736 Lasso Lane. CITY OF EAGAN
3795 Yilot Knob Road Eagan, MN 55122 N2 4254
PHONE: 454-8100
BUILDING PERMIT `15ffl0;%. Receipt # -
To be used for Date . 4 , 19
Site Address aS`o 1-n - Erect ['] Occupancy-
Lot Block , Sec/Sub. '?'?"?i_n ?£GTti Alter ? Zoning
Parcel $F' _ Repair ? Fire Zone
Enlarge ? Typz of Const.
z Name .,
Move ?
# Stories -
3
Address
Demolish ?
Front _ ft.
City
Phone Grade ? Depth it.
p Name APProvals Fees
ou Add Assessment -_-
uq ress
--
Water & Sew. --
Cit Phone
r-
"
Police
Name - Fi
FW re
?? Address Eng.
Q"' Ci Phone Planner
Council
I hereby acknowledge thot I have read this opplication and state that Bldg. Off.
the information is correct and agree to comply with all applicable
' APC
rnances.
Stote of Minnesota Statutes and City of Eagon Ord
Signature of Permittee - '
Permit
Surcharge
Plan check _
SAC
Water Conn.
Water Meter
Total 20.50
A Building Permit is issued;ta =`` i ''i" on the express condition that
all work shall b= done in accordonce with all opplicoble Stote of Minnesota Statutes and City of Eacan Ordinonces.
Building Official - -
Pe?M # Date Is?N PwINNIM
Plumbing
Mechonical
INSPECTIONS DATE INSP. Rough-In Pinol
Footings Date Insp. Date InW.
Foundation Plumbing
Frame/ins. Mechanical
Final
Remarks:
CITY OF EAGAN Remarks
Addition Saddlehorn Lot 12 Bik 2 PdfCei I20. 02
1I,? ?
OwnerftV?'r +"=Streec 736 LaSSn Lanp State F.agan, MN 55123
Improvement Date Amount Annual Years Paymem Fieceipt Date
STREETSURF..% Imp. 1981 1944.00 97.20 20
STREETRESTOR. 70 1981 1216.00 60.50 20
GRADING
SAN SEW TRUNK ZHO OO COOSS91 10/15/80
*SEWER LATERAL
WATERMAIN
*WATER LATERAL 1981
WATER AREA S
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 420.00 #29563 4-12-82
BUILDINGPER. '
sac pp 12085 11-5-74
PAFK
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
(Z"? Z EAGAN, MINNESOTA 55122
DATE
19
RBC 61 V 6D
PROM
AMOUNT $ I
& DOLLARS
1 oo
? CASH [_1 CHECK
FOR
-57 ? I
White-Payers CopY
Vellow-Posting Copy
Pink-File Copy
Thank You ?
BY
k
'r COI
; Site
PERMIT #
MECHANICAL PERMIT RECEIPT a
aTV oF ??caN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: IA
:T PRICE: PHONE: 454-8100
Sec/Sub
a) Name "
m Addres?
c City Phone _
?
r
Name
f `
? c Address
0
? Ciry
?
Phone-
? TYPE OF WORK
i Forced Air M BTU
Boiler
? M BTU
I
Unit Heater M BTU
Air Cond. M BTU
! Vent CFM
Gas Piping Outlets # .y\
Other
BLDG. TYPE WORK DESCRIPTION
Res. New
;
Mult Add-on
Comm. Repair
Other
FEES ?
RES
HVAC 0-100 M BTU -$24
00
.
ADDITIONAL 50 M BTU .
- 6.00
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
1 PER PEHiIAIT
GAS OUTLETS
MINIMUM - 1
50 EA
-
(
) .
.
COMM/1ND FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE R CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON d -A
FiEMODELS - 12.00
MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50 r
PERMIT PRICE GOES ?
$? f+ BEYOND $1 ppp)
FEE:
S/C:
TOTAL:
r l,11{, ,A44 . v-
JI
FOR: CITY OF EAGAN
,. . _ _ _ - - ---?-•-?--
zFi,n
,/_,
Dute:
Site Address:
CITY OF EAGAN
9795 Pilot Knob Roed
Eagan, Minnesota 55122
Phone: 454-8100
PERMIT
736 Lasso Lane
Lot ~ 81xk Sub/Sec
Saddle Horn Addr
Name B111 Sexton
Address 736
?
n•-?_-? ^
Eagan
City Phone:
RuniPca Sewes'
Name
p.
'
` Address 816 AS;! i "a'':
e
0
V
City ?.
Phone:
This Permit is issued on the express condition that oll work shall be
Minnesota $tatutes and City of Eagan Ordinances.
No.
Receipt No.: ?d/ol- 3
Single I
Residential
1Nulti Res., Comm./Ind.
New/Alter. / Repair
I Cost of Instollatian
Permit Fee
Surcharge ?
Tota I
done in accordarxe with all epplicable State of
Building Official
CITX OP EAGAN
3795 Riot Kno6 Road
Eagan, MN 55722
Zoning:
Owner:
Address:
Site Address:
Plumber. ds
1 agroa to eomplq with fhe Cily of Eugan
Ordinanees.
Bv
Dote of Insp.:
SEWER SERVICE PERMIT
PERMIT NO.:
DATE: ?
No. of Units:
R f. S 7
Connection Charge:
Account Deposit:
Permit Fee:
Surchorge:
Misc. Charges:
Totai:
h..._ o_:A.
CITY OF EAGAN WATER SERVIC E PER MIT
3795 Pilot Knob Road PERMIT NO.:
Emtgae, MN 55122 DATE:
Zoning: - No. of Units:
Owner.
Address:
Site Address:
Plumber:
?
?-c.??
Meter No.:
Connection Charge:
Size: Account Deposit:
Reoder No.: Permit Fee:
1 agroe to eomply wiifi fhe City of Eagan Surcharge:
Ordiaancas. Misc. Charges:
Totol:
By Date Paid:
Date of Insp.: Insp,:
CITY of EAGAN
BUILDING PERMIT
Owner ...1....""..`?:.."?.'`..-?`?`."`?.........?............ ................••-
g-,
.??..`.f.?'?..?....{?.`.'_'.-.'.`.".:..-`.--..'C,.............
Add:ess (Praseni) 'a
Suilder ................................................................................................
...4
Addrasa ...... .................•••..................................--••----.........._...............
DESCAIPTiON
r j? r
N2 3454
3795 Pilot Knob Road
Eagaa, Minnesofa 55122
954-8100
Date ................................................
...................
5loriea To Be Used For Front Dep3h Hetgh! Eat. Coci Permi! Fee Remarks
-^? ` / I / / / • ?-o ?t? i f?-?E..?.?-$?" .o.-c.?-?
¦_nramrnwr srn: c-a
Slreel, Road or other Description of Location I Lo! vBiock Addition or Trae!
`7
This permii does ao3 authorize the use oi streels, roads, alleps or sidewalks nor does it give the owner or hia agant
the righ! !o creaie anp situation whieh is a auisance or which presenls a haaard !o the health, safety, eonvsnienee . and
genezal welfare !o anyone in the communiYy.
THIS PEAMIT MVST BE E$T ON THE" PREMISE WHILE THE WORK IS IN PAOG SS.
c.? (.?--4'ri-t' hea ermission to eraei a...•.• ••`?:" `'.? . ................
This is 3o certify, 3hat ......................... p p
...................... °----•-.---° --°.. .... . . . ....... _ u oa
the above described premise subjec! 3o the provisions of al] applicable Ordinances for the Cif of EagarC
/
-°---...?°?!.:. -.._-------------------- per ....... ---------- ....... ?L.Q,u?ce ----?`••``.---?---.??-.?"?......
..... •Buildiag Inspector
...?..?? ...............°-•- -- MaY°or v ?
?
12,z
CITY OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
PERMIT NO.: Fii
The City of Eagan hereby $rants to Wenzel pll+mf+inq& uaati.,q
of EAtr,=..n
a PLLIMBING Permit for: (Owner) ILirchnar nQ -
at 736 Lasso , pursuant to applicatiori dated 0/23f7S •
Fee Paid: S20.00 dated this _3,0 i day of c,m?, 19_15_.:
.50 s/c
Builciing Inapector
Ytechaiiical Permits: •
Bi.u `i'otal:
12
CITY OF EAGAN
3795 1'ilot Knob Road
Eagan, Minnesota 55122
PERMLT NO.: 764
The City of Eagan hereby grants to
Comnlete Air Beatinc & ooolina I11c.
of 5611- 152nd St.. Huqo, MN 55038
a SSATSNG --?permit for: (Owner) HarveY ?chner
7?? ' ?
at 735, 745, 7?'Lasso ? pursu8nt to application dated 11/ZO/75
.
Fee Paid: $60.00 dated this 26 day of HO°• , 19 ?-
1.50 s c
Building Inspeetor
Mechanical Permits: -
Bid Total ?-
,
. CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN $5122 N2 4254
PHONE: 454-5100
BUILDING PERMIT APPLICATION $59900, Reteipt #
APril 4, 77
To ba used for GaraQe Date 19
Site Address 736 Lasso Ln Erect ?j Octupancy
Lot 12 Block 2 Sec/Sub. Ssddle Horn Alter ? Zoning
Parcel .# Repair ? Fire Zone _
Enlarge ? Type of Const. V
m Nome Wiiliam Sexton Move ? # Stories.
3 Address 736 Lasso Ln Demolish ? Front 26 ft.
? Cit E n Phone 452-5188 Grade [] Depth 24 ft.
ce
0 Name _ Same aS above Approvals Fees
v??
Address
? r;...
Name
Address
Assessment _
Water & Sew
Police
Fire
Eng.
Planner -
Council _
I hereby ocknowledge that I have read this application and stote that gldg. Off.
the information is correct and ogree to comply with all applicable AP?
Stoie of Minnesoto Stotutes and City of Engon Ordinances.
?
Signature of Permitte?
A Building Permit is issued
ail work shall be done irv/c
Permit 1o.vv
Surchorge 2.50
Plan check
SAC
Water Conn.
Water Meter
roral 20.50
on the express condition that
of Minnesota Statutes ond City of Eagan Ordinances.
Building Official
YiLLAOE OF EAOAN
3795, Pilot Knob Road
Engan, MN 55122
toning: Rl
Owner:
Address:
Site Address: !
Plumber:
Rec. 412085
I agrea to comply with the Villuge of Eagan Connection Charge400. 00 .pd 11/5/4
Ordinancee. Account Deposit:
Permit Fee:
Surchazge:
By: Misa Chazgea:
Date of Insp.: Total:
Insp.: Date Paid;
SEWER SERVICE PERMIT
PERMIT NO.:
DATE:
No. of Units:
36 Lasso Lane - Saddlehorn L12 B2
rp,n.;.r,. •:?:l? ?W
.C?.F??:i.?,:?„?•4h?F?dj?it..?t i:`...?:? .f.:d.?..y:Y ??`?!1t7ii.,Ci?C:p {'. ? ? .WS
CITV OF e::.,(•aGAl:l
CFtSl'•1i.lc.i;s 1B "If:.l'i!`4.1.Nf:1... i'dI)u 749
BAT,..I,; t7,., f.? R f!'::? i?.i.i:? T7:MEs; B,,?.?
.,.4:;:;9
I%
N^iMF'a IiICF{FirD N1 F•!Fl'i1iiGRi_UNl±
;ici.fi `lrlfl:l. i;it'.; I...E't`iifi?fJ I._fiNH. 111o25
205 900:k. 736 1...ASt'sil I_F1Ni: 2o59
Toi:r,:l. Rc-..:ei.p+, ArEr:,un.F - i.i.::',.75
CF?:i.09535
1..!:iL.f' .C;.i:, NA;yl.;4'
•'S?ij{, y?.l.-b?}:y. ?:u:}.v us.r p :..?yr .a:.y ?.nr ?,.oJ:.?..?...?? ? .? .?:
1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL) ? I 13- -7 s?
IFS9 0 3830 PILiOT KNOB RDN 55122 q,
659-681-4675
New Construction Reaulrements
? 3 registered sRe surveys showing sq. N. 01 lot, sq. ff. of house
and gl roofed areas (20%'e maximum lot coveraae allowed)
? 2 copies oi plans (show beam d. window sizea; poured tnd. design; etc.)
D 1 se1 of energy calculations
D 3 copies of free presenation plan if lot ploMed aker 7/1/93
Remodel/Reoalr Reavirements
2 copies of plan
1 set W energy calculations for heated oddRions
i sRe suney for exte?ior addffions 3 decks
DATE: CONSTRUCTIONCOST: / ??S/ozpO0
DESCRIPTION OF WORK: &c KoG7
STREET ADDRESS: 11JZ, I-aS s,,n ! Gt 1'Ie
LOT: ----BLOCK: ?-- SUBD./P.I.D. #: ?• 1? ? ??? l'`--
Y '
) 4
Name:
o U f
! / V / Phone #:
f uY?
PROPERTY last First
OWNER
Street Address:
?o ?
asso
City ? c? 9 ?t h State: Zip:
Company: 140 Wrvr" Q1 OuV,/ /S Phone #:
(area code)
CONTRACTOR
Street Address:
?Ga
??e?sCirr P License #2S? 7 Exp. ?dGb
Ciry d State: lyh Zip: 2
ARCHITECT/
ENGINEER Company: Name:
Telephone #: area code ( )
Street Address: Registration #:
City State• Zip:
Sewer 8 water Iicensed plumber (reaulred for new eonsfruction oniv):
Penalty applies when address change and lot change is requested once permff is issued.
1 hereby acknowledge that I have read thls appllcation, sfate that the tnformation c , and ree to comply plicabl
State nrm e?cnd-Cily of Eagan Ordinances.
I\
, D ?-- -- Signahire of Applicant:
LA OFFICE USE ONLY
Certifi y -cieived Yes _ No ? -
Tree Preservation Plan Received _ Yes _ No _ Not Required
i . ,. .. , . ,
'.r°. ,. . . , .
?
' . .
.
.. . .
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?TM+3+T:?.1+?R:?4m?•T%?.5•`'hTMti 4(YC -0??: yil?,/.`,???' ?:N'M1`?,.;!:A+1'?R'???.TinTT???: .
CITY UF kAGAN
LAFN.T:I::ke 0;7il:NnL.Npe 7133
VA T£x; ? :10.'12/9p T'IM':=. :v70 , .
$
N, HM?::?. - z?PERzAL S:r.ta?NG, '!:Nr. . , :
:32tU 9001' 736 L.i1: S€1 Lt@ 25
"c'19t1C1l. 73G 'L:ASstl f..P! .4,.00
3?i.o':9003':: 39i6 F''Al. T a0 E: W' 'c?Q?.25
2i.•55 9CJDt 3916 F€i!_.l'aAfr-- W E?,.UU
." .
l
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. ? - . . . . . .
o1.a.;. ReCe:Epi; Amo»nt < :I72nit7
a..!SE'fi' T.Iaw, .AN ' , -
?kkC??*??:#c**?s?W?c*?kX?*?K?ks}c?:?k?c?X*?kiick*?k?Y?XaK?ksK**?N :-
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EACAN
3830 PILOT KNOB RD - 55122 ?
651•681-4675
New Conshucfion Reauiremenh
? 3 reghMred ske surveys showing sq. ff. of lot, sq. B. of house
and all roofed areas (2079 moximum lof coveraae allowed)
? 2 coples of pians (show beam & window sizes; poured ind. design; etc.)
? 7 set of energy calculatbns
? 3 coples of hee rese ation plan ff lot plaited aRer 7/11/93
DATE:
DESCRIPTION OF WORK:
STREET ADDRESS:
Remodel/Reoair Reaulrements
?5'7 . -a- t?
10 - ID _ 9?
2 copies of plan
1 set oi energy calculaNons for healed addHiona
7 sffe suney for exterior additions & decks
CONSTRUCTION COST: ? coo ?
LOT: i ? BLOCK: -D- SUBD./P.I.D. #:
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Name:^/1,1v1<4P11,y1 /<?wiN J 6-`194121q-14 Phone #: GS? `//D???j ?
Last First
Street Address: 7 36 L195SG GfNE
City P1q6`fi^-.7 state• zip: 53 f .2 3
city stnte: ??? `
? ?
Company: Phone #: l? 3
(area code)
Sheet Address: /O /Vf° ucense # FSExP•i?i ?
Company; Name:
Telephone #: area code (
5treet Address: Registration #:
City
Sewer'8 water Ilcensed plumber (reauired for new constructlon onlv):
State:
Penalty applles when,address change ond lot change is requested once permff Is issued.
Zip: .5-S 30
Zip:
I hereby acknowledge that 1 have read thia appllcaHon, state that the informatfon is cortect, and agree to c mply with all apptlcabl
State of Minnesota Statutes and City of Eagan Ordinances.
Signalure of Applicant
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
D::t ? - Z?- ?- -7 -'7
BU''f DTY?G ='3RNIIT r`.:aPLsQATlO:d
I?(_:T ) )- FT.Ot:Sr oZ ADDIa3:Qa"7 Sc I Cl C'llC.' /1
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R?-I.i:E.G Fi S? ^.??ti0:.'a T`.?il-9nJ.'.?i? li' LT?`'i.?"-',T.r_42TEl7
ac::?F.n.ttr3
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BsT'114A!E0u cc:.;a ? '
'* 4!5 7_ ?? ss
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5 C' LC.t
Cp*,7:Ci!?'.CTOR l_l-) 1l 14inir TELEPHOidi. I10.
AiIJSF'3u
"tto'U?n Ir_ciL+d? vtli.te plan, bixil.ding plar.s, and energy Calculatiu>:s tritl: ihis
ar, l:.c-tirn
Signed ?.
OFI'ICE USE
or
J
%'AL[J21 i IO--n-4 ?, OD C? -
5AC
V?a,>.i??,_
-,-?'2 , COlli3RC^In:'i
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ESSi;Z?iT CLER:< BUILIIING DSFT. POLICE 1`:LPT.
=7V30
Loc .s s o Lca he--
TJiTIIc:dt & .°r::tZlt DrP,"'.. FIIL rirPT. R11I'IiTC DEPT.
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301
lOo-3'
736 L,14:3.5 o
,
?
MASTER CARD
LOCATION L &„S',s(7 a /
OWNER
STRUCTURE AND
LAND USED AS
Permit
No.
Issued Issued To
Contractor Owner
BUILDING
PLUMBING
CESSPOOL - SEPTIC 7ANK
?•
W E LL
ELECTRICAL
HEATWG ? 14??
GAS INSTALLING ?
SANITARY SEWER
OTHER I
OTHER I
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING SEPTIC
FOUNDATION 0? / CESSPOOL
FRAMING
., TILE FIELD FT.
FINAL
ELECTRICAL
HEATING DEPTH
OF WELL
GAS INS7ALLATION
SEPTIC TANK ?
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
Violations Noted
on Back
COMMENTS:
BEA BLOMpUIST THOMAS HEDGES
MAYpq CITV ADMINISTHAfOR
THOMA$ EGAN .
MAqK PARRANTO CI? OF EAGAN ALYCE BOLKE
qTY CLERK
JAMES A. SMITH
THEODORE WACH7ER 3705 PILOT KNOB ROAD
couNCa MeMeeas ? EAGAN. MINNESOTA r
55122 V, .
. PNONE 434-BI00 . ,
.;.
` :i -- -
May 21, 1980
Loan Guarantee Division Veterans Administration
Fort Snelling Federal Building
St. Pau1, MN 55111
RE: 736 Lasso Lane (Lot 12, Block 2, Saddlehorn Addition)
Dear Sirs;
I have been requested by a Ms. Sheryl Brown to have the enclosed form
completed by a Certified Health Official in the City of Eagan. This
letter is to inform you that the City of Eagan does not have a Certi-
fied Health Official on its Staff to verify the results as found by
Markley Laboratories pertaining to the water quality of the private
well located at the above referenced property. We also do not have
ar?y information that we can forward in regards to tYie existing well
at this location as it was installed prior to the time that any inspec-
tion services were provided by the City of Eagan.
This letter is also to inform you that the City of Eagan is currently in
the process of installing sanitary sevuer,watermain and storm sewer
facilities to service the above referenced lot under Improvement 79-13.
This utility construction is expected to be completed and operable by
the end of June 1980. It will provide sanitary sewer and water services
from the mains in the street to the property line of the above refer-
enced lot. It is presently City policy that whenever City supplied
sewer and water services are available, that.the individual property
must connect within two years of date of availability.
Please feel free to contact either myself
Works, Mr. Tom Colbert, if there are any
the information contained in this letter.
or our Director of Public
additional questions regarding
Sincerely,
rkvwoM? 1*rC'#Nr
Thomas L. Hedges,
City Administrator
cc: Sheryl Brown, Sales Assoc., Century 21
Marve Hamrick Inc., 7702 SOth 5t, So., Cottage Grove, MN 55016
THE LONE.OAK TREE ... THE BYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY.
Mr .rt .,
a• ??UJ
MARV HAMRICK, INC.
7702 80th St. So.
Cottage Grove, Minnesota 55016
Business (612) 459-9955
Toll Free Watts Line- 1 -800-328-1353
May 14, 1980
Tvm Hedge,s
C-i.ty Adm-ivi,istica-ton
C.%ty oi Eagan
3795 P.i,Eat Kwab Raad
Eagan, A4.innuota 55112
Decur. Mfc. Hedges,
m
19a
&0
Enc,2a,sed .iz a copy oA a we,P? tmt cawducted by Manhtey Labvncr,tvr?i.es vn
the phapelty taca,ted in Eagan a,t 736 La.sso Lane. The Ve.tehans Adm.i.wiztxctti.vn
n.equ,uca that the we.Q.Q tnt be ce4,ti.6ied by a He.at.tk 066-i.aia,e. The enc.eazed
bvnm 26 - 6395 ?s 4a& that putcpvde.
16 the C-i.ty a? Eagan dam nvt have a heaZth v?4tic.ia,2 wha eun eompte,te
th,i,s ?anm, a .ee.t.tvc ?5tu,t.i.ng that {act adcbce?s3ed xa the Ve?tenav?,s Admi.vi,c.?s?ii.ation
w.i.Q.2 e acceptcebte.
16 thene cuce uny que,sti.aws ptecuse g-ive me a ca,22. I've encta3ed a
Atamped, addne?hed enve,2vpe to the mo&tgage eompany hand,P.i.ny the toccn.
Thanlz yvu,
ov
SGtelcyt Bkawvt
Sa,eu Assae.i.a.te
CENTURY 21
Mcucv HamA.i.cfz, 1 nc.
Enc:
Each Office Is Independently Owned And Operated
113
REALTOROD
' Form Approved
•---__?__ 40, ' OMH No. 76-R0376
VETERANS ADMINISTRATION
REPORT OF INSPECTION, INDIVIDUAL WATER SUPPLY ANO SEWAGE-DISPOSAI SYSTEM
(TOP SECTION TO BE FILLED IH BY VA.)
PRIVACY ACT INFORMATION - This report is required by law (38 U.S.C. 1804). Failure to report can result in refusal of VA
financing for purchase or constrtiction ot this property
KGIONAL gifKE „
,C.: -i "ua.ranty Division ipOVERiY ADDRESS
73` 445S0 A'qAjr. SUlDIVISION NAME
Veterans AdLqinistration ,
,
elling Federal bldgw
S ?
p`p?, M?• ?
??I
NOCKNO. lOTNO,
n
Ft. je IX
55113i
NAME Oi WIIDEN ?
.
.
;. NM1E Of IENDER /
#wr
vsNqA#a NAr? ?awx
FiRsr M CISE NO.
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NEW ICI E%IS71NG
TOTAI NUMBER sASEMEM CAN ATTIC OR OTNEN AREA !E MADE IN10 iF YES, NOW WATEN SUPPIY AND SEWAGE DISPOSAI (CMck)
UVING UNRS lEDROOMS lA7H5 ?YES ADDITIONAL lEDROOMSi _ /MN'!i . . NlIK COMMUNRY INDIVIWAI
. r yyATElt yUpKY !V
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NO YES
NO SEWAGE OISPOSAI EY
PART I-fOR USE OF INSPECTING OFFICIAI (fill in below inlurmaiion applimbla ro wbjec? ins?allation)
INSTRURIONS: If nsw iniMllafion, inspscf fw compliancs with opprovsd.sxhibih and rxord any obsorved informolion not tAown on, w which vmiM from,
tAs approvsd sYhibih. If axiiling inAollalion, lurnish as much of The infamalian aa moy ba avoilable. As applicabb uu in"ctoi s stokh on rwena.
INDIVIDUAL WAiER SUPPLY SYSTEM
Distance fo maresf public wahr main, fssL Si:a of main, inch@s.
Individuol welb Q ors Q oro tat customory in neigAborhood.
` Givs mwf mant ncwd of failuro of wolb in immed'qte riciniy b fumiah adequaM aupply of waror
\
Vroputist in nwiyhborhood Q ora Cl aro nof boing dowloped with 6oth individuol wwror-wpply ond wwvpadispowl sytNmi.
tof size: feet .vide, fast deap. Dwelling wt back fiom front properly lim, leef.
Individwl wolar wpply fran,. ? prilhd rnll. ? Driven wall. ? Dug we1L C] Bond wdL .. . . - ' ;? .. . . . ,. .. .
Dislonce of wall from: " • .
Building (oundation, feth, nwhsl Icq lina af C] hoM. ? side. ? rwr, 4M;
?i .
... wsl iron wvrer, faeh, file "wer, bas; mptic fank, fNt; dispowl Fwld. hN:
` .
N^PaW Dit. Mf: afpool, hoq otMr teurcn of poaibls pollWion, f"t.
Well conflruction: ' - . . . .
Diameter, inches. Total dapeh, fpf. Typs of casinp, . DepMh of cwinp, hef.
• Apprwcimah deplh of pumping kvsl of waror in well, fNf. ApproximaM yisld, gollom pw minuN.
. Saoled wataNight b dspM of faat. .'
Extarior fpau around casing waled with, Cl Gmnl prouL ? Puddlad clay. C] Ordinary bodFill. - , -,. . ...
We11 cover: C] Concrate. Cj Wood, C] MNoI. Opsniags in well mwr wohrtigAf: ? Yas. ? No.
Yump: C] Shollow, well. C] Ds*p wsll. Langlh of droP Pipe, feet. Pump tapacily, 9olbnt par minula.
, Lomled in: C] 6ofamenl. ? Pump rodn oH bosamenL E] Pump heuw obovf preund. ? Pump pit.
Pump room properly dmiead: C] Vss. C] No. Pump mounling wateniphC [] Yss. 0 Na, ' . ' -. .. . _ ._. " - - -.
Type of ftornge: ? Proswm. ? Groviy. Copocity, pallom. . .? . i . . .,
Hos bacbriolopiml exominolion ol woter baen mada? ? Yss. Q No. If onawar is "ys," qM dob
Qualiry of wabr ? is Q is not sotisfatlory for human eontumpeion.
ImMlbfion F] does E] does not mmply wilh approved sahibib, if oay. -
INDIVIOUAL SEWAGE-DISPOSAL SYSTEM
YRIMANV TREA7AIENT consish oi ? Saptic Mnk. ? Gsspool.
Sepric tank:
Distann from wall,__ fest Mobriol, Numbar oi tompart
Tolal liquid capaeiry, '_galbro. Capaeiy inkr eomportmetnt, • gulloe?.
.. ..
..
..
-
, Iniids Iseglh, fwt. Inude widlh, hN. liquid dop1A, fnN. . .
?
. CNfpool:
? Dislancs from: Well, tsN: foundafion, feaf: nwn.r br liro m E] irom. Oside. 0 reor test.
Insida diamshr, feet. Depffi, feet. liquid copaciy. 9ollons. Lininq mo I .
SECONDARY TNEATMENT consisft of C] DisMibution boa arkd 0 Tile ditpowl fleld. 0 Sespags pih. r
. Tile dispowl'Fiald: . . . . ,. . . . . .
.. ?
Disroncefrom: Wsll, feet; fovndation, faNi neonst bt line at ront. 0 sida, [] nar,
faL ?.?? .. .
iToMI knyth ef tile lines, hat. Number ol Oiston twosn liny, feel. •??. ?:? ??? •. .
?Tmal oRfttive obaorPeion oroa in boMOm of Mnehes, quan . Tnoch widM, inchn. ,.. .
LapM of wch line, fest Dsp1h, bp of flle b RniaA grad incb". , , . ' , . , - - •
? Type of filMr maMrioL ClGravol. Olrokon ftan. ? Cind . OHwr
?. OapM of filbr maprial MnwIM ei4. inehes. of RIM maMiol owr lite, inehn. ,. j
r
SMPn7o pib: p , , , . .
? .
' j NurtiMt of pih, OuNido dkm?Mi, ?NL Deplh, bml. lining moMriot
Dislance fran: We11, fNh, kun , fNh, nwreA bl lirr o1 p hont. Q siM, Q rwr, fwf. . ,.. '
i . -
If eaisliop intlallaeien. 9iw ell IM folbwinp ilionol information oroilablr. ` . . . - ' . , . . .
; Dishnq to nwrNt: iublic iswor. IsN. (pnmvaifr rytbm, fNt. . ,., . .
Appro¦imoN diracfion of wrfo dminaqe of lof. ApprozimoN sleq. hN.pw 100 fNt.
: Soil isr 0 Loum. ? 5 y bom. ? Cloy. ? Sandy clay. [] Goorw wnd or gravel. 0 Murdpan. ? Rock. Olhw
Numbor oi boMipo . If M&n o baamnY? [] Yw. [] No, lassmsnf droins b
fiaNrN in bo t: Cl bundry troy. 0 Toilet. [] BofhNb. ? Slwwor. ? None. ? Fber droin. ? Svmp pump• .
' leundrywe di"ml: Dincf. M? SNpopopif. Who. TFrouqhwmp pif fo, oSptie ionk. '? SNpapssyib.
? h fooli dmin proridod7 [] Yei. ? Ne. Droim bi C] Surfaa. 0 Dry well. Q Sump inbcwnmnf. OiMr
spwk or onaway dmin b: [] SuRoco diaharpe. [3 Dry vwll. Oqwr
o/ haw" wwv below fmisF prade al foundation, fosf.
YART 1 (Continusd on rowns)
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OCT I 07! 45-6395 '3UPERSEOE9 V0. F'ORM 26•6396, JAN 1403,
WMICN WIIL NOT BE USEO.
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PART I (?tknod)
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CO?n ??? i17 If/1MM/ M?OIL ?{ C011?10M O? ?OIMd ?1d ?O? 1?W?1 w OII OpINQ? ?OI ? Q11?111 Y WYd? dNO1? 111 ?10i?. ?
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rasrcctia+ or Momouu wAia saxr srsTw Nuoe w,
STAIE .? COUNIr ? ww mum Aunam ? owiwxs MKctw oAre of atsrtcna+
saMArwe a aarernw awKU?
!IS?KTIOM OF MIDIVDUAI SEWAGE4DR105M S115TlM ?40E Ari
? STAi! ?COIMIY D I.OCJLL 1lA/M
51CIIAi1M Of INSP'[C7r16 OINCW rmE
VA COMRIMKL NSRCIW
1M
fART il-FOR USE OF IME NEALTM DHART OFFICIAt REYIEWING ItEPORT
weo a+ rne aaouunow MWMM NeaoN A?a wNee, AvAruM uso.NAnaN,
n a+Ne orMaN a,xe (u»a) ,
O n.?e O c?r ??«,u oe?? a Hu.TM
iNAT TNIf pOMDUAI WAM SUAIY f1?S1EM 0-
? SATE/ACIOR? K A DOMESM WATER SYMIY ?O? TI? SW[C? PlOrERPI ,.,
? NOi SATS/ACTORY AS A DOMESf1C WAfER SUMLY K* TNf 51NJER rROrEtTY
W!0 ON T!! IIMORA1Al1ON U?Of1ED NOLOM. MO OTlM AYAItMLt MIMAM110N,
R K TNE OFlNWN OF iNE (CIeti)
? STAT! ? COINAY ? IOGI DBAiTMEM Of !lAl1X ,
-' iMAT 1M5 MbNDt1Al 3EWAGE4115IOSAI SYSTEM. WIRI RORR MNMBiANCt.
CAN !E EIIlKTEO TO /UNC710N SAiISFACfOMIY AND IS NOT I1RLLY TO QEAfE AN
? MISAMtARY COND1110N
? CANNOT K EXllCIED TO fUNC(ION SAIISMCTOMtY -
1lMAYIf . ?
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DAi! . , fKiHAlM Of KYIEY11H6 qRCII1 , ? . .
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?un m-wR usE OF vA oFFcE
I hove rwiewed 1M forpoiny and the psRinent VA Complanta Impecfion RipoA and rxommend fhal M+s ..
individual waNr wpply tyslsm bs considand ? Ausplabk ? Not'accepmbl?'
itdividual wwapadispowl sysbm bs eonsidand ? AeospAable Q Nqf acceprable ? .
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` i ne niarxiey i.ai?vraLuriebo) Auc. ;
1853 OLD HIGHWAY 8 • NEW BRIGHTON, MINN. 55112
, , ^-• 612-633-5477i. ,,xv 'r? neo.
TO ? D~.: • W??w? -e +r: r, < .. ,
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We find that the sample marked: DOMsliC weZl motsl?
at 736 Lasso Laue _ F?Eaa. Miztn.
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has the following analysis:
f . . . , .ii.:f
Nitrate aitroggsa loss 'Llmn 0.5 pI=
Snrfactanfs lesa ttm 0.1 pp=
Co2lforu graaP orraimm a11 negativo
(M lses thsn 2.2,400a1)
I certify thiD ?annVie oontorme to S3A & VA- .`- .
drinking sster ataadards tor t,hs abaw pnrtty
teste sad that iZ ma dra+m by a repraomtitivt
of Merklty bsborafiosUs iram tho welt wa Lhe
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' THE O IES
, By _
....;, : :: . -
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 736 Lasso Lane
Lot: 12 Block: 2 Addition: Saddle Hom
PID:10- 65800- 120 -02
Use:
Description:
Sub Type: e - Furnace & Air Conditioner
Work Type: Replacement
Description: Fumace & Air Conditioner
Comments: Questions regarding electrical perm
952- 445 -2840.
Fee Summary:
Ashley Orman
Contractor:
Standard Heating & Air Conditioning
130 Plymouth Ave. N
Minneapolis MN 55411
(612) 824 -2656
ME - Permit Fee (Replacements)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
equirements should be directed to Mark Anderson, State Electrical Inspector,
$50.00 0801.4088
$0.50 9001.2195
$50.50
Owner:
Matthew T Miler
736 Lasso Lane
Eagan MN 55123
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Issued By: Signature
Mechanical
EA078530
06/26/2007
ePermit
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
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