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1041 Keefe St
Use BLUE or BLACK Ink orOrfice U, I , City of Ea on Permit 4. I , E I Permit Fee: I 3830 Pilot Knob Road I Eagan MN 55122 I Date Received: I Phone: (651) 675-5675 1 Staff: I Fax: (651) 675-5694 1 1 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: f f Site Address: / © Ie e~~/ Q Unit Name: Phone: V~ l ?s~ ~1 f 3 I RESIDENT / I ~e Jcj Ms~ OWNER Address /City /Zip: 10 Eo qQ }i, Mn J Applicant is: Owner Contractor TYPE OF WORK Description of work: n S) (y O f`~'1 ' Construction Cost: Multi-Family Building: (Yes / No ) Company: Contact: CONTRACTOR Address: City: State: Zip: Phone: License Lead Certificate Does this project require Lead Remediation? ❑ Yes )4 No (see Page 3 for additional information) If no, please explain: 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 the 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.oopherstateonecall.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 ns. X f rA t) L) f? Iq A)-b X C & 0~~ Applicant's Printed Name Applica 's Signature Page 1 of 3 ?CITY OF EAGAN Remarks Addition McKee 3 Lot ? Blk 1 Parcel 10 47752 010 01 10111 Keef e St. Owner/%%L'_?- gtreet State Eagan:,MN 5ri121 improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 347.10 31L. 71 10 Pa.7.d STREET RESTOR. GRAOING SAN SEW TRUNK 100.00 3. O P21d * SEWER LATERAL 1 WATERMAIN * WATER LATERAL OQ 46.50 ZO Pa.1d (Uo WATER AREA E `'• ? STORM SEW TRK 961 198 437 29,13 15 STORM SEW LAT - CURB 8i GUTTER SIDEWALK STREET LIGHT WATER CONN. 280-00 1228 12-4-7 BUILDING PER. sac 400.00 1228 12 -7 PARK . .._.2. BUILDING PERMIT CITY OF EAGAN 3795 Pilot Keob Road Eogan, MN 55122 N! 6141 PHONE: 454-8100 Receipt # To be wea for Est. Volue Dnte , 19 -- $ite Address Erect ? Octuponcy lot Block Sec/Sub Alter ? Zoning . . Repair p Fire Zone Parcel # E l of Co T t orge n ? ype ns . W Nome Move ? ?E Stories Z Address Demolish p Front ft. /?'?.. _1' . 1. • ?1L?_? Grade fl Deoth ft. °` Name Approvola Fees - Zo Aeegeemant I Pgrmit ?? Address ~ Ci Phone Water & Sew. Surcharge Police Plan check ?W Name F W Fire SAC ?? Address Eng. Water Conn. `W Ci phone Plnnner e Council it I hereby ocknowledge thct I have read this application and state that Bldg. Off. the Information is correct ond ogree to comply with oll applicoble pPC a? State of Minnesotu Statutes and Ciry of Eagan Ordinonces. Signotum of Permittee A Building Permit is iswed to: on the express conditian that oll work shall be done in accordance with oll appiicable Stote of Minnesota Stotutes ond Ciry of Eogan Ordinances. Building Official hnalt # oah lw*d Puwlttee Plumbing 2077 Mechanical - INSPECTIONS DATE I?y$P, I Rouph-I n Finol Footings Dote Imp. Date Irup. Foundation Plumbing Frome/ins. 'D S Mechonicol Finol j ' -i - fQ?- I r+i'?d?C{ Remarks: re ,pl" e .?o-w?. a•u? ? CITY OF EAGAN 3795 Pilot Knob Road No. Eo9an, Minnesota 55122 , P6one: 454-8100 PERMIT Date: Site Address: Lo? Block Sub/Sec. INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIONS Receipt No.: Single Residential Multi Name New /Alter / Re oi r p . . Address Cost of Instollation ? City Phone: Permit Fee Name Surcharge ? ? ? Address e 0 V City Phone: Total This Permit is issued on the express condition that ali work sholl be done in accordance with all applicobie Stote of Minnesoto $tatutes and City of Eagon Ordinonces. Building Officiel ? l?C? ? CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: ,•, ',• Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: ID+f PERMIT SUBTYPE: TYPE OF WORK: INSPECTION .. . D. ? ? Pertnk No. Parmft Holdar Date Telephona N ELECTRIC PLUMBING HVAC Innpectlon 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 BSMT R.I. BSMT FINAL DECK FfG DECK FINAL VILLAOE OF EAUAN ` WATER SERVIC E PERMIT 3795 Pibt ?wbRoad PERMITNO.: 16 4& 1L.S?t' Eagnn,MN 55122 DATE: 12/4/74 Zoning: Rl No. af Uni[s; 1 Owner: C1dY'EnCQ IU1llt5on Address: % `/ 2v /? ? - 7YCl Site Address: 1041 Keefe St * d• 2A 77n g,I Plum6er: 53me ' . Meter No.: 22757630 Connection Charge: 2II0.00 pd 6ize5 8 k2ork Account Deposir. 15.00 pd Reader No.: 426442 permit Fee: 10.00 yd 1 agree to comply with Tha Villoqa of Eagan Surcharge: .50 pd Ordinonces. MiscTl@KfA}`ges: 60.00 pd To[afi°Yerhorn 10.65 pd $Y Date Paid: Date oF Insp.: Insp.: YILLAOE OF EAUAN SEWER SERVICE PERMIT 3795Piiotkn?bRoad PEHMITNO.: kil}tg 2412 Eagan, MN 53122 DATE: 12/4/74 Zoning: Rl No. of Units: 1 Owner: Clarence Knutson _ Addreas: Site Address: 1041 Keefe St. Plumber: samP I agna to eompy wifh tha Village ef Eogan Connection Chazge: 400.00 pd OrdinaMes. Accaunt Deposit: 15.00 pd Perxnit Fee: 10.00 pd Surchazge: .50 pd : Misa Chazges: S - y Date of Insp.: Total: Inap.: Date Paid: CITY OF EAGAN 3795 Pilot Knob Read Eagan, MN 55722 PHONE: 454-8100 BUILDING PERMIT APPUCATION N"_ 6141 Receipt $? ?7$1- ? To be ueed Por SF DWG ADD. Est. Value 13 .000 Date 9-41 1980__._ Site Address 10l+1 Keefe St. - Erect ? Occupancy Rl _ Lot 1 Block 1 Sec/Sub. MCK62 3Td Alter ?- Zoning Rl Porcel # ReDair ? Fire Zone U Enlorge 0 Type of Const _ Nome Mark A_ Dandtire Sld Mo # St i w ve ? or es Z ? Address lOQl Keefe St,. Demolish ? Front 1?7 ft. C. Eagan, Mri. Phone li.52-4370 Grade ? Depth 24 ft. m Nome Apprwala Fees 0 _ ? ?U Address r ?:... Name _ Address Assessment _ Water & Sew. Police - Fire Eng. Planner - Countil _ Permit 4240 Surcharge 6.00 Plan check 21-00 SAC Water Conn. Water Meter Rood Unit I hereby ocknowledge that 1 have read this opplication and state tFwt Bidg. Off. the information fs correct ond agree to comply with all applicoble APC Total hQ _ 5(1 Stote of Minnesota Statutes qnd? gaga?Ordinan? es. ? /?-rl ? ?C Si9ncture of Permittee ?/1% ? a^??utee..<r A Buiidin9 rem,tc is issued ro: Mark A. Dandurand on the express rnndition that oli work shali be done in acwrdfon'c/ew?/jt'h_a??ll?/qpp-li7w-ble State of Minnesota Statutes and City of Eogan Ordirwnces. Building Official /? ?'`? ?'? =:I: / EAGAN TOWNS H' P IG P E 9? NI I'° Owne: --_"_!-'-r..IL..?!?4?^?--'-'-..I -.?? -- -- .. .... Eagan Towaship Address (Pre .._---- -'----------- ..._.....--._._.....-?------'----- r Builder enf) _ -_! .. -. . - ---- - n --r-. . Addsess - -?!?!/. ---- -?? .. -- -` -'--°------- DESCRI TION Town Hell 209 D a!---------.=.-P.C---... -' - Siories To Be Used For Froni Depfh Heighf ? Esl. Cos! ?Pesmi! Fee Aemarxs LOCATION ? or This permit does nof Aihorise the use of sYreeis, roads, alleys or sidewalks nor does if give the ownex or his agenf the righf !o creaie any sifuation which is a nuisance or whieh presenis a haaard Yo the healSh, safeiy, eonvanience and geaeral welfare to anyone in the communiYy. THIS PERMIT MUST 8 EPT ON T P EM E WHILE THE WORK IS IN PROGR . ? This is !o eerfify, ihai....?. ?j?has permissioa fo erec! a......... ..' _. ..--'_--"_ ---------------------- uPoa the abov ese/riprgmise irovisions of the Building Ordinance fox Eagan Towns ' d April 11, 19 1d 55. ?\///?s.y',?L/. Per _ ...................._--.....---`-'-'-------._...-------....----.. Building Inspecior EAGAN 'r0llliNS F-I I P 277 ? BIJILDIiVC; PERR?iIT Ownex/ J. /./? -c .._.._?-/- u?''4: ?` -'?-O?L/ - / ...... -?1-°-- `-- ` Address (Preseni). . ?. ._t5%?......... -.. Builder ............._....??-L???2..?.--'---....- Address ..... DESCRIPTION Eagan Township Town Hall . DaTe ???-??..... Sfories Ta Be /T-7?aed For Froni Depih HCos! Permi! Fee Remarks LOCATION or This permii does not au osize the use of streels, zoads, alleps or sidewalks the righf to ereale any si! ation which is a nuisanee or whiah presents a hazaxd genersl welfare Yo anyone in the eommunity. THIS PERMIT MUST Bpy??? ?pT ON THE P IS %WHILE THE WORK IS IN This is So ceslify, lhaS...Y..??lf??._ ....rZ.?:v"as permission So erec the above des ibed mi to the provisions of the Building Ordinance 1955. a!Y.-?-?' -`--°-- _Per .._..._.._...----- ? f Chairman of vp? Soaxd or iracx nor does it give Sfie owner or his ageni !o the healfh, safefy, eonvenienae and PROGAE S. ? ! aa ?_. ._6`-P...........upon ------------------ - for Eagan Township pted April 11, Building InspecSOr EAGAN TOWNSHIP BUILDING PERMIT Ownex ..._.._.?-.?L?a..Y.. c.h c....... ....?.._?.... `.- N.GLL. r.lLif/.... Address (Preseni) tT... .............................. Builder ............ sr.5l7................................................... '-------'- -' Address DESCRIPTION N° 1308 Eagan Township Town Hall Dafe _. ?/?1..°._?'_--"__"""-_. Sfories To Be Used Foz Fron1 Depih FIeighi Esi. Cosi Permii Fee Remarks "Plo? 9ToY?q'C- ? - LOCATION Sireei, Road or oiher DescnpSnon oi i.oaanon _I i.ox mocx naainon or 7'ract This permit does not aufhorise the use of sfreeis, roads, alleps or sidewalks aor does it give the owner or his agent the righ! !o creafe any sifuafion whieh is a nuisance or which presenis a hazard 2o the health, safety, convenienae and general welfare io anyone in the commvniiy. THIS PEAMIT MUST BE KEg?' ON ,H PR)EMISE WHILE THE WORK IS IN PROGRESS. This is !o cerlifY, ihai..--_'-_?C?'!c2`:? _--.•: - - . - ...........has permission !o eree! _.- _-_--._. ... .. pan '--• -' - -- . . the above descsibed premise subjecf io !he provisions of the Buildinq Ordinance for Eagan Township opted April 11, 1955. ? ?p A ,? ----------- ..'..'_ ' _ "".".._ ?!...._.. .._...-.-._.°°°K?'.- .1----.?`-'-.c°'..?.-1--'-'---.._.... Per a"2 q Q ? Chairman of Tnwn Soard Buildin In3.. ?Pee.eior 4'6 CITY OF EAGAN Include 2 sets of plans, 1 site plan w/elevations & BUILDING PERMIT APPLICATION 1 set of energy calculations. To Be Used For ' ,,?e ? 4,4, Valuationkt- %J Date I - Y - 80 Site Pddress: lO4I Kee-re. ST. ko,aQAJ OFFICE USE ONLY Int ? Block L Sec./Sub. Mrb'ee 3"6 Erect Occupancy Parcel #: _ ALL .A- ?o*J Alter Zoning ?- - Repair Fire Zone o M K A 17 d l Enl arge? TyPe of Const. -° c.mer: a,.v n.?v Ll va. n? c M # Stories ove Pddress: J(A{ ke-e.rre- ST. Demolish Front ft. City/Zip Code: Ea 4 a,,,? M ru SSI a ? ? : Grade Depth 2.9 ft. Phone #: . q5a-14370 APPROVAI.S FEES Contractor: C??ti:.• r? e? ,? Pddress: City/Zip Code: Phone #: Assessments on Permit Water/Sewer Surcharqe G +?° Police Plan Check I Fire SAC Enq. Water Conn. Planner Water Meter _ Arch./Eng.: pwnre.Y Address: City/Zip Code: Council Road Unit Bldg. Off. APC Phone #: TOTAL L ? rmm?- " Mlnnesota St3te Boartl of Electricity Griggs Midway Bldg. - Room N191 1821 University Ave., St. Paul. Minn. 55104 - Phone 297-2111 L ( REQUEST FOR ELECTRICAL INSPECTION S 764651 CH?CK BELOW WORK COVERED BY THIS REQUEST Type of Building New Add. Rep. Check Appliances W'ved Foi Check Equipme¢t Wired Home ? ? Range ? Tempoiary Wiring ? Duplex ? ? ? Water Heater 0 Lighting Fixtures ? Ap[. Bidg. ? ? D Dryei ? Electric Heating Commercial Bldg. ? El ? Fumace ? Silo UNoader ? Industnal Bldg. ? 0 ? A'u Conditioner ? Bulk Milk Tank ? Fatm ? ? ? List ) List 1 Other ? ? ? p y HeheTSl p y Hehe155 COMPUTE INSPECTION FEE BELOW Service Enhance Size: # Fee Feeders.flSubteeders: # Fee Circuits: # Fce 0 to ] 0 Amps. 0 t30 Am eies 0 to 30 Am etes ? 101 to 20s. 31 ro 100 Amperes 31 ro 100 Am eies ; Above 20mps. Above 100 Amps. Above 100 Amps. Transfotm emoteConttolCirc. Par[ialorothe[fee Si ns , ecial [nspection Minimum fee $5. Remarks ' ' TOTAL FEE l6 i I, the Electrical Inspector, hereby certify that the m'ade! v '/_ ?i-dd (Final) This request void 18 months from This request void 18 monttts from Date oofPs Request /O - Q4-ffO Fire Nu. S 76465 I, as lN'I.icensed Electdcal Contrac[or OOwner, do hereby request inspection of the a6ove electri- cal wiring installed at: MC k e? Add ?'t io -? Street Address o[. Route No. 1,0191 k' e e?'e s?: Ciry ???rL Section Township Which is occupied by Is a roughin inspection required on this job? No ? Yes 2"? Ready Now ? Will Call Y? 3000 /nax? ef/ J3ve_ Power Supplier A4 S. P Address Aje?i,l e r 4 11Jn . SSOS'S Electrical Contractor 7Xe w. aS 9 /63L't Contractor's License No:y??S6 ( ompanK Name) ?/ ?/ Mailittg Address ca?0 d -r t? P, ??1- 7'P a r I ( ectrl I Contr or or Ow ?' ky n nis installatlon) Authorized Signature ?? ?. ? Y Phone No ZSR- YoT 9'7 (EI¢ctrical Contractor or Owner Making Thlz Inz ion) SVQ7E 0O&CD QOpV This inspection request will not he eccepted 6y ffie State Board uniess proper inspection fee is enclosed. SEDGWICK HEATING & AIR CONDITIONING CO. HEATiNG Josr,o. Fr 8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 887-9000 TEST RECORD ADDRESS I? // K, t/-,- S/ OCCUPANT +" ?9 ?A7 tl U rA`? ^ SOLD BV MAKE H 6 41 SERIAL NO U c I?? 0 s-?? ? THERMOSTAT_ -fL 76 a VALVE IV ?' ?v "GS?? J LIMIT ?' ?' j LIMIT SETTING /G a FAN SETTING f, 'M PILOT TYPE IGNITION MODEL PILOTTIMING I i n7 / PRESSURE ? r ) PERCENT COz '7 INPUT CFH PERCENT Oz ? STACKTEMP. 3 _/v PERCENTCO FORM 235 (FEV 11I89) CITV e `fi 'A '- OWNER 'S 1--7 INSTALLED eY s'° } ` `il " c k MODEL ? z 7 7.fc>°° INPUT i VENT SIZE L/ TVPE OF NER N Ue'L LINER SI2E _-?- FIiTERS: SIZE 2 a X 7 r NUMBER r WIRING Is: 7 U ic TEST TAG LIGHTING INST. DATETESTED I U- 0 -O ( COMPANYTESTING NAME OF TESTER FOqMDISTRIBUTION. WHITECOPV -JOBFILE VELLOWCOPY -CITY PERMIT# !4'y0?9-- RECEIPTDATE: US1DENTlAL PLUM$INfi PEiMTf APPLICATION crrY oe EAsAv SSSO £ILOT KNOB RD - EAHRN. MP 55122 651-681-4675 Please complete for: SITE ADDRESS: OVVNEn iJAti9c: : INSTALLER NAME: STREET ADDRESS: CITY: ? single family dwellings > townhomes and condos when permits are required for each unit ? backflow preventer for irrigation system DANDURAND,MARK 1041 KEEFE STHEET EAGAN, MN 55121 (651) 452-4370 Place a check mark next to the oermit work tvoe TELEPHONE #: (AREA CODE) STATE: New residentiaf dwelling unit under construction and not owner/occupied $ 90.00 ? Add-on, modification or alteration to existinq dwelling unit, including: $ 50.00 • abandonment of septic system • new installation/repair/rebuild of RPZ . lawn irrigation system • water turnaround Nature of work: ?'.?j??R.L_¢_ i??q7?P? 2dPiIr Septic System, new/refurbished - $ 225.00 • includes Ccurity & Consulting Inspector fees • requires MPC license State Surcharge $ 50 Total $ SO-S(7 Reminder. Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc. I hereby acknowledge that I have read this apphcalion, sWle that the informatlon is correct, and agree to comply with all a is the applicanCS responsi6iliry to nohfy the propedy owner thal the Ciry of Eagan assumes no liability for any damages operahonal and maintenance activities to the facilities constructed under this permit within City propertylright-of-wayle? ZIP: OF PERMITTEE TELEPHONE #: (IV'7cA GODE) ?f Edganordinances:At ? 1l 'City dunng Its riormal I I1 I,k o i`r I? 'I 1•i .o MAR 0 R 2001 ?? - #PERMIT C1TY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 ck C94z PERMITTYPE: suxLozNs Permit Number: 0 2 5 7 3 7 Date Issued: 0 6/ 2 3/ 9 5 SITE ADDRESS: 104! KEEFE ST LOT: 1 BLOCKa 1 MCKEE 3RD P.I.N.: 10-47752-020-02 DESCRIPTION: ,. 6,u`i1tl1ng,Permit Type SF (MISC.) Building Work Type ALTERATION ? ? i ;' : ' '?`:;>` . ??? ? ? ?, :, . ._ .. i REMARKS: FEE SUMMARY: VALUA7ION Base Fee Plan Review 5urcharge Lic. Search Fae Total Fee $187.25 $65.54 $6.00 $5.00 $263.79 $12,000 CONTRACTOR: - flpplicant - sT. LIC. OWNER: DIVERSIFSEp AMERICAN CONST 19297982 20017349 DANDURAND MF1RK 5115 EXCELSItlR BLVD 107 1041 KEEFE 5T ST LOUIS PARK MN 55416 EA6AN MN (612) 929-7962 I hereby acknowledge that I hava read this application and state that the information is correet and agree to comply with all applicable State of Kn. Statutes and City of Eagan Ordinances. I APPLICANTIPERMITEE SIGNATURE M Ri,r?I (? A ISSUED eV: IG?NRTURE T INSPECTION 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`Lor0 1044 KEEFE ST MCKEE 3R0 PERMIT SUBTYPE: SF (MISC.) BUILpZNG 625737 06/23/95 i BLOCK: 1 APPUCANT: 4 DIVERSIFIED AMERICAN CONST (612) 929-7982 TYPE OF WORK: ALTERATION INSPECTIONTYPE FRAMING .. . ROUGH IN PLBG ,. ROUGH IN HTG FINAL ? ? ? J i. 4! !} CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1995 BUILDING PERMIT APPLICATION (RE 681-4675 Ia.G3.?5 ' PfAY 11 ? t595 -w -e: b ? 3 registered sHe surveys ? 2 coPbs of plen ? 2 copiea of pWns (indude beam & window sizes; poured fid. design; etc.) ? 2 aite surveye (exterior adddiona 8 decks) ? 1 energy calwlaUons ? 1 energy calculaticns Tor heated edditlons ? 3 copies M Vee presenation pWn R bt platted after 7/1193 requies No ? ? ?) CONSTRUCTION COST: 7 Q o DATE: DESCRIPTION OF WORK: LG STREET ADDRESS: ? LOT ' BLOCK } ?2 c .4N SUBD./P.I.D. #: PROPERTY Name: Phone #: OWNER `"V Street Address- City: 5tate: Zip: CONTRACTOR Company? s.Oiai 0,C. 4gowl' Phone #: Street Address: XL?.I?, L cense #•r2200 ,?C?, .?a City:?c L- ?Gl? StateZip, S ARCHITECTI Company: Phone #• ENGINEER Name: Registration #Street Address* City: State: Zip: Sewer & water licensed plumber. change are requested once permit is issued. I hereby acknowledge tliat I have read this application and state that appliqble State of Minnesota Statutes and City of Eagan Ordinances,,- OFFICE USE ONLY Certifiwtes of Survey Received Tree Preservation Plan Received Signature of AppliQ _ Yes _ No _ Yes _ No Penalty applies when address change and IM information is correct and agree to comply with all OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ? 02 SF Dwelling o 07 4-plex ? 12 Multi Repair/Rem. 0 17 Swim Pool 0 03 SF Addition ? 08 8-plex o 13 Garage/Accessory ? 20 Public Facility ? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous ,,Q--05 SF Misc. 0 10 _-plex ? 15 Deck WORK TYPE ? 31 New A"3 Alterations o 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFnRMATION Const. (Actual) Basement sq. ft. MCM/5 System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. R. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. YsY Depth Footprint sq. ft. ? SAC Code a/ Census Bldg Census Unit APPROVALS Planning Building Engineering Variance Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit SIW Permit S!W Suroharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: ? Valuation: $ 1210°D % SAC SAC Units CITY USE ONLY LOT ? BL PERMIT #: SUBD. A Ci C 1a_?_ -?r- RECEIPT #: RECEIPT DATE: i a 3s?sg _? -?5- C,d 2000 MECHANICAL PERMIT (RESIDENTIAL) Date: Gf ) I j ?o r) Complete this section on if you aze installing HVAC in a single family dwelling, townhome or condo under construction and not owner/occupied. • HVAC: 0-100 M B T U ADDITIONAL 50 M BTU • Gas outlets (minimum of one required @$3.00 ea.) $ 30.00 6.00 5tate Surchazge .50 Total $ Complete this section onlv if you are remodelin¢, addin2 to, or re airin an existing single-family dwelling, townhome, or condo. Please indicate if it is a new item, alteration, or repair. New _ Alteration ? Repau ? Furnace Air exchanger Reminder: Call for inspections _ Other A'u conditioning Other Fee $ 30.00 State Surcharge .50 Total $ 30.50 SITE ADDRESS: e-e e * "Qrxn " V OWNERNAME:&'fQ ? /"/QrK YlC'?UY . _/ rxorrE#: NSa=y??? ( CODE) ? ( /e - -,..G INSTALLERNAME: 'f" v1ejP.4 kl°L'10? iT PHONE#: CJ/3?"??(1 STREET ADDRESS: t ?'L 91/1 CITY: ??P ?h P I STATEM_ ZIP:5_55? CZTY OF EAGAN 3830 PILOT KNOB RD EAGAN D47 55122 651-681-4675 / A aa? II vLA I?t GNATURE OF P ITTEE L BL SUBD. APPROVED BY: INSPECTOR PERMIT #: RECEIPT#: RECEIPT DATE: 2000 MECHANICAL PERM_IT (COMMERCIAL) CITY OF EAGAN 3830 PILOT 1IN08 RD EAGAN, bIId 55122 651-681-4675 Please complete for alI commerciaVindustrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE': WORK TYPE: _ New construction _ Install U.G. Tank _ Interior Improvement _ Remove U.G. Tank _ Processed Piping W/ten installing/removing underground tank, call 651-68I-4675 jor inspection by fire marshal and plumbing inspector. Description oFwork: Fees: I°/a of conhact price OR $30.00 minimum fee, whichevet is geater. Undergound tank removaUinstallation = minimum fee Contract price: $ x i%_$ (Base Fee) State surcharge calculate at $.50 for each $1,000 Base Fee TOTAL $ SITE ADDRESS: OWNER NAME: PHONE #: (AREA CODE) TENANT NAME (IMPROVEMENTS ONLl): WAS TfERE A PREVIpUS TENANT IN THIS SPACE? Y N. NAME: INSTALLER: ADDRESS: CITY: PHONE #: - (AREA CODE) STATE: ZIP: CITY USE ONLY SIGNATURE OF PERMITTEE , --- - -- -- -- - -- -- - - -- ---- -- --- -- -- - - --- _ - -- - ? ; , ? , ? - ? ?. i ? I 1 • . ; GARAG?' ? ? ----------?--?--- - ;- - ? ? a?' as h' ' C'? I ??Lln.vC r?nOla.9Q'9 I? i f _ . U fi I ? ? 7 Adb',-F;en.i --- 1oc? 3`'a Aeb,4 8 , ]04/1 E F. ? S-T ? ------ - - .............. . _ _ ---? - - --? -- ---------------------___?"?-- ..._ sstax.? _ ?,- - - __._... _._ .: _. .._.. ...:.. ?. , D ?i'oe CITY USE ONLY PERMIT RECEIPT DATE: RESIDMIAL MECFIANICAL PEitMl'1' APPL1CATION CITY OF EaFfiAN 3$30 f'ILOT KNOS RD Er46AN MN 55182 651-681-4675 Please complete for: ? single family dwellings townhomes and condos when permits are required for each unit Date: ? SITE ADDRESS: loT l OWNER NAME: TELEPHONE #: 6.,1 I 'YW"Vj (AREA CODE) INSTALLER NAME: gFnCWfCK HF11TiNG & AIR CONDITIONING COELEPHONE #: 8910 W@I1MAhI1 AYBflU@ SODUI (AREA CODE) STREET ADDRESS: Minn8apob, MN 55420 CITY: STATE: ZIP: New residential dwelling unit under constructionand not owner/occupied $ 70.00 _V_/ Add-on, modification or alteration to existin dwelling unit $ 50.00 • furnace replacement • airexc anger • air conditioner ' ? ? • ' • other ?- Nature of work State Surcharge $ 50 Total $J(6 , &) Reminder: Call for inspections. SIGN F P? Updated 1/01 CITY USE DNLY PERMIT #: APPROVED BY: INSPECTOR RECEIPT DATE: COMMERCIAL MECE41VICA1. PBgM1T AtPPLICATlON CI1'Y oF f AH!!lv 3$30 PILOT KftOB EiD EAsM, Mx 55 122 651-681-4675 Please complete for: all commerciallindustrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: SITE ADDRESS: OWNER NAME: PHONE #: (AREA CODE) TENANT NAME (IMYROVEMENTS ONLY): WAS TfIERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME: INSTALLER: ADDRESS: CITY: WORK TYPE: New construcrion _ Intenor Improvement _ Processed Piping Specify Nature of Work ZIP: Install U.G. Tank Remove U.G. Tank When insta[ling/removing underground tank, call 65I-68I-4675 for inspectian by Fire Marshal and Plumbing Zinspector. Fees: 1% of conuact price OR $50.00 minimum fee, wlnchever is greater. Underground tank removallinstallarion = minimum fee Contract price: $ x 1% _$ (Base Fee) State surcharge calculate at $.50 for each $1,000 Base Fee TOTAL $ SIGNAT'URE OF PERIvfITTEE PHONE #: - (AREA CODE) STATE: Updated 1lOl Cities Di ital uality Control The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. -d` 1308 , y ? kDDiTioN ' . ;}---, ????(((YYY??w ?? T `. I NV ? pr, ?• ' /,;.vc i ` Si r?**•( ` p irl - -p ; - ? ? - 4 c rk ? ?y 1 I ? ? ?` 4 ? -??.. I i . , •? ? ?K ? j- I • N?k. ? ?,.??- ?°? ?i .? .Q-K--?...?- °?'-?a ??R w-?-? ??- ,??.,..?.,._.Q.? ? <^-- ?- '`?""c ?-.??..,?_ d? , ? ??e, ,2?-- ?? ?,",:.?..,?_.J--?, ??z-«.- ??,,,?-v--??A o-??..?_ ra ? ?° ?, ?a ._.?- c-v-- ?^?-^-?-.? ? ? r j>o L - ?C D U N?? ENVIRONMENTAL MANAGEMENT DEPARTMENT GROUNDWATER PROTECTION SECTION 14955 Galaxie Avenue • Apple Valley, MN 55124 952.897.7557 • Fax 952.897.7568 • www•co.dakota.mn.us MUNICIPAL NOTICE OF WELL SEALING PERMIT APPLICATION DATE: November 3, 2004 TO: Tom Colbert/Wayne Schwanz (EM) RE: Well Permit #: 04-H230019 Municipality: Eagan Fax #: (651) 675-5694 Well Type; Domestic Environmental Specialist: Olsen The Water and Land Management Section of the Dakota County Environmental Management Department has received the following permit application for the well described. If you require further review of the application or if you have any questions or concerns about it, contact the Environmental Specialist listed above or our office at (952) 891-7557. If there is no response from your office within 24 HOURS (excluding weekends and holidays), we will assume that you have no objections to the issuance of the permit. Please note that permit issuance is always wnditioned on the pennit applicanYs observance of and compliance with all applicable state, county, and municipal laws and codes. Well Contractor: Thein Well Company 11/2/2004 Time: Time: Date Application Received: Anticipated Drilling Date: Anticipated Grouting Date: Property Owner: Well Owner: WELL LOCATION: Rita A Dandurand Rita A Dandurand PLS Coordinates: 1/4, SE 1/4, NW 114, SW I/4, Sec 02 Town 027 Range 23 Street Address: 1041 Keefe ST PIN Number: 104775201001 WELL INFORMATION: Diameter: Casing Depth: Total Depth: Static Water Level: Aquifer: COMMENTS: F1e Edik uiew 7ools Appllcations 6T MCKEQST Help MCKEEST Connec#ian I Comme[rts I Eegan Building I Eagan Oevelopmerrt ? permits Owner I Eagan AssesslSales I Eagan Propentjr I Eagao ParcellD 104775201001 ? Address 7041 KEEFE ST Owner 7 DAN[?URAND RITAANN? - - 1041 KEEFE ST EAGAN MN 551 21-1 41 0 Clwner 2 , Owner 3 S j Owner 4 51' . Parcel daEa wpdated August 27, 2004 Use BLUE or BLACK Ink r For Office Use I I Cit of Ea a~ ; Permit I I Permit Fee: f~ 3830 Pilot Knob Road Date Received:` Eagan I VIN 55122 P= C I^ I V E D Phone: (651) 675-5675 I I Fax: (651) 675-5694()11 Staff: I CSr-F, 00 2 1 _ 2011 RESIDENTIAL BUILDING PERMIT APPLICATI0NI9->? Date: Site Address: Unit Name: a. V K ycz, fV C~ V" a-,n Phone: 1-3 RESIDENT OWNER Address / City / Zip: Applicant is: Owner Contractor / ff Description of work: `V C~_- A_) TYPE OF WORK Construction Cost: L ! S Multi-Family Building: (Yes / No ) Company: Contact: CONTRACTOR Address: City: State: Zip: Phone: License 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 I N conclude that the 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.oopherstateoneGall.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 Code must be completed within 180 4da Ca x Q ifA-.'~ LA- r CL z.~ Printed Name Applicant's Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE / 01 , SUB TYPES foundation - Fireplace _ Porch (3-Season) _ Storm Damage _ Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family) - Multi - Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) 01 of Plex Lower Level Pool Miscellaneous Accessory Building WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior _Alteration _ Fire Repair _ Windows _ Demolish Foundation Replace Repair Egress Window Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION QD Valuation 1 a~ Occupancy MCES System Plan Review t4l Code Edition SAC Units (25%100% Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Gas Service Test Gas Line Air Test Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In -Air Test -Final Windows Insulation Retaining Wall: _ Footings _ Backfill _ Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 11,111 City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: Date Received: Staff: 2012 SEWER AND WATER REPAIR / DISCONNECT PERMIT Date: 1 1—.)---)--- (0 Fee: $60.00 City Sewer City Water Repair Disconnect Description Of Work: gepr1 t f bco k i,— !1 <e wCr p✓ i'p Street Address for Proposed Work I Q "E' KQ.-4,q . .,i-fe c4- OWNER Name: t�i�Gt 9a,nd(jfGf rd- Phone: t /-q,>o?— °j.?%D Address / City / Zip: f 0 id 1 i +--f-L 6ic.el bt 14 n Applicant is: Owner y Contractor Licensed Name: (i-7..ie/-1 Pipelayer Master Plumber X Property Owner /j £V(, /e- Phone: ‘7-- 3Y 3 —429 �5 /l� s Ti G 0--Z. '4.e.. , Address / City !Zip. / 6 s l/7 Pipelayer Training Certification Card #: or Master Plumber License #: 016.7? 3 9.- ,/4 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. I understand this is not a permit, but only an application for a permit, and work is not to start without a permit. Applicant (Print Name) Applicants Signa v(e CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground util ty damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.00pherstateonecall.orq d Cir//. 6 /- �l'3•- C 9 C� � 9/W� soli A //'' / Q. !�- } 96bLL£17t99 Ogg 6uigwnld uage!S PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA158206 Date Issued:10/01/2019 Permit Category:ePermit Site Address: 1041 Keefe St Lot:1 Block: 1 Addition: Mckee 3rd PID:10-47752-01-010 Use: Description: Sub Type:Residential Work Type:Replace Description:Standard Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener). Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 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 - Alesia M Tasa 12760 Eagle Ridge Dr Burnsville MN 55337 (651) 341-3620 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature