1556 Highview Ave
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RESIDENTIAL .
BUILDIN'G PERMIT APPLICi4TION I
crrr oF EnGM ? .
? 3830 PILOT KNOB RD - 55122
657-681-4675
? r•
NewEonaWCUonReaufremeMe RemodellRaoaIrRenulramenb .
.3..registared sileeaurveys siwwing sq. R Wlot. s9• 14 of hoWe; and all roafederees . 2 apta?of pan .. °. . .
?! . .{2096 meAnum bl coverege aliowed) • 1 sel ot Ene(gyCakulatiure.for heated atlditions 2 copies. of plan shoxnrigbemn d wiMow s¢as; poured found desgn, ele.) . 1 eite sWVeY la exleftr
addiUons 8 decks . '.
' ? . 7sel oF.F.rrerBY GelaAetiona ' . Indicatett home served bj':seplk system Por:adtlitbre .. . : . -:..
. 3 copies of rree Preservation Plan if lot qatled afier 711183
" ....RimJoistDetal.Qplbns selaclkmsheel(bkpawhh3orleaBUniLS) . . : .. _
. _ .. i,.r -• .
K, '" DATE °r - Cr _ o I VALUATION ? 1100 O?C)?` ?
. JOB SITE ADDRESS 15S i?V,
1F MULTI-FAMILY,BUILDING, HOW MANY UNIT$?
•"'PRORERTYOWNER NaJ-i oo.-X,tAo/lvy,
? . . . . .?.4, ? . ?., : TYPE OF WORK ?a F!2e Pai i FIREPLi4CE(S) 0
APPGICANT Sa m PHONE#
? 'ADDRESS ZIPCODE°
x r?t -
? <RAG.ER# CELLPHONE# laL,41G,-219!? FAX#
?
NE1V RESIDENTIAL BUILDING ONLY - FILL QUT COMPLETELY `? •'
Energy Code Cate9ory MINNESCQTA BULFS 7670 CA1'EGORX 1
(check one) - Rasfdential VentilatiohCategory 1 Worksheet`SubmtKed
Eriergy Envelnpe Calculations Submltted
MINNFSOTA RULFS 7672.
New Energy Code Worksheet Submltted
z Plumbing Gontractor: Phooe #: `
'Piumbing System InCludes: _ Water Softener _ Lawn Sprirfkler Fec; $9000
Water Heater No. of R.I. Batiu
+ c : Na. of $aths
MechankalConhactor. - Phone,li
Mechanical. System Includes: Ait Conditioning Fee: $70 00"? .i
Heat Recovery System
?
Sewer/Water Confracfor. Ph b 4j?
?! • .. . . . ( , -4 .
All above informaHon must he submitted prior to processing of applicatlon.
s n?' 1 hereby. acknowledge that I have re4d this applieation, siate thaYthe infortna 8?' , Letomply n-
?' with all applicable State of Minnesota Statutes and City of Eagan Ordi nce
€ = Slgnalure o} Applfcdnf ? ??7 • '?--"'°" ?.'
a.
Certfficates of Survey Recelved _ Tree Preservation Plan'Received _ Not Required :_ • • ::-:
ro? .
?, .. . ' upe?ea.I
«.
,,..?
?. ? ,
1101 Foundation O 07 05-plex
? 02 3F Dwalling O 08 06-plex
? 03 01 of _ plex 13 09 07-plex
13,04 02-plex O 10 08-plex
O OS 03•plex O Ti 10-plex
O OB 04-piex ? 12 12-plex
O 31 New ? 35
? 32 Addition O 36
? 33 Alteration ? 37
p' 34 !RepleaemeM
Valuatlan Censns Code
SAC Units "
Nbc of Units
?Nbr. of'Bldgs
Type aF Const
. .;?,
OFFICE-US8,0NLY'.;,?'?
. f w:
.
•
-
S}
,. ?
'
-
. .
O 13 76=piex
'.
,?a.
: ?
O' -'20 'Pool ,,
.
. .
r
30-Accesso ry ' ,Bltlg
O 16 Fireplace O 21 Porch (3-sea.) ? 3,1 'E)d. Aft - Mnffi
0.17 Garege r,chlAddn. (4sea.) O
022 P,o 33 ExL Alt - SF
O 18 Deck r
O. 23 Porcti (screened) ' O^,36; `Multf _
.
O' i9 Lower Level ' O 24 Storm+m8mage
Plbg Ynt_N 0 25 Miscellaneous
ln4lmprovement ? 38 Demolish (Intedor) 0- 44 Siding
Move Bidg. !? 42 Demolish (Foundapon) O 45 Fire Repair
Demolfsh (Btdg)` " 0 49 RBroof p 46'i. WfndowsfDoors
•Demolltton (Entire Qltlg anly) • Glve PCA handout to applicant
Occupancy u MElES System
Zoning ? City Water
Stafes Boostee Pump
8q. Ft. PRV .. .
Length Fire Spcinklered
CNidth ,: .
iREQUIRED INSPECTIONS
`FooUngs (new bldg) FinaUC.O.
_ Footivkp (cleck) ? FinaUNo C.O.
_ Footings (addition) Plumbing
Foundation I-NAC'
Drain Tile , i -
Roof Ice & Waur Final Ot1ie"i
_ Framing Pool Ftgs Air/Gas Tests _ Einal
_ Fireglace _ R.I. _ A'v Test _ Fina] Siding SNcco Stone
Itsulation _ Windows (newheplacement)
-
Approved By Buliding Inspector
Base Fee - ?
Surcharge
' Plan Review
MC/ES SAC
Ciry SAC .
' Water Supply & Storage
` S&W 'Rermit4 Surcharge ^ -
Treafinent Plant
_ Plumbing Permit '
• .. Mechanical Permk
License Search '
Coptes , . .
,. Other
, ToWI - -
, ` . v . . . . .
?
'CITY OF EAGAN Remarks ? • ? ? ?f ?' ? .
dwner ".,' , i' U 17U71 ?-1.5ireet cvc}v ?ai.ul.oy rtviu. uwy . 5tate ya?cu 1'iLY >J ? c?
Improvement Date Amount Annual Years y Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
DI? 4,60 7
SAN SEW TRUNK y„ 'I 22.00 27. O 3 Pai.d
I # SEWER LATERAL 1970 O
WATERMAIN
# WATER LATERAL 1970 4220.00 , 4 71 -13-
WATER AREA 1977
?
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
\
WATER CONN
SUILDIN ER.
SAC
PARK
CASH RECEIPT
i ' ? • •
CITY Co" EAGAN
P. O. BOX 21-199
EAGAN, MINNESOTA 55121
<
l
/ DATE 19
RtCtIV<D
IROM •t-( ?l ??.
IIMOUNT $ ?
& DOLLARS
?oo
? CASF{ ? CHECK
r
rOR
?,? ?l??. . ? - RlJ l' / . )'? ?i •
f
/UND CODi AMOUNT
.- ?
Thank You . .
sv
White-Payen Copy
Yellow-Postinp Copy
Pink-File Copy
' CITY OF EAGAN . ? 015j 7
3830 Pilot Knob Road P O Box 21-199 E n MN 55121 -
. . , a9a .
PHONE: 454-$100 ?
BUILOING lERM{T R«?ipt #
Site Addreas 7w lR Erect ? Occupency
Lot Block Sec/Sub
--- - - • %' Remodel Zoning
Pareel No. . Repair Type of Const.
Addkion ? No. Stories
? y,,y
' Move ? Length
? Name
W
; Demolish ? Depth
Addres
?? s Int Impr. ? Sq. Ft.
City Phone Install O
-
N
m
`•r?': ?YYrv?ow r?Os
a
e
~
?? Addresa Assessment Permit
?- City Phone Water 3 Sew. Surcharge
1, Police Plan Review
?u Name Fire SAC
?? Addre+s Enp. Water Conn.
?W City Phone Pioe+ner WaterMetet
Counci) Road Unit
1 hereby ocknowledgs that I hove read this applicntion and stote thet gldg. Off., Tr. PI.
tF?e information is torrett ond egree to comply with oll applicable APC Parks
State of Minnesoro Statutes ond City of Eegoq:4rdinoncex
Var. Date Coples
Sipnature of Permittea a-
,Tatal
A Bufldiny Permit Is issued fo: on tho txpress condition 1hol
al? work sholl be dorw in xcordanee with oll opplicobls Stote of Minneaoto Sfatute: and City of Eapan OrdinonceL
ewlding offipoi
Parmit No. PwmR Holdir Daa Telephone ?
Plumbiny
w.VA.C.
Elecdic y' ! c? ?
Softaoer
InWsetion Dste (nsp. Other
Footinys 1
Footings II
Foundatlon
Framing
Roofiny
Rough Plbg.
Rough Htg.
Insui.
Fireplace
Final Htg.
Final P1bg.
Final
Csrt/Occ.
Water Oewibe Locition:
Well
Sewer
Pr. Disp.
' CITY OF ;AGAN N0 1 Q 5 8 7
3830 Pilot Kno6 Road, P.O. Box 21•199, Eagan, MN 55121
PHDNE: 4548100
BUILDING PERMIT rteceipt ?F J
Te ee u..a fm REtnon,r en.voiue 5_nnn oate
SiteAddress - 2840 STRT.F;V MFvt')R TAT. AWV Erect ? Occupancy
Lot _1- Blcek SS cec/Su6. S E)"t' n Remodel Zonin
Peroel No. RePair ? Type of Conrt.
Addition No. Stories
a Narime JOE SPAM$ Move ?
li
h ?
D Length
?
Address 450 WHITE emo
a
K DR I
t
I
? pepth
City W ST PPUL Phone 4 n
.
mpr.
57-28116 Insta?l ED Sq. Ft.
z AVPrevalf Fem
=.,O Name $?j? -
u? Addreas
? City Phane
Name _
Address
City Phone
1 hereby acknowledge thnt I hova read this opplicotion ond stnfa that
the inlormation is rArrecf and agree to wmply with oll opplicoble
Stah of Minnesorc Starut?es (o'ol Ciry of Eug ;Ord,,i,r,a_,n,?j/p?j
Sipnoturc of PermiMea ? ""`R-
A Buildfng Permir Is issued . JOE SPANDE
all work aholl be dorm In ccwrdmm wieh4oll appJScoble Stote of Min
Assessment _
Water S Sew.
Police -
Firo
Enp.
Vlannsr _
Council _
Pefmit S??Sn
Suroharge -2.56
Plan Review
SAC
Water Gonn
Water Meter
Road Unit
Bldg. Off7LS/$5 Tr. PI.
APC Parks
Var.Oate Copies
Total 51 nn
rn iha expfeaf conditlon thoo
vewta Statutes and Ciry o£ Eeqen Ordinances.
Buildinp Oflitiol
flug 17 06 10:08a Corey Carlson (651) 653-3200
7?775
zoas RESIDENTIAL PLUMBING PeRnnir APPLica oN
, CITY OF EAGAN
3830 PILOT Kf+106 ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dweilings.
p.2
'0•6D
Date?,?, 06
/ T
Site Street Address
Unit #
Property Owner Telephone # Q+t ? 51110 - Z! 4 3
Contractor Cai kSU{> "?)VN4b1VlG LV?C. 7elephone# ( )7?4??~1??0
Address City statel vv\ Zip L6i2::)-
Other
The Applicant is:
Owner (/_KContraetor
_
_
Septic System _ New _ Refurbished Submk 2 sets of plans and MPC license tndudes County fee
$ 100.00
Per as-buiit $ 10.00
Alt ons to existing dwelling $ 60.00
Add plumbing fixtures. This fee indudes installation ot a water soYtener andlor wat
heater at the same time. 1f you are instaHing oniv a water so/tener and/or waft
heater, do nat complete this section; move to the ne# sec[ion and chedc the
appliance(s) you are irutalling.
_SeQtlc System Ab2ndonmeM
_WaterTumaround (add $130.00 if a 5/8" meter is required)
Other
Water Sottener Water Heater $ 15.00
_ rrew _ replacement
Lawn irKgation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
Total
1 hereby apply for a Residential Plumbing Permit and acknowledge that the information is co
work will be in confortnance with the ordinances and codes of the City of E and
urrdersiantl this is not a permit, but only an application for a permit, work is not to t
accordance with the approved pian in the event a plan is requirecf to vi p v
Chce.?n.
ApplicanYs Print Name Appli s Signaiu
e and accurate; that !he
plumbing codes; that 1
ermit and work wil[ be in
Address: 1556 Highview Ave. Zip: 55121 Permit: 66767
THE FOLLOWING ITEMS WERE/WERE NOT COMPLETE AT FIIJAL INSPECI'ION ON :/D'3O -D6
Yes - No Comments
Final grade - 6" from siding
Permanent ste s - garage
Permanent st s- main entry
Permanent driveway
Permanent gas
Retaining Wall or 3:1 Max Slope
Sod/Seeded lawn
Trail/curb damage ?
Porch
Lower level finish
Deck
Fireplace i
• Verify with your builder that roof test caps from the plumbing system have been removed.
• Tum off water supply to the ouCSide lawn faucets before freeze potenual exists.
• Call the City's Engineering Department at 651-675-5646 prior to working in right-of-way or installing
irrigation system.
? BOILDING INSPECTOR:
71,711-7
c.L I ?-t-i?J (.efasd? 't?p?,vlc?`?
2004 RESIDE IAL BUII,DING PE APPLICATION
City Of Eagan ?'!? 0 - (°(' -1 6'3-
-?) i7?--t.(? y
`l U .s-0
3830 Pilot Knob Road, Eagan MN 55122
? pip c? ? -I 6 9
Telephone # 651-675-5675 F # 651-675-5694 /}
/? ?,?p???l
New Cons4uction Reouirements e LQIQ? ? 'R'emod?e eoair Reoui2ments ?-?? ? 0 , ( 01 ' OC)fiice Use Oniv
3 registe2d site surveys showing sq. ft of bt sq• R W house; and all roofed a 5 2 copies of plan Cert of SurveyRecd WY??iV`?"')
(20%maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plen Recd Y._ ?
2 copws of plan showing beam 8 window sizes; poured fourb design, etc. 1 site survey for addNons & dedca Tree Pres Reqwred ,_ N
1 set of Energy Calalations AddBion - indicate Honsife sepfic system On-sile Septlc System _Y _ N.
3 copies of Tree PreservaGan Plan d lot platled afler 711/93 I r ?-l C.a !'l a a n (?rt S?Y
Rim Joisl Detail Options selection sheet (bldgs wAh 3 or less unb
G f ? ?
Date ? r 20 coo5truction cost
Site Address e unjusre a
Description of Work .
IEW oi''? 'j'z
-" ?(? ?? J? ?
u?UR ?i?. i'I
° d 5
MWti-FamilyBldg _ Y5< N Ftireplace(s) _ 0 z 1 _ 2
Property Owner X?iE?-g po f2 S /T? Telephone # ?"l
- - 2
Contractor
-
Address ? City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential VentilaUon Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted - a Submittad
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumberkc--M.rz- Telephone #(??) 4- 9-57 ?
Mechanical Contractor Telephone #(
i ?
Sewer/Water Contractor Telepho I??#' LrI
` I?4s
I hereby apply for a Residential Building Pernut and aclrnowledge that the i formation iTtWlete d accurate;
that the work will be in conformance with the ordinances and codes of the ' u-ancllhe State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
pernut; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of lans.
Ap icant's Pf ed Name
? A D EW N o9,?f's /r???/?y
ApplicanYs 5ignature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
3?C 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo)
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_v or _ N ? 25 Miscellaneous
Work Types
,;? 31 New ? 35
? 32 Addition ? 36
? 33 Alteration ? 37
? 34 Replacement
Valuation 0 ?U0
Census Code 1 l'? l
SAC Units
# of Units ? # of Bldgs ?
Type of Const ?
C?
-A.
?
Int Improvement ? 38 Demolish Interior
Move Building ? 42 Demolish Foundation
Demolish Building* ? 43 Reroof
*Demolition (EnUre Bldg) • Give PCA handout to applicant
Occupancy MCES System
Zoning L City Water
Stories Booster Pump
?
Sq. Ft. PRV
Len9th ? Fire Sprinklered
a
W idth
Footings (new hldg)
Footings (deck)
Footings (addition)
Foundation
Drain Tile
Roof Ice & Water _ Final
Framing
Fueplace C R.I. %4 Au Test X Final
Insulation
Approved By:
Building Inspector
---- ---------------------- --------- ------------°---- ?
Base Fee (' ? ? ?j?
"'' sl //??7
Surcharge 0
Plan Review 37?
MC/ES SAC ?-
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Tocal
T
?
n U
- I.cL'- 4
0 y
? 30 Abcessory Bidg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 44 Siding
? 45 Fire Repair
? 46 WindowslDoors
REQUIRED INSPECTIONS
?. FinallC.O.
FinaUNo C.O.
Plumbing
HVAC
Other
Pool Ftgs _ Air/Gas Tests Final
Siding _ Stucco _ Stone _ Brick
Windows
Retaining Wall
T
Lae
A7-De-o
79
Pemut Number
REScheck Compliance Certificate
2000 Minnesota Energy Code
REScheckSoftware Version 3.6 Release 1
Data filename: C:1Program Files\Check\REScheck\Nader.rck
PROJECT TITLE: Nooryshokry Residence
COUNTY: Dakota
STATE: Minnesota
ZONE: 2
CONSTRUCTION TYPE: Single Faznily
WINDOW / WALL RATIO: 0.20
DATE: 10/12/04
DATE OF PLANS: 9-03-04
COMPLIANCE: Passes
Mauimum UA = 568
Your Home UA = 566
0.4% Better Than Code (UA)
Ceiling 1: Raised or Energy Truss
Wall 1: Wood Frame, 16" o.c.
Window 1: Above-Grade:Wood Frame:Double Pane with Low-E
Door 1: Solid
Door 2: Glass
Basement Wall I: Solid Concrete or Masonry
Wall height: 9.0'
Depth below grade: 8.5'
Insulation depth: 9.0'
Basement Wa112: Solid Concrete or Masonry
Wall height: 3.5'
Depth below grade: 3.5'
Insulation depth: 3.5'
Floor 1: Slab-On-Grade:Unheated
Insulation depth: 4.0'
Propased and Maximum U-Factor Averages
Checked By/Date
Cnoss Glazing
Area or Cavity Cont. or poor
Perimeter B-Yalue -B'_alu e IL-FacIol IIA
1778 44.0 0.0 39
3988 21.0 0.0 171
704 0350 246
120 0.0'70 8
108 0350 38
580 13.0 10A 19
240 13.0 10.0 9
52 10.0 36
Proposed
Average U-Factor
Maximum
Allowed U-Factor
Above-Grade Windows and Glass Doors 0350 0.370
Includes Foundation Windows > 5.6 ft2
COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans,
specificauons, and other calculations submitted with the permit application. The proposed building has been designed to
meet the 2000 Minnesota Energy Code requirements in RES checkVersion 3.6 Release 1(formerly MECchec,? and to
comply with the mandatory requiremenrts listed in the RES checkInspection Checklist.
Date /101'/ Z `OL}
0-655-7cc- ??tC? Coi 7
,._-.
TREE ?RE?,E,??"???'??????PLA?V?St?MMAF?l? k?`
?
?
(PLEASE READ ATTACHMENTS)
E
Development N 4???? aDL[ () L
Lot Number ?I Block Number ?
Address tN_[fV iCl.() &1( -('y
Builder ?
PHONE NUMBER:_ ?SI ` CIL-) ?- - ) 22 I
CONTACT:N A D 'i fZ. N O DK 1( Stf O K\) ?
Tree Protection Reauirements:
1- Tree Protection Fencing Installed On Site
Oak Tree Pruning (Immediately seal wounds during April 1 to July 37)
Therapeutic Pruning
Retaining Wall
Other:
Reolacement Trees:
oN
As Follows
K Not Required FV
?- ?
: Attachments: Yes
No ?
Additional Notes
H:\gh0ve12004fi1e\treepreslTree Preservation Plan Summary-2004
LOT SURVEY CHECKLIST FOR RESIDENTIAL
° BUILDING PERMIT APPLICATION
PROPERTY LEGAL: f o'F Z?? ?, k I ll,?C?(?t?,? ?in(cl.?"1%?„
. . DATE OF SURVEY: 9121 /O4
d
LATESTREVISION: JO?JZIa'9'
m
c
R
r
U
o z
a
DOCUMENT STANDARDS
? ? • Registered Land Surveyor signature and company
• Buiiding Permit Applicant
? ? ? • Legal description
-0' ? ? • Address
0 ? ? . North arrow and scale
f)3 D ? • House type (rambler, walkout, split w/o, split entry, lookout, etc.)
? • Directional drainage arrows with slope/gradient %
0 ? • Proposed/existing sewer and water services & invert elevation r sWt{ lw"f!"F d0? AJO?' L?C?C wY
? • Street name &1la1T4 0001-16y4.
9 D
? .r
? . Driveway (grede & width - in R/W and back of curb, 22' max.) £xcead5 /070 ir1aX'r»wrn grq,de as per 64y COA,
• Lot S
F
1 guare
ootage
,9 D 0 • Lot Coverage
ELEVATIONS
Existina
D ? • Sewerservice (or Proposed)? AIsFtv tita d??. ?vcufwv,d dfAr1I1 On sWA1... J%LsAt 5L%tJ
'
.;7
0 ?
0 0
? • Property comers - 4' ad a.ll ?Pe?y ?.ernf/
S 4U4W GQLIIM14* kCA*?OA +eo. 41'tA44Cr1
Z
D • Top of curb at the driveway and property line extensions +tiw, qo4 -6,4Q?, 56044.
)T
? ?
? • Elevations of any existing adjacent homes *6A p, ,WW.0v% VA`
• Ad
equate footing depth of strudures due to adjacent utility trenches
? 0 0 . Waterways (pond, stream, etc.)
Proopsed
.? 0 0 • Garage floor
.B ? ? + Basement floor
iz
) ? ? • Lowest exposed elevation (walkout/window)
.0
4
Af El P' • Property comers
? ? • Front and rear of home at the foundation
PONDING AREA (if aoplicable)
0 'gr ? • Easement line
0 'K 0 . NWL
11 ;r ? • HWL
0 ? ? • Pond # designation
D ? ? • Emergency OverFlow Elevation
0 -? ? • Pond/1Netland buffer delineation
DIMENSIONS
?('? • Lot Iines/Bearings & dimensions
??-/ • Right-of-way an street width to back of curb)-$eL A.?KIM- onSL?,r?Q.?
?????? • Proposed home dimensions including any proposed decks, oF erhangs greater [han 2',?p[?„ etc.
U (i.e. all structures requiring permane ootings)
? • Show all easements of record and-any ity utilities within those easements
• Setbacks of proposed structure and sideyard se back of adjacent existin structure ??1 ??rmum Slopes
,? yf • Retaining wall requirements, if;any ? ? ?? ?--- OP RefA1111i1Q W?l WlU
i
a.1 Ll. fS !1 ??_•,? H(;Ulr6tl ?
Reviewed: i ?
. ?O?,e <?ate
G:fFORMSIBuilding Permit Application Rev. 12-16-03 Name /Wv
OCT-4-2009 15:05 FROM:SCFWRI`¢ LANO SLRVEYO 6514236949 T0:6123777337 P•2
?
tilELNfAR R. SC4l1iYANZ
??„ .-6qNE}SyRVEYBRSclP16. "^ - , 7-m4098
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Also shuwing the Lacatian of a prapaed Iwuee atakeA tnereon.
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1
• CLAIM VOUC,HER- REFUND REQUEST 'T h?ed ?
CITY OF EAGAN
MAKE CHECK PAYABLE TO: NADER & ASSOCIATES
ADDRESS:
EACAN MN 55121
LOCATION: 2840 STSLEY MEM AWY P.I.DJLEGAL: L012, Bl, SPANDE, JOSEPH A
RECEIPT #/DATE: 07-23-99/114111 VALUATION:
REASON FOR REFUND: FEES PAID PREVIOUSLY PERMIT #:
TYPE OF REFUND:
Electrical Permit 3211-9001 $
Plumbing Permit 3212-9001 $
Mechanical Permit 3213-9001 $
Building Permit Fee 3210-9001 $
Plan Review Fee 3422-9001 ?
SAC (MC/WS) 2275-9220 S
SAC (City) 3866-9379 $
SAC (Admin) 3446-9001 $
Water Connection 3865-9220 $
Sewer Pennit 3743-9220 $50.00
Water Permit 3713-9220 $
AccountDeposit 2252-9220 $15.00
Water Me[er 3716-9220 S
Water Treatment 3868-9220 $
Surchazge 2155-9001 $
Utility Acct Overpayment 2250-9220 $
Curb Box Deposit Refund 2253A220 $
Construction Meter Dep Refund 2254-9220 $
Water Usage Chazge 3711-9220 $
Other $
TOTAL • $65.00
[ declare under the penalties of law that this account, claim, or demand is just and that no part of it has been paid.
'? / September 7, 1999
S[GNA 'URE ? 7 qA DATE
/, ?
city oF eagan
PATRICIA E AWADA
MaYO,
PAULBAKKEN
BEA BLOM9UIST
PEGGV A. CARLSON
SANDRA A. MASIN
Council Members
September 7, 1999
NADEA & ASSOCIATES
2840 SIBLEY MEMORIAL HWY
EAGAN MN 55121
RE: SEWER HOOKUP
Dear Mr. Nodryshohry:
THOMAS HEDGES
City Actminisfrator
E.J, VAN OVERBEKE
Cih/ Clerk
In July 1999 you applied for a permit to connect to City sanitary sewer. It has come to our
attention that the previous owner, Bryan Hayes, paid a sewer permit fee and account deposit on
this property in 1996. Therefore, we are refunding the following fees to you:
• sewer permit $50.00
• account deposit $15.00
$65.00
If you have any questions in this regard, please feel free to contact me.
Serely, ?
!_.
Doug R d
Chief Building Official
DR/js
MUNICIPAL CENTER
3830 PILOT KNOB ROAD
EAGAN. MINNESOiA 55122-1897
PHONE: (651) 681-4600
FAX'. (651) 681-4612
1DD:(651)45n-8535
THE LONE OAK TREE
THE SVMBOL OF STRENGTH AND GROWTH IN OUR GOMMUNIN
Equal Opportunity Employer
MAINTENANCE FACILITY
3501 COACHMAN POINT
EAGAN. MINNESOTA 55122
PHONE: (651) 681-4300
FAX:(65)) 681-4360
iDD'. (651) 454-8535
`
crrv uF r_.FlGAN
CASH7LF<: JS TEFY4INAI... Nf): 76s3
DATLc 07/23139 'fIMF: 13:5038
ILi :
NANEe NADEF: t: FlSStIC;:1:A7G5
3866 3374 2840 S:[BI._E'Y MEM L0Q,.00
3446 9001 2840 SIEiI."r.'.:Y MEM iC1.50
2275 9220 2840 Sl:$I..E'Y MEM 1,039.50
2242 9220 040 S:I:i•LE:Y MEM I..`io00
3743 9'20 P840 S7:BI_EY NiEM 50.00
21bI 9001 2840 SzBLf_V MEM 0.50
2250 9001 2840 S.T.RL.EY MFt1 50.00
7a+,a:L.Rnceipt Amount% :Lp265.50
cRi. Wa. l.
usrh iDa JaN
??;1X#Xt%?1kW?f 'MX??k?C1k?F .;?kM%t?,'7k?n?k?1k?kMMNc?YiX?kK?kX??X#?'M'?C
JJot Block ? PID # 11'F>/0O - 01 a -D / Sewer lvraaa-?erinit-# J ?,
Plat .fo J e,O h f ?o!7?L Q/ -e- Date --71?'J C1 Receipt # 1 l U I ?
/ CITY OF EAGAN
1999 SEWER AND WATER CONNECTION AND AVAILABILITY CHARGES
EXISTING RESIDENTIAL PROPERTY
Sewer ? Water
Lateral chazge @$21.85/ff $ I,at al chazge @$22.10/ff $
Trunk @ $880/connection Trun $920/connecrion
City SAC 100.00 Sc o ni nJ Water s ly & storage 825.00
Base SAC 1,050.00 ?O SD SAco i Date pa
Date paid i o'?9 S 6 SPt
Receipt #
Receipt # Treatment plant 468.00
Account deposit 15.00 )CCDE Q Water meter •"Ins ions req'd prior 114.00
Sewer permit & surchazge 50.50 SPE P-!?h to ' sumg
Subtotal $?? 'SU Account deposit 15.00
Azo--S? Water permit & surchazge 50.50
Subtotal
D-2cz?0 - 90U 1 Plumbing permit & surcharSe g
30.50
Total $ Total $
Sewer and Water
Se r lateral chazge @ $21.85/ff
Water teral charge @ $22.10/ff
Sewer hu" $880/connection
Water trimk 920/connection
City SAC 100.00
Base SAC 1,050.00
Date paid ipt #
Water supply & sto e
Date paid Receipt
Treatment ant -46$:99'ej
Water ter "•Inspections rcq'd prior to ing -1-N4.96'e- 00
_ S e?.J 2 f
A unt deposit -3@.go !5
ewer and water permit & surcharge 100.50
So
Subtotal $ ? 66
Plumbing permit & surcharge .50
Total $ ?
, ---------- ---------- -------------- -------------- --------------- ------ ----- ----- ---------- ------ ----------
? OFFICE USE ONLY
PropertyownerAla.d2#' IUOD?vS W?',/ ? PRVrequired:
Address C?kyo J, b ie y 1v7e re oy--=r Wi,ti,X' ? R-O-W Permit: Ciry Cty
?
Phone number ? Unpaid $
n ? Permit Fees:
Plumber
City financed:
Lot 0 12 Blk I PID # 1 0-40100-0 I 2-0 ]
?•- Plat SPANDE, JOSEPH A charge (SAC)
paid
' CITY OF EAGAN
1996 SEWER & WATER CONNECTION CHARGES
EXISTING RE5IDENTIAL PROPERTY
Sewer connection
5ewer
Date
Account deposit
Sewer permit &
Subtotal
* Plumbing rmit & surcharge
Tap
Sewer availability charge (SAC)
Date previously paid Receipt #
Water availability charge (WAC)
Date previously paid Receipt #
Account deposit
Sewer & water permit and surcharge
Water meter
Treatment plant
"0.Q0
15.00
50.50
$ 1,065.50
. 20.50
Sewerlwater permit # 29286
Date I I/26 /96 Receipt # 67058
Date
Account depdsi
Water permit &
Water meter
Treatment plant
Subtotal
?
O
15.00
50.50
A l1GO-P-
-39fr.96Q-
$1,328.50
\ * Plumbin ermit & surcharge 20.50
Tap
tal
?J
Sewer & water connection charges ? ?? J
aubtotal
* Plumbing permit & surcharge
Tap(s)
Total
charge (WAC)
paid
?" ?
30.0a
100:50
--3964)A-e--
$2?no &60
?
?
$ ]30.50
,,/
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S'V
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1?
* A plumbing permit is also required. It will be issued only to a plumber licensed wrth the City or to
the homeowner if he is actua!!y doing the work.
Property owner ??? ?o 4?a-e--S
Address
Phone no
Plumber
Water connection
OFFICE USE ONLY
PRV
l SA?,
No. of ta s
ConAoc,Vj '
?hq?yr.r Al 6 li I ?
Waiver
Lot Blk PID #
Plat
Sewerlwater permit #
Date
Receipt #.
.a
?
CITY OF EAGAN
1996 SEWER & WATER CONNECTION CHARGES
EXISTING COMMERCIAL PROPERTY
Sewer conrtection charges Water connection charges
SAC ($1,000/unit) Treatment plant ($396/SAC unit)
Date previously paid Water permit & surcharge 50.50
Receipt #
Sewer permit and surcharge 50.50 5ubtotal
Subtotal * Plumbing permit & surcharge
Tap
* Plumbing permit & surcharge
Tap Total
Total
Sewer & water connectian charges
SAC ($1,000/unit)
Date previously paid Receipt #
Treatment plant ($396/SAC unit)
Sewer & water permit and surcharge 100.50
Subtotal
* Plumbing permit & surcharge
Tap(s) _
Total
The number of SAC units is determined by the Metropolitan Council Wastewater Services.
* A plumbing permit is also required. !t wi!l be issued only to a plumber licensed with the City or to
the building owner if he rs actua!!y doing the work.
Praperty owner
Address
Phone no
Plumber
OFFICE USE ONLY
PRV
No. of taps
Assessments
Waiver
a.
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AS OF: 09/24/1992
?
PPOPERTY ID: 10-20450-200-01 1
S/A# ASSESSMENT DESCRIPT. YEAR TM RATE TOTAL ANN.PRIN. PAYOFF CD
100040 SAN SW TRK 1967 30 6.0000 20.74 0.00 0.00 PP
100105 STM SW TRK 1970 20 8.0000 112.90 0.00 0.00 CL
100201 WATER AREA 1972 15 8.0000 32.58 0.00 0.00 CL
100257 WM/STM LAT 1973 20 8.0000 36.50 0.00 0.00 PP
100444 S/L STUB 1980 15 8.0000 31.48 0.00 0.00 PP
100467 TREE REMOV 1980 05 8.0000 1.47 0.00 0.00 CL
101033 STREET#306 1985 15 11.0000 231.27 0.00 0.00 PP
101034 SSLAT 306 1485 15 11.0000 56.75 0.00 0.00 PP
102239 WLTK W364 1991 10 8.5000 380.90 38.09 342.81
------ SUbIIMARY OF LEVIED 380.90 38.09 342.81
****** 1992 P&I CERTIFIED 125.28
------ SUMMP,RY OF DEFERRED 0.00 0.00 0.00
------ Si7MMARY OF PENDING 0.00 0.00 0.00
------ SUMMARY OF CLOSED 523.69
Press ENTER; or F1, F4, F5, F7, F8
SPECIAL ASSESSMENT SEARCH SUMMARY
AS OF: 09/24/1992
PROPERTY ID: 10-40100-012-01
S/A# ASSESSMENT DESCRIPT. YEAR TM RATE
------ SUMMARY OF LEVIED
****** 1992 P&I CERTIFIED
------ SiJhII+IARY OF DEFERRED
------ SUPIIMARY OF PENDING
------ SUMMARY OF CLOSED
SEE COMMENTS
TOTAL ANN.PRIN.
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0.00
0.00 0.00
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0.00
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Press ENTER; or F1, F4, F5, F7, F8
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1985 BUILDING PERlIIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS NUST BE LICENSED WITH THE CITY OF EAGAN
6,0,p? ? INCLUDE 2 SETS OF PLANS
? ? ?// /? ? 3 CERTIFICATES OF SURVEY
LeJz9.?L'o 1 SET OF ENERGY CALCULATIONS
c
To Be Used For: 6???j?_ Valuation: ?J Date: ?7 os
Site Address: ae6t6'
Lot: -L 62ock 52-5 Sect/Sub
Parcel 11
Owner :S??
ro
Address 1we -??
City/2ip Code
Phone
Contractor ?
Address
City/Zip Code crz5wp
Phone P4
Arch,/Engr. ?
Address ^
City/Zip Code
Phone # ?
, OFFICE USE ONLY
Erect Occupancy
Remodel ? Zoning
Repair y, Type of Const
Addition N of Stories
Move ?
? Length
Demolish Depth
Int.Impr. Sq Ft
Install
APPROVALS EEES
Assessments Permit 'SD.S-°
Water/Sewer Surcharge
u 2.?
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Council d Unit
Bldg Off Treatment P1
APC Parks
Variance Copies
TOTAL S • 6?
r
? '00?? .
°r
L
?
Oetober 24, 1969
/O eUNUO C>/b
Ci:. Precie^ici: Post
2840 3ibley Eighway
3t. }'aul, Iiinnesota 55118
Dear P1r. Poat: -
Your requeat to have the assess:nent for sewer laterals
on flilldalA Terra,ce tranaferred tn Highview P.venue
was again revie:aed by the EoarC of Sunervisors a-i
their meeting of Octoher 21at. This had previoualy
been reviewed by both the Soard and the Assessment
Ccmmittee and they felt the benefit is on the pronerty
abutting Hilldale Terrace ar.cl there is r.o justification
for switching this tsasessment to Highview Fvenue.
They regret that they cazinot act fnvorable nn ycur
reauest but Peel that this is the only fair way
to asoess your pxro?.-erty.
VeTy tIV7.J yours,
{N]rs.) Alyce Bolka
Clerk of Eagnn Tov.mship
4 Y \I _ : , ? 1 ?
TO
?
FROM
Bonestroo, Rosene & Associates, Inc.
1381 EUSTIS STREET
ST. PAUL 8, MINNESOTA
Mldwcy 6-4886
SUBJECT:
rOLD t
DATE: -5ar ?13
ili? /`?.?-?C2/,^? -
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Uf?C.C1' G???? ? ..t?-?.Li, lnJ-'t?G'?- !?t! ? ?•,,,? ""'??. ? ?I?Lo-??..
PLEASE REPLY TO SIGNED /
B?
DATE SIGNED
? oaa,.,,qc -o.. B po,KLr,,,,, N. Y. THIS COPY FOR PERSOP! ADDRESSED
?_;? l3 19?9
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CLAIM VOUQHER - REFUND REQUEST
CITY OF EACAN
MAKE CHECK PAYABLE TO: Nader & Associates
ADDRESS: 2840 Sibley Memorial Hwy
Eagan, MN 55121
LOCATION:
RECEIPT #/DATE:
REASON FOR REFUND: 2840 Sibley Memnrial Hwy
114111/7-23-99
Over payment P.I.D./LEGAL:
VALUATION:
PERMIT #: Lt 012 BI 1 Joseph A. Spande
S& W 36887
TYPE OF REFUND:
ElectricalPermit 3211-9001 $
Plumbing Persnit 3212-9001 $
Mechanical Permit 3213-9001 $
Building Permit Fee 3210-9001 $
Plan Review Fee 3422-9001 $
SAC (MC/WS) 2275-9220 $
SAC (City) 3866-9379 $
SAC (Admin) 3446-9001 $
Water Connection 3865-9220 $
SewerPermit 3743-9220 $
Water Permit 3713-9220 $
Account Deposit 2252-9220 $
Water Meter 3716-9220 $
Water Treatment 3868-9220 $
Surchazge 2155-9001 $
Utility Acet Overpayment 2250-9220 $
Curb Box Deposit Refund 2253-9220 $
Construction Meter Dep Refund 2254-9220 $
Water Usage Chazge 3711-9220 $
Other 2250-9001 $ 50.00
TOTAL $ 50.00
I declare under the penalties of law that this aceount, claim, or demand is just and that no part of it has been paid
c
SIGNATIIRE
?1A X DAT, ?v' ? 1
4b:
TO: F1LE
FROM:
DATE:
MEMO
city of eagan
WILLIAM ADAMS, COMBINATION BUILDING INSPECTOR
dULY 23, 1999
SUBJECT: 2840 SIBLEY MEMORIAL HIGHWAY
-I?OT"UT2; BLOCK-I,-JOSEPH A SPANDE
?_-_ -
On July 20, 1999 I made an inspection of the site. Wenzel Mechanical was installing the sewer and
water. The connection was on Highview Avenue. Jerry, Wenzel Mechacucal, told me they dug on
the south side of the house looking far the septic tank. There was no Yank - just 55 feet of pipe into
the ravine.
Combination Building Inspector
WA/js
cc: Dale Schoeppner, Assistant Building Official
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S712EET-N0: 2840
STREET-NAME; SIBLEIC HEMORIAL HWY
ZIP-CODE: 55121
NUMBER-OF-UNITS: 1
PERIOD-CODE; 1
SERVICE-NAME: OFF
CIASING-DATE: 10-04-93 '
A[ETER-N!]MBBR: 44622421 .
METER-SERVICE-DATS: 03-27-91-
HETER-SI2E-CODE: 1
AVG-MONTHLY-CONS: 6
PREVIOUS-WTR-CONS-1: 1
PREVIOUS-WTR-CONS-2: 20
PREVIOUS-WTFt-CONS-3: 11
PREVIOUS-WTR-CONS-4: 35
IAST-NETER-READING: 114.
IAST-M1'R-RDG-DATE: 10-2$-93
SEWAGE-CODE:
SWG-CHG-WTR-COI15'-?J- -'
PREVIOUS-CNANGE-DATE: 11-03-93
GTR-TAX-OVRD: N
USER-IND-2: C
DET-END-LIT:
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41
1
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?,
City of Eagan
3830 PILOT KNOB RD
EAGAN, MN 55122
(651) 675-5675
Site Address:
Lor. z slock:
PID: 10-49800-020-01
Use:
1556 Highview Ave
1 Addition: Nader
Permit Type: Building
Permit Number: EA065628
Date Issued: 08/02/2004
Description:
5ub Type: Single Fam
WorkType: Demolish Building
Description:
Census Code: 645
Occupancy:
Construction Type:
Zoning:
Squaze Feet:
Remarks' Call for final inspection.
? Separate peRnit required for Ciry Sewer and Water disconnect. (ld)
Fee Summary:
BL - Base Fee 75.00 0801.4085. Surcharge - Fixed
0.50 9001.2195
Total Fees: $75.50
Contractor:
St. Lic_:
NADER NOORYSHOKRY
1550 HIGHVIEW AVE
- Applicant -
EAGAN, MN 551211108 612-916-2193
I hereby acknowledge that I have read this application and state that the information is conect and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
ApplicanUPermitee: Signature
issued By: Signature
I 0? 18?04
?--
?
xe--?
v?
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWCtion Reoulremenis RemodellReoair Reauirements Offce Use Oniv
3 registered sile surveys shovring sq. ft. of lot, sq, ft of hause; and all roofed a2as 2 copies of plan Cert of Survey Reed _ Y_ N
(20%maximum lot coverege allowed) 1 set of Energy Calculalions for heated add'Aions Tree Pres Plan Recd _ Y_ N,
2 copies of plan showing beam 6 window saes; poured found desgn, etc. 1 site survey for additbns & decks Tree Pres Required _ Y_ N
1 set of Eneyy Calculations Atldttion -indkate 'rf ons8e sep6c system On-site Septic System _ Y_ N
3 copies of Tree Preservalion Plan'rf lot platted after7/1193
Rim Joist Detail Oplions seledion sheet (bldgs wiM 3 or less units
Date P, / 2- / Construction Cost
SiteAddress Unit/Ste li
h K 2
Description of Work DelYiO1110U5 <
Multi-Family Bldg _ Y_L/N Fireplace(s) ? 0 _ 1 _ 2
Property Owner NR d?y ? C? v y 5? o?r y Telephone k((vf 2)'?16 -2/ % 3
Contractor m4d_? ? f?SSOC.,
Address I 550 ai ? ?' l2-11 City ff-4qa1
State A4 A/ Zip 55124 Telephone#(9S2) ??31-SOS
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan?
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Y_ N If so, 25% plan review
Telephone
Telephone
Telephone D ??
AUG p 2
I hereby apply for a Residential Building Permit and acknowledge that the info tion is complete an accurate;
that the work will be in conformance with the ordinances and codes of the Ci te of MN
Statutes; 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.
N?d..., NC? s11o?
Applicant's Printed Name
; .?
A plicanYs Sig ure
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garege ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-piex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Yor_ nl ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building" ? 43 Reroof ? 46 WindowslDoors
0 34 Replacement 'Demolition (Entire 81dg) • Give PCA handoutto applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FiaallC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings(addition) _ Plumbing
Foundarion HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final
_ Framing _ Siding _ Stucco _ Stone _ Brick
_ Fireplace _ RI. _ Air Tes[ _ Final _ Windows
_ Insulation _ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Permit # (o?$ (,- Receipt Date:
? ., Y '1 30 3- (
?,N_!
CITY OF EAGAN 6' ?-
2004 SEWERIWATER REPAIR OR DISCONNECT PERMIT
Date
Address/azea to be repaired
Description
Owner:
Street Address:
Zip Code:
p?? ? ? ? dT
?
? AUG 0 4 2004
Installer: Ac PrL-0- p(.0w kk-c Telephone: P7 '
(area code)
tl/ Address:
City
Zip Code: -T--sa
?
Applicant's 'nted Name Applicant' gnature
Sewer X
5 S?
c.-e .
Fee: $50.50
Water '><,?
Telephone.
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 1 01 I ? I D L?
Site Street Address S f L ? U, p-0 % Unit #
Property Owner Ava JO POd 0 r 5 ?? o l? fl Telephone # ( )
Contractor ntµ{L ofk?.b<<..^ .??C- Telephone# (Da)
Address ?? a°o r' ?^^ u < City ?a IZ 6/f State °"^ Zip ST74 i
The Applicant is: _ Owner ? Contractor _Other
Alterations to existing dwelling $ 50.00
_Add plumbing fixtures.
Jf you are only installing a water softener and/or water heater, the fee is $15.00 plus the
state surcharge - see next section.
_Septic System Abandonment
_Water Turnaround (add $121.00 if a 5/8" meter is required)
Dther:
Water Softener Water Heater $ 15.00
_ replacement _ additional
Lawn Irrigation System _RP2 _PVB _new _repair _rehuild $ 30.00
State Surcharge $ 50
Total $
I hereby apply for a Residential Piumbing 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.
?c(e ?K??-L 12 ?
ApplicanYs Printed Name Appli, canYs Signature
Certificate of
House Location for:
Nader Nooryshokry
767.5
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" DELMAR H. S:CHWANZ
LAND SURVEYORS, INC.
14555 SOUTH ROBERT TRAIL ROSEMOUNT, MIfdNE50TA 55068 65 d23-1769'04098
lot File - H04098
SLIRVEYOR'S CERTIFICATE
HIGHVIEW AVEZ.
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Property Description:
Lot 2, Block 1, NADAR ADDITION, according to the
recorded plat thereof, Dakote County, Minnesota.
Also sliowing the location of a propsed house staked thereon
I hereby certify that lhis survey, plan, or reporl was prepared by me
or undar my direct suparvision and thai l em a duly ReQislered Lend
Burveyor under lhe lews of lhe Btate oT Mlnnesota.
Dated im - .
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? SCHWANZ •
Minneaota Llcense No. 8625
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Certificate of
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DELMAR H. SCHINEFNZ
?- --4ANBfPURVEY-QRS,4fdE. -
/14555 SOUTH ROBERT TRAIL ROSEMOUM', MINNESOTA 55088 661_12317404098
? -Plot File - H04098
House Locati6R" t0I`: URVEI"OR'SGERi1FICATE 1 0
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LOT AREA = 20,638 5a. FT.
HOUSE & GARAGE AREA =
2,764 SO.FT.
COVERAGE = 13.3%
SEWER IN4EflT PER CITY P
= 75? 7
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? Property Description:
p? Lot 2, Block 1. NADAR ADDITION, according to the
recorded plat thereof, Dakota County, Minnesota.
Also shbwing the location of a propsed house staked thereon.
I hereby cerlity lhat thie survey, plan, or reporf was prepared by me
or under my direct supanisfon end ihat I am e duly Regiatered Lend
Surveyor under the lews of the Sta1e of Mlnneaote.
Dated IrZE-y/SEl) /d
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MinneaMe License No. 8625