3788 Greensboro DrCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 3788 Greensboro Dr
Lot: 2 Block: 2 Addition: Greensboro 1st
PID:10- 30900 - 020 -02
Use:
Description:
Sub Type: e- Windows/Doors
Work Type: Windows/Doors - New/Replacement
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Home Depot At Home Services
656 Mendelssolm Ave. N
Golden Valley MN 55427
(763) 542 -8826
PERMIT
City of Eaan
A framing inspection is required when installing a Bay or Bow window or if the opening is altered. Smoke detectors are
required in all sleeping rooms prior to final
inspection. When wall studs or ceiling joists are exposed, hard -wired detectors are required. Battery operated types are
acceptable if the wall/ceiling finish (i.e. sheetrock) has to be removed to install a smoke detector.
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total: $90.00
Applicant/Permitee: Signature
- Applicant -
Construction Type:
Occupancy:
Owner:
Joseph E Towle
3788 Greensboro Dr
Eagan MN 55123
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$88.50 0801.4085
$1.50 9001.2195
Building
EA083987
07/02/2008
ePermit
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply with all applicable State
Issued By: Signature
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 3788 Greensboro Dr
Lot: 2 Block: 2 Addition: Greensboro 1st
PID:10- 30900 - 020 -02
Use:
Description:
Sub Type:
Work Type:
Description:
Census Code:
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Home Depot At Home Services
656 Mendelssolm Ave. N
Golden Valley MN 55427
(763) 542 -8826
e- Windows/Doors
Windows/Doors-New/Replacement
House
434-
Applicant/Permitee: Signature
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
- Applicant -
Construction Type:
Occupancy:
Carbon monoxide detectors are required by law in ALL single family homes.
$88.50
$1.50
Total: $90.00
Owner:
Joseph E Towle
3788 Greensboro Dr
Eagan MN 55123
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
0801
9001
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
Building
EA088069
01/28/2009
ePermit
REGIUEST FOR ELECTRICAL INSPECTIQN
10- See instructions for compieting ihis torm on back ot yellow copy.
M 3 5.224 'X" Below Wft-C&VW'by 7fiTs Request
EB-00001-08 1
:XINm S ?
ew Ad6 ep. TypeofBuilding ` ptiancesWired EquipmentWired
Home Range Temporary 5ervice
Duplex Water He ter Electric Heating
Apt. Building Dryer Load Management
Comm./Industrial Furna other (specify)
F Air C di ioner
; Other (sp cify) Contrecter Rcmarks:
i - W? ?? ?
a
? v ?1 ? n ?? ?Q
-
?,?
Compute lnspection e Belo : -1
# ' Other e Service Entrance ' Fee # Circuits/Feeders Fee
/ Swimming Pool ? 0 to 200 Amps 0 to 100 Amps
Transformers ' Above 200 =Amp Above 100 Amps
? SignS / Inspector's Usa Only: 7DTAL
Irrigation Qoo
Spacial"Inspebtion 1 I ,
?
Alarm/Communicatio 4lATION MAY 8E OHDERED DISCONNECTED IF NOT
THIS IIV67;A
Other Fee COlbIPt, ED WITHIN 18 MONTHS.
I, the Electrical Insp tor, hereby Rq°9 '" ' oate
certify that the above in [CtfOtl I(d?
` inal Date
been made. '
?
OFFICE USE ONLY I
This request void 18 montha iro \-
i
i
- - -- - --. . _ _ i _. . _. . ---- -- ----------- -- -...- - -- ------ ---------- - -
M 35284 , iv\,; -3,
Request Date Fire No R il? u h-in inspectfon NQTICE: You Must Call Electrical Inspector
` Fe ulred?
?Yes fl No If A Rough-In Inspection
Is Required.
I,k licensed contractor ? owner herepy request inspection of above electricai work at:
Job Adtlress (Street, Box or Roule No.) , City
? 8 S r r c?.
Section No. Township Nam or No. pange Nb. ' County- '
Q+
Occupant(PRINT)
t-l' I - - Phone No.
Power Supplier Ac.ldress
Electrical Contracipr (Company Name) Cortractorl License Na.
Ct))Jjns Ele l( bn CI?. CA U Co
Mailing Address (Conhactor or Owner Making Installation)
?'s1U ?
Authorized Signature (CoMractodOwner Makirtg I stallation) Phone Number
_I??.Ll?l.l _?A1 I'iv(.]E
1
MINNESOTA STATE BOARD OF ELECTRICfTY
///111
Grlgga-Miciway Bldg. - Room S-173 ?
1827 Universtty Ave., St. Paul, MN 55104
Phona (612) 642-0800 THtS INSPECTION REQUEST WILL NOT,^
BE ACCEPTED BY THE 5TATE 80ARD `-?
UNLESS PROPER INSPECTION FEE IS
?? ENCLOSED. -
REGIUEST FOR ELECTRiCAL INSPECTION
po. See instructions for campleting this fomt on back ot yellow copy.
M ?--3,'r?,3-6.2 `X° Be/ow Work Covered by Thrs Request P,)( +
ew Adtl Re . TypeofBuilding AppliancesWired EquipmentWired
C( Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building yer Load Management
Comm.llndustrial Furnace Other (Specify)
Farm Air Conditioner
Other (specify) Contractor's Remarks:1?
J
++-
Compute lnspection Fee Below:
# Other Fee # ServiceEntranceSize Fee # CircuitslFeeders Fee
Swimming Pooi 0 to 200 Amps o to 100 Amps
Transformers Above 200 Amps Above 100 Amps
SignS I nspectorg Use Only: 7f'OTAL r?
Irrigation Booms V
Special Inspection
AlarmlCommunication THIS, INSTALLI4TION MAY BE OHDERED DISCbNNEGTED IF NOT
Other Fee CaMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Aough-in Date
certify that the above inspection has
6een made. Finai Date
OFfICE USE ONLY Thia request void 18 months from
-- - - - - ----- ----------- -- - - -------- - -- ---
-
? ?i ,,-i,7ci.
-
M 35362
Request Date
1 v- - a Fire No. Rough-fn Inspection
Re$Iuired?
?.Yes ? No NOTICE: You Must Call Eiectrical Inspector
If A Rough-In Inspectian
Is Required.
ISiLlicensed contractor ? owner hereby request inspection of above electrical work at:
Jab Address (Straet, Box or Route No.) Cfty
Section No. Township Name or No.
J Rahge No. C unry
(-??
OGCUpaM (PRINT)' = .
'
e L10 Phone No. `-
PoWer Supplier Address
Electrical Contractor (Company Name) • 7
- -?rr ?l C ? 'nuC-?-?o?n ? c oMractort Ucense No.
ov o to
Ma ling Address (Contractor or Owner Making Installatlon)
-l -e S? • Q0..u` ? K)
on
Authorized 5 nature (ContrRCloNOwner Maki tl
? 1,,M
n m _
Phone Nub r
a ? - ? ?533
1NlNNE30TA 3TATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Grlggs-Mldway Bldg. - Room 3-173 BE ACCEPTE6 BY THE STA'fE 80ARD
1821 Univernlty Ave., St. Paul, MN 55104 UNLESS PROPEFi INSPECTION FEE IS
Phone (812) 642-0800 ??-?' ? ENCLOSED.
BLDG. PERMIT ti0. I
01-3210 ?^ T
, 'Blc?g: rmit
01-34'22 A •` ?
Plan Check
01-3445 Surch./Adm.
01-3446 SAC/Adm.
01-2155 Surcharge
17-3860 Road Unit
20-2275 SAC
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permi
20-3743 Sewer Permi
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTAL
?
?
J ?.
? CASH RECEIPT •
CITY 4F EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
?DATE _„ 19
r+acsIven . / / A
$
BY
?., , .., . -
. ?.
White-Peyers CopY
Yellow-Posting Copy
Pink-File Copy
Thank You
CUSTOMER'S DEPOSIT
Joe Miller Const, $ 30.00
Depoeitar .? (,c'?,?,
3788 Greensboro Drive Receipt No. 72088
„?.A - --
Account No.
REGORA OF Z'RANSFERS
New Addreas DaCe Atcount No.
Applied on account $
Refunded $?.? 19 Gheck No.
BAGAN WATEx AND SSideR DEPARTlENT
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
. ? + ja isclttt
? PERMIT SUBTYPE:
vSPECTIUN RECORD
PERMIT TYPE: '
Permit Number:
Date Issued:
APPLICANT:
TYPE OF WORK:
I INSPECTION .. • DA
,? :
Permit No. Permlt Holder Date Telephone li
S/W
PLUMBING
HVAC
ELECTR
ELECTRIC
Inspection Date Insp. Comments
Footings I
Foundation
Framing
Roofing ?
lr3 J
Rough Plbg.
Rough Htg. s, d y?
Isul. ?
Fireplace
Flnal Htg.
Orsat Test
Final Pibg. Pibg. Inspector - Notify Plumber
Const. Meter
Engr./Plan
Bidg. Final
Deck Ftg.
Deck Final
Well
Pr. Disp.
• PERMIT #
PWMBINGi PERMIT RECEIPT #
CITY OF EAGAN . i .
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE
Site Address Lot Block
Name
?
? Addre.
c City _
? Name
3 Addre
p City ?
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMiJM - 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)
BLDG. TYPE WORK DESCRIPTION
Res. New
Mult Add-on
Comm. Repair
Other
NO.; FIXTURES TOTAL
Water Closet - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
Urinal/6idet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whirlpooi - $3.00
Gas Piping Outlets - $1.50
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE
STATE S/C:
GRAND TOTAL•
FOR: CITY OF EAGAN
. . PERMIT #
. ,
• MECHANICAL PERMIT
' CITY OF EAGAN RECEIPT #
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
- CONTRACT PRICE: PHONE: 454-8100
Site AddrT ^ r BLDG. TYPE WORK DESCRIPTION
Lot.,.
Block Sec/Sub ?
? Rgs
-_ NeW
Mult Add-on
? Name
? Comm. Repair .
i
Address .
Other j
c City Phone
-• , ? , , FEES
Name "?- ° - - RES
HVAC 0-100 M BTU
$24
00
? .
-
.
c Address ADDITIONAL 50 M BTU - 6.00
p City ? ? - Phone (RES. HVAC INCLUDES A/C ON NEW
? CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMIn - 1.50 EA.
TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
Forced ?r B7U APT. BLDGS. - COMM. RATE APPLIES - -
B
i l
T
M TOWNHOUSE & CONDOS - RES. RATE APPLIES
er
o B
U MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT -
50
.
Vent. ? CFM (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # BEYOND $1,000)
Other
FEE
S/C: ? SIGNATURE OF PERMITfEE
, .
'
TOTAL•
FOR: CITY OF EAGAN
CITY OF EAGAN ? ? 13323
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHON E: 454-8100
BUILDING PERMIT Receipt#
7o be used tor SF DWG/GAR Est. Va1ue $105, C)00 Date MARCH 10 ,11987
Site Address 3788 GitEE?ISBUxO DR ?
Erect
? ?3
Occupancy
Lot 2 Block 2 Secisub. GAEENS BORO 1ST Remodel ? Zoning
Parcel No ' Repair ? Type of Const. v
. Addition ? No. Stories
¢ Name JOSEPr ^iILLER CONST Move ? Length
=
18133 CEDAf2 AVE SO Demolish ? Depth
3
° Address
' Int Impr. ? Sq. Ft
ARH
?ity F 1NGTtRone 892-1010 Install ?
2 o Name SAME
-c Address
~ City Phone
W W Name
i=
u n Address
i z
W Ciry Phone
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 Orlinances.
Signature of Permittoe? •- ????,?c... _ ?,
' ?OSEPH MILLER4CUNST
A Building Permit is issued to: -!
all work shall be done in accordance with all applicable State o( Minneso
Building Official
Assessment
Water & Sew.
Police
Fire
Planner
Council
Bidg. Off.
APC
Var. Date
Permit + ,?"••?
Surcharge 25T
? 2
7 3
Plan Review
SAC h25•UO
Water Conn. 525.00
Water Meter 67.00
Road Unit 3(}5•()()
Tr. PI. 180.00
Parks
Copies
- - • $2,532.25
on the express condition that
City of Eagan Ordinances.
PermH No. Permit Holder Date TMsphorw k
Plumbing
H.V.A.C.
el.eaie
Son«N?
In.pacdon Dan Imp. Commenh
Foofings 1
fooNnys II
FoundaNon
Frsmin9 y / ,y? ?j /1/? /?- ?•?J ,TcuST
Rooflny
Rouyh Plbg. -?- Q] fJ, ,
Roug, Htg. y1 p?
Insul. y ? ? ?
Fkeplaee
FMsI Hty.
Flnsl Piby.
Bldq. Final
Ca1. Occ.
z
Dock Fty.
Deck Frmp.
WNI
Pr. Dlsp.
OF EAGAN Permit Na .3 703
PIIorKnpb Road Meter No:
3ox 21199 Reader No:
M N 55121
Date: 5-6-87
Size:
Date:
nn. Chg: 525.00pci Zoning:
;t Dep: 15 •00pd No. of Units: ?
•mit Fee: It)• 00pd
charge: • 50P,' 1 agree to comply with ihe City of Eagan
Plant ' "" •'??0i-', Ordinances.
ter. C. ; ; 4; P.?
:c.: By
WATER SERVICE PERMIT
OF EAGAN '
P???T K?1ob Road SEWER SERVICE PERMIT 1
3bx 11199
PERMIT NO.:
ri, MN 55121 DATE; 5-6_0-7
9: Ti
No. of Units: Z '
??'{iller Cocsr.
'- 1 agree to eomply wRh the City oi Eagan v N }ha
Connection Charge; - 515 • 00
Ordinances, Account Deposit: 15
U't)pd
Permit Fee: 10 0Opd
Surcharge: 50
f gy n ??? :
?
Date of Insp.: Misc. Charges:
? Insp" 7otal:
??__. Date Paid:
CITY OF EAGAN Permit No:
3830 P.(!ot Knab Road Meter No:
P.O. Box 2' 199 Reader No: ? ?
Eagar? MN 55121
,
Date: 5'` `87
Size: 61- " e., c.K
oate:
?. ?
SiteAddress: 3728 l:rtnnchnrn iri<<E? 72 R? ?rePnsGOr,? lst
D1.....'{,4-., --
Conn. Chg: 525.00 Pd \IM
\igoS `-{
W!=?on?r
-
q
?
-
Acct Dep: I_5 .0() . d
Permit Fee:
Surcharge: rI Q dl?V
•`? , ty I?q?e oA14 with e Clty of Eagan .
Tr. Plant
-, f ?
Meter, e
Misc.: By
?
WATER SERVICE PERMIT
? CIn °F FA"N SEWER SERVICE PERMIT
? 3830,pIlot Kngb Road
i P.O. BoxA'199 PERMIT NO.: '????
Ea9a4+'l1AN 55121 DATE: , _
? Zoning: - 7::1 Nn. of Units: 1
' Owner. .7oe ? filler Const.
Address:
SiteAddress: 37-818 Grec+: _ r? v?' :' T? rr. eatls:boro lst
Ptumber. Plymvut?? P M- 1$
3-1 07 ,` d
' 1 agree to comply wNh tf?al?? ca1l ien arge: 5' 5 - 11011
e,
i.
l Ordinances. _
'? t
TELEPHOl?E - tL'?..t??GOUh[?'e biit: 1 5_(lcl?rt
? it e •is1 10_?1??
REQUIRED A
g?'`
By s?,rr,
?a
Misa' Charges:
Date of Insp.: Total:
InsP•: Date Paid:
[.
i
CITY OF EA?iAN Permit No: ??d' Da?: ? c:7 ?
3830 Pilot Knob Road Meter No: Size: ?
P.O. Box 21199 Reader No: Datec
Eagan, MN 55121 ?
Site
C.-reen
5nS.0Q d F1
Conn. Chg: 7 n.
Acct Dep: 7• 00pd _ No. of Units: "
Permit Fee: i0, 00pd
Surcharge: ' S0pd 1 agree to comply with the City of Eagan
Tr. Plant V0' ?10pa Ordinances.
Meter. 67 nngu
M isc.: By j
WATER SERVICE PERMIT '
- -- - -------y
--- --
' OF EAGAN SEWER SERVICE PERMIT
i Pilat Knob Road- -
Box 21199 PERMIT NO.:
?;- .. .:
on, MN 55121 DATE:
?9: ?'?' No. of Units: i
er - Joe Miller Const.
---- % ? ?
ae to comply wRh the City pfffi`aga6-" Conn ' n Charge:
?. _
iances. ount Deposit: -
Permit Fee:
Surcharge:
Misc. Charges: -
of Insp.: Total:
REQUEST FOR ELECTRICAL INSPECTION
( ? See inshucnons tor compleeng this farm On buk af yellaw copy
M -3 5 2.8 4 "X" Below Work Covered by This Request
? EB-00001-08
f / ? 9-S 7
`?; 4 RX 13cX??
e Add Rep TypeotBuilding A hancesWired EquipmentWUed
Home Range 1 1 7emporary Service
Duplex Water He ter Electnc Heanng
Apt Building Dryer Loatl Management
Comm /Industrial Furna Dther (Specify)
ExLa- Air C d ioner
Omer (SPIC iry) Comr c r ,R,am'alrxs
Com fe Inspectian e 8elo ? . I _ - ^
L??
l.
# Other e # Service Entrance5 ee # Circmis/Feeders Fee
Swimming Pool 0 to 200 Am s 0 to 100 Amps
TranSformers Above 200 _ Amp Above 700 _ Amps
SignS Inspedors Use Only TOTAL
Irrigation !\
Sv
Sp Insp hon
Alarm/Com unicatio THI5 I A A ION MAV BE ORDERED OISCONNECTED IF NOT
Othei F COFfpk WITHIN 18 MONTHS.
I, the Electncal Insp or, her b R ug in Data
certifythattheabovein
been made. ection a in
' oate
OFFlCE USE ONLY
Tnis requeat vaiC 18 manl ira
/??51%3 \
M 3528 /4?Ys7
7V
4
Request Date ire No -in Inspeclion ?
uired7 NOTICE: You Mus(Call Elecincal Inspeclor
If A Rough-In InspecMion
Yes ? No Is Reqwretl
1 0 licensed contractor ? owner he e request inspection of above electrical work at:
Job Adtlress (SYre9t, eox or Route No )
m Qry
E
3 o4cui
Sedion No Township Name ar No. Range No. Counry 1 ?
? 1 `"
Occup nt(PRIN? phone No
-e?? - -
Pawer SupPli¢r Adtlress
Eledncal CoMradOr (Company Name)
Collins Elec-tr? ' Coniract^•5 L?cense No
C11k C7 (o
Mailing Atltlr¢ss (ConVactar o? Owner Makmg Installatwn)
?
`
?-
P
J 5510 '7
A
? r .
?,? .t?
Authonxetl Signature (COnVactoAOwner Makmg I slallanion) P?one Number
?-
3
MINNESOTA STATE BOARD OF ELECTpICiTV cJ? ? ?
Griggs-Mitlway Bldg. - Roam Sh73 ti•C??
1821 Unlversity Ave., SI. Peul, MN 5510J (f???
Phone (612) 6A2-0800
THIS INSPECTION REQUEST WILL NOT?QS
BE ACCEPTED eVTHE STATE BOHRD ??1`O
UNLESS PROPER INSPECTION FEE IS y
ENCLOSEO
p
?
A 3'5 3 6 2
Request Date
? "? Fi No Rough-in Inspectian
Repmred7
?Yes ? No NOTICE: Vou Must Call Eledrical Inspeclor
IiA Rough-In Inspechon
Is Requiretl
I'FAlicens contractor ? ner hereby request inspectio bove electrical work at:
Job AOtlre (Street, 6ax or Route N
r o
SecOOn o Tow ip N e o o Range No. C un
?
pccupan[ (PRKT)
y Phone No.
O
1 ' I
PowerSuppher ?- dtlress
Eleclncel ConVactor (COmpany Name)
c otractOr§ 1-censg No
qol
o? 5\ 0
Mailing Atldress (COnVactor or Ownar Makmg Installatian)
a-l ? ?-es ee_ IW.?J S?7 07
Authonxed 5' natura ConVactOtlOwner Mekil g In talla0on) Phone Num
??.c?,?nn.n?? _ . _ a?. r
-ag33
MINNESOTA STATE 90AHD OF ELECTHICRY_ ?L THIS INSPECTION REOUEST WILL NOT
Gripgs-Mitlway Bldg. - Room 5173 BE ACCEPTED BY THE STATE 60ARD
1821 Universky Ave., SI. Paul, MN 55104 n• ??1 UNLESS PFOPER INSPECTION FEE IS
Phone (612) 842-0900 L'`? ? ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION
? See instmclions for compleLng this form on back of yellow copy
M 3 5? 6 2 "X" Below Work Covered by This Request
0 c?? /?-
? ? Rx i aa??
New Add Rep TypeofBuilding AppliancesWired EqmpmeniWired
Home Range Temporary Service
Duplex Water Heater Electnc Heating
Apt Builtling Dryer Load Management
Comm /Industrial FufnaCe Other(Specrfy)
Farm Air Conditioner
Olher (spacily) Contractor5 Femarks.?1U,,
Compute Inspection Fee Below:
# Other Fee # ServiceEntranceSize Fee # Circuils/Faeders Fee
Swimming Pool 0 to 200 Amps D to 100 Amps
Transformers Above 200 _ Amps A6ove 100 _ Amps
SIJnS [nspecror5 Use Only TOTAL
Irrigation 8ooms
?
, ?? ?
s .5
Special Inspection '
Alarm/Communicahon THIS INSTALLATION MAY BE ORDE SCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rough-in oate
certifythatthe above inspection has
been made. F,,,ai ? e
OFFICE USE ONLV
TNS requB3t witl 18 monlhs hom
CITY OF EAGAN
Np
13323
3830 Pllot Knob Road, P.O. Box 21-1 _
99, Eagan, MN 55121
PHONE:454-8100
BUILDING PERMIT
Receipt# ?j?/
?
To 6e used lor SF DWG/GAR Est. Value $105,000 Date MARCH 10 19 87
3788 GREENSBORO DR
Site Address
Erect 11
Occupancy R3
Lot 2 Block 2 Sec/Sub. GREENSBORO 1ST Remodel ? Zoning
Parcel No Repair ? Type of Const. V
.
Addition ?
No. Stories
? Name JOSEPH MILLER CONST Move ? Length
z 18133 CEDAR AVE SO oemolish ? Depth
3 Address
FARMINGT?
892-1010
° Cit Int.lmpr. ?
? 5QFL
Y
ane Install
o Name SAME Approvals Fees
?? Address ASSesSment Permit 8' 0
? City Phone Water & Sew. Surcharge 52' 50
? Q Police Plan Review 259.25
Fw Name Fire SAC 625.00
?z
a Address
Eng.
Water Conn.
525.00
a W Ciry phone Planner Water Meter 67.00
Council Road Unit 305.00
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.Oit. Tr.PI. 180.00
in(ormation is correct and agree to comply with all applicable State of
Minnesota Statutes an ity of Eagan OFd'n ?nces APC Palks
'l Var. Date Copies
??
AAJ4
Signature of Permitte A ??
- TotaL
A SEPH MILLER CONST
A Building Permit is issued to: on the express condition that
all work shall be done in accord ce with all applicable te of Minnes StaW s and Ciry of Eagan Ordinances
Building Otticial
REQUEST FOR ELECTRICAL INSPECTION
T ? See msmicnorjs Por compknng this rorm on back oi yellow copy
M 3534 1 -X" Below Work Covered by This Request
,?'.
? ?8- j-0b.
ew .4dd ep' Type of Building ApphancesWired EquipmemWired
!J Home Range Temporary Service
Duplex Water Heater Eleclnc Heating
Ap[. Budding Dryer Load Managemem
Comm./Industrial Furnace Other (Specity)
Farm Air Conditioner
Other (specdy) ConVactor5 Remarks
Compufe Inspection Fee Below.
Jt Other Fee # ServiceEnirance5ize Fee # Circwts/Feetlers Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps Above 100 _ Amps
Siglts Inspeclorg Use Ony TOTAL
Irngation Booms 1s,?`j(?
Special Inspection D
AIarMCommunication ED
THIS INSTALLATION MAY B DISCONNECTED IF NOT
O[her Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rouyn,n
certify that the above inspection has
been made. Finel ???
OFFICE I1SE ONLY
Thrs request void 18 months fmm
9J?_
5341.;28?Q
Request Date
/j
^ pt u No. Pough-in Inspechon
ReQuiretl'+ NOTICE: Vou Must Call Electncal Inspeclor
If A Rough-In Inspecnan
y
?
N Ql0 g-Yes ? No Is Reqwretl
Iiog licensed contrector ? owner hereby request inspection of above electrical work at:
Job Atldress (SVeet, Box ar RoNe No ) . Qry
3T3 C ?ee? b3CIz)
$eqion No Tawnship Name or No Range No Counry
_,^
T?
Occupant (PRINT) Phone No
Pawer Supplier Address
Electncal Contractor (Company Name)
E1? ? al Co
fi'L?C? n
?. Comrac[or§ License N.
D?r
Mailing Adtlrass (Co Vacio or Owner Making Inslella0on)
,;?qg S. ?-Pmk
S.
f?) rJ 5S IL)?
Authorizetl Sig aWre (Coniractor/Ow1rer Making Inslallation)
? V?KJ,L^?-? I 1 JU ? ?n i ' Phone Nurpb=r ???
/1 1 ?,
/1?oi ..? ty
O
MINNESOTA STATE BOAflD OF ELECTRICITY oi•??., `^ THIS INSPECTION REOUEST WILL NOT
Griggs-Midwey Bidg. - Aaom 5-113 C1?, 1 ??n 1 9E ACCEPTEO 6V THE STATE BOAflD
1821 Unlversity Ave., Sl Paul, MN 55104 UNIESS PROPER INSPECTION FEE IS
Phona (612) 642-0800 IR r-,-p lqc e ENCLOSEO
,16-?ss 7 REQUEST POR ELECTRICAL INSPECTION ?yEeA-oooai/-/os
, See inabuctiona br compleL'p lhia form on back of yellow coDV.
upq 4 "X" Below Work Covered by 7his Request r
PheylAddl NeO.T -Tyoe of Build?nc Aooliancee Wired Equ?ument Wired
al
C Fee ServlceEnireneeSize k Fae Faedars/Subieeders N Fee Circuits
(1 to 200 qm s 0 to 30 Am s I 0 tn 30 Am
Above 200 qmps 31 to 700 qmps , OD 31 to 100 q y
Swimming Pool Above 100_Am s Above 700_Amps
Transiormers Irrigation Booms D' Pertial.'Other bee 1
? SignS Special Inspection S/ ?,(!
7bTOTAI FEE Iv•
'Eemn.ks -2,
' I, the Elechical
.37 Inapettar, hereby
? certilV tha[ tha above
?,,,,? ection hes baen
i nis reQUest wid y
_ ? ?
18 months from _rr-??
? 8 0 8 9 4 .50 . co
fleque&t pate - Fire No. RouBh-in Inspec[ion
??/ 7 Re uiretl? ?Ready Nuw ?WiII Notify Insuec-
I yes nNo lor When peady
t?
Q&Licensetl Electrical Contrflctor 1 hereby reQUest insoection of ebove
? Owner olectricel work mstallad al:
Street Address, Box or Houte No.
37 Y'e 5?oro
Lr1 Ue. Cay
eQ at'1
ecuan o..
I
Townshio ame or o.
en8e No.
County\
L?Gt-gU4GL
OccuDant WqINTI
Joe Mrller Phone No.
Pawq Suppher
l.?GikO'(GL- ElG'e-, Atldress
30? a?0?
Elecincal Conttactor iCompany Name)
/Vlid[a?1cl 0 cc?-+vt c- Coniractor's License No.
MaihnB .4ddress IConvactor or Owner Making Instailation7
gSoo W eo Q 4(,A C?urHSVL l tG
AuMoti d Signamre (Contrecta Owner MabnO Installauon) Phone Number
-9& 11
8
0
MINNESOTq STATE BOARD Of ELECTNICITY THIS INSPECTION REQUEST WILL NOT
Grippa-MiAwey BIdO. - Room N•797 0E ACCEPTED BY THE STATE BOAND
UNLESS PROPER INSPECTION FEE IS
1827 Universitv Ave.. St. Pnul, MN 65104
Phone(812)642-0800 ENCLOSED.
INSPECTION RECORD
CITYOFEAGAN PERMITTYPE: sulGOiNG
3830 Pilot Knob Road Permit Number: 022111
Eagan, Minnesota 55123 Date Issued: 10 / 01 / 9 3
(612) 681-4675
SITEADDRESS: L oT: 2 BLOCK: 2 APPLICANT:
37$8 GREENSBORO DR HEAT-N-GLO FIREPLACES
GREENSBORO (612) 890-0758
?
PERMIT SUBTYPE: TYPE OF WORK:
FIREPLACE NEW
DESCRIPTION (GAS)
? CITY OF EAGAN
5830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT TYPE:
Permit Number:
Date Issued:
PERMIT
UILDIMG
022111
10/01/93
SITE ADDRESS:
3788 GREENSBORO DR
LOT: 2 BLOCK: 2
GREENSBORO
P.I.N.: 10-30900-020-02
DESCRIPTION:
FIREPLACE
NEW
? i -i?``fSl -.\' jj
Q I Gr
(GAS)
B,u3lding:Permit Type
Building?`Work Type
? -
l
?
\\11 '' ?? " _
REMARKS:
FEE SUMMARY:
Base Fee $25.00
Surcharge ' $.50
Total Fee $25.50
CONTRACTOR: - Appli.cant - sT. LIC. OWNER:
HEAT-N-GLO FIREPLACES 18900758 0002960 CLARKE VON
3650 W HWY 13 3788 6REENSBORO OR
BURNSVILLE MN 55337 EAGAN MN 55129
(612) 890-0758
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable 5tate of Mn.
StaCutes and City of Eagan Ordinances.
I
APPLICANT/PERMI7EE SIGNATURE
n L{Al5 & I w
' ISSUED W. SI'NATUR
REAC IYATE _
PE IT f
1111
CITY OF EAGAN -
1893 BUILDING PERMIT APPLfCATION
ss1-a67s
SINGLE 8 MULTI-FAMILY 2 sets of plans, 3 registered slte surveys, l copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set af
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month.
in which request is made, 2) address is thanged or 3} lot change is requested once permit
is issued.
Date 5d Yaluation of work
Site Address: ???=_6000 ?n-
STREEt fI1lTE /
Tenant Name: (commercial only)
IAT Q- SLOCK 2- SUBD. ?{
,?J Xk P ?`(?'?,Y
.
M
P.I.D.
?
Descri tion of work: d?
The applicant is: Owner Contr ctor ? Other (Dectribe)
Name Ihil t ? ' J Phone
Property LAST F1R3T
Owner pddress AaZ?W??V ?-
STREEi 97E /
State
Cit
y
U
Phone
Company
Contractor Address .?R?--? l:U JGU4 ?3 License 6 d Exp.
City State ?k ? Zip 5'_`T33?
Company - Phone
Architect/
Engineer Name Registration #
Address
City State ZiP
Sewer & water licensed plumber . Processing time for
sewer 8 water permits is two days once area has been approved.
I hereby acknowledge that I have read this applicatian 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.
2orZ
?
1987 BIIILDING PERMIY APPLICATION - CITY OF E6GAN
SINGLE FAMILY DWELLINGS
INCLDDE 2 SEfS OF PLANS, 3 CERTIFICATFS OF SITRVBY, 1 SST OF ENERGY CALCQLATIONS
?
?
DiOTE: ADDRESSES FOE CORNER LOTS - CONTRACTOR/HOMEOWIQER MDST DESIGNAYE i1HICH ADDRESS
IS DESIRID. NO CHANGfiS FIILL BE ALLOWSD ONCE BOILDING PERhIIT IS ISSOHD.
MOLTIPLE DWELLINGS - RFSIDENTIAL RENTAL iTNiTS FOR S9LE OAITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIRVSY - CHECK TiITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COPR76RCIAL
ZNCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
105, cnc)
To Be Used For: I iX,[.CJ men-k- Valuation: ?
Site Address 3-73g,?/r?p/?h & I- (
Lot a Block ?
Parcel/Sub
Owner
Address
City/Zip Code
Phone
ContractoK-jQgJVL -n. J ' oz-,
9ddress / /3 3?,??/d_C?CI.?f •9a-?
City/Zip Code
Phone
Arch./Engr.
Address
City/Zip Code
Date: 3-q",? 7
On Site Sewage_
MWCC System /
On Site Well
City Water ?
APPROVALS
Assessments
Water/Sewer
Police
Fire
Engr
Planner
Council
Bldg Off
APC
Variance
Occupancy ? 3
Zoning {Z,!
Type of Const
(Actual)
?
(Allowable) S?
ik of Stories
Length
Depth
S.F. Total
Footprint S.F.
FM
Permit 518.5'°
Sureharge SZ ?O
Plan Review 7 5?,zs
SAC, City loo .
SAC, MWCC SZS.
Water Conn 525
Water Meter (27.
Road Unit 30!5 .
Treatment Pl l Sb.
Parks
Copies
TOTAL p?
s-
Phone #
570 x Iz
I?J2x.44
TRI-LAND C0. SITE PLAN FOR:
SURVEYING ? SERVICES JOSEPH MILLE R CONST.
?-
, 4655 NICOLS ROAD
EAGAN, MINNESOTA 55122
I 1_G I 3% I
N 89°31'56" E
147.79 9oi?o
.? (
Z ? 10 f 31'! a3141? l4p1,5?- 1 s
I
? z Z
O O a? oo (5)
? a.°cn° n, ?pti LOT 2 ?
I N
C ? oQ?S?. ? --s OD
0
?7 ro ( 5
< ? IqO??N? _? 0?? Dn?w4SGqn4 U{:1?1y C?fFmenf ? -
m 156?71 ` o°)
N 890 31 56?? E
I ? '0 _
I ?
f..,. .
, , ?.. . .
PROPERTY DESCRIPTION
LOT-2-, BLOCK? ,
GREENSBORO FIRST ADD.
aceordiny to ihe reeorded plat thereof N
DAKOTA couMy, MinneSwa SCALE : I30' LEGEND ?,,
o DENOTES IRON MONUMENT 'PFfO? SEO GARAGE F100R ELEVATION?
o DENOTES WOOD HUB SET PROPOSED FIRST FLOOR ELEVATION
C$y$r?DENOTES EXISTING SPOT PROPOSEO BASEMENT FLOOR = B4(x O
ELEVATION ELEVATI ON
89$,y DENOTES PROPOSED SPOT
ELEVATION
DENOTES DRAINAGE DIRECTION NOTE: VERIFY ALL FLOOR HEIGHTS WITH
?
FINAL HOUSE PLANS
I hersby certify that this survoy,plan or
rsport was preporod by me or under my -""
direct supervision ond that I am a duly 8radley wenson, Mn. Rs4. No. 15235
Raqistered Land Surveyor under ihe
Laws of ths State of Minnerota. Date ?
.,
One or Ttiw Family
All Other
?+?+ +? llUlLUllill LGyI1H1P1?:?11EXTkRlOR ENVELOPE pVEl2AQE 'fUll COtiPUTATION
(To be submitted with building permit application)
Duelling ? Oxner
Contrnctor N'"";'4 f'f,iLL??
#85
Site Addrese
Date
Phone
LII7F)AL FF.BT OF
E;CPOSED V7ALL f t. above grade
1OTAL EXPOSED WALL AREA SQ. FT.
OPAQUE tvALL COftSTRUCTI0t1: "U" Value x Area
lletail- r;z "U" O 32? x SQ.
reference - ??'? • itull -n x S2.
lroro nUn , (>+o_x SQ.
attached "U'l x Sa.
cliects °Ult x SQ,
nplt x Sq.
S7II7D01VS: "U" Value x Area
Nalce & TyPe JNSf)/, CL?YI?r"U" 14
n u / x
-
flu n X
n ?
iqUit
n x
Urr y
DOORS: "Url Value x Area
FT. 7?•?5!0(U)(A)
FT. ? ,oR= l0.3 (U) (A)
FT_ - 7-
FT.= (U)(A)
FT. _ (U) (A)
FT. _ (ll)(A)
SQ. FT. (U) (A)
SQ. FT. _ (U)(A)
SQ. FT. _ (U)(A)
SQ. FT. _ (U)(A)
I•Iz':e &
n Tyoe x SQ.
uun
g7 x
SQ.
n
n npn
x
SQ.
_ T x SQ.
Toxnt.s zZ r 9•LO sq.
AVERADE "Ulf
TOTAL ( U) ( A) VALUES rq?
Z I
.
=
, O SS
DIVIDED BY TOTAL 1lALL AREA 72loQ.Z0
?
AVERA(iL•' "Ulf .115 ar lesa for 1&2 family duellinge
R00 F/CEILIN(I :
TOTAL AREA: 9S Z ?
FT. 417'00 = S•S (U)(A)
FT. FT. Z/bO =(U) (A)
- (U) (A)
FT. _ (U)(A)
FT._ 194 . Z/ (u)(A)
Detail reference
f l'Ull "aZl e ?U)(A)
SZ
rom
nttached sheete. IVUlf
x
"U°
g.
S -"--
`
FT,
U)(A)
` (
Describe oneninga x
VIUlt SQ. FT.
(
U)(A)
in roof
. x
uU?? S9. FT. (U)(A)
x SQ. FT. - (p)(A)
TOTAI, (U)(A) VALUES DIVIDED BY J9?99 TT?}L?j 9SZ ?,? 1_ 9•qq lVTA\
TOTAI, ROOF/CEILINf3 Af2EA ?}SZ
AVERA4E "Utt ,025 for ventilated rooie.
•Qz/
GeoV7 ?y w,a-J,
IS-33X (3¢+34-+ZS+ZS?
CowC ,
•Cv7x ( -234t34+28j zr?,) = g3.o0 4z
0 w""ex-. ?,AET 11
,P.?1. ??:7
•83 x?(o8+lo8t5?ot5lo, ?. ZoS.?-.?'
%i![UbG+U-?y
?xr4 =
zox(vo =
Z4x9-g =
2•?o x3=
4-o X?-=
89- x tv =
$.o k ]I =
7. Uo
l0,oo
Sv.9.o
gg,oo
4-1
3Q s-?z., e?.T? = zl,ao
Z? 5?ft-? ? = Zl,oo
lo= PA .Tio = 4Z?oo
6T. ??kc
NT F?a_____5E? cv,? EczAe.s
'?i WRcJ- ZL/vQ.ZO
Gess 83.og
?i ?'1 105.84
w?'s l6t,zo J'S35. /2
Dro,t.'s gy.oo ----
1,7.?:
oo?
zBx? _
9s,? 'W'k
--WALL sECTIQP--
Determdning "Ds' valuee at Roof, Wallp Rim# and Cottc. Block
ROOF/CEII.INa
1.) Interior Air !'ilm
2.) 5/800 ayP. sa.
3.) Ineulation
4.1
5.) Exterior Air Film
(STILL)
(R) VALUE
0.61
.56
11400
.61
upo ? 1/R= ?GL aOTAL (R)= 4.r.73
WALL
6.) Interior Air Film
7,J }'S aYr. Ha.
8.) Inaulstion
9.) lo,!,-'-Z,rc
10.) Masonite Siding
11.) Exterior Air Film
R VALUE
0, 68
.45
IR,oo
20?
.b
.17
StUn = 1/R= TOTAL (R)= 73.p,
?
RIH
12.) Interior Air Yilm
13.) Inauletion
140 211 Fir Rim Joiat
150 P?vx."f-?' Tc
16.) Maeonite Siding
170 Exterior Air Film
R VALU
0.68
f9,oo
1.88
z?
.6?
.17
ubu a 1/Re jQ TOTAL (R)a Z¢4H
FOUNDATION
180 Iaterior Air Film
19J
zo. ) K-11 yx/PpleD
21,) 12" Coaorete Block
22.)
23.) Exterior Air Film
R VALU
0.68
/00
1.28
.17
upn a l/Ra .07?0 TOTAL (R)=I3.13
?
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
D7DTR: PAYMfsC OF FEE AT 1IM pF
Arrr,icAMoN DOEs Nar corsrIWM
APPROVAL OF PERNII'r.
INSPDCfION OF SEWE3t AM/OR F7P,'ER
TTSI`AT.T.ATTONS WIId. NCYP BE SCHED'
vr.M vnrtM PEPMT Ms sEM
APnxovm.
P ease Print
1) PROPERTY ADDRE55;
LEGAL DESCRIPTION:
g' EXISTING STRCGZLiRE, DATE OF ORIGINAL BL?III7ING PERMIT ISSL'ANCE: '
(Nbn ear ..
PRESENP ZONING/PROPOSID pSE: - /,
[] COflNERCIAL/REPHIL/OFFICE B-`iR-1 SINGLE FAMILY
? IM?TSTRLAL Cl R-2 DL'PLEX (7Wo Onits) ?
n INSTII[JTIONAL/GOV?P ? R-3 TOWNEi0U5E (Three + Units) ( Lnits)
R-4 APARTMEN'P/CObIDOMIN2[,fi1 ( Units )
2) ?
NAME:_ Soe. Mo eo ws t'
ADDxESS: l$ l 33 CQ..Qwh a?<::
CITY, STATE, ZIP:_
? PHONE: $41- l(s !D
3) • u i: 5-
CITY, STATE, ZIP:
- NAM: Pc?.
aDDREss: a 312 P ,?1?.. ?/
_. '
?ONE: S'f?- --3670? MASTER LICENSE#
.^1l1[[IDCL5 L].C2I15E:
Active
F?cpired
Not recorded
stai Initial
4) •• y•:.?
NA"E: S•r ?i.. ? .+?s ? ? '
ADDRESS:
CZTY, STATE, ZIP:
PHONE:
-5) ? r• ? ? a• • ?• : o • a? - a??
D-CONNECi'IQN TO CITY SEWEIt 2r"CONNECTZON 1C0 CITY WATEE2 rl 07'fMR '
6) '? •' • i• ET_?PLE}SE HOLD APPROVFD PERNIZT FC)R PICK-UP BY ONE OF ABDVE
? PLFASE MAIL APPROVID PERMIT TO 1. 2, 3. 4, ABOVE
q,,,y? • (Circle one) '
7) r r.. L 1.? ?;v?,S= i?7
FOR CITY USE ONLY -" '
PERMIT # I5SUED ?
f ?a -3
Pd w/Bldg. Permit FEES:
$ SEWER PERMIT (INCLDDE SORCHARGE)
$ $ //,'• ? WATER PERMIT (INCLUDE SC'RCHARGE) .
$ WATER METER/COPPERHORN/OCTSIDE READER
$ $ WATER TAP (INCLODE CORPORATION STOP)
$ $ SEWER TAP
$ $ / ?•/? -D ACCOLNT DEPOSIT - SEWER
$ $ ACCOUNT DEPOSIT - WATER
$ $
WAC
s $ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRCNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRONK SEWER
$ $ LATERAL BENEFIT/TRLNK WATER
$ o $ WATER TREATMENT PLANT SORCHARGE
•
$ $ OTHER:
$ ?:? / 7. rr-fJ $ y/O--z) TOTAL
?X
RECEIPT RECEIPT
DOES LTILITY CONNECTION REQLIRE EXCA VATION IN PUBLIC RIGHT OF WAY?
Q YES IF YES, THEN A" PERMIT FOR WORK SVITHIN PUBLIC
Q
NO ROADWAY" MUST BE
DIVISION
LIST ISSUED BY THE ENGINEERING
AS
NDITION
. .
A CO
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY;
TITLE:
DATE: ?7?- /? 7
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
:*TOTF': PA7DN6Nr OF FF.E AT TIME pF
: ??=oN DOES wr mmmmm
: APPROVAL OF PERFIIT.
: INSPr]CTZON OF SESM APID/OR F7A'[ER
: TA1SR`A77.ATTONS FnL NCYr $$ $C'ED-
: ULID UNrII, PEWT AAS BEEN
: APPR(JVID.
^ zxxyexxw+rxx,+xxxxxxiex.:::rxxxY:xw:w,rx
1] PROPERTY ADDRESS:
I,EGAL DESCRIPTION:
IF EXISTING ST72C'G7[]RE, DpTE OF ORIGINAL BLILDING PERMIT ISSL'ANCE: '
..
, PRESEDTr ZpNING/PROPpSID L'SE: (Mn Year)
? Ca'Y4ERCIAI./REPAIL/OFFICE f? R-1 SINGLE FAMILY .
INCK.'STRIAL
Q ? R-2 DCPLEX (2wo Units)
f-I INSTIZUTIONAL/GpVERNAg,'NT ? R-3 TOFINHOIISE (Three + Units) ( Onits)
R-4 APARTMENT/C06IDOMINIUM ( Units)
2) .jj?w. kj?
NAM'i' A ?-
ADDRESS: '? '
#z? CITY. STATE, ZIP:
PHONE: _- -`?
?
3) • u ?:?• N?,l+?. For City Ose .
- Plumbers License:
ADDRESS: Active
% i
CITY. STATE, ZIP: Not-rrecorded
PH0NE: - LICENSE#
St Initlal
¢) ?•• •• • ia?• ?
NAPE:
_ ADDRESS:
CITY. STATE. ZIP:
PAONE: "
$) ? r• ? a• • ?• : a - a? - ??
A CONNECTION TO CITY SEWFdt CONNECI'ION TO CITY WATII2 Q pT(-1ER ' -
3
' 6) ,?? PLEASE HOTD APPROVED PERMIT FOR PICK-IIP BY Ob2E OF AEOVE --•- ----
T 1 2
? FLF'.ASE MAIL APPROVID T--TO
, 3, ¢, pBp? (Circle one) 7)
-- . I=OR CITY USE ONLY
PERMIT # ISSUED
? ??G O Z
Pd w/Bldg. Permit FEES:
$ $ SEWER PERMIT (INCLUDE SURCHARGE)
$ $ WATER PERMIT ( INCLODE S[!RCHARGE)
$ U7 7?? ? $ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLC'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ G' D ACCOUNT DEPOSIT - SEWER
$ $ ACCOL'NT DEPOSIT - WATER
S $ wAc
S $ sAc
$ $ TRUNK WATER ASSESSMENT
$ $ TRCNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRCNK WATER
$ WATER TREATME[3T PLA[3T SLRCHARGE
$ $ OTHER:
$ l3 TOTAL
'7/3
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MUST BE ISSLED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE: _ ? ?f d /
r
CLAIM VOUCHER - REFUND REQUEST
CITY OF EAGAN
CLAIMANT_ COLLINS ELECTRICAL tiON?TRU?TIQN
ADDRE55 278 STATE ,,4?11LEET
_ ST._PAl1L,_MN_ 55107
Location 3788 GREENSBORO DRIVE
B2?_GREE14SBOROI
Receipt No./Date 14412_]0113L93 _. ________
Reason for Refund DUPLICATE PERMIT
Type of Refund Electrical Permit 01-3211 $ 15.00
Plumbing Permit 0I-3212 $
Mechanical Permit 01-3213 $ -
Surcharge 01-2155 $
Water Connec[ion Permit 20-3713 $
Sewer Connection Permit 20-3743 $
Account Deposit 20-2252 $
Utility Account Over-payment 20-2250 $_______
Other: $
$
TOTAL $ 15.00
I declare under penalties of law that this account, claim or demand
is just and that no part of it has been paid.
--- -S G A UkE-- - - ----? ---???DATE------
?/_? ?
CLAIM VOVCHER - REFUND REQUEST
CITY OF EAGAN
CLAIMANT COLLINS ELECTftICAL CONSTBUCTION CO_
ADDRESS_278 STATE STREE_T___________________________
_ST _ PAUL,_MN_ 55 107 ----------------------
Location _ 3788 GREENSBORO_DRIVE
_ L2s B.2 GREENSBORO IST
Receipt No./Date _ 149 57/10_25_q3 __________
Reason for Refund DUPLICATE PERMIT_____________________
Type of Refund Electrical Permit
Plumbing Permi[
Mechanical Permit
Surcharge
Water Connection Permit
Sewer Connection Permit
Account Deposit
01-3211
0 1-32 12
01-3213
0 1-2 155
20-3713
20-3743
20-2252
$_15.00
$
$ -
$
$
$
S
$
$
$
$ I5.00---
lltility Account Over-payment 20-2250
Other:
TOTAL
I declare under penalties of law that this account, claim or demand
ia just and thaC no pait of it has been paid.
/ ll/01/93
'
I N ---------------
-? TURE D--- - - ---------- ATE
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?-----------------
? Fa? otfice U?se5 ?
? Pertnit #:
? Pertnit Fee:
I
? Date Received: ?
I I
? Staff: I
I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: v Z s ZaC?X ' Site Address: G??e? 5 bc?ri7 4-?? •
Tenant:
Suite #:
RESIDENTIOWNER Name: Q )Obe_vk 1 c7i,JI2. Phone: (0161 6;°63 92-50
Address / City / Zip:
Applicant is: _ Owner ? Contrador
TYPE OF WORK Description of work: ]<?F
Construction Cost: 41 .1 t I -Z-w .(>(1 Multi-Family Building: (YesNo X)
CONTRACTOR Name: 41t (.rQ!EjZn?t,., F_,e fe,-io.r, License #: 2-C6 -7 9 (v 0 `f
Address: 3 l l 3 ( -g' _T`r.
City: L)c.004c? State: -/NA% Zip: S 5 a Fs$
Phone: [J! 2 L'lC. Z(,S`'k`{ Contact Person: c
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category i Worksheet • New Energy Code Worksheet
Category Submitted Submitted
(4 submission type) • Energy Envelope Caiculations Submitted
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 8 Water Contractor: Phone:
NOTE: Plans and "supporting'documents that you submFt are considered fo'be public information. PaYio`ns of
the information rnay 6e classified as 111 if you provide sp,ecific reasons that would permit the City to
" ?'conclude ttiat fhe are trade seerets. I hereby acknowledge that this information is complete and accurete; 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 apphcation 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 rase of work which requires a review and approval of lans.
x? 1 V c'?{?t l-. ?7?5 V?c.,h ?W --
x
ApplicanYs Printed Name Appli Ys Signa r
Page 1 of 3
2,3
City of Eagan
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#: ) �u )--/C
Permit Fee: CLCD
Date Received: 11'71'P—
Staff:
►'Z P --
Staff:
L
INFLOW & INFILTRATION PERMIT APPLICATION
_ Plumbing / Sewer & Water
Date: ` /a‘ / ��' Site Address:
1
Tenant:
n�
Name:
Phone:
Suite #:
Address/ City / Zip: 3'S
Name: \ > ��
License #:
Address: \ O O`k C� City:
State: C'� Zip: \a-'3 Phone: ` `� � � �
Contact: cam-- �� .. , .c. Email: \ _ _ ( 8 \`�+� e
PLUMBING (Within the building envelope)
Sump Pump Repair
Other:
Description of work:
SEWER & WATER (Outside the building envelope)
Repair
Other:
FEES
$60.00 / Each (includes $5.00 State Surcharge)
TOTAL FEE $
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.cityofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd.
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
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 . +lication 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 ca - of wor ich requires review and approval of plans.
T
x
Applicant's Printed Name
Applicant's Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA164149
Date Issued:09/21/2020
Permit Category:ePermit
Site Address: 3788 Greensboro Dr
Lot:2 Block: 2 Addition: Greensboro 1st
PID:10-30900-02-020
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Joseph E Towle
3788 Greensboro Dr
Eagan MN 55123
(651) 366-2538
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature