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4785 Galaxie Ave /330- Use BLUE or BLACK Ink r I I For Office Use Per mit#: Eainan &I City of l I j Permit Fee: / ~ Jb I 3830 Pilot Knob Road I Eagan MN 55122 ~ d 5a too Date Received: 04 Ec( g D,K. Phone: (651) 675-5675 j Fax: (651) 675-5694 I Staff: L -----------------I 2010 MECHANICAL PERMIT APPLICATION Date: 7--7-/0 Site Address: 6.doLxi-- /-eve Tenant: S C u Suite RESIDENT / OWNER Name: ::ZA901A 15, Phone: 625-1 1223-- (f~(V Address / City / Zip: q7,35 h i-e - 2-CONTRACTOR Name: (1,5V '7~/ /4,U' ,\AG License Address:/ S S ; ly 1~4~ / City: ~Lt QicU vt State: MpA) Zip: ~S(Z Z Phone: (D,e`/ Contact: ( Email:jc[a (I-At eLcZ-eAUDC ts- TYPE OF WORK New Replacement Additional Alteration Demolition Description of work: NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. PERMIT TYPE RESIDENTIAL COMMERCIAL Furnace New Construction Interior Improvement Air Conditioner Install Piping Processed Air Exchanger Gas Exterior HVAC Unit _ Heat Pump Under / Above ground Tank Install / _ Remove) When installing/removing tank(s), call for inspection by Fire Other Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes State Surcharge) $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ ~S SU TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ x1% $50.50 Minimum (includes State Surcharge) = $ Permit Fee - If Permit Fee is less than $1,000, surcharge is $.50. - If Permit Fee is > $1,000, surcharge increases by $.50 for each = $ Surcharge $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). = $ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground _ Rough In _Air Test -Gas Service Test `In-floor Heat -Final Exterior HVAC Screening Inspection a - - , , INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, MinnesQta 55122-1897 Date lssued: " I `' 11? `4`x ? (651) 681-4675 SITE ADDRESS: PERMIT SUBTYPE: i <, Ici t I I ? APPLICANT: TYPE OF WORK: INSPECTION .. . .. , ,. I ;%i{r s F- L i MntVv; l I fii , M11°. t ttl I 1o +R f r 1 iNo t t11 i Nto ? ? Permit Holder Date Teiephone # SEWER/ WATE R PLUMBING Hvac Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE - ?- FIREPLACE AIR TEST FINAL PIBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYOROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CASH RECEIPT 'CITY OF EAGAN P. 0. BOX 21-199 EAGAN, MINNESOTA 55121 !J v DATE J ? 19 / r eEeeIveo FROM ? ? AMOUNT $ r & DOLLARS ?oo [-]CASH ?CHEGK ? ? • ` MOII FUND CODE At.tOUNT - . y . . Thank You ? .- ???- Bir i 1Mhite-Payers CopV Yellow-Posting CopY Pink-File Copy REACTIVATE FOR DECK- UNDER $500 VALUATION Gj41j•LIAM ROSKE 452-5432(H) CITY OF EAGAN 456-2923 (W) 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 )V. P" PHONE:454-8100 r'^ 40967 BUILDING 'PERMIT Receipt ,.:, ? T? v ...J Lw. ? ' .Ci: •.- FN Vnln? .' ?' , ? . ., .. M?e ? ... . . "i?.'?[i " _ to , : Site Address Erect Remodei Lot Blxk Sec/Sub. '? ? •; G'' r. Repair ? J Parcel No. Addition ? Move ? ?. at Name ? , .. Demolish ? Address Int Impr. ? City Phone Install ? Occupancy _ Zoning ? Type of Const. No. Stories Length . Depth Sq. Ft. o ' Approvab Fees Name i =? O Add Assessment Permit ress u? Cit Phone Y Woter & Sew. Surcharge Police PlanReview -"9 •. =? ?W Name Firo SAC . J? s? Address Eny. Water Conn. OCW City Phone Plonner Weter Meter Council Road Unit "`? • C) 0 1 hereby ocknowled9e that 1 have read this opplicotion ond stote that Bldg. Off. • ` ' Tr. PL ?' •??' the {niormation is correct ond ogree to tomply with oll applicoble AP? $tote of Minncsota Stotutes ond Ciry of Eogan Ordinonces. PSrks Var. Date Copies Sipncturc of Pem+ittee Total /? Building Permit Is issued to: on the express tonditia? Ihot all work sholl be done in otcordante with oll opplicoble Stote of Minnesota 5tatutes ond Ciry of Eoflan O?dinonces. . 8uildinp Officiol ? Y i Permit No. Psrmit HoWer Dats Telaphone # binp /v ?. 11- A.C. HV ? 5 [ tric endr Inspeetion Date Other Footinga I Footings 11 _.? ? Foundation Framiny qoofin9 j Rouyh Plbg. Rough Htg. Insul. e, Finplace Final Htg. 7 ? . Flnsl Plbg. Final cwvocc. ? Watsr ??ibe Loeation: Wsll Sewer Pr. Dlsp. CITY UF EAGAN Remarks Addition BERKSHIRE PONDS Owner Street 4789 Aa l axi e Aventte 10 13750 190 03 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. '^`i 1982 239.09 23.91 10 0//,g(a '2/'Z?(e STREET RESTOR. O C 60 GRADING SAN SEW TRUNK 7 1982 176.04 11.74 15 7. 3 4j0 a 1,p SEWER LATERAL t 1982 57.24 3.82 15 , 2 ? * 88 ' 28 53 70 , cr ?/ ? -? WATERMAIN rL?j 1982 . 46.09 - , 3.07 15 p, 7 ?f m ?t WATER LATERAL WATER AREA 19$2 176.04 11.74 15 STORM SEW TRK ? Cy0 /I oZ (P,F> STORM SEW LAT CURB & GUTTER ' SIpEWALK STREET LIGHT Road Unit . WATER CONN. . - BUILDING PER. 10967- SAC 525.00 PARK Racaipt MECHANICAL PERMIT Pertnit No. CITY OF EAGAN -,C, nr, Fee R - , a Fill in numbered spaces SIC . ?C;? Type or Prfni /egiblY L -?10• 50 T o 1. Date 1v-18-e5 2. Instaliation Cost ?'?-}`'•?`l 3. Job Address471% v`Aot Blk. Tract 4. Owner . m 5. Contractor Phone 6. Address 7 ? kL? r ?? °'? vt -. 7. City State ??`.. Zip 8. Building Type: Residential 0 Commercial ? tnstitutional ? 9. Work Description: New 0 Add ? Alter ? Repair ? 10. D6SCflbe Tn4`p11 pis faTOed nJ-r Fuel Type 'SL41' G:i° ? F- 11. No. I Eauioment 8TU - M. Ea. ForcedAir No. EQUiament CFM AirH ndlin : Mfg. g a Boilers Mfg. Mech. Exhaust ? Unit Heater Mfg, Other Air Cond. Mfg. ? Gas, Piping Qutlets 12. 1 hereby certify that the dbove 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 numbered and approved. Approved _ CITY OF EAGAN 454,6100 Rooeipt PLUMBING PERMIT Pennit No. crnr oF EAGAw ? F w Fill in numbered *sacea S/C Type or Print /sp/bJy T t r ' o 1. Date .? 2. Installation Cost 3. Job Address . •, ? Lot Blk. Tract 4. Owner ? ? f •> ^'? 5. Contractor - Phone . 6. Address 7. City Siate 2ip _ 8. Building Type: Residential'0 Commercial ? Institutional ? 1 9. Work Description: New)C Add O Alter ? Repair ? 10. Describe 11. No. Fixtures Water Closgt No. Fixtures Ce o l/D i field Bath tubs ssp o ra n S k ti T Lavato?y ep c an $oftner • Shower Well ? Kitchen Sink Urinal/Bidet Othe i Laundry Tray r ' Floor Drains Drinkiny Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to oomply with all ordinances and codes governing this type of work. Signed : for Rou9h F inal InspeCtions: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-8100 Nlettr No.: 6.l S/?`' Size: ?, Reoder No.: 1'2F M217 7 Z, omolp wia fiw Cihr ef Eelew C1TY OF EAGAN 3830 Pilot Knob Road P. O. Box 21439 Eagan, ?YIN 55121 Zoninp: _ OwnO?: t t? Mdrcss: Sita Addreas: Plumber: Meter Na,. Stze: Reader No.: I MF" te eaaolr w" !IN Cihr of Eoyaw Orriseeam ey _i Dote of Insp.; CITY OF EAGAN 3830 Pilot Knob Road , P. O. Box 24199 Eagan, lVIN 55121 Zoninp: Owner, /lddress: S1te /Add?ess: , Plumber. I MM ro aes* willi !w phr of fasaw Or11senew WATER SERVICE PERMIT PERMIT NO.: f1tTG. ,. 7.7 WATER SERVICE PERMIT FERAAIT NO.: DATE: - No. of unrts: Connection CharQe: -,!.? Account Deposir: - Pertnit Fee: " Surchorpe; Misc. Ct,orpes; Totcl: - bate Poid: ' Intp.: SWER SERViCE PERMR PERMIT NO.: D111'E: No. of Units: By __ Dote of Inap,; Insp.:___ Connectlon Chorpe; AcOOCmt Mposit: Parmit Far. Surchorpa; Misc. Chorpes: Totcl; Date Pald: - CITY OF EAGAN N°_ 10 9 6 7 3830 Pilot Kno6 Road, P.O. Box 27-199, Eagan, MN 55121 ' PHONE: 454-8100 BUILDING PERMIT Receipt # 7 7 To M ased fer SF DWG/GAR Est.Value $62•000 _. Dete SEPTEMBER 13 1985 , _ SiteAddress 4785 GALAXIE AVE Erect gl Occupancy R3 c Lot 19 Block 3 ec/5ub . BERKSHIRE PONDS Remodei O_ Zoninp ul Repeir ? Type of Const. v Parcel No. Adtlition ? No.Stories RSM HOMES Move ? Length 36 a ? Name 14486 UPPER GUTHRIE CT Demolish ? Depth 46 ? Address Int Impc ? Sq. Ft. City A.V. Phone 435-8868 Install ? ? Name SAME 452-3499 Appravals Fees s? Address ?- City Phone Name _ Address Pnone I hereby ackrwwledge thof 1 have read lhis application and stote tFwf fhe informotion is corcect ond ogree fo comply with oll applicobla Stofa of Minrusota Statu s a ity of Engan Ordiiwnces. Siqnoture of PeaniM• A Building Permit fs issued M: RSM HOWIRt oll work shall be done in ocmrdante wifh oll plicoble_Stote of Mii Assessment _ Water 8 Sew. Police - Fira Erp. Plonner CAUncil 13ld9. Off. 9/12/85 APC Var. Date Permit sumnarea 31 _ 00 Plan Revlew 1 S 9_ S Q sac. 525.00 Watar Conn. 500.00 waee. Mete. 63 . 00 RoadUnit 280.?0 Tr. Pi. 132.00 ParkB ? Copfes Total 'S 2 ,DOg.s0 on the exprcss cordiNOn Ihai and City of Eoqon Ordinonces. 8uildlnq Officiol ..0 /S'Sb t? r PLUMBING (RESIDENTIAL) ?yAa (0-7 Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Please complete fot: Single Family Dwellings Townhomes and Condos when permits aze required for each unit Date?1 / ? ? . Site Address ?.LJC.I L Unit # Praperty Owner Telephone # (65() 1096-1010 contractor H PIP€WARKG R . . ?7d ?DD ROAD address hAN a?1 6AN 3 ci? ? , 2 (?1) 365 1340 state zip Telephone #( ) The Applicant is _ Owner Contractor Other Septic System New Refurbished Su6mit 2 sets of plans and MPC license $ 100.00 InGutles County fee. Additional consultant fees may apply. Altera[ions To Existing Dwelling Unit, Including $ 50.00 _ Adding fxtures to lower levels or room additions, excluding water softener and water heater _ Abandonment of septic system - Water turnaround (+ 5!8" meter if needed -$121.00) Other: _ RPZ _ new installation _ repair _ rebuild ? $ 30.00 _ Lawn irrigation system D C ? Water softener ? Wat h t _ er ea er $ 15.00 ? replacement _ additional State Surchaege $ .50 Total $ 1 I hereby apply for a Residential Plumbing Permit and aclrnowledge that the information is complete and accurate; that the work will be in confomiance with the ordinauces and codes of the City of Eagan and with the Plumbing Codes; that I understand tlns is not a pemut, but only an application for a pernut, and work is not to start without a pernilt; that thelwork will be in accordance with the approved plan in the cpse of work which requires a review and approval of plans. Applicant's Printed Name ApplicanYs Signature cIrv oF E.AcAN CA&'N.T.ERe 5 1'E.RM.T.NAL. N0. 775 DA'iE. 01/1.9/93 1'IME: 15:02e1.3 ILl., NAME: HEARTH SF:RV1:Cf=.S INt; 3210 9001 4785 GAL.AX2E AU 60.00 2i.55 9001 4785 GALAXIF AV 0.50 , ? Tot17, ReCeipt Amoslnt: 60.50 Cfi L0 i.3B9 USF:Ii TCis NANCY ? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (651) Q81-4675 PERMIT PERMITTYPE: El 11zLC,7.N r Permit Number: Gi 3 4 4 n 8 Date Issued (6 1 i 19 19 3 SITE ADDRESS: a78 5 rRt.tAzr_ t;'.'r-_ LQTa :1.9 U L.UCK: 3 BEF.KSHIRE PONOS P . i.N. : 7.0-1s"150--:L9 0 -03 DESCRIPTION: E?u'?.ldinis`.?ner?mic uildtrrq 1,4. r?l_ Type ' ?en_us Code t 1 i k. FTPiFF't,ACE NE w 434 RL7. REaIIJEN'iZAI_ 'l ( _ t ?_:%' •?? 4 `?J ;?`? } y4= REMARKS: CHI1+9N EYJP?1_UE I'q I1?, 1" ^F -1.IN3!?L=:1'- .11 w:Ur?? C(tY+1Ci'A!.Tiq fi. FEE SUMMARY: BaSe Fee $5U . 00 Si.ircharc7e ',.SVi Tatal Fre 60 e50 CONTRACTOR: - n p u.l i r. a n r- OWNER: j1E"AP,-fI-I SERVTCES„ SNC. 11078558 SCI-IIilI4MEt.F, OlkLI.EN ? hs13 sHn001A Lar;E u? E d 7 85 6ri_AxIE i,VE LiNo LHxrs mr.! 5 5 0 14 rw6 aN 11 N 5 51>_'2 ! 651.I 40I-8.558 I h3rebu acknowledoe that I haWe read t:ha„?, aPRlicatiarf and state that the in.tormatiori is c.or-rgc'C. anx] aqree teaeomply wi.T.h a1L aapJ.3.cabt.e StaTp o'f Mi7. Statutes and citv Uf Eaqan brdinances. I APPLICANT/PEPMITEE SIGNATURE -i "& ISSUEO BV: SIG ATURE - 3 ?-l '--t acy 49 1999 FIREPLACE PERMIT APPLICAT(ON CITY OF EAGAN 3830 PILOT KNOB RD - 55122 (651) 681-4675 l ` D /-( ?qz? ate: Description of Work: ? Construct nerv flreplace _ Alterationu to existing _ Install yas iiesert onlv _ Install gas line nnlv Other a G? ?c k -?. 7 b dd ?) ?l -7 Av, o a ress: Lot: ? $lock: -'2) Subdivision/P.I.D. #: A 1 o n ?? ?? O?r?n?n Applicant (circle one only): Owne ,Contracto PermitFee: $60.50 ?661 # Name: Phone : PROPERTY Last Firsy OWNER ? Street Address: Ciry ? State: M? Zip: C ? ? ?? ? °? # S q07^sSSg Ph (4t Company: 17 ?Q-( c??? 1 C one FIREPLACE I3v`STALLER Sheet Address: 6?0 % -? 4? ^ :5,?aoQ3 et, L City ? " V,6 l-Q lLState: Zip: Company: t-y p r)_A 5e_r 1/ Phone #: GAS LINE INSTALLER Sheet Address: City State: Zip: I hereby acknowledge that I have read this application and state that the information is correct and agree ro comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. / DA ? - - Signature J0,1NI 1 9 1cj°Q 1987 BOILDING PERMIT 9PPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS INCLDDE 2 SETS OF PLANS, 3 CERTIFICATFS OF SDROEY, 1 SfiT OF ENERGY CALCOLATZOAS NOTE: ADD&ESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MIIST DESIGNATS WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE AI.LOWED ONCE BIIILDING PERMIT IS ISSQFD. M[TLTIPLE DWELLINGS - RFSIDENTI9L RENTAL DPiITS FOR SALE QNITS INCLUDE 2 SETS OF PLANS, CERTIFICAT6 OF SURVSY - CHECB iIITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS ' COP4IERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND To Be Used For: ?/,evK Valuation?t"j Date: 7NLV- 4,.4 ?effcl Footprint S.F. Phone # Site Address 47!i5 OFFICE IISE ONLY Lot Iq Block ? On Site Sewage _ Occupancy MWCC System Zoning J Parcel/Sub On Site Well Type of Const t/ ? City Water (Actual) Owner ; (Allowable) l? of Stories Address y 7?S Length City/Zip Code ESf2 2 Depth S.F. Total - Phone y5 2'JEy7jZ . USY.-212 ? ApPR0Y9LS FEgS Contractor Assessments Permit Water/Sewer Sureharge Address Police Plan Review Fire SAC, City City/Zip Code Engr SAC, MWCC Planner Water Conn Phone Council Water Meter Bldg Off Road Unit Arch./Engr. APC Treatment P1 Variance Parks Address Copies TOTAL City/Zip Code William H. Roske 4785 Galaxie Ave_ Eagan, MN 55122 Estmate for 11'A12' decH: on front of house: Quantity Description 3 Posts 6x6x6i.:- Treated 1 Peam 2X1VX12' - Treated 13 Joists (12) and ledqer 2X8Y1,2' treated 20 Joist hangers for 2X97S 15 ibs 16d and lOd qalv_ nails 3 Concrete premix 10 - lb bags 288 5/4X6 Redwaod custom decking - lin ft. Fr i ce (-1mount ?M.24 T-24.87 $o. 58 :VS. SS 16.79 £82_94 t.59 4: 11.8n t.69 $10--;5 $1.55 $4.65 ?r.39 :£112.32 Total = $255.51 l [.i ??-e ?- Z ?- ?'`t ` 6x6 ?oos?s ??«? .7> ?-, S - G?L / ?? / ?? / 2/84 CITY Or EAGAN APPL2CATION FOR PEPuMZT SEWER AND/OR WATER CONNECTION 1) PROPE.Tt!'Y' ACD?,Z.SS: r FraL. OySC??_'TICV _ L) A°PLIC=.NT IS'-ti•:E: P.CI?SS: CII^', 5'-7=- , ZTP: PI:i:VE: 3) PLL: *A? NA.•TF': ACCRESS: ? CITY, STA'IE,', ZIP: PF.CVE: , 4) :ER , NFVMEe AUDRESS: CITY, ST','I'r-, ZZP: PhC}VE. UP..W.{ (T,ti? II?]ITS) ? R-3 ZC7.,.C{JSE (''RM. '- L`1IT5) ( Wi_S) ? R-a Utiz_s; ? CCs?ME2CL?L/F2ET'?IZ?CF:'I? Q Iti'DL'S i 2IrlL Q L\STI'?LTIOVILL/GGV??2:?r,'?; ^ IPLEASE PHI,tiII PR! PWMBER LICENSE p_?'??jg'`,?n retror a i 5} II3pIG",''E :4[-1ICH P&?4•7IT ZS BEP:G REt?(.TF.STID: ? C):u1ECPZO?I 'R7 CITY SETr7ER ? CLD1'.QF,?PIG:I TO CITY ATATER ? ?'i'.ER (PLL'T,.,? OFSCRIBE) 6) IIQDIG,: C:E: ? PI=15E F?OID APPRWID pgt,+1IT FC1R PZCS?-UP BY ONE OF AFQVE ? PLEtiSE :''.\IL APP PIIZ?IIT TJ 1. 6. 3. 4 AEW£ (Circle one) 7) SIG.AT[.'RE: c , ?- , .• ,: . - - - OATE: (PCEASE PRINT) 3'r' S"T=? cE, Dcli : 0?' C_?clGi.AL =.+?ILDZ:r' .? -" ST ISJ,.: ?\?: ;[•'w= -- - - L'S: XR-1 SL:GL: :P^nSLY ? R-2 C T FOR CITY USEONLY PLONBE ICEti ?c Activ i ed f Reyord ? ? ??v?/ ar? inir„ M! WCl.+li?rl st !lgau f? ?t •.+'s? at?a ar s?r ?.ssa :? a?R `a/ki!??1lsJ? s w?? S?saa FOR C I T Y U S E ON:,Y PER`tIT °- ISSUED . . Fcr. S : S /L) ? ?CJ nERMT1 (I`Il'L'JL`. =C-.L'.A-RUL) {'7ATEc2 PER141_:` (ILICiuD: SIIRCHARGE) $ ? WATER METER/COPPERHORN/OUTSID: READER $ WATER TAP (INCLUDE CORPORATION STOP) $ SE:vER TAP Oi._1T ACCOUNT DEPOSIT - WATER WAC S.x S =o ? SPC $ TBGNK WATER ASSESS?SE2IT $ TRuiQK SELvER ySSE55:iEPiT s LATEP.AL BENEFZT/TRU`]K SE:•ib'R $ I.aTERrIL BENEFIT/TRWK WATER $ WATER TREATMENT PLANT SURCHARGE $ S $ OTHER: TOTaL PutiI0LT:1T PAZD/R,r_,r-'-vI2T DOES UTILITY CON.)ECTION REQUIP.E EXCaVATZON ZN PUBLZC RIGHT OF WAY? I c--7 YES ZF YES, THEN H"PERh1IT FOR WORK WITHIN PUEiLIC ROADWAY" MUST BE ISSUED BY THE Q NO ENGZNEERING DIV:SION. LIST AS A CONDI- TION. SUBJECT TO TIiE FOLLOS9ING CONDITIONS: APPROVED BY: TI: LE: ` DAT°_: + a? ? ? w 00 0%?, ?c? re 8tw 8cw w ? w o.- wM w.a Ot8V rf W*pg w.+ . ? -# 16 ? ? 6 . -,-) . 1985 BUILDINC PERMIT APPLICATION - CITY OF EAGAN NO'fE: ALL CONTRACTORS MUST 8E LICENSED HI1'H THE CITY OF E6GAN INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCULATIONS To Be Used For; NC ?v <? f .t? `?? ^?S • Valuation: ? Date: _ 1 U Site Address: OFFICE USE ONLY d Lot: 19- Parcel U Owner Address Block ,? Sect/Sub ?/' ? j f.•?v-,?,- ?? ?? ncl? Erect k Remodel _ Repair Enlarge _ Move _ D.emolish , ., ?? FuCr ade _ Occupancy Zoning Type of Const U of Stories Length Depth gqpt ? 2-I -S? ? City/Zip Code ?1 / Z cJ Cr _-____ -.•____- Contractor S,rLdf%j F pppROVALS _____-_ _-? Address Assessments Permit Sc?. 2 City/Zip Code Water/Sewer Surcharge ? Phone 1i !/ 7` 3 .?- ? ? ( d' - Police ?j'e %?Z 3 y? Plan Reviea SAC n gr Hater Conn Arch,/En gr l - ? k'' '• - Planner Water Meter y council oad unit Bld OPf Address g /? Parks Phone $ % 5-l_} APC Variance Treatment P1 Torni. 1 32. CONSUlTIN6 EHaiNEENS ENGINEEAING PIAHNEAS ond LAND fURVEYOCOMPANY, INC. rAOSE N**466, 1000 EAST 1461A STREET, Bl1RN5VILlE, YIHNESO7A 5533? PN 432-3000 Cer?Zf Z ccc?` S'?Z?trYe t? L¢Oat .I??crLp??osL: Lp-r 19 BLOCK 3 BERKSH1RE . lU ORT+-i SCALE /"• 40' =--- ? %i ,_... ? 4? h n °?°?• ? / DAKOTA coUK?TYI MiNNESOrA , DENOTES EX/ST/NG ELEVATIOIU (94e•0) DErt1oTE5 PROpo5E0 EGEVATION I°OND5,0 /NDICATES piRECTioA! OF SURFAcE DRArN46E FIIU 15 yED _ GARA6E F400R E1.6VA7-10N = 9?,T . o N 89° 35' 34" W - 207.65 i; - =' = o - --- o -- ?q t 2e.r. (?1-, ?C3 ",? Lyr4l ? 70 O r'?' L O T 34b.33 ? :,? - - - - - - - - DRA/NA6E AND 26 I, 87 UT/LITY EA56M0IT N 89° 35 ' 34" W 50' re, I !O N p - I O N N N N S yi I J ? ? ; (934,0) X ? ?A „l Ihereby certity that thia ie a truc and carrect representation ot a trtet ot land as shawn' and deecribed hereon.. Ae prepared by tna on thi• ,3Am day ot .S?BE'? s 19.8 . o..iiinn. 1te6. No. ;t: /'79/-?-- STO 2006 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 NewConsNxtion Reouirem k 3 regislered si? surveys shaviig sq. ry. oT bt. sq. ft. of house: arW A rookd areas (20°6 mmimum lot caerege allorred} 2 oopies of plan shwving bmm & wimbve yizes; ppired (ourld daign, ek. 1 sei of Energy Cafcuiations 3 wpies of Tree Preseaation Plan if bt platkd afier 71193 Rim Jdst Defail Opfiais selecfion sheet (puildirigs with 3 or less units) NGnoegasco mechazricai venlitation foan RemodellReoair Reairemenm 2 coPres of plan shvwing Gmtings, beams, joisis 1 set af Energy Cakulations fw heaEed aclchans 7 siEe survey (pr adr16ais 8 decks Add'Non - ind"xatg dorr-site septre system Z?'C/' e0 Offae Use OnN CertofSurveyRecd _Y _N Tree Pres Plan Recd _Y _ N TreePresRequited _Y _N On-siteSepticSyslem _Y _N Daft 9 ? y 1 0-7 ry ° Canstruction Coat DOc9 . SiteAddresa y7r3?'S ?T/4'kh-;e- N.--' ?? -? ? Unit/Ste # DescripiionofWork _ 5o cf;1'-°f Malti-Family Bldg y /?N Fireplace(s) 2 Property Owner % M Telephone # ( `Sl 7S - LY I CoMractor Address O'b 7 CCiL City S%`+'?tua?°r S? A? ZiP S54'Z. Telepnooe#(4S/ ) y3q-176o COMPLETE T!i!S AREA ONLY IF CONSTRUCTIM?fi A NEW BUILDING Energy Code Category - MinnesM R»les 7670 Catr¢orv 1 _ Minnesota Rules 7672 (J submi?ion type) • Residetkial VeNiktion Category 1 Worksheet . New Enetgy Code Warkstieet Su6mitted Submitted • Energy Envebpe Calcuiations Submitted In the lasf 12 monihs, has the City of Eagan issued a permit for a similar plan based on a master plan8 - Y _ N ff yes, date and address of master plan: Licerned Plumber Mechanicai Contractor Sewer/Water Contractor Telephone #? Telephone #( Telephone #( I hereby apply for a Residentiai Building Perniit and acknowledge that the information is complete and accurate; that the work will be in confomiance with the ordinances and codes of the City of Fagan and the State of MI3 Statutes; I understand this is not a permit, but only an applicatinn for a permit, and work is not to start without a pennit; that the work will be in accordance with the approved plan in t6e case of work which requires a review and approval of plans. INC4?' 1!29WSo-A"/ Applicant's Printed Name Applicant's Signa6ure /? \ REQUEST FOR ELECTRICAL INSPECTION Ee-uuuo,:ua (Q "?C? ' See instruetions lor completin9 this form on back oi Vellow coov. (G. -/0 ?'y S `p MORI '"X:' Below Wark Covered by 7his Aequest AAd Rp,?1. _-,{ype of BuilCing . Applianma Wired Equiumenl Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtmes Apt. Building Dryer Electric Heatin Commercial Bldg. Furnace Silo Unloader Industrial BIAg. Air Conditioner Bulk Milk Tank Farm ' otner peci y thmr (sper.ilv) t er SVeci y Ot er Other Compute Inspection Fee 8elow M Fae Sarvice EntrenceSiza Faxdars/Subieaders N Fee Circuits 0 to200qms Oto30Ams Otn30Ams Above 200 Amps 1 to 100 Amps 31 to 100 q y Swimmin Pool n Above 100-Anips Above 100_P.m)s Transtormers , rrigaton Booms Partial.Other Signs pecial Inspection g J TOTA Nemarks 2 ? L F E Rough-in Fi^al D te 1 1,the Elac Inspectoq hweby certify that the abave inspeclion has been maae. tOlsreQUeatvoitll8monthsirom V ?' -/ ?)qv Ci's Street Atldress, Boz or Ryute Na . City 715- G?lqz-J? ? ?-. ecUOn o. Township Name or No. Ranye No. County Occupam (/pp INT) r ?V f/ i _ 7Z Paw t Supp/lJ er r !{?o,K lr55 ???/?rLC._.. . AAtlress Electrical ConNaclor (COmpanV Neme) ConVactor's license No. Mailing Address (Conhaclor or Owner MakinA Installation) • Authorjpetl Sig re IGonvactor n" iny nstallationl Phone Number U% _ -- - - ?? ? ? ? Licensed Elec[rical Con[rectm I hereby request inspection ot above . )KOwne, electrical wo,k installed at MINNfSOTA STATE BOAXD OGELECTHICITV iTHIS INSPECTION 0.EQUE5T WILI NOT Griggs-Midway Bldg. - Room N•191 eE ACCEPTED BY THE STATE BOARD 1821 Universitv A.ve., St. Paul. MN 55104 UNLESS VPOPEH INSPECTION FEE IS Phone (612) 287-2111 ENCLOSED. 1-s request voitl ?_ _(LG'` G? 8 months from J '? PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA154254 Date Issued:03/06/2019 Permit Category:ePermit Site Address: 4785 Galaxie Ave Lot:19 Block: 3 Addition: Berkshire Ponds PID:10-13750-03-190 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 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 - Thomas J Mccauley 4785 Galaxie Ave Eagan MN 55122 (612) 817-1770 Wenzel Heating & Air Conditioning 4145 Old Sibley Memorial Hwy Eagan MN 55122 (651) 894-9898 Applicant/Permitee: Signature Issued By: Signature fit 0 f For Office Use ° offi fr ::: 47„ E AG N : 10-` t4 3830 PILOT KNOB ROAD(EAGAN, MN 55122-1810 CEIVtj';D Date Received: i-/aa (651)675-5675 TDD: (651)454-8535 I FAX:(651)675-5694 AAV 2 2 2 019 staff tc) buildinainspectionscitvofeaoan.com 2019 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: S-.a—I cl Site Address: 4 8 5 C0-0 q y;' A V Tenant: /__ Suite#: Resident( tiilftlBf • Name' /'en c c /1 ' C C c w ) -e y Phone: (o 12 X 17 /7 90 Address/City/Zip: 8S Co )o Y,e Awe S-s /a Name: e.S.0 i c n P) .i,-., b i S-e r v i Le S License#: PC Co lb It 3 S $ ContractorAddress: P O . car o1 r)1 a City: c:.8 o ,r\ State: y'Y\Ai Zip: S S / Phone: (o S ^ (a 8 )-- g 2 S 2-- Contact: Contact: ' Email: I tie ) )) Type of Work New _Replacement Repair Rebuild _ ModifySpace _Work in R.O.W. Description of work: Water Heater Lawn Irrigation(_RPZ/ PVB) Water Softener D@SCin Add Plumbing Fixtures( Main/_Lower Level) Septic System New Description: Abandonment Connection to City Water from Well RESIDENTIAL FEES $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation(includes State Surcharge) $60.00 New fixtures, adding or removing piping (includes State Surcharge) $60.00 Septic System Abandonment $100.00 New Residential(fee collected with Building Permit) $115.00 New Septic System (includes County fee and State Surcharge) $60.00 Connecting to City Water from Well*+$290 for Meter and$190 for Radio Read=$540 *Sewer&Water Permit also required for connection charges TOTAL FEES$ (p 0 ' °Q 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.aooherstateonecall.org You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeanan.com/subscribe. I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. J� Applicant's Printed Name plicant's Signature Page 1 of 2