4555 Johnny Cake Ridge RdCITY OF EAGAN N.? 9?Q?
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 ,
BUILDING PERMIT Recelpt # 1/-=
Te b? w?d Mr 3 SEASON PO?aIe $16,000 ?e JUNF: 25 , 19 tSZ.
4555
Site Address JOHNr?Y CAKE RIDGE RD ?3
Erott 0 Occu
anc
18 p
y
ti n
I
.
Lot
Blo? .
.
Sec/
h. Alter ? Zonin
'?
?
_
L ?
I
?
1 lJ _
g
Parcel No. ' N/A
air p Fire Zone
Re
p
?
E
l
T
f
THGk?
NFLVIN arQe Q
n
ype o
Const,
ac Name
S?E ?Ve ? # Stories
Z Address Demolish p Length 24
t City Phone 454-7259 Grade ? Depth ?_ Sq. Ft.
? [rVttLwr,?"1 iSUlLUC.Kb
, o Name D AVE SO
?? Address.,. - 70
1-- Citv Phone
Name _
Addresa
City -
Phone
I hereby acknowledge that I have reod this application ond state that
the informcfion Is correct and agree fo comply with all applicoble
Stote of Minr?esota Statutes ond City of Eagan Ordinances.
Sipnoture of Permittee
N0?1',)F]FST BUILDM
A 8uilding Permit Is issued to:
oll work sholl be done in occordonce with all opplicoble State.:of Mir
Buildinp Officicl -
ApProvals Feas
Assessment
Woter & Sew.
Police Permit Q
Surchorfle 8.00
Plon check 56.25
Firo SAC
Enp. Water Conn.
Plonner Water Meter
Council Road Unit
Bldp. Off,
?
APC Totol •
on t ha exprcss condition Ihnr
wta Statutea ond City of Eapon Ordinonces.
Parmit No. Permit Holder Miac. Permit No. Holder
Plumbing
H.V.A.C. Dc? ? ?,( ?3It`I
Well
Water
D"isp.
Sewer
ele«.ic
Inspeetion Date Insp. Other
Footinpt
Foundation
r
Freminy 7vn?
Rouyh Plbp.
Rouyh HVA
Insulation
Final Plbg.
Final HVAC
Final 4 -'
?
Water Dacribe Locatio n:
Well a C?9
Sawar
Pr. Dbp.
Receipt
MECHANICAL PERMIT
CITY OF EAGAN
Permit No.
Fee
Fill in numbered spaces S/C
Type or Prini legibly Tot.
1. Date 2. Installation Cos?
3. Job Address
-?
4. Owner
5. Contractor Phone ;?S `/
?-
6. Address C/1
7. City State Zip
8. Building Type: Residential ? Commercial ? Institutional ?
9. Work Description: New ? Add O Alter ? Repair ?
10. Describe
11.
Type
No. Equi ment 9TU - M. Ea.
Forced Air No. Equipment CFM
A
Mfg. ir Handling:
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Othe
`
Air Cond. .
r
Mfg. ?
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.
i?._ --
Signed : ? - ' !%for
Rough ? Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
CITY OF EAGAN Remarks
Addition Wood ate 2 d Lot 18 Blk 2 Parcel fg 84601 l?
i d
Owner 7• Street 4555 r74bnny ['alce RdQ, Rck-`State F.agan,Mt3 5I
?? l... .. i Q
-
Improvement F
Date
Amount
Annual
Years
Payment
Receipt
Date
STREET SURF, 1974 5.11 1.02 5 Paid
STREET RESTOR. 1976 1034.75 344.92 3 Paid
GRADING
SAN SEW TRUNK 1974 99.42 6.63 15 Paid
* SEWERLATERAL 1976 3068. 1 1022.90 3 Pdi
WATERMAIN
* WATER LATERAL 1976
* WATER AREA 97
* STORM SEW TRK 1976 3
* STORM SEW LAT 1976 3
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
sa,c 400.00 12109 11-8-74
PARK
?
, ? ???? 1Y------
:;? , ? ?? ? ,?•.
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued;
(612) 681-4675
SITE ADDRESS: APPLICANT:
nr r rit,rtr I? i?
1iii???it.ll f I .'i?li i4 4 d
?
PERMIT SUBTYPE: TYPE OF WORK: V f' F A T R
k1f RI1tlF
Pertnit Holder Date TNephone #
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING ?
FOUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
corvoucnvm
TEST
HYDROSTATIC
TEST
BSMT R.I. •
BSMT FINAL
DECK FTG
DECK FINAL
REQUEST FOR ELECTRICAL INSPECTION
O o?? 5 40, see insiru^Aans lor campleting Ihis form on beck ol yellow capy.
"X" Below Work Covered by This Request
`?°1`?oZ?EB?00001A9
ywH.
?
Ne Add ep. Type of euilding Appliances Wired Equipment Wired
Homa Range Temporary Service
Du lex Water Heater Elactric Heatin
Apt. Buildin Dryer oad Managament
Comm./Industrial Furnace Other (Specify)
Farm Air Conditloner
Other (specly) Contractofs Famarks:
Compu[e Inspection Fee Below:
# Other Fea # Service Entrance Slze Fee # CircuitslFeeders Fee
Swimmin Pool 0 to 200 Am s 0 to 100 Am s
Transformers Above 200_Am s Above 100 -Amps
Si ns inspactors usa oniy: p/ TOTA?"?
Irrigation Booms ,,
5 eciel Ins action
Alarm/Communication THIS INSTALLATION MAY BE ORDEHED DISCONNEC7ED IF NOT
Other Fee COMPLETED WITHIN 1B MONTHS.
I, the Electrical Inspector, hereby
certlty ihat the above inspection has
6een made. R°u9n-in
-
F'"ai oate
oe?a ? 7
OFFICE USE ONLV ?
This raquest voltl 18 months Irom
Y(W 54'/_54 7
l8-aA
Fequest Date
/ Fire No. Rough-In Insp ion RaQUiretl
(VOU m st call Inepector reetly) Ina ectl n blhar Than RaBh-In
Will qHy Ipepector
eedy N4w
-?, 9 ?] Ves ?ao ?
Dale Reatl 9 V?
I icensed contractor ? owner here6y request inspection of above electrical work at:
Job Atltlress ($Vael, Box or Roule No,)
5's5!E? iMT•M cA?C
R?q. ?d Clty
rfvq?I ,.C
Section No. Township Nama or No. Renge No. County
/9Kd`Ti4
Occupanl PRINT) Phone No.
ae ?L r/?'?
Power Suppller
34??A L, Atltlress
ARr1//i/?!
7-x( Md
ElecMCal Conirador (COmpeny Name)
r
`
e
9
F Contractor's Llcense No.
Ao-az7`1
,e????
r u
P.? ,
-1
?
Mailing Adtlress (COnVactor or wne Making Installatlon)
? ?
D
/ .?
ANhotlze eWre (Coniract wne Making InstalAaNon) PhOne Number
5
`
9 _0 B 6,
$
LMHIkESOTA STATE APO OF LEGTq THIS INSPECTION REOUEST WILL NOT
GN88e-Mltlwey Bldg. Room 5-128 BE ACCEPTED BY THE STATE BOARD
1827 Univeralty Ave., St. Paul, MN 65100 UNLE55 PROPER INSPECTION FEE IS
Phone (672) 692-0800 1 ENClOSEO.
YILLAGE OF EAGAN
3795 Pilof ICnob Road
Eogan, MN 55122
ZOtliOg: ??rtn
1 ogree fo comply with fha Villoga of Eagan Surchazge: . nV Yu
Ordinancos. Misc Chazges: L'- C6°
Total: ?
Da[e Paid: _
Date of Insp.: ? - Insp.:
WATER SERVICE PERMIT
PERMIT NO.: 1629
DATE: 11/15/74
No. of Units:
rILlAOE OF EAOAN SEWER SERVICE PERMIT
1795 Pilot Knob Road PERM[T NO.: 2329
Eagan, MN $5122 DATE: 11/75/74
!.oning: PUD No. of Units:
lwner: New tIOriaon Homes Woodqate II
\ddress:
ii[e Addreas: 4555 Johnnv Cake P.idne
?lum6er: - Thompson Plwnbinq Co.
ograa to comply with fhe Villags oi Eogon Connection Chazge:.eTOO. 00? d
Jrdinoncas.
ay:
lare of Insp.:
nsp.: -
Accoun[ Deposit:
Permit Fee: 10.00 pd
Surchazge: • 50 pd
Misa Chazges
Total:
Date Paid:
SEDGWICK HEATING & AIR CONDITIONING CO. HE^TiNC JOB NO.?°
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000 TEST RECORD
.\A_ 0 . CIN 7
ADDRESS `lS?S?I.Ct?F?`a IuCr
OCCUPANT Iv?ul'J OWNER J
SOLD BY? j INSTALLED BY
MAKE ? p I-jrn
SEFIAL NO. y -s
?z?`
FAN SETTING ` b Hv-C,C`
PILOTTVPE
IGNITION MODEL I l..l?krCJW?-
PILOT TIMING _
PRESSURE
INPUT CFH
STACK TEMP. b?? PERCENTCOz
PERCENT
PERCENT CO v
FORM 235 (REV. 11189)
MODEL 6-60(t N V 7G'N
INPUT
VENT SIZE
TYPE OF LINER ? v
i/
LINER SIZE n
FILTERS: SIZE -- ;?26"" NUMBER
WIRING ??rJIJ-r102w?-
TEST TAG T?
i-
LIGHTING INST.
DATE TESTED
Q t i.
COMPANY TESTING
NAME OFTESTE
FORM OISTRIBII . HITE FILE YELLOW COPV - CRV
CITY OF EAGAN
-3$30 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMI7
ReceiPt #
N° 9209
Te M und fer 3 SEASON PORgpValue $16,000 pate JONE 25 1984
5itenddress 4555 JOHNNY CAKE RIDGE RD Erect ? Occupancy R3
Lot 18 slock 2 Sec/Sub. WOODGATE 2:N? qlter ? Zoning Rl
Parcei No. 10-$4601-180-02 Repair ? Flre Zone N/A
eniarea p Type af Const. V
w Name THOR NELVIN Move p # Stories
; Address Sp'ME Demolish ? Length 24
b City Phone 454-7259 Grade ? Depth L2 Ft
Sq
.
.-
? NORDWEST BUILDERS Avvro•als Feos
p Name
?? Address 12505 XENWOOD AVE SO
i- City SAVAGE pnone 894-3770
Name SPECIALTY SYSTEMS
Address
City _
Phone
Assessment _
Water & Sew.
Police -
Fire
Eng.
Plonner -
Councll _
1 hereby ockrwwledge ihot I have read this opDlicotion ond state thot gldg. Off.
the inlormotion is torrect ond ogree to camply with oll opplicoble APC -
Stote of Minnesota Statutes and City of Eogan Ordirwnces.
SiOnuture of Pertnittee
Perrnit $ 116.50
$urcFwrge $ • ?0
Plan check 58, 25
SAC -
Water Conn.
Woter Meter
Road Unit _
Total $ 182.75
11 Building Permif Is issued to: lNVt(UWES'1' riUlLUri1tS on the express condition thm
oll work shall be done in accorda w rh II apDlicable ot f 'nnewto Stututes ond City of Eagon Ordinances.
BuHding Offkial ?'?' , _
HOUSE HEATING TEST RECORD D-21429??/?,'?"?
ADDRE55 4555 Johney Cake Ridge ppT. - FLOOR CITY SUBURBEagan
OCCUPANT Thorleif Nelvin nwNFp Yea
HEAT LOSS
SOLD BY -
Elactrieal Work By
TYPE OF HEAT
%
GA _ FA X HW -STEAM
INSTALLED BY Sedgwick Htg.
Gas Lins By ft if
SPACE HTR. UNIT HTR. OTHER
GAS DESIGN
Williameon
MAKE 111?-10-5 MAKE OF BURNER_
Model Model
Ssrial 7421065 Max. BTU Rating-
INPUT 100,000 BtH MAKE OF FURNACE
Model
CONTROLS
THERMOSTAT Cm 280 Heat P?Iyg
M
H
Valvs • ?Z300C
•
Limk P-obshaw RF'L 750n
Limit Sstting 200of
Fan Settin9 90 f& 120 P
Pilor Type Couple
Pilot Make
Vent Size
KIND OF LINER A1um• SIZE 8" NONE
Drak Hood Vertical Regularor
Filterz Size 16° % 25`' Num6ar 1
Chimnay Location Inside Ye8 Outside
Chimney Cons}ruction Metalbeatoe
Pilot Model $moke Bomb Wiring
Pilot Timing 52 Seconda proft OK Tsst Tug Yeg
L.W. Cut Off Daor Pressure Lighting Inst. Yee
Prossuro 4.3°W•C, PmcentCOZ 7.0% Defe Te:tad 1?30?5
Input CFH 100?_-Peresnt OZ 8•7% Company Teating C ?
..v ???..+
emp. `?50 f psrcent CO . 0•0?
Stuek T Name of Tesfar ?
Fwm 235
DATE HTG. INST.
CONVERSION
fb? CITY OF EAGAN Include 2 sets of plans,,
' 1 Certi£icate of Survey 6
BUILDING PERNQT APPLICATION 1 set of ener9 y cal.culations.
? SF?? PoRCf-?- ? `?A tooc+? °°
T'o Be used For Valuation Date
ress: ?Zsss ja NN
Site P,dd Ny C44F Iro, OFFICE USE ONLY
r?
Int /d slock -?, sec./sub. [Jooov,?rE Z?Erect . Occupanc5'
Parcel #: /D ?yC/100/ - 1d U -- O 2 Alter
Repair Zoning
Fire Zone
?E? V?/1J E??e ? ?'?'? of Const
i
??
0 Move # Stories
Address: ?5ss S04 NNY Demolish _ Front ft.
ft
Grade Depth .
1 2
City/Zip Code: ?Af ,A-n/
Phone # : qS? -72 Sq APPlZO?1ALS F?
Contractor: &
aQ GtJ S-? ?fU/?Q?S
Address:
City/Zip Codev 55?3 ]
Phone #:
Arch./Eng.;lL
Adclress: I
City/Zip Code:
Phone #:
Assessments
water/Sewer
Police
Fire
Eng.
Planner
APC
O££.
Per[nit ? i
?v • ?
SuY'ChaYge
Plan Check 58, ?
SAC ?
Water Conn. ?
Water Meter ?
Road Unit
TOTAL /?'a . 7 S
CITY of EAGAN
BUILDING PERMIT
Ownoi ..........(.leS:.'^r.-..............
Addsess (presan!)
Builder .................................
Addreea ......
. ;, ?
N6 3459
3795 PiloS Kao6 Road
Eagan, Minnesota 55122
454-8100
a.:. ... .. ...:'. l a-. 7:y ..............
Bioriea To Ba Used For Fron! Depth Heigh! Eat. Coc! Perm!! Fea Aemuko
qX ? 4
" LOCATION
or
>--
This permit does aot aulhorise the use of sfsaefs, raads, alleys or sidewalks nos does i! 9iva the owaer os h[e agent
the zighlto ereale any siluation which is a nuisenee or whieh psasente a hazard !o the heallh, safelp, tonvaaioacs and
general welfare !o anyone in the communilp.
THIS PEAMIT MUST SE KEPT ON TIi;, PREMISE WHILE THE WOAK IS SN PAOG ESS.
Thla is !o certifp. !hal....?:.':?t?.._ .... . . .. ... . .?._..-._hm permiuion !o exeet a- _--•• -• `?`.°:?_?. on
the above described premise subjeci io e pxovisions of all applicable Ordinances for ihe C of Eagan
?-."... """"...a ....... ............'--.. Per ..........................._?.Y:'`?`-....???
.""__""__'.......'_""'..Y_""' "_
Ma _.................."""
or Buildiny Impcefo[
Xs
/ I'- ?
C.ITY OF EACAN
3795 Pi_].ot tu:cb Eoad
Eagan, Minnesota 55122
PERIvi[T NO.: 594 _
The City of Ea.gan hereby grants to ceo. SeclRwic}_. Fieatina
of 1002 Xenia Ave. So.
. i . .C.. ?, ... aPermit for: (Owner) tlew 1 .
Cake Rddge
at 17na cw,.+,* ggiTny er„v, purauant to application dated
FPe Paid: snn_nn dated this1.ci__day oY
1.00 s/c
Building Inspector
PQzchanical Permits:
Bi4 Total:
rnis reauPSa vaia
18 iranths hom
UJ 35968
YSSx , e - av-F v
ftequest ate Fire No. peug fea? nsPeciion qeatlv Now Q Will Nntifv. InsDec-
? Yes ? No tor Wh.n PeaAv
Lidnsed ElAclrical Contrac[or I
. I hereby request inspection of above
Owner ' electrical work installed et
Sveet AaAress, eoa or R/oute No.
? / Citv
?
h
S$?
C
4 1 c '1
v
r
n r
ecbon o. Townshlp Name r No. Ra e o. ouuty
b /a
Occupent (PflINT) hone No.
Power SuDplier . Address
E ectrica Conv2ctor
Ifompany Namel Contracfor's License No.
?
r Ti-?? o t?s,sic ?/??c7
Mai
l
ine.4ddress IContrac?or or wner MakinB ?nsta'lationl
y
- j
Nuth rized 5? ?a ure IConhaCmr Owner kin0 Installation) Phone Number
y? rS U -7 ?L"O
4INNESOTq STqTE BOARD OF ELECTtJI&Y 7HIS INSPECTION REQUEST WILL NOT
Gri99s-Midwey Bldg: - Noom N-187 BE ACCEPTED BV THE STATE BOANO
UNLE55 PPOPEfl INSPECTION FEE IS
1821 University Ave., St. Paul. MN 66104
ow...e 16121 297_2111 ENCLOSEO. ,
59 19 -'J REQUEST FOR ELECTRICAL INSPECTION EB-00001.03
0 59 68 0 See instructions for completiin9 ihis form on back of yellow copy.
"X" Below Work Covered by This Reqc?.6t - ? .
N Ad,01 Hep. Typo ot Builtling AnPliances Wired Equipment Wirad
Home Range Temporary Service
Duplex Water Heater Lightin Fixtures
Apl Building Dryer Electric Weatin
Commercial Bldg: Furnace' Silo Unloader
Indusinal Bldg. Air Conditionr.r Bulk Milk Tank
Farm Offier peci y Other (SUOCify) -
t er Specify Mer Otner
Caaipute lnspection Fee Below
4 Fee ServiceEmrence5ize II Fea Faetlars/Subfeeders ll Fee Circuits
- Otol00Ams 0 to30Am2s 0 to30Ams
101 to 200 Amps 31 to 100 Amps 31 to 100 Ai
Above 200 qmps Above 700_Am s Above 700_Amps
Transiormers Remute Control Circ. ' Partial% herF e
Signs
Special Inspection
g_
?
. \
T
'
?
Remarks Z
S OT I
9EE
/
/??
flough-in 1, the Nachicel '
Inspectoq h¢reby
c rti(y that tha above
Final . napectiun has been
? ? ? mede.
This request void
ia mnnNS hom
IM, iM?•1?MI?
_ ??
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
FERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
PROJECT NBR:
BUTLDING
032563
07/17/98
92563
SITE ADDRESS:
P.I.N.: 10-84601-180-02
DESCRIPTION:
4555 JOHNNY CAKE RIpGE RD
LOT: 18 BLOCK: 2
WOODGATE 21VD
REROOF
8uildiFtg,.Permit Type
Buikding W;ork Type
Census Codea- "N s , • ? ? , ?'_.,
?. z?.
STORM DAMAGE
REPAZR
434 ALT. RESIDENTIAL
r
?
3 ??! q ? r ?? + ? •;}'_
REMARKS:
FEE SUMMARY:
CONTRACTOR: - RPPllcanr - si. LiL .0??pp
RONEL RE9TORATTONS 14351932 0002158 NE'LVI'N THOR
P 0 60X 240744 4555 JOHNNY CAKE RIDGE RD
APPLE VALLEY MN 55124 EAGAN MN 55122
(612) 432-3444 (651)454-7012
I hereby acknowledge that 3 have read this applicatinn and sCete that the
? i>nfdrmationx'soorrec't and agree to comply y,rith aJ;l apgl.i.cable St3te, of Mn.
Statutes and City of Eagan Ordinances.
APPLICANT/PERMITEE SIGNATURE
" Q" I-go
ISSUED 8Y: SIGNA7URE
?as.? 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PII.OT KNOB RD - 55122
681-4675
Naw Conshuction Reouirements RemodeVReoair ReauiremeMs
? 3 registeretl site surveys
• 2 wpies of plans (inGuOe Deam 8 window saes; poured fiE. design; etc.)
? 7 energy ealwiffiions
? 3 copies of tree preservation plan H IM pWUed after 717193 required: _Yes _ No
DATE: _ -j
DESCRIPTION OF WORK:
yS-TREET ADDRESS: _
,/
LOT: )155 BLOCK:
PROPERTY
OWNEg
?
CONTRACTOR
ARCHITECT/
ENGINEER
? 2 copies of plan
? 2 site surveys (extenor addkions 6 decks)
? 1 energy calalations tor Aeated additions
CONSTRUCTION COST; i? ? ?
3- SUBD./P.I.D. #: W OOC?
!Vv c1v ; PA
Name: N-et V/N ??' Phonet7: `L?v' 701?3
Last First
Skeet
City State: Mf-- Zip: j! a;L-
Company: ?Ne? La?14726,f Phone #:
StreetAddress: edF aelU 7?Lt? License# 00U a/J-,p ?
City 4*(/r Stare: Zip:
Company: Phone #:
Name: Registration #:
Street
City
Sewer & water licensed plumber (new construction onty):
and lot change is requested once permit is issued.
State:
t hereby acknowledge that I have read this appliqtlon and state that the information
State of Minnesota Statutes and City of Eagan Ordinances. ,,
Signature of Applicant:
OFFICE USE ONLY
Certificates af Survey Received _ Yes _ No
Tree Preservation Plan Received Yes No Not
Zip:
Penalty applies when address chang
and agree to comply with all applicabl
L f" gL a• CITY USE ONLY RECEIPT#: 950,3 9
SUBD. UJA.? 5;,2?A RECEIPT DATE: / 11-7/( o
1998 PLLTMBING PERMIT (RESIDENTIAL)
CITY OE EAGAN
3830 PZLOT IINOB xD
EAGAN, W 55122
(612) 681-4675
Please complete for: D single family dweliings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
-------------------------------------- ------ - _-
FIXTURES - - ----- --------
EACH -- ----------- ----------------
# TOTAL
Shower 3.00 X -
Water Closet 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Hot Tu a 3.00 x =
ater Heat
or rain
Fl 3.00
3.00 x =
x
o
Gas Piping Outlet ' minimum - 1 3.00 x =
RoughOpenings 1.50 x
Water Softener `for dwellings under constructian 5.00 x =
Water Softener ` for existing dwelling 20.00 x =..
U.G.Spflftkl8f "fordwellingunderconst 3.00 =
U.G. Sptinkler ' for existing dwelling 20.00 °
AIYer2tI0n5 ' to exisNng residence 20.00 =
Water Tum Around 20.00 = .
Private Disposal System ' MPC iic. 75.00 =
(new and refur6ished systems)
_
Private Disposal Systems " Abandonment 20.00 -
RPZ (new installation only) 20.00 =
STATE SJRCHARGE .50
TOTAL
S
•- ° ------------------------•-------------------------
I hereby acicnowledge that I have read this appiication, state that tFre information is canec[, and agree -to - comply - wilh all applicable City of Eagan orclinances.
It is the applicant's responsi6ili?-'^^^'?R•.?"? ^•^^°?•.^W^°• "'°'-"'°?"'•"'`-`--an assumes no liability for any damages eaused by the City during its
normal operetional antl mainte NELVIN, T is pertnit within City propertylrighROf-wayleasement.
4555 JOHNNY CAKE RIDGE ROAD SITE ADDRESS: _ EAGAN, MN 55122
(612)454-7259 04NNER NAME:
INSTALLER NAME: ?I Q?.?i lAN/I ?-l.l>"191?MGI / TELEPHONE #:
STREETADDRESS:
CITY: ( ijC OLI S STATE_ Nl?- ZIP.: ??o g
s
OF PERMITTEE
CO/PERMIT FORMS/RPLBG PERMIT (RES) - 1998
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4555 Johnny Cake Ridge Rd
Lot: 18 Block: 2 Addition: Woodgate 2nd
PID:10- 84601 - 180 -02
Use:
Description:
Sub Type: e - Fumace
Work Type: Replacement
Description: Furnace
Comments: Quesetions regarding electrical permit requirements should be directed to Ma rk Anderson, State Electrical Inspector,
952- 445- 2840Crystal Gemuenden 8910 Wentworth Ave S Bloomington, MN 55420 952- 881 -9000 Crystal.Gemuenden @Se
viceExperts.com
Fee Summary:
Contractor:
Sedgwick Heating & Air
8910 Wentworth Ave S
Minneapolis MN 55420
(952) 881 -7739
Surcharge -Fixed
ME - Permit Fee (Replacements)
Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply
of Minnesota Statutes and City of Eagan Ordinances.
h all applicable State
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
$0.50
$30.00
$30.50
Owner:
Thorleif N Nelvin
4555 Johnny Cake Ridge Rd
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
9001
0801
Issued By: Signature
Mechanical
EA075804
11/07/2006
ePermit