3960 Mica Tr
Use BLUE or BLACK ink
f or Offic* Use
Eap Pemm;r. D 4 Sal 4lo
Ul 0 1. Permit Fee: s~r I
3830 pilot Knob Road AU6 8 I I
Eagan MN 55922 i t d'-11~
Phone: (651) 675-5675 i Date Received:
Fax: (659) 675.5694 I Statf: ML
2010 MECHANICAL PERMIT APPLICATION
Date• Site Tenant: Suite o.
z_
RESIDENT I OWNER Name: Phone: 7
Address / city I ip:
CONTRACTOR Name: ace $1~~„~
Address: Cityr
State: ~ ~ Zip: Phone: L;
C~ F t:
Contact
TYPE OF WORK New Repiaosment Additional Alteration Demolition
Deacripdon of work: AC`q-,~f-o(
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.
Fug SID&NTIAL New Construction COMMERCIAL
PERMIT TYPE interior improvement
_ _ ,Air Conditioner Install Piping Processed
Air E hajnger Gas Exterior-HVACUnit
Heat Puns, p Under I Above ground Wank Install f Remove)
Otlter "When k""w ghemoving tank(s), call for Inspection by Fire
Mar" and Plum ' i
RESIDENTIAL FEES;
$55.00 M ni imUM Add-on or alteration to an existing unit (includes $5.00 State Surcharge)
$95.00 Fire repair (replace burned otd appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ vV TOTAL FEE
CO MMERCIAL FEES:
$75.00 Underground tank instailationtiemoval OR Contract value $ x1%
$55.00 Minlinga (includes State Surcharge)
$ Permit Fee
- If the PaW Eft is IQ" than $10.010. surcharge is $ 5.00
- if the Permit Egg is > $10010, surcharge incr6sses by $.5o for each $1,000 Pemat Fee $ Surcharge
(to. a $10,010411,010 Permit fee reqtdreea a S 5.50 surcharge)
$ TOTAL FEE
g" BEFOF XW M Call GopMr Stab One Cal at (661) e5e-0002 for praawftn against underground ud tin darpage. Call 48 hours
before you Intend to dig to receive Weates of underground Willdw www_ aooherstateonecall.ora
I hereby acknowledge that this Wwmadon 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 wok will be in accordance
with aPpr~ed plan in the case of wok which requires a review and approval of plans.
x x
Applicant's Printed Name Applicant's f
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough In Air Test _Gas Service Test -In-flour Heat Final
Exterior HVAC Screening Inspection
CITY OF EAGAN Remarka * Ceddr GZ'ove Acc7uf181t1Qn _ (LKAA/l -
Lot 11 Rik lA Parce110 16704 110 10
Mica Trail s,te Eaqan• MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1967 . 0
SEWER LATERAL 1967
WATERMAIN
? WATER LATERAL 972 607.00 .28 25
WATER AREA
STORM 5EW TRK 23 1974 70.00 4.66 5
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
sAC 200.00 716 4-9468
PARK
INSPECTION REC4RD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS:
1 r, ? i ? Rc, r?t b
39t - 0 M t 1:F9
f.F(lrll: t.aRtiV#. 46
APPLICANT:
, • . ?i? 1 . ? . ?+i i 1 ??
( tr ? ?' ) t{c'.: •S:??$!-.
I 77771
;
PERMIT SUBTYPE: . TYPE OF WORK:
I !'ATK
Itll(}f 114(i)
Pertntt No. Permit Hoider Date Talephone #
ELECTRIC
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAINING
RQOFING ,
w
ROUGH
PLUMBING
A "-
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUI
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TES7
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FINA!
?
, j .
,
CiTY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS: , ,, i
PERMIT SUBTYPE:
INSPECTION RECORD
PERMIT TYPE:
Permit Number:
Date Issued;
? I fi 1- F„- r; APPLICANT:
TYPE OF WORK:
11: . , I I I i ?+;f
„ .,
? r
i I I r
t ?i i I iI
I-iJ Nl11jlJ (df ('I AI ( Mf lV f l
INSPECTION DA • D•
?
?
Permit No. Permit Holder Date Tetephone #
S/W
PLUMBING
HVAC
ELECTRIC
ELECTRfC
Inspectlon Date Insp. Comments
Footings t
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Orsat Test
Final Plbg. Plbg. lrtspector - Notify Plumber
Const. Meter !
Engr./Pian
Bidg. Final
Deck Ftg.
Deck Final
Well
Pr. Disp.
EAGAN TOWNSHIP
BUILDING PERMIT
o..ne: ...--.C.:Lc?-e!c------ - 11!? ..-r-s----/.?.. _....?c?:. _...C?.9.--:...-
Address (Pzesen!) -.;?--....:?..'_-Il..?.'.'.`.:?'?.-_.f.i_'t?"'.'+.-' .
Suilder ..............................................................
Address ........_ ........................---.......------_....----°------`---- -
N° i'751
Eaqan Township
Town Hall
Dale ......... ILd .................-..
DESCRIPTION
Stories Ta Be Used For Fron1 Depih Height Esl. Cosf permit Fee Remarks
or
LOCATION
IAl b-c . s'
1'his pezmii does not aulhorise the use of sixeeis, roads, alleys or eidewelks nor does i2 give !he owner or his aganf
the righf !o create any sifuation which is a nuisanee or which preseafs a hazard fo the health, safefy, convenience and
general welfare So anpone in the community.
THI3 pERMIT MUST BE?y KEPT ON THE PREMISE WHILE THE WOAK IS IN PAOGRESS.
Thls is !o cerrifp, lhaf..Li....2.:.....L.?![r??r..?rr..-__ ..................... haspermission !o erecf a----- lx........... -' ?'--""-'- - "
. ?-?- u
.""'._ Pon
the above described premisa subject fo the provisions of the Buildinq Ordinance for Eaqahip adopfed Apri1 11,
1955.
Q, /fg
.............. ?.fj!?..._ _t/?- !:--_........... ..........._---... Per ..................1K.c! u....._.............
/
...... hairman of Tnwn Board Building Impeclor
4' B
' - CITY of EAGAN
BUILDING PERMIT
DESCAIPTION
. ..
N2 3318
3795 PiloY Kaab Road
Eagan, Minnesota 56122
454-B100
Date ....
?.°....... . ?.?}.-.7.?l.? ...............
6losiee To Be Uead For Fron! Deplh Heigh! Est. Coe! Permt! Fea Aemuks
,?,,,..
cl ?76 () V'V
??
.
y j, Su a.,?
- Slsaet. Aoad or olher Deaeripilon ai Locafioa I Lo! I 81ock I Atld[fion or Treet
t'% I tv I C' l-s. =P ___?i
1'his parmii does not aufhotize the use of slreels, zoads, alleys or sidewalks nos doec it give the ownes or hia agea!
the sigh!!o creale anp silvaiion whieh is a nuisanea ox whieh presenis a hasard !o the 6ealfh, aafe2y, conveoienes aad
ganeral welfare to anpone in the commu»itp.
THIS PERMIT MUST BE EPT ON THEC-6PREMISE WHILE THE WORK IS IN PROGRESS.
Th[s Ia !o eeriifp. 1hal--.. .................... ............... hea permissioa !o ereei a........ ?•----•c-----?-.-.- ?..? ............................ _upon
the above described premise subject fo the provisioas of all applicable Ordinances fos ihe iiy o' f£ g?an .......... .................... 27.:.t. ---- (Z-A:G c Per ?..-et ?f?c._..r'?"'-'
-
."---...-- ---'-'--.......... ......................................................................................................
MaYor -6 Bullding Tmgeclor
?
0? RESIDENTIAL
???j BUILDING PERMIT APPLICATION
cirv oF Eacnro
3830 PILOT KNOB RD, EAGAN MN 55122
651-881-4675
? 13 `1 ?
New Canstruction Reuulrements
• 3 registered sRe surveys showing sq. ft. o( lot sq. H. of house; and ail mo(ed areas
(20°k maximum bt croverage ailowed)
. 2 wpies of plan showing beam 8 window sizes; poured found design, etc.)
• 1 set of Energy Calculations
• 3 copies of Tree Preservallon Plan rf lot platted afler 711193
• Rim Joist Oetail Options seleclion sheet (bldqs wilh 3 ar less units)
DATE VD-?L16' C)'t--
SITE ADC
TYPE OF
RemodeVReoair Reaulrements
• 2 copies o( plan
. 1 sel of Eneryy Caiculations far heated additions
. i site survey (or ezteAor addilions 8 decks
. Indicate if home serred by septic system for additions
VALUATION 4g-+I • 2-`4
APPLICANT Catastrophe Restoration Se?vices Inc
STREETADDRESS 2489 Rice St Suite 70 CITY RosBVille STATE-MZIP55113
TELEPHONE # 651-734-9433 CELL PHONE #
PROPERTY
,ULTI-FAMILY BLDG _Y V-N
FIREPLACE(S) a?0 _ 1 _ 2
FAX #?'j=51-dR3-M19
TELEPHONE#
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESO'1'A RULES 7670 CATEGORY I MINNESOTA RULFS 7672
(V submission type) • Residential Ventilation Category 1 Workshee[ Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Piumbing Contractor: __
Plumbing system includes:
Mechanical Contractor:
Mechanical system includes:
Sewer/Water Contractor:
Water Softener _
Waler Heater _
No. oF Baths
Air Conditioning
Heat Recovery Systein
Phone #
Fce: $90.00
Fee: 570.00
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicabie State of Minnesota Statutes and City of Eaqan Ordinanc'.Qs.
Signature of
OFFICE USE ONLY
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
Phone #
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
OFFICE USE ONLY
O Ot Foundatlon ? 07 05-plex ? 13 18-plex ? 20 Pool O 30 Accessory Bldg ?
? 02 SF Dwelling ? 08 06-plex ? 76 Fireplace ? 27 Porch (3-sea.) ? 31 Ext. Alt- Multi
? 03 Otof_plex ? 09 07-plex ? 17 Garaga 0 22 PorchlAddn.(4-seaJ ? 33 Ext.Ait - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 MuIU
? 05 03-plex ? 11 10-plex O 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New O 35 Int Improvement O 38 Oemolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. 0 42 Demolish (Foundation) O 45 Fire Repair
? 33 Akaration ? 37 Demolish (Bldg)" ? 43 Reroof O 46 WindowslDoors '
? 34 Replacement •Demolitlon (Entire Bldg only) • Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning Ciry Water I
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. af Bldgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ FinallNo C.O.
_ Footings (addition) _ Plumbing
Foundadon
-
HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tesu _ Final
_ Franilng _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Fiual _ Windows (new/replacement)
_ Insulation _ Retaining Wall
---
---- Approved By , Building Inspector !
-__--------
-
Base Fee - ----- ---????__
---
-----_----_______?????
Surcharge
Plan Review ?
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit f
Mechanical Permit
License Search
Copies ,
Other ,
Total ?
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITEADDRESS: LpTe
3960 MICA TR
CEDAR GROVE 5TH
PERMIT SUBTYPE:
SF (MISC.)
INSPECTION RECORD
PERMITTYPE: euzLorrvc
Permit Number: 0 2 4 9 5 4
Date Issued: 12 / 13 / 9 4
11 B L 0 C K: 10 APPLICANT:
TWIN CITY STORM SASH CO
(612) 546-8160
TYPE OF WORK:
REPAIR
DESCRIPTION (WTNDOW REPLACEMEN7)
INSPECTION
FRAMINB D. .
ROUGH IN PLBG ..
ROUGH IN HTG FINAL
F-
L
?
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT TYPE:
Permit Numher:
Date Issued:
C?3`4(01
BUILDING
024954
12/13/94
SITE ADDRESS:
P.I.N.: 10-16704-110-10
i..,, (WINDOW
B,yilding' Permit Type
Building 0it*rk Type
0
?
?
f
?
?
/ ..r
DESCRIPTION:
REPLACEMENT)
SF (MISC.)
REPAIR
Ffl??
REMARKS:
FEE SUMMARY:
Base Fse
Swrcharge
Total Fee
FERMIT
3960 MICA TR
LOT: 11 BLOCK: 10
CEDAR GROVE 6TH
VALUATTON
$106.00
$4.50
$112.50
$9,000
CONTRACTOR: - Applinant - sT. Lzc. pWNER:
TWIN CITY STORM SASH CO 15468160 20020888 LARSON WAYNE
10825 GREENBRIER RO 3960 MICA TR
MINNETONKA MN 55305 EAGAN MN 55122
(612) 546-8160 (612)452-1091
T hereby acknowlsdge that X have read this
inforroatian is correct anzi agrae to comply
5Catutes ansY Eity nf Eagan Qrdinances.
APPLICANT/PEFIMITEE SIGNATURE
applicat3an arrd state that t'he
with a11 appZicable 5tate trf Mne
I
'?ssu oev?s$"u-?"E i-'-?-
?4 "4
CITY OF EAGAN
1994 BUILDING PERMIT APPLICATION
681-4675
?!o cf3 ?
4111.zo
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
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 q Valuation of work e6) 4• oo
Site Address: ?IG'Fl L
STREET SUITE 0
Tenant Name: (commercial only)
IAT BIACK ? SUBD. n'Vu
1?i7? .J P.I.D. #
Descri tion of work: ReYI70l,6 e I -'`T [A//l1//,)0Z1.'S
The applicant is: ? Owner 2r-Contractor ? Other (Describe)
Name ??.50 { Lfh/,V1? Phone
Property LnST FIRST
Owner Address i'Y1/L'8
STREET STE M
City _GQ,GI?/Z State Zip ?Sl ?2-
Company Phone
Contractor iion nc.
Address License #avQ?'ag?? Exp..?-3/• 5
:.;.os
Cit; Stat2 Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water p`ermits is two days once area has been approved.
I hereby cknowledge that I have read this application and state that the information is
correct d agree to comply ith all applicahle State of Minnesota Statutes and City of
c?n Ord nances.
Ff ?
Signature of Applicant:
OFFICE U5E ONLY
BUILDING PERMIT TYPE
? 01 foundation ? 06 Duplex ? 11 Apt./Lodging
O 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc.
? 03 5F Addition ? 08 8-Plex O 13 Garage/Accessory
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace
? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck
WORK TYPE
? 31 New ? 33 Alterations ? 35 Tenant Finish
? 32 Addition ? 34 Repair p 36 Move
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Oepth
APPROVALS
Planning
Engineering
REQUIRED INSPECTIONS
? Site
? Wallboard
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
? Final
? Framing
? Draintile
? Insulation
? Fireplace
Permit Fee
Surcharge
Nian Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
vstmc;p,:
?
?sA
? 16 Basement Finisfi
? 17 Swim Pool
? 18 Comm./Ind.
? 19 Camm./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
SAC %
SAC Units
CLAIM VOUCHER - REFUND REQUEST
CITY OF EAGAN
MAKE CHECK PAYABLE TO : TCSS ACQUISITION INC
ADDRESS : 10825 GREENBRIER RD
MINNETONKA MN 55305
1030 SAVANNAH RD .
LOCATION 3960 MICA TR
HECEIPT #/ DATE CR 34952/DEC 13, 1994
REASON FOR REFUND ovExrnnMENr
TYPE OF REFUND ELECTRICAL PERMIT
PLUMBING PERMIT
MECHANICAL PERMIT
SURCHARGE
WATER CONNECTION PERMIT
5211-9001 $
8212-9001 $
9213-9001 $
2155-9001 $
3713-9220 $
SEWER CONNECTION PERMIT 3743-9220 $
ACCOUNT DEPOSIT 2252-9220 $
UTILITY ACCT OVER-PAYMENT 2250-9220 $
CURB BOX DEPOSIT REFUND 2253-9220 $
CONSTFtUCTION METEF DEP REFUND 2254-9220 $
WATER USAGE CHARGE 8711-9220 $
OTHER: SUILDING PERMIT 3210-9001 $ 15.75
$
I declare under the penalties of law that this account, claim or demand is just and
that no part of it has been paid.
Rl.15h7?1?^1-.. J?q i;?r?1 12/13/94
Signature` JP-13 -?y Date
C???
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
BUILOING
029@95
10/22/96
SITE ADDRESS:
P.I.N.: 10-16704-110--10
DESCRIPTION:
3960 MICA TR
LOT: 11 BLOCKs 10
CEDAR GROVE #5
(RQOFIN6)
rmit Type SF (MISC.)
1-.,?k Type REPFlIR
??_•"'?a 434 ALT. RESIpENTIAL
F4
? ' ?"i? ' ,?? R ??
%?? . ?.V ?3! ? ? ?`? Y1
REMARKS:
FEE SUMMARY:
VALUATION
Base Fee
Surcharge
Totel Fee
$87.25
$2.00
$89.25
$4,000
CONTRACTOR: - Applicant - sT. LTC OWNER:
SELA ROOFTNG & REMODELING 18238046 0001050 LARSON WAYNE
4100 EXCELSIOR BLVD 3960 MICA TR
5.7 LOUIS PARK MN 55416 EA6AN MN 55722
(612) 823-8046 (612)452-1091
.. .. __. ,. 4 , . o x.
z hereki+? acK,rv;aw1 edz??e `?hat `? h?v?? ?^aazl ¢?h?.? ?isipl3cat?ian antl' ?tat-e kWe4t. ttre
infarmatio-n ,'s ocr'rr,`.?ct ^??1'cJ ?gr??}? tt?; ?g`m?t?.y kC?.'?17 ak3,rt ?pp='licah?? ,S_??Ce'af mYt. '
? StatuL'es and_ t 3?y ts= 4'a??s?a C??d3c?artr?0,?
6 a$y^ Y
? ?? _ ???n ?.??
APPLICAMlPEflMITEE SIGNATURE I SUED B SIGT'tAT p
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
? ? 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
46 681-4675
RemodeVReoair Reouirements
? 3 registered site surveys ? 2 capies of plen
? 2 copies of plans (indude beam 8 window sites; poured fid. design; etc.) ? 2 stte surveys (exterior additions 8 decks)
? 7 energy calculations ? 1 energy celeulations Mr heeted additions
? 3 copies of tree preaenatbn pisn H bl pletled after 7N/93
requked: _ Yea _ No
DATE: ?D-z-Z . ?? CONSTRUCTION COST:
DESCRIPTION OF WORK: T Ce72, -??-
STREET ADDRESS: 3(766 IV16'9" % 29-1G-
LOT I I_ BLOCK 1.0 SUBD./P.I.D. #: CZJ/)n/ ?Iln19L??
PROPERTY Name: Phone #:
OWNER
Street Address, 317 46 ?/4-1 7-r-41
City: rA6 04J State: /11 'V4) Zip: _r-S-l 2 Z-
CoN7RAC7oR Company: ' Phone #:
5treet Address: c-r i 4100 EXCELSIOR BLVD.
CnTn a?a,a
nuic anaK M
, ItiNF
icense #
•
ID# 0001050
City; State: Zip'
ARCHITECTI Company: Phone #-
ENGINEER
Name: Registration #'
Street Address•
Ciry: State: Zip:
Sewer & water licensed plumber:
change are requested once permit is issued.
Penaliy appiies when address change and lot
1 hereby acknowledge that I have read this applicafion and state that the information is corcect and agree to comply with all
applicabie State of Minnesota Statutes and City of Eagan Ordinances.
Signature ot Applicant:
OFFICE USE ONLY
Certificates of Survey Received
_ Yes No
-??-?
Tree Preservation Plan Received Yes No
BUILDING PERMIT TYPE
OFFICE USE ONLY
? ?.
C?
V
Ra y
?? #. ?4•' ? ?9+??
? 01 Foundation o 06 Duplex ? 11 Apt./Lodging o 16 Basement Finish
0 02 SF Dweliing o 07 4-plex ? 12 Muiti RepairlRem. ? 17 Swim Pool
0 03 SF Addition o 08 8-plex o 13 Garage/Accessory ? 20 Pubiic Facility
0 04 SF Porch ? 09 12-plex o 14 Fireplace ? 21 Miscellaneous
0 05 SF Misc. 0 10 = plex o 15 Deck
WORK TYPE
0 31 New o 33 Afterations ? 38 Move
a 32 Addition o 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actuaq Basement sq. ft. MCNVS System
(Aliowabie) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq, ft. Census Code.
Oepth Footprint sq. ft. 5AC Code
Census Bidg
Census Unit
APPROVALS
Planning Buiiding Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MC/WS SAC
Cfty SAC
Water Conn.
Water Meter
Acct. Deposit
S/VH Pertnit
SIW 5urcharge
Treatment PI.
Road Unit
Park Ded.
Traiis Ded.
Other
Copies
Total:
% SAC
SAC Units
Valuation: $
EAGEiN TbWNSHIP
3795 Pilot Knob Road
SC. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR 5E47ER SERVICfi CONt3ECTiON
DATE: April 8.1968
OWNERCedar Grove Const. Co.
NUMBER 142
Addreas Lot 11 Blk 10 GG 5
PLUMBER Steins T7ZpE pg plpE
DESCRIPTION OF BUILDING
Industriali Commercialf Residential Multiple Dwelling No, of units
Location of Connections:
Connection Charge
Permit Fee 7•50 Pd.
Street Repairs
Total
Inspected by:
Date
Remarka•
sy.
Chief Inspector
In coasideration ot the issue arrd delivery to me of the above permit, I
hereby agree to do tfie proposed work in accordance with the rules an8
regulations of Eagan Tocroship, Dakota County, Minneaota
By
Please notify when ready for inspection and cotmection and before any port3on
of the work is covered.
< o.
THE SIiSSEI COMPANY
1 850 Coma Avxnua
St.'aul, MinneSOta 55108
P-Kermit by-.a4L6d
? Legal Description
p lot
? Bik-
0 Add'n
D Value?
(4'(yp( GonSt.
Slab: ? In y Sussei
? By nwner Approx.
25TRqTINGS POINTS ONLY
S.P.L.
S.S.P.L.
fl.P L.
r ? Alley
F
&,Tquare With
? ijpds
B?Mesh
d'Sod Rem. B
? g Mix
9 Mix
K ? T ping
amping
?'? ?J.?Ec?
?liy G,ade Point
? CQtiDUIT
" H. Dr. Offset
? S.D. Location
GBoc.kS O8Y Ownet
CYVJindows
Existinn gerage• No C
? per,cneA lx?1Siiached vus [
$ar o1 az'etinp:_11`-'?y'?".
Existinc, garage will 6e:°`
? L; as is
Cpr verted to L.S. - ey owmr
D flernoved By: Owner?
Sussel ?
Jank M ist 8e Removed By Owr
? Spec:ify other rertrovals by Sus-
sel or owner - e+ees, busnes, etc.
? ShoN ap{xox. dist, garage to
hcuse and all prop. lines
StaF es visibie • ? YO ? No
Sun ey available - C?'es Cl No
C Sce? ial instructions from
av 1w.
Inor T : rnl.yTl
`'/ .?i i ...
?l Iv _s 3,3/d`
WORK ORDER
NAME -PHONE #
JOBADDRESS J7C44 //I,l&,A?%l . .
)nA of
. .?
iT t
\ .
1 ,
W? .
iaL?a
2w!. v+ [Y:.`RC?
MASTER CARD
LOCATION , OWNER
STRUCTURE
LAND U ED ASD 2 O )c:Z?, ? iO 7- Fg?
Permit
No. I
Issued Issued To
Coniractor Owner
BUILDING
PLUMBING 33 /? 1 ?y •? ,S'?rs-P?
CESSPOOL - SEPTIC TANK
VJELL
ELECTRICAL
H EATI NG
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER
Ifems Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING
FOUNDATION X-3_ SEPTIC
CESSPOOL
FRAMING c
TIIE PIELD FT.
FINAL
ELECTRICAL /
j
HE.4TING DEPTH
OF WELL
GAS INSTALIqTION
SEP71C TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
Violations No}ed
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS -
TO 6E USED ONLY IN EVENT OP OBSERVED VIOLATIONS
PERMIT NO, DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZFD AND DESCRIBED AS
? GOMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED 8Y CONDITIONS BEYOND
CONTROL.
? REINSPECTION REQUIRED
REINSPECTION REVEALED
DATE OF REINSPEC?ION
CERTI FICATI ON - I certify that 1 have wrefully inspected the above in which I have no interes[ presenc 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 apecific require-
ments for off-site improvements relating to [he property inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILOING INSPECTOR
COMMENTS:
OATE
4bo
MEMO
-c'ity of eagan
TO: DIANE DOWtJS, UTILITY BILLING CLERK
FROM: ED KIRSCHT, SR. ENGINEERING TECHNICIAN
DATE: AUGUST 23, 1993
SUBJECT: STREETLIGHT ENERGY COSTS-CEDAR GROVE NO. 5(208 LOTS)
This memo is to inform your departmerit to begin to invoice the energy costs at the single
family rate effective August 1, 1993 to the property owners in Cedar Grove No. 5 Addition.
Block 1, Lots 1-22 22
Block 2, Lots 1-19 19
Block 3, Lots 1-11 11
Block 4, Lots 1-16 16
Block 5, Lots 1-25 25
Block 6, LOt5 1-22 22
Block 7, Lots 1-25 25
Block 8, Lots 1-5 5
Block 9, Lots 1-2 2
Block 10, Lots 1-23 23
Block 11, Lots 1-14 14
Block 12, Lots 1-9 9
Block 13, Lots 1-15 15
208
The City is currently being biiled by Dakota Electric for streetlighting in the above listed
subdivision.
Edward J.?'irscht
Sr. Engineering Technician
cc: Mike Foertsch
EJK/je
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA118281
Date Issued:10/30/2013
Permit Category:ePermit
Site Address: 3960 Mica Tr
Lot:11 Block: 10 Addition: Cedar Grove 5th
PID:10-16704-10-110
Use:
Description:
Sub Type:Reroof & Siding
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.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 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 -
Marlys S Larson
3960 Mica Tr
Eagan MN 55122--293
Sela Roofing Remodeling
4100 Excelsior Blvd
St. Louis Park MN 55416
(612) 823-8046
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA142376
Date Issued:05/01/2017
Permit Category:ePermit
Site Address: 3960 Mica Tr
Lot:11 Block: 10 Addition: Cedar Grove 5th
PID:10-16704-10-110
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 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 -
Marlys S Larson
3960 Mica Tr
Eagan MN 55122--293
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA177781
Date Issued:07/18/2022
Permit Category:ePermit
Site Address: 3960 Mica Tr
Lot:11 Block: 10 Addition: Cedar Grove 5th
PID:10-16704-10-110
Use:
Description:
Sub Type:Furnace
Work Type:Replace
Description:
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 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 -
Marlys S Larson
3960 Mica Trl
Saint Paul MN 55122--293
Haley Comfort Systems
3708 Broadway Ave N
Rochester MN 55906
(507) 281-0138
Applicant/Permitee: Signature Issued By: Signature