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1957 Jade Lane
TOWN'OF EAGAN 3795 Pilot Knob Road St. Paul, Minn. 55111 PERMIT N0.• 75 Thompson Plumbing for ;the The Boaxd of Supervisors hereby grants to Sally Corporation of 12201 Minnetonka e PLUMBING Permit for; (Owner) Sally Corporation ar 1957 Jade Lane , pursuant to application dated 1/6/71 Fee Paid: $20•04 Dated'thia 6th day of January , 1971. 8uilding Inspectar EAGAN TOWNSHIP BUILDING PERMIT Ownex . - .....? . ... . . . - '-- --... ....°---...._.... .. -•--- - . Address (Pxesen!) ..la- --- ."' -'-...? ."-------. ?-CR._?.. Builder .._.--- 4,-?:.cecY-..................... ..........-...._......°•°----...._.. Add:asa DESCRIPTION I1T° 2361 Eagan Township Town Hall ae:a .... xlY..?7..0 .................:.... 5iosies Ta Se Used Fos Fsoni Depih Heigh! Esl. Cos! Pesmit Fae Aemarks ? 3d/8'ii .2G I ?o/ 6e-0 r_ o?'=l !a / ? /gs7 os This permit does ao2 authoriae the use of sireeis, zoeds, alleys or sfdewalks aor doee it give the owaer or hia agenY the rigL!!o ereaie any sifuafion whieh is a nuisance or whieh presenis a hazard !0 the health, safefy, coavenience and general welfare fo anyone in the commuailp. THIS P£RMIT MUST SE EPT ON THE PREMISE WHILE THE WOAK IS IN PROGA SS. Thia is !o eesiify, lhai.., ----?.s .......... ..................has parausaion 2o erec! a..... .... .....°.?.p.?..?.''..?".?...--- -........_upon the abova desesibed psemisa sub e! !o !he prov?siona of iHe Building Ordinanee for EegaY?Townahip 4'dopted ApsSl 11. 1953. At... -'-"". .......... Per --..........- ...... ?"_'..GZ ... Cheirman ? ?Tnwn Boerd,(j ?. BuSldSng?pec EAGAN TOWNSHIP BUILDING PERMIT Ownes ....x T---^^-..-..-..---.fiL :. ......-_"--"""'-- Address (Braeen!) .... .?7?--.-?---.?--...----.....- ? Q U Bvilder ........ ?^:^-'-^?...._...D...r---............................................. .................... Addresa ..._°---' DESCAIPTION 11T° 2541 Eagan Township Town Hall Dale -.- .. 21 ................ Biories To Be Used Foz FronS De !h Heig hf Esf. Cos3 'Permit Fee Remarks ? ?^---d-?-- zy ay I Los $iocs naaiuon or zsact ! 3 f /?,? ?z?G?-?-,.._.-?Q..Q.?? This permit does aoi aulhorise the uee of slreelc. roads, alleys or sidawalke nor does it glve the owaar or hia egent the righ! Yo create any siluation whieh is a nuisance or whieh presenls a hesard !o the heallh, seteiy, conveaience end general welfare !o anyone in the communitp. TFIIS PERMIT MUST SE KEPT ON TH£ PREMISE WHILE THE WORK IS IN PAOGAESS. ThL is !o eerlify, that..... ,?:: ....... ?_.-?:?............has parmissioa !o ereat a....... .....a'Z-.._?.? ..:....??/ ...o.?.......... . ypon the above described psemise eubjea! !0 the provisions of the Building Ordinence for Eagan To shid Apr91 11, 1855. - •.... :. ...J`^.`....`:---°....-'-'---. Per .................. .:"."._.......-............................................................. ? -. ha?s n ot Tnwn Boerd Suilding°Inapeclor TOWN OF EAGAN 3795 Pilot Knob Road 8t. Paul, Minn. 55111 PERMIT NO.: 66 The Board oP Supervisors hereby grants to RTv tk"j_Ug_Co• Of L(y37 Chiragn_ Ay.anna Srnith_ Mnls_ 9507 & H.AF T7NG _ Permit for: (Owner)_5,L,1.. romnY?Lat _ 957 Tade Lane. St. Paul _, SSl llpursuant to application dated _Tanuar7t_4, 1271___ __._.__ _• Fee Paid: Dated this 13th day of .8nua ? 1971 . Building Inspector 7/a ?y?/ ja?'9' 9 ? 3852 0 /- i9' ,61. . ? ?-?-0° ReQuest Date Fr No . Rou h Inspac1bn Require09 XQ Ready Now ? Will Notity Inspeqor 7 1] 89 ?Yes [5Wo VfienRaatly7 113 licensed contractor ? owner hereby request inspection of above electrical work at: Job Adtlress (SVeel, Boz or Route No.) Ciry 1957 Jade Lane Eagan n No. Sectio Tow?rehip Name or No. Renge No. Counry Dakota Oocupanl (PRIIJn Phone No. Donald Wallin 890-1650 Power Suppiier pypneas Dakota Electric Co. 4300 220th St. Farmington, MN 55024 Electripl CoMrec[or (Company Name) Coritrectw5 License No. Total Electric, Inc. 039842 4 Mailirg Atltlresg (COnbacbr or Owrier lAelting Inslallation) 1537 92nd Lane N.E. Blaine, Mn 55434 Authonzed SignaWre (COroractOr/Ownar Making InstaVatlo Phone Number 786-8484 MINNESOTA STATE BOARO OF ELECTpICITY THI3 INSPECTION REOUEST WILL NOT GriggsNltlwey BWg. -poom 51M BE ACCEPTED eYTHE STA1E BOARD 1821 UnlvenYty Ava„ SL Payl, NN 551 W UNLESS PROPEfl INSPEGTION FEE IS Phone (612) 6,12-0800 ENCLOSED. ?141/?g9 0 38.)/ll REQUEST FOR ELECTRICAL INSPECTION ? Sce instrtatians for mmpleling Ihis brm on back oi yellow copy. `X"Below Work Covered by This Aequest 1 E6-00001-07 Me% Adtl Rap`. " Type of Building AppllancesWired EquipmentWired g Home Range Temporary Service Duplez Water Heater ElecVic Heating Apt. Building Dryer Other (Specify) Comm.Mdustrial x Furnace Fartn x Air Conditioner Other (speciy) Centrector5 Remarks: Compufe lnspeclion Fee Below: # 01her Fee # Service Entrance Size Fee # CircuitsiFeetlere Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transtortners Above 200 _ Amps Above 100 _ Amps Signs irepecwrs usa only: TO7AL Irrigation eooms ?j ? 5.50 Special Inspection Alarrn/COmmunica[ion Other Fee I, the Electrical Inspeaor, hereby f h RO1gn-in oaw certi y i at the above inspection has been made. F;,,ai oa p p?f OFFICE USE ONLY ? This requesl voi0 18 rtwnNS /rom RECORD OF COMPLAIIVT Date C.omplaint taken by T/_% t2 rz,6! 2- 11, +i?? p? Type of buflding Name __ ? T??1?/?} [.-/J ?ti La1-L P)N-.j Address f? S4 z 7" 6-1.) 14L _ L PU Legal description Phone number Complaint GL D M-3 4; FV 4 Action taken Al? Ff741,Am 61C` Commenu n? G`?v/v'l r G-At`S Z a r $1Bi18tUfC (o? ??? ?'7 C) , = 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New ConsWCtion Reauiremenb RemodeUFteoair Reauiremanls Otfice Use OnN 3 registered site surveys showing sq. ft. of lot, sq. ft. af house; and all roofed areas 2 copies of plan Cert of Survey Recd . _ Y _ N (20% maximum lot cove2ge allowed) 7 set of Eireigy Calculatbns for heated additions TreePres Plan Recd _Y _ N, 2 wpies of plan showimg beam & windaw sizes; poured found desfgn, etc. 7 site survey for addNOns 8 decks Ttee Pres Required _ Y _ N lsetofEnergyCalculalions Add'Non•indicefeif onsdesepNcsystem OnsiteSeptla:System _Y _N 3 copies of Tree Preservation Plan if bl plaCed after 711193 Rim Joist Detail Options selectlon sheet (buiWings wiM 3 or less unils) D&t¢ L/ / oS / O$- ConstructionCost dOO09" Site Address S ? L10.de / n,r- Unit/Ste # E0. N SSrt2- Description of Work ? Multi-Family Bldg _ Y_K N Fireplace(s) _ 0 K 1 _ 2 PropertyOwoer A_l?-?,e? M SrH..\z Telephone#(b5%) 45Y-e42'9 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 Ventilation Category 1 Worksheet • New Energy Code Worksheet (Jsubmissionrype) Submitted Submitted • Energy Envelope Calculations Su6mitted Have you previously constructed a building in Eagan with a similar plan2 _ Y K N If so, 25% plan review fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone # ( Telephone # ( J 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 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. ?rbzr? M. Sc?nv.\z Applicant's Printed Name ?44A, S Applicant's Sign tur RESIDENTIAL BUII.DING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-56 New ConsWCtion Reauirements RemodeUReoair Reouiremenls Office Use Onlv 3 registered site suneys showirg sq, ft o( lot, sq. fl. of house; and all roofed areas 2 copies of plan Ced of Survey ReW _ Y_ N (20% maximum lot average allowed) 1 set of Energy Calalations for healed additions Tree Pres Plan Recd _ Y_ N 2 copies of plan showing beam 6 window s¢es; poured found design, etc. 1 sita survey (ar additions 8 decks Tree Pres Reqd _ Y_ N 1 set of Energy Calculations Additlon - indicefe i(on-site septic system On-site SepGc System _ Y_ N 3 copies of Tiee Preservafion Plan if lot platted after 711193 Rim Joist Detail Options selection shcet (bldgs wAh 3 or less units Date Construction Cost ?? ? .3 `? • 14 LI / SiteAddress 195 7 jacDe 'dN Unit/Ste # a an tU 55 i a?l. Description of Work r ,?d0 ev s ?@ Multi-Family Bldg _ Y JZ N Fireplace(s) _ 0 _ 1 _ 2 Property Owner S C h`f l Z i Telephone #((;;Sl Contractor Address 3 D ? CJ i?e u-vq City 9v r'dt Svi ffP State _ MW Zip 5y 3S 7 Telephone # ( q$'Z) ? qq- 3G W COMPLETE THIS 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 (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously consiructed a building in Eagan with a similar plan? _ 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 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. PC, , I 0/q an.e/fF' ApplicanYs Printed Name Aignature PERMIT CITY OF EAGAN 38?10 Pilot Knob Road Eagan, Nlinnesota 55122-1897 (612) 681-4675 PERMITTYPE: BuzLozNc Permit Number: 0 3 3 3 5 9 Date Issued: 0 9/ 2 2/ 9 8 SITE ADDRESS: P.I.N.: 10-11700-130-01 1957 JflDE LANE LOT: 13 BLOCK: 1 KEN APPLEBAUM DESCRIPTION: R E R O O F Bu,i:1d'1ng;-Permit Type B,oil.ding 'Wark Type ?':ensus C'ode ? '" r' ` ' \t ?: ` t a : .. .._ STORM DAh1AGE REPAIR 434 ALT. RESIDENTIAL ' .,, , . ... _; REMARKS: FEE SUMMARY: CONTRACTOR: ? - Hpp RWW' 1957 JADE EAGAN (651)454-8425 iicanz - DONALD LANE MN 55122 I herpby apknowledge thet I have.readthis applicaT.-lon ancl'.state.that the i;nf`carmatzon is correct and agree'to cvmply with all appli.cable 5tate of Mn. Statutes and City of Eagan Ordinances. APPLICANT/PERMITEE SIGNATURE ? ?J? -T?UED BV: SIGNATUR J 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAC}AN -? ! 3830 PII.OT KNOB RD - 55122 C? _ a 3 _N 681-4675 ? New Construdion Requirements ? 3 registered sde surveys - ? 2 copies of plans (inGude beam 8 window sizes; poured tnd. design; etc.) ? t energy plculations ? 3 wpias of tree preservation plan H lot platted after 711193 required: _ Yes _ No DATE: 61- /7 ' ?,r DESCRIP N OF W STR EE T ADDRESS: RamodeVRepair Repuirements ? 2 copies of pian ? 2 sita surveys (exterior addRions 8 decks) ? t energy wlculations for heated additions ? BA ? CONSTRUCTION COST; ?I 9O0 LOT: I? BLOCK: SUBD.lP.I.D. 0-? Ca `1 C=? lh-'? PROPERTY OWNER Name: l?o/,//Y? Phone#: y?3 y- ?`f?21 Last First Street Address: / FS 7 Tiq al Q 4 Aw ciry ?09 9/9? state: !?'/ /2/ zip: / Z? Company:Phone #: CONTRACTOR Street Adc City _ ARCHITECT/ ENGCNEER Company: Name: Street Adc City _ ?Zip: Sewer 8 water licensed plumber (new construction onty): and lot change is requested once permit is issued. Penalty appiies when address charn h all applica: ly wit I hereby acknowledge that I have read this appliption and state that the a7z:z State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: ^ OFFICE USE ONLY RECEIVED Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No _ Not Required $y; /° License # State: ZiP: Ph'one #: Registration #: _ State: EAGF.N TDWNSHIP 3795 Pilot Knob Rosd St. Paul, Minnesota 55111 Telephone 454-5242 PERtUT FOR WATER SERVICfi CONNECTION Date: January 6, 1971 Meter Billing Name: Sally Corporation Site Addreas: 1957 Jade Lane, Sr. Paul 55111 Owner: Sally Corporation 8illing Address 614 West 54th St., Mpls. Plumber: Thompson Plumbing Number: 529 /,i"/ k• ?? ?zbC'iUvq Chg. 260.00 pd 1/20/71 geter Permit Fee 10.00 pd 1/6/71 ,:.•.r?..?.?- ,? y_,-o . Meter Readinp- Meter Dep. Meter Sealed: Yes_ Add'1 Chg. NO ITotal Chg. Buildiag is a: Residence ,,,, tlultiple Ao, Commercial Industrial Other Inspected by Date Remarks: r:Z-iuSPEr,i;U'N FEE FOR ;iiiPROPERLY INSIALLED METERS. Bp: Chief Inspector In conaideratian of the issue and delivery to me aE the above permit, I hereby agree to do tke proposed work in accordance with the rules and regulatious of Eagan Township, Dakota County, Mfnneso a By: ? ??tT ?9.!' )C Thomnson Plumbine Please notiiy the above office when ready for inspection and conaection. ERGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICB CONNECTION DATE: January 6, 1971 g[MggR 688 ?a3 ° I lc - ? OWNER: Sally Corporation Address 9 7_Tad Laney., St_ Paul 55111 PLUMBERThompson Plumbing TyPE OF PIPE cast iron DESCRIPTION OF BUIID ING Indastriall Commerciall Residential I Multiple Dwelling I No, of units Locatioa oE Connectfona: Connection Charge 200.00 od 1/20/71 Permit Fee 10.00 pd 1/6/71 SCreet Repairs Total Inspected by: Date Remarks• By. Chief Inspector In consideration of the issue ancl delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Toemship, Dakota County? t,l ?? By 0 Thompson Plumbing 12201 Minnetonka Blvd, Pleaae notify when ready for inspection and connection aad before any portion of the work is covered. MASTER CARD r 1 L_J • 9 LOCATION OWNER STRUCTURE AND LAND USED AS x:1 4' ) * --? - I.*O FCh Y'. wavql ifteAd ik Permit BUILDING PLUMBING CESSPOOL - SEPTIC TANK No. I _ Issued I 1 / Issued To Contrac}or - Owner WELL ELECTRICAL HEATING GAS INSTALLING I SANITARY SEWER OTHER OTHER I Ifems Approved (Initial) Date Remarks Distance From Well FOOTING FOUNDA710N ? ? 7O ? SEPTIC CESSPOOL FRAMING TILE fIELD FT. FINAL ELECTRICAL ' HEATING GAS INSTALLATION DEPTH OF WELI SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING ? } d '7? ; , %?''ly?7J / • WELL $y SANITARY SEWERd.(Alp, ? - ' Violations Noted on Back COMMENTS: MASTER CARD • LOCATION OWNER STRUCTURE AND LAND USED AS Permit I No. Issued Issued To Coniractor Owner BUILDING PLUMBING J?•!?__y? I -?? ? ? ---•?a`ff ? ? CESSPOOL - SEPTIC TANK VJEIL ELECTRICAL HEATING GAS INSTALLWG SANITARY SEWER OTHER I OTHER I • 0 Items Approved (Inifial) Dafe Remarks Distante From Well FUOTING TIC FOUNDATION CESSPOOL FRAMING fl FT. FINAL ELECTRICAL HEATING DEPTH OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING WELL SANITARY SEWER Violations Noted on Back COMMENTS: THE SUSSEL CO. 1850 COMO AVE. ST. PAUL CAII: 645-0331 SALESMAN --r. ^' 11 ( CONTRACT DATE fGu u 12,'97/ ?asy/ CONCRETE WORK ORDER NAME IW k 0 aMU ili A- WO(.t-?n PHONE# 11 5, o,•at JOB ADDRESS 11 5 3 Oe L+I • CODE AREA CONTRACTOR L JOB # ? Permit by ? Legal Description ? Lot 13 ? Blk 1 ? Add'll 'n N r i i1 (1122 ? Value OTypeConst. (,flAiSGi% 9 Square With ?? Rods fgMesh 19 Sod Rem. - By Pt tJ Af e. ? 5-8ag Mix 96-Bag Mix Yl Tamping ? No Tamping ? A.B.U. .u.?n e. 2-Startings Points Only S.P.L. S.S.P.L. R.P L. alley House /D /len2 F-cgtmt Other CONDUIT Ef O.H. Dr. Offset 2?5.0. Location ? Blocks [rl Windows GRn, I ? 1' . FOR OFFICE USE ONLY JOB #f CONTRACT # 300- INDICATE THE ITEMS BELOW ON LAYOUT ' t`t?3#I?F i°'r {?{? 3?r i..0w,. _ , i , L t ?Lu ? J -?-F-'-- - + ? i - ' r _ l < < , y ? ,_ . T_ . , t.. --- ? ' • ? a ' - ? , . ? ;_ ?, t _ ._ i . . ? { . + .- - i 4 ?y 1 aL ? ?- I k-,(0 1-11, , 1 ? { I t-?, ... i .. r: .l? _ i , . _ . i L ? ?? :' ? ? < </,f••_,? ?_? ', _?? ?,1fi?J??,_? - -?? ` a? ? ?, ?? --,- . _ . a r _ i i 1? I ti . ._ , _ ? . ? . .. .... i I_ ? . I . ' ? , ?. . ? . . ?' PART OF CONTR+ACT L? ?1 ?"' ?v 1 _ `, .. i ?. ? ? i_.. ? ?_ ; i? r . a; r P-4 REV. 0 ;` 7 T?? v 4k- -\J?, ..:? ` i ? -i i i ' - i_ ? , - ?. ? _ ? --?'? ?- ' ? -4-? y ? J J t ll? ? 71 _GTlON i--! r+-. ?-- - 7 Ken e?ppo.JIIU7] ! • ? ? ? N ? ? l)ro aFOG? c j ? / 3ut:-??7 F. C. JACKSON LAND SURVEYOR R[61HT[RED UNO6R UAWB OF BTATB Or MINNESOTA LIC[H8[U BT ORDINANCC OF CITY OF MINNiAPOl18 3818 EAST SSrH STREET PA. 4-4681 6urbepor'g QLertificate -- lg ? ??- ??i-oP a ? e .f ? ? 1 0 \9 i,' /7 e I NER[BY CERTI?Y THAT TN[ ABOVB I{ A TPUE AND OONRlCT RAT Or A SVRV[Y OF Lot 13 Lilnc}c 1, Ken l+pnolbHtin Addition. Dnkot,u Countp,:,.inr es+otc.. ? 5c.?/„ /'-=9 AS BURVEYEO BY ME TH19_ -1ytd• DAY oF_ Noe. __,,,p._1970_ ?I) ? /7? ),-TRATION. SIGNfiD---f - -- f F. C. JACKSONMiNr+esorNo. 3600 n ?i N . HOUSE HEATING TEST RECORD ADDRESS APT. FLOOR CITY SUBURB ? OCCUPANT OWNER ? HEAT L.OSS DATE HTG. INST. SOLD BY ; INSTALLED BY Elsctrical Wwk By Gas Line By +TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE MAKE OF BURNER Modol Modol Ssriol . ? Max. BTU Ratiny INPUT MAKE OF FURNACE Modsl CONTROLS THERMOSTAT Heat Plup VsM Size Valve KIND OF LINER ? SIZE NONE Limit Droh Hood Regularor Limit Settiny Filfers Si:a ? Number ? Fan Setting Chimnsy Location Insida Outside Pilot Type Chimney Construction . Pilot Make Pilot Model Smoke Bom6 - Wiring " Pilot Timing Draft Tsst Tay L.W. Cut OfF Door Pressure Lighfin9 Inst. Pressuro Percent CO2 Dote 7ested - Input CFH Peresnt O2 Compaey Testing Staek Tamp. Parcent CO Name of Teater _ f 0% Fum 235 ?- ^ - ^ -?INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: I N ? 3830 Pilot Knob Road Permit Number: ' Eagan, Minnesota 55122-1897 Date Issued: ' (612) 681-4675 ? SITEADDRESS: < <fi - ? < M M r. ? APPLICANT: I I Ili r%Nf 1'::1 1 , rs I t' N AF'F'I i t<Aitiq lr, `,11 q!,y PERMIT SUBTYPE: TYPE OF WORK: 14 F, a jI 7 7 L I Permk Holder Date Telephone i? PLUMBING HVAC Inspection Date Insp. Commenls FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING 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 %.i I Y OF EAGAN Remarks ? Addition APPELBAUM+ lMq Lot Blk 1 Parcel 10 11700 130 Ol Owner -Dni,)Ald? L). )01//tJ Street 1957 Jade LanC scate Eagan, t+N 55122 _ /Sm RQpeJbti u!- / ?=''L Improvement Date Amount Annual Years Payment Receipt Date S7REET SURF. 1967 J.} 7. 0 62.50 10 Paid 1dj1 STREET RESTOR. (SL1Y'f .? 1972 1461 . QD 46. 10 lo Paid GRADING SAN SEW TRUNK *SEWER LATERAL 1971 20 WATERMAIN ? *WATER LATERAL (301 1971 1 97. 50 84.87 20 Paid WATER AREA 9Ee water COriri. Paid 317 1-20-71 * STORM SEW TRK 1971 20 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 260 00 1$ 1-20- 1 BUILDING PER, sac 200.00 3178 1-20- 1 PARK • . . . MECHANICAL PERM(T CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 •• -? :i „ . _ PHONE 454.81Q0 I $It@ Lot. m Name ? Address c Ciry ? Name c Address p City Phone TYPE OF WORK Fo?ced Air Boiler Unit Heater Air Cond. I Other ? OuUets # ' M BTU M BTU M BTU M BTU CFM FEE: S/C: TOTAL• BLDG. TYPE Res. Muit Comm. Other PERMIT # - RECEIPT # - DATE: For Office Use WORK DESCRIPTION New Add-on Repair FEES RES. HVAC 0-100 M BTU - -$24.00 ADDITIONAL 50 M 8TU - 6.00 (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMIn - 1.50 EA. •: COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - 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) ? ? . SIGNATUR P E ? FOR: CITY OF EAGAN ?i /?? MAR-21-2012 WED 10:38 AM LITHO FAX NO, 9529482150 P. 01 . ~e Use BLUE or BLACK Ink I For Office Use I Gall r I Permit#. 1 1 P City of Eatil C<.eA C Permit Fee: 3830 Pilot Knob Road I I Date Received: I Eagan MN 55122 lrtJb~"' ~z- I I Phone: (651) 675-5675 bS1-'5S" --ebo l j Staff: Fax: (651) 675-5694 INFLOW INFILTRATION PERMIT APPLICATION Plumbing 1 Sewer & Water Date: Site Address: Tenant: Suite Name: Phone: ~n51^3'S V - ~Q O' RESIQEN'T f R- ,57 4e , Address /City /Zip: tea - t.U1. ~L a N+N a Name: license City: Address: _ GQW'1'RAGTOR State: _ zip: Phone: ° Contact: Email: PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope) F i +E.qF Wf3Fl~' Sump Pump Repair Repair Other: Other: r - Description of work: a~si~Rl~TioN - FEES $60.001 Each (Includes $5.00 State Surcharge) TOTAL FEE $ *Permit fees will NOT be reimbursed by the City of Eagan. if you plan to submit III repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www,citvofeagan.comllnflow, or City Hall at 3830 Pilot Knob Rd. 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 aopherstateonecal .or 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 approval of plans. xCYWN-3- x APPIicanVa Printed Name App s Sight re rf7 ©ate 7,_, . 'a. ReviewedtF► FAR AF'I~CE:;USE -777 -77 .1 :Reqult d Jns p@otl'one:.. Under.Ground Stough-In- _Firai l'