4543 Hay Lake Rd SRepeipt PLUMBING PERMIT Permit No. ?
? CITY OF EAGAN
Fee ?
I Fill in numbered spaces
TYpe or Prrnr legibl y
S/C
ToL -
,? ?
1. Date A??7 . 2. Installation Cost T?3. Job Address Lot? ? Blk. Tract
-o4/a-o.?
4. Owner
5. Contractor /`7/? ? E ? ?'? Phone
6. Address/'?=i" MAn; '6'
7. City ??•.? )?? << , State /- ~'' Zip
8. Building Type: Residential Cg Commercial ? Institutional ?
9. Work Description: New q Add 11 Alter ? Repair ?
10. Describe
11.
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/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 1 agree to
comply with all ordinances and codes governing this type of work.
Signed :
for
Final
Rough
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
Owner
OF EAGAN
Strest
lex
10-56150-040-02
r r 4 p-?
Improvement Oate Amount Annual Years Payment Rece" Date
STREETSURF. 1981 310.74 15.54 20 264,1S
STREET RESTOR.
GRADING
SANSEW TRUMK 575 1981 9.28 17.96 20 3.40 A012702 9-6-83
SEWER LATERAL
111, SAN UW TRK LAT BEN 198
WATERMAIN
WATERLATERAL 5-71 1981 • • 20 146.56 A012702 9-6-83
WATER AREA 198 359. 8 7 20 305,,40
STORM SEW TRK ?'N lg? ? 435%
STORM SEW LAT g 1-?) 1984 7.83 15
. 7D
CURB & GUTTER
SIDEWALK
STREET LIGHT
ROAD UNIT 500.00 36552 6-20-83
WATER CONN. 900.00 t I
BUILDIN R.
SAC ?i
K
CITY OF EAGAN Remarks .,Ll?, 1 ?>L#?Sa/?-
Addition OVERHILL FARM 1ST ADDN ?ot pt of 4 g?k Z Parce11,0 °i61.5Q 9?7. O?.
owner Street 4543 S HAY LAKE ROAD State
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF, 1186.82 A014634 10-3-84
STREET RESTOR.
GRADING 883
SAN 5EW TRUNK
SEWER LATERALQ g?Z I
i L5AN SEW TRK LAT BEN 1984 170.21 11.35 15 158.87 A014634 10-3-84 ?
WATERMAIN
WATERIATERAL 1989 975 02 195-00 9 975.02 C009606 10
WATER AREA
STORM SEW TRK $ 1984 326.73 21.78 15 304.95 A014634 10-3-84
STORMSEW LAT--rrk 11 1984 58.70 3.91 15 54,79 " "
z x 1985 365.67 73.13 5 7 0 1 - -
CURB & GUTTER '
SIDEWALK
STREET LIGHT
WATER CONN,
BUILDING PER.
SAC
PARK
CITY OF EAGAN Remarks ? YI- e? ION ?J••???L?/-?/9 - *6
I/addition OVERHILL FARM 1ST ADDN Lot pt of 4 alk 2 Parcei 10 561 '1.0 042 02
O ner street 4545 S HAY LAKE ROAD scate
I ?
Impr vement Date Amount Annual Years Payment Receipt Date
STREETSURF, 1984 1483.52 296.70 5
STREET RESTOR.
GRADING 68 3 p 7,51 0 Q D 9 ?
SAN SEW TRUNK
SSZSEWER LATERAL ?r 1985 2 .2_1? -2 51 • B o a a ?y
1 ZSAN SEW TRK LAT BEN 1984 170.22 11.35 15 170.22 C008324 8-3-83
WATERMAIN
1887- WATER LATERAL 1985 ?
WATER AREA
I682- Services x 1985 ?
' STORM SEW TRK $ 1984 326.74 21.78 15 326.74 C008324 8-3-83
STORM SEW LAT -y'?k '113 1984 58.69 3.91 15 58.69 " "
z St. S Lateral 1985 ?
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN
BUILDING PER.
SAC
PAR K
I I
?
?.-
9795
cirY oF EAGAN
Pilot Knob Raad Eogae, MN 55I21
7HONE: 454.8100
NTU
BUILDING PERMIT Receipt .# ? ?' -, -7;--
To be eud far 1/2 DUPLFX & GAR Est. Volue $52,000 Dote Ttlne 20
5?te Address_451w5 So Ha3?Lalre. noad Erect ? Occuponcy R-11
Lot 4 Block 2 SecfSub. Ovarhill Farm lat Alrer p Zoning r,-2
Parcel # 10 56190 c`lLil (l Repoir ? Fire Zone 1'.A
Enlarge D
IHomB Vivant rrng C'nnptr»erinn Move U
Address 7490 1()Srt, Gr _ FAar Demolish ?
r:...r,,..ar r_,- are ou..__ i, .i_11,Ra Grade rl
Nome Ow+Pr _rr.-.-..
/lddress Asse
ci!x Phone Water & Sew.
Police
va Name
?Z Fire
0 Address Enp
?
Z .
"
< ' Ci Phone Picnner
I hereby ocknowledge thet I have read this oppiicution ond state that Council
Btdg. Off. -
the information is correct and ogree to compiy with ell epplicable
State of Minnesota Stotutes and City of Eegon Ordinonces. APC
Sipnnture of Pertnittee -
A Building Permit is issued to: Vivant Bros. Construction
oll work sholl be done in occordorxe with oll applicuWe 5tate of Minnesoto
Permit (l(1
Surtherge
Plon check 144_ 5n
$qC 5? 5 _ fl!1
Water Conn. 4.5,0 .r0,0
._
Woter Meter 60• 00
Road Unit 250.00
Tota, $1744.50
on the axpress condit{on thrn
Stntutes ond City of Eagnn Ordinances.
Type of Const, V
#k Stories
Length.3fl,
Depth.4.6Sq. Ft.
Buildirq Officiul
Permit No. Permit Holder Misc. Permit Na. Holder
Plumbing ?j(Q? ? yfa e 7 2(/ ?'3
,?.?.A.?. ?773
W.??
Water
Disp.
5ewer
Electric tJO$(I tIA 60js :TDM1150
S04?ne? &/0/ ekll' wn 1?-16-?°3
Inspection Date Insp. Other
Footings
Foundation
Frsminp
Rough Plbg. I?
Rough HVAC _?/-,?? ?
Inwlation ? ?
Final Plbg. ?
Final HVAC
Final n,gC
46W ,rT ?
Water Describe Location:
Well ,
5ewer ?
Pr. Diap. -. `
r T??^ INSPECTI
CITY OF EAGAN ?
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 68i:4675
SITE AD'DRESS:
PERMIT SUBTYPE:
I I ; 1,11I•11 1 M
f 1MAt
t1UlIf17NE
0r.qt 48
10 /3A /gf
J
4N RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
4,1 1(1 APPLICANT:
•: „ ,,. ;
?r,i.•? ??,:• ?•?;c?
TYPE OF WORK:
rvrw
10 ., >>, ? I 'In: ( t3AS)
Parmk No. PertnR Holdw Date Telephone k
ELECTRIC
PLUMBING
HVAC
Inapectlon Date Inap. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE Z
FIREPLACE
AIR TEST
• ?
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FlNAL
CITY OF EAGAN
3795 Nlor Knob Road Esyan, MN 55122
PHONl: 454-8100
Receipt #
i ?rU
? ? ? ?. ? `?
J
Syte /ddreu 4543 So. tlay Lake Rnad Erect )a p??upaMy R-3
Lot 4 81ak.__Z5ec/Sub. Overhill r'aI 'n lst Nlter ? Zoning i-?
ponet # 10 56150 040 02 Repoir ? Firc Zone
E
l f
n
v
n
arpe ? Type o
Co
st.
Nor»e _ Vivant F3ros. GonstrLCtion Mo
e Sro
i
W v ? r
es
Z
6 qddfess 2420 105th St. EBst Demolish p Length :38
cin,Inver Or. rita_ m..,.,. 451-3483 Grade ? Depth46-Sq. Ft.
? Name_ Owner
0
OU Addresa
? r??., o?......
I hereby acknowledge that I have read this opplication and state that
the inlormafion is correct und agree to comply with all applicable
State of Minnesoto Statutes and City of Eogan Ordinances.
ASSessment
Wcter & Sew.
PoliCe
Flre
Enp.
Plonner
Council
Bidg. Off.
APC
SipnatuT of Permittea -
Vivant Bros. Construction
A Building Permit is iuued to:
all work sholl be done in acoordance with,dll appliooblq Stote of Mlnnesota
8uitdfnp Officiol
Pe?mit `ny • UV
Surcherfle 26.00
Plan check 144.50
SAC S?_5.00
Wate? Conn. 4 5tl _ (ln
Woter Meter 60,0C
Road Unit 2? 1. 0(1
Torai S1744.50
on the exprcss conditlon thnl
Stotutes ond Ciry of Eayan Ordinances.
Permit No. Permit Holder Misc. Permit No. Holder
Plumbing 3(vtv ?"' • e? 7-211-53
H.V.A.C. a -7 -7
w.n
wn..
Disp.
Sower
Electrie W O$ul (/q I" SeJf 71L7,"
IrHpection Dste Insp. Other
Footings
Foundatfon
Framiny 4.)
Rouph Plb aJ
Rough HV t-7/-0 r y
Inwiion
Finsl Plbp ?
Final HVAC
Final ?
Water Descrihe Loestion:
YWII
Srwer • ,
Pr. Disp.
MECHANICAL PERMIT
CITY OF EAGAN
.-,
? ??"'? ,-.'
Permit No. "
Fee ? - ?
? Fill in numbered spaces S/C ?
Type or Print legibly Tot.
? 00 . O
1. Date 2. Installation Cost ?+S U
o ? 3. Job Address ?°iZb Y?' Lot' f Blk. ? Tract
--T--r
4. Owner (J 'I,ti1 ! fS YD s
5. Contractor q I1 Nq Phone 3F° %
6. Address 7.2?`? ? l,-r 15 clQ /( J-f (JP s Ci •
7. City f? 'C-A FI"4 State rn?' Zip 5_5 YL 3
8. Building Type: Residential iM Commercial ? Institutional 11
9. Work Description: New E3 Add ? Alter ? Repair 0
10. Describe L Fuel Type c) R
11.
No.
? Eauioment 8TU - M. Ea.
Forced Air No. Equiqment CFM
Ai
H
dli
Mfg. an
ng:
r
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all Qrdinances and codes governing this type of work.
Signed: _ ,iT?',` J'rt?Li;
for
Rough F inal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
"?
Receipt 'S ?7
PLUMBING PERMIT
CITY OF EAGAN
Permit No. -
Fee
Fill in numbered spaces S/C ?D
Type or Print /egibly ?
? Tot . .: G_50
1. Date ? ls ?' r a 3 2. Installation Cost `
l .4,1? ? ? • .,
3. Job Address Lot Blk. ?? Tract
4. Owner l'f ? ?? - -- -
T c•:>. =il.
5. Contractar u + ? - Phone f' 3 G
6. Address
7. City 'J -? ? ?F v State Zip
i
8. Building Type: Residential Commercial ? Institutional ?
9. Work Description: New )? Add ? Alter ? Repair ?
10. Describe
11.
No.
?- Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
/ Bath tubs Septic Tank
i?-- Lavatory Softner
( Shower Well
? Kitchen Sink
Urinal/Bidet Other
? Laundry Tray
i Floor Drains
Drinking Ftn.
51op Sink
Gas Piping Outlets
12. I hereby cenify 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 rtdmbered and approved.
Approved C,ITY OF EAGAN 454-8100
,?r:'
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE
19
AMOUNT $ I
& DOLl.ARS
?oa
? CASH ? CHECK
FOR
FUNO CODE AMOUNT
Tha You ..
? • BY
? White-Payers COPY
Yetlow-Posting CopY
Pink-File Copy
CITY OF EAGAN WATER SERVICE PERMR
3830 Pilot Knob Road pERM1T NO.:
P. O. Box 21199
MN 551g1
Eagan DATE:
,
2oning: ' No. of Units:
Owner: 7
Addross:
. L• 5_"- ??verinill F_z'?: lst
?
u - , p
;
Site /lddress: .
t PIUR1ber: T__'. 4
C . :: .J -'?
j
Connection Charge: -
Metar No.:
Account Deposit:
Siu: !(? . ??'?
Reader No.: Pem+it Fee: ,
1 egeee fo eanpb wilie tw Citr sf Eoqen Surcharge:
Mlsc. Charfles:
Ordiwnoa.
Total:
Date Paid:
BY
Dnte of I nsp.: I nsp.:
......" ....__ PERMIT NO.:
ox??..`21199
MN 55121 DATE:
No. of Units;
v-c.; -.,, , . .4 - ?+25.00 pd
1 as? eo canOhr wNl? tl» CMq d Eagos Connectlon C]wrye:
Ordi"nea. Atcourit Deposif: nt
Permit Fee:
Surci+arye: .
BY Misc. CF+orpss: -
Dote of Insp.: Total:
pott Paid:
I nsp.:
CI'f Y OF EAGAN
3830 Pilot Knob Road
Zoning: SEWER SERVICE PERMR
P. O. Box 21199
Eagan, MN 55121
PERMIT NO.:
D^7E: k du?:lex
No. of Units:
100.04 pd
I ..- wn -a
1 ym to eomPhr wieb !Iw City of Eeges Connedion Chorye:
Ordynasces. Account Deposit: _
Permk Fee:
Surdharpe:
By Mist. CFwroes: -
Dote oF Insp.: Totol:
Insp.: Dota Poid:
I
P. O. BOX 21199 PERMI I NU.:
?-?3
Eagan, MN 55121 DATE: ??-
Z
RZ of Units:
No ?`???°x
oning: .
Owner: `l1V ent Bros Cflt1sL -
/lddress:
4
ak
I
1i
?
?
d L?+ B2 OVerhii:l ='ar': l?'?
e
+
+5
?
Site Addreas:
+3
Plumber• Pr?f:c T'lb; ? Scherff
• Inc)
Meter No.:
Connedion Charge: 4 ! v? .
'
Size: Acwunt Deposit:
1?•?0 p?
Reader No.: Permit Fee: ..50 ?ci
1 ey? to eomplp with the Cit?r of Eagen Surchorge:
Oirdiwawas. Miac. Charges: ":?ter
Total:
R„ Date Pcid:
Address:
Date of I nsp.:
cirr oF EAcaN $164
0
9795 PiIM Knob Read Eagan, MN SSf? •
PHOIIE: 434-8700
BUILDING PERMIT Receipt #
Te ba usad Mr 1/2 DUPLEX & GAR Est, Value $52,000 pate June 20 t983
Slte Address 4543 So. Hay Lake Road Erecr yy
•?
O[CUpancy R-3
Lof 4 Black 2 Sec/Sub. Overhill Farm ist qlter ? Zoning R-2
Porcel # 10 56150 040 02 Repoir ? Fire Zone NA
V
Enlarga ? Type of Const.
s Name Vivant Bxos. Construction Move ? * Stories
? 2420 lOSth St. East
Address
Demolish
? ?
Len h 38
cin.Inver Gr. Hts. ok,...e 451-3483 Grode n Depth 46 Sa. Ft._
0
i?
o?
u?
r
Name Owner
Address
Nome _
Address
I hereby ackrwwledge fhat I haVe read this opplicotion and state that
fhe intormation is correct and agree lo wmply wifh all opplico6le
Slote of Minnewfo Statutes ond Cify of Eagan Ordinonces.
Assessment _
Water $ Sew.
Police -
Fi.e
Eng.
Planner _
Council -
Bldg. Off. _
APC
Signoturf of Pertnittee -
ivant Bros. onstruction
A Building Petmil is issued to:
oll work sholl be done in accordonce with ?a?y!p?lica t f?Ati esota
Bullding Officiol
Feea
Permit co?.w
Surchurge 26.00
Plon check 144.50
SAC 525.00
Woter Conn. 450.00
Wnter Meter 60.00
Rood Unit 2$0.00
Totol $1744.50
on the exprea conditlon thai
Statutes ond Ciry of Eagan Ordirwnces.
if CITY OF EAGAN
?-
BUILDING PERMIT APPLICATION
Include 2 sets of plans,
1 site plan w/elevations &
1 set of ener9Y calculations.
'Ib Be Used For 2 bup EX valuario ?o Date
sire AdIaIress: ys?{'? Sa, ?ae.? LakE f2A A
Lot `( Bloclc ? Sec./Sub.&ecltiZliiVarHn Is+ Erect x
Parcel #: ? p s(n l So C4c) o Z A1ter
Repair
Qaner: V i V ?-v.-ac gro s, ?o vts}. Enlarge _
Nbve
Pddress: o2lAXD )05-4-? S?? L-0.3?- Demolish
City/ZipCode: ?nUp ?(`Corov2 ?{-}-S? SSo7S Grade
Phone #: y S(? 3 y$ 3
Contractor: (n W yL? Y'
Address:
City/Zip Code:
Phone #:
Arch./II'ig•: WAY?S VOrl 59-l`Vt"C@.
Address: (ODCJ t<<qU41L 54,1Sw-if
City/Zip Caie: Su r rtsQ t' l ? E 55 3 3?
Phone # : ? 3
OE'FICE USE ONLY
Occupancy .?
Zoning ?
Fire zone
Type of Const.
# Stories
FYOnt 3g ft.
Depth y6, ft.
APPROUAI.S FEES
Assessments Pexmit
Water/Sesver Surcharge
g'
o26
-
Police Plan Check ??
Fire SAC
Ehg. Water Conn. SU
Planner Water Meter Go
council Unit a so
Bldg. Off. / -
APC
TO'i'AL
y? o
??
???-?
: , . p ?,t gt t4
?
CITY OF EAGAN
BUILDING PERMPP APPLICATION
Include 2 sets of plans,
1 site plan w/elevations &
1 set of energy calculations.
'Ib Be Used For t Du?1ti7- 4- G0.'C' Valuation tr.5 o9.00d Date
Site Ad/'dress: ? 5 So .qac? L?c?`
Lot `l Bloclc 2 SeC./Sub.
Parcel #: l U S(01 S o 0? 0 0)`Z
Owue.r- WJ 0.+ti-? B1roS Co vi4 ?
Address: otqZ0 IoS+? S? ,0Ag }' -
City/Zip Code: TkkuF-r Grove f-{-?S? SSb"7S
Prone #: q S f - ayi? 3
Contractor: LilY\-QC'-
Address:
City/Zip Code:
Phone #:
Arch./Eng.. _
Adclress:
City/Zip Caie:
Phone #:
(o-?'-? 3
OFFICE USE ONLY
?
Erect Occupancy lQ,3
Alter Zoning ??-
Repair Fire Zone .v
Enlarge Type of Const.
Ja-
Nbve # Stories
Dem-nlish Front ,3 ft.
Grade Depth ft.
APPRU F'EES
Assessments ?
Pernut 289-
Water/Sewer Surcharge ? -
Police Plan Check
-
Fire SAC ?
IIZg. water Conn. ys-o ?
Planner Water Meter 6o ?
council aa unit a" ?tP
Bldg. O£? ?
APC
`I171'AL t ? 4"-?
CITY OF EAGAN
9795 Pilat Knob Reod Fagon, MN 55122
PHDNEi 454-8700
BUILDING PERMIT
Receipt #
N° 8165
Te be used for 1/2 DUPLEX & GAR Est.Value $52,000 pate June 20 1983
Site Addreu 4545 So. Hav Lake Road E.ecr [?} Occuuoncy R-3
Lor 4 Block 2 SeclSub. Overhill Farm ist qlrer ? Zoninq R-2
parcal # 10 56150 040 02 Repoir ? Fire Zone NA
V
Enlarge ? TYpe of Consf.
,? Na,,,e Vivant Bros. Construction Move ? # Srories
; Addrass 2420 lOSth St. EBSt Demolish ? Length 8
b C; Inver Gr. Hts. pho, 451-3483 Grade ? Depth 46 Sq. Ft.-
? OwneT
N ADVrorab Feet
ame
Addrezs
? n..,
Name _
Address
I hereby ockrwwledge that I hove reod this application ond sfate that
Ihe intormation is correct and ogree to comDlY M'ith all applicoble
Stute of Minnewta Statutes cnd Ciry of Eagon Ordirances.
Assessment _
Woter 8 Sew.
Police _
Flre
Eng.
Pionner -
Council _
Bldg. Oif. _
APC
Sipnature of Permittea -
ivant ros. onstruction
A Bullding Permif is Issued to:
oll work sholl 6e done in accordance wifk?nll aooli eState d-Minnemtc
Permit LBy.UU
Surcharge 26.00
Pion check 144.50
SAC 525.00
Woter Conn. 450?00
Worer Meter bU UO
Rood Unit 250.00
rorol 1744. 50
on the express eonditlon Ihnt
Stotufes ord City o4 Eapon Ordirwntes.
Buildinp Oificiat
RESIDENTIAL
p BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAPI MN 55122
651-681•4875
New Conatructlon Beaufremenis
• 3 registered sile surreys sliaxing sq. iL ai lot, sq. it. M house; anC ?II roofetl areas
(20% maximum bt coverage allowed)
• 2 copies of plan showing beam 8 window sizes; poured touM Oesign, elc.)
• lsefofEnBrgyCelculatbns
• 3 copies of Tree Preseivation PWn'rf bt platled after 7/1/93
. Rlm,bistDetailOptbnsselectionsheet(bldgswith3orlessun'ds)
DATE 71?9?U ?
SITE ADDRESS
NPE OF
APPLICANT ? SYTQ,n
STREET ADDRESS
TELEPHONE #(d,) - Sf :!::?3?CELL PHONE #
MULTI-FAMILY BLDG _ Y >QN
_ FIREPLACE(S) ,10 _ 1 _ 2
HemotleVNeoalr HeauhemeMs
• 2 copies ol plan
. 1 sat of Energy CakuNatlons for heated additlons
/ • 7silesurveyforeAerbreddAions&decks
• Indicete if home sened by septic syslem for atldilions
VALUATION '
s
Phone #
FAX #
PROPERTY OWNER rPj:? k ? ? 'J& ???/ I I ? S Wf6ELEPHONE # ?D?I ` `i Q?"f /p3
-------------------------- ---------------------------------------- --°-----------------°-°--
COMPLETE THIS SECTION FOR "NEW° RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RLTLES 7670 CATEGORY 1 MIA'NESOTA RULES 7672
(4 submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Wumbing Conhactor: __
Plumbing system includes:
Mechanical Conhactor:
Mechanical system includes:
SeweVWafer Contractor:
_ Water Softener _
Water Heater _
_ No. of Baths
? Air Conditioning
Heat Recovery System
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
$171, 7S
// e1/o 2 9r !l
ATEO-W 21PS%"4
Fee: $90.00
Phone # II U
Fee: $70.00
F TT UnI
all applicable Sg t of Minanesoa Statlut p al nd t City of Eagan pr e Infor eation is? yrect, and
with ?
Signalure of Applica
..___._..____..._.___r__.___OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex O 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi
? 03 01 of _ plex O 09 07-plex O 17 Garage ? 22 PorchfAddn. (4sea.) ? 33 Ext. Alt - SF
? 04 02-plex 13 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
0 OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04plex ? 12 12-plex Plbg_Yor_ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) 0 44 Siding
O 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair
O 33 Alteration ? 37 Demolish (Bldg)' O 43 Reroof ? 46 Windows/DOOrs
? 34 Replacement 'Demolkion (EMire Bldg only) - Give PCA handout to applicaM
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings(deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AidGas Tests _ Final
_ Framing _ Siding Stucco Stone
_ F'veplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulaaon _ Retaiumg Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply 8 Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
.?.. ..- -
y _ ..i-oTa.L 13TU. ' V-933 FpcN giDE 1'l19N # 3 -263C ?
• Sa FT- 9!Z
weacnerarrys Comtruetiou No.
Guide In+alatioa
1l'+ ^ F I Doors Rcferen« 1 Out. CVall Int. WAN Ceiling Roof Fl'oS I Kind How Applied
ee- o ea- 0 19_ . ?
1 ?•i i"?"?•tiiCi noom ? ?engih !3`O' Width JL'O"Heieht $' O"II ( Fl.1 # 28 ED Room I Length 14'0" Width /2?o"Height $' O u
Windows and Dee.a-GaA.e. ...A e__ ?
He. wmlh
ot paee x.1
gm
o! p?n•
No. ot
Il.ltl•
Linw[ tL
uf eraek
wna
q. fL
2 Z'o- 't'o" i tv 16
Coef. &o
Inhl4stion 20 ?p ?00
Glasa 16 SD SOO
F?cP. wall 200
Net exp. wall 7 ? Zg$
Int. wall
eioo.
Ceil. ! 56 (02
.vui nLu.
Reqwred aq. ft. E.D.R. or sq. ina. W:p, kader arct
?11•1 19aTh Room I LrnBth 7i6" Width 8'
Windows and Doors---Cra,ka. ...1 A...
No. Wlalp
otD.e. HoIgCt
otww Np e[
II'Ob Lo.l fl.
et<ne4 Are6
q.fl.
Z z'an 3'0" 17 Iz
Coef. Btu
Lifiltration 17 40 6$O
Glen 12 SO GOO
Exp. wall 20$
Nec cxP. Mdl QG ? 1372
Int. wsll
Floor
??_ 168 672
ldel tftu. 3'Z+}
_ Required iq. ft. ED.R. or p. inL W.A. Leader area
F1.ILiyi, t{all Roomll.eneth 15'6" WidthWO"Hei¢htft'o1•
Ne. Wlatn
of Dana Halsn[
oI pan@ Na.ot
Ilfhu Lla.,llt.
e[ enok ArN
p. A,
Coef. Btu
Infilttation
Glw
Exa. We?I 60 ? y?zo
Nee rsp. wall
lnt. wall
Floor
Ce'l' 6 256
wial acu. 6 7 &
Required sq. ft. E.D.R, or uq. in:. WA. I.eader srea
I Fl. 0 2V Room I Length$'6" Width 616" FieSght$'0"
Windowe and Doore-Crackage and Arca
Ne. W WN
ef D.n. Hal?nt Wo. ot
of p?v? IIiAU Gnul lt
ef creek Arw
?p, ft.
-
1 3'0.? 6,g„ 0 20 20
EJE
Coe£ Be,
In6ltntion z0 4?0 1600
Udu 2o SO 1000
&p. wall Z
Nee e:p, w.u
Int. wall 32 7 t z'}
Flour
ced. 55 4- Zzo
..w1 O.U.
Windom an d Doors-Cracka ge and Area
Na. WICtE
a(Dae, H.IsCt
afpaw Na ot
Ofeu Llnul tt.
alene4 An.
q.ft.
1,g„ ,of I S 29
Coef. Btu
L?fi?tretion 3s 10 ?'11oo
Glais 29 SO 1'F5,O
Exp. wall iZO -
Net e:p. waU 91 Co37
Int. wsll
Floor
Ceil. 233 4 93z
1 o[al Stu,
:D.R. or p. iuL W.A. Leader ares I
I RoomlLength 2M"0"WidthI o'o" Heieht 8'O"
Deen-1_raekas' wnrl Arww
Nn WIJIh
of o.n. H?I?Yt
etyan? Na, ot
IIfAt? Lln?al [a.
ef enek Ar??
p. i4
Z 3,0„ 31F
Coef. Btu
InGltration SO 40 2000
Glsss yZ $O 2600
E7[p. Wnli 1(?
Net ezp, wa0 10 7 56
Int, waU
eloo.
Cd• t'FQ 960
I ocai aIu. G ?G
Required sq, ft. E.D.R.,or sq. ios. WA. Lseder area
-----• - -
...?.?
We\thffd(lpf n?a Ci.?Ula!
13'indows I Doon ReEeronce
e' lo Y?o 19_
No, W IGIIt
of Dine H?If?l
o[ D No. of
IIrHb Llo?l tL
of enek Ana
N. tt
2 310" G' " 1 34 44
2 2'0" 440" 1 20 16
tr r 3S 29
Coef. &a
lufiltrntion 'I? 3SG0
Glaaa So 300
Fxp. wall 30
Netexp.wall INSVL 3 7 S26
Int. wall VJf I"/vl I S 10320
eioor 2736
CGa.
Total Btu. CZff 4 G
Requited sq. ft. E.D.R. or sq. ina. WA, l.eader arca
F1.1 Room Length Width Height
Windowe and Doort-Crackaae ond Area
Na wmte
ot Dan0 NNffK/
of 0?ne ao. o[
Ilfhts Lia.a e.
o[ enek An.
m. fl.
Coef. Btu
Infiltratioo
Clau
Fsp. wall
Net exp. waU
4nk wall
Flon.
Ceil.
Cocshnceoo No.
V1d1 Ceilioe Roof
iasd.eion
How
Wi ndows aM! Uoon- -I-rato ge aaa .,??.
No. wla?e
ef Da oi, xN?tt
o! Wes 140.09
IIsCu Llewl tt.
et <nek wre•
W? «•
Coef. Bm
In5ltratioo
Giau
Ecp. wall
Net ezP. well
Int. wsn
Ftoor
(?•?.
Twal Btu. - ?
Requued sq h. ED R or tq ms• W.A. 1-iader area ?
f7.1 (toom I Leaqth Widch Height
Windows and Uoors---a.racu
wiate x.+rei no- oe
No, a[ paw of Mw 11[eu ge ana nrea
u?..? n. w...
o! tnek M. «.
ef. tu
In6lUation
G1ats
Exp. w.0
Net e:p. wsll
Int. wsU
Floor
Ccil.
Totai Btw
Requued sq k ED R or sq ins W.A. Leader aree
F1.1 Room I Lengdi Width Height
'-J IL_..- !`...L.s. .nd Area
NP W Wt?
otp?n? Hd?Ot
ely?e? Na o[
Il?ht? Lln??l [t.
e[CneY
I
C«f. Bm
Infiltration
Glaa
EnP. wal]
Net exp. waU
Int. wall
Flom
CCiI.
lotal tftu.
Required sq. ft. ED.R..or sq. ios. W.A. Lender arca
y :
Gene Vivant
IVANT VIVANT BROTHERS CONSTftUCTION (612) 451-3483
2420 East 105th Street
Inver Grove Heights, Minnesota 55075 R.onald Vivant
ROTHERS (612) 432-6047
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t...:...?...? ,..1_.. •, ... ., ,,,?,..
,,.,.?.._ x+r+ ....... ..
PERMIT
CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 029148
(612) 681-4675 Date Issued: 10 / 3 0/ 9 6
SITE ADDRESS:
4545 HAY LAKE RO S
LOT: 42 BLOCK: 2
OVERHILL fARM iST
P.I.N.: 10-56150-042-02
DESCRIPTION:
r? (GAS)
uild'ing-.Permit 7ype
uilding 04rk Type
ettsLis Gode
? . ,. . ? ..
Jk ? d G
?-r
F.IREPLAGE
NEW
434 ALT. RESIDENTIAL
,? a 5
i.
. a?` i ..
REMARKS:
FEE SUMMARY:
Base Fee $25.00
Surcharge $.50
Total Fee $25.50
?
+
CONTRACTOR: OWNER: - Applicant -
HILTS DANIEL
4545 HAY LAKE RD S
EAGAN MN 55123
(612)452-5376
?
i
I hereby acknowledge that,:I kaave read;,thi??, appiication.,a nd_"statI e th-at the
information is aorrect and aqree`to comply with all applicable.State of'Mrt.
Statutes and City of Eagan Ordinances. APPLICANT/PEFMITEE SIGNATURE ISSUED B' : SI WATUR
CITY OF EAGAN
' ? 3830 PILOT KNOB RD - 55122
? 1996 FIREPLACE PERMIT APPLICATION V
68t-4675
DATE: 10- 3 D - 9' 6
DESCRIPTION OF WORK: _ CONSTRUCT NEW FIREPLACE: _ WOOD BURNING Y GAS
ROOM TO BE INSTALLED IN:
INSTALL GAS INSERT ONLY IN EXISTING FIREPLACE
INSTALL GAS LINE ONLY IN EXISTING FIREPLACE
OTfER:
H'/
STREET ADDRESS: ? / `- ?- (f--
LOT ?O ,2 BLOCK SUBD.IP.I.D.#: IIIN),) /XX '1"7Jhm-
APPLICANT: (circle one only) OWNER CONTRACTOR
I hereby acknowledge that I have read tYris application 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
FII2EPLACE
INSTALLER
Name:
Signature:
I)R/j /E? Phone#: ?S2-S37{o
utt /I / Fl4R ? . / _
Street Address: VS`f ?
City:
A
Company:
5ignature:
Street Address: License #:
City: State: Zip: -
GAS LINE Company:
INSTALLER
Name:
Signature: _
Street Address:
City:
Phone #:
5tate:
V -fz-S376
Zip:
State: 141A) Zip:
M
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 14 Fireplace
WORK TYPE
? 31 New
o ;2 Addition
? 33 Alterarions
a 34 Repair
GENERAL INFORMATION
Census Code.
SAC Code
REiNIARKS
.
Chimney/flue must be inspected before concealing.
('Lq t g 2
Council Minutes
January 18, 1983
00101u
OVERHILL PROPERTIES - iiAIVER OF PLAT L /- '7
, " GIA--?
The application of Overhill Properties, Inc. for waiver of plat to divide
tain home lots into individual orrnership xas submitted. Mr. Dehler was
present and the Advisory Planning Commission, at its meating on January 11,
1983 recommended approval, sub,ject to certain conditions. After discussion,
Egan moved, Smith seconded the motion to approve the application subject to_
Lhe recommendation of the Planning Commission, including compliance with all
applicable ordinances. All voted yes. R 83-2
SEE PLAT FILE
HAAAGEEP!ffiiT APpLICATIONS - COHDITIONAL IISE PERMIT
The application of Management Applications and Innovations, Inc, for
conditional use permit to allow more than three amusement devices at the
former A 8 W Restaurant at 3998 Sibley i9emorial Highway was submitted to the
Council. Tom Truax and Dave Maddis were present. The Advisory Planning
Commission recommended approval subjeet to all conditions provided in the
Amusement Device Ordinance. Smith moved, Thomas seconded the motion to ap-
prove the application, sub,jeet to the same conditions. All voted yes.
EETPY BASSEIT - EAGAN HILLS WFST PLANNED DEVELOPMENT AMfENDMENT
The request of Betty Bassett of the Eagle's Nest Home for amendment to
the Eagan Hills West Planned Develooment to allow a change in the proposed use
and allow R-2 as underlying zoning was submitted to the Council. The staff
recommended the Council continue consideration of the amendment until the
February 1, 1983 meeting and upon motion by Wachter, seconded Egan, it was
resolved Lhat the application be continued until the February 1, 1983 meeting.
All voted in favor.
` OFF-SALE LSQUOR LICENSS POLIC7C CfIANGE
AND
HCM OFF-SALE LIQUOR LICENSE
The request to consider a change in the liquor licPnse policy to allov an
additional off-sale liquor license in the Cedarvale area and also the applica-
tion of MGM Liquors for off-sale liquor license uere, upon motion by Wachter,
seconded Egan, continued until the February 1, 1983 meeting. All voted in
favor.
8
?? ?
i.of q , giae-ua-
(D-itrM. ll +arm 1S4
MEMO TO: DOOG REIDO, CHIEF SIIILDING OFFICIAL
FROM: THOMAS A COLBERT? DIRECTOR OF PIIBLIC WOR1C8
DATEC NOVSMBER 71 1991
BIIBJECT: LOTS 1-7, BLOCR 21 OVERSILL FARM 18T ADDN
OTILITY SERVICB REMOVAL REQUIREMENT WITH BUILDING PERMIT
IBSUANCS
The above-referenced lots were originally platted and are currently
zoned as R-2 Duplex/Twinhome lots. Accordingly, two sets of sewer
and water services were installed to each platted lot to
accommodate each of the individual dwelling units.
It is my understanding that the potential exists for a single-
family house to be built on these lots where only one set of ;
services would be activated. In such situations, the City requires
that the second set of services be abandoned in accordance with
City Code 3.20, Subdivision 3(copy enclosed). This requires that
the services be disconnected at the main in the street which
requires excavation within public right-of-way. Correspondingly,
a separate permit for work within public right-of-way must also be
acquired in conjunction with the building permit issuance to ensure
that the appropriate performance and warranty bonds are submitted,
that construction and restoration are in accordance with City
standards and that our record plans can be properly modified.
I would appreciate it if you would put a specific notation on each
of the above-referenced lots regarding this requirement and to also
help to ensure its application to any other similar situation
throughout the City. Your cooperation and assistance in this
matter will help to inform the property owner/builder of this
requirement early in the process so that it can be properly
budgeted and scheduled as well as protect the City's infrastructure
system. ease let me know if you have any questions or concerns
regardi g his matter.
?
Director of Public Works
cc: Wayne Schwanz, Superintendent of Utilities
Mike Foertsch, Assistant City Engineer
Enclosure
Cities Di i? tal Quality Control
The following image represents the best
available image from the original page.
Every effort was made to capture the content
from the original page.
S 3.20
t"l 0
O ( :
( O ( ? C •?
Cl!t C.C?
coeccc??
UI): C'041
( •C (_C 0
_ C? l'• L C. ?. ?
- _ ,
?c i" CCC
C / (: C C? •
t 0
C C •4.
U? C ( (.???
?. • .:• C. C. L
SEC. 3.20. RQLES AND RBGQLATIONS RSLATING TO WATBR
SERVICB. .
Subd. 1. Deficiency of Water and Shutting Off
Water. The City is not liable foc any deficiency or failure
in the supply of water to customers whether occasioned by
shuttin9 the water off foi the pucpose of making repairs oc
connections or by any other cause whatever. In case of
fice, or ala=m of fire, Watec may be shut off to insuce a
supply for fire fighting. In making zepairs or construction
of new works, water may be shut off at any time and kept off
so long as may be necessary.
Subd. 2. itepair of Leaks. It is the
responsibility.of the conaumer or owner to maintain the
service pipe fcom the curb stop into the house or other
building. In case of failure upon the part of any consumer
or owner to cepair any leak occu=ring in his eervice pipe
within twenty-four (24) hours after oral or written notice
has been given the owner or occupant of the premises, the
water may be shut off and will not be turned on until a
reconnection charge has been paid and the water service has
been repaired. When the waste of water is great oc vhen
s not pcoc eded svith imme8iately.
turned off l if etlie t epair i be
C? Subd. 3. Abandoned Services Penalties. All.
have service en abandoned?or, Cfor eany reasonhe have ebecome euseless
foc further service shall be disconnected at the main. The
ownet of the premises, served by this secvice, shall pay the
cost of the excavation. The City shall perform the actual
thecst eetoright of-weyishall becomeethecpropectye of from
City. When new Cuildings are erected on the site of old
ones, and it is desired to increase the old water rV
new permit shall be-taken out and the regular tapping Chatge
for shall
to cause or allow anyservice pipeltofbe
peasn $ i
hammered or squeezed togethec at the ends to stop the flow
of water, or to save eapense in improperly removing such
pipe from the main. Also, such impcoper dispositian thereof
shall be coccected by the City and the cost incurred shall
be botne by the person causing or alloving such wosk to be
performed.
Source: City Code
Effective Date: 1-1-83
Subd. 4. Service Pipes. Every secvice pipe must
6e laid in such manner as to pcevent rupture by settlement.
The service gipe shall be placed noY less than seven feet
C,
43
(4-30-84)
/j,67i
2007 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please wmplete foc single family dwellings & townhomes/condos when permits are required for each unit
?70-?
Date 6 QZ
Site Address L c- re 21) Unit #
Proper[y Owner I I Ii S, C ef,?U Telephone #( )
Contractor l9cj`? NCe.?!tx c.,o4 /ai ?
/
StreetAddress 1 6CGS-3c2lir7 4VC OI City
LLlrY vet)C
State tr1/1J Zip GLl 'I Telephone #(?j
Bond #: Expires:
"l
contractor _ Other
The Applicant is _ Owner -k
Fire repair (replace burned out appliances, ductwork, etc.) $ 90.00
This fee applies when extensive mechanical repairs are made to a building.
Add-on or fllteration to existing dwelling unit $ 50.00
/
Replacement _ New
furnace _Additional /
air exchanger
air conditioner
heat pump
other
Sta[e Surcharge $ .50
Total $
I hereby apply for a Residential Mechanical Permi[ and acknowledge that the information is complete and accurate; that the work will
be in conformance with the o[dinances and codes of the CiTy of Eagan and with the Mechanical Codes; that I understand Ihis 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
apQroved plan in the case of work which requires a review and approval of pkeqs. -
`?`-.--??
Applicant's Printed Name Applicant' Signature
2007 COMMERCIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete £or. commerciaUindustrial buildings
mulli-family buildinps when seoazate certnits are not reauired for each dwelline unit
Date
Site StreetAddress Uuit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor
Street Address City
State ' Zip Telephone# ( )
Bond #: Expires:
The Applicant is _ Owner _ ConVactor _ Other
Work Type
_New Construction _In[erior Improvement _Install Piping _ Processed _Gas _E?cterior HVAC Unit•*
•*HVAC units must be screened
UndedAbove ground Tank Instal] Remove
When installing/removing tank(s), call for inspection by F ire Marshal and Plumbing Inspector
Nature of Work:
PeRnit Fe¢S S70a0 Underground tank installatiodremoval
550.50 Minimum (includes Stare Surcharge)
or
Contract Value $ x 1% _ $ Permit Fee
$ State Surchazge
. To calculate surcharge
If Permit Fee is less than 51,000, surctwge is 50 cencs.
If Permit Fge is > $1,000, surohazge increazes by 5.50
for each $1,000 Permit Fee (i,e, a$1,OD7-$2,000 Pertnit
Fee requires a $1.00 surchazge). -
$ Total Fee
I hereby acknowledge that this information is complete aod accurate; that the work will be in conformance with the ordinances and
codes of the City of Eagan and with the Mechanical Codes; that T understand this is not a permit, but only an application for a permit,
and work is not to s[art without a permit that the work will be in accordance with the approved plan in the case of work which
requires a review and approva] of plans.
Appiicant's Printed Name -
--------------------- -------------- ----------- -----------------------?
Approved By: , Inspecror
ApplicanTs Signature
Required Inspections: _ U.G. - M. _ Air Test _ Gas Service Test _ Infloor Heat Final
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - -
I For Office Use
~ Permit I
I
City of Ea I _
I Permit Fee: /i2 ,
3830 Pilot Knob Road I
Eagan MN 55122 I Date Received: I
Phone: (651) 675-5675 j
Staff:
Fax: (651) 675-5694 L
INFLO INFILTRATION PERMIT APPLICATION
Plumbing / Sewer & Water
Date: 3 J Site Address: 1 ,4 /.l S ~y Lc, Ke- ~lk~Cc
Tenant:r'vi~l'~ Suite
Name: 1,74, 0I 1,S Cor 6.D Phone: 4 - y5az L~ f/p
RESIDENT I OWNER - r T r P l
Address / City / Zip: 15
L'~~ 1 r~ y l G 11~~ 1~1~
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 Description of work: I C t J C, I'~ V Uj L- j
e
e)'v1 C XA7 V- b Q U. ' J BSI C iC_
FEES
$60.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $
*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.citvofeagan.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.orq
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 req ' a reA w and approval of plans.
x+S kc~ly_) x
Applicant's Printed Name Applicant's Signat
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground -Rough-In Final
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA126089
Date Issued:08/13/2014
Permit Category:ePermit
Site Address: 4543 Hay Lake Rd S
Lot:041 Block: 02 Addition: Overhill Farm 1st
PID:10-56150-02-041
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 .
Jackie Terrell
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 -
Phyllis M Corbo
4543 Hay Lake Rd S
Eagan MN 55123
(651) 452-1448
Walker Roofing Company
2270 Capp Rd
St Paul MN 55114
(651) 251-0910
Applicant/Permitee: Signature Issued By: Signature