3809 Heather DrPERMIT
City of Eagan Permit Type:Building
Permit Number:EA128505
Date Issued:11/17/2014
Permit Category:ePermit
Site Address: 3809 Heather Dr
Lot:5 Block: 01 Addition: Briar Hill 4th
PID:10-14993-01-050
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
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 -
Mervin Murakami
3809 Heather Dr
Eagan MN 55122
(952) 607-6400
Pella Northland
15300 25th Ave N #100
Plymouth MN 55447
(763) 355-1300
Applicant/Permitee: Signature Issued By: Signature
*City ot88QHu
3830 Pilot Knob Road
Eagan MN 88122
Phone: (651) 675.5676
Fax: (651) 6754694
Use BLUE or BLACK Ink
For Office use
Permit #
Penni! Fee:
Date Received:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: h/- 9 /' L Site Address: o 9' HH 774 L2 biz
Resident/
Owner
Name: ek A14.3 4 el /+t E � + A./ C,
Unit #:
Phone: 74 3- Sys — 9 7 7
Address / City 1 zip: Sso D E e 01-7-* u R AV, A) , ) A 6.1,t614- Vokia Y /VA)
Sr VA 7
Applicant is: Owner 2fContractor
Type &Work,
Description of wort: £Pr. / L)J J �o W
construction Cost Multi-Famlly Building: (Yes / No _J
Co d'actor
Company: E 1 Ex- r £e/ Q 2 / 4i rJ7 . at: Contact flA ✓, 0 I13.412 -a/
Address: 'ID.- IBJ f,O J`- City: /h PL- S
State: I'i1 A Yip: Say/ 9
License* 1.3 C x q/ / 3 /
Phone: 10/ 2- S4/- 4a24/3
Lead Certificate #:
If thereproject is exempt from lead certification, please explain why: (see Page 3 for additional Information)
1LhL s_ Qv/IY Posy- )Y7 '
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the Iaet 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes __Jdo If yes, date and address of master plan: _
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
CALL BEFOREU DIG, Call Gopher State One Call at (651) 461-0002 for protection against underground udfity damage. Ca1148 hours
before you intend to dig to receive locates of underground tdillties. www,aopherstateonecail.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 undaraend thia ie not a perk, but only an application for a monk, 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 perk Issued In accordance with the Minnesota State Build' Code must be completed within 180
days of permit issuance.
g 4 ✓' o at. z..2,
Applicants Printed Name
EZ/8T 39$ d 1NIvW lX3 I3S
x.
Applicant's Signature
Page 1 of 3
L9Z9T98ZT9 LZ:bt VW/TT/170
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE
19
R6 CBI V 6D
FROM
AMOUNT $ ?
& DOLLARS
oo
7
E:] CASH ? CHECK
FOR
wnice-aaver: cocv
Yellow-Posting Copy
Pink-File Copy
Thank You
O??' sv
CITY OF EAGAN
oa,,;,;,,,, BRIAR HILL 4TH ADDN
Owner
Lot 5 Blk
Street 3809 HEATHER DRIVE
10-14993-050-01
EAGAN MIlV 55122
improvement Oate Amount Annual Years $S Payment Receipt Date
STREET SURF, 102, jQ'Jj Paid LU1Cl Y' Orl inal rcel
STREET RESTOR. Z 1975 70.69 7.07 10
RRARM Street 1984 1227 . 78 245.56 5 7?6 0 1636 /o //Js
**Sewer Lateral 3 c 1984 2136.20 427.24 5 ? A 7a o/(r & O /o/i7 Zs
SAN SEW TRUNK 40 1968 29.60 .99 30
. ?D16 (oD o// %s
SEWER LATERAL TRK125 1983 237.37 23.74 1? lp
,/9 Q/? ?y O /D ?,?
*Sewer Lateral 109 1971 32.42 1.62 20 •12, f}O/!v O 741
**WATERMAIN 1984 5
*WATER LATERAL 1971 ZO
WATER AREA 32 1977 59.19 3.95 15 .2. 3(? D /d 7r,
**Stubs 1984 5
STORM SEW TRK 131 1984 323.50 64.70 5 9./o O/ 3 (o 101177,f7
*STORM SEW I.AT 1971 20
**Storm Sew Lat 98
CURB & GUTTER
SIDEWALK
STREET--I6FFY1009 1986 153.70 15.37 10 153,70 C-10 16 /6 -,?
Road Unit 240.00 3 222 11-24-82
WATER CONN. 420.00 if
BUILDING PER. 6
SAC
PARK
CITY OF EAGAN Remarks
Addition BRIAR HILL 4TH ADDN Lot 6 Rlk 1 Parcel 10-14993-060-01
Owner' 5treet 3$11 HEATHER DRIITE Scate EAGAN MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
$TREET SURF. OZ
STREET RESTOR. 2-1 1975 70.69 7.0 10 -pniA
%DiAMk]At Street $ 1984 1227.78 245.56 5 736.68 A014799 10-31-84
**Sewer Lateral $Zc' 1984 2136.20 427.24 5 ++ rt
SAN SEW TRUNK 1968 29.60 .99 30
SEWERLATERAL TRK 5 1983 237.37 23.74 10
*SEwer Lateral 1971 32.42 1.62 20
8-19
**WATERMAIN 1984 $
*WATERLATERAL 1971 ZO
WATER AREA 1977 59.19 3.95 15
**Stubs 1984 5
STORMSEW TRK ? 1984 323.50 64.70 5 0- - 4
*STORM SEW LAT 1971 20
**Storm Sew Lat 1984 5
CURB & GUTTER
SIDEWALK
STREET?rMBM'r' 1009 1986 153.70 15.37 10 A53,76 /o-/ -S?y-
Road Unit 240.00 33222 11-24-82
WATER CONN. 420.00 if it
BUILDING PER. (Sl
SAC
PARK
CITY OF EQGAN Remarks
Addition BRIAR HILL 4TH ADDN Lot 7 Rlk 1 Parcel 10-14993-070-01
Owner* Street 3813 HEATHER DRIVE State EAGAN MIlV 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 2 1971 Paid U11C1 O 1 inal ar @
STREETRESTOR. Z, 1975 70.69 7.07 10 7•15 A012331 6- ?-83
MRARM Street g30 1984 1227.78 245.56 S 1227.78 C008595 10-11-83
**SEwer Lateral tZq 1984 2136.20 427.24 5 2136.20 C 85 S 1- - 3
SAN SEW TRUNK p 1968 29.60 .99 30 13.92 A012331 b-10-83
SEWERLATERAL TRK 5 1983 237.37 23.74 1 213.64 " "
*Sewer Lateral jpj_ 1971 32.42 1.62 20 11.36
**WATERMAIN 1984 5
*WATER LATERAL 1971 ZO
WATER AREA 1977 59.19 3.95 15 31.61 A012331 6-10-83
**Stubs 1984 5
STORM SEW TRK 1984 323.50 64.70 5 323.50 C008595 10-11-83
*STORM SEW LAT 1971 20
**Storm Sew Lat 1984 5
GURB & GUTTER
SIDEWALK '
STREET EfBMT
/009 1986 153.70 15.37 10 163,70 - /O 1 / 0- - 5
Road Unit
WATER CONN. 420.00 it it
BUILDING PER,
SAC n n
PARK
CITY OF EAGAN
Addition
Owner-
HILL 4TH ADDN
Lot 8 slk 1 Parcel 10-14993-080-01
street 3815 HEATHER DRIVE starE EAGAN MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. Z
STREET RESTOR. Z 7.15 A012435 7-11-83
RRARM S reet g 1984 1227.78 245.56 5 1227.78 C008598 10-11-83
** Z 1984 2I36.20 427.24 5 2136.20 " "
SAN SEW TRUNK 0 1968 29.60 .99 30 13.92 A012435 7-11-83
SEWERLATERAL TRK7z5 1983 237.37 23.74 10 213.64 " "
*Sewer Latera 0 1971 32.42 1-62 20 11.36
**WATERMAIN 1984 5
*WATER LATERAL 1971 I
WA7ER AREA 31.61 Am12435 7-11-83 I
**Stubs 1984 5
STORMSEW TRK -63 1984 323.50 64.70 S 323.50 C008598 10-11-83
*STORM SEW LAT 1971 Za
**Storm Sew Lat 1984 5
CURB & GUTTER
SIDEWALK
STREET MO"K- I009 I986 153.70 I5.37 10
Road Unit
WATER CONN. 420.00 it it
BUILDING PER. 768
3
SAC -
PAR K
Receipt PLUMBING PERMIT Permit No.jc?
