2850 Highview TerCITY OF EAGAN Remarks
Addition Valley View Plat 1 Lot 6 sik 2 Parcel 10 81400 060 02
Owner !-," ' ' ! i.l ,", Street 9$50 H,ighvi aor TPrrarP State EaQan; MN 55121
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR. avin 1962 735. ?? $73.50 10
GRADING
SAN SEW TRUNK 410 1968 $100.00 $3.33 30 PAID
ie SEWER LATERAL 1970 LO
WATERMAIN
*-I ATERLATERAL 1970 $2510.00 $125.50 20
?k WATER AREA 1970 ZO
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
HUILDING PER.
SAC $200.00 1062 1 - -
PARK
INSPECTI4N RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Ea an, Minnesota 55122-1897
9 Date Issued:
(612) 681-4675
SITE ADDRESS: ' ?l 0" `' APPUCANT:
t??i f, t;t?arl
11 ,, 1 ,,;ri
,
? t.rY vxFw I>talf aii 346-8000
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION DA . .A
1 1? i'; I:t?l1? !?il( ! r' , i uj• fq 17AMAwi1
?
r-L J
PermR Hoider Date Telephone A
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING iAk
ROUGH
PLUM8ING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
-
EAGAN TOWNSHI P 322
BUIL.DINC; PERbrllT
Ownex .._?tSC.?.,l..?..X.......?? F67 ........._ . Eagan Township
Address (pxesenLi) J---- T owa Hall
..--------- ------------- ------- __' ?
Builder ------`C'"??--'-"'--`4'"?' .
Addreas Dale?.^..L?--?-.J? ..............
-----....---'---"------...------------°----'-- ------------- --------------------------
5Yories To Be Used For Fran1 Depih HeighY Es1. Cosi
? PesmiS Fee %emarks
??.
' LOCATION ' If
or
':? U u
This permit dgdy 6oi au3horise the uee of sYxeets, aoads, a3leys or sidewalks nar does if give the owner or his ageni
the sigh! !o er e e any sifuation which is a nuisaace or which presenfs a hazard !0 the healih, safefy, conveniance and
general weltare fo anyoxe in the communiiy.
THIS PERMIT MUST BE _ PT ON PA,PISE WHILE THE WOIiK IS IN PAOGR 4?.
This is !o eerlifp. YhaY----y ._r....c.._._ ?? _?L?...__.'.has permission Yo erect a.-...- ....__"._._ ..._ ----------------------- upon
'
the abover'?es? r o x e provisions of the Building Ordinance for Ea3an Tow ?p adopEed 4pri1 11,
4?5?.:-1-..,..dY-'Y ---- - - ---`------- Per ---------------------------------------- --------- ----------------------------------------------- ..
Chairman of oard Building Inspec2or
66X?
2004 RESIDENTIAL MECHANICAL PE1iMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please comple[e for: single family dwellings & townhomes/condos when permits are required for each unit
:50 - sa
? / ?
I)
t / ??'L'
a
e
Site Address lWO V Unit #
Pra
ert
O
? Csz
- 36V1
U Q-,Q
,
-? 000co D?
T
l
h
# (LOJ, ) l
p
y
wner -
?
J C
< -
e
ep
one
Contractor r
O'Connor -?
'
Plumbing, Heating eL Cooling
Street Address I
1904 Vermillion S4. ? City
State I HfsSngs, NN 55033 Telephone # (rQ c? -71
? - -- - - ?
Bond Expires:
The Applicant is _ Owner ? Contractor _ Other
Add-un or alteration to existing dweiling unit $ 30.00
? furnace _Additional LReplacement
air exchanger
air conditioner _New _Replacement
other
50
$
S[ate Surcharge
? ?
.
SEP 0 8 2004
3? • 50
Total ?
B
I hereby apply for a Residential Mechanical Pernvt 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 [he Mechanical Codes; that I understand this is not a
pemut, but only an applicarion 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 wMch requices a review and appLOVaI of plans. _ I
Applica ' Printed Name Appl eent Signature
2004 COMMERCIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: commercial/indushial buildings
multi-family buildings when separate permits 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 #: Eapires:
The Applicant is _ Owner _ Contractor _ Other
R'ork Type
_ New Construction _ Underground Tank _ Install _Remove "see below
_ Interior Improvement _ Install Piping _ Processed _Gas
Nature of Work:
'*When instalfing/removing underground tank, call for inspectiorr by Fire Marshal and Plumbing Inspecfor
Pet'01It FCCS: $7050 Undergcund tank installation/mmoval
$5050 Minimum (includes State Surcharge)
or
Contract Value $ x I% PerntitFee
• IFpemut fee is $1,000 or less, add $.50 ? $ State Surcharge
If DCLRIlt fee is over $1,000, add $.50 for
every $1,000 uernut fee $ Total Fee
I hereby apply for a Commercial Mechanical Pernut and acknowledge that the information is complete and accurate; [hat the work
will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand tlus is
not a permit, but only an applicarion for a pemilt, and work is not to start witbout a permit; that the work will be in acwrdance with
the approved plan in the case of work which requires a review and approval of plans.
Applicant's Printed Name
Applicant's Signature
Approved By: Inspector
RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan NIN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
3?,75
New Constmction Reauiremenls RemodeUReoair Reauirements Office Use Onlv
3 registered site surveys showing sq. N. of lot, sq. R. of house; and all roofed areas 2 copies of plan Cert of Survey ReaJ _ Y _ N
(20% mazimum lot coverage allowed) 7 set of Energy Calculations tor heated addNons Tree Pres Plan Recd _ Y _ N
2 copies of plan showing beam & window sizes; poured (ound design, etc. 1 site survey for additions & decks Tree Pres Reqd _ Y _ N
1 set of Eneigy Calculations Addifion - indicate if wrsde sep6c system Onsite Septic System _ Y _ N
3 apies o( Tree Preservalbn Plan if lol platted a8er 7l1/93
Rim Joist Detail Options selection sheet (bldgs wilh 3 or less unifs
Date 10 / 0 7 / 0 J Canstruction Cost
Site Address Zx S(? t, n
wC,?1/ 1 F liJ
MI'L UniUSte #
Description of Work e L)?- `1J ! MIo WS' 6- ;16
Multi-Family Bldg _ Y N? Fireplace(s) _ D _ 1 _ 2
Property Owner j3r1A C-e J o h h S J'/l Telephone #( 651 ?'OG 2
-
4 LLC
Contractor cZQ t t
a,C,
I Yl ,
Address c 23 W ,a 4ccS t S?. City fm( v)n
State f?l. IV Zip 5 0 Telephone #( 6 1 2) 377- (`1 q ?
COMPLETE TIi1S AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submissiontype) Submittad Submitted
• Energy Envelope Calwlations Submitted
Have you previously constructed a building in Eagan with a similar plan2 _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Telephone # (
Mechanical Contractor
Sewer)Water Contractor
Telephone #(
Telephone #(
I hereby apply for a Residential Building 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 State of MN
Statutes; I understand this is not a permit, but only an application far 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.
?- ?l ILCG?C `l?C./G?•?,?
Applicant's Printed Name ApplicanYs Signature
OFFICE USE ONLY
Sub Types
? Ot Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 76 Fireptace ? 21 Porch (3-sea.) ? 39 Ext. Alt - Multi
? 03 01 of _ plex O 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Eut. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bidg)' ? 43 Reroof ? 46 Windows/DOOrs
? 34 Replacement *Demolftion (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bidgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addirion) _ Plumbing
_ Foundarion HVAC
_ Drain Tile Other
Roof _ Ice & Watei _ F inal Pool
Air/Gas Tests
Ftgs Final
_ Framing _ _
_
Siding 5tucco Stone _
_ Fireplace _ R.I. _ Au Test _
Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
ToWI
Building Inspector
FERMIT
CITY OF EAGAN
3830 Filot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMITTYPE: ??ILnING
Permit Number: 0 3 2 8 8 9
Date Issued: 08 / 12 / 98
SITE ADDRESS:
2850 HIGHVIEW TER
LOT: 6 6LOCK: 2
VALLEY VIEW PLATERU
P.I.N.: 10-81400-060-02
DESCRIPTION:
T.O. & aeROOF
ermit 7ype 5TORM DAMAGE
q,rk Type REPAIR
'?"?''"434 flLT. RESIDENTIAL
?
J°!, ..nw?.
re?=°-=i: ?`ts
z a
I' dP
00
a ?a
ereMg m
REMARKS:
TEARQFF & REROOF [lUE TO STQRM DflMAGE.
E ?
siawwp??
4.° c.l ?tFE 4IY ??„/IGt ??5.?-. mI! 8+4
?acr
FEE SUMMARY:
CONTRACTOR: - Applicant - sr. LIC. OWNER:
TOP GUN 13468000 20128211 SCHMSDT BRIAN
10736 NORMANDflLE BLV[7 2850 MIGHVIEW TER
BLOOMINGTON MN 55437 EAGAN MN 55121
(612) 946-8000 (651)
I ," " T t??rmk?y aekn;flwl?d?? a?h:
crect
? =` ?ta?utese ?"r?ct ?i.t?<°c#`?, Ea
? . . _ e =?. e. .. -
APPLICANT/PERMITEE SIGNATURE
inances. -'.
? ISSUED BV: SIGN URE'
,
.?,?
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
; CITY OF EAGAN
3830 PII.OT KNOB RD - 55122
`j 681-4675
?-(I-
New Construction Reauirements RemodeVReoair Reauirements
? 3 registered site surveys ? 2 copias of plan
• 2 copies of plans (inGutle beam & window s¢es; poureA fnd. design; etc.) ? 2 site surveys (exterior add'Riona & decks)
? 1 energy calwladons ? 1 energy calculations tor heated adddions
? 3 copies of tree preservation plan H lot plaCetl after 711/93
required: _ Yes _ No
DATE: S? I /D f qs CONSTRUCTION COST; yS00, °b
DESCRI ION OF WORK:
STREETADDRESS: 'ZS5U N- ultA) `PAn('l."
LC T: ? C!_JCX a ?_?an.?o.!.r?. #: V wvuWs V.J_A lJ'-
- -?-
Name: SY-? 1 ?1/? t?" ?.'l (Ctr?..? phone
PROPERTY 1.ast First
OWNER ' -
Street Address: 2g50 ??-Py1'tU( ? ,J ?-k11/1 .
City U State: rvk V-) Zip: ?..7 ? 4 2?
? a-?sQ ?5? l
Company: T-op -61 U N Phone #:
CONTRACTOR " .?,?,? ???,?? ?py?I
Street Address: ? 4 o? 3n(?lZ/Wli%L-G31.CA!0 L? cen?tt Z? 1 GO G-f /
City ?.}xCSTI?Vl ?ns,?-' v-` state: ??1_, zip: X-5 73 7
ARCHITECT/
EIVGINEER Company:
hiamn•
Phone #:
_ Re¢isretinn #: __ _
Street Address:
City
Sewer & water licensed plumber (new construction only):
and lot change is requested once permit is issued.
Stare: Zip:
Penalty applies when address chang
1 hereby acknowledge that.l have read this application and sTate that the infortnation is correct and agree to comoly with all applicabl
State of MinnesoW Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
CerGficates of Survey Received _ Yes _ No
Tree Preservation Plan Received Yes No
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Dupiex
? 02 SF Dwelling ? 07 4-plex
O 03 SF Addition ? 08 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. ? 10 _ plex
WORK 7YPE
? 31 New ? 33 Alterations
LJ u Hduliiufl G 34 Ftepair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
O 11 Apt./Lodging ?
? 12 Nlulti Repair/Rem. ?
? 13 Garage/Accessory ?
? 14 Fireplace O
? 15 Deck
? 36 Move
? 37 Uemalition
...
16 Basement Finish
17 .Swim Pool
20 Public Facility
21 Miscellaneous
Basement sq, ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SNV Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ued.
Other
Copies
Total:
- ? --
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
_ Engineering Variance
Valuation: $
% SAC
SAC Units
1 .?
