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4225 Lexington Way?Csf? I C O ,? U N ? ENVIRONMENTAL MANAGEMENT DEPARTMENT ? GROUNDWATER PROTEC710N SECTION 14955 Gaiaxie Avenue • Apple Valley, MN 55124 952.891.7557 • Fax 952.897.7588 • www.co.dakota.mn.us MUNICIPAL NOTICE OF WELL SEALING PERMIT APPLICATION DATE: July 29, 2004 TO: Tom Colbert/Wayne Schwanz (EM) RE: Well Permit #: 04-1-1225138 Municipality: Eagan Fax#: (651) 675-5694 Well Type: Domestic Environmental Specialist: Rutten The Water and Land Management Section of the Dakota County Environmental Management Department has received the following permit application for the well described, lf you require further review of the application or if you liave any questions or concerns about it, contact the Emironmental Specialist listed above or our office at (952) 891-7011. If there is no response from your office within 24 HOURS (excluding weekends and hoiidays), we will assume that you have no objections to the issuance of the permit. Please note that permit issuance is always conditioned on the permit applicanYs observance of and compliance with all applicable state, county, and municipal laws and codes. Well Contractor: Date Application Received: Anticipated Drilling Date: Anticipated Grouting Date: Property Owner: Well Owner: WELL LOCATION: Don Stodola Well Drilling Co. 7/28/2004 Time: Time: Veit & Company Veit & Company PLS Coordinates: _ NW 1/4, NE 1/4, NE 1/4, Sec 27 Town 027 Range 23 Street Address: 4225 Lexington AVE S >• : PIN Number: 100270001201 WELL INFORMATION: Diameter: 4 Casing Depth: 121 Total Depth: 125 Static Water Level: Aquifer: COMMENTS: Fjie Edik Wiew Taols ,gpplications Nelp ?+i P R K Y \ f ..d:i Connection ? Commerrts I Eagan Building I Eagan Developmsnt ? Farmits Owrrer I Eagan Assessl5eles I Eagan Proper#y I Eegan ParcellD 1Q027QQ01201 Addrsss 4225 LEXINGTON 4VAY Owner 1 C)wnsr 2 Owner 3 Owner 4 Search PID 100270001201 I Search Mouse ? 146 M1LLEH1ALLE lNC ? ry 1556 MURPHY PiCWY " EAGAN MN 55122 ?. b S'6?jLq 2004 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. ?J ? ? S Date ? / 3 ? ! ol Site Street Address Unit # PropertyOwner ? I ?uv11 ?? ??, q M. 11v Telephone #(4?1 ?-7a3 - 713 "1 Contractor _ Vc: Telephone # (76 1 ) yaK - ;0 yz Address Iyooo 1/c:? Pi"c City??J State M6? Zip Ss37 The Applicant is: _ Owner Contractor _Other Alterations to existing dwelling _Add fixtures to rooms, excluding water softener and water heater XSeptic System Abandonment _ Water Turnaround (add $121.00 if a 5!8" meter is required) Other: $ 50.00 Water Softener Water Heater _ replacement _ additionai $ 15.00 Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00 State Surcharge $ .50 Total $ 5a. Sa 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. -- :51f o.. Muc 1 j» Z?2? ApplicanYs Printed Name Ap i anYs Signature ? s6;?3 -7s s 19 2004 RESIDENTIAL BUILDING PERMIT APPLICATIOPT City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone 9 651-675-5675 FAX # 651-675-5694 New Conslrudion Renuirements RemodeUReoair Reoulremenls Office Use Onlv 3 registered site surveys showmg sq. fl. of lot, sq. ft, of hause; end aU mofed areas 2 wpies ot plan Ceri of Survey Recd Y _ N (20°k maximum lot coverage allowed) 1 set of Energy Calculations for heatetl additions Tree Pres Plan Recd _Y _ N 2 Copies of plan showing beam & window s¢es; poured found design, etc. 7 site survey toradditions & decks Tree Pres Required _Y _ N lselofEnergyCalalations AddiBon-indicatei(an-sitesepficsystem On-siteSepticSystem _Y _N 3 copies of Tree Preservatlon Plan'rflot platted after7/1193 Rim Joist Detail Options seledion sheat (bldgs with 3 or less units nace 7t i 3 o r o`f lM+lil.' e - tratthM cost 13,? a oo. o 0 SiteAddress YRa15 L.tx' .ivn L.1t Unit/Ste # DescriptiooofWork RtJ.de...4 ..( UausG Multi-Family Bldg _ Yk N Fireplace(s) _ 0 _ 1 _ 2 PropertyOwner Ka-. M: lt'r v?j 1, ?.{.nr. Telephone#(61? ) 7.2,3 -713'7 Contractor VG'? 4- C? _-i c , Address 1,4400 ? Ve:k Plqi, CiTy f2ojers ?;,?a%4 State /N hl Zip Ss3 ? y Telephone #(763 ) y-77•0!? COMPLETE THIS AREA ONLY IF Energy Code Category - Minnesota Rules 7670 Cateeorv 1 • Residential Ventilation Category 1 Worksheet (J su6mission type) Submitted • Energy Envelope Calculations Submitted A NEW BUILDING Minnesota Rules 7672 . New Energy Code Worksheet Submitted Have you previously constructed a building in Eagan with a similar plan2 _ Y fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone # ( Telephone # ( Telephone #( N If so, 25% plan review I hereby apply for a Residential Building 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 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; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. 7saso.. Muellcr Applicant's Printed Name A ' ant's Signature QFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg ? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi ? 03 01 of_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea ) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc, ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Pibg_v or_ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Fountlation ? 45 Fire Repair ? 33 Alteration ? 37 pemolish Building* ? 43 Reroof ? 46 Windows/Doors M 34 Replacement `Demolition (Entire Bldg) - Give PCA handout to applicant 0 1 3 aa 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 I NSPECTIONS _ Footings(new bldg) FinaUC.O. _ Fooangs(deck) FinaUNo C.O. _ Footings (addition) _ Plumbing _ Founda6ion HVAC _ Drain Tile Other Roof - Ice & Water _ Final Pool Ftgs Air/Gas Tests Final _ Framing _ _ _ Siding Stucco Stone Brick _ Fireplace _ R.I. _ Air Tes[ _ _ Final _ _ _ Windows _ Insulation _ Retaining Wall Approved By: , Bu ilding Inspectar Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total EI . ` , CUPLA-MANMa 74000 Veit Place • Rpgers, MN 55374 • Phone 763.428.2242 • Fax 763.428.8348 • www.veltcompanies.com 9.CI'.19]X Earthwork Demvtitian UnAerground Uiiiities Environmental i0untletlon Systems Induzviai Sarvlces amrme5re acnon Eq-1 oavawniM bnpieyer ? VEIT & COMPANX9 INC. Date: Wednesday, August 18, 2004 Total Pages Including Cover Page: 2 To: Craig Novaczyk - Ciry of Eagan Fax Number: 651-675-5694 From: Jason Muelker- Veit & Company, Inc. ' .?., f.i' • . ,.r., .?. ? Notes/Comments: Re: SeptiC Tank Abandonment @ 4225 Lexington Way, Eagan, MN The fpllowing is a copy of the septic pumping service report by Boss Pumping. Three septic tanks existed on the site. Two were pumped and one was dry. All tanks were removed by Veit and ihe holes were backFilled. The concrete tanks were hauled to Vonco II LLG Landfill in Becker MN. Please call me if you have any quesrions or if you require any additional information. Thanks, Jason Muelfer 763-428-6743 Confltlentialily NoGce: Tha CCam0ntl51 accornPanYoS thps fax co^oIns renfidenttal infomolan. "fhe informanon is onty for the ue6 Of tl79 Irtten6atl reclpreM nametl ehovC, N you are not the "sdenOeC reciDienC, you are hemby nvtlfl2d thet arry dixlosure. oopying, disMbution, er the laking of any action m rtlience on tlhe mntents of the IBieMPied IMOrtna[ion excea[ 115 tlMect tlefvery to tha intended reaDierR named is strfetly prohibited. H you have recenred lhm fax in ertor, pl9ase no5{y us immediateVy hY tN9phane ta artange for retum M the Ori9inal Aocuments te M. "Best Servicp in rhe eusiness" VdE-d Z00/100 d Y10-1 BYEB BZY E9! gB!uEaWOo 11an-008i El:ll YOOZ-9fIY-Bl 87Z88zb29L Name: t I f?. Address: ? c;ty: Zip: Phone: (_ ) or BiII To: - State: . ,.i [1 Day ? Nigttt Wnrk Deccrintinn P.O. Box 534 Forest Lake, MN 55025 Offtce (651) 466A800 Dffice (763) 434-6744 Fax (651) 982-1357 7[nvoice #: _ D `f js I_ Date: -- Ed-,! G? 4- 5'` Purchase //p i // Q J') ? Qrder #: /1( ? ?7 U?7 Type of Service Xtesideetial ? Commercial m Time En:JW-Time put . Residential Commercial OY 1 Tauk +?J # of Gallons: Flammable Trap/s: ? nt1 2 Tanks ? # of Galloas: Sand Trap: ? ? ? Lift Sfation ? # of Callans: y Sand Pitls or Trench: ? o,'PLJi,Gallons x4w G ?e Trsp: ? ? Dump Site: ?j,J /3-?-. Flolding?aok/s: ? - WasteType: DomesticlDPhde/Holding LittSration: [] OTHER: Method af Removat Total # otGallons: Dump SFte: - CleanadthroughManhole [] Waste'Cype: Camrn/1ndsL/Aom/Dilure/?folding Pumped through Vent Pipc ? Partioa of Cover lZemavM ? •,Ul aoiid wastc dispoup eneMods arc spproved by i, M.C.E.S. aadlor M.P.C.A. Condition o4 Baft7es: GOOD ? Otder ? ?`ype of Ssrvice Evideace o[ Urainage Problems: Xes ? No ? Regulsr Maintena , Yes 0 No 0 CommenLt: Urgent/Emergeecy: Yes ? lvo CJ Commeats: a Pumping g . . ? FaymentMethods Permit Cash: ? Check: ? (# } Miscellaneous Sand / Dump $illin 0[ptUCrC48l O` IyIA ' TOTAL DUE , Te s: Net 30 Days ' I ? Thank You for chaosing $OSS Pumping. We appreciate your business. e abo described work will be / has been completed properly based on the xn£ormation and descriprions givezt. We are eommitted to "doing the job night", the first time, every time. Service Accepted By: _ YZE-d i00/200 d Y10-1 8YE8 BdY 891 ? Date: _ saiuedwoO 3iBAiYOtll £ V l l 900d-90tl-B l