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3136 Farnum Dr. - ' cIrr oF EAcaN 3795 ?ilaf Knob Raud Eo9ae, MN 35122 7tf S 4 PHOML: 454-8100 BUILDING PERMIT Receipt # To be w.d ie. 1 of 4 PLEX Est, Value $58,000 pate April 19 14 83 Site Address 313RR Farntun Drivn E?ect )Q Occuponcy R-3 Lot glock 2_ $ec/Sub, Coachman Land "'nd Niter p Zoninq FD Parcel # 10 1 R j5lU?'Q_(l? Repoir ? Flre Zone 'A . Name COSChman Land Co. W z Addren 2$32 Prior Ave. No. ? ., ... .,._ ,.,.-- Z0 v u? ?- Nor„a Rosewood Construction Divieion o0 Addross 2432 Prior Ave. No. Assessment Nome _ Address I hereby acknowledge thot I have read this opplicotion and stote thet the information is correct and egree fo comply with all epplicoble State of Minnesoto Stotutes ond City of Eagan ardinonces. Sipnature of Permittee A Building Permif is issued to: oli work shoil be dor?e in xcordonce Buildinfl Officfot Enlarfle O TYpe of Const. VA Move p # Stories Demolish ? Length_._4h_ Grode Q Depth 26-5q, Ft. A ro?ols Fses Water 8 Sew. Police Fira Eng. Planner Council Btdg. Off. _ ^PC Permit 307_ nn Surcharge 29- 0o Plon check 151 _ 5n SqC 525 _ Ou Water Conr450 09_ Water Meter60 • OQ Road Unit 250.09 Totol $1774.50 lvu ?.v ae.iL.LV4..{.1...... lOiV?l on tha express Condition thnr oppllcable Stote of Minnesota Sratutes ond City of Eayan Ordinonces. Permit No. Permit Holde? Mise. Parmit No. Holder Plumbi?y H.V.A.C. ?D S S1-re??z Well Wat?r Disp. Sswer Elect.ic wo'1zqzo Inspsction Date Insp. Other FootinSs -7/- ?c? Foundetion Framinp 7 ? Rouph Plbp. . L _ Rouyh HVAC ,7_S3 ? Gif S f r 5 t ??/,r ? Insulation Finat Plbg. - 714 Final HVAC Final Webr Deserihe Location: VUell Sewer ' Pr. Disp. BUILDING PERMIT X ° 7Q' 33 Receipt Te bo rad ior 1 of 4 PLEY Est. Velue $58.000 Oate April 19 , 19-&3_ Slte /lddross ? 73R F,arn,,,o Tlri .p Erect ? Occupancy R3 Lot 3Blotk _2_ $ec/Sub. Cnachman L.and Znd Alter 0 Zonlny pn Parcel #--??-IJ1-151 C330 tJ2 Repoir ? Fire Zone NA Enlarpe ? Type of Ca,sr. vn W Nome C'•Qat-hmn-t i.anr? rn- Move ? # Stories _ ^ddress 2432 Prior Ave. No. Demol;sh ? Length46_ 6 c'ir„ Roseville w,,,.,. h1F-Ansr? Gmda ? Depth-Zfi-SQ. Ft. A Narr,e Rriser,rood Gonstructlon Divi a i nn ?? Address 2432 Prior Ave. No. ?- ri... _z9 S[. Name Address I hereby acknowledge that I have read this applicotion ond state that the intormotion is correct und ogree to comply wifh all applicoble State of Minnesoto Stotutes and City of Ea9an Ordinances. Siynaturc of Permittee Rosewood Conetru, A Building Permit Is issued to: oll work shall be done in accordorxe with oll opplicoble Stote Buildlnp Offlciol CITY OF EAGAN =715 Pllof Kiw? Rosd Eogon. MN 55122 PHONE: 454-8100 ^sseument Water 8 Sew. Police Fire Eny. Plonner Council 81dy. Off. APC Permit 1A07 _ nn Surchcrge 29-00 Plon check 1 53_ 5(1 SAC S 2 5 _ j!1 Woter Conn.l?ZQ Q.a Woter Meter 60.00 Road Unit 250.09 Tota, $1774.50 on the express condiNon thnr and City of Ea9an Ordinonces. Psrmit No. Permit Holder Mise. Parmit No. Holder Plumbing H.V.A.c. w.n wat.. Disp. Ssw?r Electrie w612411 En?c?ck. 5-?3-?f3 Inspectlon Date Intp. Other Footinyt tJ, Foundation Freminq Rouqh Plbg. .77 -,e RouOh HVA 7_7-S IZ?.L? (?j/V S 1" Inwletion l? Final Plbp. .? ? Final HVAC Final water Describe Location: Well Sower Pr.Obp. - CITY OF EAGAN Remarks J -r 'Addition COACHMAI( LAND CO 2ND ADDA Lot ? elk 2 Owner Street 313 FAABUM DRIVS S Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. IJI& 1974 Psid ilYl Qr parcel 10- 900-011- 1 STREET RESTOR. 19 3 'f 5 • 17 154 • 3 5 603.34 J4012717 9-8-83 GRADING l 1971 0, d 138.61 A012717 9-8-83 SAN SEW TRUNK M ? SEWER LATERAL y tr •• 1526.72 A012717 9-8-83 WATERMAIN 1 1912 Psid M i WATER LATERAL WATER AREA .1977 n n M• STORM SEW TRK Z Paf d ? • iSTORM SEW LAT 1983 *• CURB & GUTTER ' 510EWALK STREET LIGHT 250.00 35320 -19- 3 WATER CONN. SO.OO BUILDING PER. SAC 525-00 PARK ..I Y UF EAGAN Remarks '-` Addition COACHMAN LAND CO 2ND ADDH Lot 1 Rlk 2 Owner screei 31368 1rARaON DRIYE S Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. S 1 4 Paid 1111 er arC@1 10- 900-011- 1 STREET RESTOR. ' 1983 754• 17 15o.83 5 GRADING 01 1971 Pai d (3radin 2 1083 - 173.29 34.66 5 138.64 A012710 9-7-83 SAN SEW TRUNK 196 8 Paid ? SEWER LATERAL 1973 I "Sewer Lat 1983 1908.35 381.61 5 1526.68 A012710 ? _7_83 WATERMAIN ? 1972 pBiQ ! ? WATER LATERAL 1973 WATER AREA 19T7 •*iister Lat 1983 5 STORM SEW TRK Zgl - 19T5 Paid WWSTORM SEW LAT - - -- - - 1983 S WW9 1ces e r v 1 3 CURB & GUTTER SIDEWALK STREET LIGHT ROAD UAIT 250.00 35320 4-1 -8 WATER CONN. 450.00 n ? 6UILDING PER. 7932 SAC n n PARK CITY OF EAGAN Addition Street Lot 3 Blk Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. 4 Pai I' 8TCl1 10-0 0900-011-3 1 STREET RESTOR. 155 1983 T54.17 150.83 603.34 A012800 9-21-83 GRADING lp 1971 Paid " Gra in 1983 173.2 4.66 138.61 A012800 9-2183 5AN SEW TRUNK p 1968 Psld ft IF SEWER LATERAL + n •; 8 1908.35 8.6 1526.72 A012840 9-21-83 WATERMAIN III 1 2 Psid n * WATER LATERAL 1973 o? K WATER AREA n n N 1! ? STORM SEW TRK 1 PiiQ n *fSTORM SEW LAT 1983 **Services 1983 CURB & GUTTER SIDEWALK STREET LIGHT 250.00 35320 4-1 83 WATER CONN. 450.00 M BUILDING PER. SAC n H PARK CITY OF EAGAN Remarks ,4r f 50? -78 ? Addition COACEMAN LA$D CO 2ND ADDII Loc 2 Rlk 2 Parcel 10-18151-020-02 owner street 31388 FARIYUM DRIVE State EAaAN Ka 55121 Improvement Date Amount Annual Years Payment Receipt date STREET SURF, p g O- OO-Oll- 1 STR E ET R ESTOR. 1983 4.1 150-83 5 01.68 A014 20 12-6-84 GRADING 101 1 1 Paid p Grading 1 1983 173.29 34.66 69 . 31 A014920 12-6-84 SAN SEW TRUNK qV 1968 PBia n 11 SEWER LATERAL ? tt n ** 763.36 A014920 12-6-84 WATERMAIN Psid d IF WATER LATERAL 10 n n WATER AREA 1977 n n NN STORM SEW TRK 1915 Paid NASTORM SEW LAT 1983 5 ** v 1983 CURB & GUTTER SIDEWALK STREET L.IGHT ROAD UNIT 250-00 4-19-83 WATER CONN. 4 O.OO „ „ BUILDING PER. SAC ft 1t ? PARK ? Receipt -- ' MECHANICAL PERMIT CITY OF EAGAN I Fill in numbered spaces I TYpe or Print /evibly Permit No. - Fee -' S/C Tot- - 1. Date ? 2. Installation Cost 3. Job Address u416'Lot -- Bik. Y? Tract ? 4, Owner 5. Contractor ; i, r ; •? 6. Address , , ? ; , _;? -•` L , ) ; , ,1 ; ?. ; 7. CitY State ? ? ?• f ` Zip 8. Building Type: Residential W Commercial ? Institutional O 9. Work Description: New ? Add 0 Alter ? Repair ? ? 10. Describe Fuel Type 11. No. ? Eauioment STU - M. Ea. Forced Air ' r• ?' No. Equiqment CFM Ai H i Mfg. T , . . ng: r andl Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Qther Air Cond. Mfg. Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to camply 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 454-8100 Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee FiJl in numbered spaces S/C -' Type or Print /egib/y Tot. - 1. Date 2. Installation Cost 3. Job Address qi 1ji r, Lot ? Blk. ? Tract I I"- .'?+ ? 4. Owner . . 5. Contractor Phone • `'r? 6. Address _ 7. City State Zip 8. Building Type: Residential ED Commercial ? Institutional O 9. Work Description: New Q Add ? Alier ? Repair ? 10. Describe Fuel Type 11. No. i E.qyioment STU - M. Ea. Forced Air YC/CCV No. EQUiament 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: Oate 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 Prini /egib/y Tot. - 1. Date 2. Installation Cost 3. Job Address Lot I Blk. ? Tract • 4. Owner ` 5. Contractor, - ' ? Phone J 6. Address 7. CitY State Zip 8. Building Type: Residential L9" Commercial O Institutianal ? 9. Work Description: New Add O Alter O Repair ? 10. Describe Fuel Type 11. No. Equi ment BTU - M. Ea. Forced Air No. Equipment CFM Ai H li Mfg. •=i „ ? f , ? r and ng: Boilers Mfg. Mech. Exhaust Unii 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: Oate Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 :ceipt f MEGHANICAL PERMIT _ CITY OF EAGAN ? . ` Fi!l in numbered spaces Tvne or Print /eoiblv L Date ,:' , ' ` ? 2. Installation (+ Permit No.3-? Fes S/C ?J Tot. 3. JobAddress^'=! ?`??u?+??-'l• LotBlk. Z- 4. Owner n 5. Contractor, ? ,.I Phone Cl c? 6. Address ., l i r 7. City State Zip -- I 8. Building Type: Residential ? Commercial ? Institutionai ? 9. Work Description: New El"' Add ? Alter ? Repair Q i ! 10. Describe i{ f l;? sLti 1 ,, r L Fuel Type 11. No. 1 EqJpment 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. ( hereby certify that the abave 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 INSPECTI4N RECaIZD f CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (651) 681-4675 SITE ADDRESS: APPLICANT: ., . , . •?< ; ,., ? PERMIT SUBTYPE: TYPE OF WORK: ?fEanI I I ?N , tr1`;+ I., 1:'i ?r?f •.; I rit; INSPECTION DATE INSPTR. INSPECTION TYPE D' ' Frt ", . i IIIMFl1 y;`f 1 11F'. hll1'?, ! C3f` Il9rl?r (' If' CI NI' 1 F L Mr tA I I ri, t f ?$ 9, -? ? ? I Permit Holder Date Telephone # SEWER/ WATER PLUMBING HVAC inspectivn Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUM8ING PLBG AIR TEST ROUGH HEAS1NCa GAS SVC TEST IN5UL GYP BOARD ' FIREPLACE FIREPLACE AIR TEST 4(,?r FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL pDMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST NYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL °"rTi? / Reaeipt PLUMBING PERMIT CITY OF EAGAN FiII in numbered spaces Type or Print legibly Permit No. - ?? 3 " Fee cU.UU S/C •So Tot. 1. Date 2. Installation Cost ? . l. liviu:t?.? 3. Jab Address 31 36L i'?tUti?i•? ? Lot 2 Bik. 2 7ract ZA?' *L 4. Owner -.?Yr:+?JUOL l;UciP 5. Contractor 3,;AULTi15 PLUiuiL'rG I,o; phone 7nq"4OU7 6, Address 10641 1v1AluiCATJ 5'1. 7. City L i..'?jlrr+ State +"u'? • Zip ?i431 ? 8. Building Type: Residential 13 Commercial ? Institutional ? 9. Work Description: New E] Add ? Alter C) Repair ? 10. DeSCribe nUUU H?tttu°•` 11. No. 2 Fixtures Water Closet No. Fixtures Cesspool/Drainfield 1 8ath tubs Septic Tank Lavatory Softner f Shower Well ' Kitchen Sink Urinal/Bidet Other ? Laundry 7ray 1 U.50 S&wz:: ? Floor Drains 1 v.SU MH1'?,: Drinking Ftn. Slop Sink Gas Piping Dutlets 12. I hereby certify that the above infor,mation is true and correct, and I agree to comply with all ordiq8nces anc/c?s go).(e'rning this type of work. ; i /i ?--?-' ? Signed: r1?. s'/LG(,'?;. ` for Rough Final Inspections; Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY UF EAGAN 454-8100 Receipt ? PLUMBING PERMIT Permit No. CITY OF EAGAN . Fee cv.v Fill in numbered spaces S/C • ?'? Type or Prini legibly - rnt 1. Date 0 3 2. Installation Cost 3. Job Address 3130 :iuuru. _ Lot ? Blk. 2 Tract 1".L ----,- ? nJ 4. Owner +'vJ.urYUUL ?UttP 5. Contractor ??tiu:.;lli;? PLui•?Ii?? i.;?. Phone lOL>-Lvv; 6, Address 10641 7. City State l?r Zlp S. Building Type: Residential El Commercial ? Institutional ? 9. Work Description: New ? Add 0 Alter 0, Repair O 10. Describe 6'UL)L 11. No, Fixtures Water Closet No. Fixiures Cess ool/Drainfield ? Bath tubs p Septic Tank Lavatory Softner ? Shower Well ? Kitchen Sink Urinal/Bidet 0ther— - ? Laundry TraY ,• ? 1 U.7v .???ti .:,..? ? Floor Drains J Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above infotmation is true and correct, and I agree to cflmply with all ordinances and cbdes govqcning thls type of work. ? Signed: for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. AqProved C1TY OF EAGAN 454-8100 I)L- Receipt ?- - ? ' PLUMBING PERMIT --- Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C ..5 J Type or Print lcgib/y Tot. 1. Date "!123f03 2, Installation Cost 3. Job Address r- . 3136B Loc 1 Blk. liUt?.?s i?•1it? 2 Tract "'L 4. Owner 1??6EWOOL ?ORP 5. Contractor "iiJLTZES PLliribLtiG lirv phane 700-L?)07 B, Address :' 1?l J: • 1'???11 7. City .6 ?a+?L State •;•+ + 2i6 554?4 8. Building Type: Residential El Commercial ? Institutional O 9. Work Description: New 4] Add ? Alter ? 4tepair ? 10. Describe a+UUL r'1:1u'lr' 11. No, 2 Fixtures Water Closet No. Fixtures Cesspool/Drainfield 1 Bath tubs Septic Tank ? I..avatory Softner ? Shower Wetl 1 Kitchen Sink Urinal/Bidet Other ? l..aundry Tray ? Floor Qrains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that thq above i for.mation is true and correct, and I agree to comply with all ordin8nces ano ' go r-,ai+?g this type of work. Signed : for Rough Final InspectionV Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8700 Receipt PLUMBING PERMI7 Permit No. - CITY OF EAGAN , - Fee 1U. ?lv Fill in numbered spaces S/C .? j Type or Print legib/y Tot. 2 U. iti 1. Date 4/20/di 2. Instatlation Cost 3. Job Address 3130 fAru,l,r: Lot4_Blk. 2 Tract r- 4. Owner AOSEWOpD ?;U:tF 5. Contractor ":iULTIr?S PLi.i:lbIhC 1:+.Phone 786-4007 6. Address 10841 mANiU?TO 7. City LLr?lirL State ._:,. Zip `•`1. 4 8. Building Type: Residential t) 9. Work Description: New 13 Commercial O Institutional ? Add ? Alter ? Repair ? 10. Describe .'•UO.Lll t I 11. No. 2 Fixtures Water Closet No. Fixtures i Ce l/Dr field 1 Bath tubs sspoo a n Se tic Tank 3 Lavatory p Softner j Shower Well ? Kitchen Sink Urinal/Bidet Other ? Laundry Tray ? lu.?)j ? Floor Drains 1U.5U ?tr. _ . . Drinking Ftn. Slop Sink Gas Piping Outlets 12. 1 hereby certify tbat the abave 'nformation is true and correct, and I agree to comply with all drdinances a co?les gcnre nlng this type of work. 7". Signed : ?" Rough Final Inspectiorfs: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 ? '74S CITY OF EAGAN Pilet Keob Raad Eayon, MN PHONEs 454-8100 7332 BUILDING PERMIT Recelpt # -- ? Te bo UNd fa 1 of 4 pLEX Est. Value S58.000 Dnte Ap2'i 1 1 4 , 19$3__ Site Addreu 3136B Farnum Drive Erect ? Occuponcy R--3 l.or 1 elock 2 Sec/5ub, Coachman Land 2nd Alrer ? Zoning PD parcel # V) 191 51 ()110 1' Repair ? Fire Zone NA Enlorpe ? Type of Const. V11 oWc Name Co3Chmstl ?.811d Co. Move p Stories z 2432 Prior Ave. No. /lddress Demollsh ? Length 46 GRosevilla phone 636-8050 Grode ? Depth 26 Sq. Ft. ?j Name RnApwood CnnAtru _t i en Df vi ei on Approvob Fees ?? Address 2432 Prior Ave. I3o. Assessment Permit 307.00 ? rs.., Woter & Sew. Surcharpe 29.00 Police Ncme Firo Nddress Enp, City phone Plonner Counci I I hereby acknowledge thot I hove read this applicotion ond stote that Bldg. Off. the intormotion is oorrect ond ogree to comply with oll oppiicable ^PC _ State of Minnesota Stotutes and City of Eagon Ordinances. Sipnature of Permittee Plon check153.50 SAC 525 . r)0 Water Conr4 ''Q QQ.._ Worer Meter 69..-.2D- Road Unit 2 51 00 Totul St 77G Sn ??o?'.?VVU +?VilObLLLt:LiVLL LiYjallJll A Building Permit is iuued to: _ an the express conditlon thai oll work shall be done in accordonte wlth oll opplioable Stote of Minnesoto Statutes ond City of Eapon Ordinances. 9uildinp Offitiol , ' " ? Pormit No. Permit Holder Misc. Permit No. Holder Plumbinq 34CJ ?j"a5 (?_u H.V.A.C. 3g e??z g-?o-?3 W.ll wmr Disp. S?wrr - Electric (,vo'7Z?{Z ?[E1Le?Y`l'C.K 5,2?-$' IrKpaction Dste Incp. Other Footingt •7 Foundstion Framinq ? - Rouyh Pibp. -? 1(? Rouph HVAC -7$3 ? Inwiation 2itla Finsl P16p. -TS Final HVAC ? c 10 ` Final Wammr Desai6e Locetion: YYell • Sawer Pr. Dhp. - . - , BUILDING PERMIT 3795 P1lot OF EAGAN oed tagow, MN SS12= E: 454-8100 Receiot !t :?? G T13i .1 n Site Addrcu .31.3u rarnum irive Erect ?g R_3 ccupancy O Lot 4 Blotk 2 $eC/Sub, Coachman Land 2i; Alter p Pu oning Z Parul ?t 10 13151 340 02 Repolr ? Firc Zone T'A Vri ' - Enlorps ? Typs of Const. 19 oac .maii . nd o. No? _ v M # Stories W z 2432 P D1 /' i o e ? 46 r or .ve. o. Address Derr,olish ? Length c-i..,".oseville w,.,... 536-8050 Grode Cl Depth 26 Sa. Ft. o Na,,,a Foaewooct c:onstruction Dlvision _ PP'•°" u? Addfen 2432 Prior Ave. North Assessment _ #-- Ci Rosev111e phone 631-3254 woter & Sew. Pol ice ? UOI W Name Fire ?? Addreu Er?p, <W Ci Phone Plonner , Countil ( hereby acknowledga that I have reod this opplication and stote thot Bldy. Off. - the informotion fs correct ond agree to comply with all opplicoble APC Stote of Minnesoto Stotutes ond City of Eagan Ordinances. Sipnoture of Permittee A Building Permlt Is issued to: Rosewood Construction Division all work sholl be done in occordonce with oll opplicable State of Minnesota Statutes ? Buildinq pfflNol Plun check153.50 SAC 525.00 Woter Conr6?S0 30 Woter Meter 6 0- 05 Rood Unit 25D,00 I Total $1774.50 on tha exprcss conditioh thnr and City of Eogen Ordinonces. Permit No. Permit Holder Misc. Parmit No. Holder 33? u? (? j J Qs4z3V t Oe C Erh -Z-1 M' r.so-7z'4z1 Irapection Date n% Other Footinps Foundation 4 Freminq Rou9h PIbY? -l ) -C ? Rouph HVAC ?-'j-&3 ?W Inwlstion - Final Piba Final HVAC Final Wabr Desa'ibs Location: VYell Sewer Pr. Disp. ` ? REQUEST FOR ELECTRICAL INSPECTION ,., ' See instructions lor completing this form on back of Yellow copy. ?3(" Belo?Wo? CO? red by This Request ' ee-oooai.oa .. 3545`1 Adtl Nep. TypB o( 6uiltlin9 ApOliantes Wired EquipTenl WireA Home Range Temporary Service Duplex Water Heater Lightin,y Fixtures Apt. Building Dryer Electric Heatin Commercial Bldg. Fumace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank farm Otnnr oeci v tn"r ISneclfvl t ar ?y Other Oth.r Compute Inspection Fee Below # Fee ServiceEnhanceSize U Fee Faeders/5ubfeedPrs N Fqa Circuitg U to 200 Am s 0 to 30 Am s 0 to 30 Anws Above 200 q..... y 31 to 100 Amps 31 to 100 Am s Swimming Pool Above 100_Am s A6ove 100_Amps Transformers Irrigation Booms cSb Partial%Other Fee .0 Signs S4>ecial Inspection $ T Rema.ks O AL FEE 37.,Ta Rough-in . Date tha lacvicel he,eby Findl ? D?te ' ? 4? O cemsrtify that the nbove insoaction has been tle. Thierequestvo1d19montMtrom " 1 d,mponQhs f?om'/d? 5_ Z Zj L` L 4:? ?? l-.O 01L`.Vl n+tq •\ 3s ` p? W3 71 SC) Fit? 07 2 5+ 2 2 LavlL z 9enue5t f]ate Fire No. Roodh-in Inspection ?J Feqwr ? OReatly Now ?II Notify Inspec- ?'/_ es ?No mr When Ready ?ICensed Elac4ical ConVaMOr I hereby reqvest inspaction of a,bove ? Owner electrical work insielled et: Sveet AAdress, Bon or Route No. '313 Citv ection o. Township Name or No. Hange No. County Occ ntt (PRINT) Ph e No. ?v 31-• ? S Po r Supplierr Atldress /? neI ' /V , V, , (J ElecVical Convact i ""T ?- ? ? ?yNrMe1 ., y i_ vu Go cto 's Lic nse N o. ' 'y? y:1': f MailinpAdJre1s9 1R ?r?';C' TM1ek6?'fpns?tal?i9n}?A • 3?11Y ;J j,!•7r Authorized ?o r ontt?Vtpr?Qry?/'R?cii Ct9?`Y K ?Liil.t.t' Phone NumOer MINNESOTA STATE BOANO OF ELECTflICITV THIS INSPECTION PEQUEST WILI NOT G,iees-Mitlwey eltle. - 0.oom N-191 8E ACCEPTED BY THE STATE 00AflD 1821 University Ave., St. Paul, MN 55104 UNLE55PHOPEP INSPECTION FEE IS n?___ 1-1 nov -,. ENCLOSEO. REQUEST FOR ELECTRICAL INSPECTION ' See inshactions fo, completing this form on baek of yellow copy. 012420 r<-? . t.? X"' Below Work Covered by This Request EB-00001-04 r': 354 $q Adtl Rep. TypB Of Buildinq Appiiancns Wiretl EquiUmenl WireA Home Range Temporary Service Duplez Water Heater Lighiin,y Fixtures Apt. 6uilding Dryer Electric Heatin Commercial Bldg. Furnace Silo linloader Industrial Bldy. Air Condltioner Bulk Milk Tank Farm Oihe, ,veciFV oiher Isnedfyl ? Pr SueclSy ther On%ci Compute lnspection Fee Below k Fee $erviceEntranca5ixe k Fee Feedars/5ub}eeAxrs # Fee Circuits 0 to200qms- 0 to30Ams 0 tn30Ams Above 200_qm)s 31 to 700 qmps 31 to 100 A s Swimming Pool Above 100__Amps Above 100_Am s Transiormers Irrigation Booms Partial: Other Fee rG,Q Signs Special Inspection S Remarks n.._ i? 38.va TOTAJ, E z? , „ --- PouBh-in ( D`'1e? the ncal / ?/ SPecto?, ha/oby certity that the above Final ` ?teye ? inspection has been mede. TM1ls?aauartlveiClAmonlMhom This reques[ void ?- z-l 18 months fmm ''IN 059234 (A , T3zi coac?a?a ? 3 s3 qy ?.Eit?- Co I Z n? /O t o p Rnqu t Oa2v ? ? Z . a q a Fire No. RovBh-in Insnr:ction Raqu eA7 ? Reatly Nnw ll Notity, Inspeo- Wh R , , , No , en eatlY ;Kki.emied Elecvical Contmctor ? Owner 776 I hereby request inaoection of ebove elechical work installed aU Street Address, B a or fla???e No. 3 i3? CitY ection o. Township Name or No. RanBe No. CownY IA r-tr(+k OecupantfAlN_ T) 1??a?-,+??NDU b R'p _ Phone No. Powe? Supplier S P N Atldress ?L EiocvicalLCCC nUar.[orylC?Om?p?any e+) - ? CJ6"J ?L?cyq 1 ??„l6- ? (/?W - C m??}//a?cm?ri'?s License No. 6 V W 1' ?' Mai qg Atltlress ICUnt t?o?r ?o-r Owtn„a?r;yMaking Insraila[uw1 N. RN?SV'VvfaN 'izI- R1AL VK'`j -S?91E7, Auth i ed Sig a Co t ct /O n r Making Installationl Phon m-wby?er lryp ?V??f ` MINNESOTA STATE BOARD OF ELECTAICITY THIS INSPECTIpN HEQUEST WIIL NOT Griees-Mitlwev Bld9. - Aoom N-191 gE ACCEPTED BY TME STATE eOARD 1821 University Ave., St Paul. MN 65104 UNLESS PROPEH INSPECTION FEE IS ... 1-1 ..,...... ENCLf]SFD_ • REQUEST FOH ELECTRICAL INSPECTION .r EB-o°°°i-°" (?'?t? /1q ' See instrvctions for comolating this form on back of yellow copy. l%IT I I l1 / / G .. I "'X " Be`fow Vorc ?overed by This Request AAtl Nep. TyOe oi Builtling Appliuncas Wiretl EquipmenL Wired i Home Range Te!nporary Seroice ' Duplex Water Heater Lightiny Fiztures Apt. Building Dryer Electric Heatin Commercial Bldy. Fumace Silo Unloader InAustrial Bldg. Air Conditioner 8uik Milk Tanlc Farm tner 'aecOv 01n<,r lSUer,;fN ? or pcr,lly Ot er 01h,,r (.'ompute lnspection Fee Below N fee ServiceEnVenceSiza n Fee Fertders/5u1bteeders N fee Cirwits U to 200 qm S 0 to 30 Am s 0 to 30 Amus Above 200 qm???: 37 to 100 Ainps / 31 to 100 Am s Swimming Poal Above 100 _Arn s Above 100_P.mps Transiormers Irrigation Booms ;-_i0 Partial-'Other Fee . p Signs Special Inspection S T Re?rks ,2 a e . ? ? ?SG?O OT F E ? ?j , n .? .. . 1 ? •-?- Rough-in . ate ? 111 / ?/3 0 I ns ?he her I Oectm b , e V c til th t fh b I Final ' ? Dale/ [. er y a e n ove 'nspectimi has bean J /01 1?`O matle. I ThISreauesivoltllBmontissfrom REQUEST FOR ELECTRICAL INSPECTION -i , See instructiona for completing this form on back ot yellow copy. "X'' BeP0w &9ovkred by 7his Request EB-00001-04 w, 353q? Nm? FAtl Rep. TyOe o1 6u0tling ADPlinncn5 Wiretl Equipm¢n1yYimd Home Range Temporary Service Duplex Water Heater Lightiny Fixtures Apt. Building Dryer Electric Heatin Coinmercial Bldy. Furnar,e Siio Unloader Industrial BIAg. Air Conditioner Buik Milk Tank fHfm Otha, Pem Y Other fSUaci(y? [ er uecify Ofier piher Compute lnspection Fee Below p Fee ServiceEntrenceSiza g Fee Ganders/SUbtnetlers k Fee Circuits 0 to 200 Am s 0 l0 30 Am s 0 to 30 Am s A6ove 200 qnnps 3112 700 qmps 31 to 100 qm s Swimming Pool Above 100__Am s ? , Above iQ0_Am s Transionners Irrigation Boon?s ,J Partial-'Other Fee Signs Speciallnspection S I Aemarks ?',4a ' ' ' ?eS V T? O t-1v.h Of? 1 • floueh-in Dntr, r I, HBC ' AI Inspe or, herohy Finel DA F' certify that the nbove ^ ? - inapectlon has been 4 mede. Thia reauast voltl 18 monfRS trom ,.h,s reque5t void 5-z3 18 mon[hs fmm W072421 Lyi13z1 ceaclnn LAtia, Zn4 3sLt C& Y 3-7 Lso flequest Oate S / ` 3 Fi?e No. Nouph-in InsVectinn Ae mr ?Rently Now WYfr Notify, Inspeo- «? Wh R A ! p Q es ?NO en ea y &ticensetl ElecVical Con[rflctor I hareby request inspection ul ebove ? Owner elecvical work installed at SVeet AAd(ess, Bor or Route o. I 313? ?., Ciry ectwn o. Township Name or No. ftanye No. CovnlyPi Oc pant IPqINT) osr: WooQ ?ONS?" Ph no No. ? - s Power Supplier /*v- s. . Adtlress ? Electtical Connactor ICompany am ECTRI RIC? ? Cnnvncior' License No. Maiiing Address (Contracyor,?? "r ?hs,ta'' M I ??? • c ? ? YaJ ` ?;?y , g,/iiv 5 Au[horized Signawre 1 r u ?er : a`kipgTl`n stallati iT t1JJ X .: -. Phone Numbor _ .?:;Li"- L AZ1 MINNESOTA STpTE BOARD OF ELECTHICITV THIS INSPECTION HEQUEST WILL NOT Griggs•Midwey 61dg. - floom N-791 BE ACCEPTEO 6Y TME STqTE BOAflD 1821 Univaraitv Ava., St. Paul, MN 55704 UNLESS PNOPEF INSPECTION FEE IS ...__. ,-, - .... ENCLOSED. Tti,s ,ea.e.:. ?o,d f!- a 3 18 mon[hs fmm W07241.7 L31 Sz, CoaclInw.a,1 L4VlC Z??'- 3s48y 27 ts-o Req? est Date • : ?') ? ? Fire No. Rough-in Insoection Fe?qu, ed? / ?Ready Now Notily Insue.- t Wh '_, / J es ?NO ?. o. en Featly 4K. censed Eleclrical ConVactor I heraby request insDaction ot ebove ? Owner electricnl work installad aC S[ Address, eox or Rout No. r/ / ???'? Ci?V ectbn o. • Township Name o? No. RdOge u. CoWrty ? O pan[(PpINT) os?' oo Phone No. Po er Supulier Aatlress ElecVical Conv a? TT; Co -?r,tor's Licensa No. Mailing Address (COnt r kifi9tYft9 io ' ' PLE VALLEY, NiN 55124 AuNorized SigneW?!•Ait feel&o?YtkQq(ml_in'l`1¢jh14T116lStaIIlA461?1L' L,1Vn.i? ???a Phone Number MINNESOTA STATE BOARD OF ELECTHICITY THIS INSPECTION NEQUEST WILL NOT Grie9s-MiAway Bltle. - Aoom N•197 0E ACCEPTEO 6Y THE STqTE BOpqD 7821 Univaraity Ava., St Peul, MN 55106 ' VNLESS PPOPEH INSPECTION FEE IS o?._.... 1a11? oo, 1?11 ENCIOSED. • REQUEST FOR ELECTRICAL INSPECTION ' See instructions for campletine this form on back ot Vellow coPV. ?- 0°1`2417 "X'' Below Work Covered by This Request {y EB-00001.04 w: 3sR g? ev4 Addj Rep.j Type of Builtlin9 APOliancxs Wired Equiunient Wiretl Home Range Temporary Service Duplex ' Water Heater Liyh[iny Fiztures Apt. Building Dryer Electric Heatin Commercial Bldg. Furnace Silo Unloader Industrial Bidg. Air ConAitioner Bulk Milk T&nk Ferrit Othet vaciry 0111ur (SUer.f{y) t er ISUeiafy ther Othor Compute lnspection fee Se(ow q Fee ServiceEnheneeSiie q Fea Fexders/SUbleedars fl Fee Circuite 0 to 200 qm s 0 to 30 qm s 0 tn 30 Am s Above 200 qmps 31 to 100 Amps J 31 to 100 Am s Swimming Pool Above 700_Amps Above 100_Amps Transiormers Irrigation Booms c 7SO Partial-'Other Fee ?d Signs Special Inspectiun S T Rema ks • A i _ 1? 3V,GQ AL FEE a? nr) /..4VIOLd7, / J ,. ! \ O/••,`/ flough-in - D` Ei? I the E ocvicai ' spacmr. heroby ' tif M t th ' FinOl t ?; f OAIe f cer y e e nbove ? spection has been de. . TMx reauest vaiA 19 menfRS irom This request void 5-Z-2 C00.C.?/??lQ 35? (J Y 18 rtpn[hs from ??72'420 L??L Z^_ 3? ,So Request Date Fire No. Rough-in Invpec[ion RequireA? ?Ready Now ?II Notifiy Inspec- ?/ ?es ?NO tor When qeady 4?rcensed ElecVical ConVac[or I hereby request inspectlon oi above ? Owner elaeerieal work instelled at 5[reet AAdress, eox or Route No. / 8 . 13 CiN F cuon o. Township Name or No. Range No. Cmnty Oc unt (PqINT) as? o? n?sfi Pho e No. 3/ -3 s' Power Supolier iU , F:P. vivf?W Address Electncal Contractor (COm{?f?blY???j?J1 L++++" ?1W1 ?TtLT/ 5 LIGCf1S2 NO, ar MINNESOTA STATE BOAXO OF ELECTRICITY Grigps-Midway Bltlg. - Room N•791 1827 University Ava., St Paul, MN 56104 THIS INSPECTION HEQUEST WILL NOT BE ACCEPTED BY THE STATE BOAND UNLESS PPOPER INSPECTIpN FEE IS FNCI.OftFII cirr oF EaaaN N ? 7934 3795 Pilef Knob Raed Eagen, MN S5742 • ' PHONEi 454-6700 BUILDING PERMIT Receipf # To M wad fer 1 of 4 PLEX Est.Value $58,000 pate April 19 19 83 Site Address 3138B Farnum Drive Erecr )0 Occupancy R-3 Lot 2 Block 2 Sec/Su6. Coachman Land 2nd Alter ? Zoniny PD Parcel # 10 18151 020 02 Repoir ? Fire Zona NA Enlnrye ? Type of Const. Vn W Name COaCh[nan LdnCl Co. Move ? # Stories ; Addreu 2$32 Prior Ave. No. pemolish p l.ength 46 ° c; Roseville pho„e 636-8050 Grode ? Depth 26 Sq. Ft.- o Ncme Address 2432 PT10T Ave. No. ?t Assessment Permit 307•00 5 F Ci Rosevilie p?M 631-3254 Warer 8 Sew. Su.charge Z9 • 0?' Police Plon check153.50 F ?w Nome Fire SAC 525.00 ?Z ?a Addrea Enp. Water Conr/k S(1 _ 0(1 <"' Ci Phone Plcnner Water Meter 60.00 Councll Rood Unit 250.00 I here6y acknowledge thof I have read this apDlicotion ond stote thet gldg. Off. the inlormofion is wrrett ond agree to comply with oll opplicoble $1774 50 Slate of Minnesota Statutes und Ciy of Eagan Ordirqnces. APC . Total Sienature of Permittee RoSewood Const uction Division A Buiiding Permit Is issued to: m tha express condltion tFun all work sholl be done in occordonce wit II oppliw6ls, ate of MI o Statutes ond Ciry oi Eagan Ordinances. Bulld7np OfNciol ?? ., - aa+N ? Rosewood Construction Division Avvrorab Faos ? CITY OF EACaAN N? 7932 9793 Pllof Knob Road Eegen, MN 35143 PHONE: 454-8100 BUILDING PERMIT Receipt # ? Te bs med Mr 1 of 4 PLEX Fst.Value $58,000 Date Au ril 19 , 19-u- Site Addreu 3136B Farnum Drive Erecr 7{g Occuponcy R-3 Lot 1 Black Z Sec/Sub. Coachman Land 2nd qlrer ? Zonin9 PD porcel # 10 18151 010 02 Repalr ? Fire Zone NA E l T f Vn n arge p ype a Const. W Nome Coachman Land Co. Mo„e ? # Stories ; Addreu 2432 Prior Ave. No. pemolish ? Length 46 b Ci Roseville pho„e 636-8050 Groda ? DepYh 26 Sq. Pt.- ? Rosewood Construction Division Name ApP.orab Fae. 0 Address 2432 Prior Ave. No. f r;n. RncPVilla oL..__ 641-4254 Name _ Addrexi I hereby acknowledge that I have read this application and store that the inlormation is correcf and agree to wmply wilh all opplicoble State of Minnesoto Stotutes and City of Eogan Ordirwnces. Sipnafure of Permittee A Bullding Permit is Issued to: Rosewood Construction all work shall be done in occordance with oll appli le Stote of Building Officiol ?U1/ Y.f Assessment - Woter & Sew. Police - Fire Enp. Vlonner _ Councll _ Bldg. Off. - APC Permit 3U! . UU Surchorge 29.00 Plan check 153 . 50 saC 525.190 Water Conr?,+snn Water Meter 60. 00 Rood Unit 250.00 _ Total $1774 _ Sfl on the expresa conditlon Ihnt Statutes ond City of Eagan Ordinances. BUILDING PERMIT N° 7933 Receipt # To M wad hr 1 of 4 PLEX En yalue $58,000 pOfe A pril 19 1 q 83 Sira Address 3138 Farnum Drive Er a O R-3 e )a ccupnncy Lor 3 Block Z Sec/Sub. Coachman Land 2nd qlter ? Zoning PD parcet #_ 10 18151 030 02 Repoir ? Fire Zooe NA Enlarge ? Type of Const. Vn W Name Coachman Land Co. Move ? # Srories ; Address 2432 Prior Ave. No. pemolish p Length 46 b ci Roseville phone 636-8050 Grode ? Depth 26 Sq. Ft.- z Rosewood Construction Division Anorovals Fees o Name ?? AddfeSS 2432 Prior Ave. No. r r:... Roseville 691-795G Name _ Addreas I here6y ackwwledge thot I hove reod this opplicarion and state thot the inlormotion is correct ond agree to comply with all aDPlicoble State of Minnewto Statutes ond City. of Eagon Ordinonces. Assessment _ Water 8 Sew. Police _ Ft.e Eng. Plonner _ Council _ Bldg. Off. _ APC Permit J V/. V V Surchorge 29.00 Plon check 153.50 sAC 525.00 Woter Conn. 4 50 _ 00 Water Meter 60.00 Rood unir 250.00 Total $1774.50 Bulldinp Offkiol ?CITY OF EAGAN Sipnafure oi PermiMeo ? osewoo onstruct.jon Division A Building Permit Is issued fo: i on tha express wndition thnt nll work sholl be done in acwrdance with all rca6le Stot. /_-"pwosol'6'SPa_tutes and City of Eapan Ordinonces. 3793 iilef Knob Rood Eagan, MN 55722 PHONF: 454-8700 CITY OF EAGAN 9795 Pilef Knob 0.aed Eagan, MN 55141 PHONE: 4448100 BUILDIN51 PER'hAIT T. ?. ...e 1e. 1 of 4 PLEX $58,000 Site Address ??-?v raiuuu„i? Lot 4 Bi«k 2 Sec/SubCoachman Land 2i parcel # 10 18151 040 02 rc Name Coachman Land Co. ? Address 2432 Prior Ave. No. q Roseville pF,am 636-8050 o Name Rosewood Construction Division fu 2432 Prior Ave. North 8? Address ? r:...Roseville w,,,.,. 631-3254 Nome _ Mdren I hereby uckrwwled9e thot I have read this application ond stote that fhe inlormotion Is correct nnd ogree to comply with ali opDlicable Stafe of Minrrewta Statutes and City of Eogan Ordinances. N° 7931 Receipt .# ` ?r[.,-V1 e.ecr 7Vq acucancv R-3 Alter ? Zoning PD Repolr ? Fire Zone NA Enlarge ? Type of Const. Vn Move ? # Stories Demolish ? Length 46 Grode ? Depth 26 Sq. Ft.- Approrals Fsoa Assessment Water & Sew. Police Fire Eng. Plonner Council Bldg. Off. APC Permit Jvi w Surchorpe 29 • 00 Plan check1$3.$0 SAC 525.00 Water ConrkSO - f10 Water Meter 60.00 Road Unit 250.00 roral $1774 . 50 Sipnaturc of Pertnitlee ? A Building Permir Is issued to: Rosewood Construction Di?ision m the expreu condieion thal oll work sholl be done in accordonce with oll aODli le Stare.of Min wta Itpultes and Ciry of Eagan Ordirwnces. Buildlrp OfHclal CITSt OF EAGAN Include 2 sets of plans„ - 1 site plan w/ei.evations & ? BUILDIfJG PERMiT APPLICA'FION 1 set of enex'gy.calculations.. Rb Be Used For X Valuation Date Y` 7`8-S Site Pddress: 3i38 .? &2NUP OFFICE USE dNLY rAt z slorx z sec./sub.C'onr,kAQXz,uO.Erect occupancy Parcei ?d ( 8lS t O 20 d Z Alter zoning PO _ Repair Fire Zone ? Owner: i???gy?v_w (d?