1676 Hickory LaneCITY OF EAGAN Remarks
Addition Woadgate lst Addition Lot 7 Bik 3 Parcel 10 64600 070 03
Owtner ' '+'''•ti `' MOAA4 ",Street 1676 HiCkorY Ln. State Eagan, MN 55122
? li:(,l.?P,t?. _ a??(?l llti_.T':
Improvement Date Amount Annual Years Payment Receipt Date
STREET SUR F.
STREET RESTOR. pAVI G 1976 410. 12 136.71 3 PAID
GRADING
74 115.45 23.09 5 PAID
SAN SEW TRUNK 1974 93. 54 6. 24 15 PAID
* SEWER LATERAL
1975
15
WATERMAIN
* WATER LATERAL 1975 15
?t WATER AREA 975 15
* STORM SEW TRK 1975
* STORMSEWLAT ? 1975 $1505.70 $100.38 15 PAID
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. $130.00 11730 9-23-74
9UILDING PER.
sa,c 400.00 11730 9-23-74
PARK
CITY OF EAGAN Remarks
Addicion Woodqate lst Addition Lot 8 Rik 3 Parcel 10 84600 080 03
owner•??a('??z 'Ckdd-. Street 1678 Hickorv Lane State Eagan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
- ?j STREET RESTOR.
GRADING
SAN SEW TRUNK tE lq74 93. 54 6. 24 15 PAID
* SEWER LATERAL 1975 15
WATERMAIN
* WATER LATERAL 1975 15
,k WATER AREA g 5 15
* STORM 5EW TRK 9 7 5,
* STORMSEWLAT 7 1975 $1505.70 $100.38 15 PAID
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATERCONN. $130.00 11730 9-23-74
BUILDING PER.
SAC 400.00 11730 9-23-74
PARK
CITY OF EAGAN Remarks
addition. Woodgate lst Addition Lot 5 Blk 3 Parcel 10 84600 050 03
/owne?Kqw%i Ul.t. Street 1680 Hickory Lane 5tate Eagan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.pAVING :
6 $410.12 $136. 71 3 PAID
GRADING
PAVING 1974 $115.45 $23.09 5 PAID
SAN SEW TRUNK 1974 $93. 54 $6. 24 15 PAID
* SEWERLATERAL 1975 15
WATERMAIN
* WATER LATERAL 1975 15
* WATER AREA 1975 15
* STORM SEW TRK 1
* STORMSEWLAT 1975 $1505.70 $100.38 15 PAID
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. $130.00 11730 9-23-74
BUILDINGPER.
sAC $400.00 11730 9-23-74
PARK
CITY OF EAGAN Remarks
Additiorr oodgate lst F,ddition Loc 6 Rik 3 Parcel 10 84600 060 03
Ownef Strqet 1682 Hickory Ln. State Eagan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR. pAVING 1976 410.12 136. 71 3 PAID
GRADING
1974 115.45 23.09 5 PAID
SAN SEW TRUNK CP1,211 1974 93. 54 6. 24 15 PAID
* SEWER LATERAI 1975 15
WATERMAIN
* WATERLATERAL 1975 15
?e WATER AREA 1975 15
* STORM SEW TRK
it STORM SEW LAT 1975 $1505.70 $100.38 15 PAID
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 11730 9-23-74
BUILDING PER.
S,4C 400.00 11730 9-23-74
PARK
ClTY OF EAGAN
3795 Pilot Knob Rood Eagon, MN 55122
PHaNE: 464-8100
BUILDING PERMIT Receipt #
To rs osed for Est. Value Date N2 6706
_
, 19
Stie Address Erect p Occupancy
Lot Blxk Sec/Sub. ' Alter p Zoning
?
Parcel #
?
Repair p
Fire Zone
? Enlarge ? Type of Const.
?
'
dx Name
W Move p # Stories
-
=
3 Address Demolish p Front h.
b
Ci Phone
Grode p
Depth
°C Name Approvols Fees
?F
u? ?re?
Assessment
Permit
I
Ci p} Water & Sew. 5urtharge -
??
°C Police Plan check
Name
Fi
Fira
5AC
?? Address Eng. Water Conn.
? ?W Ci phone Planner WaterMeter
Council Road Unit
? I hereby acknowledge that I have read this applicotion and stute thet gldg. Off.
the informotion is correct ond ogree to comply with oll opplicoble AP? Totol
5tate of Minnesotn Statutes ond City of Eagcn Ordinonces.
Sipnature of Permittee
A Building Permit is issued to: on the express condition that
oll work sholl be done in occordante with oll npplicable Stote of Mlnnesota Statutes and City of Eagan Ordinances.
i Building Officiol
Pensk # oale Iw?d FwmktK
Plumbing
Mechonical
INSVEtTIOAfS DATE INSP• Rouph-In Final
Footings Dote Irup. Dote Inso.
Foundation Plumbing
Frome/ins. Mechanical
Final -j'- L
Remarks:
. . . .. . . . . -, . .- , .-'.c .. _ . . .
? CITY OF EAGAN Y? 18406
3830 Pilot ICnob Road, P.O. Box 21-199, Eagan, MN 55121
` PHONE:454-8100
BUILDIAlf-; PERMIT Receipt # ?
Tc 5e used 4or ;Es! v?.!..e 9• :{' Date SZ? 27 , 1990
Site Addre
Lot 8
Parcel No.
Block
W Name ?O? J AitICO
3 Address 1678 HICKORY LN
° Citv EAG" Phone 7 1
Address 367V w n~I Ij
Ucc City BUgH SVILI.E Phone 890-0758
?
W W Name
? ; Address
a W City Phone
t hereby acknowlege that I have read this application and state that the
information is correct and agree to comply with a11 applicable State of
Minnesota Statutes and City oi Eagan Ordinances. '
Signature of Permitee ?
A Building Permit is issued to: ??T-N'? t
on the express condition that all work shall be done in accordance with all
applicabie State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
II i OFFICE USE ONLY
Occupancy -
2oning -
(ACtuaq Consl -
(Allowa6le) -
# of stories -
Length -
Depth _
S.F. Total -
S.F. Footprints -
On S4te Sewage _
On Site we11 -
MwCC System _
Ciiy Water -
PRV Required -
Booster Pump -
APPROVALS
Planner _
Council
BIdg.Of1. _
Bidg. Permit
Surcharge
Plan Review
SAC, City
SAC.MCWCC
Water Conn
Water Meter
AccL Deposit
S+W Permit
StW Surcharge
Treatment PI
Road Unit
Park Ded.
Copies
TOTAL
FEFS
25.00
.SO
2S. SO
Permit No. Permit Holder Oate Telephone #
WATEfi
SEWEfi
PLUMBING
H.VA.C.
ELECTRIC
Inapection Date Insp. Commenta
Footings I
Foundation
Framing
Roofing
Rough Plbg.
Rou9h Hig.
Isul.
Fireplace iO 1
J 9?
?
Fnal Htg.
Fnal Plbg.
Const. Meter Plbg. Inspector - Notify Plumber
Engr./Plan
Bldg. Final
Dedc Fig.
Declt Final
Well
Pr. Disp.
PERMIT #
MECHANIC AL PERMIT RECEIPT #
CITY OF EAGAN
DATE: =
3838 PILOT KNOB ROA D, EACAN, MN 55122
' CONTRACT PRICE: PHONE: 4 54-8100 For Office Use Only: ?
i Slt@ Addres5 BLp,r,, npE WORK DESCRIPTION ?
! Lot Block . Sec/Sub Res ` New 'd
? m
Name Mult Add-on
E
Address i- y 4
I L*? Comm. Repair
Oth
c
City < <
Phone ' r- Br
NBme
L_ FEES
RES. HVAC 0-100 M BTU -$24.00
c Address } ,,. ADDITIONAL 50 M BTU - 6.00
' p City ` Phone -4 (RES. HVAC INCLUDES A/C ON NEW '
'
CONSTRUCTION)
r
'
50 EA
GAS OUTLETS (MINIMUM - 1 PER PEFiMIT) - 1
.
.
.
TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
ForCed Air M BTU APT BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONQOS - RES. RATE APPUES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
Vent CFM $ (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # BEYOND $1,000)
Other R
FEE ?
r s
uFFAE
E
N
F
?
siC:
. J
?
2
,`?1`?!/
/9a
t
TOTAL• "-
FOR: CITY OF EAGAN
INSPECTION RECQRD
' CITY OF EAGAN PERMIT TYPE:
? 3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
i SITE ADDRESS: APPLICANT:
PERMIT SUBTYPE:
, . ?
TYPE OF WORK:
Ifi €';1?? Y!' t? t? h!
ft f.. V A! f<
NF' f+n;) ? r Ni,
R (1.01 13), t(,F36f lI111 ? )
7
Permft No. Permit Holder Dete Telephone S
SNV
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspei.Mion Dabe Insp. Comments
Foo6ngsl
Foundation
Framing
pmoang
Rough Plbg.
Rough Htg.
Isu1.
Freplace
Final Htg.
Orsat Test
Final Plbg. Plbg. Inspacta - Notify Plumber
Const. Meter
EngrJPlan
.
Bidg. Fnal
Deck Ftg.
Dedc Final
Well
Pr. Disp.
?? . ??? ?
/e>• LD -
YILLAGE OF EAG11N WATER SERVICE PERMIT
1445
3795 Pilot Knob Rood PERM[T' No.* 4?26?74
DATE __ . ______
Eogon, MN 55122
PUD No ofllmts -- ----
Woodqate, New Horizon Haaaes_ -.-
Oun'?' _ _ - ---- ? ------- -
;1Jdi,55 ' _
676 78-80-82 HickorY Lane --.-----
_
Sice? Address _ --____-_-
- -
mp
Plumbcf son Plumbing-Co-. ?
- - ---- - -`-- -
Cmmet [mn CharKl`-"-'-?? -
Wlor No
5?r?• Aceouni UeF?su "10.00pd - - -
Per?mt Fee* -- - --
Headcr No ?.50 4"XPd
- -- ?"
- -
1 agree to wmply wieh the Ville9e o4 Eogen Sun targr: -- --
Ordinances. MIS( CharGi-c -- ' - -- -' - --- '
To[al:
13 llatePaid. __- - - ?-- -----
v
--___. _
-- --
U.iieullneP __-
//?
--?67 --_-- ?/
4-
-sz a --72s
i L Y`v, -
-- - - - -- - ----? -- ?'---- - --
?G
? ?• 7.??' ? ?
_ -- -?
J
i
WATER SERVICE PERMIT
VILLACE OF EAGAN 1445
3795 PJot Kaob Road PLRMf! NO a?Z6???
"
Eagun, MN 55122 11A
Ch,
I??I?Ili4 L?? _ NO OI I?IIILS
4doodqate, L7ew Horizon Homes
?
lEJ6- 3?80-82 Flickory Lane
.????I?t...
Tl,omp, on Plumbing Co. '
%1„. ( unncinun ( n:u
,, ni iI-uul Uiqm.n 10. OOpd
H, ?dl,i Nl, 11,n„n i,r .50 fiSQxpd
1 oyree ta comolv with rhe Villa9e ol Ea90n Sunherer=
M', l harqo.
Ordmonces
lotal
It. U<ne P.ud
? Insp _
^ ?v e> ? ???
1?
i
vaL OF EAOAN SEWER SERVICE PERMIT
3795 4.bf Knoo Road PERMIT NO.: 220'
Eagon. MN 55144 DATE: 4/26
Zoning; PUD No. of Units:
Owner. woodg±_,--N_w Enri7n++ xinmPs
Addresa:
Site Address: 1676-78-80-62 Hickory Lane
Plumbe:: Thomnson Plumhinq Co.
1 ogras to eomply wifh the VHlaye ol Eagan Connection Chazge:???
Ordinancas. Account Deposit Permit Fee:
Surchazge:
gy. MSsc. Chazgee:
Date af Insp.: Total:
Insp.: Date Peid:
CTTy pg EAGAN Include 2 sets of plans,
1 site plan w/elevations &
BUILDING PEM?ffT APPLICATION 1 set of energy calculations.
'Ib Be Used For --J`';' c? Valuation ?(pJL-) C"D Date
Site Pi3dress ?m ; r,.?r.:?„?? OFFICE USE OIJLY
Lot 6 L B1ocJc Q. Sec.%Sub. G?«"d 6)F'rect OccuPancS'
/v ?Iaoo oSroo3 Alter 7.A??1
Par?l #: ?;,5?'cr to ?1„!-' i5yic?
- gepair Fire Zone
O.mer: ?15 Uc, 1 lERt-) Ehlarge _Type of Const.
Address:
City/Zip
1b?? HICi?2? L\ M°ve # Stories
Deirolish Front
Code: 'E&C fli\j 5,ci I 3'? Grade iDePth -
Phone #: LIS? ???[9 3m,o
ContracWr: Cj?.L?F
Pddress:
City/Zip Code:
Phone #:
Arch./Ehg.:
Adclress:
City/Zip Code:
Phone #:
APPROVALS FEES
Asces_satents Pexmit g -
T4ater/Sewer Surcharge i =v
Police Plan Check
Eire SAC
Ehg, Water Conn.
Planner Water Meter
Council Road Unit
Bldg. Off.
APC
ft.
TOTAL ?d -C9
. CITY OF EA6AN
3795 Pilof Knob Raad Eagan, MN 55122 N2 6706
v . N PHONE: 454-8100
BUILDING PERMIT APPLICATION Receipt #
Te be uted for DECA Est. Value $650 Date JiTMP R
Site Address 1678 Hj.CkOTV I,flIIE Erect J] Occupancy
Lot g Block 3 Sec/Sub. WoOd GBte AdCl. qlter ? Zoning
Porcel # 10 8 4600 080 03 Repair ? Fire Zone
Enlarge ? Type of Const.
W Namy Doug Tieben Move ? # Stories
3 Address 1678 Hickory Iane Demolish ? Front -1916" ft.
°
ci
Phone 454-8993
Grade
?
DePfh 12- ft.
_ A..-.....1. Ceae
p Name _
??rAddress
'' f:n.
Nume _
Address
I hereby acknowledge thot I have read this application and stute that
the information is correct and agree to comply with all opplicable
State of Minnesota Statutes and City of Eagan Ordinances.
Assessment _
Water & Sew.
Police -
Fire
Eng.
Planner -
Countil _
Bldg. Off. _
APC
Pertnit ? an
Surcharge 1..«nn----
Plan check
SAC
Water Conn.
Water Meter
Road Unit
Total 1 n - nn
Signature of Permittee I
A Building Permit is issued to: 1bL Tj P}1PT on the express condition tFwt
all work shall be done in accordance with oli applica e Stote of Minn ta. ?Sf-a.?tures? and City of Eagan Ordinances.
Building Official ? ?.L'6..Y-
_ r?ooagd-re ist=
CITY of EAC9AN
BUILDING PERMIT
.............. ,2e ?
Ownex ...... I ............-.......?. :._?:............... ?- .
Addeeas (pre:enl) ...?.`??O.l ;!:?:r.?,.•e?Cs-.??-? J 0-+"??''?
.... ............ . ................ .. Ss3 y3
sui,aar ................ -r.-w..............................
Addreaa .....
3 . ,o
-7 ` N_
3785 Pilo! Knob Road
Eagaa, Miaaesote SSIYt
454-6100
tx
3401
Dele .... I..-a,:;.-
Slarise To Ha Ucad For Fron! D4plh He h! Esl. Cost srml! F?e R?mu
?
v
l
LOCATION oZ 1-3 9 " °
?J
U? . . . ..... Per .............. .?"`::."......._............... .................................................
_... ? ..............-`......... /..7??.._........... /n',/,
? Ma or -6 SulWinq Intpacfor
P
Thia pe:mit does noi authorise the use oi slreefs, soada, alleps or sidewdks nor doaa [t gin !ho oaaor er his spent
the righ! !o cxeale any aiivation which is a nnisance os whieh preseds a hasard !o the heelth. safely, toaven[eACe and
ganeral waliare !o anpone ia the communify.
THIS PEAMIT MUST SE KEPIT/ 'ON THE PREMISE WHILE THE WORK IS IN_ PAOGAESB.
This is !o eerfify. ... . -has permission !o eraet ........................nyos
the above described premise subjecY the provisions of all applicable Osdinanees for fhe Citp af Eegen.
OP
GAN
T C
'
ITY
EA NO 18370
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454-810D /??q
BUILDING P IT Receipta ?•/
Tobeusedfor FI LACE Est Value $1,000 Date SEP 13 ,1990
Site Address 1678,HICPORY LN
Lot 8 Block 3 Sec/ WOODGATE OFFICE U ONIY
P2fCel N0. Occupancy FEES
-
Zoning
w Name ANfHONY J ARICO (Adual) Const Bldg Permit .?1n
o AddfBSS 1?178 HICKORY LN (AllOwabie) - SO
Surcharge -
City EAGAN Phone 456-9 1 x oi sto??es -
P?an Rewew
Length _
F Name SAMR Dept - SAC
City
?a Address 7otal .
-
SAC. MCWCC
'- City Phone F. Footprincs -
' W ater Conn
On
e Sewage _
?
ww
NamC
On Ste II
- Waler Meter
_? Address Mwccsyste -
Qi
<W
City Phone
atywater AcCL Deposit
PRV Required SPN Permtl
I hereby acknowlege Ihat I have read this applicaUOn a state Ihat ihe Booster Pump - SiW Suroharge
information is correct and agree to comply with all phcable State of
Mmnesota Statutes and Can Or 'nances. ?
ily of g
Treatment PI
Signature of Permitee IIPPROVALS qo Unit
/
A Building Pemtit is issued to: tud 0 J ARICO Plwner - Park De .
on [he express condillon that all work all be done in accordance with all counciI ?-
applicable S[ate of Mmnesota Statut s and
City
of Eagan Ordinances. Bldg. Oft Copies
y ?
?
BuildingOfficial .ivAn R o;rli? IllvLd
\.? Vananr» - TOTAL 25.50
CITY OF EAGAN ?0 ? $4O6
3830 Pilat Knob Road, P.O. Box 21-199, Eagan, MN 55121
?
PHONE:454-8100 (1
i\
,f/
BUILDING PERMIT Receipt # '
l ??
?/ -r «
To be used tor FfRFPf+S['F' Est. Value $1 , 000 Date SEP 27 , 199Q
Site Address 1678 HICKORY LN
Lot $ Block 3 SeGSub. WOODGATE OFFICE USE ONLY
Pareel No. oecupancy - Fees
Zoning -
w Name ANTHONY J ARICO (ACtual) Const
0
_ Bldg. Permit 25.0
Address 1678 HICKORY LN (Allowable) -
50
? Surcharga .
City EAGAN Phone 456-9791 rolsmnes _
Plan Rewew
Length _
o Name HEAT-N-GLO Depih SAC
Cit
f -
,
y
Q
a Address 3850 W HWY 13 S.F iotal -
?
? City B iRN V• Phone 890-0758 S.F. Faolprinls _ SAC, MCWCC
H'ater C
nn
On Site Sewage o
_
? W NBme On Site Well w
M
-
aler
e1er
Addl'e53 MWCCSystem _
i W City Phone City Water _ Acct. Deposit
PRV Required _ S/W Permlt
I hereby acknowlege that I have read this appbcation and state ihat lhe Booster Pump - SMl Surcharge
iniwmahon is correct a d aqree to compry with all pplicable State of
MinnaSOta StaWtes an i of Eag
a
n
Ufdinan , Treatment PI
?
?
/
Signature ot Permitea u?1z) APPROVALS Road Uml
A Building Permit is issued to: HEAT-N-GLO Pla^OQ1 - Park Ded.
on Ihe express condilion thal all work shall be done m accordance with all Council _
applicable Slate of M
mnesota StaNtes and City of Eagan Ordinances. gidy, pn, _ CoOies
.
Building ONicial rnsf Variance - TOTAL 25.50
? auc
7 3.
czrt or r.Acau
3795 ri7.ot Iu.eb P.oad
Eagwz, ','Iiiinesota 55122
PERMZT NO.: SAfi _
The City of Ea.oan hereby grants to r,,,, ?oa,,,..;,.y :,e-ta».,
- °f 1001 `tonia 7?ua
a HEW'ING Permit for: (CNrner) P?ew Horizon tIOmes taoodgate
676 S-EO-2
at nirkory I3ne ? pursuant to application dated _ 1??????8
Fee Paid: ^E0.00 dated this 15 day of *TOV ? 19 74
2.00 s/c
building Inspector
Mechanicz.l Permits:
3ii: Total:
?
HOUSE HEATING TEST RECORD
D-2143'7
ADDRESS-„ I '+"6 A i, :n?'.y Tana ApT.-FLOOR CITY SUBURB Eag8C1 ,
OCCI;PANT nnno OWNER New Horizone
HEAT LOSS DATE HTG. INST.
SOLD BY
Eleetrieal Work By
TYPE OF HEAT
/
-INSTALLED BY Srd=iek Heating
Gas Lins By It
GA _ FA _x HW -STEAM SPACE HTR. UNIT HTR. -OTHER
GAS DESIGN
MAKE Wi11i8msori MAKE OF BURNER_
Model 1117-07-$ Abdel
Swiol 7439311 Max. BTU Rating-
INPUT 75 ,OOOBtU }l:['. MAKE OF FURNACE
Model
CONTROLS
THERMOSTAT C 6 Heat Plug Vent Size n
Valve Nf•A. V800c KIND OF LINER alom SIZE g" NONE
Llmit P-obahaw RFL 7.r10 Draft Hood vertical Ragularor
Limit SeHing 200f Filtera si:e 16a25 Number 1
Fan SetTing 90f 120f Chimney Loeation Insida yeB Outside
Pilot Type COllp1E Chimney Construction metal 'beetos
Pilof Make
Pilot Model $moke Bomb Wiring
PiloT Timing 60 9QC• Draft ok Test Tag Ye8
L.W. Cut Off
Door Pressure Lighfinq Inst. se8
Prossure 4_5"wr. percantCOZ 70% Date Teated -21/18/7.5
InputCFH 7K Pareant OZ Company Tesiing
Stack Temp. SOOf percent CO ?•?? Nams of Tester 14 ?
CONVERSION
Form 235
HOUSE HEATING TEST RECORD
D-21427
ADDRE55 1678 Hickory Lane AP7.-FLOOR CITY SUBURB Eagan
OCCUPANT GarV R Lnnd OWNER yes
HEAT LO55 DATE HTG. INST. GAS C0. METER BADGE
SOLD BY INSTALLED BY egw1C ea 1ng
Eleetrieal Work By Gas Line By
TYPE OF HEAT GA _ FA X HW STEAM -SPACE HTR. - UNIT HTR. -OTHER
GAS DESIGN CONVERSION
MAKE N'illi?m8011 MAKE OF BURNER
Model
Model
Serial 7239751 ??•- ? Max. 8TU Rating-
INPUT 75,AOOBttti?{-•? MAKE OF FURNACE
CONTROLS
THERMOSTAT CID5?80 Heat Plug
Valre j4,A, V800C
Limit gb8bAW R E ZJD
Limit Setting 9nof
Fan Setting
Pilot Type
Pilot Make
Pilor Model
Model
4"
Vent Siza
KIND OF LINER almn SIZE NONE
DraFt Hood VeTt1C&1 Reyularor '
Filters Size 18z25 tilumbor 1
Chimney Location Inaide S'e8 Oufside
Chimnay Construction metal beetoe
Bomb Wiring
Ok Test Tag Ye8
Pressura Lighting Insye9
Tested 2/18/75
C S BRImT CO
Smoke
Pilot Timing 69, gae, Draft
L.W. Cut Off Door
Pressure 4_ 5"wc Percant CO2 7•5%
Input CFH 75 Percent OZ
Staek Temp. 510f percent CO 0•0
Form 235
Date
Company Testing '
Name of Teeter '! ? ??
HOUSE HEATING TEST RECORD
D-21427
ADDRESS 1680 Hiskpr3r--Laae APT._FLOOft CITY SUBURB$&ggg
OCCNPANT 61@IIS A Sm3th OWNER yag
HEAT LOSS DATE HTG. INST.
SOLD BY INSTALLED eY $edgvj_rak Rariab
Elactrical Work By Gos Line By SeagiFiek Reg.ti-ag
TYPE OF HEAT GA FA _.3E HW _STEAM -SPACE HTR. -UNIT HTR. _OTHER
GAS DESIGN
MAKE w#I }j .....g.... MAKE OF BURNER
Model }}}J-Q]-3 Model
CONVERSION
$erial 743$214. Max. BTU Rating-
INPUT 73,e0eBtu/hr. MAKE OF FURNACE
CONTROLS
THERMOSTAT em26e Heut Plug
Valve M $ V$OQC
Limit $p}gha.., uFi 750
Limit Sstting 200 f
Fun Serriny $0 f 120 f
Pilot Type _
Pilot Make _
Pilot Model _
Pilot Timing
L.W. cu, orr
Model
Vent Size 411
KIND OF LINER nlimm SIZE A" NONE
Drah Hood per*iral Rsgularor
Filters Sizelfjx25 Number 1
Chimney Location Inside Ye6 Outaide
Chtmney Const.ucriun mPtal be6tos
Smoke 8omb _
Draft
Door Prassure
Wiring
TesT '
Lighting Inat.
Pressure 4 31tGTC Psreent C02 Z.Q% Date Tested
Input CFH 79; Peresnt 0 2 $. 7,%, Company Tes*' g C. S. BRIGHT COMPAN14 I
STOCk Temp. 450 f PerronT CO n-007 Name of Tester ?r-,4;A.?,4pmA? '?
0
Form 235
HOUSE HEATING TEST RECORD
ADDRESS - 16R5), Aieknry T,ane APT
OCCUPANT n?na
HEAT LO55
SOLD BY
Elactrical Work By-
TYPE OF HEAT GA
/
MAKE Willi
-
Modal 1117
DATE HTG. INST.
OWNER
D-21427
FLOOR CITY T-SUBURB Eagan
Ndw Horizons
INSTALLED BY SedgwiC },ea llig
n
Goa Line By
FA x_HW STEAM -SPACE HTR. -UNIT HTR. -OTHER
GAS DESIGN
MAKE OF BURNER
Model
? $xfal T4382.13 Ma:. BTU Rating-
INPUT 75000+0hp. MAKE OF FURNACE
CONTROLS
THERMOSTAT I`mPF'+n Heat Piug
Volve M.,,A VROOr
Limit RO77911AW R.li'f 7511
Limit Satting 9,nnf
Fon Setting
Pilot Type
Pilot Make
Model
CONVERSION
4"
Vent Size
KIND OF LINER a1nID SIZE 611 NONE
Drok Hood YCx't1C81 Regularor
Filters Size 18525 uumbsr 1
Chimnay Locatfon , Inside 3*eg Outside
metal bestos
Chimnay Construcfion
Pilot Model Smoke Bomb Wiring
Pilot Timing R() Rert. Draft o k Test Tag YeB
L.W. Cut O(f Door Pressure Lighting Inst. yeg
Proasure 4?Kllme ParcenfCO,, $"0% DateTsated 2/18f75
Input CFH 75 Pmcsnt OZ 'z -,-??l??o? Company Testing S T /C?
$tack 7emp. Kl /lf Peresnt CO ..0..•••y? Nams of Testsr
Form 235
%
?
APPLfANCF
PERFORMANCE 7EST `
Atfacb to gas Jine edJaclsnt to ?atator.--_-
Heating Corrtractor conwned Ae yiy a n;c --
Name of Tester
/.t / / _
, Date -?s ?
Jab Address C W?18 I+ig[p,?? IX4
Heating Contractor Controlled Air .-
Name o! Tester
Date ? 7 G ..
-
Percent OZ
-
-!
-
Percent COZ --2 -- - I
Peroent CO
Stack 7emp. Y7 p I
_ v
,
-, i... ion
CiiY% i/ I
/ /Or Yii/
11, lluwr
a 0848 115- - ?`?°°
Request Dete Fire No Rou -in Inspection
qa i,?>
57(Reatly Now ? WJI Naity Inspector
Wh
R
tl
>
? Yes o an
ea
y
I? Lcensetl contractor ? owner hereby request in5pection of above electrical work at
Job AdEress (SOeel Box or Rowe N. )
L
690
? City
cc cl 'o9
Z
ao
D
i '
-
Sechon No Township Name or No. Range No. county
Da?o?a
Occupant(PRINT)
o ?-c -e L ,`? z?tcr Ppone No
??? qo,3
Power SopOLer ?-
Dq,A'(9 tq C; ?GC Atltlress
Elecmcal Gonttactor(COnpany Name) ?
/`? s K ? /e ?r? ConVactork Ucense No,
o
Mailing AQtl255 (COnhaclor Ot Owner M9kinq Insf311dtiOn)
a?1 i?ie .? Ca '
NolM1OnzeO Sgnamre ? v oriOwner Mahing I lallanon) Phona Number
MINNESOTA 51ATE BDAqD OF ELECTPICITyI
Grlggs-MlEway Bltlg. - Room 5113
1821 Unlvernity pve., St Paul, MN 55104
PMne (612) 66241800
THIS INSPECTION REOUEST WIIL NOT
BE ACCEPTEO BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
ENClOSED
?/??„/Sp REQUEST FOR ELEC;RICAL INSPECTION
I? See Insimclions lor eompleting this lorm on back oi yellow copy
@ 5 Q 8 4 8 "7C" 8elow Work Covered by This Request
ee?ooooi-o7
N???? ???4?
ew Add Rep - "fypeotBUildmg ApPhancesWired EquipmeniWired
Home Range Temporary Service
Duplez Water Heater Electnc Heating
Apt Buildmg Oryer Other (Speciy)
Comm /Indusirial Furnace
Farm Av Conditioner
ily) ConVactor§ pemarks
Other (spec
Compute Inspectron Fee Below:
# Other Fee # ServiceEnlranceSae Fee # Circuns/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 A ps
TranSformers Above 200 _ Amps Abo Amps
SIgOS Inspeclor5 Use Only ? TOTAL
S?
Irrigation Booms ?J -Q /-57
Special Inspecnon
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby
certity that the above inspechon has
been made. Aough-in
Finai oa+e
oa
7-
OFFICE USE ONLY
Ths request voitl 18 montM1S Irom
411? Clty of Eapn
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
--------------,
? For OHice Use I
I Permil M? I
? I
??) I
? Permit Fee:
I ?
? Dale Received: '??' U? I
? Slall: ? ?t I
'----------C------I
2008 RESIDENTIAL PLUMBING PERMIT APPLICATION
Site Address:
Tenant:
Suite #:
RESIDENTIOWNER Name?\?A l.%l ?kQ-1 L Phone:?
Address ! City 1 Zip
CONTRACTOR Namee^??cn??.
-
-
Address:
l
City: State: Zip: 7mn110-
Phone: 1?.? i T(11 0Contact Person:
TYPE OF WORK _ New -"PReplacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W
Descri tion of work:
PERMIT TYPE RESlDENTIAL
Water Heater ? Water Softener
_ Lawn Irrigation Add Plumbing Fixtures
L_ RPZ /_ PVB) (_ Main _ Lower Level)
Septic System _ Water Turnaround
New
Abandonment
RES/DENTIAL 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 ($70.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned ou[ appliances, ductwork, etc ) (includes $.50 State Surcharge) ??
TOTAL FEES $__
????en a??u codus vi ti?_ ??,r u,
I here6y acknowledge Ihat ihis informalion is complete and accurate; ihat the work wm oe m conwrmance wim e umi?a
wi mthout a permil, Ihal Ihe work will be in
Eagan; thal I undersland Ihis is nol a permit, bu1 only an application lor a permit, and work t to slart
accordance with Ihe appmved plan in the case of work which requires a review and approval o ipian .
x
Applicant's Printed Name Applican ' Si re
FOR OFFICE USE Revlewed By: Date:
Required Inspections: _Under Ground _Rough-In _Air Test _Gas Test _Final
7(.vo SC
NOv ao2oos
zoos RESIDENTIAL PLUMBING PeRnnir aPPUCaTioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date?h ///S?
Site Street Address 10? ? L4) • Unit#
Telephone #?51
Owner &rt-}'1 (?
S
LM 0
I P
rt
,
_
-
rope
y
hone# 051J34:5`I300
Tele
?
p
(
Contractor
-
City State hN Zip ,la3
Address "
The Applicant is: _ Owner 11?contractor Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
i
Alterations to existing dwelling
$ 50.00
Add plumhing fixtures. This fee includes installation of a water softener and/or water
? heater at the same time. !f you are instalfing onlv a water softener and/or water
heater, do not complete this section; move to the next section and check the
i appliance(s) you are installing.
_Septic System Abandonment
_ Water Turnaround (add $130.00 if a 5/8" meter is required)
Otner:
kWater HeaYer
? Water Seftensr $ 15A0
?
new ,,?replacement
_
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
? State Surcharge $ 50
/ ,5-5b
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, worc is not to start without a permit and work will be in
accordance with the a proved plan in the event a plan is required t b r, vi d and approved.
ApplicanYs Printed Name Ap can Signature
#D
ities Di ig tal Quality 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.
? CITY OF Zr1GAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT
PERMIT TYPE: ?
Permit Number. c "Date Issued: '
SITE ADDRESS:
DESCRIPTION:
i 1 i ; , ?.t-;*,',
l;u?lf i t,y l-tur'? fy; ?
IiUI , i _ ;il : ' )
R. 1'R I ; ?
,- • 1 ?? , ? .?'F- ? ?- ..1 ..
REMARKS:
FEE SUMMARY:
I CONTRACTOR: OWNER:
?..
?-
Lt'YV6y
, . r-,i?? -.,, t_ ?•?,: •?-9: ...?d
rl ri
?-
APPLICANT/PERMITEE SIGNATURE ISSUEO B SI ATURE
? ? ,
Cities
itv 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.
INSPECTIO
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
? u
PERMIT SUBTYPE:
?
?
N RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
APPLICANT:
TYPE OF WORK:
REACTIYATE _
PERMIT # 1%06 Ll
CITY OF EAGAN
1993 BUILDING PERMIT APPLICATION 434,00
681-4675
SINGLE 8 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 capy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
r 3) lot change is requested once permit
d
h
i
dd
o
s c
ange
ress
in which request is made, 2) a
is issued.
Date /Pla'-° 1- /-1 $ / 'V Valuation of work !S:?S o U
Site Address: 14t24o Llkkn Ld p
SUITE 0
STREEi
/
Tenant Name: (commercial only) I'AjoOoe7d'`Et /()wi?i?vi+ceS
LOT BIACK SUBD. Y?)?????p•i? P.I.D. 1?
v
Descri tion of work:
The appl icant i s: ? Owner El Contractor ? Other (Deccribe)
Name cr-O56?3 Rrkc--2 Phone 4iLIy0
Property LASt ?FIRST
Owner Address
SiREET STE N
City State ZiP
Company AI54',arcppStr, T?rj c- Phone ?3'? 532?
Contractor Address NA`-" License # 37y') Exp. ?g4
City 01'p?5- State 1'?/U ZiP ,55 4-1ZZ
Company Phone
Architect/
Engineer Name Registration #
Address
City State ZiP
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have re d this app1 cation and state that the information is
State of Minnesota Statutes and City of
correct and agree to comply with 1 applicable
Eagan Ordinances.
?--.
-
?
'
-
.?,?J
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
?.
O 01 Foundation ? 06 Duplex ? 11 Apt./Lodging -•
? 02 SF Dwg. O 07 4-Plex ? 12 Multi. Misc.
? 03 SF Addition ? 08 8-Plex ? 13 6arage/Accessory
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace
? 05 SF Misc. ? 10 Multi. Add'l. ? 15 Deck
WORK TYPE
? 31 New ? 33 Alterations O 35 Tenant Finish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
0 of Stories
Length
Depth
APPROVALS
Planning
Engineering
REGIUIRED INSPECTIONS
? Si te
? Wallboard
Basement sq. ft.
lst F1. sq. ft.
2nd F1. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Building
Variance
? Footing
? Final
..??
-""'a3 1-
_---?
?'rl; Bas1ment Finish
? 17 Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
O 37 Demolish
MWCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler
Census Code
5AC Code
Assessments
? Framing ? Insulation
? Draintile ? Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
5/W 5urcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Lopies
Other
Total:
vatuotim: $
SAC %
SAC Units
CTTY GF I°AGAN
CASH7:L"I'Ce JS TE:RMINFlL N0: 718
?ATE- 07/t6/93 'i'IMI=.:: 0:57?43
ILiv
NAME:; ADDEI:i VAIIJF E.XI'EFi:[Of"tS? INC.
32:1.0 300i. 1657 HTC:f;OftY NT 1.33a?5
2:L'.55 900:I. 1657 HIGKqfiY WT ;3..°itl
32.I.II 900j. j.665 FIICF.(]f2Y Ii:L 139.25
2J.55 9001. 1665 f•ITCF;OfiY HI 3.50
3210 900 1 17pR HICKOFiY HI 1.3'3.?5
Z:I JJ 9001 !'70Ei FiT.C;F:0RY HI 3 .50
3210 9001 1724 NSCKORY H:C 139.25
2155 900:1. J.724 HICt(f.1fiY H2 3.50
2c^.i(l 'JUpf. l,641. PIICF:I'JRY LA 139.25
2155 9001 1641. hIICF:01tY LA 3.5L7
Ck:li.3489 Cf:lN'1'TNUE
l.1SI::F IIl; tAN X??k C()NT'TNUE
coNrzNue:
cITV aF r_ncAN
cA<;fazEr,: 38 rr:::r,MlNnL n!a: 7is
Dr1TE.- 07/16/39 T'IMI::s iQc57:44
ILi ;
NAME: ADDED Vl-tL.UE F.:XTEfiIORS, .T.NC.
3210 9001. 1+-,76 HIIItillfiY L.A 199.25
2155 900j. 1676 I-IICKORY LA 3.50
.
Total Recript Amaun+,: E356.50
CFtJ.184Ft3
l.1S1:7R ID: JAN
`I yyy I3UILUING NtKMI'i' AWPLICA'i'1(7N IRESIDENTIA
?6v? CITY OF EAGAN
3830 PILOT KNOB RD - 55122
851-681-4675
New Consfiucfbn ReauiremeMs Remodel/Reooh Reaulremenh
D 3 reglslered sHe surveys ahowing fq. M. of lot, sq. ft. of house
and gH roWed areas (20% maxlmum bl eoveraae ailowed)
? 2 copies of plans (show heam A. window sher, powed Ind, design; etc.)
D 1 sM W energy calculaNons
? 3 copies of free preservation plan tl lot plalted aAter 7/1/93
DATE:
DESCRIPTION OF WORK:
STREET ADDRESS:
ec-?<C?
2 copies ot plan
1 ut of energy cakulalions for heafed adtlBions
1 fNe iurvey lor exterior addlNons s dacb
?
.ai,(1 , 7
CONSTRUCTION COST:
Z
LOT: 7_ BLOCK:' 1 ? SUBD./P.LD. #: w
Name: U?A?. 4",Lel'?w0-$5 Phone Ik:
PROPERTY L s? Fkd
OWNER .
SheetAddress: fE(S??-r ? CCL
City State: P/µ? Zip: SS"/ 2Z-
Company: 4&? Phone k: 6s QS3 `g(77
(area code)
CONTRACTOR
SfieeiAddreu: 4f_? :2 6 41<?<-MAU- license9k??1? Exp. 'Vd'0
ciy tqj. atote: zip:
ARCHITECT/
ENGINEER Gompany: Name:
. Telephone area code ( )
Shee't Address: Reglshation IF:
, City State: Itp:
Sewer 3 water flcensed plumber (reaulred for new conshuctlon onNi:
PenaNy applies when addreu change and lot ehange la raquested once permM b bsuad.
I hereby acknowledge thal I have read fhis applicalion, afate that the InFormaHo fa et, a rce to eomply wMh all appllcabl
State of MlnnesWa Statutea and CMy of Eagan Ordinanees.
Signature W AppttcanF:
• OFFICE USE ONLY
?? -
Certificates ot Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
IS310
1990 BUILDING PERMIT APPLICATION
CZTY OF EAGAN
SINGLE FAMILY DWELLINGS
2 SETS OF PLANS
3 REGISTERED SITE SURVEYS
1 SET OF ENERGY CALCULATIDNS
MULTIPLE DWELLINGS
2 SETS OF PLANS
REGISTERED SITE SURVEYS -
(CHECK WITH BLDG. DEPT.)
1 SET OF ENERGY CALCULATIONS
# OF RENfAL UNITS
# OF FOR SALE UNITS
COMMERCIAL
T
2 SETS OF ARCHITECTURAL
& STRUCTURAL PLANS
1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCS
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.
To Be Used For
Site Address
Lot ? Block ?
Phone p-7 91
Contractor
Address
City/Zip Code
Phone
Arch./Engr. _
Address
City/Zip Code
Phone #
?/ g?? sv
I? E C Valuation:C>C>Date:
I07fl ??kQQ"f {.?.}?. ? OFFICE USE ONLY
FEES ?
Occupancy
Zoning a-J
Actual Const ?
B1dg. Permit
Allowable Surcharge 16-0
# of stories Plan Review
Length SAC, City
Depth SAC, MWCC
S.F. Total Water Conn
Footprint S.F. Water Meter
Acct. Deposit
On site sewage_ S/W Permit
On site well S/W Surcharge
MWCC System _ Treatment P1.
City water _ Road Unit"
PRV Park Ded.
Booster Pump _ Copies
?
SUSTOTAL
APPROVALS Penalty
Planner TOTAL
Council
Bldg. Off.
Variance
City/Zip Code E??A.,K) _f'-??/ ZZ..
. i a
?
1990 BIIILDING 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 SPEGIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WNEN: 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.
To Be Used For:
Site Address /(p?
Lot ? Block ?
Parcel
Owner
Addres
City/Z
Phone
Contra
Address
City/Zip Code
Phone % ?01 JV
Arch./Engr.
Address
City/Zip Code
Valuation: I't). 0" Date: qU
USE ONLY
FEES
Occupancy
Zoning
Actual Const Bldg. Permit f. ?
Allowable Surcharge .hn
# of stories Plan Review
Length SAC, City
Depth SAC, MWCC
S.F. Total Water Conn
Footprint S.F. Water Meter
Acct. Deposit
On site sewage_ S/W Permit
On site well S/W Surcharge
MWCC System _ Treatment P1.
City water _ Road Unit'
PRV Park Ded.
Booster Pump _ Copies
SUBTOTAL
APPROVALS Penalty
Planner _ TOTAL ?
Council
Bldg. Off.
Variance
Phone #
2001 STORM DAMAGE PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122 ?Cl
651-687-4675
Reaulrements
LC?
? 2 coPiea of plan O O f S Y o vy
CY S? , DATE: C? % l p C\ -- 0( CONSTRUCTION COST:
DESCRIPTION OF WORK: KEPFn Ik Ls---)AI Ck- DA_ GC? If multi-famity bldg., how many units?
IIdDICATE THE FOLLOWIPlG EQUIPPflEiVt TO BE REPLACED AWD BY WHOM: '
_ Plumbing _ Homeowner or Contractor Name gA I N(30 cx-' KCS'I d 2 ?L) IL)
_ Mechonfcal _ Homeowner or Coniractor Name
"Note: If somebody oTher than the homeowner is performing plumbing or mechanical work, they must applyfor appropriafe
permit. Only licensed plumbing contracTOr or homeowner may complete plumbing work.
STREET ADDRESS:
( C.lr_h f'`V
LOT:
BLOCK: SUBD./P.I.D. #:
PROPERTY
OWNER
Name: J Av\- E S KP`1 2Q" Phone #:
Last Flrst
clty Elti G A lLJ state: r?\ A2 zlp: 5S j 2 z
Shset Address: 1(' -7 ? 14 1 G
Company: ?.-l? )+u f3(7 C-? ?? S7b (ZA?J ? pnone #: `T (0 3 ..? O? J b ZOQ
(area code)
CONTRACTOR Sheet Addreu: b S (kIti P i S? LFL 4censeri p? '? 0?Exp. 3 --02-
?.L?
ari sta?e: irn, ?v ZIp: S SJ 3 a.3
r p v ?
JUN 0 8 2001
V_-:--- -
I hereby acknowledge that I have read this applicaflon, state that ihe information is correct, and agrae to compty wllh allapplicable State
ot Minnesofa Stafufes and City of Eagan Ordinances.
Signature of Applicant: ??? ?
OFFICE USE ONLY
BUILDING PERMIT SUBTYPE
? 24 Storm damage
WORK TYPE
? 33 Alteration
? 37 Demolish (Bldg)* *- Give PCA handout to applicant
? 38 Demolish Interior
? 42 Demolish Foundation
? 43 Reroof
? 44 Siding
? 46 Windows/Doors
(ozf75a.
2004 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.
Date _& ! In_ / 6!q
Site Street Address 16-76 Unit #
^ payPr ?152-?35-l65?
Property Owner K 1 a kP PC/? P.r50 C1 Telephone #(?5I)157Gq-G'37 3
Contractor Telephone # ( )
Address City State Zip
The Applicant is: Owner _ Contractor _Other
Alterations to existing dwelling $ 50.00
_Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_Water Turnaround (add $121 00 if a 5/8" meter is required)
Other:
?Water Softener Water Heater $ 15.00
/
replacement _
L additional
Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00
State Surcharge $ 50
$ irS
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.
ApplicanYs Printed Name ApplicanYs Signature FH?JUN ?0 T ' 10 2004 H
i
i ?o?i3itcefuse
? Pertnit#:
I Permit Fee:
I ?
? Date Received: ?
I ?
I Staff: I
I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: / -/ 7 -db SiteAddress: 7& --
Tenant:
Suite #:
RESIDENT / OWNER Name: WDOX 64 T ? /tIUl} Phone:
Address l C'ity 1 Zip:
Applicant is. _ Owner ? Contractor
TYPEOFWORK Description of work: T£AI2- Of=f= ?- R- £4 vOF
Construction Cost: J 3 000 Mulli-Family Building: (Yes X ! No ?
CONTRACTOR Name: C?-? License #: 902 ? 7
Address: ?L)H iT€ 120 CK P- L
City: State: Zip: S?;-33?
Phone: /So2 -2 `j/- yP7S- Contact Person: ? / i k £
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
C2te90ry 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 8. Water Contractor: Phone:
NOTE: Plans and supporting`documenfs that you submit are.considered to be public°iniormation. Poftions of p
the information may be classffied as'non-public if you provide`specific reasons that would permit the City tb
a conclude fhat the are frade secreis.
I hereby acknowledge that this information 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 permi[, but only an application for a permit, and work is not to start without a pertnR; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans. L?Q
n,?
x0"IIL"£ i x
ApplicanYs Printed Name plic nYs Signat e
% Page 1 of 3
f For Office Use
S
EAGA Permit#: /....577F1-7/
N
Permit Fee: ZE
'/" eivE Date Received: �,7- 7
3830 PILOT KNOB ROAD EAGAN, MN 55122-1810 �.d►
(651)675-5675 TDD: (651)454-8535 I FAX: (651)6 694.,R Staff: _.
A
buildinainspectionsCa Citvofeactan.com
1 7 2010
2019 RESIDENTIAL We • _ - MIT APPLICATION
Date: 1 l 7— l 7 Site Address: /6767 76 Ft`C-ICC 174, Unit#:
Name: WOOc( c4i ie 0VI41( Ass oc 'ot'{-`ph [Phone: v 5-1 - V541-73Y7
Resilden l 1 ( � lam/` 11 (1 19 r Ea9 q 53 102
Owner Address/City/Zip:
(
Applicant is: Owner X Contractor
Type of Work
Description of work: ' `'- `ac l f ar 0 1!1C aim J ? !ac tz
Construction Cost: ` J /aO Multi-Family Building: (Yes /No
Company: Ind l rule nh D i' ���1S ����at.�'� tact: -5.4.Ve 13or.ng4
q .
Address: 7 5 l 3 FOX 6Q�D C City: 1-ot rrrt• Ili -61
Contractor l[� 1 _
State* Al Zip: 5-' O ` Phone: 4.Gf a` 59 Em 68
License#: 6 17 D Q b 1 Lead Certificate#:
If the project is exempt from lead certification, please explain why:
No /0011/4M _ q, j BOO r`h
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:
Fire Suppression Contractor: Phone:
NOTE:Plans and sapporing 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.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.cityofeaoan.com/subscribe.
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.
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.aopherstateonecaliorq
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 approva of ans.
x S**Y8fi „gar/'i')Dirt!l x
Applicant's Printed Name Applicant's Signat re �'-