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3630 Crestridge CtCity of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 3630 Crestridge Ct Lot: 061 Block: 01 Addition: Buffer Hills PID:10- 15400- 061 -01 Use: Description: Sub Type: e - Air Conditioner Work Type: New Description: Air Conditioner Comments: Questions regarding electrical perm 952- 445 -2840. Fee Summary: Contractor: Angell Aire 12253 Nicollet Ave S Burnsville MN 55337 (952) 746 -5200 ME - Permit Fee (Replacements) Surcharge -Fixed Total: Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - Permit Type: Permit Number: Date Issued: Permit Category: equirements should be directed to Mark Anderson, State Electrical Inspector, Owner: Georgene A Christenson 3676 Pilot Knob Rd Eagan MN 55122 $50.00 0801.4088 $0.50 9001.2195 $50.50 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply of Minnesota Statutes and City of Eagan Ordinances. h all applicable State Issued By: Signature Mechanical EA083612 06/17/2008 ePermit Wertificate vf Ccc"anc? WU4 af Cfagan Imepartmeut of 13ni[bing anopccHon This Certiftcate issued pursuanr to the requirements of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the fo!lowing: DUPElC 1434 use cLissiecu;on: sag. Pennic rb. ?? VN CDBSL ?r TYve ? n? e' ryICP? UUB I? F.AC?iN Owner of Buildiog Address 3676 , s f Btild'mg Ad&ess Locality 03/12/Q3 Daze: Building Official POST IN A CONSPICUOUS PLACE t!? r ---, Cfertificate of Cccupanc4 CM4 of Cfagan eeoartmcnt of 13aftixg 3K"tien This Cenificate issued pursuant to the requirements of rhe Uniform Building Code certifying that at the time of issuance this structure was in canpliance wilh the various orrlinaRCes of the City regulating building construction or use. For the following: SF IWG DUpiEX 1534 use aassiacation_ sWy. Pumit Wo. Occupancy Type 7,oni_ng pi_sgict tl1?U[i W s Owner of Building pddmss 3630 CEEMWE r.T f f g Address ??ity 03/25/Q3 7 / ? 1S nau: Building icial POST IN A CONSPICUOUS PLACE Address 3632 CESuupm coU-RT Zip 5512 3 Lot' 4 Blk t Sub swmHIIZS THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: 03/12/93 Yes No Inspector: ? Final grade (6" from siding) Permanent steps (garage) ? Permanent steps (main entry) Permanent driveway ? Permanent gas Sod/Seeded grass Trail/curb damage ? Porch Basement finish Deck Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to the outside lawn faucet before freeze potential exists. Contact engineering divisioo at 681-4645 before working in right-of-way or installing underground sprinkler system. ? White - City Copy Yellow - Resident Copy Pink - Contractor Copy Address Zip 5512 3 hot 6 Blk 1 Sub sFm frrr T S THESE ITEMS WERE / WERE NOT COMPL.ETE AT THE TIME OF THE FINAL INSPECTION. Date: 03 25 43 Yes No Inspector: Final grade (6" from siding) ?/ Permanent steps (garage) Permanent steps (main entry) V, Permanent driveway Permanent gas ? Sod/Seeded grass Trail/curb damage ? Parch Basement finish ? Deck Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to the outside lawn faucet before freeze potential exists. Contact eagineering division at 6814645 before working in right-of-way or instailing underground sprinkler system. ? White - City Copy Yellow - Resident Copy Pink - Contrxtor Copy CITY OF EAGAN Remarks Additio BUFFE HILLS ADDITION Lot 6 Blk 1 Parcel 10 15400 060 01 Owner ? ?• ? ? ? > Street X _- 4?2L12 G'-?L`• State Eagan, MN 55123 ?(? ?s:? r?? ..? ? . ? 1 .? Q •3? ,t t. - ? :a"i ' ?. ; ,- Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. ?. 1 STREET RESTOR. GRADING SAN SEW TRUNK 1971 under oI'1 inal arcel SEWER LATERAL WATERMAIN WATER LATERAL 1973 under OT1 1 2.1 32'C WATER AREA 1 2 STORM SEW TRK ?15' 455.70 45.57 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 8UILDING PER. SAC PARK :-?3:?- - - - - - INSPECTI4N RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Rflad Permit Number: Eagan, Minnesota 55123 Date Issued: Control No. 1128 0011,.:4 A9 /1y/ 92 (612) 681-4675 SITE ADDRESS: LuTr h tit oc ? t APPLICANT: 36:;M ff3a CRESTRiD4E c1' f,tIRIfiTEN%DN BI.DA CO. GaN HUFi- Ek 1111 1?i ( G1?) 4b2-1061 PERyff,p?UBTYPE: TYPE OF WORK: Nrw I i 1 • A R I P T I O N *em"??R'??#?E -- C 1 . ?0i1 1 I Ni; .A . 1'RAM t N0 .? I w.m a rj uw t[ Na$. f I RFF'l l1t f. kF MAtrr . <i I (3N i kAt I lift ?• ?I PermM No. Permk Holdw Dde Tilephone # SJVY PLUMBING HVAC ELECTRIC EIECTRIC inspection Date Inep. ComnNnts Fooengs I l?s?L 11J,? FounAatlon Framing `?l?/??2 g RW" 3 Ro"g' Plbg. W - - l,? .? ' Rough Me- ?. Flreplace FinW "tg' °'se' jOM Fnel abg. II' ,l3?i PIb9. Inspector - NMiiy Plumber Carist Meter EnyrJPlan eag. Final Dedc Ftq. Deck Final weu Pr. Dfsp. r3? 3O ? INSPECTION RECORD CIlY OF EAGAN ? 