4066 Halite LaneCITY OF EAGAN Remarks ?
Addition CEDAR GRO' ?-?1 #7 Lot -- 35 aIk 5 Parcel l? 16600 350 05
Owner tQ-?EY?i?1 ?VIA-W 11 Street 4066 Salite Latle State Eagan, NN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1970 5$.18 2.08 28 Paid
* SEWER LATERAL 1971 20
WATERMAIN
* WATERLATERAL IL? 1971 1,615.00 84.75 20 Paid
WATER AREA
* STORM SEW TRK 131 1971 20
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 280.00 5060 12-2-71
BUILDING PER.
sAC 240.00 5060 12-2-71
PARK
INSPECTION RECORD
' CITY OF EAGAN PERMIT TYPE: ?"M 111Hfi
3830 Pilot Knob Road Permit Mumber: s I94
( Eagan, Minnesota 55122-1897 Date Issued:
(651) 681-4675
? SITE ADDRESS: APPLICANT:
PERMIT SUBTYPE:
. . I . 1;
TYPE OF WORK:
Iit •yi'RTf'3'I(IN
Rt Ftr?i I l
INSPECTION .. . D.
! RKS s RFFLAt.F R()Ot
?
IL
nARanr aNr? rri
MNril
Permit Holder Date Telephone #
SEWER/
WATER
PLUMBING
HVAC
Inspection Dab insp. Commenta
FOOTINGS
FOUND
FRAMING
ROOFINCi .?i
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
MEfER
IRRIGATiON
METER
FLUSH
MAINS
coNOUCTivm
resT
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FINAI
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN A 7D QO
I? 3830 PILOT KNOB RD - 55122 J?
851-681-4675
Cai??d 6-?q-UI
New Constructian Reauiremenh RemodellReoafr Reaufrements
• 3 registereA sile surveys showiig sq. ft. of WL sq. fl. of house; and all roafed areas • 2 copies of plan
(20%mazimum lotcroverage allawed) . 1 set of Energy Calculatbns far heated additions
. 2 copies of plan shovnng beam & window sizes; poured found design, etc ) • 1 sRe survey for eztenor additians 8 decks
• i set o( Energy Caladations . IrMicate if home served by septic system for additions
• 3 copies of Tree Preservatbn Plan A lot platted aRer 711193
• Rim Joist Detail Options seleclion sheet (bldgs with 3 ar less unAS)
DATE ID- J I-"n I VALUATfON
JOB SITE ADDRESS 4D b?, -PQ1 i Te_ L-a-n2
IF MULTI-FAMILY BUILD?+I-NG, HOW MANY UNITS?
PROPERTY OWNER l7r=rU ?. 61-Pe`1
TYPE OF WORK ?e c-)'C FIREPLACE(S) 210 _ 1_ 2
APPLICANT GrQranru D. 6re? PHONE#b51-IORI-2S2L'7
ADDRESS L..4XIQ ??Q?CLY?1 MT? ZIPCODE 551aA
PAGER # CELL PHONE # FAX #
NEW RESIDENTIAL BUILDING ONLY - Flll OUT COMPLETELY
Energy Code Category _ MINNESOTA RULFS 7670 CATEGORY 1
(check one) - Residential VenGlation Category 1 Worksheet Subm? ?^I-?--
- Energy Envelope Calculations Su6mitted
_ MINNFSOTA RULES 7672
- New Energy Code Worlcsheet Submitted
Plumbing Confractor: _
Plumbing System Includes:
Mechanical Contractor:
Mechanical System Includes:
Sewer/Water Contractor.
_ Air CondiUoning
Heat Rewvery System
Fee: $90.00
Phone #
Fee: $70.00
Phone #
All above information must be submitted prior to processing of applicadon.
