Loading...
4333 Medary AveCITY OF EAGAN Remarks Addition Lot $ Blk 3 Parcel 10 64400 M? 0-4 Owner Screet 4333 MPdar= AnP State Edgsn,= 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTQR, GRADING SAN SEW TRUNK * SEWER LATERAL 70- WATERMAIN * WATER LATERAL WATER AREA STORM SEW TRK * STORM SEW LAT 1976 3 CURB & GUTTER SIDEWALK STREET LIGHT ; 1980 67.80 13.56 $ WATER CONN. BUILDING PER. SAC PARK CITY OF EAGAN , 3830 Pilot Ktab Road, P.O. Box 21•199, Eagan, MN 55121 ? PHONE:454-8100 BIjJILDING PERMIT Receipt Te 6e wrd W DFLCX 13COEF Est. Value a6n 0(w Dote k2a:TT, a4, 19 ?u5 SiteAddress 13333 ''"?DAFZY AV' Erect 0' . Ocapency 3 Lot Blxk Sec/Su6 --Ij/,,F"y t*'y.j,J?r?..t.. e Remadel ? Zoning . Repair ? Type of Const. Parcel No. Enlarge ? No. Stories " If d SC•j121D`d' Move ? Length ? Name ?u = ,?,, SAI Demolish ? Depth Address Grade ? Sq. Ft. U City Phone -' Install ? c S['Irtil': ApPeovals Faes o Name u llsxsunent Pertnit ? Address U i City Phone Woter a $ew. $urchorge P I' PI Revie ?W ?uW Name x? Addrese ?W City Phone o ?ce FIro Erq. Planner Council N an w SAC Water Conn. Water Meter Rood Unit 1 hereby acknowiedge that I have read this opplicotion und stote tFwt gldg. Off. -4/2405 Perks tha inlormation is correct and ogree to wmply with all cpplicable APC I Total StaM of Minnewto Stotutes cnd City of Enflan Ordincnces. • -' , ?- Var. Date Siynotum af Permittee il 114 6nAdtI4T A 8uilding Pertnit Is issued M: _ on Me express conditlon 1hal oll work shall De done in ocmrdan[s with oll opplimble State of Minneaoro_Statutea and Ciry of Eapan Ordirances. Buildinq Officiol ' _kl Permit No. Pertnit Holder Dete Tele hone # Plumbing H.VA.G Electric Softeaer Inspedion Date Insp. Other Footings yS o, `? Foundation Framing Rooiing Rou? Plbg. . Rough HVAC Inwlation Finsl Plbp. Final HVAC Final Cert/Oce. Wahr Deseribe Loeation: . YVell Sewer Pr. Disp. CITY of EAGAN ? BUILDING PERMIT Ownes .Kl,(/_ ?•-....... . . r .....................................•••-• Add:esa (preaen!) ..................... --.... _--- .................. Huflder ..?J ,e?°'?,-..-••-• - -2?tJ._ .................................... Address .Y.?2.?B..?I...?.?,P.st,?'...? ?I. ?'?'z.?4"/•?c?0-'.,/??'wi-r?'??5??35 &'y r/ u,iw N° 3844 3795 Pi1ot Knob Road Eagan, Minnesofa 55122 454-BI00 aa:a :?.:?..'.7? " LOCATION Stree2, Road or ofher DescripYion of Location I Lot B1ock Addoa o: Trac! lf 333 vA!Z' I 3 I _ Z?. This permit does aot suih iae ihe use of slzeets, roads, alleys or sidewalks aor does i ive e owaar oz his agenf the right fo ereate any situaiion which is a nuisance or which presents a hazard !o the health, safety, convenienee aad general welfare !o anpone in ihe communify. THIS PERMIT MUST BE KEPT ON 'I'HE "EMISE WHILE THE WORK IS IN PROGRE-SS?n. This is !o eer3ity, thai..??-•---,???................ baspe:musion !o erect a. 2-- ihe above described premise subject So fhe provisions of all applicable Ordinances for f e City of Eag ?---k "'""ypon ..?.,..................................................... • Per , --?-•? -an ?'` "-?'`""?•.F--?-'"?-!??..-•- • Mayor • •••••••-•_• ............. ... ..•••••••.... Suilding Inspectos ?? CIlf.OF aAr,hT1 3?95 ?':i.?:o± ILiob Ro:z,d Ea?,:n, i-I=rne::o-ta 55122 iz- /-/- 9 'rZ.?,',vII'T' ATO, e 807 T7e City of i;a.gan hereby grants oi 4637 Chica, a HEATING Pe=it for: ((7wner)_ atu _ 4333 Medant Ave. pursuant to Fee Pa1d; $20•00 dated this 29 day .50 s/c to Ray N. Weltez Heating_& A/C oAVe._ So. , 55407 .???. __ WindsorDev. QorP• application dated 3/22/76 _ of March Builc',ing Inspector P?ec:::anicaJ. Perrni+s: Bid Totaie , . CITY . Cr' LP.C,ljrl 3i:?5 Pil.oi; I;.^cb 'i;oad p?:r?= NO.:. 675 . . -- - ; . - 4 T:,e C_ty of Ea.gan herer.y g: ants to ThomPson Plumbinq do. -? Of 12201 Minnetonka Blvd. ? ?Ads0! L?8- V. ZbYp.v i a PLUMBING Pe?a?it for: (Owner) Warren Andereon, & Ne?+ Horiaon Hamee 7flrd 4 "? -----.---? _? uan t to aj?plzcation dated 5/5/76 , billed Fe? ftkk;: _ 160.00 ? dated this Stibay oi MaY ? 19 76 . 4.00sTc Statement #865 • L'aiidin.- Inspector ' L_1 rio-,.i?'7.!-. ? CiTY OF EAGAN N 0- 101 4 2 3830 Pilot Knob Road, P.O. Box 21-198, Eagan, MN 55121 ' PHONE: 454-8100 BUILDING PERMIT ttece+pt # t Te 6e ard ier DECK ROOF Est. Volue $4 r000 pote APRIL 24 lq 85 Site Address 4333 MEDARY AVE erect CK Oca,pancy 5 Lot Bloek 3 ?/Sub RIVER HILLS 9 Remodel ? Zoning . Repair ? Type of Const. Parcel No. Enlarge ? No. Staries Name JIM SCHMIDT Move h D li ? ? Length h Z ? Addreas S?E emo s Grade ? Dept Sq. Ft. city PAOne 894-5621 instan ? ? Name SP'ME ou Addreas ul ? City Phone ?W Name ?? Address tw City Phone 1 hereby ocknowladge fhot 1 have read this applicction and stote that the intormotion is correct and ogree to comply with oll applicoble Stata of Minnesoto Statutes nd iry of Eoyan rdinanus. , Sipnoturo of Permittea w Building Permie Is iuued to: JIM SCFiMIDT all work shall be dons in accordcnee with all coolicalsk State of ir Fees Asussment Permit +"_'_ • ?jv Water d Sew. Surchorge 2.00 Police Plan Review fira SAC Enq. Water Conn. Plonner Water AAeter Councfl Rood Unit BIdg.Off. 1 1Z 241285 Parks - APC I Total --5T6--3-U-- Var. Date on ths expreas condition that and City of Eoqon Ordinances. Buildirp Official VILLpCE OF EAGAN WATER SERVICE PERMIT 3795 Pilor Knob Rood PERMIT NO.: 1970_ Eogon, MN 55122 pp7'E; 515/76 Zoning: RI No. of Units: 1 Owner: WindsOr Dev. Oprp. Address: Site Address: 4333 Medary Aqe./ IS B3 RH 9 Plumber: V?MvPgOri P11IDlbiIlg CD. Meter/? o.: ?803919 Connection ChazPs•? ? Size?/ 5/8 RoCk Account Deposi[: Reader No : 751170 Permit Fee: 10.00 billed 865 I a9r6ee }c eomOly with the Villoge of Eagan SurcharRe: • 50 billed 865 Ordinonces, Misa Chazges: 60.00 pCl Total: BY Date Paid: Date of InsR.: Insp.: *aLAcEIOF EAOAN SEWER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: 272$ Eagan, MN 55122 DATE: 5/5/76 RT Z i of Units: No 1 on ng: . Uwner: Wi*+dsOt' DeV CorP Address: Site Address:4333 MedarTt Plumber. ThomPson Pltm?bina Co 100.00 pd with the Villoga o4 Eogan Connection Chaz l I ne to com g?.50.00 pd . r ag p osir nt De A Ordinaeces. . p ccou 10. 00 billed 86 Permit Fee: .50 billed 865 Surchazge: Chazges: Misc gy. . f I Total: 7ate o nsp.: ; ngp Date Paid: , CITY U5E ONLY PERMIT #: 4.?`? l I?v RECEIPT DATE: EOOQ ftESIDEPTIAL MECRANICAI. PERMIT APPLICATIOA crrY og EAsAN ssso Pn.oT KNos Rn EAEMM1v 551 Ss 651-6$1-4675 Please complefe for: ? single family dwellings townhomes and condos when permits are required for each unit Date: °1- 36 -0 Z- SITE ADDRESS: " 3'5 ?j MC= O/-f R--' ?'"s"j C_ OWNER NAME: L , ^ C.N N ?v-y' L-_.? INSTALLER NAME: STREET ADDRESS: CITY: Place a check maric next to the permit work type ? ZIP: ??F_r????TTN _ Add-on, modification or alteration to existinp dwelling unit L OCT 0 4 2002 $ 30.00 • fumace replacement • air exchanger gi, • air conditioner -= -- °- - • other Nature of work: Zwo c )C,P1Gs?>1C,-A?rvC- _lDiooo g0`1e> State Surchar e $ .50 Total $ 30. i ; SIG ATURE 014 PERMITTEE RESIDEWTIA. FIEA79NG ?'e Allk„ 1W'C, 1815 E.ast 41st Street, Suit? ;?%. N?Inneapoi6s, MN 55407-3425 °51 e' 7"4-189c? STATE: TELEPHONE #: 6 r'J k TELEPHONE #: b I 'Z- 72- 4 - I g c1 ! 1/02 CITY USE ONLY PERMIT #: APPROVED BY: INSPECTOR RECEIPT DATE: 2002 COMbIEftCLfEL MEC}IANICi4I. PERM1T APPLICAT10ft CITY 0F EAfi4R 3$80 PILOT KNO$ RD EMM. MN 55Y 82 651-6$1-4675 Please complete for: all commerciallindustrial buildings multi-family buiidings when separate permits are not required for each dwelling unit DATE: SITE ADDRESS: OWNERNAME: PHONE#: - TENANT NAME (IMPROVEMENTS ONLY): WAS THERE A PREVIOU5 TENANT IN THIS SPACE? Y N. NAME: INSTALLER: STREET ADDRESS: CITY: TELEPHONE #: STATE: ZIP: WORK TYPE: New construction Install U.G. Tank _ Interior Improvement Remove U.G. Tank _ Processed Piping SpecifyNature of Work: When installing/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and Plumbing inspector. Fees: 1% of contract price OR $50.00 minimum fee, whichever is geater. Underground tank removaUinstallation = minimlun fee Contract price: $ x 1 % State surchazge TOTAL $ (Base Fee) calculate at $.50 for each $1,000 Base Fee SIGNATURE OF PERMITTEE Updated 1/02 .: L 5 SUBD. ? CITY USE ONLY BL 12; ver l-h m G4-b, RECEIPT #: RECEIPT DATE: I V^2J-Oo PERMIT# L33 % o 2000 PLUI-MING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 651-661-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system CIYT11DFt EACH # TOTAL Alterations to existing dwelling - minimum fee Describe: $ 30.00 Bath tub $ 3.00 x = $ Floor drain 3.00 x = $ Gas pipin outlet ' minimum -1 3.00 = $ Hot tub/spa 3.00 = $ Kitchen sink 3.00 r = $ Laundry tray 3.00 = $ Lavatory 3.00 = $ Septic System new/refurbished " requires MPC lic. 75.00 x = $ Septic System abandonment 30.00 x = $ RpZ new installatioalrepairlrebuiid 30A0 x = $ Rough opening 1.50 x = $ Shower 3.00 x Underground sprinkler if dwelling is under consVuction 3.00 x = $ Underground sprinkler if existing dwelling Water closet 30.00 3.00 x x = = $ $ Water heater 3.00 x l = $ Water softener if dwelling under construction 5.00 x = $ Water softener if existing dwelling 30.00 x = $ Water turnaround 30.00 x $ State Surchar e .50 --> ----> --> $ .50 TOtal _> $ Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc. --------------------------------------------------------------------------------------------------------------------------------------------- 1 hereby acknowledge that I have read this applicatlon, state that the infarmation is coned, and agree to comply wRh all applicable City of Eagan ordinances. It is the applicanYs responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the Ciry during its normal operational and maintenance activities to the facilities constructed under this pertnit within City propertylright-of-way/easement. SITE ADDRESS: ? ?3 m EDA94 OWNER NAME: TELEPHONE #: CPR,--L (AREA CODE) INSTALLER NAME: Nie, ga=l,? TELEPHONE #a?S-l -0SS-5 (AREA CODE) STREET ADDRESS: r?'C A? ?/n1?5 t'? CITY? ST TE: 0 T SIGNATURE OF PERMITT'EE B?r_ i 4 IZ) /q 2, 1985 BUILDING PERNIT APPLICATION - CITY OF EAGAN MOTE: ALL CONTRACTORS !{UST BE LICENSED WITH THE CITY OF EAGAN INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCULATIONS To Be Used For: Valuation: 4?(D66- 04' Date: q- Z4 Site Address :Y3 33 ?2cQCa.? -7 Al [1 C . OFFICE USE ONLY -r- Lot: s Block \.J Sect/Sub Erect ? Remodel Parcel # Repair Enlarge Owner j'c ? Fn ?4"I- Move p Demolish Address Y 3 33 hZ`v?c-?r ??-* Grade _ City/Zip Code Phone y $?(- rC ?L ( Contractor Address City/Zip Code Phone Arch./Engr. Address City/Zip Code Phone li APPROVALS Occupancy Zoning Type of Const 1l of Stories Length Depth Sq Ft Assessments Permit 44 _ Water/Sewer Surcharge 2.=° Police Plan Review Fire SAC Engr Water Conn Planner Water Meter Council Road Unit Bldg Off? Parks APC ? Treatment P1 Variance TOTAL V6- S U I ?" # js yo DA'1.T : BUILDIi`dG PEM,i'C'r APr T,TC,A..T''OY CHECK LotBlock Addition Parcel and section number Street ---??----- Owner Address T:='- L t: Developer 7i Address-??,-,? Zone-Ordinance #52 /6 7'?.ti / P?• a Lot Size 7?, CP X3 O c?"?'xfc Total area Ju 90? ?.. b Platted ? Unplatted Building Size le?R ?L6 'y'• Total area /?JTq?A Occupancy 5 1= /-,?.?,.,oD?p_????n Type of construction /d?_??".?,., Q _ Setbacks: 5treet sides 39 Rear ' Sides o,ca;. 2° Nac?ae Parldnga Total area Parlang area setbacks: Street side Rear Sides Landscape apprrnral Special Assessmentse ShC charge Water areas Tota1 spaces Bond required @ $450.00 = 4D . rr0 / 'r L-` • OP /24ln Sca Assessed Unassessed If assessed: Connection charge If unassessed: Connection charge Lot division: Additional assessments needed Laterals: Assessed ? laaiver of hearing a Needed Assessrnent clk Qs Water & Sewer Dept Not needed ? Not assessed Not needed ;i }3uilding Dept ? Police Dept _ Fire Dept (Comm & Ind only) MASTER CARD LOCATION ? A133 OWNER . c .. STRUCTURE AND ? LAND USED AS Permit ? No. Issued Issued To Contractor Owner BUILDING PLUMBING V V ? 7G CESSPOOL - SEPTIC TANK WELl ELECTRICAL HEATING GAS INSTALLING Q t?j 7 -u----F- -- 3? a ••? ' SANITARY SEWER I OTHER I OTHER l I Items APProved (Initial) Date Remarks Distance From Well FOOTING SEPTIC FOl)NDATION ? I CESSPOOL FRAMING TILE FIELD FT. FINAL ELECTR{CAL ? HEATING DE PTH OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING -aq?7 WELL SANITARY SEWER - ? Violations Noted on Back COMMENTS: COMPLIANCE INSPECTION REPORTS TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS PERMIT NO. DATE OF INSPECTION CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ? NO EVIDENCE OF NON-COMPLfANCE OBSERVED. ? ACCEPTABLE SUBSTITUTIONS OR DEVIA710NS. n NON-COMPLlANCE. BUILDER WILL COMPLY ??J WITHOUT DELAY. ITEMIZED AND DESCRIBED AS FOLLOWS: NON-COMPLIANCE. BUILDER DOES N07 INTEND TO COMPIY. ? COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYED 8Y CONDITIONS BEYOND CONTROL. ? REIhSPECTION REQUIRED REINSPECTION REVEALED DATE Of REINSPECTIOtJ CERTI FICATION - I certify that I have carefully inspected the above in which 1 have no interest present or prospective, and that I have reported herein all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require- ments for off-site improvements relating to the property inspected. ? ALL IMPROVEMENiS ACCEP7ABCY COMPCE7ED BUILOING INSPECTOR COMMENTS: OATE 23 DEVELOPMEIVT CORPORAT[O(V February 26, 1976 Mr. Da1e Petersons: City of Eagan 3795 Pilot Knob Rd Eagan, MN 55122 Dear Mr. Peterson: Enclosed please find a check in the amount of $1,027.50 for building permit fees, surcharges, SAC, water connections and water meters on: Lot 5 Block 3 River Hi11s 9th 4333 Medary Ave This home will be a Model 76-52, Elev B, and wi11 include: Walk up bsmt to garage Brick front under cantilever Living room fireplace Patio door dining- no deck Applia.nces Colored bath fixtures Enclosed also please find a set of Master Plans for Mode1 76-52 for your files, and a proposed plot plan for Lot 5 Block 3. A1location of funds is on the check stub. Thank you for your cooperation. 5incerely, WINDSOR DEVELOPMENT CORPORATION Warren R. Anderson Vice President WR,A/ks Enclosures cA \ 1! J1; J I) 27, fgls s' ?$ SUITE 192. 4660 WEST 77TH STREET, EDIIYA, MINNESOTA 55435 • PHONE (612) 831-0717 Cities Diaital Qualitv 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. /dli )4???J C; ?"•? ] ?..? G?_._? ., l ? „?; t' .,•? ?^ j. ?. ? .? ! ? fY` 1 -^ ? r P•, -,c,,, / .. , ? ?. l a • i i ! ? ? = ? ? '??1• ? ?$?3? . .__ ? ? ? , ? 1- . F' • ? ?!3 -?,- ?1 ) I i?? , ? -? -i , ? I 7 N?? N I ? S'> I ? ? l • -?yi? ? ?' i ° A ? ? ,. J? ? ; . . . . ? 42 ? i \ f. \ Y\j cd ?. q ; f. a il . a 17 f1? ia ? S I s ? ? j ? ? ??. ?j . • , •? % `,. i ` ? ? -- `? ` .. , (j s ' e0 N. ?V 1 ! f, . 1 '? ? 1' i '?? ^t Y . , , • `• f / v ? ojrl 1^ ?? UY {,Lp 4 y d4A ?. ?.? ?`.. ' .. . . ?? . ? ...?.?..'s.__.......,?...,?.?,.-.,...._?-.-.....Aw?`? ?-.?..- _-....T-?_..._._-:-¢?•-•/ _._"__.._«._..__?.__' ` .. r j.. ? 1 i - .t I I ` Use BLUE or BLACK Ink r I For Office Use I of Eakan 1 Permit a I V °.05 I I Permit Fee: 105 3830 Pilot Knob Road Eagan MN 55122 j I Date Received: 0 13 I Phone: (651) 675-5675 Fax: (651) 675-5694 Staff: I L----------------J 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ~d 7 D/ Site Address: Unit op or I Name: r /t Phone: Od Resident/ i i Owner Address / City ! Zip: Jy. / Applicant is: Owner contractor Type of Work Description of work: a Construction Cost: Multi-Family Building: Yes /No ~ s ff Company: ll~ 1jXA41OrS Contact: Address: _33o f,. Agk y k ov City: ~h Contractor 1 L' State: ~L Zip: 41t179 Phone: License Lead Certificate A07-1 Wl~ 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 thelt 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.aooherstateonecall.ora I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x 4dade owq~ x - Applicant's Printed Name l'41 nt's S' natur Page 1 of 3 Use BLUE or BLACK Ink � �-----------------i +�;�� � For Office Use � ., � !o?�3a 7 � ClU O1 1J� 1111 ��,"�� I Pennit#: � Y � r�� � ��. �� � � Permit Fee: � 3830 Pilot Kn'ob Road � / ,/� Eagan MN 55122 �UN 2 6 ���1� I Date Received; '�(o '��`'� Phone: (651)675-5675 � � � Fax: (651)675-5694 BY; • � Staff: � ..�����������������J 2014 RESIDENTIAL PLUMBING PERMIT APP ICATION Date: �' `�' Site�ddress: ....1� /'"V Tenant: Suite#: ��: �„,�,���v ,��'ji� �,.f ut; �j, , sy.ly 3�� '� '3 �8`�k �r'T! �`1t. Z . �� „ �> �����*��; s ,� Name: '� . � ..- Resi en�lOwner h Phone: '� r ��� �.��� ��� k ����,���,��'�;�' �,.�,�` �': Address+�City/ZiP: `L.. �� s � .: , �� � �� � ���y� Milbert Company Inc dba Cul ` n Water �":''.�� � �.��� , ��_���;� ,��� `����: . , Name: ���nse#: WC643176 ��d���w �'��� �� � ' � 180150t Street East ������� � .�� � Aaaress: c;t Inver Grove Hgts. ����Conxractor Y� ��z�t���������,������ �� M N z� 651-451-2241 <� „5 � r �r� � � State.:, p; 55�77 Phone: �k ��� t��tx ��� � � � ... � ��� ��,����r;T�s� �'x,�. �ontact: WIIIIa1'Tl":R MIII�2C't Emaie '��������� °�' ��r Nlew Replacement _Repair _Rebuild _Modify Space Woric in R.O.W. ��Typ"�e of Wor — — °�7t`�„ fy �� ' �� '` � � f7�T�i�> ��i �,�5` . ��r �,��� ����� � Des'cription o work: �x;��.��, f�� ��� RESIDENTIAL , �� „�� n �`�'� �� `�'�d�� Water Heater �`�k c � s;�� �� �, 4'x�x ��;. �' �Water Softener , �,��� "�� ,F� Lawn Irrigation(_RPZ/_PVB) ��� Permit'T � �+ �. � � yp•� ' Add Plumbing Fixtures�Main/_Lower Level) � �������,.��� �,�=�r Se�ticSystem ��,�,����� ������ t '�;��,�_ ���� �.N�w Water Turnaround �,�r'��,�}�,;<��'�� � . �3h��„t$�,i+,.�✓ti w'�.' 'e �� � `�� Abandonment RESIDENTIAL f�EES: - $&O.OD Water Heater;Water Softener, or Water Heater and Softener{includes$5.00 State Surcharge) � $60.00 Cawn`Irrigation(includes$5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Tumaround*(includes$5.00 State Surcharge) , 'Water Turnaround(add$200.00 if a 5/8"meter is required) �115.00:Septic Svstem New($10.00 per as built)(includes County fee and$5.00 State Surcharge) G� TOTAL FEES S � ' CALL BEFORE YOU DIG. Call Gopher State One Call at(651j 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive'locates of underground utilities. www.gopherstateonecall.or4 I hereby acknowledge fhat this informa_ion is complete and accurate;that the work will be in conformance with the ordinances and codes of the City oi Eagan; thaY I understand this is not a permit but ony an appiication for a permit, and work is not to start without a permit; that the work wlll be In acwrdance with:the approved plan in the case of wo►k which requires a review and approval of plans. X:��,�11,� � �.4����-- x Applicant's'.Printed Name Applicant's Slgn ure �'} -� �x �,. �^ , . �c;,� ..�.v ._,�- e� c srk�' �.� u� n�rv�JI� ��� M1 ��a � �' , hT'����. Y`j �� d y� � �F�R 0 F�� �.S � ��U�'ai9����� 'r���r �^ '�p` �z � � ♦ ,3 , � �y �"a��.�� « � i; �Re���� ����� peCaA��h� ,�� R Q � , 6 �° [f� !�� �r,: „ . . y f k � � �° �� :�,� �"� � d � 4���r.yh4 I , _ : � .• : Meter ela ecl Ite t� i�"= � �_� � �A � �� .. ��� �.�'�r�:��� -�� �� � � � a., . ..,k d ..��,..� .. :- �_ . = r �. .. . q 351 8'9 410/` City of Ba 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Date: I. J Li f loQ OC[062016 Use BLUE or BLACK Ink For Office Use Permit #: /369 S 8 Permit Fee: Date Received: /0 - w "( 17 Staff: 2016 MECHANICAL PERMIT APPLICATION 0 Please submit LI (2) sets of plans with all commercial applications. Site Address: LI 3 3 /`A1 d o- / e • Tenant: Suite #: Name:Oti i I bU r tcdikhg / Address: I" I O y VCCUr i I I) oll J '1 State: M N Zip: 7 3 Contact: and h r License ##::> Le,` 1 .KJ Hash i ash ns Phone: 1151-113- -'IIT 7 Email: 4r41 f I O I t • it V i _` ► OSLO New X Replacement Additional Alteration Demolition Description of work: RESIDENTIAL Fumace NX Air Conditioner Air Exchanger _ Heat Pump Other New Construction Install Piping Gas COMMERCIAL Interior Improvement Processed Exterior HVAC Unit Under/Above ground Tank ( Install / _ Remove) RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit, includes State Surcharge $100.00 Residential New, includes State Surcharge =$ Lv TOTAL FEE COMMERCIAL FEES $60.00 Permit Fee Minimum $70.00 Underground tank installation/removal Surcharge = Contract Value x $0.0005 If the project valuation is over $1 million, please call for Surcharge Contract Value $ x .01 _ $ Permit Fee = $ Surcharge TOTAL FEE =$ I hereby ackpowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x Ka sseui Mo YS hrki Applicant's Printed Name x Applicant's Sign )/tit kshde