565 Lone Oak RdI ? < ??. ZZ>
/CI/ 3(F 2007COMMERCIAL BLTILDING PEUMT Arrr,icATiorr
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675
Plans are considered public infarmation unless you state they are trade secret and why.
• Structural Plans (2) sets
• Civil Plans (2)
• Certificate of Survey (1)
• CodeAnalysis (1) "
. ProjectSpecs (1)
• Spec Insp & Testing Schedule (1) '
• Soils Reparl (1)
• Meter size must be esta6lished
)
1
)
?
J
)
• SAC determination - call 651-602-1000
• Soils Report (1)
. Certificate of Survey (1)
• Structural Plans (2)
• Arohitectural Plans (2) sets
: HVAC units req'd. on bldg elev. /site plan
• Civil Plans (2)
. Landscaping Plans (2)
. CodeAnalysis (1) "
• EnergyCaYculations (1) "
• Emergency Response Site Plan (1) *"*
• Spec. Insp. 8 Testing Schedule (1) °
. Eleciric Power & Lighting Form (1)
. ProjectSpecs (i)
• Master Exit Plan (1)
• SAC determination - call 651-602-1 000
• Fire Stopping Submittals
. Fire Suppression/Alarm Form
• Meter size must be established
. Architectural Plans (2) sets
• CodeAnalysis (1)
. Project5pecs (1)
• Key Plan (1)
. Master Exit Plan (1)
. Energy Calculations (1) not always"
• Elec. Power & Lighting Form (1) not always'
• Meter size musf be esta6fished-if applicable
• SAC determination -ca11 651-602-1 000
Call MN Dept of Health at 651-201-4500 for details regarding food & beverage or lodgiog facilil
** Contact Building Inspections to see if it is required and for a sample.
"`*• Permit for new building or addition will not be processed without Emergency Response Site Plan.
Date c? / di9? /0-7
Site Address S(p S LC)NE A
Tenant Name 1/ JN-CAoN^%'r Construction Cost ??o 00
.
K IZOPO UniUSte #
Former Tenant Name
Description of Work 0e1'h0L-1'T I0V Q OC?P, SS, 3a?
Property Owner ?-A('? z 1 &f?'7 A?'- L- ? Telephone # ( ?i'r-1 ) ?C?3 ? g?.?
Applicant is: _ Owner X Contractor
Contractor Contact #: (70) 7 d `, 99?;?
Address 10q(}(? 9,1qa( Ac,.E
State M! v City MA(*,C 60pL6
Zip ?S Telephone # (10) ti oA ?. 9 9 9-s-
Arch/Engr ON??
Address
State Registration #
City
Zip Telephone # ( )
Licensed plumber installing new sewer/water service: Phone #:
1 nereby apply tor a Cotnmercial Bullding Permit and acknowledge that the information is complete and accurate; that the work will be in
conformance with the ordinances and codes of the Ciry 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 cordance with the approved plan in the case of
work which requires a review and approval of plans.
A-91t J < rAa:ZVTVJ
Applicant's Printed Name Appli&n't s 5igKature
i
Y v
11
Ordinance No. 114:
WELL CONSTRUCTION AND ABANDONMENT
WELL PERMIT
DAKOTA COUNTY PUBLIC HEALTH DEPARTMENT
ENVIRONNIENTAL HEALTH SERVICES SECITON
WATIIt QUALITY MANAGEMENT UNTT
14955 Galaxrie Ave., Apple Valley, MN 55174
Telephone: (612)891-7556
WHEREAS, the NON-TRANSFERABLE
PERMITTEE/DBA: Keys Well Drilling ISSUED TO #62012
ADDRE38: 413 N. Lexington Pkwy REVIEWED BY JML
St. Paul, MN
91-9227
Pe:mit No.
has submitted a permit application, has paid the sum of one hundred
($100) dollars to the County of Dakota as required by Ordinance Number
114 and has complied with all of the requireinents of said Ordinance
necessary for obtaining this permit to permanently seal the well(s)
described herein:
An abandoned well(s) with a casing diameter of 4 inches, depth(s) of
317 feet and completed in drift will .be permanently sealed. The
well(s) shall be cleaned of equipment and debris, disinfected, neat
cement pressure grouted and terminated at least two feet below grade.
The well is located in the municipality of Eagan as follows:
Well Location: Property owner and Well owner and
Address (if different) Address (if different)
565 Lone Oak Rd. Cray Research
Eagan, MN
NOW, THEREFORE, Keys Well Drilling is hereby permitted and authorized
to permanently seal the well(s) described and located above for the
period November 1991 to November 1992 subject to all provisions of said
Ordinance, the Minnesota Water Well Construction Code and any
conditions attached on the reverse side of this permit form.
Given under my hand this 30th day of December, 1991.
ATTEST ENVIRONMENTAL HEA TH SUPERVI50R BWMNMF&TAL HEALTH DIRECTOR
t ? r lll? oau cr,. ,oo cvc fo. s. svof 12116 r. I
DA KU T A G'OU1V / Y
DOHNA M. ANDIllItlhN
vuuue HeairH aiaFCTop
t6121450-2e14
PUBLIC WEALTH OEPARTMENT
CQMMUNITY SflRVICES DIVISION
PubliC HCalih NuiSing frv_ironmen?l y?allh Emergency M(idiCel
$9rviceg 2rvi?es.
SBrviC85
?
REPIY TO
C rvorfnefn 9enice Conier
97 Eeei WeMNOrth Iwenue
Wsd 6l Peul. MN 66110
le,:y +30-Qet4
c.. ie, x> 450•:e4e •
q WlSIHM1 $oIYKO t.l111?I
14065 Ga4w0 OWwpo
ADPla Wlily. mNi3, H
(Gi:t etI•7e00
r¦. Jaix) esi-oaa
DAKOTA COUNTY PUSLIC HEALTH DEPAItTMIINT - WATR•R QUALITY MANAGEMENT
WESTERN SERVICE CENTL+R, 14955 Galaxie Ave. west, Apple Valley, MIlV 55124; (612)891-7556
FACSZMILE (612) 691-7473 •
IqUNICIYAL NOTICE OF WLLL P,LRMIT APPLTCA?ION
?....-'........?.........,..._....._.?.___
SE13D T0: ToM, Co?Gti?,(`f MUNICIR,4i.ITY: S.z a.A
OFFICE: TELSPAONE:( ) FACSIMILE:( )y?jf?$36-3
aTe" . •?f? INSP?CTOR # AP7'rELyPHOZfE:. ? 3
AATE/TIME FORWARDED:IE ?p?Z?qr COt41ENTS:
fitFEH TO WELL PL+RMIT N0. _•?? _4?.7
DAKOTA COUI3TY WATER QUALITY MANAGEtIGNT NAS RECEIVED THE WELL PERHIT APPLICATION(5) DE-
SC[tZBED BELOW. PLEASE NOTE: IF YOU RLQl1IRE FURTtiER RLVYG?J OF THIS APPLICATI0:1(5) OR
YF YDU HAVt ANY QUE5TIONS OR CONCF•RNS ABOUT IT, CONTACT OUR OFFICE AT 891-7556 aR THE
ENVIRONMENTAL HLALTti SPECIALI5T LISTED tlBOVE. IF THERE IS NO RESPONSE FR03f YOUR OFFICE
WITHINT 24 FIOt1RS (E.ICLUDING WtEKCNI7S ANi? HOLTDAYS), 5TAFP' WTLt AS5lTME TFIAT YOu HAVE Nb
OBIECTIONS TO TFIE lSSt1ANCE OF THE PERMIT. ALSO PLEr1SE NOTE THAT PERMIT ISSGANCE xS
AtWAYS CONDITIQNED 0`I THE OSSERVANCE OF AATD CO-Kt'LIAVCE WITH ALL APPLICABLE LbCAL RE-
QUIRE`IEVTS Ah*I} ORDI:IANCES. A COPY OF THE SJLLL PBR."SIT IaILL Bt FORWAxnm WkiLN CQlTLETfip.
pROpER"t'Y OWNER: wELL OGTNER: Sc,, ?, p
LOCATTOY OF WELL(S): ADDAESS s", • ?p Q?rr, Ag4k,
PROPERTY LD N0. COOttDT;lATES: OFAL&)0V5iWF.5rOF SECTIOy
TOIIVSI{IP Q-7 NORTH, RANGE;.-LWE5T. MUNICIPALTTY: E'b?Qrl
IJIF
WELL DRILLLR:
'pvs DATE RECORDED:
A.'dTICLPATED DRILI,Y:IC/SEALLNG DATL• (IF KtvOtJ:l) ;?
WELL(S) DESCRIPTIO\: PRIFfARY USE__???{?sf?? _ NEW CQNSTRUCTTON` RECONSTRUCTZO\'_
TE*IPORaRY CAPPI\G- PCAMANENT SGILTNG.Xa\\tli.lt AL-\I\TFNANCE: RECLAIMED _ REGISTGI2ED
I4GLL DL•,4^II;fEIi-v--I\CIIES. WL•LL DLPTHaaFI:l.T. AOL;IPER rltt,.?% C r?t1 QC'lJ /,jZ96o
VOTZ:S R,,_fi. - rA fri(P Lpriie daw..9 Fr.r4t.:.( -
Ar, rci r.v ...,nl - . ,
f? - FA
L A Bonner sons
INCORPORATED
Date: APRIL 1, 1992
MINNESOTA DEPARTMENT OF HEALTH
717 SE DELAWARE STREET
DIVISION OF ENV'IRONMENTAL HEALTN
MINNEAPOLIS, MINNE50TA 55440
ATTN: Mr Jim Nye
(612) 623-5339
SUBJECT: WELL ABANDONMENT
SIT.E AI.AGR_AM
RE: NOTIFICATION
Dear Mr Nye,
NORTH
S t-?e- uj "1 S (--, t?? i7
This letter is to notify you of a water well in your district that should
be sealed according to the Water Well Construction Code MCAR g4725.2500-2900.
E.H. RENNER 8 SONS, INC has been notified by the owner of this property or
an interested party and have subsequently submitted to them an estimate for
the sealing of this we11 under our LICENSE #71015. We have also included
a copy of the current code with our estimate.
In submitting our estimate, the owner may also receive additional estimates
and hire any number of Minnesota licensed water well contractors in the area
to seal this well. Nowever, there is a possibility that this well may not
be properly sealed and thus jeopardize the ground water and Public Health.
E.H. RENNER 8 SONS, INC. wishes to provide you this information for future
reference with the abandonment report when submitted.
PROPERTY OWNER: UNKNOWN
ADDRESS:
PHONE #
CATE 9-i2-9
LOCATION: 565 LONE oAx RoAn WELL DIA. [lx
EAGAN, MN. DEPTH: [7x
Sincerely Submitted,
Raymond T. Renner, V-President
E.H. RENNER & SONS, INCORPORATED
STATE LICENSE #71015
CC: CITY OF EAGAN
3830 PILOT RNOB ROAD
EAGAN, MN. 55122
ATTN:
Equal Opportunity Employer
RFCE31?EjW
WELL DR/LUNO FOR FOUR OENERATIONS
15688 Jarvis Street N.W., Elk Rhror, MN 55330
(812) 427-8100 Fax: (612) 427-0533
? - 2004 ?
n, 5?? 1 5
C O V N T Y
September 14, 2004
(FZ,\? ?ly
\ f? ?
?
David Schultz
Environmentai Managemenc Vieau Associates Inc,
Barry C. Schade 7710 Computer Ave., Suite 120
Director Edina, MN 55435
Dakota Counq
Wescern Service Center
14955 Galaxie Avenue
Apple Valley, MN 55124
951891.7557
Fax 952.89 1.7586
wrwv.ro dakota.mn.us
Dear Mr. Schultz:
In regard to your request for information regarding the property located at
565 Lone Oak Road in Eagan, I have the following reply:
1. Enclosed is a list of licensed hazardous waste generators for the
specified area.
2. Enclosed is map indicating the locations of known dump sites within
the specified area.
3. Enclosed is a map for the pipelines within the specified area.
4. Enclosed are lists for CERCLIS, NPL and PLP sites within Dakota
County.
This information was arrived at with the most current data available. In
issuing the information Dakota County assumes no responsibility as to the
activities undertaken.
The 2004 Dakota County fee schedule adopted by the County Board of
Commissioners on October 28, 2003 requires that you be billed for services
provided by this Department. Staff time for this review was 0.50 hours at
$90.00 per hour for a total cost of $45.00. Pfease make a check or money
order for the total amount made payable to "Dakota County Environmental
AudiY" and send to my attention.
If you have any questions I can be reached at (952) 891-7547.
Sincerely,
William Freischel
Environmental Specialist
Hazardous Waste Regulation
Encl.
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9528917000
5EP-07-2007(FRI) 15:08 Dakota County POD
14.4K
(FRX)9528917000 P.001/001
r
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?.
WATER RESOURCES OFFICE
GROUNDWATER PROTECT1bF! SECTION
14855 Gataxia Avenue • Applo Valloy, MN 55124
952.891.7557 - Fsx 952.897.7588 • www.cadakota_mn.us
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MUNiCIPAL NOT[CE OF WELPERMIT APPLIGA7[QN
UATE: 5eptemUer 7, 2007
TO: Tom ColbertlWayne Schwanz (t.M)
RE: Wcll Pcrmit #: 07-H264323
Mut?icipality: Lagan
Fax#: (651) 675-5694
wclI Typc: Domestic
Watcr Itesaurces Speclalist: Rutten
"the Dalcota Cauniy Water Resouraes ()ffice hus received the folJowing pcrmit applicaNon for the wel] described. If
yau require furtl3er zeview of the application or if you have any qnestions or concerns about it, contact the Water
Resource Specialist ]isted above or our office at (952) 89I-7557. If there is no response from yaur office within 24
HpURS (excluding weekends and hblidays), We will assume that you have no objections to the issuance of the
peiznit Plcasc note that permit issuance is atways cbnditioned on the pCrn]it appiicant's observance of and
compliance with ull appFicable state, counry, and municipal laws and codes.
Wc11 Contractor:
Dute Application Received:
Anticipated Dritling Daic:
Mticiputcd Grauting Date:.
Propcrty Owner:
Wcll Owner:
WELL LOCA'TTON•
Don Stodola Well Drilling Co.
snraoo7
Time:
Timc:
Rachel Contracting
Rzcliel Contracting
PLS Coordinatcs: 114, SF 114, SW 1/4, SE 1/4, Sec 01 Town 027 Range 23
Strcet Addtess: 565 Lane Oak RD
PYN Nu?nber: 10I850144000
WELL INFOTtMA1'ION•
Diametcr:
Casing Depth:
Total Depth:
Static Water Level:
Aquifer:
CUMN[ENTS:
City of EAGAN Lege"d
[?'-:?1 tEighligMed Featura
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PID:
C 100010001575
; 565 LONE OAK RD
ti f EAGAN,MN 551210000
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Property Owner Assessing Sales
PIN: 100010001575 PID: 100010001575 Year Built: 1979 Sale Year: 0
House#: 565 Full Name: EAGAN HEIGHTS LLC land Value: 260600 Sale Month: 0
Street: LONE OAK RD Address 1: Mo GREGORY S MILLER Building Value: 30200 Sale Value: 0 -
Apt: Addrpss 2: 860 BLUE GENTfAN RD STE 175 Toial Vaiue: 290800 - Sale Tax: 0
Zip 551210000 City ST: EAGAN MN 55121 NetTaz: 7421.66
Code:
Total 7az:
7921.66
Lot: 005000 12723
Zoning
Plat: SECfION 1 TWN 27 R4NGE 23
PT OF SE 114 OF SE 1/4 COM NE COR 5 Zane Code [SqR]: PD
Legal: 250 FT W 350 FT TO BEG S 966.39 FT W
" Zone Desc: Planned Development .
46639 Ff N 46638 P
f E 46638 FTTO LandUSe Code: SA
BEG
LandUSe Desc: Special Area