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4325 Kaufmanis WayCITY OF EAGAN Remarks Addition WILDERNESS PARK 211d Addition Lot 6 Blk 3 Parcel 10 84251 060 03 Owner Street State Eagan, HA1 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 69.40 C008541 9-26-83 SEWER LATERAL ? WATERMAIIV WATER LATERAL WATER AftEA 1979 827.20 82.72 413.60 C008541 9-26-83 STORM SEW TRK 1979 STORM SEW LAT CURB & GUTTER I SIDEWALK STREET LIGHT ROAD IT 250.00 36311 6-9-83 WATER CONN. 450.00 Ir tt BUILDING PER, 8125 SAC 25-00 n ?+ PAR K Cities Digital ( Control The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. , ,• • CASH RECEIPT ? CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 R¢C EI V ED FROM ' AMOUNT $ I & DOLLARS ?oo ? CASH ? CHECK ?oR White-Payers Copy V Yellow-Posting CoPY Pink-File Capy T You BY CITY OF EAGAN _. 3795 Pilot Knob Raed Eogoe, MN 511122 t• _ 6? ?.. .. PHONEs 454-8100 - BUILDING PERMIT Receipt Te be used ior 5I' DtdG/GA?. Est. Volue $31, 000 Dare J ? une 9 , 19 83 Site Address 4325 K.3ufmRri18 L1AV Erect ? Occupanty 111- 3 Lor h Black _..3_ SeclSubWilderne8s Parl: 2ttd ^lter p Zonin9 R-1 parcel # 10 84251 067 03 Repair ? Fire Zone :.3A E T V nlorye p ype of Const. W Nome :' • '?eterSen ConBt. . IAC. ?? ? # Stories Z Addrcss 4701 W. 110Ckt St. Demolish ? Length 53 9 C; nls, 55437 phane 334-5144 Grode ? Depth 4`-' Sq. Ft. lz 0 Nom@ Owner Approrals Fea• u Address Assessment Permit 17 6-W) ? ~ Cit phone Water & 5ew. Surche?ge 4[] _ 50, ? Potite Plan check 1 RR _ Clfl W Name F 0() 525 A ire . 5 C ?? /?ddress Enfl. Wnrer Conn. ,?3.`1d_ ilCi ? W City phone Plcnner Water Meter A-1-0.1 Gouncil Road Unif ? 50 00 1 hereby acknowledge that I Frove reod this application and stote that Bldg. Off. the inlormotion is carcect and agree to comply with all applicuble ?? State of Minnesota Stotures and City of Eagan Ordinonces. Totol ??,?..,.?? Siynoture of Pemnittee A Building Permit is issued to: S. Petersen L'on4t., Inc. on the exprcss condition thai all work shall be done in actordonce with oll oppliooble State of Minnesote Siatutes ond City of Eagan Ordinancta. Buildiny Offlcicl Permit No. Permit Holder Misc. Permit No. Holde? IR n Z , /L -2? l za EbMr'c (Oa5$QSg' ?Set?ASb S-17-Y3 -?E ? wes-rQ 0 `? `` 7?zt?-S3 Inspection Date Insp. Other Footings FoundBtion Framinp Js? Rough Plbp. Rouph HVAC Inwlation 7 ? Final Plbp. ? Final HVAC . Final ? WMer Describe Lacation: w.n . sewor Pr. Oisp. . Receipt -?` MECHANICAL PERMIT CITY OF EAGAN Fill !n numbered spaces Type or Prin[ legib/y ? r % Permit Na - Fee ' f S/C -? Tot. ? ? 1. Date 2. Instaliation Cost 3. Job Address LotBlk. 3_ Tract 2r? 4. Owner 5. Contractor Phone -?-? ? 6. Address '7 s 7. City State %ti----, Zip 8. Building Type: Residential H'' Commercial ? Institutional 11 9. Work Description: New 0- Add ? Alter ? Repair ? 10. Describe Fuel Type _".&V0-'? 11. No, - Eauioment 8TU - M. Ea. Forced Air No. EQUiament CFM Air Handlin : Mfg. g 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 ppverning this type of work. f, . Signed : -?- for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-8100 r ??? Receipt -•? ' PLUMBING PERMIT Permit No. . CITY OF EAGAN + . ?? Fae _ _... ? F Fi!l in numbered spaces S/C Type or Print legib/y Tot. 1. Date 2. Installation Cost -?. 9? i_ ?. i i . , ;. : ( ?? ?• i? . 3. Job Address , LotBlk. ? Tract 4. Owner - ? ' - ? 5. Contractor 6. Address 7. City . ' , .. 8. Building Type: ResidentiaE?- i 9. Work Oescription: New,V 10. Describe Phone I State Zip ? Commercial ? Institutional O Add O Alter O Repair ? 11. No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other t' 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 OF EAGAN WATHt SERVICE PERMR 383+0 Pii, . Knob Road - P O B 21199 PERMIT NO : , ` -- . . ox . Eagan, MN 55121 DATE: 6-2 0-LA I Zoninp: iI No. of Units: 1 Owner: ?3vea Pe;,tr3e Add?esS: Site Addrcsr 432` ^:ftu:'ra.nis 'da;f L(. ?33 Wilderaeas Park 2nd PlUR1bEr: + r No : AAet Connection Charye: !; %`: .00 rd . e Size: Account Deposit: ^ . ?JO F>c' , " Recder No.: Permit Fee: I ayree M oasPly wilk !he Citp of Eeyaa Su?chorge: • 50 I)d Gdt.esaa. Misc. Choryes: =•0.00 oci meter By Dote of I nsp.: Total: Date Paid: Irnp.: SEWER SERVICE PERMIT cmr oF :,.GAN 3795 PIIot Knob Roe/ PERMIT NO.: Eegan, MN 55122 DATE: Ianinfl: No. of Units: ` OWflBf: ^r•.,P-_`fi:..? . _. ,^._i'fi . Address: Site Address: '.;25 Kaulhania wa;r ,.,-r.e`:s - Plumber. ) ^• 1aym fo amplq wltb tIN Cthr of Eagen Connection Chorge: •`' " Ordinanop. Acwunt Deposit: R? Dote Of Insp.: Permit Fee: • ?'?? 5urcharpe: Misc. Charges: ?C-f9T 6119C<`v4,097101t,1 jL-T? 25 -- --- r-c 4l374 ,qivo?eo1vFOA,,?,?y i'rz oF ?c,ruv -?0 - ? l nsite plan w/eleva ? tions s BUILD2NG PERNIIT APPLICATION 1 set of energy calculations. To Be Used For Valuation ? Date ?/ - ?.3 Site Address :q j,? S??? yAa vt t,S?a OFFICE USE ONLY ? OC2N?Sf t,ot slock 3 sec./sub.((f/L ,od,eK ,2?? Parcel #: (O $?( ?S l o iop Qaner: Fiidress: /-W City/Zip Code: fy/?G3' hS4<3 7 Phone #: ,(,yY- /415? Contractor: ,/7y Address: City/Zip Code: Phone #: Arch./Eng. : Address: City/Zip Code: 4 hone #: OLE cI PQrn.ti+ -Wo5'?j?fS$ Erect ? Occtitp?-umcy 3 Alter Zoning Repair Fire Zorie Enlarge Type of Const. Nbve # Stories Demlish Front ft. Grade Depth y ft. APPROVIILS FE?S Assessments Peimit _m? 7/ aba Water/Seaer Surcharge 5M ? Police Plan Check Fire SAC Enq. Water Conn. Is-o 0 Planner Water Meter 0 Council Road Unit R( S'Q T Bldg. Off APC TO'I'AL I p ? a l 5c) ? K??- ?t`Pn.Son ?(EL? -S-L1-£r3 C?? CITY OF EAGAN 9795 Pllet Nnob Reod Eagan, MN 55IZ2 PHONE: 431-8100 BUILDING PERMIT To ba utad for SF DWG/GAR Est.yalue $$1,040 N° 8125 Receipt # a-311 n_._ June 9 e 83 Site Address 4325 Kaufmanis Way Erect $g Occuponcy R-3 Lor 6 Biock 3 See/SubWilderness Park 2nd Airer p Zontng R-1 parcel # 10 84251 060 03 Repair ? Fire Zane NA Enlarge ? Type of Const. V rc Na,ne S. Petersen Const., Inc. Mave ? # Srories Z Addreu 4701 W. 110th St. Demoltsh ? Length 58 ? Ci M pls. 55437 phom 884-5144 Grode p Depth 49 Sq. Ft.- p Name OWiler Avororels Faes ??? Address 1- r»., Name _ Address I hereby acknowledge thof I have read this opplication and stote Thot fhe inlormotion is correct and ogree fo comply wilh all upplicoble Stata oi Minnesoto $totutes and City of Eagan Ordinances. Assessment - Water 8 Sew. Police - Fira Enp. Planner _ Councll _ Bldy. Off. _ APC Sipnoture of Permittee ' A Buildin9 Permit is issued ro: S. Petersen Const., nc. all work shall be done in occordonce with utl auolic4ble Staf inne! Permit Z)Io.uv Surcharge 40.50 Plan check 188.00 SnC 525.00 Water Conn. 450.0 Woter Meter 60.00 Road Unit 250-00 Total 91889_50 on the expreu Wndition Ihnr Statufes ond Cify of Eagan Ordirwnces. Building Officiol REQUEST FOR ELECTRICAL INSPECTION ' See inelrucirons tor comvleling this torm on back of Vellow copy. R" BeRWAred by 7his Request EB-a0001-04 w: 35S Ad flep. Type 01 BuJtlmg ApplmncBS W.retl Eqmpm¢nt WireJ Home Range Temporary Service Duplea Water Heater Lightiny Fixtures Apt Buildmg Dryer Electric Heatin Commeraal 81dg. Furnace Silo Unloadc;r Industnal Bldg. Air Condi[ioner Bulk Milk Tank Farm Othxr peci y therlSpomW1 t er Sueufv Ot er Other Can'unute lnspecUOn Fee Selow k Pee SarviceEnttanceSiz H Fee Feptlers/Suhfeeders # Fxe Circurts 0 to 200 Am s 0 to 30 Am s () ta 30 Am os Above 200 qmps 31 to 100 qrnps 31 to 100 Am s Swinvning Pool Above 700_Am s Above 100_AmPs Transformers Irrigation Booms I sm P2rtial-'Other Fee Signs Speciallnspection S TOT YFE a,?? /? F ertu?r"I ' l.. . # / iw ni^,l as v? flough ?n ? ?rte I, t ctrical Inspector, hereby eertify ehet the nbove Final .nspeciion has been ? .?, ? //T/ made. Iamnn?natmm . - . ,^/ This reyuest void S_-? ? 18 rtwnths f-om w 05?RQ58 L4ai 63? wrld.I PKIarid 35 gto I Eot ob Bepuest Date ?f Fire No. Nouph-in Inspecbon Reqwred? ?Ready Now Will NobtY Inspec- ' ? 3 ??es ?NO ?or When ReatlY Licensed Electnc?l Co?ttractor I hereby requestmspecLOn of above ?Owner electncal work installed ne Street Address, Box or floute Np. - ?Q QtY 11395 Sectipn o. Township Name or No. Range No. County Ocp,l,ipant (PRINT) .5 Phone No, Pa er S D] Addre Eleclncal ontracmr (COmpany Name) ! Con tof's Lmense No. ? y? iling Address (ConVactnr or Owner Ma M king Instailatmn) q G ? • Au[h ized S?g^amre I nt r/ wner ak?ng I tallaLOn) Phone Number v S' ? I ? ` THIS INSPECTION flEa49ST WILL NOT MINNESOTA STATE BOARD OF ELECTRICITY Gnggs-Midway eldg. - Noom N491 BE ACGEPTED BV THE STATE 90APD 1821 University Ava., St. Paul, MN 55106 UNLESS PPOPER INSPECTIDN FEE ?S ENCLOSEO. ? REQUEST FOR ELECTRICAL INSPECTION Sae inetruetions for compleUmJ this iwm on beck oi yellow copV• 058963 "X" Below Work Covered by This Request EB-00001-Oq 3-73a3 Atld Rap. Type of eviltlmg ApOliaaces Wired Eqmpment Wired Home oO\ Bange Temporary Service Duplez Water Heater Lightin, Fixtures . Apt. Bwidmg ?ryer Electnc Heatin Commercial Bldg. Furnace Silo Unloader Industnal 81dg. Air Condrtioner Bulk Milk Tank Farm otner oeci y t er Ispoafyl [ r,r Suecrty Oiher Other _ Compute /nspectron Fee Below p Fea ServiceEntrance5ixa N iee Faetlers/SUbieeders Fen Cvcurts 0 to 200 Am 5 0 to 30 qm s to 30 Am s Above 200 qm s 31 to 100 qmps 0 31 to 100 Am s Swimmin Pool Above 100-.4m s Above 100_P,mps Transformers Iuigatton Booms Partial%Other Fee Signs Special Inspectio? S TOTA Rercarks? r ,7 6 ? n _(9(? c..- r,J i71 aN i,v / r ri o-WJ,&_ "v- kir w --1 Pouph'm Date 1, the Ele mal I r 3 ?ntioec,o,, ha,abv certify that the n6ovs Final inspaction has baen ?/ ???7.• C? mada. Thls reouest void 18 montR4 from This recIcest vmd 7-Z(p 18 mo:rths.fmm W058963 UaI ks 31 w 1- (d- PJ? .:2 na 373a3 ?a.oo floquest ?ele Fire No. Rough-in Insoectio7 ReaVyred? Aeatly Nuw I]CW?II Notity Inspec- 0 y? ?? ? N?es No r?tir When fleady l, censetl ElectnCal Contrador I herebv reQaeat mspection of ebove O.er electrical work instelled er. Stregt Atldres6 11or Route Na. c Gty . ? 1* ecl onn o. Township Name or Nango Cowity P k / c l Occu antIPRIN ? rsP LD f,? Phone No. c ? Ys ? Power S Pp ier ? Atldress ? Electncal Conv ctor ICompenv Namal ? Contrar,tpr's LiCense No. L dress (COnvactor ar Owner Mjng Madmp lauo ? ? AuMonzetl Signawre _ZWr torl nar Making InstallalioN PJh$? n?e Number h J (? `?SJ eo`?' / J THIS ?NSPECTION NEQUEST WILL NOT MINNESOTA STATE BOARD OF ELECTRICITY Gr,gga•MidweY Bltlg. - Noom N-191 8E ACCEPTED BY THE STATE BOARO 1821 University Ave., St. Pevl, MN 55104 UNLE55 PROPEH INSPECTION FEE IS ew....., 19111 24z2i1t ENCLOSED. (g.ertiftrttte n# (Orrixpttncy Citp of Cagan Erpttrftnrnt nf BuilDing 3ns}rrrfinn Tbit Cntifirutt irtued Purtuant to tbt nguinmrnts of Sectron 306 0( tix Uniform BuiGling Coda crtifying that at the timt of iftuann thit strunure wat in tomplianrr with tbc variouJ ordinanrts o f the Cuy ngulating building mnnruction or xx. For the f ollowing: 11.cum?m SF DWG/GAR MdLPeemitNa. 8125 oao? ryK R3 7Ywcm.?nm V F;mz NA z, wm« Rl OrmofBUOMj S. Petersen Const. Aaa?4701 W. 110th St., Minnea 8,??,,,4325 Kaufmanis Way L;,YLot 6,Block 3,Wilderness ??F ? Park 2nd August 30, 1983 &?Wnoffkw .69- mo: .c.. i. . cex...cuw. ...<. ? s4 PERMIT# LS D- I U ? RECEIPT DATE: SOOE USIDENTIAL PLUM$INH PEitMTT APi'L1CATION CITY UF £R6AN 3830 PaoT Kxog Etn EAs,ax, Mx 551E2 651-891-4675 Please compiete for: single family dwellings, townhomes and condos when permits are required for each unit, backfiow preventer for irrigation system SITEADDRESS: _ 1Kl.lsGLan [ S V V OWNER NAME: : ?/? L? L ? ? D Ly ?o TELEPHONE #: (U5' ) 70"I 2, (AREA CODE) INSTALLER NAME: STREET ADDRESS: JOr6IbW1 ` tLl.lMbivL,,? TELEPHONE#: (0i2-92-7"' /4033 20105 (AREACODE) CITY: STATE: Mr.1 ziP: 5540$ _ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00 includes $40.00 County fee Note: Additional consultant fees may apply • MODIFICATIONIALTERATION TO EXISTING DWELLING UNIT, INCLUDING: _ Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00 _ Abandonment of septic system. _ Water turnaround - existing dwelling unit (+ 518" meter it needed -$118) Other: y ? _ RPZ: new installation/repair/rebuild JUN 2 1[UU7 $ 30.00 _ lawn irrigation system - BY - ReplacemenUadditional: _ water softener X water heater $ 15.00 State Surcharge $ 50 Total $ 15 50 I I herebyacknowledge Ihat I have read this applicalion, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It is lhe applicanPs rasponsibility lo notify the property owner Ihat the Clty of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities lo the facdilies consUucted under lhis permit within Cily pro ert -o(-way/easement. SIGNATURE O PERMITTEE 1/02 RESIDENTIAL ?-? ?a BUILDINC PERMIT APPLICATION CITY OF EACAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-881-4875 New ConsVuctlon Beauirements • 3 registered slle suneys showing sq. ft oi bt, sq. il. W house; and all roofed areas (20% maximum bt coveraga allowea) . 2 copies o1 plan showing 6eam & wintlow sizes; poureU found tlesign, ek.) • lsetotEnergyCalculatans • 3 copies of Tree Preservatlon Plan tl lot plattetl afler 1/1193 • Rim ,bisl Detail Optbns selectbn sheet (bkigs wim 3 or less untts) DATE 7 1,b ??- SITE ADDRESS 4?? ?C A U FhiAN t TYPE OF WORK-7 QOB f eA2 JV -?-46 APPLICANT STREET ADDRESS 30 l ? TELEPNONE # CELL PHONE # L&?_STATE(P14' ZIP 5 SYdA FAX # (h 12 f 71, 11 lJBB PROPERNOWNER b_ L4 IW kpr? TELEPHONE# b!Y?LO_ ?Y2f ---- ----° ----------- ------ ----------------- ---------------------- °---- --------------- ----- -- COMPLETE THIS SECTION FOR °NEW" RESIDENTIAL BUILDINGS ON4Y Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MI ? (d submissian type) . Residential Ventilation Catagory 1 Worksheet Submitted • N ? ?ork?h? • EnargyEnvelopeCalculatlonsSubmitted ? ???_ 1 6 ZOD2 PIum6ing Conhacfor: __ Plumbing system includes: Mechanical Confractor: Mechanical system includes: Sewer/Water Conhactor: _ Wa[er Softener _ _ Water Heater _ No. of Baths Air Conditioning Heat Recovery System MULTI-FAMILY BLDG _ Y vIN FIREPLACE(S) _ 0 _ 1 _ 2 Phone # 00 Fee: $70.00 I hereby acknowledge that I have read this appllcation, state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and Cfty of Eagan Ordin nces. I Signalure of Applicant ........... -............ °--......... _...._......... _----?r?.r.???_..._......_..._...??..._._._ OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 RemodeVReoalr Neauiremenu . 2 copieS Ot pl2n • 1 set of Energy Cakulatlons tor heated addftions • 1 Si[B SuN6y 10r BIABfbr addflbn3 $ dBCk3 . Intlicate if home senretl by septic syrtem for addttions VALUATION ? 9Z7 l•°v /1 j- ? S _ Phone # Iawn Spritilcler No. of R.I. Baths Phone # OFFICE USE ONLY O 01 Foundation ? 07 05-plex ? 13 16-plex O 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 G&plex ? 16 Fireplace O 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex O 09 07-plex ? 17 Garage O 22 Porch/Addn. (4sea.) ? 33 Ext. Alt - SF ? 04 02-plax ? 10 08-plex ? 18 Deck O 23 Poroh (screened) Q 38 Multi ? OS 03-plex ? 11 10-plex ? 19 Lower Level O 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Yor_ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding 13 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair ? 