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550 Lone Oak Rd? CITY OF EAGAN 11 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: " I i?nlt n?:l t?19 ',IIti1+IV I(Itp1 It PERMIT SUBTYPE: PECTION RECORD PERMIT TYPE: Permit Number: Date Issued: + 1 rr n a, •7 - eY < -?. - iJurr , . , _ APPLICANT: TYPE OF WORK: (lF'.i'Fif'f lrly Hll I I Ii I Nf? N: lhvA W5lL { JF)?& ? N F IJ ( F N iRY F. raakAi7f 1 INSPECTION .• • .A `. ? I .{ AHA1.F";,kFWY f'"s {2tiH!?}iFit fNhN!!Y i 1 Ft Ift/I A1 1:1(l 10 ' .. i'". IL ?-?=0b ? 7 ? Permit No. PermN Holder Date Taiephone M ELECTRIC PlUM81NG IS 030'0.?' HVAC Inapectlon Date Insp. Comments FOOTINGS FOUND FRAMING / ROOFING ' ? ROUGH PLUMBING [/? PLBG AIR TEST ROUGH HEATING GAS SVC TEST i. INSUL GYP BOARD ? FIREPLACE FIREPLACE AIR TEST - ? 1 1/ FINAL PLBG Z e G Y\ ?\ C U w? p v? cr FINALHTG r c-r CO F r eC+ ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FfG -- - - - - - - . . . -- '-- - DFCK FINAL Np? `?l???jt?1 ? ? i - - A? 17?14 N6nof nJ-TT FJ •0- +ra c,eu ort2 4 ?rlv > W. IT •- CCi.r I CITY OF EAGAN Remarks -?' ? - Addition AUDITORS SUB #38 Lot 1 aIk i`- Parcel 10 03800 050 02 Owner c U °I- Y+j i I?'? Street 550 IAne Osk Rosd State St. Pdulp M 55111 L ?`1 , E- I ; Improvement Date Amount Annual Years Payment Receipt Date STREET SUR F. STREET RESTOR. GRADING SAN SEW TRUNK 1970 $40.00 21.60 2$ SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA STORM SEW TRK 1984 1683.00 112.20 15 1683.00 C008344 5-4-83 STOflM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. gUILDING PER. SAC PARK / v e) 3 c do vsv a.)- 7'14 :3?' CI'I`Y OF EAGAN 3795 Pi1ot Knob Road Eagan, Nlinnesota 55122 PERNIIT NO.: 285 The City of Eagan hereby grants to Corcoran Hardware of Rosearount MN 55068 a WE,. Permit for: (Owner) Rav Ehlext P-t 55o r.one oalc Road , pursuant to application dated 4/22/74 . Fee Paid: $10.(10 dated this 22 day of April , 1 9 74 e .50 e/c Building Inspector Mechanical Permits: Bid Total: / ? CITY USE ONLY ' ? Q' ?j V L ? BL ? ?(-C?L?•D ?? }?i(`.(l-t:1,C,iTX- J? C,? RECEIPT#: U?° 0C;F-- SUBD. ?O' OJb OO ' RECEIPT DATE: 11'S/J r 1997 PLUMBINfi PERM1T (RES1DENTIAL) C11'Y OF £!FfilkA 3$30 PILOT KAOB QD f.tkHAA, biN 55158 (61E)6$1-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system FIXTURES EACH # TOTT 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 conatruction 5.00 x = .. . r.aLcI uuuclicI ror exidi?y cweEting ..,. ,? cv. v X _ - U.G. 5prinkler * tor dwelling under const. 3.00 = U.G. Sprinkler ` for existin dwelling 20.00 = ItefetlOnS to existing residen 20.00 = Water Tum Aroun 20.00 = Private Disposal System ' Dak Cty lic. 75.00 = (new and refurbished systems) Private Disposal Systems • Abandonment 20.00 = STATE SURCHARGE .50 TOTAL COW ----- ----------------------------------------------------•-------------------------------------------- --------- I hereby adcnowledge that I have read this application, state that the information is correa, and agree to comply with all applicab -- agan ordinanoes. ft is the applicanPs responsibility to notify the properiy owner that the City of Eagan assumes no liability for any damages caused by the City during its nortnai operational and maintenance adivities to the facilities conatrueted under this pertnR within City property/right-af-way/easement. SITE ADDRESS: OWNER NAME: INSTALLER NAME: ?7dh.rv?? ? S f'?ocN f- TELEPHONE #: STREET ADDRESS: cirr: STATE: ZI P: OF PERMITTEE CDlFORMS/PLBG PERMIT (RESIDENTIAL) 1997 ? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: P.I.N.: 10-03600-050-02 PERMIT PERMIT TYPE: Permit Number: Date Issued: 550 LONE OAK ftD LC7T: 5 BLOCK: 2 HUDITORS SUBCIIVISION #38 CPos7?V,,,? BUILDING 027594 05/21/96 DESCRIPTION: (ENTRY & GARAGE) ermit Type SF ADRITION 7ype NEW 6,ft 434 AL7. RESIDEN7IAL ?p ill ar ?. ?. P ? , w, i?' REMARKS: A 5EPARRTE PERMIT I5 REQUIRED FOR ANY ELECTRIGAI. WORK FEE SUMMARY: VALUATION Base Fee Plan Review 5urcharge Total Fee $718.60 $359.25 $36.50 $1,114.25 $73,000 CONTRACTOR: OWNER: - Applicant - wxEnEMANN Jflv 550 LONE QAK R[7 EAGflN MN 55121 (612)933-2277 ! A1{.1I1 kDtfilfm'L - ISSUED EIY: S NATU E V • , i1 /'I ? / //./? 1 ? I ? 1? Q' V? CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 New Construction Reauirements RemodeVReoair Reauirement s ? 3 registered site surveys ? 2 copias of plan ? 2 copies of plans (inGude beam 8 window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior addkions & decks) ? 1 energy calculations ? 7 energy calcuiations tor heated additions ? 3 copies of tree preservaiion plan K lot plaBed after 7!1/93 required: _ Yes _ No DATE: I m A-?? c1 c0 CONSTRUCTION COST: DESCRIPTION OF WORK: `'??`s?? ? ,c? L,e me- cr?? ` ?1a4 ? '?+ ?? ? 4?'??- ?J?? ? l on C")?? STREET ADDRESS: . f, + auOti?cg 5u?ba?viS?ar1 LOT ? BLOCK ? ?? wk 933 - aa`? -? PROPERTY Name: OiEdemA-!1/1 Phone#: owNeR ust 50 L - 5 o - c3 n StreetAddress- i Ciry: ?G?Pr R ti) --- state: M?) zip: coNTRAcTOR Company: ' Phone #: Street Address: License #: City: State: Zip: ARCHITECT/ ENGINEER Company: 5 `? _ tMC44f-d. Phone #• laq - %932 Name: C-it-e-ci P e.imef Registration #:? Street Address- ka'1 1?""c'a City: ? Lr\R State: M 1?)._ Zip: T Sewer & water licensed plumber: change are requested once permit is issued. Penalty applies when address change and lot 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. -.1 , _ OFFICE USE ONLY Certificates of Survey Received Tree Preseroation Plan Received Signature oP Applicant: _ Yes _ No Yes No GurE ?C1r,2. d\V r [I ? _? °--/ =?-•- ? ? J1..' F $?' . OFFICE USE ONLY . 4 •?,: , 3UILD ING PERMIT TYPE , 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish - 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool ?'03 SF Addition o 08 8-plex a 13 Garage/Accessory ? 20 Public Facility 71 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous -t 05 SF Misc. ? 10 = plex ? 15 Deck WORK TYPE -j 31 New ? 33 Alterations o 36 Move /'32 Addition ? 34 Repair ?. 37 Demolition 3ENERAL INFORMATION :,onst. (Actual) (Allowable) JBC Occupancy ?oning = of Stories _ength Depth APPROVALS Basement sq. ft. MC/WS System Main level sq. ft. City Water Sq. ft. Fire Sprinklered Sq, {{. PRV Sq. {{. Booster Pump sq, ft. Census Code. 924 Footprint sq. ft. SAC Code 6L Census Bldg ? Census Unit d ::)ianning Building Engineering Variance ? Permit Fee Valuation: $ ?3i o00 Surcharge . Plan Review License MCNVS SAC City SAC Water Conn. Water •Meter Acct. Deposit SIW Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies S/Z x !5--e/' : Z? ?Yb 3' ZX ?S ------------------ Z?, 1aYe G'/t,9G.iG SP4G£- 3zi?66 = S/Zx Ip = ?? fO 7 Z Z?X?7 " ?r6?n6?C= Total: 7Z??71o % SAC SAC Units 500' 2 61' L?NE ?AK R?AD Form for use with Minnesota kutes part 7670.0475, Suap. 'l 1& 2 Family Residential "Cookbook" Method ft..mw? BUILDER Minimum Criteria: Rim Joist: R=19 insulation Fouadatnn Windows: Insutamd gizss. 1rI" air spue. 'snod or vinyl frame Enay doors: 134 inch solid wood with storm or better ' t L__ STEP 1 Window & Door Area I Total Window & Door Ama in Sq. Feet WWDOWS (including foundation windows): Dimensions Qnty. Arr.a x ` , ts • x ? ? ? ?t,, ' x ` 3 ? tt x x x x x x x X DOORS: (v x O'l ;I `I 0 ??.t 1 ° LI O '' : Tatal Area of window 8t Doors 114), A Total Wall qrea ia Sq. Ft Wall Totai Perimecez Height Area L8 115?. a 5(? Total Area of wail 1 yn 8 B I STEP 2 Calculate area as a oercent of wall I Box A(window & door area) divided by Box B(total wa11 anea) times 100 eqnals the window and door area as a pcrcent of wall azea (Boz C). BozA 114 e)- x 100_ BoxB lqdcb ?0•? C I ST'EP 3 Design Featuns I ASSEMBLY FRAME wAL,t.: OPIIOV STANDARD FRAI?NG GVTfYIIJStJUA170N R• ?q SfiEA?HNG: LESS TBAN k•5 [::]?/ -.. 1U6+e..: UASU?c R-5 OR AtORE v?luti ? ,k„ ? wnaaows (excepc totu&um, wuaows): u-FACPOR U• .3(0 Fmm the table, detersnine the mazimum perant wiadow & door arta for the desiga opaoas selecud aad eater the value in boz D below: l(o. ? n Box C must be less t6aa or equal to Box D R- ? . ? •- OIVE- ac 'IWaFAIVIILY RFSIDIIVTIAL BUIIDIIVG P RffXYJFnV((COOK K) APPROACH "MENUMENMEMIM ? MAXIMUM WINDOW AND DOOR AREA AS A PERCENT OF OVERALL WALL AREA From Mnn. Rules,part 7670.0475. svbpart 2, item F Cavi Window U-Factor Framin Insulation Sheathin 0.49 0.36 0.31 0.27 STANDARD R-13 > R- 7 23.4°k 17.8% 21.3% 24.3% S?ANDARD R-13 > R- 5 12.4% 16.4% 19.7°k 22.5% STANDARD R-15 > R- 5 22.9% 17.1% 20.1°k 23.4% STANDARD R-18 < R• 5 12.19'0 16.00/ 18.8% 22.0% STANDARD R-18 > R- 5 14.0°k 18.6% 21.8% 25.3% 0 STANDARD R-21 < R- 5 12.8°k 17.0% 19.9°/a 23.1°/p... STANDARD R-21 > R- 5 14.5% 19.3% 22.5°k 26.1°k Additional calcu}ated values STANDARD R-17 < R- 5 11.9% 15.7°k 18.4°k 21.5% STANDARD R-17 R- 5 13.8% 18.4% 21.5% 25.0% 0 0 0 ADVANE-EB NOfCS: Window area equals mugh opening minus installation clearances. Window U-factor must be detennined by either the National Fenestration Rating Council standard 100-91, or ASHRAE 1943 Handbook of Fundamentals, Chapter 27, Table S. ; 4 CITY USE ONLY L ? r BL ? RECEIPT #: SUBD. kL` RECEIPT DATE: C) 0 PERMIT # 2000 PLLTMBING PERMIT (RESIDENTIAL) CITY OF EA6AN 3830 PILOT KNOB RD EAGAN, MAI 55122 651-681-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system FIXTURES EACH # TOTAL Alterations to existing dwelling - minimum fee Describe: $ 30.00 Bath tub $ 3.00 x = $ Floor drain 3.00 x = $ Gas piping outlet " minimum -1 3.00 x = $ Hot tublspa 3.00 x = $ Kitchen sink 3.00 x = $ Laundry tray 3.00 x = $ Lavatory 3.00 x = $ Septic System new/refurbished " requires MPC Iic. r.. _; 75.00 X = $ --7 zS-- Septic System abandonment 30.00 x = $ RPZ new installatioNrepairlrebuild 30.00 x = $ Rough opening 1.50 x = $ Shower 3.00 x = $ Underground sprinkler if dwelling is under construction 3.00 x = $ Underground sprinkler if existing dwelling 30.00 x = $ Water closet 3.00 x = $ Water heater 3.00 x = $ Water softener If dwelling under construction 5.00 x = $ Water softener x exist+n9 aweit;n9 30.00 x = $ Water tumaround 30.00 x --- _ $ State Surcharge .50 --> -> --> $ .50 Total --> -> ----> ---> S S - 5 Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc. -----------•------------ -------------------------- ------------------------------------------------------------------ I hereby aGcnowledge that I have read this application, state that the information is corred, and agree to comply wfth all applicable Cily 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 nortnal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement. ssZ) ) SITE ADDRESS: ?- L O ti e d Aeo A ? OWNER NAME: :, I A.e IA? i FO/evn t4 0 a TELEPHONE #: (AREA CODE) INSTALLER NAME:,J ? STREET ADDRESS: t u (A f' I ' TELEPHONE y 3 7 , ? 7``es L v J3 4Jrsef (AREA CODE) yviM . Ss o 3 CITY: STATE: SIGNATURE OF PERMITfEE ;JOU , 1 0 2000 4 , ,}£ ,?, ?. JP Y >`i': r r .-'sJ f? °8 ? Y P e_ s•n e i Y v `,?. ?. , 1{ . . i Minnesota Pollution Control Agency ? Individual Sewage Treatment Systecas Program ,. Has Issued . ? _:.,-___..-... . _ .. . _ _ .-_ ........ ..,..___., r = _?µ H Joseph J. Kulhanek, D.R.P. " J & J Excavating f • installer Expires: 3-15-01 License #535 MPCA INFORMATION: 1-800-657-3864 , . ISTS LICENSING: (651) 2967309 , ?'?`j J&J Excavating 19739 Coates Blvd Hastings, MN 55033 Phone (612) 437-2205 Site Evaluation Subsurface Soil Investigation And Abandonment Of Old 5ystem Jay and Jamie Wiedemann '-5059 Lone Oak Road Eagan, Mn. 55121 INTRODUCTION This report summarizes the findings of the Site Evaluation and Subsurface Soil Investigation completed by Joe and Robert Kulhanek for Jay and Jamie Wiedemann. This testing was done to evaluate a new site for the currently failing on site sewage system. We were instructed to test in the front of the house This site was selected because of its size. TEST HOLE LOCATIONS AND ELEVATIONS Perc # 1 is located on the south corner of the soil treatment area. Perc # 2 is located in the north end of the proposed drainfield area. SUBSURFACE INVESTIGATIONS Test borings were made in the proposed treatment area Test holes # 1-2 revealed the same thing 0-12" a dark brown soil 1211-24" a light brown sandy loam down to 36" then a darker brown soil to 63" then a vary gravely soil with small rocks. Auger would not hold a sample after 65". Bor holes 3-4 revealed the same soils a dark brown soil to 12" then 12" to 66" the same darker brown sandy loam soil. No water was found in bore holes after four hours. [ See log of soil borings.] PERCOLATION TEST RESULTS Number one and two perc test holes were used to evaluate the soil and used to calculate the amount of drainfield needed for this residence. perc hole # 1 was tested at 9 minutes per inch. Perc hole # 2 was tested at 5.6 minutes per inch. [See percolation data sheets enclosed.] • PERCOLATZON TL??,.sfATA ;;iE T Test hole loca[ion 'J?;V vbAlC G+14/t....2pL Hale number t Dace test ho2e was prepared ? Depth of hole bottom,aI4 inches. Diameter of hole, T_ inches. Soil data from test hole: Depth, inches Soil texture _ Q '•1 C ? ?l j? ?- l ?S C' '? Method of scratchinR sidewall _ S)v% * LI, G* r1a N TO e= Depth of pea-sized gravel in bottom of hole, 1 O inchea. Date and hour of initial water filliag 0 g3C i1= tY - Zc C ? Depth of iaftial srater fil2ing, E v i. l inchea above hole bottom. Method used to maintaia a[ least 12 iaches of srater depth in hole for at least 4 houra Percolatian teet readings made by w0p,u j Oc ? atarting at /Z j a.m. (date) duriag teat, ? iaches. 1loi.? rl 1\?j f N A Av:u on . Meximum rrater depth above hole bottom T1me Time Iaternal, Kiautes Heasurement, inchea Drop ia water Iavel, inchea Percolation rate, minutea per iach Remarka ( S --? ! Z C. ! cs 3 ? .? ? .+{ "It Z s ? Percolation rate - q miautes per inch. Teac linla location_ Nole number °"\ Date test nole vae prepared Depth oF hole boccom,Y_ i„?he,. Ciameter of hole, V_ inches. So1I date from [est Iiola: Depeh, inchea Soli t¢xttire 4- i2" I a -'?11 y 'r Ar, Hechad oF acratchinq aideval2 3 rn o. 0. Ce *r Cerc:? of pea-sixed gravel in bottom oE hole, .ncfies. i DatA and hour of initl.al vater fi111ng Q$ 30 1?'15s- `L C r„ Cepch af initial vate[ filling, EuI,& inchee abave hole bo[tcm Hethad ueed to maintain at least 12 inches of vatar depch in hola for at lease 4 hours M+ANLy?L Percolacian test readings s.ede by ?i o? ;e?, an 1ta`6' "w etartirtg st 1 ZSl , Iiaximum vater depth abovt hale bnc.?T (date) •m during cest, It' inchee. time 21me Interval, Htnutes Heaauremeat, iaches Drop fn water level, inches Percolacion rate, ' minutes pat ic:ch Remarka 1 ?. , 10 ? b _'Lss?._ _ _ ? ?-- ? - ? ? ? ??_ - :L iLL__ 71 ! °! / 0 ?SP i -r F.? e P ! -- - 1 ?- i _... .._ ? --- Percciatiart race ? 6-0 ?V minutea per inch. B-53 r ? t S ,._ ,; •: F - ? It - fl n l t Is ° ° ° ° ° ° ° ° ° g ° ti S c e e 9 e a $ a e c @ g 8 S @ e e ` e \ \ \ \ 1 ? U .4 L. 4. L .l `' y ? • Z t? .,p ? ^G S V J J O o 2 ro ? o- s r u a 0 ?4 ?M Py f ? L. cy r `„ . ? in Te ?' .J '? o e i ? ..0 ?n - ? ? Fl - I I I U b T. # auiao4 Z # vueioq £ # zutioq it # xucioq S # aulaoq Figure B-24b , ' • ? . : ..? v d s fn ? ? . E CD ? R ? h I ? i ? t ? , , I ? f I O ? 1?1 i ? L f I ? ? 3 i? g ?a • ? ; ? t.:s b?.sl iZo o n? 1 !' .?' 1 INDIVIDUAL SEWAGE TREATMENT SYSTEM WORKSHEE'I' FI,O?V qi? ?' /1. Estimatcd - fipd measured x 1.5 = _ gpd $LP"TIC TANK VOLUME B. i?ac ecn,f?Ai•+ mc.!-i_9311ons SOILS (Silc cvaluation datn) C. Depth to restricting laycr = l0 7 fect D. h4aximum depth of system C- 3 ft = 3 [cct E. Pcrcolation rate ik MPl F. Soil 5izing Factor 1 X1 so.1ft/gpd (Scc tablc 3) TREIVCFI BUTTOM AREA H. For trenchcs with C inches of rock bclow thc pipc: A x F= x =_ sq ft of bottom arca ? For trenches with 12 inches of rock bclow the pipe: AxFx0.8= x_x0.8= sqftofbattomarca J. For lrcnchcs with 18 inChcs of rock bclow the pipc A x F x 0.60 = x x O.fili -37-1_ sq ft of bottoin arca K. For trenches with 24 inchcs of rock bclow thc pipc: AxFxO.l= x_x0.6=M- sqflofbottomarca i3ED T307'7'OM AREA L. For seepage bedc with C, or 12 inchcs o( rock bclnw the pipc; 1.5xAxF=1.5x x_=_sqftnfbottomarca ]20CK VOLUTviG IN CU f-t' M. Rock deF?th below distribtition pipc plus 0.5 foot limes boUom area: M=Rock dcpth (ft) + f indies x Arca (f-l, l, J, L or K) (_ fr+o.5tr) x_=GS? cu rc ROCK VOLUME IN CU YT.7S N. Volumc in cu (t divided by 27 , M+27=cuyds_+27=.j?) cuyds ROCK WEIGHT 0. Cubic yards times 1.4 = tons N x 1.4 = tons x 7.4 =36 tons DIST'RIBUTION (Chcck onc based on slope) _ Bed (less than b% slopc) Trenches Drop boxes (any slopc) ? Distributian box (level to slightly sloping) TRENCH LENGTH P. Selecttrench width = y?ft Q. Pivide bottom area by trcnch width: (11, 1, J, nr K) + P= lincal fcet _+_4alincal fcct tnrvN nREn R. Select trench spacing, center to center =7 feet S. Multiply trench spacing by lincal fect P x Q= sq ft of lawn arca .-x_.=18?b sqft • LAYOUT (Use othcr sidc) 1. Select an appropriate scale; one square = a n feet. 2. Show pertinent property boundaries, right-of-way, easements. 3. Show location of house, garage, driveway, and all other improvemcnts, existing or proposed 4. Show location and layout of sewagc lreahncnt system. 5. Show location of watcr supply wcll. 6. Dimension all set backs and scparatia» distances. ' [ctim:ucd Scwagc Flows in Galluns pcr d:iy (gIxl) umbcr oC 13cdrooms Typc 1 Typc II T'ypc Ill Tvpc IV 300 225 180 450 300 218 w''= 4 600 375 256 °r`I„ 5 75() 450 29'1 valuc. in G 900 525 332 Iirc ?. 7 1050 600 370 11 °` R 12(X) 675 408 cni „,,. SepticTank Gpacitics, in p,Nllnn+ Numbcr o( Minimom Liquid 1•iquid capacity w•iih Bcdrooms Capaciiy gnrbagc disposnl 2 or Icss 750 1125 3 o, 4 I(Xx) I S(NI 4 or 6 15(IU 2250 7, R or 9 2(xx) 3(xK) ovcr 9 --°-- Soi1 Chsractcrislics auJ ficquircd Arcas for ScHapc'frculmcnl Pcmolaiim Ratc in Sqwm Gallnm Alinmcs pcr Inch soii l'c.Lu« n.:tpcr p« <i<>ref (MPI) gaUan pca ayuare fnuI d+ Pasicr ihan 0.1 • Crorsc SinJ ••"- ""- 0.1 t0 5 Sand QA3 1.20 QI io 5 \' finc ond •' I.67 4160 • G to IS Sandy Loam 1.27 0.79 IG to JO Lmm 1.G7 0.60 31to45 Silti.cnm 2.UU U50 46 to GO Clay Lnam 210 0?5 Slnwa than 60... CIaY """ ""' ? T 2 inch Covcr I 4 inch Pipc 6-24 inch Kuck 13clow thc I>il I ? s;.?,? }..?, ra ?. G? ?. m b?,.? s , . . - f... ? ?••i I?--; - , , ,` A •,, .-.,,! „" .f I ? ? ---- ? -- ? , + , ? d i I I? I ' ? ? j , . , ? i I ? ? ? ? ? 'I I I I ? i i ? I ? ? ? i { I i t? O ? ? ? ? I i ? I I ? i ? ? • ? ? { . r ? i • 1 I ? ? v I I ; ? xr I Ie? ; ? I I f ? ? ? L?; i?(w? 14 I i L -1 I ? I I I ? ? I I ? 1 ? I I I I ? I I ? 1 i O m ? I ? PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA093239 Date Issued: 03/29/2010 OR Permit Category: ePermit 41~ it~ of E3 E Site Address: 550 Lone Oak Rd Lot: 5 Block: 2 Addition: Auditors Subdivision 38 PID:10-03800-050-02 Use: Description: Sub Type: e-Windows iDoors Construction Type: Work Type: Windows Doors-New ; Replacement Description: House Census Code: 434- Occupancy : Zonin,: Square Feet: 0 Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openin,s, 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 S3K $88.50 0801.4085 Valuation: 3.000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195 Total: $90.00 Contractor: - Applicant - Owner: Renewal Andersen Dale D Heacock 1920 County Road C West 5 50 Lone Oak Rd Roseville NIN 55113 Eagan NIN 55121 (61)264-4777 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 Cite of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA100952 Date Issued: 09/12/2011 OR Permit Category: ePermit 41~ it~ of E3 E Site Address: 550 Lone Oak Rd Lot: 005 Block: 002 Addition: Auditors Subdivision 38 PID: 10-03800-02-050 Use: Description: Sub Type: e-Reroof Construction Type: Work Type: Replace Description: House Census Code: 434- Occupancy : Zonin,: Square Feet: 0 Comments: If there is no ice protection inspection prior to final, the contractor must meet the inspector Nva ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: BL - Base Fee S3K $88.50 0801.4085 Valuation: 3.000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195 Total: $90.00 Contractor: - Applicant - Owner: Reo Solutions Dale D Heacock 20609 Kaftan Ct 5 50 Lone Oak Rd Lakeville N1N 55044 Eagan MN 55121 (952) 236-9455 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and Cite of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature SEE 2 6 I Par 9-19-11 El~i Scivage Treatment System (T) I Wbr d 1 F t Price 01 wig ) % nn __S7X21 Inspector: 7 70K License #t i Certification 4 C6.0 r er on , i re able ~e and our (l Mum, ystLL,_ w dc n;z~ a The pn tit 9.f?ndHF(iF€ of the ansk on c irt- L Ws F...m +,x Sc retni"tt- its rNarvant, ~ tfA, i€ig of tuk s3s€eiri of € me in ft.Q future. of the nunicro irwt Mures. ect4Ishich rMay Met i OpUf izEi4dt3 of • . <t'=3?c bt$ 0iiis thh& . +.,,j tkt J}f" i;70i1~tCi3~£~ s~;kB k-ii€i pW .3w$';'& 5 ° Y i AiL. '!N ~ 4L'ifl `3" 3? Cs.*.9'ti or SY7Epiied' arising from m the inspection of the - n -11 00 or khk report. Wi! are LA's'o fnot ass rfai€ inn the I€Iipact £ £ syste p is €t.I' i g I Sri ~ kt. 651 or Email info ;,spin u Minnesota Pollution Compliance Inspection Form Control Agency Existing Subsurface Sewage Treatment Systems (SSTS) 520 Lafayette Road North ` t Paul, MN 55155-1194 Doc Type: Compliance and Enforcement Instructions on page 6 Sutnma>ly Form (Completed form must be submitted to the local unit of government within 15 days.) Parcel number: 10-03800-02-050 System status: ® Compliant F1 Noncompliant For Local Tracking Purposes: (based on ail compliance requirements) Property information Property owner name(s): Fannie Mae Property owner phone: Property address. 550 Lone Oak Rd. Eagan MN 55121 Property owner address (if different): PO BOX 650043, DALLAS TX 75285-0043 County: _ Dakota Permitting authority: Eagan Date system constructed: 2400 Reason for inspection: Sale System Description Brief system description: 1500_gl. 2 compartment tank with 100 _ Pump tank to Chambers Local permit number. None Pound Number of bedrooms: 4 Design flow rate w NIA Is the system: In Shoreland area? El Yes ® No in Wellhead Protection Area? C7 Yes 0 No An U.S. Environmental Protection System serving a Minnesota Department Agency (EPA) Class V Injection Well? n Yes RI No of Heath (MDH) licensed facility? Yes 0 No Compliance Status (Based on state requirements - additional local requirements may also apply.) Based on the information gathered and reported on attached forms, the compliance status of this system is (check one): E Certificate of Compliance -valid until (3 years from date of report): 9i19/2014 El Notice of Noncompliance - For Noncompliant systems: The reason for noncompliance is: _ This noncompliant system is classified as (check one below):__ El Imminent threat to public health & safety n Failing to protect groundwater n Not in compliance with operating' permit Certification f hereby certify that all the necessary information has been gathered to determine the compliance status of this system. No determination of future system performance has been nor can be made due to unknown conditions during system construction, possible abuse of the system, inadequate maintenance, or future water usage, Name Ron Smith Certification number: 8208 Business license name and number B's Pumping Service License # 29.46 or Name of local unit of goveent: Signature: Date: 9-19-11 Required Attachments n Hydraulic Performance Tank Integrity Operating Permit Form (if applicable) ® Soil Boring Logs ® Soil Separation Z System drawing/As-built drawing n Any local requirements that are different from what is required on this form M Other information (fist): linspector Comments Upgrade Requirements (derived from Minn. Stat. § 115.55) An imminent threat to public health and safety(17PHS) must be upgraded, replaced, or its use discontinued within ten months of receipt of this notice or within a shorter period if required by local ordinance. If the system is fwlinq to protect ground wator, the system neust be upgraded, replaced, or its use discontinued wiihin the tiara required by local ordinance, if an existing system is not failing as defined in law, and has at least two feet of design soil separation, then the system need not be upgraded, repaired replaced, or its use discontinued, notwithstanding any local ordinance that is more strict. This provision does not apply to systems in shoreland areas, Wellhead Protection Areas, orthose -used in connection with food; beverage, and lodging establishments as defined in law. wnrw.pcat.stAte.mn.us 654-246-6340 - WO-657-38" - TTY 691-282-5332 or $00-657-3864 - Avaitable in alternative formats wq-wwtsts4-3i - 4124109 Page t of 8 Parcel number: 10-03800-02-050 System status: ® Compliant Noncompliant (as determined by this fbrm} Hydraulic Performance and Other Compliance Compliance Inspection Farm for Existing SS7S Compliance Issue #1 of 4 Date of observation: y 9-16-11 Reason for observation: Property `transfer This form expires upon next inspection or in three years, whichever occurs first: 9-16-14 Compliance questions/criteria: (Required) Verification Method*: (Optional) ropriatebox) _ {Chock the appropriate box} Does the system discharge sewage to the E Yes No © Searched for surface outlet ground surface? ~ Performed hydraulic test Does the system discharge swage to drain ❑ Yes No the or surface waters? Searched for seeping in yard Does the system cause sewage backup Q Yes ® No ❑ Checked for backup in home into dwelling or establishment? Q Excessive ponding in soil system/D-boxes Do other situations exist that have the Q Yes M No ❑ Homeowner testimony potential to immediately and adversely impact or threaten public health or safety ❑ Examined for surging in tank electrical, unsafe-covers `etc. ? "Black soil" above soil dispersal system Any "yes" answer indicates that the system is an imminent threat to public health and safety. © System requires "emergency" pumping 0 performed dye test Does the system pose a threat to ground ❑ Yes N No Other: water for any conditions deemed non- protective as determined by the inspector "Yes" indicates that the system is failing to protect ground water. If "yes", describe the condition noted.- No standard protocol exists. This list is not exhaustive, _ in sequential order, nor does it indicate which combinations are necessary to make this determination. Certification This form is to be completed and attached to the Summary Form of the Minnesota Pollution Control Agency's (MPCA) Compliance Inspection Form for Existing Subsurface Sewage Treatment Systems. Observations, interpretations, any conclusions must be completed by an inspector. Completed form must be submitted to the local unit of government within 15 days. Property owner name(s) Fannie >~~ae Property address: 550 Lone Oak Rd. Eagan MN 55121 Property owners address (if different): PO BOX 050043. DALLAS TX 75265-0043 County: Dakota - Property owner phone: 1 hereby certify that I personally made the observations, interpretations, and conclusions reported on this form and that they are correct. Name: Ron Smith Certification number. 8208 Business license name and number: __B`s Pump ng-Service Li_cense_# 2946 or Name of local unit of Bove n nt_ - Signature:--.?-~.- Date: 9-19-11 www-pca.state.mn.us 651-29£-6300 800-657-3864 TTY 651-282-5332 or 800-657-3864 - Available in alternative formats wq-wwfsts4-3t 4124101 Page 2 of 8 Parcel number. 10-0380£1-02-050 System status: [D Compliant ❑ Noncompliant (as determined by this farm) Tank (Integrity and Safety Compliance - Compliance Inspection Form for Existing SSTS Compliance Issue #2 of 4 Date of observation 9-16-11 Reason for observation: Routine Pumping This form expires on (three years): Compliance questionsicriteria: (Required) Verification Method**: (Optional) (Check the appropriate box) (Cheek the appropnato box) Does the system consist of a seepage pit*, ❑ Yes No cesspoq , drryw I or leaching it? ❑ Probed tank bottom Do any sewage tank(s) leak below their ❑ Yes Na ❑ Observed low liquid level desiclned o ep rafi~n depth? I„] Examined construction records If yes, identify which ® Examined empty (pumped) tank sewage tank leaks. ❑ Probed outside tank for "black soil" Any "yes" answer indicates that the system is failing to protect ground water. ❑ Pressure/vacuum check * Seepage pits meeting 7080.2550 may be compliant if allowed Other in ordinance by local permitting; authority. No standard protocol exists. This list is not exhaustive, in sequential order, nor does it indkate which combinations are necessary to make this determination. Safety Check 1. Are maintenance hole covers damaged', cracked, or appeared to be structurally unsound? ❑ Yes* 0 No 2. Were maintenance hole covers replaced in a secured manner (e.g., screws replaced)? ® Yes ❑ No* 3. Was secondary access restraint present (safety pan, second cover, or safety netting) - highly recommended. ❑ Yes 0 No 4. Are other safety/health issue present? ❑ Yes* ® No Explain: *Sys tern is an imminent threat to public health and sa€ety. Certification This form is to be completed and attached to the Summary Form of the Minnesota Pollution Control Agency's (MPCA) Compliance Inspection Form for Existing Subsurface Sewage Treatment Systems. Observations, interpretations, and conclusions must be completed by an inspector, maintainer, or service provider. Completed form must be submitted to the local unit of government within 15 days. Property owner name(s): Fannie Mae Property address: 550 Lone Oak Rd. Eagan M~! 55121 Property owner's address (if different): Pa BOX 650043, DALLAS TX 75265-0043 County: Dakota _ Property owner phone: l hereby certify that i personally made the observations, interpretations, and conclusions reported on this form and that they are correct. Name: Ron Smith Certification number: 8208 Business license name and number: B's Pumping Service License # 2946 or Name of local unit of gg'cove nment; Signature: Date: 9-19-11 _ _ _ ww.V:PCa.state.rtm.us 651-296-6300 800-657-3864 TTY 651-282-5332 or 800-657-3884 Avaitabte in alternative formats wq-wwists4-31 = 41Z4109 Page 3 of 8 Parcel number 10-03800-U2-050 System status: E Compliant n Noncompliant (as determined by this forma Soil Separation Compliance and Other Compliance Compliance Inspection Form for Fisting SSTS Compliance Issue #3 of 4 Date of observation: 9-19-11 Reason for observation: Property Transfer This information on this form does not expire. Compliance questions/criteria: (Required) Verification Method": (Optional) (Check the appropriate box) (Check the appropriate box) For systems built prior to April 1, 1996, and not located in Shoreland or Wellhead Protection Conducted snit observation{s) (attach boring logs) Area or not serving a food, beverage or ❑ Two previous verifications (attach boring logs) lodging establishment; Q Other: Does the system have at least a two-foot vertical separation distance from periodically saturated soil or bedrock? ❑ yes ._0 No For non-performance systems built Apr 1 il performance systems 1996, or later or for non located in Shoreland or Wellhead Protection Soil observation does not expire. Previous observations Areas or serving a food, beverage or lodging by two independent parties are sufficient, unless site establishment: conditions have been altered. Does the system have a three-foot vertical separation distance from periodically saturated o1 or bedrock?* s _ ~ Yes ❑ No 'For reduced separation distance systems (i.e., "performance" systems under old 7080.0179 or ? May be reduced by up to 15 percent if allowed in local Type IV or V system under new 7080.2350 or I ordinance. 7080.2400): No standard protocol exists. This list is not exhaustive, Does the system meet the designed vertical in sequential order, nor does it indicate which separation distance from periodically saturated combinations are necessary to make this sail or bedrock?" E Yes E] No determination. Any "no" answer Indicates that the system Is failing to protect ground water. Certification This form is to be completed and attached to the Summary Form of the Minnesota Pollution Control Agency's (MPCA) Compliance Inspection Form for Existing Subsurface Sewage Treatment Systems. Observations, interpretations, and conclusions must be completed by an inspector or designer. Completed form must be submitted to the local unit of government within 15 days. Property owner name(s): Fannie Mae Property address: 550 Lone Oak Rd. Eagan MN 55121 _ Property owner's address (if different): PO BOX 650043, DALLAS TX 75265-0043 County, Dakota Property owner phone., 1 hereby certify that l personally made the observations, interpretations, and conclusions reported on this form and that they are correct, Name: Ron Smith Certification number: 8208 Business license name and number. B's Pumping, Service License It 2946 or Name of local unit of g rnent: Signature: Date: 9-19.11 www.pca.state.mn.us - 651-296-6300 800-657-38" TTY 651-282-5332 or 800-657-3864 Avaitabre in attemative formats wq-wwists4-31 - 4124109 Page 4 of 8 9-19-11 1 conducted a compliance inspection at 550 Lone Oak rd., Eagan, MN 55121. 1 checked with Dakota County and they had no records. I checked with the City of Eagan and they only had a permit pulled for private sewer in 2000 by 1&I Excavating. From the information I gathered it appears the system was installed in 2000. There are two trenches. I dug and found them to be chambers. 1 60' and 1 @ 55'. The bottom of the trench is at 24". Soil borings found no restrictions to 60". Ron Smith r Inspector 8208 550 Lone Oak Rd. Eagan Drawing not to scale 9_19-11 N Two Chamber Trenches----------*" BI 0 Pump Tank 1500 gl. 2 c septic Tank House Well O . v r: ~ ~ tx ~ u. Viz, ~ v a~ w v u v ?3 c 0 0.0 2'2 ~p~ a we ~r~ s a34.u w~ wi wx r wwc4 cs u.w 0-4 c~ G) L~ \ {S~ _I. CQ A. ~ ~ ~ ~ "J ~ ~ ~ (6 ^pv ~ N v !d "t7 4!A ~n .b Cif c.~, vJ ~ ,D C f 'f !~..-15 rn e•t ...J. ~ s.. c ° ~ as c~ - a ~ c~ v O G C v o ~ Q v c ° ° «i o ° o on -60 Tin CJ v c c- v n o .5 c 94 'L, -2 41 25 /G J) l7 a. Gn v:> ' ^ rr.:.:~ G, W ti.. {:t P- ate. Z7 C a: LE2 4 ;7- v~ i•, CL z a c o m c~ cap as co va 0 CCU 0 w 00 m o o xs o c c r, o cill C? U►1 - u U U u afs y a~ O N G v_ O a7 o az o c3 _ ~Q v ups _ U~C7 UQC7 LQC7 C7t ~7 uGz UC~C7 b • ut7 O h 2 c 4t ~ti try U-i p iJ G~ ac rq co s 44 C A U PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA125488 Date Issued:07/24/2014 Permit Category:ePermit Site Address: 550 Lone Oak Rd Lot:005 Block: 002 Addition: Auditors Subdivision 38 PID:10-03800-02-050 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Janel Behrends 122 West 3rd S Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088 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 - Ronald Hagen 550 Lone Oak Rd Eagan MN 55121 Haley Comfort Systems 122 West 3rd St Hastings MN 55033 (651) 437-0338 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA130163 Date Issued:04/08/2015 Permit Category:ePermit Site Address: 550 Lone Oak Rd Lot:005 Block: 002 Addition: Auditors Subdivision 38 PID:10-03800-02-050 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. Applicant: Tony Boerner 2090 County Road 42 W Burnsville, MN 55337 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 - Ronald Hagen 550 Lone Oak Rd Eagan MN 55121 Tony's Appliance 2090 County Road 42 West Burnsville MN 55337 (952) 435-2442 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink r________________^ I For Office Use � • � Permit#: �� D�� I � � I City of ����Il � �� ; � Perrnit Fee: 3830 Pilot Knob Road I � Eagan MN 55122 I I Phone: (651)675-5675 I Date Received: I � I Fax: (651)675-5694 � I � Staff: I �-----------------� 2015 SEWER AND WATER CONNECTION AND AVAILABILITY CHARGES EXISTING RESIDENTIAL PROPERTY �� � �� �t� � �����. �' ��� !� �� � ����. � Address: �� �� �4 � � � '��- �3 �_ . �. � 4. .^.^e�;. 2 : � ;�a ��" . Property Owner: ''�� � �✓� �` � : - � � .���-_ �_� � �'-�.� �,�� /�,` �} � � ��R� -��'��rt� � . Phone: v J � � ��� ��g � Contact Name: f ��^�`1 ��`�� � 8 tt � � '� �ani�/�t���F�rm��� � —s--*�� � � � ��9 w+" Plumber: ;;�� ,����;� ����! � , �' �� �����#.' �� ������UI' �' ,�; �ra � ._�`..��"'. ':�x:.-..:..;, , , �r�"".. , . ilu�.r�;fi��:�Id�_-� ����. r �` ,��:y_ � ; ' �1 �. �� ��s���IR z�li�i�ti��tid(m�`� h�� _..;��k.- � ..� �<�`'=` ��� I�� ����r �ao��� ' E�.. � Ni , t ' � ��;. y na� � , � 7 �� ��r�dl.(G� '� , � - ��� `���� � � Sewe rvice Water Service t�l_� Sewer later harge Water lateral charge Q�.�,,n�,,,�, �a.z1�, ' Sewer trunk Water trunk � Qc�,o�c„� \�F3 0�3 City SAC @$100/urn Water Sampling Fee ` d� ,�Q� MCES SAC @$2,485/uni Water supply storage ����� � Receipt#: te: Receipt#: , Date: Permit Fee $60.00 Treatment Plant @$843.50/unit g 6�'►'3�5� ' State Surcharge $5.00 Permit Fee $60.00 TOTAL: State Surcharge $5.00 *P/umbing Permit Required-water meter to be g 9`� .5.� acquired with building permit TOTAL: i� �., "`ra � »� � , It i,��, i �- i :;�F,j,ll�`!���'�R rr. <.�a NUb �i i . =�6 i ..,pi�.�xm�"��ii�l�s�.`�hii4����u4���+3,`� a W i,:: � c .�� 7<<. �;�'d�"�7"'�u}�i�k�i'+�'��li�tl� i a ' (�"��-.. �7����:��� �i4 � �h�Nt��'��1� . ,..3..:sa� w�'a°�w.. in� d : "- i.�t i�. ' �k:��%_� - :.. � , ec�Jr . ' :.-., ..'�(°»"a i�°u`a?,�G.�a� . . . .-: '..� ' -�. ra-..... "' Sewer Service � Water Service ������ Sewer lateral charge � er lateral charge �� � �o/ Sewer k Q Water trunk � ��rj'� Water Sampling � ��� � City SAC � �,o�' � MCES SAC �� �� �✓ �,...�'� Receipt# , Date � � '�" �� at ppty&storage '�' 7 �� � Receipt# , Date �-� �J Treatment plant �_,s� �a Permit Fee $120.00 �v--e�'' � State Surcharge $5.00 ~ �� *P/umbing Permit Required-water meter to be acquired with building permit TOTAL: Number of SAC units is determined by the Metropolitan Council Environmental Services(651)602-1000. 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.org Cc: City of Eagan Finance Department Sep 21 2015 09:37AM I(rueger 952-447-6169 page 1 � 3 3 0�� Use BLUE or BLACK Ink � Fo ffice Use---------� I C�} Ot �n A� i PermilAk: � b� 1 Q�ll � � Permh Fee: I 3830 Pilot Knob Road � � Date R eived: � Eagan MN 55122 � � Phone:(651)675-5675 � I Fax:(651 j 675�694 � � � _ '�---—=—=—--=—� 2015 SEWER AND WATER REPAIR/ DISCOIdNECT PERMIT Date: � '�1�' Fee: ffi65.00 City Sewer City Watec �Repair Disconneet Description Of Work: !l 'o ,l� �,p���`l�T�'�1�. �1 3 ��'��'�-C��` Z. �,�.1•'�I" � _\ , � 5treet Address for Proposed Work � �J" �0� �,� �� Name: � Phone: �1���' 1�Lf'���� Owner I nformation Address J City/Zip: S�' �,��. �Gti�„ �,�:�, Applicant is: Owner Contractor Licensed Pipelayer� Master Plumber Property Owner Name: ���� � Phone: \��� 1�1�` (�J� Address i City/Zip: 1�� I ,��� �� � �(1 ,{ �, �� Pipelayer Training Certification Card#: or Master Plumber License#: I acknowledge that the information is complete and accurate and f at the worlc will be in conformance with the ordinances and codes of the City of Eagan and ihe State of MN Statutes. 1 understand t is is not a permit, but only an application for a permit, and wo�lc is not to siart without a permit, Applicant(Print Na e) plicant's nature � CALL BEFORE YOU DIG. Call Gopher State One Cal at(651)454-0002 for protection against underground utility damage. 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X � X Z o ,.. . . . . . . . � O,. � O � O � O � O w U O O 6� O� � � h I� Cp �p � � � � � � � � � � Use BLUE or BLACK Ink . r----------------� I For Office Use � I C� � "' `� `7.�._�"--� ��7T O f �n n� � Permit#: � � ��o, �� , J 1 Q d i Permit Fee. � 3830 Pilot Knob Road � Eagan MN 55122 � Date Received: � Phone: (651) 675-5675 � I Fax: (651) 675-5694 I Staff: _� �---------------- I 2015 RESIDENTIAL PLUMBING PERMIT APPLICATION Date. � ✓ � �� ��j'4-�� � � /.�.�`�`�--�� Site Address: � � (_P � Tenant: Suite#: �t�sidentlC'�vuraer Name: E-� -. �v ��G��� Phone:_ C-��� ` 7 `�`'g� Z`6G� Address/City/Zip: �7 �� L-�i �� ���� � \ . r�-� Ctir 1"� N S J�2- 1 ' Name: License#: �o17tt'�C#G'1' Address: City: State: Zip: Phone: Contact: EmaiL• Ty�e'+D#Wt�rk —New _Replacement _Repair _Rebuild _Modify Space _Work in R.O.W. � � _ Description of work: � G 2� C i� RESIDENTIAL /. �i Water Heater "J � �' `�����v'�--- Lawn Irrigation(�RPZ/_PVB) Water Softener ����� �� P�r������Q Add Plumbing Fixtures(_Main/_Lower Level) Septic System New Water Turnaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation(includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic Svstem Abandonment,Water Turnaround"(includes State Surcharge) "Water Turnaround(add$210.00 if a 5/8"meter is required) $115.00 Septic SYstem New(includes County fee and State Surcharge) TOTAL FEES$ ��' �� 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. , _..� �. .._ �.._..... —---�.. ,_,..., x — � c�~) �C��,�--, x � `� � ApplicanYs rinted N e Applicant's Signature �dR OFFICE USE Reviewed By: Date: Itequired Inspections: Under Ground Rough-!n Air Test' Gas Test Fir�af Meter Related items: Meter Size Radio`Read t�lanometer S#aff: PERMIT City of Eagan Permit Type:Building Permit Number:EA171997 Date Issued:09/10/2021 Permit Category:ePermit Site Address: 550 Lone Oak Rd Lot:005 Block: 002 Addition: Auditors Subdivision 38 PID:10-03800-02-050 Use: Description: Sub Type:Fireplace Work Type:Gas Insert Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to concealing. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 3,000.00 Fee Summary:BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 $90.00 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 - Ronald & Kathryn Hagen 550 Lone Oak Rd Eagan MN 55121 (651) 319-3860 Chimney Doctors P O Box 240722 Apple Valley MN 55124 (952) 888-5252 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA172442 Date Issued:09/30/2021 Permit Category:ePermit Site Address: 550 Lone Oak Rd Lot:005 Block: 002 Addition: Auditors Subdivision 38 PID:10-03800-02-050 Use: Description: Sub Type:Residential Work Type:Alteration Description:Fireplace gas line Comments:Please call for a Rough In and Air Test, prior to the Final Inspection. Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) 210-0754. 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 - Ronald & Kathryn Hagen 550 Lone Oak Rd Eagan MN 55121 (651) 319-3860 Chimney Doctors P O Box 240722 Apple Valley MN 55124 (952) 888-5252 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA174267 Date Issued:01/13/2022 Permit Category:ePermit Site Address: 550 Lone Oak Rd Lot:005 Block: 002 Addition: Auditors Subdivision 38 PID:10-03800-02-050 Use: Description: Sub Type:Windows/Doors Work Type:Overhead Garage Door Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements 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 within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 1,500.00 Fee Summary:BL - Base Fee $1500 $62.50 0801.4085 Surcharge - Based on Valuation $1500 $0.75 9001.2195 $63.25 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 - Aaron Pfeffer 550 Lone Oak Rd Eagan MN 55121 (651) 319-3860 Twin City Garage Door Co 5601 Boone Avenue North Minneapolis MN 55428 (763) 533-3838 Applicant/Permitee: Signature Issued By: Signature