4447 Clover Lane
Use BLUE or BLACK ink
For office use 1
I
i Permit I
Cat of Ea
EaIl
I
+ Permit Fee:
3830 Pilot Knob Road I
Eagan MN 55122 i Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
L---------
2010 RESIDENTIAL BUILDING PERMIT APPLICATION C R . b -7-0 1
Date: g',~/._>0/0 Site Address: 1 ( MC'L~y r, f` 462
Tenant Suite
RESIDENT / OWNER Name: Phone:
Address / City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK i o
Description ofwork: 0,\rl,~}V,C~
Construction Cost: Multi-Family Building: (Yes / No
CONTRACTOR Name: L~P_r k" d„ . 71~ A J C . License .'S ®7Q
Address: (C!_ Cam, S cA)t- cart. City: n c'., I,- bk" L
State: -h d Zip: .S"1 Dg Phone: C-51 - 7S-? 783
ct: t_ Email: ~Nec- ciL - coo-,
COMPLET HIS 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 suppotf docur m►ts that you subn* and considered to be public kWormadom Portions of
the hNOnJ1atiion may be dies b%d as r►tu► public If you provide specft reasons that would per=* the City to
conclude that 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.g_opherstateonecall.oro
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approv of plans.
X 9C~ ,.c~~`~ x
-AtJA
Applicant's Printed Name Ap ica s Signature
Page 1 of 2
C(
DO NOT WRITE BELOW THIS LINE l
SUB TYPES
Foundation _ Fireplace _ Porch (3-Season) _ 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 d Occupancy MCES System
Plan Review Code Edition 144P-;b? J7 SAC Units
(25%_ 100% Zoning City Water
Census Code ~r Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Sheetrock
Footings (Deck) Final / C.O. Required
Footings (Addition) 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 ~}~f 0
Surcharge ~j
Plan Review
MCES SAC
City SAC
Utility Connection Charge
(i
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 2
Lin.
ROBE
fNGINCCRING P1.ANNEAS and UIND SjUflVEYOAS
COMPANY, INC,
1000 EAST 1461h STREET, BURNSVILLE, MINNESOTA 58337 PH 432-3000
CE'T"
aa C Q j?,e Qj- aS`x~
1. Q►at .QWy-4A2fortt LOTS 5,6,7 AND 6, BLOCK 3, EoEN AooiTION,
DAKOTA COUNTY, MINNESOTA
`~3/9•~_l DENOTES EKISTINo ELEVAT/ON
(920.0) DENOTES PROPOSED ELEVAT/OA1
INDICATES DIRECTION OF SURFACE DRAINAGE
920.00 FIN1514E0 6ARA6E FLOOR ELEVAT/OA/
NORTH
SCALE : 30'
7 r 920. '
(917.o) /33.?
'Ln 52.00 81.27 An
3
DRAINA6E ANA 5r I rS
UrrLITY 6A59ME1UT I LOI 5 ~ ,io LOT f
~J (9/6.4) o°I 44.67 ~9/9,
N I-;
PRO OSEO
a N 4 UNIT N e' ~ o
p N 89 56 02 f J
r 0 Z -Gb.53 - L
o -
z _ -
-7 06 1T
(9/6.s~ r v
T6J, w
$I BULL ING
'M
) I
~92/,7~ 0 4` 9 X92 2. Z; 1 `14
30' FRONT 5UI LPIWG
sErsAcIC G/NE s~ LOT LDI 7
I N, I
(920. i
9/9. 'r o 52.00 Ozz4' 18.34 1 0 (92
f
70. 34 L= 33-60 9 s'i
~R-3 90.0o 0
N 89° 59' 02'' E I d 0/0*
-At ~Y 1 CLOVER LAME
U sag.
i
i9/9~9¢L 5.9.4 90 92A61
o
S hereby certify that this is a true and correct representation of a tract of
land as shown' and described hereon.. As prepared by me on this /./sr... day of
/~10(/CMBER 19 9S .
.I
,Minn. lea. xo., 14-'JR3
PERMIT #
PLUMBING PERMIT RECEIPT #
CITY OF EAGAN
3830 PIL OT KNOB ROAD, EAGAN, MN 55121 DATE:
CONTRACT PRICE PHONE 454-8100
Site Address"77 /_4
`
3
i c BLDG. TYPE WORK DESCRIPTION
Lot
2 Block -
Sec/Sub /
-`
Res. New
Name Mult Add-on
? AddreBs/-c -2 Comm. Repair
? Citg- Phone;? Other
?
Name ?
"-00? N9. FIXTURES
Water Closet - $3
00 TOTAL
?
.
-?
; Addr / Bath Tubs - $3.00
S
Z _
O Ciiy f Phone / ?
-- Lavatory -$3.00 -
Shower - $3.00
T-
FEES Kitchen Sink - $3.00 -
COMM/IND FEE - 1% OF CONTRACT FEE -T_ ?undry Urinal/Bidet - $3.00
Tray -$3.00
-
MINIMi1M - RESIDENTIAL FEE - $10.00
MINIMUM - COMM/IND FEE - 20
00 / Floor Drains - $1.50
= r
• Water Heater - $1.50 ?
STATE SURCHARGE PER PERMIT - .50 Whirlpool -$3.00
(ADO $50 S/C IF PERMIT PRICE GOES Gas Piping OuUets -$1.50
BEYOND $1,000.00) Softener - $5.00
Well - $10
00
.
TPrivate Disp. - $10.00
Rough Openings - $1.50
SIGNATURE OF PERMITTEE FEE - - ' ?
STATE S/C:
FOR: CITY OF EAGAN GRAND TOTAL• ?-='
.. ..C'
PERMIT # CITY OF EAGAN FEE
' c MECHANICAL PERMIT
RECEIPT # 454-8100 S/C
MINiMUM RESIDENTIAL FEE - $10.00 + $.50 TOTAL ?) L1 1? U
DATE ? P- MINIMUM COMMERCIAL FEE - $20.00 + $.50
1. Bldg. Type: Res Comm Inst 2. New Add Alter Repair
? . ?
3. Total Bid Price ? 4. Job Address `2
Lot - Block ? Sec 5. Owner :-:s_
6. Contractor olL ru = S - . ? ? tut ,, i - ?_ , -cfG[ ;)4_ _ t - -
(Name) A {Streeq (City) (Zip)
7. Contractor Phone # = i
RESIDENTIAL HEATING - ` 01-100,000 BTU's -1$P4.00. Each additional 50,000 BTU's or fraction -$6.D0
RESIDENTIAL COOLING - 01-24,000 BTU's -$12.00. Each additional 6,000 BTU's or fraction -$6.00
MODIFICATIONS/ALTERATIONS -$10.00 minimum fee
HEATING VENTILATING HOT WATER STEAM AIR COND.
eIR PIPING PROCESSED PIPING AIR HAND. EQUIP. RtFRIG.
RES. GAS PIPING OUTLETS -$1.50 TANKS: LP. UNDERGROUND OTHER
COMM./IND. RATE - 1!'o OF TOTAL BID PRICE PLUS:.50 STATE SURCHARGE FOR EACH $1,000 OF FEE.
Signed: for
Approved • Inspections: Date Rough Insp. Date Final Insp.
3$30 PILOT
Site Address ??? ?? =+r" ? ?
? Lot ?r] Block
Sqc/Sub -
`
t VN ? -? , d
` L Name rr f: i,?, ; 'p:
?
? Address
Ciiy Phone
? i
Name
? c Address
; p City lf Phone
FEES
COMM/IND FEE - 1% OF CONTRAGT FEE '
MINIMJM - RESIDENTIAL FEE - $10.00
MINIMUM - COMM/IMD FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
FOR: CITY OF EAGAN
PERMIT #
RECEIPT #
DATE:
BLDG.TYPE
Res.
Mult
Comm.
WORK DESCRIPTION
New _
Add-on
Repair
NO. FIXTURES
Water Closet - $3.00
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water 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:
TOTAL
S
STATE S/C:
GRAND TOTAL: ' ASO
f
• ? . . w. ??
BUILDING PERMIT
CITY OF EAGAN
3830 Pilot Knob Rosd, P.O. Box 21-199, Eagsn, MN 55121
PHONE: 454-8100
Receipt $ _,
P
Site Address
Lot B1cek Sec/Sub.
Percel No,
W Name _
; Address
U
? Name
tu
u? Addreea
f'. itv
Name _
Address
Phone
I Fxrcby ocknowledga that I hove rcad this opplicotion and stote thaf
ihe inlormotion is torrett and ogree to comply wifh oil applicoble
State of Minnesoto Stotutes ard City of Eogon Ordinonces.
Slynotum of Permiftee
A Bulldiny Permif Is issued to:
oll work shall be done in occordance with cll opplicoble State of Mir
Buildirq Offlciol
Volue ``'O' AOQ
Erect
Remodel
Repair
Addltfon
Move
Demolish
Int Impr.
LJ
? Occupancy
2oning
? Type of Const.
? No. Stories
? Length •
? Depth
? Sq. Ft. .
r-i
Assessment I
Water & Sew.
Potice
Firo
Enq.
Planr?er
Countil
Bldg. Off. APC
Var. Date
Permit ? ? • 09
Surcharge = ?- 0 0
Plan Review 50
SAC
Water Conn. ?V ?? • ? ?
Water Meter
Roed UnR - +
?.
T. DI . ... . ,
I ....'...... . . .
Total
on the expefs cOndifbn Ihoe
Srotutes ond City of Ecflon Ordinonces.
ll? I ' 11F,41
Pamk No. PKmk Holdw Dab Telsphone ?
Ptwnblrp
H.VA.C. ? .9c a Z
ENetrie ? S 3 p
Sottener
Impeetion Date Insp. Uthar
Footlnps 1 " fg. ? Lo
FooUngsll
Foundatlon
Fnniing - ` ? "?J 6 4i .,e
Noofing
Rough Pibg.
Rou9h Hty.
Insul.
Flnplacs
Final Htg. b M
Flnal Plbp. - f( .- -g(. , •
Flnal 2
Cert/Oca -2 -? ?
w??r DKCribe Location:
Well
Sswar
Pr. Dlsp.
?..?.Q...r•-=
PLUMBiNG PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAI
IACT PRICE PHONE: 454-8100
Lot ,4 Block _1'
.
m Name '
L
? Addrets ? c City-sC?-dt"" u
? Name '---Q -? ??
(D
Addre
O CitY
PERMIT #
RECEIPT #
MN 55121 DATE _
-?--??,
?
BLDG. TYPE WORK DESCRIPTION
Sec/Sub
Res. zl- New ?
',` ? Mult Add-on
Comm. Repair
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMiJM - 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)
Ir
? FOR: CITY OF EAGAN
I
?
N . FIXTURES
P Water Closet - $3.00
-? ?OT
- `'?
Bath Tubs - $3.00 - " 'f
ZLavatory - $3.00 S
Shower - $3.00
T-Kitchen Sink - a3•00
= V'"
Urinal/ Bidet - $3.00
Laundry Tray - $3.00 'j
Ftoor Drains - $1.50 ?
Water Heater - $1.50 '
Whirlpool - $3.00
Gas Piping Outlets - $1.50
So(tener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE
STATE S/C: 5
?
2
OC}
GRAND TOTAL• -
? . .
PERMIT #?`" ? G GJ CITY OF EAGAN FEE _
MECHANICAL PERMIT S?C _
RECEIPT # 454-8100
-y Y 6 MINIMUM RESIDENTIAL FEE - $70.00 +:.50 TOTAL
DATE MINIMUM COMMERCIAL FEE - $20.00 + $.50
1. Bldg. Type: Res Comm Inst 2. New Add Alter Repair
3. Total Bid Price 0 ?. 4. Job Address LHw7,
Lot ? Block ? Sec C c' 11-?ciC x 17 lTl l 5. Owner
_1 ? ? •,? ? ' , ;- „? , _ s. ? ^ ? < ?
6. Contractor ? ? M ?' • , n ! , ,,. --s, h 1 < o
(Name) (Street) (City) (Zip)
7. Contractor Phone #
RESIDENTIAL HEATING - - -$24.00. Each additional 50,000 BTU's or fraction -$6.00
RESIDENTIAL COOLING - 01-24,000 BTU's -$12.00. Each additional 6,000 8TU's or fraction -$6.00
MODIFICATIONS/ALTERATIONS -$10.00 minimum fee
?
HEATING VENTILATING HOT WATER STEAM AIR COND.
?IR PIPING PROCESSED PIPING AIR HAND. EQUIP. RtFRIG.
RES. GAS PIPING OUTLETS -$1.50 TANKS: L.P. UNDER(3ROUND OTHER
COMM.IIND. RATE - 145 OF TOTAL BII? PRICE PLUS $.50 STATE SURCHARGE FOR EACH $1,000 OF FEE.
Signed: 3-???..? , . , ?Y . for • .' -?t 1. -?.
Approved Inspections: Date Rough Insp. Date Final Insp.
. . . .. . . . r --• . -.... . . . . . . .. .
PERMIT #
PLUMBI NG PEHMIT RECEIPT #
CITY O
3830 PILOT KNOB R F EAGAN
OAD, EAGAN, MN 55121 DATE
CONTRACT PRLCE: PHONE 454-8140 '
Site A ess BLDG. TYPE WORK DESCRIPTION
Lot Block Sec/Sub
Res. New ?
? Name MuM. Add-on
j ? Address `k- ! - Comm. Repair
j ?
Ciiy - -
Phone
Other
NO. FIXTURES TOTAL
Name " Water Gloset -$3
00 a
3 Address .
Bath Tubs - $3.00
p City Phone Lavatory - $3.00
Shower - $3.00 '
Kitchen Sink - $3.00
FEES & UrinaVBidet -$3.00
COMM/IND FEE - 1% OF CONTRACT FEE ?undry Tray - $3.00
MINIMUM - RESIDENTIAL FEE
MINIMUM - COMM/IND FEE - $10.00
_ 20
00 Floor Drains -$1.50
,
I STATE SURCNARGE PER PERMIT . .50
, ?Nater Heater -$1.50
?Nhirlpool -$3.00
I(ADD $.50 S/C IF PERMIT PRICE
BEYOND $1
00
00 GOES Gas Piping Outlets - $1.50
.
,0
) ? ?Softener - $5.00 `
Well - $10.00
? Private Disp. - $10.00
Rough Openings - $1.50
SfGNATURE OF PERMITTEE ? FEE
?.
"
STATE S/C:
FOR: CITY OF EAGAN , GRAND TOTAL• - -`?
' • ' L. ;.
BUILDING PERMIT
Parcel No.
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
Receipt
? Name ;'^Ol] Vt:'..: ? 40MES a ;tir'
? `Address
City Phone
Remodel
Repair
Addition
Move
Demolish
Int Impr.
?
0
0
?
R!!? 112 4 i.
Occu pancy
Zaning
Type of Const.
No. Stories
Length
;..
Depth
Sq. Ft. "
oc •: j;_ ! ? ` N8R1@ wpProrols
O
@
? Assessment
Address
? City Phone Water 8 Sew.
Pol ice
G °C
?Z Name Fire
?? Adclress Enp,
tW City Phone Plonner
Councii
1 hereby ocknowledge that I hove reod this opplication and stote that gldg. Off. j J
fhe informatiOn i5 tOrrett pnd ugree to comply with oll applicoble APC
State of Minrxsota Stvtutes nnd City of Eagan Ordinances.
Var. Oate
Sipnnturc of Pem+ittee
A Buflding Permit is issued to: y on
all work sho11 be done in occordonce wifh all oppliooble Stote of Minnesoto Statutes ond City ol
Buildinp Official
F*es
Permit
Surcharge
Pian Review 15 L? --, l
SAC
Water Gonn.
Weter Meter i
Road Unit ?
CoPies
u
Total ? e ezpress cond+tion thai
:o9en Ordinonces.
Permit No. Permit Holdsr Date Telephone #
Plumbinp & /V, r?C S ;} ) \ 3 j g L
H.VA.C.
Electr;c
Softene?
Inspaetion Data Insp. Other
Footings I
Footings 11
Foundstion
Fssmting
Rooflng
Rough Plby % -7 -
Rough Htg.
Insul.
FireplaCe
Final Htg.
Flnal Plbg. 444
Final
Cert/Occ. ?? GJqJ
W?+? DotCribe Location:
We11
Sewsr
Pr. Dlsp.
.....,
--?
PERMIT #
PLUMBIN(3 PERMIT RECEIPT #
cmr oF E?GAN X ?
3830 PIl.OT KNOB ROAD, EAGAN, MN 55121 DATE: ISec/Sub
m Name
? Addre
c City -_
? Name
3 Addre
O c;ty'C
FEES
COMM/IND FEE - 1%OF CONTRACT FEE
MINIMJM - 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)
OF PERMITTEE
FOR: CITY OF EAGAN
BLDG. TYPE WORK DESCRIPTION
Res. ? New -?
M ult Add-on
Comm. Repair
Other
Np. FIXTURES
?-Water Closet - $3.00 TOTAL
Bath Tubs - $3.00 -
?Lavatory - $3.00
Shower - $3.00
? Kitchen Sink - $3.00
Urinal/Bidet - $3.00
?
Laundry Tray - $3.00 -
? Floor Drains - $1.50
J 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: '
l
PERMIT #
RECEIPT #
DATE
m.q
CITY OF EAGAN
MECHANICAL PERMIT
454-8100
MINIMUM RESIDENTIAL FEE - $10.00 + $.50
MiNIMUM COMMERCIAL FEE - $20.00 + $•50
FEE
S/C
TOTAL
1. Bldg. Type: Res ? Comm Inst 2. New ? Add Alter Repair
3. Total Bid Price ?-?-? 4. JobAddress '-1cj4?1? ?.?: x;??n ??L?
Lot-[) Block Sec C- `??'' ??? •?r I/ v? 5. Owner 'r`:_ ? Z.%'1 L A I c
s. Contractor kl.,Flikn4(- Jtien j )Yd.a, lgc.
(Name) (Streea (City) ? (Zip)
7. Contractor Phone # ?G27
RESIDENTIAL HEATING - rot -100,000 BTU's ='$24.00. Each additional 50,000 BTU's or fraction -$6.00
RESIDENTIAL COOLING - 01-24,000 97Urs =$12.00. Each additional 6,000 BTU's or fraction -$6.00
MODIFICATIONS/ALTERATIONS -$10.00 minimum fee
HEATING VENTILATING HOT WATER STEAM AIR COND.
eIR PIPING PROCESSED PtPING AIR HAND. EQUIP. RtFRIG.
FiES. GAS PIPING OUTLETS -$1.50 TANKS: LP. UNDERGROUND OTHER
COMM.IIND. RATE - 1°Yo OF TOTAL BID PRICE PLUS $.50 STATE SURCHARGE FOR EACH $1,000 OF FEE.
Signed: ryLd, tU for
, .
Approved Inspections: Date Rough Insp. Date Final insp.
Pwmft No. Pamit Holder Dau Telsphone it
PlumbinW > ; L,
H.VA.c. C? ?X a a y?
ENctric
Softwar
Impaetion Date Insp. Other
Footings I
Footings 11
Foundatlon
Framing y ?
Roofing
Rough Plbg.
Rough Htp.
Insul.
Ffroplaca
Flnat Htg. 1 746 4
Flnal Plbg•
Final
Cert/Occ. Gt//y
Water Doseriba Loeation:
W?II
V
Sewer
Pr. Disp.
, .
PERMIT #
PIUMeIMG PERMIT RECEIPT #k
qTY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE
CONTRACT PRICE: PHONE: 454-8100
Site <?,
Addr ss / ??; :_?^
BLDG. TYPE WORK DESCRIPTION
Lot_? Block Sec/Sub
Res. New `? -
m Name u'? ''`' ' Mult Add-on
? Addre" /_1 -S Comm. Repair
c City-??-,?' ??tsPhone -S / 7/ Other
Name -'?- ?'"'r. ' ?.. ':?? r_,?«' -
• ??c_? NO. FIXTURES
LWater Closet - $3
00 ?OTAL
s
? `•
? .
f-
' ? .
I
3 ?c. ts
_
Addr
? Bath Tubs -$3.00
p ?.?,
City ll.z-a c,''-F'
Phonez '?? - S 6 ? Lavatory -$3.00
Shower - $3.00
FEES f
Kitchen Sink - $3.00
COMM/IND FEE - 196 OF CONTRACT FEE Urinal/Bidet - $3.00
=Laundry Tray -$3.00
MINIMi1M - RESIDENTIAL FEE -$10.00 Floor Drains -$1.50
MINIMUM - COMM/IND FEE - 20•00 ' Water Heater - $1.50 '
STATE SURCHARGE PER PERMIT - .50 Whirlpool -$3.00
(ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets -$1.50
BEYOND $1,000.00) 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 #CITY OF EAGAN FEE
y 4 ? MECHANICAL PERMIT
RECEIPT # 454-8100 S/C
y MINIMUM RESIDENTIAL FEE - =10.00 + $•50 TOTAI
DATE MINIMUM COMMERCIAL FEE - $20.00 + $.SO
1. Bldg. Type: Res ` Comm Inst 2. New i-- Add Alter Repair
3. Total Bid Price 4. Job Address
? •
?J ? c? l' : 7 ?.?-? ? 6?•1 ? ?
Lot Block Sec 5. Owner,
'
? 7. ' '`'' `P J ?,.??;? ? (1f'(` . ? l..i 5 ?.?J. %1 ?-i/y? ' C.LI'??YC?I? d?? t ?,C?,`t
6. Contractor , • ? ?'- ? ' ?'-; :? u
(Name) ? (Streeq (Cily) ? (Zip)
7. Contractor Phone #
RESIDENTIAL HEATING - `? 41-.100A00 BTU's ?$24.00. Each additional 50,000 BTU's or fraction -$6.00
RESIDENTIAL COOLING - 01-24,000 BTU's -$12.00. Each additional 6,000 BTU's or fraction -$6.OQ
MODtFICATIONS/ALTERATIONS -$10.00 minimum fee
HEATING VENTILATING HOT WATER STEAM AIR COND.
nIR PIPING PROCESSED PIPING AIR HAND. EQUIP. RtFRIG.
RES. GAS PIPING OUTLETS -$1.50 TANKS: LP. UNDERGROUND OTHER
COMM./IND. RATE - 1% OF TOTAL BID PRICE PLUS $.50 STATE SURCHARGE FOR EACH $1,000 OF FEE.
Signed: for
Approved Inspections: Date Rough Insp. Date Final Insp.
• ?• ' CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
QUILDING PERMIT Receipt ?Jt
To w wed ia E st. Volue Dot e , 19 '
5ite Addrese Erect ? Occupancy
Lot Block Sec/Sub Remodel ? 2oning
.
Parcel No. Repair ? Type of Conat.
Addition ? No. Stories
Move ? Length
Name Demolish ? Depth
=
? Address Int Impr. ? Sq, Ft.
City Phone Install ?
A ? Name _
U Address
?
f- Citv -
Name _
Address
City _
Assessment Permit
Phone Woter b Sew. Surcherge
Police Plan Review
Firt SAC
Enp. Water Conn.
Phone Plonne? Weter Meter -
Courcil Road Unft ?
1 hereby acknowled9e that I havt reod this opplication ond state thnt Bldg. Off. Tr. Pl ` -
fhe informotion is ovrred and agree to comply with oll applicable APC
5tota of Minnesota Stotutes ond Ciry of Eogon Ordinonces. Perks
- - Var. Date C???
Slpraturc of Pertniftee
(?UC?) Vr?, , _' Total
h BuHding Permlt is issued to: on tha txpress conditlon tho+
ol) work shofl be done in atcordonte with all cpplic?able State of Minnesoto Stotutes ond City of Eoflon Ordirbnces.
Buildinp Offlciol
Feea
Pwmit No. Pwmit Holder DiU Telephone ?t
PIum6lnp t ?- J ATCk:c.?S?'>'1 ' ???5 (e
H,VA.C. ? X? ?'t ?I' I? T • °? o? ?
Ehietric <
8oitMwr
IMpeetion Date Insp. Othar
Foatln9s I
Footings II
Foundatlon
Frsmin9 ?Z'te,
Roofing
Rough Plbg.
Rough Hty.
InEUL
Fireplace
Final Htg.
Flnal Plby. -.r/-
Flnel
CNt/Occ.
Water D.scri6. Locnlon:
WeII
Sewer
Pr. Dlmp.
CITY OF EAGAN Remarks
Addition Eden Addition Lot 7 Bik 3 parcel #10 22750 070 03
owner screet 4447 Clover Lane 5tate Eagan NIlV 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 50470 . .
STREET RESTOR.
GRADING 1982 2 . 46. 6o
SAN SEW TRUNK
IF SEWER LATERAL 77 j?
WATERMAIN
M WATER LATERAL 1982
WATER AREA 3 ?
Services ? 1982
STORM SEW TRK C 1982 256.00 51.20
w STORM SEW LAT 1982 5
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. n a
BUILDING PER. 11 39-11242
sac 525.00
PARK
CITY OF EAGAN
Addition Eden
Lot 8 Blk 3 Parcel #10 22750 080 03
4447B Clover Lane State Eagan MIlV 55122
Improvement Z Amount Annual Years Payment Receipt Date
STREET SURF. ?(, I
2 504. 70 100.94 'rJ
STREET RESTOR. V
GRADING 232.99 46.6o
SAN SEW TRUNK 07 rf? 4.20 15 1
# SEWER LATERAL 1982 1896.46
WATERMAIN
* WATER L.ATERAL 1982
WATER AREA 2W JQ77 62.93 4-20 1 -1;
• Services 1982
STORM SEW TRK 1982 256. oo 51.20
• STORM SEW LAT 1982 S
CURB & GUTTER
510EWALK
STREET LIGHT
WATER CONN.
500.00
9UILDING PER. 11939-11242
sac 525.00
PARK
CITY OF EAGAN Remarks
Addition Eden Addition Lot 6 sik 3 Parcel #10 22750 060 03
Owner ' st,eet 4449 Clover Lane State Eagan AMI 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SUFiF. 1982 ?t?.']? 100.94 ?j
STREET RESTOR,
GRADING 1982 2 . 46.60
SAN 5EW TRUNK
iF SEWER LATERAL 39 1982 1896.46 319,29 5
WATERMAIN
1F WATER IATERAL 1982 5
WATER AREA
• Services 1982
STORM SEW TRK ?j 1982 2 G.OO 1.20
# STORM SEW LAT 1982
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CaNN, 500.00
SUILDING PER.
SAC
PARK
CITY OF EAGAN Remarks
Addition EdPn AdcLtiAn Lot 5 Blk 3 - Parcei #1 fl 27750 (150 03,
Owner f?"' Street 4449 B Clover Lane State Eagan NW 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 5(1 1982 504.70 100.94
STREET RESTOR.
GRADING Q 1982 2 .99 46.60
SAN SEW TRUNK 1) / 1974 62.93 4.20 15
* SEWER LATERAL 82 1896.46 379.29
-.-.
WATERMAIN
* WATER LATERAL 1982 S
WATER AREA 1977 62.93 4.20 1$
* Services 1982
STORM SEW TRK 182 2 6.00 51•20 S
M -STORM SEW LAT 1982 5
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 500.00
tr
n
BUILDINGPER. 11219-11242.
sac 25.00
PAR K
INSPECTION RECORD
' CITY OF EAGAN PERMIT TYPE:
I 3830 Pilot Knob Road Permit Number:
? Eagan, Minnesota 55122-1897 Date Issued: 6 ' ' 0 '
i (651) 681-4675
? ,•, i . . , ; , r, ,
I SITE ADDRESS: <<, i APPLICANT:
? ? •? , +rVF Pt 1 AN;
,?.;4
PERMIT SUBTYPE:
( t; t:' 1 111lH ? 72<jN
TYPE OF WORK:
11 PaIa
i:f-Pl Af'E Fi[(1TN6
t.,?' 4I4l?
Permft Ffolder Daba Telephone •
SEWER/
WATER
PLUMBING
HVAC
Inspection Dete Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAI
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued: '' '• I
(651) 681-4675
SITE ADDRESS: r ; APPLIGANT: I
t, , t '''JF F, 1 Atli i 1t , 1 1:0 p,OW V}> i', i iIh! ? t I
PERMIT SUBTYPE:
..,
(F,??') f??18-=72AH
TYPE OF WORK:
? I F'nTR
,1: i 11IN , i f-I pr? ?lOtN?'.
I. N 111
{ :10 K`. : lttlf f h
F
? ?Ofl
L
?
Psrmft Holder Dste Telephone #
SEWER/
WATER
PLUMBING
HVAC
Inapection Date Insp. Commenta
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
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
CONDUC7IVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
? CITY 4F EAGAN PERMIT TYPE:
C 3830 Pilot Knob Road Permit Number.
Eagan, Minnesota 55122-1897 Date Issued:
? (651) 681-4675
SITE ADDRESS: ' 0 ?-' APPLICANT:
i ir; I • ttl i)[;t,
?14 A'1
lII?M
r:IJST?IM roNt'f ?P'i% t:pN
(til?J tt??LS-1:??+Ql
0 y??otp
PERMIT SUBTYPE: TYPE OF WORK:
: i r nrR
!:,. :..I; s+ ?!?f i I i l At:F titOlNli
Permk Holder Dats TNephons x
SEWER/
WATER
PLUMBING
HVAC
Inspection Dete insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
flOUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIFEPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
coNOUCTivirv
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
INSPECTION RECORD
CITY OF EAGAN
3830 Pilot Knob Road
PERMIT TYPE:
Permit Number:
g ~n•<iH
Eagan, Minnesota 55122-1897 Date Issued:
(651) 681-4675
SITE ADDRESS: "f., 4' 4^ APPLICANT• .
•
?• ?. F ti 1 AN4
?{i! Fa t t1.? ) ti104-
PERMIT SUBTYPE:
',,I, I I I
TYPE OF WORK:
111'?:r'kf1'1 Inrd
I ARKfi: UNIT 8.
Pf l'nTR
kt F'I nrJ 'tiCtlfNr,
?
?
Permft Holder Date Talephone 1i
SEWEW
WATER
PLUMBING
HVAC
Inspection Oate Inap. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUM8ING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
OR5AT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METEF
FLUSH
MAINS
coNOUCnvirv
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
SEDGWICK HEATING & AIR CONDITIONING CO.
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000
?????j ?6V?-1t? ?Gt?? t
ADDRESS CITY `
OCCUPANT ' / u',t OWNER _
SOLD BY INSTALLED
SEFIAL NO.
THERMOSTAT
FAN SETTING _
PILOT TYPE _
IGNITION MODEL
PRESSURE ? V? ` PERCENT CO,
INPUT CFH ? PERCENT 02 .
STACK TEMP. ? PERCENT CO
FORM 235 (REV. itl89?
WIRING -
TEST TAG ?
?
LIGHTING INST.
COMPANY TESTING
NAME
d
aIBUTIOYWHI{E"COPY - JOB fILE YELLOW COPV - CITY
HEATING JOB NQ 7 514
TEST RECORD
? ITY OF EAGAN WATER SERVICE PERMR
0 Pilot iCnob Rosd
. Ci. Box 21199 PERMIT NO.:
agan, fiAN 55121 DATE:
Zoninp: _ No. of Units: -
r. ,
fliS: -
/lddrcss: ? .
.r
umbsr
.
Wftr No. ? 7 S?O 7 •??
(??1?h°r?°'
U.
„ ?
?t.
R9M
r lo
.lr.. *o aemoy wNM RfOW ML'L! Mn ee:
?'f"*AR
. Misc. Chargs: s , ;+)r
? Total:
??.a.?
1? Date Poid:
of Insp.: Irnp.:
N6
CITY OF EAGAN SEWER SERVICE PERMR
3830 Pilot Knob Rosd
P. O. Box 21199 PERMIT NO.:
Eagan, IWN 55121 DATE:
Zonirp: No. of Units:
Ownor. _ . ..- ?
/lddrcss: -
Stte Add?ess: ' - .
Plumher.
I ymo to eeniplp wilr tM Cihr of yp¦
Orli"sen.
By
Date of Insp.:
C.onMCtian - ?
Acoount Dep?l
Pamdt FM: ,
Surchcrp+:
;
Miu. CFwrqes: ?
Totol: ?
Dah Po1d:
C17Y OF EAGAN WATER SERVICE PERMIZ'
3830 Pilot Knob Road
P..tr?isox 21199 PERMIT IVO.:
Eayan, MN 55121 D/1TE:
Zoninp _ No. of Units:
'. s
Ownlr, 'rn•aAddreas: v i
ber.
r no.:
to .owsdy wIM
gy /?-"- ?c-•?6s-?
Date of I nsp.:
CITY OF EAGAN
3830 Pilot Knob Road
P. O. Box ;?1199
. EagZn, MN 55121
Zonlrp:
Owner: , .
/lddross:
Site Addross:
Plumber. • -
I Mne Nam* wML liw C*/ d imNw
Ordiwewps,
By
DoM of Irap.:
n pddn.
'on . ??-' • ??L!Fici
sit:
%
. 1 1. ?;ln ?
5urchorpe: - -?
Miac. Chorpss:
Totol:
Date Pafd:
SEWER SERVICE PERMI'
PERMIT Np..
DATE:
No. cf Units:
"den A,.?r?"
Connection
?unt
p?ep?•
Panr+it Fw:
Surchorye:
Misc. phorgm
Totol:
Doh pa1d.
CITY OF EAGAN
3$30 Pilot Kn
b R
WATER SERVICE P
?
o
oad
P. Q Bor ';.199
Eagaci, MNf 55127 ERNIIT
PERMIT Np.:
. D,RTE:
Owne?:
Add No. of Unih: 'i - x
?
row.
.7?te AW1m:
`
Plumber: u
- i
Meftr No.: 3 0$
Size: 1C1 ? ,.
on Chnro°:
Rooder No.: ?° t:
?
tR
? Nn? to aowolp wpb ? FEhnit Fee: 1 Ci . ,
? Surchorye: . ?0
?. Mtac. Chorpts: 1 32.!?bad '''`,
?c
gy ???'w.....? Totol:
Date of Insp.: DWe Paid:
Inap.: I
CITY OF EAGAN
3830 Pilot Knob Road
P. O. Box 21 199
Eagan, MN 55121
Zoning:
Ownar.
Address:
Site Address:
Plumber:
ue Homes
1 qne 1e awty wYli 1M GFy of !qpm
OrJiMeaa.
By
Date of Insp.:
SEWER SERVICE PERIMIT
PERMIT NO.:
D/1TE:
No. of Units:
Ca.?n.etron Owrpe:
Acoount Depodt:
Rs"nFt Fae:
Surchorpe:
Misc. Chorpss:
Total:
Date Paid:
CITY OF EAGAN YVATER SERVICE PERNIIT
3830 PiloIt Knob Rosd
- P.. O. Bok 21199 PERMIT NO.: .
Eagen, MN 55121 DATE: - Zonind: _ No. of Units:
Owner. •, :lue fiomes ?
/Iddnas: ?
Slee /1ddrom 4449 (;lov-i
Plunber:
AAeftrNo.:.370/8!?.0?`y ---aIth---_ 44roe: 54t).Or,.
tt ocl tseTuTu
51u: ?yni19. 0 (? 1, :'
Rendsr No.:o 3 N y 7y
1 nr.. to.ow%oy wtlb 04RED srq lo. sOnd
o?N..wa... NuK. a,o.pss: Z 32. aooa
Totol: ? t)Orc? ie er
$Y DoM Paid:
Dote of Irrsp.: Intp.:
CITY OF EAG
AN
3830 Pilot Knob Road fEWM sERVKE PLVR
P. O. Box 21199 PERMIT NO.:
Esgan. MN 55121 DATE:
Z°rnnp' No. of Unih:
Owrnr.
/lddrcss:
Sit+e /lddrcss: ,,vei 3.ort, ?
Vlumbsr. . . .
"
I n!r" h esiyy wNl? !M Cby of Gpw ConrncNon Chorpe; .;
.
- ? "
OrriMSeN, ! -
_
Ac.ca+nt Deposit: .
Pom* FN:
i Surchorpe:
c BY Misc. Chorgm
Dote of Inap.: Totol:
Imp" CoN Paid:
This request void ?7 `D ?Cil ? d .3 [!S
8 nwn[hs /rom ?> > a ? ?
8 0 9 5 9F;5
Reques? Date
-? Fire No. Rw?gh-in InsVecbon
fl qu re??
[]fleaAy Now Will NoutY InsPec-
?- es ?NO or Wh¢n Ready
? Licensetl Electncal ConVnclor I hereby request inspection oi above
? Owner electncel work inslalletl al.
Street Address, Box o, Route No.
C1 ?k ? ?.. j Cn
ecLOn o. TownshiD Name or No. RanPe No. unty
Occu ?-n/t• ?IPpINT (
VLILJ`? :U- Phone No.
Po` er Supplie
??_..)? AAdress
(Company Name) ?
Electncal ConV
actor Comrar,tor's Licen?c No.
n
?
?A
MadinB Address IConVartr or r'?r M? g Installahonl
??
oraed Sig^ature (Cont ac wner Making Installation)
?
?
% Phone Num
? ber ?^, ?
??
? . ?
?tJ?-- .c
n
MINNESOTA STATE BOAHD OF ELECTNICITV
Gr,B9s-Midway Bldg. - Room N-191
1827 University Ava., St Peul, MN 55104
Phane 16121 297-2111
THIS INSPECTION NEQUEST WILL NOT
BE ACCEPTED 9V THE STqTE BOAND
UNI.ESS PROPEH INSPECTION FEE IS
ENCIOSED.
3? l D-? 6 REQUEST FOR ELECTRICAL INSPECTION . ee-ooooi.oa
I ? ??See inatmctwns for comDleting this form ? back oi ? Ilow coOV.
03?s-
"'X" Below Work Covered b This Re uest
i AiPioj'ReD.j -Type oi BwlCing ? Appliances WirM Equ.ument Wved ?
Duplex Water Heater Lightiny Fixtures
Apt. Buildmg Dryer Electric HeaLn
Commercial Blda. Fumace Si!o Unlouder
Air
mn Fan Na/nw
p Fee Service EnhancaSize Y Fea Feaders/SUbinxders N Fen Circmts
.O 0 to 200 Am s 0 to 30 Am>s 1.0 0 to 30 Am
Above 200 qm py 31 to 100 Amps 31 to 100 A s
Swimmmg Pool Above 100_Amps Above 100_Am '
Transiormers Irrigation Booms Partfal,'Other Fee
Signs apeciaiinspection
Bemarks ?TOTA E
i0(
Noueh-m Date
EIecV
ro Inspac or, herehy
cert,fy that the above
Final /? ( ^` ?ne.??? insDection has been
? 1? ? mede.
•hia repuest voia 18 monihs
This re0uest voitl 3?? d?-?6 (O b C/
18 monffi5 from
o) 0 9?9 6 6 4- 9/ A 5, X Y) a_v
Request Date
? Frte No. HouPh-?n InsVecbon
R quired7 ?,/
?Ready Nuw ?y7 Wili Notify Inspec-
, ?es ?NO ??o? When fleady
? LicensCd Electnwl Contractor I hereby raquast mspeciron ot above
? Owner elactr?cal work installed at
Sveet Address, Box or Route No.
? C?
.
??
? ? ` a ic\ c-?,
ection o. Township Name or No. Hunge No. Co ty ^ ?.
c
Oceapant IPFINT Phun¢ Ne.
er Suppl-??? Atldress
Ele ical Conhactor IComDany Namel Cunvactor"s Liccnse No.?
Mailm9 Atld/res?s ICpxr?{^??y mrpCr Owner/?"v?]?,kin?p 7Install
??U V V ?.J Y I ? L' C I'CJ
onzetl Signature IC Va tor Owner Makind InstallaLOn1 Phone Numper LL/
oic ' ?n/'?
'-/ `l ?--?`
MINNESOTA STqTE BOARD OFELECTHICITV
Grigos-Midway Bldg. - Noom N-191
1821 UniversitV A`/e., SL Peul, MN 55104
Phone 16121297-2111
THIS INSPECTION PEnUEST WILL NOT
BE ACCEPTED 9Y THE STATE BOARD
UNLESS PqOPER INSPECTION FEE IS
ENCLOSED.
?y REQUEST FOR ELECTRICAL INSPECTION . k'M Ea-oocwi,-oa
See iris[ructions lor completmg ffiis form on baek ot Yellow copy.
ii--, n Q;qR4 "X" Below Wak Covered by 7his Request
Typ'6 0f Building APCliances Wired Equipmenl WVeA
Home Range Temporary Service
Duplex Water Heater Lighuny Fixtures
Apt. Bwlding Dryer Elec[nc He.rtin
Commercial Bldg. Fumace SIlo Unloader
Industnal 81dg. Air Conditmner Bulk Milk Tank
Farm
Other pe? V
Oth, ISt?auivl
I nr SGOafy ther Oiher
!'mm?uia /ncnarlinn fan Halnw _
N Fee r5atviceEntrence5ixa N Fea feeders?5ubfae?e?s Feg Gucuits
D to 200 qmps 0 to 30 Am s 0 tn 30 Am s
Above 200 Amps 37 to 100 Amps I C. 31 to 700 q
Swimming Pool Above 100-Amps Above 100_AmVs
Transiormers Irrigation Booms Pertial,'Other Fee
Signs Speaai Inspection C
?? TOTA
Remarks
r I J OG
Rovgh-in
? a1e {?
?.?7.(( I, t e ElecVicel
InsP eby
certdy that tha above
Final ? Dn1e
'-A) inspac4on has been
mxde.
TMa raQueai void 18 monllre irom
This requesl void ? i l? ?? `
7A >:,,?nths fram
o flQ.riG72 L(., 83.
to obsy
4r U-7 ri
Ren??est D21e Fire No. FouPh-in liisp¢ction
eq ruA?
I
?Reatly Nuw?ill No1rty Insper
r Wh
n q
d
Ves ?Nn e
ea
y
? Licensed Electncal Contrector ? I hereby reQUast mspection of above
? Owner eleetrical work inslelled at:
Box or Route No.
SVeet Ad22
G C?
4
E
ectmn o. Township Name or Nu. Hange No. ommy
?
Occupnnc IPflINTI1 Phone No.
P er Suppb AdAress
? ?J
Ele l ?Convac[or ?fCOmpany Namel . '
QL--. ?C-A Convact?or-"ys License No.?
Mailinp AdJress (Convac r or Own r Mab'^ng I1nistOailabon)
? 1 ? f 'v ? ?
A ¢ed S5gnamre, ICmtractod wner Makine InstallaGOnl Phone Nomber
I?SL?J '
MINNESOTA STATE BOANO OF ELECTNICITY
Griggs-Midwey Bldg. - 0.oom N•191
1821 University Ave., SL Peul, MN 55104
Phone 1812) 297-2111
TMIS INSPECTION flEQUEST WILL NOT
BE ACCEPTED BY THE STATE BOARD
IINLE55 PNOPEft INSPECTION FEE IS
ENCLOSED.
