1276 Balsam Tr E!M Ciry of Eegea
I nsp..
. ............ .?,.,.r. .
Permit Fee: -
Surcharge:
Misc. Charpes: _
Total:
Dote Poid: _
CITY OF EAGAN 1NA?ER SERYICE PERMR
3830 Pilot Kgob Road ,
P. O.-Bjx 217t9 PERMIT NO.:
? Eagan, MN 55121 DATE:
I Zoninp: No. of Units: ?
I Owner: ic:il :a1.sanen
Addreas:
5tte ?rc?; 1276 L. ?alsara St. I:9 FI ??'iic?erness Run b
Plumber: "-c. C'_1 0.:, ?1 c a l
Ahetar Na.: Connection CFwrge:
, 5ixe: Atcount Deposlt: 3•,, p
Reoder No.: Pe?mit Fee: i"') . 00 ?+u
; 1ogm M eeaiolp w1t6 tha City of Eagan Surthnrge: .0 pd
I 3?.
I Ordiwo-ps. Misc CharQes:
By _
Dote of
Tntot:
Date Pnid:
ICITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot K nob Road
-P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 pATE;
ZO"i^a: No. of Units: 1
pw,ner; '?eii Ralsanen
Address:
Site Addrass: 1275 U. Balsam St. 1..9 P1 ?lilderness Run 'v
Plumber: ?r: :'echanic
5- i 7-85 51492 100.00pfi
` I fasm to - mvh wkh Ni. Ger ei E.?es Connsctton O,orpe: 425. 0Opd
r prdisOmm Acoount Daposit: 15.00 „[)c!
4
! PlrRIi{ FlQ: r`
? Surchorye:
By Ahisc. CMnpes:
Dote of Insp.: Total:
Insp•:
? Dah Pold.
r
? . ..
' CITY OF EAGAN
• 1 • M ? • ? . ' •.• ?
? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 -
BUILDING PERMIT Receipt #
Site Address 111176 j BALSAM 2
2
.
-
Lot 9Block I_ Sec/SutyT11.J
X1l1gs OFFIC E USE ONLY
Parcel N0. Occupancy FEES
Zoning _
W Name ?IL- d S1?RLb tA2S A1?RH (Actual) Const Permit ??
BId
_ g.
_
Address 1776 E LLAta ?it (abwable)
0
City FA?'•w11 Phone
612_1261
+? of stories
-
-
rchare 2.C0
Su
9
Plan Re
ie
Length 1L v
w
? Name _ w1-1-EN C(??ts In?riO N Depth 1
S! SAC
ci
_ ._
. ,
ry
0"
U? Address .?l544.? pR? YAY S.F. rotal -
SAC, Mcwcc
? City FAcwN Phone _ 68A..sine S.F. Foo?rints _
? On Site Sewage _ Water Conn
Uw
W Name On Site Well
w Water Meler
?? AddfASS MWCC System _
Acct
De
osit
<W City Phone Cfry Water _ .
p
PRV Required - S/1N Permft
I hereby acknowlege that I have read Ihis applic
information is correct and a e lo comply with
Mi
S
? ation and state that Ihe
all applicable Slate oi 8ooster PumP - SNV Surcharge
nnesota
tatutes and City
Eagan Ordinaoces.
i Treatment PI
Signature of Permitee f APPROVALS Road Unil
A Building Permil iued t?? ??$?
? Planner - p?k Oed.
on the express co ?tion that all work shall be don e in a
ccordance`f with all Council _
applicable State of Minnesota Statutes and City of
• Eagan Ordinances. Bldg. Off. Copies
8uilding Official Variance - TOTAL 65.00
? PermR No. PennR Holder Dsie TNephone #
IMITER
SEWER
PIUMBING
H.VA.C.
ELECTRIC
InsQectlon Date Insp. Comments
Foolings I k z(o lJ,S ,QS )",-+•S ? h
? le) r? ca l/ m i Nr .
Foundation w ) 4
Framing
Roofing
Rough Plbg.
Rough Hig.
Isul.
Fireplace
Final Htg.
Orstat Test
Final Plbg. Plbg. Inspector - Notify Plumber
Const. Meter
EngrJPlan
Bldg. Final
Dedc Ftg.
Dedc Final
weu
Pr. Disp.
? • .
CITY OF EAGA
3830 Pilot Knob Road, P.O. Box 21-1
PHON E: 454-810
BUILDING PERMIT
To be used for PQQi, Est. Value =13 ,000
Site Address _ 1276 B E&LSM ?R
Lot -9 Block I_ Sec/SuUFILDERNESS
Parcel No.
11 W Name ItlCtL A SIJg RAItAmIl
? Address 1276 E S?LW 'fR
° City P.AGAN Phone 452-3263
t?o- Name AfPiJt P?A?-? L Sp? I?IC
Address 14bSC? Fanw LVi
City ?ppLF Vwt-1_F-tr Phone 451--5391
Name _
Address
Phone
I hereby adcnowiege that I have read this applicacion and state that the
information is correct and agree tp v?ith all applicable State ot
Minnesota Statutes and City of E n rdinances.
?
T
Signature of Permitee -
;
A Bwlding Permit is issued toy- w"1.S lOOLS 6 SlAS IliC
on the express condition that atl work shall be done in accordance with all
applicable State ol Minnesota Statutes and City of Eagan O(dinances.
Building pfficial ! I., i I ' I :
Eagan, MN 55121 19 .?
Receipl #
--_- - - -- :?
OFFICE USE ONLY
Occupancy -15--2 FEES
Zoning
(Actuat) Consl _ BIdg.Permit ¦2119¦w
(Allowable) - Surcharge 6.
;Y oi Stories
Length Plan Review 94• ?
Depth SAC, City
S.F. Total - SAC, MCWCC
S.F. Footprints -
On Site Sewage _ Water Conn
On Site Well - Waler Meter
MWCC Syslem -
City Water _ qcct. Deposil
PRV Required _ S!W Permit
Booster Pump - S/W Surcharge
Treatment Pi
APPROVALS Rpad Unit
Planner - Park Ded.
Cauncil
BIdg.Oif. _ Copies
Variance - TOTAL Z"• 30
I pormk Mp. Permlt Holder Date Telephone #
N{ATER
SEWER
PLUMBING
H.V.A.C.
EIECTRIC
Inspectlon Date Inap. Coemrbnts
Footings 1b? &'Z/-g
Foundation
Framing
Rooling
Rough Plbg. .
Rough Htg.
Isul.
FirepiaCe
Final Htg.
Orstat Test
Final Plbg. Plbg. Inspec.9or - Notify Plumber
Const. Meter
Engr./Plan
Bldg. Final
Deck Ftg.
Oedc Final
weli
Pr. Oisp.
' `CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 681-4675
BUItDING PEff4T?,tI? Receipt #
To be used for 8PJMDEL Est. Value $4,000 Date 'TAN $ . 1992
Site Address aA ro aNAwc?n IK
WTLDZRNZSa
9
1
RM 6
OFFICE USE ONLY ?
Lot
BIOCk
SeClSub FEES
Parcel No. Occ"pa"cy - 6
3
00
?. ?? .
.
Zoning
Nam lfelL i SUW RAISANHN (Aclual) Const _ Surdiarge 7*00
Addrm 1276 IL Ljl.$AM TR (Allowable) - Plan Review
? chy LA4Al1 M ZP 55123 enf htories =
LkBrBe 5.00
9
Phone 452-3263 Depth - SAC, ci,y
? Name ALL" C4NST S.F. Total - SAC, MCWCC
?
?
qddfe?S -?649? P?NKVB I?JAY S.F. Footprints
On Site Sewa
e -
wate? Conn
(`,fty EAGAN MN ZjP
55122 g
On Site Well _
Water Meter
? bs8-810(?
?1Of12 MwcC System =
Acct. Deposil
8 ?? # ?01?2 City Water _
PRV Required - SIW Pe?mit
I hereby acknowlege that I h vq read this application and st ate that Ihe Baaster Pump - S+W 5urcharge
inlormation is correct and ee to comply with all applica ble State of
Minnesota Statutes and Cityf Eagan Ordinances. Treatment PI
SignaWre of Permitee APPROVALS Road Unit ?
A Building Permil is is4 ed to: CNS4 Pl ?? - Park Ded,
on the express condition that all work shall be done in accordance with all Co+ncil -
applicable State of Minnesota Statutes and Ciry of Eagan Ordinances. Bldg. Off. _ CoPfes
709
?
Building Olficial ? " ' v?e - TOTAL
Pertnk No. Permft Holder Oate Telephone #
S/W
PLUMBING //!? y'a.• 3l -3f ?
FIVAC
ELEcrRic
ELECTRIC
Inspection Date Insp. Comments
Footings I
Foundation
Framing
Roofing
Rough Plbg. r- ?/-9 Z
Rough Htg.
Isul.
Freplace
Final iitg.
Orsat Test
Final Plbg. Plbg. InSpecta - Notily Plumber
Const. Meter
EngrJPlan
eldg. Final ? Z, 2 ? G t ?n.T2
Dedc Ftg.
Dedc Flnal
WeU
Pr_ Disp.
? ' ' ' ~ r A 'h B I! ?)
. -?._ CITY OF EAGAM ,
3830 Pilot Knob Rosd, P.O. Box 21-198, Eagan, MN 55121 ?.
PHONE: 454-8100 •
eU1LDINCt rERMIT rteceipt ?F
T& V rsd iar Fd Vni'.. ' . ii. ffn*. _ 19
Sits Addren & :t Erect 0 OccupancY
Lot Block seeiSub Remodel ? Zoning
. Repair ? Type of Const.
PrcN No. Enlarge ? No.3tories
. Move ? Length
Name
` Demolish ? Depth '
Addrm
I
?
Grade
?
Sq. Ft.
Citv
Phone Install ?
u?
3AME
Address Assesunent
City Phona Woter 3 Sew.
_ Polfu
Name Fin
Address Enp,
City Phons Plonner
Council
Percnit
Surchorqo '
Pian Review
S11C
Woter Conn.
Water Mettr
Rood Unit
1 hercby acknow{odpo thot 1 have rood this appliwtion and state that Bldg. Off.
the inlormation Is corcect ond ogree to comply with oll applicable
APC Total
Stafe of Minnesoto Srotutes and City of Eoqon Ordinonus.
Var. data
Siqnofun of Pemuftee ,
A Buildinq Pem?it Is issusd to: , on fhe ??resr tonaitlon thot
di worlc shdl be dorw in accordonte wifh oll appliooble State ot Minnewfo Statutes and City of Eopon Ordinonces.
8ufldirq Offtcial
Pwmit No. Pwmit Holdw Deb To1l hone it
Plamesna
H.VA.C. r ;c-k
ElseMc 3 2 g5 ? I?.r' ? S U. U
13
Softwwr
Irnpsetion Dan Insp. OthK
Footinps
Foundation ?
Fnminq
Roofinp . G
Rouoh Plbp. ?
Rouqh HVAC
Inwlation 'x 6?
?
Final Plbp.
S-
Finsl HVAC
Final
10-
Cart/Oce.
Water Doscribe location:
IM?II
Sover -
Pr. D'ap.
Receipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN Fee
' Fil1 in numbered specss S/C
Type or Print legibly Tot
1. Date - ' 2. Installation Cost ,
3. Job Address 7' E. Lot Blk. ? Tract
4. Owner • , i l .,w S us eui Fta -1
5. Contractor «ri n:< ;t • :=:,4,na; Phone
6. Address
4030 Beau D' Rue Dr.
7. City - State Zip
8. Building Type: Residential.O Commercial D Institutional O
9. Work Descxiption: New [?] Add ? Alter 13 Repair ?
? 10. Describe Fuel Type '+t.
f ».
No. Eqyipmen,t BTU • M. Ea.
Forced Air No. Equioment CFM
Air Handlin
:
Mfy, g
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mf9• Other
' Air Cond. ? ? .
Mfg.
Ges, Piping Dutlets
12. I hereby oertify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
tigned' for
Rouph Fir?sl
Inspections: Date Insp. Date Inap.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
? CITY OF EAGAN
3830 Pilot Knob Road
i Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
I!1 I!?1 1+lli '.', k11N b fll
PERMIT SUBTYPE:
. I ! ri i , i i
N(I rr t
n E : . , P i 1, 1 i , , ?,,
t;rk I I i I N10
Rt Mari i?. s, i ?? ?1.) uM iI r?M A( i t
F
L
TYPE OF WORK:
I ( ra n i
TION RECORD
PERMIT TYPE:
Permit Number:
Date issued:
APPLICANT:
(r?l.) c,tati t?lNSy
Fill [ 1() 1 M N
N.'!7'ih
06 /A3 /96
FtP"NA.IR
( ?rw?r?F rNd /s rt) rN(a ?
Permit No. Permit Holdar Date Telephone #
ELECTRIC
PLUMBING
HVAC
Inspection Date Inap. Commentc
FOOTI NGS
FOUND
FRAMING
ROOFING
r-/rn
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLOG FINAL
L
r"?'t
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
INSPECTIUN RECURD
CITY OF EAGAN PERMIT TYPE: '
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
i
PERMIT. SUBTYPE:
;
. `?
i i ME,•.
I N fi 1
?
?
TYPE OF WORK:
111 ,1 1; i 1'i InN
1 i.rt Pf I N i.
?I
?
Permlt No. Permk Holder Data Telephone 8
S/W
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspectlon Date Inap. CommerHs
Footings I
Foundatan
Framing
Roofing
Rough Plbg.
Rough Htg. O A??
p vr ?-rJ?
18U1.
?s/ •
' A.
Rreplace
Final HTg.
Orsat Test
Flnal Plbg. Plbg. Inspector- Noti(y Plumber
Const. Meter
Engr./Plan
Bldg. Final
Deck Ftg.
Deck Final
Well
Pr. Disp.
CITY OF EAGAN Remarks
Addition Wilderness Run 6th Lot 9 aik 1 Parcel 10 84355 090 01
Owner'?Y.1:tikCLw,.?,[l, Street 1276 F.as - Bal s m T ai 1 State Eagan, MAl 55123
I? r.- I101lli, ;r, r ?
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
5AN SEW TRUNK 1973 161.21 8.04 20 S43 C '/U 3Q o ?'oZ(o-?S
SEWER LATERAL
WATERMAIN
' WATER LATERAL
WATEFi AREA 1977 162.14 o $: ?T' 15 a O - a-? -?5
.
STORM SEW TRK OAR ],978 628.22 4 1.$ 8 ,15 Z 93, - i o3ac?
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 500.00 „ „
BUIIOING PER. 10192
sAC 525.00
PARK .?` S
This repues[ voitl
112d °58 ? L
Request=.ate „? - ?? Fire No. flough-in Irepect?on
ReQU retl?
a0v N. Q Will Noury lospec-
?Yes ?NO [or Whr.n ReaJy
Wicensed Electncal Contractor ? ?roby reqwast inspection oi above
? Owner electrical work inslalled et:
Streei Address Box or Noute No.
/
z ?? Ciry
.
ection o. Township Name or No. Range o. ?y? q?
? 6 T
0ccupan PqI?T) _
y? ?, Phone No.
r Supplie
EI Conv tor (Campany Na ? ? C acmr's License No.
d 0 -L:r
Maili p Address (COn[racror or Owrrer Makine ?.tailatfon)
lo G./
Auth Signaturomra r Owner MakinO I.sWl ti n) ? (
PM1O avMer / ?
7
''OT#OBTpTE BOARD OF ELEC7111CITY BTHIS E ACCEPfED'B? 7NE STAIE BOANDT
Way Bldg. - Room N-791
v Ave., St Paul, NN 55106 UNLE55 P110PEN INSPECTION FEE IS
' ?? ? ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION EB"00001-04
l ' Sea insirvctims iw comleting Mis farm m back d yallav copY. __J / p)(5
032858 ' '"X'" 8e/o?D Work Eavered by This Request ?? ?
Add Reo. Tvox ot Buildina i Aooliacees Nir.d EquiDmenl Wired
ElectriC
ndustrial
M Fee ServiceEntraneeSiza Fee Feeders/SU6feetlcm p Circwts
0 to 200 Am s 0 to 30 Am s 0 tn 30 Am
Above 200 Am?s r 31 to 100 Amps I 31 to tOQ A
Swimning Pool
I A6ove 100-Am - A6ove 1004
Transiortners lrtigation Boons Partial:Other Fee
I_I I SIgns ' I iSpecial Inspection TOT
'? ,?s ?-)flemarks
_ +? Ll \ ( qv•/
,
Nough-in Dare
? /??? , thc biYal
Impec[or. heraby
m?ify thet lhe above
?inal Uy?t
y r?peetian bs been
' ? ? _
f 'd? mede.
ftftzZoothatrom,
?ia la yi ?--, ! /0aGow1-
p 15 2;1., :i
?
Reques Date
/-? Fire No. Foughin Inspeclion
fiepuired4,
? Reatly Now n?yYWOtiy Inspedor
!J? ?Na
V'ea WhenReatly?
I1-tCe-nsed coMractor :] owner hereby request inspection of above elecirical work at:
JaE Adtlress (Sheet Box or RoN
r) 4?e N ? ? City
ec"
Setlion No. Township Name or No. Range No. County
OccupaM I INT)
a_,4- ^
4 Phone No.
Power upplier Atltlress
O'
Elecincpl GonlractorlGOmpany Neme)
ir, lN ?
f' . ConVador's Llcensa No-
s ?
maieng ncaress (COnvacror o }ow er maaing mstanati ;
O'I
AolM1Orizec Synalur ICOnlractor?Owner Making Inslallation) Phone Number
MINNESOTA STATE BOAHD O?ECTPICITY THIS INSPECTION REOUEST WILL NOT
Griggs-MiEway 610g. - Room S-1)3 BE AGCEPTEO 6Y THE STATE BOARp
te31 Oniverel[y Ave.. 51. Paul. MN 55104 . UNLE55 PROPEF MSPEGTION FEE IS
Phone(612)602-0800 ENCLOSED.
CITY OF EAGAN Np 19562
? 3830 Pilot Kno6 Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT
Receipt #
Tobeusedfor SCREENED PORCH Est.Value $4,000 oate AUG 19 ,1991
Sile Address 1276 E BALSAM TR
Lot 9 Block 1 Sec/SubWILDERNESS RUN 6T OFFICE USE ONLY
PdfCEI N0. Occupanry _B--3 FEES
W
Name NEIL 8 SUSAN RAISANEN Zoning
(ACtual)Const
Permit
BIdg
63.00
o Address 1276 E BALSAM TR (Allowable) _
- . 2
00
City EAGAN Phone 452-3263 xof stories Surcharge •
11' Plan Review
Lengih
o Name ALLEN CONSTRUCTION paPlh sa0. crt
'
Address 4649'? PENKWE WAY
S.F.Tolal y
ur CitY EAGAN phone 688-81oo S.F. FOOtprints _ SAC. MCWCC
'N
C
On Site Sewage - ater
onn
W Name on sae wan
- water Meter
N
1 AddfBSS MWCCSystem
Aw?
Deposit
Clfy PhOnB Ciry Waler _ .
PFV Required - SfW Permil
I hereby acknowlege that I ha ead this appli i n slate Ihat [he Booster Pump - SiW Surcharga
inlormalion is correct and a ee compy all p¢able State of
Minnasota StaNtes and Ci1y f Eag n Ordin ces, Trealment PI
Signalure ol Permitee pPPROVALs Road Unil
A Building Permil is sued to: Planner - park Ded.
on the express condition thal all work shall be done in accordance with all Council _
applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Oil. Copies
Builtling Official Variance - TOTAL 65.00
CITY OF EAGAN
, . 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55127 NQ 2 002 2
PHONE: 681-4675 0,0
BUI ?LDING PERMIT Receipt # .
RESIDENTIAL
To be used for gEMODEL Esc Value $4, 000 pyte JAN 8 , ?g 92
Site Address 1276 E BALSAM TR
Lot 9 Block 1 SeGSubWILDERNESS
RUN 6T OFFiCE uSe ONLY
FEES
Parcel No. occuPancy - 6
Bldg' Perrrt 3.00
Zoning -
Nffipe NF.TL. & SIIS N ATSAN .N (AcWapConst - Surclt3tge 2.00
? Addl'PSS 1276 E BALSAM TR (Allowable) - pLyn Rehew
? EAGAN MN
Oj(y Z?P
55123 :? of Siones
L -
?? 5.00,
0 englh -
Phone 452-3263 Deplh - SAQCiry
Name ALLEN CONST S.F. Total
- snc,MCwcc •
o S.F. Foolprints -
Addl'QSS 4649'§ PENKWE WAY e
o
Sit
S Water Conn
V ewag
n
e _
(;jry EAGAN MN Z'jp 55122 On Site Well Water Meter
? Phone 688-8100 MWCC System =
AccL Deposit
?
lkense # 0001062 Ciry Water
PRV Required
-
_ SNJ Permit
I hereby acknowlege that I ha reatl this appli tion s te Ihat the Boosier Pump - SNJ Surcharge
intortnation is correct and ag6eN to comply all pli le State of
Minnesota Statules and City f E an Ordi s. Treatment PI
Signature ol Permitee APPROVALS qpyd Unit
A Building Permit is is ed to: LEN CO 5 Pianner - park Detl.
on ihe express contli on that all work shall be done in accordance with all Council
applicable State ol Minn
e
ot
a Statutes and C
s
iry
o
f Eagan Ordi nances. gld9, pry, _ Cooies
{
?
?
?
-n
,
d
Builtling Oflicial _??1 1 I lLl
? ` .. -? Variance - TO7AL 70.00
r
CITY OF EAGAN No 19279
J 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8700
BUILDING PERMIT Receipt # C- I e5,;2-
To be used for POOL Est. Value $13 , 000 Date JUN 18 , Jg 91
SiteAddress 1276 E BALSAM TR
Lot 9 Block 1 SeclSub?LDERNESS RUN 61
Parcel No. _
wlName NEIL & SUE RAISANEN
o Address 1276 E BALSAM TR
City EAGAN Phone 452-3263
2, o Name APPLE POOL & CPA IN
g? Address 14650 GLENDA AVF
? City ApPI VA .i. .Y Phone 451-5391
Uw Name
x,? Address
W
a City Phone
I hereby acknowlege that I have read Ihis application and state ihat Ihe
information is correct and agree p M th all applicable State of
Minnesota Statutes and Cit of E a rdinan ?s.
Signawre of Permitee
A Buiming Permit is issued to. APPLE POOLS & SPAS INC
on the express condition that all work shall be done in accortlance with all
applicable Slate of Minnesota Statutes antl City of Eagan Ordinances.
Building Official
Occupancy
Zqning
(Actuap Const
(Allowable)
8 olstories
Lenglh
Depth
S.F. To1al
S.F. Faotprints
On Site Sewaqe
on ste wen
MWCC System
City Water
PRV Required
Booster Pump
APPROVALS
Planner
CaunCil
Bldg. OH.
Variance
OFFICE USE ONLY
M_2 FEES
33'
16'
Bldq. Permit
Surcharge
Plan Review
SAG Cily
SAC,MCWCC
Water Conn
Water Meter
Accl Deposit
S/W Permit
SNJ Surcharge
Treatmant PI
Road Unit
Park Ded.
Copies
TOTAL
144.00
6.50
94.00
L44 JU
533? ? L
o MAKI d -T ? i`1
' u ?)_in, A) 1 k) , ) ,i '? 1. i_
i3.ov
NequgsCDat¢? _gs- Fire No. AouBh-in Inspec[ion
Repuiretl? /
?4G
Ready Nuw ? WiII Nutify InsOeo-
mr Wh
H
d
o
?Y?s
??. en
ea
y
? Licensetl Electrical Cantractor I hereby reques[ inspection ol abova
?Owner electrical work installad at:
Stree[ Address, Box ar Bouie No.
26 8.4-LS,1-14 7" City' '
C
cUOn iownship Name or No. Ranpe No. County
I ?'
J
Occu - nt (PRINT)
El ? P une p?
PowrSu li
?Q
? ess ??/
/
?
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e ;;?; p
Electn 1 ConVactor (Campany Namel
7`"`
/ Con ac[o,'s License No.
d a?
-
,?.
e?
C Gy
?lailinp AdJress (Contrac[or or Owner Making Instailationl 9
4
6 l
/
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0
3 x- ev
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AuM ' ed SiB??ur onVac r Owner Making Installation) Phon 'jumber ) ) ']?
?i? ? ? / / F G
YINNFSpfp gTpiE gpppp OF EIECTRICITY THIS INSPECTION PEQUEST WILL NOT
Griyps-Yidwey Bldg. - Room Nd97 eE ACCEPTED BY THE STATE BOARD
7827 Uniwrsiqr Avn.. St Paul. MN 56106 UNLESS PNOPER INSPECTION FEE IS
p? I6121 2972111111 ENCLQSED.
REQUEST FOR ELECTRICAL INSPECTION E800001-08
A399-5 ==?.?? Losks9?'
? See in ciions lor r.omule?ing this lorrn on back ot yellow copy. ?Q ?j `? n R Q I/v? J?m?-"X" Below Work Covered by This Request ew Rtltl R6p. ° Type of Building AppliancesWiretl EquipmentWired
Home Range Temporary Service
Duplex Wate Hea[er
r Electric Heating
Apt Bullding Drye
r Other (Specify)
Comm./Indusirial Furnace ?
Farm Air Condi?ioner
OtM1er Isyecily) Conlracto(s Remar
/?J1.SCeiea17eOL( S
Compute Inspection Fee Below//2r:Va Ila-1?0w's ?
# Olher Fee # ServiceEniranceSize Fee # CimuitslFeeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps GY?
Transformers Above 200 _ Amps Above 100 ps-. _
Signs Inspector's use ony: ?
Irrigation Booms `U R
Special Inspectfon ?
Aiarm/COmmunication THIS INSTALLATION MAY BE D D NNECI'@D IF P
Other Fee COMPLETED WITHIN 78 MONTHS. ?„
-
I, the Electrical Inspector, hereby aouqn-m oae ?
.
certifythattheaboveinspectionhas
been made. F,,,ai oaie
OPPICE OSE ONLV ?
This iequest voia 18 months irom
\ t n
?
J
REQUEST FOR ELECTRICAL INSPECTION k1M EB-o°°°'A°
a n ? ' Sea instruetions f6r-cwnplnKnB this form on bnck of Vellow copy. ??? 6 J ?4 G ??
?Q 32853 ""X"" Be/ow Work Coveied 6y This Request
Add NYD- TYpe ui 6uilding APPlipn[n! WirBC Equipment WireA
Home Ranye Temporary Service
Ouplex Wa[er Heater Lighting Fiutures
Apt. Building Dryer Bectric Hcatin
Carniercial BIAg. Fumace Silo Unloader
Industrial Bldg. Air Conditioner Buik Milk Tank
Fam Other pec, y OtherlSVecifyl
Other Suecify Othe, Othe?
Comnute lnsuection Fee Below
i Fee ServieeEntranceSiae p Fee Fanders/SUbfeeders k Fee Circvits
0 to 200 0 to 30 Am s 0 to 30 Am os
Above 247A,11 31 to 7 00 qinps 31 to 100 A s
Swimming Pool Above 100_Am s Above 100_Am s
TransPomiers Irrigation Booms PartiaL?Other Fee
L I Si?s ? I ISpecial Inspection ?-^?. f
TOTALF.E?E/i
qouph-in Da[e ?. ?ha Electrical
? Inspec?or, hereby
tliW lM1a1 ?he above
Fi?l
41 ??fe ingpeetion hes baen
?`l/`4 matle.
?? g/?/ REQUEST FOR ELECTRICAL INSPECTION
li? Sae insVUCtions lor complenng tNS lorm on beck ol yellow copy.
I 5 0 L 1 y "X" Below Work Covered by This Request
9"T EB-00001-08
t=s ?,: O 00?
ewl AQtl Rep. Type of Building AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater Eleciric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial Furnace
Farm Air Condilioner
Olher Ispecilyr Comrehors Remarks:
Compute Inspection Fee Below:
# Other Fee # ServiceEntrance Size Fee # Circuits/Feeders Fee
I wimming Pool Q l0 200 Amps 0 to 100 Amps
Transiormer5 Above 200 _ Amps 0_ Amps
SiynS Inspecmrs llse Only: TOTAL
Irrigation Booms L?Q ? s
Special Inspection
Alarm/Communication THIS INSTALLATION MAV 6E ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 M S.
I, the Electrical Inspector, hereby AougM1in
Ili
certify that the above inspection has
been made. F,,,ai oa?e ?
(
OFFICE USE ONLY ?
This reQUest voitl 18 manlhs irom ?
/a t ? ?I?_ ? ??
p 62 84 c/?
ReQOest Date Fire No.
?/_ Rouqh-in Inspec
Fequired?
? Reatly Now ill Notity Inspeclor
When Read
?
/_
? :L Ves C No y
I?licensed contractor E) owner hereby request inspection of above el t' work aY'`'
Job Adtlress ?StreeL Box or Route Na.)
/a2 :? 5T " / TiY,?i % Ci?y
E•???a?
Section No. Township Name or No. TR,,,e No. ? Counry
?
OcCUpantiPqlNT) PM1On`e, o
Power Suppher Adaress
Ele I Gonlracmr (GOmp?y Na/?9e? Contraclor?5 L?ice?nse NJo.
MaJing AdOre65 (COnVaclor or Owner Making Inslallalion)
Bxi ?S'U ' %s. D
Amnorrzen Sg emre iCOnvzcto,Own Uakiny Inslailaiion) Phone Number
t?a?? %•l:zi?=?a?c? 7???- ?/9?
MINNESOTR S$T4 BOARD OF EIECTRICITY THIS INSPECTION REOUEST WILL NOT
Griggs-Mitl9ni - Poam 5-113 BE HCCEPTED BY THE STATE BOARD
1821 Oniversity Ave.. St. Paul. MN 55100 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642A800 ENCLOSED
.
CITY USE ONLY
PERMIT RECEIPT DATE:
1
2008 iiESIDENTIAL 14IECHANICAL PEMIT APPLICATIOft
crrY og $wsax
3630 PILOT KAOB gD
£FtHAA b1N 55122
631-6$1-4878
Please complete for: ? single family dweliings
townhomes and condos when permits are required for each unit
Date:
?
SITE ADDRESS:
OWNER NAME: ?Y?Cr?Q..L TELEPHONE #:
INSTALLER NAME: TELEPHONE #,
STREET ADDRESS:
CITY: z ?z?J6I? STATE: ??
Place a check mark next to the permit work type
ZIP:
Add-on, modification or alteration to existin dwelling unit $ 30.00
,,,?furrace replacement
• air exchanger
• air conditioner
• other
Nature of work:
_-- - . r^ - ?;
li;
, .. ., L-bi
l
L
?
'
State Surchar e $ .50
J
TOtal
$?d. ?
e ?t O 3??LHY.t+t.ew %/1
SI AI' ? E TTEE ?Ij ?-%`--
voz
--D l<?
New Conatruction Reoulrements
• 3 registered sife surveys showing sq, ft. of lot, sq. ft. of house; and all mofed areas
(20% mazimum lot coverage allowed)
• 2 coples of plan showing 6eam $ window s¢es; paured (ound design, etc.)
• 1 set of Energy Calculatiom
• 3 copies af Tree P2servation Plan'rf lot platted a@er 711193
• Rim Joist Detail Options selection sheet (bidgs with 3 or less uniLS)
DATE 'S L 2-V ' `
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EACAN
3830 PILOT KNOB RD, EACAN MN 55122
651-881-4675
-D.C) U . 1 S?
RemodellReuair Reaulremenls
. 2 copics of plan
• 1 set of Energy Calculations for heated additions
• 1 site survey for e#enor additions & dacks
. Indicate rf home served by septic system for addilions
cJ?
VALUATION 0/060 '
SITEADDRESS I 27 C FE. ??FLSR^'? D- • MULTI-FAMILYBLDG _Y `!V?
TYPE OF WORK T"- af-I-' ' Rc 94,f` 4?SQS' - FIREPLACE(S) _ 0? 1_ 2
APPLICANT ?^^'-?" c•"- l?S?, • L?,{i,? Ca
STREET ADDRESS 12- Z y 1 N? ? ?wT A ?? s, CITY STATE /?'?- ZIP 337
i
TELEPHONE #-7 0 -`y s 5
CELL PHONE #
FAX #y ) V "'' `r q Z-r
PROPERTYOWNER_CV,el.- IL Ar`K/a/?,c_.-- TELEPHONE# /, SySZ- 3 z63
------- -------------------------------- --------------------------------- ----------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNL;SO"PA RUI.F:S 7670 CATEGORY 1 MINNES01'A RULES 7672
(J submission type) . Residential Ventllation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
. Energy Envelope Calculations Su6mitted
Plumbing Contractor: ___ ______ Phone #
Plumbing system includes: Water Softcner Iawn Sprinkler Fee: $90.00
Water Heater No. of R.I. Baths
No. of Baths
Mechanical Contractor: Phone #
Mechanical system includes: _ Air Conditioning Fce: $70.00
_ Heat Recovery System
Sewer/Water Contracfor. Phone #
----°-----°---°--°---°--
-
-
-
I- -°------°-----------------°----°--°------- --- -- tt nn °-------
-
-
l
lidl?
?
?
?
hereby acknowledge
that I
h y
g comp
ave read
r
,c
a
this
application, state that the informatio O
with all applicable State of Mi nnesota Statutes and City of Eagan Ordina?es. n M[L?L?-fl-2??2 II
Signafure of Applicanf
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4l02
CITY OF EAGAN
3830 Pilot KnOb Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMITTYPE: BuiLplNG
Permit Number: 0 2 7 7 3 6
Date Issued: 0 6/ 0 3/ 9 6
SITE ADDRESS:
P.I.N.: 10-84355-090-01
DESCRIPTION:
1276 BALSAM 7R E
LpTe 9 BLtlCK: 1
WTLDERNESS RUN 6TH
(ROOFING/SIOING)
e r m i. t T y p e -&
p,rk Type REPASR
? '%434 ALT. RESSDEN7TAL
C
?a?' a m
??9? a+ B?s?? ?
REMARKS:
STORM pAMAGE - N-0 FEE
FEE SUMMARY:
CONTRACTOR: - ,qpplicant - sT. ?IC.OWNER:
ALLEN CONST 16888100 0001062 RAISANEN MEIL
4649 1/2 pENKWE WAY 1276 BALSAM 7R E
EAGAN MN 55122 EAGAP! MN 55123
(612) 688-8100 (612)452-3263
I.. ia
'inf
5ts
?. _ .
_.,.
IS? BY?IGNRTU E ' ?
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
aamndnUReoalr Reouirements
? 3 regislered site surveys ? 2 copies of plan
? 2 copies ot plans (inelude beam & window sizes; poured fnd. design; ete.) ? 2 site surveys (exterior additions & decks)
? t energy calcuialiona ? 1 energy calculations for heeted additions
? 3 apies of tree preservation plan H lot platted aRer 7/1/93
required: _ Ves _ No
DATE: ?3A? CONSTRUCTION COST:
DESCRIPTION OF WORK:
STREET ADDRESS:
LOT L BLOCK ??LEA'/ 4-J4rIL65' Cv.&
IZ- 76 Al? !/
SUBD./P.I.D. #: L --1-?"!??L;, J71///"H kRZ
?G (A22; lruln"a- al;?$
PROPERTY Name:,dfAiVall, 441-fA ,)Jf? Phone #: ??? ?3LG.3
OWNER
Street Address-
City: 64A4) State: isird Zip:
CONTRACTOR Company: Phone #: ??? 6W
Street Address: , 49L df-" wL4-,? License
city; State: W/fJ Zip:
ARCHITECT! Company:
ENGINEER
Name:
Phone #:
Registration #:
Street Address:
CRY: State: Zip:
Sewer 8 water licensed piumber:
change are requested once permit is issued.
I hereby acknowledge that I have read this application and state that the
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Penalty appiies when address change and lot
is correct,6nj/ agree to comply with all
Tree Preservation Plan Received Yes No
't4qqq
CITY OF EAGAN
1994 BUILDING PERMIT APPLICATION
681-4675
?ffz.- JK 0
P/' t???•i? 'l13 `
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request 1s made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date ? U Valuation of work ?
5ite Address: ?.2 Z 6 L 4,3/aLSf1N1 r2
STREET SUITE M
Tenant Name: (commercial only)
LOT ? BLOCK ? SUBD. ??? P Z D. #
Descri tion of work: TOfZ?&4-: s
The applicant is: ? Owner O Contractor ? Other (Deseribe)
Name H)S H 0J1= N " 4E I t, P h o n e ZZ%g`
Property LAST FIRST
Owner qddress ??(lL6 ra1-1
STREET STE #
City State Zip
Company fif U-1L-FP?v,0 fn/O_ Phone a-4>rQ':37?z
Contractor Address <3 3??9?O?L-?f License # Exp.
City S'7' P6 ?j__ r State i''l ti' Zip 55/U
Company Phone
Architect/
Engineer Name Registration #
Address '
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with all applicable 5tate of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging
? 02 SF Dwg. 11 01 4-Plex ? 12 Mult1. Misc.
? 03 SF Addition ? 08 8-Plex j2;13 Garage/Accessory
E-1 04 SF Porch ? 09 12-Plex ? 14 Fireplace S~t?,
1:1 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck
WORK TYPE
?31 New ? 33 Alterat9ons ? 35 Tenant Finish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual) ?
(Allowablej n/
UBC Occupancy M-/
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Engineering
REGIUIRED INSPECTIONS
? site
? Wallboard
Basement sq. ft.
lst F1. sq, ft.
2nd F1. sq, ft.
Sq. Ft. total
footprint Sq. ft.
On-site well
On-site sewage
Building
Variance
?I Footing
?Final
? Framing
? Draintile
f38
o,
i
0
? Insulation
? fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
I valuacim:
s 3,000
l z. u I& - / S z- x/6 ?>
.43 1 r> -7 Z_
,.? ? ?. ?..
0 17 Swim Pool
? 37 Demolish
? 16 Basement Finish
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
MWCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code
Census Bldg
Census Unit
Assessments
SAC %
SAC Units
-J( CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
1276 BALSAM TR E
LOT: 9 BLOCK: 1
WILDERNES5 RUN 6TH
P.I.N.: 10-84355-090-01
PERMIT ? IU4qrff
PERMITTYPE: eurLozNs
Permit Number: 0 2 4 7 9 9
Date Issued: 12 / 0 2/9 4
DESCRIPTION:
(SHED)
?. ?.
Bw'?ldin"??, Permit Type
Bui#,ding 4.tork 7ype
UBG OccupanGy\
Cartstruction Typ,e
GARFlGE/HCCE550RY
NEW
M-1
V-N
?? ;ry L
? f??
"p
5
REMARKS:
FEE SUMMARY:
VALUATIQN
$3,000
Base Fee
Surcharge
Total Fee
$54.00
$1.59
$55.5@
CONTRACTOR: - APP13cant - OWNER'
HEARTLANp IMDUSTRIES SNC 12223976 RAtSliNEN NESL
533 RANpOLPW AVE 1276 BALSAM TR E
ST PAUL MN 55192 EAGAN MN
(612) 222-3976 (612)298-1645
I here-by acknowledge that I have read th3s a-pplicatiort arrd stmte that the
informataon is enrrect and agree to comply wsth a11 applieab3.e State of.Mn.
5ta5utes and Gity of Eagan Drdinances,
?] `.(/)/?/??/? .
APPLICANTP RMITEESGNATU E ? ISSUE BY;SI URE
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS: Lo r:
1276 BALSAM TR
WILDERNESS RUN 6TH
PERMIT SUBTYPE:
GARAGE/ACCE3SORY
INSPECTION RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
BUILpIN6
024799
12/02/94
9 BLOCK: 1 APPLICANT:
E HEARTLAND INDU57RTES INC
(612) 222-3976
TYPE OF WORK:
NEW
OESCRIPTION (SHED)
INSPECTiON ., . .A
FOOTINGS FRAMING
FINAL
F
L
J
u ?O-a4 i
' -.00
1? 11 ?dy ? TI'LK JHPhKHY 1NU, hH]{ NU, b12 ?y8 lbJJ
??.?a.,v?? . ' , . . : vrJc?+•in
?
DELMAR H. SCHWANZ
L4N0SUAVEVGRY; INC,
qpifitareG Unaol Lowa of Th4 St+ls ot Minnaaola
1978 - YMSYN 57REEY W. - BOX M R06@MOUNT, MINNES9TA b6068
o <t?fl-S.?-`SUFiV6YUA'$CEATIFICATE
?
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0?
9+.s 9*oa
, C
?-
?
T7rainage aad Y?Q?yP6
utilit?r
eaeemant '
? I
n1 ??7
\? ??•
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? ?gg 40
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OCT 25 '94 12:25
.. 1'
?-br??t?'W`' `?d 9
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PHONE 672 423-7769
r uZ ur ?Il
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EAGAN
R E ?tt W p
9Y
DA7E 85)
SCALE: 1 inch - 50 ft.
E1e,vations Bhoun are existing
and based on aesumed ilatum
o Denotes iron pipe ,
Praposed gara&e flaor
alGVatilori 10?2aa- --
QRbL--
5 K90
I
I f hereby certify that thia ln a
true and correct repreaentation o;
Lot 9. Blook 10 wii.bERTtFS5 RUN
? SI]CTF[ ADDITxON, BCCpx"d11'1$ to the
? ?k reearded plat thEreof, Dakota CountY,
t'h Minneaota.
? Also ehowing the locati.an of a
? propotlad houee aa ataked theraon.
Taatgd.,A.pr12_234-AJ•- 985 •
?_ ,---?r--__--_
612 298 16_3 PRGE.02
1992 BUILDING PERMIT APPLICATION
CITY OF EAGAN
REQUIREMENTS: 100 t I
SINGLE FAMILY 2 SETS OF PLANS, 3 REGISTERED SITE SURVEYS, 1 SET ENERGY CALCS.
MULTIPLE DWELLINGS 2 SETS OF PLANS, 3 REGISTERED SITE SURVEYS, 1 SET OF ENERGY CALCS.
# OF UNITS RENTAL FOR SALE
COMMERCIAL 2 5ET5 OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF
SPECIFICATIONS, 1 SET OF ENERGY CALCS.
PENALTY APPLIES WHEN TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING
DAY OF MONTH IN WHICH REQUEST IS MADE QR LOT CHANGE IS REQUESTED ONCE PERMIT IS
ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH
ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
To Be Used For:,?,y,? Valuation: Date:
Site Address 1,27 7/ 2?etQ-r
Lot ? BloCk FEE
Occupancy Bldg Permit
?
31
Parcel/Sub? Zoning Surcharge a. 00
,. Actual Const Plan Review
Owner ? Allowable License Fee ?
# of stories SAC, City
Address ??g, Length SAC, MWCC
Depth Water Conn.
City/Zip Z S.F. Total Water Meter
FootpriM S.F. Acct, Deposit
Phone
41 '?p S/W Permit
On-site sewage S/W Surcharge
Contractor w 7A On-site well Treatment PI.
MWCC System Road Unit
Address ?y City water Park Ded.
PRV Trail Ded.
City/Zip ZL Booster Pump Copies
Phone_,/o -V ?-
Licens.,?'%e6Z
APPROVALS SUBTOTAL
Penalty
_ Planner Lot Change
Council T07AL .?
Arch./Engr. Bidg. OfF. l-7 52 O.s. ??,??
Variance
Address
City/Zip Code
Phone #
a(nir. . Processingtime
is two ays once area as been approve .
agrees that all work shall be done in accordance with
ail applicable State of Minnesota Statutes and City of Eagan Ordinances.
1991 BUILDINGMIT L CATION
CITY OF EAGAN ?
SINGLE FAMILY DWELLZNGS MIILTIPLE DWELLINGS COM!ffiRCIAL
/
2 SETS OF PLANS 2 SETS OF PIANS 2 SETS OF ARCHITECTURHL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PIANS
1 SET OF ENERGY CALCUTATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
_# OF RENTAL UNITS
_# OF FqR SALE UNITS
PENALTY APPLIES HEiEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY IAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER HUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALIAWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LIGENSED PLUMBER.
To Be Used For
Site Address
: ? Valuation
/374 E.?l' alsq m?j ".' /
Lot 9 Block /
Parcel/Sub WiIdCY/I£SS '-?un (o-'?-
Owner
?h
Address
City/Zip Code /%?,4eJ 6?-
Phone
Contractor
Address
City/Zip Code
Phone
Arch./Engr.
Address
Date :
OFFICE OSE ONLY
`T
Occupancy R
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F.
On site sewage_
On site well _
MWCC System _
City water _
PRV _
Booster Pump _
APPROVALS _
Planner _
Council
Bldg. Off. g 9 g/ OS
Variance
FEES
Bldg. Permit
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Acct. Deposit
S/w Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trail Ded.
Copies
3, oi,
,OD
SIISTOTAL S
Penalty
Lot Change ?
TOTAL
agrees that all voTk shall be done in accordance with
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
City/Zip Code
eaaement
?
•;;.?,•,,,.
y
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ti
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Drainage and wo?°?„as
utility S0" ?
,
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DELMAR H. SCHWANZ
LANDSURVEYONi? ING.
RpisUrW Unaer Lawa ot TM Sbte of Minnesota
2978 - 746TM STREET W. - BOX M ROSEMOUNT, MINNESOTA 66068
p 4eS2?TSURVEYUR'SCERTIFICATE
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/ Nk??'??
ss.s R ' n
I f4c?vEy ?f? . \
\? !
/ ? ?•.s
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MOp..LL[V. .. . ?
,...
M
EAGAN
Re ?W o
BY
DATE
?
?
1,
SCALE: 1 inch = 50 ft. 1 v
Elevations ahown are exieting
and based on assumed datum
o Denotes iran pipe ,
Proposed garage floor
elevaClon /O,?2o19
? i hereby certify that this Sa a,
? true and correct representation of
Lot 9, Block 1, WILDffitNESS RUN
? 3YXTH ADDITION, according to the
recorded plat thereof, Dakota County,
? irlinneaota.
Also showing the location of a
propoaed house ae ataked thereon.
.,
23. 1985
P"; 8 7/2 4 4/8
PHONF 672 423-1769
.
1991 BUILING"PIT1ICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
MULTIPLE DWELLINGS
?
l6
COlRIERCIAL ?
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCUTATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCUTATIONS 1 SET OF ENERGY CALCS
_# OF RENTAL UNITS
_# OF FOR SALE UNITS
PENALTY APPLIES HHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT YICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER. , f:4??Tfr p?({EGO
.1-N G Ra.u„aj
To Be Used For: ?//t'((A[?449criC.-valuation: 13, 000 Date:
Site Address lo2?G .5/'%AjCGL$Gtyo-rr
Lot ? Block /
GulLZ?p2A?SS /??/v SixT?
Parcel/Sub
Owner R1R15u/+/f,v N67c ? St1f'
Address 197!r lE-_ A C{CSQrr.j
City/Zip Code
Phone y Sp+ ^-? 2-Is 3
Contractor ?lonr Dm&5 s Sl-GS/.t/c
Address /zllis-D C 6z-mb-4 "4yt::-
City/Zip Code
Phone (" la s 3.Fz
Arch./Engr.
Address
City/Zip Code
Phone #
OFFICE USE ONLY
Occupancy ?'7r
Zoning
Actual Const
Allowable
# of stories
Length
Depth / (p?
S.F. Total
Footprint S.F.
On site sewage_
On site well _
MWCC System _
City water _
PRV _
Booster Pump _
APPROVALS
Planner _
Council
Bldg. Off. S -/?P-9/1
Variance
FEES
Bldg. Permit 14 y .ov
Surcharge (, g'A
Plan Review ,00
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Acct. Deposit
S/w Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trail Ded.
Copies
SIIBTOTAL
Penalty
n
Lot Change A 00
TOTAL V
agrees that all work shall be done in accordance with
(Si ature Contract
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
CertiPicate for:
- ?• Neal Raieanen 87/24a-/e
eaeement
DELMA6t H. SCHWA.NZ
lANOSURVEVGRC) INL,
RaqiaUntl UnOer Laws o/ The 5[ate of Minnesota
2978 - 116TH STREET W. - 80X M ROSEMOUNT, MINNESOTA 56068
? "SURVEYOR'SCERTIFICATE
?9s?
?
* ? cuas
68 9yo0 ?
Y
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acuReDrainage and utility tOP ?
to s06Us
/w%.s 04.e +o.
M `hM ? h
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hp ED ry ?
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102.17
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PNONE 612 423-7769
EAGAIV
R E?t?E Wg D
B
DATL 5'l0
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C ! IC V
33 // tOP ??' N
t? :!
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r I
IM
yh? /
r
I
po"p LLLV.
T7• ?
?-
?D
SCALF.: 1 inch - SO ft.
Elevations ahown are existing
and based on assumed datum
o Denotes iron pipe .
Proposed garage floor
elevat•ion lO1??ef7
? t.
1 .
S hereby certify that thie is a°
? true and correct repreaentation of
I Lot 9, Block 1, WILDERNFSS RUN
? 9IXTH ADDITION, according to tha
recorded plat thereof, Dakota County,
m Minneeota.
? Also showing the location oP a
? i proposed house as ataked thereon.
1 - Tkatset3 - 6nr4l 23 _ 1985
?
CiTY OF EAGAN N 0- 10 1 9 2
3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121 /
BUILDING PERMIT PHONE:4548100 R"eiat # 5 ( Y
Ts M owd iar SF DWG/GAR Et. Value $135,000 pote MAY 8 Iy 85
SlteAddran 127 E. BALSAM TR erecc 12 oocuoancy R3
WILD RUN (TIi
Lot 9 elack 1 ?/Sub Remodel ? 2oning Rl
. Repeir ? Type M Conrt, v
Parcel No. Enlarge ? No. Storiea
NEIL RAISANEN Move ? Langtn 75
? Name
4383 GARDEN TR
Oemolish 1:1
Depth 45
?
Addrets
E A
452-3263 Grade ? SQ. Ft.
. Phona
CitY Install ?
SAME Ayprovab Feet
N
Z? ame
O
520
o? Addresf
u Assessment .
Permit
67
50
? CitV Phone Water 6 Saw. .
SurcF+orpe
Police Plan Feview 260.25
r,W Neme PHILLIPS PLAN SERVICE Fira SAC 525.00
_? A?ma PENNOCK LN Enp. WoterConn. 500.00
iW City APPLE VAL Phone 432-2044 planner WoterMeter??00
Councll Raed Unit 98()- 0
I heieby ocknowledga tFwt 1 how raad this opplicotion and state tMf gldg. Off. S 8 8 S T. P. 132.00
the inlormotion is Correcf and agree fo cwnply with oll applicoble A? Total $2. 348 _ 25
Sraro of Minnasoro Stetuts and Clry of?agan Ordirancea?
Var. Date
$ipnotun of PermiMee
w BWldinp Permit Is iuuad ro: NEIL RAISANEN an the axpmss eorditwn ihat
all work sholl be done in acoordance with all a 'mbla 5 o in ta Stmrtd ry of Ecpon Ordinancas.
BWldinp Offkid `? y - -
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS 19UST RE LICENSED WITH THE CITY OF EAGAN
INCLUDE 2 SETS OF PLANS
1?7.g//? L??iIS? m 7?. 7 SET OFRENERGYTCAL?CULATIONS
To Be Used For: /?
KeSfDeNCE Valuation:?6_L? Date:
ICY-, ??_ l 3?-:) oao. °°
Site Address: OFFICE USE ONLY
w??oenNESS
Lot: ? Block r Sect/Sub IZUn? Erect x Oecupancy
Parcel ll
OwnerhEIL ?-SUS,4n! lCFNSRNenI
Address '/3f,.3 ()VOcAJ _7Z}/L
Remodel
Repair
Enlarge
Move
Demolish
Grade
Zoning
Type of Const
41 of Stories
Length
Depth
Sq Ft
3
R- I
'Si
-75-
45
cityiziP Code el& l?tK SS'/?3 ---------•
Phone y?a -3a63 APPROVALS
Contractor SdFL%-
Address S(d-M
City/Zip Code 1'
Phone I I
Arch./Engr. P{-(!Lt(l9,s" PLAN SE/c'UiLj?7
Address PENNOGK 1WN
Assessments Permit
Water/Sewer Surcharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Couneil Road Unit
Bldg Off Parks
APC Treatment P
Variance
TOTAL
cityiziP Code ¢}pp?_C ?I?t-u?`(???, 5Sl,,??/
Phone II y3a? -J!y
??Id,R.. 5"e
SZD. T
3SdL, ?
525. •?
r7?. ?o
Z$O. ?
l32 °°
-?,, 3 ve,
??s
[ S .fd ( v?G? ? ?
(J
?Zx So = 3&c) x S4- ? 19 44?
I?x32 - 51Z ? S4- _
704 x ?? - 774 4
32 x 2Z "?
f 4x rL8 ? ? 2 x 4 (
Z? x Z? 4t
1 ?q 3Z?
?
?
? ?•*.
?-20•5+
I 67 _+
260 • 25 +
527• +
SDO• +
63 • +
280• +
132 • +
2+348•25*
A191z. (1-Sv-51LV lb/S.fN?
eJ
,
r1 ,
? 6Jv6Z&Y C,ftuuLA-,-ioA1s
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-- „ -
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?_ _ S! " ,Qfte-?_ ivSU4,97-10_N 9 -- -
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---
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31
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-- - - c. ?. -
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- - - G,?, , y _ Sz-i,Ar .SHwe 630
---
?
L?iv'iU'Orr
6hS ?.e?-??o ?i2
?
Certificate Por:
_
.' Neal Raieanen Bk: 87124a14Y
DEIMAR H. SCHWANZ
LANDSURVEVONS, INc-. " -
. RsgistvM UnOK Laws of TM SGte of Minnesota
2878- 146TH STREET W. - BOX M ROSEMOUNT, MINNE80TA 56088 PHONE 612 423-7769
?? 1
\?"SURVEYORB CERTIFICATE i
M9
? B
• y?p?p?o"
as° 9y-°o ? 7?
Drainage and
utility TOP o ?
easenent ? ? ?` ?------ ) ?
66
M ??hM??'I ,y g V
? .? 04s. 102.1?
i ?
rov xue ? .
\ ?1 • ei • _ ?.,,. j
V` q
a
?I 6 top r°' , N `?1
3CAI,E: 1 inch a 50 ft.
Elevations ahown are exieting
and based on asaumed datum
+6•3 o Denotes iron pipe
fuRbF?- ?
Proposed garage floor
I ? elevation IO?a D
i)
/ ? •? s
?
f
? n.+
hereby certiPq that this ie a
trne and correct representatlon of
Iat 9, Bloek 1, WILDERNESS RUN
$I7CPl1 ADDTTION, according to the
reeorded plat thereoP, Dakota County,
I ?/V m Ninnesota.
1 ?
.? ' !llao ahowing the location of a
propoeed houee as staked thereon.
? tl + / Dated: April 23, 1985
/¢Z, oo ivB9- ? s- 37E
ZIL??.!/??1';. i
MINNESOTA REGISTRATION NO.6625 ? -?
? ? :
1 2/84
? CITY OF EAGAN
y
i APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTIODI
(PLEASE PRINT)
1) PROPERTY ADDRESS a p? 7 PV'
r.Frnr DESCRIPTION:
(Lot/Block ubdivislon or Tax Parcel I.D. NLmber)
f IF F"{IS^=_:G STRL'CTjRE, DAT' 0F ORIGiVtIL 'L'IT..P,L"G FE;':'IT ISSJ;*:CJ:
j PRESLT ::^`Ti-?ir/P??OPOS"D USi: C9'R-i S_7GL: Fe?"vr:,?•
? R-3 DUP= (Z'no L'tiITS)
E3 R-3 TOri?II-IOUSE ('PIfftEE + LT[VITS) ( UNITS)
? R-4 APAR'IMENT/CODTDONLTNI[M ( UNITS)
? CONnNERCIAL/RETAII,/OFFICE
? MMCSTRZAL
Q INSTI'I4JTIONAL/G9VEE2IVNIENT
Z) AppLICF1NT (PLEASE PRINT)
?] ( ?
NAME: f
C % 1v'nr(-
-
ADDRESS: 40F.
CIT'Y, STATE, ZIP:
PxoNE:
3) pLU„BER /?--L--- PLEASE PRIHT) i0R CITY USE ONIY
?'ME' H? lf gkn&A4II/'tl
ADDRESS: PLUMBERS LICENSE:
[? ive
CITY, STATE, Z7
jy/.
eMA
Expi d
?
1 STEA
PHON,1,f??3- PLUMBER LICEHSE // 25?f E? af Record
ni ia
¢) OCCUp??CWNER ?.j' (PLEASt PRINT)
N?1ME: ?i L ?/t % l ? / ,v.a }
ADDRESS: i /-'6'i?rr.l
CITY, STATE, ZIP:
,
PfKKY.VVE:
5) INpIG'1TE WHICH PERMI'T IS BEING REQUESTID:
/
LJ ION TO CITY SEZ^TER
Q?NNF,CTION TO CSTY WATER
? OTIM (PLEASE DESCFtISE)
6) INpIG;TE (DNE:
7) SzQ?LA=:
? PLF1'1SE HOL? APPROVID PERMZT FOR PICK-UP BY ONE OF ABOVE
L5 PLFIISE MAIL APPR(7VfD PERNIIT TO 1, 2,5, 4 ABC7VE
? (Circle one)
DATE:
?
F 0 R C I T Y U S E Q N L Y
PERMIT ° ISSUED
-?
ft
.-
. i
/ . .
?
y? •• , l .
' • . , F°ES;
• ,
-.'
`?$ ?_ /
!??-fL-? ?. .
.
CHARGE)
'?? SE?r1EP, n?'?2:9IT (I'7ELjliD? SUP
_.
_ .
WATER PERb1IT (INCLUDE SURCHARGE)
J $ lp ???-u WATER METER/COPPERHORN/OUTSIDE READER
? $ WATER TAP (INCLUDE CORPORATION STOP)
?
i '
$
S°_';dER TA:,
, $ ACCOUNT DEPOSIT - SE';?ER
r ,?f $ ACCOUNT DEPOSIT - WATER
$ WAC
$ SAC
$ TRUNK WATER ASSESSP9ENT
$ TRUNK SETidE4 ASSESS•:1ENT
Q $ LATERAL BENEFIT/TRUNK SEWER
$ LATERAL BENEEIT/TRULdK WATER
$ OTHER
$ TOTAL
$ ?? S U AiMOUNT PAID/RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGiIT OF WAY?
? YES ZF YES, THEN A"PERMIT FOR WORK WITHZN
?--PIIShSC ROADWAY" MUST BE ISSUED BY THE
NO ENGINEERING DIVISION. LZST AS A CONDI-
c? TION.
SUBJECT TO TFiE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE:
masww" ntwm?m wm?qu wpppm4wp
Raw??a?ilwi? ?t+?
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA108980
Date Issued:01/29/2013
Permit Category:ePermit
Site Address: 1276 Balsam Tr E
Lot:009 Block: 001 Addition: Wilderness Run 6th
PID:10-84355-01-090
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to Mark Anderson , State Electrical Inspector,
952-445-2840
Ashley Orman
130 Plymouth Ave N
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 -
Neil D Raisanen
1276 Balsam Tr E
Eagan MN 55123
Standard Heating & Air Conditioning
130 Plymouth Ave. N
Minneapolis MN 55411
(612) 824-2656
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA112953
Date Issued:08/27/2013
Permit Category:ePermit
Site Address: 1276 Balsam Tr E
Lot:009 Block: 001 Addition: Wilderness Run 6th
PID:10-84355-01-090
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Ashley Orman
130 Plymouth Ave N
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 -
Neil D Raisanen
1276 Balsam Tr E
Eagan MN 55123
(651) 336-6886
Standard Heating & Air Conditioning
130 Plymouth Ave. N
Minneapolis MN 55411
(612) 824-2656
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA114107
Date Issued:09/11/2013
Permit Category:ePermit
Site Address: 1276 Balsam Tr E
Lot:009 Block: 001 Addition: Wilderness Run 6th
PID:10-84355-01-090
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Jayme Meyers
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Neil D Raisanen
1276 Balsam Tr E
Eagan MN 55123
Bayport Roofing And Siding Llc
10 South 5th St, Suite 700
Minnepolis MN 55402
(612) 235-7663
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
r
For Office Use I /�
I' ,l'ly
:::::/
II/6-City of Eaaal �/4/h er ' I..i. --3'1
3830 Pilot Knob Road
Eagan MN 55122 Date Received: f i
Phone: (651)675-5675 j1-{
Fax: (651)675-5694 Staff: I.►�-�
2017 RESIDENTIAL/ BUILDING PERMIT APPLICATION /
Date: 3/f 117 Site Address: l a7 B f yv\ —rrail I Ems. Unit#: A)/6-
I I
733. b
Name: 1 ,Gi� � Cu���G�I� '� Phone: �Psi-
Resident/ I I 76 &.(sa Tia r� ( E—. ��,�] 141 N 5123
1 owner Address/City/Zip: jYl V
Applicant is: Owner Contractor
Description of work: Q (bask. k;tchei P A t�1�/shrwe r to -6)(I0\,t t l-6skeci-b'(f?m6)1
Type of Work
Construction Cost: �k ` zSr�b Multi-Family Building: (Yes /No � )
, TCompany: Contact:
( Contractor , Address: City:
(
State: Zip: Phone: Email:
I
License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why:
c2,„_.--\
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
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:
Fire Suppression Contractor: Phone:
NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of
the information maybe classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
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.qopherstateonecall.orq
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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
i\
41 k �v iktr, -� �r
x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
7& i4 1 DO NOT WRITE BELOW THIS LINE /C"//‘.- ---5--
SUB
.-SUB TYPES
—
Foundation Fireplace Porch (3-Season) Exterior Alteration (Single Family)
Single Family Garage Porch(4-Season) Exterior Alteration(Multi)
Multi Deck Porch (Screen/Gazebo/Pergola) Miscellaneous
01 of_Plex Lower Level Pool Accessory Building
WORK TYPES
New Interior Improvement _ Siding Demolish Building*
Addition Move Building _ Reroof Demolish Interior
Alteration Fire Repair Windows Demolish Foundation
Replace Repair Egress Window _ Water Damage
Retaining Wall *Demolition of entire building—give PCA handout to applicant
DESCRIPTION a
Valuation af‘19S. Occupancy f q MCES System
Plan Review Code Edition t. ,;,-;. .," SAC Units
(25% 100% y ) Zoning City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings (Addition) X. Final/ No C.O. Required
Foundation Foundation Before Backfill )t HVAC_Gas Service Test Gas Line Air Test
Roof:_Ice &Water _Final / Pool: _Footings Air/Gas Tests _Final
Framing X 30 Minutes 1 Hour Drain Tile
Fireplace:_Rough In Air Test _Final Siding: _Stucco Lath _Stone Lath _Brick_EFIS
Insulation Windows
Sheathing Retaining Wall: _Footings—Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee / fr
Surcharge
s1
f,
Plan Review �,° i V Iv J;46
MCES SAC �° Ir'n`,
�
City SAC 6 Al 1
Utility Connection Charge
S&W Permit& Surcharges ri/i'‘
Treatment Plant
q 391 Copies x,,, _ .'
TOTAL
Page 2 of 3
Use BLUE or BLACK Ink
r
For Office Use
. 1' /t(,) Cr2 go
City of Eaaall Permit#: �_,//ma�yy
Permit Fee: Y ii)°�
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 Staff:
Fax: (651) 675-5694
2017 RESIDENTIAL PLUMBING PERMIT APPLIC TION
Date: / Site Address: i % g-z:,. _ _6.-6-.14,frc / /
Tenant: Suite#:
ReSltliUt/OWt1fi3T Name: t/� a�41-fk,--e..._
S� . Phone:
I
Address/City/Zip: g , _ _v'L. V
I
L `-j
Name: ,p.p pI,,I,C, ) t,-.. Lt------.. License#: 06,2- 3?P 1 f
Col ra+ for Address: q35 t�',2,c.1 f z( i' i9v. .. /J City: LE?c.J0t�c�
State: rt J) Zip: C..5 Phone: 6(Z 3,?S 72 -
Contact P �\ 7ft'lc-�"f`-�Email e��0 `,
to�b �. �/6.?-t,..\ ------ �('
,
New Replacement —Repair —Rebuild Space Work in R.O.W.
Type of Work — — ;
Description of work FP k-CJ J i t 2 L'u b ,,,'S
RESIDENTIAL I
i
t Water Heater
Water Softener
Lawn Irrigation( RPZ/—PVB)
Rent*Type �„dd Plumbing Fixtures ( Main/if Lower Level) f
Septic System —�'
—New ? Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation (includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround*(includes State Surcharge)
*Water Turnaround (add$280.00 if a 3/4"meter is required) i
$115.00 Septic System New(includes County fee and State Surcharge)
TOTAL FEES$
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.gopherstateonecall.orq
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� the work will be in
accordance with the approved plan in the case of work which requires a review and approval
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'OR OFFICE USE • Reviewed By: bate:.
iequire'd Inspections: ;Under Ground Rough-In Air . Gas Tett Fin
Neter Related Items: Meter Size Radio Read Manometer &tat . , . . .