4175 Dodd RdReceipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN
Fee
Fill in numbered spaces S/C
Type or Print legibly Tot.
1. Date - 2. Installation Cost
3. Job Address ' Lot Blk. Tract_
4. Owner 'Iel Anderson
5. Contractor C'entraire, Ii c Phone !41--104 ,
6. Address 1.3025 Pioneer Trail
7. City State Zip
8. Building Type: Residential ? Commercial ? Institutional ?
9. Work Description: New ? Add ? Alter ? Repair ?
to '-a:s furnac.? - •i ?
10. Describe lr:nx uri: lc:u Fuel Type
11.
No. Equipment BTU - M. Ea.
Forced Air „rr No. Equipment CFM
Ai
Handli
:
Mfg. r
ng
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. 1 hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed: for
Rough Fi I -?
Inspections: Date Insp. Date ; 1 Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Receipt
i
PLUMBING PERMIT
CITY OF EAGAN
Fill in numbered spaces
Type or Print legibly
:'arm it
Fee
S/C
Tot.
1. Date - 2. Installation Cost l
3. Job Address 11ot Blk. ' Tract !- `f
4. Owner
5. Contractor Phone
6. Address
7. City State Zip '
8. Building Type: Residential 0 Commercial ? Institutional ?
9. Work Description: New ? Add ?
10. Describe
11.
Alter ? Repair ?
No. Fixtures
Water Closet No. Fixtures
Cess
ool/Drainfield
Bath tubs p
Septic Tank
Lavatory ftner
S
Shower 1 o
Well
Kitchen Sink
Urinal/Bidet Oth
Laundry Tray er
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. 1 hereby certify that the above information is true and correct, and 1 agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
CITY OF EAGAN PERMIT TYPE: ,??
r . u 1 ?
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 = Date Issued: 06 1 r v
(612) 681-4675
SITE ADDRESS: Ill ]'Q
11000 fir)
( fit r 1 14) H 14
PERMIT SUBTYPE:
L F-
APPLICANT:
2 ftt rrt:Y?, !:,:.
i. i ?cr?l I fJ?,
(6 1 t ) 451-?i?:3y3
TYPE OF WORK:
of '.i 1. 11 r i fIN
At H RAT i nN
kf Vfl(' -
Permit Holder Date Telephone it
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
CITY OF EAGAN
Addition _Spy-don 24 Lot Rlk Parcel 10 02400 020 58
Owner- Street 4175 ?oda Rd. State Eagan MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA 1984 995.00 66.33 15 b-()
/
.? - -
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
SA fj
?o6 ? V47
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EAGAN TOWNSHIP
UILDING PERMIT
Owner ..:/..
Address (pre
Builder ........
Address ......
DESCRIPTION
N° 244
Eagan Township
Town Hall
Date //e.
5-, Al Dao - sr
Stories To Be Used For Front Depth Heigh! Est. Cos! -Permit Fee Remarks
A4] lja,4e?l _
%- XA LOCATION // T A
110-
5r
This permit d/ J riot authorize the use of streets, 'roads, alleys or sidewalks nor does ive )" ner or his agent
the right to cr to any situation which is a n ante or which presents a hazard to the !h, safe! convenience and
general welfare to anyone in the community.
THIS PERMIT MUST BE T ON,?' FIE ISE WHILE THE WORK IS IN PROGR t
This is to certify, !ha!_.-...4.:-:T!'......-..---....has permission to erect a ..... .. ......--.--.--- ..--.-.----.---------------upon
the above described mfse sub-ec ovisions of the Building Ordinance for Eagan Tow adopted April 11.
1955. ,--... - - -E?
------------- --- -.._ Per ...... _....... .... ......... .----...----'---- ildi - .... .
Chairman of Town Bung Inspector
?Z `/ b ;20 - 5-?
EAGA N TOWNSHIP
UILDING PERMIT
Owner
Address
Builder ._4.._.?
Address -----``----°
N? 366
Eagan Township
Town Hall
Dale 'f/.._:...-- -1...._..
Stories To Be Used For Front Depth He
i
gh! Est.
Cost Permit Fee Remarks
ei
? /
?r /
LOCATION / 1
Street. Roa% o other Description of Location Lo! Block Addition or Trfict
Thu 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 com unity.
