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4495 Clover Lane" CITY OF EAGAN ,3794 Pilot Knob Rmd Eagan, MN 55722 N2 6176 PHONE: 454-8100 BUILDING PERMIT APPLICATION Receipt # To be uud for 1 Of Q plex Est. Value 42,000 Date 9-16 , 1 98Q_ Site Address 4497 B CloVeP Idl Erect o( Occu anc p y Lot 28 Block_I_ Sec/Sub. F(7en Add. Alter ? Zoning PD Parcel # 10 79750 980 01 Repafr ? FireZone 3 E l f C T arge ? n ype o onst. V ? Name Tilsen Homes Inc, Move ? # Stories Z Address 627 S. Snelling pe,„orsh ? Front -?- 0 Ci Phone h2 _5501 Gmde ? Depth fr. ? 0 Name Aporovala Feea iE Address ? r.., Name _ Address I hereby acknowiedee that i hove read this applicotion and state that the informofion is correct ond agree to tomply with all applicoble State of Minnesota Statutes ond City of Eagan Ordirances. Assessrdk?'t 9.11 _Rfl Water & Sew. Police Fire Eng. Plonner Council Bidg. Off. APC Permit 170 ''2n $urchorge PI nn Plan check h() 25 SAC 5?)5 nn Water Conn. Zf15 flfl Woter Meter (,n nQ Road Unit I R_?. 5 nl1 Torol 1, 276. 75 Signoture of Permittee I A Building Permit is issued to: T1152Z1 Homes, IriC. on the express condition rtwt oll work sholl be done in accordoncs with a?ll ?g/p?pl,i?m?ble SSqt?e ?of _Minnesota Statutes and City of Eagan Ordinances. Buildirg Officlal ??'?k / same crrir oF Ee,GaN 3795 %lot Kno6 Road Eagon, MN 55142 PHnNE: 464-8700 BUILDING PERMIT APPLICATION N? 6175 Receip+ # POry /' Te bo uead for 1 Of Li. p1eX EsL Vnlue 42,000 Date 9-16 , 1seQ- Site Address 4497 Clover Ln. Erect Ky R3 Occu onc p y t.or 27 eiock 1 Sec/5?6. Eden Add. Aire. ? Zoniny PD Parcel # 10 22750 27!1 01 Repair ? Fire Zone 3 E l f C T f V urge n ? ons ype o . - w Name T11Seri HOmeS IriC. Move ? # Stories 3 Address 627 S. snelling Demolish ? Front L4 ft. ° r.... C+ P.,n 1t„ ok....e tiaR_SSm Gmde ? Depth 22 ft. p Name ? ?U Addrew S3ID@ ? Ci Phone ?W Name _? Address I hereby acknowledae thot I have read this opplication and stafe that the information is corred and ogree to comply with all applicoble State of Minnesota Statutes and City of Eagan Ordinances. Fees Water & $ew. Police - Fi.e Eng. Plenner - Council _ Bldg. Off. _ APC Permit 1GV.7V Surcharge 21.00 Plan check 60.25= y,C 525.00 Water Conn. 305.00 Woter Meter 60.00 Road Unit185.00 Total 1,276.75 Signature of Pertnittee I A Building Permit is issued to: Ti1SeR Homes, IIIC. on the express condition that all work shnli be done in acrnrdorue w' ail applicuple, [S?tot-e of Minnesoto Stntutes and City of Eagan Ordirances. Building Official 442 J crrr oF eacaN 3795 Pilof Knob Road Eagan, MN $5122 PHONE: 454-8700 BUILDING PERMIT APPLICATION N° 6173 Receipt .{k 4?- To 6e uaed fer 1 Of 4 A12X Est. Volue 42s000 Date 9-16 , 1930_ Site Address 44 95 B Clover Lri. Ered gfl Occuponcy R'3 Lot 25 BI«k 1 Sec/Sub. Eden Add. Alter ? Zoning PD Purtel # 10 22750 250 Ol Repoir ? Fire Zone 3 E l f C T t V n arge ? ons ype o . w Nome Tilsen Aomes. Inc. Mow ? # Srories Z Address 627 S. Snelling Demolish ? Front 44 ft. ? Ci Phone h98-55m Grade ? Depth 22 fr. ? Nume Apvrovnia Feee p ? ?? Address Sallte ~ Cif Phone ? ?w Name ?w Address I hereby acknowledge that I hwe reod this applicotion and state that the information is correct and agree to comply with all applicable Stata of Minnesota Statutes ond City of Eagan Ordinnnces. Signmure of Permittee - A Building Permit is issued to: all work shall be done in acco Building Offidal AssessrAGt !?k Woter & Sew. Police - Fire Eng. Planner - Council _ Bidg. Off. _ APC Permit 120- 5n Surcharge Pi _(1() Plan check h(1. 25 SAC 525 nn Water Conn. 305 n0 Water Meter 60 ()o Road Unit ? QF nn Torat 1.276.75 y],GgyZHompg., Tnn on the express condition that oll appJipablq State of Minnesota Statutes and City of Eagon Ordinonces. ' CITY OF EAGAN 3795 Pilot Knob Road Eogan, MN 55122 N2 6174 ?PHON?: 454-8100 BUILDING PERMIT APPLICATION ReceiPt Te be uted for 1 Of Q plex Est. Volue 42,000 Date 9-16 , 1960 Site Address 4495 Clover Lri. Erect O Occu onc R3 C p y Lot_.26 Blotk_L- Sec/Sub. Fde n Add_ Alter ? Zoning ?1) pOfCel # 10 22750 260 Ol Repair ? Fire Zone ? Enlarge ? Type o4 Const. ? z Name Tilsen Homes Inc. Move ? # Stories 3 Addreu 627 S. Snelling _ oemorsh ? Front k. ? Ci S t_ PaU1 Mn pFrone 69$-5501 Gmde ? Depth ? 0 Nome APVrovoh Pen ? ?u Address Nome _ Address I hereby ockrwwledge that 1 have reod this npplication ond state that the information is correct ond egree to comply with all applicable State of Minnesoro Stotutes and City of Eagan Ordirwnces. Assessnt 9-11 -Qn Water & Sew. Police Fire Erg. Plonner Councii Bldg. Off. APC Permit 1LU.7U $urtharge 21.00 Plan check 60.25 SAC 525.00 Water Conn. 305.00 Woter Meter 60.00 Raaa unir 185.00 Toral 1 ,. 276_ 75 Signature of Permittee I A Building Pem,ir is issued ro: Tilsen Homes IriC. on the express mndition thot all work shall be done in accordance_fQith ail aoolir,ahle.-State of Minnesota Statutes and City of Eaean Ordinances. same Buildirg Officiol `- -•? CITY OF EAGAN 3795 Pilot Knob Rood Ecgon, MN 55122 N2 6174 ' PHON E: 454-8100 BUILDING PERMIT Receipt .# , Te ba wed fer Est. Value Date , 19 5ite Address Erect Q Occupancy Lot Block Sec/Sub. Alter p Zoning parcel # Repair ? Fire Zone Enlarge p Type of Const. c o Nome Move ? # Stories W Z Address Demolish ? Front ft. O Ci phone Grode ? Depth ft. ? Name pp v p ?? Address Assessment Wnter & Sew. ~ Ci Phone ?a Pol ice FW Name Fim ?? Address Eng. Z " Ci Phone <' Planner Council I hereby acknowledge thot I have read this application and state that Bldg. Off. the information is correct and ogree to comply with oll opplicoble Stota of Minnesotn Stotutes ond City of EoQcn Ordinances. A ro ols e°°- APC Permit Surcharge Plan check SAC Water Conn. Water Meter Rood Unit Total Signatum of Permittee I A Building Permit is issued to: on the express condition that nll work sholl be done in nccordonce with oll opplicable Stote of Minnesoto Statutes ond City of Eagan Ordinances. Building Official PennM # peh lauw PorelftM Plumbing :2; Mechanicol oZ ^Z. d ? Sr INSPEGTIQN$ DATE INSP. RougFwln Finol Footings -? ? Oote Insp. Date Inap. Foundation Plumbing Frame/ins. MecFwnical ? Finol ? • Z Remarks: ' 'cirY oF EAc,AN • 3795 Pilot Knob Road . Eagan, Minn-w?o 55122 No. Phene: 454-8100 PERMIT Dcte: Site Address: Lot Block Sub/Sec. Nome . s Address a City Phone: Nome . ? ? Address e 0 u - City Phone: This Permit is issued on the express condition thot all work sholl be Minnesota Stotutes ond City of Eogan Ordinances. INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIONS Receipt No.: Single I Residential Multi Res., CommJlnd. I New/Aiter. / Repair Cost of Installation Permit fee Surchorge Total done in accordonce with all opplicoble Stote of Building Official CITY OF EAGAN a 3795 Pilot Knob Road Eagan, MN 55122 N2 6176 • PHONE: 454-8100 BUILDING PERMIT Te 6a vrwd inr Site Address Lot 81ock Portel # W I Name Z Address 0 o Nome _ ?' Address Nome _ Address Receipt # Erect 0 Occupancy Alter p Zoning Repair 0 Fire Zone Enlarge ? Type of Const. Move 0 # Stories Demolish ? Front ft. Grade ? Depth ft. Approva Is Fees Assessrrient Water & Sew. Police Fire Eng. Planner Council Permit Surcharge Plan check SAC Water Conn. Water Meter Road Unit I hereby acknowledge that I hove reod this opplication and state that gldg. Off. the infortnotion is correct ond agree to comply with all npplicable ?PC Total Stote of Minnesoto Statutes and Ciry of Eogon Ordinunces. Signoture of PermiMee A Buiiding Pem,it is issued to: on the express condition that oll work sholl be done in ocoordante with oll applicable State of Minnesotn Statutes and City of Eagan Ordinances. Building Officiol p Pamit #k Dofe Isersd PermlttK Plumbin9 Mechanicol a $ el- cl? INSPECTiONS DATE INSP. Rough-in Final I FOOtingS .?, - yC D e Insp. Dote Inzp. Foundation I Plum in ? Frame/ins. lL _ -/- Mechanical ? Final --i7 ? Remorks: CITY OP EAGAN 3796 ?lot Knob Road No. Eayan, Minnesoro 55122 INSPECTOR NOTIFICATION PAene: 454-8100 R E Q U I R E D B Y LAW PERMiT FOR ALL I NSPECTIONS Date: Receipt No.: Single I Site Addreu: Residentiol Lot Block Sub/Sec. Multi Res., Comm./Ind. I Name New/Alter./Repair. . ; /lddress Cost of Installotfon O City Phone: Pennit Fee ` Name Surcharge ? Addreu ?'? r '' • - ? City - Phone: Totol This Permit is issued on the express condition that all work sholl be done in ottordunte with all applicoble Sfote of Minnesota Statutes and City of Eugan Ordinonces. Building Offfciol . -1 ILDING PERMIT CITY OF EAGAN 3795 Pilot Knob Reed Engon, MN 55122 PHONE: 454-8100 Sita Address Lot BI«k ? Sec/Sub. ? '?Pn Parcel # W Name - ; Address ' b p Nome ? ?? Address 1-- r:*., vti.,.,e I hereby acknowledge shat I have read this applitotion and stote that the information is correct and agree to comply with oll opplicable State of Minnesota Statutes and City of Eagan Ordirances. Receipt # N4 6173 Erect Q Occupancy Alter ? Zoning Repoir ? Fire Zone Enlarge p Type of Const. Move ? # Stories Demolish ? Front ft. Grode ? Depth ft. Appeorals Fees Assessrnent - Woter & Sew. Police Fire Eng. Planner Council Bldg. dFf. _ APC Permit Surcharge Plan check SAC Water Conn. Water Meter Road Unit Total Signoture of Permittee I A Building Permit is issued to: on the express condition thot all work sholl be done in accordonce with all appliaoble State of Minnesota Statutes and Ciry of Eugon Ordinances. Building Official reewk # pah hnnd PnaktN Plumbing - 'C'e v?--e Mechanical 9-45 ? #_ '.'L Q ('- '.4- 3 7 2f2!J>?- f_' INSPECTIONS DATE INSP. I Rouflh-In Final Footings Dote Irnp. Date lnsp. Foundation Plumbing Frame/ins. Mechanicol ? Finol /I Remarks: Tww l4.-lq cirY oF EAcaN 3795 Pilot Knob Read Eaqan, MinnetoM 55122 No. Pbone: 454-8100 PERMIT Date: Site /lddress: Lot Block Sub/$ec. Nome . ; AdAress O City Phone: Nome Address City Phone: This Permit is issued on the express condition that all work shall be Minnesota Srotutes and City of Eogan Ordinonces. INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIOfVS Receipt No.: 5ingle I Residential Multi Res., Comm./Ind. I New/Alter./Repalr Cost of Instullotion Permif Fee c, ..??,,,.,,n Tota I done in accordonce with all npplicable State of Buitding Official ?..... .-: BUILDING PERMIT To 6e umd for Site Address Lot Block Parce! # - CITY OF EAGAN 3795 PiloY Knob Road Eogon, MN 55122 PHONE: 4548100 M0 a Name W Z Address 0 .'.C";(t Name i hereby acknowledge Yhat I have read this application and state that the infortnation is correct and agree to comply with all applicabie State of Minnesoto Stotutes ond City of Eagan Ordinunces. Receipt # N°_ 6175 Erect ? Occupancy Alter ? Zoning Repair ? Fire Zone Enlarge ? Type of Const. Move ? .# Stories Demolish ? Front fit. Grade ? Depth ft. Approvols Fees Water & Sew. Police Fire Eng. Pionner Council Bldg. Off. - APC $urcharge Pian check SAC Woter Conn. Water Meter Rood Unit Totol Signature of Permittee I A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable Stote of Minnesoto Statutes and City of Eagon Ordinances. Building Official R t? Permit # Dete laoed PeUiffee Plumbing / 5 Mechonicol .?(pa `? ?'-ZC5 -$ • t °YL E v -4- . ?, 7- s INSPECTIONS DATE INSP. Rough-1 n Finol FoOtingS ?Date Insp. Dare Insp. Fou tion Plumbing Frame/ins. MethaniCGl ? ? Remarks: .? ? cirY oF U"N 3796 Piloc Knob Roed No. Eo9an8 Minnemofa 65122 Phowe: 454-8100 PERMiT Date: Site Address: 497 Clover Ln. Lot Block Sub/Sec. Nome nr-;;y? ; c Address i1-,-- ? ? City Phone: Name . g Address c 0 V? City Phone: This Permit is issued on the express condition that oll work shall be Minnesota Stafutes ond City of Eogan Ordinances. INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIONS Receipt No.: Single I Residential Multi Res., Comm./lnd. I New/Alter./Repoir Cost of Installation Permlt Fee Surchorge Tota I dane in accordonce with ell applicoble StnTa of Buildinfl Officiol CITY OF EAGAN Remarks AdditiOn Caeil AaQ1L10II Lot Lb Blk ? Parcel if l U LL /Sll LhU [1 Owner nU 1) l + . Street 4495 Clover Lane stete Eagan MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. Cp 1982 504.70 100.94 5 403.76 A011238 7-9-82 STREET RESTOR. GRADING it QL 1282 232.99 1+6.6p 186.40 A011238 7-9-82 - . SAN SEW TRUNK 1974 . 4.20 15 25.22 A011238 7-9-82 # SEWER LATERAL ? 1982 1896.46 379.29 1517.17 WATERMAIN • WATER LATERAL 1982 WATER AREA ? ? 1977 . 37.79 A011238 7-9-82 * S s 1982 STORM SEW TRK j? Cl 1982 26.0o 51.20 5 204.80 A011238 7-9-82 • STORM SEW LAT 1982 5 CURB & GUTTER SIDEWALK STREET LIGHT 185.00 20918 9 16 80 WATER CONN. 305.00 2091$ 9 16/80 BUILDING PER. 6174 SAC PARK CITY OF EAGAN Remarks Addition Eden Addition Lot 25 Rik 1 Parcel #10 22750 250 01 owner Street 4495B Clover - Lane State Eagan M 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. 6-7 1982 504.70 100.94 5 C)., p (oo (q ?f-Z-y/ STREET RESTOR. GRADING 1982 232.99 46.6o 2? • ' Ly-`?J SAN SEW TRUNK ? q 1 2.41 A010515 8- 1-81 N SEWER LATERAL ,- 1 -1982 -1896-46 .29 5 rC? 0 7• 9 -L -?l WATERMAIN # WATER LATERAL 1982 9 WATER AREA 3 4 8 8-241 -83 • 3ervices 1982 STORM SEW TRK 1982 256.oo l.ZO L 7. S IC( " Z "8 iF STORM SEW LAT 1982 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 305o'00 17 9 16 80 9UILDING PER. SAC PARK - CITY OF EAGAN Remarks Addition Eden Addition Lot 27 Rik 1 Parcel #10 22750 270 Ol Owner Street 1"97' Clover ? Lane State Eagan MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. $2 504.70 100.94 403.76 A011136 6-3-82 STREET RESTOR. ] GRADING Our) ? 232.99 46.60 186.40 it ti SAN SEW TRUNK a(?/ 1974 4.20 25.22 it It 1F SEWER LATERAL 1982 46 -479.29 5 1S17. ],] WATERMAIN • WATER LATERAL 1 82 WATER AREA (f 37.79 * $ 2YiCe8 1982 STORMSEWTRK ^h 1 82 2 6.00 1.20 204.80 • STORM SEW LAT 1982 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 305;00 20919 9 16 80 BUILDING PER. SAC PARK CITY OF EAG4N Remarks . Addition Eden Addition Loc 28 Blk 1 Parcel #10 22750 280 01 Owner ? ` - - Street 4497B Clover Lane State Eagan MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. ;o 9 504.70 100.94 403.76 A011178 6-17-82 STREET RESTOR. GRADING 0 1982 232.99 46.6o • SAN SEW TRUNK c? ( 1974 62.93 4.20 15 25.22 IF SEWER LATERAL 182 18 6. 46 29 5 1517.17 WATERMAIN ? WATERLATERAL 1 $2 WATER AREA 197 .9 4.20 15 37,79 ? 3ervices 1982 STORM SEW TRK 1$2 2 6.00 1.20 204.80 • STORM SEW LAT 1982 5 CURB & GUTTER SIDEWALK STREET LIGNT WATER CONN. BUILDING PER. s,ac 525.00 PARK ?* - Receipt MECHANICAL PERMIT Permit No, CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print legib/y Tot. 1. Date 2. installation Cost 3. Job Address Lot ; Blk. _L Tract j 4. Owner _ 5. Contractor 6. Address _ 7. City Phone State Zip 8. Building Type: Residential ? Commercial 0 Institutional O 9. Work Description: New O Add O Alter O Repair ? 110. Describe I11, Type No. Eauinment STU • M. Ea. Forced Air No. Enuiament CFM Mfg. Air Handling: Boilers Mfg. Mech, Exhaust Unit Heater Mfg. Air Cond. Other Mfg. Gas, Piping Outlets 12. 1 herehy 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. '' Apptoved CITY OF EAGAN 454-8100 Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C TYpe or Print legibty Tot 1. Date 2. Installation Cost 3. Job Address Lot Blk. Tract 4. Owner 5. Contractor 6. Address 7, City 8. Building Type: Residential O 9. Work Description: New ? 10. Describe I 11 State Zip Commercial ? Institutional ? Add ? Alter O Repair O' Fuel Type No. Eauinment 8TU - M. Ea. Forced Air No. EQUiqment CFM Ai H dli : Mfg. r an ng Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. I hereby certify that ihe above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough F inel ? Inipections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-8100 Phone Recaipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Prini /egib/y 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 O Commercial El Institutional 0 9. Work Description: New 0 Add O Alter 0 Repair ? 10. Describe Fuel Type I 11 No. f Eauipment BTU - M. Ea. Forced Air No. Equipment CFM : Air Handlin Mfg. g Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. I hereby oertify 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 7" Receipt _ 1. Date 3, Job Address 4. Owner 5. Contractor _ 6. Address Phone 7. City State Zip _ 8. Building Type: Residential O Commercial ? Institutional ? 9. Work Qescription: New ? Add ? Alier ? Repair ? 10. Describe Fuel Type I11 No. Eauioment BTU - M. Ea. Forced Air No. Eouipment CFM Mfg. Air Handling: Boilers Mfg. Mech. Exhaust Unit Heater Mfg. h O Air Cond. t er Mfg. Gas, Piping Outleu 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 Finel '- Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. . Approved CITY OF EAGAN 454-8100 MECHANICAL PERMIT Parmit No. CITY OF EAGAN ? Fee _ Fill in numbered spaces S/C Type or Print /egib/y Tot. 2. Installation Cost Lot__?'__?Blk. ,??? Tract _ CITY OF EAGAN PERMIT TYPE: ' 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITEADDRESS: t 1!i IJ , PERMIT SUBTYPE: ? APPLICANT: TYPE OF WORK: iiE 1X.r`itPl ft7ri I r:Y',, iNi t tME!;t AQ 7491 . ANl1 440 ? Permit Holder Date Telephone # 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 AIA TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVIN TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL 95 Pil ot Knob Road gon, MN 551Z2 Ize TY OF EAGAN ning: ner: dress: Address: mber. ter No.: : WATER SERVICE PERMIT PERMIT NO.: DATE: - No, of Units: Connection Charge: Account Deposit: _ Permit Fee: 5 ch Reader No.: 1 ogree to eomply with tha City of Eagan 45 Pilot Knob R oad qan, MN SS122 ning: taft TY Of EAGAN ner: dress: Address: mber: ter No,: : der No.: ree M - Ip with fh Ci f E ? ? Connection Chorge: Account Deposit: _ Permit Fee: ur arge. p e ty o agon $urtharge: Mi- rdinoneer. Misc. Chorges: Ordinonces. Misc. Charges: - Totol: Total: Y Dote Paid: BY Date Paid: B ? D ate of Insp.: Ins Dote of Ins p• • D.• 1 nsp.. CITY OF EAGAN SEWER ` in oF EAGaN SEWER SERVICE PERMIT 96 Pilot Knob Rood Ecgan, MN 53122 Zoning: Owner: Address: Site Address: Plumber: PERMIT NO.: DATE: No. of Units: 1 ag?ee to eoinply wOh fhe Ciry of Eayon Ordinanees. .? . Bv Dore of Insp.: Connection Chorge: ? Aecount Deposit: Permit Fee: Surchorge: Misc. Charges: Totol: Dpte Puid: 377,3 Pilof Knob Road r.agon, MN 55122 Ion i ng: Owner: Address: Site Address: _ Plum6er 1 agres ?o comply with the Citr eF Eogan Crdinaneea. By Date of Insp.: I nso.: _ WATER SERVICE PERMIT PERMIT NO.: DATE: No. of Units: SERVICE PERMIT .? PERMIT NO.: DATE: No. of Units: Connection Chorge Account Deposit: . Permit Fee: Surcharge: Misc. Charges: _ Totol: Date Paid: ??oa S This request void ?j ? 18 months from ? ?? Date of this Request 11-17-1980 Fire No. T 3794 I, as fiLicensed Elecirical Contractor ? Owner, do hereby request inspection of the above electri- cal wiring installed at: Street Address or Route No. 4495 Clover Lane City Eagan Section Township Range County Dakota Which is occupied by Tilsen Homes (Name of Occupant) Is a roughin inspection required on this job? No D Yes:9 Ready Now D Will Call n Power Supplier Da,kota CountY _ Address F'arn?ington Electrical Contractor 0oB, Thompson Electric Coa Contractor's License Nd??.06?2 (COmpany Name) Mailing Add-°°° 12201 Mtka Blvd o, Mtka 55343 Authorized STATE BQARD COpY This inspection request will not be accepted by the State Board unlass proper inspecdon fee is enclosed. Minnesota State Board of Elscbicity / Eg.00001-02 Griggs Midway Bldg. - Room N181 1821 University Ave., St. Paul, Minn. 55104 - Phone 297-2111 .?RtQUEST FOR ELECTRICAL INSPECTION ;4 'T' 3794 ? r,v mr7rc ncllIlFCT CiLEL:K t3N,LUW WUtClt l,V v CR Type of Building New Add. Rep. ,_v n i i i,aO ,.,.?.?...,. Check Appliances Wired For Check Equipment Wired For ? Home ? ? ? ? ? ? Range Water Heater ? ? Tempotary Wiring Lighting Fixtures ? Duplex Apt. Bldg. ? ? ? Dryer ? ?? '?2 Elecuic Heating Silo Unloader ? ? Commercial Bldg. ? ? ? ? ? ? Furnace Air Conditioner e ?2 °?? Bulk Milk Tank ? Industrial Bldg. List ? nn List Farm ? ? ? n; Qr TM a}? ,?, _ Qthers? Other ? ? ? pthers Here ? riere r.ri ??ty CUMYUIt 1NJrM_ llVl v rrc nci.v" ? Circuits: F F. Seivice Entrance Size: # FeE Feeders&Subfeedecs: ? ee 00 2 0 to 100 Am 0 to 30 Am res 0 to 30 Am eres 1 , 10 l to 200 Am s. 31 to 100 Amperes 31 to 100 Am res Above 200 Amps. Above 100 Amps. Above 100 Amps. Transformers Remote Control Circ. Partial or other fee ?.' Signs Fftcial Ins ection Minimum fe . Remarks jigl l TOTAL FE 2,00 Q7 -.`??