2896 Lexington Ave?????? INSPECTIQN RECORD
CITY OF EAGAN PERMIT TYPE: ??" r1 1) rN'?
3830 Pilot Knob Road Permit Number: b? .' ?+ N s? tEagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: 1 ; `i i ? 0 ?{ ?' 0 1. t , APPLiCANT:
i. Fx1w6iOM avt ?.
Mr.'?:rF :tp(t
PERMIT SUBTYPE:
I I ,•r i .1 r
D'cvVir•;1t11t-0 nW?;riAr? kAIN';t
t61:11 `I;!y-111ft"
TYPE OF WORK:
nl iE 1;111 Ii)N
INSPECTION
.,, D• . .•
iFi /,i
?
., . ,. . : ` -
??
_ ?
Pertnit No. Permlt Holcter Data Telephone Ii
ELECTRIC
PLUMBING
HVAC
Inspectlon Dete Insp. Comments
FOOTINGS
FOUNU
FRAMING ? r!
ROOFING
'?? 7jDh !#,?} tCled
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINALHTG ??? P ?, dG2
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FINAL
CITY OF EAGAN Remarks
5treet ?
11 aIk 2 Parcel 10 i.77K2 110 02
xington Ave. So. State Eagan,MN 55121
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1968 1
* SEWER LATERAL
WATERMAIN
* WATER LATERAL 1968 1020.00 1
WATER AREA
STORM SEW TRK 1985
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN,
BUILDING PER.
s,ac 2498 -22-70
PARK
EAGAN ,'OWNSH' P Ne 138
BIJILDiNG PERW61'T
Ownex -a It-
Builder - - - Addzess (Presen!) ...._....r.
............_ -------------- ..... ...
Address ._. ----------------------- ...--------------
DESCAIPTION
Eagan Township
Town Hall
Daie .l.----t-35?..---.......
Siories To Be Used Foz Froni I DepYh Heigh! Esl. Cos3 Permif Fee Remarks
V?T U / r
or
a'?y?
? J'?'Ooao
nor does if give the owner or his agenf
!o the healih, safefy, convenience and
,,
This pexmit does riof aulhoxise the use of sireels, (96ads, alleys or sidewalks
the righi fo create any siiuation which is a nuisance or which presenis a hazard
general welfare to anyone in the communiSy.
THIS PERMIT MUST BE KEPT ?N TH P
This is So cerfifp, fhal EMISE WHILE THE WORK IS IN
.?? . ? ...... has parmission !o erec
?G.....
the above escribed
' ci i ihe ovisions of the Buildin4 Ordinance
1955.
7r?Pe
PAOGAE 5.
Y a---- --------- ---------....------- upon
for Eagan To s ip adopfed April 11,
. .._ .._ _ .. ...... ............ --- ..._.............. ... ...._
-- °- .._.. . __...._..... _
Chairman of Board Building Inspeeios _ - -
EAGAN TOWNSHIP
N° 2'749
Eagan Township
Town Halt
- 7z
Date .
........ ..................
Siories To Be Used For
iJ 0 Front Depih Heighf Esl. Cos!
i Pesmi! Fee Remarke
LOCATION /d-S'o
Slreel, Road os oYhei Descripfion of Locafion I Lo! Slock AdAtflon os Trac!
I l1 Q -7Aei/? 11:9' a?"?
This permii does aot aufhori:e the uae of sl:eels, roads, alleys or sidewalks aoz does it give the ownes or hia agen!
the rigb! !o creafe any siluafton whieh is a nuicanee oz which presenls a hazard fo the healih, safety, eoavenience aad
general welfare !o anyone in the community.
TFIIS PERMIT MUST BE KEPT ON THE AEMISE WHILE TAE WORK IS IN PROGRESB.
Thia ia !o eerlifp, ihat..... 10.'.:'Y?±---_...... haspermicsion 3o erect a.......e. ........... _upoa
the ahove deseribed premise subjee! !o the proviaiou of the Building Ordinanae for Eagan Township adopled April 11,
1955.
......... .........._--.:!:. ..°---".t.`..:."^?J...-----... Per .......................... 9'!?? ....fl..:?---..................
Chaismaa of Tnwn Soard Huilding Inspecloz ?
