1921 Jade Lane? --- -? CITY OF EAGAN ?? Include 2 sets of plans,
' 1 site plan w/el.evations &
p BUILDING PERMIT APPLICATION 1 set of energy calculationse
7.b Be Used Eor valuation`o, `l, n b 6 Date .?l,t/e ?2?,?
Site AdrdLress: OFFI(E USE OI?Y
Lot T Block Sec./5ub. hA 4pp1F ?xu'?'"rect OccuAancY .3
Parcel #: 10 1(-10 0 CqO ?? Alter Zoning
Repair Fire Zone ?
_ e of Const.
Oaner: ?'lt.? ?arge ?
r Move # Stories
Address: jl?Ie' De.ttblish Front J? ft.
City/Zip Cocle: Grade Depth )? ft,
Phone #: T.Sy APPROVALS FEES
Contsactor: ?.e s.•.,, /j
Address:
City/Zip Code:
Phone #:
P,rch./Ehg. :
Address:
City/Zip Code:
Phoxe #:
Assessments
Water/Sevrer
Police
Fire
En4 -
Planner Water Meter
Council Unit
Bldg. Off.
APC
TOTAL / //
??-`?'(k??'? - T -117?
?"'b, '-') V1Er' - 1s-23-92
Permi.t
Surcharge y
Plan Check
SAC
Water Conn.
?p i/loa cyG o/
TOWN OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
PERMIT IdO. tf;Q
The Board of Supervisors hereby grants to SunHucnu ntimtaruc rn_
of
e vt.ttRihtC Permit for: (Owner) SALLY COMPANY
at _jq?l nnd ISL7 .Tndw i_nnoi, 6aesn 55122 , pursuant to applicaCion dated
9/16171
Fee Paid: 40_00 Dated this 17th day of September , 197 1,
1,00 s/c
Building Inspector
/ J/ J' A ?
TOWN OF EAGART
3795 Pilot Knob Road
Eagan, Minnesota 55122
PERMIT N0. 139
The Board of Supervisors hereby grants to Aay N. Wilter Heating Co.
of 4637 Chi.cag_o Avenue So;. Mitmeapolist Minn. 55407
a HEATING Permit for: (Owner) Sally Company
at 1921 Jsde Lene. Eagan 55122 , pursuant to application dated
August 19, 1971
Fee Paid: $20.00 Dated th3s 20th day of August ? 197 1.
.50 s c
Building Inspector
EAGAN TOWNSHIP
BUILDING PERMIT
own.: ..... ............. . ; ---- - ------------ -
Addsess (PSeseni) .............. a-...... ::.'....:"-"".._....-----".....
""--'--------'
Huildar
Addrau
DESCRIPTiaN
11T° 2495
Eagan Township
Town Hall
Dale .._-.....................
Blosiea To He Usad Fos Froe! Daplh Hatghi Eel. Cos! ' Parmi! Fea Aamarke
A-3, a,-d iv
n:ree:, noea or o:ner yeaeripxion ox Loeaxion I LOi nIocs AQ61fiOn ot zraet
This permil does ttot aulhorise the use of siseels, zoade, alleya or sidewalks aor does St give the ovrne: os hSa agea!
the iight fo ereate anp sifuaiion which is a nuisanee or whieh presenls e hazard fo the healih, safetq, conveaience aad
ganesal welfare to anyona in the eommunify.
THIS PERMIT MUST SE KE T ON THE PREMISE WHILE THE WOAK IS IN P AOGAESS.
T6is is !a cerfify, lhat......... ....-_.---... ..... .?.?...----------- ............._--has permisaion !o eree! a....,lt:..: ..... <'e-f :?.---_ . upon
?
the above described premise eubjea !o the provisioaa o! the Building Ordinanee for Eag
Towashippled AprSl 11.
........................ '-----.......... . ...:.: Per ._.--.............--'-'-- --...........5?.!..`::-:=-".5`.-;?.....--•--....
Chai an ot T?dh Board Suildinp Impecior ..?g
CITY OF EAGAN
9795 Pikt Kne6 Rood Eagan, MN 5512= NO 7370
PNONE: 434-8100 -
. BUILDING PERMIT Receipt g
Te 6e wad hri'1MZLY ROOM ADD. Est Value $9•000 Date `7une 25 19 82
Site Addreu 1921 Jdde IdnE E
t O R-3
rec
(R ccuponcy
Lot 4 Biock 1 Sec/Sub. Ken App18b8uG1 Add. Alter ? Zoning R-1
porcel # 10 11700 040 Ol Repoir ? Fire Zone NA
V
Enlorge ? Type of Const.
c Nome T110R183 176IDb1EY Move ? # Stories
? Addrea 1921 Jade Lane
Oemolish p
Length. 16
Ct 5 phone 45 4-7050 Grode ? Depth 14 Sq. Ft._
?p Name Teriw SViesenberae r AVOrerals Faes
Z
V?u
f
Nome _
Addreu
1 hereby acknowledge that I hove reod this opplication and state that
fhe inlormotion is mrrect und a9ree to comply with oll appliCOble
State of Minnewto Stotutes ond City of Eagan Ordinonces.
Signature of Pertnittee
A Building Permif Is issued to: TeT
11 work shotl be done in oscordance with all
'dirig Official
Azsessment _
Woter 8 Sew.
Police _
Fire
Eng.
Planner _
Council _
Bidg. Off. _
APC
Permit l4.ov
Surcfwrge 4.50
Plon check
SAC
Water Conn.
Woter Meter
Rood Unit
Totel $79•00
_ on the express condition th.n
City of Eagcn Ordinances.
CITY OF EAGAN
' 3795 iilet Knob Raod Eagan, MN 55122 N2 4402
PHONE: 454•8100
BUILDING PERMIT APPLICATION Receio+ # -?719---
Site Address
Lor U siook_ f Sec/Sub. 1Bb3tAri Add17
Parcel # _
a Name Z= T`r'?h1P}7 ?
w
; Address 1921 J213 _ Tanp
o
a Name W2atern (7cm-,t _ Cn
o? Addreu 6950 Wayzata Blvd.
u
t' Ciri-D%1J5 Phone 54(;-32R5
ww Neme
rw
_? Address
Erect X] Occupancy T
Alter ? Zoning Rl
Repair ? Fire Zone
Enlarge ? Type of Const.
Move ? .# Stories
Demolish ? Front ft.
6rade ? Depth ft.
Aoorovals Feea
Assessment -
Woter & Sew.
Police _
Fire
Eng.
Planner -
Council _
Permit 17.110U _
Surcharge 7 - O(1
Plan check
SAC
Woter Conn.
Water Meter
I hereby acknowledge that I have read this opplicotion and stote that gldg. Off. '
the information is correct and agree to comply with all opplicable qpC Totol ?_ nn
State of Minnesota Stotutes d City of Eagon Ordina?
Signature of Permittee z
A Building Permit is issued to: WQSb2Tn Cnngt (''O on the eupress condition that
oll work shall be done in occordance with all oppliv/Ple State o?fpJ? in?Tnesoto Stotutes and City of Eagan Ordinances.
Building Official -L ?!>.C?LC-c1->Li ?
i
4 REQUEST FOR ELECTRICAL INSPECTION „-w es- ooooi -oa
B See instrvctions for comple[ing this fonn on bnck of vellow cn ?'-? 1.7-? ?? . py. ?
X" 8elow Work Covered by This Aequest
NB Adtl Pep. Type of BuilAin9 AppliantBS Wiretl Equipmen[ Wiretl
Home Ranye Temporary Service
Duplex Water Heater Lightiny FixNres
Apt. BuilAing Dryer Electric Heatin
Commercial Bldg Furnace Silo Unloader
Industrial Bldy. Air Conditioner Bulk Milk Tanlc
Famt Other snecifv 0111orfspe1d00
t?er (SUCCify) Other Oth,,r
Compute lnspectinn Fee Belaw
A Fee Service (EnVancaSize d Fne Feetlers/SVbfeeders p Fee Circuits
6 to 1 UO qm )s 0 to 30 qm ps too 0 to 30 Am s
a' 701 to 200 qmps 31 to 100 qmps 31 to 100 Am s
Above 200 qmps A6ove 100_Amps Above 100_Amps
Transionners Remote COntrol Circ. `S6 Partial?'Other
Sic?ns Speciallnspection
$
Re:mnrks aZIIO TOTAL FE
d
Rough-in p te
i-tlma Elecvical
Inspactoq herebV
rtif
Final ca
y thet the nbova
Pecti hps been
t?? f
nis mquest vaitl / /C?/t ??%? ?i?L,e? )
8 niunths hom N --?
This request voiA ?/Z3
?18i7'17?05 ,
61 , kEh A-T?130l10g1
zZ•op
Rnque.gt Date Fire No. Nough-In InspecGOn.
Rep retl?
?FeaAy Now Nlill Nolify InsPer.-
A
?&VQ. v ?J.Yes ?No tor When ReadY
? Licensed Elecfrical Contractor I hereby request inspaction ot above
90v'ner . elecVical work installed at
Streot Address, Box or nute Nn. City
er.von o. Townshin Name or No. . Ranye No: Covnly
Ln
Or.cupnnt(PplNT)
4 Phnne No.
4?5-y-
Puwer Sup0lier
t7/J/' rA Atldress ?
'(\
Eleclrical ConVactor ICOmpany Namel tr.iccor's License No.
ur u e /'
Mailinq AAJi
e
s
s I
COntrac[nr or Ownor Makinp Instailntion)
`
^
^
Q
Au[horized i0?a?ure ICoMra tod ner Making Ins[alla[ion)
? Phone Number
y} y- ?GSa
MINNESOTA STqTEBOARD OF ELECTflICITV THIS INSPECTION REQUEST WILL NOT
Grigqs-Midway Bltlg. - Boom N-191 BE ACCEPTED BY THE STqTE BDARD
1821 University Ave., St Paul. MN 55104 UNLE55 PflOPEN INSPECTION FEE IS
P6..no'161P1 2972111 ENCLOSED.
y?REQUEST FOR ELECTRICAL INSPECTION ee-ooooi_oa
T 7 1 110 6.? See instructions for complating ihis torm on back of yellaw copy.
J
"X" ork Covered by 7his Request j D$`q Z
ew Add Nap. Type ol euilAing Appliancxs WireA EquiUment WireA
Home ftange Temporary Service
Duplex Water Heater Liyhtiny Fixtures
Apt. Building Dryer Electric Heatin
Commercial Bld,y. Fumace Silo Unloader
Industrial BIAg. Air Conditioner Bulk Milk TaMc
Farm oiner snem vi onnorlsoo. :ity1
[her Spnr.ifv. Offier Other
Compute lnspection Fee Belnw
k Fee ServiceEntrence5ize a Fee Fxeders/5ubfeetlere N Fee Circuits
?? to 100 qm s 0 to 30 Am ?s •? 0 tn 30 Am s
101 to 200 Amps 31 to 7 00 Amps 31 to 100 Am s
Above 200 qmps Above 100_Ainps Abave 100_Amps
Transionners Remote Control Circ. ,?-0 Partial%Other Fee
$Igfls SueCial IpS{leCtlOn i?
S Or
flemu?ks ? C+
? n ctiTC n...Lr "r? /1 ? r?I 0?
? O L FEE ?
1_ srl
l ? \Ji?c_si\ a.••? ?" " . ! _L ( I .w
Final
This rapuest v
18 ninn(hs from
cercity that ffie abuve
jnspgction has boen
'
's request wid 7(p
?
,Bmonth.% frorc` y
° ;? 1709
Lq , BI , h n A,pplit /,au..? 36gqZ
zoI ocD
Request Date
Y
j
/ Fire No. RouPh-in Insuer?ion
Re? ed!
'
?RaaAy Now?Will Notify Insnec
Wh
W
(J
( ?
,??
es No r
en FeatlV
? licensed Electrical Con?mctor I hereby raqLjest inspeclion of ebove
?Ownpr el
i
t
t
l
k i
ll
d
t
ns
ac
ca
wor
a
e
a
r
Street Address, Bax nr Rout No. City
11
l P L ? /7,c,
er.tion o. Township Nmme or No. Ranpe Na CnuntY
L
Occupant (PFINT) /
? Phune No.
ysY-??so
/?
/ v Cn
Pow?Ce?r Supuli.eyr
?
?
? Address
f?
?/iF L-
E-G 5?
. /i71.J+- D
Elech ai ConVa
ctnr ICOmpnny Namel Contrar,tm's License No.
p
Uo A_UX"
Mailing AA'Jre.s,s ?(C^onu?actor or Dwner Makiny InstaflatioN
Auffiori Signature ICOnh ?tor/Own r MakfnB' ?ationl Phon Numbr.r
?y-??
?o-
MINNESOTA STATEBOARD OF LECTflICITY 101, 7HIS INSPECTION qEQUEST WIIL NOT
Griges•Midway Bldg. - Hoom N.191 BE ACCEPTED BY THE STATE BOARD
1821 Univarsiry Ava., St. Paul-, MN 65104 UNLESS PHOPER INSPECTION FEE IS
Phnnw 16121 2972111 ENCLOSED.
PERMIT
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
1921 JADE LANE
LOT: 4 BLOCK: 1
KEN APPLEBAUM
P.I.N.: 10-11700-040--01
DESCRIPTION:
C I.r%? f,f- 1-.A(,l:N
.':3 1E.h'N:[NAI... NOs ?6"7
I!A7E.s n.jj./n9/98?
!.S"'t.p.eppi,
NRd?.=:,; Ti.1!-r:VraL W:rn!Dr:,N ,r,:p;;F'FlNY
r'?'. - (ROOFINB)
Building
Permit Type
S 1.0 01
?(
I r3n i
C:'r?^!AEeA!;
.r.,
a•, ?
,,
E£uilding t%;I`'??k Type F' I
.,
R. ?fr-,:I. 1809 i„] ,PdRC+firt: C
3(:1[]
,'?Census C'ode ,
434 R 900; 19,:1 tADk. I_AN! li.??.'r'_;
2+ _; i9 ?:t
?
ra,z?p
,
n?
PSP
\ ?!
tt
i"dr[ii4,}I• ????fl'?C!
?r %t. .
?
4 I- R 7 i
4yI ?
%k'S Yr'?YfYnW.;X?'yF Xr.{?4'n ??:;i.? 'n ?h Y;m:h.;k>FMyF : REMARKS:
FEE SUMMARY:
VALUATION $6,090
Base Fee $112.25
Surcharge $3.06
Total Fee $115.25
CONTRACTOR: - applicant - sT. Lzc OWNER:
THERMAL WINpOW & SIDING CO 17020415 2010729 TREMBLEY TOM
2005 BUSN AVE 1921 JADE LN
.JST PAUL MN 55119 EAGAN MN 55122
'(612) 702-0415 (612)454-7050
. . . Y- R ni.
I hereby acknowledge that I.have read this appljcation and state that the
,f ?Mn.,,; .
StatutesiendiCityrofcEagan klgrdir?anc'esomply ?+3th a11;, aPp??,?.c?t}le 5;ta?„e ?z
L
?t,
APPLICANT/PERMITEE SIGNATURE Ro;ral
- SUEJ BS? IG ATU E _
. ._"?
PERMIT
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
1921 JADE LANE
LOT: 4 BLOCK: 1
KEN APPIEBAUM
P.I.N.: 10-11700-040-01
DESCRIPTION:
(ROOFING)
BuYlding;,Permit Type
,,Building WQr,k Type
Census Code=
;s -&?-?
49` H .
8 l°x'
1E. e :f
PERMIT TYPE:
Permit Number:
Date Issued:
SF (MISC.)
REPAIR
434 RLT. RESIDENTIAL
0 t?
?
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
Total Fee
VALUATION
$112.25
$3.00
$115.25
$6,000
BUILDING
031746
04J09/98
CONTRACTOR: - Applicant - ST. I.IC OWNER:
THERMAL WINDOW & SIDING CO 17020415 2010729 7REMBLEY TOM
2005 BUSH AVE 1921 JADE LN
JST PAUL MN 55119 EA6AN MN 55122
`(612) 702-0415 (612)454-7050
I fiere6y acknowledge that-I ha`ve read tMis apQl3oation°end 3tate thdt tfie '
information is carrect artd-agree to corn{31y w;ith`ali a.ppl9:ca61e,State o;f Mn„
Statutes arrdCi'ty u'f Eaga'h Ord3.rjan?&s.'
APPLICANT/PERMITEE SIGNATURE
,?u?,
E "1. IG ATU E
SU
,. ? -?.....
t_ -
3114 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PII.OT KNOB RD - 86122
681-467b
New ConstruGion Reauiremants RemodeUReoair Reavirements
? 3 registered ske swveys ? 2 capies oi plan
? 2 copiea of plans (include beam 8 window saes; poured fnd. design; etc.) ? 2 sife suneys (exRerfor addkions & dedcs)
? 7 energy calculations ? t energy calwletions for heated addRions
• 3 copies of tiae preservalion Plan H lot platted after 7/1193
required: _ Yes _ No
DATE: q- l-QS CONSTRUCTION COST; ? (?7UO"
DESCRIPTION OF WORK: :J?` l2 "cY-e-
STREET ADDRESS: _ (9 a' I ?q& LA-t?
LOT: BLOCK: SUBD./P.I.D.#: N-o"n 044Do6.l
?
Name:_ -FA-1n, YJ ?_ I Q/O Phoue #:
PROPERTY 1.est Fust '
oWNER ?? ? L ,?
S?eet Address:
City E+2, ?, State: M,,,J Zip: `'S 7I
Company: ?T-Pea2 c?aR (_ Wrnl dcr.?j h S? p rJ? Phone #:
CONTRACTOR rz
Street Address: ??? t ,???? ?14/? • License # Q
City Sx ,jpxj L State: U? &l Zip: ? S 1) q
ARCHITECT/
ENGINEER Company:
Phone #: _
Registration #:
Street Address:
City
State:
Zip:
Sewer 8 water licensed plumber (new construction ony): . Penalry applies when address chang
and lot change is requested once permit is issued.
I hereby acknowledge that I have read this applica6on and state that the infortnation is correct and ag to comply with all applicabl
State of Minnesota Statutes and Ciry of Eagan Ordinances. / 77 „
Signature of
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
2000 STORM DAMAGE PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
Reaulremenh
? 2 coples W pla
DAiE: I ? CONSTRUCTION C05f:
p --') -?' -C-) (D
DESCRIPTION OF WORK: It multi-family bldg., how many unlts?
INDICATE THE FOLLOWING E6IUIPPAEINT TO BE REPLACED AIdD BY WHOM:
? Plumbing _ Homeowner Qr Contractor Name
_ MeChanical _ Homeowner pl ContraCtor Name
•`NOte: If somebody other ihan the homeowner is performing plumbing or mechanical work they must apply forappropriate
permit. Only Iicensed ptumbing coniractor or homeowner may complete plumbing work.
STREET ADDRESS: <?('/?(jti (i LA-Vl e 1 ?il'-?G2 NI? G?;117
LOT: ? BLOCK: I SUBD./P.I.D. #: V-C V?. 1jiL?c ?('i ?A vv---
Name: Law' Ao&? Pnone x:
rROreerr ast First
OWNER {?-
Sheet Address: 1617- l[,et, "
ciy naa : state: lti1 zip: l,z-
Company: GL9 .TLcQ t-kine #:
(area code)
CONTRACTOR 40
i, LicenselK-?-M°of( ExP•? D ? UI
Sheef Address: aty w4A state: zip: 5
I hereby acknowledge thaf I have read this applicafion, state thaf Me informafion is correct, and agree to compry wilh all applicable StaFe
of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
CITY USE ONLY
LOT ? BL ? PERMIT #:
SUBD. Cl-PN? VJCJl,f.1,1 RECEIPT #:
RECEIPT DATE:
c- R l ????
? a9,-o c)
2000 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PIIAT IINOS RD
EAGAN hIIi 55122
651-681-4675
Date:
Complete this section on if you are installing HVAC in a single family dwelling, townhome or condo under
construction and not owner/occuoied.
• HVAC: 0-100 M B T U
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one required @$3.00 ea.)
$ 30.00
6.00
State Surcharge .50
Total $
Complete this section ortlv if you are remodelin?, addina to, or re airin an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or repair.
New Alteration
? Fumace
_ Air exchanger
Reminder: Call for rnspections
/? Repair _ Other
??
_ Air conditioning
Other
Fee $ 30.00
Sta?P Surchasge .
Total $ 30.50
SITE ADDRESS:
OWNER NAME: n? PHONE #: 6 S l -
(AREA CODE)
INSTALLERNAME: W?'?iH31ADHEAI4^'9tXDP,"t/z?"'T^:.:::?C0. PHONE#:
(AREACODE)
STREET ADDRESS:
CI'i'Y:
cTeTF- 71P- .
EAGF.N TOWNSHIP
3795 Pilot Rnob Road
SC. Paul, Minnesota 55111
Telephone 454-5242
PERtAIT FOR WATER SERVICE CONNECTION
Date: JLn 9, 1977 Number: 654
Billing Name: Sallv Co.
Owner:
Plumber• Thompson Plumbing Co.
Meter Reading
Location of Connection Meter Size?
DID NOT PAY $60.00 for METER Meter No.-?'iy, _
6/29/71
Permit Fee 10.00 pd 9/17/71
.50 pd 9/17/71
Meter 1??KX 60_00 nd 9/17/71
Meter Sealed: Yes_ IAdd'1 Chg.
NO I1bta1 Chg.
Buildiag is a:
Residence X
tRultipie ro, Unit
Commercial
Industrial
Other
Inspected by
Date
Remarka:
Site Address: 1921 Jade Lane Lot 4 k,. A.
Billing Fddress
$25.00 ftE-IiVSPECiIflN FEE rOR
IMPROPERLY {NSl'ALLED h9E1'ERS,
By:
Chief Inspector
Ia consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Towitahip, Dakota Countq, Minnesota.
By: ---
Thompson Plumbing Co.
Please notify the above office when ready for inspection and connection.
EAGAN TOZdNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWSR SERVICE CONNECTION
DATE:June 29. 1971
OWNER• Zallv Co.
PLUMBER Thompson Plumbing Co.
NUMBER 811
?^.?.
Addresa1921 ,7ade Lane Lot 4 r, Ps96ZrG;?trj?1?
TYPE OF PIPE Heavy Cast Iron
DESCRIPTION OF BUILDING
Industriall Comerciall Reaidentiel ` Multiple Dwelling f No. of units
R
Location of Connections:
Connection ChargeS200.00 nd 6/29/71
Permit Fee 10.00 pd 9/17/71
.50 p /71
Street Repairs
Total
Inspected by:
Date
Remarks:
$y
Chief Inspector
Ia consideration of the issue aad delivery to me of the above pezmit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Tormship, Datcota County, Mianeaota
By
Thompson Plumbing Co.
Pleaae notify when ready for.inspection aad connection and before any portioa
of the work is cwered.
MASTER CARD
0
-/•/rA
STRUCTURE AND
LAND USED AS
Permit
No,
Issued Issued To
Con}ractor Owner
BUILDING
PLUMBING
CESSPOOL - SEPTIC TANK 2y?s
' /(,n `--u
WELI
ELECTRICAL
HEATING
GAS INSTALLING i
SANITARY SEWER
OTHER
OTHER I
•
0
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING F-i SEPTIC
FOUNDATION /O CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL
HEATING ? DEPTH
OF WELL
-
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WEIL
SANITARY SEWER ap,
, Violations Noted
on Back
COMMENTS:
x/0 +Ivo.Z
'7- l?-22'?`?' ?-??9
nate:
BUILDIfIG PSRhIIi P.PPLICATIO?4
LOT? BLOCK ADDITIOI1-1021
? ---
.....,:?; & SPCs2pP7 1•NIIIIER IF U11PLATTED
Gs c;.r.C.^cL ' /d- I ?? ? r} E? ..-... ..
OCCUPARICY ? USE
ay a?
.. ?-
,..-::? ;:Os^
?D J r'e?3'1 E]ICV TELEPHOIVE 110. ?•.? ? SU__.._..__,
!'iYf
?
19 v? d 2; L? e -.--
co,:;:,snc:?R TELErxorrE TTO. 54?1?-?38s
F_n^aESS
--y?--- -
Notes Include site plan, building plans, and enezgy calculations c^ith ihi.^
application n
Signed
OPFICE USE
?1?b6o ?
t_zwvr-.maozI
''-Wi2 c:Ji1i18C'=TOP1
.,_..,'::R METER
_'rJILDIPIG PF,RIlIT FEE
,UxcNS.r.cE FrE
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F. C. JACKSON
LAND BURVEYOR
RE018TEREO UNDER L-AW6 OF BTATE OF MINNEBOTA
LIG6N6ED BY ONDINANC6 OF CITY OP MINNBAPOLIB
3818 EAST SSrN STREET PA. 4-4681
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burbepoc'S Oertificate
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1 MEREBY CERTIFY TMAT THH A90Vfi IB A TpU[ AND OONRBCT PLAT OP 11 SURVEY OF
Lot 4block 1, Ken ,lopelaaum Addition.
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Minneapolis, Minn. 55426
Citr Garoge Side ` X X Apron
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INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number.
Eagan, Minnesota 55122-1897 Date Issued: '(612) 681-4675
SITE ADDRESS:
. qN?
K k IV AEJ'l t kAItFl
PERMIT SUBTYPE:
4 lit ,.,. : APPLICANT:
( ? 1 ,' ) 4?.' vi ?i l '•
TYPE OF WORK:
I ,1 ,.,r I? i F' i t I ,1<i
I I - F TNt,
[ir 1 Nii 1 11
kci, A iP
(Ftfirif iNCiI
?
Pe?mR No. Pormit Holder Date Telepfiona A
ELECTRIC
PLUMBING
HVAC
Inspectian Dab Insp. Comments
FOOTINGS
FOUND
FRAMINO
ROOFINO y//U/!l p
ROUGH
PLUMBING
'
PLBG
AIR TEST
ROUGH
HEATING
GA5 SVC
TEST
INSUL
GYPBOARD
FlREPLACE
FIREPLACE
AIR TEST
FlNAL PLBG
FlNAL MTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
CITY OF EAGAN Remarks
Addition APpEZBAUI'', I''N Lot 4 Blk
OwnerThesmwS 1_. zi- Urni?aiA Street 1921 Jade Lane
TT- rnb?2tl
22
01
(mprovement Date Amount Annual Years Payment Receipt Date
STREETSURF. 15- 1972 22.0 . 31
STREET RESTOR.
GRADING
5AN SEW TRUNK
SEWERLATERAL
WATERMAIN
WATERLATERAL 131 1971 1 97. 0 84.U7-- 20 Paid
wATER AREA see water conn. Paid 752 -2 -`j1
M- STORM SEW TRK 1971 20
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN, 200.00 3752 -2 -71
BUILDING PER.
sAC 200.00 3752 6-28- 1
PARK
Receipt " PL.UMBING PERMIT i
Permit No.
. CITY OF EAGAN
, -
Fee
fill in numbered spaces S/C
Type or Print /egibely Tot
1. Date 2. Installation Cost ?.
3. Job Address ?-" Lot Blk. ?
? Tract i• S1
4. Owner ,
5. Contractor ?Phon e ' -? ;• ? ?
6. Address f- ?
7. City ' ; • State Zip '
8. Building Type: Residential ES
9. Work Description: New ?
10. Describe
11.
Commercial 11 Institutional ?
Add ? Alter ? Repair ?
No. Fixtures
Water Closet No. Fixtures
Cess
ool/D
i
field
Bath tubs p
ra
n
Se
ti
Tank
Lavatory p
c
Softner
Shower Wel I
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
51op Sink
Gas Piping Outlets
-- - ,
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed: for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Receipt MECHANICAL PERMIT Parmit No.
. CITY OF EAGAN
• Fee
fill in nurnbered spaces S/C
Type or Print /egibly Tot.
1, Date 2. Installation Cost
3. Job Address Lot Blk. Tract
4. Owner
5. Contractor '
6. Address ?
7. City State
Phone y ' 71, ?
Zip
8. Building Type: Residential Cl Commercial ? Institutional ?
9. Work Description: New ? Add D Alter ? Repair ?
10. Describe Fuel Type -
1 11.
No. Eauioment 9TU - M. Ea.
Forced Air No. Equipment CFM
Ai
H
dli
Mfg. r
an
ng:
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outtets
12. 1 hereby certify that the a6ove information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
. . . . . PERMIT #
MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DA7E:
:ONTRACT PRICE: PHONE: 454-8100
'ite Addre s BLDG. 7YPE WORK DESCRIPTION
ot Block ? Ser/$ub Res. ? New
? Name T Mult Add-on ?-
? Address Comm. Repair
c City Phone Z Other - ' _;s
Name ?
? c Address
3
O Ci C?i7
tY Phone
TYPE OF WORK
Forced Air M BTU
' 8oiler M BTU
, Unit Heater M BTU
Air Cond. M BTU
Vent. CFM
Gas Piping OuUets #
Other
FEE
S/C:
TOTAL•
FEES ?
RES. HVAC 0-100 M BTU -$24.00 I
ADDITIONAL 50 M BTU - 6.00 +
(RES. HVAC INCLUDES A/C ON NEW ?
CONSTRUCTION) ?
GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA.
COMM/IND FEE - 1°.6 OF CONTRACT FEE ?
APT. BLDGS. - COMM. RATE APPUES
TOWNHQUSE 8 CONDQS - RES. RATE APPLIES '
MINIMUM RESIDENTIAL FEE - ALL ADD-ON & ?
REMODELS - 12.00
MINIMUM COMMERCIAL FEE ?
- 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES ?
BEYOND $1,000)
SIGNATURE
FOR: CITY OF EAGAN
CITY OF EAGAN
3795 Pilot Knob Rood Ee4en, MN S'i142 7170
? ?HONEs 454-8100
, BUILDING PERMIT Receipt #
Te be wed for ' Est. Volue Date _, 19
51te /lddrcss Erect
0
Occup°nq
, .
Lot Block Sec/Sub. i• • Alter ? Zoning
parcel # Repofr ? Firo Zone
,
N Enlorfle ? Type of Const.
cWe ome hbve ? # Stories
Z
? Address Demolish ? Lengih
Ci pho? Grade ? Depth Sq. Ft
.
.
A?ra? Assessment
dZZ3:a,3 NOTQ . i+YYrv?aw
.
Ci Phax Woter Sew
Police
Name Firo
Addross Eny.
Ci Phone Planner
Council
1 hereby ocknowledge that I have reod this opplicotion and stote that gldp. Off.
the intormation is correct ond ogree to comply wifh oll npplicable A?
State of Minnesata Sfotutes and City of Eogan Ordinonces.
Fees
Permit
$urchorfle
Plon check
SAC
Water Conn.
Woter Meter
Rood Unit
Total
Siynature of Permittee ?
11 Building Permit Is issued to: on ths express condition tFat
oll work shell be done in ocwrdarxe with all oppliwble Stote of Minnesota Stotutes and City of Eepan Ordinances.
Bufldiny Officiol
Parmit No. Parmit Holdar Misc. Permit No. Holder
Plumbin9 '7_9''`
H.V.A.C. .JD 8?0
w.u
w?r
Disp.
w?r
Sft
eaccric I70S 4c.YV?c-
7170°(
Inqqction Data Insp. Other
Footinpt - ".; - "
Foundatan
Framinp
Rouph Plbp.
.
Rouph HVA
Inwlation
Final Plby.
Final HVAC
Final ? y
Waftr Wsc?fbe Location:
YVell
5ewer
Pr. Ditp.
.
BUILDING PERMIT
Site Address -' '-' Jad?-'
Lot ' Block
Parcel #k
? Name
W
3 Address i 1- J:]+"irt
? City ,,.?,..? '...
? Name ??'l;?'Ste?•r ? ?
,o
?? Address
1- r:... ?'r l G
Name _
Address
rir„
CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 55122 N2 4402
PMONE: 454-8100
Receipt # (;71 Q
I hereby acknowledge that I hove read this application
the information is correct and agree to comply with
Stote of Minnesota Staiutes ?d City of Eogan Ordir
Signature of Permittee
A Building Permit is issued to: • t'??::?='?' :-?Y ??
oll work sholl be done in accordance with all opplicabl
Building Officiol -
ond stote
all appli
State of
yo Occupancy T
? Zoning D1
? Fire Zone _
? Type of Const.
0 # Stories
E) Front ft.
n Depth it.
oter & Sew. Surchorge
lice Plan check _
,e SAC
19. Water Conn.
3nner Woter Meter
iuncil _
dg. Off
Total 17,00
I
on the express condition thot
Stotutes and Ciry of Eayon Ordinonces.
Pamit # DaRe Iww Pwsklr
PI umbi ng
Mechunicnl
INSPECTIONS DATE INSP.
ough
-1
Fl?
Footings Date InaP. Date (rMp.
Foundation Pltanbing
Frnme/ i ns. Mechanioal
_Final ?•?•
-
-T
Remarks:
. . -,n„ .. . . . .. . . , , . _ . . . - r
GAS WORK ORDER
?p
1072 Payne Ave. STANDARD 410 W. Lake St.
St. Paul, MN 55101 9 Minneapolis, MN 55408
651 /772-2449 b H EAT I N GO 612/8242656
& AIR CONDITIONING
A Blue Dor Service Co. EQUIPMENT INFORMATION
LAST 1-15 .?c_/ FIRST '
ADDRESS
CITY ZIP 1.2- Z
HM PH WK PH
TECH DATE `- ?
TYPE
MAKE
MODEL - rJ? 3(?'? ?
SERIALI 1<00 i¢ O 2 SO ,?
NPbT
ORSAT TEST RECORD o
C02 GU % METERED INPUT 8Z--> Cfh CHIMNEY TYPE v
02 °r6
LIMIT SETTING 'Zv o 1-4
° FLUE SIZE in.
CO % PILOT OUTAGE O sec CONNECTOR sIZE ^'
NET STACK TEMP ° TOTAL CHIMNEY INPUT btUh
?
?
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA157170
Date Issued:08/07/2019
Permit Category:ePermit
Site Address: 1921 Jade Lane
Lot:4 Block: 1 Addition: Ken Applebaum
PID:10-11700-01-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
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 -
Abel Asfaw
1921 Jade Lane
Eagan MN 55122
Haley Comfort Systems
4320 Hwy 52 N
West Frontage Rd
Rochester MN 55901
(507) 281-0138
Applicant/Permitee: Signature Issued By: Signature