3826 Laurel CtCITY OF EAGAN Remarks
Additiori Bxiar-Hil-1 Addition Loc 18 Blk L Parcel??.Q 1.G9.S,?? Igp 0??
Owner4iy-21/j ?i?''L"L Street 3826 Lat171i?1 Coux't State Eag211, 1?f 55122
Improvement Date Amount Annual Vears Payment Receipt Date
STREET SURF. 1971 g1d under arcel 10 0 000 O LO 25
STREET RESTOR. 1975 61.62 6.16 10 18.50 A010325 6-26-81
GRADING - , 1982 123.04 24.61 5 123.04 C007244 9-14-81
S reet Surf 0fP 1982 600.76 120.15 5 600.76 C007244 9-14-81
SAN SEW TRUNK Z 1968 34.49 1.15 30 18.53 A010325 6-26-81
** SEWERLATERAL K 1970 97.38 4.87 20 39.06 A010325 6-26-81
** water lat stm trk 1970 20
WATERMAIN
* WATERLATERAL /T 1971 28.22 1.41 20 12.7 1 A010325 6- 6-8
VVATER AREA S 1977 52.14 3.48 15 34.79 A010325 6-2681
*** S W Lat Stm L 5' 1982 1431.44 186.29 5 1431.44 C007244 9-14-81
S7pFMSEW TRK 1971 251.34 12.57 20 113.18 A010325 6-26-81
* STORM SEW LAT 1971 20
Storm Sew Trk 1982 402.73 80.55 5 402.73 C007244
--
CURB & GUTTER
SIDEWALK
STREETti$tiT 1009 1986 153.70 15.37 10 530 C- 62?-I5` /U-/? ?
Road Un'
VVATER CONN,
n
n
BUILDING PER. rga it It
SAC
n
v
PARK 250.00 18599 4118/80
-
CITY OF EAGAN Remarks
Addition?? Rriar H111 Addition Lot 20 Blk 1 Parcei_k1.0?41p_2.p.p_p.1
Owner_11L(.TJ'rl/ streec 3828 LauTel COUrt scate Eagaa, hIN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF, 1971 P ld U
STREETRESTOR. g' i9'J$ 61.62 6.16 10 18.50 A010598 9-24=81
GRADING 1982 123.04 24.61 5 123.04 C007265 9-21-81
8 600.76 120.15 5 600.76 C007265 9-21-81
SANSEW TRUNK 1968 34.49 1.15 30 18.53 A010598 9-24-81
** SEWERLATERAL 1970 97.38 4.87 20 39.06 A010598 9-24-81
** water lat $ stm trk 1970 20
WATERMAIN
* WATERLATERAL IA7 1971 28.22 1.41 20 12.71 A010598 9-24-81
WATER AfiEA ?Td 1977 52.14 3.48 15 34.79 A010598 9-24-81
*** ' 1431.44 286.29 5 1431.44 C007265 9-21-81
STORMSEW TRK 14,5 1971 251.34 12.57 20 113.18 A010598 9-24-81
* STORM SEW LAT 1971 ZQ
1982 402.73 80.55 5 402.73 C007265 9-21-81
CURB & GUTTER
SIDEWALK
STREET-646+4.L 1009 1986 153.70 15.37 10 .°76 0-10ya 10-12-fs-
Road U it
WATER CONN.
S 0 , 00 it
SUILDING PER, 5997 It
snc 525.00 " "
PARK 250.00 18599 $0
CITY OF EAGAN Remarks
Addition Rri ar Hi 11 Addi Y_i ntl Lot 17 elk 1 Parcel #10 14990 170 Ol
Owner Kii•?l 1?. Clio,?t gtreet 3830 Laurel Court stete Eagan, MIId 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STFEET RESTOR. /dfD
GRADING - 1982 123.04 - 24.61 5 123.04 C007242 ' 9-14-81
Street Surf 1982 600.76 - 120.15 5 600.76 C007242 9-14-81
SAN SEW TRUNK e 1968 34 - 4q I - 1 -1; s n
.3
45.
A010186
5-19-81
** SEWERIATERAL Q(?
*,t
WATERMAIN
+t WATEfi LATERAL
WATER AREA ?
*** S W Lat Stm L 5? 1982 1431.44 286.29 5 1431.44 C007242 9-14-81
' STORM SEW TRK 31 ?g
* STORMSEW LAT 197
Storm Sew Trk 1982 402.73 80.55 5 402.73 C007242 9-14-81
CURB & GUTTER
SIDEWALK
STREETt? 1009 1986 153.70 15.37 10
Road Unit 185.00 20114 7 2 80
WATER CONN. 305.00
ie
r
BUILDING PER, n n
SAC ?? i
PARK Z$O OO 18599 4/18/80
CITY OF EAGAN Remarks
Addition Sriar Hill Addition Lot 19 eik 1 Parcel #t0 74990 190 01
oW„8r Ku1 h, ?: ? fr Street 3832 Laurel Court stete Eagan, MW 55122
Improvement Date Amount Annual Vears Payment Receipt Date
STREETSURF. ? 9-
STREETRESTOR. a/ 1975 61-67 6-16 10 1$.5U A009794 12 22 80
GRADING ?' 1982 123.04 24.61 5 123.0 C 7 --
Street Surf ,p 1982 600.76 120.15 5 60 . C007233
--
SAN SEW TRUNK 18.53 A009794 12 22 80
** SEWERLATEFiAL 39.06 A009794 IZ 22 80
** W
WATERMAIN
* WATER LATERAL 107 1971 28.92 1.41 90 12.71 A009794 12 22 HO
WATER AREA 35 34.79 A009744 1? 22 80
*** S/W Lat Stm L ? 1982 1431.44 286.29 5 1431.44 C007233
--
STORMSEW TRK ZZ5 971 251.34 1 -2 - 57 113.18 A009894 12 22 80
* STORM SEW LAT 1971 2
Storm Sew Trk 1982 402.73 .55 9-14-81
CURB & GUTTER
SIDEWAIK
STREETtt0H'T- 1009 1986 153.70 15.37 10 -
Road Unit 185 00 2011 7124/80
WATER CONN.
BUILDING PER.
SAC
PARK 250.00 18599 4 18 80
CASH RECE(FT -
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE
19
r+ecerveo
FROM
AMOUNT $ I
& DOLLARS
,oa
? CASH 0 CHECK
FOR
`
CASH RECOPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE
RriCEi V ED
19
AMOUNT $ I
& OOLLARS
Ioa
? CASH FICHECK
POR
White-Payers Capy
Yellow-Poatinp Copy
Pink-File Cqpy
Thank You ?
BY
? ?.
CASH RECEfPT -
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE
weceiveo
19
AMOUNT $ I
h DOLLAR$
[D CASH F? CHECK
1 oo
Thank You
C>? o- .
BY
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
CASH RECEIPT-
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
RECEIVED
FROM
DATE
AMOUNT $
19
DOLLARS
ioo
? CASH ? CHECK
FOR
White-PaYers Copy
Vellow-Posting Copy
Pink-File Copy
Thank You ?
???_ BY
BUILDIl?!'C PERMIT
.
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PMONE: 4548100
SiteAddresi 3832 I.AITREL COURT
Lot _19 Blxk Ol Sec/sub. RRIAR HILL ADDN.
Parcel No. 10 14990 190 Ol
W Nan,e RICHARD J. REATTY
? a,ddres, 3832 I.AUREL CT.
City F-AGAN - Phone 452-5774
Name nWP'ER ---- --- ----
Address
Phone
Name
Address
City Phone
I hercby ocknowledpa thot I hove reod this opplicotion and stote thaf
the intormation is correct ond ogree to comply with cll applicable
Sfats of Minnesota Stofutes ond City of Eagan Ordinanus.
Sipnature of Permittee -
A Building Permit is issued to:
alt work aholl be dons in occo
Buildirq Offtciol
?a yd
Erect ? Occupancy R-3
Remodel ? Zoning R-1
Repair ? Type of Const. V
Enlarge ? No. Stories
Move ? Length
Demolish ? Depth
Grade ? Sq. Ft.
Appro vols Fns
Assessment
Wnter 3 Sew.
Police
Firo
Enp.
Plonner
Council
Bldg. Off.
APC
Var. Date
Permit ZU. SU
Surchorpe 1.00
Plan check
SAC
Water Conn.
Water AAeter
Road Unit
Parks
Total S 21.50
on the sxprcss conditbn that
Iappliccble Stote of Minnewta Statutes ond City of Eayan Ordinoncet.
?
Permit No. Permk Holdsr Dato
Plumbinq (c
H. V A.C.
Electric
Sohener
inspsMion Date Insp. Other
Footinyc
Foundation
Freming
Rouph Plbp. `
Rough HVAC ?
Inwbtioo
Fiml Plbp.
fl1H4VAC
Wauf DescriM Loeation:
Nkll
Sewer •
Pr. Disp.
Receipt PLUMBING PERMIT Permit No.
CITY OF EAGAN _
Fee
FiU in numbered spaces S/C
Type or Print /egibly Tot. ?
1. Date 2. Installation Cost
3. Job Address _V'. ? ?'?/: rc JZot?Blk. ? Traci
4. Owner e ;, i,2ri' i > ? ?y - ( - _
c- "
5. Contractor •, "- , F Phone
6. Address 4,0 1 r
7. City
State
Zip
8. Building Type: Residential R Commercial ? Institutional ?
9. Work Description: New ? Add ? Alter 15J Repair ?
I 10. Describe /? •?O FiYT?t<<, ,- ?;,4 St n+i
1 11.
No.
? Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
/ Lavatory Softner
? Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
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 ordinan(ces 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
CITY OF EAGAN
3795 P11ot Knob Rood Eagon, MN 55122 N°- 5989
PHONE: 454-6100
BUILDING PERMIT Receipt #
?? aCp
To^6e ufad fer Est. Value Dote . 19-
Site Address Erect p, Occuponcy
Lot ? Block Sec/Sub. Alter ? Zoning
P
l Repair ? Fire Zone -'
arce
#
Enlarge ? Type of Const. t`
W TOllef ^? '
Name Move ? # Stories
Z
; ?;.. . ,,
Address r 1 ?
Demolish ?
Front
k.
;r<`i11 n ?
Grode ?
Qepth
ft
Ci Phone .
?
0 Name Approwlt Fees
U Assessment ? -
O
Address
~ Cit pha?e Water & Sew.
VC, Police
Fw Name Fire
?? Addreu Eng.
aW Ci Phone Planner
Council
1 hereby acknowledge that I hove read this application and state that Bldg. Off. ?
the infarmation is rnrrect ond agree to comply with all applicable
State of Minnewta $tatutes ond CiTy of Eagan Ordinances. A?
Signature of Permittee
Permit
Surcharge
Plon check
SAC
Water Conn.
Water Meter
Road Unit
i _
Total '
A Building Permit is issued to: on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagon Ordinances.
Buildira Official
Pamlt * Daft laaad PWMMMe •
Plumbin9 P 37e - ' p
Mechonical - - D ,
INSPECTIONS I DATE INSP.
Rouph-In
Final
FoOtingS ' Date Insp. Llate Insp,
Foundation 3G Plumbing
Frame/ins. C Mechnnical
Final .
Remarks:
No.
CITY OF EAGAN
3795 Pilot Knob Road
Eagen, Minnesow 55122
Phone: 454-8100
.7)1 i;n,!) - .. - PERAAIT
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
Date: Receipt No.:
Single
Site Address: 32 Lfl'1'.tl Residential ?'. Of 4 r'! -;'
La 1' Block 1 Sub/Sec. ?l i8Thi11
Name 071ef80Il Builder^ New/Altec/Repoir ; Address '- %316 Holvoke T P..
" Cost of Installation
O
City Ve.11EYr 7`1?• Phone: Permit Fee ,
Name r?PS1Z f'yL4.71 .",
p? Surcharge
y Address 14 744 S, r'?}:•,•t ",•
? City Phone:
20.50
This Permit is issued on the express condition that all work sholl be done in accordance with oll appliwble State of
Minnesota $tatutes and City of Eogan Ordinances.
?._A. ? I Building Official
_? • -- CITY OF EAGAN
3795 Pilot Knob Roed
No. Ea9an, MinnesMa 55122
Phen.: 454.e100
PEIUAIT
Date: - -30
Site Address: '12 I..at1I'@I Cfi.
1ca ?
Lot Block Sub/Sec. ?y'ar il
Name ' cllefsan 3uilder-s
; Address ''-3826 fl°lyoke i-,..
VAl1Cj') i1l.
City Phone:
Nome "''???iCk60Il ri@8 ti ?'?.
.
? :10
? Address
City Phone:
This Permit is issued on the express condition that all work shall be
Minnesota Statutes and City of Ea9on Ordinances.
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
Receipt No.:
Single
Residentiul " -
Multi Res., Comm./Ind. I
New/Alter./Repair
Cost of Installation
Permit Fee .
Surcharge ?
Tota I
done in occordance with all applicable Stote of
Building Official
? ._.
BUILDING PERMIT
CITY OF EAGAN
3795 PiIM Knob Road Eagan, MN 55122
PHONE: 454-8100
Site Address ' -?1 COUS' t,
Lot Block Sec/Sub.
Parc¢i #
aWc I Name
? Addre!
0
Idl.
o Name _
?
i? Address
Nome _
Address
Receipt #
N4 5988
?
Erect f?• Occupancy
Alter ? Zoning
Repair ? Fire Zone _
Enlarge ? Type of Const.
Move ? .# Stories
Demolish ? Front ft.
Grade ? Depth ft.
Approvals Fees
Assessment _
Woter & Sew.
Police
Fire
Eng.
Planner -
Council _
Permit
Surcharge
Plan check
SAC -
Water Conn.
Water Meter
Road Unit
I hereby acknowledge that I hove read rhis application and state that Bidg. Otf.
the information is correct and agree to comply with atl applicable
State of Minnewta $totutes ond City of Eagan Ordinances. APC Total
Signature of Permittee
A Building Permit is issued ta ` "on the express condition thot
oll work shall be done in occordance with all applicable State of Minnesoto Statutes and City of Eagan Ordinances.
Buildinq Officiol
x
Pannk # Dote luaed PermMhe '
Plumbing ff cl$l Jel_
Mechanical
INSPECTIONS I DATE INSP.
Rough-In
Finol
Footings Dot Insp. Date Insp.
Foundation Plumbing
Frame/ins. Mechanicol ?
Finol
Remarks:
.A1.
• CITY OF EAGAN
. • 3795 Pilet Knob Rood
No. lagan, AAinnesofa 55122
Phene: 134-8100
PERMIT
Dote:
9-9-80
Site Addreu: 3330 LBUI`el Ct.
Lot Block ` Sub/Sx.
BI`j.fl2'hi11
Name -lefBOn Builde.r._
`
Address 13816 iiolyOke :..i.
; I
O
Cit ?iB11.P.-r I"m
Y Phone:
Nome -
L
20.00
L4 Address 11i7/t5 S. 'Ollo?`t iS`.
? Cit
Y Phone: Total
This Permit is issued on the express condition thot oll; work sholl be done in accordance with oll appliwble Stote of
Minnesoto Statutes and City of Eagon Ordinonces.
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
Receipt No.: '2n
Single , I
Residentiol
Multi Res., Comm./Ind. I
New/Alter./Repair
Cost oi Instollation
Permit Fee
I Building Official
CITY OF EAGAN
? - ? 3795 Pilof Knob Roed
No. Eagen. Mlnnasota 55142
Phoea: 454.8100
PERMIT
Date:
Site Address:
Lot - Block
9-9-80
3$30 Laurel Ct.
1 Sub/Sec
HTiSThill
Nome 31lefson I3u31derT
? Address 3816 hOlyOjCC' I.L.
?
'-?le Jalley, rAn
City Phone:
,•? 'r! --,--.r)n Iiea±i.r.r
Nome
p.
g Address
e
? .
City Phone:
This Permit is issued on the express condition that all work shall be
Minnesota Stotutes and City of Eagan Ordinances.
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
Receipt No.: I rl1C
$ingle I
Residential
Multi Res., Comm./Ind. I
New/Alter./Repoir
Cost of Instollation
Permit Fee
Surchorge c
Tota I done in accordance with all epplicable State of
Building Official
4&1
? 11,11rr#ifirttt.e uf (Orrupttnry
Citp of (Eagan
j9P,pftl'flriPttt Af BIYtlbirig lItSpPl'tlltkl
Tbit Certificate iaued purruunt to the requirementr o f Section 306 o f the Uni fosm Building
Code cMi fying tbat at tbe time of istuana tbir nructure wut in complianu with thc variouJ
ordirranres of the City regulating building ronnruction or ure. For thc f allouang:
un clasdficari--_ L_of 4 P= &de Perrrdt No 5988
OrcupanryType_3]at-TypeCoosbuctionV Fire Zane 4 ZoningDirtrict RI
Buading Addtta - Locali
?Bu
angoiEcial ? ml
?pT IM A CON4?1C1
5-1-81
•-.
BUILDING PERMIT
CITY OF EAGAN
3795 Pibt Knob Rood Eagen, MN 55722
PNONE: 454-8100
Lot Block ?/,cinc?i??^l9rP18I1 19- Q
W Name
3 Addre
0
? Nome _
0
OU Address
f r:...
Name _
Address
I hereby acknowiedge that I hove read this applicotion and state that
the information is correct and agree to comply with all applicoble
State of Minnewto Stotutes and City of Eagan Ordinances.
Signoture of Percnittee
Receipt #
N4 5987
Erect Q Occupancy
Alter ? Zoning
Repoir ? Fire Zone
Enlorge ? Type of Const.
Move ? # Stories
Demolish ? Front _ ft.
Grade
?
Depth ?
ft.
Approvulz Fees
Assessment ' - _
Woter & Sew.
Police
Fire
Eng.
Planner
Council
Bidg. Off.
APC
Permit
Surcharge ??°
Plon check
SAC
Water Conn.
Water Meter
Road Unit
Total
A Building Permit is issued to: `` ' `' on the express condition that
oll work sholl be done in accordance with all applicable State of Minnesota Stotutes and City of Eagon Ordinances.
Building Official
Parcel .# . , , ` .. ,
? ? ? •
Pamk # DaM baed P?klw
Plumbing
Mechanical
'v Yo7b?A 1? -d 9•-f'a
INSPECTIONS DATE INSP.
Rough-In
Firwl
FOOtiflg5 D e InaP. DOte InsD•
Foundation ^. Plumbing
Frame/ins.
Mechanical ?
Final
Remarks:
. cinr oF UG,s?N
4
3795 PiIM Knob Read
No. Ea9en, Minnesota 55122
Phone: 454-8100
PERMIT
Dote:
Site Address:
Lot Block Sub/Sec.
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
Receipt No.:
Single .:. . - . , I
Residential
Multi Res., Comm./Ind. I
lefson 3uilder.s
Nome New/Alter./Repair
; Address ? lf? HOI}TO1:P Id1.
Cost of Installation
Hlle;•-, .._,.
???Y Phone: Permit Fee
-?, z R;ran
` Name Surchorge
Tr "-/T'il 5 2.
Address e
e
Cih' ? . .. . . . Phone: Total
This Permit is issued on rhe express condition that all work shall be done in xcordance with all applitoble Stote of
Minnesota Statutes and City of Eagan Ordinonces.
Building Official
CITY OF EAGAN
3795 Pilot Knob Read
No. ' Eagen, Minnesofa 55122
Phone: 454-8100
PERMIT
Date:
Site Address: -?illTC'1 Ct.
Lrn Block - Sub/Sec. Briarh{ 11
Nome iollef9on Bu3ld?_1-
e Address 13216 HOlYOke i?'1.
?
City .'_y`t?le vflU2y, 1'TII. Phone:
Nome -a.il;r
p.
L
? Address
I City - - - Phone:
This Permir is issued on the express condition that oll work shall be
Minnesota Statutes and City of Eagan Ordinances.
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
Receipt No.:
Single I
Residential
Multi Res., Comm./Ind. I
New/ Alter. / Repai r
Cost of Instollation
Permit Fee
Surcharge
Tota I
done in accordance with all applicable State of
Building Official
C?ert'tftratr of (Orrupttnry
Citp of (Eagan
Uppttrimpnt nf BuilDing Jnsprrtimc
Tbit Certi ficaa ircued Purcuant to tlx requiremenu o f Section 306 of the Ui:iform Building
Code cntifying that at the timc of iatuanct thit ftructurt was in compliance witb thc variour
mdinancu o f the City rcgularing building contt+uction or u re. For the f ollouang:
UwQRInr=om 1 of 4 PLEX lUde.P<rrr;,No. 5987
o=trMrTrne R3 Trwcow?um V Fvezon 3 zrnwq Msmct R3
Oww o«,,,,,,.gTollefson Builders ,,aa. 13816 Holvoke I.e., Apple
g??nq pdy? 3828 Laiu'el Ct. L,,.J;ry IAt 20, Block 1.Briarhill
?-_ By:
? D,«, September 17, 1981
?CE
,»,
MECHANICAL PERMIT RECEIPT # '?a 7 I
CITY OF EAGAN
?
, 3830 PILOT K
N, MN 55722 DATE
A
T
CON
RACT
PRICE: PONE: 4548
00
Site Address r
gLpG, TypE WORK DESCRIPTION
Lot ? v Block Sec/Sub Res New
Mult Add-on
°' Name
-
m Address , -2, J r, Comm. Repair
?
City
Phone 1 Other
FEES 1
?
? Name
Address RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU
'
3 _ 6.00
O Ci
?Y
Phone (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION) i
GAS OUTLETS (MINIMUM - 1 PER PERMIn - 1.50 EA. ?
TYPE OF WORK COMM/IND FEE - 146 OF CONTRACT FEE ?
Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES
Boiler
M BTU TOWNHOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8 ?
Unit Heater M BTU REMODELS - 12.00
Air Cond. 'P)M BTU $ l,Z Cp MINIMUM COMMERCIAL FEE - 20.00
Vent CFM ? STATE SURCHARGE PER PEAMIT - .50
ADD $
50 S
C
P
(
.
/
IF
ERMIT PRiCE GOES
Gas Piping Outlets # $ BEYOND $1,000)
Other
FEE:
S/C: SIGNATURE I E
TOTAL•
FOR: CITY OF EAGAN
• CITY OF EAGAN w 15484
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
- PHONE: 454-8100
Bl'tiLDING PERMIT Receipt #
To be used for tTC" Est. Value ig1i"rl? Date may 17 , 1 sft g
SiteAddress JFit ?A'tREL -XuuT
OFFICE
USE ONLY
Lot i(' Block Z Sec/Sub?„ZAF HI???.
PflfCel N0. Occupancy - FEES
Zaning -
W Name ?F??°u Fkn `?N ??K
(Actuaq Const -
Bldg. Permit
Z6.??G
o Address -??23 Z++Ut? L C+.uf:T (Nlowable) -
h
S
?
City PAGAS Phone # of saries - urc
arge
Plan Review
Lengih _
o Name L}:TI.? BLX >'•RI%??:?''?`?j- Depth - SAC
City
?a Address 4Ykil 1bO2'ti &Y'k::ET 'r1I:5T S.F.Total - ,
SAC, MCWCC
? OItY .<JJi??ti:ar Phone k23-6:? S;, S.F. FoolpriNS _
water Conn
On Site Sewage -
?Q
? w
Name
On Site Well -
Water Meter
=
?
Address MWCC S stem -
Y
u Acd. Deposit
aw City Phone Cirywacer _
S/VJ Permit
PRV Required -
I hereby acknowlege that I have read this application and state that the Booster Pump - SNY Surcharge
intormation is correct and agree to compty with all applicable State ot
Minnesota Statutes and City ot Eagan Ordinances. Trealmenl PI
Signature of Permitee - APPROVALS Road Unit
f' a.?.,''i%.?i:..l . ??A1,''! ; .
A 8uilding Permit is issued to: Planner
-
Park Ded
on the express condition that all work shall be done in accordance with all Council
applicable State ol Minnesota Statutes and City of Eagan Ordinances.
gidj, pH.
Copies ?
?•
Building Oflicial Variance - TOTAL 2 fi ? 51%)
Permit No. Permit Holder Data Telephone #
WATLR
SEWER
PLUMBING
H.V.A.C.
ELECTRIC
Inspection Date Insp. Comments
Footings I
Foundation
Framing
Roofing
Rough Plbq.
Rough Htg.
Isul.
Fireplace
Final Htg.
Final Plbg.
Const. Meter Plbg. Inspeclor -Notify Plumber
Engr./Plan
Bldg. Final
DBCk Ftg.
Deck Final 5
Well
Pr. Disp.
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: ;,; •
Eagan, Minnesota 55122-1897 Date Issued:
(651) 681-4675
SITEADDRESS: APPLICANT:
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION ., . .A
I
?
I I
?
Permit Holder Data Telephone #
SEWER!
WATER
PLUMBING
HVAC
Inspection Dete Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
6LDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITV
TEST
HYDROSTATIC
TEST
BSMT F.I.
BSMT FINAL
DECK FTG
DECK FItVAL
? CITY OF EAGAN PERMIT TYPE:
! 3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(651) 681-4675
SITE ADDRESS:
f PERMIT SUBTYPE:
"'iN i mN N
18 Ei tor M
?tv?i?!I r+l
w•::.,??:_ :?,
APPLICANT:
TYPE OF WORK:
_ai rt Rni rOr+
rW. I M`,t It I/HA'+ 1 rNi
INSPECTION .• . .A
I - 1
Permk Holder Date Telephone M
SEWER/
WATER
PLUMBING
HVAC
Inspectlon Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIRTEST /
l7LCr?
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
iv1AINS
CONDUCTIVITY
TEST
HVDROS7ATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
.?
(I.erftftrtttr of (Orrupttnry
Citp of Cagan
Be,pttr#mrnf nf Bixiiding Ansprrfinn
Thir Certificate raued par.rrrant to the sequirements of Section 306 of the Uniform BuiJding
Code artif ying that at the time o f issuarue thi r structure war in compliancr with the variour
ordinancu o f tht City rcgulating bwlding conttrrution or ure. For the f ollouvng:
un c,.dfic.qm pI OF /, PI,EIC Bldg. Pemtit No. 5986
OccupuxyType iLl Typecomwonon r FireZona 3 ZoningD'uMcl R3
a.w ore0ati6 Tolln£gnn %iilAnrwaa. ,
amaing naanm 3826 Laurel Ct. La.,;,Y Lnt 189 137nnk 10 RriArhill
l. . r„ t?- , t e- - er:
z:"? I w«: June 23, 1981
_iA
?t iw n ?vtcuoUs
aai
,
` ,.
e"o
BUILDING PERMIT ?
CITY OF EAGAN
3795 iilof Keo6 Road Eagan, MN 55722
PHONE: 4548100
Site Address
Lot t$ Block Sec/Sub.
Porcel
#
c
W
z
0
Nome . .. - .. .? .. .,
... - .o ,yo e .n.
val
a Name _
0
?? Address
Cit -
Ww Nome _
rW
=Z Address
I hereby acknowledge thot I have reod this application and state that
the informotion is correct and ogree to comply with all applicoble
$tate of Minnesota Statutes ond City of Eagon Ordinances.
N4 5986
Receipt #
Dote
, 19
Erect ? Occupancy
Alter ? Zoning
Repoir ? Fire Zone
Enlarge ? Type of Const.
Move ? # Stories
Demolish ? Front ft.
Grade ? Depth ft.
Aonrovab Fees
Assessment " --"'--
Water & $ew.
Police
Fire
Eng.
Planner
Council
Bldg.Off. ?'-
APC
Permit
Surcharge
Plan check
SAC -
Woter Conn.
Water Meter
Road Unit
Tota I
Signature of Permittee ?
A Building Permit is issued to: on the express condition tFwt
oll work shall be done in accordance with oll applicable Stme of Minnesota Statutes and City of Eagan Ordinonces.
Building Official
3
Pem?ff ? pab Irwd pwmiMN
Plumbing
M honiwl 9ovC) - - O °•
GC/ o?U ? ? ?9? }'d Q
I
INSPECTIONS DATE INSP.
Rough-In
Finoi
Footings I D?ate Insp. Date Insp.
Foundation Plumbing
j/f /,
Frame/ins. L
Mechanical
Final
Remorks:
?
?
?
?
\
`
• • • crrir oF E?caN
3795 Pilot Knob Read
No. ' Eugan, Minnasota 55122
Phane: 454-8100
PERMIT
Dote:
9-9-80
5te Address: 3826 Lfltu'Cl Court
Lot Block Sub/Sec.
Bi'18TY11 u
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
Receipt No.: ?
Single _
Residential
Multi Res., Comm./Ind. I
Name Tollefeon F3Uj.1dr?TS New/Alter./Repoir V
; Address 16 HOlyO?!e T_'1 .
O Cost of Installation
_'i?p ie lralley, , h'? 4?/?-' ,s.?"
City Phone: Permit Fee .
` Nome Gen2 Surcharge ? Address 14745 S.
? City Phone: Total This Permit is issued on ihe express condition that oll work shall be done in accordance with all oppliwble State of
Minnesoto Stotutes ond City of Eogan Ordinances.
Buildinp Officicl
No.
CITY OF EAGAN
3795 Pilof Knob Roed
Eagen, Minmaofa 55122
Phene: 454-9100
PERMIT
Date:
9-9-80
Site Addreu:
3826 I,aurel Ct.
,
Lot Block ` Sub/Sec.
Briarhill
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
Receipt No.:
Single I
Residential
Multi Res., Comm./Ind. I
Name lollefson Buildere
New/Alter./Repair
; Address 1?16 FiOlyCl'° ?._. ?
Cost of Installation
O
Valley, .' ?. '
City ' Phone: Permit Fee
Name drickaon i;eCtS_*;c SurcFwrge
.
? Address 1rn3r) Beall P ' illr,
e
;,..?, .
City Phone: Total
This Permit is issued on the express condition that all work sholl be done in accordance with all applicable Stote of
Minnewta Stututes cnd City of Eagan Ordinances.
Building Official
1082 Payne Ave.
St. Paul, MN 55101
651 /772-2449
LAST S ?cti ti-t.T <r FIRST
CITY
GAS WORK ORDER
STANDARDJ 410 W. Lake St.
0 Minn 612/824 26565408
b HEATING
HM PH , , /? -Gbyy
TECH
ZIP ??_YL 7
WK PH
DATE Z- ze?r '0J
TYPE i G
MAKE ?
MODEL 7?2 .9.J
SERIAL ?f -77_-C
INPUT ? (901-'
ORSAT TEST RECORD
C02 l/ % METERED INPUT Cfh CHIMNEY TYPE )nni
02 G % LIMIT SETTING ° FLUE SIZE b in.
CO :qf?.?l ? % PILOT OUTAGE S2C CONNECTOR SIZE ? Iil.
NET STACK TEMP U ? TOTAL CHIMNEY INPUT d y; i7 _btuhx?~
& AIR CONDITIONING
A Blue Dot. Service Co. EQUIPMENT INFORMATION
CITY OF EAGqN SEWER SERVICE PERMIT
3795 Pilor Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Pluinber.
I agree fo eomplr with the City of Eagan
Ordinances,
Bv
Date of Insp.:
to tomply wiffi the Cify of Eagan
Connection Charge:
Account Deposit:
Permit Fee:
Surcharge:
Misc. Charges:
Totol:
Date Paid:
WATER SERVICE PERMIT
PERMIT NO.:
DATE:
No. of Units:
Connection Charge:
Account Deposit: _
Permit Fee:
Surcharge:
Misc. Charges: -
Total:
Dete Paid:
7
JF EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No, of Units:
Owner.
Address:
Site Address:
Plumber: -
1 agree M eumplp with the Cify of Ecgon
Ordinaneoa.
By
Date of Insp.:
I nsp.:
Connettion Charge:
Account Deposit:
Permit Fee:
Surcharge:
Misc. Charges:
Total:
Date Paid:
OF EAGAN
a,
?NATER SERVICE PERMIT
3795 Pilor Knob Road PERMIT NO.:
DATE:
Ecgan, MN 55122
Zoning: - No. of Units:
Owner: -
Address:
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reoder No.: Permit Fee:
1 agree M aomply with the City of Eogan Surcharge: _-
Ordinances. Misc. Charges:
Total:
By
Date of I nsp.:
Date Paid:
SEWER SERVICE PERMIT
CfSY -OF EAGAN
d :
PERMIT NO
3795 Pilot Knob Roa .
Eagan, MN 55122 DATE:
Zoning: No. of Units:
O
wner:
Address: -
Site Address: , -
Plumber. -
f E
h
Ci
h ction Charge:
nn
C -
agan
Yy o
f
e
1 agree ta eomply wit o
e
osit:
nunt De
A
Ordinances. p
cc -
? it Fee:
P
erm
e:
har
S
g
urc
es:
Char
Mi
gy g
sa
t
l:
T
Dote of Insp.: o
a
id:
D
t
P
Insp.: o
a
e
CITY OF EAGAN
3' 95 Pilot Kno6 Road PERMIT NO.:
Eagan, MN 55722 DATE:
ZO^'^g: No. of Units:
Owner:
Address: _
Site Address:
Plumber:
I a9rea M eomply with tha City of Eagan
Ordinances.
By
Dote of Insp.:
I nsp.:
Connectian Charge:
Account Deposit: _
Permit Fee:
Surcharge:
Misc. CFarges: -
Total:
Date Poid:
CITY OF EAGAN WATER SERVICE PERMIT
3795 PiIM Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: _ No. of Units:
Owner,
Address:
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee:
1 ogree M eomply wifh Yhe City of Eagan Surcharge:
Ordinonces. KA;?, r?.,,.,.e... .
By
Date of Insp.:
OF EAGAN WATER SERViCE PERMIT
Pilot Knob Road PERMIT NO.:
MN 55122 , DATE:
I? - No. of Units:
Connection Charge:
Account Deposit: _
Permit Fee:
Surcharge:
Misc. Charges: -
Total:
Date Paid:
I nsp.:
10;1,i
474 I
. .:. ... .: ..:. .: .....
, . . . .: ,. .. _ . . . . ..
CITY OF EAGAN
? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
'BUILDING PERMIT PHONE:454-8100 Receipt
Te 6a wed for FINISH BASEMENT Est. Volue 1,200.00 Date JULY 13 1 y 84
site Address ' 3832 LAUREI. COURT erect ? occupancy R-3
Lot _19 slock Ol Sec/Sub. BRIAR HILL ADDAT. Remodel M Zoning R-1
Parcel No. 10 14990 190 (ll Repair ? Type of Const. V
Enlarge ? No. Stories
ne Name RICHARn J. BRATT`' Move ? Lenyth
; Address ?R?? TA TRp[ C'T Demolish ? Depth
? City F.A(;AN Phone 457-5774 Grede ? Sq. Ft.
w
O .. .. _ .. . . .... .. ., ., .,
Name OWNER
Z
8u Address
? City Phone
?
FW
Name
?
,
-? Address
v
'
< W City Phone
I hereby acknowledge that I hove read this appiicotion and state that
the informotion is correct and agree to comply with oll opplicable
Stote of Minnesoro Statutes and City of Eagan Ordinances.
Sipnature of Permittee '
Approvab Fees
Assessment Permit 20.50
Water & Sew. Surcharge _ 1.00
Police Plan check
Fire SAC
Eng. Woter Conn.
Plonner Woter Mefer
Council Rood Unit
Bldg. Off. Parks
APC Totai, S 21 .5()
'
Var. Date
A Bwlding Permit is issued to: on the express condirion thot
all work shcll be done 'n accordonce wit oll ?aJpp•licable_ State of Minnesota Statutes ond City of Eogan Ordinonces.
Buildiny Officiol R-/
,. i
?_ /? r
V?
?
? . . ? • ? . . ?
Inc u e sets of plans,
?? • CITY OF_EAGAN 3 Certificate of Survey &
' BUILDING PKRM2T APPLICATION 1 set of_ energy cal.culations.
-S oo -
To Be Used For rini;5,y 24SLf,,£'9)7 - Valuation a2R? Date 7- l? -OP5/
site Aaaress: 3q3?2 1A uRc?- <2 7.
Lot I I Block (J I Sec./Sub.6 t i Gcn u; l 1 ?Erect
Parcel #: lqD U T Alter x
Repair
Owner :?c ?-r-AiC' 7 J ? c.4 l T,v Enlarge
? NYove
Address: 33'32 lA tJk eZ L 7. Dennlish
City/Zip Code: [,q G Ani lLi L Grade
?;sc,eac
Phone # : Sl S ? - S 7 7/ ?? ? - S93S APP7?OZIAIS FEES
Contractor: S?s? /= uu;Fe y5G zc3??
Assessm2nts
Pernu.t z-? ?
' Water/Sewer Surcharge
,q ?yq E
Address: 5 Police Plan Check .-
City/Zip Code: Fire SAC -
Phone En3• Water Conn. -
Planner Watex Meter -
Arch./Eng•: Council Road Unit -
Bldg. Off.
Address: APC
City/Zip Code:
Phone #: • ToTAL o21, cJ ?
OFFICE USE ONLY
OccuPancY ? - 3
Zoning 2-1
Type of Const. ?
# Stories
Front ft.
Depth ft.
Minnesota State 9oard of Electricity
Griggs Midway fildg. - Room N191 ? q gg_OOW 1-02
1111111k 21 _Uniqeesity Ave.. St. Paul, Minn. 55104 - Phone 297-2719 _I
FFE.Q?IEST FOR ELECTRICAL IIUSPECTION ? 82040
CHECii?'BELOW WORK COVERED BY THIS REOUEST
Type qf 8uilding New Add. Rep. Check Apptiances Wired For Check Fquipment Wited For
Home XX ? ? Range ]U 4•O Tempozaty Witing ?
Duplex ? ? ? Water Heater ? Lighting Fixtuies BC
Apt. Bldg. ? ? ? Dryer ? Electric Hexting ?
Commercial Bldg. 0 ? ? Furnace o Unloader ?
Industrial Bldg. ? ? ? Air Conditi qr?
Li 'LI `? j
? µlk Milk Tank ?
E'azm ? ? ? st , f
Hthers . ' , Ltiist
thersL
Othei
- 11 El
0
ere
ere
COMPUTE INSPECTION FEE BELOW
Service Entrance Size: # Fee FeedersBcSubfeeders: # Fee Ciccuits: # Fee
0 tu 100 Am s. 0 to 30 Am eres 0 to 30 Am eies
101 to 200 Amps. 31 to 100 Amperes 31 to 100 Am eres
Above 200 Amps. Above 100 Amps. Above IDO Amps.
Transformers RemoteControlCirc. Partial or other fee
-50
Signs Special lnspection Minimum fee $5.00 1
Remazks JefE D. TOTALF 3 3$,00
1, the Electrical lnspector, here c,eftify?hat ;zh f above,?qspection has been made.
(Rough-in) ?,+ '=-',?'"`? Date
(Final) Date
This request void
18 months from
?
This request void : f `
18 mont7ls from'
Date pf this Request 8-29-1980 Fire No. S 82040
l, aFM Licensed Electrical Contractor OOwner, do hereby request inspection of the above electri-
cal`wiring installed at:
.
Street Address or Route No. 3832 Laurel Coust City-Fagan
Section Township Range County Dakota
Which is occupied by Tollefson.
(Name of Occupant)
Is a roughin inspection required on this job? No ? Yes O Ready Now ? Will Call Fc[
Power Supplier Dakota Cty. Address Farmineton
Electrical Contractor O.B. Thompson Electsic C0. Contractor's License NoA1'262
(Company Name)
Mailing Address 12201 Mtka Blvd., Mtka J5343
(ElectricallCOntractrn-or Ownei Making This Installation)
AuthorizedSignature ^r?Phone No. ->:,?-,?;, c =. y.
(Electrlcal Contiactor or Owner Making This Installatlon)????R WARD ?0?? This inspection request will not be accepted 6y the
State Board unless proper inspection fee is enc0osed.
>t?REQUEST FOR ELECTRICAL INSPECTION Ee-ooooi-oa
, See instructians for complating this torm on 6ack of Yellow copy.
"X" Belovw Work Covered by This Request
.
Mid Rep• TYqe Of Building APPlia?tas Wired Equfpment Wired
Range Temporary Service
Water He ater Lightin,y Fixtures
ildinc? Dryer Electric Heatin
ft cial 81dg. Furnace Silo Unloader
lal Bldg. Air Conditioner Bulk Milk Tank
Other peciFy Other (Sper.ityi
pecify Other Oiher
Compute lnspection Fee Belaw
# Fee Service EntrenCeSize # Fee Feeders/Subteeders H Fee Circuits
U to 200 Am s 0 to 30 Am s 0 to 30 Am s
Above 200_qmpsi 31 to 100 Amps 31 ta 100 Am 5
Swimming Pool Above 700-Amps Above 100_Am s
Transformers hrigation Btioms !3 Partial%Other e
Signs Special inspection
TOT L FEE
KO
Rema rks
f1 R _?
le
Rou h-in uace
B ? I, th ical
InsOaCtor, hereby
certily chat the sbove
Final Date inspection has 6een
made. r ?
This request void 78 monlhs trom " -' ?- i"pScO r'Y 17 ",
?? ?.? ? a 0 - s2:) a
This request void ??? ?
18 rtanth5 from
Anii*754tq Lt°tf?°1
Request Date Fire No
t 7-/ / ?
L L7
? ??(a N y
1iI l AdA 14. u v
h-in Inspectiun
ired? OReady Nuw Q Will NotifY InSPec-
'es ?No tor When Ready
M Licensed Electncal Contractor I here6y request inspeciion uf ebove
Owner electrical work installed at:
Street AAdress, Box or Route No.
3F3..?, City
it 14-GA-
ecUO? o• Tow/n?ship Name ur No. Range No. C-o'7un?.ty
z4
V.J
OccupaM (PIiINT) Phone No. (,J
'
iCFf?? J 5/ 5
,;? S 7711
Power Supplier Address
;D._ F. A.
Eleclrical Contractor (Company Name) Contractor's License No.
Mailine Address (Contractor or Owner Making Instailation)
5-A/l, Z7
Authorized Signature (Contractor/Owner Making Installa[ion) Phone Number
?? -2 - S 7 7/
f? THIS INSPECTION HEQUEST WILL NOT
MINNESOTA STAE BOARD OF ELECTRICITY
Griggs-Midwey Bldg. - Room N-191 BE ACGEPTED BY THE STqTE BOARO
1827 University Ave., St. Paul. MN 56104 UNLESS PROPEH INSPECTION FEE IS
Phanx (612) 297-2117 ENCLOSED.
Minnesota Stata Board of Electricity
Griggs Midway 81dg. - Room N197 EB-00001-02
W821 University Ave., St. Paul, Minn. 55704 - phone 297•2111
CHECK BEELUW WORK CO ELtCTBYFilCAL
TH S REOUEST 'NSPECTION S 82041
Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired Foc
Home XMC ? ? Range TT4*UV Temporary Wiring ?
Duplex ? ? ? Water Heater ? Lighting Fixtuzes lox
Apt. Bldg. ? ? ? Dryer ? Electric Heating ?
Commercial Bldg. ? ? ? Furnace 12X2o 0 Silo UNoader ?
Industrial Bldg. ? ? ? Air Conditioner ? Bulk Milk Tank ?
Farm ? ? ? List t )
O[her ? ? ? HeieIf S? t eis}
)
COMPUTE INSPECTION FEE BELOW ?a (AN
Secvice Entrance Size: # Fee Feeders& Sub
? Circuits: # Fee
0 to 100 Am s10 IIG . 0 0 to 30 Am e 0 to 30 Am eres 10
1 .
20*00-
101 to 200 Amps. 31 to 100 Ampe 31 to 100 Am eies
Above 200 Amps. Above 100 Amps. 1i Above 100 Amps.
Transformeis Remote Control Circ. - Partial or other fee •
Signs Special Inspection Minimum fee $5.00
Remazks JefF D.
TOTAL FEE ,?.
38.0
I, the Electrical Inspector, hereby cert' at b ve Inspection has been m
(Rough-in) / ???_ ? Date ?- o? o°?-?v
(Final) Date /? ?? fsd
This request void
18 months from
n!,? I
This request void L17 61'
l8 months from r ?-
Date of this Request 8.29-1980 Fire No. S 82041
1, asV: Licensed Electrical Contractor OOwner, do hereby request inspection of the above electri-
cal wiring installed at:
Street Address or Route No. 3830 Lauxel Court City Eagan
Section Township
Range County Dakota
Which is occupied by Tolle£son
(Name of Occupant)
Is a roughin inspection required on this job? No ? YesXR Ready Now ? Will Call:U
Power Supplier Dakota Cty. Address Fa.rmingtort
Electrical Contractor 0. B. Thompson Electric Co. Contractor's License NA'.L7962
(COmpany Name)
Mailing Address 12201 Mtka B1vd., Mtka :? ;55343
(Electrlcal Contractor or.OwnecMaking TDis lnstallatlon).
Authorized Signature Phone Nor
(Electrical Contractor or Owner Making This Installatlon)
Q???? ????? D ?0?? This i?speetion request will not 6e accepted by the
N? 1n1 State Baard uuless proper inspection fee is enclosed.
Minnesota State Board of Electricity
? Griggs Midway Bldg. - Room N191
`-'.:Z1 University Ave., St. Paul, Minn. 55104 - Phona 297-2711 ?7 C 1?
FLEQUEST FOR ELECTRICAL rNSPECTION ?CHECK BELOW WOkK COVERED BY THIS REQUE3T d?
EB-00001-02
82042
Type Df Building New Add. Rep. Check Appliances Wired Foc Check Equipment Wired Foi
Home XM ? ? Range 04 s Temporacy Wiring ?
Duplex ? ? ? Watet Heatex ? Lighting Fixtures
Apt. Bidg. ? ? ? Dryer ? Electric Heating ?
Commercial Bldg. ? ? ? Furnace EK2*00 Silo Unloadei ?
Industrial Bldg. ? ? ? Au Conditioner ? Buik Milk Tank ?
Fazm ? ? ? List
Qthers# ist
hers
?
Other ? ? ? Here re
COMPUTE INSPECTION FEE BELOW ? I n11, \\\U1
Service Entrance Size: # Fee Feede[s$Su ' s: . C'uwits: # Fce
0 to ] 00 Am s. 0 to 30 Am s 0 to 30 Am eres 10 20.00
101 to 200 Amps. 31 to l00 Am s 3] to 300 Am res
Above 200 Amps. Above ]00_Amps. Above 100 Ampa.
Transformers Remote Control Circ. Pactial or other tee .
Signs Special Ins ec[ion Minimum fe
Remazks Jeff D• TOTALF E??(S'? 8100
I, the Electrical Inspector, hereby certifyat?the ?tf?'v?`msgeas been ?
(Rough-in) (/cJ, c?c?l€? ; ate ? !G~?
(Final) Date
This request void
18 months from
This request void L,20? 61 ? C?!?u^?'''"--? ??, ' I,i 4{
1$ months from
Date of this Request 8-29-1980 Fire No. S 82042
I, as Micensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wiring installed at:
Street Address or Route No. 3828 Laurel Court CityE??
Section Township
Itange County Dakota
Which is occupied by Tollefson
(Name of Occupan[)
Is a roughin inspection required on this job? No ? Yes fi Ready Now ? Will Call FK3[
Power Supplier Dakota CtY. Address k'armir]bt'ton
Electrical Contractor O.R. 'i'hompson Electric Co. Contractor's License No937A2
(Company Name)
12201 Mtka Blvd., Mtka 55343
Mailing Address „
(El?ecytF;ical ? ontroctyo?r!"or O ef'Making This Installation)
s:t?l Phone No. 933°25216
Authorized Signature
(Electrical Contractor or Owner Making This Installation) ??Q?? p???? Q? ,?? ? This inspection request will:not be accepted by ffie
State Board unless praper inspection fee is enclosed.
??/v/,y / ••-....w? rvn rLc%,irtiVHL INSPECTlON ?
. ? Sea instructions tor completing this fwm on back o( yellow copv. EB-OOQ01C06 ,
D4 R LdS !; "X" B@/OW Work CnverP(I hi. Th:?
f+Ad Rep. TVPa of Bwldin9 APPlioncea Wired - l '- EquiGm¢nl Wired
_ Home Fanye Temporary Service
Duplex Water Heater Lightiny Fixture
Apt. Building
Commercial Bldy.
Dryer
Fumace s
Electnc Heaun
Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm lner ner.,fy Oihe, lSUC?-?f?)
1 er pecify Other Othur
OR 7(IUI E IOS p@Ct/Oq FP.B BBInW .
Fee I ServiceEnlrenceSize
Sw i mm
Fransfc
i i gns
? Ffnal
Thie repuesl voiC 18 montha from
------'
s ?? cuits
A
31 to 100 qi iips 00
Above 00_Am s W 100A
gation Booms 'Other
Speciallnspecton
F ?Q In
? Date
.._._. ' I,Ihe Elactncal
InsDector
hereEy
p? p ,
certify that the above
i
?? nspection hes been
made.
This request void U/? ?
18 mpnths from
D 334_05 ./,?;?
?? ?
*G o-?
Re.qug s:Dete Fire No. Rouph- inI nsVer,tion
p7 ?? X Reed? ? ?Ready Now E Will Nolify Inspec-
V? L? es No tor When Ready
M-L'rensed Eleclrical Contractor I hereby request insoection of above
? Owner electrical work installed at:
Street Ad ress, Box /o!r?Route No.
? O City
ecUOn o. TownShip Name ot No. Range o. Cowity
O?/\
P?T) G • !CJ V? ? i Phoi No.
/7v
Power SupDlier ? A ress 0
Elect ??TC T?('C
1T?' Contractor's License No.
Mailmp d r nenMa ?aA1,gx5on)
Vti? q Tyr,.?+a?V ' d,`t
Y
Autho ized Signature (Contracmr/Owner Makfne Installation) Phone Number
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs•Midwey Bld9. - Floom N-191 gE ACCEPTED eY THE STqTE BOARD
1821 Universitv Ave.. St. Paul, MN 55104 UNLESS PROPEH INSPECTION FEE IS
Phone (672) 642-0600 ENCLOSED.
T#s TeQ 4est void !S'/l C%? I
18 ?.?3 from ?
Date of this Request 8-29-1980 Fire No. 82045
I, as:U Licensed Electrical Contractor ?Owner, do hereby request inspection of the above electri-
cal wiring installed at:
Street Address or Route No. 3826 Laurel Court City-&g?.n
Section Township Range County Dakota.
Which is occupied by Tollefson
(Name o1 Occupant)
Is a roughin inspection required on this job? No ? Yes)ti Ready Now ? Will Callb6a
Power Supplier Dakota Cty, Address Farmington
Electrical Contractor O.B. Thompson Electric Co. Contractor's License NA37962
(Company Name)
Mailing Address 12201 P.Qtka Blvd., Mtka ,,55343
(EJ??tr?? n? tar-or Ownei.Making This i nstallation)
Authorized Signature
Phone No.
(Electrical Contractor or Owner Making This Installatlon)
S? U??? p O U??? ?O?'?This inspection request will not be accepted by ffie
State Board unless proper inspection fee is enciosed.
Minnesota State Board of Electricity
Griggs Midway Bldg. - Room N191 ?2
A,1W University Ave.. St. Paui, Miqn. 55104 - Phone 297-2111 ?(1 1 ?
-'`'?EQUEST FOR ELECTRICAL INSPECTION
CHECK BELOW WORK COVERED BY TH[S REQUEST
EB-OOQO1-02
82045
Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For
Home DaK ? ? Range • Tempo7ary Wiring ?
Duplex ? ? ? Water Heater ? Lighting Fixtures Ju7C
Apt. Bldg. ? ? ? Dryei ? Electric Heating ?
Commercial Bldg. ? ? ? Fumace kk2a00 Silo Unloadec ?
Industrial Bldg. ? ? ? Air Conditioner ? Bulk Milk Tank ?
Fazm ? ? ? List
) List
Other
?
?
? }
Hehelsl
Oeiels?
COMPUTE INSPECTION FEE BELOW ]?? J???
Service Enttance Size: # Fee 11 Feedecs&5 :_&der5A;3kt.L V_Fbe- Circuits: # Fee
0 to 100 Am 11 U to 3U A eres CJ U to 3U Am eres
101 to 200 Amps. 31 to ] 00 A` peres 31 to I00 Ampeies
Above 200_Amps. Above 100 Amps.1 T 11 Above 100 Amps.
Remarks Jeff D. TOTAL FE (3 7 1
I,the Electrical Inspector, hereby c tha e o?e inspection has been a
(Rough-in) Date -- ?
(Final) ? ,?r ? i Date ((p -?
This request void v ? - ?
18 months from
•00
C?rrt'tfiratt uf (Orrupttnry
Citp of (Eagan '
igrpttrtmrnt Lif Builbircg Jn.sprrtinn
r
?GO[5 ?Bl
Tbir Ccrtificatt ic.rued purtuant to the requirementt of Sation 306 oJ the Uniform Buildrng
Code ccrti f ying that at the time of i.uuancr thir structure war in compliancr wirh tix varioar
ordinancu o f the Cit y reguluting bxilding conrnuction or un. For the f ollowing:
A
&dg.Pomm No
the clamiliwaim 4-PLEX 5989
Oc-Pw" TYPe R3 TYp Cmalruction V Fiie Zone 3 Zoning DUuict R'3
Ovne+ofBuaNn` Tollefson Bldrs. ,,,dam 13816 Holyoke Ln,Apple `
BuMogAddtw 3832 Laurel Ct L.WitY L19,B1,Briarhill
zt_vo zxfz&!?? By 12-11-80
eu?wnBO?a.i ? rn«:
•GT IM ? CONY.ICVOYt .YC.
CITY OF EAGAN
3795 Pilot Knob Rwd Eogon, MN 55722
PHONE: 4548100
BUILDING PERMIT APPLICATION
To be uaed for
Site Address /"'-v vvur u
Lor 18 Block 1 sec/Sub. Briarhill
parcel # 10 14990 180 01 Plan #9-269
s Nome
Z 13816 Holyoke Lnr:
3 Address
° C,h, Apple Valley phone 454-6873
?p Nome `
?? Address
1' CiN Phone
Name _
Address
N4 5986
Receipt # -?2 U
Erect Occupancy n}
Alter ? Zoning R3
Repair ? Fire Zone 3-?
Enlarge ? Type of Const. V
Move ? # Stories
Demolish Q Front _ 44 ft.
Grade ? Depth 24 ft.
Aoorovals Feee
Assessment 11S
Water & Sew.
Police
Fire
Eng.
Pianner
Council
Permit j`+-? • ?v
Surcharge 26.00
Plan check 71.75
snc 525.00
Water Conn. 305.00
Woter Merer 60.00
Road Unit 185.00
1 hereby acknowledge that I have reod thts application and stute that gld9. Off. 6-24-$0
the informotion is correct ond agree to comply with alI applicable l, 316.2`J
$tate of MinnesoTa Statutes cnd City of Eagon Ordinances. APC Total
Signature of Permittee 4zeea?
A Building Permit is is5ued to: ' Tollefson $uilders on the express condition that
nll work shall be done in ocmr4qnce with oll_applicable State of Minnesoto Stotutes and Gity of Eagan Ordinances.
Building Officiai
?V CTTY OF EAGAN Include 2 sets of plans.
1 site plan w/elevaticins &
BUIIDING PERMIT APPLICATION 1 set of energy calculations.
To se vsed For _--Ljj---, valuationDate 4? ---;:?G'-
Site ss: OFf'ICE USE CNLY
I,?t?ry?? ??Block 5ec./Sub.,a2z.-t-c?J ET? _?. ? R
Y??i #:" ? ? ?fle ---
Uaner:/ Q u
Address: %
Citl'/Zip Code:? ? C .
Ptbone # : 4155- ar-7
Contractor:
Address:
City/Zip Code:
Phone # :
Arch. /Eng. .
Pddress:
Enlar4e
Move
Dariolish
Grade TYPe of Const.
# Stories
flront ft.
DePth ft.
APP%)VATS FEES
5-?
a E y
assessmenrs r?eit J y3
Water/Sewer Surcharge ;
Polioe Plan Check
Fire SAC
gng, Water Conn. ?bs =°
Plancber Wdter Meter
Council Road Unit Lle-V
Bldg. OfF ?
APC
Ci.ty/Zip Code:
TO
Phone #: j„` ?3 ??? ? ? ?TAL
CITY OF EAGAN
. '' 3795 Pilot Knob Road Ecgan, MN 55132 N2 5987
PHONE: 454-8100
BUILDING PERMIT APPLICATION 40*P-T7 Receipt # ?2e
To be uaed for 4-PLEX Est. Vclue r 0 Date 7-2l+ 19 82
Site Address 3828 Laurel Court __ Erecr $? Occuponcy R3
Lot 20 Blxk 1 Ser/Sub. Briarhill Alter ? Zoning R3
Parcel .fp 10 1LF990 200 Ol P1a11 #9-269 Repoir ? Fire Zone - 3
V
a: Name Tollefson Builders
3 Address 13816 Holyoke Lane
o ?:-. Apple Valley 451+-6 73
0:
Z0
U?u
?
Name _
Address
Name _
Address
1 hereby ccknowledge that I have reod this opplication and state that
the information is correct and ogree to tomply with all applicable
Stote of MinnewM SMtutes ond City of Eagon Ordirwnces.
$ignature of PermiRee 'M -alie??
A Building Permit is issued to: Tollefson Builders
all work shall be done in accordonce with alL,ooclicable State of Mii
Enlorge ? Type of Const. __-
Move p # Stories
Demolish ? Front 44 ft.
Grade ? Depth 24 ft.
Aoorovals Fees
Assessment
Woter & Sew.
Police
Fire
Eng.
Plonner
Council
Bldg. Off.
APC
' Permit 14.2 . 2v
Surcharge 26.00-
Plon check 71.75
snC 525.00
Water Conn. 0 .00
Water Meter 60.00
Rood Unit 185.00
Toral l, 316.25
on the express condition that
Stotutes'and Ciry of Eagon Ordinonces.
Building Officiol
Cl•ry pF EAGAN . Include 2 sets of plans,
1 site plan w/el.evations &
BUIIDING PERNIIT APPLICATION 1 set of erexgy calculations.
Zb Be Used For valuation7/'U DDO Date
Iz,
" ?r I
OE'FICE USE ?Y
Site Address:.?, ,;? ?-ti:..P
Lot ? ry??? ? Block Sec. /Sub. ? ?? ZocY ?
Parcel # :?// ?l?y?/J ?/JD /I/ ? _ y'-.•2 ? ?/
Owner:/
Pddress: /3??/?i
City/Zip Code:? z.. C
pn? # : 6 ?73
Cbntractor:
Address:
City/Zip Code:
Phone #: - ----
Arc.h. /?g. .
Address:
City/Zip Code:
Re i.r Fire Zone
Fa
Enlarge Zype of Const.
Move # Stories
Dc?mlish Front ft:
Grade Depth a ft.
APPEiOVAIS FEES
AssessrmnrsY p?tt
Water/Sewer Surcharge a G -011
Polioe Plan Check I?-
Fire SAC
gg, Water Conn. ,3c5s?
Planner Water Meter &_o
Council Roai Unit
Bldg. Off. .2 %
APC
Phone #: ,? 'I?O?PAL
' ? ?_ S
CITY OF EAGAN
3795 P11ot Knob Road Eagan, MN 55122
PHONE: 454-8100
BUILDING PERMIT APPLICATION Si
Site Address 3830 Laurel Court
Lot 17 Block 1 Sec/sub. Briarhill
parcel # 10 14990 170 Ol Plan # 9-269
w Name Tollefson Builders
; Address 13$16 Holyoke Ln. _
Name _
,o
ou Address
F- r;w
Nome _
Address
N° 5988
Receipt #
Erect Ek Occuponcy ?LJ
Alter ? Zoning P3 -
Repair ? Fire Zone 3
Enlarge ? Type of Const. V -
Move ? # Stories _
Demolish ? Front 4f+ ft.
Grade ? Depth 24 ft.
Approvals Fees
Assessment KUb--4-? Permit 14 i. ?)U
Water & Sew. Surcharge 26.00
Police Plan check 71.75
Fire snc 525.00
Eng. Water Conn. 0 00
Plonner Water Meter 60.00
Council Road Unit 1$5.00
I hereby ocknowledge thot 1 have reod this application and state that Bldg. Off.
the information is Correct and agree to tomply with all applicable APC Total l. 316.25
State of Minnesoto Statutes and 'ty of Eogan Ordinances.
Signature of Permittee &7• J
A Building Permit is issued to: Tnl1afGon Rlii I r?P?S on the express condition that
nll work sholl be done in accord3?qce with oll gqplicable State of Minnesoto Statutes and City of Eagan Ordinances.
Building Officiol
?
CITY QF FAGAN
Include 2 sets of plans,
1 site plan w/el.evations &
/ BUILDING PERMIT APPLICATION 1 set of energy calculations.
To Be Used For 7-?t??_ valuation?/'l??4DD Date
Siteess:? -?-'; "? . ?' `. •?.z.Q ?? OFFICE USE O1?Y
ry-VB
Iot; ? Bi?x
1 ?L •_. _
s?./sub. `I
?? o???
R3
1 n»0
Pa?Y?Ce --?57F Altex Y? zoninq 3
Owner: /
Address:,?
City/Zip Code:(
Phone #: ?S
Contractor: _
Address:
City/Zip Code:
Phone #:
Axch./Eng.:
Address:
City/Zip Code:
Phone #:
Repair Fire Zone 3
?zJ Enlarge 7.ype of Const. r/
` Nbve # Stories
Demolish Front y ft.
Grade Depth -( ft.
o,r-7
APPROVArS FEES-
Assessments ? Perniit
Water/Sewer Surcharge
Polioe Plan Check )/
Fire SAC ?-25 =
gnq, Water Conn. 3 0,S ?
Planner Water Meter /,b ?
Council Road Unit / iRS-?
Bldg. Off.
APC
'DOrPAL
CITY OF EAGAN
3795 PiIM Knob Road Eagan, MN 55122
PHONE: 454-8100
BUILDIIVG PERMIT APPLICATION
Site Address
Lot 19 Block 1 Sec/sub. Briarhill
Parcel # 10 14990 190 Ol Plan #9-269
z Name ?"?-?c? o.?.LU11LLC1 a
i 13 1 Holyoke Ln.
3 Address _
° :,.APPle Valley „?___ G5G-hR7?
?
o Name _
z?
?? Address
~ Ci
GFw Nome _
W
Z
Address
N4 5989
Receipt # ?d ll°r_
Erect Occupancy n?>
Alter p Zoning R3
Repoir ? Fire Zone ' 3
Enlarge ? Type of Const. _ V
Move ? # Stories
Demolish [] Front 41+ - ft.
Grode ? Depth 24 ft.
Aoorovals' Feet
Assessment
Water & Sew. --
Police
Fire
Eng.
Planner
Council
' Permit 1/{J . /V
Surchorge 26.00
Plan check71.75
snc 525.00
Woter Conn. 305.00
Water Meter 60. 00
Rood Unit 185.00
I hereby acknowledge thet I have read this application ond stote that gldg. Off. 6'29-$0
the information is wrrect ond agree to comply with all applicuble APC Total 1, 316.25
State of Minnesota Statu/teys, and City of Eagan Ordinances.
Slgnature of Permittee i//•
A Building Permit is i5sLied ro: Tollefson Builclers on the express condition thot
all work shall be done in accordancy/#vith oll applisa Ie State of Minpesota Statutes and City of Eagan Ordinonces.
Buiiding Officiol
CITY OF EAGAN _ Include 2 sets of plans,
l.site plan w/elevations &
BUIIDING PERNII'P APPLICAZZCN 1 set of ener9Y calculations.
2b Be Used For Valuation'?1196' . DOD Date lo ._ -;2 6-? -??
? e .?, ?
Site Address: ?' `e ? , OFFICE USE ?Y
Lo ??a ? Blo?c Sec. f5"b. Erect .__XOccugaancy /Q3
parcel' ; /?1`l9? oat.-61 p.].t.er zoning
, RepaiL' Fire Zone
Ow a EYilarge Type of Const. _
ner: Mave # Stories
Address: / o _?'" ?,• ' Dennlisli FYont y ft.
City/ZiP Code:c, -
? Grade
pepth ft.
dz
pnom e, ?7.3 aPPxavxLs FEEs
ay??
contractor: Assessments Pezmit
Add
ress:
Water/Sewer
Surcharge a?-03j-
71
. Polioe Plan Check 71
City/ZiP Code: Fire SAC
Phorie #: En4• water Conn. j06?
"
Plaruber Water Meter 0
pr,h./Eng• : -- - Council Road Unit 1 S--
Bldg. Off. ?
Address: p,pC
City/2ip Code:
Phone #c 6 -,23 -?5d
, .. CITY OF EAGAN N9 16484
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUFLDING PERMIT PNONE: 454-8100 Receipt # a 2-'c- i
To be used for DECK Est. Value $1, 000 Date May 17 1989
Site Address 3828 LAUREL COURT
Lot 90 Block _]._ Sec/Sub.BRIAR HILL OFFICE USE ONLY
PdfC@I N0. Occupancy - FEES
Zoning -
W Name FRED FROKEN BROCK (ACWaI) Const - Bldg. Permit 26.00
a Address 3828 LAUREL COURT (Allowable) - Surcharge _ rn
City EAGAN Phone # ot siories -
Length _ Plan Review
, o N8R12 -['.RFATT VF. Ri TIC; MATNTF.NAN Depth - SAC, Ciry
?Q AddfeSS 41 $1 160TH STRF.F.T WF.ST S.F. Total -
SAC, MCWCC
? City RoSEMf1UNT Phone 473_6310 S.F. Footprints -
1- On Site Sewage _ Waier Conn
F W Name On Site Well - Water Meter
'x? Addl'6S5 MWCC System -
?Z Acct. Deposit
a W City Phone Gry water -
PRV Required - S/W Permit
I hereby acknowlege that I have read this application and state that the Booster Pump - S/W Surcharge
information is correct and agree to comply with all applica6le State of
Minnesota Statutes and C? of Eagan Or inances. Treatment PI
Signature of Permitee ? APPROVALS Road Unit
A euilding Permit is issued to: CREATIVE B G MAINT. Planner - park Ded.
on the express condition that all work shall be done in accordance with all Council
applicable State of Ap?id esota Statut and Ci? y of Eagan O nces. 81dg_ pry, _Copies 2.00
` Vanance TOTAL 28.50
Building Official 6 ?•? -
,
KOEHNLEIN 12,«,N?Co??ErAVFNU?sa??,??
' PHONE (612) 89Cd'272 .
BURNSVILLE, MINNESOTA 55337 '
LIGHTOWLER ' CERTIFICATE OF SURVEY for CARL TOLLCrSON
JOHNSON
Lots 17, 18, 19 and 20, Block 1- BRIAR HILL
I N C o N P o a., E o llakota County, A2innesota
ARCNITECTS FARGO, NORTH DAKOTA '
MORRIS, MINNESOTA
ENGINEERS L PHOENIX, ARIZONA
Iti ?
?G
? r
?
o
?? -
\ \
61
?
\\
? ?.?.
?.
. -;" N, r ` 1%
a.?? Hr'1A_
?9 ??'. r C? N 1
2.
o ? Q I.?`vO •- ??,??
?
--If3
a.I-T
C.-
f
, 3\ \
?
?
AtL
?
C
--1-
?GJf/O
G)
?.
.\
.?
?
I hereby certiFy that this survey, plan or
report was prepared by me or under my direct
supervision and that I am a duly Registered
Land Sutveyor under the laws of the State
of Minnesara.
Date Reg. No.-.-?
2006 RESIDENTIAL PLUMBING PeRnmT aPPLicaTioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122 '
651-675-5675
?. .. .. ... .......:.... ....... ... .......?U . . .. ._:.. ..
?,w._._?_.. . ..... .,.., , . .
Please?complete for modifications to existing residential dwellings.
Date?l
Site Street Address , 02 R lfil?l.(.t?P/' ?• Unit #
Properly Owner 1 ? ? ? V ??1(1 ?oci / Telephone # (4Aj
Contractor Telephone # ozr7( ).-3425' t?`I l?
Address ? a 1?ud A id, City eZk Ce, State j M Zip 40-I a.3
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 and/or water
heater at the same time. !f you are installing onlv a water softener anc!/or water
heater, do not complete this section; move to the next section and check the
appliance(s) you are installing.
_Septic System Abandonment
_Water Turnaround (add $130.00 if a 5/8" meter is required)
Other:
Water Softener Water Heater $ 15.00
new re
lacement
_
p
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
l APR 1 2 90n7
T
t $,S•C50
o
a
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the
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, but only an application for a permit, work is not to start without a permit and work wili be in
accordance with the approved plan in the event a plan is required to tle reviewed and approved.
ApplicariYs Printed Name Applicanfs Signature
OP
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
? ? f , s0-
Date 06
Site SEreet Address Unit #
Propeity Owner K.11 CmD L-e, k -e?i S) V?"C Telephone #??
H.P. PIPEWORKS
Contractor 3670 DODD ROAD Telephone #( )
Address EAGAN, MN 55123 City State Zip
The Applicant is: _ Owner v Contractor _Other
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures (excludes water softener and/or water heate r--complete next
section if installing these appliances).
_Septic System Abandonment
_ Water Turnaround (add $125.00 if a 5/8" meter is required)
Other:
-
Water Softener ? Water Heater
$ 15.00
_ new ! replacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
Total
L_ -
E $ ?? •5U
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the 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, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
\Ubnd?:l H-?'l
Applicant's Printed Name
, k UkA 0 ? - Ni??
Applican's Signature r,??
1 II I?
r
- ---,
2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Tetephone # 651-675-5675
Please complete for. single family dwellings & townhomes/condos when permits are required for each unit
--is 36 S:0
Dafe I (D / 15
Site Address 5?"3a Unit #
Property Owner Telephone # ( )
i 'Connor
O
Contractor
_ plumbing, Heatipg 8i Cooling ;
Street Address 1904 Vermillion S4. City
Hastings} MN 55033
St
t
I /
hone #(lQ5} I
Tele
a
e p
Bond #• Expires:
The Applicant is _ Owner Contractor _ Other
Add-on or alteration to existing dwelling unit $ 30A0
-)e, furnace _Additional ? Replacement
air exchanger
air conditioner _New _Replacement
other
State Surcharge
U .50
OCT ` ° zuR 3o-5a
Total $
By
I hereby apply for a Residential Mechanical Pernvt and aclrnowledge that the information is complete and accurate; that the work will
be in conformance with the ordinances and codes of the Gity of Eagan and with the Mechanical Codes; that I understand this is not a
pernut, 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.
1`-'Ie,?h at'? Kr'jAPp ,-aW?ham 4/n aA?
ApplicanYs Printed Name Appli6alrtW
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construcfion Reauirements RemodeUReoair Reauiremenis m
3 regislered site surveys showing sq. fL ot lot sq. il of house: and all roofed areas 2 copies of plan "-?
(20°,6 maximum lot coverage allowed) 1 set of Energy Ca?ulations for heated additions k?[e?'?n?t?eat ? f1??- d?
2 copies o( plan stawing beam 8 window sizes; poured found design, etc. 1 site survey for addiGons & decks dW4?";?,%?' ??`,r- ?
1 set of Energy Calculations AddiGon - indicate i( onsife sepfic system ?it? ^?e??t'??
3 copies M Tree Preserva6on Plan if IM platted after 711193
Rim Joist Detall Optlons selection sheet (bidgs with 3 or less units
Date v /)?' l? 2 7 /
!??'' /
Construction Cost C-; 06V •
Site Address
Unit/Ste {f
Description of Work t?
Multi-Family Bldg _ Y-XN Fireplace(s) _ 0 2
Property Owner ,YV I"`'L C A/L/A' /t to LCjtl-? Telephone #
Contractor
Address - // -r- City Li-
State Zip '-? Telephone #(qS2) Y??' ?C 7Z
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category
• Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) Submitted Su6mitted
• Energy Envelope Calculations Submitted
Have you previausly constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone #(
Telephone #(
R rjP T 0 T L
? s, ; 2nnn ?
, ?
F?,,
I hereby apply for a Residential Building Permit and acknowledge that the information is tcomplete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagaifiand the Stale-Of-MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to st?art 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. I
I/VVM?
pplicanYs Printed Name Applicant's Signatur
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OB-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Mul4 Misc.
? OS 03-plex ? 11 70-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-piex Pibg_Y or_ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior 0 44 Siding
? 32 Addition ? 36 Move Buiiding ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 WindowslDoors
? 34 Replecement 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ FinallNo C.O.
_ Footings(addition) _ Plutnbing
Foundation HVAC
Drain Tile Other
Roof Ice & Water Final Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding _ Stucco _ Stone _ Brick
_ Fireplace _ R.I. _ Au Test _ Final _ Windows
In;ulation _ Retaining Wall
Approved By:
Base Fee
Surcharge
Plan Review
MClES SAC
City 5AC
Utility Connection Charge
S&W Permit & Surcharge
Treatrnent Plant
License Search
Copies
Other
Total
Building Inspectar
('TTY DF FAGAN
CA!?,H.T.G!"y: S iEFiM.LAlAL. NOe 697
l1F17E2 02117/99 T:CMEw Oi.Bi?:?i
IL.i e
RAMEa WALTFk M[CMAN:CC'AL INC
3210 9001 3826 I...FtUfiEl... GT 60.00
205 3001 3826 LAURE1.. CT Q.SCI
i
Tn+.a1 Ftecei.p+ Amount e 60.50
CR iIJR985
USER .T.D: NANCY
X??X?k??Xc?e?X???k?z?X?C?XXc?c?#?%XeMXt?X%C??X%?%?kc?ksX kC?%?XXc??X?X?X
CITY OF EAGAN
3830 Pilot Knab Road
Eagan, Minnesota 55122-1897
(651) 681-4675
PERMIT
PERMIT TYPE: B U I !r) r. iv G'
Permit Number: LA ' ?? ? 3 C'
Date Issued: 0' / ' ' ! 9 9
SITE ADDRESS:
3 ?-2 6 L A IJ I,:c L a: T
?.a1- : ia ??LOcK; I
t;hi'If,R H :l"LI_
P. _I ,Y`d. o 1.0 -9.14 9 90 -18 0 -0 1
DESCRIPTION:
r?A s :I,:N srR'rlG A s 1_1 N E
6 ptl lcli h?..l='e rmi.i: 1'VPe f7F2cl'l_Fif" E
V$uil di rh< ' i -W4,rk Type A L1'ERH1]:nr!
eei'tsi.rs !1''4 ALT, Ftc5l:DFN1 :T.FlL
_•-?_. _ ta
•? ?` :
3
?
u'0? ? ? { Fk? ?.
ti3
a
" a t'll ` i
6` e ... .. kS •s" ?
REMARKS:
t;il1'f'IRIr`r'UE 1-1U5i i;i' 1hd:3P F=GI"t? f) B t'f (:)tjF CUl`dCFiAI.:INGe
FEE SUMMARY
t;asc (=se "?60.00
Su rrhai qF
TvY:a.]_ f'pe $E;7.50
CONTRACTOR: I- App-l- .i? ?? nt - OWNER:
WAITER CONTF;ACT7:NG 1S6 'I.8013 S TF'ICl CIFNNS3
7420 Ci7Ll.lMBlJfS RVF rn 33?'6 LF1(1RE1. LT
RIC;I-IFTEI_D MiV 5542; EA G(iN Mi4 55i2 2
(01-2? 8 61-L" +t113 i6 5 119 9 t4-14 -2 i
( I
I her?ebv uc:i<noa:tledqe trtot I tiavo read Lhi.s appl.seatzon and staLe thrat the
3ntot-maCiaan is coa.rect and aqiryep #:o cornp.l.v with a1.1: applirOle Stato ca!' Mn.
StattaU,s arrd Citv ot Eaqan
` 1 -APPLICANTlPEFMITEE SIGNATURE
SSUED 8Y: SIGN TURE -
-16 ().LM
a-i7 -q9
1999 FIREPLACE PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
(651) 681-4675
Date:
Description of Work: _ Construct nerv fireplace _ Alteratinus to existin,
? Install Qas insert oulY _?>4 Install ;as line orzlv
Other
Job address: Z,4 LG ll-? (21
D
I }1"L?
#
Lot: Block: SubdivisioniP.
. .
:
Applicant (circle one only): Owner Contractor Perntit Fee: $60.50
Name: Phone
PROPERTY Last First
OWNER /' "??p
???
' /
?`
?
Street Address: p .e{QL-i?G-t
?. ,
-
City State:Ad.A___ Zip:
Company: Phone#:
FIREPLACE ?,? /
INSTALLER Street Address: a5?? 1 0SY/ t, f?y .
City State: Zip:
Company
TI _ 11.
GAS LINE
INSTALLER Street Adi
City
I hereby acknowledge that I have read this application and state that the information is correct
and a?ree to comply with all applicable State of Minnesota Statutes and City of Eagan
Ordinances.
S nature
StaCe: Zip:
;?k>X);;`?f'{<i?';Y;ni4i?: ;;Yi' ) ? .?i.,??f.,..?z )' :4:4;[;iC`1;;;;;?•}',:i;?,?`)?'y'ry{},v.,;s,9' ;S
n •+
i~ ?. Y ? !?' ?'.1•'?I..rAN
CAUHIE!'\ 6 :., r ERMINi ii... NO" 779
i'nYE,? ? W19/98 TT.Ni;: „„ 00009
r .. ?D',
NANEe M:l:l;c: i4(:iliS GCtNS'i'ItU:.?:CON Ct7 3:NC
205 900:1 27.00
3210 9001 3809 HEAi H'W R DR 0205
1').t?.J 1
::IC.
l.
r?1?'ti ? ..?.I..?J.
?????
.
:i_?..C.
? ?? 1°??C.1?`le,-JI.?I'
u..."(
i?t
_I_.
L
?i C.2.C_?..C?J
`
:?C?.?.41 ?',lit.???. :?F'r
:1
8t ?...i"!?..?i\?
::.?... f aT ??.r1?.£?,S?v?l
300 ?.??:.1.1. (
Jj]{.fl.?.?. f
???'!?.I??..f.li'...R
DR
09.75
.}..?t.1. r;c: 1"I... _. ?11-?1; ri AmCi+.iFVh;i 95000
?. ,_:e:: CRO99:) 37
U92R ID:. N17f'!("Y
>???` )??'f: ? i?:Ti:J:%h ??M1i?.`'iY? i? h.: \ i?\ ?\ r?\ qQ` )?i lPJ ?JeC%r\l' J?YU?.;'? Ji, t.::!: ,•`b?: ri?
PERMIT
CITY OF EAGAN
-3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(651) 681-4675
PERMIT TYPE:
Permit Number:
Date Issued:
guxLozNG
03A07?
11f18/98
SITE ADDRESS:
3826 LAUREt. C;T
LOT: 1.8 BLOCK: ]
BR:CAR hIILL
P. T. Pd .: 10-14 9 9 F7-18 O--o1
DESCRIPTION:
T.O. & REROQF
Buildinq'-Permit Type MULTI. (MISC. )
Building Work Type FtEPAIR
Census Code 434 ALT. RESIDENTTAL
c « v
i ,.
r Y 4 , ) '-'= ? ? ? r i f 1 i( 4 I
. . ,.. ... ... .
i d .. . ,,. ` } _. .... f ` a ?.. _ , ...,
.?,.
r , - ..., t..?-
REMARKS:
SNCLUDES: 3828. 3830.. AN1) 3832.
FEE SUMMARY:
VALUATION $13,000
Base Fee $199.75
Surcharge 6,50
Total Fee $206.25
CONTRACTOR: - flpplicant - sT. Lzc. OWNER:
MIKE MOHS CONSTF2UCTTON CO 17211107 5456 BRIAft HILL A55UCIATIQN
3414 SNEI.I..ING AVE S 3826 LAUREL C'i"
MTNNEAPqL''S hiN 55406 EAGAN MN 55123
.(612) 721-1107
1 hereb,y acknawledge that I have read this application anck istate that Che
infiormation is cprrect and aqree to ctamply wiGFi a11 app.lieabJ.e State o# Mn.
? 5tatutes and' Ci'ty afi Eagan Qrdinanr-es. J
K-t . e...-@
APPLICANT/PERMITEE SIGNATURE UED BY: SIGNATU E
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNIOB RD - 55122
681-4675
New Construcfion Reauirements RemodeVReoair Reauirements
? 3 registered site surveys ? 2 wpies of plan
• 2 copies of plans (inGude beam 8 window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior additions 8 dedcs)
? 1 energy calculations ? 7 energy calculations for heated add'Rions
4 3 copies of tree preservatian plan if lot plalted after 711i93
required: Yes No
DATE: / 1/? Z//6?- CONSTRUCTION COST; I Z ? 7 7S? ?
DESCRIPTION OF WORK: -r;eR 2 A'°'r
STREET ADDRESS: ZS' 3 a- 32 L.4, cyge? ?)
LOT: I? BLOCK: ? SUBDJP.I.D. #: G\"'`- ?Ai
Name: & (4 2 ! // Phone #:
PROPERTY Last First
OWNER
Street Address:
City State: Zip:
Company: /vl 1 /ti-P 4,5 lAN 5 ( CU N C-- Phone #: ? Z 2
CONTRACTOR ?• //?
/l'vnj //?
Street Address: :->Ve//
?'? vE- 5rv License # ?? s
City i' `
/ ?/lS State: Zip:
?.
ARCHITECT/
ENGINEER Company:
Phone #:
Name: Registration #:
Street
City
State:
Zip:
Sewer 8 water licensed plumber (new construction only): . Penalty applies when address chang
and lot change is requested once permit is issued.
I hereby acknowledge that I have read this applicadon and state that the infortnation is correct and agree to comply with all applicabf
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:C? l 2L, _ ?? /?.
OFFICE USE ONLY
Certificates of Surdey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No ? Not Required
?? ?,.i e? tr•1 i y.,yd;.?.? 4 W+p.?b ?.dW?v? i d:??.. .v.Y,.y
l:lil?'1?tFiC?„)'(,i?'l?.?f-il•?.,nn.p1?iLinY?f:}'?CQ6?.?e?,..?i:)!f7,C.?S.d7?:);::dAC::C`1 ? ".'?Cp.aJ?.
C:I:1'V OF .F..A(:,Ai`!
f.::ASH:i:li=F;;; S '?'EF"tP':[h•1Ai._ Nt7e 760
DFi7i::s QVGE?,>99 'IIMEg 0709^::32
IV.
NAME: MARt`.. A. `iTE:N,!=Ti-1
320 `JC'IOt 38:39 I...ftl..lRE.L. t.',r r;t)„On
205 9001 3839 LAIJF;F.::l_. r:'1 i:J.,"'.'ifi
'tn ta:L Rece: i.o+. 4mruun tv t',t:) o50
CF't07; 0.
liSl'r.:i3 17!C NANCV
\)?/?4?LalaY 1 +1 1 1 I.JIU: ? • f L 1 ?t, e 4 •
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
. `° 3830 PILOT KNOB RD - 55122 o
„? _9
0 (651) 681-4675 ,., c(? (? „_s?
v?xx
New Construction Reauirements RemodeVReoair Reauirements
? 3 registered site surveys
? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.)
t 1 energy calculations
4 3 copies of tree preservation ptan if lot platted after 7/1/93
required: _ Yes _ No
DATE: 3 - aq "q9
DESCRIPTION OF WORK: ?ICCK CX+UnS?(O{rl
? 2 copies of plan
? 1 site surveys (exterior additions 8 dedcs)
? 1 energy calculations for heated additions
CONSTRUCTION COST: $ A55. OU
STREETADDRESS: 393D LaU.re-? COU-`r-+" I Cckq-c?
LOT: BLOCK: I SUBD./P.I.D. #:
tvame: c5-1"eXlSc?h mQrk. Phonett: (951-HO5-0N4
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
3tate: Zip:
Phone #:
Registration #:
State:
Zip:
Sewer & water licensed plumber (new construction only): . Penalty applies when address
ohange and lot change is requested once permit is issued.
I hereby acknowledge that I have read this appiication, state that the information is correct, and agree to comply with all applicable
54ate of Minnesota Statutes and City of Eagan Ordinances.
_.?
Signature of Applicant: a
---
•`?"?
? OFFICE USE ONLY , ?• ?
? - -
Certificates of Survey Received _ Yes No ' ' • `"` "°"'°"? !
..._.._._ _ _ _._._.? .__ ... .__._ .
Tree Presenration Plan Received _ Yes _ No _ Not Required
Last
First
Street Address: ? 9 ?0 LCLLLc? ? ?o LR-r+
City _EM a n State:
Company:,
I\4 N Z;P
Phone #:
551a-
5treet Address License # Exp.
City
Company:
Name:
Street Add
City _
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
0 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. ? 10 _-plex
WORK TYPE
? 31 New ? 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
Y .
.-»
?
? 11 Apt./Lodging 0 16 Basement Finish
? 12 Multi RepairlRem. p 17 Swim Pool
? 13 GaragelAccessory p 20 Public Facility
? 14 Fireplace 0 21 Miscellaneous
A, 15 Deck
? 36 Move
? 37 Demolition
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Faotprint sq. ft.
,
?
Census Code
SAC CQde
Census Units
CensuS Bldg
MC/ES System
City Water
Boost& Pump
PRV '
Fire SpIrinklered
APPROVALS
Planning Building 42- Engineering . , Variance
Permit Fee Valuation: $ 2 ?G
Surcharge
Plan Review License ?
MClES SAC
City SAC '
Water Conn:
UVater Meter '
Acct. Deposit
S/W Permit
SNV Surcharge
Treatment PI.
Park Ded.
Trails Ded. ,
Other
Copies
TotaL• ?
% SAC ?
SAC Units
?i
?
?
:?
BriarHill Homeowners Association
3800 Heather Drlve
Eagan, Minnesota 55122-1623
.
Apri19, 1999
Mark Stenseth
Mikki Chadwick
3830 Laruel Ct.
Eagan, MN 55122
Dear Mikki and Mazk,
This is in response to your request to have your existing deck extended.
You are authorized by the BriarHill Homeowners Association to extend your deck as
follows:
The deck can not extend further than the corner of the building and not extend
further out from the buildin,g than the existing deck. The new deck must be
cosmetically identical to the current structure. The must be built using 2" X 10"
treated joists and 4" X 6" treated supporE posts, with a deck flooring of 4/5 treated
cedar lumber which must be attached to the joists with screws, not nails. The
support post must be placed or seated on at least 48" frost footings or as per the
City of Eagan's building codes.
Please note the deck rr?ust comply with all City of Eagan's building codes.
Sincerely,
??4
Jon Moller
BriarHill Homeowners Association
Board of D'uectors
KOEHNLEIN 121IX1NiCOLLEI AVFNUt SOW H
.. PHONE (612) 8901272
BUfiNSVRIE, MINNESOTA 55337 ?
LIGHTOWLER cIiRTIFICAI'L OP SURVEY for CARL TOLLGfSON
JOHNSON
Lots 17, 18, 19 and 20, 131ock 1- BRIAR IIILL
1 » e oP . o..,E o Dakota County, Minnesota
ARCNITECTS RARGO, NONTM DAKOTA
ENGINEERS MORRIS, MINNESOTA
PHOENIX, ARIZONA
</ .
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o9,j
V r I
r-1?--
C'?{? .^.Lbb 4 fo? .
;2'o 05, ?sq"\tf
• "?n -C? ?.o:? --'IPl a?V,?>U ;??. `Y?';
Gl
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?' • ti'l',?`?;,, ?? ? ;C?.4 `
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„
,\\
I hereby cettify that this survey, plan or
report was prepared by me or undcr my direcc
supervision and that I am a duly ltegistered
Land Surveyor under the Iaws of che Scate
of Minnesota.
Date Reg. No??.,_
.4J .??.i..?•.?i ? ..?..?..? .?,.:...?.r,:?.?iiM. ? .?:J.. i ? ?...1. •.; ?'?i.?
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CIryY [iF i].iilaAN
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5210 ':,??f?I.)i "?Ji:-'I.'.
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205 9001 .•h:.Y'?Y
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? ? t. ?? I
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? ?ur.:.,.
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02; 0 900:. 3035 I...a'd.1X;::1_ t";r' G1
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TV.: . . ? ::
(;}2'.105f
1999
1?
New Conshuction Reaulrements
BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675 nn
3
Remodel/Repair Reauirements
? S registered sRe suneys ahowing aq. R. of lot, sq. ff, of house
and all roofed areas (20% maximum lot covernae allowed)
? 2 copies of plans (show beam 3 window sizes; poured Ind. design; ete,)
? i set of energy calculaiions
? 3 copies of hee preservatton plan M lot plalled afler 7/1 /93
DATE: S -aS '" 1!1r
2 copies of plan
1 sef of energy calculations for heated addffions
1 sRe survey tor exterior addNions d. deeks
CONSTRUCTION COST:
$
DESCRIPTION OF WORK: nP['_ L eA%0-hS ION
STREET ADDRESS: -315.?a Lavre 1 C+
LOT: ? BLOCK: Z_ SUBD./P.I.D. #: ?1A? JC7"A
st qoS--9VJS
Name: ftek;??sana!( Phone
PROPERTY Last First
OWNER . Street Address: 3 v 3P. L avrei Go(Jrr
CONTRACTOR
ARCHITECT/
ENGINEER
City L5kqa-4'-" State: /YIN Zip:
Company: Le141AD1Yl0r1 CON i-i[G44 hA Phone #: ?( ;L 7y,?" 79 7Q
(area code)
Street Address: DO TQT+?.? AlAt /?l! license #201-ISIXExp.,3 110
City V?0s1MDh;? State: /hN' Zip: S.S.?W
Company:.
Telephone #: area code ( )
Name:
Street Address: Registration #:
City
.Sewer 8 wafer licensed plumber (reauhed for new constructlon oniv):
Stcte:
Penalty applles when address change and lof change is requested once permN is issued.
Zip:
.1 hereby acknowledge that I have read this applicahon, state that the information Is correct, and agree to comply with ali appllcabl
State of Minnesota Statutes and CMy of Eagan Ordinances. l? ?
Signature of ApplicaM: •??` 40X-'
OFFICE USE ONLY
Certificates of Survey Received _ Yes
Tree Preservation Plan Received _ Yes
_ No
_ No _ Not Required
,-r-_
f"------- ?
L•i I?
' ? -
,-
OFFICE USE ONLY '
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Firepiace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea.
[3 03 1 of _ plex CE,.,OS 6-plex ? 13 16-plex ? 18 Deck i; ? 23 Porch (screened)
? 04 2-plex -,E]'-09 7-plex ? 14 Apartments ? 19 Lower'Level 24, ftrm Qamage
0 05 3-plex 10 8-plex O 15 Lodging ? 20 Pool 0 .25--ItiAisce9laneous
•.,
WORK TYPE '' ? •??'-' ..`~ ;
,• ? ?:i•?•. ? .. • ' ? .? s.
? 31 New ? 35 Tenant Impr ? 39 C?as Line Only' ? 4v3" 181knglSoffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert p 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove 0 45 Fire Repair
? 34•i?e¢rair, ??.,cC] 3$ ` Demolish (Interior) ? 42 Reroof ? e,
` `* Give PCA handout 1o a plicanAfor demolitior? p ? rmitl ?,
GENER%?h-.fRMi?-?N ?!t'j?Y,{?> ;-`?;??,N ,.?
Const. (Actual)
(Allowable)
UBC Ocau,pane?;^
r??
Zoning "
# of Stories
Length
WiBtft, ?'.? = i •"' :•
,
? • ? Bas
fit
t i
?
° o
'
us C
d
errT
.sq.
:. ? .?'r • r:.
e
e
is
o
q
S - f4 Main level'sq. ft. -SAC'Code _C) I
cz - 3 : sq. ft.
,;
ft No. o?, n?ts f;
.?
N
?ldg
sq.
. o. of
s O
sq. ft. MC/ES System
? sq: ft? .
_
? ? City Wateti
. Footprint sl????- ',n i •1", ?
?°± ;jqgstotTijmp
• ..
. ? ,., r?
Planning . •?.
PRV ii
Fire $'rinklered
?, ?
r ..?a f 4 " a ?. S.M ,•+. t1 +
:?. . .•- .'i ?<. S,'r: ? ?•? ? ?
. ? I.
Building r'• ? - Engineering t`t •`'',+'??/ari?ance
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
40
Valuation: $
Trails D.ed. ! ;
1
Other x - .. . ?-• • ?, •? ti.. • d
.? ?1 t x`, J t •.
Capies `
Total:
SAC Units
% SAC
i
BriarHill Homeowners Association
3800 Heather Drive
Eagan, Minnesota 55122-1623
?
May 7, 1999
Sandra Brekke
3832 Laurel Ct.
Eagan, MN 55122
Dear Sandra,
This is in response to your request to have your existing deck extended.
You are authorized by the BriarHill Homeowners Association to extend your deck as
follows:
The deck can not extend further than the corner of the building and not extend
further out from the building than the existing deck. The new deak rnust be
cosmetically identical to the current siructure. The must be built using 2" X 10"
treated joists and 4" X 6" treated support posts, with a deck flooring of 5/4 treated
cedar lumber which must be attached to the joists with screws, not nails. The
support post must be placed or seated on at least 48" frost footings or as per the
City of Eagan's building codes.
Please note the deck must comply with all City of Eagar2's building codes.
Sincerely,
/7,9-
Jon Moller
BriarHill Homeowners Association
Board of Directors
. - -.
KOEHNLEIN
LIGHTOWLER
JOHNSON
1 N C O 11 P O 11 A T[ D
ARCHITECTS
ENGINEERS
12700 NIC04l E I AyFNUt. SOI ITI/
PHONE (612) 890-1272
BURNSVILLE, MINNESOTA 55937 I
CGRTIFICAI'E OP SURVEY for CARL TOLLEPSON
I,ots 17, 18, 19 and 20, t3lock 1- BRIAR fIILL
Dakota County, Minnesota
FARGO, NORTM DAKOTA
MORRIS, MINNESOTA
PHOENI%, ARIZONA
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REWMWn ED
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I hereby certify that this survey, plan or
report was prepated by me or under my direct
supervision and that I am a duly Registeted
Land Suiveyor under the laws o£ the State
of Minnesota.
Date Reg. No? ,
`
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CITY USE ONLY
I PERMIT RECEIPT DATE: ?j- ? - C)
USID£NTIAL M£CEMICAL P"MIT APPLICATION _
crrYoF EAGM
. . . .3$30 fILOT-KNOS RD
.. , :• '_ _ ? . g,4ek1V'141N 5518E ' . 65t-6$1-4675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date:
SITE ADDRESS:
OWNER NAME: M G r
TELEPHONE #: (0 15 L-YOj - 0d !
(AREA CODE) ?
INSTALLER NAME: TELEPHONE #:
„ (AREA CODE)
?4^c?:??U-i?;:3
STREET ADDRESS:
CITY:
STATE:
ZIP:
. ..
Place a check-mark next to the aermit work tvpe -- -" -
_ New residentiaf dwelling unit under constructionand not owner/occupied $ 70.00
? Add-on diPicatiop or alteration to existin dwelling unit $ 50.00
• furnace replacement'-,
,
• air exc
• air conditioner ?
• other
Nature of work: ?(Z,/' rr_? C(
State Surchar e $ .50
Tota I s !50 =?
Reminder: Call for inspections.
MAR a1- z001
TURP
Updaled U01
PERMIT # 4IL;-3
RECEIPT DATE: 7 ? -() I
fiUIl}ENT[AI. PLUbI$IN6 PUMTT Af'PLICATION
crrY oF EAem
S$SO PILOT KNOB gD
EAsArt, hfx 55122
651-6$1-4675
Please complete for:
SITE ADDRESS:
OWNER NAME: :
INSTALLER NAME:
? single family dwellings
? townhomes and condos when pertnits are required for each unit
? backflow preventer for irrigation system
TELEPHONE #: S? 9y3- 41163
(AREA CGDE)
TELEPHONE #:
, -' ? I (AREA CODE)
STREET ADDRESS: `/
'L ?,-` ?i ?,C? e,
CITY: ?a?&e STATE: ZIP:
Place a check mark next to the aermit work tvae
?Mw
_ New residential dwelling unit under construction and not owner/occupied $ 90.00
S? Add-on, modificat? or alteration to existin dwelling unit, including: $ 50.00
• abandonment of septic system
• new installation/repair/rebuild of RPZ
• lawn irrigation system -
• water turnaround
?'-l
?"_ '
EuV"
Nature of work: V(SU- ?'Y\
, .
,
_
.
1
_ SepticSystem,new/refurbished - JUL 1?200 225.00
• includes County & Consulting Inspector fees
• requires NiPC iicense
?' -- :_•_
__
State Surcharge $ .50
Tota I
Reminder: Be sure to scheduie inspections of alterations, i.e. water heaters, water softeners, etc.
I hereby acknowledge tnat I have read this application, state that the information is correct, and agree to complywith all appticable City of Eagan ordinances. It
is the applicant's responsibility to nolify the property owner that the City of Eagan assumes no liability tor any damages caused by the City during its normal
operational and maintenance activilies to the facilities constructed under this permit within Ciry property/right-of-way/easement.
SIGNATURE OF PE MITTEE
Updated 1101
SINGLE FIMILY DWELLIHGS
2 3ET3 OF PLINS
3 BEGISTERED SITE SQR9EYS
1 3ET OF ENERGY CgI.CS.
1989 BUILDIHG PERIM APPLICATION
CITY OF EAGAN
lATLTIPLE DiIELLINGS
2 3ETS OF PLANS
REGISTSRED 3ITE SIIR9E23 -
(CHECg WlTH BLDG DIV. )
1 SET OF E9EAGY CALCS.
C01MRCIAL
2 SETS OF ARCHITECTURAL
& STaOCTQRAL PLANS
1 3ET OF SPECIFIC9TIONS
1 3ET OF F•NERGY CALCS.
MULTIPLE DUiELLINGS AENT9L t1NIT8 FOa SiLE IINITS ? i OF QNITS
lIOTEs ADDAES3E5 FOfl CORNER LOTS - CONTAACTOR/H0ME0{iNEA HD3T DESIGNASE iiHICH ADDAE55
IS DESIRED. RO CHANGES iTILL BE ALLOi1ED Od1CE BUILDING PERMIT I3 IS3IIED..
SEWER & WgTEA PERMIT F'EES AND ACCOUIiT DEPOSIT FELS iTILL BE INCLUDED iTITH THE SUILDINa
PERMIT FEE. PROCESSING TIME FDA 3EWER AAD WgTEA PERMITS IS TiTO DAYS ONCE d PEAMTT HAS
BEEN CONlPLETED INDIC9TIHG A LICEN3ED PLO!'IDEA.
PEN<Y APPLIES 4dHER1: PERP9IT IS AIOT PAID FOR YN S&ME MOIdTH IT Y5 REQOESTED.
LOT C8AP8GE IS REQIIESTED OIdCE PERMIT IS ISSITED.
(. WZ`„ I?+L) ?6a'??'`,??r?o?
To Be Used For: ,?,b ('/I/ Aa'l.?? Valuation, . ?SS Date: $r"/),?
Site Address 7$ 29 40y?t4*1- GeT,
Lot ?u Block I
Parcel/Sub KkIa•Q HIUL
owner ,ot?o kr*d ?ag*,?,
dadress
City/Zip Code /.,qc??r?^'•
Phone
Contraetor GRW)T7? ?f 04A"i.
Address 41t1 5r2EF77-
?
City/Zip Code /GD,S?'?d??-T ??te•,
Phone
Arch./Engr.
Address
City/Zip Code
f co0-
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F.
On site sewage
On site xell _
MWCC System _
City vater _
PRY required _
Booster Pump _
APPR0o9LS
Planner
Couneil
Sldg. Off.
liariance
FEES
Bldg. Permit 96•00
5ureharge .S?
Plan Review
SAC, City
SAC, MWCC
Water Conn
Water Meter
Acet. Deposit
S/iJ Permit
S/ft Sureharge
Treatment F1.
Road Unit
Park Ded.
Copies ,2 ,OJ
3DSTOTAL
Penalty
TOTAL
Phone 0
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City of Eapn
3530 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax:(651)675-5694.
? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ?
I For,Cjff,Fe Use ?
? Permit #: (> ? ?I / j :
? ??J`, ?
? Permit Fee: 5 , o G
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? Date Received:
I I
I StafF. ?
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-----------------?
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 4l 3lo g Site Address: W?Z' A 2 ?41LL Tow ,? /-fo H.., L S
Tenant:
Suite #:
RESIDENTlOWNER Name:Cla 6l550c„4;10.J f;.?.+?e,?yz 0444641,lL'?7- phone: ?43,Y5y-3?R7
Address / City / Zip: 3 g X4 Z`s,,nrc eT,
Applicant is: _ Owner X Contractor
TYPE OF WORK Description of work: n£ Gl?
Construction Cost: y/ D"0. d v Multi-Family Building: (Yes X / No
CONTRACTOR Name: l3 £/ lfx rLtLi o2 Z-2P. License#: Ic- R y// 3 1
Address: y4 -S" L..1.
City: /77 y"L 5. State: M,? Zip: SSV? 9
Phone: Contact Person: b"E 4L Rai S
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
(4 submission type) • Energy Envelope Calculations Submitted
in the last 12 months, has the City of Eagan issued a pertnit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans`and supporting: documents that you submit"are considereal to,be public rnformation.. Portions of
the information may be classifietl as`'non-pu6bc if you provide specific reasons that would permif fhe;City to :
conclude thaf the are trade`secrets. ..?° A
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 wor 's not to sta out a permit; that the work will be in
accordance with the approved plan in the ca n f%WypCry?iqtrre?u ?' w and approv of ans.
?S l? LE'
x L9 LJl l? d +L dLs2i_5. T X.
ApplicanYs Printed Name 3 2Q?j Applicant's 5ignature
Page 1 of 3
.A . .
% DO NOT WRITE BELOW THIS LINE. .
SUB TYPES
` ? Foundation ? 05-plex ? 16-plex ? Accessory Building ? Pool
? Single Family ? 06-plex ? Fireplace ? Porch (3-season) ? Ext. Alt - Multi
? 01 of _ Plex ? 07-plex ? Garage ? Porch (4-season) ? Ext. Alt. - SF
? 02-Plex ? 08-plex 0 Deck ? Porch (screen/gazebo/pergola) ? Multi Misc.
? 03-Plex ? 10-plex ? Lower Level ? Storm Damage
? 04PIex ? 12-plex ? Miscellaneous
WORK TYPES
? New ? Interior improvement ? Siding ? Demolish Building*
O Addition ? Move Bu ilding ? Reroof ? Demolish Interior
? Alteration ? Fire Repair ? Windows ? Demolish Foundation
? Replacement ? Egress Window ? Water Damage
' Demolition (entire building) - give PCA handout to applicant
DESCRIPTION:
Valuation 30I0 . o'T? Occupancy T_J?C - I MCES System
Plan Review Code Edition 2CIE> 7 SAC Units
(25%_ 100% Zoning City Water
?
Census Code y 3
t Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Const. Width 149
REQUIRED INSPECTIONS
Footings (new bldg) Sheetrock
? Footings (deck) Final/C. O.
_ Footings (addition) ? FinaUNo C.O.
Foundation HVAC
Drain Tile Other:
_ Roof: _Ice & Water _Final Pool: _Footings AidGas Tests _Final
_ Framing Siding: _Stucco Lath _Stone Lath _Brick
Fireplace:_R.I. _Air Test _ Final Windows
_ Insulation Retaining Wall
Reviewed By: Building Inspector
RESIDENTIAL FEES:
Base Fee
Surcharge
Plan Review
MCIES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
Total
- • Page 2 of 3
? • t
"KOE?HNLEIN
LIGHTOWLER
JOHNSON
1 N C O R P O R A T L D
ARCHITECTS
ENGINEERS
12700wGOLlE[ nVF.NUE ;Oii114
PHONE (612) 890-7272
BUiiNSwLLE, MiNrJESOTA 55337 (
CGRTIFICA7'E OF SURVEY for CARL TOLLGPSON
i
Lots 17, 18, 19 and 20, alock 1- BRLAR HILL
Dakota County, P9innesota
FARGO, NORTH DAKOTA
MORRIS, MINNESO7A
PHOENIX, ARIZONA
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I hereby certify that this survey, plan or
report dvas prepated by me or under my direct
supervision and that I am a duly 22egistered
Land Surveyor under the laws of the State
of Minnesota.
??
?ozb
,3S3-Z
v fLe l ,
Date Reg. No.
tAU?"1 G
. ?EvoEWED oa?
?
08/12/2011 13:58 6128616267 BEI EXTERIOR MAINT PAGE 01
.
/10/1 '7
please, coal Use BLUE or BLACK Ink J
+arnctivn+ r .rtd wet I MWON&tbe t
PennR
of Eajan ~-7. I ! a }
I Permit Fee:
3830 Pilot Knob Road
Eagan MN $5122 12'~ 0 l - `f ffl Date Received 1
Phone: (661) 67&4676 mss: l star
Fax: (661) 6764684 I _
2
4
010 RESIDENTIAL BUILDING PERMIT APPLICATION Fe
Date: S //2 / t Sloe Address: 382(- 3528 - 3834 - g3~ L.sv2~Z. ('J~~~~r
Tenant: Suite it:
RESIDENT I OWNER Name: ~o A0xx+srn07✓ F.~irr✓ /He+~s~T Phone: 76 3- i9VV - 37,2 7
Addmss l Cdy / Z"ip: R"_ Ff5w 1,,4.16E A, Af/ _,1f- AW0_ AAA O5 311
Applicant is: Owner L Contractor
TYPE OF WORK Description.ofwork: Rw2mo_k/E #Ald R'6pG~Y~ IeIJUF
Construction Cost -it. 000 Multi-Family Building: (Yes / No __j
CONTRACTOR Name: gEi r 7 °ip(Z M.EkNT. Cv)2P License
Address: fZ26 T City amAo2!2fo1,rf
state: 1~ A~ Zip:.~SS Phone:
Contact: J-4y10 Ernati: che/ x z . Ca/ 7
COMPLETE THIS AREA JQNLY IF CONSTRUCTING A ,N,,,,M 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:
Sawer & Walter Contractor: Phone-,
NOTE Plans erid si p,p&n9 dkVMwft dtatYw Saba* am cons/dww to bo pubme MfomMadon. Poffim S of
> fitl'ornIatJor► any be classbigal sa 'W6 ib/Jic Il`YOU p speclt torts aw wow PetfMN the City to
oortcltloliA►:am are *we twi"L
C~ LL BEFORE Y U DIG. Cali Gopher State One Call at (651) 45"002 for protection against underground utility damage.
Cali 48 hours before you intend to dig to receive locates of underground utilities. Q ed)necall.ora
I hereby acknowledge that this Information Is complete and accurate: that the work will be In conformance with the ordinrancos ana 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 parmlt; that the worts will be in
accornence with the approved plan in the case of work which requires a review and approval of piano.
x C~iQI S r4N1~~~z'j~
Applicant's Printed Name Applicant's Signature
FA XAF0 Page 1 of 2
!/_1 Z 1r COPY
Use SLUE or BLACK Ink
.
For Oflloe Use
Permits; I
~ . Z
MY of Wan I Permit go&
I i
3830 Pitt Knob Road
Sagan MN $6122 j Date Receiw d: j
Phone: (651) 6754CO t 1
Fax: (661) 076-4694
~ Staff ~
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: "J Site, Address; I V1 6, 3ITA C. 310 o, 0,3 231 4.4 Lj. t L C -T. Unit y:
Name:c o Fd C: 7' /y1 r4~J 4fn;,P MBAJ ; x,~C vs •s"~i3 9770
Phone. 7l
bvl~ler . Address / City / Zip: VS0 G v e Al ' ,Z p _604h Z ► VnK4t4_j
Applicant W. Owner ~ Contractor
TYP ;iL?f, f, Description ofwodc `7".~.•1~2 OIGf^ e> 2E "Y of-
Construction Cost: Q Multi-Family Building` (Yes No
Company: GCE 1 ExrEa"oR N47,a; . &ZP Contact -hAW h %vQjk r 5
ev.
crt Addres6: ~a tti1 6 i~ ~0? . City: PG s .
State: ZIp: Phone: G'~it - g6 / Z'/3
•1,4 •
License 49C A q) / 3 / lead Certificate 0:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
. '~~c.~eas ~21.•QutLr Pos: ! p7 fl
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW UILDING
In tlw last 12 months, has the city of pagan 1=49d a permit fora similar plan based on a master plan?
.,.._Yes ,No If yes, daft and address of masfar plan:
LlrenwW Plumber Phone:
Mechanical Contractor. Phon-
Sewer & %trr CyontracCor Phone:
~.~;jyy ~!ry'!W~•'~ I M~~ I may.
.A%:r•" ,i~•~!`~.~'C qy~l r`.1. p.,... ~ .•l.If.v
CA~s.~~G YOU OIG. ~ - ' ?
pher StA/e ono Gatt et 681 4S4.p002 for protection against underground utility damage. Call 46 hours
beMre you utbsnd to dig to recevVe locates of underground utllkies. o
^
Il.o
I hereby acknowledge that this Intormatlcn is complete and aawrdte; that the work wdl be in conformmnoe with the ordinances and codes of the City of
Eagan: that I understand this is not a pew, but only an application for a permit, and work Is not to start without a pwrdt: that the work will be i6
ocrwnianm whh the a rwved ran In ire case W work wnioh raquk a a m view and dppmvar of plans.
EKC'rlor work auth*rb*d by a building Wink Issued in accordance with the Minneecta
days of pem* muence>< Strafe Bulldcn Code moat be wmpiamd witlmin 180
. >~~rqv~~ ~+a22~s
Applicants Prinfad Name x
Appllcatnft Signature
Page 10(3
5O/TO 39Cd 1NIVW 1X3 139 L9Z9T98ZT9 E5:5T ETOZ/bZ/OT
Use BLUR or BLACK Ink
For Office Use I
My Permit
of Eajan Permit nee: 19 13.0
3830 Pilot Knob Road
Lil-
Eagan MN 55122 i Date Received: ( I
Phone: (651) 67Sd5675
Fax: (661) GTS-6694 staff_ I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ~Cy 3r - l3 Site Address. -3 8x1-,38Xf, 3830, 3$3,2 JAUREL 611-, Unit 0:
Name: L3'/& 4C Phone:763 - S S3- 977o
R16'* UAddress/ City t dip: gso Dzcw7'V2 Av ~ lA Ga4DE.~ 1144,L-cr WA)
Quitner
Ss wl 7
Applicant is: Owner ,Contractor
Descrlption of work: L a- ~ £ P L 4 In t 7, 4 4G
Tp: of!1gri:
Construction Cost: an, cro Multi-Family Building: (Yes No )
S
Company: r CA--l o A JY~id ~ aY . Cv RP Contact 64 fl J3-/2..,2)
Address: I/cam W 100 City: /tiI PL S
State: zip: S$'~// r1 Phone Lor - (o ! - 1 y3
License G 4// 3 f Lead Certificates
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
I~L"ra,r poS;- JF?
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:
MOTES Rlahs. a6d` ~
ser . d9,00M. a tt iis~►r C r ~coo$ . [i<'t+O ;Pa~l~~~ ►~Nof
i
_
the lnforms2eon.: .be.e~ssifl' ;ngrr• It:rif` ~ vI :s e~t#1t!!aa'~Iirs~>..
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 4154-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities, www•aooherstatsonacall.oro
I hereby acknowledge that this information is complete and accurate; that the worts will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan In the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued In accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x ~4✓, 0 S x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
TO/TO 39Gd 1NIVH 1X3 139 L9Z9T98ZT9 TZ:60 ETOZ/T6/0T
41/)P
City of Evan
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use �
Permit #: I / j
J 7 -7
Permit Fee: &0-0c),
Date Received:
Staff:
2015 RESIDENTIAL PLUMBING PERMIT APPLICATION
Site Address: a 6vi- �lzf
Tenant: Suite #:
Name:
Address / City / Zip: 3g ;Z 1-.4JPOH eat ?'
Phone: 6t—Yo.2 —.3Si1
Name: AAA (>46 rayl �es5-r'P-4,C.
License #:
Address: CI ra ✓�- ZI City: S: 5rpA-4..) �-
State: 4,tA9 Zip: sd7 Phone: X5-1— 4/5-1- 3g6
Contact:140 (P
Email:
_ New )(Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W.
Description of work:
RESIDENTIAL
( Water Heater
Lawn Irrigation (_ RPZ / _ PVB)
Septic System
New
Abandonment
Water Softener
Add Plumbing Fixtures ( Main / _ Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes State Surcharge)
$60.00 Lawn Irrigation (includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes State Surcharge)
"Water Tumaround (add $280.00 if a 3/4" meter is required)
$115.00 Septic System New (includes County fee and State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One CaII 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
1 hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
D f cess K
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Applicant's Printed Name
Applicant's Signature