THIS PERMIT MUST BE //EPT N T PR SE WHILE THE WORK IS IN PROG S.
This is to certify, that ..P._ ... ...... -.1 .... ................. has permission to erect a__-LLf r :FAG. ....._.__._....__...._....upon
the above dese ' prem' o the revisions of the Building Ordinance for Eagan Tow fp adopted April 11,
1955
---'-......-- - -.....c ' -?.r. ---------- Per
Chairman of 0 oard Building Inspector
411?citV of eagan
PArr.K;Lk E AWADA July 5. 3002
mlay„r
MR DARREUS WILSON
PAUL BAKKEN 4175 DODD ROAD
PEGGY GYRLSON EAGAN bIN 55123
CYNDEE FIELDS RE: 4175 Dodd Road
NIEGTILLEY
Council .Members Dear Mr. Wilson: •.
The City has received information that the individual sewage treatment system at the
THOMAS HEDGES aforementioned property has been classified as a failed system as defined by MN Rules, Chapter
7080.0020, Subp. 16b and City Code Section 4.04.
City Adrthinistraror
A failed system occurs when:
I. There is insufficient vertical separation from the bottom of the drain field to the high water
Municipal Center: table or bedrock.
3830 Pilot Knob Road 2' ?, bottomless or leaking septic tank is present
3. There is discharge from a cesspool, drywell, or seepage pit.
Eagan, MN 55122-1897
Phone: 651.681.4600 Failed systems must be repaired, or replaced, within 180 days of this notice. If at any time the
system backs up or discharges above grade, corrective action should be completed within 30
Fax: 651.681.461-' days.
TDD: 65 1.454.8535
Minnesota Pollution Control Agency licensed contractors must complete all repairs or
replacement of Individual Sewage Treatment Systems. The City has a list of septic designers and
Maintenance Facility: installers in Dakota County available for your use. A permit is required before corrective work
3501 Coachman Point on the system begins.
i
Eagan. ;SIN 55122 Your attention to this matter is required to protect the health of your family and the community.
Phone: 651.681.4300 Only a properly designed and operating system can treat the effluent to reduce harmful bacterial
and other contaminants.
Fax: 651.681.4360
TDD: 651.454.3535 ; If you should have any questions, please contact me at 651-681-4676. Thank you for your
cooperation.
www.ciryofeagan.com Sincerely,
THELONEOAKTREE i
1 he Symbol of suengt}h
and gnmdh in our
Mike Lence
Senior Inspector
ML. ld
cc:
mmmnnirv
Date Schoeppner, Chief Building Official
2/25/02 Water/Wastewater-ISTS4.31
Compliance Inspection Form for Existing
Individual Sewage Treatment Systems Minnesota Pollution
Control Agency
Completion of this form fulfills the minimal requirements of Minn. Stat. § 115.55 (2001) and Minnesota R. ch. 7080 (1999). Please refer
to local ordinances for other requirements or information, especially for compliance reauirements for bedroom arldinonn
General:
Date of Inspection: x 42- Reason for inspection: Fi r"u ek-f pur" Y Ale e.Yed
Property Owner(s) ljrreus,j IC f?v !l/i l orr Telephone Lo7Z
Person requesting inspection 0M e_cyiuer5 Telephone ( )
Site Address
L? ' o n. R City Ea?a.1 Zip Code -/2
Fire No./ Parcel No. County V? (<e I<a Township
Legal Description
Local Regulatory AuthorityG;f? d`Eaan
Date system constructed l rI4 80 s ?? System in Shoreland Area: yes no System in Wellhead
Protection Area: yes no System serving a MDH licensed facility: yes QLocal Permit # (if any) ,- e- ?
Systems built prior to April 1, 1996 and not located in
Shoreland or Wellhead Protection Area or Serving a Food,
Beverage or Lodging Establishment Systems located in Shoreland or Wellhead Protection
Areas or Serving a Food, Beverage or Lodging
Establishment, or systems Built after
March 31, 1996
Is the system an Imminent threat to public health or Is the system an imminent threat to public health
safety? (a yes assn er is an 17PHS system) or safety? (a yes answer is an 17PHS system)
- Discharge of sewage In the ground surface? YES t,dQ'7 - Discharge of sewage to the ground surface? YES NO
- Discharge of sewage to draintile or surface waters? YES NO - Discharge of sewage to draintile or surface waters? YES NO
- Sewage backup into dwelling? YES NO - Sewage backup into dwelling? YES NO
- Situation with the potential to immediately and - Situation with the potential to immediately and
adversely impart or threaten public health or adversely Impact or threaten public health or
safety? YES NO safety? YES NO
3s the system failing? (a yes answer is a failing system) Is the system failing? (a yes answeris a failing system)
- Less than TWO feet of vertical separation between - Less than THREE feet of vertical separation between
system bottom and saturated soil or bedrock? NO system bottom and saturated soil or bedrock? YES NO
- A seepage pit, cesspool, drywell, or leaching pit? Q? NO - A seepage pit, cesspool, drywell, or leaching pit? YES NO
Is the system non-compliant? Is the system non-compliant?
- Is the system regulated under a monitoring plan or - Is the system regulated under a monitoring plan or
operating permit? (if no, go to page 2) YES (0 operating permit? (if no, go to page 2) YES NO
If yes, If yes,
- Has the required monitoring taken place? YES NO Has the required monitoring taken place? YES NO
(if no, the system is non-complying) (If no, the system is non-complying)
- Does the monitoring indicate that the system meets Does the monitoring indicate that the system meets
performance expectations? YES NO performance expectations? YES NO
(If no, the system is non-complying) (if no, the system is non-complying)
?9 C H T N
JUN 04 2002 (jj jI Page 1 of 2 wq-wwists4.31
Property Owner(s) 1/<zrre_"5; R- fk.I (ail, f5e? Fire No./ Parcel No.
System Components (Please describe the system components and attach site sketch showing system location):
thGirC i?er ?rr'a ca / /Q?H.r[? Sn*? SnO rTCS /hCG (L(O is Or /?yRK? L/ I1R. PJ I-e?/rJ{?'C?L GQK
L°dKl /V ?roq IXhdr??r' f'onT OT h10/"Y i. 1p??if rOGIC df?d?3 Y'[ AJ•?h p([tc f? IX?(/?
What methods were used to make the determinations for the compliance Inspection? (Note: No standard pmtoco /exlsts.
The following list is not exhaust/ve, or in sequential order nor indicates which combinations may necessary to make a determination)
Watertight tank(s)
X Probed tank bottom
? Observed low liquid level
? Examined cont. records
Examined empty (pumped) tank
Hydraulic Functioning
? Searched for surface outlet
? Performed hydraulic test
? Searched for seeping in yard
? Checked for back-up in home
? Probed outside tank for "black soil" o Excessive ponding in soil system/D-boxes
? Pressure/vacuum check
Other D,, fv op
ki?
? Homeowner testimony
? Examined for surging in tank
"Black soil" above soil system
? Other
Based on the compliance criteria, the system status is, (check or
imminent threat to public health or safety (ITPHS), ? non-compliant (m,
previous conditions). Therefore, this document is a: ? Certificate of
Is this system an EPA Class V Injection Well? ? ves W. no
protect groundwater) ? an
l rnmoliant (none of the 3
Certification
I hereby certify as a state of Minnesota licensed Inspector and/or Designer I or Qualified Employee Inspector and/or Qualified Employee
Designer I that I conducted an Investigation that accurately determined the compliance status of this system and that my recorded
observations are accurate as of this date. No determination of future hydraulic performance has been nor can be made due to
unknown conditions during system construction, abuse of the system, inadequate maintenance, or future water usage.
Inspector's name (print),d V )el tie ?-c ? lid Phone 952- y6c(- O`j
License and/or Registration Number 19117 Address
Employed by eft- SetrUrce or/W _TAc,Address TA93 25011L S_e, 10
altteyrl?leNI/I/??5D4r5/
Signature z?Jle Date
Upgrade Reguirements jderlved from Minnesota Statutes§ 115.55)
An 17PHS must be upgraded, replaced, or its use discontinued within ten months of receipt of this notice or within a shorter period if
required by local ordinance. If the system fails to provide sufficient groundwater protection, then the system must be upgraded,
replaced, or Its use discontinued within the time required by rule or the local ordinance. If an existing system is not failing as defined In
law, and has at least two feet of design soil separation, then the system need not be upgraded, repaired, rep/aced of its use
discontinued notwithstanding any local ordinance that is more strict. This does not apply to systems In shoreland areas, we//head
protection areas, or those used in connection with food, beverage, and lodging establishments as defined in law.
Suggested Attachments
1) Site sketch could also include: well, well setback to system, dwelling or other buildings, tank(s), reserved soil treatment area,
surface water and soil boring locations. Include as-built drawing if available.
2) Soil boring logs, showing each horizon. Indicate the texture, color, redoximorphic features depth to bedrock, standing water and
whether the material is fill.
3) A list of any and all requirements of the local ordinance that are different from the state requirements referred to on this form.
4) A homeowner survey of system performance, signed by the homeowner as being factual.
5) Monitoring data as appropriate.
Page 2 of 2
Vertical Separation Distance
' d Conducted soil boringy
3, {
Depth to limiting ?lay?e°rr ?
Depth to system pottrarn 3.3Ft
? Examined records
? LGU Limiting Layer Verification
? Other
S)r91 /Bust Copt! ?hu? td 6?
Pu'"Pe? be I sztr&c- es or
b7C up ItAv' hous'
Soil Boring Log
Date:
V"C'tt. Borings made by:
Address: Nl7ti l7a R Q Da 1,:a( He--fcX leer
c ty Slate Zip Lic. # ?
Boring method: Auger Pit Probe Other Cnlnr rlaaaifirnfinn evafam, nrtie.
Boring Number R2_' Boring Number
Surface Elevation Surface Elevation
Soil type at system depth: Soil type at system depth:
Depth
Feet Texture Color Depth Texture Color
Feet
mss Sind L.. I0YR
?
,
t , -7 ! o?., - t LeaAt ??41
2 --- 2 ---
L /
a
3-
_ l/
JaHat Cld r! vavr+-
4 4 --'
5_' S
6 --- 6
7 _.- 7 ---
Structure: Blocky Platy Prismatic None Structure: Blocky Platy Prismatic None
Slope: % Slope: %
End of boring at ?}• D feet. End of boring at feet.
Standing water table: yes no Standing water table: yes no
Present at feet of depth, Present at feet of depth,
hours after boring. hours after boring.
Mottled soil:
Observed at
5Lfeet of de
th
3 Mottled soil:
Ob
p
.
--
i-- served at feet of depth.
Not present in boring hole Not present in boring hole
Observations and comments: Observations and comments:
PERMIT # ? `a
RECEIPT DATE:
2002 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF £AGAN
3630 PILOT KNOB RD
EAGAN, KIN 55122
651-661-4675
Please complete for: single family dwellings, townhomes and condos when permits are required for each unit,
backtlow preventer for irrigation system
SITEADDRESS: 2e 13? 4Qa?? X/ / OL;,?
OWNER NAME::6a`'/`tiy5 ? /'11. TELEPHONE#: C51- av-YC'Z
(AREA CODE)
INSTALLER NAME:
STREET ADDRESS:
TELEPHONE#: C.5/- ???02 GjLr
(AREA CODE)
CITY: F-4g<„_ STATE: ZIP:
_ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 1D0.00
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.
/
X Water turnaround - existing dwelling unit (+ 5/8" meter if needed - $118) 1 ,C-) c)
Other:
_ RPZ: new installation/repair/rebuild $ 30.00
lawn irrigation system
Replacement/additional, _ water softener _ water heater $ 15.00
State Surcharge $ .50
Total $
I hereby acknowledge that I have read this application, state thatthe information is correct, and agree to complywith all applicable City of Eagan ordinances. It
is the applicant's responsibility to notify the property owner that the City of Eagan assumes no lia It for any damages caused by the City during its normal
operational and maintenance activities to the facilities constructed under this permit ' Ci a ght- - yleasement.
SIGNATURE OF PERMITTEE 1/02
yi7s Jo D D ?2 l>
city of aagan
Addendum Report for
Dodd Road
(Diffley Road to Wescott Road)
Service Utility Improvements
City Project Nos. 850 & 862
Eagan, Minnesota
September 9, 2002
File No. 49-01-115
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DODD ROAD (DIFFLEY ROAD TO WESCOTT ROAD) ° a tle i k e
s EE AND WlI INPRMUEN - CURB AND GMER ??? s I t
CM CONiPACf N., D1-10, Cf1Y PROJECT No. B50
r
It is felt that at the time of change in the use of land for this parcel, the necessary connections to
the sanitary sewer line in Witham Lane can be made.
Proposed Improvement - Water
Since this parcel already has water service for its current needs met, it is felt that at the time of
land use changes, a connection should be at that time. Water main is available at Witham Lane
and along the entire north property line. Therefore, no additional water improvements for this
property will be done at this time.
Lot 1, Block 11, Hills of Stonebridge, PIN# 10-32990-010-11 Figure Number 49
Existing Conditions - Sanitary Sewer
This parcel currently has 4 sanitary sewer services extended to its south property line as shown in
Figure No. 49.
Existing Conditions - Water
This parcel currently has 4 water services extended to its south property line as shown in Figure
No. 49.
Proposed Improvement - Sanitary Sewer
No improvements are necessary at this time.
Proposed Improvement - Water
No improvements are necessary at this time.
Parcel 020-58, PIN # 10-02400-020-58 Figure Numbers 50,51
Existing Conditions - Sanitary Sewer
This parcel currently does not have access to sanitary sewer. An 8" sewer line exists in Dodd
Road adjacent to this parcel as shown in Figure No 50.
Existing Conditions - SwRitala .r wArTb2
This parcel currently does not have access to a water service. A 12" water main line exists in
Dodd Road adjacent to this parcel as shown in Figure No 50.
Proposed Improvement - Sanitary Sewer
This current owner of this parcel requested individual services for sanitary sewer and water. The
owner did not indicate any want to subdivide in the near future. This lot does have the potential
to subdivide, but would have to be done utilizing a flag lot geometry. This would also likely
require the need to relocate the current house location. Therefore, only the current needs (4"
PVC sewer) for services are proposed to be met as shown in Figure No. 51. At the time of any
lot split request, the necessary connections can be made to a sanitary sewer manhole and water
main available within city right-of-way, outside of the newly constructed street.
Dodd Road Street and Utility Improvements 7
Proposed Improvement - Water
As indicated in the previous paragraph, only the current water needs (1" copper water line). of
this parcel are proposed to be installed as shown in Figure No. 51.
Summary
The following table summarizes each parcels improvement (or lack there of) that is proposed.
Parcel Number Proposed Sewer
Improvement Proposed Water
Improvement
010-02 None 6" DIP shared with Parcel
012-02
012-02 None 6" DIP shared with Parcel
010-02
010-05 None 6" DIP
010-78 8" PVC None
010-52 None None
010-53 None None
Lot 1, Block 11 Hills of
Stonebrid e None None
020-58 4" PVC I" Copper
Dodd Road Street and Utility Improvements
z ?` I
04106 6,??o ,.58
F- 1) To
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pp_
ALL
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---- ,-
o? M}5 1
PROPERTY DATA SYSTEM
OWNER NAME AND ADDRESS INQUIRY :CURB 302
PROPERTY ID Owner Change Date :NEXT
10-02400-020-58 00/00/0000 A;;;;;;;;j2
• OWNER
LAST NAME FIRST M CORP TAXPAY ADDR
: Owner: LABARRE WENDY J N Y Y
: Addrl: 4175 DODD RD Addr2: EAGAN MN 55123
: Addr3: Addr4:
: Owner: BOETTCHER PATRICK D N Y Y
: Addrl: 4175 DODD RD Addr2: EAGAN MN 55123
: Addr3: Addr4:
• Owner: L? S 2 q
- 7 1 S
. Addrl: Addr2:
• Addr3: Addr4:
• Owner:
• Addri: Addr2:
: Addr3: Addr4:
Type PID: press ENTER; or F1, F2, F5, F8
q
3 RD
V
l /
_4
t ILI
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Tnio yell wed drilled under q Jwisdictim And this report ie trw to
the heat of V kawledge And ballet,
Licensee In
Busune.e Nmne
Ltemee No.
Addreae
Sla`ed Date
AutTOrised Repreeentetlve
WORK COPY _ Name of
Drnler - sns aanM
Permit #: 1 It a C C' r Receipt Date:
iq0
CITY OF EAGAN
2002 SEWER AND WATER CONNECTION AND AVAILABILITY CHARGES
EXISTING RESIDENTIAL PROPERTY
075 'Qc.,J4 Q? OFFICE USE ONLY
Address
`1
Property Owner 1Jt. ?r t4S Lot C16t7Aj /r0 PRV required
Telephone# b5/- 6'M-DC O
Plumber I.J?e KZ?/ jtqtc-4ct&L ac I
Date of Inquiry /C)?-
Sewer
Lateral charge @ $23.35/ff
Trunk @ $945/connection
City SAC
MC/ES SAC
Receipt # , Date
Septic abandonment
Permit Fee
State Surcharge
Total
N\ City ?g County R-O-W Permit
Water
Lateral charge @ $23.60/ff
Trunk @ $985/connection
100.00 Water supply & storage
1,200.00 Receipt # ate
Treatment plant
50.00 Permit Fee
50.00 State Surch e
SO Plumbing trequired-water
$
meter tplbe acquired with plbg permit
Sewer and Water
Sewer lateral charge @ $23.35/ff
Water lateral charge @ $2160/ff
Sewer trunk @ $945/connection
Water trunk @ $985/connection
City SAC
MC/ES SAC
Receipt #. Date _
Water supply & storage
Receipt # , Date _
Treatment plant
Septic abandonment
Permit Fee
State Surcharge
Total
Plumbing permit required
water meter to be acquired with plbg permit
ON 100.00
1,200.00!
880.00
540.00'
50.00
100.00/
.50
880.00
540.00
50.00
.50
$
CA 6N)
r/
cc: Carolyn Krech, Finance Department
1-10 _-)-dUu
Lot Block PID# Sewer /water permit #
r-
Plat J? c.A \ O o -c)- 4 Date Receipt #
CITY OF EAGAN
2000 SEWER AND WATER CONNECTION AND AVAILABILITY CHARGES
EXISTING RESIDENTIAL PROPERTY
Sewer
Lateral charge @ $22.30/f
Trunk @ $900/connection
City SAC
Base SAC
Date paid
Receipt #
Account deposit
Septic abandonment
Sewer permit & s ge
Subtotal
Total
Sewer and Water
Water
$ ge @ $22.55/ff
Late $
Tru40/connection
0.00 Watly & storage 840.00
1,100.00 Dd
R
Z
Trealant
492.00
15.00 Wat**Inspecti req'd prior 114.00
30.00 issuing
50.50 Accosi 15.00
$ Wat' surcharge 50.50
Sub $
ge
Plum rmit & surchar
30.50
$
Sewer lateral charge @$22.30/ff7?a(t Zh??r/`d YN° G?„??
ri v ?
Water lateral charge @ $22.55/ff
Sewer trunk @ $900/connection I ,sv 01)
Water trunk @ $940/connection l?a+ r, f G
City SAC t 1 0.00
Base SAC
Date paid Receipt #
Water supply & storage
Date paid Receipt #
Treatment plant
Water meter **Inspections req'd prior to issuing
Account deposit
Septic abandonment
Sewer and water permit & surcharge
Subtotal
Plumbing permit & surcharge
Total
Property owner S 0.-, ? `{ f r ?
Address y 1-1 `: 1 ) a Act 420
Phone number L5 ? - E?,'; --)- - 13 ?4 S
Plumber
1,100.00
840.00
492.00
114.00
30.00
30.00
100.50
$cd-5v
30.50
OFFICE USE ONLY
PRV required:
R-O-W Permit: City Y4 County
Unpaid $
Permit Fees:
City financed:
cc: Carolyn Krech, Finance Department
CITY OF EAGAN
130 Plot Knob Road
gan,'Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
PERMIT
PERMIT TYPE: BUILDING
Permit Number: 0 3 2 2 4 4
Date Issued: 06/12/98
4175 0000 RD
LOT: 2 BLOCK: 58
SECTION 24
P.I.N.: 10-02400-020-58
DESCRIPTION:
REMARKS:
FEE SUMMARY-
Base Fee
Surcharge
Total Fee
SF (MISC.)
ALTERATION
434 ALT. RESIDENTIAL
REROOF
Bu ildi'n'g_Permit Type
Building Work Type
Census Code
E
,t
VALUATION
$87.25
$2.00
$89.25
$4,000
CONTRACTOR: - Applicant - ST. LTC OWNER:
J&B ROOFING 14570391 2006969 BOETTCHER PAT
4175 DODD RD 4175 DODD RD
0 ST PAUL MN 55075 EAGAN MN
612) 457-0391 (612)452-7959
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-
Statutes and City of Eagan Ordinances:
APPLICANT/PERMITEE SIGNATURE ISSUED BY: SI NATURE
998 BUILDING PERMIT APPLICATION (RESIDENTIAL) "l OF EAGAN
3830 PIIOT CITY KNOB RD RD -
7,?gq
3 v . 55122
681-4675
New Construction Requirements
? 3 registered site surveys
• 2 copies of plans (include beam & window saes; poured fnd. design; etc.)
? 1 energy calculations
• 3 copies of tree preservation plan if lot platted after 711/93
required: _Yes _ No q?)
DATE: ? 3 u, P i O
DESCRIPTION OF WORK:
STREET ADDRESS:
Remodel/Repair Requirements
4 2 copies of plan
? 2 site surveys (exterior additions & decks)
? 1 energy calculations for heated additions
CONSTRUCTION COST; 13 RD • W
LOT: BLOCK: 'r) SUBD./P.I.D. #:
Name: 'Ace Amer- PP r Phone #: 4/5J
PROPERTY last 1 ' First
OWNER Street Address:/,/) n -
75 ? X? Zt4 4?1.
City C_Q 000 State: alt) Zip:
Company:, 1.4 A P,69 -(7!4 Phone #: kJ57-6,?2
CONTRACTOR _
Street Address: ?t - 1?5 License # City ,)D . ")?. I Q L't / State: M& I Zip:
ARCHITECT/
ENGINEER
Street Address:
City
Phone #:
Registration #:
State: Zip:
Sewer & water licensed plumber (new construction only): Penalty applies when address Chang
and lot change is requested once permit is issued.
1 hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicabl
State of Minnesota Statutes and City of Eagan Ordinances. /? 77 > ?
Signature of Applicant: z, /
U
OFFICE USE ONLY ^ CV.- U i
Certificates of Survey Received Yes No U
,i)
Tree Preservation Plan Received Yes No Not Required
PERMIT
City of Eagan Permit Type: Mechanical
3830 Pilot Knob Rd Permit Number: EA079312
Eagan, MN 55122 . Date Issued: 08/15/2007
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 4175 Dodd Rd
Lot: 2 Block: 58 Addition: Section 24
PID 10-02400-020-58
Use
Description:
Sub Type: e - Air Conditioner
Work Type: Replacement
Description: Air Conditioner
Comments: Questions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector,
952-445-2840.
Brian Welke
Fee Summary: ME - Permit Fee (Replacements) $50.00 0801.4088
Surcharge-Fixed $0.50 9001.2195
Total: $50.50
Contractor: -Applicant - Owner:
Haley Comfort Systems Darreus Wilson
122 West 3rd St 4175 Dodd Rd
Hastings MN 55033 Eagan MN 55123
(651) 437-0338
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.
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA090367
Eagan, MN 55122 . Date Issued: 07/28/2009
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 4175 Dodd Rd
Lot: 002 Block: 058 Addition: Section 24
PID 10-02400-020-58
Use
Description:
Sub Type: e-Reroof Construction Type:
Work Type: Replace
Description: House & Garage
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary: BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
Valuation: 3,000.00
Total: $90.00
Contractor: -Applicant - Owner:
Royalty Remodelers Darreus Wilson
4411 Slater Rd 4175 Dodd Rd
Eagan MN 55122 Eagan MN 55123
(612) 414-8199
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.
Applicant/Permitee: Signature Issued By: Signature
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675-5675
www.ci.eagan.mn.us
PERMIT
41/'
C!tyofEaQan
Permit Type: Building
Permit Number: EA108547
Date Issued: 12/13/2012
Site Address: 4175 Dodd Rd
Lot: 002 Block: 058 Addition: Section 24
PID: 10-02400-58-020
Use:
Description:
Sub Type: Single Fam Construction Type:
Work Type: Day Care Inspection
Description:
Census Code: Occupancy:
Zoning:
Square Feet: 0
Comments: Jennifer 612-998-1411
Fee Summary:
Day Care Inspection
$50.00 1221.4216
Total: $50.00
Contractor:
Owner:
Darreus Wilson
4175 Dodd Rd
Eagan MN 55123
- Applicant -
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.
Applicant/Permitee: Signature
Issued By: Signature