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1041 Beatrice St CITY OF EAGAN Remarks Addition McKee Addition X61 Lot 28 Blk 2 Parcel 10 47750 280 02 Owner '/4'A street 1041 Beatrice St. State Eagan, MN 55121 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF, STREET RESTOR. Pavin 1969 311.50 31.15 10 PAID GRADING SAN SEW TRUNK 1968 100.00 3.33 30 PAID * SEWER LATERAL 1968 20 WATERMAIN WATER LATERAL & SEW 1968 F8n5'0.nO 0 42. 50 20 WATER AREA STORM SEW TRK 1984 .0 26.87 15 403.00 0008326 8-3-83 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. $200.00 480 11-6-67 BUILDING PER. SAC 200.00 480 11-6-67 PARK 11O ~~i"•/ 200S RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan F 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomesfcondos when permits are required for each unit Date Site Address Z04,61 t I J Unit # Property Owner ~r► SC~YN Telephone Contractor Street Address ` o, + - l t CAI- ~ G~~~,~ nr i ~ M~.~•~ ~ City State K% . Zip Telephone # (ta i l) f 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 Cal L t:1 / L S ► A r joas State Surcharge $ 50:` Total $ I hereby apply for a Residential Mechanical Permit and acknowledge that the information. is complete and accurate; that the, 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 ap oved plan in the case of work which requires a review and approval of la wi ~ y Applicant's Printed Name Appl ca Signature JUL 2 6 2oo5- By 2005 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: commercial/industrial buildings multi-family buildings when separate permits are. not required for each dwelling unit Date 1 / Site Street Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( } Contractor Street Address city ( } state Zip Telephone # Bond Expires: The Applicant is Owner Contractor Other Work Type New Construction _ Underground Tank Install Remove **see below Interior Improvement Install Piping -Processed -Gas Nature of Work: **Men instal/tng/removing undetgrround tank, call for inspection by Firs Marshal and Plumbing Inspector Permit Fees: $70.50 Underground tank installation/removal $50.50 Afhd { m (includes State Surcharge) or Contract Value $ x 1% _ $ Permit Fee. • If permit fee is $1,000 or less, add $.50 Z:> $ State Surcharge if permit fee is over $1,000, add $.50 for every $1,000 wit fee $ Total Fee I hereby apply for a Commercial 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 of plans. Applicant's Printed Name Applicant's Signature Approved By: Inspector Date: t _,o jqq.j~ 6q 7- -7~ C 2005 RESIDENTIAL BUILDING PERMIT APPLICATION l/ t7S 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 only 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Ced of Survey Recd _ Y _ N (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Reed - Y _ N, 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Required _ Y _ N 1 set of Energy Calculations Addition - indicate if on-site septic system 0n-site Sepik System - Y _ N 3 copies of Tree Preservation Plan if lot platted after 711/93 Rim Joist Detail options selection sheet (buildings with 3 or less units) Date t0 / / S Construction Cost ! 07eD Site Address `l~ ~✓1-~ / C495 Unit/Ste # Description of Work IAIIS V' Multi-Family Bldg - Y N Fireplace(s) - 0 - 1 - 2 Property Owner Telephone # (07) _?,30 -rO 70' Contractor Address// ~~~4Z-73 WN04- dl217tCf__ City State Zip 7 J Telephone # ( ) e;91 71 Q~~y COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Category _ Minnesota Rules 7672 Energy Code Category Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (4 submission type) Submitted Submitted • Energy Envelope Calculations Submitted o Have you previously constructed a building in Eagan with a similar plan? . - Y _ N If so 25% plan review fee applies. Licensed Plumber Telephone # ( ) Mechanical Contractor Telephone # ( ) Sewer/Water Contractor 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. - !r (71 'A~ i Applicant's Printed Name App "Signature i' I .._J t pC L_.,..... 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. ❑ 05 03-plex ❑ 11 10-plex X 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex Plbg_y or _ N ❑ 25 Miscellaneous Work Types 641 f"~ j `J 4 ~t! ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish Interior ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Building ❑ 42 Demolish Foundation ❑ 45 Fire Repair ;X 33 Alteration ❑ 37 Demolish Building* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant Valuations Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) _ Final/C.O. Footings (deck) Final/No C.O. Footings (addition) _ Plumbing Foundation ~C HVAC _ Drain Tile T Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests -Final Framing _ Siding _ Stucco - Stone - Brick Fireplace _ R.I. _ Air Test - Final _ Windows Insulation _ Retaining Wall Approved By:_~ , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SACS Utility Connection Charge S&W Permit & Surcharge,., Treatment Plant s License Search P Copies Other Total C) 577 V RESIDENTIAL BUILDING Permit Application 7 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 Only 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan _ Cert of Survey Recd (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions _ Tree Pres Plan Recd 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks _ Tree Pres Not Reqd 1 set of Energy Calculations Addition - indicate If on-site septic system _ On-site Septic System 3 copies of Tree Preservation Plan if lot platted after 711/93 Rim Joist Detail Options selection sheet (bldgs with 3 or less units Date Construction Costs Site Address /l =E-S~~~ Unit/Ste # Description of Work D---C,Y.. A-1--D AT [Ct~ Multi-Family Bldg - Y N Fireplace(s) - 0 - 1 - 2 Property Owner ~ 1 M A ~c~ u Telephone # Contractor A _ Address AU, Ci State Zi Telephone # '~L 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 Licensed Plumber Telephone # ( ) Mechanical Contractor Telephon Sewer/Water Contractor Telephon i#~ ) I I hereby apply for a Residential Building Permit and acknowledge that the infirm :4s-cei°tzte amd 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 fora permit, and work is not to start without a permit; that the work will be in accordance with the approved Ian in the case o A which requires a review and approval of plans. Applicant's Printed game A licant's ignature 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. ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex Plbg_Y or _ N ❑ 25 Miscellaneous Work Types ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish (Interior) ❑ 44 Siding 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair 33 Alteration ❑ 37 Demolish (Bldg)* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant Valuation - l~ Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units ! Sq. Ft. PRV Nbr. of Bldgs I Length Fire Sprinklered Type of Const VA) Width REQUIRED INSPECTIONS Footings (new bldg) _ Final/C.O. X Footings (deck) Final/No C.O. Footings (addition) _ Plumbing Foundation _ HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests -Final Framing _ Siding Stucco _ Stone Fireplace _ R.I. -Air Test -Final _ Windows (new/replacement) Insulation - Retaining Wall Approved By T , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge t.J Treatment Plant License Search Copies Other Total 05/28/2003 12:17 7635851710 JOHN A UBL PAGE 02 SiT . '-Q ' r- . ' .Try.. 1 d• Y e N.RSS' `S5 . R . 1,,p YA: ~ f 4 o, y ~s ,e c r., o r Dakota CouMv- begl~.I~ 3 "03 4 :..s .C:' {.~1 ai ..r. 75 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OP 6AGrAN- 3830 PILOT KNOB RD - 55122 651681-4675 > 3 registered sEe surveys dwwkg s% ft. of lot. sq. ft. of home 2 coples of plan and id roofed areas ) 1 set of energy cakes healed additiow > 2 copies of plus (stow beam & wiwdoow styes: poured Ind. design: ek.) 1 site wrvey for rexteior adds 6 dead r > 1 set of energy calculftns > 3 copies of tree preservation plan E lot platted odor 7/1/93 DATE: _ CONSTRUCTION COST: t fit! DESCRIPTION OF WORK: ~ Iz- USA 2~ 6-Alga STREET ADDRESS: S LOT: BLOCK: SURD./P.I.D. C ~P Name:Phone: PROPERTY Last Rd OWNER Q flr'T- Street Address: / City State: w fi _ y 4- Company: & ?!wS Phww0: (area code) CONTRACTOR Street Address: I 4P~N Sc>- Ucens* # 49 " 7 Zip: City x/12 -5 State: W7^/' ARCHITECT/ ENGINEER Company: Name: Telephone E: area code ( ) Stre* Address: Registration B: City State, tea: Sprwer & wafter licensed plumber (r+ Ued for new construction onlvl: Pertpily applies when address change and k* change is requested once permit Is issued. 1 he6by acknowledge that 1 have recd this application, state that the tnformatb comply vi"apPlIcub! Sire of Minnesota Statutes and City of Eagan Ordinances. Signature of App3cae#: Q, Goe OFFICE USE ONLY k Qutficates of Survey Received Yes. No r I ` S' 2 f9 'T'ree Pieservation Plan Received Yes No Not.Required 11 OFFICE USE ONLY BUILDING PERMIT TYPE 0 01 Foundation ❑ 06 4-plex ❑ 11 10-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 02 SF Dwelling . ❑ 07 5-plex ❑ 12 12-plex ❑ 17 Garage ❑ 22, PorchtAddn. (4-sea. ❑ 03 1 of plea ❑ 08 6-plex ❑ 13 16-plex - ❑ 18 Deck ❑ 23 Porch (screened) ❑ 04 2-plex ❑ 09 7-plex ❑ 14 Apartments ❑ 19 Lower Level © 24 Storm Damage ❑ 05 3-plex D 10 8-plex ❑ 15 Lodging ❑ 20 Pool ❑ 25 Miscellaneous WORK TYPE ❑ 31 New ❑ 35 Tenant Impr ❑ 39 Gas Line Only ❑ 43 Siding/Soffds/Fascia ❑ 32 Addition ❑ 36 Move Bldg. ❑ 40 Gas Insert ❑ 44 Windows/Doors 33 Alteration ❑ 37 Demolish Bldg.* ❑ 41 Wood Stove ❑ 45 Fire Repair III ❑ 34 Repair ❑ 38 Demolish (Interior) ❑ 42 Reroof * Give PCA handout to applicant for demolition permit GENERAL INFORMATION Const. (Actual) Basement sq. ft. Census Code (Allowable) Main level sq. ft. SAC Code UBC Occupancy sq. ft. No. of Units, Zoning sq. ft. No. of Bidgs # of Stories sq. ft. MC/ES System Length sq. ft. city water Width Footprint sq. ft. Booster Pump PRV III Fire Spdnldered APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Parts Ded. Trails Ded. Other Copies Total: SAC Units %'SAC r i. . {°1!,ll~.t l..~lf": 1•' "i7, 1"1 ;+.f.'„E'l r.. : YX 9001 4050 BEATRICE S 93 16l":*5 W5 9u00i 1950 PF1'a!•f:+.{;',., ~070 9001 1011 BEATRICE 0 { CENTIME: ''nt fi:!r~r~,",., •vl ,:M. .i:- ;;ll t: :H :L k,L•vL r..t: I. t:..t ' .(r.1 •:5: ~5r f y !:.~'"ii ~.:tt~. ~if'..~i: ~6~;yr-~e •.'~r"{:.hl.~M1 x,1,1 r , i-. ,:~:.~-:y~!{: }P. A:,:i}:, r,.11 er:3~. J~:~~.`Fa kl:':':~.:':..i:.r.i:•.E:•.F:-~•.l::i.:jr.•t..~t..i:•.li:,:i;•.l: ..is ~,f::~,r:ir.{: •i::l:-Jr: a r ~•,r:"a..ip.q•.:#':1; f.: +.a•:}'f f44y:` IN& Nor 344, ~Y ""/96 TIMEI 102809 • z; k U-0 m , 3if 6 t, :a . „i,i I:::::, :,.if •lr.. .,'.,t, i.t } i' :l •i ff•.: l:t 50) a psapipt „ ~ I ~ }.c: :r: J: ,p-.. :+::r.: •i.,e::•I 1 ~ is •e-:l: qr-.;•a,a: a: u, :I:+i: . ~ +r: •f% r:: r-.~: 5~..._ r lv rp. r;:#, a•:; ~,•r„ _ - 1 pp-- - - ! ; PERMIT CITY OF EAGAN BUILDING 3830 Pilot Knob Road PERMIT TYPE: Eagan, Minnesota 55122-1897 Permit Number: 028405 (612) 681-4675 Date Issued: 08/29/96 SITE ADDRESS: 1641 BEATRICE ST LOT: 28 BLOCK: 2 MCKEE P.I.N.: 10-47756--286-02 DESCRIPTION: MAC SOUND ABATEMENT Building Permit Type SF (MISC.) Building Work Type ALTERATION UBC Occupancy R-3 U-1 Construction Type V-N Z o n i n q R-1 Census Code 434 ALT. RESIDENTIAL REMARKS: FEE SUMMARY: VALUATION $16,666 Base Fee $162.25 Surcharge 5.66 Total Fee $167.25 CONTRACTOR: - Applicant - ST. LIC•O MON PAUL BLOM CUSTOM HOMES 18913773 6601116 RR 8675 135TH ST W 1041 BEATRICE ST APPLE VALLEY MN 55124 EAGAN MN 55121 (612) 891-3773 (612)927-4576 - 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 Mn. Statutes and City of Eagan Ordinances. AP LIC NT/PERM[TEE SIGNATURE ISSUED BY: (GNAT L - I t4c6 CITY OF EAGAN 3830 PILOT KNOB RD - 55122 996 BUILDING PERMIT6 1P LIS ATION (RESIDENTIAL) ~l 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.) ♦ 2 site surveys (exterior additions & decks) ♦ 1 energy calculations ♦ 1 energy calculations for heated additions ♦ 3 copies of tree preservation plan if lot platted after 7/1193 required: _Yes _ No DATE: I K- 19o CONSTRUCTION COST: " DESCRIPTION OF WORK: 3&Ild -U 14-gAwI,~.(/ 7- z5o STREET ADDRESS: ~~7nfc~ 1L^ LOT BLOCK SUBD./P.I.D. PROPERTY Name: ~N D S~ 0 - P~4V q- z \ /Al Phone VJ17- 21'55~~ OWNER LAST FIRST Street Address 1~~~ fC- F- City: r- EAW V State: Zip: '~~4 CONTRACTOR Company: Phone PI-3 V3 BLOM CUSTOM HOMES, INC. Street Address: 8675135TH ST, W. License ll~~ APPLE VALLEY, MN 55124 City: State: Zip: ARCHITECT/ Company: Phone ENGINEER Name: Registration Street Address- City: State: Zip: Sewer & water licensed plumber: Penalty applies when address change and lot change are requested once permit is issued. 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. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received Yes No J u L 2 3 1996 Tree Preservation Plan Received Yes //No _ _ _ _ _ _ - _ OFFICE USE ONLY BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish ❑ 02 SF Dwelling ❑ 07 4-plex ❑ 12 Multi Repair/Rem. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-plex ❑ 13 Garage/Accessory ❑ 20 Public Facility ❑ 04 SF Porch ❑ 09 12-plex ❑ 14 Fireplace we 21 Miscellaneous ❑ 05 SF Misc. ❑ 10 = plex ❑ 15 Deck WORK TYPE i - .40 v"A F - ❑ 31 New X33 Alterations ❑ 36 Move o . 32 Addition ❑ 34 Repair ❑ 37 Demolition GENERAL INFORMATION Const. (Actual) V A Basement sq. ft. MCNVS System (Allowable) y~i _ Main level sq. ft. City Water UBC Occupancy-1 sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Depth Footprint sq. ft. SAC Code 01 Census Bldg i Census Unit ,Q APPROVALS Planning Building y Engineering Variance Permit Fee Valuation: $ /0,000 Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit SNV Permit SNV Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Other Copies I Total: % SAC SAC Units i EAGAN TOWNSHIP 149 LJIL DING PERMIT Owner ----I-------- - - Eagan Township Address (present) _ Town Hall Builder Y tag - - 1 DateS..G Address DESCRIPTION Stories To Be Used For 11 Front Depth Height Est. Cost Permit Fee Remarks LOCATION Street, R or other Description of Location Lo Block Addition or Tract This permit does not authorize the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and general welfare to anyone in the community. THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. This is to certify, that .--has permission to erect a------------------------ --------------•--upon the above described re a subjions of the Building Ordinance for Eagan Township adopted April 11, . Per of TBuilding Inspector Ordinance No. 114: WELL AND WATER SUPPLY MANAGEMENT Permit No. WELL PERMIT 92-9047 DAKOTA COUNTY ENVIRONMENTAL MANAGEMENT DEPARTMENT WATER AND LAND MANAGEMENT SECTION 14955 Galarie Avenue, Apple Valley, MN 55124 !•3~i~ Telephone (612) 891-7011 WHEREAS, the NON-TRANSFERABLE PERMITTEE/DBA: Don Stodola Well Drilling Co. Inc. ISSUED TO #27173 ADDRESS: 15306 Hwy #7 -REVIEWED BY Swenson Minnetonka, Mn. 55345 has submitted a permit application, has paid the sum of one hundred. five ($105) dollars to the County of Dakota as required by Ordinance Number 114 and has complied with all of the requirements of said Ordinance necessary for obtaining this permit to permanently seal the well described herein: An abandoned well with a casing diameter of 4 inches, depth of 140 feet and completed in unconsolidated sediments will be permanently sealed. The well shall be cleaned of equipment and debris, disinfected, neat cement pressure grouted and terminated at least two feet below grade. The well is located in the municipality of Eagan as follows: Well Location: Property Owner and Well Owner and Address (if different) Address (if different) 1041 Beatrice St. Goger Kocherer Eagan, Mn. NOW, THEREFORE, Don Stodola Well Drilling Co. Inc. is hereby permitted and authorized to permanently seal the well described and located above for the period March 1992 to March 1993 subject to all provisions of said Ordinance, the Minnesota Water Well Construction Code and any conditions attached on the reverse side of this permit form. Given under my hand this 30th day of March, 1992. /&h A.Y~~^ L/ C r1 ATTEST ENVIRONMENTAL UPERVISOR ENVIRONMENTA NAGEMENT DIRECTOR 03/30/92 11:48 DAKOTA CALNnY-4ESTERN SERV. CTR. 001 c3 y I Ordinance No. 114: WELL AND WATER SUPPLY MANAGEMENT MUNICIPAL NOTICE OF WELL PERMIT APPLICATION DAKOTA COUNTY ENVIRONMENTAL MANAGEMENT DEPARTMENT WATER AND LAND MANAGEMENT SECTION •14955 Galaxie Avenue West, Apple Valley, MN 55124 Telephone (612) 891-7011 Facsimile (012) 891-7031 CAPE: 3/ TIME: AM M SENT: Mail Other IPA Oh IGIAL TITLE TELEPHONE MUNICIPAUTY ADDRESS FACSIMILE FROM: LAY10 SGcJi d ENVIRONMENTAL SPECIALIST TELEPHONE REFERENCE: 92.- 92117, WELL PERMIT NO. NOTICE: The Water and Land Management Section of the Dakota County Environmental Management Department has received the fpllowing permit application(s) for the well(s) described. If you require further review of this application(s) or If you have any questions 'or concerns about it, contact the Environmental Specialist listed above or our office at telephone (612) 891-7011. If there is no response from your offloe within 2~4 hours '(excluding weekends and holidays), Water and Land Management staff will assume that you have no objections Issuance of the permit(s). Please note that permit. issuance is always conditioned on the permit applicant's observance of and compliance with all applicable laws and codes. A copy of the well permit(s) will be forwarded to your office when Completed. DESCRIPTION: PROPERTY.OWNER '20M ~ y WELLQI DfNerenQ LOCATION OF WELL(S): ADDRESS rn I ZEICE S7' 0--e ;z aj ~G PUBLIC LAND SURVEY COOP- II ATE: OF - OFOF OF 8EC ON ,T. N., R. W., MUNICIPALITY: e- -A PROPERTY ID NO. WELL CONTRACTOR: ls~ S WC&A iL LICENSE NO J APPLICATION RECEIVED SUSCONTRAUTEUTO: PERMIT TYPE: NEW CONSTRUCTION RECONSTRUCTION REPAIR(No Permit riegvireA PERMANENT SEALING `''ANNUAL MAINTENANCE: 7EMPOR RY CAPPING RECLAIMED-Utf- REGISTERED-USE 'MARY USE OF WELL(S) CASING DIAMETER INCHES: LENGTH FEET; WELL DEPTH J.4 f FEET: AQUIFER COMPLETED: OPEN HOLE SCREENED ANTICIPATED DRILUNG/SEALING DATE(BKnown), COMMENTS: STATE OF MINABANDO ED ~F11 RECORD DEPARTMENT OF HEALTH M~ V c e e 1. LOCATION OF WELL- MINNESOTA UNIQUE WELL NO. (leave blank if not known) County Nam Dakota Township Naar Township Number Range Number Section No. Fraction 4. WELL DEPTN (completed) Data sealed N E is it of . 4 Ea an 27 s 23 Wr 2 13 0 ft. (13 4 a Numerical Street Address and City of Well Location or Distance from Road S. IL ING METHOD (if known) Intersection cable tool 93 Reverse U OMwn lOQ Dug 1041 Beatrice St. Eagan, MN 55121, 6 Werlow Rod Sp A+r Bp Bored 110 30 Rotary 613 Jetted N3 Power Auger Show exact location of well (in section grid with •X•) sketch up of wall location 6. OBSTRUCTIONS N Wall obstructed 13 Y No - : • Obstructions removed Ye 13 No If obstructions cannot be m ' removed. contact NON M - - - • -I- - E ergs sealing. T 7. E Dom$tic 413 monitoring 40 heat Loop z4 _ 20 Irrigation 5[3 Public 90 Industry S • 313 Test Well C "0010081 1113 Commercial m---- 1 wL-----~ 713 Air ceaditioninq i10 2. PROPERTY OWNER'S NAME Nailing Address if different than B. 5 NG(S) property address indicated above Black Threaded 13 213 Sal v. 5p Mal dad Roger Kocherer SAME 313 Plastic 40 stainless steel MAROKESS 3. FORMATION LOS COLOR FOWMTIONF FROM TO In. to 1 26 ' ft. If not known, indicate formation log from new wall or nearby wall. in. to ft. Drift 0 130, g. SCREEN Screened wail from, ft. to _UO ft. (It known) Open Nola from _ ft, to _ ft. 10. STATIWATER LEVEL ft.Y"Sce below E3 above land Date Measured 1 3 11. WELLHEAD COMPLETION 10 Pitless Adapter 40 Found Buried Basement offset 13 Weal Pit 16. REMARKS. ELEVATION, SOURCE OF DATA - CASINGS REMOVED. CASINGS PERFORATED. ETC. 12.IN6 INFORMATION Grout 4" Well Apptox. 130' Deep. Neat `ant ~nt°n't' 8 Bags Cement Grout material fro. 30t0Q ft. cu, yds 10 lbs. Bentonite - - 2 Men, Labor, Rig and Cement Grout Pimp. 13. NEAREST SMWM OF CONTAMINATION feet direction type Well disinfected before saeiing? p Yes 14. PIMP p Removed Not Present Type: 10 Submersible 30 L.S. Turbine Reciprocating 20 Jet 40 Centrifugal 60 IS. EXISTING WELLS (Please sketch locations of abandoned and active walls in remarks sec on or an back.) Other unus i1(s) an property? Yes No Abandoned: remnant [3 Temporary Q alod 17. WATER WELL CONTRACTORS CERTIFICATION This wall was sealed under my jurisdiction and this report is true to the best of my knowledge and belief. DON STODOLA WELL DRILLING CO., INC. Licensee Business Nam 27172 License No. Address 15306 Hwv 7. Minnetonka, MN 55M signed Date 4-13-92 Mark Stodola oats -1 - 2 OFFICIAL ABANDONED WELL RECORD (May be used for Property Transfer) Nam of OM11er ZmPCRzfUr. Frzr ran zmv I EAGtli TQW;?SHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR WATER SERVICE CONNECTION Date: Number: 28 Billing Name:ky4,,) Site Address: /~~~Y/__ Owner: Billing Address ,ya~lf Plumber: `~~,i~'Gc:GL Location of Connection Meter Size Connection Chg. 9200.QQ Pd.11/6 Meter No. Permit Fee , 7.50 Pd 11/7 Meter Reading Meter Dep. 15.00 Pd 11/ Meter Sealed: Yes Add'1 Chg. NO Total Chg. $222.50 r Inspected by Date Building is a: Remarks: Residence,-x- Multiple No. Units Commercial Industrial By: Chief Inspector Other In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County,.Minnesota. Please notify the above office when ready for inspection and connection. l EAG11i TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: NUMBER 46 OWNER: L 4_1? .,RAddress/V'/ PLU11BEP/+`C;N i - TYPE OF PIPE DESCRIPTION OF BUILDING Industrial Commercial Residential Multiple Dwelling No. of units Location of Connections: Connection Charge $200.00 Pd 11/6 Permit Fee 7.50 Pd 11/7 Street Repairs Total $207.50 Inspected by: Date Remarks: By Chief Inspector In con^".ieration of the issue and delivery to me of the above permit.. I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota Please notify when ready for inspection and cornect:9on. and before ar).,:- poetica of she work is covered. 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. Date- _I 1j L4 Site Street Address jC'~Ll l Er6t~1jr t C Unit # Property Owner 1 Y Yl~~(~ Telephone # q a C Contractor Y) i;~ Telephone # ~~~1 Address 'D ~C i L~ l /G(jCj~C city tC ~C-11~~ State Zip The Applicant is: _ Owner Contractor -Other Alterations to existing dwelling $ 50.00 Add plumbing fixtures (excludes water softener and/or water heater--complete next section if installing these appliances). -Septic System Abandonment -Water Turnaround (add $125.00 if a 5/8" meter is required) .Other: Water Softener 1 Water Heater $ 15.00 new I replacement Lawn Irrigation _RPZ _PVB new -repair -rebuild $ 30.00 State Surcharge $ .50 Total $ 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 the event a plan is required to be reviewed and approved. 1 fI~' II'1 C,~ 1, f.Li ~ , ~'l 1 tf fl 2005 Applicant's rinted Name Applicant's Sig ature IOU By }15 k For Office Use I Permit City of Eakan Permit 3830 Pilot Knob Road I Eagan MN 55122 I Date Re I Phone: (651) 675-5675 ; APR 2008 Fax: (651) 675-5694 I Staff: - - - - - - - - - - - - - - J 2008 MECHANICAL PERMIT APPLICATION By i 11 Date: Site Address. ~e•r r r- 7u__ L_ Tenant: j Suite RESIDENT / OWNER Name: i Phone: Address / City / Zip: CONTRACTOR Name <•`l r it rt ~I ftr License , Address ~z City: % State: ( Zip: Phone } Y~ f Contact Person: TYPE OF WORK New 'Replacement Additional rr Alteration Demolition Description of work: Inb 1 '~lNv, y\,ac.-e NOTE: Both roof mounted and ground mounted mechanical equipment Is required to be screened by City Code. Please contact the Mechanical Inspector or one of the Planners for information an permitted screening methods. PERMIT TYPE RESIDENTIAL COMMERCIAL /Furnace New Construction Interior Improvement Air Conditioner Install Piping , Processed ' Air Exchanger Gas Exterior HVAC Unit HVAC units must be screened - Heat Pump Under /Above ground Tank Install / _ Remove) _ Other When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) r} $ FJO • -~J TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ x1% $50.50 Minimum (includes State Surcharge) Permit Fee - If Permit Fee is less than $1,000, surcharge is $.50. - If Permit Fee is > $1,000, surcharge increases by $.50 for each = $ State Surcharge $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). $ TOTAL FEE 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 Linda ,kynaxdef x 'd-a- qC& V`Q r I,$ Applicant's Printed Name Applicant's Signatu FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground - Rough in _Air Test -Gas Service Test _In-floor Heat -Final INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: ' 3830 Pilot Knob Road Permit Number: 02446 Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE A DDRESS: U411 fig 0 f, V, APPLICANT: 104) HfAt i1:t' Si M04 ('1114011111 HOIIW~' PERMIT SyUy`BTYPqE: TYPE OF WORK: A}y A y N vcl,CTION TYPE DATE INSPTR. INSPECTION TYPE D L~l k. FRAiMiN1i s P i --Off A l l ON C1t i1 E.N Hr" I fHAU Y Permit No. Permit Holder Date # ELECTRIC PLUMBING HVAC Inspwdon Date Inspm comments FOOTINGS FOUND FRAMING • ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL l~"~~ l4 BSMT R.I. BSMT FINAL DECK FTG A DECK FINAL I i