4080 Halite Lane
~ ---Use BLUE or BLACK Ink
For O-ffice Use
City of Eapfl (s ~ i Permit ~
C~ I Permit Fee: G_b I
3830 Pilot Knob Road 1 I
Eagan MN 55122 j Date Received:
Phone: (651) 675-5675 I 1
Fax: 675-5694 1 Staff: I
(651) I I
`________________J
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: y Z /D Site Address: Yo L~_V
Tenant: Suite
RESIDENT I OWNER Name: bo-uld 412-1, Phone:
Address / City / Zip: !~,q &-0 #a f / k
Applicant is: Owner Contractor
TYPE OF WORK Description of work: C iL d c~lC' f720 l tl~t G
Construction Cost: vc;?,~DD Multi-Family Building: (Yes / No )
CONTRACTOR Name: License
Address: City:
State: Zip: Phone:
Contact: Email:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permitfor a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that 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.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
X_ I a o l~ t'O CZ~ x
4AApplicant's Printed Name plicant's Signature
Page 1 of 2
CITY OF EAGAN Remarks
Addition CEDAR CRnVE 47 Lot Blk S Parcel 711- 1fi6A[) '47A A5
Owner Street 4480 Hallfte I,ane State Edcfdn. MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 51 1970 58.18 2.08 28 Paid
* SEWER LATERAL 1971 20
WATERMAIN ?
*WATER LATERAL L 1971 1,615.00 80.75 20 Paid
WATER AREA
* S70RM SEW TRK 1971 20
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 300.00 6269 8-I6-72
i BUILDING PER.
sac 260.00 6269 8-16-72
PARK
CITY OF EAGAN
I 9795 Pilot Knob Rood Eagon, MN 55122 Ng 5323
PHONE: 454-8100
BUILDING PERMIT Receipt ?E
I .
To ba uiad for ` ? "(- ? ` Est. Value ,r, •
Dcrte
•-
Site Address
?
Eroct :0
Occuponcy
?
Lor Block Sec/Sub.
Alter ?
Zonin9 =
, Porcel #
Repair Q .
Fire Zone -
Eniorge ? Type of Const. ?
W Name Move p # Stories
?
3 Address demolish ? Front ft.
b Ci Phone 17-, Grode ? Depth ft.
°C Nome
o Approrols Fees
u
?re? Assessment Permit
? Water & Sew. Surcharge
Ci pho?
? Police Plon check
W Name
F W
Firo
SAC
?3 Address Eng. Water Conn.
iW Ci Phone Planner
f l
C Woter Meter
I hereby acknowiedge that I have reod this applicotion ond state that ounc
Bldg. Off.
the informotion is correct ond agree to comply with all applicnble ,
Scate of Minnesoto Statutes and Ciry of Eagan Ordinunces. APC Total
? Signoture of Permittee . .
A Buiiding Permit is issued to: on the express condition that
all work shall be done in accordance with all applicoble Stote of Minnesotc 5totutes and Ciry of Eogon Ordinarxes.
Bullding Offitiol
L
Peemit # DoM hmved Pann&t"
Plumbing
Mechanical
INSPECTIONS DATE INSP. Rough-In Find
Footings Dote Inap. Date Inep.
Foundation Plumbing
Frome/ i ns. Mechanica i
Final -2D-
Remorks:
CITY OF EAGJ?N
3795 Pilat Knob Road Eoaan, MM 55122 N2 4838
PHGNEs 454-8100
BUILDING PERMIT ReceiPt # 10164
Te be used for La-,Am S}+ed Est. Value Date .t`''?t' 6• , 19
5ite /lddress - s = •- - -- Erect ? x Occuponcy `
Lot ?) Block ? T $ec/Sub. L:C 7 Alter ? Zoning
Porcel # Repair ? Fire Zone 3
Enlorge p Type of Const. ?`
W Na? 3:?hr. f No?'?? Move ? # Stories
Z3 Address 4`)80 'iati?te Demolish p Front ft.
b Ci •.a?an pFmxw 4 5 4 -41 '- 8 Grode ? Depth ff.
ame a[I@ APProveb Feea
? o N '_
Addre:
?
? ra«„
Name _
Addreu
I hereby acknowledge thot I hove reod this upplication and state that
the informction is correct and agree to oomply with all applicable
Stute of Minnesota Stotutes and City of Eapan Ordino ces. ?.
r1 .!
Signaturc of Permittee
Assessment -
Woter 8 Sew.
Police
Fire
Eng.
Planner
Council
Bldg. Off. _
APC
Permit " • -
Surtharge
Plon check
SAC
Wcter Conn.
Water Meter
Torol 6.50
A Building Permit is issued to: ", 'n t"L-tor? on the express condition thot
all work shall be done in accordonce with all applicable State of Minnesota Stotutes ond City of Eagon Ordinances.
Building Officiol
??nnit # poh hried PawfltM
Plumbing
Mechanical
INSPECTIONS DATE INSP. R???n Final
Footings Date Irap. Dote Imp.
Foundation Plumbing
Frome/ins. Mechoniccl
Finol
Remarks:
INSPECTION RECORDA ?
I? CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
? Eagan, Minnesota 55122-1897 Date Issued: fi (651) 681-4675
I I . , (, ; '. K', 1.
? SITE ADDRESS: APPLICANT:
HA l ) l i' 1 A1V
f: nvf' 8 i
PERMIT SUBTYPE:
TYPE OF WORK:
IlC':t J: tlI I f ilry
aF F?Arr ',rr,rr+t
iNSPECTION .. • .A
I F-
7
l ? - --
Permit Hoider Date Telephohe #
SEWER/
WATER
PLUMBING
WVAC
Inspection Date Insp. Comments
FOOTINGS
FOUIdD
FRAMING
ROOFING
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
67
DOMESTIC
ME'fER
IRRIGATION
METER
FLUSH
MAINS
coNOUCnvirv
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:' I ra i 4,
fill
S010 I I; I ANt
1 i?f'11t Gkli'!I ' ? II
l PERMIT SUBTYPE:
I „I I „ .
rfh f,-;s??0 01
.l .- Eci oil ?
PERMIT TYPE:
Permit Number:
Date Issued:
APPLICANT:
+.Ikyi.i1l flial1 ''I 'Vi
( 6 L -' i .S.lr{ • h1?04
TYPE OF WORK:
IsF'.I'Klf't ( IrN
11111 1 i if 1 ?+6
N,'r' ;.)F?
O?4/ 1 v /vb
I I i.t P tAt ?%
AI f F t1A 1 11?N
( 1 N`,1- k t )
INSPECTION TYPE DA . rA
?
I_
Permit No. Permit Holder Date Telephone •
ELECTRIC
PLUMBING
HVAC
Inspectlon Dah Insp. Comments
FOOTINCaS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GA5 SVC
TEST
INSUL
GYP BOARD
FIREPLACE Az/
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDCi FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
CITY OF EAGAN PERMIT TYPE: ? ? ? ? ?? ? ?+?•
3830 Pilot Knobs Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued: •r' (612) 681-4675 . ? .
SITEADDRESS•` I.".: Ie--I.bIsci--.:i;1c? et,
' I ti r? 32 111.11l:r, ;
? rr "r nNf ?
PERMIT SUBTYPE: •
APPLICANT:
t ?..t ? ) ??:sa i• - g+?
TYPE OF WORK:
unv1 n
INSPECTION .A . .A
I kRky: A"iF.PARATF PERhIrT U; RI UUlkl:n 1`0R ANY {?tl1MiilN(i +?fr EI_( t:fR 1l-R1. 14101Nk
?
?
J
Permlt No. Per mit Hotdw Oate Telephona 3
ELECTRIC
PLUMBING 9M
HVAC ?
Inspectfon Wft Insp. Comments
FODTINGS
FOt7ND
FRAMING ?•? , i??
?B ?
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
HEA NG r^
GAS SVC
TEST
INSUL
GYP BOARD
FiREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL i.'3 2<. 5a.-j," 13;2
i
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
'y'a
riL- wr"F.
CITY OF EAGAIV Include 2 sets of plans,
l 1 site plan w/elevations 6
BUILDING PERMIT APPLICATION 1 set of energy calculations.
• .?'N yrou.v ?"?- }??/ ? / , fj
To be used forsw'/_M? oo/ Valuation Date !d!! ?
Site Address ry??d /?f,![?j??
Lot Slock ? Sec./Sub. G G 7
Parcel ll
Owner:
Address:
Phone 11:
Contracta
Address:
Phone ll:
Arch/Eng.:
Address:
Erect ?
Alter
Repair
Enlarge
Move
Demolish
Grade
OFFICE'USE NLY
Occupancy ?
Zoning
Fire Zone .3
Type of Const. t/
B Stories
Front ?i' ft.
Depth /11 ft.
Approvals Fees
.?
Assessmen[ Permit ?
Water/Sewer. Surcharge y ?_
Yolice Plan Check
Fire SAC
Eng. Water Conn.
Planner Water Meter
Council _ Road Unit
BLdg. Off.
APC
PhanP 0: TOTAL
BUILDING PERMIT APPLICATION
Pool & Fence
cirr oF EAcaN
3795 Pilet Keob Road Eagan, MN 55121
PHONE: 450.8700
N2 5323
Receipt #
8
$ite Addrew `YVOV ?a.c
Lot 32 Block 5 Sec/Sub.Cedar GYOVe #7
Parcel #
rc Name M?nnp-s
6922 5
? Address
? rr • St. Paul
p Name Sme
z?
8u
Address
~ Ci
?w Name
s? Address
I hereby ocknowledge that I have read this applicotion and state that
tMe informotion is corred ond ogree to comply with all applico6le
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee -
A Building Permit is issued to:
all work shall be done in acco
Building Official - ?X
St. North
Erect {t}C Occupanty R3
Alter ? Zoning Rl
Repair ? Fire Zone 3
Enlarge ? Type of Const. V
Move ? .# $tories
Demolish ? Front 35 ft.
Grade ? Depth 17 ft.
Aowovals Faes
Assessment -
Water & Sew.
Police -
Fire
Eng.
Planner _
Council _
Bidg. Off. -
APC
Permit
Surcharg?
Plan check
SAC
Water Conn.
Water Meter
Taal 31.00
age Products on the expres condition that
State of Minnesoto $tatutes and City of Eagan Ordirmnces.
, cITr oF ea"N
? 3795 Pilot Knob Read Eogan, MN 55721 N2 4838
<BNE: 454-8100
BUILDING PERMIT APPLICATION Receipt #
? P 10264
?y,)
To 6e uaed for T.awn Shed Est. Value Date
- ---- June 6, 19 78
SiM Address Erect ? X Occupancy i
Lot-32_ B lock_5 Sec/Sub. ca 7 Alter ? Zoning Rl
Porcel # Repair ? Fire Zone - 3
Enlorge ? Type of Const. V
s Name .Tohn C NOLd Move ? # Stories
Z
0 Addreu 4080 H811te Demolish 0 Front fr.
Ci E n Phone 454 -4198 Gmde ? Depth ft.
SdmE AvPrwals Faes
? N
0
Zu
V?
?
ame _
Addrea
Nnme _
Address
1 hereby ocknowledge that I hove reod this aG
the infortnotion is wrrecf an gree to wn
STate of Minnesota Smtutes Gn Ci of EoSignature of Permittee ???? (
?
A Building Permit is iss to: Johc
oll work shall be done accordaote wh all
Building Official
ation ond state that
with oIl opplicnble
Assessment
Water & Sew.
Police Permit 6.00
Surcharge .50
Plan check
Fire SAC
Erug.
Planner
Council Water Conn.
Woter Meter
Bldg
Off
.
.
APC
Total 6 _ 50
C Nord I on the express condition ffiat
coble Stote of Minnesota Stotutes and Ciry of Eogen Ordinonces.
,= t
r -? y EAGAN TOWNSHIP
BUILDING PERMIT
owne: .-w-? -
_ .......... ...............
Addreas (Presenf) --„8r,--....... _-:-_-4??-
- --. . _. _........................ ....
Builder _.- -.--.
Address ....
DESCRIPTION
N° 2803
Eagan Township
Town Hall
..... . _'----
Date ..............
Sfories To Be Used For Froni Depih
- Heigh! Esf. Cosf if Fee Remarks
8So
T,3
G.PU
or
?
li-o
>.oca aaaixion or -rracx
7
This permit doea aoi`auihorise the use of sizeefs, zoeds, alleys or sidewalks nor doea it qive the owner os his agent
the righlfo creale any sifuaiion which is a nuisance or which presenfs a haaard !o the heallh, eafeip, convenlance and
ganeral welfare !o anyone in the eommunily.
THIS PERMIT MUST B£ KEPT ON THE PREMISE WFIILE THE WOAK IS IN PROGAES .
This is fo eerlify, fhaf---GG-:t_!::?---- ..... ...............has Permission !o esecY a_-'_ . ?----'-- ......_""---
----- ......-'- _-uPoa
the above describad premise subject fo the provisions of the Building Ordinance for Eagan ?ownship doplad April 11.
1955.
.................. ................ .......S............--------------------- Per ------------- -. _.. .. ?:
....
..... . I m
Ch irman of Tnwn Board 8 u ' ?.? pec - . :oi
?
,la in
? 9
i4 ?7l J(O O?IXC. ici ? lJ
i A?G c- lzll?ia s?
O
8 9 9 6 9 ?
?
r a
&E
Requ s[ Da '
? Flre No. Rou -In Inspecton Feqmretl
ll
t
h
a
)
Y Inspeclion Olher Than ough-In
?
R
W
ll N
I
m
d
N
t
// ? .
rs
? OU m t ca
inspec
or w
en rea
y
( j
ow
i
o
iy
nspec
r
ea
y
Yes ? No Date Reatly
I? licensed contractor Q4wner hereby request inspection of a6ove electrical work af
Job Atltlr
BSS (SVeel, Box or Raule
No
.
` Qty
G
)
?
/
J
QOO a (
?
° f
r
..n.
T?
Section N. Township Name or No Range No County
n?(PFINT) /
7!
Phane No.
QJi 0l2 ?I
Power Suppher ACtlress
EIeG cal ConVactor (COmpany Name) Contradofs License N.
mee7W'1 PX
ding Ad ss (COnVactor or Owner Making InSfallation)
U
U
Au[hor SignaWre on[mcloqOwner ng I tallatwn) Phone Number
p
INNESOTA STATE BOARU OF ELECTH
I THIS INSPECTION REQUEST WILL NOT
GNggs-Midwey Bitlg. - Poom 5126 II II I I I ? I I I I I I I I I II BE ACCEPTED BY THE STATE BOARD
1821 Univarsiry Ave, SL Paul, MN 55100 I UNLESS PROPER INSPECTION FEE IS
Phnne 16121 fd741HM ? FNCIOSEO
?
`/I V?o
es-ooooi-o
s
REQUEST FOR ELECTRICAL INSPECTION 04,111
? See mslrudions tor completing this form on back of llow copy "X" Below Work Covered by ThIs Request Ne Ad Rep Type of Building ? Appliances Wired Equipment Wired
Home Range Temporary Service
uplex Water Heater Electric Heating
pt Bwlding Dryer Load Management
I omm /Industrial Furnace O[her (Specify)
Far, Air Condrtioner
t
her(specity) Comradors Remarks
Compute Inspection Fee Below: ?SM?'
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps Ahove 100 -Amps
SIgnS Inspecmr's Use onty TOT L
Irrigation Booms y" ? Q
Special Inspection / d'
Alarm/Communication THIS INSTALLATION MAY 8E ? ?ISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MO
I, the Electncal Inspector, hereby Rough-in oat
ceAify that the above inspection has
been made. oate
OFFlCE USE ONLY This request voitl 18 monihs imm
r,trv oF h:nrr,N
rASHIER: JS iEfiMINAI_ N0: 943
tAYE:: 07/30/99 T7hSl::e 12244c43
ID: .
NnMF : AFs_r,-PF.F?MTl'S
200 9001. 1225 f,iFALiLiOrt: 'f 05.25
205 9001 4225 i!!iFlUDOCK T 3.00
3210 90()1 4080 wIALI:'1'E LtJ Li.:1..,25
205 9001 4080 HAL_T.'T'F.:: 1_N 2.50
?
r'
TOt ] l. Fiut_e7.Qt Amaurtita 24?.00
cRi.i ¢6r a.
USE:F't 10 .7AN
?KMYF?k*M%F?kSkaCX??kYFYF?%?l?k?F$tKokJk$c??, ?Ci$?kmMM?YF 'M3F??k?XXt
C?? 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
s.
CITY OF EAGAN
3830 PILOY KNOB RD - 55122
651•681-4675
New Conshuctlon ReauiremeMs Remodel/Reoalr Reauirements
3 registered aMe surveys ahowing sq. R. of lot, sq. R. ot house
and all roofed areas (20% maximum lot eoveraae cllowed)
2 coples of plans (show beam a window sizes; poured Ind. design; efc.)
1 sel ot energy caiculations
3 coples of hee preserxatfon plan N lof plaHed a(fer 7/1/93
DATE:
2 copies of plan
1 set of energy calculations For heafed addNiorn
1 sHe survey tor extedor addNlons 6 deeks
CONSTRUCTION COST: 4 'T&w ?
DESCRIPTION OF WORKJ6n?Uf?h -/ Kt-'- 4'f JC2)C-
STREET ADDRESS:
LOT: ? BLOCK: ? SUBD./P.I.D. #:
Name:_ PO ? ZJ%() U lj Phone #: 8 -i I -642/ `9118Q6
PROPERTY Lan Fim
OWNER ,?,^V? ???
Sheet Address: "Z
City FctqQn State: Iip:
Company:AmErICM EJUI KII)n GM1ft?1D(5 Phone#: kha ?e)7-C9?'r7?z
(area code)
CONTRACTOR ?I ?q f
Street Address: t?"t7 I U t CO f kfAd°L ' :?C_ License #c9OVq?vS3 Exp:?&=c
City &r1??Me State: I?1 Zip: 155337
ARCHITECT/
ENGINEER Company: Name:
Telephone #: area eode ( )
Sfreet Address: Registration #:
City State• Zip:
Sewer 8 wafer Iicensed plumber (reaulred for new conshuctlon onlv
Penally applies when address change and lot change Is requesfed once permN Is issued.
1dereby acknowledge that I have read this applicaflan, atate thal lhe Informahon Is correcf, and agree to compiy with all applicabl
Stote W Minnesota Statutes and Ciiy of Eagan Ordinances.
t Signature of Applieant:
OFFICE USE ONLY
.-
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
?
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea.
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Levei ? 24 Storm Damage
? OS 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia
? 32 Additian ? 36 Move Bidg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) p 42 Reroof
" Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
Engineering
Census Code
SAC Code
No. of Units
No. of Bldgs
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation:
E
SAC Units
°/a SAC
3a-s-7
?
s'
EAGlaN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minneaota 55I11
Telephone 454-5242
PERMIT FOR SEWfiR SERVICE CONNECTiON
NUMBER 1093
Address s-I0 7-10 4ZtrIS1AZ? 44Q?Y=P
TYPE OF PIPE
DESCRIPTION OF BUIIDING
Industriall Commerciall Residential I Multiple Dwelling I No, of units
Location of Connectione:
Connection Chargei?60.00 od 8/16/72
Permit Fee 1U.00 vd_8/16/72
.50 pd 8/16/72
Street Repairs
Total
inspected by:
DaYe
Remarka•
By
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 and
regulations of Eagaa Tormship, Dakota County, Minneso•a
ByQb?
Pleaee aotify when ready for inspection and coanectioa and before any portioa
ot the work is covered,
DATE: A 11 ! -7_
23a- s- 7
?
.
,
EAGFN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERYaT FOR WATER SERVICE CONNECTTON
Date
Bill,
Owne
Plimm
Connection Meter
mber:
te Address:
lling Address713qa 6,J?l ?
1,0 )?r+ aAP, N h 7? -?;6?
Meter No. lPermit Fee_ ?10.00 d8/16/72
.5p p?l 8?Ib/72 s/c
Meter Reading Meter Dep.
Meter Sealed: Yes_ IAdd'1 Chg.
NO iTotal Chg.
Inspected by
Da[e
Building is a: I Remazka:
Residence Z
I4ultiple hyo, Units
Commercial
Industrial By:
Other Chief Inspector
In consideration of the issue arni delivery to me of the above permit, I
hereby agree to do tte proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota.
By:
Please notify the above office when readq for inspection and connection.
MASTER CARD
OWNER (.1 eOfIAr e'A*,VfT
S7RUCTURE AND w? y wA?
LAND USED AS
Permii
No.
Issued I Issued To
Contrador Owner
BUILDING 28p3
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALLING 230
SANITARY SEWER
OTHER 1Jf. c?33 I
OTHER I
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING
? SEPTIC
FOUNDATION -?
OJ. 7 7? 1 CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL
EPTH
HEATING D
OF WELI
GAS WSTALLATION
SEPTIC TANK
CESSPOOL I
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER ?
/1-13 -2 Y
" Violations Nofed
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO. DATE OF INSPECTION
.
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
? ACCEPTABLE SU85TITUTIONS OR
DEVIATIONS.
? NON-COMPLIANCE. BUIIDER WILL COMPLY
WITHOUT DELAY.
NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
AND DESCRIBED AS
? REINSPECTION REQUIRED DATE OF REINSPECTION
REINSPECTION REVEALED
CE RTI FICATION - I certify that 1 have carefully inspectad the above in which I have no interest present or prospective, and that I have reported herein
all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved pians and specitications, and any specific require-
ments for off-site imprwaments relating to the property inspected.
? ALl IMPROVEMENTS ACCEPTABtY COMPLETED
euiLoiNc
96po 29
PERMIT
CaTYOF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(651) 681-4675
PERMITTYPE: guzLosNG
Permit Number: 0 3 3 8 2 6
Date Issued: 10/27/9 $
SITEADDRESS: 4080 HALITE LANE
LqT: 32 BLOCK: 5
CEDAR GROVE #7
P.T.N.: 10-16706-320-05
DESCRIPTION:
,.y REPLACE SIDING
Bu??dtn`g--Termit 7ype
Bw'ilding Wo(k Type
rGlensus Code?
?
,
`-
?'"?'?
STORM DAMAGE
kEPAIR
434 ALT. RE5TpENTZAL
'
REMARKS:
FEE SUMMARY:
CONTRACTOR:
OWNER: - APPlicant -
POLZIN DAVIL7
4080 HALI7E LANE
FAGAN MN 55122
(651)681-9896
I hereby acknawledge that I have read this
information is carreat and agrea ta comply
Statutes and CiCy of Eagah Ordinances,
I
APPLICANT/PERMITEE SIGNATURE
appla.catian and state that the
with all applicabxe State of Mn»
-?)? ?'se -
'. SUED BY: SIGNATURE
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
, .
CITY OF EAGAN
3830 PII.OT KNOB RD - 65122
es i-ab7s 1 b-??7
New Construction Reauirements
• 3 registered sita surveys
? 2 copies of plans (inUUde beam & window sizes; poured fid. Eesign; etc.)
? 1 energy calwlations
? 3 copies of tree preservation plan H bt platted aRer 711193
required: _ Yes _ No
DATE: /Da?`??.{'
DESCRIPTION OF WORK: E -S/? I?v/?Ff-
STREET ADDRESS: _I`D
alol-e
RemodeUReoair Reouirements
? 2 copies of plan
? 2 site surveys (ezterior addkions 8 deGcs)
? 7 energy calculations for heated addkions
CONSTRUCTION COST;
LOT: 8 oZ BLOCK: s SUBD./P.I.Q. #;
State:
Name: 06 IZ-/?/ Phone
PROPERTY Last Firsc
OWNER StreetAddress: " r'D 4`fC LJa-Z-e
City /_a jddl_ State: /t Zip:
14
Company: Phone
CONTRACTOR
Sffeet Address: License #
City
ARCHITECT/
ENGINEER Company: Phone #:
Street
City
Sewer 8 waier licensed plumber (new construction ony):
and lot change is requested once permit is issued.
Zip:
Registration
State: Zip:
1 hereby acknowledge that I have read this application and state that the
State of MinnesoW Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received Yes No Not
Penalty applies when address chang
is correct and agree to comply with all applicabl
_? ; ?X5
L' `
F
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
? 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. O 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 RepaidRem. ?
? 13 Garage/Accessory ?
? 14 Fireplace 0
? 15 Deck
? 36 Move
? 37 Demolition
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
Basement sq. ft. MC/WS System
_ Main level sq. ft. City Water
_ sq. ft. Fire Sprinklered
_ sq. ft. PRV
_ sq. ft. Booster Pump
_ sq. ft. Census Code.
_ Footprint sq. fr. SAC Code
Census Bldg
Census Unit
Buiiding Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City 5AC
Water Conn.
Water Meter
Acct. Deposit
S!W Permit
S/W Surcharge
Treatment Pi.
Park Ded.
Trails Ded.
Other
Copies
Total:
Yaluation: $
°h SAC
SAC Units
? CI?Y OF EAGAN PERMIT
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
coo?93
PERMITTYPE: Buz?o=N?
Permit Number: 026731
Date Issued: 11/2 g/9 5
SiTE ADDRESS:
4089 HALITE LANE
LOT: 32 BLpGK: 5
CEDAR GRQVE 7TH
P.I.N.: 10-16706-320-05
DESCRIPTION:
Baj lding Af,,krmit 7ype
B?uYidin_g Wo*J?, TYPe
?r .
y
u 3 .. "
{R;:
s?e.redp
'?; "s na?aaer,
BASEMENT FINISH
ALTERATION
re
*? s? _ ?"? P5! ?
-4 ? r ?? = ??, ?
o?v,??',,m us ae ;?.
REMARKS:
A SEPARATE PERMIT I5 REQUIREp FOR ANY PLUMBSNG OR ELECTRICAL WORK
FEE SUMMARY:
6ase Fee $35.00
5urcharge $.50
Tatal Fee $35.50
CONTRACTOR: OWNER: _ Applicant -
POLZIN DAVID
4080 HALITE LN
EACrAN MN
(612)681-9896
I?h.ereby`:ackrrnwle.d'ge.tMaCI 11 ha-Ve read th3q',_app].'rc,ation 'and' statlt?th?a?t.-the
'.inf_orinetAo h:is cArr,e?a.t and;=a.gree to cGinply°_with.al'1 applioatZlgZ t a"fe of M+1-?e Statutes'and?Gity 'af Eagan,;=CJ_r_dinanCes.:- .a
APPLICANT/PERMITEE SIGNATURE
?l?dS,R?T?? I m.?-
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITEADDRESS:p - =•N.: 1e-167 0 6-320-e5 APPLICANT:
LOT: 32 BLOCK: 5
4080 HALITE LANE pOL2IN
CEDAR GROVE 7TN (612) 681-9896
PERMIT SUBTYPE: TYPE OF WORK:
BASEMENT FINISN
BUILOING
026731
11/29/95
pAVID
AL'fERATItlN
INSPECTION
RAMZNG D. .
INSULATION ,.
OUGH IN PLBG FINAL
REMARKS: A SEPARATE PERMIT IS REQUIREO FOR ANY PLUMBING OR ELECTRICAL WORK
,:._: ?." ;? ;?._ , ?., .': ;,. ?- ? , ".?,?.,? ... .... .... ... . _...... z ?;
?
-- --. -,-r-i-r?- ?•?: ?- .-?--r- ?-,-r. ,__ , ?... ... . ; . ...., . . ? , ? ? ., -- ? -
! 1, i
;I
..?.. .. '_?•
1(q5 CITY OF EAGAN
3830 PILOT KNOB RD - 55122
11996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
c,t9u,.fl !1-w
? 3 iegistered site surveys ? 2 copies of plan
? 2 aopba of plane (fndude beam 8 window aizes; powed fid. Aesign; etc.) ? 2 s8e suneys (exterbr add'Rions & decks)
? 1 energy calalatlons ? t energy calculations for heeted additions
? 3 copies of tree preaervation plan H la platted after 7/1/93
fsquired: _ Yes No
DATE: hS CONSTRUCTION COS
DESCRIPTION OF WORK: PJn ' 51-- ? u3OWw.u
STREET ADDRESS: Zi U ? Aal°k Le??
LOT ? ? BLOCK ? SUBD./P.I.D. #:
PROPERTY Name: R'12 '-' /JaL?i .1 Phone #:
OWNER ?D?
- ?mC?
Street Address
City: ? ?--- State: 11'?k
SSj?
Zip: -4,4W2
coN7w?cTOR Company: C.. Phone #:
Street Address: License #-
City: State: Zip•
ARCHITECTI Company: Phone #•
ENGINEER
Name: Registration #•
Street Address,
City: State: Zip:
Sewer & water licensed plumber: . Penalty applies when address change and lot
change are requested once pertnit is issued.
1 hereby acknowledge that I have read this application and state that the infortnation is correct and agree to comply with all
applicabte Shate of Minnesota Stawtes and City of Eagan Ordinances.
Signature of Applicant: J)t
OFFICE USE ONLY
Certificates of Survey Received
Tree Preservation Plan Received
_ Yes _ No
_ Yes _ No
0 9 1995
OFFICE USE ONLY
IL
`
,
BUILDING PERMIT TYPE
0 01 Foundation o 06 Duplex a 11 Apt./Lodging ?6 Basement Finish
0 02 SF Dwelling o 07 4-plex o 12 Multi RepaidRem. 0 17 Swim Pool
0 03 SF Addition o 08 8-plex o 13 Garage/Accessory o 20 Public Facility
0 04 SF Porch o 09 12-plex o 14 Fireplace o 21 Miscellaneous
0 05 SF Misc. 0 10 _ plex o 15 Deck
WORK TYPE
0 31 New :?e°33 ARerations o 36 Move
0 32 Addition o 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MC/WS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code. ?
Depth Footprint sq. ft. SAC Code O!
Census Bldg ?
Census Unit ?
APPROVALS
Planning Building
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SIW Permk
SNV Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
_ Engineering Variance
?
Valuation: $ ISO? ?
% SAC
SAC Units
PERMIT 600-9
---)(6ITY OF EAGAN PERMITTYPE:
3830 Pilot Knob Road B U I L D I N G
EBgan, Minnesota55122-1897 Permit Number: 026395
(612) 681-4675 Date Issued: 0 9/ 14 / 9 5
SITE ADDRESS:
4080 HflLITE LANE
LOT: 32 BLOCK: S
CE6AR GROVE 7TH
P.I.N.: 10-16706-320-05
DESCRIPTION:
( I N S E R T)
?
V`i1d!ti-g`:=;,P;ermit l'YPe
?uild,irtg _ W.v'r;kA TYPe
?.. ,o
? .??• ??
I24
pa i^R°?,-. ? tg
z?
FIREPLACE
AL7ERATION
b k• ?°2 i
REMARKS:
FEE SUMMARY:
6ase Fee $25.00
5urchargs 0
Tatal Fee $25.90
CONTRACTOR: - qppiicant - s'r. Lzc. OWNER:
WOODLflNO 51"OVESJFIREPLACES 13356606 0002558 WESTSN CftAIG
1203 WASHINGTON AVE 5 4080 HflL.ITE lN
MINNEAPOLIS MN 56415 EAGAN MN 55122
(612) 338-6606 (612)681-9964
Z hereby ackanoul¢`dqe'tbaC l•?S ,hatie?•read tfiisapp:lioa'tia-ft and s't°a:te t.haE= tha
. ,
3nfarrfiaCia?n'°i5. C"arre,?t anrJ; ?aqr'e? ?ti compE?yzC-h_,'al1 .ap.P]i?oat?ie S?a¢f Mri;._;
'. Stabutes and? City, ofi ?Eagan• tfrdinanc#s.
? ' - ? " ? . . .. . . ? • - , ..; , ?.._ ___? ?
APPLICANLPERMITEE SIGNATURE
Ift 41A.1 rn?
ISSUED 51 ATUR l
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
APPLICANT:
5
SITEADDRESS: p.I. N . : 1e-16 7es-sze-ms
LOTc 32 BLOCKa
4080 NALTTE LANE
CEIJAR GROVE 71'H
PERMIT SUBTYPE:
FIREPLACE
?
? ._ ? ...:
W00[7LANC] STOVE5/FIREPLACES
(612) 338-6606
TYPE OF WORK:
DESCRIPTION
BUILpING
026395
0sri4,+ss
ALTERATZON
(INSER7')
. : . . . ......... ..?.. . ?.
.. , . .,.m __ . : ?
o .?
CITY OF EAGAN
? 3830 PILOT KNOB RD - 55122
1995 FIREPLACE PERMIT APPLICATION
681-4675
DATE: 'S
DESCRIPTION OF WORK: _ INSTALL NEW FIREPLACE: _ WOOD BURNING
INSTALL GAS LOG ONLY IN EXISTING FIREPLACE
AREA TO BE INSTALLEC
STREET ADDRESS:
,! J n?
GAS
LOT ji BLOCK L SUBD./P.I.D.
APPLICANT: (circle one oniy) OWNER CONTRACTOR
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.
PROPERTY Name? Phone #: (n ?? ?? y
OWNER "sT `.8T
Signature:
Street Address• /??a
City: &rel? State: ?U Zip;
FIREPLACE Company: Phone #:
INSTALLER 4"n
Signature: :?L?° aLV`A'Y -
Street Address: 1 74 &License #:,)??-?S?5-0,"
City: Iwb.¢i C ? State: /W Zip• ??
GAS LINE Company:
INSTALLER
Name:
Signature:
Phone #•
Street Address•
City: State: Zip:
INSTALL GAS LINE ONLY IN EXISTING FIREP LACE
VOTHER: ..? ?.L ? lao ?()VA c,
S
OFFICE USE ONLY
BUILDING PERMIT TYPE
U/ 14 Fireplace
WORK TYPE
? 31 New
? 32 Addition
? Afterations
Repair
GENERAL INFORMATION -
i.ensus C:ode.
SAC Code
REMARKS: Chimney/flue must be inspected before concealing.
:?.
..0?. ' ?_ a ??;a""•
FEES
Pertnit Fee
Surcharge
Other
Copies
Total:
SUZLDING PF.RMIT APPLICATION
7?, ?
nnxE 6- b -78'
Znclude 2 sets of plans, 1 site plan w/elevations and 1 set of energy calculations.
To be used for s?D
Valuation
Site Address;
Lot Block See. Sub. Parcel Number
3v 5 7 /q2 ?'-RovE?
7p
i `
1?0reb
Telephone a
'
•
Owmer
Address L/7'C
? u.
tractor ?
Co Telephone
,
n
Address
/En
A
h
S r'rE Telephone
q•
rc
.
t
Address
OFFZCE U5E
Erect Occupancy
Alter Zoninq
air
R Fire Zone
ep
l Type of Const.
arge
En
# of Stoiie5
Move
li
h Front
s
T)emo
d Depth
Gra
e
OFFICE USE
Date of Approval & Initial FF.ES
..-c,
?
Pezmit
Assessment _- - -- --
. c c?
F7dter/Sewex Suroharge
-
Police P1an Check --'
SAC
Fire l
U
Eng
• I.later Conn • - -
S7ater Meter -
Planner ?-
(buncil
Rldg. Off.
TpTAL
A.P.C.
? • .
,
- f??- -
--- --? - ---- - --- - ----
- ---~-- -1---- - - - - --- - __?
- - - --,?o-=- --=.%sy '- - - - - - - - -
_ ' „ - - -- -
----- -; --??? - -- -- -
- - -? -
0
- - -- ? - - ??` ---- -
? -- - - - - -
?
i I
--r- -
? ? -
-- ? ?
SV
a?
??-
-- - ?--- ---- -- --
--------------------
-- - ? - - --- --- - --- - - - ------ - --
CITY USE ONLY
L ?? BL 'r RECEIPT #:
SUBD. l ! alu*? '77:? DATE:
1995 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOS RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
FIXTURES - EACH NO. TOTAL
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 =
Raugh Openings 1.50 x =
Water Softener 5.00 x =
Private DispoSal ' Dakota Cty. licenae 20.00 =
U.G. Sprinkler' home underconst.
' 3.00 '
Alterations
to existiny 20.00
Water Tum Around 20.00
STATE 5URCHARGE .50
5
TOTAL ??0
SITE ADDRESS: y6F° L?`A- -
OWNER NAME: -b,40D /DOIZA/
INSTALLER NAME: 4446
STREET ADDRESS:
CITY: ? STATE Ay Zlp; S? ?l L
PHONE #: (
°STU`NATQfF ?? -
OFFICE USE ONLY
L _ BL _ RECEIPT #:
SUBD.
DATE:
1995 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please compiete for: o all commerciaVindustrial buildings.
P multi-family buildings when separate permits are np1 required for each dwelling
unit.
DATE: CONTRACT PRICE:
WORK TYPE: _ NEW CONSTRUCTION _ ADD ON REPAIR
DESCRIPTION OF WORK:
15 WATER METER REQUIRED? _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING:
WATER FLOW: GPM. ARE FLUSHOMETERS TO BE INSTALLED7 YES NO.
FAILURE TO PROVIDE THIS INFORMATION WILL RESULT IN A DELAY OF METER IS5UANCE.
WiLL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM7 YES NO.
IF SO, YOU MUST APPLY POR A SEPARATE U.G. SPRINKLER PERMIT.
FEE: $25.00 minimum fee or 1% of contracf price, whichever is greater. State surcharge at $.50 per
$1,000 af ga= fee due on all permits.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL
SITE ADORESS:
TENANT NAME:
STE. #
OVYNER NAME:
INSTALLER:
ADDRESS: _
cirr:
PHONE #:
METER S12E:
SIGNATURE:
OFFICE USE ONLY
" DATE:
STATE: ZIP:
APPLICANT
_ INSPECTOR:
P&rfre Pooc 6 pArIo
• MINNESOTA PACKAGE PRODUCTS, INC.
• 6922 55th Avenue North North St. Paul, Minn. 55109
Phone 770-1313
?
CUS'fOMER NAME DATE
ADDRE55 PHONE
POOL SIZE TYPE
Directions to job site
Diagram pool site in relatian to house, garage, property line, and wires. (Allow 3" variance)
i
?
/X
_ ? ..
;.
41.--
W..'0%
1. indicate deep end by (X).
2. Mark location of filter and/or heater by (#Z).
3. Indicate approx. elevation af pool in relation to a permanent fixture on the property. If there is no permanent fixture, mark
the diagram with the symba! (A) at grode point.
4. Will trees, clothes poles, power lines or ony other obstructian be encountered? Yes ? No ?
If yes, ezplain
5. Does customer wish to retain any or all dirt from pool excavation?
If yes, explain
6. Indicate and explain any special instructions not covered abave.
7. Pacific Pools recommends that the customer construtt a retaining wall as soon ns possible after the pvol is completed.
` Yes ? No ? Show in diagram.
8. tusYomer understands that some damage may be done to the yard and/or driveway while entering and leaving the yard during
construction. Initial here .
9. Customer acknowledges receipt of grounding instruction sheet, and is responsible for grounding end electrical wiring of
the pool. Initial here . '
10. Customer acknowledges the fact that he is responsible for the gas installation for heater if applicable. Initial here .
Crew Chief Use Only
Inspection Required
1. Walls ?
2. Plumbing ?
3. Footing ?
4. Flectrical ?
5. Other ?
Call Mr
at
I I Phone No. 11
Yes ? No ?
SPEClAL N07E TO 7HE CUSTOMER:
If you wish to change: filter position, slope of land, extra concrete, or anything
else stated in this outline, please call your salesman at the office - 770-1313. Crew
chiefs are not authorized to change anything on the job or make any promises for
work to be done by them. Any changes that are not authorized by the office will be
charged at a standard rate - no exceptions.
Selier 5ignature Customer 5ignature
Use BLUE or BLACK Ink
r
For Office Use I
Permit#: J C
City of Ealian
Permit Fee.
3830 Pilot Knob Road I I
Eagan MN 55122 ; Date Received: 10h t5- I
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: /O Site Address: oa Unit M
Name: Phone: 9507- j0S-,9p00
Resident/
Owner Address / City / Zip: NYC rs
Applicant is: Owner l Contractor
Type of Work Description of work: 'To, C~g r - orl-P .,A, X e- -radT 4" t 5LS qp_ Construction Cost: !9 1 00. Multi-Family Building: (Yes /
No )
Company: iLATq\. ak Seeyt4s J~iccontact:
l ~ 1 ce ~ZZ J,.2 City: IVI~d~~
Contractor Address: .
State: -/'JCL Zip: SS3~ Phone:
License SoS~JqS' Lead Certificate SL~✓a~ -
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.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 of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be corn wi in 180
days of permit issuance.
x ct x
Applicant's Printed N e Applica rgna
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA119977
Date Issued:01/07/2014
Permit Category:ePermit
Site Address: 4080 Halite Lane
Lot:32 Block: 5 Addition: Cedar Grove 7th
PID:10-16706-05-320
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.
Chad Bettin
3208 First Street South
Waite Park, MN 56387
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 -
David M Sethney
4080 Halite Lane
Eagan MN 55122
(651) 324-6242
Ecowater Systems
P.O. Box 428
Waite Park MN 56387
(320) 251-2505
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
r
For Office Use
Permit
City of EaRa~
Permit Fee: LL O'
Pilot Knob Road I r )
Eagan MN 55122 I Date Received: ((1 I
Phone: (651) 675-5675 I P
Fax: (651) 675-5694 I Staff:
I I
2014 RESIDENT~IfA^~L BUILDING PERMIT APPLICATION
Date: Site Address: "'7C...J Unit
Name: r Phone:
Resident/
o Q C E1l1z.
Owner Address/ City/Zip:
Applicant is: Owner Contractor
U 6J~1G~
Type of Work ` Description of work: /0h),1J2Yv_ Z42 dj~*
41
Construction Cost: Multi-Family Building: (Yes o )
Company: G?/- ~LC Contact: Ze c/f r
Contractor Address: ` 7U ~~/~c17 ~C.~ City: ~e Cc
State:/( Zip: Phone-5;•C g66-WbEmail: a- Qk3Yl/' ~Cd crl
License 63g6EY, Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permitthe City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
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.
x//2"/
x
Applicants Printed Name pplicant's Signature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation _ Fireplace _ Porch (3-Season) t. Exterior Alteration (Single Family)
Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Multi)
Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Miscellaneous
01 of _ Plex Lower Level Pool Accessory Building
WORK TYPES
New Interior Improvement _ Siding _ Demolish Building*
_ Addition _ Move Building _ Reroof _ Demolish Interior
_ Alteration Fir Repair _ Windows _ Demolish Foundation
Replace ✓Repair Egress Window Water Damage
Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION d U
Valuation Qd Occupancy MCES System
Plan Review 1-Lb Code Edition SAC Units
(25%_ 100%Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC Gas Service Test Gas Line Air Test
Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final
Framing Drain Tile
Fireplace: -Rough In -Air Test -Final Siding: -Stucco Lath -Stone Lath -Brick
Insulation Windows
Sheathing Retaining Wall: _ Footings _ Backfill Final
Sheetrock Radon Control
Fire Walls Erosion Control
Braced Walls Other:
Reviewed By:~~` Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
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Use BLUE or BLACK Ink
For Office Use
'r City fEaaali Permit#: /1191-1(49
Permit Fee: ?/'
3830 Pilot Knob Road
Eagan MN 55122 RECEIVED Date Received:
Phone:(651)675-5675
Fax:(651)675-5694 Staff:
MAY 15 2017
I roil •II num
A A I 4ft dm/Ihm, SIM MAI•II G PERMIT APPLICATION
Date: 5/I5/i 7 Site Address: 410 SO. /-7411-e-/ Unit#:
•
Name: sco-Tri g4rei Phone:1,5/ - 59- 9.11.Z_
Resident/
Owner Address I City I Zip: 4710 Se e....44^.) 4-041N) •
Applicant is: Owner K Contractor
Description of work:
Type of Work Z5,000 c)()
Construction Cost: ti-t it7 c4),,\1&.,5f ,1-00• Multi-Family Building: (Yes /NoX)
Company: VY f ,iv Contact: W /Y4/2470941
Address: 13.55- / S- re-1 City: vf4 (-Ceti Contractor
-
Contractor
State:041NiZip: . 50 6 Phone: /- -1/A4m fdt-ITFeat1).57.--. "4-11
License#: 40./90 9 Lead Certificate#: f_I /61.g f5—
If the project is exeint-4 v,tri-
COMPLE:Tr. .77 7 771.2 7:7-7 717:
In the last 12 months,has the City of E8g-11,11.-SSVf_."-
Yes No If yes;datp and aridraqc
.
Licensed Plumbcr: Ph Sewer&Water _
Fire. ...---- Pi!------
_ ---•
NCTE: .1:
CALL CErt,rzi-N.'._—! .."_—_
be !": 7`7" www.ciopherstateonecall.orq
Eagan; that I understand this is not a permit, but
only an nrantir.ntinn. fnr a permit 0,..4 ve.ses, ii. nea, ef-.4 Lts.vt
accordance v.ith It=
1A/ /VC)/Z- erkg-i411Z-14)vi,. /'
i3
DO NOT WRITE BELOW THIS LINE -14- /(-t 7(0?
SUB TYPES
_ Foundation _ Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family)
)( Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
_ Multi _ Deck — Porch(Screen/Gazebo/Pergola) _ Miscellaneous
01 of_Plex _ Lower Level _ Pool — Accessory Building
WORK TYPES
_ New _ Interior Improvement _ Siding _ Demolish Building*
_ Addition _ 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 ( b(0 (, 0 Occupancy 11-4,..t. MCES System
Plan Review Code Edition ,t)i( SAC Units
(25% 100% V) Zoning l 1. City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction l f) Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
—
Footings(Deck) Final/C.O. Required
—
Footings(Addition) X Final/No C.O. Required
Foundation Foundation Before Backfill HVAC Gas Service Test Gas Line Air Test
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: 11 , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge 1, 1 i
Plan Review fit[', / >*,4 4
MCES SAC ii1 r'
City SAC
Utility Connection Charge
S&W Permit&Surcharge 0 r" ``
Treatment Plant
Copies
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA142951
Date Issued:05/24/2017
Permit Category:ePermit
Site Address: 4080 Halite Lane
Lot:32 Block: 5 Addition: Cedar Grove 7th
PID:10-16706-05-320
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:Kitchen remodel
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 -
Scott M Sethney
4080 Halite Lane
Eagan MN 55122
Area Lakes Mechanical
9393 140th St W
P O Box 146
Montgomery MN 56069
(507) 334-6171
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA168183
Date Issued:04/13/2021
Permit Category:ePermit
Site Address: 4080 Halite Lane
Lot:32 Block: 5 Addition: Cedar Grove 7th
PID:10-16706-05-320
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$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 -
Scott M & Kari A Sethney
4080 Halite Ln
Eagan MN 55122
(952) 905-8900
Milbert Company (culligan)
1801 50th St E
Inver Grove Heights MN 55077
(651) 451-2241
Applicant/Permitee: Signature Issued By: Signature