2043 Copper Lane
' Use BLUE or BLACK Ink
For office U_se
City Permit of Ea ~~n Permit Fee: 0o I
3830 Pilot Knob Road i /
Eagan MN 55122 I I Date Rec ived:
Phone: (651) 675-5675 AN ~ `51 v ~ I
I
Fax: (651) 675-5694 I Staff-
--J
2011 RESIDENTIAL PLUMBING PERMIT APPLICATION 22) L-n
Date: 4-10- Site Address:
Tenant: Suite
RESIDENT / OWNER Name: s~toixtfs Ph(one:
Address/ City/ Zip: C(C U
CONTRACTOR Name: 02 i YaT o l License
Address: r~)X ldP ~ City: '
State:- Zip: Phone:
Contact: Email:
TYPE OF WORK _ New X Replacement _ Repair _Rebuild _ Modify Space _ Work in R.O.W.
Description of work:
PERMIT TYPE RESIDENTIAL
Water Heater _ Water Softener
Lawn Irrigation RPZ I PVB) Add Plumbing Fixtures L_ Main / Lower Level)
Septic System Water Turnaround
_ New
Abandonment
RESIDENTIAL FEES:
$55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation (includes $5.00 State Surcharge)
$55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround" (includes $5.00 State Surcharge)
'Water Turnaround (add $166.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
$95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) 60
TOTAL FEES $
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 w rk which requires a review and approval of plans.
x~ x z2gw
Applicant's Printed ame Applicant' ature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground -Rough-In Air Test -Gas Test -Final
l~~~g secs
CITY OF EAGAN Remarks * Cedar Grove AC'cniisition
Addition CEDAR GRUVE #4 l.ot 41 Rlk 4 pef,,, 10 16703 410 04
Owner ?` -`'• /??- Y?- Street 2043 Copner Lane State Eagan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
* SEWERLATERAL 1972 1,304.00 52.16 25 Peid
WATERMAIN
? WATERLATERAL 1972
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
51DEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: ?? 1? U 1 Ml?
3830 Pilot Knob Road Permit Number: ?i?'?g?
Nf?/11/42
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: LQT A q j, f# L tl(:K •, A APPLICANT:
3843 COPPER LANE C4,1l1M?RY SIDE ?t10i.$ •
' CEGAR ONOVE 4 t612j 131-9746
?
PERMIT,&UPTYPE: TYPE OF WORK: Nru
F(lOi'TMG
FINAE
IFFMlA1?K?+: REGExPT # (2019030
I"OR00140 POOl.
'7l9
f
??---?- - ?_;-=?-__?_--,_ -------- =-- -.1
LL
Psmtlt No. Permft Holder Dste Telephone #
snW
PLUMBING
HVAC
ELECTRI
ELECTRIC
Inepection Dats Inap. Commentc
Pootings I
Foundation
Framfng
R4ofing
RDUgh Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg. -a/.,
Orsat Teet
Final Pibg. Plbg. Inspector - Notify Plumber
Const. MBter
EngrJPlan
Bidg. Finel
Deck Flg.
Deck Final
Well
Pr. Disp.
HOUSE HEATING TEST RECORD
ADDRESS APT
OCCUPANT OWN
HEAT LOSS DATE HTG. INST.
_FLOOR CITY 6 '"YU BURB
SOLD BY INSTALLED BY
Eleefrical Wark By Gaa Line By -
TYPE OF HEAT GA _ FA A- HW ` STEAM SPACE HTR. -
UNIT HTR. -OTHER
.?-,n G
) K??? ? 5 ?D-5{ GN
`
? CONVERSION
MAKE ? MAKE OF BURNER
Model
Model
S
i
l Max
BTU RaTin
a
er .
g
INPUT MAKE OF FURNA
Model
C TROLS
?
THERMO TAIy H
Pl t Size
Vs
?? ? eat
ug n NONE
SIZE?
Valve 1
LimiT ?,''?6° KIND OF LINERA
DmfeHood TI) *-a VCcr,r -
Regularor LO&J .?fis?'+?1<???
