4650 Lenore LaneCITY OF EAGAN Remarks
Additian Ri dgecl i ff Fi rst Addn. Lot 31 /? Blk 9 Parcel #1(1 639R0 31/l QZ
Owner Street 4650-?-"?rC.GMIPt LQYIF, State Eagan. MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF,
STREET RESTOR.
GRADING
SAN SEW TRUNK 3 1980 184.49 12.30 15 147.62 C007671 2-18-82
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA
STORM SEW TRK 19$2 638.24
STORMSEWLAT 1982 955.45 5 955.45 C007616 12-23-81
Services 1982 637.75
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road Uni -?400.00 59091 1 15 86
WATER CONN. 500.00 11 11
gUILDING PER. 11445
SAC 595-00
PAR K
. ., . r .. .. . . . .. .. . .. .. . .. .-.. . . ,; . . .
CITY OF EAGAN r
3830 Pilat Knob Road, P.O. Box 21-199, Eagan, MN 55121
? PHONE: 454-8100
BUILDIkG PERMIT Receipt tt
19 is6
Tobeusedfor SF DwG?GAR Est.value ?Y60r()00 Date JANUARY 15
SiteAddress 4650 I.ENOF2E LN Erect CIC Occupancy iz 3
Lot 11- Block 1 Sec/Sub. RiDGF,CLIFFE 1SF16model ? Zoning l1,I
Parcel No. Repair ? Type of Const. v
Addition ? No. Stories
s Na me SON1S CnNSTRUCT ION CO Move ? Length d n I
Demolish ? De th 44
3 Address 4? ?70 RAH[? RD p?r
°, c;ty iiAGANPhone 452-4?21 InstsNPr. O Sq.Ft ?
?
I
cc ?:A
=
o Name ME:
,°? 0
-c Address
~ City Phone
W W Name ??E0 !'?i+t'ISFIEL?D
_; Address 920(1 3 5?i
aW Citv b1'?":'?`'i Phone 890-9000
I hereby acknowledge that I have read this application and state that the
information is correck and agree to comply with all applicable State of
Minnesota Statutes and City of Eagaq;Ordinances.
SignaWre of Permittee
A Building Permit is issued to: SONS CUIvSTROCTIC?N
all work shall be done in accordance with all applicable State of Minneso
Assessment Permit S 313.00
Water & Sew. Surcharge 30 . 00
Police Plan Review-156 50
Fire SAC 575 • 00 ?
Eng. Water Conn.5QQ OG
Planner Water Meter63a 50
Council RoadUnit 2$0 .00
Bldg.Off. 1/15/f3 Tr. PI. 132 •u u
APC Parks
Var. Date Copies
Total ?,' G, Ej 5U. G J
Co
on the express condition that
i Statutes and City of Eagan Ordinances.
Building
• PormH Na Ps6mit MWder Date TNaphone 8
Plumbin9
.4
:< lL aL
1 i
i
.
H:V.M.C. / ?
Electric
Soflenar
Inspectlon Date Insp. Commenb
F?n?e. i
Footings II
Foundation
Framin9
RooNng
Rough Plbg. ?Z 4 O? / ? ? ?/5 • _ C?
Rougb Htq. `e;
Insul.
Fireplace
Flnal Ntg.
Flnal Plbg,
Bldg. Final
Cert. Occ.
Dxk Ftg.
Deck Frmp.
Wall
Pr. Disp.
PERMIT # (0
MECHANICAL PERMIT RECEIPT # /
?/ 62L
/
CITY OF EAGAN
3630 PILOT KNOB ROAD, EAGAN, MN 55121 DATE
CONTRACT PRICE: PHONE: 454-8100
Site Add?ss 4650 Lenore g?, TypE WORK DESCRIPTION I
Lot 'S I Block a-1_ Sec/S?,b r - ?
? Res. ? New
Kleve HehYAqcT & Air C?S , I?
Name " i
Mult Add-on
? Addre ss130?5 Pioneer Trail Comm. Repair c City Fc?en Drairir phone 0'?1-4211 ?ef 11 I
5534n
Name
c Address
O City Phone
TYPE OF WORK
Forced Air M BTU
Boiler M BTU
Unit Heater M BTU
AirCond.' '"on-riS73-2E1 MBTU
Vent CFM
Gas Piping Outlets # rus'nac,:
aner
FEE
S/C:
TOTAL:
FEES
RES. HVAC 0-100 M BTU $24.00?
ADDITIONAL 50 M BTU 1
- ?.a0
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
,
?
,
? .;?-'.._,?',,v,??' -" .,;.?,
SIGNATURE OF PERMITTEE
1 t? II
FOR: CITY OF EAGAN
Receipt PLUMBING PERMIT Permit No.
CITY OF EAGqN . •
Fee
Fill in numbered spaces . S/C
Type or Print /egib/y Tot. ' 1. Date U`Al 2. Installation Cost
3. Job Address ' Lot - / Blk. Tract ?
> .
4. Owner
5. Contractor 1 ? Phone
6. Address
7. City ? State ' 2ip '
8. Building Type: Residential ?
9. Work Description: New ?
10. Describe
11.
Commercial ?
Add ? Alter O
Institutional ?
Repair ?
No, Fixtures
Water Closet No. Fixtures
Ce
UDr
i nf ield
_ Bath tubs upoo
a
Se
tic Tank
_ Lavatory p
ftner
S
Shower . ,, o
Well
_ Kitchen Sink
Urinal/Bidet Oth
_
Laundry Tray er
Floor Drains
Drinking 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 ordinanoes 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 454-8100
CITY OF EAGAN 454-8100
DEPT. OF BUILDING INSPECTIONS
* *
Correction Notice
Located at /79 S/?) ?-e-
I have this day inspected this structure and
these premises and have found the following
violations of city codes governing same:
When corrections have been made, please
call 454-8100 for inspection.
Date s-a_ 296, GZ) 7
Inspector City of Eagan
DO NOT REMOVE THIS TAG
' CITY OF EAGAN
: 3830 Pilot Knob R
SEWQ SC'
oad
P. O. Box 21199 RVICE PERwQR
iCagan
MN 55121 PERMIT NO.:
,
, Zonlrq: D^TE:
pwner . . No. of Untta:
Addrcss;
,
Site Addrcas:
, •; ,
Plumber. • _ _., ; _ s? -
I M?w te eNeiy' wMM Ib Glryr
i y
o
gan
"MIIp{, Conntdion Chorpe:
ACOOUrI} Dpppdh ' .
PamR Fes:
gy Surchorps: '
Dare of I
nrp.: Misc. CJwrpes: i
Totol:
Dota Paid:
CITY OF EAGAN
3830 Pilot Knob Road WATER SERVICE PHtMIT
P. O. Box 21198 PERMIT NO.:
Fagan, MN 55121 DATE:
Zoninp: -
OwMr: L,C;'2Ef . No. of Unitr.
^ddrom
$it! /1dd?eri' ;'`?.,?: -t••cO'c- '.li . „ ? n : _ ? ... . ._. ' ? ; i : i.
Plumber.
Meter No.: Connection Chorge:
Size: AcmuM Deposit:
Reoder No.: Pertnit Fee:
?oem te eew0l? wM6 1M pry of Gyan Surchorge: ?
OeJlnenoM. Miae. Chorpas:
Totol: '
BY Date Paid:
Dote of Irap.: Insp :
CITY OF EAGAN
3830 PilaFf Knob Rood WATER SERVICE PERl1A1T
P. O. Box 21199 PERMIT NO.:
Ea9on. MN 55121 D^?:
Z?i?• ' << I OZ t7R3 Cor, s t. No. of Units: ?
Ownsr;
Address:
Sita Address. + 0 Lenore ;i.i. st.
Plumber.
M!t!r Plo.: 36 -5 Jr/ J 3 9 r ? -
?°roQ' F'-
siu: ' ` ?? ?ir;,
Reodsr No.: ?.?n? 1 -?t?? F • ? ?
?eYM FO OOwl?r W1lII fM Clh bf?ssw
By
Dote of Insp.:
.)1?tL'Y' .
CITY OF EAGAN
BUILDING PERMIT
N° 11445
Receipt # ?2/0''
SF DWG/GAR 000
$60 JANUARY 15 86
Tobeusedtor Est.value ,
Date 19
SiteAddress 4650 LENORE LN Erect E6 Occupancy R3
Lot 31 Biock 2 Sec/Sub. RIDGECLIFFE 1SrJNemodel ? zoning Rl
Parcel No. Repair ? Type of Const 1.7
Addition ? No. Stories
¢ SONS CONSTRUCTION CO Move ? Length 40
= Name 4370 RAHN RD Demolish ? Depth dd
o Address
EAGAN
452-4721 ' Int. Impc ? Sq. Ft.
Ciry Phone Install ?
¢ SAME Aoorovals Fees
0
=U
oQ
U Q
?
Name
Address
3830 Pilot Knob Road, P.Q. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
Phone
u¢ GEO MANSFIELD
F W Name
?a Address 9200 35W
a W cih, BLMTN phone 890-9000
I hereby acknowledgethat I have read this application and statethatthe
information is correct and agree to comply w' h all applicable State of
Minnesota Statutes and ' of Eag ? rdi
?
i %
Signature of Permittee ?
A euilding Permit is issued to: SO S CONSTRUCTION/
all work shall be done in accordance with all aookcab eiState of Minnesa
Assessment _
Water & Sew
Police
Fire
Eng.
Planner
Council
Bldg. Off. 1/ 15 / 8 6
Permit $ 313.00
Surcharge 30.00
Plan Review 156. 50
SAC 575.00
Water Conn. 500. 00
Water Meter 63 . 50
RoadUnit 280.00
Tr. PI. 132 . 00
Var. Date Copies?00
Total '
,
on the express condition that
qta tes and City ot Eagan Ordinances.
Building Official
REQUEST FOR ELECTRICAL INSPECTION Eg-000O7-04
' See instructions for completirng this lorm on hack of Yellar copy.
10
"'ll" Below Work C9vered by This Request
A ^n???n? ? Or
~Aduirtlep.1 Type o1 Building I Apptiences Wired IEquipmen[ WirOd I
I I I I Duplex I I Water Heater I I Lightinq Fixtures I
Commercial Bldg. Furnace Silo Unloader
Industrial Bidg. qir Conditioner Bulk Milk Tank L. .... Other Deci v [har ISnerifvl
ction
p Fae ServiceEntrance5ize. M Fee Fenders?Suhteeders N Fee Circuits
0 to 200 Am 5 0 to 30 qm s 0 to 30 Am
Above 200 AmpS 31 to 100 Amps 31 to 100 A
Swimming Pool Above 100_Am Above 1Q0_A
Transtormers Irrigation Booms Partial-'Other Fee
Signs - Special Inspection $ ?-
Hemarks ?i : TOTAI. FE?E?J//?
w ? / ? VIVoVC, ?
flouBh-in 1 Date
1. ihe EI
? / lospectar. ereby
Certilr thBl 2hB abOVa
Final ( ? e jnspectiun hay 6een
made.
fhNreVuastvoldt8monthafrom ?
This request void S?y,iiiioy` 18 r??on[hs}rom
(VaA irs-
,"14yD
Re ired? -' -I?]flead¢'No?v []Wi11 Notify, laspec-I
cTQ,16 18? 1986 [?ves ? No tor when Neady
rf Licensed Electrical Contractor I hereby request inspection of above
? Owner electrical work imtalled at:
Street Address, Box or Poute No. City
4650 Lenore Exgan, NYnn
ection o.
Township Name or No.
Range No.
Counly
I I Dako ta
OccupantlPRINTI Phone No.
Sons Construction Co 452-4721
Power Supplier Address
Dakota h'Iectric F'arm8ngton , MBnn
Electrical Contrac[or (Company Name) Contracioi s License No.
Idelson Electric 04Z-545-9
Mailing Address (COntractor or Owner Making Instailation)
Webster, hltttn 55088
Autho e Signatu (Con
ne akin
scallalion)
Phom Number
7 1 461-2274
MNESOTq STATE BOARD OF ELECTRICI7Y THIS INSPECTION REQUEST WILL PIOT
Griggs-Midway Bldg. - Noom N-191 BE ACCEPTED eY THE STATE BOARD
1827 University Ave., St. Peul, MN 55104 UNLESS PROPER INSPECTION FEE IS
ow....e Ia171 V97-2111 ENCLOSED.
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
• CITY OF EAGAN
3830 pELOT _?046RD - 55122 ?
V
651
New ConsWCtion Reciuirements
? 3 registered site surveys showing sq. ?t oflot, sq. ft ofhouse
and ail roofed areas (20% maximum lot coveraae aliowed)
? 2 copies oi plans (show beam & window sizes; poured fnd. design; etc.)
? 1 set of energy calalations
? 3 copies of Vee preservation plan if lot piatted after 711/93
DATE:
DESCRIPTION OF WaRK: -f"Par[N(F CZZnC) i-e Iz
STREET ADDRESS:
LOT: ? BLOCK: SUBDJP.I.D. #:
Remodel/Reoair Reauirements
? 2 copies of plan .
? 1 set of energy calculations for heated additions
? 1 site survey for exterior additions & decks
CONSTRUCTION COST:
PROPERTY
OWNEIi
CONTRACI'OR
ARCHITECT/
ENGINEER
Name: WVn fivrM V r Phone k: 9:7 / S ?
Last First ?
Street Address: L&??? Lepoc& Lqlk-)?___
C i t y 0Q? ------ Stake: rn _n_ Zip: 52c7` 0- _
/ l a- ?iSS ?- O U LF
e#: ??6 -7 P
License # Fxp.
City _ ( m.`---- State: zP' s?-=! '7
Street
City.
Phone li: --------
___ _ Regist[ation #:
State: Zip:
Sewer & water licensed plumber (reauired for new construction oniv):
Penalty applies when address change and lot change is requested once permit is issued.
I hereby acknowledge that 1 have read this application, state that the information is correct, and agree to compty with aN appiicable
State of Minnesota Statutes and City of Eagan Ordinances.
, , . .. .. , Signature of Applicant: ?
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No RECEIVED
Tree Preservation Plan Received _ Yes _ No _ Not Required MAY 17 1999
BY:
r
,1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LIqENSED NITH THE CITY OF EAGAN
\
1
MMERCIAL
SINGLE FAMILY DWELLINGS
INCLUDE 2 SET OF ARCHITECTURAL
& STRUCTURAL LANS; 1 SET OF
SPECIFICATION, AND 1 SET OF
ENERGY CALCULATIONS
$2p000 LANDSCAPE BOND
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
To Be Used For : Valuation : Date :
r-----
Site Address f,fL„11r L d"- OFFICE USE ONLY
Lot 3/ Block Z
Parcel/Sub L/ 7'
Owner SG ia } CG/v
Address
City/Zip Code?
Phone '7 22 /
Contractor >G,crr
Address ?3' 6 )Z/+f?/? /llX
City/2ip Code h'/,u S J/L?
Phone yQ -. C/7?-1
Arch./Engr. (? G'e,
Phone # Erect K
Address 9 2-C?ri
City/Zip Code
Remodel ?
Repair
Addition ?
Move ?
Demolish ?
Int.Impr. ?
InstaZl ?
APPROVALS
Occupancy
Zoning
Type of Canst
lF of Stories
Length
Depth
Sq Ft
FEES
Assessments Permit
Water/Sewer ?
? Surcharge
Police Plan Review
?_....._.
Fire _...
SAC
Engr ? Water Conn
Planner? Water Meter
Council? Road Unit
&
Bldg Off reatment P1
APC Parks
Variance Copies
TOTgI.
???
'TRi - LAN D c o.
SURVEYI NG
SERVICES
4655 NICOLS ROAD
EAGAN, MINNESOTA 55122
iyR
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I \?
?
I
.... . .. ; 3?
io
i
I
I
I
SITE PLAN FQR:
SONS CONSTRUCTION
?
?
?
40
\
\
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?
\
?
MQ \
?«•?
\
;r
i
e l
G? N ?F
)M i ? \
111y"s
I
1
\ Q
t° LEtVORE LANE
Scale
t" = 30'
• ?? ~i? '.s??'.
-
PROPERTY DESCRIPTION
LOT-aL, BLOCK? ,
R1TY.F[LIFFE FiQST AOnlT10A/
accordinq to the recorded plat thersoi
DaKo,-a County, Minnesoto
LEGEND
o DENOTES IROIV MONUMENT PROPOSED GARAGE FLOOR ELEVATION = l02.00
? DENOTES WOOD HUB SET PROPOSED FIRST FLOOR ELEVATION = lo2.so
OENOTES EXIST I N G SPOT PROPOSED BASEMENT FLOOR =
ELE VATI ON ELE VATI ON
OENOTES PROPOSED SPOT
ELEVATION
? DENOTES DRAINAGE DIRECTION NOTE: VERIFY ALL FLOOR HEIGHTS WITH
FINAL HOUSE PLANS
I hersby certify that this survey, plan or
rsport was prepared by me or undor my,
direct supervision and ihat I am a duly
Reqistered Land Surveyor undsr the
Laws of the State of Minnesotu.
Bradley 0. ,$4enson, Mn. Req. No. 15235
Date * 10 .Sanuarx. 1986
:
, ?•?
? • .
EXTERIOR EPJVE*_,C?E AVERAGE rU ` COT?rJTATSO:I
,
Ot"INER
" T i 1 r?r SITE ADDRESS Qu 'u r_ yf
.------'HOh1EL>>
CONTRACTOR S?>?,; C`v,?,_:rii«rz??•,? c?. DAT^s T
-
Determine arorking square footage of each.
1. Total exposed wall area ....??;?j !sq. ft. x.1z = ?1-33': 10
2. Total roof/ceiling area, .... f?k sq. ft. x.026
Total exposed wall area above floor =
a. Total wall vrindcw area .... ........ ..... /, n,??
b. Total door area ........................ z>). , '
c. Total sliding glass area .............. ??)`?,
d. Total °ireplace ora21 area .............. •-
e. Total wall framing area (average 10%)... f. Total net wa11 area above floor ........
g. Total rim joist area . . . . . . . . . . . . . . . . . . . I .? c?, c? u
Total exposed Poundation area = ?,?_
h. Tctal foun3ation i,;indow area ..........
i. Total net foundation area 3bove grade .-7<
Determine "IU': value of each wall segment.
. I16.05?
a
X
b. X nu r , /3
c -__ '/6
. X nUn ;,
D. X ° -
e. /' 7.74
.
- g `vlf
?:
" .
f.
7 1 X U
?',. I d c-, o }( "U"
h.
°- X ,IUf: . Q
- .---?
---?---
. i. ?.77, 7)
X
nUf, ---
. v = ?
5?
3....' .............:......................... .Total o 1?
If iteri #3 is the same as, or less than item #1, you have met the
intent of 5BC 6406(c)2.
. ?. •
? . ,
?, •a 1'•
v • ?
Total exposed roof/ceiling area
J. ^zotal skylight area ................ .
k. Total roof/cei.ling framing area (average 10• 91't
1. Total net insulated reof/ceiling area ....... Determine."U' value for each roof/ceiling segment..
y
j ? --- x 1.U11
}C.92OtUn rDr? 74? _+ ;2.•7> .
1. x ,:v,, , ? ? ?f = :21. 3 3
4 ................................... ....... Total
If total o:' f.'4 is the same as,,or less than #2, you have met the
intent of SBC 6006(c)l.
A2ternate Hui
To utilize ihe total envelope
bq the sum of items {f3 and N4
iter,?s Iff'1 2n3 h 2.
' 1. + 2.
3. + 4.
I
iditig Envelope DesiF,a
syster, nethod, the values established
shall not be greater than the sur.:,of
s
a
.• ' 1 •'NUA 0 • I 0' 0 i' ' I? ' 71• 'OI•
•21' 1 • • •?? • ` •• ? ? 1 il ?I • • ; ktRa .
CITY OF EAGAN
APPLICATION FOR PERMIT SEWER AND/OR WATII2 CONNECTION
(Please Print)
1) PROPERTY ADDRESS : ? 43,6(7 4L° h/r^3 i^ Ey _.
LEGAL DESCRIPTION:
vision or
IF EXISTING STRti'CT['RE, DATE OF ORIGINAL BUILDING PERNffT ISSL?ANCE:
(Mon Year)
PRESENP ZONING/PROPOSID L'SE: R-1 SINGLE FAMILY
R-2 Dt'PLEX (Ztao Lnits)
R-3 TOWNHOt'SE (Three + Lnits) ( Lnits)
R-4 APARTMENT/CONDOMINIL'M ( Lnits)
CONMERC IAL/RETAI L/OFF ICE
INIDU5TRIAL
INSTI'It)TIONAL/GOVERNMENT
2) r... ,
NP.N1E: S?IYb.S QL.&L/C f! fi'1,
ADDRESS : 1127/) I?/-/yN
CITY, STATE, ZIP: bx
?
PHONE: m
3) • i:?- NAMEn For City Lse
: ` l '?'?.-rf gj.?v ? P1LUnbers LicensE
ADDRESS: 3 SoZ ive
crTY, STATE, ZIP: Al o R TH F`c L„12_ 4Expire
D?(p MASTEF2 LICENSE #O (
PHONE:
Staff 4) • . : . ,,. -,5'0y4-s' r. 6117A S ^
ah U
ADDREss: 413 rLI) /T?if?-N AU
CITY, STATE, ZIP:
PHONF::
5) i? ?• • a• a?.
? COi?]['.CTION TO CITY SEWER ? CONNECTION TO CITY WATER
Q OTHIIZ (Please Describe)
?'? • i
6)
?• PLEASE HOLD APPROVF.D PEE2MIT FOR PICK-t'P BY ONE OF ABOVE
/-
CJ PLEASE MAIL APPROVFD PII2MZT TO 1, 2, 3, 4, ABOVE
(Circle one)
7)
F O R C I T Y U S E O N L Y
PERMIT '-` ISSUED
F°TES : $ ?C?•;?U
$ /U .-5-o
$ (2 =? i.. .
$
$
$ /.C v c?
$
$
? !JU_G4'J
$
5
S
$
.. $
, $
?
T?i a U
$
.$
$ ! C?.Z. ?Cs
SE:':L.°. PER?1TT (I`ICLvDE SU?.C=?RGL)
WATER PERA4IT ( Ii1CL'u'DE SL RC.°.ARGL )
WATER METER/COPPERHORN/OUTSIDE READER
WATER TAP (INCLUDE CORPORATION STaP)
S?EE,dER TAP
o_..=?
ACrOUNT D.F.POSIT - Tr7ATER
WAC
SP C
TRGAIK 69ATER ASSESS:iENT
TRlii1K SE:JER ASSESSbIE^IT
LATEP.AL SE:IEFIT/TRUNK SE::TER
LATE:Zr},L BENEFIT/TRUNK WATrR
WATER TREATMENT PLANT SURCHARGE
OTElER:
TOTAL A?lOU;;T PAID/RECEIPT $3?
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
YES IF YES, THEN A"PERMIT FOR WORK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
? NO ENGINEERING DIVISION. LIST AS A CONDI-
TION.
SUBJECT TO THE FOI•LOSJING CONDITIONS:
APPRpVED BY:
TI:LE:
:
DAT° : // /?.??
Use BLUE or BLACK Ink
F . For Office Use ~/f I
non Permit
City of Ea I G
C Permit Fee: I
3830 Pilot Knob Road RSCFNEID I
Eagan MN 55122 1 Date Received:
Phone: (651) 675-5675 p t 7
Fax: (651) 675-5694 AQ~ Staff: I
INFLOW & INFILTRATION PERMIT APPLICATION
Plumbing / Sewer & Water
Date: 30 47// 7 Site Address: q63_0 L -e 1 0 L a, -e A-"
Tenant: ` kJ"-e_ 1`- Suite
Resident/Owner 9 Name: , ~i ~otir c -ter- Phone: ~z t l~ 2S°0 Address / City / Zip:
Name: License
Contractor Address: City:
State: Zip: Phone:
Contact: Email:
PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope)
Type of Work _As, Sump Pump Repair Repair
Other: Other:
a~ ~ ~wew Description of work • Sid ,,.Q
Description
r.3 Cf t' .,.f` ; ~~c.~ ~t „~'--~-c~ 4 ~ c~ ~ m~.,,t v °-~ar gi c~-~° w-,P!'- ~i'S~''r•
LFFE.ES00 /Each (includes $5.00 State Surcharge) TOTAL FEE $-1!5
~
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1l1 repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.citvofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call
48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 -Final
Use BLUE or BLACK Ink
r----------------�--�
I For Office Use �
I (� I
C�� O1 �� �� j Permit#: � �� /�� I
Y � � Q� a� �
� Permit Fee: � �' �
3830 Pilot Knob Road I � � � I
Eagan MN 55122 � Date Received: � � �
Phone: (651)675-5675 I I
Fax: (651)675-5694 � Staff: ... �
I I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
..;�" `
Name: �`.-c�S�U.Gi �Lc'_S�r� Phone:
Resident/ �.
Owner Address/City/Zip: ��S � [,-�-vtGi�� LG-��- , �a�'U�1J�
Applicant is: Owner � Contractor
Type of'Work' Description ofwork: ��- 'r��`
Construction Cosfi V���d Multi-Family Building: (Yes /No�
Company: ��I�V'�V�YV� �"�►'«�> �� �M C Contact: Jd s��^�'����`
Contractor : Address: �rC:�1� T���.�v� ����� 1.� s� city: �a�Ca�� Lrc�v�
� - State: iv`� Zip:�� ���� Phone: �S�"���5��� Email:��so�ti`�e ea;n`��c�o�' �'���ctr��(QYt.t
�
License#: ���� 7��� Lead Certificate#: ni
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 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.thaf you submit are considered:to be public information.:Portions of
the informafion may be classified as non-public if you pro�ide specific reasons that would permit the City to
conc/utle that they 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.qopherstateonecall.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 Minneso ta e Building ode must be completed within 180
days of permit issu nce. �'
r/_ � f;,:
x ,�(1�l'�t'`� � �
x �.
ApplicanYs Printed Name Applic nYs Signature
Page 1 of 3
Rug 21 2014 9: OOPM BRUCKMUELLER PLUMBING INC 6516882160 page 1
Use BLUE or BLACK Ink
r—�--- ---------�
iFor Office Use � ,
� j Permit tl: ��� j
G�t� of ���a� ; ;
' Permit Fee: � �
3830 Pilot Knob Road �
Eagan MN 53122 � Date Received: �
Phone: (659) 675-5675 i �
Fax: (651) 675-5694 f Staff: I
�---------------��k��
� �
INFLOW & INFILTRATIQN PERMIT APPLICATION Z��
✓ Plumbing / Sewer&Water � �i
Daie: � -a�y Site Address: �1�.�iC� L�Pnbr� L_�n E' �d
Tenant: Suite#•
_ �, �
'`�°�-�� '�F`" Name:�l?5�']_� �1'7e1�� �/�[e�.�2^�t , Phone: L2ja'�' �S7"3 70�'7
.«
RE&10��T''��E1� �►''-
'� � �'� J Address/City/Zip:�(,jG'L Vl �� � ���
, ,�, n
,_e<..;-:
'�t� :�, x ,. r^� ,l ,+
i ';,; � ' Name:_l�!`(�(:K/�''Zl.�i=-�ll,�` ���tr�»��`!1�► .�-�'�c�, License#: �Cp.l g`5/-,P�')')
; �
3 �`�'�����+ ��`7 ���v� Ca r
' y � a l�'"� t, : Address: I` t')l?c;c,',r�/�+''7d It /�}i/Clk,t C.� City: _L�=C2G��l�
���"�G���� state t� S/ �
�, �r� :�—Zip; � �� Phone: �P .� f..��i�B` L'Q,,C� 7n�
5
� 4 e
� �'� { Contact• �I`r',,,� ��p��Email: !� rY1
' __1r, � L � - .
� � ' � PLUMB/NG(Within the bui�ding envelope) SEWER 8 WATER(Outside the building envebpe)
a�`��� 3�
;lyR�°��,�y�(�*� ✓Sump Pump Repair Repair �
1 4 4g �?I�"' t ax
i �ya1R 4
y Other. Other:
��:
' �i �
�"'�t� �trt.i.: ..i.,.
a��,rp � a i� f'4
� r
x r � 1��� N.�p o
DES� '� N Descriptlon of work:����_�ccm f) l.at�c m� !)�iPl r n ra � r, � (..c��°��_
a s
� � �
:: � ,!i i
srV ,r
FEES
E60A�!Each(includes$5.00 S1ate 5u�arge) (�9O ,
TOTAL FEE s �C�''
*Permit fees will NOT be refmbursed by the City of Eagan. If you plan to submit I/l repair costs for
reimbursement,two quotea from qualifl�sci contractors must accompany this application. A list of contractors
can bo found by vlsiting wvirw.citvofeaaarr,com/inflow,ar City Hall at 383Q Pilot Knob Rd.
CALL BEFORE YOU DIG. Cail Gopher Slate One Call at(65��454-OOOZ for protecGon against underground utility damage. CaU
48 hours before you intend to dig to receive locates vf underground atilities. www.aopherstateonecall.org
I hereby acknowledge that this information is compiete and accurate; that the wark will be in conformance with the ordinances and
codes o/the CiEy of Eagan;that I understand this is rtot a permit,but onty an application for a pem�it,and wo►k is not to atad without a
permit;that the work will be in accarclance wfth the approved plan in the case of work which requires a review and approval of plans.
X �c,�.l�e �r�r��c'rnc,�p!l-er x ��
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