4815 Eriks Blvd? CITY OF EAGAN
??? 383? Rilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
GA? d
Site Address ? S?? `-' ? rti' `? B Ll?li
Lot ?' Block `' SeclSub. Z???IN V1EM ?ANO&
Parcel No.
W Name GkG? e '?6?FG..IP
o Address ; 5? ? k' S*Y-VI:?
City ' ???• Phone 4??-66?0
o Name ??`??
,r
>Q Address
?? City Phone
Name _
Address
I hereby acknowlege 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 Ciry of Eagan Ordinances.
Signature of Permitee ? * .- '
A Building Perm?t is issued to: ???ct. :n,: r.n? :??,°?r
on the express cAndition that all work shall be done in acCOrdance with all
applicable State ot Minnesota Statutes and City of Eagan Ordinances.
Building Official
sx' ?1'
. .?_ ? ? ? ?.
Receipt #
OFFICE USE ONLY
Occupancy ?`'" ? ? `? 1 FEES
Zoning -
(Actuap Const V- Bldg. Permit t)4. Q?
(Allowable) Y???
Surcharge T f?
?
# oi Stories
3? ?
Plan Review
? ?•?
Length
Depth 26 ? SAC, City
S.F. Total - SAC. MCWCC
S.F. Footprints -
On Site Sewage _ Water Conn
On Site Well - Water Meter
MWCC System -
Acct. Deposit
Ciry Water -
PRV Required _ S'W Permit
BoOSter Pump - SAN Surcharge
Treatment PI
APPROVALS Road Unit
Planner - park Oed.
Council -
BIdg.Off. _ Copies
`''?"?
Variance - TOTAL
Permit No. Pe?mit Holder Date Telephone #
WATER
SEWER
PLUMBING
H.V.A.C.
ELECTRIC
Inspection D e Insp. Comments
Footings I
foundation
Framing
Rooting
Rough Pibg.
Rou9h Htg.
Isul.
Pireplace ho ? C f
Fnal Htg.
Fnal Pibg.
Const. Meter Plbg. Inspector - Notify Plumber
Engr.lPlan
Bldg. Final
oec* tis. v ,'{?•? .+- s
Ueck Final / -*vt /JL?L 46-
Well
Pr. Oisp.
CITY OF EAGAN Remarks
Addition Twin View Manor Loc 3 eik 5 Parcel 10 78200 030 05
Owner?+ Street 4815 Eriks B1Vd. State Eagan+MN 55123
Improvement Date Amount Annual Years qy Payment Receipt Date
STREET SURF. Z$ 1983 3687.77 368.78 10 281 . 6 C010 $1 6- -$
STREET RESTOR.
GRADING ? 1$2 1311.56 8.44 i 961.84
SAN SEW TRUNK 1976 1 .oo 1.00 1 ?j . 00
9F SEWER LATERAL 1982 4142.29 276.15 1,5 3037.69
-
WATERMAIN
?F WATER LATERAL 1 82 1
WATER AREA Z.L, 1280 280.00 j$.6'J 1$ 168.04
Services * 1982 1
STORM SEW TRK -7 1$2 61.00 37.4o 1 411.40
?F STORM SEW LAT 1982 15
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUIIDING PEF.
SAC
PARK
CIT11' OF EAGAN
3830 Pilot Knob Road
P. O. Box 21199 '
Eagan, MN" 55121
Zonirg: `' '
Ownsr:
/1ddreaa: -
SIh /lddrcn:
Jilumber. _
Meftr No.:
,(size:.?i
Reader No.:
1 Mrw Ie eowol? wp6 elw Ckp
Ono
ert
WATER SERVICE PERMR
PERMIT NO.:
D11TE:
No. of Units: 1
Charge; i(?Q. 0Q pd
posit: 15.00 nd
10. 00 ad
i Surcho?ye: • ?`? pLl. -
Misc. Chorgss: - 1%?• T) Pd
By?
Total: " wr rer
Duts Paid:
DarFe of Insp.: ltuip;
CITY OF EAGAN SEWER SERVICE PERMR
3830 Pilot Knob Roed
P. O. Box 21799 RERMIT NO.:
Eagan, MN 55121 DATE: %-- 't
Zoninp:
Ownsr.
No. of Units:
Address:
SiM Addross: - r i ' - . _ , L '? I 'l P s Twi n Vi r.4 w, . . . r -
PIUmblr: ?e. i iL-r P i?6•.
`i 21:3 i 100.00 p:i
? Nna to e?.py whU elu ciryr d 4?0D C,on?ection Chorpr 425 -00 Std
OdiNra?, Accpuint
Permit Fw: Surcharps:
By
Date of Insp.:
Misc. Cho.pm
Totd:
Doh Pald:
zl s?F'7
41. -189
91 REQUEST FOR ELECTRICAL INSPECTION 7? y
-1.tainn95ola State Board of Electricity
1821 University Ave., Rm. S-728, St. Paul, MN 55104
Phone (612) 642-0800
Home Duplez Apf. Bld . 01her: New Addn
Commerciol Induslrial Form Remod Re oir
Air Cond. Ht . Equip. Warer Hir. Load Mgmt Other:
Dryer Range Elec. Heot Temp. Service
"X" above !he work covered by this requesf. Enter remarks in this space and on the ba af rhe white copy on/y.
Colculate Inspedion Fee - ihis Inspection Request will not be accepted wifhout the correct (ee:
Ofher Fee # Service Entrance Size Fee k Circui[s/Feeders Fee
Mobile Home Pork Siall 0 l0 200 Amps 0 to 100 Amps
Sheet Ltg./Traflic Sig. Above 200-Amps Above 100_Amps
Tronsformer/Generator INSGECTOP'S USE ONLV
? TOTAL
?
$ign/Oudine Ltg. Xfmr. /?lW" T"??' ?6/s
?/1 I
O• r v
Alarm/Remote Control ?? 1J
Swimming Pool i fie"by ce?ri ma? dee: I? hercin a? tha dme, no
IrrigOfiOn BoDm RougMn Dore
$
enol Ins
ecfion
p
p
Investi olrve Fee Finol Oate
THIS INSTALLATION MAV BE ORD D T .1B1IHM1-4B#IONTHS.
d 4 0 2 3 7
Request Dale , Flre No
S y ? iiough-in Inspection
Feawretl?
?ReatlyNOw ? ???ot? ?n?s,pectar
d l'] j
Yes 4 N.
IiXhcensed wnlractor ? owner hereby req uest inspection of above eleclriCal work at.
Job Atldress (Streel Box or Route No ) Qry
4815 E3ctx Eriks Blvd. Ea an
Seclion No Township Nama or N. Ranqe N. County
Dakota
Ocoupant (PRWT) Phone N.
6reg & Michele Dor mp
Power Sup01ier Adtlass ?],Q
DEA 4300 220th St. W. Farmington, NIN 5502
Ele<hmal Comractor (Company Name) CoOVactor5 Lrcense No
Corrigan Electric 0 39549 8
Mailing Atltlress IConVaCtor or Owner Makmg InstalleVOn)
P.O. Box 475 Rosemount MN 55068
AuthonYetl SignaWre IGonlrectorlOwner Making Inslallacron) Phone Numtier
423-1131
MINNESOTA STATE BOAPD OF ELECTRICITV THIS INSPECTION REOUEST WILL NOT
Gnggs-Mitlwey Bldg - Poom S-173 G BE ACCEPTED BV THE STATE BO/+RD
1811 Univereity Ave., St Peul, MN 55104 ? UNLES$ PftOPER INSPECTION FEE IS
Phane (612) 642-0800 ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION
nq r? 0, See m-tmdwns lor compleLng this lorm on back ol yellow copY. y?? +e9? /?/- 93
L; 4 O L 3-7 ( "X" Be/ow Work Covered by This Request CkQQxw
ew Add Rep TypeotBmlding Appliances0red EqwpmeniWiretl
Home Range Temporary Service
Duplex Water Heater Electnc Heating
Apt Bwlding Dryer Olhec(Specily)
Comm./Indushial Furnace
Farm . Av Conditioner
Other (suecily) Conlractor5 Remarxs'
Compufe Inspection Fee Below,
# Other Fee # ServiceEnirenceSze Fee # CircwGS/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps Above 100 _ Amps
SignS inspectorg Use onty TOTAL
Irngation Booms
Speaal Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee "'U COMPLETED WITHIN 78 MONTHS.
I, the Electrical Inspector, hereby
certiry that the above inspection has
been made. RO09""" ' r oaca
Final ?
OFFICE USE ONLY
This repuest vmtl 18 manths irom
p 49756
Repuest Dale Fre No Rough-in Inspection
R2qWred? f
{? RBBtly NOw ? WIII No01y 105p2L10!
Ves No When Feady?
I? licensed contrector ? owner hereby request inspection of above electrical work aT
Joh Ftltlress fSVeet B?r Rou,
¢S4q
/ C L /?
/ J ?/`
/.
?
ICl
?J v City {??
/_
?
Seaion N. Townsmp Name or No Range N. County
Ocwpa/m}q? INTi Phone No /^
`
4L/ / 4 ' ? ? !+""C / ??"
Powe' Svppli¢r Atltlr¢ss ?? 3 ? /'y
Y
Elecincel ConVactoriCompany Namel ? . ConUaotor5 License No
Mailiny AOtlress IC hatlororOwnpr Ma4in Inslallai
Aut9o?izetl 5? at o raclo,;Owner Maki Inslallatqn? PM1one NumOer
MIN TE BOA F4!'lCfRICITV? ?}T• /// (? / INSPECTION
BEInGCEPTED BYTHEOSTATE BIMRDT
G nggaMidwa Room S-1]
.1., 1821 Un-i y Ave , St a 4..y04 ? -Ff- /
? ! UNLESS PROPER INSPECTION FEE IS
P 61]) 602-0800 ENCLOSED
?/?/?/ REQUEST FOR ELECTRICAL INSPECTION >.'=""'"? EB-00001-OB
'p/ See msvuctons lor tompleong this lonn on bacrc ol yellow mpy
0 4'7 7:) Cj v "X" Below Work Covered by This Request
ew Atld ep ' rypeofBuiltling App6ancesWired EquipmeniWired
j Home Range Temporary Service
Duplea Water Heater Elecinc Heating
Apt Buildmg Dryer Other (Speaty)
Comm /Industnal Furnace
Farm Au Condihoner
O!M1er (suealy? ConVedors Ramarks
Compute Inspechon Fee 8elow
u Other Fee # ServiceEntrance Sae Fee # Circwts/Feeders Fee
Swimming Pool 0 to 200 Amps 0 ta 100 Amps
Transformers ? Above200_Amps Above100_Amps
Sgns inspactors Use Only OTAL
Irngahon Booms
Special Inspecnon
Alarm/Communicahon THIS INSTALLATION MAY BE ORDER CONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Elecincal Inspector, hereby Roughin
cerhfy ihat the above mspection has
been made F,,,ai oac
l?
OFFICE USE ONLV
Tros reyues: vmo i8 monins trom +
? Q' i ? OFFICE USE ONLY This requesl void 18 monlhs fiom wlidafion date pnnted in Il+is box
` ,-. , `1 tii4n'9
tllllillllillilllll?llllllllilhlll lilllllllil?l?? ?5 ??- `???- "?-` '
* 11 4 1 61 8 9 9* PLEASE PRINT OR TYPE
keqoest 0 re
'l RougMn mspecfbn reqwred2 Ves 0 No Inspttnon Olher Than RoughJn ? Neody Now Will Cull
_
?
7 [You most mil Ihe inspecmr when mady? ?are Reody:
I, i sed contrador owner hereby request inspection of the above electrical work at-
Jo6 et 8ax, or Route Na ) p) } City
? Zp Cade
r,C?a P/VOt {c 2v'i 5? B o? ?
Sxhon No Township Nama or No Rarige No Fre No. Couny ?
Dci !\'fJ-t '
pon1 + 1
-T04\ E?J Af
-116
Power Suppliw addme,
Elxniml Canhacbr Gompany No
tvW :?, r-c Connactar Lcensa No NwsM Lc N. (Plant Elecr. Only)
Mailrtg A ress (Conka<Iw or Owner Perfwmirg Insmllanon]
u r
Authy' ing Inslallolion) Phone Nqa
EBO000IAi(18/96 ?-..r?e...e........., ?a?.?e.n?v?.u..??...?e...v..vvn?...v?..ov
BUILDING PERMIT
ATTACHED GARAGE &
To he used for ENTRY Est Value
14,000
Site Address 4815 ERIK' S BLVD
Lot 3 Block 5 Sec/Sub. TWIN VIEW MANOR
Parcel No. _
wlName GREG DOSENKAMP
o Address 4815 ERIK' S RLVD
City EAGAN phone 454-6690
.o Name S?
gp Address
? City Phone
?
w W Name
?? Address
aw Citv Phone
I hereby acknowlege that I have read ihis application and sta[e that the
miormation is correct and agree to comply wrth all apphcable Sta[e of
Mmnesota Statules and Citv of Eaaan Ordmances. ,
N4 16561
Receipt # v •) ---) n 0
Date .7IINF1 7 . 1984-
OFFICE USE ONLY
Oaupancy R-3 M=1
Zomng R-_1.
(ACtual) Cons! V?- ` Bidg Permrt
FEES
154.00
7.00
77.00
(Allowable) V-N Surcharge
# ofstones
Lengih 30' Plan Raview
Depih 26' SAC, Ciry
S.F. Total - SAC, MCWCC
S F. Faolprinis -
On Site Sewage - Waler Conn
On Sne Well - Water Meter
MWCCSyslem -
Accl. Deposit
Gty Water _
PRV Required - SN1 Permit
Booster Pump - SIW Surcharge
Signature of Permrtee ? APPHOVALS
A Bmldmg Permit is issued to. G E Planner -
on Ihe ezpress condition that all work shall be done in accordance wit all Council -
applicable State of Minne.s.ota Stalutes and Qty ?o/f Eagan Ordinances. BIdg.ON. -
8uilding Olficial -, I ` Al?q-? A1??1 2 L variance -
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55721
PHONE: 454-8100
Treatment PI
Road Unil
Park Ded
Copies
TOTAL
238.00
410 W. LAKE ST. 1072 PAYNE AVE.
MINNEAPOLIS, MN 55408-2998 DD ST. PAUL, MN 551013892
612/824-2656 EATING nNDA1R CoNDITtoNiNG Co 67 2/772-2449
Senia, 7T e Twie Ciries Sixt f 930'
ORSAT TEST RECORD
ADDRESS c?o ??cY CITY
OCCUPANT C?- • p2r?., ??.,?
, ? OWNER
DATE HTG. INST. INS TALLED BY z
GAS LINE BY -
TYPE OF HEAT: GA FA?HW STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE MAKE OF B
MODEL a 3 6 o L 9/?.9i??DEL
SERIAL 2,;? ,y S'- 5 MAX. BTU RATING
INPUT 6'p (70 'a MAKE OF F CE
CONTROLS
THERMOSTAT /zGV C._HEAT PLUG - VENT SIZE
VALVE KIND OF LINER SIZE NONE'L_l?
LIMIT T' DRAFT HOOD REfaULATOR %,v Ucz.?.c,?l
LIMIT SETTING l 7 O CHIMNEY CONSTRUCTION ;)o C--
/
FAN SETTING 44-.;?pd/ DRAFT Y?-? TEST TAG ?.??
PILOT TYPE_
- LIGHTING INST. ? C
PILOT MAKE
PILOT MODEL?
?
??
PILOT TIMING ? e?;
PRESSURE '3, S PERCENT C02 S. ? DATE
INPUT CFH PERCENT 02 1?? I
STACK TEMP.?/ Q PERCENT CO . O NAME
TESTED a a ?- 9/
OF TESTER
?'
, 1989 HITILDIAG PERIiIT APPLICATION
CTTY OF EAGAN
I (A(* I
SINGLE FIMILY DWELLIPGS lIITLTIPLE DHELLINGS COl4'IERCIAL
2 3ET5 OF PL6N5 2 3ETS OF PLANS 2 SETS OF IACHIiECTUR6L
3REGISTEAED SITE 3QRPEYS BEGISTHAED 3ITE SIIR9EYS - 6 STAOCTURAL PLANS
1 SET OF EIiERGY CALCS. (GBECH iTITH HLDG DIV.) / SET OF SPECIFIC9TION5
t SET OF Sii&!IG! CiLC3. 1 SET OF BHERGY CALCS.
MULTIPLE DiiELLINGS RENfAL DIiTT3 FOA SALE DNTfS 1 OF IIliITS
BOTEs ADDRFS3ES FOA COANEA LOT3 - COATRACfOA/HOMEOflHEA !lQST DF.SIGNATE IiHICH 1DDRFSS
I3 DFSIRED. HO CBANGFS i1ILL BE ALLOiiED OPCE BOILDING PERMIT 78 ISSDED..
SEiIER 6 N6TEA PERMIT FBES AND ACCOUNT DEPD52T FEES IiII.L B& INCLODED iiITH THE BUILDIN(i
PERMIT FEE. PROCffiSING TIME FOA SEWER AND U9TER PEIniITS IS TiiO DAYS ONCE A PERMIj SAS
BEEN COMPLETED IHDICATING A LICENSED PLUlBER.
PENALTY IPPLIES WfiENt PEAMIT IS NOT PAID FOR IN S@ME MO[VTA IT IS AEQOESTED.
LOT CAANGE IS REQUESTED ONCE PEAMIT IS ISSUED.
fbfAY ;. .. 19uy
lk1TAaGMm
To Be Used For: (?-rR? E? Valuation: ? Date:
Site Address YS/S C&//s? alv z
Lot ? Block ?
?
Parcel/Sub T.v/.v / 4 .F 1N 14A44or
Owner
Address yR/ S E f?? r 414..X
City/Zip Code C,42,aiv. SS>?
Phone y sy - ZC 9c??
Contractor
Address
City/Zip Code
Phone
9reh./Engr.
l4,000 .,_?.,,? ,,,...., .......
Oceupancy R- M'1 FEF.4
Zoning R-f
Actual Const V-N Bldg. Permit ISq.OC
Alloxable V-N Surcharge 7. A?
E of stories Plan Review nq,oJ
Length SACO City
Depth d4 SACt MWCC
S.F. Total Aater Conn
Footprint S.F. Kater Meter
Acet. Deposit
On site sexage S/W Permit
On aite xell S/W Sureharge
tiWCC System _ Treatment P1.
Citq vater _ Aoad UniL
PRV required _ Park Ded.
Hooster Yump _ Copies
SOBTOTAL
APPAOVAL3 - Penalty ?
Planner r??
Couneil
Bldg. Off.
Varianee
Address
City/Zip Code
Phone #
6 A R,4,ge
3 o x 2?= 7fj'o
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TOP CtiORDS: 2x4 Fl p 1
2x4 FL21ooF-t.BEt•3b-7
BOT CHORDS: 2x4 FL p 1
WEBS: 2x4 NF M7
WEDGES: 2x4 fL p1
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No wane oc knols allowed In plate area. X-LoeaUon Len to Right
An plates w ue symmetrfc aboullne jolnt 7C 0.00 6.61 7.47 13.01 18.54 18.50 26.00
u111086 othefw150 ShOWII. 0.00 8.67 16.00 17.39 26.00
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HEAD ALL NOTES ON THIS SHEET.
OflAWING TO BE GIVEN TO ERECTING
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TC Lfv9 40.0 psf DutFac - Lbt : 1.15
7C Dead 10.0 psl DurFac - Plt : 1.15
BC Livo o.o psf O.C. Spacing : 24.0"
BC Dead 70.0 pst Deslgn Criteda : TPI
TOTAI 60.0 psl Seqn : 2.0- 798
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2/84
CITY OF EAGP,N
APPLICATION FOR PERNIIT
SEWER AND/OR WATER CONNECTIODT
-??rt•?t i (PLEASE PFINi)
,
1) PP.OPEzI'Y ADDRESS: ?;- ?'/ 3
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(Int/Blcck/Su:aivisicn or 'Pax Parcel Z.D. NiznDer)
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ACD:?ESS:
CIT", 5M?'E, ZIP:
PI:ONE:
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ATCRESS: PLUY.B
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CITY, STATE, ZIP: 4't'/e I" Attive
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PF.O?IE: ?/.SZ-/S ?1 pLUMBER LFCENSE il Q J'ot of Retord
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PFiO`IE:
LPLtASE PR1NO
5) INDIG.TE ;vHICH PER•LIT IS SEZNG Rf.'O
UES'IED;
0, Cb:INECPIO:I 'ICJ CITY SETr1ER
Eq CC:N=ICV TO CITY UATEIt
? dit'fR (PLGliE DESCFtIBE)
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7) SZC:?'I?,r?tE:
PM?E F'.OLD APPRWID PERNLIT FOR PICF:-Ur 8Y ONE OF
D?'?APPR(7? PEP.lIT
DATE:
MR ?! OI-rliqfl?Oi? l? Lel?.a ? •.
fl1? fr ? I!f[p ?r? ? i i iiii:? a 1[ !!!lflls?y? S!!! i?sgr
F O R C I T Y U S E O N L Y
P=•°`^•r^.' °- ISSUED
rrEs : $- /(? ? o
$ ll7 S v
$ ?oU
S
$
$
$ I?=UCI
+5
$
$
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S
$
$ '
$
$ _??,5 0 - U?-rJ
S..r..':G.D. PEBMTT (P_ICL::D: SU?C :iRGc)
WATER pEP,.^4T': (Ii7CL'uDE cuaC:iARGn)
WATER METER/COPPERHpRN/OUTSZD: REi,D:R
WATER TAP (ZNCLCDE CORPORATI0:1 S^OP)
SL.YLR T.'-1P
-_.,?•i::i'? ?..=r,S?= _ __: _?
ACCOUiNTT DEPOSIT - P]AT_°3
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TR(i?IK IVAT°R ASJLSS.:E:.'T
TRu:JK SEWER ASSESS?SE?iT
LATEP.AL BEivEFIT/T°U`IK SE:•::'
L.ITc,RrIL BEVEFIT/TRU::K D7AT°3
TAATER TREATMENT PLA:VT SURCHARGE
OTHER:
TOTAL
A,`?OCJ:;T PAID/REC°I2T ; si/j/
DOES UTILITY CONNECTION REQUIP.E EXCaVATION IN ?U&LIC RIGi-IT OF [JAY?
? IF YES, THEN n"PERMIT FOR 'AORK WITHI.1
PUSLIC ROADWAY" MUST BE ISSUED BY THE
NO ENGINEERING DIVZSION. LIST AS A CONDI-
TION.
SUEJECT TO TFiE FOLLO[9ING CONDITIONS:
APPROVED BY:
TI.LE:
DAT°:
^f" swsm m on m+nWcM ra'k" wwm wqw-s?wM w.400towl"I sM w.awEmwlwj" 044" rcM ON sww..
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CITY OF EAGAN
3830 PIIAT KNOB ROAD
EAGAN, HN 55122
PHONE: (612) 454-8100
... . .,
FOR CITY USE ONLY ?
PERMIT #
RECEIPT•# a?
DATE: ?
PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE E
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
-------------------
WORK DESCRIPTION
NEW CONST _
ADD ON cZ
REPAIR _
OWNER NAME:
SITE ADDRESS: lW5- ??? .C?S• /.? /dtd
r nT •? ELOCK ? SUB^. .i7 s<1f.Y`? U.r.[.t?? '• W''""' -
INSTALLER: s./? ? ?`? Y4 x A-11 r l r-? ta? ?ADDRESS: 1/lJ o s f .Go /? ?
CITY: ZIP:
PxoNe #:
FEES
ADD-ON MINIMUM
HVAC 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OUTLETS - MINIMUM
OF 1 PER PERMIT
DWELLINGS &
$15.00
24.00
6.00
3.00
SUBTOTAL: $
STATE SURCHARGE: .50
?F
:nmpr ; ;
cti-- .
SIGNATURE OF PERMITTEE
a?
C044MERC.71'IJDU$TRIAT:. PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRZAL BUILDINGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
------___-__ ° -_°-------------
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE
FOR:
CITY OF EAGAN
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING - $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18
STATE SURCHARGE
TOTAL:
(SIGNATURE)
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA159416
Date Issued:12/16/2019
Permit Category:ePermit
Site Address: 4815 Eriks Blvd
Lot:3 Block: 5 Addition: Twin View Manor
PID:10-78200-05-030
Use:
Description:
Sub Type:Windows/Doors
Work Type:Overhead Garage Door
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings, 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: 1,500.00
Fee Summary:BL - Base Fee $1500 $62.50 0801.4085
Surcharge - Based on Valuation $1500 $0.75 9001.2195
$63.25 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 -
Derek T Bronson
4815 Eriks Blvd
Eagan MN 55122
(612) 702-6961
Twin City Garage Door Co
5601 Boone Avenue North
Minneapolis MN 55428
(763) 533-3838
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA169642
Date Issued:06/03/2021
Permit Category:ePermit
Site Address: 4815 Eriks Blvd
Lot:3 Block: 5 Addition: Twin View Manor
PID:10-78200-05-030
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. We encourage you to retain an electronic copy of
photos until the project passes a final inspection.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
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 -
Derek T Bronson
4815 Eriks Blvd
Eagan MN 55122
(612) 702-6961
T 10 Construction Services Llc
16754 US 10 Bldg 2
Elk River MN 55330
(612) 254-8060
Applicant/Permitee: Signature Issued By: Signature