4338 Leo Ctr ^1?^' INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road
Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
i . . i 4 H--i ? . ? 1 0 0 t
SITE ADDRESS: i n i i t; i f? r r i APPLICANT:
PERMIT , .?URTYPE: TYPE OF WORK: ?
? ??: ,,M?.;,; ?•nrrz ?
I
INSPECTION D. • D•
I
I
I
I
I
F
L
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Permit No. Permit Holder Dete Telephone #
ELECTRIC
PLUMBING
HVAC
Inspectfon Date Inap. Commenta
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIH TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAI PLBG
FINAL HTG
OASAT
TEST
BLDG FINAL ? .J?pn
I L Gfw?
/Yl
l .
BSMT R.I _ I
_ -
-
BSMT FINAI ---- ? ---
DECK fTG
DFCK FINAL
PERMIT # lG ??a
MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN ?
3830 PILOT KNOB ROAD, EAGAN, MN 55127 DATE:
CONTRACT PRICE:
SiteAddress ``'
Lot / )- Block
y I?sO
A Add
c City
Name }n -1.n_rL
3 Address
p City Phone
TYPE OF WORK
Forced Air M BTU
Boiler M BTU
Unit Heater M BTU
Air Cond. M BTU
Vent CFM
Gas Piping Outl-Fe-b? # Y-
Other
FEE:
S/C:
TOTAL:
BLDG.TYPE
Res. .?
Muit
Comm.
Other
WORK DESCRIPTION
New ?
Add-on
Repair
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
SIGNARURE OF PERMITTEE
?.
FOR: CITY OF EAGAN
CITY OF EAGAN Remarks
Addition WILDERNESS PARK 2ND ADDITION Lot 17 Blk 4 ParceI 10 84251 170 04
Owner U(i" I`, t Street 4338 Leo CouTt state Eagan, MAI 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK a, t.,A. , a A U f.. 13 ' 6
SEWER LATERAL
WATERMAIN
WATER LATERAL
* WATER AREA 1979 753.41 7$.34 10 t5 . oj?gq?o /-/3 -
dk STORM SEW TRK 1979
STORM SEW LAT -
,
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road Unit 260.00 #4725 10-2 -8
WATER CONN. 470.00
BUILDING PEF. 9649 n ?r
SAC 525-00 n r.
PARK
CASH RECEIPT
CITY OF EAGAN
P. 0. BOX 21-199
EAGAN, MINNESOTA 55121
DATE
RECEIVED
19
AMOUNT $ I
& DOLLARS
+oo
[]CASH F?CHECK
• ?./ //// ?
FOR
BY
White-Payers Copy
Yellow-Posting CoPY
Pink-File Copy
Thank You
Receipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN
Fas. ,
fi/l in numbered spaces 5/C
Type a Print legiblY Tot
1. Date 2. Installation Cost
3. Job Address Lot?Blk. ?-( Traci
-?
4. Owner
5. Contrector Phone -
6. Address
7. City _ State Zip
8. Building Type: Residential 0, Commercial ? Institutional ?
9. Work Description: New ? Add ? Alter ? Repair ?
10. Desaibe Fuel Type
11,
Na. Fquipmenr BTU - M. Ea.
Forced Air ? No. Equiament CFM
Air Handlin
:
Mfg. g
Boilers
_
Mfg. _ Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gea, Piping Outlets
12. I hareby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Final
Inspections: Oate Insp. Date Insp.
This is your permit whan numbered and approved.
Approved CITY OF EAGAN 464-8100
. . .... .-u:Gr
y CITY OF EAGAN 9649
' 3830 Pilot Knob Road, P.O. 8ox 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt #
Te 6o wed Fer SF ?%':JG/CAZ F.# vM". 579. UG:i n..,e OCTOBF.R 25 i0 84
SiteP,ddre?s 4338 LEO CT
Lot I/ elock 4 Sec/Sub. WILD PK 2
Parcel No.
? ?. i L•ar,r..?G1? 4VpJa 1lVV
W Name
Z Address
? M `c' Phone ' 5 4
City
S. PFTERSEN CONST INC
O Name
Z? 4 7 1l1 ?•? 1 7 ;:-„ ,.'r:
uu Address - - - F- City Phone
I hereby acknowledge that I h
the iniormation ii correct an
State of Minnesota Stotutes ?
Siqnature of Perm?ittee -
A Building Permit Is issued to:
oll work shall be done in acco
Buildinp Official
Phone
and
Erect `'I Occupancy
Remodel ? Zoning
Repair ? Type of Const.
Enlerge ? No. Storie
Move
? ?
Length
Demolish ? Depth
Grade ? Sq. Ft.
Appro vals Fees
Assessment
Water & Sew.
Polica
Fire
Eng.
Planner
Countil
Bldg. Off.?
APC
Permit
Plan check 185.00
SAC 525.00
Water Conn.470.00
Water Meter _ a
Road Unit
*t co??y
?? . 50
Total ?,1,9113.0
- on the express conditlon tha+
oll opplicoble State of Minnesota Statutes and City of Eagcn Ordinances.
Permit No. Parmit Holder Date
Plumbing -
H.VA.C. G9
Electric
Sohener
Inspection Date Insp. Other
Footings 3
Foundation
Framing ./Y- J
Rouyh Ping.
Rough HVAC ,?'
Inwlation ?-? 'oe
Final Plbg. ??7 8
Final HVAC
Final
C.n,oce. C64- (410-) r
Water Deseri6e Loca n:
Wal I
Sawer
Pr. Disp.
Receipt?
,
PLUMBING PERhAIT.
CITY OF EAGAN
I Fil1 in numbered spaces
Type or Print legibly
1. Date 2.
3. Job Address
4. Owner
Installation Cost
Permit No.
Fee
S/C
Tot. •
Lot 81k. Tract _ J!^-
5. Contractor Phone
6. Address
7. City ' State I Zip
8. Building Type: Residential ? Commercial ? Institutional ?
9. Work Description: New ? Add ? Alter ? Repair ?
10. Describe
11.
No, Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
_ Bath tubs Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet
Laundry Tray Other
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
wmply with all ordinances and codes governing this type of work.
Signed : for
Rough final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CtTY OF EAGAN 454-8100
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road pERMIT NO.:
P. O. Box 21199
Eagan, MN 55121 DAT??
? ?ing: No. of Units:
Owner. ..A . 1'-teraera CeC.ar_
Address:
Site Add
Plumbec
'.4 wiZ-))
1 pno M aanVly wiM !ho Cihr oi Esyae
Ordlmeea.
By
Dote of Insp.:
I nsp.:
CITY OF EAGAN
3830.Pilot Knob Road
P. O. Box 21199
Eagan, MN 5512;1
2oning:
Q„ner. Svend
Addrcss:
Site Address:
C
ConnscNon Charpa: 14 2 ' , 00
AecourM Depoait: 4 ? ? `.
ParmR Fee: , ,t,
Surd+a?9a:
Misc. Charoes:
Totol:
DoM Paid: -
WATER SERVICE
PERMIT NO.:
DATE:
- No. of Units:
Conet
emess ra
No.:
eader No.:
sgree M ewnVM whh Mm CitY of Eegan
of Insp.:
Connection Chorge:
AccoVAt DepoSit: ?
Permit Fee: _
Surcharge:
Misc. Charges: -
Totol;
Date Paid:
Insp.:
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilct Knob fload
P. O. Box 21199 PERMIT NO.:
DATE:
Eagan, MN 55721
Z?ing; No. of Units:
.`Owner:
Address:
a :.,
t?w??'•:
? 11,4 ;a3 ac :.
L
Site Address:
`
Wumber:
Meter No.: 3 9617a' S3 Connection Charge: pG pr,
'
Size: ? ••/gac%? - Acaount Uepostt: ?
Reoder No.: D? L ?C3F 0 _ Permit Fee:
1 ayrem to eomyly wilh FM Cih of Eagas Surcharge:
-
Misc. CharQes: !
Total:
D
P
id:
By a
ate
of Ins
:
t
D I^SP•:
p.
e
o
/ - / 6 - b O `J
LJ.VV VV
PERMIT
,
- ' CITY OF EAGAN M 9649
3830 Pilot Kno6 Road P O. Box 21-199- Eaaan. MN 55127
PHONE: 454-8100
BUILDING PERMIT rteceipt
To ba used for SF DFX'/GAR Est. Volue $ 7 9, 0 0 0 Date OCTOBER 2 5_ 19_$4
SiteAddress 4338 LEO CT Erect ? Occupancy R3
Lot 17 elock 4 Sec/Sub. WILD PK 2 Remodel ? Zoning
Parcel No. Repair ? Type of Const. V
Enlarge ? No. Stories
S. PETERSEN CONST INC Move ? Length 7
?
Z Name
4701 W 110TH
ST
Demolish
?
Depth 28
Address MPLS 884-5144 Grade ? Sq. Ft.
city Phone
? Name S. PETERSEN CONST INC .
su Address 4701 W 110TH ST
City MPLS Phone 884=5144
Name _
Address
City -
Phone
I hereby ucknowledge that i hove read
ihe in}ormotion is wrrect and agree
Stote of Minnesoto Stotutes and Ci,?6
Sipnoture of
A Building Permit is issued to:
all work shall be done in acco
Stion and stote that
with all-at-oriiabla
Approrab Fees
Assessment
Water & Sew. .
Police
Fire
Eng.
Plonner
Council
BIdg.Off,10/25/84
APC
Permit a 31U. V U
Surcharge 39.50
Plun check 1 85- O 0
5qC 52 5_(] 0
Water Conn. 470.00
WoterMeter 63.00
Road Unit 260.00
*gw(copy) '.50
Tocal Tr,--913.00
S. PETERSEN CONST INC on the express condition that
rit,1? oll applicablr'S'fato?of Minnesota Statutes ond City of Eagcn Ordinances.
8uilding Officioi
?'ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN .`'
? INCLUDE Q SETS OF PLANS,
? CERTIFICATES OF SURVEY
0 SET OF ENERGY CALCULATIONS-?
To Be Used For: 5r.DW?1G?pwaluation: 19L000__ Date:
Site Address: ??3? ?eQ ?'?, , ? ? ?k
?lliL iCN ?'>
Lot: /7 Block: ySect/Sub:F,aP-rs nv Erect: )C Occupancye
Parcel #: Remodel: Zoning_
Repair: Type Of Const:
Owner: Enlarge: # Stories: ?
Move: Length: 1 Z
Address: ?f7o / Grl Demolish: Depth:
City/Zip Code: 37 Grade: Sq. Ft. : U,;
Phone # :
Contractor: " " • ' ?
?
Address: Assessments: Permit: 370e? l
City/Zip Code- Water/Sewer: Surcharge: 3`?.SOT
Police: Plan Rev.:
Phone #:^ Fire: SAC: 525,°? ?
Engr. : Water Conn: ¢lp
Arch./Eng:_ Planner: Water Meter (o3.2O?
Address: Council: f, Road Unit: 21op.°°?
Bldg. Off.: Parks: ?
City/Zip Code: APC: sa
Phone#: variance: ? // /3•D a
minnesota State Hoartl ot tlectnctty
1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703
R+EGUEST FOR ELECTRICAL INSPECTION
CHkK BELOW WORK COVERED BY THIS REOUEST
P 77344
'Fype of 9uilding New Add. Rep. Check Appliances Wued For Check Equipment W'ved For
Home ? ? Range ? Temporary Wiring 55
Duplex ? ? Water Heatei ? Lighting F'uctures ?
Apt. Bidg. ? ? ? Dryei ;," i V r' j0 ?
' Electric Heating ?
13
Comme:cial Bldg. ? ? ? +!
Furnace' Silo Unloadei
[ndustrial Bldg. ? ? ? Bulk Milk Tank ?
Fazm ? ? ? List List
Other
?
?
? Others
Here ? Others
Here ?
COMPUTE INSPECTION FF.F. REI.OW
Service Entcance Size: # F Feeders&Subfeeders: # Fee Cucuits: # Fce
0 tc 100 Am s. .? 0 to 30 Am eres 0 to 30 Am eres
101 to 200 Amps. 31 to 100 Amperes 31 to 100 Am res
Above 200 Amps. Above 100 Amps. Above 100 Amps.
Trahsfocmeis Remote Control Circ. Partial or o[her fee
Signs Special Ins ection Minimum fee $5.00
Remazks TOTAL FEE
1 S
I, the Electrical Inspector, hereby? `?' fy t v i ection has been ma??
(Rough-in) ? ? Date
(Final) r Date
This request void 18 months r
'I7ris reque5t void 18 months from
Date of this Request ?- d?- 7- ?/ ? 77344
l, as Licensed Electrical Contractor O Owner, do hereby request inspection of the above electri?
cal iring installed at: 7j J-3i(.? CL-
Street Address or Route No.
Section Township
Which is occupied by
Range County
Is a ioughin inspection required on this job? NoA Yes 0 Ready Now,,K Will Call ?
Power Supplier 4240-- _49.riLtGtiAddress 'T
Electrical Contractor Contractor's License No
(Company Name) ?f
(/
Mailing Address 20 yff ? ? ,c?,/?,Qit?sf AdZI-1
Authorized Signature
(Electrical Contractor or
....,
Phone Na
(??j'Q?? This inspection request will not be accepted by the
7j ?J ? ? State Board unless proper inspection fee is enelosed.
REQUEST FOR ELECTRICAL INSPEC710N ee-ooooi.oe
, See inslructions for completing this torm on back of yellow copy.
A nl7#211 "'X" 8e/aK;;Work Covered by This Request
Mev- Add Rap. Tyoe oi Building Apptiances Wired Equipmant Wired
Home Range Temporary Service
Duplex Water Heater Lighting Fixtures
Apt. Building Dryer Electric Heatin
Commercial Bldg. Furnace Silo Unloader
Industrial 81dg. Air Conditioner Bulk Milk Tenk
Fafm Othp,r Peci y Other fSUecify)
t r,r peci y ther Oth¢r
Comnute /nsDection Fa.e Belnw
M Fee Servic anceSize M Fae Feaders/Subfeeders N Fee Circuits
j ? ?to m s 0to30qm s d.? 0to30Am s
Above 200 Amps 31 to 100 Amps 31 to 100 A s
Swimming Pool Above 100_Am s Above 100_Amps
Transformers Irrigation Booms i Pa her Fee
o,..
.._,?_ _ Signs Special Inspection
.. _ . $ ??,5 TOTAL EE
?-U
[Fi h- n El el ? pector, herehy ertify that the above al p Da1e *espection has baen
Thie raouest void 19 monMS trom
., s d4ues, ..o,d t( Y 5 r ?/ r d- a-U - 6 y
18 months from . e4 0.-M211 LI 716_1( 6j,'Id Pe Z_ ?a).ov
Renypst Date
?'} ?„ Fire No. Rouph-in Inspection
Req ired?
?Ready Nuw ilI Notify Inspec-
/I -'"j 7k ?ves ?No or.When Ready
Licansed Elec[rical Contraitor I heraby request inspection of above
Owner electrical work inatalted at:
Str et?Address 8ox or Ro te No. Citv
'3 x e 9 4 ?
or ,4o.
Occupant PRINT) ' Phun No
!?, 'p, )-7 GonS ?ruu??o ? Jr'/ yy
-- ? ?
El e t ical Contractor ICompanv Name) Contracmr's license No.
R & r R D? ?L O O
M
ailing AdJress IContractor or Owner Making
Instailationl
n
,h ?!
190 N J J
Authored Signature ont od0 r Making I talla on Ph
on
e
Number
"
?
V V^
/
f 02
MINNESOTq STATE BOAflD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
GriB9s-Midway Bldg. - Room N-187 BE ACCEPTED BY THE STpTE BOARD
1827 University Ave., St. Paul, MN 65104 UNLESS PROPEH INSPECTION FEE IS
Phone (672) 297-2711 ENCLOSED.
PERMIT
CITY OF EAGAN BUZLDING
3830 Pilot Knob Road PERMIT TYPE:
Eagan, MinnesOta 55122-1897 Permit Number: ?????' ?
(612) 681-4675 Date Issued: 06 /24/ 96
SITE ADDRESS:
P.I.N.: 10-84251-170-04
433$ 1.E0 CT
LOTe 17 BLOCKe 4
WILDERNESS PARK 2ND
DESCRIPTION:
RFRnnF
STORM DAMflGE
REPAIR
434 ALTe RESIDENTIAL
REMARKS:
FEE SUMMARY:
tiR??.• "?ey??rsax?Pi.e
?
k'
rs?er? ci?..sA<???,?'?aww`zae rtl
CONTRACTOR: - APP1icant - ST. LIC.?WNER:
OAVID WE88 CONS7RUC7TCiN 18613002 6887 BERGSTROM HERB
711 0 18 AvE 4338 LEO CT
RICHFIELD MN 55428 EAGAN MN
(612) 861-3002
APPLICANT/PERMITEE SIGNATURE
IA4? r
ISSUED BY: IG IATURE
CITY OF EAGAN
0 S 3830 PILOT KNOB RD - 55122
?? ? 1996 BUILDING PEaMIT APPLICATION (RESIDENTIAL)
681-4675
NPw Construdion Reauirements RemodeUReoalr Reauirements
? 3 registered site surveys ? 2 copies of plan
? 2 copies of plans (include beam & window sizes; poured fid. design; etc.) ? 2 site surveys (exterior additions & decks)
+ 1 energy calculatfons ? t energy caleulaHons for heated additions
• 3 copies of tree preservation plan H lot platted after 7/1193
required: _ Yes _ No C,
DATE: CONSTRUCTION COST: o ?
DESCRIPTION OF WORK:
STREET ADDRESS:
LOT ? BLOCK ?
a
S
0" Led C
SUBD./P.I.D. #: -YLe34,
PROPERTY
owNER
CONTRACTOR
ARCHITECT/
ENGINEER
Name: 1 E r? n .llv
Street Address• ?{ 7'? ? (T C
Phone..#:
Gity: L 4.. '1 vD State: -,&--IL Zip:
Company: LOLIVIr?l- Phone
Street Address: O- License #: 31
oy
City: /Z IC 4% •, (OI State: ,,/ ? /v Zip: ? J- Z?.? ?3
Name:
Company:
Registration #:
Phone #:
Street Address*
City:
Sewer & water licensed piumber:
change are requested once permit is issued.
State: Zip:
Penalty applies when address change and lot
I hereby acknowledge that I have read this appiication and state that the information is correct and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: r
OFFICE USE ONLY
.
Certificates of Survey Received
Tree Preservation Plan Received
_ Yes No
_ Yes _ No
; _,,,.qertificate fpr:
• Dunn.& Curxy
Svend Peterson
4701 Weat 110th St.
Bloomirigtons ?' DELMAR H. SCHWANiZ
LANDSURVEVpR
ReqistpM Untlar Laws of The Stals ot Minnesota
2878- 146TH STREET W. - BOX M R08EMOUNT, MINNESOTA 66088
S 43°5(?'op ?
59. 7?
5?
w I
?0 I
0
13 I
?
ZI
SURVEYOR'S CERTIFICATE
N -
?
k-J
?
( joa. i
?n I i'01
? rya` Q4
P
/a 3u?3 - p ?' lns. 3 R.
?o/ N - os ,? o y?Pos?o
zY ?2
6
•s
? A?
"1b/ /ob.13
99. ? d o ?,yNa
?t
d-
qd.?q ? R=?a 9?8 ?a
T?'??na6 ?j R?y
? by : ?
t?° aya9
C ??R
? Houee ataked Oetober 10, 1984
?
',
w-' '
MINNESOTA REGISTRATION NO. 8$25
3c;
N
Scdl e
Elevations shown are
o 111?existing
?
? I hereby cer•tify tl$at this
is a true and correct represenf,:it3on
? of Iat 17, Block 4, WILDERNESS
PARK SECOND ADDITION, according to
aV the recorded plat thereo£, Uakota
° County, Minnesota.
Dated: July 27, 1979
kpprove8 for Dunn & Curxy Real E;state
1Km.agetnent, Inc.
?
PHONE 672 423-1769
Proposed garage floor
elev. ___._.,_-_._•
o 0
X
??
2/84 ,
1 CITY OF EAGA[V
APPLICATION FOR PERMIT
SEWER AND/QR WATER CONNECTIOAJ
(PLEASE PRINT)
1) PP.OPE,.T' 1DDRESS: ??,? L ?Q
C`?O ? f?T?
rFrU DE.scz'1r7cv: 167'/7. &M(G 421
iLot/?Block/Subcivzsicn or Tax Parcel I.D. Nlrt?erl
-
r S'?"'?".. DtlT?.' G_' CRIG? ;P1. :iiii:.Z`. --, *^ c"„
. .? F?_??.;
' ---_---- '
? PZ.S? ?' Td R-i Sil;G',? r^p.%riT.=J • .
? P.-2 GUP; ?,: ('??-:0 L11ITS )
? R-3 'I(7,,-NHCi;SE (T:-=- + L'?-II"'S) ( UQI'"S)
? ?-4 LTVliJ/
? CCZ'fi'T..?CIAL1RET1-??OFFTCL .
? rmi.rJl.?.'?1.
? r1sTZ???zc.?./cc??-<:?????:
2) Appj,ja7?-%T (PLEASE PRI,4T}
ADDRESS: 11701 A.)
CIT: , ST: TG' , ZIP :
Px=:
3) pL!.7,Igca (?E?S;PRINT) FOR CITY USE ONLY
?
ADDRESS: PLLiHBERS LICE45E:
Z] Active
CIT?', STATE, ZIP: lj = Expired
?u5??- p
PHa?= ? PLUMBER L I C E N S E # Q Not of Rec rd
3rr initi
41 0.'C[.TPANT/Gf'ZIF'Z NA %rLcaac NH1ni)
f?:
ADDRESS:
CITY, STATE, ZIP:
PHO.IE:
S) INDICA'PE 4JHICH PEIRMIT IS BEItiG RDQUES'TED:
C0"?1ECTIQN 'Ii7 CITY SE;•7?t
C=.NBCrIC11 'Ib CIT`i jvATF.12
? CI'fT?m (PLEIaSE DESCF,IEE)
6) INIDIG=
? PIZ`LSE f:OID APPROVID PERMLT FOR PICK-UP SY ONE CF '1EGVE
?Z?LEASE ?7-LIL APPRO= PER'-LIT TO 1, 2,0 4 i+BCVE
(Circle one)
7) SI=TL.'.^?E: ? DATE: ??
??EaR?iwa+f?:l? ar " ?
.
F 0 R C I T Y U S E O N L Y
PERLIIT °- ISSUED
17- 1
F°ES. $ ??-cJb SEi??
$ I('- s C-1 WATER PE:2P4IT (INCLUDE SURCHaRGE )
$ WATER METER/COPPERHORN/OUTSI.^.? RE?.DE3
$ WATER TAP (INCLGDE CORPORATICV STC?)
$ S.7.,:11ET; T?..D
$ ?S'OU ACCOUNT GEPOSIT - SE::ER
$ ACCOliNT DE°OSIT - WATER
S ?70 -0-) WAC
$ SZ-S ?}D SAC
$ T?2U:IK NATE_°. ASSESS.dE:IT
$ TRliV:i S?.":vER ASSESS?IE?IT
$ LATERAL SENEFIT/TRUNK SE:?iER
$ LATERAL BENEFIT/TRUNri WATER
$ ' OTHER
$ TOTAL
$ 7-?-? AMOUNT PAID/RECEIPT
DOES UTILIT'I CONNECTION REQUIRE EXCAVATION I[V PUBLIC RIGnT OF WAY?
? YE5 IF YES, THEN A"PERMIT FOR WORK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
? NO ' Et?IGINEERING DIVISION_ LIST AS A CaNDI-
TION.
SUIIJECT TO TFIG FOLLOG]IDIG CONDITIONS:
APPROVED BY:
TIT*,E:
- ? -?-
DATE :
t sw ONes wMAN ErME
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA113006
Date Issued:08/28/2013
Permit Category:ePermit
Site Address: 4338 Leo Ct
Lot:017 Block: 004 Addition: Wilderness Park 2nd
PID:10-84251-04-170
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Michael Yoakam
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Herbert W Bergstrom Jr
4338 Leo Ct
Eagan MN 55123
Great River Remodeling
15703 - 93rd Circle NE
Elk River MN 55330
(763) 241-9596
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA135818
Date Issued:04/06/2016
Permit Category:ePermit
Site Address: 4338 Leo Ct
Lot:017 Block: 004 Addition: Wilderness Park 2nd
PID:10-84251-04-170
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Insert
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Herbert W Bergstrom Jr
4338 Leo Ct
Eagan MN 55123
(651) 456-9066
Glowing Hearth And Home Llc
100 Eldorado Dr.
Jordan MN 55352
(952) 492-9276
Applicant/Permitee: Signature Issued By: Signature