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4346 Nicols Rd L Use BLUE or BLACK Ink I For Office Use ° Permit "s zo I City of Eap I Permit Fee: [ J ~I 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: r31~~ j I I Phone: (651) 675-5675 Fax: (651) 675-5694 Staff: 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 7 3 I Site Address: 3Li (o tV ~~r n LS 1Kdt Unit Name: r ~ Phone: (oj'a- a lt`o 1 d R-,7 RESIDENT / c OWNER Address/ City /Zip: 3~(0 i GOIS R Gc,~~ S S l 'f I.J Applicant is: Owner contractor Description of work: 19 ..l y 0 Rrw vo < d K- Y . TYPE OF WORK < r Construction Cost: A go `dU Multi-Family Building: (Yes / Nq ) r Company: ~TDttZti + - D-,N. l.lS= Contact: k uc%~ C C) Address: IBS ~V _ St~ti d £,~Ui City: C~(AK G~-z- CONTRACTOR Staterr Zip: Phone:. License % Lead Certificate ~ Cl S ° l 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: 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 they 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.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. x V 4 e.t G ~1~ 1~1.~ U~ x Applicant's Printed ame Applicant's Sig ture Page 1 of 3 ? COntrol INSPECTION RECURD ? No. CITY OF EAGAN PERMIT TYPE: N ii i i. E't rtF? 3830 Pilot Knob Aoad Permit Number: Eagan, Minnesota 55123 Date Issued: 112/16/92 (612) 681-4675 SITE ADDRESS: 1. 0'r: eews 031 o+:tc rSSWAPPLICANT: 4346 NIf.01,S 00 0G0 :1M1"I? ?.CAM RErMODELIN6 I19C CEDAfr RROVf! 1TM (6'12) 653--6020 PERMIT SUBTYPE: TYPE OF WORK: ', t ( M i ';r: _ ) REPAIR OFSCRTPTION S7DIMii/80fiTt f 1'ASC -- - __ - - - __ _ - - - - - - -- -_ RfMARkgt RECF [PT * ' PKmR No. Psrmlt FWWer Dau TeNphorn • SlYV PLUMBING HVAC ELECTRIC ELECTRIC Inspsetbn Dds Inop. Comments Footings 1 Foundatbn Framhfg 11-311inB Rough Plbq. Rou9h Htg. Md. Firepfac;e Ffrad H6p- Oreat TeBt Final Plbg. Plbg. Inspector - NaRify Plumber Const. Meter ErprJPten Bldg. Final J ? Up //1 Deck Ftg. Dedt Finel Wetl Pr. Diep. CITY OF EAGAN Remarks * Cedar Grove Acqyisition Addition CEDAR GROVE #4 Lot 6 Blk 6 Parcel 1Q 16703 060 d6 owner?-?? j? ???`=< =^r'? y street 4346 Cedar Avenue Stace Eag?, MN 55122 Improvement . Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK # SEWER LATERAL 1,304.00 WATERMAIN * WATER LATERAL 1972 WATER AREA STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PAR K EAGAN TOWNSHIP BUILDING PERMIT Owaez ...... .4-, - qe ge- .C/ .............._"'------........ Address (Present) ...--°---------- ``.?'°`? "' --... . Builder .......... - - .. --.- ..... • .-4...? ................'--'----'.--- ?3 Address ................... .................. ..."`°--......-----------.._. ...`----- DESCAIPTION acO N° 1341 Eagan Townahip Town Hall Dale ... ?-`?1..?!.?...... "'-"""""'. Siories To Se Used Far Froni Depih Heigh! Esl. Cos! Permif Fee Remarks 2y u LOCATION Streei, Road or ofher Descripfion of Locafion I Lo! I Block ? Addifion or Tract G 1 6 1 e,.& 0- y This permit does not aufhoxize the use of slreets, roads, alleys or sidewalks nor daes it give the owner or his agenf the righi !o create anp siiuaiion whiah is a nuisance or which presenSs a hazard 20 the healfh, safelp, eonvenience and gexesal welfare !o anpone in the communilp. THIS YERMIT IKUST BE EI P?T O'N THF? PREMISE WHILE TEi£ WORK IS IN PROGRESS. This is !o cerlify, ---°----.....a'4? ---......---........has permission !o eseet a.... ------ - ----------- -•---°-----°_.......... upoa the above described premise subjeol !o the provisions of the Building Osdinance fos En To ship adopled April 11. 1955. ? a o....--- .....- -....----°°°--?U:KJ.. /?.... _6?.. Per . -- ........ _ ?....._g .------------------° Chairman of Tnwn oarB d 2 - ? Buildin Ins ecior EAGAN TOWNSHI_P N° 124., BUILDING ,PERMIT ? . Ownei ....-.....(.,Q7..:......----------- -. ' Eagan Township Address (Presenf) ._?_"...(/i?.:.447iciG<C---------- ------ --------- ? Town Hall . . ......... Builder ? '. .--.... - ? --- .... .--'----°--._....... __ ---?---......_..__......__. ... ? . / ? ??, ? ............... . ? Date __ ... Address .... .... .......... ?---...................... .......... ........ ...------------ -.._..---- . DESCRIPTION Used For Froni Slories ?.To?Be ? .? Depih - Heighi Esi. Cost Permif Fee -- Aemazks T -- -- _ --- - . . -_ ? - Sfreel. Road or oiher Desczipnon ox Loeanon I Lox Inlocx I namnon or iract o[ ?7 ?? 6, 3?? G3» hL This permii does not aulhorize the use of sfreels, roads, alleps or sidewalks aor' does if give the owner or his agent the righi !o creafe any sifualion which is a nuisance or which presenis a hasard to the health, safety, convenienee and general weifare !o anyone in the community. - ., I THIS PERMIT MUST BE KEPT ON TH£ PREMISE WHILE THE WQRK I5 IN PAOGRESS. .? ' This is io cesfify, !o .erecf a...-.'?.r ..` ?,?.'..?.".?. J....... . ?L'::'?;G.. . ... . ? upon the above described pzemise subjeci !o the provisions of !he Suilding Ordinance for EagarYl7'Ownship adopi . e April 11, 1955. ? ? v"'?d?-•?_.------°----. Per ....._.FrL...il=p 'C....:.......................... .. _""_"_........_"'_......... " ................'' Cheirman of TnwnAoeAd Building Inspeaior PERMIT C°n ° N° 1400 ? CITY. OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B u Y 1. n.r N c Eagan, Minnesota 55123 Permit Number: 001947 (612) 681-4675 Date Issued: 12 / 7. 6 J 9 2 SITE ADDRESS: 4.31 46 NTC(7L5 RD I.OI'! 0006 i3LOCK: 0006 CEilFlR GFtOVF I Tti 10--16703-47647-06 DESCRIPTION: .. SI[J1NG!S(JFF]:-f /FHSCIFa ;'Quildi,'rag Per -mi't: i?.YPe Sr (H7:SC.) Buil.d.ing"',Work 7ype REpAIR REMARKS: a e c r tP'r ih FEE SUMMARY: VAI.UATZON $10,000 [3asr, F'ee $11 7.0 0 Surcharge 00, TnT.al Fee $1.22.00 , CONTRACTOR: - A p p 1 i c a n t- s T. L1 COWNER: ANIERTCRN RFI+i00ELINCi TNC 15530020 0002406 STAUDIN6ER PAUL. 3700 F4NNA}"OL1'h Lh! 1134 C, IVICOLS R0 PlYMOUTH MN 56447 FA(sAN MN 55122 (512) 553-0028 (012)452-5975 I hareby acknowledqe ihai: I hava read this application and state that the information i.s correct and agree to comply wiT.h all app)icable State of Mn. L Statutes and CiCy of Eag7n Ordinances. ? (L 4?mQ'P ,-?.a?a R?;? ? rn?1 APPLICANTlPERMITEE SIG ATURE ISS ED Y: SIGNAT RE PERMIT N REACTIVATE _ CITY OF EAGAN 1992 BUILDING PERMIT 681-4675 APPLICATION SINGLE 8 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COhMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies when typing of permit is requested, but not picked up by last working day of month in which re uest is made ar lot chan e is re uested once ermit is issued. Date luation of work ? Site Address• BTREET SUITE N Tenant Name: (commercial only) IAT (_ SIACR I SUSD. I,QGULr_ P.I.D. * Descri tion of work: 06 G'eai The applicant is: ? Owner Cantractor 0 Other coes«sne> Name _ ' ??«g?? ? Phone Property O LA5, FIRST t wner '- lloo% pdd ress STREET STE / "?t? St Cit t ? Z i y a e p Company Phone U Contractor AddresvA?Iao License # 06 Exp. City Dulc 5tate Zip,::J? Company Phone ArchitecU Engtneer Name Registra4ion # Address City 5tate Z;p Sewer b water licensed plumber . Processing time for sewer & water permits is two days once area as een approve . I hereby acknowledge that I have read this application and state that the information is correct and agree to comply wi h all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applica . " ?t r A54- s5-l 5 LrT Jy ? NAME SIZE ? . f Dr-.lrra5 E. TEL1..e.h.toEtZ ?Z4,+t,4. eLOCK #, - ADDRE55 ?/LUE ? ?ry 434(o l.. to?.rz NvE i s ;ti= [y`? 1fl! /E T AREA TYPE _ i t_c,. E..,EC?A2 l.t?zovc 17n?!??;n•? Ic..?ze,r1 ? I . 24 .? i :o ? cli T ?uuov.T .& s; -Un.?T )- ga. ao 67?y72 ?----------------- ; Clty of Eatan I Pertnit Fee: I 3830 Pilot Knob Road Eagan MN 55122 i Date Received: i Phone: (651) 675-5675 i stan: Fax: (651) 675-5694 1 ' -----------------? c M N t to t Use BLUE or BLACK Ink For Office Use I ~ Permit non City of Ea Ed I Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: '~3-12- j Phone: (651) 675-5675 l I Staff: Fax: (651) 675-5694 I 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Date: '7/1 ZSite Address: ~J34 Iv C- C> L S IRC~ Unit Name: S fir~ L-A CS l ro (~,Zjc_ Phone: Y SJ_ S `3 S RESIDENT / OWNER Address / City / Zip: 3 t-Cto C~L.S PC) P VAc31[+t~ , SS L ZZ a Applicant is: Owner ontractor TYPE OF WORK Description of work: P, v,-,. II-- Construction Cost: Multi-Family Building: (Yes No ) SAD rz l l.~ ~1 lti a1~ C Company: Contact: CONTRACTOR Address: )3Ss ~~w~yr~ P~D, SL, L ~k City: LF\l~-p~-~ State:VN'N VV Zip: SS I Z_ Phone: ( 1- 73 1 License 3 C 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: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of r the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they 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.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. x k ~ V C-4 i T-L w, x Applicant's Printed Name Applicant's Sign re Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA129178 Date Issued:01/16/2015 Permit Category:ePermit Site Address: 4346 Nicols Rd Lot:6 Block: 6 Addition: Cedar Grove 4th PID:10-16703-06-060 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. Applicant: Tony Boerner 2090 County Road 42 W Burnsville, MN 55337 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 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 - Beverly Staudinger 4346 Nicols Rd Eagan MN 55122 Tony's Appliance 2090 County Road 42 West Burnsville MN 55337 (952) 435-2442 Applicant/Permitee: Signature Issued By: Signature For Office Use .�� �� 1%1 ; ; �i � :::e: EAGAN e I� 71 14-1, AUG 16 2018 Date Received: 3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 (651)675-56751 TDD:(651)454-85351 FAX:(651)675-5694 Staff: buiidinainsoectionsCa citvofeaaan.com L 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 8/16/18 Site Address: 4346 Nicols Rd Untt#: Name: Beverly Staudinger Phone: 612-296-7089 Resident/ 4346 Nicols Rd Ea an,Mn 55122 Owner Address/City/zip: g Applicant is: Owner X Contractor Description of work: Drain Tile Type of Work K-11 Construction Cost: 7080'00 Multi-Family Building: (Yes ,/No X ) Company: Standard Water Control Contact: Kelly Henderson Contractor Address: 5337 Lakeland Ave N City: Crystal State: MN Zip. 55429 Phone: 763-537-4849 Email: mike@standardwater.com License#: BC001522 Lead Certificate#: NAT-21436-2 If the project is exempt from lead certification, please explain why: 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: Fire Suppression Contractor: Phone: NOTE:.Plans and supporting documents that you submit are considered to be public information. Portions of the Information maybe classified as nonpublic If you provide specific reasons that wouldpermit the City to conclude that they are trade secrets. _ You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an emal update on the City's website at www.cityofeagan.comisubscribe. 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. 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.gonherstateonecall.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 Kelly Henderson x Applicant's Printed Name Applica gnature 9.1,1-fte1. .1 3LP I DO NOT WRITE BELOW THIS LINE SUB TYPES _ Foundation — Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family) _ Single Family ___. Garage — Porch(4-Season) _ Exterior Alteration(Multi) Multi _ Deck — Porch(Screen/Gazebo/Pergola) 4Miscellaneous _ 01 of_,Plex _ Lower Level _ Pool _ Accessory Building WORK TYPES New — Interior Improvement ____ Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior _ Alteration _ Fire Repair ^ Windows _ Demolish Foundation Replace * Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION Valuation l j DP) Occupancy /1. MCES System Plan Review Code Edition 00\40/s, SAC Units (25%_100%, ) Zoning R,.1 City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction -76-- Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) Final I C.O.Required Footings(Addition) x Final I No C.O. Required — Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test Hood Roof:_Ice&Water ,_Final Pool: Footings _Air/Gas Tests _Final / ` Framing 30 Minutes 1 Hour Drain Tile Fireplace:_Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath Brick_EFIS °Ss Insulation Windows Sheathing Retaining Wall: Footings_Backfill Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control Shower Pan — Other: — Reviewed By: , Building Inspector I RESIDENTIAL FEES � A ' Base Fee 2 V v Surcharge 'l-) Plan Review `f)01 61)P1 MCES SAC City SAC 5 "/ -i 0 Utility Connection Charge1.,„ ('1. S&W Permit&Surcharge - 1 Treatment Plant r• ,''1/7° Copies 3 -DS'<12- r�J / V TOTAL Page 2 of 3 • qi.ttivs_d t For Office Use ; Permit#: /0-®c) grI lY E AG N Permit Fee: IAF CEIVED °)-� -f Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX:(651)675-5694S E Q Staff: buildincinspections@cityofeagan.com 7 2018 L 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: Name: EU 'y S 11�� V I N IA'L Phone: (0 L Z- Z €i0 g(o cs -•L� Address ty Zip: 7 3 `! t O ! 1�X1)'. .11" l`► 5l Z Applicant is:/CiOwner Contractor ew Description of work: 9`YL MD D.4..I ISA Pe (vlrt 144 J M 19,N L(i't� (IA) '% 11 1Y) ,hi 9 y k - ) ?. Construction Cost: Li D ) Multi-Family Building: (Yes /N•� Company: C.11'(Z I f-.) Pl N S -1.7V L Contact: DNA OL SO 14 Address: N a D 'PA K It 1)• City: C. k 1N PftS5a 2001 i� 5 Phone:q5Z ry Email: PAP( ChYi5+1A/JSIN State:MN Zip: ��7 License#:DL 0037) 1 Lead Certificate#: /f / -7/ b Zy If the project is exempt from lead certification, please explain why: 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: Fire Suppression Contractor: Phone: wPna u classifie u t . a vr3� m oilpu41161u Y� l r a ; X 1 bw You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaaan.com/subscribe. 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. 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 accordance with the approved plan in the case of work which requires a review and approval of !ans. x DAVE O45'v19 x Applicant's Printed Name Applicant's Signature '&/(o /1/"'hv/S X[� / DO NOT WRITE BELOW THIS LINE /.S/ t2/ SUB TYPES Foundation — Fireplace Porch(3-Season) _ Exterior Alteration(Single Family) ?‹, Single Family _ Garage _ Porch(4-Season) Exterior Alteration(Multi) _ Multi _ Deck _ Porch (Screen/Gazebo/Pergola) Miscellaneous 01 of_Plex _ Lower Level _ Pool — Accessory Building WORK TYPES _ New Interior Improvement _ Siding _ Demolish Building* — Addition _ Move Building _ Reroof _ Demolish Interior _ Alteration _ Fire Repair _ Windows Demolish Foundation Replace _ Repair _ Egress Window X Water Damage Retaining Wall *Demolition of entire building/ give PCA handout to applicant DESCRIPTION— f Valuation 100° Occupancy MCES System Plan Review Code Edition 0#411,01, SAC Units (25%_100% ) Zoning 1R-` City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction Width REQUIRED INSPECTIONS __ Footings (New Building) Meter Size: Footings(Deck) Final/C.O. Required Footings (Addition) /` Final/No C.O. Required Foundation Foundation Before Backfill )( HVAC_Gas Service Test Gas Line Air Test Roof:_Ice&Water Final /v Pool:_Footings Air/Gas Tests Final Framing 30 Minutes 1 Hour Drain Tile Fireplace:_Rough In Air Test Final Siding: Stucco Lath Stone Lath _Brick_EFIS AInsulation Windows Sheathing Retaining Wall:—Footings_Backfill Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control Shower Pan ___?K_ X Other: fl E7, Reviewed By: I (/ , Building Inspector RESIDENTIAL FEES Base Fee Surcharge opfloPlan Review MCES SAC City SACLi 0 / 0 ° ° Utility Connection Charge l S&W Permit&Surcharge Treatment Plant Copies TOTAL Page 2 of 3 For Office Use �j as$ i i '',or :::e: ja`/l Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD:(651)454-8535 I FAX: (651)675-5694 Staff: buildinginspectionsa..citvofeagan.com L 2018 RESIDENTIAL PLUMBING PERMIT APPLICATION Date:a ? 7/r Site Address:s�?X‘ o1/`eti 0 Is k Tenant: Suite#: . ., _ ._. ._ ._. , ..., .,, .... ,..a__,.-. ...,m.._ _ ______ .. ,a_..F Name: Phone: I -_.__. �,. Resident/Owner Address/City/Zip Name:/0/ / C.®/ iM mMb,License#: ?C 6/73 0 I Contractor Address: � �/ State/� Zip:ss 'V Phone:,X3 5 Z5 ?$ CoA ntac Email• jJ1 L 41 i/ •/ i C F?,'Y/ ......: T of Work -New ,Replacement 'Repair —Rebuild —Modify Space —Work in R.O.W. Yp Description of work 'ke i d c ji7 - /© ,9 , ),‘r©O -'F'J s- RESIDENTIAL I Water Heater Water Softener I Lawn Irrigation(—RPZ/—PVB) I Permit Type IAdd Plumbing Fixtures ( Main/—Lower Level) l Septic System _New ` d Water Turnaround }} P i $ Abandonment 1 RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation (includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge) *Water Turnaround(add$280.00 if a 3/4"meter is required) $115.00 Septic System New(includes County fee and 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.aopherstateonecall.orq You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaoan.com/subscribe. 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 accordancean�JJwith the approved plan in the case of work which requires a review and approval of plans. Applicant's in ed�� c����/,'") elii../ i naturey ni��/ FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In Air Test Gas Test Final Meter Related Items: Meter Size Radio Read Manometer Staff: PERMIT City of Eagan Permit Type:Building Permit Number:EA171443 Date Issued:08/16/2021 Permit Category:ePermit Site Address: 4346 Nicols Rd Lot:6 Block: 6 Addition: Cedar Grove 4th PID:10-16703-06-060 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 - Beverly R Staudinger 4346 Nicolas Rd Saint Paul MN 55122--191 (612) 296-7089 Mad City Home Improvement 5020 Voges Road Madison WI 53718 (651) 500-0514 Applicant/Permitee: Signature Issued By: Signature