4071 Mica Tr
Use BLUE or BLACK Ink
jfihhh~ For Office Use
I I
'Ir City of Ea Win I Permit#:
I ~
I Permit Fee: '
3830 Pilot Knob Road
Eagan MN 55122 I Date Received:
Phone: (651) 675-5675
I Staff:
Fax: (651) 675-5694 L
2010 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address: 4071 1qr c`i
Tenant: J-' Suite
RESIDENT / OWNER Name: Phone: &r( 6,fl VJ2p
Address / City / Zip: 7 i I d
CONTRACTOR Name: 3-e f License M
Address: City:
State: Zip: Phone:
Contact: Email:
TYPE OF WORK - New _ Replacement _ Repair - Rebuild - Modify Space - Work in R.O.W.
Description of work:
PERMIT TYPE RESIDENTIAL
X Water Softener
Water Heater
Lawn Irrigation RPZ PVB) Add Plumbing Fixtures Main Lower Level)
Septic System Water Turnaround
_ New
Abandonment 2
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
*Water Turnaround (add $166.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
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 o plans. 147
X 5-4ve-7. 6Sl-e 1f® X
Applicant's Printed Name icant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test -Gas Test -Final
CITY QF EAGAN Remarks* (edaz' Graive Acquisitian
Addition CmAR GROVE #5 Lot 15 Rlk 5 Paresl 10 16704 150 05
1r
Owner ' ? r1 Street 4071 Mfca TraiI State Ea9an, MN 55122
Improvement DAte Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADfIVG
SAN SEW TRUNK
* SEWERLATERAL 1972 1,304.00 52.16 25 931.04 A003853 -11-77
WATERMAIN
* WATER LATERAL 1972
WATER AREA
STORM SEW TRK Z?0 1974 70.00 4.66 15 51.36 A003853 -11-77
STORM SEW LAT
CURB & GUTTER
SIOEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued: f (612) 681-4675
SITE ADDRESS: APPLICANT:
+•i I. tcl ti?r r. - •
4071 MTCA tR Cb%TEl.i.n S'iFVF
c[nAit UC+nvE. ?'?'iN (612) 581-9826
?
I
3 W
?
S Y:.? ? i 2
-1
J
PERMIT SUBTYPE: TYPE OF WORK:
. , !;f PAiN
Eri_RCiu1,
Permft No. Permk Holder Date Telephone 8
ELECTRIC
PLUMBING
HVAC
Inapection Data Inep. Comments
FOOTiNC'iS
FOUND
FRAMING
ROOFING
t
?4J
ROUGH
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 FINAL
DECK FTG
DECK FiNAL
EAGAN TOWNSHIP
BUiLDlNG PERMIT
N° 1401
Eagan Township
Town Hall
Dafe ??.r.[?..4EL?'..??.?11.6-4
:......
DESCRIPTION
Stoiies To Be Vsed For Froni Deplh Heighf Est. Cosi Permii Fee Remarks
- ----
?? ,.?
d' 7 -
or
LOCA
or Ti
_ W:?
This peimit does noi: aulhorise the ?use of slreels, roads, alleys or sidewalks nor does it give the owner or his agen!
the righf Soereafe any situhiion.which is a nuisance or whiah presenis a?hazasd So the healfh,-'safeiq, aonvenience and .
general welfare fo anyone in the communify.
THIS PERMIT MUST BE KEPj.013 THE P?REMISE WHIL£ THE WORK ISIN PROGAESS.,
Thia i5 fo aeriifp. lhai_,.?.t ?.'._ Q^•:o.....!-n.,,:..'."....__...has permisaion !o erect a..6._,(lei:' :Px.... .___"__ ' _upon
_.._.._..._...
the above described premise subject fo the pxovisions of the Suilding Ordinance for Eaga ownship a opied April 11,
1955.
.......... .--------- ------.....--°'--.........Cr:....... ...... --'------------ . Per .---.-.`%wY_µ.?"`?C..-?"--?L•`-"=:?.............--'-----...
Chairman of Tnwn Board ?
4 -'? Suilding Inspecfor
1
.. . .A :.. ? .___,_.,.
EAGAN TOWNSHtP
BUILDING PERMIT N? 1788
Ownex Eagan Township
_...._..- - '? ? a -.......- ?-----..
---- - ? ,.
Address (Pxesen!) ?? .... ?
."..-"----?"-'-..: Towa Hall
°---....--' ..............
...............
Builder ....? ........ o - ------- . .._..l"°..._ . •.,_ .Y •F ?,?
Date ...... ---............................
Addsess ...................... ........................------........_....-----.....-----•-°°
DESCRIPTION
Sfories To Be Used For Front Depth Heigh! Eai. Cosf PesmiS Fee Remarks
/di so 9, ..-?? s-/
LOCATION
Slree2. Aoad os olher Descrip2ion of Locafion I Lot I Block I Addiiion or Traei
/51 .5- 1 C,"P S'
This pe:mii does aot suffiorise the use of s2reels, roads, alleys ox sidewalks nor does it give the owner ot his agant
the sigh! !o crea2e anp situafion w6ich is a nuisanca or mhich preseals a hexard to the health, safely, convenience end
general welfare !o aapone ia the communify.
THIS PERMIT MUST BE KEPT ON/ ?THE PAEMISE WHILE THE WORK IS IN PROGRESS.
This is !o ceriifp. Shal._? ?..?.:..l..d?!r?.-1--?---------.has permission !o ereef a...... -- ........... -°-°-................._upoa
the above described premise subjee3 2o the provisiona of the Building Ordinanee for E an Tomnship adopled April 11,
1955. , /,??
._•"_'-.....'--.......---..?Q:..`r`?........... Per ...... ...._...---'? ?.-'-?^:.._.._":.I._....?c.?!'?....--'-•-'..._...
% bhairma of Tnwn BZard.. ? Suildin Ins ecfor
PERMIT
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT TYPE: B u z ? o z N ?
Permit Number: 0 3 0 5 4 4
Date Issued: 0 7/ 31 J 9 7
SITE ADDRESS:
4071 MICA TR
LOT: 15 BLOCK: 5
CEDAR GROVE 5TH
P.I.N.: 10-16704-150-05
DESCRIPTION:
REROOF
Building"Permit Type
Building Wcrrk, Type
f ?y
C@qS?US QQd;$
/ • .. . ? ? .^.-,"-b.
e
j ?.
r?
{'`vk
?
REMARKS
5F (MISC.)
REPAIR
434 AL7. RESIDENTIAL
'
`'y
?? ?-- ? ?i
t i
C-
FEE SUMMARY:
VALUATION
Base Fee
Surcharge
Total Fee
$74.75
$1.50
$76.25
$3.000
CONTRACTOR: OWNER: - Applicant -
COSTELLO STEVE
4071 MICA TR
EAGRN MN
(612)681-9826
I hereby acknowledge that I have read this application and state that the
information is correct and egree ta com°ply with all applicable State Qfi Mn.
? Statute?,O and CiCy qf...Eagan drda.rrances.`,,`_
?
APPLICANT/PERMITEE SIGNATURE
?UEDhY: ? ONATU?E---
1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)
required: _ Yes _ No
7-3o-q'J _ ??oao.?o
DATE: CONSTRUCTION COST: •
DESCRIPTION OF WORK: ??'? ?
' - CITY OF EAGAN
8830 PiLQT KN08 RD - 65122
681 r4675
New Construction Reauiremenffi RemodeVReoair Reouirements
? 3 registered eke surveys ? 2 copies ofplan
• 2 copies af pians (inGude beam 8 window saes; pouretl hW. design; eta) ? 2 sfte surveys (exterior addldons 8 decks)
? 1 energy calculations ? 1 energy calwlatlons for heated additians
? 3 copies M tree proaervatfon plen H lot platted after 7/1/93
STREET ADDRESS:
6-?-
LOT /-57 BLOCK
PROPERTY
owNeR
J` SUBD./P.I.D. #: _
Name: -5P"y Css4-e-Ilo
(n?
S4vc-
Phone #:
(o &'I -`1824A
Street Address: ?0-71 Mj Cc, -rrr.
City: Ea-„ C--VA State: M"j Zip;
CONTRACTOR COmpany:
S-e- Ic-
Street Address:
City: State:
Phone #:
License #:
ARCHITECTI Company:
ENGINEER
Name:
Phone
aa ?
Zip:
Registration #:
Street Address:
Ciry:
State:
Zip:
Sewer & water licer.aed plumber (new construction only): . Penally applies when address change
and lot change arc requested once permit is issued.
I hereby acknowledge that 1 have read this application and state that the information is orrect and agree to comply with ail appiicabie
State of Minnesota Statutes and City of Eagan Ordinances. //??41
??`"U
Signature of Applicant: Q? ?
OFFICE USE ONLY
Certificates of Sunrey Received _, Yes _ No
Tree Preservation Plan Received - Yes - No - Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex o 12 Multi Repair/Rem. 0 17 Swim Pool
0 03 SF Addition o 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
* 04 SF Porch o 09 12-plex o 14 Fireplace n 21 Miscellaneous
n 05 SF Misc. 0 10 = plex o 15 Deck
WORK TYPE
n 31 New o 33 Alterations o 36 Move
? 32 Addition ,+W 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MC/WS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinkiered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code.
Depth Footprint sq. ft. SAC Code
Census Bidg
Census Unit
APPROVALS
Planning Building Engineering Variance
Permit Fee ? • 75
Surcharge ). Sv
Plan Review
License
MC/WS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total: '7& -0? 5
Vaiuation: g ? lqOOD. M
% SAc
SAC Units
? 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EACAN
3830 PILOT KNOB RD - 55122
851•681-4875
New ConslrueNon Raaulremenh
D 3 reglsfered alfe wrveys ahowlny aq. It of loT, sq. tl. a( house
crW gJ_I rooted creos l20°J6 maxlmum bt coveraae atloYte?
? 2 eoplea of plaru fahow beam R window sizes; poured Md. design: elc.)
n 1 sel of anergy calculaliom
D 3 coples ot hee pretervatlon plan H lot platted after 7/1 /99
DATE: ??ZIDO
DESCRIPTION OF WORK:
SiREET ADDRESS:
LoT: 15
T`r?t
BLOCK: ? SUBD./P.I.D. #: t ?° vovL
PROPER7Y
OWNER
COMRACTOR
ARCHIiECT/
ENGINEER
5S1'e ICo S1e-V,0-,, P,ane C lo S7 - G e/- ?Tz
Name:
Layt Flrsl
Sheet Address: b 7
^,C'c, TrCc e /
Cly CR oi a-" State: A ''t Dp: 2
Company: Phone #:
(area code)
Sheef
Cily
Stqte:
Company: Name:
Telephone #: ( )
Sheet Addreas: Regishatbn t:
City
State:
Sewer/water licensed plumber (H Installina sewerlwaterl: Ph°nelk
Zip:
Zip:
1 hereby acknowledge ihat I have read Ih1s applicaHon, sate thaF 1he InfomwHon Is rtect, a??j,Aagree to comply wHh all appBcable State
of Minnesota Stahrtes and CNy of Eagan Ordinanees.
Sigrmlure ot ApplicanY. «
OFFICE USE ONLY
2 copies ot plan
1 set o( en6rgy calculatlona tu h9ated addlllons
1 site wrvey fa exfedor addiflons R decks
CONSTRUCTION COST:
ltcense # Exp•
Certificates of Survey Received _ Yes _ No
Tree PreservaNon Plan Received _ Yes _ No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation O 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.)
? 02 SF Dwelling ? OS 06-piex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 03 01 of
plex ? 09 07-piex ? 78 Deck ? 23 Porch (screened)
? 04 _
02-plex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage
? 05 03-plex ? 11 10-plex vioy Yor_N ? 25 Miscellaneous
? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bldg.
WORK TYPE
? 31 New ? 36 Move Bldg. ? 43 Reroof
? 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding
? 33 Alteration ? 38 Demoiish (Interior) ? 45 Fire Repair
? 34 Repair 0 42 Demoiish (Foundation) ? 46 Windows/Doors
' Give PCA handout to appl icant for demolition permit
GENERAL INFORMATION
SAC Code
No. of Units
No. of Buildings
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
W idth
Basement sq. ft.
Main level sq. ft.
sq.ft.
sq. ft.
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning Building
Engineering
sq. ft.
sq. tt.
Footprint sq. ft.
Census Code
MC/ES 5ystem
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
? 31 Ext. Alt - Muki
0 33 Ext. Alt - SF
? 36 MuRi
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:
Valuation:
SAC Units
% SAC
d?? /7,S-8
?
\
? 31 ? -
?
, -
.,
? ? r ?
-- - -
•
? - ; `'-
- ??
' ?
-
?
?
C.2 Yye h ?s7b
,n
_•_ L o? ?/Sr___? ? v??S ;-??Y Gr-??5? -
-• ? ? _ -Sc???- /??=-?o? - -_
- - -- - -- - ---?
v
,
-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 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 yi
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 ahove listed
subdivision.
Edward J. irscTit ^
Sr. Engineering Technician
cc: Mike Foertsch
EJK/je
PERMIT
City of Eagan Permit Type: Building
Eaaan. Permit Number: EA093996
Date Issued: 05/18/2010
OR Permit Category: ePermit
41~ it~ of E3
E
Site Address: 4071 Mica Tr
Lot: 15 Block: 5 Addition: Cedar Grove 5th
PID:10-16704-150-05
Use:
Description:
Sub Type: e-Reroof Construction Type:
Work Type: Replace
Description: House & Garage
Census Code: 434- Occupancy :
Zonin,:
Square Feet: 0
Comments: If there is no ice protection inspection prior to final, the contractor must meet the inspector Nva ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary: BL - Base Fee S3K $88.50 0801.4085
Valuation: 3.000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195
Total: $90.00
Contractor: - Applicant - Owner:
Sela Roofing Remodeling Steven J Costello
4100 Excelsior Blvd 4071 Mica Tr
St. Louis Park MN 55416 Eagan MN 55122
(612) 823-8046
I hereby aeknowledae 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 Cite of Eaaan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature