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1640 Hickory Lane Use BLUE or BLACK Ink I MEN= i j Permit City of Eap I Permit Fee: 3830 Pilot Knob Road AUG 12 pC~~ Eagan MN 55122 RC i Date Received: I Phone: (651) 675-5675 I j Fax: (651) 675-5694 j Staff: I PERMIT APPLICATION 2010 MECHANICAL Date: ~O Site Address: '4 ~s~l i N L h Tenant: Suite # RESIDENT I OWNER Name: Phone: Address /City/Zip: CONTRACTOR Name: A I~) Llc lit 1 ~i ea 1-1 - Address: City: ~~yy State: VVM) Zip: Phone: (}'L~-`'1 Contact: ail: TYPE OF WORK New Replacement Additional -Alteration Demolition Description of work: Me t e~ ntcao~uI~ n s-. uir c e d1t Cl u r d ,qr n phanicaL lnspectorfor, uifo rm atlo :nt,,on; 'qm_ tttea ~scre0610g"6 o s , e ease,c tact. c RESIDENTIAL COMMERCIAL PERMIT TYPE _Fumace _ New Construction _ Interior Improvement .ZAir Conditioner _ Install Piping _ Processed _ Air Exchanger _ Gas _ Exterior HVAC Unit _ Heat Pump _ Under / Above ground Tank C_ Install / _ Remove) When installing/removing tank(s), call for inspection by Fire Other Marshal and Plumbing Inspector RESIDENTIAL FEES: 2D $50.50 Minimum Add-on or alteration to an existing unit (includese'State Surcharge) r $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ ` 5'co TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ x1% $50.50 Minimum (includes State Surcharge) = $ Permit Fee - If Permit Fee is less than $1,000, surcharge is $.50. - If Permit Fee Is > $1,000, surcharge increases by $.50 for each = $ Surcharge $1,000 Permit Fee (i.e. a $1,001$2,000 Permit Fee requires a $1.00 surcharge). = $ TOTAL FEE 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 dlg to receive locates of underground utilities. www•aooherstateonecall.orn 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 a rdance with t e approved plan In the case of work which requir, a review and approval of pla x x Applicant's Printed Name App ca s Signa ure e~iew B e p s~l,.:r~~_:rAIr~T~st;r ervice ~s f1- CITY OF EAGAN Remarks Addition Woodqate lst Addition Loc 25 Blk 3 Parcel 10 846?0 250 03 OwneYu rscreec 1640 Hickory Ln. scate Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. pAVING 1976 410.12 $136. 71 3 PAID GRADING A I 1974 115.45 23.09 5 PAID 5AN SEW TRUNK 25! 1974 93 . 54 $6. 24 15 PAID * SEWERLATERAL 1975 15 WATERMAIN * WATER LATERAL 1975 15 * WATER AREA 1975 15 * STORM SEW TRK 19 75 * STORMSEWLAT 1975 $1505.70 $100.38 15 PAID CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. $130.00 11730 9-23-74 BUILDING PER. sa,c $400.00 11730 9-23-7 PARK CITY OF EAGAN Remarks Addition Lot 26 Rik 3 Parcel 10 84600 26 0 03 Owner U,f ' " Street 1642 Hickory Ln. State Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. pAID GRADING z 3 ID SAN SEW TRUNK t.? 1 AID * SEWER LATERAL 15 WATERMAIN * WATER LATERAL 1975 15 * WATER AREA * STORM SEW TRK ?c STORMSEWLAT ZO? 1975 1505.70 100.38 15 PAID CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 130.00 11730 9-23-74 SUILDING PER. sAC 11730 9-23-74 PARK CITY OF EA04N Remarks Addition Woodgate lst Addition Lot 27 Bik 3 Parcel 10 84600 70 3 Owner &_b?:l , A/JUT%36/3 Street 1629 Walnnt T.ane State Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. ? STREET RESTOR. paVlII 1976 1 $410.12 $136. 71 3 PAID GRADING PAVING 1974 $115.45 $23.09 5 PAID SAN SEW TRUNK Z? 1974 $93 . 54 $6. 24 15 PAID * SEWERLATERAL 1975 15 WATERMAIN * WATER LATERAL 1975 15 * WATER AREA 1975 15 * STORM SEW TRK ie STORMSEW LAT q 1975 $1505.70 $100.38 15 PAID CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. $130.00 11730 9-23-74 BUILDING PER. sac 730 9-23-74 PARK CITY OF EAGAN Remarks Additio Woodqate lst Addition Lot 28 Rlk 3 Parcel 10 84600 280 03 Ownerl6,!,?s6AL 4 Street 16-41 Wal mit T.ana 5tate Eagan, MN 55122 IO ? Improvement Date Amount Annuai Years Payment Receipt Date STREET SURF. ;jD STREET RESTOR, pAVING 1976 $410.12 $136.71 3 PAID 9R*R!b& PAVING oJ 3 1974 $115.45 $23.09 5 PAID SAN 5EW TRUNK 1974 $93 . 54 $6.24 15 PAID * SEWERLATERAL 1975 15 WATERMAIN * WATER LATERAL 1975 15 * WATER AREA 1975 15 * STORM SEW TRK 1975 * STORM SEW LAT 1975 $1505.70 $100. 38 15 PAID CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. $130. 00 11730 9-23-74 BUILDING PER. SAC $400.00 11730 9-23-74 PARK CITY OF EAGAN 3795 Pilot Knob Rond Fagnrt, MN 55122 N°_ 6724 PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for Est. Value Dcte , 19 Site Address Erect E] Occupancy Lot Block SeclSub. Alter 0 Zoning Portel # Repair ? Fire Zone Enlarge ? Type of Const. - Nume Move ? # 5tories W 3 Address Demolish ? Front ft. 0 Ci Phone Grode p Depth ft. °t N APDrovais Fees ame ,o ?u Address - Assessment Permit ` ~ Water & Sew. Surchorge Ci Phone Police Plan check ?W Na^1e Fire SAC ?? Address Eng. Water Conn. w <W Ci phane Planner Water Meter Gouncil Rood Unit I hereby acknowledge thar I hnve reod this upplication und state that gldg, p{f. the information is correct and agree to comply with all applicable APC 7otal State of Minnesota Stututes and City of Eogan Ordinances. Signoture of Permittee A Building Petmit is issued to: on the express condition that oll work shall be done in accordance with all applicable Stute of Minnesota Stntutes and City of Eagan Ordinonces. Buitding Officiaf r.rmM # oet. i..o.a r«.M+.. Plumbing Mechanical INSPECTIONS DATE INSP• RougFfln Finol Footings Date Inap. Dute Irtsp. Foundation Plumbing Frame/ins. Mechanical Final PA ? Remorks: / -020? -?/ -?,/`C/Lafi?A (??^C<<i /?- v v CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, PHO N E: 454-8100 BUILDING PERMIT To be used for Est. Value ? •JJ??_ Eagan, MN 55121 Receipt ? Date ' ,19 Lot BIoCk SeC/Sub. Dn Site Sewage MWCC System ParCel No. On Site Well City Water s Name ? Address ° City Phone '" o Name . -1 7 ? 4 { • ; ? ? Address APPROVALS 9 f- City Phone Assessments Water/5ewer yVj W W Name Poliee _ g Address Fire ? W City Phone PEngr. I nner I hereby ecknowledge that I have read this epplicetion and state Bldg. Off that the informatian is conect and agree to comply with all applicable APC State of Minnesotn Statutes and City of Eagan Ordinancea Variance Signature of Permittee OFFICE USE ONLY _ Qccupancy _ Zoning _ Type of Canst _ (ACtuaq (Allowable) * of Stories Length Depth S.F. Total Footprint S.F. FEES Permit _ Plan Review _ SAC, City _ SAC, MWCC _ WaterConn. _ Water Meter _ Road Unit _ Treatment Pt _ Parks Copies TOTAL A Building Permit is issued to: on the expresa condition that all work shall be done in accordance with all applicable State of Minnesota Statutea and City of Eagan Ordinances Building Official Psrmit No. Pe?mft Holder Dab Telephons Plumbing H.V./lC. Electric Softener Inspection Date Insp. Comments Footings I Footings II Foundatfon Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Final Pibg. Bldg. Final - cert occ. Temp_ LP Deck Ftg. Deck Frm9• ,Je.CI ? C.n r': ? ?S ; f• ,? f<<, Well L P?? r tc 12/ ?S Pr. Disp. CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: ! A PERMiT TYPE: Permit Number: Date Issued: APPLICANT: N1: . ,.' I .. Jt ; , i!; ( r., i. b 1, •)3 h:3., K. PERMIT SUBTYPE: TYPE 4F WORK: . , . , . . . ,, INSPECTION D. . D. ., ? ,: ?1, . , (bl i1I I ,-tl i I i.l I ti1f:F'. IM1 11{tll IcA:' (! 111 '?G ) 1411 k01,'; 1 M 1b:'f) (i.CF1 . i) I1..:i t ti?! ,')aI.JhtlJllt 1N ? Pennft No. Pertnit Holder Date Telephone S ELECTRIC PLUMBING HVAC Inapectlon Dete Insp. Comments FOOTI NGS FOUND FRAMING ROOFING ? `?-- ? ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GA5 SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FfG DECK F1NAL ' VILLAGE OF EAGAN WATER SERVICE PERMIT 3795 Pilot Kno6 Rood PERMIT NO.: __. 1450 Eogon. MN 55122 4/26/74 --- ---- pqTe. , Gnnio}; _ UD - __-- ? , __'_ No. uF Limts. -----,_-_- ()Nv n, , Woodyate,.New.HOrizo n Homes ? -- Ad(jfP1\ ? " ----- --------- -- SliN .?adr?.. 9 31 _walnut - Lane - s 1640742 Hickory Lane ------ wnber ompson-P UIIlb1n CO g -- - - ----- -- -- . ------ -- Mrtr•r No ? . __ - ----------- -- ------ ----- ?-- Oonnection Charke ? ._ - - Account Deposu: --_..--- Re.idrr No Prrmit }'ee. 10.00 pd I ogree ra complr wirh the Villoge al Eoqen Surc harge. ___ _ • _ 50 pd Ordinances. Misc. CFIarKes? - Total ?- Iiv %,' I)elrof Insp' -- DatePaid'_______ Insp: L, 1 - - --- , - ----- ------•-- - --- - - -- -- --- - - ? -,?7y1,/1? g - ? y Z 7 a ` / l (?. ?-37y /T /?G ? '/_ 6 ?'? ?2- ? 7 ???/._/__`•?_ ?S' .?'D O Iv _ ? . --? - ?--- ? .?_?-- - --- - -- -- ?`-- ----- -- --- --- - - - ? r ?, YILLAOE OF EAC tA SEWER SERVICE PERMIT 3795 PibF3(nCb?food PERMIT NO.: 2210 Eagon, MN 55122 DATE. 4/25/74 'Loning: nirn No. o£ Units: Owner:- [•7nnAnaro n.e... v..._:...._ .,?'_ Address: - Site Address: 7 h 9-51 [aL7 nut 7.an & 1640-42 Hickory LahC Plumbec m e.homnson PlumUinq -p, I ogree }o eomply wiih Ma Villoge oi Eoqan Ordinonces. BY: Connection Chazge/? Accoun[ Deposit Pertnit Fee: 10. 00 pd Surchazge: • 50 Qd Mtsc. Charges: Date of Insp.: Insp.: - Total: _ Date Paid: CITY OF EAGAN N 0 13 9 7 4 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE:454-8100 BUILDING PERMIT Receipt# 75906- To 6e used for DECK Est. Value $700 Date JDLY 27 ? 9 87 SiteAddress 1642 HICKORY LANE Lot 26 Block 3 Sec/Sub. WOODGATE ADD Parcel No rclName JUDY GRANAHAN W = Address S? ? City Phone $63-4349 (H) ,o Name SAME 452-1729 (W) ?Q Address ? City Phone w W Name Address ew City Phone I hereby ecknowledge that I have read this application and state that the information ia correct and egree to complywith all applicabie State af Minnesota Statutes and City of Eagep Oidinances. Signature ot Permittee A Building Permit is issue all work shall be done in accordance with all Building Official OFFICE USE ONLY On Site Sewage _ Occupency MWCCSystem _ Zoning On Site Well 4 _ Type of Const City Watar _ (Achel) (Allowable) # of Stories Length Depth S.F. Total Foo[print S.F. APPROVALS PEES Assessmenta _ Permit $15.40 WateVSewer _ Surcharge .50 Police Plan Reviaw Fire _ SAC,City Engc SAC,MWCC Planner _ WaterConn. Council _ Water Meter 81dg.Off. _ Road Unit APC _ Treatment P7 Variance _ Parks Copies TOTAL t' 15.90 on the express condition that nnesote,Statufes and City ot Eagan Ordinances. -ciTr oF FAcnN 10. . 3795 Viloe Knob Rmd Eagan, MN S5722 PHONE: 454-8100 N? 6724 Receipt .jk - BUILDING PERMIT APPLICATION Site Address i"67 -ac Lot 27 Block 3 Sec/Sub. Woodg8t2 Parcel # 10 84600 270 03 m Name Robert Knudaon 3 Address 1629 Walnut Lane ° ?:... ''?gan o"..__ G52?490fi p Nome F& N GP.nera7?'.onat ?? Address 9564 !tI'B31 E. ROad ? ?:... BloominAton M,...e 423-3295 Neme _ Address 1 hereby acknowledge that I have read this application and state that the information is correct ond agree to comply with all applicable State of Minnesota Statutes ond Ciry of Eagan Ordinances. Signature of Permittee A Building Permit is issued to: 'F all work sholl be done in acmrdance Erect ? Otcupancy - Alter ? Zoning Repair ? Fire Zone Enlarge M Type of Const. Mrne ? # Stories Demolish ? Front ft. Gmde ? Depth ft. Approvoia Feas Assessment - Woter & Sew. Police ? Fire Eng. Plonner - Council - Bidg. Off. - APC Permit ? ?-nn Surcharge -5n Plon check SAC Woter Conn. Wuter Meter Raad Unit Taai $1? 50 Rt, on the ezpress condition that of Minnesota Statutes and City of Eagan Ordinances. Building Official V CITY OF EAGAN BUILDING PEEtNIIT APPLICATION Include 2 sets of plans, 1 site plan w/elevations & 1 set of energy calcu].ations. 7.b Be Used For 4J ?CK Jx-q.C{ . Valuation p d? Date 6 -- / 7- ffI site pdaress: ?,? c? ?. •? i ?, ?.f LA) oFFzce usE oru.Y Lot -?-Z Slock ?- sec./siab. Erect pccupancy Parcel #: ?? ??{ C¢ d c? a? D u3 Alter zoning Repair Fire Zone Owner: ^ h' ' f ?? ? Enlarge _ Zype of Const. 17 ' ? Gjt Nbve # Stories Addres5: . S? Demolish Front ft. City/Zip Code: Grade Depth ft. Phone #: a .5'2 - 3`? B? APFROVAIS FEES Contractor: /-S-Af Address: qSE y Tra., E City/Zip Code: -fc"n? Phone #: 9.1?- Arch./Ehg.: Address: Assessments Water/Sewer Polioe Fire En4 • Planner Council Bldg. Off. P.PC Pexmit Surcharge Plan Cttecic SAC Water Conn. Water .^leter Road Unit City/Zip Code: , F-Phone #: ? fileodqa.Te Isfi ., . CITY of EAGAN 3401 BUILDING PERMIT Owner ... . ?,v 3795 Pllof Knob Aoad ..............?---.................. ... . . . - . fJ" . ............ .. ...........- -'....... .... Eagan. M?naesola 55112 Addrecs (precen!) ...?.?1.?-? ..... ..................................................... .. 454-8100 ? / Huilder ......... ......^-'Y:'?-?`:'......................................... .--------- -..... ... Dab ....g..- . Addran .... .... ....._._...... .... . ................................................."'-"".-------------------- Storissl To He Uaed Fox Fron! Dsplh H& ° b! Est. Cmt srmS! Fea Aemasks ? , 71 I LOCATION ? i 3 9?5 0 Streef, Aoad or oiher Dsscrtpfian o! Loealion I Lo! Bloak Add!lfon or Tract This permit daes no1 aulhorise the uce oi alreele, roeds, elleys or sidewalke nor daas it glvo the ownes oi hb a"ai the righi to exeate any siluation which is a nuisanae or whieh psesenls a haza:d fo ffie heellh, tafelp. COOvenIepp sad general welfara to anpone in the communify. THIS PERMIT MUST SE KEPT ON THE PREMISE WHILE TFIE WORK IS IN. PROGRE88. This is !o cerfify, ..... .....haspermission !o ereet .... ?:`.':!::..`.?.- ..................__-qyoa the above described premise subjec! 46 the provisions of all applica6le Oxdinancea Sor the Citp of Eagan. - ................. ....._...?......... ..................... .. .. Paz ..... - ..../.l?".`:.?._........:.??:..?`....; :?.......---........................... Mayor f? Buildlnq Insp?clor Ot? -l "? 6 -3 wo e'dyafe / CIT't OF EAC'a.Td 3795 Pilot Ktiob P.oad Eaaan, Minnesota 55122 PFR41'£ NO.: cec The City of Ea.gan hereby grants to ,._„ Qe,,qw4,,,, va-.+vg °f 1001 Xortia g HEklEti9 Permit for: (Owner) .,e.. ar...+s.+.. n....,_e m....w..ate 162?-31 Nalnut 6 at }?e???,W I ^_-p -, pursuant to application dated Fee Paid: $80 Go_ dated this Ir ,.__day of ve . 2.00 s/c Building Inepector Mechanical Permita: Bid Total: 3 HOUSE HEATING TEST RECORD D-21237 -5,-oW ADDRESS 1840 Hiokory* Lane ppT.?p LOW CITY SUBURBEagaR OCCUPANT None nwucp NG.sc HoT ZoY1a HEAT LOSS SOLD BY _ DATE HTG. INST. 3A5 CO. METER BADGE 4 INSTALLED BY 3Bdk'wi6k Htg• Gos Line By it to Electrical Work By - TYPE OF HEAT GA FA X HW-STEAM SPACE HTR. -UNIT HTR. -OTHER GAS DESIGN MAKE WilliameOn MAKE OF BURNER_ Modol 1117-07-5 Model Sxial 7340792 Moz, BTU Rating- INPUT 75,000 Btll HT, MAKE OF FURNACE Model CONTROLS THERMOSTAT Cm 260 Heat Plu9 Vent Size n ? ValVe M.H. V8VBC KIND OP IINER Alum, NONE SIZE B? Limir Robehaw RFL 75011 orafrtiood ertical Reqolaror Limit SaMin9 200 f Filters Size 1611 8 25" Numbar 1 Fon Sa}ting 90of & 1200f Chimney Lecotion Inzide Yee Outside Pilot Type COUple Chimney Construciion Metalbeetos Pilot Make Pilot Model Smoke Bomb Wiring Pilot Timing 69nSeconds Draft ?g Test Tag Yes L.W. Cut Off Door Pressure Lighfing Inst. ee Presaure 4•4"W.C. PertentC0 7'0% DateTsstsd 12109/74 Input CFH 2 74 PeresnT OZ R„-7-,,?-- Gmpany Testing Stack Tamp SOOof parcent CO 0•00 ? Nama oF Tesfar n??- ? . Form 235 CONVERSION -41?,swii HOUSE HEATING TEST RECORD D-21237tiz?? ADDRE55 1642 HiCkoDy Lane APT, OCCUPANT _ FLOOR CITY SUBURBEagan OWNER N¢w Hox'iZOt18 HEAT LO55 DATE HTG. INST. GAS CO. METER BADGE #Sed iCk Ht SOLD BY INSTALLED BY ? g• Electrical Work By - TYPE OF HEAT GA Gas Line By FA X HW _STEAM-SPACE HTR. _UNIT HTR. -OTHER GAS DESIGN MAKE WilliamgOII MAKE Model 1117-07-5 Modsl Se,;,l 7439651 ' M,x, INPUT 75_000 Btn/ Ar_ MAKE Modei OF BURNER n n CONVERSION BTU Rating- OF FURNACE CONTROLS THERMOSTAT Cm 260 Heat plu9 Vent Size 4t' Valve M A VROOn KIND OF LINER Alri m. SIZE 6" NONE Limit R/f}1AYIAW RFl 750n Droft Hood VET t7.C81 Reguloror Limit Setting --`L(10of Filters Size 1611 x 25" Number 1 Fon SeTting 4oof Rr 1211of Chimney Locatfan Inside Yes Outside Pilot Type ?'.f1nF1P Chimney Construcfion Metalb@949 9 Pilot Make Pilot Model Smoke Bomb Wiring Pilot Timing 50 Secnnde pra{} OK Test Tog Ye8 L.W. Cut Off Daor Pressure Lighting Inst . Ye9 d Preszure 4•'4'??•C• PerceniC02 7•0?° Dote Testsd 12j 10j74 8..,7_%_ InputCFH 75 Percent 0 Company Testing 2 Stack Temp. 49Oof Percent CO 0•00% Name of Tester Form 235 14 HOUSE HEATING TEST RECORD D-21237 ADDRESS 1629 W8ltlllt Laae APT.-FLOOR CITY OCCUPANT NONE OWNER New Horizone HEAT LO55 - SOLD BY Elechical Werk By TYPE OF HEAT GA DATE HTG. INST. GAS C0. METER BADGE d iCk Ht INSTALLED BY e? g• Gas Line By of _ FA X HW -STEAM -SPACE HTR. -UNIT HTR. -OTHER GAS DESIGN MAKE Williamaon MAKE OF BURNER -susutts Eagan CON V E RSION Model 1117i 07-5 Model $mia1 7440309 Max. BTU Rating - INPUT 75,000 Bt '_ MAKE OF FURNACE CONTROLS THERMOSTAT C'm 260 Heat Plu ? Valve M.A. V8 10c Limit M.A. 1-4064A Limit Setting 2000f Fan Serrin9 9o°f & 120°f Pilot Type Couple Pilot Make Modal 4" Vent Size KIND OF LINER A1um% SIZE 5" NONE Drak Hood vQrt. Regularor Filters Size 16n 3f25" Number 1 Chimney Lacation Inside YQQ Outzida Qiimney Construction MetalbeetOB Pilot Modal Smoke Bomb Wiring Pilot Timing 84 Seconde pra{t Ok Test Tog YQB L.W. Cut Off Dow Pressure Li9hting Inst. Yeg Pressure 4.5"W,C, Pe,centC02 7'0% Date Tested 12f9/74 ' InputCFH 75 Percent OZ 8.7% - CompanyTesting r001 t IIS BC18 t. BB Stack Temp. 0 560f , 0 0 per?nt CO o Name of Tester ?L Fwm 235 ,-'4 HOUSE HEATING TEST RECORD D-212377?? ADDRESS _ OCCUPANT 1631 Walnut Lane, HEAT LO55 DATE HTG. INST. SOID BY Elecrrical Work By TYPE OF HEAT APT.-FLOOR CITY SUBURB E$gan OWNER New Horizone INSTALLED BY SedgwiCk Htg, Gas Lina By „ of GA _ FA `HW STEAM -SPACE HTR. GAS DESIGN MAKE WilliaoasOTl MAKE OF BURNER _ Model 1117-07-5 Modal Swio1 7412288 Max. BTU Rating _ INPUT 75,000 Btri AT, MAKE OF FURNACE CONTROLS THERMOSTAT C'm 260 Heat lu P Valva ?aoC M.H. Limit Robshaw RFL 7501i Limit Setting 200of Fan Se»ing 9009 & 1200f Ptlof Type Couple Pilot Make Pilot Modal Pilot Timing 72 SQCOt1t38 L.W. Cut Off 4,5"W C 7 0% Pressure- , , 4ercanf COZ InputCFH 1 Percenf OZ 8•7 0 0 SFQ0f Slack Tamp. . ' Percent CO Form 235 Modsl Vent Size `f.. KIND OF LINER AlIIm. SIZE R° NONE Drok Hood VCRtle81 Regularor F{Itars Size 1611 % 2511 Mumber 1 Chimney LocaTion Inside Z'ee Outside Chimney Construction ivtet8lbeStoe Smoke Bomb Drof+ - Wiring Tszt Tag Y@9 Dow Pressure Lighting Inst. iea Date Tssted 12[9r74 Company Teating r'ORlbil6tlOII S ecia 1C8 Name of Tester CONVERSION UNIT HTR. -OTHER 7?G 5 0? $ S ??- 6 5 2 6 / ? 4 W ? 44, ?3 0 ? r,? / av ReQUesi Diaie Fve No FougMn InsOeo[ion ReOmred+ XReaOy Now p Will NoMy Inspector ` ' VBS XNO M1¢n ReaC" h I?Klicensed coniractor D owner hereby request mspection ot above electncal work at. Job Atldress (SireeL Bax ar Roule N. I Qty Sedion No, Townsnip Name or No Range No Couny Occupant(PRINTi r''?.a. r- Phone No PowarSupOl,er qtltlress Eleclncal Comracior iCompany Neme) Gonhacmr6 License No 1 h'I?TSr?b /e.Gl rIG G4 02.Z6 L{ Mailinq AGEress ICOnimctor or Owner Making InstallaUOn) _ 7 os z7 ? -- Authenze0 SiqnaWre iContr3ctor?Ow er Making ins;alla o ? Phone Number 6?? 7 z?!- MINNESOTA STATE BOAHD OF EL'ECTRICITY THIS INSPECTION REOUEST WILL NOT Grl99s-MiEway Bldg. - Raam S173 l BE AWEPTED BYTHE STATE BOARO 1831 Onivpr6lty Avp. 51 Paul. MN 55100 M? UNLESS PROPER INSPECTION FEE IS Vhone (612) 642-0800 ? ?? ENCLOSED r?/? 15 ;EQUEST ' oFORoEP ECTRUCA?L MSPECTION Q - "X" Below Work Covered by This Request °TMe,.' G EB-o0001-OB - a s g 8, ew Add Rep Typeo(8uildmq AppliancesWrted EqwpmeniWned ? ? Home Duplex Range Water Heater Temporary Service Electnc Heating Apt Building Dryer Other (Specity) Comm./Industnal Furnace ? Farm Air Conditioner Ocner (speniyl onvactor's Remarks ? Compute Inspecfion Fee Below. a Other Fee # Service EntranceSrze I Fee # Circutls/Feeders Pee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above200_Amps Above100_Amps S19n5 Inspector's Use Only TOTAL Irrigahon Booms Special Inspechon Alarm/Communicallon THIS INSTALLATION MAY BE ORD ED ONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspecror, hereby Ro°9h-'" r ? oaie cendy ihat the above inspection has been made F,,,ai '- ? OFFICE USE ONLY Tnis request vo,0 t9 montns Irom d 0 9 9 6?? ??i a ? / Reqvest Date Fire No Rough-in Inspeceo Reqwred4 eady Now 7 WAI Notily Inapector F tl '+ Wh .]Yes p en ea y ? ; hcensed contractor ? owner hereby request inspection of above electrical work at: Jab Atltlress lSlreel Box or Route No 1 City 6, y?-- ?c°?-a?' Sec ion Yo Township Name or No Range No Counry OccupaM (PRINT) Phone No .T D ?.? /1??l?i% Pawar Supplier Atltlress EIecV¢al Commctor lGOmpany Name) ConVaclor'S Lrcense No. G e"' d9fi4 Mailing Atldress IC vaclor or Owner Maii InstallaLOn? Aut ignaWr t ci ne axing Installation? umber Pnone N J / !OC> MINNESOTA STA BOAflD OF EIECTRICITY THIS INSPECTION REOUEST WILL NOT GrlggrNlEway Bltlg. - Noom ^s173 BE AGCEPTED BY THE $TATE BOARD 1821 Univemiry Ave. 51. Paul. MN 55104 UNLE$$ PROPER INSPECTION FEE IS Phone(61])642-0800 ENCLOSED REOUEST FOR ?TRICAL INSPECTION p ? See insimc[wnrbr comple ng this lorm on back of yellow mpy L Er'996$ "X" Below Work Covered by This Request "VTM!?d ? ,11 EBA0001-08 ew Atltl ep TypeofBwlding AppliancesWiretl EqwpmenlWrted Home Range Temporary Service Duplez Water Heater Electric Heating Ap[ Building Dryer Otheo-(Specify) Comm.llndustnal Furnace Farm Air Condrtioner . Other Isyentyl ConVactor's Remarks Comp?ite lnspechon Fee Befow. A /7` ? # Other Fee # ServiceEnfranceSize Fee # Circuits/Feetlers Fee Swimming Pool 0 to 200 AmpS 0 to 100 Amps Transformers Above 200 _ Amps Above 100 _ Amps Signs Inspector5 usa Only: TOTpL Irngation Booms Speciai Inspecuon ! AlarmiCOmmumcauon THIS INSTALLATION MAY BE ORD DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 1H MONTHS. I, the Elecirical Inspector, hereby Ro°9n-'" oaie certify ihat the above inspection has been made Finai oate OFPICE USE ONLY This repuest wW 18 monihs hmm (..'185-1 2005 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. V DateI_l-?1 /S01? ? Site Street Address ??yp 1ni CtDM ?Q? t% Unit # ? Property Owner ?yCz pGYc1Vm(9?? Telephone # (15A) M-1d1Os Contractor Telephone #((05l ) 22e-q011 Address `?"JOS 94MI ? ?- City Stater Y? Zip?IDZ The Applicant is: _ Owner Y- Contractor _Other Alterations to existing dwelling _ Add plumbing fixtures (excludes water softener and/or water heater--complete next section if installing these appliances). _Septic System Abandonment _ Water Turnaround (add $125.00 if a 5/8" meter is required) Other: $ 50.00 _ Water Softener ? Water Heater _ new ? replacement $ 15.00 Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00 State Surcharge $ 50 Total 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. m%i Gl.e.v-Aam ApplicanYs Printed Name Appl t IT ? FEB 0 4 2005 2006 RESIDENTlAL PLUMBING PeRmi7 aPPUCAriorv CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN Mtd 55122 651-675-5675 Piease complete for modificaUons to existing residential dwellings. Date ) I ?7 I ok Site Street Address ? b q?, Unid # Property Owner AU kfSy A00rp-- Telephone #( 0) 10L M7 Contractor _ Telephone # Address ? Qgo - ?J? W v City I^ a f M: D'{ e? State?_ Zip ?s°aq The Applicant is: _ Owner ? Contractor _ Other Septic System _ New _ Refurbished Submit 2 sets of pians and MPC license Includes County fee $ 100.00 Peras-built $ iQ.00 Alterations to existing dweiling $ 50.00 _ Add plumbing fixtures. This fee indudes instaliation of a water softener and/or water heater at the same time. lf you are installing oniv a water softener and/or water heater, do not complete this sec4ion; rrtove to the next sectlan anU check the appiiance(s) you are installing. ??i??' ' S'? _Septic System Abandonment Water Tumaround (add $130.00 if a 5!8" meter is required) ? 7?? = Other. ? ..\ ? Water Softener ? Water Heater S 15.00 _ new ? replacement Lawn Irrigation _RPZ _PV8 _new _repair _rebuild $ 30.00 Sta2e Surcharge $ .50 Total S ??• ?) ? I hereby apply for a Residential Pium4ing Permit and acknowledge that the infarmation is complete and accurate; that the work wiil be in conformance with the ordinances and codes of the City of Eagan and ihe plumbing codes; that I understand this is not a permit, but only an application for a peRnit, work is not to start without a permft and work will be in accordance with the approved plan in the event a plan is required to revie ueci?and approved. A a-c K 1C; ift d s e+?. L-A ApplicanYs Printed Name ApplicanYs Signature lb? City of Eapn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax:(651) 675-5694 ?---- ------------i I For Office Use ? ? ?59 ? Permit#. ? I Permit Fee. I ? Date Received ? I I ? ? Staff: ? I ------------------ 2008 RESIDENTIAL BUILDING PERMIT APPLICATION ? Date: 9-/9'-O0 SiteAddress: Tenant: C+?c?u??s Ilo3/? lJ?t?.?ur L W1#tNu-r LA?=? . a/ !_ yickday ?n.?. - Suite #: RESIDENTiOWNER Name: (/OCODC?A-T£ /VOA Phone: Address ! City / Zip: Applicant is: _ Owner x Contractor TYPE OF WORK Description of wark: TEA 2 !S f/^ 4- PC?-?? 1- Construction Cost: 006 Multi-Family Building: (Yes _ I No ? CONTRACTOR Name: e `} _11- kov (- f ^) (,, License #: Address: I710c)- 10H J"T'?c /LOGK 2b City: ?JR?S Ul t.c-? State: Zip: S 5 3 3 7 Phone: ?119 -75 Contact Person: 1,-(Ie £ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateqory 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted (4 subfl'lission type) • Energy Envelope Calculations Submitted 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 supporfing documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provlde specifi'c reasons that wou/d permit the City to conc/ude that the are trade secrets. i hereby acknowiedge that this information is complete and accurate; that the work will be inconformance with the ordinances and codes of the Gity m 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 . ?jc?fi44L P?U21CST2A.)? X ` ? l ApplicanYs Printed Name Applica Ys Signa e Page 1 of 3 Clty of Eaian 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r_ _ _ _ __ _ _ _ _ _ __ _ j Pertnit#:? I Permit Fee. I T- ? ? Date Received: j ? I I Staff: I i 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: -? 3o - 0 9' Site Address: ?cl?oZ ?I ' 3 1A)4{/JUT L K) >? yQ- ya 1)/< Tenant: 1 OO?4!}T £ 904 Suite#: 1- ? RESIDENTlOWNER Name: Phone: Address 1 City 1 Zip: Applicant is: _ Owner _ Contractor TYPEOFWORK Description of work: RDOFi,--'G Construction Cost: /"'? Multi-Family Building: (Yes _ I No ? CONTRACTOR Name: C 4' S 2oD1=ING License #: Address: I7/0 / ^ ?JH' !7y- koe-K kj? City: [S JJQNSV(t-Cc State: Zip: S?3 'S / Phone: IS?v2 -g9I - YD 7S Contact Person: ZY/ Kz COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet C2t0gOry Submitted Submitted (4 Submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a pertnit 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: NOTEr;Plans and'supporting docame»fs thaf you submif.are con0dered to'6epublrc?inforniatiort" Portions of ? dassified as non putilic nE you provide specrtlc re?sons that would perm?t the C?ty to .. ° the mformairon rriay, be ? ? arP... .. ,J}'1a?y i °.*a ?t` .. .,{, t"-a s,., 1", :.. ?/-??. {L Ulal IIIP. ?YJP. $P.r.lP.l$.,:7 n I hereby acknowledge that this information is complete and accurate; that the work will be in confortnance with the ordinances and codes of the Ciry of Eagan; that I understand this is not a permit, but onty an appliwtion for a permit, and work is not to staA without a permrt; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. G?,`/ `-.'C xl'IIKf u302t'S772s?/1?t? _ x \ Applicant's Printed Name Appl" anYs Sig ture Page 1 of 3 ?---------------- ? Fgypffi?:47se 7 1 ? Permit#: C• ?-?// I ? Permit Fee: 2.Jv I ? ? Date Received: i staff: i L_________________ 2008 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: 1-Ob Site Address: MT 1 HiCV-V ( Tenant: Suite #: ( 5H95 Ph " hi &? e RESIDENTIOWNER 0 one: Name: A / 117C?{ , - Address / City / Zip: SCLYYLQ. r `'J S 1 a a' CONTRACTOR Name: License #: (D 0 10 -PM Champion Address: 3670 6odd Rd. #100 State: Zip: Ciry: Phone: Contact Person: o I G? I'1 TYPE OF WORK _ New ?Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W. Description of work: PERMIT TYPE RES/DENT/AL ? Water Heater Water Softener ?u) U ? MAR o 3 2008 Lawn Irrigation Add Plumbing FiMures (_ RPZ !_ PVB) Main _ Lower Level) SepticSystem _WaterTurnaround New Abandonment RES/DENTlAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge) "Water Turnaround (add $136.00 if a 5/8" meter is required) $100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ 50,5o I hereby acknowletlge that this intormatlon is compiete ana accurate; tna[ me worK v,nn oe m conrormance wnn me oromances anu wue. ut me ?ny .? Eagan; that I understand this is not a permit, but only an application for a pertnit, 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 plan x x\ IUXYLGS 171. NI"af K ApplicanYs Printed Name Applica Signatur . ? ; .<.. , _ . ,.,• ?,. ?Date FOR OEFICE USE, ` Reviewed Byt Required-Inspections: Under Ground?, -Rough_.In ?r' ?_t Air Test-: GashTest - <_S ._ . ........ h . ,'le.?? ." . 5 bqg« 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for. single family dwellings & townhomes/condos when permits aze required for each unit X'30,',33 Date / SiteAddress ?IQ'(I k /T/C/?C.YGy Unit# /n Property Owner /yC! Q.Q f 1/ Aru&E Telephone #( lA.l 1) 9a,s- /y(? 7 Contractor /'7tX(f //? Street Address q7 n n /7.J ?? S/ W City XcUe/r1coli/ State Zip ??J Q Telephone #((0S1 ) ,3Qa - Q Q(0 Bond #: Expires: The Applicant is _ Owner ? Contracror _ Other Add-on or al[eration to existing dwelling unit $ 30.00 furnace _Additional _Replacement air exchanger ? air conditioner _New )(Replacement other State Surcharge $ .50 Total $ 3osd I hereby apply for a Residential Mechanical 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 with the Mechanical Codes; that I understand this is not a permit, but only an application for a permit, and work is not to star[ 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 Ap"ans. ?Ti?u?.T (49?[lrrn-ms Applicant's Printed Name Signature Jf?G JUL 1 4 2005 L! ??--- 2005 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for, commercial/industrial buildings mulh-family buildings whcn separate pettnits are not required for each dwelling unit Date Site Street Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) Contractor Street Address City State Zip Telephone # ( ) Bond #: Expires: The Applicant is _ Owner Contractor Other Work Type _ New Construction _ Underground Tank _ Install _Remove'"see below _ Interior Improvement _ Install Piping _ Processed _Gas Nature of Work: **When insialling/removing underground tank, call for inspection by Fire Marshal and Plumbing Inspector P¢I'tlll[ FC05: $70.50 Underground tank mstalla[ion/removal $50.50 Minimum (mcludes St&tc Surcharge) OC Contract Value $ x 1% Permit Fee • If ep rmit fee is $1,000 or less, add $.50 => $ State Surcharge [f pe rmit fee is over $1,000, add $.50 for every $1,000 ermitfee $ Total Fee <<,ereoy appry ror a commerciai nnechamcal Yermrt and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the Ciry of Eagan and with the Mechanical Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. ApplicanPs Printed Name Applicant's Signature Approved By: , Inspector CITY USE ONLY PERMIT #: 1 RECEIPT DA7E: I?-'19-0 !t£SIDENTIAL M£CHkAICAL P£iiMIT APPLICATION crrYoe g,e?eAx 3$30 P1LOT KNOB RD EnsAN auv 55 1 22 651-691-4675 ? Please complete for:> single family dwellings townhomes and condos when permits are required for each unit Date: o SITEADDRESS: OWNER NAME: (-C?, TELEPHONE (AREA CODE) INSTALLER NAME:? G G1> TELEPHONE #: CdT I - Z?lZ? (AREA CODE) STREET ADDRESS:-2vL??2 E) 1,44 5? '?- :?)? L--) - i ? - 0- • L7Q-K CITY: STATE: ('f-\I?..J ZIP:SSU+ Place a r.her.k mark neYi tn the narmit wnrk ivne New residential dwelling unit under constructionand not owner/occupied $ 70.00 ? -, modification or to exlstina dwelling unit $ 50.00 • furnace replacement ?- , • air conditioner i • other Nature of work: State Surchar e I $ 50 L Total $ r50 Reminder: Call for inspeetions. n CITY USE ONLY PERMIT #: APPROVED BY: INSPECTOR RECEIPT DATE. COMMERCIAL MEC}ImICAl. PEfiM1T APP11CATION CITYOF EALfiAN S$SO PILOT KN08 iiD EAsA1v,Mv 551 Es 651-6$1-4675 Please complete for: all commercial/industrial buildings multi-family buiidings when separate permits are not required for each dwelling unit DATE: SITE ADDRESS: OWNER N,AME: PHONE #: - (_AREA CODE) TENANT NAME (IMPROVEMENTS ONLY): WAS THERE A PREVIOUS TEA?4A'T IN THIS SPACE? Y N. NAME INSTALLER: ADDRESS: CITY: N%ORK TYPE: New construc[ion _ Interior Improvement _ Processed Piping Specify Nariue of Work PHONE #: - (AREA CODF.) STATE: ZIP: Install U.G. Tank Remove U.G. Tank When ilrstalling/removii:g underground tank, cal! 651-681-4675 for inspectia: by Fire Marshal mul Plus:bixg Lixspector. Fees: 1% of conuact price OR $50.00 minimum fee, whichever is greater. Underground tank removaUinstallation = mmimum fee Contract price. $ x 1 % = $ (Base Fee) Stare surcharge calculate at $.50 for each $1,000 Base Fee TOTAL $ SIGKATURE OF PERR4ITTEE Updated 1/O1 PERMIT # '/ RECEIPT DATE: f- RESll}EPTIAL PLUMBIIVH PE#iMiT APPLICATiOH crrY oF F-Asm S$SO PILOT KNO$ itD EAstkP. Mlv 55122 r 2-'? y - 0 1 ? 651-681-4675 ?D Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit )? backHow preventer for irrigation system SITEADDRESS: I ?0 D-? ?\ N-t...? LN • OWNER NAME: : V'Y-?'?(CCk_ TELEPHONE #: ?061 - ?I?,_'•-^?, ."? (AREACODE) y ? ?_Y\ INSTALLER NAME: ?? Y\i (.Cg TELEPHONE #: 6G-1?i 3f? `t? (61-1) STREETADDRESS: q3Q)(?. I TU??? 54- ? (AREA coDE) CITY: ?C???GG1'ns1l?-1 STATE: 1° Vv 21P' CAU Place a check mark next w the permit work type New residential dwelling unit under construction and not owner/occupied $ 90.00 ? Add-on, modification or alteration to existina dwelling unit, including: $ 50.00 • abandonment of septic system • new installation/repair/rebuild of RPZ • lawn irrigation system • water turn d Natureofwork:??i??? , Septic System, new/refurbished - $ 225.00 • includes County & Consulting Inspector iees • requires MPC license Water turnaround - existing dwelling unit, including: $ 50.00 • 5/8" meter 115.00 $ 165.00 State Surcharge $ .50 t l $ I00 G To a Reminder. Schedule inspections of alterations, i.e. water heaters, water softeners, water turnarountl, etc. I hereby acknowledge that I have read this application, state that the inforrnation is correct, and agree lo complywith all applicable City of Eagan ordinances. It is the applicanPs responsibility to notiTy the property owner that fhe City of Eagan assumes no liability for any damages caused by the City durin ats normal operatlonal and maintenance activities to the 3cilities consWcted under this permit viFhin Ci p?operty/right-of-way/e ement. SIGNATURE OF PERMIT-* U ated 9/01 /3 7 % ? 1987 BIIILDING PERMIT 9PPLICATION - CITY OF EAG9N SINGLE FAMILY DWELLINGS INCLIIDE 2 SETS OF PLANS, 3 CERTIFICATES OF SORVEY, 1 SST OF ENERGY CALCOLATIOHS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MIIST DESIGNATE WHICH ADDRESS IS DESIRED. NO CH9NGES WILL BE ALLOWED ONCE BQILDING PERMIT IS ISSDED. M[JLTIPLE IIiiELLINGS - RFSIDENTIAL RENT9L DAITS FOR SALE UBfITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF S[IRVEY - CHECK ilITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 7 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND To se Used For: D E C K Valuation: At7o a°-= Date: G/?? / IF 7 Site Address / (v ?oZ ?,Jte??Ly A', Lot a , Bloek ?3 -,-- Parcel/Sub owner -:7'04 G2AnuA11.41LJ Address /?qa /,'ieKoR y 4A1VF i - City/Zip Code F,46?,4l SS/d d Phnnc?/?)?'?,3=y349 ?E1??13? i?a9 Contractor lo//U6 7Y?E CvnRk Address DURSBLoF_o City/Zip Code Phone Arch./Engr. _ Address City/Zip Code Phone 4I On Site Sewage_ Occupancy MWCC System Zoning _ On Site Well Type of Const _ City Water _ (Actual) (Allowable) Ik of Stories Length Depth S.F. Total Footprint S.F. Aeraovu.s FE-PS Assessments Permit I -5"io Water/Sewer Surcharge 7?:02: Police Plan Review Fire SAC, City Engr SAC, MWCC Planner Water Conn Council Water Meter Bldg Off Road Unit APC Treatment P1 Variance Parks Copies TOT9L / S • /rB ?.. ? ? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: PERMIT PERMIT TYPE: Permit Number: Date Issued: 1640 WICKORY LANE LOT: 25 BLOCK: 3 WOODGA7E P.I.N.: 10-84600-250-03 ?? ??9 d d '?) BUILDING 025242 03/20/45 DESCRIPTION: ?-, (ROOFING) wildtnc,?-Permit Type SuLldinq wo•r-k Type i r r MUL7I. (MTSC.) REPAIR ,,??=? , I i ? -v e•? _ REMARKS: INCLUDES 1642 (LfIT 26) HICKORY LN FEE SUMMARY: VALUATION $6,000 Base Fee $81.00 3urcharge ,$3.00 Total Fee $84.00 CONTRACTOR: - qpplicant - 51. Lzc. OWNER: ALLSTAR CqNST INC 15935325 0003297 WOODGATE TOWNHOME ASSOC 3315 N HWY 100 1625 HTCKORY HILL MINNEAPOLIS MN 55422 EAGAN MN (612) 593-5325 (612)452-3922 I hereby eckrsowledge that T have read this applicaCion end state thaC Che information is correct and agree to comply with all applicable State of Mn. L Statutes and City of Eagan Ordinances. _ APPLICANT1PEfiMITEE SIGNATURE --??loc? R.oi R,l.l rit? 1N5YLC;'1'lUN 1ZL(:Ollll CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: LOT: 25 BLOCK: 1640 HICKORY LANE WOODGATE PERMIT SUBTYPE: MULTI. (MISC.) APPLICANT: 3 ALLSTAR CONST INC (612) 593-5325 TYPE OF WORK: DESCRIPTION BUILDING 025242 03/20/95 REPAIR rRnnFrNr,I INSPECTION FRAMING .. . ROOFING ,. INSULATION FINAL REMARKS: INCLUUES 1642 (LOT 26) HICKORY LN 1629 (LOT 27) 1631 (LOT 28) WALNUT LN F L ? ? ??_ ? ? cmr oF ??GaN JL61411995 3830 PILOT KNOB RD - 55122 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 ? 3 registered sile surveys ? 2 copies of plan ? 2 copies ot plans (indude beam & window sizes; poured fid. design; etc.) ? 2 site surveys (exterior eddkions & dedcs) ? 1 energy calaladona ? 7 energy wlaletions for heatad addiBons ? 3 copies oi Lee presenation plan ff lot plattad afler 7!1/93 required: _ Yes _ No DATE: L-/6- 75 CONSTRUCTION COST: <400 DESCRIPTION OF WORK: Tt'y urF rE raof ' STREET ADDRESS: /b 27 LOT .` ?'?. BLOCK A _ Lu-7 SUBD./P.I.D. #: PROPERTY Name: /d?. ,ke.«L 4IJoc" ufieH Phone#: yS z'321ZZ OWNER `"`T Street Address• /6 Z 7 - 3/ w?i?,r 1`9,P -yz 6?-, AO,4 Ck K?- City: ? u State: I'+, N Zip; Ss ii Z CoNTw?cTOR Company: ('o-? ,I,' Phone #: 5 y-7 f31-f Street Address: 321S ti/fw? /2 z) License #: 3a y 7 City:_L;g /s State: k-t4,?l Zip: SSyz z- ARCHITECTI Company: Phone #: ENGINEER Name: , Registration #• Street Address* City: State: Zip: Sewer & water licensed plumber: change are requested once permit is issued. Penalty applies when address change and lot 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. Signature of Applicant: 4 G? //'?^'?'T ?' - OFFICE USE ONLY Certificates of Survey Received Tree Preservation Plan Received _ Yes _ No _ Yes _ No OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Dupiex ? 11 Apt./Lodging ? 16 Basement Finish o 02 SF Dwelling o 07 4-plex ? 12 Multi RepaiNRem. 0 17 Swim Pool 0 03 SF Addition ? 08 8-plex o 13 Garage/Accessory o 20 Public Facility ? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous 0 05 SF Misc. ? 10 = plex ? 15 Deck WORK TYPE 0 31 New ? 33 Alterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit Engineering Variance Permit Fee Surcharge 3 °= Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies u? Total: % SAC SAC Units Valuation: g 5800 °= 2000 STORM DAMAGE PERMIT APPLICATION (RESIDENTIAL) cirv oF eacari 3830 PILOT KNOB RD - 55122 ? 9-1 651-681-4675 Reaulrements ? 2 copfes ol plan pqh; //-a7y-G0 CONSTRUCTION COST: DESCRIPTION OF WORK: STkVS -/?+.SuLfkTian? S1?Q?? ? If mu11i-tamity bidg., how many unlts? 17/ IMDICATE THE FOLLOWING EQUIPMEPIT TO BE REPLACED AND BY WHOM: 1 ?Plumbing _ Homeowner gE Conhactor Name }`? = Mechanlcal _ Homeowner pj Contractor Name e "NOte: If somebody other than the homeowner is performing plumbing or mechanical work, they must apply for nppropriate permit. Only Iicensed plumbing coniractor or homeowner may complete plumbing work. STREET ADDRESS: 1G':P°/ W,4la?4F- l-AN?=- J LOT: BLOCK: 3 SUBD./P.I.D. #: W6M& PROPERTY OWNER CONTRACTOR Name: L"sF2i5 Phone#:6;S%) 6ee `3 alCn Lbst Flrst SheetAddress: 1(v,;2`I C-c?rA&cT Lflni? City ???? State: /?w Zip: 5s_/4?1? Company: S`a yy)-e- Phone #: (area code) Sheet CI}y State: Zip: I hereby acknowladge fhat I have read ihis applicatlon, state lhat the information is correct, and agree to compty with all appiicable State of Minnesofa Sfalutes and City of Eagan Ordinances. License # Exp. Signaiure of Applicant: ?? ? 2000 STORM DAMAGE PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55722 0 651-681-4675 Reauirements O -? -2? -o V ? 2 copies of plan DATE: b I?2A 6 C u?CpN?CT10N COST: LP) I500- 2-1 D60 _ I U DESCRIPTION OF WORK: ? c Y?c 1 (3? ,&Dr If multi-(amily bldg., how many unifs7 S.ect???-aj INDICATE THE FOLLOWIMG EQUIPAAEfdT TO BE REPLACED APlD BY WHOPA: _ Plumbing _ Homeowner g[ Confractor Name _ Mechanlcal _ Homeowner QL ContraCtor Name "NOte: If somebody other than me homeowner is performing plumbing or mechanical work, they must apply forappropriafe permiT. Only licensed plumbing contractor or homeowner may complete plumbing work. SiREET ADDRESS: ? j ?1 W?- ?n ?7 Lk h? LOT: ?)- c5-' BLOCK: ? SUBD./P.I.D. #: T .?nho????f' ?ZA- PROPERTY OWNER Lu ndCj Y2 a? /?lCc 6r c lL Phone #: Last Firat I Sheet Address: l 63/ Wcol mtd cny srare: Company: CONTRACTOR Sheet Addi City _ MZ1p: Phone #: (area Code) Llcense # Exp. State: Zip: I hereby acknowiedge that I have read this application, state thatthe infortnation is correcT, and agreeto comply wilh all applicable State of Minnesota Stalutes and City of Eagan Ordinances. Signalure ot Appllcant: OFFICE USE ONLY BUILDING PERMIT SUBTYPES ? 01 Foundation ? 07 05-plex ? 02 SF Dwelling ? 08 06-plex ? 03 01 of _ plex ? 09 07-plex ? 04 02-plex ? 10 08-plex ? 05 03-plex ? 11 10-plex ? 06 04-plex ? 12 72-plex woR?c nrPE ? 13 76-plex ? 21 ? 17 Garage ? 22 ? 18 Deck ? 23 ? 19 Lower Level ? 24 Pibg _Y or_ N ? 25 ? 20 Pool ? 30 Porch (3-sea.) Porch/Addn. (4-sea.) Porch(screened) ? Storm Damage Miscellaneous Accessory Bldg. ? 31 New ? 36 Mave Bldg. ? 43 Reroof ? 32 Addition ? 37 Demolish (Bldg)* ? 44 Siding ? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair ? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors * Demolition permit - Give PCA handout to applicant GENERAL INFORMATION No. of Units No. of Buildings Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length W idth Basement sq. ft. Main level sq. ft. sq.ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Census Code MC/ES System City Water Booster Pump PRV ? 31 Ext. Ak - Mutti ? 33 Ext. Aft - SF 36 Multi ?- ?lQ6 CITYtiSEOhZY LOT ? BL ;J RECEIPT #: ? 1 ? ? l ? StiBD. W0j'a RECEIPT DATE: 1999 M£CHANICAL PERMTT (RESIDENTIAI) CffYUF EAfiAN sbso Paor xxos Rn EAfiAA MN 56122 Date: 7',1 S- 15' (651) 691-4695 Complete this section a-nft if you are installing HVAC in single family, townhomes or condos under construction and not owner /occupied • HVAC: 0-1U0 M B T U $ 30.00 ADDITIONAL 50 M BTU 6.00 • Gas outlets (minimum of one required @$3.00 ea.) • State Surcharge: .50 • TOTAL: Complete this section onlv if you are memodzling, ad.a,:ng to, or i-epairing exisciLig siagle farni:y dwetlings, townhomes, or condos. Please indicate if it is a new item, replacement item, or repair. _ New tll Replacement _ Repair _ Other ? Fumace G?Uf?,? Jd'JX/?1/V.1bd70 ?/ Air conditioning L? l/ a.?f?irl ?/ _ Air exchanger, i.e. Vanee system, etc. _ Other Reneiuder: Ca11681-467i for inspections. $ 30.OU State Surc6arge: .50 Total: $30.50 SITE ADDRESS: ON'v'ER NAME: PHONE#: SoZ j- S/.L J U ? ItiSTALLERNAME: i>=+?aiGlsi;K;::=?fT3a PHONE#: ---....,. . - ?.?.??. e3°.i1i STREET ADDRESS: - •,,, - _ . • ? ?.: ? ?. .-_?. CITY: STATE: ZIP: ?(?7YIlGn ,? ? // / . . SIGNATURE OF PERMITTE ?/yl.(,?? 15 FOR.?1S BLD•MECH PERbfIT (RES) - 1999 L BL SUBD. APPROVED BY: CITY U5E ONLY INSPECTOR RECEIPT #: RECEIPT DATE: 1999 M£CfiANICRL fEfiMff (CQMM£RCIRIa CI'fl' OF E4fiAN 3830 PILOT KNO$ RD £i4fiAN, MN 55122 (651)6$1-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are Mt required for each dwelling unit DATE: CONTRACT PRICE: WORK TYPE: _ NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: FEES: 1% of contract price OR $30.00 minimum fee, whichever is greater. Processed piping - 530.00 CON1 RACT PRICE x 1% PROCESSED PIPING PERMIT FEE STATESURCHARGE TOTAL ----------------------------------------------------• SITE ADDRESS: OWNER NAME: TENANT NAME (IMPROVEMENTS ONLY): 1NSTALLER: ADDRESS: CITY: PHONE #: STATE: ZIP: PHONE #: ($.50 per $1,000 of nermit fee due on all pemilts.) SIGNATURE OF PERMITTEE ?.. _ OF 300 PILOT KNOB ROAD. V.O, BOX 21199 EAGAN. MINNESOTA 55121 PHONE: (612) 454-8100 SEA BLOMQUW ?wv« DATE: August 21, 1985 THoMwsEc,yrr a soninH ADDRESS: 1629 Walnut Lane LEGAL DESCRIPTION: Lot 27 - Blk 3 Woodgate Addition JAMES JERRY TFiOMAS THEODORE WACHTER ' CourclMen?e iFiOMAS HEDGE$ CMy AtlrKbkola EUGENE VAN OVERBENE cm ciwnk Dear Eagan Resident : RE: RIGHT-OF-WAY/BOIILEVAROS - CITY PROPERTY It has been brought to the attention of the Public Works Department that you have placed a structure or obstruction on the City right- of-way in violation of the City Ordinance referenced below. CITY ORDINANCE SEC. 10.32. OSSTRUCTIONS ON PUSLIC PROPERTY Subd. 1. Obstructions. It is unlawful for any person to place, deposit, display or offer for sale, any fence, goods or other obstructions upon, over, across or under any public property without fiist having obtained a written permit from the Council, and then only in compliance in all Yespects with the terms and conditions of such permit, and taking precautionary measures for the protectibn of the public. An elec^trical co:3 or device of any kind is hereby included, but not by way of limitation, within the definition of an obstruction. Su6d. 6. Continuing Voilation. Each day that any person con- tinues in violation of this section shall be a separate offense and punishable as such. ' SEC. 11.1. GENERAL PROVISIONS Subd. 9. Structures in Public Right-of-Way. No buildings, structures or uses may be located in or on any public lands or Right-of-Way without approval by the Council. . The public riqht-of-way or boulevard is that area from the curb to your property line (approximately 13 feet) and is intended solely for utilities and snow storage. The structure must be removed from this boulevard area to provide for required storage and also to protect our snow removal equipment from damage. We apoloqize for THE LONE OAK iREE. .. THE SYMBOL OF STRENGTH AND GROWfFI IN OUR COMMUNIIY s`• C RIGHT-OF-WAY/BOULEVARDS - CITY PROPERTY PAGE 2. the inconvenience this relocation may create, but it is necessary to prevent damage to your structure and also to our snow removal equipment. The only exception to the ordinances are mail boxes if they are installed according to Federal specifications as furnished by the post office. A copy of this letter notifying you of this violation will be placed in your parcel file with a copy to the appropriate enforcement division. THEREFORE, YOU ARE HEREBY NOTIFIED TO HAVE TRE VIOLATION CORRECTED AND THE OBSTRUCTION REMOVED WITHIN 60DAYS OF THE DATE OF TRIS LETTER. After that time, you will be subject to the fines as stipulated in this ordinance. The City of Eagan cannot accept any responsibility for damage that may occur to those obstructions' that are in violation of the City Ordinance. If you have any questions, please feel free to call me at 454-5220. Yours truly, William H. Branch, Superintendent Public Works Department WHB:jbd r . Rocks on the boulevard 09/17/2007 09:43 FA% 6514510531 BEISSEL WINDOW 2007 RESIDENTIAL BUILDING PERMIT APPLICA'IION City Of Eagan 3830 Pilot Knob Rosd, Eagan MN 55122 Telephoue # 651-675-5675 FAX # 651-675-5694 New Cautmetlon Requinarnents 3 reg'stered ule eiweys yhoxcng sq. 8 ef let, aq. ft W Iwuae, and sll roofed ereea (20%mawmum ht wverage aRwred) 7 Sqls RepoR it pfopmed builCing fs b ba yeced on daW'bed sdl 2 coples o1pWn showing Oeam 8 wlndow sixes, poured found deslgn, em 1 cal ef Enmgy Cakulatwns 3 wpie6 of Tree Pieservahon Pon il lot pletled after 711/93 Rim Joret Deted Odiom sela? shaet (buildvgs wNh 3 w ISSS ump) MNIIEQ89C0 f118fh811ItlI VbnlilihOfi fOIR1 HemMaUReoah Raou'vgmerti 2 copbs of plan chcwng footings. 6aems, ip6tr, 1 mt d Energy Calculntiona ta haeted addllbna 1 site survey br eOditions & dxks Additlon - iMlcefa if on?slfe ssp& sysfem Qooz m??a?a,sr?r? ???:r,•??''a 17.LM Plans are considered public information unless vou state thev are trade secret and the reason. Date 09 / 17 / 07 Site Address 1640 Hickorv Lcire ConstructionCost 5,220.00 Unit/Ste # 7lescription of Work ROPlacnRe°t wirrdOws Multi-FamirySldg X Y_ N Fireplace(s) _ 0 _ 1 _ 2 ProyertyOwner I,ayc;e Parkinson ' Telephone p( 651) 454-3415 ContrecWr 8essse1 Windc7w and Si.ding Addrecs 1635 Oakdale Avernue State Minnesota CibWest St•Paul Zip 55718 Telephone il ( 651) 451-6835 COMPLETE TNIS AREA ONLY IF CdNSTRUCTING A WEW BUI Energy Code Category '- Minnesota Rules 7670 Cate or 1 _ Minnesota Ru (J suemission rype) • Residential Vendlatlon Catepory 1 WOrkaF?eet • New Enerpy Submitted 3ubmlHed • Energy Envalope Calculatlon6 Submitted In the Idst 12 months, has the City of Eogan issued a perrnit for o similar plan bosed an p master plan? _ Y ,_ N If yes, date and oddress of master plan: Licensed Plumber Mechonical Coniractor Sewef/Woter Contrqcior Telephone #( Telephone # ( Telephone # ( I hereby apply for a Residen6al Building Yermit and acknowledge that the information is c that the work will be in conformance with the ordinences and codes of the City of Eagen Statutes; I understand this is not a pennit, but only an application for a permit, and work is pcrmit; that the work will be in accordance with the approved plan un the case of work which approval ofplans. P'Q ??t Applicant's Printed Name NbAfShcet implete and accurate; and the State of MN not to start without a reauires a review and 6514510531 ';7/26P7 09:42 FA% 6514510551 BEISSEL WINDOW 001 09/ MBEISSEL . ffl WI_N DOW R S I D I NG Tdevhone (651) 451-6835 I 1 1 1635 Oakdale Avenne, West St Paul, Minnesata 55118 Fax: (651) 451-0531 FAX COVER SHEET dATE' ce rm++ r 17- oa7 COMPANY: city-of Eagan Building Pexmit Dept. ATTENTtON: PeggY FAX #: 651-675-5694 PHONE #: FROM: sue NllMBER OF PAGES INCLUDING COVER SHEET: MESSAGE: 7.2v3nks Peggy .far all your help, Sue 3 ORIGINAL WILL: ? BE SEN7 VIA REGULAR MAIL Q NOT BE SENT IF YOU DO NOT RECEIVE ALL PAGES, PLEASE NOTIFY OllR OFFICE. THANK YOU! Famity Owned & Operr[ed Since 1950 Ir b, Clty of EaiaIl 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (657) 675-5694 ?----------------- ? ?"_o'r:iSfEice l1'sc ? Permit #: , I Permit Fee. ? ; ? Date Received: I ? I Staff: I i 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 36' - 0 9 Site Address: /?0,? L k) 1G yo - ya l)/?ko2 , Tenant: 00obCqML 90p suice #: RESIDENT / OWNER Name: Phone: Address I City I Zip: Applicant is: _ Owner _ Contractor TYPE OF WORK Description ofwork: K00Fi --)G Construction Cost: ? ?i?0Q Multi-Family Building: (Yes No ? CONTRACTOR Name: C +s 200)=ING License #: 9,21Y Address: I7I07^ jH !7'Z ko e-K ki? City: At)1QNSV1LC6_: _ State: Zip: 5.?3 3/ Phone: ?So2-S9I - Y? 7-5- Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted (4 submission t)pe) • Energy Envelope Calcuiations Submitted In the last 72 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 supp,orting documenfs'that y'ou subroif are considered to be public enformaGon. Portions of the mfoiination.may be classrfied as non=public if you provide speafic reasons that would permit Lhe City fo ? ?. ? „_ . conclude ihat the are trade secrets:' " I hereby acknowledge that this infortnation is complete and accurete; 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 reqwres a review and approval of plans. ?.?/ 4Jc x ' I l I(-E A3'02KS'77z?? /1J !S G x \ ApplicanYs Printed Name Appl' anYs Sig ture Page 1 of 3 PERMIT City of Eagan Permit Type: Building 3830 Pilot Knob Rd Permit Number: EA079802 Eagan, MN 55122 . Date Issued: 09/14/2007 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 1640 Hickory Lane Lot: 25 Block: 3 Addition: Woodgate 1st PID 10-84600-250-03 Use Description: Sub Type: e-Windows/Doors Construction Type: Work Type: Windows/Doors-New/Replacement Description: House Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: 9-17-07 This property is a townhome. I have dead dated this permit. Sue will fill out new application for 1640 Hickory Lan and fax it to me. She will call me with a new address for this permit that will be a SF home or twin home. pf A framing inspection is required when installing a Bay or Bow window or if the opening is altered. Smoke detectors are Fee Summary: BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 Valuation: 5,220.00 Total: $90.00 Contractor: -Applicant - Owner: Beissel Window Siding Layce W Parkinson 1635 Oakdale Ave 1640 Hickory Lane W St Paul MN 55118 Eagan MN 55122 (651) 451-6835 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. Applicant/Permitee: Signature Issued By: Signature .. , � � Use BLUE or BLACK Ink ---------, � For Office Use � I � Cit of �a a� ; Pe��t#:13a��u ' Y � � � �Q . � � � Permit Fee:_ � 3830 Pilot Knob Road � � � _ �i Eagan MN 55122 I Date Receive � Phone: (651)675-5675 � � I Fax: (651)675-5694 �U� 1 8 �O'� �_Staff___ � ��J 2015 RESIDENTIAL L MBING PERMIT APPLICATION ✓ J 1 � � Date: Site Address: � Tenant: �a;�1f"""�^' ' ! Suite#: �F �;;�- =�,�- � ��--��-�� $ k� � � Re�Side,n O, , Name: Phone: �" �� .�,� 1�'^� �`\ ` �� r� ' Address/City/Zip: t� � t��r1, � ; F. .. �,. , � _ � Name: �bert Co�pany Inc dba Culligan Water �icense# �C641376 , _ � �Co tracto � Aaa�ess: �180t SO`� St East ��ry: Inver Grove Hgts. _ � � �� state:� Mn zip; 55077 Phone: . 651-451-2241'�� `, �r��. �'�� Contact: Wllllanl R M11beTt� Emaii: � y= ;w � � �, . � � � _New �Replacement _Repair _Rebuild _Modify Space _Work in R.O:W. T�.� e,o �;�� .� � Description of work: � � RESIDENTIAL �� ,� � � �� y"�� Water Heater �� ' �,Water Softener '�� Lawn Irrigation�RPZ/ PVB) �@erm� Typ , " Septic System Add Plumbing Fixtures�Main/ Lower Levei) ,y — , , � . New Water Tumaround i, " � Abandonment � R�SlDERlTIA�F�ES: $60.00 Water Heater,Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge) � w6�J.Q0 La�vn lsrigatian(includ�s$5.00 min;,�,um State 5urchargej $60.00 Add Plumbing �ixtures, Septic Svstem Abandonment,Water Tumaround*(includes$5.00 State Surcharge) *Water Tumaround(add$200.00 if a 5/8"meter is required) $115.00 Septic System New($10.00 per as built)(includes County fee and$5.00 State Surcharge) � O O � TOTAL FEES$ 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.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 1 understand this is not a permit, but only an application for a permit, and work is not to start wlthout a permit;that the work will be in accordance with the approved plan in the case of work which reguires a review and approval of plans. x � � �-L�� x � Ap icanYs Printed Name App canYs Si ture ;•�� - •. � u � - �R.., . � � � �F R��FFG,, �R�,� : �Req.uir .d s2pec :=�" _ . � � - �Me er .�ela�s',I . _ er� iz: , , �n_ , � � ,�� _, ,