4255 Augusta LaneCITY OF EAGAN
3830 Pilot Kno6 Road
P. D. Box 31,199 "
? Eagan, MN 55121
\Ing. Joseph
r,
/lddress: ---??
'X Site Address: -K
WATER SERVICE PERMlT
PERMiT NO.:
?
DA7E:
Na. of Units: ?
MeMr No.: 1-2 'Y - ' Connection Charge: Z •• F."
10
- ' 4vA 940°slt: 5 . 0 nr
Size: 11 RE U 4cC
Rea No.: 6 9 L 4, Permit Fee: F). 0 pG'
1 esne !o ?pip wkb liie Citr ef Eeqew Surcho?ge: . J pc
r,:s .00 nd meter
Orateanca. Misc. Gwrpes:
Totol: -
B? Date Paid
Date of Insp.: Insp.:
CITY OF EAGAN WATER SERVICE PERMR
3830 Pilot Knob Road
P. O. gor. 21199 ' PERMIT NO.:
Eagan, MN 55?121
Z D/?TE:
Za+i??p. " No. of Units:
Owner: oaep er onst
Addrass:
Site ??? ugusta a?le ,unset st
Plumber:
Meter No.: Connection Charge: ? ? . ?,
SiZQ: /,CCOIIIIt DCpOSi?: • ?Jl? "pJ(:
Reodsr No.: . , p
.? .
Pcrmit Fee:
1 yew !o eo?nplp wNh iw Ci1r ef Ep"w Surcharge: •? n
O?dise?a?. Mlsc. Chorpes: ., p meter
Totol:
By Date Poid:
Date of I nsp.: I nap.:
CITY OF EAGAN SEWER SERVICE PERMR
3830 Pdot Knob Road 7018
P. O. Box 21199 . PERMIT NO.:
Eagan, MN 55127 pATE; 1 L-20-84
Zoninp: - nl No. of Units: I
Owner. JQSeph t:iller Cone t
Addresx
sit, Addross; 4255 Auptusta Lane L7 B1 Suneet lat
pl„mber; Pl yraouth Plb
-
10-19-84 47168 iou.
GU Pa
to .ew*wkb!r. Cihr ef h?.. Connaction C?+orge: 425.00 d
7
OrliMnoa. /4awurK Depos(r. 7
5 " P
Prnnk Fw: . , p:
SurcFwroe:
BY Miac. Chorpex
Darte of Irop.: Totol:
Itip.: DoM Pold: _
? Y CASH RECEIPT •
` CITY OF EAGAN
P. O. BOX 21-199
EAGAN. M?NNESOTA 55121
DATE
19
weceIven
FROM
AMOUNT
s
& DOLLARS
1 oo
? CASH F] CHECK
FQR ?
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
Thank
BY
, CITY OF EAGAN
• 3830 Pilot Knob Road, P.O. Box 21-199
PHONE: 454-8100
BUILDING PERMIT
Ta 6o ue" fer SF DWG/GAR Fd V.,L . $50,00
?
Site Ad 4255 AUGUSTA LN
Lot ? Blxk ^ec/sub. sUNSET ST
Parcel No.
W Name
z Addre
, o Name _
u? Address
f- Citv -
Name _
Address
Sipnoture of Permittee
JOl
A Buiiding Permit Is issued to:
all work shall be done in accordonce with
Buildinfl Official
4s??
Eagan, MN 55121 ? .
Receipt #
,,,,.e OCTOBER 19 ,0 84
CONST
Erect 6 Occupancy R3
Remodet ? Zoning
Repair ? Type of Const, y
Eniarge ? No. Stories
Move ? Length 4
Demolish ? Depth 24
Grade ? Sq, Ft.
Wuter & Sew.
Police
Fire
SAC
Phone Pionner
Council
that 1 hove read this opplicotion and stote that gldg. Of
rrect and agree to tomply with oll applituble APC
tatutes and City of Eogun Ordinances.
Var. Dat
Water Meter v ?. v v
Road Unit 260.00
Parks
Total i
on the express condition thot
ond City of Eapan Ordinonces.
Parmit No. Permit Holdsr Dato
Plumbing ? ? ? ? • ?( - 3U -?/? ' t ' ? ?
H.VA.C.
Electric AW)IA I ? -? 3 •$ ? 3-),50
Softener
Inspection Date Insp. Other
Footings
Foundation
Framing ?Clw
Rough Plbg. ? IYA
Rough HVAC
Insulatian
Final Plbg.
Final HVAC -8"G?
Final
Cert/Oce.
Water Dascribe L ion: '
Well
Sewe?
Pr. Disp.
Receipt ' PLUMBING PERMIT Permit No.
CITY OF EAGAN
, Fee
Fill in numbered spaces S/C
Type or Print legib/y Tot.
1. Date 2. Installation Cost
3. Job Address Lot • Blk. Tract
4. Owner
5. Contractor ' Phone
6. Address
7. City State
Zip
8. Building Type: Residential 0 Commercial ? Institutional O
9. Work Description: New Add O Alter ? Repair ?
I 10. Describe
1 11•
No, Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
- ?.
Lavatory
Softner
Shower Wel l
? Kitchen Sink
-?-- Urinal/Bidet
Laundry Tray Other
F1oor 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 ty,pe 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 % O MECHANICAL
CITY OF Ep
Fill in numben
Type or Print
1. Date 2. Installation
3. Job Address Lot-
4. Owner
5.
Permit No.
Fae
S/C
Tot.
_Blk. ? Tract ?
` I
Phone ? 0-
, . '. i
6. Address
7. City State ? !- Zip
8. Building Type: Residential (0" Commercial O Institutional O
9. Work Description: New K)' Add ? Alter O Repair ?
;
10. Describe Fuel Type 1
11.
No.
1 F.quioment STU - M. Ea.
Forced Air No. Equipment CFM
Air Handlin
:
_
;•
Mfg.
g
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg,
Gas, Piping Outlets
12. I 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.
r
Signed : for
Rough Flnal
Inspec'tioni.: Date Ins . Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EACaAN 464-8100
, . „? , . .- . , .. . ? , ... .. ? . .
PERMIT #
PLUMBING PERMIT RECEIPT # ?I3I KL'
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
Site Address
m Name _
? Address
c City .?
? BLDG. TYPE WORK DESCRIPTION
Block -4 iec;Sub1!!tAjj ' Res. ? New /
Muit. Add-on y?
Comm. Repair
Phone
y Name
3 Address T,,!:p SS-?? L?-1
p Ciry Phoneuc-1-2 I07
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIaENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
FOR:
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING
y0. FIXTURES TO L
_LWater Closet - $3.00 ? 00
__J__Bath Tubs - $3 00
__?_Lavatory - $3.00 ?S• 00
Shower - $3.00
Ki!chen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Orains - $1.50
Water Heater - $1.50
Whirlpool - $3.00
Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMI'n
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE:
STATE S/C:
• ?D
GRAND TOTAL: Z)
( f
Receipt PLUMBING PERMIT Permit No. CITY UF EAGAN
Fee
. FiII in numbered spaces S/C
Type or Print legibly Tot. 1 J
??
1. Date l\? 2. Installation Cost
3. Job Address ? -) , ^? (\X"x°Lot ? Blk. ` Tract
?-
4. Owner
5. Contractor ? Phone
6. Address •? u `?, -,L,
7. City State
8. Building Type: Residential ti
9. Work Description: New ?
2ip
Commercial ? Institutional ?
Add ? Alter ? Repair ?
10. Describe !1 i ? 0 J ? 111
` /1 n ,f 0 i
11.
No.
'- Fixtures
Water CI set No. Fixi res
spool/Drainfield
' Bath tubs
Septic Tank
? Lavatory $oftner
? Shower
Wel I
? Kitchen Sink
Urinal/Bidet Other
? Laundry Tray
? Floor Drains
N
Drinking Ftn. ?
Slop 5ink
? Gas Piping Outlets
1.
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances4ncJ codes governing this type of work.
- , '
--
Signed : -?'•. '?` ?' i i?• '?': 1 for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
?'116c) •tl`lkl
? PLUMBING PERMIT
CITY OF EAGAN
Pt?mit No.
FN
' Fill in numbered spaces S/C
Type or Prin[ legiWy ToL
1. Date 2. Installation Cost u
Y
3. Job AddresslU?? .t! -?, l..i.Lot?Blk. Tract tl St i
11
4. Owner
ii1GYlaej ?.J !"??DE""S
5. Contractor Sa rY1e ato l ove Phone '7
d
6. Address 4?a m C 3"s a L oV C
7. City !:- r. State ( { !': Zip tp ..% ?
8. Building Type: Residential E( Commercial ? Institutional ?
i
9. Work Description: New ? Add Q Alter ? Repair ?
r ? ! , r
10. Describe ?:dci 6?3?h room c>ir? w ,R.'r' I ev e i.
11.
No.
? Fixtures
Water Closet No. Fixtures
i
field
Ces
l/Dr
, Bath tubs spoo
a
n
$e
tic T
nk
? Lavatory p
a
Softner
Shower Well
Kitchen Sink
Urinal/Bidet Oth
Laundry Tray er
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping,0utlets
12. I hereby certity that the above intormation is true and correct, and I agree to
Comply with all Pydi nces end cocie?t governing this type of work.
ry;,
?gned : !/ .'r c? _ ? ? wJCSGt•A---' ? for
Rouyh Finsl
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
CITY OF EAGAN Remarks
a,ddition SUNSET FIRST ADDITION Lot 7 Blk 1 Parcel 10 72985 070 01
owr,er Street 4255 Augusta Lane State Eagan, MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK -- S 1981 168.57 8.43 20 126.47 C009997 1-14-85
SEWERLATERAL
WATERMAIN
WATEFi LATERAL
WATER AREA 1981 168.57 8.43 20 126.47 C009997 1-14-85
STORM SEW TRK 903 1985 547.79 36.52 15 511.28 C009997 1-14-85
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road Unit 260.00 #47168 10-19-84
WATER CONN. 470.00
BUILDING PER. n si
5AC 525
00 ri tt
PARK .
?
CITY OF EAGAN
Assessment
Woter 8 Sew.
Palice
Fire
Eng.
Planner
Council
Bidg. Off, 1 0 I8 8
APC
Var. Date
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8700
BUILDING PERMIT rtece iat #
Te be uwd fer SF DWG/GAR Est. Value $50,000 pate OCTOBER 19_ 19 84
SiteAddress 4255 A[1GOSTA LN Erect 14 Occupancy R3
lot 7 Block ! Sec/Sub. SUNSET 1$7.' Remodel ? Zonin9 R-L
Parcel No. Repair ? Type of Const. V
Enlarge ? No. Stories
? Name JOE MILLER CONST nnove ? Lenyth 40
Z Address 18133 CEDAR AVE Demolish ? Depth 24
9 City FARMINGTO41hone 431-2001 Grade ? Sq. Ft.
o Name $AME
?? Address ?
r City Phone
Name _
Address
City
Phone
1 here6y ockrawledge that I have read this application and state that
the inlormotion is correct ond ngree to comply with all oppLcable
State of Minnewta Statutesj}tand City of og gO,,rd)irwnces.
Sipnmure of Pertnittee ??+?
A 8ullding Permit Is istued to: JOE MIL CONST
all work shall be done in xcordonce with oll o [ca le Staf?of-Mii
N° 9633
Faea
Permit 9 LOJ. V V
Surchorge 25.00
Plan check 141.50
snc 525.00
Water Conn. 4 7 0. 0 0
Water Meter 63.00
Rood llnit 260.00
Parks
7otal $1, 767.50
on the express condition thol
Statutes and City of Eagan Ordinances.
Building Official
. VjQ?e1Q1F*TJU0eTME
,
ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN -
-47G+K?,Zl_ I o2 9 ?• 10• 9? ?5 3 QNCERTIF19ICATES OF SURVEY
5. F, Dki(a. ?UpQ, Q SET OF ENERGY CALCULATIONS
To Be Used For: Valuation: QFJe)- Date: j0-16-JP51
Site Address: 4la??js" ??y/??,??j?,#- • ?
Lot: ?? B1ock:?Sect/Sub: ?? 'Erect: X Occupancy:
Parcel #= Remodel: Zoning: ?-I
Repair- Type Of Const: ?
Owner: Enlarge: _ # Stories:
Move: Length: go
Address: Demolish: Depth: Z4
City/Zip Code: Grade: Sq. Ft.:
Phone #:
Contractor
Address:
City/Zip Code:
Phone # : 4&
Arch./Eng:_
Address:
City/Zip Code:
Phone#:
Assessments:
Water/Sewer:
Palice:
Fire:
Engr.:
Planner:
Council:
Hldg. Off.:
APC:
Variance:
Permit: 283.°-6
Surcharge: 25.`-°
Plan Rev.: I 41 ,`?
SAC: 525. ?=
Water Conn: q?p.°-
Water Meter (03.°=
Road Unit: 2(co.9=
Parks:
?
f) ? / 7,Sv
This reque5t voiE `lG ???
18 months trom ? ? .
A 094568 6t ?
lall3l1 q
3??. 0
q6s
Re Oale
,? Rre No. Rough-m Inspecbon
Rep red?
?Ready Nuw W?11 Notity inspec-
-5 Yes ?No ?or When ReadY
Z Licansed Electrical Conbnctor , 1 Aeraby requasl insOecLOn of above
Owner elechwal work installad at
Stree tlr ss, Box or Fou[e No.
J Citv
acL n o Tpwnship ame or o.
I Range No.
Otcupan t R NT) Ph n No.
Po er ner s
actr I ntra [o Company N e) ont r? Licensa No.
Mai in dJress IC tractor or Ow akinB ?ristailano
55/?3
A a 11ation
5 pnature ntra or Owner M roe ? Phon NUmber
2
1 ?
MINNESpTp STATE BOARD OF ELEC flICITY THIS SPECTION PEQUEST WILL NOT
Gripas•Midway Bidg. - Xoom N•797 BE ACCEPTED BY THE STATE BOANU
1827 UniveraitY Ava., St. Peul, MN 56709 UNLESS PPOPEH INSPECTION FEE IS
Ph.n. 19121 287-4111 ENC LOSED.
;EQUEST POR ELECTRICAL INSPECTION - ' ee-00001-04
Sea instructions tor cosDlaline this torm on back ot Yellow copy. ?Ii ? I?, J
A Q ? 4q6g "'1('".8@/ow Work= ,-d by This Request ?
iJ
Add 8ep. Typa oi Buildin0 _ 9PPlientee Wired Eqmomenl Wired
I I I I Duplex 1 I Water Heater 1.+.eLlqhtinp Pixtures I
loader
q Fee Service Entrance blta p Fee Feede.s/5ubfeeders # Fne Circuits
i? 0 to 200 qm 5 0 to 30 qm s 0 to 30 Am
Above 200 qmps 37 [0 100 qmps 31 to 100 AMPS
Swimmin Pool Above 700_A; M Abave 100_Am s
Transiormers Irtigation Booms :Partial-'Other
Fee
LL ISigns -- - ? Special hispection
Remarks ? 'S ,?i
TOTAL E
?%7,__,
?? ? the ETectciw'?
Inspeetoq herabv
c rtily thet the above
??e q ?., cinspection hes baen
tl" /d'01 mede.
This repuast void 1B montlm irom
Thiz rxpuesl voitl
18 months (rom .
22 N/.
w
7'?/d U
?
- --- ?p ..? ._. ..__...... ... ._?.....
p Aeqwred? oReady Now 'II Notify Inspec-
5/S7 ?es ?Nn [orWhenFeadV
?
? Licensed Elecbical Contractor 1 hereby reQUe'st inaoeotion ot above
WK0wne1 electncal work mstalled at
Sveat Address, Baa or Route No. City
55
ection o. Township ame or Nn. Range No. County
Occuoant IPRINTI Phone No.
Power Su001ier Address
1 ?
Elec[ncal Contracior (Company Nama)
?umer Con actor's License No.
Ma,lin0 /lddress ICOntraCtor or Owner Makmg Instailabonl
14-2 !s
Author¢ed SiBnatw ? nhactnr/Owner akm Installatio Phone Number
?
O
MINNESOTA STATE BOARD OF EIECTNICITY THIS INSPECTION REUUEST WILI NOT
G,.99s-Midwey Blde. - Room N-797 BE ACCEPTED BY THE STATE BDARD
7821 UniwersitY Ave., SL Paul, MN 55104 UNLESS'PflOPEN INSPECTION FEE IS
Pnnn» 16121 297-2111 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION E3%8-o"
w ?
? / See inatructians lor comoletin9 Ihis form on back of vellow cooV.
'L. 4 4-32 2 "X" Be1ow Work Covered by This Request
?lifviAdd flep. Type ol BwlEing Appliancee wuree Equipment Wired
Water
Silo Unbader
Bulk Milk Tan
k Fee Se/vmaEntmnceSae p Fee Fexdars/Subieedera k Fee Grcwts
U to 200 Am s 0 to 30 qm s 0 to 30 Am s
Above 200 Amps 31 to 100 Amps 31 to 100 Am s
Swimming Paol Above 100_Am s Above 100_AmUy
Transiormers Irrigation l3ooms Partial,"Other Fee
Signs SVecialinspection
Nemarks , . $ a?. j0 TOTALFEE-1 ,
/ )
//-] ?l.tne ct'
C./-
{/ R r J? Inspectoq 1ere0y
carhly lhat the above
I Final mspechon hes been
- . _ ?G d ( mede.
thn repuast vola
Thrs reques[ wltl ?? ? Z / O ?
18 mpnths Trom
A 079670 11 L1/2-, ,J U-..,?
Request Dale Fire No. Rouph-in Inspection
RequireA?
?qeaAy N. <11 Nolity, InsDec-
?,?? Da'res [I Np mr When Ready
(3 ,?, /liceosed Electrical Contractor - i hprebr reYUest :napection of ebova
Ur Uwner electriral wmk imLlled aL
Sneet AdCress, Box or floute No. Gry
t1255 u ? t'a
ection o. Townshi Namn a No. nge No. Coun[y
6
Occvpant IPflINT) Phone No.
r 52- f0
Power uDPlia Address
-
O 1
Electriyl Contractar ICanVanv Name) Con racior's License No.
Mailinq Add?ess ICantractor or Owner MakinB I?sbllaHOn)
?a
Authorized Sipnature (Co actor Owner Making I ta?lat?m) Phone NuvMet
ININNESOTA STATE BOA11D OF EIEC7NICRY THIS INSPECTION REUUES7 WIIL NOT
Gripge-Ididwav Bldg. - Room N-191 BE ACCEVrED BY THE STATE 90ARD
1821 UniversiN Ave., St. Paul, 4N 55104 UNIESS PROPER INSPECTION FEE 6
Phone 18121 2972111 ENCLOSED.
5--? Yv + IEQUEST FOR ELECTRICAL INSPECTION Eg-00001_04
' See j.tr.tidns for eoinpb[irq this ircm on back ol w11ow copy.
A ""X'" Be/ow Work Covered by This Request ?(?( d
079F70`
FAd Rep. Tvoe ot 8uilEinu Aooliaxes Nired ..- Equioment MireE 1
itioner
N Fea ServiceEMmmeSiza # Fee FeeAers/SuOfeaders M Fee Gircuita
0 to200qm to30Ams 0 to30Am
Ahove 200 qm - to 100 Amps 31 to 100 Anw
Swimming Pool J a 100
AEbove Above 100_Amps
Transformers nigation Boonr Partial,"Other Fee
Signs Special Inspection ?
Hertmrks TOTAL FEE ?
Rouah-in Date ? /
E
e
fectrifal
??? nsuecbi, I?erabY
certity ttrei [Ir above
Final _ 1e
?
-i? tion Aas
bBpn
0e
? j .
71iq repuast vob 18 monttu Imm
_-TRI-LAND INC. Certificate of Survey for :
SURVEYING JOE MILLER CONSTRUCTION INC.
SERVICES
Eagan, Minnesota 55121
YORKTOWN PLACE
M
?. N8q
P?^ t
S?
?
?
7
0
o,
0 00,
O 1
Z I
?-- - -
y
N
0
n
,
?.r.
I--fi
C
C
Z
J
Q
v!
D
I ?
?
as' I
?L
V
26
LEGAL DESCRIPTIO"I: Lot 7, Block 1, Sunset First Add.
Garage fl= elev. 933.
Lowest fl. elev. 934.00 ?
A/'
I
I hereby ceriify that This survey, plan
or report was prepared by me or under
my direct supervision and fhat 1 am a
duly Registeied Land Surveyor under the
Laws of ihe Stote of Minnesota.
Scale 1 inch = 30 feet
B rad ley(wenson Mn. Reg No. 15235
v
Date'
.o
2/84
CITY OF EAGAN %
APPLIC:ITION FOR PE:hMIT
Nlil
' SE:JER AND/OR L4ATER CONNECTION
(PIEASE PRINT)
1) PROP= ADDPESS: ?.2SS f?1'
r Fru. Dr,.cctrP'?"cN: i- ?
Gm f- 7 x/c
(I,oc/Block/Su;civisicn or Ta =arcel I.D. NL:..,.>er)
S DA?y 0F OivTG :?3i., -:.=-'i-
?
pn?S4T ::^•'i ;r:/??OFOS= SL:"L: F11-.+5?,•'
? 3-2 CCJP= (?'t'0 L^II?'S!
? R.3 iC?:,ti,urv-cr (m!= - L'_`7ITS) ( r:,'1=7--)
13 2_4 L'::1=5i
? CCiL'?SE:CI:.i./R.t^'uL?Ci: i?' `_ -
Q 1'CliSi???.i,
? _^_7,SLI.L?`IC?:.'?I./ Ci.'. a?: '\?.ic'?+r
2)
NV•1E: ?TUG /?i.IIGF-
aCcREss: (
Cm"', ST,= , ZIP: ?.?ys'yr.Yc?a A?1? SSG ?'SL
PxoNE: 5,31- 2001
3) Pa7 T17-11
NPI?: ?PL?dSc rN1NT)
???
? ?
?` '
? ?? FOR C:TY USE 09LY
?
'-f.Woui
?C
U4v
--T PLUP ERS LIC:NSE:
ADGi2c5S: /'(ZZB J3A'-P .? ?. i Active
CZTY, STATF.', ZIP: N(.U Sj L4L Ezpired
.da?icn Q ?Noy/of Record
PHONE: 5Srj,36 2J PLU:MBER LICENSE N2p(„??!'3 d?p
arr inicia
4) OCMP2%1,]T/C?•;i•]&2 NAN1E: (PLEASE PRI'li)
ADDRESS: .5'?R4m_ Es ?Z?
CIT"!. STATE, ZIP:
PH(h^IE:
S)
6) Pi:DZG,."?.. C:--:
2!?-PL:-ASE F?OID APPP,(T1FD PER.1I1T FOR PICi:-L'P BY QNE OF '11E?i'E
C] PI.E?tiSE :*.aIL APP4CVm PER'-LLT 'I`'J 1. 2. 3, 4 AF.4VE
(Circle one)
7) sicaILM: Z'611.40?-&&eAa? DAzE:?uiYB?
IIVDZC:.TE W7iIC:I PERiUT IS BEING REQIJESTID:
&CC.`P.VECTIO.I 'PJ CITY SE.TrIER
El CO:Tv"DCrIC`:I 'ICJ CITY wATER
Fl dif?'?'.4 (PLL'r'15E DFSCR2DE)
m! R aal?I11s.1V s r1 Oe ?Y?a?ea ! f r+? v-sso?a ? s s ?issa .a a?! tiR:aRlsl?i? S?f ?AS ? S???
F O R C I T Y U S E O N L y ,
praIMIT ' ISSUED
Frrs' $ !n --zT
$ eo s?a
$ 4n ., ?^d
S
S
rs--?-
$
$
S
$
$
$
$ .
S
$ l el 4 ?--?
rJE.1?_D TJr.A\1Ty (TN?."'1_' r Di"_.
- ,?.,?? ?o..._..aa-L)
WATER PER1117 (I::CiuDE _;;nCH3rZGn')
WATER METER/COPPERHORN/OUTS:D° READER
WATER TAP (INCL'uDE COR?ORATION STC2)
5E;•iEY TAP
a_:
ACCOU,`iT DEPOSIT - S4AT°_3
Wi,C
SAC
TrZCiVK [qAT°R AS;ESS:!E.iT
TRi::dK S:;:ER ASS-E:,S:iE:•iT
Ln:: R`nL BE:d[,FTT/T3UNK S: :'iE3
LATERaL BENEFIT/TRU?iC WAT°_R
OTHcR
TOTAL
AMnti.?'T PAIDjREC°I?T # ? f5z?,?
DOES UTILITY CON.IECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN A"PERyIT FOR :dORK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
[] NO ENGINEERING DIVZSION. LIST AS A CONDI-
TIO[V.
S[JEJECT TO TEIE FOLLOSJING CONDITIONS:
APPROVED By;
TI':LE:
DATE:
?e ?. w ?c+¦ ?e ? s? ? nc? ?a ss? w? ? ? w sia w? w_a ?? w ?? ?.04 wCa Ne = se M PO Ra nc M w ijft M M
q-? -744
2006 RESIDENTIAL PLUMBING PeRnnir aPaucaTiorv
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
)5, <--jD
6
1
C b
Date
I
!
' Site Street Address ? Unit #
PropertyOwner MI(' ia' AkD.c'zs Telephone# ((551 )`-(S,2? ?« `
i Contractor HR Panpayjorks Telephone# (65t)
Address City State Zip
The Applicantv?a???1 OAYR7 SSractor _Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee includes ins[allation of a water softener andlor water
heater at the same time. If you are insfalling on/v a water softener and/or wafer
heater, do not complete this section; move to the next section and check the
appliance(s) you are installing.
_Septic System Abandonment
_Water Turnaround (add $130.00 if a 5/8" meter is required)
Other
Water Softener Y_:Water Heater $ 15.00
new 11?_c replacement
_
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ 50
i
Total I
Sn
S?`')
.
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 qity of Eagan and the plumbing codes; that I
understand this is not a permit, but only an application for a permit, work is noY to start without a permit and work will be in
accordanc,e with the approved plan in the event a plan is required tp ?(Yevie,yred and approved.
En /??( o
ApplicanYs Printed Name Applican Signature
7T o
71
2007 RESIDENTIAL BUILDING rExMIT arrLicaTTOrr
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsUUCNon Reouirements
3 regislered sile surveys showing sq N. of lot, sq. fl of house; and eIl rao(ed areas
(24% maximum lot wverage allowed)
1 Soils Report if praposed building is l0 6e placed on dislurbed sail
2 copies of plan showing beam 8 window sizes, poured Pound design, etc.
1 set of Energy Calculations
3 copies of Tree Preservation Plan i( lot platled aRer 711193
Rim Joisl DelaA OpNons seledion sheet (buildings wM 3 or less unils)
Minnegasco mechaniwlventilatianform
RemodeVReoair Reouirements
2 copies of plan showing tootings, beams, joists
1 sel of Energy Calculahons for healed additions
1 sile survey for additions & decks
Addition - indiwte ilonsife septic system
?? 69D
Office Use Onlv
Cert of Survey Recd _ Y_ N
SoilsReporl _Y _N
Tree Pres Plen Recd _ Y_ N
Tree Pres Required _ Y_ N
On-siteSepUcSyslem _Y _N
Plans are considered nublic information unless vou state thev are trade secret and the reason.
Date $ / V / -af7 ConstrucNan Cost 3R1?.' ° 0
Site Address ya AuCi i-s i? ??I/' UniUSte #
G
DescripNon of Work /Ce,?` c? r1?T'
Mul6-Family Bldg Y?N Fireplace(s) _ 0_ 1 _ 2
Property Owaer /o/i'?t TelepLone # ( )
Contractor ?? ?f ?? -
Address comsiCib'
State ? Zip Telephone # (66'/ )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
EnOttJy Code Category , Residenlial Ventilation Calegory 1 Worksheet • New Energy Code Worksheel
(-I submission lype) Submitted Submided
. Energy Envelope Calculations Submitted
In The last 12 months, has ihe City af Eagan issued a permiT for a similar plan based on a master plan?
_ Y _ N If yes, date and address of masTer plan:
Licensed Plumber Telephone #( )
Mechanical Contractor Telephone #( )
Sewer/WaterContractor Telephone#( )
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accwate;
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
pernut; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
ApplicanPs Printed Name
? licant's Signatur?
?
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA127405
Date Issued:10/01/2014
Permit Category:ePermit
Site Address: 4255 Augusta Lane
Lot:7 Block: 1 Addition: Sunset 1st
PID:10-72985-01-070
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Andrea Preusse
4145 Sibley Memorial Hwy
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 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 -
Michael D Albers
4255 Augusta Lane
Eagan MN 55123
(651) 452-2107
Wenzel Heating & Air Conditioning
4145 Sibley Memorial Hwy
Eagan MN 55122
(651) 894-9898
Applicant/Permitee: Signature Issued By: Signature