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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