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4272 Moonstone Dr Use BLUE or BLACK Ink , I ' Permit I~ Of E gm,n 05 1 1 Permit Fee: OC I 3830 Pilot Knob Road (((///0 1 1 C I Date Received: 1 Eagan MN 55122 1 Phone: (651) 675-5675 ffli~ 1 6 I Staff: I Fax: 675-5694 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: I I Site Address: q DjP itilyLckn6 Dr Ca Q a k~:) Tenant: Suite : , s - RESIDENT/OWNER Name. ~ fTti1/ C1~I IrY1 ot'~.S Phone~0~i~ Y ~j Address/ City/ Zip: CONTRACTOR Name: License 31-1815874 Address: Appliance Connections nc City: State: 'r ye: 61 y `I 5 `t Contact: Shakopee, MN-l"a79 TYPE OF WORK - New Replacement _Repair -Rebuild _ Modify Space - Work in R.O.W. Description of work: PERMIT TYPE RESIDENTIAL X Water Heater Water Softener Lawn Irrigation RPZ PVB) Add Plumbing Fixtures Main Lower Level) Septic System Water Turnaround _ New Abandonment RESIDENTIAL FEES: $55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $35.00 Lawn Irrigation (includes $5.00 State Surcharge) $55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) *Water Turnaround (add $166.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) $95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 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._qopherstateonecall.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 acc dance with the approved plan i t case of work which requires a review and appro al of plans. ~ r x C )a mi, alpc~?'( 9 fy) e x Applicant's Printed N m App ican'fs Signatur FOR OFFidE'USE Reviewed By Date:. Required Inspections: 'Under Ground' ''°ROugh-In ;AlrTest GaSTest "'Final s Use BLUE or BLACK Ink 1 n ~c_cc Cit of Ea I Permit G1~~'~~0 I Ed 11 I 1 Permit Fee: I 3830 Pilot Knob Road I I Eagan I VIN 55122 i Date Received: I Phone: (651) 675-5675 I Fax: (651) 675-5694 Staff: L________________~ INFLOW & INFILTRATION PERMIT APPLICATION Plumbing I Sewer & Water Date: Site Address: 117-1 Tenant: Suite Name: Sa'n" Ca'10®S Phone: tf 2, D~141"99 Y RESIDENT / OWNER Address/ City /Zip: l n n I ZZ Name: License CONTRACTOR Address: City: State: Zip: Phone: Contact: Email: PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope) TYPE OF WORK Sump Pump Repair Repair Others D LLM J0 TbAll Other: 101 Description of work: j 5C1 pa n 1) LLM rte A L o in DESCRIPTION Ids - (-C)L"q 6 WL L InA . -01 1 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.cityofeagan.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 <I.ndro. C M PdE~ x jqdAA2 Applicants Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date. Required Inspections: -Under Ground -Rough-In !Final CITY OF EAGAN 9796 Pltat Kwo6 Road Eagos, MN 55122 N! 4992 PHONE: 454-8100 BUILDING PERMIT Rece;pr # To be wed fer Carage Addition Est. Value 1'400'ni) Date 9-26-7" 19 Site Address '., `" oonstrne I?r. ive Erect i ? OCCUpOnGy Lot ? Block 2 Sec/Sub. CG2 Alter ? Zoning ' Porcel # Repair ? Fire Zone Enlorge Type of Const. .ee ':a s?•n?. ce Nome Move ? # Stories 3 Address 4='72 "Toonszorie E)r. Demolish ? Front ft. b Ci '=g31t Phone 454-3528 Grode ? Oepth ft. . .. _... e...........i. e.e. °C Nome Zo o? Addross u ? r:«., Nome _ Address I hereby acknowled9e thet I hove read this application and state that the informatlon is correct ond agree to comply with all npplicable Stote of Minnesoto Statutes and City of Eagan Ordinences. $ignCture of Permittee A Building Permit is issued to: all work shall be done in occo Building Officiol Assessment _ Woter & 5ew. Police Flre Eng. Planner Council Bidg. Off. _ APe Permit ' . " . Surchorge ' Plon check SAC Water Conn. Woter Meter Toral n `il_)? wlk- ^ on the express condition that ith oll applicable Stote of Minr?esota Stotutes nnd City of Eogan Ordinances. PennM # oaM Iswd ?awNtM Plumbing Mechaniwl INSPECTIONS DATE INSP. Rouph-In Final Footings Dats Irup. Dafe Irnp. Foundotion plumbing Frome/ins. Mechonicol Finol ? Remorks: CITY OF EAGAN Remarks Cedar Grove Acquisition Lot 19 elk 2 Parcei 10 16701 120 02 Street 4272 Moonstone Dr. State Eagan., MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. 88.5- 1266.95 84.46 15 1266.95 C009944 11-9-84 STREET RESTOR. GRADING 3f SAN SEW TRUNK SEWER LATERAL 1972 1304.00 52.1 6? 2 _ WATERMAIN # WATER LATERAL 1972 WATER AREA STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. ' BUILDING PER. SAC ?- PARK EAGAN TOWNSHIP BU,ILPING PERMIT Ownar Address Builder ......._ ? . . . . ........... ' - - I.??'?!il :. Addresc °-- ..................J.;l..`4?:. ?!._!..:?...?:?.I./..4:/.!!?//` DESCAIPTION N? 2555 Eagan Toweship Towa Hall D ete .J.4--t, / . A?.1.?.1• •-? -.. / Bfosies To Sa Used For Fron! Depih Heigh! Eet. Cos! Permi! ea Ramarks /l.L /O ??- ?W S.C 3r0a /n t ..X 4?4eol0 S?- sireei, xoea or otner llefesipuon os Loca:ion I +.o= I niock I AC6lilOR 0I '129CI ? I ?Z- This pe:mit does aot authorise !he use of alreele, roads, alleys ox sideaalke nor does it give !he owner or his agee! !he righ! !o ereale anp situation whieh is a avisance or whieh presents a hsaard !o !he healih, safely, convenfeaee and general welfare !o anpone in She eommunily. THIS PERMIT MUST BE,jCEPT4? N ?PREMIS/?j WHILE THE WORK IS IN PROG SS This is 2o eaxlify. !haly?-1L1..?.KY..G{?....__..has permission !o erea! a.... . upoa ........... .................._. _ !he abgv,e dgsoribed premi0e,subjee! 20 !he provisions of the Bui?a?6"?dinanqe far? g? Township adopied April 11. r HOUSE HEATING TEST RECORD ADDRESS 4,;t-7OZ M0 O ,"-S+?„'t' D(l° _ APTFLOOR C TY 6q OCCUPANT OWNFR l9FNa(tAlhQ. ?alSw HEATLOSS DATEHTG.INST. SOLD ev HOME ENERGY CENTER INSTALLED BY HOME ENERGY CENTER Electrical Work By HARRISON ELECTRIC Gas Line By TYPE OF HEAT GA FA X HW- STEAM - SPACE HTR. UNIT HTR. OTHER .13A5Wi9iG1'C ' .. ... . . . ' ...eFO ,. . „ „ .Model Serial THERMOST, Valve W Limit __j Limit Setting Fan Setting . Pilot Type _ Pilot Make _ Pilot Model _ Pilot Tming. L.W. Cut Ofl Pressure Input CFH Stack Temp. Form 235 Heat MAKE OF BURNER_ Model Max. BTU Rating _ MAKE OF FURNACE : Model C_ Percent C02 Percent 02_ Percent CO . Vent Size KIND OF LINER_ Draft Hood Filters Size _ Chimney Location Chimney Construction Smoke Bomb _ Draft Door Pressure_ Date Tested_ Company Testing Name of Tester_ Inside _ SIZE NONE Regulator Number Wiring _ Test Tag Lighting EAGAN TO W IeI SHI P BUILDINC; PERMIT /??_?... Ownex ---------------------------- Address (Presen3) ---:t?.7.?"•--- '-----'--'--..--__.__-----.l?l-e Builder --.--....:(45?rv,?l,e•---Q--'-S..L?-`------- Address ----------?-`-..-.-'------'---------.._.....__---- u DESCRIPTION N° 1478 Eagan Township Town Hall na:e.0-4q.._.17.r..?-2_.4.G...._. 4 5tories To He Vsed_ For Fronf Depih Heigh! Es:. Cos! Permi! Feel Remarks _ D 4 - --- - LOCATION Sireei, Road or oSher Descnp'.ion oT Locailon I Lot I filock i Addlf3on or TracY I / 9 1 --?- ? 6 -,-L7 --.2-- This permii does nof aulhorise the use of streefs, roads, alleys or sidewelks nor does if give the owner or his ageaY the righi !o create any sifuafion which is a nuisance or which presenis a hazard !o the healih, saleYp, convenience and general welfaze fo anyone in the communify. THIS PERMIT MUST BE 1{EPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. ? This is fo aertify. lhaf.Qz -... WR.I-C.s.Y.t4-.4 - .____._..._.....has permission !o exect a__._.___.........."' """'. .. ' ' "" ...... upon the above described premise suhjec! !o the provisions of the Building Ordinance tor E an Tow ship adopied April 11, 1955. . . ...(l ?-?f?r-?.._..... Per - - -- - - '-_'. ... ....... ........... "-"_'-""'-.'- ............ '- ---- ---- ' . Chaixman of Tnwn ?Board ? $uildin Ins eclor EAGAN TOWNSHIP BLlILDINC; PERfv11T Ownex "'-"--'.......... Address (pxesen!) ._.15A.4J......._?:....???. !?/? ?"' --- -- -'- Buildez Address DESCRIPTION N° . . 763 Eagan Township Town Hall Date ....?'?.l.----/?6/.... v Sfories To Be Used For Froni Depih Heigh: Est. Cosf rmit Fee P o Remazks - - - l5j? ? ? ?14 o LOCATION Sireei, xoau or oiner 17escr±piion ax i.ocation Lo! 7.'•lock I Aatliiion or 1raci ? • d..a ? &.d? ?. -A? A? ? M This permit does noi aufho:iae 36e use of slreels, roads, alleys or sidewalks r.or does i3 give the owner or his ag-nt the xighi !o creale any sikuation which is a nuisanee or which presenfs a hzzard !o the heal4h, safeSy, convenience and general we3faze !o anyone in the eommunity. THIS PERMIT MUST BE?KEPT OCrT?HE PREMISE WHIL£ THE WORI{ IS IN PROGHES3. ? i This is fo eertify, iha2.._._..?.??..................... hflspermission fo exeeija_'__. 4__.....___...._..._"""'_____ ------------ "_.upon the above described prem' subjee-,]o ihg?? vxsions of Ehe Building Ord'anance for Eagan Township adopied April 11, 1955. ..Y..__`.....?T..'? -----°--'°-??---°-----'-_ Per --------------_....---`----- ° ""-.. _.--'- .................."---------_'°---- Chairman-..... -- of Tnwn Board Building Inspeclor CITY OF EAGAN 3795 Pilof Kno6 Reod Eagae, MN 53122 PHONE: 454-8100 BUILDING PERMIT APPLICATION r„ " ..,eA f,,. Garage Addition F? v„i,,, 1,400.00 Sire nddress 4G/L moonstone urive Lot 19 Block Z Sec/Sub. CG2 Parcel # w Name ?cc rminwicn ; Address 4272 Moonstone Dr. ? ?: Eagan ,,,,,,,_ 454-3528 ?. p J Name _ r ?? Address f r:... Name _ Address I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with ull applicn6le State of Minnewta Statutes and Ciry of Eagan Ordirances. N2 4992 Receipf .fk ????" (; Erect ? OccupancY ? Alter ? Zoning R-1 Repair ? Fire Zone 3 Enlarge [$ Type of Const. V Move ? #Srories Demolish ? Front 18 Grade ? Depth 10 ft. Aeeromis Fe¢5 Assessment _ Water & Sew Police _ Fire Eng. Planner - Council - Bldg. Off. _ APC - Permit V• uv Surcharge 1. 00 Plon check SAC Water Conn. Woter Meter Totol 10.00 Signature of Permittee I A Building Permit is issued to: L0e W on the express condition thM ull work shall be done in acwy?" ?with ol a licable State?of Minnesota Statutes and City of Eagan Ordirancea Buildinp Officfal ^-` "`"F.i' ?? , ?? Cdafi/v BUILDING PERMIT APPISCATION ?Y7 Include 2 sets of plans, 1 site plan w/elevationa and 1 set of energy calculations. 7b be used far Valuation Site Address: ya-7a maTAsTMe Dz.rvz L-o, qA-,., Vr, w _ Lot Block See. Sub. i9 tq- GG ? Owner J,,ra: IjALS?Jic1? Address Qa.72 YY)o?w?Stdrie T,> Am,V_mw . Parcel Numbar Telephone qsq -a?ag Contractor Addresa Arch./Eltg. Address Erect ' Alter Repair Enlarge Nbve Tlemolish Grade Telephone Telephone OFFICE USE pccupancy Zoninq Fire Zone Type of Const. # of Stories Front DePth ? 0 O£FICE USE Date of Approval & Initial Assessment v7aterlSewer Police Fire Enq. Planriar Council Aldg. Off. A.P.C. FEES Pezmit 9 Surcharge Blan Check ? SAC tqater 4bnn. 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HC7?.^,Y CCRTIF^/ qNA4 TPIQ ACOV:i !D A 4RVit AMYf 9II'. c 4 FZ..Y 6P A Gli6V"Y Q7 - ?- .. _. . . .... .. .. ,. _ .. . - , - ? , I •. l.-6y2-Yf j2bsna11 Cvta$.C < pi ... , , ` . . C-t`3LU1'uy9 T.1?,YdYle - ? .. , ? '?•, . , y. ? • ? , , i ' ?, ? .? ,. . . . . . „) -, . .. ° ?? . . , a , •,. ? . . ?. ' ' .. ttd? " A5 SURYGYEO RV MQ TH p 22DAY 67wpnO A D. 1 t?AsA_n -.!i`i 1F ? ` ? ? . . '. . , . ' ianeo . . ? ? ? ,1<5 ?? •'_; .;!.. _ ?? ..? . r F. G.. JAGi?CQM. `f"?. 17N,t A R601(3TR4T1,PRA ,Mq• p9pQ . . . . . i ? ? ? - . ? . ?'4?.. r . . . ?? . CITY USE ONLY /^ L BL o2. RECEIPT#: / r?,?(/S7 SUBD. Dr4? n/: Lr_.o±ac, "e,-Z?l RECEIPT OATE: ???P 97 1997 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for. . single family dwellings . townhomes and condos when pertnits are required fbr each unit ? backflow preventer fbr underground sprinkler system FIXTUREg EAC-H m TOTAL Shower 3.00 x = Water Closet 3.00 x = Bath Tub 3.00 x = Lavatory 3.00 x = Kitchen Sink 3.00 x = Laundry Tray 3.00 x = 3.00 x - Water Fleatbr 3.00 x z0"2L 3.00 x Gas Piping Outlet ' minlmum - t • 3.00 x = Rough Openings 1.50 x = Water Softener ' for dwellinga under consWCtion 5.00 x = WaterSoftener 'torexistingdwelling 20.00 x = U.G.Sprinkler 'tordweningunderconst. 3.00 = U.G. Sprinkler ' for exisdng dxrelling 20.00 = AftBf2t10n3 ' to existing rosidence 20.00 = Water Tum Around 20.00 = Private Disposal System * Dak Cty lic. 75.00 = (new end reNrbished aystems) Private Disposai Systems' anandonmerrc 20.00 = STATE SURCHARGE TOTAL .50 I hereby ackrwvAedge that I have reed this applicaHon, state Nat the iMomietion ia corred, and agree M compry wfth all appliwble Ciry of Eagan ordinances. ft is the appliraM's responsbility to notly Me property owner thet tha CNy of Eagan essumes no liebility fbr any damages caused by 1he City during its rrortnal oparationel and meirRenence adN1Nes 'IiL'es corksWCled under this (xrtnit within City Property/riphtof-way/easement. WpL5W I CK LEE 4272 MOOti51 OtiE DR I VE SITE ADDRESS: ERGAPI , 55 122 01NNER NAME: H 454-3328 U - '--- INSTALLER NAME: STREET ADDRESS CITY: M-PLS I - ST TELEPHQNE#: ZIP: 5154n8 RE OF PERMITTEE A( 1 zz&-,g /T ?-k ?e?-7 a-- - o? l 9 da'?2 d2 C,° 1? ? - - - ?'S' 0 ? - - r - i ? 0 0 ? ?- ? I ? _? ? - - - 0 ? - - ? ?? 0 tr I I I? 0 0 ? .- -75-O? o ' - g 33 7 a- RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Comtruction Reauirements • 3 registered site surveys showing sq. tt. of IoC sq. ft. ot house; and all roofed areas (20% maximum lot coverage allowed) • 2 copies of plan showing heam 8 window sizes; poured found desgn, etc.) • 1 se[ of Energy CalculaGons • 3 copies of Tree Presarva6on Plan if lot platted after 711l93 • Rim Joist Detad ODtions selection sheet (bidgs wiM 3 or less units) DATE ?I? I ?- () ;L SITE ADDRES TYPE OF WO APPLICANT STREET ADDRESS TELEPHONE # ?Q"3ClS-IY?CSCELL PHONE # Idgas RemodellReoair Renuirements . 2 copies of plan • 1 set of Energy Calculafions for heated additions . 1 site survey for exterior additions 8 decks • Indicate if home served by septic system for additions ?b VALUATION ?? ?r? 0. - v ? . UITI-FAMILY BLDG Y N FIREPLACE(S) _ 0 _ 1 _ 2 I,STATEP)A)ZIP?-?i?3t .? FAX # PROPERTYOWNER TELEPHONE# -------------------------- -----.............. ------------------------------------------------- COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MIVN1:50'1':\ RLfL1:5 7670 Gv1'CGORY I M[\\L:SO"1'A RiiL1:S 7672 (J submission type) • Residential Ventilation Category 1 Worksheet Submilled • New Energy Code Worksheet Submitied • Energy Envelope Calculations Submitted Plumbing Controctor: ____ PlumUing systcm includcs: Mechanical Contractor: V[cch,mic.ll svstcm includc;: Sewer/Water Contractor: _ Watcr Softcncr Watcr Hcater No. oC 13aths Air Condilioning I-Icat Rccox'cry Systcm PllOl1l' # Iawii Sprinklcr No. of R.I. Baths Phone # Phone # --------------------------------------------°----------------°---------------------°------------------------°--------- I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. I j Signafure of AppBcant OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 OFFICE USE ONLY ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 AccessoryBldg ? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement O 38 Demolish (Interior) ? 44 Sitling ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) Final/C.Q _ Footings (deck) FinaWi o C.O. _ Footings (addition) _ Plumbing _ Foundation HVAC _ Drain Tile Other Roof _ Ice & Water _ F inal Pool Ftgs AidGas Tests Final _ Framing _ _ _ _ Siding Stucco Stone _ _ Fireplace _ R.I. _ Air Tes[ _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By Base Fee Surcharge Plan Review MClES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total Building Inspector MECHANICAL (RESIDENTIAL) -9z,6_-z Permit Application City OfEagan 3830 Pilot Knob Road, F,agan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Plcasc complefe 1'or. Single Family Uwellings 'fownhomes and Condos when permits are requircd for each unit Datc ? a' -7 c?' Sit Add YM d d N ST_d N,& DK- Unif # ress e Property Owner 6P- .,4 lot t H'e' w&L S W l eK- Telep6one #( ) ?i? s? ' Y S`? ? 3 S`L Contractor - HOWIE ENEROY CENTER StreetAddress 15= WM iPI28 City . N 654a7 Tele hone # ( Zi 7 b3 ) 4-76- 11 ? J State p p The Applicant is _ Owner L-?'Contractor _ Other Add-on, modification or alteration to existing dwelling unit $ 30AU furnace replacement air exchanger air conditioner rn ? other - n BY - ? g 50 State Surcharge ? 3o s?a Total l hereby apply for a Residential Mechanical Permit and acknowledge that the information is compiete and accurate; that the work will be in conformance with the ordinances and codes of tlie City of Eagan and with the Mechanical Codes; that 1 understand this is noi n permit, but only an application for a permit, and work is not to start without a permiY, that lhe work will be in accordance wiih ihc approved plan in the case of work which requires a review and approval of plans. o S E AA-a j /'Vl EqF rZ Applicaut's Printed Name Applicant's Signatur MECHANICAL (COMMERCIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone 9 651-675-5675 FAX 4 651-675-5694 Please complete for: commerci3l/industrial6uildings multi-fam;ly buildings when separate permits are no[ required for each dwelling unit Date Site Address Unit # Tenant Name (it applicablet Previous Tenant Name ? Peupeeiy O;vuer - - - --- ------ -- Telephone # ( ) Contractor Street Address .,?v... ,. City State Zip Telephone # ( ) The Applicant is _ Owner Contractor Other Work Type _ Newconstruction UndergroundTank _Install _Remove _ Interior Improvement. Call for inspection during installationfremoval of tank _ Processed Piping Nature of Work: Permit F¢¢ $50.50 Minurtum Fee (includes Slale Surchargc) Contract Value $ x ;.% = $ pe.rmitFee • If permit fee is $1,000 or less, add $.50 => $ State Surcharge If permit fee is over $1,000, add $.50 per $1,000 Pemut Fee $ Total Fee . t___1_. _ _.,v,vuy nyp,y ,vi a wmmerciai rviecnamcat reruut antl acimowledge that the information is complete and accwate; that the work will be in conformance with tae ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a pemut, but only an application for a perniit, and work is not to start witLout a permit; that the work will be in accordance with the approved plan in the case of woik which requires a review and approval of plans. ApplicanYs Printed Name ApplicanPs Signature Approved By: , Inspector Date: -;? ys2"1 Zoos RESIDENTIAL PLUMBING PeRnnir aaPLicartoN CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. $'iS. 5 0 Date'D7 23I05 - CAMPOS,SAN?RA SItB Street AddfeSS _ 4272 MOONSTONE DRIVE U?I? # EAGAN, MN 55122 (612) 242-9959 PropertyOwner Telephoneq ( ) Contractor. Ndrblum PLL4,m (7f n ? Telephone# Address 2-qD5 C1ar"FI$L4 f1V. SD. City mTZS Statem k1 Zip(?Gqog 11, The Applicant is: _ Owner V Contractor _Other Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license includes County fee $ 100.00 ' Per as-built $ 10.00 Alterations to existing dwelling $ 50.00 _ Add plumhing fixtures. This fee includes instaliation of a water softener andlor water heater at the same time. If you are installing onlv a water sottener and/or water heater, do not complete this section; move to the next section and check the appliance(s) you are instaliing. _Septic System Abandonment ? - L 8 _Water Turnaround (add $130.00 if a 5/8" meter is required) Other: / Water Softener Water Heater $ 15.00 / _ new 1! replacement Lawn Irrigation _RPZ _PV8 _new _repair _rebuild $ 30.00 State Surcharge $ .50 Total $ i GJ 5n I hereby apply for a Residential Plumbing Permit and acknowledge 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 plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not t stait without a permit and work will be in accordance with the approved plan in the event a plan is required to ZSe`;evje?{u?Ianh[approyed. , Jeff-rew L. Nortlorvi, ?i`? ApplicanYs PrinfL:rd Name City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4272 Moonstone Dr Lot: 19 Block: 2 Addition: Cedar Grove 2nd PID:10- 16701 - 190 -02 Use: Description: Sub Type: e- Reroof Work Type: Replace Description: House Census Code: 434 - Zoning: Square Feet: 0 Comments: If there is no ice protection inspec acceptable in lieu of inspections. Fee Summary: Valuation: 3,000.00 Contractor: New Life Contracting Inc. 2478 Hillwood Dr E Maplewood MN 55119 (651) 274 -6943 steven virkus PERMIT City of Eaan BL - Base Fee $3K Surcharge - Based on Valuation $3K Total: Applicant/Permitee: Signature - Applicant - Construction Type: Occupancy: Permit Type: Permit Number: Date Issued: Permit Category: on prior to final, you must meet inspector with ladder and flat bar. Pictures are not Owner: Sandra J Campos 4272 Moonstone Dr Eagan MN 55122- -204 $88.50 0801.4085 $1.50 9001.2195 $90.00 Issued By: Signature Building EA086130 09/16/2008 ePermit I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State 46. City of Eapil 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use Permit #: I O ( Permit Fee: L.V" ® Date Re eived: Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: LIZ -72— . .4tiSTrp vf-') DXIy /a4/.4-ri . - -ti 5)71L Unit #: Name: SOL n8 rC Ca. tn, ip c Address / City / Zip: 427.2 Dlt _ E/4G .-tom Applicant is: X Owner Contractor Phone:4 1 f Description ofwork:4j tAE-55 ltb..7t' t _ Construction Cost: Multi -Family Building: (Yes / No X ) Company: Contact: Address: City: State: Zip: Phone: License #: Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 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: Phone: Sewer & Water Contractor: Phone: Mechanical Contractor: NOTE: Plans and supporting documents that you submit are considered to be pu, the information maybe classrbed as non-public tf you provide specific reasons tl conclude that they are trade 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 1 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 1 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 U (a_Ca pryl poS Applicant's Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA116976 Date Issued:10/14/2013 Permit Category:ePermit Site Address: 4272 Moonstone Dr Lot:19 Block: 2 Addition: Cedar Grove 2nd PID:10-16701-02-190 Use: Description: Sub Type:Reroof 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. Carbon monoxide detectors are required by law in ALL single family homes . Chuck Glum Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Sandra J Campos 4272 Moonstone Dr Eagan MN 55122--204 Highmark Exteriors 11237 Nicollet Ave S Burnsville MN 55337 (952) 882-8904 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA127900 Date Issued:10/20/2014 Permit Category:ePermit Site Address: 4272 Moonstone Dr Lot:19 Block: 2 Addition: Cedar Grove 2nd PID:10-16701-02-190 Use: Description: Sub Type:Fireplace Work Type:Gas Insert Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to concealing. Carbon monoxide detectors are required by law in ALL single family homes . Valuation: 3,000.00 Fee Summary:BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 $90.00 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 - Sandra J Campos 4272 Moonstone Dr Eagan MN 55122--204 Hearth And Home Technologies 2700 N. Fairview Ave Roseville MN 55113 (651) 638-3309 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA163061 Date Issued:08/12/2020 Permit Category:ePermit Site Address: 4272 Moonstone Dr Lot:19 Block: 2 Addition: Cedar Grove 2nd PID:10-16701-02-190 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 - Steven J Lawrence 4272 Moonstone Dr Eagan MN 55122 Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 Applicant/Permitee: Signature Issued By: Signature