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1802 Karis Way7 CITY OF EQGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT TYPE: Permit Number: Date Issued: rrll I I it I ro fi; 1A:44 SITE ADDRESS: . .. . 0AY PERMIT SUBTYPE: F L 71pw-.:nw-tl` APPLICANT: :? H ti t ttC V c i 61.' l, Ht,.i•-NN49 TYPE OF WORK: Iir Ii, i! i 1 110 kUi>nrr? FtUFrllRri' /?: I (1ltM lIAMAe?F -1 J Permit Holder Date Telephone !t PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ? ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST ? BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS corvoucTivirv TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CITY OF EAGAN Remarks Addition RiClaecliff F.l-rSt Aci?n. Lot ?$ Blk 9 Parcel #1 f1 6398f1 280 fl-2 Owner Street 1802 Karis Way state Eagan, hIN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK , $ 1.2 c0o 21-2 SEWERLATERAL 1305.42 5 1305.42 C007616 12-23-81 WATERMAIN WATERLATERAL 19$2 12(0.]9 S 1260.79 C007616 12-23-81 WATER AREA 2 STORM SEW TRK 1982 638.24 S 638.24 C007616 12-23-81 STORMSEWLAT 1982 955.45 5 955.45 C007616 12-23-81 Services 1982 637.75 5 637.75 C007616 12-23-81 CURB & GUTTER SIDEWALK . STREET LIGHT ROAD UNIT 240.00 #29820 4-28-82 WATER CONN. 420.00 11 BUILDING PER. s,ac 525.00 ' PARK Receipt • ? PLUMBING PERMIT CITY OF EAGAN Permit No. v . Fee Fill in numbered spaces S/C Type or Print /egrb/y Tot. .7 1. Date 2. Installation Cost 3. Job Address4?,'(:1o7?? Lot Tract ? . 4. Owner -Ij , 5. Contractor,/-/ Phone 6. Address,/ ??/ 7. City.- State -' Zip 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New iA Add O Alter ? Repair ? 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs Se tic Tank Lavatory ? p Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify tfiat the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work, Signed : Inspections: Date Rough _ Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 for Final r--A CASH RECEIPT • CITY OF EAGAN 2 3795 PILOT KNOB ROAD 2g? EAGAN, MINNESOTA 55122 DATE RECE11/ED 19 AMOUNT $ I & DOLLARS +oo ? CASH r-I CHECK FOR Thank You - ??- BY I/ White-Payers Copy Yellow-Posting Copy Pink-File Copy Receipt PLUMBING PERMIT Permit No. T_ CITY OF EAGAN Fee - fill in numbered spaces S/C Type or Print legib/y ? ?- Tot. :-?:- 1. Date 5- 4- ri Z 2. Instaltation Cost 3. JobAddress1802 naris 64aY LotO4 S' Blk. cl Tract 4, Owner Ur r in Thoenbson 5. Contractor Wenzel I•iech. Phone 452- 1_',65 6. Address 3600 Kennebec '-r 7. City il,agan State Minn Zip55122 8. Building Type: Residential Od Commercial ? Institutional 0 9. Work Description: New 0 Add ? Alter ? Repair ? 1 10. Describe I 11. No, ? Fixtures Water Closet No. Fixtures Cesspool/Drainfield / Bath tubs Septic Tank Lavatory ? Softner / Shower Well Kitchen Sink ? Urinal/Bidet Laundry Tray Other / Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 OF EAGAN aad Eagon, MN IEs 4S4-8100 BUILDING PERMIT 1 Ta 6a uned inr Receipt # M_._ r' ,e Erect ? Alrer ? Repoir ? Enlarfle ? Move ? Demollsh ? Slt! AddfC55 . Lot Black 5ec/Sub. Parcel # oc Name W Zg /WdrQSt b _ °C Ncme 0 z u? /?ddress Name _ Address I hereby ocknowledge thot I hove reod this opplication ond state thot the iniormotion is correct and agree to wmply with ofl applicable Siate of Minnesota Stotutes and City of Eagan Ordinonces. Sipnoture of Permittee /1 Building Per?nit is issued to: oll work shall be done in accordance Buildinp Officiol Ft. OcCUponcy 2oning Flre Zone T....s ..L /^......? Assessment Water 8 Sew. Pol ice Fire Enp. Planner Council Bidg. Off. APC Permit Surcharge Plun check 5AC Water Conn . Water Meter Rood Unit Totol - on the express condition thn+ ait opplicnble Stose of Minnesato Statutes ond City of Eeyan Ordinonces. Permit No. Permit Holder Misc. Permit No. Holder Plumbin9 {'lZ? H.V.A.C. ? ?j WE1?Ct-I? ?0 3 $Z w.ii Water Disp. Sawer . Electric ? 0 $q g F??C ? Inspection Date Insp. Other FootinQs Fwndation Framing Rouyh Plbp. _ _ ? q Rouph HVAC . (? Inaulation „ Final Plby. Final HVAC ?. ? Final Water Desaiha Location: VYall , Sewer Pr. Dlsp. Receipt MECHANICAL PERMIT CITY OF EAGAN Permit No. Fee Fi/I in numbered spaces S/C Type or Print leyibly Tot. 1. Date ? • 2. Installation Cost ? . 