4350 Kaufmanis Way
Use BLUE or BLACK Ink
r
For Office Use ~/Q I
Permit
City of EaEa~ k5.
Permit Fee:
3830 Pilot-Knob-Road
Eagan MN 55122 I Date Received.
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
I
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: jj Unit
Name: Do~ds ~ti6~-r[I/1 Phone:
RESIDENT 1
OWNER Address / City / Zip: N i-r4441 IS JA Z&4
44 35 U
Applicant is: Owner Contractor
TYPE OF WORK Description of work: (
Construction Cost: IF6'- Multi-Family Building: (Yes
Company: i CL r Contact: SS
CONTRACTOR Address: `f~ City:
State: Zip: ~~o? Phone:
License #:-F(, 0- 1-73e-)- Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
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.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not 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 approva f plans^
Exterior work authorized by a building permit issued in accordance with the Minnesota tat uilding Code must be completed within 180
days of permit issuance.
X_- x
Applicant s Printed Name App cant's Signature
Page 1 of 3
CITY OF EAGAN Remarks
Addition WILDERNESS PARK 2ND ADDITION Lot 20 e1k 4 Parcel 10 84251 200 04
Owner ? +? 1? ?? • Street 4350 KatifmanT s Wa3r State Eag3II , MN 55123
Improvement " Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
5AN SEW TRUNK 1 1 .11 AOZO 6 -82 '
SEWER LATERAL
WATERMAI N
WATER LATERAL
* WATER AREA !V,14iL 1979 791.26 79.12 10 474.78 AM 6 --82
iE STaRM SEW TRK 1979
STORM SEW LAT
CUR6 & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 305.00 20232 7/31/80
BUILDING PER.
s,ac 525.00 20232 7 31 80
PARK
CITI' OF EAGAN
3795 Pi{ot Knob Raod Eagan, MN 55124 H2 6 U a Z
. PHONE: 454-8100
BUILDING PERMIT ReceiPt #
To bs ared for Est. Value Date - , 19
Site Address Erect ? Occupancy
Lot Block Sec/Sub. Alter p Zoning
Partel # Repnir ? Fire Zone
Enlarge ? Type of Const.
W Nome Move ? # Stories
3 qddreu ' Demolish ? Front ft.
o - , . ?.
C
Grnde ?
Depth ft.
i phone
p Nnme _
?
?a Addreu
?
C'ifi.
Nume _
Address
Assessment Permit
Woter & Sew. 5urcharge -
Police Plan check _
Fire 5AC
Eng. Woter Conn.
Plcnner Water Meter
Council Rood Unit _
'xl 5r1
I hereby acknowledge that I have read this application and state thot Bldg. Off.
the informotion is correct und agree to compfy with all opplicable APC Totol
Stase of Minnesota Statutes and City of Eagon Ordinances.
Signoture of Permittee
A Building Permit is issued to: on the express condition thot
oll work shcll be done in acoordance with oll applicable State of Minnesota Statutes ond City of Eagan Ordinances.
Building Official
Pensit # DoM laued PerailHe
Plumbing 3 - f'Q
Merhanicol
INSPECTIONS DATE INSP.
Rough-In
Firwl
FOOtings ? Dote Insp. Date Insp.
Foundation Plumbing ,'
Frame/ins. MechanicaF-11 '
Finnl
Rernarks:
-? ? CITY OF EAGAN 17911
?
? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 5512?
.?
BUILDING,FERIV11T PHONE:454-8100
Receipt # 1
?
L
DECK ;1 ,000 MAY Zg 90
?
To be used for Est. Value
Date . 19
?? ??IS iIAY ?
Site A lss
?
WTMU5 OFFICE USE ONLY
?
Lot
BloCk Sec/9Ub
P3fC@I NO. OCCUpancy - FEES
DUAli6 6 JODY lE?I?N Zoning - 23.?
? Name (Actual) Co?t - Bldg. Permit
"''
?
AddreSS S uAY
(Allowable)
- Surchar
e s0
?
0 Cit KWAAN
y
75034 a
Phone
# oi Stories 9
?
Plan Review
S? Length ?
o Name Depin snc, ciiy
}
?? Address S.F. Total -
C
C
C
?
City
Phone
S.F. Fooqxints SA
, M
W
C
-
Water Conn
On Site Sewage _
?
W
Name
On Site Well
- Water Meter
W
Z
?
Address MWCC S tem
? -
=
<W
City
Phone
Ciiy Wafer ncct. Deposit
-
S/W Peffnit
PRV Fiequired -
I hereby aCknowlege that I av read this appl io and state that the Booster Pump - ?y?/ Surcharge
information is correct and gr to comply wi all pplicable State of
Minnesota Statutes and Ci of agan Or ces.
? Treatment PI
.
Signature of Pertnitee
?u't?
J
APPROVALS
Road Unil ?
D[1AM OR JQflY H planner
A Building Permit is issued to: -
Park Ded.
--
-
on the express condition that all work shall be done in accordance with all Council T
.Db
applicable State of Minnesota Statutes and Ciry ol Eagan Ordinances. gidy, pry, _ Copies
Z6
5
.
I
Building Of}iCial Variance - TOTAL 0
•
?
f ,
Varmit No. Permit Holder Date Telephone #
WATER
SEWER
PLUMBIVG
H.V.A.C.
ELECTRIC
InrDecNon ?ate Insp. Cormnents
Meter
Final
No. ' iI-)78
cirr oF E?GAN
3795 Pilat Knob Roed
Eeqan, Minnesota S5122
Phene: 454-8100
_ qti*4. PERMIT
Date:
9-8-80
Site Mdreu: IIi
Lot Blotk 4 Sub/Sec.
6'::1ldern•
INSPECTOR NOTIFICATIQN
REaUIRED BY LAW
FOR ALL INSPECTIONS
Receipt No.:
Single
Residential
Multi Res., Comm./Ind. I
Name
- "
New//liter
/Repair
.
.
Address Cost of Installation
?
r. ,
City " Phone: ?
Permit fee
Name
-
Surchar9e
?
Address - . ` . , . .
?
I
City ' Phone: Total
This Permit is issued on the express condition thot all work shall be done in occordance with all appliwble Stote of
Minnesota Stotutes ond City of Eogon Ordinances.
Buildinp Official
cinr oF EAc,AN
. 3795 Rlot Knob Road
• Eegan, Minnesoee 56122 INSPECTOR NOTIFICATION
No. - PI'°"°: 454-e100 REQUIRED BY LAW
PERMIT FOR ALL INSPECTIONS
Dote: I Receipt No.: 'S
$ingle
Residential
Site Address: '
Lot Black Sub/Sec. Multi Res., Comm./Ind. I
. Petersen C.onstruetion Ine. ?-?n
N°^x New/Alter. /Repair
.
$ Address
? Cost of Instollation
? ?,1 , •?.
Ciry Phone: Permit Fee
.
Nome r 5urthorge ? Address ' • .i' L? ? ? - ,
? , ... _ ? • _?,
City - Phone: " - Total
This Permit is iuued on the express condition thot oll work shall be done in occordonce with oll epplicable State of
Minnesote Statutes ond City of Eogan Ordinances.
Buildiny Official
WATER SEttVICE PERMIT
CITY OF EAGAN
3795 Pilot Knob Road PERMtT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner; -
Address:
Site Address:
Plumber:
Meter No.: Connection Charge:
5ize: Account Deposit:
Reoder No.: Permit Fee:
1 agros to eomply wfth the City of Eagon Surchorge:
Ordinances. Misc. Charges:
Toto I:
By Date Pnid:
Date of Insn.: InsD.:
-
_
CITY ", e'AGAN SEWER SERVICE PERMIT
3795 Pilat Knob Road PERMIT NO.:
6ogan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
1 agres fo eomply wifh fhe City of Eagan Connection Charge:
Grdlnances. Account Deposit:
Permit Fee:
Surcharge:
BY Misc. Chorpes:
Dote of Insp.: Total:
Insp.: Dote Poid:
CITY OF EAGAN
.? 3795 Pilot Knob Road Eaean, MN 55122 N2 6002
• PHONE: 454.8100 v(C.??
BUILDING
PERMIT APPLICATION
Receipr # '
Te 6a used fer SF DWG/ Est. Value 58 , 324. oare 7-31 , 19-8a-
Site Address 4350 Kallfmantls Erect M Occupancy-P 3
Lor 20 eiock 4 5ec/Sub. Wilderness Park 2 Alter ? zoniny E1
Porcel # 10 $4251 200 0/+ Repair ? Fire Zone 3
Enlarge ? Type of Const v
x Name S. Petersen Construetion Inc, nnove ? # Srortes
z
O
Addres@ 4701 W. 110th St.
_ Demolish ? 72
Front 4t.
l? S, '?1, 55 7 Grode ? Depih 26-8 ft.
?' one
?
Neme
Same
ApDrorals
Fees
?a
Q Address
s
H r:... e?.."
Name _
Addreu
1 hereby acknowledge thot I have read
the information is correct and agree
Stote of MinnesoM Statutes and S3t?
Assessment.A
Water & Sew.
Police
-
Fire
Eng.
Pinnner _
Council -
Bldg. Off. ?
APC
Pertnit 153_00
Surcflarge 29 - 5n
Plon chetk 76 _ S(1
SAC 595 nn
Water Conn. 305.00
Water Meter 60.00
Road Unit 185.00
Total 1,334.00
Slgnoture of I
A Building Permit is itsued to: on the express condition that
all work sholl be done in a/? r•da?n.ce wit II a liwble State of Minnesota tat es dnd Ciy of Eagan Ordinances.
Building Officiol ^?^-?? -?-?--2+"-) -?A% -e
4:e' dw" -
'Ib Be Used
CITY OF EAGAN Include 2 sets of plans,
p&I o'v 1 site plan w/elevations &
BrTrTr,rnr_ PFRMTT APPT.T('ATION 1 set of energy calculations.
S?
For 14?1, Valuation Date
Site Ptldress / „3-ba I. A[t-,?iat? 2?
IvitOERNES r
Lot 020 Blocx 171 S2C./S .pdPi( a-? Ereot
Parcel #: Alter _
' Repair
Oaner: S Tri?.?SE•v Croro;?veTio?/ dj?nlar4e
Nbve
Address: 4170 / Ltl //D 7W S-F- i°YY/?G S penplish
City/Zip Code: 3 7 Grade _
Phone #: '?'Kioe -
Contractor: S.,W/+r or---
Pddress:
City/Zip Code:
Phone #:
Arch./Ehg. _
Iuidress :
City/Zip Code:
Phone #:
'IbTAL
6 7 1 ?9 _'? a
?,Zes •- d'o
OFFICE USE ONLY
occupancy ?'. 3
- zonirig
Fire Zone 3
'Lype of Const.. ?
# Stories
Fmnt ft.
Depth ..sG Bft.
APPROVALS ?G
p.ssessmpnts Pernut /s3, ao
?qater/Sewer Surcharge ? g co
Police Plan Check 74„re
Fire SAC t3,5na0
glq, Water Conn. 3ec.s6
Planner Water Meter Gn,00
Council Road Unit /RS.Od
Bldg. Off. q _
APC
I
BUILDING PERMIT
To be used for DECK
CITY OF EaGAN NO - ? ?.9 ? ?
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 ?
Receipt #
Est Value $1, 000
Site Address 4350 KAOFMANIS WAY
Lot 20 Block 4 Sec/SubWILDERNESS PARK 2
D OPFICe USE ONLv
P2fC01 NO. Occupancy - FEES
Zonmg -
w Name DUANE & dODY FERA(:F.N (ACtual) Const - Bldg. Permit
? Address 4350 KAIfFMAN7S WAY (alloweble) - s
.50
n
r
City EAGAN PhOne 370-5034 # otStones uro
ge
a
-
' Plan Review
23
_ Lengih -
o Name SAME Depth SAQ Ciry
.
?° Addfess S.F.7otal -
o< SAC, MCWCC
'¢' Clty PhOne S F Footprints -
Waler Conn
0n Site Sewage _
?
ww
Name
On Sile Well
- Water Melar
13 Address MwCCSystem -
o0
<w
City PhOne
Ciry water Acct Deposit
_
S/YJ Permit
PFV Required _
I hereby acknowlege Ihat I e read this apple and state lhat the
Fft Booster Pump - SnN Suroharge
iMOrmation is correct and gr e lo co(((???ply w'
a pp6cable State ot
Minnesota Statutes and Ci of agan Ok?anc s. Treatmant PI
f?„
Signalure of Permitee
?? ?? ?
APPHOVALS
Fioad Unit
DUANE OR JODY FF GEN
A Building Permil is issued lo:
Planner
- park Ded.
on the express contlinon ihat all work shall be done in accordance with all Camii -- 1.00
applicahle Sta[e of Minnesota Statutes and City o
l Eagan Ordinances. gldy pry, _ Copies
{
BUlltling Oliicial ?N_A.V,1r
? J! LL.??1 Variante
0
_ TOTAL 26.5
r \
mmnesoca bcace noara ot necviaty
Griggs Midway Bldg. - Room N191 ?
-,]AZ,14lniversiry Ave.. St. Paul, Minn. 55104 - Plrone 297-2171
REQUEST FOR ELECTRICAL INSPECTION
CHECK BELOW WOAK COVERED BY THIS REQUEST
EB-00001-02
90352
Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For
Home 0 ? ? Range ? Temporary Wiring ?
Duplex ? ? ? WaterHeater ? LightingFutures ?
Api. Bidg. ? ? ? Dryer ? Electric Heating 11
Commeccial Bldg. ? ? ? Fumace ? Silo Unloade: ?
Industrial Bldg. ? ? ? A'u Conditloner Bulk Milk Tank ?
_
Ferm ? ? ? pList }t DishZ
i$ I
?
Othei 0 0 ? Hehe
) "' ? ere
ll
COMI'UTE tNSPECTION FEE BELOW ?
Above
W? COIDplB'E6 H0118B WiTiAg p TOTAL
I, the ElecMcal Inspector, hereby ceat th?dve ifispectbn has bee
(Rough-in) ? Date _
(Finai) Date This request void
to 1
ya, °°
e_ 7? y0
18 months from
'Ihis reguast void
1$.m6nths from
Date of this Request 9-5-80 Fire No. a J O vZ) ?
I, as p Licensed Electrical Contractor OOwner, do here6y request inspection of the above electri-
cal wiring installed at: x 5/2/
Street Address or Route No. _4350 uf11AT'} R W= City.?F. ge-n
Section Township_
Range County Dnkota
Wh;clris occupied by saend Peteraon Construction
(Name of O<cupant)
Is a roughin inspection required on this job? No ? Yes El Ready Now ? Will Call 12
Power Supplier D?ota E1.9Ct2'3.C Assn Addcess 821 rd 3t. Farmin on M[3 '
Electrical Contractor Ken SOTeneon $ectMe Contractor's License NoA3UW
(COmpany Name)
MaIlingAddress 8100 12th Ave. So.. Blonmino+.n„_ Hmr sri.?n
Authorized Signature
SUM BQaL3D
or
xo. 854-4470
This impection request will not 6e accepted by the
State Board unless propar inspection fee is enclosed.
Minnesota State Board of Electricity a
19554Unieersity Ave., St. Paul, Minn. 55104-Phone 645-7703 n j, 0
RFQO.IEST FOR ELECTRICAL INSPECTION ?
CHECI4 SELOW WORK COVERED BY TH1S REQUEST 4295
Type of Building New Add. Rep. Check Appiiances Wired Foc Check Fquipment Wired For
Home' 0 ? ? Range ? "temporary W'ving ?
Duplex ? ? ? Water Heatei ? Lighting Fixtures ?
Apt. Bldg. ? ? ? Dryex ? Electric Heating ?
Comme[cial Bldg. ? ? ? Fumace ? Silo Unloader ?
lndustrial Hldg. 0 ? El Air Conditioner ? Bulk Milk Tank ?
Farm List L
ist l
Other
?
?
? Q
Heiers? p
y
Heieisl
COMPUTE INSPECTION FEE BELOW
Service Entrance Size: # Fce Feeders&Subtcedeis: tt Fee Cvcuits: # Fee
0 to 100 Am . 00 0 to 30 Am tes 0 to 30 Am eies
101 to 200 Amps. 31 to 100 Amperes 31 to 100 Am etes
Above 200 Amps. Above 100 Amps. Above lOQ_Amps.
Transformers _ RemoteControl Circ. Partial or other fee
S' ns pecial Ins ection Minunum fee $5.00
Remazks k ` j ,. ? a? ServiCO
s?'?1.?1t TOTAL FEE
I, the ElectrW IrApectdi'; 5eieby certify that the above inspection has been made. /Q, Cp)
?
(Rough-in) Date
(Final) Date D
This cequest void 18 months from
This request void 18 months from ,or D?
1 ,
42950
Date of this Request August 15? 1980 . s
I, as ?-}.icensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wiring installed at: /,aQ 0041, Cf/'Q 1?
Street Address or Route No. 4350 Kaufinetnis Way Lt. 2 Hlock 4 City Eagan
Section Township Range County Dakota
Which is occupied by
Is a roughin inspection required on this job? No 0 Yes ? Ready Now v Will C?
Power Supplier Dekota FaLectr3C Aa3n Addcess 821 rd 3t Faxmin on MN
55024
Electrical ConVactor Ken Soresl8on FaLectPiC Contractor's License No. A 3
(COmpany Name)
Mailing Address 5100 12th Ave
Authorized
????? p(DARD COPY
Phone No. 85lr4470
This irispection request will not he accepted 6y the
State Board unless propw inspxtion fee is endosed.
Trr#i#irtttr nf Orrupttnry
Citp of (Eagan
igrpttrtmrnf nf iguilbing Jnsprrfiun
Tbic Catificatt irtued Purtuant to tbe requirrmrnu of Sertion 306 0f the Uniform Bailding
Code crrkf ying that at t& time of iaruanrt tbis structurr mar in comPlianct with the variaur
ordinanns of thtCity ngulatrng building ronn+rrrtion or rue. For the follouung:
U.cj?fi?m sr nm Bid,PmWt N. 6002
awwdrTYa R3 hveW.?mo V eiRZ . 3 um% o"?ct Rl
a,,,,,aD.ff,,,,S. Petessen rbnSt. ,,a,701 W. 110th St., Mfi15.
Park 3iA
? Wta: rehruarv in, 1982
Z4F
?9`?D ??
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
657-675-5675
Please complete for modifications to existing residential dwellings.
Date ? / .:-:?
?/?
Site Street Address ? l?i ?b 1,1 ?ll'1C? h L2) Unit #
Property Owner? l?.?lS1 Telephone #?G??
Contractor ? CZ-C:\\? iiL-Q l 1 ?? t ftk 2 7elephone#
Address CL-k-_1 ??? ???p V1 City ? a'-State lk?1 Zip b J
The Applicant is: _ Owner 7- Contractor _Other
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures (excludes water softenec andlor water heater--complete next
section if installing these appliances).
_Septic System Abandonment
_Water Turnaround (add $125.00 if a 518" meter is required)
Other:
?Water Softener _ Water Heater $ 15.00
_ new ? replacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ 50
Total $ 15
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
rZ
ApplicanYs Printed IVame Ap canYs Signature I i
h:1AY 4 2009
Certificate ?far.
. . Dunn & Curry
Svend Peterson
4701 West 110th Street
sloomington, Mn. DELMAR H. SCHWANZ
55437
LANOSVRVEVOR
p"itbrstl VnCer l.aws of TM St+te of Minneso[a
2978 - 146TH STREET W. - BOX M ROSEMOUNT, MINNESOTA 56068
SURVEYOR'S CERTIFICATE
Bk e -f 8/I
PHONE 812 473-17ei
Approved for Dunn & Curry Real Estate
Management, Inc.
by:
i
? -.30
_ SCale.w D? '
0
?
O
?
a" /
? t4 /
/
%
otn /
? A
1 O
3D?
020
S
e i.?l \ 6 ?.
c/
a
?G
a j
-?S
F
Drainage 8 Utility
e$aQment .c
5
I g
?
?a
N
N
?
N
?
\ G S
1??? 3y ? f ? 021 23"V?
?YtL-,yti a s s ?
/S
I hereby certify
Lot 20, Block 4,
recorded plat th,
r
'? - u.- . 13\' 6-.
30 ? 60 .
0
that his is a true and correct representation of
WILDERNFaSS PARK SECOND ADDITION, according to the
sreof, Dakota County, Minnesota.
Dated: July 27, 1979
Revised to show proposed house as ataked J 25, 1980 ?
? r?
,
_ l`?
MINNESOTA REGISTRATION NO.B645
/
? ?
?
liqll
1990 BUILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
MULTIPLE DWELLINGS
COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
ilar a a RECa
To Be Used For: D 1- Ck Valuation: ? bb (7 Date: 5-'oL2-/ d
Site Address )/35-0 9 ? I.J OFFICE USE ONLY
Lot -i?U Block ? I FEES
Parcel/Sub W J-
Owner u&"?
Address 4,30 26??
?
City/Zip Code ?q?qo••..i /K /J 5YU-3
Phone /?? -,$j),3 9?'
Contractor
Address
City/Zip Code
Phone
Arch./Engr.
Addres
City/Z
Phone
it
Occupancy
Zoning
Aetual Const
Allowable
# of stories
Length
Depth 1g'
S.F. Total
Footprint S.F.
On site sewage_
Z site well _
CC System _
City water _
PRV _
Booster Pump _
APPROVALS
Planner _
Council
Bldg. Off. S/L3
Variance
Bldg. Permit 's,Da
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 j0 0
SUBTOTAL
Penalty
TOTAL ???)
. , rtiflcate Par.
,JUnn & Curry .
3vend Peteraon
4701 West 110th 3treet gk o 9.8/1
sloomington, t1n. DELMAR H. SCHWANZ ?.
55437
LANDSUNVEVOH
qpittvW VnOW Laws af The Statf 01 Minnesoto
2878- 146TM STREE? W. - BO% M H06EMWNT, MINNESOTA 56068 PHONE 812 423-77N
SURVEVOR'S CERTIFICATE
Approved for Dunn & Curry Real Eatate
Management, Inc.
by:
i
?
ca1 e7 '30
.?
. O? ?
/
o1O ?
tiryj`• / ??? .
?o-p6
.o
o S
? U
?
?
O
?
Drainage b Utility
eaaaeent ?
? ? 6 \ yo P x
P ?
? Q 5' S Sp 21 g.
o r 10
Q,
S 30 ° ?• .
0
?
I hereby certiPy that this is a truE: and correct representation oP
Lot 20, Slock 4, WILDERNESS PARK SECOND ADDITION, according to the
recorded plat thereof, Dakota County, Minnesota.
?
8
$
00
N
(4
?
N
Q`
I;
J
Dated: July 27, 1979
Revised to ahow proposed house as etaked J ;352 1980
,
_,?.k'.ti%?,,:?• ? '"?.y..(/ _
, MINNESOTA REGlSTRATION N0.8876
U
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - - -
I For Office Use
Permit
City of Eagan I s. 5~-;-
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
I I
Fax: (651) 675-5694 i Staff:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:v J Site Address: Unit
Name: ~On ~1 ti d1 Phone:
RESIDENT/
OWNER Address / City / Zip: (
Applicant is: Owner Contractor
TYPE OF WORK Description of work: Ov-
Construction Cost: Multi-Family Building: (Yes / No )
Company r'~ v~ l~f//1/l Contact: d
CONTRACTOR Address: J City: r[ dr
State: Zip: `~?Da Phone: 4u, 30 ?6 /0
License bJ I D~~ Lead Certificate
If the project is exempt from lead certification, pleas xplain wh : (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
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.org
I hereby acknowledge that this information is complete and accurate; that the work will be in con rma a wit 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 i of sta ithout 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 I s
Exterior work authorized by a bu ding permit issued in accordance with the Minnesota tat it ng Code must be completed within 180
d ZIermit i suarlCe.
r
x
x
Ap licant's Printed Name Appli n s i nature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA131647
Date Issued:06/30/2015
Permit Category:ePermit
Site Address: 4350 Kaufmanis Way
Lot:020 Block: 004 Addition: Wilderness Park 2nd
PID:10-84251-04-200
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Douglas M Kuehn
4350 Kaufmanis Way
Eagan MN 55123
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA131647
Date Issued:06/30/2015
Permit Category:ePermit
Site Address: 4350 Kaufmanis Way
Lot:020 Block: 004 Addition: Wilderness Park 2nd
PID:10-84251-04-200
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Douglas M Kuehn
4350 Kaufmanis Way
Eagan MN 55123
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature