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4540 Greenleaf Dr WCity of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4540 Greenleaf Dr W Lot: 004 Block: 003 Addition: South Oaks PID:10- 71200 - 040 -03 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: Contractor: Controlled Air 21210 Eaton Ave Farmington MN 55024 (651) 460 -6022 X253 ME - Permit Fee (Replacements) Surcharge -Fixed Total: Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - $50.50 Owner: Kathleen M Haselberger 4540 Greenleaf Dr W Eagan MN 55123 -2058 Permit Type: Permit Number: Date Issued: Permit Category: Mechanical EA077280 04/12/2007 ePermit equirements should be directed to Mark Anderson, State Electrical Inspector, $50.00 0801.4088 $0.50 9001.2195 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 Issued By: Signature SEWER A WATER PERMIT CITY OF EAGAN 3830 Pilot Knob Rd. Eagan, MN 55122-1897 DATE SITE ADDRESS 1 LOT BLOCK APPLICANT: ADDRESS: CITY, STATE PHONE:' PLUMBER: _ ADDRESS:- CITY, STATE ZIP PHONE: OWNER: G rEU LiL ?IJ 9-[.9 X I4 (X.[ /t ADDRESS: "y,; Ho C% i? 2nl La A CI L CITY, STATE r 14 (x,4 N M N Zlth? y! ?? PHONE: 14S Z _6 121.) I'D m OFFICE USE ONLY METER # PERMIT DATE 8131 A9 CHIP # ?6 0 !k? 7 PERMIT # 10707 METER SIZE Z!Z cl B.P. RECEIPT # C 3263 ISSUE DATE 9r-7-9'9 B.P. RECEIPT DATE 812189 PRV -BOOSTER PUMP r .0 ZIP PERMIT REQUESTED SEWER WATER - TAPS - COMM/IND RESIDENTIAL NEW EXISTING Lawn Sprinkler Meters are to be Installed Ahead of Domestic Meters on Water Line. it WILL NOT be given for Deduct Meters. I AGREE O COMPLY WITH C"OF. EAGAN ORDINANCES SIGNATME WHEN METER ISSUED PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. SEWER & WATER PERMIT CITY OF EAGAN 3830 Pilot Knob Rd. Eagan, MN 55122-1897 DATE F SITE ADDRESS LOT BLOCK CITY, STATE PHONE: METER # CHIP # - OFFICE USE ONLY PERMIT DATE 8131,99 PERMIT # 10707 METER SIZE B.P. RECEIPT # C 3263 ISSUE DATE B.P. RECEIPT DATE 8/2/39 ,L PRV - BOOSTER PUMP jo PERMIT REQUESTED SEWER WATER - TAPS COMM/IND RESIDENTIAL 0 - NEW ? EXISTING PLUMBER: ADDRESS: CITY, STATE ZIP PHONE: OWNER: - Fizz i4 lcil' ADDRESS:'= W c? y l G' k rt _AL t rI % (J.? . CITY, STATE A /n ZIP; y PHONE: Lawn Sprinkler Meters are to be Installed Ahead of Domestic Meters on Water Line. Coedit WILL NOT be given for Deduct Meters. I AGREE TO COMPLY WITH CRT OF EAGAN ORDINANCES SIGNATURE WHEN METER ISSUED PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5224 FOR INSPECTIONS. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: ,ii l +! lint PERMIT SUBTYPE: f APPLICANT: [It'. .I 1 ., i 61 I: ttoI"1 4hI r,I 30 TYPE OF WORK: t I VAN1N+, ----------------- IN N RECORD PERMIT TYPE: Permit Number: Date Issued: ?++? ! I I+ ! NO 0 /_i7 1w4 Permft No. Permit Holder Date Telephone # S/W PLUMBING HVAC ELECTRIC ELECTRIC Inspection Date Insp. Comments Footings 1 ?' lJ Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final HIg. Orsal Test Final Plbg. Plbg. Inspector- Notify Plumber Const. Meter Engr./Plan Bldg. Final Alp, Deck Ftg. Deck Final Well Pr. Disp. Receipt MECHANICAL PERMIT CITY OF EAGAN Permit No, " r- Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date 2. Installation Cost 3. Job Address Lot Li Bilk. Tract 4. Owner 5. Contractor Phone 6. Address - 7. City State Zip 8. Building Type: Residential Commercial ? Institutional ? 9. Work Description: New [;?' Add X 1 10. Describe 1 11. Alter ? Repair ? Type No. Equipment BTU - M. Ea. Forced Air No. Equipment CFM ndlin Ai : H Mfg. g r a Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Air Cond. Other Mfg. Gas, Piping Outlets 12. 1 hereby certify that the above information is true and correct, and 1 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 4548100 CITY OF EAGAN Remarks Lot 4 Blk Parcel 0 71200040 03 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA STORM SEW TRK g/ STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK PERMIT # -' Y I MECHANICAL PERMIT RECEIPT # CITY OF EAGAN ; ( . DATE: 3830 PILOT KNOB ROAD, EAGAN, MN 55122 CONTRACT PRICE: PHONE: 454-8100 For Office Use Only: ' Site Address --- < BLDG. TYPE WORK DESCRIPTION Lot Block Sec/Sub x New Res. - ' .- Mult Add-on A? 7 Name ` 2 6F - Comm. Repair Address _ ?' - i = Other c ti Cit Ph " L" y one FEES c Name l- ? - y " ^ ) RES. HVAC 0-100 M BTU ADDITIONAL 50 M BTU -$24.00 - 6 00 Address ' L i k . Cit s ?, . Ph - / (RES. HVAC INCLUDES A/C ON NEW p . y one CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1 50 EA ` . . TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLIES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMODELS - 12.00 Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 Vent. CFM (ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets # BEYOND $1,000) Other FEE: y° ?? T Si N UR ?F P MITTE S/C: d ?10 TOTAL - FOR: CITY OF EAGAN / /?yPLUMBING PERMIT L'd' ??l I ea t For ?,G CITY OF EAGAN PERMIT # CONTRACT 3830 PILOT KNOB ROAD, EAGAN, MN 55122 ---- -- PRICE PHONE 454-8100 Site Address _j k 0 !L ?-LF}F Lot 9 Block Se??SUh Name Address c City Phone Add CRY Phone FEES COMMAND. FEE -1% OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APLUES MINIMUM - RESIDENTIAL FEE $12.00 MINIMUM - COMM.IND./FEE $20.00 STATE SURCHARGE PER PERMIT .50 (ADO $.50 SIC PER EACH $1,000 OF PERMIT FEE) t0. e Res. Mult. Comm. Other RES. PLBG. LY - NO. Water Closet - Bath Tubs - $3. Lavatory - $3.00 Shower - $3.00 Kitchen Sink - $: Urinal/Bidet - $3 Laundry Tray - $ Floor Drains - $1 Well - I Private Rough DATE: a / of L a 7 WORK DESCRIPTION New Add-on Repair COMPLETE THE FOLLOWING: FIXTURES TOTAL .00 $ (ts-$1 PER F -$10.00 Igs - $1.50 PERMIT FEE: STATES SIC: ~GRAND TOTAL: T-=--, PERMIT # ? -3 ?l MECHANICAL PERMIT 7 40cr CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT # DATE: 7 J CONTRACT PRICE: PHONE: 454-8100 For Office Use Only: Site Address'-' BLDG. TYPE WORK DESCRIPTION Lot Bloc k` Sec/Sub Res. New -" ' Mult Add-on Name `Z ? ' Comm. Repair Address J2 c City Phone `'y ' - l ' 1 ,7 . Other FEES Name ) 4 RES. HVAC 0-100 M BTU -$24.00 ADDITIONAL 50 M BTU - 6 00 3 p Address City j - , iv Phone . (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1 50 EA TYPE OF WORK . . COMM/IND FEE - 1% OF CONTRACT FEE Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLIES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMODELS - 12.00 Air Cond. M BTU $ MINIMUM COMMERCIAL FEE - 20.00 Vent CFM STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets # B OND $1,000) Other + FEE: - ?r 4, ' SIGNATURE, F PERMITTEE -` S/C: 62 ?S '? ` '?? f ' TOTAL- ' F R ITY F A : C E GAN O O Minnesota State board of Electricity 1954,University Ave., St. Paul, Minn. 55104-Phone 645-7703 REQUEST FOR ELECTRICAL INSPECTION CHECK BELOW WORK COVERED BY THIS REQUEST P 68291 Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For Home ? ? ? Range ? Temporary Wiring ? Duplex ? ? ? Water Heater ? Lighting Fixtures ? Apt. Bldg. ? ? ? Dryer ? Electric Heating ? Commercial Bldg. ? ? ? Furnace ? Silo Unloader ? Industrial Bldg. ? ? ? Au 'lion Bulk Milk Tank ? Farm ? ? ? List' List Other El El ? Hei Herers# COMPUTE INSPECTION FEE BELOP Ar`0 W L`? Service Entrance Size: # Fee Feeders&Subfeedeis: # Fee Circuits: # Fee 0 to 100 Amps. 0 to 30 Amperes 0 to 30 Amperes 101 to 200 Amps. 31 to 100 Amperes 31 to 100 Amperes Above 200_Amps. 1 1 Above I00_Amps. Above 100 Amps. Transformers 1 1 Remote Control Circ. Partial or other fee -? Signs 1 1 Special Inspection Minimum fee $5.00 ,4 d-CJ Remarks TOTAL FEE Ile I, the Electrical Inspector, hereby certify (Final) This request void 18 has been 7dae. pate ,Date EAGAN TOWNSHIP BUILDING PERMIT Owner .................. ......,-I -...........-----------•--. ........---------------*...--- Address (present) ...1. .T...°. ?t?....o......J Builder ........ 101.4_ ...................................................... . Address ..................................... .-------------------------- ----- ---------- -- DESCRIPTION N® 2689 Eagan Township Town Hall i-/." 2_ Date .....°° .................._.................. Stories To Be Used For Front Depth Heigh! Est. Cost Permit Fee Remarks Got 161ockc AMU= Or Tract This permit does not authorise the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and general welfare to anyone in the community. THIS PERMIT MUST B , EPT ON THE PREMISE WHILE THE WORK IS IN PROGR SS. This is !o ce:lify, that ...,... t%...._ ......... ......_..............has permission to erect a..-.. .......... - . •°.•.......... upon the above described premise subject to se provisions of the Building Ordinance for Eaga Township adopled April 11, 1955. /7 ............. .............X.Y.' "°.`..................... ...... ?%??........ Per ............_....._ 4"` P ....... .........`...: `.:.:........................ Chairman of Tnwn Board Building Inspector 6 16 TOITJ OF EAGAN 3795 Pilot Knob Road Eagan, Minnesota 55121 PERMIT NO. 233 The Board of Supervisors hereby grants to George Haselberger of 1740 Marion - Apt. 15 a PLUMBING Permit for: (Owner) SMAe at 1L9i0 W. Greenleaf Drive Eagan , pursuant to application dated 6/29172 Pee Paid: PO-On Dated this ;)}h day of Jnno , 191. .50 8/0 Building Inspector BLDG. PERMIT NO. 4%116 w . 6UM IMJ Q,. I n4- 11 NG,, 13 Srn -l h 63,t c 01-3210 Bldg. Permit 01-3445 Surch./Adm. 01-2155 Surcharge 013422 Plan Review 79-3866 Sewer Conn. 20.2275 SAC 01-3446 SAC/Adm. 20-3865 Water Conn. 20-3716 Water meter 20-2252 Acct. Dep. 20-3713 Water Permit 20-3743 Sewer Permit 20-3868 Water Trmt. 75-3860 Road Unit 28-3855 Park Ded. _CZSIO W TOTAL L/?.? S 6?/cS TOWN OF EAGAN 3795 Pilot Knob Load Eagan, Minnesota 55121 PERMIT NO. The Board of Supervisors hereby grants to ind a Permit for:Rac( t. M7n" at WELL , aggtWrj6;6)e? cation dated 4540 W. Greenleaf FeWg4tdk9g 1972 Dated this $10.00 .50 a/c day of , 19_ 19 July 72 Building Inspe, or G I TOIFN OF EAGAN 3795 Pilot Knob Road Eagan, Minnesota 55121 PERMIT NO. 104 The Board of Supervisors hereby grants toHeierke Trenching of Oliff Road# Eagan a CESSPOOL Permit for: (Owner) HasselbOg at 115110 li Greenleaf D , pursuant to application dated 7/13/72 Fee Paid: #10.00 Dated this 13th day of 'TUB 1972 SIC -50 Building Inspector 1 REOLIEST FOR ELECTRICAL INSPECTION s.00001-09 See instructions for completing this form on back of yellow copy. 111. 7 3?q S X" Below Work,Coyered by This Request Ne yep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm,/Industrial Furnace Other (Specify) Farm Air Conditioner Other (specify) Contractor's Remarks: G gt^AO?L (a,ejw Compute Inspection Fee Below. # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Above 100 -Amps Signs Inspector's Use Only. TOTAL O Irrigation Booms "7n'V Special Inspection Alarm/Communication THIS INSTALLATION MAY B DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. ' I, the Electrical Inspector, hereby tif th t th b i Rough-in • Date ?i Y/ cer y a e a ove nspection has been made. Rural 112 /7'" Date ? / OFFICE USE ONLY I/Q_A-F WWI __ I This request void 18 months from ?/ 0=100®967 0 av 4 &3 0 0 sr - Req est at p Q Fire No R ugh-In in lion Required (You mu all inspector when ready) Ins action Other Than R n Read Now ill Notif ector Ins S 0 7 ? y y p Yes No Date Rea 1 ? licensed contractor Z Owner hereby request inspection of above electrical work at: Job Address (Street, Box or Route No) City Section No. Township Name or No. Range No. County ((?? QQ O ant(PRINT) `F i2 Af' Ph No. 4a'Z- -a X30 Power Supplier Address Electrical Contractor (Company Name) Contractors License No. Manion ress IContract or Owner Making Installation) ih r ed Signature ntractori ner Making Installation) one Number r MINNESOTA TATS BOARD OF ECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room 5-128 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55106 UNLESS PROPER INSPECTION FEE IS Phone (612) 602.0800 _ ENCLOSED. This request void 18 months from J/ w 7 -;7 / ?? Sa?fho Date of this Request 68291 ?t/ - I, as ? Licensed Electrical Contractor wner, do hereby request inspection of the above electri- cal wiring installed at: Street Address or Route NoS`?` Section Township Which is occupied v Range Is a roughin inspection required on this 'ob? NO Yes ?? (Electric Con/ tC?? or or?Owner Authorized Sienature PowerSuppli?r,` ?'.? Addrdss Electrical Contract or?? (Company Name( Mailing Address V Ready Now Q v Wi Call R( Contractor's License No. _ Nod?-?? ? miecVleat contractor or owner gll)Rmg j nos instauatwn) S???'L- ME E Oply (? This inspection request will not accepted the State Board unless proper inspection fee is enclosed. INSPECTION RECORD CITY OFEAGAN PERMIT TYPE: BUILDING 3830 Pilot Knob Road Permit Number: 021583 Eagan, Minnesota 55123 Date Issued: 07/27/93 (612) 681-4675 SITE ADDRESS: LOT: 4 BLOCK: 3 APPLICANT: 4540 GREENLEAF DR W HASELBERGER GEORGE SOUTH OAKS (612) 452-6130 PERMIT SUBTYPE: GARAGE/ACCESSORY 7 TYPE OF WORK: ADDITION --------------------- ------------ J cr rY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 PERMIT PERMIT TYPE: Permit Number: Date Issued: 71 021583 07/27/93 SITE ADDRESS: 4540 GREENLEAF DR W LOT: 4 BLOCK: 3 SOUTH OAKS P.I.N.: 10-71200-040-03 DESCRIPTION: U8C Occupant ovil4inq tell Building W14 B4111diri-Permit Type BuIldittg k1 rk Type nt ,per GARAGE/ACCESSORY ADDITION M-1 23 22 CrJL3 M REMARKS: FEE SUMMARY Base Fee Surcharge Total Fee VALUATION $90.00 $3.50 $93.50 $7,000 UUN 1 KAU I UK: OWNER: - Applicant - HASELBERGER GEORGE 4540 GREENLEAF DR W EAGAN MN 55123 (612)452-6130 I hereby acknowledge theta I have read this application and state that tie information 3s correct and agree to comply with all applicable state of 114n. Statutes and City of Zagan Ordinances: 19 ?APIEE-SIGNATURE ISSUEb : SIGNATURE kRMIT CITY OF EAGAN REACTIVi4iiT 1993 BUILDING PERMIT APPLICATION 681-4675 sq?. F f Jim SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month. in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date Valuation of works ?J Site Address: 6z 'e _A fiN ShN. v? iZ3 STREET SUITE N Tenant Name: (commercial only) LOT y BLOCK 3 SUBD. ? ? P.I.D. N v JGJi/ OA/ ? ?? O? . Description of work: t The applicant is: 2 Owner ? Contractor ? Other (Describe) Name r 2G?Z G% ,Z-Z- Phone Property LAST FIRST ,,9 FT0, o? 9o P<" Owner Address Z?Z STREET STE k City FLA&An! State 07A/ zip 'J'j /Z'3 Company Phone Contractor Address ?'I fly License # Exp. City State Zip Company Phone Architect/ Engineer Name Registration # Address City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that ave read this apppplication and state that the information is correct and agree to compl ith all applicable State of Minnesota Statutes and City of Eagan Ordinances. j Signature of Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE Iff 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 03 SF Addition ? 08 8-Plex 0 13 Garage/Accessory ? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 05 SF Misc. ? 10 Multi. Add'l. ? 15 Deck WORK TYPE ? 31 New ? 33 Alterations ? 35 Tenant Finish I0 32 Addition ? 34 Repair ? 36 Move GENERAL INFORMATION . ? 16 Basement Finish ` ? 17 Swim Pool ? 18 Comm./Ind. ? 19 Comm./Ind. Misc. ? 20 Public Facility ? 21 Miscellaneous ? 37 Demolish Const. (Actual) Basement sq. ft. MWCC System (Allowable) 1st Fl. sq. ft. City Water UBC Occupancy M-1 2nd F1. sq. ft: - PRV Required Zoning Sq. Ft. total Booster Pump M of Stories Footprint Sq. ft. N,7- Fire Sprinkler _ Length On-site well Census Code 7qJ 8 Depth 2z' On-site sewage SAC Code APPROVALS Planning Building Assessments Engineering Variance REQUIRED IN SPECTIONS ? Site EZ Footing IR Framing ? Insulation ? Wallboard R Final ? Draintile ? Fireplace Permit Fee R0, 00 valuation: $ 7000 arge PlanhReview 3.5? 16_ 6997, License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pg. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC % SAC Units CITY OF EAGAN SEWER R WATER CONNECTION CHARGES - 1989 EXISTING PROPERTIES SEWER CONNECTION CHARGES SAC $ 675.00 Previously Pd. Receipt # ACCOUNT DEPOSIT 15.00 SEWER PERMIT 10.50 TOTAL: $ 700.50 WATER CONNECTION CHARGES WATER CONNECTION $ 580.00 Previously Pd. Receipt S WATER METER 90.00 TREATMENT SURCHARGE ACCOUNT DEPOSIT WATER PERMIT PLUMBING PERMIT TOTAL: TOTAL FOR SEWER & WATER HOOK-UP: $11636.50 OFFICE USE ONLY PROPERTY OWNER :1I r1?s ?1 c? cA, pQ ?s Q , t ADDRESS: qS TELEPHONE S: q S 1 3 L:? B: J ADD: SAN " 228.00 15.00 10.50 12.50 $ 936.00 WAIVER OF HEARING OF SPECIAL ASSIGNMENT City Project No. 536 I/We hereby request and authorize the City of Eagan, MN (Dakota Co.) to assess the following described property owned by me/us: Lot 4. Block 3. South Oaks Addition for the benefit received from the following improvements, constructed under City Project No. 536. Said assessments have been preliminarily computed as follows: ITEM QUANTITY RATE AMOUNT PROJECT Sanitary Sewer Lateral 1 ea/lot 3,943.00 $3,943.00 536 Water main Trunk Area 1 ea/lot 655.00 655.00 536 Water main Lateral 1 ea/lot 3,252.00 3,252.00 536 Services 1 ea/lot 929.00 929.00 536 Storm Sewer 1 ea/lot 934.00 934.00 536 Street 1 ea/lot 7,361.00 7,361.00 536 TOTAL $ 17.074.00 to be spread over 15 years at an annual interest rate of 9% against any remaining unpaid balance. The undersigned, for themselves, their heirs, executors, administrators, successors and assigns, hereby waive notice of any and all hearings necessary, and waive objections to any technical defects in any proceedings related to these assessments, and further waive the right to object to or appeal from these assessments made pursuant to thins agreement. / Dated:( /)(16 / 6? h 17 Geore D. Has ?itC?t?c% / J') K thleen M. Haselberger STATE OT?/Ht'?'%(.L?s'?Un-? ) )SS COUNTY OF ?? C ) On this .xS day of before me a Notary Public within ?Td? for said Coun personally appeared 6'erorG/` 7.ArNGfE ? 94? f&ofo me personally known to be the person, des ribed in and who executed the fore oing instrument and acknowledged that executed the same as y free act and deed/ Nctary,IPlic NUAILYN L NNCNEAPFENNIC j 1,,, NOTARY PUBLIC - MINNESOTA APPROV`D DAKOTA COUNTY My Cominlsslon Exp. Feb & 1999 Eagan Public Works Director t•.i:-*;r*;t.i-TUir=NSOCTION ILA? F!-':xS SPECTAi_ ASSE PROPERTY I.D. TO DAYS 10-71200-040-i'' S. P.0 ASSESSMENT OEtSCR. YR YRB SPECIAL ASSESSMENTS ±EiSMENTS SEARCH SUN MARY DATE: 02102/89 _____-SPECIAL FLAGS----- RATE TOTAL ANN.PRIN. PAYOFF COMMEN7 100814 SS -Wk. F-,. ??. 1,_, J.i. f_i _ / 01. f'.'_ii .. (;t_; f.%_ _, ,_,_i_..a :il 100815 S-l f- Kr 83 13 10.00% 370 .00 . 00 .00 t 1'? CLOSED 336 SOUTH 11411<::S 11rTi_. '';, ..o Itr, 0 ii.;zj 17074 ,00 17074.00 17074.00 F f-: N:.; SU NMARY JF ACTIVE .00 .00 •.00 uat a THIS YEAR' TOT P&I .00 ,„ ,...K.,,,f..e_w. .. SUMMARY OF ;=''IEi'•lL1.NG 170r4 .00 170=4.00 CITY OF EAGAN Remarks Addition South Oaks Lot 4 Blk a Paroal_ Q 71200040 03 ni, Owner?i Street 4540 r nnlnag ? - P I1L'. ?rate l J Improvement Date Amount Annual Years Payment Receipt Oats 1 STREET SURF. STREET RESTOR. GRADING 0. ?OO 94.'67 15 37() n() con A96 i S EWER LATERAL WATERMAIN WATER LATERAL WATER AREA STORM SEW TRK g/ 0517 nn rnnArgA 30 26 8-31 TORM SEW LAT_ S - - CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK i r.. ?S M, Ell qty ;. ?iC .dlr `'?' r tNI ?+ Yi1 rl: M? ' .' vel cl•••o••? ?0,®,:;t3a?,?fJ q-? , ?r 'T In Ilk n jFiF*****^ T=;ANSAC T I DN ID: 8765 SPECIAL ASSE PROPERTY i.L. TODAYS 10-71200-040-07 S.A.# ASTE22P"IeNT Le.'._'OR. YR YRS SPECIAL ASSESSMENTS SMENTS SEARCH SUMMARY DATEK 00/02/Bi ---SPECIAL FLAGS---- 1-2-3 -4-5-6._ 7 _.8-9-1 () RATETOTAL -ANN.PRIN. PAYOFF COMMENT 10OB14 ,_c - R!:: 83 15 10.00% W7.05 .00 00 CLOSED 10OB15 S-TRK 83 15 10.00% 370.00 .00 .00 CLOSED 1OP536 SOUTH OAKS UTIL .. ST 00 0 .00% 17074„00 17074.00 17174.00 PEND ate x SUNMA::Y '_F ACTIVE .00 .00 ,c; irtkri:# THIS YEAR'S TOT P&I .00 **x ex.r SUMMARY OF OENDINL 17074.00 17074.00 V f (/J day MASTER CARD 0 OWNER STRUCTURE AND LAND USED AS - 3-Se...&O. • Permit BUILDING PLUMBING CESSPOOL - SEPTIC TANK No. 2/%89 2.33 104 Issued y-zSs 79 Issued To Contractor Owner WELL ELECTRICAL HEATING f' 1 GAS INSTALLING . SANITARY SEWER OTHER OTHER Items Approved (Initial) Date Remarks Distance From Well FOOTING s 21 -!7 SEPTIC FOUNDATION CESSPOOL FRAMING TILE FIELD FT. FINAL ELECTRICAL HEATING - Iry JI/ DEPTH OF WELL _ GAS INSTALLATION ! SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING WELL SANITARY SEWER I Violations Noted on Back COMMENTS: .r -? AR5--) 2006 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 1$ -10 (DO) New construction Requirements Remodel/Repair Requirements Ollice Use Only 3 registered site surveys showing sq. ft. of lot sq. ft. of house; and all roofed areas 2 copies of plan showing foolings, beams, joists Cent of Survey Recd, Y. _N (20% maximum lot overage allowed) l set of Energy Calculations for heated additions Tree Pres Plan Recd _Y -N. 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Required _Y ?._N I set of Energy calculations Addition- indicate ifomsde septic system On-site Septic System _Y _N 3 copies of Tree Preservation Plan Slot platted after 711193 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form 31 /? Date o q / Construcon Cost S O(9,9 -0o , L Site Address 'T S q (' Lke s f ? t' PQ Iq g? Unit/Ste # Description of Work o 0- ©sY` s ?S Multi-Family Bldg _ Y Y N Fireplace(s) _ 0 1 - 2 Property Owner 915ellk' Telephone#(ol) yJ? ?l ?O Contractor f` ` (2an 'C rw 11 h?- Address f ? - C? ?( [.Gt 7 City ` / State 41 /t/ Zip $Y/0'q Telephone # (6(I) a!? l R COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (J submission type) Submitted Submitted . Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? - Y - N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( Telephone #( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; 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 ' the case of which requires a review and approval of plans. 164(5 (U. .? r V?4 Applic is Printed Name ' - pp tcant's Signature ' rrR.+rrmm.yrr -x•v.~u.w+,~.. ~.y..~.,+a of ...r.~wrw..ro .an aw.n.i. ~w~~+~'.w..irwa.w+n~Yw.~m~"...'~m~.,w.i~~:wF~n.~w.~re, q5n ~m~e. mp MV .4 vG. ^ ~~w.>~.....~w.........~..e.iw.a:.,•..n.....u .n~-.v.w.n~'~v~w~=~w.n+w. +...wa.. .w.+~.~+..nMr.~..w...~ ~k. ~ ti~~~~~~ e ® t _ i 1 n 4 s _ 1 { i R i~i { 1 f F 1 i ~ ~ ~ ~ ~ ~ I 4 i r ~ 4 F { f 3 7 i E r i p ~ ~ ~ ~ 9 x i ~ ~ _ i ~ ~ ,p If ~ f ~ r 1 R _ ~ ~ ~ / ~ ~ f ~ ` 7 E I i Y ~ _ ~ ; i I S ~Ro "v~ ~ i 4 - p ~ 9 r i N i i y r ~ ~ 4 i ~ j j I t _ _ _ _ 3 I r ~ i f 1 I ~ ~ ~ 1 ~ i~ i f 1 t i t } ~ ' ~ i ~ t ~ i J i j ~ I t ~ i .._v~. _ _ k a . ~ _ ~ _u.....:.. ` 1 2 - f ew~~ ~ i. w J. ,.a ,....N ~».~,•.w~av.,~~ W< m.M1m... ~cea.c.... s,...w.. .....n.w,,...ch.......~,.N.r.,q,.,w.n~r vn..n rn. w +...ww.. upr~.-,w ,a i ~ ~ - ; i i r t R _5 3 Y.~. - t *`j 4 2 ; ~ S. - ~ ~ F' re ~,s> , r~ „ ~ r' ~JQ 9 2 ® x s ~p(d5 a _ tE~C ~stiiJO® < 22® x ~i' ~ a ~ CAF , C ~ X e 4~~~ '?gZ~?~~~? `.o t 'fi e ~ ~ g i 3 f a ~ . ~ ;r a ~ / f I < ' n4 I ~ VV ~ d W.u.2~fmNmnbMhv+aY~+$+i'J!n.+..1. 1~'LtY j4~ t't s. e ~ 3 ~i f~ T. k V ¢ n ~ r ' ~ ~ ~ ~ ~ s I ~ p ` ~ J, a t ~ a . ~ Z ~ ~ ~ ti G $ q t ~ 4 s ~ ~ r l f, ~ ~ a: ~ , - ~ a ~ ~ ~ J A A a ' ~ + S` ~ y $ a i; ~ ' 5 eA E r p ~ 1 i ~ S _ P I: a ~ ~ ~ ! R _ ~~xwe.~:~~ t i A g ~ < y 1k ~ 4. ' r i ~ I' e ' - i.. i ~ ~ { _ t 1 z t d ~ 5 s a i K M ~ # _ f, n i i p s t ~ r R ; 1 ~ , ~ n - ; - , t r. ~ S t t ~ PF'~^,r,.<, c 1 ~ ~ ~ - ~ ~ ~ r" _ r< 9 e ~ r, { DaaWL ~r ~ a `-r , '~r ~ ~ ~ ~ i_ 1~ _t E CAS 4..: A 1 PERMIT City of Eagan Permit Type:Building Permit Number:EA113373 Date Issued:09/03/2013 Permit Category:ePermit Site Address: 4540 Greenleaf Dr W Lot:4 Block: 3 Addition: South Oaks PID:10-71200-03-040 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 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 - Kathleen M Haselberger 4540 Greenleaf Dr W Eagan MN 55123--205 Action Roofing & Siding Llc 1315 Southview Boulevard S St Paul MN 55075 (651) 457-2642 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink r For Office Use Permit#: 1 3 3a Gj /' * City of E � Permit Fee: /0�' a-3 CC_ 3830 Pilot Knob Road RECEIVED , Eagan MN 55122 Date Received: 6-1?'/7 Phone: (651)675-5675 JUN 1 2 2016 Fax: (651)675-5694 Staff: 2017 RESIDENTIAL UBUILDING PERMIT APPLICATION Date: ( _c 2-6(`( Site Address: LJc/ U 6-" uCfr- � - X67— Unit#: Name: ® \V l�r I L ) ('-1��ezQ 6Z.& Phone ( — l Resident/ OWner Address/City/Zi `7p: S 7 �"td1t /� ©2 (,W�-J Applicant is: Owner YContractor Description of work: � G/4'�f £� 'cxe Type of Work Construction Cost: /6` G Multi-Family Building: (Yes /Nom ) Company: 7A-'(') C1 f/e-1 (Cu'fl-14"744✓C 2L4��C./ Contact: Ok(611") NO/11/3-r.e _Contractor Address: /re -tuer— 7/" SP`2f=t,1- City: QCcC'Mf/(�fin' Stat Zip:J J '�� Phone: 9&2- vo3— Email: /'b' � c_ License#: ((�S�/ Lead Certificate#. J# /://0-5:57 — If the project is exempt from lead certification, please explain why: 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: Fire Suppression Contractor: Phone: NOTE:Plans and supportingdocuments that you submit are°:considered to be public information." Portions of the information may be classifiedas if you provide specific reasons hat 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.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 . .lans. Exterior work authorized by a building permit issued in accordance with the Mi •sota ate Building Code must be completed within 180 days of permit issuance. te.(44,/ //o (ii fri I Ap cant's Printed Name X licant's Signature 'pP 9 Page 1 of 3 ' For Office Use Lfil .`� ; s Permit#: /.5a&S i /-r r� EAGAN '` i� .0 ., 11I t ....0 Permit Fee: 1 i/47.73- ..... Date Received:'-.7 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 R_CiTVET rk I (651)675-5675 I TDD: (651)454-8535 I FAX:(651)675-5694 Staff: buildinqinspections(a)cityofeagan.com O 18 L JI JUL 1 2 2 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: ./S-51-0 W 4 etzicFetkEicrr a i , Unit#: -mac m / 6D511 1-4 - 013a Name one: Re i en#/ �'} ,,1 ;9- lner / ' Address/City/Zip: \, 7"CJ • G-7(4. --)0( f�J reft-01110 �N �03 "�'t Applicant is: Y. Owner Contractor x r Description of work: tyat V / LEr �- ' pe Werk Construction Cost, GOO 10'b Multi-Family Building:(Yes /No ) x Company: Contact: Contractor Address: City: �" State: Zip: Phone: Email: License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: 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: Fire Suppression Contractor: Phone: ��v NOTE Pians Suppression C ortr docu ents that you s r it ` , `e si bfi ®rm+ation Portions:fat:: /on a+die class�edas.non publip f p provide specific r � that.tii ould permit the C tyto .c , the ..are secrets.`, t,yp .p � � y �# 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.citvofeacian.com/subscribe. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. CALL BEFORE YOU DIG. Call Gopher State One Call at(6.51)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 a rda ce with the approved plan in the case of ork which requires a review and appro,al o,plans. x "I `EENJ illige Lie6A. rI�'IV'' 7) .-C� Applicant's Printed Name Appl ant's Signature 6iZeekk,z1( / �DO NOT WRITE BELOW THIS LINE // 7//� GQ-(.U. /506, / SUB TYPES Foundation Fireplace _ Porch(3-Season) Exterior Alteration (Single Family) Single Family Garage _ Porch(4-Season) _ Exterior Alteration (Multi) Multi 1_ Deck _ Porch (Screen/Gazebo/Pergola) _ Miscellaneous 01 of_Plex Lower Level Pool Accessory Building — WORK TYPES _ New — Interior Improvement _ Siding _ Demolish Building* yAddition _ Move Building _ Reroof _ Demolish Interior Alteration _ Fire Repair _ Windows Demolish Foundation _ Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION Valuation )__ ( p'V Occupancy .01...i." MCES System Plan Review Code Edition