2269 Clark St. . . • PERMIT #
PLUMBING PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Address
Lot 4 __T 7 Block , Sec/Sub
n, 1
y Name
m .
? Address ?
C C.Ity Phone
? Name ?
m •. ? '
Address
3
O Ciry Phone
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNNOElBE & CONDO - RES. RATE APPUES
MINIMUM - RESIDENTIAL FEE ?- $12.0b
MINIMUM - COMM/INO FEE - $20:(j0
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
sJ?vMirr`Eg
FOR: CITY OF EAGAN
BLDG. TYPE WORK DESCRIPTION
Res. New
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Ki?chen Sink - $3.00
Urinal18idet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
_..?_Water F#"er-_$1 50 - . --.- ? r1
Whirlpool - $3.00
Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIn
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE: '
STATE S/C:
? .
GRANO TOTAL•
CITY OF EAGAN Remarks
Addition R1ver Hi113 9th Lot 13 Blk 4 Parcel I Ain 04 ,
Owner?U l K. `. R['1`E. ?}')- C)1?" ?? ? 5 Street 2269 C1arkSTree?" State Eagan,It 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
* SEWER LATERAL -
WATERMAIN
WATER LATERAL
WATER AREA
STORM SEW TRK Paid thl:`ll UY'll ville
* STORM SEW LAT 1976
CURB & GUTTER
SIDEWALK
STREET LIGHT '.}?6 $
' WATER CONN.
205.00
BUILDING PER. 7
SAC
PARK
INSPECTION RECORD
CITY OF EAGAN - PERMIT TYPE: `i " `1 !' 1 "F'
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
? SITE ADDRESS:
?l l; IYIi!'
PERMIT SUBTYPE:
c!l1I,L1 t N
. iY - •- 1 61 1 . q o) VJ q -- 1. : Fi - 67 si
APPLICANT:
TYPE OF WORK: , rr Fi A j t (IN
WI)FkT
i I I Nfkl
? ?
Permh No. Permit Hoider Date Telephone #
ELECTRIC
PLUMBING
HVAC
Inspectfon Date Insp. Commenta
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 •
BLDCi FINAI
BSMT R.I.
BSMT FINAL
DECK FTCa
DECK FINAL
?
CITY of EAGAN
BUILDING PERMIT
owo.= .......????? .,.._::.l2.C?c-??....._.......`.'...............
. .............................
Addreu (Preseni). ...............................................
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Buildex ......... ..... Xle:(e: ? ?C?......,7.'??-... .?.: _ .. ?...4. u,
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Addre9! .................:. ....6?C•-....?.. ... ..... .. : 1.....:.....:?.?.a.?'-.?.
DESCBIPTION
. ,.
N° 3772
3795 Pi1o! Kmb Road
Eagan, Mixnesoia 55122
454-8100
Date ....... ......'_.?.a:...c.?. /??95
64osiec To Be Uasd Fos Fron1 Deplh Heighi Es2. Cos! Pesmit Fsa Remuks -
l
- , /
12
`
c.wuv LOCATION
5lreei, Road or ofher DeseripYion of Loeation 1 Lo! Block I AddIlioa os sae! '
?
/S
This permit does not aulhorisel the use of sl:eels, roads, alleys or sidewalks nos does ik give the o*ner o[ Lis agea!
the right to create any situaiion which is a nuisance or which prasents a hazard !o the hea?th, safaly, convealeacs end
genesal weltare !o anyana in the cammunily.
THIS PERMITMUST BE KEP/T ON THE PREMISE WHILE THE WORK IS IN PAOG S ?
This is !o cerlify, ffiaf....?.E,d`.,-.;?_ yl:----.-.---.hes permission 2o eree! --....ra2 . npon
the ahove described premisg..w?ijecf?to the provisions of all applicable Ordinances for Ife CYAy of Eagan.
_ ..:?
_?.....
---` - ?....._...... Per ..........
Mayor
13 -?/- Y. 'i.
i4;V'evh,lS
CITY OF EArAN
3795 Pilot Knob Road
Eagan, NLinnesota 55122
PERICT NO.: UG
The City of Eagan hereby grants to PAY u y-It-r
ef Mr'° -
a Permit for: (Cwner) W,.,,,e„_ .,s., ?,p?
69 lark St. &
at 4341 Medarv Ave. , purauant to application dated 114 .
Fee Paid: $40.00 dated this 7 day of Nov. , 79 75 .
1.00 s/c
Building Inspector
Mechanical Permits:
Sid Total:
CITY.OF E.4Ge?N
3795 1 ilot Knob Road
Eagan, .+iinnesota 55122
We)lJ 1-36 a ?l
e?"/,L r /41,11S
P2PuUti P,J..
Tt-ie City of ragan her. eby gr=i,ts to Thon'Pson Plumbinq Co.
?p 12201 Minnetonka Blnd.
a PLUMBING Permit for: ((hmer) Windsor Dev. Corp.
2269 C ar -?
at pursuanc to apnlicatirn: dated.
Billed
Feexktzd: nated this 12 yc,,-,?v of January
_?.7 -- -- -
10/17/86
19-76 - ---
L'?.111v.i11;? _TriS"i7G'C LOi
N:`echanical Permi';s:
646
iici 'Cota.l:
i.«,........,..__ _..._.. _.. ..?._•___
YILLAGE OF EACAN
WATER SERVICE PERMIT
37i3 Pilor iinob Road PERMIT NO.: 1918
' Eogon,MN $5172 DATE: 1/12176
'. Zoning: No. of Units: 1
Owner: Windsor DeV. COTP.
Address:
Sice nadress?269 Clark St. 13 B4 RH fl9
Plum -r: Thompson P1Mb3ng Co.
r No.?A?- Connection Charge:205. 00 pd
Size: ^S?/ Account lleposit: _
Reader No.: .?d.S? (0 _ permi[ Fee10.00 bllled #674
n v
I
oyrLe fo /o? Ir w'i?h tha Village oi Eogon Surcharge: • 50
/ .f il
O
d?i?aYC ? Misc. Charges: _60-00 ..?_
Total:
- BY Date Paid:
Date of Insp.: Insp.:
YILLA6E Oi EAOAN SEWER SERVICE PERMIT
3795 PilotKnobRood PERMITNO.: 2E75
Eagaa, MN 55122 DATE; 1/12 76
Zoning: RII 1
WindSOZ No. of Units:
Owner: Dev. Corp.
Address:
Site pddress: 2269 Clark St. L13 134 RFI 1P9
Plumber: 'Phompson Niwding Co
I a9r" fo eomply with fM Villoga of Eagan Cormectim Chazge"G7. Gu yci
Ord10°°°°& Accoun[ Deposit:
Permit Fee: 10.00 billed 4674
Surcharge; • 50 " "
$Y0 Misa Charges:
Date of Insp.: Total:
Insp.: Date Paid:
MASTER CARD
-a ?
OWNER
STRUCTURE AND
LAND USED AS
Permii
No.
Issued Issued To
Coniractor Owner
BUILDING
PLUMBING GAf(, ?
f
CESSPOOL - SEPTIC TANK
VJELL
ELECTRICAL
HEATING t 1.CI _ { Lio
GAS INSTALLING I
I
SANITARY SEWER I
OTHER
OTHER
Ifems Approved
(Initial)
Daie
Remarks
Disfance From Well
FOOTING SEPTIC
FO UN DATI ON - 7 CESSPOOL
FRAMING
FINAL
ELECTRICAL TILE FIELD FT.
HEATING DEPTH
OF WELL
6A5 INSTALLATION
SEPTIC TANK
CESSPOOL
DRAWFIELD
PLUMBING
WEII
SANITARY SEWER
??ti.N. ? ?s _ ? ?
_
Violations Noted
on Batk
COMMENTS:
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CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
2269
LOT:
RIVER
P.I.N.: 10-64400-130-04
PERMIT
e,< 6g0 / 5 / 0 --7-9(e
PERMITTYPE: BuzLozNG
Permit Number: 0 2 8 9 9 4
Date Issued: 10 / 0 4/ 9 6
CLARK ST
13 BLOCK: 4
HILLS 9TH
DESCRIPTION:
?%GAS INSERT
Bu`YXdin'g'.Permit Type
Building Wd;rk Type
,fCB?1SUS Cfld8. ?
*
r
? ?--
r '.
ky/
\.? aryv{x . ?.
. ? ' '?4-' - .
FIREPLACE
ALTERATION
434 ALT. RESIDENTIAL
7 ?
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
Total Fee
i:
$25.00
$.50
$25.50
CONTRACTOR: - Applicent -
6AVIC & SONS PLBG 1755646$
12725 NI6HTENGALE ST NW
COOtV RAPIDS MN 55448
(612) 755-6468
?
I hereby acknowledge that T have read this application and staCe that, the
inPormatian is carrect and.agre,e to cam,ply with a11 applicable State af Mn.
Statutes and Gity of Eaga.n Ordinancas,
?
APPLICANT/PERMITEE SIGNA7URE ISSUED BY: NATURE
OWNER:
ROSE GREG
2269 CLARK ST
EAGAN MN
(612)894-8562
I
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
1996 FIItEPLACE PERMIT APPLICATION
681-4675
/
DATE: / f? `' ?
DESCRIPTION OF WORK: CONSTRUCT NEW FIREPLACE: WOOD BURNING
A INSTALL GAS INSERT ONLY IN EXISTING FIREPLACE
_ INSTALL GAS LINE ONLY IN EXISTING FIREPLACE
OTHER:
FlYSl
ROOM TO BE INSTALLED IN:
STKEET ADDRESS: ?;zg 9
LOT _L BLOCK ?` SUBD./P.I.D.
APPLICANT: (circle one only) OWNER
I hereby acknowledge that I have read this applicaUon and state that the information is correct and agree to comply with
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
PROPERTY
OWNER
FIItEPLACE
INSTALLER
GAS LINE
INSTALLER
Name: l? Q A y j Zd ?(L Phone #:
Signature: _
5treet Address:
City:
Company: _
Signature: _
Street Address:
License #:
City: State: _
Companyl ??,`'- 65z?,P6
Name:
Signatu
Zip:
Phone #: 2
Street Address:
City: /?CJ??- ??.y?x-??' State: Zip:
GAS
ery- 6-?-4a
State: Zip:
Phone #:
PERMIT # RECEIPT DATE:
2002 iZE.SIDEN'f1AI. PLUMB1Nfi PERMIT APPLICATION
C1TY OF EAfiAN
SSSO PILOT KNOB RD
HAflAN, auV 551 22
651-681-4675
Please complete for: single family dwellings, townhomes and condos when permits are required for each unit,
backflow preventer for irrigation system
SITE ADDRESS:
OWNER NAME: : TELEPHONE
(AREA CWE)
INSTALLERNAME: Ao? CY,s-i*N1t TELEPHONE#: '/lS .
? ? ? (AREA CODE)
STREET ADDRESS: S'7 3 CT -
CITY: 1Yr?sDSe+_ STATE: L? • ZIP: SV.aV-Z
SEPTIC SYSTEM, new/refurbished (requires hvo sets of plans and MPC license) $ 100.00
includes $40.00 County fee
Note: Additional consultant fees may apply
• MODIFICATION/ALTERATION TO EXISTING DWELIING UNIT, INCLUDING:
_ Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00
_ Abandonment of septic system.
_ Water turnaround - existing dwelling unit (+ 5/8" meter if needed -$118)
Other:
_ RPZ: new installation/repairlrebuild $ 30.00
_ lawn irrigation system
ReplacemenUadditional: AV-water softener _ water heater $ 15.00
State Surcharge M .50
otal JUN
r
2 0 100 1
7
I hareby acknowledge that I have read this application, state lhatthe information is correct, and a e to com g?nth all aoolica6iP r. wnf rdinances. It
is the applicanFS responsibilityto notify the property owner thatthe City of Eagan assume ility for an m ra y e i uring its normal
operational and maintenance adivities to the HcilRies construded under this permitvitfiin ity;Zropertylr' --way/ ?'-
SIGNATURE OF PERMITTEE 1/02
/
Use BLUE or BLACK Ink
r
I For Office Use
~~ll I
Permit#: / 7I
City of EaWan s
Permit Fee: 105-4
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: ~3
I
2013 RESIDENTIAL
C~BUI DING PERMIT APPLICATION
Date: /0- e/ _ 2p/SSite Address: 22 6 / 4 Unit
Name: Z' /I~ Phone: 2.
Resident/
Owner Address / City / Zip: 2 2-6 ZQ } r ~ ~ ~ x(22
Applicant is: Owner Contractor
Description of work: Q roo
Type of Work _
Construction Cost: Multi-Family Building: (Yes / No )
Company: /q Contact: V q C 65 - 2Vg~- 2 60
Contractor Address: IZ L-Y~ac K ~i City: V
State: ~ Zip: Phone: -l 7 Z
License 46 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
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 St completed within 180
days of perm' it issuance.
x V~.C /J~~G(IGr!O x
Applicant's Printed Name Applicant's-5 g at e
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA119312
Date Issued:11/22/2013
Permit Category:ePermit
Site Address: 2269 Clark St
Lot:13 Block: 4 Addition: River Hills 9th
PID:10-64400-04-130
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Insert
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Paul R Grengs
2269 Clark St
Eagan MN 55122
(612) 840-4455
The Fireplace Guys Llc
680 Hale Ave N #110
Oakdale MN 55128
(952) 326-1919
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA136995
Date Issued:06/10/2016
Permit Category:ePermit
Site Address: 2269 Clark St
Lot:13 Block: 4 Addition: River Hills 9th
PID:10-64400-04-130
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & 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 -
Paul R Grengs
2269 Clark St
Eagan MN 55122
(651) 894-8562
Genz Ryan Plumbing & Heating
2200 West Highway 13
Burnsville MN 55337
(952) 767-1000
Applicant/Permitee: Signature Issued By: Signature