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2849 Lexington AveINSPECTION RECORD . CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: I (612) 681-4675 I SITE ADDRESS: APPLICANT: .s 13 i.',4.t; , 7 b 1 sitt-, ? t:, ! PIt, I l~ri T,I'.,, r i' ? 1?• ?.?{ r.? i E4rrr , r?l; s, PERMIT SUBTYPE: TYPE 4F WORK: J11I4 N,??. ?I)tlMi 11V????1 rt 1 .1 ut, INSPECTION . . ??t. .• DA • ? • i'?. . Ir' , ! ? DA 1t#14likKS+ ASUt-'ANATt: PF_I:plt! Is; kit_Q1,11WEtP uOR ANY H.1Mti1NIt 01? I:I.r, tI?1'7ql G.IiiFrE Permit No. Permit Hoider Oate Telephone 0 ELECTRIC PLUMBING HVAC Inspectlon Date Insp. Camments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GRS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAI HTG QRSAT TEST BLDG FiNAL ?r1 v BSMT R.I. BSMT FINAL DECK FTG OECK FINAL INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (612) 681-4675 ' SITE ADDRESS: APPLICANT: i! . 1 i'Jl; t urJ fii!i: ' , , ' PERMIT SUBTYPE: i I I TYPE OF WORK: t?f" ',1 P 1 P I 1 11 N r;r?•A I V If;nuFlNri1 Et? tli ?fiF?yql? ? ,? ?t:" ??"'?}y PermR No. PermR Holder Date Telephone 11 S!W PLUMBING HVAC ELECTRIC ELECTRIC Inspectfon Date Inap. Comments Footings I Foundation Framing Rooflng Rough PI6g. Rough Htg. Isul. Fireplace Final Htg. Orsat Test Flnal Plbg. Pibg. Inspeclor - Notify Plumber Const. Meter Engr./Plan Bldg. Final Deck Ftg. DeCk Finel wen Pr. Disp. _:.i,;.1. ,,k .`,,_.. GTYOFEAGAN Rema?I?dl/&?CS • ;: 0 Addition Secti.on 3 Lot 3 Rlk 7? Parcel 10 00300 030 715 street 2$49 So. LexLngto11 5tate_ Ea,gan,MN 55121 Owner Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 1968 115. 3.85 30 51.75 AOIO 28 2-24-82 SEWER LATERAL ' WATEfiMAIN J`I WATER LATERAL WATER AREA ,.N, 1977 11 . O 3 0.77 ? STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK I I EAGAIiI TOiNNS F°I I P Ne 232 I Ownex '-- dJBLDt?IG i?ERidll'f --...----_.-'--- yY. Address (Presenf) -?---?'... ?---?-- - -----..-=i.._?..... Builder ...._------ ------------------------------------------------ .------ __ Address ..... .----------------------- ------------- --..------ -------- ------- -----------'-`-- DESCAIPTION l Eagan Township Town Hall Dafe .°`.. .7....`!!.?.? SYreel. Rd d or lher Descripiion of Localion I Lo! Block aaainon or rracx 1'his pezmif does not aulhorize use of slreels, roads, alleps or sidewalks nor does it give the owner or his agenk the right fo e:eafe any situation w ch is a nuissnce or whieh presenis a hasard io the healih, safefy, eonvenience and general welfare !o anpone in the communify. THIS PERMIT MUST BI{FR ON T E PREM SE WHILE THE WORK IS IN PROGAESS. This is io ceriifp, ihaf.._----!,(.J ...... .........-------- ......._'.._..._.... has permission to esee3 a........_..._.._......_..........._....'.._......._._...upon the above described premise jee! !o the provisions of ihe Building rdinance for Eaga ownship adopYed April 11, 1955. V?????V `?\V M --."----....--------- -----........------...-----'-----_.____ Per ..?...Y...--_'1. -_'- ? - ?- --.....--?-----'---`-"'---°- Chairman of Town Board 8ui1 'ng Inspecior ? i ,. '7%s07 2007RESIDENTIAL BUILDING rERMIT arrLicnTioN City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Naw Construction Reaui2menls 3 registered site surveys shaxing sq. ft. of lot, sq. ft of house; and all roofed areas (20°h maximum lot coveraqe ailaved) 1 Soils Reporl dpraposed building is to be placed on disturbetl soil 2 copies of plan show(ing beam 8 window sizes; poured found design, etc. 1 set of Energy Calculations 3 copies of Tree Preservation Plan "rf lot platted afler 711/93 Rim Jaist Dehii Ophans selectian sheet (bmldings with 3 or less uniLS) Minnegasco mechanipl venfilation form 130. t,?-v RemodeNteoair Reauiremenls Office Use Onlv 2 mpies of plan showing tootirigs, beams, joisLS Cert of Survey Recd _Y _ N 1 set of Energy Calculations for heatetl additlons Soils Report _ Y_ N 1 site survey foraddifions & decks Tree Pres Plan Reed Y N AddNOn - indicate if on-site sepL'c system Tree Pres Required Y N On-sde Septic Sjstem _Y _ N Plans are considered ublic information unless ou state the are traet and the ?ason. nace i?.o i2s-X,)7 coosvuctioo cost '? 30 CC) Site Address Zf 11 e7 L ?TDN AvC . 5 . UniUSte # Description of Work 4.) 14LE L G?1(k,-/- {L/ki^'tP. Multi-Family Bldg _ YIX N FirCpiace(s) _ 0 _ 1 _ 2 Property Owner 71N? d- AICLSSA f'?-ts IWN Telephone # (6 (L ) 3 S'L S 7 Contractor HOM+Ct3is E ?Ktb t-wS 1 ?l-/? C Address 3$9 3 C?t-E State o-i ?4 p/L, Zip $C l ZZ CiTy C!A5 J Telephone #(6i1 ) 7/Y• OrtS yf COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category . Residential Venhlatlon Category 1 Worksheet • New Energy Code Worksheet (Jsubmissiontype) Submitted Submitted • Energy Envelope Calculations Submiqed In the lasT 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan8 _ Y _ N If yes, date and address of master plan: Licensed Plumber '[EII II Telephone #( Mechanical Contractor JUN 2 1 2007 Telephone #( Sewer/Water Contractor 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 e of work which requires a review and approval of plans. , fLuSS C?,NO C3?a1?T Applicant's Printed Name A plican s Signature DO NOT WRITE BELOW THIS LINE Sub Tvpes ? 01 Foundation ? 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 03-plex ? 06 04-plex Work Tvpes ? 31 New ? 32 Addition ? 33 Alteration ? 34 Replacement ..- ] . ? ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt • Multi ? 09 07-plex 0 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 EM. Alt - SF ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebolpergola) ? 36 Multi Misc. ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage 0 12 12-plex ? 25 Miscellaneous ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 37 Demolish Building' ? 43 Reroof ? 48 WindowslDoors 'Demolition (Entire Bldg) • Give PCA handout to applicant D@SCrIDtl011: WaterDamage_Yes Valuation Plan Review _ 100% or _ 25% Census Code SAC Units # of Units # of Bldgs Type of Const Y 13 Occupancy p -3 MCES System Code Edition TRC -Acbo Zoning $ 7? City Water Stories Booster Pump Sq. Ft. PRV Length Fire Sprinklered W idth _ Footings (new hldg) ? Footings (deck) _ Footings (addition) _ Fo.mdation _ Drain Tile Roof _ Ice & Water Final 1? Framing _ Fireplace _ R.I. _ Air Tes[ _ Final Insulation Approved By: ? , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total REQUIREDIN5PECTIONS _ Sheetrock FinaUC.O. Y_ FinaUNo C.O. HVAC Other _ Pool Ftgs Air/Gas Tests Final _ Siding _ Stucco Lath _ Stone Lath _Brick _ Windows _ Retaining Wall Bohn yVell Drilling Co. 16550 Baseline Avenue Shakopee, MN 55379 952-445-4809 Gary M. Sohn Lrc. #1043 ^y ? ,/ o!! Date: ?. ? ?0++l2.? } ..,,., ; 5v.- .. , f= $-0 9 ? ?._A o. ??. )V. /a? 3 x ? ? , ?deaK ;? : • . '•• 'E I • . . . y r• ? h'v /j dc ; ur c ? F ? . . ?...__i ? . ? : . . ? y .. - . 4r??._....:._, i ; __,.r. ..._.,.. „_., i . , ? " .. . -... . , > ; • . .. , .. , ;./Oa-P aielY ..,. ,.., .._ .. ? • '"" . . ; , _se.. . ? .. . . , . , ? , ERaGAN ? 10R1S bmelam D?sifodD9NG INSPEC7 • • ? 0 100 200 i ? , ; ? i? I - , , j ? i ' ; i , ; ;? i . S7ATEOFMNJ % i / . / ` / / / n ? i / ' . aom? ma?s i . / . W6?75 a700 i 7048 186.03 ? ? ? ? ..J lLOUp?? _ Q .z+czc---- - ,? 7824 ?... 2449 ? - % / i „ 442.18 ,- 02[N8 ?: : .. ?. 1875 Feet N ; i ,. ; ? --- ?-- -- -- _,?? . I ? ? ? . 14,3- _.... 15500 ? -. -- '- I ' i - -? iss o0 ?- --- ? ; - ??I._ '__""f5540 ? i . ; 14 nNU9t] 15500 ?I ?rohui_'?5 g = -- issro ?,ssm . _ R ? ---- _44 iss.ao .`-- ? tss ao -- - I ?-- 8 '-. `smn° ? 8 I ? ? f7r'k ?' ' 13 'T c ' _ dpOp - tln?k ,:14 ` , , ? _ ....Y3000 ( i _- ?_ L i j1 o f ? o SCRIe :v 777& 1 2007 RESIDENTIAL PLUMBING PeRnniT aPPUCATioN CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please com lete for modifications to existin residential dwellin s. /iq . 5b Date 05 I II / 20c>`7 Site Street Address aW LeiIhAoY1 !?"VG• 5. ?il??qh Unit# PropertyOwner 'Af 0 4 1?ehy5u- ?N"f-bn Telephone# (bIZ ) ?1152-' !q3? Contractor r%'ohn N(CII bYilIinqLO. Telephone# (`?0Z) `f45^ +001 Address ??01°I_0 DAlvr , 5Fr.i01 , City JDvdGtVl State Mr.l Zip 6r2-??F? The Applicant is: _ Owner & Occupant ? Licensed Wuinbeng Contrector Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee $ 100.00 Per as-built $ 10.00 Fire Repair (replace burned out fixtures, etc.) $ 90.00 This fee a lies when extensive lumbin re airs are made to a buildin . Alterations to existing dwelling $ 50.00 _ Add plumbing fixtures to main level lower level. This fee includes installation of a water softener and/or water heater at the same time. If you are installing onlv a water sokener and/or water heater, do not complete this section; move to the neut section and place a checkmark next to the appliance(s?oIS t? installing. ?U1 ? n?7 ? D [E ?? _Septic System Abandonment MAY 4 2007 _Water Turnaround (add $736.00 if a 5/8" meter is required) Other: Water Softener Water Heater $ 15.00 _ new _ replacement Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00 SWte Surcharge $ 50 Total $ 110.50 I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, 6ut only an application for a permit, work is not to start without a permit and work will be in accordance with the approved plan in the event a plan is required to be reviewed and approved. !?ak? 1N1. ibohn. Appli nt's Printed Name ? -A?Lvie'('l Applican s Si ture iiriDIVIDUAL SEWAGE SYSTEM AS-BUILT Date mstalled s 3WPermit No,4rJQ771(9 Owner: r l7lrv ProjectAddress r3rP?".F CJa1.it0 f0 n.A vGS House Type: I I III Property ID No.(PIN) (Dak Co Tax Info l -438-4576, or www.co.dakota.mn.us) Cit /Twp? ?i'1. Installed for?Bdrms or ?? gal/da Commercial Use? Y! NewReplace ?Repair ?Addition Property Transfer U grade? Y? Bsmt Lift Pump? YIFuture? Y,?N Jacuzzi? Y?Garb Disp? Y Soil Survey Map Unit -" Soil Compacted?Y,Q Fill Soil? YQ N Circle Soil Texture: (Faster than 0.1 mpi) Coarse Sand Medium Sand ti 4- -W r Sm p .d v^ rd . L Sand 0.83 FINE D 17 San y oam 127 Loam 1.67 Silt Loam, Silt 2.00 Sandy Clay Loam 22 Silty Clay Loam Clay Loam Silty Clay, Clay 4 2 (Slower than 120 mpi) Soil dry enougiZ tor conshuction? l N : Pr ? ?.`?Q' SETBACKS op.Lines 10'? i + Bldgs 10' to Tank? & 20' to Dmfld Well(s) setback? ( )not installed yet Well DepthXA ( )Orig. Well Record ( )Measured ` Distance to Lake -Creek "- Wetland Buried Water Pressure Lines 10' to Tank & Drnfld? System located by Photos? Y GPS? Y/ J? SEPTIC / HOLDING TANK? g New ? Existing Liquid Capacit 1 compartment or 2? Made by Watertight??f ' N Baffle Type: astic Fiberglass Sanitary-T Concrete No. of Inspection ipesf_ 4" ' di2 Tank Level/ N No./Diam. Manhole Access Inyet / Outlet ! enter No. & Height of Manhole Risers d1X 8 New Tanks 4 ft or less below Final Grade Y Pipes into Tank Sealed? with h4oud? Y N Riser into Tank Base Sealed? wit N Outlet Effluent Filter? / N Type MOUND / ATGRA E: Percent Slope_% Scarification Method: Di Width Up Down Side_ Clea ock? Y/ N Depth Below Pipe inches Clean San _Y / N Depth UpslopeDownslope_" Inches to Mottling_'Pipe Size/Spacing Perf Size/Spacing ? Final Cover Depth " Rock Bed Size Supplier: Sand Base Size Supplier: Upslope needing dradiversion. N Provided? Y/ N Gr ?ng done: Roug / F?na ? ' ( Seeding ()Sod to one by: /)M( ?? L,?,e4 ?? 1? I hereby certify, as installer, that this indiJ?dual sewage treatment system was installed according to the approved design, and as applicable, this Municipality's Sewage Treatment System Ordmance, & accurately locates al/ system componenfs forlater relocafion. Installer { _ - , 1 / 1: ? L- ?' P?t;u ? i? ? el f` t?5`'lbe d Line drawn from Tanks t Pump Truck Access < 100'?? N RESERVE AREA? Y/ Fenced Off? Y Owner informed to pres rve Reserve Area? Owner given S_e ?tic System Owner Guide? Y TRENCHES,IBeD ?R GRAVELLESS DRAIN LD: Drop boxes I?veI?Y / N Type - concrete ?plastic Trench Depth ? Width 5(r Number of Trenches_Tfench Bottom Level Y/ N Trench Lengths Spacing Rock Clean?Y N 2" over?Pipe N GeoTextile CovN Depth Below Pipe? n ?" Soi Backfill Depth Graveiless Pipe Size? Made by 'r Chamber Size? Made by ? Absorption Area: Sq Ft Lineal Ft Trench Bottom to mottling / bedrock? in? ches PUMP TANK Made by /aSO r Capaci No. & Height of Risers C Seale ? N Pump Manufacturer Model # ? Horsepower?5 GPMFeet of Head e"_ Cycles,Per DayT7? Gallons Per Cycle t7 Size of Discharge Line Type of Eiectrical Hookup ost box tank Alarm Location ?g 1 basement Alarm: ank Alert Level Alarm / Oth,errt,- rlvr.ia , er? Y/A (? Water MeteraJY ProfessionalOnsite vu..n PCA Lic. No. VqJ Company oate. *Approved: No Yes Yes with Conditions: V Bohn We// Dri//ing Co. 18190 Dairy Lane, Suite 101 lordan, MN 55352 Phone:952-445-4809 Fax: 952-445-1439 Percv/ation Tests, Soi/ Borings & Septic System Design CREATED BY.• _efprd M. Bohn. DATE COMPLETED: 03-10-07 LICENSE # 1043 PREPARED fOR: Jaret Huston MAILING ADDRESS.• 2849 Lexlnaton Avenue S? Eaoan MN 55122 PHONE #: FAX #: SZTE LOCATION INFORMATION: WORK #: 6I2-331-1932 MOBILE #: ? W V ?EWE D sY - l CP.T ownrEas• SAME _uitvi,iu h2'SPE6TIENS B€PT.- SITE ADDRESS: SAME ADDITION: LOT COUNTY.• Dakota TOWNSHIP: Eaoan T.• 17N R: 23W S: 3 BLOCK DpsJgn must be paid /br, by whom it was prepared for, piior tiv re%as/ng it to any c»ntractor tn bid or to any City, Township or CouMy office lbr permitdng. We reserve ahe dght tv ho/d unti/ payment has Geen received. Designed For: Type of System: Septic Design Info Sheet New Rock Trench OR Mound rocked 0" X 000' sand area 00' X 00' Shared Mound Chamber Design Criteria: 6 Number of Bedrooms X Replacement, Gravel-less Trench At-Grade X Pressurized Treatment Bed Altemative, Other, Performance Garbage Disposal (Y or N) Grinder or Ejector Pump Proposed (Y or N) Septic Tank: X 1000ga1 1500ga1 3000ga1 2 tanks X 1250ga1 1500ga1(2-c) 2000ga1. ( 2 - C ) Pump Tank: 1000ga1 X _1250ga1 1500ga1 2000ga1 500ga1. System Information GravityFlow to septic tanks and pump tank, pump effluent up to pressure bed General Construction: Divert all surface water away from the drainfield area during construction Fence off the drainfield area before permit application. Site Considerations: N Is this a preliminary design? (more to be done in future) N Have the property lines been marked? mark wiN Y or N N Has the 100yr flood plain elevation level been checked? N Do we have a survey? N Is high water elevation mark needed? N is water way easements marked? N Is septic in well head protection area? N Is there a basement IiR pump? N Is septic near private drainage Y Old septic tanks to be pumped & hauletl aN (tile lines, ditches, culverts, etc...) Y Septic tank truck access available? N Any buried utilities or water lines in the way N Trees to be removed? N Existing septic tank to be pumped and inspect? 'f Well Over 100ft. deep? N Diffcult tank 8 drain field equipment accesslworkability? N Variance needed? N Is there a wetland setback concern? (See Below) Y !s site staked Miscellaneous Info.: recommend installing an effluentfilter DOSING CHAMBER SIZING All boxed rectangles musf be entered, &e rest will6e calculated 1. Determine area A RecWnglearea=LzW 0 ft x Oh = #VALUE! N1 B. Cirde area = 3 14 x radiue 3.14 x 0 2ft= 0.0 R2 C. Get area fmm manufacture h? 2 Calculate gallons per inch There are 7 5 gallons per cubic foot of wlume, there(ore muldply phe area (1A, 8 or C) times ihe conversion facta and diwde by 72 inches per fool lo calalale galWn per inch C? I Width Sudace area x 7.5112 = #VALUE! e x 7.5 / 12iN% = 29.0 gallon per inch 3 CalculaterolalWnkwlume A Depih irom bottan of inlet pipe bO tank 6ottan = 43 in B. Total tank volume = depih from boNom of inlet pipe to tank 6oflom(3A) z galfn(2) = 43 in x 29.0 gal(n = 12470 gallons 4. Calculate gallons to cover pump (with 2-3 inches of watercovenng pump) (PUmp and block hei h[+2 incfies) x gallon per inch ( 16 + 2 in) x 29.0 gaUin = 522.0 gallms 5 Calculate total pumpout vdume A. Select ump size for 4-5 doses er da . Gallon er dose = gpd (see FiqureA-1)1 dosas per day = 750 gpd 1 4dosx?Jday = 1875 9allons A•1 Ertimated Sewage Flows in GPD Numberof Bedroans Classl Classll Classlll ClasslV 2 300 225 180 60'/0 of 3 450 300 218 the 4 600 375 256 values 5 750 450 294 inthe 6 900 525 332 Classl, 7 1050 600 370 II or II 8 1200 675 408 columns Length Radius Legal Tank: 500 gallons or 100% the daily flow or Altemating Pumps E-20 Volume of Liquid in Pipe Pipe Diameter Liquid perfoot inches allons 1 0.045 1.25 'J.076 1.5 0.110 2 0.170 2.5 0.250 3 0,380 4 0.660 B. Calculatedrainback 1. Detertnme total pipe length 30.0 R 2. Detertnine liquid vdume of pipe, 017 gaUk (see figure E-20) 3 Orainbackquantity = 3040 N(SBi) x 0.17 gaUR(582)= 5.1 gal jr1;,t_ C. TMaI pump out valume = dose volume(SA) * d2inback (5B3) 0 12%1 1875 gallons+ 5.1 gallons= 1926 gal 6 Calalale float separation distance (using total pumpout wlume) Total pumpout volume(5C)/ galfnch(2) 1926 gal I 290 galrin = 6.6 inch 7. Calculale volume for alarcn (typically 2- 3 inches) Alami deptlh (inch) x gallon(nch(2) _ ?in z 29.0 galfin = 87 gal 8. Calculateto[algallons=gallonsoverpump(4)+gallonspumpout(5C)+gallonsalartn(/) 522.0 gal + 192.6 gal r 87.0 gal = 807.6 9al 9 Total tank depth = total gallons(B) 1 galloMn(2) 801.6 gallons/ 29 9aVin = 27.6 in Recommended ,alculate reserve capadty (75 % of the daily flow) Da ly Bow x 0 75 = 750.0 z 0.75 = 562.5 oallons '¢uPSp ciP: I hereby ceNfy that I have complefed this work in accordance with all applica6le adinances, mles and laws (signature) (license#) (date) Page 1 of 1 Trench and Bed Worksheet All boxed rectangles must be enfered, the rest wiN 6e calculated 1. AVER.4GE DESIGN FLOW A. EsGmated 900 gpd (see figure A-0) or measured x 1.5 (safety facfor) = 0 gpd B. SepGc tank capacity 2250 gallons 2- tanks Estmated ewage ows m GPD Number af Bedrooms Class I Class II Class I I I Class IV 2 300 225 180 60°k of 3 450 300 218 the 4 600 375 256 values 5 750 450 294 in the 6 900 525 332 Class I, 7 1050 600 370 Ilorll 8 1200 675 408 columns 2. SOILS (Site evaluation data) C. Depth to restricting layer = use?feet D. Maximum depth of system Item C- 3 ft = 2.5 feet E. Texlure loam Percolation rete 16-30 mpi F. SSF 1.67 ftZ/gpd (see fgure D-15) G. °k Land slope 0 % D-15 Soil Characterisitcs B SSF Perc Rate Soil Tecture SSF mpi sq fU d < 0.1 * Coarse sand 0.83 0.1- 5 Medium sand 0.83 Loamy sand 0.1-5" Finesand 1.67 6 -15 Sandy loam 1.27 16 - 30 Loam 1.67 31 - 45 Silt loam, silt 2.00 46 - 60 Clay loam, 2.20 sandy clay or silty clay 61 -120"` Clay, sandy 420 or silty clay >120n.. " No trench >25% of lotal system Soil with >50% fine sand particles A mound mustbe used ''** An other or rfortnance s stem C-1 Se tic Tan k Capaci in Gallons Numberof Minimum Capacitywith Capacity with Bedrooms Capaci Garb. Dis . and Lift 2 orless 750 1125 1500 3 ar 4 1000 1500 2000 5 or6 1500 2250 3000 7, 8 or 9 2000 3000 4000 Q-4: Sni1 flUraele.ivticR au<I Snil hixinµ lulnr, ISSFI Ior Gnveli?» i'ipc ..... .. ....................................... .. .. ..................... rn'm??s,e/:u:YV sa tWwex y..l.o?e/?aoti rkit?in?,,::<.^: n i s,= ; ?•,xtnr- a?<a ' n:a L G.IIY? `MN3 III s:i ' 3d•.C?i'd' ?o or?is , ,."n:,Mn, ' na: :::I'r711 . LtYN11 111h i:wa oas nrxiq:7, •i.r«?? Ilim::`^•F i:Zu 'p.`l t<e;:.ar.s•:Plciti?e1mrt01T'•L> ? •?•••, ' x.?_cnisf:rra?l<Il;rµamn?hl.?u.ila ,.`al:uiv:nF :%h...r nvn c i i, e e?at. vm hx af^d ••atifl v.tlh:iwlx?h >?xa.c,L?v,c.s .lawla: Fixt?l.eh•a +:az?.c:cl,viC:y?wntla si.?u Page 1 of 2 3. TRENCH OR BED BOTTOM AREA H. For trenches with 6 inches of rock below the pipe: A x F= 900 gpd x 1.67 fUapd = 1503.0 ft2 1. For trenches with 12 inches of rock below the pipe: A x F x 0.8= 900 gpd x 1.67 fUgpd x 0.8 = 1202.4 ft2 J. Far trenches with 18 inches of rock below the pipe: A x F x 0.66= 900 gpd x 1.67 ftlgpd x 0.66 992.0 fe K. For Venches with 24 inches of rock below the pipe: A x F x 0.6= 900 gpd x 1.67 ftlgpd x 0.6 = 901.8 ftZ L. For gravity beds with 6 or 12 inches of rock below the pipe; 1.5 x A x F= 1.5 x 900 gpd x 1.67 fUgpd = 2254.5 ftZ M. For pressure beds with 6 or 12 inches of rock below the pipe; A x F= 900 gpd x 1.67 ftlgpd = 1503.0 ft2 4. DISTRIBUTION (Check all that apply) ?Bed (<6°k slope) ?Drop Boxes (any slope) ?Rock Trenches Distribution Box (<3°a) Chamber Pressure Gravity Gravelless 5. SYSTEM WIDTH, LENGTH AND VOLUME M. Select width = 25.0 ft N. If using rock, divide bottom area by ? use 1500.0 ftZ / 25.0 ft = 60.0 lineal feet Rock depth below distribution pipe plus 0.5 foot 6mes bottom area: (Rock depth + 0.5 foot) x Area H, I, J. K, L) ( 0.5 ft+0.5ft)x 15?0.0 ftZ = 1500.0 Volume in cubic yards = volume in cubic feet divided by 27 1500.0 /27= 55.6 yd3 Weight of rock in tons = cubic yards times 1.4 55.6 x 1.4= 77.8 tons 0. If using 10" Gravelless Pipe, length = Flow (A) x Gravelless SSF (see figure D-9) gpd x 0 fUgpd = #VALUE! lineal feet P. If using a Chamber (H, I, J, K[based on height of chamber slats] divided by width oi chamber in Tt) I ]ryZ / ? it = #VALUE! Iineal feet 7. LAWN AREA Q. Select trench spacing, center to center = ?feet R. Multiply trench spacing by lineal feet R x Q= sq. ft. of lawn area 9 x 60.0 = 540 fe 8. LAYOUT Select an appropriate scale; one inch = 30 feet Show pertinent property boundaries, rightsvf-way, easements. Show location of house, garage, driveway, and all other improvements, existing or proposed. Show location and layout of sewage treatment system, well and dimensions oi all elevations it3 Page 2 of 2 Yo? ?t 6e al crosl # Z4 T!/'a ? Z.;y n..T Bohn We!! Drilling Co. 16550 Baseline Avenue Shakopee, MN 55379 952-445-4809 Gary M. Bohn Lic. #17DI ate: Z ••?4.....P /,:.? .?.._-... z ?.. ; PRESSURE DISTRIBUTION SYSTEM All boxed recfangfes must be entered, the resf wi(f be calwlatetl. 1. Select number of perforated laterals: 2. Select perforation spacing = ?5 ft 1 ['arl f•?.r.i?:F'/?n_?51/a' 3. Since perforations should not be placed closer that 1 foot to the edge of the rock layer (see diagram), subtract 2 feet from the rock layer len th 60 -2ft= 58 ft 4 Determine the number of spaces between parforations. Divide the length (3) by perforation spacing (2) and round down to nearest whole number. Per(oration spacing = 58 ft/ 5 ft = 11 5. Number of perforations is equal to one plus the number of perforation spaces (4) ' Check frgure E-4 to assure the num6er of perforations per fateral guarantees < 10% discharge variafion. 11 spaces + 1 = 12 perforationsAateral Ed Maximum Number of 114 inch perforatfons er lateral to uarantee <10%dischar e variatlon Perforation Spaang feet 1 inch 1.25 inch 1.5 inch 2.0 inch 2.5 8 14 18 28 3.0 S 13 17 26 3.3 7 12 16 25 4.0 7 11 15 23 5.0 6 10 14 22 E-6 Perforation Dischar e in GPM Head Perforations diameter feet inches 3116 7l32 1/4 1a 0.42 0.56 0.74 2° 0.59 0.80 1.04 5 0 94 126 1.65 a Use 1 0 fool for single-family homes. b. Use 2 0 feet for anything else 6. A. Total number of perforations = perforations per lateral (5) times number of laterals (1). 12 perfs/ lat x 5 laterals = 60 perforations B. Calculate the square footage per perforation. Recommended value is 6-10 sqk/perf. Does not apply to at-grades. 1. Rock bed area = rock width (ft) x rock length (ft) 20 ft x 60 fl = 1200 ftZ 2. Square foot per perforation=Rock Bed Arealnumber of perfs(6) 1200.0 ft2 / 60 perfs = 20.0 ft?/ perf 7. Determine required flow rate by multiplying the total number of perforations(6A) by Flow per perforations see figure E-6) 60 perfs x 0.56 gpm / perfs = 33.6 gpm 8. If laterals are connected to header pipe as shown in Figure E-1, to select minimum required lateral diameler; enter figure E-4 with perforation spacing (2) and number of perforations per lateral (5). Select minimum diameter for perforated laterals = 1 1!2 inches 9. If perforated lateral system is attached to manifold pipe near lhe center, like Figure E-2, perforaled laleral length (3) and num6er of perforations per lateral (5) will be approximately one half of that in step 8. Using these values, select minimum diameter for perforated lateral = 1 1/2 inches. .._ ;. " .. - - ?.?.? . .-"`" ..,T...,.?_ ' v?9v. s-i: reanMdd woa??a m Ene d ev.rom 1 hereby certify that I have completed this work in accordance with all applicable ordinances, rules and laws. (signature) 1043 (license#) (date) Page 1 of 1 PUMP SELECTION PROCEDURE All boxed rectangles must be entered, the rest will be calculated. 1. Determine pump capacity: A. Gravity Distribution 1. Minimum required discharge is 10 gpm 2. Maximum suggested discharge is 45 gpm For other establishments at least 10°k greater than the water supply rate, but no faster ihan the rate at which effluent will flow out of the disMbution device. B. Pressure Distribution - see pressure design worksheet Selected Pump Capacity: 33.6 gpm .. ir?:et .?..,...._..... 2. Determine head requirements: A. Elevation difference 6etween pump and point of discharge. 10 feet -°° B. Special head requirement? (See Figure - Special Head Requirements) Ofeet C. Fnction loss 1. Select pipe diameter 2 in 2. Enter Figure E-9 with gpm (1A or B) and pipe diameter (C1) Read friction loss in feet per 100 feet from Figure E-9 Fnction loss= 2.30 fU 100 ft of pipe 3. Determine total pipe length irom pump discharge to soil system discharge point. Estimate by adding 25 percent to pipe length for f tting loss. E uivalent pipe length times 125 = total pipe length 30 ft x 1.25 = 37,5 feet 4. Calculate total friction loss by multiplying friction loss (C2) by the equivalent pipe length (C3) and divide by 100. FL= 2.30 fU100ft X 37.5 ft I 100 0.9 feet D. Total head requirement is the sum of elevation difference (A), special head requirements (B), and total friction loss (C4). 10 ft + 5 ft + 0.9 ft Total Head: 15.9 feet 3. sois 3? c tutal P:Ue ; ; 24 e:eVc'ICr x Special Head Requirements Gravity Distribution Oft Pressure Distribu6on 5it :vE':.,.,, E-9 Friction Loss in Plastic Pipe per 100 R nominal Flow Rate i e diameter gpm 1.5" 2.0" 3" 20 2.47 0.73 0.11 25 3.73 1.11 0.16 30 5.23 1.55 0.23 35 6.96 2.06 0.3 40 8.91 2.64 0.39 45 11.07 3.28 0.48 50 13.46 3.99 0.58 55 4.76 0.7 60 5.6 0.82 65 6.48 0.95 70 7.44 1.09 Pump 5election 7.1. A pump must be selected to deliver at least 33.6 gpm (1A or B) with at least 15.9 feet of total head (2D). I hereby certify that I have completed this woric in accordance with all applicable ordinances, rules and laws. (signature) 1043 (license#) Page 1 of 1 . ? ? Bohn We!! Driiling Co. 16550 Baseline Avenue Shakopee, MN 55379 952-445-4809 Gary M. Bohn Lic. #1043 _ r---i/ t.1 a I Date: tjo uSe ./ ; f=8-o-7 / RO' ._ . ___?_.. .._. ?_: . . _; , s?pr• ? ?c , .. . . , . F ; .., ; 0. ... ,. ._ ??...:.. .. .. 1 ? ' ? ? - ' ... . : .?.e. ?. . . _ ; _ ... . . ? _ . , . . .. . . ... . , . . ? ? ` . ?o?l<? . ? . .. .?. _, _ .. ?ea • . -IqT;?r:,e D ; _ .e. . .?...__ • . . , .. . _ _.. . ?? ? s,? . x . . ' .. _ _. ( . - . . .rv 3 _._... ... _ •..? . . .. ..? . ....e. _ ??d<<<a ? ? ? ?. I Company Name Bohn WeII Drilling Percolatlon Test Performed By: Gary Bohn TestedFor: JaretHuston Test Hole Locffiion: 2849 Lexington Ave. S. Teat Hole #: P -1 Mefhod of scretching aidewall: 1 x 2 wih nails Depth at bottom of hole 12 inches Date presoak started 5/7/2007 Deplh of Initial water fllling: 10' above hole bottom Mefhod used to maintain 12" of water depth in hole for 4 hours Date perc reading conducted: 5/8107 Maximum depth a6ove hole bottom during test 6 Licenae #: 1043 DlameterofHole 6 inches Depth of gravel at bottam: 2 inches Stsred at: 1:OOpm aulo fill Starting at: 920 AM inches Time Time Interval Minutes Measurements Inches Drop in Water Level Inches Percolation Rale M(nutesrfnch Refll To 9:20 6 9:35 15 5118 0.88 17.0 6 ins. ?- - -- 9:50 15 5118 0.88 17.0 6 ins. 10:05 15 5118 0.88 17.0 6 ins. Percolation Rate = 17.0 minutes per Inch 5/8/2007 8:55 AM ? Company Name Bohn Well Di Percalallon Test Pertormed By: Tested For. Jaret Huston Test Hole Locatlon: 2849 Lexing TestHole#: P-2 Bohn Method of scretehing sidewall: 1 x 2 wih nails Ave. S License #: 1043 Uiameter of Hole 6 inches Depth at bottom of hole 12 inches Date presoak started 5!7/2007 Deplh of initial water filling: 10' above hole bottom Mefhod used M maintain 12" of water depth in hole for 4 hours Date perc reading conducted: 5/8107 Maximum depth above hole bokom during test 6 Depth of gravel st bottom: SWred al: 1 OOpm auto fill Starting at: 920 AM inches 2 inches Time Time Interval Minules Measurements Inches Drop in Water Level Inches Percolffiion Rate Minuteslinch Refill To 9:20 6 9:35 15 5118 0.88 17.0 6 ins. _ 9:50 15 5118 0.88 17.0 6 ins. 10:05 15 5118 0.88 17.0 6 ins. PercolationRate= 17.0 minutesperinch 5/8/2007 8:56 AM I Soil boring Log Date: f - 7-07 aient:_ a- ctik 1A ? s Borings made by: Address: afsVq La.r:.. .? ., A.,.. S G-??'Y u ?r_•?anl 4?0, .?.- 2 104 CM U Slale Zip Lic # Boring method: nugerp-? Pit Probe other Colorclassification system: Munseu otner Boring Number Boring Number Surface Elevation Surface Elevation Soil type at system depth: Soil type at system depth: oepth Texture Color Deptn Texture Color Feet Feet ? --- -- s?%r yy 1 --- f//r /0 G«. 2 --- z --- ?- AG 3 --- 3 -- St?.sPl _ ?ow?fP f??d /oyjr f'?/y -- w,'t? sr,er 4 --- 4 --- 5 --- 5 --- 6 --- 6 --- 7 --- 7 --- Structure: 8iocky Platy Prismatic None SffUCtufE: 8locky Platy Prismatic None Slope: % Siope: % End of boring at & feet. End of boring at feet. Standing water table yes no Standing water table yes no Present at feet of depth, Present at feet of depth, hours after boring. hours after boring. Mottled soil: Mottled soil: Observed at feet of depth. Observed at feet of depth. Not present in boring hole li Not present in boring hole 4__ . Observations and comments: Observations and comments: ,.• Soil Bonng Log Date: S- 7-O ? ProiectLocation: ? 8y9 L?r?naT., ?i??. s Twp. Client: Borings made by: Address: 6AL'y U. r?r.N n( I 04?) Ciry Slala Zip Lic. tl Boring method: au9ery_ Pit Probe otner Color classification svstem: nnunsen Other Boring Number Boring Number Surface Elevation Surface Elevation Soil type at system depth: Soil type at system depth: oeptn Texture Color Depth Texture Color Feet Feet /O R w. ?Dqw-? Wi 2 --- 2 --- ?vGi.,. ?Dy? 6 -- 'Y/ - -- y 7,f J 3 --- w,? SrNPr --- sti.,d w-?JT?, 4 --- 4 --- 5 --- 5 --- 6 --- 6 --- 7 --- 7 --- StfuCtuf2: Blocky Platy Prismatic None StYUCtufe: 8locky Platy Prismatic None Slope: % End of boring at j(;, feet. Slope: % End of bonng at ? feet. Standing water table yes no Standing water table: yes no Present at feet of depth, Present at feet of depth, hours after boring hours after boring. Mottled soil: Mottled soil: Observed at feet of depth. Observed at feet of depth. Not present in boring hole _?. Not present in boring hole Lr Observations and comments: Observations and comments: Permit #: Receipt Date: CITY OF EAGAN 2007 SEWER AND WATER CONNECTION AND AVAILABILITY CHARGES EXISTING RESIDENTIAL PROPERTY Address C,/ cv Property Owner (15/-?,?l t.? Telephone # `7 Plumber Date of Inquiry Contact Name 4" Sewer SerJice Sewer ]ateral charg< Sewer trunk @ $1,1 City SAC MCES SAC Receipt # Septic abandonmer? Perntit Fee / State Surchgge ' (}FFICE LiSE ONLY /lb PKV rcquircd Ycs ? City ? County R-O-W Yermit Water @ $28.60/ff Water trunk @ $1,200/connection 100.00 Water supply & storag,, ? 1,070.00 1.675.00 Receipt # Date",.. Treatment plant 660.00 50.00 Permit Fee ? 50.00 50.00 State Surcharge1-Z ? .50 .50 P1umUing peutftt required -- water meter to be acquired with plbg penxut $ I 04tai $ Sewer and Water 4" Sewer Service 1" Water Service Sewer lateral charge @ $2830/ff - Water lateral charge @$28.60/ff x?6 £F, ? i? 3. Sewer trunk @ $1,150/connection Watertrunk @ $1,200/connection /,soa ciri sAC 100.00 MCES SAC 1,675.00 Receipt # , Date Water supply & storage 1,070.00 Receipt # , Date Treatment plant 660.00 Septic abandonment 50.00 Permit Fee 100.00 State Surcharge .50 Total s gI79,L Ylumbing permil xequired Water meter to be acquired with plbg permit Sewer '~. ZX$- 691.00 1" Water Ser $2830/ff Water latcral cc: Carolyn Krech, Finanee Department -? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT PERMIT TYPE: Permit Number: Date Issued: 67?- 3gi yS 3 d,yS' eu LornG 025171 03/10/95 SITE ADDRESS: P.I.N.: 10-00300-030-75 2849 LEXTNGTON AVE LOT: 3 BLOCK: 75 SECTTON 3 DESCRIPTION: MAC SOUND INSUlATION f8uildirig_Permit Type SF (MI9C.) Building Wurk Type ALTERATION ? t ?. ,?. ;. REMARKS: A SEPARATE PERMIT I3 REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK FEE SUMMARY: VALUATION Base Fee Surcharge Total Fee $117.00 $5.00 $122.60 $ie,e,ee CONTRACTOR: - p,pplicant - sT. Lz OWNER: CITY VENTURE CORP 13793890 000391 JACKSON VIVIAN 1313 STH ST SE 2849 LEXIN6TON AVE MINNEAPOLIS MN 55414 EAGAN MN 55121 (612) 379-3890 (612)454-1185 I hereby acknowledge that I have read this application and state that the infarmation is correat andagree to comply with all applAcable Stete of Mn. L Statutes and City ofi Eagan Ordinances. _ .-.-? `? n oraa I? ?_ APP IC NT/PER ITEESIGNA7URE ISSUED Y. GN E : +?? • ' CITY OF EAGAN 111 3830 PILOT KNOB RD - 55122 ? 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681 -4675 New Construdion Reouirements RemodeUReoair Reouirements ? 3 registered sHe suneys ? 2 copies of plans (include beam & window sizes; poured fid. design; etc.) ? t energy cakulations ? 3 coples ot tree preservation plan 'rf lot platted atter 711J93 required: _ Yes _ No DATE: I I `7 ? CC DESCRIPTION OF WORK: cosT: ? q `fl 5 • ", STREET ADDRESS: LOT ?L BIOCK ? SUBD./P.I.D. #: PROPERTY Name: ?a??Sb 1 \ U ;r Phone #: IS OWNER `w'. ? I Street Address• ' ^ ' City: ? acI (L ti State: L? Zip: rlv CONTRACTOR Company: s P \ r. C? Phone #: 1-7 0 Street Address: ?_?? License #: C 3 , q City: State: iA1? - Zip- S5 1 ARCHITECT/ Company: Phone #? 421,f' L1" 624 ENGINEER Name: Registration #: O 1 Street Address• ? ?? 1 ? ???-k?, v ?'''? • City: State: gt Zip: 5540 Lil Sewer & water licensed plumber. change are requested once pertnit is issued. I hereby acknowledge that I have read this application and state that the applicable State of Minnesota Statutes and City of Eagan Ordinances. OFFICE USE ONLY Certificates of Survey Received Tree Preservation Plan Received Signature of Applicant: _ Yes _ No _ Yes _ No p? I L?- ? 2 aopies of plan ? 2 site ewveys (ez[erior addidons & decks) ? 7 energy calculatlons tor heated adddions Penatty applies when address change and lot is correct and agree to comply with all FrB 2 2 1995 OFFICE USE ONLY BUILDING PERMIT TYPE ..w ? • ? .?. ,.. .s , .?,. «.".,? 0 01 Foundation o 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ? 02 SF Dwelling ? 07 4-piex ? 12 Muiti RepaidRem. 0 17 Swim Pooi 0 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility ? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous 0?05 SF Misc. 0 10 _-plex ? 15 Deck WORK TYPE ? 31 New a:::?33 Alterations o 36 Move ? 32 Addition ? 34 Repair o 37 Demolition GENERAL INFORMATION Const. (Actual) _ Basement sq. ft. MC/WS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Depfh Footprint sq. ft. SAC Code Census Bldg Census Unit APPROVALS Planning Building Engineering Variance y?y oi U Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: ? Valuation: $ _ /O,Oaa - % SAC SAC Units PERMIT ? CITY ?F EAGAN 3833'Pilot nob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: P.I.N.: 10-00300-030-75 DESCRIPTION: ? PERMIT TYPE: Permit Number. Date Issued: 2849 IEXZNGTON AVE LOT: 3 BLOCK: 75 SECTION 3 ,--?_` (ROOFING) uilding',Permit Type uilding Wo?rk Type ? \ Z 1 / 1 t - 5F (MISC.) REPAIR BUZLOING 021991 09/17/99 ; REMARKS: FEE SUMMARY Base Fee Surcharge Total Fee VALUATION $63.00 $2.00 $65.00 $4,000 CONTRACTOR: - flpplicant - 5T. LIC. OWNER: BEFORT ROOFING INC 12270868 0002099 JACK30N VIVIAN 336 W WATER ST 2849 IEXINGTON AVE ST PAUL MN 55107 EA6AN MN (612) 227-0868 I hereby acknpwledge that I have read this application end state that the information is correct and agree to comply with all applieable State of Mn. Statutes and City of Eagan Ordinances. ? APPLICANT/PERMITEE SIGNATURE ?a ft??l.l m?( -?ISSUED B : 51 NA7U E REACTI4ATE _ CITY OF EAGAN PEwMIT # 1993 BUILDING PERMIT APPLICATION =:?? • ??' Uqql 681-4675 ? SIN6LE & qUtXF -FAMILY ? 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architecturat & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month- in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date Valuation of work 5600 ? Site Address: a?yy ?sYil 11r(, SiREET ? SU[TE Y Tenant Name: (commercial only) IAT I_ BIACK SUBD. .1J J P.I.D. M Descri tion of work: The applicant is: ? Owner OfContractor ? Other (Daseribe) Name ai? Phone Property LAS' FIRST Owner Address Z°;L'? J ?" i STREET STE M City e State Zip ' Company o T-7 Leaj?' "Te- Phone Contractor Address 336? W License #'46 9'1 Exp. -_ City State '(,'+? ZiP =?/O:? Company vnone ArchitecU Engineer Name Registration d Address City State ZiP Sewer 3 water licensed plumber . Processing time for sewer 8 water permits is two days once area has been approved. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applica6le State of Minnesota Statutes and City of Eagan Ordinances. Signature of Appl icant: L 3 BL SUBD. S'e C.h- C) CITY USE ONLY ln ? RECEIPT #: ? 1 vl ?-2?- 2? RECEIPT DATE: PERMIT# ?'7 1999 PLUM$IN6 PERMIT (fi£SIDEVTIAL) CfCY OF E1kfiRP 3830 Paor KNoa sn fnsAu, MNssi22 (651)681-4675 Please complete for: ? single family dwellings D townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system FIXTURES EACH # TOTAL Bath tub ? 3.00 ^ - $ Floor drain 3.00 x = $ GeS I in Outlet ' minimum - 1 3.00 X = $ Hot tubls a 3.00 x = $ Kitchen sink 3.00 x = $ Laund tra 3.00 x = $ Lavato 3.00 x = $ Minimum fee alterations to existin dwellin 30.00 x = $ , d Private Dis osal S stem new/refurbished * re uires MPC iic. 75.00 x = $ Private Dis osal S stem abandonment 30.00 x = $ RPZ new installation/re air 30.00 x = $ Rou h o enin 1.50 x = $ Shower 3.00 x = $ Under round s rinkler if dweilin is under construction 3.00 x = $ Under round s rinkler if existin dwellin 30.00 x = $ Water cioset 3.00 x = $ Water heater 3.00 x = $ Water softener if dwellin under consvuction 5.00 X = $ Water softener if existin dwellin 30.00 x = $ Water turnaround 30.00 x --- _ $ State Surchar e .50 --> ---> ----> $ 50 Total --?- --? ---? ._-? $ *13c) Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc. ----TnslA??'hoPL---'o r------- ---------- ----'? J9b ?o-r-----?-?d '? I hereby adcnowledge that I have read this appliption, shate that the infortnation is cortect, and agree lo comply witti all appli?le Ciry of Eagan ordinances. It is the aRPliranPS responsibility to notiTy the properry owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within Ciry property/right-of•way/easement. SITE ADDRESS: OWNER NAME: : Z TELEPHONE#: &SI- 4OS-DSS(o (AREA CODE) _ INSTALLER NAME: 1/1,Ii1kd ? kkS 1 C ILL TELEPHONE #: f°Ia -T OV `903c) ?? ? (AREA CODE) STREETADDRESS: .3S?.rI ?S?' r?¦? ?? CITY: Bax?e ST ZIP: rll-f IGNATURE OF PERMITTEE ._ L?, Bik Plat Date CITY OF EAGAN 1996 SEWER & WATER CONNECTION CHARGES EXISTING RESIDENTIAL PROPERTY Sewer connection c Sewer a 'labilit Date previ si Receipt Account deposit Sewer permit & Subtotal * Plumbing rmil Tap PID # 10-nn-Ann-MO-75 Sewer/water permit # charge (SAC) paid & surcharge .Date 15.00 50.50 $ 1,065.50 2050 Receipt # charge (WAC) $/760.00 paid ,? Water permit V Water meter Treatment plant Subtotal 15.00 50.50 107.00 396.00 $1,328.50 & surcharge \ 20.50 Tap Sewer & water connection charges Sewer availability charge (SAC) Date previously paid Receipt # Water availability charge (WAC) Date previously paid Receipt # Account deposit Sewer & water permit and surcharge " Water meter Treatment plant Subtotal * Plumbing permit & surcharge Tap(s) Total $1,000.00 760.00 30.00 100.50 107.00 396.00 $2,393.50 20.50 * A plumbing permit is also required. it will be issued only to a plumber licensed with the City or to the homeowner if he is actually doing fhe work. ---- ----___-------- --------- --------- ------ ------------------- OFFICE USE ONLY Property owner vTVTau TArKSf1AT PRV N onP Address 2849 LEXINGTON AVE Phone no. A s_I I R S _ Plumber Water connection No. of taps Assessments y$ Waiver %Ie i SPECIAL ASSESSMENT SEARCH SUMMARY PROPERTY ID: 10-00300-030-75 AS OF: 02/15/1996 S/A# ASSESSMENT DESCRIPT. YEAR TM RATE TOTAL ANN.PRIN. 100040 SAN SW TRK 1967 30 6.0000 115.50 0.00 P99999 POSTPONED ASSESSMENT 0000 10 0.0000 0.00 0.00 ------ SUMMARY OF LEVIED 0.00 0.00 ****** 1996 P&I CERTIFIED ------ SUMMARY OF DEFERRED 0.00 ------ SUMMARY OF CIASED 115.50 ------ PENDING ESTIMATE 0.00 Press ENTER; or F1, F4, F5, F7, FS Main Prev 2 72 Menu Page CN 10:49 .? ? Y 9 e1e?c. ? K?? n ?wfev- e ', 6e,0,7 . ?'/- uJmbp r wo ?f r date/??/ cltmi?.1,??, PAYOFF CD 0.00 CL PN 0.00 Go To Exit Legend Next Page CAPS 1/sad , 50 / ?ot e ?BY?/Lof= yS_0a o?,.3G7.S 0 G'?av.ia?7el /6707. 50 ? 387Z 0? ?-e r/C?, J( /'PJ %P QQ eC2?i C2 ?0 -r.4 U /1 G) P I tiJGt bi, ?7 ? ry ? , I nio 'l t-qr rYl l ? G /it????(/ r? w ?ngl??P?.?S ? U4Y,UF gA(iAN Atldition .SeCt'.1.OI7'3 Y- Lot ? Rlk Owner `JI 111 C' 11 street 2849 SO, LflX311Pt0I1 -.- 55121 Improvement Date Amount Annual Vears Payment Receipt Date STREETSURF. 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" _ . . .. ? : { July 11, 1979 D-36 MnrpoT FEL ACQUISITION Parcel 11A S.P. 1982 (35E=390) 905 I 35E-4 (40) < That part of Tract A described below: Tract A. The North 75 feet of the South 2049.8 feet of the East 474.83 feet of the East Aalf of the Southeast Quarter of Section 3, Township 27 North, Range 23 Weat, Dakota County, Minneaota; which liee westerly of Line 1 deacribed below: Liae 1. Beginning at a point on the south line of Tract A hereinbefore described, " distant 305 feet west of the southeast corner thereof; thence run northeasterly to a point on the south line of the North 458.5 feet of - the Northeast Quarter of the Southeast Quarter of said Section 3, distant 215 feet west of ita intersection with the east line of said Section 3 and there terminatiag; coataiaing 0.31 acre, more or less; together with all right of access, being the right of iagrese to and egress. from, that part of Tract A hereinbefore described, not acquired herein to Trunk Iiighway No. 35E., • ? Names of parties interested in the above described land and nature of interest: Vivian L. Jackson, also ) known as Vivian Jackson ) Fee ----- - 1, Aetna Life Znsurance Company . , Mortgage .? ? _. . . .. . . . .- '- ---'-•-`-- - ?-??--- .._ _...__?._..: . _ . . -- '?----- ?-. . . , "?City of Eagan Easement and ,'• ? ?- U" _ County of Dakota Taxes ' - ' July 11, 1979 D-36 Parcel 11A S.P. 1982 (35E=390) 905 FEE ACQUISITION I 35E-4 (40) r?a Op3p0 03D 7? J ( J That part of Tract A described below: Tract A. The North 75 feet of the South 2049.8 feet of the East 474.83 feet of the East Half of the Southeast Quarter of Section 3, Township 27 North, Range 23 West, Dakota County, Minnesota; which liea westerly of Line 1 described below: Line 1. Beginning at a point on the south line of Tract A hereinbefore described, distant 305 feet west of the southeast corner thereof; thence run northeasterly to a point on the south line of the North 458.5 feet of the Northeast Quarter of the Southeast Quarter of said Section 3, distant 215 feet west of its intersection with the east line of said Section 3 and there terminating; containing 0.31 acre, more or less; together with all right of access, being the right of ingresa to and egress from, that part of Tract A hereinbefore described, not acquired herein to Trunk kiighway No. 35E. Names of parties interested in the above described land and nature of interest: Vivian L. Jackson, also ) known as Vivian Jackson ) Aetna Life Insurance Company City of Eagan County of Dakota Fee Mortgage Easement and Special Assessments Taxes 659665 ? C I T Y O F E A G A N CERTIFIED LISTING OF POSTPONED SPECIAL ASSESSMENTS LEGAL DESCRIPTION: ? Section 3, Twn.27i Ranqe 23, E 474.83.Ft. of N 75 Ft. of S 2049.80 Ft. of SE ; Ex.31 Ac Hgwy. COUNTY IDENTIFICATION NUMBER: 10 00300 030 75 ? POSTPONED SPECIAL ASSESSNIENT: Water Area Assessment Pursuant to M.S.A. 429.061, Subd. 2, as amended by the 1980 Session Laws, Chapter 560, Section 5, I hereby certi£y that the City of Eagan has approved the postponement of the special assessments as set forth above on the property described. Dated this ?q -T }4 day of NA ..k yt f-- 1984 EXEMPT FROM STATE DEED TAX STAMPS This Document Drafted By: City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 ??" ' "`' ` ?•i,>-' - Certificate .,:?;VanOveibeke, City Clerk of ceitiiftha,? the foregoing is a true .;?1i; : ... . (.. . Exe pt from State Deed Tax Uakota County Tm surer A ? 6o 01 ve, E.J. Overbeke City erk/Finance Director Cit?y of Eagan drr?ct cp,pv. , C1ty Hereby ?i STATE OF MINNESOTA ss. County of Dakota Office of County Recorder This is tcrti'y 'tl'?at the witnin ins±ru. t :,as -d for record i? this o;f ca hlasf , or, ±he day 9 , .. D. 19 ? a 'ciock F,i., anc3 inat the same was duly recorded in Dakota County Records. JAMES N. Doi nm Daputy 6;CC? -ti?L/ ?