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2002 Diffley Rd t Use BLUE or BLACK Ink For ofTice; I City of Eap ; Permit Permit Fee: :%MC 1 3830 Pilot Knob Road I ; Eagan MN 55122 1 Date Received: 1 Phone: (651) 675-5675 i Staff: - 1 Fax: (651) 675-5694 1 i INFLO INFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water Date: _ ^ t 0 Site Address:. am Tenant: h1 LEE&1 SI-M SuiteM RESIDENT / OWNER Name: K c7~E~ Phone: VIA" S (g.3 . Address / City / Zip: 9ma-DI -pokb TF~,~~j sslz?, Name: - License 9" 3R 3 !71n B(. Address: 't yR ~ l 1, loo, Sr. City: L l t CONTRACTOR State: K -Zip: Phone: bs; - 5J' O I Contact Nt I LAR kU) Ll; Email: @ PLUMBING (1Nithin the building envelope) SEWER & WATER (Outside the building envelope) TYPE OF WORK Sump Pump Repair Repair Other. A_ Other. Description of work: jL?q S171YLD1pooV E La- Lt or- ourr o DESCRIPTION TT O S FEES $55.001 Each (includes $5.00 State Surcharge) ' (Rev. 6-30-10) TOTAL FEE $ SS. *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit III repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeacian.com/inflow, or City Hail at 3830 Pilot Knob Rd. CALL BEFORE YOU DIG. Call Gopher State One Call at (661) 4540002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.oopherstateonecall.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 1 understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x 4owLE Ir x 01 .4 If 1 617~ Applicant's Printed Name Applicant's Sign re FOR OFFICE"USE Reviewed By: Date: Required Inspections: -Under Ground -Rough-in -Final EAGAN TOWNSHIP j? BUILDING PERMIT Owner ----- Address (present) Z..,_.140el.. .._...... _............ _... Builder .... _...-..-_ .......... ................... ....................... Address ..... ._ ........ .........._...__......-._.........---- .. G o Be _ Used For _ Front _- gy9o .? . po. LOCATION ?el_kl atl or other Description of Location N? 1.145 Eagan Township Town Hall Dale - /? 1< < '0' . on or 't'ract t?-t . l0e .Z? This permit does not authorize the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and general welfare to anyone in the community. THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. This is to certify, to erect a...4...__"_.. ...... r.'°-'??4?`. .upon the above described premise subject to the provisions of the Building Ordinance for Eagan ship adopie3VApril 11, 1955. ??j .J? . ?rQO"'F/ -a.L...------- Per .... ..._..NI.. E? j'` rt. !?c:!S.d.....__....-.....-_. Chairman of Tnwn Byrd Building Inspector This ruounst void ?? 1?Q ?e mon' romrr A , /'^/ TL LZ1 g?1 Cfan_r- Crow. Z n cL 9 -e, n-7 8- /0. o c] Request D.I. 11-12-82 Fire No. Rough-in Inspection RequneR 3[ -IReady New ?AWNotify,Insuec- K ? ?Yes L?No or When Ready ?ki7[ensed Electrical Contractor I hereby regpast inspection of above ? Owner electrical work installed at: Street Address, Box or Route No. City 2002 Co. Rd. 30 Eagan etlJpn o- Township Name or No. Range No. County Dakota Occupant (PRINT) ?ton Shaffer Phone No. 452-51813 Power Supplier Addrrss Electrical Contractor (Company Name) Contrar, u+r's License No. Rossoll, Inc. 40828 8 Mailing Address (Contractor or Owner Making lestailatlon) F.O. Box 254 Lake Elmo, Mn. 55042 Au o i gnature (Contractor/Owaer Making Installatinn) Phone Number c 770-5046 MINN SOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room N-191 - BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phnnn 18121 299.2111 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION -.w eR-ooool-os See instructions for completing this form on beck of yellow copy. T 76542? ,.: "X" Below Work Covered by This Request '3 3 OZ $? Now Add Reps , Type of Building APPI is nces Wired Equipment Wired g Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt Building Dryer Electric Heating Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Other peci fy Olhur ISper: ifyl [hei I pnciW Other Other Compute Inspection Fee Below - _- n Fee Service Entrance Si" d Fee Fenders/Subfeeders p Fee eircgits 0 to 100 Amps 0 to 30 Amps 0 to 30 Aries ' 101 to 200 Amps 31 to 100 Amps 31 to 100 Amps Above 200 Amps Above 100Amps Above 100_Arrlps Transtonners Remote Control Circ. Partial 'Other Fee Signs Special Inspection 8 flema rks 1e.5 ?? TOTq/. _ nd7 U• Rough-in Dn to I the c[rical Inspector, hereby tif th t th b Final i Date 1' ? ? cer y a e a ove inspection has been j ` made. This request void 18 manths I'm CITY OF EAGAN Remarks Cedar iii _ "_,.Q-L•..siti0n Addition,--Cedar Grove 2 Lot 2 Rik 1 Parcel 10 16701 020 01 Owne ?•L /street 2002 Co. Rd. 30 State Eagan:; MN 55122 Improvemen Date Amount Annual Years Payment Receipt Date STREET SURF. EEO 1985 1266.95 84.46 15 STREET RESTOR. GRADING SAN SEW TRUNK - *SEWER LATERAL Rik 1972 1304-00 2.1 2 Pa1d WATERMAIN WATER LATERAL 1972 WATER AREA STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 9UILDING PER. SAC PARK Fee Fill in numbered spaces S/C ? Type or Print legibly Tot. 9- SC) 1. Date 2. Installation Cost 3. Job Address 202 UO Lot81 k. Tract 4. Owner !- 5. 6. Address Phone U3q-770 7. City Q r-\ State MA) zip 55) ?2 8. Building Type: Residential $- Commercial 13 Institutional ? 9. Work Description: New ? Add 11 Alter 11 Repair ? f 10. Describe Fuel Type &?4 , 6a 5 1 11. Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN No. V Equipment BTU - M. Ea. Forced Air No. Equipment CFM Ai dli H Mfg. ^ Z r an ng: ? 7 ?OS`t Boilers 't I ?ZvSSow?? Mfg . Mech. Exhaust Unit Heater I I - 19 gL Mfg. Other Air Cond. Mfg. U 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 Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-8100 ------------------ 75 ? s j Permit#: I if ? Permit Fee: ?' 6 I Date Received: j I I I Staff: I 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: /1)'9 ` 9" Site Address: Tenant: RESIDENT / OWNER Name: \r' Phone: Address / City / Zip: Applicant is: -Owner Contractor TYPE OF WORK Description of work: l.ltZ;?,) I Construction Cost: 3 (rzon t oo Multi-Family Building: (Yes No CONTRACTOR Name:New Life Contracting Inn License #: 6030 Old Cedar Ave. S Ste. 119 MWS 55425 N Lie. #2024948 651-274-6943 Fax: 952-405-6106 State: Zip: 1111TY68i . Phone: David Johnson Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Category Submitted Submitted (4 submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents.that yob submit are considered to be public informaton „'Portions of ,- the information may be classified as non pUblicif your provide specifrc reasons that woufdpermit#fie City to ;l" concludeftiat the :ar?`trade secrets. " ?', I hereby acknowledge that this information is complete and accurate; that the work, will be in conforman a 'th the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permi, and ork is not to tart 'thout a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approv f pla s. ""lu Juuuauu , x x Applicant's Printed Name Applicant's Si ature Page 1 of 3 Suite #: City of Eagan 3630 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-6675 Fax: (651) 675-5694 Name: 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: / 1 ? 00O Site Address: 'tenant: RESIDENT/OWNER TYPE OF WORK CONTRACTOR 2 002 (7 I .fti ci, Address / City 1 Zip: Applicant is: _Owner --XContractor Description of work: A k^ ot" L/ L' Construction Cost: '3(0001 ----- - --------- ? Permn #: ? ` ? Perms Fee: ?Q • 0 b I j Date Received: j I I I Staff: 1 V - --J Phone: 8: Multi-Family Building: (Yes _ / No Name: _ New Life VotltraCtin4. Inc. License ft: 8030 Old. Cedar Ave. S Ste. 119 City: Ptr 651-27"043'Fax: 952 405-67(16 State: 6866 too Phone: _ DaVid Johnson Contact Person: Zip: COMPLETE, THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Category Submitted Submitted (J submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber Phone: Mechanical Contractor. Phone: Sewer & Water Contractor: - Phone: I hereby acknowledge that this information Is complete and accurate: that the work will be In con Eagan; that I understand this is not a permit, but only an application for a permit, ork is accordance wnh the approved plan in the case of work which requires a review and app vc x Liavla J6rl46n Applicant's Printed Name and codes of the City of that the work will be in l0179 Page 1 of 3 140C91 2006 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos when permits are required for each unit W3054 Date/ / Site Address Unit # Property Owner 64Ai ! K7 0?- Telephone # (?' Q ) ?D Contractor HALEY COMFORT SYSTEMS,INC. Street Address 122 4TH ST W _ City HASTINGS State _ MN Zip _ 55033 _ Telephone # 651.437.0338 _ Bond MN22641 Expires: 9/3/2006 The Applicant Is Owner Contractor Other Add-on or alteration to existing dwelling unit $ 30.00 furnace -Additional New XReplacement airexchanger T Y air conditioner 77?? heat pump other State Surcharge $ .50 Total $ 1 hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the ?york will be in accordance with the approved plan in the case of work which requires a review and approval of plans / /17 Applicanfs Printed Nam Applicant S Sign Y Use BLUE or BLACK Ink � r-------- ________;�m r � I For Office Use � • � Permit#: �� `f/"l'� Clty of �a�� Permit Fee: / ��l�� #f 3830 Pilot Knob Road _ - .� � I ' Eagan MN 55122 '•' � Date Received: 'lFs=lS � � Phone:(651)675-5675 � � ,, .._ � � Fax:(651)675-5694 -� - - �'�� I Staff: i I 2015 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: ;,� Unit#: �� ".�- ��-�� " Name: � n��i ��'�' �C' Phone: � �� £ Address/City/Zip: d'L � C�� 1��,��° (_ d 'w ��F: � r"�� : `: „ ` � �� ` Applicant is: �Owner 'Contractor ` �' '., i �: �, f � } �, �� Description ofwork: �� .S�i �� r�, A 1 '' �1:�� ° ��,�; Construction Cosf: I� �� Multi-Family Building:(Yes /No ) �� :x*� � ..-� . � "� �'� f� � � � � Contact. ' - � � } Company 'Y� ..�, ��. � � �� Address: City: �� t # � � � - . State: Zip: Phone: Email: �: ��:. `ri �� . n License#: * Lead Certificate#: If the project is exempt from lead certification, please explain why: ;,$ COMPLETE THIS AREA ONLY IF �ONSTRUCTING 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: Fire Suppression Contractor: � Phone: �� mm � ans�� r� cu� #ha' �+ou�+��3t,`' � 'src� a e 1i �' �x � ��# i ��,1'l� �'�'�t37!� �/ ��',sS1� � � �,�? �p � '�� 8 � � T��`� �`O , � � w�� p �,� � s r. � . ,, �ri� ...� �� ' � �, � � �� CAL� 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.aoaherstateonecall.orq ' I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of th 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 ill 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 Buildin Code must be complet withi 180 days of permit issuance. x �'tr��/ �l`� x Appli�anYs Pri ted Name pplicanYs Sign ture ' Page 1 of 3 � ��i'�. �� ,(-� lC---c,� j�� DO NOT WRITE BELOW THIS LINE l ,S�v,.,-�jS� SUB TYPES + Foundation Fireplace _ Porch (3-Season) Exterior Alteration(Single Family) � ' Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi) _ Multi _ Deck _ Porch (Screen/Gazebo/Pergola) Miscellaneous ' _ 01 of_Plex _ Lower Level _ Pool _ Accessory Building WORK TYPES _ New _ Interior Improvement _ Siding _ Demolish Building* _ Addition _ Move Building Reroof Demolish Interior _ Alteration _ Fire Repair Windows Demolish Foundation _ Replace _ Repair .� Egress Window _ Water Damage _ Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION „� Valuation � Occupancy ,�'�'jc--/ MCES System Plan Review � Code Edition ot ' SAC Units -- (25°/a_100% I/ ) Zoning �/ City Water — Census Code �!'9y Stories — Booster Pump _.. #of Units / Square Feet � PRV .- #of Buildings I Length � Fire Suppression Required -' Type of Construction �,j�{ Width �,_. �_— REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) � Final/No C.O. Required Foundation HVAC Gas Service Test Gas Line Air Test Roof: _Ice &Water _Final Pool: _Footings _Air/Gas Tests Final � Framing Drain Tile Fireplace: _Rough In Air Test _Final Siding: _Stucco Lath _Stone Lath _Brick Insulation �, Windows Sheathing Retaining Wall:_Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression: _Rough In_Final Braced Walls Erosion Control Other: Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee �3 ?- Surcharge Plan Review '�i' ? �- MCES SAC City SAC Utility Connection Charge S8�W Permit&Surcharge Treatment Plant Copies TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA178379 Date Issued:08/15/2022 Permit Category:ePermit Site Address: 2002 Diffley Rd Lot:2 Block: 1 Addition: Cedar Grove 2nd PID:10-16701-01-020 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the water damage. Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 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 - Randall Vern Bradach 18267 Italy Ave Lakeville MN 55044 Bradach Roofing, Siding & Seamless Gutters Inc 18267 Italy Ave Lakeville MN 55044 (952) 892-6015 Applicant/Permitee: Signature Issued By: Signature