j'" SAC Units (25%_100% )() Zoning City Water Census Code ((\\ Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: x Footings (Deck) Final/C.O. Required ( Footings (Addition) y' Final/No C.O. Required Foundation Foundation Before Backfill ,(` HVAC_Gas Service Test Gas Line Air Test Hood Roof:_Ice &Water Final Pool: Footings _Air/Gas Tests _Final Framing 30 Minutes 1 Hour Drain Tile Fireplace: Rough In Air Test Final Siding: _Stucco Lath _Stone Lath _Brick_EFIS Insulation Windows Sheathing Retaining Wall: _Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression: _Rough In_Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: 1 L.r , Building Inspector t. RESIDENTIAL FEES Li. iv, §.7,-KI/V1 Base Fee Surcharge0 6A),... Plan Review MCES SAC J 2 `n City SAC q0 X / (% Utility Connection Charge S&W Permit&Surcharge Treatment Plant Copies TOTAL Page 2 of 3 ySUoC,2cE�tICxcd� May.15.2020 10:29 Deana Tank Inc 7635311801 P 1/ 1 Use BLUE or BLACK Ink For Office Use I��� I City of Eaafl Permit e; [ (A9 3830 Pilot Knob Road Permit Fee: 4.—co --- Eagan MN 65122 Phone:(661)676.6676 Date Received: Fax: (661)675.5694 Staff: J 2016 MECHANICAL PERMIT APPLICATION ❑ Please submit two(2)sets of plans with all commercial applications. Date: 5/15/20 Site Address: 4540 West Greenleaf Drive Tenant: Kathleen Haselburger Estate Suite#: • Name: Jane Chars Phone: 612-990-3969 Address City zip: lanechars@edinarealty.com Name: Dean's Tank, Inc. License#: 0475 ,Contractotr, • . Address: PO Box 22515 City: Robbinsdale • State: MN Zip: 55422 Phone: 763-535-0194 Contact: Doug Nething Email: deanstank@gmall.com New Replacement Additional Alteration Demolition : " 'Type of'INork Description of work: Removal and disposal of underground heating oil storage tank NOTE:Roof mounted and ground mounted nfdchanical equipment.is required•to be.screened by City Code. Please•confect't1he Mechanical;.Inspecto(for,.infor'matlon.on;permitted sc eening;;inetlhods., RESIDENTIAL COMMERCIAL • _ _Furnace _New Construction Interior Improvement Porfinit Type•' —Air Conditioner •_Install Piping _Processed Alr Exchanger 'Gas Exterior HVAC Unit Heat Pump Under/Above ground Tank ( install!„Remove) „ X Other Underground Tank Removal RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit, Includes State Surcharge $100.00 Reaidentlei New,Includes State Surcharge =$ TOTAL FEE COMMERCIAL FEES Contract Value$ x.01 $60.00 Permit Fee Minimum $75.00 Underground tank installation/removal,Includes State Surcharge =$ Permit Fee Surcharge=Contract Value x 80.0005 °$ Surcharge If the project valuation Is over$1 million,please call for Surcharge •$ TOTAL FEE 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 plane. x Douglas L Nething x ithehir Applicant's Printed Name Applicant' Ignature 001‘OFFICE.USE • • :Required;inspect('ona: • ' Reviewed.BY;• . :. ,:Date: Unde,I'round•••.. ough In . .07*' :`'Caa;'S0010e:^rest 101,o0;Heat . . Final: MAG Scteening PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA162710 Date Issued:07/24/2020 Permit Category:ePermit Site Address: 4540 Greenleaf Dr W Lot:4 Block: 3 Addition: South Oaks PID:10-71200-03-040 Use: Description: Sub Type:Residential Work Type:Alteration Description:Washing machine & dryer 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 (miscellaneous)$59.00 0801.4087 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 - Kathleen M Haselberger 4540 Greenleaf Dr W Eagan MN 55123--205 (651) 440-1049 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA173552 Date Issued:11/16/2021 Permit Category:ePermit Site Address: 4540 Greenleaf Dr W Lot:4 Block: 3 Addition: South Oaks PID:10-71200-03-040 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) 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 - Bryant & Abby Ortega 4540 Greenleaf Dr W Eagan MN 55123 Bonfe's Plumbing & Heating 455 Hardman Ave South St. Paul MN 55075 (651) 228-7140 Applicant/Permitee: Signature Issued By: Signature