4641 Beacon Hill Rd
Use BLUE or BLACK Ink
I,-For Office. U,,:
I
'T' City of Eajan I Permit I
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 I Date Received: I
I I
Phone: (651) 675-5675 RECEIVED I Staff: I
Fax: (651) 675-5694
- - - - - - - - - - - - - - - - - J
JAN 10 2011
INFLOW I FILTRATION PERMIT APPLICATION
Piumbing / Sewer & Water
Date:-[ 1 /11 Site Address: 41 'J~MOz
/ I . Au .M N L
Tenant: Suite
RESIDENT /OWNER Name: Phone:
`
~ 41 p-, zn L401 AA
Address / City / Zip: W 4 (a3
Name: -h -Swv\. License W/ J/( 53,3#4
Address: r
f 1 Zk Embet AA) City: 00
CONTRACTOR
State: -m-►~} Zfip::. Phone: -551 a-Q Contact: V ~~MKJ\ l U► ~L.~+Tfail: ,
PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope)
TYPE OF WORK Sump Pump Repair Repair
Other: Other:
Description of work: 1 V l J
DESCRIPTION
FEES
po
$55.00 / Each (includes $5.00 State Surcharge) (Rev. 6-30-10) TOTAL FEE $56-
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit I/1 repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.citvofeagan.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.oopherstateonecall.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 witho t a
permit; that the work will be in accordance with the approved plan in the case of work wh' h requires review and ap oval of pla
-7n I
X l~e~ca.Y&I/Y- In /0 CL,
X
Applicant's Printed Name Ap Si nature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground -Rough-In -Final
Ark, 4ftt, -i.111 AAMO-
C~~rftftr~tt~e of (~rru~ttnr~
Y~
Cit of (Eagan
Brpartmrnt of Builbing Jnapertinn
This Certificate issued pursuant to the requirements of Section 306 of the Uniform. Building i
. ~J Code certifying that at the time of issuance this structure was in compliance with the various
k j ordinances of the City regulating building construction or use. For the {ollouing:
?1
6392 '
U. el.oefiatice S DMIGAR Bid& Permit No. k6
OcatparryType TypeCaa+tnxtioavFireZone 3 Zoning District i~
~j
Centex Hanes 8601 Darnel Rd,Eclen Prairie",.
Own" of Budding Address
' Bttgaing Aameat 46 41 Beac m Hill d,,,Y I25 , B1k BeacM r~
/Qf ~I By:
3-23-81
i~ Date: - ~
Building O
ffEw
CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 55122 N~ 6 3 9 2
PHONE: 454-8100
BUILDING PERMIT Receipt # -
To be and for Est. Value Date 19
Site Address Erect ❑ Occupancy
Lot Block Sec/Sub. Alter ❑ Zoning
Parcel # Repair ❑ Fire Zone
Enlarge ❑ Type of Const.
0! Name Move ❑ # Stories
z Address Demolish ❑ Front ft.
9 city Phone - Grade p Depth ft.
Name Approvals Fees
,o
ob Address Assessment Permit
~ city Phone Water & Sew. Surcharge
Police Plan check
WZ Nome Fire SAC
ua Address Eng. Water Conn.
<W City Phone Planner Water Meter
Council Road Unit
I hereby a&nowledge that I have read this application and state that Bldg. Off.
the information is correct and agree to comply with all applicable APC Total
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 applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
remit # Daft bawd remitttt
Plumbing &-,&
Mechanical
INSPECTIONS DATE INSP. Rough-In Final
Footings u2(~- Date Insp. Dote Insp.
Foundation _ Plumbing ~g
Fram ins. Mechanical
Final CV,
itFOe,~.1„~J
Remarks: 3 -.-)-3 -5-( 2t--y
CITY OF EAGAN
3795 Pilot Knob Road
No. Eagan, Minnesota 55122 INSPECTOR NOTIFICATION
Phone: 454-8100 REQUIRED BY LAW
PERMIT FOR ALL INSPECTIONS
Date: Receipt No.:
Single
Site Address: Residential
1
Lot Block Sub/Sec. Multi Res., Comm./Ind.