GTY QF EAGAN
• Fee
Fill rn numbered spaces S/C "
Type or Prini legibly
ros. = ?'SU
1. Date (6-S 2. Installation Cost'?,;,? y 7) •p C)
??"f1?n7/rt.n I'1" ? z,e, n'c
3. Job Ad re? LotBlk. Tract ?c.?;r/
4. Owner /r? S
5. Contractor ; ?f????i/'? /? Phone ??.? /ly-/
6.
7. city
sso61 e
9. Work Description: New Add 0 Alter ? Repair ?
10. Describe
11.
I ??-
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
? Bath tubs 5eptic Tank
Lavatory Softner
Shower Well
? Kitchen Sink
Urinal/Bidet Other
T
?
Laundry Tray '%r
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and,codes governing this type of work. ?
. i
i
Signed: for
?
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
8. Building Type: Residential lr Commercial ? Institutional ?
Receipt' ' '? MECHANICAL
CITY OF EA
? Fill iR numben
Type or Print
1. Date 2. Installation
3. Job Addresa-., Lot,
4. Owner . , . • . . _ ,
5.
VIIT Permit No."- ' --
Fee
?ces S/C
Y Tot.
Blk. / Tract ? .
Phone
6. Address
7. City State Zip
8. Building Type: Residential D Commercial ? Institutional ?
9. Work Description: New ? Add ? Alter ? Repair ?
10. Descrihe Fuel Type
I 11.
No. E,quipment BTU - M. Ea.
Forced Air No. EQUiament CFM
Ai
H
dli
Mfg, an
r
ng:
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed :
for
Rough Flnal
Inspections: Date InsP. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Receipt -- - ?
?
1.
3.
4.
5.
6.
7.
PLUMBING PERMIT Permit No. _? - -?
CITY QF EAGAN
Fee
?
Fill in numbered spaces S/C --? ?'
Type or Prini legibly
Tot.
> >-.
Date,-% -?-?_2. Installation Cosi*l::?-!, y 70 0 D
Job AZ413??7-#V? ? LotBlk. Tra t14; I% i
Owner
Contractor ?.t/c/j,?/ /c?T? ?.? Phone 4/2 3 -/ i Y`/
Address ? y 7 y S u v. '? c?°i ?.S rf .?
citv state /y"1 nJ • zip ':;_ S?j5? £?
8. Building Type: Residential Commercial ? Institutional 11
9. Work Description: New LY1, Add ? Alter ? Repair ?
10. Describe
11.
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory Softner
Shower Well
? Kitchen Sink
Urinal/Bidet Other
Laundry Tray ?7i -Tf: ? ,?. f• ?
? Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. ( hereby certify that the above information is true and correct, and I agree to
comply with? ?ordinan(,,es;m codes governing this type of work.
5igned : for ?-=•.c` /- r? ?/ ?? fi.i?
?
Rough Final
Inspections: bate Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8700
Receipt. MECHANICAL
CiTY OF EA
? . ' Fill in numben
Type or Piint
1. Date-± ?•'?-' . .2. Installation
3. Job Address ? Lot
4. Owner
IT Permit No.
Fee
S/C
Tot.
- ,
Blk. ? Tract ? ? ?
5. Contractor Phone
6. Address
7. City State Zip
8. Building Type: Residential ? Commercial O Institutionai ?
9. Work Description: New O Add ? Alter ? Repair O
10. Describe Fuel Type
11.
No. Eouipment STU - M. Ea.
Forced Air No. Equipment CFM
Air Handlin
:
Mfg. g
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg, Other
Air Cond.
Mfg.
Gas, Piping Outleu
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved • CITY OF EAGAN 454-8100
Reoeipt ? PLUMBING PERMIT Parmit No. `CITY OF EAGAN
- Fes
? Fill in numbered spaces S/C
Type or Print /egib/y Tot
?1. Date- 2. Installation Cost'w ? ?f ??1 • v r?
3. Job Addr?t Lot Blk. Tract
„
4. Owner
5. Contractor.-LL=,- f? a/,c->A-?, Phone
6. Address i ?t ; 'Y` , ' ?? ; ?•n ? .? , " I ? ! i?'rl ? I
7. City State i ? K 1 Zip 8. Building Type: Residential iB' - Commercial ? Institutional O
9. Work Description: New,2' Add ? Alter ? Repair ?
10. Describe
11.
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
r? Bath tubs Septic Tank
Lavatory Sohner
? Shower Well
? Kitchen Sink
Urinal/Bidet Other
Laundry Tray -i ? ?i. ?; ; ?•f L
' Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : 47???"; for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Receipt MECHANIC.
CITY OF
. ?
Fill in numi
, Type or Pr,
L Date - r 2. Installat
3. Job Address Lo
4. Owner
6. Address
7. City State
8. Building Type: Residential ?
Permit No:-? Fee
S/C
Tot.
-Blk. ? Tract
,, .
Phone
Zip -
? Institutianal ?
9. Work Description: New ? Add ? Alter ? Repair ?
10. Describe Fuel Type
11.
No, Equioment 8TU - M. Ea.
Forced Air ' No. Eauiament CFM
Ai
dli
H
Mfg. an
ng:
r
_ Boilers
Mfg.
Unit Heater Mech. Exhaust
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed :
- for
Rough F inal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464,8100
INSPECTION RECOR
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: .
Eagan, Minnesota 55122-1897 Date Issued:
(651) 681-4675
SITE ADDRESS: ' ' ". : 10 ' 1 4 y93-0t:0 0 1
Ruc: , U 11Er1F:1c,
, ,, ? ri i F•1 r' f? li ?i ,
Mfir1Af; Ilil I +1111
PERMIT SUBTYPE:
, .
APPLICANT:
hl l h t Iq +l 1) `5 f C? 14'; TRU C I( Il N I t i
r(.1.•? ;:0
i t 101
TYPE OF WORK:
W `0 Iz 14, 1) nN f i:r ,. I.:i irI iI I l
I INSPECTION . . r
(
I F
? L
?
?
?
Permit Holder Date Telephone k
SEWER/
WATER
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING /
?
ROUGH
PLUMBING
PLBG
AIR TEST
ROt1GH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDR03TATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FINAL
Receipt :- PLUMBING PERMIT Permit No. . ClTY OF EAGAN
, pee i
Frll in numbered spaces S/C
Type or Prini legib/y - i
Tot. -' O • -; ? ' I
1, Date 2. Installation Cos0t,f> ? 7(7 •O]l I
• ? ?
??? ,?t''? fl ,?
3. Job Adtl?e?s`s- Lat J, Blk. Tract
L1 ?
4. Owner i_) /?L.- 17x= i
5. Contractar tl• zf/Y ? ?,:?24Zzl ftl Phone
. _,
6. Address fiy ;v_r??C).
f ?
-;
7. CitY v-22 rcxJ il/State ??/t? Zip " j r•??,
8. Building Type: Residential C? Commercial ? Institutional ?
9. Work Description: New 0" Add ? Alter ? Repair O
10. Describe
11
No.
'-? Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
? Bath tubs Septic Tank
Lavatory Softner
5hower Well
? Kitchen Sink
Urinal/Bidet Other
-'-
Laundry Tray = .' -h
y.
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
E
12. I hereby certify that the above information is true and correct, and I agree to
comply with al'I,ordinances and codes governing this type of work.
SlgJ7ECJ : <L`?i`? .?" . ,` ?.r/ : j f `
or.
Rough Final •
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
hi
?.? -?
Receipt?
h } ,
?
Fi// in
1
i1
Permit Na
Fee
S/C
Tot. !
1. Date ' 2. Installation Cost
3. Job Addrex:'i%'`' Lot ? Blk. / Tract
4. Owner " -
5. Contractor Phone
6. Address
7. City State Zip
8. Building Type: Residential ?
9. Work Description: New ?
10. Describe
11.
Commercial O Institutional ?
Add ? Alter ? Repair O
Type
No. Eauipment BTU - M. Ea.
Forced Air No. Equinment CFM
Ai
H
dli
Mfg. . • r
an
ng:
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Qutlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
5igned : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
BUILDING PERMIT
\
TO he Ysld Fee
3795 IiIN Kneb Road Eegon, MN 55122
PHONg: 454-e100
Slte Addre!ss
Lot Black Sec/Sub.
Porcel #
ac Name
W
? Addrcss
Ci p}one
Nome
ip
j? Address
~ Cit Phone
; W Nome
;(Z Address
I hereby ocknowledge that I hove reod this applicotion ond stcte thot
the inlormotion is correct ond ogree to comply with oll opplicoble
State of Minnesota Statutes and Ciry of Eogcn Ordinunces.
Sipnoturc of Permittee
/1 Building Permit Is issued to:
all work sholl be dorw in accordance with all opplicoble Stcte of Min
Buildir?p Offlclal
7??nc?
[1 t3
Reoeipt
, 19
Alter ? Zoninfl
Repofr ? Firo Zorx
Enlnrpa ? Type of Const.
Move ? # Stories
Demolish p Length
Grode ? pepth Sq. -Ft.
Approvals F*es
Assessment
Water 8 Sew.
Police
Firo
Enp.
Planner
Council
B*. Off.
APC
Permit
Surcha rpe
Plan check
SAC
Water Conn.
Warter Meter
Rood Unit
Total
on the express corxlition thm
ond City of Ea9an Ordinances.
iolder
Plumbing
l
t
Well
-ter
w
Sftwr
Electric
Footings
Foundation
Framing
Insulation
Final
Wa"r Dncrilw Locttion: .
[e?tf Lor-e e,e/i5
?zs
?
•
YVell ?
-i
?
b?9c%? i
Sower
Pr. D'ap.
CITY OF EAGAN
. 3795 PIlef Kieo` Raad Eayan, MN 55122
- PHOIdEs 454-8I00
BUILDING PERMIT Receipt #
TO bf wtd f0? .. . ti }' l. . Esf. Vnltm '•I f1..se -.. ? o
SIt! AddflSS T- !. !' l
Lot Block Sec/Sub. , rL,_r
1
Porcel ?qt
m Name '
W
? Address . ? '
c:n, o?,...._ ? 3
"o Name
,
u? Addre:
? r:.,,
1 hereby acknowledge thot I have read this application ond state thot
ihe intormotion is corred and ogree to comply with oll applitoble
Sfate of Minnesota Srotutes nnd City of Eogon Ordinonces.
Slpnoturo of Permittee
A 8uilding Pertnit Is Issued to: .- 7
oll work sholl be done in acwrdance with ell opplicable '
Buildinq Officiol
Erect [j Occuponcy
Alter ? Zoning
Repair ? Fire Zone
Enlarps p Type of Const.
MOV! 0 # StOf195
Demolish ? Length
Grode ? Depth Sq. Ft.
Aoororals Ftes
Assessment Permir
Water 8 Sew. Surchorge
Police Plcn check
Fire SAC '
Enp. Water Conn.
Planner Woter Meter
Courxil Rood Unit '
Bldg. Off.
APC Totol
on the express condifion thnt
Minnesota Statutes ond City of Eogan Ordinonces.
yo. ?
Holder '
Well
Woor
Disp.
Somr
Footings
Foundation
Framing
Rouph HVA f
inwlation S?
Ftnel PIb4 •2 eJ
Ffnal HVAC -zO3 ?
FIna1 •z _ y
woof Doscribe Location:
YWII
Sawsr
Pr. Dkp.
1795 Nlot Keob Roed E0q011, MN 55143
iHONE: 454-8100
BUILDING PERMIT Recelpt #
Slte /lddrcss : iv-
Lot Bixk Sec/Sub.
Parcel #
oc Name
W
9 Address
a:
Z0
ou
ug
r-
n
Ercct Q Qctuponcy
Alter ? Zoning
Repoir Q Fire Zone
Enlorpe ? Type of Const.
Move O # Stories
Demoliah ? Length
Grode Q Depth Sq. Ft.
Appeovafs Fees
llssessment _
Water & Sew.
Palice
Permit
Surchorpe
Plen check
SAC
Woter Conn.
Water AAeter
Road Unit
U? Name
FW
W W Firo _
?? Addross Enp• -
<W Ci Phone Plonner _
Council _
I hereby ocknowledge thot I have read this opplication and stote thnt Bldp. Off,
the informotion is correct and agree to comply with oll applicabte ^? _
Stote of Minnesoto Stotutes ond City of Eagan Ordinonces.
Sipnnture of Pertnittee
A Building Pertnit is issued to:
oll work sholl be done in occordonca with olt opplicoble State of
Buftdinq Officiol
Totol
on ths expresa condition thot
ond City af Eaflon Ordinances.
Psrmit Hvldar Miu. Permit No. Holder
Plumbing ff jiftz,??K? 3-
H.V .A.C.
Well
Watar
Disp.
Sower
Ekctric Wo(o'q3 ?b v? E.G? -ZS-$3
Inspection Date Insp• Other
Footinys
Foundation
Froming
4
7-
Rough Plb¢ .?9. - ?
Rouph HVA
Inwlation
Final Plbp. Ad4
Finst HVAC
Final
Watsr Dsscri6e Location:
YVell
Sswar '
Pr. Dhp.
BUILDING PERMIT
T. F.. ....A t...
37lS Pilof
Eeten, MN 33122
. ;t
$ 3e, `bUQ
Site /lddrcss
Lot Block Sec/Sub.
Parcel #
ot Name
? /lddross
Name
?? Add?ess
rir,,
1 hereby acknowledpe thet I heve read this opplication ond stote Hwt
the informoti9w-f's correct ond ogree to comply with ali opplicobla
Stote of Minnesoto Stotutes ond City of Eagon Ordinances.
Sipnoture of Permittee
A Building Pertnit is issued to:
oll work sholl be done in occordnnce with oll oppliaobte Stute of Mir
Receipt #
Eroct 0 Octuponty
/llTer ? Zonirp
Repoir ? Fire Zone
Enla?ps ? Type of Const.
Move p # Stories .
Demolish ? Length
Grode p Depth Sq. Ft.
Approvols Fees
Assessment Permit
Water & Sew. Surchorfle
Police Plon check
Firo SAC
Eny. Water Conn.
Plonner Water Meter
CouncH Rood Unit
Bldg. Off.
APC Total
. on the express conditlon thnt
sota Statutes ond City of Eoflan Ordinances.
Bulldinfl Officiol
Psrmit No. Permit Hoids? Misc. Permit No. Holdar
Plumbiny ?a„Z? 7? ' ?L-? '3-7-0 3
H.v.n.c. l( 7D c?d ?. ?so - ?(-8"3
Wsll
Water
?isp.
Sawer
Electric WolpQ3 ?'?fel-• ?(`tS-?
Impsction Data Insp. Other
Footingt ?
Foundation
Freminp
Rough Plbg. •? ?.? ?
Rough HVA - :_63 , /?t,/
Inwiation
Finai PI6p. ? ?
Final HVAC
.f
Final .y
?
W?r Dncribe Location:
VYell
Sewer
Pr. Dbp.
+
CITY OF EAGAN SEWER SERVI CE PERMIT
' 3795 Pltot Kneb Rood PERMIT NO
:
169an. MN 55122 .
DATE:
Zonirg: ,
Owner
No. of Units: .
.
Address:
Site Address: T . r
4r
h
Plumber. .
1 eoeee to eem? w?eh Hhs
city of Ea
ap ]! 1?, , Il ??,?
C
9
Ordinaneq, onnecNon Chor+pe :
,,tcount peposit:
Permk Fee: . '
Surdwrpe:
B
Y Misc. CFw?ges:
Dote of Insp.:
Totol:
Insp.: Dcte Pold:
CITY OF EAGAN SEWER SER VICE PERMIT ?
3795 Pllot Knwb Regd PEFtMIT NO.:
Eagan, MN 55122 DATE:
Zoninp: No. of Units:
Owner.
Ad
"
dress:
Site 4ddress: ` ea,thex Prj.ve
?
Plumberr ., r : - -, _. r•.a., ? n_. ,,.. ogew M aomplp wMh fM Gty of Eagae
of Insp.:
? ,. .
Connection Cherpe:
Account Deposit:
Permk Fee:
5urcharye:
Mtse. Chorges;
Total:
?ITY OF FA"N WATER SERVICE PERMIT
3795' Pllot Knob Road
6oqan, MN 55122 PERMIT NO.:
DATE:
Zoning; -
No. of Units:
Owner.
Address:
>i.e Address: r.
- ? ,
PlUMVer: ' .?!'enn _ r-,? . r
No.:
to eomplr whh !h& City of Eayon
Connection Chnrye;
Account Deposit: -
Pertnit Fee:
Surcharge;
Misc. Chorges: _
Totnl: _
Date Paid.
CITY QF EAS.AN WATER SERVICE PERMIT
3795 Pllot Knob Rood PERMfT NO.:
? Eogon, MN $5122 QATE:
. Zoning: No. of Units:
Qwner; '
Address: -
Site Address: _- il-,-
Plumber:
, Meter No.: Connection Charge:
Size: Account Deposit;
Render IVo.: Permit Fee:
l agrae to eompIy wkh the City of Eagan Surchorge:
Ordinanees. Mlsc. CFwrges:
Total:
By Dote Paid:
Date of I nsp.:
Insp.:
ICITY OF EAtiqN
3795 Pilof Knob Rond
10904, MN 55122
Zoning: - ' "
Qiv?12f:
Adcl?BSS:
Site Address: " ' 1 ? '-?•.?•-!,
Ptu.nbec
Nleter No.:
Size:
Reader No.:
I egroe Ro wmplr with !he Citr o# Eagon
Ordinances,
aY
Date of Insp.:
to oompir with f6e Ciqr of Eogan
WATER SERVICE PERMIi'
PERMIT ND.:
DATE:
_ No, of Units: unIt 4
Connection ChQrve; ^ .. -
Account Deposit:
Permit Fee; ' -
Surcharge:
Mlst. CFarges: }
Total:
Dote Peid:
Conneceton Chorne:
Account Deposit: _
Permk Fee:
Surcharge:
Mix. CFarges: _
Totol:
Date Poid:
NTY OF EA,GAN SEWER SERVICE PERMIT
1795 Pilot Knob Resd PERMIT NO.:
eagon, MN 35122 DATE:
!oning: No. of Units:
r
?wner: - , - ' - .
,Ite Address:
'lumber: -
21/'=?! •?_ .. , ?.., ;,.
agree to eomply wilh the Ciey of Eagon Connection Charge: ?22
Irdinanees. AtcouM peposit:
Permit Fee:
Surcharge:
Y Misc. Charges:
CIT'l OF EAGAN
3795 Pilot Knob Rood ---- - --- • _~•M•
Eayan, MN 55122 PERMIT NO.:
DATE:
Zoning: -
>1VPICr: . r NO. Of UhItS:
i . ?.
lddress: - -
No.:
to aomply with !ha Cilr of Eogen
Connedion C.harge:
Account Deposit: _
Permit Fee;
Surchorge:
Mlsc. Chnrges: _
Totol:
Date Paid:
cIn QF EAGAN WATER SERVICE PERIWT
3795 Pilot Knob Roed PERMIT NO.: 4618
Ragae, MN S61 D/1TE: 3I24 83
RIV No. of Units: unit -plex
Zoniny:
a„ner_' Tollefson Suilders
/lddress:
No..
ReadEr No.: IJ
1 egno ta im+,yy"h ei» urr
BY tv
Date of I nsp.:
Connection Charye: 42(1 _ Od = d
Acoount Deposit:
Perrnit Fee: 10 00 Fd
Surchorge: .50 d
Mist. Chorges: 6(} O0-{d mat a
Total:
Date Paid:
ciTY oF EeGnN WATER SERVICE PERMIT
3795 Pilot Knob Roed PERMIT NO.: 4617
3l24/83
Eagan, MN 55722 DATE:
Zoning: RIV No. of Units: 1 unit 4-p1 Px
OwMr: Tollefson Builders
dressc
re Address: 3809 Heather IJr LS B1 Briarhill 4th
myer; IarGOn Genz Th•an -
M er No.: Connection Chnrge: 420_00 prl
Sizei ?/? ?' ?^•-?- Account Depoait:
Reader No.: ../?f? ?4 ?7 3 Permit Fee: 10 00 nd
1 agrea ta wmvlY wiTh eha Ciry of Eagen Surcharge: - 50 F,d
Ordinanw.
gy
Date of Insp.:
Mise. Charges: 60_00 pd mPta:
Totol:
Date Poid:
REQUEST FOR ELECTRICAL INSPECTION EB-00001-04
?-
4.. -' See insii?tions for completing this torm on back of yellow copy. ? 0??9360 ?
"ll" Be/ow Wark Covered by This Request 35? ?(
Ninni AAd Rap. Typ¢ ol Buildinq Appliances WirBd EquiVment Wired
Home Range Tempnrary Service
Duplex Water Heater Lightiny Fixtures
Apt. Building Dryer Hectric Heatin
Commercial Bldy. Fumace Silo Unloailer
Industrial 81dg. Air Conditioner Bulk Milk Tdnk
Farm Or ei oeci v Dinar Isoecuvl
IIIP.( SUECIfy ()}hCf O1hL'I
ComUUte Inspection fee Below
Fee Sarvice EntrenceSize k Fee Feetleas/SUbiexders p Fee Circuits
Oto200Am s
Oto30Am s -dr
Oto30Am s
A6ove 200 q?n??y 31 to 100 Amps 31 to 100 Am s
Swimmfn Pool Above 100-Amps Above 100_amPs
Transrormers trrigation Booms O Partial:'Other Fee
Signs Specialinspection $.B
Remarks o TAL FEE ?
/ J/7.0
? i• i
Nough-in Datey
? Y?? 1, ihe ectricxl
Inspecto?, hereby
tif
th
h
b
Final
? e
U?t? R car
y
nt t
e a
ove
insoection hes been
? ? / made.
TNnrwnuwntvnltllAmnnMSfrom - ' N `?
This request vold q Z15 L,o?5 C? (p ?`7 4-g1
18 mnn[hs from ?
V069360 4k(t q4 -?'
3s(4 Uy
/ 70(ao
'/ ?/ ?? Requir ? Neady N Will N
? otity, Inspec-
I-f es No ?r When Ready
GLicensetl Elecvical Contmctor ? I hereby raq.est inspection of above
? Owner electrical work ins<alled at:
S[ree[ Address, Box or Route No. _
u
// /3?/S
pr
fl
3?b9 Ciry
?
?
e
v,,
y
- a ? ii,
ection o. Township Name or Nn. Rsnge No. County ?
a ?d °c.
Occupxnl(PRINT)
L
/ Phone No, ?
e
(?
Power Supulier
!? kf C/e . A a c. Atldress ?
?vYmir
Electrical ConYrar.tor ICompany Name)
' l
E' Conhactor's License No.
yF
ecr iC
a7 e/
D
, 3
ailinp AAJress (ConV
do?u actor or Owne?r ?Making Instailationl .?J (?
?/VY? S 5q/UQ -//f 3 7d
uthorized Signawre Comractor/Owner Makina Installati n
' ?9f?NdJ/ (L(//C / G? l ? Phon/e}N?/umber
?7(/ -35:5?
MIQNESOTA STATE BOAO O LECTqICITY THIS INSPECTION NEQl1E5T WILL NOT
Griggs -Mitlwev Bldg. - Room N-797 BE ACCEPTED BV THE STATE BOAND
NLESS PXOPER INSPECTION FEE IS
1821 Universiry Ave., St. Peul, MN 55104 U ENCLOSED.
"`; ; ?rrtifirtt#e `?rf (?rrix?ttnr? ? ;,
\, ?itp of= tfagan .
3grparftnrn# nf Builbing lnsprdimi
Tbit CMi ficate irtuul Qartuant to thc nquiremeiur of Settion ,306 ; 0( the Uniform BuiWing
Codt urtifriag tbat at tix time o f ittuarui tbit.itrrirturr wdrP+:n1 irompliann wrtb the vanotu
wdinancrt of the City ngaloting buildirsg ronrlrurtion oi ate. Far the 10110wing: ?
. ,.,. ?
.
u..crwn"uoo 1of 4 PLEX V{?` 'i ' t siao.nm:tno. 7683
a«war'rm R3 Trac?nm V FRZ.. NA ' z?rew,d,, PD
Tollefson Builders,,dd. 1655 Norwood Dr., Eagan
3815 Heather Drive ,W....Lot 8,Block 33riar Aill
By: ? -
Baakw p,a, June 28, 1983
8
uYe.
. ' ?tertifir?t#r nf (?rrix?ttnr?
Citp of Cagan
Drpttrtmrnf nf 16uilbing lnsprriimi
Tbu Carti(itate ittrud purtuant oo e6e rrquiremrnu of Settion 306 oJ Ibt Uni forrrt Bailding
Code ttrtifying tbat at tix tirae of irruanct tbrr ttrrature was rn comQliancr with tbe vuriour
ordindnca of tbrCrty+egxlating building wnn+uttrors ar ure. Fw the followirig:
u»cww?nm 1 of 4 PLEX aa6.h,?;,No. 7682
oewwar'hp R3 '1Ywc? V FiRZ. NA zommamfi« PD
a,W,?md?z Tollefson Builders Aaa,,,1655 Norwood Dr., Eagan
D.gd,?Aft„ 3813 Heather Drive L,,O,YLot 7 Block 1, Briar Hill
4th
1? Q? ?t?:
_?? May 26, 1983
? ? a
.e., ,. . w..n??. ...?.
CITY OF EAGAN
9795 Pps1 Knob Rmd Eogan, MN 55142 Np 7W
PHONE: 451-8100 -
?..
BUILDING PERMIT 2eceipt # 3 ??1---
Te M msd fei 1 of 4 PLEX Est. Value 036.000 Dace Nov emher 24 iq-82--_
Sire nddreu 3815 fleather Drive Erect (71 occupuncy R-3
Lot 8 Block 1 Sec/Sub. Briar Hill 4th Alter ? Zoninq PD
parcel # 10 14993 080 Ol Repoir ? Fire Zone NA
V
Enlarge ? Type of Consf.
W
0
Z?
O<
u?.
r
Name Tollefson Builders Move ? # stories
Addren 1655 Nox'wood Drive Demolisb ? Length 44
qty Esx an 55122 phone 454-6873 Grode ? Depth 26 Sq. Ft.-
Nom OWIIEI Approvela Fees
Address Assessment Permit 220.00
Name
Addreu
Water 8 Sew.
Police -
Fire
Erp.
Planner _
CouncH _
I hereby acknowledge thof I hova reod ihis opplicotion ond stofe fhat gldg. Off.
the inlormation is correct ond agree to comply with all opplicoble _
State of Minnesota Stotutes ond City of Eagan Ordinonces. APC
Signoture of Permittee
A Building Permif Is issued to: TOilefoll work sholl be done in ocmrdonce with oll
?
Buildinp Officiol
Surcharge 18.00
Plan theck> > 0. 00
snC 525.00
Water Con420• 00
W orer Meter 60. 00
Rood Unit 240.00
Toral $1593.00
on the express condition thai
Statutes ond Ciry of Eogan Ordinances.
CITY OF EAdAN
' 9795 Pllet Kne6 Rood Eagcn, MN SSlll NO 7682
. PHONE: 434-8100 ?? -
BUiLDING PERMIT Receipf '
# - -Z? ?; ,?L,-I
,
7o bs y.ed far 1 of 4 PLER en.vaiatt $36.000 n.,r> Novemher 24 ,0 82
Site Address 3813 Heather Drive
Lor 7 Bi«k 1 Sec/Stib. Briar Hill 4th
Parcel # 10 14993 070 Ol
w I Name Tollefson Buildera
? nddreu 1655^Norwood Drive ,^'^
o Name OW[ler
t-
?u Address
Nome _
Address
I hereby ocknowledge that I have read this opplicotion and state that
the intormotion is correct und agree to comply with oll oOPlicoble
$fate of Minnewta 5lotutes and City of Eagan Ordinonces,
Sipnofure of Permittee
A Building Permif is issued to: Tolli
ull work sholl 6e done in occordance with
Buildinq Officiol
E.ecr m acuacncy R-3
Alter ? Zoning PD
Repolr p Fire Zone NA
Enlorge ? Type of Const. V
Move ? # Stories
Demolish ? Length 44
Grode ? Depth 26 Sq. Ft.-
Aovrovols Foes
Asussment Permit «W.Uv
Water 8 Sew. Surcharge 1$•00
Police Plon check 110.00
Fira SAC 525.00
Eng. Water Conn.420.00
Plonnar Woter Merer $0• 00
Council Roud Unit 240.00
Bldg. Off.
APC rorol $1593.00
on fhe expreu mrditlon thm
Minnetota Sfotutes ond City of Eagon Ordinances.
CITY OF EAGAN
3795 Pilot Knob Rmd Eogon, MN 55112
PNONEs 454•8100
BUiLDING, PERMIT
$36,000
N° --7681
Receipt #
Date November 24 ?
Sue nddress 3811 Heather Drive
l.or 6 el«k 1 See/Sub.Briar Hill 4th
Parcel # 10 14993 060 Ol
W Name Tollefson Builders. Inc.
z nddress 1655 Norwood Drive!
p Name
Z
?lV Addre.
1- n...
Nome _
Address
I hereby acknowledge thot I hove read this opplicotion and stote that
the informotion is correct ond agree to comply with all opplicable
Stata of Minnesoto Statutes and City of Eogan Ordirwnces.
Sipnature of PertniMea
A Building Pertnit Is issued to: Tol]
oll vrork sholi be done in accordance with oll
Buildinq Officiol
82
e,aa U o«uaoncv R-3
Alter ? Zoning PD
Repoir ? Flre Zone MA
Enlarge ? Type of Consf. V
Move ? # Stories _
Demallsh ? Length44-
Grode p Depth--215_Sq. Ft.-
Avprovals Fees
Assessment Permit ZZO.OO
Wafer 8 Sew. SurcFwrge 18.00
Police Plnn.check 110.00
Fire SAC 525.00
Eng. Water Conn.420.00
Plonner
.
Water Meter 60,00
Councfl Rood Unit 240_08
Bldg. Off.
nvc romi 1593.00
aOL ° on the express caditlon thnt
of hd' Ita Statutes and City ot Eagan Ordinances
CITY OF EAGAN
3795 Pilef Knob Rood Eagan, MN 55122 Np 7680
iHONE: 454-8100 -
BUILDIWG PERMIT Reteipt # .7 ->' -1,
Te hs mee fe. 1 of 4 PLEX Est yal1e $36,000 pare Novemher 24 jy 82
5ice Address 3809 Heather Ilrive
E
t
O R-3
rec
]I ccuponty
Lot 5 elock 1 Sec/Sub. Bt18r Hill 4th Alter ? Zoning PD
Por«l # 10 14993 050 Ol Repair ? Fire Zone N
V
Enioree ? Type of Const.
W Name Tollefaon Buildere Move ? # Stories
? Addroa 1655 Norwood Drive Demolish ? Length 44
q EaP an 55122 phom 454-6873 Grode ? Depth 26 Sq. Ft.-
o Nomre aii.ner ApP.oral. Fees
:jx
u? Address
Assessment
Permit 220.00
r ci Phane Water & Sew. Surchorge 18.00
w Police Plan the[k11O.00
?
Nome
Z Fire SnC 525.00
_
?? Address Erp. WaterConn?420.Q0
i'° CI Phone Planner WaterMeter60.00
Council Rood Unit 4 nn
I hereby acknowledge thot I hove read this opplication and stote ihat gldg. Off,
the inlormotion is correct and ogree to comply wlth oll opplicable
Srote of Minnewro $tatutes and Cify of Eogan Ordinonces. AP? To?a? $l 594_00
. SlOnoturo ot Permittee
A Buildinq Permit is issued to: Tollefson Builders IIC. on fha expres3 Condifion thm
all work thall be done in accordance with all opplicob Sfa of i eaota Stotutes and Ciry of Eagon Ordinonces.
Bulldinp Official -?D ? ?i?l Z
r
" Tallo£san Euildera Inc. Oz.1135i
183-13
'
ScAC.E l'=¢D' JACKSON - SURVEYORS
I
11i4tGT[XEO UNO[R LAWi O? /TAT[ M MiNN[SOTA
I 3618 EAST 55th STREET, MINNEAPOLIS, MN 55417 727-3484
i I *arbcpoc'g lCctKficate ? I
3 ?
• ???vo rES 30 ? 30 f
. m
-J? pRi4/NAG? ? ?c ai
go•r
`? 23 Q 2iw2?f?' ?? ? w 1' .
000.0 E?C/ST//?/6 EGE?. ? - ? ? u?
++
LLJ
e
1
g
+ty go.'?
23__rcCF v,,J,4yd' 23 ' e'
I Y
. •?? ? ?! ?J - ? . ` /
L?
?Proposrd G*rrge Floor E1QVi -4$W
Propoaed Bleament Ploar Elav.. 91.37
Propoeed Firet Floor Elev. 78.37
i HERlqY CZRTIFY THAT TN[ ABOV! IY A. TpU[ AND CORR[CT PLAT OF A SURVLY OF
Lote 5,6,7,8 Bloclc 1, 6riar Hill 4th. Addition,
Dakota County, Minneaota
Af BIIRVCY[O SY M[ TNIB-_ 8th. - Nov. 1982
-OAY OF-__ A.O.
SIGN[O ? '
F. C. JACKSON. MiNp t? e RW? MTiOw. NO. 3600
?
?, CITY Cu' sdY'.,AN Include 2 sets of plans,
1 site plan w/elevations i
? BUIIDIIVG PEId-Q'I' APPLICA7'ION 1 eet Of enezyy C81cs11dtiqnB.
'ib He [19ed?? Valuatioh Date
?
i
?
Int''a ?7 • 91d
ParaBl I s C)
Qwnert
Addseea:
CYtY/Z1P Oode:
P!1[1[IB #:
1lddstaes: /g?:5
CitY/Zip Cl?de:
Pt1o19 #: ?/
J1id1./EYg.:
Raureee: •
at7f/Zip Cb3e:
Pimana i: ----
II .3 I.?,? .38/S ,--- ?c%• OFFICE USE ODTI.Y
Sec./Sub.? ?LC 414!;t-Erect
?- Occupancy
? d Sp O} ntter zoning
Repair Fi.Ye Zone
Enlanye _ 'i'yne nf Const.
Fbve # Stocies
Deielish Front ft,
?'"+? Depth - (, ft.
water/Sewer Surchasye'-
Police Plan t]1EeC'.k
ss1 Z.3L- Fire s1C
E4 • ' Water Co[v1,.
Planner Water Meter
Courtcil poad Unit
? . Off. ? - - ? _
'mmrw 41 ? S`L Z t o d
1
i
.
? ?
? b??
3? '????
??
?,?
- ?, ,
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PERMIT
CITY OF EAGAN
3830 Pilot Kno6 Road
t Eagaii, Minnesota 55122-1897
(651) 681-4675
SITE ADDRESS:
PERMITTYPE:
BurLDING
Permit Number. y 3 4 0 7 4
Date Issued: 11 / 18 J 4 8
38esa iir_Ar?ER nR
LOTc 5 BLOL'Ka 1
i3RTAR HILI_ 4Tfi
P.T.N.: 10-1.4993-050-01
DESCRIPTION:
T.O. & RFROpF
Building P,ermiT. T,yp2 MULTI. (M.ISC.)
f3uilding Woelz_ Type REPAIR
Census Code ? 434 ALT. RGSIDEN7IAL
?
REMARKS:
TNCLUDESa
FEE SUMMARY:
38].1, 3313, AND 3815.
VALUATION
Base Fee
Surcharqe
Total Fee
$212.25
$219.25
$14,000
CONTRACTOR: - Applicant - sT. Lzc. OWNER:
MTKE IhOHS CONSTRUCTION CO 17211107 5456 BRIAR HILL ASSOCIATlOPI
3414 SNELLING AVE S 3509 HEA7HEH UR
tfSNNEAPOLIS MN 55406 EAGAN hIN 55123
(612) 721-1107
S hereby acknowledge that I have read this applicatian and state that the
information is correct and aqree to comply with a11 appJ.icable State afi Mn.
L Statutes and City ofi Eaaan C)rdinances. J
APPLICANTlPERMITEE SIGNATURE I ED BY: SIGNATU E
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAC}AN
4 3830 PII,OT I{NO; RD
? -55122
lO O
New Construdion Reauirements
RemodeVReoair Reauiremenls
• 3 registerad site surveys
? 2 copies of plans (inGUde beam & wintlow s¢es; poureO fntl. tlesign; etc.)
? 7 energy calculations
• 3 copies of tree preservation plan 'rf lot plaked aRer 7/1/93
required: _ Yes _ No
DATE: Nd?l? i ( ?1?8
DESCRIPTION OF WORK:
e
STREET ADDRESS:
LOT: S BLOCK:
;69 - // -/3, /S
? 2 copies of plan
? 2 ske surveys (exterior adtlkions 8 decks)
? 1 energy calculations for heated add8ions
CONSTRUCTION COST; / Si 7 75 "&-?
0 L-
SUBD./P.I.D. #: ?' i l 1 l,-,L
Name: 6x, ! 4 .2 y/ // Phone
PROPERTI' Last First
OWNER
Street
City State: Zip:
l?0 4?S
Company:_ L!!! ( i k e /vL2k5 C6 Ph
CONTRACTOR
Street Address: License k 3 ?s b
City State: ? Zip:
ARCHI7'ECT/
ENGINEER Company: Phone tf:
Name: Registration #:
Street Address:
Ciry State: Zip:
Sewer & water licensed plumber (new construction ony): . Penally applies when address chang
and lot change is requested once permit is issued.
I hereby acknowledge that I have read this appliption and sfate that the infortnation is conect and agree to comply with all applicabl
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant 7
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 0 06 Duplex
? 02 SF Dwelling ? 07 4-plex
O 03 SF Addition ? OS 8-plex
? 04 SF Porch ? 09 12-plex
0 05 SF Misc. ? 10 _ piex
WORK TYPE
? 31 New ? 33 Afterations
O 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
? 11 Apt./Lodging ?
? 12 Multi RepaidRem. ?
? 13 Garage/Accessory ?
? 14 Fireplace ?
? 15 Deck
? 36 Move
? 37 Demolition
Basement sq. ft.
Main Ievei sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
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
7otal
a?a.as
-1 .0
?
Engineering
Valuation: $
21 .
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
MCMJS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
°k SAC
SAC Units
oF
3830 PILOT KNOB ROAD. P.O. BOX 21199
EAGAN. MINNESOTA 55121
PHONE: (612) 454-8100
OCTOBER 4, 1985
GUNARS AND JULIA ZVANERS
3811 HEATHER DRIVE
EAGAN MN 55122
Re: Project 399, Final Assessment Hear
Dear Mr. & Mrs. Zvaners:
ections
BEA BLOM9UIS7
Mv«
THOMASEGAN
JAMES A SMITH
JERRV THOMAS
THEODORE WACHTER
CouncY Mambers
TFiOMAS HEDGES
Clry AdnrisValar
EUGENE VAN OVERBEKE
Ciry Clark
On September 17, 1985, the Final Assessment Hearing was held
for improvements associated with the above referenced project.
Your property was identified as havinq a final assessment obligation
of $153.70 to be spread over 10 years. However, you have an
opportunity to pay this amount off in full without any interest
penalty up to October 17, 1985.
Based on our recent telephone discussions, you informed me that
you no longer have an objection after you reviewed your purchase
agreement and found that the seller of the property was responsible
for this assessment and accordingly provided an escrow account
when determined_
I am returning to you your notice of the special assessment with
your hand written objection on the back that you submitted at
the Final Assessment Hearing on September 17.
If you need any additional assistance or clarification pertaining
to the process, please feel free to contact me.
Sincerely,
Thomas A. Colbert
Director of Public Works
enclosure
TAC/jh
THE LONE OAK TREE...THE SYMBOL OF STRENGTH AND GROWfN IN OUR COMMUNIiY
65 $ r, 842.05 +yj.e,lk,?,l. ,?0 S?
5(o`7 o a-o5o7a
2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Plcase complete for: single family dwellings & rownhomes/condos when pemuts are required for each unit
Date -1 / 21 / QL _
Site Address 3?5 oPa Avx DY l`! F, Unit #
e
Property Owner Rc
? Ct,{ Kp ?-. c) P
k Telephone #(/p
Contractor ? ? PlC,e-JA d_na +(eL
StreetAddress Q_?DnA oltr? 5t. Kfn City Nf. t4y1 6ky-
state (71N( z[p 55304 Telephone#(76 3 ) ?4 3Lf-7141
Bond #: Expires:
The Applican[ is _ Owner 7X Conhactor _ Other
Add-on or alteration to existing dwelling unit $ 30.00
? furnace _Additional XyReplacement
air exchanger
airconditioner _New _Replacement
other
State Surcharge
I s .50
';! JUL 2 3 Z004 ? ?
L?
Total 1J
JU,_
BY ?
E-y----- ;*?-
I hereby apply for a Residential Mechanical Permit and acimowledge that the inFormatiou is complete and accurate; that the work wil]
be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a
permit, but only an applicarion for a permit, and work is not to start without a pernvt; that the work will be in accordance with the
approved plan in the case of work which requires a review and approval of pjans.
10Ew5°L 3RCk.So n ACJGGL
ApplicanYs Printed Name Applicant's Signature
2004 COMMERCIAL MECHANICAL PERNIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please comple[e for. commerciallindustrial buildings
multi-family buildings when separate permits aze not required for each dwelling unit
Date
Site Street Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner _ Telephone # ( )
Contractor
Street Address City
State Zip Telephone # ( )
Bond #: Expires:
The Applicant is _ Owner _ Contractor _ Other
Work Type
New Construction _ Underground Tank _ Install _Remove **see below
Interior Improvement _ Install Piping _ Processed _Gas
Nature of Work:
*"When installing/removing underground tank, call for inspection by Fire Marshal and Plumbing Inspector
Permit FeeS: $70.50 Underground tank installation/removal
$50.50 M:nrmum (includes Stite Surcharge)
or
Contract Value $ x 1% _ $ Pernut Fee
• If e? rmit fee is $1,000 or less, add $.50 ? $ State Surchazge
If nernut fee is over $1,000, add $.50 for
every $1,000 permit fee $ Total Fee
I hereby apply for a Commercial Mechanical Pernut and acknowledge that the information is complete and acwrate; that the work
will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is
not a pemvt, hut only an application for a pemut, and work is not to start without a permit; that the work will be in aceordance with
the approved plan in the case of work which requires a review and approval of plans.
Applicant's Printed Name ApplicanPs Signature
Approved By: , Inspector
4b> Clty of ?ap
?-. . Ar? ? •
? Permit #:
? PermitFee:
I
? Date Received:
I
I
I Staff:
L ------??
/2008 RESIDENTIAL PLUMBING PERMIT.APPLICA
Date: ?' A Site Address:
? ?
Tenant:
RESIDENT / OWNER I Name: _
CONTRACTOR
TYPE OF WORK
PERMIT TYPE
RESIDENTIAL FEES:
Address / City
New
RESlDENTlAL
X Water Heater
James Thompson
3811 Heather Drive
Eagan MN 55122
6129645298
suite
Phone:
ocr r s zoos
Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W.
Lawn Irrigation
(-- RPZ / _ PVB)
_ Septic System
New
Abandonmenf
_ Water Softener
Add Plum6ing FiMures
C_ Main _ Lower Level)
_ Water Turnaround
$50,50 Minimum Water Heater, Water Softener, ,or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround` (includes $.50 State Surcharge)
`Water Turnaround (add $136.00 if a 5/S" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ducfivork, etc.) (includes $.50 State Surcharge) C? O
TOTAL FEES $ S0 ^'
I hereby acknowledge fhat this inforzna6on is complete and accurate; that She work wfll be in con ance w'rth the ordinances and codes of the City of
Eagan; that t understand ihis is not a permit, but only an application for a pertnit, and wo s not to start wiJhgut a permit; that the urork will be in
accordance with ihe approved plan in the case of work which requires a review and approv of pl?/f /, //
City: 1 Av (S. State: M Zip: 55 D
Phone:1-tYM 6('('Lfl,/33 Contact Person: ie J S
x?)e?FY?e,t?1 I. ? ?! oT bl a?v?. X ?/??k??-
ApplicanYs Printed me Appl' anYs Signature
05/22/2009 11:05 6128616267 BEI EXTERIOR MAINT PAGE 05
Sao 57
- - - - - - - - - - - - - - - - - -
130`7
Perrrilt 0;
City of W11 Permit Fee:
3830 Pilot Knob Road
MN 55122 Date Received;
Eagan
Phone: (651) 675-5675
Staff:
Fax: (651) 675-5694
X008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: f v - Site Address: E/~ l2- 49A VE
Tenant: Suite
RESIDENT I OWNER Name: v ss~u,orro d , n•,an•GrQ Phone: 37.x'7
Address I City I Zip: 7Da ~A 5'T ~ SH 2AA ~'O.QA 6 X5.3//
Applicant is: Owner Contractor
TYPE OF WORK Description of work: A67MOV .9N4 R~~°[.at ~r4X''r/.4 t- °+af
Construction Cost: aouo -P-x~~~ Multi-Family Building: (Yes 1 No
CONTRACTOR Name; .B L T 14119 MATT. 4IP License
Address: 7D~ '60
City: eec4s- . stater Zip: ? 9'9
Phone: 1/3 Contact Person:
e3- ( 2
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules- 76-70 Category 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
(I submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan Issued a permit fora 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:. Plane and supportring'doetim nats'tha# you su ,m~a~ ete„t b>}a dl red fo ba pirblf information.- Portions of;.
the information may be c l a s s s i r i e k l M-17. ~i b l i p rf y o f ~ p i r c t v t ~ a I i asons that, Would permit the City to
~I c
ctflld!'irida;i`f78t tha ~lQ~•tiat3i' Sarre' , ' , , , ~ .
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 or
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' tha caae of work i In, rA and approval of I s_
S'O 4•:
x (4,
Applicant's Printed Name Applicant's Signature
Page 1 of 3
Use BLUE or BLACK Ink
-
For Office use --y--12
Perna ~'1
of Eajan I ;y _ l
I SU
I Permit Fee: I 1
3630 Pilot Knob Road I
Eagan MN 55122 Date Received: 0 3 I
Phone: (651) 575.567s I I
Fax: (651) 675.5684 I Staff. I
1 i
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: y-~'' /3 Site Address: 1%,
Unlt;6•
Name:% 1,95SOep4"°s A:-,..►r1-,.1c.~L Phone' 76319dl-37A7
Address/ City /Zip: ')o.AR X. Sir 1,+,iC Q b r~'l,u-pct'. !~2~~ .J SS it
Applicant is: Owner Contractor
Description of work: T£ /L- o i= R ~Z F t,S E GG, s Cam. 2 °r,FS pi.1,C y
TY~ of'NV~ek
Construction Costs 77 [r0 Multi-Family Building: (Yes / No i)
Company Contact: Ibx v
io S
Address: City
State: Zip: .S'SH/ Phone: L Z- G 2 V S
License M C 'g S/ Lead Certitlcatit
If the project is exempt from lead certification, please explain why: ($ee 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 penult for a similar plan based on a master plan?
`Yes _No If yes, data and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor; Phone:
Sewer & Water Contractor: Phone:
J
A.
~'~4►r7~1~Qf1 ~~~~'C~~~'#1,4;•.1CIRtitt~,p~~~~~M~fr'IRII►~arts~,>~_;'~~..'
cps~lalt~t~ei6~'~6 ~e,tras~'sectaefs-'~,
CALL R FORE YQU~ DIG, Cap 0013119r State On* Call at (651) 454.0002 for protection against underground utility damage. Call 48 hours
before you Intend to dig to receive locates of underground utillies. MELMperstviteoneraff,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 pwrri t, 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.
Extorlor work authorized by a building permit Issued In accordance with the Minnesota Building ust be completed within 160
days of permit issuance. X
Applicant's Printed Name
Applicant's Signature
Page 1 of S
60 /TO 3J~d 1NICW 1X3 139 L9Z9T98ZT9 ET:ZT ETOZ/80/b0
c!yof
3830 Pilot KnOb Road
Eagan MN 85122
Phonic (151) 0764675
Fax (681) 8754894
Use BLUE or BLACK ink
. For Mx Uta (ePaint
Permit Peci
Cate Reef red:
Wt.
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
SitoAaatoa3: 3805, 32';/, 3g/3/ i67.4". /aL4rN DR. unit 0:
Name; 4 A e r /r1AAi4 m L phone; 743 -sf3 9/)0
Address /City !Zip: �� t`. t W-1-0.. Q /9V ' .Z 19 G'st,�►E.a Vi1'LLIJ,_
Aro .T't7
Applicant is: _ Owner 2C_ Contractor
Deoc iptlon of work: -r>r.ga oP (2,t- P-ao
ConstructionCost /3 'CO, co Multi -Family Building: (Yes x / No
Company. rE ! EJ=-cm,o.e "trArr. e,02.14 contact • Avid ZS,*
Addreaw dos W 603. S7.. City: A/Pt. S .
smut bp: Sr4/19 Phone: /°'z - 4A4/3
Uaense 0 & yl/ 3 / toad Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
131.6 W aL-1st,,4r Pos - /F
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In tins bat 12 months. has the City of Eagan hound a permit for a a4nitar plan based on a taaatar plan?
Yes No Wyss, date and address of master plan:
Licensed Plumber. Phone:
Mechanical Contractor: Phone:
&war & Water Contractor: Phone:
MOIN,::�"]�M•�•-.�,.. .e k u,.Z. �:yvr'�G.'J�..• yt�ry�rY f.� _ — to .. !arl�s�
the ��"1'11��eya.i .4f4 1;,'-_k [. ,-,..i,,rl,.--4, ,:_`':",,L .� vti� • . "s-un.t, y :f_,- w , _ ` v,-. .:
, ,i ti .c tis
CALL YOU
before youEFI� reran CalllocaGot o One Call at 051) 454.0002 fir protectionderma. Cal 48 hOwa
underground utleties, wwr,goonerststaonscaa.e et
I hereby that
adtAowie* lhat this informationacomplete and accurate; that the work WI be in conformance with the ordinances and codas ofthe Qy al
, bind thio i6 nota Mut but 0111/an apgQeatlen for a pan* and work to abut without a vomit tot the nett 411 II
ttnoro ore pan in tna Oats W Wait wYON Iopto r. a roaow and approval l et
permitatefier
days of si.m a Pent) Issued In accordance waft the �1kY1eoc $i0m Coda mini: bt comistad within 180
Appbaants Prettied Nam
t'0/80 39 d
Applicant's Signature
7 g X
Papstora
1NI'W lX3 I3a L9Z9T98ZT9 SETT 8TOZ/LZ/TT
*City of bin
3830 Pilot Knob Road
Eagan MN 66122
Phone: (851) 676-6675
Fax: (661) 675-8894
Use BLUE or BLACK Ink
For office Uso
Permit al:
Permit Fee: a--13
Date Received:
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 3 - L `/ " 14/ Site Address: 3$° 9 3 ? I , 9 r 3, 3 "5` N ATA/L'Q 62. Unit #:
Resident/
Owner
Name: k i MAW 4 6 At Ew; .s. k; C..
Phone: 743 - a 93.-- 9 7 7 a
Address / City / Zip: 8S0 Q E C Orr U & 4v, A L W "' 14pas Y JA)
Ss VI 7
Applicant is: Owner 2fContractor
TYPO of W°rk,
Description of work: I?% o v E. a- RLP rte f- �• ' s.J 6 d 1' a S� "a' AI 47-4 l"
Construction Cost / 4 Y Uri, UO Multi -Family Building: (Yes / No _)
Cont ctor
Company: £ 1 e c. r / o 2 /niH wT - Co aP Contact DA ✓ r p 43„/LAI S
Address: h/os w 6001 �-
State: / "` Zip: 5-5-4/1 Phone:
City; nrn PL
?,i - ('-Ca2V3
License #: L x / 1 > Lead Certificate #; _
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
l�pe,l,(DS_ I1ure.r
Posr is7i
COMPLETE THIS AREA ONLY W CONSTRUCTING A NEW IBU DING
In the Iaet 12 months, has the City of Eagan issued a permit fora similar plan based en a master plan?
_Yes _No If yes, date and address of master plan;
Licensed Plumber. Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Fops and *Opqrf;1 9f self? COnaieTeilh ril:¢:
the deo/i deo/Mit/on
CALL BEFORE YOU DIG Call Gopher State one Gall at (651) 454-0002 for protection agairst underground utility damage- CaU 48 hours
before you Intend to dig to receive locates of underground utilities. www, looher6tateonecall.oro
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
Eaoan: that I understand this Is nota permit. but only an application for a paand work is not to start without a permit; that the work will be in
accordance wirmlt, th the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit hauled in accordance with the Minnesota State Building, Code must be completed within 180
days of permit issuance.
x A ✓' 0 Ru/t1L,f
Applicant's Printed Name
90/170 39Cd
Applicant's Signature
X,
Page 1 of 3
1NI17W 1X3 I3S L9Z9T98ZT9 SS:TT bTOZ/172/80
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA122073
Date Issued:04/24/2014
Permit Category:ePermit
Site Address: 3809 Heather Dr
Lot:5 Block: 01 Addition: Briar Hill 4th
PID:10-14993-01-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Holly Flood
1408 Northland Dr #310
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 -
Mervin Murakami
3809 Heather Dr
Eagan MN 55122
Sedgwick Heating & Air Conditioning
1408 Northland Drive, Suite 310
Mendota Heights MN 55120
(952) 881-9000
Applicant/Permitee: Signature Issued By: Signature
City of Eapjtll
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651):675-5654
MAY 2 7 2014 Use BLUE or BLACK Ink
For Office Use
Permit #: ffA /623on
Permit Fee: d'(O.0•
Date Received: �: 27—JhG
Staff:
Aio
2014 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address: 3BDA� . A( �
Tenant: 'rJt. Suite #: (�
Name: UfAl! yr vP\
Address ' City / Zip: i►1ii i i/ C.rriU
MilbertName: u
Company Inc dba Cullign Watercense#: WC643176
Address: 180150th Street East City: Inver Grove Hgts.
State: : MN zip: 55077 Phone: 651-451-2241
Contact: William ;R _'M i l b e rt. Email:
RESIDENTIAL
Water Heater
Lawn Irrigation L- RPZ / _ PVB)
Septic System
New
Abandonment
eplacement Repair _ Rebuild _ Modify Space _ Work in R.O.W.
Water Softener
Add Plumbing Fixtures ( Main /_ Lower Level)
Water Turnaround
RESIDENTIAL FEES: -
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $200.00 if a 5/8" meter is required)
$115.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES a .—
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 informa_ton is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that 1 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 ap I of plans.
:L/f///4i 4
Applicants Printed Name
x
Applicant's
ignature
Sd 7 L
SEDGWICK HEATING & AIR CONDITIONING CO. HEATING JOB NO. 41
1408 NORTHLAND DRIVE, SUITE 310 • MENDOTA HEIGHTS, MN 55120 • (952) 881-9000 TEST RECORD
ADDRESS 3& n 1~51~ CITY f~ (3 ~ r MAY 18101
1
OCCUPAN OWNER W (&o'
SOLD BY INSTALLED BY rr
MAKE u MODEL
SERIAL NO. mat y 9/ 3~? INPUT WOK
1 Dt~p
THERMOSTAT VENT SIZE q it r3
VALVE TYPE OF LINER U cN~-
LIMIT LINER SIZE l~ v
LIMIT SETTING- ~j FILTERS: SIZE NUMBER
FAN SETTING WIRING FA64-f'
PILOT TYPE TEST TAG
IGNITION MODEL S , LIGHTING INST. ll
PILOT TIMING
j DATE TESTED
PRESSURE PERCENT CO, / ~ C ( ILK
INPUT CFH (O o,C PERCENT 02 COMPANY TESTING
STACK TEMP, PERCENT CO ~ NAME OF TESTER
FORM 235 (REV. 10/10) FORM DISTRIBUTION: WHITE COPY - JOB FILE YELLOW COPY - CITY
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA138502
Date Issued:08/31/2016
Permit Category:ePermit
Site Address: 3809 Heather Dr
Lot:5 Block: 01 Addition: Briar Hill 4th
PID:10-14993-01-050
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Mervin Murakami
3809 Heather Dr
Eagan MN 55122
Sedgwick Heating & Air Conditioning
1408 Northland Drive, Suite 310
Mendota Heights MN 55120
(952) 881-9000
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA178701
Date Issued:08/30/2022
Permit Category:ePermit
Site Address: 3809 Heather Dr
Lot:5 Block: 01 Addition: Briar Hill 4th
PID:10-14993-01-050
Use:
Description:
Sub Type:Water Heater
Work Type:Replace
Description:Standard Water Heater
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:
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
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 -
Mervin Murakami
3809 Heather Dr
Saint Paul MN 55122--162
Champion Plumbing Llc
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature