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785 Diffley RdCITY O$ EAGAN 3793 Pilot Knob Road Eagan, MN 55122 PHONE: 434-8100 BUILDING PERMIT APPLICATION Site Address ' "' u ..'Y .was. ?. Lot Block Sec/Sub. Parcel # 10 02400 010 055 W Name Robert Fawcett w Z Address nen cnnl o Name Star Contractors g Address 6960 McUson Ave W Go lcbn Va ey o e 542-1100 city ph W Name z r _? Address I hereby acknowledge that 1 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 Permittee Receipt # N" 6592 IV I/ ia Erect ? Occupancy --- -- -- Alter ? Zoning Repair ? Fire Zone N Enlarge M Type of Const. Move ? # Stories Demolish ? Front 22 ft. Grade ? Depth 20 ft. Approvals Pees Assessment _ Water & Sew. Police Fire Eng. Planner - Council Bldg. Off. _ APC Permit ltf. UU Surcharge 2.50 Plan check SAC Water Conn. Water Meter Road Unit Total 20.50 . A Building Permit is issued to: Star Contractors on the express condition that all work shall be done in accordanrg wit all a? 61 o f Minneso?a Statutes and City of Eagan Ordinances. Building Official o EAGAN TOWNSHIP N° 1652 BUILDING PERMIT Owner ----------------/p-?----- Addxess (present) / c ...... ? (e G S i !` i .... 9 ------------------------------ ........ ------- Builder ------- 52.-rte1 ..--... ?sit- Z:! ?:?: ....._........_.... Address ...... DESCRIPTION Eagan Township Town Hall Date'cl" ft -/.. j..Z.`4'7..... .. Stories - To Be Used For Front Depth Height Est. Cost Permit Fee Remarks or LOCATION Acme-<-r! Y? 3.30 / '7 S? .S G???°la.`' rj4? This permit does not authorize the use of streets, roads, alleys or sidewalks nor does if 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 B>EP N THE REMISE WHILE THE WORK IS IN PROGRESS. This is to certify, , ----------- p .-- la- --Ll- ................................--°--------has permission to erect a...??-° - -.F°..----•°........?. ............. upon the above described premise sub act to the provisions of the Building Ordinance for E n Township adWted April 11, 1955. / ................--°--- - -°---. h. .. .. - . ,(. `:ri =-'-``-'-----...---....... Per .--`----... LL?zr ---...--------.. Catrn,of Town B jird Building Inspector a , 11 CITY OF EAGAN Include 2 sets of plans, ?C 1 site plan w/elevations & BUILDING PERMIT APPLICATION 1 set of energy calculations. To Be Used For C aNra' i 9-- valuation i5*, Oa'a Date 4" i"g f Site Address: 78s u. Lot Block Sec./Sub. Parcel #: /C o q-#00 0/0 (n 5-6- owner: Vv610-ex t F?Cl1+,! C2? ? Address: CGU - ? City/Zip Code: Ev _a m Phone #: ? SA - L A') t Contractor: ' { U?r 1 P?1"St Ll JZ ;- Address: bi 5 vt-W City/Zip code: GrOU 1,9`4 55¢7 Phone #: S'U- hoy Arch./Eng.. Address: OFFICE USE ONLY Erect Occupancy Alter Zoning rQ ?3 'T Repair Fire Zone &A Enlarge Type of Const. Move # Stories Demolish Front ft. Grade _ Depth *Zo ft. APPROVALS FEES Assessments Permit /a aC Water/Sewer Surcharge a -- Police Plan Check Fire SAC Eng. Water Conn. Planner. Water Meter Council Road Unit Bldg. Off. APC City/Zip Code: Phone #: TOTAL " ocD .-q-U CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 RKCKIV 6D FROM AMOUNT $ 0 ~OZg6t) - 6/0 5 j -ac -DOLLARS goo ? CASH ? CHECK FOR BY White-Payers Copy Yellow-Posting Copy Pink-File Copy Thank You CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 PHONE: 454-8100 Site Ad//dress Lot Block ?- Sec/Sub. 5S C -? Parcel # a Name .+ u R - W Z Address G Phone Name A Address ~ C1 Phone Name W W F W An Address 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. Erect ? Alter ? Repair ? Enlarge ? Move ? Demolish ? N2 6592 Occupancy Zoning Fire Zone Type of Const. # Stories Front ft. Death ft. Assessment Water & Sew. Police Fire Eng. Planner Council Bldg. Off. APC Permit Surcharge Plan check SAC Water Conn. Water Meter Road Unit Total Signature of Permittee I A Building Permit is issued to: ` on the express condition that all work shall be done In accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official BUILDING PERMIT Receipt # Penh # pate I Mw Perslttee Plumbing Mechanical INSPECTIONS I DATE INSP. or Rough-In Final Footings _ Date Insp. Date Insp.- -Foundation Plumbing Frame/ins. Mechanical Final Remarks: Receipt ,6 l PLUMBING PERMIT CITY OF EAGAN Fill in numbered spaces Type or Print legibly Permit No. Fee ::s c+o S/C 'Sb Tot. S Sh 1. Date 5' -F'. -9-?3, 2. Installation Cost 3. Job Address 7I F5 Cc,/Q 3.0 Lot I C Blk. SS TraclgL(2 jc?) 4. Owner keld"-T T rtU.xET7' 5. Contractor AIX)?EC,.&e"I. Phone 95 2 6. Address 3(e-e- - /C Eli - BBC 7. City >?11.Ati State d yi) Zip 5 2 8. Building Type: Residential 14 Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ® Repair ? 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cess ool/Drainfield Bath tubs p Septic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray J [ T L7 T Floor Drains , si uPaJ - ??? - 2 1 i?L?.u/ 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: rlr`_ - for Rough Final Inspections: Date Insp. Date S''$$3 Insp. This is your permit when numbered and approved. Approved , CITY OF EAGAN 454-8100 CITY OF EAGAN 3795 Pilot Knob Road Eagan, Minnesota 55122 Phone: 454-8100 Water Softener PERMIT 10/16/79 Date: Site Address: 785 County Rd. 30, Lot - Block 3 --% Sub/Sec. Name 1"Obert Fawcett Address T5 Co. Rd. 30 City =a1 Phone: No. 297 Receipt No.: 16296 Single I Residential Multi Res., Comm./Ind. I New/Alter./Repair. Cost of Installation 5.00 Permit Fee lbert Co. (CSW) .50 ` Name Surcharge Address 7 001 Marie Ave. C V - :.o. r . rn.ul City ? Phone: Total This Permit is issued on the express condition that oil work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official CITY OF EAGAN S. _ Addition Section 24 Lot Blk Parcel 10 02400 010 55, owner RD RAP-f Y ?Art?e %L e_ ?Akx °gtreet 785 Co. Rd. 30 State EagangMN 55123 --3 -j3 -; Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK SEWER LATERAL WATERMAIN ? 1984 4950.00 330.00 15 WATER LATERAL WATER AREA ({ 1 252-07 is Stub gy `? 1984 456.45 30.43 15 STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 450.00 37550 7-28-83 BUILDING PER. SAC PARK :ITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road ": , 3. O. Box 21199 PERMIT NO.: Tc; T7, -T :agan, MN 55121 DATE: toning: No. of Units: Address: No.: Connection Charge: Account Deposit: _ r No.: Permit Fee: e b Camay with ow City of [age* Surcharge: 18eee. Misc. Charges: - Total: Date Paid: of Insp.: Insp.: 7RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN .? 3830 PILOT KNOB RD, EAGAN MN 55922 659-689-4675 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.) • 1 set of Energy Calculations • 3 copies of Tree Preservatbn Plan if lot platted after 711193 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE ?Q 04 b -L SITE ADC TYPE OF APPLICANT STREETADDRESS 66/ UVWt( atjLt KE TELEPHONE #f09-45L J/45'-CELL PHONE # PROPERTY ULTI-FAMILY BLDG _Y kN FIREPLACE(S)- _ 0 _ I _ 2 =na ATE -EMI PZ? 1. FAX #(QL-V-g9G TELEPHONE # - t ,l Z l COMPLETE TH15 SECTION FOR KNEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MINNESOTA RULES 7672 (J 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. *0 Signature of Applicant OFFICE USE ONLY Water Softener Water Heater No. of Baths _ Phone # Lawn Sprinkler No. of R.I. Baths RemodellReoair Reauiremerds • 2 copies of plan • 1 set of Energy Calculations for heated additions • 1 site survey for exterior additions & decks • Indicate if home served by septic system for additions VALUATION hRL - Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 Y9015i) RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 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.) 1 set of Energy Calculations • 3 copies of Tres Preservation Plan if lot platted after 7/W3 Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE JOB SITE If-- 0? IF MULTI-FAMILY BUILDING, PROPERTY OWNER, TYPE OF WORK-9 APPLICANT ADDRESS 4? 4 /n? u kt PAGER # UNITS? CELL PHONE # FIREPLACE(S) _ 0 -1 -2 PHON E# ZIP CODE S5_0 _FAX#651-7?3_QOh 0 NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMP Energy Code Category _ MINNESOTA RULES 7670 CATEGORY t (check one) - Residential Ventilation Category 1 Worksheet Sul: - 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 FCC: $70.00 All above information must be submitted prior to processing of application. 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 EagaOrd' es. SlgnatureofAppltcant `iIUN Certificates of Survey Received _ Tree Preservation Plan RecelelveVd! _ Not Required Updated 2002 _ MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Phone #: Water Softener _ Lawn Sprinkler Water Heater No. of R.I. Baths No. of Baths RemedelfRegair Requirements 2 copies of plan 1 set of Energy Calculations for heated additions 1 site survey for exterior additions & decks Indicate if home served by septic system for additions VALUATION DO r??,a5 10:29 FEB 22, 2000 L-?. I o Q1.55 1011 ?1 L\ Municipal Notice of Well Permit Application Dakota County Environmental Management Department Water and Land Management Section 14955 0alaxie Avenue West Apple Valley, MN 55124 Tel (612) 891-7011 Fax (612) 891-7031 DATE: February 22, 2000 TO: Tom Colbert/Wayne Schwanz Fax #: (651) 681-4612 FROM: Water and Land Management RE: Well Permit #: 00-H163740 Municipality: Eagan 9114/`9 rrwt 1/1 ??OUCWell Type: Sealed Environmental Specialist: Luehrsi The Water and Land Management Section of the Dakota County Environmental Management Department has received the following permit application for the well described. If you require further review of the application or if you have any questions or concerns about it, contact the Environmental Specialist listed above or our office at (612) 891-7011. If there is no response from your office within 24 HOURS (excluding weekends and holidays), we will assume that you have no objections to the issuance of the permit. Please note that permit issuance is always conditioned on the permit applicant's observance of and compliance with all applicable state, county, and municipal laws and codes. Well Contractor: E.H. Renner & Sons bate application received: February 17, 2000 Anticipated Drilling Date: Time: Anticipated Grouting Date: Time: Property Owner: Rachell R Fawcette Well Owner: Rachell R Fawcette WELL LOCATION: PLS Coordinates: 1/4, sw 1/4, sw 1/4, sw 1/4, Sec 24, Town 027, Range 23 Street address: 785 Diffley Rd PIN Number: 10-02400-010-55 WELL INFORMATION: Diameter: 4 Casing depth: Total depth: 160 Static Water Level: Aquifer: COMMENTS: _> CITY OF EAGAN ,TEL=6516814612 02/22'00 11:26 p o f P/a n, West 3301 Of Skl of Sw%? W Sectia'r,. 24, % wp, 27.? L /b - o,Z ?oQ - O/O- Sam/ J 330 ` S CE] PYoyosed But Idi-ng (douse b? C 660 ?f,eo?-s 1 5 74 01& 3 FORM 204 NvailabM M1Om' Ees ?wc. l0wn d. mess 01470 City of Eagan 3795 Pilot Knob Road Eagan, M 55122 Date: August 22, 1979 Dakota County Abstract Co. 1250 Highway 455 SPECIAL ASSESSMENT SEARCH Hastings, NIN. 55033 RE: Section 24-27-23 The west 330 ft. of sh ATTN: MRY 795 County Road 30, Eagan, NN. 55123 Enclosed herein is the search which you requested made0on0tthelabove described property: Kin o Improvement Runs Beginning Original Ar..ount Balance Due NONE I further certify that according to the records of said office, the following improvements are contemplated or pending after having been approved, and are now in the process of planning or completion. Kin o Improvement Approximate date o Completion Approximate Cost NONE WAIVER: Neither the City of Eagan nor its employees guarantees the accuracy of the above information which was requested by the person or persons indicated. Nor does the City of its employees assume any liability for the correctness thereof. In consideration for the supplying of the indicated information in the above form, and for all other consideration of any nature whatsoever, any claim against the City of its employees rising there from is hereby expressly waived. Levied assessments to be paid to the County Auditor at Hastings, Minnesota 55033. very truly yours, SPECIAL ASSESSMENT DEPARTMENT W1. DAKOTA COUNTY ABSTRACT CO. 1250 Highway 55 HASTINGS, MINNESOTA 55033 437-5500 Please send me a Pe Assessment Search on the following 0 24-2 -2 The West 330 feet of Sy SW-41 785 Court Road 30, Eag ro-off /cb - 'V ,t of 10, Block 4, Cedar Grove No.6 1 639 Gold Trail, Eagan Enclosed please find a check_ for $$10.00 to cover costs. a Thank You Mary city of eagan Date: April 2, 1993 Requested Sy: Ron Helmer Special Assessment Search Re: Section 24 - 10 02400 010 55'71 THOMAS EGAN Mayor PATRICIA AWADA SHAWN HUNTER SANDRA A. MASIN THEODORE WACHTER Council Members THOMAS HEDGES City Adminins1ratof EUGENE VAN OVERBEKE City Clerk On the attached form is the City's response to your search request on the identified property. The information includes the. original amount of the assessments and the payoff amounts of the assessments on the parcel. In addition, pending assessments are included for improvement projects that have been ordered to be installed by the City Council as they may affect this parcel. The levied and pending assessments may or may not reflect the complete assessment obligation based upon the parcel's current use or zoning. Certain parcels have not been assessed at the appropriate rate per their zoning/use. The City's policy is to review the assessment obligation of parcels at platting, replat- ting, rezoning, waiver of platting, and prior to the issuance of conditional and special use permits and certain building permits and in other unique situations. A condition of approval requires the parcel to assume its additional assessment obligations that have not previously been levied for existing public improvements. The City's Engineering Division can provide further clarification of this policy, if you desire. WAIVER/DISCLAIMER: Neither the City of Eagan nor its employees guarantees the accuracy or completeness of the information provided which was required by the person or persons indicated. Nor does the City or its employees assume any liability for the correctness thereof. In consideration of receiving and using information on the attached form and for all other consideration of any nature whatsoever, any claim against the City or its employees rising therefrom is hereby expressly denied. Pending assessments cannot be paid until levied. Levied assessments can be paid to the CITY OF EAGAN. truly yours, MUNICIPSRBCMAL ASSESSMENTS THE LONE OAK TREE. MAINTENANCE FACILITY 3830 PILOT KNOB ROAD 3501 COACHMAN POINT EAGAN. MIN,E7?OTA g.122-18t7 THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY EAGAN. MINNESOTA 55122 PHONE: (61, WB3a6OenPHONE: (612) 681-4300 FAX: (612) 691-4612 Equal Opportunity/Affirmative Action Employer FAX: (612) 681-4360 IDD: (612) 454-8535 TDD: (612) 4548535 SPECIAL ASSESSMENT SEARCH SUMMARY AS OF: 04/02/1993 PROPERTY ID: 10-02400-010-55 S/A# ASSESSMENT DESCRIPT. YEAR TM RATE 100846 WATER AREA 1983 15 10.5000 100847 WATERMAIN 1983 15 10.5000 100848 W-STUBS 1983 15 10.5000 102114 SSTK 581 1990 10 8.0000 1OP607 DIFFLEY RD ST & UTIL 0000 01 0.0000 ------ SUMMARY OF LEVIED ****** 1993 P&I CERTIFIED ------ SUMMARY OF DEFERRED ------ SUMMARY OF PENDING ------ SUMMARY OF CLOSED TOTAL ANN.PRIN. PAYOFF CD 3781.00 252.06 1260.40 4950.00 330.00 1650.00 456.45 30.43 152.15 4620.00 462.00 3234.00 7557.00 0.00 PN 13807.45 1074.49 6296.55 1756.04 0.00 0.00 0.00 7557.00 0.00 0.00 0.00 Press ENTER; or F1, F4, F5, F7, F8 city of alagan THOMAS EGAN Moyor PATRICIA AWADA SHAWN HUNTER SANDRA A. MASIN THEODORE WACHTER Comeff Members Special Assessment Search THOMAS HEDGES //!f City Adminlslraror Date: L E. J. VAN OVERBEKE City Clerk Requested By: Re:.? a On the reverse side or attached form is the City's response to your search request on the identified property. The information includes the original amount of the assessments and the payoff amounts of the assessments on the parcel. In addition, pending assessments are included for improvement projects that have been ordered to be installed by the City Council as they may affect this parcel. The levied and pending assessments may or may not reflect the complete assessment obligation based upon the parcel's current use or zoning. Certain parcels have not been assessed at the appropriate rate per their zoning/use. The City's policy is to review the assessment obligation of parcels at platting, replatting, rezoning, waiver of platting, and prior to the issuance of conditional and special use permits and certain building permits and in other unique situations. A condition of approval requires the parcel to assume its additional assessment obligations that have not previously been levied for existing public improvements. The City's Engineering Division can provide further clarification of this policy, if you desire. VANER/D BIKER: Neither the City of Eagan nor its employees guarantees the accuracy or completeness of the information provided which was required by the person or persons indicated. Nor does the City or its employees assume any liability for the correctness thereof. In consideration of receiving and using information on the attached form and for all other consideration of any nature whatsoever, any claim against the City or its employees rising therefrom is hereby expressly denied. Pending assessments cannot be paid until levied. Levied assessments can be paid to the CITY OF EAGAN. Very truly yours, ^\Ck Gti SPECIAL MUNICIPAL CENTER 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122.1897 PHONE: (612) 681.4600 FAX (612) 681-4612 TDD:(612) 454.8535 THE LONE OAK TREE THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY Equal Opportunity/Attlrmatlve Acton Employer MAINTENANCE FACIUTY 3501 COACHMAN POINT EAGAN. MINNESOTA 55122 PHONE: (612) 681.4300 FAX: (612) 681.4360 TDD:(612) 454.8535 SPECIAL ASSESSMENT SEARCH SUMMARY AS OF: 04/17/1996 PROPERTY ID: 10-02400-010-55 S/A# ASSESSMENT DESCRIPT. YEAR TM RATE TOTAL ANN.PRIN. PAYOFF CD 100846 WATER AREA 1983 15 10.5000 3781.00 252.06 504.22 100847 WATERMAIN 1983 15 10.5000 4950.00 330.00 660.00 100848 W-STUBS 1983 15 10.5000 456.45 30.43 60.86 102114 SSTK 581 1990 10 8.0000 4620.00 462.00 1848.00 102561 ST 607 1994 15 6.5000 7551.96 503.46 6545.04 SSTK LARGE LOT CREDIT 0000 00 0.0000 0.00 0.00 PN ------ SUMMARY OF LEVIED 21359.41 1577.95 9618.12 ****** 1996 P&I CERTIFIED 2413.86 ------ SUMMARY OF DEFERRED 0.00 ------ SUMMARY OF CLOSED 0.00 ------ PENDING ESTIMATE 0.00 Press ENTER; or F1, F4, F5, F7, F8 Main Prev 2 72 Next Go To Exit Menu Page CN Page Legend 13:11 CAPS * Use BLUE or BLACK Ink For Office Use I Permit#: ii-- J City of Ea a ~ n I Permit Fee: lf. Q' 1 3830 Pilot Knob Road i 1 ~3 I Eagan MN 55122 I Date Received: Phone: (651) 675-5675 I I Staff: Fax: (651) 675-5694 I `2013 RESIDENTIAL PLUMBING PERMIT APPLICATION - ~~WV JA4 vm~ , Date: 33 Site Address: Tenant: Suite Resident/Owner Name: Phone: Address / City / Zip: VW V Name: MILBERT COMPANY INC dbn CULLIGAN WATER License 063031-WC Address: 1801 50111 STREET EAST City: INVER GROVE HGTS Contractor State: MN Zip: 55077 Phone: 651-451-2241 Contact: BILL MILBERT Email: Type of Work - New PReplacement _Repair -Rebuild - Modify Space Work in R.O.W. Description of work: RESIDENTIAL Water Heater Lawn Irrigation RPZ / PVB)Jater Softener Permit Type - Septic System Add Plumbing Fixtures L Main Lower Level) New Water Turnaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener (Includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround` (includes $5.00 State Surcharge) *Water Turnaround (add $200.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) TOTAL FEES $ ' CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 prov Ian in the case of work which requires a review and approval of plans. x x~~/ Applicant's Printed N me Applicant's Signature FOR OFFICE USE Reviewed By Date: Required Inspections: Under Ground Rough-In Air Test Gas Test Final 1% C!ty of Eaali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: b`S? Date Received: Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ' Site Address: _ Ori iteditUnit#: Name: RSL 1I1 �.,,JC-C t ' Phone: LSI - 4/s 140402 Resident/ Owner Address/City/Zip: 71 Ot P4'1% Rol • Applicant is: Owner )Contractor Type of Work Description of work: ke S �r�� 1-c !k. he- cd (• t V , Construction Cost:) ),(63'x' Multi -Family Building: (Yes / No Company: J• 8cr.3n— ( Contact: J47 4/16./411 Address: 3.) 3 v Ger k t #N -c- City: 51 tom's A / (� State: 01Zip: 53-11 % Phone: 75) - 3/ 3-99.1'4 License #: yi `/ 0 Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 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: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: NOTE Plans and supporting documents hai .the information maybe classified as noxi' pu r " : cono d emit are considreto be pi `u provide specieficd reasons e -='trade secrets:_ is information. Portions of at,would permit the City to CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x1o. (ar9w�C�� Applic'nt's Printed Name x Apg jtay(t's Signature Page 1 of 3 For Office Use (7( „ t Permit#:EAGAN kN r ISIr 4t. PermitFee: 0 Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TOD:(651)454-8535 I FAX:(651)675-5694 I Staff: buildinginspectionseityofeagan.com 2018 RESIDENTIAL BUILDING PERMIT APPLICATION _ . Date: 9 Site Address: ) ' N,LICA V Unit#: Name: r1-kr 1141'tI Phone: Resident/ : Owner Address/City Zip: _if x ) L - 91(4 1 ()J./n.4 30s2e. 71X 2 " Applicant is: Owner Contractor Type©f Work ° 1— Description of work: Yie,‘ ' 4 1 Construction Cost: Multi-Family Building:(Yes /No ) Company: )'4)J 1411 de/ S Lir)f" ) Contact: Contractor Address'' 1(1)-( Ong, City: VI bo State: Zip: Phone: &C 1 7 ,Email: 5,, License#: Lead Certificate#: 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: TE:Wiens and supporting document;that you submit are considered tole public inforniation. Portions of the information may be l classified as non-.ublic if ou provide specific reasons that would it the Cto conclude that the are trade secrets. j You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.cityofeagan.comisubscribe. 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. 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. w!-•:,.:w o her at-onecall or. 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 approv.1 of plans. x \ SC 11 x Applicant's'Printed Name - Applicant's igna ure For Office Use * ,- , *,' t *,,,, tt„, ,ls ,,,,,* • . Date Received: 3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 (651)675-5675 i TDD:(651)454-85351 FAX:(651)675-5694 Staff: buildinginspectionsPcityofeagan.corn L..... ____; 2018 RESIDENTIAL PLUMBING PERMIT APPLICATION 9- ) i.' Date: , 1' - 4, ClLl Site Address: -737 r) j_c i-t-ti ii.<6 0 ti Tenant: Suite#: Name: il-kt,il Int- ilzrr-6. L (—C.„... Phone: tiOvvner , • , _,) /60 _ .r, t,,,.\r,i ,j.„1c,,,,,, c\., tt_ ,, e 1 ,,, Resider* ., _...,,„,‘ c- , c L T-70 I-- (1 I in (10 Address/City/Zip: ..,. .. Name: ,., , 7-, 4, „I , i i'4°'J -- --L.", -+1 I Joe-1(?,. di/if,. , License#: Contractor „e- , Address; RA-)Z ..). IfY11.-0 , Stiv .t "--.);)1,y _ City: 11Th State: ,) cis 0 Zip: r 2-C>2- Phone: ((--jOS.--Li-., 2. }C7 Contact: , Email: I. c,0-1---; . .. , ...... ....................—.... Type of Work New Replacement Repair Rebuild Modify Space _Work in R.O.W. , Description of work: JC ' ' e 0 micle 1C4/71 „,.... RESIDENTIAL Water Heater _Water Softener Lawn Irrigation( RPZ/ PVB) Permit Type . i , ,,,,,- , Add Plumbing Fixtures( Main/*Lower Level) .k., Septic System New Water Turnaround (7/Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation(includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge) *Water Turnaround(add$280.00 if a 3/4"meter is required) , ,--,,( $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES $ --1 L CALL BEFORE YOU OlO. 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,Qopherstatelonecalorg You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www;cityofeacian.cornisubscribe. 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 forapermit, andworkof ork 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 reviewandapproval plans. 2/ 3,,... , 4 ) 7 LI L.,2t\ +,-- e 1 1..." - 1 1 ,,J- x -,a eA; 0 1 ,.-Irmi Applicant's Prjated Name Applicant's gighature FOR OFFICE USE Reviewed y: Date: Required Inspections: Under Ground Rough-In Air Test Gas Test ,Final Meter Related items: Meter Size Radio Read___ Manometer Staff: