3133 Dodd RdThis request yoid 5 f /17 C.f?a^ o/Q A-1
18 months front
-y- of
>ed Electrical Contractor
Owner
nspecU
? No
g3a?
S7, co 0
Now ? Will Notify, Inspe,
mx When Ready
1 hereby request inspection o1 above
electrical work installed at
Street Address, Sax oute o. ?? C- Ci
r
action o. T ashlp Name or o. Rmlge No. t?
V Co my
Occupy t ftINT
a Phunc No.
Power Suppl r Address
S,
Electri Contr t IComVa N el Contractor's License No.
rQ
clingAdd ass Con or caner Making Instailationl
17 r
/ /
Au[ed ie/ta lure C trector? i ng Installation)
ner Ma^ Phone Number
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r,
MINNESOTA STATE BOARD OF ELE RICITY
Griggs-Midway Bldg. - Room N•191
1821 University Ave.. SL Pont. MN 55104
Ph... 16121 297-2111
THIS INSPECTION REQUEST WILL NOT
BE ACCEPTED BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
ENCLOSED.
qqq ((p???f REQUEST FOR ELECTRICAL INSPECTION
hyry 15 8 6 20 See instructions for complet this form on back of yellow.copy.
>K'""Below Wo:ik covered by This Reques
X,« ES-00001-03
3-2'
New Add Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lighting Fixtures
Apt. Building Dryer Electric Heatin
Commercial Bldg. Furna e i Silo Unloader
Industrial Bldg. A andi M er B Ik Milk Tank
Farm then SP Other (8cecltVl
t her Sucnty Ot r Other
Compute Inspection fee Below
k Fee,. Service Entrr nice S ixe p Fee eders/Subfeeders # Fee-._ Circuits
I I U 15 lMML toM0MArnb3 1 1 1 31 to 1 D0 AmDS 1 I 131 to I J0 Amu, I
algns apeaal inspection 42 1 Remark^ S TOTAL F E [Jj,
Rough-i Date
I, [he Electrical
Inspector, hereby
certify that the abov
Final
Date q y
/? e
-pection has heen
- ?? made. '
This reouest void -.?-
18 months from _ -?s,-
CITY OF EAGAN Remarks
Addition Lot Blk Parcel l u U I LUU 1 1 ) ;11 (
Owner Street State_ EAGAN MN 55221
Improvement Date Amount Annual Y rs Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 197o 0.00 21.60 2
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA 1977. 10 431.67 1
STORM SEW T R K 1 22,329,00 1488-60 15
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
:
SINGLE FAMILY DWELLINGS
"IS OF PLANS
..-,ISTERED SITE SURVEYS
.)WT Of ENERGY CALCS.
1989 BUILDING PERMIT APPLICATION
CITY OF E?GAN
MULTIPLE DWELLINGS
2 SETS OF PLANS
REGISTERED SITE SURVEYS -
(CBECH WITH BLDG DIV.)
1 SET OF ENERGY CALCS.
COMMERCIAL
2 SETS OF ARCHITECTURAL
& STRUCTURAL PLANS
1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCS.
MULTIPLE DWELLINGS RENTAL UNITS FOE SALE UNITS / OF UNITS
ROTEt ADDRESSES FOR CORNER LOTS - CONTR?CTOR/HOMEOWNER MOST DESIGNATE WHICB ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT 13 ISSUED..
SEWER A WATER PERMIT FEES AND ACCOUNT DEPOSIT FEES WILL BE INCLUDED WITS THE BUILDING
PERMIT FEE. PROCESSING TIME FOR SEWER AND WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS
BEEN COMPLETED INDICATING A LICENSED PLUMBER.
PENALTY APPLIES WHEN: PERMIT IS NOT PAID FOR IN SAME MONTH IT IS REQUESTED.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
DEMO LI TloN R--R h (T- - [HousC 6ARAG6
To Be Used For: 1??p0??`Ska.? //Valuation: -'? Date:
Site Address 3 / 3 o Dadd Fd. OFFICE USE ONLY
Block Z 7 S 1:c?M 1-L
Parcel/Sub 0I7-r7n -Olt>, 21
Owner ?Qi`?! K?¢ L , Si C L
Address dOa.cff ?r J ?i (?G•
City/Zip Code
Phone 9e5-8LI33
.tractor
address
City/Zip Code SS / G
7 APPROVALS
Phone Z 2 Planner
Council
Arch./Engr. Bldg. Off.
Variance
Address
City/Zip Code
Phone 0
Occupancy
Zoning
Actual Const
Allowable
1 of stories
Length
Depth
S.F. Total
Footprint S.F.
On site sewage
On site well _
MWCC System
City water
PRV required _
Booster Pump
FEES
Bldg. Permit 155,
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn
Water Meter
Acet. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Copies 5a
SUBTOTAL
Penalty
TOTALS=
q
M
M
Ho A
6,g2ac?E
56,
ORDINA AAM :NO. 1147
WELL CONSTRUC7ION AND ABANDONMMNT Fe-ME No,
WELL PERMIT
899069
`.? DAKOTA COUNTY PUBLIC HEALTH DEFAZn 7i T
ENVIRONME`iTAL HEALTH SERVICES SECTION
J*z
WATER QUALITYM&NAGEWENT UNIT
.u E Wentworth Ave, West SL PIUL Mt 5SUS
Telephone: (6L)450-2607
WHEREAS
PERMITTEE:
DBA: Keys Well Drilling Company
ADDRESS: 413 N. Lexington Parkway
St. Paul, MN 55104
has submitted a permit application, has paid the sum of seventy
five ($75.00) dollars to the County of Dakota as required b
ordinance Number 114 and has complied with all of th
requirements of ,• said ordinance necessary for obtaining thi
permit to permanently seal the well or wells described herein:
An abandoned private water supply well, shall be cleaned c
equipment and debris, disinfected, neat cement pressure groute
and terminated at least two feet below grade. The well has
casing diameter of 2 inches and an approximate depth of 80 feet.
and located in the municipality of Eagan on the property
Owner: Mike Sill-CEO Roadway
Address: 3133 Dodd Road
Eagan, MN
Telephone: 631-8944
Well Owner (if different)
Address: Sec. 12,T27N, R23W
Telephone:
NOW, THEREFORE, Keys Well Drilling Company is, hereby permitte
and authorized to permanently seal the well or wells describe
and located above for the period August 1989 to August 199
subject to all provisions of said ordinance, the Minnesota Ovate
Well Construction Code and any conditions attached on the revers
side of this permit form.
Given under my hand this 21st day of August, 1989.
NON-TRANSFERABLE \-_?,( UL'LV_4 _
ENVIRONMENTAL HEALTH SPECIALIST
KCB'---.. v2c ?Gv' ATTEST %A?ir , . , ''' ..?., ,,j•i
ENVIRONMENTAL I(EALTH SUPERVISOR PUBLIC HEALTH DIRECTOR