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4484 Clover LaneCITY OF EAGAN 3795 Pilot Kno6 Read Eagen, MN 55123 PHONE: 454-8700 BUILDING PERMIT APPLICATION N° 6167 Receipt # To be med fer 1 Of 4 p1B% Est. Value 42,000 Date 9-16 , 19ao_ Site Address 44g6 B CloVer ISI. Erect 1$ Occupancy R3 Lor 15 ei«k 2 5ec/5.b. Eden Add, qirer ? Zonin9 PD Pprcel # 10 22750 150 02 Repair ? Fire Zone 3 E l T f C t V n arge ? ype o ons . w Nome Tilsen Homes Inc. Move ? # Srories ; Addrew 627 S. Snelling Demollsh ? Front 44 ft. b Ci .(ll Phone-Fi,qR-55 Grode ? Depth • 22 ft. p Name ApPrwols. . Fees Address Nome _ Address I hereby acknowiedge that I have read this aDplicotion and stete that the information is cnrrect Gnd agree to comply with all applicable State of Minnewta Stotutes and City of Eagan Ordirwnces. Signature of Permittee same Woter & Sew. Police Fire Eng. Plonner - Council - Bldg. Off. _ APC Permit ?4V.JV SurcMr9e 21.00 Plon check60.25 snc 525.00 Worer Conn. 305.00 Wmer Meter 60.00 Rood Unit 185.00 Torol 1, 276. 75 A Building Permit is issued to: TljSEri HOIDaG Tnn - on the express condition that oll work shali be done in accordonce w' all appli le S ote of Minnesota Statutes and City of Eagan Ordinonces. i Building Officlol 9( • CITY OF EAGAN 3795 Pilet Knob Road Eagan, MN 55722 - . PHONE: 454.8100 BUILDING PERMIT APPLICATION Receipt g Site Address 4kan cloVer t?n. Lot16 BIxkZ_ Sec/Sub. F.r7Pn Adri Parcei # 10 22750 160 02 w Name Tilsen Homes Inc. z Address 627 S. Snelling 3 - ° -- - -- '-' --- w =0 V?v r Name _ Address Name _ Address same I hereby acknowledge that I have reod this aDPlication and state ihat the information is correct and ogree to comply with all applicable StaM of Minnesoto Statutes und City of Eagan Ordirwnces. Sigrwture of Permittee _ A Building Permit is issued to: oll work shall be done in acm Building Otficial N? 6168 Erect gja OccuponcY H.3 Alter ? Zoning PD Repair Q Fire Zone ? _ Enlarge ? Type of Const. 1J Move ? # Smries ?- Demolish ? Front Grode p Depth ft. Aoororals Fees Water & Sew. Police - Fire Eng. Plonner _ Council _ Bidg. Off. - APC Permit 14V.7V Surcharqe 21.00 Plan check 60.25 snc 525.00 Woter Conn. 05.00 Water Meter 60.00 Road Unit 185.00 Total 1,276.75 3T Inc _ on the express condition that ot Minnesota Stotutes and Ciry ot Eugon Ordinances. CITY OF EAGAN 3795 Pllof Knob Rov'"`- Eagon, MN 55122 PHaNE?148100 BUILDING PERMIT APPI.ICATION N°_ 6166 Receipt # To 6e used fer 1 of ¢ p1eX Est. Value 42,000 Date 9-16 19SO , Site Address 4484 $('l ov T T n Erect $X Occuponry R3_ Lot14 Biock 2 Sec/sub. Eden Add. Auer ? Zontny ' PD porml # 10 22750 140 02 Repoir ? FIre Zone 3_ Eniaree ? Tyce of Consr. _ V w Tilsen Homes Inc. Name Move [j # Stories - ^ ; Address h77 R Rnal l i ng Demolisb ? Front _ 44 _ ft. ° Ci St. Paul, Mn phone 695-5501 Grade ? Depth 22 sr. ? Aoorova6 Faes Zo Name same OU Address Name _ Address I hereby ackrwwledge that 1 have read this applicotion and state that the information is rnrrect ond agree to comDfY with oll applicable State of Minnesota Statutes ond City of Eagan Ordinances. Water & Sew. Palice _ Fire Eng. Planner - Counctl - Bldg. Off. _ APC Permit 1GV.7v Surcharge 21•00 Plon check 60.25 snc 525.00 Water Conn. ?3 5. 00 Woter Meter 60, 00 Road Unit 185.00 Toral 1,276.75 Signoture o4 Permittee I A BWlding Permit is issued to: Ti l Gen HOmeS, InC. on the express condition that all work shall be done in accordance w}* oll applicablg St,ote of Minriesoto Statutes and City of Eagon Ordirances. Building O4ficiol CITY OF EAGAN 3795 Pibf Knob Rood Eagan, MN 55122 PHONE: 454-8100 BUILDING PERMIT APPIICATION value Site Address 4`}04 U?Uvci- ?i. lot 13 Block z 5ec/sun. Eden Add. Parcel # 10 22750 13.0 02 rc Name Tilsen Homes Inc. z 627 S Snelling Address . Cit Phone 698-5501 ? Name 0 S3.i7le 06 Address V ? Cit Phone GW Name F iA Address I hereby acknowledge thot 1 have read this opplication and state that the informatian is torrect ond agree fo comply with all opplicable State of Minnesota Stotutes ond City of Eagan Ordinances. N2 6163 Receipt .fk ? Erect g}C Occuponcy R'3 Alter ? Zoning PD Repair ? Fire Zone 3 Enlarge ? Type of Const. V Move ? # Stories _ Demolish ? Front 44 ft. Grade ? Depth 22 ft. Approvale Feas Water & Sew. Police - Fire Eng. Planner - Council _ Bldg. Off. - APC Permit i?v.?v Surcharge 21.00 Plan check 60.25 snc 525.00 Woter Conn. ?3 5.00 Water Meter 60. 00 Road Unit 185-00 Total 1,276.75 Signuture of Permittee I A Building Permit is issued to: Til sPn HoIDBS. II1C, on the express wndition that all work shall be done in aaordance ? ith all applicqble}?Sto?te of Minnesota Statutes ond Ciry of Eagan Ordinances. Building Official / ? r%s?A.P -[...a.rt.-? .--? crnr oF EAGaN •%'""? ? .? 3795 Pilot Knob Rood Eogan, MN 55122 N2 6163 PHGNE: 4548100 BUILDING PERMIT 1 OI" 4 nle% Site Address ' Lot Blotk Sec/5ub. Porcel # W Name 3O Address C'itv P?,nns Receipt # ` Nome _ z oE Address u? Nome _ Address Erect ? Occuponcy Alter p Zoning Repolr ? Fire Zone Enlorge ? Type of Const. Move ? # Stories Demolish ? Front ft. Grade ? Depth ft. Appeorals Fees Water & Sew. Police Fire Eng. Planner Council Permit Surchorge Plon check SAC Water Conn. Woter Meter Rood Unit I hereby acknowledge thot I hove rend this application ond state that Bldg. Off. the information is oorrect and agree to comply with cll opplicable APC Totol Stote of Minnesota Statutes ond City of Engan Ordinonces. Signature of Permittee A Building Permit is issued to: on the express condition that all work sholl be dorre in accordance with ctl opplicable Stote of Minnesota Statutes cnd City of Eagan Ordinances Building Offitiul ? • i• y . U[faA-t-,,•c- woco8??? 7--12 -g3 a. 6-ti+f 3en Pennk # Dah Imad ?HmMt« Plumbing iZs s `t -I q -$ 5 ? ''Me ni al h ' ` 12-?3 ' c a c ?pi • 7 ? -Ec, -7 3 - 2 -$ INSPECTIONS DATE INSP. Rou9h-I n Final Footings Dote nsp. Dote Insp. Foundation Plumbing •?a Framez/ins. Final ? 'E/-/P e? Mechonioal Remorks: ` . ?i?-?.D ?-9-? eva ??? ???u.c??,.?s l??-.??,?2????`u'°?c?`/' `/-30 -?b ?C`;. r?, D • ?. 6 PERMIT # PLUMBING PERMIT RECEIPT # ClTY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MM 55121 DATE: Site Address ,S`7tl'V LGO vt ??. G,oA Lot Z -?_ Block ls? Sec/Sub ? Name ? Addre c Ciy L Name 3 Add? O Ci1Y FEES COMM/IND FEE - 1% OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE - $10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHAFiGE PER PERMIT - .50 (ADD $50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) TYPE WORK DESCRIPTION Res. New 1< Mult ? Add-on Comm. Repair Other NO. FIXTURES T TA6 Water Closet - $3.00 Bath Tubs - $3.00 Lavatory - $3.00 Shower - $3.00 ZKitchen Sink - $3.00 6 Urinal/Bidet - $3.00 Laundry Tray - $3.00 Floor Drains - $1.50 ? s ?Water Heater - $1.50 s Whirlpool - $3.00 -A-.2---Gas Piping OuUets - $1.50 Softener - $5.00 Well - $1Q.00 Private Disp. - $10.00 Rough Openings - $1.50 a OF FOR CITY OF EAGAN FEE -R;? STATE S/C: GRAND TOTAL• ZRL S a CITY OF EAGAN 3795 Pllot Knob Road Eagon, MN 55122 N2 6 166 PHONE: 454-8100 BUILDING PERMIT Receipt # ? To 6e esed for Est Value DaTe 19 . Site /lddress Ered Q Octupancy Lot Block Sec/Sub. - Alter ? Zonirg P Repoir p Fire Zone orcel $k Enlorge 0 Type of Const. , oWC Nnme Move p # Stories z ? Address Demolish ? Front ft. Cl Phone Grode ? Depth ft. IVCmB z?p o? Address uF 1?:... o?.__ Name _ Address I hereby acknowledge that I have read this appfication ond stote that the informotion is carrect and agree to comply with all applicable Stnte of Minnesoto Stotutes and Ciry of Ecgon Ordinonces. Water & Sew. Police Fire Eng. Pfanner Council Bldg. Off. APC Permit Surchorge - Plan check _ SAC Woter Conn. Water Meter Road Unit - Total Sipnature of Permittee I A Building Permit is issued to: on the express condition thot all work shall be done in cccordonce with all appliwble State of Minnesota Statutes and City of Eagan Ordinonces. Buildiny Officiol ?lEe?-?i cQ1 wo$3$d-? ?-? Z-$ 3 0j, `7'`io,,,pso?'1 Pennk Deto htwd ??euMtw Plumbin9 12 55 -7 -( - ? l l ? • - ? ?-121-93 C o, INSPEGTIONS DATE INSP. Rouqh-In Final Footings Dafe InsD. Dota Insp. Foundation Plumbing fQ• • FrCme/ins. Mechaniwl Finol Remorks: ? ?h7 ? 5qR I- tol?c (gS- Pre 1? w • Site Address ` Lot N Name _ c Address O CitY - PERMIT # RECEIPT # DATE: MECHANICAL PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 PHONE: 454-8100 TYPE OF WORK Forced Air M BTU Boiler M BTU Unit Heater M BTU Air Cond. M BTU Vent CFM Gas Piping Outlets # „ Othe(Go,, ' FEE S! C: TOTAL: BLDG. TYPE Res. -? Mult Comm. Other WORK DESCRIPTION New ?L Add-on Repair FEES RES. HVAC 0-100 M BTU - a24.00 ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 ADDITIONAL 6 M BTU - 6.00 GAS OUTLETS - 1.50 EA. COMM/IND FEE - 1% OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE - 10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) , SIGNAT RE PERMITTEE FOR: CITY OF EAGAN 0. + BUILDING PERMIT To bs ated for " Est. Value 5ite Address Lot Block Sec/Sub. Parcel .# of Ncme W ? Address • ? I1BiliT,F; o ce Ncme ? o 0?) Address CI Phone ?w Name FW Address I hereby ncknowledge that I have reod this cpplicatian ond state that the information is correct ond agree to oomply with all applicable State of Minnesoto $tatutes and Ciry of Eagan Ordinances. Signature of Permittee I A Building Permit is issued to: on the axpress condition thet all work shall be done in accordance with all applicable Stote of Minnesoto Statutes nnd City of Eugan O?dinances. Building Official CITY OF EAGAN 3795 Pilot Knob Road Eogen, MN 55122 PHQNE: 454-8100 Receipt # .0 _ N°?• 6168 Erect ;- 13 Occupancy Alter ? Zoning Repolr ? Fire Zone Enlarge ? Type of Const. Move ? # Stories Demolish ? Front ft. Grade p Depth rt. Aavrovnh Fees Assessmen? ' -11- Permit Water & Sew. Surcharge Polite Plan check Fire SAC Eng. Water Conn. Planner Water Meter Council Rood Unit Bldg Off. . -T APC Total '- • ?"' FennM # OeM Mpd PonnittM Plumbing Mechanicol '/l EP &`tsso la - ?v-? o . ? T o0-1?sc? ? INSPECTIONS DATE INSP. Raugh-in Firtal Footinqs - Q- 1 Date Ins . -Date-A Irnp. Foundation Plumbing Frome/ins Final - </-& Methanical ?i Remarks: - -; ? ., cirY oF EAGAN ' 3795 Pilo! Knob Road Eogan, MN 55122 N? 6 167 PHONE: 454-8100 BUILDING PERMIT Site Addreu Lot Block Sec/Sub. Porcel # ac Name W z Address ? - -- , , .. _ , ,.. . . .., . '. Ncme 'io ? ? Address 3'.1'., oL..__ Ncme _ Address I hereby acknowledge that I hove read this applicotion ond state that the informotion is correct and agree to comply with all applicoble Stote of Minnesoto Stotutes and City of Eagan Ordinances. Receipt # Erect ? Occupancy Alter ? Zoning Repoir ? Fire Zone Enlarge ? Type of Const. Move ? .# Stories Demolish ? Front ft. Grnde ? Depth ft. Approvols Fees Water & Sew. Police Fire Eng. Plonner Council Bidg. Off. - APC Surcharge Plon check SAC Woter Conn. Water Meter Road Unit Total Signature of Permittee I A Building Permit is issued to: on the express condition thot pll work shall be done in occordance with oll applicoble Stote of Minnesota Stafutes and City of Eagan Ordirances. Bu(Iding Official Permk # pete Iwewl hewMlM Plumbing ,:?"' j C( Mechanical 'Z(p 7 6e, INSPEC'fIONS DATE INSP. Rouqh-I n Final Footings Dote Insp, Oate Inap. Foundation Plumbing , Frame/ins. ? -/a- 1*3 Mechanical _ 93 Finnl pSP Remarks: CITY OF EAGAN Remarks Addition F.den Addition Lot 13 eik 2 Parcel #10 22750 130 02 Owner " screet 4494 C7 over Lane scate Eagan NW 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. ? 19$2 504.70 100.94 5 STREET RESTOR. GRADING D 1982 46.60 5 SAN SEW TRUNK a/ 1974 62.93 4.20 15 * SEWER LATERAL WATERMAIN ? WATER LATERAL 1982 WATER AREA 4yg 1977 62.93 2 1 Services ? 2 STORM 5EW TRK 182 256.00 1.20 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 305'00 20909 9 15 80 BUILDING PER. 6163 SAC PAR K CITY OF EAGAN Remarks Addition Eden Addition Lot 14 Rik 2 Parcel #10 22750 140 02 Owner i,t.i..y r_ st?eet 4484B Clover Lane statB Eagan MN 55122 Improvement Date Annual Years Payment Receipt Date STREETSURF. ? 1.9$2 504.70 1.00.94 STREET RESTOR. L GRADING Uqb 1 $Q 2 46.60 5 SAN SEW TRUNK 1974 62.93 4.20 15 (' p/ 5 #- SEWER LATERAL t c 182 1896.46 279.29 - WATERMAIN f WATER LATERAL 1982 S WATER AREA 1977 62.93 4.20 1$ a ' 0 * Services 1982 STORM SEW TRK 1982 256.00 51•20 5 IF STORM SEW LAT 1982 5 CURB & GUTTER SIDEWALK STREET LIGHT Rd.UAIT 185.00 20910 9 16/8Q WATER CONN. 305.00 20910 9/16/80 BUILDING PER. 6166 SAC PARK - CITY OF EAGAN Remarks Addition Eden Addition Lot 16 Rik Owner - I r•i!!r r' Street 4486 Clover Lane Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 19$2 504.70 100.94 5 4 STREET RESTOR. GRADING 82 232.99 46.60 186.40 A0108 6 1-28-82 SAN SEW TRUNK 19 4 62.93 4.20 15 2.22 Aolo896 _2$_$2 * SEWER LATERAL S2 4 2 WATERMAIN • WATER LATERAL 1982 WATER AREA g 4.20 15 17.79 - * Service6 1982 STORM SEW TRK 1982 2 6. ?0 1. 20 201+ 80 AM896 -28-82 1F STORM SEW LAT 1982 5 CURB & GUTTER SIOEWALK STREET LIGHT WATER CONN. 305.00 12 9 16 80 BUILDING PER. 6168 SAC PARK CITY OF EAGAN Remarks Addition Eden Addition Lot 15 Blk 2 Percei #10 22750 150 02 Owner street 4486B Clover Lane State Eagan NW 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. Q 19$2 504.70 100.94 5 302,82 4 j}- -$ STREET RESTOR. GRADING (PqO 1982 232.99 46. C)O 139.81 A01214 4- -8 SAN SEW TRUNK ,741 'Zl.O A0121 4 4-2 -8 1F SEWEF LATERAL 8 1896.46 .2 .88 WATERMAIN M WATER LATERAL 1982 WATER AREA A012134 4- -8 • Services, 1 STORM SEW TRK 1982 256.00 1.20 1 3•6o A0121 4 4- -83 * STORM SEW LAT 1982 CUR6 & GUTTER SIDEWALK STREET LIGHT Rd. UNIT WATER CONN. 305.00 20911 9 16 80 BUILDING PER. 6167 SAC PARK - - Receipt PLUMBING PERMIT CITY OF EAGAN Fill in numbered spaces Type or Print legib/y 1. Date 2. Installation Cost 3. Job Address Lot ?- Blk. 4. Owner ?•? Permit No. ' Fee S/C Tot. °2 Tract ('\ 5. Contractor Phone . 6, Address ' 7. City -- State Zip 8. Building Type: Residential 0 9. Work Description: New El Commercial O Institutional O Add ? Alter ? Repair ? 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: tor , Rough Final „ inspections: Oate Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee fill in numbered spsces S/C ' Type or Prini /egib/y Tot. 1. Date 2. Installation Cost 3. Job Address Lot Blk. Tract I 4. Owner 6. Contractor 6. Address 7. City 8. Building Type: Residential ? 9. Work Description: New 0 10. Describe 1 11 State Zip Commercial ? Institutional O Add ? Alter O Repair ? Fuel Type No. Eauinment STU - M. Ea. Forced Air No. Equiament CFM Air Handlin : Mfg, g Boilers Mfg. Unit Heater Mech. Exhaust Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to oomply with all ordinances and codes governing this type of work. Signed : for Rough Final InVections: Date Insp, Date Insp. 7his is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 ? ?.,...- ^ I Phone Receipt ,,+` ? -' - { ? CITY OF 1. Date - 2. 3. Jo6 Address 4. ,y NIT Permit No. -? - 1 I Fee ices S/C Y Tot ` 81k. Tract 5, Contractor Phone " 6. Address 7. City State Zip 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 10. Describe Fuel Type 11. No, Eauioment 8TU - M. Ea. Forced Air ? No. Equipment CFM Ai Ha dli Mfg. r n ng: 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 Flnal Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt PLUMBING PERMIT Parmit No. CITY OF EAGAN Fee Fill in numbered spaces ' S/C Type or Prin[ legib/y T ot. 1. Date 2. Installation Cost 3. JobAddress Lot j/J Blk. - Tract 4. Owner : 5. Contractar Phone j i 6. Address ? ? i 7. City State Zip 8. Building Type: Residential ? Commercial ? Institutional 0 9. Work Description: New El Add O Alter O Repair ? 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs Septic Tank Lavatory Sottner Shower Wel I 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: Oate Insp. Date Insp. .? This is your permit when numbered and approved. Approved CITY OF EAGAN 454.8100 (,J Reaipt -1 l? I'i/ ,_? 1. Dm 2. Insta 3. Job Asidress 4. O+nrner '? 1 Sul 5. COflV8Ct0r_ 8. Address 7. City i S, State 2ip 8. Building Type: fissidential 0 Commercial O Institutional O 9. Work Descxiption: Nevir. E3 Add ? Alter ? Repair ? 10. Deacribe Fuel Type qB§x 11. No. ' Equipment BTU - M. Es. Forced Air ? No. Equipment CFM Ai H dli : Mfg. r an ny Boilers Mfy. Mech. Exhaust ? Unit Neater Mtg. Other Air Cond. Mfy. Gac, Piping Outlets 12. 1 hereby certify that the above information is true and correct, and 1 agree to comply with all ordinanoes and codes governing this type of work. Signed for - Rouyh F Inal Inapections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY QF EAGAN 464,6100 PERMIT Pwmit No. ' FM rd s,pacnt ' S/C _ regibJy TOL ? COSt ? Blk. ? Tract , . '11' 1 ', OKOf12 2619 Coc>ii Rpoirs 3iicf Receipt ' • , PLUMBING PERMIT CITY OF EAGAN I fill rn numbered spaces Parmit No. Fee S/C Type or Pnni legib/y Tot. . 1. Date nC 2. Installation Cost 3. Job AddressSYY-`t?/ ? Lot Blk. Tract ?'! O [? !` /c c. . ` , • 4. Owner " _• ? /L. ?:, , ? _. , 5. Contractoi ??^ ? -ft ?. , . _? ? ^- ? ? • Phone 6. Address,-- :?` ?G • ' ?" ? 7. City,!; ; "'-•" ? ?- State ':,?.4 Zip.?.sit?i 8. Building Type: Residential Ir 9. Work Description: New 0 Commercial ? Institutional ? Add ? Alter ? Repair 0 1 10. Describe 1-1= ,; • G'• ` : 1 11. No. cT Fixtures Water Closet No. Fixtures Cesspool/Drainfield ' Bath tubs Septic Tank ..? Lavatory Softner ? Shower Well f Kitchen Sink Urinal/Bidet Other T. _ 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 ordinaTces and codes governing this type of work. !?-K Signedi' for Rough F inal Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt . MECHANICAL PERMIT Permit No. - CITY OF EA6AN Fee Fill in numbered spaces S/C Type oi Prini legibly Tot. 1. Date 2. Installation Cost , 3. Job Address Lot Blk. .=- Tract 4. Owner - 5. Contractor Phone 6. Address • 7. City State Zip 8. Buitding Type: Residential ? Commercial ? Institutional ? 9. Work Description: New 0 Add ? Alter 0 Repeir ? 10. Describe Fuel Type - 11. No. Equipment BTU - M. Ea. Forced Air No. Equiqment CFM Handli Ai : Mfg. r ng Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. 1 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 Ftnal Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-8100 Receipt PLUMBING PERMIT Permit No. CITY OF EAGAN Fee _ Fill in numbered spaces S/C _ Type or Prin[ Jegibty Tot. 1. Date 2, Installation Cost 3. Job Address Lot ' Blk. Tract 4, Owner 5. Contractor Phone 6. Address 7. City State Zip 8. Building Type: Residential IN 9. Work Description: New 0( 10. Describe 11. Commercial O Institutional ? Add ? Alter ? Repair O No, Fixtures Water Closet No. Fixtures onl/Drbinfield Cess ? Bath tubs p 5eptic 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 : Rough for Final ?Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. 0 Approved CITY OF EAGAN 454-8100 Receipt MECHANICAL PERMIT Parmit No. CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Prinr legibly Tot. 1. Date 2. Installation Cost ? 3. Job Address Lot Blk. Tract 4. Owner 5. Cflntractor Phone 6. Address 7. City State Zip 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New JD Add ? Alter ? Repair ? 10. Describe Fuel Type 111. No. Equi ment BTU - M. Ea. Forced Air No. EQUipment CFM Mfg. Air Handling: Boilers Mfg, Mech. Exhaust Unit Heater Mfg. h O Air Cond. er t 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 Final •Inspections: Date Insp. Date Insp. This is your pertnit when numbered and approved. A.pproved _? ?CITY OF EAGAN 454-8100 Reoeipt PLUMBING PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Prinr legib/y Tot. 1. Date 2. Installation Cost 3. Job Address Lot 'I - Blk. Tract 4. Owner 5. Contractor Phone I 6. Address 7. City State Zip 8. Building Type: Residential Cl 9. Work Description: New 0 10. Describe Commercial ? Institutional O Add O Alter O Repair ? 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 : for Rough Final Inspections: Date Insp. Oate Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 ? Raceipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C Typs or Print legib/y Tot. 1. Date 2, Installation Cost 3. Job Address Lot Blk. Tract i 4. Owner ? 5. Contractor 6. Address 7. City State /k Zip 8. Building Type: Residential ? Commercial O Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 10. Describe Fuel Type 1 11. No. Equ'ipment 8TU - M. Ea. Forced Air No. Eouipment CFM Mfg. Air Handling: Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Oth Air Cand. er 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. 5igned: for Rough Final Mspections: Date Insp. Date Insp. This is your permit when numbered and approvad. 1?pproved CITY OF EAGAN 454-6100 Phone Receipt 1. Date MECHANICAL PERMIT Permit No. - ? CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print /egibly Tot. 2. Installation Cost Lot Blk. Tract 3. Job Address 4. Owner 5. Contractor 6. Address 7. City Phone 8. Building Type: Residential ? 8. Work Description: New El 1 10. Describe I 11. State Zip _ Commercial ? Institutional ? Add ? Alter O Repair O Fuel Type No. Equopment BTU - M. Ea. Forced Air No. Equipment CFM i Mfg. A r Handling: Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Oth Air Cond. er 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 Final Inspections: Date Insp. Date Insp. ? This is your permit when numbered and approved. Approved CITY OF EAGAN 454-6100 INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: . „ , I W.; r 1, 1 hNE I-N I PERMIT SUBTYPE: ? I I' '.'' l ] Ni. APPLICANT: ti1•91J4 TYPE OF WORK: F 1 NA1 ? nrtir krMI r1utrf ? 111rv .f . ? ? rns'? ?";?.' ? ?' a?. f s a '? . ?? : ?+t?x ``°?''. :.._i•? ., .. . .. ' . . . ' . . ? Parmlt No. Pertnit Holder Date Telephone M ELECTRIC PLUMBING HVAC Inspectlon Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLUG FINAL BSMT R.I. • BSMT FINAL DECK FTG DECK FINAL l?/? . T qV L7 !?i ?? EO-fy OF EAOAN WATER SERVICE PERMIT/ Pilot Knob Road PERMIT NO.: , MN $5122 DATE: No. of Units: ess: Address: No.: No.: to aomply wifh !he City of Eagon Connectian Charge: Account Depasit: Permit Fee: Surcharge: Misc. Charges: - Totof : Dote Poid: CITY OF EAGAN 3795 Pilot Knob Rood Eagon, MN 55122 Zoning: ? Owner; _ Address: Site Address: Plumber: PERMIT NO.: DATE: No. of Units: ; . , ? lc I agree to eaunply with the City of Eagan Ordinanees. By _ Dote of Insp.: I nsp.. CITY OF +EAGAN 3792 Pilot Knob Rood Eogan' r? N1N`?5122 Zoning: ; TTT _ , Ownes: ?{1saP? ?T^?^A^-? Address: Site Address: 4424 ^lgvC? Plumber: Meter No.: Size: Pl?-- ? Reoder No.: r 1 egroa to eomplr with the City of Eagon ' Oedi nces. . Date f Insp.: CITY OF EAGAN SEWER SERVICE PERMIT : 3795 P11ot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoninq: No. of Units: ; Owner: Address: P i Site Address: - ° ? i: Plumber: 1 agroe to eomplp wifh fhe City of Eagan Connection Chorge: Grdinunees. Account Deposit: , Permit Fee: Surcharge: By Misc. Charges: Dote of Insp.: Total: Insp.: . Date Poid: , ? Connection Charge: Account Deposit: _ Permit Fee: $urcharge: _ Misc. Chnrges: _ Totol: _ Date Paid: WATER SERVICE PERMIT PERMIT NO.: DATE; 1 ?12 /'' 1 ('i /" 1 } _ No. Of Units: ? ??'? ??7 ?dea Arldn - Connection Charge: _ Account Deposit; - Permit Fee: 1 n_(lrl ncl--- - Surchorge:• - 5f) Misc. Charges: ?fl nn nA r?e?tP: Total: - Date Paid: - Insp.: WA? ??? PBJPJT WATER SERVICE PERMIT 11?,1.?,4 / tGAN iM? ??R?NI7 N13.: 4 b Cnob Road PERMIT NQ.. f!1lS. ? T - DATE ; ? ?r.t ? ? . }• :? 65122 DATE: -?No. Of Unlbt No, of Units: : . ., ! L??31.f'.S? .'1 ` . _a , •'a _ . ? ' !;i ;-:er rC ..-?F n a r,? . .. - ;. : • r, . . . „ ? w_ ereHon Chof'0?: . ? .«?. Connection Charge: /?oeouMt Depait•1 trt Acwunt Deposit: ? ? Permit Fee: Psrrllit Fil: A ??dy ?? f?rO 5??: ??° ,.,?:Z c,:?,-- ly wifh fi?e City of Eagan Surchorge: ? Mhe. C]tor? Misc. Charges: T'ow; Total: poh PMiid: Dute Paid: ? f1f?J.• . . I nsp.: kI . OF EAGAN Piloi Y.nob Rood PERMIT NO.: , MN 55122 DATE: No. of Units: Address: - agree to eomply with t6e Ciiry of Eugon Dote of Insp.: Connection Charge: Account Deposit: _ Permit Fee: Surchorge: Misc. Chorges: - Totol: CITY OF r4GAN .l SEWER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: -- Eayan, MN 55122 DATE: Zoning: No. of Units: ` - - Owner. Address: " Site Address: - Plumber: - gree fo eomply wit6 Nhe City of Eagon Connectlon Charge: c dinanees. Account Deposit: Perrriit Fee: ' Surcharge: I Misc. Chorges: ote of Insp.: Total: : : Date Paid: sp. n' REQUEST FOR ELECTRICAL INSPECTION Ea-oooot-oo , See instructiona for completing thia fwm on back of yellow copy. "X? ?epo ? r o lred by This Request ? . Hall 1, the Ele ?c ir l Inspeclor, hereby , certify that the above (inspection has been mede. 7his reQuest vold 7?-' Z L) l? 18 mpnths irom ? G G .7?1J L -1IV 0$ 38n4 rhn ..? ? Request Date 7???,???? Fire No. Rough-in Inspection Requ?red? ` ?Ready Now]oWiii Notify Inspec- GZ? .--- 312Yes ? No tor When Ready ---?--- I hereby request inspection ot above ? OWnef electrirwl wn•I, i ..n-I Ie.l .. Street Address, Box or Route No. City 4484 B. IDL Clover Lase Fk4gan ection o. Township Name or No. Range o. County DQkOt& OccupantlPRINTI Phone No. Tilsen Homea Power Supplier Address DekOt&. Cty• FarmingtOII Electrical Contractor ICompany Name! Contractor's license No. O.B. Thompgon Eleatrfc Co. d40602 Mailing AdJress (Contractor or Owner Making Instailation) 12201 Mtka Blvd., Mtka 55343 Authorized Signa IContractor Ownor Maki Insta ti 1 F3k ? Pho u r ??-`??21 •- •. -_-n airait nUqhp VF ELEGTRICM r I r+is inSPEGTION REQUEST WILL NOT GriflBs-Midwey Bldg. - Room N-191 8E ACCEPTED BY THE STqTE BOARD 1821 University Ave., St. Peul, MN 66104 UNlESS PROPER INSPECTION FEE IS Phone 16121 297_21 11 ENC LOSEO. CITSt OF EAGAN 3nclude 2 sets,? of pldins, 1 site plan wje?ua?a & . F., BUIIDING PEFd1IIT APPLICATION T set of_ enex'9y ?1 ,-- t1on8+ ;, . Tp' Be Uee'd:FOr ? Site ;Pddz?ess U?('??p B CG(0? . rAt :/SS?u?-' _ Owtrer: fiLSe'?=`''? OA -s ,. _..,_----.- ?' ?-?=''-?.._a. c C •i??i. Valuation i)n Date t?° GY L.4ai? Ok'F'ICE USE ONLY • . , , ', ,t??? AN ? EY2Ct; q=*,aDCY" ; ,city%zip`COde: sr ?9u,l? Nt `NNIGrade Dept' , 64 e - r'Sa / Phorne APPRC7VrVS FM . Coritractor: Sa.?a Assessnents ermit •: J??? ` [?later/Sewer Surchar4e? ??.-- -AdBxess:, Police Plan CheckFire SAC ?. , . Ftater Ctarui.S, , Phexie #• ? ' Planner '4Tater Meter '- Coureil ? 7777-7-7-'Pbad Unit ' Arc3't /? ". Bldg. Off- APC Pdd:LESSX.: ' C3,ty/Z1P.,.?L',OC?C?:: '1CYPAT, Pharte #: ? tt CITSt OF FAGAN Include 2 sets of plaana. , tic?S 1 site plan w/el&a gUII,pTNGpET?IiT APPLICATI?1 i.ca0,-: ' set Of e.ner9YcaScul.at 1 • ?2b He Use& Fbr Valuation Date `. ?-2- 9 ? ? . ? site.Addxess CFFICE usE ONLY , s Lot 1--4 ':Block oZ ' See./Sub.' ' ea%OJ'F•seCt. ? Oc.cupancY =" - • Paroel # „Y?/? ??750 /% lJ " t?'? Alter ? Zwii'i4 ' Fire Zone." 7. En e e? ? 2ype of Const hbv N $tories `... drnss.,`, p,d Front , C?t7f/Zi{reade: S7' Au. it2 i niN SSl / b Grade ?' ?F? -. - Phortie Assessments . Perntit ?..,,. ContractOr: Sa en E Watax/Sewer Surcharge.: Addressi ?:: Police P,lan Check"? . - ? ?-02,? - fa.tY/Zip'Oode: Fire E?. ? Water Conp- ° , _ Pkwne Planner -=??,=, Watier Mefsr; Council Foad Unit Arch /k?6g ldq. Off- B ? , _ Addrese: 11, . Catl'/z? Pode: L, ! ?: - 'I Orl'A Phone #i x' -L : Irclwie" 2 sets ;of plana N CITSt (T E"C,AN - 7: sit2 •plvi.wle7evat?,'oc?s 6 ' ? « _ B[IILDING PE13+IIT APPLICATION _ ??tia? .,,' 15e? of, er?xq?! ,. 'lb Be. [JSad :For Valuatiori C) Dat,e .,.-- ^ t site rdciiess oFF'icE dsE aN%Y ? sec. Oqcupancv,._ ?..- : ? Zorurig Parael _#i T/ r Zpne =. . r . Fire .? ' - En].anle fA6 S NG. ? ' ?O -`- L ?? TYPe of Const. ` ' e l [ Q?12T . A S Move ? ? 3,., . # .J,tAL 1si ?BS.,:,?,,._.s .^ ?f • S „ $ .VGt?/NA DEmL191' l a 'F'L??11t th ''oZo2 ft..;, De ? c5.ty/zip', Code: ae cr sr ?164,,j du1,ny., P Phone Assessments ??Y, %?? Pesnat Fc u - Tdater/Sewer Surcharqe Police Plazi Chebk,- .; . . ` Fire , Sl? _ . . .- ; _ . ? S . Eng. ; Water Corni., ` o"5" Planner. Fiatei' Meter', "' 6 ? ----- Couttcil --.,; iao?d Unit, Bldg'. 'Off -7? APC . T02'AL . dt °?? . . f , .o . . . , . ? . . .._ ;_ ? . ?,? .. . . . . . A C ? ' . , . . , ; _ . Include 2 : sets af , plans , [?°?'- ? N EAG & 1 site plan w/eIevat.ions BC7TLDIl3G:'E?ERMIT APPLICATION. set Of enex9Y Cale1l?:Akl.ens., Tb Be tlsed, kbr Y Phs< Valu3t.i.0i7. Date S1te Addx?ess ;C?k'f1ICE USE ONLY Slock ; Sec d?, Erect Occupancy Parcel ? Alter gepair Zoning Fire ZorS . ? . ` ul e s 2w c- 4? J o ' ; ? LS? w Eh1arJe ? ' Type of Cbnst .. ' ? ?..; ?,, O rber Move Stories # Addregs Aanolish ! P'mnt ? 2i.P Cocle: ?S7'. - ?2ew.f,_L+2.1 niN_ _ ?SI /6 Gratle DePl ' Phone #: (o 0_ ?. AFPSK?7ATS ? ??. ? S ?ws?? a n . Contractor: [4ater/Sewer "Surchar9e.:. Hddress: Police P1an Qieck??p ' Fire EW City/Zio: t3vde: Eng, W1t,er` CAnsti 305?;, " ,s Phcme II?? . PlanneY .',Wdt,cY Mete?' Iaoa?J ? Uni? il C rc3r,? pi 71dg ? e ss : Caty/Zip `Cade o ` ?PAL . Phone #s r ,ms ,,-cre::t ?old jp//(n i/3? v Cl0, a 0 18 mcnths from 7 67549 9< --7 0- 1 Raquest Clute ' Firt) No. Rnu?P-in InsUeriinn PeGurteJ? E]Aeatly Now R)Vill Nolily Inspec 10-13-1981 }(E ves ?rv io. wnen auadv 7a Licensed rlechiml Conva(ior I herebv reouest .nsVecbun o1 above ? OwnE.r elucincal work nie[nlled a1 Slreet Address, Bna nr Route No. Citv 4484 B Clover Lane Eagan rmmo o. Townvhin Name ue Nn. Hanyo Nn. Co niy Dakota Occuuac> 1PRINT) Phone Nn. Tilsen Homea Power SuUVI ier Atldress Da.kota Cty, Farmington Elacbical Contraetm ?COmpanY Narno) Conkac?nr's I ieense No O.B, Thompaon ElectricCo. 9?}0602 Mniline AdJre.ss (COntracmr or Owner MTkmu InstaJanon) 12201 Mt Blvd„ Mtka 55343 Authonzed Sip _ u?(Convactodpl My? l In, la 'n) Phone Nwnber ?/'/??, J3?_2F'7 MINNESOTq STATE 90ARO OF ELECTRICITY d THIS INSPECTION REQUEST WILL NOT Griggs-MiAwqy Bldg. - floom N-191 BE ACCEPTED 8V THE STATE 80ARD 1821 Universrty Avx., St Paul, MN 55104 UNLESS PROPEH INSPECTION FEE IS Phone 16121 297-2111 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION ?W Ee-ooooi-ea ? , See mstrur.4or18 Im cnmoiebng (his form un back ol vellow copv 'r ? 7549 ' y "X" Below Work Covered by Thrs Request Nnw Aau iep. Tvue oi Bwi?iinj Apoliances wired Equinment Wvee Home Range e00 Temporary Seivice Duplex Water Heatei ICX Lighting Fixtures APt. 8uiidin11 Dryer Electnc HeaLn Cominr;raal Bld( Fumace Qo Q Silo Unloadm Industtial eldy Au Con(lrtionor Bulk MilkTenl< Farm UI v ? nihhv ISUerilv) Othor ISUeci(Y OdM1[, Olhrr, ', inupuie rnauecuun ree veiow r Fee ServocaEntranceSize N Fee Feedc.rs/SuAfeetlers N Feo Cv urts 10 IICi 10 ?Qo 100 Am is 0 to 30 Am n 17o50 0 tn 30 !am >s 101 to 200 F?mps 31 tn 100 qmp5 31 to 100 Am _ Above 200 Amps Above 100_Amps e Above 100_Amps TransWr{nst Remote Control Qrc. Parb21. Other 'Signs? i1 Special Inspection $4 0 50 Re, ?(?3 7 1 1 ° \ 1, ,_l Re„ - TOTAL FE /fQ.OQ flungh?in 'u Dnte 1 thn Eleclncal II?C , l.Li•F-•-.??v?,?`*? (I Y , Insuuctor,heieby ?????? D . I'l cerli7y that thx nbove - ` ? ec4an has been n15 lepUE'.Gl VOIp ?8lliflolh5 f1IIIII I ?rs ,e4uest vo,d?ql!(v C?? , g?? ?? ??lo, a p ?e „xsh7'S°4s ?Z -7 R ?-r R-qurs[ !]ute - Frq No. Hnuqb-in InHper?inn .????????8? Ryepgu ed' DReatlY Nnw.]0Will Nr.v(y Invpoi- -C{Y, ?N 1 Wh R,.dY T ' I hereby requeso insVection ui abuve ? Owner electrical wark insalled at: Sirecc Addiess, 8oz m pnuie Nn. ?o' 448 Clover I.ane - -- Eagan ". 1 11on " Township Name nr Nn HInqr Nu. - County - Dakota Occupant IPRINT) Phone No. Tilsen Homes Powcr SunVlier ndAress Dakota Cty, Electric Farmington Elrctnczl Cnnnactor iCOmpany Ntunol Cnnh.ictor's License No O.B. Thompeon Electric Co. . A40602 Maiiing AdJrrss (COntra?tor or pwner Makro? In;ra;iauonf 12201 M#doL Blvd. Mtka 5 3 Aothnrved S, Fa[yre (Convacior/Owner Iiiny In rII ion7 s n ?? ? ?' r PhonP Numb¢r ?q C^} 4 ?? G •r4,.?=::? d - /^s?;;^?J?J ?? ?161 c oUwnU vnuteixlelTy V l?ns uvsreciiUN aEQUEST WILL NOT Griggs-Midwoy 8ldg. - Noom N-191 BE ACCEPTEO 9Y THE STqTE BOARD 1821 UniversityAve., St. Paul, MN 55104 UNLESS PNOPEN INSPECTION FEE IS Phone (612) 297-2111 ENCLOSED. p ? REQUEST FOR ELECTRICAL INSPECTION es-oooai-oa /? See instruchons fnr cnmpletiny this fonn on back ot vellow r.npy. -7 ?5 'T tJ { "X' Be/ow Work Cnvered Gv This Renuesl .--) -7 e Atltl fleu. Tyne af ewldin9 AUPliances Wvetl Equqnnent WireA HO1°e Aiiiye ? Temporary Service Duplex Water Heater g Liyh6ny Fixtwes llpt Building D ryer Electric HeaLn Commercial Bldy Fumace , Silo Untoadei InduSLial Bldy. qir CondiLOnei Rulk Milk Tank Fa fm Othrr Sormfvl y Olh er SOUt:?I? ?e oQ0 Officr Lltl nthe, ISD??rifvl Olhrr hanceS¢e L Fee Fee.ders/SabteeAers H Fce C u mis Am )s 0 to 30 Am ?s 0[n 0 Ant s m 0 Amps 31 co 100 /?mps 31 to 1Arn es D qmPs Abnve 100-Amps Aboe 10_Amps ers Remore Control Grc. U Partial Otfi • gris `? Speaal Inspection 90 Runiarks ?.•? S 40• TOTAL FE Y \\` \ ? 1 Nuu9h-m v ? ? ( Uatc (. I, the Electncal ? fInspectar, hereAy Finnl ?? ? cer.ify thac the Tbove .necbon has been maAe. Tlns reai?est voin itt ililanths hom This request void -7`? 5 a t?i ?? V`w ?q s 18 rtqnlhs from /? Q Q nnnfl-4Q ?7 q? vu vv v..f- ? Revuest Dale Fire No. RouPh-m Inspecuon Requ red? ?RcaAy Nnw3gWi11 NovfY Inspec- 7 ri iQA3 Myes ?NO «or When Readv EXLmenseA Elec[ncal ConVactof I M1ereby repaesr uus?e.:--.. -. ----- ? Owner alechicnl work installad at. Gtv SVeet Address, eox or Foute No. ¢484 Clover Lane ?gan ecUOn o. Township Name or No. ?RanUi No. Cnunty Dakota Phone No OcWpnnt IYHIrvI? Tilsen Homes Power Sup0lier Atldress Bakota Cty. Farmington ' Elec[ncal Convactor (Company Name) S License No. Contrecme O.B. Thompson Electric Co. A40602 Madinp AdJress ICOmractor or Owner Makmg Instatlationl 12201 A4tka Blva., Mtica 55343 re IConvactor?Owner M?kin InyFnl?vonl Authonied Si?l? a.? MINNESOTA SAYTE BDAND OF ELECTNICITY G,iggs-Midway Blde• - poom N•191 7821 UniversilV Ave., St. Paul. MN 55104 Phnnw (612) 297-2111 ..x.. 1 THIS INSPECTION NEQUEST WILI NOT BE ACCEPTED BY THE STAiE eOARD UNLESS PNOPEN INSPECTION FEE IS ENCLOSEO. « Eg-OOOU1-04 REQUEST FOR ELECTRICAL INSPECTION ,. ' See insiructm?s for campleLne this l°rm on back o? Vellow covV• w Work overed by 7his Request Eq?„pme„c wi.ea This re,ur<[ vniA ?,.. ,s r?o ,» ? ?,? 7?, ??f1 Re,uest Date Nre No. iR toqq?fe??lnsuectmn ?He?dy Now?'??I Nnldy Insueo ^?(?-13-190'? 1 ?'?:c ?No LurWhenResitlY Muyr,:ensotl Elec111cal CunLractur 1 heraby ?aquqsl inspection ol abova n Own.r elnctnenl work in5talled et. Siieet Adifrass, Boa or Houte No. Cny 4486 Clover Lane Ea8sn ecuon n Township Name or No. Range No. GouniY Dakota OccuU????t IPflINTI Phone Nn. Tilsen $omes Power Supplier Address Dakota Cty. Earmington ' Electncal ConVactur IGompany Neme1 a License No. Conhactor O.B. Thom son Electric Co. 0602 M.uline QciJress ICOnVar.tor or Owner M;ikin9 Installahonl 12201 Blvda9 Mtka 55343 Author¢ed Si a rp(Co?n.?ua`cto?r/O,w"ner ? r ing I tal ion) ! ??? ^Pho?nje Number .73s7^2F2 1 vrv v,ar MINNESOTA STATE BOAflO OF ELECTRICITV w ?Hi5 ?Nyreeiwrv neuvw? wu, rv?i GrigBS-Midway Blde. - paom N491 BE ACCEPTEO 9Y THE STATE BOAHD 1827 UniversilV AyA., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 297-2111 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION ,?•„ es-ooooi.oa 4 r? )5 5 ?1' See i structions lor rompletin9-this torm on hack of yellow copv. (3 / •,X.. Rn!n. n? 61/nik?Givo,-cd hv 7his Renueil N¢w Add R¢p. TyVe nl BOIId?n9 APVIidnCeS Wi?ed Eryuipme?+t Wired Horna Rango Tempoiary Service Duplex Water Heater Liphnn? Fixtures Apt Bwlclin? Diyer EIectno Heabn Cronrneicial Bldg. Fumace 2.50 Silo Unlnader Indusbial Bldg Air Condiiioner gulk Milk Tank Faim o?n u oin?:? iSne?if vl Ot,e? lsyeciiy Othei Otnor ...,.. .?........... (ee r..__._... _' __._.. ServiceEnVaneeSiza H Fee Feaders/Subfeedere rt Fee Cvcu ?0 (} 1 ? to 100 Am >s 0 to 30 Am u 1 ? 0 to 30 Am ?s 101 ta 200 qmps 31 to 10D Amps 31 m 100 Am s Above'L00 Amps A6ave 100-AmPs />bove 100_????PS Transiormers "-.\ Remote Con[rol Grc. .50 Partial-'Othei Fe Sicns , ' Specialinspecunn s 0 o TOTAL FE LfQ. F k 4 5 e ci?ini s ,U? V ? n tl ll , the Electncal Inspectoq hereby cervty that the nbuve Fln:il 1?P J Uection I1d5 hBen lhis request void iy mnnths hum CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: DESCRIPTION: B PERMIT PERMIT TYPE: Permit Number: Date Issued: 4486-B CLOVER LANE L07: 15 BLOCK: 2 EDEN i" Permit Type i nqy_rk Type ?. ? . d ?- REMARKS: FEE SUMMARY: Base Fee $45.00 Surcharge $.50 Total Fee $45.50 DECK RDDITION 434 ALT. RESIDENTIAL BUILDING 028799 09J27J96 .XK:?( M>}:`k.%l.k:??k?%K?(){:?'(?>k 'M7k?:1?ktX<YFY,S?'(PF?)K1Xh"?YnX.#?,t?YX6< C:I'TY (li' EA. rAN 0 TI-.RM7:NFl1._ NiJ. 91. LICtTf-.: 09/27/96 T7.NIE.: 14 L'Ei3701 T:O: NAMl'_'„ KA'1'I-IEf,1:Nl:" A GIe.4"^IIFlFtT .3,,.10 9001 4486P CI..OV.F..Ft I_N 45.00 21°;°S 9001 440h:,A CI...QUEh LN 0.50 Tcrtr:l 6'Frcaipt Aniount r 45.50 CRCIf,579(3 Us:r•: Tn;; nANr.v :%7X?'F?'F.A'."',..XY?YFXiI?(Jk%K?**i ?1k1K>k?n7k?>k'M?t?1k??'M7k?3k??F7k?XC CONTRACTOR: OWNER: - Applicant - GEPHART KATWERINE 4486-B CLOVER LN EA6AN MN 55122 (612)681-9174 ? hereby acknow Statu es an,a Ci -- i??eµ? yth?ktY?y I ha??+ye, r0,iOdL?s:,?y Nth??,karpp?y{IAf?-i??*ayty- Y y W? V II'f y W l.l .. Eadarn OYclinan6ks: ?..... _.?_. ... ?.._..__ _ .. a _._?? ?, _ ,?- GNATURE ISSUED BY SIG ATUR CITY OF EAGAN 3830 PILOT KNOB RD - 55122 iqq 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) , . it 681-4675 ?;' ,,? • ? '?- r ? J .?. 7 ii Reoulremen ? 3 regislered site surveys ? 2 copies oi plan ? 2 copies ot plana (inGude beam 6 window sizes; Doured fid. design; ele.) ? 2 site surveys (exterior additions & decks) ? 7 energy oalculations ? 1 energy calculations (or heated addilions ? 3 copies ol tree preservation plan N lot platted eRer 711l93 required: _ Ves No CYO DATE: -777I/" CONSTRUCTION COST: ? f o DESCRIPTION OF WORK: STREET ADDRESS: I % TL - '06 LOT ? SUBD./P.I.D. #: %,V ' 4,44 -&/ - Z1 PROPERTY Name:??r/Z/rJf Phon FRI' 12'L ?t? ' y owNER StreetAddr?? ? ' D S?g City: ? State: /I) Zip: one CoNTrv+C7oR Company: `SUt ' Street Address: License #: City: State: Zip:? ARCHITECTf Company: Phone #: ENGINEER Name: Registration #: Street Address•_.-__..-. City: State: Zip: Sewer 8 water licensed plumber: change are requested once permft is issued. I hereby acknowledge that I have read this application and state that the 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 Penalty applies when address change and lol atio is orrect and gfee to comply with all ? ??C WED SEP Q 4 M6 --------------- C7j:Y OF EAGAN 3830 PIIAT KNOB ROAD EAGAN, ?IN 55122 PHONE: (612) 454-8100 fS ? C 1?N S? P.Y:, ; Y?;R?3 ? T 1& OF CONTRACT FEE. STATE SURCHARGE _ $.50 FOR EACH $1,000 OF PERMIT FEE. PROCESSED PIPING - $25.00 $25.00 MINIMUM FEE. "SIDE. PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WNEN PERMITS ARE REQUIRED FOR EACH IINIT. -------------- WORK DESCRIPTION NEW CONST _ ADD ON k REPAIR _ OWNER NAME: -IW-6 jQ.YYc? SITE ADDRESS: A44?4 ? ?fU"4- LOT: ,f _?_o BLOCK O SUBD. MW INSTALLER: AIR CONDITIONING INC. ADDRESS: BLOOMINGTON, MN 55420 CITY: ZIP: PHONE #: ?SU'355? CONTRACT PRICE x 18 GOMMERGIAL(TNDU$TRTAT.:; PLEASE COMPLETE THIS PORTION FOR ALL C0MASERCIAL/INDUSTRZAL SUILDINGS, APARTMENT SUILDINGS, 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: PHONE #: STATE SURCHARGE TOTAL: FOR CITY USE ONLY PERMIT # RECEIPT #-'160o",55 DATE: ADD-ON MINIMUM HVAC 0-100 M BTU ADDITIONAL 50 M BTU GAS DUTLETS - MINIMUM OF 1 PER PERMIT SUBTOTAL: STATE SURCHARGE: $15.00 24.00 6.00 3.00 $ ?-- 6, - .50 TOTAL: $ ? (S 's-v b/-bbtitsb.ln ??a? SIGNATUREOFER?fITTEE $ (SIGNATURE) ZIP: FEES FEES ? FOR: CITY OF EAGAN L/0 gL ? CITY USE ONLY RECEIPT #: SUBD. ?? RECEIPT DATE: z 1998 PLUMING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PIIAT IINOB RD EAGAN, t+AI 55122 (612) 681-4675 Please complete for. ? single family dweilings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system - ------------ ------ FIXTURES -???_?-__- EACH # TOTAL Shower 3.00 x = Water Closet 3.00 x = Bath Tub 3.00 x = Lavatory 3.00 x = Kitchen Sink 3.00 x = Laundry Tray 3.00 x = Hot Tu6lS a 3.00 x = - ater eater 3.00 T = x Floor rein 3.00 x = Gas Piping Outlet ' minimum - 1 3.00 x = Rough Openings 1.50 x = Water Softener ' for dwellings under construction 5.00 x = Water Softener ` for existing dwelling 20.00 x = U.G. Sprinkler ' for dwetling under const. 3.00 = U.G. Sprinkler `forexistingdwelling 20.00 = Aiterations ' to existing residence 20.00 = Water Turn Around 20.00 = Private Disposal System ' MPC iic. 75.00 = (new and refurbished systems) Private Disposal Systems' nbandonment 20.00 = STATE SURCHARGE .50 TOTAL i - - - - -- I hereby acknowledge that I have read this epplica6on, state that the inforrnetion is correct, and agree to comply Nrith all applicable City of Eagan ordinances. tt is the applieanYs responsibility to notify the property owner that the City of Eagan assumes no liability for eny damages caused by the City during its nortnal opera6onal and maintenance activities to the facilities conshuded under this permit within City propertylrightwf-weyleasement. SITE ADDRESS: `?` V& e4 o v,6?- L,,?/ OWNER NAME: ORE•?T ?/CI?O INSTALLERNAME: TELEPHONE#: STREETADDRESS: CITY; ve" 77l STATE: ?//•? ZIP: SIGNATURE OF JS/FORMS BLDG/PLBG PERMIT (RESIDENTIAL) 1998 2004 RESIDENTIAL MECHANICAL PERNiIT 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 Date_3L__ Site Address Uni[ # Property Owner Telephone # ( ?,?/) yS ? - ??OU? Contractor Bumsville Heating Street Address 12481 Rhode Island Ave. So. C;ty Savage, Zi Tele hone# (?SZ)??'/`7 V?'? p State p 16 U(A:?507` E i 6 U 7 res: ap Bond #: The Applicant is _ Owner ? Contractor _ Other Add-on or alteration to eaisting dwelling unit $ 30.00 ? furnace _Additional ?Replacement air exchanger New ?Replacement >c? air con itioner ?/ ? ? other ?,U?j"?./ 1?l?? State Surcharge $ .50 ' $ To[al i hereby apply for a Residenrial Mechanical Permit and aclmowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a pernut, but only an application for a perrrilt, and work is not to start wit6out a pernat; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plar&j _ 612,7(2. &c,sn6 ??n& AO.D??l??L?.r . ? Applicant's Printed Name Applicant's Signature ,59-l?q PLUMBING (RESIDENTIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone 9 651-675-5675 FAX # 651-675-5674 Please complete for: Single Family Dwellings Townhomes and Condos when pemuts aze required for each unit $IS-,?z Date Site Address 44M ,p Vt.i/ Zic.l2z Unit # PropertyOwner Hu(Lhlrls6Y1 ,J'e4 Telephone#(GS2) 423- IOZc1 Contractor P. r I Ff?VVD1( J?S Address .3u7 o City ('') State 1Vl,lv Zip Telephone# The Applicant is _ Owaer ? Contractor _ Other Septic System New _ Refurbished Submit 2 sefs of plans and MPC license $ 100.00 InGudes Counly fee. Additional consultaM fees may apply. Alterations To Eaisting Dwelling Unit, Including $ 50.D0 _ Adding fxtures to lower levels or room additions, excluding water softener and water heater _ Abandonment of septic system " ? L? Water tumaround (+ 5/8 meter if needed -$121.00) P = Other: Q?, r ? _ RPZ _ new installation _ repair _ rebuild BY 30.00 _ Lawn irrigation system _ Water softener L Water heater $ 15.00 X replacement _ additional State Surcharge $ .50 Total $ I hereby apply for a Residential Plumhing Pemvt and aclmowledge that the information is complete and accurate; that the work will be in confonnance with ffie ordinances and codes of the City of Eagan and with the Plumbing Codes; that I understand tlus is not a permit, but only an applicauon 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 p?. ? J Z (Se. ?D flC? ?,? r? l?-f Applicant's Printed Name Ap icanYs Signature 4 s?s/ 2004 RESIDENTIAL MECHA1vICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephoue # 651-675-5675 Please complete for. single family dwellings & townhomes/condos when permits are required for each unit naee J? ?? I/( l 6 `1 Site Address / 7 v-,e'r Unit # Property Owner So n Telephone #( y a 3-7(a IT Contractor ?q??eJ L?P %/{'a t • n S ? .? %r TA C . StreetAddress c ?dy.qV?C'W Gh • City S[ate ? ?? Zip Telephone # Bond k: Expires: C ontractor _ The Applicant is _ Owner _,Z Other Add-on or alteration to existing dwelling unit $ 30.00 4 furnace _Additional _Repiacement air exchanger _ air conditioner _New XReplacement other State Surcharge $ .50 ? $ Total ? EjUL i? ?A4 4 ?!I , I hereby apply for a Residen6al Mechanical Pemvt and acknowledge that the informa ' is complete and acc that the work will be in con£ormance with the ordinances and codes of the City of Eagan and with the 3s 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. ApplicanYs Printed Name App icant's Signature 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 ??0 a:) New Construction Reauirements RemodeVReoair Reauirements Office Use Onlv 3 registered srte surveys showing sq. R. of lol, sq. ft. of house; and all roofed areas 2 copies of plan Cert of Survey Recd _ Y_ N (20% maximum lot coverage ailaxed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd _ Y_ N, 2 copies of plan shawing beam 8 window sizes; poured found desgn, etc. 1 site survey far add'Aions 8 decks Tree Pres Required _ Y_ N isetofEneigyCalculations Adddton - indicafeifon-silesepticsysfem On-siteSaplic System _Y _N 3 apies of Tree P2servation Plan 'rf Iot plaped afler 7/1193 Rim Joist Detail Options selection sheet (buildings wilh 3 or less units) n9l /4? / ? Date ?? % UO ConstructionCost SiteAddress ?l?fRfp ??/?/? ,?,,,, - ( / ..?t?u'- A, /3 7 aw ?ff C?X-Snit/Ste # Description of Work 1'?0 d? i6h Q Multi-Family Bldg _ Y_ N Fireplace(s) 1 _ 2 Property Owner Telephone # ( tµ? ? ) ? • ?? d Contractor Q Address ?555r] City State M Zip TelepNone#(?$? COMPLETE THIS AREA ONLY IF Energy Code Category - Minnesota Rules 7670 Cateeorv 1 _ • Residential Ventilation Category 1 Worksheet (J submission type) Submitted • Energy Envelope Calculations Submitted A NEW BUILDING Minnesota Rules 7672 . New Energy Code Worksheet Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N fee applies. Licensed Plumber Telephone #( Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( If so, 25% plan review 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, 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-revi,1 ? lew7wdj approval of plans. ? Uo 2 J ?e05 .? Applic Ys Printed Name Applicant's gnature ?. _ - :7S 3 3 4 200 ? 1983RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 4T -?-a.aa New ConsWctron Re wrements 3 registered site surveys showing sq ft of lot, sq, N of house, and all wofed areas RemodelfReoair Reamremenis 2 copies of plan Office tke bnlu CedvdSurveyRecd" R d _.,Y __LN Y I4 (20% maximum lot coverage allowed) 1 set of Energy Calculaiions for heated addiUOns ec TreePcpS PISn ired Trae Pres ftequ , _ _ N _Y- " 2 capies of plan showing beam &windv++ saes, poured found design, etc 1 site survey for adihons & decks Additron - indicate it on-site septic sysfem . Dh-Sils BePtiCraptem . .,. -Y _ N i set of Energy Calculalions 3 copies of Tree Preservaiion Plan if loi platled afler 711/93 Rim Joist DetaA Op4ons selechon sheet (bmldings with 3or less units) Date 9 1 cp0_1 Construction Cost a?' -QU SiteAddress /4qgl o UQ.1- Ltl Unit/Ste # Description of Work 3 !?j- 1 q + Multi-FamilyBidg V YJ? N Fireplace(s)>C o _ 1 _ 2 Ma 5 qJ(?o jo-An 5 0t'1 Telephone # (6S t) Property Owner r? p'ioJ V?.Vj( a s: jVj?,•,,)S f-no..4,4A Contractor ' ? W-5 ?s9 s'ty 'lUIqlIi2.l.J --?T- ( L '? Address ?? ? St t . , f ?L Zip Telephone#(bVI) ad,3-06?r a e L;L? 202 821oS COMPLETE THIS AREA ONLY IP CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 _ ?esota Rules 7672 Energy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted . Energy Emelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. p ECERU2 IS n Licensed Plumber ns ?lephone #( ? Mechanical Contractor Telephone # ( Sewer/Water Contractor 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, 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 he--o? 6 Applicant's Signatur 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax:(651)6T5-5694 ?________________i I EppOff?e Use j Permit#: ?'7n71f ? j I Pertnit Fee: 9° . e0 ? I ? ? Date Received: y a? j I Staff: 1 i 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Li -?D -Q? Site Address: Tenant: i,k y-r) Suite #: RESIDENT / OWNER Q l LI Jyv- 12 Phone: Name: Vi (Q ? ` AAI?MM-- 551 1Z Address ! Cdy / Zip: 9(3 ? . Applicant is. _ Owner -)L- Contractor TYPE OF WORK Description of work: I('A ?C??l Lt??! „ . Construction Cost: Multi-Family Building: (Yes No ? CONTRACTOR Name: ?Ar1 C License c_JL.C.JV/? Address: lX 1aq ? I C?1 ? 0`k\r(2_ City: f? Qy\ State: 4bL Zip: p - ?- w? ' I r, /?',/ Phone: ?y?J???.?1 `?Y??U'ContactPerson:?? tizA COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submiried (4 submission typB) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a pertnit 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: NOTE: Plana and sripporting do"cuinents that. you submit are considered to be public information._ Portions of the information may be classified'as non-p'ublic if you provide specific reasons that would permit the City to ' concluife thaf 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 pertnit, but only an application for a permit, and work is not to start without a parmR; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. xS??,??n?t`?? ??- ApplicanYs Printed Name ,4ht's Signature Appjic Page 1 of 3 ? ? FuiOHicellser _________ ? City of Ea??Il I Permitli: v J I? j ? Permit Fee: 3830 Pilot Knob Road Eag8I1 MN 55122 j Date Received: j Phone: (651) 6755675 ? Fax: (651) 675-5694 j Staff: 2008 RESIDENTIAL BUILDING PERMIT APPLICA ?UG o 5 2008 Date: 7-30' 0'/ Site Address: ?-d" 4181 CI/OU e4" LN 1 ? Tenant: Sulte RESIDENT I OWNER Name: 5t? 41n Q a'+%darS C?.-?C, K- afo Phone: Address ! City / Zip: Applicant is: _ Ovmer X__ Contractw TYPE OF WORK i i Description of work: Q¢-6_1d Construction Cost: 2/ Multi-Family Building: (Yes I"C / No ? -'`Ovnc ?Q(W2/nWri/s Li ense237 QJ??IS CONTRACTOR c 1 Name: ?/?/ 1 V Address: Jy 8Y r`' Y b ?1 ' ? City: ?ln?/h i/'K nl^-? State: m'? Zip: U?`J ,5 . Phone:+ct7?-?`Zi?v- 3Y0xontactPerson: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 Energy Code . ResidenGal Ventilatlon Category 1 Worksheet • New Energy Code Worksheet CatCJory Su6mitled Submitted (4 SubmisSlOn typ9) • Energy Envelope Calculations Su6mitted In the last 12 months, has the City of Eagan issued a permlt for e similar plan based on a marter plan? Yes No It 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 (nfom+atlon. Portfons.ot the lnformatlnn may be classfifed as non-publlc If you provide specffic reasons that would permit the C(ty fo conclude ihat the are trdde secrets. I hereby adcnowledge that this information is complete and accure[e; that the woik will be in conformance wiM llie ordinances and codes ot Me Ciry of Eagan; that I understand this is not a pertnit, but only an application for a permd, and work is not to start withoul a permd; that the wak will be in accordance wilh the approved plan in the case of work which requires e review ard approvala An? X .fl J&Pt? X ApplicanYs Prlnted Name ApPlicant's Signature Page 1 of 3 . DO NOT WRITE BELOW THIS LINE SUB TYPES ? Foundation ? OS•plex ? 76-plex 0 Accessory Bullding ? Pool ? Single Family ? 06-plex ? Fireplace ? Porch (3-season) ? Ext. Alt. - Multi O 01 of _ Plex ? 07-plex ? Garage 0 Porch (4-season) ? Ext. Alt. - SF ? 02-Plex ? OB-plex ')RT Deck ? Porch (screeNgazebolpergola) ? Multi Misc. ? 03-Plex ? 10-plex ? Lower Level ? Storm Damage ? 04-Plex ? 72-plex ? Miscellaneous WORK TYPES ? New ? Interior Improvement ? Siding ? Demolish Building" ? Addition ? Move Bui tding ? Reroof ? Demolish Interior ? Alteration ? Fire Repair ? Windows ? Demolish Foundation ? Replacement ? Egress Window ? Water Damage ' Demolition (enfire building) - give PCA handout to applicant DESCRIPTION: Valuation Occupancy MCES System Plan Review Code Edition SAC Units (25%_ 100% Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Const. ? Width REQUIRED INSPECTIONS Footings (new bldg) ? Footings (deck) Footings (addition) Foundation Drain Tile Roof: Ice & Water Final Framing Fireplace:_R.I. _AirTest _Final Insulation Reviewed By: L? Sheetrock Meter Size: Final/C.O. ? FinalfNo C.O. HVAC Other: Pool: _Footings _Air/Gas Tests _Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wall Building Inspector RESIDENTIAL FEES: Base Fee Surcharge Plan Review MCIES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies Total t,A w(_ u 5! 00 L) Page 2 of 3 Dakota County Real Estate Inquiry < Page 1 of 1 ? q{? ?q ? q q4 r- ?ou? ?O, Dakota County Real Estate Inquiry oem uvaatea 712412008. Need Help? WhaYs New? Map navigation Select option and click on map: Zoom In Zoom Out Pan Identify EIEF? Show Full County Map Small Map Legend Real, Estate Parcels El Parcets E3 Common. Dmnership Mtltlater IR RlWf, Easemem ?OedicatM RNV Tax Parcels Market Value Recent Sales Year Built Air Photo Torrens Refresh Map r?eGISUre h,niJ?S A- - io' P- ?1"g= Choose ONE search meMotl, enter criteria, and dldc Go or hit enter key. House #: Go OR PIN: Go http:/lgis.co.dakota.mn.us/scripts/esrimap.dll?Name--webq 1 &Left=531383.630139583&Bottom=217765 3... 8/5/2008 PLEASE READ DISCLAIMER This apDlication was developed by Ne Dakota Caunry Office of GIS in cooperation with Assessing Services and the Property Taxation & Records Departmenis \) u u n, Gidc on ihe Dakola County Logo above to reWm to the home page City of ?apIl 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax:(651)675-5694 oS•eC6 C' CL ------------------ ? Frn UFtice Use I ; Perm,t#: , ? ? Pertnit Fee: ? Date Received: j i I StaB: I ?---- - ---------? 2008 RESIDENTIAL BUILDING PERMIT APPLICA7OWuG o 5 2008 Date: 7-30' a'/ Site Address: Wb 6 d"' e U PA' L N ;.. _ ?sa _---- Tenant: RESIDENT / OWNER Name: LGP.d A/n e Q.s3' 1JerS Phone: Address / Clty / Zip: Applicant Is: _ Owner X_ Contractor TYPE OF WORK Description of wark: e-6,)J 'G'l2' Construc6on Cost: 2/ Mu1ti-Family Building: (Yes No ? I CONTRACTOR Name: VJb6Pi'S OOraQ ?ipWejntvrO? License#:?00097J7 Address: ?`Y ciry: ?ni 1,ns 4&J sute: A'JN- ziP: Phone: 5ctv- ?` Zw- WZ 3Contact Person: 644-4- 1kJb" COMPLETE THIS AREA ONLY iF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 Energy CodB . Residential Ventilatlon Category 1 Worksheet • New Energy Code Worksheet CetBgOry Submitted Submitted (4 BUbmisslOn typB) • Energy Errvelope Calculations Submitted In the last 12 moMhs, has the City of Eagen issued a permlt for a similar plen based on a mes[er plan7 _Yes _NO If yes, date and address of master plan: Llcensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water ConVactor: Phone: NO7E: Pfans and supporHng documer+ts that you su6mit are consldered to be public lnformaUon. Portions af the InformaNon may be classl/Jed as non-publlc H you provlde speclBc reasons that would pertnlt the Clry to conclude that the are trade secrets. I hereby acknovAedge that this infamation is complete arM accura[e; that the work will be in conformance wiih the ordinanoes and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permR, and work is not to sWrt without a permit; that Me work will be in accordance xnth the approved plan in fhe case of work which requires a review and approval of plan. X X AppllcanYs Printed Name ApplicaM's Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES ? Foundation ? 05-plex ? Single Family ? 06-plex ? Ot of _ Plex ? 07-plex ? 02-Plex ? 08-plex ? 03-Plex ? 70-plex ? 04-Plex ? 12-plex ? 76-plex ? Fireplace ? Garage x- Deck ? Lower Level ? Accessory Building ? Porch (3-season) ? Porch(4-season) ? Porch (screan/gazebo/pergola) 0 Storm Damage ? Miscellaneous ? Pool ? Ext. Alt. - Multi ? Ext. Alt. - SF ? Multi Misc. WORK TYPES O New ? Interior Improvement ? Addition ? Move Building ? Alteration ? Fire Repair )9- Replacement DESCRIPTION: wo Valuation Occupancy Plan Review Code Edition (25%_100% Zoning Census Code Stories # of Units Square Feet # of Buildings Length .? Type of Const. T V a? Width REQUIRED INSPECTIONS Footings (new bldg) y Footings (deck) Footings (additlon) Foundation Drain Tile Roof: Ice 8 Water Final Framing Fireplace:_R.I. _AirTest _Final Insulation Reviewed By: ? Siding ? Demolish Building` ? Reroof ? Demolish Interior ? Windows ? Demolish Foundation ? Egress Window ? Water Damage . ' Demolition (entire building) - give PCA handout to applicant MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Sheetrock MeterSize: FinaI/C.O. ? Final/No C.O. HVAC Other: Pool: _Footings _AidGas Tests _Final Siding: _Stucco Lath . _Stone Lath _Brick Windows Retaining Wall Building Inspector RESIDENTIAL FEES: Base Fee Surcharge Plan Review MCIES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies Total ??c 7, ?) 4P d Page 2 of 3 ------------------ ??? ? ; PermR#: ? Pannft Faa: a 73 ? ? Date Receivad: ?? v 1 I ? C. I I Staff: / I ---------------- 2008 RESIDENTIAL BUILDING Date: 0 -O 1? Site Address: Tenant: Suite #: i(..Iv Ph RESIDENT/OWNER one: Name: Address ! Gty / Zip: Applicant is: _ Owner ? Conhacta TYPE OP WORK Description of work ( 2 Construction Cost: I - Cl0 Muttl-Famity 8uilding: (Yesx_ / No CONTRAC70R Name:,Ai&Q`5 tkMp, ?',?rAf[)tJN,?a')8&l7"s License u ZO ?7f ??37 Address: /Y IlY `z?A `µ S'7': W• City: ,r4flr! ?/W 7aj State: M?!? Zip: Phone: 45-' i`Y d- 3Y Z,3 Contact Person: C06?? a) 4 9K COMPLETE THIS AREA ONLY IF CONSTRUCTIN,G A NEW BUIlDlNG Minnesota Rules 7670 Cateaorv 1 Mionesota Rules 7672 Enargy Code . Residential VeMila6on Category i Worksheet • New Energy Code Wakshset Category suw„med s„mnrtced (d eubmisslon typB) • Errergy Envelope Calculatlone Submitted In tlhe last 12 months, has the Gty oT Eagan Issued a permk fw a simllar plan based on a mester ptan7 _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical ConRacror. Phone: Sewer & Water Contractor: Phone: N13T;?r:Ptansaf ndsupp+prtk?g .+locumeritstl?tycri'submt?aie=ca?rsidered`to#?puGlks?n?to? ?a/?o?rsctf;?. " e? ?lt}? ta ; r'k'M'yoa piiiirk?e spsafc r?aatfrrs tl?af war?ai PenoTt ?l! tha,"liNomwtlon;rriey;trd`o1?87?? ridP? " ?- 7 " _ _ _ ALOIlGlfld9t??1?1 ?HY61?6Bfliill;? ' m «!+, , 7777, I hereby acknowledge lhat Mis irAamation is wmplete arid accu2te; that the work will be in conformance with ihe ordinances and codes of the City oi Eagan; that I untlerstand INis is not a permit, bul only an applica6on for a perrnit, and work is not to start without a permit; that the worlc will be in accordance with the approved ptan in the case of work which requires a review and approval of pl /?? X er?ae?" p??.he15 x ?? 6?I!?S AppllcanYs Printed Name Applicarrt's Signature Page 1 of 3 APPLICATION Use BLUE or BLACK Ink Far Qffl~e Use P T1 j Permit j city of Ea RECEIVED I I E I Permit Fee. 3630 Pilot Knob Road DEC 01 2011 Eagan MN 55122 I Date Received: Phone: (651) 675-5675 l I Fax: (651) 675-5694 1 Staff: I I 1 2011 RESIDENTIAL BUILDING PERMIT A - s PPLICATION Date: Site Address: Unit Name: / - Phone: RESIDENT / OWNER Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: ,`A.L yau.) Construction Cost: loe o ®C'o Multi-Family Building: (Yes / No Company: Contact: Lve. S ca)t'; _;c CONTRACTOR Address: <L-,6tA)e,_W,. 8 1•p- 1'1c>C City: cA 0)0 4-e State: N►)- Zip: 1 ~Phone: License QC)(, 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 may be classified as non-public if you provide specific reasons that would permit the City to concluda 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.ggpherstateornecall.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 appro I of plans. _"~Q e- x I _4rA4_-~ , ;L-a- Applicant's Printed Name A i ant's Signature Page 1 of 3 j4 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 r Plex _ Lower Level - Pool Miscellaneous _ Accessory Building - WORK TYPES New - Interior Improvement _ Siding _ Demolish Building plac Addition - Move Building _ Reroof _ Demolish Interior _ Alteration - Fin: Repair Windows Demolish Foundation - i2e Repaiv - - - - Egress 1AfiWdow - =-_~If/d1Wr-Damage - Retaining Wall *Demolition of entire building -give PCA handout to applicant DESCRIPTION Valuation` Occupancy MCES System Plan Review Code Edition SAC Units (25%_ 100%-)b Zoning City Water Census Code 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 Sidin ~ -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In Air Test Final 9. Windows Insulation Retaining Wall: _ Footings Backfill Final Meter Size: Radon Control Erosion Control Reviewed By: Building Inspector RESIDENTIAL FEES Base Fee Surcharge z Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 2 These particular site plans were drawn from the previous permit. The decks will be rebuilt on the exact same footprint*. The contractor noticed that the original decks were drawn incorrectly/not to scale and did not want to further confuse the drawings. *4492 Clover Lane will be extended 7' From:ALLSTAR CONSTRUCTION 19529427464 09/1712013 08:54 #582 P.077/079 Use BLUE or BLACK Ink For Office Use Clt O!~ ~!1 !Permit # 1 I "a I ~ Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 j Date Received: 'L' 1 j Phone: (651) 675-5675 1 I Fax: (651) 675.5694 1 Staff: _ v 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: lit 2 0l _ Site Address:'-414,ggiHB1t- %,14g1A MXt 11L _Unit M Name: _ Gleh C ~ 0: G aS Company Phone: I Resident/ p. , Owner Address/City/Zip: US-61 VW p01Yk."r Et~lW Naly1C,M.N 5`r~~~ I Applicant is: Owner Contractor Type of Work Description of work: -I(XV off am Construction Cost: ~Ig12po-Do Multi-Family Building: (Yes / No Company: Agay Wadm fil LLE Contact: _ At Address: VJ1% I ftal SfirN ~1f"3 City: MAW lifts Contractor state: _ Zip: EGaGol Phone: 952-- License m G7CWNC519 Lead Certificate Nft T- 10 L04 -0 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: 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 pennit the City to conclude that th y 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 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. 11 X_ 14 o_L_;U1 Applicant's Prin d Name Applicant's Signature y; Page 1 of 3 From:ALLSTAR CONSTRUCTION 19529427464 10/21/2015 12:30 #269 P.015/020 Use B�tEE or BLRCK!nk �----------------- iFor OHice Use � C)t �f c� c� j Permit#: J� � . 1L� 1 Q�Q� � -3 �. � � 3830 Pilot Knob Road RECE�VE � Permit Fee: � Eagan MN 55122 OCT '� � ZQ��j � Date Received: � Phone:(651)675-5675 � � Fax: (651)675-5694 1 Staff: � I I ��__��__��.�J 2015 ��SI��I�L �E�EL�3iNG PEl��T�aPP�.ICATtOIN Date: Site Address: Unit�!: �.�a.,ti,..,..o�,,...�,...�..,..a...�.,�.�,.�,.�,.vm�..�..�,...-�-,,... v�..,_<....�.�...,..........r.�.<�..,.,�..,.��.,�,,.�..�....�.��_,_- - .�...n,N.....,.�,��_�,�.�.�Fld,�.-.,,.,. .. a.,�.,^.�...•.��....�.�...�:.a.. . ., ,,. - ..� ' Name: t.�n�,�✓4: 1 t��3�e"s� ��e•t �d�F Phone: N�/g � � Resident/ ,]� � OWner � Address/City/Zip: c�7C/5�'��l�af � g'7� � �p-�° � ' � � � Applicant is: Owner � Contractor �..,�,..,,....A...,., ..�,.,�-,��, .»...a,..N...-.-..,,�,..a,._,��,.,�..,.�«,....,�._�.�..4 .,._.>,....---,...�.,.,:,.._., .�..,..<�.w_....�...a.,.�..,.__.��.,:.�..,�s�,�.M.�..,.,��...,.._..:..�_,,..,,.,,��.L,,...,,,�,.,:__.�.._ .. € ..,., � , ,,., ^ ----�-•� Description of work: �� r�r in/i i/� �`y°..�'�� .r+(" "' i�/�3� CLEVW7�cr. G�Z a � Type.of Work y � � � v Construction Cost� �l'Go-�'�'�„''' Multi-Family Building (Yes �No � a,..y.._a...�.,...- - ...,..a�..�,:u...:.,,:,_u..�,�...,,z-,_�._-,,,,,.,.._. .�, u � '.�,�. �-:�,�� ...............�.y._...,.,.:,s...��...,n . �..-..,-.r.....�....,..�r.__.�._.�.,,..�....,,...,�.-.,.�,t.. s � .._.....�,_...,b,.._._��a,.�..-,.,�.:-,..,�,M,,..�,...� � � Company:�I��Art �nS��t�t�,�r1 t/✓�/�a�tfi/!`��rc� Contact: �.,,�,m �Q il�..�.,� � � ; Address: 7�ii/5 /n��'S�',�-,ro�L ��- - �;,,4,k�. /Q� City: �A �� t FF..� ` � Contractor � ro P � State:�Zip; ��3�`� Phone: �2-5��2�'75/5��Email:_�n'��ct 1/�"�z 6". ��. � � � � � License#: ..�� 4"q�`� ��G� Lead Certi�cate#: /�'r• .��9(l+EI L � € `__. _ . �-.,._.�,.�.m,��..�,�.�..o..,��.,..n,_„s...�_�.�..�.,x.,..�.�,,.. _,�..,�.�.- _�,...,...�„�...�.�...�..�, _. _._ ._ . . ..b.,.. ....�.�.�..,,..._,.� � If ihe projeci is exempt from lead certification, please explain why: ��L� �„� �c�� ,'.,o,�,.�.,.,y�,�....�..,�..�.._�.,....� ..�..�..�.,.�.�..�.^,,.,�.�=t...r .�,.�.t.v.-��.,.,�,.._��.,�.�....�.��s.m..�r,�.,.,,�:..c.-._�.��.._.�.�.....�...�.��.�,.�,...�.,._.s�. � � COMPLETE THIS AREA ONLY IF CONST'RUCTING A NEMI BUILDING �� In the last 12 months,has the City of Eagan issued a permit for a simila�plan based on a master pla�? � ' � � � � Yes No If yes,date and address of master plan: � � � Licensed Plumber: Phone: � � � . �� Mechanical Contractor; Phone: Sewer 8 Water Cont�actor. Phone: � � � � � Fire Suppression Contractor: Phone: � .��..�..,.��.,._,,._:..,�,...�..,..�..,,...u...:,�..M..._..::.�,.,�_..,�.,...�,�.n:.._,.,..�,..,._„�,�.....�,�..,s.v..,,.,��....,.,�.,.�.,.,_.�.t...,�..a�.. .��....�,....��..��,..N....,m.�., �..�,s.T_�.......�,..� .,,M.. ..� � NOTE:Plans and supporting documents lhat you submit are considered to be publfc inforn►ation. Portions of .. the informafton may be classifred as non-publfc if you provide speciffc reasons that would permit!he City to � � conc/ude that!he are trade secrets. �z...�,-_..._.,..R�..,��..,.�..,.�.�..�_�.�.:,�..x,.r:....�N�.�H.�_x,.=,�., ..�..�xY�.�_..��.....��,�Y,,�..<_..�.�.�,.,,��...„�,.M...�.-r�:.y.,....-_..�.�.,.�..�...Y,,,_,...�,:.��...�.��..r...._,�.,�..�.�,�_.� CALL BEFORE YOU DIG. Call Gophe�5tate One Cali al(651)4540002 for protection against underground utility damage. Cell 48 hours before you intend to dig to receive locates of underground utilities. www.aooherstateonecall.ora I hereby acknowledge that ihis 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 bui(ding permit issued in accorda�ce with the Minnesota State Buiiding Code must be cor�pleted within 180 days of permit issuance. � ,.,,�_...._, �,,,.= X -�:s;;�... ,�//�� X �'"~ ''"��" .� Applicant's Prinied Alame �„Applic nt's Signature � Page 1 of 3 - e*i� 0 EAGAN n 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 1 FAX: (651) 675-5694 buildinginspections(a)cityofeagan.com -------------I For Office Use �y n/ I 1 Building Permit #: �Tl L,1J��j I I I I S&W Permit #: I Permit Fee: I I I I Date Received: I I I I I I Date Issued: I---------------------J RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Applicant is: ❑ Owner Contractor Homeowner Unit #: Name:�ibyV,e—CDk As�5C�C'Ipt_4k C> Address: CJ�/ ri 4k.Ii�d+v City:aQ 0. Phone: Email: Description of work: P,,, Q C, Type of Work Construction Cost Type of building: ❑ Single Family ❑ Townhome, of units Twin Home Compan :17QM t/t 't c.�_ o\� Contact: Building Address:6 q B CA& UJP-<- - &� Y City:�GCP� Contractor f/ '/s 5-k/ Phone6tz-J'f State:Wip: License #: o ti Expiration Date: Sewer & Water Contractor Company: Address: Required for State: Zip: Phone: Email: new construction ( License #: Expiration Date: Contact: City: ` 1 understand that Plumbing, Mechanical, and Fire Suppression work require separate applications. NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Contact Gopher State One Call at (651) 454-0002 or www.gopherstateonecall.org for protection against underground utility damage. Contact Gopher State One Call 48 hours before you intend to dig to receive locates of underground utilities. I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. �( ,0.V �2� 1�e--\C + x Applicant's Printed Name A licant's Signature