2115 Kings Rd
Use BLUE or BLACK Ink
r -
For OtFlce Use
I I
I
I Permit
non
City of Ea
3830 Pilot Knob Road i Permit Fee:
Eagan MN 55122 I 1
Date Received:
Phone: (651) 675-5675 I j
Fax: (651) 675-5694 j Staff: I
L -----------------I
2010 MECHANICAL PERMIT APPLICATION
Date: Site Address:
Tenant: Suite
RESIDENT / OWNER Name:T 11,14 `e V° Phone:
Address/ City/ Zip: ( _ c j a
.
CONTRACTOR Name. T( L 1 i~ License
L ~ l
Address: _ 1 City: C-10, J\(f •Ci>4~7-N
State: Zip: Phone:
Contact: Email: o Pe C, L ' / r y
TYPE OF WORK New Replacement XAdditional Alteration Demolition
Description of work: Pat a4~~ Ac", TCeon
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
PERMIT TYPE RESIDENTIAL COMMERCIAL
Furnace New Construction Interior Improvement
Air Conditioner Install Piping Processed
Air Exchanger Gas Exterior HVAC Unit
Heat Pump Under / Above ground Tank Install ! _ Remove)
When installing/removing tank(s), call for inspection by Fire
OtherL~R Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge)
$95.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ TOTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank installation/removal OR Contract Value $ x1%
$55.00 Minimum (includes State Surcharge)
Permit Fee
- If the Permit Fee is less than $10,010, surcharge is $ 5.00
- If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee Surcharge
(i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge)
TOTAL FEE
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.caopherstateonecall.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 p(la)n in the case of work which requires a review and approval of plans.
xl~ , x
-Y\ r
Applicant's Printed Na Applicant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground - Rough In -Air Test -Gas Service Test -In-floor Heat -Final
Exterior HVAC Screening Inspection
Use BLUE or BLACK Ink
w~ For Office Use
St~ j Permit #:5°~~ I
City of Eapn ;
Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 ; Date Received: j
Phone: (651) 675-5675 I I / I
Fax: (651) 675-5694 staff: DIY
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: 1 16d
Tenant: OVt~I E Suite
RESIDENT / OWNER Name: 646 1 I dl~YlS~ e: 65/_'/ ~ 5
Address / City / Zip: ,2//-5 K(/J6L P61.1 Ca 11 Qd 55
Applicant is: Owner _X_ Contractor
TYPE OF WORK Description of work: QQAdl Vrmo f/- a K~ 4,4 t ssuc
Construction Cost:?. V 001 Xo C Va64t l Multi-Family Building: (Yes / No
CONTRACTOR Name:.AL t ✓1 License/ boa <33q 7
Address: r e City: A GY1 ta
State: n Zip: 5S:367 Phone: --7&3- 7SS_48 S l
Contact: Jc>S)l Email OJA k" rc°/l?OC1r/' f4 'co
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.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conf ance 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 ` t to st rt 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 pl s.
x cL x
Applicant's Printed Name Appli ni s Signature
Page 1 of 2
9
Use BLUE or BLACK Ink
l -
F,7r office uge - - - - - - - ~
E n 114 j Permit L15;
NY of I
I Vi
3830 Pilot Knob Road i Permit Fee:
Eagan MN 55122 Date Received: ll1
Phone: (651) 675-5675
Fax: (651) 675-5694 1 staff:
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 10 Site Address: 115. t yy+'
Tenant: Suite
RESIDENT I OWNER Name: :r0_WL_A VRa_V 16 u C' 1r Phone:
_k 5
Address /City /Zip: Yj~J_ Ccj r Yj~
-12
Applicant is: V Owner Contractor
TYPE OF WORK Description of work: IN 1i kW 591cv+ POOL 'JNpa)'Ishey) k
Construction Cost: Multi-Family Building: (Yes / No
CONTRACTOR Name: License
Address: City:
State: Zip: Phone:
Contact: Email:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan Issued a pe it far a simile lan based on a master n7
Yes ,.,,_No If yes, date and address of master plan: t;~~
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 nonpublic 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.gopherstateonecall.oro
1 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 1 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.
ApplrcarWs Printed Name Applicant's Signature
Page 1 of 2
I/
46l S cR
{
DO NOT WRITE BELOW THIS LINE
`S
I
SUB TYPES
Foundation Fireplace _ Porch (3-Season) Storm Damage
Single Family Garage Porch
(4-Season) Exterior Alteration (Single Family)
Mufti Deck Porch (Screen/Gazebo/Pergola) Exterior Alteration (Multi)
01 of _ Plex Lower Level Pool _ Miscellaneous
Accessory Building
WORK TYPES B ovP 5 C?ON~ 1C7~f1G~rU a
oil
New T Interior Improvement T Siding Demolish Building*
Addition - Move Building _ Reroof _ Demolish Interior
-7y Alteration - Fire Repair Windows Demolish Foundation
- Replace - Repair Egress Window _ Water Damage
Retaining Wall } 3rL„Y - t v o *Demolition of entire building - give PGA handout to applicant
/
DESCRIPTION
Valuation tccupancy Jat/A MCES System
Plan Review Code Edition rVkr SAC Units
(25% 100°!o} 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) Sheetrock
Footings (Deck) Final I C.O. Required
Footings (Addition) Final I No C.O. Required
Foundation NVAC
Drain Tile Other:
Roof: lIce & Water Final Pool: -Footings Air/Gas Tests Final
Framing Siding: __.,Stucco Lath Stone Lath -Brick
Fireplace: -Rough In Air Test Final Windows
~c Insulation Retaining Wall: _ Footings Backfiil Final
Meter Size: Radon Control
_ Erosion Control
Reviewed By: Building Inspector
_RESIDENIIAL FEES v(
Base Fee
l~
Surcharge of
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge as
Treatment Plant,
Copies
V
TOTAL
Page 2 of 2
j l Ll 0
ppr-
Use BLUE or BLACK Ink
F-----U-se
For O ffice I
City of EaRd~ j Permit#:
I o
Permit Fee:'
3830 Pilot Knob Road
Eagan MN 55122 j Date Received: j
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 Staff:
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: o t k O aj
Tenant: -4 O YY) at's 9W i- Suite
RESIDENT /OWNER Name:, M(A, nj ISe't 4 1 Y1C'Y12U.5 0" oner ~QS 1-'qO5 -c 8f
Address / City / Zip: I ! 5 (S O~G1 QA cs~ lco~
Applicant is: Owner Contractor
TYPE OF WORK Description of work: ~ V-0b T
Construction Cost Ls O.OO Multi-Family Building: (Yes / No D( )
CONTRACTOR r MJ Construction & Remodeling
Contact: Janet Eckroad
13743 Aberdeen St. NE, Suite A ianetCami-constructiommn.com
1 Ham Lake, MN 55304 Office: 763-785-8851
c License #20233970 Exp. 3/31/2010 Fax: 763-795-8799
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..qopherstateonecall.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.
4 y
9 t p~
Applicant's Printed Name Applicant's Signature
Page 1 of 3
r
For Of" Use
1
City of Eajan j Permit#; ~J ~
I -7U 1
I Permit Fee: I
3830 Pilot Knob Road 1 l
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 i Staff: I
-----------------i
2009 RESIDENTIAL 9 BUILDING PERMIT APPLICATION
Date: Site Address: z>/~,~tk~~
-103 I
Tenant: Suite
I
RESIDENT/ OWNER Name: Phone:
Address / City / Zip: Applicant is: Owner Contractor
TYPE OF WORK Description of work: Gts
Construction Cost: Multi-Family Building: (Yes / No
CONTRACTOR Name: License
Address: 711
City: State: J~ Zip:
Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
submission type) • Energy Envelope Calculations Submitted
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 informadon. Pbrtions 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
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 riot a permit, but only an application for a permit, and work is riot to start without a permit; that the work will be in
accordan oe ' h the approved plan in the case of work which requires a review and approval of plans.
W7
Appilosars Prlmbed Name q AV t+s ma is
I r Page 1 of 3
Aq
i
DO NOT WRITE BELOW THIS LINE
SUB TYPES
❑ Foundation ❑ 05-plex ❑ 16-plex ❑ Accessory Building ❑ Pool
❑ Single Family ❑ 06-plex ❑ Fireplace IK Porch (3-season) ❑ Ext. Alt. - Multi
❑ 01 of _ Plex ❑ 07-plex ❑ Garage ❑ Porch (4-season) ❑ Ext. Alt. - SF
❑ 02-Plex ❑ 08-plex ❑ Deck ❑ Porch (screen/gazebo/pergola) ❑ Multi Misc.
❑ 03-Plex ❑ 10-plex ❑ Lower Level ❑ Storm Damage
❑ 04-Plex ❑ 12-plex ❑ Miscellaneous
WORK TYPES 0/
❑ New ❑ Interior Improvement ❑ Siding ❑ Demolish Building*
Addition ❑ Move Building ❑ Reroof ❑ Demolish Interior
❑ Alteration ❑ Fire Repair ❑ Windows ❑ Demolish Foundation
❑ Replacement ❑ Egress Window ❑ Water Damage
Demolition (entire building) - give PCA handout to applicant
DESCRIPTION: ,t
Valuation j Occupancy lµ MCES System
Plan Review Code Edition 7 SAC Units
(25% 100% Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Const. Width
REQUIRED INSPECTIONS
Footings (new bldg) Sheetrock Meter Size:
Footings (deck) Final/C.O.
Footings (addition) Final/No C.O.
Foundation HVAC
Drain Tile Other:
Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final
Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace:-R.I. -Air Test -Final Windows
Insulation Retaining Wall
Reviewed By: , Building Inspector i I C4.1 10 rIA-1
RESIDENTIAL FEES:
Base Fee
Surcharge X
Plan Review
MC/ES SAC
City SAC a&6 iL
Utility Connection Charge
S&W Permit & Surcharge)
Treatment Plant 7
Copies / r
r--
Total
t\ its P
) ok IX
J~
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1H01HAd003H1 AB 03103IONd SI 4331VHOVdOONI ONIl300W37! S Nouon i1SNO0 rW A8 NOIS30 SIHI
l] 'll~i pl,~ 66L8-96L-£9L # Xe=l L999-99L-£9L # lal ZU95 N W `ue63 o o_ o_
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763 795 8799
Oct. 1. 2009 3:49PM MJ CONSTRUCTION No-1207 P. 1
siding . Windows . Roofing
Additions • Decks • Remodeling
CONSTRUCTION
MODELING 13743 Aberdeen Street NE, Suite A
Ham Lake, MN 55304
Phone: 763-785-8851
Fox. 763-795-8799
WWW.nnj-ovnstructionmh.oom
Fax
To: Terry @ City of Eagan From: Jason Wetzell
Cell: 763-238-6412
Fax: 651-675-5694 Pages: 3, including cover
Phone: Date: October 1, 2009
Re: Truss engineering (Kuether) C:
• Commenls:
Terry,
Truss drawings for 2115 Kings Road for your review. If you have any questions,
please call Bruce Iverson at 612-884-7141.