/ CD • ??e - T? of Const. -- Move # Stories Address: L? 3 Z- P/u(tt? (U . Demolish Front fi-. City/Zip Uale.s-j / 17-i Grade DePth ft. Ptcne #: L36- Sb,Sz? C011tTaCtor: ?t? ? Address: ?i ,t? tQ Ue c3ty/ziP Coae: Pnaie #: Ar+ch. /Frig. Address: City/Zip Code: Phom #: APPRDVALS FM - Assessments Water/Sewer Police Fire ? er C,ouncil Bldg. Off. APC Pexmit 30 `7 (ob Surcharge Z4 ? c) C) Plan ChecJc 53 ?.Sb SAC SZS,oC? _ Water Conn. qso , o t? Water Meter Coo 'o a Road Unit Zso? 06 zvra,i, - 1 `??? , SO _ • .- ??R CITY OF EAGr,-M Include 2 sets of plans, 1 site plan w/el.evations & BUIIDING PMIIT APPLIG4TZOP1 1 set of energy,calculations. ro He Used Fbr l c) ?-- q P( ? x valuation?J??i 06 o Date v ` ?'t ?, ;ite Pddress: 313(a 3 PAPPu,µ, (1/iM,W OFFI(E USE OfII.Y Lot Block ? Sec./Sub.&e7Gc ZN?1Erect Occupancy Z3 Parcel #: (O l'?o` ( S? d( a O 2- Alter Zonincl _- Fspair Fire Zone JFmer: 6y4 CO . Enlarle _ ? -- Z}'Pe of Const. TLIV ?,1 Nbve Address: ;?-(?37 /i,G(n , ??AJ m? Demelish # Stories Front y(? ft. aty/Zip Code:?risauftlL Grade DePth 8 £t. Phone #: r;2 3L - TDS"b APPRpVAIS FEES ---- ' ? xmtractor: 1 ? Assessments t?o?prrv?/ ??V & Pexnut '307 Address: Water/Sewer Surcharge - Police Plan Check :itl+/Zi.P Code?- / ' `/ Fire .r? SAC v`?O ,S Phone ? Eng • _ Water Conn. !7 ? ?--?- Planner Water Meter !cd !1rch./Eng. : Council Road Unit Bldg. Off. -? Acldress: APC _ :ity/Zip Oode: ehorie #: ? S Trn'P.L, ? ('1-I % CITY pF FAGALq Irclude 2 sets of plans, 1 site plan w/el.evations & BUILDING PERNIIT APPLICATION 1 set of enexgy_calculations. Rb Be Used Foi , 0?-- ? V?lti _K Valuation Date L(- 7- (?- ?') site paaress: '3136 ?R21JUM OFFICE USE ONI,Y wt 3_ alocx. -z sec./suu.?ft4404 I'Au0 Erect X_ occupancq 3 ._ Parcel #: ! o l`d l5 ( O'? C) 0 2 Alter zoninq Repair Fire Zone ? Oaner: Enlarge _ Z'ype of Const. _y Move # Stories Address: 3 Z P/LXOvALW • Decolish Front tt- City?Zlp Cbde?osto;tl? CKJ i 1 2J Grade Depth ft. Phone #: C 36-lz0 5b oDntL'aCtor: nt,??, &U-? Address: 437, citl,/ziP coae: S511 3 Pncne #: 63?- 3 2,?54 Arch./Eng. ? ??Ukp?1 /(/! • Address: -? City/Zip Oode: Phone #: APP%)VAI.S FEES --Y_ Assessrents Water/Sewer Police _ Fire EnJ • Planner Council Bldg. Off. APC Permit ?36 Surcharge Plan Check /S3 sHC Water Conn. Water Meter Road Unit SO -120 _ z+=L r? ?? 3- 1 y CITY OF EAGAN Include 2 sets of plans, L 1 site plan w/el.evatiaris 6 - BUZLDING PERNIIT APPLICATION 1 set of enexgy calculationso 7b Be Used Far ? oF ?{ pltiX vai,lation S?M poo Date Ll '-7 - $- 3 _ site paaress: 3 r N> Fka.uu,w f?V? 'f cn r r?ot +? 91orx. 'vsec./suu. Erect -e- Paxrel # : OHmer: ?/jYtC6w ? Address: {% r?-? 3 L A./r'' /? ?1c , ?Uo c;.ty/zip coae: ?v?'l1L .SS//3 Phone #: fv,3??. - ?O.Sb Contractor: ?? l_inad7l ? Address: 0 ? City/2ip Code: ;?.+?sL ^ S.?i 1 l?j Phox?e $: FsZ. 1 Ht+ch./?g.: [?Ler.c ti/Lau,o.?/H, Address: Move Demolish 6rade OFFI(E USE ODII,Y Occi?pancp Fire Zone 'i A ype of Const. ? # Stories Fmnt f i pepth . ft. APP%)VALS F•? --- Assess[nents Water/Sewer Police Fire ? . - Planner Council Bldg. Off. APC Pennit ,30 ? ? Surcharge gly Plan Check SAC 6 _ Water Conn. SO Water Meter (?. Road Unit S<St7 City/2ip Code: Pnone #: 5 O ter O? oZ R?ep r ??? C?u1' ? Enlarge ? ?4;? 1 2006 RESIDENTIAL BUILDING PERMIT APPLICATION ? ,:;k 1 ? - ;, r=> City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Conshuction Requirements 3 registered site surveys showing sq. ft. of lot, sq. ft. of iwuse; and all roofed a2as (20%maximum lot coverage allowed) 2 copies of plan showing beam & window sizes; poured found design, etc. 1 setofEnergyCalcula6ons 3 copies of T2e Presenation Plan if lot piatted aher 71153 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Minnegasco mechanipl ventilation (ortn _.___ RemodeVReoair Reouirements Offce:UseOnN 2 copies oF plan showing footings, beams, joists Cert of Survey Recd N 1 set of Energy CalculaUOnS for heated additlons Tree Pres Plan Recd _Y _ N. 1sitesurveyforaddifions&decks TreePresReguired _Y _N Adddion-indicateilon-sifesep6csystem Onsile5eptic5ysiem _Y _N Date 12 0,6? Construction Cost ?? ? o cD ? Unit/ste # Site aaeress ?--c Descrip[ion of Work -???, oLf G c i? wAe- fo t?o ci 2 Multi-Family Bldg ? N Fireplace(s) _ 0 _ 1 _ 2._3 -47' j Property Owner roi lY rTelephone #( ) As LOlkl Contractor address City State .?? `v Zip Telephone #( 7f3) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category . Residential Vendlation Category 1 Worksheet • New Energy Code Worksheet (Jsubmissiontype) Submitted Submitted . Energy Envelope Calculations Su6mitted - In the last 12 months, has the CiTy of Eagan issued a permit for a similar plan based on a masTer pian? _ 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 information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval ofplans. Applicant's Printed Name ApplicanYs Signature 2004 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX 4 651-675-5694 13 New Construction Reouiremenis RemodeVReoair Reoui2meMS Oifice Use Onlv 3 registered site surveys showiig sq. ft of lot sq. ft. of house; and all roofed areas 2 copies of plan CeR W Survey Recrl _Y _ N (201/o maeimum lotcoverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd Y_ N. 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for addNons & decks Tree Pres Required _ Y_ N 1 set of Energy Calcula6ons Addifion - indicek i(on-sife septic sysfem On-site Septlc System _ Y_ N 3 copies o( Tree Pieservation Plan if lot platted afler 711193 Rim Joist Detail Optlons selection sheet (bldgs wAh 3 or less uniLa Date Constructio¢ Cost r7? - -1 Site Address ? CR ?(Y\. k_? w_ l- UniUSte # ? Description oF Work Multi-Family Bldg _ Y_ N ireplace(s) _ 0 _ 1 _ y . ? Property Owner Telephone # ( ) Contractor i ? Addresa n Ci State Zip??1 Telephone # &-) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted 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 Telephone #( Telephone # ( Telephone # ( ) I hereby apply for a Residential Building Pernut and aclrnowledge that the iaformation 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 app;eqal of plans. jn Applicant's P4i7fted Name U-ApplicanYs SwNttitre /V/ ? 2004 RESIDENTIAL BUII,DING PERMIT APPLICATION City C5f Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reaviremenls RemadeVReoair Reoui2menLs 3 registered site suneys showing sq. ft. of bt, sq. ft M house; and all roofed areas 2 copies of plan (20% maximum bt wverage allowed) 1 set of Energy Calculations for heated addl6ons 2 copies of plan showing beam & window sizes; poured found desgn, etc 7 site survey for additions & decks 1 set of Energy Cakulations Addifron - irMicate i(onsite sepfic system am 3 copies of 7ree Preservatiun Plen'd bt plaftd atler 715193 Rim Joisf Detail Options sefectlon shcet (bldgs with 3 or less unils Date Il /ILP?kc! Construction Cost 10,01C-n- Site Address Unit/Ste # Description of Work??&a? ?? n?t 1S ????CS'? ?? 1??7 •13'f?: 5'?? Multi-Family B1Ag _ Y Z( N Fireplace(s) J 0 _ 1 _ 2 Property Owner L-CsjA..P Telephone # 165 L) qSZQ_"S-Z. RENEWAL BY ANDERSEN Contracmr 1920 COiJNTY RD. "C" WEST Address ROSEVILLE, MN 55113 City 651-264-4777 State Telephone # ( ) LICENSE #20130983 - COMPLETE THtS AREA ONLY fF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy COde CBtegory . Residential Ventilation Cafegory 1 Worksheet • New Energy Code Worksheet submission typa) Submitted Submitted • Energy Envelope Calculations Submitted Have you preyiously constructed a building in Eagan with a similar plan? fee applies. Licensed.Plumber Mechanical Contractor Sewer/Water Contractof ? ? !C Iti ' t JUN "L a 6114 ? Y Telephone #( Telephone # ( Telephone # ( I hereby apply for a Residential Building Permit and acknowledge that the information ij complete and accurate that the work will be in conformance with the ordinances and codes of the City of Eaga?? of" 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. OCIa? ??? ?,sn?l Applicant's Printed Name A licant's Signature N If so, 25% plan review Y VVP V d I 4V'/1 .uv ?c . o? rna r od o! 1-?;00 Kary?ry?, ?p. ?U?? re al .? . . 3une'7,200) City of Eagan . 3836 RiIcrt $nob Rond I:a$an. MIN 55122 To Whom It Maq Crntoern: EIder 7ones is suthorjzed to ptM buikUng pftmits for Renewal by .4adeism_ PIease alIow Eldcr Jott" to provide this seryice for us in F,agan. 'Ma enthpri2?qpn ?4 vaiid for eny w date theCttybcyond 6/6l0 I: until a?oy,4 by ??n ??Y ?y? it in wii? - I rcquest this authoxizaflon Be accepted expedidonaly, es W not dela rhe- ' ovr building pcanita ?y fprthcr. Picaac caII mc if thcro ara nnY Y• m P?Witg of cantacted at 763-502-4'7U6. 4?ona•.z caaixi _ 1: r Your immqdiate attcation to tflis matter 3s a?m6arm. 5inotYivly, ymond R Rau nscalIation Managcr Ranowal by Andascn CorPvration C:c: TCnrn_F.iAr.r 7nnec ?4 Gk d P„? ?mi? ?ist„,Zo, Received Tiroe Jun. 1. 1'07p}d . W BIU ; 2004 RESIDENTIAL BUII.DING PERMIT APPLICATIONZA? ? City Of Eagan 3830 Pilot Kuob Road, Eagau MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construdion Reou(remenffi Remodel6teoair Reauiremems 3 registered sife surveys shaving sq. ft of bt, sq. ft of house; and all roofed areas 2 copies of plan (20% marimum Wt coverege aibwed) 1 set of Energy CalaAations fw healed edditions 2 wpfes of plan showing beam & wiMOw sizs; poured found design, ek. 1 sde survey for additions & decks 1 set of Energy Catulations AaN'dion • indicate if onsfte septic sysfem ME 3 capies of Tree Praservatlon Plan'rf lot platted after 711/93 Rim Joist Detail Options selection sheel (bldgs with 3 w less uniLs Date Construction Cost Site Address ? 3! " f Unit/Ste # Description of Work Mu1tI-Family Bldg x\Y _ N T Fireplace(s) _ 0_ 1 _ `/ Property Owner??.-? . 4 Telephone # ( ) Contractor t Address.Z;2 ? City State ?y7 Zi Tele hone # ? P P (? ) -;DZ{4S NCeG ? COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Ene Code Cate -M?Ilesota Rules 7670 Caterv 1 _ Minnesota Rules 7672 ?y 9ory . Residential Ven0lation Category 1 Worksheet • New Energy Coda Worksheet (Jsubmissiontype) Submitted Submltted • Energy Envelope CalculaBons Submifted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Telephone # ( Mechanical Contractor Sewer/water Contractor Telephone #( Telephone #( I hereby apply for a Residential Building Permit and aclaiowledge that the informarion ???omnlete anZ? accurat?; that the work will be in conformance with the ordinances and codes of the City of Eagan ana zne ?iate arivri? Statutes; I understand this is not a pemut, but only an pernut; that the work will be in accordance with the apl approval of plans. ApplicanYs Printed Name for a permit, and work is not to start without a in the case of work which requires a review and OFFICE USE ONLY Sub Types ? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ?P 18 Deck ? 23 Porch (screenlgazebo) ? 38 Multi Misc. ? 05 03-plex 13 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous Work Types ? 37 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Buifding ? 42 Demolish Fnundation ? 45 Fire Repair ? 33 Alteretion ? 37 Demolish Building` ? 43 Reroof ? 46 Windows/Doors )ZD 34 ReplaCemBnt `Demolifion (Entire Bidg) • Give PCA handout to applfcant Valuation 0od, Occupancy --3_ MCES System Census Code y3 zoning 2-3 Citywater 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) ?Q FinaUNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Ice & Water _ Roof Final _ Pool Ftgs _ Air/Gas Tesu Final _ _ Framing _ Siding _ Stucco _ Stone _ Brick _ Fireplace _ R.I. _ Air Test _ Final _ Windows _ Insulation _ Retaining Wall Approved By: M/?" , Building Inspector -------------------- ------ -------- -- -------- --------- ------------------- ----°- Base Fee Surcharge Plan Review MC/ES SAC City SAC Utilify Connection Charge S&W P'ermit & SUrcharge Treatment Plant License Search Copies Other Total 18150 COACIiMAN LAND CO 1ST 18151 COACffiVIANI,ANDC02ND 18152 COACHMAN LAND CO 3RD 3136/ 3136B 3138/ 3138B 3140/ 3140B/ 3142/ 3142B 3141/ 3143/ 3145/ 3147 10 18151 040 02 01002 030 02 020 02 10 18151 040 03 01003 030 03 020 03 10 18150 010 02 02002 030 02 040 02 10 18151 030 04 01004 040 04 020 04 10 18151 01005 02005 03005 04005 FARNUM DRIVE PAGE20F2 3144/ 3144B/ 3146/ 3146B 3148/ 3148B/ 3150/ 3150B 3149/ 3151 3152/ 3152B/ 3154/ 3154B 3153/ 3155 3156/ 3156B/ 3158/ 3158B 10 18150 020 04 030 04 10 18151 01006 020 06 040 06 030 06 10 18150 01003 020 03 10 18151 010 07 020 07 040 07 030 07 4-plex 4-plex 4-plex 4-plex 4-plex 4-plex-othcr 1/2 ° 1575/1577 Four Oaks Rd 4-plex 4-Plex-Other I/2 = 1571/1573 Four Oaks Rd 4-plex 9 OFFICE USE ONLY BUILDING PERhIIT TYPE ? 14 Fireplace WORK TYPE O 31 New ? 33 Atterations ? 32 Addition ? 34 Repair GENERAL INFORM.4TION Census Code. 434 SAC Code 01 REMARKS Chimney/flue must be inspected before concealing. 3 q "-)- ?_-) ?-- CITY OF EAGAN 3830 PII.OT KNOB RD - 55122 1998 FIItEPLACE PERMIT APPLICATION 681-4675 DATE: 12" /jo Name: Pi l? l,k `2. e va- V-\ P6one N: Last First DESCItIPT'ION OF WORK: _ Construct new fireplace _ Aherations W existing _ Install Pas insert onlv Install line onl X Other LtJ?d? /14?JJ A.v1OA , AAh0.1 qy ? ? Farnu o - JOB ADDRESS: LOT: ?- BLOCK: ?. SUBDMSION/P.I.D. #: LbC?C_G1 VK(A V\ LCi VIA APPLICANT (circle one only): OWNER CONTRACTO I hereby acknowIedge that I fiave read this appGcarion and stace that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. PROPERTY OWNER FIREPLpCE INSTALLER GAS LINE INSTALLER 's r?o ? ) -,)--I(, -,? E--? PERMIT FEE: $50.50 Street City State: Zip: S? I -D- I Phoae#: (0/2 `1D>38..j8 Strcet Address: ,u W Licrnse # CrtY Li1a.? State: At) ZiP: ? PERMIT CITY OF EAGAN ? 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (651) 681-4675 SITE ADDRESS: P,:I:..N.: 10-181.w1-03H--t?"' DESCRIPTION: ax 3 a FaRNUr=i uR i.c;T; 30131.or..K: 2 CC1f4CHMNPJ LAND CQ :;LIP,AD PERMITTYPE: e[i 1 1.1) zH r Permit Number: 0 .i 4 2 3 8 Date Issued: ,i. ) /Z6/ q8 G,45 IPlSER7IL1NES fLQC 8i.aAA dimi.t l"yne FIRLF'L Ar,E N?ikdinq Wa"t?k Type ALTEF2ATIClt?1 6hSGS Cot}E -\,, 4 314 131..1", RF"ID'r"N711A1- -s REMARKS: - CH7MNEY/FI_UE i%UST CE INSPECT'EU BE'FORE CUiVCE7.lL.7:PIG. UN II' B, . FEE SUMMARY: Surcharae 0 C 0 _ lOLaJ. f2G $60.!'o CONTRACTOR: - Aoa -? dcant - fIIR QUflL'1'TY SEftVICES L401.3838 3940 LESLIE CUIR EXCEI.SIpft MN 55331 612 ) 4 0 1 - 3 83 5 j OWNER: RRl1E E, VFiiV 3238 Ffa(dNUM DR EFIGAN hiN 551z1 I hereby ack.nowledge tliat r hstve read 'Ctiis npplicatit5rr arrd' state thaC ttto infarmation is eort-ect aiic{ a4ree tfl eomply wztH a1l applicable Statc ot Ifln. 5tatuTes and Gity tpf Eaqatt Qrcttnahcss. APPLICANT/PERMITEE SIGNATURE (1\ P t? SUEO BY: SIG1ATURE I CITY USE ONLY L e7 q BL ? /J 1 RECEIPT #: SUBD. 1.B?I "?Ol "?/. RECEIPT DATE: PERMIT# 1999 PLUM$INfi PEfiMIT (f{ESIDEN'TIAL) C11']' OF £1kfiAN 3$30 PILOT KNOB RD £E46AN,1NN 55122 (651) 6$1-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system FIXTURES EACH TOTAL Bath tub $ 3.00 x = $ Floor drain 3.00 x = $ Gas i in outlet ' minimum -1 3.00 x = $ Hot tub/s a 3.00 x = $ Kitchen sink 3.00 x = $ Laundr tra 3.00 x = $ Lavato 3.00 x = $ Minimum fee alterations to existin dwellin 30.00 x = $ 30 • Private Dis osal S stem new/refurbished ' re uires MPC iic. 75.00 x = $ Private Dis osal S stem abandonment 30.00 x = $ RPZ new installation/re air 30.00 x = $ Rou h o enin 1.50 x = $ Shower 3.00 x = $ Under round s rinkler if dwellin is under construction 3.00 x = $ Under round s rinkler if existin dwellin 30.00 x = $ loset 3.00 x = $ Water heate 3.00 x = $ ater so tener if dwelling under construction 5.00 X = $ Water softener if existin dwellin 30.00 x = $ Water turnaround 30.00 x ---- _ $ State Surchar e 50 --> ----> ----> $ 50 Totai --> --? ----> --°> $ a ? Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc. ..----- -----------------?-------------------,--" ---------------------------------------------------------- ------------ I hereby acknowledge that I have read-this applicaGon state-that-Ihe informafion is correct, and agree to comply with all applicable City of Eagan ordinances. It is the applicant's responsibility to notify the property owner ihat the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-wayfeasement. SITE ADDRESS OWNERNAME:: TELEPHOf'#:J??a - n [5 ?- ? r ?i9ti^? (AREA CODE) INSTALLERNAME: u'IY/vJik-4 TELEPHONE#: 7/?Y STREET ADDRESS: J I3 ? I}?? ? p, (AREA CODE) CITY: STATE: w SIGNATURE OF PER TEE L 0`'' ?/ ?I CITY USE ONLY RECEIPT #:9 ? d? B 7el SUBD. rxTw) RECEIPT DATE: 1/6 / PERMIT # 1999 PLUM$INH PER14iTP (RESIDENTIAL) cTTY oF EAs,aN S$SO PILOT KNOB iiD £Afi141V, AiN 55122 (651)6$1-4675 Please complete for: ? single family dwellings • townhomes and condos when permits are required for each un4t ? 6ackflow preventer for underground sprinkler system FIXTURES EACH # TOTAL Bath tub $ 3.00 x = $ Floor drain 3.00 x = $ Gas i in outlBt ' minimum - 1 3.00 x = $ Hot tub/s a 3.00 x = $ Kitchen sink 3.00 x = $ Laund tra 3.00 x = $ Lavato 3.00 x = $ Minimum fee alterations to existin dwellin 30.00 x = $ Private Dis osal S stem new/refurbished * re uires MPC iic. 75.00 x = $ Private Dis osal S stem abandonment 30.00 x = $ RPZ new installation/re air 30.00 x = $ Rau h o enin 1.50 x = $ Shower 3.00 x = $ Under round s rinkler if dwellin is under construction 3.00 x = $ Under round s rinkler if existin dwellin 30.00 x = $ AVM-er-cToZM--? 3.00 x = $ Water heater 3.00 x = $ if dwelling under canstruction 5.00 x = $ Water softener if existin dwellin 30.00 x = $ Water turnaround 30.00 x ---- State Surchar e .50 --> ----> ----> $ 50 Totat --> --> ----> ----> $ 3 0. o Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc. ------------ --------------- -------------------- ----.._..- -- -------------------- -------- ------- - --- -------------- ----- I hereby acknowledge that I have read this applicafion, state fhat the information is covect, and agree to compiy with all applicable City of Eagan ordinances. It is the appficanYs responsibility to notify the property owner thai the City oi Eagan assumes no lia6ility for any damages caused by the City during its normal operational and maintenance activiUes lo the facilities constructed under this permit within Ciry property/right-of-wayleasement. SITE ADDRESS: OWNERNAME:: Le>r TELEPHONE #: ?' O C7 eZ ? (AREA CODE) INSTALLER NAME: /Ic. jd?Xexwf TELEPHONE #: 6f? - E STREET ADDRESS: G y ? 30 V ?c l? ? (AREA CODE) ?"???s / r4 ,? CITY: ?-L.A STATE: ZIP: ?S SIGNATURE OF PER EE CITY OF EAGAN WATER SERVICE PERMIT , 3795 Pilot Knob Road 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: 1 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 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: By Misc. Charges: Dote of Insp.• Total: Insp.: Date Paid: