4419 Cinnamon Ridge Cir
_ C1TY OF EAGAN O 3?
? 3830 Pilat Knob Roed, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
dUILDING PERMIT Receitn #
T- A : _?.i • i. _ _C.? Vwl? , . _ s ?.?V , i f'LNa ,.hr' ?.LL.? 19 _?z _
Lot J
Parcel No. -
W I Name ,. _
? Address
r7 .. 'tl CL..... ?_i ?a L l. --
,t Name
?1 Address
I.- r.irv Phnnn
Address
Citv Phane
I hereby acknowledgs thot I ha+re reod this application and stote that
tha +ntormation Is torrecf ond agree to comply with oll opplicable
State of Minnesoto Statutes and City of Eagan Ordirwnces.
Sipnaturc of Permittee {
j?lr7t/ I?" , ... ?JLL..:..'?
I? 6uilding Permit is Issued to:
oll work sholl be done in occordante with qll opplicable State of Min
Buildfnp Officiol .
Erect Q Ocw pancy : - . ,
Remode! ? 2oning
Repair ? Type of Conat,
Enlarge ? No.Stories
Move ? Length ? -
Demolish ? Depth o ?
Grade ? Sq. Ft.
/lssessment
Water b Sew.
Pol ice
Fire
Enp.
Plonner
Council
BId9. Off
APC
Var. Date
Pennit
Surchnrps
Plan Review
SAC
Water Conn.
Water Mtter '
Rood Unit
Total
on the axpfess cor?dition thot
ond City of Ecypn Ordinances.
...:,,.?o...???.....•.:..?.....?. =?? - -?.?,?.?.?.-- - -----?,???:.._..??.:.?,?.;....,
Parmit No. Pormit Holder Gats Telephone #
Plumbing
H.V.a.C. 'I - 1-5 9 Gc5
electric I Co o r Yjo--v5 v),00
Spltensr
Inspection Date Insp. Othor
Footinqt
Fpundatian
Framinp ..?,.?
Roofing
Rouoh Plhp. _
Rouyh HVAC
Inwlation
Final Pibp.
Final NVAC S?
Final
Cart/Oec. ? t(J ? ?
riater Wscriba Location:
YVall
Sewsr
Pr. D'ap.
Receipt . PLUMBING PERMIT Permit No. •
CITY OF EAGAN
, Fas
" Fill in numbered spaces S/G
Type or Print legibly Tot.
1. Date ?' - 2. Installation Cost
3. Job Address Tract ? h n
4. Owner --
5. Contractor
6. Address
Phone
7. City f" State Zip
8. Building Type: Residential 0 Commercial O Institutional ?
9. Work Description: New ? Add ? Alter ? Repair ?
? 10. Describe
? 11•
No.
:9 Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
% Bath tubs Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
? Laundry Tray
' Floor Drains
Drinking Ftn.
Slop Sink
' Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all.ardinances and codes governing this type of work.
Signed : I for
., Rouyh Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved C1TY OF EAGAN 454-8100
Receipt
MECHANICAL PERMIT i
Petmit No
CiTY OF EAGAN .
Fes ;
fill in numbered spaces S/C ?
Type w Pr/nt legibly T
ot I
1. Date 2. Installation Cost +`? ?-? .. • i
. . - . I
3. Job Address Lot Blk. Tract
4. Owner • .''dT'ieS eMlue1'S
5. Contractor ;`'ri tAC, Iti:.. Phone °°QO-', .
6. Address . s' %'- ch . ? :
7. ?'.ILy ???ri:l"a'S5£Cl $L2L! ' ? ',!)?>t Zlp J.)"'
8. Building Type: Residential C7 Commercial O Institutional ?
9. Work Description: New 42 Add ? Alter O Repair O
10. Describe :? . Fuel Type
11.
12. I hereby certify that the above information is true and correct, and I ayree to
comply with all ordinancea and codes governing this type of work.
Signed : for
Rouyh Flnal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-6100
No, EQuioment BTU - M. Ea.
Foroed Air No. Equiament CFM
Ai
dli
H
?
Mfg. ?orr ir e r
an
ng:
Boilers Mech
Exha
t
Mfg. .
us
Unit Heater
Mfg. Other
I AirCond. 2,; . :?? .
Mfg.
Gas, Piping Outlets
CITY OF EAGAN N° 'I O O 3 1
3830 Pilot Knob Road, P.O. Box 21-199, Esgan, MN 55121
PHONE: 4548100 L5D
BUILDING rERMIT Receivt #
To MwW for ? OF TWIN HOMI& Voiue $49, 000 pate APRIL 3 ly 85
? - -- -- - -
SiteAddrea 4421 CINNAMaN RIDGE CIR Erect Cx Occupancy R3
Lot 10 Block 4 S,c/Sub. CINN RIDGE 3RD R°"'°del 11 Zonin9 R4
? T
f C
ype o
onst. jT
Repair
Parcel No. Enlarge ? No. Stories
Name DEVRIES BLDRS More 0 I..enqth 24
fi
h ? D
th
D
?
7564 MARINER DR
Addr
ep
emo
s
64
?
eas Greda
Sq.Fc.
Crty MAPLE GRV Phone 424-2611 Install ?
SAME Approvols Fe"
Name
S
Z
50
?
Addreaa
?
, Assessment Permit .
24
50
?
City Phone .
Woter b 5ew. 5urthorqa
139
25
.
Police Plan Review.
W Name GAGE
k Fih SAC 525.00
BOONE AVE NO
zt3 Address 500.00
Enp. Watcr Conn.
?W City BROOKLYN P?ane Plonnar WoterMeter 63 • 00
2 8 0
0 D
1 Fxrcby ockrowlodye thot I haw rood this opplication and state that _
Cow,c;l Rood unir
Bide, off. 3/ 2 9/ 8 5 q+ , p, 132.00
the informetion is torrett ond ?ee to tomply with oll opplicable
on
dinan
of E
O
u
s
t
't
f Mi
S •
Total
r 1
2 5
9-?-2
C
? g
S
.
tofu
es o
y
StaN o
nnewto
G
n ?
,
.
. Date I
Var
?
?
'V-
?
Sipnoture of Permitte? zz"j 1
A Building Permit Is issued W. DEVRIES BLDRS on the express conditlon thot
oll work shall be done in acco?donca with oll oppljeqble State f Min sota Statutes ond City of Eapon Ordinontes.
Buildin
Official
p ?
y•f G l. l. J.lvivr;.C?..>? + 1C ;.LJIYL' l:.lh
Site Addreu
Lot ?? Block Seclsub. C. Z IJ ; J :? I i i
Parcel No.
W Name ., , . .. . . _ , . , ?, ., . . .
z i ?? ', -:-s" l.`•'.F:t?. f._,
Address
? CILY PhOn@
Name
oV? Addreas
f- Citv _ Phone _
Name
I hereby ncknowledpe that I hove read this cpplicetion ond stote thof
the intormotion is eorrect and a9ree to comply with oll opplicoble,
State of Minnesoto Stotutes ond City of Eo9on Ordinonces,
5ipnotum of Pern+ittee •,•_V!`.T"?
A Buildlrg Permit is issued to:
all work sholl be done in occordonce with all appliaabla State of Mii
Bufldinp Official
Remodel LJ Zoning •
Repai r ? Type of Conet.
Enlarge ? No.Stories
Move ? Length . ,:
Demolish ? Depth
Grade ? Sq. Ft.
Install ?
Aosrovals Fea
Assessment
Woter & Sew.
Pol ice
Fin
Er+o•
Planner
Courxfl ?._
Bldg. Off. 3 ? -
APC
Var. Date
Permit 0
Surchorpe
Plsn Review
S^C ' U L
Water Conn. J!',
Woter Meter j ?
Road Unlt
?..?1?.
Total -41 r94_2 .4S
on tF» expnw conditlon Ihat
ond City of Eapon Ordlnonces.
cirY oF EAGAN '?? -1 904 31
3830 Pilot Knob Rosd, P.O. Box 21-199, Espan, MN 55121
PHONE: 454-8100
eU1LDING PERMIT Receia #
?_ .,. :•_.Y,., ,,,. ., ,,. .. . „ .. .
Pwmit No. PKmit Holdkr DsN Telephone ilt
Plumbing l? (4 l( 6 VI S r r_- ? r
H.V A.C. r ;3 ? /y'AA-0-1
ENctric (
Softenwr
InWactian Datt Insp. Other
Footinq w
Foundation
Framinq 40•
Roofing
Rouqh Plbq. . p ?
Rough HVAC
Inwlation
FinatPlbq,
Final HVAC ?j
Final
CKt/Ooc. .,?
w?r D?scribe Lotation:
S?v?r
L
L
Pr. Disp.
.
Rocsipt
Psrmit No. ?
( f _ r Fe. ?
Fill !n numbened apeces S/C
Type or Prini Isgidly ToL
t. Date 2. Installation Cost r? :???? •
3. Joh Address lot Blk: % Tract
4. Owner c
5. Contractor '- r? t I ni' . phone
B. Address ? ?) eW° `Ah `treeL
93a-osz6
7. city :??:.`tassea? state ' A nnesot?, Zip 17
8. Building Type: Residential 0 Commercial ? Institutional D
9. Work Description: New El Add O Alter O Repair ?
10. Describe +!+ ;"J': Fuel Type ;^ ? . ?•? =.
11.
No•
? F?quipmeaL BTU - M. Ea.
ForoedAir No• Euuiement CFM
Ai
H
.
Mfg. ' ??r g:
r
andlin
Boilen
Mfg. Mech. Exhaust
Unit Heater
Mfg, Othe
I
Air Cond. r
Mfy.
Gas, Piping Outlets
12. I hereby oertify 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
Rouqh F Inal
Inspections: Date Insp. Date Insp.
This is Your permit when numbered and approved.
Approved CITY OF EAGAN 464•8100
Receipt ? -
? : . _.
PLUMBING PERMIT
C1TV OF EAGAN
Parmit No.
Fee
` Fill in numbered spaces S/C
TypP or Prin[ legib/y Tot.
1. Date 2. Insta{lation Cost
. .
? ? _ i ,•-. ?c. -: : - - , C.i! ?„` /'1
3. Job Address Lot / l-) BIk: ? Tract
t , -P- ?dy 3
4. Owner /L-
5. Contractor
Phone
6. Addres5 ?v?lJ C f????,.,?.?..• ?. t.'.? ?`r
7. CitY -.l k? State Zip - ` • -
8. Building Type: Residential Q- Commercial ? Institutional ?
9. Work Description: New 0 Add El Alter ? Repair 0
I 10. Describe
1 11.
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tu6s Septic Tank
' Lavatory $oftner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
? Gas Piping Outlets
12. I hereby certify that the a6ove information is true and correct, and I agree to
comply with all wdinanres and codes governing this type of work.
Signed : for
? Rough'Final
lnspectios?s: Date {nsp. Date 1nsp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
?^
CITY OF EAGAN Remarks
I CIMiAMONL RIDGE 3RD Lot nt - 10 Bik 4?
, oWner Street 4419 Cinnamon Ridge Cr
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF, se )riginal O O Bk
STREET RESTOR.
GRADING
5AN SEW TRUNK
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
51DEWALK
STREET LIGHT
Road Unit 0.0 50623
WATER CONN. 500.00
'
13UILOING PER.
SAC Q
PARK
CITY OF EAGAN Remarks
Addition CINNAMON Ridge 3RD Lot pt . 10 Bik 4 Parcel 10 17402 101 04
Owner Street State F.a oa,n , MN 5?i? 22
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. S@Q original lOt 10 bl. 4 OT' prepai assessment
STREET RESTOR.
GRADING
5AN SEW TRUNK
SEWER LATERAL
WATERMAIN
WATER LATERAI.
WATER AREA
STORM SEW TRK ,
STORM SEW LAT
CURB & GUTTER '
SIDEWALK
STREET LIGHT
. 0 50623 4/4/85
WATER CONN, rj00. 00
BUILDING PER,
sac 525.00
PARK
OF EAGAN
Lot 10 Blk 4 pa??, 10-17402-1
Owner
n,or.lJ /D / -O 4l S?L- lGtng -.-,)
? Improvement Date Amount Annual Years Payment Rece' Date
STREET SURF. 1 34 925 •44 C 49 -il- 5
? STREET RESTOR,
GRADING
SAN SEW TRUNK Lqf 1973 .22 6.81 15 ?
* SEWER LATERAL g. 90 -
47 5 91.
? .
WATERMAIN
? * WATER LATERAL 1985
WATER AREA ZOI 1973 131.44 8 15 17.56
I* Services x 1985
STORM SEW TRK 1979 381.69 19.08 248.13
* STORM SEW LAT x 1985
CURB & GUTTER
SIDEWALK
STREET LIGHT
?
Uni 280.00 5062 4/4/85
WATER CONN. SOO.OO " ??
BUILDIN R. O, 0031
sAC 525.00
RK
CITY OF EAGAN WATER SERVICE PERMIT
3830"Pilot Knob Road
P. O. Box,21199 ? PERMIT NO.:
Eagan, MN 55721 DATE:
Zoning: <«• No. of Units: '? fjilT]I PY
Owner: 'eVrieS :;lt"r3
llddress:
Sita Address• 4421 Cinnaric•n ?
. ye Circln 7.1 ti I',4 i`inTi it??tca <
Plumber,
AActef Na.: Connection Charge: n(1 nti
; Size: /lccount Deposit: 5 - of) j"' ?
Reoder No.: Rermit Fee: 10.00 De-
1 peN fe oon* wi1M tlw Ciey of Eesew Surcharge: . 50-iL-
Ordieo.o... 132.00 pd "lCd:
M1sc. Choroes:
63.00 gd meter
Totol:
BY -
Date
of Insp..
Date Pnid:
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Itnob Road
P. O. Boac 21199 • PERMIT NO.: ?4
Eagan,:VIN 55121 DATE: 4"11'-'-
ZoninD:; No. of Units: ¢. Px
Qwner: i L2
t4ddresc
C
'I
?
F
o.: .?? 9 ? 7?
r ? ? 3 Connection Charge• yn? _ nr? r,:
Size: ' o
Reade No.:
I ym ro ao-ply wilh 41N Ciryr of BMqen
OrdiNnpm
By
Date of Insp.:
AccounFbeposit: _ 5 , 94 n
Permit Fee: lO.OJ c?_
Surchorge: • ?0 pd,
Misc. Charges: 1.32.00) nr.a ?
TOTGI: ' ? • 1? F:Cj iilk.'t
Date Paid:
Irisp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road i
P. O. Box Z1199 PERMIT N9.: r,
Eagan, MN 55121 DATE: 1 '-- ` ` -'?
??in0: R2 No. of Units: ;2 dttp1Px
dwner DeVriee B1cIr8
Address:
Slte Addi
Plumber:
1 agm to owwPy wiM e1N Ciey of EWn
Ordinaueu.
By
Date of 1 nsp.:
Connectton aorpe: 425.00 pd
Aacount Deposit:
Permk Fee: 15. O0 pd
10.00 pd
Surcharoe: .50 Pci
M1sc. Charges:
Totol:
?
?
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilcft Knob Road -3 6 3 ?
P. O. Box 21199 PERMIT NO.:
MN 5512'I "
E D/1TE:
agan,
Zoniny: :;2
oY -,I
No. of Units: 13 c111);)1
DeVries P.ldrs
p
ner
.
w
Addrm: I
Site Addrosr 4419 1 n non Rid
I
ge rirci o t 10 R4 [' t nn P a? g1, 't
Plumber. Blavlock I'1Lg ;
Meter No.: Connection Chorqe: S1(71_ fl(1
Size: Account Deposit: 15.00 <i
Recder No.: Permit Fee: io . 0 Q Pc' _
1som to comPb wilM !Iw City ef Eoww Surcharge: AQ .d
Ordineeam AAlsc. Chorpea: 1'Q. f50 :D;
TotoL• f;3 ^ ; ptd :neter
g Dote Poid:
y
Date of Insp.: I^sp•: -A
WATER SERVICE PERMIT
PERMIT NO.:
DATE:
. NO. Of U17If5: % j LD 1?x_
r .c«, qn.a,ar?: ',??n_nn n-?
[der No. - ? 'A ??eposit: 15.00 pd
No..02 0 Pemnit Fee: I 0. 0 C p??
se M eoinph? wiN? !IN Ciryr ef F?w Surcharge: .6Q ??i aao.,, Mix. cnarpes: i '?gn n?ye,
? Torol:
? Dota Poid:
L,i i r V r t/?
3830 Pilot K
P. 0. Box 21
Eagan, NiN '
ZOfllrlg: _Y
`reSS.
Site Address:
Iwnber: -
CITY OF EAGAN . SEWER SERVI CE PERMIT
3830 Pilot Knob Road 7252
Box 21199 PERMIT NO.:
P
O
.
. 4-1--
1 p^?;
Ea
an
MN 55'?
g
,
g
i d
l
t" No. of Un1ts:
Zoning: I
up
es`
Owner: ;?e ries B rs
Address:
Site Address:
Plumber.
I.yne to oonqy wNh dK CiM of lesee Connection Chonpe: 425.00 pcl
Onlieeaea. ACCOUM Deposit: 13.0 P
c:
Permit Fee: . p
Surchoroe: . p
By Misc. Charpes:
Dote of Insp.: Total:
Insp.: Dota Paid:
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:4548100
BUILDING PERMIT ReuiDt # -
h OF TWIN
$49,000
SieeAddreu 4419 CINNAMON RIDGE CIR
Lot 10 slxk 4 Sec/sub. CINNAMON RIDGE
Parael No. 3RD
Neme
Address
City MAPLE GRV Phone 424-2611
SAME
o Name
Addresa
• City Phone
?uZ Name
io Address
m
,uZi
City Phone
N_ 10030
Erect 0 Ocwpency R3
Remodel ? Zoning R4
Repair ? Type of Conat. _Ir
EnlarBe 0 No. Stories
Move ? Length 24
Demolish ? Depth 64
Grade ? Sq. Ft.
Install ?
Aoororals Feas
Assessment _
Woter 8 Sew.
Polite _
Fire
Enp.
Ptonner -
Council _
Permit • 50
Surchorpe 24.50
Plan Review139+2 S
SAC S25 OO
Wafer Conn. s.QR- 00
Water Meter #;-A? 00
Road Unir 00
1 hereby acknowledga thot I haw read fhis application ond ztare that gldg. Off. 3 2 9 8 S T. P. 13 2_ 0 0
fha inlormafion is [orrecT ard ogree fo comply with all opplicable APC Total $1 949 25
Stafa of Minrrosota $tatutes and C' of Ea?an Ordirwpces. . Var. Date ?
Sipnofure of Permittes ,?"'"`
A Building Permit Is issued W. DEVRIES BLDRS on the expross cadinon tha+
oll work sholl be done in aecordance with oll a/pp?liwble Sta Inneaota Statutea ond Ciry of Eapan Ordirwncea.
BWidinp Official
?
in's ."-esT wia 5 V ?LP (
? muntns f.om
L?o
? I r?re n
4-8-ts5
Ljl(Licens¢d Electnwl Comractor
? 0-ner
Street qtldress, 91x w Route No.
4499 CInnamon Ridye Circle
ecLnn o 7.nshiV Name or No.
Eagan
Occvpant 4PRMTJ
ueVries Builders
uakota Electric
:-ectncaI Ccntnactm (On
Contemporary E1
Y Read N
? v awR
Will Nol.iv Inspeo-
?N^
C5 [ Wh
e Nead
Y
? Mrebr .eo..est
Nech?cal wwk l :?wecx:on ot abo?
?vlled ai:
Citv
Eagan
Cauntv
Dakota
Phone No.
_ 424-2611
4300 - 220th 5t. W. Farmington, MN
M Namei
:tric, Inc.
o, 0419167
Gri ?wu1A STATE BOAXD OF E ICII
gas-Mi?Y Bldy. - q?m 1
1?1 Universip Ave.. St. Paul. MN S6lOi
?hone (612) 297-2111
TNIS INSPECTIpN REQpEgT wILL NpT
9E ACCEPiED py THE STATIE BOARD
; UNLE$5 pqppEF INSpECT10N FEE IS
ENCLpSEp_
?EauESr roe REcrwcnL inrWEcnow
0149 ,.?*.?.:a.? ro. ?oeee? mis r? ? eao. Eaoooo,-oa
6 5 -•X-- ,e,._.. W=_._ ,.._ . _ _ OF ",to.,
TAis requ¢st wid
U??a( ` ?-(p 5
1 WMTgn, ? L,I UV 1/ `"I ?/1 "l J f ?' d
Request Oate Fire No. Rough-in 1 ctfon ?
4_?_OL' i ed? fleatly N. Will Nolify.lnspec-
OJ es ?NO [or Iqhen q¢ady
? Ucensetl Electncal Comractor 1 A¢rabv request inspectfon of abuve
? Owner eleciriral work in¢ralled ar
SVeet qtltlress, Baz or Rou[e No. CitY
4421 CInnamon Ridge Circle Eagan
ecLOn o. Townshup Name or No. Range No. Coumy
Eayan Dakota
Occupa,t (PpINTI
DeUries builders Phane Nu.
424-2611
Power Supulier Apdress
akota Electric 4300-220th St. W. Farmington, MN
Electncaf Con[racmr (Company Name) Convar.mr's L¢ense No_
ontemporary Electric, Inc. 0419167
Maihnp Address (COntrac[or o? Qwner Makinp Instaila[fonl
810 Hemlock Lane Ma le Grove, Nn 55369
AuU?Orrzed Signature IComrac?or/Owner Making Instaliation] Phom Nomber
1 424-4232
WINNE$OTA STATE BOANp OF EIIeICTRICITY
Grigpg.MidwaY Bldg. - Room N-1e1
1821 University Ave., St. P.O. MN 56104
Pho,re f612) 29721 11
THIS INSPEGTIpN pEQUEST WLLL NOT
BE ACCEPTED 9Y THE STATE BOAflD
UNLESS PROPER INSPECTION FEE IS
ENCLOSEO.
(/? ?^1l REQUEST FOR ELECTRICAL INSPECTION
214966 See insiruetinng for rompletify fhia fprm m back W yoilow 7
copy. (,
"X" " Be/av Work Covered 6 This R ?r b
- g?
y equest
f.na Hep. TVCe of 8u??aing Aooiiancas wi.w e
quiome..t wi.e.J
X Home Range Temporary Service
Duplex
j
B?fldmg Water Heater
Oryer Lightiny Pixtures
ECectnc Heatin
nercial Bldg. X Furnace Sila Unbader
Industrial Bldg. Air ConAiboner Bulk Milk Tartk
Farm Othur oece y D ls washer
Qthe? ($pec?ry)
tM:r 1 Veciry e?er
is osa
o«,'
N Fee ServiceEnxranceS?za q Fee Peeden/5ubteeders !t Fee Cimmtg
? t° 200 AmPS 0 to 30 Am s Q. U 0 to 30 Am -
Alwve 200 Amµs' 31 to 100 Amps 1 4 31 to tOQ A
Sw?mning Pool Above 100_Amps Abuve 100_Amps
Transformer5 frrigation Boo?rs
• Pattfal.'OMer Fee
S?9'S SVeaaF l?ispect7on ? ?
?
??°°
l 47.5 ?
,
TOTAL FEE
ir
llg Of dOUble hunoalrn.i , i -,. r, ?
Roueh-in
? D,ite
1_ the Elee.vx?
I?pec?or. ?ereby
F?nal / C°dufi' tlrel the abuye
Date nas ncen
?ae.
n u. .. ? ? ?.. ? ,.., ? , o m.,..... ......,
.. , 4
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
0F TWIr.? 40ME 1 SET OF ENERGY CALCULATIONS
To Be Used For: ? Valuation: OCO. op Date: 3?1s"ds`
Site Address: C/y /q /L V,-4 OFFICE USE ONLY
NaV-'sN '/ZoF i, k,41
Lot: /D Block ? Sect/Sub ? rect X
Remodel
Parcel It Repair
Enlarge
Owner 4- Move _
Demolish
Address 7?Ly Grade
City/Zip Code 36 4 --------•
G
Phone y o ,( ab ,i APPROVALS
Contractor ,5,,._.(,
Address `
City/Zip Code
Phone ^
Areh./Engr.
-?
Address ?o,.? C?•,,?_ ?1,?_
City/Zip Code
Occupancy
Zoning
Type of Const
IF of Stories
Length 2'-
Depth (o¢
Sq Ft
„
Assessments Permit 2I 8. -
Water/Sewer Surcharge Z2F?i2
Police Plan Review l 3q, PS
Fire SAC SZS,`'
Engr Water Conn sclp.
Planner Water Meter b 31
Council Road Unit 2ep. aO
Bldg Off Parks
APC Treatment Pl ? 32. °a
Variance
S Yd a s-
/
TOTAL r
Phone f1
.
.. .; ? ,?•
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LZCENSED WITH THE CITY OF EAGAN
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
'/2 bF TwiNi4c 1 SET OF ENERGY CALCULATIONS
n? -
To Be Used For: ptl? Valuation: q-J,CCO, 22 Date: 3 2 r- S'r-
Site Address: (AJa ) b",'"J CC?- OFFICE USE ONLY
`rou7N l/z oF Lot: f0 Block 7 Sect/Sub Erect ?C
Remodel _
Parcel fi ^- Repair
Enlarge
Owner ,? ?/?., ?j?,Q,? • Move _
Demolish
Address Grade
City/Zip Code
Phone -
Contractor
i
Address ?
City/lip Code -
Phone
Arch./Engr.
U
Address r-1.11 0„1 }2u
City/Zip Code a.,,dj.
eorRnvet c
Occupancy 2-3
Zoning ?-4
Type of Const 4
1! of Stories
Length Z4?
Depth ?
Sq Ft
Assessments Permit
Water/Sewer Surcharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Council Road Onit
Bldg Offs z S Parks
APC Treatment P1
Variance
TOTAL
??Q -? 5D
L IU
24"?
? m
? -3 64
ee
i?a, a s
Phone 11
°CAUVINo H. HEDLUND
Land Surveyor Civil Engineer
7726 Morqan Avenue Souih
Rich/ield,Minnesota 55423
Phone:866-2823
-? ;
JOB N0.
SURVEY FOR: John Petrries
DESCRIBED AS: Lot 10, f3lock 4, CINNt1DtON RIIIGI: 3ftD ADnITION, City of P,agan, P;ikota
Cowity, Dfimtcsotu ?nd rescrving ctiscments of rccard.
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y a•
ClNl1[AMOnt ??D??S6S \
C<?
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Tap of Foundat;on • 9 zr. 3
B.+semen-C ?loor' • 9l ,9. `L
,('irrr9e -Ffoo/ c `)ZO, 9
'Propa5.d Elevdti+on c (f!?
EXiSt;np ?/eVntton5
Dra;na?? .D?rect;ens -?
??net<s Lot Corner O
CERTIFICATE OF SURVEY
I hereby certify ihat on 3?le) Ig5 I surveyed The property described obove and that
ihe above plot is a correct representotion of said survey. ?
C ic"r.!'?U-<.:ti/'?• ?1?'i?LG?%h?
Caivin H. Hedlund, Minn. Reg. No. 5942
?
2/84
? CITY OF EAGAN
I cC.t /
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTIOTT
(PLEASE PRINT)
1, PROPERTY ADDRESS: y VI % /;
r-Frar. DESCRIP'TICN: ???> cn o? S? Qi '"??7"
(Lot/Block/Subdivision or Tax Farcel I.D. Niu:icer)
I I'r' E;IS:'_:G SML'CP'RE, DATE O-v ORIGi IAL cuIIS7=G =--HST ISS?:?=:
P°ESL,"?' Z^:7rr,/nt?pPpS=- L'S: 0 R-1 SitiGT, : FP_MILY
?R-2 DUPL....`'Y ('IS:O GTIITS)
it 3 TCI.,:1iLF'_CUcE (Tf'p.: + li:IITS) ! Wi I"'S?
p n-4 A^rAR'^1?]T/CC`.?G-ff`:I[,11 ( UiVITSi
? CQtiMERCL3L/RE.TAII,/OFE'IC::
? 11DL'ST.2IAL
? INSTI;'C,TIO.]AL/GGVE.RI`IMENT
2) AppLICA?N (PL SE PHINT) ?
??
1
` e
NA[•tE: ?
El l/
OL
? a V)l ?)i rl h ( "0 .
P.DD.RE55: ?7, 3 / - t- IX /? (I C' •.??'J
CITY, STATE, ZIP: Nl ('_ h r- r ? /(J 3
-
PHOLNE: c ?
-S/
3) PEU,IBER PLEASE PNiNi) FOR CITY USE O4LY
nkME•
ADDRESS: ? PLERS LICEYSE:
Attive
CITY, STATE, ZIP: Ezpired
PHONE: dASiLr?
PIUMBER LICENSE N = at f R cord
af n1t13
4) OC.tiUPANT/ClwNEFt NAME_ ? lrLtn5t- ieliJ
anDREss: ?/,SG• ? /? fl [? ,?l e E`_ . l?,F_i r/?
CTTY, STATE, ZZP: MFlloIC 6P'U(/F. ? Lli1L7 55:-3k7
PHONE-
5} INpIG'1TE L+IHICfi PERNIIT IS BEINC; REnUESTFD:
CODINECPION 'I10 CITY SEFJER
CONNFICTIQN 'Ib CZTY SVATIIt
0`1E1ER (PLFIISE DESCI2IBE)
6) ILJDIG;':L C.1E:
7) SIa.*A'IV'RE:
? PLEaSE kIOID APPROVID PER+4IT FOR PICFC-b? BY ONE OF ABOVE
? PIFIISE r*AIL APPROVED PER.tiLiT M 1, 2? 3, 4 ABOVE
, (Ci?ie one)
-? ,
4 DATE: - -,10 -?5
MRRAiL+Rf6JYi?n?satlo:a?r9??sH[v.sas: ' ` •? . "
i#p i i/i ?.sii:? a 1t !!llE1Al11'y!FJ? s'!? !! i oFi?i? ?
FOR C I TY U 5 E ON;,Y
PERMIT °- ISSUED
FEES: $ ? D- ?e•-o
$
S
$
$ /-??- °'-'°
$ S-`s--?. •`-2!
$
$
S
$
SE?^iER °E4MrT (I`ICLC;DE SU°Cfi?RGE)
WATER PERP4IT (INCL'JDE SliRC;?ARGc)
WATER METER/COPPERHORN/OUTSIDE READER
WATER TAP (INCLUDE CORPORATION STOP)
SEWER TAP
^CCOi;::T _,?0SI= - 07:,?3
ACCOUAIT DFPOSIT - UlAT°B
WAC
SPC
TRU.IK WATER ASSESSME:VT
TRli:IK SEWER ASSESSMEiIT
LATERAL BEDIEFIT/T2UNK SE:•7ER
LATERrIL BENEFIT/TRUNK WATER
OTHER '
$
S 11a ? °?
TOTAL
AI"IOU:VT PAID/RECEIPT /
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGciT OF WAY?
YES IF YES, THEN A"PERMIT FOR 'r70RK WITHIN
? PUBLIC ROADWAY" MUST BE ISSUED BY THE
NO ENGINEERING DIVISION. LIST AS A CONDI-
TIOLV.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:.rLat.g
/
DATE:
we wl?mwarm .? miia .ks namse mum
?? w ? w f? ww w.a ?+? w ?? ? w.a wt ? sa ?? ?a ?c? w sw w ?
?
=T I'
?? 2/ 8 4
? CITY Or EAGAN
? t?111 ? APPLICATION FOR PERMIT
• SEWER AND/OR WATER CONNECTIODI
(PLEASE PPINT)
?
?
PxoPERTY ADnREss: ?I (/
' ) r? ry
? c ?
?
r.FrAr nEscRiprZCy: o _29 G
(Lot ock/Subclivision or Tax Parcel I.D, itmwer)
? I'r' S'?PL'C'TU:2E, DATE OF OiZTGuIAL ::UI`??7' P.:G =_mST ISsz;Ai;G.:
,
PI?ESL": ?:^`II;r,/P?OPOSED IISc: O R-1 SD;GL: cP_'UL?LY .:=- __ ,
5(E2-2 DUPT= (TNO UT?ITS)
? R-3 'iC7.,RNTICUSE (Tf%= + L'iIITS) LNITS)
? tC"4 L'VITj)
? CCktiMERCLAI./RET'•ASL?OFFIC::
? 1NMCS'IRL:?L
? NSTI-.7,'TIO:IAL/GGVM;rL%YiE?."I'
2) APPLI= (PLEASE PRIVT)
RIAvIN; ll ?)/U /n hi/l6 ?r"1
?D?SS: - I / c4 A v? ?o .
cri^r, sraT_-, zzP: A (, e l It? LS?L 3
PF:0NE:
3) P??MER NAME PLEASE PRINT) FQR CITY I7SE OHLY
.
ADDRESS: ?
-J
J?
(
? ?-
PLUC RS LICEHSE:
_
.9y1, Actiye
CITY, STATE, ZIP; Expired
PHONE: MASiL?
PIU,MBER LICENSE Q Hot f fl cord
a r nitia
4) OCCUPANP/C7.'JTIQ2 lPyEgSE PR NT)
NF?ME: ?[? i fI.??S
ADDRESS:
CIT`l, STATE, ZIP: Z rf iUG X /L)
r-
PHONE:
S) IIVpICI1TE WIIICH PEE2MIT IS BEING REIQUES1'Ep:
? COD1fIF.CI'ION TO CITY SDTg2
CbNDIDCTZO;I TO CITY [dATEFt
? 0_PE1ER (PLL'IaSE DFSCRIBE)
b) lirUl(iNiT: C:+E:
7) SICNZ[,°RE:
E] PI.EASE F?OID APPRGVID PERAtIT FOR PICI;-UP BY ONE OF
`aPI,E7ISE P*AIL APPR(7VED PER?LiT TJ 1, (? 3, 4 FIBOVE
(Circle 1
DATE:
•4 ??e aai?re.?v s a? a.c.e?ac? ?r ? rr.s:a=r.e as o s.?s'sa:a a?e ae.c.f.,ra?.? ar a s ts??sar s
FOR C I T Y U S E ON;,Y
PE2MZT u ISSUED
F
F°ES: $ SE:^iER DcittlT'i (I_1?C1, .::.? ?? JUorz1.• r
?.R?.?G-•
, ....._.)
$ WATER PERU1IT (INCiuDE SLiRC:?AcZGn)
$ WATER METER/COPPERAORN/OUTSIDE READER
$ WATER TAP (INCLUDE CORPORATION STOP)
$ SE;dER TAP
$ y S, ..-e :1r^Oi::7m _...?GST= - S_:.?3
$ ACCOUNT D.F,PpSIT - UlAT°R
$ WAC
$ SPC
$ TRU,IK WATER ASSESSiMENT
$ TRuNR SETdER :,SSESS}i°NT
$ LrITERAL BEDIEFIT/TRUNiC SE:•?ER
$ LATERAL BENEFIT/TRUNK WAT°R
$ OTHER '
$ TOTAL
o-?
$ AMOli::T PAID/RECEI?T n ?-15?r`ep -91
DOES UTILZTY CONNECTION REQUIRE EXCAVATZO[V IN PUBLIC RIGi-IT OF WAY?
? YES IF YES, THEN A"PERMIT FOR 'r70RK 'r1ITHIN
? PUBLIC ROADWAY" MUST BE ISSUED SY THE
NO ENGZNEERING DIVISION. LZST AS A CONDI-
TION.
SUIIJECT TO TflE FOLLOWING CONDITIONS: •
APPROVED BY: =?Ade_e
TI.LE:
DAT°_: * - //-
A eFtft MUM mlw! mazsn vrtwf! mJo sFlnl"
rJ7,5-) 1
,
2007 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Cans W ction Reqmremenfs
3 registered site surveys showing sq. fl. M lot, sq h. of house; and all roofed areas
(20%maximum lol coverage allaxed)
1 Soils Report if proposed bwlding is to be placed on distur6ed sal
2 copies of plan showing beam 8 wndow sizes, poured fountl design, etc
1 set of Energy Calculations
3 copies of Tree PreservaUOn Plan H lot platted afler 711193
Rim Joist Detail Op6ons selecbon sheet (6wldings wiM 3 or less units)
Minnegasco mechanical ventilation form
RemadeVReoair Reawremenls Office Use OnN
2copiesofplanshowingfoolings,beams,joists Cert o(SurveyRecd _Y _N
1 set of Energy Calalanons fa heated atlditions Sdis Report _ Y_ N
1 sile survey for additions & decks Tree Pres Plan Recd Y N
Addihon-indiratedon-srtesepACSystem TreePresRequired Y _N
On-siteSepticSystem _Y _N
Plans are ccansidered public ir?farrna#s"on un6ess vo€s state t?sey traae cr?k a dthe reasan.
Date (4_ / Z3 / 07 Construction Cost ?/ 3-?'ELL 9' 1
-
SiteAddress q`{l`I ?
Unit/Ste t!
Description of Work Fero
Multi-Family Bldg zf?Y _ N T
Fireplace(s) --'o _ 1 _ 2
PropertyOwner
a?J TelephoneH(GSI ) 33s-2-4o4
ConMactor ?j Prr?c;r- C c?r c? ? ? rc 5
Address ?'-?!]02 95-th il, N . City /`ZeA?- •6-rb?`e-
State def A/ Zip,S3`3Eq Telephone#C(z) 2Z1-36?bk
s?
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Cateeorv 1
• Residential Ventilation Category 1 Worksheet
(J submission type) Submitled
• Energy Envelope Calculations Submitted
A NEW BUILDING
Minnesota Rules 7672
. New Energy Code Worksheet
Submittetl
In ihe last 12 monihs, has the City of Eagan issued a permit for a similar plan based on a master plan?
_ Y N If yes, date and address of master plan:
Licensed Piumber
Mechanical Contractor
Sewer/Water Contractor
T herehv annlv fnr a Residential Rnildina Prrmit and acknnwle.dve
is comolete and accural
e;
that the work wili 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 on4y an application for a permit, and work is not to start without a
permit that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
S lrcse N (CTf+7Z [.)r-_A L.L`
1 Applicant's Printed Name App i Ys ure
S
Telephone # (
Telephone #(
Telephone #(
.,
r17 5l )
DO NOT WRTTE BELOW THIS LINE
Sub Tvpes
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea ) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OB-plex ? 18 Deck ? 23 Porch (screenfgazebolpergola) ? 36 Multi Misc
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Bwlding ? 42 Demolish Foundation X 45 Fire Repair
? 33 Alteration ? 37 Demolish Building` ? 43 Reroof ? 46 Windows/DOOrs
? 34 Replacement 'Demolltion (Entire Bldg) - Give PCA handout to applicant
Work Tvoes
D@SCrIDtIOfI: Water Damage _ Yes
Valuation 0 U 0 Occupancy MCES System
Plan Review -,k? 100% or _ 25%
Census Code ? Zoning City Water
i
SAC Units
Stories
Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const ? Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ Sheetrock
_ Footings (deck) Final/C.O.
_ Footings (addition)
? Final/No C.O.
Foundation T HVAC
Drain Tile Other
Roof lce & Water Fina] Pool Ftgs AidGas Tests Final
Y Framing _ Siding _ Stucco Lath _ S[one Lath _Brick
Fireplace _ R.I. _ Air Test _ Pinal Windows
y lnsulation
T` Re[aining Wall
Approved By: Building Inspector
Base Fee
Surcharge
Plan Review
MCIES SAC
City SAC
Utihty Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
/
6I?,s6y
`J
2007 RESIDENTIAL PLUMBING PeRnnir aPPUCaTioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Plcnca rmmnlata fnr mnriificaTinna tn aYistinn rPSiriential dwellinas
? {? • ?
Date ?I?I
Site Street Address `Y-( ( ? CI NrV? {Z??C?E ??Q, Unit#
Property OwneAM, 1fbQ2?N,?, Telephone #( )
, Contractor r ???? v-)\ C o " Telephone # d` Oj Z- -3101
Address ) `L1 ??-- ?3S ST- "`) City ?-? kVL`LF StateZip
, The Applicant is: _ Owner 8 Occupant -41-1censed Plumbing Contractor
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
Fire Repair (replace burned out fixtures, etc.) $ 90.00
This fee a lies when extensive lumbin re airs are made to a buildin .
Alterations to existing dwelling $ 50.00
? Add plumbing fiutures to ? mam level lower level. This fee indudes
installation of a water softene?,andlor water heater at the same time. If you are
installing on/v a water sofrener and/or wafer heater, do not complete this section;
move to the next section and place a checkmark next to the appliance(s) you are
installing.
_Septic System Abandonment
_Water Turnaround (add $136.00 if a 5l8" meter is required)
Other:
Water Softener _ Water Heater $ 15.00
_ new _ replacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
Total $
I hereby apply for a Residential Plumbing Permit antl acknowledge that tne inrormacion is compiece anu ncwIaLU, Li 10< <l IV
work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I
understand this is not a permit, 6ut only an application for a permit, work is not to start without a permit and work will be in
accordance with the approved plan in e event a plan is requir to be reviewed qd-appreved.____
Applicant's Printed Name ApplicanYs Signature
Clty of Eap(IQ
fl
3830 Pilot Knoh Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
2008 MECHANICAL PERMIT
Date: Site Address:
7enant:
Suite #:
It ;
?_6
I r l/ h
? ?
RESIDENT / OWNER ne:
1
Name:
vl
! Zi
A
/ Ci
.
p
ddress
ty
CONTRACTOR Name: ?? License#:
?
Address: v
State: Zi
: ?
p
City:
s
Phone: ontact Person:
TYPE OF WORK - New ? y. Replacement _ Additional _ Alteration Demolition
/
? ? P?? f11i
/
Uescriptlon of wark:
`NOTE: Both roof maunted and groun mounted mechartical equiprrment !s requfred to
be screened by.City Code. Please ntact the Mechanical lnspector or one of the
Planners ior information o'n rmltted screenFn methods. .
/ RESIDENTIAL COMMERCIAL
PERMIT TYPE New Construc[ion Interior Improvement
?(Fumace -
Install Piping _ Processed
Av Condrooner -
Extenor HVAC Unit
Gas
Air Exchanger
- _
_
' HVAC units must 6e screened
_ Heat Pump Under! Above grounq Tank L_ Install!_ Remove)
Other " When installinghemoving tank(s), call for inspection by Fire
- Marshal and Plumbin Ins ecior
RESlDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 FifO r2p8ir (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharg $?O
? U
TOTAL FEE
COMMERClAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x 1°h
$50.50 Minimum (includes State Surcharge)
_ $ Permit Fee
- If Permit Fee is less than $1,000, surcharge is $.50.
- If Permit Fee is >$1,000, surcharge increases by $.50 for each =$.' State SUrCharge
$1,000 Permit Fee (i.e. a$1,001-$2,000 Permit Fee requires a$1.D0 surcharge).
TOTALFEE
$
i nereny acrcnowieoge tnat tnis mrormauon is compiete ana acwrate; mac me worn win oe ui coiu?". "e w?L . I .r "Ul, ?a. ti.. a.. ...?- - ,... .,1, .., ?..y..• •, .• •....
I understand this is not a pertnit, but only an applicanon for a permit, and work is not ro start without a permit; that the work will be m accordance with the approved
plan in the case of work which requires a review and approval of plans. r
X
ApplicanPs rinted Name pplicai ' ure ?
FOR OFFICE U3E Reviewed B -' Date: '
Required Inspections: _Under GTOUnd _ Rough In Air Test Gas Service Test -`In-floor Heat _Final
,? ,
- _? rni?oa use/--? ------,
yqhd?7 Tn5 i
j Permit#: `-'??'" ? ?
? ?
1 Permit Fe
? Date Rec i
I i
I Staff.
L____ -111 __________I
TION
6 61
Use BLUE or BLACK Ink
I
I For Office Use
~ Permit I
City of Ea ~a~
I Permit Fee:
3830 Pilot Knob Road I
Eagan MN 55122 I Date Received: aa" fZ I
Phone: (651) 675-5675 j
Fax: (651) 675-5694 L Staff: --I
2012 RESIDENTIAL PLU BING PERMIT APPLICATION
B4 ,
Date: Site Address: V7 ;qla al',- A
Tenant: Suite
RESIDENT I OWNER Name: Phone:
/ / ( t t
Address /City /Zip:
Name: hW l r ~C c License 6 5
CONTRACTOR Address: City: cagoh S
State: Zip: _ Phone:
Contact: ~S4Email:
TYPE OF WORK -New _Replacement 4~ZRepair -Rebuild - Modify Space - Work in R.O.W.
Description of work: oe- c
f 40 &/M
RESIDENTIAL
Water Heater
Water Softener
PERMIT TYPE Lawn Irrigation RPZ PVB)
Add Plumbing Fixtures Main Lower Level)
Septic System
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $189.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $
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.gopherstateonecall.org
I 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 I understand this is not a permit, but only an application for a permit, and work is not to start without a per it; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Applicant's Pri ted Name Applicant's Signatwrg-
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
Oct.18. 2013 8:59AM Crest Exteriors 651-463-8095 P. 12
Use ULUE or 13LACK Ink
~ For Office Use - I
I
I
I lqq~3
j Permit
City of Ea~a~ I Cs~
Permit Fee:
3830 Pilot Knob Road I
Eagan MN 56122 Date Received: t
Phone: (861) 676-6675 1 I
I Staff: l
Fax: (851) 676-61184 l
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address; I Unit#:
Name, V ULL Phone:
• address ~ City ~ zip: C n n
Applicant is: -Owner V Contractor
Description of work: r
o
Construction Cost Multi-Family Building: (Yes No
\ ConlacL 1
Company:
Address:
Slate: ~ rJ Zip: 1 Phone: 12- [_.+C1
License BC, l0 2 Z Lead Certificate it
If the project is exempt from lead certification, please explain why: (see page 3 for additional Information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan Issued a permit for a simller plan based on a master plan?
Yes ZNo If yes, date and address of master plan:
Licensed Plumber; Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor; Phone:
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Si Es=PI& s tl po i'" ` "doe h o m't sre' 10 e' U
the, Q a o c/ o de o s.t at` it -Ae. l ci1vo
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CALL BEFORE YOU DIG. Call Gopher State One Call at (681) 454-0002 for protection against underground utility damage. Call 48 hours
before you Intend to dig to receive locates of underground ullllues. herslate Il.or
I 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 I understand this is not a permit, but only an application for a permit, and work Is not to start without a permit; that the work will be In
accordance with the approved plan In the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit Issued in accordance with the Minnesota State Building Code must be completed within 190
days of permit Issuance.
x x
Applicant's Printed Name Applicant's Signature
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