Name New/Alter. /Repair
Address
Cost of Installation
City Phone: Permit Fee
Name Surcharge
Address
City Phone: Total
This Permit is issued 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
% CITY OF EAGAN
3795 Pilot Knob Road
No Eagan, Minnesota 55122 INSPECTOR NOTIFICATION
Phone: 454-8100 REQUIRED BY LAW
PERMIT FOR ALL INSPECTIONS
Dote: Receipt No.:
Single
Site Address: Residential
Lot Block Sub/Sec. Multi Res., Comm./Ind. I
Name New /Alter./ Repair
3 Address Cost of Installation
O City Phone: Permit Fee
Name Surcharge
Address
e
City Phone: Total
This Permit is issued 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
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road A 6
Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675 i fA 4~ c, 44
SITE ADDRESS: i 1 1 1r 4114, APPLICANT:
It l t l NO
I f! ,
PERMIT SUBTYPE: TYPE OF WORK: I;1 1 All I?
INSPECTION TYPE DATE INSPTR. INSPECTION TYPE DATE INSPTR.
F
Permit Holder Date Telephone S
PLUMBING
HVAC
Inspection Date Inap. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
CITY OF EAGAN Remarks
Addition BEACON HILL ADDITION Lot 15 Blk 1 Parcel 10 13500 150 01
Owner f'YLu\ ~K Lij,(-i (-KrLI Street 4641 Beacon Hill Road State_ Eagan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. ~0 1982 1806.93 200.77 9 1806.93 0007377 10-1-81
STREET RESTOR.
GRADING I 1982 526.46 58.50 9 526.46 0007377 10-1-81
SAN SEW TRUNK 976 135.97 9.06 15 90.67 A008956 3/18180
* SEWER LATERAL (0% 1982 3116.46 346.26 9 3116.46 0007377 10-1-81
WATERMAIN
* WATER LATERAL 1982 9
WATER AREA 1982 198.01 22.00 9 198.01 0007377 10-1-81
* Stubs 1982 9
STORM SEW TRK Iaq L 1982 359.82 39.98 9 359.82 0007377 10-1-81
* STORM SEW LAT 1982 9
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road Unit 19-S-00 11/25/80
WATER CONN. 305.00 22050 11/25/80
BUILDING PER.
SAC 80 22050 PARK
CITY OF EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address: j,
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee:
1 agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
BY Date Paid:
Date of Insp.: Insp.:
CITY OF EA(3AN SEWER SERVICE PERMIT
3795-Pilot Keob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
1 agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
BY Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
Vie- 30 i
This request void , ~S: ~ I~ ~ ~~•-t"` ~ ~ 30 -7(.0
18 months from
Date of this Request ► I b I Fire No.
Y 16648
1, aE`~1 Licensed Electrical Contractor ❑ Owner, do hereby request inspection of the above electri-
cal ring installed at:
et Address or Route No. 11411( 1~Cat~t C~ I~- 1~1J. City
ion Township Range County i
Which is occupied by C1={v't H` hL
(Name of Occupant)
Is a roughin inspection required on this job? No ❑ Ye~ Ready Now ❑ Will G2*d
Power Supplier Address M1`'f ' ItQ 6 -
1`-pp,,
Electrical Contractor eLL- Contractor's License NOPU99
+ (COmRany Name) l~
Mailing Address ~ RD,.
(rte ncal ntractor or Owner Making This Installation) r
Authorized Signature Phone No J'"~Sz4
(Electrical Contractor or Own r Making This Installation)
ST AW N U 1~ RD ((D PV This inspection request will not accepted the
~j [j°" State Board unless proper inspection fee is enclosed.
m1nne5e1a here noara Or CIMITIOlry
= Griggs Midway Bldg. - Room N191 / EB-00001-02
1821 Gniversity Ave., St. Paul, Minn. 55104 - Phone 297-2111 7 W
REQUEST FOR ELECTRICAL INSPECTION 16648 ✓
CHECK BELOW WORK COVERED BY THIS REQUEST
Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For
Home ❑ ❑ Range ❑ Temporary Wiring
Duplex ❑ ❑ Water Heater ❑ Lighting Fixtures
Bldg. El El El Dryer Electric Heating El
t.mercial al Bldg. ❑ ❑ ❑ Furnace Silo UNoader ❑
Industrial Bldg. ❑ ❑ ❑ Air Conditioner Bulk Milk Tank ❑
List List
Farm E] E] ❑ $erers~ Hertersl
Other H 1
COMPUTE INSPECTION FEE BELOW
Service Entrance Size: # Fee Feeders&Subfeeders: # Fee Circuits: # Fee
0 to 100 Am s. 0 to 30 Amperes 0 to 30 Amperes
101 to 200 Amps. 31 to 100 Amperes 31 to 100 Am eres
Above 200 Amps. Above 100 Amps. Above 100 Amps.
Transformers Remote Control Circ. Parualorotherfee t
Signs Special Inspection Minimum fee $S.
Remarks O Ptif TOTAL FEE 0,
I, the Electrical sPe r~ that bove insPction has been ma e.
U9T uY
(Rough-in) P Date
(Final) ~}e ay 7d -h
This request void ~L
18 months from
_ CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 55122 N2 6392
PHONE: 454-8100 y ~ )
BUILDING PERMIT APPLICATION Receipt # _ ~rU -
To be used for SF DWG/GAR Est. Value 48 000 Date 11-24 193a--
Site _Address /+1 Beacon Hill Rd. ( 53,1 Erect ® Occupancy R3
15 1) Beacon Hill Alter Rl
Lot- Block Sec/Sub. ❑ Zoning
Parcel # Repair ❑ Fire Zone 3 _
Enlarge ❑ Type of Const. V
W Name Centex Homes Move ❑ # Stories
8601 Darnel Rd. 46= ft.
b Address Demolish ❑ Front
CityEden Prairie, hone 941-(1671 Grode ❑ Depth 50 ft.
o Nome Approvals Fees
oG Address same Assessment Permit 135.50
u~ City Phone Water & Sew. Surcharge 24.00
Police Plan check 67.75
Z Name Fire SAC 525.00
uD Address Eng. Water Conn.. 305.0
.Q
aW city Phone Planner Water Meter 60-00
Council Road Unit 185-on
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 APC Total 1,302.25
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Peunittee
A Building Permit is issued to: Centex Homes on the express condition that
all work shall be done in accordance wJRh al_I appli ble State of Minn oto Statutes and City of Eagan Ordinances.
Building Official / e. 7~ J
For Otf(ce,Use
! Permit# V45 3
I
City of Eap ~ I
Permit Fee:
3830 Pilot Knob Road j - 3/
Eagan MN 55122 Date Received: f
Phone: (651) 675-5675
C ~Zy
i
Fax: (651) 675.5694 i Staff:
200x08 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 7"5 /-0 0 Site Address: Lf 0 / / 9-&~CV h
Tenant: Suite
RESIDENT / OWNER Name: Ko, I 6 CZC, Phone:
Address / City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK Description of work: T£:~/!^r%/
Construction Cost: ! oo U Multi-Family Building: (Yes _ / No
CONTRACTOR Name: / 11 i't9 S o l~ License r /
Address,:, b a /J V I ~
City: a Pe,rk- State: I'LIN _ Zip:
Gt T`!'~- szayl
Phone: to % S6' 00 30 Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Category 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 that yousubmit are considered to be public information. `Portions of
the information may be classified as non-public if you provide speciflc,reasons that would,permit the City to
conclude that the are trade secrets-
I hereby acknowledge that this information is complete and accurate; that the work wiff 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 witho t a permit; that the work will be in
accordancee~ with the approved plan in the case of work which requires a review and approval of plans.
x~~i~ ~UF~h~Jn x
Applicant's Printed Name Applic s nature
Page 1 of 3
61 -<P sa
2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION . ws f 2
City Of Eagan
3530 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 / /
Site Address lO `ti GC 091/1 Unit #
T7~ Telephone # (~~J r) S~-
Property Owner k a4,,-(
Contractor
UAUD HEATIIwi & AIR CONDITIONING CO.
Street Address 410 WEST LAKE STREET City
MINNEAPOLIS, MN 56408-2998
( )
State 12-824-%%, Zip Telephone #
Bond Expires:
The Applicant is Owner Contractor Other 1
Add-on or alteration to existing dwelling unit $ 30.00
- 6y
furnace Additional Replacement
air exchanger
air conditioner -New -Replacement
other
State Surcharge $ .50
Total $ 3O , 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 Cit of Eagan and with the Mechanical Codes; that nderstand this is not a
petnrit, but only an application for a permit, and work is n to start without a permit; that the work w' a accordance with the
approve an in these of work quires a review an approval of plans.
Applicant's Printed Name Applicant's Sign
at
PERMIT
CITY+OF EAGAN
3830 Pilot Knob Road PERMIT TYPE:
Eagan, Minnesota 55122-1897 Permit Number: B~ J~ R 6 N G
(612) 681-4675 Date Issued: 09/2S/98
SITE ADDRESS: 4641 BEACON HILL RD
LOT: 15 BLOCK: 1
BEACON HILL
P.I.N.: 10-13500-150-01 -
DESCRIPTION:
REROOF
130- ~?Ivh' RTPermit Type STORM DAMAGE
B1a ldang'VQ,rk Type REPAIR
,W"eneu Cad434 ALT. RESIDENTIAL
m= nt.s
,n v
g
`a 5£1 E ~ms:Yt`ni
_ -3 E b9~~a
.'P I5
n' ss°a _ snm c , 's§ .a
k> E d. M`r ~°'v^ k~ '#3.n a 3)4t t - k k q!{ `4 d , gt a" wj
REMARKS:
FEE SUMMARY:
pp scan - ST. LIC. OWNER:
"clc~ RLTOF7NG 18950040 20139140 GARZA RAUL
11583 RUPP RD 4641 BEACON HILL RD
BURNSVILLE MN 55337 EAGAN MN 55122
(612) 895-0040 (651)452-4360
hereby ackh,owled.gj~,Chat r have re'd •t'hte .a'ppkacat irta aritli°st 1 ti t` he m
€ zrma ion. carrept and agrea:'to camp3Y`.wx~ h.'at2 app J cable' e ~t rt;
51 t~:t e and C 6°f Eagan°:Ord'3il~Ptces. 1
- rr m
E
APPLICANT/PERMITEE SIGNATURE UED BY. SIGNATURE
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
• s CITY OF EAGAN 9-,D(;-,9
3830 PILOT KNOB RD - 55122
`j 681-4675 1-16190
New Construction Requirements RemodeVReoair 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)
♦ t energy calculations ♦ 1 energy calculations for heated additions _
4 3 copies of tree preservation plan N lot platted after 7/1193
required: _Yes _ No /
DATE: q- 2) Al CONSTRUCTION COST; SGo~ y
DESCRIP ON OF WORK: ~ ~on ~ 114,9104.q
T
STREET ADDRESS: "~'CY1
LOT: 15- BLOCK: SUBD./P.I.D. a C 3 v I~ S
Name: COQ X7-6 Phone
PROPERTY Last First
OWNER
Street Address: (•7~CW Wy ~.I l ~I l / Jt [lt
City a Q State: Zip:
Company:{->{- Z Phone 14 on y41)
CONTRACTOR )r ~ 110 /vat `n
Street Address: _ izc,-) Q M IV # [J
City 15 U42 A g Vr 11s State: MIV Zip: ~h 5 5
ARCHITECT/
ENGINEER Company: Phone
Name: Registration
Street Address:
City State: Zip:
Sewer & water licensed plumber (new construction only): Penalty applies when address chang
and lot change is 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 applcabl
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant
OFFICE USE ONLY D L
Certificates of Survey Received Yes No
Tree Preservation Plan Received Yes No Not Required i
yd~~r CITY OF EAGAV Include 2 sets of plus,
n 1 site plan elevations &
BUILDING PERMI' APPLICATION 1 set of energy calculations.
To Be Used For ValuatioopnlI ; CJDD Date
Site Address: nQttev,7 pd OFFICE USE ONLY
Iot Block ;$ec./Sub. i Erect pC Occupancy
Parcel Alter Zoning /
Repair Fire Zone
Owner: C,P1jtPX gom eS Enlarge _ Type of Const.
Move # Stories
Address: yn e Demolish _ Front ~l ft.
.rt ft.
City/Zip Code: 4 d41' pra Grade Depth
Phone fvb'7/ APPROVALS FEES
Contractor: Assessments z Permit has- 41.
Water/Sewer Surcharge y •1-
Address: Police Plan Check
City/Zip Code: Fire SAC-
Phone Eng. Water Conn. 3 0 S
Planner Water .Meter / d
Axch./tng.: Council Road Unit ig
Bldg. Off.
Address: ApC
City/Zip Code:
Phone TOTAL
Pente fica te for:
x Homes Midwest Inc.
8601 Darnell Road
Eden Prairie, Mn. 55344 /2AN ~%32
DELMAR H. SCHWANZ
I~ LANOSURVEVOR
1p ggIfUYW UnOn L+ws of TM 5lNS of Minn~t,
q 2576 - 146TH STREET W. - BOX M ROSEMOUNT, MINNESOTA 66668 PHONE 612 Ui17W
SURVEYOR'S CERTIFICATE
Top of Block
~g 41J Garage Floor 957.5 ft. .
- D ment Floor
r1
ILL PDAU
19
D I o P~po05f~ r yo o °
NoaSE ' N polo( q bD
0
r, ? 2
So.3 ~ k qyA.
r
GSA NAGE ~ 1r^ p
I hereby certify that this is
a true and correct representation
of Lot 15, Block 1, BEACON HILLS,
W VVV according to the plat thereof,
Denotes proposed finished gradeDakota County, Mn.
I® C Denotes wood hub
duly 5. 1979
z I Benchmark: Top hydrant between lots
4 13 & 14, Blk. 1, Elev. 957,26 ft.
c
Revised to show proposed house November 18, 1980
ti
+.u
a
MINNESOTA REGIS RATION NO. 5646
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122 t_7 0, O
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Requirements RemodeUReoair Requirements Office use.OnN
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% mmimum lot coverage allowed) 1 set of Energy Calculations for heated additions Tfee Pre,pion R
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions 8 decks i~r~ Prssft¢quir
l set of Energy Calculations Addition - indicate if on-site septic system OnsiteSeptic System _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 / ~72/ Construction Cost p yd
Site Address `/6y/ /y~ pmt rlr j//~r~ Unit/Ste #
Description of Work //gyp - f ' a(e,
Multi-Family Bldg _ Y Y N Fireplace(s) _ 0 _ 1 _ 2
Property Owner ~j 1 p5,xrZl_ Telephone # (61-1) YFe9- y~6 D
Contractor /1j;&
~
Address City 49 i7 s,-,✓A
State Zip Telephone # (g~ 9
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
(J submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N alfn i ew
fee applies. ~ Licensed Plumber Telepho (W
Mechanical Contractor Telephon ( )
Sewer/Water Contractor Telephon B
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.
DBa
Applicant's Printed Name Applicant's Signature
I For OficeUse I
City of EapIl Permit#: 7,L +r3
C ~ I
3830 Pilot Knob Road Permit Fee:
Eagan MN 55122 j Date
Received-
Phone: (651) 675-5675 ~nn
Fax: (651) 675-5694 i Staff: -
2008 RESIDENTIAL BUILDING PERMIT APPLI ION , 3 2003
Date: r7 Site Address: 1 e 2
Tenant: RaOI Gar2,31 t
Suite
RESIDENT / OWNER Name:. Rau 1 6a rzQ Jr- Phone: (2si -45a -43(0o
Address lCity /Zip: 4(041 g C~ -t4,kk Road I Fir f~N
Applicant is: _ Owner A Contractor
TYPE OF WORK Description of work:
Construction Cost: t*, 't ~c~i an
Multi-Family Building: (Yes No
CONTRACTOR Name: Nltnnr~an ~t~ m+Qew~t~'i cAse#: ~;Ci- 5
Address: 13t(o Sect Sife_P4 Su, ~e InL
City: -A4 yel5~ State: \L-Zip: 5401(0
Phone:_1 I5-3P'I-35M Contact Person:SCn4+ Me-gerl e-ger
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Cateoorv 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 that you submit are considered to be public information. Portions of
the Information may be classified as nonpublic if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
I hereby acknowledge that this information is complete and accurate; that the work will be i 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 w 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 f plans.
x Scoff-} Meter x
Applicant's Printed Name Appli n 's Sig u
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA174094
Date Issued:12/23/2021
Permit Category:ePermit
Site Address: 4641 Beacon Hill Rd
Lot:15 Block: 1 Addition: Beacon Hill
PID:10-13500-01-150
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Raul Garza
4641 Beacon Hill Rd
Saint Paul MN 55122--270
Hero Plumbing Heating & Cooling Inc
10900 Hampshire Ave S
Minneapolis MN 55438
(612) 827-4674
Applicant/Permitee: Signature Issued By: Signature