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4261 Diamond DrINSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: lilt ANONA OR ? 1 I I A li #:i fi t 1'11 F ?' i•! E+ PERMIT SUBTYPE: 9 F, APPLICANT: TYPE OF WORK: Al 1FFRAI TW4 NA t FI Ftv14of?,/WN01-j REP OF CI?IP'T ION INSPECTION DATE INSPTR. INSPECTION TYPE DATE INSPTR. Permit Holder Date Telephone # PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING. PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL 'ilr/v s /AL-L- f-1 ff 10 tv,, - - - - - - - - --- - - - - - INSPECTION RECORD Control No. 1322 CITY OF EAGAN PERMIT TYPE: BU 1 I DIN&, 3830 Pilot Knob Road Permit Number. ! "3 *1 Eagan, Minnesota 55123 Date Issued: 1.1 /10/92 (612) 681-4675 SITE ADDRESS: t v? ; 42A I DIAMOND OR f,. P OAR GROVE 2NO PERMIT SUBTYPE: E (hSic..) Hf MAltk 9; PEcE 11'1 # 11 B L OC. K% a APPLICANT: TWIN CITY STORM RASH CO (612) f"46--8160 TYPE OF WORK: NEW OESCIRIPTION SIDING Zip, o 3E pp x m 7 ° b m r° `- 0 c° m ? 0 °c ac q CE 1 T 2 ? ?I ? r r Z7 n n 0 ?_ 7J Z n n 9 3 z 0 m 1 3 x v_ 1 0 3 ? a w o_ 0 w CITY OF EAGAN n..a. Owner Grove Street T?-1?C ?--'(imp 1 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. PPIS 9 5 1266.95 84.46 15 1266.95 0009264 8-27-84 STREET RESTOR. GRADING SAN SEW TRUNK # SEWER LATERAL 1304-T) 52-16 2 paid WATERMAIN WATER LATERAL 1972 WATER AREA STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK EAGAN TOWNSHIP './ pQBUILDING PERMIT Owner ,. . J?iC..fiC.?:1CrYRA............... '-. Address (present) ........ .... l...L...1....... . ehalvt Builder :------'...... .----------------------------------------- -- ----------- -- Address DESCRIPTION N° _718 718 Eagan Township Town Hall Date Stories To Be Used For Front Depth Heiigh! Est. Cost Permit Fee Remarks LOCATION Street, Road or other Description of Location Lot Block Addition o Tract C?. This permit does not authorize 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_ .............................................................has permission to erect a-------------------------------------- ..._...........-..-...upon the above described promi ubject tto the provisions of the Building Ord' rice for Eagan Tow hip adopted April 11. r 1955. ???--'s. c _?A1 .................'- '---- ....-.........of --nwn I-----..........--... Per ------.... ..... .y""!d'.. Chairman of Tnwn Board Sui n Ins actor. .. -... I EAGAN TOWNSHIP No 657 BUILDING PERMIT Address DESCRIPTION Eagan Township Town Hall Dal l---??<l Stories To Be Used For Front Depth Height Est. Cost PJR mit Eetl Re _ r s _ ' - This permit does not authorize 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 MUSTyg},g /??rEPT T I EILE THE WORK IS IN PROG?g?/SS. ??- This is to certify, ihrtt'L!C ? 6 =A ..-... `..has permission to ere a---T"......_ ... .................................upon the above described premise subject to the provisions of the Building Or nce for nsh'p adopted April 11, 1955. ,?Jp -".f-¢ , _..------------ ..._.-------- .--------------------------------------- Per Chairman of Town Board it i rJ Inspector II?IIiII Iu Q II I II REQUEST FOR ELECTRICAL INSPECTIONs5 V'ul Minnesota State Board of Electricity 1821 University Ave., Rm. S-128, St. Paul, MN 55104 * 0 L24 5 6 1 1* Phone (612) 642-0800 S J Home Uupez Apt. Bldg. Othe% New Addn Commercial Industrial Farm Remod a air Ar Cond. Htg. Equip. Water Htr. Load Mgmt. Other. Dryer Ran a Elec. Heat Temp. Service abboo Qe the he/?w.o?rk? covered by this request. Enter remarks in this space and on the back of the white copy only. Calculate Inspection Fee - This Inspection Request will not be accepted without the correct fee: Other - Fee # Service Entrance Size Fee # Circuils/Feeders Fee Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps Street Ug./Traf is Sig. Above 200 Amps Above 100 Amps Transformer/Generator INSPECTOR'S USE ONLY TOTAL Sign/Outline Ltg. )(fmr. ' Alarm/Remote Control aD- Swimming Pool I here tern char I Ins d the elearical ins o anon desuibed herein on the dares sated Irrigation Boom Rough-In Dole S ecial Ins ection p p Investigative Fee Final TH IS INSTALLATION MAY BE ORDERED DISCONNECTED(W )WT CO D IT IN 18 MONTHS. 245-672 OFFIC US ONLY This request void 18 months from validation dale printed in this baU? O S?7 5S' _- 4 ryp1 PLEASE PRINT OR TYPE Regsest Dak Rough-.n inspetlion regwred2 ? Yes ON. Inspection Other Than Rough In: ? Ready Now Will Call i (You must toll the Impecor when ready) Date Ready: I,. ? licensed contractor ? owner hereby request inspection of the above electrical work at: Job Address (Street, Box Rouk No.) . City Zip Code ?J/ / Section No, Township Name or No. Range No. Fire No. Coon,-2 Q Phone Nv /n 3 r / ^ Power Supplier Address EI rmactor tCampany Name) )0,4567V Contra cor Liceme Na. Moskr tic No. (Plant Elect Only) Mailing Address (Contractor or Owner Pert rmm, Inst9bloyan)?• n ? A a (ContmMrorO rP nsml n) Phone No. ??J 7 E8- lA- 0 6/95 S ATEBOARO COPY-SEE INSTlIUCTONS ON BACKOF YELLOW CO REQUEST FOR ELECTRICAL INSPECTION r°. E- ,See instructions (or completing this form on back of yellow copy. T `8?5,0 2 X_eBelOw Work Covered by This Request Ne Add Rep. Type of Building Appliances Wired Equipment Wired' Home Range Temporary Service Dtq)lex Water Heater Lighting Fixtures Apt. Building ryer Electric Heating Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Fa on Other SPec,fy Other ISpecifyl I her l5ppcifv Other Other Compute Inspection Fee Below p Fee Service Entrance Size {I Fee Feedars?Subfeeders k Fee Circuits 0 to 100 Aln )s 0 to 30 Aro)s j 62 4-0 0 to 30 Amps 101 to 200 Amps 31 to 100 Amps 31 to 100 Amps Above 200 Amps Above 100_Amps Above 100_AmPs Transtormers Remote Control Cite. ,S"V lpartial%Other-Eau Signs Special Inspection ? T Remarks • . ??•'? OTA E G? Roughs Data , v I, the Electra aI Inspector, hereby certify that the above Final D+' a inspection has been made. 18 months honi This request void Y12,q TI 8 5-5"'0 2 Lily 6$, r?VF- ` 3I s`ls /0,00 Request Date Fire No. Rough-in Inspection Required ?Ready Now - Notlty Insuec- 7 _? ,.,., / ?Yes LfNO , tar When Ready wensed Electrical Contractor I hereby request inspection of above ? Owner electrical work installed at: Street Address, Box or Rf Nn. . Ci 4 C2' /V O 0 fa° ecLpn No. Township Name or No. Rangc No. County /"Z'/ INT) L T`h non No. Ppwer Supplier Address Electr'cal Contra clor (C ompan Namol Contra rtor's License No. cc7`2?- s?? S' S'J i . o-Address (Co ractor or Owner Making Ins ti 'on l ? h ? Auth na ?1 ntractor w r Making Installation) Pane Nmnber ?J YY ' ? t J MINN SOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Roam N•191 BE ACC EPTEO BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 - UNLESS PROPER INSPECTION FEE IS P6nn. IR121 297-2111 ENCLOSED. ,q,)-7r RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 I 11 ? `-I S New Construction Requirements RemodeVReoair Requirements Office Use Only 3 registered site surveys showing sq. ft of lot sq. ft. of house; and all roofed areas 2 copies of plan _ Ced of Survey Recd (2(r/. maximum lot coverage allowed) 1 set of Energy Calculations for heated additions -Tree Pres Plan Reod 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for addillons & decks _ Tree Pres Not Reqd l set of Energy Calculations Addition- indicate ifon-site septic system _on-sile Septic System 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Detail Options selection sheet (bldgs with 3 or less units Date 3 7 03 Construction Cost $4,035.00 Site Address 4261 Diamond Drive, Eagan MN Unit/Ste # Description of Work Tear off and reroof Multi-Family Bldg - Y x N Fireplace(s) x 0- 1 _ 2 Property Owner Dakota County CDA Telephone # ( 651) 675-4481 Contractor Kathy's Construction Inc. Address State 7837 12th Avenue South MN City Bloomington Zip 55425 Telephone # ( 952) 854-5884 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted Licensed Plumber Mechanical Contractor Sewer/ Water Contractor Telephone #( Telephone # ( Telephone #( IN MAR 1 U I hereby apply for a Residential Building Permit and acknowledge that the inform ion is corn_d ac urate; that the work will be in conformance with the ordinances and codes of the City ?an and the Siate r ?_ f MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. ( 1 16A uwe!?, Applicant's Printed Name App 4nt's Signature PERMIT#u RECEIPT DATE! 8008 RESIDENTIAL PLUM$INfi PERMIT APPLICATION ?j CITY OF EmAN Q '4'0 3830 PILOT KNOB RD U a _ - D a £AGAN. MN 55122 651-681-4675 Please complete for: single family dwellings, townhomes and condos when permits are required for each unit, backflow preventer for irrigation system SITEAWRESS: L}ZlQ OWNERNA : 1Y2Vf- TELEPHONEM INSTALLER NAME: V I bLSOR, P1 C TELEPHONE #: STREET ADDRESS: CITY: STATE: J?1 L( u 3 -y5y 5 ZIP: 55 9 SEPTIC SYSTEM, new/refurbished (r uires two sets of plans and MPC li nse) $ 100.00 includes $40.00 County fee Note: Additional consultant fees may apply • MODIFICATION/ALTERATION TO EXISTING D LLIN NIT, INCLUD ING: Adding fixtures to lower levels or room additions, a uding ater softener a d water ters. $ 50.00 _ Abandonment of septic system. _ Water turna nd - existing dwelling unit (+ /8" m ter if nee ed 118) Other: \ RPZ: new installation/repair build $ 30.00 awn irrigation, system Replacemen dditio I: so ener water heater $ 15.00 State Surcharge D iC fc' /7 $ 50 /dN 2 1 Total 2002 $ I hereby acknowledge that I have read this application, state that the information is correct, an a to ' m`p?yedRf li e City f Eagan ordinances. It is the applicant's responsibility to notify the property owner that the City of Eagan assume o'lipbility fora damage cause City during its normal t7d"AJ UtZ"'C, AREA CODE) operational and maintenance activities to the facilities constructed under this permit with il?lri f / , se ent. Q SIGNATURE O PERMITTEE 1/02 CLAIM VOUCHER - REFUND REQUEST CITY OF EAGAN MAKE CHECK PAYABLE TO: ERICKSON PLUMBING ADDRESS: 1471 92ND LANE NE BLAINE MN 55449 LOCATION: 4261 DIAMOND DR VALUATION: RECEIPT #/DATE: 2199312-1-02 REASON FOR REFUND: NO PERMIT REQUIRED PERMIT #: 48825 TYPE OF REFUND: Plumbing Permit 9001.4087 $ 50.00 Mechanical Pemtit 9001.4088 $ Building Permit Fee 9001.4085 $ Plan Review Fee 9001.4222 $ SAC (MC/WS) 9220.2275 $ SAC (City) 9379.4681 $ SAC (Admin) 9001.4246 $ Water Connection 9220.3865 $ Sewer Permit 9220.4532 $ Water Permit 9220.4507 $ Account Deposit Water Meter Water Treatment Surcharge Overpayment Curb Box Deposit Refund Construction Meter Dep Refund Other 9220.2252 9220.4509 9220.4685 $ 9001.2195 $ .50 9001.2250 $ 9220.2253 9220.2254 TOTAL $ 50.50 I declare under the penalties of law that this account, claim, or demand is just and that no part of it has been paid. February 1, 2002 SIGPJrti RE DATE PERMIT CITY OF EAGAN 3830 Pilot Knob Road EF3gar,; Minnesota 55122-1897 (612) 681-4675 PERMIT TYPE: BUILDING Permit Number: 0 3 2 2 8 2 Date Issued: 06/23/98 SITE ADDRESS: 4261 DIAMOND DR LOT: 11 BLOCK: 8 CEDAR GROVE 2ND P.I.N.: 10-16701-110-08 DESCRIPTION: i BATH REMOD/WNDW REP B-uild'3n"q„-Permit Type SF (MISC.) Building. Work Type ALTERATION Census Code 434 ALT. RESIDENTIAL REMARKS: FEE SUMMARY: Base Fee Plan Review Surcharge Total Fee VALUATION $174.75 $113.59 $5.50 $293.84 $11,000 CONTRACTOR: D6J REMODELING 350 FULLER ?y!{? PAUL (612) 690-2649 - Applicant - ST. LIC 16902649 2006980 AVE MN 55103 OWNER: DAKOTA COUNTY HRA 2461 DIAMOND DR ROSEMOUNT MN 55068 (612)423-8171 I hereby acknowledge that I have read this information is correct and agree to comply Statutes and City of-Eagan Ordinances. APPLICANT/PERMITEE SIGNATURE application and state that the with all applicable State of Mn. ISSU IGN R J 6 y.yyyny`yy y,{ JJ''yy.y,..y_y.yuw, yyyy. yy?.yy+g.. . yI"{yy,y.y.y,y).gIXlT,TR`TITTMT'n`4TTM9MMTMTT9TTTTT??X?`T1"PTf MMT '!. A.ttlER f TERMINAL .',15%0-3-1 Mo 808; 'PATEN . 96/2'is8 TIY 2 TDa NAME'd, D t J REMODELING 5ErVlCE ,32i0 9001 4261 DIAMOND -DR , 174.75 :3422 9001 426i DIAMOND .DR l,i3.59 2i55 900i.4261,D[AMONDLiR 5.50 Total Receipt Ap,»>nt: 293.84 CR094084 USER-ID. NANCY ?k?NX?YF*?Xc?;?sk?k?>X?k?NC?;?k?c?k??*?C?KtX:XkYe?czk ' 52 1 38 BUILDING PERMIT APPLICATION (RESIDENTIA 7 13 34 W2013 (? ? CITY OF EAOAN 3830 MOT KNOB RD - 55122 681-4675 New Construction Requirements ? 3 registered site surveys ? 2 copies of plans (Include beam 2 reiric•: sizes; poured fnd. design; etc.) ? 1 energy calculations ? 3 copies of tree preservation plan if lot platted after 7/1193 required: _ Yes _ No DATE: to ` (r `::N Remodel/Repair Requirements ? 2 copies of plan ? 2 site surveys (exterior additions & decks) ? 1 energy calculations for heated additions DESCRIPTION OF WORK: STREET DRESS: 1f L Q ( UIXI-W)Al® V 1I BLOCK: SUBD./P.I.D. UCTION COST; 4L Name: Vl+lO} A 69yiV/ 17 /-1 Phone#: PROPERTY Lait Firsts ?Z3`?17I ?J T,[ OWNER qy, Z&x S7i?.G Street Address: 1 City ,Q?Sn?ocw? State: /?fit/ Zip: '5t061 Company:, 1 T) ?I 11?C7? lr /y &Phone #: tF /lnn "? ?v??5 c'J CONTRACTOR Street Address: 350 teiey ;< XVZ5 License # yooT902- city 1944 State: Zip: ?rJlt? ?? ARCHITECT/ // ENGINEER Company: 1- Name: Street City Sewer & water licensed plumber (new construction only): and lot change is requested once permit is issued. State: Penalty applies when address chang I hereby acknowledge that I have read this application and state that the info on is ect and agree to comply with all applicabl State of Minnesota Statutes and City of Eagan Ordinances. ? - hV- Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No Not Required Phone #: Registration #: Zip: OFFICE USE ONLY a -`.4 ?; Of". BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 02 SF Dwelling ? 07 4-plex ? 03 SF Addition ? 08 8-plex ? 04 SF Porch ? 09 12-plex XL 05 SF Misc. ? 10 = plex WORK TYPE F".4-rt+po? 31 New ? 33 Alterations ? 32 Addition ? 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning ? 11 Apt./Lodging ? 16 Basement Finish ? 12 Multi Repair/Rem. ? 17 Swim Pool ? 13 Garage/Accessory ? 20 Public Facility ? 14 Fireplace ? 21 Miscellaneous ? 15 D ck IZF e v Z?fL / WIAIWo) rZ?7PL ?1GBMSn1T- 0 36 Move ? 37 Demolition Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft, sq. ft. Footprint sq. ft. Building M3 Engineering MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit Variance of v Permit Fee Surcharge Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Totat.`? -t! ? r Valuation: $ //,000- - ji SA 61? 1d.$AC Units a PERMIT Control No. 13 2 2 CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55123 Permit Number: 0 018 3 0 (612) 681-4675 Date Issued: :t, 1 / 2 0/ g 2 SITE ADDRESS: 4261 DIAMOND 1) R LOTS 1.1 BLOCK: 8 CEDAR GROVE 2ND DESCRIPTION: sT,DING Building Permit Type SF (IrIISC.) Building---,.Work Type NEW ),, REMARKS: RECEIPT 4f Q FEE SUMMARY: VALUATION $:9,000 Base Fee 1108.00 Surcharge 4.C,0 Total Fee $112.50 CONTRACTOR: -- Applicant - ST. utOWNER: TWIN CITY STORM SASH CO 1.5468160 0003090 DAKOTA COUNTY HRA 108,25 GREENBRIER RD 2196 145TH ST W MINNETONKA MN 55343 ROSEMOUNT MN 55068 (612) 546-8160 (612)423-4800 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 Mn. L Statutes and City of Eagan Ordinances. J R ??'ra t 17! 91 f?Aj APPLICANTIPERMITEE SIGNATURE 'ISSUED B_: SIGNATURE 1992 BUILDING PERMIT APPLICATION ° 7 CITY OF EAGAN 11.30 REQUIREMENTS: $!12.0 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 SETS 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 DB 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: Valuation: Site Address Lot 1L_ Block, Parcel/Stub r •r OwnerA, 4, -/; P,,f Address X4/96 - City Phone Contractor 090-911i-Zt9 Address avoa a31USNBUO SZOOL ., City/Zip -2f W71 Phone Arch./Engr. _ Address City/Zip Code Phone # O ROAD 10825 GREFL M _-M 612-548-6180 Date: Occupancy Bldg Permit Zoning Surcharge Actual Const Plan Review Allowable License Fee # of stories SAC, City Length SAC, MWCC Depth Water Conn. S.F. Total Water Meter Footprint S.F. Acct. Deposit S/W Permit On-site sewage S/W Surcharge On-site well Treatment PI. MWCC System Road Unit City water Park Ded. PRV Trail Ded. Booster Pump Copies SUBTOTAL APPROVALS Penalty Planner Lot Change Council TOTAL Bldg. Off. Variance FEES Sewer/Water. Licensed Contr. . Processing time for sewer/water permits is two days once area as been approved. f.i agrees that all work shall be done in accordance with (S gnatur o er ittee all applicable State of Minnesota Statutes and City of Eagan Ordinances. CITY USE ONLY L BL RECEIPT #: 5 UL Q/ ?1n? SUBD. C? Stt. D?? DATE: 1996 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: single family dwellings ? townhomes and condos when permits are required for each unit FIXTURES EACH tLQ. TOTAL Shower 3.00 x = Water Closet 3.00 x Bath Tub 3.00 x = Lavatory 3.00 x = Kitchen Sink 3.00 x = Laundry Tray 3.00 x = Hot Tub/Spa 3.00 x Water Heater 3.00 x Floor Drain 3.00 x = Gas Piping Outlet * minimum - 1 3.00 x = Rough Openings 1.50 x = Water Softener 5.00 x = Private Disposal * Dakota Cty. license 50.00 = (new and refurbished systems) U.G. Sprinkler * home under const. 3.00 Alterations * to existing 20.00 = Water Turn Around 20.00 STATE SURCHARGE .50 TOTAL Z0 1 SITE OWNER NAME INSTALLER NAME: /??/rA STREET ADDRESS: GI`- IVE CITY: /?? /? O'41t)2 STATE: ZIP: PHONE #: (? ?z) `7k-3 -?SZ?S SIGNATURE OFtYERmr L BL a ' CITY USE ONLY RECEIPT M SUBD. DATE: 3/s?9<o 1996 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: single family dwellings ? townhomes and condos when permits are required for each unit New construction Add-on furnace Adel-mon air r+mreltinninn od'roA 'J?( 3•iny, fsi.; ?r :.v. Van-v 31 stomp atc. Date: EE ES ? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00 ? HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ? Gas Outlets (minimum of 1 required @ $3.00 each) ? State Surcharge .50 TOTAL 40"S--b SITE ADDRESS- -7 d? (a/ OWNER NAME: 2)1?z"7;v INSTALLER STREET ADDRESS: -?-? ?-- --J- CITY: ?C/Gl Chi S' PHONE #: 4S4S `ve PHONE M 4Z-77? /4 ZIP: Use BLUE or BLACK Ink 1 For Office Use City of Eap I Permit I I Permit Fee: 0° 3830 Pilot Knob Road I I Eagan MN 55122 j Date Received: j Phone: (651) 675-5675 I ~J (a Fax: (651) 675-5694 1 Staff: 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 2,2_ tO Site Address: ps ~'4 n' &1~ " Tenant: Suite RESIDENT / OWNER Name: cbj~- 1 / Phone: (_O.- (-V) S' 9 Address / City / Zip: \Z 1 Wv (Cf l e..~ Applicant is: Owner Contractor TYPE OF WORK Description of work: Gh~ e~c-f-.R S Construction Cost: Multi-Family Building: (Yes / No CONTRACTOR Name: Q; a- t ~),~~-_0kS t- _L License#: Address: -on City: uc. M !t State: W Zip: ZZ Phone: - 8- Contact: Email K- Lt7vtilY4C~C!? ( L~C 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: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be 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.gopherstateonecall.org 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: x :jk~_ Applicant's Printed Name Applicant's Signature Page 1 of 2