Thank you for your attention to this matter.
Jason
Oct. 1. 2009 3:49PM MJ CONSTRUCTION No.1207 P. 2
r ,
LLL
L Larsen
Lereon Specialty Structures Inc
6931 Hobe Lane
White Bear Lake, MInnesOta 55110
651 429 5143 Fax: 651 429 6761
Scherer Brothers Lumber Co. September 30, 2009
ATM, Scott Carlston
3253 E. 4" Ave.
Shakopee, MN 55379
RE: MJ Construction
rob #83986
Dear Scott:
It is my understanding it is desired to extend the earns on the above referenced project
from 2'-0" to 3'-0". The roof sheathing will also be doubled with two layers of
sheathing. The extra layer of sheathing only weighs approximately 1,5 psf. This is an
increase of about 3.3 percent of the original design loads. This is negligible and will not
have any appreciable affect on the trusses. The trusses area only spanning 141-0" and are I
not working very hard at all.
The extra P-0" extension on the overhang does increase the stresses on the cave member.
By reinforcing the top chord with an additional 5'-0" long 2x4, the stresses will be within
allowable limits for the design load conditions. With the truss fully loaded with the
design snow load, the outboard end of the eave will deflect less than 118 of an inch with
the doubled member. (See detail 3).
V hereby oenify that this plan, speelOwdon,
or report was prapered by me or under my ~
Yours truly, dkW supervision end that 1 am a duly
Licensed Profee0wel En0lrreer under the
laws of the state of MlnrWoa.
Prtnt Name: WMMe C. UM
Wayne C. Larson, P.E. Stgnatum-
Date '7-20-122 lJcww O 7831
F
Oct. 1. 2009 3:50PM MJ CONSTRUCTION No-1207 P. 3
M~
NC
f e -
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aye an
yv
WQ-Y1 D
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i
• - AtZtWrq~i:."TRVSS 6~ikwD '
~Ld6 q
Aoo 2x4
Gp,maw S I aii✓
I hereby Cerny that tills plan, epectficatlon, {J
OL or report was prepared by me or under my 93-M
Larson Licensed supervision and that I arn a duly
Licensed Professl ofess[onal Enginee eer under the
tJ
Larsen Specialty 3lructures Inrr laws of the Slate of Minnesota.
9051 Hobe Lane Print Name
Waite Bsar Lake, Minnesota 55110
$61 429 $143 Fax, 661 429 0411 Signalure fi
www.mtldredl Ocomessl.net rl
Date-,?-'30- Llcenae! 7031 Comm. No.
CASH RECEIPT ?
CITY OF EAGAN
P. O. BOX 21-199
L_AGAN, M4NNESOTA 55121
. .. _ : ? '
DATE 19
11RGEWtd ? . .
FROM .
pMOUNT $ I
FUNO GOD.E AIAOUNT
/
.. .. h... , ..
Thank You
Nr-O 3 7 16
BY
White-Payers Copy
Ysllow-Postinp CoRY
Pink-File CoDY
CITY OF EAGAIV
Remarks
Addition . Lot 30 Bik 2 Parcei 10 81950 300 02
o st?eet 2115 Kings Road State Eaq an, MN 55122
Improveoent Date Amount Annual Years Payment Receipt Date
STREET SURF. ?'' Imp. 1981 3519.27 351. 92 10 / .? p/ /.L /O i7 85'
STREET RESTOR.
GRADING
l
c
/
- •
.
-- -
? 7 • -
SAN SEW TRUNK
* SEWER LATERAL /7ff S
•
WATERMAIN
* WATER LATERAL
* WATER AREA
* STORM SEW TRK
* STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
5AC
PARK
INSPECTION RECORD
I CITY OF EAGAN PERMIT TYPE: ?? 1 1 fa i t3H
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
r?ra??? t_?.?„?, . ; F, t:? i??c???• ai?,i; t
PERMIT SUBTYPE:
, .. ,
TYPE OF WdRK:
() e!;;rR XP i r=tN
II , F tM: - I ?-6 -°i R I 6
r;1-V nf.P
Pft?)
(iin tiFI
?
i
?
Permit No. Pertnit Holder Date Telephone #
ELECTRIC
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEAT'ING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR 7EST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
? CITY OF EAGAN
E 38s0 Pilot Knob Rqad
P. Q. Box 27199
Eagan, MN 55121
Zoninp:
OwrNr.
Address:
,. Sita Address:
`. Plurnber.
Ioyr« eo oepy wilb dN Ciyr oi laws
Ordiaaeoas.
By
Dote of Insp.:
SEWER SERVlCE PERMR
PERMIT NO.:
DATE: " - -
No, af Units:
? --? -?
CorrKCtlon Charpa: ' , .
_ . J i. .
Account Deposit:
,
Pamdt FN: - •
Surciwrqe:
Misc. Charpm
Totol:
Date Pold:
?Yl VLA w S
Y
? CITY of EAGAN
BUILDING PERMIT
S ......
Owas= . J . ..-1?--.f.:..if.,.t..4??...? . ............... .
.. '-'--'--... .. /J
Addrass (precenf)
Bullder ...........:'.x...h.Ce:K..f ........................................... "---...._.......
Addreaa ...........-'---.--....... .....................'---............-'---..........................
DEBCAIPTION
N4 4026
3795 PiloY Knob Road
Eagen. Minnesola 55122
454-B100
Dsls ........ l.6........ ........
Slories To Be Uaed For Fron! Dap2h Haigh! Esl. Coe! azml! Fea Aemsslu
v ' v LOCATION ° I ""- _
or
i
This permi! does no! aulhorize the use of etreels, roada, allaps or sidewalks ao: does i! ve the owasr os Lis agent
the right to ereale aap siluation which is a nuisanca or which presenlc a hazard !o the healfh, safelp, coavanianee aad
general welfaxe fo anpone in the eommunify.
THIS PEAMIT MUST BE KEPT ON E//pREMISE WHILE THE WOAR IS IN PAOGRESS.
This is !o eesrifp, lha2..?e.?c..l.`.. .......hespermissioa !o arect a...r?.f/.'?.J
the above descrihed premise subjec! Ya the pr~ o'/i s of all applicahle Ordinaaces for the Cilp oi Eagan.
......f/._:_?. - -' -------.............................................. Per ........
..............._ •-_°--
? Ma or Buildiap Impaclos??
Eagan Township
Dakola Couniy, Minnesoia
? Application Eor Bnilding Permit
T uilding or work wnlemplaled. Cirele eorrec3 deseripiions.
esidenlia Com mereial Indusiri al Olher--------------------------- --'_.--------------------- .---- ?---
&vild Enlarge Alier Aepair Insiall Move Wreck Oiher .............
;
/ r
, ?
(
?
Dimensions---------
------
-
?
- -
- ---
----------------
..............
Cosl-------
ta.
DeYails or remarks Q^:??9
?
G ...--..-----
---- _
.
.........
-------
'f ....""-. __
._......_.....---- ----..._-------._. -
_-----------
Loeaiioe
PEAMIT NO. se(fE/.?MP.
^-?I «
Daie
Number SPree! Beiween wba2 cross slreeSS Sisa Esi. Valualion
Lo! Bloclc Addition Reuxrangemeni or Traef
Owner .....-"'__G-??-- ----'-"-'?-?-?-f--?------------------
ConiracYos
Address ----- ?-1??----?1-_YS.-'?-5------- .4fA ..'...Fz'q(CW]`.....WL?
?/ - b ( ? ?
Af113i055 ------------- ------------------- .-------------------- .-'-' """'_"_"'-'------"---'
The undersigned hexehy makes apnlication for a permit !o
$ do woxk as herein apecified, agreeing to do all work in siriei
To1a1 fee collecied. accordance wi3h ihe building oxdinance adop2ed April 11, 1955
by ihe Eagan Township Boaz o upexnisors.
PermiY fees are no! / '
refundable. VlA\
..... . ' .'--K Cuig. . . ........ '
??ned
r/
a 59397 /D/ 3 9e2
°a
ReQUest Da[e
?Q
? Fire No Rough-in Inspecnon
Requiretl'+
,
A?Ife?ady Now ? Will NoWy Inspector
WhenRefltl
9
Aa.l / GYes Ril. y
I icensed contractor ? owner hereby request inspection of above electrical work at:
Jop Adtlress (Slreet, 8ox or Route No
OL,
Seclion N. Townsnip Name or No Ra?ge No
,2 m .4
OccupaM (PRIN24- Phane No
I.-W q?t' ?< 7iJY
Power S I ' rer
r- MOress
Eleclr¢al onl clor (Comp?ny NamB)
1 Contra or§ Lwense NO
,
?
MAtltlre nVacror or Own aking Installa0on)
lor erM mg nstallaL Phone Number
NINNESOTA STATE BOAPO OF El IT' THIS INSPECTION REQUEST WIIL NOT
Grlpps-Midwey BItlB. - pmm St BE ACCEPTEO BV TNE SiATE 80ARD
1821 UnWersiry Ave., St. Paul, MN 55704 UNLESS PROPER INSPECTION FEE IS
Plwne (812) 642-0800 ENCLOSEO
REQUEST FOR ELECTRICAL INSPECTION 'o'"" ?"+a
? / es-ooom.os
See inaYmtlians for com0letmg this farm on back of yellaw copy ?'
a 5 9 3 9 7 ??x° Below Work Covered by This Request ??`•;?
ew Add ReP. TypeofBUiltlmg AppliancesWrted EquipmentWired
Home Ran9e Temporary Service
Duplex Water Heater Elecinc Heating
Apt Bwlding Dryer Other (Specity)
Comm/lndustrial ' Furnace
Farm Av Conditioner
Omer (speciy) Camractors Remerk
6??
Compute Inspection Fee 8elow:
# 01her Fee # ServiceEnlranceSae Fee # Circuits Fee
Swimming Pool 0 to 200 Amps 0 to 100 Am
Transformers
Above 200 _ AmpS
Above 100
;ps
SIgf15 InspecWrSllse Only
Irriganon Booms ?U'?
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTEO IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby pou9h-m 'r oaia
certiy that the above inspection has
been made Final a ?'
OFFICE USE ONq
Tlns request mitl 18 montns Irom
Wr?;?:•#.Y,;N; I t,;r.d:4:*a #c?'??Y?;h:"M. :S:Xt;Y:I" ;.M:k:%f'?!:d'WY '.`.A*
r..rTV nr Fnc;AN
t_? S TF:-?.;r? ? n.?:•.,,iI,E?:: rCr,A, NO.. 55,
.
..i
r ?_.., ? ? ,a? . ..:.i;? ; ?s?:.;; .f:?e ?5c>;':i.
'F;T" iE:.. `7r . T?..? ...
?
2210 900i. 2t15 I;TiaG=: PU 74.75
2i.'+5 900'.I A! °', R;:NG`; r:I"i ! „Q
Tn',;i'E. .. e:int Arcnourr!;t: :'r;,,,;:?'r
f;,dpSQ23`)
UsEi: ?.r,:. NAr?CY
v?'(?;i'%;,hv,?•?.W"? ?%kY,,,?,,fi;?,?gY:?tYr';k?X'.'„?.y?t>k>k?r*>k?•?,:;;::.K.'<,y,:??;;y>;?'k
lCITI( OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
BUILDZNG
030720
06J29J97
SITE ADDRESS:
2115 KINGS RD
L07: 30 BLOCK: 2
VIENNA WOODS
P.I.N.: 10-81950-300-02
DESCRIPTION:
( R 0 D F I N G)
?;%
ft
ermit Type
"i1,d3.n?g'?-P SF (MISC.)
,,
??u=???f3.rirg,?RUlC?rA Type REPAIR
434 ALT. RESTDENTIAL
r
- ? r
r s.i i"r s4c,?
s
s?e,
zs
" -?#?:?', x? ?".?t?'", _'•' '_ ' " ??"'§is.?icu,:??"
REMARKS:
?,e??,
? ? u , ?.
„? ?w
FEE SUMMARY:
VALUATION
Base Fee $74.75
Surcherge $1.50
Total Fee $76.25
$3,000
CONTRACTOR: OWNER: _ Applicant -
KUETHER hIARY BETM
2115 KINGS RD
EAGAN MN 55122
(612)405-0581
T 7aere#?:??#irrowlexlcj?;';f
nr.
APPLICANT/PERMITEE SIGNATURE
Avia ?.I,r
ISSUED Hr. SI NATU
3 0110 997 BUILDING PERMIT APPLICATiON (RESIDENTIAL) 41 (, . ZJr
cirr oF e,acaN
3830 PILOT KNaB RD - 55122
681-4675
New Cunstrvction ReauiremeMs
RemodeURenair Reauirements
? 3 registered ske surveys ? 2 copies W plan
? 2 copies of plans (include beam & window sizes; poured fid. design; etc.) ? 2 site surveys (exterior additions & dedcs)
? 1 energy calculatians ? 1 energy calculations for heated add'Rions
? 3 eopies of tree preservation plan rf lot platted after 7/1/93
required: _ Yes _ No
DATE: c, ')k9* ?CR? CONSTRUCTION COST:
?
DESCRIPTION OF WQRK:
STREET ADDRESS:
LOT -30 BLOCK
?-
/ PROPERTY
OWNER
CONTRACTOR
ARCHITECT!
ENGINEER
Name: )? \s.4,tLQ-+^ WIhP?yV),04 Phone #: _??S-QS'??,..,j
IA6I PRbi
Street Address:61l }L-) Y?`KIA
City: F?aL ,To ny\ State: Y11 ND Zip: 5'?-p 1?k2.
Company: 1? Phone #:
Street Address: `? iq4'Y\-4 License
City: State:
Company:
Name:
Zip:
Phone #:
Registration #:
Street Address:
City:
State:
Zip:
Sewer & water licer.sed plumber (new construction only): Penalty applies when address change
and lot change are, equested once permit is issued.
I hereby acknowiedge 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 Ciry of Eagan Ordinances.
Signature of Applicant: OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received - Yes - No - Not Required
?
BUILDING PERMIT TYPE
OFFICE USE ONLY
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ?
? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ?
? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ?
? 04 5F Porch ? 09 12-plex ? 14 Fireplace ?
? 05 SF Misc. ? 10. = plex ? 15 Deck
WORK TYPE
? 31 New ? 33 Aiterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Basement sq. ft.
Main Ievel sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Pianning Building
Permit Fee 7zl 75
Surcharge /• so
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: 7 &.as
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
_ Engineering Variance
Valuation: $ ?000` cn2
°k SAC
SAC Units
L.ot JO Hlock o2 P[D # Sewer /water permit k
plat ?y„?.G? lt/o-t? Date Receipt #
CITY OF EAGAN
i?998 SEWER AND WATER CONNECTION 8? AVAIIABILITY CHARGES
\ ?,A''? EXISTING RESIDENTIAL PROPERTY
Sew Connection & Availability Charges Water Connection 8 Availabilit Char es
Lateral benefit 21.30/ff $ Lateral benefit @$21.50/ff?
Trunk Q $860/co ion Trunk @ $895/connection
SAC 1,100.00 Suppty & storage (WAC) 807.00
Date paid Datc paid
Receipt # Receipt #
Account deposit 15.00 Treatment plant 444.00
Sewer pernut & surcharge 50.50 Water meter 111.00
Account deposit 15.00
Subtotal S Water pemut & surcharge 50.50
Plumbing permit & surcharge 20. Subtotal $Lv5a
Total $ Plumbing permit & surcharge 20.50
Total $??
Sewer a Water Connection 8 A ilabilit y Char es
L,ateral Benefit 21.30 and/or $21.50/ff $
T?unk @ $860 and/ $895/connection
SAC 1,100.00
Date paid R ipt #
5upply & storage (WAC) 807.00
Date paid Receip
Treatment plant 4 .00
Water me[er I 11. 0
count deposit 30.(?
Se r and water permit & surcharge 100.50
$
Plumbing per & surdiarge ? 20.50
Total
Property
Address
Phone nu
Plumber
OFFICE USE ONLY
PRV required y.s _
Number of taps 0_
? ?reo f
D? Availability ?-1;2-
T-
City financed ?1 ?_?1? I?
T I
Lot Block P[D
Plat
Sewer lwater pennit
Date Receipt
CITY OF EAGAN
1998 SEWER AND WATER CONNECTION 8 AVAILABILITY CHARGES
EXISTING COMMERCtAL PROPERTY
Sewer Connection & Availability Charges Water Connection & Availability Charges
Lateral benefit @ 21.30/ff
Trunlc Q $1,790/acre
SAC @ $1,100/unit
Date paid
Receipt #
Sewer permit & surcharge
Subtotal
Plumbing permit & surcharge
Total
$ Lateral benefit Qa $27.15/ff $
Trunk @ $1,875/acre
Supply & storage (WAC) @ $2,955/acre
Treatment plant @ $444/SAC unit
Water permit & surcharge 50.50
50.50
Subtotal $
$
Plumbing permit & surcharge 25.50
25.50
Total $
$
5ewer and Water Connection & Availability Charges
Lateral Benefit @ $21.30 and/or $27.15/ff $
Trunk @ $1,790 andJor $1,875/acre
SAC @ $1,100/unit
Date paid Receipt #
Supply & storage (WAC) @ $2,955/acre
Treatment plant @ $444/SAC unit
Sewer and water permit & surcharge 100.50
Subtotal $
Plumbing permit & surcharge 25.50
Total $
The number of SRC units is determined by the Metropolitan Counci! Wasrewater Services (602-1000).
Property owner
Address
Phone number
Plumber
OFFICE USE ONLY
PRV required
Number of taps
Availability $
City financed
LM 3 q_ Blk 2 PID # i n_R 19 5 n_3 nn_n2 Sewer/water permft
Plat ViFNNA wnnns Date
Receipt #
Jr1?P?ahe?
ClTY OF EAGAN
1994 SEWER & WATER CONNECTION CHARGES
EXISTING RESIDENTIAL PROPERTY
Sewer connection charg es Water connection charg es
Sewer availabi(ity charge (SAC) $ 900.00? Water availabiliry charge (WAC) $ 725.00
Date previously paid Date previously paid
Receipt #
A
t d
i
? Receipt #
ccoun
epos
t 15.00 tx Account deposit 15.00
Sewer permit and surcharge 50.50 'od Water permit & surcharge 50.50
Water meter 115.00
Subtotal $ 965.50 Treatment plant 348.00
Tap 5ubtotal $1,253.50
Totai Tap
Total $1,253.50
Sewer & water connection charges
Sewer availability charge (SAC)
Date previously paid Receipt #
Water availability charge (WAC)
Date previously paid Receipt #.
Account deposit
Sewer & water permit and surcharge
Water meter
Treatment plant
Subtotal
Tap(s)
Total
$ 900.00
725.00
30.00
100.50
115.00
348.00
$2,218.50
OFFICE USE ONLY
Property owner GERALD PRIGGE
Address zils xINr,s Rn
Phone na 683-8220 (JUDY CUMMINS - RllRNF.T RRAi.TY)
Plumber
Sa";-}a.y Seo.c- Se?..:ce Ar N.E
PRV r 5
No. of taps x0n ¢
Assessments /Yoa e
Waiver tIlZQ
?"
eovnev O?f-Lor' LIrq7PiKSRV?;L4RJ 5 w. Co..+« 04 'L 0
SPECIAL ASSESSMENT SEARCH SLJrIIMARY
AS OF: 03/25/1994
PROPERTY ID: 10-81950-300-02
S/A# ASSESSMENT DESCRIPT. YEAR TM RATE TOTAL ANN.PRIN. PAYOFF CD
100199 SAN SW TRK 1972 15 8.0000 140.00 0.00 0.00 CL
100448 S/W L STMT 1980 10 8.0000 4232.34 0.00 0.00 PP
100507 STREETS 1980 10 8.0000 3519.27 0.00 0.00 PP
------ SUMMARY OF LEVIED 0.00 0.00 0.00
****** 1994 P&I CERTIFIED 0.00
------ SiJAIIMARY OF DEFERRED 0.00 0.00 0.00
------ SUMMARY OF PENDING 0.00 0.00 0.00
------ SiJD4dARY OF- CLOSED 7891.61
Press ENTER; or F1, F4, F5, F7, F8
?• '
?
?? • ?i
2/84
? CITY Or EAGAN
APPLZCATION FOR PERMIT
SEWER AND/OR WATER CONNECTIODi
(PLEASE PfiINT)
1) PROPIIZtY ADDRESS: - r??/,??lr??rSS 8b
rFMr nES=tirzc:v: La7- 36 Ci Z oG*g
(Ir?t/Block/Suh,division or Tax Parcel I.D. Nisn?r)
?";I:='=:G STRCC7= , DA'iB 0F Or^.T_GuIAL r.iiIiDl:`:G _°E7;-1IT ISS??\C.:
?
"
?
PFESr-`._' Z.^Ii 7:/?ROPOSr'? ?, ?R-1 Si?GL : FptiffLY
? R-2 DUPL.,.z"{ ('Iti%'p Ur7ITS)
0 R-3 7G:%-?FCTJSE + L':1ZTS} ( rN2'L'S)
p R-a apaRT2--Ir/ccMa-s*MUM ( wzTs)
? cavIMERc=AL/RE:AI:,/oFFzcr
? mm?s?,
? 1.vsTZT7,?rz011-U/cc=NTME:?,T
2) F,ppTZ= (PLEASE PRIl1i)
ADDRESS:
CIT7, 5TAT:', ZIP:
PHONE:
j) pLumBER
rra PLEASE PfltNT) FOR CITY USE ONLY
rE: Jd2kiel2hE
ADCZE55: J?
!n o d PLUH9ER5 L.I6E4SE:
ctive
CIT1', STATE, ZIP: Ezpir
PfiONE: '?"z
r_? 6 ?1 PLUMBER LICENSE N (j p/ f";LSS No af Record
/
3 t lnt la
?J U.L'UY.ANP/C???IER jYLLR,?t YHlrIfJ
NANIE - - 911'7-r1 9C .4f /f D
ADDRESS: ???-
CITY, STA'I'E, ZIP:
PEi0NE:
5) IIVpICl,TE WIiZCH PERi41T IS BEING RfX)UESTM;
COPIN?CPION"TO CITY SEY7ER
? COPINECTICN 'M CITY S•]ATEg
? Cr':MR (PLEASE DESCRIBE)
? PM7\SE f?OID APPRaVFD PER.+IIT FOR PICf:-UP BY ONE OF 11BOVE
? plZ?+s'E MAIL APPROVED PEPMIT T+J 1, 2, 3, 4 ABWE
n (Circle one)
7) SIC,-ATC,: - (p ? ?1 Az-ep???
-ti ?? ?
DATE; ? &1,1J-
?f ?la:wiqfl.iai?:i sals?al?! ?iPr?ss?ara?l/ ssir.ia:?altLal?tfMYi?ial ???rasKissa? r
F 0 R C
PE?2MIT °- ISSUED
T Y U S E O N L Y
F°ES: $
$
?
$
S
? ?? v rJ
S
$ ?
$
S
$
S
$
$
SF..:"iLR niRMTT (I:,ICT:JLE JUP.CHAR'.-G)
WATER PERP4IT (INCiIIDE JLRCFIAaGG)
WATER METER/COPPERHORN/OUTSIDE READER
WATER TAP (INCLUDE CORPORATION STOP)
SE?dER TAP
?(..?.r_.•l._ln ..._.S.r..'?1? ? J_...:?
AC^OUNT D.F,PpSIT - 4iATER
WAC
SPC
TRtiNK WATER ASSESSME.1T
TRti:4K SEWER ASSESSDIEDIT
LATERAL SENEFIT/TRUNK SE:,lER
LATE?2AL BENEFIT/TRUNK WATER
OTHER '
$ TOTAL
$ AMOUNT PAID/gECEZPT
DOES UTILITY CONNECTION REQUIRE EXCr1VATZON IN PUBLIC RIGiIT OF WAY?
? YES IF YES, THEN A"PERMZT FOR 'AORK WITHIN
PUBLIC ROADWAY" MUST BE ISSiJED BY THE
?[VO ENGINEERING DIVZSION. LIST AS A CONDZ-
?'-- - - TION.
SUBJECT TO THE FOLLOWING CONDITIONS:
.01
APPROVED BY:
1'I:LE:
DATE: ?.?/???
LN?41119K dty oF cegen _
3830 PILOT KNOB ROAD, P O. BOX 21799 BEA BLOMQUIST
EAGAN. MINNESOTA 55121 Mayor
PHONE: (612) +754-8100 THOMAS EGAN
JAMES A SMITH
JERRV THOMAS
THEODORE WACHTER
Counal Members
iHOMAS HEDGES
CdY Admmisfrafor
APY.11 15, 1985 ' EUGENECVACIOk ERBEKE
Mr. & Mrs. Gerald Prigge
2115 uir,gs Road
Eagan, MN 55123
SU&TECP: PRIUATE SEWAGE SYSTEM
LO'1' 30, BIOCK 2 V=II1 WOpDS ADDITION
De3r Jerry:
The private sewage disposal system located at 2115 Kings Road is becaning
a nuisance to your neighbors on Oak Way. I think that it might be advisable
for you to mnnect to the sewer located near your septic systen before the
Metropolitan Waste Control Ccttnission increases tkieir connection charges,
and the ccamplaints frisn the neighboring properties becane a majar issue.
There is a sewer connection available far you located 5 feet northwmst of
the manhole that is near the center of the easement on your property. The
present Metropolitan Waste Control Cannission connection charges are $525
and the Eagan inspection fee is $10.50.
Please give this oonnection serious consideration and i£ you have any questions
please feel free to oontact me.
Sincerely,
? terso
Chief Building Tncmctor
CC: Dale Ihuilcle, City Planner
/nlb
THE LONE OAK TREE. ..THE SYM80L OF STRENGTH AND GROWTH IN OUR COMMUNITY
YS Y
MEMO
TO: DIANE DOWNS, UTILITY BIL!!NG CLERK
FROM: ED KIRSCHT, SR. ENGINEERING TECHNICIAN
DATE: MARCH 16, 1994
SUBJECT: ELIMINATE THE NEIGHBORHOOD STREETLIGHT ENERGY BILLING
FOR LOTS 26 THROUGH 31, BLOCK 2, VIENNA WOODS.
2905, 2107, 2109, 2111, 2115 & 2119 KINGS ROAD
This memo is to inform your department to eliminate or remove the neighborhood
streetlight energy biliing for Lots 26 through 31, Block 2, of the Vienna Woods subdivision.
At the time Venna Woods was platted and originally developed, neighborhood
streetlighting was not installed along Kings Road. There currently are streetlights located
at the intersection of Nicols Road and Kings Road and across the street from Lot 25,
Block 2 of Vienna Woods with an approximate distance between the two streetlights of
1200 feet on Kings Road.
?'1J?,IS?4 `.k V?'?.,G/t-/
Ed Kirscht
cc: Mike Foertsch
Jerry Wobschail
Encl.
EJK/je
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m `.
? t ;t1MD
W[ . = Z . Oe[- MOD
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VIBURNUM R TRAIL
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w?[?}? ( • ' e L '
W O ' i S i N ?\0 ?0 ` M/NY bq?• ry ?d ?lOJ b 1! 1= . ?w ?l1 ? ? wa: y/
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,Y : Ce to Y'° 081-06 O f0 '?r N ?'? ?
1' n
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I , oHNgoN ? 7 ii t ?: kto = s° `41 s' ` ?M y?S 032- O O. r? d•
I '? ? , ' ? ???m i p . • ?? f ?e " a ?? ? Wr
? ? • S ? ? lwYS'N• ^ ? w ? 4
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1;Y10 ? K I N G S??? ?rjG•e1it?LL?L??R 0 A 0 ???00p: ,.?? 'S' "-.?«u?'wr uan--. • `
YW
a:i I Ati ur
C
MASTER CARD
3
STRUCTURE AND
LAND USED AS 6bd i_ _ 7JA0 //'
Permit
No,
Issued Issued To
Coniractor Owner
BUILDING
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING SEPTIC
FOUNDATION ?R 7- CESSPOOL
FRAMING -3-?-0 TILE FIEID FT.
FINAI
ELEC7qICAL
HEA7ING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SAN17ARY SEWER
Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPOftTS
TO 8E USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
NON-COMPIIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? ACCEVTABLE SUBSTITUTIONS OR
DEVIATIONS.
NON-COMPIIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS? COMPLETION OF CERTAIN IMPROVEMENTS
WILL 8E DEIAYED 8Y COND4TION5 BEYOND
CONTROL.
? REINSPECTION REQUIRED
REINSPECTION
DATE OF REINSPECTION
CERTI FICATION - I certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein
all significant conditions oLserved to he at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
6UILDING INSPECTOR DATE
23
Lb T ??( a,,.,
,.;Yi S ?.(
?
II ' I ! I f I I I I I I f I ! i I I I I I I I I I I f I I I T?VP?-?P?`?-1 I
IM
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--4
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?
S?r-. 31
Peggy Fleck
From: Peggy Fleck
Sent: Friday, July 31, 2009 10:44 AM
To: 'mbkuether@comcast.net'
Subject: 2115 Kings Rd
Attachments: 2115 Kings Rd.pdf
Hello Mary Beth,
Attached is a copy of the Sewer & Water Permit Application and the Plumbing Permit Application. Both are required
when converting to city water. The grand total, which includes both permits, is $2,151.00.
Please let me know if you have any questions, my direct number is 651-675-5674.
Best regards,
Peggy
a a~
Peggy Fleck I Clerical Tech ( City of Eagan
City Hall 13830 Pilot Knob Rd I Eagan, MN 55122 1651-675-5675 1651-675-5694 (Fax) I pfleck@cityofeaaan.com
Ciq f
U a UJj
THIS COMMUNICATION MAY CONTAIN CONFIDENTIAL AND/OR OTHERWISE PROPRIETARY MATERIAL and is thus for use only by the intended recipient.
If you received this in error, please contact the sender and delete the e-mail and its attachments from all computers.
1
r - - - - - - - - - - - - - - - I
For Office Use
I
/a I Permit
City of Ea Un j I
ll I
I Permit Fee: I
3830 Pilot Knob Road
I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 j staff:
Fax. (651) 675-5694
2009 SEWER AND WATER CONNECTION AND AVAILABILITY CHARGES
EXISTING RESIDENTIAL PROPERTY
Address: S C~ ` OFFICE USE ONLY
Property Owner:
Telephone (Q~ d~ I 17 PRV required
Plumber:
Jo City- 4,; County R-O-W Permit
Date of Inquiry:
Contact Name:
SEWER WATER
Sewer S rvice Water Service
Sewer late I charge Water lateral charge - p -
Sewer trunk Water trunk
City SAC $10 .00 Water supply storage $1,150.00
MCES SAC $ 2, 00.00 Receipt , Date:
Receipt Treatment Plant AOO
Septic abandon nt $ 50. 0 Permit Fee Permit Fee $ 50.State Surcharge State Surc rge $ 0.50 "Plumbing Permit Required - water meter to be
acquired with building permit
TO L• TOTAL:
SEWS WATER
Sewer Service
Water Service
Sewer l ral charge @ $28.30/ 1S s~
Water late charge @ $28. /ff / 1
Sewer trunk $1,150/co ection J ' lu~?/ , J
Water trunk @ 2001 nnection f ~~em
City SAC $100.00 .
MCES SAC $ 2,000.00 J 161.,00
Receipt # ate
Water supply storage $ 1,150.00
Receipt # Dat
Treatment ant $ 735.00
Septic ab donment $ 50.00
Permit F $ 100.00
State Su arge $ 0.50
'Plumbing Permit Required - water meter to e
acquired with building permit
TOTAL:
1
1 For Office Use
n Olf Ea~~11 Permit
City 3830 Pilot Knob Road Permit Fee: I
I
Eagan MN 55122 j Date Received:
Phone: (651) 675-5675 1
Fax: (651) 675-5694 1 Staff: I
2009 RESIDENTIAL PLUM NG PERMIT APPLICATION
Date: Site Address:
Tenant: Suite
RESIDENT / OWNER Name: Phone:
Address / City / Zip:
CONTRACTOR Name: License
Address:
City: State: Zip:
Phone: Contact Person:
TYPE OF WORK -New _Replacement Repair -Rebuild _ Modify Space - Work in R.O.W.
Descri tion of work:
PERMIT TYPE RESIDENTIAL
Water Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
l- RPZ / PVB) Main _ Lower Level)
Septic System Water Turnaround
_ New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround" (includes $.50 State Surcharge)
'Water Turnaround (add $165.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) /
TOTAL FEES
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
x x
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections; -Under Ground -Rough-in Air Test -Gas Test Final