1360 Jurdy RdCITY OF EAGAN Remarks f?rX ExEm PT- /aadition " DoI711yWOOd Addt1. Lot 27 Bik 4 Parcel ?ft 20960 270 04
Owner- Street 1360 Jurdy' Rd. State '?gan,? 55121
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
.?. STREET RESTOR. ? 1975
GRADING
SAN SEW TRUNK 1 62.80 1 25 40.21 A006490 8-14-78
SEWER LATERAL
WATERMAIN
.?. WATER LATERAL
WATER AREA - 1975
?k STORM SEW TRK 1975
* STORM SEW LAT 1975
CURB & GUTTER
SIDEWAIK
STREET LIGHT
WATER CONN.
BUILDING PER. ?
SAC
PAR K
CITY OF EAGAN
AAdition_Dgnnvwood Addn. Lot 28 Blk 4 Parcel '*+ 209E0 280 04
?a 7
Owner Z Street 1364 Tlr Rd. State E2.e'an,MN 55121
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR. ? •?r.ri
GRADING
SAN SEW TRUNK 3 1 0 62.80 2.51 2 40.21 A 06491 8-14-7
*SEWER LATERAL 1 21 S 8 429.76
WATERMAIN
* WATER LATERAL 1975 5
* WATER AREA 1975 5
* STORM SEW TRK 1975
* STORM SEW LAT 1975
CURB & GUTTER
SIOEWALK
STREET LIGHT
WATER CONN. ?
BUILDING PER. ?qt •
SAC ?
PARK
`Reoeipt"_
$' MECHANICAL PERMIT Permit No.
CITY OF EAGAN
Fee
Fill in numbered spaces S/C
Type or Printlegibly
Tot.
1. Date 2. Installation Cost
3. Job Address Lot Bik. ' Tract
4. Owner
5. Contractor Phone
6. Address
7. City State 2ip
8. Building Type: Residential ? Commercial ? Institutional ?
9. Work Description: New O Add O Alter ? Repair ?
I 10. Describe Fuel Type ?
I11.
No. Equioment BTU - M. Ea.
Forced Air No. Epuipment CFM
Ai
H
dli
Mfg. r
an
ng:
' Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
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 F' I
Inspections: Date Insp. Date Insp. R_
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
- --.? Receipt PLUMBING PERMIT Permit No.
CITY OF EAGAN
Fee I.-•
Fill in numberied spaces S/C
TyQe or Print legib/y
Tot.
1. Date 2. Installation Cost -
3. Job Address Lot Blk. Tract -4. Owner •
5. Contractor ? -Phone '
6. Address
7. City State Zip
8. Building Type: Residential GL Commercial ? Institutional ?
9. Work Description: New ? Add ? Alter ? Repair ?
10. Describe
11.
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory ? Softner
Shower Well
Kitchen Sink
Urinal/Bidet
Other
Laundry Tray
Floor Drains '
Drinking Ftn.
1 Slop Sink
Gas Piping Outlets ?r
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
/ > / a / /F l ??? d? 1`1? '
INSPECTI4N RECORD
CITY OF EAGAN PERMIT TYPE: ???; t.??ia??
3830 Pilot Knob Road Permit Number: 40600
;
Eagan, Minnesota 55122-1897 Date Issued: ::? s? !•??', ,
(612) 681-4675
SITE ADDRESS: APPLICANT:
I ?iJfa ilfit I! I I
PERMIT SUBTYPE:
TYPE OF WORK:
Fi 1 TERATinM
?.?I.ITUTNG frl 0 i3R`ajW[N'p[3W
INSPECTION DA
Z2
EL? • DATE INSPTR.
.?? ?
_<.,..
? - ?
;, -
f.._ . ,.
Psrmft No. Permit Holder Date Telephone #
ELECTRIC
PLUMBING
HVAC
Inspeetion Date Insp. Comments
FOOTiNGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
MEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAI
BSMT R.I.
BSMT FINAI
DECK FTO
DECK FINAL
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS: + ?i ?? o
1 i+?J:I?Y IrI?
I 'i{il ?? It?i
PERMIT SUBTYPE:
TYPE OF WORK:
W .I + t i f ? 10!
kU(!1ilN(i
14 ti H
e5/06 j96
REF'AIR
( f XFtE: pAMAfiF. )
INSPECTION DA • .A
r•?????,?t ? ?? ?: ??, ? ? r??,,
ISPECTION RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
APPLICANT:
,„ '':+ , I
{ i- I . ) , - I .. .,•i?.
