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4395 Dodd Rd1 ae p 66 aq . 1 EAGAN TOWNSHIP BUILDING PERMIT Owner .....-_1?..-.?...:2n."?.-.....:?ti::??. .. _ .. ............."---_. Address (present) ?:...z......_ s:??':cN: . `- Builder"" / J -._J .................._...._...`FSr..t.,coF:C.x.-:?::?_?..----.........._......... _ _.... Address .....------ DESCRIPTION N° 1675 Eagan Township Town Hall Dale ............ Stories - To Be Used For Front Depth Height Est. Cos! Permit Fee Remarks LOCATION Street, Road or other Description of Location Lo! I Block Addition or Tract q3R This permit does no! authorise the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and general welfare to anyone in the community. THIS PERMIT MUST BE 3CEPT 0* THE PREMISE WHILE THE WORK IS IN PROGRESS. This is to certify, that..... ., ............._d"^?-°.-. .....-..........haspermission to erect a....,l?''-`_'??- -.-??:b!......I' t._?!5 ?.:........upon the above described premise subject fo the ovisions of the Building Ordinance for Eagasi Towns125 a pled April 11, 1955. ........... ................. Per .............................. .....4 t P Chair an of Town Board Buildin Inspector 4.?. CITY_QF E-AGAN N2 13749 3830 Pilot Knob Road, P.O. Box 21.199, Eagan, MN 55121 BUILDING PERMIT PHONE: 454.8100 Receipt # 7 - 5Y'f,z To be used for DECK Est. Value $1,000 Date JUNE 9 ,19 87 Site Address 4395 DODD RD Lot 060 Block Parcel No. 29 Sec/Sub. SECT 25 ;IName STEPHEN PRATER Address SAME o City Phone 452-9400 (W) a lName SAME 454-7150 u< Address City Phone w W Name Address x z City Phone 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 a o aggn QAAinan . Signature of Permittee ?'C/ ?/ A Building Permit is issued to: STEPHEN PRATER all work shall be done in accordance with all applic a State of Building Official OFFICE USE ONLY On Site Sewage occupancy MWCC System Zoning On Site Well Type of Const City Water (Actual) (Allowable) # of Stories Length Depth - S.F. Total Footprint S.F. APPROVALS FEES $20.50 Assessments Permit Water/Sewer Surcharge .50 Police Plan Review Fire SAC, City Engr. SAC, MWCC Planner WaterConn. Council Water Meter Bldg. Off. Road Unit APC Treatment P1 Variance Parks Copies TOTAL $91_M on the express condition that M inyfe?otarSt>3tutes and City of Eagan Ordinances. CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PH ON E: 454-8100 BUILDING PERMIT Receipt # To be used for Est. Value ` I Date .) ,19 Site Address Lot Block Sec/Sub. Parcel No. ic Name 3 Address G City Phone Name o 0 Address P. City Phone City OFFIC E USE ONLY On Site Sewage Occupancy MWCC System - Zoning On Site Well _ Type of Const City Water (ActuaQ (Allowable) * of Stories Length De th p SF. Total Footprint S.F. APPROVALS FEES Assessments Permit Water/Sewer Surcharge Police Plan Review Fire SAC, City Engr. SAC, MWCC Planner Water Conn. Council Water Meter I hereby acknowledge that I have read this application and state Bldg. Off. _ Road Unit that the information is correct and agree to comply with all applicable APC Treatment Pt State of Minnesota Statutes and City of Eagan Ordinances. Variance Parks Copies Signature of Permittee TOTAL 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. Ruilriinn Off irini Permit No. Permit Holder I Date Telephone* I Plumbing H. VAC. Inspection Dots Insp. I Comments Pr. Disp. CITY OF EAGAN Remarks - 4 *-,'e--- Addition Section 25 Lot Blk Parcel 10 02500 060 29 Owner Street 4395 Dodd Rd. State Ea 821 1 7- Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. -';QA2 - 94 154-15 20 STREET RESTOR. GRADING SAN SEW TRUNK .S7S iggi 16R1 5n 84 OR ?() * SEWER LATERAL 574 ;(14?. 50 162.13 !S I, WATERMAIN * WATER LATERAL 7 1710.00 85.50 20 0 WATER AREA S71, 3981 3683 so 8408 ?0 X17, / r- STORM SEW TRK 1985 2161 00 14407 is 2161 00 C009 367 Q-4-84 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN I `4 1-4 3830 PILOT KNOB RD - 55122 I 651-681-4675 n fi I-- Vv" A New Construction Requirements • 3 registered site surveys showing sq. ft. of lot, sq. It. 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 Preservation Plan if lot platted after 7/1193 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE JOB SITE ADD RemodellReoair Requirements C) 1 • 2 copies of plan 1 set of Energy Calculations for heated additions • 1 site survey for exterior additions & decks VALUATION (EXCLUDING LAND) IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER Ii-$el kLC-? N0 TYPE OF APPLICANT FIREPLACE(S) PHONE #' 1 _2 _3 .??1-6 ADDRESS m?- ZIP CODE z? PAGER #(01:1(6ss P -& CELL PHONE # 10?1 2-50 02--7-1 FAX NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 (, \\ (check one) Residential Ventilation Category 1 Worksheet Submitte Energy Envelope Calculations Submitted n Plumbing Contractor: Plumbing System Includes: Mechanical Contractor: _ Mcch>mical System Includes: Sewer/Water Contractor: Air Conditioning Heat Recovery System Phone # Phone # Fee: $90.00 Pee: $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 Eagan Ordinances. r\ /\ - Signature of Certificates of Survey Received - Tree Preservation Plan Received t Not Required 4 4-- e Updated 1101 _ MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Phone #: Water Softener Lawn Sprinkler Water Heater _ No. of R.I. Baths No. of Baths OFFICE USE ONLY ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex lNh 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext, Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or- N ? 25 Miscellaneous 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant ?v Valuation Occupancy 14r-3 MC/ES System Census Code Zoning --! City Water SAC Units ?L Stories / Booster Pump Nbr. of Units l Sq. Ft. 1?2 4,0 PRV Nbr. of Bldgs j Length Z/ 01 Fire Sprinklered Type of Const Width ?JC2 .- - Footings (new bldg) Footings (deck) _ Footings (addition) -20 Foundation Drain Tile Roof _ Ice & Water _ Final t'J Framing Fireplace _ R.I- _ Air Test - Final Insulation Other Pool _ Ftgs _ Air/Gas Tests _ Final Siding _ Stucco _ Stone Windows (new/replacement) Approved Byz4e-, Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total REQUIRED INSPECTIONS _ Final/C.O. ,LO Final/NO C.O. Plumbing HVAC 19'1, I 1 S?I ("NG 6If k{f- GC ,zb k Va. ,-?rf /b,Qa?9, as "A Family Tradition Since 1955- Fagan Office 1250 Yankee Daxlle Road Eagan, MN 55121 Office (612) 688.0000 FAX (612) 688.9183 April 14, 1997 To: The City of Eagan It is understood that no interest will be paid on the $2,000 given to the City of Eagan for connection fees for sewer and water hook-up at 4395 Dodd Road. , .4, f 7 C-- "C ? Kathi ooley/Buyer J 1 J ockie/Buyer A MWopohmn Financial cDn4)aW. 1 } 1? ?UC x-,-- /6 7S' ,J` - (Vp- a&-f z, d -al G b Z? M 1 Y q fi t /0/4 I L?Z?1 SEc.z?? ?o.sP.s?iaoa, RaU-fte, 4444" & 4UOcsat , Yotc. __ C%olrAUpsny 6.rg+?*ee-u 0 1335 ?U. '1,....c J(,yA,,..,, 36 1 /f...4 M,.r-.4. 55ff3 PA.,. 6f1-636-9600 June 2, 1981 1956 - 25th 981 U, Mr. 6 Mrs. Edward schwas nniversary 4395 Dodd Rd. Eagan, Mn. 55122 t 0110 G. R ouo nao. Y.E. kuaru W' . Rm nu. Y.F.'. L aepM1 C. 4... A. Y. L'. u,adrr.,d A. rrmars. r.F. Rnhor'J L . Avnrr. Y. f.. Juror, f. n/ n.... P.I:. 61'nn R. funk. P.F. Frith A. Gardon. P.E. Lhornm F..\'u rrs. P.L. Ru ha,d 11. Fuzrrr, P.E. R.d)r.I G. .Rhr.n irhL P1, ifunru L. Sun ula. P.E. M,Wd C. 11 dt. P.E. 4ny A. Lmvdn P.E. Afark A. Hanlon. P.h. l hurls A. En Aenn Lru Af. P.x,hkr llmlur: Af. nls., nand P. nlemr Re: Boulevard Restoration City Project 241, Contract No. 79-13 File No. 49106 Dear Mr. 6 Mrs. Schwanz: I have been in contact with both of the contractors that are responsibia: the repair of the boulevard sod restoration and the placement of the bir ous curb. Both contractors are prepared to complete this work in the near future. There are however some questions concerning the sequencs manner of construction which must be discussed with you. We propose to schedule the bituminous curb construction first so that grade match for the sod work could be more easily accomplished. Howevar installation of a four inch surmountable curb across your northerly (It will aggravate the drainage problem. It may be possible to construct curb and leave a small opening to allow some drainage to occur until i when the drainage problem is corrected. With regard to the lawn restoration work it was the contractors opiniac the work was not up to their normal workmanship standards and that he w., work with us to correct the problem. The proposed corrective action of: 1. Adding topsoil to the sod joints and applying seed and fertilizer the entire boulevard area. 2. Placing additional sod as required along the south edge of the ncri ly driveway entrance to repair that area. 3. Remove and replace the sod on the north side of the north driveway. 4. Match in the boulevard sod to the bituminous curb as installed by the bituminous contractor. Please call me at 636-4600 or 454-1532 at your convenience so that we may dis- cuss these details. Yours very truly, BONESTR00, ROSENE, ANDERLIK & ASSOCIATES, INC. lez7 Jerry Bo dton? JB:li cc: Tom Colbert 4479a /O O 2500 6(ya -:?l 5 za, Z-y- t BEA BLOMQUIST MAYOR CITY OF EAGAN THOMAS HEDGES CITY ADMINISTRATOR THOMASEGAN MARK PARRANTO JAMES A. SMITH THEODORE WACHTER COUNCIL MEMBERS April 29, 1981 MR & MRS ED SCHWANZ 4395 DODD ROAD EAGAN MN 55123 Re: Drainage Problem Dear Mr. & Mrs. Schwanz: 3795 PILOT KNOB ROAD EAGAN. MINNESOTA 55122 PHONE 454-StOO 4 f_ ?r EUGENE VAN OVERBEKE CITY CLERK when we concluded our meeting held in your driveway on April 27th, I indicated that I would respond to you within two weeks as to the position of the City and its available options pertaining to correcting the drainage problan that you are presently exper- iencing. Upon reviewing this problem with all parties who have been involved in the construction of the City streets and utilities and the development of the Overview Estates, it is felt that the City cannot authorize expenditure of City funds to correct a drainage problem created by a private development. In this particular case, the City feels that the drainage prcblen was created by the elimination of the low drainage area previously located adjacent to and north of your property. This low drainage area was eliminated during the grading of the Overview Estates by the devel- oper, Mr. Jim Sewald. In order for me to perform any corrective work to solve your drainage problem, I would need direct authorization fran the City Council due to the necessary expenditure of funds required. There are two options that you have available to get the problem resolved. The first would be to deal directly with Mr. Sewald to have him correct the problem that was not properly resolved during his first attempt. our conversations on April 27th indicated that Mr. Sewald is reluctant to perform any additional work. Consequently, it would appear that it would take legal action on your behalf against Mr. Sewald to correct the problem. Your second option available is to request the City Council in writing to direct the City staff to either resolve the problem or to pursue legal action against the developer to insure that he performs whatever corrective action is necessary. If you wish to pursue the second option, you should submit a letter to the City Council in care of my attention, and I will place it on the next available Council meeting so that we may initiate the necessary corrective action required to solve your problem. I hope you can appreciate the position of the City in its reluctance to spend public dollars to solve a private developer's problem. I would like to assure you that we will do everything possible within our authority to help you resolve your prcblen. If you have any questions pertaining to the options that You have, please feel free to contact me. Sina?rel A. olbert, P Director of Public Works TAC/jac cc - Thomas L. Hedges, City Administrator THE LONE OAK TREE ... THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY. ?.? a s off e _ ? '3 4 KETCHAM AND REGIS, ATTORNEYS 1456 YANKEE DOODLE ROAD EAGAN, MINNESOTA 55121 16121454-6981 KENNETH P. KETCHAM DOROTHY A. REGIS 'S9?p !?rF 1? Al March 19, 1950 'Pe 11 Mr. Edward Schwarz 4395 Dodd Road Eagan, MN 55123 Re: Drainage OF COUNSEL JAMES T. SKONNORD Dear Mr. Schwanz: At your request, 1 have examined your properly and the property adjoin- ing you to the North. It is ohvious, fr,;r, icckir:g at the scene that they have filled the proposed Lots directly to tl:c North of your property. I strongly suspect the City shculc_ force them to drain the water away from your land and make it drain on the back property line of the houses on Saddle Street (your prcp<1'y line). They definitely have increased the amcunl of Ell on this property, with any water or melting snow going on your property which is now lower. [ am sending a copy of this letter to Dale Runkle, City Planner, and Thom-- as Hedges, City Administrator, to put the City on notice thal there is a prob- lem. Please contact me after review?r.,g this letter. Thank you. Sincerely yours, Kenneth P. Ketcham KPK/bm cc: Mr. Dale Runkle Mr. Thomas Hedges O O , - 0 "A Family Tradition Since 1955"- Fagan Office 1250 Yankcc Doodle Road Fagan, MN 55121 Office (612) 688-0000 FAX (612) 688-9183 April 9, 1997 Mr. Bill Adams and Mr. Doug Reid City of Eagan Jean Norris REALTOR', GRI Dir: (612)686-2090-? Bus: (612) 688-0000-" Res: (612) 454-8003 Fax: (612) 688-9183 It is understood that the buyers of 4395 Dodd Road in Eagan will be assuming all costs (approximately $7,000) to hook up to city sewer and city water. This agreement further releases any and all liability to the seller regarding the well and septic located on the property. T'he hook-up of city sewer and city water shall be comoleted within ten months of the closing (April 25, 1997). i Buy r ate G C/ CP B er Date Seller Date ?'-' ????^' ??/V C / ling Agent/Listing Agent Date S ing Agent,(Listing Agent n t A MewPahp FinmwW wnww r: i a6ie -2OO-J(P/-(nn-6,f4 686-4767 420 oan/ -rUe.?'? &Lq"'g BAs-J6128 1:296076&521: 8L t? ' i?1I II i ! it •II z` dl- L1 19 42686 M ,wrercniras? ? i.eoa rra xx? • ?uFncnxmwmv I n I I ? m m;S ?C7q A-wIQ ? . city of eagan THOMAS EGAN Mayor April 10, 1997 MS JEAN NORRIS EDINA REALTY 1250 YANKEE DOODLE RD EAGAN MN 55121 RE: 4395 DODD RD LOT 6, BLOCK 29, SECTION 25 HOOK-UP TO CITY SEWER Dear Ms. Norris: PATRICIA AWADA BEA BLOMQUIST SANDRA A. MASIN THEODORE WACHTER Council Members THOMAS HEDGES City Administrator E. J. VAN OVERBEKE City Clerk As you and I discussed earlier today, this letter is to verify that the City of Eagan is in agreement with the aforementioned property connecting to the City sewer system within ten months. With this being the case, there is no need to provide a septic system test at this time. If I can be of further assistance, please let me know. Sincerely, oc,-1?4? Doug Reid Chief Building Official DR/js MUNICIPAL CENTER 3830 PILOT KNOB ROAD EAGAN. MINNESOTA 55122-1897 PHONE. (612) 681-4600 FAX: (612) 681-4612 TDD. (612) 4548535 THE LONE OAK TREE THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY Equal Opportunity/Affirmative Action Employer MAINTENANCE FACILITY 3501 COACHMAN POINT EAGAN. MINNESOTA 55122 PHONE: (612) 681-4300 FAX (612)681-4360 TDD'. (612) 454-8535 *dtV of eagan THOMAS EGAN Mayor April 7, 1997 ROBERT & CONSTANCE MERTZ 1468 SOUTHRIDGEAVE y EAGAN MN 55121 RE: SEPTIC SYSTEM Dear Mr. & Mrs. Mertz: PATRICIA AWADA BEA BLOMQUIST SANDRA A. MASIN THEODORE WACHTER Council Members THOMAS HEDGES City Administrator E. J. VAN OVERBEKE City Clerk A March 26, 1997 inspection of your septic system by Mr. Ed Samuelson found it to be non- conforming. This letter is to notify you that you must hook up to City sewer system within the next ten months. Please contact Building Inspections staff at 681-4675 for a breakdown of the permit fees or you may contact me direct at 681-4677 Monday through Friday between the hours of 7:30 - 8:30 a.m.; 12:30 - 1:00 p.m.; and 3:30 - 4:00 p.m. Sincerely, William Adams Plumbing Inspector WA/js MUNICIPAL CENTER 3830 PILOT KNOB ROAD EAGAN. MINNESOTA 55122-1897 PHONE- (612) 681-4600 FAX'. (612) a1-4612 TDD: (612) 454-8535 THE LONE OAK TREE THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY Equal Opportunity/Affirmative Action Employer MAINTENANCE FACILITY 3501 COACHMAN POINT EAGAN. MINNESOTA 55122 PHONE: (612) 681-4300 PAX:(612) 681-4360 T DD. (612) 454-8535 L BL CITY USE ONLY RECEIPT #: SUBD. 4-2-600 ` 0 (?L9 RECEIPT DATE: 1997 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: . single family dwellings townhomes and condos when permits are required for each unit backtlow preventer for underground sprinkler system FIXTURES EACH NO, TOTAL Shower 3.00 x = Water Cioset 3.00 x = Bath Tub 3.00 x = Lavatory 3.00 x = Kitchen Sink 3.00 x. _ Laundry Tray 3:00 x = Hot Tub/Spa 3.00 x = Water Heater 3.00 x = Floor Drain 3.00 x = Gas Piping Outlet " minimum -1 3:00 x =. Rough Openings 1.50 x = Water Softener *for dwellings under construction 5.00 X = Water Softener ' for existing dwelling 20.00 x = U.G. Sprinkler • for dwelling under const. 3.00 = U.G. Sprinkler ` for existing dwelling 20.00 = Alterations `toexisting residence 20.00 = Water Turn Around 20.00 Private Disposal System ' oak cry lic. 75.00 = (new and refurbished systems) Private Disposal Systems 'Abandonment 20.00 = STATE SURCHARGE .50 TOTAL I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during Its normal operational and maintenance actM ies to the facilities constructed under this permit within City property/right-of-way/easement. SITE ADDRESS: 4395 Dodd Road OWNER NAME: INSTALLER NAMEWeierke Trenching TELEPHONE #: 454=3626 STREET ADDRESS: 660 Cliff Road CITY: Eagan STATE: MN ZIP: 553,22 SIGNATURE PERMITTEE 7-1"7 ?3A 10/10/2007 15:59 FAX 0512223831 Semple Excavating INC 10/10/2007 11:47 EH RENNER & SONS a 6512223@31 9 002 NO.534 P02 n d Barin w W WELL OR BORING LOCATION g o an o N MINNESOTA DEPARTMENT OF HEALTH H 263586 OwnV Nmm WELL AND BORING SEALING RECORD AyRnaeofA U*u9 well Not M dwalo12 810rums. CJ1VW 1031 a?NVw•&-W - ..._- _ Y1MINUp Name lawnaNp No. faro" No. YRLrion le Ffaenln im. •. IB.i ale Saeletln/? g 1 10 ?^'? oplo WM Of GeAno ConcrnXatd A G R . 7 ` GPs L¢ti1uGO_ dogmas, mlnares_ sacb 0b Daplh &fOn Ssalmy x_ apWOI ON11I1- N. LOOATION: LoVlutla_ JOWre _ ni "'w-...._.. aumlda IFER(S) .._-.^-..? " STATK' WATER LEVEL WavMleal Snael AddiunwFlrv NulRya arNCUrw WUYw00rM.S LPaatlell Agw'Ief MUUlsyulhr SlnBle + y.Q 1 R DaN Memurea d ; : En t j1pOFIND L l Mssimn rta a .. _wmsrsuP* Weil D Mani, wel show coast sounim m "1 w Danny UketN1 P of wall m R0 vAn1-x• MMimn dY104 r a 1Im1 hm?p w t ; C: sCOY9lens auRWa L: Env. Flare Hues ? Olner__ -1-3-7--S. (- Oslow , , g n re p K 0 ` row roedn?un bw y r N CASINO TVPGM . .! sum L: PBmO [':I rih [I timer -..._......... - -. ...p.. ..'.. ..r.. WEWIFADCOMPLETION { i OuWdm: 0 W? Nulfn LJ Al Grmb InalAal L l Iowa nenf Offeei .. .. .. .. .. ' N No I [ r Mas Ll wnru Pn C1 wrma ?P% A+4vrdufllnk . .... '.. ..... L. I I.J wim Dwmwl Lome _._ k I..Ohw---. - - PROPFF17YOVJN*Ft U.1PxDMPANY ME DASINOM) 1Rlar?Rp?? Diameter Dwh 3?lin r*04107 Annular spacsinltlaly ym lads Pr a VaaIAA!'AM1 RWileutpn aunrxslMaMlxA raaaN ._....?_. m,lran .0._ m-q-- - i?Yea r:NO r] I' No nnwm 3190 South Loop Rd _....... 41.Uwn N__..--h, LJYaa I_ No Yas - No nllnlamwn Eagan, MN 55123 it, aam .. ..... .. to- _-- It CJ *4 C No 1 roe i No F) Owl WGLL O'AMEH'S NAME=MOINY NAME SCREEWOPFN HOLE WRY xwnart maWap 00ar0m it d,1leMxt llNrr p?alllrN++wwftl ddaieaanda4laa OPan Hie from -?IR0 - %. fNi3Tr1UCT1(INB j Actldrs p Plea n Chedc,mwe l n OPNts L. FR JdGo OWP N 0n .. + typo of OaNAmGdro COesonas) ......... ...... .. ....?_-.- _.._ OEOLO"Al. MATERIAL COLOR •. NARWIiea OR RM TIO FROM M 01a4woSarn rimmrem 0 *4 ? No Oescee^ __ - __ __ A e FO PUMP I1001 tmewO,ind0945 aMRRJHO fnrMwiian kw fm m rmwtw wall a poling. 1A e TYP ......._.-...aaubt irS1 n 11 MCI 1He- -, __- B M 00 USED TO SEAL ANNULAn MOE BI WM S CASINOS, OR CASINO NID BORE HOLG No Annular 9peae Erame r? Anm1ler 4was O.OwW Mm Tlerlliu Pip LJ Guohg PodbmeurvRemoval 1 fA1lfRralR1 Li flom0wd n . _ ... ...... _. sI. fmrn m -_ n vod d ]fl V l a wala ar ei 16. from.., m_ it 1 T'* 01 PadhMd'-,... _._......_....._ ...- - - ORCLMNG MA" W.ISI /One of el aomam= B6 ft.. ono boy w bamm%ao. no lee.) ? Grcunny Malarial _.- (mm .. m_-__ yame - bog0 AL r NCdf „(,.Tn t Irom 0 _ Ia-_L1_37. R.,..?_ wJ4 .- bw •n t ee G ? ... .__. ?- Imm tu_......... h., Yerds.. .. ... ABys T.?? . OTHER WELLS AND BOP NGS i110NARIC%WUACE OF DATA, DIFFIWLTIEB ya SSALIND 0111er UReeebd eRO YRUeatl wNl H D0dR9 WI Propor[y7 Ll vee No Hmv MM07-. - . • . J.-_ LIOPAS40 OR REGMTERHO COM ACTOR CEATW 0 "ON TNa wall as baring was walml In xeuaenae WM MRneeal. Rlrtrq chophn 17ES'TM MNrmation "Is in" m mil mfMft is we M SIB bees of my hnaMRlye. Water Lovel in Above Welly 155sw1 Bate Water Level Taken: 01/06/1978 <Krsz OV Radwkal/on Ma E ..R ons, Inc. 1431 Unique 136535 - ?MlgQ AOp NA 0AP0 .aam,wobanamn 9/21/07 UM. RCPT DP HEA -J COG„ M 2 6 3 5 8 6 - yIy Y fJ?RP ---.• • . ....._ _.. ---------- I 143a 10; 1464613 U L1 0 Cr A 1 2001 09ie, 2007 V -? C? 7/O 10:42 EAGAN ENG+COM DEV 4 92223831 2007 BUILDING MOVE PERMIT APPLtcAvor4 City Of Eagan 3830 Pilot Miob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 NO. 802 D01 q6.O ?I Date/ /0 l07 '(?pL _` _+ Street Address Of Building To Be Moved j? "I .) I J L oOd kBQC? Proposed Destination City s S State e Highlight origin, route & destination on current ClAy map. If County/State roads are used, provide copies of those permits. Proposed Date of Move : r/ c'e nr5e I Time ?M Rm .? o. P 12 $? a.m. _ p.m Notify Eagan Police Department. Eagan Police will not accompany move until time coordination has been made with neighboring municipality. Size orStructure 26 X 6 0 . Weight Is structure connected to City Sewer City Water _ Septic Well Kel"jek- 1r7000rS L Electric Service Gas Service Other El Gus: Ser4ce- / arty responsible for utilities disconnect _ Owner _ Mover other 6'a' /ro?k ?X. Building in Eagan to be moved out of Eagan. Building in Eagan to be relocated in Eagan (requires Council action). Building to be moved into Eagan from another City (requires Council action). 'Building Owner Name I,t-Q 1XA ( e I_ K? 1m_ rn !A-A 11-D rI ( Street Address a.?I_ao U11le-ke i y I I ?? City State MM P?( Zip 5T013 Telephone 061)1) 11- t R7 -? Land Owner Name P4 1 Tali k a/?t?SCQG/? f)exed oQ eA4 v Lp Street Address 3 [,1LO S L C 4e5 oLC>? City BLXt-nSV ]I k j State jVjVj Zip 5 30X Telephone # (Q51) i-L 1- aq? If /and owner is not rise same as building owner, provide approval from land owner to Ue ?rS work on thepropeNp Mover Name d rk , Street Address City es 1"C State P \J_ Zip 55 130 Telephone # (6t 114-149,1 MN. License # (must submit copy) I guarantee I will repair any and all damage to local roadways, utilities, and public right-of-way that may be damaged by this moving operation. I acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Stances; I understand this is not 1p it, but only an appli4tif for a permit, and work is not to start without a permit: that the work will be in accordance with the appr ed p in thg case of w k w ch requires a review and approval of plans. V i ' lem.2?- Applicant (Print Name) Applicant's Signature Y- no b ?so??h ) G R y? ?qs ??y s` z sa ??-? tO Minnesota Department of Transportation k, Q? Office of Freight & Commercial Vehicle Operations ?', OF TR?' - i 395 John Ireland Boulevard - - i >r es Mail Stop 420 - - - ,_ - St Paul, MN 55155-1899 _ Building Mover License . CERTIFICATE NO: 143685 ISSUED TO x y SEMPLE BUILDING MOVERS, INC. ? K The above named license holder has complied with die license requirements and is hereby issued this Minnesota Building Mover License which wi li tea,- ,- expire on the date shown below. - r >- _ - a? EXP,'?'?TIONDATE: JUNE 30, 2008 The license holder agrees to comply with all applicable State and Federal Regulations Failure to comply may result in revocation of this license. ??; The License Holder may not perform building moving operations in Minnesota unless the velticles have_been registered and display a valid identification cab card issued by the Minnesota Department of Transportation. .' - FOR VERIFICATION CALL (651) 366-3680 d? SEMPLE BUILDING MOVERS, INC. EFFECTIVE DATE: 06115/07 1045 JESSIE STREET - 1s4 X., ST_ PAUL, MN 55101 N ?F r. i .r*i *? 1 k i S ? ?. ? x? ?" t k ?s a ca ".?'£? t 9 Iex yy gf 4 x 3 v \ V t t? 1 4 Y ? a ? 4 Gfll` 'iui e5'? V?*^ A ?. k6 ,?? ? j`1 i S ff f b? i.4 ?, ?'?* \,q t '? ? e {-> a '§{ 4, 3 V Yip k ?• .?? ? ?q > ? ?` 3'` ?' 1 a?. '?i tk r s ? .t ?a ? `T ? ? /??? p1 ? ,? ? R ?+`. K( ? P ? ? n. s??' t yv "µZ F i(`? ? o F rt ? #d y "C v "'? ? /? °it ?? •, !/"'t ? l -, f?,x ?-,a.l l ?` /4 ?` ?? " jtt ?? v``.? ?'Sf ? t ,' ?1 ? nf• z++L 7 ? ?' °rq"-.e+ ? -: t / ??? , ?ae t '& i [ ° ?{ ??v; 't' a.*> , G ?'` Y v 1 .i i ?. £,> ? t • ._ ,? 1,. =ronl: Lisa Jonnson At. Maguire Agency FaXID: TO: Denise Date: 91 11:01 AM Page: 2 of 2 o D CERTIFICATE OF LIABILITY INSURANCE GPID L DATE SEMPL-1 09/049/04/07 /07 PRODUCER THIS CERTIFICATE M ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Maguire Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1935 West County Road B-2,#241 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Roseville MN 55113 Phone:651-638-9100 Fax:651-638-9762 INSURERS AFFORDING COVERAGE NAIC# FITSUREO --- NSURERA St. Paul Fire & Marine INSURER B St. Paul Travelers 24775 Setaple Building Movers, Inc. 1 INSURERC state Fund mmaal zn:urmce 045 Jessie Street St. Paul, MN 55101 INSURER D: INSURER E LU THE POJUES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMEh4, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE IdAY BE ISSUED OR MAY PERIAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SIJBJE_CT TO ALL THE TERMS, EXCLVMON3 AND CONDITIONS OF SUCH ttILICIE£ 4GtiR63ATH -LWTS£MOWN MAY HAVE BEEN REDUCED BY PAID CLAMS IN UT LTR I NSR TYPE OF INSURANCE POLICY NUMBER DATE (MMIDD IV DATE (MMIDD/YYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,0 00, O D 0 A X COMMERCIAL GENERAL LIABILITY 660-1732L127 06/01/07 06/01/08 PREMISES (Ea occurence) $ 100,000 _ CLAIMS MADE FX ] OCCUR MED EXP (Any one person) $ 5 , 000 PERSONAL %ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 I GENT AGGREGATE LIMIT APPLIES PER -- P PRODUCTS - COMP/OP AGG $2,000,000 RO- POLICY X JECT LOC AUT OMOBILE LIABILITY 8 X ALTO ° COMBINED SINGLE OMIT c de E t $1,000,000 _ NY BA45930000 06/01/07 06/01/08 ci ( a a n ) AIL O'?r NED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Par person) X HDILDAUTOS BODILY INJURY $ X RUN OWNED AUTOS (Per.,dent - PROPERTY DAMAGE $ (PeracGdI GA RAGE LIABILITY AU'(OONLY-EAACCIDENT $ ANY AUTO EA AGO $ - OTHER THAN AUTO ONLY GOD $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ .$ WORKERS COMPENSATION AND EMPLOYERS' LIADILITY 'IS X TORYLIMTUL ER C 1 ANY PROPRIETORIPARTNEREXECLITIVE 0 5647.206 06/01/07 06/01/08 EI-FACHACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED' It vas J .n Da EL.DISEASE -EAEMPLOYEE $500,000 u Sr,CIA; PROVISI O NS below E.L. DISEA5E-POLICY LIMIT $500,000 OTHER A Cargo 660-1732L127 06/01/07 06/01/08 ACV up to $125,000 $2,500 Ded. DESCRIPTION OF OPERATIONS ! LOCATIONS I VEHICLES l EXCLUSIONS ADDED BY ENDORSEMENT l SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION XEAGANZ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN City of Eagan NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Attn: Building Inspector 3830 Pilot Knob Road IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Eagan MN 55122 REPRESENTATIVES. AUT RIZED R RESENT IVE , IL ACORD 25 (2001MR) ©ACORD CORPORATION 1988 9528917000 SEP-14-2007(FRI) 11:36 Dakota County PDD Gam/ +?ZdNG??? C o u N r r WATER RESOURCES OFFICE GROUNDWATER PROTECTION SECTION - 14955 Galaxie Avenue Apple Valley. MN 55124 952.891.7557 • Fax 952.891.7588 • www.co.dakota.mn.us J ?r4 MUNICIPAL NOTICE OF WELL SEALING PERMIT APPLICATION DATE: September 13, 2007 TO: Tom Colbert/Wayne Schwan (EK RE: Well Permit #: 07-1=I263586 Municipality: Eagan . Fax #: (651) 675-5694 Well Type: Domestic Water Resources Specialist: Luehrs The Dakota County Water Resources Office 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 Water Resource Specialist listed above or our office at (952) 891-7557. 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: Date Application Received: Anticipated Drilling Date: Anticipated Grouting Date: Property Owner: Well Owner: E.H. Renner & Sons 9/12/2007 Cascade Development Cascade Development Time: Time: WELL. LOCATION PLS Coordinates: 1/4, SW 1/4, SE 114, NW 1/4, Sec 25 Town 027 Range 23 Street Address: 4395 Dodd RD PIN Number: 100250006029 WELL INFORMATION: Diameter: Casing Depth: Total Depth: Static Water Level: Aquifer: (FAX)9528917000 P.,001/001 COMMENTS: City of EAGAN p phtad FeaWro Mi tdl end ? ? cv--? ? '- ,ice>? LLR P"`i k4WCipal BotCxiary 'm.2 Condo PSirde sacdmn .,./ sffaabs s6-eetwmaa ¦ lakes ® Parks --- ?- ? Parcele K i PID: I 100250006029 ae j i 1 I 4395 DODD RD EAGAN, MN 551230000 I J i I ?I y Property Owner Assessing Sales PIN: 100250006029 PID: 100250006029 Year Built: 1968 Sale Year: 1997 Nouse#: 4395 Full Name: GARY D TSTE JORGENSON Land Value: 106200 Sale Month: 4 Street: DODD RD Address l: 4395 DODD RD Building Value: 193400 Sale Value: 165000 Apt: Address 2: _ Total Value: 299600 Sale Tax: 0 Zip City ST. SAINT PAUL MN 55123-3010 Net Tax: 2914.42 Code: 551230000 Total Tax: 2914.42 Lot: 003040 25 2723 Zoning Plat: SECRON 25 TWIN 27 RANGE 23 PT OF 5 1/2 OF NW 114 BEG INT S LINE Code Z ne R-1 & CA DODD RD W ON S LINE 696 FT N ( t S Legal: 190 FT E PARR S LINE 700.3 FT TO CIL Zone Dent: Residential Single DODD RD 5 ON GL 190.07 FT TO BEG LandU% Code: LD LandUse Des : Low Density (0-4 uniWacre) Lot ° Blk PID# ?0-ft.2??i1-t71o?-24 Plat Sewer/water permit # 1? ? 1.16 Date _h 3 6 - Q 4 Receipt # 7_?1 I d ??? f7z CITY OF EAGAN 1997 SEWER & WATER CONNECTION AND PERMIT CHARGES EXISTING RESIDENTIAL PROPERTY Connection and Permit Date pry ious Receipt # Account deposr Sewer permit & Subtotal ter Connection and Permit Char charge (SAC) 50.00 WateA paid Date 15.00 Account depdsj1 50.50 Water permit & Water meter $ 1,115.50 Treatment plant charge (WAC) $,780.00 paid * Plumbing permit & surcharge 20.50 Subtotal Tap Utility, connection * Plumbing rmit & surcharge Tap l Utili connection otal Sewer & Water Connection and Permit Charges Sewer availability charge (SAC) $1,050.00 Date previously paid Receipt # Water availability charge (WAC) 780.00 Date previously paid Receipt # Account deposit 30.00 Sewer & water permit and surcharge 100.50 Water meter 109.00 Treatment plant 420.00 Subtotal $2,489.50 * Plumbing permit & surcharge 20.59 15.00 50.50 109.00 420.00 $1,374.50 20.50 Tap(s) Utility connection 6 ??4?930 P?cro0 Total - ?+(1no.D0 _?Receip?-?'l?0<<g * A plumbing permit is also required. It will be issued only to a plumber licensed with the City or to the homeowner if the homeowner is actually doing the work. OFFICE USE ONLY Property owner CL _A IM°/?1.iI ? l(nf 1. iTl Pjr Address 494 L1rN1..tA• U Phone no. 0L " 4 rfo Plumber I I J.Iri N - ?WI PRV 15? No. of taps Utility connection AIM0, Waiver SPECIAL ASSESSMENT SEARCH SUMMARY AS OF: 10/02/1996 PROPERTY ID: 10-02500-060-29 S/A# ASSESSMENT DESCRIPT. YEAR TM RATE TOTAL 100573 WATER LAT 1980 20 8.0000 1710.00 100574. SEWER LAT 1980 20 8.0000 2042.50 100575 SEWER TRK 1980 20 8.0000 1681.50 100576 WATER AREA 1980 20 8.0000 1681.50 100582 STREET 1980 20 8.0000 3082.94 100903 SSTRK383 1984 15 10.5000 2161.00 102574 ST 659 1994 15 6.5000 1225.00 SSTK LARGE LOT CREDIT 0000 00 0.0000 0.00 ------ SUMMARY OF LEVIED 0.00 ****** 1996 P&I CERTIFIED 155.98 ------ SUMMARY OF DEFERRED 0.00 ------ SUMMARY OF CLOSED 13584.44 ------ PENDING ESTIMATE 0.00 ANN.PRIN. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 PAYOFF CD 0.00 PP 0.00 PP 0.00 PP 0.00 PP 0.00 PP 0.00 CL 0.00 PP PN 0.00 Press ENTER; or F1, F4, F5, F7, F8 Main Prev 2 72 Next Go To Exit Menu Page CN Page Legend 10:19 CAPS FINANCIAL GUARANTEE/CASH DEPOSIT INFORMATION Payment Informatio Date: -7 / ¢] -7 Amount: $ oZ L; . CSC Receipt p: 7 02? g (please attach copy of receipt) Paid by: L Cr Q?; Type of deposit: Location of activity: Person(s) to refund to:. Address: Refund Information Reason for refund: Refund authorized by: Date:..,....., Payment made: Date: Check #: Amountt$. A F-11M Trudidon Hinge 1955-- Eagan Office 1250 Ym,k ee Doodle Read E%m, MN 55121 Office (612) 688M FAX (612) 688.9183 April 14, 1997 To: The City of Eagan ??SO-7.36 ''? 31?SQr,aCe/•f'? It is understood that no interest will be paid on the $2,000 given to the City of Eagan for connection fees for sewer and water hook=up at 4395 Dodd Road. Rathi ooley/Buyer i J ockie/Buyer A M e n o p o U a n F i m rc W co V W. v neom• 5 20?? RESIDENTIAL BUILDING PERMIT APPLICATION j 2 CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Construction Requirements • 3 registered site surveys showing sq. ft of lot, sq. ft. of house; and all mated 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 Preservation Plan if lot platted after 711193 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE 1"f` 00 SITE ADDRESS TYPE OF WORK APPLICANT STREET ADDRESgS TELEPHONE # %,a CELL PHONE # bb?I 7 PROPERTYOWNER 1 1OAAY (001ey TELEPHONE# 51- t7" I ----------------------------------------------------------------------------------------------- COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ NII NNESOT:1 RULES 7670 CATEGORY 1 _ mfg) 0-ri (;j 7, (J submission type) . Residential Ventilation Category 1 Worksheet Submitted It?llf nerg C e6}y0 S • Energy Envelope Calculations Submitted JUN 1 4 2002 Plumbing Contractor: _____ Plumbing System includes: Mechanical Contractor: MCChantical svstcnt iucludcs: Sewer/Water Contractor: Water Softener _ Water Heater No. of Baths _ Phone I I I.asvn Sprinkler No. of R.I. Baths Phone # 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 Cirdin ce Signature of Applicant 7- OFFICE USE ONLY Air Conditioning Heat Recovery System Remodel/Repair Requirements • 2 copies of plan 1 set of Energy Calculations for heated additions • l site survey for exterior additions & decks Indicate if home served by septic system for additions VALUATION l 7 X663 00 Phone # ULTI-FAMILY BLDG _ Y X N FIREPLACE(S) -0-1 -2 Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required Updated 4/02 X37 1 SINGLE FAMILY DWELLINGS - CITY OF EAGAN INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR /HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS - RESIDENTIAL INCLUDE 2 SETS OF PLANS, CER 1 SET OF ENERGY CALCULATIONS COMMERCIAL RENTAL UNITS FOR SALE UNITS OF SURVEY - CHECK WITH BLDG. DEPT., INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, o $2,000 LANDSCAPE BOND X i onf To Be Used For: ? E'cK Valuation: /6 ?- Site Address ?/ /fir -064J96/ I Lot 660 Block ZI Q Parcel/Sub 2p ?( ?C?J a Owner ?P!}?Il P41'f1T??Z Address y3RS 1)"dw City/Zip Code FA6r4,v 5S/23 Phone( ??- 7/0 W `/S2-9y0o Contractor Address City/Zip Code Phone Arch./Engr. Address City/Zip Code Phone # Date: 6'?"? On Site Sewage_ MWCC System On Site Well City Water _ APPROVALS Assessments Water/Sewer Police Fire Engr Planner Council Bldg Off APC Variance Sa so Occupancy Zoning Type of Const (Actual) (Allowable) # of Stories Length Depth S.F. Total Footprint S.F. FEES Permit Surcharge Plan Review SAC, City SAC, MWCC Water Conn Water Meter Road Unit Treatment P1 Parks Copies TOTAL Permit # / -7 r Receipt Date: 2007 Sewer/Water Repair/Disconnect Permit City Of Eagan 3830 Pilot Knob Road Eagan MN 55122 Telephone # 651-675-5675 Date / f/ / 0Y Fee: 50.50 X City Sewer City Water Repair Disconnect Description hca An 9? 0-?I 1 eCL ,) WC4-442S -SeWey- Street Address for Proposed Work ??9s ?t 9t?C'1 ICJ Owner Name Street Address 3 aae7 '500?-K Z.0 610 City L9( r\4Utli2 State `s'tn Zip r Telephone # (61.1) . . , Licensed Pipelayer _ Master Plumber _ Property Owner Name Strect Address P, cr at`t-C ? City Sk _ Pc . t r ( State CnI) t, Zip S5 /b? Telephone # j Pipelayer Training Certification Card # or Master Plumber License # I acknowledge that the information is complete and accurate and that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes. I understand this is not a permit, but only an application for a permit, and work is not to start without a permit. Applicant (Print Name) ApplicanPs Signa e A B C D E F G H MENDOTA HXXHrS 1)W )I50 2M 18" I)W IM 1.w 130 CITY OF EAGAN q . o s 1 2006 a, m ... LEGEND !• •W PIdC SV][IIPS eu e .wnw 3 ?? tAQR [ ..a , 't ' p e .. r ` , ! 3W - - _ wa u? 5 M\\W V s JBW 7 eon 8.is,v 9r 10 J K 65. 2. 2 r 0 ? U s ti w? i? 10 G ;] " i 3 % EP Od° a .... tai ANON L f 1 t? ''.k• ??;, 4 ? .'"'. ?,,?) 3 / 3 4, f LF9 µ(\,L5 REG1pNP PPRK J??l `/? L - I I } ? ? w?.. ? ieoo RE, CC L/ 12 C " a -- „?, ,,. soon APPLE VAUE ROSEMOUNT :too -ISO 1Np 1850 IIW Isto IaLO I?Sp I10p 950 6so soo A B C D E F G H I J. K L L SfO s zboo