16
55q 5 ? RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55922
651-681-4675
New Construction Reauiremenb
• 3 registared site surveys shmr5ng sq. ft. o( lot, sq. ft. of house; aM all roofed areas
(20% maxumum lot coverage allawed)
• 2 copies of plan showing beam 8 window saes; Doured found design, etc.)
• 1 set of Erceqy CalculaGons
• 3 cropies of Tree Preservatlon Plan d lot pia@ed after 711l93
• Rim Joist Detail Options selecdan sheet (hldgs with 3 or less unils)
DATE ??2 La
?
r-
RemodeURenair Reguirements
• 2 copies of plan
• i set of Ene(gy Calculatrons for heated addAians
• 1 site survey fur exterior additions 8 decks
• Indicate if hane served by septic system lar addilions
VALUATI0t*1?
SITE ADDRESS r???LE??I n ? MULTI-FAMILY BLDG _Y ?N
TYPE OF WORKSI?lf?6 FIREPLACE(S) S? 0_ 1_ 2
APPLICANT
STREETADDRESS 'oAb`1?p LP%) N,t,? aN
TELEPHONE # LdSIt-I CELL PHONE #
FAX #
PROPERTYOWNERQ0}l'? V"F1?L TELEPHONE#\
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Catagory _ MINNFSOTA RULES 7670 CATEGORY 1 _ MINNESOTA RULES 7672
(4 submission type) • ResidenGal Ventilation Category 1 Worksheet Submitted • i e Co11e?Norks4@e
. Energy Envelope CalculaBOns Submitted
OCT 0 2 2n,7
i
Plumbing Contractor: Phone # _
Plumbing system includes: _ Water Softener _ Iawn Sprinkler ,-;.J---F.ee: 190.1
_ Water Heaker _ No. of R.I. Baths
_ No. oF Baths
Mechanical Contractor.
Mechanical system includes:
Sewer/Water Conhactor:
_ Air Conditioning
_ Heat Recovery System
I hereby acknowtedge that I have read this application, state that
with all applicoble State of Minnesota Statutes and City of Eaga5
Signature of
IS
ZIP
Fee: $70.00
to comply
OFFICE USE ?LY
Phone #
Phone #
Certificates of Survey Raceived - Tree Preservation Plan Received - Not Required _
Updated 4102
RESIDENTlAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651•681 -4675
Yew Canstruction Repuirements
• 3 :egi5ferea 5de surveys Showing sq. ft. of lol. Sq ft. of house, aiM ail roofed afeas
120°b:naximum Iot coverage allowed)
• 2 mcres of plan showing beam 3xindow ;2es; poured found design, etc I
• 1 aet of Energy Calculanons
• "s eopies of Tree Preservatwn Plan if lot platted aRer 717l93
. 3im Jorst Oetail OpBons selecuon sheet (blCgs vnth 3 or less uni4s)
_ Water SoRener
Water Hcater
No. of Baths
?
DATE 7 ? (?a VALUATION ?
?.`oC?' \v:' ?XiClq?'OR AQ..k-
<n e.?? • ?
SITE ADDRESS MULTI-FAMILY BLDG _ Y _?)N
TYPE OF WORKRogC - ?? FIREPLACE(S) _ 0_ 1_ 2
APPLICANT ::S??\NEtCZ
STREET ADDRESS STATEWJ ZIP s?,2
TELEPHONE # CELL PHONE # (ESI a7c? ?kj?_PAX #Q?l- S-R-2070
PROPERTYOWNERVVsy'?eZ TELEPHONE# 6?,1'32(,'
---...-•---------------------------------------------------------------------------------------
COMPLETE THIS SECTION POR "NEW" RE5IDENTIAL BUILDINGS ONLY
Energy Code Category _ ?1INVFS0T.1 RULGS 7670 C:A"CEGOliY I MiV\ESOT.A iti'LP5 7672
(. suhmission rype) • Residential VentllaGOn Category 1 Worksheet Submrtted • New Energy Code Worksheet SucmiCeC
• Energy Envelope Calwlations Su6mitted
Fnu 7 -Tonn
Plumbing Contractor:
Plumbing system includes:
Mechanical Contractor:
LV[cch;ujicil scsLcm includrs:
Sewer/Water Contractor:
Phone #
Phone #
---°-------------------------------------------------------------•----------------
I hereby acknowledge ihat I have read this application, state that the informc
with all applicable State of Minnesota Statutes and City of Eagan Ordi anc
Signature of Applicant
Fcc:
rcc: SiQ.00
•---------•-----------•-•----°°-
is correct, and agree to comply
OFFICE USE ONLY
Certrficates of Survey Recerved _
v
?? .