Permil No. Permit Holder Date Telephone /
ELECTRIC
PLUMBING
HVAC
Inspectlon Date Insp. Commenta
FOOTINGS
FOUND
FRAMING :?94% tr'1CN
l/
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEA7ING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FIN.4L
(•L
b4e
BSMT R.I.
BSMT FINAL I
vnu?ag oF eaaaw
370 Pilot Knob Road
Eo9an. MN 55122
Zoning: RI
WATER SERVICE PERMIT
PERMIT NO.: 2091
DATE: 11 19 6
No. oC Units:
Owner: MATHEWS IND. INC. Address: -
Site Address:
umber: Kotz Plumbinq - Mathews
M r N? fa S? ?/3S Connection Chazge: 2 Z 0. 00 pd
Size. Account Deposit:
Reade}.No.: 6,. C?.3 ?( Permit Fee: 10 . 00 pd
I ee;t? com I wiTA tha Vill yi? . 50 pd
p Y m,ya 4f Eogon e harge:
--????GM' Chazges: 60.00 pd
, ?- rj?
?
BY Dare Paid: Date oC Insp.: Insp.:
YILLAOE, qF-EAOAN
3795 Pilof Knob Road
Eagon, MN SSIlI
SEWER SERVICE PERMIT
PERMITNO.: 2841 -
DATE: 11/19/76
7,oNng: R r No. of Uni[s: 1
Owner: MATHEWS IY?D. II]C.
Address:
SiteAddress:l3f4 Jurd road L28 P.?1 Uonneywood
Plumber: Rotz Plumb rtq CO. - Mdt ews
3.0/1/76 ?F4261 100.00 pd
1 oyree ro wmply with tha Vilbgo of Eogan Connec[ion Chazge50. 00 pd
Ordinoncss.
By:
Date of Insp.:
Insp.: _
Account Deposit.
Permit Fee: 10.00 pd
Surchazge: •50 pd
misc. cnargea:
Total:
Date Pafd:
YI64AOE Oi EAOAN SEWER SERVICE PERMIT
2842
3795 Pilot Knob Read PERMIT NO.:
11/19/76
Euyan, MN $5122 DATE:
Z'orung: RI No. of Un1ts: 1
Owner: MIt@[3EW5 IND. IDIC.
Address:
Si[eAddress: 1360 Jurdy Rd. T27 i34 nonneywood
Plumber: Kotz Plumbing Co. - Mathews
10/1/76 $426 1 100.00 pd
I aq.es fo complY wiTh fha Village ef Eagao Cannectlon Charge 3 5 0. 0 0 pd
O.dinane„. Accoun[ Deposlt:
Permit Fee:10.00 pd
• 50 pd
Surcharge:
gy: Misc. Chazges:
Date of Insp.: , Total:
' Insp.: DatePaid:
w4re?.ac& OF eacaN WATER SERVICE PERMIT
3795 Pilot Knob Road PERMITNO.: 2092
Eagon,MH 55122 DATE: 11/19/76
Zoning: R= No. of Units: 1
Owner: MATHEWS IND. INC.
Address:
site Address: 1360 JurdV Rd. L27 A4 DonneYwood
i>tumber: Kotz Plumbing - Matheps
Meter 1 N.
?
?
X 0 0 p d
? Connection Chazge: 22P
D
Si
k Accoun[
eposit:
?e?der No.: ?? /11 C-.9 Permit Fee: 10.00 Pd
1f fc m?f with the Yill?• of Eogon Surchaz e: . 50 pd
6r??/. / Misc.Chazges60.00 pd
Total:
By Date Paid:
Date of Insp.: Insp.:
/0<0 0
yhi5 'Pyuz5i vo,a ? L ZSl g? Do^ n?1? uwo?? - ?G: -7
18 months from -- -_ _-.- . % . -- - -U. _C.i.c,.go..£?i?,,' .. ;
Dale pf t Request g-3 Fue No. T 4 3 8 6 4
l, as t icensed Electrical Contracror U Owner, do hereby request inspection of the above electri- i
cal wiring installed at:
-- ---- /? G '
Street Address or Route No. City L 6A''J
Section
Range County7.4k'O7`A
Which is occupied by
(Name of OccuDant)
Is a roughin inspection required on this job? No I$ Yes ? Ready Now ?J Will Call ?
Power Supplier Address
ElectricalContractor/ Ua&rt k?sr F 1- tG42f G 40 ??8??
Contractor's License No. _
Mailing Address ag/ (Camoan^y Name)
3 - 3C-? /d-u? A).9
Authorized Signature IYf?l
(ElpGCrlcal Contrxtor or owner mauln9 rMS InsUllaUOn)
[??`, ,? r? ;{ .?a This impeetion request will not 6e accepted by the
? B??? l?LLJ?GA C'?? ?? State Board unless praper inspection fee is enclosed.
? Mir.nnnuta Smta 3oaru o: :iec[r+ci[v
ix-Griggs ?Nidway Bldg. - Room N197 '
7 University Ave.. St. Paul. Minn. 55104 - Phone 297•2171
REQUEST FOR ELECTRICAL INSPECTION
CHflCSC BELOW WORK COVERED BY THIS REOUEST
Apt. $ldg. ? ? 0
Commercial Bldg. ? ? 0
Industrial Bldg. ? ? ?
Farm 0 ? ?
Other ? ? ?
Chect Appliances Wired
Range ?
Water Heatei ?
Dr3'et ?
Fumaa-7 66lhfe5cg
Au Condiuoner ?
OMPUTEINSPECTION FEE
EB-00001-02 7
-;?Z Cos 9- 7'1
T 43861 I
Temporaty W¢ing ?
Lighting Fixtums ?
Electric Heating ?
Silo UNoadei ?
Bulk Milk TarJc ?
ncmarRS
TLgj? !?O f I e/2S /0, SoF4c TOTALFE aU? .
1, the Electrical tnspector, hereby certif ? the v ms,ecti has been made.
(RougE?? Date
(Finalj Date
This requesEVOi? . , T-
18 months from' ?
O ?9 V 1 O REQUEST FOR ELECTRICAL INSPECTION
? See IM1Structlons far wmpleting this form on back ol yellow copy.
1, - ., ..: "X" Below Work Covered by This Request
.?="•`••°„???
EB-00001-09
e Atid Rep. Type of Building Appliances Wired Equipmeni Wired
Home Range Temporary Service
Du lex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./Industrial Fumace Other (Speci 1
Farm Air Conditloner
OUier (specity) Contraclols Remerks. . ,
j2?.c?-k-wrhr?5 -t?b?i er
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimmin Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200_Am s A6ov.e?iLlO_Am s
$I f13 lnspecrors Use Only: ? TOTAL
Irrigatlon Booms °?
?l ?
S ecial Ins ection v
L
-
?
AlarmlCommunication --
.?-
-..NECTE:D IF NOT
THIS INSTALLATION MAY ngnFR
Other Fee COMPLETED WITHIN 18 MONTXS.
I, the Electrical Inspector, hereby
certify that the above inspection has
been made. Rough-In
'
F?nai ? r" oe?e
i , 021
OFFlCE USE ONLY
This request vaitl 18 months Irom
? ' r
6o Ar 10 ad ` ? U°
Request Data ? (
't /??/.
1 Fire N. Bough-ln In Hon Requlred
(VOU must c inspector en reatly) Inspection Other Tra oughdn
0 Raetly Now ?Will Notify Inspector
- ? ') T ? Yes No Dete Reatl
I&ipensed contractor ?owner hareby requeat inspeclion of above electrical work at:
JoG Atldress (5 et, Box or Roula No )
i3l.v,Tc.c,e-6Y I ? Cily
?
Section No, Township Name or No. Renge No. Coun ,,,.
Oc PaM (PRIN'n ?.^
;? Phone 1??? /? l `
{V?J
4
?+Kc?+?4 ry ? O
Power Sopplier Atltlress
Elecltlcal C vect C ny N e)
L?l k??l? ? ? Contracior's lkense No.
GlqO ?
Mailing /AreCqnM1a r Ownar Meking Iny\?pIlation)
?
?
?
Y?1 C?/ ?? V
/ ' i
Aulhorizetl ' r(C r/Owner Maki Ins n t Phone Number
MINN60TA STATE BOARD bF ELECTHICITf iH15 INSPECTION REQUEST WILL NOT
OriggaMitlway Bltlg. - fioom 8-128 BE ACCEPTED BY THE STATE BOARD
1821 Univerolry Ave., St Paul, MN 35104 UNLESS PflOPER MSPECTION FEE IS
Phone(612)fi42•0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION
II? III I IIII M821 Un e sity AvearRm. SI ? 8city Paul, MN 55104 ???
* 0 2 3 64 7 5 ?*Pnone (siz) saz-oeao ?(o
Home t. Bldg. hfV: -• New Addn
Commercial Indushial Form Remod Re air
Air Cond. Htg. Equip. Water FHr. Load Mgmt. Other.
D er Ran e Elec. Heaf Tem . Service
"k' above ihe work covered by ihis request. Enter remarks in this space and on tbe back of the white copy only.
?1C1 YYY)CJ
Calculore Inspection Fee - This Inspection Request will not be accepfed without the correcf fee:
Olher Fee # Service Emrance Siie Fee # Ciwih/Feeders fee
Mobile Home Park Stoll 0 to 200 Amps 0 to 100 Amps
Sireef L}g./Troffic $ig. Above 200 Amps bove 0 Amps
Transformer/Generotor INSPECTOP'3USEONLY TO? p/ C-
?
?
Sign/Oufline Lig. Xfmr. ?[
V -7
r `,
Alarm/Remote Conirol
Swimming Pool
i here <em that I ins Med the elerniml ?nsk oHOn described hareln on ihe dares -mied
Irrigation Boom Rough-In Daro
Special Inspedion
Inves}igahve Fee
I Fino n Dore
THIS INSTALLATION MAY BE ORDER SCONNE ED IF NOT COMPLETED WITHIN 18 MONTHS.
2^S.? -/? ? C ?
u J OFFIC USE ON/LY- This requestvoid iB months from valldafion date pnnred In lh/is yh?oyx
o?e?/? Y o?/ / G
PLEASE PRINT OR TYPE
as? Da Roogh-in inspecnon reqwmd2 s ? No Inepection Olher Than Rovgh.ln: 0 Reody Now ill Call
?
? (You most coll the Inepeear when ready? Dare Ready:
I,91 icensed ronhactor 0 owner hereby request inspecfion of iFie obove eledriml work of:
Job Pddrtss ShM, Bor, or Roine N.) Ciry Zip Cade
Sedion No, TownxAip Nam<or No. Rang<Na. Fim No. ?C,owryh-' 1y?
Oavponf Phone No.
Pov.er5opplier Address
'ca) ConhvMr (Company Name ense No,
Condmcm
r L
ic Master li<. Na. (Plam EIM. Only)
/
? 1
?
y
" g Pddmsa n?mcror r O.mer Pe omiing Insmllmio
-
F 5407
i
e
r
s4 c ffip
s
?
- 4
PuMorizcd 5' wm (Conkacror or er Pedorming ImmllaNm)
- -C1r_ ? NU.l? Ph No.
`? J 1 lo
EB-OOOOlA-10 6195 U 5 qTEBOAflOCOVY•SEEINSTNUCTIONSONBACKOFYELLOWCOPY
. I a to q CoLi- ? -?
-T
1-3 - ? l
NOTAAil\, IEO?_5?-- E4-CA- v- <,C- Cot , zr-?, (a
CO(-- rL?c_(
t
I?CEc`O- -q .)(,56"7
?
CITY of EAGAN
BUILDING PERMIT
Owner ........... 51XTR$...TI3.EM..HQMES ..........................................
Addrese (rsecens) .......... ox...L5A,..Amainnua,...Minn............
Bulldar .....bfa-thews..Iad..... Inf . ...................................................
Addrass ...PO Box 306? .Northfieldx..Minn .................„
. .
N4 4101
3795 Pilo! Knob Aoad
Eagan, MinnesoYa 55122
454•6100
DaYs ........ QCtOhei...1y...1$Z.fl....
6loriea To Be Uced For Frox! Daplh Heigh! Eel. Coe! PerXnS! Fael Aamuks
155.00
Duplex 72 34 NA 50,000. 25.00 l
This permit doea aof au2horize the use oi sireels, roads, alleys or aidewalks aor doea 4t give the owner or hit agen!
the righf !o ereate anp silvalion which is a auisance or whioh presenla a hasard !o ffie health, safelp, ooaveaience and
ganeral welfare !o anpoae in the eommunifp.
THIS PERMIT MUST HE KEPT ON THE PREMISE WHIL£ THE WOAK IS IN PROGRESS.
Thia is 2o earlify, t6al------------------------ ........................................ has parmission Yo aract a............................................................ _upon
the aboveribeemise supjecY fa the provisions of all app' able Ord ces fo he Ci
............... .-?---- ............. ...................---............. Pes ....... . . ............... ......... r?..Q.. ?.f,?.e?.......................
-- ............
Mayor uildinq Impactor
Bate:
7
Lax 2 ? 9I -I5?s sLOCx
PARCEL & SLCTIOS] PNAIS3ER IF
1
ADDITION /0
.. . .
ADDRFSS OF PARCEL --
700I14G_ OCCUPAPICY USE
ESTIi?1ATED COST ', 7?C? yl rJ d
o?*TIrErc?? TELEPxoNE No. L45 ? -
anoxESS ?o? /S`Y /? tw ?s?..•?•?:? ?< <^-? -
COIITRF1CTOR TELEPfiONE PIO. (+?fS "Zv S??U
Notec Include site plan, building
application
VALU?COjo
SAC
Y7ATER COPTiVECTIOFd
L7ATElt P9ETER
BUILDING PERt4IT FEE
SURCHARGE FEE
PLAP7 CEECK FEE?
?ARK DEDIC21TIO14 FEE
OTfiER
TOTAL*
energy calculations vzith this
??1 ??
pF` ICE USE??
?%
0. °-O_-
APPROVALS:
?BUILDING DEPT. POLICE DEPT
ASSESSMEi\TT CLERK__j2?7
filAiER & SE47ER DEP'F. FIRE DEPT. PARK DEPT
BUILDII?G PERMI2 APPLICATTON
L?
D"e)
ae
?-/ / ' ry g3
a -?
MASTER CAR.D
LOCATION °?? Zq g ?/-, 1
OWNER 3 '-
STRUCTURE AND
LAND USED AS •- 1 ii.L?/ .1?A? la n n n. V/ L/-/ ?7iJ ?/I r
Permit
No.
Issued Issued To
ConiraGtor ? Owne
BUILDING
PLUMBING
? J=T-
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALUNG
SANITARY SEWER
OTHER I
OTHER ? I
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOT I NG SE PTIC
FOUNDATION / . n /5_7G CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL
HE,4TING DEPTH
OF WELI
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUM6ING
WELL
SANITARY SEWER
t' `-
Viola}ions NoTed
on Back
COMMENTS:
i
„A?.
PERMIT erz°?o9'?
CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 2 7 4 S 0
(612) 681-4675 Date Issued: 0 5/ p 6/ 9 6 ,
SITE ADDRESS: '
1360 JURDY RD
LOT: 27 BLOCK: 4
DONNYWOOD
P.I.N.: 20-20960-270-64
DESCRIPTION:
(FIRE DAMAfiE)
101A114401g?%Permit Type SF (MISC.)
?u?.1?di?? 7ype REPAIR pE= GertsCEg.?b434 ALT. RESIDEN7IAL
° Yk ?t
ta?Y &p ?I§ty"exr? 9 sreWg`a+i Ia 01i-01i ? g ?,+a0"
m? ts ?1.,. L?y?i?? ? ?ttv,w111 £a °'u si°Yi 0 ???Vak ?'?W-W a?
ArT
REMARKS:
FEE SUMMARY:
VALUATION $16,000
Base Fee $237.25
Plan Review $118.63
5urcharge $8.00
Total Fee $363.88
CONTRACTOR: -- Rpplicant - ST. LTC.OWNER:
SflMPSON--LIND6REN 17215546 9003129 DAKQTfl COUN7Y HRA •
2228 E 95TH S7 2496 145TW S7 W
MINNEAPOLIS MN 55407 RDSEMQUNT MN 55068
(612) 721-5546 (612)423-8119
? herelay ?ck??swl?c(?s. XJ?aC:,i„ h'?u? read Ythas S ;a.ppSicatiaon and state ttr;?t ,=the
3n*a'rm-at3ott V;i? ee? ?rie? a?rg?e tu?° campIya St?t0er`F PFrk
" =5t?dtUCOS AYf'?`.''ktyr3Y?'?`?#??Il AC4f3[1E7ttce5
- ; ? . . _ , ` . . . ,. . - .. ._ .,. . . ?
lfl RVA ! .?
ISSUED BY: IG TURE
CITY OF EAGAN
jL441o 3830 PILOT KNOB RD - 55122 j3mfl
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Construetion Requirements RemadeVRenair Reauirements
? 3 registered site surveys ? 2 copies of plan
? 2 copies of plans (include beam & wlndow sizes; poured Tnd. design; ete.) ? 2 site surveys (exterior additions & decks)
? 1 energy calculatlons ? 1 energy calculatlons for heated additions
? 3 copies of tree preservatian plan if lot platted after 717193
required: _ Yes No J
DATE: CONSTRUCTION COST:I
f-- ?n _ , _.n
DESCRIPTION OF WORK: ' ? it ° °?-
STREET ADDRESS: o ''¢ l
LOT 91 BIOCK ? SUBD./P.I. . #: ILm??l
PROPERTY Name: D11oiRofA- Phone #:
OWNER Wi? ? I vinar
Street Address? r4 ??S ST lr? ?
City: ?05 c 6>'1 o u-n.?? State: MA-U Zip: 6 C,
coN'rrtacTOR , CompanySk n' S o>\--) L; /? J e7k-) Phone #: 7a ?s ? 7?
Street Addres€??,? License
City: /M? / -.,) State:Al'''N Zip:S ??1O
aRCHI7ECT! Company: Phone #-
ENGINEER
Name: Registration #:
Street Address•
City: State: Zip:
Sewer 8 water licensed plumber:
change are requested once permit is issued.
Penalty applies when address change an,
I hereby acknowiedge that I have read this application and state that the information is correct and agree to com ly wit'
applicabie State of Minnesota Statutes and City of Eagan Ordinances. ?
Signature of Applicant:
OFFICE USE ONLY
Certiflcates of Survey Received _ Yes No
Tree Preservation Plan Received Yes No
L BL
SUBD.
CITY USE ONLY
RECEIPT #: J6j-Ar1`--
DATE: 7 4 9
1996 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
FIXTURES EACH NQ. TOTAL
Shower 3.00 x =
Water Closet 3.00 x =
isaih 1 Uu
Lavatory 3.00 x =
Kitchen Sink 3.00 ;c =
Laundry Tray 3.00 x =
Hot Tub/Spa 3.00 ;c =
Water Heater 3.00 s. Db
Floor Drain 3.00 x =
Gas Pip'ing Outlet ' minimum - t 3.00 :t =
Rough Openings 1.50 x =
Water SoRener 5.00 x =
Private Disposal * Dakote Cty. license 65.00 =
(new and refurbished systems)
U.G. Sprinkler' home under const. 3.00 =
Alterations ' to existing 20.00 =
Water Turn Around 20.00
STATE SURCHARGE .50
TOTAL at 6 • !?D
SITE
OWNER NAME: ,
INSTALLER NAME•
STREET
740 - a74 -e9?f
CITY: 6IwkS? STATE: I? l N ZIP: 55-441)
PHONE #: ((D I ?) rI ??- LI SGI-S~
isaA?6 S+ - N E: .
/I I I, 0001D 1994 MECHANICAL PERMIT (RESIDENTIAL)
/? f? ?- gO?U?' CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681f4675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMTTS ARE REQUIl2ED FOR EACH UNIT.
NEW CONSTRUCTION
ADD-ON A/C
A DD-Or? FUR+:; ? f o i ? c-YL-
FIREPLACE INSERT
DATE I 1~ 6- Gly-
FEES
HVAC: 0-100 M BT'U $ 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS (MINIMLTM 1 @ $3.00 EACH)
ADD-ON/REMODEL (EXISTING CoNSTRUCTION) $ 20.00
STATE SURCHARGE .50
TOTAL av, s?
SITE ADDRESS: ? 3[P`4 J V.-Ira.4 Rd
OWNER
WST.
TELEPHONE #:
2M 3-9IOb
ADDxESS: 440 10,,e.rde. ST
CITI'. 1`_1]! ?LD? STATE: YY7r1 ZIP CODE: 555?1
TELEPHONE #: 4)vA_OoSJr
2-1-S ?
SIGNATURE F PERMITTEE
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