595 Autumn Oaks Ct Use BLUE or BLACK Ink
r-----------------
I For Office Use �
I �'] f �
C7� O� �n n n j Permit#: � �� + � / I
i Y Q�Qli I I
� Permit Fee: �
I
3830 Pilot Knob Road � �jd��� i
Eagan MN 55122 � Date Received: �
Phone: (651) 675-5675 I �
Fax: (651) 675-5694 I Staff: I
�—————— ——————————I
;
20�4 RESIDENTIAL PLUMBING PERnnir aPP�ica iorv
Date: ���l Site Address:��_� /�<���U,�.c�r� �� �'�,S CI c.�v'
Tenant: Suite#:
r
Resident/Owner Name: � �� �� v^ �i�. c� � � �'' Pnone:
Address�/City/Zip:��� ��`C.-��V'1 V�1 U S o�1��-�----
\ f � j --L.c�.L.—
Name: �i� (�,�t ��t i License#: �
� /
COt1�1'aCtOt'I , ' Address: .� �`�` City: G :_�
State: i�,/� Zip: J� � Phone:___�� ^�(�� >( � �
r � l i (
Contact: �1C,1 !� ��� Email: �t< ( C,r��-, �L� G���
4
���
Type Of WOt'k —New _Replacement _Repair _Rebuild �Mo ify Space _Work in R.O.W. C�
Description of work: � � � . ��t/` f/ c� C�c�c c �
RESIDENTIAL
Water Heater
Water Softener
Lawn Irrigation �RPZ/_PVB)
Permit Type: ) I
Septic System �L Add Plumbing Fixtures�Main/ l Lower Level)
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge)
$60.00 Lawn Irrigation (includes$5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround*(includes$5.00 State Surcharge)
"Water Turnaround (add$200.00 if a 5/8"meter is required)
$115.00 Septic System New($10.00 per as built) (includes County fee and$5.00 State Surcharge)
TOTAL FEES $
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.qopherstateonecall.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 work which requires a review and approv I of lans.
x � � tt � �U./l �,� `�' �,/''� X /�
ApplicanYs Printed Name Ap icanY gnature
FOR OFFiCE USE Reviewed'By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
Meter Related Items: `Meter Size Radio Read Manorneter ' Staff:
•.? , .
CITY OF EAGAN
_ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
rPHONE: 454-8100
BUILDING PERMIT Receipt # , ro be used ror DECK Est. Value i 1 .000 Date MwY 20
Site Address 39S AUftHO (IAK.S CT
Lot 12 . Block _2 Sec/Sub. COt111T4Y NDL1.di
Parcel No.
W Name tiC[ ELLIS
; Address 593 rurrM oAK.s cr
° City F.wGAt1 Phone 683-0165
,o Name BOERQZ' HUSSi
Address 2091 VISU@NIM iR
Z~
U ¢
? City ?'-wW Phone 456-0S6?
UW Name
W W
0 ; Address
<W City Phone
I hereby acknowlege that I have read
information is correct and agree to G
Minnesota Statutes and City Of Eagary(
r
Signature of Permitee ?
A Building Permit is issued to: R(
Building ONicial
ation and state that the
all applicable State of
e in accordance with all
Eagan Ordinances.
OFFICE USE ONLY
Occupancy 1Mr- FEES
Zoning _
(Actual) Const - Bldg. Permit 2s-00
(Allowable) _
Suroharge A1
# or stories
Length Plan Review
Deplh SAC, Cily
S.F. Total -
SAC, MCWCC
S.F. Footprints _
On Site Sewage _ Water Cann
On Site Well - Water Meter
MWCC System _
City Water
_
ct. Deposil
Ac
PRV Required _ S/W Permit
Boasler Pump - 51W Surcharge
Treatment PI
APPROVALS Road Unit
Planner
- park Ded.
Council
BIdg.ON. _ CoPies
Variance - TOTAL 23.30
Permit No. Permk Holder Data Talephons +M
WI,TER
SEWER
PLUM8ING
H.VA.C.
ELECTRIC
Inapection Date Insp. Comments
Footings I
Foundation
Framing
Rooting
Rough Plbg.
Rough Htg.
Isul.
Fireplaoe
Final Htg.
Orstat Test
Final Plbg. Plbg. Inspector - Notily Plumber
Const. Meter
EngrJPlan
Bldg. Fnal
Deck Ftg. S a !f/
Dedc Final ` S p/ S
Weil
Pr. Disp.
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used for `-' nVCf GAR Est. Value s 111 ? OtJ'? Date
Site Address '}45 AUTU?(`i {;A}CS CT
Lot Biock a SeGSub. ?OUwrRY BOLLAW
Parcel No.
W Name =:LILIF CON$'fRU(;'!'1:)ii
o Address
City Phone 4??143F
, o Name
?Q Address
Ir
CitV Phone
Name _
Address
Phone
I hereby acknowlege that I have read this application and state that the
informa6on is cwrect and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Permitee
A Building Permit is issued to: 6LILF L' ?•'??'`-'?' o•?C-110N
on the express condition that ail work shall be done in accordance with all
applicable State of Minnesota Statutes and Ciry of Eagan Ordinances.
?i: .1 .6 ?''7
OFFICE USE ONLY
Occupancy FEES
Zonfng k` t
(Actual) Const V-lq Bldg. Permit 6 7 $ - -31--
(Albwable) V-m Surcharge 5S - 5o
# ot Stories -
Length Plan Review 3 19- Ck
Depth SAC, City 1clin-'-??
S.F.Total - SAC,MCWCC 5 7 S•`?V
S.E Footprints
On Site Sewage -
_
Water Conn
?80 -GL•
On Site Well - Water Meter 90•00
MWCC System x.X__ ?
City Water A Acc
t• Oeposit }
?• ?
PRV Reqwred uX.- S,'W Permit
'.`•U
Booster Pump S/W Surcharge 1• n??
? TreatmentPl 228.w
APPROVALS Road Unit 340.00
Planner - park Ded.
Council
BIdg.OH. _ Copies
Variance - TOTAL ? - '? ? r • ?"?
Permit No. PermR Holder Date Telephone #
WATER
SEWER
PLUMBING 9,
????v 'w ,,:.? ? 10 4189 ? ao
H.V.A.C. C' " O ° ^ ? Ci ?o '
?
3I 0
ELECTRIC t?''7144 O ? - •. >tC. .3 /419
Inspsction Date Insp. Comments
Foo6ngs I
Foundation
Framing wj?
Roofwg
Rough PIh9.
Rough Htg. 3' 13
lsui. 3? 2 b 9 5 i? 1--7.v- -.,- 5,1".
Frepiace v-wA
Fnal Htg.
Fnal Plbg. '_?' _ h_•? I ii'
Const. Meter Plbg. Inspeclor - Notify Plumber
Engr./Plan
Bidg. Final 'iX
Deck Ftg.
Deck Final
Well
Pr. Disp.
. •
•?
Trr#tftrate uf (OrrupaMry :
Citp ot (Eagan
aPval'bmf of ilIltibl" jttlwP1'1iDti
This Cerrificate issued pursuant to the requiriencenu of Section 306 of the Uniform Building
Code certifying that at lhe time of issaance this strucrure was in compliance wrtJi rhe various
ordinances of the City regulating building rnnstruction or use. For the following.•
c?e cimeaaoo MWIGAR Bldg, pe,,oii No, 16127
o-PMKT Tra R3/M 1 zoning Douia R) Tra con$L VN
Owner o[ Buildiegffi'II'? OMMM M=N pddrrss ? ?M(R Cr+ ?
?IcHN Addrm 595 AIMN QAKS 00[1RT ,,;tyL12, B2, OQINlRY H3I0W
o.k: 0ORW'J.t 19, 1989
Building
POST IN A CONSPICUOUS PLACE
--,? .
PLUMBING PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
PMONE: 454-8100
Site Address " ' -) -j '/17 .%
Lot ' <' Block f SeciSub
Name
m
?o Address
c City Phone
Name
3 Address p City Phone `
- FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $2Q.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
SIGNATURE OF
-? ?
FOR: CITY OF
PERMIT #
;
RECEIPT #
DATE:
BLDG. TYPE WORK DESCRIPTION
Res. New _
Mult. Add-on
Comm. Repair .
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NQ. FIXTURES TOTAL
-Water Closet - $3.00 $
- Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1 .50
Whiripool - $300
Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
?r
'
?_Rough Openings - $1.50
FEE: ` z
STATE S/C:
GRAND TOTAL•
. PERMIT #
MECHANICAL PERMIT RECEIPT #
CITY OF EA(iAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: ?
CONTRACT PRICE PHONE: 454-e100 For Office Use Only:
Site Address BLDG. TYPE WORK DESCRIPTION
Lot Block - Sec/Sub Res. New
MuR. Add-on
m Name
A Comm. Repair
?o
c ddress
City
Phone
Other
FEES
? Name RES. HVAC 0-100 M BTU - $24.00
c Address `i -?-° ADDITIONAL 50 M BTU - 6.00
p Ciry Phone? "y (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1
50 EA
.
.
TYPE OF WORK COMMIIND FEE - 1% OF CONTRACT FEE
Forced Air ?.<2^ M BTU ?`° •? ' APT. BLDGS. - COMM. RATE APPUES
C
OS
ES
RATE APPUES
OND
- R
.
TOWNHOUSE 8
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Heater ? M BTU REMODELS - 12.00
MINIMUM COMMERCIAL FEE - 20
00
Air Cond. M BTU
T .
STATE SURCHARGE PER PERMIT - .50
Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping OuUets # $ BEYOND $1,000) '
Other ?
FEE
..
SIGNATURE OF PERMITTEE
S/C: ?
TOTAL• FOR: CITY OF EAGAN !
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILD?4G PERMIT Receipt #
To be used tor Est. Value Date_
N'. 1V 127
Site Address 5`- 5 Al;'l dl?lt5 C'T
Lot I M1 Block ? Sec/Sub. ?OtTN'i'RY H4LLOW
Parcel No.
W Name B?•jLIE CO3ti51'RIICTIUti
3r Address 644 .;t'?E4.IGR f:'f
°• City EkE;A\ Phone 4.54--;438
"' Name
_e
g? Address
Nity Phone
?
yVj W Name
H
U ; Address
i W City Phone
I hereby acknowlege that I have read this application and state that the
inlamation is correct and agree to comply with all appiicable Slate of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Permitee
A Building Permit is issued to: =•? ? ? ? ? ? ???h? ?ryI ? ??
on the express condition that all work shall be done in aocordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
8uilding Official
OFFICE USE ONLY
Occupancy R" 3 L7 1 FEES
Zoning :: 1
(Actual) Const V-? Bidg. Permit 678•00
(Albwable) V-N Surcnarge 55.50
# of stories
Length
58,
Plan Review 339.00
Depth 481 SAC, GitY 100.00
S.F.Total - SAC,MCWCC 575•00
S.F. Footprints -
5'' U• 00
On 5ite Sewage _ Water Conn
On Sile Well - Water Meter 90•00
hewCCSystem LL-
?
Acct. Deposit 30.?0
Ciry Water
XX
S
N
P
i
2C • DO
PRV Requirad erm
.
V
t
Booster Pump - S!W Surcharge 1.00
Treatment PI 22$ • c-
APPROYALS Road Unit 340.OC
Planner - Park Dad.
Council -
BIdg.Oft. _ Copies
Varianoe - TOTAL 3 ? 035. gli
DATE: 2/16/89 /
RE? 595 AUZVMI OAKS CT., L12, B3, -OUN?Rif? RQLIAW ADD.
X Ylur Sewer & Water Permit for the above property has been completed. It will be held at the
Nblic Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
I-6ALL PUBLIC WORKS (454,5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannot be completed for the following
' reasons:
. ;
? Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or xcupancy allowed until further notice.
' COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before isSUanCe.
...
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POUCY.
Secretary, Building Inspections Dept.
DATE:
2/16/89
R. . 595 AUTU2iN OAKS CT., L12, B2, COUNTaY HOLIAiI MD..
xx ?
Your Sewer & Water Permit tor the above property has been completed. it will be held at the
Rublic Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TQ
PALL PUBUC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannot be completed for the following
reasons:
a?
? Your Sewer & Water PeRnit for the above property has been completed, but the meter cannat
be issued or occupancy allowed until further notice.
i
COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter sixe must be
contirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454=8100) before issuance.
WARNING: SEFORE DIGGING, CALI LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
: - REGIUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
P.O. Box 24; 99
Eagan, MN 55121
SITE ADDRESS _
LOT ;_= BLOCK
` r -t- SEWER - WATER - TAPS
APPUCkNT: e"' c
ADDRESS: COMNUIND - RESIDENTIAL
CITY, STATE ZIP
PHONE: 14 NEW - EXISTING
PLUMBER: • r ?? _ r • ? i ' ,
ADDRESS: _ s? 5101 I AGREE TO COMPLY WITN CITY OF
CITY, STATE EAGAN ORDINANCES:
PHONE:
OWNER: _
ADDRESS:_
CITY, STATE
PHONE: -
OFFICE USE ONLY
PERMIT DATE / 1 v/8 r,
WATER PERMIT # SEWER PERMIT #
METER # B.P. RECEIPT # = i 1 1?
READER # B.P. RECEIPT DATE 9IL'I
METER SIZE
ISSUE DATE - PRV _ BOOSTER PUMP
PERMIT REQUESTED
ZIP
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TYVO WORKING DAYS FOR PROCESSING. FOR STORM SEWER PERMITS, CONTACT
ENGINEERING DEPT.
CITY OF EAGAN PERMIT # -
CONTRACT 3830 pILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT #
PRICE PHONE 454-8100 DATE: ?
Site
Lot _
? Name
? Address 5`? S
cjlv j-- ?f ? u Il
N
C ..? E
?,.'c...I n CJGk *.> C I
k _ Sec/Sub _
L l? S
-? ?.{ ? ct rn vl O g? s
Phone 6 9.%
C
BLDG. TYPE WORK DESCRIPTION
Res. ? New x
Mult. Add-0n
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURE3 TOTAL
Water Closet - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
UrinaUBidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
1Nhirlpool - $3.00
Gas Piping Oudets - $1.50
(MINIMUM -1 PER PERMIT)
Softener - $5.00
Well - $10.60
Private Disp. - $10.00
Rough Openings - $1.50
? U. G. SprinWer System - $12.00
PERMIT FEE:
V'`" STATES S/C:
GRAND TOTAL: ? Z •'??
FEES
COMMJIND. FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APLLIES
MINIMUM - RESIDENTIAL FEE $12.00
MINIMUM - COMM.IND./FEE $20.00
STATE SURCHARGE PER PERMIT .50
(ADD $.50 S/C PER EACH $1,000 OF PERMIT FEE)
J /o
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
P.O. Box 21199
Eagan, MN 55121
WATER
SEWER PERMIT #
B.P. RECEIPT # B.P. RECEIPT DATE
OFFICE USE ONLY
PERMIT DATE
METER SIZE
ISSUE DATE
SITEADDRESS 5`-45 AI1TlJMN O9K5 CT
LOT .L_- BLOCK := SEC/SUB
?? -
? APPLICANT: ; oL
ADDRESS: ` r ---
CITY, S rATE ? ZIP
PHONE:
PLUMBER:
? ADDRESS: _ - ;a ¢? ? • <--.c ? ?i r 1
CITY, STATE _ _ , . f • ZIP - - , PHONE:
OWNER:._
ADDRESS:_
CITY. STATE
PHONE:
i-X PRV - BOOSTER PUMP
y
PERMIT REQUESTED
ZIP
SEWER '- WATER - TAPS
- COMM/IND = RESIDENTIAL
= NEW _ EXISTING
I AGREE TO COMPLY WITH CITY Of
EAGAN ORDINANCES:
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. FOR STORM SEWER PERAAITS, CONTACT
ENGINEERING DEPT.
CITY OF EAGAN N? 16127
? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt # ?
To be used for SF DWG/GAR Est Value $111,000 Date 1989
Site Address 595 AlITi1MN OAKS C.T
Lot 12 Block Z Sec/Sub. COUNTRY HOLLOW
Parcel No.
w Name BLILIE CONSTRUCTION
Address 644 SUPERIOR CT
o City EAGA N Phone 454-1438
o Name SAME
?u< Address
City Phone
U?
Name
?w
i; Address
aw City PhOne
I hereby acknowlege that I have read this applicahon and state that the
iniormation is correct and agree to comply with all apphcable State of
Minnesota Stawtes and i,ry, of-AEagan O?rdlnpan?ce?s.
Signature of Permilee _? ?w?1 $YA3-XX-
A Bwlding Permit is issued to: BLILIE CONSTRUCTION
on the ezpress condition ihat all woik shall be done in accortlance with all
applicable State of Minnesota!1StaWt1es antl Ciry,! of Eagan Ordinances.
Builtling Official ???? 1'A • 1 ? .? I
OFFICE USE ONLY
Oaupancy R-3 1-1 FEES
Zoning K--l
(ACtual) Const V=N Bltlg. Permit 678.00
(Allowabie) V=N
Surcharge
55.50
# of Stones
Length 58 ' Plan Review 339.00
Oepth ?+8 ? SAQ City 100.00
SF Total - SAC.MCWCC $75.00
S.F Fooiprints -
`
580
00
On Sle Sewage _ Nater Conn .
On Site well - Water Meler 90.00
MWCC Sys[em xl_
3
Qry Water
7IX qcct. Deposd 0.00
PRV Required XX_ SIW Pertnit 20.00
Boosler Pump - S;W Surcharge 1.00
Treatment PI 228.00
APPROVALS Road Und
Planner - paB Detl.
Council -
Bldg Off _ CoPias
Variance - TOTAL 3,036.50
BLyD PERMITNO. /?r/?
/ LCL-?{C.hza-? 4&?6
' 07-3210 Bldg. Permit
01-3422 Plan Check
01-3445 Surch./Adm.
01-3446 SAC/Adm.
01-2155 Surcharge
75-3860 Road Unit
20-2275 SAC
203665 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 SewerConn.
28-3855 Park Ded.
TOTAL
O AO
:4:?-
? ol
i C/9 n/?
7/rs?/? r 9??,sc
? 1 47 51 / . - )?u?ltc
RequescDate C
2^ ? ^?/` 7
? Fire 140. Rougtr' n pedion
Requi '+
?eaay Now ? WII Nonfy Inspecmr
R
d
?
?? M
0 ? Ves o an
ea
y
I?+y licensed contractor ? owner
i' hereby request inspection of above electncal work at:
Jab Atldress (Sireet, Box ar Route NoJ Ciry
?? 0jit- ?
Seclion No Townsh,p Name Or No Raige No County
Oxup (PRINn Phore No.
1
?
P e ppl r Address /
Eledr?rsl Conlrecfot (CO any Na ) ConVaclor5 License No.
D 39 3
Meih AOtlress (COn r or Owner Ma ' g Insfailatiai)
?
od- ?J
` 51-lz 3 /
Authonz Sign re( oMrador Ins Ilatron) v Phone Numher
?zo -3l2?S-
NINNESOTA STAiE BOARD OF ELECTAICffY / THIS INSPECTION REQUEST WIIL NOT
OrlggaMlNray Bltlg. - Room S-173 BE ACCEPTED eV THE STATE BOARD
1821 Univenity Ave., St Paul, MN 55104 UNlESS PROPER INSPECrIDN FEE IS
Phone(fi12)6C2-OBOp ENCLOSED
j?Zrl REQUEST FOR ELECTRICAL INSPECTION
? See insVUqwns for completing Ihis fom an DaW ol yellow copy
? 14 751 X" Below Work Covered by This Request
' -0oom-07
%W ,'/'s0
e Atld Rep TypeofBUilding AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt Bwlding Dryer Other (Specity)
Comm./Industnal Furnace
Farm Air Condilioner
Other (spealy) Con nor§ Remer? \
Compute lnspectian Fee Below:
# Ofher Fee # ServiceEntrenceSize Fee # Cirewis/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps ? Above 100 _ Amps
SigpS Inspector5 Use Only. 7p S
irtigation eooms rJ . OJ
Speaal Inspection
Alarm/Communicaiion
O[her Fee
I, the Elechical Inspector, hereby
tif
th
t
h
b Rough-in oate
cer
y
a
t
e a
ove inspection has
been made. F,nei oare :
OFFICE USE ONLY
This request wW 18 moMhs from
This reavest wid
18,nion[hs ITom
D 36948
j -/? _&?'
Lwensed Electncal Coniractnr
' I harebv reauest insDection of abova
electncel work installed aO
5[reat AtlAress, Box or Ravte No.
d V L!ti/ CitY
eciwn o. Townsrip Name or Nn. Range No. C
O apaM fPBINT)N ?
?
?.ewr Phone No.
er uppl ? ? Addre
E ma
I ConyarJUC (CompanY Namqj
n f?1L..
1
CO tra 3ictor's L1cense N
G i-
MailinB!lddress IConVactor or Owner MaWng I tailauonl
?13? S?3 3 7
Authonze ig^a re 1 a r wn Maki InstallaUnonl Phone Number
no -3 )ar
?i c? s7
irp No. uph-?n Inspecbon I
q reA? ?Aeady Now ill Nouty Inspec-
Vos nNo r When qeadY
MINNESOTA S ATE BOAHD OF ELECTRICIY TNIS INSPECTION NEQUEST WILL NO7
? BE ACCEPTEO 9Y THE STqTE BOAHD
Grup9s•Midwev BIdB• - poom N•791 UNLESS PNOPEP INSPECTION FEE IS
1821 Universitv Ava.. St. Peul. MN 55104
Phona (612) 642-0800 ENCLOSEO.
REQUEST FOR ELECTRICAL INSPECTION ee-ooooi-os
I , See instructions far compledn9 this form on back of Yellow copy. 4 5VI,n5'7
D 3 6 g48 "X" Below Work Covered by 7his Request
de R.P. Tyoe oi auimine aooiLoncen wi.ee Ea.iume.i Wi.xd
Home Ranye Temporery Service
Duplex Water FYeater Lightiny Rxtwes
Apt Bwlding Oryei Electnc Heabn
Commercial Bldy. Fumace Silo UnIUaJer
Industrial BIAg, qv Condrtioner Bulk MiIk Tank
FHrm thrr peri y Oth"r (Spr.cify)
[ nr Sueci y Other plh.r
c,ompute lnspection Fee 8e/ow
N Fee ServicaEntrancaSize
U to 200 qm s
A6ove 200 qinps 8 Fee Fexders/Subfeaders
0 to 30 qm ?s
31 to 700 qinps N rt
^ Cvcwts
0 tn 30 Am s
31 to 100 A s
Swmvning Pool Above 100_Amps Above 100_/a?nUs
Trensrormers Irrigation Booms Partial- Ot
Sig?s
Special Inspecnon
Nerryrks TOTA FEE7, ?
NouBh-m ?'11e
I. the Elecincel
InSpBCtoq herg
y
n
Final cerldy that tha bove
a
i? ?
mspec4on hes been
meGe.
1llqf8qY89[v010
? CITY OF EAGAN N? 19083
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used fOr DECK Est. Value $1,000 Date I1AY 20 ,1991
Site Address 595 AUTUMN OAKS CT
Lot 12 Block 2 Sec/Sub. COUNTRY HOLLOW OFFICE USE ONLV
PefCBI NO. Occupancy M-Z FEES
Zomng _
w Name RICK ELLIS (ACWapConst - BIdg.Permit 75-00
; Address 595 AUTUFIN OAKS CT tNlowable) -
50
0 S??cna?qe _
City EA? Phone 683-0165 x of sto??es
16, Plan Review
lergth
o Name ROBERT HUSER oePin 16' snc
city
i Address 2091 VIBURNUM TR S.F.Total ,
u? Crty EAGAN Phone 456-0564 $F FOOtprinis _ SAC,MCWCC
Water Conn
On Site Sawage _
? W
w Name on sae weii
-
W
t
M
t
w er
a
er
e
s-' Addfess MwCCSyslem -
Qi
a W
City Phone
ciry waier
_ Aat Oeposit
i
S/W
PRV RequirBtl - Parm
t
I hereby acknowlege that I have read this applicaaon and state that ihe Booster Pump - SnN Surcharge
information is correct and agree to co
rth all applicable State ol
Minnesota Statutes and Ci} I g
Ores.
E Trealment PI
?
Signature of Permitee ?C!
w APPROVALS Road Unit
A Building Permit is issued to: ROBERT HUSER Plenner - park Ded.
on the express condition thal all work shall be done in accordance with all Council
applicaDle State of M
innesota Statutes and
it
C
y ot Eagan Ordinances. gla9_ pff _ Copies
?
?
?,
)
IL1Nl,(?R?I ?y rf'[?
Builtling Oflicial .?
Variance
-
TOTAL
25.50
-I CnA5
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
so .50
ck.,,,. 3rz3
Date Iq r Z3 I D`-J
Site Street Address ???IY]/\ V[.?1 S? Unit #
Property Owner ZuJYYS soa"u{, WC{ar yV,V-1- Telephone# (LSI )99q-IT 7°IS
Contrector Teiephone # ( )
Address City State Zip
The Applicant is: Owner _ Contractor _Other
Alterations to existing dwelling
? Add plumbing fixtures. This fee includes putting in a water softener and/or water $ 50.00
heater at the same time. !f rLou are insfallinq onlv a water softener and/or wafer
heater, do not complete this section. Move to the next section and check the
appliance(s) you are installing.
_Septic System Abandonment
_ Water Turnaround (add $125.00 if a 5/8" meter is required)
Other:
Water Softener Water Heater $ 15.00
_ new _ replacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ 50
Total $SB. SU
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
th vent a plan is required to be reviewed and approved.
G ?
A licant's Printed Name App' afit' ig ature
I -Io°°
2005 RESIDENTIAL BUILDING PERMIT APPLICATION C k"?. 3 r Z 3
City Of Eagan C, /au
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Conshuclion Reauiremenls RemodeUReoair Reauiremants Office Use Onlv
3 registered site surveys showirg sq. ft. of lot, sq. lt of house; and all roofed areas 2 tropies of plan CeA of Survey Recd _ Y_ N
(20%maximum btwvarage aflawed) t se[ af Energy CalcWations for heated additions Tree Pres Ppn Recd _Y _ N.
2 copies of plan showing beam & window sizes; poured found design, efc. 7 site survey for additions & decks Tree Pres Requi2d _ Y_ N
1 set of Eneigy Calculations AddiNon - irMicate iI on-sRe septk sysfem On-sfle Septic Syslem _ Y_ N
3 copies of T2e P2servatbn Poan'rf lot platted afler 711193
Rim Joist Defal Options seledlon sheel (buildings wBh 3 or less units)
Date I_ / 2- 2, / 0 CT Construction Cost 5f9U77
Site Address 7 q5 il4)AIY? UnidSte #
Description of Work F,.;1
c
4,?.,!2,
?PAfC?
?,[d?xNn?L,2
.. On 161401-
?
, 1
Multi-Family Bidg _ YX N Fireplace(s) _ 0?K 1 _ 2
PropertyOwner ,d,un<S s MA ln ii? (JVnnijc. Telephone#((pS?
Contractor
Address City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Catecorv 1 _ Minnesota Rules 7672
Energy Code Category . Residential Ventila6on Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
In the last 12 months, has ihe City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Telephone #(
Mechanicai Contractor
Sewer/Water Contractor
Telephone # ( )
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the 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 accordance with the approved plan in the case of work which requires a review and
approval of plans.
K2N2,,e
A licant'sPrintedName A c n S ature '3 2005
I?,BY- -
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex PIbglf-Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
t? 33 Alteration ? 37 Demolish Building" ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement 'Demalidon (Entire Bldg) - G ive PCA handout to applicant
Valuation ,yb 0 0 Occupancy MCES System
Plan Review 100% or 25%
Census Code Zoning City Water
SAC Units ? Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs / Length Fire Sprinklered
Type of Const 7 Width
_ Footings (new bldg)
_ Footings(deck)
_ Footings (addition)
Foundation
Drain Tile
Roof _ Ice & Water _ Final
? Framing
Fireplace _ R.I. _ Air Test _ Final
? Insulation
n Df
Approved By: guilding Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
REQUIRED INSPECTIONS
FinaVC.O.
? Final/No C.O.
? Plumbing
? HVAC
Other
_ Pool Ftgs AidGas Tests Final
_ Siding _ Stucco _ Stone _ Brick
_ Windows
_ Retaining Wall
.
.
1989 BOILDING PEffiiIT APPLICATION - CITY OF EAGAN
3ItaGLE FAMILY DWELLINGS I G ? 2 11
7NCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTEs ADDRESSFS FOR CORNER LOTS - CONTRACTOR/HOMEOWNfiR M03T DESIGNATE WHICH ADDRFSS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BiIILDING PERMIT IS ISSOED.
M[TLTIPLE DWELLINGS RENTAL ONITS FOR SALE ONIT3 # OF UNIT3
INCLUDE 2 SETS OF PLANS, CERTIFIC9TE OF SIIRVEY - CHECK WITH HLDG. DEPT., 1 SET OF ENERGY
CALCULATIONS
COMAfERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
- - , ?B 1 0 198?
To Be Used For: Valuation: ? Date: z^ ?''^B
Site Address
Lot L Bloek
Parcel/Sub
Owner
Address
City/Zip Code
Phone
Contractor`?'L , L, ST
Address 4 1+ ? K (ls-!-t
City/Zip Code Oc.q,f,?.?_ ? y--?
?
Phone ?J5 `{ • ( 4 2-
Arch./Engr. _
Address
City/Zip Code
Phone #
ll l, DDa' -----
Occupancy -R 3 M.I FE€S
Zoning R-I
Actual Const V-N Bldg. Permit
Allowable Y-N Surcharge
# of stories Plan Review
Length SAC, City
Depth y8 SAC, MWCC
S.F. Total Water Conn
Footprint S.F . Water Meter
Aeet. Deposit
On site sewage_ S/W Permit
On site well S/W Sureharge
MWCC System ? Treatment P1.
City water 7? Road Unit
PRV required Park Ded.
Booster Pump _ Copies
TOTAL
APPROVALS
Planner
Couneil
Bldg. Off.
Variance
Council .
NOTE: Sewer & Water Permit fees and aecount deposit fees will be included in the building
permit fee. Processing time for sexer and vater permits is txo days once a licsenaed
plumber has applied Por a permit at City 8a11.
1/A Lu AT IO?J
G ra
Zox Zz. = yU?
1o x zo= 2?
?--
?y0 u!S'- 9G00
1?USC?T
-----
2?;?c ?? ? 8S4
I 2 y
-, = ? z
Isb X ??f= z IS96
I sT FLonP?
2X7_ - t4
^r
o a
3 _: ..
,?
o•,.
fi7N•OU+
s7•5o+
3s9•ou*
r?s6a•ou+
3036•50*
679•OU+
55•5U+
33J•OU+
1Y964•OU+
3, t1S6•5U*
.
COINySTR
'. I p ?4180 `
' i., .. . .
g?ca ° 123.21 N - =
? N 89°55 08 W za. i
oa B.C.
DRAINAGE ?
? p i - - - - - - - - - - - - ??o EASEMENT H?
Wo ?s
$il' 16 4 /. . ? .
w ,?.
(7 3 ? ? ` 34 DRAINA6E 9 ,
/ UTILITY EASEMENT
0 N I? 1 ?
M e ROq?3 ?. bipJ
U/??IhrG N .
O ti : I h MN
'. 2??'? I? q?, 16 N ?2
W ?NOER,.
_ 9.38
12 btir. rD NSr `:''. " .
m
io
a M L Da?
132 hf r`ld•??:a?i?a?'?:+=??
cqti "J
?q,?y sGMm `_81.12r Re32 Oa?.a''?
dDf4°OS'2 e?a? RE???R?I
-? • M? _ ? - .
r QU1" UMN
.:. OqKS =-
.
}Proposed Basement Floor Elev :a e20.0<:,:'.. ., ,
C ::`.,.,,•: ??:?;°: > :: ,? :-;>-:?;:;.-.?._'w .::.: .--_
Proposed Garage Floor Elev
Preposed First Floor E3ev
Proposed Elev BEARINGSSROWN'ARE_TH8 SAME AS
Exfsting Elev 8oao S80wN ON':TBE.RECORDED PLAT;::. .
`i hereby certify that this is a true and -
f o Denotee??rIron'`Floitument Set
correct representation of a aucvey o o Denotes-,Iron;NOnument Found
:the boundaries of:
x Denotes Spike Set =: •?;•.,
Lot 12 Block 2,. COUNTRY HOLLOW,
- o Denotes.6ub Set_,
Denotes Surface'Drainage
according to the recorded plat _
the[eof, Dakota County, Minnesota, 0 15 30 60
and of a proposed building.'°As surveyed
by- me or under my direct supervision SCALE IN FEET
eY
CBe
1989
*
%
v
,
,
da of F
.
this
?-, "
;S PROGRESS ENGINEERING, INC
-
c Av .-
Lelana C.N. smith, Lana surveyor CONSULTING ENGINEERS
Minnesota Reqistration No. 14942
Copyright: 14300 NICOLLET COURT
Reproduction of this drawing prohibited SUITE 235
without Written approval of the above BURNSVILLE, MN55337
aigned.
'1'
EXTERIOR ENVELOPE AUERAGE "U" COPIPUTATION
04lNER
SITE ADORESS I.-t>T I Z ?jLoc.t Z. Cvw+.-r?? ?.
CONTRACTOR L/G/c'' CG1l/17- DATE
PHONE
Determine working square footage of each.
l. Total exposed wall area ...... .21 sq- ft. x-1L
2. Total roof/ceiling area ...... /? b 7 sq. ft. x_026
Total exposed wall area above floor = /9oy _
a. Total wall window area ...........................
6. Total door area ................................. 77
c. Total sliding glass door area ............ .... _ 3u
d. Total fireplace wall area ....... ... ......:..... 2 D
e. Total wall framing area (average 10%)...'......... .
f. Total net wall area above floor .................
g. Total rim joist area ............................ /1S-O
Total ezposed foundation area = f/ 7
'-'
h. Total foundation window arca.....................
i. Toal net foundation area abcve grade ............ ?
Determine "U" value cf each iaall segment.
a. /52.74 x "u" 't 51 = 791 ?Ia
b. ??n7 X .-U.- ,1?73 = 4t-65
c. 30 x liu° , SS = ?G • So
a. x ,.U„ , -72 = Iy?yO
e. x "u" 'aF
f. /o5193 13 z llu° • 0y = 526, 93
g. 45 V X ,tu„
h. " X liull
i . //? X fouil
3 . ...................................Total = PJ y 2
If item #3 is the same as, or less than item kl, you have met the intent
of 58C 6006(c)2.
' .,
• wAU'scr.r:oNs
»OTE: use 154, of opaquc wall.area Por
frame construction
e
l, rio i
/ 1 • D rG?'/ . ?/S
_.
3, ?i.nches soft 14001
4. ? P 2 41
S. _ !/rF1 Z?,'idiiYG • B/
6. 8xterior air film ? 0.17
Total //' 4?S
FRAt1E F1ALL
Construction R-Value
l.
2.
3.
4.
5.
6.
ll= • a y
1.
2.
3.
4.
5.
6.
F00.7JD?.TICN
4IALI.
FIG. Y3
? ` ?,s?
. o _ _ . ? •
. ?
? _ . • . • :
o . • -/ - ? b '
i F. v
1. interior air film 0.68
7 . 7• G'?
• 3. 1?' '.svif 2il
• 4.
5.
• 6. 8xterior air film 0.17
Total
SLAB ON GRAD2
? , ? . . .
???1?? ?? ?( • ? ? ? • ? ?• ??• :.
Irr " ? ' e •, . ' i?i =
/[1 ? ', • • ??l
" ' •'///
FIG. #4 ' ? • ? • ?
i(1 6 •. o '//I ?
x-
NOTE: Indicate type, "?:" value, denth and
placenent of insulation.
r.
Paqe Three
ROOF/CEILING ,
? . - . . : `'??!"• Conatruction R-Valuo
J?
FU3 4 1. InGer or air film ' 0.61
2. ?tl!//r! •S&
3. 71WW441r
4. Fxterior air film (still 0.61
. vmlr ?Ill ??.? t ?i11(? Total
. '\\? '?J ? 't?= ' °?S , •
Vented Heat flow
uP . .
FIG. 95
1. Interior ai Film
2.
3.
4. Er.teriur air lm
0.61
1.
2.
3.
4.
5.
Not-c:' Use additional sheets if more space is
needed for details and calculal-ions.
.
I Heat flow up -vented
FIC. 116' . .
; _ ovn-r,:a.acu 1 r .
. Heat ?
, flov up '
FLA. 47 , .
Totat exposed roof/ceiling area = /GJ 7
J. Total skylight area .............................
k. Total roof/ceiling framing area (average
1. Total net insulated raof/ceiling area........... / S/.3o
Determine "U" value for each roof/ceiling segment.
X Pull
k. i6 jA-? X„?„
i: /sr?• 3 x iiuoi
4 ..................................Tota1
If total of p4 is the same as, or less than #2, you have met the intent of
SBC 6006(01.
Alternate Building Envelope Design
7o utilize the total envelope system method, the values established by the
sum of items #3 and #4 shall not he greater than the sum of items dl and #2.
+ z. ;2 .??
3, ?09?89 +a.
. . 140t3
1991 SIIILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
MULTIPLE DWELLINGS
?-- Date: 5 /?%
i
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCUTATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
_# OF RENTAL UNITS
_# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY IAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSIIED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER M[IST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALIAWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER 6 WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For:
Site Address
?c^Ck ??y va?luation:
C.i?P?
(-
Lot j & Block 1i
Parcel/Sub eoAouUvq
Owner IL" ?'.(?llry _ K
Address ?A6 W tvMhV?O'\ a
City/Zip Code
Phone (.(/7/°J
Contractor Ww-:t
Address ?;i 141h04WO `1A)U
City/Zip Code ?? (LALU •
Phone "rd((/" (J6:JlPd+
Arch./Engr.
Address
City/Zip Code
Phone #
OFFICE USE ONLY
Occupancy M' 2+
Zoning
Actual Const
Allowable
# of stories
Length
Depth ?
S.F. Total
Footprint S.F.
On site sewage_
On site well _
MWCC System _
City water _
PRV _
Booster Pump _
APPROVAIS
Planner _
Couttcil
Bldg. Off. E13?/2'/
Variance
COMMERCIAL
FEES
Bldg. Permit
Surcharge ,SO
Plan Review
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Acct. Deposit
S/w Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trail Ded.
Copies
SUBTOTAL
Penalty
Lot Change
TOTAL 16-50
i4j ?w agrees that all work shall be done in accordance with
(Signa ure of Contractor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
i.
? . '
i UNOER
CONS7. ?
?419p
123.21
:,, ?:'. ' , • 4 ? .
- ?• ?I -ez.:?o3 ?2.6 ?? ? N 89°55'08°W
04 B.C. . ; ,
ORAINA(iE ,{ .
EASEMENT'; i,
,? ?? ?? ,? ,?? ? •?. ;?,5:
' "?v'?? ? ? •? ' ? 9 ? ? ?.
1e
W 3 ' . i • ? 34
. ? '... C7 ' ?: IDRNWWE
P ,
,?/ UfILITY EASEMENT
RO
r ?
pos
BVlCOQ D N I,
•_•: . . 2fo-P.
?ER ., ?,?:.,,,..,•, :
W COAt
. •S,T .ra:,..?y,.??p:d':??G?:.:G(i ??'t ,
n ., • ?
..Er
a
,.
: ..: _
L ??/ . Q O f fy.' ( d't? ?^?I'?: ?: ''? • ... .
'•Txi • ? _ "? ?i?..? ? 4:r'::..C„ : ?...I i' j;?. ;:. .
^ , . ? ` ?? M? _ .?:tilio?f",?.' . . ?i?;..I:.i.S:• .,?` .,?
y ' .. ... rai..; '•
T? ? ? . ? .. • _ .iJ'? . • .
?-=81.IQ _ `?.
Nci
R_32 .',? •J'I ? . ',:4,;'
4 ?"
p?
?'%? v ..t?:;,;:•;::;'.'?;??'.
y:1u,,A}4a1-,^'r'??•?5,?°.`y.r{'rt"': . ??''•?j' :??i?;i(?L.' ..?¢.;?t?'i:.:
auruMN
2tyv.« j-[.k?.ir?e???
:o?sed'Basement+'{Ploor?iEleva.e2oAt,?;?:,::..;._ :C"
'?'poaed Gatage F1oor BLev ??4??.ak,? T E 4 r'
Preposed"PirsE Ploor..E3ev •s2eA:?=.:...... _,.;?,;;a._c?t..;:.,?;-_?:_:..:
'^;;-Proposed Elev BEARIHGS SBpW????RS'T8S' ?SA?1E 7?8
; 8xisting • Elev SHOW? ?1t?CORDED PL71T
..?, J'y'? :`P[':'`. "?? ??F t. ,.t' ..w-:.1?:.,. 1`.?':::i,+,;°`;::.^;j ?"?: • ,.
.. . .. ;,...?, t .., t
. •?r:!'i=,hereby certifyrthat this.is:.a:stiue,and!, .. „ : ;::.,.:t..?,?qf,,;?+:•,.?;ri„?;.,::?:..;-;;..,,?;,:;i.':?.
_ o Deno?e , Monument ?: Se > .
;. eorrect . representation !of „ a survey. of
' tbe.;boundariea oFs ': . "`:"°;' •:+ " •lDenoLes::IYOa•,Moi?ument:=FOUnd
Denotes:Spike??Set._:;;;:?;:?.:; ..:.:
,
., EOt.:L? . ?..83ock ' 2 i... CW?ITRY-.HOCLOW Deaote
,r according to Ehe recorded p3at .?--- Denote? Surface Diainage
-ttieceof,'. Dakota . . County. Minneaota, 30 60' . .
,? and ? ? ? -? : ..........:: . .
;
` ???:.:'?=?'';•of .a, `proposed buildiag. 1?s"surveyed . .,, ..•
•. y m?,or under `my direct aupervision LE IN FEET "
this da of F£Bem??eY . 1989.
c Av PROGRESP ENGINEgRING, INC
Leland C.N. smith, Land Sutveyor CONSULTING ENGINEERS
xinnesota Regiatration No. 14942 ,
Copyrights?`, 14304 NICOLLET COURT
?8eproduction of this drawing prohibited ISUITE 235 ,
?. :)9ilhout . written'spproval of the above BURNSVILLE, MN55337
? aiqned.
O
s tn"!
^ Ity OF
89-1436
3830 PILOT KNOB ROAD 4 a 6 6 7
EAGAN, MINNESOTA 55122-1897
PHONE(612) 454-8700
FAX: (612) 454-8363 8pecial Aasassment 8earch
Date: October 16, 1989
Requested Sy:
Re: 10-18275-120-02
Lot 12, Block 2
Country Hollow
First Security Title
V1C ELLISON
Maya
7HOMA5 EGAN
DAV1D IC GUSiPF50N
PAMEtA McCRE4
IHEODORE WACHTER
councA Members
n+onans HeoGEs
CiryPOminishafor
EUGENE VAN OVEf78EKE
CM Cien
On the attached form is the City's response to your search
request on the identified property. The information includes the
original amount of the assessments and the payoff amounts of the
assessments on the parcel. Zn addition, pending assessments are
included for improvement projects that have been ordered to be
installed by the City Council as they may affect this parcel.
The levied and pending assessments may or may not reflect the
complete assessment obligation based upon the parcel's current
use or zoning. Certain parcels have not been assessed at the
appropriate rate per their zoning/use. The City's policy is to
review the assessment obligation of parcels at plattinq, replat-
ting, rezoning, waiver of platting, and prior to the issuance of
conditional and special use permits and certain building permits
and in other unique situations. A condition of approval requires
the parcel to assume its additional assessment obligations that
have not previously been levied for existing puhlic improvements.
The City's Engineering Division can provide further clarification
of this policy, if you desire.
WAIVER/DISCLAIMER:
Neither the City of Eagan nor its employees guarantees the
accuracy or completeness of the information provided which was
required by the person or persons indicated. Nor does the City
or its employees assume any liability for the correctness
thereof. In consideration of receiving and using information on
the attached form and for all other consideration of any nature
whatsoever, any claim against the City or its employees rising
therefrom is hereby expressly denied. Pending assessments cannot
be paid until levied. Levied assessments can be paid to the CITY
OF EAGAN.
Very truly yours,
," /r/7
?
SPECIAL ASSESSMENTS
Attachment
THE LONE OAK TREE...THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNIT/
Equal Opportunity/AffirmaTive Action Employer
TF;HN3FaCTIUN ID: R768 SPECIAI_ ASSESSMFNTfi
SF'ECIfiL ASSESSMENT'S SEHRCH SUMMARY
F'ROF'EF;TY I.D. TQDAYS DpTEg 10!16/89 ---SPECIAL FLAGS----
1-2-3-4-5-6-7-8-9-10
I0-18275-120-02
-------------------------°-------------°-------------------------------
5. A. # AaSESSh1EPlT PESCF.. YR YRS FiATE TOTAL ANN. F'RIN. RAYOFF COMMENT
10147' STREFT W794 87 5 9.00'!. 112.62 .00 .00 F'FEF'AY
101605 SI_Tr;505 88 ].S 9.00•; 449,06 .OU .iiG PREPAY
10i607 1=JL.TY'505 HB 15 9.00% 100.77 .00 .00 PREPAY
101609 SSTk;.`;OS 88 ].5 9.007: 770.49 .00 ,iiii F'FEF'AY
1016i0 SSI_Tf'..505 68 15 4.00% 330.21 .00 .00 PREPAY
101684 S1`F..491 88 15 9.00"/. 433.86 .00 .On PREPAY
101685 SI_TF 441 88 15 9.00'l. 456.36 .00 .UU PREPAY
101686 W"ff:: 491 86 15 9.00;t, 417.17 .00 .iiC> PREPAY
SUMNIARY CIF ACTIVE .00 .00 ,00 COMM
?*#*** THIS YEAR'S TOT P«[ 560.62
****?**********************************
CITY OF EAGAN
CASHIER: JS TERMINAL NO: 794
DATE: 09/28/00 TIME: 14:29:59
ID:
NAME: SELA ROOFING & REMODELING
3210 9001 595 ATMN OKS CT 167.25
2155 9001 595 ATMN OKS CT 4.50
Total Receipt Amount: 171.75
CR137974
USER ID: JAN
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN ?
3oL? 3830 PILOT KNOB RD - 45722 I'I' Is
651-88141675
New Contfiucflon Reaulremenh RemodeUReoalr ReaWremenh
n J reglsfered sIte wneYa showinp 7q. B. W lot aq. fl. of housa
rnM go roofed areaa ($QX mmdmum lot coveraae aibwe?
> 2 eopiea ol pWmu (show bean 8 wlnibw slxea; poured fnd. deElgn; etcJ
> 1 set of enerqy calculatlons
> 3 coplaa oi hee preaervatlan plan H bf plaltetl alfer 7/1/93
DATE: 0_ Y 3 - 671
2 copiea a plan
t aef ol energy calculaHons ta heated addillona
1 site wrvey tor exlaAOr addltlona & decb
CONSiRUCTION COST:
DESCRIPfIONOFWORK: Ic:?u-fdf+ K-2 daz) -r b?
STREET ADDRESS: ?Ar4., oY1 n ?c
LOT: 11- BLOCK: ? SUBD./P.I.D. M: .?[1.1
Name: f CICS 4CLt C.l? Phone#:C9cd'S- ?((9 fT
PROPERTI( tas? Fitst
OWNER cyvrv?-?-
Sheet Address:
CNy Sfate: ZiP:
. Company: Phone 9:
We6A Fi00FINQ & R (area code)
COMRACTOR 4100 EXCELSIOR BLVD.
Sheet Address: gjT. LOUIS PARK, MN 55416 lkense #?? •?
ID #OOQ1050
city SMte: ° ZiP:
ARCHITECT/
ENGINEER Company: Name:
' Telephone i: ( )
Sfreet Address: RegistraNon #:
Cny Sfate: Zip:
Sewerlwater licensed plumber (i1 Installina sawarlwater): Phon8 IP. ( ---?
I hereby acknowledge ttat I have read Ihis appllcalbn, slafe fhaf the info 9 om _with an applicable Staf<
of Minnesota Statutea and CHy of Eagon Ordinancea
Signalure of ApplicanY.
OFFICE USE ONLY
Certiflcates of Survey Received _ Yes _ No
Tree Preservatfon Plan Received _ Yes - No _, Not Required
CITY USE ONLY
PERMIT #: RECEIPT DATE: 1l17-0I
MS1DENTIlkL MECHANICAI. PEtM1T APPLICATION
cm'oF ErtsAx
sbso Paor xxog gu
EA6AN bIP 55122
681-6$1-4675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date: ii- 16-ol
SITEADDRESS: '?q'J? ALHUyr1D Oa-k-S CotN-6--
OWNER NAME: ?\C?L EI I 1 S TELEPHONE #: (c 6-)t CQ FS 3 O I(CCj
(AREA CODE)
INSTALLERNAME: ?.StY15V?lL ??-?tY? +IC TELEPHONE#: 5bL g(?'I-OCf?S
(AREA CODE)
STREETADDRESS: ?,`?U.?! I Y?`ldC?9.. ?S?l?i ?- S•
CITY: Q.C'Q?1Q STATE: ZIP:
Clorn ? rhur4 mnr4 ncv} }n }ha narmiT wflrk }V[1P
.
New residential dwelling unit under constructionand not owner/occupied $ 70.00
X Add-on, modification or alteration to existin dwelling unit $ 50.00
• furnace replacement
. air exchanger
• air conditioner
• other
Nature of work:
State Surchar e $ .50
Total $
Reminder: Cal/ for inspecdons.
.,
?
SIGN TU OF PERMITTEE
Updated 1/01
PERMIT #:
APPROVED BY:
CITY USE ONLY
INSPECTOR
RECEIPT DATE:
COMMEtCMLL MEGH"CAI. PEiiM1T APPIICATIOft
C1TY OF EAHm
3$30 P1LOT KNOB SD
EA?sAv, huv 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:
SITE ADI3RESS:
OWNER NAME: PHONE #:
(ARHA CODE)
TENANT NAME (IMPROVEMENTS ONLI):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
ADDRESS:
CITY:
PHONE #: -
(ARLA COD6)
STATE: ZIP:
WORK TYPE: New conshuction Install U.G. Tank
_ Interior Improvement _ Remove U.G. Tank
_ Processed Piping
Specify Nature of W ork
When installing/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and
Plumbing Iinspector.
Fees: 1% of conhact price OR $50.00 minimum fee, wluchever is greater.
Underground tank removaUinstallation = minimum fee
Contract price: $ x 1%= $ (Base Fee)
State surcharge calculate at $.50 for each $1,000 Base Fee
TOTAL $
SIGNATURE OF PERMITTEE
Updated 1/O1
i
i -o?`affceiisa
i Permit#: M ?
/'? • lJ
I Permit Fee: li
? Date Received:
\J ?
I ?
? Staif I
I
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:
Tenant:
Suite #:
RESIDENT I OWNER Name: /?a lq ? cp,,,,ti? Phone: 11 7W
Address / City / Zip. C-?-
Applicant is: _ Owner ? Gontractor
TYPE OF WORK Description of work: QAeL Z-
Construction Cost 1 /S` Y3 /, Multi-Family Building: (Yes No _?z
-?
CONTRACTOR Name: )F "o-'vs e?v-IyL/? License#: 'L?+4s15`?°f
Address: 54 /U-r
City: State: H'L1-/ Zip: i `775-3
Phone: *31a-`tr-3 -36.,Y5? Contact Person: `SoL
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
(4 submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan.
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents thai you submit are considered to 6e public information. Portions of $
the information may be c(assiried as non-public if you provide specific reasons that would permit the City fo
conclude that the are trade secrets.
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 pertnit, and work is not to start without a permit; that the work will 6e in
accordance with the approved plan in the case of work which requires a review and approval of plans.
X X _z? ?
ApplicanYs Printed Name Applican Sign re
Page 1 of 3
??
City of EaaaIl
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 6755694
V? L? ? Iti L? L/
u?I ? ,, A IV t n ?.., .,_
_ <• ?.,
I Fui Oinrr U56 I
? Permit #: ?
i ?
I Permit Fee: . C) .
? Date Received, ?
i
i ?
? Sfaff: I
L -----------------I
2008 fNECF$ANICAL PERMIT APPLICATION
Date: :? 2?i' 4?: f Site Address: -SVS yyGL rLC ?),j
Tenant:
Suite #:
RESIDENT/OWNER Name: L o- z CIv'u,i A9 ,¢,Si"o J, Phone: / vSY-
Address / City ! Zip: ?yl- l71 C° -
CONTRACTOR Name: aURNSVILIE HEATING &NC, INC. License #:
3451 t, urnsw e g V?ray
Address: _ SIu}a 120
8urnsvilie, MN 55337
Ciry: State: Zip:
Phone: J-5-:? k``i y G'(-) 6 S? Contact Person: - LC.1lc'-/l
TYPEOFWORK New _Replacement _Additional _Alteration _Demolition
Description of work: --k'h y C(.?
NOTE: Both roof mounted anal ground mounteal meahanical equipmeni Is requirred to
be screened by City Code. P/ease, contact, the hlechanical InspecWr or one of the
P/anners for lnformation on rmlri.ed screeain methods.
PERMIT TYPE RESlDENTIAL COMMERC/AL
Furnace _ New Construction _ Interior Improvement
Air Conditioner _ Install Piping _ Processed
Air Exchanger _ Gas _ Exterior HVAC Unit
-7 ' HVAC units must be screened
_ Heat Pump Under / Above ground Tank (___ InsWll / Remove)
Other ** Nlhen insYallinglremoving tank(s), call for inspection by Fire
Marshal and Plumbing Ins ector
RESIDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 Fire repair (replaca burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
S?
$
TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x 1%
$50.50 Minimum (includes State Surcharge)
_ $ Permit Fee
- If Pertnit Fee is less than $1,000, surcharge is $ 50.
- If Pertnit Fee is >$1,000, surcharge increases by $.50 for each =$ State SUrCharge
$1,000 Permit Fee (i.e. a$1,001-$2,000 Partnit Fee requires a$1.00 surcharge).
$ TOTAL FEE
I hereby acknowledge that this information is complete and accurate; that ihe wnrk will be in wnfortnance with the ordinances and codes of the City of Eagan; that
I undersfand this is nol a permR, but onty an applicatlon for a permit, and work is not to starc without a pe xihthat Ihe work wi in accordance with the approved
plan in fpecase of work whiafi requires a review and approval of plans. ?
X J ?[-S'4.?,
X c lt..{'? j,r 17 ?-?
Applicant's Printed Name AppllcanCS Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Grou Rough In _Air Test _Gas Service Test In-floor Heat Final
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 595 Autumn Oaks Ct
Lot: 12 Block: 2 Addition: Country Hollow
PID:10- 18275- 120 -02
Use:
Description:
Sub Type:
Work Type:
Description:
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
e- Fireplace
Gas Fireplace (new)
Contractor:
Hearth and Home Technologies
2700 N. Fairview Ave
Roseville MN 55113
(651) 633 -2561
Improvements to the home may requ
concealing.
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
Construction Type:
Occupancy:
e smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
Carbon monoxide detectors are required by law in ALL single family homes.
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
- Applicant -
$88.50 0801.4085
$1.50 9001.2195
$90.00
Owner:
Lazarus M Abasiri
595 Autumn Oaks Ct
Eagan MN 55123- -162
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Issued By: Signature
Building
EA091041
09/04/2009
ePermit
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
PERMIT
Permit Type: Plumbing
City of Eagan
Permit Number: EA105540
Date Issued: 07/18/2012
Permit Category: ePermit
Site Address: 595 Autumn Oaks Ct
Lot: 12 Block: 2 Addition: Country Hollow
PID: 10-18275-02-120
Use:
Description:
Sub Type: e - Water Heater
Work Type: New
Description: Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Kris Oien
Comments:
3670 Dodd Rd
Eagan, mn 55123
651-365-1340
PL - Permit Fee (WS &/or WH) $55.00 0801.4087
Fee Summary:
Surcharge-Fixed $5.00 9001.2195
Total: $60.00
Contractor: Owner:
- Applicant -
Champion Plumbing Lazarus M Abasiri
3670 Dodd Rd., #100 595 Autumn Oaks Ct
Eagan MN 55123 Eagan MN 55123--162
(651) 365-1340
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.
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA119334
Date Issued:11/25/2013
Permit Category:ePermit
Site Address: 595 Autumn Oaks Ct
Lot:12 Block: 2 Addition: Country Hollow
PID:10-18275-02-120
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
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 -
Lazarus M Abasiri
595 Autumn Oaks Ct
Eagan MN 55123--162
(651) 756-8003
Home Depot At Home Services
656 Mendelssohn Ave N
Golden Valley MN 55427
(763) 542-8826
Applicant/Permitee: Signature Issued By: Signature
Apr 2916 09:31a AA Garage Door LLC.
44,0 City ef Ea�ali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
651-702-0838 p.1
Use BLUE or BLACK Ink
L
For Office Use
Permit#: /
Permit Fee: /t).6.
Date Received:
Staff:
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 4!28!2016 Site Address: 595 Autumn Oaks CT unit #:
Phone: 651-756-9041
Address / City / zip: 595 Autumn Oaks CT, Eagan 55123
Applicant is: Owner ./Contractor
Description of work:
$1400.00
Replace existing overhead garage door on attached garage.
Construction Cost:
Multi -Family Building: (Yes / No )
Company: AA Garage Door LLC contact: Dave Sands
Address: 401 9th Ave City: St Paul Park
Name: Lazarus Abasiri P
State: MN Zip: 55071 Phone: 651-289-7121 Email: dave@aagaragedoor.com
door.com
Resident/
Owner
Type of Work
Contractor
License #:
Lead Certificate #: LSR 147842
If the project is exempt from lead certification, please explain why.
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
----_..._.__._._.:._..... conclude that they are trade secrets.
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA144344
Date Issued:07/21/2017
Permit Category:ePermit
Site Address: 595 Autumn Oaks Ct
Lot:12 Block: 2 Addition: Country Hollow
PID:10-18275-02-120
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Lazarus M Abasiri
595 Autumn Oaks Ct
Eagan MN 55123--162
(651) 756-9041
Pronto Heating & Air Conditioning
7415 Cahill Rd
Edina MN 55439
(952) 835-7777
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA170787
Date Issued:07/16/2021
Permit Category:ePermit
Site Address: 595 Autumn Oaks Ct
Lot:12 Block: 2 Addition: Country Hollow
PID:10-18275-02-120
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Lazarus M Abasiri
595 Autumn Oaks Ct
Eagan MN 55123--162
(516) 271-5986
Legacy Restoration Llc
15350 25th Ave N, Suite 114
Plymouth MN 55447
(763) 354-7660
Applicant/Permitee: Signature Issued By: Signature