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2025 Flint LaneCITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT TYPE: i;+f I + 11 t +yrI Permit Number. sr ?' f, / a 7 Date Issued: i! f? I/'a5 SITE ADDRESS: c.l-OAir (ottiftill iR1i PERMIT SUBTYPE: APPLICANT: ( r ? ! ,"' } !i 4 rs - ?1 `i H E9 TYPE OF WORK: t?F ';r f< i f' I[ 1iN I I, ii t 1 NriS I N A I F Hi1M I M14 ft1.MhRk.'•: : A'D I: i'l1fiA I f PFRf'01 I 1`: Rt=!Ift I fi F 11 f il{t 11h1`i f_ ! tI 10 i t AI. li?t 0 ? iEili) i i IuN i t r? ? t f rk U ?t t, 1, A i iJ , ? ° I ?__. -J Permk No. Pertnit Holder Date Telephorro A ELECTRIC PLUMBING HVAC Inspection Date Insp. Commente FOOTINGS FOUND FRAMfNG 7 !/K/ ROOFING l??xqtr P ROUGH PLUMBING PLBG AIH TEST ROUGH HEATING GAS SVC TEST ` INSUL GYP BDARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTC, ORSAT TEST BLDG FINAL / IQ ?ll BSMT R.I. BSMT FINAL DECK FTG DECK FlNRL I ? Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK -Yc SEWER IATERAL 1?2 . 52. 31 WATERMAI N WATER LATERAL WATER AREA STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK CITY OF EAGAN Remarks Cedar Grove Acquisition ' EAGAN TOWNSHIP BUILDING PERMIT 2239 Ownex ...... lalt?C- --.----!-': - .....?Q............................ Ea9an Township Address IPreaenfl ...°.'?.°. .....:-` ...................... Town Hall Builder ....,?-raS........L?.tr.r. :-n?.:....C.J..°...t ...........................° ?/1? ?70 Dafe ...... "'_'-". ....._ ..............-":.... Addreas ? ..... ...° ° ....._./....- . ...... .......... .... .?::.....x?..?-w.-?. DESCRIPTION 52ories To Be Used Far Fxoni Deplh Heighf Esl. Cos! Permi! Fee Remarks ^ a??• ?.G.?. ?,. i? id .??.-? 9 ? LOCATION au 1 7 1 C, -*. 3 Thls permit doea aot euthorise the use of sixeets, zoads, allaps or eidewaiks nor doea ft give the owaer or hfs sgen! the right io ereale any s!luaiioa which is a nuisanee or whiah presents a hazerd !o the 6ealih, safelp, eonreaianca end general welfare !o anpone in the eommunilp. THIS PERMIT MUST BE PT ON THE PREMISE WHILE THE WOAK IS IN PAOGAESB. y This ie !o eerlifp. lhet..._-_-L..?^..:.`.'^.?-.....-.---_ ...................has parmission !o erea! e........?f..... ?:?.^:::°.....:...._upoa lheabove described pxemise aubjec2 !o the provisions of the Bufldinq Ordiaanee for Eagan Township adoplad April 11, 1855. ...................... ....... . .. .......,?(?. ........ ............. Pe: ......... -,6?--.-.. ...... ...:..................--:.............. Chairman Kf Tnwn Baard 'g Suilding Inspeator EAGAN TOWNSHIP BUILDING PERMIT Owner ? ' p ..-__......... --- ----- Addr,esa (Presenf) ...... ?^-?-?._.--?.......__.. Builder .......... .................. ............. _..___........_.._ Address .__--... .....--------- ---- _. DESCRIPTION h'° 1.180 Eagan Township Town Hall Date ..71-7/L`.?.... Siories -- _- To Be Used Far --___ Fronf Depi-_-h _- Heighi Lf. Cosi Es - Permii Fee Remarks ; '- o: .tJ? 2 3 /3.? C? j 3- - iocx naaition or Tz .vY - -/9-?7 l3.18- This pexmit does noi aufhorize the use of sireeis, roads, alleys or sidewalks nor does i2 give the owner or his agenf the righ2 fo creafe any situation which is a nuisance or which presenls a hasard So the health, safeiy, convenience and general welfare So anyone in the communiiy. THIS PEAMIT MUST BE KEPT ON HE PAEMISE WHILE THE WORK IS IN PROGRESS. This is fo eeriify, lhai(2.C.L..iL ..... .... ...... .`:!?-w...Cs?--.has permission !o er¢ci a----- &...a.. _.?... ' ?..?.?, .. ._..............._...^ pon the above dcscribed premise subjecY So the provisions of the Building Ordiaance far Eagan TdWnship adopled ril 11, 1955. ............................IkLIL.?- f..v!.`? Per .__..._.._(.z-c.cf Chairman of Tnwn Board o? •,l `Buildin Inspector 'I a3 9 ? yx;5 ??f?, 44c? MASTER CARD , -. OWNER , r 1 A? s R STRUCTURE AND I LAND USED AS IL J ? S (7 3 Permii No. Issued Issued To Contractor Owner BUILDING PLUMBING k StIt'7hiJ Oh? CESSPOOL - SEPTIC TANK VJELL ELECTRICAL HEATING GAS INSTALLING I SANITARY SEWER I OTHER I OTHER I `J • Items Approved (Initial) Date Remarks Distance From Well FGOTING SEPTIC POUNDATION I b-?y?_7U CESSPOOL FRAMING 7 ? iILE FlELD F7. FINAL ELECTRICAL I HEATING DEPTH OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUM8ING WELL SANITARY SEWER Violations Noted on 8ack COMMENTS: . PERMIT Mo1:5'oaa 3-- ?CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G EagBn, Minnesot8 55122-1897 Permit Number: 0 2 6 7 6 7 (612) 681-4675 Date Issued: 11 / 2 7/ 9 5 SITE ADDRESS: 2625 FLIN7 LN LOT: 20 BLOCK: 7 CEDAR GROVE 3Rp DESCRIPTION: REPAIR) 6ARAC,E/ACCESSORY ADDITION ? ) / I I ??? 1 t? ? ?./ U i'?.. ,.....J _. (INCL FIRE Bui?lding'-Permit Type Building Wor,?? Type *i ?.. ... REMARKS: A SEPARATE PERMIT IS REQUIREO FOR ANY ELECTRICAL WORK FEE SUMMARY: VALUATSOM Base Fee Plan Review Surcharge Lic. 5earch Total Fee $262.25 $91.79 $9.00 Fee $5.00 $368.04 CONTRACTOR: - Applicant - sT. LIc. OWNER: GIERTSEN CO 15461300 0001796 KASSUBE 860 DECATUR AVE N 2025 GOLDEN VALLEY MN 55427 EA6AN (612) 546-1300 DAVID FLZNT LN MN ? 2 hereby acknowledge that I have read this information is correct and agree to comply Statutes and C3ty of Eagan Ordiriances. -S a . APPLICANT/PERMITEE SIGNATURE $18,000 application and state that the with all applicable 3tate ofi Mn. ?03,, `Rp ?,C! ISSUED BY:?IGNATURET? J CITY OF EAGAN 3830 PILOT KNOB RD - 55122 + 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 ? 3 registered site surveYs ? 2 eopies of plan ? 2 copies of plens (include beam & window sizes; poured fitl. design; eto.) ? 2 site aurveys (exterior eddlflona 6 decks) ? 1 energy calwlatlons ? 1 energy calculations Tor heated add'uions ? 3 copiea ot tree presenation plan if lot platted after 7/1193 required: _ Yes _ No Gu`?O DATE: ?? !2CONSTRUCTION COST: /?( (? DESCRIPTION OF WORK: STREET ADDRESS: ' LOT __jL BLOCK q , SUBD./P.I.D. #:' l -p1lfGh, LltfX_ iklt PROPERTY Name:??/?,??! PhOne OWNER ^^? FaU Street Address ?%?? ?llyf" ??u.e City: ? State: AM Zip: c?- CONTRACTOR Company: ( , r P e??S eGU Phone #: ?1 ize?"I?2n / Street Address: &C44i,c/' License #•? Z!?fb ?,2 City: Ceyl Id P14 Vew, /k [Z State: i i v(_ Zip:_A- ARCHITECTI Company: Phone #- ENGINEER Name: Registration #• Street Address- City: State: Zip: Sewer 8 water licensed plumber: Penalty applies when address change and lot change are requested once permit is issued. 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 StaWtes and City of Eagan Ordinances. Signature of Appiicank ' OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservatipn Plan Received Yes No OFFICE USE ONLY BUILDING PERMIT TYPE 0 01 Foundation o 06 Duplex o 11 Apt./Lodging o 0 02 SF Dwelling o 07 4-plex ? 12 Mutti Repair/Rem. o 0 03 SF Addition ? 08 8-plex A' 13 Garage/Accessory ? 0 04 SF Porch ? 09 12-plex ? 14 Fireplace o 0 05 SF Misc. 0 10 _ plex o 15 Deck WORK TYPE 0 31 New o 33 Alterations o 36 Move X 32 Addftion o 34 Repair o 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. (Aliowable) Main level sq. ft. UBC Occupancy sq. ft. Zoning sq. ft. # of Stories sq. ft. Length sq. ft. Depth Footprint sq. ft. APPROVALS Planning Building Engineering Variance Permit Fee Surcharge Plan Review License MCNVS 5AC City SAC Water Conn. Water Meter Acct. Deposit S/W Permft S/W Surcharge Treatment PI. Road Unit Park Ded. Traiis Ded. Other Copies Total: Valuation: $ 0 ? O ? 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous MCM/S System City Water Fire Sprinklered PRV Booster Pump Census Code. 4?38_ SAC Code o ? Census Bidg ? Census Unit % SAC SAC Units IIi13i95 14:58 S 612 423 2255 CHRS NOUAK RRCHT ooundary & Locatimf Snrvey Por: Devid IGaautfe 2025 Fl int Inne , , . Axynn, MN 55123 . . DELMAR H. SCHWANZ uwn aunvcroPs. RMMwW untir t? M nw 0W. a 11"nn0w1 1050 90UTM pOBBRT TR110. R08EMOUNT, MINNESOTA 660E8 Posl-It'" „--v ,? , brand fax transmlttel memo'7671 0 ol p?go ? TM co. SQb - db Phon.. . FsrR? ? R/? (JF? sFM ? BURV£YOR'S CERTIFICATE 10?/9 e?v?zs+?ee N Fcalec 1 lnch r 30 fe.et O r Iron y1PA monament Rxloting fr_naee Proponed ner gnrRge ? 01 rxnrer f pt lnn t Rlock 7, CF•hntt c:NOVF. NU. 3, , aacording to thc tecorded p1aY lT10[eof, \ ?lo Dnkota County, Minn?note. - .41 .? d ? o N \ Z? nrninaqn a ulilft.y ? r.weemnnt R F.*latln9 nouec ,. ,:,.. ??Y1p??,?X- ' ,,... ..... • K' '? C;:LtdAR H.'. ? > 6 i ::(;N4'.'1NZ - 8G25 - ?a? ? ?f ?• ?uR :•'ti a ` \ f. t>niMrumnmm?? ? `p7'°?'?o 1 hsrsb? wrdty 1Ad IMs twwY. Wa^, or r.poA was yro"hA hr IM OI uMN my OIfiCI WplMNOn anE tMl 1 nm a duly Reqlatsrad Land 8unhror undll?\ Iho IOM o11M 8tpe of MInm"OIt. 11-10=95 o.na . `N,• . ? 9• .. ? lixinting gar.wye 41ab f? e?t?r flre! ? ?,'h ?O ryti ? ? A'T ' DeImar H. Beh+'dnt MMnswu PptMrstlon Ne. !!26 ? j PLUMBING (RESIDENTIAL) Permit Application n/ City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Please complete for: Single Family Dwellings Townhomes and Condos when pemuts aze required for each unit Date_j 3 Site Address F,1, 1,/Vf ? Unit # Property Owner Telephone # ( ) Contractor Address City V,-¢-b State /-)? Zip 6:]?O:bS Telephone # The Applicant is _ Owner (! Conhactor _ Other Septic System New Refurbished Submit 2 sets of plans and MPC license $ 100.00 Includes County fee. Additional consulWnt fees may apply. Alterations To Eaisting Dwelling Unit, Including $ 50 00 ? Adding fiMures to lower levels or room additions, excluding water softener and water heater . _ Abandonment of septic system _ Water tuma r? yund (+ 518" meter if needed -$121.00) ` ? _ Other: ?! --?a-p-?A. VvL.e ,n ? ??