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3620 Denmark AveCITY OF EAGAN 97 rw 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 4548100 . c BUILDING PERMIT Receipt # To be used for 1 OF 4 PLEX Est_ Value $53,000 r1ntP DECENIBFR to 64 Iva' Ila IU20 E 146TH ST 1 hereby acknowledge that I hove read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Perrnittee -- L INC A Building Permit is issued to: all work shall be done in accordance with all applicable State of Mil Building Official Erect Remodel ?X Occupancy R1 ? Zoning R Repair ? Type of Const. V 1 HR Enlarge ? No. Stories. 2 -it Move 13 Length Demolish ? Depth 22 Grade ? Sq. Ft. Assessment Permit -e s.. ° • v v Water 8 Sew. P l Surcharge 26.50 k 146.00 Pl h o ice Fire an c ec SAC 525.00 Eng. Water Conn. 470.00 Planner Water Meter 63. U 0 Council - Road Unit 260.00 1 BIdg.Off . Parks APC $ 1 Total , 7 82 50 ' Var. Date on the express condition that Statutes and City of Eagan Ordinances. Site Add _ _ --- L Lot Block SICISub. CROSSROADS OF Parcel No. EAGAN Permit No. Permit Holder Date Plumbing 5o a? ?v U j cf (o G p 0 g V -3 H.VA.C. PIP (f Electric a;k sz Softener Inspection Date Insp. Other Footings Foundation Framing - `r Rough Plbg. ?_ Rough HVAC Insulation Final Plbg. Final HVAC Final Cert/Occ. O _ Water Desc be Location: Well Sewer Pr. Disp. CITY OF EAGAN T r 9"?r 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 L, BUILDING PERMIT Receipt # -'`-- Tw v r..d 9" 1 OF 4 PLEX Pet V.1- $53,000 n...e DECEMBER 3 10 84 Site Add?esg 1 , CROSSROADS OF Lot 4 Block Sec/Sub. Parcel No. EAGAN W Name CROSSROADS PARTNERSHIP 102U E 146TH ST Z Addre?s City ti Phone 432-8240 Erect L :J Remodel ? Repair ? Enlarge ? Move ? Demolish ? Grade ? Occupancy R3 Zoning Type of Const. V 1 HR No. Stories Length 4 Depth Sq. Ft. JADRON INC I? Approvals Fees Name t02O 1415- 0 IS 3:11 ST pu Address u? Cit BURNSVILLE ph 432-8240 Assessment Water &Sew. Permit Surcharge 26.50 y one Police Plan check 146.00 tee JOHN KINSFLL W W Name Fire 525.00 SAC uz Addres 12131 ND A F. NO -- Eng ?.: 0 Water Conn. 4 _P _ 5590477 <W City . E O V one Planner Water Meter 63, 0 0 Council Rood Unit 260,00 1 hereby acknowledge that I have read this application and state that ? Bldg. Off. ?? Parks the information is correct and agree to comply with.all applicable APC Total State of Minnesota Statutes nd City of Eagan Ordinances - Var. Date C??? J? Signature of Permittee MARELL INC A Building Permit Is issued to: on the express condition Ihat all work shall be done in accordance with 9H applicable State of, Minn esota Statutes and City of Eagan Ordinances. Building Official ` `C J r Permit No. Permit Holder Deft Plumbing 5 (? tJ S / (0 5 8 7 c7Zl H.VA.C. d- -2_ Electric LA is ;7•S-% Softener Inspection Date Insp. Other Footings J Foundation Framing Rough Plbg. Rough HVAC Insulation Final Plbg. Final HVAC Final _ -?G e aU "6 ?F Cert/Occ. Water Describe Location: Well Sewer Pr. Disp. BUILDING PERMIT 'r_ " .--A ¦__ 1 OF 4 PLEX $53,000 iv 9759 Receipt * _. DECEMBER 3 - 84 Erect U Occupancy Remodel ? Zoning Repair ? Type of Const, V HR Enlarge ?' No. Stories Move ? Length 44 Demolish ? Depth Grade ? Sq. Ft. Appro vals Fees IMIIIC Address 1020 E 146TH T BURNSVILLE 432-8240 I hereby acknowledge that 1 have read thi the information is correct and agree to State of Minnesota Statutes nd City of Signature of Permittee A Building Permit Is issued to: all work shall be done in occordonc[ with Building Official CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 that Assessment Water b Sew. Police Fire Eng. Planner Council Bldg. Off.11 /2 9/8 APC Var. Date 0 Permit Surcharge 26.50 Plan check 146.00 SAC 525.00 Water Conn. 470. 0 0 Water Meter 63. 0 0 Road Unit 260.00 Parks Total r 78275-0 on the express condition that Minnesota Statutes and City of Eagan Ordinances. Site Ad jV - -- -------.-- --- - Lot Block Sec/Sub. Parcel No. EAGAt,.! Permit No. Permit Holder Date Plumbing 5 (v h S c( P lc, r- 3 H.V.A.C. 5 a S- Electric Softener Inspection Date Insp. Other Footings j? Foundation Framing ` Rough Plbg. _ Rough HVAC Insulation Final Plbg. AZ D Final HVAC Final - ?f. "3 0 B 5? Cert/Occ. - r W Water Descri Location: Well Sewer Pr. Disp. CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21.199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT TA " am" t:e. 1 t)? 4 PLEX $53,000 nw??c 1020 E 1415TH ST Address „- _ _ Signature of Permittee 4 E Building Permit Is issued to: 11 work shall be done in accordance application and state that omply with all applicable Eagan Ordinances. 9'60 fr?. Receipt # Erect LJ Occupancy R1 Remodel ? Zoning Repair ? Type of Const. iR Enlarge ? No. Stories Move 11 Length 44 Demolish ? Depth -- Grade ? Sq. Ft. Assessment Water 8 Sew. Police Fire Erg. Planner Council Bldg. Off. 11/29/89 APC Var. Date Permit 0 Surcharge 26.50 Plan check 14 6 . 00 SAC 525.00 Water Conn. 470.00 Water Meter 6 3 . 0 0 Road Unit 260.00 Parks Tota I on the express condition thoi Statutes and City of Eagan Ordinances. Site Add `. _.".--"'-' Lot Block!SUb. CROSSROADS OF Parcel No. EAGAN Permit No. Permit Holder Date Plumbing H.V.A.C. J d-lc? ?'!y d 5 ?? - ?a d Electric P?,l 3??Y 01 S`a Softener Inspection Date Insp. Other Footings Foundation Framing ' Rough Plbg. Rough HVAC Insulation Final Plbg. Final HVAC Final Y 3 ?? ?? G GN C'D Cert/Occ. td 4?Z7 Water Descri Location-V 61 Well Sewer Pr. Disp. Receipt' ' MECHANICAL PERMIT Permit No.'57"7? (- CITY OF EAGAN I .j Fee 901;P Fill in numbered spaces S/C _ 5 n Type or Print legibly Tot 20 • 50 1. Date 1 - 7 g - r, 2. Installation Cost 3. Job Address r) ?' it ..1 r Lot?Blk. `7ract 4. Owner D. Ii. GuStpf sots Ilc?^lll,hlo Hoatl;l(-. Ind rill' COnd1rjC. ,_. n' 5. Contractor Phone ' - ' 6, Address ? F 1 9 Coon R R n i d S R 1 v d. 7. City ooti RADIOS State Fn. ZrV Vn22 8. Building Type: Residential ®X Commercial ? Institutional ? 9. Work Description: New 0( Add ? 10. Describe 11. Alter ? Repair ? Type Fa S No, Equipment BTU - M. Ea. Forced Air 75,00() No. Equipment CFM Air Handling: Mfg. Carrier Boilers E h h M Mfg. ec . x aust 1 h ca t h Unit Heater 1 k 1 t Mfg. Other Air Cond. Mfg. Gas, Piping Outlets nt.er to furnace 1 1 -A 12. 1 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. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-8100 Receipt 'I , l U MECHANIC L PERMIT Permit No. CITY OF.'EAGAN Fee ?f).00 r ? (1 Fill in numbered spaces S/C • Type or Print legibly Tot. 20, 3 1. Date 1- 2 Q - 115 2. Installation Cost c 1.cr2 l L? xv? ?r? q622 p P n a rl r k 1. Job Address Lot ? Blk. T.- 4. Owner D. 'f. Gustafson nependahle ehatinn aflOCAir Cond., Inc.757_504{ 5. Contractor Phone s. Address 2619 Coon R a p i d s B l v d . 7. City b o o n Rap ids, State M n. Zip S C d 8. Building Type: Residential EIX Commercial ? Institutional ? 9. Work Description: New)U Add O Alter ? Repair ? 10. Describe 11. Fuel Type Gas No. 1 Equipment BTU - M. Ea, Forced Air 75 • 000 No. Equipment CFM Air Handling: Mfg. Carrier Boilers Mfg. Mech. Exhaust 1 hat h Unit Heater 1 k i t Mfg. Other Air Cond. Mfg. Gas, Piping Outlets niter to fur dace, 12. 1 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. Signed : ' - for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee, ? Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date 2. Installation Cost 5 i 3. Job Address Lot Blk. Tract --- 1., - 4. Owner 5. Contractor Phone 6. Address 7. City State Zip 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 10. Describe Fuel Type { 11. No. Equipment BTU - 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 F- I - I 12. 1 hereby certify that the above information is true and correct, and 1 agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-8100 Receipt 1. Date 2 3. Job Address 4. Owner _ 5. Contractor 6. Address Permit No. Fes d spaces S/C egibJY Tot. Cost Blk. Tract Phone 7. City State Zip 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 10. Describe Fuel Type 11. No. Eguipment BTU - 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. 1 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. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 4548100 Receipt PLUMBING PERMIT CITY OF EAGAN Fill in numbered spaces Type or Print legibly 1. Date 2. Installation Cost Permit No. Fee S/C Tot. 3. Job Address .'! AVII t Blk. Tract _ 4. Owner 5. Contractor(,UfISU I Z dated r 14-, i r, a Phone 6. Address I w-iU Cliff 7. City Liurnsyil1E State 11 1ri zip 8. Building Type: Residential 6 Commercial ? Institutional ? 9. Work Description: New b Add ? I 10. Describe 1 11. Alter ? Repair ? No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner i Shower Well I Kitchen Sink Urinal/Bidet Other i Laundry Tray t Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. 1 hereby certify that the above information is true and correct, and 1 agree to comply with all ordinances and codes governing this type 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 1 Receipt PLUMBING PERMIT Permit No. CITY OF EAGAN Fee fill in numbered spaces SIC Type or Print legibly Tot. 1. Date 2. Installation Cost 3. Job Address-:?4.. Jerui+tlrk :wEi.ot Blk. ' Tract i 4. Owner uuS>rOddS Gf E;? jai: 5. Contractor CollSolidated P1lll:ib111.1 it Phone 6. Address 1 530 E. C11 f F Rd. Heacii1g 7. City -iuriSV71 ie State + .? Zip bj, 37 8. Building Type: Residential 0 Commercial ? Institutional ? 9. Work Description: New 6 Add ? Alter ? Repair ? I 10. Describe 1 11. No. 2 Fixtures Water Closet No. Fixtures Cesspool/Drainfield I Bath tubs Septic Tank ` Lavatory Softner Shower Well t Kitchen Sink -? Urinal/Bidet Laundry Tray Other i Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. 1 hereby certify that the above information is true and correct, and 1 agree to comply with all ordinances and codes governing this type 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 PLUMBING PERMIT Permit No. CITY OF EAGAN Fee fill in numbered spaces S/C Type or Print legibly ` Tot . 1. Date ?- - ` 2. Installation Cost 3. Job Address" ' ` !? 1?rr :,v'-1.ot Blk. Tract 4. Owner Crossroads of £ 5. Contractor LGi1SQl 7 datLu Pj UI7bj.tJ Phone o94-369-06 8. Address L i I i 7. City kit tIsyi I Ii State zip 3 37 8. Building Type: Residential b Commercial ? Institutional ? 9. Work Description: New b Add ? Alter ? Repair ? 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner Shower Well I Kitchen Sink Urinal/Bidet Other i Laundry Tray Floor Drains Drinking Ftn. Slop Sink C 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 type 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 PLUMBING PERMIT Permit No. CITY OF EAGAN Fee fill in numbered spaces S/C Type or Print legibly Tot. 1. Date 3 2. Installation Cost '' >L 3. Job Address "`,LL-ot - Blk. Tract 4. Owner (a't;SSr`Vat?S u! d1t 5. Contractor'Con'sa I 1 dateu F i i i! ; i. Phone l:;d "i ik: 6. Address 1633 L. 7. City Y ' State Zip ,'?.•j 8. Building Type: Residential 0 Commercial ? Institutional ? 9. Work Description: New D Add ? Alter ? Repair ? 10. Describe 11. No. - Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner Shower Well ` Kitchen Sink Urinal/Bidet Other Laundry Tray Floor 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 type 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 CITY OF EAGAN Remarks Additior. WssROADS OF EAGAN Owner Street 3620 13 0,L 1 10 18700 130 01 0-1 Denmark Avenue State Eagan, MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF . 1986 703.41 140.68 5 STREET RESTOR. Pj 1981 GRADING ` SAN SEW TRUNK 1971 *SEWER LATERAL 1981 WATERMAIN *WATER LATERAL 1581 WATER AREA Fs 1971 *STORM SEW TRK 1981 *STORM SEW LAT j 7Z, 1981 CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 260.00 WATER CONN. 470.00 BUILDING PER. V SAC 525.00 PARK CITY OF EAGAN Remarks Addition CROSSROADS OF EAGAN Lot 14 B1k 1 Parcel 10 18700 140 01 Owner Street 3622 Denmark Avenue State Eagan, MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF h , 1986 703.41 1 STREET RESTOR. > GRADING a SAN SEW TRUNK *SEWER LATERAL WATERMAIN *WATER LATERAL WATER AREA T *S ORM SEW TRK *STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT Road nit -260 00 aAR()62 12-3 84 WATER CONN. 470.00 11 1+ BUILDING PER. SAC 525.00 PARK CITY OF EAGAN Remarks CROSSROADS OF EAGAN Owner Street Lot 15 Blk 1 Parcel 10 18700 150 01 3624 Denmark Avenue State Eagan; MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1986 703 41 140 68 5 . . STREET RESTOR. 1981 GRADING G' ' SAN SEW TRUNK 1972 *SEWER LATERAL ( 1981 WATERMAIN *WATER LATERAL 1981 WATER AREA 5 1971 *STORM SEW TRK 1981 *STORM SEW LAT 1981 CURB & GUTTER SIDEWALK STREET LIGHT Road Units 260.00 48062 12-3-84 WATER CONN. 470.00 rr it BUILDING PER. of SAC 525 00 t' PARK CITY OF EAGAN Remarks Additidn CROSSROADS OF EAGAN Lot 16 Blk Owner Street 3626 Denmark Avenue 10 18700 160 01 State Eagan. 11N 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF 1986 , 703,41 140.68 STREET RESTOR. ALI& 1981 GRADING SAN SEW TRUNK 67 1972 *SEWER LATERAL 1981 WATERMAIN *WATER LATERAL 1981 WATER AREA /Z 1971 *STORM SEW TRK 1981 *STORM SEW LAT 1981 CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 260.00 12-3-94 WATER CONN. 470,00 BUILDING PER. SAC 929-00 PARK CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road 5878 P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 _ _ DATE: Zoning: RITT No. of Units: 1 unit tnhse r: Crossroads UVlddrew Partnership Site Address: 362E Denmark Avy umber: Consolidated Plbg Me r No.: 3 5? 2 7 3 C Size: - Vz Reader No.: U 9 L .2 / O '{ D 1 some to @a n* with tw City of Eagan Or/bwaeee. , By - Dote of Insp.: Connection Charge: 470 _ 00 pd Account Deposit: 15.00 vd Permit Fee: 10.00 yd Surcharge: .50 pd Misc. Charges: 11-nn pil Total: Date Paid: Insp.: CITY OF EAG,AN SEWER SERVICE PERMIT 3830 Pilot Knob Road 7 067 P. 0. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: 277 Zoning: T'III No. Units: unit tn.;!;^ t r Crosaroads artnc.. 110) Address: Site Address: 2F r'enrar 1 Plumber: - Onsqat 1 some to amply with tlw City of Eepa Ordloanees. ' Connection Charge: Account Deposit: 15. r) pd Permit Fee: 10.00 pd Surcharge: .50 pd Misc. Charges: Total: By Data of Insp.: 3830 Pilot Knob Road 5879 P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: 12-10-84 Zoning: RTTI No. of Units: 1 unit tnbRP Owner: - Crossroads Partnership ?ddresa: Ito Address: _ 3624 Denmark &ze .15 B1 Crossroad-, of Eagan Plumber: Consolidated Plbg r No.: 3!Z 9 q 73 6,? Connection Charge: - 470-00 Pd size: .5;?Q " (Z G Account Deposit: 15.00 pd Reader / No.: n J I-- a /,0 L{ -L. I some to eaaoly whir the City of Eagan Ordihhoaiw. Date of Insp.: Permit Fee: 10.00 pd Surcharge: .50 pd Misc. Charges: 63.00 pd mete Total: 2-fid 3e =rr--- Date Paid: Insp.: CITY OF EAGAN SEWER SERVICE PERM 3830 Pilot Knob Road 7 068 P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: 12-14-84 Zoning: FIII No. of Units: 1 unit tnhse Owner. Crossroads Partnership Address: Site Address: X6`4 r'emwiri- Ave 1.1 Al Crossroads of Fagan Plumber COIlsolI i.2ted rl'bo I epee to campy with ow CNy of Eepn Connection Charge: 425.00 pd --r57.M pd ormos hose. Account Deposit: Permit Fee: 10.00 P Surcharge: .50 P By Misc. Charges: Dote of Insp.: Total: Insp.: Dote Paid: CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road 5880 P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: - - Zoning: RTTI No. of Units: - 1 unit- nh sP ner CMISSMads Partnership ress: • Ito Address: 3622 Aug umber: Consolidated Plbg Meter No.: ? ?/ 9 y 7 3 s g Size: Reader No.: 0 !z I some to amply whir the City of Eeyee Ordinances. By ? Date of In Connection Charge: _470.00 pd Account Deposit: 15.00 __pd Permit Fee: 10.00 pd Surcharge: .50 pd Misc. Charges: - 63.00 p x Tnpt p Total: aim-he rn ,pate Paid: ? Y// S 8S rnsl CITY OF EAGAN 3830 Pilot Knob Road P. O. Box 21199 Eagan, MN 55121 Zoning: Owner: _ Address: Site Add, Plumber: SEWER SERVICE PERMIT PERMIT NO.: 7069 DATE: - - •, • No. pf Units: ua - to se 1 49110 to mmply with ow City of Eagan "re"el. By Date of Insp.: Connection Charge: 425.00 pd Account Deposit: P Permit I": p Surcharge: . > > r?a Misc. Charges: Total: Insp.: Dote Paid: _ 91 CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road P. O. Box 21199 PERMIT NO.: 5881 an, MN 55121 DATE: 12-10-84 iu2 kIII No. of Units: 1 unit tnhse r; Crossroads Partn er i,p Address: Site Address: 3620 Denmark Ave L13 R1 Crongr nadR of Eagan umber. Consolidated Plbg Meter No.: 3Y 9 Y73 70 Connection Charge: 4 7 0.00 pd ? Size: 9; Account De osit: 15.00 pd Reader No.: `f /D `/6~ p Permit Fee: - 10.00 pd 1 epee to elnoly willr the City of Bgpn Surcharge: . 50 pd 01Aaeaces. j \ Misc. Charges: Total: 63.00 pfl mater and -hsv._ By •.•--J- ` Date Paid: Date of Insp.: Insp.: CITY OF EAGAN 3830 Pilot Knob Road SEWER SERVICE PERMIT P. O, Box 21199 PERMIT NO.: Eagan, MN 55121T DATE: 1..- '•.4 ; I Y Zoning- Cr No. of Units: unit ossroads 7artnersl,ip Owner: Address: Site Address: 70 Penmark Ave T.13 rl rres., roads of nn 'Plumber: CnneO stet ?+ 1 off" to amply whir tiro City of Eases Connection Charge: 425.00 pu Orais4son. Account Deposit: ' • PC Permit Fee: • ' D v Surcharge: By Date of Insp.: Misc. Charges: Total: Date Paid: - IIIIIIIIIIIIN BUILDING PERMIT APPLICATION --CITY OF EAGAN _ . j ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN 5,7 INCLUDE © SETS OF PLANS, © CERTIFICATES OF SURVEY I OF 4 FLEX © SET OF ENERGY CALCULATIONS To Be Used For: Ar? _ Valuation: ? OD8 Date: Site Address: 3(x20 j?EFAr?A2K AVE, Lot:J3 Block: Sect/Sub:Cj,?OS_? 04 A/?S Erect: Parcel Remodel: Repair: Owner: ?/PDSSR? jZS P??erN sNiP Enlarge: Move: Address: Imp _545f 1114,f? ST, Demolish: City/Zip Code: /?/pVS?/LLE , /ZL V ss337 Grade: Phone z a 4 Contractor: ? ???? Address: f ,7 2J F AST ST Assessments: Permit: 2R2 '° City/Zip Code: &)4AIfVI14?, /Y//n/ Water/Sewer: ? 5S ?3? Surcharge: Z(o,? ,. Police: Plan Rev.: Phone #:?( Z y=?2?Fn _ Fire. SAC: 525, Engr.: Water Conn: 4_10, Arch./Eng:?dl? N Planner: Water Meter (03, Address: / 22,3/ L? f/y! /tD2 Council: Road Unit: 2uo. _ Bldg. Off.: Parks: City/Zip Code: m gPGji 6-7,? odf APC: Variance: X-? Phone#: Z ) tSy _ Qf77 Occupancy: Zoning: Type Of Const: # Stories: Length: Depth: Sq. Ft.: 2-1 R- 3 4-I h-fQ, 4+ ZZ "I ? . -ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN INCLUDE © SETS OF PLANS, Q © CERTIFICATES OF SURVEY SET OF ENERGY CALCULATIONS To Be Used For: ? of 4 R ?x Valuation: Date: Site Address: ?)6N Dai-4Mpoz_ QVE. • • Lot: 14 Block: Sect/Sub: GR /xn er Parcel #: Owner: Address: City/Zip Code: Phone #: Contractor: Address: City/Zip Code: Phone #: Arch./Eng: Address: City/Zip Code: phnna#- Erect: / Remodel: Repair: Enlarge: Move: Demolish: Grade: Assessments: Water/Sewer: Police: Fire: Engr.: Planner: Council: Bldg. Off.: APC: Variance: Occupancy: Zoning: Type Of Const: i41, # Stories: Length: 44 Depth: ZZ Sq. Ft.: Permit: 292 Surcharge: 2-& 75 Plan Rev.: ? 4c?.°- SAC : Rix. Water Conn: 4"70.°" Water Meter 63.E Road Unit: 0r„n. y.?_4 Parks: /7i? - so 0.111sablIqUeMUDIX 110aff."103A 1 0.310 'Fill ALL CON TRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN C INCLUDE © SETS OF PLANS, S © CERTIFICATES OF SURVEY SET OF ENERGY CALCULATIONS To Be Used For: c)F j PL-EX Valuation: 53. E Date: Site Address: 3(2-4 DENMAEG /? c. • Lot:?5 Block: Sect/Sub:G2055?0?05 of Erect: X Occupancy: GaN _ Remodel: Zoning: 2-3 Parcel #: Repair: Type Of Const: Cl-UHF, Enlarge: # Stories: Owner: Move: Length: 44 Address: Demolish: Depth: Z2 City/Zip Code: Grade: Sq. Ft.: Phone #: Contractor: Address: Assessments: Permit: Z92,= Water/Sewer: Surcharge: Zro,s City/Zip Code: Police: Plan Rev.: Q(o °° Phone #: Fire: SAC: ?25•? Engr.: Water Conn: 4-10 Arch./Eng: Planner: Water Meter (0'5.° Council: Road Unit: Address: Bldg. Off.: „_Zy -gg Parks: City/Zip Code: APC: Variance: ?7G - nhnna4- AId. CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN INCLUDE © SETS OF PLANS, © CERTIFICATES OF SURVEY SET OF ENERGY CALCULATIONS To Be Used For: I bF 4 FLEX Valuation: r 3,OCV Date: Site Address: '>Cpz(o ??iJMAJZk (A VC. Lot: I(o Block: I Sect/Sub: ?`OS of Erect: Parcel #: moo. AH Remodel: Repair: Owner: Enlarge: Move: Address: Demolish: City/Zip Code: Grade: Phone #: Contractor: Address: City/Zip Code: Phone #: Arch./Eng: Address: City/Zip Code: phnno*- Occupancy: Zoning: Type Of Const: Y -I N2. _ # Stories: _ _ Length: }Q _ Depth: Z- 7-Sq. Ft.: Assessments: Water/Sewer: Police: Fire: Engr.: Planner: Council: Bldg. Off.: APC: Variance: Permit: 2`12 Surcharge: Z.G.50 Plan Rev.: X4(0,°` SAC: 525," Water Conn: 410. Water Meter (05. °. Road Unit: 2ralt! /T-YU Parks: /7K,- .50 CITY OF EAGAN N9 9757 3830 Pilot Knob Road, P.O. Box 21.199, Eagan, MN 55121 12 PHONE: 454.8100 6 BUILDING PERMIT Receipt # O 0?=='_ To be wed for 1 OF 4 PLEX Est. Value $53,000 Date DECEMBER 3 Iq 84 est 3620 DENMARK AVE Erect Site Ad ?X Occupancy R1 l Lot .S Block sec/Sub. CROSSROADS OF Remodel ? Zoning R3 Parcel No. EAGAN Repair ? Type of Const. V 1 HR Enlarge ? No. Stories a Name CROSSROADS PARTNERSHIP Move ? Length 4 4 z 1020 E 146TH ST Demolish ? Depth Address Grade BURNSVILLP 432-8240 ? Sq. Ft. ?hone City z JADRON INC o Name C Address 02 E 146TH ST L City BURNSVILLFPhone 432-8240 u? JOHN KINSELL Ww Name 71 Address 21 2ND AVE NO ? City MAPLE GROVFPhone 559-0477 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permifes ++ K^- C;19 ? A Building Permit Is issued f-ro?rMARELL INC all work shall be done in accordance wit applicable S)CIU79f Mir Building Official Approvals Fees Assessment 'Permit L y L. V U Water & Sew. Surcharge 26.50 Police Plan check 146.00 Fire SAC 525.00 Eng. Water Conn. 470.00 Planner Water Meter 63, 0 Council Road Unit 260.00 Bldg. Off. 11/29/8 Parks APC --?a?-C Total 4ir ?•?0 Var. Date on the express condition tho' Statutes and City of Eagan Ordinances. CITY OF EAGAN ° ' 9758 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 4548100 BUILDING PERMIT Receipt # To be used for 1 OF 4 PLEX Est. Value $53,000 Dote DECEMBER 3 Iq 84 Site Address 3622 DENMARK AVE Erect 13 `3 Occupancy R1 Lot 14 Black 1 Sec/Sub. CROSSROADS OF Remodel ? Zoning R3 Parcel No. EAGAN Repair ? Type of Const. V I HR Enlarge ? No. Stories Name CROSSROADS PARTNERSHIP Move ? Length 4'f ? 1020 E 146TH ST Demolish El Depth 22 CityrBURNSVILLE Phone 432-8240 Grade ? Sq. Ft. i? Name JADRON INC IUZU E 146TH ST Address City BURNSVILLE Phone 432-8240 w I Name JOHN KINSELL xZu Address 12131 61ND AVE NO <Z City MAPLE GROXWone 559-0477 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 nd City of Eagan Ordinances. Signature of Permittee ?.-- - f^ ?^- A Building Permit Is issued to: MARELL INC all work shall be done in accordance with alhttaolicable Statif-obMit Approvals Fees Assessment _ Water & Sew. Police - Fire Eng. Planner Council Bldg. Off-r APC Var. Date Permit ---- Surcharge 26- 0 Plan check 146- n 0 SAC 595_n0 Water Conn. 47(11- 00 Water Meter 6-4- n 0 Road Unit 7F,n _ n0 Parks Total 5 on the express condition that Statutes and City of Eagan Ordinances. Building Official ----------------- I Vbeoffl U9 Permit #: Li lL/ ;J 1 I C???(?r1fz 38 Permit Fee: ?_ I 7'UN?x g ? 2008 I Date Received: I I j Staff: ------I I COMMERCIAL BUILDING PERMIT APPLICATION Date: /rSiteAddress:?UJ?b )1Fnny/K- kc-- Tenant Name: DR G L)C T h7FS O t-) (Tenant is: -New/ -,X- Existing) Suite #: PROPERTY OWNER Name: 1l. ii CaUS I F?FGOQ Phone: 6o5l -454 - 3352- Address / City / Zip: Applicant is: Ti Owner Contractor TYPE OF WORK Cx61-106 -l OC K5 Description of work: RC9Q+C 4?5- ^ Construction Cost: ' t 400 - q CONTRACTOR / n Name: N-)) ft J-T tf?, C r)I)iLDffS License#: ?/ I Address: t ? r I L-k<\)FAN S? Z p Zip: 511 -7 ! City: 1 r?L)L< State: MIq t) T -+ZZ? contact Person: Phone:(0?1 Z j ARCHITECT / I / Name: NRegistration #: ENGINEER Address: City: State: Zip: Phone: Contact Person: Licensed plumber installing new sewer/water service: Phone #: NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of ' the information may be classed as non',public if you provide specific reasons that would permit the City to .,1.? conclude that the are trade secrets. 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 \ n accordance with the approved plan in the case of work which requires a review and approval of plans. e J/ x O7?j ?1 ?C? Applicant's Printed Name Page 1 of 3 DO NOT WRITE BELOW THIS LINE g SUB TYPES: ? Foundation ? Apartments ? Lodging ? Miscellaneous WORK TYPES: ? New ? Addition ? Alteration ?S Replacement DESCRIPTION: Valuation Plan Review ? (25%_ 100 % Census Code y3y # of Units # of Buildings / Type of Const. ? Public Facility ? Accessory Building El Commercial / Indus trial A Ext. Alteration-Apartments pl& f s ? Greenhouse ? Ext. Alteration-Commercial ? Antennae ? Ext Alteration-Public Facility ? Nail Salon ? Interior Improvement ? Siding ? Demolish Building' ? Move Building ? Reroof ? Demolish Interior ? Fire Repair ? Demolish Foundation ? Windows ? Water Damage ' Demolition (entire building) - give PCA handout to applicant Occupancy Code Edition Zoning Stories Square Feet Length Width /J7G - MCES System `?«(h SAC Units City Water ' Booster Pump ?{ C'd PRV Fire Sprinklers 0 SheeVock Meter Size: _ Final/C.O. REQUIRED INSPECTIONS Footings (new bldg) Footings (deck) _ Footings (addition) Foundation Drain Tile Roof: _ Decking _ Insulation _ Final - Ice/Water Framing Fireplace:_R.I. _AirTest -Final Insulation Final CIO Inspection: Schedu Reviewed By: _ Base Fee Surcharge Plan Review SAC-MCES SAC-City SJW Permit SAN Surcharge Treatment Plant Treatment Plant (Irrigation) Park Dedication Trail Dedication Water Quality Water Supply & Storage (WAC) ?L Final/No C.O. 9- HVAC _ Other: Pool: -Footings -Air/Gas Tests -Final Siding: -Stucco Lath -Stone Lath -Brick Windows Retaining Wall re-Marshal to be present. _ Yes -No Building Inspector Reviewed By: , Planning Financial Guarantee Storm Sewer Trunk Sewer Lateral Street Water Lateral Other c0,P/,;S Total Sewer Trunk - Water Trunk Page 2 of 3 t fgp?• t?.€ "i_7 yew` T - ?y ..M1 d? ??r ' s fie (z ? 3cao N 36? ?, ? 3G?G r•- r ? 1 -? ??' 1 t7 f1 - .. } a raq- 7. so-0 1 i f &P S ? ER Y ?z AS IS ?I E- N lo 1\41 f ? i S?'i ? f ? EF/`J ?t?..Db"QA'L716R'91?1 Vn R (? C1 0 1Y T7 BUILDING INSPECTIONS DIVISION 2/84 / CITY OF EAGAN Il4l APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION (PLEASE PRINT) 1) PROPERTY ADDRESS: v I?CN?q ?/f LEGAL DESCRIPTION: (Lot/Block/Subdivision or Tax Parcei I.D. N r) IF F"{IS":_:G STRUCTU^:2E, DATE OF ORIGINAL EUILDL`?;G P=--.,ST ISSUANCZ: PRES=, ZO:Tr?;Y:/PI?OPOSED USE: ? R-1 SD;GLE FPMILY 0 ?t-2 DUPT.?•Y (TWO UNITS) - p R-3 Ta, QFCUSE (TH-FEE + UNITS) ( ! UNITS) ? R-4 APARL`1ENT/CC21JG•? 111-J,,4 ( UNITS) Q CC LmIE CIAL/RE".AII,/OFFICE ? INDUSTRIAL ? INSTITUTIONAL/GOVER`MENT 2) APPLICANT (PLEASE PRINT) NAME: ADDRESS: CITY, STATE, ZIP: PHONE: 3) PLUeSER , PLEASE PRINT) NAME: ?oNSG/ 4;Z4 ZP ' (/ FOR CITY USE ONLY _ ' _ PLUMBERS LICENSE: ADDRESS: -, Active CITY, STATE, ZIP: al.f'NSd/LGf Expired PHONE- 'L`94V PLUMBER LICENSE N Not of Record Z)taff nitro 4) O=ANT/C1.4NER NAME: ADDRESS: CITY, STATE, ZIP: PHONE: (PLEASE PRINT) v 20 F //6 ST 1191V y?2 ?ZyO 5) INDICATE WHICH PERMIT IS BEING REQUESTED: yrI ® CONNECTION TO CITY SEWER Y CONNECTION TO CITY STATER 017f E.R (PLEASE DESCRIBE) b) 1ID1CY,il: ONE: BY ONE OF ABOVE PLEASE'-1.ATL APPROVED PERMIT TO 1, 2,C] 4 ABOVE (Circle one) 7) SICMTURE: DATE: ?! ?! a?-M1lA! i !!l?JQ?1c?! ?t A ?-7i:ii? i? i i ?.sii:? a 1t It ?FJllli?.r f?l f? 11t lS Sai?pir A F O R C I T Y U S E O N L Y PERMIT ISSUED FEES: $ , d .d $ /d `P o $ $ $ / S a fJ $ $ $ S SEWER PERMIT (INC=_DE SURCHARGE) WATER PERMIT (INCLUDE SURCHARGE) WATER METER/COPPERHORN/OUTSIDE READER WATER TAP (INCLUDE CORPORATION STOP) SE?1 TAP ACCOUNT DEPOSIT - WATER WAC SAC TRUNK WATER ASSESSMENT TRUNK SEWER ASSESSMENT LATERAL BENEFIT/TRUNK SE?:TER LATERAL BENEFIT/TRUNK WATER OTHER TOTAL AMOUNT PAID/RECEIPTS DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE F-71 NO ENGINEERING DIVISION. LIST AS A CONDI- TION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: _?r.?- p?? DATE : La - 7 -g 3% w.ps owl= ?M iw ok" !m on .w?mw wcaw 04 wpwE Wm wtm w.+ wt-MM m iwgw wtfq w*a mm is wiw W! w mm m w." w . 2/84 CITY OF EAGAN ?)(( / APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION (PLEASE PRINT) 1) PROPERTY ADDRESS: /JGL LEGAL DESCRIPTICN:> (Lot/Block/Subdivision or Tax Parcel I.D. N r) IF F'YIS-=.-G STRUCTURE , DATE OF ORIGINAL EUILDIING PE : IT ISSJa ;C : PRESENT 2^`Tr r;/PROPOSED USE: ? R-1 SMiGLE FAMILY ? -2 DUPL...`"{ (2R'0 UNITS) R-3 M-,1,-ICUSE (TEIREE + UNITS) UNITS) ? cR-4 APA.R7 EN'T/COLmo- INiLr,4 ( UNITS) ? CQM?EPCIAL/RETAII./OFFICE ? INT)USTR= ? INSTITUTIONAL/GOVE.RLniT:,T 2) APP=cz%. TP NAME: (PLEASE PRINT) ADDRESS: CITY, STATE, ZIP- PHONE: 3) PLL?TBER PLEASE PRINT) FOR CITY USE ONLY NAME_ - CvGNSGL//J?Tf/L?L??C//T? ?o ADDRESS: PLUMO RS LICENSE: Active CITY, STATE, ZIP; Expired PHONE: UMBE PLUMBER LICENSE N Q Not )f Record a nitia 4) OCCUPANT/CSPPIII2 NAME: IrLLNJG Pnini; ADDRESS: 'ti (- CITY, STATE, ZIP: jam' ?(//GIG PHONE : S) INDIC171TE WHICH PERMIT IS BEING REQUESTED: y rr CONNECTION TO CITY SEWER r CONNEzPION TO CITY WATER ? C/iI]ER (PLEASE DESCRIBE) 6) INDIC,T^E C:iE: PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE ? PLFASE MAIL APPROVED PER,UT TO 1, 2a 4 ABOVE (Circle one) 7) SIG:?IAm B: DATE -12e 2 L ?)7 ¦! i Of:R?VYJO! i 0 li,g? ! S IYtlii4i# i i i isii:l?a i !t!l.f?iJli S ?! i ISllSai A F O R C I T Y U S E O N L Y PERMIT °- ISSUED FEES: $ o e, $ $ $ S $ $ $ S $ $ S $ SE'W'ER PERMIT (INCLUDE SURCHARGE) WATER PERMIT (INCLUDE SURCHARGE) WATER METER/COPPERHORN/OUTSIDE READER WATER TAP (INCLUDE CORPORATION STOP) SEWER TAP ACCOUNT DEPOSIT - WATER WAC SAC TRUNK WATER ASSESSMENT TRUNK SEWER ASSESSMENT LATERAL BENEFIT/TRUNK SEWER LATERAL BENEFIT/TRUNK WATER OTHER $ TOTAL $ o?-/, ee AMOUNT PAID/RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE czt NO ENGINEERING DIVISION. LIST AS A CONDI- TION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: 7m>o?a ,??c TITLE: DATE: fc? if#EXAM iiiN=kft 0&i8&8k-i/!i1!iM4F-J!/4fg5k4W6kiMW?WW." 8*mi•1WdB NRi/tWAftlW ii -0 jw ?i 2/84 CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION (PLEASE PRINT) 1) PROPERTY ADDRESS: b LEGAL DESCRIPTION ,y (LOt/Block/SutcliVision or Tax Parcel I.D. N tuTber) IF L=S ::_.G STRCCT<-RE , DATE OF ORT_GPIAL EUILDD:G P=_.ST IS A? C,: Zear) PRESE`: T Z'IPi;/P1?0POSE7 USE: D R-1 SiiGL° FP rtSLY ? R-2 DUPL.`'Y (7%'0 UNITS) CVR-3 TCi,1II?OUSE ('I'Pp.T--., + LWITS) ( - WITS) ? R-4 APARr2EIT/CCi'R7C INIIJM ( UNITS) ? CCMMERCLAL/REETAIL/OFFIC ? LADL'STRIAL ? INSTITUTIONAL/GOVE.RiNb)=T 2) APP==-, IT (PLEASE PRINT) NAME: ADDRESS: CITY, STATE, ZIP: PHONE: 3) PLL:IBER NAME: J r PLEASE PRINT) L FOR CITY USE ONLY ADDRESS: ' PLUMBERS LICENSE: Active CITY, STATE, ZIP: Expired PHONE: R'icR PLUMBER LICENSE H Q Not of Record r nitl? 4) OCCUPANT/QQ 1GI2 NAME SOS IPLLASE PRIt ADDRESS: ;2p ?^ ira /6 sl CITY, STATE, ZIP: PHONE: 5) INDICATE WHICH PERMIT IS BEING REQUESTED: Y ® CONNECTION TO CITY SL•*rIER CONNECTION TO CITY STATER ? 9111F12 (PLEASE DESCRIBE) 6) r,'Dl= ONE: HOLD APPROVED PERMIT FOR PICK-UP BY ONE 1 MAIL APPROVED PERMIT TO 1, 2C 4 ABOVE (Circle one) 7) SICzmURE: DATE: ?! R q??A? i i li:g? ]? i 1!Itpi?ii N s s w.i i=i:i i a! ll lltfRi!!'i f? rys is Sw.V.??r t7 F O R C I T Y U S E O N L Y PERMIT u ISSUED I FEES: $ ioS'o $ io.rc $ ?3. S S $ $ $ $ S . SEWER PERMIT (INCLUDE SURCHARGE) WATER PERMIT (INCLUDE SURCHARGE) WATER METER/COPPERHORN/OUTSIDE READER WATER TAP (INCLUDE CORPORATION STOP) SEWER TAP ACCOUNT DEPOSIT - WATER WAC SAC TRUNK WATER ASSESSMENT TRUNK SEWER ASSESSMENT LATERAL BENEFIT/TRUNK SEWER LATERAL BENEFIT/TRUNK WATER OTHER $ TOTAL $ ,7 .. :?/ AMOUNT PAID/RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE NO ENGINEERING DIVISION. LIST AS A CONDI- TION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY:o?n TITLE: '-/? Q DATE : /? - 7 - 8 P AsJu OEM iii wm mmm!s mum wmwsmm wss MiRwAmpim W"m w:s ow1om Win lLM N*wxlw"w ws 2/84 ` CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION (PLEASE PRINT) 1) PROPERTY ADDRESS: LEGAL DESCRIPTION (Lo t/Block/Subdivision or Tax Parcel I.D. N r) IF E;IS'I'_:G STRUCTURE, DATE OF ORIGi^-m BUILDING PEP-'-!IT ISSUANCE; PRES= Z.^,`II?F /PROPOSE USE: ? R-1 SZ?GLE FPMILY ? R-2 DUPL.X (7%70 UNITS) H'R-3 Ta,7N?CUSE (TI-,.- UNITS) ( UNITS) ? R-4 APART1ENT/CCMrA%SiIII'M ( WITS) ? COMMERCIAL/RE", AII,/OFFICE ? INDUSTRIAL p INSTITUTIONAL/GOVELNMEtiT 2) APPLICr..NT (PLEASE PRINT) N \NIE; ADDRESS: CITY, STATE, ZIP: PHONE: 3) PLUMBER NAME: /PLEASE PR/INNT ( `CUVSGL/ -/,I!/ FOR CITY USE ONLY ADDRESS: PLUMB S LICENSE: Active CITY, STATE, ZIP: Expired PHONE: it - _ft ' PLUMBER LICENSE # o o Record at Initial 4) OCCUPANT/cuum MME ?k//SS o 1/lS (PLEASE PRINT) ? ? ?//? T PS? • ? l//? L-% I / ADDRESS : , 117- CITY, STATE, ZIP: PHO E : r zG 5) INDICATE WHICH PEP IT IS BEING REQUESTED: y 0 CONNECTION TO CITY SEWER / Yr CONNECTION TO CITY WATER ? OMER (PLEASE DESCRIBE) b) IP:DIC: ii: ONE: PLEISE HOLD APPROVED Pj r+ IN:g i -112 BY ONE OF ? PLEASE h*AIL APPROVED PERMIT TO 1, 2,0 4 ABOVE (Circle one) 7) SIC,-AMM: DATE: /??; w A-R,gf?je:s i p lw??,w fe R A a-?.fo? i w E ?si?:? a f! tl ?Fl?:+fs?!a f? 1! s acia ea F O R C I T Y U S E O N L Y PERMIT °- ISSUED FEES: $ / o -?- a $ .o5'a $ 1 3 ? a . zJ $ /-5 o d $ /S`. o rJ $ l7 d- ad $ SETJER PERMIT (nICLUDE SURCHARGE) WATER PERMIT (INCLUDE SURCHARGE) WATER METER/COPPERHORN/OUTSIDE READER WATER TAP (INCLUDE CORPORATION STOP) SEWER TAP ACCOUNT DEPOSIT - WATER WAC SAC TRUNK WATER ASSESSMENT TRUNK SEWER ASSESSMENT LATERAL BENEFIT/TRUNK SEWER LATERAL BENEFIT/TRUNK WATER OTHER $ TOTAL $ AMOUNT PAID/RECEIPT 4 DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE NO ENGINEERING DIVISION. LIST AS A CONDI- TION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE:«L?/ DATE : L . C?J me ti+ME=wmsm.kwrcmwwww?w?wswwsowaw_awlwiwwmRawms!w=06RwF&Wwsrwm 11/29/2016 1 :20PM FAX 9529858836 Bulldog lj0001/0003 Use BLUE or BLACK Ink For Office#: Use Penh /L7/ 7 C� City Olf Ea&afl Penh Fee: - a 3830 Pilot Knob Road Eagan MN 65122 Date Received: Phone:(651)676-5675 Fax:(651)675-5694 Staff: V J 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 11/29/16 Site Address: 3620, 3622, 3624, 3626 Denmark Ave Unit#: Name: Phone.Crossroads Partnership . 651-454-3352 ,: �'�..i '•:,i-;:`..;:;;;^:`r.:c•, esiden ..,.•'•• 1500 McAndrews Rd W. Ste. 100, Burnsville, MN .55337 OWnei ';• Address/City i Zip: Applicant is: Owner X Contractor description of work Remove & replaced asphalt shingles .•,Type'�of�Work''' Construction Cost $15,000.00 Multi-Family Building:(Yes X /No ) company: Bulldog Contractors, LLC Peter Retka Contact: Address' 21663 Cedar Ave city: ' Lakeville C,ontractor:','; State: MN Zip; 55044 Phone 651-253-8211 Email: pretka@bulidogroofs.corn License* BC639635 Lead Certificate* NAT-F162654-1 If the project is exempt from lead certification,please explain why: 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:subniit are considered to be:public information: •P.ortions of.,•; the information may,be classed as non public if you provide,specific reasons that would permit the City.to conclude that they 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,00pherstateonecall.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. x Peter Retka • Applicant's Printed Name Appli ants Signatu Page 1 of 3