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4655 Cambridge Dr uaG owc w o~vn inn For Office Use l 1 I I ~~g of Eajan Permit J ~ Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 1 Date Received: 1 Phone: (651) 675-5675 1 Staff. Fax: (651) 675-5694 i INFLOW & INFILTRATION PERMIT APPLICATION < Plumbing / Sewer & Water Date: . 2- Site Address: t 0,2 ise. C ~ 5~ n T~ Tenant: Suite RESIDENT OWNER Name: ¢A" Phone: AF4Y ! Address /City 1 Zip: F_ -C •l,, lo, Name: License CONTRACTOR Address: City: State: Zip: Phone: Contact: Email: PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope) TYPE OF WORK Sump Pump Repair Repair Other: Other: d. A .C G S~~m y -tea DESCRIPTION Description of work: J~ 1-4 FEES .IC $55.001 Each (includes $5.00 State Surcharge) (Rev. 6-30-10) TOTAL FEE $ *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeacian.com/inflow. or City Hall at 3830 Pilot Knob Rd. 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.popherstateonecall.org 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 approval of plans. Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground Rough-In -Final CITY OF EA"N WATER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: Eagan, MR SS1 ZZ DATE: Zoning: No. of Units Owner, - Address: Site Address: 45 55 r L:=1 A ~1eac c-i, Plumber: Meter No.: • Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: agree to comply with the City of Eagan Surcharge: } ' Ordinances. Misc. Charges: Total: By Date Paid: Date of Insp.: Insp.: i CITY OF EAGAN SEWER SERVICE PERMIT i 3795 Pilnt Knob Road PERMIT NO.: Eagan,-MN 35122 DATE: Zoning: T No. of Units: a<:e ;i: r t1oF. Owner: i 'Address: Site Address: i r;- Plumber: Y' i) I agree to comply with the City of Eagan Connection Charge: ` - U Ordinances. Account Deposit: Permit Fee: Surcharge: BY Misc. Charges: Date of Insp.: Total: Insp.: Date Paid: CITY OF EAGAN 8798 Pilot Knob Rood Eagan, MN 88122 " PHONE: 4344100 BUILDING PERMIT Receipt # To be toed for % Est. Value Date Site Address '4' '"'a a:.:-tom Erect Occupancy Lot Bloc, Sec/Sub. Alter ❑ Zoning Parcel # ' S Repair Q Fire Zone Enlarge ❑ Type of Const. of Nome Move ❑ # Stories - Z sn~- Address Demolish ❑ Length n Grade Q Depth Sq. Ft. Ci Phone Approvals Fees Name O ~U Address Assessment Permit F City Phone Water & Sew. Surcharge Police Plan check W W Name Fire SAC YK Address Eng. Water Conn. i W city Phone Planner Water Meter Council Road Unit a I hereby acknowledge that I have read this application and state that Bldg. Off. the information is correct and agree to comply withall applicable APC Total ry h State of Minnesota Statutes and City of Eagan -Ordinances. j Signature of Permittee A Building Permit is issued to, on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official Permit No. Permit Holder Misc. Permit No. Holder M C4 -F C1 k W E' Plumbing . U-7 3 /flick, H. V.A.C. Well Water Disp. Sewer Electric " & -j q3l0 g Svn Iz-f~-fS. Inspection Date Insp. Other Footings 1z 3-!1 'b Foundation Framing U) Rough Pibg. Rough HVAC Insulation 0 q Final Pibg. uJ Fines HVAC st 04 Final •,j,~ ACt 4; 6. k2 Water [Describe Location: Well Sewer Pr. Disp. CITY OF EAGAN 9795 Pilot Knob Road Eagan, MN 55122 !v PHONE: 454-8100 BUILDING -PERMIT > S Swim Pool ii Fence Receipt # +f, .t To be used for - Est. Vclue g n a nn^ Date Site Address - 4655 Cambridge nre Erect ® Occupancy 83 Lot 21 Block 4 Sec/Sub. Beacon Hills Alter ❑ Zoning Rl Parcel # -10 13500 210 04- Repair ❑ Fire Zone NA Enlarge ❑ Type of Const. NA W Name Wesley Ask & Constance P asema move ❑ # Stories = Address 4655 Cambridge Dr. Demolish ❑ Length 16 city Phone 452-5221 Grade ❑ Depth-3$-Sq. Ft. Name Valley Pnnl s Approvals Foes ,O Address 661 Cliff Rd. Assessment Permit 62.50 city Burnsville Phan., 894-1480 Water & Sew. Surcharge 3.50 G Police Plan check W Name Fire SAC XZ Address Eng. Water Conn. iW Ci Phone Planner Water Meter Council Road Unit I hereby acknowledge that I have read this application and state that Bldg. Off, the information is correct and agree to comply with all applicable 66.00 State of Minnesota Statutes and City of Eagan Ordinances. APC Total Signature of Permittee A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of tnnesota Statutes and City of Eagan Ordinances. Building Official Permit No. Permit Holder Misc. Permit No. Holder Plumbing H.V.A.C. Water Weil Disp. Sewer ,r, ~ Electric Inspection Data Insp. Other Footings Foundation Framing Rough Plbg. Rough HVA Insulation Final Plbg. Final HVAC Final D ~I Water Describe Location: Well `Sewer Pr. Disp. CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 . ( V PHONES 454-8100 BUILDING PERMIT Receipt # To be used for SCREEN PORCH Est. Value $2,000 Date May 16 19 83 Site Address 4655 Cambridge Drive Erect Occupancy Lot 21 !eac on Hill Alter Zoning orce► Repair Flre Zone Name Wesley 0. Ask Enlarge ❑ Type of Const. oc C9 Move ❑ # Storie z Address 4655 Cambridge Drive Demolish ❑ Lengthy City Eagan 55122 Phone 452•-5221 Grade ❑ Depth 1- Sq. Ft. Op Name Owner Approvals Fees u Address Assessment Permit Ad 52 50 u~ Phone Water & Sew. Surcharge 1.00 city Police Plan check ,Z Name Fire SAC Address Eng. Water Conn. W Ci Phone Planner Water Meter XK Council Rood Unit 1 hereby acknowledge that I have read this application and state that Bldg. Off. the information is correct and agree to comply with all al pI' able APC Total $33. SO State of Minnesota Stotutesl a City f Eago ?:nce 5lgnoture of Permittee A;Building Permit is issued to: Wesley O. Ask on the express condition 1hai =..afhiwork shall be done in accordance with all oppli a State of ' sots Statutes and City of Eagan Ordinances. i c - Building Official ` ` 1 Permit No. Permit Holder Misc. Permit No. Holder Plumbing H.V.A.C. well Water Disp. Sewer Electric Inspection Date Insp. Other Footings -f7=1t; (btu Foundation Framing Rough Pibg. Rough HVAC Insulation Final Plbg. Final HVAC Final X19 " Zz_ Water Describe Location: Well Sewer Pr. Disp. I CORRECTION NOTICE DATE: I Address xn Site Name J Owner/Agent Telephone Owner/Agent Address Ordinance Nos. and Corrections - Correct By n d' ~ -for reinspection Eagan Dept. of Inspection Inspector: ri 3795 Pilot Knob Rd. Eagan, Minnesota 55122 _ 454-8100 Dept.: a, - Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces SIC Type or Print legibly Tot. i . 1. Date °f! 2. Installation Cost 3. Job Address Z.(15L~ -x,,:bi Lot Blk. Tract 11 4. Owner r. , TL 5. Contractor - Phone 6. Address LO7 IZi.cr n . -r:: 7. City '.?'•~s` `ol4 State Zip 8. Building Type: Residential Commercial ❑ Institutional ❑ 9. Work Description: New 0 Add ❑ Alter ❑ Repair ❑ 10. Describe Fuel Type 11. No. Equipment BTU - M. Ea. No. Equipment CFM 1 Forced Air i(ftis~0!) Air Handling: Mfg. Boilers Mech. Exhaust Mfg. Unit Heater Mfg. Other Air Cond:-1;-~". Mfg. Gas, Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all, ordinances and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454$100 Receipt PLUMBING PERMIT Permit No. CITY OF EAGAN-, \ Fee Fill in numbered spaces S/C Type or Print legibly Tot. r 1. Date ? f 2. Installation cost t - 3. Job Address `Lot :2 ,1 4 Tract -t 4. Owner 5. Contractor 'Phone J 6. Address --z 7. City State / Zip 8. Building Type: Residential CJ Commercial ❑ Institutional ❑ 9. Work Description: New Add ❑ Alter ❑ Repair ❑ 10. Describe 11. No. Fixtures No. Fixtures Water Closet Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray i' Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : _ - . for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt PLUMBING PERMIT Permit No. r" CITY OF EAGAN a Fee " Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date - 2. Installation Cost 3. Job Address' Lo ract 4. Owner 5. Contractor` Phone 6. Address 7. City : State Zip 8. Building Type: Residential LK} Commercial ❑ Institutional ❑ 9. Work Description: New ❑ Add ❑ Alter ❑ Repair 10. Describe 11. No. Fixtures No. Fixtures Water Closet Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for ough Final Inspections: Date-)'-'20-W-? Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 J CITY OF EAGAN Remarks Addition BEACON HILL ADDITION Lot 21 Blk 4 Parcel 10 13500 210 04 Owner ~,i ~ `T P 1 u A`, ; ` C- C(a~f Street 4655 Cambridge Drive State Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1982 1848.67 205.41 9 1643.27 A011017 4-7-82 STREET RESTOR. GRADING $ 1982 537:84 59.76 9 478.08 A011017 4-7-82 SAN SEW TRUNK 1976 135.97 9.06 15 72.55 A011017 4-7-82 *SEWER LATERAL 1982 3182.83. 353.65 9 2829.19 A011017 4-7-82 WATERMAIN WATER LATERAL 1982 9 WATER AREA [04 1982 202.00 22.44 9 179.56 A011017 4-7-82 * Stubs 1982 9 STORM SEW TRK g7,, 1982 367.77 40.86 9 326.91 A011017 4-7-82 *STORM SEW LAT 1982 9 CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 1981 185.00 28231 12-21-81 WATERCONN. 1981 335.00 28231 12-21-81 BUILDING PER. 7040 SAC 1981 -';25. 00 28231 12-21-81 PARK CITY OF EAGAN j1Tq 7040 3795 Pilot Knob Road Eagan, MN 55122 PHONE: 454.8100 BUILDING PERMIT Receipt To be wed for SF' nur./nAR Est. Value $68,000' Dote nanpmhar 71 19_$1_ Site Address 4655 MmhriAW nritea Erect Occupancy R-3 Lot 21 Block 4 Sec/Sub_ Beacon Hill Alter ❑ Zoning PD Parcel # 10 13.50_0 210 041 Repair ❑ Fire Zone NA Enlarge ❑ Type of Const. VII W Nome Joseph M. Miller Christ., Inc. Move ❑ # Stories zz Address 1411S antthrip Amp_ Demolish ❑ Length 60 City Apple Vallev phone 454-4753 Grode ❑ Depth 48 Sg. Ft.-. Name Owns-r Approwals Fees uU Address Assessment Permit 337.00 ~ City Phone Water S Sew. Surcharge 34.50 Police Plan check 168.50 fW Nome Fire SAC - 7~-f10 Address Eng. Water Conn. 335.- nn iW CI Phona Planner Water Meter 6_ 0.00 Council Road Unit 185.00 1 hereby acknowledge that I have read this application and state that Bldg. Off. the information is correct a agree ompiy witf all applicable $1645.00 State of Minnesota Statut d f 't'ienees APC Total Signature of PermiMee A Building Permit Is issued t j JO h M. Miller (bnSt• , Inc. on the express condition that all work shall be done in accordance with all applicable of MInnestot tatutes and City of Eagan Ordinances. Building Official ? 0~ ~>yl a A Trrtifiratr of (Orru,paury c t Citp of Cagan v' k Drpartmrni of Guilding Inapertion This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building V, Code certifying that at the time of issuance ibis structure was in compliance with the various ordinances of the City regulating building construction or me. For the following: 7040 P 4' UN c4-ffi- m 17WGfGAR 61de Po mrc Na Znury Ovt.rc1 FD '~4 Fin Z. Om„P~T bP TTp Cm,im O do et Joseph M. Miller ddn.14115 Guthrie Ave. ,Apple Val " ~ l BuBd,,Apde 4655 Cambridge Dr. ,n, ~19t 21 Blodc 4 BeaCOtt~iill ~,y l0 ~L(LiL Aot-~~ u / March 26, 1982 BWdiee Ofna,l ,yN Mb. ~ ~ " ~ .on n w eer.wmuan ruc, V ~1~ ~ - "i E ~ a-a -.a•a.~`~ "aria / oas .e. r CITY OF EAGAN N~ 7979 3793 Pilot Knob Rood Eagan, MN 33124 PHONE: 434-6100 J BUILDING PERMIT Scrim Pool & Fence Receipt # To be used for Est. Value $7_000. Date --May -3 , 19~ Site Address 4655 Cambridge Dr, Erect Occupancy R3 Lot 21 61«k 4 Sec/Sub. Beacon Hills Alter Zoning RL ❑ Parcel # rI0 ^.135QQ „~10 041 Repair ❑ Fire Zone NA Enlarge ❑ Type of Coast. NA a Name Wesley Ask & Constance Claseman Move ❑ # Stories Z Address 4655 Cambridge Dr. Demolish ❑ Length 16 City Phone 452-5221 Grade ❑ Depth 32 Sq. Ft.- Name Valley Pools Approvals Fees i~ 661 Cliff Rd. Assessment Permit 62.50 o Address Burnsville Water & Sew. Surcharge 3.50 City Phone ~W Police Plan check w Name Fire SAC u~ Address Eng. Water Conn. <W city Phone Plonner Water Meter Council Road Unit I hereby acknowledge that i hove read this application and state that Bldg. Off. the information is correct and agree to comply with all applicable APC Total bb.UU - State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permittee A Building Permit Is Issued to: on the express condition that all work shall be done in accordance with all applica Ig, State of ne Statutes and City of Eagan Ordinances. Building Official + CITY OF EAGAN ~T 9795 PBat Knob Rood Eagan, MN 55122 N? 8043 PHONE: 454-8100 ~S`/~j- BUILDING PERMIT Receipt # d To be used for SCREEN PORCH Est,yalue $2,000 Date May 16 1983 Site Address 4655 Cambridge Drive Erect 4 Occupancy Lot 21 Block 4 Sec/Sub. Beacon Hill Alter ❑ Zoning Parcel # 1043 0° 2lW_ Repolr ❑ Fire Zone Enlarge ❑ Type of Const. a Name Wesley 0. Ask Move ❑ # Stor$ Address 4655 Cambridge Drive Demolish ❑ Length Ci Eagan 55122 phma 452-5221 Grode ❑ Depth 11 Sq. Ft.- Name Owner Approvals Fees o~ Address Assessment Permits V~ City Phone Water & Sew. Surcharge 1.00 Police Plan check Fire SAC I(. Name Address Eng. Water Conn. City Phone Planner Water Meter Council Road Unit I hereby acknowledge that I hove read this application and state that Bldg. Off. the information is corre nd agree to comply with all a plicable APC Total $33.50 State of Minnesota Sto City f Eagar, ni once Signature of Perrnittee J fo.ll A Building Permit Is issue ta: Wesle 0. Ask on the express condition Ilia' all work shall be done in accordance with oil oppli a St o - eso Statutes and City of Eagan Ordinances. Building Official c 4 This request voitl~~l(J a'l 1 -^~y\ ` `.L J ~Q • T18 months from / 1 - - 674-39 so4~ Request Date Fire No. ROUPh-m InsuecLOn Re mredr ❑Ready Now Will Non ty Inspec- 12-11-1981 ~s ❑NO for When Ready kiLicensed Electrical Contractor I hereby request inspection of above ❑ Owner electrical work costal led at Street Address. Box or Route No. City 4655 Cambridge Eagan eciwn o. Township Name or No. Range No. County Dakota Occupant tPRINT) Phone No. Joe Miller Power Supplier Address Dakota Cty. Fa=ington Electrical Contractor (Company Name) Contractor's License No. O.B. Thompson Electric Co. A40602 Mailing Address (Contractor or Owner Making Installation) 12201 Mtka Blvd., Mtka 55343."" Authorized Signature itContractor Owner Maki Rg Installation) ^ Phone Numbed , 9133 MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT - Griggs-Midway Bldg. - Room N•191 BE ACCEPTED BY THE STATE BOARD 1821 University Ave.. St. Paul, MN 55106 , UNLESS PROPER INSPECTION FEE IS io.oi I., 11r1 ENCLOSED. "'J ,1 REQUEST FOR ELECTRICAL INSPECTION EB-00001.03 T BG-7 3 90 See instructions for completing this form on back of Yellow copy p X'" elow Work Covered by This Request '28"O L Add Rep Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Heating Commercial Bldg. Furnace 2.50 Silo Unloader Industrial Bldg. Air Conditioner 2,50 Bulk Milk Tank Farm they pea fy ther (Specify) tlrer $VCCIfy Sher Other Compute Inspection Fee Below # Fee Service Entrance Size n Fee FendprS/Stibfeeders 11 Fee Circuits • to 100 Am s 0 to 30 Amps 0 00 0 to 30 Am 1 101 to 200 A 31 to 100 Amps 31 to 100 Am Above 20 s r Above 100-Amps Above 100-Amps Transt er Remote Control Circ. 0 Partial%Other Fee Signs Special Inspection s TOTAL FE ( flxinnrks 50.50 !0 RnCale Hough-in O`11C 1, the Electrical .2 Inepecto,. hereby 0- A comfy that the itmy. I F nal Date non has been 10 p made. This request void 18 months hom This request void (0--~_ L~l l 1 t ~Ga lta~ (~t l ty G 18 months from 1111 W 27532 --&-o Inc I Request Date - -t Fire No. ROURh-In Inspection r^ Re quired7 Ready Now Q Will Notify Inspec- W ❑Yes ❑No for When Ready ,,,117] Licensed Electrical Contractor I hereby request inspection of above ~y Owner electrical work installed at: Street Address, Box or ou to No. City ecuo No. 1 Township Name or No. ange No. C unty`` yy f'0 Occupant (PRINT) Phone No. LE K -S I Power Supplier Address ~L lC - Electncay. atractoo, (Wm p any Name) Ccntramor's License No. Mailm ((llA(//Q/d~~1rerrllsss~`~Jll(ContrllaCC~-ocl~ot`r oorr Ow er Maki Inste lla uap) 5 ~ n ~ ^S ~ l d Sign t re (Cc for Winer Me ns tallation) Phone Number Ste- S~ a MINNESOTA STATE BO RD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg, N-191 BE ACCEPTED BY THE STATE BOARD 1821 University Ave-, St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS , Ph-.. 18121297-2111 ENCLOSED. W27632 REQUEST FOR ELECTRICAL INSPECTION c« EB-00001-03 See instructions for completing this form on back of yellow eopV• I, -V Below Work Covered by-,. his Request (p L~ G aw Adtl'Bep. Two of Building Appliances Wired Egmpment Wired Home Range - Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Heatin Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Other peel y Other specify) y Other Other Compute Inspection Fee Below b Fee Service Entrance Size # Fee Feeders/Subfeeders p Fee Circuits 0 to 100 Amps 0 to 30 Amps 0 to 30 ,Am s 101 to 200 Amps 31 to 100 Amps 31 to 100 Amps Above 200 Am s Above 100_AMPS Above 100_Am s Transformers Remote Control Circ. Yjaj , SO Partial 'Other Fee Signs Special Inspection $t, o Remarks, FEE Rough-m ( r e/_2o- I ns pector, hereby "c Hy that the above Final ( jdate action has been This request void 18 months from I For 61068 llse I 3 79 41 City of Eagan ; Permit I I Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: j Phone: (651) 675-5675 i scoff: Fax: (651) 675-5694 1 I 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: t00'15X U /Sit®IAd'dress: IFLo`~ CAmhr i daP be F-Gq" ( N SH( ZZ Tenant: nri 0.rj C31 Ltl' 1 II 7 Suite / OWNER Name: 2ri" G1 t t rl Phone: b51- (a 8g g93S Address/City/Zip: 1+LSi CarK6r'c(9? OQ EQita. MO 5512ZZ Applicant is: -Owner ~ Contractor TYPE OF WORK Description of work: C-~ e - l~04 Construction Cost: 10t t>Oq . U4 Multi-Family Building: (Yes_/ NOV_-j CONTRACTOR Name: AZ4-eC ooi n0. t~ CVx4ru.C4 6x- License Q0139)40 Address: 4105 Ayi✓ f4 City: I) r-ook9in ?ark State: K11zip: 11 55gg3 Phone: ?63 ° 315- b'730 Contact Person: rlA/1S Wit COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Catooory 1 _ Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted 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 8 Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public infOrmatlOM Portions of the information may be classified as non-public N you provide specific reasons that would permit the City to conclude that t 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 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. x. ( c1~ i,Yl4~ x AIIQA,j Applica s PnntO Name Applicant' Signature Page 1 of 3 I ~p PERMIT # q 331I RECEIPT DATE: 5-15-01 RESIDENTIAL PLUMBING PERMIT APPLICATION MYO EAll 3830 PUM SNOB RD KAGM, ME 55122 651-681-4675 Please complete for: ➢ single family dwellings townhomes and condos when permits are required for each unit ➢ backflow prreeventer for irrigation system c~ SITEADDRESS: /Cl y OWNER NAME: t irL✓~ y \ V h TELEPHONE (051 _ (fl`S~' `193c6 (F !EP. CODE) INSTALLER NAME: MIGCE & SONS TELEPHONE qsa Ts\ - 20 ~n STREET ADDRESS: 60512th Avenue South (AREA CODE) MN 55343 hopidiris, CITY: STATE: ZIP: Place a check mark next to the permit work type New residential dwelling unit under construction and not owner/occupied $ 90.00 ~c Add-on, modification or alteration to existing dwelling unit, including: $ 50.00 • abandonment of septic system _ • new installation/repair/rebuild of RPZ • lawn irrigation system • water turnaround 111 MAY Nature of work! \pte lA1p#c ~ ~eC I,` 5 j L11j .,J _ Septic System, new/refurbished - $ 225.0 • includes County & Consulting Inspector fees • requires MPC license State Surcharge $ .50 Total $ Reminder: Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc. I hereby acknowledge that 1 have read this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It is the applicant's responsibility to notify the property owner that the City of Eaga assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this per within Cit propert ht-of-way/easement. ZdAPA I NATURE OF PER TTEE Updated 1101 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF FAGAN t I 3830 PILOT KNOB RD - 55122 1 (651) 681-4675 New Construction Requirements Remodel/Repair Requirements # 3 registered site surveys # 2 copies of plan # 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) # t site surveys (exterior additions & decks) # 1 energy calculations # 1 energy calculations for heated additions # 3 copies of tree preservation plan if lot platted after 7/1/93 required: _ Yes _ No DATE: 3 - aa - 67 p q CONSTRUCTION COST: DESCRIPTION OF WORK: p ~j r cl STREET ADDRESS: C~//~J7 br" i q L) LOT: a , BLOCK: SUBD./P.I.D. CCl t~ l lk Name: Phone tI r b O p / O PROPERTY Last First OWNER Street Address: 7 SS Y / r~ ~7 City654 { n V -&/Y State: Zip: IaG~ Company: Z ` e C-~ IqO ()f Phone CONTRACTOR Street Address: -3 U 043 t^ License #,j b t3q / Exp. City Q V r pi 5 U V State: Zip: 5-5-5 3 3 7 ARCHITECT/ ENGINEER Company: Phone Name: Registration Street Address: City State: Zip: Sewer & water licensed plumber (new construction only): Penalty applies when address change and lot change is requested once permit is issued. I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. >l Signature of Applicant/ OFFICE USE ONLY I`(~ iv1 2 0 ` II 1 Certificates of Survey Received Yes No L, Tree Preservation Plan Received Yes No Not Required TTT V110 7D t.' CITY OF EAGAN Include 2 sets of plans. • . 1 site plan w/elevat3.ons 6 BUILDING PEFNQT APPLICATION TION set of energy calculations. • 1b Be Used For AF2 r ValUation IIPP O }vj D~ Date Nov. 30•; 1981 ' Site Address: 4655 Cambridge b~ OFFICE USE ONLY lot 21 , Block 4 Bec./Sub. Be con 111 Erect ~`6ccupancy . - l 15- CC) Z l Ater Zatin Parcel ] Repair Fire Zone Enlarge-- Type of Cbnst Owner: Josenh M. Miller Const. Inc. - M" Sb= a . Front Address: 14115 Guthrie Grade Depth 4 9 ft;' City/Zip Code: /Apple Valley Phone 454-4753 APPROVALS FEES Contractor: Same Assessments Permit Water/Sewer Surcharge Address: Police Plan Check City/Zip Code: Fire SAC S" 2 O d` Water Conn. z 3 ' c k7 Q Phone Planner Water Meter Council Road Unit. Arch./Eng.: Bldg. Off. Address: APC City/Zip Cade: 1_rt Phone TOTAL ~ ~ ~ L td n' 041M tz p~ w Sri. _ 'ry9. ,^f~ .YfQ•+^'` .o-S'+~ -ra ~ ~~e,'',SS~~k ~r b `l i T i 'i.";..{>~'•.,•',-.r'~t,, " ~1~~` ii. .~i.7~ b f' i ''E'" nl~ E r I" LOPE AVEPAGE "U" COMPUTATION X v (I h ilk':.a 11 :~~~~i1~+' ~T•'4 ~i.' tT ^ DATE fV~ 1907 ii q~rr P110N1-;: 454`4753 _ ADDWSS: AAA c rzambriag.0 '';tea°"CONT13 R: tirg;;, ; rk, Determine working square footage of each ' Total. exposed wall area...... sq. ft. x .17 _ spa,;. - e 4.2. Toal roof/ceiling area 10~~9• ft. X ;05 12 = Total exposed wall area above floor LL ''a.' Total wall window area 3 'rTotal door area "nJIT F,Wtal slidin;; glass door area O ~kg;ri ' ~iap~ fireplace wall area 67 -7 1 wall fra:aing area, (average loci t 57 'y rim joist area . wall'area above-'[lour 1~td .B wall area above",floor iralX"area aboveilloor wall area above ;.f,loor.......... i".r . r.: .;Total exposed foundation area = 0' . tal foundation window'area total net foundation area above grade Determine "U" value of each wall segment" -#lt (e.g. window, door, each separate wall section) a. _AX .lull _,S _ ° ~y'_~1 ca x 'lull S = ?L 60 Pull e. 45. sw't' f. 5 x OA 2) ,a By.r•~ m MUx r '1!7 If ites 03 is the same a6, or less than.; itom @l, You 't✓x°",'~",'' lwve met the intent of aVu sDC 6005 (c) 2. T or Envelppa,A►verage "U" COMP Cation » as 2 of 4 total exposed roof/ceiling area i~ 9bta1 skylight area n. 9btal roof/ceiling framing area (average 10%)... 9 , 0..70 tnl net insulated roof/ceiling area........... It j. Determine "U" value for each roof/ceiling segment , n. X32/lo x ,.u"3_ a v~~.._ x Q., py`.S kir6 Total if total of #4 is the same as, or lw;s than 0, you have met tho intenL of BBC 5006 (c) 1. Alternate Suildin% Env"lop! D~>:i n To utilize the total cnvclope'systua v,.c.hul, the values established by the sum of items 43 and 44 shall not be greater than the sum of items #1 and #2. !A2 404,77 3.+4. f i wt ''kit'e ' R \ w `IJ To EXPOSSO WALL ~ y '.Z'~-i , lp~l . I to "7 ~ 3`°~' , ti Y SX.PoSeb WALL AfteA A e,,f X . d:. X 5 = IqG, X 1 1 i~~t• I EXPOSP h . 3 ?ATIo DRS t 83SH4-UIJI+S C5 k ` ~ 1: w~Ca~ It-Value $ Irn ~r8 m O&15 on il filed ' s soft good Lf .4 ,93 at%t ♦ d. 17 'W" air MW $ r ~b LVV 047 .t. ~L Ild'~ ~k a G~ 68 " 01 60 ! y IOU "a rt )T~o., ifA: II.'AIiR , { Yx I L .t wy { t (p,~ 41. ! • f San .1s % __".~rJ+ 5 • . 2 r 5{4L F1S '..ttl- exal ~--Q 6• exterior air film 0•17 s ,t:.:, aP ' Fatal 24.42 54- Interior air film. 0. 68 f .1w . A 0 2• 3. G. W pip'. G a I 0.17 1 r,wt.; ~n,.. t " F -'r - 6. Sxtsrior air f 16 ~~yy 1 ii•MY ) 4 t4 Jar / 1(/ lit lit 11_~ FIG. 04 e!i it ~ 0 ' ♦ _ type, value, depth and. , NQ7t : Indicate placement cf inculsticn• , cY;~. aj . • ~ 7 Y ell ti_ on R-value " , • Construction 1• Interior air film s 0.61 oil ~,~~il' ;~1}%~1j}`f~ 4. Lxtesior air film stir Total ~1• Odt6 A►M A` 1• ~interior air film 0.61 logged Beat flow 3• - +•Gi- - - r up 3. r .-A 6. 4. Extor or air 2 m stii7) • Total 5-5. ivy esp. srs✓rri ep%~,. ..u.-.+,.. i.. s.... 0.61 Inside air film r---•••t' 2• 3. 4. 0.17 /11 Outside air. film Total 1 l I i~ : ~~~~(l_I ~f 111)~~ f~'/~j/`"'///~1111~11 11 b~.4•~►M • ~ 2 3 4 Inside air film 0.61 2. vented Lent flow UP - ..Z q. Total S, f"ztside air film 0.1 3 1. film 0.61.,_ 5 Outside air film 1 2 . ' : • A, Ipte+ Ilse additional sheets if more zpaca Seeded for details oral calculations. • Slag flow up JP.t,. A7 Certificate for: "•dentex Homes Midwest Inc. Bk: 55/60 8601 Darnell Road LION wo. 9Zo81 .IJ,Eden Prairie, Mn. 55344 Joe Miller Const, 13015 Cedar Ave, So. DELMAR H. SCHWANZ Apple Valley, Mn, LANDSURVEYOR 55124 Registered Under Laws of The State of Mrnnesola 2978- 148TH STREET W. - BOX M ROSEMOUNT, MINNESOTA 86088 PHONE 612 423-1769 SURVEYOR'S CERTIFICATE ~repleoal Top C.OR6 TOP 1'1tlB ZJ,96L. N 3 El.Pa1, t }941.8 1 0.00 ' 9U;.i ~ 30 -TOP 1eo.1 S B9~ 3» 9Le E s - - - - - Tg be. I i I.14 7 3 ° e~ qp A A I lJJ T) em 0 twotov5ED N L .3 / #WsE I Z~~ ~ \ zs~~ ~ ~ w Cl 64e t~ M The IPat3 S $Q° 44' 14 " 16 \ I J to E1EJ. 957.1 164.2$\xo~'op rep lads a ej"Pil . (D Denotes proposed grade rr "7.jDenotes existing elevation ❑ Denotes set wood hub ScQle N 1 inc,Gt ~ 30 ~ee,~' Proposed garage floor Proposed top of foundation °%A•$ Proposed basement floor hereb certify that BEACON this is a true othedrecorrect corded plat thereof, Dakotat 21, Block 4y County,Minnesota. February 3, 1981 Benchmark: Top hydrant between lots 25 and 26, Blk, 3, Elevation 963.45 ft. Revised to show proposed house as staked November 16, 1981. Rautseo 11-19-61 ,2Ear5Ea /z- 3-sr MINNESOTA REGISTRATION NO. 9625 (y CITY OF EAGAN Include 2 sets of plans, 1 site plan w/elevatiorvs & BUILDING PERMIT APPLICATION 1 set of energy calculations. To Be Used For ''ff oo4- valuation l' 000 Date Site Address: y ~7 Q1~ OFFICE USE ONLY Lot aL Block A_ Sec. /sub. A60AJ1 SErect x 1pancy Parcel -0 _(_~SO C3 a(o szx_9 Alter oning / Repair ire Zone Enlarge hype of Const. Owner: .S ~Y ar ~~s R F Move v Stories Address: ~ll0~5 Cps C~RSr111 Demolish - Front /(o ft. Depth 3.7, ft. 44. City/Zip Code: LAC(,~,~ 55 Grad Phone 50? . 5 FEES Contractor: As snts Permit ~ t-Jv Address: VALLEY POOLS INC wa rASewer Surcharge 3 ° Police Plan Check city/Zip Code: y/LLE MN 65337 " Fire SAC /o Eng. Water Conn. Phone 9Y - /'Y p D Planner Water Meter . ^U Arch./Eng.: Council. .;Road Unit Bldg. Off. - l Address: r VALLEY AOOLS INC APC City/Zip Code: BURNSVttL6 MN 55337 Phone TOTAL 7faPBey saaoP~, 9nc. 651 Cliff Road BURNSVILLE, MINNESOTA 55337 (612) 894-1480 o Ag l //6/b4- 3e', a o AGAN iR VIE'vJ,ED :TY DATE ~s sx ~ I 60 P,4 9,4 I ~ DATE 01/11/83 EQUIPMENT SPECIFICATIONS Customer A Wesley Ask & Constance ClasemEAddress 4655 Cambridge Drive, Eagan Phone Home 452 5221 Office Submitted By: Valley Fools-,-Inc. POOL DATA: Pool Size 16 x 32 Turnover Rate Less than 8 Hours Surface Area 512 Sq. Ft. Filter Rate GPP•1/Sq.Ft.-, I 20 Capacity 17,000 Gallons Rate of Flow 4.4 GPM ! Perimeter 96 Lin Ft. Type of Pool Cialvanized Ste-7 'Walls, Vinyl liner PING DATA: NSF 80# Poly, and schedule 40 PVC .ction Return Manifold i ' i I i FILTER Hayward Diatomaceous Earth j PUMP & MOTOR Hayward 1 horsepower ' SKIMMERS ne yward INLETS 'Iti1o yward DIR. FLOW FTGS. Two kLAIN DRAIN ywar CHLORINATOR a/ a DISCHARGE HOSE Vinyl THERMOMETER Aquality POOL HEATER o or zone, Natural as DIVING BOARD 61 S -H Smith SLIDE Queen Curve i LADDERS ne with three steps GRAB RAIL Stainless steel ANCHOR CUPS Aluminum ;f STEPS or Wayne i erg ass acr lic with Hydro Unit , POOL LIGHTS a/ a DECK BOX N/A VACUUM KIT Head, Hose, Pole, Plate MAINTENANCE KIT Hand skimmer, wall brush WATER TEST KIT 4 in 1 SAFETY KIT Rope DECK WORK -'ECTRICAL her GAS LINE Owner ICING WORK {:ALL PORK NIA xoOL CHEMICALS Stabilizer, Stabilized chlorine, Algaecide, Pool Shock POOL COVER idinter & Solar Blanket OTHEP,S - ' i Vaeiee# 3Poo4r, Poe. 651 Cliff Road BURNSVILLE, MINNESOTA 55337 (612) 894-1480 0!1 y~srs~ i ; i ~ o gl e s Ask r 60 e,4 9A /1) I ~ J I..~... - f f WITH A P ~~^"a' r aT r.}L'~ B,Pfi~T'iR"Lf'SIYYL't'MyS,FA4RgiP.AS"-r POOL YOU CAN BE SURE.. 1 j pr'_ gw; ,.4. The steel walls are 14 gauge steel, heavily galvanized for long-life protection against the corrosive chemicals in the soils. ~ The 30-mil custom made vinyl liner is made by Kafko to assure a perfect fit on its pools. It is chemically treated to pro- f w 4 tect against algae and bacteria. You have a choice of plain or pattern liners in crystal clear colours that are easily Ile cleaned. All liners meet rigid specifica- tions. The A-frames, which provide wall sup- port, are built of the same rugged corrosion-resistant steel as the walls. Kafko adjustable frames provide positive Kafko designs and builds the steel wall alignment and strength. walls, vinyl liners and its exclusive adjustable A-frame braces in its own plant. In this way the company maintains the essential quality con Coping of white, ridged, ribbed vinyl. trol and high design standards re gwred to produce a top-quality Your Kafko pool coping is always neat trouble free product. and clean. Kafko also offers a smaller bullnose coping that allows you to bring a concrete patio right to the edge of your pool, and provides additional strength to the walls. Optional aluminum coping is also available. IS A LEADER IN Hi-rate permanent media stainless steel filter is fitted to each pool to insure THE SWIMMING clear, pure sparkling water. " Efficient filtration for the Kafko pool of your POOL INDUSTRY choice. n;niitii i • iinr rs _ p ,...m.~:. ` °:w - - ~cA9W~m.. s. -.~w~i w.-+a. •.__-fie ~leml : ;rum +aIDOKV h _ _ _ n. - .a P m-m a. • .M• [ .C 6 Rci ' ~-gym <V.! a Mi _.4 •.'a.P MS L .T.9 e nee - ~ l~ - •O: p- N011785 I i ~ ~ ~1~1'JO 'tl3Mi107 - jae 77 1 NO, I~as - = r c s e i lire ~L. i F ,l -,Xw A M'JIA T1vlt ~ x f ~ mtlti , e` f- I • i~w ~"i .`y~a.~, Six ~ _ _ SPECIFICATIONS AND DIMENSIONS amp rating water ship • 4 • 4 model B.T.U. kw 720v 20BV 240v 4e0v coon. wL IV-30 10,236 3 25 10.8 12.5 NA 1Y2" 49 a IV-60 20 472 8 NA 21.6 25 12.5 1 1/2" 49 30,708 9 NA 32.5 37.5 NA 11/2" 49 V-10 39,328 11.5 NA 41.5 48 24 1141" 49 V-30 10236 3 25 14.5 12.5 NA 11/2" 1 , 60 V•60 20,472 6 NA 29 25 12.5 l% 60 V-~ 30 708 9 NA 43 5 37.5 NA 1 1/2' 60 V•120 39,238 11.5 NA 4B" 48 24 11/2" 60 V-150 51,180 15 NA 63 3d 21 1Ys" 60 V-180 61 416 16 A 87 75 25 11 ' 60 N W avWEb M NMa Vi" -C-SPA V.120 QWVJ rete0 61 IMW 1 amp. rating model D.T.U. 208v 240v 480v water ship _ . Tfd75".71d number radng kw 1 PH. 3 PH. I PH. 3 PH. 3 PH. Conn. w4 CEF-6 20,472 6 29 20 25_17 9 11/2"_145 ' CEF-9 30,706 9 43 29 3B 26 13 1Yi 145 a,pY' CEF-12 40,944 12 58 39 50 34 17 1Ys" 145 CEF•15 51,180 15 72 48 63 42 21 lYS" 145 CEF•18 61,416 16 87 58 75 50 25 In 145 a CEF-24 81,888 24 115 77 100 67 34 1V2" 150 n.w. CEF•27 92,124 27 130 87 113 76 38 11/2" 150 CEF-36 122,832 36 173 116 150 100 50 1 Vs" 150 WATER CONNECTION FOR CEF-45 153,540 45 216 144 187 125 63 1141" 155 C-SPA"CEF SEINES CEF•54 184,248 54 260 174 225 150 7 1% 155 a• a's • i fin: gas line" dimensions meter to heater ship modeU I.T.U. water pas Y•ntylak input' Conn. Conn. 0-_100' 10.0'-200' V L W H S B wt. ..-.COMFORTZONE (outdoor) '66.1001HT 100.000 11/2' 213'4" 201/4" 31 Y2" 20" 128 28" 15" 42W - 25" 214 OG-1601HT 150,1100_ 1 h.. 1g T" tYi" - - ' 233 200,000 1 W _ 1/2"_ _11/4" 26" 18" 423'i" 25" 249 ' -003 25050/HT 250.000 11A' 1/t" 1Y4" 1Y4" 28" 21" 4234" - C6.350/HT. • 350.000 1W - 34" 1 11/2" - 28" 27 4234" - 25" 273 COMFOW WNE (Indoor-outdoor) - roM C6.100/I ]00.000_ tW 1/2" r, _ 1" 6" 213i 20Y4" 2631/' 271/1' 20" 128 00. 1501p: 150,000 1W Ys" 1" 1Y4" 6" 28" 15" 35" 27-- 25" 214 CO-2001P 200.000 1 %1- 1/2" 11A" 1 1/4" 7 28" 11. 35" 253i' 25" 233 C6*2501P, 250,000 - 11/2"_ . _ 1/2" t Yi" 11/4" 8" 28" 21" 35" 333'4" 25" 249 WATER CONNECTION FOR CO SERIES C6-3501P 350,000 11/2" W 11/4" 1141" 10" 28" 27" 35" 32V2,, 25" 273 - NOTE. peNglub NMW W Go MOUhb with NW. Wh2 MW LP MO kiN w,lh LP sulha 'AGA C.YIW tar use .,it, PIM..". Gait. - S% .dae ~ va&y Booed, 9nc. 1 URN ILAvenue South +07 Ij•~- BUR(612) MN 55337 (812) 894-1480 CITY OF EAGAN Includ 2 sets of plans, 0 1 site plan w/elevations & BUILDING PERMIT APPLICATION 1 set f energy calculations. To Be Used Foz`!fk DLIC H valuationO 000 Date S $ 3 Site Address / `floe CAAA6j2( 'f l' I OFFICE USE ONLY Lot v`Z 1 Block __Sec./Sub. fj 0,er- l I t C \ Erect Occupancy Parcel S b- - 2lo d 1~ Alter Zoning p~ Repair Fire Zone Owner: ~ro E0 I lS Enlarge _ Type of Co t. Move # Stories Address: q( S1CA1Aeje1A)GFr- Demolish _ Front ft. City/Zip Code: ~tEFSh1 ~kkrj Ss ID2 Grade Depth ft. Phone Asa-tea r FEES APPROVALS Contractor: 5~ ( Assessments P t water/Sewer S to Check~- Address: Police P an city/zip code: Fire Eng. W Conn. Phone Planner Wa r Meter l Council Unit Arch. /Eng Bldg. Off. Address: APC City/Zip Code: JnL Phone Vaeeey Paoi' 'Inc. • 651 CliH Road r BURNSVILLE, MINNESOTA 55337 (612) 894-1480 4- i /p, y o~ l 1 ©QHE,p rf,~ ~'i a a 3 of) 9 14'4 ~ AN rY W I I (p r I u/.~ s Ask i ~ It BEA BLOMOUIST MAYOR THOMAS HEDGES CITY ADMINISTRATOR CITY OF GAGAN EUGENE VAN OVERBEKE THOMAS EGAN JAMESA SMITH CITY CLERK JERRY THOMAS la :';'~4Jt ` THEODORE WACHTER Bs<']]1S PILOT XNOBtROAD CDONCIL MEMBERS BOX 111" EAGAN; MINNESOTA Y.. 55122, PHONE 4549100 y i March 26, 1982 Joseph M. Miller Construction, Inc. 14115 Cuthrie Avenue, Apple Valley, NN 55124 Pe: Iot 21, Block 4, Beacon Hill` 4655 Cambridge Drive Setback variances of ten (10) inches or less are unnecessary as they are considered an honest margin of error.' 'Ihe measurement could vary with each subsequent survey and at some point the setbacks could be correct. Sincerel We S. Peterson Building Official CC: Dale C. Rankle, Planner Parcel File DSP/bar THE LONE OAK TREE THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY. al cQ RESIDENTIAL BUILDING aI ~L~ 1 Permit Application _ City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements Remodel/Repair Requirements Office Use OnM 3 registered site surveys showing sq. ft. of lot, sq. it of house; and all roofed areas 2 copies of plan Can of Survey Recd -Y -N (20% maximum lot coverage allowed) 1 set of Energy Calculatons for heated additions Tree Pres Plan Rood _Y -N 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Reqd -Y -N I set of Energy Calculations Addition- indicate ifonsite septic system On-site Septic System _Y _N 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Detail Options selection sheet (bldgs with 3 or less units Date / ~Ao l 07 Construction Cost a l3 /b((7. CPO Site Address Y6'57-5- L 4 Unit/Ste # Description of Work Sr GC / -n Multi-Family Bldg - Y eC N Fireplace(s) - 0 - 1 - 2 Property Owner ~Ok•AN°r/'t E5a`e-rG r, rZ,_ Telephone #(65-1 Egg' q 3 Contractor G X tr -"o, C'-X'V crr' w~~t> T" Address %/d o 4, • 171e o~ - Fr cw.a -IF/. o r9 City fj- State Z"l Av • y Zip 53--# 3 ( Telephone # COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (4 submission type) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a si plan? _ Y _ N If so, 25% plan review fee applies. N~~0 L5 Licensed Plumber Telephone ) Mechanical Contractor Telephone # ( ) Sewer/Water Contractor By 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 NfN 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. Applicant's Printed Name Appl' ant's Sign e ~j 13-11 1 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos when permits are required for each unit Date LI) 9`/// Site Address ~(p~~ L1.Y ' ap f Unit # Property Owner Mara QrA O/I.f 9 Telephone#(65/ )&ffg'- q -13 Contractor StreetAddr(e~ss ,00&5 IAI,5'mod' 0). City 0 52IY1 0 .t n T State / r 1 Zip 60& Telephone # ( 6$I Ooga (P Bond Expires: The Applicant is Owner Contractor Other Add-on or alteration to existing dwelling unit $ 30.00 furnace -Additional Replacement air exchanger air conditioner -New -Replacement other State Surcharge $ .50 Total $ SO I hereby apply for a Residential Mechanical 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 with the Mechanical Codes; 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 approval r Iy4mtj Seyec sc9dlr l'fV~ (AOn4i-r-a4r App ican is Printed Name Applicr a e E9!SEP O nn 2005 D 4~v C y ~U1 fit" m fig; ~j ~ ~ • CJ's ~ ~ o J ~ R 4n to J r H , PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA161591 Date Issued:06/03/2020 Permit Category:ePermit Site Address: 4655 Cambridge Dr Lot:21 Block: 4 Addition: Beacon Hill PID:10-13500-04-210 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener 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 - Margaret E Gluth 4655 Cambridge Dr Eagan MN 55122 Haferman Water Conditioning 12142 12th Ave. Burnsville MN 55337 (952) 894-4040 Applicant/Permitee: Signature Issued By: Signature