4464 Clover Lane
- Use BLUE or BLACK Ink
For Otte Use I
City ofd clan Permit
1
Permit Fee: 1
3830 Pilot Knob Road I
Eagan MN 55122 j Date Received:
Phone: (651) 675-5675 I
Fax: (651) 675-5694 1 staff: 1
1
L- -..------------J
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ? / .~17/y Site Address: 4,L1 &41 C'. 141 vt ~ G~
Tenant: PA AJ n1 .,u Suite M
RESIDENT i OWNER Name: Phone:
Address / City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK
Description of work: LA) I'rl A,~~P't_u
Construction Cost t? 0 Multi-Family Building: (Yes No __j
CONTRACTOR Name: c'6 64 el~n le- License _ C ~O 7C1`~
Address: _ I q rn crr City: M Cc I,- be 1.v
State: hVW_ Zip: ] Dg Phone: 6 5l 75--2- ?4933
Contact: -~Cs raN"k; Email:
~aa k e~ba_, \30 - C.'
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the fast 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 suppor ft documents that you subn* are considered to be pubilu inlbrmatlon. Portions of
the iniiormatfon nay be chimWed as non public if you provide specillc reasons that would permit the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the lose of work which requires a review and approv of pans.
XS,,;os ti X
JCAA JA%-jL- 'k - -
Appiicanrs Printed Name Ap 41cais Signature Page 1 of 2
I ~Cd U DO NOT WRITE j
RITE BELOW THIS LINE I
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*
A 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 OGO Occupancy MCES System
Plan Review Code Edition SAC Units
0 0
(25 /o_ 100 /off Zoning City Water
Census Code Stories - Booster Pump
# of Units _ Square Feet PRV
# of Buildings Length $ Fire Sprinklers
Type of Construction- Width t;D
REQUIRED INSPECTIONS
Footi New Building) Sheetrock
tines Final / C.O. Required
ings (Addition) Final t 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 Wail: _ Footings Backfill Final
Meter Size: Radon Control
Erosion Control
Reviewed By: Building Inspector
F 60'
RESIDENTIAL FE
Base Fee 73
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
ROSE qq6q
PLANNEAS andaLANDx iiRVEYCRS
ENGINEERING CONS
COMPRNY, INC.
1000 EAST I461A STREET, SURNSYILLE, MINNESOTA 55337 PH 432-3000
Ce P01Y.Af Ccxzc --g# 6,XC.7-WjCeY
GOOF
4cZl .l~e'.tcr~fel? LOTS 1,2,3, AkID .4, BLOCK 2, EDEN ADDITIOtiJ/
DAKOTA coUM-fY, MINNE5oTA
X2!•1 DEMOTES Ex15TIM6 ELEVATION
(2-1.5) DENOTES . PROPOSED' ELF-vAT/OA J
OWNW--• fNDIGATES DIRECTION OF SUPFAOE DRAINAGE
94, FI1vISNED GARAGE FLUOR EL6vATlo,v
'-A" Az
REN1° ,VE
ICI O RT H ATE I I ' 9'0 ~o~
SCALE : P= 3D'
DRAINAGE A►.JD
UTILITY EASEMENT
~d u 2~ 12 \ 30' FRC#JT aulL.Dhl1G
~9~6~ ° 3,p• 6~ SETBACK LINE
4 0
O Qio 41i ti` 141 1^~1
q~b la p o ti , z
(k/ o ~0
a
Z
q) n/
tL~ O C,
N `
/ / R
ti sa ao ys 73\ `q2, tie 'h~
of - 6V
E AGAN s8'-
RE I p w ~ ~ , ,
BY '
DATE:
9ULDIt,1G -`F-CTIONS DIVISION
I hereby certify that this is a true and correct representation of a tract of
land as shown'and described hereon.. As prepared by me on this lsday of
NoveMBER , 19 8s .
• HInn. Res. No.%lti
(TOWNHOUSE)
-• • CITY OF EAGAN N°_ 1 12 5 5
? 3830 Pilot Knrob Road, P.O. Box 21•199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receivt #
Te M med Ier 1 OF 4 PLEX Ese. Val,e $60,000 pate NOVEMBER 7 I q 85
SlteAddress 4466B CLOVER LN Erect gl Occupancy R3
2
Lot 3 Block EDEN ADDITION Remodel ?
Sec/Sub Zoninq PD
Parcel No . Repair ? Type of Conat. V
. Addltion ? No. Stories
? GOOD
Neme VALUE HOMES INC Move ? Lenyth 44
Z
1460 Demolish ?
93RD LN NE Depth 24
? Address
BLAIN intlmpr. ?
7$0-5510
E Sq,pt.
City phone
Install ?
SAME ADProrab Faes
Name
Addreas
City Phone
n
Name
?? Address
?w City Phone
I hereby ockrrowfedge that I have read this opDlicution ond store that
the in(ormation is mrrecf nd agree fo comply with oll opplicoble
Sfnta of Minnewta $tofut ond Ciry of Eaga ma es.
Siprwturc of P i ee
A Building Pe it ssued to: GOOD VALUE HOMES
oll work sFwll done in accordnnce with all oppli Sfate of M(
Buildinp Officiol
Assessment _
Water & Sew.
Police -
Fira
Enp.
Planner _
Council _
Bldg. Off. 11 / ( / $ 5
APC
Var. Date
rermit $ 313.00
Surcharge 30.00
Plan Review 156.50
SAC 525.00
waterConn. 500.00
WaterMeter 63.00
RoadUnit 280_00
TcPI. 132.00
Parks
I CoPies
Totai $1,999.50
_ on the expreu cordifion Iho+
and Ciry of Eupan Ordinancea.
( TOWNHOUSE ) CITY OF EAGAN
N_ 11256
• 3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Recelpt # T
Te !e utad Ier 1 OF 4 PLEX Ft, Value $60,000 pOfe NOVEMBER 7 19 85
SiteAddress 4466 CLOVER LN Erect EX occupancy R
Lot 4 Block 2 Sec/Sub EDEN ADDI I Remodel ? Zoninq PD
Pazcel No . Repair ? Type ot Const. V
. Add'Rion ? No.Stories
Name GOOD VALUE HOMES INC Move ?
li
D
h ? Langth 44
=
1460
93RD
LN NE emo
s Depth
24
? Address lntlmPr ? ?.Ft,
City BLAINE Phone 780-5510 Install ?
SAME '`pvr"ab Fae+
F Name
}
?? Address
? City Phone
Gp
u'?' Name
?
2? Address
City Phone
Assessmenf _
Water S $ew.
Police _
Fire
Eng.
Planner _
Council _
I hereby acknowledge tFqf 1 Mve read this opplicotion nnd stote that Bldg. Off. IZ/EI/BS
the in(ormation is correc d ogree to comply with oll applicoble APC
State of Minnewto Stat te and City of Eagon Ordinnn s.
Var. Date
Si t f P Qztzr?
Permit v -'?1•
surcne,ge 30.00
PlanReview 156.50
snc 525.00
water Conn. 500.00
WaterMeter 63.00
RoadUnit 280•00
TcPI. 132.00
Perks
Copies
pno ure o erm? ?
A euild'n Perm? s GOOD VALUE HOMES INC on tM ex? C? Q4q SO
g prca cond(tbn ?ha?
oll work sholl ne in acmrdance w?th all opp7it.ap State of nne o Starutes and Ciry ol Eapan Ordinancea.
Buildinp Officiul
(TOWNHOUSE)
CITY OF EAGAN N° 11254
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454-8100 ??7
.
/
BUILDINC PERMIT
ReceiPt ?!
/ )7'
1
Te M wed fe. 1 OF 4 PLEX Est. Volue $60,000 pOfe NOVEMBER 7 1y 85
SiMAddreaa 4464B CLOVER LN Erect K1 Occupancy R3
Lot 2 Block 2 Sec/Sue. EDEN ADDITION Remodel ? Zoniny PD
Percel No Repeir ? Typa af Const. V
. AddRion ? No. Stories
N
ame GOOD VALUE HOMES INC Move O Length 44
? 1460 93RD LN NE Demolish ? Depth Zt]
Address lntlm
c ?
BLAINE
7$0-5510 p gq,pt.
City phone Install ?
.
g
Name
S?E
AVVrovals
Faes
?
?` Address
? city _
Phone
Name _
Address
City Phone
Assessment -
Water 8 Sew.
Police _
Fire
Enp.
Plonner _
Council _
I hereby ackrwwledge thof I have read this aODlicafion and slafe fhat Bldg. Off. 11/6/85
the informotion is correct a ogree to wmply with oll applicoble AP?
SMte oi Minnesolo Statute d Ciry of Eogan rdirwnces. Va Date Copies
Permit .OO
surcharee 30.00
PlanReview 156.50
SAC 525.00
Watar Conn. 500.00
WaterMater 6?00
RoedUnit 280_00
Tr.PI. 1?2-00
Parks
r. I
Sipnoture of Permi tf - Total $1,999.50
A Building Permi s is d to: GOOD VALUE HOME NC an tM ezprest condition that
oll work sholl in otcordance with al,l o?cable Sfafe f,,Min to3o Storutes and Ciry of Eoyon Ordinoncea.
Bulldinp Of/icial
( TOWNHGUSE ) CITY OF EAGAN N°_ 1 12 5 3
3630 Pilot Knob Rosd, P.O. Box 21•199, Eagen, MN 55121
. PHONE: 4548100
BUILDING PERMIT Receipr g 15E2W
T. M wd hr 1 OF 4 PLEX FN v?i. $60, 000 n,,.e NOVEMBER 7 e 85
siteqdd.esa 4464 CLOVER LN
Lot 1 e?ock Z ?c/s?b. EDEN ADDITION
Parcel No.
W. IN,rms GOOD VALUE HOMES INC
? Address 1460 93RD LN NE
City BLAINE pha.e 780-5510
ig
uS?
r
Name SAME
Address
Name _
Address
City Phone
Erect E Occupancy R3
Remodel ? Zoning PD
liepair ? Type of Const. V
Addition ? No. Stories
Move ? Lengen 44
Demolish ? Depth 24
Int ImPC ? Sq. Ft.
Instali ?
Avorove6 Fees
Assezsment _
Water 8 Sew.
Police _
Fire
Enp.
Planrror -
CAUncii
1 hereby ncknowledya ihct 1 ove read fhis apDlication ond stote thaf Bidg. Off. 11/6/8S
fhe inlormotion is CorreCf ogree to comply with all applicoble AP?
$tafo of Minnesoto $fntut and City of Eagon Ordinan
Var. Date
Sipnoture of Pemi e
h Building Pertri Is ued to: GOOD VAL(lE I30MES I?N
all work sholl one in accordance wifh a(l-applicoqfb State of MI neaoto tafutes
Phone
Permit $ 313.00
surcnarge 30.00
PlanHeview 156.50
SAC 525.00
Water Conn ?2.00-00
WaterMeter 63.00
RoadUnit 280.00
TcPI. 132.00
PaNCa
Copies
totat 1, 999. SO
_ on the expren cordition Ihat
ond City of Eaqan Ordirances.
Buildirg Offlciol
?
Lot
Parcel No.
CITY OF EAGAN
3830 Pilot Knob Rosd, P.O. Box 21-199, Eagsn, MN 55121
PH ON E : 454•8100
W Name
; Address
b City Phone
? Name. --
OV
U? Additss
F- Citv . Dhnna .
1 hereby ocknowledye that I hove read this aF
the inlormotion is correct ond ogree to corr
State of Minnewto Stctutes ond City of Ea
f. Sipnoturo of Permitfee
A Building Permit Is iuued to:
oll work sholl be done in accordante with oll
Building Officiol
and stote thot
oll applicoble
Srme of
Repeir ?
Addition ?
Move ?
Demolish ?
Int Impr. ?
r.'-1 11253
Occupancy
Zoning Type of Const.
No. Stories
Length
Depth
Sq. Ft.
^ssessment Permlt ?
Woter 8 Sew. Surcharge
Police Plan Review
Fin SAC
Eng. waee. conrL
Planner Water Meter "
Council Road Unft
Bldg. Off. Tc PI.
APC i
Pe?ks
Var. Date
Cppies
Total
on ths express conditlon thos
sota Statutes ond Ciry oi Eoqon Ordinor?ces.
QUILDING PERMIT Receipt #t
Pamit No. Pamit Hdder DaU Telephone ik
Plumbinp
H.VA.C. 9 , f
El?ctric ? ( ` /?f
Softowr
Irqpsetion Dsb Insp. Othor
Footings I
Footinps II
Foundatlon
Framiog ? )
Roofing
Rouph Plbg. .?
Rough Htp.
Insul.
Finpiacs
Flnal Hty. $-/,Z_?L
Final Plbg.
Final
GrVOcc.
Water ??ibe Location:
Wsll
Sewer
Pr. DIsP.
( TO'?L??;ryti;_
CITY OF EAGAN ' ; ; 254
3830 Pilot Knob Road, P.O. Box 27-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt #
Ts 6o rwa fer -. ??-Lr?:?: F?? V?I. $?G,. i)'i'S n...e :d['!VI?I'11Bf:R io ;. -
Site Address ?r • i; : i s t'. s; R LN
Lot Block ? Sec/Sub. ADD I`I':l: ()N
Parcel No,
W Name :=000 VAI,UE HOMES lE+lC
z Address 1. 4 1;fj 93 RD r N NE '
City Phone
=o Name
s? Address
City Phone
City
Phone
that I hove read rhis
rrect and oyree to c
and state that
oll applicoble
A : ?
N Bu114ing Permit Is issued to:
oll work shoil be done in cccordance with
EreCt kJ Occupancy
Remqdel ? 2oning
Repair ? Type of Const.
Addition ? No.Stories
Move ? Length r. ,
Demolish ? Depth •,. Q
Int Impr. ? Sq. Ft
Assessment Permit -' • L) U I
Water a Sew. Surcharge ? n. OC' +
Palice Plan Review -1. 56. 5 0'
Fire s,ac 5 25 - G0
Eny.
?I
Water Conn. `` Q.0... 00
Plonner i
Watar Meter 63.00
Councii Road Unit 24U_ a d
Bldg. Off. $ 5 Tr. PI. = 3 2 _ 00
APC Parks
Var. Date Copies
Total 4 4. 5 0
on the express wridiNon Ihot
esoto. Stotutes ond City o# Ecqon Ordir+orrces.
Pwmit No. Parmit Holder Drta Telephons iR
Plumbino C(..) )61
HMA.C.
Ekct?is
Soitonar
Iropsction Date Insp. Other
Footlngs I (,J 6
Footinys II
Fou ndation
Framing ze i B
Rooting
Rough Plbg. :-
/,;. -
Rough Htg.
Insul.
Flreplaee
Final Htg. ?o-? ,?•
Final Plbg. 42
Final
C,lrtlOcc. '?; ` _ '
Weter Deseriba Lotstion:
Well
Sewer
Pr. Disp.
( TawNHOtIsE )
sU1LDING 'ERMIT
"', . 11255
Receipt #
Site Address `? 4 f- .. ' ^
Lot ?- Black 2 Sec/5ub.
Parcel No.
.
W Name v'
; Address ' •
? City Phone Erect
Remodel
Repair
AddRion
Move
Demolish
Int Impr.
Install LJ
?
?
?
?
?
?
? Occupancy
Zoning P
Type of Const.
No. Stories
Length y
Depth
Sq. Ft. ?
?
Name
? - Aporo vsls F•"
i
? A??
Assessment
Permit t
? City Phone Woter 6 Sew. Surcharge S G_ i! ?? '
Police Plan Review 156.50
F-W Name Fin SAC ?25.(?0 ?
?? Addresa Eny. Water Conn. ?Qi oc'
t?Z.+ City Phone Plonner Water Meter t? 3•{: El '
Council Road Unit L?? 0. ?(3 {
I hereby acknowledge thot I hovs rood this opplicution and state thot Bldg. Off. Tc PI. ? 2.3 ('
fhe information is Correct and ogree to comply with all opplicable APC
k
Stote of Minnesoto Stotutes and City of Eogon Ordinonces. Par
s
. Var. Date C???
Sipnoturo of Pem+ittea .
Total
/1 Building Permit Is Issued to: on the exp?ess condition Ihat i
oll work sholl be done in ocoordance with oll opplicable State of Min nesofa Stotu tes nnd City of Eopan prdinonces.
Buffdinp Offidol
CITY OF EAGAN
3830 Pifot Knob Road, P.O. Box 21-199, Eegan, MN 55121
PHON E: 454-8100
- Pamit No. Pwmit Holder Dsa TN?phoea #
Plumbiny
H.VA.C. 65b j 4-._/
Electric s (D I g `? v/? r?J ? ?
Softsner
Inspection Data Insp. • Othar
Foo!'nys 1 1 ? 1 c? L.j6
Footinga 11
Foundatlon
Fnminq
Roofinp
Rough Plbg. AdnZE Cw0
Rough Htg.
Inwl
0
Flreplace
Finai Htg.
Flnel Plby.
Final
Csrt/Occ. -7.
wetter Oese?ibe Loeation:
WNI
8ewer
Pr. bisp.
I ? . . . . r . . ?
BUILDtNG PERMIT
SiUe Addrf
Lot `
z, ? Name _
V? Address
?- Citv -
Name
CtTY OF EAGAN
3830 Pilat Knab Road, R.O. Box 21-199, Eagan, MN 55121
PH ON E : 454-8100
Phone
I hcve reod this
and ogree to t
es and Ciry of '
Sipnature of Permittee
A Building Pernit {s issued to:
oll work shall be done in accordante with oll
Buildfnp Official
ond state that
all applicoble
A.•;
, Occupancy
Zorring r .
Type of Const.
No. Stories ?
Length
Depih
Sq. Ft.
F?es
Assessment Permit 1.: • u i3
Water 3 Sew. Surcharge ''• t' fl i
Police Plan Review
Fire 5AC
Enp. Water Conn. } v .
Pionner Water Meter ; 4}
Courui) Road Unit
Bldg. Off. "?• Tc PL
APC parks ?
F'' 11256
Receipt #
?
Copies
Total
on Ths exprtss candition Ihat
ond Ci1y o# Eoflon Ordinonces.
PerCel No. nepair u
Addition ?
, Move ?
? Name . . ? Demolish ?
? - . . .,
Z r Address Int Impr. ?
4
Soitener
` Inspection Date I lnsp. n Other I
Finsl Htg.
Well
Pr.
MECHANICAL PERMIT RECEIPT # -7 L dI L
CITIf aF EACAN ? `? / 8 ,7
3830 PILOT KN08 ROAD, EAGAN, MN 55122 DATE: ?
I Site Address V-V - BLDG. TYPE WORK DESCRIPTION
? Lot ock Sec/Sub Res. ? New
'?
Mult Add-on -A%ld?"'A•
? Name 7- LVA6C Comm. Repair
Address
j c City X-2-2 ' ah?
? - FEES
Name
RES. HVAC 0-100 M BTU ?
-$24.00
3 Address ADDITIONAL 50 M BTU - 6.00
p City Phone {RES. HVAC INCLUdES A/C ON NEW
? CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMII) - 1.50 EA.
TYPE OF WORK COMM/IND FEE - 19'o OF CONTRACT FEE
Forced Air M BTU APT BIDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Heater M BTU REMODELS - 12.00
Air Cond. - M BTU MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # BEYOND $1,000)
Other
FEE
S/C: SfGNATURE dF PEfi ITTEE
TOTAL• ?
FOR: CITY OF EAGAN
CITY OF EAGAN Remarks
Addtion Eden Addition Lot 1 Blk 2 Parcel #10 22750 010 02
-
owner screet 4464 Clover Lane State Eagan NM 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. ' Ll 19$2 504.70 100.94 5
STREET RESTOR.
GRADIMG _ (nqO 1982 2.99 A6.60 --_l
SAN SEW TRUNK ? QJ 93 4.20 15
i IF SEWER LATERAL - (OX 1982 896. 46 O.29
15
WATERMAIN
• WATER LATERAL 1982
WATER AREA - ? 1977 4.20 15
*Services 1982
STORM SEW TRK - 3 1982 OO 1.20 ?-
* STORM SEW LAT 19 2
CURB & GUTTER
SIDEWALK
STREET LIGHT
Unit 280.00 57374 11/S 85
WATER CONN. 500.00
BUILDING PER. 53-11256
SAC •
PARK
CITY OF EAGAN Remarks
Addition Lden Addition Lot 2 sik 2 Parcel #10 22750 020 02
p,,,,ner street 4464B Clover Lane State Eagan hIN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. ? ].9$2 504.70 100.94 Jr
STREET RESTOR.
GRADING (tqo 82 4 ?o
SAN SEW TRUNK y/ 1974 62.93 4.20 15 -?
f SEWER LATERAL 7
1896.46
479.29
5
WATERMAIN
* WATER LATERAL 1982
WATERAREA 1977 62•93 4.20 ZS oZ/, D
?
STORM SEW TRK 1982 26.4o 1.20
+1F STORM SEW LAT 1982
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road Unit $280.00 57374 11/8/85
WATER CONN. 500.00
BUILDING PER. 11253-
SAC 0
PARK
CITY OF EAGAN Remarks
Addition Eden Addition Lot 4 sik 2 Parcel #10 22750 040 02
Owner I.': ' street 4466 Clover Lane State Eagan NW 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. Q 1982 504.70 100.94 5
STREET RESTOR.
GRADING C(p 232.99 46.6o
SAN SEW TRUNK 1974 93 20 15
* SEWER LATERAL
WATERMAI N
i WATER LATERAL 1982
WATER AREA
• Services 1982
STORM S
EW TRK fl
Q 6.00
1..20
* STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
?2fJc"1C? LTIllt 280.
WATER CONN. .
BUILDING PER. -53-II25b
SAC
PARK
. .,r cAGAN Remarks
Adlition' 'F.den Addi ti on Lot ? Rik 2 Parcel_ #10 22750 030 02
Owner I", I ' Streec 4466B_'CloVer Lalle State Eagan MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. "o 19$2 504.70 100.94 5
STREET RESTOR.
GRADING qt) 1982 232.99 46.6O ! :- /.
SAN SEW TRUNK !l 7 3
* SEWER LATERAL , 82 1896.46 379.29 5
'
WATERMAIN
* WATER LATERAL 1982
WATER AREA
*
STORM SEW TRK 1982 2 6. OO 1.20
i STORM SEW LAT 1982
CURB & GUTTER
51DEWALK
STREET LIGHT
Road Unit $280.00 57374 11 8 85
WATER CONN, 500.00
BUILDING PEFi, 56
sAC 525.00
PARK
Roaipt MECHANICAI PERMIT
CITY OF EAGAN Parmit No. ?
FN
;. i flIl in numberod spscQS S/C
' Type or Prinr legfb/y Tot .
1. Date 2. Installation Cost
. .
3. Job Address Lot Bi k. Tract
4. Owner
5. Contractor Phone
8. AddrKs
7. City State Zip
8. Building Type: Residential ? Commercial ? Institutional ?
9. Work Description: New 0 Add Cl Alter O Repair 11
10. Describe Fuel Type
G 11.
No, Equinment STU - M. Ea.
Foroed Air No. Equipment CFM
Ai
H
dli
Mfg. ng:
r
an
Boilers
Mfg, Mech. Exhaust
Unit Heater
Mfg, Other
Air Cond.
Mfg,
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Pinal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Receipt PLUMBING PERMIT Permit Na.
CITY OF EAGAN
Fee
; r . FiN in numbered spaces S/C
Type or Prini legibly
Tot. ?
1. Date ' 2. Installation Cost
3. Job Address Lot Blk. Tract '
4. Owner 5. Contractor " Phane ,
6. Address
7. City State , Zip
8. Building Type: Residential ? Commercial ? Institutional ?
9. Work Description: New El Add ? Alter O Repair 0
10. Describe
11.
No.
- Fixtures
Water Closet No.
- Fixtures I
I
Cesspool/Drainfield
Bath tubs Septic Tank I?
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed: _ , for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Receipt
?
PLUMBING PERMIT
CITY OF EAGAN
FiII in numbered spaces
Type or Print legib/y
Permit No.
Fee
S/C
Tot.
1. Date 't' ;" 2. Installation Cost
3. Job Address Lot Blk. Tract
4. Owner
..
5. Contractor ? ?Phone ?
6. Address "
7. City State Zip `
$_ Building Type: Residential 0
9. Work Description: New ?
10. Describe
11.
Commercial O Institutional ?
Add ? Alter ? Repair O
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory 5oftner
5hower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
? Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Receipt
?
4
PLUMBING PERMIT
CITY OF EAGAN
Fi!l in numbered spaces
Type or Print legibly
Permit No.
Fee
S/C
Tot
1. Date 2. Installation Cost
r
3. Job Address ?-. ,=./_ Lot Blk. _ Tract
4. Owner
5. Contractor Phone
6. Address '
7. City State _ Zip,
8. Building Type: Residential ? Commercial ? Institutional O
9. Work Description: New ? Add ? Alter ? Repair O
10. Describe
11.
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : I for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454$100
Receipt PLUMBING PERMiT Permit No.
C17Y OF EAGAN .
Fee
• Fill rn numbered spaces S/C
Type or Prin[ legibly Tat. •
1. Date 2. Installation Cost
3. Job Address - Lot Bik. Tract
4. Owner
5. Contractor Phone
6. Address
7. City
State
8. Building Type: Residential ? Commercial ? Institutional O
9. Work Description: New 0 Add ? Alter ? Repair ?
10. Describe
11.
No. Fixtures
Water Closet No. Fixtures
Cesspool/Qrainfield
Bath tubs $eptic Tank
Lavatory Softner
Shower We I I
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outleis
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of Work.
Signed : for
Rough Final
InspeCtions: Date Insp. _ Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-$100
SEDGWICK HEATING & AIR CONDITIONING CO. HF-ATING JoB No. 5 7 a3 ?
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000 TEST RECORD
ADDRESS y 66 +3 C t fl?` l(A
OCCUPANT ? ? ? box6 ?
SOLD BY I -t' N ?
cirr '?jj0
OWNER ??J l ? ? ? " "` ?
INSTALLED BY
MAKE
SERIALNO.
?
THERMOSTAT
VALVE '
UMIT e-
i iuIT ecTruar_ / llJ ?
FAN SETTING I vw`L- '
PILOT TYPE ?
IGNITION MODEL ? C?'? r U ?
PILOT TIMING
PRESSURE PERCENT COZ
O
STACK TEMP. ?U PERCENT
MODEL GrYotM r" v 0
INPUT ?
VENT SIZE J
TYPE OF LINER
LINER SIZE
FILTERS: SIZE
WIRING S? k'f uZ"
TEST TAG
LIGHTING INST. -r
DATE
COMPANY TESTING
NAME OF TESTER
FORM 235 (REV. 17189) FORM DISTRIBVTION: WHITE CdP4`;1OWrILE YELJOW CdPY - CITY
SEDGWICK HEATING & AIR CONDITIONING CO. HEATING JOB NO. <-)?
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000 TEST RECORD
ADDRESS LNv?? ?( /L-
OCCUPANT ? h l ( h A 'µ,'L'
SOLD BY N N)-st 1`-'
CIn CA g a 0
OWNER ?S ?f I ` ? ? ?
INSTALLED BY
uo-o
SERIAL NO. r ?l 7*
THERMOSTAT
VALVE ?
UMIT - ? y e
UMIT SETTING / v O
FAN SETTING i
PILOT TYPE
IGNITION MODEL `J C C - ` (
PILOT TIMING ?
PRESSURE PERCENT CO2 U
INPUT CFH PERCENT OZ
STACK TEMP. PERCENT CO
FORM 235 iREV 11,891
MODEL 2 ,
INPUT
VENT SIZE
TYPE OF LINER v`
LINER SIZE
FILTERS: SIZE ` NUMBER
WIRING ? -i ` -'- ? 1"JZ-.!`
TEST TAG ?LIGHTING INST.
DATE TESTED
COMPANY TESTINO
?..
NAME OF TESTER
FORM DiSTRIBUTION: WHITE C - 1
? INSPECTION RECORD CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number. F; ?Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 I
I f J I?', H ?j ?t i1 i J
SITE ADDRESS:f APPLICANT: ?
?
,,,, . t + 10:11 st I AN1 ?a.? : 14
t I: fi k'N ( r, 1 'i3t.t. (iif
PERMIT SUBTYPE:
TYPE OF WORK:
ri I I,.l
t1i) I i hiil•,
F
L_
? lmni
Psrmit No. Permk Hotder Data Telephone ?
ELECTRIC
PIUMBtNG
HVAC
Inspecdon Dats Inap. Commems
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
HOUGH
HEATINQ
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FlNAL PLBG
FlNAL HTG
ORSAT
TEST
BlD(i FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
.J
DECK FINAL rI bs'
7
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
' ' i1 1'?f 11 (A Nt - {, ifW
PERMIT SUBTYPE:
TYPE OF WORK:
M A P h':: PtAtd RE V1tiJf f? HY HTi 1 Ai)AM^.
F
L
?
?
Pertnit Holder Date Telephone N
PLUMBING
HVAC
Inspection Date 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
aRSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATtON
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
[ ??
«C7
DECK FINAL
9?iom.as o4?a?ag4E?[ 7• a ? d Z
4466B etovEZ 1'anz
?ayan, cJ1?dV 55122
n?,\c /u?y ?e..(?(,?._ C? _ Q Q.f/?•-?- ? , r
A .
?.?..H?,?, , J?.r ,./,,,6?;(? E'? ??•?e ?. -
f ° 6?? ??? ?
r---_04w- AW M4
4t, Aaq
?qf
ew-7 .?
P&Ae?.
,r?t?lf? ?:e, " •
.
?????p ?
? (/dy ur ?st P u1 U-`°`? °r
/?e? a?P --?J a-t? Ca "
V ozc CdY?( GaP.C?, ?r- ??Z? ,
? ? gxr
?41Q
x( 4 .?.`"e
v
?.
I ??
??
? ? &?";)f
.9 C?.,.c`` a.?.?.y °Q,c,;,c ? ?? , ??•c4 v?... 2
a l?tcc.?.lao a ? ';,7 ,a?o c9 ?t'??
C o
?
?
? f
?? ? ??
?
CITY OF EAGAN WATER SERVICE PERl1AR
3830 Pilot Knob Road f="'
P. Q. Box 21199 PERMIT NO.: _
Eapaee; MN 5512,1 DATE:
R
Zoninp: _ No. of Units: ^P ex
,oa a_ sc lc.acs
Owrnr.
Addnm
Sit? /1dd?esr. 4466t . over Lait??
'Vickelsa:t Plt•:,,•': " '??
Plwriber. 5:)0. OOpd
MNftr No.: . &
? ? ?JO pd
51?.: ,/R 15. 10. 0 U pc?
/O
I
R it
ocdor No.: ( e?*^ 'i
? .Opd j
1 .ow' t°'°mpy' "W' el" Z„ R. ? ?..3 ? . ? S 1
Orri?onen. ?? ^v` ` MIsC. Gho ryn:
er
Total:
By Dote Paid:
Doh of Insp.: Ir?sp.:
ER SERVICE PERMIT
CITY OF EAGAN SEW
3830 Pilot Knob Road p??T NO.:
P. O. Box 11199
Eagan, MN 55121 D'`TE:
Zoning: No. of Unlts:
-
Gwnsr.
Nddress:
'Site Addron:
44umber:
I ym 10 OM11* 1ab the Cw1 of `os•
ormNmCM.
ey
Dote of Insp.:
GOflr10Cf10/1 Ch01ge:
Account DepOsif:
PaIR-Jt Fe!:
Surd+arps:
Misc. Chorpm
Total:
Dote Pold: -
WATER SERVICE PERMIT
PERMIT NO.:
D/1TE: . .? -15 •- 8 `_
No. of Units: `
51b /1dd?ess:
Plun6er. • ' , , ?
Metsr No.:
Siu: b? d ? l5 ?l(l?
ReOdOr NO.: t Fee: ' n ??tlnc?
1 p r M t o o e w 0 h v r Mb t? SurcF?o r p s:
OrilMwa?. ? Misc. Charpes: . ' _ ' . OJn?,T• --
• Total:
pcta Poid:
3$30 Pilot Knob Hoad
: "'.
PERMIT NO
P. O. Box 21199 .
Esgan, MN 55121 DATE: , _
Zoninp: No. of Units: ?
OwrNr.
/lddress: . ? .-
Site Addross:
Plumber.
1 eewMb wM !Iw Cft d yM¦
.?w. te Conrnction C]wrps: .?(j
OfNMSOM 15 .
Account apum: r
. PeR11iY F!!:
Surcharpe:
By Misc. C]'rarOts:
f I
:
t
D Total:
nsp.
e o
a
Intp.: Dah Poid:
ITY OF EAGAN WATER SERVICE PERMff
0 Pilo'r Knc•b Road
?. O. B0x 21199 PERMIT NO.:
Esgan, MN 55121 DATE:
anirg: . '13 No. of Units: `?-Fl eY
r. Good Galuc iiame:,
raw
Mdrea? 4464R Clnver
urnbar: '`'•fCkelsnn
No..
De
?v
p??.??? 1?? :?:-fpd
dar No.: /Oh7 1'O .? 7 V-9"214;A A p
,ym M Mo/1y W" !w tQ?, crgs;
Mtsc. Chorpes: ''t;
LiC.Crw"?" Tatak 63 ??'•ad ?n??<
Dcft Pald:
of . I?tsp.:
Pilot Knob Road
Bux 2"!99
n, MN 55121
SEWER SEtVICE PERMR
1 prN te eeoPl1? Wuh IIN CMT of Be!a•
Od1M.eM.
By
Dote of Imp.:
Connettian C?wr'Os:
AceDLmt pepodt: _
Pe"nit Fee:
Surchorpe:
Misc. Choroes: -
Totol:
Da" Paid:
CITY OF EAGAN
3830 Pilot knob Rosd
P. O. Box 21199 i
Eagan, MN 55121
Zaninp: _ .73
Owrwr, l'aod Value Hom,
llddrm:
Site Addrom +464 Clover Lai
plu,,,er '. ickelszn ?lum'
AAeter No.: . ?? 7
Stze: 5m
WATER SERVICE PERMIT
PERMIT NO.:
DATE:
_ No. of Units:
.
1
0
q?M h Oo?yyr 1uil? ty lG,oro.s: 132.00pd TP
• ?Q? Total: 63 OQ :net -?r
Dote Poid:
a of I rup.: Insp.:
3-iy- 8G
CITY OF EAGAN SEWER SERVICE PERMR
' 3830 Pilot Knob Road
: P. O. Box 21199 PERMIT NO.:
; Eagan, MN 55 i 21 DATE: '-` S•'-` ?'
' Zoninp: No. of Units:
Owrnr.
/lddmss:
Site /lddross: ' r,4 L:iov::r LIU1Q I,:,. :;? `F?'c:_n
?.Plumber. rI.
i.: .. - • F.?!+,(???F.,1
' I Mm to wly wMfi 1V Ghr 4 tp.¦ Connsctton Clwnps: 2 5-00"? '
QrdtMnam Accownt Depo:ih I " . M
By
? Dote of I nsp.:
Petmit Fw:
Surchorps:
Mix. CFwrym
Total:
Dote Poid:
This requesl voitl C) ?^ J
18 mon[hs (rom d ?
a 086189
L a A ;:)- :F,/-,
Renuest Date.
(?
' Fire No. Rouph-in Inspecbon
fleqw d?
?Featly Now ?yrvill Notdy Inspi?r-
/
a-d L/' !? ? es ?No T tor When Readv
? Licensed Eler.tncal Contrnctor I hereby request ins0ecbon ol above
? Owner elacbical work mst Ilad ab
Street AtlAress, Bua or Route No. Ca`/
?y6 v
ncLO?? o. Township Name or No. FanNe No. Cnumv
Occupnnt PRINT? Phonc n.
, J
l/
Power 5 uher AAdress -
Elr;ctn al ConUactor ICompany Namel Contrao:tor"s Licen se No.
- - .3
wner M
teilaboN
arlinB .4dJress IConVar,tor o
?
?
Q ?•
Authorized Si a re ICoMractor/Owne, Making Installalionl Phone Nwnher
&' G- G'o a
MINNESOTA SirOE BOAflD OF ELECTRICITY
Gri99s-Mitlway Bltlg. - floom N-191
1821 UmversrtV Ave., SL Peul, MN 55104
Phone 18121 297-2111
-IMIS INSPEGIIUN fiEQUE51 WILL NOT
BE ACCEPTEO 9Y THE STATE BOAPD
UNLE55 PROPER INSPECTION FEE IS
ENCLOSED.
;EQUEST FOR ELECTRICAL INSPECTION Ee-00001 -04/
See msfractwns for comple<ing lhis form on back of Yellow copy.
? 9.
,? n Q{? ? Q Q "%" " Below Wak rnvP/Ed by This Request --1 ?c151?
AAtl v
Xeo , Typn ol Bwltling
'Apolot.es Wvetl
Equupment Wved
Home Ranye Temporary Service
Duplex Water Heater Lightinq Fiztures
Apt Bmlding Dryer Electnc Heabn
Commercial Bld,y. Fumace Silo UnWader
InduStnal Bldg. Av Condinoner Bulk Milk Tank
Farm OtnPr , oea y, oino, isno<:,tvl
", ?SUru'- Otlhar Oihi;r
N Fee rServicaEnt raneeSae p Pee Faadxrs/Subleetlers N Fee Cucuits
r 0 to 200 qm)s 0 to 30 Am s 0-L0 0 to 30 Am s
Above 20D Amps 31 to tU0 Amps $ 0 31 tu 100 A s
Swintming Pool Above 100-AmUs Above 100_Amps
Tiansrormers Irrigation Boorc's Partial.'Other fee
Signs Specialinspection ?7 C 70? F?E`
Remnrks /` 1 ? I ,
RouBh-in Date
_ , I. e Electr?
Insp , ereby
ertify theI Ihe abova
Final spection has been
made.
ThIS re0uest void 18 moMhs irom
This reiruest vord ?
18 munths from
Renuest Date
`? Fre No. flouph-in Insuecbon
Fequirod1
?Reatly Nnw Will Noufv InsOec-
?ar Wh
F
d
? es ?NO ¢n
c;u
y
? Licensetl Electncal Contractor ? I hereby requast inspecfion ut above
? Owner electncal work installad at
Sveet
dress, Box or flou[e No.
AA City
?
/
"1 ?6 ?? QiI?L.2J U=-G
ecLOn o. Townsh?p Name o? Nn. Rnnge No. Cnunty
Occupant P INT) / ,
vGc-ec?-?- Phone Nn
Pow¢r $u pLer Address
Elect cal ConVnctor ICompany Name Contmcmr''s
License No(
?
?--?- 7
7
? / 7 /'
Mailinu Address ICOnVar.tur or Owner Mzkinp InstailaUOnl
Authoraed namre ICm[ractor?Owner MakinB InswllaUOnl Phone Number
a ?
MINNESOTqGq'fq7E eOAND OF ELECTRIGITY
Griggs-Midwxy Bldg. - Noom N•191
1821 University Ave., St. Paul, MN 55104
Phane (612) 297.2111
THIS INSPECTION REQUES7 WIIL NOT
BE ACCEPTEO BV THE STATE 60AND
UNLESS PPOPEF INSPECTION FEE IS
ENCLOSED.
REQUEST FOR ELECTHICAL INSPECTION ? E8-00001-04
See mstructions tor comoletin9 this lorm on beck ot vellow copv.
"X'" Below Work Cavered by 7hls Request
AAA 8BG Type Of BuiIeinp APqliances WvBtl EquipmBnt Wved
Home Ranye Temporary Service
Duplex N?ater Heater Liyhunq Fixtures
Apt Bw Idmc? Dryer Electnc Heabng_
Commerci2l Bldg. Fumace Si!u UnloaAer
Industnal BIAg. Air Condrtioner Bulk Milk Tdnl<
Farm ot nTI Sura v ??ne?lSae?.,tvl
M er ISUCr.ityi Oihcr n?h?"
......
M ,'...... .,..,
Gee r.,.,.._....... _..._..
ServiceEnhencaSae
H
Fee
fenders/5ubfaeders
b
Fne
Circuits
? tp 200 qmps
Above 200 A 0 to 3D Am ps
31 to 100 Amps
,?10 0 to 30 Am >s
31 to 100 Am s
Swinuninq Pool P.bove 100_Amps Abave 100-Artips
Tiansiormers Irriyation Fiuoms Partial Other Fee
Signs Special In:;pection S
? TOT
FF
G
Remarks - .. / - ? ?
y,
[A7M
Roogh-m ? - D?t•? / ?( I. t Elect
? 1 ?v'Qp InsVec or. hernby
certJy that the above
Final
e
?f ispacUOn has been
TOis requea[ ww ,e mo.nro i..i..
This request void 5
?8 nwnths tram [ ? -
?
0 86186 Fequest pate Fire No. RouPh-in InspPCtion
)? `(?jt,? fle4u ?etl? DReaAY No Will NotHV InsPec-
?? Q l es ?No «Ir When Foady
? llcensed Electncal ConVactor I hereb
? ?w??,? Y requast mspection QI above
elnu.iroi
Sheet Address, eox or Rou[e No. C
9
?
ecuon o. iownship Name or No. qan
y N C?
OrcuGan[IP I T) ? Phone No.
Poiyer Su ier AdAress
N
Eleztr al ConVactor (Company Name) Cnntracmr"s Lncense No
M
v
o
?
ailin9'lddress (Co
n
oc
nr Owner Makmp Instailanon)
?
Auihorved
nature (Con[ractor OwperIV?Jkinellationl Phone Numbar
-- o..o rcLeeinieiir wirvsrteilUNHEQLIESTWILLNOT
Griggs-Midway BIdB. - Aoom N•191 BE qCCEPTED BV THE STqTE BOARD
1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
_ Phone (612) 297_2111 ENCLOSED.
i' REQUEST FOR ELEC7RICAL INSPECTION ee-or?i-oa
. sa ,- _ . ?
?
D
Aa Fep,
_
?X'" Selow WoM60cve.sd by lhis Request
'Type Of Bmltling Appliancea WireC Equipment Wped
Home Range Ternpor2ry Service
Duplex Water Heater Lightin Fizwres
APi 8uilding Dryer Electnc Heatin
Commercial Bldg. Fumace Sib Unioader
Industrial didg, Air Condrtioner Bulk Milk 7ank
Farm oinF. _neclFV o.ner isvecitv)
IM1P? ?SI?fG??y O}hC'? O1h?,r
# Fee Service
Edtr,nc.Sjze Fee Feeders/SUbfeeders il Growts
N
0 to 2
A6ove 0 to 30 Am s
31 to 100 Amps to 30 Am s
to iQ0 Am
Swimm Above 700__Amps Above 100Am s
Tianst Irrigation eooms Partial'0 r Fee
Signs Special InspecLon
Aemarks TO FEE
?
Houah-in p
? I. e EI cal
Inspector, hereby
Final
? •/?/-,'{?'?
! cartify that the above
ms0ectton has been
matle.
rnus ?eq.PSt youa ? t ?G ?
,a ?,bntns rram
0 086187
y
L__
? a -a7-
V1 r?? i
Request Date Fire No, Rouah-in Inspecvon
eq red?
l NoLfv Insoec-
EReady Now?Wil
[or When Reatl
?
?as No y
y
? Livensetl Electncal Coniractur ? I hereby raquest inspaction of abov¢
? Owner alectncal work installed at'
S[reet AAdress, Box or Ro e No. /j Ciiv
ecLOn o. Township Name or No. anpe No. County
'
11L?
Occupantl INTI Phonc No.
Power Su? er ?? Address
Eloctrir I Contractor (Company Name??
i ?Qi21?t?? Contractor's Liccnse No.
?
Marlijn?p AdJress IConlr?cmr or Owner Mabng InstallaLOnl
Author¢e ignature IConvacmr/Owner Making InstallaUOn)
? Phone Nurnber
'6 G -
?6 ('D C)
MINNES STATE BOARD OF ELECTflICITV
Gnggs• idwav gJde- - floom N-191
1921 University Ave., St. Paul, MN 55104
Vhone (612) 297-2111
THIS INSPECTION ftEQUEST WILL NOT
BE ACCEPTED BV THE STATE 80AFD
UNLFSS PFOPEN INSPECTION FEE IS
ENCLOSED.
)REQUEST FOR ELECTRICAL INSPECTION
See instructlons tor completin9 this lorm on back oi yeliow copy.
8? X"' Be/ow Work Covered by Thrs Request
t EB-00001-04
AB Nep " Type af Buildin9 ApPIrBE Equipment Wved
Home Range Temporary Service
Duplex Water Heater LiyhLny Fixtures
Apt. Bwldinq Dryer Elecmc Heatin
Commercial Bidy. Fumace Silo Unloader
Industrial Bldg. Air Condinoner Bulk Milk Tdni<
Farm 0[her SPecify tnei i5nocity)
thrvr ISpcufY O?hcr Other
[,ampure inspa.cuuu ree aeiow
# .Fwn ServiceEetranceSae R Gee FaeAers/Subfeeders b Fee I Cucurts
0 to 200 AmPS { U t0 3U Am 5 v ,?1 ' in a' tvr ?s
Above 200 Amosi 31 to 100 Amps . QQ 31 to 100 Am s
Pool
? ? TOTA E
a
Houeh-m t ??[e ? I, the Nect I
? Inspector, heraby
erLty ffiat the qbove
Pinal
?" ? '°
3 ?Jbb' inspeclion hes been
made.
Tnisrepuestvoiammainnsn?un _. --- • .-..111 ?Yr,???
R-
! _.__----_________ f
j Permit #: ? &O 4
? 2 6D ?CJ
? Psrmit Fee:
? Date Received:
I I
I S£aff: I
?________________?
20p8 RESIDEMITlAL BUILDiNG PERMIT APPLICATION
nace: Sim aaa.ess: ? ?-
TenanC
Suita #:
RESIDENT / OWNER Name: Zwn? ry7 QnA4 Y%C ibiJ Phone:
Address i Ctty / Zip:
Applicant is: _ Owner ? Corrtractor
TYPE OF WORK Descripdon of work: con
Cpnstruction Cost: /S, C?I'YCJ . p O Muttf-Family 8uilding: (Yes / Na
CONTRACTOR Name: ??&,epeL9 46 eV -?on,?r?JE+n s Licensa? 'Z 0 4'/50 7 3 7
Address:
City: r._?t? State: o?fo Zip: -?
V
Phone: - 6 - 2`t r' 3?1_Z 1 Contact Person:
CONiPLETE TNIS AREA ONLY }F CONSTRUCTING A NEW BUIIDING
_ Minnesota Rulss 7670 Cateaorv 1 Minnesota Rufes 7672
Energy COd@ . Residenlial Yantiiaiion Category t Waksheet . Naw Enfty Gade Workaheet
Category stbnitted Submitted
(4 SUbrt1183IOP1 typ8) ' Errergy Enveioge GakulaflonS SubmiUed
M the last 12 moMhs, has the Gty of Eagan lsstced a permit tar a simllar plan based on a master pinn?
-Ves `No If yes, date and address ot mastar plan:
Ucensed Plumber: Phone:
Aechanical Contractor. phorte:
Sewer & Water ConVector: phorm;
'.- flle Hl1V?R/?} ?}? uG ?soY ? ?,lin
?V
?
.+
+j
'? i°'?'lflfi4 P?WVY? ?F ?vM?
P`..i3(/I1 ? ?'4# •:
y
.,t
?
y ?
S .
I nereby adcnmvledge that ihis informatwn is complete arM accurate; that the wwk wfll be In Cpnformance with the prclinences arai codes of the CRy ot
Eagan; that I urderstarM this is not a percnit, 6ut oniy an appiication {or a permit, arM w?artc 7g not to st withw a pennit; that dia walc wiil be in
?ar
axo1dance with the approved plan in the case of qrork which requmes a ranew and approval 0f,?,m9 ?
x
ULf ? nt,ji4e15
Applicant's Printed Nartro AppllcflnYS Signature
Page 1 of 3
!
?
December 12, 2003
Tom Gallagher - - - I
? 4466B Clover Isang
Eagan, MN 55122
Deaz Tom:
%oryt:
/2
1. !,4 uvL I'? -/" <<J
CtJ
`?J ?K, h C crl 0dl
/.G
?DJ??l ?t 0 / f
expl??e7?
y'au.
,03/ -z1oy
7?z Cr//
a,-.. w,Ii
I take this opportunity to respond to the concems expresseu ,u y.,... _...•... ..- ---
being conducted in your neighborhood and the streetlight charges on your utility bill. A
copy of your letter was forwarded to Mary Granley, Code Enforcement Technician, for
the City. Mary will attempt to address your concerns conceming the business operating
in your neighborhood. I understand from Mary that she has had previous contact with
you.
I recall a telephone conversation with you concerning the City's streetlights and the
billing of charges to the residents. The charges are for neighborhood lights and
community lights. I will explain the streetlight chazges and their jusrification.
V
0?
The community light charge pays for the operation of traffic signals and lights to
illuminate major intersections within the City. These lights aze installed to promote
safety and welfare of drivers and pedestrians as they move about the City. Their purpose
is to prevent accidents and subsequent injury at those intersections whether you aze
driving, a passenger or a pedestrian. I recognize that these lights do not shine directly on
your property, but assert that you do receive benefit from those lights as you either drive,
ride or walk about the City.
The neighborhood lights are installed to provide illumination of your local neighborhood
I streets. The justification for lighting is for the safety and welfare of the residents while
on the roadway. The lights aze instalied to provide illumination to alert drivers to the
existence of a pedestrian, a curve in the street, or obstacles such as parked vehicles and
also as a deterrent to crnninal activity. The current Ciry policy is to install sireetlights at
approximately 300-foot intervals. Some lights may be further apart and some may be
closer depending on the configuration of the streets within the subdivision. This
? configuration includes the number of intersections and the design of the streets. That is
whether the slseets are relatively straight or curved. The streetlights aze not installed to
provide illumination of driveways although that may happen.
Certainly the lights could be closer, which results in more lights being instailed, which
requires more electrical usage, which results in a larger streetlight charge on your utility
bill. An altemadve would be to petirion the City to install another streetlight to mark
your driveway. The petirioners would need to waive their right to appeal the amount of
the assessment for the cost of the additional streetlight. The cost of that installation
estimated at $1,200 would then be assessed to the benefiting properties.
I recognize the Bronko Nagurski name. He was a famous football player for the
University of Minnesota and then later the Chicago Bears. I want to thank you for your
service during WW-2.
Please contact me if I can be of service. My direct dial number is 651-675-5024.
Sincerely,
Genld R Wobschall
Cc: Parcel File
I
0 e,^? sc,? ?
• '/ ,
c? q 2? ? ?J c.?i{? ?oQ eAAI,f
-Z"k a,7 wu,c/
?
U/!iG(O
i
, . e ?Pe ? A-?, ?
7t? -?-? ? ?. ?. .?
? ?
? ?
-? ?-?- ?
_
G'?Qn/1 .- ? L1.yY? dYt ? ?
a
2
?
ANIRZ Mr. Thomas A. Gallagher
4466 Clover Ln
Eagan, MN 55122-2440
w ? ? ?e?
i ??
e4l?
6lac,l<,
,
?
?
?
iteee
4 " (
1-
t ?
7985 BUILDING PERMIT APpLICATION - CITY OF EAGAN
? POTE: ALL CONTRACTORS MUST BE LICENSED AITH THE CITY OF EAG9N
C0141ERCIAL
SINGLE FAlIILY D1fELLINGS
INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS
& STRUCT'URAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY
SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS
ENERGY CALCULATIONS 1OF ?
$2,000 LANDSCApE BOND ;j„
r'/2JC (00,aoo
To Be Used For: ' Valuation: Z??? Date:
Site Address lv
Lot ? Block ?-
?
Parcel/Sub
Owne K??? f?rs #j C.
Address./f(pd' LUr-
City/Zip Code 1q.J
Phone - <'°Z j e)
Contraetor - C;a??;
Addres
City/Z
Phone
Arch,/
Addres
City/2
Phone
!! - r
ONLY
Erect X Oceupancy
Remodel ? Zoning
Repair Type of Const
?
Addition
? # of Stories
Move Length
Demolish ? Depth
Int.Impr. Sq Ft
Install
APPROVALS FEES
Assessments
? Permit
Water/Sewer
? Surcharge
Palice Plan Review
Fire SAC
Engr Water Conn
Planner?"- Water Meter
Council Road Unit
Bldg Off Treatment P1
APC Parks
Variance Copies
TOTAL
O
7985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE:_ ALL CONTRACTORS Mp3T BE LICENSED F/ITH THE CITY OF EAG9N
COPQIERCI9L
SINGLE FAHILY DWELLINGS
INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS
& STRUCT'URAL PLANS, 1 SET OF 3 CERTIF'ICATES OF SURVEY
SPECIFICATIONS AND 7 SET OF 1 SET OF ENERGY CALCULATIONS
ENERGY CALCULATIONS'
$2,000 LANDSCAPE BOND ? o F
(oC??oN
To Be Used For: llz
?-?J Valuation;?
Site Address (fl&" Lj OFFICE
Lot p- Block ?---- Erect x
Parcel/Sub
Owner
Address
City/Zip Code ??,-
Phone 2LES?O C7
Contractor ??-
Address
City/Zip Code
Phone
Arch./Engr.
Address
City/Zip Code
Phone #
Remodel 1
Repair
Addition ?
Move T
Demolish
Int.Impr. ?
Install ,
APPROVAL3
Date;
Occupancy
Zoning
Type of Const
ll 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 lJnit
Bldg Offi/ 6 Treatment Pl
APC Parks
Variance Copies
TOT3L
? -
l/?) s
7 ;Z
?
1985 BUILDING PERHIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED ilZTH THE CITY OF EAG9N
COl4IERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL
& STRUCT'URAL PLANS, 1 SET OF
SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS-
$2,000 LANDSCAPE BON?
O
To Be Used For: Valuation:
S3te Address yy(0 6 a(jV%-
Lot IL Block .?
Parcel/Sub
Owner?-r? AL G?t?-?P I '?"L?'_J%--
Address A) c.
City/Zip Code ? ,.?..? TV3 -
Phone -7d-p ?,,'S7 c7
Contra
Addres
City/Z
Phone
Arch./
Addres
City/Z
Phone
SINGLE FAlIILY DHELLINGS
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
GqfA0 ?
? Date:
OFFICE USE ONLY
Erect -?X-
Remodel ,
Repair ?
Addition
Move ?
Demolish
Int.Impr. _
Install 1
APPROYALS
Occupancy
Zoning
Type of Const
I! of Stories
Length
Depth
Sq Ft
FEES
Assessments Permit
Water/Sewer Sureharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Council ftoad Unit
Bldg 0ffp1 Treatment P1
APC Parks
Varianee Copies
TOTAL
?
7985 BUILDING PERHIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS NUST BE LICENSED AITH THE CITY OF EAGAN
COt41ERCIAL SINGLE FAMILY DMIELLINGS
INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLAMS
& STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY
SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS
ENERGY CALCULATIONS
$2,000 LANDSCAPE BONO
I oE f?o0o0
To Be Used For; X-? Valuation: Z:2? Date: ?-
Site Address ?(ra6.? C/?„er 1.? OF'FICE USE ONLY
Lot - -? Block Y
Parcel/Sub 5Z?0-
Owner ?•sz?, ? ?C??° ?^¢?' -?'v c='
address 1546 v 93" `?` L.J N E
City/Zip Code??_ ILIJ
Phone
Contractor ol? ?
.r.
Addres
City/Z
Phone
Arch./
Addres
City/Z
Phone
Erect K
Remodel T
Repair ,
Addition
Move ?
Demolish
Int.Impr. '-
Znstall ?
APPROVALS
Occupancy
Zoning
Type of Const
# of Stories
Length
Depth
Sq Ft
FEES
Assessments
p Permit
Water/Sewer
? Surcharge
Police Plan Review
Fire SAC
Engr Water Conn
Planqer Water Meter
Council Road Unit
Bldg Off / S Treatment P1
APC Parks
Variance Copies
TOTAL
CITY OF EAGAN
3830 PILOT KNOB RD - 55722
41995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
? 3 registered sfte surveys ? 2 wpies of plan
? 2 copias of pWns (inGude beam 8 window sizes; poured fnd. design; etc.) ? 2 sNe surveys (exterior add'Rions 8 tledcs)
? 1 energy calculations ? 1 energy cakulations for heatad addidons
? 3 coples of lree preservation plan 'rf lot platted efter 711193 '
required: _ Yes _ No
DATE: 16 ' za?7-,5?,S CONSTRUCTION COST:
DESCRIPTION OF WORK: ?-2,:I I eV,,S 1,9 n a n iQti--Wj AN ??Lr
STREET ADDRESS: L-L ,9 tJ Pc-
LOT ? BLOCK SUBD./P.I.D. #:
PROPERTY Name:(::?,o-+\ ?clSLA1'1 Phone
OWNER IAST FIAS.
Street Address, ?y?? Cl o v er C.c?m ?
City: 5tate: N'Y\%&_ Zip:
CONTRACTOR Company: Phone #:
Street Address: License #:
City: 5tate: Zip:
ARCHITECT! Company:
ENGINEER
Name:
Phone #:
Registration #'
Street Address,
City:
Sewer 8 water licensed plumber:
change are requested once pertnit is issued.
State:
Penalty applies when address change and lot
I hereby acknowledge that I have read this application and state that the information is correct and agree to wmply wfth all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received
Tree Preservation Plan Received
_ Yes _ No
_ Yes _ No
???FEWED
J U iV 12 1995
---------------
EDEN HOMEOWIdERS ASSOCIATION
P.O. BOX 21476
EAGAN, MN 55121-0476
6/7/95
TO WHOM IT MAY CONCERN
SUSAN J. GREEN (4466 CLOVER LANE EAGAN, MINN 55122)
HAS THE EDEN HOMEOWNERS ASSOCIATION PERMISSION TO EXTEND
HER EXISTING DECK.
