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2140 Cliffview Drt CITY OF EAGAN N? 6 7 0 8 , . 3795 Pilot Knob Rood Eagon, MN 55122 PHON E: 4548100 BUILDING PERMIT Receipt # - To be rmed for Est. Value Dote , 19 Site Address Ered Q Occuponcy Lot Block Sec/Sub. Alter ? Zoning Parcel # Repoir ? Fire Zone Enlcrge ? Type of Const. W. Name Move ? # Stories 3 qddress Demolish ? Front ft. ° Ci Phone Grode ? Depth ft. ? Nome Approvols Faes F ?? Address ?- r;.., Pti.,..e Nnme _ Address I hereby acknowledge that I have read this opplication and state that the informotion is correct and agree to comply with all applicoble State of Minnesoto Statutes and City of Eagan Ordinonces. AssessmenY =. Water & Sew. Pol ice Fire Erg. Plnnner Council Bidg. Off. _ APC Permit $u rcha rge Plan check SAC ,.,. Water Conn. Water Meter Rood Unit Totol 1 Signaturc of Permittee I A Building Permit is issued to: on the express condition thot all work shall be done in accordonce with oll applicable State of Minnesotc Statutes und City of Eagan Ordinonces. Building Official Powk # Dah Iwed PWOIflw Plumbin9 Mechanical Z 5$? 7-L- - -it- ? i C, 7 q3y$S -7-(3-FS S?tl\YNIS INSPECTIONS DATE INSP. Rough-In Finol Footings Dote Insv. Dote Irap. Faundation Plumbing ? ram /ins. MecFanical Fi ol n _??'/z ? Remarks: Receipt MECHANICAL PERM17 Psrmit No. CITY OF EAGAN Fea ' Fill rn numbered spaces S/C Type or Print legib/y Tat. 1. Date - 2. Installation Cost ' 3. Job Address J= - Lot Blk. Tract 4. Qwner 5. Contractor Phone 6. Address .?,.C37 7. City State Zip ' 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New C3 Add ? Alter ? Repair ? 10. Describe t`--1l ?.'- ?'?c':? t 'Fuel Type `" 1 11• No, 1 Eauinment 9TU - M. Ea. Forced Air No. Enuipment CFM Ai : H dli Mfg. r an ng Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg. 7 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 - ' Rouqh Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. ,, Approved CITY OF EAGAN 454-8100 Receipt PLUMBING PERMIT CITY OF EAGAN fill in numbered spaces Type or Print legibly 1. Date 2. Installation Cost 3. Job Address Lot Blk. , ? i Tract _ ` 4. Owner 5. Contractor Phone 6. Address 7. City State Zip ? 8. Building Type: Residential ? Commercial O Institutional ? 9. Work Description: New El Add 0 Alter ? Repair O 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cess o l/D field i Bath tu6s p ra o n 7 Se ti k Lavatory p c an ftner S Shower o Well Kitchen Sink Urinai/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : Permit No. Fee S/C Tot. for . Rough Final Inspections: Date Insp. Date Insp. ' This is your permit when numbered and approved. ' A'pproved CITY OF EAGAN 454-8100 ?ntifiraft uf Orruvaury Citp of (Eagari Drparimnt rrf Builbing 3noprr#inn Tbi.r Certificatc issued pur.ruunt to tbc requirement.r of Section 306 of the Unifor»a Building Corle urti f ying that at the timc o f i.rruarrce thir structure was in com pliance with the variour ordinunces o f the City regulating buifding constf uction or use. For the f ollowing: vach-;fi-,c;oo ?MI1g12 FaIa3,4 _DWg/(Qr4&ge aiag. eerTnit No. 6M Occnpanc.gTypa +TypeComs4uctionV FireZon" NA ZoningDistAciRl. 0lvocrofBuDdFng?C[cruual?iRmAddresa r7r1?MiV411"ii'zt .0 FdCII" 1 Inc • B„adim naa. 2I4 ?.n C;l i ffvi am T)r L---utyrn+ a ni ,,..?. ?z ?.,ao„ ni ??: 8,,: ?----?.. ,,..?..__ ??__ a,WangoreCW ...,? nACe: A.t?a>>e,?t 14o_1981 rosr iw • coHSricuous ruce CITY OF EAGAN Remarks Addition CEDAR CLIFF 2ND ADDN. Lot 2 eIk 3 Parcel Owner lrk L ` 17)162 L?i. st?aat 2140 Cliffview Drive State_ Eagan, MIIV 55122 Improvement Date Amount Annual Years Payment Receipt Date ' STREET SURF. 1']'] 5 355.31 5 STREET RESTOR. GRADING L 1983 Z 1 522.84 C007835 9-13-82 SEW TRUNK 4T.68 A0107 -1 - 1 ,t SEWER L,4TERAL 2 ' WATERMAIN * WATER LATERAL 1983 5 WATER AREA A010 7 -1 - 1 * STORM SEW TRK ?A 361.63 AOZO 7 -1 1 STORMSEWIAT -' 1982 756.57 151.31 5 756.57 0007304 10-1-81 CURB & GUTTER SiDEWALK STREET LIGHT ? Ro WATER CONN. BUILDING PER. 6708 sAC 525.00 25061 6-9-81 PARK ? z: r3 3 2,? CORRECTION NOTICE DATE: ? '2,? e!!? Address Site Name Owner/Agent Ordinance Nos. and Corrections - Correct By ?. _ -e ze For reinspection Eagan Dept. of Inspection 3795 Pilot Knob Rd. Eagan, Minnesota 55122 454-8100 Inspector. l Z\(Q d - - - - Dept.. Reader No,: 1 agree to eomply wiN+ the Cify of Eagan Ordiaonoes. By - Dote of WATER SERVICE PERMIT PFDAAIT Ai^ . Connection Charge: Account Deposit: _ Permit Fee: 5urchorge: Misc. Charges: _ Totol: _ Dote Poid: CITIr O! EAGAN SEWER SERVICE PERMIT 3796 Mlot Knob Road PERMIT NO.: E090n, MN 55122 DATE: ZOflIng: -? -r ???, No. of Units: - Address: Site Address: Plumber: _ 't J'au1 . /' - - 1 eyree M eomply wlth the Cihr of Eagap Ordineneea, By Date of Insp.: Connectlon Charoe: Account Deposit: Permlt Fee: - Surcharge: Misc. Ciwrges: Totol: K 1 186 l07 Request Da[e Fre No. IRoLigh-in lnsPe#U R ? ???Y Now C] WAI Notity Inspector 9-18 - 9 2 Q ?? )E No When Ready? Ik licensed contractor ] owner hereby request inspeCtion of above electrical work at: .lob Rddress (Street. 8ox a Route No.I Ciy 2140 Cliffview Dr. Eagan Section No. Township Name a No. Range Fb. CouMy Dakota Oocupanl (PRINTI Phone Mo. David Leeman PoweF Supplier Dakota Electric Address Farmington Electrical Contractar ICompany Namel Contracror's License No. Roehning Electric CAO 1557 Maihng Address IConVacta or Owner Making Installation) 14811 Endicott Way Apple Valley, Mn. 55124 ignature (Contractor? Makmg In allatron, ??? Phone Number ='?? 4 2 3- 4 3 2 8 MNNESOTA STAT£ BOARD OF iLECTRICITY / THIS INSPECTION REQUEST WILL NOT Gripya•Mldway Bldg. - Room 5173 BE ACCEPTED BY THE STATE BOARD 1021 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone {672} 642-0800 ENClOSED. REQUEST FOR ELECTRICAL INSPECTION EB.000(,-08 K 16186 , Sea instrudfons for completing this torm pn back oi yeilow oopy. "X" 8elow Work Covered hv Thic ajavw„oe? TypeofBuilding - - ---, AppliancesWired ---- ?- EquipmentWirad Home Range Temporary 5ervice Duplex Water Heater Electric Heating R Apt. 8uilding Other (Specify) Comm.Flndustrial Fumace Off peak meter Farm Air Conditioner ther Ispecify) Contractor's Remarks: Compute Inspection Fee Below: ther Fee # ServiceEntranceSize Fee # ircuit5/Feeders Fee Pool 0 to 200 Amps 0 to 100 Amps rs Above 2Q0 Amps AGove 700 Amps 1 Inspe Inswpe ctort ctorg Use Only: TOT W oms AL ?s- ? pection ' ? ? munication THIS INSTALLATION MAY BE ORDER NNECTEO IF NOT COMPLETED WITHIN 18 MONTNS. I, the Electrical Inspector, hereby Rough-in Daie ce?tify that the above inspection has Fi l na been made. o ? ) " • O OFFlCE USE ONLY - TAis request void 18 manMS from i ThiZ/eq?2 voia L 2i 3-31 18 months from a?,Sa aS73422 ? Date of this Request 6-29-81 Fire No. w43485 I, as O Lacensed Electrical Contractor ? Owner, do hereby request inspection of the above electri- cal wiring installed at: Strezt Address or Route No. 2140 Cliffview L CityEagan SecUon Township Which is occupied by Zachman Homes Range County Dakota Is a roughin inspec[ion required on this job? No ? Yes?C7 Ready Now ? Will Call ? PowerSupplier Dakota Electric Address Electrical Contractor Sunrise Elec tric , Inc. Contractor's License No. 397?8 (COmpany Name) Mailing Address 4120 83rd Ave N Mols Mi nn 95443 Authorized Signature Keith R Hel?,i Phope No. 566-8600 (Elactrical Contractor or Ownar Making This Installatlon) (?'???? ? O??D fI'O?? This inspectian request will not 6e accepted hy the L} ??, State Board unless proper inspectian fee is enclosed. Minnesat3',1tWte Board of Electricity Griggs Midway Bldg, = Room N791 EB-00001-02 _ :821 University Ave„ St..Paul, Minn. 55704 - Phone 297•2111 aS 73 ? REQUEST FOR EIECTRlCAL INSPECTION 43485 CHECK BELOW WORK COVERED BY THIS REQUEST T For Wired For I Hor-e $] ? ? Range ? Temporary Wiring ? Duplex ? ? ? Wa[ex Hea[er ? Ggh[ing Fix[u[es ? ApL Bldg. ? ? ? Dryer ? Elec[ric Neating ? Commercial Bldg. ? ? ? Fumace ? Silo Unloadex ? Industnal Bldg. ? ? ? Au Conditioner ? Bulk Milk Tank ? Faxm ? ? ? List t l?A List , COMPUTE INSPECTION FEE BELOW Servire Entiance Size: ik Fee Feedecs&Subfeeders: # F # c-^ D to 100 Am s. D.CCj' 0 to 30 Am eres es / 9SU 101 [0 200 Amps. 31 to 100 Ampeies eres . Above 20 0_Amps. Tcan mers Above 100 Amps. RemoteControlCiic. Pa[tialorotherfee SiB Special lnspection Minimum fee $5.00 Rema TOTAL FEE a? i?iapc??vi uctcuy cet ? [ I III o e mspect?on nas dee9ymade. )-,?"O (Rough-m) n Q?iL?.Q,? Date / /3- -b (Final) Date / 1- ? -6 1 This request void 18 months from REQUEST FOR ELECTRICAL INSPECTI „-•. ? 5?5 J ?J ? (? ?i ? See inslrucrions lor comvleLng tM?s formun . 04- eL{pW,,,.opv- ? _ "X" Below Wmk Cave; ed by This Reauest '7 n„ z--- i Ed- 00001-03 ? New Add Aep. TYae of Building Appliancas Wiretl EquIpmen[ Wved Home Range Tempoiary Service ?uplex Water Heater Liyhnny Rxtures Apt ?wlding Dryei ElecLnc HeaYin Commercial 81dg Furndce Silo Unlo2der Industn2l B?dg Air Condrtioner Bulk Milk Tanl< Farm ONei SpeciFy Other(SUeritYl Oihei Succfv? Othor Oiher # Fee ServiceEntmnce5ize N FnP Feedeis:5"ble.rtlers 4 Fee Cvcuits 0 Yo 100 qm)s 0(c) 30 qm>s 0 tn 30 Am>g 101 to 200 Amps 31 ro 100 Amps 31 to 100 Am s Ahove 200 AmPS A6ove 100_Amps A6nve 100_Amps Transrormers Remote Control Qrc. ParLal-'Other Fee Signs All ? 'Special Insp ftemarks ?` ? ?u`' ? - i ?•? S T TAL F E ???? ? Rouph-in ? IJaie J. the Electncal Inspeclor, here6y Fnnal p p cerhly that the above - ?--21?? IspectIpn h25 bee.n de. _ 18 niontns hom This rc?Ist voQid 18 mon[ig from 4 53539 L? i 63? Renuest Datc ? Fim No. Fuugh-in Inspa<amn P qi iretl? ?Featly Now Q Will Novfy InsPec- I ?Yes No «'r When ReadY LAucensect tiectncal Contractor . 1 hereby repuest msuechon o1 above ? Owner el0etrical wnrk inetwllad ar Street Atldress, 6ox or Route No. 4 'au u---J? Crtv 6 ecUOi o. Towns ip e or No. Hangc No. Go? Oc uGani (PRINT) PM1One Nn. Power Supplier AAtlress EI ical Coniractor o Company Name) y ` n `1 Conhactor's Licunse No. Mailinp AtlJr ICont s?Q` ctor or'Owner Makinp InstailauoN ??? ?? ? J AUth rized S1gnature onv t/ wner Mxkan ?stal Uonl Phone Num?er'^ ?37- a8 7 MINNESOTq-STATE$OAHD OF ELECTA6ITY:' 'THi6 INSPECTION REQLEST WILL NOT ... Griggs-Mndw3V Bld9: - HoOT N-191 gE ACCEPTEO 9Y.THE STATE BOAflD 1821 l/nivavsityAVe., St Paul, MN55106 ' ' - .-UNLESS_P0.0PER INSPECT{pN FEE IS - Phune (6121297-2111 . . ENCLASEp. RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-881-4875 New Conetructlon HeaulremeMe HemotleVReoalr Reaulrements • 3 registared stte survays slwwing sq. ft. of lot, sq. fl. of house; and I roofetl areas • 2 copies of pFan (20%maxlmumblcoveragealbwed) • lsetofEnergyCakulatbnsforheatetladd8ions • 2 copies of plan showing beem & wtrMOw sizes; pouretl found design, etc.) • 1 sMe survey for exterbr adOAions 8 tlecks • 1 sat of Energy Celwlatbns • InGicete'rf home served by septic system IoraCdMbns • 3 copies of Tree Presarvatqn Plan tt bt plattetl afler 711193 • Rim Joist Deteil OpGOns seleclbn slieet (bl0gs with 3 or less units) ? DATE \v VALUATION 'V ti0?'? . ? 0 SITE ADDRESS ?.\y 0 ?'.L\:1;4 \i ti-i-W _b?_ MULTI-FAMILY BLDG _Y ,_? N TYPE OF WORK7`'crOZ O?? I?'E?Q 0? Sc FIREPLACE(S) _ 0_ 1_ 2 APPLICANT VIQY-fiW XCK1Yc\li STREET ADDRESS ?aRIM 4q3`d WN1113W, AV'S, _ CITY CUSTh(., STATE M(S ZIP 15514 4 TELEPHONE CELL PHONE #\D\?\ FAX q"W3 -qRl- 0? 0'1 PROPERTY OWNER_Te_l __bv?l 'bD TELEPHONE # V51- '486 4 COMPLETE THIS SECTION POR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNFSOTA RULES 7672 (4 submission type) • Residential Venlila8on Cetegory 1 Worksheet Submitted • New Energy Code Worksheet Submiried . Energy Envelope Calculations Submitted Plumbing Conhactor: Phone # ___ Plumbing system includes: _ Water Sofrener _ Lawn Sprunkler Fee: $90.00 Water Heater _ No. of R.I. Baths No. of Baths Mechanical Conhactor: Phone # Mechanical system includes: _ Air Conditioning Fee: $70.00 _ Heat Recovery System D??? n?j ? n I 1 ?' I Sewer/Water Conhacfor: Pho tl i? J u ------------------------------------------------------------------------------------ ----- I hereby acknowledge that I have read this applicatlon, state that the informati is corr, and?9tee- o comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Slgrwture of Applicant\-"-\\'A+..? -°--------'----------°---"-'-^------°-°--------._...__???.r_? OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 PERMIT # ' 3o- RECEIPT DATE: 2-'LLL_LL? -r'' ? fi£S1WINTIAL PLUM$Iftfl PEft14I1T APP11CATION crrY oF EAsAv 3830 eaor xxoa Rn EasAx, Mtv ssiE2 651-691-4675 Please complete for: > single family dwellings ? townhomes and condos when pertnits are required for each unit ? backflow preventer for irrigation system SITEADDRESS: 6;117 v OWNER NAME: : ATELEPHONE #: (AREA CODE) INSTALLER NAME: TI4,..??r TELEPHONE #: STREET ADDRESS: 2800 Campus Di., Ste. # 40 (AREA CODE) C ITY: Dl.,n . nc.r4 m?r4 ncvY }n }hc nermi} wnr4 tvna STATE: ZIP: New residentiai dwelling unit under construction and not owner/occupied $ 90.00 Add-on, modification or alteration to existinq dwelling unit, including: $ 50.00 • abandonment of septic system • new instailation/repair/rebuild of RPZ • lawn irrigation system • waterturnaround ? Nature of work: ,I/,q-4L Septic System, new/refurbi^,hed - $ 225.00 • includes County & Consulting Inspector fees • reqwres MPC license State Surcharge $ .50 Total Reminder: 8e sure to schedule inspections of alterations, i.e. wa[er nea[ers, wace soneners, ew. I hereby acknowledge that I have read this application, sWte that ihe information is correcl, and agree to compl all applicable CityoFEagan ordinancas. It is the applicant's responsibility to notiry the property owner that the Cily of Eagan assumes no liability for an ages caused by the City during its normal operalional and maintenance activities to the faciliUes consVUCted under [his permit within Cily property/r' ? ffwayleasement. SIGNATU E/? F PERMITTEE ? Updated 7l01 2000 STORM DAMAGE PERMIT APPLICATION (RESIDENTIAL) CITY OF EACAN 3830 PILOT KNOB RD - 55122 ?J I 1?5 651-681-4675 Reaulremenfs > 2 copies of plan DATE: Zll S/a/ CONSTRUCTION COST: ? ?PB?S •`? DESCRIPTION OF WORK: e2es7"r L4914y- W,9446w c/?u'??ll( multi-famiry bldg., how many units? INDICATE THE FOLLOWIfdG EQUIPMEPlT TO BE REPLACED APfD BY WHOM: _ Plumbing _ Homeowner Qr Contractor Name _ Mechanical _ Homeowner gr Coniractor Name "Note: If somebody other ihan the homeowner is pertorming plumbing or mechanical work, ihey must apply for appropriate permit. Only Ilcensed plumbing contractor or homeowner may compleTe plumbfng work. STREET ADDRESS: o!qG l°? jfT=V1C4? QA2IVP- LOT: BLOCK: SUBD./P.I.D. #: Name: kAs? Phone #: PROPERN Lasf Plrsi OWNER Skeet Addreu: 21L1G Ciry ka6aa. State: 4lA/. Zip: t7S'/7-!Z=' zye -6t?2-2- Company: Phone #: s-l- a(- o°zZ (area code) CONTRACTOR StreefAddress: '3G7fr License#Z.GZL?Gy/ Exp..3? City State: ll'Ja! • Zip: ??Z 3- Z22Z Fn[? ?? ? ?JI I? FEB 1 5 2001 1 I hereby acknowledge that I have read this application, state ihat the information is correct, ond agree to comply wilh all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signaiure of Applicant: l ? CITY OF EAGAN . ' 3795 PiIM Knob Rwd Eagan, MN 53722 N! 6708 PHONE: 454-8100 BUILDING PERMIT APPLICATION Receipt # -2 S_-Zl G ! To be uted for SF DWG/?r'M Est. Volue 47.000 Dote Jl1i1E 9 1981 Site Address -2140 C] 1ft't11nw DTi q Erect n OccupancY $4 T - Lot_2-_ Block_ ,3_ $ec/Su6.s%E.dSL C1ifP 2 Alter ? Zoning R1 Parcel # 10 16601 020 03 Repair ? Fire Zone Enlarge ? Type of Const. `1 w Nome _ 7aClimr+n Hnmagi Inr Move ? # Stories 3 Address 7760 Mitchell Rd: Demolish ? Front _ 56 ft. ° g Ci _ F.A_ n PPaipita phone 937-52() Grade ? DePth 2/h ft. ? Name (lwnnr Apvrovols _ Fees o - u? Addrei5 r ?:... Name_ Address I hereby acknowledge that I have read this application ond stote thot the information is torreci and agree to comply with oll upplicoble State of Minnesota Storutes and City of Eogan Ordinonces. Assessment A Water & Sew. Police - Fire Eng. Plonner _ Council _ Bldg. Off. _ APC Permit 1 33 nn Surcharge ?3-5f1 Plan check 66_ 5f1 SAC S9a_nn Woter Conn. 3 35_pa W oter Meter _60 .? QQ_ Rood Unit.],$5.,.n0.__ Total 1329 ?lV1 Signature of Permittee I A Building Permit is issued to: ZEtCt]ID9II Hom@9, Inc. on the express conditfon that oll work sholl be done in occordonce with oll app?li?y/yle Stote of M?i` °to Stotutes and City of Eagon Ordinances. Building Officiul d`:"-L? ? 1U CITY OF EAGAN r`? -nclude 2 sets of plans, `?-? 1 site plan w/elevations & BUILDNG PERMIT APPLICATION 1 set of energy calculations. Zb Be Usecl For Valuation Date Site Pddress: e?1 OFFZCE USE ONLY Lot a Bloclc ?J Sec./Sub. ?€?'ect X_ Occizpancy Parcel ti 0 p,lter Q3 Zoninq Repair Fire Zone ?- Enlarge Type of Const. ? Qaner: _ Move # Stories Pddress: )`1? C) Deinolish Frant 5-? ft. ? _ Grade Depth ;2? ft. ? CitY/Zip Code • ?? 4 Phane i#: C\b"` - q?jo10 J APPFt0UAL5 F'ff'S Contractor: Pddress: City/Zip Cocle: Phone #: Arch. /F7ig. : Fddress: City/Zin Code: Phone #: ao Assessments Permit ? 3 3 Water/Sewer Surcharge a23 ? Police Plan Check il'G, _S2?-o Fire SAC _ g19 , Water Conn. 3 3,5- planner Water Meter / O -? Council Rnad Unit ? ?p Bldg. Off. APC ZCYPAL L3 ?? , o 0 ? CALVIN N. HEDLUND 9609 oirarE Arsnus soutn Land $urr? sr Bloominqron,Minnesofa 55431 P Cirfl Enqflloa PhoM : 886-2080 IV $11reefor04-f ee4iXte JOB NO. 216 SURVEY FpR: 2achman Homea DESCRIBED AS- Lot 2, Block 3,CEDAF2 CLIFF SECOND ADDITION, City of Eagan, Dakota County, Minnesota and reserving.easements of record. 4D4.5 L : ? ? 10'd STKS, -75-.00 ?------, I I 'I o ?I N I 36 20 -'?- I Ib? n+i RIA2u?anp ? GAR. ry I - `o ? DRivE l j 904.8 ToP oF BLOCK = 904.5 $ASEMENT FLOOR = 901.3 GARAVE FLOOR = 904,1 pRAMR6E qRRo4v PRaPOSED ELEVATYONS E-VISTIN(y ELEVATIONS paams L-or coaroER ' o 1o'O srt-'s. 3 If1 Rj GLIFFVIEW bR1VE qo0.6 9oi.o CERTIFtCAYE OF 3 RVEY i hereby cerfify thoi on Mqy, 2'J, 190f I survtysd the property descri0ed above and thot the aDove plot ia a correct represenfotian o} soid surr,? Cairin M. Hedlund. Minn. Re¢ No. 5942 Use BLUE or BLACK Ink r---------------- i I For Office Use. //63 d~ I Permit 1 U City of Ea i i Permit Fee: S55, 00 v I 3830 Pilot Knob Road Eagan MN 55122 CDate Receiv d:_^~/ Phone: (651) 675-5675 I Fax: (651) 675-5694 I Staff: I ---------I INFLOW & INFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water Date: ~g/~3/~1011 Site Address: - q0 GQ~F iua `7c,v~ Cc~a~ , p~~ll ~512'~ 1,24 Tenant: Suite RESIDENT / OWNER Name: + ~o Phone: Address/ City/Zip: (21440 04XAew 'Dn_e, A o~1N~ 551 Name: License CONTRACTOR Address: City: State: Zip: Phone: Contact: Email: PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope) TYPE OF WORK Sump Pump Repair Repair Other: Other: Description of work: Q~xov ktrm DESCRIPTION FEES $55.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ 55.00 *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.cityofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd. 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. X_ G I Q0 x Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In Final` PERMIT City of Eagan Permit Type:Building Permit Number:EA124393 Date Issued:06/30/2014 Permit Category:ePermit Site Address: 2140 Cliffview Dr Lot:2 Block: 3 Addition: Cedar Cliff 2nd PID:10-16601-03-020 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required by law in ALL single family homes . Han Phan 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 - Tri Duc Do 2140 Cliffview Dr Eagan MN 55122 VP Construction of Minnesota Inc. 2263 Tilsen Ct St. Paul MN 55119 (612) 644-3866 Applicant/Permitee: Signature Issued By: Signature