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3840 Heather DrCity of Eatall 31130 Pilot Knob Road Eagan MN 55122 Phone: (651) 6756675 Fax: (651) 6754694 Use BLUE or BLACK Ink For Office Use na3 Permit*: Permit Fee. .10 25 Date Received: L `0 I I ! Staff. 2013 RESIDENTIAL BUILDING PERMIT APPLICATION - 9-/y Site Address: 3 ?LP) Hee97,4(-2 (alt: Unit 9: Resident/ ONfiter Name: eio 4e, f%lofN 4bZ.HtZA17 JCL r.. Phone: 763 - S-73- 9770 Address / City / Zip: sso E C i4 r U !Z AY, 3 , A 6.04bE,6 1404.4.1 Y /OA) Ss4L7 Applicant is: _ Owner XContractor Typla ofWork, Ceet-actor Description of worla f.PL A C. f_ , i u U. r / P4-. L431 a / P41^ r / Construction Cost: Multi-Famlly Building: (Yes 2C/ No Company: E 1 c 2 mil . Co /2P. Contact £ 4 ✓ / 0 $3..4 2_41, S Address: 4/4"-r L) 4,13/1 - city: m PL S State: /VAS Zip: SSW/ 9 Phone: Lo/ .'C - N 10 / - Lm Z 4/3 Ucenee #: 474(-- 24/// 3 I Lead Certificate #: If the project is exempt from lead certiflcatton, please explain why: (see Page 3 for additional information) CSLafoS- Pas'.' ),75 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 �flo If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 43+-0002 for protection against underground utility damage. Call 48 hours before you Intend to dig to receive locates of underground utflties. www, bberstateoneoall.oro I hereby admoMedye that this information is complete and accurate; that the work will be in cortfonmance with the ordinances and codes of the City of Eagan; that 1 understand this is not permit, but only an application for a permit, and work is not to start without a penult: that the vie* will be in axanance with Ire approved plan In the case of work which requires a review and approval of plans. Estarior work authorized by a building permit issued in accordance with the Minnesota State Build Code must be completed wlthin 180 days of Pen* Issuance. x ✓' 0 2 '22.if Applicants Printed Name £Z/£0 39vd x. Applicant's Signature Page 1 of 3 1NIvW lX3 I3S L9Z9t98ZI9 LZ:bt VICE/TI/V0 l BUILDING PERMIT T. 6a uead fer 1 Of CITY OF EAGAN 3796 PiloR Knob Raod Eagoe, MN 55122 PHONE: 454-8100 Reteipt # Sjte Address .aowv neaLuea Lrive Lot 51 Block Z Sec/Sub. Briar Ei12 4th Porcel # 1CI--14993-510-01 aWc Nome ; Addre b a Nome I?r?utr &'Q2/-X5--f`Y?'?` f ? ul Address Cit Phone u °C ' W IW Nome F ?,-? Address <W CiN Phane 1 hereby ocknowledge Yhat I hove reed this opplication ond state thot the inlormotion is torrect ond egree to Comply with o!I opplicuble State of Minnesota Statutes and City of Eogan Ordir?onces. Slflnoturc of Permittee ?a ..a A Bullding Permit Is issued to: pll work sho41 be done in accorderxe with oll Build'any Officiol Erect Z Occuponcy -` 3 Alter ? Zoninfl Repair p Fire Zone Enlorpe p Type of Const. j' Move Q * Stories Derr,olish ? Length Ft. Water & Sew. PoHce Fire Enfl. Picnner Cauncil Bidg. Off. APC Perm+t Plan check SAC 525? Woter Conn. Water Meter ?' `} • `J' ? Rood Unit Tatal `']-633.')0 on the express condition thal and City of Eagan Qrdinonces. Permit No. Permit Holder Misc. Permit No. Holder Plumbing 3$'S? ??ytZ.- ti h (0-27-$3 H.V.A.C. ?a S/ ?-rfi''8Y w.n W !?Disp. Ss Elactrie ;. UO Q ftS ri? Inspaetion date Insp. Other Footings _2?-?? ? Foundation Framing Rouph Plbg. loor Rough HVAC Inw Iation Final Plbq. Final HVAC Final Waftr Describa Location: Well Seurer Pr. Disp- cirr oF EAcAN ;. 3796 Pllot Knob Rood Eoyon, MN 55I22 , PHONE: 454-8100 BUILDING PERMIT Receipt # Te be w.d fe. I of 4 PLE1 En_ veii,P ?36,000 on+P October 27 19 33 .304c cieauaar urive Slte /1dd(eu Erett [JX tt--3 Occuponty l.ot 52 Block 1 /Sub. Briar Hill 4th - ? ^lter ? Zonirp - .2 01 Pa?l # 10--1 99 - Repoir p Fire Zone " Enlarge ? Type of Const. o e son u ers Z Name MOVe ? # Stories I y orwOU r ve 4?` ^ddrcss Demolish ? Length _ t ,;., Eapan 55122 454--6873 Grode 11 Depth ? Sa. Ft. °C Nome _ 0 ?? Address F- r:... Name /lddress I hereby ocknowledge thot I the intormotion is COrrett n State of Minnesoto Stotutes A55ESSm2nf T_ ??e Water & Sew. Police Fire Erg. _ Phone Plnnner Councl l have read this opplication and state thot gldfl. Off. nd ogree to comply with oll appliceble A? and City of Eagon Ordinances. Slpnaturo of Permittee - ?r--? ? i /1 Building Permit Is issued to: ull work shall be done in eccordante with I Buildinp Offlciol Permit ccv.vv L)U Surcharge 18.? Plon check SAC Water Conn. 4 5?. Woter Meter Rood Unit Total . on the express condition thnt und City of Eagan Ordinances. Permit N it Holde? Misc. Permit No. Holder Plumbing t -'1? n H.V.A.C. ? Well Water D'up. Sovrer Electric ? ?&? f -JJ• r Inspection Date Insp. Other Footings Foundation F?sminq 3 Rouyh Plbp. Rouyh HVA Ins,lation rs ?y Final Plbq. . .p' Finsl HVAC Final Wstar Oftaibe Locetion: YVell Sswer , Pr. Disp. 1 of 4 PLEX M $614 Receipt # ? ? Sire Addrcu 3644 Heather Drive Erecr ? Occupuncy ?'3 Lot 4f Block 1 Sec/Sub, Eriar Hill 4th Alter p Zoning Porcel #, 10-14953-490-01 Repoir ? Fire Zone =1A Enlorge 0 Type of Const, v oc IVame 1 'ToileFson Builders 1655 l d D Move ? # Stories 44 Z ^ddros ozwoo . rfve s perrwlish p Length 9 '.-Tagan 55122 454-Fig71 Grade f-i Depth 26 Sq. Ft. ? 0 z ou V§ r Ncme _ Addreu Nome _ Address 1 hereby ocknowledye that 1 hove read this opplication ond state thot the information is torrect ond agree to comply with oll applicable 5tata of Minnesoto Stotutes and Ciry of Eagon Ordinonces. Slqnature of Permittee ioli-tsorl :suilcler? A Bufiding Permit is issued to: all work shall be dona in acoordance with oll applicable State of Mii Buildinq Offlciol Assessrnent Water b Sew. Police Firo Enp. Plonner Councf I Bldp. Off. APC Permit LlU, UU Swcharye 18-00 Plon check 110.00 sAC 525.00 Water Conn. 450 " no Woter Meter ?'Z Rood Unit 2 S,'j 00 Totol $16 3:3 . 00 _ on the ezpress tonditiort that City of Eoqen Ordinar?ces. cirv oF EAcAN 3795 PNof Knob Raad Ea9an, MN 5512= PHONEs 454-8100 Psrmit No. Permit Holder Misc_ Permit No. Holder Plumbiny ?jgrQt ???Z ? /D-'ZII' H.V.A.C. Well Water Disp. Sewar Elect.;c z3zg0 m.4srE,t Impection Date Insp. Othar Footingt Foundation F?aminp ? Houyh Plbp. ? z?r Rouqh HVA Inwlation Final Plbp. AdCl Final NVAC .f` Flnal Wate? Desc?ibe Location: Wsli Sevuar ? Pr. D'?tp. .? CITY OF EAGAN 6 ? ? ' 3793 PiloF Knob Road Eagan, MN 53121 „ PHONE: +I54-8100 BUILDING PERMIT Receipt Te be used for 1 Q° 4 PL£X Esf. Value $36,000 Dote -- ,- 14 ? 3 I 5ite Addi I.ot 50 I Parcel # rc Name y `- ovu uuiaucao i ^dd? 1655 itorwood Drive ?agan 55122 ? 454-6873 Name _ H Address ? C'itv I hereby ocknowledge that I have read this opplication ond state th(it the informotion is correct and ogree to comply with oll applicable Stote of Minnesota Statutes ond City of Eagon Ordinonces. Sipnoture of PermitFee o. re: A Building Permit Is issued to: all work sholl be done in accordance with all Buiiding Official Erect )m Qccupancy A? J Alter ? _ Zoning ` Repoir ? Fire Zone Enlarye ? Type of Const. Move ? # Storiels ; Demolish p Length 7! 6_ Grode O Depth SQ, Ft. Assessment Water & 5ew. Police Fire Enq. Planner Council Bldg. Off. APC Li r Permit "" • "" Surcharge 18. ?Q Plan check 110. 00 SAC 525.00 Woter Conn. 430. GO Woter Meter 60. r) Road Unit "'' ''"`-" C(J Total ;?1033.00 _ on the express condition thm City of Eapon ardinances. Permit No. Permit Holder Misc. Permit No. Holder r.H. bing A.G.C. 7C9/r? ' Electric r7A32j?d ImA??? I p/I -` y I I I Date Inwlation Final HVAC Final yrti ??l Sevier Pr. Disp. Receipt PLUMBING PERMIT ? CITY OF EAGAN Iy Fi/l in numbered space+s Typs or Print /egibly 1. Date 4 / S• r.} Z 2. Installation Cost, 3. Job Addrefs Lot5;-4 61 4. Owner Permit No. 2 ^ s ?. ?. :., Fee ` c c ? ?? i .? S/C _?? Tot. ? - ??' St? • c) U .i?/'?/ /4? k. Tract _r4. ? 5. Contractor Phone j,,"T ?' - o, 6. Address 7. City 10. Describe 11 &,k r,J zip =-':?'c, ce-23 No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner Shower Wel I Kitchen Sink Urinal/Bidet Other- Laundry Tray ,; Floor Drains Drinking Ftn. ? ? Slop Sink Gas Piping Outlets i ? 12. I hereby certify.,that the above information is true and correct, and I agree to comply withkell ordinances and codes overning this type of work. . Signed : •..-_'" for Rough Finel ? Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved ?-CITY OF EAGAN 454-8100 8. Building Type: ResidentialLC- 'Commercial O Institutional ? 9. Work Description: New Q--'Add O Alter ? Repair ? Receipt PLUMBING PERMIT Permit No. ?? LJO CITY OF EAGAN Fee ` Fill in numbered spaces S/C 4- ?? . i,(: ? G ? Type or Print legibly - --- ?' Tot. /vi SL1. Date & 2. Installation Cost -71 ??U cG U 3. Job Acfdress Lot S?- Blk. ? Tract ?={;et S 4. Owner /cf?// C 7'.3? s-•- .?-?- ff ey - q -i?3 5. Contractor?? Phone 6. Address 7. City? "\r i,/! State ?"L l?lf ' Zip 8. Building 7ype: Residential El-'Commercial O Institutional ? 9. Work Description: New ?qdd O Alter ? Repair 0 10. Describe 11 No. ,l- Fixtures Water Closet No. Fixtures Cesspaol/Drainfield ? Bath tubs 5eptic Tank ? Lavatory Softner Shower Well ' ? Kitchen Sink Urinal/Bidet ? Laundry Tray Floor Drains 5 r U ;? - Drinking Ftn. 51op Sink Gas Piping Outlets ?„ - 12. I hereby certify that the above informatian is true and carrect, and I agree to comply with a.ll ordinances and codes governing this type of work. Signed:.' for / .? e . ??j?? i? J? ! Rough Finel Inspections: Date Insp. Date Insp. This is your permit when num6ered and approved. Approved ?_ 1: ?: t; CITY OF EAGAN 454-8100 Receipt PLUMBING PERMIT Permit No. CITY OF EAGAN ?v • oc? Fee Fill in numbered spaces =6/d ?U ca / Type or Print /egibly w % aTot. - ?? 1. Date /' 2. Installation Cost e) U ?y ?_3 U -v' hTi?r1i, bf. 3. Job Address Lot'Y7 Bik. Tract 4. Owner 5. Contractor c?r%%_ Phone 6. Address k 7. City ? G i& r-n State r AiA_? ? Zip 8. Building Type: Residential Q1_/1 Commercial ? Institutional ? 9. Work Description: New_0? Add ? Alter ? Repair ? 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield ? Bath tubs Septic Tank Lavatory Softner Shower Wel l Kitchen Sink Urinal/Bidet Othe'r'?X' ~e ?.{ ?f Laundry Tray ? -7 ? ? ? Floor Drains T ?------ Drinking Ftn. - Uu? \ ? Slop Sink Gas Piping Outlets - 12. I hereby certify that the above intormation is true and correct, and I agree to comply with II ordinances and codes governing this type of work. Signed : ' ,e.2, for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt .3 Ci ---? S 5? PLUMBING PERMIT , Permit No. CITY OF EAGAN F? ? ? Fill in numbered spaces S/C Type or Piint legib/y Tot%??4? --n_ 1. Date 2. Instailation Cost o v Y' -/'z? t 3. JobAcr?ss Bi k./ Tract 4. Owner ? I?+ q 5. Contractor 4 ' J TL? Phone 6. Address t 'o/ 7!4 s 7. City " State 44 e1,?_2ip 8. Building Type: Residential T,,-'Commercial ? Institutional ? 9. Work Description: New Q.,-?Add ? Alter O Repair 0 10. Describe 11. No. ? Fixtures Water Closet No. Fixtures Cesspool/Drainfield ? Bath tubs Septic Tank Lavatory Softner Shower Well , _L Kitchen Sink Urinal/Bidet ? Other'y! ! w fl :/ i n Laundry Tray "? , , --- Floor Drains Drinking Ftn. Slap Sink ? Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with 911 ordinances and codes governing this type of work. Signed :?T? for Rough Flnal Inspections: Date Insp. Date tnsp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 ? MECHANIJCAL PEFiMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE PHONE: 454-8100 Site Address L t l y ? f r BLDG. TYPE WORK DESCRiPTION o B ock ?Sec/Sub Res. ? New ? Name U G c Mult. Add-on Address `r s ? '" Comm. Repair N City 'Gf+ Phone t >> - ?; 6 Other Name FEES RES HVAC 1 0 M T ? . 0- 0 B U -$24.00 c Address ADDITIONAL 50 M BTU - 6 00 O C?tY Phone (RES. HVAC INCLUDES A/C ON NEW . CONSTRUCTION) A O T E TYPE OF WO G S U L TS (MINIMUM - 1 PER PERMIn - 1.50 EA. RK COMM/IND FEE - 1% OF CONTRACT FEE Forced Air M BTU APPLIES T Boiler M BTU TOWNHOUSE 8 CONDOS ES. RATE APPUES MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8 Unit Heater M BTU $ REMODELS - 12.00 -- Alr Cand___-?-' ? M BTU MINIMUM COMMERCIAL FEE - 20.00 Vent CFM STATE SURCHARGE PER PFRMIT (ADD $.50 S/C IF PERMIT PRICE GOES - ,50 _ Gas Piping Outlets # BEYOND $1,000) Oth er g FEE: ? . fJ f S/C: i SIG j 1.?' TOTAL: FOR: CITY OF EAGAN Receipt 1. Date ?_11A MECHANICAL PERMIT CITY OF EAGAN Fill in numbered spaces Type or Piini legibly 2. Installation Cost 3. Job Address Lot Blk. 4. Owner - - - - - -- - - Tot. Tract 5. Contractor Phone 6. Address 7. City State Zip 8. Building Type: Residential ? Commercial ? Institutional O 9. Work Description: New O Add ? Alter ? Repair ? 10. Describe Fuel Type 11. No. Eauioment BTU - M. Ea. Forced Air No. Equipment CFM dli Ai H Mfg. r an 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 r Permit No. f Fee S/C Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee FiII in numbersed spaces S/C Type or Print legJb/y Tot. 1. Date 2. Installation Cost 3. Job Address Lat Blk. Tract 4. Owner 5. Contractor Phone 6. Address 7. City State Zip 8. Building Type: Residentidl ? Commercial ? Institutional 0 9. Work Description: New ? Add ? Alter ? Repair ? 10. Describe Fuel Type 11. No. Equipment BTU - M. Ea. Forced Air No. Euuipment CFM Mfg, Air Handling: Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Oth Air Cond. er Mfg, Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances end 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 Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee Fill !n numbered spaces S/C Type oi Print legibly Tot. 1. Date 2. Installation Cost 3. Job Address Lot Blk. Tract 4. Owner 5. Contractor Phone 6. Address 7. City State Zip 8. Building Type: Residential O Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter O Repair ? 10. Describe 11. Type No. Equi ment 8TU - M. Ea. Forced Air No. EQUiament CFM Ai l H Mfg. r and ing: Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg. Gas, Friping Outlets 12. 1 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 : Rough Inspections: Date Insp. for Final Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454$100 Receipt FiII in numbered spaces Type or Print /egib/y 1. Date 2. Installation Cost 3. Job Address Lot Bik. 4. Owner _ MECHANICQL PERMIT CITY OF EAGAN Permit No, _ Fee S/C Tot. . Tract 5. Contractor Phone 6. Address 7. City State Zip 8. Building Type: Residential ? Commercial ? Institutional ? 9. Wark Description: New O Add ? Alter ? Repair ? 10. Describe Fuel Type 11. No, E,quinent STU - M. Ea. Forced Air No. Equipment CFM Mfg. Air Handling: 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 wark. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-6100 ?J CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 AMOUNT $ I Q DOLLARS ' 7 oo ? CASH ? CHECK t, IOR )z J White-Peyers CoPY Yellow-Posting Copy Pink-File Copy Tha 7t? ou ' BY CITY OF EAGAN Remarks Addition BRIAR HILL 4TH ADDN Lot 51 Blk 1 Parcel 10-14993-510-01 owner street 3840 HEATHER DRIVE state EAGAN MN 55122 Improvement Date Amount Annual Years Payment Receipt Oate STREET SURF. STREET RESTOR. MRM Street 1984 1227.78 245.56 S 982.23 A013978 6-4-84 **Sewer Lateral gZC? 1984 2136.20 427,24 S SAN SEW TRUNK 1968 29.60 .99 --10 12-94 n n SEWER LATERAL TRK z6 1983 237.37 23.74 10 *sEw R A 1971 32-42 1.62 20 9-74 **WATERMAIN 1984 5 A/VATER LATERAL 1971 WATER AREA **Stubs 1984 5 STORM SEW TRK ? 1984 323.50 64.70 5 298.80 -ASTORM SEW LAT 1971 2 **Storm Sew Lat 1984 5 CURB & GUTTER SIDEWALK STREET6i0MT 1009 1986 153.70 15.37 LO ROAD UNIT 50.40 39577 - WATER CONN. 4SO.00 of BUILDING PER. 8612 SAC PARK CITY OF EAGAN Remarks Addition BRIAR HILL 4TH ADDN Lot 52 slk 1 Parcel 10-14993-520-01 Owner Street 3842 HEATHER DRIVE State EAGAN MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. Z, STREET RESTOR. 7,11 1975 70.69 7-07 10 IG18XOM STreet ? 1984 1227.78 245.56 5 982.23 A 014165 7/6/84 **Sewer a r Z 1984 2136.20 427.24 1,708.96 " it SAN SEW TRUNK H L 12.94 t' SEWERLATERAL TRK Z WY 237.37 23.74 0 189.91 " " * 9.74 ** WATERMAIN 1984 5 *VATER LATERAL 1971 20 WATER AREA 27.67 **Stubs 1984 5 STORM SEW TRK 1984 323.50 64.70 5 258.80 ISTORM SEW LAT 1971 ZO **Storm Sew Lat 1984 5 CURB & GUTTER SIDEWALK STREETt4CWrT 1009 1986 153.70 15.37 1 ROAD UNIT 25 0 39577 10-27-83 CONN. 450.00 n ?I BUILDING PER. 8613 SAC n 1? PRRK CITY OF EAGAN Remarks Addition BRIAR HILL 4TH ADDN Lot 49 slk 1 Parcel 10-14993-490-01 Owner Street 3844 HEATHER DRIVE State EAGAN MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. J?RXRk'? STree a 198 1227 78 2 5 5 5 982.23 A013850 5-7-84 ** g 1708.96 A013850 5-7-84 SAN SEW TRUNK 46 1968 29.60 12.94 A013850 5-7-84 SEWERLATERAL TRK 1983 237.37 23.74 10 189.91 A013850 5-7-84 *S R 9.74 A013850 5-7-84 **WATERMAIN 1984 5 *UVATER LATERAL 1971 20 WATER AREA 27.67 A013850 5-7-84 ** STORMSEW TRK ?93 1 g 323.50 64.70 258.80 A013850 5-7-84 -A.STORM SEW LAT 1971 ZO ** 1 CURB & GUTTER SIDEWALK STREET 1009 1986 153.70 15.37 10 250.00 39577 10-27-83 WATER CONN. 450.00 of BUILDING PER. 8614 SAC W ft PARK CITY OF EAGAN Remarks Addition BRIAR HILL 4TH ADDN Lot 50 8tk 1 Parcet 10-14993-500-01 Owner street 3546 HEATHER DRIVE state EAGAN MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. Z 19 STREET RESTOR. 1975 70.69 7.07 10 RMRR}Q`h9C Street 1984 1227.78 245.56 5 982.23 A01 588 2-28-84 **SEwer Lateral 1984 2136.20 427.24 S 1708.96 " " SAN SEW TRUNK ql 1968 29.60 99 30 12 . 94 - SEWERLATERAL TRK 1983 237.37 27J.74 10 189.91 *SEWER LATERAL 01 1971 2 2 1-62 20 9.74 " " **WATERMAIN 1984 5 'AUUATER LATERAL 1971 WATER AREA 1977 59.19 3-95 2 2_ _ **5tubs 1984 5 STORM SEW TRfC 3 1984 323.50 64.70 5 258.80 A013588 2-28-84 -ASTORM SEW LAT 1971 2O **Storm Sew Lat 1948 5 CURB & GUTTER SIDEWALK STREET?T 1009 1986 153.70 15.37 1a RQAD IT 250.00 39577 10-27-83 WATER CQNN. 4$0.00 It BUILDING PER. 615 SAC 525,00 PARK PITY'lF EAGAN WATER SERVICE PERMIT - ' 38'j() I.t Knob Road 1 3l??TY'OF EAGAN WATER SERVICE PERMR P. O. Box 21199 PERMIT NO.: ^.Ptl.,t1(nob Road Eagan, MN 55721 DATE: :' -?. i-ri?i r•':+:???x [1198 PERMi7 NO.: -_ .?l 57 Zonlnp: `a No. of Units: 4p 1 ex Eagan, MN 55121 DATE: 10 - 27 - S" - pwner: To11PfSOn s;drs Z?ing: No. of Units: 1 of -.1, 1i?_ Address: Ownsr, r1 r c S Addross: .??i4C` ??a}r,rr ;)rivc 1,51 K1 Eriar iii11 4th Addnm: 1 r: Sitr Address: ar ' r No. d ,23 O Connedion Chorge: r: ? v Siu: R " ?- .- ? ? - Actount Deposit: No. Connect(on Charge: d 5f1 11?•?;' Read.r tVo.: 2. 1 agrN !o oanVly Odl" By + Date of I n .. _ 4N 83? rirae +.»ob Roed P. O. 8ox 21199 Eagan, MN 55121 ,. Zoning: i?•fi pwner: Address: Sit* Address: Plumber: +_; Ci1 :, ' -r aF" ey Oota af trrap. : i Sa ?_L,' ? Pertnlt Fee: 10.00 pd ? • I1cc4unt Deposit: ? . ,ef,Eayqn ; Sutcf?arge: .50 pi ' Reader No.: Permlt Fee; 1._.lyitsc. Chorfles: 60.00 ?,ci iret.?•?' ?rorwtoooT*.wlwti* ;Ctirl.Surcharya: f ' "t'otcl: O?iiee _ ?. ? ?. ? c ? ? : . - L ?- ii ? ?. • ?i/l5 M1sc. Cho rpes: •'? - ?? 1' ?, cl m y r „• ?.? ,Qotrr paid: ' tpl: 2:!?-L Insp.: By Paid: Data oF lnsp.: Irtsp.: WATER SERVICE PERMIT PERMIT NO.: DATE: _ No. of Units: 1 of 4p2ex ' •'S A `f Cor?neetfon Q?arge: 4:1+_ jU Pu -ag Acwunt Deposit; Permit Fee: 10 i1 ?-od 5 rchor e: SO `_ a?? 1o?Utilit'i ac. Chnroes: c:=?. 00 gsl ,;?Gt?:r . tLr CTRlC -GAS Wai; r-.r% w v ? A CA& poid: CiTY OF EAGAN WpTER SERVICE PERMIT 3830 Pilot Knob Raad P. 0. Box 21198 PERMIT NQ.: Eagan, MN 55121 D^TE: Zoning: `4 No, of Units: 1 v f 1; >?:?x Owner: TuIlsfSOl1 61dT5 Address: 51te Address: z??tc? ;iegther I)riva LS1 D3 isriar ;iill 4th Plumber: 4tyan AAeter No.: Connection Charye: 450.00 ;)ci Stze: Actount Deposit: Reader No.: Permlt Fee: 10.00 p.d 1 prsr ft ooiwoy with eiK Cier of Eaysn Surchorye: .50 pd Ordtaanas. Misc. Chorges: 60.00 pd ;aRter Total: By Dota Puid: Date of Insp.: insp.: i CITY OF EAGAN 3830 P;lot Knob Road P. O. Box 21199 Eegan, MN 55721 -Zoninp: Address: Slte Addrcss: S&jL :j`>:3t>;oT `)T3 Plumbar: Mehr No.. 5tze: Reoder No.: I yrw to esinPlf wilh lM City ef Eayan O?dieaaia. By Date of I nsp.: WATER SERVICE PERMlT PERMIT NO.: DATE: No, of Units: x Connection Chorge: Account Deposit: _ Permit Fee: Surcharge: Misc. CFarpea: Total: Date Paid: 3830 Pi4ot Krwb Road ---- ---- - 6Z4.i-- P. O. Box 21199 PERMIT NO.: Eagan, MN y51?1 DATE: 1 1- 7-:33 Zoninp: No. of Unlts: ^-I o 47' Ioa pwner; l'u11cf5o:: Ac;rs llddress. ^. SiM Add; Plumber: 1agrw !a eanolp wkb iM Glr ef Eogos Qedlnenees, Bw Date of Insp.: Connection Charge: 425,00 nd Acwunt Deposit: PermR Fes: ? . ?" `• Surcharpe: • '' ?? Mlsc. Cha?pes: Total: Date Pald: ?:. . CITY OF EAGAN SEWER SERVICE PERMIT ? 3830 Pilat Knob Road ' P. C?. Box 21199 PERMIT NQ.: ????? f`'-a ' Eagan MN 55121 DATE: , d Zontnp: _ ' 8 No. of Units: I of 4:?1rx 'i ?111 ? ii 1 ?r s o+ p S ? wrrr, ! /dd?ess: ' Site Addmss; ?84U is'eather Drive L61 U1 ?,riar fiill •1t': I Plumber: GBIIZ RY811 --- 1P_77_3.': 7i 1;??;,r;j . i 1sli to eenwlp whh the Cihr oi Eaoa¦ Connsttion Charpe: OediNeoq. Atcount Depcatt: Permit Fee: ' Surcharpe: -t??._... , By Mlsc. Chorpas: , Date of Insp.: Totai: Inso.: Dote Paid: CITY ('r- EAGAN ,3330 Pr.ot Knob Road WATER SERVICI . P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 flATE' ?- - No. of Unlts: 2oning: _ Owner. L Mdross: $ite /1ddrESS: Plumber: - "' .va Meter No.: Connection Chorge: Siu: Acoount Deposit: _ Reoder No.: Permit Fee: 1a4ree bcomply with the City of Eayan Surcharge: Mtst. Chorges: -?- Ordi?nce& Totnl: - Date Poid: BY Date of I nsp.: Insp.: ? CITY OF EAGAN SEWR sERVICE pERMIT .:i330 Pi;at Knob Road ? N. O. Box 21199 PERMIT NO.: '- Eagan, MN 55121 pATE; Zoninp: ' No. of Units: Z of 4 ii1 e?. Owr,.r, Tcilefso: uldrs Addross: siee wdd.ess: _ 3346 Hcather Dr ive LSCi il1 3riar ';ill 4tr Plumber. {. Cnz nYdTi :y.: 77 100.00 ;'<< ' I .ome ro Sam.ir wkb ow ca,, ef B.se. con.wria, a,aro.: - 42:, , :' 0 :-d Odi"neN. /looourrt Daposit: i ? ? By Date of I rup.: ? Insp.. Pormk F.s: 10. 00 ud Surchorpe: .50 .'U Misc. Charpes: ToMI: Dob Poid: - CITY OF EAGAN 1NATER SERVICE PERMlT ? 383C ^°lot Knob Road P. O. Box 21199 PERMIT NO.: Esgan, MN 55121 DATE: zonirg: _ Na. of Unrrs: 0.: Owner, /lddress: - SJte Address: i r i 1 t° Plumber: _ . . ? s n • ? •, c Meter No.: . Siu; Reoder No.: I e9no to aomolq wkb HN Ckr of Eeyen Ordlnona?. By Dote of Insp,: Connectian Charge: Aocount Deposit: _ Permit Fee: lO.OD 1,.: Surchorge: Misc. Ct,aroes: Torul: Dota Poid: F C lTY C EAGAN ? 3830 Pil t K b R snm ?? P??? o no oad P. O. Box 21199 PERMIT NO.: ? Eagan, MN 551 ?'f* DATE: - 1 C; -d- ? Zonlnp: •``' No. of Units: _ 1 of 4.=1; _. ' Owrnr. - i'oll fco• :;2tir- Addness: Sits Address: - 3$44 ')ri ve I 1?) t ''ri ar I i l A Pluenber. Ce?1 z +2 r at1 j, CZi I .1- :_;- ,3 3 ,.?ii 100.0!' i : ; 1 M?w to eemplp willi 1M C&y oi EysB ConrncNon Chorps: ? , 4 7- Ordinances. Acoount Deposit: Pem,it Fae: 10. 00 ",d Su?rhorpe; .50 L?1 B Y Misc. Choroes; Dote of Inap.: Total: - CITY OF EAGAN N? 8612 9795 Pilot Nnob Rmd Eagan, MN 55712 .PHONEs 454•8100 ? BUILDING PERMIT kece?pt is 77 ,? # _-T To ba utad fer 1 Of 4 PLEX Eyi.Volue $36,000 Date O ctnhar 97 19__$3- Site Address 3840 Heather Drive Erecr )a Occupancy R-3 Lot 51 gi«k 1 Sec/Sub. Briar Hill 4th Alter ? zonirg R-3 Parcel {p 10-14993-510-01 Repair ? Fire Zone NA Enlarye ? Type of Const. V W Name Tollefson Builders µove ? # Stories = nddreu 1655 Norwood Drive pemolish ? Length 44 ci Eagan 55122 phoM 454-6873 Grode ? Depth 26 Sq. Ft._ ? Name OT"'°er Apvrovals Fae. ou Address Assessment Permit 220.00 vI Water & $ew. Surchor? ZS . 00 ~ Cit Phone Police Plan check 110.00 ?w Noma Fire ' SAC 525.00 ?Z-v, Address Erp. ` WaterConn.4so•no ?w Ci phom Plonner Woter Meter 60.00 Councll Road Unit 250.00 I hereby ncknowledge thot I have read this applicotion and state that gldg. Off. the intormation is correcf ond ogree 1o comply with oll applicoble APC Totol $1633.00 State of Minnesota Stotutes and City of Eogan Ordirwnces. Signaturc of Pertnittea ------- ?0: A Building Permil Is issued to: all work shall be done in accordarxe with all Bulldinq Officiol on the expreit condition thai Statutes and City of Eoyen Ordinances. BUIL[fING PERMIT N° 8613 Receipt # To 6a mee (e, 1 of 4 PLEX En. Volue $36,000 Date October 27 , 19 83 Site Address 3842 Aeather Drive Erect [X( Occupancy R-3 Lor 52 BI«k 1 Sec/Sub. Briar Hill 4th Alrer ? zoning R-3 10-14993-520-01 Repoir ? Fire Zone NA Parcel # Enlorge ? Type of Const. V rc Name Tollefson Builders Move ? # Stories ; Address 1655 Norwood Drive Demoiish p Length 44 ° C; EaQan 55122 vhone 454-6873 Grade ? Depth z6 Sq. Ft.- ,, e...........?. e... ?o Name ? ?O Addre ? n... Nome _ Address I hereby ocknowledge that I have read ihis application and stote that the inlormotion is correct ond agree to comply with nll opplicoble Slate of Minnesota Stotutes and City of Eagon Ordinances. Signoture of Pertnittee -iolr A Building Permit is izsued to: all work shall be done in acwrdarue with Buildinq Officicl CITY OF EAGAN 9795 Pilst Knob Rmd Eagan, MN 55172 PHONE: 454-8I00 Assessment Permit GLV.VV Woter 8 Sew. Surtharge 18.00 Police Plan check 110.00 Fire SAC 525.00 Eng. Water Conn. 45Q_ nn Planner Worer Meter 60.00 Council Road Unit 250.00 Bldg Off . . $1633.00 APC Toral _ on the express condition thai ond Ciry of Eagan Ordinances. ciTr oF EacaN 9793 Pllot Knob Raod Eegan, MN 55122 PHONEs 454-8100 N° 8614 C BUILDIN6 PERMIT eecelpt # T. M?jed fer 1 of 4 PLEX Est. Volue $36,000 pate October 27 , 19 83 Slte Address 3844 Heather Drive Erect 7[g Occuponcy R-3 Lot 49 Bloek 1 5ec/Sub. Briar Hil l 4th Aiter ? Zoning R-3 Parcel # 10-14993-490-01 Repair ? Fire Zone NA Enlarge ? Type of Const. V ?c Name Tollefson Builders Move ? # Srories ? Address 1655 Norwood Drive Demoiish ? Length 44 C; EaQan 55122- pha„e 454-687 3 Grode ? Depth 26 Sq. Ft.- ? Name OWller Aovrovob Foas 0 Z u?u ? Addrea Name_ Addrelt I hereby acknowledge that I hove reod this opplication and stote that the inlormation is wrrecf and ogree to wmply wiih oll opplicable State of Minnewta Statutes and City of Eagon Ordirqnces. Sipnature of Pertnittee A Buildin9 Permit Is issued to: 1011efSOn BuiAderq nll work sholl be done in accordante wifh all oDP?i Sfa of Building Officfol Assessment _ Water 8 Sew. Police - Fira Eng. Planner _ Council _ Bldg. Off. _ APC Permit GLU.VU Surchnrge 18+00 Plan check 110.00 5nG 525.00 Woter Conn. 450 " 00 Water Meter 60 • 00 Road Unit 2$0•00 Totoi $1633.00 _ on the expresf condifion thnt City of Eopan Ordinonces. . BUILDING PERMIT CITY OF EAGAN NO 8615 3793 Pllot Knob Raad Eogan, MN 55122 PHONEs 454-8700 Receipt # J ?,7 Te M und fer 1 of 4 PLEX Est. Volue $36,000 pafe October 27 _ 1 q 83 ' Site Address 3846 Heather Drive Er t O R-3 ec gg ccupancy Lot 50 Biock 1 Sec/Sub. Briar Hill 4th Alter ? Zoninq R-3 Parcel # 10-14493-500-01 Repair ? Fire Zone NA E l T f C V n orge ? ype o onst. W Name Tollefson Builders Move ? # Stories = ? Addross 1655 Norwood Drive Demolish ? Length 44 c. Eagan 55122 Phom 454-6873 Grade ? Depth 26 Sq. Ft.- ? Na e OWner Apvrovala Fees p m F ?? Addren r ?:... eL.,'- Name _ Address I here6y ocknowledge thaf I have read this opplication ond state thaf the information is correct ond agree to wmply with oll applicuble State of Minnewto Stotutes and City of Eogon Ordirances. $ignnture of Pertnittea A Bullding Permif is issued to: Tollefson Bui oll work shall be done in accordonce with oll opplicoble StqtJ? Bulldiny Officiol l Assessment Permit 220.00 Woter & Sew. Surcharge 18.00 Police Plan check 110.00 Fira SAC 525.00 Erg. Water Conn, 4 50 _ 0(1 Plonner Water Meter 60.00 Council Raad Unit 250.00 Bldg Off . . APC Torol $1633.00 on fhe expren condifion thnt e of Eogon Ordirwnces. This ieqoest void g "7 19 m?:",,h,ytrc? l W 089297 C.st, T3cf'at- ?4 i Il y4A 37$7 l /p,op _ - ? .._. _._?:. ... ...?.?.....,.. urteA? ?Ready Nuw ? Will Nntity Inspec- 6? Req ? ?J ?Yes ?Nn [or When Reatly ?Licen`sed Electrical Contractor 1 hereby raquest inspection ot nbove Owner elecMical work ingtalled et: SVeet AAdres' on or Routa No. 8 Orl t/ e CitY q ? ecUOn o. Townsh' ame or No. RnnBe No. CountY Q ? Ocr,Lpant IPR?ovt ?? ?8 e /? ?? Phone Noi 4/571/ ???? Powe.SUpplivr 't Address .. ??" 6 C ?v , ?n Elec i al Conv ctor ICOmany Nme{ A Convactofs Licnnse No. ti *? 's (n R0 c[or or Owner Makine ??stailation) av S' s . ? ? 0) ss3? uthor' _ d ignature IConttactodOwnor MakinB Instaliation? Phone Number M L ' 5-5? MINNESOTA STqTy BOANO OF EIECTHICIT? TNIS INSPECTION REUUEST WILL NOT Griges-Midwey Bldg. - Room N-191 BE ACCEPTEO BY THE STqTE BOA0.D 1827 Univarsity Ave., 5q Paul, MN 55104 UNLESS PqOPEH INSPECTION FEE IS o.___ 1a11i on, o111 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION Sea instrvctions br comoletinB tbis torm an back of yellow copy. :"X- 8e7ODb0 l7t Covered by Thls Request - EB-00001-04 v:? 3-t9-7( HAtl Rap. TYpe oi Builtlinm AoPliances Wirntl Equipment Wired Home Ranye L ?Teniporary Service Duplez Water Heater Lightiny Fixtures Apt. BuilAinq Dryer Electric Heatin Cominercial Bldy. Furnace Silo Unloader Industrial Bldy. Air Conditioner Bulk Milk Tank Farm rne. P<;c? v, oth, ISnenty) Ne77uccify }her Other Campute lnspection Fee Below k Pee ServiceEnhenceSize p Fee Feadcrs/SUAfneders # Foe Circu'its 0 to 200 qm Ps 0 fo 30 Am ps 0 tn 30 Amus Above 200 qmps. 37 to 100 qmps 31 to 100 An s Swimming Pool Above 100_Amps Ahove 100_Amps' Transiormers t Irrigation 8ooms Pertial,?0ther Fee ' Signs ?? Speciai InsUection $ D T - Remvrks OT LEE^ /S n i nal ' I^the ETBeer? I spector, heraby ?(?` cartity Ihxt the above '?/6 t-7 insoection nas been TblsreQUealvoidl8 This reQUest voiQ ?/II ? 18 rtwn[hs from 0 "? A qa?qn-/-sd, s t ? 1-7o• 00 sz. ,g t - RR.,Re - "'if V. - FI I L4S 4i Reques 9 1 ? Fire No. - Insoactlon Roueh m Required? es ?Nn Featly NowI NoU5Cnspec- ? ror Whcn Ready Licensetl Elecvical ConVactor I hereby repuast inspection of above ? Owner elactrical work installed et: Street Address, 8ox or Foute No. o ? Cih' Gq W r, qw ecbon o. TownshiP Name or No. Range No. Cnmnly Pq k6f?- T}? Occu nt ,I PPIN . Fhone Nu. / / 1 I{ G J S Power Supplier /ca /-q ?? - Adtlress El ' al Cont actor ICO Dany amel e E . Convactnr's License No. ' ya Owner Makin Mai1nnA.4tl?drejss (COnVac[oyr/cy Instailation? ) /? ? S OC ? 7 I./o IK ?7 (/ /r f/f Q Auih aetl SiO? ure ICon actor/ wner Mak, ?.-. ng Iretallation) _ Phone Number o -35 55 MINNESOTA STA BOA THIS INSPECTION REQUEST WILL NOT Griggs•Midwey Bldg. BE ACCEPTEO BV THE STqTE BOAflD 1821 UnivarsrtY Av UNLESS VflOPEN INSPECTION fEE IS Pnnnw f6121 297.21 NCLOSED. REQUEST fOR ELECTRICAL INSPECTION ea-ooom_oa , Sea inshuctiona for comDleling lhis form on back of Vellow copy. oq„ h`? A: ""R'" 8elow Wak Cavered 6y This Request v?? C) NOM Addl ReP. Type of Huilding Appliancea Wirod EquiWmant Wired - Home Range Temporery Service Duplex Water Heater Liyhtinp Fixtures Apt. BuilAinq Dryer EI¢ctric Heatin ' Commercial Bldg. Furnaca Silo Unloader Industrial Bldg. Air Conditioner 8ulk Milk T&nk Far Other oaci y Other ISnecifyl t O[hor Othe, Compute lnspection Fee Below p Fee ServiceEntrance5ixe k Fae Fexdera/SUbleeAers N Fee Circuits 0 to200Am 5 0 t030Am s 0 m30Am s Above 200 qmps 31 to 100 Amps 6 31 to 100 A s Swimming Pool Above 100_Amps Above 100_Am s 7ransformers Irrigation Boorcis Partial-'Other Fee Signs Speclal Inspection F OTA Nemerks Y L EE 1-7? tlI V ' ? Date9 1 ? ecvicel Inspectoq heraby certily thet the above RouBh-in Final D:?te ? r?§ peetion hes been ? il?r /?1 S ??G `[ `dGno Mis repuest voitl 18 monihs irom Tnllefron Builders Inc. ? '\l ID ?i ? c !!i l?o Z 0 . 1 r lda?, Or.11476 n? 183-79 JACKSON - SURVEYORS se.t.: iI_4o1 • Denotes Iron "auriRco uwc" uwS or nwrc or roiwwrA 000.0=Exiating Elev. ; `-.Drainage ,I 7616 EAST 55ffi STREET, MINNEAVOLIS, MN 55417 7273484 ?I ? .4lRLI?CpOT}? ICCThitUd?[ 1 , - _ --9 ? ?z - • - --_ .!`? _ _ --- - 8 Z3 0 ^^ o ? 8 y 2 ,l? ?? ,z`'• ??'??h v 3, i`_ 4j' ry z?' .cr ? ? ? J X N U(?' D ! ?3 k 2i. ?? Or?e M Propaaed Garage FloDr Elev.102.0\ Prop?aed.Firet Floor Elev. 102.5 ? Propoaed Basemen[ Flaor Elev.111.0 a? . / ? lo \ I M[11[BY C[RTIIY TXAT TM[ ABDV[ If A TpU[ AND CORR[CT rLAT OF A SURY[Y OF Lota 49,50,51 and 52,Block 1,BrLar Bill 4th. Additinn, Dekoea County,Minnaeota. As sURVtYLO m'I MR TMIf 21sc. pAY OI Oct. A.D. 1983 F. C. .Q / 0 N \ \W / RWMTIUAT/OM. MO. SO00 3 /69? y ??o 3? ? ? ?0 1?? crmsr nr rncnri irriuae z sets of plans, I 1 site plan w/elevati.a?s & l OF AUI[D1NG PEPhIIT APPLICATION 1 set of enem cala?t3anr. Rb 8e ueed Lbr 4--a.v ? Valuation :?;4 y fmn Date ,114- r?-:, qQ??.s?< USE CNLY sec./sun. ?? --------.. Erect. Paxnel # s 10 ? ??( Q Q? - Alter x Zoniryg 3 ?rt =????Yi" Fde4?aix Fire 2xre lhlarge _ 7ype of oonst. ? l?dd?t: Move il Stosies ' - - Derolirh Fmnt CitY/7•1P C1x1e: Grade Deptli ?- ft. Phom r: ; oonc,recmr: ? 1ldldreaa: , ? CitY/Z1P 0;,det i Pt?or? 1: /-?. ?y ; , ]1td1 .i _ I Jlddtetts i • ? at71/Zip Coda: + Phone 1: Water/.°,e?rer gurc?? Po1.iOe PI.aR C1iecJ[ Fire sic ? Water Conn? r Water hseter [7au1cil Iioari Unit . 1Bldq, Off. - AVC zrit'AL (P 3 31 DC) ?? ?f ?R (?u (4 1 oF ciTr cr E,cnN AUUII!)IW PEFMI'P ppPLICATION zncluae z sers of plans, 1 site plan w/elevatians i 1 eet of enecgy calailatiana. Rb a. claea For 4-Y vBZuar.iw; 036?,66)0 Dnce Q?, ? l?Pi(?FI(? USF Q?ILY 11 sec./sUa. ', . 'x,, oocupancy P&zoe1 A i 10 ? I`I 4 9 qG?'O - O( ALter zoniV3 Cfi[1BY i Addm" acy/za mwm r oonkractar: -?04LL1'7/i L?'wd1A Jlddresas ? LV 1,1 fri(k!1, nYl ? C1tY/Z1P Oot3er Phane 1: arch./F]nq.: . 11ddreao s • City/Zip Cbc3e; Phorw i s Fciaar Fire Zone [ - ]:hL'arge _ Type of Oonst. 1"bve N Storiea Dennlir>h 7`ront y Gzade L7ePth j26 ft. n?rnr„rs FEES . ASSessnienta Pe.rnut Watex/Sewer Surdwr9e Nnl.ice Plan CSteak / ?r ? Fire ? ? ? ? warer C.onn, ?r WatEr Metet 0 as- OoLuicil Road Onit . 1B1d9, Off. _ ? ? "AL ( f? 3 3 ; oD a czmsr cr r•nGnN Iralude 2 sets of plana. ? 1 site plan w/elevations i ? OF AUiIDIM PEIAIIT APPLICATION 1 eet of enetyy calWlntlQo, aw 8s ueed [or Valuatioui '.?G. 060 ante ? ? ? ?? s?? L;?') V&CFFICE USF. QJLY ' - SeC./Su6. EYeCt ? OC?CUpaflC,y J 4 4?- s00 - o I ntter zorLing 3 ; t2exiir Fire 2one Q?rtIBCi 1:h1 ange _ 7ype of Oonst. • Addxwy h»v?e N Stories ' 1ioli?;tt Ymnt ? atY/Zi Grade Depdi ft. Phom r ? ? ; I ? , mntracmr: Citst/ZiP O?dei PhOf16 }i ]1ICh./F}ncj, i 1ddxfte: • Clty/2ip OQde: Ptiorm r3 water/s?ner sura,arge PoLioe ` P lan CY?eck 8ire SAC ai3. WatPx' Corv?, yso plaruiei' Watpx Mete[ aTo-? Council Road Unit ?- 1Bldg. Off. AIIC ? ?,?. ? «???cD CITY OV EPkGAN Inc1ude 2 aets of plans. 1 site plan v/elevations i 0 F IKIIIDIIJ'; PEPMiT ]4ppLICATION 1 6et Of ernxgy Calcul,atjqm. ab ,ae ured Ebr val.uati.w; Ir 0 na ngce L6h, z,? 1qPz5 Ov/ve'OFFICE USF. QQLY • ??? 5 BlOCIC _L Sw./SUb. EYeCt ? QoL1l[janCy 3 lo--?VQ4?- w.? zoniTV3 3 Repair Fire 2one ??'?9e _ TYC? of ?nst. • Add? ?? il Storiea ; ???? ?liah t'ront DePt11 ?r cbr?cracoor: A*c'a"= ak]Nztp owes Ft?ca'ie 1: 1?? _ ? - .. I ?L'?1162 • ? Cxhr/aiP Coaa: ? pnar,?+ t: water/sawer surd,arciea? Yo1.iCe P].an C]leck / / O '""" Fire SAC En9• Water C.cYV?, N6°o Plaru?er WatEr Metec 7O 12-- Cancil Auad Unit 1dg, Off. ? APC T_ 7nTAL Cities Di?i itv Control The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. .?•? i,• -...._ .,,,yme, .:aa ilriJ+"," u9bi5431 _ •1{? • ? 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' ? ?? ! ? f 1.. +. ? .. > • ? ' 1 44. 't? rt?`i ??i+• • ?..ti. . 4.????fj L.: ?? f ' ?1 l?r?. R . ?i.r? :i ? i n + ' ('? ' ? ?t tp???1r .1'?-??-? ?f• ?r ` ? -! ?w?,f ? x +f ., hq 7? f l -'?;.y?Y , '' 1?,?,? ? ... ;.'L ' : ? .j . ' ?_ .._ '.',,. . } T ?' .• . ?t Y J S Y - . r . . . i' t? .... . . ? '? ' ?1 i . ?. ? . , "? . . ? ` ?1 >1 e .f.' •.\? { :? , . . .. ? . ? .. r . ? , . " . ? ?, 'tr .' . - . • ? . ` ??% . ? ?? . . .. ;' Y ? .i . . . . - . .. ? MA t , :. 4 . . i . ' / .. C' . ? ?? . L! • e •d • . T r ? , . i Tf ? ? , r.m • ? ? - ' - ? ?? ? - ? ? ? r ' ' . . . ' . ? / ? ?• . .. i _ - ... . . ? . - ( . . . ? . ? p• . r .,y ? .. . . . . ? ' . . , .. , .t .:. . . . .. ?.' : .. ? ' _ ?.. ? . .. ? ? ':. '.: .'.. . . . -• .? . . . . . - , _ ' J. . -' : • li ' . .. ' . . ? 1.. : ? ' F ?' ? , ? • \ ? - ' . ' . - . \ •. I . - ,I ?'w_. 1? '?p ?? - a ' . i ? : ? . . .. . . . 4 `. .. _ _.? , . i. . . : ? ` E,?•? v ? - ? r! rT ` S•,` ..'? ?-a ?. K ? ? ? ? . ? ? .. . ?,,.? . ..._ ? . . .. << •?. ? nttf? (a V yi ? .. sro ? _ ' R; ] "? ?` . N :fh . F ' : Z . . ??v. ? . . . .? . . i "-'-. 1 , r. . ?.? _?.:., r ?f"?''¢. ? ? - k / - ? ?.4?. ? ? v fl . ?. ?'? - •'.> r????' y i . ?' ? ? f :.r! ? ,- f ? ? A = , d ? '.: ,{?1/,? - „ ?,? ` • • r , rr? : d M .'• 3. ` )?- f , +? " . ?:J , ? ? '. ..+ ? : ra i. ' ... .. w. ., .a;. y. r'.,,, •'!?? - ? =•;?; ; ?R "Gr. .: ? i • ? '.?. ?. ? '' S lJR..T4 'i? ?: ,.. • , : C:tTY OH' EAGFlN CASH:I:L:F? e JFi II:RMSNAL N0; 748 DATEs 08l04/99 '1'IME: 13o32s36 ID:; ' K'Ah4L"l MII:E MOHS C;C1N'3Tf;UCTTC1N C(] 3c i.Q 9001 3840 I-11=A'fl-If::7t Lift 16;7w2; 205 9001 3840 NI:f17W1=R Ufi 4.''a0 3?:IA ::)I)01 3843 HEA'fFlf"li DR 1.67.25 2155 3001 3849 HEA'il-Iliii Df't 4,50 3210 9001 :3857 I°IEATI-!Efi Df? 16 '7„25 205 9001 :3857 HEFYTI-IfcF? DI'i q•.P.'iCl 32:I.O `)(lCli 3818 I_M.)F:E'.I_. CT 1"67.25 8i.55 700:t ;381H LAURF.i:4 C°f 4.50 3210 9001 3864 I-IEA7l-IER Af; 07.25 205 9(:101 3864 I-11':A'1'hIL'-::R DFi 4,50 T'oi:a:l Itec cr:ipt Amaun+, : 068. i'S CR:I. J.4 fl4q tlSF::Ii :fU: JAN ?? ill, -? 1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4675 cHon Reaulrem ? 3 regisFered ske surveys ahowing sq. tF. ot loi, sq. H. of house and alt mofed areas f20% maximum lot eoverace allowed) ? 2 coplea of plans (show bedm a window shes; poured tnd. design; Mc.) ? 1 set of energy calculalions ? 3 copies of hee preservWfon plan R lot plaHed aFter 7/1l93 Remodel/Reoatr Reauiremenfs !111.'s 2 copies of plan 1 se1 oF energy calculatlons for heafed addRions 1 sMe suney tor exterior oddHions 3 decks DATE: 15 " CONSTRUCTION COST: DESCRIPTION OF WORK: STREET ADORESS: LOT: ? BLOCK: PROPERTY OWNER Street City tasf e5 First Phone #: State: Zlp: Company: M i Ke- jA 45 Phone #: /Z (area code) CONTRACTOR // ? ??/?/ Street Address: -?`? q`Y ShD Pil/ /WS ? ? ? si: License ? ??E?cp. ? City State: Zip: 5754/tE(- ARCHITECT/ ENGINEER Telephone #: area code ( Street Cffy Name: ) Registration #: _ State: Zip: Sewer 8 water Iicensed plumber (reautred for new conshuchon onlvl: PenaHy applies when address change and lot change is requested once Qermit ts issued. I hereby acknowledge that I have read ihis application, stafe thal rihe Infor n Is tonect, and agree to comply wRh all applicabl Sfate of Minnesofa Statutes and City of Eagan Ordinances. Signafure of Applieanf: ?- ( OFFICE USE ONLY ZI0. L/ 2 e ? SUBD./P.I.D. #: 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.) D 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) Q 04 2-plex ? 09 7-piex ? 14 Apartments ? 19 Lower Level ? 24 5torm Damage ? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous WORK TYPE ? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? q Siding/Soffits/Fascia ? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 . Windows/Doors ? 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood 5tove ? 45 Fire Repair ? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof ' Give PCA handout to applicant for demolition permit GENERAL INFORMATION Const. (Actual) Basement sq, ft. (Allowable) Main level sq. ft. UBC Occupancy sq. ft. Zoning sq, ft, # of Stories sq. ft. Length sq. ft. Width Footprint sq. ft. APPROVALS Planning 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 Pian Review License MC/E5 SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/VN Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: Valuation: $ SAC Units % SAC *?**************??*?************?****** CITY OF EAGAN CASHIER: JS TERMINAL NO: 672 DATE: 09/01 /00 TIME: 10:52:59 ID: NAME: KCJ ENTERPRISES INC 3212 9001 3572 BALTIC AVE 30:00 2155 9001 3572 BALTIC AVE 0.50 3212 9001 4644 LENORE LAN 30.00 2155 9001 4644 LENORE LAN 0:50 3212 9001 3840 HEATHER DR 30.00 2155 9001 3840 HEATHER DR 0.50 3212 9001 4180 READING 30.00 2155 9001 4180 READING 0.50 3212 9001 4379 HAMILTON D 30.00 2155 9001 4379 HAMILTON D 0.50 Total Rec eipt Amount: 152.50 CR136 805 USER ID: JAN '30`p [ ` { CITY USE ONLY L J BL ? RECEIPT#: SUBD. RrIQY 7TI'I N'I"y1 RECEIPTDATE: PERMIT# 2000 PLUMI3ING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 651-681-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkter system CIYTIIQCS EACN # TOTAL Alterations to existing dwelling - minimum fee Describe: $ 30.00 Bath tub $ 3.00 x = $ Floor drain 3.00 x = $ Gas piping outlet ` minimum - 1 3.00 x = $ Hot tub/spa 3.00 x = $ Kitchen sink 3.00 x = $ Laundry tray 3.00 x = $ Lavato 3.00 x = $ Septic System newlrefur6ished 'requires MPC lic. 75.00 x = $ Septic System abandonment 30.00 x = $ RPZ new installatioNrepaidre6uild 30.00 X = $ ? Rough apening 1.50 x = $ ' Shower 3.00 x = $ Underground sprinkler if dwelling is under construction 3.00 X = $ ' Underground sprinkler if existing dwelling Water closet 30.00 3.00 x x = = $ $ Water heater 3.00 x = $ Water softener If dwelling under constructfon 5.00 x = $ Water softener 7f existing dwelling 30.00 x = $ Waterturnaround 30.00 x $ State Surcharge rotal 50 $ •50 ; $ o. S"o Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc. --------------------------?------------------------------------•--------------------------------- ----° ------------------------------- I hereby ackaowledge that I hava read this application, state that the information is covect, and agree to wmply with - all applica6 - le City of - Eagan ordinances. It is the appliCant's responsibility to natify the property owner that tha Ciry of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activ@ies to the facilities construeted under this pertnit wkhin City property/right-ot-way/easement. SITE ADDRESS: 59 4 v 7T-e-? 1"?•2 Y J.-] r( V-L OWNER NAME:: 7CL.h1 C I (bo'^'o-au- TELEPHONE#:' (AREA CODE) INSTALLER NAME: F-C T- 'l' l r• ??Jr? TELEPHONE #: - ? r ( jf _jP ' 4/ T (AREA CODE) STREET ADDRESS: ? CITY. M T STATE: M ZIP: >? r(/ N(JG :'? I. /i?[ nv. IGNATURE 00 F P ITTEE 73 /a,,-2_ zoos RESIDENTIAL PLUMBING PeRMir,aPPLicArioN CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to exisling residential dwellings. Date V Site Street Address ??SL?c? ttErL?n??ki ol>!?- Unit # Property Owner U Y L IQ C? ?n '?P,hk'C_ Telephone #?(? Contracton ??-L1? Telephone# (11,`D) Address cb-??_.} City :J?L?r????Y1 _ Statel Zip ?-? The Applicant is: _ Owner ? Contractor _Other Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee $ 100.00 Per as-built $ 10.00 Alterations to existing dwelling $ 50.00 _ Add plumbing fixtures. This fee includes installation of a water softener andlor water heater at the same time. If you are instalfing onlv a wafer softener and/or water heater, do not complete this section; move to the next seclion and check the appliance(s) you are installing. _Septic System A6andonment _Water Turnaround (add $130.00 if a 518" meter is required) Other: ? Water Softener _ Water Heater $ 15.00 _ new ? replacement Lawn Irrigatfon _RPZ _PVB _new _repair _rebuild $ 30.00 State Surcharge $ .50 Total $ I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; tnat tne work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I understand this is not a permit, hut only an application for a permit, work is not lo start without a permit and work'will be in accordance with the approved plan in the event a plan is required o be reviewed and approved. ?-? ?.?lrllA 02 ? Applicant's Printed Name plicant's Signature 7?s?7 2006 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for. single family dwellings & townhomes/condos when permits are required for each unit -3 o,sC ?UL 2006 2 7 uate 1 Site Addres ?M`lV s_ Unit tl Property Owner l?.??t? / L (/vri // yv1 (. Telephone # Cootractor RiCWMC1ND & SONS ELECTRIC INC. dBA: GOLDEN VA LE Street Address _ 5182 WEST BROADWAY City CRYSTAL, MN 55429 state en• • caconnn Zip Telephone #( ) Bond #:_ Expires: ? d ace The Applicant is _ Owner ? Contractor _ Other Add-on or alteration to existing dwelling unit $ 30.00 ? fumace _Additional ?/Replacement New _ air exchanger air conditioner heat pump other State Surcharge $ .50 Total $ io, s(J I hereby apply for a Residential Mechanical Permit and acknowledge [hat the information is comp{ete and accurate; that the work will be in wnformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a permit, but on an application for a permit, and work is not to s[art without a perm that the work will be in accordance wi[h the approved plap the case of work which requires a review and approval of plans. Applic nYs Printed Name plicant's Signature 'Fca,r(i6 _ _ _ _ _ _ __ ' _ I 411? Clty of EapIl ; Pertnit #?( I I Permit Fee: 3830 Pilot Knob Road ? I Eagan MN 55122 ? Date Received: Phone:(651) 675-5675 I Fax: (651) 6755694 I Staff: `----------------? 2008 RESfDENT1AL PLUMBING PERMIT APPLICATION Date: Site Address: Tenant: Suite #: RESIDENT I OWNER I Name: Address / City / Zip; CONTRACTOR I Name: Address: City: Phone: Phone: 4,1-9ci 4-"1 b's? ? J I -)-- License #: ? -1 ::1 l ) --P/?'l 339 State: 7_ip: Contact Person: v-i`} S lu e- h 7YPE OF WORK _ New ,-/Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W. Description of work: PERMIT TYPE RES/DENT/AL ?/Water Heater Water Softener Lawn Irrigation Add Plumbing Fiutures (_ RPZ /_ PVB) ... ? Main _ Lower Level) Septic System Water Turnaround New Abandonment RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, oc.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 5/8" meter is required) $100.50 SeQtic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTALFEES I hereby acknowledge that this information is complete and accurate; fhat the work will be in conformance with the ordinanc ntl,114 Eagan; that I understand this is not a permit, bat only an application foc a permit, and work is not to start without a pe accordance with the approved plan in the case of work which requires a review and approvai of plans. 2008 ? x_ X ? ApplicanYS Printed Name 'Appli '.., ignat EOR OFFICE USE Use BLUE or BLACK Ink For Office Use T T • ; Permit 3 f (q~n a~ I I Ol Ea d E r L) I Permit Fee: 3630 Pilot Knob Road R~ Eagan MN 55122 APR Z ZU~Z Dates Racelved: 21' (Z j Phone: (651) 676-6675 I staff Fax: (661) 675.6694 1 r----------------- 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: UnitM Name: /ASS d e i e Tie.,! ~:~.~f.J ~4 L /r1kIlAT. Phone: fitES j.DENT;~:' Ngk Address J City 1 zip: 7o,t 2 ~:SH L.!`,rLE Ro. /►~K}GL /vRr;✓~ S S 3 / r Q# Applicant is: Owner) Contractor O d ~E fZ o~G / Description of work: Ty.RF. t;?F=~I~f±OAIK.: Construction Cost: Multi-Family Building: (Yes x I No Company: rF3l~x Ex~ /dA /11,9/,J7, evAP Contact- bAV/ 5 1301_'2/S Address: J/O.s 10 6 o'nt i/- City: 111,1'AS State: ~A~ Zip. 5s~1/9 Phone: ~~~~$W/ ~.ty3 License 0: 1/ 3 / Lead Certificate 9: 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 plant Yes -No If yes, date and address of master plan: Licensed Plumber. Phone; Mechanical Contractor: Phone: Sewer & Water Contractor: phone: :'N071r:.: s. otYow .i!ilk!n%,, :cOrll ld ft Sf:tq; :A:t!6J1 , !c s . tar ?Rc~ :EtY Eo l~►e,„sr0 ►;?s, d me tea n. m L =1:~:. i* c ` :)if Y .W' A~n....... La°K c on that d~t[d6>EliAf'>C~tB AfB:>ffdde`a6CJ'98i`$. ' '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 locales of underground utilities. www.aol;Nrstate_ nee ca0•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 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 worts 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 Minn180 s of permit leauence. day X N Vr ts aoiz4 -S x Applicant's Printed Name Applicant's Signature Page 1 of 3 TO 39Vd 1NICW 8OI2131X3 I3El L9Z9T98ZT9 519:9T ZTOZ/TZ/50 Use BLUE or BLACK Ink r _ ErirOMw~tiae__ of ESP i peowa r•ee, ~5 1 Illl. Aso pilot Knob lioad Do PAO&*& 13 ~ ~ fiu~l fss,n ~ Phone: (661) 67S•6675 I ; Got. Fax: (M) 676W • _ ~ 2013 RESIDENTIAL SUILDINO PERMIT APPLICATION per: A) ev (o i_3 810esAadrosa: 38~rs a5'yxayy,3f~YbI THEE b P., -unit I* _Vq ?'1740 fame: ~~o ACT' /r1 ,.3 6 L rit E c3 -r; 3'~ C Dhow 71.3 ' Addres / C4 I Zip: ASD h E. a4'7-wQ ✓ aa~ q 44bf4 Vbtw,~ ~19r : ~•~.s S~"yt7 Applicant is: ONrtier Cpndiec4or ` , t~est.ription ofwak: ~"~•9,Q OFD sr Construction Cott WO CRS Muth-Family Buldbgv (Yes I No,= ~ RA1:5 Company:, 1 Ese TC2ioR /~~1Y.J~ Corrtoct Avid AddreW,Yas• lrlsc,,1 Zip: Phone; & "t - Utenoe # 9 C A Hl! S I Lead Corthicate V. K the project is exempt from lead certification, please explain why: (sue Page 8 for eilditfOnal irlfcrtne6nn) ~R~n~s f.~f:e~.•Q~,~r Pos: 7 Sr COMPLETE THIS AREA ONLY IF OONSTRUdnNO A NEW BUILON® In the fast 12 montltc, has the Coq, of f bpn Inued a permit for a Similar piw+ Aaeed on a master plan? _Yes Nc If yes, datil and address of m8Mw plan: Licensed Plumber: Phone: lMechanicai Corikticsaor: Phone: Sewer a Water Cont~aebr. php,,y; Wpm. Yotim fife ~ C m twophe Gbb One 090 b (061) 46{-0001 to Diotecbon aga4at -WW--W uq 1V damage. Cis 48 hours you~ loees cf un WWOU d utAi> .erg I herby ~ that this ftmebM is art OW the work will be in conknnanm with ft a dinences and Sodas of tt* of ihat 1 tmdarabmd ttiie iS hot a paimit, but Orly an ayp~CObon for a pem>it, and work Is rat za Start WftW a pwmt fm the weinc %g bye h son,Prd~nc~ wiy, Yfe appnoy~a Of~titi~aw, arm a.yo tk rNych nWu6us a ! v Il p!: O and wl d P,,, - e*mtcw We* Adhodzed by depotpWirjebsummm a bNrldlfig panait issued in i000fdW{ee wlal tM UWMis M Stall adft code mwt br *wwI*wd wkw 100 x w4vi~ gy2R1~ 788 AppllranC® Pdrltied Name AppAoanCs Slgnats+eo Pape 1 cis b0/80 39dd 1NIdW 1X3 139 L9Z9T98ZT9 Z9:bT 8T0Z/90/TT 41/111City ofEgli 3830 Pilot Knob Road Eagan MN 65122 Phone; (661) 675-5675 Fax (651) 675-6694 Use BLUE or BLACK Ink For Office Use Permit e: 1 (N 1 c.)-1- 6J Permit Fee: IDate Reoerked: - )1a'I Staff; J 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: / - / — / y $Ite Address: 38`,10 3 r`/," y 4 3 i74�lo #: Phone: 763 - S"f3- 9770 Cao 1%.(L,E Y /OA) Ss-y.t7 Resident/ Owner 1 Name: e% 46, /J14•..1 4 b E /+tE a; i .s: ,.r C.. Address / City 1 Zip: $so L C £4 U &. A✓, A), .14 Applicant is: Owner % Contractor _ Type •otAtfOrk; Description of work: CZ£4•%-e E a• £ PL fie -L. j A 1 e d ,ossa a M 7 A L Construction Cost / // 4/C10 • at) Multi -Family Building: (Yes �i 1 No Contractor Company: E l A.> >- £.e✓ 0 2 /) Z T ,��- _ ev 12 Contact: DA ✓ r 6 ad . al S Address: 4%0s w troop State: !~1 Zip: S5 4'/ q City: /77 PL Phone: to/ z- ffbI-(e.2V3 License #: 2 Yi / 3 / Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) t�e,ti(vS_ /4, *7- Pos ' 15-71 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: Pions s ani( fO •ITOP*: theinlor►np6doijk cies '�— CALF BEFORE YOU DIG, Call Gopher State One Call at (651)484.0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground ditties. www.qopherstatppcalLorq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes d the City of Eooun: that 1 understand Ihia le not a permit, but only an application for a permit, and work is not to start without a permit: that the mat 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 Bumf Code must be completed within 180 days of permit issuance. x '1 r4 ✓, %i'ia1L� Applicants Printed Name ZO / IO 39tld x Applicants Signature Page 1 of 3 1NItiW 1X3 I3g L9Z9I98ZI9 LO:ZI tT0Z/9I/I13