1070 Kenneth StCITY OF EAGAN Remarks
Addition McKee Addition #1 Lot 11 aik 2 Parcel ld 47750 110 02
Owner?N 4- ED( ' r:? [1f??r Street 1070 Kenneth St. State Eagan, NIN 55121
Improvement DD Amount Annual Years Payment Receipt Date
STREET SURF.
? 1 STREET RESTOR.pavin i 3 .50 31.15 10 --
GRADING
Hp 5AN SEW TRUNK 1968 100. 00 3.33 30 48706 A014840 11-14-84
* SEWER LATERAL 1968 20
WATERMAIIV
VATERLATERAL & SEW 1968 850.00 42.50 20 85.00 A014840 11-14-84
WATER AREA
STORM SEW TRK JL? 1984 403.06 26.87 15 349.28 A014840 11-14-84
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. $200.00 559 12-18-6?
BUILDING PER,
SAC $200.00 559 12-18-67
PAR K
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
? SITE ADDRESS:
s i
rl} ( t
? PERMIT SUBTYPE:
PERMIT TYPE: ? 1+ 11++ IP+G
Permit Number:
Date Issued:
APPLICANT:
? ? ? ?•
? ; ? ? . ? ?,: f; I ? ??rJ ? t?if', 1
i i ' ..
TYPE OF WORK:
A I I 1(tH I I 4iN
Mni •.rilIMli t N'.I II
!+I '.i {c 11' f 1 lopt
tt11M f hit+
li(,il 1 ra 14 1 t,
I:I i ttt;1{ IN 1'1 (;ti
I f p7 f i I
?' tr: N/ii+/ ', !1 '.t't'n(./s 1 f 1 1 1; M 1 1 l'. 1r1 011 1 RI 11 1 ntt (?NY I-IIiM{t I rao, 111- I 1 11 I It / i fit 1-40 ii l
t ? 1 -+? . . .. ..
L.? ? ? ? ? ?.. .. . . . . ?' . . . .. . ... . J
Permit No. Permit Holder Date Telephone li
ELECTRIC
PLUMBING
HVAC
InspecNon DaN Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIA TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG /CSx
ORSAT
TEST
BLDG FINAL
BSMT R.I.
?
BSMT FINAL
DECK FTG
DECK FlNAL
??? 7
CITY OF EAGAN
3795 Pilot Knob Road
Eogan, Minnasota 55122
Phone: 454-6100
HEATM
PERMIT
Dcte: g-79
Site Address: 1070 R+e?uleth Street
?.1. >
Lot Block 5ub/Sec.
McKee Pst Ackin.
Name Pay L. «tAeL'sCn
e° Address 1074 Kermeth ''t'y-,F-?t
:1
City Phone:
Nome tOdri.ciUsM Fi'tc1. &
.
Address
0
City Phone:
This Permit is issued on the express condition thot oll work sholl be
Minnesoto Statutes ond City of Eagon Ordinances.
OCMBib'TIM M REQ[TIIm
No. 1493
Receipt No.: 15- 0?i1
Single I
Residentiol X
Multi Res., Comm./Ind. I
New/Alter./Repair
Cost of Installation
'C? "C" (' -
Permit Fee A*''"?'' -
., .)J
Surcharge
Toto l -
done in occordance with oll applicable Stote of
Building Officiol
K 8780 106 5s( '-
7 a3/9a- ir .Q ? ? I`3 `r-I
Fe0uesl Date -
I -^
R Fre No. RougM1-in Inspection
Reqviretl?
? Yes No
? ReaOy Now?Will NotBylnspector
W?en Reatly?
IX,censed contractor 7) owner here6y request inspection of above electrical work aC
Job PaOress (Sveet. Boa or qoute No.)
? 1 ? 1 ? 1?C1' City
? Ll
Section o, TownsM1iO Name or No. Range No. ly I'j
vbIW
Oc (PRINT) Pbone No.
??•??' 1 `/
Power upplier Atldress 5
??s
usp
1 _
3wv Krliw e 1 kto-Lb rf- u
-
Eleqnwl Conlractor IGompany Namel nVecbr'S Cica se No.
?d- (Unrihern E?ec'h^?c LR , CR Ol 3?1
Mailing Adtlress (COnrc r Owner Maki g ns ano
a - ?Q? G??v ss ?a1
c??
Author¢e [raciorr0 er Mabng Installationj Phone Number
S - Q
,
MINNESOTA STATE BOl HD OG ELECTRICITY
Griggs-Mitlway Bltlg. - Foom 5-173
1821 Universlty Ave., SL Paul. MN 55104
hone(612) 642-0800 THIS INSPECTION REQUEST WILL NOT
6E NGCEPTEO BY THE STATE BOARD
UNLESS PFOPER INSPECTION FEE IS
ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION
? 18780 See insVUCtions lor completing Ihis forrn on back of yellow copy.
ll? K
"X" Below Work Covered by This Feques!
Ee-00001.08
,?? ?,/U?o99la
ew Add Rep. TypeolBuiltling AppliancesWired EquipmeniWired
Home Range Temporary Service
Duplex Waler Heater Electric Heating
Apt 8uilding Dryer Other (Speci )
Comm./Indusirial Furnace
Farm Air Conditioner
Other Ispeciryl conhactor's Remarks
Iq()Amp ;Zr'uilire - ?\RA K'
Compute Mspection Fee 8elow.'
# Other Fee # ServiceEniranceSize Fea # Circuits/Feetlers Fae
Swimming Pool 0 to 200 Amps '-? 0 to 100 Amps ?
Transformers Above 200 _ Amps Above 700 _ Amps
SlgftS Inspector's Use Only: 't TOTAL
Irrigalion Booms r ,S
Special Inspection
Alarm/Communication THIS INSTALLATION MAV 6E O ERED DIS TECTED IF NOT
Other Fee COMPLETED WITHIN 18 MO
1. the Electrical Inspector, hereby Rouyn-m
certify that the above inspection has
been made.
• ?l
OFFICE USE ;NLV
Tnis requesl voia 18 mon[hs Imm
4
WELL PERIVIIT
DAKOTA COUNTY
el
WHEREAS, the
PERMITTEE/DBA:
ADDRESS:
ENVIRONMENTAL MANAGEMENT DEPARTMENT
WATER AND LAND MANAGEMENT SECTION
14955 Galaxie Avenue, Apple Valley, MN 55124
(612) 891-7011
Permit No.
94-9284
IInique #
H55425
NON-TRANSFERABLE
Johnson and Sons DrilZing ISSUED TO: 27580
5815 Lower 182nd St REVIEWED BY:Luehrs
Farmington, MN 55024
has submitted a permit application, has paid the sum of $111.00
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 seal the Well described herein:
An abandoned well with a casing diameter of 4 inches, depth of 135
and completed in unconsolidated sediments, will be permanently sealed.
The well shall be cleaned of equipment and debris, disinfected, neat
cement grouted and terminated at least two feet below grade.
THE WELL IS LOCATED IN THE MLTNICIPAI,ITY OF EAGAN AS FOLLOWS:
WELL LOCATION PROPERTY OWNER & ADDRESS WELL OWNER & ADDRESS
1070 Kenneth Avenue Merle Anderson Merle Anderson
4500 35th Street SW 4500 35th Stree*_ SW
Waverly, MN 55390 Waverly, MN 55390
NOW, THEREFORE, Johnson and Sons Drilling
authorized to seal the well described and
of one year from the date of this permit.
subject to all provisions of Dakota Count
Wells and Borings Code and any conditions
side of this permit.
is hereby permitted and
located above for a period
Sealing of this well is
? Ordinance 114, the Minnesota
attached on the reverse
Given under my hand wednesday, October 19, 1994
A
Environmental Supervisor
Managemen
? oz# [ooa natz:z0 es-s[-ot teoLtsazts
? ?OU?
?t? 1ayn+?
xse=x
MUNICIPAL NOTICE OF WELL PERMIT APYLICATION
DAROTA COUNTX ENVIRbNMENTAL MANAG&MENT DEPARTASEN'I'
WATER AND LAND MANAGEMBNT SECTION
14955 Galaxie Avenue Weat, Apple Valley, A9N 55124
Tel (612) 891-7011 Fax (612) 891-7031
DATE: OctabBr 19, 94
To; Tom Colbert/Wayne Schwana
Bax #: (612) 681-4612
P'ROM: Water and Land Management
RE: Well Permit 94-9284
Municipality : gagaa
Well Type: Sealing
Reviewer : Luehrs
NOTICE:
The WaCer and Land Management Section of the Dakota County Snvironmental
Management Departmerit haa received the following permit appl.ication for
the well described. If you require futher review af the applicatian or
if you have any questions or concerna about it, contact the Environmental
Specialist Iisted above or our offiee at (612) 841-7011. If there is no
reaponse from your oEPice within 24 HOURS (excluding weekenda and
holidaye), we wzll assume that you have no objecCiona to the issuance of
the permit. Please noCe that permiC issuance ie alwaya conditioned on
the permit applicantls obaervance of and compliance with all applicable
laws and codea. A copy of the well permit wxl], be forwarded to yaur
offi.ce when completed.
WELL CONTRACTOR INFORMATIpN:
Johnson and 5ong Drillin9
Application Received: 10/19/94
Anticipated Drilling/Sealing Date if known: 10/31/94 Time: .
I,OCATION OF WELL:
PL3 Coordinates 3(, nw W, ow ',f, nw X, 5ec 2, Town 27 , Range 23
Well Location 1070 Rennath Avenue
Property Owner Merle Anderaon
Well Owner Merle Andera0n
PID Number - - -
WELL INPOFiMA.T10N:
Diameter 4105
Casing depth 135
Total depth 135
3WL 105
Aquifer unconaolidated sediments
COMMENTS:
390d IEOLT68ZZ9:Htlj 3SM-00 tllO>ItiQ:QI SE:bI 76, 6T/OT
baaaa?aa??aaaa?aaa?aaaaaaaaaa PROPERTY DATA SYSTEM
° SPECIAL ASSESSMENT P&I INQUIRY °CURR 335 °
° PROPERTY ID S/A# °NEXT °
° 10-47751-110-02 102979
DESCRIPTION ORIG.ASSESSMT
ST 733 2500.00
INTEREST lst YEAR CURRENT
RATE INT MOS PAYMENT#
6.5000 14 Q
agaaaaaaaaaaaaaa?aaaaaaa? D E F
Type Year Method Int.Rate
DATE TOTAL YEARS °
LEVIED PRINCIPAL YEARS REMAING °
11/02/1998 2500.00 15 15 °
PAYOFF AAAff CIASED &AA£ TAX FORF °
AMOUNT Date Reason DATE °
2500.00
; R R A L S aaaaaaaaaaaaaaaaa?aa?a?aaa °
Principal Tnt.Due Total Due °
° aaaa?aaaasaaa?aaaaaaaaaaa P& I S C H E D II L E?a?'e??'a'e?'a?'a'????a??a5aa?fi?a'a °
° Year Amount Year Amount Year Amount Year Amount °
° 1 356.24 2 318.32 3 307.50 4 296.66 °
° 5 285.82 6 275.00 7 264.16 S 253.32 °
° 9 242.50 10 231.66 11 220.84 12 210.00 °
° 13 199.16 14 188.34 15 177.60 16 °
° 17 18 19 20 °
° 21 22 23 24 °
° 25 26 27 28 °
Type PID and S/A NBR, press ENTER; or F1, F2, FS
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9NIlIj lVNI9Ib0 1661/1£/ZI - 166I/I0/i0 '90I83d JNIIIJ
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8661/LI/60 4N(lj3?J A0 NOI1tl3IJIlON 3fiN3A321 J0 1N3W1Jtld3Q - tl1053PiNIW =10 31tl1S
£89600000
ci-?-c-o ??:? ?•
10 110 c-c0,0-
• 0 lu..0LOA) 0•
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• 0._i-. -C_ C`G C- C `E`C_G 0 a _C_(% ..0`C _t`- `0 0 _!D r'.? 0_ ) 0 N
• 04 _ ( L G-G =F" c =C _ V O E'' C ?_G.-:?y( 0
• ? "c.: C E; :C .f3 ??C ? P _C_._C=e ? C: (; 0 0_17)__13?: ) 0 •
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?
FORM SSA-1099 - SOCIAL SECURITY BENEFIT STATEMENT
SHOWN IN BOX 5 MAY BE TAXABLE INCOME.
O
1997
• SEE THE REVERSE
FOR MORE I FORMATION
Box 1. Narne Box 2. Beneficiary's Social Security Number
JUNE M MYHRE 472-22-2850
Box 3. Benefts Paid in 1997 Box 4. Benefi[s Repaid to SSA in 1997 8ox 5. Net Benefts }or 1997 l8ox 3 mmus 8o.c a)
fi9,477.6Q NOR1E V9,477,60
DESCRIPTION OF AMOUNT IN BOX 3 DESCRIPTION OF AMOUNT IN 80X 4
Paid by check or
di.rect deposit E8,952.00
Medicare premiums paid
for ou
Total Additions f4,477?6a60 NONE
/4 ? 8ox 6. Voluntary Federal Income Tau Withheid
tl?? / NONE
"-'
? /`,' ??
?? Box 7. Address
JUNC M HYHRE
2876 S LEXINGTON
EAGAN MN 55121-1424
?--9i°?'?'c"'
C/ Box 8. Claim Number (Use lbis number if you need to contact SSA)
472-22-2850A '
Form SSA-1099-SM (1 -96) DO NOT RETURN THIS FORM TO SSA OR IRS
Social SecuriLy RdreiRistration
Mid-America Program Service Center
601 East TweLftli Street
kansas CiLy, NO 64106-2859
OFFICIAL BUSINESS
PENALTY FOFi PRIVATE USE, $300
019flPG4E01050195345
c FIRST-CLASS MAIL
Mpp POSTAGE AND FEES PAID
1 SOCIAL SECURITY
ADMINISTFATION
PERMIT NO. 0-11
kiFiFFkkiEkAkf.f.Rkfe AUTOCR x* C446
JuwE n nrNaE
2876 5 L[XINGiON
EAGAN MN 55121-1424
II LIi I II Li I I I f i Jt Ii i JII t I II,II ( LI It (I II I III I I II fI( I I JJI
city oF eagen
THOMAS EGAN
Mayor
December 1, 1998 PATRICIA AWADA
BEA BLOM9UIST
SANDRA A. MASIN
THEODORE WACHTER
CouncilMembe¢
MS. JUf12 M. MyIl(6 - THOMASHEDGES
2876 S. Lexington Avenue CiryAdminishofor
Eagan
MN 55121-1424 E.J VANOVERBEKE
, CiN Clerk
Re: Senior Citizen Deferment - Parcel 10-47751-110-02 fProiect 7331
Dear Ms. Myhre:
In official action of the Eagan City Council at its regular meeting held on
November 30, 1998 your application for a senior citizen deferment was
approved. We will process the necessary paperwork to Dakota County so
your subsequent tax statements take the deferment into consideration.
The deferment will remain in effect as long as the required eligibility
conditions are met. I have enclosed a copy of the appropriate section of
the Eagan City Code that outlines those conditions. I have also enclosed
the original copies of the documents you provided with your application.
Please call me at 681-4616 or Special Assessment Clerk, Deanna Kivi, at
681-4634, if you have any questions about the defermeni or anything else
related to this action.
Sincerely,
E.J. VanOverbeke, CPA
Finance Director/City Clerk
cc: Deanna Kivi, Special Assessment Clerk
MUNICIPAL CENTER
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122-1897
PHONE: (651) 681-4600
FA%: (651) 681-4612
TDD' (651) 454-8535
THE LONE OAK TREE
THE SYMBOL OF STRENGTH AND GROWTH W OUR COMMUNITY
Equal Opportunify Employer
MAINTENANCE FAdLITV
3501 COACHMAN POtM
EAGAN. MINNESOTA 55122
PHONE (651) 681-4300
FFU(:(651)681-4360
TDD? (651) 454-8535
,. tiPPLICATION AND AUTHORIZATION FOR DELAYED PAYMENT OF TAX
ON SPECIAL ASSESShiENTS FOR SENIOR CITIZENS' HOMESTEAD
LAWS 1974, CHAPT'ER 206
STATE OF MINNESOTA)
COUNIY Oc DAKOTA )
• ?i? ?", `?_ 19?
7G: County Auditor, Dakota County, Minnesota DATE
I, the undersigned, declare under penalties of perjury:
That I reside at (p ' ,-_) 5z&, /-0 /t
That I am not less than 65 years o e a that the date o my rt is f1--i,
ThatAI am the owner of the property le,gal ?described as:
l(J _ _ ?7 75/- //D
, Property Identification No?UV 7,57.11-6D2-.
That my interest in the ownership of the above property was aquired on4
?
19?and is as follows: •
1. Sole ownership (Enter Yes, if applicable) ?? .
.. .. .. .., , .. .. _
3. OTHER undivided interest fSnecifvl i.,?_
inac on .lanuary Z, 1s?_or June 1, 191f(I owned and occupied the above property as my
homestead and such occupancy hegan on_ Q,.c Q,r, _ / 19___/p c?
_U
That the installments for im,provements on the SP CIAL ASSESSMENTS duly adopted in ordin-
ance by the(?Z; OF AS OF 19
which have been a?.jlocated against the subject pro rty would create undue personai hard-
ship on my behalf and I respectfully request that payment be delayed and that such in-
stallments be so deferred for the years 19?to
?
SIGNED:
0WNER SPOUSE
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
?. ?
I, ? Clerk of the OF Ea- aa0
IN County, State of Minnesota, do hereb ertify that th application
of S4„? rvt. yV\v irL above named, has been dvly reviewed and that '
in ac=cr ance with t?fl: minutes of official record in said chambers was duly :
APPROVED K --ENiEg as of (V oos\aa,,, 30 1$ •
inac in accordance with approvai granLed, the SPECiwi, nSStSSMEhiS Yisted beiow on the
affiants subject property levied for annual collection in the amounts and for the years
shown be so deferred with interest at the annaal rate shown tmtil such time as it is
deemed the applicant no longer qualifies or the property loses its eligibility.
ASSESShfENT D/P N0. 7'OTAL AMOUNT YEARS INTEREST RA7'E
StraPt P731 2979 $2,500 15 ' 6.5$
DATED yQ.te ?rav I 19 2-5-
(over)
??-
?
Q.t,
city oF eagnn
/ , 0, 5 SC?,-,
? ?
/0,n /(Z,- a , C
i-..r-9y
THOMAS EGAN
MaVOr
PATRICIA AWADA
BEA BLOMQUIST
SANDRA A. MASIN
THEODORE WACHTER
Councii Members
December 8, 1998
Attention: Pat Brown
Recorder's Office
Dakota County Government Center
1590 Hwy 55
Hastings MN 55033
Dear Pat,
THOMAS HEDGES
Ciry Adminishator
E. J. VAN O`?ERBEKE
CiN Clerk
?Ptease-racocd_the enclosed Senior Citizen's Deferment document on Par.cer#10= ;,
47759-410=02. Please retum to me a copy of these recorded document.
Thank you for your help and please call if you have any questions.
Sincerely,
k c? 1,-rt a-.
Deanna Kivi
Special Assessment Clerk
Enclosure
MUNICIPAL CENTER
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122-1897
PHONE: (651) 681d600
FAX: (651) 681-4612
TDD? (551) 454-8535
THE LONE OAK TREE
THE SYMBOL Of STRENGTH AND GRONRH IN OUR COMMUNITY
Equal Opportunity Employer
MAINTENANCE FAdLITY
3501 COACHMAN POINi
EAGAN. MINNESOTA 55122
PHONE: (651) 681-4300
FAX.(651)681-4360
TDD: (651) 454-8535
EAGFN TOWNSHZP
3795 Pilot Knob Road
St. Paul, Mianesota 55111
Telephone 454-5242
PERZ9IT FOR WATER SERVICE CONNECTION
Date: December 18 1s 96g7 Number: 58
Billing Name: Ras Anderson Site Address: 1070 Kenneth Street
Owner• Same Billing Addres9 Same
Plumber: All State
Meter
Meter No, 'Permit Fee 7.54 _
Meter Reading I Meter Dep. 315.00
Meter Sealed: Yes_ 'Add'1 Chg.
NO ITotal Chg.
Buildiag is a:
Reaidence ,
Multiple go,
Commercial
Induetrial
Other
Inspected by
Date
Remarka;
Bq:
Chief 7aspector
In conaideration of the isaue and delivery to me of the above permit,
hereby agree to do tte proposed caozk in accordaace with the rules and
regulations of Eagan Township, Dako
I
Please aotify the above office when ready for inspection and connection.
Pd.
Pd.
Pd.
EAGE;N T3'afiSHiP
3795 Pilot Kttob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PE?2MIT FOR SE41ER SERVICE CO:d:7cC:i0:I
DATE: December 18,, 196Z7
01.7-N£R: Rag Anderson
NUMBER 95
Address 1070 Kenneth Street Ck?PLL'M.BER All State Typg pg pipg Cast Iron
DESCRIPTION OF BUILDING
IndustrialI Co;mr.err.ialI Residential I Multiple Ihaellir.g I No. of ur.its
LocaCion of Conr.ections:
Connection Charge $200.00 Pd.
Permit Fee $7.50 Pd.
SCreet Repairs
Total _
inspected by:
Date
Remarks:
By.
Chief Ir.npect•or
In consider3tion of the issuP ar.d delSvery to me of the abose p^!^?:.'•.L-, I
hereby agr<:e to do th_ prcposed work in accordance with the r+iles a.^.d
regulations o€ Eupa Tocroskip, Dakota County, Minnesota
Sy
c.
PleEsa ,llC'iY,j.Fy 17hnn xeFdy for fr..sFecf.ion and co,n,c4.3on ar.1 `a??.=cre any poru'_on
c"r' t'he oJ? rk 3.s cev.r?d.
INSPECTION RECOKD
_ CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
BUILOSNG
025168
04/18/95
SITE ADDRESS:
LOT:
1070 KENNETH ST
MCKEE
PERMIT SUBTYPE:
SF (MISC.)
APPLICANT:
11 BLOCK: 2
DZVERSIFIED AMERICAN CONST
(612) 929-7982
TYPE OF WORK:
AL7ERATION
DESCRIPTION MAC 50UND INSULATSON
INSPECTION
FRflMING „ •
ROUGH IN PL6G .A
ROUGM IN H7G PZNAL
REMARKS: A SEPARATE PERMIT IS REQUIRED FOR ANY PLUMBING OR ELECTRICAL WpRK
?? .
CITY OF EAGAN
3830 Pilot Knob Road
' Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
p.I.N.: 10-47750--110-02
DESCRIPTION:
ti.
PERMIT
1070 KENNETH ST
L07: 11 BLOCK: 2
MGKEE
PERMIT TYPE
Permit Number:
Date Issued:
MAC SOUND INSULATION
rmit Type SF (MISC.)
r,_k Type ALTERA7ION
?pw A
p
@ A I
M
ai
e
9 l
S
k }T1 c ?i?{Y .iw9f
a^'?£ v
<. ?
Y ?
•?i ?.
?" °? . ?
(?Qvl7
efil o4re
025168
04/18/95
?if t ? 4? ?F i-''."?t. W?
4 w ?
. a
REMARKS:
A SEPARATE PERMI7 I5 REQUIRED FQR ANY PLUMBING OR ELECTRICAL WORK
FEE SUMMARY:
VALUATION
Sase Fee
Surcharge
Lic. Search Fee
Total Fae
$81.00
$3.00
$5.00
$69.00
$6,000
CONTRACTOR: - Applicant - 5r. l.zC, OWNER:
OIVERSIFIED AMERICAN CONST 19247982 20017349 ANDERSON MERIE
5115 EXCELSTOR 8LV0 107 1070 KENNETH S7
ST LOUIS pARK MN 55416 EAGAN MN 55121
(612) 929-7982 . (612)932-8146
9r "
?
j •
'G
CITY OF EAGAN
19iA BUILDING PERIVIIT APPLICATION
681-4675
-W.P.o
,A .2-.2d
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surve
calcs.
=?
3j?
COMMERCIAL j
j
2 sets of
architectural & structural pla
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date o Valuation of work 4' ,5,7 76 0. 0 a
5ite Address: f0 20 Y(?i,?.a&Z ?
STR:ET :UITE #
Tenant Name: (commercial only)
LOT ? BLOCR ? SUBD.
P.I.D. #
C'?&
Descri tion of work:
The applicant is: ? Owner 64 Contractor ? Othet' coesoribe>
Name Phone
Property LAST FIRST
Owner
qddress
STREET STE #
City State Zip
Company ? Phone
Contractor Address ,T ,e )&/v License # W/ Exp.
CitV StdtP Z1p
T?
Company Phone
Architectl
Engineer Name Registration #
Address '
City State Zip
' Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with all applicable ate of Minnesota 5tatutes and City of
Eagan Ordinances.
Signature of Applicant:
BUILDING PERMIT TYPE
? 01 Foundation
? 02 SF Dwg.
? 03 5F Addition
? 04 SF Porch
CZ05 SF Misc.
WORK TYPE
O 31 New
? 32 Addition
OFFICE USE ONLY
? 06 Duplex
? 07 4-Plex
? 08 8-Plex
? 09 12-Plex
? 10 Multi. Add'1
;2(33 Alterations
? 34 Repair
0 11 Apt./Lodging
? 12 Multi. Misc.
? 13 Garage/Accessory
? 14 Fireplace
? 15 Deck
? 35 Tenant Finish
? 36 Move
GENJFRnL !NFO4MATlO!M
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
,? of Stories
length
Depth
APPROVALS
Planning
Engineering
REG1UfRED INSPECTIONS
D.Site
O Walltroard
Basement sq. ft.
lst F1. sq. ft.
2nd F1. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Building
Variance
? Footing
O Final
? Framing
? Draintile
_12y_
?
?
?
? Insulation
? Fireplace
Permit Fee
5urcharge
Plar R2view
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
5/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC %
5AC Units
vatuec;a,_ g z?, 042;;, 6
?...?...? , ,
? 16 Basement Finish
11 17 Swim Pool
? 18 Camm.(Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
? 37 Demolish
MWCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code
Census Bldg
Census Unit
Assessments
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
659-681•4675
New Construaion Reauirements
• 3 registered sfle surveys showing sq.1t of lot, sq. k. of house; and all roofed areas
(20% maximum lot coverage allowed)
• 2 copies of plan showing 6eam & window sizes; poured found design, etc.)
• 1 set of Energy Calculations
• 3 copies of Tree Preservation Plan'rf lot plalled after 717193
• Rim Jaist Detail Optians seleclion sheef (bldgs with 3 or less units)
DATE l I ??I b"?'
JOB SITE
fv7 c) -
RemadellReoair Requirements
. 2 copies of plan
• 1 set of Energy Calculatiom for heated additions
. 1 site survey tor extenor additlons & decks
. Indicate if home served 6y seplic system for additions
SlVALUATION ?g? ?
-
IF MULTI-FAMILY BUILDING, HOW
PROPERTY OWN
TYPE OF WO
UNITS?
?
FIREPLACE(S) _ 0 _ 1 _ 2
APPLICANT yprthstar Home Improvement Inc.
ADDRESS "Simpty the BesY'
rto79ziinA1- na.,..
PAGER # Molsc6161 maw #
(952) 929•1888
PHONE#
ZIP CODE
FAX #
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CATLGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submittedf --?1
- Energy Envelope Calculations Submitted ?67? ,
MINNESOTA RULES 7672 ' r -
P2 ?
- New Energy Code Worksheet Submitted
Plumbing Contractor: Phone _-
Plumbing System Includcs: Water Softener Lawn Sprinkler $90.00
Water Healer No. of K.I. Baths
No. of'I3aths
Mechanical Contractor:
Mechanical System Includes:
Sewer/Water Contractor:
Air Condilioning
_ Hcat Recovery 5ystem
Phone #
P'ee: $70.00
Phone #
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 aIl applicable State of Minnesota Statutes and City of Eagan Ordi ce
Slgnature of Applicant
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 2002
OFFICE USE ONLY
? Ot 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. (A-sea.) ? 33 Ext. AIt - SF
? 04 02-plex ? 10 OS-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 ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement `Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MCIES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. af Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ Final/C.O.
_ Footings (deck) _ Final/No C.O.
Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof Ice & Water Final Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Sidina Stucco Stone
Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_
Insulation Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply 8 Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
J57.)6
Building Inspector
l n CITY U5E ONLY
L l l BLn o`? RECEIPT#:
SUBD. RECEIPT DATE:
1998 PLUNMING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT IINOB RD
EAGAN, NA1 55122
(612) 661-4675
Please complete for: ? single family dwellings
D townhomes and condos when pertnits are required for each unit
D backflow preventer for underground sprinkler system
------------- ---------------- ? ? ?
FIXTURES -------------
EACH -------------- -------------------- ----
# TOTAL
Shower 3.00 x =
Water Closet 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Hot Tub/Spa 3.00 x =
?Water Heater 3.00 x
Floor Drain 3.00 x =
Gas Piping Outlet ' minimum - 1 3.00 x =
Rough Openings 1.50 x =
water Softener ' for dwellings under construdion 5.00 X =
Water Softener ' foi existing dwelling 20.00 x =
U.G. Sprinkler ' for dwelling under const. 3.00 =
U.G. Sprinkler 'forexistingdwelling 20.00 =
Alterations ' to existing residence 20.00 =
Water Turn Around 20.00 =
Private Disposal System ' MPC iic. 75.00 =
(new and refurbished systems)
Private Disposal Systems' nbandonment 20.00 =
STATE SURCHARGE .50
TOTAL ZD.eo
--------------------------- • -- • ---------------------- ---------... - ---------- --------- --- --- ---------------------------- -------------------
1 hereby adcnowledge that I have reaC this apnlicatlon, state that the inkrtnation is corted, and agree to compry wiMi all applicable City of Eagan ordinances.
It is the applicanPs responsibility to notify the property owner that the City of Eagan assumes no liability for any damagas caused by the Ciry during its
normal operational and maiMenance activ8ies to the facilities constructed under this permft witbin City propertylright-of-way/easemant.
SITE ADDRE55: I 0?1? CWVl.f i/1 ?T .
OWNER NAME:
INSTALLER NAME: TELEPHONE#: ?L)
Erickson Plumbing Heatlnp Coolinp, lnc.
STREET ADDRESS: 5212 Isenti Street NE
CITY:
STATE: ZIP:
SIGNATURE
JS/FORMS BLDGlPLBG PERMIT (RESIDENTIAL) 1998
1o?j
2007RESIDENTIAL BITILDING pERrnT nrrLicariort ,
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-475-5694
NewCdstludm Reauiremenk
3 mgisfe2d sde surveys sfioxiig sq, ft, o(lot, sq. ft of house; and a11 roofed areas
(TO°k maximum IM trovxage allowed)
1 So15 Report d pmposed huldng is lo be placed on disturbed wil
2 capies of plan shovnng beam d window sizes; paured found desgn, etc.
1 set of Energy Calculatians
3 wpies M Tree Presmetion Plan if Iot pleGed after 711193
Rim Joist Detal Optiwis sekction shee9 (buiNtings xrith 3 or less unils)
MnnegasW madakalventilatlonform
Date V , Construction Cost
Site Address • UniUSte #
Description of Work ??? W?-
Mald-Family Bldg ? Y Fireplace( 0 _ 1 _ 2
Property Owner Telephone #((Is? (0 T Z
Contractor G
Addross City NICAU
State Zip ,j{t{i 7l T ? Telephone #(?? )(0l03 FRuCO
RemodeVReoair Reauirements;
2 mpies oi plan showing faotings, beanu, jasls
1 set W Energy Calculations Fw heated addiUons
1 site wrvey for addifions & decks
Ad&nn - indcafe il ar-sile septic system
Oifice Use OnN
CertofSurveyRecd _Y _N
ShcsRepor[ _Y _N
Trfle Pres Plan Racd _ Y _ K
TreeResRequired _Y _N
Onsite Septlc SysOem _Y _ N
Plans are considered ublic information unless ou state the are trade secreY and the reason.
COMPLETE THIS AREA ONLY IF CON$TRUCTING A NEW BUILDIN6
- Minnesota Rules 7670 Cateory l Minnesota Rules 7672
Enefgy Code CategOry , Residerriial Ventilation Category t Worksheet • New Enerpy Code Worksheet
(J submissian type) Submitted Submittetl
• Energy Envelope Calculetlons Submitted
In the last 12 monihs, has the City of Eagan issued a permit for a simiiar plan based on a masTer plan?
_ Y _ N If yes, daTe and oddress of masier plan:
Licensed Plumber Telephone #{ ?
Mechanicai Contractor Telephone #
Sewer/Water Contractor Telephone # ( ?
I hereby apply for a Residential Building Petmit 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 jke,aRproved plan in the case of wgkvhs?' h requires a review and
appro al of plans.
t
Ap 1' ans Printed Name
Signature
r
t ?
DO NOT WRITE BELOW THIS LINE
Sub Types
? Ot Foundatlon ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? OB 06-plex ? 16 Firepface E3 27 Porch (3-sea.) 0 31 Ext. Att - Multi
0 03 01of_plex ? 09 07-plex ? 17 Garege ? 22 PorchlAddn.(4-sea.) ? 33 Ext.Aft - SF
? 04 02-plex ? 10 08-plex ? 18 Dedc ? 23 Porch (saeen/gazeboipergola) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level 0 24 Storm Damage
? 06 04-plex O 12 12-plex ? 25 Miscellaneous
WONC TVDBS
? 31 New ? 35 int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 AddRion ? 36 Move Buikfing ? 42 Demolish Founda6on ? 45 Fire Repair
? 33 Altera6on ? 37 Demolish Building` ? 43 Reroof ? 46 Windows/0oors
? 34 Replacement •Osmoliqon (EMfre BIAg) • Gtve PCA handoutM appNcanrt
DescHutlon: wamr oam.ps _ ves
Valuation Occupancy MCES System
Plan Revlew 100% or 25°l0
Census Code Zoning City Water
SAC Units Smries Booster Pump
# of Units Sq. Ft. PRV
# of Bidgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) Sheettock
_ Footings(deck) FineVC.O.
_ Footings (addition) Final/No C.O.
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Poo( Ftgs Air/Gas Tests Final
_ Framing _ Siding _ Stucco Lath _ Stone Larh _Brick
_ Fireplace _ M. _ Air Test _ Final _ Windows
_ Insulazion _ Retaining Wall
Approved By: , 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
Clty of Eapn
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 6755694
------------------------------------------
? Case Number: 09-004313 ?
, ,
FORECLOSURE / PROPERTYDAMAGE REPORT
Date: 3/6/2009
Complaint Taken By: Terry Zelenka
Type of Building: Single Family Home
Name:
Address: 1070 Kenneth Street
Legal Description:
Phone Number:
Complaint: Water off
X Gas Off X Water Off
Electrical Off X Home is Unoccupied
Action Taken: Inspection
Comments: Home has had a Sheriff's Sale. The property appears to have a good exterior
condition and has no apparent water damage to date.
Entered in PIMS 3/11109
Signature: ?
v?
G:1Building InspectionslFORMS
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA123562
Date Issued:06/11/2014
Permit Category:ePermit
Site Address: 1070 Kenneth St
Lot:11 Block: 2 Addition: Mckee
PID:10-47750-02-110
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Gregg Biske
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Sokun Kith
1070 Kenneth St
Eagan MN 55121
Rooster Exteriors Inc
986 Inwood Ave N
Oakdale MN 55128
(612) 382-4057
Applicant/Permitee: Signature Issued By: Signature