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with ail applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Appllcant
_ Water Softener _
_ Water Heater _
_ No. of Baths
Phone
Iawn Sprinkler
No. of R.I. Baths
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 1/01
OFFICE USE ONLY
? 01 FoundaGon ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OB OB-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of_ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.) ? 33 "EM.AIt - SF
? 04 02-plex ? 10 08-plex # 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
IV 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. 0 42 Demolish (Foundation) ? 45 Fire Repair
O 33 Alteration O 37 Demolish jBldg)` ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg anly) - Give PCA handout to applicant
Valuation D19Q Occupancy A - ? MC/ES System
Census Code ? Zoning le-City Water
SAC Units _IV Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const ,S- Width
REQUIRED INSPECTIONS
Footings (new bldg)
? Footings(deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
_ Frazning -
_ Fireplace _ R.I. _ Air Test _ Final
Insulation
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding SNcco Stone
Windows (new/replacement)
Approved By 119 , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Finavc.o.
? FinaUNo C.O.
_ Plumbing
HVAC
Total
EAGAN TOWNSHIP
BUILDING PERMIT
N°
2619
Owner .l??-!?.e-.i ??`-e-.?-r ?-aC-
. ... _........_.._.....____._..._".........._.....___.
Address (Presen!) -...?. .. ................................
Bu[ldeC .............. Addrays ..................................
DESCAIPTION
Eagan Township
Town Hall
Dale
Siories To Ba Used For Fron1 Dspfh Heigh! Eei. Cos! ? Permi! Faoil , Aemart? ,
I
This permit does not authori:e the ufa of sireels, roads, alleys or eidewalke nor doea it giva the owner or hfs egan!
the 4igh! !o ereata anp situalion which is a nuisance or which presenls a hazard !o the health, safetp, convenienca and
gsnaral welfare to anyone in the eommuniip.
THIS PERMIT MUST SE KEPT ON T}iE PAFMISE WHILE THE WOAK IS IN PROGRES$.
This ia fo cerliiy, the2._ ao?.°.^:.: ....................................... ,.hasparmission !o ereef a.... -..`?..-_-?'
-----.... .---------------- . . ............ _upoo
the aLove deecribed premise aubjacf So the provisions of the Buildiag Ordinance fox Eagan ; ownship edopted April 11,
1955.
?,(??
" ...................... .... ..........L_...FrS:e>................ P0! ..... .................................... ..C"."'.......__°_..`.,J"_..........................
Chalrman oi Tnwn Board r,
eBulldinp Inapocior
CITY of EAGAN
BUILDING PERMIT
own.: ... ... ..... .. . ......... ...... ..... . ........ . ............................. °---. .
Addsess (psecen!) '? 62.i .....' . .... ................'-....... ................
..... ------- ------ ........... ..................................................
Buildes
Addreas ...7..3..7.?......e'"?`_"??'. ?"
???
1?, ..........DESCRIP TIO1Q
....................
a im
N2 3546
3795 PiloY Knob Road
Eagea, Minnesola 55122
454-6100
-
Dsla .... 4........- ... / L
........
BSOrias To Be Ueed For Fson! Deplh Haigh! Eel. Coe! Permi! Fsa Aemarks
O
- LOCATION /3,'5"u
............................. ...? :..-? -.. .
.............
Mayor
_ ?
Per ....................................... --............--•------......_- ---..........................
Huildinq Inapsclos
?G
This permit does nol aufhoxise the use of sl:eels, roads, alleye or sidawalks aor does it give the ownar or his agsnt
the righ!!o ereale eny siivation which is a nuisaaca or which presents a hasard !o the heallh, aafelp, coavenience aad
ganexal welfare io anyone in the communify. TFIIS PERMIT MUST BE KEPT ON THE PR£MISE WHILE THE WORIt IS IN PAOGRESS.
This is to cerlifY. ..... ............. haepermisatoa !o eree! d .... .?. .........'..? ....... _Upon
the above described premise subjeci !o the provisions of all applicable Ordinances fo= !h CA' i!p of Eegaa
TOWN OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
3 5- 5- /
C,G?
PERMIT N0, 163
The Board of Supervisors hereby grants to Cedar GTOVe Construct3oA Co.
of 7343 co,cora $lva FAst, soutn st. Paul 55075
a HFATING Permit for: (Owner) Same
066 Ha1i-t6-,-4-088 xalite, 4018 pumi.ca, -s -7, 3P --7,
atli007 Cinnebard & 4092 Ha11te , pursuant to application dated
9/27/71 .
Fee Paid: $100.00 Dated this 2nd day of Deoember , 197 1.
4-025 aC
Building Inspector
YL
Y
C?-7
TOWN OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
PERMIT N0, 174
D5
The Board of Supervisors hereby grants to Ce3ar &ove Construction Co.
of 731+3 Concord Blvd. East, soutn t. Poll 55075
a PLUMB3NG Permit for: (Owner) saxag
at i , pursuant to application dated
9/27/77
Fee Paid: $190.00 Dated this 2nd day ot DeCembBi' , 1971 .
2.50 kKR5 s c
$am
Building Inspector
?L
EAGAN TOWNSHIP
BUILDING PERMIT
Ownex (I.
.c?1L^.;??C....... ..............................
Addresa (Preaeni) ...??...?E..?.......... 26?.................. ....
Builder .................................................... -----........------..._........-------
Addresa ................................. .......................................................... ..
N° 2983
Eagan Towaship
Town Hall
y?-i?- 73
na:e ....
..-----°..................................
5forias To Be Used Foz Fron! Depih Haighf Esf. Cos! Permit Feel Ramarke
Sireei, aoea or oiher Ueacnption ox Loaanon I Lox I tsiocu I aaamon or -rraot
S I C & -;+--7
This parmii does aot auShorise the use of elreeis, roade, alleyc or sidewalks nor does it give the owner or hia agea!
the right to ereate any siluation whieh is a nuisance or which presenls a hazard !o the healih, sefefp, coavenience aad
ganeral welfare !o anpoae ia the eommunifp.
TBIS PERMIT MUST BE ?CEPTnpN THE PREMISE WIiILE THE WORK IS IN PROGRE 5.
This ia !o eertifp. !hal---. j_... t f............................. has permission !o ereet a......... ...._...-?-?:...._............._..........._upoa
the abava described premise subjec! !o the provisiom of the Building Ordinence for E gan Townahip adopted April 11,
1955.
.?.2<
...._.._...--.°°----.. Paz ................... ........ ,l?............•-.......---°--Q °--._?..----....._°---...•---°--°-
Chairman of Tnarn Soard ? Buildin Ina ecforoG
? REOUEST FOR ELECTRICAL INSPECTION ?y, /? E&00001-OB
? See instmcnons lor comple9na this form on Oack of yellow copy ^t'?'?..'F?gL %/K, 9s?
53 18 "X" Below Work Covered by This Request ??,41 L.S =?2
ew Atld Rep rypeofBmldmg AppbancesWiretl EquipmeniWved
Home Range 7emporary Service
Duplex Water Heater Electric HeaUnq
Apt Buildinq Dryer Other (Specify)
Comm /Industnal Fumace
Farm Air Gonditioner
Olner isyectly) Conhac r's FemaBS
. 4- T
Compute Inspectron Fee Below:
# Other Fee # ServiceEntrance5rze Fee # Crtcutts/Feeders Fee
Swimming Pool 0 l0 200 Amps O to 100 Amps
Transformers Above 200 - Amps Above 700 _ Amps
$IJOS InspetlorSUSeOnty 7QpL\ ,
Irngation Booms ( f w ;
Special Inspechon
Alarm/Communicauon THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
1. Ihe Electncal Inspector, hereby
f
h Rough-in oare
certi
y that t
e above inspection has
been made. F,nai o
OFFlCE USE ONLY
Tnis request vmtl 18 manths irom
?i?? CJ /Xa`l5
J 15 318 , 3? 7 Z/?s-5z
Reques? Date .? ^
1?f Fire No Rough-in InspecM1On
Reqwred'+
?Featly Now OWill NoLly Inspector
nR
Wh
d
'+
?
eU y?? GVes No e
ea
y
licensed contractor ? owner here6y request inspection of above electrical work at:
Job Atltlress (Street Box or oute No 1 ?
R
ii- Cily
'
/?6G?6
r'??.! /
c * N
4
Setlion No Township Name or No Range No. County
Occu ?PR?N?
t? Pno?ne/Na
'/'?1 752 -7
Power SuppLer?/ ! Aaer-e?ss 1
Elecmcai onVacror(Company Name)
GonVactor5 L¢ense No
y-
Maibnq Atltlress ICOnlractor o
r
O
w
ner MaWng Installa?ion
?
J
?
?
?T(J
? 7
Aut?onz nalure IConVacmr nqr M iog Installalion? Phone Number
v7w
MINNESOTq, TATE BOAflU OF ELECTRICITY THIS INSPECTION REOUEST WILL NOT
Grigga-MlEway BIEg. - Room 5-113 BE AGCEPTED 8Y THE $TATE BOARD
1621 Unrversi[y Ave.. 56 Paul. MN 55100 IINLE55 PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
a
P
EAGAN TOWNSHIP
3795 Pilot Knob Rosd
Se. Paul, Minneaota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTTON
Date: September 27, 1971
Billing Name: Cedar Grave Const. Co.
pwper; Cedar Grove Construction
Plumber: Stein Plumbing Company
Connection I Meter Size
NO '1bta1 Chg.
Building is a;
Residence
Nfultiple Na, Units
Commercial
Industrial
Other
12/2/71
Meter No, Permit Fee 10.00 pd 12/8/71
?id s/c
Meter ReadingL_ iMeter Dep.
Meter Sealed: Yes_ IAdd'1 Chg.
Inspected by
Date
Remarke:
Number: 756
Site Address: 4066 Halite 35-5-7
Billing Address 7343 Concord Blvd. E.
Hy:
Chief Inapector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules aud
regulatioas of fiagan Township, Dakota County, Minneao[a.
By; Gedar Grove Construction Company
?LtL?Z?.?G ? ?ILCl7/J
Please notify the above office when ready for inspection and connection.
.
.
EAGlaN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Mianesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNL+CTiON
DATE:September 27, 1971
OWNER: Cedar Grove Construction
PLUMBER Stein Plumbing
NUMBER 916
Addrese 4066 Halite 35-5-7
TYPE OF PIPE Cast Iron
DESCRIPTION OF BiJIIDING
Induatriall Comerciall Reaidentiel I Multiple Dwelling I No. of units
Location of Connections:
Permit Fee 10.00 pd 12/2/71
/71
Street Repairs
Total
Inspected by:
Date
Remerka:
Connectioa Charge 240.00 pd 12/2/71
Bq
Chief Inspector
In consideration of the issue and delivery to me of the above permi.t, I
hereby agree Co do the proposed worlc in accordance with the rules and
regulations of Eagaa Tocroship, Dakota County, Minneaota
By Cedar Grove Gonstruction Cmmpany
-//l/!7/J'?L?
/0
Please notify when ready for inspection aud connectioa and before any portioa
of the work is covered.
:f A PERMIT
CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: s u xLo z w e
Eagan, Minnesota 55122-1897 Permit Number: e 3 3 7 9 4
(651) 681-4675 Date Issued: 10 / 2 6/ 9 S
SITE ADDRESS:
P.Z.N.: 10-16706-350-05
4066 HALITE LHNE
LOT: 35 BLOCK: 5
CEDAR 6ROVE #7
DESCRIPTION:
T.O. & REROOF
Bui'ldin`g,Permit 'iype S7QRM DAMAGE
8uilding Wa'rk Type RFPAIR
.Census Code 434 AL7. RESIDENTIAL
i ?
/
P `\?? ;?..,._ ?``v, '?-??(. t•`rl??'?.L..iii?liJi a-,\
REMARK?CE RQOF ON fiARAGE AND PORCH [JUE TO STORM OAMAGE.
FEE SUMMARY:
CONTRACTOR: ' OWNER: - applicant -
GREEN GREGORY
4066 HALITE LANE
EAGAN MN 55122
(651)681-8576
I hereby acknowledge that.I have read this application and state that the
intormation is correct and agree to comply with all applicable State of Mn.
Statutes and City of Eagan Ordinances.
I
APPLICANT/PERMITEE SIGNATURE
@ I ?
-- { VSUED BV: SIGNAT E
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
9 3830 PII.OT KN ?O; RD - 55122
New Construcbon Reauirements
RemodeVReoair Reqwrements
? 3 registereE sile surveys ? 2 mpies of plan
? 2 wpies of plans (inGudo beam & window sizes, poured tnd. design; etc.) ? 2 site auneys (exterior aAd'Rions 8 deeks)
? ] energy calwlatbns ? t energy wlalations for heated addrtions
? 3 copies ot tree preservation p{an A fot platted alter 711199
required: _ Yes _ No
DATE: 0 CONSTRUC?TION CpOST; ?? OO
Oi- f'o Y??"? -, 1
DESCRIPTION OF WORK:
STREET ADDRESS: 4-104?? /7??7'e C?. _
LOT: BLOCK: ? SUBDJP.I.D. !
PROPERTY
OWNER
CONTRACTOR
Name: ( a(eet ? -C,'O ?Y Phone #:
Last Fi ?
Street Address: ?`7'?// /c L? •
City State: Zip: J?S?v?a
Company: Phane #:
Street
City
License #
State: Zip:
Phone #:
ARCHITECT/
ENGINEER Company:
Name: Registration #:
Street
City Stare:
Sewer & water licensed plumber (new conshuction ony):
and lot change is requested once permit is issued.
Zip:
Penaity applies when address chang
I hereby. acknowledge that I have read this application and state that the iniormaGon is coRect and agree to comply with all applicabi
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Appticant.
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received Yes No
t
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
? 02 SF Owe(ling ? 07 4-plex
O 03 SF Addition 0 08 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. ? 10 = plex
WORK TYPE
? 31 New ? 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
OFFICE USE ONLY
? 11 Apt./Lodging ?
? 12 Multi Repair/Rem. ?
? 13 Garage/Accessory ?
? 14 Fireplace ?
? 15 Deck
O 36 Move
? 37 Demolition
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building Engineering
Variance
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S!W Pertnit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
ToW I:
Valuation: $
16 Basement Finish
17 S1wim Poo!
20 Public Facility
21 Miscellaneous
MCIWS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
% SAC
SAC Units
MASTEft CABD
Permit
No.
Issued Issued To
Coniractor Owner
BUILDING
PLUMBING ?
?
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
H EATI NG
GAS INSTALLING
SANITARY SEWER
OTHER I
07HER I
kems Approved
(Initial)
Date
Remarks
Distance From Well
FDOTING ,}. /I -7 SEPTIC
FOUNDATION , y` CESSPOOL
FRAMING j -??- 7 } TILE FIELD FT.
FINAL
ELECTRICAL
HEATING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUM8ING
WELL
SANITARY SEWER
Violations Noted
on Back
COMMENTS:
LnNO USED as /6 X?(? ?? (r Gc dd k.
,
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVEU VIOLATIONS
PERMIT NO. DATE OF
CONDITIONS Of CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE ? NON-COMPLIANCE. BUILDER DOES NOT
OBSERVED. INTEND TO COMPLY.
? ACCEPTABIE SU&STITUTIONS OR
DEVIATIONS. COMPLETION OF CERTAIN IMPROVEMENTS
WILI BE DELAYED 8Y CONDITIONS BEYOND
CONTROL.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WI7HOUT DELAY.
ITEMIZED AND OESCRIBED AS FOIIOWS:
? REINSPECTION REqUIRED DATE OF REINSPECTION
REINSPECTION REVEALED
CERTI FICATI ON - I certify that I have cerefully inspected the a6ove in which I have no incerest present or prospective, and that I have reported herein
ail signiticant conditions observed to he at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPECTOR DATE
MASTER CARD
• LOCATION
STRUCTURE AND
LAND USED AS
Permit
No.
Issued Issued To
Contractor Owner
BUILDING
PLUMBING JL. J 7
l
_?
CESSPOOI - SEPTIC TANK -
-
WELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER ?
OTHER
OTHER ?
•
•
Items Approved
(Initial)
Date
Remarks
Disiance From Well
FOOTING ? SEPTIC
FOUNDATION CESSPOOL
FRAnaING ?- f 4? • ? TIIE FIELD FT.
FINAL
ELECTRICAL
HE.4TING
GAS INSTALLATION
?o - a Y
1 DEPTH
OF WELL
$EPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER d ? !
' +
Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
•
PERMIT NO.
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPIIANCE
OBSERVED.
? ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
DATE OF INSPECTION
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
I7EMIZED AND DESCRIBED AS FOLLOWS:
D NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED 8Y CONDITIONS BEYOND
CONTROL.
1-1 REINSPECTION REqUIRED
REINSPECTION REVEALED
DATE OF REINSPECTION
CE RTI FICATION - I certify that I hwe carefully inspected the above in which I have no interest present or prospective, and that I have reported herein
all significant conditions oLserved to 6e at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relaUng to the property inspected.
F] ALL IMPROVEMENTS ACCEPTABLY COMPIETED
BUILDING
?
?
1?? a.
ROY ZEVERINO
RourE i
PPE6COTT, WI9C. 34021
f . (716) 282.8755
MEL CORD[D
7376 CAMILL AVENU6
INVHR GROV6 HEtGHTB, MINX. S5070
(eia) 451.2+57
/
?
?
? MELROY CONS7AUCTION, INC.
? Contrmcting • Xome BuaZdting • ftemodeling
?10 6 b N?
????.,?'.?-
D?
i
i
.1'4+6tP?'"( Mr?
d:)
? MELROY CONSTkUCTION, INC.
' - Contracting • gom¢ Bua7ding • Remodeling
ROY ZEVEpINO
RoUT¢ 1
Pqescort, WIeC. 34021
1 - (716) 262-5753
?
?
N
?
M[L CORDEs
7376 CAHILL AVENU6
INVER GROVH NEIGHTS, MINH. SE076
f6121 401•2IE7
6S
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City of Eajan 1 Permit j I
1 i
3830 Pilot Knob Road I Permit Fee:
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
Fax: (051) 67S=5694 I Start I
2011 RESIDENTIAL P iIiIBiNG PERMIT APPLICATION
Date: ;ate Address: 0 G
Tenant: t
Suite
RESIDENT I OWNER 'Name:
Pte,
&AA
Address I City I Zip. b 44:9 A-,f 1w J37
v
CONtRACTOR Nanim MILBERT COMPANY INC.dba CULLIGAN _W_
Address: 1801 50"' ST EAST city. • IN M- GROVE RGI S
state:' MN Zip: 55.077' Phone. ssl '.45f-2241
Contact: _ BILL.MILM' Tj . Email:
TYPE OF WORK _ New ,Replacement _Repair _Rebuild _ Modify Space _ Work In.R.O.W.
Deseri tlon of work: ,
PERMIT TYPE Rd IDENT/AL
Water Heater1Nater Softener
Lawn irrigation (RPZ / _ PYB) Add Plumbing Fixtures Main tower Level)
Septic System Water Turnaround
.'-Nave
-Abandonment
RESIDENTIAL FEES
$55.00 Minimum Water Hester, Water Softener, or Water Heater nand Softener (Includes $5.00 State Surcharge)
$35.00,Lewn Inigati€tn pnclrldes $5.00 State Surcharge)
$55.00 Add Plumbing Fixtutes, Septic System Abandonment, WaterTumamund' (includes $5.00 State•Surcharge)
h 'Water Turnaround (add $166.00 If, a 5/8' meter Is required)
$105.00 Septic System Ne* ($10.00 pares built) (includes County tee and $5.00 State Surcharge)
$95.00 Fire Repair (replace pumed out appliances, ductwork, etc.) pncludes $5.00 State Surcharge)
O oi~
TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One Call at (631) 454-0002 for protection against underground utility damage.
Call 48 hours before you Intend to dig to receive locates of underground utiiltles.
I hereby scluvMedge that this Wr rrnadon N 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 to a permit. but only"an application br a permit, and work le to stag without a permit that the work WM be in
accord ` V L the approved pla' I the case d work which requires a nvlew and a
'Applicant's Printed Name App an s•;igna n
i F9R PF G SE sv awed By .
r [is
i
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA119510
Date Issued:12/03/2013
Permit Category:ePermit
Site Address: 4066 Halite Lane
Lot:35 Block: 5 Addition: Cedar Grove 7th
PID:10-16706-05-350
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Jason Kempel
Valuation: 4,000.00
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 -
Scott A Hansen
4066 Halite Lane
Eagan MN 55122
Residential And Commercial Exteriors Inc
16040 St Andrew Lane NW
Anoka MN 55303
(763) 443-0830
Applicant/Permitee: Signature Issued By: Signature