THSS DECK CAN BE EXPANDED IN ACCORDANCE WITH THE
EAGAN HOMEOWNERS RULES AND REGULATIONS ADOPTED SEPTEMBER
12, 1981:
"(2) DECK EXTENSIONS. THE EXTENSION OF DECK LENGTH TO
THE END OF THE BUILDTNG IS ACCEPTABLE IF THERE IS NO
STAIRWAY EXTENDING BEYOND THE END OF THE BUILDING.
EXTENSIONS THAT EXPEND THE DECK WIDTH ON THE STREET SIDE
OF THE BUILDINGS MUST RECEIVE COMMITTEE APPROVAL.
EXTENSIONS THAT EXTEND DECKS ON THE REAR OF THE BUILDINGS
TO A MAXIMUM OF (12) FEET ARE ACCEPTABLE. DECK EXTENSIONS
MUST BE PAINTED THE SAME COLOR AS THE EXISTING DECK."
PRIOR TO EXPANDING THIS DECK WE EXPECT SUSAN TO
SECURE A Bi7ILDING PERMIT FROM THE CITY OF EAGAN AND TO
ADHERE TO ALL CITY OF EAGAN BUILDING CODES DURING
CONSTRUCTION.
YOURS TRUL
DOUGLAS HELGESEN
PRESIDENT
FERMIT
CtTY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
1 SITE ADDRESS:
P.7.N.: 10-22750-020-02
4464 CLOVER LANE
LOTo 2 BLOCKa 2
EDEN
PERMIT TYPE:
Permit Number:
Date Issued:
UNIT B
BUILDING
033135
09/83/9S
DESCRIPTION:
B4J'7,dkng-"Permit Type
Building G3Crrk Type
,Census Code '
r"
,
E ,
;E
DECK
ADDITION
434 AI.T. RESIDENTINI
?;
]
REMIAW;REVZEwEo BY 9ILL ADAMS.
FEE SUMMARY:
Base Fee $50,60
Surcharge $.50
Total Fee $50.50
CONTRACTOR:
,
OWNER: - Appiicant -
EDEN HOMEOWNERS ASSpC.
P.O. BOX 22195
EAGAN MN 55122
(651)687-0597
L
I here6y acknowledga that I have read this application and state that the
infiormatibn is correbt and egree tQ cortrplywiChal3 applic`ab12 Stata of Iryn.
Statutes and City of Eagan Ordinances.
? APPLICANT/PERMITEE SI NAT E
JSUED BY: SIGNA URE
- • ° . , 1998 BUILDING PERMIT APPLICATION (RFSIDENTIAL)
? CITY OF EAGAH ?
3830 PII.OT KN46O 7 RD - 55122 ?yy. ?
,7?
New Construction Reauirements RemodeVReoair Reauirements
? 3 rcgistered site surveys
? Z wpies of plans (indude beam & window saes; poured fid. design; etc.)
? 1 eneryy calculations
? 3 coPies of tree Prexrvatwn plan iT lot platted after 711193
required: ?Yes No
DATE:
DESCRIPTION OF WORK: ,
? 2 copies of plan
? 2 site surveys (erterior adddions 8 decks)
? 7 energy calculations Mr heated additions
CONSTRUCTION COST;/
STREET ADDRESS: Io
LOT: ?- BLOCK: '?L SUBD./P.I.D. #:
PROPERTY
OWNER
Name: Phone #:
Latt Fvst
StreetAddress:
City (t ? State: Zip:
Company: Phone #:
CONTRACTOR
Street Add
City _
ARCHITECT/
ENGINEER Company:,
Name:
Street Add
City _
Sewer & water licensed plumber (new Construction only):
and lot change is requested once permit is issued.
License #
State: Zip:
Phone #:
Registration #: _
Sute:
Zip:
Penalty applies when address chang
1 hereby acknowledge that I have read this application and state that the information is correct and agree to comply wfth all appliCabt
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received 2,?Yes ? No
Tree Preservation Plan Received _ Yes _ No ^ Not
? ,.
Troy Haskins
Eden Homeowner's Association
PO Box 22195
Eagan, MN 55122
City of Eagan
Building Permits Department
September 2, 1998
To Whom It May Concem:
Marian Lee of 4464B Clover Lane has the approval of the Board of Directors of the Eden
Homeowners Associarion to extend her deck per the plan submitted to us.
All decks (including steps), not on the street side of the buildings, are allowed to be taken
out twelve feet (12') from the building. Ali decks (including steps) are aliowed to be
taken to the end of the building (front of unit), but no part is allowed w extend beyond
the brick on the front of tha unit.
If you have any questions or concerns, please feel free to contact me. Thank you for your
help.
Sincerely . ?
Troy Haskins
Maintenance Manager
Home: 687-0597
VM: 458-7010
CITY OF EAGAN
3830 PZLOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
BmGi:
FOR CITY USE ONLY
PERMIT # /e0,0-0
RECEIPT # O U 5
DATE : /a f
PLEASE COMPLETE UPYER PORTION ONLY FOR SINGLE FAMILY
h.... <4?"?.A. TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
------------------------ --
WORK DESCRIPTION
NEW CONST _
ADD ON A-
REPAIR _
OWNER NAME:
SITE ADDRESS: ??l' f or/Oq L? n
LOT:1_ BLOCK a? SUBD. (_.Uaf'L4"
INSTALLER: !? n l' ? fj
ADDRESS: / Oo 1 /)'),'-1 t So
CITY: ZIP: ??Q 1
DWELLINGS &
'--- ------------------------- -
COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
ADD-ON MINIMUM 15.00
_ SHOWER 3.00
WATER CLOSET 3.00
BATH TUB 3.00
LAVATORY 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.
_ (MINIM[TM - 1) 3.00
_ ROUGli OPENINGS 1.50
OTHER
?
WATER SOFTENER ?
_ PRIVATE DISP. 15.00
_ U.G. SPRINKLER 3.00
SUBTOTAL $
ST. SURCHARGE .50
5
50
TOTAL: ,
S
C031MEkGIAiNLYITSTBTAI.? PLEASE COMPLETE THIS PORTION FOR ALL COMMERC IAL/INDUS TRIAL BUILDINGS AND
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:
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE _ $.SO FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18
STATE SURCHARGE
TOTAL:
(SIGNATURE)
CITY OF EAGAN
(Nbnth Year)
PRESENT ZONING/PROPOSID L'SE: R-1 SINGLE FAMILY
R-2 DCPLEX (Tt,a L'nits)
R-3 TOAIDIIIOLSE (Three + L'nits) ( Units)
R-4 APART:IENT/COAIDOMINICM ( Units)
COAM4ERC7AL/RE.'TAIL/OFFICE
INIDL'STRIai,
I NSTITL'TIONAL,/GOVERNN'IHNNT
NAME: R.
&/
?E-/s 6
.
':?,
AnoizESS: (3 U X I Z FS
CITY, STATE. ZIP: !?S07 ?
PHONE: y3.i-s/71
3) • u: :w; For City L'se
NAM:
Plumbers icense
ADDRESS: Active
CITY, STATE, ZIP: CT Eired
PHONE: MASTER LICII9SE # tbaV2I1i9 ecor(
5taf 'Initial
4) o • ., m• / ?l
?: c?'Go? f?a ?ur? l7or?r CV4 s.
ADDRFSS: I'YE.
CITY, STATE, ZIP: ,p ??q iN? fa1 JV SS?S?3Z/
PHONE: ?'?fd -S S10
5) io • d a?? • s• a??
? CO.?TZON TO CITY SEWII2 ja CONNECTIO[V 'IC3 CITY WATER
Q OTHII2 (Please Describe)
6)
? PLEASE HOLD APPROVID PERMIT FOR PICK-CP BY ONE OF ABOVE
CI PLEASE MAIL APPROVID PERMiT TO 1,?,? 3, 4, ABOVE
(Circle one)
7) ?6& 2&g& ? [ZZ_123/?
IF EXISTING STRCCii'RE, DATE OF ORIGINAL BL?ILDING PERMIIT ISSL'ANCE:
F O R C I T Y U 5 E O N L Y
PE2MIT ° ISSUED
FEES: $ 16,
$ fU. 561
$
S
S
$ /j-_c•
$ ' S(JC.vC,
$
$
$
$
$
$
$
$
$
SEi:E.°. °ERMIT (I`ICLi;DE SU°C :?RGc)
WATE2 PERP4IT (INCLuDE SliRCH?,RGL)
WATER i1ETER/COPPERHORN/OUTSIDE READER
WATER TAP (INCLUDE CORPORATION STOP)
S::vER TyP
-=C :c? ".''1, ?GS i:
' ?:_ ?__
ACCOliNT DEPOSIT - F7ATE?2
wAc
SP.C
TRliVK WATER ASSESS:!E:7T
TRlii]K SES4ER ASSESSME:iT
Li„E?.?L BE:IEFTT/TRU:IK SE:=
LAicRAL BENEFIT/TRUiIK IJATE3
WATER TREATMENT PLANT SURCHARGE
OTHER:
TOTAL
ArIO[J\T PAID/RECEIPT #
DOES UTILITY CONNECTION REQUIRE EXCaVATION IN PUBLIC RIGHT OF WAy?
YES IF YES, THEN n"PERMZT FOR TAORK WITHIy
PUBLIC ROADWAY" MUST BE ISSUED BY THE
Q NO ENGINEERING DZVISION. LIST AS A CONDI-
TION.
SUSJECT TO THE FOI.LOS9ING CONDITIONS:
APPROVED BY:
TI':LE:
DAT°_ : `/ / ? "x/
s i ? • ? • ? • i ? ? • i?. • u ?. ?. . ?.
?ip
' 71' • • 7• • ? ? ? • • • M• • • ?I? ? 1 1 1 71 • ? I
•D ?
CITY OF EAGAN
APPLICATION FOR PERhffT SEWEEZ P,NID/OR WATER CONNECTION
(Please Pr1nt)
1) PROPII2TY ADDRFSS:
n/
T,FY;A7, DFSCRIPTION: 7 '°G -?j _,?
(LOt Block Subdivision or Tax Parcel I.D. Number)
IF EXISTING S1RL'CTL?RE, DAT'E OF ORIGINAL BiJILDING PERNIIT ISSL'ANCE:
(Nbnth Year)
PRESENP ZONING/PROPOSID LSE: R-1 SINGLE FAMILY
R-2 DCPLEX ('I4,v Cnits )
R-3 TOWNhiOL'SE (Three + L'nits ) ( Units )
R-4 APARTMEAPP/CODIDOMINIL'M ( Lnits)
CONA"IEEtCIAL/RETAIL/OFFICE
irroasTxzrL
INS'I I'Iti TIONAL/GOVF.E2DPAENT
2) W.TJORRIUM
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
/C,C Bh O?Y ?a? /V'•
?G /?J??%?5+ ?J ?'/ S.? i D 7.?
3) • ?:?' For City L'se
NP,ME:
, Licenst
ADDRFSS: Plumber
5?3
Eive
CITY, STATE, ZIP: C? ired
Not Recor,
pxoNE: rAsTm Lzc:ECVSE ?e?es?gq?m9 . {v
Staf Initial
4 ) • • i?•
ruaME: Go a
aDDREss: /e16 6 93 A "qwcz W.
E.
CITY, STATE. ZIP: ?1,A;L /AVF /77 X
PHONE:
5) i? a • a• • a• a?
? COiQNECTION TO CITY SEWII2 ? CONNECTION 7O CITY FIIITER
Q O'I'HER (Please Describe)
6) u • •
? PLEASE HOLD APPROVID PERMIT FOR PICK-CP BY ONE OF ABOVE
I? PLEASE MAIL APPROVED PERMIT TO 1,? 3, 4, A?JVE
(Circle one)
7) '?.i ' ,/`J? t9 ;G.? ? // //,j /d,-r
F 0 R
P=R`".IT °- ISSUED
I T Y U S
F°-^ S : $
$
$ ?d.u
$
S
$ / ? o L
S `? c <
$
$
$
$
S
$
$
?-
ON:,Y
ET1'L.. ?"D PE
. RMT_T (I?ICL..'..^.L JLo...r._c.Aa
..CLJ
WATEc2 PERflIT (IiJCL'uDE SuRC :ARGE)
WATER METER/COPPERHORN/OL'TSID : READER
WATER TAP (INCLUDE C03?CRATIODI STOP)
SE:JER TAP
nCCCi:-i'T
AG.OUNT DFPpSZT - WAT°_3
WFiC
SPC
TRli`7K S4ATER ASSc,SS:i?':;m
TRu:7K SEI4ER ASSLSS'•irNT
L?„i?,AL BENEFIT/T3U`:K SE;=-R
LA:ERAL BENEFIT/TRU::K SqATEn
WATER TREATMENT PLANT SURCHARGE
OTHER:
TOTAL
Ai`l0U`T PAID/REC°I?T # S 7c?jL-
DOES UTILZTY CONNECTION REQUSP,E EXCaVATION IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN A"PERMIT FOR W0R?: WITHZN
PUBLIC ROADWAY" MUST BE ISSUED BY TI?E
C? NO ENGINEERING DIVISION. LIST AS A CONDI-
TION.
StiBJECT TO THE FOI.LOWING CONDZTZONS:
APPROVED BY:
TiTLE:
DATE:
- %?}?
s ? ? ?•• ? ? i •• s i . . ?? . ?. .?.
??• r •a? •?? • ?? ?? ? ?? ? ? ? :
CITY OF EAGAN
APPLICATION FOR PII2MIT SEWEE2 APID/OR WATII2 CONNECTION
(Please Print)
1) PROPII2TY ADDRFSS:
LF7GAL DFSQ2IPTION:
IF EXISTING STRC'CZVRE, DATE OF ORIGINAL BUILDING PERMIT ISSC?ANCE:
(Month Year)
PRESENT ZONING/PRQPOSID LSE:
R-1 SINGLE FAMILY
R-2 DIIPLEX ('I+ao L'nits)
R-3 TOWNHOL'SE (Three + Cnits)
R-4 APARTMENT/CODIDOMINICM
COMMEF2CIAL/RE'PAIL/OFFICE
IDIDL'STRIAI.
INSTI7L'TIONAL/GOVERNNfENT
( Lnits)
( Lnits)
2) ?
NArE: N.C'ZE ,Gc
ADDREss: '6a x
CITY, STATE, ZIP: 5f. .gN o//A 197 .V S':?07 ?
PxoDE:
3) r?• For City Pse
NAME:
Plumbers License
ADDRESS: ?A/yiE CITY, STATE, ZIP: d
PF30NE: MASTEEi LICENSE #?alBS?L?h9 corc?tWaffni
l
4 ) ? ? ?• /?
N
AME: I?Od?? 0 A/fLi!-? !'?OInES
AoDxFSS: /5/6n g3 .4 sq ivc- A!eE'.
crrst, sTATE, ZIP: a I AJX c< 'y 5S413 y
PHONE : 7 rrO - S-!Srl Z)
5) io a • ?• a? ??
,$ COiVNECTION TO CITY SEWECt ?I CONNECTIO[V TO CITY WATEE2
p OTfIII2 (Please Describe)
6) ? •
? PLEASE HOLD APPROVID PFd2MZT FOR PICK-CTP BY ONE OF ABOVE
? PLEASE MAIL APPROVED PERNIIT TO 1,(D 3, 4, ABOVE
(Circle one)
F 0 R C I T Y U S E O N L y
P__°_MIT °- ISSUED
FEES: $ /G_ t'c;
$ ro.s ?
$
?-3 ? c•
S .
$
$ /S^?o
S /?;- C O
S
$
C
y
S
$
$
$ cG
9
SE.':LR !??RMTi (I.{?.CT..nLv Uor_"l?p.r`G^)
J"r J....J
WAT£cZ PERPII'P (INCL'JDE Su:CT.:eZaGi.)
WATER METER/COPPERHORN/OCTSZD: RE.IDER
WATER TAP (INCLUDE CORpORATiON STOP)
S::dER TA?
ACCOliNT DEPOSIT - 47AT°R
wac
SP.C
TRCiNK WATER ASJC.SS:IE.:T
TRli?]K SELdER ?,SSLS5:3E?iT
L`nTER?L BEi•IEFIT/TRUVK SE:?3
LATcRAL BENEFIT/TRU,IK :7ATER
WATER TREATMEnTT PLANT SURCHARGE
OTHER:
TOT?.L
AMOL`::T PAID; REC°I?T : ?7v 71
DOES UTILZTY CONNECTION REQUZRE EXCAVATION IN PUBLIC RIGHT OF WAY?
YES IF YES, THEN :y "PERMIT FOR `rlORK WITHZ'I
PUBLIC ROADWAY" MUST BE ISSUED BY THE
NO ENGINEERING DIVISIO[V. LIST AS A CONDI-
TION.
SCSJECT TO THE FOI.LOWING CONDITIONS:
APPROVED BY;
TITLEa
DAT° :
!! PI;F.ASE , NOTE- TfE: CIT)t" WILL PRC7VIDE: ONO, COPVOF? SEWER' ANDi+W?1TE;V PERMITS
= ADMT[VISTRATIVE': COS'i'S:
CITY OF EAGAN
APPLICATION FOR PII2MIT SEWEE2 AI+ID/OR WATEE2 CONNECTION
1) PROPII2TY ADDRE55:
T,FY;AT• DFSQ2IPTION:
(Lot Block Subdivision or Tax Parcel I.D. Number
IF EXISTING STRL'CTLRE, DATE OF ORIGINAL BUILiJING PERMIT ISSOANCE:
(Month Year)
PRESENT ZONING/PROPOSID USE: R-1 SINGLE FAMILY
R-2 D('PLEX ('itao Lnits )
R-3 ZDWN[-IOL'SE (Three + Onits) ( Lnits)
R-4 APARTMENT/COAIDOMIDII['M ( L'nits)
CONA9ERCIAL/RETAIL/OFFICE
IDIDUSTRIAL
INSTITC'TIONAL/GOVERIZlEN'f
2) /
NAME: ?lC.CE4a.v
ADDRESS: 13 Q)e / Z &
CITY, STATE, ZIP: SX-0 73
PxoNE: y33-6-1 7/
3) • r?•
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
MASTII2 LICENSE
Recor(
?-----
4) NP,ME : < f-?p D? 6),4 Zq c, A/O iri E
ADnREss: I Il(,v 9'3 .4 ??tic? ? ? •
CITY. STATE. ZIP: Al,g l.v& l?17
N 5'54?3?
PxoNE: 790- SSi o
5) i? • ?• • a• ?.
PrCONNECTION TO CITY SEWER 19 CONNECTION '1C) CITY WATER
[] OTHII2 (Please Describe)
6) i? • ? i
? PLEASE HOLD APPROVID PIItMIIT FOR PICK-L'P BY ONE OF AEOVE
A21- PI,EASE MAIL APPROVID PERMTT TO 1,0 3, 4, ABOVE
(Circle one) ?
7)
For City L'se
P1LUnbers LicensE
C=}lcive
F 0 R C I T Y U S E O N L Y
PERHIT u ISSUED
FEES: $ ??. } C,•
$
C$ S
$
S
$
$ c,
+S
$
$
$
$
S ??ot. GC?
$
S
S°::E.°, nEH)'!rT (I`ICL::DZ SURC : :3GE)
WATER PET.214IT (SNCLuDE SuRCHARGc,)
WATER PIETER/COPPERHORN/OUTSTDE READcR
WATER TAP (INCLUDE CORPORATIOU STOP)
S::iEB TaP
???cc::•r ___cs?: - ?_..??
AC^CliNT DF.POSIT - WATER
wtiC
SPC
TR:i:viC SQATER ASSESS:+.E.`.T
TRli:dK SEWER ASSESS:iE^i:
Le`,:E?,nL BENEFIT/TRUNK SE: =
LATE:;rIL BENEFIT/TRU:IK WATER
WATER TREATMENT PLAIQT SURCHARGE
OTHER:
TOTAL
AMOUtiT PAID/RECEIPT ; S7 ?j
DOES UTILITY CONUECTION REQUIP.E EXCAVATION IN PUBLIC RIGi-IT OF WAY?
YES IF YES, THEN n"PERMZT FOR WORK WITHIN
PUBLIC ROADWAY" MUST BE ZSSUED BY THE
?_] NO ENGINEERING DIVZSION. LIST AS A CONDI-
TION.
SUEJECT TO THE FOILOS9ZNG CONDITIONS:
APPROVED BY;
TI:LE: '
DAT° :
2005 RESIDENTIAL MECHAWWA? PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: single farnily dwelliogs & rownhomes/wndos when pertnits are required for each unit
?3D_5D
Date ` / lb_ / 66
Site Address ro 4 ,Q lJ'v//1) S&m/ Unit #
P
t
O hone #( Iv? /) Lo
Tele
roper
wner
y p
Contractor
Street Address 8910 Wentworth Ave. c;ty
Minneepoils,
state (952) 881-9000zip Telephone # ( )
Bond #: Expires:
The Applicant is _ Owner L,/ Contractor _ Other
Add-on or alteratioo to existing dwelling unit
?4o 1ct? ?a $ 30.00
? fumace _Additional ? Replacement _ New
air exchanger
?
air conditioner
heat pump
other
State Surcharge $ .50
g b.`2d
Torat
I hereby apply for a Residentiai Mechanical Permit and acknowledge that the information is complete and accurate; that the work will
be in conformance with the ordinances and codes of the Ciry of Eagan and with the Mechanical Codes; 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.
M5D
Applicant's PrintedName JAN 12 2006 Applicant's Signature
'7?71?l
zoos RESIDENTIAL PLUMBING PeRnmTaPPUCarioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Oate 5 ! ? / 0?0 ,
Sit
St
t Add
L{Li b`'f ?' 0 vtf LQl
e
ree
ress
• Unit #
I Property Owner r-) Telephone #( J
I Contractor Telephone# ( FySk) 3?S-I341?
Address(`) City C- SWte-M&L Zip CiSm?
The Applicant is: _ Owner "6-Contractor _Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
, $ 100.00
i Per as-built $ 10.00
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee includes installation of a water softe ner andlor water
heater at the same time. If you are installing onlv a waier softener and/or water
heater, do not complete this section; move to the next section and check the
appliance(s) you are installing.
_Septic System Abandonment
_ Water Turnaround (add $130.00 if a 5/8" meter is required)
Other:
-
I
Water Softener L19Vater Heater $ 15.00
_ new ?replacement
Lawn Irrigation _RPZ _PVB _new _repair _re6uild $ 30.00
State Surcharge - - - ? ?, $ 50
!UIJ U '
i
Total I J'
i
$
I hereby apply for a Residential Plumbing_Permi4 andcacknowledge 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 plumbing codes; that I
understand this is not a permit, but only an application for a permit, work is no4 to start without a permit and work will be in
accordanc with the approved plan in the event a plan is required to berevitWed and approved.
I? ? L? n '
ApplicanYs Printe Name Applicanfs Signature
N?
, , .
" )AOee
ENGINEE(?ING C P?pNHEl?IS ondOlAND SiURVEYOflS
, COMt?ANY, INC.
`?1000 EAST 1461A STREET, BURNSVIILE, MINNE507A 35337 PH 432-3000
-r4 °e1On : LO75 1,2,3, aND 4, BI.oGK 2, EDEhI ADDITIOtJ)
• DAKOIA Cov1.1TY, MIIJNESOTA
i`Z1/712) DEWOTES EX15T1.)6 ELEVATION
( 92l•5' ) DEF.IO7E5 • PROPOSED ' ELEVLI7lOM
"?- INDfC<ITES DiRECTION oF SuRFAcE DRAINA6E
,. .-92/•?.5,?= 1=lA115HED 641lq6f FLUOR ELEVqTION
f.;?., .
s,
-70h
_.-.., `
rr
1(D
. . _. . _ .. . ..--.. ??n,\
.. ,Pl
t iA I (:
N O RT H
SGALE : 1"= 30'
ORAINAGE A?.ID
o-
? U71LITY EASEMEN7 •
P? 0 ? y
36' Fhbt/T Bwt.DhUG
` 3 96e 5°? SETBACK LINE
? D?' s •
s
J?? 0
ti ti \
0
v l v OD ! r '`
;N'_
co>',? ra? ? o I C;l-'
0/ ?G ? ? ' ? ? ?c? go•?? Q
ni ^ i< SZ oe p ??
o . P
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. / . M1h. .d,
*V
wc
- ( -?S 4?x"'. '? ' ?•'?:3?? lil -? '
. 1
.
I heriby certify that thii is a true and
land uvho+m' and deacribed hsnon.. Aa 19 p?s-
• . .. . ??;?^ ?.?"-:t
?/?) :, ???`.'?'?'?j;?y?,?•iq'
/aosE .
ENGINEEAING C P?pNHERS ondOlAHD SfURN
/ COMf?(?NY, INC.
?100EAST 1461h S7REET, BURHSVILLE. YINNESOTA 55337 PH 432•3000
(92/.s)
...?--
92/.SO=
ok?
fV
n' LOTS 1,2,3, AtiD 4, BLOLK 2, EDE1J AD01T1oW?
• DAKO'fA CAVWTY, MIKINESOTq
DE?JOTES EKISTIN6 ELEVATION
bENOTES • PROPOSED ' ELEV,4T/ON
itiDfLATES DIRECTION oF SuRFACE DRAINA6E
P71A1IS14ED G4RR6E FLOOR ? 91EVAT/O/l!
NOR7H
SGALE : !"= 30'
96 Z6
:oc 9 ° 3;
D
Q. ? ?? •
0
G? ^g• 1?y \ lqti ?0?
? •a
u 4 a
O
1r,?'S SFQ ??
U%
4 L
? ?.
a? io •/ ?
?O i?
DRAiI.lAGE qMD
?O UTILITY EASEMENT
y
\ 30' FR[1t/T gUfLDlA1G
SETBAGK LiNE
•
?
s
? \00 LJ
o° •
.
%'
? N -
Ife ? --\
? (yZO.?I
R \
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n '^.? ? h \ \ b2• ? aa•
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aQ? •z> ? . ?ti ?-9 ? ,?_ J
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C , r
SB(yZ/.O
..
\ cn
tv
/ ? ?. .
, k9-.?+
? ? .. _.,
?
i ?
I hersby cnrtify that thia ie a true and eorrect representation of a traetot
land as sho+m'and deseribed hereon.. Ae preparad by ma on thi¦ lsr day ot
//?vEMBex , 19 8s . '
. ??????Nina. Esa. No. /GoP',
=- CITY OF EAGAN
3830 Piiot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
4466
LOT:
EDEN
P.I.N.: 10-22750-040-02
PERMIT
CLOVER LANE
4 BLOCK: 2
CR.CqIQ
PERMITTYPE:
Permit Number: BurLozNs
0 2 5 8 3 4
Date Issued: 0 6/ 16 / 9 5
DESCRIPTION:
? •.
86ildin9Permit Type DECK
;duilding Wb,r,k 7ype NEW
?
i•'j
..
?<1_
REMARKS:
FEE SUMMARY:
Base Fee $30.00
Surcharge $.S@
Total Fee $30.50
CONTRACTOR:
OWNER: - Applicant -
GREEN SUSAN
4466 CLtlVER LN
EAGAN MN 55122
(612)456-9450
S hereby acknowledge.that I have read this application and state that the
infarmation is corre6t and agree ?to comply with allappliaable State of Mn.
L Statutes and City ofi Eagan Ordinances. ?
iLt -AN(
A LICANT/ RMITEE SIGNATURE ISSUED Er. SI ATU E
-_-
IN5PECTION RECORD
CITYOFEAGAN PERMITTYPE: eurLortie
3830 Pilot Knob Road Permit Number: 025834
Eagan, Minnesota 55122-1897 Date Issued: 06 / 16 / 9 5
(612) 681-4675
SITEADDRESS: P•I•N.: 1e-2 27 5 e-e4 e-e2 APPLICANT:
LQT: q BLOCK: 2
4466 CLOVER LANE GREEN SUSAN
EDEN (612) 456-9450
PERMIT SUBTYPE: TYPE OF WORK:
DECK NEW
INSPECTION ., . D.
FOOTINGS FINAL
F-
L
?
_, ?
.
aosE
NGINEEAING C P?pHNEAS ond6LAND S3UflYEYOQS
COMPANY, INC.
1000 EAS7 146M $TREET, BUHNSVILLE, MINNESOTA 55337 PH 432-3000
?OCit Q4G1crJe?_ fgn: LOTS 1,2,3, An1D 4, BLOGK 2, EDfN AD91TIOtil)
? • DAKO7A CovN7Y) MINNESOTq
itZ1•1 ? DEMOTES EXISTIN6 ELEVATION
(92l•5) bENOTES • PROPOSED ' ELEViATION
? INDfLq7E5 DIRECTIUN oF SUfZFACE DRAINA66
_ v l`?, !:; F??;\1 = ?JAlISNED
4cV 4'E
ov
NORTHATE
scnLE : r^= 30'
GARASE FLUOR Et.EVA7/o,U
h?
\Q')
DRAIWA6E qIJD
UTILITY EASEMENT
?Q-
o?
?v
, 6v
>
!V
? \y
? 0,00
96 yq
3o i
0°.
\ ? /t
,
\? ? h h?/ tiv5
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0
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yp ? \_ ?0
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...
f ???`ryl??a 0X"
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9? oo G
\
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oi, s8, ?`V
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`n? /
n
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30' FiftDvT gurtDlA16
SETBACK LINE
roe
\ ?P N1
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„
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M 20, 4%
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I heriby certify that this ie a trve and corract repreeentation of a tract of
land as thoxn'and deacribed heraon.. Ae preparad by ma on this lsr day ot
^/GVEMBE?e ? 19 BS . ? ' Hinn. Ee6. No. /GaPs?
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA109223
Date Issued:02/20/2013
Permit Category:ePermit
Site Address: 4464 Clover Lane
Lot:1 Block: 02 Addition: Eden
PID:10-22750-02-010
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Kris Oien
3670 Dodd Rd
Eagan, mn 55123
651-365-1340
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
Surcharge-Fixed $5.00 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 -
Kathryn S Bierman
4464 Clover Lane
Eagan MN 55122
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:48 #582 P.065/079
Use BLUE or BLACK Ink
I For Office Use( I
npn j Permit of EaRd 1 Permit Fee: 3 .~5 I
3830 Pilot Knob Road
Eagan MN 55122 Date Received: a 1 i3
Phone: (651) 675-5675
I I
Fax: (651) 675-5694 1 Staff: 1
I I
-fin 2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: q N1 WI3 Site Address: 416 yyWa, 4LAW, L*4W9 u Laney Unit
Name: _ft C'~ QSSC,~(1 C~YYIDAYI~1 Phone:
Resident/ ~N i
Owner Address / City / Zip: N3Y N V\ PUY a\j, EdW PIf, ifif, MN 1;5N
- Applicant is: Owner K Contractor
Type of Work Description of work: ~~aY off ahd re-roof
Construction Cost: s n 1 Dlocl. Multi-Family Building: (Yes X / No
t Company: 4JNAY \~nD1,V1t~~(1'1 ~~I~ LAX, Contact:
J
Address: FJI'1J IhdIal J11 #~~3 City: n
Contractor r
act r
State: Zip: 15C23501 Phone: "I~~' "1'1 Z" 1y7y
License ,t03~ Lead Certificate
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
the information maybe classified as non-public ff 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.aopherstateonecall.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 1 understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
X_ lug I~alst~ad x (~a _
Applicant's Printed Name A Ocant's Signature
Page 1 of 3
From:ALLSTAR CONSTRUCTION 19529427464 02/10/2016 13:06 #301 P.019/022
C!ty of Earn
3630 Pilot Knob Road
Eagan MN 55122
Phone: (651) 6755675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
J
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: °MO // Site Address: `/�Ci+' VV€itr £ 4'V6 t- �Yht- /l v
...,.........,.:...,:::,...,..,�._......_..:.,,.:......................:.. Unit fl
Resident/
Owner
Type of Work
Contractor
Name: ,r/ Atif,4 /7"i &Lt. — £.1ZEi/ NO4
Address / City/ Zip: Y9/05/ OftoCo t!/O✓ - Lie
Applicant is:
Owner ii Contractor
Phone:
Description of work: /SS -J2% W/7 bin,// /,(75.— cirri/Z-6414.1•44;11 04/Y,
Construction Cost ./010G! Multi Family Building: (YesJ No )
Company: /Q il54 A2 davit ' u t reit J niiiivrruw,n Ce Contact: v) :en /4 A7-2
Address: S' 46 Indus -1-r; I Si- 3 I- -: /0� 3 city: Nil` o._ PLA- s
State: /4 Zip: 5636'3 Phone:q) 4q. '7/57 Email: %f444..//S- r"• �.. .
License #: (, o 3S io Lead Certificate #: iti/14 7 do nV -
If the project is exempt from lead certification, please explain why: ;ur /993
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Phone:
Sewer & Water Contractor: Phone:
Fire Suppression Contractor. Phone:
Mechanical Contractor:
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. CaII Gopher State One Cali at (951) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.og
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 wortc which requires a review and approval of plans,
Exterior work authorized by a building permit issued In accordance with the Minnesota State Buildin. • mpleted within 150
days of permit issuance.
x CJI r Mie-mao x
Applicants Printed Name Applic nts Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA137500
Date Issued:07/08/2016
Permit Category:ePermit
Site Address: 4464 Clover Lane
Lot:1 Block: 02 Addition: Eden
PID:10-22750-02-010
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Kathryn S Bierman
4464 Clover Lane
Eagan MN 55122
Bettin, Inc
3208 1st Street South
Waite Park MN 56387
(320) 251-2505
Applicant/Permitee: Signature Issued By: Signature
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 1 FAX: (651) 675-5694
buildinginspections(@cityofeagan.com
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RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit #:
Applicant is: ❑ Owner Contractor
Name: EGLs/� �4 o t/x-A-e— 0 y, U-__,,f ja5.s cz, a I OL4
Homeowner Address:law its gque u" /-I, City: �aaa
Phone: Email:
Description of work: P, e Q G bh-
Type of Q
Work Construction Cost:)
Building
Contractor
Type of building: ❑ Single Family ❑ Townhome, of units Twin Home
Compan)Thy �t h cl C_\lam Contact:
Address: Li�� I' rJ & W QST 1-k\y City: j4;- -GLPV_,�
State: Lip: 553�T Phone6tZ Emailia/V12 �[ �e� CSN`eo``�Q°��^
License #: t D -7r-K ) Expiration Date:
Sewer & Company:
Water
Contractor Address:
Required for State: _
new construction
Zip: Phone:
Contact:
Email:
License #: _Expiration Date:
City:
I understand that Plumbing, Mechanical, and Fire Suppression work require separate applications.
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the
information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they
are trade secrets.
CALL BEFORE YOU DIG. Contact Gopher State One Call at (651) 454-0002 or www.aopherstateonecall.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.
Applicant's Printed Name A licant's Signature