4261 Augusta LaneCITY Of EAGAN 1NATER SERVICE PERNIIT
3p3641yot Knob Roa7d
P:"O. Box 21199 PERMiT NO.:
Eagan, MN 55121 DATE:
Zoninp: - - No. of Units:
Owner:
Addr+ess; R
Site /lddrcss:
Plumber: .? ; -}lE
Meter No.
F , , ' j-;,
srze: ?A' • at.l.?/ . _ ? . ; . _. ??c?„ F°?pqs? -'' . C!^g ?
U le ?'Yl ? f Pn` ' > ? 15 '_
Reader No.: .
1iWk F!?
' 7pd
feY? m Ph? wi14 !he Citi of Eagen Surcharge: '"?
Misc. CF?oryes:
I&L Total:
-
BY Dote PoW:
pate of Insp.: Irop.:
?v fr ?S
CITY OR EAGAN WATER SERVICE PERMR
3830 Pilot KnobAdad
P..U. Box 21199 PERMIT NO.:
Eagan, MN 55121 DNTE:
Zon1nD: - -?'- No. of Units: ?
Owner: 1:
Addreas:
Stte /?ddrcas: 4261 -!aaqUSta ?.r.. Lfi
Munber. P'?•??!;1 ` ''11mbi 4' Inc ,
MeMr No.: Connection ChorQe:
SIZQ: AccOUfIf DCpOSIt:
Reoder No.: Permit Fee:
1 pm eo oeePly wuh tlw Ciry ef Eessn Surd?orye:
Ontimaam A+1isc. CFwryes:
Totol:
BY Dote Poid:
Dote of Insp.: (nap.;
CITY OF EAGAN SEWER SERVKZ PERMIT
3830.Pilot Knob Rosd
P, O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE: ;l
Zo^j^0: ? No. of Units: ?
Owror. ?X-- •''-3; J.leZ 9 ; .
^
Addrcss:
Site Addross:
Plumber:
I pme h oeowly wil% !IM Cily oi fWO Conntction Chonpe: " 5 •' i
Oedhmeam
By _
Date
AaounM Deposit:
Permit Fee:
Surchorpe: "'
Misc. Choopes:
of I rnp.: Total:
Date Pald: -
CiTY OF EAGAN
, 3830 Ptlot Knob Road, P.O. Box 21-199, Eagae, MN 55121 PHONE: 454-8100
BUILDING rERMIT Reteipt #
T. V ur" ? ? .. IJ? li.' FN Vnhu l' V J Mn i... . _ ..
Site Addrm _
Lot f .
Parcel No. _
of NHITI@ ' ? Ok• M1LLF-R CON.7T
= Address . 313 ? ?' ?'?` l'•'' A`, F
t
?:... . _ ...? .1 h'I? . . . o?.,,.... '? 31
Name
address
Citv Phone
Name
Addreas
City Phone
10801
85
Erect U Ocwper?cy ?
Remodel ? Zoning
Repair ? Type of Conat.
Addition ? No. Stories
Move ? Length - s
Demolish ? Depth
Int Impr. ? Sq. Ft.
Install O
AoamYOls has
Assessment Permit ? JU 9. U U
Water a Sew. Surcharge 2$•
Poliu Plsn Review 5 ?2 O?
Fin gp,c 51' S. 00
Enp. Water Conn. 500 • CIO
Planner Water Meter
Council Road Unit
l ! • ?
81dg. Off. Tr. PL
APC Parka
Var. Date Copiea
`?
V
•? .
Total
'
.
on the exprtia conditbn thot
;ioto Seotutes and Clty oF Ecpon Qrdinances.
I hereby ocknawledfle that 1 haw mod fhis opplicotion ond state thot
ths infonrwtion is carcect ond oqree to comply with all applicoble
Stafe of Minr+esoto Smtutes and Gty of Eaqan Ordinonces.
5iqnoturo of Pemwtfee
:i)L
A 8uildinq Pem?it Is iuwd fo: ' oll work sholl be done in accordanta with cll opplimblo 5tata of Mlnn
Buildinp Officiol '
Pwmit No. Pwmk Holda Dan TNephone ?
Plumbin9 ff U?
H.VA.C. OG? C.G?V`? ri, I5 195 ?,0-W2-Z
Electric 64 7 ; ?. S-o
sof«er
Inweetiun Dab Insp. Other
FooUnys l - ?- ?-?
Footinqs II
Foundstion
Framinq ?7 ?
Rooflng
Rouyh Plbg. - 3
Rough Hty. y <
Insul.
Flroplaee
Final Nty. D^ ? S
Rz-
Final Pibg.
Finsl
c.rvocc.
wat.r wwib. loemon:
WNI
Sewe?
Pr. Dlsp.
1. Date
<<
`3. Job Address
c -
MECHANICAL PERMIT Permit No.
CITY OF EAGAN
FM
fill in numbened spacet S/C
Typs orpri»t legiWy Tot
2. Instsllation Cost
Lot BIk. Traci.!L,,
---T
4. Owner E;s .`_? •`-?: ?' ?s i - 1 ' - ?
5. Cantractor Phone
6. Addross ,
7. City State' Zip .
8. BuildingType: Residential E}- Cammercial O Inatitutional ?
9. Work Description: New,B' Add O Alter ? Repair ?
10. Describe Fuel Type ` .
11.
Na, Epuilamat 8TU - M. Ea.
Forced Air ? Na. Eauiament CFM
Air Handling:
Mfg. , r
Boilers
Mfg. Mech. Exhau:t
Unit Heater
Mfg. Other
? _
Air Cond. ?_ ? ?•
Mf9•
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with ell ordinances and codes governing this type of work.
?.
Signed : - ----?---? for
Rouqh F fnal
Inspectiona: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
0
CASH RECEIPT
CITY aF EAGAN
P. O. BOX 21-199
EAGAN, MINNESOTA 55121
?
DATE ' 19
R<CLIY6D t . '., . ?
FROM ? - .
AMOidNT $ y ,
& DOLLARS
1 oo
[:] CASH [] CHECK
ROR U-f.
FUND CODE AMpUNT
. ' }
?
elj J
- ' 1 !
Thank You
• ':? A
B Y
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
Rsceipt.' PLUMBING PERMIT Permit No.
CITY OF EAGAN
Foo
FiN in numbered spacet S/C
TYPe or Print leyibly Tot.
1. Date'? 2. Installation Cost
3. Job Address ? • ? ' ' "' =1 LotC-0 Blk. ? Tra
4. Owner
5. Contractor Phone
6. Address 14,
7. City, <' ? State ? Zip
8. Building Type: Residential O Commerciai 0 Institutional ?
9. Work Description: New El Add 11 Alter 11 Repair 0
10. Describe
I 11.
No. Fixtures
Water Closet No, Fixtures
Cesspool/Drainfield
Bath tubs $eptic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet other
L.aundry Tray
? Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. 1 hereby certify that the above informadon is true and correct, and I agree to
comply with all oydinfinces arid codes governing this tYpe of work.
Signed:
for
Hough F inal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
CITY OF EAGAN Remarks
Addition SLTNSET FIRST ADDITION Lot 6 Blk 1 Parcel 10 72985 060 01
Owner Street 4261 Atigusta Lane State Eagan, MN 55123
Improvement Date Amount Annuai Years E5 Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK "-js 1981 16$.57 8.43 20
SEWER LATERAL
WATEFMAIN
WATER LATERAL
WATER AREA 1981 168.57 8.43 20
STORM SEW TRK 90 1985 547.79 36.52 15 ' 7 AC1460E,
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 500.00 if
BUILDING PER. 108 it
SAC , 525.00
PARK
IRE'QUEST FOR ELECTRICAL INSPECTION ,r- ee-00001 .o4
' See instructiona ror complebng lhia form on back of yel low ropy.
Below Wwk Cnvered by Thfs Request
HAd Rep. Type oi eu,ltline ApPliancea Wired Equipment Wired
Home Range Temporary Service
Duplex 74a4er_Heater Lighting Fixtures
Apt. Bwlding Dryer Electric HeaLn
- Commercial Bldg. Fumace Silo Unloader
Industnal 81dg. Air Condrtioner Bulk Milk Tank
Parm otner Soeci y otnqr ISperHVl
t .r Sueufy Offier Other
Cnmoute Insoection Fee Below
If Fee ServiceEntrancaSize Ii Fee Feeders/5ubfeetlers k Fee Circurtg ^
? 0 to 200 Am s 0 to 30 Am s a;1:,7 '-5 ' 0 to 30 Am s
A6ove 200 qmpy' 31 to 100 Amps 31 to 700 Ai s
Sw?mming Pool Above 100-Am s Above 100_Amps
7ransiormers Irngation Booms ? .Partial-'Other_F e
Signs Speciai Inspection $
?
TOTAL F /EE
Pemerks / --X 5.)O
Rough-in " ??te ? ?
?{ I, [he Ellcal
I ? 1Y InSpeCtol, hareCy
c?aC(ty thal the nbove
Final { Date ? inspaction has baen
? made.
mor -wn, .nin 18 months from
This request void
19 momhs from
.?-
D 36 Z2 5
I Request Date '
C'7
?/, Fire No. pouph-in Insper,UOn
fieqoved?
?ReaAy Nnw?,Will No1rty Inspeo
-30
? - Q / ?Yes No tor When Ready
.{!q.Licensed Eleclncal CanVactor I hereby repuest insDaction ot ebove
? O`^'^er electrical work installed at:
Street AOdress, Boz or Route No.
`?°??/ i4u us?.? .C?9.r?E Gty
Ef?',?l.1
on o.
ecv Township Name b? Nu. Range o. Coumy
D.¢ kwT
Occ.Pant 1%11NT1 Phone No.
Power SupPher Address
? A'Ib
Electncal Contractor ICOmOany Namel
Er,-?T,VE?s
C_c, . Contrar,mr's Lir.ense No.
MailinB /1tlJress IConVacmr or Owner MakinB I?stailau?o,q
KE
Authorized SiB? wre ICon actor ner aking bstallatmn) Phone Numbur
MINNESOTA STATE 60ANO OF ELECTNICITY THIS INSPECTION REQVEST WILL NOT
Griggs.MiAway Bldg. - Room N-191 0E ACCEPTEO BV THE STATE BOAND
1821 Universitv Ave.. 5i. Paul, MN 55704 UNLESS PNOPER INSPECTION FEE IS
Phone(612)642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION es-ooooi-os
? See instrachon5 lor compleLng this torm on beck of yellow copv
0 7-7 ss-7-
"X" Be/ow Work Covered by Ihis Request
D?3 6 725
Hna Nep. Type oi e?uidnne Aooliancea wlrae? Enu,u.+e.i Wved
Home Range Ternporary Service
Duplex Water Heater Liyhtinp Fixtmes
Apt. Buflding Dryer Electric Heabn
Commercial Bldg. Fumace Silo UnloaJer
Industnal BIAy Au ConArtioner Bulk Mi Ik Tenk
Farm o[nNr peu v ther ISnr.cilv7
[ er Succily
Compute lnspecuon Fee Below 4 .?n? F> i.i/ l"`:4A/.0
p Fae SarviceEmrencaSixe b Fee Fxndere/Subleeders N Fe,e Girwrts
Oto 200 Am 5 0 to 30 qm s 0 to 30 Am os
Above 200 qmps, 31 to 100 qmps 31 to 100 Am s
Swimming Pool Above 100-Am s Above 700_Amps
Transrormers Irrigation Booms Partial Othef Fee
Signs Special Inspection S SP
Aemsrks
'- TOTAL
!
ouph-in Oane I,the Electncal
?nsoacbq heraby
certity that the abova
Final , ??e ?? inspection has been
Thin reoueel vold 1B monlhe Irom
This repuest voitl
m ?
onths trom V 7 ? ??
? 050670 L
?lS /ys
3 ? sa
Reques[ Date- Fire No. RouPh-in InspecUOn
Reqorzed? E)Reatly Nuw .II Nu??ty Inspec-
? i es ?No or When ReadY
?censed Elec[ntal ConVacmr ?rehv requast inspection of above
Owner electncel work mslalled et
Street tlares?. Box ot floute No. City
ecUOn o. Townshi0 Name' r N2 Nange No. nty
Occupant (PRINT) ,
-;::!' Phone No.
Power Suppher A?1?s
ectr cal onvact r.ICompany Name) riractor's Licenso No.
Mailine Addr ss C act r or O e akinB Instailauonl .
uthonz d Siynamre (C ractor ner akin i I ionl Phof e? SNumbe
/ J
MINNESOTq STATE BOAPO OF ELECTRICITY ? THIS INSPECTION flEnUEST WILL NOT
Griggs-Midway Bldg. - Noom N-191 BE ACCEPTED BY THE STATE BOAHD
1821 UnivarsnV Ave.. SL Peul, MN 55104 UNLE55 PHOPEfl INSPECTION FEE IS
Phone (612) 297-2111 ENCLOSED.
???•
RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
a ZsT. 75'
New Construction Reawremenis RemodeVReoairReouirements Office Use OnN
3 registe2d site surveys showing sq. fL of lot sq. ft of Iwuse; and all roofed areas 2 copies of plan _ Cert of Survey Recd
(20% maximum lot coverage allowed) 7 set of Eneqy Calculations for heated additions Tree Pres Pian Recd
2 mpies of plan showing beam 8 window sizes; poured fourid design, etc. t sile survey far additians 8 decks Tree Pres Not Reqd
1 set of Energy CalcJiatbns qddNOn - mdicate i/onade septic system _ On-sRe Septic System
3 copies of Tree Preservation PWn if lot plaHed after 7l1/93
Rim Joist Deqil Optbns selection sheel (bldgs with 3 or less unAs
Date / / 0?
Site Address ??
? ?0
ConstrucHan Cost j
UniUSte #
Description of Work
Multi-Fa V Idg _ Y_ N Fireplace(s) _ 0_ 1 _ 2
Property Owner QV ?' Ta?ephone # (6`` ) 6?F? 9F7
Contractor L?! `Q- 0"dt6? C,
Address/ ?3 SJ ol-? ? s
State fTr zFe- 67 City /Vw0w/'4
Zip S50?5 Tel'ephane #(?C.yl? `/'?t8 Q?
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Cateeorv I
• Residentiai Ventllatlon Category 1 Worksheet
submission typa) Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
A NEYM4111LDING
• New Energy Code Worksheet
\ Su6milted
Telephone #)
Telephone # (? 1 -=
Telephone #(
I hereby apply for a Residential Building Permit and aclrnowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; 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 acco ance with the approved plan in the case'of work which requires a review and
approval ?
??
-? ? ??
? ? rd, 'S
Printed Name Applicant's Signature
SOYY?
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
O 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) O 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 78 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage
? 06 04-plex ? 12 12-piex Plbg_Y Or_N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interiar) O 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FoundaGon) ? 45 . . Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement •Demolition (Entire Bldg) • Give PCA handout to applfwnt
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. ? PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS -
_ Footings(new bldg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addition) _ plumbing
_ Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Fi nal Pool Ftgs Air/Gas Tests Final
_ Framing _ Siding Stucco Stone ^
_ Fueplace _ R.I. _ Air Test _ _
Final Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
I ? M
?
2/84
's CITY OF EAGAN
APPLICATION FOR PE:LMIT
SEWER AND/OR WATER CONNECTIOri
(PLEASE PPINT)
1) PROPEfYPY ADDRESS:
rFraI. DES(--RI°TICN: lr I ?a.??F? r
(Ir?t/31ock/Suc?or Ta;c Parcel I.D. NtsrDer)
?'r' S'I'pL'CP=?E , Dr1T' 0° CPT_GIZI?i, u1I:.L`L`:G ISSUANG.:
PR=SL"-" Z^:]T,T,/P}?OPOSZD CS: ? R-1 Si1;GL: c?ySLY
? R-2 DUP".?..Y (T%'D L'.NITS)
E3 R-3 :Cl.v?iII-?Ci!SE (2?aW t L^IITS) ( Wi I^'G)
? R-4 E;^rAaU=;T/CC_'mCi.1T,jILNd ? IJ.;ITJ)
Q CCin1E.:CL-%L,/RE".i,II,/OFFICE
Q ?'CL'ST:2LU
Q LtiSTIT[,'PIC:LAI./GG=ME„'T
2) A???,Ii::.T (PLEAJE PRINI)
IVV•IE: -soe- M:lleh
?DRES5: T? 13 3 ec-0.4#. p
crrY. srtizy, zzP: ?».-„, 1 ,11 +e ?r A'Ia 55002 y
PF(:)N,E: 4/3/-
3) pu:.ffim
NPl?'IE: ?PLEASE PH1NLT}
.a
Mdtcv-?7 ??tL M Ji l+< FaR CITY OSE O4LY
rDD?ss:
8 ?3 '?'' A? v
?yas PLUXB 'LICE45E:
? Active
CITY, STATE, ZIP: ?ly Mow,?,?? ?rya ? ? x' ed
PHONE: --?''`?
Sdr9?-34'J? PlUNBER LICENSE p_a06,$ /l? 3 t of Record
•.c-v??'
' arr nici?
g J CX-'C-"C,PANP/C!'ICIEFt
NJ1ME:
ADDRESS:
CITY, STA'IE, ZIP:
PH(k`IE:
jYItNJt YN1NI/
? S,*»k. 4s a'
5) INDSG"TE WF3ZCH PERiJ1IT IS BEING RF72UESTGD:
300CCN.NF.CTION TO CI1^l SDiER
2'C01':IscrZCN 'IC) CITY WATL12
? U"iIIER (PI.F115E DFSCRIBE)
6)
. [Er`PL`aSE I?OID APPRWID PER"4IT FOR PICF:-L'P BY ONE OF ABGZIE
? PIE=SE IMAIL APPROVEp PEF:IIT T'J 1, 2. 3. 4 F1FiUVE
(Circle one)
7) SIQ,--;ZL,12E: *ItJQv.__ DATE: avA=y As
? ?ea?a?a??e?rs ar a r?a " ^' • • ?
?u ? s rt o+a+?a a.t s s ss?:a :a a? r?ra?r?i ?w a+s ? aa??ssyti ,
F 0 R
PLRMIT " ISSUED
I T Y US E ONi,Y
FEES: $ JU- ?-o
$
IO?U
$
S
S
$
$ j S .???
$
$ S. -C)
S
$
$
$
$ au
$
S
$
SE:•iE.°, PER?ITT (I`_ICL:i?: SU.°.C?:2.RGE)
WATER PEi2P1IT (Ir:CL'uDE SuRCHARGc'.)
WATER METER/COPPERHORN/OUTSZD:: READER
WATER TAP (INCLL'DE CORPORATIOV STOP)
5?;1ER TAP
:?GSy-
AC^OUNT DF.POSIT - [']ATt'3
wac
sAc
TBliVK WATER ASSL55't?E.1T
TRliV?C SE;dER <`-.SSESS:i=:iT
LATEP.AL BE:4c,FIT/TRUiIK SE?':EA
LaTERrIL BENEFIT/TRU.:K SdATrp
WATER TREATMENT PLANT SURCHARGE
OTHER:
TOTAL
AMpL'NT PAID/REC°I?T 4 _532?3T
DOES UTILZTY CONNECTION REQUIP.E EXCaVATION ZN PUSLIC RIGHT OF [dAY?
r-._, YES IF YES, THEN A"PERMIT FOR WORK WITHIN
PUBLIC ROADWAY" MUST BE ZSSUED BY THE
C] NO ENGZNEERING DIVISION. LIST AS A CONDI-
TION.
SUEJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY;
TI:Lc:
DAT_°:
0*=sa WAMG wa 0c20Mslv MUM
CITY OF EAGAN N? 10 8 01
? 3830 Pilot Krrob Road, P.O. Box 21•199, Eagan, MN 55121
"" PHONE:4548100
BUILDING PERMIT Receipt
$57.000
SF DWG/GAR AUGUST _ 14 85
Da}e
Te M m"d lor
Est, Value ?q
SiteAddresa 4261 AUGUSTA LN erect EX oacuPancy R3
SUNSET I Remodel ?
Lot 6 Block 1 Sec/Sub 2oning RZ
.
Repair ? Type of Const. v
Parcel No.
Addition ?
No.Stories
W JOE MILLER CONST Move ?
Name D
li
h ? Lenyth ?
35
; emo
s
Address 18133 CEDAR AVE Int Impr. ? Depth
Sq. Ft.
b c;ty FARMINGTONphone 431-2001 inseau ?
•1' e""'
rc
0
su
f
Nama SAME
Address
Neme
Address
City
Phona
I,SSlSSmCnf _
warer a Sew.
Polica
Fire
Erq.
Plonrwr
CAUntil
PEfrtll[ 1? 3 V 4. V V
surcna.ge 28, 50
PlanReview 152.00
5,,,C 525.00
WaterConn. 500. ?0
waterbteter 63.00
RoadUnit 280.?0
t hereby acknowled9e fhnt 1 how rcod this applicction and stare thof Bldg. Off. $ 14 /$ 5 I 7r. P. 132,00
tha inlormotion is correct and agree to comply with oll applicable APC Parks
Sfate of Minnesota Statut s d Gty of /Eo,gon'fY) Ordin?onc/es.
?')'llfl YC? ?lQ' Q QJ ` Var. Date Covias 1?984. 50
Slanoturc of Permittee
A Bullding Permit Is iuued ro: JOE MILLER CONS Total $ m }he expRU conAitiai thui
oll work shall be dona in accordonce with oll oppkcobla Stote of(f.i'rli nirwta Stotutes ond City a7 Eupon Ordironces.
BuiWinp Official
? .
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED ilITH THE CITY OF EAGAN
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
5l,cxx? °"
To Be Used For: Jn,L Valuation: ? Date: I-ao2 -,PS
Site Address: OFFICE USE ONLY
Lot: ?P Block L Sect/Sub Erect x Oceupancy
Remodel _ Zoning ?-I
Parcel ll Repair Type of Const $C
Enlarge Ik of Stories
Owner Move Length ?
Demolish Depth 3S
Address Grade Sq Ft
City/Zip Code
Phone APPROVALS
Contractor ? ssessments Permit p
? Water/Sewer Surcharge Zg_SO
Address f 3 Police Plan Review {52. '-'
Cit
Zi Fire SAC
y/
p Code Engr Water Conn
Planner Water Meter
Phone Council Road Unit 280,°°
Bldg Off ? Parks
Areh,/Engr. APC Treatment P1 13 2.'%
Address Variance
TOTAL
City/Zip Code
Phone Ik
? TRI" LANU LV.
? SURVEYING
SERVICES
EAGAN,MINNESOTA 55122 SITE
JOE MILLER PLAN FOR:
CONSTRUCTION INC.
g . ....N0°OI'4Y"W
.° ? 9. zo ., ,.
?-? --
- -j ?
s s N -
i 6 ? '
SCALE- I"=30;
: ;
,_.?. -- -
.
•:
_ I
w ? \ I W LEGAL OESCRIPTION:
O
K 1
)
?
5a I C
LOT b., gL
'
?
c
Ly
iF 7 a ION
SUNSET FIRST ADD11
,,
?
?
? ?
I
!A
i • Lt '
2 Z
M 6P1ate ?,,s?- n I
? KEY:
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I hereby certify that this survey, plan ?
or report was prepared by me or under
my direct supervision and that I am a Bradley J.
duly Re9istered.tand Surveyor under theDate:
Laws of the State'-of"Minnesota . Reg.
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,3 ?O?3 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651•681-4675
New ConshucHOn ReauIremeMs Remodel/Reoair ReauiremeMa
3 registered sHe surveys showing sq. H. of lot, sq. lf. of house
and all roofed areas (20% maximum lot eoveraae allowed)
2 eopies of plans (show beam i window sizes; poured }nd. design; etc.)
t sM of energy calculaBons
3 copies of hee presenaNOn plan H lof plaNed aHer 7/1 /93
DATE: -1 (30 I cl c1
DESCRIPTION OF WORK: TQC?r
STREET ADDRESS: L4 ab ? ?'{ H a 5
LOT: --4- BLOCK: ? SUBD./P.I.D. #:
4)I 3- 7?;'
2 copies ot plan
1sef ot energy caiculalions for heWed addttlons
7 sHe survey for extedor addkbns 3 decb
CONSTRUCTION COST: ? Ll W
PROPERTY
OWNER
Name: (v lnav^ mrw? Phone
Lasf FUt
Street
A.) .
?
?ity ?. sta,e: ?nJZIP: 55 I a?
? 3a .. '6`?
Company: ? L I vUt l..vN$f J-?(XI1in phone#: 64?
(areo code)
CONTRACTOR aao ? ? ? 8'" J ?•
Street Address: license #?1v1V}z4 7 Exp. 3 3 ??
City I'J 1 DUyA i yn State: ??U Zip: SS9010
ARCHITECT/
ENGINEER Company. Name:
Telephone #: area code (
Stree't Address: Registration #:
City
Sewer 3 wafer Iicensed plumber (reauired for new construcflon onlvl:
State:
Zip:
Penaliy appiles when address change and lot change is requested once perm i issued.
I hereby acknowiedge that I have read this appllcaHon, state that ihe informah ' s con t, n agree to comply wRh all appllcabl
State v?f Minnesota Statutes and Cify of Eagan Ordinances. ??
Signature of AppllcanY.
OFFICE U5E ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
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1999 FIREPLACE PERMIT APPLICATlON
CITY OF EAGAN
3830 PILOT KNOB ROAD - 55122
651 681-4675
Date:
Description of Work: Construct new fireplace ,Gas _Masonry _ Alteratioi:s to existing
5 /
Install gas insert only _ Install L-as line only
_ Other
TOb addr2SS: A
Lot: ? Block: Subdivision/P.I.D. #: SVt "-j-
Applicant (circle one only): Owner (on:ctor Permit Fee: $60.50
Name: n, ?. ? I Wl u W 1 ?? 1 Phone#: "-J /
PROPERTY 'tast ?` Fir
OWNER ?,
Street Address: u, ?t
FIREPLACE
INSTALLER
GAS LINE
, INSTALLER
,
cicy 60 ?N(,Vl'1 ? scaco),Xj z,:
Company: ?/ ` ??J/?-?`'1 ??r WZ? Phone #: (j.t,)-- V -07I
(area code)
Street
City
State:
Company: S WF / ?
Street
City
I hereby acknowledge that I have read this application
comply with all applicable State of MinnesotatSAtutpA;
RECEI?TE? ?
NOU 1 5 1999 ;
BY:
state
State:
zip
Phone #:
(area code)
Zip:
is correct and agree to
PERMIT # RECEIPT DATE:
2002 RESIDg1VTIAL PLUM$IN6 i'EiiM1T APPIICATION
crrY og Ea?snx
3$30 PILOT KAOB 8D
SR6AA, MR 55122
651-681-4675
Please complete for: single family dwellings, townhomes and condos when permits are required for each unit,
backflow preventer for irrigation system
SITE ADDRESS: !
OWNER NAME: : A
INSTALLER NAME:
STREET A
CITY:
_ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00
includes $40.00 County fee
Note: Additional consultant fees may apply
• MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
_ Adding fiMures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00
_ Abandonment of septic system.
_ Water turnaround - existlng dwelling unit (+ 5/8" meter'rf needed -$118)
Other:
_ RPZ: new installation/repair/rebuild $ 30.00
_ lawn irrigation system
/
water heater
ReplacemenUadditional: _ water softener Z $ 15.00
State Surcharge $ 50
I
$
-?
?4-??
?
TOtal
I hereby acknowledge that I have read this application, state that the information is correct, and agree to complywith all applicable Ciryof Eagan ordinances. It
is the applicanl's responsibility to nolify the property owner that the City of Eagan assumes no liability for an'y ndamages caused byAe City during its normal
operational and maintenance activities to the facilities consWcted under this permit wit ' ity prope / n?3i Mof-wa?ee
in /JTi f!) i
SIGNATURE OF PE
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4261 Augusta Lane
Lot: 6 Block: 1 Addition: Sunset 01st
PID:10- 72985- 060 -01
Use:
Description:
Sub Type: e - Underground Sprinklers
Work Type: Underground Sprinkler System
Description: New
Meter Size Meter Type Manufacturer
Comments: Permit closed without required inspection(s). Letter sent to applicant on 4 -7 -09. (pf)
Fee Summary:
Contractor:
Preferred Plumbing
6400 High Point Trail
Prior Lake MN 55372
(952) 447 -5761
Dan Clough
PERMIT
City of Eaan
PL - Permit Fee (Res Modifications)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
- Applicant -
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Serial Number Remote Number
Owner:
Mary Ann Quam
4261 Augusta Lane
Eagan MN 55122
$30.00 0801.4087
$0.50 9001.2195
$30.50
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
Plumbing
EA085253
08/13/2008
ePermit
Line Size
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA126178
Date Issued:08/15/2014
Permit Category:ePermit
Site Address: 4261 Augusta Lane
Lot:6 Block: 1 Addition: Sunset 1st
PID:10-72985-01-060
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Tia Lindroth
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Mary Ann Quam
4261 Augusta Lane
Eagan MN 55122
Weatherguard Construction
10860 60th St N
Stillwater MN 55082
(651) 439-4320
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA156560
Date Issued:07/08/2019
Permit Category:ePermit
Site Address: 4261 Augusta Lane
Lot:6 Block: 1 Addition: Sunset 1st
PID:10-72985-01-060
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Mary Ann Quam
4261 Augusta Lane
Eagan MN 55122
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA174475
Date Issued:01/31/2022
Permit Category:ePermit
Site Address: 4261 Augusta Lane
Lot:6 Block: 1 Addition: Sunset 1st
PID:10-72985-01-060
Use:
Description:
Sub Type:Furnace & Air Conditioner
Work Type:Replace
Description:
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Beverly Woken
4261 Augusta Ln
Saint Paul MN 55123--207
(651) 452-3376
Controlled Air
21210 Eaton Ave
Farmington MN 55024
(651) 460-6022 X253
Applicant/Permitee: Signature Issued By: Signature