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4315 Clemson CirPLUM8ING PERMIT CITY OF EAGAN 3830 PILaT KNOB ROAD, EAGAN, MN 55122 a ' Site Address Lot -7_ a? ? ? c ? Name 3 Addre 0 City - FEES COMM/IND FEE - 1°r6 OF CONTFiACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APPLIES MINIMUM - RESIDENTIAL FEE - $12.b0 MINIMUM - COMM/IND FEE - $20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES CITY OF EAGAN PERMIT # / X RECEIPT # DATE: ? BLDG. TYPE WORK DESCRIPTION Res. New Mult. Add-on Comm. Repair Other . FiES. PLBG. ONLY - COMPLETE THE FOLLOWING: ' NO. FIXTURES TOTAL Water Closet - $3.00 $ Bath Tubs - $3.00 Lavatory - $3.00 Shower - $3.00 Kitchen Sink - $3.00 Urinal/Bidet - $3.00 Laundry Tray - $3.00 Floor Drains - $1.50 Water Neater - $1.50 Whirlpool - $3.00 Gas Piping Outiets - $1.50 (MINIMUM - 1 PER PERMI'n ? Soffener - $5.00 "? r ^ Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 FEE: '-' STATE S/C: GRAND TOTAL: ?y ?? FQR- &AZ.F '' . ti . CITY OF EAGAN 13130 •?- ••; 3830 Pilot Knob Road, P.O. Bax 21-199, Eagan, MN 55121N2 L 5- R'"?; ? PHONE: 454-8100 BUILDING PERMIT Receipt # To be uaed tor 1 OF 4 PLEX Est value $63,000 Date JAfJ OARY 21 , 1g 67 Site Address 4317 CLF.MSON CIRCLE Erect CIC Occupancy R3 Lot-5 - Block 2 Secisub. TRAILS OF Remodel ? Zoning pf) Parcel No. THOMA-S LAj(E Repair ? Type of Const y Addition ? No. Stories W Name t-FEW HORIZUN HOMES Move ? Length da z Demolish ? Depth o Address P_ O. BOX 1367 Int. Impr. ? Sq. Ft City MpLS Phone 420-3900 Install ? o Name SAMF Approvab Few ? Q Address Assessment Permit ? ~ City Phone Water & Sew. Surcharge _ ? a W Police Plan Review W ? Z Name Fire SAC ??, Address Eng. Water Conn. < W City Phone Planner Water Meter Council Road Unit jUS. UV I hereby acknowledge that I have read this application and state that the gldg. Off. Tr. PI. 180.00 intormation is correct and agree to comply with all applicable State of Minnesota Statutes and C?ot?a ? rdinancesy? ` APC Perks Var. Date Copies 0 Si9nature of Permittee-?? Total ,294. A euilding Permit is issued to: NEW }iOR I ZON HOl41ES on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and Ciry of Eagan Ordinances. Building Official ParmN No. Parmlt Holder on. ra.phons a Plumbiny H.V.A.C. ` % ?IX7 EIocMc C- 8ollenar Inspeellon Date Insp. Commwnb Footinys 1 Footlrys 11 Foundatbn Fnminy 3-3,JQ P? Noolfny Rouyh Plbp. RouyA Htp. Imul. W142 p Finplace Final Htq. Flnal Plbq. (D ?? '? I Bldy. FInN T A .p7 L, CM. Oec. 7.1$ L^C- ?' . Dock Fty. Dsck Frtnp. Wdl Pr. Dbp. ' ' • PERMIT lk " PLUMBING PERMIT pECEIPT # -??- CITY OF EAGAN 3830 PILOT KN08 ROAD, EAGAN, MN 55122 QATE: FES 14A 1987 CONTRACT PRICE: PHONE: 454-8100 Site Address 4317 ON Lot 81oek - „ SeclSuh, ? Name ?o Add?ess 12201 MTKA c City MTKA Phone 933-252 1 ? Name c Address 1?n RnX 1167 o Ciry MRLS Phone 420-390G FEES COMM/IND FEE - t% OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE 8 CONDO - RES. RATE APPLIES MINIMUM - RESIDENTtAL FEE - $12.00 MINIMUM - COMM/IMQ FEE - $20.a0 STATE SURCHARGE PER PEFiMIT - .50 (ADO $.50 S/C IF PERMIT PRICE GpES BEYOND $1,000.00) i • i SIGNATURE OF PERMIT TEE BLDG. TYPE WORK DE SCRIPTION Res. ? New Mult: Add-on Comm. Repair Other RES. PIBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL 4 Water Closet - $3.00 $ Bath Tubs - $3.00 Lavatory - $3.00 Shower - $3.00 Ki!chen Sink - $3.00 Urinal/Bidet - $3.00 ? Laundry Tray - $3.00 Floor Drains - $1.50 • Water Heater - $1.50 - Whirlpool - S3.00 Gas Piping Outlet5 - $1.50 (MINIMUM - 1 PER PERMI'T) Softener - $5.04 Well - $10.00 Private Disp. - $10.00 ,. - Rough Openings - $1.50 FEE: srATE s/c: .=? FOR: CITY OF EAGAN GRAND TOTAL: - ` _ . . ._._..ir.i..,,_ .. . .. . . _ . . . . . . . .._ _ _.'"_.__ __...- Site Address ? Name _ ? Address c C,Ity _ ? Name _ 3 Address p C'tY - rtHnni i? o a- ,?MECNANICAL PERMIT RECEIPT # ? 1'? CITY OF EAGAN -? ? 3830 PILOT KNOB ROAO, EAGAN, MN 55122 DATE: Iz, r?`'r? tICE: PHONE:454-8100 -, ' BLDG. TYPE WORK DESCRIPTtON Block aI; , Sec/Sub RegNew ? SEDGWICK HT Mult Add-on 8910 WENTWORTH Comm. Repair MINNFGP(11.I4Z RANI ccAar Oth@r TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. Vent Gas Piping Outlets # FEES I RES HVAC M 8T . 0-100 U -$24.00 ADDITIONAL 50 M BTU - 6.00 Phone (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) G S A OUTLETS (MINIMUM - 1 PER PERMIn - 1.50 EA. COMM/IND FEE - 1% OF CONTRACT FEE M BTU - t APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE 8? CONDOS - RES. RATE APPLIES M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON & M BTU REMODELS - 12.00 M BTU s MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 CFM ? PERMIT PRICE GOES D / BE YOND $1,000) FEE: S/C: L SIGNATURE OF PERMI EE ' Z? J TOTAL: FOR: CITY OF EAGAN T H CITY OF EA . . FOR SALE ? ? GAN ? ?? 13131 • ` ??:;?'? 3830 PilOt KnOb ROad, P.O. BOx 21-199, Eagan, M N 55121 - L5-8, B 2 PHONE:454-8100 ? BUILDING PERMIT Receipt# 7?r? j? To be uasd tor 1 OF 4 PLEX Est Value $64,000 pete Jr1iVUARY 21 1987 SiteAddress 4317B CL LMSQ[J CIRCLE Erect lN Occupancy R3 Lot V Block 2 Se c/Sub. TRAILS OF Remodel ? Zoning RD Parcel No. THOMAS LAKE Repair ? Type ot Const Addition ? No. Stories Move ? Length 44 ¢ Name :1E6d )iOR I ZOYJ HOME;i . = Oemolish ? 77 Depth o Address P.O. BOX 1367 Int.lmpr. ? Sq.Ft. City MPLS Phone 420-3900 Insrall ? o Name SAME Approvals Fees ? Address Assessment Permit $ 377.50 ? city Pnone water 8 Sew. Surcharge 32.00 t Police Plan Review 138.75 F W Name Fire SAC 625.00 = n Address ? Eng. Water Conn. 525 . 00 i W City Phone Planner Water Meter 67.00 Council Road Unit 305.00 I hereby acknowledge that I have read this applicatfon and state that the Bldg. Off. Tr. PI. 180.00 information is correct and agree t comply with all ap licable State of Minnesota Statutes and Ciof E an Ordinanc . APC Parks Signature of Perminee l / Var. Date Copies Total $2.30U.25 A Building Permit is issued to: NEW HORI ZON HO.LlEru on the express condition thai all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official PwmH No. PermH Moldm DaU TNephone N Plwrfiolno S3 / S.i H.V.A.C. Eleca+e SOMMN InipecNon Dste Inap. CommNfh Footlnys 1 Footlnys 11 Foundation Framinp RooNnq Rouyn wby. -/6- 7- 3 -111 Rouyh Htg. Insul. Pf? Pi?ePlaco r C-a tf S? t LT ?• c? .?:d /-P' 7?'• H. Final Hty. T ?/!7 /io Ffnd Plby. Bldp. Fhd Cari.Occ. /7 Look ;or C'a on Dack Fty. Deck Frmy. WMI Pr. Dkp. PLUMBING PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 Site Address Lot Block y Name IhIj*WJU11 t'LUritl 1 OU ? Address 12241 MTKA BLVD c City MTKA Phone Name NhW tfUFtlLL1ry NUMtS 6 Address PQ RnX 1367 p City MNLS Phone FEES COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE 8 CONDO - RES. RATE APPLIES MINIMUM - RESIDENTIAL FEE - $12.00 MINIMUM - COMM/IND FEE - $20.U0 STATE SURCHAFiGE PER PERMIT - .50 ;(ADD $.50 S/C IF PERMIT PRICE GOES I SIGNATURE OF PERMITTEE FOR: CITY OF EAGAN PERMIT # ?/ )T -M- RECEIPT # 70& (" _:1- DATE: FEB 1(A 1987 BLDG. TYPE WORK DESCRIPTION Res. ` New ? Mult. Add-on Comm. Repair Other I RES. PLBG. ONLY - COMPLETE THE FOLLOWING: I NO. FIXTURES ? TOTAL I Water Closet - $3.00 ? ' Bath Tubs - $3.00 Lavatory - $3.00 Shower - $3.00 Kitchen Sink - $3.00 inal/Bidet - $3 U 00 .; ? r . Laundry Tray - $3 00 ' . Floor Drains - $1.50 Water Heater - $1.50 ' Whirlpool - $3.00 ' Gas Piping Outlets - $1.50 (MINIMUM - 1 PER PERMIT) Soitener - $5.00 well - $10.00 Private Disp. - $10.00 - - Rough Openings - $1.50 FEE: _?--- STATE S/C: ? GRAND TOTAL: - l - ?9So CONTRACT PRICE Site Address ?/}.? Lot 4 12 Block D Name ? ? Address c City d c 3 O Name _ Address City _ TYPE OF WORK Forced Air ' Boiler Unit Heater Air Cond. M BTU M BTU M BTU i M BTU CFM Piping OuUets # FEE S/C: TOTAL• Res. New Mult Add-on Comm. Repair Other FEES RES. HVAC 0-100 M BTU -$24.04 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 - 1ai6 OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - FiES. RATE APPUES MINIMUM RESIDENTIAL FEE - ALL ADD-QN u REMODELS - 12.00 MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000) ? r , .? r SIGNATURE OF PERMITT E ?.? ^ECHANICAL PERMIT RECEtPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: ` PHONE: 454-8100 - BLDG. TYPE WORK DESCRIPTION ? Sec/Sub FOR: CITY OF EAGAN FOR SALF. T. H. CITY OF EAGAN ' L?_ g n 2 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 13132 PHONE: 454-8100 BUILDING PERMIT Receipt # ' To be used ior 1 QF 4 PLEX Est. value $63,000 Date JANUARY 21 19 $ 7 SiteAddress 4315?3 CI,Et"1SUiV DR Erect C? Oceupancy R3 Lot_7-Block 2 Sec/Sub. TRA?ILS OF Remodel ? Zoning pO Parcel No. THOMAS T F Repair ? Type of Const V Addition ? No. Stories 44 ? ? ? Name NE?: ;iQRT, ?,OrJ f3(7[?ES +?,fove ? Length = $l7X 1367 Demolish ? Depth 26 3 Address P.O. Int ImPr? S Ft ° Ciry M-"LS Phone 420-3900 Install ? Q o Name S?E Approvals = ? ¢ Address Assessment ~ City Phone Water & Sew. ?- ¢ Poiice W W ? = Name Fire ? = Address Eng. a W City Phone Planner Permit $ 374.00 Surcharge 31.50 Plan Review 187 . 00 ? SAC 625.00 Water Conn. 525. 00 Water Meter b?. 00 3os oa I hereby acknowledge that I have read this application and state that the Council Road Unit 1$0 00 information is correct and agree to comply with all applicable State of B?dg. Off. . Tr. PI. Minnesota Statutes and City of E"an Ordinances. APC Parks ? Signature of Permittee Var. Date Copies Tota, $2,294.50 A Buildin Permit is issued to: NEW NORT ZON HOMES 9 on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. _ ParmN No. PamH Nolder Dafe Telsphone k Plumbing e? g? ? r,?. • H.V.A.C. 47 E?c ! 73.??'??? .?/? ,Y" 5offe,w Inspection Dah Insp. Commenis Footinga I ? ? - ? Footing? II Foundatian Framinq -347 AW RooOng Rough Plbq. Rouyh Htq. Imul. F4reatace Final Hty. Ffnal Pibg. Bldg. Final ? ?9 C. ?• Cert.Occ. ? j?? ? ?.oo? r'r?i ca on rl••G ?o? ?/? Deck Pty. Deck Frmq. Well Pr. Disp. , ? . PLUMBING PERMIT , CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 Site Address Lot a? ?v c ? d c 3 O Name PERMIT # RECEIPT # ?- DATE: FEB IA 1957 BLDG. TYPE WORK DESCRIPTION Block - Sec/Sub Res, New r -' Mult. Add-on HOMPShIN Comm. Repair Address 11?? ? 1 M I KA N ciry MTKA Name NFW H(7RI70N Ht]MF' Address PQ BQX 1167 City NOLS Phone FEES COMM/iND FEE - 1% OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APPLIES MINIMUM - RESIDENTIAL FEE - $12_00 MINIMUM - COMM/IND FEE - $20.00 STATE SURCHARGE PER PERMIT - .50 (ADO $.50 S/C IF PERMIT PRICE GOES Other RES. PLBG. ONLY - COMPLETE THE FOLLOWING NO. FIXTURES TOTAL Water Closet - $3.00 $ Bath Tubs - $3.00 Lavatory - $3.00 Shower - $3.00 { Kitchen Sink - $3.00 I Urinal/Bidet - $3.00 ? Laundry Tray - $3.00 - Floor Drains - $1.50 - Water Heater - $1.50 Whiripool - $3.00 Gas Piping Outlets - $1.50 (MINIMUM - 1 PER PERMIT) Softener - $5.00 Well - $10.00 ? Private Disp. - 510.00 ?._Rough Openings - $1.50 SIGNAT , E OF P RMITTEE . FEE: J STATE S/C: k-) 3 ?- FOR: CITY OF EAGAN GRAND TOTAL: 'r ' ; .1 S ?? v rtnnm i ?r • . ?NIECkIANICAL PEFIMIT ? ? CITY OF E?iGAN RECEIPT # 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE _ -- Lot ? Block Sec/Sub - ? Name ? . et fklri ukjl,4LJ. m ? ?? Address c Ciry 1??ig ? Name c Address p City Phone PE OF WORK ced Air 41_ M BTU ler M BTU t Heater M BTU Cond. "4_ M BTU it CFM s Piping Outlets # FEE S/C: TOTAL• BLDG. TYPE WORK DESCRIPTION Res. ? New Muft 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 - 19'o 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 PERMITT E FOR: CITY OF EAGAN FUR ;ALf: T . H . --:#v *2 BUILDING PER11 To be used for 1 Q CITY OF EAGAN ?t 2 3830 Pilot Knob Roacf, P.O. Bcx 21-199, Eagan, MN 55121 tv , PHONE: 454-8100 Receipt # PLBX Est. Value $63,000 13133 41-} 87 Site Address 4315 CLSt9SON C IR Erect IN Occupenc y R3 Lot-8_ Block 2 Sec/Su6. TRAILS OF Remodel ? Zoning en Parcel No. THOP9AS LAKE Repair ? Type of Const V Addition ? No. Stories W Name - NFW HnK I?.nN HQM . z Move ? Demolish ? Length Depth 44 ; Address p- n- BOX 1367 a Int Impr, ? Sq. Ft City MP]'.S Phone 420-3900 Install ? o Name '??1?'1t Approva ls Fees = ?? Address Assessment Permit S 374.1 ~ City Phone Water 8 Sew. Surcharge 31• Police Plan Review 18? •' W Name = Fire SAC 625. ? Z Address , Eng. Water Conn. 525.1 < W City Phone Planner Water Meter 6 7 •' I hereby acknowledge that I have read this application and state that the Council Road Unit 305 •' 180 ? information is correct and agree to comply with all applicable State of B?dg. Off. Tr. PI. . Minnesota Statutes and Ci of E rdinances- /? APC Parks :7 ? i Var. Date Copie Signature of Permittee I Total ' A Building Permit is issued to: NEW HOR I ZON FirJMES on the express condition that all work shall be done in accordance with all applicable 5tate of Mlnnesota Statutes and City oI Eagan Ordinancea. Building Oif'icial I ? ? PNmil No. PrrmH Mo1dK Dde Telephons M PIum6lnp fOL-Iw H.Y.A:E. Aee, E??,?? jla?Y7 SORl11N Inspection Date Insp. Commsnb Foori?gtl Foodnga 11 Foundadon W Framiny j Rooflnq Rouyh Plby. Z ? ?' - 7 Rouyh Mly. Insul. v Flreptaee Final Hty r f C. A, Finsl Plbq. . ? ? &dy. FMaI ? A L? cart. oea _ Daek Fty. Dsck Fmp. Wdl Pr. Disp. r L ........... i , .' . ' PLUMBING PERMIT . , CITY OF EAGAN 3830 PILOT KNQB ROAD, EAGAN, MN 55122 m Name 1H(]lMN50N PLUMBINC ? Address 12201 MTICA HLVD c City MTKA Phone ? Name ntW I1UKI4UIV F1UMt5 c Address PO BOX 1367 p City MPLS Phone FEES COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APPLIES MINIMUM - RESIDENTIAL FEE - $12.U0 MINIMUM - COMM/IND FEE - $20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES FOR: CITY OF PERMIT # ? /.Rv RECEIPT # 729 6161 DATE: F?? 14R 1987 BLDG. TYPE ° WORK DESCRIPTION Res. ` New -T Mult. Add-on Comm. Repair Other RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL Water Closet - $3A0 $ Bath Tubs - $3.00 % Lavatory - $3.00 ' Shower - $3.00 ' Kitchen Sink - $3.00 " Urinal/Bidet - $100 ` Laundry Tray - $3.00 ' Floor Drains - $1.50 ?-? ' Water Heater - $1.50 Whiripool - $3.00 -?Gas Piping Outlets - $1.50 (MINIMUM - 1 PER PERMin Softener - $5.00 Well - $10.40 Private Disp. - $10.00 - Rough Openings - $1.50 FEE: ? STATE S/C: GRAND TOTAL: ? ?e V •vv . "....,, .. . . , ? + f MECIIANICAL PEQNUT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB HOAD, EAGAN, MN 55122 DATE: m rvame _ ? Address c City _ ? Name _ c Address 03 Cih+ - TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. ? Gas Piping Outlets # ? Other fa M BTU M BTU M BTU -? M BTU CFM FEE SlC: TOTAL• BLDG. TYPE WORK DESCRIPTION Res. ? New ?L Mult Add-on Comm Re ir . P 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 - 1a/o OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPUES TOWNHOUSE & CONDOS - RES. RATE APPL.IES MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8 REMODELS - 12.00 MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND S1,000) a SIGNATURE OF PERMITTEE ir FOR: CITY OF EAGAN /, G' 1 '-? °.. ) ,,/ c,u -? SEDGWICK HEATING & AIR CONDITIONING HOUSE HEATING TEST RECORD y So ADDRESS (-ar ? I S C??1MSOtJ ? CZ ?tI E CITY ?-!?+?? ...?'?? - OCCUPANT ?- ---• OWfdER 6 6NGc ZZ HEAT LOSS DATE HTG. INST. '-'- --? SOLD BY INSTALLED BY Electrical Work By T3 v, c? Gas Line By TVPE OF HEAT GA_ FA ? HW_ STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE R't ." r.l'-C MAKE OF BURNER ----- Model 9?-4 t_ p u10 3+-l n S o Model Serial L&c? Max. BTU Rating INPUT r) o a MAKE OF FURNACE CONTROLS THERMOSTATHeat Plug Valve S? 3 4? N S o}C- Limit- Limit Setting d Fan Setting _ t ? o°El PilotType - ? r- 'rCre" cc PilotMake St- ACtl" I ?N ?TnIF Pilot Model HSC \ Model Vent Size S ? KIND OF LINER - SIZE NONE Draft Hood ?? c? ? Regulator '? ? S Filters Size Number ! Chimney Location Inside K Outside Chimney Construction Smoke Bomb Wiring n*11 Test Tag _ ?jj ? S Lighting InsK-- Pilot Timing I ?S1 ST rN„N T Draft L.W. Cut Off Door Pressure 3+ 15 ?' ??• c Percent CO 2 ? '17-0 Input CFH so Percent O 2 t C)O;?U Stack Temp. a S?° F Percent C0 KJnw)E Date Tested `7 - S / Company Testing Gvu [ c.K- Name of Tester A ??j Form 235 7.7_ _-w9wq fd!"'L?' _ .. • t.?.? ? - . _ } .. _ SEDGWICK HEATING &AIR CONDITIDNING CO. ?s g /, HOUSE HEATING TEST RECORD ADDRESS % ( If' 1'Yl St?,A.?( I .e CITY OCCUPANT- 1 P(. Q e- c.A: OWNER HEAT LOSS DATE HTG. INST. SOLD BY INSTALLED BY Electrical Work By 4Gas Line By ? E'= t:it •'- ` 1? ? TYPE OF HEAT GA_ FAA HW_ STEAM SPACE HTR. UNIT HTR. ` OTHER [? I GAS DESIGN CONVERSION MAKE !?, r ., 't Model 3 9 y i ?,,+' -=u U ? L/0 '5" Serial 1?6 i 1306 S y INPUT ? CG , C?OG CONTROLS THERMOSTATZL Heat Plug Valve ??iS I?'SG? • 7 Limit ? f C i'>7 ? U Limit 5etting U Fan Setting Pilot Type Pilot Make Pilot Model Pilat Timing -Z 'LS ati L.W. Cut Off Pressure ? . 2, Percent C02 Input CFH Percent QZ Stack Temp. PercentCO N0 Aj e- MAKE OF BURNER _ Model Max. BTU Rating - MAKE OF FURNACE Model Vent Size - (7 : JUC. ? KIND OF LINER i SIZE NONE Draft Hood r`?a' u?a ? Renulator ? Filters Size Number ' Chimney Location Inside Outside Chimney Construction r .,'a ? Smoke Bomb -1 Wiring Q/? Draft ? Test Tag 1?• f'' Door Pressure _ Lighting Inst. Date Tested -Z0 Company Testing Name of Tester " - ? _--- -. _- -.. Form 235 SEPGWICK HEATING & AIR CONOITIONI - ' HdUSE HEATING TEST RECaRD , - ! ADDFiESS I -) / I - ????i,il,.- t ! /CITY OCCUPANT ' ??U Ai OWNER HEAT LOSS DATE HTG. INST. SOLD BY , INSTALLED BY Electrical Work By J Gas Cine By TYPE OF HEAT GA_ FA `HW_ STEAM SPACE HTR. UNIT HTR. OTHER_ GAS DESIGN CONVERSION MAK E -I Model c V - U 1 f ? LLArl, ?. Serial U0 6 c, INPU7 - ? lC! L Tfi E R MOST AT Valve Limit Limit Setting Fan Setting Pilot Type Pilot Riake Piiot RM1odef CONTRdLS fI Pilot Timing _L/V S?d -7 L.W. Cut Off O Pressure PercentCOZ ? t ? Input CFH 0 < -0 Percent 02 °, Stack Temp. ?-? Percent CO A10lt/e MAKE OF BURNER _ Model Max. BTU Rating - MAKE OF FURNACE Model Vent Size r, i/??c fl KIND OF LINER SIZE P0NE Draft Hood 4 Regulator Filters Size Number ? Chimney Location Inside ?` Outside Chimney Construction ?? ,''_'`,• v Smoke Bamb ` Wiring Draft ? Test Ta Door Pressure Lighting Inst. Date T5eted -`' - =2 1 '? Company Testing '4` <<? : r_ ,; s Name of Tester _ ?-t'•-> ,'%v?-c??' q G0i?- ) ?J Form 235 ? & AI - HOUSE HEATING TE: ADDRESS /OCCUPANT ?U f-u_? ,C,v OWl? HEAT LOSS DATE HTG. INST. / CITY Q0 't' - .„ SOLD BY INSTALLED BY ( 41 Electrical Work Bv - ) 71 Gas Line By _ ` • ?: ? = TYPE OF HEAT GA _ FA -L HW_ STEAM SPACE HTR. UNIT HTR. ' OTHER_ GAS DESIGN CONVERSION MAKE /u /46•j Model 3? II G4u:Gi':1•iSC? Serial yL RC 14 Gu 211 INPUT ?. Ci .CJUU THERMOSTAT Valve Limit Limit Setting _ Fan Seiting _ Pilot Type Pilot Make - Pilot Madel _ CONTROLS ` Heat Plug Pilot Timing -- 1 yL?}c?i1.. r L.W. Cut Off G Pressure ) ZC Percent CO L?? 5 Input CFH Percent 02 JUG U Stack Temp. PercentCO C- MAKE OF BURNER Model ? Max. BTU Rating `- MAKE OF FURNACE Model ' Vent Size v, i v c?i KIND OF LINER SIZE r _T. NONE Draft Hood ko ' u t Regulator '?• ? Filters Size 11Jumber ? Chimney Location Inside QU?s ide Chimney Constructi on iJ Smoke Bomb Wiring Draft Test Tag Door Pressure ? Lighting Inst_ L' Date Tested - 3 ` > ? `" G Company Testing , i C - ? Name of Tester - _?L ef--u. Form 235 CITY QF EAGAN PERMIT TYPE: 1; 1 1 10 3830 Pilot Knob Road Permit Number: 0.' 6.' "3 j Eagan, Minnesota 55122-1897 Date Issued: 61 >+f 74 /+4t% (612) 681-4675 SITE ADDRESS: i t, r t, i 6: 1, i 't ,;114 t: [FL I 1 Nt 1 f1H 1 I.'. Ill I IinMM', 1 A1kt Irt I)l r APPLICANT: f I Ff F`.l I 1 t f:11Rq n:3.t 104 PERAAIT SUBTYPE: TYPE OF WORK: ! t r r; A i i ft ta INSPECTION D• • D+ ?s ? ? PertnR No. Pertnft Holder Dste Tetaphone Y ELECTRIC PLUMBING HVAC Inapectlon Data Inap. Commanb FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FlREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FlNAL DECfC FTG DECK FlNAL CITY nF EAGAN WATER SERVICE PERMIT 3830 PiF-)t Knob Road , I P.O. Box''`t1199 ` PERMIT NO.: 4 36 ' Eagan, MN 55121 DATE: 2/ 13/ S 7 ? Zoning: R3 No. of Units: lunlt 412 1 ex ? Owner. New Fiorizon Address: - Site Addess: Plumber: _ , Meter No.:-? I Sixe: I ayroe to comply with th?vwLapa GctiS4F?{er?? - SO Ordinancss. v,?4VMisc. Charges: 67 _ (1(1 mPtnr Tota1: 18II., nn x„ BY " Date Paid: Dete of Ins .. Insp.; "" `"`'"" SEWER SERVICE PERMIT i Pilot Knob 4oad ? 7 Box 21199 PERMIT NO.: in, MN 55121 DATE: -1? 13/q7 ng: No. of Units: i'=, I ex Address: - Site Address: cM oF "oAN WATER SERVICE PERMIT 3830 PIIe' ob Road? w ,?? P.O. Box. , 93 ?? 1-??•,ERMIT NO.: 7 Ea9an, RSN'S5y21 ?XSJ I DATE:_ 2/1 3/°i Zoning: R 3 No. of Units: 1 tm i t 4P 1 ex i Owner. New }Ior i z on Address: ' "ltios Lk SiteAddess: ? Plumber. _ 1e: 5 25 - f1 0 Meter N-o-i.?:S?:' 1 5_ 0() I Size: .?l?_ Charge: 52 S . ,, ; eaaer No.: ?/' T yb-AfF-n in. n() aQres lo comply wifh the Frdinanc 07_ nn mF+Ar n t?- -? Date Paid: ? Date of Insp.: Insp.: ?7 t-7 -.-?- CITY ?--. _ OF EAGAN 3830 Pibt Knob Road P.O. Box 2118a SEWER SERVICE Eayan, MN 55121 PERMIT NO.: ?? ? Zoning; DATE:_ Owner. _ u??.. t?.,?.r ___ No. of Units: ?iit 4 1/2F f 87 7 0:9; 200.00 - ]/?{,/; 7 io l i:; I aqree to comply wkh the CNy of Eagan Connection Charge: 5,25 <In ? 89?ee to compiy with the Chy ot Eapan Connectlon Char e i?? ?•?r Ordlnances. Account Deposit: 1S nn OMlnancea, g: ? Permit Fee: 7 f1 !) n Account Deposit: Surcharge: - ?Q Permit Fee: BY Misc. Charges: By Surcharge: ? Date ot Insp.: Total: Date of Insp.: Misc. Charges: Insp.: Date Paid: Insp.: Total: Date Paid; CITX OF EAGAN ; CITY OF EAGAN WATER SERVICE PERMIT 3830 r:!ot Knob Road 5330 WW Knob Road-2j , O? ?Q. Box 2S'199 ??PERMIT NO.: - P.O. k3ox 21189 ??? / Eagan, MN 55121 DATE: Eagan. MN 5gi21 Zoning: No of Unita• 2oning: ?S ? Owner. _ Address: - Site Addess: Plumber: - ; Meter No.?3- ? Size: * ' KT@W 11^Y'1 ZOn WATER SERVICE PERMIT PERMIT NO.: 9'? ??`? DATE 2? 1 No. of Units: 1 l m l t ?? ' I n Ener. dress: e addess: 4317 ('l emson Cr L5 R2 Tr of Thos T k ?°' . . . 15. I agree to comp1y wlth the R 11). U U Ordinancas. EQ?Ji REt ??? ? • Total: 0 . e BY Date Paid: ?0. OQ t,? Date of Insp.. Insp.: 5 umber: - eter No.: == Size: ? Read r No.: I ayree to comply wRh Charge: S 2 -'?. 0 " 6it: 15.00 dlnan . I tL-V " h? ?7 67.00 meter ,.- /_ , ?v 1'otal: 180 .00 tjL_ a? Date Paid: te ot Insp.: k Insp.: ?. . . . . ' . ." CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pllot Knob Road P.O. Box 21199 9?56 PERMIT NO.: ' Eagan, MN 55121 DATE: ` Zoning: ?--? No. of Units: 1?it P eX Owner. New aiori zon ? Address: Site Address: 4',17n r1 emson ir'r LF? RQ Tr o° Thos I.k Plumber. _ ThornUSOII ? 1I26/87 70195 100.00 1 I aqree to comply with the City ol Eagan Connection Charge: _525 -00 O?dinances. Account Deposit: 15.00 Permit Fee: 10,00 ey Date of Insp.: Insp.: Surcharge: .50 _ Misc. Cherges: _ Total: . Date Paid: GTY OF fAGAN _ 3830 Pilat Knab Road P.O. Box 21199 Eagan, MN 55121 Zoning: p 3 Owner. ? V0010w, SEWER SERVICE PERMIT 9`" ;?; PERMIT NO.: DATE: 2/1.7/r7 No. of Unlts: 1 unit 4Plex Address: SiteAddress: 4327 Clamson Cr LS R2 Tr of '?'bos Lk Plumber. Thami>SOn 1/26/r;7 7?1.:15 itl(?.?0 1 agree to comply with fhe CNy of Esgan Connection Charge: 575 - 00 Ordinances. Account Deposit: Permit Fee: j;l, nn Surcharge: ,..Sn By Misc. Charges: Date of Insp.: Total: Insp.: Date Paid: BLDG. PERMIT IJO. ;7 ?/ ? ? i > : ?? •` 01 3210 ? /Bldg. 01-3422 Plan Check 01-3445 Surch./Adm. ? 01-3446 SAC/Adm. , 01-2155 Surcharge ? 17-3860 Road Unit 20-2275 SAC _77 20-3865 Water Conn. 20-3868 Water Trmt. - ? 20-3716 Water Meter 20-2252 Acct. Dep. 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewer Conn. 11-3$55 Park Ded. TOTAL t CITY OF EAGAN ? 3830 PILOT KNOB ROAD ? i EAGAN, MINNESOTA 55122 L.;i .7 cj L2 ?-CJ ? U G DATE ! 19 -? REC6IVq?'? f '. ? .. I A?IOUNT $ ??- . - . ;' . . , & DOLLARS . ,oo ? CASH ? CHECK FOR Thank You - BY ? White-Payers CopY Yellow-Posting Copy Pink-File Copy This requesl void ?o1/6-7 78 nqnths from ( 73308a Request Date Fire Ny.' ough-in InsDection ??? eq ed7 ?Ready No?ill Notify, Inspec- es 01 o tor When Fieady :25t:acensed Electrical Contractor ! hereby reQueat insAeciion ot above ? Owner electrical work installed at: 5 dress, 60 Raote No, C ?? c1cmcne D r-(?j&,_ ? ection o. Tqwnship Name or o. RanOe o. Coumy O p nt (PRI 1 ) i nnp y r ? _171 Phone No. Pow Suppli Address Ele trical Contractor ICompany Na ) Cvn ctor's 'ce e o ' . ? 4 -vi c, D M'lin ddres? ontr cto o wner a ' ns ai tion? S5 _3q2 _ Aufho j zed ntr if, wn king In st a n Phon Number W MINNESOTA STATE BOARD OF ELECTRICITY Ciriqps.Midway BIdQ. - Room N-181 1827 Univsraitv Ava.. St. Psul, MN 65104 Phone (612) 642-0800 iM15 INSPECTION REQUEST WILI NpT BE ACCEPTED BV THE STATE BOARD UNLESS PROPER INSPECTION FEE IS ENCLOSED. 1,al8-7 REQUEST FOR ELECTRICAL INSPECTION ee-00001-06 ' See inslructians tor complelinp Ihis fprm on 4eck of yellow copy. 0 7//? v r -7 0 7 fl O "X" Below Wnrk Covered bv This Reauest ? AAd ReD• Type o1 Building ADCliancsa Wirsd Equipment Wired Home ange Temporary Service Duplex Water Heater Lighting Fixtures Apt. Buiiding Dryer Electric Heatin Commercial Bldg. Furnace Silo Unloader Industrial Bldg, Air Conditioner Bulk Milk Tank Farm tner peci v chPr (5per.ify) t.r ueci y t er Och?? ompute Inspeciron Fee Below A Fee ServiceEntranceSixe p fee FeederslSuhfeeders M Fee Circuits U to 200 Am s 0 to 30 Am s 0 tn 30 Am Above 2_Amps 31 to 100 Amps 31 to 100 A Swimmin Pool Above 100_Am s Above 1Q0_Am - Transiormers rri ation Booms Partial•"Other Fee Signs Special Inspection ?- J TOTA emsirks L FE??? h Y Rouph-in ? Dte_ '7 ?, the Electrical • l Inspector, hereby ; certify thet the abpve Final inspection hea 6een L, ede. m rAM request vold 18 montts from FOR SALE T.H. CITY OF EAGAN - 13131 • LU-?i, 'B 2 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121Np PHONE:454-8100 BUILDING PERMIT Receipttr /-S Tobeusedfor 1 OF 4 PLEX Est.Value $64,000 Date JANUARY 21 19 87 SiteAddress 4317B CLEMSON CIRCLE Lot 6 Block 2 Sec/Sub. TRAILS OF Parcel No. THOMAS LAKE W Name NEW HORIZON HOMES 3 Address P-O. BOX 1367 ° city MPLS Phone 420-3900 io Name_- $AME 0? Address ? City Phone a w w Name Address z a W City Phone I hereby acknowledge that I have read this application and state thatthe iniormation is correct and agree t comply with all a licable State of Minnesota Statutes and of an Ordinan Signature of Permiriee . ?? Erect L?9 Occupancy R3 Remodel ? Zoning pI) Repair ? Type of Const.V - Addition ? No. Stories Move ? Length 44 Demolish ? Depth-2T Int Impr. ? Sq. Ft Install ? Assessment Water 8 Sew. Police Fire Planner Council Bldg. Off. Var. Date Permit $ 377.50 Surcharge 32.00 Plan Review 188.75 SAC 625.00 Water Con n. 525.00 Water Meter67..00 Road Unit 305.00 Tr. PI. 180.00 Total $2.300.25 A 8uilding Permit is issued to: NEW AORI ZOPI HOMES on the express condltion that all work shall be done in accordance with all applicabl State of Minneso Statutes and Ciry of Eagan Ordinances. Buildinq Officia? 104 FOR SALL T. H. ' CITY OF EAGAN p 13130 N L?; tg ? }; 2 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 - BUILDING PERMIT PHONE: 454-8100 Receiptu 7o be used for 1 OF 4 PLEX Est. value $ 63 ,000 pate JANUARY 21 1987 SiteAddress 4317 CLEMSON CIRCLE Erect Ci( Occupency R3 Lot 5 Block Z Sec/Sub. TRAILS OF Remodel ? Zoning pn Parcel No THOI+IAS LAKE Repair ? Type of Const. 1.7 . Addition ? No.Stories a NEW Name HORIZON HOMES nnove ? Len9th ad i o Address P.O. Demolish ? Depth?2ti BOX 1367 Ft 0 S Int.Impr. q. Ciry MPLS p hone 420-3900 Install ? i o Name _ SAME ? ? Address " Ciry Phone F W Name -: u a Address < W City Phone I hereby acknowledge that I have read this application and state thatthe intormation is correct and agree to comply with all applicble State of Minnesota Statutes and C?of Epgandina?esn Signature of Permiflee Q'??C' A ?#•Yi A Building Permit is issued to: NEW HORIZON HOMES all work shall be done in accordance with all applicable&tate of MinnesoBuiltling Official- ??? ? Assessment Permit 3/4.UU Water 8 Sew. Surcharge 31.50 Police Plan Review 187. 00 Fire SAC 625.00 Eng. Water Conn. 525.00 Planner Water Meter 67 . 00 Council RoadUnit 305.00 BIdg.Off. Tr. PI. 180.00 APC Parks Var. Date Copie r„#.i 2,294.50 ? on the express conditlon that and Ciry of Eagan Ortlinances. FOz2 SALE T. H. CITY OF EAGAN A, T.!`i-8,-y3 2 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121N2 13132 PHONE: 454-6100 BUILDING PERMIT Receipt# J To be used for 1 OF 4 PLEX Est Value $ 63 ,000 Date JANUARY 21 19 87 SiteAddress 4315B CLEMSON DR Erect C? Occupancy R3 Lot 7 Block z Sec/Sub. TRAILS OF Remodel ? Zoning PD Parcel No. THONL LAK Repair ? Type ot Const. y Addition ? No. Stories c NEW HORIZON HOMES Move ? Length 44 i Name Demolish ? Depth 26 3 Atldress P• O. BOX 1367 Int. ImPr? S4Ft ° city MPLS phone 420-3900 Install ? o Name SAME Approvals Fees ? ¢ Address ? Ciry Phone F W Name ? n Address a W Ciry 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 ot Minnesota Statutes and Cit of E an Ordinances. Signature of Permitlee A euilding Permit is issued to: NEW HORI20N HOMES all work shall be done in accordance with all applicable State ofNlinneso Building Oificial Permit $ 374.00 Surcharge 31.50 Plan Review 187.00 sAC 625.00 Water Conn.52`,L- 00 Water Meter6L 00 RoadUnit 305.00 Tr. PI. 180 . 00 I Parks Total 52.294.50 on the express condition that and Ciry of Eagan Ordinances. Assessment _ Water S Sew. Police - Fire Eng. Planner Council Bldg. Off. APC Var. Date FOR SAL$ T.H. L5-!,3, 3 2 BUILDING PERMIT Receipt # N° 13133 7° ?'/5' To be used for 1 OF 4 PLEX Est. Value $ 63 ,000 Date SANUARY 21 19 $ 7 SiteAddress 4315 CLEMSON CIR Erect IN Occupancy R3 8 Block 2 Sec/Sub. TRAILS Lot OF Remotlel ? Zoning pn THOMAS Parcel No LAKE Repair ? Type of Const. V . Addition ? No. Stories ? Name NEW HORIZON AOMES Move ? Length 44 3 Atldress P.O. BOX 1367 Demolish ? I t I ? Depth-? S Ft p n . mpr. q. . Ciry MPLS phone 420-3900 Install ? o Name SAME s PProva i $ a Address Assessment ? ? ciry phone Water & Sew. Police W Name Fi F -z re x r3 Address E . ng. W a Ciry Phone Planner Council Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe information is correcc antl agree to comply with all applicable State of B?dg. Off. Minnesota Statutes and Cjp?of E an rdir?qct ? i? APC ?? ? yJ ? ? ?? Var. Date Si9natureoiPermittee 7/?- ? %{31'IPs l A Permit $ 374.00 Surcharge 31.50 Plan fieview 187.00 Sa,C 625.00 Water Conn. 5 2 5. 0 0 Water Meter 67.00 Road Unit 305.00 Tr. PI. 180.00 Copie Total 2.294.50 A euilding Permit is issued to: NEW HORI ZON HOMES on the express condition that all work shall be done in accordance with all applicable Sta ot Minneso Statutes and City of Eagan Ordinances. Building Official ? ?-? ? CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-799, Eagan, MN 55721 PHONE: 454-8100 ? This rnpuast void 18 rnonths 1rom .- Q?? 311 ?s//? o c: RxQuest Daie Fira No. Rouph?in InsVection Fequl?ad7 ?qeady Nuw _ ill Noti}y. Inspeo- i? Yes ? No ?or When Ready ?L9cansed Elearical Convacmr 1 heraby reQUeet ins0ectlon o1 ebove ? Owner elactrieel work inelalled et: Str9et Address, eo or Rao N. i ? \ 11?? L? ? c Ivl?-?? ec[i n o. Township Name or o. I RanQe o. County Oc,AtupantlPPINTI . e 7 - Phone No. . ` ' `?v i C._l.i nr Pow3n up01i¢r Atltlress §?e tucal Convactor ICompeny Ne 1 Cnntr cmr's Licens No. ? 1 ' ! 1 / M iline A Jress (Contrector or Ownar Ma n ?. , -C & Inste lationl ? ? ' OV (l? _?' ? r- 3V3 Aul 'z na re(?o pto? Ow r MakinpIn II ionl ?o Ph e Numbe? MINNESOTp STATE 90ARD OF ELECTRICITY Orippe-Midwey 810p. - Room N-191 7837 UnivsrsitV Ave.. St. Paul. MN 66104 Phone (672) 842-0800 THIS INSPECTION REQUEST WILL NOT BE ACCEPTEO BY THE STATE BOAflD uNLESS PqOPER INSPECTION FEE IS ENCLOSED. 3%2/SS 7 REQUEST FOR ELECTRICAL INSPECTION ee-00001-0e Ill See instruetiona far completinp thb torm on beek o1 vallow copy. ?C 7? 21 1 "X" Below Work Covered by 7his Request AAtl ., Peo• TYpe of Buileine AOOlieneee WirW Equiumant Wirad Home Range Temporary Service Duplex Water Heater Lightiq Fixtures Apt. BuilAinfl Dry¢r Electric HeaLn Commercial Bldg. Fumace Silo Unloader Industrial BIAg. Air Conditio r Bulk Milk Tenk Fef01 the.r oeci y ther ISner,ifyl t nr Vcu y t ar Othur i r Fea ?ServicsEntrenee5i:a M Fe• Faedera/Subleeders N iea Circuit• ? 0 to 200 Am s 0 to 30 qm s 0 tn 30 Am Above 20 _qm?s 31 to 100 Amps 31 to 100 A s Swinmin Pool Above 100-Am s Above 100_Am ' Transiormer5 rn ation Booms ?artiel.'Other Fee Signs Special Inspection 5 TpT ` errerks w ('}?? ? 7 fiouBh-in tnepeelor, hereby cerlily thet the ebove Final inapeetion hes bean /?•? ?"?oi? ?n meda. (h1s reauest volE 18 monlhe Irom 0 yggi2 2 _ FeQues ?'`1 ? File No. R uqhln Insperprvion Fequiretl Inspec[ion Olher TM1an R In (YOU musl call inspector whe e ) ? Reatly Now ill Notity Inspecbr ?y ? Ve5 o Date Read I icensed contractor ?owner hereby request inspection of above electrical work at Job AtlGre?ss /(S/hJeet, Bax or Raute No.) City Section No. Township Name or No. flange No. Counly Occupant(PRI T) ? Phone No, ? Power Suppl r Atldress L C? Eleclricel Contrador (Company Neme) ConVacWr's License No. HTGNLAND ELECTR7C CA00847 Malling Atloress (Conlrnctor or Owner Making Installation) 2030 ST CLA7R AVE, ST PAUL, MN 55105 Authoriiea Signa ( ntrzctor/Owner Making siallation? Phone Number 690-1551 MINNESOTA 5 E A U OF LEC I THIS INSPEGTION PEOUEST WILL NOT Grigga-Mitlway Bltlg - Ro m 12B II I I I II 11 1111 1111 I I 1 111 1111 BE ACCEPTED BY THE STATE BOARD 11 1821 Oniversity Ave., ul, MN 55104 UNlESS PFIOPER INSPECTION PEE IS Phone(6121692-0800 ENCLOSED. P REQUEST FOR ELECTRICAL INSPECTION , See instmctir,ns lor completing this lorm on back of yellav copy ?/(l „X" Below Work Covered by This Request Nq'c' ilding Appliances Wired Equipment Wir ed Range Temporary Service Water Heater Eiectric Heating Load Management Furnace Other (Specify) Air Conditioner ConUaciars ft@mr k? C ( /' Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # CircuitslFeeders Fee Swimming Pool 0 ro 200 Amps 0 to 100 Amps Transformers Above 200-Amps Above 700-Amps Signs insvAnors use ohiy TOTAL Irrigation Booms n?{ Special Inspecfion ///7//1 AlarmlCommunication THIS INSTALLATION MAY ORDERE CONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONT I, the Electrical Inspector, here6y Roughin . Date cehify that the above inspedion has been made. ri„ai OFFICE USE ONLV This request voiA 1 8 manihs irom 3I,al87 REQUEST FOR ELECTRICAL INSPECTION ee-ooaoi-os &Vk ll? See insfructiorm for camDletin thie form on bnek o1 yellow copy. filej 71!1 .,Y.. R.M. w.,,o- r,,,.e,aa A,, ih;. 1 _. . . . ..... .. ..y..a.r AAd P. 7ype of 9uildine Aoolianees Wirad Equipmanl Wirad Home Range Temporary Service Duplex Water Heater Lightin Fixtures Apt. Buildfng Dryer Electric HeaUn Commercial Bldg. Fumace Silo Unloeder Industrial Bldg. Air Conditioner Butk Milk Tenk Farm thnr 15necify, ther ISOUr.ityl t er Ucc, V ther Oth.r o mpute lnspection fee Be/ow N Foe ServieeEntrenee3ize p Fee Feetlers/SUOfeaders N Fea Cim.ite i to 200 Am s 0 to 30 Am s 0 to 30 Am Above 2 0 qmpa 31 to 100 Amps 31 to 100 A Swimmin Pool Above 100_Am s Am s Abov 100 Transiormers rn tion Booms _ Partial-'Other Signs Special Inspection ? ems.ks TOT FEE _n, . .L ? ur flou0h-in i ? o: Oate vC? I, the E I ?.apec<or, hsreby Final p_ certify tMt the nbova i ? ??? `s£ 2C inspection hen been /`?E.L??' ? dLJ ? -? ?/"'O de. Mb repupt volE 18 mantlm from J/1fsS 7 REQUEST FOR ELEC7RICAL INSPECTION es-oaooi-os If, See inatructlona br compietinq Ihig form on beck of yellow coov. ? n in(a "X" Be/ow Work Covered by Ih/s Request ??Ndd? Xao.I TvPe of Buildine I Aoeliancee Wired I Equlument Wired I I I I ndustrial BIAg. j Air Conditioner ? ? Bulk Milk Tenk ? Farm ?hr? oe?r ? n che, ISnec?fv) p fe ServieeEntrancaSiza H Fee Fewders/SUbieetlers K Fee Circuits , U to 200 qm s 0 to 30 Am s 0 tn 30 Am s Above 200 qm ,s? 31 to 100 Amp 31 to 100 Amp, $winunin Pool 4Ams Above 100_ A6ove 100_Am 5 ormers Irri ation Purtial,'Other Fee "`J'b fbUeaai inspecuon S TpT ERamerks ? I, the Electrical ?nsoec?o., narre ay ??C? ? ? cerlily ffiat the bove Finel ? (y ?"Tq?}e pection has been ,) lJ' " !I ma'na ee. rnts reauesi ooid 18 rtpnths from C 7 3 3 0 9 1-7 ReaeestDa" A. ? ?? Fir¢ No. ugh-in Insuection eq ?red? OHeady Nuw ill Noiily Insoec- ? Yes ?No or When RendY ?'(Licensetl Elecvical Contractor I hereby requesl insoection ol ebova ? Owner eleeiricel work instellad eY 5 r'et Atldress, Bo or ? t! No. Cit ? ? ? /? 0 E ? ection NU. Township Name or No. anBe No. County O tupaM (PRIN Phone No. Pawer Supplier :K -fzti Adtlress ic al ConVactor ICompany mel ? Comra tor's Licens N o. (? m ?:P C?i c? iline A.tldress (COntr?actor or Owner Makine I*?st tlatio 1// 61i ?. ? ? Auth riz tl omr tor aking Ins aY nl Pho umber ? ? MINNESOTA STqTE BOAflD OF ELECTflICITY TNIS INSPECTION REQUEST WILI NOT Gripqa•Midwey BIdO• - poom N.181 BE ACCEPTED BV TME STAiE BOAPD 1827 Univeraitv Ave.. St. Paul. MN 66704 UNLESS PqOPEH INSPECTION FEE IS Phona(612) 642-0800 ENCLOSED. Thi5lbquBSl VOId -3?13(7 `8 rtqnths from 0 7 '111 n i ?; ; ? ?? :?? r; ,;, !??:, .? , ? ,? ?.?? ,-, ?; Requis Date -?? Fire No. oupp-in InsOOection qurtetl? N ?iieatly Nuw rII Nolily. InsOec- 1or When fleedy OS o es "Ej`&censed Electrical Contractor I hareDy requeat insoection ot ebove elactricel work instelled et: Jfl DwnPr Str L yet_Address, B '? te No. CJ eaion o. ownshlp Name or o. . County Oc yp?t IPPINT) J?` E L * Phone No. Address Powel.$uppl ier -/? 71 y? l ConUactor ICompeny Na Ele a ?l 6 m ?c?0 C?P(J7'?c? Con actor's Lice o. ? ?.. II- B dress 1 ontr cm o Owner a in ? I Instai ation) Lk, / v ,, Authoraed Si alure IConve Owner akinB Ins lationl - h P e Number MINNESOTA SfATE 60aflD dF E&yryc{y"CW1/ Q ?ma uva-c?.--vrv ncuvw? v ?? -.- Gr109e-Midwey BItlQ. - Room N-191 " ?-'V BE ACCEPTED BY THE STATE BDARD 1821 Uniwarsilv Ave.. St. Wul, MN 66106 ' UNLESS PNOPEN INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. I ' / r I (93?, ? ? r_ co Ai -74.30 ? 0, ? ? ?/ / N I ? `l'Q 1 Q ? .00 ? /l`4• ?3 (933.9? 9 8 v I N?4.30 ? 00'W o ? f ?? a N ? 9(e ? 29.33 ??'? f Q N I ° i°,° i PRO? FW?Oi 9E.. ?? ?s.o _za / Ul 3 199 % a.ti? ? au??o ° J ?L 0? in I ? / S ? ? ? J N m O 00. 8 K/Oa ?935.5? c? G W / _j / U O Denotes Iron Monument ° Denotes Wood Stake X000.0 Denotes Existing Elevation Proposed Top of Foundation Elevation= (000.0) Denotes Proposed Elevation Proposed Garage Floor Elevation= 9b-1.5 -4-- Denotes Direction of Surface Drainage Proposed Lowest Floor Elevation= 938.0 I hereby certify that this is a true and correct representation of a survey of Me boundaries oF Lots 5, 6, 7, and 8, Bloclc 2, TE'.E TRAZLS OF TE;OMAS LAKE, Dakota County, Minnesota. And of the location of all buiidings, if any, thereon, and all visible encroachments, if any, from or on said land. It also shows the location of the stakes as set for a proposed building. As surveyed . by me or under my direct supervision this 12th day ot January 1987 Paul A. Jo:inson Land Surveyor, Minn. Reg. No. 10938 4d CERTIFICA ?E?rOF SURVEY BOOK I? CMC(OMBS-KNUTSON ASSOCIATES, INC. >' - ooMSUtnwo uoie[[es N wo sunvtroet A sn[ rwR[es .J.Eho. _NEW _. HO[Z1ZOS?l....NOMES._ItJC. wrmuroLuw wurcHiwoM.ww?uotA T931 13 l 1986 HOILDING PERlffT ApPLICATION - CITY OF EAGAN NOTE: ALL COATRACTOHS MQST BE LICENSBD iIITH THE CITY OF EAGAN SINGLE F9MIILY DiiELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS MOLTIPLfi DWELLIAIGS - RFSIDENTI9L INCLUDE 2 SETS OF PLANS, CER 1 SET OF ENERGY CALCULATIONS COMMRCIAI: INCLUDE 2 SETS OF ARCHITECTURAL 1 SET OF SPECIFICATIONS AND 1 ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND I OF q- To Be Used For: EENT9L OeTlTS FOR SALE 08ITS J OF SORVSY - CHE($ BITH BLDG. DEPT., & STRUCTURAL PLANS, SET OF Valuation: *63,0D0.00 nate: 1/30 /S7 Site Address 4 3IS M,,,a&„ Cy-Lcp OFFI IISE W1LY Lot g Block Erect ? Oecupancy 19•3 Remodel Zoning PD Parcel/Sub 'aiZtA t&hQ Repair _ Type of Const ? Addition N of Stories Owner 'npa,J "?91644ti °q6-,&M cD,\, Move _ Length 44 Demolish Depth ZCo Address Q.0. (361C ?'3?-] Int.Impr. Sq Ft _ Install City/Zip Code 65d4D Phone 42 0- 3qGb APPROVALS FEE3 Contractor a,p q,QrO44 9ddress Aasessments Water/Sewer Police Permit Sureharge Plan Review 31,so IQ?I. Fire SAC (oZS. City/Zip Code Engr Water Conn 525, Planner Water Meter fD'1. Phone Council Road IInit ?05- Bldg Off Treatment P1 I60, Meh./Engr. APC Parks Pariance Copies Address TOTAL -Z 9r-lfi City/2ip Code Phone lf NOTE: ADDHESSSS FOR CORNER LOTS - CONTRACTOR/HOMEOiiNER MDST DESIGNAiE HHICH 9DDRESS IS DESIEED. NO CHANGFS SiILL BS ALLOiIE!) OHCE BOILDIHG PERMIi IS ISSIIED. 1986 BIIILDING PEAKIT APPLIC9TIOH - CITY OF EAGAN 90YE: ALL COPTRACTOHS MOST BS LICENSSD iiITH 'PHE CITY OF EAGAN SINGLE FAMIILY DiiELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS MOLTIPLfi DiIELLINGS - RESIDENTI9L INCLUDE 2 SETS OF P[,ANS, CER 1 SET OF SNERGY CALCULATIONS COMAIERCIAE INCLUDE 2 SETS OF ARCHITECTURAL 1 SET OF SPECIFICATIONS AND 1 ENERGY CALCULATIONS, $2,000 LANDSCAPE HOND 1 oF 4 To Be Used For: p?&njp RENTAL DIJITS FOH SALE DNITS I/ OF SQS9fiY - CHECK fiITH HLDG. DSPT., & STRUCTURAL PLANS, SET OF Valuation: Site Address Q3(5 g CQo,,,.,,? ()n,,,? Lot Bloek 2 Parcel/Sub r;?" d- r?" " Owner ?,pn `??m?, c?m.c ? Address lp C) BIGY)e 136? City/Zip Code rM"., /Tyn, S5440 Phone 420- 3q00 Contractor la.y,?a pp QQ„y„Q 9ddress City/Zip Code Phone Mch./Engr. _ Address City/Zip Code Phone 4 0 Co3,000a00 Date: 1/zlB-7 Erect ? Oceupancy R 3 Remodel _ Zoning _'FP Repair _ Type of Const SG Addition # of Stories _ Move Length Demolish _ Depth z(o Int.Impr. Sq Ft Install aerxovaLs FEES Assessments Permit Water/Sewer Surcharge 3 I.4 Police Plan Review I 87, Fire SAC &ZS, Engr Water Conn SZS. Planner Water Meter (0"7, Council Road Unit i051 Bldg Off Treatment P1 l80- APC Parks Variance Copies TOTAL oZ ? NOTE: ADDHESSES FOR CORNEN LOTS - CONTRACTOR/HOMEOflNEB MOST DESIGN9Tfi AHICH ADDRESS IS DESIRSD. NO CHANGES iiILL BE ALLOiIED ONCE BOILDING PERMIT IS ISSOED. 1986 BQII.DING PEItlIIT APPLICATIOH - CITY OF EAGAN 90YE: ALL COATRACfOES MQST BE LICENSED iiITH THE CITY OF EAGAN SINGLE F91+IILY DAELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS !lOLTIPLE DTiELLINGS - RESIDENTIAL RENTAL ANITS FOR SALB DNITS v INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SOHVSY - CHECB iIITH BLDG. DSPT., 1 SET OF ENERGY CALCULATIONS INCLUDE 2 SETS OF ARCHITECTURAL 1 SET OE SPECIFICATIONS AND 1 ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND lor4 To Be Used For: ? & STRUCTURAL PLANS, SET OF Valuation: g&??,a`)O. 00 Date: ilao /u Site Address 43 17 0 6W,?&., ciA& Lot 5 Hlock 2 Parcel/Sub ";" 0 qkent" Qp,6 Owner °npA,r 291,1!2L Ng,yga cQrA,C Address p 0 *Q6'J[ 20 City/Zip Code 5544b Phone 42 D ' 3qoD Contractor a?w 04 &9vQ Address City/Zip Code Phone Areh./Engr. Address City/Zip Code Phone # vh - ? OFFIC DSE ONLY Erect ? Oecupancy ?•3 Remodel Zoning ? O _ Repair _ Type of Const ? Addition _ # of Stories Move Length 4? _ Demolish _ Depth 240 Int.Impr. _ Sq Ft Install _ aPpaovALS Fses Assessments Permit 3-74 . Water/Sewer Surcharge 3?,$O Police Plan Review 1 8 -1, Fire SAC l02S • Engr Water Conn 57-5• Planner Water Meter (o-71 Council Road Unit ?S. Bldg Off Treatment P1 ? 8O. APC Parks Variance Copies lY)?AL ? J NOTE: ADDHESSES FOR CORNER LOTS - CONTRACTOR/HOHEOWNEB MQST DESIGNATE BHICH ADDRfiSS IS DESIRED. 90 CHANGES TiILL HE ALLONED ONCE BOILDING PEBMIT IS ISSQED. - -. ' /3/3/ 1986 BOILDING PEAMIT APPLICATIOH - CITY OF BAG9H 90YS: ALL CONTRACRORS M[1ST HE LICENSSD iiITH THE CITY OF EAG9H SIliGLE F9MIILY DiIELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS MOLTIPLS DiiEI,LINGS - RFSIDENTI6L REN'fAL IIBITS FOR SALS DNITS If INCLUDE 2 SETS OF PLANS, CfiRTIFICATE OF SDRVEY - CHEC[ WITH HLDG. DEPT.9 1 SET OF ENERGY CALCULATIONS INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, ' $2,000 LANDSCAPE BOND I oF4 To Be Used For: (zpatlQ? Valuation: $6400D_' Date: Site Address Lot ? Slock 2 Pareel/Sub OTI" d qkeluctp Lk Owner ?pN7 °I"Wn, 9?? eAr„e Address (3fa-l City/Zip Code ??,?Qp.? IY11m. S5q4b phone 420- 3qLO D Contractor „p.(/vr,¢ p,o a,g? Address City/Zip Code Phone Areh./Engr. Address City/Zip Code Phone # Gq - qlk, CE OFFI OSE ONLY Ereet ? Occupancy ?21 Remodel Zoning _ Repair _ Type of Const ? Addition # of Stories _ Move Length 44 Demolish Depth 27 Int.Impr. _ Sq Ft Install _ APPROVALS FSES Assessments Permit 3-I-7 Water/Sewer Surcharge 3Z, Police Plan Review 1 Z>B. T? Fire SAC (025, Engr Water Conn SZ , Planner Water Meter ?0"1. Council Road Unit 305 • Bldg Off Treatment Pl I So. APC Parks Variance Copies TOTAL .S-' NOTE: ADDBESSSS FOR CORNER LOTS - CONTRACTOR/HOMEOiiNEH MOST DESIGNAYE W$ICH ADDRESS IS DESIRED. AO CHANGES WILL BE ALLOflED ONCE BIIILDING PERMIT IS ISSIIED. .?- .r7 ? .. y .? , ?r?Lc.(',? G ? ?h/"71-??J ?`'` ?- =•??• ??1 zvt?l , _ _ -• _ ? " ? ? U ?"O(? ? 2L,-754 ?HEATLOSSCALCULATIONS HEATI011GSAIR CONDITIOWING CO. MINNEAPOLIS,MINN. Weatherstrips A.S.H.V.E. Con6truetion No. Insulation Wndows Doors Guide Reference Out. Wall Int. Well Ceiling Roo1 Floor Kind How Applied Yes-No Yes-No 19__ _ i,,,irIv(, o-RRO°"? Length Width Height F?• ? FI. (`(1r»rtFQ B!qRoan Length 1Y O -N?idlk !i HeigM YJi ndows a nd Doors- Cracka ge and Ar ea Windows a nd Doors- Cracka ge and Are a No. W,d,h ol ana HaiOh1 ol oane Na. ol li ??s Lineal IL pf crack Area sa. It. N?• Widih of ane Hoipht of ene Nn. of li hw L?n eal fl. of crack A?ea eQ• it• 3z ti 41 a 1 ° g R 9 1 2 b 1 10 Coef Btu Coe1 Btu Inliltretion 1? Inliltration 2. ? J tl 7 J O Glass '' 2y -lo Gless Exp. wall ;M, ^t ? Exp. wall lO Net exp. wal I 311 Net exp. wall 9• 25 $ -tm'"W9tF omY' 1 117 2 2,2 . Int. wall ?2_ '2- X 12 Ceiling - 2btA • Ceiling . 7Q(q 1.5 ( Floor Floar 1 ?f\ (t Taal Btu. 7 S, Total Btu. 3 Required sq. ft. E.D.R. or sq, ins. W.A. Leader area Raqwred sq, ft E.O.F. or sq. ins. W.A. Leader area FL 1 NIN( Roan Length Width Height HBiyM FI. ,6f)''2-t]t?qom Length J5 Width 10 Windows and Doors-Crackage and Area Ydi ndows a nd Doors- Cracka ge and Ar ea No. Wid?h OI enB HeiqM ol ena No. of 11 hb Lineal le o} crack 4rea +C? f?? No WiAth ol ne n Hxiq?t nf ann No, ul b Ms L??aet le of crack Area sq. ft. o ? N??D r 7 y c 2U r? G 2 1 Coef Btu Coet Btu Infiltration _rQ 2,24? Inliltration .Z.1 3p Q /JO Glass Zj Glass st) Exp. wall aC `a a(p Ezp. wall Net exp. wal I 1 Net exp. wall _] J 'Z, 321 Int. wall Int. wnll Ceilin9 91 z.S 2 CailinQ ts0 2.5 ? Floor Floor ( 4? Uj Totel Bta S . Total Btu. 3-->4 Required Sq. ft. E.O.R. or sq, ins. W.A. Leader grea Required sq. ft. E.O.R. or sq. ins. W.A. Leader area Roan Length Width ? Height 1 FI. floom Length I Width Height Windows and Doors-Crackage and Area W indows a nd Doors -Crack age and Ar ea N2 ??d,h O d118 Hei9h1 of flOB No. of lt 1119 lrneal ft. of CfBCIt Aeea aV• ti. No. of 809 ah? of flnM No. nl ?? ?IS l?neal fL O? CfdCk Ared BV• ??• COQi BtU CO@( Btll' Infiltration InfiltrPtion ? Glass Glass Exp. wall Exp. wxll Net exp. wall Net exp, wal l Int. wall Inc, wxll Ceil+ng 12- -A, -1 Ceiling Floar Total Btu. Total 8tu. Required sq. ft. E.O.R. or sq. ins. W.A. Leader area ? O Roquirect sq, ft. E.D.R. or sq. ins. W.A. Leadar area fr• ?HEAT LOSS CALCULATION$ 56. Sedgu4i1:16 HEATING&AIR CONDITIONING CO. MINNEAPOLIS,MINN. Westherslrips A,S.H.V.E. Conshuction No. Insulatian NTindows poors Guide Refere n Ou[. Wall IM. Wal1 Ceiling Roof Floor Kirxl HowApplied Yes-No Yes-No ce 1y__ ;FI. yQ Roan Langth l4 Wid[h Height FI, Roan Length Width Neight Ydi ndows a nd Doors -Cracka ge and Ar ea Windows a nd Doors- Cracka ge and Ar ea No. oly? a?ne 1 Heioht OB?e No.^o?l Lmeal H. af crack Area eq. li. µo WiA,h of em Hoiph[ of ane No. nt ?i hts l?neal h. af c?ack Area sa. ft• ? 2- (D Coet Btu Coef Btu inrio-acion :LO D 76a inri inscion Glass r 1&0 Glass Exp. wall Exp. wall Net exp. wall 2 Q Nat enp. wall Int. wall Int. well Ceiling Ceiling Floor . 10 j6 („p-] Floor Total Btu. .2:3(AQ Totel Btu. Required 6q. ft. E.D.R. or Sq. ins. W.A. Leader aree Ryquired 6q. ft. E.D.R. or sq. in6. W.A. Leader area FI. Room Length ? Width 11 Height FL Noam Length Width Heiyht Wi ndows a nd Doors- Cracka ge and Ar ea YI i ndows a nd Doors- Cracka ge and Ar ea Na. WiGrn of ane Heipht o1 ana No. of Inchiy Uneal h. o1 oack .4rea G4• ft. No ?yi??ry ol on0 Hp?qhI al ann No. ul li hts lmeal It. o/ crgtk Aree 50. h. Y 9 a ? ?,° ? ? q, ??. Coei Btu CoaT Btu Infiltration ? 1I-7 2 223 Infiltration Glass U Qd 0 Giass Exp, wall Exp. wall Net exp. ?I 7.gZ q. ( ( l Net exp, wall ?F+ f 2 ?1U 2.2 int. wan Ceiling Ceilinp Floor LX I? Floor Total Btu. 16A -i Total Biu. Fiequired sq. (t. E.D.R. or sq. ins. W.A. Leader area Raquired sq. ft. E.D.R. or sq. ins. W.A. Leader area FI.?,? ,,. }?t?om Length l3 Width Height FI. Room Length Wid[h Height Wi ndows a nd Doors -Crecka ge and Ar ea Wi ndows a nd Doors- Cracka ge and Ar ea NO' Wiath ol ane Heiqnt ol ane No. ul li h's L?neal h. of crack Area s4 it • NO' WiTh uf iane 7u??? ?? uf Oaoe No. nl li nls lineai h. o( crack AreT a•fi. Coe( Btu Coe1 Btu Infiltration In/iltration Glass Glass Exp. wall Exp. w»II Net exp. wall 77G'? Net exp. wall lnt. wall Int. wall Ceiling Ceiling Floar t ...X y ? V-LS?- flnor --'--_ Total Btu. Total Btu. AequireJ sq. ft. E.D.R. or sq. ins. W.A. Leader area Ruquired sq. ft E.D.R. or sq. ins. W.A. Leader area GITYOF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION 1) PROPERTY ADDRESS: LEBAL DESCRIPTION: oc NO'1E: PAYMPM' OF PE8 AT TIM OP APPLIaPMON nOEs rOr aonsazTUTE nePxova,L aF rERMIT. nisencriaN oF sE,Et Aun/CR s,m,M n T.ra'r30IZ5 WII.L NOT ffi 9(EED-- [A.m UNra, PERMuT HAs SM ArrFJDM. or IF EXISTING S1RLC1LRtE, DA1£ OF OQ2IGINAL BUIIDING PFRMiT ISSCRNCE: . . PRESENf ZOLVIING/PROPOSID L?SE: rbn ear Q ca403cIaL/!RETAIL/0FFzcE Q IHI)(JSIRIAL ? INSTITL*PIOFIAL/GpVIIwEMr 2) ? DAU'E: ADDRFSS: CITY. S'fATE. ZIP: 3) ? i: a• NAME:_tm ZA?RESS: CITY. STATE? ZIP: Pfi0NE: ?i • ? R-1 SINCT,E FAAIILY : R-2 DLWE}C (1GO C?nits) ? R-3 2DPffiODSE (Three + Units) ( Units) x-4 A2ARzrmvr/cotmuNILM ( [mits ) D4ASIE[2 I,ICETN,SE# Q) •• •;? ?..n?NANE.? . ADDRESS: • CITY. STATE, ZIP: ' PfENE: •5) " ' M' • ?• • a? ?? • . eCOtaIDC.TION 1?D C.I'PY SEWII2 (;j" ODNPIIX.TION M CITY MATER Pliabers License: 14ctive E7cpized D7ot z'ecorded S? initial Q OTHER ' . 6) ?? ?? ? PLEA.SE HOID APPROVID PII2MIT FCII2 PICK-C?P BY ONE OF RBOVE L='I ?E ?L APPRWID PF1iMIT 7?D 1, 2, ? 4. AB(7VE 7) (Circle one)n I 'y FOR -CITY USE ONLY ., , . .?. 0. . PERMIT # ISSUED - ??f Pd w/Bldg. Permit FEES: $ S 16 5o SEWER PERMIT (INCLODE SORCHARGE) $ $ ?? sO WATER PERMIT (INCLLDE SURCHARGE) $ $ WATER METER/COPPERHORN/OC'TSZDE READER $ $ WATER TAP (INCLLDE CORPORATION STOP) $ $ SEWER TAP ?? $ $ IS ACCOLNT DEPOSIT - SEWER $ $ ACCOUNT DEPOSIT - WATER S $ • WAC $ (o 15? S ?v $ SAC , . $ S - , % ? ?'•. , f ' TRtlTQK -FIATER ASSESSIIENT • S $ ' ? ` 17?L'NK _$$T0.ER.,-F45SES$MENT , $ $ LATERAL'$$NEP•IT/',Cj{UNK SEWER $ $ * + LATERAL BENEFIT/TRLNK WATER > S ??D ? r ., S . •o : . ..-'• 4 ; 1 R ' • . (qTATE ANT SURCHARGE JRFATMENT. PL $ • OTHER': . _ $ ?:?g? 0LJ ?- ? OD _ ? r'-,`-:'. -$? TOTAL --- 7D/95 - o .. RECEIPT RECEIPT DOES UTILITY CONNEC TION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? F__j YES IF YES, THEN A" PERMIT FOR FIORK WITHIN P08LIC Q NO ROADWAY" M[)ST BE DIVISION LIST ISSUED BY THE ENGINEERING AS CON IO . A DIT N. SUBJECT TO THE FOLL OWING CpNDITIONS: ? APPROVED BY: ?/?Ai,Qh,??(/?.? ? TITLE: , •. . DATE: ,-./ - L-7 CITY OF EAGAN APPLICATION FOR PERMtT SEWER AND/OR WATER CONNECTION 1) PROPERTY ADDRESS: c LEGAL DESCRIPTION: -7 Z NOTR: PA7MTP" OF PSB AT T!M[: ? ?CATION DOES NOT CMVTITE17E r,PPRwnt. aF' rEE041r. nSPECTIoN oF SEHM r,rn/UR M'tst nWDULATTCNs wIM Nom BE SCHED- tu,m [Nrn. rERrIT mAs $M APPADM. . .. .-/n?ucai ounaivision or Tax Parcel ID u IF ElQSTING 51RC'CMRE, DATE OF ORIGINAL BLTIIDING PERNIIT ISSL'ANCE: . . P12ESYN1' ZONIldC;/PROPOSID LSE: Mon ear ? COMMERCIAI./REl'AII./10FFICE ? INIDUSIRIAL ? INSTITL*PIONAL/GOVFItIZEBTr z) ? rmME: AonREss: ciTSr, sraxE, zIP: 3) NAME AMRESS:? CITY. S"PATE, ZIP: NY IViV ? R-1 SINQ.E FAAffLy ?J R-2 DC'PI.Ex (1uv Uni.ts) ' R-3 ROWDMOOSE (Three + Units) ( Units) q a-a ?ARTmENr/cormorurrzt.u4 c v,uts ) MA5TER LICENSE# k 4) ?• • • • i?- NAME:? _ ADD03SS: , aTY. STATE, ZIP: PtIONE: . Plim7b ers License: Active fSSpired D7at recorded tarf I r??it,ral 5} n ?.. , ?. : o • oi - ?? • ? ODNMX,'PION 1C} CITY SEZMIi ? CpPIINSLTION TO CITY WATER ? aPiM ' . 6) ?? • ? r E3 PLEASE fiOID APPRCNID PERMIT Pat PICK-UP BY ONE' OF ABOVE ? [vy PLEASE MAIL APPRWID PIItMIT 1+0 1, 2,3 4. ABOVE ` (Circle one) 7, ? l,l'il .LFO?y/-' .z.un,. /7 _2 .01-1 $?d FOR -CITY USE ONLY PERMIT # ISSUED ,R q 3 ? -? Pd w/Bldg. Permit S s $ 42? $ $ $ $ s ,5"a5 °-0 S (?,?5 00 $ S S $ $ $ ?197 !7? RE EIPT FEES: S /(7 SO 50 s 5 : • SEWER PERMIT (INCLODE SDRCHARGE) WATER PERMIT (INCLUDE SLRCHARGE) WATER METER/COPPERHORN/OLTSIDE READER WATER TAP (INCLL'DE CORPORATION STOP) $ 5EWER TAP $ IS ? D ACCOONT DEPOSIT - SEWER $ ACCOUNT DEPOSIT - WATER $ • WAC $ SAC , ' . , ? ?.: :. ,. ? • ° ., 3r_,?Jd $ TR'C10IF -WATER ASSESSNJENT OC'NK .S$WEgr,-ASSEStMENT $ LATERAL- lkPTIEliI'I'?*L}'AIK SEWER $ LATERAL BENEFIT/TF2I:NK WATER q _., .? tY • $ ? • _ . (!?ATER ,TREATMENT, P3tANT SURCHARGE $ OTHER': . ` , ? . D ." _ . •-,-', ' O '. TOTAL .' _ 70 lo lo ?J . RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? F__j YES IF YES, THEN A"PERMIT FOR WORK WITHZN PLSLIC Q ROADWAY" M[)ST BE ISSOED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CpNDITIONS: 4 APPROVED BY: TITLE; r • • ' : a '. DATE: } ?-04'2 CrTY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION riar.: rAMrr aP M Ax anC aF tPMcAnaa noES riom oaa-rnUJE * p,rrxOVAr, a¢T rER41T. • nuSPncrsoN OF sEWER Arn/bR WATM Ira-rar.raTrms wa.L Nom ffi 9cHED- Un.Fn vrrrB. PERMrT Hm.s EM npPRDVED. , P ease Print "l) pROPERTY ADDRESS: LEGAL DESCRIpTION: •- IF E7QSTING S2RCC1LR2E, DATE OF ORIGINAL &UILDING PERMZT ISSL'ANCE: ' PRESIIJf ZONING/PROPOSID t?SE: Nbn ear .. ? corrERcuL/IRErau./OFFica ? II'IINISTStIAL +] INSTIILTIONAL/GOVIIWETf 2) ? AO CITY. S"fATE C] R-1 SINGLE FAMILY " R-2 Di7PLEX (Ttho t?nits) . ? R-3 1OWNHOIISE (Three + Units) ( Lfiits) R-4 APARTmENP/CONIDa7INIUNI Units) 3) ' ':S" NAN?: For City Use [Avyjoi Pltnrbess License: AMRE55: ? Active CITYr STATE, ZIP: ' -cPlred Not recorded PHONE: NASTQ2 I.ICENSE# 17423M ' $ta ial 4) •• • i?• NAME: . AUDRESS: . CITY. STME, zip: PHCNE: . s> u - «• ?• . ?. - ?. d?.'PION 10 CITY SEMR Ga/ODNNIDLTION SO CITY FATIIi C( OTHM ' • 6) ?• r [:3 PLEASE HOID APPRpVID pF.I2MT FUR PICK-C?P BY ONE OF AHWE ? dE MAIL APPROVID PII2MIT TO 1, 2,? 4, ABOVE ?`_ ,. '(-x-? ' _ (Circle one) .-FOR -CITY USE ONLY PERMIT # ISSUED 1? 3 Pd w/Bldg. Permit 5 $ ?07 ?sc? $ $ $ $ S ?"?560 $ $ $ -- - $ S S S 9 . ;70/ 9 FEES: $ /D '` o $ S $ $ $ Y SEWER PERMIT (INCLUDE SURCHARGE) WATER PERMIT (INCLODE SORCHARGE) WATER METER/COPPERHORN/0[!TSIDE READER WATER TAP (INCLL'DE CORPORATION STOP) SEWER TAP ACCOUNT DEPOSIT - SEWER $ ACCOUNT DEPOSIT - WATER $ • WAC $ SAC $ - -% ? +-_ - • TRtl1QK •WATER ASSESSOENT --- --- ._; ,. .. .. I $ . ' •_ • v Tg. UNK -$EiqER;ASSES'SMENT S ' LATERAL.'$FNE?`PP/.T?L'NK SEWER ? _ $ • LATERAL BENEFIT/TRCNK WATER $ Fj}S7'EF2 , TREATMENT. PUANT SURCHARGE • ? $ ' ?•. `_ '? - y bTHER': TOTAL RECEIPT RECEZP - . DOES UTILITY CONNECTION REQUIRE EXCAVATION IN POBLIC RIGHT OF WAY? F__j YES IF YES, THEN A"PERMIT FOR F10RK WITHIN PUBLIC Q ROADWAY" MUST SE ISSLED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: v APPROVED BY: I TITLE: DATE:\ ?? ?- • b Z . 40ITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION 1) PROPERTy ADDRESS: LEGAL DESCRIPTION: Z s NOT3: PA7MW' QF PF8 AT T7t+EQF ?,?rscr?aa no? r?om oo?a-iz? A2PRwat oP PEauT. naSPFx.-riort aF sEMM Arn/OR MM irsrArLATTOrs wUL Nox EE scHED-- OikD ONPII. PII2MffT AAS Hffi0 APPRWID. IF EXISTING STRC'CILJRE. DATE OF ORIGINAL &LILDING PERMIT ISSUANCE: - PRESENP ZONING/P1tOPO5ID OSE: : Mon ear q 000MCIAL./WAsr.roFFIcE 1-7 INL'Sli2IAI+ ? IN9=1T10urL/caAaru.Errr 2) ? t?ME: AMRFSS: CITY, STATE, ZIP: 3) • i: ?• NAME:-tau ADDRESS: CITY? STATE, ZIP: PHONE: P;)Z'A ? R-1 SINGLE FAMILY ' R-2 DLVLEX (1Wp Cfiits) ? R-3 T0WMOLISE (Three + Units) ( Units) [] R-9 AP.4RimENP/CODIDOMINI[fil ( Units) I,ICFNSE# 4) • • • ??. ?y ??;, i ? ? ? _ ADDRESS: , CI77C. STA7E, ZIP: PHONE: - P,ctive E?cpired Not recorded Sta-ff tral -5) n - ?. , ?. : a • a? ?? • y eOOIaIDCTION 7t? CITY SSSdm ? COImX..TION 10 CITY HATER [3 O'iffiI2_. 6) ?? • ?? E3 PLEASE EiOID APPR(7VID PF1iMIT Mfft PIQC-QP BY ONE OF ABWE [v.Y PI.EASE MASL APPROVID PERMIT ZO 1. 2.(P3 4. AHUVE t?I . - (Circle one) . 41 94, . fOR -CITY USE ONLY . - : PERMIT $ ISSUED . X lS Pd w/Bldg. Permit FEES: ? $ $ /e') Sv SEWER PERMIT (INCLODE SURCHARGE) $ $ leSO WATER PERMIT (INCLODE SURCHARGE) $ ?? B v $ WATER METER/COPPERHORN/OOTSIDE READER $ $ WATER TAP (INCLC'DE CORPORATION STOP) $ $ SEWER TAP $ S ACCOUNT DEPOSIT - SEWER $ $ /S B ? ACCOL'NT DEPOSIT - WATER $__ $ • WAC $??S $ SAC , $ • f. $ - ? l:'•_ TR?C.?IQK -WATER ASSESSNjENT ' r $ $ ?_• ?.,,_ • . ? ,T$ONK -SEWER -ASSES'SMENT ?' .. . . . i '.. :: $ $ LATERAL1? PyNE?IT/.??Ui?1K SEWER , , _ $ $ LATERAL BENEFZT/TRUNK WATER . ?.'•l d.?.J,;: $ /lSd $ • . WATERJRF,ATMENT. PBANT SURCHARGE . \:'`? $ $ ••,?? -.a . ? ' OTHEbt': s ToTAL 766'?1,3 , RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? Q YES IF YES, THEN A"P ERMIT FOR F10RK WITHIN PUBLIC Q NO ROADWAY" MLST BE DIVISION LZST A ISSUED BY THE ENGINEERING S A CO ION D . . N IT SUBJECT TO THE FOLLOWING CpNDITIONS: APPROVED HY: TITI.E: - . • . - ,'r• t? „• `. •??.:; ? . . ,. DATE:s '?_/J -0-7 • ?p B8Y IIYBSt eay ir?r. five Emoire Drive SL Paul, Minnesola . 55103-1867 May 14, 1991 5i2?o?-c;_n `J..."'4 F"D 0 FFX 291-0099 . ?'OMWED r? irir,Y 1 J 19:1? MPCA, HAZARDOUS WASTE DlYISiON Ms. Dorene Fier-Tucker Minnesota Pollution Control Agency ?""'k, P? Tanks and Spills Section 520 Lafayette Road ? St. Paul, MN 55103 RE: Vapor Point Analysis - 4317 clemson Circle, Eagan, MN (Work Order #147) Dear porene: Please find the enclosed results of a soil vapor survey conducted on May 2, 1991 at the Ryan Residence at 4317 Clemson Circle, Eagan, Minnesota. This work supplements the previous work performed at the site (See our report dated April 1, 1991). Eleven vapor points were taken at various locations near the home's foundation in an effort to pinpoint a possible source for solvent vapors which had been detected in the flome (see enclosed map). The results do not indicate a source of contamination (see attached survey form). We are currently making arranqements with Mr. John Ryan to do an additional round of air sampling inside his home. Results of this testing will be forwarded to you as soon as they are available. If you would like us to perform any additional investigation at this site, please call me at 291-0456. Sincerely, Mike Falk Project Manager ,Environmental Compliance enclosures /? BAY WEST, INC. K`D ENVIRONMENTAL SERVICES 5 EMPIRE DRIVE ST. PAUL, MN. 55103 PfOJ2Ct NdfnB: MPCA-JOHN RYAN VAPOR SURVEY Project Number. 2080 T2ChniCl2ll: JIM HUBAELL G8010giSt: RON BALLIET VAPOR POINT ANALYSIS Background Sample: location, Depth 100' E and 39 N ot test area, 5' bu., 1220 pm. TLV HNU Result (ppm): e_o 0.3 VAP'JR POINT D4TE TIME J.7FPTH TLV (ppm) HNU (ppm) COMNIENTS VP-1 5-2-91 11:10 5' 2.0 0 VP-'L 5-2-91 11:15 5' 4.0 0 VP-3 5-2-91 1120 5' 2.0 0.3 short peak on HNU VP-4 5-2-91 1125 5' 1.0 0 VP-5 5-2-91 71:30 5' 0.5 0 VP-6 5-2-91 71:35 5' 2.5 1.5 material lod ed in HNU robe rod VP-7 5-2-91 11:45 5' 4.0 0.5 VF'-8 5-2-91 71:55 5' 0.8 VP-9 5-2-91 12:00 5' 02 VP-10 5-2-91 12:05 5' 0.6 VP-11 5-2-91 12:10 5' 0.8 l NOTES: vp? W-3 VP-2 • W-1 DECK VF DECH va- vr- t suup eENFi ,ni I SIEPS GapAGE E ASPlVLT DRNE ?ppp?E GARACE LEGEND: 0 VMOR PouR LACATION OEpC DECN 1 V a sa eo• s N ? E • fl4CKCR0UN0 VMOR PoIM v.mt M.F. urr gpY IPSST Inc. I M K.N. 5 B 91 yr?m anvs + / /Y'v. 1r a.a¢.x Am1ECf IwiE JOXN i1YAN VPPOR SURVEY CLFIASON CIRCtE n? 51IE A41P ? f6 2a80-B1 ? 1--2a' FlGURE # Q,& Bay West April 2, 1991 Ms. Dorene Fier-Tucker Minnesota Pollution Control Agency Tanks and Spills 520 Lafayette Road St. Paul, MN 55155 6aywestlnc. 612-29i-045o Five Empire Drive Fax 291 -0099 SL Paul, Minnesola 55103-1867 RDIVEMED APRU3 1991 MPCA, HAZARDOUS WASTE DIVISION RE: Remediation Activities for Eagan Site (WOrk Order #147) Dear porene: Based on our conversation of March 14, 1991, Bay West is pleased to provide you with the following report and proposed remediation activities at the residence located at 4317 Clemson Circle in Eagan, Minnesota. Backqround On March 1, 1991, Bay West was contacted by Ms. Dorene Fier-Tucker of the MPCA regarding a complaint of solvent vapors in a residential property. The owners of one unit of a quad-home located at 4317 Clemson Circle in Eagan, Minnesota had reported solvent vapors present in the lower level of their home Findings Mr. Shawn Kruse, an Industrial Hygienist with Bay West, responded to the complaint. A Foxboro organic vapor analyzer equipped with a flame-ionization detector (FID) was used to attempt to locate the source of vapors in the lower level of the home. The greatest concentration of vapors appeared to be coming from a drain tile sump located in a closet on the lower level. Vapors also were detected along tcracks and in an opening of the foundation wall inside the closet. 3M Organic Vapor Monitors (OVMs) were placed in the sump and also in the living area of the home to help identify the vapors and to approximate the exposure levels. Results of the OVM in the sump opening indicates the presence of xylene, toluene, and heptane, all at concentrations of less than 1 ppm (telefaxed to Dorene Fier-Tucker on March 11, 1991). Results of the two badges placed in the basement and upstairs living areas indicate exposures less than 0.5 ppm for toluene and xylene, and 5 mg/m3 total hydrocarbons (see enclosed results). ? Bay West Ms. Dorene Fier-Tucker April 2, 1991 Page 2 Conclusion and Proposed Remediation Activities The concentrations of vapors in the house are approximately 10 of the OSHA permissible exposure limits which were established as acceptable exposures for employees in the workplace during an eight-hour workday (100 ppm for xylene and toluene). The average concentrations of toluene and xylenes in the basement are are 0.4 and 0.3 ppm or 1.5 and 1.3 mg/m , respectively. The nonoccupational chronic toxicity reference doses (EPA-HEAST Tables, Third Quarter 1990) for toluene and xylenes are 2 and 0.3 mg/m3. In the case of xylenes, the average concentration exceeds the reference 3ose. It is possible that there is a pocket of solvent contamination or a leaking container of solvent material buried near the foundation resultin9 in the infiltration of vapors into the house through the drain tile collection field. It is also possible that this problem is only showing up in the winter months because the frozen ground has prevented the vapors from being released through trie soil. It would be worthwhile to conduct an historical review of the site to see if there may have been any past activities which resulted in solvent contamination of the property. A temporary solution to the odor problem may be to seal off the sump with plastic and caulk any cracks which may allow vapors into the home. Another possibility would be'to install a small fan outside the home near the foundation and drain tile collection system which would draw air from the system to the outside. In an effort to resolve the contamination problem, Bay West ' proposes to first perform 'a soil gas surveX around the vicinity of the home's foundation in an effort to pinpoint the source of the solvent vapors. If this method is successful we could proceed to excavate and remove the contaminated material. The estimated costs for gerformir.g the soil gas survey work and submitting a follow-up report would be $2,400. If the soil gas survey does not yield conclusive information, another alternative may be to perform a geophysical study to tlocate any metal-bearing container which may have been buried. If you have any questions on this information or would like us to proceed with the proposed remedial activities, please call me at 291-0456. Sincerely, Michael S. Falk Project Manager Environmental Compliance enclosure ? N C--o-T'? REPORT OF LABORATORY ANALYSIS iHE RSSUPRNCE Of OUALIlY REPORT ON PRO.7ECT NUMBER 52838IH March 21, 1991 Cuatomer Project Code: PACE Project No: D10315.503 To: Mr. Shawn Kruse say West, inc. 5 Empire Drive - St. Paul, MN 55103 Analyais: The following eamplee were eubmitted for analysis: . Two 3M badqe samples for toluene, xylene and total other hydzocarbone. Method: oRGANIC VAPORS Each sample was analyzed ae apecified above for toluene and uylene. The organic vapors were desorbed from the media with a solvent and the solvent analyzed uaing gas chromatography with flame ionization detection. The chromatographic peak for each analyte was compared to a calibration curve obtained from standard solutions. Milligram values were corrected for deaorption efficiency. TOTAL HYDROCARBONS Each eample was extracted with carbon diaulfide and analyzed by gas chromatography with flame fonization detection. The peak arese for the total hydrocarbona were compared to a calibration curve obtained fram standard toluene aolutions. Results: The reaults are found on Table 1. Discueeion: The OSHA permiasible expoeure limits (PELa) for the reported subetance(s) are as follows: SUBSTANCE(S) TWA STEL CSILING SRIN toluene 100 150 - PPM - 375 560 - mg/M3 xylenea (o-,m-,p- isomera) 100 150 - ppm - 435 655 - mg/M3 The eampling rates ueed were obtained from the 3M Compound Guide R35AG(611)R May 1981. The reaults contained in this report are expreseed in terms of the ? concentration per sample volume and are computed based upon data provided by the client. These values are not neceasarily comparable to any epecific permissible expoeure li.mit (PEL). PELa for the reported eubetancea are liated for your convenience. PAC&, Inc. (formerly Hager Lahoratories, Inc.), hae been AIHA accredited eince 1977. 5930 Mclnryre Sveet GoWen. CO 80403 TEL: 303-278•3400 800-9783434 FAX: 303-278-2121 Otfrees Smrmg: Muimapu6s, Mmnemm Tampa Florida lowa Ciry, lowa Sen Froxisa, CaGfomia Kemas City, M'ssouri Los Anqelea. Cal'rfomia Chuktte, NoM CaroEns Ashevib, NoM Caroline New York, New Yark Pittsbwqh, Pmnsylvania Oamer, Cobrado An Equal OOPOnuniry Empbya ? N C-- o- T-? REPORT OF LABORATORY ANALYSIS iXE ASSOP9NCE Oi pUAIIiY Page Two, SN52838IH Hay Weet, inc. March 21, 1991 Diecueeion: Labozatory data are filed and available upon requeet. (cont.) If you have any queetions, please contact our Client Servicee Department, at (303)278-3400 or toll free at (800)878-3434. Submitted by: Scott A. Ste nez Induatrial Hygiene Organice Department supervisor SAS:lh 5930 Mdntyre Street Offxn Servinp: Miimeapolis, Mmmaota Chebtta, North Grafine Galden, CO 80403 Tampa Fkrida AsMrdle. Nanh Camima TEL: 303-2703400 lowa Ciry, lowa New York, New Yark 900-8783434 San Franciaca, Calitomia Pi[ISbwph, Pamaylvania FA%: 303-2782121 Kansas City, Musouri Oemrer, Cabrado Los Angeles, Celifarnia An Equal Oppm[unily Empbyer ' - . . Pitq;r?a iNF RSSUflRXCE Of pppUiY SN 52838Z8 March 21, 1991 REPORT OF LABORATORY ANALYSIS TABLE 1 * Basement Living Area Sample Number: BP0251 Compound toluene xylene total other hydrocarbons * Uostairs Living Area Sample Number: BP0242 Compound toluene xylene total other hydrocarbone 5930 Mdnryre Street Golden, CO 80403 TEL: 303-2783400 800-8783434 FAX: 303-278-2121 Total (mg) 0.07 0.05 0.2 Total (m4) 0.06 0.04 0.2 Sample Time: 1480. minutes Aiz Concentration 0.4 ppm 0.3 ppm 5. mg/cu.M. Sample Time: 1460. minutes Air Concentration 0.3 ppm 0.2 ppm 5. mg/cu.M. Offxea Servinq: Mimrapo6s, Minneaota Tenpe, Fbride lawe Ciry, lowa San Froixiaao, Califomia Nansas Ciry, Musowi Los Aigeks, Cafilomia Charbtta, NmM CaraGna An Equal Opportunity Emptayer Ashevale, North CaraGna Naw York, Naw York Pittshurgh, Pmroylvania Demn, Calarada ? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: PERMIT PERMIT TYPE: Permit Number: Date Issued: 4317-8 CLEMS4N CIR LOTc 6 BIOCK: 2 THE TRAIl.S OF TNOMAS LAKE DESCRIPTION: (INSERT) 6uilding'--Permit Type Building W'b.rk Type ? ? ... ?! ..? __ T. 2t '.. . , .. . ? .. '.`?- ty . REMARKS: FTREPLACE ALTERATIQN cRIfO9L BUILDING 026237 08/14/95 1` E 1i.i ?f 1i3? g t qj3-i S[ IL FEE SUMMARY: Base Fee $25.00 Surcharge $.50 Total Fee $25.50 CONTRACTOR: - FIRESIDE CORNER INC 2700 N FAIRVIEW ROSEVILLE MN (612) 633-1042 Applicant - ST. LIC 16331042 0001068 AVE 55113 ? OWNER: WACHTER ALLEN 4317-B CLEMSON CIR EAGAN MN (612)686-7969 I hereby acknnwledge that I have read this information is co,rrect and agree to camply 3tatutes and City of Eagan Ordinances. APPLICANT/PERMITEE SIGNATURE application and state that the with all applicable State af Mn. a ISSUED B'o SIG fURE I INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 BUILDING 026237 08/14/95 SITE ADDRESS: Lo T: e B L 0 C K: 4317-8 CLEMSON CIR THE TRAILS OF THOMAS LAKE PERMIT SUBTYPE: FIREPLACE ? ? Z APPLICANT: FIRESIDE CORNER INC (612) 633-1042 TYPE OF WORK: ALTERATION DESCRIPTION (INSERT) 7 I I - I I CITY OF EAGAN 3830 PILOT KNOB RD - 55122 ? 1995 FIREPLACE PERMIT APPLICATION 681-4675 DATE: ? .40 IM DESCRIPTION OF RK: ?ALL NEW FIREPLACE: 4 z3.5o _ WOOD BURNING _ GAS INSTALL GAS LOG ONLY IN EXISTING FIREPLACE INSTALL GAS LINE ONLY IN EXISTING FIREPLACE ? OTHER: 'InAsn t AREA TO BE INSTALLED IN: STREET ADDRESS: "?? 1 `,r'1--> ? ? %? 6? ??r'?? LOT G BLOCK o2 APPLICANT: (circle one only) SUBD./P.I.D. #: OWNER I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with ali applicable State of Minnesota Statutes and City of Eagan Ordinances. PROPERTY owNeR FIREPLACE INSTALLER GAS LINE INSTALLER Name:Phone y51 FlRBi Signature: Street Address• City: Company: Signature: ? Street Address: City:State: ? Zip•?? Company: _ Name: Signature: - Street Address: City: Phone #: 1?; 32 -=? License #•I Phone #- 5tate: Zip: State: Zip: ? COMMERCIAL 2002 BUILDING PERMIT APPLICATION CITY OF EAGAN 651-681-4675 Name: Foundation Onl New Construction Interior Im rovement • SWCtural Plans (2) sets • Architectural Plans (2) sets • Archltectu2l Plans (2) sets • CivilPlans (2) • SWcturalPlans (2) • CodeAnalysis (1) • CertificateofSurvey (1) • CivilPlans (2) • ProjectSpecs (1) • CodeAnalysis (1)" . LandscapingPlans (2) • KeyPlan (1) • Projed5pecs (1) . CodeAnalysis (1) • Master Exit Plan (1) • Spec. Insp. & Testlng Schedule . Certiflcate of Survey (1) • Energy Calculallons (1) not always" • Soils Report (1) • Spec. Insp. & Testing Schedule (1) " • Elec. Power & Lighting Form (1) not always*' • Meter size must be established • Meter size must be eshablished • Meter size must be established - if applicable • ProjectSpecs (1) 1 • EnergyCalculatlons (1) 1 • Electric Power 8 Lighting Fortn (1) 1 • Master E)clt Plan (1) 1 ! • Emergency Response Sita Plan (1) i • Soils Report (7) i • MClES SAC determinatlon letter . MGES SAC determination letter • MC/ES SAC determination lefler call 651-602-7000 call 651-602-1000 call 651-602-1000 Food & beverage or lodging facilities - submit plan to MN Department of Health. Call 651-215-0700 for detalls. " Contad Building Inspections for sample. Permit for new 6uildings or addltions will not be processed without Emergency Response Site Plan. Ask Building Inspections for requirements. G / DATE: ORKTYPE: NEW REMODEL CONSTRUCTION COST: ?A . SITE ADDRESS: ??I -? ??? ?S eJ I??iWIS?M ?I r?i ?C TENANT NAME: FORMER TENANT NAME, IF APPLICABLE: DESCRIPTION OF WORK I-( a V'( PROPERTY OWNER StreetAddress: 1- 4 Y( l? V-J I? City: State: SUITE #: ?•---I ':?' \I?- Phone #: (?", n g r ?'7 5g 3 Zip: ' 7 5- Phone #: ( ? 2 .) L CONTRAGTOR Company: 4 Sheet Address: City: ? ARCHIT'ECTY ENGINEER Company:_ Name: Sheet Address City: Licensed plumber Installing new sewerlwater service: I hereby acknowledge that I have read this application, state that the Minnesota Statutes and City of Eagan Ordinances. Sbte: p 0 Zip: Regrstradon #: ? -. ?J state: zip':" Phone #: ( iaUOn-is-correct, and nree Jejc4np Phone #: II ? L' . i with aH applicable State of '"/ y " - ? Signature of ApplicanT.? Updated 75865 THE TRAILS OF THOMAS LAKE CLEMSON CIRCLE 4300/ 10 75865 240 02 (4-PLEX) 4300B/ 23002 4301/ 210 02 4301B 220 02 4302/ 10 75865 250 02 (4-PLEX? 4302B1 260 02 4304/ 280 02 4304B 270 02 4303/ 10 75865 20002 (4-PLEX) 4303B/ 190 02 4305/ 170 02 4305B 180 02 43061 10 75865 290 02 (4-PLEX) 4306B/ 300 02 4308/ 320 02 4308B 310 02 4307/ 10 75865 160 02 (4-PLEX) 4307B/ 150 02 4309/ 130 02 4309B 140 02 4310/ 10 75865 330 02 (4-PLEX) 4310B/ 340 02 4312/ 360 02 4312B 350 02 4311/ 10 75865 120 02 (4-PLE3) 43llB/ 11002 4313/ 090 02 4313B 100 02 4314/ 10 75865 370 02 (4-PLEX) 43148/ 380 02 4316/ 40002 4316B 390 02 - - ?? 4415/ 10 75865 080 02 (4-PLEX) I 4315B/ 07Q?2-_ -- J 43171 05002 4317B 060 02 4318/ 10 75865 410 02 (1/2 OF 4-PLEX - OTHER 1/2 IS 1613/13B CLEMSON DR.) 4318B IO 75865 420 02 4319 10 75865 040 02 (1/2 OF 4-PLEX - OTHER 1/2 IS 1617/17B CLEMSON DR.) 3 Y>1?a?- 2007 RESIDENTIAL PLUMBING PeRnnir,aPPUCaTioN CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please com lete for modifications to existin residential dwellin s. ??;5-z) Date Site Street Address -PmhDx.. l.t?ye-Unit# Property Owner j)QAAf]S„Telephone # (r-j07 ) 14Zq - g ]tp't' Contractor Y. l ! 7"'L • Telephone# (61 ?o) C.w?-IODq Z Address - 60• City State )rL. Zip55423 The Applicant is: _ Owner 8 Occupant ? Licensed 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 fixtures to main level lower level. This fee includes installation of a water softener and/or water heater at the same time. If you are installing on/v a water softener and/or water 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 5/8" 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 $ 15•60 I hereby apply for a Residential Plumbing Permit and 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 plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in a ordance with the approved plan in the event a plan is requiLMM'Lf e reviewed and approved. a_?. am-a ? (-%) Appli lnPs Printed Name Applica t s Signature 5C/%%;-- 2007 RE.SEDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Teleptrone # 651-675-5675 FAX # 651-675-5694 New consauAOn RoQuaements . 3 registered sik mn'e9s dmki9 SQ. R of Id, s9. ft af house; arid d roofed meas (20%marzimum fot mveage Maved) 7 Swfls RepWt ifqpppsed IwidaV is to be-piaced an disWuhed sal 2 mppes ntplan ahmxirg beem 8 waidnw 'smm paured kwaid design, etc. f set d Energy Celalafians 3 copfes ofTrae Presarratlan Poa ff tot Plaued aRa 711193 Rim Jdst 0eW1 Optim sdecfiOn shcet (buAdngs yrifth 3 a less units) ItinnegascomechaniplvenWationtam RmmddlRenair Reguiremen1& 2 copies of Pbn showim ftft% beans.1oists 1 set of Enagy CalculnUan6 fa heeted adMor5 1 aleairveYforaddtions &decks Addi6an-omkaleHm sdesepticsysfen 3W' gw- ORm Use Onlv CetofSurveyRecd - _Y _N ShcsRepwt - _Y _N TreePre5Plan.Recd Y _N , 72ePres ReWied ?Y _N Onsb SepticSlatem -_Y _N Plans are considered public infarmatian unless vou state thev are trade secret and the reason. ? Dste ! d S/ 0-7 - q Constrnction Cast d Q,. 4 C9 tl Site Address YU/' S` - 9,11 /3 ? Unit{SEe # ? * YJ / ) / (:i , , , l, Description of Work ? ? ` Mutti-Family Bldg ? Y_ lY Firepiace(s) p _ 12 Pro J? Pe1'rY Owner / f' <- ojC T a r.? c s L u<< Telephone #((e. j'1 ) L S S' 7cj OU Coutractor L Y 41ti(. o Address . ? - A CitY 8LtlAJSV '._Ile State Mti, Telephone # (952) COMPLETE THIS AREA OMLY IP CONSTRUCTING A NEYU BU9LDING - Minnesota Rules 7670 Cateeorv I Minnesota Rules 7672 Ene(py Cnd¢ CatBgory . Residemial Ventlla6on Cafegory 1 Waksheet • New Energy Code Warkshee[ (J submtssfon type) Submilled Submitted • Erergy Envelope Calculafions SubmNted in the last 12 months, has the Ciy of Eagan issued a pertnit for a similar plan based on a masfer plan? _ Y _ N If yes, date and address of master plan: Licensed Plumber Mechonical Contractor Sewer/Wafer Confracfor apply for a Telephone #( Telephone # ( Tetephone #( Petmit and acknowiedQe that the information is complete and accurab that the work will be in conformance with the ordinances and codes of the City of Eagan and fhe State of MN Statutes; I understand this is not a permit, but only an application for a pennif, and work is not to start without a permit; that the work will be in accordance with the approved ptan in the case of work which requires a review and approval ofplans. e-G1GP1cd-AtJ'J ?r?C?f ?w1t_ U Pw,jL [- L:J`C4? .J A- &65n-'` Applicant's Printed Name G.`& 'W-3 a.;l y XPPlicant's Sigoature: i Fo<<ot7s,u577 e g"3 05 b ? Pertnit#: I Pertnit Fee: -C) o I I n C I ? Date Rec 'ved:6i • U - QCJ I I ? Staff: I I 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: SiteAddress: y3/'7 G-/e,.u>-, U'- Tenant: J=-say. Suite#: RESIDENT/OWNER Name: Jc.so? Evi4-so, Phone: bs1- 'fY? -U7S3 Address/City lZip: 'Y 3/-7 C..Ie.--Sa?. L,+,.. Applicant is: _ Owner X Contractor T(PE OF WORK Description ofwork: crec,k- Construction Cost: a?SZ? Multi-Famiiy Building: (Yes No, _(j CONTRACTOR Name: [,L N License #: Z2c)3_6II ZQ Address: 131-36 33 140 5,.?- S City: .Q-F?_ i"i?? State: Zip: SSao ( Phone: 61 2-8r60-5-7 1q ContactPerson: 14.....e, 0 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted (4 submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: N,OTE: Plans andsupporting dooumerits.that you submit are.considered to be public information;; Portions of n ' ttre information niay be classiiied as non-pubtic 1f you provide speciiic reasons thaf woufd permit the City to - concludethat the are frade secrets :- I hereby acknowledge that this information is wmplete 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 applica[ion for a permit, and work is not to start without a pertnit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x ApplicanYs Printed Name ? Appl' s Signat Page,1 of 3 DO NOT WRITE BELOW THIS LINE . SUB TYPES ? Foundation ? Single Family ? 07 of _ Plex ? 02-Plex ? 03-Plex ? 04-Plex WORK TYPES ? New ;<. Addition ? Alteretion ? Replacement ? OS-plex ? 16-plex ? Accessory Building ? Pool ? 06-plex ? Fireplace ? Porch (3-season) ? 6ct. Alt. - Multi ? 07-plex ? Garage ? Porch (4-season) ? Ettt. Alt -SF ? 08-plex ?5< Deck ? Porch (screeNgazebo/pergola) ? Multi Misc. ? 10-plex ? Lower Level ? Storm Damage ? 12-plex ? Miscellaneous ? Interior Improvement ? Siding ? Demolish Building' ? Move Building ? Reroof ? Demolish Interior ? Fire Repair ? Windows ? Demolish Foundation ? Egress Window ? Water Damage - `Demolition (entire building) - give PCA handoutSO applicant Valuation Occupancy Plan Review Code Edition (25%_ 100%X?- Zoning Census Code Stories # of Units Square Feet # of Buildings Length Type of Const. ? Width REQUIRED INSPECTIONS Footings (new bldg) Footings (deck) _ Footings (addition) Foundation Drain Tile Roof: Ice & Water Final Framing Fireplace:_R.I. _AirTest _Final Insulation MCES System SAC Units City Water Booster Pump PRV Fire Sprinkters Sheetrock Mef.er Size: Final/C.O. ? Final/No C.O. HVAC Other: Pool: _Footings _Air/Gas Tests _Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wall ? n Reviewed By: 1 `_ , Building Inspector P?? ae?T' RESIDENTlAL FEES: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge 5&W Permit & Surcharge Treatment Plant Copies Total kc ? QC.?70 Page 2 of 3 s . Trails of Thomas Lake Homeowners Association Professionally Managed by: Paradise & Associates, LLC 2177 Youngman Avenue, Suite 170 St. Paul, MN 55116 (651)699-5300 Fax: (651) 699-7400 June 3, 2008 Jason Erickson 4317 Clemson Circle Eagan, MN 55112 Dear Jason, After reviewing your Exterior Improvement Request to add on to your current 10 x 10 deck with another 10 x 10 section, the Trails of Thomas Lake Board of Directors have approved your request. Please be aware that any costs that may occur to the deck addition or any other damages the addition may cause are your responsibility. Also, spindles, deck boards, etc. must match existing deck and the size of the addition must be comparable to the larger decks in the association. Furthermore, current and future maintenance, care and necessary repairs of this project will be the responsibility of the owner and all future owners of the home. Likewise, repair responsibilities must be disclosed in the sale documents of your home. Please call Lisa St. George at Paradise & Associate, LLC at (651) 699-5300, if you have any questions. Sincerely, Trails of Thomas Lake Board of Directors .i r_ O (93s.? ? V1/ =3 to I ` Ai 74•3p ? o ' ( I O C93d9I ? N ? ?0 7•30',o \?` ?=a ? Vl 8 l? I p•1?1/ -•r? <? N// 33 I ?o .1 y v '9lo 29.33 Q6 I ' P? Q y/ b ? N ??oB ? `bSEa ? q? • ,? ?j i % w/O 99 N -0 _ N 0 p -8(0- G. ., .p Y/ (i s o N n[ 149. V I N =" ? ? S a ? J N N ? C)5? g O O bV ?°,?O S9a? ? UJ ?F o ? Denotes Iron Monument (,o / ° Denotes Wood Stake X000.0 Denotes Existing Elevation Proposed Top of Foundation Elevation- (000.0) Denotes Proposed Elevation Proposed Garage Floor Elevation= 9a-1.5 4- Denotes Direction of Surtace Drainage Proposed Lowest Floor Elevation= 9as.o I hereby certify that this is a true and correct representffiion of a survey of the boundaries of; Lots 5, 6, 7, and 8, Bloc:c 2, THE TRAILS OF THOMAS LAKE, Dakota County, Minnesota. And of the location of all buildings, if any, thereon, and all visible encroachments, if any, from or on said land. It also shows the location of the siakes as set for a proposed building. As surveyed . by me or under my direct supervision this 12th day of January 1987 Paul A. Jo:utson land Surveyor, Minn. Reg. No. 10938 AI"-4d CERTIFICA771 COMBS-KNUTSON ASSOCIATES , INC. CCMSYITINGF1161F(lI1i0 W103UI1Y[f011iB SR[RANM[IIO _NEW... HolZ.1WNNfAqW rtl MYICNINSON.MINMESOTA Use BLUE or BLACK Ink u I- (r~nF~ For Office Use- - ~ r ttxr I f ILA C1 ~`i r^ n n~'".- f Permit City of Ea I Permit Fee: J 1 / U 3830 Pilot Knob Road 2 Eagan MN 55122 Date Received: 'I> I Phone: (651) 675-5675 I 1 Fax: (651) 675-5694 1 Staff: I I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION LOK 'f 3N-6? [Y3/7 H3 173 LA_[CfA5&4 r ` Unit Date: Site Address: t Name:-, 1`*►t c CS I Y`O ~~~r (1,64 Phone: A ! 5~? 2S9- Residentl Q Owner Address / City / Zip: t Applicant is: Owner Contractor i Description of work: 5 I Type ofWork Construction Cost;_ V, ew, TL8 kcs~acint t, s Company: Contact: : ti Contractor Address: N City 1Q- 75 State Zip: Phone . 6?--7q7 : j~GS¢ _Ll -LeaaCertl Ic"f' ate - r If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) !O 1 Itf ~ / ~ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public inforination. Portions of- the the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade'secrets+ 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.oooherstateonecall.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 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 180 days of permit issuance, x ~.k ~-.\p 5 x Applicant's Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA163439 Date Issued:09/01/2020 Permit Category:ePermit Site Address: 4315 Clemson Cir A Lot:8 Block: 02 Addition: The Trails Of Thomas Lake PID:10-75865-02-080 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 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 - Michael P Blake Tste 4315 Clemson Cir Eagan MN 55122 (612) 978-2544 Sandau Construction 9025 Hwy 101 W Savage MN 55378 (952) 403-9100 Applicant/Permitee: Signature Issued By: Signature