3991 Mica Tr
Use BLUE or BLACK Ink
r----------------
r. I For Office Use
Permit
City of Ea,,,,R I Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received: j
Phone: (651) 675-5675 I
Fax: (651) 675-5694 I Staff: I
INFLOW & INFILTRATION PERMIT APPLICATION
7-- Plumbing / Sewer & Water
Date: ( Site Address:
Tenant: Suite
RESIDENT OWNER Name: Y it IV tom" ` Phone:6_~~ I % S Z 3
/ tt
Address / City l Zip: cat 1-a: t ct1q (22
Name: License
Address: City:
CONTRACTOR
State: Zip: Phone:
Contact: Email:
rll'NG (Within the building envelope) SEWER & WATER (Outside the building envelope)
TYPE OF WORK mp Pump Repair Repair
Other: Other:
Description of w rk:
DESCRIPTION
FEES
$55.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.citvofea_qan.com/inflow, or City Hall at 3830 Pilot Knob Rd.
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 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 l t x
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground -Rough-In -Final
Use BLUE or BLACK Ink
r
For Office Use
Permit #:l j
City of Eaoa~
d b I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: D-Z Site Address: 39 C r fill, ~0 ~/Ysl
Tenant: Suite
RESIDENT/ OWNER Name: 8r,av /yt(,kellt Phone:
Address/ City/ Zip: 3q f ( ml cC"(A
Applicant is: Owner K Contractor
TYPE OF WORK Description of work:
--~2" ro3
Construction Cost: cioo Multi-Family Building: (Yes /No X_)
CONTRACTOR Name: LL c,~,p ~7y~5- t(yc. ~i~n 1rtc.o License#: ~,705'6_5 3(--7Z-
Address: 10-30 r e 51 MC- City: cDJ
State: ~-Aq Zip: 3 ~Jt> Phone: U71 46( _V7
Contact: ~ A5,,,1 Email
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.aopherstateonecall.orci
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 n o 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 pl r s.
x J lq-SOAJ /Vn'1/' x
Applicant's Printed Name App ' ant's Signature
Page 1 of 2
CITYOFEAGAN Remarks * (1-Pc1ar Gr03Ie..TjC0i+R;7'jnn
Addition CEDAR GROVE #5 Lot 10 Blk 6 Pa,l 10 16704 100 06
Ow/?ner 9` Street 3991 MiCa Trail gtate Ea9anr L+IIJ 55122
/_drz?i ? o ,
Improvement Date Amount Annual Years Payment Receipt Date
STR E ET SUF F. ..
STREET RESTOR.
GRADING
SANSEWTRUNK 34- 1967 100.00 $.QO 20 Pdld
SEWERLATERAL S':?i 1967 20 Pdld
WATERMAIN
* WATERLATERAL 1972 607.00 24.28 25 '
WATER AREA
STORMSEWTRK 1970 70.00 3.$0 20 Pdl.d
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STFEET LIGHT
WATER CONN.
6UILDING PER.
SAC 200.00
PARK
- CITY of EAGAN
BUILDING PERMIT
? ewne? .........?-?? ..........°..??..j.........:C?'':?"a??' .................. .....
C Addsaes (Preceaf) ..............................................._..-"'-- ?- --- - .... ...
sai3a?r ....... ... ? ..v? . ? -1?.. .
?.... .._ ?....:._.-:.:.c??'._- . ......... . ..............
..... ... .............. ........... .................. J
Addrecs ............? .................
DEBCRIPTION
?
N2 3602
3795 PiloY Knob Aoad
Eagan, Minnesoia ssiaa
454-6300
?
Dela ....? :.... a ..... - ...... 7 .... :1 ....................
SSOSiea To Be Uced For Front Daplh Haigh! Eai. Cost Pssmi! Fsa Ramerks
a ;7. o-v
LOCATION
Sfreel, Road ar olher Deseriplion o! Loeation I Loi I Sioox I Aaaixion or '1-ract
I / dv I e, I O, 1. .?
This permit does not aufhorise the use of slreefs, zaads, alleys or sidewalks nos does il give the owaar os Lia sgeat
the righ! !o creete anp sifua2ion whieh is a nuisaaee or whieh prasenffi a hasaxd !0 the heall6, safely, conveaieAes aad
genesal welfare fo anpoee ia the communify.
THIS PEAMIT MU$T BE ,KEP"Tp?O,.NTFIE PREMISE WHILE THE WORK IS IN PROGRESS.
This is !o cerlifY, lhat ...... ???.--........../..... (:.:.'.:_°.`.'.G? ..............das perminaion !o erect a...'... ........ _upoe
the above deseri6ed premise subjeai to the provisions of all applicable Osdinanees for the City of Eagan.
\
Maa?.,-r- -- ......... Per
.........__...........'..'_?:'_'...Y ..or ..........x.•...^..:....'_'... ............._.._"'......._."_".""" "" Buildinq .........."" I ' ru ........ pactor .........................
U .". '&
EAGAN TOWNSHIP
BUILDING PERMIT
oWna= .... .-_ir --?•-.--?-_-:?,? e_....? J . ............._.........
Address (Present) -:3.9.`.t..L........ ----- ----?-...................
Huilder .... z??ffs? .......t ... ..............---......_..--------.....
Address "---------'--.....---'-'.-Y'.-'? .....................'--....----------..
N° 1'785
Eagaa Township
Towa Hall
Da:e ... ?8'
"....'_'___' .............
Sfosies To Be Used For Fron! Dep1h Heighi Esl. Cosf Permif Fee Remarks
t`.1-? Ay ?? ? -7. -? s -, ,?' 4,-t--&..Z?.
/ 0 1 6 Id- -4 S'
or
This permif does aot sufhorise the use of s2xeels, zoads, alleys or sidewalks nor does i2 give the ownar oc his agenf
the xigh! !o creale any si2ualion which is a nuisance or which presenis a hazard Yo the health, safefy, coavenienca and
general welfare !o anpone in the communify. '
THIS PERMIT MUST BE EPT, /ONTHE PREMISE WHIL£ THE WORK IS IN PROGRESS.
Thia is fa eestify, lhat._:....°:-:^-"''.-----...........-----has permission !o ereet a..... ----" '-' '--- --- .......................... upon
the a6ove deseribed psemise subjec! !a the provisians of the Building Ordinance for E?an To ship adopSed April 11,
1955. „ ?J? /? p?
. ................"t'"`_-..---"'-..--------_. Per ................... /F(L?y- ->.!...."-?!.*.?.:..?="?.'.? "..._'-'--
C uman of Tnwn Board / Building Inspecios
d J3
EAGAN TOWNSHIP
BUILDING PERMIT
Ownex --- 9r""" . Q'°'
.. ?-- ---------- ..........................
Address (Present) -11.4-0 ...... .--------------------- ...._--
Builder
Address
DESCAIPTION
N° 142'7
Eagan Township
Town Hall
Dafe ...... .................
Siories To Be Used For Fron! Depih Height Esi. Cos! Permi! Fee Remarks
r?
??•-
LOCATION
Slreei, Aoad oz olher Descripiion of Loeslion Lo! 83ock Add3fion or Traci
7
l i1.. •in?. c w
This permit does not auihorize the use of sireeis, roads, elleys or sidewalks nor does if give the owner ar his agenY
the righf io areafe any siivalion which is a nuisance or which presenis a hazasd !o the healih, safely, coxvenience and
general weliare fo anpone in the commuaiip.
THIS PERMIT MUST BE KEPT ON THE P EMISE WHILE THE WORK IS IN PROGRESS.
This is fo eeriify, lhat. ...e:-- ?' -_ a4.!-:.'.' --_------------------------- permission !o areef a...... -a`.'_?,,_/,,_'p_?..,. `??'::z??- upon
the above described pxemise suhjecS So the provisions of the Suilding Ordinance for Eagax?/1'ownship ado . ed Apxil 11.
1955.
................. .................L?h!'1..4f.?!:i:'..?._._?4"i?-r`''?-'----.... Per .-------d-G,c--Lt...... ...._"_"""-""'_'
Chairman of Tnwn Soard - ? Bui?ding Inspecfox
R • .a
EAGAN TOWNSHIP
BUILDING PERMIT
Owne[ ...... l:.L.D«t'------- -....?----&V ,--------'--
Address (Preseni) ...?..:...... J.* -=--!-------...--"-
Builder
Address
DESCAIPTION
N° 144'7
Eagan Township
Town Hall
Dateio,/s' /yG?
-'-"-'--..."-'---f...._'---_",-"'--.
Siories To Be Used For Froni Depih Heighf Esi. Cosi Permif Fee Remarks
-- ; ? ?--
LOCATION
SYreei, Road or ofher Deserip 7 oF-Laesiion. I Lo! Slaek - Atl?ii&on.or Traet
i 7 1 i-C 1., ?
- n .1
p( ! O.lC_'r r d/J O.? /c - ?..v u i raT i .,2 i .,?
This permit does not authorise the use af sireels, xoads, alleys or sidewalks nor does ii give the ownar or his ageni
the righifo ereaie anp sifuaiion which is a nuisanee os which presenSS a hazard to the healih, safefy, convenienee and
general welfa=e to anyoae in the communi2y.
THIS PEAMIT MUST BE KEPT ON TH£ PREMISE WHILE TFi£ WORK IS IN PROGRESS. , .
??g?t "'
This ic io eeslify. !hal....'_C'r':`O.'_._.....'.• ..................haspermission !o eseet a upon
................ '_t'"' "''"""
the above described premise subjee! !o the provisions of the Building Ordinanae for Eagan awnship fldople April 11,
1955.
----------- ...........'.'..........
_.°°----°---...--•----(N!i!3_r.,i...JG'._.:`?.......... Per ...._-----...---- '?'...?:`......_.... ?............
Chairman of Tnwn Board Building Inspecior
4 ',C3.
i
/ 7 ?S
y
`
??w CA
??U'r?
?
1? 0 + , o i? ?. ?
?Qd r 6 ro ?E? l'o \?
C
9 e- c z
ROY ZEVERINO
RoUTe I
PR68COTT. WIBC. 54021
7 - (716) 262-5765
MELROY CONSTRUCTION, INC.
Contractting • Aome Builddng • Remodedting
y, IN y ?? MeL Cortosa
C?N 4 7375 GHILL AviNUE
INVER GHOVE NEIGHiB. MIHN. 35075
(e12) 431.21e7
!
18- ?j-
,3%?/ /`?,'cp tra;/
o'
2 q
A'e '4
MASTER CARD
/d
OWNER
STRUCTURE AND
LAND USED AS
Permii ,
No,
Issued Issued To
Coniractor Owner
BUILDING
!
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTAILING
SANITARY SEWER
OTHER I
OTHER I
Items Appraved
(Initial)
Date
Remarks
Disiance From Well
FOOTING SEPTIC
FOUNDATION CESSPOOL
FRAMING ? TILE FIELD FT.
FINAL
ELECTRICAL
HEATING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
042
Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRl1CTION AT THIS INSPEGTION
? NO EVIDENCE Of NON-COMPLIANCE
OBSERVED.
? NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? ACCEPTABLE SUBSiITUTIONS OR
DEVIATIONS.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
? COMPLETION OF CERTAIN IMPROVEMENTS
WIIL 8E DELAYED BY CONDITIONS BEYOND
CONTROL.
? REIhSPECTION REQUIRED DATE OF REINSPEGTION
REINSPECTION REVEALED
CERTI FICATION -1 certify that 1 have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein
all significant conditions otserved 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
BUILDING INSPECTOR
COMFAENTS:
OATE
9i1w??+p
- city of eagan
MEMO
TO: DIANE DOWNS, 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 department to begin to invoice the energy costs at the singie
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 iB
BloCk 5, Lots 1-25 25
BloCk 6, l.ots 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 currentiy being billed by Dakota Electric for streetlighting in the above listed
subdivision.
Edward J. irscht
Sr. Engineering 7echnician
CC: Mike FoertsCh
EJK/je
PERMIT
City of Eagan Permit Type: Mechanical
3830 Pilot Knob Rd Permit Number: EA079010
Eagan, MN 55122 . Date Issued: 07/26/2007
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 3991 Mica Tr
Lot: 10 Block: 6 Addition: Cedar Grove 5th
PID 10-16704-100-06
Use
Description:
Sub Type: e - Air Conditioner
Work Type: Replacement
Description: Air Conditioner
Comments: Questions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector,
952-445-2840.
Brian Welke
Fee Summary: ME - Permit Fee (Replacements) $50.00 0801.4088
Surcharge-Fixed $0.50 9001.2195
Total: $50.50
Contractor: -Applicant - Owner:
Haley Comfort Systems Brian D Nickell
122 West 3rd St 3991 Mica Tr
Hastings MN 55033 Eagan MN 55122
(651) 437-0338
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.
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA171981
Date Issued:09/09/2021
Permit Category:ePermit
Site Address: 3991 Mica Tr
Lot:10 Block: 6 Addition: Cedar Grove 5th
PID:10-16704-06-100
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Brian D Nickell
3991 Mica Trl
Saint Paul MN 55122--295
(651) 621-4631
Gladstone's Window & Door Store
2475 Maplewood Drive
Suite 110
Maplewood MN 55109-0000
(651) 774-8455
Applicant/Permitee: Signature Issued By: Signature