Ei:k$i1X%;?t:;C$.$:'M??;:?F;n:?:? %?Y•?•?:?`?9f.:??96?,;?.? .agrW.?: n<;I,::i:80kUt:':i!: tOX
t:':[ TY or- i.-Ar:;Ara
casH::r:F:.. ;.; rr,:R:?IN.r.;i_ NO„ W:s
rArEg Wr_aW% 7i:MEi 0:5102
iB _
:NAii!:::r (InAi..LA7:C i::?.t:6?VA1ItJi; ,"•:Rf.;
370 9220 2850 I'!].;:;!-I'J:f.F:i'I Y 50.00
05= 9601 2850 H7:f:':-E'J1.L".!4 "C f:i ..°i(1
To.t::nl. Rr.,r.'rr.,ip41 A1:li:]U71'Ito `ii.).`iU
CRCI65358
Uc;ii:St I1:1E NFl.f.!f:Y
LOT -L- BLOCK SUBD. 1l J! ,11,1A? 7' ?AnDIXID
RECEIPT #
z?9.?3
CITY OF EAGAN
SEWERNVATER REPAIR PERMIT
1996
Date:
_ Sewer X Water Fee: $50.50
Description:
Area/address to be repaired: -12,?
Installer: ?/?/- /--P?%/ 2`-X- c?=-
Street address: /_,, 5l -f- '-??0 27?x -??; 7 - AJ c) -
City, state & zip:
?
Telephone #: -7 -7 -7 S' K
Owner name:
Street address:
City, state & zip:
Phone #: ?7
-
?. Signa ure of Permittee'
,J ,e _ L3`A
E.SGEiN TOtdNSHIP
3795 P3iot Knob P.oad
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SF3r7ER SERVICE COIVNECTION
DATE: ir'Cj. ad ATUMMASR ? fd .
y(' -a V L). ?
OWNER:ag),W, C'K-rt 6 Address : ? ?/ ? .-f l.LGt.r? /!??-c.-?--?
TyPE OF PIP
PLUMBER ` /,??,A'yj,t?(?
? E
DESCRIPTION OF $UILDING
Industriall Commerciall Residentfal I Multiple Dweiliag I No, of units
Location of Connections;
Connection Charge 6?r!`
Permit Fee J/71T
Straet Repairs
ToCal
Inspected by:
pate
Remarka:
sy
Gtiief Inspector
Ia consideratioa of the fssue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulatioas of Hagan Towmship, Dakota Cocuity, Minnesoia
By. 1GlE,^I7E1 12i? p6 A kaTB W6
,'?^? S's? t.1; ?u€ € fZ6^B
si ?ALIJ ? MlNN 56i}}
Pleeae notify when readq for iaspection aud conuection and before any portion
of the work is covered.
RESIDENTIAL BUILDING
<( =-: Permit Application
City Of Eagan
3830 Pilot I{nob Road, Eagan Mn 55122
?C) Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWCtion Reouiremenfs RemodeliReoairReouirements Office Vse Onlv
3 registe2d site surveys shovriig sq. R. of lot, sq. R. of house; and all roofed areas 2 copies of plan Cert of Survey Recd
(20% mazimum lot coverage allowed) 1 setof Eneryy CalcuWlions (orheated additlons Tree Pres Plan Recd
2 copies of plan showing beam & window sizes; poured found design, efc. 1 site survey for additions & decks Tree Pres Not Reqd
iseto(EnergyCalculations Addftion - 'uMicafeifon-sitesepfksystem _ On-siteSep6c5ysfem
3 copies of Tree Preservation Plan d lot pWtted atter 7l1193
Rim Joist Detail Options selection sheet (bldgs wim 3 or less units
Datet7 / v'?""7 / 03
Coostruction Cost ? ?o `? ?
Site Address ?/
? 2? S0tll?g ?1 -e ''i Unit/Ste #
?
Description of Work
Multi-Family Bldg _ Yl X NJ Fireplace(s) _ 0p_ 2
Property Owner ?J ('LU'-e-, °f' &z c?4b Telephone # ( CSl) (o ?6- 90 62.
(Z'e L+? L 1'C
Contractor
Address 3 Z-?) City
State Zip Telephone # ( 6t3-77-
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Cateeorv 1
• Residential Ventllatlon Category 1 Worksheet
(Jsubmissiontype) Submitted
• Energy Envelope Calculations Submitted ?
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
A NEW BUILDING
Minnesota Rules 7672
. New Energy Code Worksheet
SubmiKed
Telephone # (
Telephone #(
Telephone # (
I hereby apply for a Residential Building Permit and aclrnowledge 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 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
permit; that the work will be in accordance with the approved plan in the case of woj??ich requires a review and
approval of plans.
?? V?z e_cd1e-7
ApplicanYs Printed Nam
OFFICE USE ONLY
Sub Types a
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Btdg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex O 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 EM. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? DS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Yar_ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Oemolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement P 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addirion) Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AirlGas Tests _ Final .
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new!ceplacement)
_ Insulation _ ReWining Wall
Approved By
Base Fee
Surcharge
Plan Review -
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
OPERATIONS 8 REGUTATORY SERVICES
INSPECTIONS DIVISION
250 South 4th Street - Room 300
r;1?J0/jS Minneapolis, MN 554157316
6 0/ lal rs General Inkrmation - 612-673-5800
TTY - 612-673-3300 FAX - (612) 370-1416
71
APPLICATIQN
BUILDING/STREET USE
JOB ADDRESS (PLEASE INCLU E BLDG #, STREET NAME & DIRECTION & BLOG NAME IF KNOWN):
Zw JrO ?Vtew 7errc?'-e.? T- ar/vl, SSizl
OWNERlOCCUPANT & PHONE NO: -
Qr,,,x, J-ok h s o h 0-59 686- gOG?
TXPfi OF WORK TO BE DONE. G6?NSTQ INSTALL 0. REPLACE ? ALTER ?..EPAIR MV? WEOfWORK: $
.--?
? G(Y Or ' lf M N,
..»«.....,....., ....................«.«,..».,..,..,........«...,..,.........,.............«...................„......-..«»..»................»..,,.,....,,.......,...,.,.».
FOR STREET USE PERMIT, DUMPSTER MUST BE PLACED AT THE CURB USING NOT MORE THAN 50 FEET OF CURB SPACE
FOR DEPARTMENT USE ONLY
PW TR4FFIC ENGINEER APPROVAL CONTACTED BY DATE
I hereby certiry that all information provided in this application form and any other information provided 6y me in support of t his application is true and
accurate to the best of my knowledge. I certify that I will comply with all applicable state and local laws and regulations in performing the work for which this
permit is issued, and that I possess all contractor and personal licenses and certficates of competency, if that ar? required for lawFul performance of the
work described in this permit. I understand that the issuance of this pertnit does not impty or authorize e? gre ting of?any such license or certificate of
competency, nor the issuance of any business or professional license. /---? n ? 1-? ,,`
l
HOMEOWNER APPLICANTS ONLY: I hereby certify that I own and am now living at the dwelling for which thA.Rgrrtt`d is being issued, and that the work is
being perfarmed by me or a member of my immediate famlty. I understand [hat, for tha purposes of this application, my immediate family is limited to my
parent, child or child's spouse. INITIAL HERE ESTIMATED VALUE OF MATERIALS $
COMPANYNAME:
`Ze`
V
?J,,, r (h . LLG
Lio v?
VLi
CONTRACTORLICEN5E#?C `JZ ? 40 I ?
O !
COMPANY ADDRESS: 3 2 J W- COMPANY PHONE #:(4 ? Z ?j 7 7 - 174 U
CITY: , STATE:AA k' ZIP CODE:SJ't U( CONTACT PERSON & PHONE #: ?!}r.9-? -°
MAKE CHECKS PAYABLE TO: MINNEAPOLIS FINANCE DEPT
!
OR CHARGE TO: MASCARD ?_ ACCT NO. .?7 ! 5 T 711 y3 i 3 0 ? l EXP DATE O`1"
?.XD r e5 S
t
?? .
:?. • ?
Value of Work Fgg
Minimum Fee-ftesidental or Commercial $35.00
$1.00 - $500.00 $21.00
$501.00 - $2,000.00 $21.00 - first $500 plus $2.75 per $100 and
fraction thereof including $2,000
$2001.00 - $25,000.00 $62.25 - first $2000 plus $12.50 per $1000
and fraction thereof including $25,000
$25,001.00 - $50,000.00 $349.75 - first $25,000 plus $9.00 per $1000
and fraction thereof inciuding $50,000
$50,001.00 - $100,000.00 $574.75 - first $50,000 plus $6.25 per $1000
and fraction thereof including $100,000
$100,001.00 - $500,000.00 $887.25 - first $100,000 plus $5 per $1,000
and fraction thereof including $500,000
$500,001.00 - $1,000,000.00 $2,887.25 -first $500,000 plus $4.25 per
$1000 and fraction thereof incl. $1,000,000
$1,000,001 and up $5,012.25 - first $1,000,000 plus $2.75 per
$1,000 and fraction thereof
An additional 65% of the permit fee is added for the Plan Review fee
Also, take the value of the work x.0005 to obtain the State of MN
surcharge fee,
Minneaaolis Street Use
Fee Schedule
(DUMPSTERS ONLY)
TYPE OF BUILDING FEE
Single Family or Duplex $14.50
All Other Residential & CommerciaL - First 50 ft $43.00
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PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA145526
Date Issued:09/13/2017
Permit Category:ePermit
Site Address: 2850 Highview Ter
Lot:6 Block: 2 Addition: Valley View Plateau
PID:10-81400-02-060
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Bruce S Johnson
2850 Highview Ter
Eagan MN 55121
Bonfe's Plumbing & Heating
505 Randolph Ave
St Paul MN 55102
(651) 228-9071
Applicant/Permitee: Signature Issued By: Signature
DEPARTMENT OF SAFETY AND INSPECTIONS
Ricardo X.Cervantes,Director
CITY OF SAINT PAUL 375 Jackson Street,Suite 220 Telephone: 651-266-8989
Christopher B.Coleman,Mayor St Paul,Minnesota 55101-1806 Facsimile: 651-266-9124
04t Web: www.stpaul.aovldsi
111111101
FUEL BURNING EQUIPMENT TEST RECORD
110 2 6 (Use separate form for each appliance)
ADDRESS:2850 HIGHVIEW TERRACE EAGAN,MN
OWNER:Bruce Johnson DATE:Sep 8,2017
Type of Heat:
❑Gravity Air Forced Air ❑Gravity Hot Water ❑Forced Hot Water
❑Steam ❑Unit Heater ❑Space Heater ❑Other:
Type of Fuel: O Gas ❑Oil ❑Other:
Gas Design Conversion
Make of Burner: Serial:
Model: Model:
Serial: Max BTU Rating:
Input: Make of Furnace:Amana
Equipment Venting Type: ❑Atmospheric O Induced Fan ❑Other:
Total BTU input of all vented gas appliances per chimney: 40,000
Type of Chimney: ❑Masonry Class B ❑Other:
Type of Liner: ❑None El Metal ❑Clay Tile
Vent Connector or Exhaust Material: ❑Type-C Type-B ❑Plastic
Combustion Air Supply Required? 0 Yes ❑No Installed? O Yes ❑No
Safety&Operating Control Tests: Yes No Fuel Analysis/Flue Gas Analysis: Yes No
Pilot/Flame Safeguard Operating Properly ✓ Vents properly without spillage ✓
Limit(s)Operating Properly ✓ Flame stays inside/Doesn't roll out ✓
Operator(s)Operating Properly ✓ Burner lights smoothly ✓
Low Water Cut-off Operating Properly ✓
All Controls Operating Properly ✓
Combustion Analysis Visual Inspection Yes No
Stack Temperature 124 °F/Net Fuel Piping System-Okay? ✓
Oxygen 8.7 % Vent Systems:Drafthood, ✓
Carbon Dioxide 7.5 % Connector,Vent Chimney-Okay? ✓ •
Carbon Monoxide 15 PPM Heating Unit-Okay? ✓
Look At The Total Heating System Before You Leave: Yes No
Does the system operate safely and properly? ✓
COMMENTS:
Name of Licensed Contractor:Bonfe Address:2850 HIGHVIEW TERRACE Phone:
EAGAN,MN
Person Doing the Test(Print):Joe Signature:
City of Saint Paul Certificate of Competency Number: