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3843 Lodestone CirCITY OF EAGAN Remarks Addition Cedar Grove #11 Lot 19 Blk 3 Parcel oWner 4,,£ 14?rhj)ct il Street 3843 Lodestone Cr. state Eagan,MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. T971 2 9. 2. 0 78,53 A004392 7-I$-77 STREETRESTOR. y T ?f ?2 .3? 12• 3 0 $].OZ A004392 7-1$-77 GRADING SAN SEW TRUNK !, v O. . 3hSEWERLATERAL 97 3• 324.79 649.59 A004392 7-18-77 WATERMAIN WATER LATERAL. . . WATER AREA ? Wtr la, & area 97 STORMSE TRK . . 1 7 STORM SE ??ar 97 .3 •-'? 14.60 A004392 7-18-77 # °rm r. • 53.68 161.05 A004392 7-18-77 CURB & GUTTE SIDEWALK ? 1 STREET LIGHT WATER CONN. 230-00 # BUILDING PER. sAC 475.00 #05659 4-14-77 PARK CITY OF EAGAN 3795 Pilot Knob Road Eogon, Minnosota 55122 Phone: 454-8100 Date: 1,qnmr-'` etJFmF'',r." _ PERMIT Fe,-) r 1_ :_ 27, L i Site Address: Lot Bloc? Sub/Sec.?/ / Nome . 3 Address O City Phane: Name . ? ,°•r Address _ e 0 V City Phone: This Permit is issued on the express condition that all work shall be Minnesota Statutes and City of Eagan Ordinances. No Receipt No.: Single I Residential Multi Res., Comm./Ind. New/Alter./Repair. Cost of Installation _- Permit Fee - Surcharge Tota I done in accordance with all applicable State of Building Official CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE RECEIVED 19 AMOUNT $ I & GOLLARS 100 ? CASH r-1 CHECK FOR d' BY ,,.., ?s;1 NUMERICAL FILE COPY w;,:a ..,rv'.rwY$+ ,gt'r^riR-'K",?l. .o, :.. «..,-, . .,r ,,, . . ?,?r. •.,?- vP. r .;? . ?, ?n-=r.:.-..a PERMIT # MECHANICAL PERMIT RECEIPT # ? 1' ? ? ? ?/ CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 ? DATE: CONTRACT PRICE: PHONE: 454-8100 For Office Use Only: Site Address '% ' ? ' ' ` ? % . ' `- • . 4 C BLDG. TYPE WORK DESCRIPTION Lot Block Sec/Sub Res. ? New urStrL m Name ea ing oo ng Mult. Add-on OX 293 Comm. Repair co c Address t4PF4 Cit Other y ? Name - FEES RES. HVAC 0-100 M BTU -$24.00 c Address ,.s ADDITIONAL 50 M BTU - 6.00 p Cib -e"'- Phone ` (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMIn - 1 50 EA . . TYPE OF WOHK COMM/IND FEE - 1% OF CONTRACT FEE ForCed Air M BTU APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPUES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8 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 $ .. _. ._1.. ?- ? FEE .. S/C: SI / 1 t bM EE TOTAL• ?'• ? L i FOR: CITY OF EAGAN 4/i???5 ? !?•G ??a ?/?9 ?/?l? CITY OF EAGAN 3795 Pilo! Knob Road Eagan, Minnesota 55122 Phono: 454-8100 PERMIT Date: Niay 9, 1977 -1^43 Lodestone ^ircle Site Address: Lot Block Sub/Sec . tlefson Builder, Name ; Ad ss, O City Phone: ??-r.z-Ryan Plumbing & "r`.c-atina Snc ? Name ? '.a?45 So. Robert Trail ? Address pe V ?.. + J'i--?t ?.I!": City Phone: This Permit is issued on the expFess condition thot all work sholl be Minnesota Stotutes and City of Eogon Qrdinonces. No. 313 Receipt No.: Single Residential ? Multi Res., Comm./Ind. I New/Alter. / Repair Cost of Installation 20.00 Permit Fee , Irl SurcFarge 20.5^ I Total done in accordance with all opplicable Stote of Building Offitial , CITY OF EAGAN 3795 Pilot Kno6 Road Eagan, Minnesoto 55722 Phone: 454-8100 - PERMIT Dote: ;ay 3? 1 77 Site Address: ' La Block Sub/Sec. ---' - Name _ =5on iiuii.c?ers -- ; Address 7 ' Da`r`'n>>ort Pvc . O Ciry ` :1qa-n _ Phone: Name Fredric,csoT: !iea_iny P Address ??30 ?' -c.u "^;ie t'r1vF 0 City Phone: This Permit is issued on the express condition that all work shall be Minnesota Statutes and City of Eogan Ordinances. No 1:_( 7 . Receipt No.: ? Single Residential Multi Res., Comm./Ind. I New/Altec/Repair. Cost of Installation Permit Fee C? irr6n?no Total done in accordance with ail applicable State of Building Official . CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 N2 4270 , PHONE: 4548100 BUILDING PERMIT Receipt # - $ite Address ' Erect ? Occupancy ' Lot Block Sec/Sub. Alter ? Zoning Parcel # _ Repair ? fire Zone _ Enlarge ? Type of Const. Name Move ? # Stories W Z Address - Demolish ? Front ft. 0 City Phone _ Grade ? Depth ft. ? o Name Approvols - Pees ?a Address Assessment ce 1' Water & Sew. Cit Phone Police F- ? WW W Name Fire F ?? Address- Eng. Z L ¢' " Cit Phone Planner - Council - I hereby ackrrowledge that I have read this opplication and state that gldg. Off. the informotion is correct ond ogree to comply with all applicoble State of Minnesota Stotutes and City of Eagan Ordfnances. APC - ; $ignature of Permittee Permit _ Surcharge Plon check SAC Water Conn. Water Meter Totol A Building Permit is issued to: - on the express condition that all work shall be done in accordonce with all applicable State of Minnescta Statutes and City of Eacan Ordinanc_s. Building Official --- - P.nnN # Dab lawd Fawlliw Plumbing Q/u? S-9 - 7 7 Mechanical y9r.7 .5-- -77 INSPECTIONS DATE INSP. Rouglrln Firal Footings Dute Irup. Data Inap. Foundation Plumbing + • j omo ? - 7 F rome / ins. Mechanicol Finol f.?? 1,J.•7? r- Remarks: SEV1fER SERVICE PERMIT CITY OF JEAGAN 3795 Pilot Knob Road PERMIT NO.: Eogan, MN 55122 DATE: Zoning: - No. of Units: Owner: - Address: Address: - Sit -- e Plumber: -- 1 agree to wmply with t6e Cify of Eagan Connection Gharge: Ordinancea. Account Deposit: By - Date of Insp.: Insp. CITY OF EAGAN 3795 Pilof Knob Road Eagan, MN 55122 Zoning _ Permit Fee: Surcharge: Misa Charges: Total: Date Paid: WATER SERVICE PERMIT ? PERMIT NO.: DATE: No. of Units - Owner. _ .-U1IC7CrB ?t_ Address: Site Address: ?=,'-'3C: s GC:'te i._. oi,...,?e.. -!n Meter No.: Connection Charge: Size: - Account Deposit: Reoder No.: Permit Fee: ' I agrce to comply witl+ rhe City of Eagan Surcharge: - Ordinanees. Misa Charges: Total: By Date of Insp.: - Dote Paid: Insp.: RESIDENTfAL " BUILDING PERMIT APPLICATION ? CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4675 New Construction Reauirements RemodeURepair Requirements • 3 registered sile surveys showing sq. ft. ot lot, sq. ft of house; and all roo(ed areas • 2 copies of plan (200lo maximum lot coverage allowed) • 1 set of Energy Calculations (or heated additions • 2 copies of plan shavirg beam & window sizes; poured (ound design, etc.) . 1 site survey for exterior additioris & decks • 1 set o( Energy Calculations • 3 wpies of Tree Preservatlon Plan i( lot plaKed after 711193 • Rim Joist Detail Options seleclion sheet (bldgs with 3 or less units) DATE 0 3- 73Arv - Oa VALUATION (EXCLUDING LAND) JOB SITE ADDRESS 6 `64'3 t-Od-f-5ibrQA IF MULTI-FAMILY BUILDING, HOW MANY UNITS? _ PROPERTY OirVNER 'macu hhkjN&% [_Y, TYPE OF WORK 8\9;L;4&j li4a? uJ( 13ir%61 SiCjir APPLICANT RMA HOME sERVicES nvc. Home Depot Installed Sales ADDRESS 3200 Cobb Galleria Pkwy., Ste. #200 Adanta, GA 30339 PAGER # 763-542-8826 BC-20268257 FIREPLACE(S) _0 _1 _2 _3 PHONE # ZIP CODE FAX # NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category (check one) Plumbing Contractor: _ Plumbing System Includes: Mechanical Contractor: Mechanical5ystecn Includes: Sewer/Water Contractor: MINNESOTA RULES 7670 CATEGORY 1 - Residential Ventilation Category 1 Worksheet Submitted - Energy Envelope Calculations Submitted I MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Phone #: Water Softener _ Lawn 5prinkler Water Heater No. of R.I. Baths No. of Baths Air Conditioning Heat Recovery System Phone # Phone # ? ?_MNO d? ? .ran? 9 4 2002 D ? Fee: $70.00 All above information must be submitted prior to processing of application. I hereby acknowledge that I have read this application, state that the information is correct, and agree to compiy with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Sfgnature of Appiicant 1).Y,1n'\ Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required , uaaated voi CITY OF EAGAN r 3795 Pilof Knob Road Eogan, MN 55142 N2 4270 PHONE: 454-8100 BUILDING PERMIT APPLICATION $319000, Receipt #p 5.55? To be used foe Sine. FetT1 D4718. d GarE. Date 19---1 Site Address- 3843 Lodestone Cr, Erect 11 Occupancy I Lot 19 Block 3 $ec/Sub. CC' 11 -- Alter ? Zoning - Parcei # Repair ? Fire Zone _ Enlarge ? Type of Const. w Name Randy Hendrikson Move ? $k Stories 3 Address Demolish ? Front 42 ft. 0 Cit Phone Grode ? Depth 24 ft. ? Name o e SoII T5. Approvals Peea 0 ? Address Assessment Permit 93.00 ? • ? Cit Apple Val Le}? phone 454-6873 Woter & Sew. -- Surcharge Police Plan check Ww W Name Fire SAC 475.00 t- _?U Address Eng. Woter Conn. 230.00 <'Z" Ci Phone Plonner - Countil _ I hereby acknowledge that I have read this application and state thot Bldg. Off. _ the information is correct and agree to comply with all opplicable AP? State of Minnesota Statutes anj City of Eagan Ordi nces. n, , ?. ? n n i _ : I n A_ Signature of Permittee 1_L?f?? ' Ktu A Building Permit is issued t 0 TO SOII Bldrs. , all work shall be done in qEcordarip with a I pplicable Stat Woter Meter 60.00 -i -FtEIEDen-7s-s oQ Total 948.50 ----- on the express condition that of Minnesota Stotutes and City of Eagan Ordinances. Building Officiol / ' ?;.s `/` ' "' L Iq E 69011 ,Zc Fiequest Date - 9 ire No. Rough-in Inspection RequiredT ?/ 174 Ready Now ? Will Notiy Inspedor ? Yes No ? ? When Readyl Ilicensed contractor ? owner hereby request inspection of above electrical work at: Job Atldress (Straet, Box or Route No.) piy fSection. Township Name or No. Range No. County I ,?n 4KOTi`I Occupant (PRINn 5/?- v c Phone No. ? - 7 1 Power Supplier OT'q 6rtkrc Atldress e7 Elechi 1 Contrector (Compeny Name r I? ? 4r ??C_ ConlracmrB Licensa No./ ?L2-5 Mailing Atldress ( ontractor or Owner Making I tallalion) ?? T C !a; v, Authoriz ig e(Conha n Ins lion) P e Number Q MINNESOTA STATE BOARD OF ELECTRICITV THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bltlg. - Room 5-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENClOSED. (p ???'9 REQUEST FOR ELECTRICAL INSPECTION es-ooam-07 ? See instruclions for compieting ihis form on back ol yellow copy. ?_ 6 9011 X" Below Work Covered by This Request ew Add Rep. Type of Building AppliancesWired EquipmentWired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. 8uilding Dryer Other (SpeciTy) Comm./Industrial Furnace Farm ' Air Conditioner Other (specity) Cpntractor5 Remarks: 14?111-o f'/e(,rJ LG .? C.° aA'L Irk S4mII oJp-c- PeaK ???er ?"cr ex.5?'? Compute Mspection Fee Below: 14G'ai+ P i,i yyl ,P ,4 C,, # Other Fee # ServiceEntrance Size Fee # CircuitslFeeders Fee Swimming Pool 0 to 200 Amps 0 to 700 Amps Transformers Above 200 _ Amps Above 100 _ Amps Signs Inspecto05 Use Oniy: pl Irrigation Booms O Special Inspection Alarm/Communication Other Fee S I, the Electrical Inspector, hereby ti h th b Rough-in Date ry t cer at e a ove inspection has been made. Final f-?-7 ?? , • I _?. oat;?, OFFlCE USE ONLY v ? This request voitl 18 moMhs from ? -? r 60?70 n::te:_ .-3 nUI7•'?7i>:G PiRMYT t.;PPLICtiTIG'?'d RLOCI: DAIJCL•;i cr, SEf'^=0v7 ':SLTi1?3E'Z IF M:il-'?.`?'1"TEiJ ADDR:RSs c,;,? q, ?r, .., ?i?,/j?/' ?.f?"?/P/1?S`?'? TELEFF;Utv*;s 1J. __._..__ ._ .?...._._._.. _ .., -:os;l_.,. occu-:'?-c? r usE -? ._.?. __?._._..r...._. "`. nr i.+ ?:.:: iass57 co?:rr?::.c?br a y?.1tci'ELEP?iOF78 !,) -- - Ylot=° wl,:r.; bui?.d.i.ag plansP and energy rculz5t_'.bns .?itl: this applicacioil Siqned . M. V?x1S,UA`I'IO'/??_? vvv.- ?<'?V ? L3't\^1L'-a i4r':2'EFi BU1.i,DING Pt;k'.i??'?.' FL'E PIM PIaAT'i cF"ii'?CX.l' ? .-,:12 ?l??'.IC DE1jS(anTfG:, I':'E C"i1Qi,it 7a 3a, oQ, - ?p o ? .. . ? ? ,!_.. Sl.. ? ? `PO1EaL? Iq A? APPROV1aLS e ASSESS;lElls'i CLEt.K AUSLAING DEPT. POLICE DEPT. -_. .. T'aZ3eFR & SbUT"R DEP'.F. FI?L DEPT. OFI"ICE i1SE PF1,.'2K DEPT. ? TallefRan tiuflders Inc. Jr.10o12 176-74A f/ F. C. JACKSON LAND SURVEYOR RF.CiIiTiRED UNDER LAWC OF lTATQ OF MINNFWTA LIG[NflD fY ORDINANC[ OF CITY OF YINN[AlOLIi ? - 727-3434 + \ 9616 =` TREET $??17 ?A--.4-d68;--- ?il? CCTti?CB C Z op, o . L 1 1 ? ? ? i ? r ? I ? t(Y ?r? ?/?nvl ?roppses ? tr+i en71 yl 2? ? . ? S f ? I H6REBY GlRTIFY TMA7 TM6 ABOV6 16 A TRUE AND OORR6CT PLAT OF A SURVLY \ 1 ~4? Lot 19,Black 3,Cedat Grove No. 11, Dakota County,Minnessta, ° L:od(T s¢oht?? Ai SuRVEYfiD BY ME THIS 22nd• DAY OF ?rCti A.O. 1977 100? ? ?• "go SIGNED- , F. C. JACKSON. Mi Tw R[aIsrnwrwH. No. 3600 t RESIDENTIAL BUILDING . • ? 59 4Y7 PermitApplication City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New ConsWction Reauirements RemodeUReoair Requirements - _. . ? - 3 registered site surveys showing sq. ft of lot sq. ft. of house; and all roofed areas 2 copies of plan (20% maximum lot coverage allowed) -. - --- - 1 set of Energy Calculatlons for: heated additions 2 wpies of plan showirg beam & window s¢es: poured tound design, eta 1 site survey for addi6ons & decks ' 1 set of Energy Calculations Addition - indicate if on-site septic system 3 copies of Tree Preservation Plan 'rf lot platted after 7/1l93 Rim doist Oetail Options selection shaet (bldgs with 3 or less units 0 . C) o 7 (a? ! I -- Office Use Onlv_ _ CeR af Suivey Recd - Tree Pres Plan Recd Tree Pres Not Reqd _ On-site Septlc System Date ? / /? / ? 2 Construction Cost Site Address -2? Cia4 $'104 'e Unit/5te # 5 .S('Z Description of Work IC, Q?noU e 1D)C(Z U- / e G/ f? ?,l/'-,nla tf W(?J4?.?U??G Multi-Famity Bidg _ Y? Fireplace(s) _ 0 ^ 1 _ 2 Property Owner ?- Telephone # ( ?S n (-,? ? -7 Z 7 Z ? Contractor Ap Q, /? /?e? Ci !, 5 w ? es e t? O of`e-- ?>ev' U 6GP S ' l3 L-???66 /6 7 Address City p v c,'o *'4 ? State Zip Telephone # (7?j) 3 % 6 " / ;or COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 CateQOrv 1 _ Minnesota Rules 7672 Energy Code C8t2gory . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (4 submission type) Submitted Submitted . Energy Envetope Calcu{ations Submitted Licensed Plumber Mechanical Contractor Sewer/Wpter Contractor Talephcne # ( Telephone # ( Telephone I?? ? II I? ?IflAY 2 0 ??3 ?I I herebY aPP1Y for a Residential Building Permit and acknowledge that the infoation is co ete anaccurate; that the work will be in coriformance with the ordinances and codes of the Cipnnd=thja-,9tE e of 1VN Statutes; I understand this is not a.permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. --S'o? Applicant's Printed Name Applica/,Z g nature OFFICE USE ONLY Sub Types Occupancy Zoning Stories Sq. Ft. Length Width ? 01 Foundation ? 07 05-plex 0 13 16-plex ? 20 Pool ? 30 Accessory Bldg -- ? `02 SF Dwelling ? 08 ? 06-plex . ? .16 Fireplace , 13 21 . Porch (3-sea.) Q .31 Ext. Alt - Multi ? 03 01 of _ ptex ? 09 07 plex _' O 17 Garage , Q 22 ,Rorch/Addn. (4-sea.) ? 33 , Ext. Alt - SF ? 04?02plez '? '1?0 08plex -' ?•18 DecK?- -?, O .23 'Porch-(screenlgazebo) ,.q ..,36 MultiMisc. ! ff 05 03 plex '? ; ? ? 11 10-plex ' ? 19 Lower Level : ? ` 24 -Storm Damage . , . , ? . . •.. ? 06 04-plex ? 12 12-plex PIbg,Y or_ N ? 25 Miscellaneous Work Types ? 31 New ? 32 Additian ? 33 Alteration /V- 34 Replacement ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 36 Move Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 37 Demolish (Bldgr ? 43 Reroof ? 46 Windows/Doors •Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Census Code SAC Units - Nbr. of Units ? Nbr. of Bldgs Type of Const Footings (new bldg) Footings (deck) 01- _ Footings (addition) Foundation Drain Tile Roof Ice & Water Final ? Framing _ Fireplace _ R.I. Air Test _ Final Insulation / ?3 ?-/ ? -L?- MC/ES System City W ater Booster Pump PRV Fire Sprinklered , . , ; ? REQUIRED INSPECTIONS FinaUC.O. ? FinaUNo C.O. _ Plumbing HVAC Other _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Siding Stucco _ Stone _ Windows (new/replacement) _ Retaining Wall / Approved By Base Fee Surcharge Plan Review - MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total .- 20 Build+ng Inspector CITY USE ONLY LOT ? BL 3 PERMIT #: 7007 SUBD. ctiaf C?ayei RECE[PT #: l.i R I 30S 7 3 RECEIPT DATE: I bI In 2000 MECHANICAL PERMIT (RESIDENTIAL) Date• -7 ` ew -oo Complete this section onlv if you aze installing HVAC in a single family dwelling, townhome or condo under construction and not owner/occuoied. • HVAC: 0-100 M B T U ADDITIONAL 50 M BTU • Gas outlets (minimum of one required @$3.00 ea.) $ 30.00 6.00 State Surcharge .50 Total $ Complete this section onlv if you are remodelins, adding to, or renairins an existing single-family dwelling, townhome, or condo. Please indicate if it is a new item, alteration, or repair. _ New X Alteration _ Repair _ Furnace ? _ Air exchanger _ Reminder: Ca11 for inspections CITY OE EAGAN 3830 PILOT IINOB RD EAGAN LMi 55122 651-681-4675 _ Other Air conditioning Other Fee State Surchazge Total $ 30.00 0 3U.50 SITE ADDRESS: 3V3 L(J(il-e 5:br7e. ( il YOWNERNAME: ma,?l lICtiI/ /S PHONE#:?p5! - ID8'U?" ??'92-' ?„ ?1?,?I,??,,,.?-/ (pREA CODE) INSTALLER NAME: W lT i'J ? I'S L?(1 L.C7! k?I C??P ? PHONE #: q5? STREET ADDRESS: ?J( ) W. /y? ? Sf , ^ S I ??A % OoDE CITY: STATE: M N_ ZIP: 55 SIGNATURE OF PERMIT'I'EE WWI L BL SUBD. APPROVED BY: INSPECTOR PERMIT RECEIPT#: RECEIPT DATE: 2000 MECSANICAL PERMIT (COMMRCIAL) CITY OE EAGAN 3830 PILOT K.JOB RD EAGAN, MN 55122 651-681-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: WORK TYPE: New construction Install U.G. Tank _ Interior Improvement Remove U.G. Tank , Processed Piping When enstalling/removing underground tank, call 651-681-4675 jor inspection by fire marshal and plumbing inspector. Description of work: Fees: 1% of contract price OR $30.00 minimum fee, whichever is greater. Underground tank removaUinstallation = minimum fee Contract price: $ x 1%= $ (Base Fee) State surchazge TOTAL $ SITE ADDRESS: calculate at $.50 for each $1,000 Base Fee O WNER NAME: PriONE #: - ' (AREA CODE) TENANT NAME ([MPROVEMENTS ONLY}: WAS THERE A PREVIOUS TENANT IN THIS SPACE? _ Y_ N. NAME: INSTALLER: ADDRESS: CI'I'I': PHONE #: - (AREA CODE) STATE: ZIP: CITY USE ONLY SIGNATURE OF PERMITTEE JUN-07-2001 15:43 PROM-RMA H0ME DEPOT AHS 7635428227 T°928 P.001/001 LYlYiiIMD P49dVEy2 OF ATT()Ip.I+TEX COUNT'Y OF .. 14EOOJ, P&o) STATE OF NffNNESOTA KNOW ALL PEOPLE 8Y THES£ PRESENTS: F-76@ TXTAT I, Todd baniel Lewis, a resident of 9amA y County, Minnesota ("Principal"), and a iicensed contractor of RNftS Home Services, Inc., DBA Home Depot Instatled Sales located at 646 Mendelssohn Avenue Nonh, Gotden Valley, NIN 55427, having a ticense number of BC- 20268257, do hereby appoint, name and coascituie Elder-Iones Building Percnic Service, Inc. ("Agent") as rny true and lawful attomey-in-fact and do authorize and granc said attorney-in-fact for me and in my name, place and stead rhe power cv execute, acknowledge, sign and deliver (in such farm as may be required by the municipality) a permit application, or any other insmunent(s) which may be necessuy and appropriate, in order to ob[ain the proper permit(s) from thg Cicy of Eagan, Minnesom for the installation, maintenance and repa[r of windows and siding (the "Work"). Tha powers conve}?ed to the Agent by this Limited Power aFARflmey are limited soleiy to the express powers delinezted herein and spply solely to the Work. This Limited Power of Artorney shall expire and autamatically be revoked on the day of T,S???, 2002, which dace is one year from che execution hereof. Furcher, the powers conveyed by this Limited Power of Attorney rnay be revoked by Principal at any rime by express revocacion and shall also be revoked by the Principal's death, disabitity, incapacity or incompetence. TN WIINESS WHEREOF this Limited Power of Attorney is executed this day of 2001. CD, Todd Danie! Lewis aWpRN TO ANT7 SLTBSCRIBED BEFORE ME by Todd Daniel T.ewis on Chis day of _?"i h10 . 20_t4_. m •r?vvwu0^ u y ub ic in'forlit e State of Minneso 13UR70N L BROWN NOTARYPUBUC•MINNESOTk My Cammissioa Expires: urcan?ahavnB?Wae?u?.a+.?e . R 7968! 6.ro3 Received Time Jun, 7• 2:56PM 1120 East SOth Stree;. ` • Bloomington, MN 55420 Phone: (952) 345-6047 • Fax: (952) 854-4909 To whom it may concem: We at Elder-Jenes Builciing pemut Service, Inc. are acting as an agent for RIMA Home SeFVices, Inc. di there are any questions, or if ttie permit has to be picked up in person, please give us a call at the number above. If the permit can be mailerl back to us, we have enclosed a seif-addressed envelope for your convenience. Thank you, KaTa Benson ext. 147 Eider-Jones Buiiding Permit Service, Inc. 1120 East 80th Street 3 Bloomington, Minnesota 55420-1498 952-854-2854 2 FAX: 952-854-4909 -- - -----------, ? For Oflioe Use I I Permit #: c? ? I ? ? Permit Fee: I ? I Date Received: ? Staff: C? C I -----------------I 2008 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: Sife Address: ? 9 'a `-ode5+? C :i-, Tenant: Suite #: RESIDENT / OWNER Name: Phone: Address / City / Zip: CONTRACTOR Name: ? E?L V' /-Y, h'Ur` ?,7? License #: Address:??? City: state: zip:5s?y? Phone: 7&V7 Contact Person: TYPE OF WORK _ New _ Replacement _ Repair _ Rebuild ?V, Modify Space _ Work in R.O.W. Descri iion of work: PERMIT TYPE RES/DENTfAI Water Heater _ Water Softener Lawn Irrigation Add Plumbing Fixtures ?_ RPZ /_ PVB) (_ Main _ Lower Level) Septic System _ Water Turnaround New Abandonment RES/DENT/AL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Sottener (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 $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, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ I hereby acknowledge that this information is complete and accurate; that the work will be in contormance wilh the ordinances and codes ot the City ot Eagan; that I understand this is not a permit, hut only an application for a permit, and work is not to start without a permit; Ihat the work will be in accordance with ihe approved plan in the case of work which requires a review and approval of plans. x ??"`?Q 1 'e f? x Applicant's Printed Name Applicani's Signatur FOR:OFFICE USE Reviewed By: ' Date: Reqaired Inspections . k' } Untler Ground ?Rougti-In ,4ir;7est ?Gas Test _Final ------------------ ? For Office:Use ? j Permit #: ? Permit Fee: I I ? Date Received: j I I I Staff: I I J 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Cl -/// L? Date: Site Address: Tenant Suite #: RESIDENT / OWNER Name: /"( Gf s Phone: 742- ?/ ? Address / City / Zip: ) LOR.e S' f'?;r c -i / ( `e- Applicant is: Owner >'` Contractor TYPE OF WORK Description of work: Llc,?S:e •w ?vt'?' iri-°o,,?yd4e r Construction Cost: Multi-Family Building: (Yes _/ No r`G ? . CONTRACTOR Name: C r&'44t v? 604 1y^dLjl&-'S Iti f License #: 2 U'% 1?, Address: City: ?" GLr'd'1 n State: f z? Zip: y?a -.jP(91 Contact Person: /Ll qi4oh )`:?, Phone: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted (4 submission type) • Energy Envelope Calculations Submitied In the last 12 months, has ihe 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: NoTEr Plans and supporting documents:that you submif are cortsidered to be public in/ormation. Portlons of the informailon may 6e classified as non=public if you provide specific reasons that would permft the Cfty to conclude thai the are trade secrets. I hereby acknowledge ihat this information is complete and accurate; that the work will be in conformance with the ordinances and codes of ihe City of Eagan; [hat I understand this is not a permit, bul only an application for a permit, and work is not to start without a permil; that the work will be in accordance wilh the approved plan in the case o( work which requires a review and approval of plans. X ApplicanYs Printed Name c EE j 11l7 I ?? c ? ApplicanYs Signature D v Page 1 of 3 SEP 0 2 2008 . DO NOT WRITE BELOW THIS LINE SUB TYPES ? Foundation ? 05-plex ? 16-plex ? Accessory Building ? Pool ? Single Family ? 06-plex ? Fireplace ? Porch (3-season) ? Ext. Alt. - Multi ? 01 of _ Plex ? 07-plex ? Garage ? Porch (A-season) ? Ext. Alt. - SF ? 02-Plex ? OB-plex ? Deck ? Porch (screen/gazebo/pergola) ? Multi Misc. ? 03-Plex ? 10-plex L? Lower Level ? Storm Damage D 04-Plex ? 12-plex ? Miscellaneous WORK TYPES ? New ? Interior Improvemeni ? Siding ? Demolish Building* ? Addition ? Move Building ? Reroof ? Demolish Interior W Alteration ? Fire Repair ? Windows ? Demolish Foundation ? Replacement ? Egress Window ? Water Damage ' Demolition (entire building) - give PCA handout to applicant DESCRIPTION: Valuation Occupancy MCES System ? Plan Review -?- -- Code Edition SAC Units - (25%_ 100% 7 Zoning City Water - Census Code Siories - Booster Pump ` # of Units f Square Feet ? PRV - # of Buildings ? Lengih -' Fire Sprinklers J Type of Consi. ? Widih " REQUIRED INSPECTIONS Footings (new bldg) Sheetrock Footings (deck) Final/C.O. Footings (addition) _It Final(No C.O. _ Foundation ? HVAC _ Drain Tile Oiher: Roof: _Ice & Water _Final Pool: _Footings _AidGas Tests _Final ? Framing Siding: _Stucco Lath _Stone Lath _Brick Fireplace:_R.I. _Air Test _ _Final Windows ? Insulation _ Retaining Wall Reviewed By: , Building Inspector RESIDEIVTIAL FEES: ? Base Fee -1-2 5urcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Piani Copies Total Page 2 of 3 ì ý ïü þýüýû ÿþþ ýüû ûúù øýýþþïöýþ ãá ýÝâ ã ÿ ÿþõ úù ø÷ öó é á ùø÷ öø÷ öó é ô óéï ÷ý õù á ù íù÷ýø Üü úÞùý ì ÷â Þù ý æðý üóó÷ ü ûýððýü þ ÷ æáýððý ÷ ýð ýýæ áý ä ý Þù øýó ü ðýø æ ý çååæ åæå ôø úù ýü ý çæ ãæã Ûýùýûæ óò õñð ÷÷ý ï óý òýøþöý ãáùøïýáö å á ï þýüýòô ë è øýó ü ý ýâ ý ý÷÷ýý ý ý ðý ýýü ÷øó ýý÷÷ý úý ðò ýúýù ýáøðþýüýíý æ ÷÷ýé úüýù ù øúüýù Use BLUE or BLACK Ink F For Office Use I j Permit I Ron City of EaE d I 1 c k- ~ Permit Fee: l 3830 Pilot Knob Road Eagan MN 55122 j Date Received: J j Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: I I I 2013 RESIDEN3IA1~ iBUILDING PERMIT APPLICATION Date: 9 61 13 Site Address: ITJ f Unit Name:- MQ,Ir'N W r iC ~'1 S Phone: RSa "q,+o_1gg7 1 Resident 1J `2 M Owner Address / City / Zip: e_ 'rcA Applicant is: Owner -X`- Contractor Description e - Type of Work Kof work: Construction Cost: 0- t}O ©U'C) 6 Multi-Family Building: (Yes / No K ) Company: 17D,-iy14er YViLG Contact: 1►bi .Bel-sde_~w Contractor Address: I lo8Sy I,)e I Come_ Ay`e City: PrIbr Lave n State: Zip: J Jr37 Phone: 7~o q License 4COL_1 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 A_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 the information may be classified as non-public if you provide speck reasons that would permit the City to conclude that the 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.oooherstateonecall.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. Exterior work authorized by a building permit issued in accordance with the Minnesota Stat ilding Code must be completed within 180 days of permit issuance. Y, ~~bt x Applicant's Printed Name App n ature Page 1 of 3 �City Date: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: r U) Date Received: Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address: Unit #: CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against undergrou • uti• y damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.00pherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start 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 Mi daysoff permit issuan nances and codes of the City of a permit; that the work will be in must be completed within 180 s Sianature Name: a.i \Psi S Phone: U61-69 '(o-7��z Address / City / Zip: Applicant is: 341--CL-14 LC rte, E tb1\ . til Irctf2.. C N LSI'\ MN IliL Owner 15 Contractor Description of work: Construction Cost: CA 1 a 9 Multi -Family Building: (Yes / No ) k. LY6iftAL l Ori . Q 1(. �. ntact Company: �-�-- �•� I � `''� Address: "7 Q7 1- IN L G City: 1 (--L e State: :�1%�. - 2► --4t p ,/,� Zip: �� /� Phone. License #: ) C (o ,37 1 4. Z Lead Certificate #: t\J tr -r - F (155/9- If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) In the last 12 months, Yes No If COMPLETE THIS has the City of yes, date and address AREA ONLY IF CONSTRUCTING A NEW BUILDING Eagan issued a permit for a similar plan based on a master plan? of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: X r. Phone: ($$ @tit$ b d #itt b •` tom, a,' k y £ �� %t'" p k CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against undergrou • uti• y damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.00pherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start 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 Mi daysoff permit issuan nances and codes of the City of a permit; that the work will be in must be completed within 180 s Sianature e Use BLUE or BLACK Ink 1 • For Office Use c� City of Ea p11 E ::::;ee U2 ,17 : 7$° ` 3830 Pilot Knob Road Eagan MN 55122 Date Received: 1- -/i Phone: (651) 675-5675 Staff: Fax: (651 - 94 7 ..1 2017 SIDENTIAL PLUMBING PERMIT APPLICATION Date:36ek 1,2f1 Site Address: �, ,.. -rd- — Tenant: / J13._ W tJ1n'.L Suite#: � `i �'is1'� :rt_rtt 1{tr r.: t; W AW APANJ' 1 o Name: _ Phone: 4.4 ,f W 1' ` i �` Address/City I Zip: `, ► 1 �7 ,fir „ AA .. L. T ,,,...,„41:,,,A,1.1} :o-1 4 9 +�� _ ,-1-.,,,..'4,`.1.!,,,/,111.". ,ry t,+�'t i.g^ft) kir-"i ,• ((� 'n ,,- r•4.! t ,l :;-*Ii'''°4�r; ri' Name: Y U \VJ-9-J* yr, C,1((/�l License#: C� 1 .4} [ .: '�it� /., ��( �C t. A . 4�L 5* City v (r et f I: t p�'0441(.414'1W:i. `', ` [trap Address: „, , . [trac . � 1 4', ,it, , ti , , Y 1 \l V 7.J�� ._�1` ��I �"�`1, v r .. s dta State: Zip: Phone: d � ,i t•7'. lu Ik 1 ,14:1��, ��,,i s a�Vii t�rr,�,J��` Contact:Ulf\ 'C/V�./ Lam. 4 Q act[(4?„11,4k4/4/eA 6eyr...) ,:+ a Email: t o £i,,,,,r tai 1 '`14.1 .. jib' . ii ® 4 t _New _Replacement _Repair _Rebuild _Modify Space _Work in R.O.W. f � I{ ,:l T•'` r to i;,;tr; • s 'In Description of work: i ``.4i f ,,{,4; {f%.-:•t,-4,-44!•-4,t �# RESIDENTIAL rf a 4`m;'tfi,� f411 4 Water Heater ,Y # '�;#(MY; q� i Water Softener ;I, tS R �n� l Lawn Irrigation�RPZ/_PVB) t ��,•n�} . Add Plumbing Fixtures ( Main/_Lower Level) i} . ,�l41 r�'i, >< _Septic System fz Jar New_ Water Turnaround ',%.,,x'. r i A ;.?i _Abandonment RESIDENTIAL FEES: $60.00 Water Heater,Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation(includes State Surcharge) $60,00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge) *Water Turnaround(add $280.00 if a 3/4"meter is required) $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES $ CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be In accordanc (with the approved Ian in e case f work whic requires a review and approval of plans, 1 V S n t ` x / '' )t ', x- VL \� Applicant's�rinted Name App cant's Signature - it;.:, n'? +. •.,:. �*2I,�., IPq^rc?:'- # C(414.7.‘i: ,'i-1 7t , �+�'mr '�' ;r3Rz �r )r" 4.1A'VtA,,fi„A' $ '�£ t = n ;. Par,+N5 i. t.;r i"t6 ' ` 1 'i t} loot 1717 di 'Y { �F' -.;tc c 1' 7$ # ,� yg ,�+ �}it ✓t �T-f( ft 5�u.. is . rl 'Z. .S•q� �, k k ,�y � {{��.-' < �l F sx r..l s k f` uFe ..:e , S, ;101. 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