1069 McKee StRsceipt PLUMBING PERMIT Permit No,
CITY OF EAGAN -,
Fee
Fill in numbered s,naces S/C •
Type or Print legibly Tot '•???
.
1. Date
2. Instaflation Cost
3. JobAddress/ ? %1• Lot Blk. ? Tract?'K?? Z
;
4. Owner z C- JA/•?
5. Contractor -?'? r? --J' Phone
iP/1 f; C ?? j,6. Address%
7. City State Zip
8. Buiiding Type: Residential El Commercial ? Institutional ?
9. Work Description: New ? Add O Alter ? Repair ?
10. Describe `'' . :%!;. ! ' _._" r • ?' ,
1 11•
No. Fixtures
Water Closet No. Fixtures
Cess
ool/Dr
field
i
Bath tubs p
n
a
Se
tic Tank
Lavatory p
Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
L,aundry Tray
Floor Orains
Drinking Ftn.
Slop 5ink
Gas Piping Outlets
12, 1 hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
• . ?-?
Signed : for
' Rough Pinal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
CITY OF EAGAN Remarks
Addition McKee 2 Lac 10 Bik 1 Percei 10 47751 1 00 01
Owner ?7,?1'•,? ; 1! . `? t.. +i; ! Street 1069 McKee ,.?iti State Ea gan,MN 55121
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. ? 1969 .lo 34.71 101
STREET RESTOR.
GRADING
SAN SEW TRUNK 1968 100.00 30 Pc'3.1d
* SEWERLATERAL lgbg
WATERMAIN
* WATER LATERAL 1968 g Q-QQ 46.50 20 12-7-77
WATER AREA
STORM SEW TRK 19$4 379.00 25.27 15
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
Gara e 6 0
WATER CONN. 200•00 2 1-1 8=67
BUILDING PER,
sac 200,00 2 1 -18-b
PARK
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
Mi f i t ;'11t
PERNIIT SUBTYPE:
PERMIT TYPE: s+
Permit Number:
Date Issued:
, APPLICANT:
1'1 [ Vfft':y F F 1 F tl A MI F{'r Yf_ A M C I) P! •A
($,l..I ;f :, ,,rtt+,
TYPE OF WORK:
?., ? t t?Ka1 ? urv
ii: i I ; I .: r1 h{/1t 1.;Qt1ND F1F3A t! Mi rl l
INSPECTION .. • .•
!'t?l?s,t1 I 4'1 ;i I t. ? I IWF?1
Permit No. Permit Holder Date Telephone k
ELECTRIC
PLUMBING
HVAC ? ? g' ?i '?Q,j • ?
Inspectlon Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
flOUGH
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 F1NAL
DECK FTG
DECK FINAL
INSPECTION RECORD
.....,,aa ".,
CITY OF EAGAN PERMIT TYPE: ,,. ; ?, ,• ? ; ?
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
I (612) 681-4675
1(1
SITE ADDRESS: APPLICANT:
1 ±1 1.11, , , t I! 1'Ifi,•.', iNf
,,, ; , - , , i', 8i10
PERMIT .SUBTYPE: TYPE OF WORK:
. r0TFRACTi)
f 1NA1
Permit No. ParmN Holdsr Date Telephone i
ELECTRIC
PLUMBING
HVAC
Inapaction Date insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIF TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAI PLBQ
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
?
L
?
EAGAN TOWNSHIP
BUILDING PERMIT
Owne: --°°. J?f.._J? -..dg'-?c-e'k ......................
Address (presenS) ---- ---
. ..---'....-------------..
Builder- ...... •..?.?..•e:.'!^... ?L!-t-e-C-t?
.__..... - -? - --- -- - - .._.. ---- -
Address ..... -x...---r); `Y:'e n--,-----
U
N° 1551
Eagan Township
Town Hall
Date ..::?f..!. 7 /?. :7 ......................
Stories To Be Used For Froni
- Deplh
- Heighi Esi. Cosi Permii Fee Remarka _
?.._w`-tl /
- I
LOCATION
SireeL Roatl or oiner Descnpilon ox i.ocanon I 1101 151ocx nauulon or iracx
• I ?+d f ?j?u. /Ccr ? -?_.c_ ???[.
Thia permit does not auihoriae the use of streels, roads, alleys or sidewalks nor does it give the ownec ax kis agent
the ri9h! !o cseafe anp situation which is a auisance or whiah pzesenfs a haaard !o the health, safely, aonvenience aad
general welfare !o anpone in the communiip.
THI$ PERMIT MUST BE EP ON THE PAEMISE WHILE THE WORK IS IN PROGRESS.
This is fo cax2if " ._
y' . ...................... haspermission !o eseci a---- Lr_.lele,.-s.1 .................. ........... upon
the above described premise subjecf lorhe provisions of the Suilding Ordinance for Eagan Township adop2ed April 11,
1855. .
? .----------
..:. .. . . ........----'---------
......__ J. __..... ..---.. ... A . . ---------. Per .---------...
.°-.. .. ?C .............°-'--'----- -- ............... ...
Ch?irman of Tnwn Board Building Ins ecfor
A
EAGAN TOWNSHIP
BUILDING PERMIT
..... . .
Ownex
/ -- . ..._- --"- --'-" -
Add:ess (Preseni) -"-'_?....?'"Q.?..:?.....?-'-'....._...
Builder ..................._'-'--....-.-'-.................'-.__'......._..........._...
Addreu ......................... ........................... -............................
DESCRIPTION
N° 2844
Eagan Township
Town Hall
Dale ---- 7.nZ.rJ'J L
5fories To Be Usad Foz Fzoni
ay Deplh
ay Heigh! Esf. Cos! Permi! Fee
ac???a.? Remarke
?
" LOCATION
or
This permit does not aulhoriae !he use of slraeis, raads, alleps or sidewalks aor doee it give !he owner or hfs agan!
!he righ! !o creale anp siluaYion which is a nuisanee or whieh precents a haaard To !he health, safefp, eonvenienee and
general welfare !o anpone in !he eommunilp.
THIS PERMIT MUST B.,E.../KEPT ON THE PREMISE WHILE THE WOAK IS IN PROGAESS.
This is !o certifp. 3hal.tt.._---y-- r`---- - CQ•°?/ ?J .......... ........ has permission !o ereci a.....---?.a .......................... _upoa
!he above descxibad psemise subjea! !o !Re provisioas of !he Building Ordinance for E geffi n Township adopfed April 11,
1955
....'--....'-'---'•----.._..?!c.*.`.iFV-'^............_.. Per .......
............_----...!:?_.`K-'...__i!..?.<r.a.-`-.•r.?......_....""_"
Chairman of Tnwn Board Building Inspecior
l3 ,.L3 ,;
EAGAN TOWNSHIP
BUILDIBVG PERMIT
Ownex --------,-
Address (P?r/esenS) u .... _.._.._-_-_-_------.__
Builder /.(.c.?t_?Cl `^'-??
Address ---?--.------
??.?..----??&
? DESCRIPTION
N° 60
Eagan Township
Tawn Hall
Dafe 04 --- 1J..,,_"_._..4_..
Siories To Be Used For Froni Depih Heighf Esi. Cosi PermiY Fee Remarks --
! f???ql'LGLGi?C- • ? -
LOCATION
Sireef, Roa ox olhex Descriplion of Location 1 Lo! 1 81ock I Addition or Tracf
L
This permif does noi aufhorise the use of slreeSs, roads, alleys or sidewalks nor does it giva the owner or his ageni
the righi !o crea3e any siissafion which is a nuisanee or which presenfs a hazard !o the healfh, safely, conveniance and
general welfare to anyone in the communify.
THIS PERMIT MUST BE IC$PT ON THE:,p A?EMISE WHILE THE WORK IS IN PROGRES ? -------------
This is !o ceriifyYha!-..??. ?'--?L.GL-=eK.--_ ........ . . - __.has permission !o ereei a ------------ ..........__...._ ----------------- upon
the above described pe subjec! !o the provisions of the Building Ordinance for Eagan Township pYed April 11,
1955.
--- - _... -----
-'_ '•' -.?. .`------/--- - ---------------.._.. Per .__..._ ---- - ---------
. iar -
Chairma o Town Board Suilding .. Inspee .
?
II HI
* 0 W5 6 11 11111 REQUEST FOR ELECTRICAL INSPECTION?Q
Minnesota State Board of Elechicity
1821 University Ave., Rm. -1 8, St. Paul, MN 55104 .
4* Phon: (612) 642-0800 ry (,O "'"''
Home Duplex Apt. Bldg. Olher: New Addn
Commercial Industrial Farm Remod Re air
Air Cond. Htg. Equip. Woter Htr. Load Mgmt. Other:
D er Ran e Elec. Heat Tem .$ervice
'R" above the work covered by fhis request. Enter remarks in }his space and on the bock of the white mpy only.
I?ecrn??+?et ?ur?tace u?.??. ?,
Cvlculate Inspechon Fee - 7his Inspecfion Requesl will not be accepted wdhoui the corred fee:
Other Fee # $ervice Enhance $ize Fee # Circvits/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Sfreef Lfg.lfraHic Sig. Above 200 Amps 100 Amps
Trans{ormer/Genera}or (/J
?
INSPECTOR'SUSEONLY TOTA
$ign/Ou}line L}g. Xfmr. ?
,
Alartn/Remote Conirol
$wimming Pool I hineloy mni thal t ins eckd the eixfiml imbllation descn6ed hmmn an the dores sm4d
Irrigation Boom Rough-In ? DvN
ecial Ins
$
etlion
p
p
Investigofive Fee F1.1
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF OT COMPLETED WITHIN 8 ONTHS.
?o s
2 9 5- lj O V A ?l? Y/] /? LY Thix request vald 18 monihs fmm validqtion dpreQnnyd in ?isb
/
•
i /7Y
`
? ?
PLEASE PRINT OR TYPE .L.
Reqaul re i inspeCion reqwred2 ? Yes _
Rovgh-in
P? Inspecfan Oiher Thon Rauqh-Im ? Ready Naw dl Coll
- - 6 stcoll the
?'!oo ma mspecror when readd Dok Reody
I, licensed contrador ? owner here6y requesf inspedion of the a6ove eleclrical work af:
Jab Pddress (Street, Box, or RoWe /N?o.)
[: ?. Gry? i?/?,? q?
L.?/' `-'/ r Lp Code ?/ I
?LI
SeNan N. Town ip Name or No. Range No. Fire N. Caunry
Oavpon
? ' Phone No ?'7 '
9
PowerSupplier Address
EI
ml
Conva"r(Company,Name) . ,..,
? l/ Conva?m? MasterLaNa.(PlontEletl.Only)
,? N ?..?
Y
Mai g Address (Conhaclor or Oxner PeAormmp Inswll ' n)
T
Autharized (Commclor ar0 nerPerfarmin Insmllahonl Ph/oneJN?/o.
/(3?
EB-OO00IA.T(r6/95 ?? STATEBOANOCOVY-SEEINSTRUCTIONSONBACKOFYELLOWCOPY
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
PERMIT TYPE: B U I L D I N G
Permit Number: 0 2 8 9 3 2
Date Issued: 0 S/ 0 5/ 9 6
1069 MCKEE ST
LDT: 10 BLQCK: 1
MCKEE 2ND
P.I.N.: 10-47751-100-01
DESCRIPTION:
MAC 5QUND ABATEMEN7
Bllih
';1ermit T y p e
SF (MISC.)
rType ALTERATION
???ets?v? Catle` ? 434 flLT. RESIDENTIAL
? . ?
&
?
?y? e$5 F i .I f ?
:.
im
, z
S
'
_
Y
4 u g
?..." $
b , p
i1
PERMIT
?;gC 6' 'G°?tiP
v,q?VmNSpot f:? ?5ulp.
° e0E9 :s= g%w kg ?'"? ?` A a
- rad?
REMARKS:
FEE SUMMARY:
VALUATION
8ase Fee
Plan Review
Surcharge
Lic. Search
Total Fse
$287.25
$143.63
$10.00
Fee $5.00
$445.88
$20,000
CONTRACTOR: - Applicant - s7. LIC.OWNER:
DIVERSIFIEq AMERICAN CONST 19297982 2001734 ZIMMERMAN BRRB
5115 EXCELSIOR BLVD 107 1069 MCKEE ST
ST LOUIS PARK MN 55416 EAGAN MN 55121
(612) 929-7982 (612)869-2771
Z, hsrv lay ?OR'ia.b,014'A'ge 'tha:C" T Er??? r?ada.??ke#s "tiar1 ot??# t-har,th6 ;...
µ?forma??ar?.yi}sycae;e???`'ct ?j??e?'?g 3?tM, 3'scatat?? ?? hir?
,.S Ha?'j.4e ?4 fl.lT"lJ. iw14.J S?4 G???}"tU Ak?'???4v?{i#Yi?? •e b §?. .F ? ., .e• ° P£ '. -i e...i'_ .......?.,.._ _ sie,a... ?
..b...?_,.? . .. ..,..?... .........,. x. .,.....a .sa.? . ,. .. ............_.?.. J >c ... >..
?AA SIGNATURE ISS? BY.? I?URE?
CITY OF EAGAN
3830 FILOT KNOB RD - 55122
43021996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681 a1675
RemodeVReoair Reaufrements
?
?
?
3 regislered aite surveys
2 copies oi plans (indude beam S window sizes; poured tnd. design; etc.)
1 energy ealwlalions
3 copies of tree preservetlon plen B lot platled after 711/83
required: _ Yes _ No
DATE:
DESCRIPTION OF WORK:
???? bb
Cr'?A tl-i6
? 2 coples of plan
? 2 ske surveys (exterlor addkions 8 decks)
? 1 energy ealculations tor healed additions
?CONSTRUCTION C05T:
STREET ADDRESS: I' ' -' '
LOT BLOCK SUBD.IP.I.D. #: rn r k 0! 2ii
PROPERTY Name: ?3Y'lk-) Phone#: &69-2771
OWNER ' ua* sws+
Street Address?? ? ? ? ?? L=?`c -
city: F?a -,-i r-x state: m? zip:
CoNTRacTOR Company: Phone #:
Street Address: 5114iFYPPI.Si,1jy. N(,d License #: A6d 173 14
- - qt
city.?} ZQ(,1 5 State: Zip:Lp
ARCHITECTI Company: Phone #:
ENGINEER
Name: Registration #:
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 applicat(on and state that the in ormation is correct and agree to comply with all
applicable Siate of Minnesota Statutes and City of Eagan Ordinances.
` Signature of Applicant
OFFICE USE ONLY ????dML?DD
Certificates of Survey Received _ Yes _ No
7ree Preservation Pian Received _ Yes _ No ---'----""""
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ?
0 02 SF Dwelling o 07 4-plex o 12 Multi Repair/Rem. ?
0 03 SF Addition o 08 8-piex o 13 Garage/Accessory ?
0 04 SF Porch o 09 12-plex o 14 Fireplace ?
? 05 SF;Misc. ? 10 _-plex ? 15 : Deck
WORK TYPE
? 31 New 33 Alterations ? 36 Move
0 32 Addition ? 34 Repair ? 37 Demolition '
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Permit Fee
Surcharge
Pian Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SNV Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
Engineering
Valuation: $
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
Variance
=7--
?
6
z pr oegcg
% SAC
SAC Units
C.T.TY OF FAGAN
(',ASHTER: S TFRMINAL NCJa 67
I?A7E. 05/21/97 T7ME:: 13:37S50
?Uw
NAME: M J MOSEfi CONSTF<UCTTON
3210 3001. 1069 MCKEE S7 74.75
21 55 900L 1069 MCF:EF' S7 1.50
Tota7 h'?reipt Ama.an+„ 76.25
cRn74i.e„
usFr, 111: Mahr.,v
PERMIT
CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: 6 u x L o zN c
Eagan, Minnesota 55122-1897 Permit Number: 030018
(612) 681-4675 Date Issued: g 5 J 21 / 9 7
SITE ADDRESS:
1869 IhCKEE ST
LOT: 10 BLOCK: 1
MCKEE 2N0
P.I.N.: 10-47751-100-01
DESCRIPTION:
(ROOFING)
F6U'ildin, 6,Permit Type
=bul7.d?irtg ??Sa.r.k TypE
Census 6ode -•.?
1
r".
? a 0
,i ??
SF (MTSC.)
REPAIR
434 ALT. RESSQENTIAL
-, ?
I
cJ`?"`?•a?^.?YkdL3
,? { t
ii
:;!
u
REMARKS:
FEE SUMMARY:
VALUflI'ION
Base Fee
5wrcharge
Total Fee
$74.75
$1.50
$76.25
$3,000
CONTRACTOR: - Applicant - s7. l.IC OWNER:
MOSER CONST, M J 14555888 0002668 VETERANS ADMINISTRATION
947 15T11 AVr N 1 FEDERAL DR
S ST PAUL MN 55075 ST PAUL MN 55111
(612) 455-5858
T hEreby acknowladge that?`T hove r4aeF'th3s appl?icat,zon and stat2 that the
informariorr is carrect arrd agree tcs a•orrrply w1th° ar1l spplicable '$Gate o# Mn.
Statutesend City vf„6agacr qrdinartcss,.
? _ -
APPLIGAM/PERMITEE SIGNATURE
,IS?fl?t RojT?1lnA ir.
1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)
36015830 PILIOT KN B RDN 65122
681-4675
New Construction Reauiremenffi BemodeUReoair ReauiremeMs
? 8 repistered site surveys ? 2 oopias M plan
• 2 copies of pWns (indutle beam 8 wlntlow slzes; poured fid. dealpn; eta) • 2 aRe aurveys (e)teAor additions 8 dedcs)
• 1 errergy calwlatfons • 1 eneigy calwlatlons for heated aAditions
? 3 copiea of tree preservetion plen H lot plalted after 7l1193
required: _Yes _ No dU
f q
DATE: ?;i d' q CONSTRUCTION COST: d' % 9S
DESCRIPTION OF WORK: f?4 (1- + rto0 p
STREET ADDRESS: /m L46ez
LOT _g- BLOCK SUBD.lP.I.D. #: _
Name: v Er?2'tis
Street Address:
PROPERTY
OWNER
CONTRACTOR
ARCHITECTI
ENGINEER
ciry: st )0n K L
?hone F6o
? L d-
T SNd«
zipSS///
Phone #:
Street Address: /9T 4 L6 License #: ??, ? n
7f
City: -5,5-P State: Zip:0.
State :4f '--
Company: h dSft-?
Company:
Name:
Phone #:
Registration #:
Street Address:
City:
State:
Zip:
Sewer 8 water licensed plumber (new construction only): . Penatty applies when address change
and lot change are requested once permft is issued.
1 hereby acknowledge that I have read fhis application and sfate thet fhe information is co nd agree to comply with all applicable
Sfate of Minnesota Statutes and City of Eagan Ordinances. e??IeW?
Signature of Applicant: 411,
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
A?!'"?'^" SP?,?.j.'?
Tree Preservation Plan Received - Yes - No - Not Required
BUILDING PERMIT TYPE
OFFICE USE ONLY
0 01 Foundation ? 06 Duplex o 11 Apt./Lodging o
n 02 SF Dwelling o 07 4-plex ? 12 Multi Repair/Rem. ?
0 03 SF Addition o 08 8-plex ? 13 Garage/Accessory o
0 04 SF Porch o 09 12-plex n 14 Fireplace n
0 05 SF Misc. 0 10 _-plex o 15 Deck
WORK TYPE
0 31 New o 33 Alterations ? 36 Move
0 32 Addition o 34 Repair o 37 Demotition
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq.ft.
sq.ft.
sq. ft.
Footprint sq.ft.
Planning Building
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 Unft
Park Ded.
Trails Ded.
Other
Copies
Total: 7&, a`J
Engineering
Valuation: $
. ? •- ±? fi
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
Variance
% SAC
SAC Units
czTV oF r_arAN
CASHIEPi: ;i TF_'kt4CNAL. NO;? 66
DATE.° 06/ib/97 TIPfI=e 15:1.3:21.
ILi a
NIAMF.: C2tJAI_:fTY F'XTEftT.ORS TKIC;
3210 9001. 1069 hff:KEE: SC' 112,.25
2155 9011 1.069 PtC;I(FE S7 3.00
1'otal f•:rceip1; Amourtit? 1.15.25
Cfi07:'ti2"i'L7
USE'R IDe NANCY
? -
? C{TY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMITTYPE: QuIL°zNG
Permit Numher: 030232
Date Issued: 06j13r s 7
SITE ADDRESS:
P.T.IV.: 10 -477 5 1-1Q0-0 1
PERMIT
1of9 MCKC[ ST
1..0T: 10 ELOGK: 1
MCKEE 2PdD
DESCRIPTION:
"e„,R RESZDE
Bj?pil3a''-;, . 4'srmit 7ype
rk Typ?
e?k
.. rrv=P?.• ?h i`e. ?ry ?? K?§ S8if9P? .. l a
sr {r,zsc.}
RLI-ERATION
434 flLTa f2c57DENTIAl
AkY+ ^Y,
L3
? wi
??
$
REMARKS:
FEE SUMMARY:
o^ase ree
Surchai-ge
Totail Fee
VflLUATION
$112.2u
_ $3.00
$115.25
:t,C3,0e0
CONTRACTOR: - AGplicant - ?) ' . `1`'. oWNER:
QUALZTY EXTERTORS INC 14575710 0001887 T?EPT (JF VET'ERRNS AFfAIRS
1622 5 R013ERT LeSS MCKEE 5T
W ST PaUI. h1N 55113 EAGAN MN
(;>lz) 457-8710 (612)725--3862
L-?? . . .. ?. ? .. . ' E_ ? ?.,. ...?_... . ?. ? . ... .. .. .. .......... ...... ... ..?, ...
APPLICANT/PERMITEE SIGNATUPE
.... _. ? iS..eR'.?. ?ev.n . i s _ . _r. .u ?.?.....,.. .......... ? . reu?
/ -' -
ISSUED : IGNATURE
? ? 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) ? ? ? S^d.S
3 b a3 a CITY OF EAGAN ??
3830 PILOT KNOB RD - 55122
681-4675 lo? l3
New Constructian Renuiremems RemodeVReoair Reauircments
? 3 registered site surveys ? 2 copies M plan
• 2 coples of Dlans (inGUde beam & window atrss; poured fid. design; etc.) ? 2 site surveys (e?cteriw addkions 8 dedcs)
? 1 energy calculetions ? 1 errergy calwletions for heated adtlitions
? 3 copies of tree preaervation plan if IM platted after 7N/93
requlred: _ Yes _ No
DATE: ? " ?a ' ?? CONSTRUCTION COST: ??a
DESCRIPTION OF WORK: `\'??"'??? S? ?? n? ?-?1?+? V 1?1?.,` SI 1 nc? AI?IK'1 ? ?<?
STF3EET ADDRESS: ??OR ? ` 'Q?- S+?
?/ `?
LOT ? D BLOCK ? SUBD./P.I.D. #: '' r C Z
PROPERTY NBme: \-?P? 5? V??t aNS ????C> Phone #: ??5 -3??-
OWNER ?..+ ?.*
StreetAddress: ?a?? rn??'?e S?
Ciry: ?iGAN State: 'M? Zip: ?Stl? ,
CONTRACTOR Company: ?f ? ? ? ? ? °iS Pho? ?: Z??-
? 3f3/ 5 0?? v??
Street Address: lo'?-"? S=? 1`?c? ??? nse #'???
City: W?`? ?? State: ?1N Zip: 5? ?
ARCHITECTI Company: Phone #:
ENGINEER
Name: Registration #:
Street Address:
City: State: Zip:
Sewer 8 wacer licer.sed plumber (new construction only):
and lot change are ?Bquested once permit is issued.
Penalty appiies when address change
I hereby acknowledge that I have read this appliqtion and siate that the infortnatio and agree to compy with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Appiicant:
OFFICE USE ONLY RECEIVED
Certificetes of Survey Received _ Yes _ No JU? 1 2
i?9i
Tree Preservatlon Plan Received _ Yes _ No _ Not Required, ?w??.
"- °. --------------_
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ?
a 02 SF Dwelling o 07 4-plex o 12 Multi Repair/Rem. o
? 03 SF Addition ? 08 8-plez n 13 Garage/Accessory o
0 04 SF Porch o 09 12-plex o 14 Firepiace n
? 05 SF Misc. ? 10 _-plex o 15 Deck
WORK TYPE
0 31 New ? 33 Alterations o 36 Move
0 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft.
(Allowable) Main level sq. ft.
UBC Occupancy sq. ft.
2oning Sq, ff,
# of Stories sq, g.
Length Sq, g.
Depth Footprint sq. ft.
APPROVALS
Planning Building
Engineering
Variance
Permit Fee //C? 0?5 Valuation: $
Surcharge 3 ?
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SNV Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
16 Basement Finish
17 Swim Pool
20 Public Faciliry
21 Miscelianeous
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
% SAC
SAC Units
? ,..
•t,1I?' 1 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
cinr oF eacaro
3830 PILOT KNOB RD - 55122 ?
651-681-4875
New ConahueMon ReauiremeMa "C 0 ?? I -;'"1l
? 3 reybteretl slte wrveys Ywwiny fq. K ol 101, fq. fl. of haise G-
and pY roofed areat (20°6 mmdmum lot covemae allowa?
> 4 coPles of Plans (show beam & window slxes: Pared tnd. deaigrr efcJ
> i sat a enerov caa,ian«,s
> 3 copies ol hee presenatlon plan if IW plaMed dRer 7/1/93
DATE: t) 6 ; oZ/ 60
?? _Irb
?-f? Calltd 615j01C
Remodel/ReDair Reaulremenlt
C?-00 2 coplea of plan
1 set W energy calcWaNOns tor heated addiMOru
1 site wrvey ta exfedor addiflona & tlecks
CONSTRUCTION COST: 9 O°c' 6 <?)
m
DESCRIPTION OF WORK: GG-V'o-
STREET AD10 DRESS: (0 .S+ LOT: ? BLOCK: ? SUBD./P.I.D. #: ?..?e ?? ? t?
i :Z70-0111
Name?'? Pr?one #: 6 S(Y Os-- 3 6 6 a
??or?
PROPERTY Lost ? Flrq ?" SI ((39 - 1331.
OWNER
Sh9et Address:
Cly rlvE-fg Vr+? SMte: n/l ? Lp:
Company: Phone N: _
(area code)
CONTRACfOR
ARCHIiECT/
ENGINEER
Sheef Address:
Cffy
Sfate:
Company: Name:
Telephone M: ( )
Zip:
Sheet Addreas: ReglshaHon S:
CHy
State:
Sewer/water licensed plumber (ii inst?Ilina sewerhvaterPhone #:
ZiP:
I herebY acknowledqe that 1 have read this aPPIicatl0n. ftte lhot Ihe iMormatlon is corteet. and agree to W ith oll apPAcable Slat,
of Minnesota Statutes and Cify ol Eagan Ordlnances.
Signature ol Applicanh?
r. - -
OFFICE USE ONLY "
Certiflcates of Survey Received _ Yes - No JM Tree Preservation Plan Received _ Yes - No _ Not Required 2
license r ExP.
BUILDING PERMIT SUBTYPES
? 01 FoundaUon ? 07 OS-plex
? 02 SF Dwelling ? 08 06-plex
? 03 01 of _ plex ? 09 07-plex
? 04 02-plex ? 10 08-plex
? 05 03-plex ? 11 10-plex
? 06 04-plex ? 12 12-plex
RK TYPE
31 New
? 32 Addition
? 33 Alteration
? 34 Repair
OFFICE USE ONLY
? 13 16-plex O 21
X 17 Garage ? 22
0 18 Deck ? 23
? 19 Lower Level ? 24
Plbg _Y or_ N ? 25
? 20 Pool O 30
Porch (3-sea.)
Porch/Addn. (4sea.)
Poroh (screened)
Stortn Damage
Miscellaneous
Accessory Bldg.
? 36 Move Bldg. ? 43 Reroof
O 37 Demolish (Bidg)' ? 44 Siding
O 38 Demolish (Interior) ? 45 Fire Repair
? 42 Demolish (FoundaUon) ? 46 Windows/Doors
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code o f
No. of Units I
No. of Buildings I
Const. (Actual) 5 •?
(Allowable) 5
UBC Occupancy U - I
Zoning e,- I
# of Stories
Length
W idth
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq.ft.
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning Building
? sq. ft.
sq. ft.
32? Footprint sq. ft.'
Census Code
MGES System
City Water
Booster Pump
PRV
Fire Sprinklered
Engineering Variance
? 31 Ext Alt - Muw
? 33 Ext. AR - SF
? 36 MuIN
?
?.
i;
t
j <
}
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
a?v
Valuation: a o
SAC Units
% SAC
? .
}
.
. ,
?
I?
33? ,30' N
??O
o
y
6
8 ..
/4 v
? dy go
?
?
90 ^?, ? ? 12
e
al ?
i ?
0
?
V W
.?
;Q
,
?o
?
T !.?
•-• iiso :..
7e I 7e I 78
7e
2- o? I?O I 9 I 8?? ( 6 I S I¢ I 3 I I/ ?
I otOl !05'l (os3 (0?(9 ?o?(S ?o?( ? /03-1 1033 ?
loZ-? 1 Z3 ro?9 !0(05 l
>o >0 7A 79 78 78 8Z-
M? KEE sr ;
7s Ta 71 78 78 79 78 78 78 78
107(0 1079 l06s 10(oy 10(c0 oslo rosa roqs' l04q loc
?/o y 8 7 6 S g 3 2 /
.
e7o'as'
]B 8. 78 78 78 18 78 79 e 7B
/0
? . . ?f . ... . . .' .' ... ?.
0
m
?
r
?
s
o ,
A .
` .,
i•?.
'LdOGfi
fq0
V--ou?-?.d
, ,.
ao??
? ?-oa.B
?f g n?-X
x
2? ° y 8
aS
a U
E:
,
.
?
?
I I
?
? ?xg.l-4a.?se
IMc, K ?e s-?"
D
\?
Lv Hi ze :1U,I'-! 0
L ?U gL ? CITY USE ONLY
?? r%
SUBO. r9,42, -d
RECEIPT#: 7 ?507a
RECEIPTDATE: S-x, ?C>(C
PERMIT # G? D _yj 2000 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PIIAT KNOH RD
EAGAN, tMI 55122
651-681-6675
Please complete for: ? single family dwellings
? townhomes and condos when pertnits are required for each unit
? backflow preventer for underground sprinkler system
PIXTURES
EACH #
TOTAL
Alterations to existing dwelling - minimum f?e $ 30.00
Describe: lcloc?.1-e. I.G?? S?w4 = ORb..?asbae
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
Gas piping outlet ' minimum - t 3.00 x = $
Hot tub/spa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tray 3.00 x = $
Lavatory 3.00 x = $
Septic S stem new/refurbished • requires MPC lic. 75.00 x = $
Septic System aeandonment 30.00 x = $
RpZ new installationlrepaidrebuild 30.00 x = $
Rough opening 1.50 x = $
Shower 3.00 x = $
Underground sprinkler if dwelling is under constructian 3.00 x = $
Under round sprinkler if existing dwelling 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
Water softener If dwalling under construction 5.00 x = $
Water softener if existing tlwelling 30.00 X = $
Water tumaround 30.00 x
State Surcharge .50 -> -> -> $ .50
Total -> -> _-> -> $ ?0, S
Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc.
I hereby aGcnowledge that I have reed this application, state tha[ the information is correct, snd agree to compty with all applicable City of Eagan ordinances.
It is the applicanPs responsibility to notify the property owner that the City of Eagan assumes na liability for any damages caused by the City during its
normal operational and maintenance activities to the facilities construded under this pertnit within City property/rightof-wayleasement.
SITE ADDRESS: 4
(
OWNER NAME: : ?ok nJG 4. 4Ae1W-T?e I<at,TELEPHONE #: (AREn CooE)
4
INSTALLER NAME: TELEPHONE
?/ (AREA CODE)
STREETADDRESS: 37Sl? kNal?( I2r6L e ??/Z
CITY: ?fa STATE: ?ii? -- ZIP: Js722-
L=---?
SIGNATURE OF PERMITTEE
't /ass.'F ?
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) r
L/ / O S7 ?j CITY OF EACAN
3830 PILOT KNOB RD - 35122
651-881-4875
r C7
New CanshueNOn Reaulremenh ? JRemotlel/Reoalr ReaiiremeMs
> S reglsroreC sIte wrveya ahowing sq. ft of bl, aq. lt. of house
and ?Ij roofed Oreas (?10%6 mmdMUm bf coveraae albwed)
> 2 copies a piaa (slww bewn a wlndow slzes; pourea md aeAgn: etc.)
> 1 aet of energy calculatlons
> J eoplea al hee P senaflon pian H lot plaMed arter 7/1193
DATE: ? ?
DESCRIPTION OF ORK:
STREET ADDRESS:
LOT: "C)
30 tvlC.
.<? zO °rt:)
BLOCK: . SUBD./P.I.D.#: /? ki& 2
Name Phone #: ?? ? Z )
PROPERTY last
OWNER ?7 ,(?
Sheet Address: ?d G / / "?G ?
city sra?e: zp: z. /
Company: Phone A: flq`SZ
(area code)
COPRRACTOR Sheet Address: -Bv X 2-46'744' Ilcense # EXP•
Clfy ArPL2?-:- V.1-c.?EY State: M/i Zip: ?Sl Z 1{'
ARCHITECT/
ENGINEER Company: No^ne:
Telephone M: ( )
Sheet Address: RegbNa„O^ 411' -
city Sfate: ZIP:
Sewerlwater licensed plumber (If lnstaitirka sewer/watarPhone #: (
I herebY ackno'Med9e Ihat I have read Mis applicaNon, stafe ttwllhe infomwlbn is corred. and agree to
of Minneaota Stafutes and Cly of Eagan Ordinances. ?
Signature of Ap Iicant:
Certiflcates of Survey Received _ Yes
Tree Preservation Plan Received -
OFF)CE USE ONLY
/
? No
Yes - No
2 coples of Olan
1 fet of energy cdculaMons for heated additlons
1 sife wrvey tor exfeAOr addlHOns A decks
CON5fRUCTION COST:
lq-
J Not Required
a0
24
StafE
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 21 Poroh (3-sea.)
0 02 SF Dwelling ? OS 06-piex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 03 01 of _ plex ? 09 07-piex ? 18 Deck ? 23 Porch (sc2ened)
? 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24
' Storm Damage
? 05 03-plex ? 11 70-plex Plbg _Yor_N ;?( 25 Miscellaneous
? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bidg.
WORK TYPE
? 31 New ? 36 Move Bidg. ? 43 Reroof
? 32 Addition ? 37 Demolish (Bldg)" ? 44 Siding
? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair
)3?, 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors
` Give PCA handout to applicant for demolition permit
GENERAL INFORMATiON
SAC Code o ?
No. of Units v
No. of Buildings I
Const. (Actual)
(Allowable)
# of Stories
Length
Width
Basement sq. ft.
Main level sq. ft.
sq.ft.
sq. ft.
sq. ft.
sq.ft.
Footprint sq. ft.
Census Code
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
UBC Occupancy
Zoning
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning Building ? Engineering
Variance
? 31 Ecc. nu - nnuni
? 33 Ext. Alt - SF
? 36 MulB
y3v
Permit Fee
Surcharge
Plan Review
l.icense
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $ 6NFoLo
SAC Units
% SAC
CITY USE ONLY D ?
L ?_ BL ? RECEIPT #:
SUB6?/? ?- ??? DATE:
?'ag5?o ? 7?9/9G
?. ? 1996 MECHANICAL PERMIT (RESIDENTIAL)
L9/1L? CITY OF EAGAN
4?.v o? 3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 687-4675
Ptease complete for: • single family dwellings
? townhomes and condos when permits are required for each unit
New construction ?-- Add-on fumace
? Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc.
Date: J u.e1'-e (a 1 199(v
??_ 4*1
? Minimum Fee: Add-on/Remodel (existing residence only) $20.00
? HVAC: 0-100 M BTU
Additional 50 M BTU
? Gas Outlets (minimum of 1 required cQ $3.00 each)
? State Surcharge
70TAL
SITE
OWNER
24.00
6.00
.5D
?•?
PHONE #: -?>f-??7'2`
INSTALLER NAME• w v v rk v -
STREET ADDRESS: N. E -
cinr: STATE: ZIP:
PHONE #: ( ??Z) fI 9 3
' c?1i 9s.1Qi
CITY USE ONLY
L BL _ RECEIPT #:
SUBD. DATE:
?l
1996 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 687-4675
Please complete for: ? all commerciaVindustrial buildings.
? multi-family buildings when separate permits are = required
for each dwelling unit.
Dr1 ii?: C:'vid-i'KF+G 1
WORK TYPE: NEW CONSTRUCTION
DESCRIPTION OF WORK:
INTERIOR IMPROVEMENT
FEES: P $25.00 minimum fee Dt 1% of conVact price, whichever is greater.
? Processed piping - $25.00
? State surcharge of $.50 per $1,000 oiReana fee due on all permits.
CONTRACT PRICE x 1%
PROCESSED PIPING
STATE SURCHARGE
TOTAL
51 I`E ACJDF2t55:
OWNER NAME:
TELEPHONE #:
TENANT NAME: (IMPROVEMENTS ONLI)
INSTALLER:
ADDRESS:
CITY: STATE: ZIP:
- PHONE #:
SIGNATURE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
EAGElIQ TOWNSHIP
3795 Pilot Rnob Road
St, Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SE4JER SERVICB CONNECTION
DATE• Oct. 18, 1967
OWNER: Leonold Van Dsek
PIdIMBER Genz & $Yan, Rosemount
NOMBER ?7-?
Address 1069 Mckee St.
TYPE OF PIPE G I- ?
DESCRIPTION OF BUILDING
Industriall Commerciall Reaidential I Multiple Dwelling I No. of uniCs
LocaCion of ConnecCiona:
•_5 A ?
Connection Charge $200.00 ?
Permit Fee
Street Repairs
Total
Inspected by:
Date
?? Remarks• G? (L
N
sy
Cltief Ir.speceor
In cnn^;9eration of the issue aad delivery to me of the above pex'-nit, I
hereby agrAe to do the prnncsed wor'c in accordanre !cith the rules ar:3
regulations of Eagan Torinship, Dakota 2Coy, T?innecBy?
77
P.lersn :^or.i.iy when ready for inspectioa end cor.ne,cti.en axul before an.7 pCr*_t.ca
os L'n•? erorl: is covered.
.
10??
EAGAN TOWi1SHIP
3795 Pi1ot Knob Road
St. Paul, t+iinnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
Date: Oct. 18. 1967
Billing Name: Leopold Van Dvck
Ow:ter• (above)
Plumber: Genz & R,vany Rosemount, Minn.
Number• ?v
Site Address: 1069 NcKee St.
Billing Addresa (2bove)_ _
Size
36? 3?fs
I u// t
Meter No. I Permit Fee 'L?a 1`l?h
Meter Reading (Meter Dep. 15.00
Metar Sealed: Yea_ lAdd'1 Chg.
NO I Total Chg.
Inspected
fol Date / Z)
Building ie a:
Residence
Multiple rto. Uaita,
Commercial
Ir.dustrial
Oeher
Remarke: (? /
BY: Chief InspecCOr
In consideration of the 3ssue and delivery to me of the above pereit, I
hereby agree to do tte prorosed work in accordance with the rules and
regulations of Eagan Township, Dakota Coua p, Minnesot
Bl*? V'
na "o1ib'
Please notify the above office when resdy #or inspectioa and connection.
MASTER CARD
LOCATION
?-
OWNER
STRUCTURE AND r I
LAND USED AS 2 y/ 'A ?j 1/
Permit
No.
Issued Issued To
Coniractor Owner
BUILDING 28yy 9•?B'2j ,SiC?F
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRIGAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER I
OTHER I
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING
? SEPTIC
FOUNDATION o
CESSPOOL
FRAMING ' TILE FIELD FT.
FINAL
ELECTRICAL
HEATING DEPTH
OF WELL
GAS INSTALIATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
-- Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO 8E USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO.
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
? ACCEPTABLE SU85TITUTIONS OR
DEVIATIONS.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZFD AND DESCRIBED AS
OF INSPECTION
NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
? REIHSPECTION REQUIRED DATE OF REINSPECTION
REINSPECTION REVEALED
CE RTI FI CATION - I certify that I have carefully inspected the above in which I have no interest present or prospective, and that 1 have reported herein
all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any sDecific require-
ments for off-site imprwements relating to the property inspected.
F-I ALL IMPROVEMENTS ACCEPTABLY COMPLETED
NG INSPECTOR OATE
?? rs a
WELL PERMIT
?-y`?
Permit No.
_ 92-9033
AKOTA COUNTY ENVIItONMENTAL MANAGEMENT DEPARTMENT
WATER AND LAND D'IANAGEMENT SECTION
11955 CaLrie Avmue, Apple V?iley, RIlV 5SI14
1'dep6oce(613) 891-7011
WSEREAB, the NON-TRANSFERABLE
PERMITTEE/DBA: Maher Well Drilling, Inc. I88IIED TO #19301
ADDRE88: 17530 Red Wing Blvd REVIEWED BY BW
Hastings, MN 55033
has submitted a permit application, has paid the sum of one hundred and
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(s) described herein:
An abandoned well with a casing diameter of 4 inches, depth of 140 feet
and completed in the drift 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 grade.
The well is located in the municipality of Eagan as follows:
Well Location: Proparty owner and Wall Owner and
Address (if different) Addresa (if diffeient)
1069 McKee St. Don Koch
Eagan, MN
NOA, THEREFORE, Maher Well Drilling is.hereby permitted and authorized
to permanently seal the well described and located above for the period
February 1992 to February 1993 subject to all provisions of said
Ordinance, the Minnesota Water Well Construction Code and any
conditions attached on the reverse side of this permit form.
Given under my hand this 25th day of February, 1992.
C?(/ p, Q i,
Ordiunm No. 114:
WELL AND WATER SUPPLY MANAGEMENT
" ??z ATTEST 4 ? r
ENVIROIIMENTAL SUPE ISOR ENVIRONME MANAGEMENT DIRECTOR
,WKL
L e o,por-6 V il" byl:?r ?'
/ i ? °f ? I C c.?.r i -
Sr fig rJ ( , ! M 6-a?1? ?
#5`Y° 3-8/7
02
0
?
?
?
?r
?
?
'27 a&?'y
?
104 ? /?c-? Pt? F. S T:
2004 RESIDENTIAL BUII.DING PERNIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWqion Reauimments RemodeVReoair Reauirements
3 registe2d site surveys showing sq. R W lot, sq. ft of house; and all rooted areas 2 copiw of plan
(20% mazimum lot cover.ge allowed) 1 set of Energy Cakula6ons for heated additions
2 coples of phan showing beam & wlndow sizes; poured found design, etc. 1 site survey for additions & decla
1 set of Energy Cakula6ons Add'dion - indicate Bonsite sepUc sysfem
3 mpies of Tree Presenratlon Plan if lot platled afler 711193
Rim Joist Detail Options seledion sheet (bldgs wilh 3 w less unifs
A `-?o.as
`?r"'t"R-8fi?y??"°"?
jy! t}?,.?: ?
§FIl?BVfE&t?Qll??
Date?_! /.Qq ConstrucHonCost
Site Address )069 /1?C j( F -37- UniUSte #
N
Description of Work kL (t7,tA
J r?,eL F/.v/ C Lf
r
, ?
-
Multi-Family Bldg _ Y _411V Fireplace(s) _ 0_ 1 !??
?y? 5-a - -
Proper[yOwner FQ/?,Ur[5?,, ?%0AA.<L Telephone#(CaS?)
Contractor
Address City
State Zip Telephone # ( )
3?{
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Tvlinnesoh Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category . Residential Ventilafion Category 1 Wwksheet • New Energy Code Workshest
(J submission type) Submitted I Submitted
_ • Energy Envelopa Calculations Submitted
Have you previously constructed a building in Eogan with a similar plan? _ Y _ N If so, 25% plan review
fee applies. Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone # (
Telephone # (
I hereby apply for a Residential Building Permit and aclrnowledge 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 i ' hout a
permit; that the work will be in accordance with the approved plan in the case of w ?iq w and
appmval of plans.
JUN 1 0 2004
rnw vcrn 104aSxtz
%
%
ApplicanYs Printed Name plicanYs Signature By
OFFICE USE ONLY
Sub Types
? 01 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 O 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ?
18 Deck ? 23 Porch (screen/gazebo) ? 38 Multi Misc.
? 05 03-plex ? 11 10-plex ?
(d"/ 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex PlbgyY or_ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
J? 32 Addition O 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
m 33 Afterafion ? 37 Demolish Building" 0 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolitlon (Entire Bldg) - Give PCA handout to applicant
Valuation J Occu anc
p y
MCES System
Census Code Zoning ? City Water
SAC Units -? Stories Booster Pump
# of Units v Sq. Ft. PRV
# oF Bldgs ? Length Fire Sprinklered
Type of Const ? Width
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
_ Foundation
_ Drain Tile
Aoof Ice & Water Final
Framing
Fireplace _ R.I. _ Air Test _ Final
4F, Insulation
REQUIRED INSPECTIONS
FinaUC.O.
2 FinaUNo C.O.
2r' Plumbing
? HVAC
Other
_ Pool Ftgs _ Air/Gas Tesu Final
_ Siding _ Stucco _ Stone _ Brick
_ Windows
_ Retaining Wall
Approved By: --:?P
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
- a5?
41,1/1°
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
APR 222016
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: OW- 2 -2v/6 Site Address: /O6% 667 Sr "-II )9A) t'7,A) Unit#:
.:."
Name: FRA•vc/SC, A, 19LUlirv7 Phone: 6 p - 806 a Sl S6.
Address / City / Zip: ',
Applicant is: Owner Contractor
t t 1 )
a Of X111 $..
Description of work: fi r z7/a.) &07/,/,'V C N/GU,c/ l/ 06
61
r l2,4i4)z ,9( L. 0 "Leat, /OS F rrb Alouux
Construction Cost: /cm, — Multi -Family Building: (Yes / No )
c�ntr:• c
q x%`
Company: O6c)/1 . Contact:
Address: City:
State: Zip: Phone: Email:
License #: Lead Certificate #:
If the project is exempt from lead certification, please explain why:
ALT /a /14iy i -it co v ; ,1/`,rvr(� oLi i. \6'-7
In the last 12 months,
Yes No
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
If yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Fire Suppression Contractor:
Phone:
Phone:
Phone:
Phone:
NOTE: Plans and s f' o w ®@ �� e e e li ii a +n w
hat ou ubmlt ar a driso
the information m P ° assrfled . ; ®ubl is f rove ® cl tc e s g hat would permit tine City o
... de"tha` t ey ar
x,�� .� ....:. � Win° >x. •... t " . p��..0 .:., .,.k.• � .. • r �. , ..
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.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x 4•i.IC/CCc /iLU/yir
Applicant's Printed Name
..400.62 Zr-a9-ez
mantes Signature
Page 1 of 3
SUB TYPES
Foundation
- Single Family
Multi
01 of _ Plex
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100% ✓ )
Census Code
# of Units
# of Buildings
Type of Construction
DO NOT WRITE BELOW THIS LINE
Fireplace
Garage
Deck
Lower Level
Interior Improvement
Move Building
Fire Repair
Repair
oce 91-
y3Y
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Roof: I' Ice & Water le Final
Framing 30 Minutes 1 Hour
Fireplace: _Rough In Air Test
Insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
Shower Pan
►/� C-�- ,
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Final
Siding
Reroof
Windows
Egress Window
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building - give PCA handout to applicant
2fte.- / MCES System
zp/y SAC Units
/ ../
City Water
Booster Pump
PRV
Fire Suppression Required
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC _ Gas Service Test Gas Line Air Test
Pool: Footings Air/Gas Tests Final
Drain Tile
Siding: Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall: _ Footings _ Backfill Final
Radon Control
Fire Suppression: _Rough In Final
Erosion Control
Other:
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Ilan Review
MCES SAC
City SAC
(Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
73 3
til
Page 2 of 3