- _ RPZ _ new installation _ repair _ rebuild $ 30.00 _ Lawn irrigation system _ Water softener _ Water heater $ 15.00 _ replacement _ additlonal ? ? n ? ?. I I n State Surcharge ?MAY 0 6 20021 I'J $ '50 Total IBY _ 50. s 0 I hereby apply for a Residen6al Plumbing Pemvt and acknowledge Hhat the information is complete and accurate; that the work will be in conformauce with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that I understand this is not a permit, but oNy an application for a permit, and work is not to start without a permir, that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. J(,,M 44l? ? 14 ApplicanYs Printed Name icant's Si ature 14 -(0C3 RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot ICnob Road, Eagan Mu 55122 O Telephone # 651-675-5675 FAX # 651-675-5694 New ConsWCtion Reaui2menis RemodelRteoair Reouiremenls Office Use Onlr 3 registered site surveys showing sq. N. of lot, sq. ft. of house; and all roofed areas 2 mpies of plan Cert of Survey Recd (20% maximum bt coverage allowed) 1 setof Eneqy Calalations for heated atlditions _ Tree Pres Plan Reod 2 copies of plan showing beam & windaw sizes; poured (ound desgn, atc. 1 site survey for addNons & decks _ Tree Pres Not Reqd 1 set of Ener9y Calculatons Addih'on - indiCafe ilon-sde sepfic sysfem _ On-site Septic System 3 mpies of Tree Pmservadon PWn if bt platted after 711193 Rim Joist Dehail Optbns selection sheet (bidgs wiN 3 or less unils Date SiteAddress 20;k> L B 3 F(/h17- L/9-NC SFTU 2 ConstrucHo¢ Cost /6-a0, UniUSte # Description of Work *mmpM jef N/Af L- Multi-Family Bldg _ Y4N Fireplace(s) Y 0 _ 1 _ 2 Property Owner MA, eriY.v K f?'/K,?E Telephone #((¢ S/ )?OBB ?? g y?p Contractor i Ff} 13IB Cd. „%wG ';?iD ?)4- 3!?40 )431 /Q y - Address "Z'(?i State 6/?'b'A9i? F?9'C.?C-lNl?cS/?? D?, R4N ?1,,? 7 City ?iITU7A? Zip 12Telephone # (4S( ) --f'7p - 317 / COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Vlinnesota Rules 7672 Energy Code Category . Residendal Ventllatlon Category 1 Wwksheet • New Energy Code Worksheet (J submission type) Submilted Su6mitted • Energy Envelope Calculations Submilled Licensed Plumber Telephone #( Mechanical Contractor Sewer/Water Contractor Telephone # ( Telephone #( L? ? APR 0 2.??3 1? I _J I hereby apply for a Residential Building Permit and acknowledge that the informa ion is comp e and ac urate; that the work will be in conformance with the ordinances and codes of the City o9 MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. zr?(.Sk& F-" f J da , Or'GJ?tr+ ? ApplicanYs Printed Name Ag,g?ic s Signahu ?1 OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? OS 03-plex ? 11 10-plex 51 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellane0us Work Types (7R7?1R-o 1y` hE G iZ e 55 W)h a o w ? 30 Accessory Bldg ? 31 Ext. Alt - Multi O 33 Ext. Alt - SF ? 36 Multi Misc. ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)` ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement •DemollUon (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy fZ'3 MGES System Census Code 3 y Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const VV\ Width _ Footings (new bldg) _ Footings(deck) _ Footings(addirion) Foundarion Drain Tile Roof Ice & Water Final Y? Framing Fireplace _ R.I. _ Air Test _ Final Insularion REQiTIRED INSPECTIONS FinallC.O. ? FinaUNo C.O. _ Plumbing HVAC Other _ Pool _ Ftgs _ Air/Gas Tesu _ _ Siding Srucco Stone _ Windows (new/replacement) _ Retaining Wall Approved By JLA -, Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge TreaUnent Plant License Search Copies Other Total ? 