`?-
LimitSetting aL)7/- Filtars Size Num4er
Fon $et}ing Chimnsy Location Inside Outaide
/1%, 4?wE~4cp
T tion
Chi
C
tr
ype
Pilof mney
ons
uc
Make
Pilot
Mo
Pilof del Smoke 8omb Wiring
Pilot Timing Draft v Test Tag ,-?
L.W. Cut Of4
Door Prossure ? ?
Lighting Inst. ''°
?
t! P
C D
T
rod
t
Prossuro ereant
O2 a
as
e
CF
Qv? P
t O
? Tes '
Co
an
Input
H
, ercen
T ,
mp
y
`Z> P N
f T
f
Staek Temp. arcenf CO es
er
ama o
Form 235
EACeo?6ol TOV!/N S hi I P
BUILDINC; PERMIT
Owaex ---- -------._?...`-?`?"?-.=-_: Co.
_----'-----`--'-'-----
Address (Presen!) _.?t-.r--..? :-..? WLW...,?t-_-??-z:.*.cr+:? •
Bvllder ----------------- --------------------- -------------------- -----.....--------'-----.
Address ............. ...................... -------------------------- _-----"-------..--..
N° 7'79
Eagan Township
TovVn Hall
Date _L?..7? Z " - &../ ---
Biories To Be Used For Frant -Depih
I Heighf I Esl. Cos! Permii Fee Aemarks
- 7
" LOCATION
or
Lo! Rlock ! Addilion or Trsci
w` H
- 4J
This permif does noi auYhorize the use of sireels, roads, alleys or salks nar does it give the ownei or his ageai
the xigh2 to creafe any situaiion whieh is a nuisance or which pxesenfs a hazard So the healih, safeiy, convenience and
general welfare fo anpone in ihe eommuniiy. '
THIS PERMIT MUST HE KEP}' ON TFIE PREMIS£ WHILE THE WORK IS IN PROGAESS -
This is !o aerlifp. . •....QO.-'-_.. _.haspermission So ereei a----- -7-'-_--.._.--_'____._- -------- upon
!he above describe re " sub'ec3 !o !h p visions of the Suilding Ordinance fez Eagan Tovrnship adopied April 11,
1955. ?
-"-'-"-- ??Za??? .-L!. ?_......--..... _ .?.-.. Per .......... .... -- ?-7- ? -- '-- - --' .../ _?
Chairman of Tnwn Board Building InspecTOr
/:M I
S S 9?--
099
p
.c?i,
Reyues? ?ate Fve No Rough-inInspecoon
FeqmrStl' ?ady Now I N O Noniy Inspecror
When
ReeGy°
Ves o
IX(Icensed contracror J owner hereby requesi inspeclion of above electrical work at:
Jo? Atltlress (Slreet 6ox or Rou1e No I
-
)ey-
c tY
I
?0
c)
Se<ton rvo Towrenry Name or o Range No ?
Ko?
a« PRINr,
? Pno?e No
?ts4-?'osy
?r
c erz--
Adtlress
PowerSUpplie .?rt1rn^ J11n1n?? n?,) `` 5S0`,
?? ?ii? n w c c t ?
EIecV cal ConbaGOi CCOnpnny Name)
- vr?herri ii--kc trrc Inc , Con c?ors L¢en5e No
C'W C? ?23?7
Mmhng Address iCOnlrecioFa Owrer MaRinyJus4 i
p'o
S ? ?t?c 1
L:)?? I IaI
A.itoor iyni Ir2q ?i0ci 5 Mnkmg Insla1lat,01? Pii Number
4s?-.3aalk, _
,
MINNESOTA STATE BOARU OF ELECTRIQT THIS INSPWTION REQUEST WILL NOT
BE AGGEPTEO
Gnggs-Mitlway Bldg - Room 5-173 BY THE STATE BOARD
1821 UmverSily Ave. 51 Pdul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 66E-OBW ENCLOSE? _
REQUEST FOR ELECTRICAL WSPECTION Eeooomoa
lo See insbucliore tor comp150ng'nrs lonn on beck ol yeliow copy
E
neiow vvarn wvereu uy
ew Aad Rep
TypeofButlding AppliancesWired
mWrted
Equipmz
,
Home e
Rang Temporary Servme
Duplea Water Heater Electnc Heatmg
' APt Bwlding Dryer Other (Specdy)
Comm /Intlustrial Fumace ?
Farm Air Contlitioner
-- oe,er isueo,ry: oo??a? s aama,us ?- r r(7 u nGl
?
`
hange se? v; ce.
?
Compute Inspecbon Fee Below,
# Other Fee # ServiceEnlranceSize ? Fee # wis!Feeders Fee
Swimmmg Pool 1 0 to 200 Amps IA9 0 ro 100 Amps
Transformers ? Above 200 ? Amps I Above 100 _ Amps ?
SgOS Inspeciors use Only
' TOTAL
S;
IrngaUOn Booms
Gul`
l
So
Special Inspection
Alarm/Commumcation THIS INSTAILATION MAY BE ORDERED OISCONNECTED IF NOT
IOther Fee COMPLETED WITHIN 18 MONTHS.
1. ihe Elecincal Inspector, hereby Roughrn Dale
certify Ihat the above inspection has
! c/
F,,,,i / DatD J4J
been made
OFFIGE USE ONLV
TN5 repu25t void 18 mor.IDS from
L
9a-
/O?o
2 2 8 19
Reque9 Date Fire No dgh-in Inspedron
aqi ? ReaOy Now C Will Noby Inspwor
'
G Ves G No When Ready
I 4.licensed contractor ? owner hereby request inspection of above electriral work at:
Job Atltlress (S?reet. Box or Route
No
I Cpy
h
?
?
?.
G
.
Secuon No Township Name or No Range No County
Occupant(PRINT)
- Phona Na
1
EezZ ? CG f'_ v
Power SuoOlier
N-?- C Atldress
Electncal ConVactor (GOmpany Name) ConVactor's License No
c
C:U?I1'?:?. ? JCYn'= ? ?.R,? ?
U`'F
Mailrng qQ?r Conlraclor ner Marcrng Installalion?
3? C (•
.]U ? 1 ,i?Atc?a
AutM1Onzetl Si5^aWre (COnttactooOwner Making Installauory Phone Number
t>
MINNESOTA ST?TE BOARD OF ELECTRIQTV THIS INSPECTION REOUEST WILL NOT
Gngqe-MlOway IEg - Room S-173 BE ACCEPTED BY THE STATE BOARO
1821 Umversiry I.ve., St Paul MN SSIDC UNLESS PqOPEfl INSPECTION FEE IS
PMne (612) 6C2-0800 ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION Es-oaooi-oe
J 22819 See mstmpwns mr wmvleong mrs lorm on bacx ot yellow copy E? . /a?p?O
X" 8elow W,;.k Covered by This Aequest
e Atltl Rep TypeofBwldmg AppliancesWired EquipmentWiretl
^ Home Range Temporary Service
Duplez Water Heater Electnc Heahng
Apt. Buddmg Dryer Other(Specdy)
Comm./Induslrial Furnace
Farm Air Conditioner
Olher(speafy) ConVactor§ Pemarks
Compute I»spechon Fee Below:
# Other rviceEntrance Sae Fee # Circwts/Featlers fee
Swimming Pool 00 Amps 0 to 100 Amps
Transformers e 200 _ Amps Above t00 _ Amps
Signs sa Only TOTAL
Irrigation Booms
S
ll T
pecia
nspeCtion
Alarm/Communication 5TALLATION MAV BE DISCONNECTED IF NOT
Other Fee ETED WITHIN 18 MONTHS.
I, the Electncal Inspector
certify that the above inspebeen made r oale
oer ?
OFi1CE USE ?NLV
This repuest vmtl 18 months fmm
2
814
A
Request Date ? Fre No Roug -in Inspeciron
d,
p ? /
? Reatly Now ?fY?Jll
?or
'
G ^
n
e
d
V t
P
o
Ves e
a
y
I El hcensed contrector Xowner hereby request mspection ol above electrical work at:
Joe A?s ??el, Box or ute No )
V 1 ?• ?ity
SecLOn N. Township m or No Rangp N. Counry
IPRINT)
Q 1?.I1t?Q Z Phona Na
POwer5v0'lier Atltllp55
Elecmc I Convacbr COmpany Nam¢I Con[ractor'S 4cense N.
&M
MaiLng tld/ress IGOmractor or Owner Making Instaltanon)
W
A e iC Ird Ow er lAakin9 Installalioni Phone Num/?bEf' 4//
(JI /1 l' V`
MINNES TE OF EL TMIS INSPECTION REQUEST WILL NOT
Griggs-Mitlway Bltlg - qoom 5493 BE ACCEPTED BY THE STATE 60ARp
1821 Universny Ave, St Psul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone(61P) 662p800 ENCLOSED
,5/jr/9?pL REQUEST FOR ELECTRICAL INSPECTION ,,',tT"N. a E8-000 1-08
J4281 ? ? See instmMions for compielinq ihis form on back oi yellow copy
'X" Below Work Covered by TMs Request
Rep- ' Uildmg AppliancesWiretl EpwpmentWired
Range TemporaryServiCe
Water Heater Eledric Heating
M Dryer Other (Specify)
strial Fumace
Av Condnioner
Conlractors Ramarks ? A•?
A ?V wU.,. E'
U.?M:?w.i
Compufe Inspecnon Fee Below.
# Other Fee # Service EntranceSze Fee # Circuns/Feeders Fee
Swimmmg Pool
Transformers 0 to 200 Amps
A6ove 200 _ Amps O l0 100 Amps
Above 700 _ Amps
Signs Inspedors Use Only TOTl1L
Irrigahon Booms ? S
S
ecial Ins
t
p
pec
ion
Alarm/Communication THIS INSTALLATION MAY BE OR Ht DISCONNECTED IF NOT
bther Fee COMPLETED WITMIN 18 MONTHS.
I, the Electncal Inspector, hereby
certify that the above inspection has
been made. Rooghin oete
oa e?' ?
OFFICE USE DNLV
This request vaid 18 months tmm
J
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT PERMIT TYPE:
Permit Number
Date Issued:
6UILDTNO
000436
05/11/92
SITE ADDRESS:
DESCRIPTION:
2043 COPPER LANE
LOT: 41 BLOCK: 4
CEQAR GROVE 4
Suixding Permit Type
' Suild'ing Work Type
` SuildiAg #:oingth
6uilding Width,
t
?
?•
?
SWI14 POOL
NEW
36
18
?. ?.
i. I_,`,?, r' t 4?Y,? • i r_q ? ?;__ti,.
?S i=`'LL;
?., ._.
REMARKS:
RECEIPT M ? dt 0 ?1-7 TNOROUND POOL
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
Subtotal
VALUATION
$12.e00
$135.00
$87.75
$6.00
$228.76
COPIES $1.00
Total Fee j229.75
COI?'?RACTOF?' - APPi1Ganc -
C NTRY S DE POOL3 17319745
9242 HUp50N BLVD
IAKE ELMO MN 55042
(612) 731-9745
OWNER:
SCNEERZ ROGER
2043 COPPER lAN£
EAGAN MIN
(612)
? Z hereby aeknaaledy* that T have read thi§ applaaation and stats that the
informatian is correet and egree to comply with all applicatrle Sterte of pln.
Statutes and City ofi Eagan Ordinances.
L
?APPLI ANT/PERMITEE SIGNATURE
,Ot?4 Rtal f T}1.11
[SSUED Y: IGNATU E
Control No. 0411_
?
CITY OF EAGAN
3830 PIIAT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
...... .. . .. . ..
ItU?C?1bN?CA?:;;?EttMI?
FOR CITY USE ONLY
PERMIT #
RECEIPT # O? ?
DATE: ldl"gl
RESIDE23`?`I,p,YLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY
.. . .
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION
NEW CONST
ADD ON ?G
REPAIR _
OWNER NAME: ?000< SG/VXJ;!'-?S
SITE ADDRESS:
?
LOT:?? SLOCK ? SUBD. ??? ?-('iY
INSTALLER: ?iwf,5?--
ADDRESS: /ArS
CITY: A'vl? ZIP: .SJ.i-/ 2 2._
PHONE #: 5? Z - 2-6 6?
FEES
ADD-ON MINIMUM
kiVAC 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OUTLETS - MINIMUM
OF 1 PER PERMIT
SUBTOTAL:
STATE SURCHARGE:
TOTAL:
DWELLINGS &
$15 00
24.00
6.00
3.00
p ?g, ?/Sro
Y?L.L? ?
.50
? S fo
$?
?i?-l-?.
4s?.
kkdTT4§,E yM PERMITTEE
opw ?,, 9,,,0 // /i s/s "-?
GOMME1tGIALJINDAST'?TA7::; PI.HASE COMPLETE THIS PURTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS,
_ .... ,. .. .. . , ..
APARTMENT SIIILDZNGS, AND MULTI-FAMILY BUZLDINGS WHEN SEPARATE PERi;TTS ARE
NOT REQUIRED FOR EACH DWELLZNG UNIT.
CONTRACT PRICE: FEES
OWNER NAME:
SITE ADDRESS:
LOT:__ BIACK _ SUBD.
INSTALLER
ADDRESS:
CITY:
PHONE #:
FOR:
CITY OF EAGAN
ZIP:
18 OF CONTRACT FEE.
STATE SURCHARGE 6 $.50 FOR
EACH $1,000 OF PERMIT FEE.
°.R,^iCESSEi Pic^IIiU .525.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $
STATE SURCHARGE
TOTAL:
(SIGNATURE)
I&
PERMIT Ri_ ?, .
CITY OF EAGAN
1992 BUILDING PERMIT APPLICATION
681-4675
?.?.?
SIN6LE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of ertergy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
?
Date /ipn q - Ya Valuation of work /l. '56
Site Address: a04Z Cvt CA-p • wi.sn.
STREET $TE 2
Tenant Name: ( oa aA Sc1n(gP k Z
L0T t? BLOCK SUBD. ciDAKGKfl VC C11 P.I.D. •
Descri tion of work: iw.vk ; o0
7he applicant is: ? Owner 0 Contractor ? Other (Destribe)
Name S4??e 2z I?vu ? d2 Phone
Property -u:T Fla '
Owner qddress ao `t 3 Co r?a6-1,2 L w,
' STREET , STE #
City g??A ? avl State 111'"_ Zip ?
Company Coi,yr42u C?}P t?ooG? Phone
C011tC8CtOP r
Address q a?l? u?SVtl QLu?y License # Exp.
City L K i_cvv? o State II1 dt Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State ZjP
Sewer 8 water licensed plumber . Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with all applicable State af Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
?. . .?r vvr v?r
BUILDING PERMIT TYPE
? 01 Foundation ? 05 Apt. Bldg E3 09 Basement Finish
? 02 SF Dwg. ? 06 Garage/Accessory JW10 Swim Pool
? 03 Two family ? 07 Fireplace ? 11 Res. Add./Porch
? 04 Mu1ti-fam. T.H. ? 08 Deck O 12 Comn./Ind.
WORK TYPE
t 3 31 New
2 Addition
? 33 Alterations
? 34 Repair
O 35 Tenant finish
? 36 Move
GENERAL INFORMATION
? 37 Demolish
? 99 Undefined
i R
? 13 Publ'fc fac.
? 14 Agricuitural
O 15 Miscellanenus
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) lst F1. sq. ft. City Water
UBC Occupancy J,.Z 2nd F1. sq. ft. PRV Required
Zoning Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft. Fire Sprinkler
Length ? On-site well Census Code
Depth /8• On-site sewage SAC Code
APPROVALS
Planning Building y-zo 9E Z? Assessments
Engineering , Variance
REGIUIRED INSPECTIONS RER/>'1+4RKS'. INGRau rr-0 PoaL,
? Site
? Wallboard
Pf Footing
P Final
? Framing
? Draintile
a?
? Insulation
O Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Mater Conn.
Water Meter
Acct. Deposit
S/W Permit
5/W Surcharye
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
f 3 5. OD v.imct«n:
--k_-FOT?
/.AO
s la? Odo
SAC %
SAC Units
S
T
D I
S
Q,
?q
- ---•?-.-•,-
31
o
CopAee Lap ° ?S
9 ??=
- f?mdo+? ScL.?e2z
pci??e ?.0`13 Copp?R??n,
Ga??e 30 ?
f
tl?vs(v
3?
M INJM u l s?7'8 k j
FROM PR PGR'7y '
/- -- --- -
L.1NE
I -- ------ . -
PE-1:]rV (1-
\ _ --- ---_ -i I 3 ?
?o{:k\7 WA?j?2
(Joo L
I . -
3
W
y'r??N??u nti
paoL I
? ? u ro iy
tia RodoA aL.,h.
Lk. CuAo, oci a
`l 3 1 , q '1 `-{5
Le55L De-,aA•d
?Ivq,CQA-.XIR
C,2nu(' 01. q
2000 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
?3 ?? CIn oF E?G,N
3830 PILOT KNOB RD - 55122
851-681-4675
New CanahucNon Reauiremenh Rertadel/Renalr RaaWremenh
n S replaleretl slro wrveys Ywwlny sq. fL of lot, tq. R. of house
and gH roofed areas (20% mmAmum lot coveraaa albwed]
? 2 ooples ol dans fshow beam S window sizes; poured fntl. detlgn: efcJ
> t set of enerpy caiadanona
n S coplea M hee preservaflon plan If lof pWHetl aNer 7/1/93
Dah:
l29-Zti`
2 topiea W plan
1 sel of energy cdculallons !w hected addNbnt
1 alte wrvey tor exteAOr addl6au &decW
CON5TRUCTION COST: s P-$5
DESCRIPTION OF WORK: 7-0 W A
STREET ADDRESS:
LOT: - L4L BLOCK: _!j SUBD./P.I.D. M:
PROPERTY
OWNER
Name: ? Z eS17C- lc?-'? Phone c
lasf Fint
Skeet Addresa: ;W.0
cer srafe: zip: SS?z-2.
. Compcny. GC.Cl S?< t? Phone #: G/L ??9?3?--?? c?
(area code)
COIJTRACTOR
Sheef Address: 0 Ucense p J!2!!-Exp. `J` 0!'
Cuy state: 147?1 zip: 57-5!ZZ J
ARCHITECT/
ENGINEER Company: Name:
Telephone Y: (
Sheet
CMy
Sfate:
nP:
Sewer/water licensed plumber (If installina sewerfwatar): PhoneM (
I hereby acknowledge Ihaf I have read Ihk applicalbn, stare ma? me mrom,anon Is c«rect, and agree to compy wHh an applicoble State
of Minnesota Sfafutes and Ciy of Eagan Ordinances.
Signature of Applicant: l? ??-
OFFICE USE ONLY
ReglshaHon 0:
CeRificates of Survey Received _ Yes _ No '
Tree Preservatlon Plan Received _ Yes _ No _ Not Required
9aIo9
City of EanaIl
3830 Pilot Knob Road
Eagan MN 55122
Phane: (651) 675-5675
Fax: (651) 675-5694
? For OHioe Use I
? I
? Permit#: I
? Permit Fee:
I ?
? Oate Received: ?
I ?
I Statl: ?
I I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: r Site Address: ?40*A 6i52K?'J ?/_/(/
Tenant:
Suite #:
RESIDENTlOWNER Name: Phone:
Address ! City / Zip: 0??'?3 W???E? '1_41? m?Al, Ml,/
Applicant is: _ Owner _ Contracror
TYPE OF WORK Description of work: 'r?A4 eF`
Construction Cost Multi-Family Building: (Yes No I
CONTRACTOR Name: A/..G zb/A/T-s License it: a0`-'37/68
Address: ?40/ /""?/ 8? -
Gty: Q_t?sEd State: zip:-53?369
Phone: 743 - ?Qv-'?Qlfl Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Categorvl Minnesota Rules 7672
Energy Code . Residential Ventilahon Category 1 Worksheet • New Energy Code Worksheet
Category Submitled Su6mit[ed
(4 submission type) • Energy Envelope Calculations Submitted
In the iast 12 months, has the City of Eagan issued a permit tor 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 constdered fo be public informaflon. Portions ot
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that tHe are irade secrets.
I hereby acknowledge that ihis information is complete and accurate; Ihat the work will be i ntormance with the ordinances and codes of the City of
Eagan; that I understand this is not a permn, but only an application tor a permit, and ork s not to start without a permit; Ihat the work will be in
accordance with the approved plan in the case o1 work which requires a review and ap val of plans.
S
x xN/z C?G?1/'GR? x
ApplicanYs Printed Name ApplicanCs Signature
Page 1 of 3
q49/a9
City of Ean n
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
------------------
? ForOffico.Use ?
' S5 383 '
I Permit fl: I
? Permit Fee• ?
? Date Received: A ?
I Staff.
i i
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: S?1/(pl4j7e Site Address: W?'PL4 a
Tenant:
Suite #:
RESIDENT 1 OWNER Name: -?rC/Phone: di --4-1- ????'' Dl3/
Address l Ciry / Zip: jOS43 EffGA?r/ ',?v
Applicant is: _ Owner _ Contractor
TYPE OF WORK Description of work:
Conshuction Cost: Sr?o 1f7? ? Multi-Famiiy Building: (Yes _ I No
CONTRACTOR Name: /4;2e /?O/.?7S &U/?-.45 License#: 40-i-J"716P
Address: 4-101 n?y gv
City: 6)15:56D State: /W Zip: ??6 %
Phone: W - 04V- /)?/a8/ Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheei • New Energy Code Workshee[
Category Submitted Submitted
(V SubmissiOn type) • Energy Envelope Calculations Submitted
in the last 72 months, has the City oi Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master pian: .
Licensed Piumber: Phone:
Mechanical Con[ractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents fhat you submit are considered fo be public informaflon. Portions of
ihe information may be classified as non-public i/ you provide specilic reasons that would permit the Ciry to
conclude thaT the are trade secrets.
------------
I hereby acknowledge Ihat this information is complete and accurate; that the work will be in contormance with ihe ordinances and codes of the Cily of
Eagan; that I understand ihis is not a permit, but only an application tor a permit, and work is not to start withoN a permrt; ihat ihe work will be in
accordance wiih ihe approved plan in the case of work which requires a review and approv f plans.
x ,(,? ?Y?/[/F? X 4n?
ApplicanYs Printed Name A p icanYs gnature
Page 1 of 3
PERMIT
City of Eagan Permit Type: Plumbing
Eaaan. Permit Number: EA093985
Date Issued: 05/17/2010
OR Permit Category: ePermit
41~ it~ of E3
E
Site Address: 2043 Copper Lane
Lot: 41 Block: 4 Addition: Cedar Grove 4th
PID:10-16703-410-04
Use:
Description:
Sub Type: e - Water Heater
Work Type: New
Description: Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:
Kris Oien
3670 Dodd Rd
Eaaan. mn 55123
Fee Summary: PL - Permit Fee (WS &or WH) $50.00 0801.4087
Surcharge-Fixed $0.50 9001.2195
Total: $50.50
Contractor: - Applicant - Owner:
Champion Plumbing Frederick W Seigars
3670 Dodd Rd., =100 2043 Copper Lane
Eagan NIN 55123 Eagan MN 55122
(651) 365-1340
I hereby aeknowledae 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 Cite of Ea-an Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
IoH$1o
Use BLUE or BLACK Ink
AMMML-
For Office Use I
j Permit ! V
City of Eap
Permit Fee. l
3830 Pilot Knob Road
Eagan MN 55122 Date Received:-5;,-
Phone: (651) 675-5675 I l
Fax: (651) 675-5694 i Staff: r
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: T C_Q -i' Unit
Phone: Name: x:52- 7 Q72r
1
RESIDENT / ~ OWNER Address / City / Zip: C L~I~aCLI~~
Applicant is: Owner Contractor
TYPE OF WORK Description of work: A'900/=-`Cf.Gy)-tiU
Construction Cost: Z 7 7 Multi-Family Building: (Yes / No )
Company: ~~¢~~Q/-
C"on at
CONTRACTOR Address: "'JtCGr/CP~ Ci
State: /)tl ''Zip: - Phone: c/
License 6(11 4~jV39- 3 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 the 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 pla s.
Appli ant's Printed Name Applican s Signature
Page 1 of 3