84 REQUEST FOR ELECTRICAL INSPECTION ee-ooooi-oa
(? ??? ?,1 See instrueiions lor completi?g this torm on back o7 yellow copy. LD y
I1-?'i-?i?-"'vr? Q 7/ "X" Below Work Covered by 7his Request
V
fleil, AAa Aep. TyOa ot emltling APOImoCas Wiree_- EQUiymenl Wired
Home Range Tamporary Service
Duplax Water Heater LighUng Fixtures
Apt. Building Dryer Electnc Heahn
Commercial Bldy. Fumace Silo Unloader
Industnal Bldg. Air Condiuoner Bulk Milk Tank
Farm other Peo y olner (soecity)
t, ueufY t er Otho,
p Fee Service EntrencaSize d Fea Fanders"Subfeeders p Fee Circuits
0 to 200 Am s 0 to 30 Am s tn 30 Am s
r
Above 200 qm)s 31 to 100 Amps to 100 Am
Swinvning Pool A6ove 100_Amps 100-AmIs
Above
Transtormers gation Booms
Irri Partial; Other Fe
ecia
Signs Spl InspecLOn
Nemarks ? S
TOTAL F ?1
j? 7•
?.
Rough-in D$-rte I, <he Electncal
/A"? Inspecmr, ne.eby
/
cartdy thet ihe above
Final Dt y y6 inspeccion has bean
?p made.
rnis reeuasl vold 18 monihs irom
ih?s re9ues[ voitl ? -/8 -G/
hsdrom 0 (/
?? m095973
do?sv
Hesi U
te Rre No. flough-?n InsVecPOn
?
I„?A ,.,
L u
L' A?redJ ?ReadY Now ill Novfy Inspec-
? Yes ? N oi When Ready
? Licensetl Elec[ncal Convactor
? Owner
I herebY request mspecnon of above
electrical work instelletl at
SUeet ddr s. ux r Route N.
c
!
? ?
? C,i?
ectmn o. Township Name or No. RanBe No
. CP nty
Occa ant IPqINTI1
?c??c ph.??
Fow¢r Suppli Atltlmss
Eiec ncal ConhactorlCompany Name)
Meiling qddress (Contractor or Owner Mikinu Instailau
4GRE 3vd vQ_ n(---) Cnn[ractor's License No.
g-
onzed SiBqature (Convactor/Owner Makine Installabonl
" ? \Y?? Phon¢ Nwnber
17- -
MIryNE50TA STATE eOAHD OF ELECTflICITV THIS INSPECTION FEQUEST WILL NOT
Gnggq-Midwav eitla- - Noom N491 BE ACCEPTED BY TME STATE BOAND
1821 Untversity Ave., St. Paul, MN 55106 . UNLESS PFOPEfl INSPECTIpN FEE IS
Phone (612) 2972711 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION es-ooooi.na
See instruetions for compleling this larm on baek of Vellow capy. / O6
p 095973 3 "'X" Below Wark Covered by This Request
OeM an Nev. Tvoe ot Buiiaina Aooina.ces wiroe Enuipmenl Wved
Home Fange Temporary Service
Duplex Water Heater Li,yhLny Fixtures
Apt. Bwldmq Dryer Electric Heatin
Commercial Bidy. Purnace Silo Unlonder
InAustnal Bldy. Air Condinoner Bulk Milk Tank
Farm Ou,Fr oeufy nrher Isne?.?ty1
t er Spewfy Ot er Other
Compute lnspection fee Belaw % Fee Service EnVenceSize A Pee Fexders/Subfentlers - N Fee Grcurts
U to 200 qm s 0 to 30 Am s 0 to 30 Am>s
Above 200qmpy, 31 to 100 Amps 31 to 100 q nips
Swimnung Pool A6ove 100_Amps Above 100_Am s
Transformers Irngdtion Booms Partia6'O
ther Fe
e
Si?s SUecial insUection ?
\
T
'
Rertarks OTAL .R6. ?
?
? e
FouBh-in pale I}fy,/? I, ?he Ele
S 'I • Inspectoq hereby
carviv ?hat the abova
Final ? DHrte S inspection hes been 42 ?? I made.
This reuueal voitl 18 montM }rom
-----------------
?
j Pertnit q: i5l?V-I O 'I
? Pertni[Fee:
? Date Recerved:
I
I 5tatf: I
' -----_:
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: siceaaarow: /-n/
Tenant:
Sulte #1:
RESIDENT / OWPIER Name: &We,S Phone:
Address / Cfry / Zip:
Applicant is: _ twner _X_ Contractw
T1fPE OF WORK Oescrip6on of work: conp
Construc6on Cost: /? ?. 0 O Multl-Famlly Hullding: (Yes / No _--
CONTRACTOR Name:A' Dm -1-yh (oJP?n s U?n?g; 2C? ?7
ZYG ? .
Address: ???i 7
/
City: rw/'') , nq f? ^3 State: zip: -?:SZ> Z
Phone: (?? - 4g' 3',/Z-3 Contact Person: &,b &" ° S
COMPLETE THIS AREA ONLY IF CONSTRUGTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesata Rufes 7672
Ener9Y Code • Residentiai venalaua, cafep«y I worxsnW • New Enetgy Cada W akaheet
Category sunmined submiaed
(4 8ubmissiOn typB) • Energy Envelope Celculatiorw Submided
In the lest 12 monthe, has the Ciry of Esgan Issued a parmlt for a aimilar plan based on e master plan?
_Yes _No If yas, date and address of master plan:
Licenaed Plumber: Phone:
Mechanlcai Conhactor: Phone:
Searer & Water Contractor: Phone:
rtde?ea?rabeput?#h?on P4rtideraol
nrorE P?a+?sand,suppArkh?gdoeumant"sthar,you.awlarnnarkcdn?
,
the MfbrmBtlan..;rriay b? clssafl'Yedss narr?ubllc-it ymU prov?'lespeclflc re8scns tNa? MiouMpe?+tf?lre Glty ta
???.?p??'??{.?p??..??yy? ? , rf 5 "tlW?WMYVHMR- !lHVS, COYIVW M` Y"? SrA.
I hereby acknovAedge tnat this iMamatiai r completa and accurate; mat ttw xrork wlll Ca in contarmance wim the ordinarices and cades af the City d
Eagan; Mat I understand this is rwt a permit but only an application fa a permd, and work is not to stqd ut a pertnR; that the vrak wiil be in
acccrrdence with the approved piart irt iha case ot which requires a review and approval o
x ?V??? ?(J?(°ir, ? ilK
AppllcenYa Printed Neme ApplicartYs Signeture
Page 1 of 3
411? City of Eapn
Mike Maguire
MAVON
Paul Bakken
Peggy Cadson
Cyndee Fields
Meg Tilley
COUNCIL MEMeEPS
Thomas Hedges
CITY AOMINISTHATOR
MUNICIPAL CENTEX
3830 Pilot Knob Road
Eagan, MN 55122-1810
651.675.5000 phone
651.675.5012fax
651.454.8535 TDD
MAINTENANCE FACILI7Y
3501 Coachman Point
Eagan, MN 55122
651.675.5300 phone
651.675.5360 fax
651.454.8535 TDD
www.cityofeagan.com
THE LONE OAK TREE
The symbol of
strength and growth
in our community.
Apri19, 2008
Land 'Fitle, Inc.
Attn: Andy Braun
1900 Silver Lake Road, Suite 200
New Brighton, MN 55112
Dear Mr. Braun:
The City is returning your check 8-36074 in the amount of $404.00 because the City
cannot accept payment on pending assessments. Project 959 is expected to be completed
later in 2008. Once the project is complete, final assessment amounts for each pazcel will
be determined and notices will be sent. If you would like us to send the special
assessment notice(s) to your attention rather than the previous seller's attention please let
us know and we'll make the change. If you have any questions don't hesitate to contact
me. Thanks for your attention to this matter.
Sincerely
Ryan 3tevens, Accountant
651-675-5032
Enc:
Special Assessment Seazch
Check #8-36074
ReP°rt Ne°'e: City of Eagan Printed: 4/2/2008
Assessment Seazch P?e? ?
Special Assessments Search
Property ID Lot Block Addition Addition NamelLeeal
10-22750-130-01 13 01 10 22750 Eden
13 1
Propert^ Address Prooertv Status - - - - - Special Flags - - - - - 2008 P& ert:
4477 Clover Lane Unit B Active 1 2 3 4 5 6 7 8 9 10 $249.03
Eagan, MN 55122 N N N N N N N N N N
SA Nbr Descrigtion Ygps rm Rat,g Total Curr Prin Pavofl Status
100241 SAN SW TRK 1973 15 8.0000 $62.93 $0.00 $0.00 Prepaid
100345 WATER AREA 1976 15 8.0000 $62.93 $0.00 $0.00 Prepaid
100638 S,W,SS-287 1981 5 8.0000 $1,896.46 $0.00 $0.00 Closed
100639 SS-TR-287 1981 5 8.0000 $256.00 $0.00 $0.00 Clased
100640 GB-287 1981 5 8.0000 $232.99 $0.00 $0.00 Closed
100650 ST-287. 1981 5 11.0000 $504.70 $0.00 $0.00 Closed
103653 Delq UB 10/07 2008 1 0.0000 $249.03 $249.03 $0.00 Final Yeaz
1OP959 Eden Addition Neighbofiood 0 0 0.0000 $401.00 $0.00 $0.00 Pending
Swnmary of Levied: $249.03 ' $249.03 $0.00
Summary of Deferred: $0.00 $0.00
Smntnary of Closed: $3,016.01
Pending Estunate: $401.00
Future Estunate: $0.00
Hookup Fee Estima[e: $0.00
Land Title, Inc.
File : 304300
Buyer : Ramona Peter
Seller : Deutsche Bank National Trust Co
Property Address : 4477 Ctover Lane Eagan, MN 55122
(1308) Assessment - Sheet - $404.00
Payable to : Clly of Eagan
Bridgewater Bank
Bloomington, Minnesota 55431 8-36074
Date
3/31 /2008
? Land Title, Iric. ?s EecrowAccounc
;1900 Silvtt YaIce Raed, Soite 26(k
' 'I4cw,$aghtoqMN55112,'
? ...'
.' Escrow Officer. Andy Braun 651-905-7007 :
aaY% Four Hundred Four and 00/400 Dotlars
i
" To C' af Ea an
Bridgewater,Bank ? " . AIe:3043W
*'loomington, Minnesota 55431, 8„?6074
' 7b7751/9'16
?
< • D'd? v
3/31/2008
s ? ..,
?
? A y; ,....1404.00 ?
?°Void aftei 186 days'
? QpEp N. _ ? , ? ?'" . ,_ ?• 39? ?
?. ' F
. ,.r:?
? :?- "f?7?. , . ;?; , , ? a, - • x ??, ` - ?
11'8360740i' 1:0910175231: 83000737V
2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: single family dwellings & townhomes/condos when permits aze required for each unit
W,s
I
Date -A, / 7 / e) "/
Site Address `-/ 'V'y 7 6 `l 0 / Unit #
6k L&'r T
l
h
#
)
Property Owner e
ep
one
(
Contractor
. . _ o :f.': L',v • . r,1.. _. / O ? ?O
Street Address
CILY L'/ ?S
State Telephone #( 9y ) 2??4 i l.'?
Bond #: Eapires:
?
? Oth
The Applicant is _ Owner
Contractor er
_
Add-on or atteration to existing dwelling unit $ 30.00
V fumace _Additional -Replacemen t
air exchanger
? airconditioner New Replacement?l .'rl%'1l? C'U1y
_ o1 AM
other
State Surcharge $ .50
To[al $
I hereby apply for a Residential Mechanical Pemut and acknowledge that the information is complete and accurate; that the work will
be in conformance with the ordinances and codes of the City oF Eagan and with the Mechanical Codes; that I understand this is not a
permit, but only an applica6on for a permit, and woik is not to start without a permit; that the work will be in accordance vnth the
approved plan in the case of work wluch requues a review and approval of plans. , D
lrq? ?,:M E r,uz mcc ?
Applicant's Printed Name ?- ApplicanYs Signature `?%%Y?
6?a 6 P,S'
RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauiremenis
3 reg'ste2d site surveys shovring sq, ft. of bt, sq. ft of house; and all rooted areas
(ZO% marzimum lot coverage allaxed)
2 mpies of plan showing beam & window sizes; paured found design, etc
1 set of Energy CalaWlions
3 copies of Tree Preservation Plan'rf lot platted after 7l1193
Rim Joist Detail Options selectian sheet (bldgs wiN 3 or less unils
0-0
OKce Use Onlv
Cert of Survey Reoi
Trce Pres Plan Recd
_ Tree Pres Not Reqd
_ On-sile Septic Syslem
Date / 7_k
/ 03 .?
ConstrucHon Cost
Site Address ?
UnidSte #
? ?A
' v\ Z
N e
i
Description of Work _
(,l
Multi-Family Bldg
/Y_ N ?
Fireplace(s) ( u 1 _ 1 _ 2
Property Owner Telephone # (6
ContracWr
Address City.
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Cateaorv 1
• Residential Ventilation Category 1 Worksheet
(dsubmissionrype) Submitted
• Energy Envelope Calculations.SyAitted
Licensed Plumber
Mechanical Contractor
? ?-
Sewer/Water Contractor
A NEW BUILDING
Minnesota Ru1es 7672
• New Energy Code Worksheet
Submitted
Telephone # (
Telephone #(
Telephone #( )
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, an r is no o start without a
permit; that the work will be in accordance with the approved plan i e case ork wluch req res a review and
approval of plans.
Geie? V h 1 Applicant's R nted Name A lic s
RemodellReoair Reauirements
2 copies of plan
1 set of Energy Calculatiore for heated addiLOns
1 site survey for addi6ons & decks
Addilion - indicate'rforrsde septicsystem
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex A 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
7( 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg) - G ive PCA handout to applicant
Valuation Occupancy IZ 3 -.a4- MC/ES System -
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const W idth
Footings (new bldg)
x Footings (deck)
Footings(addition)
Foundation
Drain Tile
Roof Ice & Water Final
_ Framing
_ Fireplace _ R.I. _ Air Test _ Final
insulation
REQUIRED INSPECTIONS
FinaUC.O.
FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Au/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Retaining Wall
Approved By 72- , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
.?
20
. ? ./ / a
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED NITH THE CITY OF EAGAN
COMQIERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL
& STRUCTURAL PLANS, 1 SET OF
SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS
$2,000 LANDSCAPE BOND
IoF
To Be Used For: -Vj-/-k:t00-_
Site Address ???Lclh.cr ?
Lot ? Block ?
.
Parcel/Sub &(v
Owner4?cL VA4ue. /-}•??e-.S .S?V
Address 1wo,,?j
City/Zip Code u?
-?----r-
Phone ?^ 5?J
Contractor
Address
City/2ip Code
Phone
Arch./Engr.
Address
City/2ip Code
SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF PLANS
3 CERTIF'ICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
(d7,o00
Valuation•
Erect X
Remodel ?
Repair ,
Addition
Move
Demolish '-
Int.Impr. ,
Install ?
APPROVALS
Date: /-S`-?
Occupancy
Zoning
Type of Const
!l of Stories
Length
Depth
Sq Ft
FEES
Assessments Permit
Water/Sewer ?
? Surcharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Council Road Unit
Bldg Offl Treatment P1
APC 71 Parks
Variance Copies
TOTAL
Phone 11
( TOidNHOUSE )
BUILDING PERMIT
._ ._ ....n S... 1 I
CITY OF EAGAN N°_ 11241
3830 Pilot Knoh Road, P.O. Box 21-199, Eagan, MN 55127 ?7 r/7/
PHONE: 4548100 6
Receipt #
4 PLEX Est. Value $60,000
Sitenddrem 4447 CLOVER LN
Lot 7 glock 3 sec/sub. EDEN ADDITION
Parcel No.
GOOD VALUE HOMES INC
c tdeme 1460 93RD LN NE
? Address
BLAINE Pnone 780-5510
City
o Name SAME
?t Address
'
City
Phone
Neme
qddress
CicY Phone
1 hereby acknowfedge rhat I hove reod rhis oOPlicarion and sto I c ble
the $tate?ofrMn?nesoto Statutes?anCty'Of?Eogan OrdinolncevP
Sipnaturc of Permi
h Building P it Is iss ro: GOO[
all wark I be e in acmrdance with all
7 1$5
Erect E Occupancy na
Remodel ? Zoning PD
Repair ? Type of Const. V
Addkion ? No. Stories
Move ? Length 44
Demolish ? Depth 2¢
Inl Impr. ? Sq. F2.
Instell ?
Approvnls Fea.
Asussment I
Woter 8 Sew.
Police
Fire
Erp.
Vlnnner
Council
Bldg. Off. 11 /6/8 5
APC
V D te
Permit .00
suronerge 30.00
PlenReview 156.50
SAC 57.00
WaterConn. 500.00
WaterMeter 63.-00
RoadUnit 280.00
Tr. PI. 132.00
Parks
ar. a ?ea
totai $1 999 • 50
INC on the exprcss condiNon that
?esoto Stotures and Ciry of Eufla^ Ord'^°^u°'
?•,
Bulldirg Official
/
1985 BUILDING PERMIT APPLICATION - CI'PY OF EAGAN
NOTE: ALL CONTRACTORS HUST BE LICENSED YIITH THE CITY OF EAGitI
COt41ERCIAL
SINGLE FANILY DWELLINGS
INCLUDE 2 SETS OE ARCHITECTURAL INCLUDE 2 SETS OF PLANS
& STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY
SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS
ENERGY CALCULATIONS
$2,000 LANDSCAPE BOND IoF
Coc>, ooc?
To Be Used For: L(, 6?? Valuation: '"?T? Date:
Site Address ?lqZB
Lot ? Block
Parcel/Sub r4 a.-?
Owner C,=? r. 4%,J(,-
Address Lq(o o -9?L4 4,A) N C-
City/Zip Code6:fa,-.t/J 5342j/,
Phone 7f0 a
Contractor
Addres
City/2
Phone
Arch./
Addre:
City/2
Phone
OFFICE USE ONLY
Erect K Occupancy r,2 3
Remodel Zoning pp
Repair ? Type of Const $C
Addition S of Stories
Move ? Length 4
Demolish ? Depth Jf}
Int.Impr. ? Sq Ft
Install ,
----------
------------------
---
APPROVALS FEES
Assessments Permit
Water/Sewer ? Surcharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Council Road Unit
Bldg Off? Treatment P1
APC 77 - Parks
Variance Copies
TOTAL
' t..
( ToWNI:OUSE ) CITY OF EAGAN N°_ 11242
3830 Pilot Knob Road, P.O. Box 27•199. Eagan, MN 55121 ,7
PHONE: 454-8100 ?'JO ??
BUILDING PERMIT Receiot #
NOVEMBER
7
85
1 OF 4 PLEX Est.
$60,000 Date
Value
lq
Te M wad h. Erect ? occupancv R-
SiteAddress 4447B CLOVER LN
EDEN Remodel
ADDITION ? Zoning PD
Lot 8 Block 3 cac/Sub. Repair ? Type of Conat. V
Parcel No. Addition ? No. Stories
Move ? Length 44
GOOD VALUE HOMES INC Demolish ? DePth 24
s Name
1460 93RD LN NE
= intImpr. ? Sa.Ft. Address
? BLAINE Phone 780-5510 Install ?
City Approvab
S?E
O Name Assessment
Addrasc Woter 8 Sew•
r City Phone Police
s
Fire
Name En9
_? Address plonner
Gty Phone
CounCil
d this oppiication ond stote that , Off. 11I6 85
l
1 hereby acknowledge thot I have reo
fhe informotion is correct nd a9ree to comply wO'?th otl cDPlicable g
PC
Faas
Permit S 313-00
Surcharge 30 _0 0
PlanReview 1 F;6-50
snc 525.00
WaterCOnn. 500.00
Water Meter __juso 0
Road Unit __2BD'0 0
TcPI. 132 - 00
State of Minnewta $totut and City of Ea9a^ r ?ne ce Var. Da I Tma? Copies $1,999.50
SIOn?ure of Permift
A ssued ro: GOOD VALUE HOMES INC on the axpross w?drti°^ lh°l
Building Pe
ull work sha done in accordance with oll opplia?ble State qrmll,,esuta Statutes ond Ciry of Eo9an Ordinancea.
8ulldiaq Off{Nal ? . _
.. . ?
1985 BUILDING PERHIT APPLICATION - CITY OF EAGAN
NOTE: ALL COATRACTORS NUST BE LICENSED NITH THE CITY OF EAGAN
COMMERCIAL
SINGLE FAMILY DYIELLINGS
INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS
& STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY
SPECIFICATIONS AND 1'SET OF 1 SET OF ENERGY CALCULATIONS
ENERGY CALCULATIONS
$2,000 LANDSCAPE BOND
loF (cO,ooo
To Be Used For: 50???7D Valuation:A-AN--?
Site Address 1-J OFFICE
r.ot Lo alook -3
Parcel/Sub rT'?.T,n.)
Owner yA4 Q gt,? a.JG..
Address
City/Zip Code
Phone `Irv $J7 C.7
Contractor
Addres
City/Z
Phone
Arch./
Addres
City/Z
Phone
Date : l1"'r'--ks~
Erect X
Remodel ?
Repair ?
Addition
Move ?
Demolish
Int.Impr. ,
Install ?
APPROVALS
Occupancy
Zoning
Type of Const
!k of Stories
Length
Depth
Sq Ft
FEES
Assessments Permit
`Jater/Sewer ?
? Surcharge
?olice P1an Review
?ire SAC
ingr Water Conn
?lanner Water Meter
;ouncil Road Unit
31dg Off II&AV Treatment P1
9PC 77- Parks
'Jariance Gopies
TOTAL
l( TOwNHOUSE ) CITY OF EAGAN N°_ 11240
3830 Pilot Knob Road, P.O. Box 27-199, Eagan, MN 55121
` PHONE: 454-8100 Sj
BUILDING PERMIT Receiot #
Te M waA Mr 1 OF 4 PLEX Eo, yalUe $60 , 000 pote NOVEMBER 7 I q 85
4449 CL0VER LN Erect ?.' Occupancy R3
SiteAddresa
3 EDEN ADDITION
6 Remodel ? Zoning
?ec/Sub.
eio?k-
Lot
Repair ?
Type af Const. _V
rcel No
P i
? St
i
N
.
a on
Addit or
es
o.
? Move ? Length 44
? GO00 VALUE HOMES INC
Name Demolish ? Depth ZQ
i 1460 93RD LN NE
Address
Int Impc ?
Sq. Ft.
? City BLAINE phone 780-5510 lnstall ?
ADVrovals iaes
?
=f SAME
f?ame
Assessmenl
PermN ?'.?.00
?? Addrew 30 . ??
Wa1ef gSeH, Surcharge
t- city Pnone
Police
Plan Review 156.50
Gw Name Fire SAG rJ25.00
?i
_-,
addre:s Eny, WaterConn. 500.00
°CZ
CiSY Phone
P{anrror
WaterMeter 63_00
280
00
Council RoeA Unit .
ocknowiedge that 1 have read this oppiicotion ond state fhat
I here6 gldg. Off. 11 6 8 5 Tr. PI. 13 z. Q 0
y
the inlormotion ia correcf nd ngtee 1o wmply with oll apDlicoble APC Parkg
Stato of Minnesofo $fot s und Cify of Eoga dinance D
V
ar. COpies
SipnMurc of P Total $l , 999.50
Ndin e' s issued • GOOD V?1L[IE AOME
A B INC on tha exprcaa condinw+ tho+
u
oll work be done in accordance wifh oI"DDliwble $ta" Minnesota Statutes ond City ol Eogan Ordinoncet.
3
Building Official ?
7985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS XUST BE LICENSED NZTH THE CITY OF EAGIN
COt4MERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL
& STRUCTURAL PLANS, 1 SET OF
SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS'
$2,000 LANDSCAPE BONDI v?
To Be Used For• Valuation:
Site Address qp,,,r 1'j f
Lot ? Block ?
Parcel/Sub cc{z,) A41 ,Lr _)
Owner ".( Q? L
Address /?Q 9034 L,J A? r,
City/Zip Code aLs'._id,)
Phone J
Contractor Q'iG...?._
Addres
City/Z
Phone
Arch./
Addres
City/Z
Phone
SZNGLE FAMILY DHELLINGS
INCLUDE 2 SETS OF PLANS
3 CERTIF'ICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
(on, o00
/--pW-0m?9
Date •
1AA--*--' ?
Erect X
Remodel _
Repair ?
Addition
Move ?
Demolish ?
Int.Impr. ?
Install ,
Occupancy
Zoning
Type of Const
ll of Stories
Length
Depth
Sq Ft
APPROVALS
FEES
Assessments Permit
Water/Sewer Surcharge
Police ? Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Council Road Unit
Bldg Off1 Treatment P1
APC Parks
Variance Copies
TOTAL
:5 o
(TOWNHOUSE ) CITY OF EAGAN N°_ 1 12 3 9
P.O. Box 21-799. Eagan, MN 55127
3830 Pilot Knob Road
,
` PHONE:454-8100 ? ?7 /
BUILDING PERMIT Receipt #
NOVEMBER 7
85
1 OF 4 PLEX En. Volue $60 ? 00 0 pO1e ?y
Te 6e awd fer
4449B CLOVER LN
Erect C?
Occupancy
SiteAddresa EDEN ADDITION
k 3 SeclSub. -
5 Remodel ?
ar ?
Re 2oninq
Type of Const. V
Bice
Lot p
Percel No. Addition ? No. Stories
Move ? Length 44
GOOD VALUE HOMES INC pamollsh ? oepth Zq
c Name
1460 93RD LN NE intImpr. ? Sq.Ft.
? Address
BLAINE pnone 780-5510 instali ?
CitY ApOrovals Faes
.00
;o Name SAMF'-- Assessmenl Permit 30.00
S? Address Woter 8 Sew. Surcharge
n Review
Pl 156. 50
CitY Phone Police a 52S.OO
W Fire
SAC
5 ??•??
Name
? E"9• Water Conn. 00
63
u? Address
Phone WatarMeter .
28 0• 0
?
? W City Council Road Unit
0 0
13 2
I hereby atk rawledge licnrlon and state thot
t I hava read this ap0
ith all apDlicable
l gldg. Off. 11? Tr. PI.
parks .
y w
the inlormation is co e and ogree to ?mp
f M nnesota St tes and Gry of Eo Ordirwn s. APC
Var. Copies
State o ?
Total $1 999.50
5ipnature of Pe ' ee GOOD VALUE HOMES INC m the ezpress conditlan that
w Building P s iszued to:
Mi ewt? Wes a?d CiNogon O irance6.
oll work sha done in occordante with cll cOPli Stote qf.
L?
Bulldinp Official
PERMIT
CITY OF EAGAN
3831 Pilut Rnob Road
Eagan, Minnesota 55122-1897
(651) 681-4675
PERMITTYPE: auit.usue
Permit Number. 034 ;? 70
Date Issued: () 1/0 8 ! 9 9
SITE ADDRESS:
P.S,P1.; 10-22750-050-03
4449e c?ovER i.ANE
LOT- ri HLOt;K¢ a
1'=OEN
DESCRIPTION:
REMARKS:
UNI f c?.
SIDIIVG
STORKf DflMFlC,C
REPAIR
434 ALT. RESIIIEhdTTAL
r?
?
REPLrace
Bulldinq, PEarmi.t 'type
F,luilef3Rg Wo?rk iype
r-Csnsus Ctrcle _
t
?
i
r/
FEE SUMMARY:
CONTRACTOR: - Rpplicant - :,7. I_ZC. OWNER:
CU57QM t:(JNCEI'TS CONS7 189S729C? ?(?14241/ UNL 01 R EG
16540 KCNFtICK LfjOP/STE fS 44443 CLOVER LflNE
LAKEVSLLE MN 65044 EAGfiN i+1N 55122
(612) 898-7290
I
I her26y ackiowlcdqe thaC T haue rsad th3.s aPpiicatiqri and sta,te that the
infiormation is correot and aqree to cornply with 811 appLicable StaCc ot hln.
5tatutes and CiT.y ot Eaqan OrdinanceB.
?
APPLICANT7PEflMITEE SIGNATURE ISOED BY SIGNATURE
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
? . - CITY OF EAGAN
3830 Pi651? 680 4RD - 55122
New Construction Reauirements
? 3 registered site surveys
? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.)
? 1 energy calculations
? 3 copies of tree preservahon plan if loc platted after 7/1/93
required, _ Ye5 _ No
DATE: 1-I QI fi
Remodel/Reoair Reouirements
? 2 copies of plan
? 1 site surveys (exterior additions & decks)
? 1 energy calcula4ons for heated additions
CONSTRUCTION COST; 43 -7 5
DESCRIPTION OF WORK:
STREET ADDRESS: C1CTi)4 ' ? 0 U
C
LOT: S BLOCK: ? SUBD./P.I.D.
I ' ',,1 ?
Yaine: l. Vj?___? P ? rl S?l ??_-__ Phone k:
PROPERTY >t ? e?'
c)bVV1:R
Sticct :\ddL css:--------------------------------------------
Citv
Sta[e:
"Lip:
/?,,,! p7 p ?"?,
Coxnpai?c:_ ?_ /?'/ --? o ee Phoue n:
COA'1'RAC I'OR
Strec[ Address:_(/ _U ?J_ ?r-_O License ii &[yZ?L_L.sp. --
"-
C.ilc ------?--°___---- --- -_' $ta[c: _???' __---- ziP' -'?=7 Y
ARCHITECT/
EVGINEER Cotnp:un':------------------------- -------- - PLonc k: --------- -------------
lYainc: Reonstratiou tY:
Slrcct
Cily ---------------- ------------------ Stalc: _ %ip:
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
PERMIT
CITY OF EAGAN
3830 Pilot,Knob Road
Eagan, Minnesota 55122-1897
(651) 681-4675
PERMITTYPE: B LJ c i_ozNc
Permit Number: 034369
Date Issued* 01 i02 /99
SITE ADDRESS:
4449 c?ovFiz LnNc
LOT: 6 HLOCK: 3
EOLN
P.I.N.: 10-22750-060-03
DESCRIPTION:
, .? REPLACE
8u`tldinq;Per-mi.C Tyoe
t3I uildina Wtf.rk 1"vpe
itensus Code A,
?_.
f
,
i
szOzNr
Sl'ORhI DHMAGE
REPA7R
n;;q ql_7. KESIDEIVTIAL
REMARKS:
FEE SUMMARY:
CONTRACTOR: - App1 i r, a n t- s T. i r r. - pyyNER:
C,USTC)hl CONCFPTS CONST 18987290 20142417 BERVIG ORDEAN
16640 KEIVRICI< 1.00P(STE B 4449 CLOVER IAPdE
LNK£V1LLE MN 65044 EHCAN MIV 56112
(61.2) 898-7290
L herehy ackrowledqe tYiati Z tiave read this spuliceitiqn arrd stat'e tMaL' the
iniormat:ion :s correct and aqrae tn comply w,a.Y,h all anplic.aGle SLaCe ot Pin.
Statutes bnd ?itY ot Eaaen qrdinancesa
I I
APPLICANT/PERMITEE SIGNATURE
ti
1 'UED BV: SIGNATU E
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
3 1+-?)#?n CITY OF EAGAN
`j 3830 PILOT KNOB RD - 55122
(651) 681-4675 l e ' ? f
New Construc6on Reawrements
? 3 registered site surveys
? 2 copies of plans (inUude beam & window sizes, poured fnd design; etc.)
? t energy calculations
? 3 copies of tree preservation plan if lot platted after 711l93
requved: _ Yes _ No
DATE. I-1-el ?
DESCRIPTION OF WORK:
Naune:_6 C Y?I Jk I YV1 A. _ 111011e N:
?---------
t.?c nsc
STREET ADDRESS: L41-11-I CI l?Q LT( )Q A ?&JYt4 ?
LOT: BLOCK: SUBD./P.I.D. #: ??--
PROPERTY
OWvLtt
CON'1'RACI'011
ARCHITECT/
ENGINEER
RemodellReoair Reouirements
? 2 coPies of pian
? 1 site surveys (extenor adddions & decks)
? 1 energy calculations for heated additions
CONSTRUCTION COST; "f 3 --7
stieer
aLy
$L1[e:
7rp:
Co[npaliy:_s3oLo rm ---6.) ------- /Phonc #: !4_l? % -------
Sireet Address:ZS!q_ ??-r? ?---'?"? /J _ License # ZO/y Z 4/1-t"xp' -----
Citr
Strcet
CiIV
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
'I
Certificates of Survey Received _ Yes _ No
sra<<: rip: fr--C9 c? ------
------ Phonc k: -----
Regsuation
------ - - -------
Slatc: -------- -- Zip:
Tree Preservation Plan Received _ Yes _ No - Not Required
PERMIT
GITY'OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(651) 681-4675
PERMIT TYPE: e u s L 0 2 N c
Permit Number: 034368
Date Issued: 01 / 0 S/ 9 9
SITE ADDRESS:
P.S.N.: 7.0-2275(,-080-03
4447B cLovEa i.an;;
LOT: 6 6LOCK: 3
FSJEN
DESCRIPTION:
REpLACE STD7NC,
Bu`lldinq Permi.t Type STORhI DAIhAGF
Qu.ildinq Oor-k Typa ftEPAiR
%Census Code 434 ALT. RESIDEN7IAL
.
/ .
.
?
;r v
° _-`v`?.. . -' --
REMARKS:
ur!sr e.
FEE SUMMARY:
CONTRACTOR: - Appiicanc -- s7. Llc. OWNER:
CUSI`OM COiVCEP`fa CONST 18987290 20142417 I4UF3EP. REBECCA
165447 KENRCCK i_U0;'/STr g 44478 CLOVER LFlNE
LAKFVILLk MN 55044 EAGAiV 11 N 55722
(612) 89ti-7290
T hersbv ac cnai,rlfadqe That 7 have read Thts appJ.;.aot'ion and ?tate Chat tlie
intormatior is correcL- artd aqree to complv with aL1 ar,?lic.;blr SYate ofi Mn.
Statutes a•1 Citv oY Eagan 4rdinances.
I
APPLICANT/PERMITEE SIGNATURE
J
ISS BY. SIGNATURE
- - 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
(651) 681-4675
New Construction Reouirements
? 3 registered site surveys
? 2 copies of plans (indude beam & window sizes; poured fnd. design; etc.)
? t energy calculations
? 3 copies of tree preservation plan if lot platted after 7l1193
requved. _ Yes No
DATE: I jg -1
Remodel/Reoav Reauirements
? 2 copies of pian
? 1 site surveys (extenor additions & decks)
? 1 energy calculahons For heated additions
CONSTRUCTION COST; Q 3 -7 f'
DESCRIPTION OF WORK:
STREET ADDRESS: ?? 9 -7 P? (JUV'(.f `-?
LOT: _8- BLOCK: 3_ SUBD./P.I.D. #: ?
CC.G?. _ Phoue
PROPERTY La+t Firsc
oWvLii
sn?eeeAdare,,:------------------ ------------- ?
Cin
State:
"Lip:
p p
(;omp?un': ? y? ---- l.?/ J/1 GQi ??---- P honc ?9o_ -- 2 G'(?-------
-
-j-`t-----?- -
CC)\'1'R\CI'012
/???1
Street Address: J_-' __ License #2(9
Cit}' --
ARCHITECT/
ENGINEER Compauy:
Namc:
Stroct :\dc
Citt ---'
State: "a dJC ----- ZiP' ?T(7 Y , -----
Plionc #: --------
-------- Itcbnstntion k: ----
Stalr. 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 applicahle
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
CeRificates 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:
Permit Num6er:
Datelssued:
BUI"LUiNG
03q:367
es/ma/99
SITE ADDRESS:
4447 Cl.OV[R LANE
LOT: 7 ,sLCICI<D 3
EOLN
P..T.N.: 10-22750-070--03
DESCRIPTION:
rtewI.mct szoIivr.,
Brii ldinu'_permit T'vpe S7URM DAPIAGE
?uSld9.nq Woxrk Type REPAIR
,"census Cocle 434 aL7. S2E5I0ENTIAL
i .
r
? •
i-
?. ,.._ . ,. ?
i
?, . - .1 :. - .i ...t . ..
r
REMARKS:
FEE SUMMARY:
CONTRACTOR: - Applicant: - sT . L zc. OWNER:
CUSTOM CONCEPI'S " ONST 18957290 28142417 GLLEftIhAN THQMAS
16540 KENRIC K LOOP/STE B 4447 CLOVF_R LAP!E
LAKEV:CLI-E P1N SS0q4 GF1C=,AN MN 66122
(612) 898-7290
L her-by ock owAedqe thac i have rcaci this apolication ond state thut the
inioi°mation s cori°ect and aqre.c3 to coinuly wiY,h all applicable ST.ate 01 Iln.
SLatutes end CiCy oP Faqan Ordin ances.
L ?
APPLICANT/PERMITEE SIGNATURE
I , o LV
ISSQ BY: SIGNATUPE
- - ?_
_?)?-?(? 1999
New Construchon Reawrements
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
(651) 681-4675 ?
RemodeUReoair Reouirements
? 3 registered site surveys
? 2 wpies of plans (inGude beam & window sizes; poured fnd. design; etc.)
? 1 energy calculation5
? 3 copies of tree preservation plan if lot platted after 711193
required: _Yes _ No
DATE: I ` 7 -
DESCRIPTION OF WORK:
? 2 wpies of plan
? 1 site surveys (exterior adddions & decks)
? 1 energy calculations for heated additions
CONSTRUCTION COST; ?_j 5
STREET ADDRESS: 4-7 `t _7 QayO A IIk_n'L9- v
LOT: ? BLOCK: ?J SUBD./P.I.D. #: ekluv?_'
Phone #:
PROPERTY r??t
oWti Lli
titrcct Address: . ---------------
CiLy
State:
"Lip:
g'q?-?-------
Compauy:_a-C? __!?'? _f- ?------- Plroue #: g'__f
CUN"I'R:\Cl'OR / -
Street:lddress: 16 qrd Lccnse#?F1JL?[??//?
City ----LJ!_--------------------- S[ate: ?-------- Glp'
ARCHITECT/
E VGINEER
Plwne 0:
Reeistntion #:
Street
City -------------- ------- ------- State: --------- ---- ZIP' ------------------
Sewer & water Iicensed plumber (new construction only): . Penalty applies when address
change and lot change is requested once permit is issued.
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.
-1?" ?
Signature of Applicant: - o
OFFICE USE ONLY i ---
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
BUILDING PERMIT APPLICATION (RESIDENTIAL)
L? gL 3 CITYUSEONLY RECEIPTIF: C?I 3O'Ijb
SUBD. L(1C? RECEIPTDATE: 5,1311 OU
PERMIT # giolz
2000 PLZJNIBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT IINOB RD
EAGAN, MN 55122
651-681-4675
Please complete for: ? single family dwellings
? townhomes and condos when pertnits are required for each unit
? backflow preventer for underground sprinkler system
FIXTURES
EACH #
TOTAL
Alterations to existing dwelling - minimum fee $ 30.00
Describe:
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
Gas piping outlet ' minimum - 1 3.00 x = $
Hot tub/spa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tray 3.00 x = $
Lavatory 3.00 x = $
SeptlC SyStem new/refurbished • requires MPC lic. 75.00 X = $
Septic System abandonment 30.00 x = $
RpZ new installation/repaidrebuild 30.00 X = $
Rough openin 1.50 x = $
Shower 3.00 x = $
Under round sprinkler if dwelling is under construction 3.00 x = $
Underground s rinkler if existing dwelling 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x $
Water softener if dwelling under conswction 5.00 x = $
Water softener if exisdng dweliing 30.00 X = $
Waterturnaround 30.00 x --- _ $
State Surcharge 50 -> --> -> $ .50
TOtal ""' "'' -' ---' $
Reminder: Cali for inspections of alterations, i.e. water heaters, water softeners, etc.
I hereby acknowledge that I have read this applicaGon, state thst the inforrnation is correct, and agree to compty with all applicable City of Eagan ordinances.
It is the applicanYs responsibiliry to notify the proparty owner that the City of Eagan assumes no liability for any damages caused 6y the City during its
normal operational and maintenance activities to the facili[ies construded undei this permit wdhin City propertylright-of-way/easement.
SITE ADDRESS:
41V
OWNERNAME:: Tw 61- LS'eTELEPHONE#:
(AREA CODE)
INSTALLERNAME: TELEPHONE?????
(AREA CODE)
STREETADDRESS: 21??0 (?r4?'J7Pz1S ? ?7 Q --
CITY: A?'?Oc.C7;V STA E: ^?-,? Z
SIGNATURE OF PE TTEE
. ?II CITY OF EAGAN FOR CITY USE ONLY
3830 PIIAT KNOB ROAD
\ I\'EAGAN, MN 55122 PERMIT #
U PHONE: (612) 454-8100 RECEIPT # D/
9"B.x?t"r,,`.?'?E?,? DATE:
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLZNGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH DNIT.
WORK DESCRIPTION
NEW CONST _
ADD ON _
REPAIR _
OWNEit NAl4E: OCU Q-ti- Yy G Pp 0 1??
SITE ADDRESS: v s D ?e
LOT: (/ BLOCK ? SUBD.
INSTALLER: ) ?L,?L 0-o
ADDRESS: "Q,,' - • I ) v p-,
CITY: ? 5'r ?ft.&,-` ZIP:
PHONE,#: 1 -0 I d-- 7 J l-
? g7GNATURE OF
°-- ---------------------------
COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
ADD-ON MINIMUM 15.00
SHOWER 3.00
WATER CIASET 3.00
BATH TUB 3.00
IAVATORY 3.00
_ KITCHEN SINK 3.00
LAUNDRY TRAY 3.00
HOT TUB/SPA 3.00
WATER HEATER 3.00
_ FLOOR DRAIN 3.00
GAS PIPING OUT.
_ (MINIMUM - 1) 3.00
ROUGH OPENINGS 1.50
OTHER _
? WATER SOFTENER 5.00
_ PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
SUBTOTAL S
ST. SURCHARGE .50
TOTAL: $ Co3OWRCZ1??;?:?7DUST$=f?L'r PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND
?µ... R MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
-------------
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP: ,
PHONE #:
FOR:
CITY OF EAGAN
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18
STATE SURCHARGE
TOTAL:
$
$
(SIGNATURE)
I . C/Z/
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. AISO, FOR TOWNHOMES AND
CONDOS WHEI+I PERMITS ARE REQUIRED FOR EACH UNTT.
NO. FIX'fCTRES EA.CH TOT?
SI-IOWER 3•00
WAT'ER CLOSET 3•00
BATH TUB 3.00
LAVATORY 3•00
KITCHEN SINK 3•00
LAUNDRY TRAY 3.00
HOT TCJB/SPA 3•00
WATER HEATER 3•00
FLOOR DRAIN 3•00
GAS PIPING OUTLET • minimum - 1 3.00
ROUGH OPENINGS 1.50
? W.ATER SOFTENF.R 5.00
---
PRIVATE DISP. • DaI.Cry. lic. 15.00
U.G. SPRINKLER • tiome uneer ooui. 3•00
ALTERATIONS • to ?ting 15.00
WATER TURN AROUND 15.00
STATE SURCHARGE .50
TOTAL: ?. 5 o
SITE AD
OWNER
INSTALI
ADDRE:
CTTY: _
STATE:M,n? ZIP CODE: Sp
PHONE #:
SIGNATURE OF PERMITTEE
+ 1993 PLUMBING PERMIT (RESIDENTIAL)
CTIY OF EAGAN
3830 PII.OT KNOB RD
EAGAN MN 55122
(612) 681.4675
IIIq? ....... .
a s
,
LQ2
.?
,
i ,
?
e ?
azz
C
?
- A/.
ao 6
i
PERSONSi RDQLIIRING, ADDITIONNL,COPIFS- WZLG, BE'' CFIARGED A$20:00' FEE. TOCO
CITY OF EAGAN
APPLICATION FOR PERMIT SEWEEt ADID/OR WATII2 CONNECTION
1) PROPERTY ADDRFSS:
T•FY;AT• DESQ2IPTION:
E
IF EXISTING STRL'CTLRE, DATE OF ORIGINAL BI!ILDING PERMIT ISSL'PNCE:
(Nbn Year)
PRESENT ZONING/PROPOSID USE: R-1 SINGLE FAMILY
R-2 DDPLEX ('IWO Cnits)
R-3 TOWNHOL'SE (Three + []nits) ( Units)
R-4 APARTMENT/CODIDOMIDTIL'M ( Cnits)
CONII?EI2CIAL/RE.'TAIL/OFFICE
INIDCSTRIAL
INSTITC'TIONAL/GOVEFZZbA1ENT
NAME: rc E so?v
ADDRESS:
CIT'Y, STATE, ZIP: e_- S-C? 7 3
PxoNE: L113
3) • i:?•
NAME:
P.DDRFSS:
CITY, STATE, ZIP:
PHONE:
MASTER LICENSE #(yY3/?? /ll ?;
For City L'se
Pliumbers Licens
Acti
C= ed
t Recor
Staff Initial
4) ?? • , i?• /
tME: /Y*? E S
AonREss: xl-?vE
crrr, STATE, ziP: lyi,y.r ;S"St/30"
PHONE:
n r? a ?: ? • a? ??
5)
;a CONNECTION TO CITY SEWER ja CONNECTION 'PU CITY WATER
Q O'I'HIIt (Please Describe)
6) u • i
? PLEASE HOLD APPROVID PERMIT FOR PICK-CP BY ONE OF ABOVE
tS PLEASE MAIL APPROVID PERMZT TO 1, 3, 4, ABOVE
M c ne
7)
?-? T
F O R C I T Y U S E O N L Y
PE7MIT ° ISSUED
E:::::=
. ? ?
FEZS: $ /fj. !?-U
$ /G- $-U
$ ?3
$
S
$ $ _ .oU
$
s
S
C
y
S
$
$
SEit--",°. °ER_`q? 7'T' . ,7,?c• rc
(2_]Cr,..?? SU.o...__mRGE)
WATE-R PEi2P1IT (ZNCL'JDE SuRC:iAc"tGE)
WATER METER/COPPERHORN/OUTSID: REnDER
WAT°R TAP (INCLUDE CORPORATIO:V STOP)
5E'.•iEF TAP
ACi_OLiNT DrP(1SIT - S'lATER
wac
SP.C
TRJV'X tOATER ASSLSS:IEi:T
TRu:7i{ c?;•;ER ASSESSvIENT
LATE:yyL BENEFIT/TRUNiC Sv:':=4
LATERAL BEVEFIT/TRU:IR ;v:A'?'BR
?dATER TREATTIENT PLANT SURCHARGE
OTHER:
$ TOTaL
$- ? GU A+'IOG'\T PAID; RECEI?T n S;7
DOES UTZLITY CONNECTZON REQUIRE EXCAVaTION IN PUBLIC RIGiiT OF WAY?
7-7 YES IF YES, THE:I A"PERh1ZT FOR 'AORK WITHIN
PUBLIC ROeIDGQAY" MUST BE ISSUED BY THE
0 NO ENGZNEERING DZVZSION, LIST AS A CONDI-
TION.
SUB.7ECT TO THE FOI.LOWING CONDZTIONS:
APPROVED BY;
TI:LE:
DAT°:
s ? ? •• s ? ? i c• o ta?• • i? r• ?• •?• ?
??• • •s• •?? • • •• ? •• ?? • ? ?? ? ? • ?
CITY OF EAGAN
APPLICATION EbR PERMIT SEWII2 ADID/OR WATF12 CONNECTION
1) PROPII2TSt ADDRFSS:
or
IF EXISTING STRCCTLRE, DATE OF ORIGINAL B[)ILDING PERMZT ISSL'ANC'.E:
(Month Year)
PRESENP ZONING/PROPOSID USE:
R-1 SINGLE FAMILY
R-2 DCPLEX (Ztao L'nits)
R-3 TOWN[IOCSE (Three + Dnits)
R-4 APARTMENT/CODIDOMINICM
COMMEE2CIAL/RETAIL/OFFICE
INIDL'STRIAL
INS7I1i'TIONAL/GOVEFtta'IENT
( Lnits)
( Units)
2) W.T'7!_JAT9Mr0a NAME: Aj
ADDxESS:
CITY. STATE, ZIP: N S,SQ _2_3
PHONE:
3) • r ?•
LVAME:
ADDRESS: ?2 c -?-
CITY, STATE, ZIP:
PHONE:
MASTEF2 LICENSE
For City Cse
Plumbers LicensE
?tive
Exp ed
O Recor(
St iti
4) •a •, • '?• NAME: 6?Qd ?f?JL1 e? AddynE=?
aoDREss: /,.??t-
CITY, STATE, ZIP:
PHOrE:
s) n • ?• • a• ?.
j0 CONNECTION TO CITY SEWEE2 ,g? CONNECTION TO CITY WATII2
Q dPHER (Please Describe)
6) u • • i
? PIEASE HOLD APPROVED PERMZT FOR PICK-C'P BY ONE OF AEOVE
? PLF.ASE MAIL APPROVID PERNLiT TO 1 10 3, 4, P.BOVE
(Circle one) ?
7) ? ?? /Ss?
,
F O R C Z T Y
S E O N L Y
PER-`4IT '-` ISSUED
FEEs : $ /6, fv
$ U U
$ au
S
S
$ /?-Ua
$
??u U
$
$
? .
$
S
$
$
$
$
, . {
SE:'iLR °E4A2rT (INCL'l;DE SURC :?RGc)
waTEa PERI+1ZT (zrzcLjnL suRchaRcL)
WATER METER/COPPERHORN/OL'TSIDE READER
WATER TAP (INCLUDE CORPORATZON STOP)
SE:dEF TAP
-rCOi;_:'r =?GSI'_ -
ACCOUNT DEPOSIT - PIATER
WAC '
SP.C
TRUVK TIATER ASSE.SS:!E::T
TRG:dK SEWER 15SESS.eA1iT
L.`-.iE?,AL SE:IEFIT/TRU:1K SF.i'i.-',R
LF,TcRtIL BENEFIT/TRUNiC S4ATER
WATER TREATMENT PLANT SURCHARGE
OTHER:
TOTAL
$ PSIOU\'T PAID/RECEZPT n 77
o " S'7?,7/
DOES OTILITY CONNECTIOLV REQUIRE EXCAVATION IN PUBLIC RIGiIT OF WAY?
Q YES IF YES, THEN n"PERMIT FOR WORK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED B5C THE
O NO ENGINEERING DIVISION. LIST AS A CONDI-
TION.
SUSJECT TO THE FOI.L0WING CONDITIONS:
APPROVED BY:
TI:LE:
DATE : ?? ?? ??
• i DKIRITATA I • M• I) Mc i ? ? ? i • u r, ?. . ?.
•mi• % •o-C •?? • r ?• • ?I? 1 ?? ? ? • ;
?
CITY OF EAGAN
APPLICATZON FOR PII214IT SF.WER ADID/OR WATII2 CONNECTION
(Please Print)
1) PROPERTY ADDRFSS:
LF7GAL DFSCRIPTZON:
IF EXISTING STRL:C'ICRE, DATE OF ORIGINAL B[)ILDING PERMIT ISSL'ANCE:
(MOnth Year)
PRFSENT ZONZNG/PROPOSID L'SE:
R-1 SINGLE FAMILY
R-2 DC'PLEX ('nvo L'nits)
R-3 'IbWNHOi:?SE (Three + L'nits)
R-4 APARTMENT/CODIDOMINIL'M
CONIINERCIAL/RETAIL/OFFICE
IAIDC'STRIAL
INSTI'Ii TIONAL/GOVERN114ENT
( Units)
( Lnits)
NANIE: /Sa_>?
ADDRESS: JA d' 'x- 1 2 r?S
CITY, STATE, ZIP: ,s'G /yJy pJj?g ?? N 73
PHONE: rj/?J3- 5? 7 ?
3) i:?• For City Use
NAME° Pltunbers Lirens(
ADDRFSS: SA i97 G: ?ive
CZTY, STATE, ZIP: C=J Expi d
PHONE: MASTER LICENSE ? Recor,
S n
4) ? • ,ia? ?
rArE: (> 6d cy/ o &-Ie'E
AooREss: 9yG l3 9'3
CITY, STATE, ZIP:
PxorE; .;7SG-
5) u ? ? ?- i • a• ??
ME CO[VNECl'ION TO CITY SEWEE2 TaCONNECTION TO CITY WATEEt
Q OTHII2 (Please Describe)
6) u - • i
? PLFASE HOLD APPROVID PERMIT FOR PI?CK-[.'P BY ONE OF AEOVE
? PI,EFISE MAIL APPROVID PII2MZT 'N l,f 2 f 3, 4, ABOVE
(C1?cle one)
7) Gt:.9-X
F 0 R
PFRMIT Y ISSUED
T Y U S E O N L
FEES : $ %. S-U
$ /G• 5--o
$
5
S
$
$
$
S Gao-.o
$ $
$
$
$
S / , oU
$
$
r.-,^o nER".1TT ? •. (I_ICL::
:c.. DE SU?C :?RGc)
WATER PERP4IT (INCLUDE SiiRC.'?ARG'n)
WATER METER/COPPERHOR:V/OUTSZD-- READER
WATER TAP (INCLUDE C03?ORATZON STOP)
S::vER TA?
=CcCi;:i'^ .,_?C•Si= - :.=.:=3
ACCOliNT DF.PnSIT - 4Ir`,TER
wac
SP C
TRU:IK SJAT°R ASSESS:?r:;T '
TRli:dK SES•7ER ASSESS?.iE:i'^
LATE?.AL BEiQEFIT/TRU`IK SEi ?.=
LATERAL BENEFZT/TRU2:K ;dAT°_R
WATER TREATMENT PLANT SURCHARGE
OTHER:
TOTAL
$ ? AMOUNT PAID/qECEIPT R J
?
DOES [1TILITY CONNECTION REQUIRE EXC?.VATION ZN PUBLZC RIGHT OF WAY?
Q YES IF YES, THEN n"PERMIT FOR 'AORK WZTHZN
PUBLIC ROADWAY" MUST BE ISSU£D BY THE
7_7 NO ENGZNEERING DIV:SION. LZST AS A CONDI-
TION.
SUBJECT TO THE FOI•LOS4ING CONDITIONS:
APPROVED BY:
,
TI:LE: -
DAT°:_ `/ / T
? 7^ • •? w ? •' • ? • i • ? • ??• ? u r ?• ? ?• ?
•d•'? •a• •1? ? P •• • ?1? 1 11 ?1 • • ;
CITY OF EAGAN
APPLICATION FOR PERMIT SELdER ADID/OR WATII2 CONNECTIO[V ?
1) PROPERTY ADDRESS:
LF]GAL DESQ2IPTION:
ki.oc/tuocx/bunaivision or iax rarcerr.v. LvuRoer)
IF EXISTING STRtiCI[.'RE, DATE OF ORIGINAL BI'ILDING PERMIT ISSCANCE:
(Nbnth Year)
PRESENT 7ANING/PROPOSID i:SE:
R-1 SINGLE FAMILY
R-2 DtPLEX (Zt,,o L'nits)
R-3 'IOWNHOL'SE (Thxee + Lnits)
R-4 APARTMENT/COAIDOMINIL'M
COIMIIMERCIAL/RETAIL/OFFICE
INIDCSTRIAL
ZNSTI'ILITIONAL/GOVIItNNN1ENT
( [Jnits )
( Units )
taAMe: sw
rDnxsss: Aa 1' l '-> &?
CITY, STATE, ZIP: r /-J/v?///9 A/ 6 -73
PHONE: ?/.3 ? - 67/ 71
3) ' r?•
NAME:
ADDRESS: Sfv
CITY, STATE, ZIP:
MASTER LI(ENSE
For City Cse
Pliunbers Li se
4) • • i?•
PHONE:
t,uME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
G'cscb? ?!.'lUC- ?OY?'/c-rr?
?l/6a 9 ? ? .g ?vE
5)
,'a CONNEC.TION TO CITY SEWER OCODIIQECTION TO CITY WATER
Q OTHER (Please Describe)
6) u • i
? PLFIISE HOLD APPROVID PEE2NffT FOR PICK-L'P BY ONE OF AHOVE
? PLEFISE MAIL APPROVID PERMIT 'IO 1? 3, 4, ABOVE
* (Circle one)
FOR C I T Y U S E ON:,Y
PcR'tIT " ISSUED
F°_ZS: $ $ U. se-`
$ (o ? oU
S
S
$
$
$
S ?-ou
$
S a.?'?o
$
$
$
$
$
$
.
SE:•ic.°. PEBMrT (INCLvLL JUP.CF:?RGL)
WATER PERf1IT (IrlCi,iJDE SliRCHARGc)
WATER METER/COPPERHORN/OUTSIDv- READER
WATER TAP (INCLUDE CORPORATZON STOP)
S::dER T??
ACCOUNT DEPCISIT - WATER
WhC
SP C
TRliVK WATER ASSESS'SE;IT
TRli:7K SE;•7ER A55ES5'rl°NT
Lr.TE?.AL BEDIEFIT/TRUi]K SEi•iER
LATcRrlL BENEFIT/TRUNK WATER
WATER TREATMENT PLAi\T SURCHARGE
OTHER:
$ TOTAL
$ AhIOUNT PAID/RECEIPT $
7 -7/
DOES UTILITY CON.IECTION REQUIRE EXC.aVATION IN PUBLZC RIGHT OF WAY?
C] YES IF YES, THEN A"PERMIT FOR 'AOR?C WITfiIV
PUBLIC ROADWAY" MUST BE ISSUED BY THE
?NQ ENGINEERING DIVZSION. LIST AS A CONDI-
TION.
SliBJECT TO THE FOI,LOWING CONDITIONS_
APPROVED BY:
TITLc:
DAT°_:
/ ?????
2007 RESIDENTIAL PLUMBING PeRnntr aPPUCarIoN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please com lete for modifications to existin residential dwellin s
Date?/?l-4
.p
SiteStreetAddress4?? p" /? 1 l??Vcr u?1? Unit#
n Telephone# (?()??ID-h7qq
P
O
?,LILAr1t
t
-?l'
6QW-E
21
-
wner
roper
y
1
,
:>
?152-'I (?-1
?,+?7V I
Contractor Vlva1 L.t' Cr1J,??,1"Ctl ((AV1Um Telephone#
Address 1'301 LGlii-C lnrl uSi"Y i c`Q EJc{_ ciry F3? a s?Yl? i I l?° _ scateN Zp GJ?
The Applicant is: _ Owner 8 OccupaM Licensed Plumbing Contractor
Refurbished Submii 2 sets of plans and MPC iicense
New
Septic System Includes County fee
_
_ $ 100 00
Per asbuilt $ 10.00
Fire Repair (replace burned out fixtures, etc.) $ 90.00
This fee a plies when extensive plumbin re airs are made to a buildin .
Alterations to existing dweliing $ 50.00
Add plumbing fixtures to main level lower level. This fee includes
_
installation of a water softener andlor water heater at the same time !f you are
installing onlv a water softener and/or wafer heater, do not complete this section;
move to the next section and place a checkmark neut to the appliance(s) you are
installing.
_Septic System Abandonment
_Water Tumaround (add $136.00 if a 518" meter is required)
Other:
2?Water Softener _ Water Heater $ 15.00
_ new _ replacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ 50
6-0
$ 1 ? ?
Total
khc
I hereby apply for a Residential Plumbing Permft antl acknowieage tnac cne inrorrnauun ls wi I 11J== all.. •"?1 -
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 pertnit, work is not to startwithout a permit and work will be in
accordance with the approved plan in the event a plan is required to be reviewed and approved.
.Nl ? I i 55?R- 1L t)fit 1/
ApplicanYs Printed Name ApplicanYs Signature
City of ?apn
I Slaff ' , ??
L ------ 4LU---------
- W----??--
? Permit#:
I Permit Fee: ?
I
? Date Recelved:
I c r
2008 RESlDENT1AL PLUMBING PERMIT APPLICA
Date: i7 • b•? Site Address:
Tenant:
Suite #:
AUG 1 1 Z008 ?
RESIDENT! OWNER Name:,/U1 WY ?t1Nr P ?)W?r? `/ ? Phone: ???
1 Zip:
Address / Cit
y
? ' ?
i
#
CONTRACTOR cense
:
Name: L
Champion
Address:
3670 Dodd Rd. #100
City: State: Zip:
K- d
Phone: Contact Person:
TYPE OF WORK _ New )CReplacement _ Repafr _ Rebuild _ Modify Space _ Work in R.O.W.
Description of work: w
PERMIT TYPE RESIDENTfAL
?ater Heater _ Water Softener
T'
Lawn Irrigation _ Add Plumbing FiMures
RPZ PVB) ? Main _ Lower Level)
Septic System _ Water Turnaround
New
A6andonment
RESIDENT/AL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharga)
$30.50 Lawn Irrigation (includes $.50 State Surcharge) `
'
$50.50 Add Plumbing Fixlures, Septic System Abandonment, Water Turnaround' (includes $.50 State Surcharge)
'Water Tumaround (adtl $136.00 if a 5/6" meter is required)
i
$100.50 Septic System NIew ($10.00 per as built) (includes County fee and $.50 Sfate Surcharge)
$90.50 Fire Repair (replace burned out appliances, duclwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
I hereby acknowledge that this Inforcnation is complete and accurate; that the work will be in conformance wkh the ordinances and codes of the City of
Eagan; that I undersland this is not a permit, but only an applicafion for a permit, and work is no[ to start without a permit: ihat the work will be In
acwrdance with lhe approved plan in lhe case of wwk which requires a review and approval of plans.
x ?tI A U II (A , 0 x ? Applican Printed Name Appllcan£s Sign FOR OFF.IGE U$E. ,;
33328 ?
Pf ¦?OM` NGINEE(?ING C PLAHNEBS °nd6lAHD SiURVEYOIIS
COMPANYr INC.
? 1000 EAST 1461A STHEET, BUANSYILLE, AIINNESOTA 55337 PH 432-3000
?dCCt 12e.lcr4pZ=pn; L-OTS 5,6,7 ANp 8, BLUCK 3, EDEN ADDITioNJ
? • DAKOTA COUNTY, MINNESOTA
??%9•s ? DENOTES EXISTIN6 SLEVATIU/J
NORTH
5GAL6: P'= 30'
(920.0 ) pFIJOTES PROPOSED ELEVLIT/Uit/
- ll./DICATES DIRECTION - Of' SURFACE DRAINAGE
920•00°` FINl5NE0 6AR46E FLOO/Z EL6VAT/pN
(9i9.o) . Ai B9° 58' oz" E
i4p; (9i7.a) /33.27
tn,Vl 52.00 81.27
- i3 -•--
DRAIA/Ae*E ANO
ur,Li-rr ,5q56MENT 5I LOT 5?? J LOT 8
0
? m o
,
• ;9?e i_? (s?9.al : z??s.e1,-.: -..
rJ
?- -
:-
?J
1- -
?
I '
?j
30' PRaNT 5UILD)N6
SfT9ACK L/NE
CO
N
_ 2 ?11
(9/b.,s,? - 52.00 ^
T6
I _°• I ?
0
m
I
I
LANE ?
5.9490 ?92A6?1
(92a. 3- )
15 •
1
ill 1-. .
,-,
,_.
Vr
?
A
O
0
?-.
I`
`. ?
?J
9, >)
I hersby certify that this ie a trve and aorrect rapresentation of a tractot
land at thown'and descriDed hernon.• As praparad by ma on thi¦ isr day ot
/?IOUIMBER ? 19 A? . .
I ?
I ?92/7i
r
? 44. 67 ?
PRO SED
4 UtiiT
p
p ' O
?
i
Bu1L ING
L 44. 167
?
,7' ?•y,
( 9/9 0)
0 ?
? ti 89° se'oz"f
?'--Iti_53 -- _
e922.2,,
23.0
- LO T 6
? LOT,,{? 7
? f l
- ?-
l?,
N 89? 58' 02"6 I d??o°
i ?
' xinn. l?sa. xo. /?,,,.GaRs
r` AOBE ' CONSUITINO EHGINBERS
fNGINEEAING PLpNNEAS and IAND fUBYEYOflS
COMPANY, INC.
, %,1000 EAST 146N STREET, BURNSYlLLE, IAINNESOTA 55337 PH 432'3000
cer-?%l?'? cca? Surv-e y
?_Q4t I?r?tert,e2='o?y• LpTS 5,6,7 AND 8, BLOCK 3, EDEN ADDITiokJ?
DAKOTA COUNTY, MINNESOTA
C§??•K) DENOTES EXI5TIN6 ELEVATIUIJ ,
(920.0 ) DENO7E5 PROPOSEp ELEV,qT/UnJ
? INDICATES DIRECTION • OF SURFFlCE DRF}INAGE
920.00" FINISHED 6ARA6E FLOOR ELEVAT/oill
IVORTH
SCAL6 : P= 30'
DRAIAlAbE AAIO
UYlLITy 6.q56MENT
(9/6.0)
3
'--'
? h
_? o a
2 -
(Pa,
:CTj
?--
?
?-
`J
I
30' FRONT 5UILDIN6
" sETPACK LiNE
.
I
N B9° 58' 02" PPX?
(917.o) /33.277
? 81.27
Ot`? i3 _'---
LOT/?
?91e,?i??(9ro.9) Z7
? I PRO 5i
r- s2,ao -
I
G
I tN20111 44.623A
?:9L2 z? '?
11e.34-
70-34 LOT 6 52.? (9L- 33 o Rc /9o.oog3.
N 89o 58' 02"E ' I A=ie* 10
f ^ry I
H $ `v
0
'?.
`. ?
.?
m I
I
? CLOVER LANE ?
I hereby oertity•.that;this ie s true snd corract rapreeentation ot a tract ot
land as shawn'and.described herson.. As praparad by ma on this isr day ot
LOT 8
( 9??
4 UNiT
? o ? 1J 89' 56'c2"E
o -'-G6.53---
-'1
I
t .
Far Office Use
City of Ea an I Permit G? I?
R I I
Permit Fee: r
3830 Pilot Knob Road
Eagan MN 55122 i Date Receive
111 C( He-
Phone: (651) 675-5675 lYf R
Fax: (651) 675-5694 o G% sta
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: `QQ Site Address: i!" I ~),V C U'e r I~1
Tenant: Suite
RESIDENT / OWNER Name: Phone: CoS ! - G~ ~`Z - QhV
Address / City / Zip: t~4f' Lr G: 1o i --p- Lo-
Applicant is: Owner Contractor
TYPE OF WORK Description of work:
Construction Cost: ye0a Multi-Family Building: (Yes / No )
CONTRACTOR Name: LeC_ki LQ ; N t' . License ~;DC)&3Q) Q
Address: 26/ Z-,,(r,. ~Ll'-
City: L,t,6 k,e ~:/m-,n State: /hv zip:
, ~SC7 y~
Phone: 6-5/- W~ 3 3 Contact Person: _ ~ 4a fh-
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
(4 submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
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.
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
l
ans.
accordance with the approved plan in the case of work which requires a review and approva1.1
i;
x Ns A x
ApplicanTis Printed Name Appli n s Signature 1
Page 1 of 3
' o
DO NOT WRITE BELOW THIS LINE
SUB TYPES
_ Foundation _ Fireplace _ Porch (3-Season) _ 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 ~Op Occupancy - ( MCES System
Plan Review Code Edition IAI IL 2 ov1 SAC Units
(25%_ 100%Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length --r-D Fire Sprinklers
Type of Construction Width "Z- C--
REQUIRED INSPECTIONS
Footings (New Building) Sheetrock
Footings (Deck) Final / C.O. Required
Footings (Addition) _,~O 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
Meter Size: Erosion Control
Reviewed By: Building Inspector
RESIDENTIAL 3E`gS-
y
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
Ll Clc,\jer Lzai&
3 a•
Z.2,r~ oa /
> o
N
° ~ J ° ( r o s~ r1r a
80.00
IV l
1
d Imo. p ? 8
iv,
r
vk
4a n7
1
10
DIVISION
From:ALLSTAR CONSTRUCTION 19529427464 09/1712013 08:33 #582 P.026/079
Use BLUE or BLACK Ink
I
For Office Use ~p
Permit ` j
City of Calm I Permit Fee: ~s
3830 Pilot Knob Road I I
Eagan MN 55122 j Date Received:
Phone: (651) 675-5675 I ( 1
Fax: (651) 675-5694 1 Staff: I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: q 71-01 Site Address: 4 1 A4 44q CAMP Ovit Unit
I Name: ftAw ~ C
Phone:
t
Resident/
Owner.. Address I City / Zip: (014st (jliUl (l bi PROMOIUr M Maine, NON r3ca l I
Applicant is: Owner Contractor
Description of work: ]My off and t -yd) I - -
Type of Work
Construction Cost: till p
010. Do Multi-Family Building (Yes! No
I r
~I
Company: ftiaV CDY 1(IAChOn ManAA1`YffJ3i Contact: ~Joe,~t~ d
Contractor , Address: 51% MU.~YW SITCH 103 City: wbilb Plain G
°~2 - 9y2-5y
State: WA Zip: rJrJ Phone:
License _ P,~CIa315` 15 Lead Certificate N19-T- 2Ugw-o
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer $ Water Contractor: Phone:
.NOTE; Plans and supporting documents that you submit are considered to be public information. Portions of 1
the information may be classified as nonpublic if, you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www,gopherstateonecall.ora
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 co~~nnpleted within 180
days of permit issuance. ry
x (jot 1.11 l,Vl d x L,, V t- 11
Applicant's Printed Name AppliC'a is Signature
Page 1 of 3
From:ALLSTAR CONSTRUCTION 19529427464 02/10/2016 13:03 #301 P.015/022
Date:
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: / TSCa°
Permit Fee:
Date Received:
Staff:
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
,24e 4 , Site Address: 1/1/4/1' 9999 ��✓G� � Unit*:
Name: OldVA- i i et — 466'1 M7,4
Resident/
Owner
Type of Work
Contractor
Phone:
Address / City / Zip: 9997- WV, C% dtZ 1v rL- £4- S w
I Applicant is: Owner x Contractor
Description of work:
Construction Cost: 4$I010dd
A'rk- W,r% t4»y/ 5:0'eri4'- Z/cebil-ed s44 42119=
Multi -Family/ Building: (Yes/ No _)
Company: ,QllstE44. 644e. 44;g44 f ��jil/tCeContact: V'WI 1114'n sk-r7
Address: C/ 04 6 1 n14S4-telt 1 S77. sr.Q rf-t /0 3 City: Mirk ;
State: OW Zip: 56369 Phone:q0-90-7 6q Email: ./%/4 //s-/
Lieense #: &403S 0 Lead Certificate ft: A/IQ'% 070 9t/ 7 gsg
If the project is exempt from lead certification, please explain why: ujur . ;. /983
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer 8, Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
•
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One 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
1 hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorised by a building permit issued in accordance with the Minnesota State Buildin ompleted within 180
days of permit Issuance.
x EhlctV
Applicant's Printed Name
Applic nt's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA151857
Date Issued:09/17/2018
Permit Category:ePermit
Site Address: 4447 Clover Lane
Lot:7 Block: 03 Addition: Eden
PID:10-22750-03-070
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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
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 -
Thomas Tste P Ellerman
4447 Clover Lane Unit A
Eagan MN 55122
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
Applicant/Permitee: Signature Issued By: Signature
®;1e I
r i �
E AGA N
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 1 FAX: (651) 675-5694
buildinginspections(a)cityofeagan.com
--------------I
r For Office Use I
I Building Permit #: �Y,��U� �✓
I I
S&W Permit #:
I
I
I Permit Fee: I
I I
1 I
Date Received: I
I I
I I
I Date Issued:
I---------------------J
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: qhQ23Site Address:
Applicant is: ❑ Owner Contractor
Homeowner
f
Type of
Work
Building
Contractor
Sewer &
Water
Contractor
Unit #:
Name: �GC � t/� (7 V\/�,Z C� .� 11�¢.y� S / 45t s e' C' c 4 l 6 l/�
Address: q t City: �aa OL v,-,
Statel—Mip: 3512 2 Phone: Email:
Description of work: P� QQ C. t -
Construction Cost
of building: ❑ Single Family ❑ Townhome, of units Twin Home
Compan j?Q Mt'c.LC_ (�\lam Contact: �" `�'
l/l
Address/ r�1 W SSTy City:
State: Lip: 553IVT Phone6t z-J7 5 EmaiI- AmeQ C
'�� 9� fi o z �� 3% 3// `�' License #: � O Expiration Date:
Company:
Address:
Required for State
new construction
Zip: Phone:
Contact:
Email:
License #: Expiration Date:
City:
ylzl�I understand that Plumbing, Mechanical, and Fire Suppression work require separate applications.
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the
information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they
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.
av L\< —
Applicant's Printed Name A licant's Signature