2- ? L UW piL l.ei el 'Yt C. c,-U 50 946__? 2007RESIDENTIAL BUILDING rExNnT ArrLicnTioN City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New ConsWCtian Reau'vements 3 regislered site surveys showing sq. ft. ot lot, sq. ft of house; and all roofed areas (20°k maximum lol coverage allowed) 1 Soils Report H proposed building is to be pWCed on disNNed sal 2 wpies otplan showirtg beam 8 window sizes; paured found design, etc. 1 set of Energy Calculations 3 oopies M Tree Preservation Plan if lot platled after 711193 Rim Joat Detail Opfions sdectian sheet (buildirgs wifh 3 or less units) Minnegasw mechanical ventilalion fofm RemodeUReoair Reouirements 2 wpies of plan shrnving foo6ngs, beams, joals 1 set of EnergyCalcula6ons for heated additions 1 site survey for additlons 8 decks Additlon-irMicafe il on,sik sepb'csystem PIaf15 A/P. COIISIClPI'PCI ouhlir information uniess vou state thev are trade secret and the reason. Date // l 7 / Site Address 20LS a? 07 14,1 --- -?'I Vl'? 1,f ?_ -- Construction Cost . B? V o Unit/Ste # Description of Work ? f- DrJ ? /7i ?Ufr? Mu1H-Family Bldg _ Y ?? N Fireplace(s) ?C 0 _ 1 _ 2 PropertyOwner /?SSok- Telephone#(l4l ) 767??o19 7°f Contractor / 'li/ r1 C2-4 6 , S Address State /yI il fc{j Zip 5-37-3 75? . City )h&5 9.r,/t Telephone H(76J )2-,1L' 7I 3c2_ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 Enefgy Code Category , Residential Ventilation Category i Worksheet • New Energy Code Worksheet (4 submission type) Submitted Submilted . Energy Envelope Calwlations Submitled In ihe last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _ Y _ N If yes, date and address of master plon: Licensed Plumber Mechanical Contractor Sewer/Water Contractor I hereby apply for a Telephone # ( Telephone #( Telephone #( ??D-670 Offce Use Onlv CerlaFSurveyRecd- _Y _N SoilsRepodc-- _Y. _N Tree Pres Plan Recd Y: _ N, Tree Pres Required. Y? _ N On-site5epticSystem _Y' _N and acknowledge that the information is complete and aceural e; that the work will be in conformance with the ordinances and codes of the City of Eagan and the 5tate oi 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 f work which requires a review and approval of plans. r??5e Applica s Printed Name Applicant's Sig re - -------- - ? ???? ?? ,?/?/ ? ? Permit #: I Permit Fee: ? Date Received: I I ? I ? ? Staff: ? L ----------------- 2009 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: q I ?S/o ? SiteAddress: ?2OZ5 n.+k Tenant: Suite #: RESIDENT/OWNER Name: w/`?? rk4')SJJ: Phone: AddresslCitylZip: 2OZ5- r?h4-"? a.ii Q5 ? 7 34 ? ?IJ? CONTRACTOR Name: License Address: 1z? 6 ?2r? f?c- ? City: tJMOk-<<F,> Lwl?- State: kio Zip: Phone: ?(03 ContactPerson: I,OLl`- TYPE OF WORK _ New 4Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W. Description of work: PERMIT TYPE RE?IDENTIAL J Water Heater _ Water Softener -Lawn Irrigation Add Plumbing Fiutures L_ RPZ !_ PVB) ? Main _ Lower Level) Septic System _ Water Turnaround New Abandonment RESlDENTfAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irfigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System A6andonment, Water Turnaround` (includes $.50 State Surcharge) "Water Turnaround (add $165.00 if a 5/8" meter is required) $100.50 SeptiC System NeW ($10.00 per as built) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, duchvork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ I hereby acknowledge that Ihis 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 pertnit; 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 ? G , X ?(('?? Applicant's Printed Name ApplicanYs Signature -----i I For Office Use I Permit ~ City of Evan I Permit Fee: JV s 3830 Pilot Knob Road I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I Fax: (651) 675-5694 I Staff: L - - - - - - - - - - - - - - - - - I 2009 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: Site Address: 2 ©25 La,-i Tenant: Suite RESIDENT / OWNER Name: r'~ Phone: Address / City / Zip: 2 $5- kV+ Z ait CONTRACTOR Name: tJ.'l.b License ~5 7 Y( C Address: tZ' ~2 uL City: t~? E-/ _ State: Zip: ~"1 I 1,7 Phone: ? C o g Contact Person: I-e/iy C 1 TYPE OF WORK - New 7L Replacement -Repair _Rebuild _ Modify Space _ Work in R.O.W. Description of work: PERMIT TYPE RESIDENTIAL Water Heater Water Softener Lawn Irrigation Add Plumbing Fixtures RPZ / _ PVB) C_ Main - Lower Level) Septic System Water Turnaround New Abandonment RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge) *Water Turnaround (add $165.00 if a 5/8" meter is required) $100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ 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 pplanns x ~f v ar\ Co..~ x (2 Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground -Rough-In Air Test Gas Test Final PERMIT City of Eagan Permit Type:Building Permit Number:EA117147 Date Issued:10/15/2013 Permit Category:ePermit Site Address: 2025 Flint Lane Lot:20 Block: 7 Addition: Cedar Grove 3rd PID:10-16702-07-200 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required by law in ALL single family homes . Michael Yoakam Valuation: 4,000.00 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 - David B Kassube 2025 Flint Lane Eagan MN 55122 Great River Remodeling 15703 - 93rd Circle NE Elk River MN 55330 (763) 241-9596 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink r For Office Us I ZI 3 Permit City of Ea ~ad Permit Fee: (Ci l fJ r 3830 Pilot Knob Road I I Eagan MN 55122 ; Date Received: ; Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I I 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit Name: /~r ~ ~N ~c~ ~S ~ Phone: `7~ t/~ ~'l t'~► Resident/ j r Owner I Address / City / Zip: -e Applicant is: Owner Contractor <rc'/Y7~ y f Type of Work Description of work: S J. ~,r, l,✓, At Construction Cost: gg Multi-Family Building: (Yes / No Company: ~i/'-e tt f~ ~r u e % Ac'MC~Fft~ it-LC Contact: l"tr yc/g kf`l Contractor Address: l S ~G3 q ,r c ,-r /VC City: 0 r /t(n: State: MA) Zip: ~.3 30 Phone: `76 3 - _,_X11 -9 21r G License C. & y ( Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING 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. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org 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. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Cod ust be completed within 180 days of permit issuance. x II C,e l~ gn x Applicant's Printed Name Applican ' afu Page 1 of 3