3105 Farnum DrReceipt
jt.! ?-i
FiIJ in
1. Date 10/15/82 2.
3. Job Address 1589 p UIiH OAKS
Permit No.
Fee p20. uu ?
S/C • ?'6 1
Tot. , 2::. 5U ?
Cost
6 Tract
4. Owner t2tiSEwQOD COi-6'.
5. Contractor Phone
6. Address 106al ;,1.
7. City .:lAlt4:: Siate 4••40 Zip
8. Building Type: Residential 14 Commercial ? Institutional ?
9. Work Description: New ID Add ? Alter O Repair ?
10. Describe
1 11•
No.
2 Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
1 Bath tubs Septic Tank
.'? Lavatory Softner
1 5hower Well
? Kitchen Sink
Urinal/Bidet Other
? Laundry Tray
? Floor Drains
Orinking Ftn.
Slop Sink
Gas Piqing Outlats
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Ffnal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Receipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN '
Fee
Fill in numbered spaces S/C
Type or Print /egib/y Tot. ' •
1. Date a 2. Installation Cost !.? • --
_:?:, . 3. Job Address .' Lot ?Blk. Tract
--" "
4. Owner , . ` .?
5.
6.
7.
l
Zip
9. Work Description: New IZI. Add ? Alter O Repair ?
10. Describe Fuel Type 11
No,
? EQJ12ment BTU - M. Ea.
Forced Air No. EQUipment CFM
Ai
H
dli
Mfg. r
an
ng:
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg. - ,
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed: for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
6. Building Type: Residential 0. Commercial ? Institutional ?
Receipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN •
Fee
Fill in numbered spacas S/C
Type or Print /egibly Tot. '
1. Date 2. Installation Cost
3. Job Address Lot -' Blk. Tract
:
.'
4. Owner
L ^
5. Contractor Phone
6. Address 7. City State - Zip
8. Building Type: Residential Q Commercial ? Institutional ?
9. Work Description: New L?. Add D Alter O Repair ?
10. Describe Fuel Type 11
No. Egujprrient STU - M. Ea.
Forced Air
- .. . No. Equipment CFM
Ai
H
dli
,
Mfg. r
an
ng:
Boilers /
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg. . --
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough F inal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
INSPECTION RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
t+il.! I I+ I aG
N.•.+n'3lo
SITE ADDRESS: ,o r- -+ lii ??f lt.
11,„ I I itil, toEl,r " kii
iI?A1.11MAN 1 kNl, i ii 1^. I
PERMIT SUBTYPE:
i 1.:i - ,
APPLICANT:..
I lir? ?
U$ti ti l 4?A
TYPE OF WORK:
iit 1,A l k
??f?.rl?rr•?aur, ( ?.1 111 NCa )
INSPECTION .. . .A
ri111?,F1 (N fi 1?? I f'?VI
HF 14aRKS oI N, t uiyr •. 114 S ( i 04 a) _; 14 ?, R iii i s,
1- -1
I
L
Permit No. Permft Holder Dabe Telephone M
S/W
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspection Date Inap. Commefts
Footings I
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Flrepiace
Rnal Htg.
Orsat Test
Final Plbg. Plbg. Inspector - Notity Plumber
Const. Meter
Engr./Plan
sr FS`
Deck Ftg.
Deck Final
Well
Pr. Disp.
. ?
7
i PERMIT
EAGAN
Permit No. (
Fee
S/C
Tot. - .?
1. ?ate 2. Installation Cost
3. Job Address:'/!? %' Z"i?''1J?'?Lot?Blk. 10_ Tract
4. Ownerf-
5. Contractor"i Phone
..?, .
6. Address'i'
? p?s?7 ' -
7. City-'? r i%. State Zi `'
8. Building Type: Residential ?D Commercial ? Institutional 0
9. Work Description: New :E] Add ? Alter ? Repair ?
10. Describe //J:?
11.
No. Fixtures
Water Closet No. Fixtures
Cesspool/Orainfield
Bath tubs Septic Tank
Lavatory x ' Softner
Shower Well
Kitchen Sink
Urinal/8idet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
F
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed :
Inspections: Date
Rough
Insp. Date
for
Final
Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Receipt MECHANiCAL PERMIT Parmit No.
CITY OF EAGAN
Fee
Fill in numbered spaces S/C
Type or Print /egibly Ta. •
1. Date ?. Z U 1- 2. Installation Cost
3. Job Address Lot Blk. Tract
4. Owr
5. Con•
6. Add
7. City
State Zip
8. Building Type: Residential P?- Commercial ? Institutional ?
9. Work Description: New ',10- Add O Alter O Repair ?
10. Describe (.• ?.•: i ? Fuel Type ?
11.
No. Equiyzent 8TU - M. Ea.
Forced Air No. Ectuipment CFM
Ai
dli
H
Mfg. an
ng:
r
Boilers ?
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
' Mfg.
L- Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with alt ordinance; and codes governing this tYpe of work.
.
Signed : ' for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
v
Phone - `/ ? ??
Receipt ' PLUMBING PERMIT Permit No.
CITY OF EAGAN '
Fee
fill in numbered speces S/C ?• ??'
Type oi Print /egibly T
ot.
1. Date 10/15/62 2. Installation Cost
3. JobAddress j?US ?????• 1' Lot ? Blk. o Tract
4. Owner :{US?WWD OOttP.
5. Contractor ?>?-HULTIE.S PLiiXbIItiG Ir,Phone J''-7o-L00T
6. Address 1 o841 ?LCvKATO ::: .
7. City bIAINy State 1'11 • 2ip ?54?4
8. Building Type: Residential C?
9. Work Description: New IN
10. Describe
11.
W (A!) YtiAA',&
Commercial ? Institutional ?
Add ? Alter ? Repair ?
No.
? Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
1 Bath tubs
Septic Tank
3
l.avatory
Softner
? Shower Well
? Kitchen Sink
Urinal/Bidet Other
? Laundry Tray ?.._ .?? 1.?, A.+
1
'
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Raceipt
PLUMBING PERMIT
CITY OF EAGAN
Fill in numbered spaces
Type or Prini legibly
1. Date 10/17/j2 2. Installation Cost
Permit No.
Fee ?20.Ov
S1C • ? ?
Tot. .-2?•?)J 3. Job Address 3107 Faxxuri L':..Lot 1 Blk. b Tract
4. Owner ztUSr:WODL
5. Contractor ;;(:HliLTIr:.S
6. Address 1 J641:?n.v U:: i.
7. City isLAIitt State A'.h . Zip >743L
8. Building Type: Residential C}
9. Work Description: New 9
Commercial ? Institutional ?
Add ? Alter ? Repair ?
10. Desaibe -.?UD FttA!"lr:
11,
No.
? Fixtures
Water Closet No. Fixtures
Cesspoa1/Drainfield
1 Bath tubs Septic Tank
Lavatory Softner
? Shower Well
j Kitchen Sink
Urinal/Bidet Other
Laundry Tray
' Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough F inal
Inspections: Date Insp. Date tnsp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
Receipt
1. Date _
3. Job Addre
4. Owner _
6. Address _
7. CitY
MECHANICAL PERMIT Permit No.
CITY OF EAGAN •
Fea
Fill in numbered spaces S/C Type or Print /egibly -
Tot. `
2. Installation Cost _ Lot Blk. Tract
8. Building Type: Residential
9. Work Description: New'O Add ? Alter O Repair 0
10. Describe ? Fuel Type
11.
No, Equioment STU - M. Ea.
Forced Air No. Equiament CFM
Ai
H
Mfg. r
andling:
Boilers '
Mfg. Mech. Exhaust
Unit Heater
Mfg. Qthe
Air Cond. . r
Mfg.
Gas, Piping Outleu
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed :
for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
5. Contractor Phone
Receipt PLUMBING PERMIT Permit No.
Ct7'Y OF EAGAN
Fee 2,).4.
Fill in numbend spaces S/C • i?
Type or Prinr /egib/y
ToiL ?
1. Date 2. Installation Cost
3. Job Address 1?91 FOtid OA.,.: Lot G Blk. d Tract
iz-z-
4. Owner
5. Contractor ?=?1iiiLTIES PLUcwIi?(?, ?one 78fi-1?0:;;'
6. Address 1,A41 j'.A!riUT'v O'T.
7. City irL, State 1.,?. Zip 7i4??t
8. Building Type: Residential Ca Commercial ? Institutional ?
9. Work Description: New 6 Add O Alter ? Repair ?
10. Describe rcaa,',,..
11.
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
? Bath tu bs
Septic Tank
3 Lavatory Softner
I Shower
Well
1 Kitchen Sink
Urinal/Bidet
Other
? Laundry Tray
? Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed: for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
CITY UF EAGAN Remarks '`-
Addition C??N LM CO. 18t ADDMdg Lot 3 Blk
Owner ' Street t fE$ R Ll- 'r ?OCk S
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 1914 ?
STREET RESTOR. 1983 150-83 5 603.34 AM2194 -16r8
GRADING ? 1 1 11 of n to
I Grading 1983 173.26 34.65 5 138.61 A0121 $ -26-8
SAN SEW TRUNK 1968 n n n a
? SEWER LATERAL 1913 n n n
** w r Lat 1983 1908.37 381.67 5 1 26. 0 A012194 -16-8
WATERMAIN 1972 ? to n of
? WATER LATERAL j 3 n n n +r
WATER AREA 1 n n n n
**Wat r L t 1983 5
STORM SEW TRK 1 n tt n n
** STpRM SEW LAT 1983 5
**Services 1983 5
CURB & GUTTER
SIDEWALK
STREET LXQy(U lp e/e
.
e- /d
Q_ _
2ka o 12641 2 -82
WATER CONN. 420.00
BUILDING PER.
5AC 525.00
PARK
CITY OF EAGAN
Addition COACHIKAR LMD C0. lst
Owner
Streei
Lot 2 Rlk
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 1 4
STREET RESTOR. 8 754.17 150-83 5 603.? A012554 $-4-$3
GRADING 1 1 n n n n
Gradin 1983 173.26 34.65 5 138.61 A012554 8-4-83
SAN SEW TRUNK 168 „ n n u
• SEWER LATERAL 1 n n u
**Sewer Lat 983 1908.37 381.67 5 1526.70 A012554 8-4-83
WATERMAIN 2 19 2 10 n of of
WATER LATERAL 1 11 It n n
WATER AREA ' 1 n to
**Water Lat 983 5
STORM SEW TRK J:M n n n n
** STORM SEW LAT 1983 $
**Services 1983 S
CURB & GUTTER
SIDEWALK
STREET LXM 100
Roan rr 4.63 10 y.
240.00
2641
10-2 -82
WATER CONN. 420.00
BUILOING PER. 7596
SRC 525,00
n
it
PARK
CITY OF EAGAN Remarks 1? ? ?? /,-r =' 2 1
I Addition CQACHMAA LA1QD C0, lst ADDITION Lot 1 Rlk 6 pefcel 10-18150-0I0-06
' Owner 5treet 310 -I FoLr v,, c.4- r1 bTL'JE- State
Improvement Date
Amount
Annual
Years
Payment
Receipt
Date
STREET SURF. 4
?id 13Ad
cel 10-0
900-
u-31
STREETRESTOR. 198 754.17 150.83 5 603.34 Pa012284 6-2-83
GRADING ( 1971 ?? -
n n n
Grading i ' 1983 173.26 34.65 5 138.61 A012284 6-2-83
SAN SEW TRUNK 1968 „ n n n
f SEWER LATERAL 1973
** t 1983 1908.37 381.67 5 1526.70 A012284 6-2-83
WATERMAIN ' 19'r2
n
n
n
n
? WATEFi LATERAL 1973
WATER AREA l, Tr it
**W r 983 5
STORM SEW TRK 975 n ?? ?r n
,** STORM SEW LAT 1983 5
**Services 1983 5
CURB & GUTTER
SIDEWALK
STREET}(XWK 1 Jf4, 3 3 e -/Qy3 /b'_/ ' S
24O.O0 2641 10-2 -82
WATER CONN. 420.00
BUILDING PER. 7595
SAC 551
5-00 o n
PARK -
-
CtTY OF EAGAN
Additipn COACHKAN LAND CO. lSt
Owner
Lot ' Blk " Parcel
Street rar nu.w? i;P C V? 5tate
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. - 1 1? Paid lII1dC bI'C ?. - d
STREET-RESTOR. 1 3 603.34 A012375 6-22-83
GRADING 19'fl to it it
Gradin ` 1983 173.26 34.65 5 138.61 A01375- 6-22-83
SAN SEW TRUNK 1968 <?
? SEWER LATERAL 1 u u t?
**Sew r Lat ? 1983 1908.37 381.67 5 1526.70 A012375 5-22-83
WATERMAIN 197? n n ?t n
? WATER LATERAL ig 3
WATER AREA 1977
n
n
a
n
i **Water lat 1983 5
STORM SEW TRK 1975 ?? n n n
** STORM SEW LAT 1983 5
' **Services 1983 5
CURB & GUTTER
SIDEWAIK
STREET ?
10 ? , 33 ?- O /Q-/ -
ROAD UNIT 240.00 2641 10-25-82
? WATER CONN. 420. OO it of
BUILDING PER.
SAC ?t n
PARK
?
. •,
BUILDING PERMIT
CITY 4F
7798 Pilot Kno6 9lood
PHONEt A
Receipt #
--- - ------- trecr u
Lot Blotk Sec/Sub. Alter p
Porcel # Repair p
Enlarye ?
oc N°me
W ?
Move
; Address Demolish ?
? r:.., [;..,Aa n
Z0
V
v?
r-
r-onat.
Name _
Address
I hereby acknowledge thot I have read this application and store that
the informotion is correct ond ogree to comply with oll opplicable
State of Minnesoto Statutes and City of Engon Ordinonces.
Sipnoture of Permittee A Building Permit Is issued to: '
oll work sholl be done in occordonce with oll opplicable Stote of Mir
Buildinp pfflciol
MN ss1u
Asseument _
Water 8 Sew.
Police
Firo
Enp.
Planner
Counci I
Bldfl. 6ff. _
/1PC
1?ivi s ion
f° 75 `7
Zonirq
FIrc Zone
Type of Const.
# Stories
Length ? -
Depth Sq. Ft.
Permif
Surcha?ge
Plon check
SI1C
Water Conn.
Woter Meter
Rood Unit
Totol
on the exprcss conditlon Ihn?
y of Eagon Ordinonces.
Permit No. Permit Holder Mise. Permit No. Holder
Plumbing ?5 lm?s
H.V.A.C. 3 Z` l ?`4-5 ?- II ' I S
Well
Water
D'np•
S?wsr i
ENetrio W3(90$' lu? ?Gr?1 1-1?-gz
?
Inspsction Date Insp. Other
FootinYf D
-Zt-$2
D?
A A 1
a -z s-sa b ?
Foundetion
Framinp ? ?7f.
Rouph Plbp.
i
Rouph HV
A
i
Inwlation ,sl
Final Pibq. ;+.??
Final HVAC ;S Q? ?C/
Final -+J
Water Detwibe Loeation:
Well .,
Sewsr
Pr. Ditp. ..
3795
BUILOING PERMIT
Te M aed for
Site /lddress
Lot Block Sec/Sub. " 'Porul #
oc Name
10
; Nddrcss
e?---
?` Nome .
z?
u? Address
?- rc*., M....._
Name _
Address
7 F: I fi
25 ie ',7.
E?ect ? Octuponcy
Alfer ? Zoninq
Repoir p Fire Zone
Enlarps ? Type of Const.
Move p * Stories
Demolish ? Length
Grode ? Depth Sq. Ft.
Approrola Fsea
Assessment _
Water & Sew.
Poliu
Fire
Eny.
Planner _
Council
Permit
Surcharge
Plnn check
SAC
Water Conn.
Woter Meter
Road Unit
I hereby ocknowledge that I have reod this upplicotion ond stote thct gldg. Off.
the intormotion is correct ond ogree to tomply with all applicoble
5tate of Minnesoto Stotutes onA City of Eagon Ordinonces. aPC Totol
Sipnature of Permittee
A Bullding Permit Is issued to: on the express condition tFxoo
oll wo?k sholl be done in accordonce with oll opplicable State of Minnesota Stotutes and Ciry of Eopan Ordinonces.
8uilding Officiol
CITY OF EAGAN
Pilet Koob Roed Eogoa, MN
PNONEa 454-8100
Est. Value I - _''?
ve
5512.2
Receipt #
Permit No. Permit Holder Misc. Permit No. Holder
Plumbing
E ?'7 ? SC.?'???E°..,? d'x -$
H.V.A.C.
Well
Water
Disp.
Sswer
EMctric
Inspection Date Insp. Other
Footings a-72-$z Tp ?
'n g fl ?
Foundatfon
Frsmina ?
Rouah Plbp. yA; -ri /
Rouph HVA
Inwlation S
Finel Pibp.
Final HVAC
Final ;;c• `
Wawr Describe Loeation:
Wlell •
Ssrwr
Pr. Disp.
CITY OF EAGAN 3795 Pilof Knob Road Eaqaw, MN 55122
PHONEs 4544100
BUILDIN6 PERMIT Receipt #
or 4 PLF)
5ite Address Erect
[] ?
Occu
anc
p
y
Lot Block Sec/Sub. Alter ? Zoning
Repoir ? Fire Zone
Porcel #
l
E T
f C
arpe
n ? ype o
ornt.
09 No?T?e Move ? # Staries
W
Z
? Address Demolish ? Length
r:... 6rade fi Depth Sq. Ft.
°` Name
o
u? /lddreu
~ Ci Phone `
u?
_. W W IV-ame
F
Address
I hereby acknowledge that I have reod this opplication ond state that
thQ information is correct and ogree to comply with all opplicoble
Stote of Minnesoto Stotutes and City of Eogon Ordinonces.
Nssessment
Water & Sew.
Police
Fire
E?p.
Plenner
Council
Bldfl. Off.
APC
$urcho rge
Plon check
SAC
Woter Conn.
Water Meter
Road Unit
Totol
Sipnature of Permittee ?
A Building Permif is issued to: on the express condition thnr
oll work sholl be done in otcordance with all opplicabla State of Minnesota Stafutes end City ot Eoyon Ordinances.
Bullding Officiol
Permit No. Permit Holder Misc. Permit No. Holder
ing
E
.C. 32q Z
weu
star _
Disp.
Savuer
Elactric (o D V?j'
Inspoction Date Insp. Qther
Footin9r p-zr-fiZ ocY. ?
bR-
Foundation
Framing S ? .
Rouph Plbp. eZ
w?
Rough HVAC
Insulation 7y
Final Plbg. ?
Final HVAC .
Final
Water Dsscribe Location:
Vltell r
Sewer
Pr. Disp. .
CITY OF EAGAN
17617
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454-8100 . '?
BUILDING PERMIT Receipt #
To be used for BA5MENT Est. Value $1 • S00 Date MAR 21 ig 90
Site Address 3107 FARNU!4 DR
Lot 1 Block 6 SeclSubCOACHHAId LAND CO
. OFFICE USE ONLY
Parcel No. occupancy - FEFs
W
Name RICHARD KAMPA d? PATRICIA SU3S Zonfng
(qctuaqConst
- BIdg.Permit
35.00
o Address '? 107 pAR? nR (Allowable) - S
h 1•?
arge
urc
City EA? Phone 452"0308 ;v ot stories -
Plan Review
Length ^
F Name S?? Depth - SAC
Ciry
= ,
o
? Address S.F. Total -
u SAC, MCWCC
? CIty Phone S.F. Footprints -
Water Conn
On Sile Sewage _
?
QW
Name
On Site Well
- Wa1er Meter
_? Address Mwcc system -
0 =
< W
City Phone
City water Acct. Deposit
-
S/W Pe
mil
PRV Required r
_
I hereby acknowlege that I have read thfs application and state that the Booster Pump - SiW Surcharge
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances. Treatment PI
Signature ot Permitee APPROVALS Road Urnt
A Building Permit is issued to: RICHARD !CAliPA Planner - park Ded.
on the express condition that all work shall be done in accordance with all Council --
applicable State o( Minnesota 5tatutes and City of Eagan Ordinances. Bldg. Off. _ Copies
3?' ?
Building Official Variance - TOTAL
Permi! No. Permit Holder Date Te4ephone #
WATER
SEWER
PLUMBING 114sto wxe=d
?3/SD
H.V.A.C.
ELECTRIC JS319 e7
Inspeetfon Date I.P. Comments
Foolings I
Foundation
Fram+ns 3 1
Roofing
Rough Plbg. -
R«,sn m9• j B IAgv
is,i.
Firepiace
Final Htg. ?j ' Q
Fnal Plbg. a? Q
Const. Meter Plbg. Inspedor - Notify Plumber
Engr,/Plan
Bidg. Fnal -Z 6 Qa
Deck Ftg.
Deck Fina1
Well
Pr. Disp.
CITY OF EAGAN
)NTRACT 3830 PILOT KNOB RDAD, EAGAN, MN 53122
PRICE PHONE 4548100
Site Address '3JL' -7 n' n+(m
Lot ? Block S6C/SUbn,11(11n'4
I eL, d"- I%4'
.. Name !V' i i h9 ? r 4 ?i ? t ? c ?l
m
?
Addr"s l ? `-? I
? Cfty Phone
t
Namet.?c(?rii
? Address ? t r t r'. ?ji
? City f?(, bL Phone
FEES
COMM./IND. FEE - t% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE 8 CONDO - RES. RATE APLLIES
MINIMUM - RESIDENTIAL FEE $12.00
MINIMUM - COMM.IND./FEE $20.00
STATE SURCHARGE PER PERMIT .50
(ADD $50 S/C PER EACH $1,000 OF PERMIT FEE)
SIGNATURE OF PERMITTE
FOR: CITY OF EAGAN
Res. ?
Mult.
Comm.
Other
For C
PERMIT # _
RECEIPT #
DATE: -
New
Add-on X
Repair
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NQ. FIXTU R ES
? ?TA?
uu
Water Closet - $3.00
Bath Tubs - $3.00
? Lavatory - $3.00
? Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50 ?
Whiripool - $3.00
-?`
Gas Piping Outlets - $1.50
(MINIMUM -1 PER PERMIT)
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
U. G. Sprinkler System - $12.00
PERMIT FEE: ?O
STATES S/C
:
?r?
??
GRAND TOTAL:
3795 Pilot Knob Rooa Eogon, MN 55122
? PHOKE: 454-8100
BUILDING PERMIT Receipt
TO bf rNd fOr .. Esi_ Vnlije
Site Address E
t O
rcc p ccupancy
Lot Blxk Sec/Sub. Alter ? Zoninp
Portel # Repoir Q Fi?e Zone
Enlarpa ? Type of Const.
oc Name
Move
?
# St
ri
u, o
es
? /?ddresa Demolish p Length
CGn, al,,,.,. 32 '- Grode ? Depth Sq. Ft.
? Name :s ?r . _ • l,
?- - ..,, ,
?? Address '
I.- r?*., o?,...._ . ... .
Name _
Addrest
I hereby acknowledge that I how reod this application and stote tfiot
the inlormotion is Correct pnd ogree to tomply with oll opplicpble
Stote of Minnesoto Statutes ond City of Eegon Ordinonces.
^ssessment
Wafer & Sew.
Police
Firo
En0•
Planner
Councl l
Bidfl. Off.
APC
Permit
Surchorge
Plon check
SAC
Water ConnA-
Water Meter
Rood Unit
Total
Sipnoturc of Permittes ?
/1 Buildir?g Permit Is issued to: on the express candltinn thnf
oll work shall be done in etcordance wlth all opplicable State of Minnesota Statutes and City of Eopon Ordinonces.
Bulldinq Officiol
i•
iolder
'Umbing
Well
ater
p
isp.
Sewer
lo
"ric
Foundation
Framing
t
Rough Plb -
lnskilation
Final HVAC - ? W -
Final u4
Water Describe Locatfon:
<.
lL
w.n w ?
1 ,
3i?,S???ir•
Sevwr
Pr. D'qp. '-
CITY OF EAGAN
Include 2 sets of plans,
1 site plan w/el.evations &
1 set of energy calculations.
BUILDING PERMIT APPLICATION
Zb Be Used Far t a(-'
'1A `C Y, Valuation ?S 9'i O O O Date (o - -6?-
site Acldress: 310-1 'F-amu w?- ?-
Iot I slocx (c seo./sub.'u,aAw,an 1av4
Parcel #: (0 (SISO 010 Dto
Oaner: Coo-ck !vLa ti L0.dl
Pddress: Zq3 7_ p?` oo t' ALfZ ./Uo ?
city/zip coae: u (" l l E ss / I 3
OFFICE USE ONL.Y
??? - x Occupan
CY
?-? -
Alter Zoning c P h e`3
Repair Fire Zone A
Enlarge _ 'Iype of Const.
Move # Stories
Desrolish Front q(o £t.
Grade Depth ? ft.
Phone #: (0 2, ( - 32 S APPROVALS FE?S
L'OIItTdCt.OYr-05E(..OOC7?, dOYl24 i bCY /
Adrlress: ?N2?
City/Zip Code•
Phone #: 3Q `??--
Arch./Eng.:
Address:
City/Zip Code:
Phone #:
Assessments
Water/Sewer
Police
Fire
? er
Council
Bldg. Off.
APC
Permit 3O ^I , O c-,
Surcharge 2 Y t 00
Plan Check / ,?5a , S G
SAC SZS• oc?
Water Conn. (( zo ? o O
Watex Meter Cc o"a o
ROad Unit 24 O' a a
? ( `l'? ( SC)
6? -w7GI5 CITY OF EAGAN
BUILDING PERMIT APPLICATION
To Be Used For 1 0P (? T-li X Valuation A Sf t O C' G
Site Address: V?k-,f' Vku WL bC i V?.
Lot '-t Block (o Sec./Sub.(15"wAanlAn ?Erect ?
Parcel #: (D I S` ( S o DL( o ??? Alter
_I Repair
Uaner: Co?cvLw?0. Y\ LA v? ?` C(9 t Enlarge -
rbve
Pddress: c2q3 Z- /UD ? Deimlish
City/zip Code: (Eo?,- ? U i( I E S S 1 I 3 Grade
Include 2 sets of plans,
1 site plan w/el.evations &
1 set of erzerqy calculations.
Date /c) - $-z-
OFFICE USE OfII,Y
Occupancy p- - 3
Zonin4 CPA) ?- 5---
Fire Zone
'iype of Gonst. ?-
# Stories
Front 4(o ft.
Depth z fo ft.
Phore #: (o 7
,I - 32 S? APPROVAIS FEES
ContractAr:P-o s? uooo CL (tiy?L-4 . b l V 1
Address: .`?JQ /--t-&
City/Zip Code:
Phone #: '3a-hV\-L
Arch. /EYig. :
Pddress:
Assessments Perniit 307 . o b
Water/Sewer Surcharge ZQt o (23
Police Plan Check j s'3 , S v
Fire SAC 525. c? o
Eng. Water Conn. zo, o 0
Planner Water Meter (o o, o (D
Council R:oaul unit .2 y o, o e)
Bldg. Off.
APC
City/Zip Code:
Phone #:
.
=AL -+ I 7 z, '( (S- 0
bf,4- 7572r
CITY OF EAGAN
BUILDING PERNII'i' APPLICATION
'Ib Be Used For ?F)" Valuation ?'S 9-l o OC)
site Pddress: Isq I Go?.+- 0 ak_s ?d- '
Lot '2- Bloclc (D Sec./Sub.Co4c? r+lanlAnol
Parcel #: (O ($ (S el) 0 2C3 o(o
awner: C'aackrkAa v\ Can d Cn ?
Pddress: Zq 3 Z p rk°o 6' /t)o r
City/2ip Code: 40St v?- l tt- Sj ll s
Phone # : co 5 ( - -_,2 s.
Contractor: eDSe W o0c?1- de)
Address: -'?t rvl
City/Zip Code:
Phone #: a)- /v?- L
Arch./Eng.:
Pddress:
City/2ip Code:
Phone #:
Include 2 sets of plans,
1 site plan w/elevations &
1 set of energy calculations.
Date tD - Z43 ' Z-z-
??
x OFFI(E USE OPII,Y
?
IF?eCt ? OCCUpanCy F--?
Alter Zoning ('p A -'75
Repair Fire zone ?tl
-
Ehlarge Type of Const. ?
_
M?ve # Stori
gs
Ueirolish -
Front 4 & ft.
Grade Depth ?- ft.
APPROVAIS FEES
Assessments
Water/S2wer
Polioe
Fire
Eng.
Planner
Council
Bldg. Off.
APC
Pexmit ?-7(c G
Surcharge -zq ? o G
Plan Check 03Z, ns;c>
SAC sZa,no
WaterConn. y2p, bC)
Water Meter [oo, n p
Rpad Unit Z O, O d
TO'i'AL "C (7 aY/S d
.d?-?sI -?
CITY OF EAGAN
BUILDING PERNIIT APPLICATION
'Ib Be Used For t 6'r T??"- Valuation 4 5fft 0 r-)?
site pddress: jSgq Fokc- Daks Rd '
Int 3 slock (0 sec./Sub.CoackKtnK ?anA ? E?ect ?
Parcel #: 10 (?i ( SD G 3C? O tD Alter
q Repair
Owner: l O^?cv? V?oLy? ??cl. Cb r Enlarge -
Move
Address: Z?[?Z -c ob-t' ?}L , lJ a ? Denolish
City/Zip Code: 4seJ " t I E- S a// j Grade
Phone #: r03 I - 3ZS
Contractor: ,OSs lAooel- (ans-1- -
Address: ? IvLL
City/Zip Code:
Phone #: SR ^4-e._
Arch./Ehg..
Address:
Gity/Zip Code:
Prorie #:
Include 2 sets of plans,
1 site plan w/elevations &
1 set of energy calculations.
Date
OFFICE USE ODII,Y
Occupancy 0-3
Zoning CPD - 3
Fire Zone
Type of Const.
# Stori s
Front 0 ft.
Depth 2 ft.
APPROUALS FEES
Assessments
Water/Sewer
Police
Fire
Eng.
Planner
Council
Bldg. Off.
APC
Permit 307 ,O O
Surcharge
PlanChec]c
SAC Szs . o 0
Wates Conn. zo o 0
Water Meter (o oo 0
Road Unit z(( o, D C:?
C?tr?#ifirtttr of (Orrupttnry
Citp uf eagan
3?r?ttrftnrni uf f?uil?ing ?lns}?rrfimt
Tbit Certifirate irturd purtuqnt Jo the rrquisrmenu o f Sarion 306 o f the Uniform Building
Codt tati f ying that at thr tinu o/ isrrutna tbir ururturr wat in tom pliantr vrith the variout
ordinamit o( the City ngulating bxilding rmutructian or utt. Far the following:
U. chffiwlm 1 of 4 PLEX BldpPemY, No. ?597
0-?'ryw R3 nr.c? V FmZ? NA z.?a,, (PD) R3
o„KaB„odia6Coachman Land Co. Add. 2432 Prior Ave. No., Ros
a„iy,Aad. 1589 Four Oaks Rd. L,,,Iiy Lot 3,Block 6,Coachman L
hn1:o v ?.i_acr1L1 co.
BY MaY 4, 1983
w?nso? ?lJ?i we.:
.o., 1. . w...u,. ....c.
CITY OF EAGAN
9795 Pilet Knob Reed Eegan, MN 55142 Np 7596
PHON[: 451-8100
BUILDING PERMIT Recelpt
re M wed fer 1 of 4 PLEX Esr.value $58,000 oare October 25 tg 82
Site Addrcss 3107 F8lht7ID DIiVe Erect gj Occupancy R-3
Lot 1 Blxk 6 Sec/5„b.aDackuaan IdSid Zet Alter ? Zoning (PD) R-3
parcel # 10 18150 010 06 Repoir ? Fire Zone NA
V
Enio?a ? ryPe ot Consr.
W Coachman Land Co.
Name Move ? .fk Stories
; Addrcu 2432 PYiOi Av6. ND. Demolish ? Length 46
v
Ci lioeev1118 SSll?h., 631-3254
Grode ?
Depth 26
Sq. Ft.-
? Name RoBewood 0O118t. D1Vj,8i0I1 ADVrorals Fees
0
?? Addrett ? aS 8bOV¢
h P:.., e1___ .CiBffie
Name
Assessment _
Water & Sew.
Police
Fire
Erg.
Plonner
Coundl
I here6y ackrwwledge thot I have read ihis aOPlicofion ond state that 81dg. Off,
the information is correct and ogree fo wmply with all applicuble APC -
Sfote. of Minnewto $totutes and Ciry of Eagan Ordinonces.
Slpnature of Pertniflee
A 8uilding Pertnit Is issued to: liD8eW00ct cOn3?
ofl work sholl be'done in occordance with all opplica6le $ ro of
Buildinp Offlciul r%? ?
Pertnit sV/.VV
$urchorge 29•00
Plun check 153.50
SAC 525.00
Woter Conn. 420.00
WarerMerer 60.00
Road Unit 240.A0
Total $1734_50 .
_ on the express conditlon thnt
City of Eogen Ordinances.
- CITY OF EAGAN
-:* 1793 Pllof Knob Reod Eaqan, MN S5121 0 7595
PNONHa IS4-8100 ?'
BUILDING PERMIT Receipt # ??y/
re M msd Mr 1 of 4 PLEB En. Voiue $581000 pme _ October 25 _ 1q 82
Site Address J+va aarnum uXa.ve
Lot 4
Porcet # Block 6 Sec/S.b.CDaCh ... n Isnd lat
10 18150 040 06
c Name ODaChman Iarid Co.
z Address 2432 Prior Ave. No.
c; seville 55113pF,o„o 631-3254
g Name Roseraood Construction Division
u? Addreu SBIDe 86 dbOVB
Cic Phone Same
f
2.
Name
Addresa
I hereby ackrwwledge fhaf 1 hova read this opplicotion and sfote that
the inlormotian is corretT and agree to comDlY with oll opplicoble
Stote of Minnewto Stotutes and Ciry of Eogan Ordirances.
$ipnoture of PermiMee
A Building Permif Is issued to: go?
oll work sholt be done in acwrdance with
Building Officiul
Erect ? Occupancy R-3
Alter ? , Zoning (PD) R^3
Repair ? Firc Zone NA
Enlarge Q Type of Const. V
Move p # Stories
DemolisM ? Length 46
Grade p Depth 26 Sq. Ft.-
Approvals Feos
Assessment -
Water 8 Sew.
Police ?
Fire
Erp.
Plonnar _
Council -
Bidg. Off. -
APC
Permit 3vl .vv
Surcharge 29.00
Plon check 153.50
5AC 525.00
Water Conn.490 • 00
Water Meter 60.00
Road Unit 240.00
rotol $1734.50
L
I on the express conditlon thn,
and City of Eogan Ordinonces.
BUILDINC+ PERMIT
CITY OF EAGAN 7
7795 Pilef Kno6 Rmd Ea9an, MN 55132
N? '/ 59g
PHONEs 454•8100 }, -
Receipt
To be mad fee 1 of 4 PLEX Fst. Value$58, 000 Dote O ctobeY 25 , 19--u_
SiM Addrcss 1591 Foux Odks Ro8d Erect Occupanc R-3
jp y
Lot 2 2 CoaCllIDari IBpo let
Block 6 Sec/Sub Alter p Zoning (PD) R-3
.
10 16150 020 06 Repnir ? Fire Zaw NA
parcel #
E f C
T V
nlaros ? onst.
vce o
W Na? C08C1fID8n IBnd OD. Movg 0 # Srories
? Address 2432 Prior Ave. No. pemoliah ? Length_46
ru.ILnaAViltw 551]3a..r_ 631-425d Gmde fl Depth26-Sa . Ft.-
Name_
z
u? Addrep
17
Noms
osewood Oonat.
Same as above
I hereby ackrmwledpe tMt 1 hove read this opplicotion and atate that
tha inlormation Is correcf and ogree fo comply with oll applicoble
State of Minnaoro Statutes and Clty of Eoyan Ordinonces.
Signoture of Permittee
A Building Pertnit Is issued M: R08e%CK
all work sFall be done in accordonco with nll
Bulldirq Off lelal
Assessment
Water 8 Sew.
Polica
Fire Permit jV / • VU
Surchorge 29.00
Plon check 153.50
SAC 525.00
Enp.
Plonner
Council Woter Conn. 420.00
Water Meter 60.00
Roud Unit 240_O(1
Bldg
Off
.
.
APC
7wal $1734.50
,?7-
- on fhe express cordition thm
and City of Eapon Ordirances.
CITY OF EAGAN
? 7795 Pitet Knob Road Eegan,
MN 55I14 _
7597
PMONFs 434•8100
BUILDING PERMIT -
Receipt
Te 6a wed hr 1 Of 4 PLEX Est. Volue $58, 000 Date OctobeT 25 1 q 82
Slte Address 1589 Foul' Oaks Road Erecr ? Occuponcy R-3
Lor 3 Block 6 Set/Su6. COac2f16Sn ISnd lst Alrer ? Zoning (PD) R-3
Parcel .# 10 18150 030 06 Repoir ? Fire Zax NA
V
Enlorge ? Tyce of Const.
? Name ?BChIIIHn LBnd OD. M # St
i
ove ? or
es
? Addross 2432 Pt10I Ave. No. Demolish ? Length 46
p Ro88vtlle 5511X0m 631-3254 Grode ? Depth 26 Sq. Ft.-
? I0088MOOd OOIISt Div3aion Aoormala Feea
?p Name •
~ S8ID@ 88 8bOVe
`y?
3r? Mdress r.w, e,"' $8IDE
Name _
Address
I hereby ackrwwledge that I have rend this applicotion and state tFwt
fhe inlormation is correct ond ogree to wmply with all opplicable
State of Minnesofo $tatutes and City of Eogan Ordinances.
Signoturc of Permiftee
A 8uilding Permif is issued to: RoSewood O0=181
oli work shail be done in accordonce with oll opplicable
Buildin0 Officiol
Assessment _
Woter & Sew.
Police -
Fire
Enp.
Plonner -
Council _
Bldg. Off. -
APC -
Permit ?vi.vv
Surcharge 29 • 00
Plon check 153.$0
SAC 525.00
Wofer Conn.420•00
WoterMeter 60•00
Road Unit 240.00
Total $1734.50
on tha expreu condition fhnt
r-e4 Eooon Ordirwnces.
CITY OF EAGAN N0 176 17
3830 Pilot Knob Road, P.O. Box 21-799, Eagan, MN 55721
' PHONE: 454-8100
BUI
DING P
(i
f'
L
ERMIT Receipt tt i
a
To be used for BASEMENT Est. value $1, 500 Date MAR zl ?g 90
Site Address 3107 FARNUM DR
LOt 1 BIOCk 6 SeGSUb.COACHAIAN LAND CO OFFICE USE ONLY
P2fC21 N0. 1$T Occupancy - FEFS
Zoning _
w Name RICHARD KAMPA & PATRICIA BUSS (ACWaI)Const BIdg
Permil 35.00
o Address 3107 FARNIJM DR (Allowable) .
_
- 1
00
Surcharge .
City EAGAN PhOne 452-030$ x ot Stories -
Plan Review
Length _
F Name SAME Oepm SAC
Cit
i
¢
o
AddfeSS
S.F. Total -
,
y
-
u SAC, MCWCC
? CIfY PhOn@ S.F. Footprints -
l
C
H'
On Site Sewage er
onn
a
-
.
ww Name On Site Well
lx--?
Addf@SS
MWCC Syslem - Water Meter
_
a W City Ph000 Ci1y Waler _ Acct. DeOOSit
PRV Requirad _ 5/W Permil
I here6y acknowlege that I have reatl this application and slate that ihe Booster Pump - SM! Surcharge
information is correct and agree to comply with all applicable State ot
Minnesota StaWtes and Ci of Ea an Or , anceS., Treatmant PI
?
`
?
[ ?• ?
?
Siqnature of Permitee
APPROVALS
qoad Unit
n Building Permit is issued ro: RICHARD KAMpA Planner - park Ded,
on the express contlition that all work shall be tlone in accordance with all Councii _.
applicable State of Minne
s
o
ta
StaWtes and
C
ity of Eagan Ordinances. Bidg. Oft Copies
'
.
,,
q
?
?( y
Building Otlicial " I ?L?1?L1.?1??? f LJ ! ?j
? Variance - TOTAL 36.00
This req?st voidu Z,_ q 1
1p,
18 months from
UU 36084 LS?- ?Jr??o"o
Ra<pues( pate
(?/? Pire No. Rough-in Inspection
Re red? ???yyy'''??j??;?
[]fleady Nuw ?eu.+NotiiY inspec-
Wh
?
? a C.V' s ?NO en Ready
«r
rOwcensed Elactrical Cmtractor I
- I herebV request inspection oPabove
ner elecVical work installed at: _
Sheiet Address, Box or Hoa[e Na. /??,? , -
l ? ?. \ !RLg= l.J?'?l> ? , Cit
ection o. Township Name or No. Range No. Co ty ??????
Occ ? nt (PpINT) Phone No.
.?.y1.J
aawer Suoplier Address '
Ele tY al Contr,a?ct?o. I?Co?mD??any Ne 1 ? ?
pQ,l,,? Conpva?c?tor's Liccnse No.
'LCS? L
Mawiling Address (Contrac[oi or Owner Makine [nstailati?opN
l vqo L'JCJK.TIA-- r°?' ?l
Aut ized Sign C nv t O er k nB Installation) Phonf?e7?N?rumber rb 3 'Qt f?
MINNESOTA STATE BOAHD OF ELECTRICITY -X* ` THIS INSPECTION HEQUEST WILL NOT
Griggs-Midwav eldB- - Room N-191 ( (/ D. BE ACCEPTED BYTHE STATE BOARD
1821 Univarsity Ava., SL Paul, MN 55104 ?(? d UNLESS PROPER INSPECTION FEE IS
o?___ lawi aw, o'll . ENCLOSEO.
A REQUEST FOR ELECTRICAL INSPECTION ,?..p ee- ooooi -oa
? vC08 4 ' Sae instructions for comOleting this torm on beck ot yellow copy. ?"'X";,aPlcw Work Covered by This Request . 32 q y,
Ne Atltl Rep. Type of Building Appliances Wired EquiVment WireA
Home Range Temporary Service
Duplex Water Heater Lightin Fixtures
Apt. Building Dryer Electric Heatin
Commercial Bldg. Furnace Silo Unloader
industrial Bldg. Air Conditioner 8ulk Milk Tank
Farm Other SPecify. Other(SUecify)
•ther Specify Ot er Other '
Lrompute rnspecrion hee Ce/ow - -
N Fee ServicaEntranceSize # Fee Feedere/Svbfeetlers # Fee Circui[s
(?_i.>O 0 to 100 qm s 0 to 30 Am s ?m 30 Am s
101 to 200 qmps 31 to 700 Amps 1 ? 31 to 100 Am s
A6ove 200 qmos Ahnve 100-Amos Ahnva 100-AmPs
I Circ.
Final
S(ien?
YA?'?/D'?Oy ^spector, hereby
cartifV ihat the nbove
. ? q?me inspection Aas baen
mede.
n
This request void
18 months from
This request void COQ(` kK4*--,\ ' 3 z[ q!
18 rtwnths from ?
?"?L I S'= c?o, a o
??1 36085
Request Oate
`
`
?- Fire No. Pouph-in Insoection
FequlruA?
?RendY Now I Notity.'}nsPec-
«?r Wh
n ft
tl
_
O
'L ?NO ¢
ea
y
.
- Licensed Electrical Conlractor I I hereby request inspection of nbove
Owner eleGrical work ins<elled at:
Stre t Address, Boa or Route No.
S`1 'TfL oAic? City
ectmn o. Township Name or No. Range No. CrtY
Occ ' [ IPPINT) Phnne Nn.
?'j?y`
Powe SaGPlier Adtlress
EI c[r?cal Convacmr (COmUany Nam 1 ?
0e???
I
Cunttactor?s License No. -
?Q
Mailing Address (CanVac[or or Owner Making InstailatioN
yU-Eo PN-JL-- ss«?
Auth ized SiBna we (C wne M king Installa[ion) .
? Phone Number
THIS INSPECTION REQUEST W(lL NOT
MINNESOTq STATE BOAPD OF ELECTqICITY 11
) BE ACCEPTEO BY THE STqTE 80AR?
Gri9ga-Midway Bide. - Poom N-791 :Vyl UNLESS PNOPEB INSPECTION FEE IS
1821 University Ave., St. Peul. MN 55104 ? ENCLOSED.
Phene 18121.297.2111
FOR ELECTRICAL INSPECTION EB-oooot_os
REQUEST ,?,,
' See instructions for complatine this form on back uf Valluw copy.
VJ 36085
"X" Bel?rk Covered by 7his Re9uest j
ew Adtl Hep. Type of 9uilding Appliences Wirad Equipmant Wired
Home Range - Temporary Service
Duplex Water Heater lightin Fixtures
Apt. Building Dryer - Electric Heatin
Commercial-Bldg. Fumace SiJo Untoader
Industrial Bldg. Air Conditioner Bulk Milk Tank
FBfm ffier Pec, y Othor ISper.ifyl
r ISpomiy [her . ONer
Campute !n pection fee Below
tt Fae Servica Entrance5ize q Fee. Fexders/5ub(eeders h Fee Circuits
O-CT[? 0 to 700 qm s 0 to 30 Am s O $L 0 to 30 Am
101 to 200-Amps A mps
31 to 102 t {Q( 31 to 100 Am s
Above 200 qmps . 5
Above 10_Amps Above 100_AmPs
Transiormers " Remote Control C. } Partial%O[her Fee
Signs Special Inspection $ P16 S TO
fleiwrks '
? EE
Rouph-in f/ Da[e ?, ?ha cvical
f???? •/1+? y nspector, hereby
?? certiW thac the abova
Final ? Dat
i 6peC[ion has baeel
? ;?.?`? ,?_y- da.
This reaue. t void '
18 nwnths tmm
F 330 id
Reque Date
?y? / ?
(/ Fire No. Rough-in Inspection
Requir
? No
s
? Reatly Now i 1 Notity Ins
pec[or
9Jhen Reatly?
I O licensed contractor ? owner hereby request inspection of above electrical work at:
Job Adtlress (Slreet, Box or Rou o.) Ciy
Senion No. Townahip ame or No. RenBe No. County `
% K/
OccuppM (PRIMJ PhOne a.
Power Supplier AGtlress
Electricel Conlra ( pany Neme)
?. Contrector5licenseyNo.
?[az )
Mailing Address (Cmtractor or pwner Making Iretallation)
W
^J J ?
Authonzetl $' re ntreclodOAwrIns/la`ll ) /
"/!Q/?/ C. ( Bv`?
n(g] N/up??b/¢1r ?-/y
Plm
!/ 4 (J (1 ?'J V.
MINNESOTA STATE BOAFD OF ELECii11CRY THIS INSPECTION REQUEST WILL NOT
GNggcMlEwey Bldg. - Noom S173 BE ACCEPTED BY THE STATE BOAHD
1B2f Univerairy Ave., St Paul, MN 55100 UNLESS PFOPER INSPECTION FEE IS
Phone(812)BC2-0800 ENCLOSED.
?/ag/9o
0 33066
REQUEST FOR ELECTRICAL INSPECTION
? See inslructions for completing thia Form on beck of yelbw copy.
"7C" Betow Work Covered by This Request
EB00001-0?
s6 ??'?;/
a Adtl, Rep: TypeoiBUilding AppliancesWired EquipmenlWired
ome Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Olher (spacify) CoMrador§ Remerks:
Compute lnspection Fee Below:
# Other Fee # ServiceEntrance5ize Fee # Circuits/Feeders Fae
Swimming Pool 0 ro 200 Amps to 700 Amps ?
Transformers Above 200 _ Amps Abo Amps
Signs Inspector5 Uae Only: OTAL
Irrigation Booms
Speciallnspection
Alarm/Communication
Other Fee
1, Sh8 EIBCIfICHI Inspector, here6y
tif
th
t th
b
i
i
h Rough-In
cer
y
a
e a
ove
nspect
on
as
been made. Final
. ?„ . ?! ' :??i, •t.?. a?e
OFFICE USE ONLY
7 requesl wid 18 monihs Imm
This request void L! 3Z"q I
18maa:hs?from (
VJ 36087
Fenuest Daie
? ?_
("'? '
? Fire No. BouOh-in Inspection
Required? . '
?Ready Niiw ?y?,
??.rv?ll NotiFy. Inspec-
( ror When Reatl
j 4 s ?No V
01cynsed ElecVical Contractor I hereby request inspaction oi above
Owner . electrical work inatallad at:
Street A?r, Bo?ypr Raute No.
3 < i
?.?.?w.
ecuon o. Township Name or No. , RanBe No. . C unly
A
Occu ?nt IPRINTI ^ ?
" POOneNo.
C?.?e.?'JQY7
?
Power $upplier Atltlress
EI ct? el Con[ractor ICOmDany Na el '
b2.r??-?or..zr-?? CoMractor's License No.
?osst4-.
Maiting AdJress (C nVacm/r or ?O?wner Makiny Installationl
O • Vd',-?rts;.JC,?L_?? ? 4$n= L SS
Auth 'r3ed SieC ct r n r MakinB Installatinn) Phone pNumber
?-E D 3 -?-'C -Z'?I
MINNESOTq STATE BOARD OF EIECTBICITY THIS INSVECTION flEQUEST WILL NOT
Griggs•Midwav Bldg. - Boom N491 BE ACCEPTEO BV TNE STATE BOABD
1821 University Ave., St. Paul. MN 66104 Z VNLESS PPOPER INSPECTION FEEIS
ow.._.. 1e111 vnv_ottt ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION EB-00001-03
38087 0 See instrvctions for complating this form on back o! Vallow capy.
"X" 8&4ow LVork Coveredby Thrs Request 3 ZQ ? J
Nea Atltl RBP. Type oi Buildin9 Applienc08 WirBtl Equipmenl Wired '
Home Range Temporary Service
Duplex Water Heater Lightin Fixtures
Apt. Building Dryer Electric Heatin
Commercial Bldg. Fumace Silo Unloader
Industrial 81dg. Air Conditioner Bulk Milk Tank -
Farm ?ther peu y. ther (Specify)
t ier Speci y Oiher Offier
Cnmpute Inspeclron fee Below - -
N iee ServiceEntrenceSixe N Fee Feadera/SUbleeders N Fee Circuita
00 0 to 100 qm s 0 to 30Am s to - ? 0 to 30 Am S
101 to 200 Amps 31 to 100 Amps , O 37 ro 100 Am -
. Above 200 Am s Above 100-Am s Above 100_Amps
iransformers RemoteControl Circ. Partial% ee
$igns Speciai Inspection S ?C? S T
Rema.ks
EE?
/L/Y q??
> >
ftouyh-in ,? Date G ,the ectricel
?f ?)F Y. aclor, hereby
certify thet the ehpve
Finol Oqate?,/p. ' ,pection hes baen
This repuest void
1 ft e.r.i.rF, h.,n,
Thisre9uestvoid'(//?
18 rtwnths iram
ZAN 36086-
flequest Data
r
w _ Fire No. Insvection
RouBh-i Req '
ui
s
tifv InsPec-
?ReaAY Now ll N.
,?wl
h
?
_
? ?
` ` ?No
e / Ior W
featlY
e9 n
?pzicensed Electrical Contracmr ( I heraby request inspection of above
f?
?J Owner eleetrical work installad ar
Street AdAres o or Fome No.
310.?.?? Citv
?R??f
ection u. Townshiu Name or Nn. :inge No. Co iryp/?
!"??.QI?TT
Occu' tlPyaQ RINTI
LB'S? w CFTiGI \.9' n Phone No. .
Power SuDPlier Adtlress
Elec^tr? a^lC^nTntr,.acto,rpIC_om`Dany Contracm`r/'s L`yic`e.nsa No.
MeilinB.4/ddresLs(COntrect?or ?r?O,„,wnerMakinglns.t{a-ll?a.,tion) - ?^ (
? b t'l.O V ?x..?/. ?j,u5?3 --' J \
Aut r-zed S?9 C c d0 e Makfne Installation) . Phone NuCm/ber
MINNESOTA STpTE BOAND OF EI.ECTRICITY THIS INSPECTION HEQUEST WILI OT
Grigps•Midway 81dg. - R.O. N-191 gE ACCEPTED BV THE STATE BOARD
7821 Universiry Ave.. St Paul. MN 65104 J f? UNLESS PNOPEB INSPECTION FEE IS
Phone (012) 297-2N1 ENCIOSEU.
RTWBST FOR ELECTRICAL INSPECTION EB-00001-03
Sea instructions for completin9 thisform on back ot vellaw copy.
M36086 , J
"X" 'Pe7ow Wark Covered by This Request 32-1 y r
Ne Add Reo. TVpe of Building Applie6ces Wiretl Equip ?t Wired
Home Range Temporary Servic
Duplex Water Hea[er Lightiny Fixtures
Apt. Building Dryer Electric Heatin
Coinmercial Bldg Fwnace Silo Unloader
Industrial BIAg. Air Conditionor Bulk Milk Tank
Farm Other peci y t er(suecity)
[ier ueufy Ner Oiher
Cnmpute l spection Fee Below
tt Fea ServiceEntrance$ize M fee Featlers/SubtaeAers # Fee Circuits
0.OrV 0 to 700 Am s 0 to 30 qm s (OI ZTIC 0 tn 30 Am s
107 to 200 Amps. 37 to 100 Amps 1 ??+ 31 to 700
?m
Above 200 qm s Above 100_Am s 1
Above 100_Amps
Transiormers RemoteControlCira SG Partial%OterFee
Signs Speciallnspection S
YC 5
L FEE
aemarks - /fif .nn
I _
Hough-in ' Date
I
?} ?7 5. ns we
Cector, hereby
cartily thet the ebova
final Data L inspection hes bean
matle.
This reques[ vniC
lb nwnths trom
I ) " 0.
2007 RESIDENTIAL MECHANICAL rntMrr ArriacnTTON
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122 l?
Telephone # 651-675-5675
Please comple[e for: single family dwellings & townhomeslcondos when pefmits ir'ud {q[ esch unit
Date ? . '/ ICNy' j ?1
,
ZO
Q')
Site Address 6'7?? > ? ? (..1, (}? ? • ? • Unit #
Property Owner - Tekphoee #[O,?, ) ?qj
Contractor
Psul Staftord Electric, Fsea ing ana-UOQIIIIU
stmetnaamss 6225Canbri49eStreet c;ty
Minneapafis, N1N 55435
State _ „__ V. .,. •n ...,. _ 9_q"94 Te6ephone # ( )
Bond #: Expires:
The Applicant is _ Owner X; Contractor _ OEher
7-`
Fire repair (replace buroed out apptiancea, dui.Kvrork, etc.) $ 90.00
This fee applies when extensive mecharrical repairs are made to a bu ild'ing.
Add-on or atteration to eusting dwe0ing unit ? $0.00
? iumace _Additional XReplacement _ New
air exchanger
air condi6oner
heat pump
other
State Surcharge $ .50
Total $ ?b_ ?S-b_
I hereby apply f'or a Residential Mechanical Permit and aoknowledge that t6e roformarion is complete and accarate; fhat the work will
hbtron ce with the rdincend c.t?des of the City of Eagan and with the Mechanical Codes; that I underMand this is not a
an applicatir a nit, and woiic is rn?t ro slart wit}xwl a tthat the w will be in accordance w the
ppm the case of ork which requires a ieview artd approval of plan
.
i t
p i ' nted Nam ApplicanYs ignature
3c . 5c
-icolA 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3530 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. single family dwellings &[ownhomes/condos when permits are required for each unit
Date ?2
Site Address?(J?? Unit #
Property Owoer p/> oQ/1,Q?-
u -. t- Telephone #(ZP, ) lGU I?.So? DdSI?
Contractor CL, MaA)?p
Street Address City
State Zip Telephone t1
Bond #: Expires:
The Applicant is _ Owner y? Contractor _ Other
Add-on or alteration to existing dwelling unit $ 30.00
furnace _Additional _Replacement
air exchanger
? airconditioner _New _Replacement
other
State Surcharge $ 50
Total $ "R),XJ
I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; tha[ 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
rQ C ,
Applicant' rinted Name
PERMIT# '-a"' ?t 7S ?v
RECEIPT DATE:
SOOE RESIDENTIAL PLUM$ING i'EEtblTf APPLlCAT10N
crrY og EmArr
3$80 PII.OT KNOB $D
EAHAR, MIY 55122
651-681-4675
Please complete for: single family dwellings, townhomes and condos when permits are required for each unit,
backflow preventer for irrigation system
SITEADDRESS: J`O-? TLt?1(\U?1/V\ -D("?-j 2
OWNERNAME:: v iY1iLSKq, -P?Linn. TELEPHONE#: CbSI
(AREA CODE)
INSTALLER NAME: 1V O rb I d YY1 PI IA.Wt61 " TELEPHONE #: (P IL' S 2-7, '4033
STREETADDRESS: .ZRO$ Gar-F"aid hryVIyIIAe. Spk-}'4I (AHEacooe)
CITY: Iv`p IS. STATE:
Mn) ZiP: 55yo$
_ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00
includes $40.00 County fea
Note: Additional consultant fees may apply
• MODIFICATIONlALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
_ Adding flxtures to lower levels or room additions, exciuding water softeners and water heaters. $ 50.00
_ Abandonment of septic system.
_ Water turnaround - existing dwelling unit (+ 5/8" meter if needed •$118)
Other:
_ RPZ: new installation/repair/rebuild $ 30.00
_ lawn irrigation system
ReplacemenUadditional: _ watersoftener X watarheater $ 15.00
State Surcharge $ .50
Total g 15.50
I hereby acknowledge that I have read this application, state thatthe information is correct, and agree to complywith all applicabla Cltyof Eagan ordinances. It
is the applicanPS responsibiliry to notity the property owner Mat the City of Eagan assumes no liability for any damages caused by fhe City during its normal
operational and maintenance activities to the faclllUes consW cted untler this permit wlthin pr rty/righ - f-wayleasement.
?
SI?NAT E OF PERMITTEE 1102
L
CITY OF EAGAN q39
1994 BUILDING PERMIT APPLICATION
681-4675
_$ 01* ..?0
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date Valuation of work
IZD O
?
5ite Address:Z544 46b
STREET SUITE #
Tenant Name: (commercial oniy)
LOT BLOCK SUSD. /',_ P.I.D. #
QCI
I. lI;
Descri tion of work:
The appl i cant i s: 11 Owner Co?contractor ? Other (Describe)
Name su.rZ ^k r,rd AecOb ?7e &(/Akg4W• i'ffl* Phone kL°' 9)5-3Z
Property LAST FIRST
Owner qddress _6,?7e 6J4fAutiiaJ 4).'? ?l?G
STREET STE A!
City _jj?? State */v Zip
Company A"sl Phone ??- NO
Contractor Address Gt16? License #/iIGL Exp.?
City 5tate /01/V Zip K?
Company Phone
Architect/
Engineer Name Registration #
Address '
City State Zip
Sewer & 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 appl' a on and state that the information is
correct and agree to comply ' all applicabl S te of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicdnt:
? CiTY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRES5:
PERMIT
1589 FOUR QAK5 Rp
LOT: 3 BLOCK: 6
COACHMAN LAND CO 1ST
P.I.N.: 10-18150-030-06
DESCRIPTION:
(SIDING)
B ildirrq?.permit Type
8?uilding Wo'=rk, 7ype
r
PERMIT TYPE:
Permit Number:
Date Issued:
SF (MTSC.)
REPAIR
BUILDING
023439
08/26/94
J
/??}+{ 1 ? ? ? ?(? ? X?? ?? l?-??, ???
J'??i'?IJ ????Y???J?{J I:]
L
REMARKS:
FEE SUMMARY:
VALUATION $500
Base Fee $15.00
5urcharge $.50
Total Fee $15.50
CONTRACTOR: - APPiicant - sr. Lzc
ALLEN CQNST 16888180 0001062
4649 1/2 PENKWE WAY
EAGAN MN 55122
(612) 688-8100
OWNER:
FOUR OAKS COURT ASSOC
3470 WASHINGTON DR
EAGAN MN 55122
(612)452-9592
116
i hereby acknawledge at S have read this
1nFarmation 3s carr c and agree ta comm?aly
Statut? end Cit?+ f! agan Qrdinanees.
application and state that the
with a1l aRplicable State of mn.
?
jlHl[1 6l4l JJ
' issueo e1: si ATUR
# ool
2000 FIREPLACE PERMIT APPL(CA7(ON
CITY OF EAGAN
3830 PILOT KNOB ROAD - 55122
651 681-4675
/ f `
Date: 41??/ / ?? 0,?
Description of Work: Construct new fireplace _Gas _Masonry
? Install gas insert only
Other
# bo 50
Alterations to existing
_ Install gas line onlv
Jobaddress: /? ?1 % {--d/.
Lot: 3 B?ock: 6_
Applicant (cirole one only): Owner ?
subaivisionrn.I.D. 4: C?Ch?ndn I.anr.I ('n, ? St
Permit Fee: ,860.50
Name: / ?(? (.? ( Phone #: ?
???
PROPERTY as ? First
OWNER _ ? rr Z-1- / J? /7
Street Address:
City State: Zip: ?, f 5/cJC?
ComPanY. ' 0/ P/hone #: (G?rX 'l?/?-%
(area code)
FIREPLACE ?? ? q 9 ??? ??
INSTALLER StreetAddress:
City g('(7 j/! Z/? 2,21"? State: l? i Zip:
GAS LINE
INSTALLER Street
City
5?//)-7 ?-)
SYate:
Zip:
I hereby acknowledge that I have read this application and state that the information is conect and agree to
comply with all applicable State of Minnesota Statntes ity of Ea rdin? es. ?
,
/ c ?
, Signa _
Phone #:
(area code)
') 8
?
_ 1994 PLUMBING PERMTT (69#4I14ER@Ift)
?,Q S ? d e n t i(` l,
? CITY OF EAGAN
3830 PIIAT iCNOB RD
. EAGAN MN 55122 ,
(612) 681-4675
PLEASE COMPLETE FOR ALL COMMERCIAI$INDUSTRIAL BUILDINGS. ALS,O?FOR MIJLTI=. _
FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED "FOR 'E;4CH:
DWELLING UNTT. _
_ NER' CONSTRUCTION
ADD ON
? REPAIR
WORK DESCRIPTION:
GQIVTRACT PRIGE: $
FEE: 1% OF GONTRACT FEE. STATE SURCHARGE: $.50 FOR EACH $1,000 OF g' ..??. FEE
MIIYIMUM FEE: $ 35.00 .."
CONTRACT PRICE X 1% $--?- ?a? 5r
STATE SURCHARGE $_? rT`?"' w
TOTAL
SITE ADDRESS: .j 9/ /""/? I,/ /? ?A-1C.5 d ,
TENANT
UWNER Nt1M
INSTALLER:
ADDRESS: /,(/J (O Z:?::.Lt1hr7-
s
CITYe ?i'T , ?-A rJ I STATEe ?24.1l) ZII':iCODE:.
pAONE #.
FOR:
CITY OF EAGAN APPLICANT . `: .
? 2`
IE: s?.#
1990 9IIILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MDNTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETEO.
PERMIT MUST SHOW A LICENSED PLUMBER.
C
To Be Used For:= Valu tion
Site Address 3 1 0-7 rCtPhUm iV2 I
Lot J_ Slock ?
Parcel/Sub _ C Wh.rryirym
Owner9-jGh0.vd f<a{Lta "cQ {,q,-WiCtA.
?
Address 3101 ??hum
City/Zip Code ??4h SSIZ?
Phone t4 5 2 - 0 3 D13
Contractor 'Kq,yvl.pct q,nff?kriua.
'?tx 55
Address 31?1 ?0.rhtlw{ 'DYiVQ.
City/Zip Code 6 24avi?
Phone d 3 D$
Arch./Engr. IU ??
OFFICE USE ONLY
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F.
On site sewage_
On site well _
MWCC System _
City water _
PRV _
Booster Pump _
APPROVALS
Planner
Council
Bldg. Off.
Variance
Address
City/Zip Code
FEES
Bldg. Permit
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Copies
SUBTOTAL
Penalty
TOTAL
:3J?o C)
O
1,0
6. 00
uv Date:
Phone #
O?q`l
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City OF Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telep6one # 651-675-5675 FAX # 651-675-5694
4 Ig(o.as
New Cons6udion Renuiremenb
3 registered sile suneys showing sq. ft M l04 sq, ft of house; and all roofed areas RemodeUf2eoairReaulremerds
2 copies ot plan
ddifi
h
t
d
v
(20% maumum lot coverage allowed)
etc.
ies of plan showing heam & window sizes; poured found des?n
2 w ons
ea
e
a
i set oI Energy Calculatlons ior
i site survey for addi6ons & decks M
R
'
,
p
isetofEnert?yCakuiations Addttion-indcateNOn-sttesepficsystem ?
,
?
3 wpies of Tree Preservatian Plan rf bt platted after 717193
Rim Joist Delall Optlons selec6on sheet (bldgs with 3 or less unib
Date Coustruction Cost
Site Address Unit/Ste #
Description of Work
Multi-Family Bldg N Fireplace(s) _ 0 _ 1 _ 2
O
(?
Telephone # l l
7 U Z?
woer
Property ,
RENEWAL BY ANDERSEN
Cootractor 1920 COiJNTY ROAD "C" WEST
Address ROSEViLLE, MN 55113 City
State 651-264-4777 Telephone # ( )
LICENSE 420130983
1?.
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Enefgy Code Category , Residential VenUlation Category 1 Worksheel • New Energy Cotle Worksheet
(4 submisslon lype) Submitted Su6mitted
. Energy Envelope Calwlations SubmiGed
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
r? +1
? n Telephone #(
Telephone # (
Telephone # (
I hereby apply for a Residenrial 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 pernut, but only an applicafion far a permit, and work is not to start without a
pemtit; at the work will be in accordance with the approved plan in the case of work which requires a review and
appravofplans. ? ?/ 1-n
Applicant s Printed Name * Applicant's Signature
?°>'°,•°"•,? ?u? ae.oo cm roa ar1 q4ao-MSSCttSl?t'cL ?k"MrDtSK,7tsn
re
.? . ? -
Juna'7> 200I
City CtEapa
3836 RiItrt gnob Road
EftM MN 55122
To Whom It May Canoern:
Fsldcr 7oncs to euthotized tD plin buMfn8 pwnits far Renawal by Anderson. Ptease atiow
date be oud 001! ?crvtcc for ua in Eagn. `ITtia muttorizetirm i5 vaiid for any
W the Ctty_ ' unbil a t6ntawal by Andersan mauazer exPresaIY revokas it fn wiittng
I rcquest rhis auHioxization bc accepted expediflously. sa
ovr haildin to noE de[ay in die Proccssing aP
S Pct=te aay fuxthcr. El«mc caIl mc If thcro arc any qncst[ona.. I can Ue
°oAtacted at 763-502-4706_
„
Your hmmqdiate sftcntion tA tliis mattcr is
sinoerely.
K asRanewal bY Audcrscn Cotpvrdtivn
C'r.: Ksrca-Flrter 7?ne?
mmztaDVUm
:
a ,
wVU:
Received Tiroe Jun. 1. I'01PM
c) 0-J
C?--° 'Z
CLATM V OUCHER - REFUND REQUEST
CITY OF EAGAN
MAKE CHECK PAYABLE TO: ELDER 70NES - ATTN: KARA BENSON
ADDRESS: 1120 E. 80r" STREET, SUITE #211
BLOOMINGTON MN 55420
PERMIT # 62980
RECELPT #/DATE: 60413 1/28/04 VALUATION: $2,000
REASON FOR REFUND: Incorrect valuation-new pertnit issued
TYPE OF REFUND:
Account De osit
9220.2252
$
Buildin Pemut Base Fee 0801.4085 $ 69.00
Construcfion Meter De Refund 92202254 $
Guub Box De osit Refund 9220.2253 ?
Fire Su ression Pemut 0801.4096 $
Ove a ent 90012250 $
Plan Review Fee 0720.4222 ?
Plumbin Permit 0801.4087 ?
SAC (MC/WS) 92202275 $
SAC Ci 9379.4681 $
SAC (Admin) 0801.4246 $
Sewer Permit 6201.4532 $
Surchar e 90012195 $
Treatment Plant 6101.4685 $
Water Peraut 6101.4507 $
Water Meter 6101.4509 $
Water Su ]& Stora e 6101.4680 $
Other(Copy) 9001.4230 $
Total $ 69.00
?oz declare under the,p,enalties of law unt, claim, or demand is just and that no part of it has been paid.
2/10/04
SIGNATiJRE DATE
r
2004 RESIDENTIAL BUILDING PERNIIT APPLTCATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Cons6uction Reaui2meMS RemodeUReoair Reauirements
3 registe2d stte surveys showing sq. fk of lot sq. ft. o( house; and all roofed a2as 2 copies of plan
(20% maximum lot cove(age allowed) 1 set of Energy Cakwlations for heated additions
2 cop'ies of plan shawing beam & wMow s¢es; poured found design, ek. 1 site survey for addi6ons R decks
1 set of Energy Calculalions AddiRon - irMicate ifon•sRe sepfic system
3 copies of Tree P2servation PWn if lot platted after 71if93
Rim Joisl Detail Options selection sheet (bldgs with 3 or less units
Telephone #(
Date )(o
/?? I 04 Construcdon cost ? O ? U 6 0_??
_
Site Address I`?J?? TOV( O O-)G.S PeiaUC? UniUSte
U ?
' 4
Descrip[ion of Work W
Multi-Family Bldg _ YIL N Fireplace(s) _ 0_ 1 ? 2
Property Owner Telephone # ( )
Xv_?
? -
J _, ?/ ? •
L
Contracto
r RENEWAL BY ANDER
?SEN
?
?l??? 1920 COUNTY ROA 16C" WEST
Addrese
l ROSEVILLE,MN 113 City
State 651-264-4777 ?\ J ione #(
LICENSE #20 0983 ?
.
COMPLETE THIS
Energy Code Category
(J submission lype)
Have you previously
fee applies.
Licensed Plumber
Mechanical
Sewer/Water
ONLY IF
Ventilafion Category 7 Worksheet
Energy Envelope Calculations Submitted
A NEW BUILDING
Mixmesota Rules 7672
. NewEnergy Code Worksheet
Submitted
a building in Eagan with a similar plan2 _ Y
?00?
,I l? DS
atr? n
?2?,g. ?
C,. c q f -?D
N If so, 25% plan review
Telephone
Telephone #(
D
I hereby apply for a Residential Building Permit and aclaiowledge that the information is-complete-asidbucterate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
A G1gGt.?.Sov?'D 'ArR-o._M. Onn2)
Applicant's Printed Name Apphcant's7ignature
w., ? ,.s1•.i. iuv ac." rna ro.) Ott 4460°L(ZyNCtiAL 45k`31YUtlt47t4['(
re a1
-
. Juna t war
? of Bapa
3836 PiIcrt $nob Road
Es$an. MN 55222
To Whom It May Concern:
EIdex Jones is authorizcd to ptg bniiding permlfs for Renewal by Andezsan_ pteasc xIlow
Eider ]ones to pmvidc this serricc for na in Fsagan. 'Mis aud?ociz$ticm i5 valid fnr any
bcyoud 616101; watiI a?awa! bY Andtrsan maMer exptesSiY revokes it in wiiting
to date the City- ap
I request this auttioazaflou bc aceepted-axpedidously. av to uot dete m the. rig
our baiiding Pcunita cmy fuzthcr. Plcasc cxil mc If thc? arc nay qnescEona. _ I can ? of
contactcd at'763-502-4706_
_ ,.
Xour immqdiabe attcation to thls maUer is
Sinaeiely,
ond &*X Rau
tistallation Maztagcr
Ranowal by Anderscn CorporatiQn
t'.r.: Karn-F.iile;r 7onec
`'?-~?? "` •?6? '57
G - 7??c3oj
C?H 0
I --
Mlruu?p?
?S+'en ?ya?+n. atzam
;
wuU:
Recaived Tiine Jan. 7. 1:01PM
2004 RESIDENTIAL BUII.DING PERNIIT APPLICATION
[D 2j SZ S City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX 9 651-675-5694
New ConsWction Reauirements RemodeUReoair Reauiremerds Office Use Onlv
3 registered site surveys showing sq, ft of lot sq. R. of house; and gll rookd areas 2 copies of plan CeR of Survey Recd Y_ N
(20% maximum lot coverage allowed) 1 setofEnergyCalculatlonsforhe2tedadtlitions TrcePresPl2nRecd _Y _N,
2 cupies ot plan showing beam & window sizes; pouretl found design, etc. 1 site survey for addNOns 8 decks Tree Pres Required ._ Y_ N
1 set of Energy Calcula6ons Adddion -indicete Hon-site sephc sysfem On-sde Sepfic System _ Y_ N
3 copies of Tree Pmservatlon Plan if lot platted after 711193 Rim Joist Detail Opdons selection sheet (bldgs wBh 3 or less units
l
Date -3 / ? / L7,-,/ Construction Cost, 2--' 5, 0 0
Site Address 3/09 ??O?? I q r`7V 1p Q/O UniU e#
Description of Work S??
Multi-Family Bldg ? Y _ N Fireplace(s) _ 0
Property Owner 10?_ Y7$„S JTGf Telephone #( )
Contractor
Address ? - City ?
State 67?2 ZIp Telephone # ((4.5) ) ?S?F( ?}C? ??
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilafion Category 1 Worksheet • New Energy Code Worksheet
submissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously consiructed a building in Eagan with a similar plan?
fee applies
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Y_ N If so, 25% plan review
Telephone #(
# ( ?°---
?-
#'( L
I hereby apply for a Residential Building Permit and ac?owledge tha? the information is complete and accurate;
that the work will be in conformance with the ordinances and codes fq ;the-Git3-aLFagan-and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and wark 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
approy.4l ofplans.
Applicant's Isrinted Name "Applicant's S5§nature
18150 COACHMAPI LAND CO 1ST 18152 COACHMAN LAND CO 3RD
3101/ 10 18150 01007
3103 020 07
3105/ 10 18150 040 06
3107 01006
3108/ 10 18152 030 08
3108B/ 040 08
3110/ 020 08
3110B 01008
3109! 10 18150 040 08
3111/ 030 08
3113/ 01008
3115 020 08
3112/ 10 18152 030 07
3112B/ 040 07
3114/ 020 07
3114B 01007
3116/ 10 18152 030 06
3116B/ 040 06
3118/ 020 06
3118B 01006
3120/ 10 18152 04005
3120B/ 01005
3122/ 03005
3122B 02005
3124/ 10 18152 040 04
3124B/ 01004
3126/ 030 04
3126B 020 04
3128/ 10 18152 040 03
3128B/ 010 03
31301 030 03
3130B 020 03
3132/ 10 18152 040 02
3132B/ 01002
3134/ 030 02
3134B 020 02
FARNUM DRIVE PAGE 1 OF 2
4-plex-other 1/2 = 1593/1595 Four Oaks Rd
4-plex-other 1/2 = 1589/1591 Four Oaks Rd
4-plex
4-plex
4-plex
4-plex
4-plex
4-plex
4-plex
4-plex
s
2004 RESIDENTIAL BUILDING PERIVIIT APPLICATION
City Of Eagan
3830 Pilot I{nob Road, Eagan MN 55122 ,
(e Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWCfionReauirements
3 registered sife surveys showing sq. ft of lot, sq. R of house; and all roofed areas
lot covera
i
e albwed
20% RemodellReoair Reauirements
2 wpies of plan
Calculafrons for heated addNOns
1 set of Ener b ._4 :19,;?
?
?P
; -
ma?c
mum
g
)
(
2 copies of pian showiig b?m & window sizes; poured found design, etc. gy
1 site survey for additions & dedcs :
1
?
m
t
d
6
lsetofEnergyCaLulations csys
e
Addttirn-indicate
on-aesep
3 mpies of Tree P2servation Plan if lot plafled after 711193
Rim Joisl Detail Optans selection sheet (bidgs with 3 w less unifs
Date ? / '2c/ a , Construction Cost
Site Address ? UnitJSte #
r?
Description of Work NQA ,{ ) [..J.,k
Multi-Family Bldg NX Y_ N Fireplace(s) _ 0_ 1 _ 2
Property Owner ?f Telephone # ( )
;
?
Contractor
Address Cit}'
State Zip !?W,21 _ Telephone # (6SJ
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Cateeorv 1
Residential Ventilation Category t Worksheet
(J submission type) Submitted
• Energy Enveiope CalculaUons Submitted
A NEW BUILDING
Minnesota Rules 7672
• New Energy Code Worksheet
SubmiKed
Have you previously constructed a building in Eagan with a similar plan? _ Y
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
N If so, 25% plan review
Telephone # (
Telephone # (V
I hereby apply for a Residential Building Permit and acknowledge that the inform??ion is complete and
that the work will be in conformance with the ordinances and codes of the City f-yEaganwuild=tke:Sta
Statutes; I understand this is not a permit, but only an application for a permit,
permit; that the work will be in accordance with the approved plan in the case oi
app v?of plans
.
Ap hcant's Pnnted Name plicanYs S' atur rj
NIN
and work is not to start without a
requires a review and
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-p(ex ? 16 Fireplace O 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 EM. Alt - SF
? 04 02-plex ? 10 08-plex 1? 18 Deck ? 23 Porch (screen/gazebo)
. ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04plex ? 12 12-plex Plbg_v or _ N ? 25 Miscellaneous
WorkTYPes De C1+
J
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building• ? 43 Reroof ? 46 Windows/Doors
ur 34 Replacement
? "Demolition (Enfire Bldg) - Give PCA handout to applicaM
Valuation Occupancy 12 43 MCES System
Census Code ? Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const ? Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaVC.O.
_ Footings (deck) X FinaUNo C.O.
_ Footings (addition) Plumbing
Foundation HVAC
Drain Tile Other
Roof
Ice & W ater Au/Gas Tests
Ftgs
Pool
Final Final
_
?
Framing _ =
=
=
Siding $tucco Stone Brick
Fireplace
R.I. AirTest _ Final _ Windows
_
_
_
_ Insulation
{ _ Retaining Wall
Approved By: ` /
1
? B
t, Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
?3,-) -)T4 2006 RESIDENTIAL BUILDING rERMiT arrLicaTiorr
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone 0 651-675-5675 FAX # 651-675-5694
New Construdion Reauiremen4s -
3 registered site surveys showing sq. ft of bt, sq. k. of house; and all roofed areas
(20% maximum lot coversge allowa9)
2 oopies of plan showing beam & window sizes; poured found design, elc.
1 set of Energy Calculafions
3 copies of Tree PreservalionPlan H lot platted after 711/93
Rim Joist Defail Options selectbn sheet (buildings wiN 3 or less units)
Minnegasco mechanipl ventila6on form
RemodellReoair Reauiremen4s
2 copies of plan showing footings, 6eams, joists
1 set of Eneigy Calculations for heated addifions
1 site survey for addilions 8 decks
Addi6on - indicate Hwr-sRe sepNc sysfem
?1,6-. ?2-!S-
Offce Use Onlv
CeR af Survey Reoi V N
Tree Pres Plan Rectl _ Y_ LJ.
TreePr2sRequlred ` '._Y _PJ
On-site5ep11cSystem _Y _N
Date Construction Cost yP ?a ?O d. O C";
SiteAddress Jsf?? j/oSy 310 To ,.- ? nc{. Unit/Ste #
Descriptionof Work
Multi-Family Bldg ?/ N Fireplace(s) _ 0 _ 1 _ 2?--
Property Owner Telephone # ( )
Contractor /CpU ..-,El c_ .
Address ic ? S tl-• City
State .111291 t/ Zip Telephone #( 7l3) 7S'-7-Od 6' 0
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Categorv 1 Minnesota Rules 7672
Energy Code Category . Residential Vendlation Category 1 Worksheet • New Energy Code Worksheet
(q submission rype) Submitted Submitted
• Energy Envelope Calculations Submitted
In the last 12 months, has the City ot Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone # (
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the infoxmation is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
Applicant's Printed Name
?
Applican£s Signature
? Gity of Eap
3830 Pilof Knob Road
Eaqan MN 55122
Phor.e; (651) 675-5675
Fax: j651; 675-5694
FarTJffc,RUs?-----_-----
I
I ?
? Permit #. , i
I Permit Fee: _. ?
I ?
? Date Received: i
i
I i
Staff:
I ?
?I IITL lU, I;
2008 RESIDENTIAL Pl.UMBING PERMITAPPLICATION II?? ?EC 0 4 200r
ate: .'2-1-V B SifeAddresr. P5!1
inant:
Suite #:
c510ENT / OWNER I Name:
Address / Ciry 1 Zip:
CONTRACTOR IName:
.1__P?can"x'srrf? ?:ame Ap?plicant Signature Phone:SO???? l??`s7
creby acknowledge fhat [his fnformation is complete and accurafe; that (he work wiil be in eonformance wdh the ortlmances anu woes ui ?11??.1'v ?nzn; tY:a1 I;jr,dersiand ihis is not
a permil, but onfy an app(icafion for a permit, and work is not to start without a permit;.that the work will be in ,
:xGanca wit ite aP?mved plan In the case of work whieh requlres a review and approval o?f plan .??
. .?.?.--.?
C X
License#: W-fl)-p-An _
Champion
Address:
City: 3670 Dodd Rd. #100 Staty? : Zip:
Phone Contact Person:
TYPE pP UJaRK _ New `! Replacement _ Repair _ Re6uiid Modify Space _ Work in R.O.W.
Descripfionofwork: -- ------ki
pERMlT TYPE RESIOENTIAL -
Waier Fleater _ Water Softener Lawn Irrigation Ndd Plumbing Fixtures
?(_ RPZ /_ PVB) Main _ Lower LeveO
Septic System
N evd
Abandonment
Water Tumaround
ES/GENF(AL Fc'ES:
i0.50 Minirnum VVater Heatzr, Wa;er Softener, or Waier Heater and Softener (indudes $.50 State Surcharge)
>6.50 Lawi-i Irriga[ion (indudes $.50 State Surchargej
;0.50 P,dd Plumuing Fixtures, Septic System Abandonment, Water Turnaround` (includes$.50 State Surcharge)
"',':!2te: ?urnaround {zdd $136.00 it a 5/8" meter is required}
00.50 SapCc System New ($10.00 per as built) (includes Counry fee and $.50 State Surcharge)
0.50 Fire Reuair (.replace burned out appliances, ducfwork, etc.) (indudes $.50 State Surcharge)
TOTAL FEES
rR OFFECE tJSE Reviewied By Date
.qoired fnspocfirans:.. Uricler Ground` 'Rough-Irr: Air,Test _?as7est + Fin a1
, -
, . ?
2`7 ??-7
6eA4-S
CITY OF EAGAN WATER SERVICE PERMIT
3795 Pilot ,Knob Rood PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: —__ No. of Units:
Owner: _
Address:
Site Address: _
Plumber: _~
Meter No.: _ Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee:
I agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
By Date Paid:
Date of Insp.• —_. Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3795 Pilot knob Road
PERMIT NO.:
Eagan, MN 55122
Zoning: DATE:
Ow ner: — No. of Units:
__
Address:
Site Address:
Plumber: --
----
1 agree to comply with the City of Eagan Connection Charge:
Ordinances.
Account Deposit:
-- / Permit Fee:
c
S urcharge:
By ✓ Ii1C rG
Dote of Insp.: r--___,a Misc. Charges:
Insp.:
Total:
Dote Paid:
City of EaQall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: k D ►kjli
Permit Fee' l Vf - a 5
Date Received: D itt (C5
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: , !) 1 .) Site Address:
)Ith R ,Awn
Unit#:
Name:
L�vx u��ncam. ,.)'c6.C\C56n Phone: V5`' a (DC04
Address / City / Zip:
Applicant is:
fir) 5 51 a\
Owner X Contractor
Description of work:
Construction Cost: %)0
Company:
21.Vaud a extestev
i?It\1 & - `\£h cktc
Multi -Family Building: (Yes / No x )
308 SW 15th St., Suite 100
Address: Forest Lake, MN 55025 City:
Contact: "�i.`Nf1LA.r l 0\-%
State: Zip: Phone:
License #: u -414c
Lead Certificate #: n aaa 3(Q -
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:
Sewer & Water Contractor:
Phone:
Phone:
NOTE: Plans and`supporting documents that you ;submit are considerer`
the information may be classified astnon public if you provide specific rens
conclude that they 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.gopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an 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.
ublic information
fat would permit
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of r� ssnje.
App Ica 's Printed Name Applicant's Signature
Page 1 of 3
Use BLUE or SLACK Ink
...447Z...$ Far Office Use
_
1
... r : * /q C2 6//� _ Cit of Ekon �ri 41
. Pemntfee: a,0-
3830 Pilot Knob Road
Eagan MN 55122 Cate Received:
Phone:(651)675.5615
Fax:(651)6754 shelf
2097 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 8-IQ I-ti Site Address: alt r 11 Lk m b r
Tenant . .... ., _. ....... __. .....�Suite 6:
Resident/Owner Name: UJ re►'LC.C'. ZaC.ks vi Phoma:,✓`' /—,9r. -ilzeio •
Address/C !
Name: 1Vrto- 4er . License ft: Oto 11(0 l
ContractorAddress: I Li 536- of 7111 e r city: L'mix.,--4. h '
• •
State:f')')1vzip:55 W7 Phone:,,262_2_:___5 !c�. -17 7 •
Contact:!IA 4 1 Ca ( r1 Enhaiki)KZ.le- CeL t n gt. le-I�$C._Cgt'h^7
•
Type of work ---New AReplacement T Repair Rebuild Modify Space _Work in R.O.W. •
....... .. .. .. ... .,. : Descriettott ofhrhhark:..ape Cu Sf�rrher4 p Pi.` rs cam✓ .
RESIDENTIAL •
ft•.Wafer Heater
• Lawn Irrigation(___RPT/ PVB) : Water Softener •
Pei111it Type Add PlumbingFixtures( Main/_Lower
• Septic System•
Level)
_New Water Turnaround •
•.. Abarhdonmerht
RESIDENTIAL .. . .
FEES: :.:.. :.......
$60.00 Water Heater,Water Softener,or Water Heater aad.Softener(includes State Surcharge)
: $60.00 Lawn Irrigation(includes State Surcharge)
$60.00 Add Plumbing Factures,Septic System Abandonment,Water Turnaround*(lndudes State Surcharge) .
'Water Turnaround(add$260.00 We 314'meter is required)
$115.00 Septic System New(includes County fee and State Surcharge) `
:..
TOTAL FEES$ W t
CAH,.BEFORE YOU DIG. Cali Gopher State One Call at(651)454.0002 for protection against underground WNW damage.
Call 48 hours before you Intend to dig to receive locates of underground utilities. ....,....•:•,:.;.:._,_._...'•''' 7...
I hatehYadalaataalie that the In malign is catalgata and accurate;that the work wit be in conformance with the ordinances and codes of tike Cay of
Flan;that I understand this is nota permit but only an application tion a maul and Is ,. to - without a pane*that the work wW be in
with the . plan h the nese of work whk:h requires a review and l: • ,!.:
X can"
Nmrhe
r
FOR OFFICE USE Reviewed Sr. Date:
Required Inspeedons; Under Ground Rough-In Air Test Gas Test Final
Meter Related Items: Meter Size Radio Read Manometer Staff.