33 Akeratlon ? 37 Demolish (Bldg)' ? 43 Reraaf ? 46 WindowslDoors ? 34 Replacement •Demolition (EMire Bldg only) - Give PCA handout to applicaM Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) _ Fina7/C.0. _ Footings (deck) _ FinaVNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing _ _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing permit Mechanical Permit License Search Copies Other Total Building Inspector Certtficat-e f'oT: Svend Peteraon . Dunn t Curry 47-1 West 11'°t.h .,t. 4}7 ' Sloomington, P1r,. ? ) t02.Z ?iE• ??`f? / DELMAR H. SCHWANZ LANDSURVEYOF Feqistme0 Untlat Laws Of The State o1 Minnasob 2978- iq6TH STHEET W. - BOX M ROSEMOUNT, MINHESOTA 56O68 PNONE 672 423-1769 Approvec3 for Dunn 1. Camr;t SURVEYOR'SCEHTIFICATE Re31 F.St3tG Pi3n3gCment., Tnc. ?Q. (1 L' ??•fn rij ?y ,. (? b3 r : x Elevations 3hown are ? existing ? Denotes set wooc' hub 73 ? ? eI '?7 fi6 ye \ ? i 'Tv?/Yu? ? qU \ ? ! ? ?C \ lJ C `J u-? '?(6 / ' G A,e ?Gooie \ \ • ? i d? s n? ys 97,bo ! ' 3 1 S c.. Q 6. Pra, osod gar(17e floor _-Q?'(? -- `/ Tdr r7u? ?, .j ,., ? ? . ? 10 (` fa ' ; ? u• - - - -- - - - ,,? q ? ? I" herety certif,y ' tna jt?pthis i3 N carrect rePrcaent Z? ti n U :,c,t 5, $lock 3, ?dSLDc:RIv":-ZS VAF.K SFCONp ADP,FTiI)1:, accordS.n;; t., t'ie recerded plat thereoP, Dakrsta Cowity, Aiinnesota. Dated: July 21", 1974 ttouae ataked Hay 5, 1983 ? ,? /... > ;.. MINNESOTA REGISTFATION NO 8625 / r SEDGWICK HEATING & AIR CONDITIONING CO. TEST HEANG RECORD 8910 WENTWORTH AVEUE SOUTH • (M`INNEAPOLIS, MN 55420 x•/(952) 881-7739 q3..-2,,5- JOB NO. 0 3 ADDRESS A` uT I n oa^) 1,5 W 1~/ CITY OCCUPANT V•1L / em-1-11 Y' AA) P6 0 /0 OWNER f W' SOLD BY OC @ "H eINSTALLED BY,~ MAKE Lr MODEL G 6 o u H V 3G3 0 9 0 SERIAL NO. o~f INPUT p - THERMOSTAT VP806po - VENT SIZE VALVE e L,&" TYPE OF LINER ~s.13_f~ y r. LIMIT LINER SIZE /d LIMIT SETTING 6 r1 FILTERS: SIZE XNUMBER FAN SETTING WIRING ~Z7 PILOT TYPE _ I~ CLC-C/ TEST TAG IGNITION MODEL LIGHTING INST. PILOT TIMING Q DATE TESTED PRESSURE ` PERCENT C02 0 y( INPUT CFH PERCENT 02 ' V COMPANY TESTING STACK TEMR PERCENT CO NAME OF TESTER J FORM 235 (REV. 6/08) FORM DISTRIBUTION: WHITE COPY - JOB FILE YELLOW COPY - CITY PERMIT City of Eagan Permit Type: Mechanical Eaaan, Permit Number: EA093359 Date Issued: 04/07/2010 OR Permit Category: ePermit 40~ it~ of E3 E Site Address: 4325 Kaufmanis Way Lot: 006 Block: 003 Addition: Wilderness Park 2nd PID:10-84251-060-03 Use: Description: Sub Type: e - Furnace & Air Conditioner Work Type: New Description: Furnace & Air Conditioner Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952) 445-2840 Fee Summary: ME - Permit Fee (Replacements) $50.00 0801.4088 Surcharge-Fixed $0.50 9001.2195 Total: $50.50 Contractor: - Applicant - Owner: Sedgwick Heating & Air Eric l\l Anderson 1408 Northland Drive, Suite 310 432 Kauthianis Wad Mendota Heights NIN 55120 Eagan MN 55123--188 (952) 881-9000 I hereby aeknowledae that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and Cite of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA113881 Date Issued:09/09/2013 Permit Category:ePermit Site Address: 4325 Kaufmanis Way Lot:006 Block: 003 Addition: Wilderness Park 2nd PID:10-84251-03-060 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes . Charles Thayer Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Eric M Anderson 4325 Kaufmanis Way Eagan MN 55123--188 (612) 968-0698 All Around Roofing & Renovations 720 Tower Drive Hamel MN 55340 (763) 447-3944 Applicant/Permitee: Signature Issued By: Signature From:Taylor Gable Fax:(763)400-4503 To: Fax: +t(651 j 6i 5-5694 Page 2 of 2 0110912015 9:49 4Jse Bl.U�or BLAC�C Ink ���r..�..;...,...__....,_...._� � Far 4fOca U'sa ��� � � ! ~ Clt ���� �Il � Pe�,��: s � � ` `� � � Pem��t�ee: 6'' ,�i i sa3o Pltot Knob Rs�ad r Eegatt(NW 55�22 � OateReeeheed; I i p.�Dne:(65i�S75•5675 Fax:(651�675•56�4 � s��, �i!f iiiYYW iu M MliR'we�M11�TlT��! 2D'15 �Z,E�[QENTlA►I. PLUNf�ING PfE�N�ITAPFl.IC�rT�ON Oat�; 1.�,���,�.�SitaAddress.'1��� �f11����:{�:� S �/Ul�� : II ��p����� 7ereant: ���'1 ��1�1�I+GCsY``�(? Sufte�ls � l��[�r��V�- � iVamet ���C.� Ph�ne. � Res�dcntt4wner ' Atl�dresslcit lZip��� � •� Narz�e' I.tcensQ#:�`�V li�"�>'i ' �lddrs$s•���� ����� � �Cipy:: ������'' Cantractcr ' '��}�'"���� ��I Slate•,��ip: Fhonc._.. 4� � � � ` . �� Gantacl: �� Etnait: � �YR e o�Wark —�ew :�Fteptacemenk l:Repair ,,._Rebuil� _IVlodiiy Spaca _Work in R.fl�W: . �4striptian oE vrar6c:. �RE DEN��A1. ihPa�er Heater _l;awn Irtigaliat�{_�tRZ/_�VBy ��1Y�1��Soft�n�r Permik Typt3 ,,,,^Add Ptumbing�ix.Wtes�JNain J_lower 1�ovet} _Septic�ystem _��yy V1laterTumaround _A�andanment ���ID�NTtA4�EES: S�O.Q01Nater Heale��`�ta�er So�tener,a�z Wat�r:Heate��nd Sattenec{Ind�sdes S5.�Op S�gte Surcharge} 560,04 L�Wt11i'i3gdtitsn(fncludes.�S.00 r�inimum 5���Surcharge) 550.Dfl Add Plumbing Fixtutes,�eptic�rlstem Aba�donmenl,Water Tt�ma�aund'(inclades�S.Ob Stat�S�,r�harga) "�A1�terTumarou�d�add�2�D,QQ it'a�t8'mQt�r Is required� 5'115.00 SemtTG Svs�e�+New(�10.�a peras bu7t)�ncludes�o�rnryiee aad SS.AO State S�rcl�ar�e) t� TOTAL FE�$ :�� �/� :, C�4L!�EFORE YQl!I�1G. �ail Gopt�er State QRe`Call gt�$.$i�4S4�U08 fot�totection�gainskundetground ut�ily.damage. Ca1t A8 hcucs belorc yau Tntend ta dig te�reteive tacatee of ut�dergCOUnd ulilities, .www herstat�necall:ar I hereby�►cknowl�d9e tte�t�his inlormau�i�cam�leta,and aara�rat�;tha�the work w�!�(n contormance withh the�d'�na�ees.a��cdes af the City eC E��a�:that�widetstan��his is act a�R4m�h.�ut o�tY an aDPrcaG�Ivra pemNt�artd work(s noR to slart vwftha�t a permi�that Ihe wak will 3�ei1n aceacdanoa Writh the a�praved ptan in t�e cas�flf�atk which requ�es a�reuiew and apprcval of pian5.. ��A�, ��F���ec ��- - f �,r-�. Xx �......�.. �` Appllcant's Ptlntad Name Appltc� t S1gna�ure FC�I�f3!EFIGE USE Rsvtewed�y. Dato: Req�itt�d Inspe���4ns; U�der��atsnd Rvugh•gn � AirT�sk Gas7est Finai firlet�er Related ttems: Meter Slz�a Radio Read Manometer SCaff.