3. Job Address "Lot Blk. Tract 4. Owner ' ?- 5. Contractor ? - phone 5 ? - 6. Address 7. City State Zip $. Building Type: Residential E) Commercial ? institutional ? 8. Work Description: New E1 Add ? Alter O Repair ? 10. Describe Fuel Type , 11. Na. i Eguipment 8TU - M. Ea. Forced Air • No. EQUiament CFM Ai H i Mfg. r andl ng: Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinanoes and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-8100 SEWER SERVICE PERMIT CITY OF EAGAN pE?IT NO.: 37y3 Pilot Knob Road Eogon, MN 55122 DATE: of Units: No Zonirp; . QW110f: ` - Address: j c r.• i Site /lddress: , Plumber: . • ? I prse to oomPly wlth the Gtfr ef Ea9an Connection Char4e: Acoount Depcsit: . prdiMnoas. Permit Fee: Surcharye: ` Misc. Charges: ey Total: Dote of Insp.: I nsp.: Dab Poid: j WATER SERVICE PERMIT ; CITY OF EAGAN PERMIT NO.: . ' 3795 Pilot Knob Roed . Eogan, MN 55122 DATE: ? '- No. of Units: Zoning: Owner: C?rTin Address: No.. No.: to comply wfth the City of Eagon Connection Charge: Account Deposit: _ Permit Fee: Surcharge: Misc. Charges: - Total: ----- Date Paid: Renewal By Andersen 350-73rdAve. NE FTidley, MN 55432 763-502-4777 #MN20130983 - New Constructian Requirements 1 D J RESIDENTIAL LDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681•4675 • 3 registered site surveys showirig sq. ft of Io4 sq. ft of house; and all rooted areas (20% maximum lot coverage allowed) • 2 copies of plan showirg beam & window sizes; poured fouM design, eta) • 1 set of Energy Calculations • 3 mpies oi Tree Preservatlon Plan'rf lot plaGed aRer 7/1193 • Rim Joist Detail Options selection sheet (bldgs wBh 3 or less units) O ? a-7 2-? ? Fr INr?q? ?a-?-o? ID RemodeUReoair Reauiremenls . 2 copies ot plan BY- • 7 set of Enef9y CalculaGons lor heateC'atlt • 15Resurveyforexterioradditlons8decks 0 DATE o•k)6U•0I ,I VALUATION (EXCLUDING LAND) JOB SITE ADDRESS I2[?e? ?hO.t:S U.Xlta - IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER M'n TYPE OF WORK APPLICANT ADDRESS PAGER # CELL PHONE # ZIPCODE 5S430 FAX # NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 (check one) - Residential Ventilation Category 1 Worksheet Submitted - Energy Envelope Calculations Submitted _ MINNESOTA RULES 7672 New Energy Code Worksheet Submitted Plumbing Coniractor: _ Plumbing 5ystem Includes: Mechanical Contractor. _ Mechanical System Includes: Sewer/Water Contractor: ? Water Softener _ Water Heater No. of Baths Air Conclitioning Heat Recovery System Phone # Phone # Fee: $70.00 All above information must be submitted prior to processing of application. 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 Ordinan es. Signature ot Applicant Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Phone #: Lawn Sprinkler Fee: $90.00 No. of R.I. Baths FIREPLACE(S) _0 _7 _2 _3 PHONE# 95a•3145•C0644 Updated 1/01 OFFICE USE ONLY 13 Ot Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Owelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? ?. ? 33 Alteration . ,0 '37 Demolish (Bldg)' ? 43 Reroof O 46 Windows/Doors ? 34 Replacement *Demolition (EnHre Bldg only) • GWe PCA handout to applicaqt '' , Valuation Census Code SAC Units Nbr. of Units Nbr, of Bidgs' Type of Const _ Foorings(new bldg) _ Footings (deck) _ Footings(addition) Foundarion Drain Tile Roof Ice & Water Final _ Framing _ Fireplace _ R.I. _ Au Test _ Final _ Insularion Occupancy Zoning Stories Sq. Ft. Length Width REQUIRED INSPECTIONS _ FinaUC.O. _ FinallNo C.O. _ Plumbing HVAC MClES System City Water Booster.Pump PRV Fire Sprinklered , Other _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Siding Stucco Stone _ Windows (new/replacement) Approvad By Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S8W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total Buiidiny Inspector CIT] OF EACAN ? Include 2 sets of plans, 6f .Y? 1 site plan w/elevations 6 BC;ILCIW, PERMIT APPLIC'ATION 1 set of energy calculations. r,-C= Dw?? c?;c r ? 1 ?, o a o - 'Ib Be Used For ?Valuation -?? Date ?pI-.),? Site Address: tA0z Vnr:s UJav (.Qkan I 08) oEPICE USE ONLY Int a8 Bloclc ol- Sec./Sub. Ri'kqp??%fAe Erect ?C Occ?-ipancY /31 Parcel #: /U,?(o'3eC??23;Nrs Alter Zoning / ; Repair Fire Zone Nd1 Owner: Pddress: City/Zip Cocie: Phone #: Contractor: (1RRIN TNf1MPCl1N unnnrc Address: a Division of U. S. Home Corporation 1712110 City/Zip Code: MINNETONKA, MINN. 55143 Phone #: 5AA- 7 333 Arch./IIng.. Pddress: City/Zip Code: Enlarge Type of Const. Nbve # Stories Demolish Front (y 2 ft. Grade Depth 196 ft. APPROVALS F'EES Assessmnts Water/Szwer Polioe _ Fi re ? Planner Council Bldg. Off. P,PC Pesmit ?/la ?- Surcharge Plan Check ? sAC sas = Water Conn. ,2 Water .Meter /op _ Road Uni.t --z'yQ E* Phone #: . TOTAL /. 74 9. S-0 - s cIrY oF EncnN N° 7203 3795 PItM Knob Road Eayae, MN 55122 - PXOHEt 451•8100 BUILDING PERMIT '' ? Receipt # . _ Te M wad 1er ? ?/GAR Est. Volue Y61 ? 000 Date Akt11 _28_ 1982 sire naareu lavc naris wav trtan tva) Lot 28 ei«k 2 socisun. Ridgecliffe lf parcel # 10 63980 280 02 rc Name vCr1T1 1[1(ffilE7l30C1 't"nPrz 2 ? Address ,-- 171r2? F P1C1riS CL'OS9.Y03d...,.. o Name «Pr u?t- Addreu ? r,.., a....._ Nome _ Addreu 1 hereby ocknowledge thot I have read this application ond state thnf fhe intormotion is mrrect und ogree fo comply with all npplicoble Stote of Minnewro Stotutes ond City of Eagan Ordinonces. Signoture of PermiMee A Buiiding Permif is issued to: Orr7-T1 all work sholl be done in acrnrdonce with alt Buildiny Officlal of e.a« IX acupancY R-3 Alter ? Zonina R-i (PD) Repair ? Fire Zone NA, Enlnrge ? TYpe of Const. V Move ? # Srories DemolisM p Length.62- Grade ? Depth-M-Sq. Ft.- Aoororals Faes Assessment _ Water & $ew. Police - fire Eny. Planner _ Countil _ Bldg. Off. _ APC pe"it 310.UV Surcharge 30.50 Plon check 158•00 SAC 525.00 Water Conn.420- 00_ Woter Meter 60 • 00 Road Unit 940 ()() Tot,, $1749 50 on the express condition thnt y of Eapon Ordinances. EST FOR ELECTRICAL INSPECTION „ ee-ooooi-oa cs y 4? ,.. See mstructions For co10e1ing this torm an back of yeilow copy. C1 i' X" Below Work Covered by This Request ?O s?O ?Ne Atld. Rep. 1'yoe oi eviltling ApDlianms Wired Equipmant Wired Home Range Temporary Service i Duplex Apt. Building Commercial Bldg. - Water Heater - Dryer Fumace Lighting Fixtures Electric Heatin $ilo Unloader Industrial BIAg. Air Conditioner 9ulk Miik Tank Fyrm OMer peaty rher ISpeclfyl ? ?' ?SUecity t ¢r Othor c,ompute inspecUOn hee BePow N Pea SarvicaEntreneeSixa d Fne Faetlers?5vbieeders # Fee Circuits ?- .l Otot00qms Oto30Ams `11J. Otn30Ams I 101 to 200 Amps 31 to 100 qmps 37 to 700 Am s Above 200 Amps Above 100_Am s Ahove 1 W_Amps Transiormers RemoteControl Circ. u PartiaVOth Signs Special Inspection g A> Renuerks 30! TOTAL (EO.6 Rough-in D: e I, tha Elechical specto he.eby Final . ?? cer ify tha q t the abova ( ?;i?? sqection hes been ? 7i.,.,,n) l?- mede. This request void I rn;s ?ea?esc ?o?d (? 18 monffis from //-7 IT 0894 Lz$i /3z, I sf? 305$$ 3o, o(C) Fequest at. . Fire No. ti Rough-in Insuecon Ra uired? Inspec- ?Ready Ntl?ill N ??? y Yes ?Nu I , 7 tor eatly icensed ElecVical ConVac[or v . I herahy requast inspection ot above Owner eleeVicel work installad at [ Atldress, Bou or Route No. I so 7- kWa5 ? GtY 6%CW . ecuon o. TownshiV Name or No. flnnge No. Couu1Y M-1-al A Occup nt IPflIN a TI Phone No. n p ' - ?j,? ?1?1? IFiUf9T?lv ? Pawer SuOPlier Address Q[?,? w(r Ele Conhactor (Cumpany Name) ? Cont actor'z License No. . . ? ?? ?-tc?rr?- Mailinp Address (Contracmr or Dwner Makine lnstailation) ' ! i I l .6 < C;4ff P-rj(h0 Authorizad Si atur IContrectodOwner Makiny Installationl Phbne Num\ber r ?.V • ?7 J? I MINNESOTA STATE BOAND OF ELECTRICITY THIS INSPEGTION flEQUEST WILL NOT Griggs-Mitlwey Blde. - Room N-191 gE ACCEPTED BY THE STATE BOARD 1821 UnivarsitV Ava., St. Peul, MN 65106 UNLESS PflOPEN INSPECTION FEE IS - I I - -- ENCLOSED. IP;LNiYt lT 719311 ? 4800 Harboui Poinre Blvd. SW Mukilteo, WA 982.75 P (425) 6092.'500 F f4251 60912781 0 wwwJrr,vls p; od u cts. co rn O r'V >- January 17, 2007 d--' Firespaces Inc. w 8545 West Highway 101 Bunisvi7ia, 1v1N. 55370 ? ?? ? TRAVIS INDU5TRIES ,e Tk, ? Concerning Permit# EA071934 Myllenbec Residencc 1802 Karis Wa z Gagan, 55122 To Whom ft May Concern: W Thank you for your correspondence in regards to the installalion of the 34DV L fireplace. We u have reviewed the proposed installation with our technical departmcnt, and the installation of the Q chimney system as presently installed (with no '/d' rise per foot), creates no safety coucerns. However, lhcre may be some performance issues because of the vent configuratioa If all the -' concerned parties are satisfied with the performance of the fireplacc, we have no further issuc n with this installation. All othcr installation clearances and specifications must be followcd as stated in the insrallation manual. w o% [ hope this answers yoirc questions on this install. Please call if you have any further questions. ? Sincercly, ? . ? Q ?---- c-- .._ ?? ---- - ? .lohn J. Beiermann Customer Scrvice Manager ? Iravis Industries, [nc. ? IN C? 5. ? -7 ? S RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651•681-4675 New ConsVUCtion Reauiremenb • 3 registered sile surveys showirg sq. ft. of lot, sq. ft. of frouse; and all roofed a2as (20% manimum lot coverage allowed) • 2 copies of plan showing beam 8 window s¢es; poured found design, etc.) • 1 sal of Energy Calculatlons • 3 copies of Tree Presarvation Plan N lot platted a0er 7l1193 • Rim Joist Datail Optlans selection sheet (Mdgs with 3 orless uniGs) DATE lG -3? U-Z SITE ADC TYPE OF ULTI-FAMILYBLDG _Y Q FIREPLACE(S) _ 0 ? 2 APPUCANT e?gGS ??e ?-?4 S STREET ADDRESS dG r-<S- CITY STATEA!t/ ZIP_S_S?W TELEPHONE#fg_-2'K'''/ 'a73? CELLPHONE# FAX# PROPERTYOWNER_ IYIi,? llC15e?? TELEPHONE# COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ ;yIINVFSOTA RliLES 7670 CATEGORY I MINNESOTA RCiLF:S 7672 (q submission type) • Residentlal Ventilation Calegory 1 Worksheet Submitted • New Ener9y Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: _____ Plumbing system includes: Mechanical Contractor: Nicch.unical syscetu includes: Sewer/Water Confractor: Air CondiUoning Heat Recovery System I hereby acknowledge that I have read this application, state that the with all applicable State of Minnesota Statutes and City of Eagan Orc Signature of Applicant Pee: $90.00 Phone # r?F?---- -_ I cTee: ?s701QOjr, ? G Phone # .? maNdis correct, and agree to comply OFFICE USE ONLY Water Softcner _ _ Wafer Heater _ No. of Batfis _ Phone # Lawn Sprinkler No. of R.I. Batlis RemodeVReoair Reauirements • 2 wpies of plan • 1 set of Energy Calculations kr heated addiUons • 1 site survey for extenor additbns & decks . IrMicate if home served by septiC syslem for additlons VALUATION Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4l02 OFFICE USE ONLY ? 01 Foundation ? 07 OSplex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-piex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi O 03 01 of _ plex ? 09 07-plex O 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Muw ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New O 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding O 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg only) • Give PCA handout to applicant Valuation Occupancy ` MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bidgs Length Fire Sprinklered Type of Const W idth REQUIRED INSPECTIONS _ Footiugs (new bldg) _ FinaUC.O. _ Footings (deck) _ FinaUNo C.O. _ Footings(addirion) _ Plumbing Foundarion HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Franung _ Siding Stuceo Stone _ Fireplace _ RL _ Air Test _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S8W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other ToWI Building Inspector 1tlUL C. R. WINDE-N?3 A OGUTES, INC. tAND SURVEYORS T*L 646-3646 FOR: 1381 EUSTIS SL, S T. PA U II M I N N. 55108 U. S. HOME CORPORATION 5 N o. , . o ? ? ? ? 5? O ZJ \ t Scale: 1" = 30' D O Denotes Iron C :? I 1 -i - r { I os¢d f{ous¢ w • ? ?Z N 1 N P?°P 2p q2 m I ,5 J ? 0 0 Z ' t5.o0 ? KARiS ?,NA Lot 28, Block 2, Ridgecliffe First Addition, Dakota County, Minnesota. WE MERE6Y CERTIfY TMAT iM15 IS A TRUE AND CONRECT REPRESENTAiION OF A SURVEY OF THE 60UNDARIES Of THE IAND ABOVE DESCRI6ED AND OF tME IOGATION OF All 6UIlDINGS, IF wNY, TNEREON, AND All V1516LE ENCROACHMENTS, IF ANY, FROM OR ON SAID LAND. Dotad tAis 2c) 4 doy of 12ri A.D. 1982 C. R. WINDEN 3 ASSOCIATES, INC. by 4"0' Survorer, Minnewla Rapitlrotion Ne. 172G NT1519 aa"" , "3 r, ???er-JoneS Building Permit Service, Iric. 1120 East 80th Street Bloomington, NIN 55420 Phone: (952) 345-6047 Fax: (952) 854-4909 To whom it may concem: We at Elder-Jones Building Permit Service, Ina are acting as an agent for Renewal By Anderson. If there are any questions, or if the permit has to be picked up in person, please give us a call at the number above. If the permit can be mailed back to us, we have enclosed a self-addressed envelope for your convenience. Thank you, Kaza Benson ext. 147 Elder-Jones Building Permit Service, Inc. 1120 East SOth Street ' Bloomington, Minnesota 55420-1498 952-854-2854 1 FAX:952-854-4909 P? CITY OF EAGAN -3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMITTYPE: auzLozNG Permit Number: 0 3 3 0 3 4 Date Issued: 0 S/ 2 7/ 9 8 SITE ADDRESS: P.I.N.: 10-63980-280-02 DESCRIPTION: REMARKS: DAMAGE STORM DflMAGE REPAIR ALT. RESIDENTIAL y 1 2^ 4 t C ?'? E! ? ?• < 1 ,? t ? Il d t a [? 0?P 1802 KARIS WAY LOT: 28 BLOCK: 2 RIDGECLIFFE 1ST REROOF/STORM eui',lding',permit Type B:uzlding W6rk Type ?,Census Cotle 434 .? a? jFEE SUMMARY: CONTRACTOR: - RIGHT WAY ROOFING 1200 E. 79TH ST BLOOMINGTON MN (612) 853-0049 Applicant - ST. LTC. 18530099 00039999 55425 OWNER: MYLLENBECK JOHN 1802 KARIS WAY EAGAN MN 55122 (651)952-9626 I hereby acknuwled-ga that I hav:e read thS,s infermation is correct and agree to comply Statutes and Gaty of Eagan ordin.anees: ? _ . APPLICANTIPERMITEE SIGNATURE PERMIT epplioat3on and state that the with all applzcabls 5tate of Mn. 'IS ED BY: SIGNATU E-T J . 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) - CITY OF EAGAN ? 3830 PII.OT KNO' RD - 55122 .? ? -9 Z New Conshuction Reauirements RemodeUReoair Reauirements ? 3 registereG sde surveys ? 2 eopies of plan ? 2 copies of plana (inGutle beam 8 window sizes; poured fiG. design; etc.) ? 2 sfte surveys (e#erior addkions & deeks) ? 1 energy pleula6ons ? t eneryy calculations for heated a0ditions • 3 eopies of tree preservatan plan if lot platted aRer 7/7/93 required: _ Yes _ No DATE: CONSTRUCTION COST; cI`'l a 3 DESCRIPT OF WORK: STR TADDRESS: 1Fsaa ?(,a2zs •`^-x Y LOT: -? '' BLOCK: ?- SUBD.lP.I.D. #: K.l4-e C Q? ( S? Name: h,%. YLL F-rJ ? EcV-- v, Phone #: q.S ?- 4 G L? (t PROPERTY Last Fiist OWNER Street Address: i SU o1 Y-?,,v^ -S wc- Y ciri E as.6 p,J state: aCU zia: 5s 12 a Company:??A : L,.,,aY 2-00qc 2.,.? Phone #: 'F%53 r'ci-o Yq CONTRACTOR ARCHITECT/ ENGINEER Street Address:12C3n f /74 "AL Si License # ??0 3Q -?iq City -Ra-k-?, Stare: f?'1 tii Zip: ?yq z S Phone #: Name: Registration #: Street City Sewer 8 water licensed plumber (new construction ony): and lot change is requested once pertnit is issued. Zip: Penaity applies when address chang 1 hereby acknowledge that I have read this application and state that the infortnation is correct and agree to comply with all applicabl State of MinnesoW Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes - No _ State: OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 02 SF Dwelling ? 07 4-plex ? 03 SF Addition 0 OS 8-plex ? 04 SF Porch ? 09 12-plex ? 05 SF Misc. ? 10 = plex WORK TYPE ? 31 New ? 33 Aiterations ? 32 Addition ? 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning O 11 Apt./Lodging ? ? 12 Multi Repair/Rem. ? ? 13 Garage/Accessory ? ? 14 Fireplace ? O 15 Deck ? 36 Move ? 37 Demolition Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building Engineering Variance Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: Valuation: $ 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous MCNVS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit % SAC SAC Units RESIDENTIAL BUILDING Permit Application City OfEagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 ?.o New Construction Reauirements 3 registered site surveys showing sq. fl. of lot sq. ft o( house; and all roofed areas (20% maximum lot coverage allawed) 2 cropies of plan showing beam & window sizes; poured found design, etc. 1 set of Energy Calculations 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Delail Optlons selection sheet (bldgs wilh 3 or less unils RemodeVReoair Reauirements 2 wpies of plan 1 set of Energy Calculations Mr heated additions 1 site survey for additionce & decks Addition - indicate if ao-mie septic system %rlo.? ? OKce Use Onlv CeRotSurveyRecd _Y _N Tree Pres Plan Recd _ Y _ N Tree Pres Not Reqd _ Y _ N On-site Sep6c System _ Y _ N Date 8/ ? a /b?) Site Address ?&b 2 l Construction Cost b U d S W DL Unit/Ste # Descrip[ion ot Work t-W d2C V- w( Ti rnl?-cv4t 0-l-\ otf.l'. k t?fGJ ?/Y7l???A Multi-Family Btdg _ Y?'N Fireplace(s) 0_ 1 _ 2 ProperTy Owner ? 6Yl M v 1 l- P n h-e P I?- Telephone #( 1161 1n Z 10 Contractor 62204li V C SYLC?VI?.f-h 04 Address 1445b ? State M ti1 I -e- QL/y? City gLi.lNlStil I?? Zip Telephone #( RS2) 4-40 -'1'lSL? COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 7 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted . Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( Telephone # ( ? M UG 1 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 NN Statutes; I understand this is not a permit, but only an appiication 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 approvai of plans. VA nc- Ch?L<? he V?- v - Applicant's Printed Name Applicant's Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling O OS 06-plex ? 16 Fireplace O 21 Porch (3-sea.) ? 31 EM. Alt - Multi ? 03 01of_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.) ? 33 Ext.AIt - SF ? 04 02-plex ? 10 OS-plex ?r- 18 Deck ? 23 Porch(screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous WorkTypes (14-0 7' `j Z'C ) / ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ?( 32 Addition ? ? 36 Move Bldg. ? 42 Demolish (Foundation) 0 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bidg)" ? 43 Reroof ? 46 WindowslDoors ? 34 Replacement •Demolition (Entire Bldg) • Giva PCA handout to applicant 0 - Valuation - - 7? Occupancy MC/ES System Census Code L Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Canst 1! / Width Footings (new bldg) ? Footings (deck) _ Footings (addition) . Foundation Drain Tile Roof Ice & Water Final _ Framing _ Fireplace _ R.I. Air Test _ Final Insulation REQUIREDINSPECTIONS FinaUC.O. ? FinaUNo C.O. _ Plumbing HVAC Other _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Siding Stucco Stone _ Windows (newlreplacement) _ Retaining Wall Approved By?1i , 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 0ric-rc ?- Jfro-? ?"U ? ?-/ o cv Z?o ??? 1802 ?C? '' ?Q C. R. WINDEN 3 ASSOCIATES, INC. iV v?????/?? lANO SURVEYORS 7al 645-3646 FOR: O 1381 EUSTIS SL, ST. PAUt# MINN. 53100 U. S. HOME CORPORATION ? o ? O W ? 5 z \1 I 1?? Scale: 1" = 30' D O Denotes Zron ? -D._ G I ? I Hcus¢ w , ? N propos¢d ' ?1 °Zo U I W 42 , J ["! 5 I O 1 _ ! Z 15•?? ? Kp, G Lot 28, Block 2, Ridgecliffe First Addition, Dakota County, Minnesota. WE MERE6Y CERTIFY TMAT TMIS IS A TRUE AND CORRECT REPRESENTATION Oi A SURVEY OF THE 60UNDARIES OF TME IAND ABOVE DFSCRIlED ANO Of TME IOCATION OF All 6UIlDINGS, IF ANY, TMEREON, AND ALL V15161E ENCROACHMENTS, IF ANY, fROM OR ON SAID IAND. Dotad this 204h dor of r; I A.O. 198Z C. RWINDEN 3 ASSOCIATES, INC. 6" br Svr.oyer, Minnewla Rapislrafion Ne.172G NT1S19 ?(W # 7v , o-, 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Corrtrucfion Raquirements 3 registered site surveys showing sq. it of lot, sq. ft. of house; and all roofed areas (20% maximum lot coverege allowed) 2 copies of plan showing beam & window sizes; poured found design, etc. 9 set of Energy Calalations 3 copies of Tree PreservaUon Plan 'rf lot platted after 717193 Rim Joist Detail Op6ons selecGon sheet (buiWings wAh 3 or less units) RemodeUReoair Renuirements Office Use Onlv 2 copies of plan Cert of Survey Reod _ Y_ N 7 set of Energy Calculations for heated addNOns Tree Pres PWn Recd _ Y_ N t siie suNey for addifions $ decks Tree Pres Required Y N Addifion - indicafe if on-s'rfe sep5c system On-site 5eptic 5ystem _ Y_ N Date ?_ / ? / _? ?6 Construction Cost q dd (? ,/ site Address Y?0AC:ti5 OC'-u- UniUSte # Description of Work Mu[6-Family Bldg _ Y2?r'N Fireplace(s) _ 0 ? 1 _ 2 Property Owner 01,4 ,n.? ? `lft - 6 Telep6one # <1 Convactor y- (-? t-d ??LCI° ,u Address v j• City F)ul:^,U?SV6 QQ ? State IN1AA Zip Jr 5337 Telephone #(Jr7 J.) $58-079 COMPLETE THIS AREA ONLY IF Energy Code Category - Minnasota Rules 7670 Categorv 1 • Residential Ventilation Category 1 Worksheet (q submission type) Submitted . Energy Envelope Calculations Submitted A NEW BUILDING Minnesota Rules 7672 • New Energy Code Worksheet Submitted In the 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 plan: Licensed Plumber Mechanical Contractor Sewer/Wpter Contractor Telephone # ( ) _ Telephone # ( Telephone #( I hereby apply for a Residential Building Pernut 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 pl in the cas f work which requires a review and approva of plans. i /' ?o,3-64Z5 tJ ?V?A ov\ Applicant's Printed Name Applicant's Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ex[. Alt - SF ? 04 02-plex ' ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex PI6g_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demofish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors ? 34 ReplaCement `Demolition (Entire Bidg) - Giva PCA handout to applicant Valuation Occupancy MCES System Pian Review 100% or 25% Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width _ Footings (new bldg) _ Footings (deck) _ Footings (addirion) Foundarion Drain Tile Roof Ice & Water Final _ Framing _ Fireplace _ R.I. _ Air Test _ Final Insularion Approved By: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total REQUIRED INSPECTIONS _ FinallC.O. _ FinaUNo C.O. _ Plumbing HVAC Other _ Pool _ Ftgs _ Air/Gas Tests Final _ Siding _ Srucco _ Stone _ Brick _ Windows _ Retauung Wall Building Inspector City of Eapn 3830 Pilot Knob Road Eagan MN 55122 Phone: (657) 675-5675 Fax: (651) 675-5694 ?----------------- ? I PermitFee: ? Date Received: rl 1 ? ? Staff: I I ------------------ 20U8 RESIDENTIAL BUILDING PERMIT APPLICATION Date: SiteAddress 2,9 %tljiX 7enant: Suite #: RESIDENT / OWNER Name:'dij Phone:?SZ Address ! Cily 1 Zip: Z90'2 14,4 /CGs 12/d / Applicant is: _ Owner ? Contractor TYPE OF WORK Description of work: `?? 60-E &?,l/f Construdion Cost:/? yJ?? Multi-Family Building: (Yes No _?Lj CONTRACTOR Name:WZE'/YA/ 42Afl4llt)I'S/,2//SLicense# Address: ? 7420 l ? Z;e/z e4 f l'_? A/ Cfty: State: ?Zip: _ Phone7?3f ? %? ??7C5 r Contad Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted (4 submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a pertnit 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°documenfs Chat you submit aie considered to be'pub{ic informatfon:e"Portions of.' , 7- the ?nfo?matron may be class?ed as ?non publicif yoo provide specific reasons lhet wou)d permit fhe Crty? fo K; conclude thaf the ar_e frade secrefs. 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 applicatfon for a permit, antl work is not to slart without a permR; that the work evill be in accordance with the approved plan in the case of work which requires a review and approval of plans. x x s? gi? pplicanYs Pri ed Name pplicanYs S gnature Page 1 of 3 p Clty of Eapn 2008 RESIDENTIAL Date:Site Address: Z&02 Tenant: - -- ------------ ? ForOfFice?l?Jse I I ? I ? Permit #: d ? I ? Permit Fee: ? ? Date Aeceived: j I ? I StaR: . _.. . . ._.._...,?,}._._...__...:.__ !----------------? BUILDING PERMIT APPLICATION Suite #: RESIDENTlOWNER_ Name/(J 1_ol/L'l'l?C4 Phone:fSZ ?:z31 Address / City ! Zip:/?Vd ? ???k15 N/l/? QG A/ Appiicant is: _ Owner --('Contracior TYPE OF WORK Description of work: /A/ CD 6 Construction Cost: Multi-Family Building: (Yes No . ? CONTRACTOR Name:?A/??l/ pa:2?& ?`SidrN icense#2C5'1 Address: j2'.2e City: f?y?D C/?f State: Phone:7,5?3 5?YI-?3 d? Contact Person: d"/Z4/21;7, COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 Enefyy COdC . Residential Ven[ilation Category 1 Worksbeet • New Energy Code Worksheet Category Submitled Submitted (4 Submi55ion type) • Energy Envelope CalculationsSubmitted In the lasi 12 months, has the City of Eagan issued a permit for a similar plan based ona 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 documenfs that you, submit.are considered to be public inforrnation. ;Porteons of the information may be c/assified as non-public i/ you provide speaific reasons ?hat would permit the,City fo conclude tHat the are trade secrets. ' I hereby acknowledge that this information is complete and accurate; that the work will be in contorrnance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, 6ut only an application for a pertnit, and work is not to start without a permit; ihat ihe work will be in accordance wilh the approved plan in the case of work which requires a review and approval of plans. se ? C_?CeT?? Applicant's Printed Name orr??? anYs Sig ture Page 1 of 3 Use BLUE or BLACK Ink For Office Use I Permit I <JQ f Z& 11- / I City of Eapn I I 3830 Pilot Knob Road Permit Fee: L Q 3 : Eagan MN 55122 I Phone: (651) 675-5675 1 Date Received: 7 5 -3 I I Fax: (651) 675-5694 I I ~ Staff: ~ I - - - - - - - - - - - - - - - - - 2013 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Date: 6/25/13 Site Address: 1802 Karis Way Tenant: Suite M Resident/Owner Name: Matt Hanson Phone: 507-250-3500 Address/City/Zip: 1802 Karis Way, Eagan, MN 55122 Name: K&S Heating, Air Conditioning & Plumbing License 0153 Address: 4205 Hwy 14 W City: Rochester Contractor State: MN Zip: 55901 Phone: 507-282-4328 Contact: Heidi Brown Email: hbrown(a,ksheating.com New XX Replacement Additional Alteration Demolition Type of Work Description of work: NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL COMMERCIAL XX Furnace New Construction _ Interior Improvement Permit Type XX Air Conditioner _ Install Piping Processed Air Exchanger Gas Exterior HVAC Unit Heat Pump Under / Above ground Tank Install Remove) Other RESIDENTIAL FEES: $60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) = $ 60.00 TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ x1% $60.00 Minimum (includes State Surcharge) Permit Fee *If the project valuation is over $1 million, please call for Surcharge 5.00 Surcharge* TOTAL FEE I CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x Rick Keehn xi.~ Applicant's Printed Name Applicant's Signature FOR OFFICE USE Required Inspections: Reviewed By: Date: Underground Rough In Air Test Gas Service Test In-floor Heat Final HVAC Screening I- For Office Use q - 51 a • i a o � o Permit#: E AGA N Permit Fee: Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildinginspectionsecityofeaoan.com 2020 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: SV, /24 Site Address: 100-01AA-8),s WY Tenant: Suite#: Resident/Owner Name: /114 Tr- ti /V$ss/ Phone:,5 4 7- 02, 21 - 3.4130 Address/City/Zip: h8D - /49i Ri &4 Y Name: iJA PC,G 8 yAfrik -rEtzP"°L License#: PC Y •�/ / Contractor Address: ?'60.-• '/ 4 , Al' City: S %f' "A& State: /UT Zip: ,,S S e 75 Phone: y� vim!- 5/ f-<7 4) .1.D11111.-A, Contact: rC Emailµ' Type of Work —New Replacement —Repair —Rebuild —Modify Space —Work in R.O.W. Description of work: g,CscGll Tankless Water Heater Lawn Irrigation( RPZ/_PVB) Standard Water Heater Add Plumbing Fixtures( Main/_Lower Level) Description Water Softener Description: Septic System New Abandonment Connection to City Water from Well � �� RESIDENTIAL FEES $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation (includes State Surcharge) $60.00 New fixtures, adding or removing piping (includes State Surcharge) $60.00 Septic System Abandonment $100.00 New Residential (fee collected with Building Permit) $115.00 New Septic System (includes County fee and State Surcharge) $60.00 Connecting to City Water from Well*+ $290 for Meter and $200 for Radio Read = $550 *Sewer&Water Permit also required for connection charges TOTAL FEES $ CALL BEFORE YOU DIG. Call Gopher State One Call Si(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. 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 )b1 p .Vetasr, .-r.e_ Applicant's Printed Name Applicant's Signature Page 1 of 2