1782 Gold CtCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 1782 Gold Ct
Lot: 22 Block: 6 Addition: Cedar Grove 6th
PID:10- 16705- 220 -06
Use:
Description:
Sub Type: e- Siding
Work Type: Siding
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
New Life Contracting Inc.
2478 Hillwood Dr E
Maplewood MN 55119
(651) 274 -6943
Applicant/Permitee: Signature
PERMIT
City of Eaan
When installing ventilated soffit material, remove existing soffit mate
take steps to ensure maximum ventilation into attic space.
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total:
- Applicant -
Construction Type:
Occupancy:
$90.00
Owner:
Miguel A Ayala
1782 Gold Ct
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$88.50 0801.4085
$1.50 9001.2195
Issued By: Signature
Building
EA087632
12/02/2008
ePermit
al (i.e. debris that could block vent openings) and
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 1782 Gold Ct
Lot: 22 Block: 6 Addition: Cedar Grove 6th
PID:10- 16705- 220 -06
Use:
Description:
Sub Type: e- Siding
Work Type: Siding
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
New Life Contracting Inc.
2478 Hillwood Dr E
Maplewood MN 55119
(651) 274 -6943
Applicant/Permitee: Signature
PERMIT
City of Eaan
When installing ventilated soffit material, remove existing soffit mate
take steps to ensure maximum ventilation into attic space.
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total:
- Applicant -
Construction Type:
Occupancy:
$90.00
Owner:
Miguel A Ayala
1782 Gold Ct
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$88.50 0801.4085
$1.50 9001.2195
Issued By: Signature
Building
EA087689
12/08/2008
ePermit
al (i.e. debris that could block vent openings) and
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
CITY OF EAGAN Remarks Seid 8c Y7tY' pGl"mitS and wtr COT311. pd. Ori 11-14-M
Addition Cedar Grove #b Lot 22 B1k 6 Parcei 10 16705 220 06
owner street 1782 Gold Ct. scate Eagan,m 55122
Improvement Amount Annual Years Payment Receipt Date
STREET SUR F.
STREET RESTOR.
GRADING
d
SAN SEW TRUNK
#SEWER LATERAL 72. O P2?.C3.
WATERMAIN
#WATER LATERAL 9277 20
WATER AREA
#STORM SEW TRK 1970 ZO
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 200OO 1072 11"2 -68
HUILDING PER.
sa,c 200.00 1072 11-20-68
PARK
. ^ . . . -.? ? rw i ,
• CITY OF EA GAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
- PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used for Pt3UL Est. Value $$, (M Date JUmL -27 , 19$9L-
Site Address 1787 Gal.?,_CT
Lot 2 Z Block .6i- Sec/Sub. OFFlC E USE ONLY
ParCel NO. Occupancy FEES
Zoning -
¢ Name !f IGUEL AYAL.A (Actuaq Const _ Bldg. Permit I£10.40
o Addre5s 1 732 u)j,() r'^' (Albwable) -
h
S
City EAGAN Phone 454-7472
#otscories - urc
arge
Plan Review
Length _
p Name U{A'? ?ML X SPA Depth - Ciry
SAC
t ,
?s Address 2D24 SIL.VEY. SEL3- 1FD- s.F.Totai -
SAC, MCWCC
? City RI?GAN Phone 6&01?W60 S.F. Footprints -
Nlater Conn
t-
,
On Site Sewage _
W w Name On Site Weil - Water Meter
AddfeSS MWCCSystem -
A? Deposi'
a W City Phone City Water
S-W Pe
mit
PRV Required _ r
I hereby acknowlege that I have read this application and state that the Booster P+mP - S,W Surcharge
information is correct and agree to comply with all applicable State o(
Minnesota Statutes and Ciry ol Eagan Ordinances. 7reatment PI
Signature of Permitee ' APPROYALS Road Unit
A Building Permit is issued to: r.A(A4 POC)S. dc 3PA Planner - park Ded.
on the express condition that all work shall be done in accordance with all Council
applicable State of Minnesota Statutes and City of Eagan Ordinances. gld9. pff. _ Copies E+.M
Building Official Variance - TOTAL 108a00
Permit No. PermH Holder Date Telephone #
WATER
SEWER
PLUMBING
?.1.?"-?• Y/Jr??T ?C Ge-!Y " LC ??/." ! ? ? O-?
H.V.A.C.
ELECTRIC ? V7'
Inspsction Date Insp. Commants
Footings I S a 7 S- ?
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireptace
Final Htg.
Fnal Plbg.
Const. Meter Plbg. inspector - Notify Plumber
Engr./Plan
Bk1g. Final
Dedc Ftg.
Detk Final
weu
Pr. Disp.
,40 Y7 CITY OF EAGAN
3830 Pilot Knob Road, P.O. 8ox 21-199, Eagan, MN 55121
PHONE:454-8100 ,
BUILDING PERMIT
r., l,o i ico? r,.. POOL
Est.Value $$,000
Receipt #
N4 16719
--?2 U;907
Site Address 1782 GOLD CT
Lot ZZ Block 6 Sec/Sub. CEDAR AROVF. 6TH OFFICE USE ONLY
P8fC01 N0. Occupancy - FEES
Zoning -
w Name MIGUEL AYALA (ACWaI) Const - Bldg. Permit 100.00
o AddreSS 1782 GOLD CT (Allowa6le) - (y
Op
S
h
City EAGAN PhOne 454-7472
hmStories .
urC
arge
-
Plan Review
Length _
?
o Name EAGAN POOL & SPA oepm - sac
cny
,
?a AddreSS 2020 SILVER BELL RD- #20 SFTotal .
-
a
City EAGAN Phone 688-0860
S.F Footpnnts SAC,MCWCC
_
e
s
( Water Conn
R
s
i On Sile Sewage _
?
ww
Name
On Sile Well
- Water Me[er
z? F?ddf05S MWCCSystem -
o? Aca Deposit
aw City Phone citywaier -
-
SW Permit
PRV Requrted -
I hereby acknowlege ihat I have read this apphcation and state that the Booster Pump - SIW Surcharge
information is correct and agree to comply with all app6cable State ot
Minnesota StaWtes and City of Eagan Ordinances. Treatment PI
Signawre of Permitee A APPROVALS Road Umt
A Bwlding Permrt is issuetl toEAGAN POOL & SPA Pianner - park Detl.
on the ezpress condihon ihat all work shall be done in accordance with all Councu -- 4
00
app6cable State of
Minnesota Statutes an
d
City
oi Eagan Ordinances. BIdg.Olf .
_ Copies
.
,
., M
? /
Builtling Olficial /{ ? 1/?li A'ju?j/ I11.l1 Variance - TOTAL 108.00
EAGAN TOWNSHIP
BUILDING PERMIT
Ownex '-- u--?-.?.- .... ......... 4.,
..........-- - .. . . _'------...... ----- --....-.__ ..._'-.'
- .... ....
Address (Preseat) --...... ..._.??: ........ !l.:-°..-...............'.
Suilder °. '---.?-:°-"`-
Address .... ....................... ............................... ....................... ..........
N° 188'7
Eagan Township
Town Hall
ne:e _..,[..............
Siories To Se Used Foz Fzoni Depfh Heighi Esi. Cos! Permii Fee Aemarks
„4-? ? X,. AW
_ ?
LOCATION ?Wa.D da+_e<=r ("-y'fya iC,rs-' eP
? Stree}, Road or oiher Deacripfion of Localion I Lo! Block Addiiion or Trac!
?->7-Y3 ?f7- 1-sa-
11--1-L-77 d3-PAq? Y ?
This petmit dces nof aulhorize the use of sireels, roads, alleys or sftewalks ndr does if give the owner or his sgeni
the righf fo creale anp sifualion whieh is a nuisance or which presenfs a hazard to the healih, safety, eonvenienee and
qenesal welfare !o anyone in the communify.
THIS PEAMIT MUST BE KEPT ON THE PREMIS£ WFIILE TFIE WORK IS IN PROGAESS.
This ia !o aerliSY, ihaf ..... f--------_...._ . ? . i
C . _has permucion fo erect a._..A -A---.- ' ? - - ? .upon
__... ........?::c?r. ......_.? ... ... ...
the ebote deseribed premise cubjecf !o the provisions of the Suilding Ordinance for Eagan TownsMp adopied April 11,
1955.
?J
^- " ...........
'----'--...- ---'. ....-z:?'-°... . ..................--..... Per ........-------.
..... ....... :f.? ..?..r.?.....................
.
Chlfrman of Tnwn Board Building Itis ecior
C 6
So..?o
Clty of Eapn
3830 Pilot Knob Road
Eagan MN 55722
Phone: (651) 675-5675
Fax:(657)675-5694
--------------
; ?- I
I Permit s: ? 6lJJ?-/ i
I
? Pertnit Fee:
? Date Received I
I Stafl:
---------------
2008 MECHANICAL PERMiT APPLICATION
Date: _ ? 261'0 Site Address:
7enant•
?..:._ ..
RESIDENT/OWNER Name: _M?9llEL- it 1/qL?{ Phone:GS/-zlSS?-7?{7?
Address / City/ Zip: 17P?o? Ko[_K) C%
CONTRACTOR Nam?_av_c? License #: ? LS _?ig$3L{(?'?
Address:/ loy Ueoe,7j,ti,?u S7-
City: 14<f -3 rt oV y 5 State: A?j Zip:
Phone: 6 Ll- q37-yf 71 Contact Person: L) 4F.N Q),4 ?4-
TYPE OP WORK ^ New KReplacement _ Additiona4 _ Alteration _ pemoliNon
Descriptlon of work: /CL ,OL?q-c K?re„?rxC E?C-5? b£xyi ?L
_ _
, ., h .,. : • .' i. ,. ,K .'y• ? ' '?fl'?a.,???i??? . . ..
. ' ? _._ . .,. ? . . .
"
3t?E'?e
'
'
?
' ?
, . c?rr??
? rdCalY??s
!ne ?f
e?na Rr?s4ir vr. olie t?'Itr?
,'
r'
.
?s.ti?jY?i?fot?tTan ot? prmltted seree ie ,rr4e#trods.
PERMIT TYPE RESlDENTIAL
X COMMERCIAL
New C
t
i
_ Fumace
? ons
ruct
on _ interior Improvement
Alr Condiboner Install Piping _ processed
Air Ezchanger _ Gas Exterior HVAC Unit
_ Heat Pump ' HVAC units must be screened
Under / Above ground Tank (_ Install / Remove)
_ Other " When installing/removing Iank(s), call for inspedion by Fire
Marshal and Plumbin Ins ctor
RESlDENTlAL FEES:
$50.50 M!nlmum Add-on or alteration to an zxisting unit (includes $.50 State Surcnarge)
$90.50 Fire repair (replace bumed out appliances, ducMroik, etc.) (includes $.50 Staie Surcharge)
$ sb 'S? TOTAL FEE
COMMERClAL FEES:
$70.50 Underground tank installationiremoval OR Contract value $ x 1%
$50.50 M(nimum (includes State Surcharge)
- If Pertntt Fgg is less than $1,000, surcharge is $.50. Permft Fee
,.
,- It Peimit En is >$7,000, surcharge increases by $.50 tor each =$ State Surcherge
$1 000 Psrmil Pee (i.e. a $1,001-$2,000 Permit Fee reGwres a $1.00 surchaige),
$ TOTAL FEE
IA.....F....nLn....1????._...._
--., --°°--•--y -a. ????, .• ??.???o????? ', '? ...a,,,, acw?nie: mat me worrc wni oe in comormance wnn tne oramances antl cotles ol the Ciry ol Eagan; Ihat
I untleretand Ihis is nol a pertniL 6u1 only an apphcatian for a permit, arW work rs not to starl wilhout a permil; [hal Ihe work will be in accortlance with ihe approved
pian m Ihe cast ot work which requires a review and approva7 0f plans.
?Yu E ffz, «,e /Jr?4 7- 1 iVS 9? /?-
x /?ti Kf.vc?ss?-u- x
ApplicanYs Prinled Name ApplicanYs Signature
FQFhOFFICEUSE qeviewed By: date:
HequiredInspecttonsc ?thider Groupd _ q,oqgh;lh _aic l;est _Gas Servise Test In,floor Heat Final
RESIDENTIAL
jIn BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681•4675
New Conatruction Reauirementa
• 3 regatered sde surveys shovnng sq. fl. of lot sq. R. of house; and all roofed areas
(20% maximum lot cove2ge allowed)
• 2 copies o( plan showirg beam & window sizes; poured found design, etc.)
• 1 sel of Ener9y Calculatians
• 3 copies of Tree Preservation %an i( lat platted after 711/93
• Rim Joisl Detail Opbons seleclion sheet (bldgs wAh 3 or less wi4s)
DATE // Llvle2_
?
• Residential Ventilation Category t Worksheet Submitted
• Energy Envelope Calculalions Submitted
SITE ADDRESS `7<8Q Go I d GOurfi MULTI-FAMILY BLDG _ Y _ N
TYPE OF WO
Water So&ener
Water Heater
No. of Baths
\ ?
?pef vU
APPIICANT M;dv)e5t 1? M
STREETADDRESS CITY OWn.Sti'Ile STATE/WZIP SS?37
TELEPHONE # 9?-?,fX'a(nCX? CELL PHONE #?/2 "?' 9y6 Y FAX #??'?y6?G77 !
PROPERTYOWNER MN4,Ke!` AVG`Gl- TELEPHONE# (o 5 7`1702
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATGGORY l MINVESOTA RULES 7672
(J submission type)
Plumbing Contractor:
PlumUing system includes:
Mechanical Contractor:
Mechviical system includes:
Sewer/Water Contractor:
_ Air Condilioning
? Hcat Recovery System
Phone #
Phone #
Fee: $90.00
- Pce: $70.00
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances. z-, ?,, ,
Signafure of Applicant
OFFICE USE ONLY
RemadeVRewir Reauiremanfs
• 2 copies of plan
• 1 set of Energy Calculadons for heated additbns
• 1 site suroey for extenoradditions 8 decks
. Indicate rf home served 6y septic system for additions
VALUATION
fIREPLACE(S) _ 0 _ 1 _ 2
• New Energy Code Worksheet Submitted
Phone #
_ Lawn Sprinklcr
_ No. oFR.I. Baths
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
?- ,
1989 89ILDIPG YERMTT APPLIC?TION
CTTY OF EAGAN
1 ? l1q
SINGLE FAMILY DiJELLIPGS
lAfLTIPLE DiiELLINGS
?
COlSERCIAL
2 SETS OF PLANS 2 3ET3 OF PLAN3 2 SETS OF IRCHISECTURAL
3 BfiGISTERED STTE &DR9€YS BEGISTfiRED 3IlE 3!)R9ES3 - 6 STEOCfOAAL PLANS
i SET OF ENERGY CALC3. (CHECH iiITH SLDG DIV.) 1 SSf OF $PECIFICATIONS
/ SET dF F.6EHG2 C1LC3. 1 88T OF ENERGI CALCS.
MTLTIPLE DNELLINGS RENTAL DNIT3 F0R SILE DHIT3 iOF uBITS
';OTEs IDDRES3E5 FOH WRNER LOTS - COATAACTOR/SOI'EOiiNER MOST DERIGNAlE YSICH iDDRFSS
IS DFSIRED. Ii0 CHANGFS iiILL BE ALt,OWED ONCE BDILDIIiG PEAMIT 13 I33USD..
SEWER 8 NATER PERMIT FSfS i11D ACCODNT DEP03IT FBES iIILL BE INCLQDED iTSTH THE HDILDINO
PERMIT £EE. PBDCFSSING TIIM FOA SEWER lAD 1iAT6A PfiRtiTfS IS TWO DAYS ONCE l PEAMIT 915
HEEIi GUMPLETED INDIC9TING A LICEASED PLOFID68.
PENALTY APPLIFS WHENt PERMIT IS NOT PAID FOR IN SAME MONTH IT IS REQUESTED.
LOT CEiANGE IS R£QOESTED ONCE PERMIT IS ISSUED.
To Be Used For e?'??/?,? ?lyaluationciz? Date:
Site Address
Lot 2 2. Block 6
Parcel/5ub CtMA 6RO(lE 67H .QD17Pl.
Oxner Iy?6uEG /kY ffZ-A-
lddress 179-2- 6L'?LZ;>
City/Zip Gode iFAKi?l(% /f/Y j55?'«?
Phone qSt/' 7 ¢-7j?
Contractor 82?6- fI-tj/ P u'.LK-S:64
Address 1-e-2G 9&-ZCRP?
CitylZ3p Code ?-IEI-Lf? lfl? SSI >-, .
Phone G
lrch. /Engr .
Occupaney
Zoning
Aetual Const
Allowable
# of stor3es
Length
Depth
S.F. Total
Footprint S.F.
C:-
On site aexage
Qn aite xell _
MwCC System _
City r?ater _
PRV required _
Booster Pump _
APPRDQAL3
Planner _ Council ?
Bldg. Off. bl2D
9ariance
f'EES
Sldg. PermiL 100•00
Sureharge t4.4nD
Plan Aeview
SAC, Citq
SACO MWCC
Water Conn
Water Meter ?
Seet. Deposit
S/Yi Permit
S/1i Surcharge
Treatmeat P1.
Aoad Unit
park Ded.
Copies ,00
SUB?OTAL
Penaltq
?OTAL
lddress
CltqlZip Code
?.
Phone 0
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? PcRoPOSED 12000 Gqctpqr
? /A16ROtAidD Ft?OL ?
, z ------------ -. --- -- - -- - -
EAGFN TOWNSHIP
3795 PiloC Knob Road
St. Paul, ,finnesota 55111
Telephone 454-5242 ,
PERFIIT FOR WATER SERVICE CONNECTION ?
Date• Number• 1 58 ?
??
Billing Name: SiCe Address.2- .,-6
?
Owner:l?? ldn.c0? (.,?? Billing Addresa
Plumber• ?.d('p??L' ?.?cG-• i
Location of Coaaection Meter Siz " Connection Chga ,---'??-{' ;
Meter No. Permit Fee 7•50
?
! Meter Reading!°+S Meter Dep. I
' Meter Sealed: Yes Add'1 Chg, i
NO Total Chg.
Inspected by
Date ?
i
Building is a: Remarks: ;
Residence_j ?
?
Multipie No, Units
, Commercial
Iadustrial By:
' Chief Inspector
i Other
i
In consideratioa of the issue and delivery to me af the above permit, I
hereby agree to do ttie proposed work in accordance with the rules and
regulatioas of Eagaa Towaship, Dakota County Minnesot?
$y:
Pleaue aotify the above office when ready for incpection aad conaection.
i
t-j
P.P.Gl.N 'TOWNSH?P
:795 Pilot Ynoh P.cad
St. Paul, 34innesota 55111
Telephone 454-5242
PERMIT_ P'OR SE47ER SERVlCE CONNECTIOPI
DATE: NUMBER 271
Oi7NERUIALs . .(0 F.ddress?-6 "'(? ?7Y,2 Azz eo?all
PL'JMBEit TYPE OF PIPE
DBSCRIPTION OF BUILDING
Industriall Coumerciall Residential I 14ultiple Dwellingl No. of uaits
Location of Conaections:
??1
Connectioa Charge .=2 --A.
Permit Fee 7.50
Street Repairs
Total
Inspected by:
Date
Remarks•
By. Chief Inspector
In consideration of the issue and delivery to me of the above pezmit, I
hereby agree Co do the proposed work in accordance with the rules aad
regulations of Eagan Tor7nship, Dakota County, MinnesoCa
By 1Ji v ?ZC/.
Please notify when ready for inspection and connection and before any portioa
of the crork is covered.
1
-cily of eagan
MEMO
TO: DIANE DOWNS, UTILITY BILLING CLERlC
FROM: ED KfRSCHT, SR. ENGINEERING TECH
DATE: AUGUST 25, 1993
SUBJECT: STREETLIGHT ENERGY COSTS
CEDAR GROVE tJO. 6(141 LOTS)
This memo is to inform your department to begin to invoice the energy costs at the single
family rate effective August 1, 1993 to the property owners in Cedar Grove No. 6 Addition
as listed below:
Block 1, Lots 1 1
Block 2, Lots 1-8 8
Block 3, Lots 1-18 1$
Block 4, Lots 1 -11 11
Block 5, Lots 1-9 9
Block 6, Lots 1-53 53
(Lots 54 through 61, Block 6, should not
be bilfed at this time)
Block 7, Lots 1-12 12
Block 8, Lots 1-18 18
Block 9, Lots 1-11 ?
TOTAL 141
The City is currerrtly being billed by Dakota Eleccric tor streetlighting in the above listed
subdivision.
Ed Kirscht 1
Sr. Engineering Tech
cc: Mike Foerisch, Asst. Cfty Eng.
EK/je
----------i
i ??rT:ot?ce?se i
? Permit#: ? ? ? ? I
I Pertnit Fee: ?
I ?
I
I Date Received: ?
I ?
? Staff: ?
I I
2009 RESIDENTIAL BUILDI
Date: 7 ? ? ? Site Address: ?
Tenant
RESIDENT / OWNER Name: c- / f ' ' '
Address / City / ip: ? 7 g ( "Id
Applicant is: _ Owner _ oniractor
TYPE OF WORK Description ofwork: JA/l /Y'/ riuL_.
Construction Cost: / C7tl__
Suite #:
Phone: 6,5-1 ? ys`1 -7 y?
Multi-Family Building: (Yes _ I No
CONTRACTOR Name License#: ';?O
9ZD
Addtess: / 7 ' i ? vw
City: I ! ?State: N Zip: ?
Phone: ID7 / ?30 ~?V?& Contact Person: / F-A/ '9"-1 7V
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 _ Minnesota Rules 7672
Energy Code • Residential Ventilatwn Category 1 Worksheet • New Energy Code Worksheet
Category Su6mitted Submitted
(4 submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Phone:
Mechanical Contractor:
Sewer & Water Contractor: Phone:
NOTE: Plans and suppoRing doeuments fhaf`you submit are considered to be public information. Portions of:
ihe information may be classified as non-pubfic if you provide specific reasons lhaf woufd permit ihe Cify to
sn?.
conclude that the are trade secrets.: _ " = !
?.A:nnnnnc enA flfAPC M1f }hP riltV 01
I here6y acknowledge that this information is wmplete antl accurate, mat me wuiM1 w??? ?? ", ....,...,,,•..•--- ----- -
Eagan, that I understand this is not a permit, but only an application for a permd, and work is not to start without a permR; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
gna e
ApplicanYs Printed Name APP? i Page 1 of 3
G PERMIT APPLICATION
&/dd '?l `7 g.--PylY
r. 2 9 43 -'??
Request Date
? F?re No Roug m Inspecban
ired?
? Reatly Now ? W II Noby Inspeclor
1
C?" `? ?? s ? No When Ready'+
)6icensed contractor ? owner hereby request inspection of above electrical work at:
Job AdEress (Streei, Box w Pou[e No )
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SecM1On No, Township Name or No Range No ?, 1_A
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Power Suppier AGtlrew
Ele n I Conlrador (
rn y Name
c? ?? ConVaqOr§ License No.
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Ma??AAds ?ConVado=or Owner Ma g Inst tt n)
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ANhorize Si nal ontraciw/Owner Meking Instellatio Phone Number ^
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MINNESOTA 5?([i BOAND DF ELECTFiICffY THIS INSPECTION PECUEST WILL NOT
Grigga-Mitlway B 8- po,oa^ 51M eE ACCEPTED BV THE STATE BOARD
1827 UnlvxaHy Ave., M. Paul, MN 65106 IINLESS PHOPER INSPECTION FEE IS
PIroM (612) 692-OB00 ENCLOSED )
&/aa/e?
P ; 2943
REQUEST FOR ELECTRICAL INSPECTION
? See iris[ructionlf tor completing Ihis torm on back of yellow wpy
X' Below Woik Covered by This Request
r E&W001-0]
e Add Rep. Type of Building AppliancesWired EquipmeniWired
Home Range Temporary Service
Duplex Water Heater Elec[ric Heahng
Apt. 8uilding Dryer Other (Specify)
Comm./Indusirial Furnace
Fartn Air Cond"Rioner
aner (sPersM) Contrecbr5 RemarkaCompute Inspection Fee Below:
# Other Fee # ServiceEntrariceSize Fee # CiraiislFeetlers Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transfortners Above 200 _ Amps Above 100 _ Amps
SIgfIS Inspedor5 Use Oniy TOTAL ?
Irngation Booms ??
Special Inspection
Alarm/Communication
Other Fee
I, the Electrical Inspector, hereby
Roueh-in
C? ?
certi(y that the above inspection has
been made. Flnel
/o7
? -07
OFFICE USE ONLY ?
This request witl 18 months irom
`?/?• 3/s? i 9 ?/? ?
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flequesY Oate Fua No Fough-in Inspeclqn
Repwretl'+
I
Ready Now ? WIII Notity InSpBClor
- ' ? Yes ? No When qeady?
I fXlicensed contractor ? owner here6y request inspection of above electrical work at:
7?
Job Atltlress (Streat, Bw or R Na)
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.___.:on No Township Name or No. Rarge No Co ?
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OccuP nt IPFII 'Ue, 1 ? ?lV` Phq NoIZ
Power Supplier Mtlress
E?Incal onbactor 'CoME eme)
C ' CoNractot5 LJ? ?.
Matling dtlress (Contractor or Owner Maki talla0o
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`J T;
AN nz S" (COMr rtOWer aking InstellaHOn) Phore Nbe
umr
lLNNE80 TATE BOAXD OF ELEGTRICffV THIS INSPECTION REOUEST WILL NOT
GrlggsM y Bltlg. - Haan &113 BE ACCEPTED BY THE STATE BOARD
1021 UnHasLLy Ave., SL Poul, MN 56100 UNLESS PROFER INSPECTION FEE IS
Phom (812) 842-0800 ENCLOSED.
REOUEST FOR ELECTRICAL INSPECTION
?r Q?rn ? See insVUCqonstoOCEAiple4ng this form on Eeck of yellow copy.
p ^ //^Q'lI 1 "X" Relnw Wnrk ('nverad hv This Rvnuosi
EB-00001-0]
0 y?? s
ew Atld Rep. v TypeofBuilding AppliancesWired EquipmentWiretl
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (SpecAy)
Comm./Industnal Fumace
Farm Air CondRioner
OMer (speeily) Contractor!a Remarks-
Compute Inspection Fee Be/ow:
# O[her Fee ServiceEnVanceSize , Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps to 100 Amps
Transiormers Above 200 _ Amps A 1 Amps
Signs Inspeclork Use Only TOTAL
Irrigation Booms
Spetial Inspection ?
Alarm/Communication
Other Fee '
I, the Electrical Inspector, here6y
h
if
h
b
i Rough-in
/ oaie >^ 7?q
r r
ove
cert
y t
att
e a
nspection has
been made.
./'_L1?,
OFFICE USE ONLY
This request vaitl 18 rtwnlhs Irom
I For office Use
Permit
City of Eapfl
I Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Staff:
Fax: (651) 675-5694
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
6-1/6)
Date: Y-?21 Site Address:
Suite
Tenant:
RESIDENT I OWNER Name: ' G Phone:
Address / City / ip:
Applicant is: Owner ontractor
TYPE OF WORK Description of work: JAI] lo) Cost: Multi-Family Building: (Yes / No
Construction )
CONTRACTOR Name: AA.1-vu 115 License p2djOJ~' .~aQ 9
Address: 7
City: G/~ State: Zip:
Phone: a25 ! i'k ~~~P' Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
('I submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
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.
X
Applicant's Printed Name Appl rgna a Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA113341
Date Issued:09/03/2013
Permit Category:ePermit
Site Address: 1782 Gold Ct
Lot:22 Block: 6 Addition: Cedar Grove 6th
PID:10-16705-06-220
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Reinaldo Cintron
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Miguel A Ayala
1782 Gold Ct
Eagan MN 55122
Ralow's Roofing
4351 Parklawn Ave.
Suite 108E
Edina MN 55432
(952) 210-4988
Applicant/Permitee: Signature Issued By: Signature