3830 Pilot Knob Road Eagan, Minnesota 55123 ? (612) 681-4675 SITE ADDRESS: e01- 6 1 f;:3A i:atsikxosiE r:r Hi1rF'trR IiJl.t;4 PERI?ff,?,UBTYPE: PERMIT TYPE: Permit Number: Date Issued: I Gontroi No. 1119 ! H{+1 i..hINQ 00 1 W44 Y<I1a919?. APPLICANT: cHkrIII?iFNI.nN Fitnci c:o, uaM ( t, 1. :) 4 b"..1bi,1 TYPE OF WORK: N} w R!" MARK'". : ) Wf. I UUF.Sr 3632 f If V.S tRiI3Eil' 1::'I `? G LJ 1'tWI (tAC i UR - : Permn No. wrmft hlowsr Date reNpnons s S/W PLUMBING ? - / / 99,- cf9v- HVAC ELECTRIC laa 0O!'J ?? ELECTRIC inppeotlan Deh ksp. Commerts Footfngs I FOUrbetlon Framing I Roofing bs B°ugh Plbg. "ro. !7/9 3 • 1,. lsul. Fireptece FinW„HW. 4w Oreat Te9t • Flnal Plbg. Plbg. Inspeclor- Notify Plumber Const. Meter Engr./Plan eldg. Ffti zsI Deck Ftg. Deck Flnel weli Pr. Disp. - ,? --I -/jA ?/o?as??--- K 5 ? ? ` 30 J Req esl Dat Fire ilouq0-In Inspec[ion ReQUired? ? Reatly Now >?Will Notily Inspeciw ?Q-??? ?} Ves _No WMn Rea4Y? IXlicensed contractor ? owner hereby reque5t inSpeCtion ot above electrical work at! Job Atltlress ISVeeL Boa or Rmte No.I r- ciry 91vi F?AC- -"*W CRE. iDGF- cT 3ia3c , Secbon No. Townsnip Name or No. Ranqe No. Counry t?, .4?-- eT OccuPdnt(PRINT) Phone No. I[7/p1 Power SvOPlier Atltlress 1), FA R ra 7 u c-r Elec?ncal Gonlratlor ICOmpany Namel GonttactorS License No. ?2'jyp i it??l? n q Atltlress iGOnlractor or Owner Making Installationl in Mail {F ? ( J ?` /?'6c ? ri ?'L\b'U 1??? dJd? Aotn i Slqnalure ICOnVac Owner M king In51ai1atioN ? a . o ? ? ,?.11 d a,,, P?one Number MINNESOTA STATE 90RRNOF ELECTF GrigghMlCway Bldg. - Room 5-173 1821 University Ave.. 51 Peul, MN 55104 PMM (812) 802-0800 THIS INSPECTION REOUEST Wlll NOT BE ACCEPTED BY THE STATE BOARD UNLE55 PROPER MSPECTION FEE IS ENCLOSED. a?R?cp REQUEST FOR ELECTRICAL INSPECTION a 15834 , See insVUdions lor completing this brm on back oi yellow wpy "X" Below Work Covered by This Request EB-00001-OB 13 ew Add R lCing AppliancesWired EquipmentWired Range Temporary Service Water Heater Electric Heating F Dryer Othec(Specity) ial Furnace Air Conditioner Camrecmr5Remerks' Compute Inspectian Fee 8elow: 8 Other Fea # ServiceEntranceSize Fee # CircuitsWJFeeders Fee Swimming Pool A 0 to 200 Amps o 0 to 100 Amps y Transtormers Above 200 _ Amps Above 100 - Amps $IeOS Inspectar's Use Only. TOTAL I ? Irrigation Booms J J? Special Inspection Alarm/Communication THIS INSTALLATION MAV B ORDERED ISCONNECTED IF NOT Other Fee ?o COMPLETED WRMIN / HS. ? I, the Electrical Inspector, hereby Rou9n.in la certify that the above inspection has F;nai oa been made. 44 , OFFICE USE 3NIY ThiS tpQU85t Witl 18 mOn1h5 hOm K1 836 . 4`1 - /o ? 9? ?/ 6 eQst Date • Rini RougRin Inspetlion ReQUiretl? ? Ready NOw ,Nlill Notity In90ecmr ° . ..Yes r No W,an ReatlY? I'g. licensed coniractor p owner hereby request inspection of above eledrical work at: JoD AOtlress ISIreaL Box or Route No.) Cily Section No. Townslii0 Neme or No. Parge No. Counp?. \ J Occupant IPRINT) Phone No. Bev? `Inri'J2.u?: , c1i `E5a_?p Power Sup plier Atltlress 1 t Electrkal ConVacior (Company Name) Cqnvac1or5license No. Cc, rk..,,, ? 1e ?tY', G ?l SC 8 Mailing Aearess IConi clor or owner Making Installalion? -), ' 475 Autnon 4tl Signawre ?COnVaclonOwne?ry'aking Installavwn) PM1One Number ti1 C?dh,t ` cl ) `133 - ? 13 MINNESOTN STRTE BOA OF ELECTRIQTY THIS INSPECTION REOUEST WILL NOT GrigghMitlwey Bldg. - Room S-173 BE ACCEPTED BY THE STATE 60ARD 18t1 Univerelty Ave.. St. Paul, MN SStOC UNLE55 PROPER INSPECTION FEE IS PWne (612) 661-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION eeaoom os ? ^? A36 See insrmctions for compieting this iorm on back ol yenow copY W "X" Below Work Covered by This Request e Add Rep. 7ypeofBuilding AppliancesWiretl EquipmentWired Home Range Temporary Service ?- Duplex Water Heater Electric Heating Apt. Building Dryer O[hee (Specity) Comm./Indusirial / Furnace Farm ( Air Conditioner OUier (specityl Contractor5 Remarks. Compute lnspection Fee Below: # Other Fee # ServiCeEMranceSize Fee # CirCUits/Feeders Fee Swimming Pool 0 to 200 Amps 15 v 0 to 100 Amps 4Q Transtormers Above200_Amps A6ova1D0-Amps SignS Inspector§ Use Onty: T TAL Sa Irrigation Booms l 5? ?) Special Inspection ? Alarm/Gommunication THIS INSTALLATION MAY BE ORDER ONNECTED IF NOT Other Fee COMPIETED WITHIN 78 MONTHS. I, the Electrical Inspector, hereby ROO9n-'" ,-7- . oere YA.V certity ihat the above inspection ha5 been made. F;nei i ate OFFICE USE DNLY This request voitl 18 monMS Irom IJ ` I :- - PERMIT Control No. 1119 CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: e u z L0 7 NG Eagan, Minnesota 55123 Permit Number: 001534 (612) 681-4675 Date Issued: 0 9/ 2 9/ 9 2 SITE ADDRESS: 3630 CRE5'fRIpGE C'r L[JT: 6 f3LOCK: :L EtUFFER N]:I.LS DESCRIPTION: -8uilda:ng Permit Type DUPI.EX Building Work Type NEW UBC Occupanc.y R-3 M-1 Construction i'ype V--N Zoning R-2 6uilding Length BB Building Width ? 54 „ . J REMARKS: INCLUUES 3632 CRES'1'RIDGF C7 S & W CONTRACT OR - FEE SUMMARY: vaLuarroN $17s>00e Base Fee $916.00 CITY SAC $200.00 Plan Review $595.40 WATER CONNECTION $1,350.00 Surcharga $89.50 WATER METER $190.00 SAC $1,400.00 ACCOUNT DEPOSTT $60.00 SAC ? 100 S&W PERMI7 & SUR $61.00 SAC Units 2 TREATMENT PLAN7 $600.00 Li.c. Search Fee ROAD UNTT , Y 760.00 Subtotal , $3,005.90 Total Fee $6,226.90 CONTRACTOR: - Applicant - 5T. LI pyyNER: CHRISTENSON BLDG CQ, DON 14521061 000761 DCJN CHRISTEN50N BLC1G CO 3676 PILOT KNOB RD 3676 PIL07 KNOf3 RD EAGAN MN 55122 EAGflN MN 55122 ' (612) 452-1061 (612)452-1061 I hereby acknowledge that I have raad this appli.cation and state Chat the information is correct and agree to camply with all applicable State af Mn. States and CiT.y ot Eagan Ordinances. L ICANT/PERMITEE IG ATURE J ! ISSUED 8 51ONATU E PERMIT lf IZEACTI\'D,,?E _ 133? CITY OF EAGAN 1992 BUILDING PERMIT 681-0675 APPLICATION $G1 221,.70 SINGLE 6 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2iets of architectural 8 structural plans, 1 set of spkcifications, I copy of energy calcs. Penalty applies when typing of permit is requested, but not picked up by last working day of month in which re uest is made or lot chan e is re uested once ermit is issued. Date I ? 1?GZ Valuation of work ? Zro}C7??- - Site Address:_?lo30/?'?2. STREET SUITE / Tenant Name: (commercial only) LOT BIACK ? SUBD._f:;k?E-i-- HIL1.5. P.I.D. if aescri tion of work: t'iEW The applicant is: ? Owner El Contractor 0 Other (Deseribe) Name GWZlST'E?J? 17 1 Phone9'GZ Ib(fl I Property LAST FIRST Owner Address `567( Pitor 14Nb5 RD STREET STE R City State FNlhl Zip rzlZZ Company `p?t GHtll?i?.t I?»ti. -N z;I?? /'Yn. Phone --f?Z lD( ( COMreCtOf Address _`56 '7(o ?JL6l" W65 R,p License N0go7<c1z Exp. s-Sl• ?i City f-i6y-'an_1 State U%1.1 Zip JFZ;;j 22- Architect/ Company Phone Engineer Name Registration # Address City State Zip Sewer 6 water licensed plumber . Processing time for sewer & water permits is two days once area as been approved. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: BUILDING PERMIT TYPE O 01 Foundation ?0.02 SF Dwg. 0 03 SF Addition ? 04 SF Porch ? 05 SF Misc. WORK TYPE `?.'31 New ? 32 Addition OFFICE USE ONLY w ? 06 Duplex 07 4-Plex ? 08 8-Plex ? 09 12-Plex ? 10 Multi. Add'1 > 13 33 Alterations ? 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Engineering REQUIRED INSPECTIONS ? Site ? Nallboard Y_N Basement sq. ft. lst F1. sq. ft. _ ?3 rt ? 2nd Fl. sq. ft. R_2 Sq. Ft. total Footprin t Sq. ft. ? On-site well 53'/z On-site sewage ? 11 Apt./Lodging -? O 12 Multi. Misc. O 13 Garage/Accessory ? 14 Fireplace O 15 Deck ? 35 Tenant Finish ? 36 Move Building Variance , -T7- 9 2 0 footing ? Final Assessments MWCC System YES City Water YES PRV Required Booster PumP Fire Sprinkler Census Code SAC Code cen5us bu i ir?js 2Z Census units 2, ? Framing O Draintile . B 16 Basement Finish ? 17 Swim Pool ? 18 Comm./Ind. O 19 Comm./Ind. Misc. ? 20 Public Facility ? 21 Miscellaneous ? 37 Demolish O Insulation ? Fireplace Permit Fee Surcharge Plan Review License MWCC SAC City SAC Water Conn. Nater Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Copies Other Total: r.tuat;m: g_?'7y'? 000 "? S , L-/D UN_ I_T I'• ? 00 r.00 :)u,oo 50, 00 10. oo , ?v, oo uNIr z:. Laloo SAC % 1,00 `Iwo SE'i6 (SF SAC Units 2. SEnurcES GnRq(,s; 2_,3xz2 = asrr,r: ?srz x c? ^ !I x 33= ?6 x 43 = Sxa)= H OuSE ; BSkf,-_ CaARA6E'. Z Zx Lo = 6smr; & x is?/2 = s3xq_ sw zic 1bx v3_ HouSE; ?? _ )a,zr7o 6y,554 '7,oyo ?S?Ios 63? 9?f ?---- 178,90°0 yyOX I(. ?? `1,040 62 363 688 i2iT x s3 = 4yo Ki6= 53 363 63 688 j zo-7 xis'r i1-o'? x53;7 Certificate For: bon ChFistenson . / 36 - 4{< DELMAR H. SCHWANZ LAND SURVEYOR9, INC. RepIN?nE Undsr Lwn ol iM Sbro al Mlnnnolo 14750 SOUTH ROBEqt tqAIL ROSEMOUNT, MINNE30TA 55068 012/423-1789 , SURVEYOR'S CERTIFICATE <'. ?1NF "- N CF??ST F' i uC.E 80? ,y " 30.0 ,0 3 0 ?-- h ? « U ?o ? K {- U K n n 893v I ? I I 0 9 H , ?m ? a8" i!- p n s 0 a Scale: 1 inch = 30 feet X WESr tQ?3 = Existing spot elev. loo, ao Sl ?- D8?•'' Q= Proposed elevation 7???_. - - ? •, ' "If. I I I ?- -- --- I ? I 1 I ? ? ?f C -??I- 4119Y? I ^ ii Unit 1 v ? 1 z I H ? N 4 / ? ? Unit 2 r 1` w a ?v i ? n h? __f I ?, ? .. __. ?( ..__ ?%IS ? ( +`y S\` ? .,........, , SC WANZ Y asas - NQ.SURj..,R Proposed garaqe floor elev. Unit 1 88?• ? Unit 2 g, J Top of block elevation Unit 1 8;r• 4 Unit 2 884.6 Lovest level elevation Unit 1 88S 6 Unit 2 R85.b ' -? /_..Z-BM: Top nut o£ hydrant at northeast quadrant of intersection of E}aCaART gWGjNE:FRINf" DL" Crestridge Lane ana Krestwoofl Description: " Lane. = 886.48 I.ot 6, Block 1, BUFFER HILLS, according to the recorded I hereby certlly thet tAla lurvey, plen. or rapoA wes plat thereof, Dakota County, MN. - prepared by me w under my direct aupervielon and tASt 1 em e duly Regleterod lenA 8urvayor under Also showing the 1 at n of roj9s)fd buildinq thereon_ tha lawe ol tM Stele ol Minnefoh. ? ? 08-19-92 Delmer H. 9ehwenx oeted Minneeote RsqlNrNlon No.S62S Revised 09-24-92 ' 1? t ? . . ENERGK CONSERVATION•SUPPLEMF.NT TO BUILUINC PERMIT APPLICATIUN JOB LOCATION, OWNER(5) CONTRACT( A. Determine the Total Exposed Wa11 Area as follous. 1. Total ttall. xindow area 2. Total door area ?L 3. Total sliding Rlass door area 2- 4. Total Fireplace area U 5. Total wall framing area (average LOx) ?.? 6.. Total net xall are., aUove floor OL 7; Total rim joist are_a //(J SIJBTOTALt Total expa,ed area ahove fioor 8. Total foundation,1windott area O 9. Total net foundationiarea above grade O SUBTO'TALI!Total exposed foundation area Grand Total Exposed'Nall Area B'. MULtipl'y the GRAND TU"CA1. EXYUSEll WAI.L AREA X?- . rt C. DpCermine [he 'fotal Exposed Roof/Ceili.ng area as follows$ 10. Total Skylite area O 111. Total raof/ce11Yng framing area /LZ 12..Tbta1 net insulated roof/ceiling area // o L. Grand Tbtal Exposed Roof Ceiling Area 2. Z. C; PHONE ySZ -J o 6 > PHUNE rl Item I AX, ]L 9-7-d1 D., MU1'tiply the Grand Tbtal Exposed Rnof/Ceiling Area X y9K - Item II ? 8 026 3/, 8'L., , . $. Determinr. the "U" value nf each segment (1-9) and rnultiply Gy the area as bllowst 1.. j o y g U., .49 2.. ? z X •' U" .13 3. 7C $U's .49 `/G 4, p X t.Uot _ .O 5:. 'kV' X IOU,, ,074 - 6•3/ 64 y x „iil,.. .01#9 - zy?o 7• g „u„ .046 - ?b6 8: X ^lln 1119 _ 9: X "U" .004 - ADD 1-9 FOR TOTAL HALL SECMENTS - Item III 9?oS? F. IIetermine the "U" value of ench segment (10-12) and multiyly by the area as follovso 100. a X "U" .55 - 11. X "U" .041 - '5"9 12. //bt X "U•' ,025) - L7.SS" ADD 10 - 12 FOR TOTAL ROUF/CELLING SEGMENTS - ICem IV _-? L, !?' 9? C. If Item No. III is the same asp or less than Item No. I. you have met the intent of State Bllildinp, Code 6006 (c) 2. HN If Item No. IY• is the same as, or less than ICem No. II, you have met the intent oE Sta[e Building Code 6006 (c) 1. °, 3l. sz - 12q,S d P.. Add item Na. I + Item No. II 49-14- - 2-/7 . 6P? .P..Add Item No. III q$;v$? + Item Nb. IV jZ•s!;- - 1"IG. 6 `--/14.SZLL-,?1'f7o7•1 L'.-'1L4-IF /yt-?FDS /Z> B? 1JVCQ.C-qBL-4) SC./Gf/TC-`' K. If the sum of items III and IV'are less thaniItems I and III ynu havd met the intent 05 the code for total envelope system (State BUilding Code 6000 and NPS 607-3.5 Overall Structure PerEbrmance Alternative ). The undersigned, as applicant for a Duildinr Permit, hereby aEfirms the above informatiom has been prepared and submitted by himself or under his direction, hereby acknowledges the information,to be corfect and accur.atei anxd'here6y presents the information with required plans in suTport of the BUilding Permtylvgplicatigne i_r Bl / CITY OF EAGAN SUBD.'??__???IZ- PLUMBING PERMIT ? (612) 681-4675 PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. CITY USE ONLY RECEIPT ? CP ?P DATE ALSO, FOR TOWNHOMES AND CONDOS WORK DESCRIPTION NEW CONST _ ADD ON _ REPAIR _ OWNER NAME:1?"'\ Cw' cl?S?f:1SCr1 ?lC?',. C?U• SITE ADDRESS:ZLc, (?- INSTALLER: ? G ?\E' C'??c•_?l CA ? ADDRESS:???1 L? • ?Lc`4- ?c- CITY: ZIP: rxorrE COMPLETE THE FOLLOWING: N0. FIXTURES EA. TOTAL REPAIR/ADD ON 15.00 ? SHOWER 3.00 ? WATER CIASET 3.00 `L ? BATH T[TB 3.00 ? IAVATORY 3.00 ? KITCHEN SINK 3.00 ? IAUNDRY 1RAY 3.00 HOT TUB/SPA 3.00 ? WATER HEATER 3.00 ? FLOOR DRAIN 3.00 t.? GAS PIPING OUT. ? (MINIMUM - 1) 3.00 ROUGH OPENINGS 1.50 _ OTHER WATER SOFTENER 5.00 _ PRIVATE DISP. 15.00 = U.G. SPRINKLER 3.00 ? w. Tvxxnxourm 15.00 STATE SURCHARGE .50 2? - TOTAL: S ?J?' S0 PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. WORK DESCRIPTION: OWNER NAME: SITE ADDRESS: _ TENANT NAME: _ SUITE #: INSTALLER: ADDRESS: CITSf: PHONE FOR: ZIP: CONTRACT PRICE: 1% OF CONTRACT FEE. . STATE SURCHARGE - $.50 FOR. EACH $1,000 OF PERMIT FEE. $25.00 MINIMUM FEE. CONTRACT PRICE x 1% $ STATE SURCHARGE TOTAL: $ (SIGNATURE) CITY OF EAGAN ? BL I CITY OF EAGAN ?? PLUMSING PERMIT ??-?-""fj?,") (612) 681-4675 REBIDBNTIAL PLEASE COMPLETE,UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION REPAIR LDAT TY USEONLY NEW CONST _ ADD ON _ EIPT # E AL50, FOR TOWNHOMES AND CONDOS OWAIER NAME: 02? CJVV(?S?ir?Scx'? {?)\C?-,_ l-l). SITE ADDRESS:' C?- INSTALLER: b-JC'-. annxsss:__lM lAn, cS?-CITY• ZIP: PHONE ??& COMPLETE THE FOLLOWING: N0. FIXTURES. EA. TOTAL REPAIR/ADD ON 15.00 f sxowEx 3.00 , L ? WATER CLOSET 3.00 .. l BATH TUB 3.00 ,:?_ LAVATORY 3.00 , A KITCHEN SINK 3.00 ? I LAUNDRY TRAY 3.00 HOT TUB/SPA 3.00 1 WATER HEATER 3.00 ?u? ? FIAOR DRAIN 3.00 • ?'? GAS PIPING OUT. I (MINIMUM - 1) 3.00 ROUGH OPENINGS 1.50 _ OTHER WATER SOFTENER 5.00 _ PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 _ W. TURNAROUND 15.00 STATE SURCHARGE .50 ? TOTAL: S ?Cc.S PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY BUILDINGS WHEN SEPARATE PIItMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. WORK DESCRIPTION: OWNER NAME: SITE ADDRESS' TENANT NAME: SUITE #: _ INSTALLER: ADDRESS:_ _ CITY: PHONE #: FOR: CITY OF EAGAN STATE SURCHARGE ZIP: CONTRACT PRICE: lY OF CONTRACT FEE. . STATE SURCHARGE - $.50 FOR. EACH $1,000 OF PERMIT FEE. $25.00 MINIMUM FEE. ` CONTRACT PRICE x 1% TOTAL: $ (SIGNATURE) CITY OF EAGAN CITY USE ONLY L G B • MECHANICAL PERMIT RECEIPT #/Oe 9 SUBD. ? (612) 681-4675 DATE RESIDENI7AL PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DR'ELIdNG3. AiSO, COMPLEI'E FOR TOWNHOMES/CONDOS WBEN SEPARATE PF.RMI'1'c pRE REQUIRID FOR EACH DWELidNG UNTf. OWNER- DOn 0 Y7y5 O ADD-ON A/C ADD-ON FIIRNACE? S1TE ADDRFSS: 96 D? f"KI Cj e, • ADD ON/REMODEL (ERISTING CONSTRUCI'ION ONLl) $ 15.00 INSTALLER: HVAC: 0-100 M BTU ? 24.00 PHONE #: I /q -$Io2 ADDITIONAL SO M BT[T 6.00 nnn-xFSS: 16 8D Gc1 F L(?o m6 e. S?. css ourZrs - rrmr-?rM i@ $a E?. ? .? - 00 crrY: r,,oz A-lc.? ZIP: JCS.37 suxcxnucF_: a .so SIGNATURE: TOTAL: $ oZ 7-50 U NO PERMIT REQUIRED FOR DUCTWORK ONLY! COMMERCIAL PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAIIIIVDUSTRiAL BUILDINGS. ALSO COMPLEI'E FOR APARTMENT BUILDINGS OR OTISER MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMTTS ARE NOT REQUIRID FOR EACH DR'ELLING UNTl'. WORK DESCRIPTION: CONTRACf PRICE: FEES 196 OF CONTRACf FEE. STATE SURCHARGE IS $.50 FOR Fr1CH S1,000 OF PERMIT FEE. $ PROCFSSED PSPING - 525.00 a hIINIIMfUM FEE - $25.00 OWNER: TOTAL: $ SITE ADDRESS: TENANT: SUITE INS1'AId.ER: ADDRESS: CI1'P: ZIP: PHONE #: CT1T SIGNATURE: SIGNATURE: CTTY OF EAGAN cITY USE ONLY MECHANICAL PERMIT RECEIPT # 99 SUBD. (612) 681-4675 DATE RESIDENTIAL PLF.ASE COMPLEPE UPPER PORTION ONLY FOR SINGLE FAMII Y DWELI.INGS. ALS O, COMPLEI'E FOR TOWNHOMFS/CONDOS R'HEN SEPARATE PERMITS ARE REQUIRED FOR EACH DWELLING i7NIT. 0ViNER° I) & K'?Sf'Eda9AJ [{ . - ADD-ON A/C 11 ADD-ON FURNACE? S1TE ADDRESS: 3a r,?_st2,? ? - ADD ON/REMODEL (EXISTING coxsTRucrcox oivrN) $ 15.00 INSTALLER: ,? t-,' C_, FiVAC: 0-100 M BTU ? 24.00 PHONE #: - g/d2 ADDTI'lONAL 50 M BTU 6.00 ADDxESs: /6 8 0 ?fe A? . S F_ uAS OuTx.Ers -MUGMuM 1 @$3 Ea'?/ 2.00 crrsr: ; aic l? K-? zrn: 53 suitcHutcE: a.so SIGNATURE TOTAL: $ 5(j NO PERMIT BEQUISED FOR DUCTWORK ONLY! COMMERCIAL PLEASE COMPLETE TfIIS PORTION FQR ALL COMMERCIAIJiNDUSTRIAL BUII,DINGS. ALSO COMPLETE FOR APARTMENT BUILDINGS OR OTIiER MULTI-FAMILY BUII.DINGS WHEN SEPARATE PERMITS ARE NOT REQUIItED FOR EACH DR'ELLING UNIT, R'ORK DESCRIPI'ION: CONTRACf PRICE: FEES 1% OF CONTRACT FEE. STATE SURCIIARGE IS $.50 FOR EACH $1,000 OF PERMIT FEE. $ PROCESSED PIPING • $25.00 $ MINIMUM FEE - $25.00 ORNER. TOTAL: $ STfE ADDRESS: 1'ENANT: SUI1'E #: INS1'AI.I.ER: ADDRFSS: CITY: ZIP: PHONE #: CT11' SIGNATURE: SIGNATURE. 1 1 11 city oF eagan . THOMASEGAN Mayoi April 30, 1993 PATRICIA AWA9A SHAWN Hl1NTER SANDRA A. MASIN THEODORE WACHTER MR DON CHRISTENSEN Cou ncil 3650 PII.OT KNOB ROAD EAGAN MN 55122 THOMAS HEDGES clly Adminiarroror Buffer Hills Addition Re: F-Lot B BlOCk 1 E. J. VAN OVERBEKE , ? , LWalver oT Plat/Lot Split Approval cnv aaik Vacatlon ot Puhlic Easement Dear Mr. Christensen: You have recently Inquired into the status of the lot split and vacation applications recen[ly processed through the City Council. The following Informatlon should be helpful to assist you in your schedule to close on the property sale. Lot Sulit The Waiver of Plat allowing the lot split was approved by the City Council a[ a regular meeting held on Aprll 5, 1993, w(th the following conditfons 1. Each unit shall be served by separate utility services. 2. All applicable City Code requirements. When all conditlons have 6een satisfactorily complied with or assured through a formal contract, a re9olution executad by the Mayor and CRy Clerk will be released allowing thls lot splft to be recorded at Dakota Counfy. The only condNlon yet to be complled with is #1. IPs schedule Is at your discretion. Easement Vacation The vacation of the 35' drainage and utifity easement along the south side oF Lot 6 was approved by formal Cvuncl action upon completion of the public hearing held on April 20, 1993. The City Anorney's Office has prepared the recordable documents which are being processed for the Mayor's and City Clerk's signatures. I anHctpate this process will be completed and recorded by the City at the County wfthin the next week to ten days. I hope this Information meets your needs. Please le[ me know if I can be of further assistance. Sincerely, ? iLg-u.eab /C:r?-&t'V4--? o as A. Colbert, P.E Director of Public Works TAC/jj cc: Marqyn Wucherptennig, Planning Aide MUNICIPAL CENTER THE LONE OAK TREE MAINiENANCE FACILITY 3830 PILOi NNOB ROAD EAGAN, MINNESOiA 55122-1897 THE SVMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY 3W I COACHMAN POINI EAGAN. MINNESOiA 55122 PHONE: (612) 681-4600 PHONE: (612) 681-4300 fAR•.(612)681-ae12- EqualOppoiluntlylAfflrmallveACtbnEmployer FAX:(et2)5et-a36o iDD: (612) 454-8535 , 1DD: (612) 454-8535 PAGE 12/EAGAN CITY COUNCIL MINUTES September 1, 1992 REQUEST FOR RECONSID] TdBY T SfEVENS Mayor Fgan invoduced this item as a Request for Reconsideratioq Building Permit Prior to Platting Property, Toby T. Steveas, Government Lot 7, SeMion 18, Township 27, Range 73. No action was taken on this item as Mr. Stevens has witbdrawn his request for reconsideration. DEERWOOD MIDDLE SCHOOL PROJECT This item' was handled eazlier on the agenda. D41N CHIt3STfANSON DUPLEX/I.UT COVERAGE ? Ma}ror Egan inUOduced this item as a request from Doa Christianson regarding lot coverage for a duplex on Crestridge Drive. DireMor of Community Development Runkle said tbat the lot coverage exceeds the maximum by 13%, which is less than originally thought. He said the garage could be acaled down in order . to meet lot coverage standazds, however, the 13% overage would have little impad. Mr. Runkle noted that the surrounding progerty owners have been surveyed and there Lave been no objections. Don Christianson advised the Council that if he had realized thaz the building would exceed maximum standazds, he would not have designed it in suc6 a manner. After discussion, Egan moved, Awada secoaded, a modon to approve issuing a buildiog permit for pon Christianson for the property on CresVidge Drive conditioned upon application for a varianbc and subject [o compliance with all application procedures. Aye: 3 Nay: 0 Abstain: 1(Wachter) FIRE TRUCK OP770NS Fue Chief Ken Soutbom apologized to the City Council foc not tequesting action of the City Council earlier in the meetiug for the options being proposed with the purchase of the pumper Wck. Mayor Egaa asked witL a$1'I9,000 bid, how muc6 the pumper wck wu under budget. Chief Southorn said S205,000had been budgeted for Wis purchase. Wachter moved, Pawlenty seconded, a motion to approve the options for the pumper truck for the Fue Depaztment as outlined in Exhibi[ A. Aye: 4 Nay. 0 UPDATE/APOTHECARY The City Administrator requested diredion of the City Council regarding any incentives the GSty might offer Apothecary, Inc., to locate in the C1ty of Eagan. After discussion, the City Council voiced its opposition to any type of financial incentives but directed staff to obtain more information regarding Apothecary and work with We firm to encourage its relocalion to Eagan. NAIVER AGREEMENT This Aqreement, made and entered into on the [??" day of 4? r;l , 1993, by and between DONALD D. CHRISTENSON and GEORGENE CHRISTENSON, husband and wife, (hereinafter referred to collectively as "Christenson"); and ELLIOTT G. HAWK, (hereinafter referred to as "Hawk"). WHEREAS, Christenson granted a drainage and utility easement to the City of Eagan, Dakota County, State of Minnesota, by an Agreement dated June 27, 1988, and recorded with the Dakota County Reoorder's Office as Document No. 877195. Said easement is over, across and under certain real property owned by Christenson and legally described as: South 35 feet of Lot 6, Block 1, Buffer Hills, according to the recorded plat thereof, Dakota County, Minnesota. WHEREAS, Christenson petitioned the City of Eagan to vacate the above-described easement; WHEREAS, Christenson and Hawk are the only parties benefitted or subjected to the easement; WHEREAS, Christenson has provided Hawk with a private easement to benefit the property owned by Hawk. NOW, THEREFORE, in consideration of the foregoing facts, the parties hereto waive any rights to notice of hearings, hearings or appeals relating to the vacation of the above-described easement by the City of Eagan. IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the date set forth above. ? ? ?L Donald D. Christenson _x? George e Christenson E iot G. Hawk STATE OF MINNESOTA COUNTY OF , On this 4CJ` h day of , 1993, before me a Notary Public within and for said ounty, personally appeared Donald D. Christenson and Georgene Christenson, husband and wife, to me personally known to be the persons described in and who executed the foregoing instrument and acknowledged that they executed the same as their free act and deed. MARY SWENSON NOTARY Pll8L1C-MINNESOTA DAKOTA COUNTY STATE OF MINNESOTA ) ? SS. COUNTY OF? On this ? day Public within and for Hawk, to me personally executed the foreqoing the same as his free act Commission Expires Oct, 23, 1994 of , 1993, before me a Notary said ounty, personally appeared Elliot G. known to be the person described in and who instrument and acknowledqed that he executed and deed. THIS INSTRUMENT WAS DRAFTED BY: SEVERSON, WILCOX & SHELDON, P.A. 600 Midway National Bank Building 7300 West 147th Street Apple Valley, Minnesota 55124 (612) 432-3136 SKH/Wkt No ^y Public, NOMARRYpugdE?iSQNNESOTA DAKOTA CCUNTY < My ?Commission Expires Oct. 23, 1994 A ?y? IS BASB!lSNT 877195 THIS EASEMENT, made this a 7!hday of June, 1988, between DONALD D. CHRISTENSON and GEORGENE CHRISTENSON, husband and wife, herein referred to as "LANDGWNER° and the CITY OF EAGAN, a municipal corporation, organized uncler the laws of the State of Minnesota, hereinafter referred to as the "CITY". WITNESSETH: That the Landowner, in consideration of the sum of One Dollar ($1.00) an8 other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, does hereby grant and convey unto the City, its successors and assigns, permanent easement for drainage and utility purposes, over, across and under the following described premises, situated within Dakota County, Minnesota, to-wit: South 35 feet of Lot Six (6), Block One (l), BIIFFER HILLS, according to the recorded plat thereof, Dakota County, Minnesota. The grant of the foregoing permanent easement for drainage and utility puzposes includes the right of the City, its contractors, agents and servants to enter upon the premises at all reasonable times to construct, reconstruct, inspect, repair and maintain pipes, conduits, mains or ponds and the further right to remove trees, brush, undergrowth and other obstructions. After completion of such construction, maintenance, repair or removal, the City shall restore the premises to the condition in which it was found prior to the commencement of such actions, save only for the necessary removal of trees, brush, undergrowth and other obstructions. The Landowner, its heirs and assigns, does covenant with the City, its successors and assigna, that it is the Ownex of the premises aforesaid and has good right to grant and convey the easement herein to the City. IN TESTIMONY WSEREOF, the Landowner has caused this easement to be executed as of the day and year fir above written. DONALD D. CHRISTENSON ?? ?A. GEORG,OE CHRISTENSON L`6024'45"- . \ C ? • ? ? y ?„ i \ J \ ? n ^ I E `•? -Q \ ? \ ?• -? G ' I \ zz,?°1z'° ---,?, 65°e V 64°44`27 : \/ pa9 \ 6zeo " q ?O ?n _ `> a iYO.lb y a V ? ? 68 ? A N I L ? u l a A m ? o I 10 0 m I O 0 125.62 %. !y?1E R^ S-TRtDGE1? COURT s1866o la6.t2 _SO U TH G ,` O ,O G' I WC \ G a? 4?? o?s O o pdJ° ? . op p °' ?' ? ? b9? V? ? ? 3 g 8 •:k?i:. Q.:>:?i' 134.72 q9 B V t •`?+',i:•»::?: ? ? x •::?:;• -- - - - ? fTl ? ? ?? . :: ,s.•:;: ?: i ?? ?•r;:? ': s+ .. .. , ? •::?. a::•:::< •'{{4(?; I C!i -? ., z ? ?C m ? i w , j?;c,?,.??'(.%'}'•:?: ? ? ' ' a 10 p i •: : y :S?y'? 7.+r:• p 0) ? 1D !w:?:; {: . l O ' i?} ' ?i}: ?' :• . - lu8w9se3 A41mn i •:.;•::.:.. I aBeuieJa SE :;'V'"'•';.';.; .;: 50 U T H 152.14 I ? -- l ? - - -- -- -- o - -- - - - - - y I m I ? o A I m ui p 0 0 m ? I g i ? i 30.00 NORTH " io y Ig ? - I 52.46- - -'- ? E 1 ' C OcNt O 77 :1 0 . ; • E ct /p ct (p F' F+ F+ 1+ O O fA ? ? ro ? r1 ry A? ?, f? M O W O Co ? 'ry l7 £ f7 'y t . : ? ?0 'f N K ? lC t, H {y x l7 '3 .t w N ?< X?t?Dt?i7W O fC c* N ct R ct'CS 1' sF-f 'afe W?O'OOt7 F? ? y ny ? ? y O rt F? N R x r w ?ro t3 r0 p' cr cr ^! fD a R ?C•?. C-P ? .1 . ? LO ? R [0 N f! :3r STATE OF MINNESOTA ) SS COD OF DAROTA ) ? he foregoing instrument was acknowledged before me this 0?7 day of Junep 19881 by DONALD D. CHRISTENSON and GEORGENE CHRISTENSON, husband and wife. ¦ KiRx s. euN^??'..c?t NOTARY PUCLrf_ DAtt?T:g THIS INSTRUMENT WAS DRAFTED BY: f.'.Y COMh1. [XPiE:'ri F-FB. 22. 1 SSD t MMyWNJVJ?r?VWNJJVNI`NNJV' • MCMENOMY & SEVERSON, P.A. 7300 West 147th Street P.O. Box 24329 Apple Valley, MN 55124 (612) 432-3136 MGD -2- 7g /6o 2007 RESIDENTIAL PLUMBING PeRnntr aPPUCArioro CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please com lete for modifications to existin residential dweliin s Date ? / 1 - StteSU?eetAddress r .S?l"1? UnH# Property Owner Telephone #(b5j) f0w 710 )n Contractor iLUVM?1N101 Telephon.# r,a ?t?g?,1oa Address ?? e?s1n I,n i Cily C'S'C1^.lCt.tn Statetj ZIP 5535'? The Applicant is: ? Owner 8 Oceupant Licensed Plumbing Contractor SepUc System _ New _ Refurbished Submit 2 sets of plans and MPC license InGudes County fee S 100.00 Per asbuiH $ 10.00 Fire Repalr (replace bumed out fixtures, etc.) $ 90.00 This fee a ies when extensive umbin re irs are made to a buildin . AlteraUons to exlsUng dwellfng $ 50.00 _ Add plumbing fixtures to main level bwer level. This fee indudes installation of a watw softener and/or water heater ffi the same time. H yrou are installMg OnIV a water softener and/or water heate, do not complete this secdon; move W the next section arW place a checkmark naxt M the appliance(s) you are installing. _,Septic System Abendonment _Water Tumaround (add $138.00 'rf a 5/8" meter ia required) Other: _ Water Softener _ Water Heater $ 15.00 _ new _ replacement Lawn Irtigatloa _RP2 PVB _new _repafr _rebuild $ 30.00 State Surcharge $ .50 Tofal $ I hereby apply for a Residential Plumbing Pertnft and acknowledge that the infwmaation is complet e and accurate that the work will be in confortnance with the ordinances and codea 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 urork will be in accordance with the approved plan in the event a plan is required t be revi d and approved. ;usc, `„tC [E c???w [ED Applicant's Printed Name plicanPs Signature JUN 0 5 2001 ? rS 41 S'a 7stl?) Z zaa7 REStDENT1AL PLUMBING PeRMrrAPPiIcaTioN CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55722 651-675-5675 Please complete for modifications to existina residerrtial dwellinas Date Jr I 3o! d ? Slte 3treet Address ??10 3 .(P ?? i Di?, LT • Unk # ? Properly Owner Ltm l .VL?? SC51n Telephone # (?j ) lv ? ??P? ? Contractor V ? ? S f l XUIy.JI ?101 Telephon. # ?,a x1y8 ?t loa ? + Address 0? J•sSei7tvn ?n,,,fi i Vt) r.a.. _ C'S'('C1CtAA Stata-Utj ZiP s535'? TAe Applicant is: _ Owner & Occupant Licensed PIum6ing Contractor Sepdc System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes CouMy fee $ 100.00 Per as-buitt $ 10.00 Fire Repair (replace bumed out flxtures, etc.) $ 90.00 This fee a ies when extensive umbin re irs are made to a buildin . AReradons to existlng dwelling • $ 50.00 _ Add plumbing fixtures to main level lower level. This fee indudes installation of a water soitener andlor water heater at the same tlme. H you are lnstaUfng on a water sofltener and/or water heater, do not complete ihis section; move to the next seetion and place a checkmark rrext to the appliance(s) yai are installing. _Septlc System Abendonment _ Water Tunaround (add $136.00 'rf a 5/8" meter is required) Other. _ Water Softener _ Water Heater $ 75.00 _ new _ replacement Lawn Irrigation _RP2 4PVB _new. _repalr _rebulld $ 30.00 State Surcharge g Sp Total $. 1 nereoy appry ror a Kesiaennai Nwmwng Permit and acknowledge that the infortnation ia complete and accurete; that the work will be in coMormance 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 partnit, work is nof to start withaft a pertnd and work will be in accordance with the approved plan in the everrt a plan is required t e revie and approved. ZaIra., Applicant's Printed Name ,00licariff Signature D I? u?? ?? II Il U JUN 0 5 2001 ? Sr?"? ? 9527588098 APR-29-2009 11:11 From:D&D MECHANICAL 9527588098 To:651 675 5694 P.1'1 1 City of Eaau U 31830 Pilot Knob Road Permit Fee. Eagan MN 55122 Onto Received: Phone: (551) 675.5676 Fax: (651) 675-5694 Staff; L---------------- 2009 RESIDENTIAL PLUMBING PERMIT APPLICATION o r-i Cie (-r Onto: Z8 -O9 Site Address; KMO Is Tenant: Suite 0' RESIDENT / OWNER Name: Goo r e?1 e_ C 4-i s+enson Phone__ _W_2- q) Address / City / Zip: .3 0 Cr e s OA G A 1•! CONTRACTOR Name: n,L Liconso Qt,. ZSZf t1 Address: (a2Qi6in 5t_ b JJ City; N_ W ___A t, U G1 state,-M.6L \ Zip: 66-7) Phone: 3 s 2- g b l5contact Person: t h? TYPE OF WORK -Now Replacement _Repair Rebuild - Modify Space _ Work in R.O.W , Description of work: PERMIT TYPE RESIDENTIAL Water Heater Wator Softener Lawn Irrigation Add Plumbing Fixtures RPZ / PVS) Main _ Lower Level) Septic System Water Turnaround New Abandonment RESIDENTIAL FEES: $50.50 Minimum Water Heater Water Softener, or Water Heater Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (Includes $,50 Stale Surcharge) $60.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround" (includes $.50 State Surcharge) 'Water Turnaround (add $165,00 It a 5/8" motor is required) $100.50 Septic System N ft ($10.00 per as built) (Includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc,.) (includes $,50 State Surcharge) 5D TOTAL FEES $ 1 hereby acknowledge that this In armat cn is complete and accurate; that the work will be In conformance with the ord nancea and codes of the City of Faganr 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 witr the approved plan in the case of work which requires a review and approval of pl s. Ap n s Printed Mama Appll nt's signature FOR QF ICE USE Reviewed By: w _ Oats: .M..FInaI Requlra Inspections:! ____Under Around __Rough-In _Air Test Gas Test 00 r 16