PID Numbez - - -
WELL INFCRMATION:
Diameter 4
Caaing de tb 135
Total dep?h 140
$TiQL 1Q5
Aquifer unaonBOlidated eediments
COMMSTiT3 :
Z 3Wd :ftj oSf'!-m ti1m :QI 9E: £t 96, GO/EO
EAGAN TaWNSHIP
3795 Pilot Knob F.oad
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTiON
D ATE • M?.rQ112., 1!268?
OWNEP.: _ Ra„ym4nd Tobias
NUMBER 127
Address 1078 Beatrice - ` - r
PLUMBER All State Plb,g. TYPE OF PIPE cast iron R,
DESCRIPTION OF BUIIDING
Industriall Commerciall Residential I Mu].tiple Dwelling I No. of units
X
Location of Connections:
Connection Charge 8200.00 Pd. 3/12/68
PermiC Fee 7•50 "
SCreet Repairs
Total 207,50
"
Iaspected by:
Date
Remarks•
By
Chief Inspector
In consideration of the issue and delivery to me of the above pem3.t, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota
?
e
PI.Qa4e r.otif.y t.,hen ready for inspection and conn^cxion ard before any portioa
o'x' t•hL wcrk is covered.
EAGAN TOWNSHIP
3795 Pilot Kaob Road
St. Paul, Minnesota 55111
Telephane 454-5242
PERMIT FOR WATER SERVICE CONNECTION
,Number: 'j4
Date• March 12. 1968
Billing Name: Ra:ymond Tobias Site Address; 1078 Beatrice Oamer: above Billing Address
Plumber; All State Plbg.
Location of Connection
?
Building is a:
Residence X
Mu1Ciple No. Units
Commercial
Industrial
Other
In consideration of the issue and delivery to me oE Che above permit, I
hereby agree to do the proposed work in accordance with the rules and
regalations of Eagaa Towaship, Dakota Countq, Minnesota.
By;
l '
/
Please notify the above office when ready for inspection and connectioa.
Meter Size
tion
. 200.00 Pa 2/12/68
Meter No. Permit Fee 7.50
Meter ReadingNieter Dep. 15•00 "
MeCer Sealed: Yes- Add'1 Chg.
NO Tota 1 Chg._222,, 5()
Inspected by
Date
Remarks:
By: ww?ri I?? i
Chief Iaspector
CITY OF EAGAN Remarks
Addition McKee Addition #1 Loc 13 Blk 3 Parcel 10 47750 130 03
Owner ? Street1078 Beatrice St. State EaQan, MN 55121
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
I STREET RESTOR. pgV1ri 1969 $31?..50 $31.15 10
GRADING
bSAN SEW TRUNK 1968 $100. 00 $3.33 30
.t SEWER LATERAL 1 20
WATERMAIN
? WATER LATERAL br S? 1968 850.00 42.50 2
WATER AREA
STORM SEW TRK 1984 403.00 26.87 15 403.00 G 8195 8-1-83
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET UGNT
WATER CONN. 00 677
- '
BUILDING PER. r
5AC 200.
0 677 31168
- '
PARK
INSPECTIaN RECORD
CITY OF EAGAN PERMITITYPE:
3830 Pilot Knob Road Permit Numiber: 0 2'510 4 ?
Eagan, Minnesota 55123 Date Ismd:
(612)681-4675
SITE ADDRESS: i,? i t.c ?i t?i, h ; APPLICANT:
1 4 ? : ? k5 t s r- A i i; ! i t i h i i . (iI i ! ? ; t A 1+! q: rJ N`: f t: () I N C
M r?.. 1 i J"• 1 t ?., .! .' )'#?J t-t ? ?) .i ? t 3)
PERMIT ?UBTYPE:
. t- ? h! " f }
TrPe oF wa?c?C:
A i.IERq'i'T(aM
( MAt' sAUMiI INS1ll. )
7 P'i2AMlid??
• J3t?s??;t? 11V k'l 1?ii
w
'Ql,1t3M f?+ tl
t 1IdAI
i,f MnErh:?; A ',I i'd11tr1lE I'r r;M I i 1?: flt 1) 4i I trt• Ir ? utx ANrT P i lfMtiiWf cik U if C;tFrlCAl Wc1RK
- PNaNt Ms. - , _#60!biiw Daft Tdepmna 4f
SIW
PLUMBNO
i
F'ounduNeri
fi'?"
RovWq
ftuoft
IsuL
Flnel Fiq.
+Q?at iYel
Rnd Pft Pb9• kwpeftr-NaiYiy Plurnber
CGnmt maier
EnWJP1an
?? AV*- ?
Dedc Fig.
Deck Fir?al
YIfeN
Pr. Mp.
--)7/24 gav4-
" EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454 -5242
PERMIT FOR WATER SERVICE CONNECTION
Date• M�sroh 1�- '- 1968
Number: 4
• Site Address: 1 8 pwatrine
u Tobin
Billing Name: — F
Owner:
�boq Billing Address
Plumber: All state Plbg
p. �.�• d 2/12/68
Meter Size Connection Chg. ... --
Location of Connection ��50
71 4/ d/ Meter No.� �??! Permit Fee � "
15•�
Meter Reading_____ _ •
Meter Dep.�� --
Meter Sealed: Yes Add'1
3(` 3,a1= f , NO Total Chg,
0
Inspected by
Date i2 /6g
Building is a:
Remarks: 4
Residence =
Multiple _ No. Units
Commercial
Industrial
BY: Chief Inspector
In consideration of the issue and delivery to we of the above permit, I
hereby agree to do tbe proposed work in accordance with, the rules and
regulations of Eagan Township, Dakota County,
By:
Please notify the above office when ready for inspection and connection.