1846 Beecher Dr401? CltY of E3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
?______-__-_-____-
I ??r C??ce Use ?
? Permit #: II/
I Permit Fee: ?
? Date Received:
I ?
I Staff: I
I ?
------------------
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ?d Site Address: iLl Z ? C'y ?
Tenant:
Suite #:
RESIDENT / OWNER Name:'2z'
Address / City / Zip /? C ? AMI S?j?2
Applicant is: Owner _zt Contractor
TYPE OF WORK Descriptian of work:???? 9r_- &Z?L
Construction Cost:;;A'9Cr C -°e'Multi-Family Building: (Yes / No
CONTRACTOR Name:t? ,642?2?i,,/?(???/I/?Sl License
AddreSS: Oran
City:RZZ L/^ 4[jf? State: ? Zip:
Phone: ??? Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDtNG
Minnesota Rules 7672
_ Minnesota Rules 7670 Category 1
_
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Su6mitted
(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 8 Water Contractor: Phone:
NOTE: Plans and supporfing documents that you submit ace considered to be public infarmation. Portions of `
the informatian may be classified as non-public if you provide specific reasons that would permit the Cify to `
conclude that the are frade se&ets:
1 hereby adcnowledge that this infortnation 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 staR 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?pplS?
,/Aicant's rinted Name Xpplicant`s ignature
Page 1 of 3
Permit #:
Receipt Date:
CITY OF EAGAN
2006 SEWER AND WATER CONNECTION AND AVAILABILITY CHARGES
EXISTING RESIDENTIAL PROPERTY
Address 1 d'7'v ?2 c- J1"t fZ- -0 r" OFFICE I;SE ONLY
-c--T
Property Owner XC-4a-f-j. KO tqi-e 1r'
PRV required
Telephone # U S [- Q
Plumber
Date of Inquiry / Ld'3Ib c
Contact Name S '2M E=
Sewer
4" Sewer Service
Lateral charge @ $27.60/ff
Trunk @ $1,120/connection
City SAC
MCES SAC
Receipt # , Date
Septic abandonment
Permit Fee
State Surcharge
Total
_ City _ County R-O-W Permit
Water
$ 673.00 1" Water Service e.o ( lec4-4 b%?Assnnt- $"7-S24)4„
Lateral charge @ $27.85/ff
Tnank @ $1,170/connection
100.00 W ater supply & storage
1,550.00 Receipt # t 3j (1 , Date
Treatment plant ? ? ?,?? ,??
°
50.00 Permit Fee 1
50.00 State Surcharge ?
.50 Plumbing permit required -«ater 570. Q 0
meter to be acquircd with plbg pennit ..S-0
$
Total $ 6b ' S-0
Sewer and Water
4" Sewer Service
1" Water Service
Sewer lateral charge @ $27.60lff
Water lateral charge @ $27.85/ff
Sewer trunk @ $1,120/connection
Water trunk @ $1,170/connection
City SAC
MCES SAC
Receipt # , Date _
Water supply & storage
Receipt # , Date _
Treatment plant
Septic abandonment
Permit Fee
State Surcharge
Total
Plumbing permrt required
Water meter to be acquired with plbg permit
cc: Carolyn Krech, Finance Department
?...,?..?-
..?,.,?-?-?-?-?-?- d-
$ 673.00 7 ?
752.00
c.4
100.04
1.550.00
? 1
1,043.00 ? :ZA-."4-o 636.00 1?--
50.00
100.00
.50
,
$1 -TA s
a Wr-Ou.J ..:. ?
.. y.??
. i
Y
wr ??? ??GAN?
, 37$5 PILOT KNOB ROAD ;
EAGAN, MINNESOTA 55772
/DATE_.?,/_
wsasweo???? _„?
T -re
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AMOUNT F t
(l?..l?.)AN? L?J ?/? .Z.r S uOLLAJt$
too
s Q CAShI 1611CHECK
FOR ?
5?? -? ?f f't_..__. ... ? - ?i•
RUPfD CODE AMOYNT
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ez-i
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Tbank Yau t
N° ??91?
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Mite-ParWs coav
veliow-PaosRing Copy
Pink-FI1e Copy
3795 A]Pila?r'K?ob?Roa?d ?P.E.J,`.IaT??`'NOt.
Eagoe, MN 35722
DATE:
Zoning: No. of Units:
Clwner;
Address:
SItE-.Add1'0S5: ?MtldG?_`?--P'Lk._....
Pfumber: ?...?
1t12/73 23917 _ 100.00 Pa.
i agree to comply with'the City of Eagan Cannection Cfiarg@: w naa .w, ?r
Ordinnnces.
AcCOUnt Deposit: °".•• "•• z•`• '
¦ a nn ?
-
Permit Fee: aYW ? ?v4 Pw.
.
.
'
Surchprge:- .
.,,
...?, ..
By
lNisc. Charges: ... x.
•
Qnte of Insp 7-
- Total:
7
In ? ?? ?
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.
-A ,Datea Pnid ,
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,
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ci-rr ??; m • - ;, u
?WIAaTER:?'SER*V1CE? P,ERNIIT
3795 PPlot Knob Rood PERMIT NO
:
Eagon, MN 53122 .
DATE:
Zoning: No. qf Unifs: ?.
Owner: Ri1FewXt3 V RnM#*r .
Address: 7 -1
Site Address: _ 7RdA ?e.e.E+hor T1 r41,e WATER To }3E R'URt?SQ t?F'A' ?L'!'
Plumber:
?
Meter No.: _17RA14RAT Connection Churge: 250. M(1 M,
5ize: _
Azco
t D
o
i
un
ep
t:
s
Reader IVo.:; 4'tEfil775 Permit Fee: 1_4'f.00 11&=
1 agras to comply weth the City af Edga n Surcharge:
Ordinances., Misc. Ciwrges: il otl
Toto l: 1 g _ nt3
gy Date Poid:
Date of I nsp.. _ I n -
. s .
P•
CITY OF EAGAN Remarks
Addition Clearview Addn. Lot 7 BIk 2 Parcel 10 11750 070 02
Owner Street 1846 Beecher Dr. ' State Eagan,Mv 55122
! 1?14?A LQl1 . Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
• STREET RESTOR. 1980
GRADING
SAN SEW TRUNK 197 7 Q 11.66 Paid
* SEWERLATERAL 1980 692
WATERMAIN
* WATER LATERAL 1980
WATER AREA 10-66 15 410
COCSo??//
9-3-7?
STORM SEW TRK
* STORM SEW LAT 1980
* service 1980
CURB & GUTTER '
SIDEWALK
STREET LIGHT
WATER CONN,
BUILDING PER.
sac 525.00 13917 4/18/79
PARK
crrv usE oivi.Y
LaT ? BL o? xECEIPT #: A ?``Q
.
SUBD. RECEIPT DATE:
1997 MECHANICAL PERMIT {RESIDENTIAL}
CITY OF EAGAN
3830 PILOT KNOB RD "
EAGAN MN 55122
(612} b81-4b75
Date: f I , .
Comglete this section onlv if you arc instauiag HVAC in single familv, townhame, or condos that are
uader construction and are not owner /occ pied.
• HVAC: 0-14d M S T U
ADDI TI''.3N"... 50M8 ?''i:3 '---
o Gas outlets ( rninimum of one required @$3:00 ea.)
• State Surcharge:
• TOTAL:
$ 24.00
_ ,a6.00
I .50
Complete this section anly if you are remodelin& adding ta, or repairins! ezisting single f$milv
dwellings, townhomes, or condas.
, n
4 Add-on furnace Add on air conditioning
o ,
Add-on air exchanger, i.e. Vanee ?5ystem, etc. Other
Minimum fee applies to all remodel or add-ans of existing residences $" 24:00
Sta.te Surcharge ? .50
Total: $ ; 20.50
SITE ADDRESS: aWNER NAIIIE: Gkl- PHONE ##:
INSTALLEIL NAME: rxorrE #: 7
sTREET AnnREss:
CT1Y: STATE: MIJ. ZIP: 53 3
` ---
_t?ql 0
?
? s - '7-0
? u
SIGNATUIRA OF PERMITTEE
cmr usF owLY ;
i. BL REGElPT #: _
SllBD. RECEIP7 DATE:
. ?
1997 MECHANICAL PERMtT (COMMERGIAL)
cIr,r oF EacaN 5830 PILOT KNQB RD
EAGAN, MN 55122
(612)681 -4875 ,
PIsase complete far. ? all commerciallindustrial buildings.
? mula-family buildings when separate permits are not required fivr each dweliing
unit. . .
DATE: CONTRpCT PRICE: w WORK TYPE: NEW CONSTRUGfiIQN 1NTERIOR IMPROVEMENT ;
DESGRlPTION OF WORK: FEES: ?$25.00 minimum fee or 9°k of cantract price, whichever is greater.
? Processed piping - $25.00
? 5tate surcharge of$,50 per $1,000 of DBI'U2 fee due on all perrnits. .
CONTRACT PRICE x 1 % .
PROCESSED PIPIIVG .
STATE SURGHARGE ? H
?
TQTAL
SITE,+1L?CR-ESS.
OWNER NAME: TELEPHONE
TENANT NAME: (IMPROVEnnENrs oMLY)
INSTALLER:
ADDRESS: ,
CITY: STA'fE: ZI P:
PHONE #:
SIGNATURE: +
SIGNATURE OF PERMITTEE CITY INSPECTOR ? `
? -- T ?
EAGAN TOWNSHIP
BUILDING PERM T
3 .Ya
o?e: ._?'.I1:..F... ....? .:......................-'-------•------?'-`:?-----------?(
Address ...... .......... ....... ` ?? ?.
Sailder .......;lLa.nae.&? ......... .............. ............ .•-- ........
Address ...:...:.............................................
DESCRIPTION
11T° 2704
Eagan Tow»ahip
Town Hall
`
....?.?. .....................
Date ? ...............
....
Sto:ies To Be Used For Front Depth Height Est. Cos! 'Permi! Fee Ramarka
v 417.7t- 'JL- Z z.- 2-LOCATION 8'D<?*, _
Street, Road or other Descsiption of Location I Lo! Block Additioa os Trac!
Ao?
This permit does not suthorize the use of s3reets, roads, alleys or sidewallcs nor does it give the owner or hia agent
!he righi !o create anp siluation which is a nuisance or which presents a hazard to the health, safely, convenience aad
qeneral welfare to anpone in the commuailp.
THIS P£RMIT MUST BE BEPT ON THE PREMISE WHILE THE WORK IS IN PAOG SS.
This is to certify, the3 ........?.........? ............... ....... ?...has pormissioa to erect a._.a_4.°`...°.:?.?'.-.-Upon
? !he above deseribed premise eubjec! to !he provisions of !he Suilding Ordinance fos Eagafi Tow hip adop d Apsil 11,
1955.
............... ...........?....................... Per ......................
!S2`.:'."::t::..-??............:»::...--........:....._...........
Chairman. of Tnwn Soard Suilding Inspeclor?
?
_t
mpet 2- 7 o4./
Lanil Plannin9 6b7S-90 ?voy CS NE.
Cond Surveyiny M/lrwombs32
solhv7est;?9 EN G i NEE R i N G, ! N C. Minnesala
Civ'il fr Municipal SUnsef 4-6066
lneerS ? sUrVeUOnS
En?inee??n9 El79 ?
ceptsfscate of surve7 fo=
M.F. G. rU?A?S
_ Q-_ ReeG?l2r 1.?r'tv e _, _ ._
? m
;ap
?
?
Vi's
i2?- LP ? (I ?
Sa4\C • 1? (o0
4- DenA? s \ror) Morwmen'N
?.._ Q? o c k 2
l hweby cerfiPy thot 66 is a lrue and oomtf rePresentafron 00 surrey etlae bovndories PPlhe obe?r aEscribed 1?d, on?d
o?'? locafion o?'a!/ bvildin9s , tlxxreoa , m7d ol/ r;sible ?u»achmenfs , ?? xy, ,??' w mid /anod. As s?veyed by me fbs? - cbtf
°?? MQ ? A.? 19-ZL
SUB U2BAN EN6/NEERlNG, INC.
L- ,?rrreyors
,
? LOCATION ?
?
OWNER N
STRUCTURE AND
LAND USED AS
MASTER CARD 7.. 47
Permit
No.
Issued Issued To •
Contractor Owner
BUILDING
PLUMBING
CESSPOOL - SEPTIC TANK
20
??O •
fj-
.S ? tN_P?
0
WELL
ELECTRICAL 0
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER
?
OTHER ?
. Items
..? FOOTING
FOUNDATION •
_ FRAMING
FINAL
ELECTRICAL
HEATING
GAS INSTAILATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
I:•-
COMMENTS:
.
Approved
(Initial)
Date
i?/ 9'' 1?
1S'-
?? ?
????
601?
t
3 liolif? . .
Violafions Noted
on 8ack
/
7
Remarks Distance From Well
SEPTIC &O ? _
CESSPOOI !`
TILE FIELD FT.
i
DEPTH L?
OF WELL ? v
? ?? ?
?
.?
COMPLIANCE INSPECTION REPORTS
TO BE USED ONIY IN EVENT OF OBSERVED VIOLATIONS
0
s
PERMIT NO.
DATE OF INSPECTION
CONDITIONS OF CONSTitUCTION AT THIS INSPECTION ,
? NO EVIDENCE OF NON-COMPLIANCE ? NON-COMPCIANCE. BUILDER DOES NOT
OBSERVED. INTEND TO COMPLY.
»
? ACCEPTABLE SUBSTITUTIONS OR ?
DEVIATIONS. COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
? NON-COMPLIANCE. BUILDER WILL COMPLY CONTROL.
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
REINSPEGTION REQUIRED DATE OF REINSPECTION •
?
REINSPECTION REVEALED
CERTI FICATION -1 certify that I have carefully inspected the above in which I have no interest present or prospective, and that I haJe reported herein
all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property inspected.
F] ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPECTOR
COMMENTS:
DATE
23
? vo PLUMBING (RESIDENTIAL)
Permit ApplicatiQn
. City Uf Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Please complete for: Single Family Dwellings
Tawnhomes and Condos when permits are required for each unit
Date / L-13
4
mu D ? Unit #
Site Address 1
Owner Telephone # q? - ?
P
t
roper
y
Contractor
. . PIPEWORKS
Address 3670 DODD ROAD City
GAN, WiN 55123
State (651) 365 134n Zip Te[ephone #( )
The Applicant is Owner Contractor Other
Septic System New _ Refurbished Submit 2 sets of plans and MPC license $ 100.00
Includes County fee. Additional consuitant fees may apply.
Alterations To Esisting Dwelling Unit, Including $ 50.00
_ Adding fixtures to lower levels or room additions, excluding water softener and water heater
_ Abandonment of septic system
_ Water tumaround (+ 518" meter if needed -$121.00)
Other:
_ RPZ _ new instailation _ repair _ rebuild $ 30.00
_ Lawn irrigation system
_ Water softener ?(?Water heater $ 15.00
/
? replacement _ additional
State Surcharge ln ?? 2 il
I K I 1 ?? ? $ .50
t
l
T sEP o 2 2003 $ 1 ". ?
a
o .
I hereby apply for a Residential Plumbing Permit and aclmowledge that the ' ?nation is complete and a curate; that the work will
-' -'-- n:?.. ra_,._.. ....,7 nd'r+e._ i nnr?Prctanr? this IS riOt a
be ln Contormance wttn tne orauiances ana coacs L uic ?:ity _ ?i Cayau auu wLu,-- .•...==..?b-?-tir---- -----------_ -_ __ __ __
permit, but only an application for a permit, and work is not to start. without a permit; that e ork will be in accordance with the
approved lan in the ca of work which requires a review and approval of plans.
Appli an 's P t Nam Appl cant's ture
l`
`?.. i.
'lh?,
TO1PN OF EAGAN .
3795 Pilot Knob P.oad
Eagan, Minnesota 55121
' .` PEIiA4IT 140. . 235
The Board of Supervisors hereby granrs to 9? Str"t pl=bing
of 9Wo - 3ra AvQ.so., ?aYOUS 55420
a PIMIDID1a Permit for: (Ownar) WG HMOs
a? 1846 8oahw???? Esgan L? Blk 20; p?no 'applicatian dated
??3/72
.
Fee Paid: $20•00 Datecl this . 7th day of JU4 , 19. 72,
:50
Building Inspector
`F
TOWN OF EAGAN
3795 Pilot Knob P,oad
Eagan, Minnesota 55121
PEItP'!IT N4.
The Board of Supervisors hereby.grants ro Id. WelteP I?.iB? CQr
o f . ahia= Am=,g _ Ma_ sth A6irRr?e,? ?.?
a Peraiit for: (Owner) mF'a HMeh
at JU R _h? ??o L? 7e,.nrt?, pursuant to application dated
7r75r72 . Fee Paid: 2A4 Dated this 28thday of ey4i& , 19-"'•
050 6I0
Building Inspector
At7Z- So.?d
2006 RESIDENTIAL PLUMBING PERM(T APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
,
Date 1 1 2.3 cj6 -
Site Street Address ?O y4 4eflai?m AP b/Q/ Ye Uni# #
Property Owner 1?141-454C40 /Qa V 61" Telephone #(?SI ) VVI' /7/1/
,,l'I ZZL &vM,,Bi AJ6 Telephone # ( )
Contractor litJ&
Address City State Zip
The Applicant is: Owner Contractor _Other:
Septic System _ New. .. Refurbished Su6mit 2 sets of pians and MPC license Include.s County fee
$: 100:00
Per as-built $ 10.00
Alterations to existing dwelling $ 50.00
_ Add plumbing fixfures. This fee includes installation of a water softener and/or water
heater af the, same time. !f you are insfalling an! _ a water sottener and/or wafer
heater, do not _ complete this section; move to the next section and ` check tMe
appliance(s) you are installing.
_Septic System Abandonment ' -
XWater Turnaround (acid $130.00 if a 5!8" meter is required)
Other.
Water Softener Water Heater $. 15:00
new - replacement
Lawn trrigation RPZ _PVB _new _repair _rebuild $ . 30.00
State Surcharge $ .50
5O
Tota! '
$
I hereby apply for a Residential Plumbing Permit and acknowledge that the informat?on ts complete and accurate; that the
work will be in conformance with the ordinances and codes. of the City' of Eagan and the plumbing, eodes; that I
undersfand this is not a permit, 6ut 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:
-.q?? L Al« 4 l.r
? Applicant's Printed Name Applican 's Signature