4253 Limestone Dr
Use BLUE or BLACK Ink
For Office Use
/ I
of j>Jajan Permit
City I
Permit Fee:
I I
3830 Pilot Knob Road
Eagan MN 55122 date Received:
Phone: (651) 675-5675 1 Staff:
Fax: (651) 675-5694 1
2010 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: _ Site Address:'t-1ZJr~ Li,%,es6(ijZ, Or.
Tenant: Rl C`AQ rC\ LPG i 1(a-Cae` Suite
RESIDENT / OWNER Name: i~l G I`C~ hop I ASe l` Phone: 651_ 4- As- ' g3ss-
Address / City / Zip: LiZS-3 1, i.,-►e r/~e 0r- -C c* • ~S'
CONTRACTOR Name:/~,0p 6L r'C C-,_~ Or /A V\_ License* gSS 4,577.5- " PEI
Address: 141as' 2'6eps A it1E_ city: Riot- Cc. ke
State: M 1n Zip: J~-s3 9LZ Phone: CIS Z- Nk a- 9341
Contact: M It I*akc Email: .5e,0 rc jAs /a &~o - co
TYPE OF WORK _New placement _Repair -Rebuild _ Modify Space _ Work in R.O.W.
Description of work:
PERMIT TYPE RESIDENTIAL
water Softener
Water Heater
Lawn Irrigation RPZ PVB) Add Plumbing Fixtures Main Lower Level)
_ Septic System Water Turnaround
_ New
Abandonment
RESIDENTIAL FEES:
$55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation (includes $5.00 State Surcharge)
$55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $166.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
$95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 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 aoaherstateonecall.ora
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. yy~
x~
Applican ' ted Name Applican Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground -Rough-In -Air Test Gas Test -Final
ciTr oF EAGAN
3795 Pilet Knob Raad Eagan, MN 55122
PHONE: 454-8100
BUILDING PERMIT Receipt .?t
N4 5319
To be wed for Est. Value Dote , 19
Site Address Ered ? Occupancy
Lot Block See/Sub.
Pareel #
W I Name _
; Address '
0
p Ncme _
Z? Address
Name _
Address
Alter p Zoning
Repair ? Fire Zane
Enlorge ? Type of Const.
Move ? # Stories
Demolish ? Front ft.
Grade ? Depth ft.
Aoorovols Fees
Assessment -
Water & Sew.
Police
Fire
Eng.
Planner -
Council _
I hereby acknowledge that I have read this app lication and state that gldg. Off.
the information is correct ond agree to comply with all applicoble AP?
State of Minnesoro Statutes and City of Eagan Ordinonces.
Signature of Permittee
Permit
Surcharge
Plan chetk
SAC
Woter Conn.
Water Meter
Total
A 8uilding Permit is issued to: on the express condition that
oll work shcll be done in occordance with all applicable State of Minnesota Statutes and City of Eagon Ordinances.
Building Officicl
?ermk # Dab Iaow PffsMfM
Plumbing
Mechanical
INSPECTIONS I DATE INSP. Rouph-In Firal
Footings Date Insp. Date Insp.
Foundotion Plumbing
Frome/ins. Mechanicol
Final
I
Remarks:
INSPECTION RECORD
? CITY OF EAGAN PERMIT TYPE: r+I +l r wG
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued: •' '' ''
? (612) 681-4675
I SITE ADDRESS: APPLICANT:
?
fis rnI V?.
'I PERMIT SUBTYPE:
TYPE OF WORK:
Kc_r•n rr
tR I?aF- rtat,t
I I t Nr.
nt ?;rer1t>i tc,W
Permk No. Permit Holder Date Telephone #
ELECTRIC
PLUMBING
HVAC
Inspectlon Dete Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
g-L2'cE'/
M8
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK f-TG
DECK FINAL
CITY OF EAGAN Remarks Cedar Grove Acquisition
addicion Cedar Grove 2 Lot 6 Bik 6 Parcei 10 16701 060. M
Owner 1I-` Street 4253 Zimestone Dr. State Eagan,MN 55122
< i/171 ? 1 J 0 ?:
Improvement Date Amount Annual Years Payment Receipt Date
STREETSUfiF. ^ S 1985 1266.95 84.46 15
STREET RESTOR.
GRADING
SAN SEW TRUNK
# SEWER LATERAL ? 197 1304.00 2,16 Z
WATERMAIN
# WqTER LATERAL 1 9
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
f
EAGAN TOWNSHIP
BUILDING PERMIT ?e 2355
Owne: •---zs.J -s.J .................. Eagan Township
Address (present) ?3 ...... .. .. .. ..... ..... .. ..? - Town Hall
Builder ........... ?-.r..-°-°°-- .............................°°--°-..._.........
Date ..... ..??.4.-??O•................
Addreas ......------•°° ..............---.......•••••.........--------............................._
5tosies To Be Used For Froni Depth Heigh! Eat. Cos3 ? Pe:mi! Fee Remarks
l I GL-d?G?? i'L?-?i+?,,.-.J I o2 G /? I Pd-°"d /'j'?? ? I !S ?/u??
LOCATION
5treet, Road or olher Desczipiion of Localion Lo! Block Addition or Trac!
?
This permit does not au3horize the use of streels, roads, alleys or sidewalks nor does it give the owner or his agen!
the right to creale any sifuaiioa which is a nuisance or which presenis a hazard to the healih, safety, eoavenience and
general welfare !a aayone in the communily.
THIS PERMIT MUST BE IPT, /ON THE gREMISE WHILE THE WORK I3 IN PROGRESS.
This is to certify, !hal.....??:...yG?,,.!r?.-?--a-?c? ...---------------- has permission !o eree2 a....... ....._.?_../.Z.°...._....... :`.:.'.`upon
the above described premise subject to the provisioas of the Building Ordinaace for Eagan Township adopted April 11,
1855.
..........••••••••••.... .••-• .......... .. ..................... Per ?
. . ...................A? ....... ......?.?ic..:,_,,,..?...•-••-••••.....•••-----
Cheirm?of Tnwn Board? ,#uildin Ins ecior
EAGAN TOWNSHIP No ?402!!!?
BUILDLNG PERMIT
Ownes (v.C?FtL?'?'?-???- -- ,„???
Addreas (presen2) ??--- - ----?.- -.?'?'_??=°'?
Suilder -----------•°------------??? .........
Address ----°---------------------------- ------- ---°-----......---------------._..._------
iIESCATATiAN
Eagan Township
Town Hall
Date !_....
.. -°- °-----°------ -
Siories To Be Used For Froni Depth Heighf Es3. Cosi Permif Fee Remarks
? l??.4rc-!C"/ 9 ?
?? '
? ????a!
?/? LOCATION
SSreeY, Road? her Descri?? Location I j3 I Block I Addifion or Traci
i?
O I I
This pe does noY sulhorize the use of sfreels, roads, alleys or sid?walks nor does it give the owner or his agen!
the xig !o creaYe any situaiion which is a nuisance or which presen3s a haaard fo the healfh, safeiy, convenience and
general welfare fo anyone in the community.
THIS PERMIT MUST B PTTHE /P?M?E W?' E THE WORIC I5 IN PROGRESSe)a
A.?sw*6t-?'}?aspermassi Yo erec! ?...----_ - -'?.----_--._...upon
This is fo cerYify, lhat-- ----- -- .......::......
the above descxibed premise subject 3o the provisions of the Huilding Ordina e or a ?n'? o nsh? G dopted April 11.
1955. / -
------?----------.... --........ °---------. =?a ----°^?•--?-?-
- ••-----°--------- -
Chairman of Town Board - ilding Inspecior
EAGAN TOWNSHIP
BUILDING PERMIT
owne: •••• ••- - ....,....... ?----........... •-••--- ----?-- ,---? ..................
Address (Presen!) -----...._. 4, -----°----°--°••---•---...-.......
Builder .... --7••?'?`?= ---•?a_-r.??---....•••......--- -°-•- °.......•.•...-•- .......
Address ...................... a......-C .........................
DESCRIPTION
N° 2311
Eagan Township
Towa Hall
Date ..... J/...J.5./?70
...................
Slories To Be Used For Froni Depth Heighi Esi. Cos! Pesmi! Fee Remarka
LOCATION
Streel, Road or oiher Description o[ Localion I Lo! Bloek Addition os T:aat
I ( ? e . '?& • .:),
Thla permit doee not aulhorise the uae of slreets, roads, alleys or eldewalks aos doee !t give the owner or hSe agent
the righ! !o create anp siluatioa which is e nuisance or which presenis a hasard !o the health, safety, eonvsaieace and
general welfara !o aapoae in the communilp.
THIS PEAMIT MUST SE I?PT QN THE P$EMISE WHILE THE WORK IS IN PROGAESS. ?
Thia is !o certifp. !hal..... ?? :....?.-ri:-a-`cr ..................has permission !o e:eci a....... • ••••-•.......... ........................ _upoo
the above described premise subjee! !o the provisioas of the Building Ordinance for Eagan Towns p adopled April 11,
1955.
--•-••••••••••••-°°--.._. .-•__•••••••••••.?:--?:.::e.^ ......................... Per .... -................................
?`"?-••...:.....--•••••••••-...•-•..
Chairmaa of Tnwn Board ? ,? Huilding Iaspector
EAGAN 'i"OWNS HI P
B9J6LDING PEFaiWIT
Owne= ....... ?-----"'=`------t?'?'?-?---------,-,°,{-)
Address (Present) •----..??'??..._...
Builder ........-- --- --°-°°-°-- ----...-------°-----••--...----
Address ......... -..................................... ----°---°--°°--- -- ----------°-------
DESCRIPTIOPI
Nc 1046
Eagan Township
Town Hall
Dale .`..//???-------...................
Stories To Be Used Fo: Fron! Depih Heighi EsY. Cos! ' Permit Fee Remarks
67
f U LOCATION
SYxeeY, Road or other Description of LocaYioa Lo! Block Addi3ion or Trae!
;2-
This permit does noY suihoriae the use of streets, zoeds, alleys or sidewalks nor does i3 give the owner or his agent
the right io creafe any si3uaYion which is a nuisance or which presents a haaard fo the heelth, safety, convenienee and
general welfare io anyone in the communiiy.
THIS PERMIT MUST BE T?N?THE PREMISE WHILE THE WORK IS IN PROGRESS.
This is to cer3ify, fhai.....?_ .., ............... has permission to ezect a.---- ...__... ..____.._._... ....____._.......__........._.upon
the above described premise subject ia the provieions of the Building Ordinance for Ea Tomn ip adopfed April 11.
1955. l 2 ? o ?
?!• ••- - -
.....-----°----...--°--- _ ...?X.?'..-------. Per .-.°-°--------- {?'?-
- --- -?--?..----------- --••---• - ".---°•
Chairman of Tnwn Board Building Inspec3or
?'( t /? ,
CITY OF EAGAN
3795 Pilot Knob Raad Eogan, MN 55122 N2 5319
1 PHONE: 4548700
BUILDING PERMIT APPLICATION
'ro be uea fo.Patio & replace Est. front Value walk 400. Receipt .#
pae
7-20 19 79
Site Address 4253 LlII12st'Arie DYiV2 Erect ;[] Occupancy R3
6
6
C?? ? #2
Lot
Block
Sec/Sub. Alter ? Zoning
parcel # Repair ? Fire Zone
V
121Ci1dYC1 0
Lorinser Enlorge ? Type of Const.
.
? Name Move ? # Stories
; Address 4253 Limestone Dr. Demolish ? Front 22 ft.
? C. qan Phone 454-4355 Grade ? Depth 5 ft.
cz Name Sam Approvals Fees
0
ou Address
u?
Assessment
Permit
50
Ci Phone Water & Sew. Surcharge •
' Police Plan check
WW Name Fire SAC
r
xt?q Address
Eng.
Water Conn.
I hereby ocknowledge that I have reod
the informotion is correct ond
State of Minnesota Statu s o i y
Signature of Permittee ;i!4E
A Building Permit is issued to:
oll work sholl ba done in acco
Planner _
uncil _
and state t g?dg. Off.
I appl.
lP cT APC _
Woter Meter
rorcl 5.50
ll"?cl on the express condition thot
State of Minnesota Statutes and City of Eogan Ordinances.
Building Officiol
?- CITY OF EAGA,Y Include 2 sets of plans,
BUILDING,gERMIT t}PPLICA ION 1 site plan w/elevations &
o?C ?5 s? 1 set of energy calculations.f
,!
To be used for ??? aValuatfon Da[e U ? /7 7r?+
/ ?
Site Address OFFICE U ONLY ?
i
Lot Block Sec. /Sub.
Parcel fl
Owner:?jj?A.??
Address:
Phone #:
Contractor:
Address:
Phone #:
Arch%Eng
Address:
Phone li:
Erect Occupancy 3
Alter Zoning
Repair Fire Zone
Enlarge
4 Type of Const.
_
Move _
9 Stories
Demolish Front a? ft.
Grade Depth i? ft.
Approvals Fees
?
?
'
Assessment Permit
?
Water/Sewer Surcharge
Police Plan Check
Fire SAC
@ng, Water Conn.
Planner Water Meter
Council Road Unit
Bldg. Off.
APC
TOTAL '? ` J ?
ToWrr oF sacntJ
3795 Pilot Y.nob 2oad
St. Paul, Minn. 55111
PEP,MIT N0.l00
The Board of Supervisors hereby grants to Richard Lorinser
of 4253 Limestone Drive a
PLUMBING Permit for: (Ocmer)
same at
same , pursuant to application dated
Apxil 5. 1971
Fee Paid: la, :..s Dated this 5th day of fx#tloc April , 197 1.
?Building Inspector
54384
Request Date ' Fire No. Rough-in Inspection
Requiretl?
Reatly Now DWill Notity Inspettor
R
tl
?
Wh
? Ves ?NO en
ea
y
censed contractor p owner hereby request inspection of above electrical work at:
Job Address (Street. Bax or Ro te No.)
4 Ci
- s3
Section No, Township Name or No. Range No. Coq
I C??
Occ a fPR-Iry7?
t (?M'?: LOr i ?? Phone No.
Power Supplier Adtl2ss
Elec 31 Contracror 1 ompany Nam
o-
i c_
c41 Contractor§ License No.
?al I 4a
Maii ng AddA(Cratlor Owner Making Inst tion) ?
Aut oriiep Si ature I o trecrodOwne? I stallationj
? Ph uJm?ber
3:S.575-
?
V
40
MINNESOTA STATE AROF EL CTRICITY THIS INSPECTION REQUEST WILL NOT
Grigge•Midway Bldg. - Rpo -1 BE AGGEP7ED BYTHE STATE BOARD
7821 Univarsity Ave., f>aul. M 55104 UNLESS PROPER INSPECTION FEE IS
Phorre (872) 642-0800 ENGLOSED,
K 543,84
REQUEST FOR ELECTRICAL INSPECTION
? See insimctions ror compieting ihrs form on back of yellow copy
9C" BE1CEv Work Covered by This Request
E&00001-08
IL
. ?;.?
e )XVd-d ?p. TypeofBuilding AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other-(Specity)
Comm./Industrial Furnace
Farm Air Conditioner
Other (specify) Coniraclor's emarks:
Compute Inspection Fee Below: -a- SU?o5iLoilialtv 6n R/o-)
# Other Fee # Service Entrance Size Fee # CircuRs/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps P.bove 100 ? Amps
Si9n5 Inspector§ Use Only: TOTAL ?
Irrigation Booms
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDE D DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTNS.
I, the Electrical Inspector, hereby Rough-in Date
certify that the above inspection has
been made. Finai oac
OFFICE USE JNLV
This requesl void 18 momhs from
,.
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I
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``
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CI"f4' i:lr. E;;r;Ara
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?7c1'7L.;? rl?3f'I.:L,i:?"r' i?Zi"i?i:, _ 00058
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T.I1;,
PnPtEn r:;E:i'2G='S 1•iOMl=. C;;1P;li- f;:
r::t?i'...1 4253 l_.?.,?._?., ...li._. t 1 ... _.?.?.. ?.? ,i::.:?;7 ?.rrw:L-4„7cr
3210
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21.:,_IL; 9001 4cr.e/3 I...Ii'II..1.} T CINI'. ,. v'..,It
'1 t:i'?:.;lY.I. ReCe;.p't i;iiiC.it_+7't& 76.05
Pr;079673)
:,-._.
_..,I...C? :i:Du .;AN
.• l J.': e. q.9n: .,?, ?D.(.W ?. rp,nYF,(,. i.:,,.>,... d nC.i,:r.r.. :?. m.;n ??x Sd.i.:,C'K:m>?.qt? %?'?k
2?CITV OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
PERMIT ?
PERMIT TYPE:
Permit Number: B U I L D I N G
@30544
Date Issued: 0 8/ 11 / 9 7
4253 LIMESTONE DR
L07: 6 BLOCK: 6
CEDHR GROVE #2
P.I.N.: 10-16701-060-06
DESCRIPTION:
(ROOFIN6)
Bwil'd-'1n??4'?j,P,ermiC Type
aBuilding 7ype
nsus, Cad s
Y+
T Z
? L1.4 1 J $?
3 ?
„?, °C ?y? _ ? •_..°? ? Y?
SF (MISC.)
REPAIR
434 ALT. RESIIlENT2AL
.ID*"s' ?'? ? ae'?t %
Cm 4YY?
? ?
REMARKS:
FEE SUMMARY:
VALUA72QN $3,000
Base Fee $74.75
Surcharge $1.50
Total Fee $76.25
CONTRACTOR: - Applicant - 5T. Lrc OWNER:
GENE'S HOME CRRE & REPAIRS 14543402 0002715 LORINSER RICHARD
2017 FLINT LN 4253 LIMESTONE pR
EAGAN MN 55122 EAGAN MN 55122
(612) 454--3402 (612)454-4355
..: " V, 'j9 .
T € C IS i i.i ti 6 6 'M k'dh° kL' 4'PP.L
.,::' a..t.; nnA3 .1 tt t+': 4 k:. tl A?P6t" I ?`4 1«y 14t f ? ry?'.
"in
"PF
`4V ? .1
?
!t
h!2 i
??
?
dkr.
1IL
l Y
P p1T .i`6
-,
",
I
I.heretiy acknowJ,edge thaCI hav'e r eai1 th2.6 appkxacWtr0rt dnd `sCa?e
:tr?farm??C?,on is carr?ct a?d ??r„e:? $ta?'?T?rl?r ?R?E??,???>n.
?
Statut,es and
,
?• ?
Csty o'f? Eas1ari ?ed3
n'an?e?
.
APPLICANTlPERMITEE SIGNATURE ISSUDlrt : 51 ?NATU E ??
1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
661-4675
[;_ :1:= :-.•_r-u?iF
? 3 registered site surveys 4 2 copies of pian
? 2 copies of plans (tnGude beam & wlndow sizes; poured fid. design; etc.) ? 2 site surveys (extarior additiona 8 deeks)
• 1 energy calculations ? 1 energy calculations for heffied addkions
? 3 copies of tree preservation lan H lot platted after 7/11/93
required: _ Yes No -
DATE: ??77 CONSTRUCTION COST: ????
DESCRIPTION OF WORK:
STREET ADDRESS: __m?c:P Z5?3 57?r'''?,?!r azI?
LOT G_ BLOCK SUBD./P.I.D. #: i odxmm.
PROPERTY Name: Phone #:
OWNER Ms, ?
Street Address: ?a?3 ?i?rl? Jo>?f
City: f?,564-V State: /Wy Zip:
CONTRACTOR Company: `4''?'phone #:
Street Address: 2U%7 /%?irT",??f License #: :;;2 ??--5
City: State: /;'.W Zip;
ARCHITECTI Company: Phone #:
ENGINEER
Name: Registration #:
Street Address:
CitY: State:
Zip:
Sewer 8 water licer•aed plumber (new construction only): . Penalty applies when address change
and lot change are iequested once permit is issued.
I hereby acknowledge that 1 have read this application and state that the information is correct and agr comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
J
Signature of Applicant:
OFFICE USE ONLY
GertificatesofSurveyReceived _ Yes _ No
Tree Preservation Plan Received _ Yes _, No _ Not Required
MASTER CAftD
? LOCATION Li m C S/ C m C /gJ J -"IC1 ? a
It .101 i
OWNER
STRUCTURE AND /
LAND USED AS v
/9??/ z 4X /?
d 0e/P L.J10LL IQew?o%
Permit ?
No.
Issued
Issued To
Contractor Owner
BUILDING 423rs
PLUMBING
CESSPOOL - SEPTIC TANK I TI?-j
i ?
--?-
WELL
ELECTRICAL I
HEATING
GAS INSTALLING
SANRARY SEWER I
OTHER I
OTHER I
C ?
.
?
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING SEPTIC
FOUNDATION rD / 0 CESSPOOL
FRAMING ?? •„ ? ? ? TILE FIELD FT.
FINAL
ELECTRICAL
HEATING
? DEPTH
OF WELL
GAS INSTALLATION -
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL 71
SANITARY SEWER
-T •
?
? Viofations Noted
on Back
COMMENTS:
PERMIT # q DO I
RECEIPT DATE: ? _o I
USIDFNTiAL PLiJMINfi PERMiT APPLICATION
ciz'Yog EAsAx
3$30 PILOT KNUB iiD
E*slkN, bIN 58188
651-681-4E675
Please complete for:
SITE ADDRESS:
OWNER NAME: :
? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for irrigation system
LORINSER, RICHARD
4253 LIMESTONE DRIVE
EAGAN, MN 55122
(651) 454-4355
TELEPHONE #:
(AREA CODE)
INSTALLER NAME: NORBLC3M PLL?INBING vW TELEPHONE #:
(AREA CODE)
STREET ADDRESS:
ciTY: MINNEAPOLIS, MN M08 STATE: Z1P:
Place a check mark next to the permit work tvpe
New residential dwelling unit under construction and not ownerloccupied $ 90.00
Add-on, modification or alteration to exfstinq dwelling unit, including: $ 50.00
• abandonment of septic system
• new installation/repair/rebuild of RPZ
• lawn irrigation system
• water turnaround .
Nature of work: rQiaIaL& VYd'ttf hWa ?
?
Septic System, new/refurbished - $ 225.00
• includes County & Consulting Inspector fees
• requires MPC license
State Surcharge $ .50
Total $00 .5p
Reminder: Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc.
I hereby acknowledge that I have read this application, state thatthe informaGon is correct, and agree to comply with all applicable Cityof Eagan ordinances. It
is ihe applicanYs responsibility to notify the proper[y owner that the City of Eagan assumes no liability for any damages caused by the City during its normal
operational and maintenance activities to the facilities constructed under ihis permit within City property/right-of-way/easement.
SI NA RE OF PERMITTEE
Updated 1101
2007 RESIDENTIAL MECHANICAL rExMIT aPPLicATiorr
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: single fami]y dwel]ings & townhomes/condos when permits are required for each unit
Date Y / /5- / 07
Site Address YaS3 ??,,.h,? ? "? Qn?• Unit #
Property Owner L??k, Telephone VZfC---
Contractor &/`C/U7,, /i/f,
StreetAddress 'y/3/ ?2" City
State )'"nl Zip S.SI,).2 Telephone #(j?aSJ ) B9 S? - 9?' ?'f ?
Bond #: Expires:
The Applicant is _ Owner t/ Contractor _ Other
Fire repair (replace burned out appliances, ductwork, etc.) $ 90.00
This fee applies when extensive mechanical repairs are made to a building.
Add-on or alteration to existing dwelling unit $ 50.00
N
Y
ew
I
furnace _Additional _Replacement _
air exchanger
i
diti
oner
? a
r con
heat pump
other
State Surcharge $ .50
Total $ -5,0
I hereby apply for a Residential Mechanical 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 with the Mechanical Codes; that I understand this is not a
permit, but only an application for a permit, and work is not to st t 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.
(?
1?D6E12. `rfu 7:.V_
ApplicanPs Printed Name Applicarlt's Signature
PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA084063
Eagan, MN 55122 . Date Issued: 07/07/2008
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 4253 Limestone Dr
Lot: 6 Block: 6 Addition: Cedar Grove 2nd
PID 10-16701-060-06
Use
Description:
Sub Type: e-Reroof Construction Type:
Work Type: Replace
Description: House & Garage
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspection prior to final, you must meet inspector with ladder and flat bar. Pictures are not
acceptable in lieu of inspections.
Fee Summary: BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
Valuation: 3,000.00
Total: $90.00
Contractor: -Applicant - Owner:
Apex Roofing & Sidling Pamela A Murphy
944 Oriole Dr 4253 Limestone Dr
Apple Valley MN 55124-0000 Eagan MN 5 5 1 22-20 49
(952) 891-1919
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