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882 Lakewood Hills Rd N Use BLUE or BLACK Ink For Office Use j Permit City of Eap I go _ 0 Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 j Date Received: j Phone: (651) 675-5675 1 1 1 staff: Fax: (651) 675-5694 I I 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 2,C1 Site Address: Unit Name: (/l/l U.[/q~ Phone: ?!Q 226- RESIDENT / q OWNER Address / City / Zip: Applicant is: ✓ Owner Contractor TYPE OF WORK Description of work:-.... &e.4c(s;_ ~ll~/►~t Construction Cost: Multi-Family Building: (Yes / No ) Company: Contact: CONTRACTOR Address: City: State: Zip: Phone: License Lead Certificate Does this project require Lead Remediation? ❑ Yes ❑ No (see Page 3 for additional information) If no, please explain: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.-gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start ithout a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval f pl x_ ~r~n/ C-Of - x Applicant's Printed Name Ap icant s Si nature Page 1 of 3 , Eagan Towr?ship Dakote Couniy, Minnesota Application for Bnilding Fermit PERMIT NO. ...................... Dafe .-/?f-•••?/?a............ Type of building or work conlemplated. Cirele correct desericlions. esideniia Commercial Indusirial Olher............................................... --°---................................................ Eufl Enlarge Altet Repair Install Move Wreck Other .................................................... Dimeasions•--. ^ Cosi.:.1....1..---- -°-......-- ?J a Deiails or remarks......................................... ...:°--°•--....-•••---- •- --...-----------°-- -? •--- ----• ---°- ....... -............................. Location (? ? 0o A • Number Siseet Setween whet cross streeis Siao Est. Valuation I I Los Block Addiiion Rearrangemeni or Tract --- (? Owne: •--°u-'..-?.........----°-•,c.lY.-.__.T?S?i?. Address ................... It+??,?._?..c.--_.?.? _.................. Contraclor ..... ----???------------------------ •---....••••------ °-?--••-••----... Address .---•------°-------•------°--••---°---°••-----°-...--°-•°°°-•---- The uadersigned hereby makea apvlicaiion for a permi3 30 $ do work as herein specifned, agreeing !o do all woTk in siriek Toial fee collected. accordance with ihe building ordiaance adopted April 11, 1955 by 3he Eagan Township Board of Supervisors. Permit fees are not refundable. ..... - • ---....... ••• --°- ............. .. .°--°------•--°--.__..._ 5igned L- /6 TOG1N OF EAGAI+] 3795 Pilot Iinob ,'.oad LI`/ 00 St. Paul, Minn. 55111 PERMIT A10. 33 The Board of Supervisors hereby grants to Cptc an Hardmage d of Roseatuust, Mino-wta 59068 a ??ELLIN8 Permit for: (Owner) at ptsul ?, pursuant ko application dated r • Fee Paid: $14.00 , Dated this--7th-day of Aprii , 147 L• . Building Inspector. EAGAN TOWNSHIP BUILDING PERMIT Ownes ........ ?• - -'° -- - --°--- ...c:. ............................... v ..... . ?/3......... Address (present) -.1ilt_4.6..... e?? . ._..9--w ...... Buildes --.........-_. AAeY Address ............................... DESCAIPTION 11T° 2324 Eagan Township Towa Hall ? Dale -••./?..: s.../ 7 U .................... Storiee To Be Used For Froat Depth I Heigh! Eat. Cosi 'Permi! Fea Ramarks l J<? X-U? ' ? l 0 f LOCATION 8ireel, Road or olher Deseription of Locafion I Lo! Slock Addilion or Tsaci s8? g.-ge, X4• ? This permit does aot suthorise the use of streels. soads, alleps or sidewalks nor does it give the owner or his agen! the righ! !o creaYe anp situation whfeh is a nuisence or which presents a hazard !o the heallh, safely, coavenience and general welfare !o anyone in the communitp. . THIS PERMIT MUST SE KEPT ON THE PAEMISE WHILE THE WOAK IS IN PROG ESS. This ia 3o ce:tifp, ihat._.....? _---?.....-,.•--° ...............has permisaion 3o erec! a.- ••-•-.`. ------ ... ...-------- _upoa the above described premiAe aubjeci !o the provisions of the Building Ordinanee for Eaga Townshiplad April 11, 1955. 12 ....-•-•-...• .................. . . ._ . ,?.. ..p. .,, -• .\••-.. .._._.......... . .. .??.._.?F`-'?'?'?---' ........ Per ................. ??:.........d1.__...._..?..... ' B hairmaa Tnwa Board ? uildin Ins eetor . . CITY OF EAGAN 3795 Pilot Kno6 Road Eagen, MN 55122 N2 4345 PHONE: 454-8100 BUILDING PERMIT APPLICATIdN $7 000 Receipt # 6246 , . _ To ba used for Garaer+ ?T DrivPws+v Dote June 6, 19 77 - Site Address 882 LskeWOOd Hi11S - Erect [-k Occupancy Lot 17 Block Sec/Sub. I'akewOOd Hills qlter ? Zoning Rl Parcel # Repair ? Fire Zone _ Enlorge ? Type of Const. W ot Name James d. Barbara Givens ? Move .# Stories 3 Address R87 i seW..,._ uill,fi Demolish ? Front ft. 0 Cit EalZan Phone 454-4715 Grade ? Depth ft. ? SBIIt@ APProvols Fees p Name _ H ? ?? Address ? ?:... Name _ Address I hereby acknowledge that I have read this application and state that the infarmotion is correct and agree to comply with oll applicable State of Minnesota Statutes and City of Eagon OrdffiVces. Signature of Permittee A Building Permit is issue t JBmE all work shall be Adoin acc ce wl all Building Offici?(=u Assessment Permit 94 _ M _ Water & Sew. Surchorge _ 5(1 Police Plan check Fire SAC Eng. Water Conn. Planner Water Meter Gountil Bidg Off. . APC Total ? s on the express condition that State of Minnesota Stotutes and City of Eogan Ordinances. NSPgCTION RECORD ? I CITY OF EAGAN PERMIT TYPE: '"' ??"'"• I 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: /QS I (612) 681-4675 I SITE ADDRESS: , r r r11 r? APPLICANT: I PERMIT SUBTYPE: TYPE OF WORK: kF- V nI ?t 4 ROtl i= 'l N Ia 1 hF ',i f: t l' 1 I IJN Permit No. Permit Holder Data Telephone # ELECTRIC PLUMBING HVAC Inapectlon Date Inap. Commente FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL / BSMT R.I. BSMT FINAL DECK FfG DECK FINAL BUILDI CITY OF EAGAN 3793 PiloF Knob Road Eagan, MN 55122 PHONE: 454-8100 VG PERMIT $1 ReceiPt # 9d for .. .,..... ,, r............... Dote o Site Address =i3} 15 Lot Block Sec/Sub. '-""'*;"'OOt1 i! f l 1 S Parcel # w I Name ? '? -aY^F!7'?. F-,i;?•?tt : o Address City Phone ? 0 Name ' -' ?? Address ~ Cit Phone u„w Name F- _7-, Address _ Erect ?: Occupancy Alter ? Zoning Repair ? Fire Zone Enlarge ? Typ= of Const. Move ? .# Stories Demolish ? Front ft. Gradz ? Depth _ ft. Approvals Fees Assessment Water & Sew. Police Fire Eng. Planner Permit _ Surcharge Plan check SAC Water Conn. Woter Meter Cuunal _ I hereby acknowledge that I have read this application and state that gldg. Off. the information is mrrect and agree to comply with all applicable ,_ ,,•y.' Stote of Minnesoto Stotutes and City of Eagon Ordinonces. APC Totol Signoture of Permittee - A Building Permit is issued to: on the express condition that oll work shail be done in accordance with all oppliwble State of Minnesota Statutes and City of Eaeon Ordinances. Building Official N2 4345 Pemit .# Dah Inaed PWnhtM Plumbing Mechanical INSPECTIONS DATE INSP. Rouph-In F(nal Footings ^Qo?`? Date Irmp. Date tnap. Foundation Plumbing Frome/inr. Mechanical Final » Remarks: CITY OF EAGAN Remarks Addition Lakewood Hills Loi 17 sik 1 Parcel 10 44350 170 00 394 r. Owner ? _?-A Ii r` =', " _ ': Street State Eagan, MN 55123 ? Improvement I Date I Amount I Annual I Years I Payment I Receipt I Date STREET RESTOR. GRADING SAN SEW TRUNK SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA STORM SEW TRK STORM SEW LAT SIDEWALK STREET LIGHT SAC PARK Type: Geotear / Chamber ? // ?_ Diemetec of Pipe Mannfactvret: - (6".2 ! Rock Trenc Nwnber of Latelals (18" ?il ?1r ?I.Stefgll.CDg[tL4 ? Sail ovec Latetals (100' msx.) (6"-36') 3e eP r.?/iAtmw Sparing ( otal Trench Depth ?? ? ?? ) Ck of Trench to 9!?Y- Total Sq. Ft Treach Bottom ,? Water Table or Bediocg ?2- 31ope of Fipe N S CiL- B', ?171 `b4? ON SITE SEWAGE TREATMEIIT'1' SYSTEM -1NSPECTION REPORT Applicant and Permit #: - --- - -- Date afInspection: _ Id. 5ite Address: 62 -- - ?--H kMMW br• ? Parcel ID: -- Municipality/fowqsiup: House TyPe: L.YII III ? # of Bedmmns ofPotentia( Bediooms Solid Ammp in Basemert: Yes /1?0 ResecveArea/?/No (I mu tminsznL) ?_?••...? ut ocpuc lantcs pa oo -wrlment+ (access for eac4 Y / N) WPbeP disPos8U8o1id pump) /??7 Total Tank Capac{ty Tank Manufacturer: -irL14uid DePth (30" min.) Tank Ihmmsions (W x LsD): ? 1L6 X // ? X _L/ JJ vwuyacu isi111QLIIgg: 49- s ao•, 32!Gn4o•, ProPertY Lines (w): drSLi9 ? D Ihop Box Mode]/Make: ? w8tertigt,t cmstr„cc;on 0 5oi1 Borings (q mia.) Gi< Q Depth to Restriction (incha) TYP?Bedrock Wata Table awwn x.tins C3• below son,umoon unr Pumping Tank: Yes No ' _ Capacity Pump Size & Model: Aletm: Yes No ype: Light / Sotmd _ PIIter _ Tank Level _ Watertight Cvnstruchon Well (50' or I Op'} 6'! S ? D Buried WaterPiessicePipes(10,): `?S 0 D ???'8'ox is Level ?/ ? Pipe ti) ?P BoX <?-Pipe Connection U ? # Perc Test (Z mio ?., ?- ? Average Perc Rata ??--aAcceptance Rate ?-16-0--Tank Cover (za^ M;n,) Cover Secured Y? No =lnlet Be$le (6' betow liquid-1" ahove inkt aown) ?! Outlet Baf}le (6^ above liquid surface) ? et a Min. Y' below Inlet = tnspection Pipes (3 min.-4^ mm.) Recreation 8c Tributary (751; c r ?S ;?D A11 OWecsF.xcePtRec. & Trib. (150'): __5 _D t.:?et lnverts (1° above auuet mvat) v?eY lIIVerts (a^ above _ $oor) Smial Distribution n;str;bunon: (??/ Pressure Date cJ VA(,Ir-- 7 7 ? BUILDI:iG Pr.M7.T_T P..rPLICA.TION LOTBLOCK '-- 1L7DTiIMT 1-41GEi.UODD 14 1LL5 PAIICEL & aECTIOT_I P7UT13ER IF UISPL:gTTEil .iS..T1DR]ESS OF PAi2CEL Z0:37'OG_ OCCUPAIVCY f USE It Es i bIQ`r7A-L ' lrw.,..a, f._ 9?- .?.+xr.ur? E.STLSiP,i'ED COS^ #VIJ a L)r•r!IFsR J?}y21E5 ??f1J?r3/w Il/G?US TELEPHOT7E i\O. ADDkEss`??? Al-90AA _ cQ:TlRAcTor. ,,51-G TELEPHOiJ? 1410. ADJRESS 'tdote- Include s9.ta plano building plans, and energy calculations aaith ttixs application ? Signed 0rrZCE U5E xnrl vAr.,oATr.o:a? d? , sAc Z'3:lTi,'ii COc3NEC^_20ed jlATER i=SETER o? BTJILDTNG PF.Ett3IT FEE R S U CF.AFtGE FEF PzM c::rczt F: Z ; PARK DEDTCI1TIO14 FLE OTi<.t.'.R TOTfiL* F.PPP.OVAI,S : A'vSBSS;'+IE;T?` CLEP.K BUILDIIvG DEPT. POLICE DEPT. T'7k3.TER Fa SEF7ER DEPi. FIRn DEPT. PF12TC DSPT. • . .a ,? . i ? - -??- . ? \ 3'? m ? T / ? ? ? a /60.0CLIFF ROAD ? u / -- C1R ? /?'125. JeM_ES_lr_lV?r15. -68Z ?--AkEWaap. ?41LLt ?. __ _ Lor #?7 M ? m ? W O? ?a IN a` IF-3 6 ? S o---?- 3?-?----- 8 0-------- - 3? -? ? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: PERMIT PERMIT TYPE: Permit Number: Date Issued: 882 LRKEWOOD WILLS RD LOT: 17 BLOCK: LAKEWOQQ HILLS DESCRIPTION: (RDqFTNG) ermit Type SF (MTSC.) I r„k Type REPAIR 434 ALT. F2ESTDENTIAL ff y i+'>: ly sy 9&els "?` vs si ? REMARKS: FEE SUMMARY: VALUATION Base Fee 5urcharge Total Fee CONTRACTOR: $74 .75 1.50 $76.25 APPLICA /PEfiMITEE SIGNATURE ??am giRT& rsi ?j rm 4 s b?k3 ? 9 cey" .''. "taki !ak 42A I u s'>± «,? .T+,`?4 $3,000 C2D ???sc?- BUILDTNG 027906 06J17J96 OWNER: - Applicant - ROE CURTIS 882 LAKEWpOD HILLS RD EAGAN MN 55123 (612)454-1648 ? o?? Ri.1-d 1 m?- ISSUED BY: IGN URE'' - CITY OF EAGAN 3830 PILOT KNOB RD - 55122 7996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 New Construclion Reauirements Remodel/Repair Reauirements ? 3 registered site surveys ? 2 copies of plan ? 2 cropies of plans (inciude beam & window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior additions 8 decks) ? 1 energy caltulations ? 1 energy caieulations Tor healed additions ? 3 copies of tree preservetion plan if IM piatted after 7/1/93 required: _Yes _ No ou r DATE: 4zhA6 CONSTRUCTION COST: DESCRIPTION OF WORK: ,?w Wd s?`,fxet . 5111Npce?r ?sra79clo-S STREET ADDRESS: ?z 4AK-?,a&,36 1y s Apo LOT / 17 BLOCK f _ SUBD./P.I.D. #: ???-?"^^ ?`?%•• ? PROPERTY OWNER CONTRACTOR Name: Z?c Z?4ArAs Phone ys"y-/4 y3 _ AS1 iIRST Street Address- 98Z L^'LaWdide, l??em " City: /-,"7 State: Company: f ' Street Address: City: zip: 53 Phone #: - License #:- Zip: State: ARCHITECT! Company: oj /i? ENGINEER Name: Phone #: Registration #: Street Address: City: . 5 State: Zip: Sewer & water licensed plumber: Penalty applies when address change and lot change are requested once permit is issued. I hereby acknowledge that I have read this apptication and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: G -'---???? OFFICE USE ONLY Certificates of Survey Received _ Yes No Tree Preservation Plan Received _ Yes _ No , Y ? ? • . -,w1 . /-; ,? CITY USE ONLY L BL ? SUBD. Q G3..? ? ?6? RECElPT#: _/OD?7 0 RECEIPT DATE: 14zlzf 0 1998 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT I4QOH RD EAGP.N, MN 55122 (612) 681-4675 Please complete for: lin s ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler syste m ---------- - ---- - ---- - - - - - ------------------- - --- 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 Tub/Spa 3.00 x - Water Heater 3.00 x = Floor Drain 3.00 x = Gas Piping Outlet * minimum -1 3.00 x = Rough Openings 1.50 x - Water Softener ' for dwellings under construction 5.00 X - Water Softener " for existing dwelling 20.00 X = U.G. Sprinkler ' for dweliing under const. 3.00 = U.G. Sprinkler ' for existing dwelling 20.00 = Altef2tl0nS * to existing residence 20.00 = Water Tum Around ? _ Private Disposal System ' MPC iic. ?? = 5? (new and refurbished systems) Private Disposal Systems " Abandonment 20.00 = RPZ (new installation only) 20.00 - STATE SURCHARGE .50 TOTAL ------------------- ----------------- I hereby adcnowled-ge that I have read this application, state that the infortriation is corcect, - and agree to comply with all applicable City of Eagan ordinances It is the applicanYs responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-wayleasement. SITE ADDRESS: OWNER NAME: iNSTALLER NAME: STREET ADDRESS: &&0 TELEPHONE#: 4,`.sy y'6.AC' CITY: , j STATE: ZIP: .:, / ?. SIGNAT OF PERMITTEE 6,S-ia 3 CD/PERMIT FORMS/RPLBG PERMIT (RES) - 1998 r , INVOICE JACK E. G1LL PROFESSIONAL BUILDING INSPECTIONS, Inc. 3565 Polk St NE Minneapotis, MN 55418 (612)789-3354 -, ? ? 16,15 11 / 10/98 Curt Rowe 8$2 Lakewood Ilills Dr. Eagan, MN 55122 ? HOURS ? SERVICE PROVIDED AMOUNT 1 Each ISeptic System Site Evaluation And Design , Date llue: l 1-25-98 $ TOTAL I $ 400.00 400.00 Note: AII invoices not paid by scheduled date of paymenl will receive one reminder nolice. If reminder notice does not result in payment, invoice will then be submitted to "National Account Services" Coliection Agency for coilection. .'. ; l, pe Professional Building Inspections and Environniental Services, inc. NATIONALASSDCIADONOF ? -J,?:?:;«"'??;sRf?,n??:z, „ .w;;, .. ??rit?;,;;,v ? .• , r;,.,?,., ?,: ,.;?:,. HUME INSPECTOflS, INC. CFRT/F/FD Jack E. Gili, CBO, President • Stale of Minnesola, Cerlified 13uilding Inspcclor, tl0246 + Cerlified Accessibility Specialisl 1119GG • Cuuncil af Amcrican (3uilding 017icials, Ccr(i(icJ 131jilding 017icial 11761 • Iniernational Conference of Quilding Officials, Cerlified f3uilding Inspector 1130795 • State of California, Registered Construction and Civil Engineering Inspector }12887 • Minnesota Pollution Control Agency, Registered Sewage Treatment System Designer I& Inspec[or # 1745 • Unitcd Stales I:nvironmenlal Prolection Agcncy, Ccrtificd Ashcslos and Radon Inspcclor • tilalc of Minncvola, (:crtilicd ('onuincrci:d I{ncrgY Aiidilur • Arbitr:ilur, Amcrican ArbiU'alion Associalion November 14, 1998 Mr. Kurt Rowe 882 Lakewood Hills Dr. Eagan, MN 55122 Subject: Septie System at 882 Lakewood Hills Dr., Eagan Dear Mr. Rowe: Please find attached invoice and septic system site evalualion / design for subject properly. Please be advised that should there be any problems with my design 1 will fumish any and al] extra required work such as soil borings, field trips, etc. at no additional charge. I will do everything possible to make my clients happy. Please contact me should you have any questions. 1 havic enclosecl an invoice duc Novembcr 25, 1998. lf you are nat in agrccmcnt wilh Ihis method of payment please advise me as to the proper procedure for submittal of my invoice ior payment. Thank you very much for allowing me ro do this work. Sincerely, Jack E. Gill Copy: Septic Inspector - City of Eagan M E M Il E R 1 EN V IRONMENTqL Ann.uwnu Asmclarton 3365 Polk Sl. N.E., Minneapolis, MN 55418 •(612) 789-3354 • Pax: (612) 781-2471 Visit our website at www.winternet.coui/'pbi STANDARD SYSTEM DESIGN INDIVIDUAL SEWAGE TREATMENT SYSTEM Owner's Name ORT KoWe Iob Site Address ? Z. LA t::Z??? Q D 4A `ca 6 Ciry or Township 'F,? A Q A N IV '' Use of BuiJding S Ci L " ? A ?A t LY .?-- B C- p KO O rv/\ Dcsign Flow Ratc f} Pcrc Rnte '? rn PE Lnnd Slopc Pcrccnc Two Required Tank Sizes Gapons Callons Lift Stnlion Tank Suc 40 A Gallons Type of System (standard, at grade or bed) SV\ t4 WRp - G? C--\? 'L-7rC2C7 T 1 pa System Size: e1 Q Q -Square Feel 3 p 0 •Linenl Fecl -Trench Widlli Depth of rock bclow pipe V-J A Depth of Rock Abave Pipe o A bilNimum Depth of Trench f? F E i ? MAXimum Depth of Trench d ? Z I h i i G rom x sting Grade j Liches st ra e nc es ng From Ex Recommended Number of Trenches Recornmended LengUi of Trenches 75- Trench Spacing Measured Center to Crnler VA () R Feet Any Other Special Conditions `b C( IF PRESSLfRE DISTRIBUT'ION IS USED, COhiPLETE TIIE PRESSIJRE DTSTRIBUTTON WORK SHEET ATTACHED. Tliis dcsign mus/ be nccompnnfed by u sile plun tlmt clcarly shows thc lucntion of Uic aren tested nnd npproveJ by ihc fullowing: L Use an appropriate scale and indicate direction by use of a north arrow. 2. Show AI,L property boundaries, rights-of-way, eascments, weNands. If neccssary, an enlarged dctail of the house sile may also be required. ' • 3. Show Iocalion o( house, garage, drivewny and all other improvements existing or proposed. 4. Show location and layout of sewage trealment system. 5. Show bcation of water supply (well and/or community supply line). 6. llimcnsion nll setbncks nnd sepnmlinn Jisinnccs. This system has been designed by a Pollution Control Agency (PCA) CertJed Pro(essional. Designer Name V A C?-, -` , l'`' PCA Certification N Address3565? pa ??? 6-r' ,, V` C Lc-,' Phone N L n ``3_7 5--4 ,L4 Signamre 4 Dale a.??h- An Equal Empbyment OpponmiirylAffimiative Aaion Employer If l'ou Need Asslstance Due to DLsabllity or Language 1Sarrlcr, Plcue Catl 430-6708 OR 430-6656 ('I'Dll 439-3220) s?ssxn? oc 3n? /. _.. ? . ? ? A-Iow?1 ' ? +?. '04 S 0 4 P U yCa'Z . 0 0 =? O?? F T?.Q 1? 34, - 3 0 0 L- F «.?-... ? o n ?.. OL-* 1 5- L F .??-s?e?t?• y ,3 ? a-i n.,..?.? . ?''^? /V`?. ,?,r•-.? /?1? ShNO .. ...?•?. . ? ? Avc ?? N - "Z? --? 988,00 f3 -t . .? , n 0 2y/D z3 u, 00 , Exi ??LhS D?y?,,Q.?i 27 Y nk qD, ? Dech ' ? NuuSE 9g6. oa ? -2 22? , Slo {p- \zL-y 992, 00 . f-A oj Ex.r 5+-lh S?so io n? l"5 Ariy wqv? weA\ ApprvxiMa're, Pf-oq?,-'1 L;`.? ?LEv?T?oN gTN?NMAI?IC I _= tooo.oo? Pa?NT$rD ot! OEc-* FY4. Sv ? L oRtN4.5.--- --- --- $ ?P ER ?-.. Tv 5-'S EVAT! o ?J S S6ALE , , .;.... C...?- ? . . , ?? ? Q -17 - ? ? A.?.h *u"v4do t n S (ope, 2y/D N E ?„1 ?7S.EQT14-- ?ANk (S}? .rn-tii1? _ ExiS+-ch5 r?o?tc MIusS IGn?S . , Slop¢. 2 s 24/°0 fSv?_Tv ..4?y Wa-k,r Wf,1\ . c4b t1 e ET --Dl_5_? ? N own* qQp rvXiMaC SECTION 208 REQUIRED SEPTIC TANK SIZING. Septic tank sizing for new and replacement residential septic ltank?n? 1 1000 gallon sized 50% greater than the State minimum requirement, (examp tank would require a 1500 gallon size), to allow for future additional anticipa?e sept c Also, if there is a planned or proposed basement toilet that wi11 require a pump, tanlc can acco dance with Minnesota Rule 70801The sizing hall be in accordance with the pump 1 following chart: DAKOTA COI?MENTS MINIMUM GEiLLONS SEPTIC TANK REQ Arooms Minimum Liquid Capacity 2 1125'b (7so) 3 or 4 1500* (1000) 5 or 6 1,Sor9 2250* (1500) 3000* (2000) m Llquid with 1125 * (lizs*) 1500 * (1500 *) 2250 (2250*) 3000 * (3000 *) pIVD Basement Sewage Li[t * 1500 (1soo *) 2000 * (sooo *) 3000 (3000 *) 4000 * (aooo *) * Multiple Compartments or Multiple Tanks MN Rules 7080 requrrements rn () for reference and comparison Multiple Compartment Tanks are required to have a eode maintenance hole (man-hole) for each compartment. Designers and installers should inform home owners of the need to have all compartments PumPed. As- built drawings should also reference this. Homeowners need to be able to locate all maintenance holes for che Pumpers: Designers aze required to state the correct Dakota County tank sizing for replacement and upgrades. It is highly recommended that "property for sale" compliance inspections indicate whether the septic tank capacity meets the above standard. The potential buyer would then be informed of the need for additional septic tank capacity requirements before adding a gazbage disposal, basement sewage lift, an additibnal bedroom, atc. , Refer to applicable MN Rules for septic tanlc sizing beyond the above chart. Questions regarding these items may be directed to your local Municipal Sewage System Inspector. 9 (3) Soil treatment systems shall be Iocated as specified in 'Table I V. Tcible IV, Minimum setback distances (feet). , Building Sewage Soil Treatment Wciter Feature Tank, Absorption Supply Sewer, or Holding Tank B.Sewer Water Supply * * * YVells buried - water suction * * * pipe, and Buried pipe distributing * * ? water under pressure Buildings*" 10 20 Froperty Lines****" 1O 1O The Orclinary High Water **" *** Level of Public Waters *Setbacks from buried water pipes and water supply wells are governed by chapters 4715 anci 4725, respectively. **For structures other than buildings these setbacks may he reduced if necessary due ta site condiHcsns, but in no case shall any part nf the indivic.iual sewage treatment syAem be lucrtted under or within die Structure. Infri?igement on building setbiicks for Fireas without loca( ordinAnce requires suhmittal of T written notification by the uwner indicating the propo,seci sethack and approval by the commissioner. "**Setbacks from lakes, rivers, anc.i streams are governed hy chapters 6105 and 6120. ****Refer to subpart 5, item A, subitem (3). "****Infringement on property setbacks fur areas withuut IOcal ordinances requires written permission frc7m any potentially affected party, an(i approval by tlie commissioner. (4) Soil treatment areas shall not be pIaced in areas suhject tt) flooding or in flood pIains delineated by local ardinance5 adopted in compliance with tlle "Statewide Standar(is and Criteria for Management of Flood Plain Areas uf Minnesc?ta" (cliapter 6120), or in areeis for wliicll regional flooc.i infr?rmoticM is available from the DNR, except dhat in areas where ten year flood infurmation is axiailable from and/or approveci by dhe DNR, soil treatment sy5tems may he installed in accorclance witli tlie F,rovisions of Appendix A, part 7080.0210, suhpart 3, item D. Lous of Soil Borings . B- Location or Ptoject ?ih`h2 LaKej.)ocA 0l`VS _D6 ve Boringe inade• by PP)T Date ?1' IY-1? -, Clas9lfication Syetem: AASHO ; USDA-SCS ; Unified ; ocher Auger.used ,(check tWO): Nand or •Pover ,_; Flighc ,,_, or' Bucket _; oche- ? . ' . . T EsT P i T- Depch, in feat 0 --- '`1AK, Pi PE DE PTH @-I 2 ? x 1-?_ 2 -- 3 - 4 ----- 5 - Depth, ?Be:t#ergrnumber ifeet Surface elevation in K brt?onis%_, ?a,,, MRX, ? U 'ph e 1,0a.mwSarld , 1'tdCe 9r?iy1lC-5 M??? IOYR S 1 ?L{ ^ vJC?lw.J?sA }?rot.Jrl _ t-oamvh S0.r1d 2 - `i ,5`(R.. 4 f y- b c-o v.)n l.oa ry-? 3 -- . lo'tQ_ 5/3 bcown w S'rcnbrown 7,5YR S?g Ivto4lJ_S 6 oF TfcST 1?tT" 7 _ C 8 - . TeS? P?T ;End of baq#tfg at (C Peet. Standing Nater Cable: ?Ap - Rtesentac feec of depth, hours after boring. Noc present In barf5g hole X . Moctled soil: Y?S (qo.1t,0?t? Observed at 4,C) feec of depth. j Noc presenc in boring hole 4 --? S - 6 -? 7 - 8 - =7T ri i Box? number ?J-Z Surface elevation qg(01 ? I ?? 5 YR- 3/2. - d1a1.?L b ro ?.a ,? (_0afy,%\.b so.n d, krace e-rga nk c- s 7,SY2'???{ - brown SQn&k C.`A,? U 0 l o Y R- '-}/q - a KL?e (lo„x's!-, bfb w n &qYNd.<b Qi[.-..,t U) ? 4, t.-q,) J S*rort9 bcuQn ??no44ln.o ? ?o?(Q- slz (.o,o TPSi- PIT nR at (DEee-. End of bp_v? Standinft water table: Vl?p Present at feec ef depc-., ))ours afcer bor!r.a. Not pYesenc in borin,R ho?e ? Motcled soil: ?ES CqFs2.,0) Observed a[ L?%Q feec of Ce;_n. Not present in boring ho'_e Obs.:rvacions and comments: Observations and coainents: T^oP ?? D R??t??FIF?r? l??r r-E?T oR iNC??? 'rT'p Al?A lN CrIELD P?-r' ?'?ELT INCNE m ARkS ?s?o,n Test ?;?5 Lous of Soil borinKa ? g-3! Loca[ion or Project I.?.. W ?; 1lS \ v Borings made• by Date 0 I r6 Classification 5yetem: AASHO ; USDA-SCS Unified ; other T Auger.used.(check tWO): Hand or Pouer ^; Plight `, or'Buckec oC^.e- x • - l-E-ST P ( i S Depth, #number - $ l 3 in Surface elevation QqM 1 0. f.eet 0 MAXimuM P?PE Y(Z 3 2- (j.n.ClL ?tOWn DEPrH @ IZ1/ ? . . Loc?mv? sand ??e n ?e ? iro Svi ? z- ti dYR 4l3 -- brow n ? l.oam? ?ay)d 3- 4 - 5._ `7, 5Y(- 4i4 - bro,.) rl un el 1oY24/3 w'i?-h d,?s},rtck s?rono? b -\ brown '1.SYR-S?g mcE11a? 7- I F N a. o? Te s?- ?%.,?@ la o o?? 8 I , ies+ End of ?g ac (4 t? feet. Scanding ueter tablet • Fbresent'ac feet of depth, hours afcer boring. No[ presenc in boring hole y_- Moctled soil: \?ES (q rbq, 5) Observed ac Lk feet of depth. ' Not presenc in boring hole Obs?rvacions and coaments; 1 >i Depth, F'iT or number ? - L4 in Surface elevation qq 2?0 feet fAK, i? z- 3- 4 -- Z?s`r23?y-c?arlLbrou?rl (}???;?y L&MSand,? ?rQCe orc?qniII cs ? D Y? ++?+-{ - C?1L ye 11 aw ?51,? ?n ?o,.?,-1 S0.nd? Govf 1oYQAIk}--dou.k ye11?-wis1. brvWn al+? d1SVAnc? s4t'on brot-?n s - -11 S'fV_ sl?6" loY lz rr.Z4 1-n 6 s0.n 6 7 -- 8 --- Eno, o? T2St t'l? C ('0t0 F?- ' Te s? Pi?" I End of?xt'ng ac ?4t0 feec StandinR water table: t?'C> Presenc at feec ef dept^, Jhours af[er bor!r.tt• Not present in'borinQ hole Hottled soil: yES (q$-:S,O) Observed aC 4,Q feec of Cep:^.. Not present in borinR ho?e ObservaCions and co=encs: TO 'P b"F D RIN 1N FIF_LD A T . 'FF- ET oR INC?-i? ?jC) TTb M 0 1-? pl:2, A lN 1=1ELD ?T . FeLT 1NC1-lE ??MARfcS ?es?qn Tes? ??TS . B-39 PERCOLATION TEST DATA S}iEET Test hole location AZ L..o_KeWOOd )AIL-L-5 Hole number ?-? Dace test hole vae prepared Depth of hole bottom, _nc=.es. DiameEer of hole, ?_ inches. Soil data from cest hole: Depth, inches b - 1r6 ir 11: 11' ; l2' Soil texture IoYfL 312- V, cOoAK- bco?nwf? 0A1ot.c1.<- .? : `Mechod oE scratchlnq sidevall U_Vh ' W 170.v15 Depch of pea-sized gravel in bottom of hole, _ Z inches. Date and hour oE initial water filling nuon , Depth of inicial aater filling, l!A inchea obove hole boctom. Mechod used to maintain at leas[ 12 inches of water depch !n hole for ac leas: G hours fe-???\ t?3/WO,?c c- Percolacion test readings made by cr. -? - C?? starting at 00 8' . Msximum Water depch above r.o'_e .._- (date) u P.M. during test, g inches. Time Time InCerval, Minutes Measurement, inches Drop in water level, inches Percolation rate, minuces per inch Remarks 00 -11;3 C7 33 - 3 `? 4l ?O?12',vp A 6 df 3 ?D -t2;3o 3 0 - 5 " 3 e, ? e ? 30- I: no 30 ? _ ? L Percolation rate - L?`t -?j minutes per inch. 9-J9 I: .; (2?; ; _. PERCOLATION TEST DATA SHEET Test hole locntlon ?,$Z ?(?,.K?vJ• ???tt?s D, }iole number_ Date [esc hole vas prepared 1t- S-Q Depth of hole bottom, Diamecer of hole, Is inches. Soll data from [est hole: Dep[h, inches 12-1$'' Hethod of scratchinq sideuall DepGh of initlal water filling, inches above hole bottom. Me[hod used to maintain at leasC 12 inches of water depth in hole for at least 4 hours Se-ii\1 %A) ?U.?ciA PJ( Percolation test readings made by ? l. cr. ?Q `qp starting at M' . Maximum water depth above no'_e (da[e) /( p'.m. . during [est, ?t) inches. Soil texture >. 2 [13 ir.c1_.es T5`??'?/2- c?o.n1L bve,,_,? ,n .lgor?* sa n mYIL4- Aa,)L szvl aW1s1, bco,,)r) • a?n V C??. .k+1-, w na? 1 S Depth of pea-sized gravel in bottom of hole, inches, Date and hour of initial wa[er filling 1?-5-?? YLpp1n Time Time Incerval, Minutes MeasuremenC, inches Orop tn water level, inches Percolation rate, minutes per inch Remarks :)5- ll; S Z ?5 - l2', o - l 30 - 3 ? ? iPL Percolation rate - "t310 minutes per inch. Minnesota Pollutzon Control Agency , Quality Division -= - :. . ? .:, .. , r . . . :: _ ?_ , .. , . .. _ ? ..z . F?t ??Individual:? a =??';` ` ?? ? ? ?` ? : ? • ? ystems Lwense c ? .. , on Transferab e " - ?e.l -. . ? .: .:?? . .. . . - . ? . . " y?? _? 1 f_ ?St4ss" •??,?r f:? 5 ' hv ? _ ..:?? ? ?-f`?' .J,r a ? f ? "_ z e.?TY. >. 2??.• /?y? ? .l?.s?t ?" "L ?4 Y. ?.'... "?' J ? ?t F - A_ c.e3?1t? ? ?:?' •JP;r4ua.,?i Y:.;?e ?Sl ' ,?_. .??? y`?.'. _ .. ? L? . . ?_. S?? ' ? ? ¦ '? '? ' e,: . . . :: o Ptr ron al -Bu?ldin . tions 1 ja?,?4 ?? ? . . 52 {:af' ?License(seld Designe . ,. . - ?..'_" ?...r._. -?. . .. _ _ . ' ? ' - y" ' . ' __ .. ._ ... _. . ..:ti.? . -• . . .. .- _ . . ;. .__.-; . Designa ed Professionals (DRP _ _ . ., . . .. .. - - 7ack E_: ,. ?er I - - Reg• --, o:12/31/00 , - - ._, .. .._. , -= , .. . ... ; .-.., r. ,,C.. . . . . . . .. . , . .. _ s.., ? . ? ` '? ' ' ? ,_? • _?? ???y;, x?'w?? J„ . '- - C? .^K . . _ . _.? ' ..1? _ . -...?-? .. _ - _ - . ' ... _ . ....:? ? . .'.' , ??.... ?.. - .::.-' . ? ?. ... . . •. . . .. . ? _ . . . . > ' - . . . : . . . ? .: '-.'..: . . ?. . - , . _ . . .._.-_ . ' '. ?.. ..?- '' ?? _. '. :..". .. . . " ' . . , .. ' '.'? .:? .... . ? . y.? . Designer I License expires 3115/99 ` • - " - ' ?-se--- >:? , •: _ Date of Issuance:'-.2/26/98 ' Peder Larson,' Coinmissioner ? Company License Number: 604 ISTSfWater Quality/NP, 520 Lafayette Roz!d, St.Pauf, MN 55155-4194, I-800-657-3864, or TDD ((or hearing and spccch impaircd only) (612) 282-5332 Printcd on «cycltd papcr conlaining nt Itasc 10°6 Gbcrs from ap<r rccyckd by consumcrs MASTER CARD LOCAT O°' Zaheu/ o o d /d dLf?Q? •? L o? / 7 OWNER STRUCTURE AND IAND USED AS Permit No. Issued Issued To Coniractor Owner 00 BUILDING zQ? 23/? PLUMBING CESSPOOL - SEPTIC TANK -? WELL ELECTRICAL i _?? ? • , HEATING GAS INSTALLING SANITARY SEWER I ' OTHER ?- 07HER • Items FOOTING FOUNDATION FRAMING FINAL ELECTRICAL HEATING GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING WELL SANITARY SEWER 0 - COMMENTS: Approved (Initial) Date Remarks /11120 . ? F-?- 6-?f ? -1,e - Distance From Well SEPTIC TILE FIELD DEPTH OF WELL FT. _ • ViolaTions Noted on Back ? w <<? COMPLIANCE INSPECTION REPORTS TO BF USED ONLY IN EVENT OF OBSERVED VIOLATIONS • PERMIT NO. DATE OF INSPECTION CONDITIONS OF CONSTRUCTION AT THIS INSPECTIDN ? NO EVIDENCE OF NON-COMPLIANCE OBSERVED. 1:1 ACCEPTABLE SUBSTITUTIONS OR DEVIATIONS. NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. ITEMIZED AND DESCRIBED AS FOLLOWS: NON-COMPLIANCE. BUILDER DOES NOT INTEND TO COMPLY. ? COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYED BY CONDITIONS BEYOND CONTROL. ? REINSPECTION REQUIRED REINSPECTION REVEALED DATE OF REINSPECTION • CERTI FICATION - I certify that I have carefully inspected the a6ove in which I have no interest present or prospective, and that I have reported herein all significant conditions oLserved to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require- ments for off-site improvements relating to the property inspected. . ? ALL IMPROVEMENTS ACCEPTABLY COMPLETED BUILDING INSPECTOR COMMENTS: DATE ? 23 Lo•r OUo. ! 7 OWNERS: MR.f MFS. JRmfS - `2n vr_ , c. Zt- a3aX .=- .% ' , / -' ;,. f;. N ? E? ? i i yo ? : r ? ? ?- d- ; i ? ; ; _ ?____ G L ! P' F f2 o A ',`? o• * 530 • 50 + 69•50+ 265a25+ 525 • 00 + SDO•00+ 63•00+ 280•00+ 132•00+ 23365o25* PERMIT City of Eagan Permit Type: Building 3830 Pilot Knob Rd Permit Number: EA089110 Eagan, MN 55122 . Date Issued: 05/11/2009 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 882 Lakewood Hills Rd N Lot: 17 Block: 0 Addition: Lakewood Hills PID 10-44350-170-00 Use Description: Sub Type: e-Windows/Doors Construction Type: Work Type: Windows/Doors-New/Replacement Description: House Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: huprovements 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 by law in ALL single family homes. Fee Summary: BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 Valuation: 3,000.00 Total: $90.00 Contractor: -Applicant - Owner: Home Depot At Home Services William E Freeman 656 Mendelssohn Ave. N 882 Lakewood Hills Rd N Golden Valley MN 55427 Eagan MN 55123 (763) 542-8826 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. Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA113674 Date Issued:09/06/2013 Permit Category:ePermit Site Address: 882 Lakewood Hills Rd N Lot:17 Block: 0 Addition: Lakewood Hills PID:10-44350-00-170 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes . Derek Lindsey Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - William E Freeman 882 Lakewood Hills Rd N Eagan MN 55123 Action Roofing & Siding Llc 1315 Southview Boulevard S St Paul MN 55075 (651) 457-2642 Applicant/Permitee: Signature Issued By: Signature 11PCity d6sp 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 RECEIVED JAN 3 Q MU Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: �lJ Date Received: Staff: 3� 2014 MECHANICAL PERMIT APPLICATION Please submit two (2) sets of plans with all commercial applications. Date: ) - L$ OA Site Address: $ % Z o 11 S Tenant: Ct--) i \ \ •P t �r�c�^ Suite #: Name: (J i\ ` cue r'• a`^ Phone: 50 7- °I `J' $ - I d 6 L Address / City / Zip: \4-Uao� 1��i5U a^ Name: 4 r L-,-i� a.` �1a to.. �. , . r License#: Address: 1$15 G_ L1 s` - SuAN-L k City: (`N....- �.c,c) INS State: n Zip: ..SS (tb1 Phone: b r Z- ZLt- t g of Contact: , /t r� ,� 1 C,. Email: Oc.n c.Ac,_o \ r. Q__ o r ^^u -1 - c o w, New Yi Replacement Additional Alteration Demolition 2. LI 4 NVA, 3C) Z -S 'JQooc) WV-)" s Description of work: RESIDENTIAL Fumace `c Air Conditioner Air Exchanger Heat Pump Other COMMERCIAL New Construction Interior Improvement Install Piping Processed Gas Exterior HVAC Unit Under/Above ground Tank (_ Install /_ Remove) RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit (includes $5.00 State Surcharge) $100.00 Residential New (includes $5.00 State Surcharge) o'b =$ 65 TOTAL FEE COMMERCIAL FEES $55.00 Permit Fee Minimum $70.00 Underground tank installation/removal *If contract value is LESS than $10,010, Surcharge = $5.00 **If contract value is GREATER than $10,010, Surcharge = Contract Value x $0.0005 ***If the project valuation is over $1 million, please call for Surcharge Contract Value $ x .01 = $ Permit Fee _ $ Surcharge* TOTAL FEE . _$ I hereby acknowledge that this information is complete and accurate; that the work will be in4onforman h t -e dinances 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 fot o start wit . a p -rrri ; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. f \ \'L Applicant's Printed Name x Applic. nt's = ignat re Use BI.UE or BLACK Ink r-----------------� I For Office Use � ' � Permit#: �� j Clty of �� a� � � Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I I Fax: (651)675-5694 I Staff: I I I 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#; r; v.�'y � �� Name: ;`.��f C-�� r/'�,� �� Phone: �� "�(� �� Resident! ° �Z32 ��-kG�.c,�UGO l��S �f,? Qyyqer '. Address/City/Zip: 1 Applicant is: '� Owner Contractor ' Description of work:� (��,� ��"�-� ��"�Ty�e of Work � '�'�' �� , �a,,�� Construction Cost: Multi-Family Building: (Yes /No �"` )'"�� ,,t � �r�� . °�-��: Company: Contact: � _��,r� a� COIItC`eCt01' Address City: �,, ' '�� State: Zip: Phone: Email: '' License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 72 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Nf)TE�plan�;antl sxuppc�rt�r,tg do�um�nts that you submit are.coiasldered to be public information: Pvrfions vf t - a- + , : �' � Y�� , T ��. �. �. ^I , ,�, . fhe�nfor;m�f�on m�y b�c�ass�fi�d'as non p�blic if yau.provide'p;ec�fic'reasc�ns:fhat w�uld permiffhe City�o . ' -� �,fr . �w,� �'�.`'��. ,,��' ��.� �� concluc�e that�f�iey are�tratle secrets.'�� CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.orq 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. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Co must be completed within 180 days of permit issuance. � � X ��l'etr�f L:- �:�-C�2..�1-1.I X Applicant's Printed Name Ap icant' Si ture Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA130710 Date Issued:05/11/2015 Permit Category:ePermit Site Address: 882 Lakewood Hills Rd N Lot:17 Block: 0 Addition: Lakewood Hills PID:10-44350-00-170 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 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 - William E Freeman 882 Lakewood Hills Rd N Eagan MN 55123 Applicant/Permitee: Signature Issued By: Signature