3659 Denmark Ave
CITY OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
PERMIT NO.: 6?2
The City of Eagan hereby grants to x!m=jMg%QR JklWb4ag & u_,++....
of RU ' gtc , M 55424
a --PLFJMUIG Permit for: (Owner) Zoba oa (Addition) _
at 3661 Denmark Ave. , pursuant to application dated 10/14/75.
Fee Paid: $5.00 dated this20 day of October , 19 75 0
.50 s/C
Building Inspector
Mechanical Permits:
Bid Total:
r
oS
16 26:S0o 0,6
TOWN OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55121
PERMIT NO. 206
The Board of Supervisors hereby grants to Thompsmi Plumbing Co.
of 12201 Minnetonka Blvd., Minnetonka 55343
a PLUMBING Permit for: (Owner) Now HoiAzon Homes
at 3659-5 Denmark , pursuant to application dated
5/15/72
Fee Paid: 580.00 Dated this 1thday of MEV , 197 2
7.00
sc
Building Inspector
/G 76-.566, 636 05
T, ,,-, mod, 7 i.
W N OF EAGAN
3795 Pilot Knob road
Eagan, Minnesota 55121
PERMIT NO. 222
The Board of Supervisors hereby grants to George Hedgwiok Heating &
Air Con!!.Ucaing of 1001 Xenia Avenue South, Minneapolis 55416
a HEATING Permit for: (Owner) New Horizon HQ=
at 3659-0-¦63 Denmark Avmue , pursuant to application dated
4/lo/72
Fee Paid: $80.00 Dated this 7th day of Jy?y , 19,x.
2.00 a/c-
Building Inspector
3
TOWN OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55121.
PERMIT NO.
/O ??Sao 6')h ?.?
206
The Board of Supervisors hereby grants to Thompsmi Plumbing Go.
of 12201 Minnatonka Blvd., Minnetonka 55343
at PLUNIDTNO Permit for: New HoA-on Fxno
(Owner) =3
at 36614Y=fit mar?c
pursuant to application dated
- /15/72
Fee Paid: Dated this 15thday of May 197 2 .
s C
Building Inspector
7
J
i0 7 -6bO o;30 05
T9,!N OF EAGA14
3795 Pilot Knob road
Eagan, Minnesota 55121
PERMIT NO. 222
The Board-of Supervisors hereby grants to George Hedgwiok Hen g & •
Air Conditi09199 of 1001 Xenia avenue Smtths Minneapolis 55416
a HEATIM Permit for: (Owner) Net Horizon Hnmae
at 1-yq?k gy® , pursuant to application dated
V10/72
Fee Paid: .00 Dated this 7th_ day of , 19
2.00 a/c -U.
Building Inspector
z
. ??? 7(?ScG oiL os-TU- N OF EAGAN
3795 Pilot Knob i[oad
Eagan, Minnesota 55121
PERMIT N0. 222
The Board of Supervisors hereby grants to George 8040 tok Heatiaa &a
ALr 2GW boning of 1001 Imia Aveate South, M =eal!olle M16
a HEATING Permit for: (Owner) New Horizon HPme®
at .63 j? Denman Am-pye , pursuant to application dated
-- W10/72
Fee Paid: 80,00 Dated this 7th_ day of J,?y 19 .
2.00 a/c
Building Inspector
it
iC 7C Svo oi6 0.5
TOWN OF EAGAIT
3795 Pilot Knob Road
Eagan, 11innesota 55121
PERMIT NO, 206
The Board of Supervisors hereby grants to Thompson Plumbing Co.
of 12201 Minnetonka Blvd., Minnetonka 55343
a PLUMBING Permit for: (Owner) Net,' Hmi:>:on Fitxaes
at 36* 7§1%-b3 Denmo) k
pursuant to application dated
5/1572
Fee Paid: ,30.00 Dated this 15thday of May , 197 2
. so
Building Inspector
3
• /c 7/60 a?G ??S
TOWN OF EAGAPI
3795 Pilot Knob Road
Eagan, Minnesota 55121
PERMIT NO. 206
The Board of Supervisors hereby grants to Thampson Plumbing Co.
of 12201 Minnetonka Blvd., Minnetonka 55343
a PIi1H8IN0 Permit for: (Owner) Ney Horizon Hanes
at 36*0-0-55 ?mark
pursuant to application dated
_ 5nsrr2
Fee Paid: 90.00 Dated this 15thday of May 197 2
ec
Building Inspector
' r
W N OF EAGAN
3795 Pilot Knob road
Eagan, Minnesota 55171
/D 7G?JOCJ D??D ?5
PERNIIT N0. 222
The Board.of Supervisors hereby grants to George 8edgwiok Heating & •
Air Conditioning of 1001 Xenia AVQMG SMth, Hinneapo U M16
a HFAMM Permit for: (Owner) _ New Horizan Houst
at !0n6-65 Denmark Avenue , pursuant to application dated
,
O P2
Fee Paid: 80.00 Dated this 7th _ day of .1niv , 19,
9.00 e
Building Inspector
CITY of EAGAN
BUILDING PERMIT
Owner
Address
Builder
Address
?V-
N3795 Pilo! Knob Road
Eagan. Minnesota 55122
454-9100
1
3768
.../f?..:'.?....-..TIC.........
Data
Stories To Be Used For Front Depth Heigh! Est. Cos! Permit Fee Remarks
NPu/Pv' led-e o2 00
This permit does not authorise the use of streets. roads, alleys or sidewalks nor does it give the owner or his agent
the right to create any situation which is a nuisance or which presents a hazard to the health. safely. convenience and
general welfare to anyone in the community.
THIS PERMIT MUST BE PT ON T PA ISE WHILE THE WORK IS IN PROGRESS.
This is to certify. that-..... sgyr'.1 ..... ...........°°°.°-......has permission to erect a.:.% f.1.ri.^?.C.K.?A?......'C...??.........__upes
the above descri,? fdremise subject to the provisions of all applicable man s for ytheCi.i, o Eagan.
...!: ..-......-- - --..........-- --........... Per ..................................
Mayor ultdinq Inspector
e1116-
EAGAN TOWNSHIP
BUILDING PERMIT
Owner ..1.5r'!n..^//.?.?.'.......,./,jd_..-.. ... ....---
V?7 rte...' ?.... ......
Address (present) ...Grcg?-?":..... V...4-•."'-'-'? SS' 3 5/,3
......................................
Builder ................................................................................................
Address ..............................................................................................
DESCRIPTION
N? 2666
Eagan Township
Town Hall
Date ...:i.•'//7L ..............
Stories To Be Use -or
- Front Depth Hatgh! Est. Cos! Permit Fes Remarks
A'r
/?? n3 ?
GYM'
.?. 4M
or
78.
1 -
,5-This permit does not authorise the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent
the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and
general welfare to anyone in the community.
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. _
This is to certify. that .... 7?.vt.. .... .._ 'o_.hespermission to erect a.
the above described premise subject to he provisions of the Building Ordinance for Eagan Township adopted April 11.
1955.
.. ...................?.......1. `:. ............. Per ...................... ?...I/.:... ... ?.......................----
Chairman of Tnwn Board Building Ina eclor
?z,s'?
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: ' .... APPLICANT:
III IJMr11'.F AVI HIM 1 b"III!1IJt! i f l?tli? R`Fltlftt f Ft : ? q t.' ri:F.
PERMIT SUBTYPE:
1" , 1
I o0I IN',
TYPE OF WORK:
01 `.1 14IF't (11N
? I NAI
fill tln)MG
0281;x3.
raHi1 tIQ6
Idf PA tR
1 1Nr t PIN. IVAr`i wAI I )
Permit No. Permit Holder Date Telephone N
ELECTRIC
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG /o 1 X43
DECK FINAL
1
1 --
OAe
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: I'lifillimill
3830 Pilot Knob Road Permit Number: w .- i .114 4
Eagan, Minnesota 55123 Date Issued: 41 !i 4
(612) 681-4675
SITE ADDRESS: APPLICANT: till ';i.. W (W+0'f 4a'vl r11 I +i{ t kl-:AhiI
PERMIT SUBTYPE:
TYPE OF WORK:
r-41 1 1
Ill Of-It I Nth''
I L--
I N ('%I
-kz
Permit No. Permit Holder Date Telephone /
S/W
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspection Date Insp. Comments
Footings I
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Orsat Test
Final Pibg. Plbg. Inspector - Notity Plumber
Const. Meter
EngrJPlan
Bldg. Final
Deck Fig. la Q
Deck Final
Well
Pr. Disp.
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
s1>t.l
f t Mk) f.'.11U1+1
INSPECTION RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
1 I) f .
fit NMAHf AVI
PERMIT SUBTYPE:
111 1„ APPLICANT:
TYPE OF WORK:
111) 1 1 11 1 Nia
?t• j.'it,J'?.i
M 1 I IIAf 1
INSPECTION TYPE DATE INSPTR. INSPECTION TYPE DATE INSPTR.
Permit No. Permit Holder Date Telephone N
S/W
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspection Date Insp. Comments.
Footings I
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Mg.
Orsat Test
Final Plbg. Plbg. Inspector - Notify Plumber
Const. Meter
Engr./Plan
Bldg. Final
Deck Fig. / N I Q
L?/su
Deck Final
Well
Pr. Disp.
CITY OF EAGAN. Remarks - `-
Addition _ Timbershore 1 Lot
3659 Derma
Owner Street
,?71J/J?GSX11 i 1
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 232
1 1 21.0 64.20 Paid
.
STREET RESTOR.
GRADING
SAN SEW TRUNK
SEWER LATERAL 1973 624.68 41.64 15 1 Paid
WATERMAIN
*WATER LATERAL 1973 15
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 110.00 6038 7-6-72
BUILDING PER.
SAC 240.00 6038 -7-6-72
PARK -
CITY OF EAGAN Remarks 1 f } L 3 n;", '
Addition Timbershore 1 Lot 2 Blk 5 Parcel 10 76500 020 05
Owner rJ ? ?! Street 3661 Denmark Aq L State Eagan, Mn 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 1974 21.0 64.20 Paid
STREET RESTOR.
GRADING
SAN SEW TRUNK
SEWER LATERAL 1973 24.8 41.64 1 Paid
WATERMAIN
K WATER LATERAL 1973 15
WATER AREA Q24agl Z!2
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 110.00 6038 7-6-72
BUILDING PER. Adn. 68 1332 10_7
SAC 240-00 6038 --7-6-72
PARK
CITY OF EAGAN Remarks "J - 1 i I `
Addition 1Timbershore 1 Lot 1 Rlk
Owner ?1'1 (1 LI C i i, 1'JU)Il'" ?i Street 3663 Denmark Ay E
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 1974 21.0 64.20 Paid
STREET RESTOR.
GRADING
SAN SEW TRUNK
rlr SEWER LATERAL 1973 24.8 41.4 15 Paid
WATERMAIN
* WATER LATERAL 1973 15
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. lln-no 6038 7-f;-7p
9UILDING PER,
SAC 240.00 6038 7-6-72
PARK
CITY OF EAGAN
Addition Timbershore 1 Lot 4 BIk
Owner r` ; ? P,, ` Nai i Street 3665 Denmark AV L
State Eagan,mn 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 1974 321.03 64.20 5 Paid
STREET RESTOR.
GRADING
SAN SEW TRUNK
SEWER LATERAL 1973 24.8 41.4 15 Paid
WATERMAIN
*WATER LATERAL 1973 15
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 110-nn 6038 7-6-7
13UILDING PER.
SAC 240,00 6038 -6- 2
PARK
r; RESIDENTIAL
BUILDING PERMIT APPLICATION
7?;-O CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construction Requirements
• 3 registered site surveys showing sq. ft, of lot, sq. ft. of house; and all roofed areas
(20% maximum lot coverage allowed)
• 2 copies of plan showing beam & window sizes; poured found design, etc.)
• l set of Energy Calculations
• 3 copies of Tree Preservation Plan if lot platted after 711193
• Rim Joist Detail Options selection sheet (bldgs with 3 or less units)
DATE 6I ?o U
Water Softener
Water Heater
No. of Baths
SITE ADDRESS 3(os9i 3G(efd3etaS t 31o(e? IIPAIMRJLt(. A1/'CJMULTI-FAMILY BLDG XY _N
TYPE OF WORK FIREPLACE(S) _ 0 _ 1 - 2
APPLICANT
STREET ADDRESS 14ln5-0 6t QJQ,?y D,v. 13 CITY 1I STATEYWJ ZIP SSA
TELEPHONE# 95oZ-511-gyoD CELLpHCNE4-- --TAX _# o???1C1)'LIvZ?O
PROPERTY OWNER
G("?-TELEPHONE#
=?-
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MINNESOTA RULES 7672
(4 submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: ---
Plumbing system includes:
Mechanical Contractor: _
Mechanical system includes:
Sewer/Water Contractor:
Air Conditioning
Heat Recovery System
Phone #
Phone #
Fee: $90.00
Fee: $70.00
--------------------------------------------------------------------------------------------------------------------------
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant
OFFICE USE ONLY
3
Remodel/Repair Requirements
• 2 copies of plan
• 1 set of Energy Calculations for heated additions
• 1site survey for exterior additions & decks
• Indicate if home served by septic system for additions
VALUATION k ) b , I"I 7 - I
Phone #
Lawn Sprinkler
No. of R.I. Baths
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111 t
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE: May 15, 1972 NUMBER 1003
OWNER New Horizon Homes Address??4 61, 63, 65 Denmark
PLUMBER Thompson Plumbing Co. TYPE OF PIPE Heavy Cast Iron
DESCRIPTION OF BUILDING
Industrial` Commercial+ Residential Multiple Dwelling No, of units
x 1 4
Location of Connections:
Connection Charge960.00 pd 7/6/72
Permit Fee 10.00 pd 5/15/72
.50777777-
Street Repairs
Total
Inspected by:
Date
Remarks:
By.
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Toemship, Dakota County, Minnesota
By
Thompson Plumbing Co.
Please notify when ready for.inspection and connection and before any portion
of the work is covered.
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
-IT -
PERHIIT FOR WATER SERVICE CONNECTION
Date: May 15, 1972
Billing Name: New Horizon Homes
Owner: same
Number 836
Site Addres :3659 61, 63, 6 Denmark
21982408
BA14WAddress 7 75 77
Plumber: Thompson Plumbing Co.
Assn 21982413
335511
Meter Size -D/u
7/6/72
Meter No. Permit Fee 10.00 pd 5/15/72
.50 pa 571T`172
Meter Reading 1, tmeterg..b 60.00 ua.
Meter Sealed: Yea_ Add'1 Chg. 300.00
NO Total Chg.
Inspected by
Date
Building is a: Remarks:
Residence
Multiple x No. Units 4 -- ?- •? '
.
Commercial Ifs PRCIl DILY INSTALLED iJECEI63
Industrial By:
Other Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota Count , Minnesota.
By:
Thompson Plumbing Co.
Please notify the above office when ready for inspection and connection.
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454.5242
/I J
PERMIT FOR SEWER SERVICE CONNECTION
DATE: mly 15, 1972
NUMBER 1003
5 Ai- S i .
OWNER: New Horizon Homes Address 3659, 61, 63, 65 Denmark
PLUMBER Thompson Plumbing Co. TYPE OF PIPE Heavy Cast Iron
DESCRIPTION OF BUILDING
Industrial Commercial' Residential I Multiple Dwelling I No. of units
I I x I 4
Location of Connections:
Connection Charge960.00 pd 7/6/72
Permit Fee 10.00 pd 5/15/72
.50 Pd 5/15/72
Street Repairs
Total
Inspected by:
Date
Remarks:
By
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota
By
Thompson Plumbing Co.
Please notify when ready for inspection and connection and before any portion
of the work is covered.
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
Date: May 15, 1972
Billing Name: New Horizon Homes
Owner: same
Plumber: Thompson Plumbing Co.
5
i
Number 836
Site Address: 3659 61), 63, 6 Denmark
21982408 ? 1 U It
U114?WAddress_ 74 75 77
Assn 21982413
335511
Meter Size 573 Connection Chg. "" 71 /6/72
Meter No. Permit Fee 10.00 pd 5/15/72
.50 p 2
Meter Reading— tmeterp at -6d 85-t-'-
Meter Sealed: Yes Add'1 Chg. 300.00
NO I Total Chg.
Building is a:
Residence
Multiple % No. Units4
Commercial
Industrial
Other
Inspected by
Date
Remarks:
By:
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota.
i
By: l'??,r ((.-cat
Thompson Plumbing Co„
Please notify the above office when ready for inspection and connection.
EAGAN TOWNSHIP I QJ
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454.5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE -Ma, 15, 1972 NUMBER 1003
Sf S /-5
OWNER: New Horizon Hmes Address 3659, 61, 63, 65 Denmark ? ..?
PLUMBER Thampson Plumbing Co. TYPE OF PIPE Heavy Cast Iron
DESCRIPTION OF BUILDING
Industrial Commercial Residential Multiple Dwelling No. of units
X 4
Location of Connections:
Connection Charge960.00 pd 7/6/72
Permit Fee 10.00 pd 5/15/72
.50 Pd 715/72
Street Repairs
Total
Inspected by:
Date
Remarks:
By.
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota
` . By.
Thompson Plumbing Co.
Please notify when ready for inspection and connection and before any portion
of the work is covered.
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
Date: May 15, 1972
Billing Name: New Horizon Homes
Owner: same
Plumber: Thompson Plumbing Co.
Number: 836
Site Address: 3659, 61, 63 65 Denman:
21982408 69- 11 -
BilM Address 74 75 77
Assn 21982413
335511
er Size Connection Chg. 7/6/72
Meter No. Permit Fee 10.00 pd 5/15/72
-50 p 5/ 1 >7'72
Meter Reading tme
rg
te
Meter Sealed: Yea Add'1 Chg. 300.00
NO Total Chg.
Inspected by
Date
Building is a: Remarks:
Residence
Multiple X No. Units4
Commercial
Industrial By: ^
Other Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota Count), Minnesota.
By: 7? Cc,/ ??--
Thompson Plumbing Co.
Plea:;e notify the above office when ready for inspection and connection.
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE: May 15, 1972 NUMBER 1003
y-5
DER, New Horizon Hanes Address 3659, 61, 63, 6$ Denmark I
PLUMBER Thompson Plumbing Co. TYPE OF PIPE Heavy Cast Iron
DESCRIPTION OF BUILDING
Industriall Commercial[ Residential I Multiple Dwellingl No. of units
I I I X 1
Location of Connections:
Connection Charge 960.00 pd 7/6/72
Permit Fee 10.00 pd 5/15/72
-50 PT-
7/7777r--Street Repairs
Total
Inspected by:
Da
Remarks-
BY.
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota
Thompson Plumbing Co.
Pleaee_notify *hen ready for inspection and connection and before any portion
of the work is covered.
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
C& 21 L 14
PERMIT TYPE: BUILDING
Permit Number: 0 2 3 9 4 3
Date Issued: 06/28/94
SITE ADDRESS:
P.I.N.: 10-76500-020-05
DESCRIPTION:
PERMIT
3661 DENMARK AVE
LOT: 2 BLOCK: 5
TIMBERSHORE
Building-Permit Type
Building Wor-k Type
1
may'.
DECK
NEW
REMARKS:
FEE SUMMARY:
Base Fee $30.00
Surcharge $.50
Total Fee $30.50
CONTRACTOR:
OWNER: - Applicant -
BEALER MICHAEL
3661 DENMARK AVE
EAGAN MN 55123
(612)452-4753
I hereby acknowledge that I have read this
information is correct and agree to comply
Statute and City of Eagan Ordinances.
APPLICANT/PERMITEE SIGNATURE
application and state that the
with all applicable State of Mn.
L(RI-4 Rial 1 ? Wd
IS ED : SI NAT E
159-4
CITY OF EAGAN
1994 BUILDING PERMIT APPLICATION
681-4675
430.0
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
talcs.
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 is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date Valuation of work T
_ (o <<,:_o, /'r-?
Site Address:
STREET SUITE #
Tenant Name: (commercial only)
LOT BLOCK SUBD.-,"? P.I.D. #
Descrf tion of work: C
The applicant is: ? Owner ? Contractor ? Other (Describe)
Name ?P e64, (
Phone e1S"2
Property LAST FIRST
Owner ?
/
k
Address
a
o?U t
o? 0'-
STREET
STE #
g
City ciGLv? State /1/ Zip . All
Company Phone
Contractor Address License # Exp.
City State Zip
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 ad t is application and state that the information is
correct and agree to comply with a 1 a pli able State 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. ? 07 4-Plex ? 12 Multi. Misc.
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory
? 04 SF Porch ? 09 12-flex ? 14 Fireplace
? 05 SF Misc. ? 10 Multi. Add'l. ? 15 Deck
WORK TYPE
? 31 New ? 33 Alterations ? 35 Tenant Finish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Engineering
REQUIRED. INSPECTIONS
? .Site
? Wallboard
+D ?
? 16 Basement Finish
? 17 Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
? 37 Demolish
Basement sq. ft. MWCC System
1st F1. sq. ft. City Water
2nd F1. sq. ft. PRV Required
Sq. Ft. total Booster PU
Footprint Sq. ft. Z
Fire Sprinkler
On-site well Census Code
On-site sewage SAC Code
Census Bldg
Census Unit
Building Assessments
Variance
? Footing
? Final
? Framing
? Draintile
? 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:
valuation: $
SAC %
SAC Units
J
4
i
W
( _.:
1 CITY USE ONLY
PERMIT #: h? RECEIPT DATE:
MSIDENTIAL MECIIANICAL PE MIT APPLICATION
CITY OF EAGAN
S$SO PILOT KNOB RD
EA6" MN 55122
651-6$1,4675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit APR i 0 2 no,
Date:y ?O I X7Y 1
SITE ADDRESS: KKD K
OWNER NAME: 1 tar r
INSTALLER
STREET AWRESS:
J
Ste- TELEPHONE #: 3
(AREA CODE)
r I I lC TELEPHONE #: *Le-)) Z 9)9 145
/
_ (AREA CODE)/-) t
STATE:
Plara a rhark mnr4 nari fn fha narmit wnrk funs
ZIP:
New residential dwelling unit under constructionand not owner/occupied $ 70.00
Add-on, modification or alteration to existing dwelling unit $ 50.00
• furnace replacement
• air exchanger
• air conditioner
• other
]]. '?? n? pp? R JU -y
Nature of work?S`I ?J 20 / O
U
State Surcharge
$ .50
Total
Reminder: Cali for inspections.
G?
SIGNATURE OF PERMITTEE
Updated I/01
11, PERMIT # "l "49 RECEIPT DATE: - 1 I -.C) L-r- I RESMENTIAL PLUM$INGa PEftMIT APPLICATION
crrY OF EAe N
l h ?J 2Y v?_ o ?? 3830 raoT xrros RD
EAGM, MN 55122
651-661-4675
Please complete for: ? single family dwellings
> townhomes and condos when permits are required for each unit
? backflow preventer for irrigation system
SITE ADDRESS: `5e ( 0 V Y
OWNER NAME: :
INSTALLER NAME:
STREET ADDRESS:
CITY:
TELEPHONE #:
(AREACODE)
NELSON.TERRANCE
3663 DENMARK AVENUE
EAGAN. MN 55123
(651) 452-3778
Place a check mark next to the permit work tvve
TELEPHONE #:
(AREA CODE)
STATE:
ZIP:
_ New residential dwelling unit under construction and not owner/occupied $ 90.00
Add-on, modification or alteration to existing dwelling unit, including: $ 50.00
• abandonment of septic system
• new installation/repair/rebuild of RPZ
• lawn irrigation system
• water turnaround
/? C l? I?,? f ?? f
Nat re of work: W W & Vval Vt f !C 1. 6
_ Septic System, new/refurbished - $ 225.00
• includes County & Consulting Inspector fees
• requires MPC license
State Surcharge ?l M
LC ? ? U $ .50
Total 1 APR 12 2001 $ SD o0
Reminder: Be sure to schedule inspections of alterations, i. ajater heater water sditeners, etc.
1 hereby acknowledge that I have read this. application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It
is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal
operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement.
?I)YKyyro
SIGNAURE PERMITTEE
Updated 1/01
CrrY USE ONLY
PERMIT #: RECEIPT DATE:
3-I
RESIDENTIAL MECHANICAL IT APPLICATION
crrY of EALem
3930 PH= KNOB RD
EAGM MN 551 Ys
651-661-4695
Please complete for: D single family dwellings
,J townhomes and condos when permits are required for each unit
Date: / % Z*7 0/
SITE ADDRESS:
l ?SJ
OWNER NAME: A/1 TELEPHONE #: E J1-5-c;;,
?j ?y (AREA CODE)
INSTALLER NAME: / L?O•?J/ /'la 164-45 TELEPHONE* (AREA CODE)
STREET ADDRESS: cpp
CITY: O STATE: zzlkl ZIP:
Place a check mark next to the permit work tvoe
New residential dwelling unit under constructionand not ownerloccupied $ 70.00
Add-on, modification or alteration to existing dwelling unit $ 50.00
• furnace replacement
• air exchanger
• air conditioner
• other
d
?
?
/7
Nature of work: / l1/Ifl CCU ?L?//
C??c
State Surcharge
$ 50
Total $ SOe S
Reminder. Call for inspections.
Updated 1101
q " ( CITY USE ONLY
LOT 0 1 BL 11? RECEIPT #:
SUBD. ?I VYw Q?? RECEIPT DATE: 7 /?
1999 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAfiAN
3$30 PILOT KNOB RD
EAGAN MN 55122
3 - l 5 (651) 691-4675
Date:
Complete this section only if you are installing HVAC in single family, townhomes or condos under
construction and not owner /occupied
• HVAC: 0-100 M B T U $ 30.00
ADDITIONAL 50 M BTU 6.00
• Gas outlets (minimum of one required @ 53.00 ea.)
• State Surcharge: .50
• TOTAL:
Complete this section only if you are remodeling, adding to, or repairing existing single family dwellings,
townhomes, or condos. Please indicate if it is a new item, replacement item, or repair.
New
Furnace
Replacement
Air exchanger, i.e. Vanee system, etc.
Reminder: Call 681-4675 for inspections.
Repair - Other
Ir axNCS r3 sF sR A/C_
X Air conditioning 1550ANX()zL)
Other -- 4 O r?
$ 30.00
State Surcharge: .50
Total: $30.50
SITE ADDRESS:
OWNER NAME: e ?P- r
INSTALLER
STREET ADI
CITY:
n
PHONE #: (n ?- 7 Jr Z - 3'7 -7R
t- IYl C, . PxopiE44 : for 1- g 9'? --1 Z
STATE: 1 1 1 1 ZIP:_ C?c SU c3?
SIGNATURE OF PERMITTEE
JS/FORMS DLD/MECH PERMIT (RES) - 1999
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
P.I.N.: 10-76500-010-05
DESCRIPTION:
PERMIT
3663 DENMARK AVE
LOT: 1 BLOCK: 5
TIMBERSHORE
PERMIT TYPE:
Permit Number:
Date Issued:
Building' Permit Type DECK
Building Wo"r- Type NEW
i
?j
BUILDING
023944
06/22/94
?< -
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
Subtotal
$30.00 COPY .50
$.50 Total Fee $31.00
$30.50
sly .. .
CONTRACTOR: OWNER: _ Applicant -
NELSON TERRANCE
3663 DENMARK AVE
EAGAN MN 55123
(612)452-3778
I hereby acknowledge that I have read this
information is correct and agree to comply
Statutes and City of Eagan Ordinances.
?_
APPLICANT/PE MITEE SIGNATURE
application and state that the
with all applicable State of Mn.
I
f s4 &A, f
ISSUED BY. IGNA URE
CITY OF EAGAN
1994 BUILDING PERMIT APPLICATION
681-4675
43!.00
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered si f energy
calcs.
1 7 1984
COMMERCIAL 2 sets of architectural & structu al plans, 1 set o
specifications, 1 copy of energy a --?--'""" "
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date 6- / /7 / `1Y Valuation of work
Site Address: 13C 6 J??i+y,=t,2lC f{ ??
STREET SUITE #
Tenant Name: (commercial only)
LOT T- BLOCK F;?D. {
rJ L1?{, ?4i1,d,?,OtQ, P.I.D. #
Description of work: i¢T?-o t:'C:(C
The applicant is: ? Owner ? Contractor ? Other (Describe)
Name /IL-?-Sviv ??rcn ,vc Phone YS' 2 - 377 8
Property LAST FIRST
Owner Address 3(2, cl 3 /Dif 7V ;?Z tc
STREET STE #
City 4!E? State 0"LZA1 Zip S S/ Z 3
Company Phone
Contractor Address License # Exp.
City State Zip
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 State of Minnesota Statutes and City of
Eagan Ordinances.
p
f
Signature o
Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation
? 02 SF Dwg.
? 03 SF Addition
? 04 SF Porch
? 05 SF Misc.
WORK TYPE
O 31 New
? 32 Addition
? 06 Duplex
? 07 4-Plex
? 08 8-Plex
? 09 12-Plex
? 10 Multi. Add'l.
? 33 Alterations
? 34 Repair
? 11 Apt./Lodging
? 12 Multi. Misc.
? 13 Garage/Accessory
? 14 Fireplace
0Y15 Deck
? 35 Tenant Finish
? 36 Move
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Engineering
REQUIRED INSPECTIONS
?.Site
? Wallboard
Basement sq. ft.
1st F1. sq. ft.
2nd F1. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Building
Variance
13 Footing
Q Final
? Framing
? Draintile
0
i
a
? 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 Pl.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
Y ?
valuatim: $
? 16 Basement Finish
? 17 Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
? 37 Demolish
MWCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code
Census Bldg
Census Unit
Assessments
SAC %
SAC Units
?Y
Vi,lee?a
Al EVJ a(t
_.
O I
PERMIT
CITY OF`E-AGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 2 8 5 8 2
(612) 681-4675 Date Issued: 08/23/96
SITE ADDRESS:
3665 DENMARK AVE
LOT: 4 BLOCK: 5
TIMBERSHORE
P.I.N.: 10-76500-040-05
DESCRIPTION:
(INCL PRIVACY WALL)
6uildinsg-tiPermit Type DECK
Building 4tp,c? Type REPAIR
Census Code 434 ALT. RESIDENTIAL
kE r , t^
i
i?
I
REMARKS:
FEE SUMMARY.
Base Fee $45.00
Surcharge $.50
Total Fee $45.50
CONTRACTOR: - Applicant - ST LIC OWNER:
NOBLE BUILDING CO 14327926 2001814 TIMBERSHORE HOMEOWNERS
6605 166TH ST W P 0 BOX 21061
ROSEMOUNT MN 55068 EAGAN MN 55121
(612) 432-7926 (612)452-2409
I hereby acknowledge that I have "read this application and state that the
information is oorrect and agree to comply-with all_ applicable,State of Mn.
State s ty of Eagan Ordinances.
UAIMA---
ISSUED Y. JIG A RE
CITY OF EAGAN
C,ASH1 EI;'e TERMINAL NO: 541.
IIIA?I::;t S C.'.1/ 9C:• 77:1`1E: 0:0105
ID.;
NAME i NOYI -7 EA-TIG CO
32 i.0 9001. 3658 DENMARK AV 45.00
205 9001 3658 DENMARK. AV 0.50
3210 9001 3665 DENMARK AV 45.00
2.15.5 9001 3665 DENMARK AV 0.50
Total Receipt Ammnt n 531..00
CRO63329
115ER 1De NANCY
iki4:YnM?n i??K?k?Xrid?k?K?rF?B.`a'rFW.?' 7k71'.tK7K?7K7KX<kt7K7k#7k78M*?krF #?k
CITY OF EAGAN ?,ap? ,
3830 PILOT KNOB RD - 55122 ?! "j'... J 0
6?601996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675 -??
New Construction Requirements Remodel/Repair Requirements
? 3 registered site surveys ? 2 copies of plan
? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior additions & decks)
? 1 energy calculations ? 1 energy calculations for heated additions
? 3 copies of tree preservation plan if lot platted after 7/1193
required: _ Yes _ No
DATE: S ^ (S - e(6 CONSTRUCTION COST:
DESCRIPTION OF WORK: De k Pe gar ? 3- a':, .,, Ct.;cr l ?
e K c ra a Lt
STREET ADDRESS: 6 Sfj
LOT BLOCK SUED./P.I.D. #:
PROPERTY Name: Tf?r Semis °?e l7?+rc 9vk.e? Phone #: 60- 11da -d
OWNER tA81 `?RBi
Street Address: Q'n 1 y / /
City: r--S0-61 /J State: /1,?( Zip: S S/2
CONTRACTOR Company: /?/? a" • Phone #: 4?3a?
Street Address: Ue x 2 `( 6d 'e// License #: 2G City: -44;41,e Z14 11-r State: 14-1-, zip:
ARCHITECT/ Company: Phone #:
ENGINEER
Name: Registration #:
Street Address:
City: State: Zip:
Sewer & water licensed plumber: Penalty applies when address change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this application and state that the informal. Lqn is correct and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received
Yes
No
No
Tree Preservation Plan Received Yes
y 4996
OFFICE USE ONLY
BUILDING PERMIT TYPE
?? fP ryp
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch ? 09 12-plex ? 1y Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 _-plex 15 Deck
WORK TYPE
? 31 New X 33 Alterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORM ATION
Const. (Actual) Basement sq. ft. MC/WS System
?
(Allowable) Main level sq. ft. City Water -
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code. y314
Depth Footprint sq. ft. SAC Code r i
Census Bldg i
Census Unit _rL
APPROVALS
Planning B uilding Engineering Variance
Permit Fee . Valuation: $
Surcharge
Plan Review
License
MC/WS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
SAN Surcharge
Treatment Pl.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
% SAC
SAC Units
X
0
r
1f D
u .?
U?
All
z
w? )
a ?
a • - m
w w A to
-o,• •• • 911014
+•
woos- aoJ?s"? -4
... .........................:p ...`............ . . . . . ............. I . ...
... .r??.w.......... .'-. ..... .
DEN MARK A?
?---- u u
u
I3 -78
6
w
• ` V N ? p N o?
KOLSTA D
TIMBER HORES I i ADD tV
>?aQ Dy?O > 4Q Ms
.. v w w a ? C
o cs v c? s o 0
c 36 52 1 '-'
?-son I
e '•
Timbershore Homeowners Assoc.
P.O. Box 21061
Eagan, Minnesota 55121
To whom it may concern:
&)C6 c ° company has the authorization to
replace/rebuild the privacy wall/deck at - 3 6 6 S QQ,l ?a rk ?4?c,
by the Timbershore Homeowners Association Board
Signed
Rep
President/Vice
Date: S- $ - 9 L
EAGAN
REVIEWED
3V Mt%
NTE 8- /,1,- 9'6 00
Phox: 612452-2409
PERMIT# RECEIPT DATE:
8008 IiI;SIDENTIAL PLUMBING EMIT APPLICATION
CITY OF IP*GM
3630 PILOT KNOB HD
KAGM, MN 55122
651-6$1-4695
Please complete for: single family dwellings, townhomes and condos when permits are required for each unit,
backfiow, preventer for irrigation system
SITEADDRESS:
OWNER NAME:: I V r a n CQ , Nye Yl TELEPHONE #: (. L51 Le_.?- -yns
(AREA CODE)
INSTALLER NAME: ?`J l G t) I OV i TELEPHONE #:
STREET ADDRESS: Ilr ? 1?.? - ? l/D (' (u (AREA CODE)
CITY: 1 (? (t 14x16 STATE: al k) ZIP: ? ? q
SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00
includes $40.00 County fee
Note: Additional consultant fees may apply
• MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
_ Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00
- Abandonment of septic system.
- Water turnaround - existing dwelling unit (+ 5/8" meter if needed - $118)
Other:
RPZ: new installation/repair/rebuild $ 30.00
- lawn irrigation system
Replacementladditional: water softener _ water heater $ 15.00
State Surcharge $ .50
Total $ 15. 5
I hereby acknowledge that I have read this application, state that the information is correct, and a ee to a
is the applicant's responsibility to notify the property owner that the City of Eagan assumes n I alit for
operational and maintenance activities to the facilities constructed under this permit within party/,
applicable City of Eagan ordinances. It
s caused by the City during its normal
OF PEOWTfE@ // 1/02
MASTER CARD
LOCATION
OWNER %/C
STRUCTURE AND i /
LAND USED AS a / tP? rp wdy m /
Permit
No.
Issued Issued To
Contractor Owner
BUILDING
PLUMBING
??,
r7
'
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING SEPTIC
FOUNDATION CESSPOOL
FRAMING
, TILE FIELD FT.
FINAL
ELECTRICAL
HEATING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
Violations Noted
on Back
COMMENTS:
yoeo
i ? V M.STER CARD
- ,//JJ. ?3Ls? Ls
LOCATION /
OWNER
STRUCTURE AND `/ , 117
/
LAND USED AS /-
Permit
No.
Issued To
Contractor Owner
BUILDING
PLUMBING
/
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING 2
GAS INSTALLING
SANITARY SEWER
OTHER L
OTHER Qo--5
• Items
FOOTING
FOUNDATION
FRAMING
FINAL
ELECTRICAL
HEATING
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
Approved
(Initial)
Date
Remarks
Distance From Well
SEPTIC
- CESSPOOL
TILE FIELD FT.
`? 2 DEPTH
OF WELL
11 `O
COMMENTS:
Violations Noted
on Back
Aug 04 09 01:43p Cse 6516464273 p.4
FohOffice-tlse I
4f Nob j Permit#: 0~D1;L 1
City of Eatan 1 Permit Fee: B'l
1
3830 Pilot Knob Road
Eagan MN 5 122 i Date Received: l
Phone: (651675-5675 r l
Fax: (651) 5-5694 i Staff
2 o9 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 2)4 L- Site Address: _1f1`t'tCsY
~31e(t f, 3 r~~3 3 4-5 Suits
Tenant:
i ? _ S tee=
RESIDENT /OWN R Name: 5 ! ZOO
Acidress /City I Zip: J~
Applicant is: Owner X"' Contractor
TYPE OF WORK Description of work: Z)Z' 1 L
Construction Cost & lrl, 1~~f Multi-Family Building: (Yes 1 No
CONTRACTOR Name:/'il'!`rl License
Address:' kj
City: yi ) LC. State: _ Zip:.z;z~ W 7
Phone: ff. Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Cod • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
N submission ) • Energy Envelope Calculations Submitted
In the last 12 month's, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No 1 yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
N'OTE• Plans an supporting documents that you submit are considered to be public Worrfmation. Portions of
c reasons that would permit the City to
the irtformatlo may be classified as non-public if you provide specifi'
conclude that the are trade secrets.
I hereby acknowledge t#fat 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 p 1; that the work will be in
accordance with the approved plan in the case of work which requires a review and apprWal of plans. yy~
r ~r
Iri
Applicant's Printed Name T p tca s Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA178687
Date Issued:08/29/2022
Permit Category:ePermit
Site Address: 3659 Denmark Ave
Lot:3 Block: 05 Addition: Timbershore
PID:10-76500-05-030
Use:
Description:
Sub Type:Furnace & Air Conditioner
Work Type:Replace
Description:
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
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 -
Virgil V Polinske
15700 15th St S
Afton MN 55001--966
Genz Ryan Plumbing & Heating
2200 West Highway 13
Burnsville MN 55337
(952) 767-1000
Applicant/Permitee: Signature Issued By: Signature