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3265 Lexington AveYILLAGE OF EAGAN WATER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: $ 0 fi9 Eogan, MN 55122 DA"CE: __ ,1 1 - 1-7 t; Zoning: Rn&.i.$.eIlf ial No. of Units: Owner:-ob_CZt F. Wid.IRa n _ Address: 25 So Lexincit gn Site Address: Same / /9 D/czQ6 6040 z Plumber. S e 1 f I SQGf "/QA) 16 Meter No.: Z 215 64 1 4 Connection Charge: $ 2 2 0 Size: _T/6 Account Deposit: 515 Reader No.: 5_5 9 A 10 I ogree to comply wifh the Villoge of Eagan By m e? ?? 1? Yv"'t7u"\ Date of Insp.: Permit Fee: S10.00 Surcharge: .50 Misc. Charges: ?G?Bo n . ?L=r Total: $318.50' Date Paid: 11-1- 7 6 lnsp.: EAGAN T011V'N SH I P BUILDING PERMIT Owner -.-°- /---................. - j--? ?? ?----.. ? -= =--T"----°----.... Address (Present) ...31 r----- qtfp-'----0Z ".'°?? ..----°--- -.. ? ? Builder - -- ?-'---?°-- ---- °.?°? ...... ......... ..... ..... ... Address ------ -- ---•---...t---°?- ---- ---.-.------.------... DESCRIPTION N° 1610 Eagan Township Town Hall Date ?...13/--l-s L-P---.... Biories To Be Used For Fron! DepYh Heighf Esi. Cosf Permii Fee Remarks I f/ - -- ???' ?D • ' I LOCATION or This permif does noi au3horiae the use of sYreeYs, roads, alleys or sidewalks nor does it give the owner or his agent the right io create any si3uaYion which is a nuisance or which pzesen3s a haaard to the healfh, safety, convenience and general welfare !o anyone in the communiiy. THIS PERMIT MUST BE EPCT ON THE?PSEMISE )WHILE THE WORK IS IN PROGRES?S. This is Yo ceriify, ?"--------- .._has permission fo erect a._...__.._??`'?'""_ n.__J .........................upon !he above described premise subjecf to the provisions of the Bnilding Ordinance for Eagan Township adopted April 11, 1955. 1 ....--•°---------• - ??0x-`----- --•--f--\ --------- .. Per ---........... ?! . t fl •+'?'-?."`-e ? ..... --°--- ---°---------t°---------------- -----.... ---°--° ------- Chai an of Tnwn Board Building InspecYor CL ' !? r ? 10 -oo- 7 C? i6 EAGAN TOWNSH I F' N0 74 BlJ9LD9idla PERMiT r?? ti Owner -4/-c'???+.----- °° - .............. °---------- -. Eagan Township Addxess (presen __.._.._..._LL?.??....?•t3.????..?? Town Hall Builder ------ - ?---°-- ? ? r - - - ---- -. - n Date? - . ---? Address ---- ??N..?l7?. 7lF.CCRiPTTAN 5fories To Be Used For Fxon! DepYh Heigh3 Es2. CosY PermiL Fee Remarks I 1?`??? ??J?; -- LOCATION Sfreet, Road o her Description of Locaiion Lo! ?Elock?Aaai:ion or 'rracs n_- This permii does not auih e the use of sYreets, roads, 11 ys or sidewalks nor does it? gine the owner or hia ageni the tighi fo czeafe any sifu ' n which is a nuisance or whieh r sents a hazard to the healYh, safefy, convenience and, generai welfare !o anyone in the community. THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORS IS IN PROGRESS. This is 3o cer3ify. thai....... °............ -----............ ,................. --.has permissioa !o erect a............ _-----........................................... upon the above describ remise s e provisions of the Building Ordinance for Eagan Township adopYed April 11, 1955. ? ............... ... ?! - - -- Pez -.. ------------- °-- - ........................... -° °----.° ................ ................ -? Chairman of Town Bo Building InspecYor b,c?-?. I-f xf n 64P. At Qcr¢ ? x 2-fp,4Z f °-- . ? ? F--- --v---? C? -?--'----a- - - - - - -?-?-? _ _ ._ jr- ..? 2 bS,- S6 ..??x 1 ? t ?no Addi-b on 26?x L / ' --? ? .. INSPECTION RECORD CITY OF EAGAN PEPIMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: i (612) 681-4675 i SITE ADDRESS: , . , ? ? .:.lu(d I ,?? i iri: f st APPLICANT: ?..i., . ' i . trn4?,I :? I HO ci a3Aj H1IHr/q7 PERMIT SUBTYPE: TYPE OF WORK: irrA 1 1 1M I INSPECTION .. . .A I ,. ? ? Permlt No. Parmit Holder Date Telephone M ELECTRIC PLUMBING HVAC InspecUon Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING / ROUGH PIUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPIACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FfG DECK FINAL PERMIT # - MECHANICAL PERMIT RECEIPT # _ CITY OF EAGAN 3830 PILOT KN08 ROAD, EAGAN, MN 55122 DATE PRICE: PHONE: 454-8100 For Office Use ite Address = ? - - - ot Block _ ? Name ^a m ? Address c Ciry Phone ? Name ,?J vYi?r.iti c Address =205 S p City _ ,..i Phone TYPE OP WORK Forced Air Boiler Unit Heater Air Cond. M BTU M BTU M BTU M BTU CFM Gas Piping Outlets # Other FEE: S/C: TOTAI: v BLDG. 7PE WORK DESCRIPTIOI Res. New Mult Add-on Comm. Repair Other iteiAace ^X FEES RES. HVAC 0-100 M BTU -$24.00 ADDITIONAL 50 M BTU - 6.00 'CONSTRUCTION) INCLUDES A/C ON NEW GAS OUTLETS (MINIMUM - 7 PER PERMIn - 1.50 EA. COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE 8 CONDOS - RES. RATE APPLIES MINIMUM RESIDENTIAL FEE - ALL ADD-ON & REMODELS - 12.00 MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PEflMIT PRICE GOES BEYOND $1,000) SIG? T?UR?E OF ," -- ?ITT E ' '• ?_'J ?Si""?? ?/ `" 0 ?. FOR: CITY OF tAGAN CITY OF EAGAN Remarks Addition Section 10 Lot eik Parcel 10 01000 020 75 owner : l-` :?!?', • ?- streec 3265 So. Lexinqton Ave. stace Eagan,MN 55121. Improvement Date Amount Annual Years Payment Receipt Date STR EET SUR F. STREET RESTOR. GRADING Street & Drain 1976 600.00 60.00 10 Paid SANSEW TRUNK 1970 180.00 25 Pdid , SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA STORMSEW TRK 197$ 720.00 15 Pdld STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 6UILDING PEF. SAC PARK Si,?, a? - f2?2(&6`?. A° w .:, a7e ? e?' r !:;:1:1'Y (:1!- I_.At:;AN r.,n::3wa:Ef,: ; s rH::RMINA!... Nn;, 70 DA7!:::;, 07•07/97 r:i:Mr:,, 0:28e00 TI:i ;; NAt4f:_;: RfJBf:_i';:7 F H:[X1MAN i,c,.l, n''JCt!:)'I. 3265 L..1.= X f1VE 1 t,'c.'. ?, r?5 r'.'9.,`S5 7001 3R6„5 t_E:X AV1•:: S 000 TUta:!. RiaC`p?:i.prr AI'iiOuYS'I;;S 63ur5 CR077S?F:1;3 uSER :r.r.:?: NANc::Y yFwYn%X>K? ?CY,SY??',?Y,:h??F>FY,??;rXt?M?k7X;::h?:K>?)Y:kM.?Ya;c?:?>X:i"•>fY.n?FX?? ? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: PERIVIIT PERMITTYPE: BUILDING Permit Number: 0 3 0 3 6 6 Date Issued: 0 7 J 0 7/ 9 7 3265 LEXIN6TON AVE S LOT: 2 BLOCK: 75 SEC7TON 1@ DESCRIPTION: I TEAR-OFF REROOF 13011 dk"04,,,Permit Type SF (MTSG. ) B?uild?i,ng ?rk Type ALTERATION ?"?CensUS God?"\, 434 ALT. RESIDENTIAL , dk. E ` A9§ €' p?s ' Cs ? P b .f?g ¢'2 2 ?VF?, 4 cJ3'? ;?..s ?f?, t??a; ,rp?'' r a •'k` a?* "pp, R??`v ?6Y i?a?5b1 G? ari ? e REMARKS: I FEE SUfUIMARY: VALUATION Base Fee $62.25 5urcharge $1.00 Total Fee $63.25 t $2,000 CONTRACTOR: OWNER: - A p p 1 i c a n t - WIDMAN ROBERT 3265 LEXINGTON flVE 5 Efl6flN MN 55121 ? (612)454-2715 T herebYackrrawledgethatqnl ha? T° inferme'Cion ,:is` co;r~rect ?an;d"i"agi; 3tatutesandCity°.-.tsf ,t ?i gan: Orr? . APPLICANT/PERMITEE SIGNATURE ,•?, _E ,. ? .., ?. . ?? ?,g 6 reWa;d this appli6atfi6n anii stote tYiat 'Ghe , .n f?: Y nances - E. : . .. ??0?• 97 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILQT KNOB RD - 55122 681 -4676 New Construction Reauirements BetnodeURepeir Reauirements ? 3 registered afte surveys ? 2 copies oi plan • 2 copies of plana (indude beam & window sizes; poured fid. design; etc.) ? 2 site surveys (exterior additions & dedcs) ? 1 energy calculations ? 1 energy calculations for heated additions ? 3 copies of tree preservation plan iF lot plalted after 711l93 required: _ Yes _ No - DATE: LLi i CONSTRUCTION COST: DESCRIPTION OF WORK: ? I 'i- °"v- c' STREETADDRESS: `)' Ll LOT <5?- BLOCK 2S 0 SUBD.IP.I.D. #: Ji-v"t.r • tv 4A"2 2 1 PROPERTY Name: Phone #: ' OWNER Street Address: City: ??4G ???- State: M n? Zip: S?'I z I . ? CONTRACTOR f- ? Company: Phone #: Street Address: ' License #: City: State: Zip: ARCHITECTI Company: - - Phone #: ENGINEER Name: Registration #: Street Address: City: State: Zip: Sewer & water licer.sed plumber (new construction only): . Penalty applies when address change and bt change are ?equested once permit is issued. 1 hereby acknowledge that I have read this appliqtion and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Gl- Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No _ Not Required OFFICE USE ONLY BUILDING PERMIT TYPE 0 01 Foundation ? 06 Duplex 0 02 SF Dwelling ? 07 4-plex 0 03 SF Addition ? 08 8-plex ? 04 SF Porch ? 09 12-plex OV-05 SF Misc. ? 10 = plex WORK TYPE 0 31 New ,-?3 Alterations ? 32 Addition o 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning 0 11 Apt./Lodging o ? 12 Multi Repair/Rem. o * 13 Garage/Accessory o 0 14 Fireplace n 0 15 Deck ? 36 Move ? 37 Demolition Basement sq. ft. Main level sq. ft. sq. ft. sq.ft. sq. ft. sq. ft. Footprint sq. ft. Building Y p' -_\ +! . .. ? . .. 1 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. ? SAC Code ?L Census Bldg Census Unit ? Engineering Variance Permit Fee / Surcharge Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S!W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: ? Valuation: $ °k SAC SAC Units f O -od0o o -fl?v-7S` 1340813 TEMPORARY CONSTRUCTION EASEMENT IN CONNECTION WITH EAGAN CITY PROJECT NO. 694 This easement, made this 3,"d day of , 1996, beriveen Robert F. Widman and Shirley A. Widman, Trustees of the Shirley A. Widman Trust dated April 25, 1995, herein refened to as "Landowner" and City of Eagan, a Minnesota municipal corporation, hereinafter referred to as the "City". WITNESSETH: That the Landowner, in consideration of the sum of One Dollar ($1.00) and other good and valuable consideration, the receipt and sufficiency of which is nereby acknowledged, does hereby grant and convey unto the City, its successors and assio s, a temporary construction easement for site grading purposes over and across the following described premises, situated within Dakota County, Minnesota, to-wit: Commencincy a[ the southeast corner of the northeast quarter of the southeast quarter (NEl/4 of SE1/4) of Section ten (10), Township t%venty seven (27), Range twentv three (23); thence north alona the east -? line of said section, one hLmdred fifty (150) feet to the place of be;innina; thence angle left 39°44' a distlnce of 290.4 feet;. thence angle right 89°44', a distance of 150 feet; thence ancrle right 90°16' a ? distance of 290.4 feet to the East line of said Section 10; thence south 150 feet to the point of beginning, all accordinj to the Government Survev thereof. Said temporary easement being the southerly 19.69 feet (6.000 meters) of the above described and that part of the above described property lying easterly of a line parallel with and 58.53 feet (27.000 meters) westerly of ttle east line of the Southeast Quarter of Section 10 Township 27 RanQe 23, Dakota County, Minnesota. Said temporar}, easement to expire December 31, 1997. 1fie b ant of the foregoing temporary construction easement for site gradino purposes includes the right of the City, its contractors, ajents and servants to enter upon the premises at all reasonable times to construct, reconstruct and inspect site grading and the further ri;ht to remove trees, brush, undergrowth and other obstructions. After completion of such construction, maintenance, repair or removal, shall restore the premises to the condition in which it was found prior to the commencement of such actions, save only for the necessary removal of trees, brush, undergroNvth and other obstructions, subject only to permanent easement alterations. RECEIVEP ApR t? ;t 1y'', The Landowner, their heirs and assigns, do covenant with the City, its successors and assigns, that they are the owner of the premises aforesaid and have good right to grant and convey the easement herein to the City. IN TESTIMONY WHEREOF, the Landowner has caused this easement to be executed as of the day and year first above tivritten. Traffifer Emered is /??? daY af Dako Cou Treasurer-Aud ? %j? STATE OF MINNESOTA) )ss. COTJNTY OF DAKOTA ) ? W ? ? (31- Robert F. Widman -o?---?-e? Shirlev A. W man The faregoing instrument was acknowled?ed before me this 3 day of 1996, by Robert F. Widman and Shirley A. Widman, Trustees of the Shirley A. Widman Trust dated April 25, 1995. , , APPROVED AS TO FORM: City Attorney's Office Dated: APPROVED AS TO CONTENT: ? lic `Vorks Department Dated: Notary Public *019 M?iA a en?ow kY M!ll1C MINNESOTA MCOMMISSION EXPIRES 1ANUARY 31, 2000 2 :'7 4-! ? ? •.? r+ V? \ J THIS INSTRUMENT WAS DRAFTED BY: SEVERSON, SHELDON, DOUGHERTY & MOLENDA, P.A. 7300 West 147th Street, Suite 600 Apple Valley MN 55124 (612) 432-3136 ? ?a CO oa Wo a -? 4 o Z =o W W N O wu zm? ¢ ? ?Z Zw ? ? ? F¢ a W? 17 fW w ¢ ?' ro - C z a a =Y W~U7 O F- Z ?. O ` U ? v U F Z j = ? ( ) U f4 2 ? (p . „ F, W 2??0 ? = V 0 Z F- V= o y ? O ? D LLI W ? W 0 O Z m ? 3 W 2 Y LL w Ua F¢ Vf z w 2 U) (9 LL C ¢ (n (j 2 0 W w a U tr ¢ v3 O ' p ti U W > 0 2 W cc F" Z 0 ? r• '?r .0s/p AffIUAV11'01: 1101tilHf. Aflidmdl of Trnstcc rcgarJing Ccnificalc of I iusi or 1'NSl In5lnimc111 pursnnnl ln A1inu. SIaL ?501I).57 Affidavit H Q) ? ? ? of Trustee STATE OP MINNESOTA SS COUNTY OF DAKOT.4 Robert P. Widman, being first duly sworn, on oath snys that N ? t?1 ^d Z .. Afflant is a Trustee named in ihat ccrtain Certiticate of Trust (or Trust Instrument) dated , 1996, and filed lor rccord ?4? 1996, as Document Numbcr in the oflicc of thc County Rccordcr of Dakota County, Miiiiiesota, regarding the Trusl named "fhe Shirley A. Widmmii lYust dated Arril 25, 1995, which Certificate ol'"l'rust was exccuted by Alrant or another Trustee or the Grantor of the Trus[ described in dic Cerlificate of Trust (or set forth in lhe Trust Instrument), and wliich relates to the real property in Dakota Cowity, Minnesota, Icgally described as follows: C ? ?J r- (` Ii ? C =?l 1 ., i? Commencing at the southeast comer of the noitheast quarter of the soudieast quarter (NE I/4 of SE I/4) of Section len (10), Township twenty seven (27), Range twenty thrce (23); thence north along the east line of said section, one hundred fifty ( I 50)leet to the placc of beginning; lhence anglc lelt 49"44' a distance of 290A feet; lhence an-lc right 8944', a distance of 150 feet; lhence angle right 90°16' a distance of 290.4 feet lo the Gast line of said Section 10; thence south 150 feet to the poinl of beginning, all according to the Government Smvey thereof. 2. The name and address of each Trustee empowered to act under the Trust Instrument at the time ot'the execution of this Affidavit is: Robert F. Widman Shirlcy A. Widman 3265 Lexington Avenuc 5oulh 3265 Lexington Avenu e South Cagan, MN 55121 Eagan, MN 55121 Pcbert F. and 3. The Trustees who have exccuted that cerlain instrmncnt, relating to the real property described above, between SYlirley A. Wichan as Trusteepand * dated April 3 , 1996 : * City of Eagn (a) are empowered by tiie provisiuns oi the Ilusi ir5trument tv scll, conve}', rledgc, mortgagc, leasc, or trsuisler litle to any inlcresl in real property held in trust; and (b) are the requisile number of Trustees required by the provisions of the Trust Instrument to execute and deliver such an instrumcnt. 4. The Trust ?X has nat tertninaled or been revoked. ? has ferminated or been revoked, but the execution and delivery of the instrument described in paragraph 3were made pursuant to the provisions of the Trust Instrumenl prior to its terminntivn or revocation. 5. There has been no amendment to the Trust InsUrumcnt which limits the power of Trustees to execute and deliver the insUVment described in paragraph 3. 6. The Trust ?X is not supervised by thc Court. ? is supervised by the Court of County, , and all necessary approval has been obtaincd from the Cowl for the'IYuslecs to execulc and deliver the instrument described in paragraph 3. 7. Af(iant does not have actual kuowledgc of any facts indicating that the'frust is invalid. I, & VA? Robert P. Widman Subscribed and Sworn to bel'ore me this 2- day 1996. ?t- r? • ?--- 17115 INSTRUMLNT WAS DRARTf3D BY (NAME AND ADDRtiSS) SIGNATURP. Of NOTARY PUDLIC OR OTI ILR OFFICIAL SEVGRSON, SIiELDON, DOUGIiBR'CY & MOLGNDA, P.A. 7300 West 147th Street, Suite 600 Applc Valley, MN 55124 (612) 432-3136 (R[3Q: 11206-13462/1)ro.j. 0694) Furiu No. 411.3-h9 ?IiIIcrU:n'is L?._al P?mu? Minncsul;i Uniliirm Cunvcyancing Blawks (1992) W za W p o ?? ?° LJD Q 00 n a T ? O O U W ? p W ? U ¢ n ¢ ? o C Z z ? r y, N W a? w w F ? Z LL _ ~ ? ? F- ? ¢ ? 7>` N D _ .? S V U U?= w P_ ? z ? m w 2 0?- ? F- U a w O g = U ? u'F 00 12 W Y LL w - ? p Z ? mq ? ?i ?o ¢¢ Z W _ ? N U. U? p Q W U O 1i la z D u- ? W W cc a ¢ ¢ 2 U W ? 0 w CC ?-- Z 0 (rescrved for recnrding data) NOTARIAL S'lAMP OR SIiAL (OR OTIIER TITI,(3 OR RANK) ..._ _....._.....-.-.--•.....:....,.-._..., " oI40TARY PUBLGMINtC ;OT.! 7,,??ti;. IA; t:?xr?rv „', I y:' •;A:{.i:. iili) • N ? O ? 1.., 1?1,'?! 1 ?,9IIr lNi'I?IFIC'nlliUPl-ILU.ti'I?N IINN..tiI,\I?.§51111t.5p I'OI'ill NO .40.I'rvi plinuc,n ni?ii?•?.i,:?,?> i l:ilhiilounCouccc:mciugl{I ,???:?i i „????:. :inks(l'/7_') liy InJividufll ?J r W Z Q W? ? ? O Z 7 p O? Z ? U ?? W Certificate W ° ? ? ° > ? Z Z Z_ n ? r1 } a ?„ (1) ? cI w? O of Trust Z2 ?o -? o? °= Q ? W ?r`-w O I- ? 2 ? ? _ a ? [ Y ? ? - =?z ° MZ ?= 0 ? _0 0 aw W ? o V ? 0 Z Z ? p F o0 ? ? o } w O? p w ? O ..``.7 W Wo Y LL w Z O y m ¢ W -'' V Q t- 2 Z w ? Cc O? U? 0 Q W V = ? o LL U STATE OF MINNESOTA ? COUNTY OF DAKO'CA ss. I (reser.•ea rot «c,??????g dam) Robert F. Widman, bci:ig firsi duly sworn, on oath says: I. The name of the Trust is: The 5hirley A. Widiiiaii Trust datcd April 25, 1995 2. Thc date of the Trusl Instrument is: April 25, 1995 3. The name oCeach GrantodSeulor is: Shirley A. Widman. 4. 7'he name of cach original l'rustee is Robert F. Widman and Shirley A. Widinan. 5. The name and address of each Trustce empowered to act under the Trust Instrmnent at the time of esecution of this Certificate is: Robert F. Widiiiaii 5hirley A. Widroan 3265 Lexington Avenue South 3265 Lesington Avenue Soulh E1gan, MN 55121 fagmi, MN 55121 6. Tlie 7'rustces are aulhorized by the Instrument lo sell, convey, pledge, mortgage, lease, or transfer tiUe to any interest in real or personal property, EXCCPT as limited by the following (if none, so indicate): NONE. 7. Any other Tnist provisions the undersigned wishes to include: NONE. 8. Tlic Trust has not terntinated or been revokcd. 9. The slatements coutained in this Certificate of Trust are true and correct and there are no other provisions in the "17ust InsU ument or amendments to it that limit thc powers of the Trustces tu sell, coirvey, pleclgc, mortgage, Icasc, or transfcr tille ro inlcresls in real or pcrsonal rropcity. S' g ture of Trustec or Grantor/SetUor ??, S? a-, By: Robcrt P. Widman Ils: 'frustce 5ubscribed and Sworn to before me this z'"1 day of A.A :1 .1996. ?---- TFIIS INSTRIIMENT WAS URAF'fGD BY (NAMG AND ADDRC•SS) SBVBRSON, SHBLDON, DOUGf IBRTY & MOLENDA, P.A. 7300 West 147t1l Street, Suite 600 Apple Valley, MN 55124 (612) 432-3136 (R[3I3: #206-13462/Proj. 11694) SiCNATURG OF NOTARY PUI3LIC OR 07'11ER Of%FICIAL NOl'AHIAL STAMP OR S13AL (OR Oi'lll?R.'ll'I'I.E OR RANK) ROBGRI B BAU0 ??n?,!ESO;?• 07AflYPUBIJG-h : IJ ttMri[wIaCGUi!Tv , ' /p-dloo0-ozo?7s'? 49- ? 9y RELEASE OF ALL CLAIMS STATE OF MINNESOTA ) ) SS. COUNTY OF DAKOTA ) In consideration of the payment of Ten Thousand Two Hundred and no/100 Dollars ($10,200.00) to ROBERT F. WIDMAN aod SHIRLEY A. WIDMAN, individually and as Trustees for the Shirley A. Widman Trust, dated April 25, 1995, (hereinafter "LANDOWNERS") in hand paid by the CITY OF EAGAN, (hereinafter "CITY") Minnesota, a municipal corporation, the undersigneds, individually and on behalf of the Shirley A. Widman Trust, their heirs, assignees, successors and beneficiaries do hereby release and forever discharge said CITY from any and all actions, causes of action, claims and demand for, upon or by reason of any damage, loss or injury, which heretofore have been or which hereafter may be sustained by LANDOWNERS, their heirs, assignors, beneficiaries or successors as a consequence of Eagan City Project 694 and that ceRain Temporary Construction Easement for site grading and construction purposes, dated April 3, 1996 and filed April 10, 1996, between said parties regarding the following described premises situated within the County of Dakota, Minnesota, to-wit: Commencing at the southeast comer of the northeast quarter of the southeast quarter (NE1/4 of SEl/4) of Section ten (10), Township twenty seven (27), Range twenty three (23); thence north along the east line of said section, one hundred fifty (I50) feet to the place of beginning; thence angle left 89°44' a distance of 290.4 feet; thence angle right 89°44', a distance of 150 feet; thence angle right 90° 16' a distance of 290.4 feet to the East line of said Section 10; thence south 150 feet to the point of beginning, all according to the Government Survey thereof. Said Temporary Easement being the southerly 19.69 feet (6.000 meters) of the above-described property and that part of the above-described property lying easterly of a line parallel with and 88.58 feet (27.000 meters) westerly of the east line of the Southeast Quarter of Section 10, Township 27, Range 23, Dakota County, Minnesota. This Release extends and applies to, and also covers and includes, all unknown, unforeseen, unanticipated and unsuspected injuries, damages, loss and liability, and consequences thereof, as well as those now disclosed and known to exist. Provisions of any state, federal, local or territorial law or statute providing in substance that Release shall not extend to claims, damages, injuries or damages which are unknown or unsuspected to exist at the time, to the persons executing such Release, the undersigneds hereby expressly waive. It is further agreed and understood that this release and payment for the Release of All Claims is not to be construed as admission of any liability on the part of the CIT'Y. Dated: l l - a ? ? ?(b r \ ROBERT F. WIDMAN, Individually and as Trustee of the Shirley A. Widman Trust dated Apri125, 1995 JSHIRLEY . IDMAN, Individually and as Trustee of the Shirley A. Widman Trust dated April 25, 1995 j(AAAAAAAAIAA.A#ArAQAAGAAAAMAA.KAAA,AAAA X ag GrORGE A. ELLEY Ni;Ta7Y PUeLIC • MlNNESOTA t DAKOTA COUNTY y My Commission Expiros Jannv ?'+le?.31,, 2000 g sn9tl3t Subscribed and sworn to before me 3�f�:��nd�l��r� ��, �(�r�r'Pr�g�a�y ��. 56C�7� � .. , - . � �I�� } 4�1-2�56 . �� {9��} ?��-6�7� '�'cz. Je��n t�r�r��rr �` . 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Y++ "r��2��1�°. &�� ,�s;�,�'' �� x ,,. >. ,.. � �. .'��>.� �~� -• �'`�: ."" �� . f � , ; � 1. 9 � ,. ��yt t S t F d % � � .� � r � � �� s : } . ; �{ 3 < ¢ � i Y �� a. `�� { � � � ~ Y .. � � ��F j . . .I. �� „ � � g t � � ° � � ; B � � � � . -�� ,�+ �"�^t;"��``�4 "�`�....��r,�� ?«:�..:,.:�3a3�t�tv�;: �s;. �� ``»�-�.�. `� 4 (w � 1" ,�a�a'..+',� ,e� �"I4'�L�'„ ,,,, ,' `' � _ � � i ' .o''""` � ,� � �� ',� t.� � � �'t ' �`• `� � ' Use BLUE or BLACK Ink �j1�C%� --------, �--------- � t � For Office Use �� ` ! � I i I Permit#: � � Clt� of ��a� � � �- � � Permit Fee: � I 3830 Pilot Knob Road R��;��V�p I Date Received: �� Eagan MN 55122 Phone: (651�675-5675 OC T 2 31015 � staff: j Fax: (651)675-5694 ________ ________� 2015 RESIDENTIAL PLUMBING PERMIT APPLICATION �- �� .� � Date• �r��'�� SiteAddress• _��(G%�� X I�► �- Y� �� . ' � � ��, Tenant: �^� � ` ��- "� �� /4 Suite#: Residen#/Owner Name: �'TJ''r �� r Phone:�a/a'� ��" �$ �� Address/City/Zip: fG°5� �'► �Y -�i� �r�, � �'.�r- Name: �� ` �� License#: � �— c� ,�- Gontracfior address:�$�� <� � ��' city�'�'��'� r`'� S �9�, . _,_ State: �� Zip: _ �� Phone: �� ` � Contact: ��`'�` Email: l�'��'� � �'�✓"��'l/„��-�7�i�, 9 �-P , Typ�Qf WOCk —New _Repiacement _Repair _Rebuild _Modify Space _Work in R.O.W. Description of work: RESIDENTIAL ' Water Heater Water Softener L rrigation(_RPZ/_PVB) Permit Type Septic System Add Plumbing Fixtures�Main/_Lower Level) � Water Turnaround � New Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(inciudes State Surcharge) $60.00 Lawn Irrigation(includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic Svstem Abandonment,Water Turnaround"'(includes State Surcharge) *Water Turnaround(add$210.00 if a 5/8"meter is required) i $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$ 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.aopherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is n to st wit u permit; that the work will be in accordance with the approved plan in th�case of work which requires a review and approval of la X �1��` �[d`'�/�►!� x App� nt's Printed Name �ca s Signa ure FOR OFFICE USE Reviewed By: �� Date: �� a`��C Required lnspections: Under Ground' Raugh-In Air Test Gas Test Final Meter Related items: Meter Size Ra�io Read Ntanometec Staff: MINNESOTA PRECAST INDUSTRIES, INC. 5 4 8 0 1 4 2"d STREET EAST ROSEMOUNT, `��=MN. 55068 �FFICE # (651 ) 437-2200 TANK IDENTIFICATION DOCUM NT (INSTALLER MUST SUBMIT THIS DOCUMENT WITH AS-BUI�T DRAWING) JOB ADDRESS: ��6� �� /� ��' �� ALL TANKS ARE ENGINEERED & MANUFACTURED TO WITHSTAND 84.00 INCHES OF RISER-SOIL ABOVE TANK LID. (CIRCLE ONE) - 1ST TANK: MODEL: 1000 SEPTIC� 1250 PUMP 15��..-�,;,� HOLDI�t - _ 1000i500 2-COMP. � OOS/1000P REVERSE LIQUID CAPACITY IN GALLONS:1000 1250 1500 1000/500 500/1000 DATE TANK WAS MANUFACTURED: � ��--- ZO � � (CIRCLE ONE) 2ND TANK: MODEL: ' 1000 SEPTIC ,�-�.� 250 UMP 1500 OLDING 1000/500 2-COMP. 500S/1000P REVERSE , � LIQUID CAPACITY IN GA�LON :100 1250 1500 1000/500 500/100Q DATE TANK WAS MANt1FACTURED: � �--- 2O � � (CIRCLE ONE) 3RD TANK: M EL: 1000 EPTIC 1250 PUMP 15 HOLDING 1000/500 2-COMP. 500S/1000P REVERSE LIQUID CAPACITY GALL S:1000 1250 1500 1000/500 500/1000 DATE TANK W MANUFACTU D: --- ZO INDIVID L S�WAGE SYSTEM AS-BUILT Date lnstalled`��ermit No.l 3�� Owner: Q—�'/ ` Project Address ".� �tt �� HO Se Type: 1 I III Property ID 0.(PIN) � - �� - �'��-�(Dak Co Tax Info 651-438-4576,or www.co.dako`ta.mn.us) C�t wp ="� Installed for�Bdrms or I � al/da Commercial Use?Y/� � ❑New Replace ❑Repair❑Addition r � � � Property Transfer U rade?�N �— � — I Bsmt Lift Pu p?l�Future?Y I,� + ( Jacuzzi?l�Garb Disp�y� Soil Survey Map Uni � � ]�/�� Soil Compacted?Y l� � � i �" Fill Soil? Y l� a� Circle Soil Texture: � (Faster than 0.1 mpi) Coarse Sand � Medium Sand � � � � � �� Loamy Sand 0.83 �� L� — FfNE�AIVC� f.�� a . nd Loam . { ��c �� , Loam 1.67 Silt Loam, Silt 2.00 � �S° � - Sandy Clay Loam 2.2 �x � �l ' Silty Clay Loam � �f'`' Clay Loam f Silty Clay, Clay 4.2 �� '�� J�U�,I�� (Slower than 120 mpi) � ��, Soil dry enough for � 00 0 construction l N i � ��r �/ /�u�� '�'� SETBACK�Prop.Lines 10'� `� Bldgs 10'to Tank &20'to Drnfld� Well(s) setback_1��Onot installed yet SU� �� fP �� '� Well Depth ( Orig.Well Record( )Measured Distance to Lake�Creek�Wetland� Buried Water Pressure Lines 10'to Tank& Drnfld?/� Line drawn from Ta s to Pump Truck Access< 100'�N System located by Photos?Y GPS?Y/ � � � RESERVE AREA /N Fenced Off. � SEPTIC/HOLDING TANK(S) [� New ❑ Exi �ng Owner informed to preserve Reserve Area? N Liquid Capaci 1 compartment . Owner given Septic System Owner Guide? Y,� Made by (� � Watertight? /N TRENCHES/BED R GRAVELLESS DRAINFIEL.D: Baffle Type: a � Fiberglass Sanitary-T Concr�te Drop boxes level'�N T�rpe con r te� No. of Inspection Pi pe�'4"/ " d�m. nk I'�1D/ T r e n c h D e p t h W i d t h No./Diam. Manhole Access� le ut nt Number of Trenches Tre Bottom Level /�j j No. & Height of Manhole Risers _ a Trench Lengths Spacing / New Tanks 4 ft or less below Final ade N Rock Clean?Y/N 2"over Pipe? Y/N GeoTextile Cover?Y/N Pipes into Tank Sealed? with N Depth Below Pipe? " Soil Backfill Depth " Riser into Tank Base S aled? with �'� �'� �/N Gravelless Pipe ' e? Made by Outlet Effluent Filter? Y/�'Type amber Size? � � ade by � � r OUND / ATGRADE: Absorption Area: Ft Lin 1 Per Slope °/a Scarification Method: Trench Bottom to mottlin /bedr ? inches Dike Wi Up Down ide pUMP TANK Made by � �f Capaci Clean Rock? Depth Below Pipe inches No. & Height of Risers Sealed? /N Clean Sand? Y/N h Upslope " Downslope " Pump Manuf er Model# Inches to Mottling Pip ' pacing Horsepower P �Feet of Head Perf Size/Spacing Fin over Depth " Cycles Per Day Ga Il ons Per Cycle Rock Bed Size Supplier: Size of Discharge Line " �" Sand Base Si Supplier: Type of Electrical Hookup st&box b Upslope ding drainage/diversion? Y/N Provi ? Y/N Alarm Location � a asement Gra ' done:Rough/Fina/ Alarm: Tank Ale ther Seeding ( )Sod to be done by: C Cle Counte . N Water Meter? Y I hereby certify,as installer,that this individual sewage treatment system Designated Regis ed �� j j was installed accor �ng to the a proved design,and as applicable,this Professional Onsite 1i Municipality's S e T m t ystem dinance,&accurately locates � - all system co o nts r I r loca ' PCA Lic.No.�Company Name (�/ �` Isnstn Iler Date: (�'� � � P ' �� Address D�e� �� L �� In � �5 ��dl� �/ Sign Date:f� I�proved:No Yes Yes with Conditions: r White copy:Co ntv Yello : wner Pink:ns aller o:\emg mt\fo rms\walm\ists\as-bu i It-fo rm.doc 4,111° City of Eaali 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 #: l 1/90/. /`0/ (? Permit Fee: 75 Date Received: Staff: t 2016 COMMERCIAL BUILDING PERMIT APPLICATION (O Site Address: 32 (5 be.kt Tenant Name:/-drd7/,`,V //a/46 /)cam 0110 � (Tenant is: New / Existing) Suite #: Former Tenant: CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. CaII 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.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. x (4 vv trIt e -v Applicant's Printed Name x Applicant's Signature Page 1 of 3 Name: pi4-- i &_ FPi le I Phone: 651 `194- O IO Address / City / Zip: 5 Z Bass woo La.ra.tt Applicant is: Owner )( Contractor .T Description of work: 1/1X le ulOW P219 lacc. wet -v-1- q I{, i Construction Cost: (0000 cact Name: 'V Tc- ke,fr0 i� •14.4• License #: Address: 3(0 43 Wood iuutic( Tt4. c ( City: E a k State: OAK` Zip: SSI 2- 3 Phone: 6I2-- 81 3813 Contact: ?A 1)% Email: el V +Chet r 0 SP al g' *-i ( • CO 04 { Archlte " .,,..� Name: Registration #: Address: City: State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewer/water service: Phone #: NOTE Plans an • •porting iocumen at yo + here cons _ e s'®• the in atso e !fieu a - • ubli 1 o u provide spec! rc`reaso a would perm ®,Jude t✓1atheyare trade secrets. A.. o " CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. CaII 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.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. x (4 vv trIt e -v Applicant's Printed Name x Applicant's Signature Page 1 of 3 City of Eaali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 RECEIVED FEB 14 21316 r Use BLUE or BLACK Ink For Office Us Permit #: I Permit Fee: U -33, Date Received: (' aLI`I `f' Staff: '647 2016 COMMERCIAL BUILDING PERMIT APPLICATION ---2'---1C° Date: Site Address: 32 ( 5 e,)6 i n5T"!i`i T+- Aq Tenant Name: Eilqafie/-i I 4I i 7:-r'1er,. (Tenant is: New / Existing) Suite #: Former Tenant: CC 1�p 0 � t�\4 i g� 1 _ Name: 1- ic1-1--fi • fin le I Phone: 65 ) 9(314- 0S- ) So Address / City / Zip: 3 ti 2 �L"..16 ,1 4,-u,v� (..tr 1 mei, S-5- 11 3 Applicant is: Owner X Contractor Description of work: O-�-�t c:2_ Patir"to Construction Cost: 2--C-Ci C ce • b L tl'ar 0t { Name: L►V + ki oji..Ai1ir�tiG 0. License #: �d35`I'/ 8 Address: 34+3 -4-) 0o 4,1 i6V"c1 T rr.4.g 1 City: EA7acv� -a�State: I � � v� � Zip: 5 S (2 3 Phone: � � � d � � — � 73 Contact: ' I ) i DU• �4i c.- v Email: i• 0f r_ 4'i e4t OS @ J road d i c' Min { V Name: Registration #: Address: City: State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewer/water service: Phone #: NOTE Plans and upporting the information ma at you submit con ` publlc lrii fie cla ublic if you viide s concluder? at{the rade secret s . 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 req *isk, a review and approval of plans. x Applicant's Printed Name x Applicant's Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation V Commercial / Industrial Apartments Miscellaneous WORK TYPES New Addition Alteration Replace Salon Owner Change DESCRIPTION Valuation Plan Review (25%_ 100% V ) Census Code # of Units # of Buildings Type of Construction Public Facility Accessory Building Greenhouse / Tent Antennae VInterior Improvement 16/ Exterior Improvement Repair Water Damage t , c.cc REQUIRED INSPECTIONS Footings (New Building) v Footings (Deck) Occupancy Code Edition Zoning Stories Square Feet Length Width Footings (Addition) Foundation Drain Tile Roof: _Decking Insulation _Ice & Water 1.," 7 Fireplace: Rough In _Air Test Final v Insulation Meter Size: Final Exterior Alteration—Apartments Exterior Alteration—Commercial Exterior Alteration—Public Facility Siding Reroof Windows Fire Repair Demolish Building* Demolish Interior Demolish Foundation Retaining Wall *Demolition of entire building — give PCA handout to applicant 13, S•!,, 5.4 2e15 /(ffL 2-_ ,fec 1- MCES System SAC Units S/71C ' 'Lf 4 x4—r City Water Booster Pump PRV Fire Sprinklers v' ,Sheetrock V Final / C.O. Required Final / No C.O. Required Y� Other: Hi( 5T1B9.44/ Pool: Footings Air/Gas Tests Final Siding: _Stucco Lath Stone Lath Brick Windows Retaining Wall Erosion Control Concrete Entrance Apron Final CIO Inspection: Schedule Fire Marshal to be present: Yes v No Reviewed By: , Building Inspector Reviewed By: %A''`( 7 , Planning COMMERCIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC S&W Permit & Surcharge Treatment Plant Treatment Plant (Irrigation) Park Dedication Trail Dedication Water Quality (/ 6 Storm Sewer Trunk Sewer Trunk Water Trunk Street Lateral Street Water Lateral Other: TOTAL: 2_,P33.4.17 Page 2 of 3 4/#1/frCity 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Date: 3/7/2016 R co'E° MpR�a2p16 Use BLUE or BLACK Ink For Office Use 1 �� Y' Permit #: ,5- � Permit Fee: 34fr 7 i L741-67"9-c/Z Date Received: 1 l Staff: 2016 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Site Address: 3265 Lexington Ave Tenant: Suite #: Name: Dutcher Remodeling Phone: 651-688-0758 Address / City / Zip: 3643 Woodland Trail St. Paul, MN 55123 Name: Walter Mechanical, Inc. License #: Address: 1013 East Cliff Rd #101City, Burnsville State: MN Zip: 55337 Phone: 952-895-1992 Contact: Rich Walter Email: mngasgrills@hotmail.com New 1( Replacement Additional Alteration Demolition Description of work: Replace furnace, a/c and thermostat. Re -do ductwork. Furnace "t-4 ( ` c` I Air Conditioner Air Exchanger Heat Pump Other ductwork 7�lew Construction Install Piping Gas COMMERCIAL Interior Improvement Processed Exterior HVAC Unit Under/Above ground Tank ( Install / _ Remove) RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit, includes State Surcharge $100.00 Residential New, includes State Surcharge =$60.00 TOTAL FEE COMMERCIAL FEES $60.00 Permit Fee Minimum $70.00 Underground tank installation/removal Surcharge = Contract Value x $0.0005 If the project valuation is over $1 million, please call for Surcharge or Contract Value $ x .01 _ $ Permit Fee v _ $ Surcharge Q U_ _ $ U TOTAL FEE 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 s . 'without a perm • that the workyifl be in accordance with the approved plan in the case of work which requires a review and approval of plans. Rich Walter Applicant's Printed Name licant's Sigrfatu City of Eagan PERMIT City of Eaan Permit Type: Plumbing Permit Number: EA135549 Date Issued: 03/23/2016 Permit Category: ePermit Site Address: 3265 Lexington Ave Lot: 1 Block: 1 Addition: Engel PID: 10-23880-01-010 Use: Description: Sub Type: Residential Work Type: Alteration Description: Fixtures Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments: Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary: PL - Permit Fee (miscellaneous) $59.00 0801.4087 Surcharge -Fixed $1.00 9001.2195 Total: $60.00 Contractor: Hessian Plumbing Services Box 22172 Eagan MN 55122 (651) 681-8252 - Applicant - Owner: Engel Family Properties Llc 3265 Lexington Ave Eagan MN 55121 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. Applicant/Permitee: Signature Issued By: Signature 411P1P City of EaQali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 APP 0 1 2016 Use BLUE or BLACK Ink For Office Use J -7 ; i/1 7c 4-tb Date Received: -J-` 6 C� Permit #: Permit Fee: Staff: 2016 COMMERCIAL BUILDING PERMIT APPLICATION Date: 'y//i(t Site Address: 3 21c 5 Lel.' t4o-- %►-- Ave 6' Tenant Name: firri EAU* _ J (Tenant is: New / Existing) Suite #: Former Tenant: Property Owner Name: Fan EiNgc-L Phone: Address / City / Zip: 32-10 5 'Leo' ki T`». / v6 ' 5 Applicant is: Owner V Contractor Type Of Work Description of work: 2. 1 m i►JL 1+J 4uS Construction Cost: �i d o a " Contractor Name: VfiLl>rj Z414-Taeel (moi i 1•.-' License #: Address: �i f 35,Resear --g—City: , ?6?Th ► State: H/ i Zip: 551 2.3 Phone: 6,Si — q62.- (1:) S Contact: -4WCic 1-1-/J ` Email: • Architect/Engineer Name: Ob•3 \c1 i ?`€ (Vec') Registration #: Address: %� `ri 1'ai,L4eE= N,y, D'- City: £D� u ) a ?OA) State: M d Zip: 5'53,41 Phone: CI 51 " 14(0S`" 272_ Contact Person: Email: Licensed plumber installing new sewer/water service: 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 they are trade secrets. 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.aopherstateonecall.orci 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. x ' 1 2". Applicant's Printed Name Applicant's Signature Page 1 of 3 - GC,ac1/71- ooN SUB TYPES Foundation ✓ Commercial / Industrial _ Apartments Miscellaneous Antennae T WRITE BELOW THIS LINE _ Public Facility _ Accessory Building _ Greenhouse / Tent WORK TYPES New Addition Alteration _ Replace _ Salon Owner Change DESCRIPTION Valuation Plan Review (25%_ 100% ' ) Census Code # of Units # of Buildings Interior Improvement Exterior Improvement Repair Water Damage /8,600-6 Type of Construction V • 6 REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) ✓` Footings (Addition) Foundation Drain Tile Occupancy Code Edition Zoning Stories Square Feet Length Width Roof: _Decking _Insulation , _Ace & Water Final Framing Fireplace: _Rough In Air Test _Final Insulation Meter Size: Exterior Alteration -Apartments _ Exterior Alteration -Commercial _ Exterior Alteration -Public Facility Siding Reroof Windows Fire Repair /05-61 _ Demolish Building* _ Demolish Interior _ Demolish Foundation ✓ Retaining Wall *Demolition of entire building - give PCA handout to applicant U MCES System /3/4- ( 5" Mgr LE SAC Units City Water Booster Pump PRV Fire Sprinklers Sheetrock Final / C.O. Required Final / No C.O. Required Other: 8A r-fuaiv & Pool: _Footings Air/Gas Tests _Final Siding: _Stucco Lath _Stone Lath _Bridle Windows Retaining Wall Erosion Control Concrete Entrance Apron 17/ Final CIO Inspection: Schedule Fire Marshal to be present: Yes No Reviewed By: CP -A- t G , Building inspector ve.out,A/ c. Reviewed By: P4 -1,S . Alalutintx_, COMMERCIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC S&W Permit & Surcharge Treatment Plant Treatment Plant (Irrigation) Park Dedication Trail Dedication Water Quality 3a9- 7s' f. zb/. 39 Storm Sewer Trunk Sewer Trunk Water Trunk Street Lateral Street Water Lateral Other: TOTAL: SZo . O Page 2 of 3 411111 City of Earn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Pe / / I Pam**! Permit Fee: Date Received: Staff: r_ 2016 RESIDENTIAL BUILDING PERMIT APPLICATION 3� ' ( x I n S • Unit #: +�'� . Date: � 2'� � l Site Address: � .� �- Resident/ Owner __a (fie.. ,n..a 1 Name: 1 0.L y/ C- Phone: `o 17_— V S". 7 3 P ki2S Le f� , e S '15 Address / City / Zip: --x 17V�-4-.) ' 1 Applicant is: Owner Contractor Type of Work Description of work: (`! p i �C�. 'T:I bt g... Construction Cost: Multi -Family Building: (Yes 1 No ) Contractor /� - i)7 Company:'/�Wi L 6"d0K040- j Contact g? CS �i2.4MOWir& Address: 510151 L= RL�� N. City: a Ut S , �j State: /�' S t p: $%& Phone: 9c2.-(991, '&il:Q/Nelae-c4P012w 4 s--6 License #: ' 405733-234:5 Lead Certificate #: /144 A T - 72..._,T3 - 1 If the project is exempt from lead certification, please explain why: (5 (4J, In the last 12 months, Yes No COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? If yes, date and address of master plan: Licensed Plumber. Mechanical Contractor Sewer & Water Contractor. Fire Suppression Contractor. Phone: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit am considered to be public Information. Portions of the information may be classified as non-public if you provide specific reasons that would ppm* the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-00022 for protection against underground utility damage. CaU 48 hours before you intend to dig to receive locates of underground utiNties. 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. Exteriorwork authorized by a building permit issued m accordance with the Minnesota State Building Code must . : comped wilhii 180 days of permit issuance. x t � r' Fyl-60 e#4 f -r2 Applicants Printed tifame Applicants Signature Page 1 of 3 City of Eagan PERMIT City of Eaan Permit Type: Plumbing Permit Number: EA137687 Date Issued: 07/15/2016 Permit Category: ePermit Site Address: 3265 Lexington Ave Lot: 1 Block: 1 Addition: Engel PID: 10-23880-01-010 Use: Description: Sub Type: Residential Work Type: Underground Sprinkler System Description: PVB Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments: Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary: PL - RPZ/PVB/Lawn Irrigation $59.00 Surcharge -Fixed $1.00 0801.4087 9001.2195 Total: $60.00 Contractor: Drain Pro Plumbing 8815 - 209th Street W Lakeville MN 55044 (952) 469-6999 - Applicant - Owner: Engel Family Properties Llc 3265 Lexington Ave Eagan MN 55121 (612) 940-7852 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. Applicant/Permitee: Signature Issued By: Signature