4017 Mica Tr
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - - 1
For Office Use
t Ol Ea n Permit
41 t f
Cl~a
I Permit Fee: I
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff:
2010 SEWER AND WATER REPAIR / DISCONNECT PERMIT
Date: C1- Z o - 10 Fee: $55.00
City Sewer City Water Repair Disconnect
~
Description Of Work: R ' r S'r_We ( t ti 'ale "I-
Street Address for Proposed Work 14 0 1 7i ['_cr T12
Name: V\ r, y f C e y'j ( U e- 'y e Ck Phone: ch Z - Z- 1 1,7
OWNER Address / City / Zip. q0 I' Cc, T12 ~g.~3. Ai Vti1>
Applicant is: Owner /Y Contractor
Licensed Pipelayer Master Plumber Property Owner
Name: _rlsi Aj Cil'ee 4~Uer Phone: C12-182-2-It
~
Address / City / Zip: (A Z T i 2 S T- S! - 3 2 19
Pipelayer Training Certification Card U 2 161 7 - V- or Master Plumber License
I acknowledge that the information is complete and accurate and that the work will be in conformance with the ordinances and codes
of the City of Eagan and the State of MN Statutes. I understand this is not a permit, but only an application for a permit, and work is
not to start withoutya permit. y j
~I I~ ~ W1rG~~ P
Applicant (Print Name) Appli ant'sSignature
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
cirY oF EA"N
3799 Pilet Knob Raad Eagan, MN 55122 N2 4958
PHONE: 454-8100
??. ? o?.? 7 ?; (.% . ?teceipt # 115'.j ?
BUILDING PERMIT a
To be used for . i' q?" ? r???O4r Est. Vo l ue Dote 19?
Site Address c;4 r- Erect ? Occupancy i
Lot Blotk Sec/Sub. Alter ? Zoning ?
Parcel #
oWe Name C1 arPnce Qahlher$
Z Address 4017 itica Tr.
? i or,nn 65G_l,F?RQ
o Nn^ne
r
uQ Addre
z
r r.,.
Name
I hereby acknowledge thnt I have reod this applicotion and state that
the information is correct ond ogree to comply with all applicebie
State of Minnesotu 5tatutes end City of Eagan Ordinonces.
. i . .
Signature of Permittee
? .
Repoir Fire Zone 3
Enlarge ? Type of ConsS.
Move ? # Stories
Demolish ? Front ft.
Grode ? Depth ft.
Approvols Feea
Assessment -
Water & Saw.
Police
Fire
Eng.
Planner
Council
Bfd9. Off. _
APC
Permit _u?
5urchorge _
Plan theck _
5AC
Water Conn.
Water Meter
Tatal a; .50
A Building Permit is issued to: ?' n? oals1 berir, on the express condition that
oll work sholl be done in nccordonce with all applicable 5tote of Minnesota Statutes and City of Eogan Ordinances.
Building Officiel
Paemit # pah Isuad Prnnitfee
(
Plumbing
Mechonical
INSPECTIONS DATE IPISP• Rouqh-In Finol
Footings Date Insp. Date Inap,
Foundotion Plumbing
Frame/ins. Mechnnicol
Finol
--
--
T
Remorks:
:
,. ; PERMIT # ?
MECHANICAL PERMIT r-; ri ? 7 C,
C
EIPT #
CITY OF EAGAN RE
? 3830 PILOT K NOB ROAD, EAGAN, MN 55122 DATE
CONTRACT PRICE: ? ,S?,p PHONE: 454-8100
Site Ad re?s ?%
? 7 1'fffle ?L gLpG. TYPE WORK DESCRIPTION
Lot
? Block., .-47 Sec/Sub
Res. New ?l
`, `LC ?
? '
' Mutt Add-on
/'?
Name d
? r
? i??3
?i'?1 c
r '?•?'??'" ?/? •
Comm. Repair
?
c Addres?
Cit
S'-?? ?r
Ph
6 Other
y one
Name FEES
RES. HVAC 0-100 M BTU -$24.00
c Address -e 75? ol ' ? ADDITIONAL 50 M BTU - 6.00
p Clty 'f????? Phone UDES A/C ON NEW
INCL
CONSTRUCTI N
GAS OUTLETS (MINIMUM - 1 PER PEkMIT) - 1
50 EA
.
.
TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
Forced Air 70 M BTU APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPUES
Boiler M BTU MINIMUM RESIDENTIAI FEE - ALL ADD-ON &
Unit Heater
Ai
C M BTU REMODELS - 12.00
MINIMUM COMMERCIAL FEE - 20.00
r
ond. M BTU STATE SURCHARGE PER PERMIT - .50
Vent. CFM (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # ? BEYOND $1,000)
Other
FEE: ?. , o n
S/C: SIGNATUR
TOTAL x
?0 ?
?? ?l
FOR: CITY OF EAGAN
CITY OF EAGAN Remarks * rpclar GmvgACcnliaitinn
Addition CEDAR GROVE #5 Lot 24 eik 5 Parcel 10 16704 240 05
Owner 'street 4017 Mica Trail state Eagatl, MN 55122
!
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK . OO
SEWER LATERAL 493-25 24.6
WATERMAIN
* WATERLATERAL 1972 607.00 24.28 2$ Paid
WATER AREA
STORM SEW TRK 1-7 1970 'JQ. QQ 3.50 20 Paid
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
sac 200.00 452 10-25-67
PARK
EAGAN TOWNSHIP
BUILDING PERMIT
owna= --..?....?'? ........... ..:.......
Addsess (Preseni) .-..:.`7?.?.?..`l.._....r..... ....
Huilder --------- -° ..............°-.....__..°---....-............................................
Address ....
DESCRIPTION
N° 2006
Eegan Township
Tomn Hall
aase _...............
Siories To Be Used For Fzonf Depih Heigh2 E
si. Cos! Permi! Fee Remazka
? f
'
LOCATION
or
This permii does not sulhorise the use of s2reeta, roads, alleys or sidewellcs nar does it give the owner ox his agenf
the sighf !o crea2e anp siluafion whiah is a nuisance or which precenis a hasard to the healSh, safeip, convenienee aad
genezal weliaxe fa anpone in the community.
THIS PERMIT MUST BE BEPT ON T PAEMISE WHILE TRE WOAK IS IN PROGqREISS. ,
TMs is !o cerii4p, lhai._d_.....-- --°----------°-°----... _i...._........ hes permission !o ereei s--??pon
the above desctibed premise aubjea! !0 the p visomof the Su(lding Osdinance for £agan Toavnship adopled April 11,
1955.
144 Y:,.,..---c-?,/.".`.:s.t!.r.?=------------.---......._... Per .................C..c........[/r?l-
. .....-""" t Chufnan oE Tnwn Soard Building Inspector
4 1 4
EAGAN TOWNSHIP
BUILDING PERMIT
Ownes l..L'?.,c..L?.-.f_c.? ,(Q-..??•?Cc-z
....
......................................... .....----.......------° -
----- ...---'...-"'_'
Address (Breseni) --.'qe .. ?/..........1!:!.?.:r ...... ...................
Huilder
Address ........................... ....... _............................................... ---------
DESCRIPTION
11T° 2617
Eagan Township
Town Hall
Dala ....//1..?°..Q.?1..7.1 ................:....
Bforiea To Be Used For Froa! Dapfh Heigh! Est. Cos! 'Perm12 Fee Ramarlu
j aso =° ?s ?
?.
LOCATION
Sireet, Aoad or ofher DascrtpHoa of Locnlion I Lo! lock Addilioa os Tsse!
?` / S I GD .$ • S_
This parmit doee not aulhorise the uce of atreels, roads, alleps or sidewalks nor does ft give the owaer es hie agea!
the righ! !o create any ailvalion whieh is a avisaaee or which preseats a hasard to the healSh, safelp, eoaveateaee and
ganeral weltere !o aayone ia the eommunity.
THIS PERMIT MUST BE KEPTON Tti$ PREMISE WHILE THE WORK IS IN PROGAESS.
Thia ia !o aerlifp. !hal..... ,?K•e `-
..: ....... ... ?....?......... ......... .. . . . ....... . .................... _
..6as permfseion !o eeee!-a../..?.. . . . . . ? ?oa
the above deaeribed premisa aubJec! So the p ovisIone o! the Building Ordinance fo: Eagea Towaship edopted Aprl1 ii,
1953.
........................... °..^ ................. Per ........................... jkI`^?.? ?.e??......
............. .....................................................
Chairmen of Tnwn Board? Bufldinq Inepeotor ?
f
CITY of EAGAN
BUILDINt3 PERMIT
Oanes ...DAHLBERG......CLAREN.U ....F.a .............................
Addsecs (psaeen!) 4017 Mica........... Trail
•" '. ............... ...............................................
Suilder ...... SQHN....C.OMEE ..............................................?--.--.........
Addreec ..... Rte. #3, Box 91S
. ? . ....................................... ...........................................
M. I W
N° 4103
9795 Pilo! Knob Road
Eagan, MinnesoYa 55122
454-B100
Daia .......10/4/76
............................
.
ories To Be Uced For Fron! Deplh Heigh! Esi. Cos! armii Fae Ramaeks
7
S/D Fireplace ?
1400.00 ?
9.00
1.00 ?
/c
or
4017 MiCd Trall
24 I 5 I CG #5
This permit does not aulhorize the use of siceals, roade, alleps or sidewalks nor does it giva the owaer or hia agan!
the righ!!o cseate anp siluafion whieh is a nuisanae or which psesents g hesard !o the healt6, safetp. ConveaSeacs aad
general welfare !o anpone in the communily.
THIS PERMIT MIIST BE KEPT pN THE PREMISE WHILE THE WORK IS IN PROGAESS.
Thfs is !o cerrifq, fha!_._?o hn ... .. Come.._ e ................................has permission !o ereM a_....._S? D F i r e..? 1 a c e ............... up?
. .............. .
the above described premise subjeei !o the provisions of all applieable Ordinances for the f Eagen
...--° .............-°=# .- Kyor .... ............--°.....°°-----. Per\\??. _.f..........._......................... Suilding IaaPector
LOCATION
cirr oF EAGAN
3795 Piloe Knob Road Eagan, MN 55122 N? 4958
. . ? rHONe: asasioo
*?70Q. 11507 _
-
BUILDING PERM?g 1 g rP LfAoVON Receipt #
To ba ueed for S4i n ? ln oW Est. Volue Date aga++_+ 10?, 19-_79
$tte Address LM7 bjr Tr Erect ? Occupancy T
Lot 24 Block 5 Sec/$ub. CG 5 Alter ? Zoning Rl
Parcel .# Repoir 01 Fire Zone 3
Enlarge ? Type of Const. V
rc Name C larcnrn Dahlbe*g MOVe ? # $tOries
Z Address 4017 MicB TT. Demolish {] Front fr.
0
Ci Eagan Phone 454-6689 Grade O DePth ft.
? Approvcla Fees
0
Zu
u?
?
Name _
Address
Name
1 hereby ockrrowledge that I hove read this apPlication and state that
the informMion is correct and agree to canply with all opplicable
$tate of Minnesota Statutes and City of Eogan Ordinances.
Signature of Permittee
AssessmeM -
Water & Sew.
Police -
Fire
Eng.
Planner -
CAUntil -
Bldg. Oft. _
APC
Permit 6 () Su_
Surchnrge
Plen check
SAC
Water Conn.
Woter Meter
Tatol F,.J`n
A Building Permit is issued eo: Clarence Dahlber _ on the express condirion ehm
all work shall be done in oc ance with all pplico6le State of Minnesota Statutes und City of Eogon Ordinances.
Buildirg Officiul
EAGAN TOWNSHIP
BUILDING PERMIT
Ownex .-_.-C_s'f - ?. ------- ..? . C`g-................ .
_ ?`,. . ... .
Address (present) ..-- .??d'? -........{?T-.--!f?`-?`.'`?? ' . ? ' .
.....
........_..__.......
........ ...
Builder ........................ ------ .............._.-----...._._..---------..._..
Address .............---------------"-'------------------....----°"------...._ ..
1447
Eagan Township
Town Hall
D a!e .?"'` La / 5` G G
.......... .......... /.......... _.........
?
Siories To ? Se Used For
-
--=--- Front-
- Depih Heighf
- Est. Cosi Permit Fee Aemarks
-- -
y ??, a??.. ? ---
. I
------ is??
-- `?--
----_.----?----
_
eei, xoaa or otner uescripiion ox Locaxion
4F ?-' --
? /5-P /O ? C -47 5-
.N 10
or Traci
This permii does not aulhorize the use of slreeis, roads, alleys or sidewalks nor does it give the owner or his ageni
the righifo create anp sifuafion whieh is a nuisanee or whieh presenfs a hazard !o the healih, safely, convenienee- and
general welfare to anyone, in the communify. - . '
THIS PERMIT MUST BE KEPT ON THE?PF},EMISE WfiILE THE WORK IS IN PROGR83S.
C?''"`° • Cy'.
This is fo eerfifq
, ihai---- C..--- ..:.__'- ..............-"----............-. has Permisaion !o erect a....
?'-----/y.-- - - <'- - ------- ........,.?} .'.... upon
the ebove desaribed premise subjeaf !o the provisions of the Bvilding Ordinance for Eagan "1'ownship adopie5 April 11,
1955.
................... ......:. ?e?'.. ...... " - Pe3 .... :_...... ..?.??..?...4-------??-c '- ?? -'----'-....- - --
..... "'......_ ' t __'_"""__"... .__.. ..
, Chairmanof Tnwn Board" " " . Huilding Inspector
G 'a•
EAGAN TOWNSHIP
BUILDING PERMIT
Ownex .......(?Gi}? ? .....C?2't? ...................
Address (Presenf) .... ??.?"?"'.._.?leL?e....?..'....?.....
Builder
Address
DESCAIPTION
N° 1510
Eagan Township
Town Hall
Da3a -----.?.:.?.7..?...1?..?...............
Siories To Be Used For Fron! Depih Heighf Esf. Cos! Permif Fee Aemazks
' "" d- O - " - ° LOCATION
SlreeS, Roed or ofher Descripiion of Locafion I Lo!_ Block Atldit3on or Traci
This permif does not aulhosise the use of streeis, roads, alleps or sidewalks nor doea it give the ownes or his agenf
the righ!!o create aap siiuafioa which is a avisance or which presenis a hazard 20 the healih, eafeiy, convenience and
general welfare lo anyone in the communify.
THI5 PERMIT MUST BE KEPT ON T E PREMISE WHILE THE WORK IS IN PROGAESS. /
....... - ---------has Permission !o erect a... .. ---. -??F-i.L . . . upon
This ia !o eertify, ihai_..L........
the above described premise subjec! !o the rovisions ot the Building Ordinenee fo Eaga. ownship ad ted ril 11.
1955. 1 ?- ....................................... ?;ci--'.4`'p'?^-?""-°_'-'_-'-- Per ....--.....f/R/r .'O...'?-.. f_"_.--?---?----?-----J-""_""""'----
Chairman of Tnwn Board GHvilding Snspeefor
A. ` ?'S ..
DIa".'E
BUl7,DZI4G PfiRMIT APPLICATION
?
Include 2 seEs of plans, 1 site plan w/elevations and 1 set of energy calculations.
?':-:Mov& 04.0 t%0102? 11$?
To be used for A*%.D 9,'')&+ac%,'G- f,eaJY"to-'N,Aec„Ualuation 700 00
?-
Site AddresE:
Lot Block Sec. SuL.
okmer C LA Kc ?u c.r i- DF/1.L?1Z G-.
ndclress L0I M: c a Tie/+;L
E ,4-6-9?). /Jl: .uN
Parcel Number
Telephone Vzq- 6?1g (7
Contractor Telephone
Address
Arch./Fa1g. Telephone
Addxess
OFFICE USE
Erect Occupancy
Alter 2oning
Repair /NSt,QcL A/6s0S; ,';,16 Zone
Enlarge Type of (bnst.
Novs # of Stories
ner,olish Front
Grade oepth
OFFICE USE
Date of Approval & Initial
FEES
Peilnit
Assessment
Water/Sewer
Police
Fire
Eng.
Planner
Council
Rldg. Off.
A.P.C.
Suscharge , S cJ
Plan Check
SAC ?
G?ater Conn-
F7ater P9eter
TOTAI,
Date: /0- :K- 76 ?
BUILDIR?G P5RPIIT P.,PPLTCA:YON
? J
LOT ?4- HLCCK .? ADDSbSO1Q a
Pi1RCET, & Sr-CTIOi3 PNPIBER IF Ui1PS,ATTED
FT]nRESS OF F21RCDT `y-QI ! /'? •Gi4 'r'2,4, L-
70TQIAIG OCCUPAA7CY i2dr L'3E
?
ESTIri9Ai"EA COST 1F/ 5 4OD, 00
pTMMER 1:4i4/ZE,VGE F. b9/4 1,Q?,er- TrLEPHOIVE tlt0.
ADDP.ESS `70/7 /yI•`LA7`?aQr-L .
COPdTRE1CTOR DAW e0/h t? TELEPHOtm, N0. a%? - a 36 5
ADDRESS oe-r *3 8Dy 91 8 -
tdote^ Include site plano building plans, and eaergy calculations aiith this
appZication
l?ee?
Signed <-- 1
? OFFICE USE
VALUnTIOid ? U? /_
" r
SAC
6'S17^tE2 COiNEC^sIQP1
47ATF12 I7ETER
BUILDING PERt%iIT FEE
SURCHARGE FEE
PIXV CFECK FEE
PARK DEDICATIObT SEE
OTFiER
TOTAL*
APPPOV.ALSa
ASSEuSMR;?1 CLEFSC
/ O -
?? -
BUILDING DEPT. PQLICE DEPT.
?fATER & SEFdER DEPT. FIRE DEPT. P11RK DEP+.
MASTER CARD
4017 MICA TRAIL L24 BS CG #5
OWNER DAHLBERG, CLARETICE E.
SiRUCiURE AND 5/D Fireplace
LAND USED AS
Permit
No.
Issued Issued To
Coniractor Owner
BUILDING 4103 10/4/76 John Comee
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATWG
GAS INSTALLING
SANITARV SEWER
OTHER
OTHER I
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING $EPTIC
FOUNDATION CESSPOOL -
FRAMING . TILE FIELD FT.
PINAL
ELECTRICAL
HEATING DEPTH
OF WELL
GAS WSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WEII
SANITARY SEWER
?
Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION ftEPORTS
TO BE USED ONIY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO.DATE OF INSPECTIQN
CONDITIONS OF CONSTRUCTION AT THIS INSPECTIQN
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPIY.
1:1 ACCEPTABLE SUBSTITUTION$ OR
DEVIATIONS.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
AND DESCRIBED AS FOLLOWS:
? COMPLETION Of CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
? REINSPECTION REQUIRED
REINSPECTION REVEALED
DATE Of REINSPECTION
CERTI FICATION -I certify that I have carefully inspected ;he above in which I have no interest present or prospective, and that I have reported herein
all significant conditions oLserved to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relatingto the property inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
R
..i? z.
19a?
?
GA R?G? ?
i 3
Ia
,u - - ? :;
NL
? ?
/-r 6 u
\
?
- - - - o ??? ?
-
3 g, 3 - - - • -
g7
ALI??
4?6
MEMO
-c'ity of eagan
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 departmeni io begin to invoice the energy costs at the single
family rate effective August 1, 1993 to the properiy 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, Lots 1-22 22
BloCk 7, Lots 1-25 25
Block 8, Lots 1-5 5
Block 9, Lots 1-2 p
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 billed by Dakota Electric for streetlighting in the above listed
subdivision.
Edward J.`I?'irscht
Sr. Engineering Technician
cc: Mike Foertsch
,,
EJK/je
CITY USE ONLY
PERMTT #: RECEIPT DATE:
USIDEPTlAL MECHEAICi41. PFRMIT APPLICATION
crrYog Ea?sm
3830 Mor sxos sn
EAfil4A M1Y 55122
681-691-4678
Please complete for: D
Date: ? ? ? -D- -7 f CJ
SITE ADDRESS: r G I
?
C
OWNER NAME: TELEPHONE #:
(AREA CODE)
INSTALLER NAME: 2_QdNJCL,,4k?Gy ? TELEPHONE #: (AR?=J? ZTJ Z?p
STREET ADDRESS: ?A?SLUS 145 -PN S?" • ? ' ? ?- G • 1-?-'I? 46?5
CITY: STATE: VYVI?_ ZIP:
Place a check mark next tn the nermit work tvee
New residential dwelling unit under constructionand not ownedoccupied $ 70.00
Le?2 Add-on, modification or alteration to existina dwelling unit $ 50.00
• furnace replacement
• air exchanger
diti
nnar
2i! COn
• other `-
Nature of work:
State Surcha e P" ? $ .50
Total JUL 3' t?'j i1'C
Reminder: Call for inspectians.
3y
?
SIGNAT ERMITTEE
singie family dwellings
townhomes and condos when permits are required for each unit
Updated 1101
CITY USE ONLY
PERMIT #: RECEIPT DATE:
APPROVED BY: , INSPECTOR
COMMCIlkL MECHANICAI. P£RM1T APPLICATiOR
CrrY og KAsm
3$30 PILOT KNOB FiD
EkHAN, Ddft 55188
651-6$1-4675
Please complete for: all commerciaVindustrial buildings
multi-family buildings when separate peanits are not required for each dwelling unit
DATE:
SITE ADDRESS:
OWNER NAME: PHONE #:
(AREA CODE)
TENANT NAME (IMPROVEMENTS ONLi):
WAS TfERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
ADDRESS:
PHONE#: -
(axsn conE)
C1TY: STATE: ZIP:
WORK TYPE: New construcHon Iastall U.G. Tank
_ Interior Improvement Remove U.G. Tank
_ Processed Piping
SpecifyNature of Work:
When installingfremoving underground tank, call 651-681-4675 for inspection by Fire Marshal and ?
Plumbing Iinspector.
Fees: 1% of contract price OR $50.00 minimum fee, wlilchever is greater.
Underground tank removallinstallation = m;n;,,n,,,, fee
Con4act price: $ x 1%= $ (Base Fee)
State surcharge calculate at $.50 for each $1,000 Base Fee
TOTAL $
SIGNATURE OF PERMITTEE
Updated 1101
r
City of Etat
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit#: /aC/37
Permit Fee:
Date Received: ( ha B
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: -ID 13
Resider
wner
Site Address:
miio., Fall
Name: MQi, (i irl (n,, rI�l�.i.i
Address / City / Zip: L ► b 11 Y► I I - T a. 1
Applicant is: Owner
ontractor
J
Unit #:
Phone: q52 -1-11Z- 2))
Description of work: 1 {, 21OeL W l dQ l S Iat.0JS+i I9 O( )
Construction Cost: ► 2 3-1)_ Multi -Family Building: (Yes / pioIC )
Company: C Y' 1-[ YlO spayukiiit Contact:
Address: 2/16 /Yin etti i is
State: rnp I Zip: 5)OC1
License #:R.42".12 13
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
1 tI(
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:
Mechanical Contractor:
Sewer & Water Contractor:
ang documents that yo
wlassified as not pbl
COncluder t
u submit are;,,,,
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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.
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.
Applicant's Signatu
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA116931
Date Issued:10/14/2013
Permit Category:ePermit
Site Address: 4017 Mica Tr
Lot:24 Block: 5 Addition: Cedar Grove 5th
PID:10-16704-05-240
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 -
Maureen G Huenecke
4017 Mica Tr
Eagan MN 55122
Exteriors Of Excellence
4580 Scott Tr
Suite 204
Eagan MN 55122
(952) 239-0560
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA155610
Date Issued:05/24/2019
Permit Category:ePermit
Site Address: 4017 Mica Tr
Lot:24 Block: 5 Addition: Cedar Grove 5th
PID:10-16704-05-240
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Maureen G Huenecke
4017 Mica Tr
Eagan MN 55122
Haley Comfort Systems
4320 Hwy 52 N
West Frontage Rd
Rochester MN 55901
(507) 281-0138
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA175267
Date Issued:03/24/2022
Permit Category:ePermit
Site Address: 4017 Mica Tr
Lot:24 Block: 5 Addition: Cedar Grove 5th
PID:10-16704-05-240
Use:
Description:
Sub Type:Water Softener
Work Type:Replace
Description:
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Alan Nicolas Riveros
4017 Mica Trl
Eagan MN 55122
(952) 564-7521
Milbert Company (culligan)
1801 50th St E
Inver Grove Heights MN 55077
(651) 451-2241
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA177378
Date Issued:06/28/2022
Permit Category:ePermit
Site Address: 4017 Mica Tr
Lot:24 Block: 5 Addition: Cedar Grove 5th
PID:10-16704-05-240
Use:
Description:
Sub Type:Air Conditioner
Work Type:Replace
Description:
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
210-0754.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Alan Nicolas Riveros
4017 Mica Trl
Eagan MN 55122
(952) 564-7521
Aquarius Home Services
3180 Country Dr
St. Paul MN 55117
(651) 777-0448
Applicant/Permitee: Signature Issued By: Signature