RemodellReoair Reouirements
• 2 copies ol pian
• 1 sel ol °_nergy Caiculanon5 for heated 30dAicns
. 1 vte survey'cr ex;enor addiUCns 8 decks
• Ind¢ate J home served by septic system for addihons
4
Phone -
Lawn Sprinkler
No. of R.I. Batt
:\ir Condiuoning
Fleal Rccoccrt• S}:striii
Tree Preservation Plan Received Not Requfred _
Updated 1%02
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
2896
LOT:
MCKEE
P.I.N.: 10-06200-040-25
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
LEXING70N AVE S
11 BLOCKa 2
3R0
r
026086
08/30/95
DESCRIPTION:
B,?iiltlaiSfc?Prermit Type SF (MISC.)
?4+i3ds?f`G)'r?4cTYpe ALTEftA7TON
?
R
aC f'q
[?+4
?
? , .. _ • E ?.h;.*m
.:8?'`?. ?w?e ? -•em_ ?z?Afl??
.?ya, w Y pe- ?¢IV£5'?f ..;
g m C`
3r',-?,
r
s w,?i u b,
v
REMARKS:
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
Total Fea
VALURTIQN
$174.75
$61.16
$5.50
$241.41
$11, 000
CONTRACTOR: - flpplicent - s'i. LzC. OWNER:
DSVERSIFIED AMERICAN CONST 19297952 20017349 SALONEK TOM
5115 EXCELSIOR BLVD 107 2896 LEXIMGTON AVE S
5T LOUIS PARK MN 55416 EAGAN MN
(612) 929-7982 (612)688-6741
r? `ttie?re?hy ackrcow3 edg-e tlaaC I havt?" ?Nead th.i s ?appla..c'a,ti6Ji a.n,d, state :t'H6t', the e? -
` irrformation i.s o5rrscC` ahd'?:aq'f aa tro. comp`Iy i-a,Il appli,aable 5t,ate #f A1n.- `
StatuCe''s'and City of ?agan Ltrdiraanaers.
?-°- -..' _' • , _.` ,.:.::• ;. ._. m°- ` = ? - - - ..?._. .,?
APPLICANT/PERMITEE SIGNATLIRE
?'1 nt,n R?;,r?_ l m?-
sUE D . I A? -C-
I
INSPEC'I'IUN RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITEADDRESS:P•I•N.: 10-00200-040-25
LOT: 11 BLOCK¢
2896 LEXINGTON AVE S
MCKEE 3RD
PERMIT SUBTYPE:
sF ( mzsc,)
BUILDING
0260$6
08/39J95
2 APPLICANT:
DIVERSIFIED AMERICAN CONST
(612) 929-79$2
TYPE OF WORK:
ALTERA7ION
INSPECTION
FRAMING D. .
ROUGH TN PLB6 ..
RqUGM TN HTG FTNAL
? •?_ _. ? . .. _ ?
?
t ?.
r` CITY OF EAGAN
3830 PILOT KNOB RD - 55122
1995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
Naw Construd"+an RacuiremeMS Remodel/Reoav Reouirements
? S iegistered site surveys ? 2 copies of plan
? 2 copies of plans (include beam & window sises; poured fid. design; etc.) ? 2 stte surveys (exterior atlditions 8 decka)
? 1 energy alculatipns ? 7 energy calculxdons fir heated addiHons
? 3 copiea of Vee preservation plan N lat platlad aRer 711193
mquiratl: _ Yas No ?
DATE: CONSTRUCTION COST: ???!?
DESCRIPTION OF WORK:
STREET ADDRESS: '
?d
?
i g
LOT ? BLOCK ?-- SUBD./P.I.D.
PROPERTY Name: Phone
OWNER 1AbT F'"°T
Street Address,
City: State: Zip:
CONTRACTOR Company: bl.?(WC,11-V1 tb4&' CAWI*hone #:OJZ 1 l?T_
Street Address: ?? I 1? License #• 6 QI I ;- ( L
Ci ? ? ? State: o? Zi •??
?,. k??- ?_ '
ARCHITECT! Company: Phone
ENGINEER
Name: Registration #-
Street Address-
City: State: Zip:
Sewer 8 water licensed plumber: Penalty applias when address Change and lot
change are requested once permit is issued.
I hereby acknowledge that I fiave read this application and stattlhW-ffi?nf' roLmaGon is corre2, ?gree to oomply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances. \ ?,/
Signature of
OFFICE USE ONLY ?" %0 r. 0 ?// k
Certificates of Survey Received _ Yes _ No •?
Tree Preservation Plan Received Yes No ^-??---
OFFICE USE ONLY
BUILDING PERMIT TYPE
n 01 Foundation o 06 Duptex ? 11 Apt./Lodging ? 16 8asement Finish
0 02 SF Dwetiing o 07 4-plex ? 12 Mufti RepaidRem. 0 17 Swim Pool
0 03 SF Addition o 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
o 04 SF Porch o 09 12-plex ? 14 Fireplace o 21 Miscellaneous
-e-05 SF Misc. a 10 = plex ? 15 Deck
WORK TYPE
0 31 New <zg,?-33 Alterations ? 36 Move
0 32 Addition ? 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actuafj
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Pianning
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S!W Permff
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
Basement sq. ft. MC/WS System
Main level sq. ft. City Water
sq. ft. Fire 5prinklered
sq. ft. PRV
sq. ft. Booster Pump
sq. ft. Census Code. Y.PY
Footprint sq. ft. SAC Code
Census Bidg ?
Census Unit
, Building Engineering Variance
Vaiuation: $ ll new
% 5AC
SAC Units
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE: dune 22. 1970
OWNER• Arnold Gloe
NUMBER /Q.1-
Address 2896 Lezineton 9ve. ?/-C) ?'?- d
PLUMBER Self TYPE OF PIPE He,gvev Cast Iron _
AESCRIPTION OF BUILDING
Industriall Commerciall Residential Multiple Dwelling No, of units
Location of Conaections: Conaection Charge 200.00
Permit Fee 18.00
Street Repairs
Total Aaet. Dep. 1600 ?
-A?%,re
In ected by: Asa•?
DaYe
Remarka•
$y
Chief Inspector
In consideration of the issue aad delivery eo me of the above pezmit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Totmship, Dakota County, Minnesota
Please notify when ready for inspection and connection and before any portioa
of the work is covered.
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Mipneaota 55111
Telephone 454-5242
PERNIIT FOR WATER SERVICE CONNECTION
Date: June 22, 1970
Billing Name• Arnold Glos
Owner: Same
Plumber; Self
ion
61? 61X'17°
Meter
xumber: IM9 /l a KG1E---3
Site Address: 2896 Lezington Ave.
Silling Addreas Same
. 260.A0
Meter No, lPermit Fee 10.00
Meter Resding iMeter Dep.
Meter Sealed: Yes_ [Add'1 Chg. Acc.Dep. 15.00
NO `Total Chg. 285•00 Pd.
Building is a:
Residence z
Multipie Ko. Units
Cammercial
Industrial
Other
Inspected by
Date
Remarks:
Bq:
Chief Inspector
In conaideration of the isaue sncl deliverq to me of the above permit, I
hereby agree to do tte proposed work in accordaace with the rules and
regulations of Sagan Township, Dakota County, Mi.nnesota.
$St:
Please notify the above office when ready for inepection and connection.
,.
?P,:=,
`" fiE8 rI /
'966
City Council
City Hall
2795 Pilot Knob Road
Eagan, Minnesota 55121
Attention: Mr. Tom Hedges
City Administrator
2,896 Lexinqton Avenue SoutY?,
Eagan, Minnesota 55121
February 8, 1980
Re: Purchase of City Land
Councilmembers:
My husband and 2 are interested in purchasing a plot of
land owned by the City that had previously gone to taxes.
The land is located on Lexington Avenue South off of Reefe,
between the residential corner lot (our lot) and the driveway
of Carson, Pirie, Scott, the recently built carpet warehouse.
As it stands now, the land has no regular upkeep in the
summer by the City. Dead trees and weeds continue mounting
giving our lot an unattractive appearance. The fencing that
Carson, Pirie, Scott placed along the back of the residential
lots north of the warehouse ends on the east side of the
City's lot, givinq us the view of the warehouse. The lot is
of no henefit to the City because it is not large enough to
build on. Selling of the lot would place it back on taxes
and save the City the cost of future upkeep.
We are interested in purchasinq this land, if at a
reasonable price, to make our lot square and to beautify it
and our lot. There is one item of concern to us. The ease-
ment has a large casing of equipment placed there by the
telephone company. We would appreciate knowing if that could
be set underground or if it is a permanent obstacle to the
lot.
Please notify us of the Council's decision: if the lot
is for sale, the price of the lot, whether anything can be
done with the casing of equipment or if the lot is not for
sale. Thank you for your time.
Sincerely,
Lofgre
Shelly.
(y.
# 715a /la o?
tVELL CONSTR(,'CTIOti ,a.vD ,aBA:tiDONNtE`"I'
NVELL PERMIT
?
AHEREAS? th8
DBA: Gary's Well Drilling, Inc.
ADDRE3S: 21220 Mushtown Road
Prior Lake, MN 55372
Pe:mi: Nu.
90-9002
has submitted a permit application, has paid the sum of one
hundred ($100.00) dollazs to the County of Dakota as required by
Ordinance Number 114 and has complied with all of the
requirements of said Ordinance necessary Por obtaininq this
permit to permanently seal the well or wells described herein:
?L•.
'`. .
An abandoned water supply well with a casing diameter of 3 inches
and approximately 130 feet in depth. The well shall be cleaned
of equipment and debris, disinfected, neat cement pressure
grouted and terminated at least two feet below grade.
The well is located in the municipality of Eagan on the property
of:
Owner: William Lofgren
Address: 2896 Lexington Ave. South
Eagan, MN
Telephone: (612) 452-6458
NoW, T?REFORE, Gary's Well Drilling, Inc. is hereby permitted
and authorized to penuanently seal the well or wells described
and located above for the period February 27, 1990 - February 27,
1991 subject to all provisions of said Ordinance, the Minnesota
Water well Construction Code and any conditions attached on the
reverse side of this permit form.
Given under my hand this 27th day o,February, 1990.
NON-TRANSFERASLB 1_b'• ??
ENVIRONMENTAL HEALTH SPECIALIST
ATTEST •?'? ???+-..'??. L, :.,-Yi,,,.;?
ENVIRONMENTAL HEALTH S- ? RVISOR P[TBLIC HEALTH DIRECTOR
DABOTA COUNTY PUBLIC HEAI.TH DEP?,R1iVIED
EW[RONME.?7TAI. HEAI.TH SERVICES SECIIO
WATER QUALIIY M N
,?YAGEMENT iJNIT
33 E Wcntwor[h Ave., Wcst SG Paul, NIN 55118
Telephone:(6L)450-2607
MASTER CARD
•
LOCATION
O`,NNER
STRUCTURE AND IF y
LANO USED AS Atr--
Permit I
No
Issued Issued To
Contractor Owner
BUILDING
PLUMBING
i ?7yI
/_ .._
_.-?.-,
CESSPOOI - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER I
OTHER I i
OTHER I I I
• Items
,'GOTWG
FOUNDATION
fRAMING
FINAL
ELECTRICAL
HE4iING
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
.
COMMENTS:
Approved
(Initial) Date ?
i'?7",
- /3 - ?i
Remarks Distance From Well
SEPTIC
fT.
DEPTH '
OF WELL
Violations Noted
on Back
? a x a .sl
Gl?ie-?? • eO
?
?8/- ? ?oi
`7
- ?--g 94 ??e-?r=h- ,?-, -?? S• - - -
-- - - -- ?i -? - -
r t ??? v?
-- - - - 411U1_
r/Y
--
- ?/ - - -- -
>
- /3 • ? - --
?Ci9? - -
-- -- - - - -- - -- --1 -
(
- - - ?
--- 0 -? - -
-- ?
- - - z,y / -- - - -- --
--?? ? ? - - --
- ? -9L?f13 - - ---- ----
- -------
- , --
- ? - 2?-- - z4 - - - Zq! - -- -
- ? - ? - - -- ? -
-- ? - - - -
- - -- -- ? ?-? - - - - -- -
A X •
r----------------1
For Office Used
City of Eapn j Permit
Cn
I Permit Fee: . ✓ (J I
3830 Pilot Knob Road I 1
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: 1
2009 SEWER AND WATER REPAIR / DISCONNECT PERMIT
Date: Fee: $50.50
City Sewer City Water V Repair Disconnect
Description Of Work: ~Q e 0 V d I t e-
Street Address for Proposed Work.
