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1045 Keefe St? 0 CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 :CORD PERMIT TYPE: Permit Number: Date Issued: EfEf I ! fi 1 "r; 0: - ?t o t 4 N > / . :' / 'l ' SITE ADDRESS: ? ?? ? : PERMIT SUBTYPE: TYPE OF WORK: Allf KqlInN , ? , , MA4° RFNf3VA i .Tf)N INSPECTION r . • D ? ?+ilt??l I N Ii i?. f I i•Ir?t k! 4NA(iM', ',I f't1f?Ali f'FkMI ('. Kf?i,?IftkF 11 F'Aft E1Fi- i1rli'At (iR F3'1_l?MI+INll t-itikb APPLICANT: .?.?.?? ?? Permit No. Permit Holder Oate Telephone N ELECTRiC M 6 PLUMBING ?N (p 7,f,-f-5'cS 5 HVAC Inspectlon Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ' ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREALACE FiREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL 0 BSMT R.I. BSMT FINAL OECK FTG (?ECK FINAI Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. y STREET RESTOR. GRADING SAN SEW TRUNK 110 I ? 1 * SEWER LATERAL 1969 WATERMAIN * WATER LATERAL 1 WATER AREA STORM SEW TRK qot 1 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 200OO 12-11 - BUILDING PER. SAC 200.00 12-11 .67 PARK ? TOWN OF EAGAN 3795 Pilot Knob Rcad St. Paul, Minn. 55111 PEAMIT N0.• 3 The Board oP Supervisora hereby granta to Thcmpson Plumbinx Co.. Inco of ln01 i9lnnetRlvd `$ Pliunbing Permit for: (Owner) at 1045 Ka Heefe St. lp y??5d cs?)a oJ pursuant to application dated -3Z1_965?__?__?,_?_• Fee Paid: $520,00 Dated this25th day cf blarch , 19-Lo-. ----- ?/- •"d" " ''I+'-?O ?'----- Bu?.ng Inspec il EAGAN TOWNSHIP BUILDING PERMIT Ownex ----vzt? -/-'J-r/-'4? ---- ..-------- -'-----'- Address (Present)..,/. .... ----°--- ?a Builder -------.. .................. ........ ..... ....................... --- Address ---- °----'----------------'°'---......----'......._--...-'---.........__.. DESCAIPTION x? 1,015 Eagan Townsfiip Town Hall Dale ._ ; ?*.'? ./.................... Sfosiea To Be Used For Froai Depfh Heighi Esl. Cost Permit Fee Aemarks y4`?. .1d A ? 3?e s -n v ? LOCATION Slreef, Road or olher Descripiion of Locaiion Lo! Bloek Addilion or TracS ?- ? r-1-7X? 3 This permit does nof auihoriae the use of slreeis, roads, alleys or sidewalks nor does it give the owner os his agent the zight to creale any si3ua2ion which is a nuisanae or which presenls a hazard !o the healih, safely, convenience and general welfare fo enyone in the eommuniiy. THIS PEAMIT MUST BE PT ON THE P$EMISE WHILE TfiE WORK IS IN PAOGRESS. This is !o eerfify. Shai.... .. .. ..-._- -VF? -------_-...haspermission !o esec2 a .............. ........ ..."" -' "-upoa the above deseribed premise snbjae! !o the provisions of the Building Ordinance for Eag?h Townahi adopled April 11. 1955. . ............. '----......_----... - ........ .........V.....`.."..'..`.?e....?.:?... Per -----...----..........?...r....?.''P?:...d'?F-..`..:??a. Cheirman of Tnwn Board Building Inapeolor EAGAN TOVVN5HIP N9 190`/ BLDILDING PERMIT Ownet /J?? t/ Address (prasent) Builder -------- tl, Address .............. DESCRIPTION Eagen Township Town Fiall ? Siories To Be Used For Fion! Depih Heigh! Esf. CosS Pezmi! Fee Aamarka / v LOCATION -?- ' f - Sireel, Road or oiher Deseription of Localion I Lo3 I ock Addition or Traci / i ? 'This permit doevno vaulhariae the use of streels, roads, alleys os sidewalks nor does if give the owner or his agenl the xight io ereale ao siYUefion whieh is a nuisance ox which presen2s a hasard !o the healYh, safety, convenienee and general welfare !o anyone in the communiip. THIS PERMIT MUST BE KEP (?N £ PAEMISE WHILE THE WORK IS IN PAOG..._SS. ? This is !o cerlify. Shai??. -...i.-?'?,?-?/..('?''.?""?` A........._..haspermisaion !o exec2 a......" ... .' ..... .i..... a.'d._.___.._......... _upon the abo ?e des ' ed premi ?ih?Nprovisions of the Suilding Ordinance for Eagan To s p opfed April 11, 1955. ' r ? .............. . ... --------- ---... ......... . . ..... . ........... Per __------ --------"---....---------...-----.....--------'-"--......-----'-'----- Chairman ot Town d 8uilding Inspecior a Q/ REDUEST FOR ELECTRICAL INSPECTION ee-ooooi-os See O O? 1 5?12 insimr.twns lor completmg this form on back of yellow copy. °X" Below Work Covered by This Request Ne Add Rep. Type ot Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt Building Dryer Load Management Comm./Industrial Furnace Other (S ecify) Farm Air Conditioner Otner (spenfy) CoCrector's Remarks' _ ? _ r?. ? # 3?4;?9•.?? ??LC? ??? rnP.r?Y.U? /1f7hOYt.c.L Compute Inspectron Fee Below: 1'jr )4Ly /a JJ/qP 56ny/f.-?- # Other Fee # Serwce Entrance Size Fee # Circuits/Feeders Fee Swimmin Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200_Amps Above 100 -Amps SIgnS Inspecmr's Use Only TOTAL Irrigation Booms cT 3S,?V Special Inspection Alarm/Communication THIS INSTALLATIO Y BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WIJ+71N 18 MONTHS. ? I, the Electrical Inspector, hereby if Ro?qn,n / oaie cert y that the above inspection has been made. OFFICE USE ONLY This request voitl 18 months (mm 0 0-91?512 4/ -o Y14.x.. _3il 60 a i6?1-i Repuest Dafe oJ / Fire o Roug?-In InspecLon uired (Vou mustcallinspector vyhed reetly) Insp c?ion Olher Than Rough-In Reatly Now ? Will NotAylnspector Q (Q ? Ves ate Reatly IXIicensed coniractor ?owner hereby request inspection of above electrical work at ,aet. aa. o ,rRoute S? Citr Seclion No Township Name or No Range N. Cou uf Occu a (PFINT) ? Phone N??? ^ ^ ?? ?i Pownr Suppher Address ? 3 /lS G?r[?er- ou?t . asevi?li Eleclncal ConVactor iCOmpany Name) ? E2-1?mv ?? CoMracrors L?rense N. IAailing Atltlress (Con' 1_rnoror or Owner MeMng Instell8tion) Authonzed I' ure (ConUactor/ wner.Mekiny Insl letion) lo? Phone Number -7?3 G829 UO?ty Ave, e St??uS MN B S?pd 'CITY II ryl?l ?1'I I?I ?Iryl I?? II?? ?I? ?'ll IIII UN ESSEPPTED ROP ER INSPECTION PBEpST Phone (612) 642-0600 U I4 ? III ? II ?I N ENCLOSED. O? ..., ?IIIIIIIII?IIII IIIIIII f?llll IIIIII I III IIII MS2IQFOR ? UYIA Ss? ?a Rmo, E1CSA? Paul ?, M`N 55104 * U 3?., 9`f 3 6 L* phone (812) 642-0800 ?j?Q ? Home Duplex Apt. Bldg. Other: New Addn Commeraal Industnol Farm mod Re air Air Cond Htg. Equip. Wafer Htr. Load Mgmt. Other: D er Ran e Elec. Heat Tem . Service "X" above ihe work rovered by this request Enter remorks in fhis spare and on fhe back of the white copy only. ,k" ,q-/C, , ,? ?no 441Wd QC&Vt,?-z Calculate Inspection Fee - This Inspection Request will not 6e accepted wdhout ihe mrrect fee: Olher Fee Service Enhnnce Size Fee # Circvifs/Feeders Fee Mobile Home Park $tall 0 to 200 Amps 0 to 100 Amps Sfree} k}q./TraHic $ig. Above 200 Amps ° A 700 Amps 7rans{ormer/Genemtor INSpECiOn'SUSEaNLr TOTALn L Sign/Outline Ltg. Xfmr. " U, U Of J Alarm/Remofe CoNrol -C? $wimlYling Pool I here6 wdi 1Fa1 I i "?al in:Wllmian de:rnbed here;n on the daro::wted Illigafion Boom Roogh-In Date S eciallnspedion p Invesfigahve Fee F???? THIS INSTALLATION MAY BE ORbERED DISCONNECTE NOT COMPLETED WITHIN 18 MONTHS. 3 1.? -ji3 6U OFQFl?C UpSE O/p?I±LY This requesl vaid 18 monihs (rom vaLdanon dore pnnled in oy? g O !T/ ? ?r 0.?. ' jI ? ?? Sv` d /7 C/ W ? ? j CIV PLEASE PRINT OR TYPE 41 Requnt Dob aa -9& Rough-rn ??pedion reqmrad2 ? Y? o d Inspeaion Other Than Roughin 0 Ready Now ill Call t B d D 7 rou mos? mll Ihe inspeMr when reo y) e ea y a I, [Xlicensed <ontradar El owner hereby requesf inspedion of fhe above elecirical work at: Job Address (Sheel, Bm, ar Roine Na.? 4 qry bp Code S ee D Seeion No Township Nome ar N. Ranee N. Fin Nn Comly Oau 3 eel e ° Phane No. 9? 4? o,v? . - PowerSuppLer Pddress Elennml CoMmdm (Company Nome? lei ?-/?SQ? fi Conhoctur Limm<NO/ 11 6{? Masler lic No. (Piant Eled Only) Moiling lddras (Contmtlor orOvmer PerFarmmg I s aliont N .?.s?.t' . P? ?^ ? AoPoonz ankoctor r P Insmllohon) Phone N? / / EB-00001h10 6/95 ( STATEBOARUCOVY-SEEINSTRVC710NSONBACKOFYELLOWCOVY ; .. PERMIT V CITY OF EAGAN BUILDING 3830 Pilot Knob Road PERMIT TYPE: E2g2n, Minnesota 55122-1897 Permit Number: 0 2 8 0 3 4 (612) 681-4675 Date Issued: 0 7/ 2 2/ 9 6 SITE ADDRESS: P.I.N.: 10-47752-020-01 DESCRIPTION: 1045 KEEFE S7 LOT: 2 BLOCK: 1 MCKEE 3RD .-„ MAC RENOVATION priildi'+?'g Permit Type SF (MISC. ) ;`Build'xng?Work Type ALTERA7ION r€etT.6us- C.od??"494 ALT. RESIDENTIAL ? / r i ? \\?4Yrft{, r t , REMARKS: SEPARATE PERMITS REQUIRED FOR ELECTRICAL OR PLUMBING WORK FEE SUMMARY: Base Fee Plan Review Surcharge Total Fee VAIUATION $187.25 $93.63 $6.00 $286.88 $12,000 CONTRACTOR: - Applicant - sT. I.IC.pN/NER: BLOM CUSTOM HOMES 18913773 0001110 STEELE THOMAS 8675 135TH 5T W 1045 KEEFE ST APPLE VALLEY MN 55124 EAGAN MN (612) 891-3773 (612)454-9455 I kaereby acknowledgethat Z have- read this-eppJ.ication arod state thet Che, information is correct and agree to comply with all applicable State of Mn• Statutes artd CiCy o'f Eagan `Ordinances.? L . _ . __. _-. .. ._.. ? ? AP T? NATURE TSS'IEDCY. S?NATUFTE?? CITY OF EAGAN 3830 pILOT KNOB RD - 55122 ? 1996 BUILDING PERMIT APPLICATION (RESIDEN 681-4675 1-W Lo ? r ,1 (t New Construciicn Requirements Remodel/Repair Reauirt ? U r? °7 ? 3registeredsilesurveys ? 2 copies of plan _____________.,_ ? 2 copies ot plans (include beam 8 window sizes; poured Tnd. design; etc.) ? 2 sile surveys (exterior a ddions ?dec s ? 1 energy calculations ? 7 energy ealculations (or heated additions ? 3 copies of tree preservatlon plan ff lol platled after 7/1/93 iequired: _ Yes _ No DATE: lD CONSTRUCTION COST: 16 7Y0 DESCRIPTION OF WORK: STREETADDRESS: /U7 LOT .1 BLOCK I v> s ? SUBD./P.I.D. #: ?y? gu_ PROPERTY OWNER Name: 5 T4 5L-r- 7! p " Street Address, gA5 `"" Phone #: City: k_41¢11 State : L1? Zip: CONTRACTOR Company: Street AddresBsLO 8675135TH ST. W. Phone #: ? License #: ? ?/??O AVPLh t City: State: Zip: ARCHITECTI Company: Phone #: ENGINEER Name: Registration M Street Address, City: State: Zip: Sewer 8 water licensed plumber: change are requested once permit is issued. Penalty applies when address change and lot i hereby acknowledge that i have read this application and state that the informatio ' correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received _ Yes No Tree Preservation Pian Received _ Yes _ No OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ? 02 SF Dweliing ? 07 4-piex ? 12 Muiti RepaidRem. ? 17 5wim Pool 0 03 SF Addition ? 08 8-piex ? 13 Garage/Accessory ? 20 Public Facility ? 04 SF Porch o 09 12-plex ? 14 Fireplace ? 21 Miscellaneous ,0-05 SF Misc. ? 10 = plex ? 15 Deck WORK TYPE ? 31 New 60'-33 Alterations o 36 Move o- 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) (Aliowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building Engineering MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bidg Census Unit Variance G/ O Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: . Vaiuation: $ /zI pt) a ? % SAC SAC Units CITY USE ONLY LOT ? BL RECEIPT #/: C -7 SUB . RECEIPT DATE: 1999 MEcHAvicAL PEMrr (REsinENnAIa CITY OF £kfikN S$SO PILOT KNOB iiD E4HAN MN 55122 aa?-?q (651) e81-4e75 Date• Complete this section onlv if you aze installing HVAC in single family, townhomes or condos under construction and not owner /occupied • HVAC: 0-100 M B T U $ 30.00 ADDITIONAL 50 M BTU 6.00 • Gas outlets (minimum of one required @$3.00 ea.) • State Surcharge: .50 • TOTAL: Complete this section ontv if you are remodeling, adding to, or repairing existing single family dwellings, townhomes, or condos. Please indicate if it is a new item, replacement item, or repair. New S_ Replacement Repair _ Other J_ Furnace Air exchanger, i.e. Vanee system, etc. Reminder: Ca11 681-4 6 75 jor inspections. Air conditioning _ Other $ 30.00 State Surcharge: .50 Total: $30.50 SITEADDRESS: ?014r'J Ke4de S+1'e-2-I" ORNER NAME: ?_(1'NYr?p ?'? rQk PHONE #: 405' (LH I Lp I\`STALLER NAYIE: RpyX'S W6)0-nk Cc4 PHONE #: 4 +? -'3 5`6'? STREET.4DDRESS: CI'CY: _'-'?YA STATE: M N ZIP: All,,;, Ca?wz SIGNATC,72E OF PER'viI'ITEE JS. FORJiS BLD, tif ECH PER.Yf iT (RES) - 1999 L BL SUBD. APPROVED BY: RECEIPT #: RECEIPT D, INSPECTOR 1999 MEcHAvicAL PERMrr ccoaME[tctAw crrY oF E,aeAv 3$30 PILOT KNOB RD EAfiAN, MN 551 EE (651) 681-4675 Please complete for: all commerciailindustrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: CON i`iLAC'1' YK1c;E: WORK TYPE: _ NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: FEES: 1% of contract price OR $30.00 minimum fee, whichever is greater. Processed piping - $30.00 CONTRACT PRICE x 1°/a PROCESSED PIPING PERMIT FEE STATESURCHARGE TOTAL SITE ADDRESS: OWNER NAME: TENANT NAME (IMPROVEMENTS ONLY): INSTALLER: ADDRESS: CITY: CITY USE ONIY PHONE #: ($.50 per $1,000 ofpLnmit fee due on all pecmiu.) PHONE #: STATE: ZIP: SIGNATURE OF PERMITTEE CITY USE ONLY ? r1 L ? BL ? d RECEIPT #: 4°? ? T SU DATE: 1996 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? single family dwellings ? townhomes and condos when pertnits are required for each unit New construction Add-on fumace A ?I Add-on air conditioning Add-on airexchanger, i.e. Vanee system, etc. ! y Date: FFFC ? Minimum Fee: Add-oNRemodel (existing residence only) $ 20.00 ? HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ? Gas Outlets (minirrrum of 1 required @$3.00 each) ? State Surcharge .50 TOTAL AA) SITE OWNER NAME' 1116l'Yl RS SW` V _ PHONE #: " 10 2-1 4jy Jq`r4'5 INSTALLER t STREETADDRESS: CITY: R? Cl.l'(1 el STATE: M?I ZIP: PHONE #: (IpIZ ) 79?'4?45 0` :C?-,f?? ? ?--? CITY USE ONLY L _ BL _ SUBD. r. RECEIPT #: DATE: 1996 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? all commerciaUndustrial buildings. ? multi-family buildings when separate permits are = required for each dwelling unit. DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION DESCRIPTION OF WORK: INTERIOR IMPROVEMENT FEES: ?$25.00 min(mum fee QI 7% of conVact price, whichever is greater. ? Processed piping - $25.00 ? STate surcharge of $.50 per $1,000 of pgmQ tee due on all permits. CONTRACT PRICE x 1% PROCESSED PIPING STATE SURCHARGE TOTAL SITE AL»RESS• .. OWNER NAME: TENANT NAME: (IMPROVEMENTS ONLY) TELEPHONE #: INSTALLER: ADDRESS: cinr: - PHONE #: STATE: ZIP: SIGNATURE: SIGNATURE OF PERMITTEE CITY INSPECTOR EAGfsN TOWNSHIP 3795 Pilot Knob P.oad St. Paul, Minnesota 55111 Telephone 454-5242 PERNIIT FOR S&7ER SERVICE CONNECIION DATE: December 11, 1967 OWNER: Victor H. Schauer PLUMBER All State Plbg. NUMBER Address 1045 Keefe St. TYPE OF PIPE Ext. Heavy cast iron AESCRIPTION OF BUIIDING Industriall Commerciall Residential I Multiple Dwelling ! No. of units X Location of Connections: Connection Charge $200.00 Pd 12A1 Permit Fee 7.50 " Street Repairs Total $207.50 Pd Inspected by Date Remarks By. Chief Inspector In consideration of the issue and delivery to me of the above pera:it, I hereby agree to do the proposed work in accordaace with the rules and regulations of Eagan Toc•mship, Dakota County, Minnesota By r ?_ r" _ ? _ ? - Plsaee r.otif.y crhen ready for inspection and comnecY.:ion ar.d before any port:cn oi thz wcrk is covered. EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERT11T FOR WATER SERVICE CONNECTYON Date: December 11, 1967 Nutiber: ZT Biiling Name• Vietor H. Schauer Site Addresa; 1045 Keefe St. C) - ? Owner: above Plvanber: A7.1 State Plbg. Meter Pd. 12/11 Meter No. 'Permit Fee 7•50_ " Meter Reading IMeter Dep. 15.00 11 Meter Sealed: Yes_ lAdd'1 Chg. NO ITotal Chg. $222.50 Pd. Building is a: Residence X Maltiple Ho, Uni Coao*iercia 1 Iadustrial Other Inspected by Date Remarka: By: Chief Tnapector In consideration of the iesue and delfvery to me of the abwe permit, hereby agxee to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota Countv_ Mtnnesota. By Billing Address above I Plea:ae notify the above of£ice when ready for inepection and connection. ,- i L BL ?i SUBD. CITY USE ONLY ,J ? RECEIPT#: rRECEIPT DATE: O ? PERMIT # 2000 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT ICNOH RD EAGAN, M4i 55122 651-681-4675 Please complete for: ? single famity dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system FIXTURES ' EACH # TOTAL Aiterations to existing dwelling - minimum fee Describe: C'(.0V0.-cA $ 30.00 Bath tub $ 3.00 x = $ Floor drain 3.00 x = $ Gas piping outlet ' minimum - 7 3.00 x = $ Hot tub/spa 3.00 x = $ Kitchen sink 3.00 x = $ Laundry tra 3.00 x = $ Lavatory 3.00 x = $ Se tic System newkefurbisned ' requires MPC Iic. 75.00 x = $ Septic System abandonment 30.00 x = $ RPZ new installation/repeidrebuild 30.00 x = $ Rough o enin 1.50 x = $ Shower 3.00 x = $ Underground sprinkler if dwelling is under construction 3.00 x = $ Underground sprinkler if existing dwelling 30.00 x = $ Water closet 3.00 x = $ Water heater 3.00 x = $ Water softener 1} dwelling under tonstruction 5.00 x = $ Water softener if existing dwalling 30.00 X = $ Water tumaround 30.00 x - = $ State Surcharge .50 -> -> -> $ .50 Total -> -> -> --? $ Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc. ----------------------------------------------•----• •--------------•-----------------...--------------------•----•------------------------ I he2by acknowledge that I have 2ad this applicatian, state that the information is corted, and agree to compty with all applicable City of Eagan ortlmances. It is the epplicanPs responsibility to notiFy the property awner that the City of Eagan assumes no lia6ilky for any damages caused by the City during its nortnal ope2tional and malntenance aGivities ta the facilfties construc[ed under this pertnk within City property/right-of-wayleasement. SITEADDRESS: OWNERNAME:: TELEPHONE#:LOS{ (0'8> --- 910? (AREA CODE) INSTALLER NAME: STREET ADDRESS: ciTV: TELEPHONE #: (AREA CODE) ZIP: S!a±4- PERMITTEE Ord"wanm No. I ld: WELL AND WATER SUPPLY MANAGENIENT Permit No. ' WELL PERMIT 92-9159 AKOTA COUNTY ENVIItONMENTAL MANAGEMENT DEPARTMENT WATER AND LAND MANAGEMENT SECTION 16955 Gdas[e Atmue, Apple V.&q, M['! 55124 Tdephone (612) 891-00I1 WHEREASt the NON-TRAN3FERABLE PERMITTEE/DBA: Don Stodola Well Drilling ISSUED TO #27306 ADDRESS: 15306 Hwy 7 REVIEWED BY Swenson Minnetonka, Mn. 55345 has submitted a permit application, has paid the sum of one hundred five ($105) dollars to the County of Dakota as required by Ordinance Number 114 and has complied with all of the requirements of said Ordinance necessary for obtaining this permit to permanently seal the well described herein: An abandoned well with a casing diameter of 4 inches, depth of 140 feet and completed in unconsolidated sediments will be permanently sealed. The well shall be cleaned of equipment and debris, disinfected, neat cement pressure grouted and terminated at least two feet below qrade. The well is located in the municipality of Eagan as follows: Well Location: Property Owner and Well Owner and Address (if different) Address (if different) 1045 Keefe St. HUD Eagan, Mn. NOW, THEREFORE, Don Stodola Well Drilling Co., Inc, is hereby permitted and authorized to permanently seal the well described and located above for the period July 1992 to July 1993 subject to all provisions of said Ordinance, the Minnesota Water TAell Construction Code and any conditions attached on the reverse side of this permit form. Given under my hand this 29th day of July, 1992. ? /?:?d?Jd'O//Ytb"_ ATTEST ENVIRONMENTAL S ISOR DIRECTOR 8i93i2007 13:53 EAGqN ENG+COM DEU 4 915076649182 7? 2007RESIDENTIAL BUILDIlNG rERMIT ArpLrcAxnox City Of Eagan 3830 PiloL Knob Road, Eagao MN 55122 Teiephone # 651-675-5675 FAX # 651-675-5694 New ConsWction Reoulremens 3 reglstefad site aurveys showing sq. h. of IM, sa ft of nouae; and J rooled ereas (20% manmum loi mverage ellowetl) 1 Soils Repori'rf proposed 6ulldlrig le to be placad On dlStufhad sql 2 Co01Ss of plen showllghbam & Windaw sl2as; poured tound d95ign, etC. 1 setof Enemy Calwlatlons 3 wplbs of Tree Preservetion PHn II IM plahEd aryer 711/33 qlm Jolst DetaII Opllons seiaclion shaat (hu0dffgs wilh 3 0r less unllcJ MmnagesCO rrachaniWl venqla0on fomi RemaGel Renair ReqWremenl9 2 coples of Dlan showinp f0olin95, eeems, Jolsts 1 sel of EnotgY Celculatians for hp0fed eadhions 1 Si(B 84NBy fOf SddId006 & QBCNg pRtltllan - intlicate II onspm septic systam N0.710 D01 1o?l"c7"? l 9O- C/`-' llw us? CeAotSurveyRenl _Y _N SoilsRepcri _Y _N ifee PfeS Pi9n Recd _Y _N SreapresRequired _Y _N OnsileSeplieSystem _Y -N "d d ublic information untess ou state the are trade secret and the reason. P1ans are consi ere Date 6 ! s / 6-1 Sita Aadress o ? +tz.. Gt N Construction Coet Los CXD ' B ? M-- C7nidste # ? (22 Aescription of Wnrk Mulli-FamilyBldg 1' N Ptirep)ace(s) _ 6 7 _ 2 Praperiy Owner U ( ,312,13 c> ? G Z>? Telephone # U-61 ? Contracfor ` - ?-YLC? .lrxS t - ?l.EJ?I Addcese Siate City Zip i0S? -1]e1ephone # ('aY'U COMPLETE TH15 AREA ONLY IF CONSTRIJCTING A NEYV BUILDING - Minnesoca I,tules 7670 CaEe¢QrY 1 7vIinnesota Rules 7672 E?ergy Code CetEgOry • Residentlal VendlaUan Caeegory t Workeheet • New Energy Gode Wodcsheet (4 submlSSionlype) SuAmltYed SuhmiLted . Energy Envelope Caiculaclons SuDmitted In the Iasf 12 monihs, has tha Ci4y of Eagan issued a permii for o similar plon based on a mosiu-r plan? _, Y _ N If yes, dofe and oddress of mas}er plon: Licensed Plumber Mechanical Contractor 5ewer/'Nater Contractor Telephone #( Telephone $f( 7elephone #( T hereby apply for a Residential 13uilding Permit and aclanowledge that flie information is complete and accurate; that the work will be in couformaiice with the ordinances and codes of the City of Eagan and the State of MN 5tatutes; i understand this is not a pennit, but only azi application for a permit, and work i,s not to start without a permit; that tbe worlc will be in accordance with the approved plvi i1t tha case of k wliich requires a review and approval of plans. v ? Appli an s nnted Naane ? ApnlicanYs Signatur PERMIT Permit Type: Plumbing City of Eagan Permit Number: EA105435 Date Issued: 07/13/2012 Permit Category: ePermit Site Address: 1045 Keefe St Lot: 2 Block: 1 Addition: McKee 3rd PID: 10-47752-01-020 Use: Description: Sub Type: e - Water Heater Work Type: New Description: Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Kris Oien Comments: 3670 Dodd Rd Eagan, mn 55123 651-365-1340 PL - Permit Fee (WS &/or WH) $55.00 0801.4087 Fee Summary: Surcharge-Fixed $5.00 9001.2195 Total: $60.00 Contractor: Owner: - Applicant - Champion Plumbing Gwenne Dykhoff 3670 Dodd Rd., #100 1045 Keefe St Eagan MN 55123 Eagan MN 55121 (651) 365-1340 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. Applicant/Permitee: Signature Issued By: Signature