="S?ce"` I, the ElectriIns ctar, re?yrtify that x#?e above io,,..rt?,?.,1 ?j;c:?. C has been made. r_.t I ! -I 7-#' V (Final) This request void 18 months from 95 Pilot Knob Road ISh TY OF EAGAN g?an, MN 55122 hing: ner: dress: e Address: Plumber: Meter No.: Size: Reader No.: , 1 agree to tamply with the City of Eagan Ordinanees. BY - 10ote of Insp.; . WATER SHtVICE PERMIT ? crrir oF EArmaH WATER SERVICE PERMIT PERMIT NO.: 37e5 Pilot Knob Road PERMIT NO : DATE: Ea an MN 55122 . g , bATE: Na. of Units: Zoning: _ No. of Units: Owne r: Add ress: Si te Address; Plumber: Connectlon Chorge: Meter No : ? Account Deposit: . Si • Connection Charge: Permit Fee: ze: Account Deposit: ' Reoder No.: PermiY Fee: Surchorge: 1 ogree to eompiy with fhe City of Eagon Surcharge: Misc. Chorges: _ Ordinoneea. Mis4. Charges: 7oral: Dote Paid: By 'fotol: Insp : D Dote Poid: . ate of Insp.: Insp.: ? CITY OF EAGAN SEVNER SERVICE PEitMIT 3795 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No, of Units: Owne r: Address: Site Address: Plumber: 1 agree to comply wlth the City of Eagun Ordinances. By Dote of Insp.: I nsp.:-- Connection Chorge: Account Deposit: _ Permit Fee: Surcharge: Misc. Chorges: Total: Dote Paid: CITY OF EAGAN 3745 Pilot Knob Raod Rogan, MN 55122 Zoning: OWner: Address: Site Address: Plumber: 1 agree to comply with the Cilr of Eagon Ordinanees. By Dote of I nsp.: I nsp.: _ SEWER SERVICE PERMIT PERMIT NO.: DATE: No. of Units: _ ,, - r: r•. Connettion Churge Actount Deposit: . Permit Fee: Surchnrge: Misc. Charges: _ 6 Total: Date Paid: - CSTY OF FAGAN Include 2 sets of plans, T site plan w/elevations & gUII,pING pERMIT APPLICATION 1 set of energy calculation5. T6 Be Used For _ valuation. GOC Date 5ite Ptldress : q4(9-7 /3 ClGo,er L4ti,e_ OFFICE USE ONLY r,ot a 8 siocx ? sec./sub. kdPA?: 4" srect X o,,,,nrv Parcel #: /D Alter zoning ?+ Repai,r Fmi..r.?e 7one ? l?, . . OV7L12r: 1/?SC/? fNG ?1'3Y?Ie _ `II"'. Of, COTISt., Move # Stories Address:, a 7 Demolish Fmnt Grade DePth CitY/Zip Code: Szf 10Aw?? /b1?/, SSiIL Phone #: G9?- SSo/ FEES Contractar: pddress: City/Zip Code: Phone Arch./Eng.. _ Pddress: City/Zip Code: Phone #: APPROVMS t Pexrnit j'Wo s5= s Assessmen Water/Seaer Surchar4e ;2/ ? Police Plan Check _ !.o' '=U Fire SAC g?, Planner Water Conn: 3ds' Ydater Meter -'-`? , , Council Road.Unit^,_ ? Bldg. Off. ` APC . J CITY OF FAGAN Include 2 sets of plans, 1 site plan w/elevations & gAII,pING PERNffT APPLICATION 1 set of energy calculations. To Be Used For Valuation 6?,g,ISC7v Date ?-L?--?a Site Pddress °/(l 9 7 C%va r Lot a.'7 Block _/ Sec./Sub. JzCer rarcel #: ,/Or AV,7.SD 47d D/ owner: Ti/5e? Ne.orss Ln,c Address: !oL'7 S. S.ve!/wJ_ City/Zip Code: oft Rtu /, '4VA?- _ S iLa Phone #: eor- SSO/ Contractor: -Cslz.-. e Acldress: City/Zip Code: Phone #: Ptidressn.g.. - City/Zip Code: Phone #: OFFICE USE ONLY Erect rl\ Occupancy ?.3 Alter zoning Repair Fire Zone ? Enlarge' _ TyPe of Const. Nbve # Stories Demolish Front ft. Grade Depth a2 ft. APPFbOVAI,S FEES Assessments . Perndt i2o? ?4ater/Seaer Surcharg? - Police Plan CYaeck 4a ? Fire SP? ?7-2 S gng, Water Conn. ? Planner Water Meter / o Council Road Unit Bldg. Off. - T APC CITY OF EAGAN Include 2 sets of plans, 1 site plan w/elevations & BUILDING PEFMffT APPLICATION 1 set of energy calculations. ? 'Ib Be Used For V. ?,Q[?, C Valuation -1,2 00o Date -49 Site Pddress C tr n.t pFFICE USE ONLY Lot ? slocac / sec./sub. ?o Erect ? occupancv IC'? Parcel # : 71'D 4 521 /J / Alter Zonin4 ? I- - REpair Fire Zone 3 Owner: Ti /S en/ 1faiLtkrl Z.v a.- Adciress: 6a? S SncGG,.:,c City/Zip Code: Fhone #: G9A-Srci/ Contractor: Pddress: City/Zip Code: Phone #: Arch./Fng.: Adclress: City/Zip Codee Phone #: Ehlarge _ 7ppe of Const. Nbve # Stories Demolish Front </ ft. Grade Depth 12.2 ft. T4ater/Sewer I Surchar9e s- Police Plan Check Fire SAC gnq, Water Conn. 3 03 Planner --- L- Water Meter - 75? Council Road Unit ySr.S Bldg. APC TOTAI, CImy pg EAGA.7 Include 2 sets of plans, 1 site plan w/elevations & BUILDI[JG PERMIT APPLICATION 1 set of energy calculations. Zb Be Used Ebr Valuation oy?206d Date Site Pddress WqS? ('ovr r LANe- Iot ?2( slocx _L sec./sub. 446v - Erect T? Parcel # : 44 '1zg75-D A].ter owmer: TrlseA/ Na.vre-s Z-V c Address: loL'7 S S AAt // rNr City/zip Cocle: sr A4-w/?; MA/ SS//G Prone #: Contractor: ?.1 Pddress: City/Zip Code: Phone #: Arch./E1g. Address: City/Zip Code: Phone #: RPpair Enlarge Move - Dennlish Grade pFFICE USE ONLY pccupancy .3 Zoning Fire Zone 3 7ype of Const. U # Stories Front /{ ft. pepth a-,1- ft. APPEx7VAiS FEbS ? Assessments Permit /020 T4ater/Sewer Surcharge Police Plan Check Zo Fire SAC ? gg, ? Water Conn.. a"- Planner Water Meter (00 : Council Road Unit 7 Bldg. Off. APC TOTAL /a )lo 'o SEDGWICK HEATING & AIR CONDITIONING CO. HeaTiNc 8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000 TEST RECORD ADDRESS OCCUPANT SOLD 8Y MAKE O?Vl/'1L' r T SERIAL N0. 5720 7 " b 2 Z v 6 THERMOSTAT_ VALVE _ LIMIT LIMIT SETTING FAN SETfING PILOTTVPE IGNITION MODEL PILOTTIMING ? ry ` ? I? •? PRESSURE 7e ? PERCENT COz ? INPUTCFH-(? PERCENTOz ? S7ACK TEMP. ( 3 ? PERCENT CO C) FORM 235 (REV. 1 V89) ciTv JOB NO. 5 Cf 4 (?p Y OWNER VVIM?"L"'Pb? C -f+ INSTALLED BY ?y MODEL 46( /vl PV J 6G? ? cr-T1 INPUT ?6 v ? G VENT SIZE o / NPE OF LINFR LINER SIZE FILTERS: SIZE i'? ? OBER WIRING -.-r? TEST TAG LIGHTING INST DATE TESTED COMPANYTESTING ?[J4 NAME OF TESTER ?'? FOFM DISTRIBUTION WHRE CAPY-JOB FILE VELLOW COPY - CITY .? J oa This request void ?'Z?i re.`?"- ?"J ? n S 3 a 18 months from Cate of this Request 11.-17-1980 Fire No. T 3793 I, a!YZ Licensed Electrical Contractor 0 Owner, do hereby request inspection of the above electri- cal winng installed at: Street Address or Route No. 4d45 B Clover Lane City. Eagan Section Township Range County Dakota Wluch is occupied by Tilsen Homes (Name ot OccuOant) Is a rougltin inspection required on this job? No ? Yes91 Ready Now ? Will Call Gt3c Power Supplier Dakota Count]¢ Address Farmington Electrical Contractor 0.R. Thnranson E12ctxic ^ Contractor's License NaUDLQ?_ (COmpany rvame) Mailing Address 12201 Mtka Blvd., It4tka 55343 (Electncal Contractor or??owyner MaNi?ng.,'?T?hi?s Insta=ll?atlon)??3-2Cnq Authorized Signature F ` ? , ? Y' i" • t? ?? •l/ ?yhone Na `" ? (EltttNCal Contractor or Ownev Makirtg Thls InStallation) ????? ????? ?( 0?El ??/ This inspeciion reqoest will nat 6e accepted hy the @? State Board unless proper inspection fee is eedosad. Minnesota State 8oard of ElecVicity ? gg.00001-02 Griggs Midway 81dg. - Noom N781 55104 - Phone 297•2111 M inn. 21 University Ave., St. Paul, REQUEST FOR ELECTRICAI INSPECTION -I J 3793 CHECK BELOW WORK COVERED BY THIS REQUEST € Type of Building New Add. Rep. Check Appliances Wiced For Check Equipment Wieed Fo? Home ?? ? Range s Temporary Wixing ? ? Duplex ? ? ? WatexHeater ? LightingFutures ? Apt. Bldg. ?? ? Dryer ? 9 00 2 7 F,lectric Heating Silo Unloadei ? Commercial Bldg. ? ? ? ? ? ,,?, q0 . Cumace 1? °00 nex ^L diti C i gulk Milk Tank ? Industrial Bldg. ? . o r on A Lis[ ) Faxm 0 0 D List Otherst " s •=^"'?-?- Otheis} ? ? ? r Hete Here 1 (;UMt'U 1C 11V JrCA, t lvl N r cn Feedets&Subfeedeis: F # # Fee Cucuits: ?? Service Entrance Size: # ee ? 0 to 30 Am eres 0 to 100 Am s.1 II 50 0 to 30 Am eres 101 ro 200 Amps. 31 to 100 Amperes 31 to 100 Am eces Amps. Above 200 Above 100 . Above 100 Amps. _ Transformers &emoteCoMrol Ciic. Partial o? o[hex fee Minim?m fee $S. Signs ? pecial lns ection ? 1? 32 ?? Remarks j?y],1 ?/.' TOTALFE + ?..T?'? I, the Elect ' al Inspector, hereby certify that been ?ide.,' ?. I (Final) This request void 18 months from ?a7, % l, Tids request void f q 18 inonths from ? Date of this Request 11.-17-1980 Fire No. t - 3796 I, as Z#Licensed Electrical Contractor ? Owner, do hereby reques[ inspection of the above electri- cal wiring installed at: Street Address or Route No. 4497 Clover Laae City Fagan Section Township Range County nAkota. Which is occupied by Tilsen Aor.:es (Name of Occupant) Is a roughin inspection required on this job? No ? YesTN Ready Now ? Will Call 19 Power Supplier nakota Courts Address Fsrmi neton _ Electrical Contractor O.B. Thomvson Electric Co. Contractoi s License NaA0602 (COmpany Name) Mailing Address 12201 ldtka fllvda t Mtka 55343 (Electriwl Contractor or Owmr MakinS•Thls Installatlon) Authorized ?}???? ? f?V????? ?( O?? This inspection request will not be accepted hy the f1 U State Board unless proper inspeetion fee is enclased. Minnesota Stata Board of Electricity / Eg_0o001-02 Griggs Midway Bldg. - Room N191 University Ave., St. Paul. Mmn. 55104 - Phone 297-2711 n I? 7 - REQUEST FOR ELECTRiCAL INSPECTION ol T 1 3796J v nroicorT 4V TL]iC DG(l1117CT l,C1Gl.KELLVYY Type oi Building New Add. Rep. ........-..?..,?_- Check Appliances WiTed For Check Fquipment Wired Fo: ?C ? ? Range ?400 Temporary Wiring ? Home Duplex ? ? ? WaterHealer ? LightingPic[uies ? Apt. Bldg. ? D 13 ? Dryer ? Electcic Heating O CommemialBldg. ? ? ? Furnace ?r?2000 SiloUnloader ? Industrial Bldg ? ? ? Au Conditionei 7E3C2a00 Bulk Mdk Tank . List L ist ) Fasm p [hers ??l snaxx4w•• p } He?ers1 Other ? ? ? H 1 eie „?..T..,,., ccc nci nw LVIYIC V 11i 11Y?]1 L1.11Vi Seevice Enttance Size: # ? ??.v Fee vv •• Fcedess&Subieeden: # Fee C'ucui[s: # Fee 12 00 0 to 100 Am s o 0 to 30 Am eres 0 to 30 Am eres ]Ol to 200 Amps. 1 to 100 Amperes 31 to 100 Am tes A6ove 200 ps. , ?Above 100 Amps. Above 100 Amps. Transforme s 1:A 4: - 'Remote Control Circ. Parlial or othef fee ns Si _e, ` Special Inspection Minimum fee 55:00' g Remacks Elgll I, the Electrical Inspector, hereby certify thf TOTALFE ?/.Jv 2^? n has been ma n,fa , i - aj=016 (Final) This request void 18 months from Min,,..,,ota State Board of E19Ctricity ? Griy,s Midway Bldg. - Room N191 ? 1821 University Ave„ St. Paul, Minn. 55704 - Phone 297-2111 RE.4UEST FOR ELECTRICAL INSPECTION .r CHECK BELOW WnFFx mvFRFn av Turc uFnriFCT EB-00001-02 'Z7Q9?? Type of Building New Add. Rep. Check Apptiances W'ved For Check Equipment W'ved For Home Duplez Apt. Bidg. Commercial Bldg. Industrial Bldg. Fazm Other ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? Range Wa[er Heater Dryer Fumace Au Conditioner List Hehets? 18 . 1 ? ? 2 00 ?° ?20? 9 0'_ e Tempoiary Wiring Lighting Fixtures Electnc Hea[ing Silo Unloader Bulk Milk Tank List s? Rther1 ere ? ? ? ? ? COMPUTE INSPECTION FEE BELOW Service EntTance Size: # Fee Feedecs&Subfeedeis: # Fee Cvcuits: # Fce 0 to 100 Am s.i OTJ 7.50 0 to 30 Am eres 0[0 30 Am etes o 101 to 200 Amps. 31_ro 100 Amperes 31 [0 100 Am eres A6ove 200_Am s. Transfoxmers .1 've 100 Amps. emQteControlCirc. Above 100 Amps. Partialor otherfee Signs ,is `Specizl [nspection Minimum fee S:B Remaiks Hall - TOTALF E??--;ro 32.00 ¦, Lne nmcmcaz mspector, her¢by certliy (Final) This request void 18 months from has been m3de. d)am . f,lJ -,'l This request void 18 months from Date of this Request_ _ 11-17-1980 FITe No. 1- 3795 I, a&xffl Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri- cal winng installed at: Street Address or Route No. 4497 B. Clover Lane CitY Esgan Sectlon Township Range County Dakota Which is occupied 6y m; 1 cen ?3T nmae (Name of Occupant) Is a roughin inspection requiced on this job? No ? Yes EF Ready Now ? Will Call Mx PowerSupplier_ nakn+a f'nUnta Address Farminetnn Electrical Contractor O.B. Thomqsan Electric Co. Contractor's License NA 0602 (COmpany Name) Mailing Address 12201 P;Stka P1%-d., jyjtka 55343 (Electrical Contractar o, Owner Maklng Thii Installatlon) Authorized Signature ?1'Fi'?-phone N0,33-2521 (Electrlwl Cpn[ractorb?'Owne? Making TMs IDetalla'tlan) This inspection request will not be accepted by the l?% ? ?( State Board unless proper inspection fee is enclosed. 5/5[i REQUEST FOR ELECTRICAL INSPECTION ee-oo001-07 I a?yi? ? ? SPe insmctia.; lor completing this lorm on back ot yellow copy 5 4x] x6?y ,. sY 0 0465,C ":X" Below Work Covered by This Request ?.- ._? ew Adtl Rep TypeofBmlding AppliancesWVed EqwpmenlWired Home Range Temporary Serwce Duplex Water Heater Elecinc Heating Apt Bwlding Dryer Olher (Specdy) Comm /Industrial Furnace Farm Av Conditioner Other(speoity) Conlractors Remflrks Compute lnspecbon Fee Below: # O'her Fee # Service Enirance Srze Fee # brcwtslFeeders Fee Swimming Poal 0 to 200 Amps 0 ta 1?0 Amps Trans(ormers Above200_Amps Ahove100-Amps Signs Inspeator5 Use Only ? T?TAL ? Irrigahon 8ooms ,,. 00 ? SpeaallnspecM1On Alarm/Communication THIS INSTALLATION MAY BE ORDERED ISCONNECTED IF NOT Other Fee COMPLETED WITHIN 78 MONTHS. I, the Electncal Inspector, hereby Ro°9n-'" oaie cenify that the a6ove inspection has been made F,nai OFFICE USE ONLV This recuest vdtl 18 monihs Irom 04650?,???? ? Request Date Rre No Pough-in InspBdion equire ??/ "/ ? RL7 Vestl' pqNo Ready Now 0 W?hen ReadyPecror t?licensed conlractor ? owner hereby request inspection of above electncal work at Job Atltlress (Slleet, 8ax or Route No ? Qry r11 ?7 -.? /'7 Seclion N. Township Name or No Ranga N. Counly? OccuOanz (pqINT) Phone No 1__a1 Pawer Supplier Atltlress Eiectncal G{onnacmr ?Company Name) Connactors License No Mei6ng qddress (COntractor or Owner Making Installalio ? lJ 71o Nmbonjg^A,SignaWre ICOmrac[oNOwner Makfi g Installation) Phone Number / / MINNESOTA STATE BOARD OF EIECTRICITY THIS INSPECTION REQl1EST WIL OT Gtlggs-Midway Bitlg - Room 5-173 8E ACCEPTED 6V THE STATE 80APD 1821 Unlverslty Ave., St Paul, MN 55100 UNLESS PROPER INSPEGTION FEE IS PMne (612) 662-0900 ENCLOSED `1 5iu6c, 2006 RESIDENTIAL PLUMBING PeRnniTaPPUCaTioN CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55722 651-675-5675 Please complete for modifications to existing residential dwellings. ??? 'E?50 Date 9 I ? 1 C KJ l Site Street Address 44E] anwf I&nP Unit#-t - Property Owner I Y l.i (X lri o-_ I? ?1 Telephone #klql) ? Contractor Telephone # ((pjr) 306`134 Address O City State,-"? Zip The Applicant is: _ Owner /kSontractor _Other Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee $ 100.00 Per as-built $ 10.00 Alterations to existing dwelling $ 50.00 _ Add plumbing fixtures. This fee inGudes installation of a water softener andlor water heater at the same time. !f you are installing onlv a water softener and/or water heafer, do not complete this section; move to the neut section and check the appliance(s) you are installing. _Septic System Abandonment _Water Turnaround (add $130.00 if a 5l8" meter is required) Other: Water Softener >e?Water Heater $ 15.00 e _ new replacement 4L Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00 State Surcharge $ 50 ? (5 ?n ToWI I hereby apply for a Residential Plumbing Permit and acknowledge that the information is compiete ana accura[e; cnac cne work will be in conformance with the ordinances and codes of the City of Eagan and fhe plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accordan with the approved plan in the event a plan is required to be r2viewed and approved. ? ? ?? e J-) ApplicanYs Pnnted Name Applic nts Signature ? 1999 .^ :]?) CO?Iq ew Consfruction Reaulre ments D 3 registered sRe surveys showtng sq. N. of lof, a and gy roofed areas (209 moximum loi cove ID 2 coples of plans (show beam 6 window sizes; D 1 set of energy calculaNons ? 3 copies of free preservatian plan N lot platted DATE: _/ai_ 124 l I 9 DESCRIPTION OF WORK: Iq ? STREEf ADDRESS: ?I ?I?-I -4' LOT: = BLOCK: 1 PERMIT APPUCATION (RESIDENTI?AL CITY OF EAGAN 76 3830 PILOT KNOB RD - 55122 651-681-4675 Remodel/Reoair Reauhemenfs` . of house 2 copies of plan e ailowed) 1 se1 of energy calculafiom for heafed addiHons ured fnd. deslgn; etc.) 1 sBe survey for exterior addkions 8 decks 7/1/93 ? ? CONSTRUCTION COST: .I.D. #: Phone #: (00-1 4 n,Co 4 gS-Z PROPERTY OWNER Street Ci1y . CONTRACTOR Street ARCHITECT/ ENGINEER city Telephone #: area code ( Streefi Address: City Sewer 8 waFer Iicensed plumber (reauired for ne,w conshvcflon onlv Penalty applies when address change and lot c Ihange Is requested once permB is issued. ' I hereby acknowiedge that I hwe?ead this appllncation, state ihaf the i?ormot n i? State of Minnesota Sialutes and Ci of Eagan Or,`dinances. Certificates of Survey Received _ Tree Preservation Plan Received last 4i--- Signaiure of Applicany-.4 OFFICE USE ONLY _ No - No - Not Required State: Zip: 5Z72z Phone #: (area code) License # _ State: Zip: Name• ) Registration #: State: compry wNh 4 iggoi C" . Eden Homeowner's Association PO Box 22195 Eagan, MN 55122 Andrew and Mary Pat Habemias 4497 Clover Lane Eagan, MN 55122 June 25, 1999 To Whom It May Concem: The Eden Homeowner's Association lias given ti?e Haienciases Yennissicm tu bru1d an extension to flizir deck providing it meeCs Eagan's codes. It may be eatended up [o the end of U?e house (the front of their unit). Sutce rt faces the sttvet, it uiay nat have stmrrs attached or extend outwazds towazds the street. Their plan meets these criteria. When the work is dane and signed offby ilia ciiy, iw,itl need a copyof the;signed permit for our records. Sincerely, --- r - ? Troy kins Maintenance Manager 4482B Clover Lane Eagan, MN 55122 651-687-0597 troy@haskins4homes.com . ? ? ? ? • • ? ? • ''?' ? N? • ? ?• , . ?..?.•s _ _ =?1 WIW ,?? ' '+? _ .. ? .. ? _ f`• ? • ? ` ? ? » •. r . ' • ? . ? • . ? ? r ?? .• ?, •-` ? r • ? ? ? ? • , ~? ?• ' ? _ ? - ,. ?.•/ t ? • M ? ?•? ? y ? ? ? ? .?? •• ? . . ' ~? ?• ? 1 i • t s ? ? • • ?? _ , ?-? ? ?•,• - , .: j...j ? • « .' \ ` . : / ' i ' dOp ?I, ` • .? 1 • • ? . ? • • . ? ,i , ??', • r / ..?l? ? ? ? _ ?? (e?'D 2005 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 ?/S,Sd Please complete for modifications to existing residential dwellings. CTr??T T- Tn ?? Date ? I rI JAN 14 2005 `! Site Street Address 'T 5"8 0,h9 L Unit # PropertyOwner ll,C"i(`e? ??yl?:rJ? Telephone# (KDI) to?oa"?IS?o Contractor ? 1 v? G-S Telephone #[?7? Address 2ioio t(ro i.11 .I CitV ALap State rt t Zip The Applicant is: _ Owner ` Contractor _Other Aiterations to existing dwelling $ 50.00 _ Add plumbing fixtures (excludes water softener and/or water heater--complete next section if installing these appliances). _Septic System Abandonment _Water Turnaround (add $125.00 if a 5/8" meter is required) Other: Water Softener 'fWater Heater $ 15.00 _ new i'?replacement Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00 State Surcharge $ 50 Total $ 156-0 I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accordance with the approved plan in the event a plan is required to be reviewed and approved. k(ISOie,n ??1(?l?zr?, Applicants Printed Name Applicants Signature 15- 1 S0 6"5&& q II City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Il Telephone # 651-675-5675 2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION ?tJ Please complete for: single family dwelLngs & 3e) . sz) when permits aze required for each unrt Date r, / QS / C>`-A I? Site Address l ? Unit # ? ProperTyOwner .5I K`ARE'1?E'E?_ I Telephone#((cj.5? Contractor Street Address ?(` j(r t(1 .????t ?:e, City State Zip [;F) Lj t Telephone # ( (,fnrj i 2 ) cJ ? H a5 3 Bond ? Expires: I The Applicant is _ Owner I 7 U ? 1 Conhactor _ Other Add-on or alteration to exisGng dwelling unit $ 30.00 fumace _Additional _Replacement FAUG 0 2 2004 air exchanger i diti a rcon oner New Replacement _ _ other --- -- ? State Surcharge , $ SO Total $ I hereby apply for a Residenrial Mechanical Pem be in conformance with the ordinances and code permit, but only an application for a pemut, anc approved plan in the case of work which requues Ap licant's Printed Name ? Y and acknowledge that the information is complete and accurate; that the work will of the City of Eagan and with the Mechanical Codes; that I understand this is not a w not to start without a pernut that the work will be in accordance with the ? revie and approval of plans. . A / / ApplicanYs Signature CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: P.I.N.: 10-22750-260-01 4495 CLOVER LANE LOT: 26 BLOCK: 1 EDEN DESCRIPTION: T.O. T.O. & Bui'1dY"ng-.iPermit Type Building Work Type ,Census Code' fs ° PERMITTYPE: auxLqrNc Permit Number: 0 3 2 9 6 6 Date Issued: 0 8 J 19 / 9 S REROOF/STORM STpRM DAMAGE REPAIR 434 ALT. RESIDENTIAL ? ?m __ {'•, ' _f ,? _ n '? i ' ? ???. r ' ?"; J/ !? t?? ?? ?'^?- ? _.s • , ; ? .. .' REMW?DES: 44958, 4497, ANp 44978. FEE SUMMARY: B?U}TKSTRRN?RCOMPANIES 9116 DIAMOND DR EAGAN MN (612) 452-5598 .,NNlicdnu - Si. Lil. OWNER: INC 14525598 0008676 EDEN HOMEOWNERS ASSOC. 4495 CLOVER LflNE 55122 EAGNN MN 55122 (651)686-7106 ? I hereby acknowledqe thet I have read this information is correct and agree to comply Statutes and City of Eagan,Ordinances. APPLICANTlPERMITEE SIGNATURE FERMIT appliceCian and state Chat the with all applicable State ofi Mn. SUED BYSIGNATURE J 1998 3 aI G ? New Construction Requirements ? 3 registered site surveys ? 2 copies of plans (include beam 8 window sizes; p • 7 energy qlculations ? 3 wpies of tree preservation plan 'rf IM platted aftef required: _ Yes No DATE: :?/ N?/g- DESCRI ION OF WORK: STR A?DDRESS: S LOT: ? BLOCK: eara ? PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PII.OT KNOB RD - 55122 681-4675 RemadeVRepair Reauirements ? 2 copies of plan ired fid, design; etc.) ? 2 site surveys (exterior add'Rions 8 decks) ? 1 energy calculahons for heated addkions CONSTRUCTION COST; , II SUBD./P.I.D. #: V\- Name: G?JC.°w a/t PROPERTY Lwt oVi'NER yy ?? Street Address: . City Company: ?Y I1 CONTRACTOR Stree[ Address: City IE.`1 ARCHITECT! ENGINEER Company: Name: Street Address: CiTy Sewer 8 water licensed plumber (new construc and lot change is requested once permit is iss 1 hereby acknowledge that I have read this app State of Minnesota Statutes and City of Eagan OFFICE USE ONL Certificates of Survey Received ? Ya Tree Preservation Plan Received YE Phone #: 6.76 716 6 el I onry): Penalty applies when address chang cation and state that the information is coRect and agree to comply with all applicabl Ordinances. Signature of Applicant: No No e State: yn/y! Zip: si- [a? ? Phone#: ??G{ rSS?? () °l. I License # Y(?O 76 State: Zip: VrV /C;ja Phone #: Registration k: _ State: Zip: - CITY OF EAGAN FOR CITY USE ONLY 3830 PIIAT KNOS ROAD EAGAN, MN 55122 PERMIT # P80NE: (612) 454-8100 RECEIPT ....... DATE: ~l - W;AEqqlSS.f: PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS 5 TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNZT. ------------------------ --------------------------------------------------------- WORK DESCRIPTION NEW CONST _ ADD ON _ REPAIR _ oWr,ER rrnME: 714on_e5 p SKu&'ws SITE ADDRESS: (-) Ll 9'T 9 C-" ugk'- L-" ?_ IAT: NI BLOCK L SUBD. 06"r" INSTALLER: *MtE $ afuc A p 605 • 12TH AYtrAIE S ? ADDRES S : _ H? IN 55343 fl3ld7f-@f€P-'c-y31 y576 CITY: ZIP: PHONE #; 9 3 1- / ? 74 401z'`k? SIGNATURE OF PERMITTEE COMPLETE THE FOLLOWING: N0. FIXTURES EA. TOTAL ADD-ON MINIMUM 15.00 SHOWER 3.00 WATER CIASET 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 OiIT. _ (MINIMUM - 1) 3.00 _ ROUGH OPENINGS 1.50 _ OTHER _ WATER SOFTENER 5.00 PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 SUBTOTAL S IS . S ? ST. SURCHARGE .50 TOTAL: S J 5. SJ COMMBACZfiL?INDLTST&IALs; PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL SUILDINGS AND MIILTI-FAMILY BUILDINGS WNEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: OWNER NAME: SITE ADDRESS:_ LOT: BLOCK INSTALLER: ADDRESS: CITY: PHONE #: FOR: CITY OF EAGAN SUBD. ZIP: FEES 18 OF CONTRACT FEE. STATE SURCHARGE _ $.50 FOR EACH $1,000 OF PERMIT FEE. $25.00 MINIMUM FEE. CONTRACT PRICE x 1% $ STATE SURCHARGE $ TOTAL: ( S I GNATIJRE ) $ 2000-BUILDING PERMIT APpLICATION (RESIDENTIAL) $6W ??) I 2'f„(?"?(J „ CITY OF EAGAN `"? 3830 PILOT KNOB RD - 55122 Ib 5. 5 0 C)0- 1?)31Sv 851-881-4875 OC NewConshucrionReaulrerreMs ?p?Ic? _ 6??-7. 00 Remodel/Reoair Reaulremenh ? ? 3 registered slfe wrveys ahowing aq. ll. of lof, aq. fl. of h0use 2 Copies of plan antl gH rooletl areas (20% rtaxlmum bt caveraae aNowe? 1 set of energy cdculatlons Iw healed ddtllHons D 2 caplea of p1aM (show beam & window dzes; poured Md. dedgn; elc.) 1 site survey fw exfeAOr addlqons A tlecks > t :et a energy caiculanona ? 3 copies of hee preaervaBan plan H lot plaHed afler 7/1/99 DATE: CONSTRUCTION COST: DESCRIPTION OF WORK: ?xT?IL?IQN ui?-- 4E7CK SiREET ADDRESS: 44`7-?- ,0 CC rt yj-=i2 LOT: <PO BLOCK: ? SUBD./P.I.D. #: Name: ?VVVVS)e? ??5,SE Phoneft: Lo6 I-"?5?- 775 j PROPERiY lasl Fint OWNER 11, r ? , r 1,, ,-- Sfreef CHy ZP6Ga State: ? Zlp: . Company: v)S? 1/%C Phone A: (?"??d'^ (area code) COMRACTOR stroerAaaress: (??l,? ucanse #9? Ey,'?(.?,,,,, . , ??v?? City (I L State: &J Zip: ARCHITECT/ ENGINEER Company: Name: Telephone M: ( Sfreet Address: Reglshation ri: Clty State: SeweNwater licensed plumbar (if installina seweNwater): Phorve #: Zip: I hereby ackrwwiedge Mwt I have read this applicaHon, state fhat fhe in(ormation Is cortect, and agree to comply wNh all apppcable Sta of MlnnesoM Stafutes and Cifyr of Eagan Ordinances. Signaiure of Appi'icanf: ? Certificates of Survey Received _ Tree Preservation Pian Received _ OFFICE USE ONLY Yes No Yes _ No ? Not Required ? OFFICE USE ONLY BUILDING PERMIT SUBTYPES ? 01 Foundation ? 07 QS-plex ? 02 SF Dwelling ? OS 06-piex ? 03 01 of _ plex ? 09 07-piex ? 04 02-plex ? 10 OB-piex ? OS 03-plex ? 11 10-plex ? 06 04-plex 0 12 12-plex WORK TYPE .2z?' GENERAL INFORMATION ? °13 16-piex ? ? 17 Garage ? ?18 Deck ? ? 19 Lower Level O Plbg _Y or _ N ? ? 20 Pool ? 21 Porch (3-sea.) 22 Porch/Addn. (4-sea.) 23 Porch(screened) 24 5torm Damage 25 Miscellaneous 30 Accessory 81dg. 31 New ? 36 Move Bidg. ? 43 Reroof O 32 Addition ? 37 O Demolish (Bldg)* ? 44 Siding 33 Alteration ? 38 ? Demolish (Interior) ? 45 Fire Repair Demolish (Foundation) ? 46 Windows/Doors 34 Repair ? 42 " Give PCA handout to applicant for demolition permit SAC Code No. of Units No. ot Buitdings Const. (Actual) (Allowable) UBC Occupancy Zoning .0 \_ # of Stories fL Length Width Basement sq. ft. Main levei sq. ft. sq.ft. sq.ft. MISCELLANEOUS INSPECTIONS O Stucco/Stone APPROVALS Planning Building Permit Fee Surcharge Plan Review License s no MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit Sl1N Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Totak 5• D ? IU sq. ft. sq. ft. Footprint sq. ft. Census Code MCIES System Ciry Water Booster Pump PRV Fire Sprinklered 6G Engineering Variance Valuation: $ i, z?0 4r ? 31 Ext. Alt - Multi ? 33 Ext. Aft - SF 0 36 Muld y3H SAC Units % SAC I ? ... ? s C4*t ?- ? n-- ??'i- ABING PERMIT (RESIDEIVTIAI.) CITY OF EAGAN 3830 PII.OT KVOB RD EAGAN MN 55122 (612) 6814675 PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIFiED FOR EACH UNTT. NO. - FIXTURES I EACH TOTAL i SHOWER il 3.00 WATER CLOSET 3•00 BATH TUB I 3.00 LAVATORY I ? 3.00 KITCHEN SINIK 3•00 LAUNDRY TRAY 3•00 HOT TiJB/SPA I I 3.00 , WATER HEATER 3.00 FLOOR DRAIN 3.00 GAS PIPING OUTLET • m+o+mum - i 3.00 ROUGH OPENINGS 1.50 WATER SOFI'ENER 5•00 PRIVATE DISP. • nek.cry. tic. 15.00 U.G. SPRINKLER -bome under consc. 3.00 ALTERATIONS • w adsiing 15.00 ° '? WATER TURNii AROUND 15.00 STATE SURCHARGE .50 TOTAL: ---- -- - - ? I /5•50 SITE ADDRESS _I LOtiG JUDV 4497 CLOVER LFlPE OWNER NAME: EflGHN , 55122 - H 481-0311 N INSTALLER ` - - BING J M ADDRESS: ?OS GARFIEID AVENUE SOUTH . CTT-y: 827-4033I 627-419-tATE: ZIP CODE: PHONE #: ( ) I SI NA RE OF ERMITTEE city of EaiaIl 3830 Pilot Knob Road Eagan MN 55122 Phone:(65Y)675-5675 Fax: (651) 675-5694 2008 RESIDENTIAL BUILDING oate• 72^ Z ' 1`?'? / SRe Address: Tenant: RESIDENT / OWNER ? Name: 0 ! Phone: Addreu / City / Zip: 7 a'-k .[? 479(15P+C"4' IS Ll2)0(_ Applicant is. _ Ovmer Contracta TYPE OF WORK Desaiption ot work: Construction Cost. 0 •? Multi-Famlly Bullding: (Yes No ? CONTRACTOR Name: - "e[6 hbN@. ?.i+??MG6 s License #: Z c) 4 Adtlress: lTeq 214 ``?A. City: Ewrnf r15 twi State: fA U Zip: Js 2) 7-T 7d'V C?17Pi G,S Phone: r0?7I ' ?Z3 Contact Person: ! JLlu COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateoorv t Minnesota Rules 7672 Energy Code . Residential Ven6lation Category 1 Worksheet • Naw Energy Code WoAcsheet Category Submitted SubmiHed (4 sUbmlBSion (yp8) • Energy Envelope Calculafipns Submitted In the last 12 moMhs, has the City of Eagan issued a parmlt for a similar ptan 6ased on a master plan? _Yes _No It yes, date and address ot master plan: Llcensed Plumber: Phone: Nbchenical Contractor: Phone: Sewer & Water Conhactw: Phone: NOTE: P(ana end wpportlrtg doctrments that you;submrt ane eonsidered to be pirbf(c Intomrailon. Pariio»s o/ , fhe informatfon may be classHled as non-putrl?c!t you provide specific reasans that woerid permit ihe Clty to conclude that the aie trade secrets: I hereby acknowledge that Mis information is complete and accurate; that the work will be in confortnance wiffi the ordinances and codes of the Ciry pf Eagan; that I understand this is not a permit, hut only an applicahon for a permit, and xrork is not to start without a permit; Mat the work will be in accordance with the apprwed plan in the case of work which requires a review and approvai of plans. 6 1 , .? X Bber? ,a6yeLp x ? Applicant's PHnted Name Applica 'e Slgnature I^ For_Dff(ce 4i?,g 16?7 I CfL Permit % ? ? Oate Received: j i i I Staff: I i ----------------- N Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA109201 Date Issued:02/19/2013 Permit Category:ePermit Site Address: 4495 Clover Lane Lot:26 Block: 01 Addition: Eden PID:10-22750-01-260 Use: Description: Sub Type:Residential Work Type:New Description:Furnace Comments:Questions regarding electrical permit requirements should be directed to Mark Anderson , State Electrical Inspector, 952-445-2840 Ashley Orman 130 Plymouth Ave N Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088 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 - Cynthia M Arle 4495 Clover Lane Eagan MN 55122 Standard Heating & Air Conditioning 130 Plymouth Ave. N Minneapolis MN 55411 (612) 824-2656 Applicant/Permitee: Signature Issued By: Signature From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:25 #582 P.002/079 Use BLUE or BLACK Ink For Office Use j Permit M , t City of Eap I Permit Fee: 79 11°9/ 3830 Pilot Knob Road Eagan I I Eagan MN 55122 ~ Date Received: ~ j I I Phone: (651) 675-5675 Fax: (651) 675-5694 i Staff: 06 1 - - - - - - 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: q-5- 2013 Site Address: S Lm 5 y 1 unit Name: CdtVl ftr7 C'0 • ~Vi( = Wm h~ Phone: Resident/ Owner Address/City/zip: V439flitu We&t payk-W U , Edetl%Mitie , MN %-Nq Applicant is: Owner -)LContractor i Type Description of work--Tear off and re- roi~ of Work Construction Cost: S OIS. OD Multi-Family Building: (Yes JC /No Company: A119INY [QnCJMCtDn W .rilLContact: JQC tact tfmd Contractor Address: 5145 Indl TiAl S1 etf # 103T City: MCIDiL Nam State: MN zip: 653,59 Phone: 952-941-74S79 a License BC10315'15 Lead Certificate NRT- 20910"4_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 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:aooherstateonecall.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. ! xJoe N-Qilsfegd x fly- ~ Applicant's Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA139718 Date Issued:11/04/2016 Permit Category:ePermit Site Address: 4495 Clover Lane Lot:26 Block: 01 Addition: Eden PID:10-22750-01-260 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Cynthia M Arle 4495 Clover Lane Eagan MN 55122 (651) 269-8859 Window World Twin Cities 2211 11th Ave E, #130 N St. Paul MN 55109 (651) 770-5570 Applicant/Permitee: Signature Issued By: Signature • ° For Office Use %° ° f Permit# •mss sr/ E AG N RECEIVED Permit Fee: b , '� MAR 14 2018 i Date Received: 5 � 3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff: buildinginspections aacitvofeagan.com L. " Y 2018 RESIDENTIAL ER L/\ NG MIT APPLICATION Date , .. Site Address. ni3 Tenant: —... i,44-.,:: '\...' e- i Suite#: 4 �® Na e: A.,../ ,r; i J._ ___0 r Phone: 3 061 ` l 3 j �•� ' r // / SS . i 4,"„.4-4-4...,, � ' Address/City/Zip, y,-4 ✓ `` i �' ` Name: MILBERT COMPANY dba CULLIGAN WATER License#: WC641376 l f'; m Address: 1801 50TH STREET EAST City:y: INVER GROVE HEIGHTS l State: MN Zip; 55077 Phone: 651-451-2241 r�i tfEtt Contact: BILL MILBERT Email: gloria.abas@culligan4water.com !t',..., gyps ,' 4e:: r _New Replacement Repair _Rebuild Modify Space Work in R.O.W. v r a.:t, r4.6 Description of work: 41 s �.# , �g. ,� RESIDENTIAL fi ,' ` w' - `,1 t`, ," Water Heater �.v 4ivicg t P ,, Lawn Irrigation(__-RPZ/—PVB) X Water Softener �� PermitrTyro 4 — � � Septic System _Add Plumbing Fixtures(_-_Main/ „ Lower Level) v � . ,- , , New Water Turnaround — „ -,ly, - - P ._r .. -, Abandonment RESIDENTIAL FEES: $60.00 Water Heater,Water Softener,or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation(includes State Surcharge) $60.00 Add Plumbing Fixtures,Septic System Abandonment,Water Turnaround*(includes State Surcharge) *Water Turnaround(add$280.00 if a 3/4"meter is required) $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$ 60.00 CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www,gopherstateonecall.orq You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www,citvofeagan,com/subscribe. 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,:n application for a permit,and work is not to start without a permit; that the work will be in accordance w the approved a I e cas .f work ich requires a review and approval of p s. )3() (?)}(Y\ - /1( __- Ap )Cant's Printed Name C , , 1 x Applicants Signature *y Alt x1.11 10s Y r. 'I 3 ' , a: o�" r' :' y -c,,,,,,,:,,, a- f FOR FIICCE�USE + i r * P g I �: °? 3 , A,` - x1 a4 '"r4 + .r"t r. .4,v1•4740~� i ,, i;- ,tr ,c, '3,41.0#3" r .4` a'pM .tea ff: 1Req irred Inspeo io s :- 6- G .un. ,; §( s Ir'h t �a tF �F alp ' +w rc " 41 ‘4,- 4' ,' ''. fir e 4 :::, Nlet`er Reiated Items, ` Meta Size . $,� 44' '1/ o ,ea •grl ome e� z , aS a 4 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA156965 Date Issued:07/26/2019 Permit Category:ePermit Site Address: 4495 Clover Lane Lot:26 Block: 01 Addition: Eden PID:10-22750-01-260 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 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 - Cynthia M Arle 4495 Clover Lane Eagan MN 55122 Haley Comfort Systems 4320 Hwy 52 N West Frontage Rd Rochester MN 55901 (507) 281-0138 Applicant/Permitee: Signature Issued By: Signature -------------i i For Office Use I Building Permit #: i� i 0 I I �0 �i I S&W Permit #: EAGAN I Permit Fee: Date Received: I 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 1 (651) 675-5675 1 FAX: (651) 675-5694 I I Date Issued: I buildinginspections(a)cityofeagan.com 1---------------------, RESIDENTIAL BUILDING PERMIT APPLICATION Date: W 7 /o4g2L2 Site Address: Unit #: Applicant is: ❑ Owner aContractor I 71Name:)_� e d k_ A!9C S e, C" a-41 Cy Homeowner Address: �� pC e q `�1� q 5 City: �aQ O_`� State:% Wip: 1>, Phone: Aoki-e' Email: Q Description of work: ►" 2 t: Type of Construction Cost Work Type of building: ❑ Single Family ❑ Townhome, of units Twin Home -Ths ��L/L (fO,—�-ef Compan r�A_�_,�-`p�/� Contact: Building Address: z-/3�� ( . i � j V-\A/ City:F-6ZF A Contractor State:% &4: �U `7/�/Phone6tZ-J,/ / / b 62(0 2 �� !Q(� License #: �� J Expiration Date: Sewer & Company: Contact: Water Contractor Address: City: Required for State: Zip: Phone: Email: new construction rLicense #: - Expiration Date:- ! I understand that Plumbing, Mechanical, and Fire Suppression work require separate applications. NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Contact Gopher State One Call at (651) 454-0002 or www.gopherstateonecall.org for protection against underground utility damage. Contact Gopher State One Call 48 hours before you intend to dig to receive locates of underground utilities. I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Z� Applicant's Printed Name A licant's Signature