OWNER Name: Phone:
Address / City / Zip: 41A a &T A'Jeju)
Applicant is: Owner ✓ Contractor
Licensed Pipelayer V11, Master Plumber Property Owner
X, L+
Name:,
Phone:726 \ ~p
E
Address ! City / Zip: YY7 1 `'L/
Pipelayer Training Certification Card or Master Plumber License
I acknowledge that the information is complete and accurate and that the work will be in conformance with the ordinances and codes
of the City of Eagan and the State of MN Statutes. 1 understand this is not a permit, b onl an application for a permit, and work is 0:~ 4 not to start without a permit.
_q b11~~
Applicant (Print Name) A plicant' Sign u e
09/18/2014 14:11 FAX 651 451 7740 CULLIGAN l�0001/0002
�l„e�� �� -�dR— ,� �'�U���G �`r'` "���t�a�.c�
� �-��- �-a-y/
Use BLUE or BIACK Ink
j----------------,
� For Oftice Usa �
_ �� ��t,������ i Permit!t: /4S 7�� / I
. ty of E��a� �,� , ,
Permtt Fee:
3830 Pilot Knob Road � �� SEP 18 2014 i �/ ] i
�;7 � �
Eagan MN 35122 . E, � 1 Date Received: / � ��
Phone:(651�675=5675 ���f' � � �
fax:(651).675-5694 - � S��� i
' �����������������J
, 2014 RESIDENTIAL PLUMBING PERMiT APPLICATION
Date: � Site Address: ���50 ' ""r��"�3'��b/� /� S
Tenant: s���#:
�� �' - '�""'
,*_� f (��
� �sidentlO�w � Name: Phone: ��eZ"e����iT 7
�� Address�City/Zip: , �p � j�
� i '����` " `�� Milbert ompany inc dba Culli Water
. Name: � � - ����se#: �NC643176
;� �� ..
�� .� Add�ess: 180150t_ Street East �;�,: inver Grove Hgts.
�����.;< ,,. . .
- � state:. :MN, z�p: 55077 Pno�e: 651-451-2241
�Y- '�'��; _,�:; r .Contad: W I I I I a fYl' R�M I(bC f't Email:
.Y� +�� � ` �New Replacement _Repair _Rebuiid _Modify Space Work in R.O.W.
� p�e f�1N,r' t — —
,.:. ' . Deseript(on ofwork:
.�
, "'�' - RESIDENTIAL
�.,
� Water Heater
:e_ A �a � � �WaterSoftener�
' _Lawn Irrigation(_RPZ J_PVB)
. P.e;rrt��.,YT''y ; Add Plumbing Fixtures�Main/_Lower Level)
�'� Septic System —
� �',. ����' � � _,.,New _Water Tumaround
;_��; . Abandonment
.:RESIDENTIAL FEES: �
=.�60'i00 VNa4er`He�Eer,=Water Softeoe�,or Water Heater and Softener(includes$5.00 State Surcharge)
' �.360:00 Lawn��lrrigafion:(includes$5.00 minimum State Surcharge)
$6'O.00 Atld;Plu�bing`Fixtures,Seatic Svstem Abandonment,Water Tumaround'(includes 35.00 State Surcharge)
�� � .�`Watec�Tum�round(add$200.00 if a 5/8"meter is required)
�115 00 SeptiC.SVStem New($10:00 per as`built)[ncludes Cou�ty fee and$5.00 State Surcharge) �
TOTAL FEES S
CAL'l'BEF.ORE.lf`OU DIG. Call Gopher State One Call at(651)454-0002 for protedion against underground utility damage.
Ca1198�hours'befare`you'intend to dig to receive'locates of underground utilities. wv�rw.aooherstateonecall_ora
I�hereby ack�owledge YTiat this�informa:ion fs eomplete and axurate;thel the work will be in confortnance with the ordlnances and codes of the City ot
: Eagan;.'.Chat�l'undersland:fhis is not a.permlt, but ony an application tor a,permtt,and work ts not io start wfthout a pertnit;that the work will be in
�accordance:witli:lAe.appiroyed plan in lAe case of work which requires a review and approval ot plana.
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