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2995 Lexington AveReceipt MECNANICAL PERMIT Permit No. CITY OF EAGAN Fss - FiH in numbered s,paces S/C Type or Prrnt /egib/y Tot. 1. Date 2. Installation Cost 3. Job Address Lot Blk. Tract 4. Owner 5. Contractor Phone , 7 6. Address 7. City 8. Building Type: Residential L? 9. Work Description: New El State 2ip Commercial ? Institutional O Add 13 Alter ? Repair El 10. Describe e_Fuel Type 11. No, Eauinment 8TU - M. Ea. Forced Air No. Equiament CFM Ai li Mfg. r Hand ng: Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Othe Air Cond. ' . r Mtg. Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough F' Inspections: Date Insp. Date ' Insp. ? This is your permit when numbered and approved. Approved CITY OF EAGAN 454.8700 CITY OF EAGAN Remarks ?•?? , ? ?? ?.?-?Z-{ C?'_11L n'2;. 1 i=, tZ1':?FC?1 Addition Sectionr 3 Lot r7 77 Parcel 10 00300 070 77 L1?' , Blk Owner ?`?Lllazk2l 4.?? 1,.??? Street 2995 So. LPacj.YlgtOri State Eagan,MN 55121 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET AESTOR. GRADING SAN SEW TRUNK -r 1968 100.00 3.33 30 * SEWER LATERAL.? 1969 WATERMAIN * WATER LATERAL?, 1969 ? 8 Q 89.16 20 WATER AR EA STORM SEW TRK 1019 1986 742 . 50 49 . 50 15 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 320.00 6-1 - BUILDING PER. SAC 2 .OO 449 6 ' - PARK CITY OF EAGAN Remarks-- _ 5?? aC Addition Section 3 Lot IL eik 77 Parcel 10 00300 040 77 Owner '-11-E?`-? Street -296rJ' SO. Lexington State Eagan,MN 55121 -1) 9 ?.?.?./ _ C Improvement Date Amount Annual Years Payment Receipt Oate STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK q0 1968 .AS58SS@ er parcel 034- 3 SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA 209.00 13 . 93 1 STORMSEWTRK 1019 1986 910.4.0 '- 60?...b9 15 cj/O.?O -/o ?{? 10 -II-?'S STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 13UILDING PER. SAC PARK vIu_.e SF EAOAN SEWER SERVICE PERMIT 3795 Pilot Knob Rood PERMIT NU.2596 Eayon, MN 55122 DA7'E: 6119/75 Zoning: ga No. of Units: 1 owner: garlan R_ R >»hm Address: 995 gn_ in Site Address: :) xingfon AVC. . Plumber: Wei6rko c R aschex I agne to complr with rM Village oi Eagan Connection Chazge925.00 pd Ordinancas. Account Deposit: 15.00 pd Permit Fee: 10.00 pd Surchazge: .50 pd By: Misc. Chazges: Uate of Insp.: Insp.: YIL! 46E OF EAGAN 3795 Pilot Knob Rood Eagon, MN 55172 Zoning: Ri- Owner: ?_?+-2, Addresa: /0 TotaL Date Paid: WATER SERVICE PERMIT PERMIT NO.: _=45 . nATF.: 5/191_75 No. af Units: 1 . Site Address: -2995-SO-.-LexiII4t°^ sve Plumber: Weiork /'. gaqnher Meter No.: 24245172 _ Connec[ion Charge: 320.00 pd _ Size: 5/a_BpcC1dfl11 Account Deposir. 15.00 Pd Reader No.: 623Q58 Permit Fee: 10.00 pd__. I ogras to comply rrith the Vil ge of Eagan SurcharKe: • 50 Pd Ordinoncas. 4-1, Misc Charges: 60.00 pd _ TntaL 10.65 pd By Date of Insp.: Date Paid: [nsp.: 'p//O q W7Y?? M 2 52,o-pD??c=osr-?? Repuesl are / Frte No Rough-In InpseIX?on ReQwretl ?Vou must Cell inspecbr when reatly) Inspac0on Other Tben Rough-In ? qeatly Now Wtll Notily IngOeclor C ? Yes No pete ReaE I licensed contractor ? owner here6y request inspection of above electrical work at: J Atltlress(Sireei. 6ax or Roule No,l - ? Ci SecLOn NcY Township Name or No Ra.ge No C? ?? Octpp f(PiiINT? h Pbane No, ow r Supplrer qdtlress EI a Contraclor (?ompeny Naphip ? " ' ? ? Co ?tor Licanse U ai AtlOr SICOn <ior or bng Inslallation? 7 1 onxetl SignaWre IContracto wnar MaWn Installalion, P?one Num er MINNES A STATE BOARD OW ELECTPICITY Q / I THIS INSPECTION REOUEST WILL NOT Gtlggs-MI y Bltlg. - Room 5-173 111? ? ? BE ACCEPTED BV THE STATE BOARD 1821 University Ava.. SI. Paul. MN 55100 UNLES$ PROPER INSPECTION FEE IS Phane (612) 6E2-0800 ?ENCLOSEO, ? REQUEST FOR ELECTRICAL INSPECTION r See insVUCOOns tor completing IDis Form on Oeck ot yellow copy EBOW01-OB ? N22852 X" Below Work Covered by Thls Request ?•,m,. ew Add Rep TypeolButlding ApphancesWired EquipmeniWired Home Range Temporary Service Dupiex Water Heater Electric Healing Apt 8mlding ?ryer Load Menagement Comm.lVnduslrial Furnace Other (Specily) Farm Au Condiaoner Otner (sueary) Convactor's Remarks Lp E ?.KLI ?`p G . lJ Compufe Inspection Fee Below # Other Fee ServrceEniranceSrze Fee # Circmis/Feeders e Swimming Pool f 0 to 200 Amps O to 100 Amps Transformers Above 200 _ Amps Above 100 _ Amps SignS Inspxmr's Use Only 7Q7 IrngaUOn Booms l J- c9L? Speaal Inspection ? Alarm/Communication THIS INSTALLATION MAV BE ORDERED ISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 HS. f I, ihe Electncal Inspector, hereby if h Rou9n-m ' cert y t at the above inspection has been made Fhai ? oae OFFICE USE 3NLY / TM1is requesl mid 18 monihs Irom 6; 4 i N T V Apn121, 2006 ' City of Eagan Surveyor s OKce Attention Pam Dudziak Dakota Counry 3830 Pilot Knob Road Westem Serwce Cencer Eagan MN 55233 14955 Galute Avenue Apple Valley, MN 55124 Re: FAVRE DEVELOPMENT ?9aSLex?.c?oy, ?S 952.891.7087 Fax 952 991.7097 ?wwvm.dakota.mnus The Dakota County Plat Commission met on Apnl 17, 2006, to consider the concept plan of the above re£erenced plat. The plat is adjacent to CSAH 26 and County Road 43, and is therefore subject to the Dakota County Contiguous Plat Ordinance. This concept plan is located in the northwest quadrant of the CSAH 43 CSAH 26 intersection. The proposed two access points do not meet the Spacing Guidelines. The Plat Commission stated that no access would be allowed along CSAH 26, which requires one-halfmile full access and one-quarter mile far a three-quarter access. The proposed plan combines one existing parcel with a por[ion of another parcel (outlot). The Plat Commission recommends that the ciry not approve the parcel split of this proposed properry. The Ordinance requires submittal of preliminary and final plats for review by the Plat Commission before a recommendation is made to the County Board of Commissioners. No work shall commence m the County right of way until a permit is obtained from the County Transportation Deparhnent and no permit will be issued unril the plat has been filed wiYh the County Recorder's OfFice. The Plat Coinmission does not review or approve the actual engineering design of proposed accesses or other improvements to be made in the right of way. The Plat Commission highly recommends early contact with the Transportation Department to discuss the permittmg process which reviews the design and may require construction of highway improvements, including, but not limited to, turn lanes, drainage features, limitations on intersecdng street widths, allowance and size of inedians, etc. Please contact Gordon McConnell regarding permitting questions at (952) 891-7115 or Todd Tollefson regarding Plat Cammission or Plat Ordinance questions at (952) 891-7070. Sincerelv. Todd B. Tollefson Secretary, Plat Commission c: Susan Fussell, Loucks Associates i5 P- .,iar v,wr wnn wx wn.??N?..za? i.rv [Wh on.nnnaranm'[a Page 1 of 1 Pam Dudziak From: Susan E. Fussell [sfussell@loucksmclagan.com] Sent: Monday, April 10, 2006 224 PM To: todd.tollefson@co.dakota.mn.us; Pam Dudziak; Brady Mueller Subject: Favre Development - Lone Oak and Lexington - Eagan, MN - Concept Plan Attachments: Itr 4-10-06.tif; 6018sp04a_041006.pdf Todd Enclosed is the concept plan for the plat commission review And letter attached. We will see you Monday. Susan Fussell, PE Project Engineer Loucks McLagan 20 E Thompson Ave W. St. Paul, MN 55118 651-259-6211 Dir 651-4573645 Main 651-457-8642 Fax On April 24th Loucks McLagan will have moved to the expanded Loucks Associates office in Maple Grove, in order to serve you better. Below will be our new address, phone #s, and email Loucks Associates 7200 Hemlock Lane Suite 300 Maple Grove, MN 55369 763-496-6763 Dir 763-424-5505 Main 763-424-5822 Fax sfussell@loucksassociates.com 04/10/2006 i •, - ? 20 Faet Thumpsun A, Swre Si Paul, MN ?511 I'e1651 457 3(45i1'-"q{;`,£ Fan 651 457.8642 AprIl 10, 2006 hnme@loucksm<1a,,-?n_com;?_„_,?y?_,-?,,; , uv«w ioucksmc n.<om - Enyi'r`o{imental xMr. Todd Tollefson Plat Commission Chair Dakota Counry Surveyor's Office Westem Service Center ' 14955 Galaxie Avenue Apple Valley, MN 55124-8579 Todd.tollefson@co,dakota.mn.us Dear Mr. Tollefson Please find enclosed a concept plan for the Favre Development. This plan is being submitted for concept review and access locations at the plat commission meeting on April 17", 2006, at 9:D0 am. This site is located on the northwest corner of Lone Oak Road and Lexington Avenue in Eagan, MN. The site is approximately 1.8 acres, and is bounded by two county roads, single family to the north and mini storage to west The west lot, only the north portion was developed; the majority of the lot is a pond. I have spoken with Pam Dudziak at the City of Eagan, she is aware that we are submitting directly to county for concept review. We are also forwarding this concept plan and letter to her, for her information. The City of Eagan does not have a formal concept review process. Myself, the client and the client's architect will be at the meeting to discuss this site further with the plat commission. If you have any questions or need additional information before this meeting, please call me at 651-259-6211. Sincerely Loucks McL?an /. ?? Fusse I, Project Engineer cc. Brady Mueller, Krech, O'Brien, Mueller & Assoc Pam Dudziak, Planning, City of Eagan. Enclosures APR I 1 2006 ???,e? bi,nnezpolu So Pau! , MEMO T0: SHANNON TYREE, PROJECT PLANNER FROM: THOMAS A COLBERT, DIRECTOR OF PUBLIC WORKS DATE: MAxCH 18, 1992 SUSJECT: {PHItCEL 10-00300-051-77?& 030-77 (CRATE PROSPECTS PROPOSED ACQIIISITION) ACCESS/CURB CIITS TO COUNTY ROADS 43 (LEXINGTON AVENOE) AND/OR 26 (IANE OAR RD) On March 6, you distributed a memo to all City Departments informing us of potential acquisition of the above-referenced parcels by Crate Prospects with the intent to develop them into some type of retail facility. Your memo indicated that Mr. Jim Roberts, of Crate Prospects, is hesitant to proceed with any development in this area without support from the City for curb cuts providing full access to County Roads 26 and/or 43. As everyone is aware, this access issue is under the jurisdiction of Dakota County through their access permit and/or road improvement design process. On July 2, July 16 and August 6, 1991, three public hearings were held to discuss the improvements and signalization of the intersection of these two County roads. Although the project was not approved and suhsequently canceled as a result of the concerns raised by the owners of the property in question, it was with the understanding that the project would be delayed and reconsidered in 1493 as a part of the County's 5-Year Capital Improvement Program. This delay was to allow the affected property owners time to evaluate and adjust the impact of this eventual improvement to their existing uses as well as any potential change or upgrade. This intersection/signalization improvement will require the installation of raised concrete medians to provide proper channelization of traffic to accommodate the substantial turning movements through this intersection. Due to the existing and projected future traffic volumes, it is not anticipated that any median cuts will be approved. Therefore, it is my understanding that any existing or future driveway access within the limits of this intersection/roadway improvement will be limited to a"right-in/right-out" movement only. Any acquisition and/or development proposals for property within the project limits should take these access issues into consideration. Any development proposals that do not conform to the future County road improvements and County requirements should be accompanied by written approval from Dakota County before formally processing a development proposal through the City. Director of Public Works TAC/jj cc: Mike Foertsch, Assistant City Engineer John Wingard, Development/Design Engineer MEMORANDUM r TO: All Departments FROM: Shannon Tyree, Project Planner DATE: March 6, 1992 RE: Crate Prospects. -7? Mr. Jim Roberts of Crate Prospects has been entertaining the idea of purchasing the property directly across I.exington Avenue from their existing building, P.I.D. #'s 10-00300- 051-77 and 10-00300-030-77 (see exhibit). Their proposed plans are two fold; they would like to restore the existing dwelling on 051-77 and use it as a design studio and retail space with access and pazking on 030-77. In the long run they would eventually like to return their design studio to their existing location across the street and use the 051-77 property as a restaurant. Jim Robens has told me they particularly like the "country" feel of that area, realizing that the future use of the sunounding property will be developed into some sort of industrial or commercial development. Mr. Roberts told me that the house was once a school, they would like to hold on to a bit of that heritage. Although they would not go strictly historical. What Mr. Roberts is looking for is the cooperation from the City regarding the current status of the curb cut on L.exington and/or L.one Oak Roads. They are not too willing to proceed with any upgrade in this area without backing from the City. If you have any comments on this proposed proposal please send them to me in writing. If you need more information or assistance with this matter, please advise. 5 Shannon Tyree t i v 7 ? o>• ? I wg z 1 \, rnNU j' , ? .' _ oU?l '111;,; ? 1 ??F ' , ?-, ...,, ? . --?-? ?-_ •? U51-71 a ... .. 5 ? D ?, ? 1IONE N• t ORM RV14?vUIT [SAII NO.Pf .F>z ?? „o L, KEE Cty d !ar? • - V i L ? , ... • -:?• ?? ? , ry 4?t D - . ? ? .. ? .. StREET Q)P? IxP , , , s ?M Cz gr - Dave: When would you be willing to reconsider this project as 3 of the 5 Council members have now expressed some regret in not approving the project last year. Also, are you prepared to proceed with the entire County Road 26 improvement in 1993? If so, the City would like to proceed with a schedule that would add at least 6 months to the process associated with Diffley Road. Tom I? FaHABni LAxsoN ? FENLON ? VOGT? ?-- n PxoeEssIoru+L AssocinnoN oF A=nNeYS aT Lnw Mmneapolis Office 193$ PIPEft]AFYRAY TOWfR ZZZ SOUTH NMTH STRHET MIr.NEaeoLis, bllNNeso7q 55402-3337? 612 339-6321 • FncsiMar 612 339-4714 Reply to Minneapolis January 2, 1992 Mr. Jim Sturm Eagan City Planner 3830 Pilot Knob Road Eagan, Minnesota 55122 Saint Pau( OfficeJOO MERCI'OR TOWE0. 444 CfDAR STREET SAMT PAUL, MINNESOTA 55I0I-2I26 612 222-6321 • Fncsianin 612 222-8905 Re: Lot Comhination Agreement Our File No. 10186/000 Dear Jim: In accordance with our discussions, enclosed for your records please find a fully executed duplicate original Lot Combination Agreement concerning Mr. and Mrs. Harlan Bluhm. You will observe that the County Recorder placed a stamp on the reverse side of the last page acknowledging that the Agreement was filed with the Dakota County Recorder on December 31, 1991 at 10:13 a.m. The Agreement was also given Document No. 1020554. Thank you very much for your assistance and cooperation in this matter. If there is anything else you would like or need, please feel free to contact me at your convenience. 1992. Best wishes to you and yours for a healthy and successful Yours very truly, 4Khoff RoRnalrc Enclosure cc: Mr. and Mrs. Harlan Bluhm (w/o enclosure) LOT COMBINATION AGREEMENT WHEREAS, Harlan R. and Audrey N. Bluhm (hereinafter "Owners"), are the Owners of two adjacent parcels of real property located in Dakota County, Minnesota. See Exhibit A. The first parcel (hereinafter Parcel A) is identified as Tax Parcel I.D. No. 050-77? and is described as follows: Part of the+SE 1/4 of Section 3,JTownship 27, Range 23. The second parcel (hereinafter Parcei B) is identified as Tax Parcel I.D. No. 040-77 and is described as follows: Part of the SE 1/4 of Section 3, Township 27, Range 23. WHEREAS, the City of Eagan has approved that Parcels A and B be combined into one tax parcel in consideration of the Owners' agreement to obtain the City Council's approval before the parcels may be split at any time in the future. NOW, THEREFORE, the Owners hereby agree as follows: 1. The Owners agree to allow the Dakota County Auditor's Office to assign one tax parcel identification number to the area consisting of Parcels A and B. Iiarlan R. Bluhm (? k) . eeuk?? Audrey N. $luhm ? ? ? ?PGP?o??? yI `'° `o . ./ N4 4?N•il 2 N W I J J Z? Y qy? ' oel r• ul s t K ~ • VW 11 ? 6 `` ..r.r?. 1? ? " ? ? ? ? ,•? ` ?.., - i u1Y.q? p , E &.1 X?=E • i ? ?,...; l4UNE OAK FOAUY^CSAH N026 &xhibit "A" ' . \ {?kt, ? ?y7 ?L k a5a.:?? ? ? ° ?' c ?' ? ?w?? $??? ? , c,Ty c6qay ?ate: ? City of Eagan Assessor 3395 Pilot Knob Road Eagan, Minnesota 55122 Dear Sir: ' ! J - 0 Z-- S.P. 1982 - 905 Parcel 3 In conjunction with the sale of a portion of our property in Eagan to the Minnesota Department of Transportation (Description attached), we agree to continue to pay, after the sale, the same total special assessments which are presently amortized against this property. County Parcel Number L- 10-003007050-77J Sincerely, W44-a'""'?' X!?%? Harlan R. B1uhm The City of Eagan agrees with the above stipulation and will concur with said agreement upon receipt of legal division notice from the County of Dakota. -e h Assessor CITY OF EAGAN Date: 8 4 73 t Suly 11, 1980 FEE ACQUISITION D-141 Parcel 3 S.P. 1982 (35E=390) 905 I 35E-4 (40) 100 All of the following: That part of the Southeast Quarter of the Southeast Quarter of Section 3, Township 27 North, Range 23 West, shown as Parcel 3 on the plat designated as Minnesota Department of Transportation Right of Way Plat Numbered 19-35 on file and of record in the office of the County Recorder in and for Dakota County, :Sinnesota; containing 0.09 acre, more or less; together with other rights as set forth below, forming and being part of said Parcel 3: Temporary Easement: A temporary easement for highway purposes as shown on said plat as to said Parcel 3 by the temporary easement symbol, said easement shall cease on December 1, 1985, or on such earlier date upon which the Commissioner of Transportation determines by formal order that it is no longer needed for highway purposes. t 44•191 ? '° ` k ;`eP,qRTMENT OF TRANSPORTATipN R4GHT OF K'AY PARCEL LRYQUT ir;*urmation required: Propnsed RM! line and accnu taking. Lo4 Iines and dimensions, W r?4 qrs.o„w Outiine and location of eit buildings snd Improvements, 5ireet or highway frontape. ?4o,c COUN7Y Q,?K07"r1 PARCF.L N0. ? 3 .„ .2049tAN 12. .BtUHM ___ Scale 1" ? /eO . ft. ?! ..--" . ? . ....? ? ? ? C L ? ` I N? VI : I w ILJL S?G i, e Aj ? 6 0 O t- -1' i. . u S 9 ? ? or1E OnK _? C f, .09 Q.- {' 4c'4' r.`. Date Parcei No. .? ?., ?? j(3? I a +4 v' ?.. yl i 6Y3; ^?t„?S? 1•d e, e? i ? KRECH, O'BNIEN, MUELLER & ASSOCIATES,- MFiRC?e SNMm1E1mvTy Immor? 61I5 CohJl Avenua imer Go.e Meghe nn-emm 55076 657.451 4605 kx 651 451 0917 kamamc(dWmmnc mm vsm a? m n.an fO1?rmma u ? ? Z W } Q Z O ?- ? z X W ? m t- a ? N W J 4 W ? W ? 1 Q LL 9 4 ? ? p? a 324'-6" ? I I -------- ------- -- --- -- ---------+--- LONE OAK RDAD ? I ?.? ? ? PROPOSED SITE DEVELOPMENT PLAN r.npb• fF?FL? OYAB ORAV'11 Bt'. GKK? BY. DA1E ?M/oc ?N? Use BLUE or BLACK Ink r _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ I For Office Use I I Permit City of EaRd hermit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: ; Phone: (651) 675-5675 I I Fax: (651) 675-5694 i Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: - Site Address: cJ(,tJ~~ L ~>e ~r~',~ at^v<, Unit Name -f l i~ J I V Phone: 6 1~-- XO" 0> 7 RESIDENT / ,A( OWNER Address / City / Zip: V v Applicant is: Owner Contractor Description of work: TYPE OF WORK F ' Construction Cost: ( Multi-Family Building: (Yes / No x) Company: 3)20 GC COA r L Vao Contact: O P O CONTRACTOR Address: w ] d S 4b ~ S ' City: ' 6'11V/~ State: YI' A/ Zip: S 3 Phone: 3© S`~~2 License a? Q Z ~`f c1 Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. 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 x Applicant's Printed Name Applicant's Signatur V 1 Awa eN SC Page 1 of 3 1 For Office Use ,--- �- o )_.? �� J i , :::e: a..w: 's`w.w+ t Date Received: 3830 PILOT KNOB ROAD 1 EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildinoinspections(c�citvofeaoan.com L 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: lName: Phone: f Resident/ Owner I Address/Cit /Zip: Z ,(7 Applicant is: Owner Contractor Ii TType of Work Description of work: T (loti5,e Yp t Construction Cost O© (.-VMulti-Family Building: (Yes /No ) Company: C.. Contact: L ,�: ,r p y: PA i-e_- _ Contractor Address: UJ kzi 8 .t/ City:2tii-yGme..,6 State:�� Zip:)SO77 Phone: f �i'vSC� Email: I 1 License#: Lead Certificate#: ' ! If the project is exempt from lead certification, please explain why: i 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? i Yes No If yes, date and address of master plan: i i Licensed Plumber: Phone: Mechanical Contractor: Phone: i Sewer&Water Contractor: Phone: i r Fire Suppression Contractor: Phone: t NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe classified as non- ublic if ou •rovide specific reasons that would er►nit the Cit to conclude that the are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. 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. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gooherstateonecall.org I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with t app ved Ian in the case of work which requires a review and approval of plans. x 4/OA_ x ilesrL&Yri Applicant's Printed Name Applicant's Signature For Office Use � ����� e�* e :::: „J Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff: buildinginspections(c�cityofeagan.com L 2018 SEWER AND WATER REPAIR / DISCONNECT PERMIT Date: /F!f—i Fee: $65.00 City Sewer City Water Repair Disconnect Description Of Work: Street Address for Proposed Work //_ L.a*/ i't'Ct Name: _DO kit Phone: Owner Information ; Address/City/Zip: Applicant is: Owner Contractor Licensed Pipelayer Master Plumber Property Owner ^� pry Name: P/IC /Phone: r63— c -S p3 Address/City/Zip: /1/ & Y ACC/ age( 871.4i Pipelayer Training Certification Card#: or Master Plumber License#: I acknowledge that the information is complete and accurate and that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes. I understand this is not a permit, but only an application for a permit, and work is not to start without a permit. ALA_ e Applicant(Print Name) Applicant's Signature You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq