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4401 Clover Lane
CITY OF EAGAN /. 9795 Pilof Knob Reod Eagan, MN 55122 Tz 0 8396 PHONE: 4348100 BUILDING PERMIT Receipt # Te ba und 4oe 1 of 4 PLEX Est. Vulue $35,000 Date August 17 _ 19 83 Stte Address 1809 Walnut Lane E R-3 red $]C Occuponcy Lot4Q_ BI«k3_ $ec/Sub. F'd?tion Alter ? Zoning (PD ) R-3 parcel # 10 22750 400 03 Repoir ? Fire Zone NA V Enlarge ? Type of Const. w Nome Tilsen Homes. Inc_ move ? # Srodes Z r Addreu 627 S. SnellinQ Ave. Demolish ? Length43_8 ? Cft St. Paul 55116pho. 698-5501 Grade ? Depth32_Sq. Ft.- o Nome Own2I Avvrovola Fees i? Mdress Const. Of£1Ce Assessment Pertnit 215.50 ? Ci p?? 777'9252 Water85ew. Surcharge 17.50 ? Police Plan check 107.75 W Name Fire SAC 525.00 ?? Address Eng. WoterConn. 45n.(1(1 iW Ci Pl?one Pianner WaterMeter 60.00 Councll Road Unit 250.00 I hereby acknowledga thot I have reod this opplicahon ond sfote that gldg. Off. fhe intormolion is correct and agree to comply with oll applicoble $1625.75 State of Minnewta Statutet and City of Eogan Ordinonces. APC Totol Signoture of Pertnitteo i sen omes, ? A Building Permir is issued to: ! on the expreu condition 1hm oll work shall be done in acmrdarice withMopyli Tgte-gf?dinne lota Smtutes and City of Eagon Ordinoncea. Buildinp Oificiol CITY OF EAGAN NO g394 3795 Pllof Kno6 Raad Eagan, MN 55122 . ° PHONE: 4548f00 ? BUILDING PERMIT Receipt # 5Y3/0 G Te ba umd fer 1 of 4 PLEX Est. Volue 0 35,000 pate August 17 _ 19 83 Site Address 4401 Clover Lane E,ect gg Occuuancy R'3 Lot 38 B lack 3 Sec/Sub. Eden Addition Alter p Zoning (PD) R-3 Parcel # 10 22750 380 03 Repalr ? Fire Zone NA V Tilsen Homes Inc. Er,torga ? Type of Conn. W Nome , Move ? # Srories z Address 629 S. Snelling Ave. Demolish ? 43-8 Length_ Ci St. Paul 55116phO11e 698-5501 Gmde ? Depth 32 Sq . Ft.- c N OWtter AvProvals Feea p ame ?? Address Const. Office 1- ru., o6..... 777-9252 Nume _ Address I hereby ackrwwledge thot I hove read this applicotion ond state thot the information Is correcf ond agree fo comply wifh oll upplicoble State of Minnewto Stotutes ond City of Eo9an Ordinnnces. Sipnoture of Permittee i sen Homes, c A Building Permll Is issued to: all work shnll be done in accordonce with I applicoble S te of Buildinp Official Assessmenf - Water 8 Sew. Police _ Fire Eng. Plonner _ Council _ Bldg. Off. _ APC Permit °1J•?v Surchorge 17•50 Plnn check 107.75 SAC 525.00 Water Conn. 450.00 Warer Meter 60.00 Road Unit 250.00 Torol $1625.75 on the express cordiHOn ihni Statutes and City of Eogan Ordirwnces. CITY OF EAGAN 3793 Pll K R d E M N ° 8395 , - ot neb eo agen, " PHONE 454 8100 N 3512= , s : - BUILDIN PERMIT ? ??O ? G Receipt # To M mad hr 1 of 4 PLEX En, yalue $35,000 Date AuQust 17 , 1 q 83 Site Address 4401B Clover Lane Erecr ?y Occupancy R-3 Lor 37 Blxk 3 Sec/5ib, Eden Addition Aker ? Zon;n9 (PD) R-3 Purcel # 10 22750 370 03 Repalr p Fire Zone NA E V nlorpa ? Type of Const. W Name Tilsen Homes, Inc. Move ? # Stories 9 z Address 627 S. SnellinQ Ave. per,wlish p Length 43-8 c;r„ St__Paul 55116p,0,,, 698-5501 G.ude ? Depth 32 Sq. Ft.- o Name uwner ?? Address Cnnct_OffioP oL'_' 777-9252 Name _ Address I hereby acknowledge thot I have read this applicotion ond stote thof the inlormation is corrett and agree fo camply wiih all opplicoble Slote of Minnewta Statutes ond Ciry of Eogan Ordinances. Sipnature of Permittee A Building Pertnit Is issued to: Tilsen Homes, Inc. oll work sholl be done in occordarxe with al o liwble State of Building Officiol ? Assessmenf _ Water 8 $CW. Police _ Fire Erq. Plonner _ Council _ Bldg. Off. _ APC hes Permit G1J.JV Surcharge 17.50 Plan check 107.75 sAt 525.00 Water Conn. 450.00 Woter Meter 60.00 Road Unit 250.00 Torol $1625.75 _ on Nu express condiNon ihni ond City of Eaqan Ordinonces. Permit No. Permit Halder Misc. Permit No. Holder Plumbin9 37j ?t Jc R?,A",3 u H.V.A.C. ??ZS ?P?cM?Jb[rC ?I^8?0-? E'aMric wess 3$Q o,?? 7lw 4-zo ?3 Inspection Date Insp. Other Footings ? Foundation Framing -43 44 Rouph PI6g. tUU ' Inwlation i^ I, Final P16g I? Finel HVAC ? i Fina Water Well Sewer Pr. Disp. Ueacribe Location: CITY OF EAGAN 3795 PIld Knob Rwd Eayon, MN 55123 PHONEs I54•8100 BUILDING PERMIT Reteipt # 19 %;3 To b? wed for 1 of ?: PLr ;; Est. Vclue t35,000 Oote `' '„: t .1 - a nu ',3I1° n_ S Site /?ddross Erect -}] Occupancy Lot B 3 I:den 1lddition Alter p Zoninfl PD ??-3 ' . Porul # ?ohk ??--;?/S?? ' Repcir ? Fire Zone "A. i s Enlorge ? Type oF Const. ?` e r ac =o o, u? ? Name . . +, ??L ? nc .? u , • Move Q # Stories Add? S. n?? ng ve. pemoHsh ? Length4 3•-8 62/ G?,?r. au ' ph? '- Grode ? Depth 3? Sq. Ft. ApProva Is ie.s Name Address ?Ionst. Office Assessment_ ? - -' Woter 8 Sew. CitY Phone Police Nome Firo Address Enfl. Plonner _ Council Permit Surchorye Plon check ? )7 77 ' 5AC Wuter Conn. Woter Mefer Rood Unit 1 hereby acknowledge that I hove read this opplicotion and state that gldg. Off. the inlormation is correct cnd Cgree fo comply with all applicoble ^? ,r?a? .?- State of Minnesoto Stotutes ond City of Eagon Ordinances. Sipnature of Pertnittee 1t3e . A Bullding Permif is issued to: an the express condiNon Ihnr oll work shall be done in occordante with oll appUoable State ef AAinnesota Statutes ond City of Eagan Ordinances. Buifdirp Offidol ? Permit No. Parmit Holder Misc. Permit No. Hoider Plumbing 3'?3? ?'? H.V.A.C. Well Water r Disp. Sewer Electrie wo8' n4 3 O.B, ?e Se?1 Q? ZO ? Irqpaction Dste Insp. Other Footinyt Foundatioo Fnminy Rouqh Pibq. d _ w Rouph HVA inwlation Finsl Piba , 7-;{ Finsl HVAC ? Finsl WaUr DKCrlbe Location: Well ' Sewer Pr, D'up. ' CITY OF EAGAN ' 3795 Nlet Knob Reed Eayan, MN 'if 122 PHONE: 454-8100 BUILDING PERMIT Te be rad iw 1 of 4 PLEX $35,000 Receipt # N,2 $?1) 5 ?- 17 83 Site IWdrcu B Clover Lane Lot 37 Block 3 Sec/Sub. Eden Addition Porcel # 10 22750 370 03 Ncme ` ti ocu uvuca tua . ? /lddmss 627 S. Snelling Ave. St. Paul 5511G? 698-5501 " vwucL o Name ?? ?lddress Const. Office L, r- r..., n?..,.._ Name _ Addreu Erect 11 Octupanty R-3 Alte? ? Zoninp `' ` Repoir ? Fire Zone ? Enlarge ? Type of Gonst. Move D ? # Storie? + " emoliah p Length -?_ 6rode ? Depth Sq. Ft. Apororalt Faes Assessment - Water & Sew, Police Fire Eny. Planner Councfl Bldg. Off. _ APC I hereby ocknowledga thot I hore read this opplication and stafe that the intormotion is correct and ogree to comply with oll opplicable Stata of Minnesoto Stotutes ond City of Eogon Ordinonces. Permit --? ---- 5urcharge ?T Plon check .?? WoCer Con ?0 Water Meter Road Unit ` 7) ' nT) rotal • 7 5 Slqnature of Pertnittea I en . m , _ c. A Bullding Permlt fs issued to: on ths express condition fhni oll work sholl be done in accordarxe wifh oll opplicable State pf Mirtine%otrStotutes ond Ciry of Eoflon Ordinances. Buildinp Offitiol ? Permit No. Parmit Holder Misc. Permit No. Holder Plumbing ??j? ?` k-? -A, 43 H.V.A.C. ?Q { DE ? VlQDl10 t?'Z ? 4 Well Water Disp. Sftwr Elemic wo83?Q? o-B,T?ok. 9-zd -23 Irapeetion Date Inap. Othar Footinqt Orly Foundation F?sminp ` Rouph Pibp. Rouph HVA Inwlation ?G L Final Plby. Final HVAC . ? ? Final ZcO Water Dacriba Location: Well Sawe? , Pr. Disp. cirY aF EAcaN 8795 Pikf Knob Roed Esgan, MN 551?,2 ' PHONEt 454-8100 BUILDING PEItMIT Receipt .# T.. L- .».A s... 1 of 4 PLisX C_ .._1.._ 0 35,T_2-J tlti<,ust 17 ?^rv?. ViVYFL Site Adi?? r?ss a+o"c Laen :.e . i i_oi: Lat Block $ec/5ub. Poreel # 10 22750 300 03 _ . , . oc Name Z S. ne ng :ae. fi Add5?. Paul 5116 .,698-5501 °C Narr?e - - ---- i° Const. 0 ice u? /lddress _ ? ri•., uti,,... Name _ Address I hereby acknowledge that 1 have read this applicotion ond stote that the informotion is correct and ogree to comply with oll appiicoble State of Minnesoto Statutes and Gty of Eagon Ordinonces. Sipnoture of Permittee A Building Permit is issued to: oll work shall be done in occordnnce Buiidiny Officiol 32?4 83 Erect !`?' Qctupancy Alter ? Zoning Repofr ? Fire Zone Enlor9e ? Type of Const. Move Q # Storie$ Demolish Grode p ? 1 Length u Depth ?- Sq. Ft. Approval• Fees Assessment Water 8 Sew. Police Fire Enp. Planner Council Bidg. Oft. APC Permit ?----' Surchorfle Plan check _,25 uu_ SAC Water Conn. 450.00 _zTT.MT Wuter Meter Road Unit ??IT Totol • ? on tha express condition that ate of (aAim,955tn Statutes ond City ot Eogan Ordinonces. Permit No. Permit Holder Misc. Permit No. Holder Plumbin9 3'73 ( ?l ?,?'j H.V.A.C. Well Water Disp. Sawer Electric w0$'3$'Q? q•m43 Inapection Date Insp. Other Footinps Foundation Framinp Rough Plbg. Q, d Rouph HVA Insulation Final Plbg. 2L. yd . Final HVAC Final A0 Watar Qescri6e ation: ' wan Sewsr Pr. Disp. CITY OF EAGAN Remarks Addition Eden Addition Lot 4? aik 3 Parcel #10 22750 400 03 Owner i- * Street 1809 Walnut Lane State Eagan NIN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. 1982 504.70 100.94 5 2_29_84 STREET RESTOR. GRADING 1$$2 232,99. 46.6o 5 93.22 A 013603 2-29-84 SAN SEW TRUNK !! 1974 62.93 4.20 15 16.84 A 013603 2-29-84 SEWERLATERAL 1982 1 . 379•29 5 758.59 A 013603 2-29-84 WATERMAIN WATER LATERAL 19 5 WATER AREA 1977 62.93 4.20 15 29.41 A 013603 2-29-84 3ervices 1982 5 STORMSEW TRK 1982 25 .00 51.20 5 102.40 A 013603 2-29-84 F STOFiM SEW LAT 19 2 5 CURB & GUTTER I SIDEWALK STREET LIGHT ROAD UNIT 250.00 38106 $-17- 3 WATER CONN. 00.00 11 BUILDING PER. 8397 SAC 525,00 t? tt PARK CITY OF EAGAN Remarks ~ Addition ?den Lot 39 Blk 3 Parcel #10 22750 390 03 Owner Street _1811 Walnut Lane Scate Eagan NW 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF, 1982 504.7a 100.94 5 STREET RESTOR. GRADING 1982 2?. 4(.(Q 93.22 A013417 1-6-94 SAN SEW TRUNK 1974 62.93 16.84 A013417 1-6-8 ? SEWER LATERAL 182 1896.46 319.29 758.59 WATERMAIN ? WATER LATERAL 1982 WATER AREA 7 1-6-84 • services 1982 STORM SEW TRK c 1982 256.00 51.20 102.40 A013417 1-6-84 ? STORM SEW LAT 1982 rj CURB & GUTTER SIDEWALK STREET LIGHT ROAD IT 250.00 39106 8-1- 3 WATER CONN. 45O. dQ it of BUILDING PER. 8396 SAC PARK CITY OF EAGAN Remarks Addition EdUn Addition Lot 38 eik 3 ParceI #10 22750 _ 380 03 owner V". .} - 1% -? Street 4401 Clover Lane staie Eagan MN 55122 Improvement Date Amount Annual Years $5 Payment Receipt Date STREETSURF. D 9$2 50T.-70-- • 100.94 A015675 6-21-8 STREET RESTOR. GRADING UqG 1982 2 .. 46.60 46.63 it SAN SEW TRUfVK Jql 1974 4.20 15 12 . 65 " " i SEWER LATERAL 1982 pq 3 .2 O 11 WATERMAIN * WATER LATERAL 1982 WATER AREA 7 25.22 • SErvicea 1982 STORM SEW TRK 1982 256.00 51.20 5 51.20 • STORM SEW LAT 102 5 CURB & GUTTER SIDEWALK STREET LIGHT ROAD UNIT 250.00 38106 9-17-83 WATER CONN. 450.00 BUILDING PER. 8394 SAC 525,00 PARK CITY OF EAGAN Addition ??n Additien Lot 37 Blk Owner street 4401 B C lover Lane Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. ?• 1982 504.70 100.94 5 201.88 A 013753 4-12-84 STREET RESTOR. GRADING UqC) 1? 2 . 46.60 93.22 SAN SEW TRUNK 1974 62.93 4.20 15 16.84 • SEWER LATERAL ? 1982 1896.46 319.29 5 75$.59 WATERMAIN • WATER LATERAL 1982 WATER AREA 977 62.93 4,20 15 29.41 • 3Ervices 1982 STORM SEW TRK (Aq 1982 k26.OO 1.20 102 .4O f STORM SEW LAT 1982 5 CURB & GUTTER SIDEWALK STREET LIGHT RO IT 250.00 38106 8-17-83 WATER CONN, 450.00 6UILDWG PER. SAC t? n PAR K 2 r i t R PLUMBING PERMIT Permit No eoa p . ' CITY OF EAGAN Fee ?x "f ? Fill in numbered speces S/C Type or Prini legibly T t o . 1. Date 2. Installation Cost 3. Job Address `t Lot-?9 Blk. ? Tract L? t ' / \ 4. Owner 2 "-.•%, , 5. Contractor Phone 6. Address 3 7. City:;, IflwVJ.zT- State -A'4„ , Zip? 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New O Add ? Alter O Repair ? 1 10. Describe 1 11• No, Fixtures Water Closet No. Fixtures Cesspool/Drainfield ? Bath tubs Septic Tank _L Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet ^ OthQt--" TL Laundry Tray !? C _CJ Floor Drains r Drinking Ftn. Slop Sink Gas Piping Outlets F 12. I hereby certify that the above information is true and correct, and 1 agree to comply wilh all ordinances and codes governing this type of work. Signed : for Rough F inal Inspections: Oate Insp. Date Insp. This is your permit when numbered and approved. Approved ? CITY OF EAGAN 454-8100 ? - ---- Receipt MECHANICAL PERMIT Permit Na GTY OF EAGAN : • , I Fee Fill in numbered spaces S1C ' Type or Print legib/y , Tot. , 1. Date 2. Installation Cost -, 3. Job Address Lat 1 Blk. ? Tract 4. Owner " ? - 5. Contractor Phone 6, Address y - 7. City State 2ip " - 8. Buitding Type: Residential Commercial O Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 10. Describe- Fuel Type 11. No, Eauioment BTU - M. Ea. Forced Air No. Epuipment CFM Air Handlin : Mfg. g Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to oomply with all ordinances and codes governing this type of work. Signed ; for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved - CITY OF EAGAN 464,8700 ! Receipt " MECHANICAL PERMIT Permit No. CITY OF EAGAN " Fes Fill in num6ered spaces S/C Type or Prinr /egibly Tot. 1. Date 2. Installation Cost n - ? 3. Job Address Lot_?40_Bik. Tract 4. Owner 5. Contractor 6. Address Phone " 7. City State Zip 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New ? Add O Alter ? Repair ? 10. Describe Fuel Type • 11. No. Eouioment 9TU - M. Ea. Forced Air No. Equipment CFM Handli : Ai Mfg. r ng Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mtg. Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 ?Z111"- ? : ]: PLUMBING PERMIT Permit No. ? 3 Receipt " CITY OF EAGAN zc; e ,o F ee FiII in numbered spaces S/C Type or Print /egibly Tot. 1. Date 2. Installation Cost 3. Job Address [ car\d LotVQ _Bik. Tract?CS r r? 4. Owner 5. Contractor }\ a ?.?+. Phone 6. Address ? 7. City J ;r?'il ??t, State Zip L- 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter O Repair ? I 10. Describe 1 11. No. ? Fixtures Water Closet No. Fixtures Cesspool/Drainfield I/ Bath tubs Septic Tank Lavatory Softner Shower Well % Kitchen Sink Urinal/Bidet OtFje'r ? Laundry Tray Floor Drains l $? I ,?_? U Drinking Ftn. ? Slop Sink --- ---? Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : / for ? Rougfi Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved T? t- ` CITY OF EAGAN 454-6100 Receipt PLUMBING PERMIT Permit No. 5-7 - CITY QF EAGAN r Fee aU t 'C? Fill rn numbered spaces S/C ? U Type or Print legib/y Tot. -> 1. Date 2. Installation Cost ' ? ?, K- la ti^.'? ? 3. Job Address Lot3 :7,Blk. ? Tract L Cl E? 4.Owner l,4'/-yt`'N , 5. Contractor "L? r9R1fr-?Il?-- Phone 6. Address A-o C~L1, ic, l: 7. City TJ??^1T.?y. State )1±? AV12 Zip 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter O Repair ? 1 10. Describe 1 11. No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs Septic Tank ? Lavatory Softner Shower Wel I ? Kitchen Sink Urinal/Bidet Othey- - Laundry Tray - L Floor Drains _ Drinking Ftn. - 51op Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. 5igned : (_J(cfor Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved `CITY OF EAGAN 454-8100 - ?--- 1-- ( I J ! I Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN ? • .? . Fea -' ? E FiII i» numbered speces S/C Type or PrinC /egibly ? Tot 1. Date 2. Installation Cost 3. b Address ?Lot Blk. 3 Tract - .?Z_ 4. Owner -- _1? 5. Contractor Phone % _: - ? 6. Address ? 7. CitY -- State Zip 8. Building Type: Residential D( Commercial ? Institutional ? 9. Work Description: New ? Add D Alter C7 Repair ? ? 10. Describe I-)? Fuel Type ¢-// 11. No. F.quioment BTU - M. Ea. Forced Air No. EQUipment CFM Ai H dli Mfg. r an ng: Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outleu 12. I hereby certify that the above information is true and correct, and I agree to Comply with all ordinances and codes governing this type of work. Signed : for Rough Flnal lnspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-8100 Receipt PLUMBING PERMIT I CITY OF EAGAN ? - ' Permit No. Fee { 1 ?J Fill in numbered speces S/C ' ? Type or Prini legibly Tot. 1. Date ':'-1 2. Installation Cost ?C UF r ?? 3. Job Address r,?ot?_Bik.? Tract LC.. 4. Owner !` , i ,'(-1 14 - /10 5. Contractor Phone ?l _ 2 Z 6. Address ` ' 7 -i ,.--7-ar4 7. City jl e .y7yState .,) f/ .jne,,N. Zip 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New ? Add O Alter O Repair ? ( 10. Describe 1 11. No. ? Fixtures Water Closet No. Fixtures Cesspool/Drainfield j_ Bath tubs Septic Tank ? Lavatory Softner Shower Well L Kitchen Sink - Urinal/Bidet Qther L_ Laundry Tray Floor Drains Orinking Ftn. ? Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and 1 agree to comply with all ordinances and codes governing this type of work. Signed : ?x ? T / "'e' for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-8100 \ f Reoeipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee fill in numbered speces S/C ' Type or Prinr /egibty Tat. - - 1. Date ?,/? 2. Instailation Cost 3. Job Address ;"? Lot L"'Bik. Tract"- 4. Owner `'`/4?yt!-? Phone - ? ' 6. Address ?' ? .9 J ' ' ' ' • " 7. Gty State Zip - 8. Building Type: Residential,E) Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ? Repair 11 10. Describe r_-'- ,? •!_ " -• =? Fuel Type? - -? 11. No. Eauinment BTU - M. Ea. Forced Air No. Equiament CFM Ai dli H Mfg. ng: r an Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes i governing this ty.pe of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 . CITY OF EAGF1N Include 2 sets of plans, 1 site plan w/elevations & gUILDING PEFMIT APPLICATION 1 set of erierqy calcu.lations. onp- Date Zb Be Used For ?'ov cz -Lg.5 ? Valuation ? ._ E OFFICE U5E ONLY Site. Address ?.SO?.. Wa1n?Lan ? I,ot 4Q_ Block _L__ Sec./Sub. ??,,N?, or??orJ Esect ?' ? Oecvpaney ' . Zoning G Paroel # ; L (7 ? n C? e? ? Alte Repair Fire Zcane m?±-? E?.ar3e 'I? of-CA[15t- O??z -- move Stories Address; Denr?lish _ Front ? ft? ? ? . DePth City/Zip Code: Grade - Phone #: APPRaVAIS FEES Assessments Pernut ? l - Contractor: [?Tater/Sewer o? A` • 11: P li Surchar9e C?k D Plan Address: C?-z-? ?A ?r? n , ce o ? Fire a SAC ? s City/Zip Cbde: 1 L ?- Water Conn. .SD Fhone #: ?9???io1• ns planner - Wat.er Meter O Road Unit a5D 7 u _ 7 7_ 252- Couneil Bldg. Off./o- Sl Arch./ErYg.: - APC Adcll.ress: City/Zip Code: . . • - 'In?rAL Phone #: cirY oF EAGAI , . 3795 PilaR Knob Rood Eagon ' PHOHEs 454-8I00 BUILQING *ERMIIT To _be wed for _ 1 of 4 PLEK W Value $35,000 i Site # - ' MN $31 22 N° 8397 Receipt # _-? ? /U + aote August 17 _, 19 83 Erect ? Occuponcy R-3 /11ter ? Zoning (PD) R-3 Repcir ? Fire 2one NA Eniorgs ? Type of Const. v Move ? # Stories Demolish ? Length43_8 Ft. pu Addren i;oIISt. UTT1Ce Assessment Permit 113 •?U u? Cit Phone 777-4252 Woter & Sew. Surchorge 17•50 Police Picn check 107.75 ?Z Nome Fire SAC 25.00 L Address Enp, Water Conn. 4`n _ nn Ci Phone Plonner Water Meter 60. 00 Council Rond Unit 250.00 t hereby acknowledge thoT I have read this applicotion ond state thot Bldg. Oft. the iniormation Is torrect and ogree to comply with o!I upplicoble APC Total $1625.75 $tate of Minnesoto Statutes ond City of Eogan Ordirwnces. Sipnaturc of Permittee A 8uilding Permit Es [ssued to: Tilsen Hames, c . on the axpress condition thn+ oll work sholi be done in accordarxe with oppliGabl te o 'nne Statutes ond City of Eogen Ordinances. 8uiidirg OffiNol F • °f ' C? ?? ? t 0 CITY OF EAGAN Include 2 sets of plans. 1 site plan w/elevations & •: BUILDING PEFd4LTT ?nLICATION 1 set of enerqy calculations. i`'? - ore v??? afr ? Date -- Valuation 'Ib Be Used Fbx pFFICE USE ONLY Site Address ?N A.??? Erect ?''?`ncY z,ot ? Block ?c. /Sub. zortirq ? Alter t0 Fire Zone hane S = _ :a- ?- 3Z?? . ,.?,..? ,.. , n o "1- Bldg. Oft. APC . . ?,I,? 1 ZS - ?' Tnclude 2 sets of plaris? ?J CITY OF EAGAN 1 site plan w/elevations & BUILDING PEFdMIT APPLICATION 1 set of energY calculations- - o'ne Dat?e Valuation 3?b66 - Zb Be Used For pFFICE USE ONLY -•- -,??,.., l1AK-\1 A -t Pnone w: A ' ? - r J??' ? 1/v S Include 2 sets of plans, CITY OF F.AGAN 1 site plan w/elevations & BUILDING PERTATT 11PPLICATION 1 set of enerqy calculations. Date dne u n't+ - ? 'Ib Be Used For Valuation's3??-- -S ?? o U?.'? c?-? ?- _ C7FFICE USE ONLY Site AddreSs_. 0.1 B_- I?t BIoCk ?,3 SeC./Sub. 1iOE?J b?='M00 Erect occupancy --.-?? ZoniN Paroel G? S C? ?-7C? d? ? pwrier : . p,c3dress : A1teY' .-- Repair ?'ire Zone Enlarge TYpe ofConst. Move !_ # Stories ft. Derx?lish Front ft. Grade DePth ? - pOl1C@ Fire Eng ' - r .iw. ---- - . SAC Water Conn. Wat,er Metex' FiDad Uni.t '- Address: City/Zip Cade: ' Phone #: 'IC7I'AL ?)W R.ll Bldg. Off.Q" APC . Road Zontnp: t'UD Ownsr; Ti 1 se11 Mmea /lddresa: te /lddreas: e140 C1 AV - .aner umber: , r No.: .2 3 7/ A S. SJ?- Size: _..?'? k ir der No.: ,? ?y?w to emply wilh !iN Cihr of Eooom OnoMIIOM. ay J . of I . L L CITY OF EAGAN 3830 Pilot Knob Road P. O. Box 21199 Eagan, MN 55121 Zoninp: PUC Uwnsr: _ Address: Site Addi Piumber: 1 e0ree to aomPy wMh the Cil'r of Eo9e10 Ordinenat. By Date of Insp.: WATER SERVICE PERMIT PERMIT NO.: - 5040 OATE: 9 Q- -83 No. of untts: 1 of 4-pbex ConnacNon Chorqe: 450 - DD ;Ld- Account Depostt: Parn,ir Fee: 10.00 p Surcharge: .50 pd MilC. G10rol5: fin - nn pd 111P_fiRT ToMI; Dars Pcid: SEWER SERVICE PERMIT PERMIT NO.: 6127 DATE: No. of Units: ( Connectten Chorpe: Accourrt Deposit: Perrr,it Fea: 1?1.00 hd Surchorye: • St• ??? Misc. Choroes: TotaL• Date Paid: 5i1NER SERVICE PtsRMIT -? C17Y OF EAGAN 6126 ? 330 Pilot Knob Road p?IT NO.: ? p. O. 8ox 21199 DA?E: p 4 ?x Eaaan, MN 55121 k'41t1 No. of Units: Zoninp: 'Ii1SC?t tlOmeS ow"°r' loit s^ 11 ' Address: $401ii CIA LANL L3Kn site Address: ersu Plumber: I Oome [O 0O1* With 1h! CiRY of lOse" prdinoncss. By 415.()0 ?d ?nnecHon Cho?e: uM DePOsit: Acco ? permit Fee: Surehar0e: Misc. Charoer. Total. pote of Insp.: pote Paid: im I nsP.: CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road pERM1T NO.: P. O. Box 21199 9-6-5 Eagan- MN 5?5121 DATE: nf 4nlex PUD No. of Unirs: 1 Zoning: ner, •r . mss: te /lddroas: r P r: ? ?J ? S S 7 Connection Cha?s: 450 r No.: . `? /i - Nccount Deposit: S ; eader No.: A 5-6 Permit Fee: I a?re- to oomPh whb Na Ciep of legee $urcharpe: hn prdineaam _ Misc. CFwrpes: r Total: , Date Paid: BY pote o Insp.: ? 7 Z??! IMp.: CI I Y OF EAiaAN 3830 Pilot Knob Road P. O. Box 21199 WATER SERVIC PERMIT NO.: E PERMR •? •''' 1- Eagan,MN 55121 DATE: Zoninp: No. of Units: 1 rf 4n2ex Owner. "i ilsen f10mCS Addrass: Site Addron: 1811 Walnut Lane L39 63 i.,!cn AL.ddtion Plumiber. 'wgLa Anderann-R 41;?,; z Mister No.: Connection Charfle: 450.00 na $iu: Account Deposit: Reader No.: Permit Fee: ' '' ;ii} •. ? 1 agne to oowPly wifb Nw Ckr oi fayos 5urchorge: ..ri :) ttd "Rseaw Mlac. CFwrpes: f: D. 0:1 pd Btet e2' Total: ev Data Paid: TY OF EAGAN SEWER SERVICE PERMIT 30 Pilot Knob Road ?;1 ; c; 0. Box 21199 PERMIT NO.: gan,MN 55121 DA?: '-C-.'? 1'1« No. of Units: 1 0 4plex ning: mer. TSlS n 110t^e5 Date of Insp.: F'CITY On EAGAN i 3830 Pilot Knob Road ` P. O. Box 21799 ! Eagan, MN 55121 Zoninp: P(!ri owncr: 'T i 1 sen lfomes Add?ess: Stte Addrass; 1811 Wa In ut Z Plurnber: 3-17-33 34106 --`I 160.00 pd 8-I7-t33 38106 > -- s no ? 1 yn? to aoniPy wiNh t6e Cihr of Eage¦ Connection C]+arps: ..42?.?1d- 1 gem M aamply wilh Nw city °f i)J Ordiaaneas. Atcount OepOSit: ? ?O?O? IOV.UD ?ionCho?po: 42i , (lr1 ?ld PermR Foe: 10. 00 ; x3 Nccount Deposit: Surcharpa: •? ? "'d Permlt Fes: 1l' . 3(! ;,3 gy Misc. Charyes: BY Surelwrpe: Date af Insp.: Total: Date of Insp.: Misc. Charpes: Insp.: Oatt Daid: Insp.: Total: DoM Potd: SEWER SERVICE PERMIT PERMIT NO.: r; l 2•s DATE: J-6-33 No. of Units: _ 1 ?= •'? ji 1 eX I CASH RECEIPT R6CHI V BD CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 AMOUNT $ I & DOLLAR$ 1 ea ? CASH E]CHECK ROR - ? j' White-Peyers Copy Yellow-Posting Copy Pink-File Copy Th You BY Thusrequestvoid ` - Z- C) (?qc)' CdL Y"- ?b q 18 rtwn[hs from M4Q83H3 Ua,sa Feqaest Date Fre No. Nouph-in Insuectiun Hr rted' ?Ready Now? Will Notify Insoec- 9-?6-1ge3 ??os ?Nu [or Whan Ready 'ftLicensed Electrical GonVactor 1 hereGY oaquest insPection of ahova ' ? Owner electncal work instellad eY Street Address, Box nr Raute No. City 1809 Walnut Lane Eagan ecLOn o. Township Name ar No. A?nUe No. Cowny Dakota Occooant (PAINT) Phone No. Tilseri omes Power SupDlier Dakota Cty. Electric Co. AAAress Farmington Electncal Comracmr (COmuany Namel Cont0602s License No. A4 O.B. Thompson Electric Coo MailinB Address (COntmctor or Owner Makanp InsiailaboN 12201 Mt iva., Mtxa 55343 Auffior¢ed Sig tv Contractod(?Wner M g Ins atnI ? Phone NumOer 933-2521 g MINNESOTA STATE BOARD OF ELECTRICITY ? 1^1s Irvsrtcuurv ntuursi witL rvuI Grie9s-Midwey 91de. - poom N497 aE ACCEPTED BV THE STATE BOABD 1821 4niversity Ave., St. Peul, MN 66700 UNLESS PNOPEH INSPECTION FEE IS Phone 16121 297-2111 ENCLOSEO. REQUEST FON ELECTRICAL INSPECTION EB-00001-09 See inshuelwns for completing this twm on back ot Vel low wOV. ? „lO ?W rk Co?red bv lhis Heouest 3$? ? 7 Ada Fev. Typa ot emlrmp Avolunces wired Enuiumenl Wired X Home Range o00 Tempo:ary Service Duplex Water Heater 00 Ligh[iny Fixtures Apt. Buildmg Dryer Electnc Heatin Commercial Bldy. Furnace Z. Silo Unloader Industrial Bidg. Air Corditioner Q, 0 Bulk Milk Tdnk Parm hP? -? omer ?soc?.?ev? t er Pecify t cr Other p Fea ServlceEntrence5ize p Fee FeaAws/Subfeetlers # Fee Crtcurts 0 G10.0 0 to 200 Amps 0 to 30 qmps 0 tn 30 Am s Above 200 Arnps 31 to 100 Amps 31 to 100 A s Swimming Pool Above 100_P.mps />bove 100_AmYs 7ranstormers Irrigation Booms . Pertial-'Other Fee Signs Specfal Inspection 00 $43 AL FEE flemarks llirtk HRLZ • .rf .-.?1 Nou9h-m -- Date v - ? i '??? th? ricalV ? ns ector, hereb t }y th h above 34?j?/ spechon hes Eeen final i _/_!? l ae. tliis repuest voi018 montls irom Th,s,e4..s, va,d q-Zn L 34 , 331 EdiLv\ 3g?? y 18 months tmm 0838 UU Rzques[ Date 9-16-19s3 Fire Na. on Roue??-?nspec?? pe u red?.I es ?NO mv ?Ready Now LyWiII Nnuty, InsDec- tor When ReadY ? Licensed Electncal Contracmr 1 hereby requast mspectwn ot ebave - e?e??nrni wnrk instelled at: $treet Atldress. Boa or Route No. C?ty 1811 Walnut Lane Eagan ecl?on o- Townvhip Name or No. Fanyn o. County Dakota OccuOdnt (PFINT) Phone No. Tilsen Homes Power Su00her Address Dakota Cty. Electric Farmington Electncal CnnVevtor ICompeny Namel Comracmr's License No. A40602 0>B. Thompson Electric Co< Madm Add ess IContractor or Owner Ma 55?343ailabon) L4tk Bl d ? a v .? 1 Mtka 122 Authoraed S 5fw re ICmntractor Ownng 9G y MINNESOTA STATE BOAND OF ELECTNICITY ? BE ACCEPTED eY TME STATE BOARD GrigBS•M,dway BId9- - poom N•197 UNLESS PflOPEP INSPECTION FEE IS 1821 Univarsify Ave., Sf. Paul. MN 66104 ENCLOSED. Phone I6121 297-2111 REQUEST FOR ELECTRICAL INSPECTION EB-a0001 -oa ? ?. '' Sea inatructions lor com0letinq <his torm on back of Vellow copv. •v?•?..?11,;.? i!Y 4/..i?C.i h?. TAie Ranrrueir 1 7 1001 isei Hdd Rep. Type ot BmlCing AoPliancns Wiretl Equipmenl Wved g Home Range 5if Teinporary S.rvice Duplex Water Heater Liyhtiny Fixtuies Apt. Building Dryer Electric Heatiil Commercial Bldy. Furnace • Silo Unloader Industrial Bldg. Farm Air Conditioner 2, 0 8ulk Milk Tank iner ISUeuWI t e Suculv Ot er Other ?.vu p r+iinc ? io Fea po ........ . .... ......... SenvICeEntrence5ae u Fae Feeders/SuOfeedars Fxe Circurts (t 10.00 0 to 200 Am s 0 to 30 Am s • 0 to 30 Am s Above 200 qmps 31 to 100 Amps 31 to 700 qm s I Swinvning Pool Above 100-Amps Above 100_Amps I Transiormers Irrigation Boorcis e Partial-'Other Fee Signs Special Inspecuon $43•00 T l F Re marks Dick Hall -L FouOh-in aaa?,,tt¢¢¢ mal msoector, neroby certdy thal the above Final D ? ? ? i pecLmi has been ?e. This roQUeaf voitl 18 montnsfwm ? 5-97? ---7 UFFlCE USE ONLV This reqoesl void I 8 monMS kom vaiioouon ., n e med in mnsnox ?V , l ?? ? ON lIlIIIIIUIII IIIIIIII?I ?I ? IIIIIII?II / l111UU U ?K 0 4 4 0 5 7 6 7* PLEASE PRINT OR TYPE Requesi Oote Roughin inspecfon reqviredx [] Yes ? N. Inspec?ion 01her Than RwgMn ? Ready N. 0 Will Coll [Yw mus? mll ihe mspecror wfien reody) Dare Ready. icensed contmdor ? owner hereby requesi mspection of the above electriml work at I , fe No I Job Address [Streeq 8w?, or C?ry Zip Cade u:. I s $eceon N. Township Name or No Rorge No. Fre No ^M Plwne N. Occ . upont ?o Y?C9 ` power Supplter Address ? Elecr, Conrcacror (Campany ) Connodon ccenu No Ma.ier 6c N. (Plant Elecr. Only) ?.. ,yi L/rg?AdJdresIs (Cronha<?or/p??_.??nar Pedorming Insiol eon) ? ? ? ? ? /'?°?`? L ?rI Z pywneNa. Au?M1 d Siqnalure IConvonor or Owner Perfoimtng Insmllalion) ?.. .n B e I a n n 0. . ? A1 n 1 1 1., . .. .?. _ E8-0D001 11 8/96 STATE BOAH PY - SEE P13THUCiION$ ON BACK OF YELLOW COPY 44 57E ?/?9?7 ? REQUEST FOR ELECTRICAL INSPECTION VIAMinnesota State Boartl of Electnciry 1821 llniversiry Ave., Rm. 5-128, SL Paul, MN 55104 = Phone (612) 642-0800 Home Duplex Apf. Bldg. Other. ????? New Addn ommeraal Indusfrial Form Remod Re air Air Cond. Htg. Equip. Wa}er Hh. Load Mgmt Other Dryer Range Elec Heaf Temp. Service "X" obove the work coveied by ihis request Enter remorks in this space ond on fhe back of the whiie copy only Calculofe fnspecfion Fee - This lnspechon Requesf wd) nof be accepted without Ihe correcf fee. Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Mo6ile Home Pork Sfall 0 to 200 Amps 0 to 100 Amps Streel Ug./Traffic Sig. Above 200_Amps Above 100_Amps Tronsformer/Genemtor INSPECTOR'S USE ONLY TOL Sign/Oufline Lfg. XFmr ? Alarm/Remo}e Conirol Swimming Pool I -"" I hare6 rnm 5 ed the elpcmcal irsmllahon dattnbed herein on the dore+sroled rrigafion Boom _ Raghle , /? Dp1e Speciollnspecfion f T I[IV82119OhVE F¢B HIS INSTALLATION M Y BE O Final paye ?( ` RDE E ISCONNECTED OT COMPLETED WITHIN 78 O THS. jYc:W ey- 05 39 ,/? /? Request Date ire N. Raugl+-in Inspection Reqwrad9 N peatly Now O W?II Notiiy Inspector + 06-02-93 y ?ves pNo whenReady 1X hcensed contractor ? owner hereby request mspecnon of above electrical work at: Jab Atldress IStreet Bax ot Raule N. ) 1809 Walnut Ln. Cily . EAGAN Section No Township Name or No Range No Gounry Occupanl(PRINT) Phone No 452-8925 Lois Johnson POWBf$IIpPlIB! Addl086 Dakota electric,CO. Elec7ncai Conlracto, IGOmpany NAii Contractor§ Lwerise N. Brandon electric,Inc. CA 00307 Maihng Atlcress (GonVactor or Owner Makiog Installenon) 7701 Colfax ave.NO.Brooklyn Park,MN 55444 AN ignatore IComremor/pwner kng InstaNauo???? ^ Phona Number - 560-5311 MINNESOTA STATE BOARD OF EIECTFIQTY TMIS MSPEGTION FEQUEST WILL NOT 47^ BE ACCEPTED BV THE STATE BOARO 1821 Umversiry Ave.. S[ Paul. MN 55104 A? UNLE55 PROPER INSPECTION FEE IS V ENGLOSEO Phone (61E) 642-0800 EB-00001-09 REaUEST FOR ELECTRICAL INSPECTION /,y?? -3 Z V//?/( O ? See insVUCtrons tor compleLny IDis brm on back of yellow copy 5y'y J?y?? ;?en`.+ ?- 3?9 3 0 5 ,x" Below Work Covered by This Request Equipment Wired ?,?,? q Typeof8 Id 9 ? anc W etl ? Heater Farm olner (apecdyl Inspection Fee Below' Other Fee mna P001 Booms IOther Fee I I, the Electncal Inspector, hereby certily ihat the above inspeciion has been made JFFICE USE ONLY f15 request voitl iB monihs trom Wiring A/C Circmts/Feeders Fee eSize Fee # Oto10DAmps 0 to 20q?Ve 100 - Amps q Servroply Above Amps (rornL $15.50 ?speclcr's Use I ? t MAY BE ORDERED DISCONNECTED IF NOT THIS INSTALLATION C Thiz:..ouest vo?d C( -ao La$, g3? ?d3g(i `f ,ami„uns,rom u^ e--,. Wp 083891 7°" Request Date FIre No. Re uhredt nsVectwn ?qeatly Now$?^1lIf NoLfy Inspec 4 9 i6 1983 :aYes ?No mr When Ready ]M Licensed Electncal ConVac[nr 1 hereby request inspechon oi ebove M 0 BIBCtfIC81 wOfN If151811BO 9,. c eox or Poute No. Street Address. City 4401 Clover Lane Eagan ecinon o. TownsriD Nome or No. Fenge No. Cow rt y T _ '- Ltl60ta OccupnntlPRINTI Phone No. Tilsen Homes Power $upDher Atldress Dakota Cty, Electric Farmington Electncal Comramnr JConiu.ny Namel Contracmr's License No. Aq0602 O.B. Thompson Electric Co. MailinB <.ddress IComractor or Owner Makine Installavonl 12201 Mtka Biva., a4tka 55343 Author¢ed 5 a re (Conuactor/Ownk?ny I? ? tmn) Phune Number 933-2521 ? J , eeT WII I N(1T MINNESOTA STATE BOARD OF ELECTNICITY V BE ACCEPTED BY THE STATE eOAAD Griggs-Midwey 91dg. - Room N-191 UNLESS PflOVEN INSPECTION FEE IS 1821 UmvarsiiV P.ve.. St. Paul, MN 65104 ENCLOSED. Phone (612) 297-2111 REQUEST FOR ELECTRICAL INSPECTION EB-00001.04 u ? See inelructions tor comOlelinB thie lorm on bock ot yellow copy. Thic Raniiac/ ? Oco W Add Nap Typa nl Bwld,n0 APplmnces Wired Equipment Wved Home 7p( Range ??Q Temporary Service Duplex Water Heater Liyhtiny Fixtures Apt. Bwlding Dryer Electnc HeaUn Commercial Bldy. Fumace . Silo Unluader Industnal Bldg. Air Conditioner 2 Q Bulk Milk Tenk F2rm ??' 00 ihe? ISUer.?tyl thnr ucufy Other Othur ...,.. p ,y...,, ,..., Fee ? ................ _._-_ Sarviee EMraneeSize fl Fea Fexders?5ubteeders N Fne Circurts jJ 1QeQ0 b to 200 qm s Above 200 qmps 0 to 30 Am s 31 to 100 Ainps '? e ? ? tn 30 Am 31 to 100 Am Swimming Pool Transtormers A6ove 100_Am s Irngation 8ooms o Above 100_Am s Partial-'Other Fee signs specia? ??spection $ 43 00 a ? Remarks ' 1C1{ H8?.1 ? 1 c RooUh-in ? /y / ? / ???e 1. V ncel' InsOactoq hereby V carUiv that tha xbove Da?e. ecUOn has been F?nal 0de. C? •f ? ThLa reauest voltl 18 manihs Irom REQUEST FOR ELECTRICAL INSPECTION r EB-00001-04 ' See inatruc4ons for rompleti ng this form on back o} yellow copy. "X Be/"ow !'??r??overed by This Re4uesl A;id ReP. TYpe of Bu?ld?n9 APVlmncns WrteA Euuipnient Wired Home Range 5.00 Tempora.'y $ervice Duplez Water Heater Lightiny Fiztuies Apt Bwldinq Dryer Electric He2tin Commeraal Bldg. Furnace e Si!o Unluade, Industriai Bldy. - Air CondiLOner . Bulk Milk Tank Ferm J u ?tDi j°D ehe .00 Omc, isn?=ntvi ?her ISVecrty Other Othi.r M Fae ServwaEnfranceSize +1 Fee Feaders/SUhfeeders d Fae Cvcmm Ampsl I I ai to iuu Amps I I I 31 to 100 ann.,? I "9"? sUeaa I InspecLOn Rem3rks S 43,00 T FEE fl `r1 Rouyh-in D?:z ' Inspactor, he?eby Fnal - carLfy that the above O f ? nsoection has baen ed e. Thisrequestvoid a-ZB L3-7 L 63? ?a.E_ V\ 3g•?O?p// 18 months from 4rq083RS4 Re?ues[ Date Fre No. Rnuyh-in InsUection 0-2 16-1983 ? qPuired? 34?Yes ?Nn ?Reatly Now [[?ill Nouty Inspec- tor When Rautly 1 hereby requxst jnspectian oi above ? Owner oio?.....e? ..._.?. .'_'_ Stree[ Address, Bax or Rnute No. iv 4401 B Clover Lane Eagan ecUOn o. Township Name or No. anBe No. County Dakota OccupantlPRiNTI Phone No. Tilsen Homes Puwer Supplier Adtlress Dakota Ctye Electric Farmington Electncal Conva"or 1Company Namel O.B. Thompaon Electric Co. Comrar,tnr's License No. A40602 Mailmg Address IConVacmr or Owner MakinO instailabonl 12201 tuTtka Blvd. 0 I+4tka 55343 Auffionee? S(gna?are ConUactodOwner Makfp Ins[ul tio I ' Phnne Nwnbur r 933-2521 . nUHnU Ur cLccIniciTr G I^ib l^+srccnurv xE4UEST WILL NOT Griggs-Midway Bldg. - poom N-197 BE ACCEPTED BV THE STATE BOAflD 1827 UnivarsitV Avx., St. Peul, MN 55104 UNlESS PflOPEfl INSPECTION FEE IS Phona 1612) 297-27 71 ENCLOSED. : 2004 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan p.? 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 4&"Wt New Constructlon Reauiremenfs RemodeVReoairReauirements " 3 registered sita surveys showing sq. fL o11oL sq. ft. of house; and all roofed areas 2 apies of plan Cer?" R (20%maximum bt coveiage albwed) 1 set of Energy Calculations for heated addPoons 2 copies of plen showing beam & window sizes; poured found desgn, etc. 1 site survey for additions 8 decks res? `? ui? 1 set of Energy Calalatlons Addition - iiMlcete ifon-site sepfk system Qn,-s?g( 3 copies ot Tree Preservatlon Plen'rf bt pletted after 711193 Rim Joist Dehail Options selection sheet (bklgs wBh 3 or less units ?t Date ?/?-0 ?/ 01 Construcrion Cost ?1'J?? ,?, ? Si[eAddress `1`yiSk CkQIb? UniUSte # Description of Work ?n ,C]Q f`i A' ? Ly LA,.1N !?A ?S ?J? i (? 1?C r ?l?n ?.1QkM ? ?J • Multi-Family Bldg X Y_ N Fireplace(s) _ 0 _ 1 _ 2 Property Owner M'E; Y".-e'` Telephone #(LqS I) 4 S o? '4 o`Z I q RMA HOME SERVICES, INC. Contractor Home Deopt Installed Sales ndaress 3200 Cobb Galleria Pkwy.Ste. #200 c'ty State Atlanta, GA 30339 Telephone #( ) 763-542-8826 BC-20268257 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeory 1 Minnesota Rules 7672 Energy Code Category . Residential Vantilation Category 1 Worksheet • New Energy Code Worksheet (Jsubmissiontype) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Telephone # ( Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( I hereby apply for a Residential Building Permit and aclmowledge 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 State of MN Statutes; 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 appro al of plans. plicant's Printed Name pplicant's Signature^ Installed Siding and Windows LIMTTED POWER OF ATTORNEY CUUN1 Y OF COBB STATE OF GEORGIA KNOW ALL PEOPLE BY THESE PRESENTS: THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania ("Principal"), and a licensed contractor of RMA Home Serviccs, Inc., DBA Home Depot Installed Sales locr±ed at 660 Mendelssohn Avenue North, Go1.de^ Val?ey, MN 55427, having a license number of BG 20268257, do hereby appoint, name and constitute Elder-7ones Building Permit Service, Ina ("AgenY') as my true and lawful attorney-in-fact and do authorize and grant said attorney-in-fact for me and in my name, place and stead the power to execute, acknowledge, sign and deliver (in such form as may be required by the municipality) a permit application, or any other instrument(s) which may be necessary and appropriate, in order to obtain the proper permit(s) from the City of Eagan, Minnesota for the installation, maintenance and repair of windows and siding (the "VVork"). The powers conveyed to the Agent by this Limited Powe: of Attorney are limited solely to the express powers delineated herein and apPiy solely to the Work. This Limited Power of Attomey shall expire and automatically be revoked on the 21 st day of lbfay, 2004, which date is one year from the execution hereof. Further, the powers conveyed by this Limited Power of Attorney may be revoked by Principal at airy time by express revocation and shall also be revoked by the PrincipaYs death, disability, incapacity or incompetence. IN WITNESS WHEREOF this LimiYed PoNver of Atrorney is ?.aecuted this 21 st day of May, 2003 ? e David N. Katz SWORN TO AND SUBSCRIBED BEFORE ME by David N. Katz on this 21 st day of May, 2003. Notary P aic in for the State o'eorgia My Commission Expires: January 21, 2006 396816 v3 Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor. 3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPOT ?O y p b? 2004 RESIDENTIAL BUILDING PERNIIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reouiremenffi RemodeVReoair Reauiremenfs 3 registeied site surveys showirqg sq. ft. of lot sq R of house; and all roofed areas 2 mpies of plan (200h maximum bt ooveroge albwwetl) 1 set of Energy Caiculatiore for heated additlons 2 copies of plan showing beam & wintlow sizes; poured found design, etc. 1 sfte survey tor additions & dedcs 1 set oF Energy Calculations Addftn - irMicafe Hori-sife seAtic system mm 3 copies of Trae Preservation Plan if bt platted after 711193 Rim Joist Defail Options selection sheet (bidgs with 3 or less unifs Date Q6 / Site Address ? UVa4c G Construction Cost /// ?- Unit/Ste # ?---?'r'? Description of Work Multi-Family Bldg \ZY _ N Ftireplace(s) -)<?o _ 1 _ 2 ProperTy Owner Telephone # ( ) ?- Contractor Address State vy/n/ City //tJ- /lrG Zip 5 .S?/C) Telephone # (6!;-/) ? ? - ??v7G COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - TvIinnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 Energy Code CategOry . Residential Venfilation Category 1 Worksheet • New Energy Code Worksheet (Jsubmisslontype) Su6mitted Submitted • Energy Envelope CalculaNons Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( Telephone #( rD I hereby apply for a Residential Buiiding Permit and acknowledge that the informa ' n is complete and urate; that the work will be in conformance with the ordinances and codes of the City o ' e tate of MN Statutes; I understand this is not a pernut, but only an application for a permit, and work is not to start without a pernut; that the work will be in accordance with the approved plan in the case of work which requires a review and appmval of plans. cn A i ApplicanYs Printed Name Applicant's 5ignature Building Permit Application Date R- 5 -?b _ permit iF --- Owner'8 Cunl ra c lor's Name Name Owner'e Cuntrector's Addrese Addrese The above named applican[ does hereby apply for a building permi[ [o perform the following described construction worl lo wiq ?T--Silik- -'V-s2Am 1`u ?14-A f!'tTA0?L7 1-S-tn52? `??iAME. C A62A6'?-'` lBrlaflY dwcdW wark W W dono, Sush u; 1o buSW Y?torY /ram* houN 6nJ otlatAq l-,brY fr?m? p?y?, pr ? J mnm? 4uuw1 Address o! Building Legal Description 1?GCj + I?-,I I W0. nJ'1' Ln1he- LOLS Hlk. Additlon a401- raqotg C-wkrtT- lar\e 3-7,31B,3q,90 ? tEDENJ ?nfl;fi?o?; Set Backa (Minimum) Occupancy (Structure To Be Used As) Left Right Rear Front -•-?-? --- - . ? . . Valuedon . C r C LGVEQ. L-AuE v ` E?< -72-94 q ? 7L . . ? ??- ? • • ? 3? . . . . . ? 3? ? . . , ( . . . . . , . . , / . . . ?e?,? . . . ? , . . . . . ? ?%/i?? ?• •q •?? ? ? ,?-? / . . . . •7 : ? ' .rii/? ,i • . AL.AW EL.. ? 2- . . ? „ •., ? r,?? % ? . . . . . \ \?_'' -` ' ?? , `/ ? ` • • • ? I• ? ._, . . . ? . . . . . . i . ? . . , ^78 9'7' . E ?14 a . . •? ?. . . L.. t16? 62 -6 E 9qo.? . . . . . S . . . . . . , W AtN vT LAN E PLOT PLAN Show rtrceta, lot dlmensiona, eet backe and dimertolone o( Wtting and propoeed 5tructurq. ..'.. 1..11. _k2% _ • 6lmatum ot AooUo.ot -' youse Sq. Ft• _ Garege Sq Ft.- Ydnn1 t Suxcharge 947.5 Plan Check uriveway MWCC SAC WAC ; Fees f. 18ixnAWn W ApProvlns 0111641l OvIE' lJN rT GV- i?LEY; ??;A`?te ? t? i"T ) , EX'PENIOR liNVELOYE SPACB "U" COMPU'i'ATLON • ?', ' (To be submitted with building permit application) bs ^ )ne or Cwo family dwelling Owner N1C>C? All other _x Site Address ?,'UAll_tJ OT ?_atiC-_? ?a1 CLOUEf? 'ontractor T,L?'>EN; ?ONI?-> :s.1JG• Date ?;-5-k;?j Phone LINEAL FT. OF EXYDStiD WALL a4 +24 + + ++_X';?q ft. above•grade= (a I -1a S tfT('DERt1U?t ? TOTAL EXPOSEU WALL AR6:A 5Q. FT. ' )PAQUE WALL CONSTRUCTION: "U" Value X area "U" X sq. ft. _ (U) (A) ?j _ "U" sCp4q.X aq. ft. ?i3 5.? = Z(o•3 (U) (A) _ Detail reference llU" X sq. ft. _ (U) (A) from "U" X sq. ft. _ (U) (A)' attached sheets r?1CQ E-rE P,l C-EK "U" sq. ft. (U) (A) "U" X sq, ft. _ (U) (A) nUn- X sq. .ft. --(U) (A) WSNDOWS: "U" VALUE X AREA iNb??1S'a KOiC-3E? kGi.B& Nake & type .1 11 DOORS: "U" value X area _ 2g.3 sq. ft. = 2Q•O sq. ft. = Sq. ft. 1..0 _sq. ft. •. = sq. ft. = sq. ft. = sq. ft. 2?.!] (U) (A) _ (U) (A) _ (U) (A) Make & Type 'l n = (U) (A) ?? ?? (@ ?t-XloE ..? U X sq. ft. ZY).G ^ 'lUll X sq. ft. _ (U) (A) It ?? - "U"? X sq. ft. (U) (A) ?lUll X sq. ft. - --------------?li) (A) (U) (A) VALUES _ •1O7 TOTALS sq. ft. (U) (A) D 6Y TOTAL WALL AREA (o*-?? 0 AVG. "U° F. "U" .17 or less for 1&2 family dwellings .22 or less for all other buildings ON FP.AMING ' R-Value ? f ao.?2 CA q ?.It"?EFi?' W? CL•MR??RTk'b??U?? .3?, X sq. Ft. X sq. f[. "U" X sq. ft. • "p": X sq. ft. , y . . ut?j+= v tirv?'t r' ROOF/CEILING: TOTAL AREA: sq. ft. ??Uu? S X sq. ft. ?7ti•0_= (A) Detail refexence . _ ?? ?? X sq. U ft. -- (U) ------- (A) rom f --- ' (U) (A) . - -.-_ u?n X sq. ft. - attached sheets (U) (A) U"X sq• " ft _? _---- Describe openings _ ? (U) (A) X sq. ft. _ in roof „ VAL UES 114 TOTALS " ft (A) -TOTAL (U) (A) I DIVIDED BY TOTAL ROOF/ 5r16, Q CEILING AItEA AVERAGE "U" .OS for ventialated roofs . .10 for all other conatruction ROOF/CEILING: NOTE* R-value L ? Ai'R --? z._;h?c L-MLnQ M 3._CF??? M •'?2. 4. _?-r.' • ^?_A ? R G,.1 5' ? .?? •? 6._ 39 -? - ?- If average "U" values as calculated above do not meet the Energy Code Requirements, the "Alternate Envelope Design" as outlined in SBC 6006 (g) may be used. Additional sheets may be'used to show calculations. r -,r ?. 1993 MECHANICAL PEjtMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 6814675 PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. NEW CONSTRUCTION ?C ADli-uiv aic ADD-ON FURNACE DATE HVAC: 0-100 M BTU ADDITIONAL 50 M BTU GAS OUTLETS (MINIMUM 1 C$3.00 EACH) ADD-ON/REMODEL (Ex1sTiNG CoNS7RUCi'ION) STATE SURCHARGE, TOTAL SITE ADDRESS: OWNER &y . er?S ?- /-z FEES $ 24.00 6.00 $ 15.00 .50 ? /ll TELEPHONE #: `?"K- ADDRE : ?C/?ZI ??G?m?? Cer- CITY: ' STAT?i /,/-r?L ZIP CODE: TELEPHONE #: ll Cl ? 7 CITY USE ONLY LOT b ? BL 4- RECEIPT N: 7/ '?J g a, SUBD. ef-G(R.v,-- RECEIPT DATE: Ww 9/ 1997 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PfLOT KNOB RD EAGAN MN 55122 Date: (612) 681-J675 ???? Complete this section onlv if vou are installine HVAC in sin2le familv, townhome, or condos that are under construction and are not owner /occupied. • HVAC: 0-100 M B T U $ 24.00 ADDITIONAL 50 M BTU 6.00 • Gas outlets ( m;n;mum of one required @$3.00 ea.) • State Surcharge: .50 • TOTAL: Complete this section oniv if vou are remodelinE, addinE to, or repairing eaisting sinale familv dwellinas, townhomes, or condos. Add-on furnace ? Add on air conditioning Add-on air exchanger, i.e. Vanee system, etc: = Other Minimum fee applies to all remodel or add-ons of existing residences . $ 20.00 S*zte SurCh2rge -50 Total: $ 20.50 SITE ADDRESS: OWNER NAME: INSTALLER NAME: STREET C?TY: WI As . . PHONE #: _ PHONE #: ?? (?i a X VZ _ STATE: ZIP: S[G TURE OF PERh[ITCE T9-lv47 ? 2008 RESIDENTIAL BUILDING PERMIT Date: I '& / - U? Stte address: 7enent: ------------------ ? -75 a ? Permit Fee: /?• rJ V i I / I j Date Recaived: ? I n ? I i s?arc: [i i APPLICATION ci?4 (r&cs''q,? ? rlinf k n( ?``I '/s - o e Sulte S: RESIOENT / OWNER Name: `,C- i4J Phone: Address i ciry / zip: Applicant is _ Owner 4 ConVac[or TYPE Of WORK Descxiptlon of work: Pf, r Construction Cost: L? 00 Muld-Family Buiiding: (Ves / No CONTRACTOR r ?./ Name: ? d m?[ 1-yn40?UJ2+n s ticense #: 2 o?I7 Address: SY0A s/ Z/1.1- _ Gry: rwr? ; `rlvc1 1i state: 0711) ,rp: -S?z Phone: Contact Person: K?CJ?' C,V??LS COMPLETE THtS AREA OPILY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 Energy Code . Residentlal Verrtilabon Category 1 Workshaet • New Energy Cade Worksheet Category submined Submitted (4 submisslon type) • E^er9y Emelope Celculadons SWnnitted In the last 12 months, hes the Gty of Esgan iseued a permit for a simllar pian based on a mastar pten? _Yes _No If yes, date and address ot master plan: uce,sea wumber: Phone: Mechenical Contractor, pryone: Searer & Water Contractor: p?wne; , NOTE P/ans and akpporr?l?rg docerments thafY4u aut+nr? e? caA?dered,tab?a prrbi? 1r?tomraNar? 7?rtlnr+s »t the InMrEeraNan r{taY be class/t&tdas;naf• p t tb dlc d y m tt? r vlde sq?FNc ea?sor+s !?t would pQrmlt7fi?e C/ry t?r - o y ? ? .. i ?( ? ? .? y . v C?D l'? ?/?RI/R??/iR W P h?? ? hew ? + <.. I hereby acknovAedge Mat Mis infwmation is complete arW accurate; that the work wlll be in conformance with the ordinNnces and oudes of Ne Ciry d Eapan; Mat I understand this is not a permR, but only an apphca6on fa a permit, and work is not to st with ui a pemtR; that the work witl be in accoNance with the a?oved plan in ihe case of ak which requires a review and approvaM x iS x A pplicant's Printed Name AppIfcaM's Signature Page 1 of 3 From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:41 #582 P.047/079 Use BLUE or BLACK Ink Abb. t For Office Use _ I 1 I Permit I I City of Eap 1 Permit Fee: i O I I I 3830 Pilot Knob Road I pt 1 I Eagan MN 55122 I Date Received: I t Phone; (651) 675-5675 Fax: (651) 675-5694 1 staff: I I I f, 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 2013 Site Address: I RQ9 11811, L44 LIL AB WAhlf L_OiU Unit ~'n {{~~ID r ` ~j Name: l~l~l~i l t ly~ 010' ~OISSP.L*1 C~YYI~i Phone: i Resident/ /city /zip: 3g C/I W1J~ ~Ykwow PGAW WAIYI f MN %3414 owner ' Address M Applicant is: Owner Contractor Type of Work Description of work: -Tim Dff Qr4 ye-VO Construction Cost: 1 Itnhm-oo Multi-Family Building: (Yes X /Nom Company: 1T~tft W tul.ll n { mTn& L Contact: (Jac 19 Contractor Address: 51y5 Mau&lcu Si rty--r 4 le City:.__hWG lain State: Myq _IIZ,iipp: Phone: gyy~L IySN License Lead Certificate NAT- 2-LAV4'-'0 If the project is exempt from lead certification, please explain why. (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months,.has the City of Eagan issued a permit for a 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: i NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of ~a 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.oro 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_ ftad x ' f `dot Applicant's Printe Name Appli nt's Signature Page 1 of 3 From:ALLSTAR CONSTRUCTION 19529427464 02/10/2016 12:57 #301 P.007/022 *City ofEaQall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: J© Permit Fee: Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date:Q'ddllr Site Address: /O9 4/1 u✓ 4lvl /4 / 114e/' iG ..... _..._... t ,3 Unit *• Resident! / - G 4 Owner Address / City / Zip: de -o, � �� G4tltc /y�OJ 6441/1-r�iG Owner )( Contractor Type/ 1of Work Description of work: '-.5 1,0 r44 1/,Cn y/ 5:47/ss Name: 404VA /VA la - 4-6E/J f/OA Phone: /11/4 Applicant is: Construction Cost: lo?oj 4006 Multi -Family Building: (Yes "o ) Company: /41(514L d di'tYa 011 inity;11161211 t Contact: "i4 r A ri i,� Contractor Address:S/-S I r dw34-riA 1 s?< ��t,=f X03 City: Mfrp PLi rr dl State: 17114 Zip: 55359 Phone: '9V^7416'f Email: s%t%PJgGZ-!/S- ,r• License #: BIC 6/0.3S 0 Lead Certificate #: A/f/41-- a?® q , V " If the project is exempt from lead certification, please explain why: AL k -r r"4 /983 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: Fire Suppression Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of 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 Cali at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall,orq 1 hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that 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 Buiidin ,`mt . mpleted within 180 days of permit issuance. x Ul lIi,na x Applicant's Printed Name Applic$nt's Signature Page 1 of 3 ®, 1 • f fEAGAN 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 1 FAX: (651) 675-5694 buildinginspections(o)cityofeagan.com --------------I For Office Use I I Building Permit #: I I I j S&W Permit #: I I I Permit Fee: I I I I Date Received: I I I I I I Date Issued: t---------------------' RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: �h qZ?W3 Applicant is: ❑ Owner JELContractor t Homeowner Type of Work Building Contractor Sewer & Water Contractor Unit #: Name: EGCe�A �oVkAe_ (�D� -�j �t-r�5c�CX Or, k Cb l� Address: `/yoQl� City: i;;-a 0.y,, State:M%Wip:55122 Phone: Email: Description of work 9 ,—, QQ C, t - Construction Cost:J l �,q �21 Type of building: Compan T7Q� l/ :S&:y- �Contact: �J�`� �✓ Address:( f�i ��1 W ��T Btl=\AZ V ? City: ,Qe_V VG���' StateAwip: 5_37 T Phone6t z-.211Emailt_a/Ul2 �C �e �CSN`�'�"A �l -��oz�� r� License #: � i? .Expiration Date: .7F/ �% /L S Company: Address: ❑ Single Family ❑ Townhome, of units Twin Home Required for State: Zip: Phone: new construction Contact: Email: License #: Expiration Date: City: I understand that Plumbing, Mechanical, and Fire Suppression work require separate applications. NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they L.9re trade secrets. CALL BEFORE YOU DIG. Contact Gopher State One Call at (651) 454-0002 or www.gopherstateonecall.org for protection against underground utility damage. Contact Gopher State One Call 48 hours before you intend to dig to receive locates of underground utilities. 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. /1,1 V + x Applicant's Printed Name A licant's Signature