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1037 Kenneth St?Fj'/g /9 e,[ REQUEST FOR ELECTRICAL INSPECTION p ( / ? See inslmctions br compleling ihis brm on pack oi yellow cropy. Cv O 2 5 46 . 'X` Be/ow Work Covered by This Request dc?sgq? EB-00001-08 ?ro ew Add Rep. TypeolBuiltling AppliancesWired EquipmentWired Home Pange Temporery Service Dup?ex Water Heater Eleciric Heating Apt. Building Dryer Load Management - j Comm./Industrial Furnace Other (SpeCily) Farm Air Contlitioner Ofiei (syecify) GonVaclorS Remarks' Compufe Inspection Fee Below: • # Other Fee # ServiceEmranceSize Fee # Circuits/Feeders Fae Swimming Pool 0 to 200 Amps ¢to 100 Amps Transformers Above 200 _ Amps bove-7 _ Amps Signs Inspectors Use only: UC? TOTA .S m Irriga[ion Booms ?? ? Speciai Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITNIN 18 MONTHS. I, the Eledrical Inspector, hereby certify that the above inspection has been made. Rouyn-m F,,,ai oe?e oste OFFICE USE ONLY This request void 18 months Imm C? 02546 a e ; Request oate . ? Fire Nti- . Rou9h-In Inpsedion Required Inspecfion Otnar Tn?Y ougn-In ? ?/ ? au cell inSpa or when reatly) ? Reatly Naw?'?,Will Notlly Inzpector Ves N. Oate ReeE 10 licensed contractor A owner hereby request inspection of above electrical work at: Job Atldre (Streel. Box or F t No.? n Ciy ( L/n V/7 • r od $eciion No. Townshlp Name or No. Range No. County Ocw am (PRINT? Ppone No. ein ? ?A 0 w P,?I'' Pawer SuppAer Mtlress Electnwl Gon rac t (COmpany Name? ConVadorS License No. o a?e-oc?.ner- Mailing AOar ss fGOnlraclor or Owner Making Instelialionl Dv AW ignaWlp ICONrInStdlld I PhOnB NumD Bf `J G.l?, ? Y I ESOTAOATE BOAFD OF ELECTRICITY THIS INSPECTION fiEQUEST WILL NOT I s-Midway BIdB, - Ream 5-173 BE ACCEPTEO BV THE STATE 90ARD 62/ University Ave.. St. Paul. MN SStOC UNLESS PROPER INSPECTIpN FEE IS Phone161P)602-0800 ENCLOSED. Ae, q- - a-p 7I EAGAN TOWNSHIP BUILDING PERMIT Ownex .............. ..... Address (Presen2) --'A3''--..A,-?-'-C..^..?: ....... "--"--- Builder ---- - 4? '''-'`--?-- ------ -------- ------- ---------------------------------------------- -- [ Address ----------------------------------------------------- -----'_.....__----.....--`----.... DESCRIPTION N° 856 Eagan Township Town Hall ?/`Yllo Z.? Dale ............ ..........-°------.. 5tories To Be Used For Fron! Depih HeigHi Esi. Cosi ermi! Fee Remarks +?"'?.A w a? O . o?-G C/ LOCATION SlreeS. Road oi oiher Descs3p2ion of Locafion I Lo! Block Addiiion oz Tiaci This permif does no3 aufhorise the use of sixeets, soads, alleys or sidewalks nor does it give the owxer os his ageni the righf fo ereaSe any situazion which is a nuisance or whieh presents a haaard !o the healih, safeYy, convenienee and general welfare !o anyone in the communiiq. THIS PEAMIT MUST BE KEPT On TfiE PREMISE WHILE THE WOAK IS IN PROGAESS. This is 2o cerlify, fhai_.?V-------- .??----------------------- haspermission Yo erect a_._......_ .... ........."""... .t............._"'..upon 3he above d scribed premisa subjec! !o the pxovisions ot the Building Ordinance for Eag Townshi adopled April 11, 1955. Q f ? . ` ...-_...... ......... ....'--...............°--------....... '-'. ..-??.??..----------..... Per ...._....._........---- - t..?? .---?._... ?-?._.... Chairman awn Soard Suilding Inspec3or 61.6. INSPECTION RECORD . , „ CITY OF EAGAN PERMIT TYPE: ?'r 3830 Pilot Knob Road Permit Number: ? .' •> >..' 4 I Eagan, Minnesota 55122-1897 Date Issued: r fa / 26 / u6 (612) 681-4675 ? SITE ADDRESS: ? ?? ? . . ??? u?. ? : PERMIT SUBTYPE: APPLICANT: ?t.i -1 aha TYPE OF WORK: iIi I,rVIPTr1,1; I I f .ilNil I N ?. NFU ? - ( rnS > Permk No. Permft Holder Date Telephona k ELEC7RIC PLUMBING HVAC Inapection Dsts Insp. Commenb 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 FTG DECK FINAL CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS• ' 1 1 IJW t i; . I 4fi ON RECORD PERMIT TYPE: Permit Number: Date Issued: fs i ?? ?. ?, ' , APPLICANT: riil rI (I ra6 *:I N>>I'l. 0 4) /A'1/96 PERIIAIT SUBTYPE: TYPE OF WORK: i r t kA i t fIN INSPECTION DA • D• ?AM i Flt. ; iitl(yfl ! N li 1I 1 NA I ?. ? Permit No. Permft Hotder Date Telephone M ELECTRIC PLUMBING HVAC Inspectlon Date Inep. Commenta FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARO FIREPLAC i FIREPLACE AIR TEST FINAL PLBG FINAL HTCa ORSAT TEST BLDG FINAL [ BSMT R.I. BSMT FINAL DECK FfG DECK FINAL I CITY OF EAGAN Remarks Addition McKee Addition 4k1 Lot Z Bik 1 Parcel 10 47750 020 01 Ownert street 1037 Kenneth St. State Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR, paViIIg -ui 1969 $311.50 $31.15 10 PAID GRADING SAN SEW TRUNK 1968 $100.00 3.33 30 PAID * SEWERLATERAL 1968 20 WATERMAIN * WATER LATERAL 1968 85?.?0 .5 20 P ID WATER AREA STORM 5EW TRK 1984 403.00 26.87 15 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. sAC 200.00 520 11-21-67 PARK - _ - - • ? ?-? - ? - -- _ ? _ _---_ _----=? _ _ -- _?_ , _ . _ . _ _ _ - .. - - --- - . -- ---- - - ----- - ` -- ?_ - -?_ ? ? ? - - _ - s---• w- k..: ? ??. ij - !t3 .- . . ? ? J? ? Y ?b 9 t . -k `?• . '`? `1`- • ? ?? w?^n WO?"'`?? •.. ?? 3 ? {#i'? ..,?, `t.. ? ?F; ? ? ?i ' ?' ?, s ? ? ?i? .. ,.' ? ' `? y: ?'a" _ ?? ? ? ? ? f' ? - -?. ; ?- ? F i4 d ?? ?. p i'!1' v, " . ,? i ? ? t ?,?'p-? t •.: .?4; . -?? '?" ? ? ' ? ? '' , ';1"?w;V ?? ???' }? ` r Z?,.? r'.? ? #a??;?'1: - `'"?j • ?? ''Fr? 4 ' 1 .? ? - . ,. . . ?. i-. ; t . . =RWk. il - ? 4rf I fi e; _ ?. ? ?, ',: ? ? . . . . M?,.?. ?Y'?• i , 4.?! T , ?? :'? ,?x ' R ? .,??'?".- . 1 ?i??\. a ' ?•,•< City of Eakan Memo To: Inspections Personel From: Jeff Munsterteiger- Code Enforcement Date: 10/24/2008 Subject: Non-Conforming Structure On an inspection of the premises because of a foreclosure, I discovered an addition had been added to the back of the garage. The addition had no visible foundation and appeared not to be constructed to code. Working from aerial photos, the structure appeazed to have been modified somewhere between 1997 and 2000. c:r.rY or !:rAC,'r?.r, C.1::i,!-!2I:::R- MIG; T;:::R:tirA+(`:!... Np1" ._;.sg i.f;/'.'...';!.':)r_, '1:1'.M;F e i.:I. n? ir 9001. :i.rz';r i=;!=NWF...,.,_?? 'i ;7100 , ?, , „..,i. n:: ., -.????...,. r;.,, ? 50, .......,..? :; . .. ? •,•.i.,.::.. ? i., PERMIT ` CIYY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT TYPE: Permit Num6er: Date Issued: BUTLDING 029124 10/25/96 SITE ADDRESS: 1037 KENNETH ST LOT: 2 BLOCK: 1 MCKEE P.I.N.: 10-47750-020-01 DESCRIPTION: (GA5) rmit Type FIREPLACE r}s Type NEW 494 AL7. RESSDENTIAL ' a. ?a F ??1? ?`??'' '?,a i we ??-,.. F -rm§t?s ?.? ? LL, REMARKS: FEE SUMMARY: Base Fee Surcharge Tota] Fee $25.00 $.60 $25.50 FCONTRACTOR: OWNER: - Applicant - BARLOW GEORGENE 1037 KENNETH 57 EAGAN MN 55121-1413 ' (612)454-2145 I her'sby a inform:atica ?Staiutes°a ?? ?? ? -?? - SSUED B SIG TUR CTfY OF EAGAN 3-qi ? 3830 PILOT KNOB RD - 55122 1996 FIREPLACE PERMIT APPLICATION 681-4675 DATE: C2 DESCRIPTION OF WORK: 3 J? ,?o ?CONSTRUCT NEW FIREPLACE: WOOD Bi1RNING ?GAS INSTALL GAS INSERT OPILY IN EXISTING FIREPLACE _ INSTALL GAS LINE ONLY IN EXISTING FIREPLACE O'CHER: ROOM TO BE INSTALLED IN: STREET ADDRESS: / L4 f l LOT ? BLOCK .?- SUBD./P.I.D. #: r?C koL APPLICANT: (circle one only) OWNER CONTRACTOR I hereby acknowledge that I have read this application and state that the informarion is correct and agree to comply with all applicable 5tate of Minnesota Statutes and City of Eagan Ordinances. PROPERTY OWNER FIREPLACE INSTALLER Name: Signature: ? / Street Address: .? '?7 ?i ei?ilE`/ ?"h J`T - .? City: CV G.?? Company: _ Signature: _ Street Address: Ciry: GAS LINE Company: INSTALLER Name: Signahxre: - Street Address: City: Phone #: State: i •AI Zip: Phone #: 5tate: License #: State: Zip: Zip: . r i- : . . .. m;ki'F?k>X>kAu?k??k7K>X1h?k??k?K?%?kok# 'M$! N('%Y6X?}kkCVF?%?k?8>X:i??7KY,: rITV 01= CA.'.:iN:C!F:Fta S ff'.RMT_NAl. N(Jr 74 DA1'F=;; 09/09/96 'T'7:riE; 15;;1.9:03 M., ?i?AME: I...ANLi L HCIME: :I:NC; 300 9001 1037 ECENNI3:TH 5'T 199a7; 34;i.'.2 `)OO:L :IA37 IiEPlNl..';'41 51 99.518 205 9001 1.03'7 KE:NNI::TI-1 5'f 6.50 3430 9001 W37 KE:NNL:1'H f3T 5.00 2210 9001 057 N!;Y.I?:L S'1 212.25 3422 9001 'LQS'r t'iCF;fi:lE: SC 9.Ofr,.:l.3 MJ;J 90(]1 ±.057 NiCKi=-: s?r 7„00 '1'otal. 1"ter_er:ipi; Amouni: e c;3t'?. ;1 r.Rf l64Q}"i, I_!SI'_:fi .T.fl:; NRiN?IY ?X<?k?K%:XtN::d?kYF%?>X?, ?kXc%<1F;n ?k?k???k?X>X>k?k?k',M:$W 'h<7k%k?%%i:*yFkz E :. • _ CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: P.I.N.: 10-47750-020-01 DESCRIPTION: PERMIT PERMIT TYPE: Permit Number: Date Issued: 1037 KENNETH ST LOT: 2 BLOCK: 1 MCKEE (MAC SOUND INSUL) 8uildinq:?Permit Type 5F (MISC.) 8uilding l3g.rk Type ALTERATION Census Gode 434 ALT. RE5IDENTIAL f j;,,^"' ti..3f. . ?+a.. BUILDING / 028776 @9J@9/96 REMARKS: FEE SUMMARY: VALUA7ION $13,000 Base Fee $199.75 Plan Review ` $99.88 Surcharge $6.50 Lic. Search Fee $5.00 Total Fee $311.13 CONTRACTOR: - Applicant - sT. IIC.OWNER: LANp & HOMES INC 14216868 26011121 BARLOW CHRIS 13001 REVERE LN N 1037 KENNETH ST MINNEAPOLIS MN 55316 EAGAN MN 55121 (612) 421-6868 (612)454-2145 I here6y acknewledge that I have read thzs application and st'ate that the informatAo'n is correct and agre:e to comply with all applicabl;e State of Mn. ? Statutes antl Ci'ty of Eagan Ordinances. J APPL CANT/PERMITEE SIGNATURE ISSUED B': 51 NATUR loqqL CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 New Conslruction Reauiremenls RemodeVReoair Reauirements 4m• 1J ea..Q?".? 4-L ? 3 registered site surveys ? 2 copies of plan ? 2 copies of pians (include beam 8 window sizes; poured fnd. desiqn; etc.) ? 2 site surveys (exterior additions & decks) ? 1 energy calculatlons ? 1 energy caleulations for heated additions ? 3 copies of tree preservation plan if lot pladed after 7/11193 required: _ Yes _ No DATE: f'afil'?lO CONSTRUCTION COST: l°?, 7? DESCRIPTION OF WORK: STREET ADDRESS: A2 77 LOT I BLOCK SUBD./P.I.D. #: PROPERTY OWNER CON7RACTOR Name: a44ud L?L Phone #: yS`?'aiS?S U9i fiRSi Street City: State: 'Ty"/z Zip: Company: Phone 27°2'1 ' Street Address: ?.u? z-- ? License #: oV7,!9111-21 City: je?,a,?ti-. State: /0?t Zip: ARCHITECT! Company: ENGINEER Name: Street City: Sewer 8 water licensed plumber: change are requested once permit is issued. State: Zip: Penalry applies when address change and 6d I hereby acknowledge that I have read this application and state that the information is correct and agree to comply witla aiA applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: ? OFFICE USE ONLY RECEOMED Certificates of Survey Received Yes _ No .? SON Tree Preservation Plan Received Yes No -- Phone Registration #: OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? ? 02 SF Dwelling ? 07 4-plex ? 12 Multi RepairlRem. ? ? 03 SF Addition o OS 8-plex ? 13 Garage/Accessory ? ? 04 SF Porch o 09 12-plex ? 14 Fireplace ? ,,o?05 SF Misc. ? 10 = plex ? 15 Deck 11VORK TYPE ? 31 New ?k-33 Alterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit 5/W Permit 5/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: +R 4., 0' .. '1 r 4' ?"' 3 •. ly,, ^4 , 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous _ Basement sq. ft. MC/WS System ? Main Ievel sq. ft. City Water ? _ sq. ft. Fire Sprinklered _ sq. ft. PRV _ sq. ft. Booster Pump _ sq. ft. Census Code. LI??I _ Footprint sq. ft. SAC Code or Census Bldg ? Census Unit o Building m? Engineering Variance Valuation: $ '3. 0 ci 0 -?- % SAC SAC Units CITY OF EAGAN Log Bn?fJ/ MECHANICAL PERMIT SUBD. f?-- (612) 681-4675 RESIDENTiAL RECEIPT # /Oe DATE i? as 9?- PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELI.iNGS. ALSO, COMPLETE FOR TOR'NHOMES/CONDOS WHEN SEPARATE PERMITS ARE REQUIRED FOR EACH DR'ELI.WG UNIT. pWNEg; ?UGE0.?E <, I(?Mc`I HAUow' ADD-ON A/C ADD-ON FURNACE STTE ADDRESS: 1037 KfNrJ6TH 57YLE6f EA6 44?f ADD ON/REMODEL (EX[STING CONSTBUCfION ONLI) S 15.00 INSTALLER: RtRS T2f*m jiTk G(e0LF'l4 lel[: HVAC: 0-100 M BTU 24.00 PHONE #: y0-na2?5 ADDITIONAL 50 M BTU 6.00 ADDRESS: j147(e IZt?ER-wc?%o DRWE, $?RNf5UtuE GAS OU1'LEl'S • MINIMUM 1@ $3 EA. crrY: zrn: ??7 suitcanxc& $ so SIGNATURE: TOTAL: $ JS, SO NO PERMIT REQUIRED FOR DUCTWOKK ONLY! COMMERCIAL PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIALINDUSTRIAL BUILDINGS. ALSO COMPLETE FOR APARTMENT BUILDINGS OR OTHER MULTI•FAMILY BUII.DINGS R'fiEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. R'ORK DFSCRIPTION: CONTRACT PRIC& FEES , 1% OF CONTRACf FEE. STATE SURCHARGE IS $.50 FOR EACH $1,000 OF PERMIT FEE a PROCFSSED PIPING - $25.00 $ MIIIIMUM FEE - S25.00 OR'NER: TOTAL: $ SITE ADDRFSS: TENANT: SUI1'E #: WSTAI.LER: ADDRESS: CITY: ZIP: PHONE #: CITY SIGNATURE: SIGNATURE. EAGHN TO'v1NSHSP 3795 Pilot Knob P.oad St. Paul, Minnesota 5J111 Telephocte 454-5242 Pr?tMIT FOR SEWER SERVICE CONPd^C:IOPI DATE: Nov. 21, 1967 NUMER 71 0ldNER: Glalter Fletcher Address 1037 F?* ? iC. _17? PLL??BER Al1 State Plbg. TypE OF PIPE Ext. heavy cast iron DESCRIPTION OF BU73AING Industriail Cmimercial` Residential Multiple Dweiling No. of nnits N X Location of Connections: Connection Charge $200.00 Pd. 11/21 Permit Fee 7•50 /t SCreet Repairs Tota 1 $207.50 Inspected by: DaCe Remarke• By. Chief Irw^eector In consideration of the issuP and delivery to me of the above pc*r:Et, I hereby agree to do the prePosed work in accordance with the rules aad reguiations of Eagan Tocroship, Dakota County, Minneaota 8y PIeepe r.otiFy vhen resdy for irspection and corn:ctioa as.: bQiore an.y port:vn ez cria w_rk is cevered. I ? t ? r J EAGAPt TOWNSHIP 3795 Pilor Knob Roud St. Paul, MinnesoCa 55111 Telephone 454-5242 PERFILT FOR WATER SLRVICE CONNSGTION Date:Nov. 21, 1967 Billing Name: Walter Fletcher Owner• above Plumber: All State Plbg. Meter Number• 44 Site Addreas: 1037 Kenneth Billing Address Meter No. ?Permit Fee ?•50_ Meter Reading Meter Dep. 15.00 Meter Sealed: Yes ?Add'l Chg, NO ' Tota1 Chg. $222'50 Building is a: Residence X Multiple Hq, Commerc ia 1 Industrial Other Inspected by Aate Remarka: By: Chief 7.nspector In consideration of the 3ssue and delivery to me of the above permit, I hereby agree to do ttn proposed work fu accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota. sv: Pd. 11/21 Rd ?. Pd. 11/21 Flease notify the above office when ready for fnspection and connection. 09i15 '93 15:45 ID:IIAKOTA CO-WSC FAX:6128917031 MUNxCIPAL NMYCg pg WELL PMWIT APPLICATTON DAKOTA C0UNTy ENVIgpNNENTAL HANAGEMBNT DEPARTM$NT NA7ER 14955 Gt1laXie AVEnuW?B?t,?Ap?Tpa118yI? HN 55124 Te1 (612) 891-7011 Pax (612) 891-7031 DATBs Septembex 15, 1993 TO: Tom Colbert/Wayne Sahwana FRVHt water and Land Nanagemant RBt Nell Permit ;; 93-8221 14un3.cipalitX : 1sAgan PAGE 1 Fbst-It" brend fax trens htal memo 7B71 +?m peye. w I llb /6'Yh COUKAV ?°"' /?. 0191 on. l Nail Type; Sealing Reviewer z Rutken xoTicE: The Water end I,anc] Managament saotion cf the Ua.kote County Snvironmental Hanagement bepartment has received the followinq permit applioation for the well deserlbed. If you xeqtlire Puther review of the 8ppliaatiol? or if you heve pny questiotts pr contserns aboub it, contact the Bnvironmenta] speoial.fst listed abovg pr our oPfice at (612) 891-7011. If there is np reappnsa from your ofPice within 24 HOURS (exOYuding wee?kends gnd holidas the ) we will asau?pe that y4u hava no objeotions to the iesupnce of x pe y nni?., pleaBS nnte that permit iesuance is ai?raps Conditioned on he permit appllaant's observance of and aompli?ance with all applicable officonwhendoomple?.edPy °f the aell psrmit mi11 be forwarded to your WSLL CONTRACTpR TNFp72MATION: Garp 'e Well Drilli n n tioipated Drilling/?•Sea]inA ?1Date it known: Ti1he t : IACATION pF WF;r,L; PIS Coordinates Well Loaation 2037 Kenneih Btreet ?• sec , Tawn , Range Property owmer Eugene Har2oW W@11 Owner Eugene Harlow FtD Number 10,47780-02-001 i98LL INFOIiMl?TION: biameber q casing depth 123 Total Qepth 127 $wL 97 Aquifer Unooneolidated Bedimente CoMAlBN'ts : R=96% 6128917031 09-15-93 03:45PM P001 #02 City of Eapn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 ------------------------------------------ ? Case Number: 09-004328 ; , , FORECLOSURE / PROPERTYDAMAGE REPORT Date: 3/6/2009 Complaint Taken By: Terry Zelenka Type of Building: Single Family Home Name: Address: 1037 Kenneth Street Legal Description: Phone Number: Complaint: Water off Gas Off X Water Off Electrical Off X Home is Unoccupied Action Taken: Inspection Comments: Home has had a Sheriff's Sale. The property is for sale. Home appears to be in good exterior condition and has no apparent water damage to date. Entered in PIMS 3I11/09 (SB) Signature: 226 G:IBuilding InspectionslFORMS k Use BLUE or BLACK Ink For Office Used , Permit ~ My of Ealan Permit Fee: 3830 Pilot Knob Road I Eagan MN 55122 j Date Received: Phone: (651) 675-5675 i I Fax: (651) 675-5694 Staff: I -----------------i 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 'r L / 4t Site Address: 1037 `5 - Tenant:: Suite 8: RESIDENT / OWNER ASS Name: CW2_3s lie Phone: 1-1 7~ 6 - 1266 Address/City/Zip: '1 Applicant is: Owner 2SContractor TYPE OF WORK Description of work: ®v"'j s Sn/ ^ t"" s Construction Cost 'K./ 00 - Multi-Family Building: (Yes I No k } CONTRACTOR Name: 4 f" ~-•`f"~ S ITV ` 1 r~ L d `f Z Address: l br7 ~c~. * 2 . City: 4-pri-e- Vt t 4f state: MA Zip: S-5-r?-'y Phone: R~ _SPC r_ *oo Contact Person: 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. ~A,-N r.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the YMDrk WIN be i rrrance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a pemrt, and rk rat t a permit; that the work will be in accordance with the approved pan in the /'of workwhich requires a review and a of 2/~N~c9N+/t Zit 6CG.1 X X Applicant's Printed Name is Page 1 of 3 v