3768 Grey Dove Lane.? ? INSPECTI4N RECORD Control No.
CITY 4F EAGAN PERMIT TYPE: BUILntNG
3830 Pilot Knob Road Permit Number: 000366
Eagan, Minnesota 55123 Date Issued: 0+/26/92
(612) 681-4675
SITE ADDRESS: Lo r: I BLnG Kz a• APPLICANT:
3158 G1tEY pt1V'E L.11M1? 44A1lSt CiINST INC. 3 0
1'fl" VIFLi 131 (612) 439-0199
PERMIT SI?BTYPE: TYPE OF WORK:
"[ScE.L.aNEOus te?PAIR
` ?tk?4MARK5s RI?•?RQ??IMfS
f INt'llJpfS 3772. 3174, $778. 370*, $784. 3786, & 979? SRlEY QOAIE LANP
PermR No. Permft FWlder Dste Talephone A
S/W
PLUMBiNG
HVAC
ELECTRIG
ELECTRIC
Inepecfion tJete lnep. CommerRs
Footings I
Faundation
Frsming
Roo,ing '111-2 s/ l ?
aouan Piby.
Rough Htg.
isul.
Fil'eplace
Final Htg.
Otsat Test '
Final Plbg. Plbg. Inspector- Notify Plumber
Const. Mder
EngrJPten
Bldg. Flnal
deCk Ftg.
Deck Final
Well
Pr. Disp.
CITY OF EAGAN Remarks
Addition S"1NVIEW TQWNHOUSE Lot 1 Bik 20 Parcel 10 77100 OZD 20
C'-t 3768 Grey Dove Lane State Fagan, MN 55121
Owner
.? . . ., 1 • " O, f7,-5 i 2 "7-
improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. gg 1975 141.08 14.11 10 Paid
STREET RESTOR.
GRADING
Street 1009 1986 200.75 20.07 10
SAN SEW TRUNK
*SEWERLATERAL q 1973 1,429.03 476.34 3 Paid
WATERMAIN
* WATER LATERAL & StLl}JS 1973 3
* WATER AREA 1973 3
?E STORM SEW TRK 1 3 3
* STORM SEW LAT 1973 3
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
CITY OF EAGAN
Addi*ion '1'QTtMTF:W T('IWNHd[IGF.G Lot 2 Blk 7n Parcel I4 777 QQ Q2Q 7Q
ownerr (';-? F'• ??• 'K:7? Street 3772 Grey Dove Ldne State Eagan. MN 55121
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. $g 1975 141.08 14.11 10 Paid
STREET RESTOR.
GRADING
Street 009 1986 200.75 20.07 10
SAN SEW TRUNK
+tSEWERLATERAL 1973 1,429.03 476.34 3
WATERMAIN
ir WATER LATERAL & 3t17bS 1973 3
* WATER AREA 1973 3
iF STORM SEW TRK 1 7
* STORM SEW LAT 1973 3
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 170.00 7400 2-8-73
BUILDING PER.
sac 4
PARK
CITY OF EAGAN Remarks
Addixion TOwiwTEW TDWNiOUSES Lot 3 eik 20 Parcel 10 77100 030 20
Owner k?a y F''g- 11; • ` I Street 3774 GY'ey DOVe LdriB State Eaqan• MN 55121
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. SS 1975 141.0$ 14.11 10 Pdid
STREET RESTOR.
GRADING
treet 1009 1986 200.75 20.07 10
SAN SEW TRUNK
* SEWER LATERAL
WATERMAIN
* WATER LATERAL stlibS g 3
* WATER AREA 1973
* STORM 5EW TRK 1973 3
* STORM SEW LAT 1973 3
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 170.00 7400 2-8-73
BUILDING PER.
SAC
PARK
CITY OF EAGAN Remarks - -
Addi;ion ToWNV2EW ToWtaxovSES Lot 4 Btik 20 -Parcel 10 77100 040 20
Dwner1 ?J Street 3778 Grey Ve Ldne 5tate Ea4an, MN 55121
??nv• , ? `;i. ;r' ,l1: Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. SB 1975 141. 0$ ]14.II. 10 PAj.d
STREET RESTOFt.
GRADING
Street 1009 1986 200.75 20.07 10
SAN SEW TRUNK
*SEWERLATERAL 1973 1,429.03 476.34 3
WATERMAI N
* WATER LATERAL & 3t11}JS 1973 3
'k WATER AREA 1973 3
it STORM SEW TRiG, 1973 3
# STORM SEW LAT 1973 3
CURB & GUTTER
SIDEWALK
STREET IIGHT
WATER CONN. 170.00 7400 2-8-73
6UILDING PER.
sac 240.00 7900 2-8-73
PARK
CITY OF EAGAN
Addition TOWNVEIW M Lot 5 Rlk 20 Parcel 10 77100 050 20
Owne » , ot"Lem IAV)sOrl ?F Street 3780 Gx'eY DOVe L311e State Eagan, MN 55121
E N. N-avoiA_` K U• Saa-I-bloj?-F
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. A-1 SB 1975 141.08 14.11 ZO Pdj.d
STR EET RE5TOR.
GRADING
Street 1009 1986 200.75 20.07 10
SAN SEW TRUNK
*SEWERLATERAL 1973 1,429.03 476.34 3 Paid
WATERMAIN
* WATER LATEFiAL & Stl]}JS 1973 3
* WATER AREA 1973 3
1F STORM SEW TRK 1973 3
* STORM SEW LAT 1973 3
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 170.00 7400 2-8-73
BUILDING PER.
sa,c 240.00 7400 2-5-73
PARK
CITY OF EAGAN Remarks
Additjon TQWNVIEW TOWNHOUSFS Lot 6 elk 20 Parcel 10 77100 060 20
-,- .
Owner Street - 3784 Grey Dove I.ane State Eaqan • MN 55121
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. $$ 1975 141.0$ 14.11 10 Paid
STREET RESTOR.
GRADING
Street 1009 1986 200.75 20.07 10
SAN SEW TRUNK
?SEWERLATERAL 1973 1,429.03 476.34 3
WATERMAIN
* WATER LATERAL & Stl1b3 1973 3
WATER AREA 1973 3
?F STORM SEW TRK 1973 3
* STORM SEW LAT 1973 3
CURB & GUTTER
SIDEWALK
STREET UGHT
WATER CONN. 170.00 7400 2-8-73
BUILDING PER.
SAC
PAR K
CITY OF EAGAN Remarks
Addition ;MWNVIEW TOWNHOUSES Lot 7 Blk 20 Parcel 10 77100 070 20
Owner +Street 3786 6ra,ti•-Dovi Lalrie State F'.agan, MN 55121
v ,
improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. .? 14.11 10 Paid
STREET RESTOR.
GRADING
Street 1409 1986 200.75 20.07 10 75 C-/0? 1/0-/0 -e5-
SAN SEW TRUNK
* SEWER LATERAL ?j 1973 429. 03 476.34 3
WATERMAIN
,k WATER LATERAL 3
* WATER AREA 1971 3
* STaRM SEW TRK 1973 3
* STORM SEW LAT 1973 3
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 170.00 7400 2-8-73
BUILDING PER.
5AC 240.00 7400 2-8-73
PARK
CITY OF EAGAN Remarks
Addision TOWNVIEW TOWNH OUSF«S Lot B Rlk 20 Parcel 10 77100 080 20
OwnerChCA??fS W`. AvlYlal M (hr,4,+Street 3790 Gz'eY Dove L ane State Edgan , MN 55121
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. '7? sB 1975 141.08 14.11 10 P87.d
STR EET R ESTOR.
I
GRADING
Street 1009 1986 200.75 20.07 10 60 1C /0
SAN SEW TRUNK
ytSEWERLATERAL I'll 1973 1,429.03 476.34 3 Paid
WATERMAIN
* WATER LATERAL & Stt]b8 1973 3
* WATER AREA 1973 3
* STORM SEW TRK 1973 3
*STORM SEW LAT 1973 3
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATERCONN. 170.00 7400 2-8-73
BUILDING PER.
sAC 240.00 7400 2-5- 3
PARK
PERMIT #
PLUMBING PERMIT pECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 pATE: x
Site Address ?
? BLDG. TYPE WORK DESCRIPTION
lot
Block Sec/Sub Res. New
Muit. Add-on
- Name ? Comm. Repair
0
m Address ` Other
c Ciry Phone -' , RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
j NQ. FIXTURES TOTAL
Name Water Closet - $3.00 ?
Bath Tubs - $3.00
? ?
Address ? t
3
00
" Lava
ory - $
.
O - Phone
City ` 5hower - $3
00
.
_ Kitchen Sink - S3.60
COMM/!ND FEE - t% OF CONTRACf..FEF -
' APT. BLDGS - COMM RATE APPUES
' TOWNHOUSE 8 CONDO - RES. RATE APPUES
MINIMUM - RESIDENTIAL FEE - $12.Oa
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMiT PRfCE GOES
! FOR: CITY OF EAGAN
Floor Drains - $1.50
--- ?_Water Heater - $1.50
Whirlpool - 53.00
Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIn
SoRener - $500
Well - $10A0
Private Disp. - $10.00
Rough Openings - $1.50
FEE:
STATE S/C:
GRAND TOTAL•
?O )?1DA G/o ?D
7% Vi?uJ ? stii
' UILLAGE OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
PERMIT NO.:
The Village of Eagan hereby grants to ?meel4Aat.eA Pinmhing (!e.
of 1500 ('.li£P Aead Rnrnnvdlle MN 55337
a Permit for: (Owner) Tpyipqj,ew
37 72-74-78-80-84-86-90, & 3767e71-73-77- 1- 5.6rey Dove Lane and
at377946_78_80.89-86 eaa Rrihin p%want to application dated „_ ,2_
Fee Paid: $1,og m dated this 13*h day of N„Qv„h,,,. , 1 922-_•
10.00 a/c
Building Inspector
I4echanical Permits:
Bia Total:
/9
/- ?-b- /
VILLAGE OF EAG.AN
3795 Pilot Knob Road Tw/9s?iPli%
Eagan, Minnesota 55122
?'ENMIT NO.: 288
T
lhe Village o£ Eagan hereby grants to Rqy N. Welter Aeat3Ag Co.,
of 4637 i:1?icago Aneuue So., Mpls. 55407
a HE I?r Permit
forc (Owner) Metrmn Properties-Townviea
76 72-74-78-Bo-84-86_?0
at pove LaAe e , pursuant to application dated 11/29/72
Fee Paid: 160.0 dated this 30th day o£ NOvBmbOr ? 79 2
4.00 U C
Building Inspecto-r-'T,
PieaLanical Permits:
Bid Total:
?
- ')r
" EAGAN TOWNSHIP
BUILDING PERMIT lq•° 2567
Owne: ._.^?'.?:".:'.7r?....?_..•.-???--°---?r-'-'u'............................... Eaqan Township
Address (PresenS) ?...--°l.... ... ?An:.:. Town Hall
Suilder
Aaa:a.a
DESCRIPTION
nate ..1? ......................
Stories To Be Used Fox Fron!
-- Deplh Heigh! Esl. Cos! ' Permi! Fee Remarks
?'r ?°-'^"`
-i?---vL.. G I//7 /
. .: = e'..JL.J..- , _ / " LOCATION
Slreai, Road or other DeaeripHon of Laeation < AddiSion or Trac!
? -
This permit does aoY aulhoriae the ,. ??
uce of s2reels, roads, alleys or sidew?lks aoz does !t give the owner or h3s agen!
the right to czea2e any situazian which is a nuisanee or which presenis a hazard !o the health, safetp, eoaveeience aad
gaaesal welfare fo anyone in the eommunifp.
TFIIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGAESS.
?...... T ... P
This ia fo ceriitY, lhai...................... ......................................... haspermisston io aree! a...?r7.._.........?^.4.?.'..!?f.':_on
the above deseribed premise subjec! !o the provisions of the Suilding Ordinanee for Ea9an Tbwr.....nship .. adopled April 11,
1955.
.......................... (? .?19rL........"'-an_?.:. ?"" "....'-_. Per ...................... . ?.?.?...?.'.?..,?........ . -_Y..?...........
.
.
? ?vildin ... Ins . P .
. eelor -
r% Chairm af Tnwn Board .
-7 -7
2006 RESIDENTIAL BUILDING PERMIT APPLICAT[ON
' City Of Eagan
? 3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
6?2_7 7 "`? S
New Constmchon Reouvements RemodellReoair Reauirements QifiCC'Use OnN
3 registered site surveys showing sq R. of IoL sq fl of house; and all rooled areas 2 copies of plan showing foo6ngs, 6eams, joisls Cer}M Survey Recd Y _N
(20%maximumlolcoverageallowed) isetofEnergyCalculationsFOrhearetladdi6ons TreePresPlanRecd Y =N
2 copies M plan showing beam 8 window sizes; pouretl (oun0 design, etc 1 ste wrveyfor addNOns & decks Tfe9_Prea Required ; o, „ ?yY;ii?IN
->
isetofEnergyCalculations Add)hon - lndicatedon-sdesepticsysfem Oo-3heSeptic$ystemf ? '
'_'Y _N
?
3 copies of Tree Preservauon Plan rf lot platted affer 711193
RimJoistOetailOptionsselec1ionsheet (6mldingswitll9orlessUnils)
Minnegascu mccltanical vcntilation fonn
Date
/ I (/ QP •
C
-- Construction
ost
Site Address O_
c? %r UniUSte #
. 77
Descrip[ion of Work -cct -r '0r P?(-(`)Qp
Multi-family Bidg ? Y_ N Fireplace(s) _ 0 _ 1 _ 2
Property Owner ?d ?? Y\LTtf1 ALe Telephone # LVQ)?
Contractor ???4 Ex ?tir` (D`(in
Address C43eea C a liQ[,fa Yy01Q._ AL, t1J City ?aryy-N;?
S[ate 1710 {rl
Zip tGOc3ll-? Telephone # kp66.- L4(dj ( Q lst
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cate2orv 1 Minnesota Rules 7672
Enefgy Code Category Resitleniial Ventilation Category 1 Worksheet • New Ener9Y Code Worksheet
(Jsubmissiontype) ? Submitted Submitted
• Energy Envelope Calculations Suhmitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan2
_ Y _ N If yes, date and address of masTer plan:
Licensed Plumber
Mechanical Coniractor
Sewer/Water Contractor
Telephone # (
Telephone # (
Telephone # (
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 aad
approval of plans. ?.
"- ?i
Applicant'?Yinted Name Applicant's Sig?ature •
?g(01
2005 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.
,.f? °
oate 3 1 `6 / d S
Site Street Address 37 ;7 'F5' 64,8 ?)VJe L. Gn e Unit #
Propeity Owner LjerJ 6?00jrrj e Telephone #(&/j 3 3G DOG 7
Contractor L!??e-aj ??u/^ Ati OL / Telephone # ( GI.S? .239 `/22
Address 7S8/ 470? sd• d1l. City f aKPu,'11r State n? Zip SSdyzl
The Applicant is: _ Owner [? Contractor _Other
Alterations to existing dwelling
_ Add plumbing fixtures (exciudes water softener and/or water heater-complete next
section if installing these appliances).
_Septic System Abandonment
_WaterTurnaround (add $125.00 if a 5/8" meter is required)
Other: $ 50.00
Water Softener x Water Heater
_ new ? replacement $ 15.00
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ 50
Total $ ls !
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. T-7 rQ -
1 -
?Uh? .S/rad'
ApplicanYs Printed Name
2005 ?..,Appli ant,s Signature ul `J?
E?--- _-?
MASTER CARD
68 .. 70?
st r l, - ? ?
, , .
OWNER ?•?,?v??«/ Cir+?Tr?r .
STRUCTURE AND ?!r U h L?f
LAND USED AS
Permit
No.
Issued Issued To
Coniiacfor Owner
BUILDING
PLUMBING
CESSPOOL - SEP71C TANK
-cs-p?-
WELL
ELECTRICAL
HEATING
GAS INSTALLING ` r?
-T II ? 1 yoo ?
SANIiARY SEWER
OTHER I
OTHER I
Items
FOOTING
FOUNDATION
FRAMING
FINAL
ELECTRICAL
HEATING Approved
(Initial)
Date
Remarks
Distance From Well
SEPTIC
CESSPOOL
TILE FIELD Ff.
DEPTH
OF WEIL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING ?
-
WELL -?-r-?
I ,
SANITARV SEWER
J
_
?
Violations Noted
on Back
COMMENTS:
INSPECTION RECORD I Control No. 0325
CITY OF EAGAN PERMITTYPE: euiLDrNG
3830 Pilot Knob Road Permit Number: 000365
Eagan, Minnesota 55123 Date Issued: 04/28/92
(612) 681-4675
SITEADDRESS: Lor: i sLocK: 2e APPLICANT:
3768 6REY DOVE LANE HAUSE CONST INC, J G
TOWN VIEW 1ST (612) 439-0189
PERMIT SUBTYPE:
IqI9CELLANEOUS
TYPE OF WORK:
REPAIR
?
?
REMARKS: RE-ROOFIN6
INCLUDES 3772, 3774, 3778, 3780, 3784, 3786, 6 3790 GREY DOVE LANE
PERMIT ?
CITY OF-EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT TYPE:
Permit Number:
Date Issued:
BUILDING
00@365
04/28/92
SITE ADDRESS:
3768 GREY DOVE LANE
IOT: 1 BLOCK; 20
TQWN VIEW SST
DESCRIPTION:
Bnildin'g Permit 7ype
6uilding Flork 7ype
UBC Ocoupancy,_
REMARKS:
MISCELLANEOUS
REPAIR
R-3
I("r-
l_J
YJ ?W r
RE-ROOFIN6
INCLUDES 3772 3774 3778 3780 3784 3786 & 3790 GREY DOVE LANE
FEE SUMMARY:
Base Fee =120.00
5urcharge $.50
Total Fee $120.50
CONTRACTOR: - Applicant - sT. LIC. OWNER:
HAUSE CONST INC, J 6 24390189 0005350 TOWN VIEW ASSOC
1039 EAGLE RIDGE CIR 1771 FLAMINGO OR
STILLWATER MN 55082 EAGAN MN 56122
(612) 439-0189 (612)688-6247
i hereby acknowledge that I have read thfs appliaativn and sCata that ths
information is correct and agree to comply with ail app2iceble State of Mn.
SYatutes and Ci,Gy of Eagan Ordinanaes.
?
Control No. 0325
??
APPLICANT/PERMITEE SIGNATURE ISS E Y IGNAT 1 ? RE
PERMIT iCITY OF EAGAN
1992 BUILDING PERMIT APPUCATION
681-4675
SINGLE 8 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural 5 structural plaos, 1 set of .
specifications, 1 copy of ersergy calcs.
Penalty applies when typing of permit is requested, but not picked up by last Working day
of month in which re uest is made r lot chan e is re uested once ermit is issued.
Date C)W /nol Valuation of r+ork
Site Address: 3?lvF? ?L?''/ .Dv?? ?
STREET su *
Tenant Name:
Lor eLaK ? swo. TOWN VlEW IST p,! '
A7E)D! T I D
Descri tion of work: -REQOOF
The applicant is: ? Owner ?Contractor ? Other cww+ee)
Name _Tcl .l l) i g v A?S GC .• _ Phone
Property usT fIRST
Owner pddress S?t "1 ??1& R i nrao %?\CZ .
STNEET tTE f
City F kca.?,m State Nl ZiP
Company7( . ? ? NA+ 1??? `Q.O N??. SNGPhone L?3?1 ? b l'?6°I
COntf8Ct0r Address RAjf?6 2,'iQclTLicense !Exp.!?3T
tity ll[uj5L[ S1 State ,P/111? ZiPS?4??
Lompany Phone
Architect/
Engineer Name Registration /
Address
City State Zip
Sewer 8 water licensed plumber . Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this apPlication and state that the information is
correct and aqree to comply with all applicable State of Minnesota Statutes and tity of
Eagan Ordinances.
Signature of Applicant:
vrr?vc uac
BUILDING PERMIT TYPE
? 01 Foundation ? 05 Apt. Bldg E3 09 Basement Finish
? 02 SF Dwg. O 06 6arage/Accessory O 10 Swim Pool
? 03 Two family ? 07 Fireplace ? 11 Res. Add./Porch
' b 04 Multi-fam. T.H. O OS Deck L] 12 Comm./Ind. `
WORK TYPE
? 31 New jg 34 Repair ? 37 Demolish
a '--• r .
? 13 Public Fac.
O 14 Agrlcultural
? 15 Miscel]aneous
? 32 Additlon O 35 Tenant Finish ? 99 Undefined
E3 33 Alterations L] 36 Move _
GENERAL INFORMATION
Const. (Actual Basement sq. ft. MWCC System
(Allowable? lst F7. sq. ft. City Mater
UBC Occupancy ? 2nd F1. sq, ft. PRV Required
Zoning Sq. Ft. total Booster PumP
? of Stories Footprint Sq. ft. Fire Sprinkler
Length On-site well Census Code
Depth On-site sewage SAC Code
APPROVALS
Planning Building
Engineering Variance
Assessments
REQUIRED INSPECTIONS REZ-7MARKS. RERDO? J NCa
? Site ? footing ? Framing
0 Mallboard ? final ? Draintile
O Insulation
O Fireplace
Permit Fee 15.Q0 wu.sta,:
Surcharge
Plan Review
License
MWCC SAC
City SAC
Mater Conn.
Hater Meter
Acct. Deposit
S/W Permit
5/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total : /S. So
s
5AC %
SAC Units
D l BL CITY USE ONLY RECEIPT#:?- ? ?
SUBD.?Y/o219?? DATE-
1896 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for. ? single family dwellings
? townhomes and condos when permits are required for each unit
New construction ?Add-on fumace
? Add-on air conditioning Add-on airexchanger, i.e. Vanee system, etc.
Date:
EM
? Minimum Fee: Add-on/Remodel (existing residence only) 20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required @$3.00 each)
? State Surcharge .50
TOTAL
SITE
L
OWNER NAME: I.A) i «/evr-- 17u r So -tt PHONE #:
INSTALLER NAME' wd ? le-f's ? 0-cl Msi d-e- /- ;?' I( dC ?o c-
STREET ADDRESS: ?CO ? 0 L)«-S
CITY: Ie STATE:MA zIP: SSI? y
PHONE #:
W
vz
??
Tuw,vvl,E)N
EAGfN TOWNSHIP
3795 Pilot Knob &osd
St, Paul, Mianesota 55111
Telephone 454-5242
PERNIIT FOR WATER SL+RVICB CONNECTION
Date: November 13, 1972 Number: 1039
Biliing Neme• TO?v-iew Site Address; nk3768 ? 3772 Grey Dove La$a
? Owaer: Billiag Addreas
---77?7e' '777-,-, ,77
Plumber. ?
l- -26
a lo ?1,? lo
7
Meter No, IPe:mit Fee 10.00 pd 11/13/72
ao/?n
Meter Reading
Meter Sealed: Yea_
ICO
Inspected by
Date
??
Add' 1 Chg.
T#?l c g?98,
,?
??? ? ?_.e<.
? ias?i9/7`?3
Suilding ia a:
Residence
Mltiple xx T*o.
Commercial
Iadustrial
Other
Remarks:
$25.00 f',E-IF;SPECTiON HE FOR
IMPROPEkLY iNSTALLED METERS.
By:
Chief Inapector
In conaideration of the iseue and delivery to me of the ahove permit, I
hereby agree to do ttn proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Mianesota.
BY:
Consolidated Plwnbing Co.
Please aotify the above office when ready for inspection and connection.
-2-
?7 7
??
EAGAN TOWNSHIP ??`?J16w
3795 Pilot Knob Road -?,!I"
St. Paul, Minnesota 55111 I?
Telephone 454-5242
PERMIT FQR SEW$R SERVICE CONNECTION
nATE; November 13, 1972 NUMgER 1204
?- ??,
OWNER: Townview Address 768,& 3772 Grey Dove Lane
PLUMBERConsolidated Plumbing Co. TYPE OF PIPE heavy cast Iron
DESCRIPTION OF BUILDING
Industrial) Commerciall Residentiel I MulCiple Dwelling I No, of units
+ I I xx I 2 townhouses
Location of Connectione:
Conaection Cha
=Be"/yA "?,?? ?/?
Permit Fee 10.00 nd 11/13[72
.50 pd 11/13/72 s/c
Street Repairs
Total
Inspected by:
DaCe
Remarks:
By.
Chief Inspector
in consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulationa of Eagan Toemship, Dalcota CouaCy, Minnesota
By.
Consolidated Plumbing Co.
Please notify when ready for.inspection and connection and before any porCioa
of the work is covered.
I-N
lat3, ;9k ao
7-0 cu n vi e LL)
EAGAN TOWNSHIP
3795 Pilot Knob Rosd
St. Paul, Minaesota 55111
Telephone 454-5242
PERtUT FOR WATER SERVICE CONNHCTION
Date• November 13, 1972 NumyeY• 1040
Billing Name: TOS"Tavie^' Site Addreas 3771+ & 3778 Grey Dove Lane
Owner: Billing Address
ISt
Plumber: Consolidated Plumbing Co.
Location of Connection Meter Size Connection Chg c? g
Meter No, Permit Fee 10.00 pd 11/13/72
.50Jpd 11/15/72 s/c
Meter Readinp_ Meter Dep.
Meter Sealed: Yes_ 'Add'1 Chg.
NO i Total Chg.
4-11,
Buildiag is a:
Residence
Multipie x Bo. Units
Commercial
Industrial
Other
Iaspected by
Date
Remarka:
townhouses - JO RE-IN?PECTiON fEE FOR
:'dOPERLY IPdSTALLED METERS.
By:
Chief inspector
In conaideration of the issue and delivery to me of the abwe permit, I
hereby agree to do t8e proposed work in accordance with the rules apd
regulations of Eagan Towaship, Dakota County, Mi.nnesota.
By:
Consolidate d Plumbing Co.
Please notify the above office when ready f r inspection and connection.
?717?
9
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EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONI3ECTION
DATE• November 13, 1972
pUf4BEg 1205
OWNER: I?0wnview Addres _ 3774 & 3778 Grey Dove Lane
?
PLfJMBER Consolidated=Plwnbing Co. TypE OF PIPE heavy cast Iron
DESCRIPTION OF SUIIAING
Industriall Commerciall Residential
Location of Connections:
Multiple Dwelliag I No, of units
Canaection Charge.?-
Permit Fee. 10.00 pd_11/13 72
.50 pd 11/13 72
SYreet Repairs
Total
Inspected by:
Date
Remerks•
By
Chief Inspector
In consideration of the issue and deliverq to me of the above pexmi.t, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Toemship, Dakota County, Minneaota
By
Please notify when ready for inspection and connection and before anq portion
of the work is covered.
1
S- I)-&
%"a cu/,/ v /C v(l
EAGAN TDWNSHIP
3795 Pilot Knob Rosd
St. Paul, Mianesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICB CONNHCTION
Date: November 13, 1972
Billing Name:
Townview
NO ' Total Chg.
Owner: Billing Addresa
Plumber: Consolidated Plumbin g
Location of Connection Meter Size Connection Chg.,9 0?--d
Meter No. Permit Fee 10.00 nd 11 /13/72
•50 pd 11/13/72
Meter Reading Meter Dep.
- Meter Sealed: Yes Add'1 Chg.
is a:
Residence
Multiple x Ko. Units
Commercial
Industrial
Other
Inspected by
Date
Remarka;
Number• 1041
Site Address: 3780) & 3784 Grev Dove Lane
$25.00 RE-!PlSPECTION FEE FOR
OMPROPERLY IPaSTALLED METERS.
Hy:
Chief inapector
In conaideration of the issue actd delivery to me of the abwe permit, I
hereby agree to do tte proposed work in accordance with the rules and
regulations of Bagan Township, Dakota County, Minnesota.
By:
Consolidated Plumbing Co.
Please notify the above office when ready for inspection and connection.
?
EAGEiN TOWIVSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTIOtd
DATE: November 13, 1972
N[1LffiER 1206
-dcl
OWNER: Townview Address 780/& 3784 Grey Dove Lane
L?
PLUMBER. Consolidated Plumbing Co. TYPE OF PIPE heav.v cast Iron
DESCRIPTION OF BUIIAING
Industriait Commercial
Locatian oF Connections:
Sy
Chief Inspector
Iu consideratioa of the issue and delivery to me of the above permit, I
hereby agree Co do tfie proposed work in accordance with the rules and
regulationa of Eagan Tormship, Dakota County, Minneaota
Sy.
Consolidated Plwmbing Co.
Pleaae notify when ready for inspection and connectioa and before anq portion
of the work is covered.
?c 2 townhouses
Connection Charge ?d ?? %
Permit Fee 10.00 pd 11/13/72
. p
Street Repairs
Total
Inspected by:
Reaidential Multiple Dwelling No, of units
DaCe
Remarks•
?
,Cof 7, jgk 20
7-6mnvlew )sy"
PERMIT FOR WATER SERVICE CQNNEGTION
Date: November 13, 1972 Number; 1042
Billing Name: Toanview Site Address: Sb ,3,790 Grev Dove Lane
Owner: Billing Address
Plumber: Consolidated Pluznbing Co.
er
4
EAGF.N TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
Ass'n meter - 22379539-387
Meter No. ?Permit Fee 10.00 pd 11/13/72
Meter Reading Meter Dep. .0 pd 1113/72
1/24/73
3790 - 22 79534-387572
?
6 - 2 / LrL6-37?-
1L1?• G7 -3 ? 37
?
Building is a:
Residence
tiultiple x No. Units 2
Commercial
Industrial
Other
Meter Sealed: Yes- Add'1 Chg. (ra . ?
-?- a--* 3
NO Total Chg.
Inspected by
Date
Remarks:
ion
_5.00 P,i:-!;,;3i'EUi;ON fEE Fi?R
,MPROPERLY itVSTALLED METERS.
Sy:
Chief Iaspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do tte proposed work in accordance with the rules and
regulatioas of Sagan Township, Dakota County, Minnesota.
By:
Consolidated Plumbine Co.
Please aotify the above office when ready for inspecCion and connection.
`
Jaf7 )Sk Q6
EAGIjN TOWNSHTP
3795 Pilot Knob Road
St. Paul, Minne3ota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
?ATE: November 13, 1972
OWNER• Townview
PLUMBER Consolidated Plumbing Co.
NUMBER _ 1207
/ T-? (-T?
Address /' 86 & 3790 Gr pove Lane
? .-
TYPE OF PIPE heaw cast iron
DESCRIPTION OF BUIIl)ING
Industriall Commerciall Residential i Multiple Dwelling I No, of unfts
I I I xx I 2 townhouses
Location of Connectione:
Connection
?r?e
Permit Fee 10.00 nd 11/13/72
.50 pd 11/13/72 s/c
Street RepaiYs
Total
Iaspected by:
Date
Remarks
By.
Chief Inspector
In considerstion of the issue aad delivery to me of the above permit, I
hereby agree to do the proposed work in accordsnce with the rules and
regulaCions of Eagaa Totinship, Dalwta County, Minaeaota
Sy
Please notify when ready for iaspection and coimectioa and before any porCioa
of the work is covered.
MECHANICAL (RESIDENTIAL)
Permit Applicarion
City Of Eagan
lo O?-`-? q 3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Please complete for: Single Family Dwellings
Townhomes and Condos when permits are required for each unit
Date n (o / 3c --,) / G -,?)
?? T?
a Unit #
Site Address
s
st?
? rY, 55ru- <<l
Property Owner TzV e c^ -?lt?- LJ'E.7?7L f? p?2 Telephone #(Co5l) (a F-i C. -`tj9 I I _
0 ?
Contractor ,[
, ,
?
S
Add
V5 114 s4-h
2j
( ?k
?it
sV W.
C?
P
?
ress
treet
o
D y
,
-
-
_
Sta[e Zip ? Te?ephone # ( (aSI
The Applicant is _ Owner _ Contractor _ Other
Add-on, moditication or alteration to exisGng dwelling unit $ 30.00
furnace replacement
air exchanger
? air conditioner
other
State Surcharge
li $ .50
Total I
?
$ _2?.?
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; tUat I understand this is not a
pemut, 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.
': (v^ . ? M
Applicant's Printed Name Applicant's Signature
2006 RESIDENTIAL MECHANICAL rExMiT nrrLicATioN
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete foc singie family dwellings & townhomes/condos when permits are required for each uni[
Date
Site Address 3 -7 2 A C?Ye_t_k ??-•`?J ?-? ' Unit #
Property Owner ?--U +1- n 11 ? o tr)G-r Telephone # l? ? ) L4S1-3 1 SS
Contractor Wohlers Southside Htg. & Air, Inc.
6950 W. 146" St., #106
Street Address Apple Valley, MN 55124 City
(952) 431-7099
State Telephone # ( )
Bond#: l`tiL-LQSy`?q8"7 Expires: /la-??rj-0tF'
The Applicant is _ Owner X Contractor _ Other
Add-on or alteration to existing dwelling unit $ 30.00
_ furnace _Additional ,L_Replacement _ New
air exchanger
? air conditioner
heat pump
other
State Surcharge $ 50
Total
I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and acwrate; 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 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.
Cr,C_k_c?_ U_Ic?h,arS , "t o ?_c---,
Applicant's Printed Name App icant's Signature.
?-----------------
? Permit#:
I Pertnit Fee: 1SV
?
I
? Date Received:
? Staff: ?
L -----------------
2008 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Slte Address:
. r i
Tenant:
$UItB #:
RESIDENTIOWNER Name: Phone:
Address 1 City / Zip: GGL 0_,r) tA5 G 1?-?
CONTRACTOR Name: License #: (z9l1 ? ()'Pm ?
?
Address: Champion
651-21651340
City: 3670 Dodd Rd. #100 State: Zip:
agan, - 39 .
?
1
Phone: ContactPerson:_
TYPE OF WORK _ New VReplacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W.
Descri tion of work:
PERMIT TYPE RESlDENT1AL
'/WaterHeater _WaterSoftener
_ Lawn Irrigation Add Plum6ing Fixtures
(_ RPZ /_ PVB) (_ Main _ Lower Level)
Septic System _ Water Tumaround
New
Abandonment
RESlDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irfigatlon (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround` (includes $.50 State Surcharge)
`Water Tumaround (add $136.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, duclwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $ ?tl
. ... . . ... . _ _ _ _ " ..,.. .?' '?"""_ .._w ..,.w.... ..a ??.., r?e, ..?
I h0f0by 2CK00wIeagO VIB[ VIIS IntOfmauOn IS Compie[e ano ac?[aie; mai uro wUin wm oc nI w???..?•?_...? •••........•..•.•..•.----- --- .-
Ea9an; thal I undersfand this is not a permil, but only an applicatlon for a permit, and work is not to start without a permit; that the work will be in
accordance with lhe approved plan in the case of work which requires a review and approval of plans.
x Jcl,6i2. 5 6•,k4e o r x
Applicant's Printed Name ? ApPi+1ca
FOR OFFICE USE.? ,'? "
?i:.?o-'•I .?..,??_r.-.eC.,'? , ,r . ?; ??j?a,
RnnrtirnH'.IrienFf:fillncL`?• :;• .'. T1!'r4
r((
311390-V
Use BLUE or BLACK Ink
---------I
For Office Use 1
Cit,y of Eatdfl , Permit , I
1
I Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 I Date Received: I
Phone: (651) 675-5675 I I
1 Staff: 1
Fax: (651) 675-5694 L -----------------I
t,l 2010 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: aV --r U Site Address: 2 ~yl_
Tenant: Suite
~r b "3
RESIDENT / OWNER Name: Phone: ~11.$-/'
Address / City / Zip: 3 -2 iP e Op vz o°til. ,
CONTRACTOR Name: 6 License
Address: City:'~~
State: i t Zip: Phone: l~/ J
Contact: 9 N J44-6- Email:
TYPE OF WORK New _ Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W.
Description of work:
PERMIT TYPE RESIDENTIAL
Water Heater Water Softener
Lawn Irrigation RPZ PVB) Add Plumbing Fixtures Main Lower Level)
Septic System Water Turnaround
_ New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
*Water Turnaround (add $166.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 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.cioi)herstateonecall.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 ~-r k ~e x
App icant's Printed Name Applicant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground -Rough-In Air Test Gas Test Final
Use BLUE or BLACK Ink
r
For Office Use
I I
I Permit i
City of EaInQ~ I ~a o
I Permit Fee:
3830 Pilot Knob Road I
Eagan MN 55122 I Date Received:
I
Phone: (651) 675-5675 I Staff:
Fax: (651) 675-5694 L -----------------I
2012 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address: d V-e ~ ct'~
Tenant: Suite
RESIDENT / OWNER Name: CS Lk `r 5 G ` Phone:
Address / City / Zip: S
Name: G- K 2 C- Uji- License
Address: U G 6-t City: V V^ ` e d C'+CA--
CONTRACTOR q p
State: Zip: Phone: (t
Contact: Email:
TYPE OF WORK -New _Replacement -Repair _Rebuild X Modify Space _ Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
Water Softener
Lawn Irrigation RPZ / _ PVB)
PERMIT TYPE Add Plumbing Fixtures Main / Lower Level)
Septic System
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn`;Irrigation (includes $5.00 State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $189.00 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)
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.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 unde tand 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
accordanc t pproved plan in the case of work which requires a review and approval of plans.
x v x
Applicant's nted Na a Applicant's Sign ur
FOR OFFICE USE Reviewed By: 1 Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
Use BLUE or BLACK Ink
' I For Office Use
'Ir j Permit & I . V
non I
City of Ea na
Permit Fee. ~z I
3830 Pilot Knob Road
Eagan MN 55122 j Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
Name: s, l~.la/1sl ~ ~
0-TT- Phone6ZD Y V -2031
RESIDENT /
OWNER Address/City/Zip:
i
Applicant is: Owner Contractor
Description of work: "(/a
TYPE OF WORK
I Construction Cost: 6 006 Multi-Family Building: (Yes No ~
Company: L~~ Contact:
_G N I RACTOR Address: Z(,pp V City: if
j State: _ Zip. ! Phone:
I
I License Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of l
i the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that then are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.aor)herstateonecall.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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x ' (1, alu It a 't V,3 m r-- x F 1
App icant's Printed Name Applicant's Signature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE 4
- - 7- .
SUB TYPES
- Foundation - Fireplace _ Porch (3-Season) _ Storm Damage
- Single Family - Garage _ Porch (4-Season) _ Exterior Alteration (Single Family)
- Multi Peck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi)
01 of - Plex _-Lower Level _ Pool _ Miscellaneous
Accessory Building
WORK TYPES
- New _ Interior Improvement _ Siding _ Demolish Building*
- Addition _ Move Building _ Reroof _ Demolish Interior
Alteration _ Fire Repair _ Windows _ Demolish Foundation
Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION
Valuation 200,0, &c- Occupancy t j2G - I MCES System
Plan Review Code Edition S007 A4-594 SAC Units
(25%_ 100% ✓ Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction ✓b Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final / C.O. Required
Footings (Addition) y Final / No C.O. Required
Foundation HVAC _ Gas Service Test Gas Line Air Test
Drain Tile Other:
Roof: -Ice & Water -Final Pool: Footings -Air/Gas Tests -Final
V1 Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace: -Rough In -Air Test -Final Windows
Insulation Retaining Wall: _ Footings - Backfill _ Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
g - 3 Z b8, 3 -~~a 3 74 ~~7$ , 3~ 80, 37 8 4.3'18 (o ► 3J&1 o C-sreA~ Dzv .
Use BLUE or BLACK Ink
For office Use
i
t
Permit 16 ,3` (10
t
City of Ea
~ Permit Fee: ~ 1 I ac.5 . D ~J i
3830 Pilot Knob Road t t
I Date Received: 12CI I t-,7 I
Eagan MN 55122 I I
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 l Staff t
L---------------- I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION j,
• - - ~ 3790 7r`'? LAILI-
Date iCT-a~'t3 Site Address: 37L4 3~7,a, 377N 3775, 3')80. 3-)Sy, Unit#:
F----- ---..........e_..o.~ Name: Phone:
Resident/
I Owner i Address /City /Zip:
t
i
Applicant is: Owner Contractor
Description of work: Q
Type of Work i ^
; Construction Cost: d Ol a0z) Multi-Family Building: {Yes / No
Company: ~~~°ta2~~f1 no>fct~ ar,' Contact: d~
I i Address: City
Contractor i z#
State: tyl A ~ Zip: 10"53 -1 Phone:
( License #`f Lead Certificate #
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes ____No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor. Phone:
Sewer & Water Contractor: _ Phone:
1 NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of
f the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that rheyare trade secrets
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protectinn aciainst underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. ,
I hereby acknowledge that this information is complete and accurate; that thr, ,r rk 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 pem-tit, stud work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
Applicant's Printed Name Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA119902
Date Issued:12/31/2013
Permit Category:ePermit
Site Address: 3768 Grey Dove Lane
Lot:1 Block: 20 Addition: Town View 1st
PID:10-77100-20-010
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Diane Wagner
1770 Gervais Ave.
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
$60.00 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 -
William Bursott
3768 Grey Dove Lane
Eagan MN 55122
(651) 666-5578
Perfection Heating & A/c
1770 Gervais Ave
Maplewood MN 55109
(651) 777-7620
Applicant/Permitee: Signature Issued By: Signature
!"
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