3284 Donald AveEAGAN TOWNSHIP
BUILDING PERMIT
Owner (!0'
Address (present) .1.. °. °-. G......`^ of -...ST :` >
Builder
Address
DESCRIPTION
t/
NO. 2986
Eagan Township
Town Hall
Dale .... ?. _.2.5- ?.3
ories To Be Used For Front Depth Height Est. Cost Permit Fee Remarks
7 s y i 9, s-? J 1o - s/& 3v e .?? .
. ? .4- ' ? ° .emu LOCATION 17.2• o-v
or
This permit does not 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 KEPT ON THE PREMISE WHILE THE WORK IS IN PROGA SS.
ti
This is to certify, thal..._?sb:c.P.--._.........haspermission to erect a...... ....-._ ._?...
'. .......pled ......... _ upon
the above described premise subject to the provisions of the Building Ordinance for Eagan owns hip doApril 11.
1955. ,Q ?
................... -----:..---....1/...?-Per .................g-----•••p-8
Chairman of Town 80 Buildin Ins c I o r
z P. kyqoj-12?
I ';
VILLAGE OF EAGAN
3795 Pilot Knob tioad
Eagan, Minnesota 55122
PEMIT N0. 3`_
The Village of Eagan hereby grants to TllCM-pson plumbing ro,
Of 12201 Himettanka
a Permit for: (Owner) Marell Construction
at 3284
maid Ave , pursuant to application dated 5/22/73
Fee Paid: $?1L- . dated this 22nd day of May , 19 73
.50 s/c
Building Inspector
Mechanical permits:
Bid Total:
Z-1 e- le?tra z
. . .- .
VILLAGE OF EAGAN
3795 Pilot Knob ttoad
Eagan, Minnesota 55122
PERMIT N0. 3K3
The Village of Eagan hereby grants to Ray N. Welter Heating
of 4637 Chicago Ave. So., Mpla. 55407
a HEATING Permit for: (Owner) Marell Construction
at 3281y Donald Avenue pursuant to application dated 5/21/73
Fee Paid: 20.00 dated this 22nd day of Marty 19 73
0 a c
Building Inspector
Piechanical Permits:
Bid Total:
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
LOT:
3284 DONALD AVE
ROBERT KARATZ
PERMIT SUBTYPE:
SF (MISC.)
2 BLOCK: 1 APPLICANT:
PANELCRAFT OF MN INC
(612) 721-6628
TYPE OF WORK:
BUILDING
023057
03/04/94
ALTERATION
DESCRIPTION (SIDING)
INSPECTION TYPE
FRAMING .DATE INSPTR. INSPECTION TYPE
ROUGH IN PLBG DATE INSPTR.
ROUGH IN HTG FINAL
INSPECTION RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
1
VILLAGE OF EAOAN SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.: 2029
Eagan, MN 55122 DATE: 22 _
Zoning: R-1 No. of Units:
Owner: Marell Construction Co.
Address: ????TZ-
Site Address: 3284 DoneldAvernle
Plumber: -Thompson Plumbing Co.
1 agree to comply with the Village of Eagan Connection Charge: 375.00 Pd 4/25
Ordinances. Account Deposit: pd 5/22/73
Permit Fee:
Surcharge: 50 gd 5/22/73
By: Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
WATER SERVICE PERMIT
VILLAGE OF EAGAN PERMIT N?/2W1209
73
3795 Pilot Knob flood DATE. 1
Ea9on,MN 55122 R_1 No. of units.. -- -- - -
Marell Construction
chvner:
--
Address. ? 328 Donald_Av--enu_e -
- ---- g_6-19
O._ e
Site nddre•s - 9 --- .44--P-
plundhrr Thomp on P1umbin _ 244
y ?? _ Connection Chat g .
?1etcr No.:7 9 ?v Account Deposit' -- ---- 5/23
- - - _pa.
Sire. '"-/e 10 00
. / Permit Fee: - = _gd 5J22/7-3_
G
Ii ogr - - of Eagan E ge: LO-00 ? ---
1 a9r" to 4o comp ly wish the Village o ----- -
Misc. Char Qes. -p -
Total: --
Ordinances. ? _, --._- -
Date Paid:
G
pate of lnsp=
MECHANICAL PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
BLDG.TYPE
Name
Address
c City A
Name _
c Address
p City -
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outlets #
Other
M BTU
M BTU
M BTU
M BTU
CFM
FEE:
S/C:
TOTAL:
PERMIT #
RECEIPT # `-
DATE:
For Office Use Only:
p
WORK DESCRIPTION
Res. New
Mult. Add-on
Comm. Repair
Other
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE -- ALL ADD-ON &
REMODELS - 12.00
MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000)
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
>i?/q j
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS: t i l l
PERMIT SUBTYPE:
'ECTIQN RECORD
PERMIT TYPE:
Permit Number:
Date Issued: i' t> ! !
APPLICANT:
?iil t I•i?l i :11 MN IN,
I It
TYPE OF WORK:
AI Ik RA I I ON
I ) 1 - , + V 1 1 ' 1 7 ( ) N ( ` , I It 1 Pit ;)
INSPECTION TYPE DDATE INSPTR INSPECTION DATE INSPTR
. .
7
Permit No. Permit Holder Date Telephone #
S/W
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspection Date Insp. Comments
Footings I
Foundation
Framing
Roofing
Rough Pibg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Orsat Test
Final Pibg. Pibg. Inspector - Notify Plumber
Const. Meter
i
Engr./Plan
Bldg. Final
Deck Ftg.
Deck Final
Well
Pr. Disp.
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3836 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
PERMIT SUBTYPE: TYPE OF WORK:
IN SPECTION TYPE .DATE INSPTR. INSPECTION TYPE DATE INSPTR.
tij'
e
q
4
4?5 !1
i
Permit No. Permit Holder Date Telephone #
S/W
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspection Date Insp. Comments
Footings I
Foundation
Framing
Roofing (' O
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Orsat Test
Final Pibg. Plbg. Inspector - Notify Plumber
Const. Meter
EngrJPlan
Bldg. Final
Deck Ftg.
Deck Final
Well
Pr. Disp.
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS: I i1 , „ 1
Ir1ltMI t, AVI
PERMIT SUBTYPE:
, M!
I I 1 1% AN If N).
ON
:CORD
PERMIT TYPE:
Permit Number:
Date Issued:
APPLICANT:
1 111 PiH
TYPE OF WORK:
III 'xfe 1 11 1 11114
I I HAI
Hia111)1N6
0;08859
09/19/96
I H1
Al f f. RA If l l)N
Permit No. Permit Holder Date Telephone N
ELECTRIC
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
?f
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
CITY OF EAGAN Remarks
Addition ROBERT KARATZ ADDITION Lot 2 Blk 1 Parcel 10 41300 020 Ol
Owner ? r i 1- ? -, luki th 6A0I i Ja.l, street 3284 Donald Avenue State Eagan, MN 5514
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 1975 535.92 10 Paid
STREET RESTOR.
GRADING
SAN SEW TRUNK 1968 38.34 1.27 30 Paid
* SEWER LATERAL 1973 1,822.24 91.11 20 Paid
WATERMAIN
* WATER LATERAL & Stubs 1973 20
WATER AREA
* STORM SEW -N* lat. 1973 20
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 240.00 8307 6-19-75
BUILDING PER.
SAC 375.00 7850 4-25-73
PARK
PERMIT# '
RECEIPT DATE:
2002 MIDENTIAL PLUMBING PERMIT APPLICATION
CITY Of EmAN
3830 PILOT KNOB RD
EAeAN, MN 551 EE
651-661-9675
Please complete for: single family dwellings, townhomes and condos when permits are required for each unit,
backflow_preventer for_irrisation_svstem_
NIZNIK, MARK
SITEADDRESS: 3284 DONALD AVENUE
EAGAN, MN 55121
OWNER NAME:: (651) 452-1466 TELEPHONE #:
_ (AREA CODE)
INSTALLER NAME: Worblom '?1IA.VVVbiv?q TELEPHONE #: (4912'927- `Id33
STREET ADDRESS: 20105 Gorfictd AVy'vlue. Govtii (AREA CODE)
CITY: rJ I S. STATE:
M Q zip: 5540$
_ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00
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.
- Water turnaround - existing dwelling unit (+ 518" meter if needed - $118)
Other:
- RPZ: new installation/repair/rebuild $ 30.00
- lawn irrigation system
Replacement/additional: water softener X water heater $ 15.00
State Surcharge
Allr 1) 9
')(
in) 50
Total {? $ SO
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 applicants 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 activities to the facilities constructed under this permit withiy pr arty/right•of-way/easement.
5 RE OF PERMITTEE 1/02
PERMIT
OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT TYPE:
Permit Number:
Date Issued:
(2 dog(' G
B U L IN /k Er
%
023057
03/04/94
SITE ADDRESS:
3284 DONALD AVE
LOT: 2 BLOCK: 1
ROBERT KARATZ
P.I.N.: 10-41300-020-01
DESCRIPTION:
iding
lding
(SIDING)
ermit Type SF (MISC.)
o.rk Type ALTERATION
REMARKS
FEE SUMMARY.
Base Fee
Surcharge
Total Fee
VALUATION
$54.00
$1.50
$55.50
$3,000
CONTRACTOR: - Applicant - ST. LIC. OWNER:
PANELCRAFT OF MN INC 17216628 0002179 NIZNIK MARK
3118 SNELLING AVE S 3284 DONALD AVE
MINNEAPOLIS MN 55406 EAGAN MN 55121
(612) 721-6628 (612)452-1466
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
Statutes and City of Eagan Ordinances.
V
APPLICANT/PERMITEE SIGNATURE ISSUED B). SIGNATURE
CITY OF EAGAN??.
1994 BUILDING PERMIT APPLICATION
1 681-4675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date _3 Valuation of work _:ZOE)
Site Address: 32,6q AV .
STREET SUITE #
Tenant Name: (commercial only)
LOT L BLOCK I SUBD. P.I.D. #
Description of work: Pes;0lie)
The applicant is: ? Owner Contractor ? Other (Describe)
Name 1Uiz,v*_ z- ppr Phone
Property LAST FIRST
Owner
Address 3--8q l-),n&m b
?V-
STREET STE #
City J faG??J State /-I v0 Zip 55l?/
Company r"AANEG?,Nf`T Phone '--rz1 -6,6Z?
T
Contractor Address _31 t'?K sn??n fty- e?-,o License #c?z?zi 1 Ex
3
p
?
??'?'
,?
City ?P 3 State vl?' ZipS2
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
1hereby 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.
Signature of Applicant:
--mac CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
P.I.N.: 10-41300-020-01
ROOFING
u ldin4- Permit Type SF (MISC.)
uilding-dt?rk Type REPAIR
CW0 0
BUILD N
`ILA
020938
05/13/93
DESCRIPTION:
?L'Ev 1 acquit
REMARKS:
FEE SUMMARIF
Base Fee
Surcharge
Total Fee
PERMIT TYPE:
Permit Number:
Date Issued:
3284 DONALD AVE
LOT: 2 BLOCK: 1
ROBERT KARATZ
VALUATION
$31.00
$.65
$31.65
$1,300
CONTRACTOR: - Applicant - OWNER:
B & B ROOFING 15710248 NIZNIK MARK
6760 MADISON ST 3284 DONALD AVE
FRIDLEY MN 55432 EAGAN MN
(612) 571-0248 (612)452-1466
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.
PERMIT
APPLICANT/PERMITEE SIGNATURE ISSUED BY. 6IGNATURE4
411
INSPECTION RECORD
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS: LOT:
_3284 DONALD AVE
ROBERT KARATZ
PERMIT SUBTYPE:
SF (MISC.)
PERMIT TYPE:
Permit Number:
Date Issued-
2 BLOCK: 1 APPLICANT-
B & B ROOFING
(612) 571-0248
TYPE OF WORK:
DESCRIPTION
BUILDING
020938
05/13/93
REPAIR
ROOFING
La11, I,I IIC, r;01p Lnbe. ;I,Vri,
!lLl it 14?W71. Int!F,
f5 f l fl f-) 41 1 i
'r,-3.-v1 - rPl°d7:?,9i?-R; rv F7
!5(01'1.1<1 11 V149.1
1 Il ,, 1 ()f:V
[E .8d 0f1:11";f !) V/1F
t9SP??8R
P..AfI"DIbA.U
REACIVJI _
PERMIT #
W 1y ;11
CITY OF EAGAN
1993 BUILDING PERMIT APPLICATION
681-4675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month.
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date Valuation of work U C-)
Site Address:
STREET SUITE #
Tenant Name: (commercial only)
LOT -- SLACK SUSD. 1 P.I.D. k
Description of work: 6?- U1-? (?C5
The applicant is: ? Owner Contractor ? Other (Describe)
Name fl ZN1k' Phone 4/5-Z_
Property LAST FIRST
Owner ?Vf
5U&
1
)
7vlr-)
/
-
Address
0
STREET STE !
r1
City I-_A6 "11L State d Zip
Company Phone S7/ -6, ZI/?
Contractor Address 67/"90 1l%r9/I/?11?I > % License # AeTIL Exp.-
city f^?2 'f State Zip }_y 2
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply yt4# all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
i
U
CITY OF tAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
P.I.N.: 10-41300-020-01
DESCRIPTION:
PERMIT
3284 DONALD AVE
LOT: 2 BLOCK: 1
ROBERT KARATZ
PERMIT TYPE: BUILDING
Permit Number: 0 2 8 8 5 9
Date Issued: 09/19/96
SIDING/WINDOWS/MISC
ermit Type SF (MISC.)
ctµrk Type ALTERATION
434 ALT. RESIDENTIAL
.?? i'_ s agcp sa i''sra? :$' ss 4f? O E3 y :.?p,w
tiffs ,.C s I QGc^ig,•. "'Wa `+§F.i re ? ? x Ru ?:
REMARKS:
FEE SUMMARY:
VALUATION
Base Fee
Surcharge
Total Fee
$149.75
$4.50
$154.25
$9,000
CONTRACTOR: - Applicant - ST. LIC OWNER:
PANELCRAFT OF MN INC 17216628 0002179 NIZNIK MARK
3118 SNELLING AVE S 3284 DONALD AVE
MINNEAPOLIS MN 55406 EAGAN MN
(612) 721-6628 (612)452-1466
hei eby acknaw,Ia e tC??t `I his e' read tht1% apto tic?n end Mate' that ;thE
a nfp°rmati,tzn, rrec- ,,,an, agree to carsply with a21- ?bplxeable atrTt -,a 0 7 Mn ,
StatUt s and Ca ,t o`fi ar r1 tl dIn?rrces
L w: r.
APPLICANT/PERMITEE SIGNATURE SS E BY. SIGNATURE
...? h tx"!: ?. J';f y(,F.i<F ?. '{.' ?."r}.i ?-'? i•?*f. < ? Jr _y?.;
CITY OF EACAN
' . .. is _ TERMINN. NQ ;'
PAM D9/19/96 11VEg 150 PPM .
OF MN TNIC
2155 9POT 3FB4 DONALD AYE
2210 9001 40RO BLCKHWV RD 174 .7!.,
EAK5 900i 4Q20 IKXKHW( RA 5 . 5??
....O.......'4.f
USER Tur JAN
AMM*
c CITY OF EAGAN
0 3830 PILOT KNOB RD - 55122
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Construction Reouirements
Remodel/Repair Reouirements
? 3 registered site surveys ? 2 copies of plan
? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior additions 8 decks)
? 1 energy calculations ? 1 energy calculations for heated additions
? 3 copies of tree. preservation pland lot platted after 711/93
required: _ Yes _ No "
DATE: CONSTRUCTION COST:
?L rep acem2.tit w1 nd n?aS
DESCRIPTION OF WORK: _! 2 G2 IrOF F / Y e5i of 2 r ? .r',?,1 r Sr'? G7t DD LS
3a8`1 - ?U?la tGII --riue-
STREET ADDRESS: At)e
LOT BLOCK SUBD.IP.I.D. #:
PROPERTY
OWNER
CONTRACTOR
?- 1?ya-
ARCHITECT!
ENGINEER
Name: N; Zr)i K
UST MIT
Street Address 3a84- Do n ict ? Ue'
City: ECtQa? State: 1n zip:-
Company: PQn2 iCX-O.F-+ pP Mn Phone#:
Street Address: 3(l8 She-(1; nq A5 License l
State:
City: M i pkl eLt-po i(is State: m n Zip: SS?C(o
Company:
Name:
Phone
Registration #:
Street Address'
City:
Sewer & water licensed plumber:
change are requested once permit is issued.
SS(a- 1
-la i-?rOz8
a r-) q
Zip:
Penalty applies when address change and lot
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.
Signature of Applicant: I-
OFFICE USE ONLY
No,K K Phone #: ySa - l"(0(0
Certificates of Survey Received Yes No
Tree Preservation Plan Received Yes No
1'.en A-?pclbr=.um
F. C. JACKSON
LAND SURVEYOR
REGISTERED UNDER LAWS OF STATE OF MINNESOTA
LICENSED BY ORDINANCE OF CITY OF MINNEAPOLIS
3616 EAST 55TH STREET PA. 44681
S.4 /e./ I ZQ l
?nrbepor'g GCertifitaYc If
1 - - / 2S' - If
Q)
0
ro
m
? a
o
b
h
0
N
G??a
2S
?ERESY CERTIFY THAT THE ABOVE IE A TRUE AND CORRECT PLAT OF
Lot 2,31ock l,aobert KBrata Addition,
Drkotrt Coanty,Mlnnesotc.
THIS-Ut-1+_-DAY OF App __w.D._]
s,??,? ?ry?rr
St7 in ? ?/-?-5 3 d ao Rai , ?e Cti,
N. No. 3600
MASTER CARD
STRUCTURE AND
LAND USED AS
Permit
No
Issued Issued To
Contractor Owner
BUILDING 24? s 0 6 y 73
PLUMBING J r!/
77 S 2
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALLING
Z
SANITARY SEWER
OTHER
OTHER
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING SEPTIC
FOUNDATION S%TZ _ CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL
HEATING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING Spa Z- _ -3
WELL
SANITARY SEWER{,
r'
1.
!1
k
Violations Noted
on Back
COMMENTS:
OWNER 1#aMx
-BLUE or BLACK Ink
For Office Use _---_----I
o ----Use-
-
l v~~~~ 1
33~ j Permit
-To b LL 1 c,~ 1
City of Eap Permit Fee:
3830 Pilot Knob Road 1 IZ
Eagan MN 55122 1 Date Received:
Phone: (651) 675-5675 1 f
Fax: (651) 675-5694 staff- _ _ _ _ _ _ _
2012 MECHANICAL PERMIT APPLICATION
Date: Site Address: ► i / V
Tenant: IU Suite
-AN
' RESIDENT / OWNER Name: Phone:
JLJ Ut)V)A f M Al 1
5"
i
Address /City /Zip:
L
N
ame::
low
Address: { V Cit
CONTRACTOR
State: Zip: Phone:
Contact: Email:
Demolition
New Replacement
~nnAdditional Alteration
TYPE OF WORK Description of work: i~ 1 t Yr~~ 1~~~(S~`
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical inspector for information on permitted screening methods.
RESIDENTIAL COMMERCIAL
7z~- mace New Construction Interior Improvement
PERMIT TYPE - Air Conditioner _ Install Piping _ Processed
Air Exchanger Gas Exterior HVAC Unit
Heat Pump Under/ Above ground Tank I_ Install/_ Remove)
Other
,69SWENHAL 6 .00 Mjny~l~dd crlpr alteration to an existing unit (includes $5.00 State Surcharg
$100.00 Fire repair (replace burned out appliances ductwork, etc.) (nclu ed $5.00 State Surcharge) _ $ lY( OTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ x 11%
$60.00 Minimum (includes State Surcharge) = $ Permit Fee
- If the Permit Fee is less than $10,010, surcharge is $ 5.00 = $ Surcharge
- If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee
(i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) = $ TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before
you intend to dig to receive locates of underground utilities. www.gopherstateonecalLOrsr
1 hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that l understand this is not a permit, but only an application for a permit, and work is n t to start without a permit; that the work will be in accordance
with the p ved plan in the case of work which requires a review and approval of plans.
x ha CA x
Ap i t' Printed ame App is n ' Signatur
FOR OFFICE USE
Required Inspections: Reviewed By: Date:
Underground Rough In Air Test Gas Service Test In-floor Heat Final HVAC Screening
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA126619
Date Issued:09/03/2014
Permit Category:ePermit
Site Address: 3284 Donald Ave
Lot:2 Block: 1 Addition: Robert Karatz
PID:10-41300-01-020
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Alex Shikhlinski
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
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.
Contractor:Owner:- Applicant -
Mark E Niznik
3284 Donald Ave
Eagan MN 55121
Delta Construction Inc
11299 Harness Draw
Woodbury MN 55129
(651) 691-5021
Applicant/Permitee: Signature Issued By: Signature