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3039 Eagandale PlCASH RECEIPT CITY OF EAGAN r` 3795 PILOT KNOB ROAD DATE 19 RECEIVED FROM eA AMOUNT 1, 1 $ DOLLARS CASH .NECK J1 ?. FOR 1 _ ? S FUND CODE AMOUNT i Thank You BY 1 62368 - White-Payers Copy Yellow-Posting Copy Pink-File Copy EAGAN, MINNESOTA 55122 " ION IN fl' T POOL _ `31139 i 3041 EAGAI? TY OF EAGAN BLDG. VA APT. P . L" ERMITS (Z POOL BLDGS) 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 I PHONE: 454-8100 BUILDING PERMIT Receipt # POOL BLDGS B To be need for Est. Value Date 19 Site Address Erect ? Occupancy Lot Block Sec/Sub. Remodel ? R i ? Zoning Parcel No. r epa Type of Const. Addition ? No. Stories Name w Move 11 m li h ? D Length D h Z x Address e o s I t I ? ept F b mpr. n Sq. t. City Phone Install ? Nam Approvals Fees , U Address Assessment Permit City Phone Water 8 Sew. Surcharge ba: ?uZ Name Police Fire Plan Review SAC U0 Address W Cit Ph Eng. Water Conn. y one < Planner Water Meter Council Road Unit I hereby acknowledge that I have read this application and state that Bldg. Off. Tr. Pl the information Is correct and agree to comply with all applicable . State of Minnesota Statutes and City of Eagan Ordinances. APC Parks Var. Date Copies Signature of Permittee , A Building Permit Is issued to: Total on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. + ' Building Official Permit No. Permit Holder Date Telephone Plumbing H.VA.C. Electric Softener InWeetion Date Insp. Other Footings i ' Footings ll Foundation J --2 Framing YG ?'? ' ^ Roofing Rough Plbg. Rough Htg. Insul. Fireplace Final Htg. 09* Final Plbg. Final CwvOcc. Water Describe Location: Well Sewer Pr. Dlep. CITY OF EAGAN - SEWER SERVICE PERMIT 3830 Pilot Knob Road P. O. Pox 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: No. of Units: 'i Owner f Address: S Site Address.... Plumber: I some to comply west the Cky of Esye¦ ordlemneee. By Dote of Insp.: CITY OF EAGAN 3830 Pilot Knob Road P. G. Box 24199 Eagan, MN 55121 Zoning: Owner: P-00dy. n c . Address: Site Address: Plumber. Meter No.: Size: Reader 5T A" 9<Ar I pees to campy wht Hre Clfy ors<inesoes. Connection Charge: Account Deposit: Permit Fee: Surcharge: Misc. Charges: Total: Date Paid: + WATER SERVICE PERMIT PERMIT NO.: DATE: - No. of Units: POOL I' tYW^ ale Place Ll B2 P.azandale Lemai metes By Dote Paid: Date of Insp.: S'r G /P6 Insp.: CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road P. O. 89u 21199 PERMIT NO.: Eagan, MN 55121 DATE: 'toning: No. of Units: Owner: Address.. Site Address: Plumber. Meter No.: Connection Charge: Size: Account Deposit: Reader No.. Permit Fee: i agree to comply wilt Hw City of Lsoes Surcharge: Orliasseee. Misc. Charges: 1 Total: By Date Paid: Date of Insp.: Insp.: WATER SERVICE PERMIT PERMIT NO.: DATE: n No. of 5 Units: CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Kr^tb Road P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: No, of Units: Owner: Address: Site Address: Plumber: I agree to eempy wiM tho CHI of Began ormaaneee. By Dote of Insp.: CITY OF EAGAN 3830 Pilot Knrb Road P. O. Box 21199 Eagan, MN 55121 Zoning: Owner: - - - r Address: Site Address. a Plumber. r Meter No.. Size: Reader No.: I agree to aonrpy whir the City of Kwo ordimaaoo, By Date of Insp.: Connection Charge: Account Deposit: Permit Fee: Surcharge: Misc. Charges: Total: Dote Paid: WATER SERVICE PERMIT PERMIT NO.: DATE: No. of Units: _ Connection Charge: - Account Deposit: Permit Fee: Surcharge- Misc. Charges: Total: _ Dote Paid: _ rnsp.: CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION xxxxxxxxxxxxxxxxxxxxx-.:x..xxxxx NOTR': PAYMENT OF FEE AT TIM 0 E APPLICATION DOES NOT CONSTITUTE APPROVAL OF PERMIT. INSPECTION OF SEWER AND/OR WATER IN9iAr ATIONS WILL NOT BE SCHED- ULED UNTIL PERMIT HAS BEEN APPROVED. Please Print 1) PROPERTY ADDRESS: C)'j LEGAL DESCRIPTION: ,/) C. LID kuur/fSlocK/buoaivis ion Or Tax Earcel ID #) IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: PRESENT ZONING/PROPOSED USE: (Mon Year) © COKCRCIAL/RETAIL/OFFICE Q INDUSTRIAL n INSTITUTIONAL/GOVERNMENT 2) ADDRESS: CITY, STATE, ZIP: PHONE: 3) r: NAME: R-1 SINGLE FAMILY R-2 DUPLEX (Two Units) R-3 TOWNHOUSE (Three + Units) ( Units) R-4ARTNIhSIT/CONDOMINIUM ( Units) ADDRESS: •% 41 CITY, STATE, ZIP- -j-D PHONE:.-'/0 7-16 (v MASTER LICENSE# 4) a m .: o •iu:?? NAME: ADDRESS: CITY, STATE, ZIP: PHONE: Active Expired Not recorded Steal CONNECTION TO CITY SEWER ?i CONNECTION TO CITY WATER 6) a • PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE 0 PLEASE MAIL APPROVED PERMIT TO 1, 2, 4, ABOVE (Circ a one) 7) n r• -' y?go - Y 1l n 3NNJi , c LC% i}elm _<-- / r?i? FOR CITY USE ONLY PERMIT # ISSUED 7el-4 °? Pd W/Bldg. Permit FEES: $ $ 1D- S'0 SEWER PERMIT (INCLUDE SURCHARGE) $ $ &) 5 d WATER PERMIT (INCLUDE SURCHARGE) $ $ /0 3 S G WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) C ? 9$ SEWER TAP $ $ ACCOUNT DEPOSIT - SEWER $ ACCOUNT DEPOSIT - WATER $ $ WAC $ $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ $ -,• MATER TREATMENT PLANT SURCHARGE t $ $ OTHER: $ $ Q q ?' S TOTAL ;Z 3s ? RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION,IN PUBLIC RIGHT OF WAY? ED YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: F G Jj r CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION TX%%XXXX%XXX%%%xxiwF w.cw wx.[xxi(FxxxxxxT x* NDTE: PAYMFW OF FEE AT TIME OF APPLICATION DOES NOT CONSTITUTE APPROVAL OF PERMIT. INSPECTION OF SEWER AND/OR WATER INSTALLATIONS WILL NOT BE SCE -- ULED UNTIL PERMIT HAS BEEN APPROVED. ---------- - - (Please Print) 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: - (Mon Year} PRESENT ZONING/PROPOSED USE: ? COMMERCIAL/RETAIL/OFFICE ? INDUSTRIAL n INSTITUTIONAL/COVERAAgTT 2) NAME: ADDRESS: CITY, STATE, ZIP: PHONE: ? R-1 SINGLE FAMILY ? R-2 DUPLEX (Two Units) 3 TOWNHOUSE (Three + Units) ( Units) R-4 NAPARTMaU/CONDOMINIUM ( Units) 3) NAME: ADDRESS: CITY, STATE, ZIP: PHONE: -k57-1661 MASTER LICENSE# riumoers W.Cense: Active Expired Not recorded staff initial 43®.?.wav: NAME: ADDRESS: CITY, STATE, ZIP: PHONE: '5) n r •: :: • a• ?? CONNECTION TO CITY SEWER OQ CONNECTION 'Ili CITY WATER OTHER J ?(i 6) SIGNATURE:' PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE PLEASE MAIL APPROVED PERMIT TO 1, 2, d)4, ABOVE A (Circle one) FOR CITY USE ONLY PERMIT # ISSUED Pd w/Bldg. Permit $ $ $ 1? YI $ A I c / Y( $ 1r G $ ? Ir S c $ WAC $ SAC $ TRUNK WATER ASSESSMENT $ TRUNK SEWER ASSESSMENT $ LATERAL BENEFIT/TRUNK SEWER $ LATERAL BENEFIT/TRUNK WATER $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ $ j-6 TOTAL RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? Q YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: . FEES: $ %U 5-0 SEWER PERMIT (INCLUDE SURCHARGE) $ %C 5 O WATER PERMIT (INCLUDE SURCHARGE) $ / C.3 5 O WATER METER/COPPERHORN/OUTSIDE READER $ WATER TAP (INCLUDE CORPORATION STOP) i SEWER TAP v$ !. ACCOUNT DEPOSIT - SEWER ACCOUNT DEPOSIT - WATER TITLE: DATE: