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4411 Clover Lane Use BLUE or BLACK Ink Fot Office Use I G, I I Permit City of Eaun aIl I I I Permit Fee:. 3830 Pilot Knob Road + 1 Eagan MN 55122 Date Received: Phone: (651) 675-5675 t I Fax: (651) 675-5694 i staff. L--------- 2010 RESIDENTIAL BUILDING PERMIT APPLICATION C Date: _j -,DjF PW site Address: z~ / I C_ k 0 u, .A- L+c ~N- Tenant: Suite RESIDENT / OWNER Name: Phone: Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: Y it) Construction Cost:1 000 Multi-Family Building: (Yes ! No CONTRACTOR Name: ~_l .Nn>y_ .c, c License* 2 C9C0 t-?O p Address: 1q(.5- Ge.J e y cs_ Ajm r.+t_ City: _00- State: cs State: Y11 Zip: SSI 9 Phone:\ Co S' 7S2- '7 t! 33 Contact: A (Se- S- cC A~c, Email: P_ rs v-r COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes -No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor. Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the 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.ooaherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and odes 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 approv YL&;;:~ plans. 4 e~ "skC4 x Applicant's Printed Name Ap Ica Vs Signature Page 1 of 2 C ~ C) ~1 (v DO NOT WRITE BELOW THIS LINE SUB TYPES _ Foundation Fireplace _ Porch (3-Season) i Storm Damage Single Family _ Garage _ Porch (4-Season) Exterior Alteration (Single Family) Multi Deck Porch (Screen/Gazebo/Pergola) Exterior Alteration (Multi) _ 01 of Plex Lower Level ` Pool Miscellaneous Accessory Building WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building* _ Addition _ Move Building _ Reroof ^ Demolish Interior _ Alteration Fire Repair _ Windows Demolish Foundation Replace _ Repair - Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation CV'? Occupancy MCES System Plan Review Code Edition SAC Units (25%+. 100%--) Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction V ' ✓ Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) \Z Final / No C.O. Required Foundation HVAC Drain Tile Other. Roof: -Ice & Water -Final Pool: -Footings Air/Gas Tests Final Framing Siding: -Stucco Lath Stone Lath -Brick Fireplace: _Rough in Air Test -Final Windows Insulation Retaining Wall: Footings , Backfill _ Final Meter Size: Radon Control Erosion Control Reviewed By: Building Inspector RESIDENTIAL FEES Base Fee Surcharge J Plan Review ( (ALf*-) 1i r MCES SAC City SAC r o Utility Connection Charge t~VV~ L S&W Permit & Surcharge v J Treatment Plant Copies 5 TOTAL k f~lj%~r ' I`z' ofo - (r~ Page 2 of 2 P ROBE ENGINEERING "su1.TIHa ENOIIVID PLQIINEliS and lRl funvCYOns CQMPANY1 INC. .1000 EAST 146A STREET, BURNSVILLE, MINNESOTA 55337 PH 432-3000 -ZA9-q -12fagr1,e, Z-oTL: L075 29, 30, 31 AND 32, BLOCK 3, EDEN ADDITION, DAKOTA COUNTY, MINNESOTA CAS l DENQ7'ES EX/57 //V G- E-LFVA~7"lc?A-1 (93s•-) DENO'T-Ea PROPOSED ELEVATION INDICATES DIRECTIOKI OF SURFACE , DRAINAGG° NORTH `i Z•Z= FINISHED GARAGE FLOOR ELEVA"T/OA 5cAb5 3o' L 1 G .P 14 30' 30, FRO MT BUILDING SETBACK LIME N~ 93 .2 EAST j4j "f X936 5~ - 160.00 L9±3.2)1 3'J 5' 4IMI 79.77 -i,a(9Z70)_ 8C' 23 I 1 Z~ 10LOT i ~5 SOT 29 om I 3n I 2 ~~~9 ~3a: ~39,z h M~q•?~ M I o•~ I 88 . ao I ' W I of u~ 4 z 15 1 PROPOSED 4- U N T~ N&7°44,43„W` m Z v I 76.00 k to M BUt DING h; v o. vM 88 . oo ~39. o J , °~I JdrXg! L0~34'L~ 1t.s~ W ry3e:~ rte) /074 ,0Gh aa <939.Z~ i I 31 kn , LOT 32 I~ 66-90 A/ 600 o" S ( 1 J- ~ 11/ (939, 3~ 1. 07'1417-Y qAo r 39'S~ r E,~SEMENT i I hereby certify that this is a true and correct representation of a tract. of land as shown' and described hereon.. As prepared by me nn this 7z-Al_ day of ~l`1~~~11 , 19 84 1111in. Reg. Ho. . (f PERMIT # PLUMBING PERMIT RECEIPT # ? cITY oF En?ca,K 3850 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: CONTRACT PRICE: PHONE: 454-8100 Site Address BLDG. TYPE WORK dESCRIPTION Lot Block Sec/Sub Res. New ? N?me " ` ? Mult Add-on ? Comm. Repair ? ' c Ciiy` Phone 3 3 4P, Other NO. FIXTURES TOTAL ? Name Water Closet -$3 00 $ . ? Addres,& Bath Tubs - $3.00 p Ciry Phone 'f ° '"' f' Lavatory - $3.00 Shower - $3.00 Kitchen Sink - $3.00 ' FEES Urinal/Bidet -$3.00 COMM/INQ FEE - 146 OF CONTRAGT FEE Laundry Tray -$3.00 MINIMUM - RESIDENTIAL FEE _$10,00 Floor prains -$1.50 MINIMUM - COMM/INQ FEE _ 20,00 Water Heater -$1.50 STATE SURCHARGE PER PERMIT - .50 Whirlpool -$3.00 (ADD $50 S/C IF PERMIT PRICE GC1ES Gas Piping Outlets - $1.50 BEYOND $1,OOO.UO ,? -L-Softener - $5.00 Well - $10.00 Private Disp. - $10.00 -Rough Openings - $1.50 31GNATURE OF PERMITTEE FEE: ? STATE S/C: ? FOR: CITY OF EAGAN GRAND TOTAL: ?' •- ?M?? ?,.:?,,.?f: ? CITY OF EAGAN ' 3830 Pilot Knob Road, P.O. Box 21-199, EaQan, MN 55121 ••-- ??? r? PHONE: 454-8100 BUILDING PERMIT Aeceipt # To be used ror 1 OF 4 PLEX Site Address 4411 CLOVER Lot 31 Block 3 Sec/Sub.- Parcel No. W Name u%Puu vna,uc nvs•ir-2 o Address 1460 93RU LI3 City !?LfiZN I?Phone 780-5510 + 0Od Date NLARCH 20 .19 86 i o Name SAI?iL•' 0? Address ~ Gity Phone I hereby acknowledge that I have read thisapplication and statethat the information is correct and agree to comply with all applica6le State of Minnesota Statutes and Ci gan Or nances. Signature of Permittee- Z? A Building Permit is issued to: G00D VALUE iI4MF:S all work shall be done in accordance with all applicatJYe State of Minneso Erect ?? occupancy R'3 Remadel ? Zoning PD Repair ? Type of Const. V Addition ? No. Stories Move ? Length 44 Demolish ? Depth 2d Int. Impc ? Sq. Ft r Instail ? i Approv als Fees Assessment Permit $ 27 4 • Water & Sew. Surcharge 24.00 Police Plan Review 13 7. () U Fire SAC 575. UU Eng. Water Conn. 54U . Q u Planner Water Meter 63 • SL) Council Road Unit 2510. U(? Bldg. Off. 3E14/8 Tr. PI. 156.OU Var. Date I Gopies Tota1 $2,019.50 on the express condition that Statutes and Ciry of Eagan Ordinances. Building 1t I w.mn No. I vermn Haa.? I oaea I Telsphone k I Pibg. Flnai Occ. Ftg. Dbp. . . , . : . : ,. - _ . _ • ` . . PERMIT # (?? •?? c? ? . MECHANICAL PERMR RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: Site Address Lot-3 / Block ? Sec/Sub BLDG.TYPE WORK DESCRIPTION ? Name 'a Addre c City'_ Name • ? c Address p Ciry TYPE OF WORK Forced Air Boiler Unit Heatet Air Cond. Vent Gas Piping Outlets # Other =.,`M BTU M BTU M BTU M BTU CFM FEE S/C: TOTAL• Res. Mult - ? Comm. Other New Add-on Repair FEES RES. HVAC 0-100 M BTU -$24.00 ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 ADDITIONAL 6 M BTU - 6.00 GAS OUTLETS - 1.50 EA. COMM/IND FEE - 1% OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE - 10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) SIGNATURE OF PERMITTEE OF EAGAN ? PERMIT # PLUMBING PERMIT RECEIPT # 3 3 CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: Site Addr - , i'/ • .< , • Lot? Block ? Sec/Sub m Name ? Addre c City _ BLDG. TYPE WORK DESCRIPTION Res. `- New Mult Add-on Comm. Repair ? Name 3 Addre p City L FEES COMM/IND FEE - 1% OF CONTRACT FEE MINIMJM - RESIDENTIAL FEE - $10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SWRCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) SIGNATURE OF ` FOR: CITY OF EAGAN l N FIXTURES TOTAL. Water Closet - $3.00 $ ? Bath Tubs - $3.00 c ZLavatory - $3.00 _ Shower - $3.00 I Kitchen Sink - $3.00 Urinal/Bidet - $3.00 1 Laundry Tray - $3.00 =Floor Drains - $1.50 / Water Heater - $1.50 ? Whirlpool - $3.00 Gas Piping Outlets - $1.50 Softener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 FEE STATE S/C: GRAND TOTAL: •, ? DATE: 5/21/91 RECEIPT: 101477 SITE ADDRESS 4411 CLOVER LANE Unit # L 31 g 3 Sect.ISub. WOHLERS SQUTHSIDE - 431-7099 Permit # 130 16 INSPECTION INSPECTOR DATE COMMENTS 6///9/ 0 X5-°?. MECHANICAL PERMIT CITY OF EACiAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 BLDG.TYPE Name J c 2t 10- 1-2 LL-_„LA: ? c Address p City Phone TYPE OF WORK Forced Afr M BTU Boiler M BTU Unit Heater M BTU Air Cond. M BTU Vent CFM Gas Piping OutlE+ts # Othen, ,-n ifT : . .,u FEE S/C: TOTAL• Res. ? Mult Comm. Other PERMIT # REGEIPT # DATE WORK DESCRIPTION New ?. Add-on Repair FEES RES. HVAC 0-100 M BTU -$24.00 ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 ADDITIONAL 6 M BTU - 6.00 GAS OUTLETS - 1.50 EA. COMM/IND FEE - 196 OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE - 10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) ? SIGNATUYE OF PERMITTEE FOR: CITY OF EAGAN CITY OF EAGAN :r 3830 PNot Knob Road, P.O. Box 21-199, Eagan, MN 55171 PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for 1 Ok' 4 PLL;XEst Value $48,000 Date 14AKCN ?•- 1163^ 3 20 19 b6 Site Address 44118 CLOVER Lra Erect Occupancy u' 773 Lot 3A$lock 3 Sec/Sub. EDr:?! ADVITIQI? Remodel ? Zoning pD Parcel No. Repair ? Type of Const. V ? Addition No. Stories = Name V?D VALUI•; HOb?f?S Mave ? length Demolish ? Depm 44 24 1460 93RD LN Address I t I ? S Ft o Ciry BLAINF?hone 780-5510 mpr. n q. Instau ? o Name- SAt-iF Approvals Fses ?°, i Address Assessment Permit $ 274.00 ~ City Pnone Water & Sew. Surcharge 2Q - 00 Police Plan Review 137.OU ?¢ F W Name Fire SAC 575.00 = Address 3 ? Eng. 500 . 4 ? Water Conn. < W city Pnone Planner Water Meter 63.50 Council Road Unit 290.00 I hereby acknowledge that I have read this application and state that the Bldg. Off. 3/14 8 Tr. PI. 156. D V information is correct and agree to comply with all applicable State of Minnesota Statutes and Ciiy of Eagan Ordinances. APC ParkS Si nature oi Permittee 9 Var. Date Copie Total s 'sz' 01g-•50 GQOD VALUL•. IiGMES A Building Permit is issued to: on the express condition thai all work shall be done in accordance with all applicable State of Minnesot a Statutes and City of Eagan Ordinances. Building Official ` E.-. 1 '- ?; ParmN No. ftrmH Holder Deh TNephone N Plumbiny lj.3 H.V.A.C. 3 EIecMe Softener Inspectlon Data lnap. Commwnb Footinys I ?..? FooHngtll Foundal{on Framiny RooHnq Rouyh Pibq. Rouqh Htq. Insul. Ff?eplace FMal ?ng. Ffnal Plby. 22 Bldy. Flnal ? Csrt. Occ_ Doek Ffy. Dock Frmy. LDIp. • • 3830 MECHANICAL PERMIT CITY OF EAGAN . PERMIT # RECEIPT # ? ??? MN 55121 DATE: y-?1) 5ite Address ? BLDG. TYPE WORK DESCRIPTION Lot ? Block Sec/Sub R ? Name ' es. New M l u t Add-on 7@ Address C R omm. epair c City - Phone Y pth er Name FEES ? c Address RES. HVAC 0-100 M BTU -$24.00 p City Phone ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 ADDITIONAL 6 M BTU - 6.00 TYPE OF WORK GAS OUTLETS - 1.50 EA. Forced Air M BTU COMM/IND FEE - 1% OF CONTRACT FEE Boiler M BTU MINIMUM - RESIpENTIAL FEE - 10.00 Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00 Air Cond M BTU STATE SURCHARGE PER PERMIT - .50 . (ADD $.50 S/C IF PERMIT PRICE GOES Vent CFM BEYOND $1,000.00) Gas Piping Outlets # Other FEE: - SiGNATURE OF PERMITTEE S/C: ' TOTAL: FOR: CITY OF EAGAN ` PLUMBINa PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 PERMIT # RECEIPT # ? ? r3 3 DATE: Lot_?-J`Block _::5 Sec/Sub y Name S Addre c City = ? Name 3 Addre O CrtY - FEES COMM/IND FEE - 1% OF CONTRACT FEE MINIMJM - RESIDENTIAL FEE - $10.00 MINIMUM - COMMlIND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) OF FOR CITY OF EAGAN BLDG. TYPE WORK DESCRIPTION Res. New Mult Add-on Comm. Repair Other NQ. FIXTURES % Water Closet - $3.00 TOTAL ' $ TBath Tubs - $3.00 - T Lavatory - $3.00 ' Shower - $3.00 I Kitchen Sink - $3.00 Urinal/Bidet - $3.00 _4__Laundry Tray - $3.00 Floor Drains - $1.50 + Water Heater - $1.50 ^ Whirlpool - $3.00 Gas Piping Outlets - $1.50 Softener - $5.00 Well - $10.00 Private Disp. - $10.00 - - _ Rough Openings - $1.50 7 t FEE STATE S/C: ` GRAND TOTAL• ^ ?' " ; , iJ Z 1'.; cmr oF EaGAN 11661 . 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 -- PHONE: 454-8100 i BUILDING PERMIT Receipt # ?! } ?f Tobeusedior 1 UF 4 PLL•XEstValue $48,00U Date •14AHCH 20 19 86 Site Address 4413 CLOVER LN Erect OX Occupancy R3 Lot 308lock 3 Sec/Sub. EDE AI ADDIITOIv' Remodel ? Zoning pD Parcel No Repair ?? Type of Const V . Addition ? No. Stories vGOD VALUB HOKE S Move ? Length de Name Dem olish ? Depth 24 1 ' Addre I t I ? S Ff 0 Bz air' F n . mpr Q Q Ci? . ?jh one Install ? - = o Name Approvals Fe oQ Address Assessment Permit - ~ City Pnone Water 8 Sew. Surcharge Name - Add ress Signature of 1/41.- Police _ Fire - Eng. _ Planner Council ivauuuaaNMuwuv?iai?uaw?cu?a?u?c Bldg. to comply withp4l applicable State of _^ GOOD VALUE HOMES Var. Plan .001 Water Conn. 500 . Water Meter 6 ? • Road Unit 290. Tr. PI. 156. Parks Copies Total $2,019 ' A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable 5tate of Minnesota Statutes and City,ot Eagan Ordinances. Building Official I • I P.m,n No. I PermH HWdor I oats I Telephons N 1 Plbq. Hf9. Plbg. Ffnsl Occ. Fty. Frmy. Disp. .?---- • . ,. PERMfT # PLUMBING PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: CONTRACT PRICE Site Add ss C, ,.: . -?-. Lot _ Block ? Sec/Sub m Name ? Addre c City _ Name 3 Address p Citv "' Phone FEES COMM/IND FEE - 196 OF CONTRACT FEE MINIMiJM - RESIDENTIAL FEE - $10.00 MINIMUM - COMMIIND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) FOR: CITY OF EAGAN BLDG. TYPE WORK DESCRIPTION Res. New -` Mult Add-on Comm. Repair Other NO. FIXTURES TOTAL L Water Closet - $3.00 $ -,? ? Bath Tubs - $3.00 " ? Lavatory - $3.00 Shower - $3.00 =Kitchen Sink - $3.00 - $3.00 ,UrinallBidet Laundry Tray - $3.00 Floor Drains - $1.50 ? Water Heater -$1.50 ? S U Whiripool - $3.00 -7 Gas Piping OuUets - $1.50 Sottener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 -? FEE s ? STATE S/C: GRAND TOTAL: ? ?' ?? ? • ' PERMIT # /-- MECHAHICAL PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: )NTRACT PRICE PHONE: 454-8100 Site Address BLDG. TYPE Lot Block 7q_ Sec/Sub Res. m Name Mult ? Address Comm. c City Phone Other ? m c 3 O Name _ Address City _ TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. Vent Gas Piping Outleb # Other M BTU M BTU M BTU M BTU CFM WORK DESCRIPTION New _ Add-on Repair. FEES RES. HVAC 0-100 M BTU -$24.00 ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 ADDITIONAL 6 M BTU - 6.00 GAS OUTLETS - 1.50 EA. COMM/IND FEE - 1% OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE - 10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) , FEE ??-. - ?' - ?1- / , S/C: r SIGNATURE OF PERMITTEE TOTAL• FOR: CITY OF EAGAN ?;P?7R'?oAY,E Ji•? i; ? CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ??12 11630 PHONE: 454-8100 BUILDING PERMIT Receipt # , t ?-,,` ? Tobeusedtor 1 UF 4 PLti:X Estvalue $45,000 Date MARCH 20 ,19-b6 4413B CLOVE Site Address R LN Erect ? X Occupancy R3 c Lot 1'BloCk 3 Sec/Sub. £UEN AUUlTIONRemodel ? Zoning pr) Parcel No Repair ? Type oF Const t? . Addition ? No. Stories GCiOD VALUF: ;iOHL:S Move ? Length nd a = Name V Demolish ? Depth 2w ; Address 0 760-5510 ?LAIN? Int.lmPr ? S Ft Q City hone Install ? Z o Name $?E ? 0 < Address " Assessment _ ~ Citv Phone l; Water 8 Sew. Police Fire Eng. Planner I hereby acknowledge that I have read this application and state that the gldg. information is correct and agree co ly with all applicable State of Minnesota Statutes and City . rdin es. APC. [ Signature of Permittee Var. C=(30D VALUE HO.MES A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State ot Minnesota Statutes and City of Eagan Ordinances. Building Official - • ``'-'' 4 Fees Permit 274.00 Surcharge 24.0 Plan Review 137.0 SAC 575.00 Water Conn. SUO .0 Water Meter 63 . 5 1 Road Unit 290• 0 ( ,Tr. PI. 156.0 Parks Copies 019.5 Total ? prrntft No. PNmk Madkr DNe TN?pFwrn N PlumWnq H.V.A.C. EMeMe SoRener Inspactlon Cats Inap. Commenb FooHngs I ?-? Footinys II Foundstbn Framiny - 3_ 86 Rootinp RouyA Pibp. A Rouyh Htq. . 3 . 4 . , Insul. Flnplece Flnal Hty. Flnal Plby. Bldq. Final Cert. Oec. Deck Fty. Dock Frmy. YYeY Pr. Dbp. 0 . • PERMIT # MECHANICAL PERMIT RECEIPT # U a" CITY OF EAGAN , 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: BLDG.TYPE ? Name j§ Addre c City':_ ? Name _ c Address O cjh+ - TYPE OF WORK Forced Air BoUer Unit Heater Air Cond. Vent Gas Piping Outlets # Other FEE SlC: TOTAL• M BTU M BTU M BTU M BTU CFM Res. Mult Comm. Other WORK DESCRIPTION New Add-on Repair FEES RES. HVAC 0-100 M BTU -$24.00 ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 8TU - 12.00 ADDITIONAL 6 M BTU - 6.00 GAS OUTLETS - 1.50 EA. COMM/IND FEE - 146 OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE - 10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) SIGNATURE OF PERMITTEE FOR: CITY OF EAGAN PERMIT # w T PLUMBING PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: CONTRACT PRICE: PHONE: 454-8100 Site Address BLDG. TYPE WORK DESCRIPTION Lot? Block Sec/Sub ? ` Res. New m Name ? ' ' °l?` ?' •?- - ' ? Mult Add-on Address ? ' Comm. Repair c City Phon Other Fl ? ES N?_ TOTAL >-- Name ? ? Water Closet c Address ? Bath Tubs -$3.00 O . CitY Phone '?0 ' 475_/ C ! Lavatory - $3.00 • Shower - $3.00 ZKitchen Sink - $3.00 FEE S Urinal/Bidet - $3.00 COMM/IND FEE - 1% OF CO NTRACT FEE / Laundry Tray -$3.00 ' MINIMJM - RESIDENTIAL FE E - 3?0.00 _LFloor Drains -$1.50 MINIMUM - COMM/1ND FEE - 20•? ? Water Heater -$1.50 - STATE SURCHARGE PER PE RMIT - •? Whirlpool -$3.00 (ADD $.50 S/C IF PERMIT PRI CE GOES Gas Piping Outlets -$1.5Q - BEYOND $1,00O.OOy Softener - $5.00 Well - $10.00 ?Private Disp. - $10.00 Rough Openings - $1.50 SIGNATURE OF PERMITTEE FEE ' STATE S/C: FOR: CITY OF EAGAN GRAND TOTAL: PERMIT # ' PLUMBING PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: PHONE 4548100 Sec/Sub m Name ? Addre c City•_ .. Name 3 Addre O CitY - FEES COMM/IND FEE - 1% OF CONTI MINIMUM - RESIDENTiAL FEE MINIMUM - COMM/IND FEE STATE SURCHARGE PER PERM (ADD $50 S/C IF PERMIT PRICE BEYOND $1,000.00) FOR CITY OF EAGAN FEE 5^ " BLDG. TYPE WORK DESCRIPTION Res. New Mult Add-on Comm. Repair ,. . Other NO. FIXTURES TOTAL t r Cl t - $3 W 00 $ , a e ose . - Bath Tubs - $3.00 .1 = ? Lavatory - $3.00 Shower - $3.00 Kitchen Sink - $3.00 Urlnal/Bidet - $3.00 $10.00 20.00 •50 Laundry Tray - $3.00 Floor Drains - $1.50 Water Heater - $1.50 Whirlpool - $3.00 Gas Piping Outlets - $1.50 Softener - $5.00 06- Wel1 - $10 00 . Private Disp. - $10.00 Rough Openings - $1.50 FEE STATE S/C: GRAND TOTAL• CITY OF EAGAN Remarks Addition Ed@n Aaai't.lO1L Lot Rlk 3 Parcel #10 22750 310 03 _ OWr?er street 4411 Clover Lane stete Eagan NIIV 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. ?°GJ D 19$2 504.70 1.??.94 5 STREET RESTOR. GRADING W 1982 232.9 46.60 SAN SEW TRUNK l 197 Z ? SEWER LATEfiAL Lzl? 1982 18 . 6 319.29 WATERMAIN * WATER LATERAL 1982 WATER AREA * Ser*icea 1982 STORM SEW TRK 1982 256.00 51.20 5 • STORM SEW LAT 1982 5 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK CITY OF EAGAN Lot 32 Blk 3 Parcel #10 22750 320 03 Addition L? ??dditre.. owner screet 4411B Clover Lane State Eagan MIN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. " L 1982 4 7? 100.94 cJ STREET RESTOR. GRADING 1982 2 . 46.64 SAN SEW TRUNK S/ 1974 62 93 4.20 1$ • SEWER LATEfiAL 1982 j4 379.29 .5 WATERMAIN ' f WATER LATERAL 1982. WATER AREA JVY 1977 62.93 4.20 IS • ?S e 1982 STORM 5EW TRK ? ^ 1982 26. oo 1.20 1F STORM SEW LAT 19$2 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 9UILDING PER. SAC PARK CITY OF EAGAN Remarks Addition $d,gn }?dl'klGA Lot 30 Blk 3 Parcel #],A 777S0 30(1 (]3 owner screet 4413 Clover Lane State Eagan NA1 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. G? 19$2 504.70 100.94 5 STREET RESTOR. GRADING (a l) 1982- 46.60 5 SAN SEW TRUNK SEWER LATERAL L6? WATERMAIN * WATER LATERAL 1982 5 WATER AREA * Services 1982 STORM SEW TRK 1982 2 6. 00 1.20 ?k STORM SEW LAT 1982 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 9UILDING PER. SAC PARK CITY OF EAGAN Addition Fden Additian Loc 29 eik S Parcel #10 22750 290 OS owAer street 4413B Clover Lane state Eagan NIN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. (or, Lj 1982 rj04.']0 100.94 5 STREET RESTOR. GRADING 46.60 5 SAN SEW TRUNK 1974 62.93 4.20 15 • SEWER LATERAL WATERMAIN N WATER LATERAL ? 13 WATER AREA 69-9-1 4-20 1 * BeryiCes 8 STORM SEW TRK o 1$2 256.00 51-20 iF STORM SEW LAT 182 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. ' SAC PARK I CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (651) 681-4675 . , ., SITE ADDRESS: , . , .. PERMIT SUBTYPE: <1 f; I I I; r PERMIT TYPE: Permit Number: Date Issued: APPLICANT: TYPE OF WORK: , I ., t? 511?1oa t I I ' rtiI rc f f'rnr.? ? ? ? Permfl Holder DaLe Telephone N EWERI WATER PLUMBING HVAC Inapectlon Date Inap. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL (3YP BOARD FIREPLACE FIREPLACE AIF TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC MEfER IRRIGATION METER FLUSH MAINS coNOUCrivm TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL ----- ---- INSPECTI0N REC ORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (651) 681-4675 SITE ADDRESS: ' , , , ? ???•i {; f rt??, PERMIT SUBTYPE: ?t i II i Nil 4.<4 A 1 iwT /t?U APPLICANT: TYPE OF WORK: !7 1 iNAI F L ? ? Permk Holder Datc Tebphone # sEwEw WATER PLUM8ING HVAC Inspectlon Date Insp. CommeMs FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPIACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVI7Y TES7 HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL ? CITY OF EAGAN I 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 i SITE ADDRESS: ? •+%t I I ri ? I r)VE f: t AWt i I?f tJ ? ` PERMIT SUBTYPE: 11 + 1„I f cN?? 11- oN REcoRD PERMIT TYPE: Permit Number: Date Issued: APPLICANT: I li, 'rl I 1 ti 1,' 1 hti.S 101.) TYPE OF WORK: i i NAi nIMi l7i11 1 (I ! Nt, N .' i %1 F'i 8 07 I tbic? I rt ? ? Permk No. Permft Holder Date Telephone f SNV PLUMBING HVAC ELECTRIC ELECTRIC Inapection Date h?sp. Comments Footings I Foundation Framing Rooting Rough Plbg. Rough Htg. Isul. Flreplace Flnal Htg. Orsat Test Fnal Plbg. Plbg. InSpector- Notiiy Plumber Const. Meter EngrJPlan Bidg. Final Deck Flg. ? ?" 93 ??1 ? `' -' ' .2 3 - ? DeCk Final Well Pr. Disp. .? INSPECTI4N RECORD i CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (651) 681-4675 SITE ADDRESS: i i I i-? PERMIT SUBTYPE: ?.. - ,.,? ., . 0 Nk t?? k? APPLICANT: TYPE OF WORK: '', , I + I i . ! . f'tl.l I t It 1 Nft ? :,1 :4 ,i4" *1 /aK/og kE I`i 11( i '. 1 ls 1 N F M6 7 L 5 1146t _j PermR Holder Date Telephone N SEWER/ WATER PLUMBING HVAC Inspection Oete Inap. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST FOUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS coNOUCrwiTv TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG FDECK FINAL INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 PilOt Knob Road Permit Number. -4 '4 r: I Eagan, Minnesota 55122-1897 Date Issued: (651) 681-4675 SITE ADDRESS: APPLICANT: (OvF P t An+U 0 ' PERIIAIT SUBTYPE: TYPE OF WaRK: I ? I., I'A rp; VCfii Ar.:f I,107MCi I r ; r4 r. -; - i, N , i " F 66 , 7 L 5i1,?°0 1 - - ----------------------------- Permit Holder Date Telephone # SEWER/ WATER PLUMBING HVAC inspection Date Insp. Comments FOOTI NGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATIIVG GAS SVC TEST INSUL GYP80ARD FIFEPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSA7 TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL T nF EAGAN WATER SERVICE PERMIT ?. Hot Knob Rwd• P: O. Box 21199 PERMIT NO.: Esgan, MN 55?1;1 DATE: Zoniny: No. of Unlts: ` :L`O?_ ' a, .i'_ J• _., Owner, j 41- Site /lddreu: -. , ?.? m• ?, . F?? .. , . ? Plumber: M@ftr No.: 37b /8.2 B'/ Si:e: BB 0M 11116., Reoder No.: 1 sNw Iv esenpIp wilh !? Turcha?e: . ??- O?liw??. Misc. CFwrpes: TotoL• ;?'. ,:iettr ? By Date Poid: ' Dote of Insp.: Irnp.: : " f TY OF EAGAN 130 Pilot Knob Road 0. Box 21199 ?aan, MN 55121 to oom* wM elr Cihr of 4?e¦ SEVVER SERVlCE PERMR PERMIT NO.: n.rc. conn.cN«, aar,oe: AoOpunt Depeaif: _ Pomnit Fee: Surdharge: Misc. Chorgm _ Totol: DoN Poold: CIYY OF EAGAN ?wv%vsw u0Nnw1vi rc?uR?? 3830 Pito K nob Road ??c l P. ?8. Box 21199 PERMIT NO.: '' Eayan, MN 55121 D/1TE: ' - ' Zonlr+0: ' No. of Units: Owrwr: : 00d V81U@ .iCIItEo llddrass: Sift Mdnis: ?441- Clover Lane 7 .3(1 " . _ ? AMn. Plumber. ' el;,on P um '.' 6 Meter No.: g ? ?ii; .,..,, ?? Stu: ' ?. t _ a?. .: 3N re ?.??1?. ??. 0 v?, I Nmw to aompyr wilh !w C.iry(w. oro¦.se... _..? 1tRO.iaroes: 156. c pd TP ; BY Dote of irnp.: ?"- G 8?? Totai: 0??. ?Ljpa mereT Dote Pbid: Irap.: CITY OF EAGAN SKW1R SOVICE pERAR 3830 Pilot Knob Road P. O. Box 31199 PERMIT Nd.: . Esgan, MN 55121 DATE: Zaninp: No. of Unib: - Owrwr. . - i ,? ; :???. r:-ac•3 Add?ess: - SItO /1MroSt: '` ?e ?' ?? ,)??:._ • ? , - , PltNt1blr. 1opw te o? ;l/ wft !V Cft of 4ve ddirwwa& By Date of lmp.: a'r'Y°: Conrmtian llmunt Deposit: ' Prrmk Fw: Surcha?pe: Misc. Chorpas: Total: Dah Poid: L. CITY OF EAGAN WATER SERV CE, PERMR ? 3830 PiPot Knob Rosd 4t' P. (I. Box 21199 PERMIT NO.: _ MN 55121 E DATE: agan, - ?ing; No. of Units: Val:..: - ac ; n O w sr: 5? Add?e6f: ?i ?f 11? ,i0'> c• ' ?' ? ' 7 Y? AddP Plun+ber '_? ; ;•'?,. ? ? -1Ei . D ; Sni_l . n?_r?'. " Mehr No.: r r ,n? ?? 15. 0,0Il T) $1u: T& { I itC?Qa . OEM te oorillp wNh !iw ° ?illL .-?^i.1 , r- vE? . . ? r ?Mnp/. V ? v / '0_0' Total: l'Y OF tAGAN WATER SERVICE PERl1AR 30 Rilo't Knob Road ; z?; 5 9. Box 21198 PERMIT NO.: _ _, pn, MN '5 W1 . DATE: - ? -- nlrg: No. oF Units: /lddrrss: No.. ? '?l •1 ct{on Chorqe: n.e ee.o.rhr wo aiw0`lai4..-- o""°" REQUIRED vn ,/?? Tael: _ .rr? Doo. Poia: :I1'Y OF EAGAN SEIAIER SERVlCE PERMIT 830 Pilot Knob Rwd '. O. Box 21199 PERMIT NO.: ' :agan, MN 55121 DATE: { - ' -- :anirg: ? No. of Units: 1wner. ;?,. . ?ddross: ih Addnss: •- 'ILwniaer. ' • . -- _ '. ' .-. . , ..•? . 1•`71 ^- . ?. Nm towkb tM Clly oi EaN¦ Ca+neetion Chorpe; -'? j• viiM?• llcaount Deposit: Prrmit FN: SurrhOrQe: y Mtsc. Chorom ote of Inip.: Totoi: up'= 1 Dcb Paid: mec ? CASH RECEIPT , CITY 4F EAGAN P. O. BOX 21-199 EAGAN, MINNESOTA 55121 DATE 14 R=CtI V tO FRpJ AMOUNT $ , I R DOLLARf too ? CASli Q CHECK FOR BY White-Payers Copy Yellow-Porting Copy Pink-File Copy -1-hanK you ..? ? ;.x?-j ? ?a :,- • . This rbque5t void J 16 mon(hs from C _18067 Fepuest Data fire No. Rouph- 'n Inspecuon Re9wred> DReady Now W?II Noufy Insae.- c; - az!:?- ?r &es ?No or When Reatly 0 Licensed Electncal ConVactor 1 hereby reques' msDec<ion af above n Owner electrical work installad at' Sv et Address, Box or Ro te No. C?? C? ? ? ecuon o. Township Name or No. ange No. unly `+. ? Occuuanl IPRINTI Phone No. Power SupOlier f Address ElVucal Con[ractor ICompany Namel ?-t, )-e_ I k l ) C ractor. s ?, ense No. aUOn ine nstai Ma hne p.tlJress ( onVacm?Owner a ? 1 l or ed SiBnawre (Conhact dOwner Making Insta11at1on) f Phone Number ? MINNESOTA STATE BOAXU OF ELECTflICITY Griees-Midwey Bldg. - Noom N-191 1821 UnivarsitV Ave., St. Paul, MN 56106 Plwna (812) 297-4111 InI51rvSY[GIIVrvX[LLU[J1 WIILrvUI BE ACCEPTED BY THE STATE 6ppPD UNLESS PROPEfl INSVECTION FEE IS ENCLOSED. S-,:)-3 -,,Y(GREQUEST FOR ELECTRICAL INSPECTION ee-ouooi.oa IIi See instmchene Im com0le4ng this fwm on back of yellow copy. ( aQ Q 18067 "X" Below Wak Covered by This Request Adtl Re0• TVCe ot Bufltlmg Appbancea Wind EquiVmaN Wired F.% Buik Mil k Fee Servico EntreneeSiza p Fee Feeders/SuEteeders N Fee Grcuns U to 200 Am 5 0 to 30 Am s ? tn 30 t1m s Above 200 qmps 31 to 100 qmps 31 to 100 Am , Swinming Pool Above 100_Am s Above 100_Amps Transiormers Irrigatron Booms Pertial/Other Fee Signs Special InspecUOn Nertyrks S 4?, ' TOTqL-FEE ^ G _ ?? ? e ` Nough-in Da[e - -/ tha I. -Elecirrcgl e ? p?-7 nsoecb., hereby ' certify that the xbove Final Date 3 ingpecOOn hes baen 0 - maea. (hb reauest vold 18 montM from Thit re0uest void 5-.?a-? lL' ({?C?-?l(?Kl 18 months from Q 18068 ? ? 3 fle;uest Dzte Fire No. ?oughfea,InsV?er.uon 0 qeady Nuw fQ?l Nnuty InsPec- ?"' ?) T? n I a?Yes No r When ReaEV ? License0 Elecvical ConVactor I hereby mquest insOacUOn of ebove -...L mclalled et. Sveet qtldress, B x or R e No. / n City I T ecuon a. Townshi0 eme or No. RanBe No. C?? ? Occu nt IPAINTI \f Y Phone No. P r $uODlier Atldress al Convactor (COmpany Name) E Comractor's LmensNo. ? Y ?? A ), Mai 0 Address IConlractor o?7 ?_yvner kmg Instailavo.l nzed SiBnature I on r cmr Owner Making InsrllatmN Phone Number l? T R QUEST WILL NOT See instmcbons lor com0 ein9 .,.... ,. . - ,.,,a.o.I h, 7his Reouest TH MINNESOTA STqTE BOARD OF ELECTHICITY IS INSVEG ION E Gngga-Midwav eldg. - floom N-191 BE ACCEPTEO 9V THE STATE BOARD UNLESS PROPEM INSPECTION FEE IS 1821 UmversitV Ave., St. Paul, MN 65704 ENCLOSED Phone 16121 297-2171 Eg.00001.04 REQUEST FOR ELECTRICAL INSPECTION „ " C? -=a I t this brm o. beck o1 Yellow cooV. This reQUes[ vmd 18 rcwnths (rom C 18085 636 b? ?'O - Fre No. RouPh-i InspecLOn Rnquest Oata R qwred? QRaady Now W.II NoutV I?sPec- 5 ?? ?Na or When fleady E] Liwnsed Electcal Conhactor 1 hareby request inspection or above wiarvical wark installad at' U vrvne, Street Ad ess, Box Route No. C I' ? ¢ct ..n o. Townsbip Name or No. nd^Be No. 4' C Oc dM WRINT) ? v Phone No. Power $uPVlier a4 k !ltltlress Elec mal ConVac[op(Company Name) ?nv?or's License No.. C . c? -e mr Mailmg AdJress IContrc o wner Making Instailauon) /1?'Q ?? ^ (?? ,? ?_? Autlpr¢ed$1gna[ure Conaactor Owner Making Installavonl ? ? /1')C.vSb?-- ? Phone Number` 5C? (? A - Tu c imcPCClinu ncnucST wILL NOT MINNESOTA STAYc 90ARD OF fLECTRICITY Griggs-Midwey Bld9. - Room N•191 1821 Univers,ty Ave., SC Peul, MN 55104 Phone (612) 287-2111 eE ACGEPTEO 9Y THE SiATE BOAAD UNLESS PROPER INSPECTION FEE IS ENCLOSED. /. 5,?71 /?'?" REQUEST FOR ELECTRICAL INSPECTION 1 5ee inshucbons lo, complebng thss r«m on back of yellow coov. W EB-OOW1.04 634)(,/ ?' f 1 Q( 1 S2 t? "X" Below Wak Covered by 7hts Reqijest AAu'ABD? v v .. TVDe of 8u?ld?ng AOPlka^cea Wtred Equ?pmen? WveA Ranye Temporary Service Water Heater Ltghtiny Fixtures Dryer Electnc Heatui M Furnace Silo Unloade.r Air Gondrtioner ec. v Bulk Milk Tank tner (Snenfvl hy Othe, Other r u p ryuae • ro Fea Yr........ . ee ......... ServiceEntrenee5iae h Fee Fexders/Subfe¢ders ts 0 to200Am 5 Dto30Am s A6ove 200 qmps 31 to 100 qmps 3 A s Swinxning Qool Above 100-Amps M AmPs Transtormers Irrigation 8ooms her Fee Signs Special Inspection flemarks ?. 4 ! Aough-in f D '?1e i_ I, ?he al 3 Inspector, hereby cer1AV lhet lhe above final uosaection has Eeen f .rede. Thm reques( vold 18 monihs imm This requas[ void 78manths iron, 1 He?uest Date - Fre No. RooPhetl?InsVer,tmn ?qeady Nuw?,?W?ll NoLty Inspec- ? ;??Y ?N lor When ReadV 0 Licensed Eleclncal Convactor 1 hereby request lnsPectron ot aDnva wl..ntnral work mstalled a[ U ?wne? Sveet ddr ss. Box or floute No. ? ecuon o- Town i0 Name or o. RenBe No. Cit ? tY / ?uGant (PRINT) ? vcLLI-?? Phone No. Pow¢r SuDpber Address Electncal Contractor (CompaqY Name) Contreamr's Licanse No. ???? ry_? ? ?tLn r 1 ? . E s Ma? ng Address fContractor or Owner Making InstallauoN l ?? ` _.} ag ? AQ J I? AutAqnzed S,enature IContrectodOw?er Making InstallatioN CLLci-y rno? btr Ph1, ne Number 5C' C, - ?? o0 I ECTION flEQUEST Wlll NOT THIS NSP MINNESOTA STATE BOARD OF ELECTRIGITV BE ACCEPTED eY THE STATE BOARO Griggs•MitlwaY Bldg. - poam N-197 UNLESS PFOPEN INSPECTION FEE I5 1821 llniversitY Ave., 5t. Vaul, MN 65704 ENCLOSEO. Phone 16121 297.2111 ?1?7/?? REQUEST FOR ELECTRICAL INSPECTION ea-ooooi-oa ? ? See instrucvons tor comoleting this torm on back of yellow cooV. 2 a n n[) 11' "r" aaI„a., Ill Cnvered bv 7his Request \; 1V VVV - - Equipme??Wired AAd pd0. TVPe ot Bwltlmg AOOisantesWireE Service ora T m Home nge p ry e Duplex ter Heater Liyhuny Fixtures Apt. Bwld?ng ryer Electric Heatin Commercial Bldg. J mace Silo Unlonder Industnal Bldg. Cond?LOner A,r Bulk M?Ik Tank her Spe??iv Other ISpenfYl Farm ? .r SVOCfy hee ????? l.ul llpute rna Ycouvn . cc -- EntrenceSize tl Fee FexderS/Subfeedere N Fee - Grcwts p Fea Sarvwa 0 t 30 Am 0 tp 200 Am s 0 tp 30 Am s n A6ove 200 Amps 31 to 100 Arnps 31 to 100 A s Swimming Pool P.bove 100-Am s Above 100-Ampr ' Irngation Booms Dther Fee Partial- Trensrormers Signs Special InspecLOn g ??? TOTAL Re m?rks 47.0 HouOh^? ??1e I, ihe Eled Inspaclor, hereby t cerldy that Ihe above . D j?}e ,p ins0action hes been Final ? n , ,?ae. (bw rGquest witl 18 moniha Irom r19/ / lo / 0/25Z7 q Q .1U0;7 oo 9115 Reques• Daie ? re No Rough-in Inspecnan Reqwretl? ? eatly Now p Will Natdy Inspector tl ? Wh fi = Vas y en ea - ? I icensed contractor ] owner hereby request inspection of above electrical work at Job Adtlras's/ BVaet B/o?x o/r Rome No I I tJ Nr Cily ` r 1} Vw/?/ Seclion Nc ITOwnship Name or No Range No Coun?y 1,14 t'o ? Ocapa iPqINT? PhoneN ? V ? C? V Power SuppLer naeress Eleclncal Coni lCOmpany N3mPl Contr2Ct0l5 Li08n6B NO Mettler Electric 042252 Mailing Adtlress iCO,cractor or Owner Making Installalion? 1240 - 46th Ave. N.E. Autnonzea Signawre iGOmracrorvOw-inr Ma'ung instaliaton) PM1One Number Michael L. Mettler >????? 574-9744 MINNESOTA STATE BDARO OF ELECTRIGITI/ THIS INSPECTION REOUEST WILL NOT Gnggs-Midway BIEg. - Room 5-173 BE AGGEPTED BY THE STATE BOARD 1921 UNVersily Ave.. St Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSEO I^ REQUEST FOR ELECTRICAL INSPECTION Es-ooo01-08 0- Sea inst-uclmns br compleung [nis torrn on back ol yeilow copy !VA -' 10 ? "X" Below Work coverea oy I nis rrequesi ew 9dc Rep' TypeotButlding AppliancesWued EqwpmentWired Home Range I Temporary Service Duplex Water Heater Elecinc Heahng Apt Butlding Dryer Other (Speafy) Comm ilndustrial Fur Farm r Condrtioner Other(syeafyi onVaciors Femarks Compute Inspechon Fee 8elow # Other ? Fee # ServiceEniranceSae l Fee # Circwts/Feeders Fee ? Swimminq Pool ? 0 to 200 Amps 0 to i00 Amps Transformers Above 200 _ Amps e t00 _ Amps Signs Inspecmr's lJSe Oniy TOTAL ?ri hngation 8ooms ? v Special Inspecuon AlarmrCommunication THIS INSTALLATION MAV BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspectoc hereby RU09n"° oace cerllfythattheaboveinspectionhas been made. i Final Date ra OFFICE USE 9NLV Tpis repuest voitl 18 monNS from 2007 RESIDENTIAL PLUMBING PeRnniT aPPUCarIoN ClTY OF EAGAN - 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dweilings. /s, s-v Date 07 Jody Grider Site Street Address 4411 C)over Lane #B UniE # Eagan, MN 55122 Property Owner 6519943862 phone # ( ) Contractor ilw!) 7elephone# (GIZ) ?Z7-U033 Address2qO? ?.?V ' City iri'' o? StateZip ?fyog The Applicant is: _ Owner ? Contractor _Other Refurbished Submit 2 sets of plans and MPC license New Septic System Includes Counry fee _ _ $ 100.00 Per as-built $ 10.00 Fire Repair (replace burned out fixtures, etc.) $ 90.00 Alteratians to existing dwelling ' $ 50:00 _ Add plumbing fixtures. This fee inctudes installation of a water softener and/or water i heater at the same time. !f you are installing onlv a water soffener and/or water heafer, do not complete this section; move to the next section and check the appliance(s) you are installing. _Septic System Abandonment Water Turnaround (add $136.00 if a 5/8" meter is required) Other: Water Softener Water Heater $ 1$•00 _ new -X- replacement Lawn_Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00 State Surcharge $ 50 - $ is so Total I hereby apply for a Residential Plumbing Permit and acknowiedge that the intorrnation is compiete ana accurace; ina< <ne work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a per it, work is not to start without a permit and work will be in accordance with the approved plan in the event a plan is requ t be review and approved. Jf-(T .t),orLloI4Q ican Applicant's Printed Name Ys Signature n 1986 BIIILDING PERIm APPLICATIOA - CITY OF EAG9N HORS: 9LI. C09TRACTOBS MQST BE LIC86SED iiITH THB CITY OF SAGAH C0MfERCIAL SINGLS FAlIILY DiiELLZNGS INCLUDE 2 SETS OF 9RCHITECTIIRAL INCLUDE 2 SETS OF PLANS & STROCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY SPECIFICATIONS AND 1 8ET OF 1 SET OF ENERGY CALCULATIONS ENERGY CALCULATIONS $2,000 LANDSCAPE BOND To Be Used For: I / ? -?!j ? Valuation: Date: Site Address qi-//i "' ? ? OFFICE DSB OPLY Lot 3 Bloek 3 Ereet _ Occupaney Remodel Zoning Parcel/Sub Repair Tppe of Const _ Addition # of Stories Owner Move Length Demolish Depth Address 1??ef?) Int.Impr. ? Sq Ft Install City/23p Code ---------- -------------------°- Phone APPROVAI.S FSES Contractor Assessments Permit Water/Sewer Sureharge Address Police Plan Review Fire SAC City/Zip Code Engr Water Conn Planner Water Meter Phone Council Road Unit Bldg Off3 14 z,6StbTreatment Pl Areh./Engr. APC Parks Varianee Copies Address YOTAL City/23p Code Phone 0 NOTS: ADDRHSSES FOR C06NER LOY3 - COATAACTO&/HOMHDi1NSR MDST DFSIGHATE WHICH ADDRESS IS DFSZRED. HO CH9NGES WILL HE ALLOIISD ONCE BOILDING PERMTf IS ISSIIED. CITY OF EAGAN N 0 11662 FOR SALE UNITS 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 -. PHONE:454-8100 BUILDING PERMIT Aeceipt ? MARCH 20 86 8,000 Value $4 Date 1 OF 4 PLEX Est ,19 To be used lor . R3 ? Occupancy 4411 CLOVER LN Erect SiteAddress 3 ADDITION Hemodel ? Zoning EDEN V Lot 31 Block Sec/Sub . Repair ? Type ot Const ? Parcel No. AddiUOn ? No. Stories 44 th ? L , a eng Move GOOD VALUE HOMES Demolish ? Depth a Name w z 1460 9 3RD LN int Impr. ? Sq. Ft. o pddreBsLAINE 780-5510 instau ? cin, Phone Fees Apprmals o Name i? S?E Permit $ Assessment 2?4.00 0 0 Z 4 ? a Address Water & Sew. Surcharge . Q0 137 ty Phone planReview Police - 5 7 5. 0 0 - Fire SAC 500.00 J. Narne 9 Water Conn. E? . 63.50 ddress WaterMeter Planner h 00 290 ,ry one P Road Unit . I hereby acknowledge ihat I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes an d City. E n Ordm ces. Signawre of Perminee, O VALUE HOMES A Building Permit is issued to: all work shall be done in accordance with ? phr ?e Stat? of 1 innes; Building Official ? Council BIdg.Off. 3 14 86 APC Var. Date < a tutes and City of Eage Tr. PI. 156.00 Parks Copies 7otal $2.019.50 n the express condition that n Ordinances. , FOR SALE UNITS CITY OF EAGAN N0 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55127 - 11663 ' - PHONE:454-8100 ?G BUILDING PERMIT Receipt# 86 1 OF Value $48,000 4 PLEX Est Date 20 MARCH '19- Tobeusedfor . R3 LN 'E] nc 4411B CLOVER Erect y Occupa Site Address 3 EDEN ADDITION Remodel ? Zonin9 Lot 32 Block Sec/Sub. . Fiepatr ? Type of Gonst. V Parcel No. Addrtion ? No. Stories D VALUE HOMES Move ? Demolish Length Depih 24 =me 0 93RD LN Int.lmpr. ? Sq.Ft phone l80-5510 ?nstall ? e........is Faea i F Name SAME $ a Address a ? City Phone ?s w W Name ? ?? Address q oi Cin, Phone I hereGy acknowledgethat I have reatl this application and statethatthe information is correct and agree to comply with all applicable State of Minnesota Statutes and Ciry of Eagan Ordinances. Signature of A Buildmg Permit is issued to: all work shall be done in accordance with all applwable Building Official Assessment _ Water R Sew. Police - Fire Planner Council 4/86 Bldg. Off. 3/1 Var. Date GOOD VALUE AOMES $ 274.00 Permit 24.00 Surcharge 137.00 Plan Review 575.00 SAC Water Con n. 5 0 0. 0 0 Water Meter 63 . 50 Road Unit 290 . 00 rr. PI. 156.00 Parks I Copies--- $- ?.Qi-9-50 - on the express condition that of Eagan Ordinances. . 1986 BOII.DING P? APPLICATIOH - CITY OF EAGAN NOTE: 9LL CAHTRACTORS M[1ST BS LICSN56D itITH THB CITY OF EAGSB COP4MOCIAL SINGLH F9NIILY DWSLLINGS INCLUDE 2 SETS OF ARCHITECTURAL INCLIIDE 2 SETS OF PLANS & STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS ENERGY CALCIILATIONS $2,000 LANDSCAPE BOND To Be Used For: J f? Valuation: .? ` •- Erect Remodel Repair 9ddition Move Demolish Int.Impr. Site Address 44 0 b ?--? 4h OFFICE DSB ONLY Lot 3a Block `7j Pareel/Sub Owner Address 1%?Q 9 3'Z-45:?7 z? City/Zip Code Phone ?Z= - Contractor I-lj Address City/Zip Code Phone Arch./Engr. _ Address C3ty/Zip Code Phone # Install Date: ?j /Z-?55C5 Occupancy Zoning Type of Const U of Stories Length Depth Sq Ft 9PPEOYALS FSES Assessments Perm3t Water/Sewer Surcharge Police Plan Review Fire SAC Engr Water Conn Planner Water Meter Council Road Unit Hldg Off3-14-965tA Treatment P2 APC Parks Variance Copies R'OT9L NOTS: ADDEE3SFS FOR CORAER LOTS - COPTRACT08/HOHEOiRiES MIIST DESIGNAYE WHICH ADDRE4S IS DESIxHD. N0 CHANGES NIC.L BE ALLOWSD DHCE BQILDING PERMIT IS ISSiIED. FOR SALE UN ITS 3830 Pilot Knob Road! P.O. Bo 2G-A199, Eagan, MN 55127 N2 11661 ' PHONE: 454-8100 BUILDING PERMIT Receiptp Tobeusedtor 1 OF 4 PLEX Estvalue $48,000 Date MARCH 20 1g86 4413 CLOVER LN y Erect LS xs Occupancy Sde Address EDEN ADDIITON 3 30 Remodel ? Zoning Lot Sec/Sub. Block Repair ? V Type of Const. Parce l No. Addition ? No. Stories GOOD VALUE HOMES Move ? Length 44 ' w Name Demolish ? )d - Depth O Addres _ ?LAINE Int. Impr ? Sq. Ft. Install ? phone Ciry $AMF APProvals Fees o Name 74 .00 _ `u ?p Address Assessment Permit h ? City Phone Water & Sew. Surc arge -=. 00 p I i Plan Review F z Name ? y Address ¢ W City Phone I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and Ciry n a n Ordin ces. j Signature of Permittee,,? GOOD VALUE HOMES A Building Permit is issued to: all work shall be done in accordance with all applicable State of Mi esc Building Official ' oce - Fire Eng. Planner- Council - Bldg. Off. 3 Var. 575.00 SnC water Con n. 500.00 Water Meter 63.50 Road Unit 290.00 Tr. PI. 156. 00 Parks Copies--T .? T? 50 on the express condition that an Ordinances. 1986 HUII.DING PERMIT 9PpLICATI011 - CITY OF EAGAN AOTS: ALL M[IST BE LICBNSSD ilITH THE CITY OF SAG9N INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS $2t000 LANDSCAPE BOND To Be Used For: Valuation: Date: Site Address IM13 OFFICE DSS ONLY Lot '? 0 Bloek 3 Pareel/Sub Owner Address 9 3 City/Zip Code Phone Contractor (j ??yp Address City/Zip Cade Phone Areh./Engr. Address City/Zip Code Phone 8 COt4lEItCIAL SINGLE FAMILY DBS[.LINGS INCLIIDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCULATIONS Erect Remodel Repair Addition Move Demolish Int.Impr. Install Occupancy Zoning Type of Const U of Stories Length Depth Sq Ft 9PPROVALS FSES Assessments Permit Water/Sewer Surcharge Police Plan Review Fire SAC Engr Water Conn Planner Water Meter Council Road Unit Bldg Off 3 I 86 SiA Treatment Pl APC Parks Variance Copies TOT9L NOTE: ADDRESSSS FOR CORRER LpTS - CONTRACYOB/HOMEOSiNSR M[JST DESIGNATE iiHICH ADDRESS IS DSSIBSD. NO CHANGES IiILL H8 1LLOfiTM ONCE BDII,DId1G PSRI4IT I3 ISSUED. F CITY OF EAGAN 0 F,OR SALE UNITS ??? ? 3830 Pilot Knob Road, P.O. Box 27-199, Eagan, MN 55121N2 PHONE: 454-8100 BUILDfNG PERMIT Receipt # 11660 1 OF 4 PLEX vaiue Est $48,000 oate iy? To be used lor . R3 4413B CLOVER LN Erect C? Occupancy pD SiteAddress 3 EDEN ADDITION Remodel ? Zonin9 Lot 29 Block Sec/Sub. Repair ? Type of Const.-V- Parcel No. Addihon ? ? No. Stories 44 Length GOOD VALUE HOMES Move Demolish ? Depth w Name Int. Impr. ? SQ. Ft. o Address BLAINEphone 780-5510 Install ? Ciry Fxa i o Name SAME ? Q Address ? piry Phone U Q wW ?z x? u <i W Name Phone I hereby acknowledge that 1 have read this applwation and state that the information is correct and agr e to comply with all applicable St te oi Minnesota Statutes and C, o a n Ordi ces. Signature of Permitte GOOD VALUE HOMES Assessment Water 8 Sew. Police Fire Eng. Planner Council BIdg.Off. 3 14 81 Var. Date 274.00 Permit 24.00 Surcharge 137.00 Plan Review 575.00 SAC 500.0 0 Water Conn. 63.50 Water Meter 290.00 Road Unit 156.00 Tr. Pi. Parks Copies ? ? 50 . - on the express candition that Ea9an Ordinances. A Building Permit is issued to: lica faG f Minnesota all work shall be done in accordance with all app Building Official Jla% ( ; V e L 1986 BUILDING PBRMIi APpLICATIOH - CITY OF EAGAH NOTSs AI.L COHT(iACTOHS MOST HB LICENSED WITH YHS CITY OF EAGALT eommnCiAL SINGLS FAlIILY DWSLLIHGS INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS & STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SUR9EY SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS ENERGY CALCULATIONS r - $2,000 LANDSCAPE BOND To Be Used For: ? ?j- Valuation: ??Q? -....? Date: L?- /02-$6 Site Address OFFICE IISS OHLY Lot fi Block Erect Y? Occupancy - Q 3 Remodel Zoning P9 Parcel/Sub Repair _ Type of Const SL Addition ?l of Stories Ocmer Move Length Address Demolish Int.Impr. Depth Sq Ft 24- City/Zip Code Install _ ------------- -----------°-- ------- Phone :??29 APfROVALS FSS.S Contraetor Assessments Permit 2l4• ? Water/Sewer Surcharge 2¢, Address Police Plan Review j3 7, Fire SAC S"75, City/Zip Code Engr Water Conn SDO. Planner Water Meter (v 7?-° Phone Council Road Unit I-1:5i O- Bldg Off3148CSr?Treatment Pl l S(o. 9reh./Engr. APC Parks Variance Copies Address _ TOTAL City/Zip Code Phone # NO?S: ADDRF.SSfiS gp8 CpgNER I,pTS - COPTRACTO&/HOMF70WNSR lIQST DSSIG86TE HHICH ADDRESS IS DfiSIBED. NO CH9NGES WILL SH 9LLOilBp ONCE BOILDING PERHIT IS ISSQED. PERMIT CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (651) 681-4675 PERMIT TYPE: °IJ T i D 1 N c Permit Number: 034346 Date Issued: 01 /08/9 y SITE ADDRESS: P.Z.N.; 10-22750-290-03 44136 CLGUER LHNE LOT: 29 BI.qCK: 3 EDEN DESCRIPTION: ? . ? . ? , . .. . _, ., . .. REMARKS: u r! t T t3 . FEE SUMMARY: CONTRACTOR: - ApPLicant - sT. LZC. QWNER: CUSTOM CONCEPTS COPtST 18987290 20142417 HEDlUNO NANCY 16540 KEPdRICK LOOP/STE 6 41138 CI.OVER LHIVL`- LAI<EV:fLIE Mh 55044 CAGFlN Mhl 55122 (612) 898-7290 I here.by acknowledqe Chat I have rsad Lha.s zpolicaCion arid atate Chat the infiarmataon 1s earrect ancl evree tn comply wiY,h all app.lica6lF 5Y.ate oi' Mn. SYatutes and Citv oY Eaqan Ordinances. IL J ? APPLICANT/PERMITEE SIGNATURE ISSULDI) BY. SIGNATURL i REPLFlCE SIDING BullrJinp Permit TvUe ST'OftM OAmAGE FIuSldLnq Wts,rk Tvpe RL-PFeTR ?-Cen--tis Codc, A, 434 AlT. RSS57DEIVTIAL e. '' 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) . . CITY OF EAGAN 3830P? 51) 68104?-55122 -q Ot -t o New Conslruction Requirements ? 3 registered site surveys ? 2 copies of plans (inGude beam & window sizes; poured fid design; etc.) ? 1 enerqy calwlations ? 3 copies of tree preservation plan if lot platted after 7!1/93 required: _ Yes _ No DATE: I - -I " gtq Remodel/Reoair Reauirements ? 2 copies of plan ? 1 site surveys (exterior additions & decks) ? i energy calculations for heated addihons CONSTRUCTION COST; y 3 7 S DESCRIPTION OF WORK: STREET ADDRESS: C-kO(J..,;I 9, Lo,n-? LOT: BLOCK: SUBD./P.I.D. #: <E:Ju V\1 ------------------ PROPERTY I:?c First ? qbl'VEIt Su?eci Address:-------------- -- ------------------ -------- City - ------------ -- State: ---- ---- zip' ----------- (:ompvi??:__ Pltonc t?: ?rL-s1?-?----- --------- CONTRACI'OR ?- Street License QOl 'y 2.? /? Esp. ----- Cu}' ----------if---l? -- - Slatr. -zs?---- Zip: ---- ARCHITFC I/ ENGINEER Coinpany:------------ ---- --- Pliouc #: -------------- Vamc -- --- Registiahott #: --------- ----------- SliCf[ t1(IdfCSS:_---- __-'__-------------- ___--_--------- _'__ ClCy ----- _----------- __---SIflII': -------- ___ ZI[): Sewer & water licensed plumber (new construction only): _ change and lot change is requested once permit is issued. Penalty applies when address I hereby acknowledge that I have read this application, 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: r--- OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes - No - Not Required PERMIT CI.TY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (651) 681-4675 PERMIT TYPE: B u z L o t NG Permit Number: 0 3 /13 4 5 Date Issued: 01 I08/ S 9 SITE ADDRESS: 4413 CLUVC•R LANF LOT: 30 L?LfICK: 3 1- 0E 1d P.T.td.: 10-22750-.'.00-03 DESCRIPTION: REPLACE S.IDIN6 Biriidind._Permit 7vpe S1Oi?M DAMA6F 43us1dtnq Worl< Type, FEPATh2 Cnnsuc CtsdP 4:34 WLT. RE5TUENTLAL . REMARKS: FEE SUMMARY: CONTRACTOR: - FaPplrc..ris-. - s-1. LzC. OWNER: CUSII"OM CONCEPTS f.;ONST 1II987290 20142417 THOMPSON DOUG 16540 KENP.ICI< LOOP/STE B 44.73 CLOVER LANE LFlKE`JI:LLE MN 55044 EAGAN MR! 56122 (672) 898-7290 i iierebv acknow.lpdno thit :[ have read [his apolicaiion and ht,ate that the inPo,•mat_ion i4 ci>rrer:t and aqrep L'o r.omplv wi.tli all applicabite State ot Mn. Stnr.utes ?aod Citv oT Laqan Ordin?nces_ I APPLICANT/PERMITEE SIGNATURE Q,SSUEDBY.SIGNATUFIE I 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) ? ' • CITY OF EAGAN 3830 PILOT KNOB RD - 55122 q (651) 681-4675 New Construction Reqmrements ? 3 registered site surveys ? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ? 1 energy calculations ? 3 wpies of tree preservation plan if lot platted after 711l93 required: _ Yes _ No DATE: I --1 -9 ? RemodellReoair Reowrements ? 2 copies of plan ? 1 site surveys (extenor addi[ions & decks) ? t energy calculahons for heated addibons CONSTRUCTION COST; L-? ?J 7 S DESCRIPTION OF WORK: STREET ADDRESS: LOT: -3 0 BLOCK: SUBD./P.I.D. #: ? N;unc __ Plione #: PROPERTY OWN LR Strccl : City S[a[e: Zip: C;omp:ui}': (_VVU? ? -- Yhone #: (? l GS=??/tJ------- CON"1'li:1Cl'( ) lt StieetAddress:_/?Ecense#WIY2?/?Z Lxp. c«v ----------? -? ------------- sL«e: _ - -------- Zip: --- ARCHITECT/ E\GNEER Phone #: Registntton #: SU'cet Address:-------------- ----------- ---------------- C:ily -------- ------------------- ----- Slalc: ------------- Zip' Sewer & water licensed plumber (new construction only):. change and lot change is requested once permit is issued. Penalty applies when address I hereby acknowledge that I have read this application, 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: OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received - Yes - No - Not Required REACTIVATE _ R [?CEO VE D F'e?t MIt*N J U L 0 2 1993 D,1q k 8l" --- - cirr oF EaGAN 1993 BUILDING PERMIT 681-4675 APPLICATTN ?? a ? --? SINGLE 8 MUITI-FAMILV 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, l set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month. in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date 7 -2_ Valuation of work Site Address: 13 C/a,,?,? r??r n F STREET SU1TE / Tenant Name: (commercial only) r i? aLOCx TSUBD.Fd'?j.r ?Jdcj * P.I.D. Descri tion of work: rer. , The applicant is: 0 Owner ? Contractor 0 Other (Deetribe) Name 5l.12 r-a T- A??r,?? Phone l, 9?3-!c! ? Property LAST FIRS Owner Address tiW11 R C_ / 0?,- '4 a H0, STREET ' STE M City ?._dA H State N1va . Z i p Company f5??.: Phone Contractor Address License # Exp. City State Zip Company Phone Archttect/ Eng(neer Name Registration M Address City State Zip Sewer & water licensed plumber . Processing time for sewer & water permits is two days once area has 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: _ UFFIGE U't VIVLY BUILDING PERMIT TYPE ? 01 Foundation ? 02 SF Dwg. ? 03 SF Addition ? 04 SF Porch [3 05 SF Misc.. WORK TYPE ? 06 Duplex ? 07 4-Plex ? 08 S-Plex El 09 12-Plex ? 10 Multi. Add'7 ? 31 N" ? 33 Alterations *.32 Addition ? 34 Repair GENERAL INFORMATION ? 11 Apt./Lodging O 12 Multi. Misc. O 13 Garage/Accessory ? 14 Fireplace X15 Deck ? 35 Tenant Finish 0 36 Move Const. (Actual) Basement sq. ft. (Allowable) lst F1. sq. ft. UBC Occupancy ? 2nd F1. sq. ft. Zoning Sq. Ft. total M of Stories Footprint Sq. ft. Length ? On-site well Depth On-site sewage APPROVALS Planning Building Engineering Variance REOUIRED INSPECTIONS ? Site Footi ng ? Wallboard Final 0 Framing ? Draintile ? T 0 ? Insulation ? Fireplace Permi t Fee 2 ??p Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit 3/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies ,50 Other Total: Yaluation: $ . ?. ? 16 Basement finish ? 17 Swim Pool 0 18 Cortm./Ind. ? 19 Comin./Ind. Misc. ? 20 Public Facility ? 21 Miscellaneous 0 37 Demolish MWCC System City Water PRV Required Booster Pump Fire Sprinkler Census Code SAC Code Assessments SAC % SAC Units PERMIT CITY OF EAGAN 3830 Pilot Knob Road Eagan, Mir.viesota 55122-1897 (651)681-4675 PERMITTYPE: R (J sL n_i.N n Permit Number. 0 3 4 3 4 3 Date Issued: 01 107 /99 SITE ADDRESS: P.L.N.: 10-22750-320-03 9411Fi CI.OVFti I_APIE iOTo :32 FSIUCY.- 3 EuEN DESCRIPTION: , REPLACE SIDiN6 Bul.tdin?,? P ermii: Tvo -a S1'ORM DAMFIGE Iitai.l dinq Warl; Tvpe f?EPAIR ,Cetisus Code \ A34 ALT. RESIDENTIHI. ? .^.? i. ? ?i? . . REMARKS: UNT,T R. FEE SUMMARY: CONTRACTOR: - Anplicant -- sT. t.tr.. OWNER: (:U5101+1 CONCEP75 CpNS7 18987290 20142417 LAMBERI" JULIE 16548 KEIV92.[CK I_UOP/STc B 94116 CLOVEft IANE LAKFV:CLLE MN 55044 [AGr11V MN 55122 f6121 R98-7290 I I herebv Ucknowtedqa that I have i-ead this apolication and state L'hat the intorrnation LF aori°ecC antl aqrwe to comp.ty with all applica6da SCat:FZ of INn. SY.atuT,es and Ctty o't Eaorn Ordi.nances. I? - I APPLICANT/PERMITEE SIGNATURE IS9 ED BY: SIGNATURE 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN l I? 3830 PILOT KNOB RD - 55122 '7 l?? n (651) 681-4675 ! New Construction Reawrements RemodellReoair Requirements ? 3 re9istered site surveys ? 2 copies of plan ? 2 copies of plans (inGUde beam 8 window sizes; poured fnd, design; etc.) ? 1 site surveys (exterior additions & decks) ? i energy calculahons • 1 energy calculations for heated additions ? 3 copies of tree preservation plan if lot platted after 7/1l93 required: _ Yes _ No DATE: 1 -7 - q q CONSTRUCTION COST; (43 7S DESCRIPTION OF WORK: STREET ADDRESS: LI ?'I I?r-5 c IC?k LOT: ? BLOCK: ? SUBD./P.I.D. #: N;une:---L_i_tmlalr_-?------- ? (.lli 1 'C- Ylio(le ik: PROPERTY Lua First owvi:it s<<«< Aaa«ss: ----------- ----- City State: zip: I -.) a-- Co,,ip.ulv:-??-?--- 29- -------- co??rx:??rox ? ?? StreetAddress:??!?.?/?,? _' ALtcense#?/„{G1fZ_Exp. ch>? -------67--4? ----- -------- st,te: ?C/-? --- Lip' ---- ARCHITECT/ ENGNEER Coivp:uiy:------------ ------------- ----- --- Yhone #: --------- ----- ---------- - Reo*isiration #: Strcc[ Address: -------------- ----------- Citv ----- --------------------- - Statc: ----- --- Zip: Sewer & water licensed plumber (new construction only): _ change and lot change is requested once permit is issued. Penalty applies when address I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. n/! 7 Z", Signature of Applicant: ?a, ?•y? OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No - Not Required PERMIT CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 {651) 681-4675 PERMIT TYPE: B u i?. 01 N r Permit Number: 0 3 4 3 4 2 Date Issued: 0 1 % 0.7 / 9 9 SITE ADDRESS: P.C,N.: 10-22750-310-03 4411 ct.oveR LAivG 1_OT: 31 BtUCK; ' L-DEIV DESCRIPTION: REPLflC:L" SIDTNG Bu:tl?iinc',Perrnit l'vpe STORM DflMAf,L owildinq Work Tvpa REPAlR /t:insuc Coi?e ?? 434 ALT< RESIOEP!7I61L . ? . ..??i , ????? ?` . ??-• ,x . i . REMARKS: FEE SUMMARY: CONTRACTOR: - RPp1icant - sr. Lzc. OWNER: Cl1STOM CONCEPTS CUNSi 1898729L'? 20142417 I.FE RUDREY 9.b64A K E M RICIC L0 0 P15ff_' B 4411 CLDVEh2 I-ANE LAKEVILLE hIN 56044 EpGHN MN 55172 (612) 898-7: 943 I nere6y acknowl^dae i.haC T have t-ead tl-iis apolication 6nrl st+aT^ that the iriiornation is correct and aqree t.n comuJ.v with a11 aoplicable Stal-p ot Mn. StiatuLas and C:.ity at Eanan Ordiriances. iI APPLICANT/PERMITEE SIGNATURE ? UED BY: SIGNATURE 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) - ' CITY OF EAGAN 3830 PILOT KNOB RD - 55122 l 9 ` (651) 681-4675 1 " r7" ? I New Construction Requvements ? 3 registered site surveys ? 2 copies of plans (include beam & window sizes; poured fnd, design; etc.) ? 1 energy calculation5 ? 3 wpies of tree preservahon plan if lot platted after 7/1/93 required: _ Yes _ No DATE: l ? -? 9 DESCRIPTION OF WORK: C?tU RemodeilRepair Reauirements ? 2 copies of plan ? 7 site surveys (exterior additions & decks) ? 7 energy calculations for heated additions CONSTRUCTION COST; "I 3 -7 J U U STREET ADDRESS: c? I( ( I CkC?vQ'r ?C? vi o LOT: 3 1 BLOCK: 3_ SUBDJP.I.D. #: L?---------- Yhonelt: PROPERTY 1-? F;rsi OW"V1:R SU'ee[ Address: CiLy State: zin: __Ts_L? ?'LL--- Ylionc H: C2lS U?'?.I ??? _ C(?\"IR.\Cl'OR v ? StreetAddress:?C???b_y_'??LP_'Liccnse?IA/4Z?/1_Exp.------ Gn ------L L--------------- Sta[c: Y _------ Z''P' 6? OZ?? -- ARCHITECT/ E V GIPIEER Sircct Citv Sewer & water licensed plumber (new construction only): _ change and lot change is requested once permit is issued. Penalty applies when address I hereby acknowledge that I have read this application, 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: 49W-L? 67 OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No _ Not Required Yhone #: ------ -------- Rerish-ation --- S[ate: "Lip: CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: :*TOT?': PAYMENS OF FEE AT TSME OF : APPLZCA'LTON DOFS NJT CONSTI2STPE APPROVAL OF PERNIIT, aisrEMoiv oF sF.:Wax Arro/at WAIEa a T.TATTONS WIId. NCYP BE SQED- ULID UNTII, PII2NIIT AAS BFEN APPR(7VID. (Lot/B1ock7Sub ivision or Tax Parcel ID ) IF E}QSTING STRCGZCRE, DATE OF ORIGINAL BC?ILDING PERMIT ISSL'11NCE: PRFSENP ZONING/PROPOSID LTSE: ??n Year ? COrmERCIAi./REf11IL/OFFICE ? R-1 SINGLE FAMILY Q INIDUSTRIAL Q R-2 DLPLEX (1t„p Lfiits) n INSTIZ[JTIONAL/GOVERiag,'NT ? R-3 Zl7WNiOUSE (Three + Units) ( Onits) . p R-4 APARTMEN'p/CODIDOMIDIILTI ( Units ) 2) NAME: ADDRESS: 42 CITY, $TATE, ZIP: PxorE: 71 . 3) • ,:?,. NAME: ADDRESS: ? CITY. STATE, ZIP: PHONE: MASTER LICENSE# 4) •• • g- NAME: . ADDRESS: CITY, STATE, ZIP: PHONE: •5) ' ?: • ?• : a • o? ?? ? CONNECTION TD CITy SEWEEt ? Cp?,"tION ZL7 CITY WATER P1lIItb2L'S LiCEI1S2: ACt1V2 EScpired Not recorded St?f Initial ? aiim , . . . 6) ? • • i• ? PI,EASE HOLD APPRpVFa PE[iMIIT FOR PICK-UP BY ONE OF ABOVE ? PLFIiSE MAIL ApPROVID PERMIT 1b 1, 2 3. 4. ABOVE ? /a/-/ (Circle one) FOR CITY USE ONLY ? PERMIT # ISSUED lvis Pd w/Bldg. Permit FEES: $ $ /6 - So $ $ 1l?-5-U SEWER PERMIT (INCLUDE SORCIiARGE) WATER PERMIT (INCLUDE SC'RCHARGE) $ GxJ 'S D $ WATER METER/COPPERHORN/OL'TSIDE READER $ $ WATER TAP (INCLODE CORPORATION STOP) $ $ SEWER TAP $ $ /,5. ?a ACCOUNT DEPOSIT - SEWER $ $ f5, C?U ACCOC'NT DEPOSIT - WATER $ $ wAc $ ? Jr7?S . Cr7J $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ • LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ s U $ J? 4a TOTAL ',z 11?V RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCA VATION IN POBLIC RIGHT OF WAY? ED YES IF YES, THEN A" PERMIT FOR WORK WITHIN POBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVIS20[V. LIST AS A CONDITION. SLBJECT TO THE FOLLOWING CbNDITIONS: APPROVED BY: TITLE: DATE : _?41/?4 CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION *RYl'F': PAYMRnlI'' OF FF.E AT 1LNE OF APPLICATION DOFS NOT CONSTI1ViE APPROVAL OF PFRMff'f. n4SPncizotv oF sEVM r,rm/ox VMaER TTiS'T'A77.ATTON$ WIIS. NdI' HE $CHID- ULFD []N1'IL PERMIT HAS BFEd APPROVID. •******?***,r*?*a**?,arr***:*******+* (Please Print 1) PROPERTY ADDRESS: Zc%?? ZS LEGAL DESCRIPTION: •- _ Lot B ock Subdivision or Tax Parce ID IF EXISTING SIRL'CLSJRE, DATE OF ORIGZNAL BLILpZNG pgtMiT ISSL'ANCE: ' , PRFSENP ZONING/PROPOSID CSE: bbn Yea q CONR7QtCIAL/RETAIL/0FFICE IIaJCSTRIAI, [[ INSTIZS,"SIONAL/GOVII2NIINEN'p 2) NA6'IE: f? ADDRESS: CITY. STATE, ZIP: A o-,L( ? PHONE: q > J - 6 i 3) u c ?• NAP'lE: ADDRESS: CITY, STATE, ZIP: PHONE: ? R-1 SINGLE FAMILY Q R-2 DLPLEX (Ztao Dnits) ? R-3 TOWNfIOC?SE (Three + Units) ( L?nits) q R-4 APAR7'Nm/C0DIDON1iDII(.T1 ( Units ) v- l.? 1NASTER LI(ENSE$ 4) •.. • • •.iu?: JJ , / 'T* ( L /?Y? , /?. ??? '?«/ _ AoDRF-ss: CITY, STATE, 2IP: ? PxorE:_ t) ? Active Fbcpired Not recorded Starf--tial 5> i"m ?i i d• •?• : a • n? - a? ? CONNE(.TION TO CITY SEWER ? CpNN?CpION TO CITY WATIIt ? Oi'HER ' . 6) 115 • O 'i- ? PI.EASE HOLD APPROVID PEPMT E'OR PICK-UP BY ONE OF ABOVE -' --- -- Ql PLEASE MAIL APPROVID PERMIT TO 1,(?P2 3, 4, ABOVE (Circle one) ' 7) r. r• u• • s? l'`?"? ?/C.?•EL??s d? .FOR -CITY USE ONLY ?V PERMIT # ISSDED 7?f6 3 P?6 Pd w/Bldg. Permit FEES: $ $ 16-5D SEWER PERMIT (INCLUDE SURCHARGE) $ $_ ?C)• SO WATER PERMIT (INCLUDE SURCHARGE) $- $ WATER METER/COPPERHORN/OL'TSIDE READER $ $ WATER TAP (INCLODE CORPORATION STOP) $ $ SEWER TAP $ $ ACCOUNT DEPOSIT - SEWER $ 15 $ ` ? ACCOC'NT DEPOSIT - WATER $ $ WAC $ `57`5-` ov $ SAC . $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRONK WATER S $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: TOTAL RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN POBLIC RIGHT OF WAY? F--j YES IF YES, THEN A"PERMIT FOR WORK SVITHIN PUBLIC Q ROADWAY" MUST BE ISSUED By THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CbNDIT20NS: APPROVED BY; TITLE: DATE : CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION *ATS: PAYMFNC QF k'EE AT TIME OF APPLICATION DOFS NOT COASTI4LTtE APPF20VAL OF PFd2NQT. INSPFX.TION OF SESER APID/OR WATII2 aSTAr.ramrONS WIIS, NOT BE S(HED- UI.ID UN7PIL PERI-ffT HAS BEETI APPRaVID. 1) PROPERTY ADDRESS; s'- y?3 C?ld?t?2 LEGAL DESCRIPTION: . Lot Block Subdivision or Tax Parcel ID I' E}QSTING SIRL'CiLTRE, DATE OF ORIGINAL H-1 ILDIN„ PERb1IT ISSL'ANCE: ' ? . PRFSIIW ZANING/pROPOSID OSE: Mon Year q corNERcIAz./RErazr,/oFFic-E ? IDIDC?STRIAI, [I INSTITUTIONAL/GpVERNZ1ENT 2) 1?? R-1 SINGLE FAMILY Q R-2 DOPLEX (Two IInits) ?c R-3 TOWNHOIISE (Three + Units) ( t?nits) p R-4 APARTMENT/COAIDOMIf1IUM ( Units ) N1ME:Ce? ADDRESS: Ase>l CITY, STATE, ZIP: PxorrE: 3 - S % 7/ 3) u ca• NAMEs RDDRFSS: ? CITSC, STATE, 2IP: PHONE: MASTER LI(ETiSE# 4) ?a• ? ? DInME: _ ADDRESS: CITY, STATE, 2Ip; PHONE: ? - riiucioers License: Active Ecpired Not recorded St?Initial .5) ? v? ? d• • oi• : ? • ?? - ?? ? CONNECPION TO' CITY SEWIIt 0 CpNNE)CrION 4U CITY WATII2 ? 0'IggTt_. 6) " .•?. ? RLEASE HOLD APPR0VED PEEtMIT FOR PICK-UP BY ONE OF ABOVE -°'- -- PLFASE MAIL APPROVID PEE2MIT TO 12 3. 4. ABOVE . (Circle one) 7D r r u• ?/l./r.?f? % r.e.r...?.. o// ?.` FOR CITY USE ONLY PERMIT # ISSLED Pd w/Bldg. Permit FEES: $ $__ "5 0 SEWER PERMIT (INCLUDE SURCHARGE) $ WATER PERMIT (INCLUDE SORCHARGE) $ WATER METER/COPPERHORN/OL'TSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ O71 ACCOUNT DEPOSIT - SEWER $ $ ACCOUNT DEPOSIT - WATER $ ? D73 ? C?D $ WAC . $ 09 $ SAC $ $ TRL?NK WATER ASSESSMENT $ $ TRL'NK SEWER ASSESSMENT $ $ LATERAL BENEFZT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ TOTAL RECEIPT { RECEIPT DOES LTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? Q YES Q NO IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MOST BE ISSOED BY THE ENGINEERING DIVISION. LIST AS A COIVDITION. SUBJECT TO THE FOLLOWIN6 CbNDITZONS: APPROVED BY; TITLE: DATE : CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION *KYl'F': PAYMMF,t>7r' OF FEE AT TIME OF APPI,ICATION DOFS IVCYr CONSPIIT.TIE APPROVIIL OF PFRMIIT. INSPDLTION OE SEWEIt ADID/OEt MTER Ij1S'LATTATTOu$ WrT.7. NOT $E $(Hm- ULID UNTII. PF.RNIIT HAS BEIId APPROVFD. +* * ?: ? * *+r:,t * *,t tr t,t *+* * * *+t * * *,r *,t * * * P ease Print) 1) PROPERTY ADDRESS: !/L/f _? /? ? /10 Z/ 4?e LEGAL DESCRIPTION: •- . Lot Block Subdivisyon or Tax Parce ID IF EXISTING STRCLMME, DATE OF ORIGINAL BOILD2NG pERMIT ISSL'ANC.E: ' ? PRF_SEENF ZONING/pROPOSID OSE: (fbn Year Q COIg'E2CIAL/Rfi'PAIL/OFFI(E Q IbIDC'STRIAL [] INSTI7-1TIONAL/GpVEI2?'p 2) R?@II C] R-1 SINGLE FAMILY R-2 D(?PLEX (ZW L?nits) ? R-3 TOWNHppSE (Three + Units) ( L?nits) p R-4 APARTMENp/CONIDOMINILTI ( Units) ADD CITY, STATE, ZIP: PHONE: 3) u i: ?• NAME: ADDRFSSe CITY, STATE, ZIP: PHONE: MASTER LICENSE# 4) •?? • ? NAME: ADDRESS: CITY. STATE, 2IPo?s?=Q PHONE: . eltuwers i,.icense: ? Active ESxpired Not recorded StaTF 7nitial •5) ? '? v ? a• ?• : a • a? - a? ?f CONNF'.CTION 7O CITY SEWEE2 J?a ITII CpNNF)CTION TO CITY WATER ? pTFIER ' . 6) ?? ?• u• r ? PLEASE HOLD APPROVID PEE2BfIT EbR PICK-UP BY ONE OF }1HOVE ----- PLEASE MAIL APPROVFD PERMIT TO 1,2 3, 4, ABOVE (Cirale one) ' 7) r r. u• ? j ?.!'=? t-?s-sr?re---? _ FOR CITY USE ONLY - PERMIT # ISSUED Pd w/Bldg. Permit FEES: $ $ SEWER PERMIT (INCLLDE SURCHARGE) $ $ %fJSd WATER PERMIT (INCLUDE SURCHARGE) $ $ WATER METER/COPPERHORN/OL'TSIDE READER $ $ WATER TAP (INCLLDE CORPORATION STOP) $ $ SEWER TAP $ $ ACCOUNT DEPOSIT - SEWER $ $ ?S.Cr"a ACCODNT DEPOSIT - WATER $ SO O p-? $ WAC $_ ?5 75`. ?-o S sAc $ $ TRL?NK WATER ASSESSMENT $ $ TRC!NK SEWER ASSESSMENT $ $ • LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRLNK WATER $ $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $- Oa? I y•S G? $ J? ?' tr7J TOTAL -lo l 7? l0 ?/ 1.3-3 RECEIPT RECEIPT DOES UTILITY CO[VNEC TION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? ? YES Q NO IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSLED By THE ENGINEERING DIVISION. LIST AS A CO[VDITION. SUBJECT TO THE FOLLOWING CbNDITIONS: APPROVED BY; TITLE: DATE: CITY OF EAGAN 3830 PIIAT KNOB ROAD EAGAN, 141N 55122 PHONE: (612) 454-8100 FOR CITY USE ONLY PERMIT # ?c3C?/?d RECEIPT #?- DATE: ..._......... 1?S?p?N?'IA?3 PLEASE COMPLETE DPPER PORTION ONLY FOR SINGLE ] ...? . .. ... . .. ? TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. ------------------------ -----------"°_--------'-----------°-' WORK DESCRIPTION FEES NEW CONST ADD ON -v? REPAIR OWNER NAME: U-u?Lu,F Q• AL SITE ADDRESS: 44II ft"a (J?t, LOT: IS ` BIACK ,?' SUBD. INSTALLER: 1Yhk6rS ADDRESS: xm) I4-st, ault CITY: ZIP: S?JI? PHONE #: y?I-qOQQ ADD-ON MINIMiJM tiVAC 0-100 M BTU ADDITIONAL 50 M BTU GAS OUTLETS - MINIMUM OF 1 PER PERMIT SUBTOTAL: STATE SURCHARGE: TOTAL: DWELLINGS & 24.00 6.00 3.00 $ S?u .50 $1S: S?O SIG TUR OF PERMITTEE Cq.3dMERCTAT./TNIJU$T#.CTAI..t YLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDZNGS, APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE ' NOT REQUIRED FOR EACH DWELLING UNST. ------------- CONTRACT PRICE: OWNER NAME: SITE ADDRESS:_ LOT: SIACK _ SUBD. ' INSTALLER: ADDRESS: CITY: ZIP: PHONE #: FOR: FEES 18 OF CONTRACT FEE. STATE SURCHARGE _ $.50 FOR EACH $1,000 OF PERMIT FEE. PROCESSED PIPING = $25.00 $25.00 MINIMUM FEE. CONTRACT PRICE x 18 $ STATE SURCHARGE $ TOTAL: (SIGNATURE) CITY OF EAGAN 2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION (?3 f I i City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos when permits are required for each unit "-l-'3cr_ a'i I o i d nate Site Address ?Z / ? p c- LI? Unit # Property Owner ? Telephone # ( ?s a C?S Contractor Street Address 410 WE3T LAKE STREET c;ty M State , 612-824-28be Zip Telephone # ( ) Bond #• Eapires: The Applicant is _ Owner _NContractor _ Other Add-on or alteration to esisting dwelling unit $ 30.00 ? furnace Replacement- _Additional ' \ _ air exchanger t air conditioner New Re lacement - - - P FE3 other - ?.,. State Surcharge $ .50 T t ? $ .5 a a I hereby apply for a Residenrial Mechanical Permit and acknowledge that the information is complete and accurate; that the work will be in conformance witL the ordinances and codes of the CiTy of Eagan and with the Mechanical Codes; derstand this is not a pemut, but only an applic tion for a ermit, and work is not to start without a et?ti?• that the work w' e' cordance with the a p oved plan in the case f w c requires a revie d approval of pla . Applicant's Printed Name Ap icant's Sign ??22W 2007 RESIDENTIAL PLUMBING PeRnniTaPPUC,aTioN CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 .*lS- 50 Please complete for modifcations to existing residential dwellings. Do not combine inside and outside olumbina on the same annlir.ation senarate annlications and oermits are reouired. Date Site Street Address C l[Z ffic? . Unit # Property Owner Gl Telephone #kqcj 1) (e)p) '-T- 0qu Contractor Telephone # Ch arnpion Address 691_365_1340 City State Zip Eagan, AAPI 5512U3-1339 The Applicant is: _ wner 8 Occupant Y Licensed Plumbing Contractor Septic System New Refurbished Submit 2 sets of plans and MPC license Includes County fee $ 100.00 Per as-built $ 10.00 Fire Repair (replace burned out fixtures, etc.) $ 90.00 This fee a lies when extensive lumbin re airs are made to a buildin . Alterations to existing dwclling $ 50.00 _ Add plumbing fixtures to main level lower level. This fee includes installation of a water softener and/or water heater at the same time. !f you are installing onl a water sofrener and/or water heater, do not complete this section; move to the next section and place a checkmark next to the appliance(s) you are installing. D _Septic System Abandonment _Water Tumaround (add $136.00 if a 5/8" meter is required) OCT 0 g 20( 7 ' Other: Y_ $ 15 00 Water Heater Water Softener . _ new ? replacement Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00 State Surcharge $ 50 T I $ oW I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate, tnat tne worc wui oe in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I understand lhis is not a permil, 6ut only an application for a permit, work is not to start without a permit and work will be in accordance with the approved plan in the event a plan i reqwred to be reviewed and approved. z ApplicanYs Printed Name Applica Ys gnature 7'"' ------------------ i? ? i j Permit Jt: _??_ I ? Permii Fee: d?.?• O? I I I ? Date Recerved: I r?, I ' Statf: i 2008 RESIDENTIAL BUILDING PERMIT APPLICATION oeta: -Z 7? og' Site naam8: 44 11 -W13 clov e,/ Lt1 Tehant: RESIDENT / OWNER Name: QaP,6 '4 iJ Phone: Address / Gry / zp: Applicant is: _ Ovmer _X_ Contractor TYPE OF WORK Descrip6on of work: kv- r Constructian Cast: 1? dCk? _ 0 O Multl-Family Bulldng: (Yes / No _j CONTRACTOR Name: ?rj ?j?P?S 1?d J?P 4-1*,1I/t)?em License #: 2 ? qil 25 7 Address: Llil) I CitY: rN J'h rrig State: J`27/n) Zip: pnone: - 48 ' con+act Ferswr &b &bd e G S COkIPLETE TF{IS AREA ONLY iF CONSTRUCTING A NEW SUILDING _ Minnesota Rules 7670 Cateaory t Minnesota Rules 7672 Energy Code . Residential Ventliatiwi Catepory t Wotksheet • New enevgy code worksnW Category Submitted Suhnitted (4 submlSSl011 typ@) • Enerpy Envelope Calculations SubmiUed In the lest 12 moMhs, hes the Clty of Eagan fssued a pertnit for a simllar plan besed on a master ptan7 _Yes _No It yes, date and address of master plan: ucensed Plumber: Phona: Mechenlcal CoMractor: Phone: Sewer 8 Weter Contrector. Phone: IUOTE: Plans and suPPdrj -ft clocumm+?s thet?tw aubmlt are?suhstUe?ed to be pubUc h???on potY?ns ot . ? thsMh%rmatlon be?l?ssaled -p qvi a'r?nslAat ?vould?Yin# 11?-Glty? , , np7 (e if dt rfl e s p e?c 740 p! ' y ? . , • I .. • ? M ? rsj ` .`L'i •.VO[iWM??YIHf i??Y.i?OYQ?LW3GlJ. f,? } T.._. i I hereby adcnowledge tAat this iMOrmation 5 cmmplete and accurata; that the work wlll 6e in Contortnance with ihe ordinenees and codes af the City of Eagan; that I undarstand this is nnt a permit, but only an appiuafion for a perm8, and vrork is not to 5t wM ut a pertnit; that the woric will be in accordance with the approved plan m the case or153 which requires a re?ew and approval x (nbe?k .?r,i ?- x I K ApplicanYs Printed Name Applicant's SlgneNre Page 1 of 3 .n • t W- 3 1 fJWff 58 111 EERING ?oi?su?.T??to ?t?ou?EEns ptn?+?IEns ona tniIu 3unvEVoeI COMPANY lHC: 1000 tA3T 1461h iTREET; BUANSVILLE, IIINNESOi11 5633T PII 432-3000 ? ;- Ctj?-??jlrZ cct? ???"'y-e? ? ? ?OQt .X?1.?.Jdj'{? '.ggtCfL: L075 29, 30, 31 AND 32, BLOCK 3, DAKOTA CUUNITY, MINNESUTA EDEN ADDITIUN, 011%s j DEN07-155 6XlSTING 6LE'VATIOA/ (935•0) bENOTES PROPOSEp ELEVA7fUN -?- INDICATES DIIZEC7IUIJ OF SURFACE UWIINAGE NORTN `?395= FINISNEU GARAGE FWOR ELEVAT/ON ScAIE : I" Y 30' EAGAN REVI WEID 9Y DATE -7 L_?...? Li L _ 30. ' 30' FROIJT BUIIDINbI SfiTgqCK Lt?,IE rN? 3b.z b'1 EAST 9,5 fu' 160.00 . . ? ? ;9¢3_Z? -m , 79.77 9 ?.v 93?=0) 6b.23 _ -_ ?n ? P'J - - - - - - - ? , ° 11 L3o L0T\29 I5 ? z ? m ? ?3B.y?39,1 ??p . 5d , 945. J I ? i?t-- -- ? ?°J N? qI2e is, n' r PROR056D i 4-UNIT ??. 1187°44'q3"W` ? 4i 79.00- -- -- •c sz.41-- ? 4? .? I ?. . , - - i ?• , r % A O ? y . BUI DING f9 L O T939 W (939.i) ^ 1 4 ?• LOT 32 °??' :•?KS.N; .` - 8/,.3/__??`' -?. / N 3y L? '° ?? ti ? •1) ? I ... 85.?59 ? ? 5 66.90 N Bo° ?_ I .. 48 os1 'v, / _? j RAiNA6E ?. Gl `_ `J ? /UTy EASE?NT 1 ` x ? K 0 z I hiriby tartify thht thie ie e true and correct repreeentition ot a trlet of land is ihawn' itid deecribed ltereon.. Ae prepared by me on thi¦ 7N day ol 1,VAwwJ. _ j ? - , 14 r,1 Ninn. !lei. 116+..LGojr ? CITY OF EAGAN 3830-Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 PERMIT PERMIT TYPE: 7BUILoi NG Permit Number: 021488 Date Issued: 0 7/ 16 / 9 3 SITE ADDRESS: 44116 CLOVER LANE LQ7: 32 BLOCK: 3 EDEN DESCRIPTION: 13,et3lding).Permit 7ype ,8utltling W'?rk 7ype f'BUild:ing tendrth / 8uildltvg Width`--" _t?-? ?? ? r? DECK ADDITION ao 8 Li ??•?µj?? t"' '? REMARKS: FEE SUMMARY: Base Fes $25.00 COPIES $1.50 Surcharge $.50 Total Fee $27.00 5ubtotal $25.50 CONTRACTOR: OWNER: - ApPlicant - SCHRAFFI AGNES M 44118 GIOVER LANE EAGAN MN (612)683-1017 t I I T hereby aeVcnowlgdgH xha$ I ha've read Cfl3,s; appliaatintt andstate thi?rt ths informatissn is corre,et and agpee ta aom¢1y. tvith ail applicals2e Stats af Mr1• statutes and City pf Eegan,Ordinanees. ; L ???.? ft o,'rL I ]'h ,N 4a'm_d_.e 4/./4 APPLICANT/PEIiMITEE SIGNATU (-15S ED e: 51 NATU E INSPECTION RECORD CITYOFEAGAN PERMITTYPE: BuzLoiwG 3830 Pilot Knob Road Permit Num6er: 021488 Eagan, Minnesota 55123 Date Issued: 8 Y/ 16 / 9 3 (612) 681-4675 SITEADDRESS: LoT: 32 BLpCK: 3 APPLICAN7: 44118 CLOVER LANE SCNRAFFT AGNES M EDEN (612) 683-1017 PERMIT SUBTYPE: TYPE OF WORK: DECK ADDITION (- -7 E ? . ? a., , . . .,. 7 fhtC- 58 ROQE ENGIN6EI?ING "o?'sul.Ti1io ei+ou+EEns P?nttt+Ens cnd IAHU dunvEVOns COMPANY, INC. . 1000 EAST 1461h STFiEFT, BUAHSVILLE, 111HNESOTA 55337 Pfl 432-3000 Cer? Zgvat 17eocrtg2ion: L075 29, 30, 31 AND 32, BLOCK 3, EDEN ADDITlO/J, DAKOTA CUUN7Y, MINNESUTA DENOTt'S (935•0) pENOTES -?-- INDICAT65 NORTH q39•S- F1fJI5HED SCALE 1 I " = 30' 6XI57'ING 6"LEVAT1oN PROPOSED ELEVATlU1V DIRECTION OF SURFACE pFtl41NAGE GARA6E FWOR ELEVATlON EAGAN REVI )IO,E BY DATE ?" I Q "Y>C? ? "Is --r-- L _ (J 1 30 '? -7 c' J -30'FRONT SU)lDiN6l SEjgp,CK LIF,IE EAST -? /60.00 L L_U i c-C., " If:l -Ln 79.77 80-23 _'? l°y - - - - I ti o 1O I LOT 15 om ? 3o M LOT 29 I Z (?n ^? I (9'1_R,o_I -}- - 12% 00 ?p Imt-- -- r e ? ? i 4? ?h? N? q?e is n' r PROR05ED ? • ?L ? 4-UNIT N Bl° 44143°W` I m x : 2 I BUI DlNG 2 ti u a' LOT 4.1? C?.S? i W ?938.?1 ?J ?93Rz) ,/ ^ (n? ?/oQ 31 LQTf 32 3?.5 8/, 3? ? 1 N 37. ? ' a -~-?°l l?? I N Boo q8, o? v, L??i i I hareby certify that thia ie s true and correct repreeentation of a tract ot land as shown'and deecribed hereon.• Ae prepared by me on t1iis 7TJl day of 19 84 . : • ? , ,? ., •*•? 11inn. 1tea. No. /koUS" 67 C!tyofEaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use / �7 Permit #: / 0) q c2 Permit Fee: 40.d Date Received: 1 t Staff: 2012 MECHANICAL MECHANICAL PERMIT APPLICATION �] Date: 10/23//t2 Site Address: Liq fl C/OUer �C41.C, A Tenant: Suite #: Name: Address / City / Zip: Ltd , (55/.2 Name: CI.!" P/) Address: (t -x) 7y7'ayLci Phone: & 5/' 303 --73 )' g J State: /` / !1 V Zip:J� 0c Phone: Contact: C ett 11-7 lam— Email: New V Replacement _ Description of work: i �► License #: City c (90-0-1 Ls�-aag-9 Additional Alteration Demolition RESIDENTIAL ‘VFumace Air Conditioner Air Exchanger Heat Pump Other New Construction Install Piping Gas COMMERCIAL Interior Improvement Processed Exterior HVAC Unit Under / Above ground Tank ( Install / Remove) RESIDENTIAL FEES: $60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) y� $100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) = $ "" TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ x 1% $60.00 Minimum (includes State Surcharge) - If the Permit Fee is Tess than $10,010, surcharge is $ 5.00 - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) = $ Permit Fee = $ Surcharge = $ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 he approved plan in the case of work which requires a review and approval of pia Cl'�A /VOVO, Applicant's Printed Name x Applicant's Signatu 4101'' City of Ekon 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 4(x), 00 j�`59'- 5 5 Use BLUE or BLACK Ink For Office Use Permit #: 1 1 O r1] '513 Date Received: 5Ia Li,/ i Permit Fee: Staff: 2013 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Date: 50 1 (13 Site Address: LI -L-1 It i t O JY li Y i Tenant: }� On ' C °VI Ir 11 �1-� L�1 i� Z Suite #: ResidentlOwner R 0 Y\ 4- 1-f- (OVA V'1,rrBLk C -4'i O I] Phone: (11S 1 303 C3 I9 Name: �/1 Address / City / Zip: _ Y r `-+ 1 -6 Contractor Name: Q Holm/ 1-x..11 V1 . If - License #: ? 2-2-02_651 Address: 19 L 4 VP,VYVi i i 1,1 OV L ¶ 4 ►-1 City: 1-161 S ii State: I - t� Zip: SS b7-,3 Phone: 6Q51-- ' 31" 9i,L' 1 Y Y1 Contact: lc -1,")..1 Email: ►cx=Yvt.f.ifrici c.i.son OhP- U-VVCLIY.cow Type of Work New Replacement Additional Alteration Demolition Description of work: NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening ;methods. Permit Type RESIDENTIAL Furnace COMMERCIAL New Construction Interior Improvement i Air Conditioner Air Exchanger Install Piping Processed Gas Exterior HVAC Unit Heat Pump Under / Above ground Tank ( Install / Remove) Other _ _ RESIDENTIAL FEES: $60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State burned out appliances, ductwork, etc.) (includes Surcharge) / /� V v $5.00 State Surcharge) = $ t 0 • TOTAL FEE $100.00 Fire repair (replace COMMERCIAL FEES: $75.00 Underground tank installation/removal $60.00 Minimum (includes (includes $5.00 State Surcharge) State Surcharge) $1 million, please call for Surcharge OR Contract Value $ x 1% = $ Permit Fee *If the project valuation is over = $ 5.00 Surcharge* =$ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq 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. x K"e.. V171/ Applicants Pi nted Name x1 Applicant's Sigi'ature (Pibutzu„, FOR OFFICE USE Required Inspections: Underground _ Rough In Air Test Gas Service Test _ In -floor Heat _ Final HVAC Screening Reviewed By: Date: __- _ From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:40 #582 P.044/079 City of Eakan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651)675-5694 Use BLUE or BLACK Ink For Office Use �n 4 Permit #: 1 W 5 ` Permit Fee: Date Received: C17(11 l t 3 Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION nate: 4-5-10I3 SiteAddress: 4411 4411614413 4413b Gtr Lane, ane✓ Unit #: Resident/ Owner Name: EGikl itO1iOI GIt) C✓10► tY%% ( parKi Phone: Address / City / Zip: (0138 Gil Weft ktrkvw y ettun Prat ht.( MN 5534y I Applicant is: Owner Contractor Type of Work Description of work: TCaY Off clhd Ye- roof Construction Cost: 319, I O.OD Multi -Family Building: (Yes X / No _) Contractor Company: AtilStlY CortintaiDY1 Mal lU 11C,Contact: LIOC tirAlcitad Address: 5145 1nctustw S1YfC+ 44 Io3 City: Maple Plain State: 11/4(4 Zip: 5S35P) Phone qs2,- °I` -R' 1HGLI License #: BC(031515 Lead Certificate #: N111- Wile -VD 1 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) in the last 12 months, Yes No If Licensed Plumber: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: Phone: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: NOTE: Plans and the. information N` supporting documents that you submit are considered to be public information. Portions of 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. Calf 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.aooherstateonecall.orq 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 VUt HMO -m:1 Applicant's Printed Name x 2 Apfili¢ant's Signature Page 1 of 3 From:ALLSTAR CONSTRUCTION 19529427464 City of aan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675.5675 Fax: (651) 675-5694 02/10/2016 12:59 #301 P.009/022 Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: / 4 ea Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Of /d/e, Site Address: y%//- al/f.1e Unit #: 4,5 Resident/ Owner Type of Work Contractor Name: 6/V,4 r f of - 4/3 &/ 1 -lo Address / City / Zip: T �// *Vs 6;fg- Applicant is: Owner Contractor Construction Cost: f 01 000 Multi -Family Building: (Yes o ) Company:,4ii&44. d rifkrr.c 1 Ah:ftriellaneeContact: wi /1/t ` //0 Address: �f446 (ndW54 ri 4 1 Si-- .5-0;LC /03 City: %VTh jle-RA- Iil State: %i itAI Zip: 5'636' Phone:q 4 ' 614 Email: ii74getllS r. -4 2- -. License #: (DAOiSO Lead Certificate #: AM -r- e4®9(,f - e� Phone: /✓//, 4.G1,01, J Description of work: 8-.5fa /eV/TA /417,,07/ 5; A If the project is exempt from lead certification, please explain why: gut Ur ` /993 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 pian? 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 thatthey 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. aopherslateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building yl.. pleted within 180 days of permit issuance. • x of l` iT Applicant's Printed Name Applic>nVs Signature Page 1 of 3 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 MAY 162016 Use BLUE or BLACK Ink For Office Use Permit Fee: 6 - on Permit #: Date Received: Staff: 2015 RESIDENTIAL PLUMBING PERMIT APPLICATION Site Address: CLo _ A {MA) *A Date: Tenant: Name: Suite #: Phone: 4051 -. J 3 _ 7 (q Address / City / Zip: ` �� f► ,`�� Name: Milbert Company Inc ciba Culligan Water Address: 1.801 50th St East State: Mn Zip: 53077 Phone: 651-451-2241 Contact: William R Milbert License #: WC641376 Email: 1 New Replacement Repair _ Rebuild Modify Space Work in R.O.W. Description of work: RESIDENTIAL Water Heater Lawn Irrigation (__ RPZ / PVB) Septic System New Abandonment XWater Softener Add Plumbing Fixtures L._ Main / Lower Level) Water Turnaround RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) "Water Turnaround (add $200.00 if a 5/8" meter is required) $115.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) /� TOTAL FEES $ (DO , 0 0 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.000herstateonecall.orq 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 ac r ordance with the approve la 'nthe e of work hich requires a review and approval of plans. Applicant's Printed Name X iC� /u • "jV 1( App cant's Signature City of Eagan PERMIT IP1' City of Eaan Permit Type: Building Permit Number: EA136538 Date Issued: 05/18/2016 Permit Category: ePermit Site Address: 4411 Clover Lane A Lot: 31 Block: 03 Addition: Eden PID: 10-22750-03-310 Use: Description: Sub Type: Windows/Doors Work Type: Replace Description: Two or More Windows/Doors Census Code: 434 - Zoning: Square Feet: 0 Construction Type: Occupancy: Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary: Valuation: 4,000.00 BL - Base Fee $4K $103.25 Surcharge - Based on Valuation $4K $2.00 0801.4085 9001.2195 Total: $105.25 Contractor: New Windows for America 2123 Old Hwy 8 NW St. Paul MN 55112 (651) 203-0149 - Applicant - Owner: Connie M Buchholz 4411 Clover Lane Unit A Eagan MN 55122 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. Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA138262 Date Issued:08/17/2016 Permit Category:ePermit Site Address: 4411 Clover Lane A Lot:31 Block: 03 Addition: Eden PID:10-22750-03-310 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Connie M Buchholz 4411 Clover Lane Unit A Eagan MN 55122 (651) 303-7319 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature i / f ® o I I I I I EAGAN 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 1 FAX: (651) 675-5694 buildinginspections(a)cityofeagan.com -------------I For Office Use I I Building Permit #: obo I I I I I I S&W Permit #: I I C�J I I Permit Fee: � 1 I I I A-0I I I Date Received: I I I I I I Date Issued: I i- - - - - - - - - - - - - - - - - - - - - J RESIDENTIAL BUILDING PERMIT APPLICATION Date: �h qZ?W3 Site Address: Unit #: Applicant is: ❑ Owner IlContractor Name: �G(�V� b v,�e Cc>ja5'Sc, C'_I Ct_4 k 6 U-\� Homeowner Address: OW 3 Y413 Liq 11 /� (� ) � City: a IIJ Stat .[M WLi �� Phone: Email: Description of work:t�- Type of ! Work Construction Cost '7 Type of building: ❑ Single Family ❑ Townhome, of units Twin Home Compan Th-�� CV1:S& -LA c_ \ Contact: (2-0,v'� �f Building Addressl�A t�tVlieS`�r 1 Contractor �J /? State: Zip: 5:53 Phone6t Z-/'/ 5 EmailCjAke�C V_ey -2 - cP License #: Expiration Date: �- - - - Sewer & Company: Contact: Water Contractor Address: City: Required for State: Zip: Phone: Email: new construction License #: Ex iration Date: ` 1 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 are 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. E�\e_xc�y�+ x Z_ z, �,; � Applicant's Printed Name A licant's Signature