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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 1,c1 .c 4u, T -T, i--5- )?, d 4,:-'_ /6 , ? oa ?b?u 1 j,qof/?t SST k ?/4j-LS3-T -? (? /Y) ?,4,?J 5 P 1",4 erd:`OL (i I- a're4 ?9j -Tm i `To kl I 9d 0oD n 4 + sue' Py ?0 -vzq-o0 -o2-o-sa I- t -7 4-?7 b 0 i?> D 'i?- (-?) 1 /43. so ? r- 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 9 x av{ uMMF21 w ?6O R°I? C?i15M? AFEE (mCKKN EfMiyf EnSMO OJtNR' 3d41E[l 1° [gSTMe IY 4.V ET 9J0 925 , 920 - - 915 mMC11 q r w.'Ee n io a [ 910: 905 900 S7 ?i r? i; 1 meCY. Ip M ?3' O.i e. r ME?R°FN[PW4 LCGTW P ?aS9M[°REWCxr•44t.MM WI PYCPCryq ?[[I°tdm?ta#RwLL 1.11 MTMR cbfThUCTW MTNT[5 .5 I.T TTt '.I- ITT ^ [ W #l Aril nSVE o w.uRE n W`FPxFO BT ngTRE 10 5 11 ME GTiIRµMT.71IIXS..w 1-r 0IIIIER WI-Ii 1cMl 6 wFR o cwMN1 e9¢ REWI- e[la[ Sr.aR1 rc avE FNS. I ii.- z. oird? 4r(w x15V ? 4[na ?r ?n u. s ? a[. wy-I ?a rn IT DODD ROAD d V311° 3 E y?5( ..__ i.. .. .. !. 930.1 ,,W ['P. ?? _ ?Oll4C, iV [YiPW rS'vt3f.HWn \1 >n ux.:Emm _ 925 LEO61xC GI1W W - ree ' o.us: r" 5m• ..... L.... ._.:_ _.. _.... a. ,. xxv. ?4 R.? 2 T -AL 3 O Lo w cr. LL SEWER k WATfRMAIN I _HERITAGE DEVELOPMENT, INC. I.. STONEBRIDGE PONDS 1- 7 _ .24 < Y R OAD " vl.e i -9J, 4 - i g g e m 9i _: Q EA 932.4 7 4 93T.1i- Rg E ? _ --- NOW -?13R.3 9b. 9]2 St D19. } _933.1 9'FS D9 '. 9KE 93t 1 ? sloe -01% . x _ __ $ _j _ .. fi Y 92x.1 EkR: a ro ? g 93Y:T6 _ - _ ENx92 Je -931] 6YNB KS'. e'R ,e tEAMAN ePANIIE OgIK/ PIK __ WE.22 el _ ? : 9R>.ee g > pI ?; C $ 9159 03 spy , \ 3 ', < is J 4 4v 1 92 0 7156 '.: con" azar $ YI 06 i '. M O D i R 91 D 91M13 1 ?: 9?4 K" ?^2Y 19 914e p CX ? 1 OXFORD ROAD .h J 021 c. I Pr 912.9 F KS 11 R = E 911. 910.6 906A Owl 1 ,g 9p6,0 _ _ _ _ _ ' ? q} 903.9 e ' 8 _ _ e -801"6 ' B5 S I . ' _ BNZ eo&" 0.5] 99 3 _ FS ? 1 -(0?96 ?B g A 1446]3 ;_ 4 4o A 8 N MI,IDRIVE 9 E m.u TT E eM4 6 U u e (P EAGAN, MINNESOTA ?JNPP 1 D --2-07- v - 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 e% A_. pp_ ALL ? r r ---- ,- 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 -- n ??s ? _ ??,,?ti-t,'Df?c?.? C,t, ?•?-G.l?u.,??x?_py;?? ?rr,?dX? .? ?,?^,??;,in ?.. 1.(.t r 1 10 ?c I?ec f STATE OF M[HVESIITA OF HEALTH ffPART1 ?OQ WATER WELL RECORD "vesora uxfpue wecc NO. 9 "u WATER }'pr r+dtex swap Ee LL Minnes WCATIC, GF 1 ota itahrae ZSBA. 02-,08 . Corot) X. ' Prectlm e t Section Xwder Tsrnehlp X?nber Henge Number I. PPGPET'IT xv-5 'AWN l X. nr 3 e. or x. ea.. Anre letsnee and DSrzcGlm (mm pond intenectlms oe Etreae Addreu and Ct[y of Velt L ou[f on 1:1, r tt _ T? +I LG 1 /L_? ZJ ?? LL l?? 1 1 e X ? . r ! J 1 Bpq exact lmetlm of v<11 I. eectiw gr16 vlth %. &Retch map o f ..It location. yyLL DE'FSTq eaeplet<tl Dete mle .7 3 lei W E B I?Cnhle tool IL] Reverie 1Q Grl- 1OF DOg 11oN rod 30 Ai C a-d ISQ 2UN 11 r If m. In Rota, 6F] Jetted 90 Pmee Auger S I(R D-lie AQ Public Supply ]j Industry 2Ej Yrrlgetlon J 50 At, Condltlunl.A fl?COnmerelel 2. PCNNATiGN [OG CGSg 4 IIAP°XF55 D! PoHMATIDX T`NX T° ^ SQ Peet Aell ` - - y ? CA.SIXC ------- TNEIGHT: Ahon YSiem V l N. 11_ ? [-l" ?l DISH. I welaedgl Ewfa- ft Thre.ded ? . 1 1 ` x.? ?<) 9I.ra 1.712 Ge1e. Dp " ( tt, depN V<Ighti.../ft. to !( .. lm. to ?_tt. depth in to I deptp Driw Shcei '..X No , . ., , SCAB - N?e Or open hal< tom tt. to tt. - . "??14V?- _ LCl.ii _?. ;1J C pe il?,.t14: gt 41 4 Me. slnt/cnorc ILA Length ? ' 1 f? I1 14:?? ft, f[I'IlNG51 - Bet between yy_ ft. and z ?t? 7vzl?? I a R t. ari . I r. • _ ft. and f[. 1 u `V G ` Ifr ? I 1 `' I -rx e1?n tt. 5a b<lov- E] above Data Xkeewed W 1\ J ? 1mtl?_wYece I [tt, efter_hn. pvmPlnB I?J 8-0m. rt. ettm _pn. puvping __?g.p.a. ILgPltlens adapter 2LJ Baaement of feet IS At Ideal 12" AYea MA. Cu. YIN. 10neat ceaant 10 Bentonite JD ?c ? Petit: rr? ft, to_ ft. Tram f0. to ft. 13. Nee est source "lweaible contneinatlon /t..• _feet lt-. alytdnyotim J??J?tL '}Lil\Ytype Well disinfected neon enmpletfonl yea L5 No Date lnetellad C+?6?- ONO, installed manuradtnnr'a Nome _ _-i E i'',f 1 1 ? /?J _ Model L'r r'(?) 4 I ILL' ?t1VOItx.2 y Length or drop pipe L??ft. capacity WaGeriel of drop plpe__ar'l Type: lba5vbmenible 3`JL.S. llrb lne2 50 ReGlprocerln8 2L] J.' 40 Centel fugal 6Q 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