1640 Norwood Dr
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - - -i
I For Office Use I
e I /
Permit
City of Ea a~ I I
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 I Date Received:
I
Phone: (651) 675-5675
I
Fax: (651) 675-5694 Staff:
2012 SEWER AND WATER REPAIR / DISCONNECT PERMIT
Date: Fee: $60.00
City Sewer. City Water Repair Disconnect
Description Of Work: r~
Street Address for Proposed Work lJ d
Name: D on, (=C ` Phone:
OWNER Address/ Cit / Zi ll/D `rW O
Y P
Applicant is: Owner Contractor
Licensed Pipelayer Master Plumber Property Owner
Name: ~J' UV Y✓ Phone: ~L D67
Address / City / Zip:
Pipelayer Training Certification Card 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 i t a it, but only an application for a permit, and work is
not to start without a permit.
of U
Applicant (Pr Name) icant's gnature
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
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHON E: 454-8100
BUILDING PERMIT Receipt ?
To be used for Est. Value ? Date ,19
Site Address -
Lot Block Sec/Sub. Parcel No.
a Name
W
3 Address
° City Phone -
,a Name "
? Q Address
P City Phone
Name
Address
City Phone
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 Eaean Ordinances.
Signature of Permittee
A Building Permit is issued to: ?
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
On SRe Sewape Qccupancy
MWCC System Zoning
O^ S1te Well (Actual) Const
City Water (Allowable)
PRV Required * of Storiea
Booster Pump Length
Depth
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr./Assess. Permit
Planner Suroharge
Council Plan Revfew
Bidg. Off. SAC, City
Variance SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P1
Parks
TOTAL
Psrmit No. Permit Hotdsr Date Telephont s
Plumbing
H.V.AC.
El@OSriC
/
Softener
Inapection Date Insp. Comments
Footings I
Footings II
Foundation
f8f111119 ?
Roofing ?- 7 - b y ';/?` ?
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Final Pibg.
Bldg. Final
Cert Occ.
Temp. LP
Deck Ftg.
Deck Final
wen T/JG - aCO ?-?
Pr. Disp.
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE
19
wacsrvio
rROM
AMOUNT $ I
& DOLLARS
+oo
C]CA5H []CHECK
FOR '(J Z1 r
White-Peyers Copy
Yellow-Posting Capy
Pink-File Copy
Th nk You
??'" B Y
CITY OF EAGAN ? 17
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHON E: 454-8100
BUILDING PERMIT Receipt #k
To be used for Est. Value Date 19
,
Site Address ? ? j'' ' ''` ' • '?? i' ":
Lot Block " Sec/Sub. T 1 A; - Y
Parcel No.
a
W
2
3
0
a Nan
.o
? ? Add
?¢- City
SM1E:
J
OF FICE USE ONLY
On Site Sewage _ Occupancy
MWCC System _ Zoning
On Site Well _ Type of Const
Ciry Water _ (ActuaQ
(Alloweble)
* of Storles
Length
Depth
S.F. Total
Footprint S.F.
APPROVALS
PhOnB Asseasments
Water/Sewer
Police
Fire
Enqr.
Phone
Planner
Council
I hereby ecknowledge ihat I have read thia epplication and state Bldg. Off,
thattheinFormationiscorrectandayreetocomplywlthallepplicable APC
State of Minneaota Statutes and City of Eapan Ordinances. Variance
Signature of Permittee -
A Building Permit is issued to:
all work shall be done in accordance with all applicable State of Minnesota Statu
Building Official
FEES
Permit
_ Plan Review
_ SAC, Cfry
_ SAC, MWCC
_ Water Conn.
_ Water Meter
_ Foad Unif
_ Treatment P1
_ Parka
Copies
TOTAL
_ on the express condition that
and City of Eagan Ordinancea
Permlt No. Pormit Nolder Date Telephons it
Plumbing
H.V.A.C.
E lectric
Softener
Inapection Date Insp. Comments
Footings I 3 n
Footings II
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Fina! Htg.
Final Plbg.
Bldg_ Final
Cert. Occ.
Temp. LP
Deck F g.
Deck ?72-8-^ l)
Well
Pr. Disp.
cirY oF Uc,AN
, i 3795 Pilet Knob Read Eagon, MN 56122 : ?
PHONE: 454.6100
BUILDING PERMIT Retelpt # '
To w wW Mr SF WGJGAR Est. Value $99 ,0[)0 pate Julv 8 t9 83
Site Address 1640 ?durwood Dr1ve Er
t R-3
O
ec ccuponcy
Lot 9 Blotk 3 ?/Sub 71rittsny lst /hiter ? Zoning R-1
Porcel # 10 15000 090 03 Repoir ? Fire Zone NA
l
f Enlorye ? Type of Const, v
99 Name To
Ie
son Euildors, Ix3C. M # St
i
Z
" ove ? or
es +
KU
-- ^ddrea dorwood Drive
s 1655 . pe,,,ol;sh Q Length
? Cjty E ausn 55122 pFone 454-6873 Grode p Depth 3E' Sq. Ft.
_ ?!wner
Nome wpprovals
O
?? /lddress
r Assessment
Water 8 Sew
Cit Phone .
?
? Police
?W
Nome
W
Fira
Addrass Eng.
<'Z" Ci phore Plonner
Council
I hereby ocknowledge that I have reod this applicotion ond state that Bldg. Off.
the informotion is correct and ogree to comply with oll appliccble
Stota of Minnesofo Stotutes and City of EaQan Ordirances. A?
Faes
Permit 4 3U . UU
Surcharpe 49.50
Plan check 215. QQ
s^c 525.00
Water Conn. 450.00
Water Meter 60.00
Road Unit 250.00
Total $19 7 9. 50
Signature of Permittee I
To e soa u ers, nc.
A Bullding Permit fs Issued to: on the exprcss conditfon thrn
oll work shell be done in accordonte with oll appliaoble State of Minnesota Statutes and City of Eagan Ordinances.
Buildirg pifitiat
t
Psrmit No. Permit Holder Misc. Permit No. Holder
Plumbing q lj y / $
H.V.A.C. C7 ! o? p
Well
Water
Disp.
S?vrsr
Elsctric `9 l A(I Lt 1-11'a ?
Intpection Date Insp. Other
Footings -22-8, P-1.4.)
Foundation
Framinq
Rouyh Pibq.
Rouyh HVA
Inwlation
Final Plbq.
Final HVAC ?f
Final ? .
Wa"r Qswibe Location:
Wsll .
Sewer
Pr. Dfsp.
Receipt MECHANICAL PERMIT Permit No. •
CITY OF EAGAN
Fee
Fill in numbered spaces S/C
Type or Prinr legib/y Tat.
1, Date 2. Installation Cost
3. Job Address Lot Blk. ? Tract
4. Owner
5. Contractor - Phone
6. Address
7. City State 2ip
8. Building Type: Residential ? Commercial ? Institutional ?
9. Work Description: New 0 Add O Alter ?
I 10. Describe
I 11.
Repair ?
Type
No. Epuioment 8TU - M. Ea.
Forced Air No. Equipment CFM
Air Ha
dli
:
Mfg. n
ng
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved - CITY OF EAGAN 454-8100
Receipt PLUMBING PERMIT Permit No.
CITY OF EAGAN
j Fee
„N?t i t
Fill in numbered spaces S/C ?
Type or Prinr legibly Tot ?
1. Date 2. Installation Cost
3. Job Address Lot l Blk. ? Tract i
4. Owner - - " ? -- •--
5. Contractor ` Phone • ? ?
6. Address
7. City State
A41-"„ ?. Zin
8. Building Type: Residential ? Commercial O Institutional ?
9. Work Description: New ? Add ? Alter ? Repair O
10. Describe
11.
No.
-
- I Fixtures
Water Closet No.
- Fixtures
Cesspool/Drainfield
' Bath tubs Septic Tank
-
l Lavatory Softner
?-- Shower Well
Kitchen Sink
Urinal/Bidet Other
1 Laundry Tray
?
Floor Drains
Drinking Ftn.
- Slop Sink
r
i
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough f inal
Inspections: Date Insp. Date Insp.
This is your permit when num6ered and approved.
Approved CITY OF EAGAN 454-8100
INSPECTI4N RECORD
CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number. '? 4 0
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: {•?+ ?+ i? ? ? c?: . APPLICANT:
UI?
_ F„
.
`P ?
- ,
?? •
. _ ? ?-- --- ---'' _ _ _
PEPM1T §4.?T?f PE: TYPE OF WORK:
!+i ' ? . ? ; ! 1 (tl! i,t i:E101
Permit Hotder Dete Telephone R
PLUMBING
HVAC
Inspection Date Inap. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
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
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTi V I TY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FINAL
CITY OF EAGAN Remarks
Addition t3RITTA1vY Lot 9 -sik 3 Parcel 10 15000 090 03
owner 1 yll". ?' street 1640 Norwood Urive State
-,;
-? .
Improvement i Date Amount Annual Years Payment Receipt Date
STREETSURF. 6-6 3.9 ?OIZ, 3 .5- /O /7 '
STREET RESTOR.
GRADING ,5'1 C 28.58 ?? ? 8 •??.3 O Ilo 3S lo ?0 /7 S?
SAN SEW TRUNK "C ao?• ?I A? ? .3,S?o ?0 /7 ?.?
* SEWER LATERAL 1981 5040 87 336.06 / 3 C?•(cZ O/lo,3S?o ?0 ??7 S
WATERMAIN
* WATER LATERAL
WATER AREA / / p . O O /4 O /(o .3S' /O / PiJ
STORM SEW TRK 6-11 32.83 l5 3 a 8,3S ?9o / 35
* STORM SEW LAT igRi
CURB & GUTTER
SIDEWALK
STREET LIGHT
ROAD IT 2
WATER CONN. 450.00 11 t?
BUILDING PER. 8218
SAC ?r rt
PARK
CITY OF EAGAN SEWER SERVICE PEitMR
2533 "ilf: t Knob Road
P. O. Box 21199 PERMIT Np.:
Eagan, MN 55121 DATE:
Zoning: - E-T No. of Units: ?
Owner.
Address:
Site Address: 1F;" 4TgCIIZVod-1):C--Lg H3 $r4Gt?7--i
Plumber:
i 1 egres to eomAyr wkb tis Ciry af Easan Cannection Chorye: - 425,00 Fd
BY Misc PERMR
3830 Pilo3 Knob Road 5 19 ?,
P. O. Box 71199 PERMIT NO.:
Eagan, MM 55127 DATE:
Zani??9: ? I No. of Units: 1
Owner: To17 ?+Fnr?n BL{ 7 dnrr
Address:
Site Addross: 1filQ Nnr.?Cnri ?l r TA B'? Rrirtur? y r
Plumbar: retlz RyaII
Meter No.: Connection C??arge: SO.00 r,ci
5iu: Accowrt Doeposit:
Reader No.: Permit Fee: ?n •?? D?
I?rw ie oainolp ? t?e Cit?r of EMen Surchorge: . SC! pc?.
Ordinenar. Miac. Charges: ??D.f?0 c,d mE?ter
Totnl:
BY Dote Paid:
L3nte of Insp.: Inap.;
cIrY oF Eac,aN -" WATER SERVICE PERNIIT
3830 Pilot KROb Road 5198
P. O. Box 21199 PEttM1T NQ.:
Eagan, Mlri 55121 DATE: 11-16- 83
Zoning: B T No. of Units: ?
Q?yner; Tnl 1 afcnn R+ii1Aora
rESS:
t
/?ddress: 1h40-?zwesd.??l ?1.4-83 SrAttatz3 Lt
?r Genz Ryan
ii
No.: ? S D
r Connection Q?orge: 450. 00 Pd
Size: 8 "'''?-? Atcount Deposit:
Reoder No.: ?412 A 5/a permit Fee: 10.00 pd
1 w?w te oospy wi?h !M Citr of Eayon surcho?ye: .50 pd
Ordie.soM. Mtsc. Chorges: 60.00 Ud met+
? Total:
By Date Paid:
Dete of Insp.. (ntp..
Ordineaees
. AttourM Deposit:
10.0?r nd
Pertnit Fee:
Surchorpa:
. Chor?es:
Date of Insp.: Totnl:
? ?R ? Date Poid:
!
CITY ?F
EAGAN WATER
SERVICE
RESIDENTIAL
.7 BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
New Conshuctlon Reauirements
• 3 registered sde surveys showirg sq. %. of lat, sq. ft. of house; and II roofed areas
(20% maximum lot coverege aibwed)
• 2 copies of plan showing heam & window sizes; poured faund design, elc.)
• 1 set of Energy Calculations
• 3 copies of Tree PreservaGan Plan i( lot platted aRer 711/93
• Rim Joist DeUil Options selecGon sheet (Cldgs with 3 or less units)
DATE `? 3! d9
JOB SITE ADDRESS /0y0 Nr w>n c,/
If MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTYOWNER tl)ch A$, ,,,,o/
TYPE OF WORK Gr.v4-sv ;rnd d?...?/ r.
APPLICANT
ADDRESS
PAGER #
FIREPLACE(S) _ 0 _ 1 _ 2
_ PHONE#C?'S'/J ?q o - %1t1iCY
ZIP CODE
CELL PHONE # lya 7-V63-Y503 fAX #??S/?5'6? ?Y6 ;Z
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
MINNESOTA RULES 7672
New Energy Code Worksheet Submitted
PlumbingControctor: Phone#: 6s/ S'.1°3 -- // YS:
Plumbing System Includes: ? ater Sohener _ Lawn Sprinkler Fee: $90.00
_ Water Heater _ No. of R.I. Baths
_ No. of Baths
Mechanical Conhactor. _
Mechanical System Includes:
Sewer/Water Contractor.
Air Conditioning
Hcat Rccovery System
Phone #
Phone #
1
All above information must be submitted prior to processing of application.
Fee: $70.00
By 7q)
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 Ordinan
SlgnatureofApplicant ??
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 1101
? 9I6.36
RamodeUReoair ReauiremeMa
• Y topies of plan
• 1 set of Energy Calculations for heated additions
• lsitesurveyfore#erioradditions&decks
. Indicate if home served 6y septic system far addilions
K
VALUATION 7 P
OFFICE USE ONLY
? 01 Foundation
? 02 SF Owelling
? 03 Ot of _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 07 05-plex ? 13 16-plex
0 08 06-plex ? 16 Fireplace
? 09 07-plex )(17 Garage
? 10 08-plex ? 18 Deck
? 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Y or_ N
? 20 Pool
? 21 Porch (3-sea.)
)< 22 PorchlAddn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
O 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
x 32 Addition ? 36 Move Bldg. ? 42 Demoiish (FOUndatlon) O 45 Fire Repair
? 33 Aiteration ? 37 Demolish (Bidg)` O 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation U
?tn./ Occupancy 23 -??- MC/ES System
Census Code ??
?` Zoning ?L Ciry Water
SAC Units 0 Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
?
x
X
REQUIRED INSPECTIONS
Footings (new bldg)
Footings(deck) FinaVNo C.O.
Footings (addirion) Plumbing
Foundation
Drain Tile
Roof Ice & Water Final Other
Framing
Fireplace _ R.I. _ Air Test _ Final
Insulation
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
_ Pool _ Ftgs _ Air/Cras Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
Approved By T ? , Building Inspector
{ •: ?,?,„???,??
L _
Jt! "z, n? OLO I G
g
d?L ..5 I° OF T?°ad
r?a??? _
? 30 Accessory Bldg
? 31 EM. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
q1 / 9 ?.
?
?
?c? / ? D
FinaUC.O.
?
HVAC
. cirr oF ea"N
R3795 ilkt Keob Road Eagan, MN 55122
PHONEs 4548100
BUILDING PERMIT Receipt .#
N° 8218
,,76 9a G-
Te ba med far SF HHG/GAR Est,yalue $99,000 pate Julv 8 1 q 83
Site Addreu 1640 Norwood Drive Erect ? Occupancy R-3
Lot 9 Block 3 $ec/Sub. Brittany lst Alrer p Zoning R-1
Parcel # 10 15000 090 03
Name 1Vy1C16UL1 DUIILLCLSq 111C.
Addron 1655 Norwood Drive
Nome
?? Addre,
? r....
Nome _
Address
1 hereby ocknowledga that I have read rhis applicotion ond state tFat
the in(ormolion is correct ond ogree fo compiy with oll oppliceble
Stote of Minnesota Stotutes ond City ot Ea9an Ordirances.
Repoir ? Fire Zone NA
Enlorge ? Type of Consf. V
Move ? # Stories
Demolish ? Length 60
Grode ? Depth 36 Sq. Ft.-
Avorovnb Faes
Assessment _
Water 8 Sew.
PoHce -
Fire
Erq.
Planner _
Councfl _
Bldg. Off. _
APC
Permit 430.00
Surchorpe 49.50
Plan check 215.00
5AC 525.00
Water Conn. 450.00
Water Meter 60.00
Rood Unit 250.00
Torol $1979.50
SiOnOfure of Pertnittee I
ers, Inc.
A Building Permit is issued to: To e son Bui on the expresf conditlon Ihm
all work sholl be done in accordance with all applicable State Minnewta S utes ond City of Eegan Ordinancea.
Bufldinp Official
iL
' "CITY OF EAGAN N! 141 17
3830 Pilot Knob Road, P.O. Box 21-189, Eagan, MN 55121
PHO N E: 454-8100 ?0l i
BUILDING PERMIT Receipt# 7 G
To be used tor DECK Est. Value $1, 500 Date SEPTEMBER 2
19 87
Site Address 1640 NORWOOD DR
Lot 9 Block 3 Sec/Sub. BRITTANY
Parcel No.
: Name DANIEL J RAYMAN
; Address SAME
? City Phone 681-681-6224
,o Name SAME 452-0955 (H)
zf
OFFICE USE ONLY
On Site Sewage _ Occupancy
MWCC System _ Zoning
On Site Well _ Type of Const
City Weter _ (ACtuaq
(Allowable)
it of Storiea
length
Depth
S.F. Total
Footprint S.F.
?a Address ppPROVALS FEES
? City PhOne Assessments _ Permit $29•00
f? Water/Sewer _ Surcharge 1.00
W W Nem@ Police _ Plan Review
t z
_-
Address Fire SAC, City
-
u= Engr. _ SAC,MWCC
4?y City PhOnB Planner _ WeterConn.
Council _ Water Meter
I hereby acknowledge that I have read this application antl state Bldg. Oi[ _ Road'Unit
thattheinformationiscorrectandagreetocomplywithallapplicable APC _ TreatmentPl
State of Minnesota Statutes a City f Ea n Ordinances. Variance _ Parks
Copies
SignatureofPermittee TOTAL ???6?
A Building Permit is issued to: DANIEL J RAYMAN an the express condition that
all work shall be done In accordance with all applicable te of Minne ta Statutes and City of Eagan Ordinancea
Building Official
CITY OF EAGAN {vo 15 5 0 9
3830 Pilot* nob Road, P.O. Box 21 •199, Eagan, MN 55121
PHON E: 454-8100 Q ry
BUILDING PERMIT Receipt# O(,70
Tobeusedfor PORCH/DEGK Est.Value $7,500 Date AUGUST 22 ,1988
Site Address 1640 NORWOOD DR
Lot 9 Block 3 Sec/Sub. BRITTANY
Parcel No.
a Name DANIEL J RAYMAN
3 Address 1640 NORWOOD DR
0 City EAGAN phone 452-0955 681-6224
OFFICE USE ONLY
On Site Sewage _ Occupency
MWCCSystem _ Zoning
On Site Well _ (Actuap Const
City Water _ (Allowable)
PRV Required _ # of Stories
Boaster Pump _ Length
Depth
S.F. Total
Footprint S.F.
IName SAME
0
?Q Address
P City Phone
w
i
a
z
W
Name
Address
City _
I hereby acknowledge that I have read this application and state that the
inlorma[ion is correct and agree to comply with all applicable State of
MinnesotaStatutesan ty Eaga1nOrdipv? ^nces.
Signature of Permittee __ L. A Building Permit is issued to: DANIEL J RAYMHN
on ihe express condition that all work shall be tlone in accordance with all
applica6le State of (M?innesota S"ta't?utes and City of Eagan Ordinances.
Building Off
APPROVALS FEES
Engr./ASSess. Permit
P!anner Surcharge 4-9Q.
Council Plan Review
81dg. Oft. b SAC, City
Variance SAC, MWCC
Wa[er Conn.
Water Meter
Road Unit
Treatment Pt
Parks
TOTAL 94.00
?rle5i REQUEST FOR ELECTRICAL INSPECTION
? See inaW IXions br completing Ihis Form on back of yalbw copy.
p?
E? 9 5 9 4 7 -= X" 6Elow Work Covered by This Request
Esa0ooio7
ew ndd Rep: 7ypeoBuilding AppliancesWired EquipmentWired
Home Range . Temporary Service
Duplex Water Heater Eledric Heating
ApL Building Dryer Other (Specity)
Comm./Indushial Furnace
Farm ' Air Conditioner
OUier (spedy) CamreMor5 Remarks.'.,?/ n //l?ntf .rC?.1?1 /?llf7
Compute Inspectron Fee Belaw:
# 01her Fee # ServicaEntrenceSize Fee # CircuksiFeeders Fee
Swimming Pool 0 to 200 Amps 0 to to0 Amps
Transformers A6ove 200 _ Amps Above 100 _ Amps
Signs Inspectork Use onN: TOTAL ?Sp
Irrigation Booms
Special Inspection
AlartnlCommunication
Other Fee
I, the Eledrical Inspector, hereby
certity that the a6ove inspection has
been made. R°uen-in
F;?ei
. a
oa?e T?q
? ?
OFFlCE USE ONLY
Tliis request witl 18 manths tro.
m 95947 c
Raqueat Da?e '
Q Fire No. Ro -i Inspection
R ' T
? Yes ? No
? Ready Now ? W II NoUry Inspectar
When Reatly?
I El licensed contractor )(0^wner hereby request inspection of above electrical work at:
Job Addreae (Slreet, Box or Route No.) Ciry
&:47-az?
Section No. 7ownshlp Name or No. Rerge No. Counry -
A4iq
OccupaM (PRINn
f .
Power Supplier Atltl?eas
Eleclrical Contraclor (Canpany Name) CoMractaS License No.
Mailing Atltlrees (ConV9clor or Qwner Meking Instellation)
Authoriz n u ontracror r Making Instailafion) Pnorie N(u?mbar
/ G
MMNESOTA ST BOA OFjCCECTRICITY ? THIS MSPECTION REQUEST WILL NOT
GNggaNitlwey IC9? R.
?173 BE ACCEPTEO BYTHE STATE BOARD
1821 Univerelty Ave., SL Paul, MN 55109 UNLESS PROPER INSPECTION FEE IS
Phone (812) 692-0800 ENCLOSED.
This reQUest void / 9-SO
18 months Imm
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-?? ? Fire No. Fnugh-in InsOection
fle wreA?
?Reatly Now yyy,,,
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?Will NotY InsUec-
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R
Yes ?Nu e
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eady
Licensed Elec[rical Co ntrac[or I hereby request insveccion uf above
' Owner elacvical work insmlled at
Street AAtlress, Bax or floute No. Citv
F
lO K-p r L43 CC31? ln-_ ck-?
ecuon o. Township Name or No. liange o. Counry
?
Occupant (PPINT)
-m 11e??lr\- Phone Nu.
Pawer Supplier Adtlress
EI trical C, ontractor\IGOmoany Nnme)? Contracto,'s I.icense N,o/.
?
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Mailine ddres?s IACOntraclor or O er Making InstailatioN
_
M?S 7 - . - N? ts.)o
AuMorized Sig Convactor Own r Makiny Installaiion)
? Ph me Number
`.`?
THIS INSVECTION REQUEST WILL NOT
MINNESOTA STATE 80AflD OF ELECTqICITV
Gripes-Midway Bldg. - Noom N-191 BE ACCEPTED BV THE STATE BOqRD
UNLESS PflOPEN INSPECTION iEE IS
1827 Univarsity Ave., St. Paul, MN 55104
Phone 16121 297-2711 ENCLOSED.
'it/ REQUEST FOR ELECTRICAL INSPECTION EB-00001-04
?:
' See inseructions tor completing thls form on back of yellow copV. ?
"X"' Below Work Covered by Thrs Request ?0 0 9
Add Rep. TyOa oi Buildine AOPliunces Wired Equipmem Wired
Home Range Temporery Service
Duplex Water Hea[er LlGhtiny Fixtures
Apt. Building Dryer Electric Heatin
Commercial Bld,y. C Fumace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm ' °Gy (SOncifv)
I P.! ISVCCI(y OS OLhCf
FPP BP.IOW
p Fee Service EniraneeSixe N Pee Faeders/Suhfenders rt Fee Circuits
0 t0 200 Am 5 0 to 30 qm s - S 0 m 30 Am s-
Above 200 qinps. 31 to 100 qmps ? $. b 31 [0 700 Am s
Swimming Pool Above 100_Amps Above 100_.4mps
Transiormers Irrigation Eiooms '? Partial,'Other Fee
Signs Speciallnspection $ T E
Remvrks / ? . Db ry
v
RouBh-in 41the EIecV'
Insp , ereby
ertify lhet the nbove
Final e/ . nspection has Ceen
(O meEe.
TMe reQueel void 18 montns (rom
CITY USE ONLY
PERMIT #: RECEIPT DATE:
2002 RFSIlDEIVTdAL MECHANICAd. PERMIT APPLIICATpC11V
crrY oe EAsa4rr
sgso PILOT KNOB
EAriAN UN 55122 p
651-681-4675
APR 1 6 200z
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date: A '?:) 11) 2-
SITE ADDRESS:
OWNER NAME: )_1 JjV 1 ?V r(J`,? `C, TELEPHONE PL
INSTALLER NAME: V 1 TELEPHONE #: (0?51
STREET ADDRESS:
CITY: STATE: ? ZIP: J--?1-?-
Place a check mark next to the permit work type
,
Add-on, modification or alteration to existinq dwelling unit
$ 30.00
• fumace replacement
• air exchanger
• air conditioner
• other
Nature of work:
rai,A //UC Ti f2
c?r ? O
State Surchar e $ 50
Total
i .
SIG A TE
1102
FERMIT
CITY OF EAGAN
3830 Pilbt Knob Road
Ea;an, Msinesota 55122-1897
(612) 681-4675
BUILDING
033403
09/23/98
PERMIT TYPE:
Permit Number:
Date Issued:
SITEADDRESS: 1640 NnRwnno nR
LOT: 9 BLOCK: 3
BRITTANY
P.I.IV,e 10-15000-090-03
DESCRIPTION:
nt rcuur
BLj..JdViti'% P e r m i t Type
8,er,??Ldlng?V4o?rk Type
s+;? ?
`417
? .?a a ,;.?*?dt<
STORM DAMAGE
REPAIft
434 RL7. RESZDEN7TAL 97 x„, ,
'n' '4 au 2T^S. ?g+[ a#I
REMARKS:
FEE SUMMARY-
11.1 Aa
t
`u m 4 ?9 ?41s
j . ? R?
?t G4 V 1t,?,.?: aLw? §u a?°, va
rn? T{?erTn p - nNNlll;clfli. -^ JI. Lll,< A?(N ER:
C'tTSTOM`?DI+?'EPTS CONS7 18987290 291q2417 F?AYM?AN DANIEL
16540 KENRICK 100P/STE 8 1640 NQftW00D DR
LAKEVILLE MN 55044 EAGAN MN 55122
(612) 898-7290 (661)782-5556
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PII.OT KNOB RD - 55122 9.? 3-?t ?
681-4675
New Construction Reauirements
? 3 registerod sde surveys
? 2 copies oT plans (inUuCe beam S winCOw saes; poured fid. design; etc.)
? 1 energy calculations
? 3 wpies af tree preservation plan'rf lot platted after 7M193
required: _ Yea _ No
DATE: ??Z Z ? ?Cl1
RemodeUReoair Reavirements
? 2 copies of plan
? 2 ske surveys (exterior addkions 8 dedcs)
? 1 energy calculations for heatad addftions
CONSTRUCTION COST; `"
DESCRIPTION OF WORK:
STREE ADDRESS: i L" Li d ?? P?rr c7On6? Jc? ?',
LOT: 9 BLOCK: 3 SUBD./P.I.D. #:
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Name:' m CW\ ?)G!1 i e I Phone #:
Last Fint
S Ci(?
City / G 9? State: Zip:
Company: CuStOlll COACBptS CptlSh'UCljOtl lllC. Phone #:
1115450 enric Loop, Suite B
Street Address: Lkeville, MN riSAdd
Ciry (612) 898-7290 stace:
Street
Ciry
Sewer & water licensed plumber (new construction only):
and lot change is requested once pertnit is issued.
I hereby acknowledge that I have read this application and state that the information is correct
State of Minnesota Statutes and City of Eagan Ordinances. _el /??
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
Zip:
Phone #:
Registration #: _
State: Zip:
License # 2G'161 Cn?? ? t-
Penalty applies when address chang
agree to
OFFICE USE ONLY I
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16
? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17
O 03 SF Addition ? 08 8-piex ? 13 Garage/Accessory ? 20
? 04 SF Porch ? 09 12-piex ? 14 Fireplace 0 21
? 05 SF Misc. ? 10 = plex 0 15 Deck 1
WORK TYPE
? 31 New ? 33 Afterations ? 36 Move
? 32 Addition E3 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual)
(Allowabie)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq.ft.
sq. ft.
sq.ft.
Footprint sq. ft.
Planning Building
Permit Fee
Surcharge
Plan Review
License MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
SN1l Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Engineering _
Valuation: $
MC/WS System
City Water
Fire Sprinklered
PRV 11
Booster Pump
Census Code.
SAC Code 11
Census Bldg
Census Unit
< _
Basement Finish
Swim Pool
Public Facility
Miscellaneous
_ Variance
% SAC
SAC Units
1 " 1?88 BUILDING PERMIT APPLICATION - CITY OF EAGAN ?
SINGLE FAMILY DWELLINGS
? 0 q
INCLUDE 2 SETS OF PLANS, 3 /LOTS S OF SURVEYp 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNCONTRACTOR/HOMEOWNE R MUST DESIGNATE WHICH ADDRESS
IS DESIRED. NO CHAN ALLDWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENPIIL QNITS FOR SALE UNITS U OF UNITS
INCLUDE 2 SETS OF PL 5, CERTIFICATE OF SURVEY - CHECK WITH HLDG. DEPT.,
1 SET OF ENERGY CA ULATIONS
COhA1ERCIAL
INCLUDE SETS OF ARCHITECTURAL & STAUCTURAL PLANS,
1 S OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS 1j7 ,?
To Be Used For: ti- Seadon ?iYYh Valuation: ?i7_S00 00 Date: B?/??f3 8
Site Address /&?
Lot F Block
Parcel/Sub
Owner -n,.,.,./ . s'. ,
Address /G40 A"l0e.?coel JJr
City/Zip Code F_ddcr?Yl ez?. M22
Phone
Contractor
Address
City/Zip Code
Phone
Arch./Engr. _
Address
City/Zip Code
Phone #
On site sewage Oceupancy
MWCC system _ 2oning
On site well Aetual Const
City water _ Allowable
PRV required _ Il of stories
Hooster Pump _ Length
Depth
S.F. Total
Footprint S.F.
APPROVALS
Engr/Assess
Planner
Couneil
Bldg. Off.
Variance
iw(?I.??
Permit
Surcharge
Plan Review
?t&,SAC, City
SAC. MWCC
Water Conn
Water Meter
Road Unit
Treatment P1
Parks
Copies
TOTAL
90
?
? , ? .? .. ,, .
. _. .
??
?
I
?: --
I?XI?i-, ?t.?? ???„ ??ino
1987 BQILDING PERMIT 9PPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
INCLDDE 2 SETS OF PLANS, 3 CERTIFZCATES OF SIIRVEY, 1 SET OF ENERGY CALCOLATIOAS
NOTE: 9DDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOGNER MIIST DESIGNATE RHICH ADDRESS
IS DFSIRED. NO CH9NGES WILL BE ALLOWED ONCE BIIILDIHG PERMIT IS ISSIITsD.
MULTIPLE DWELLINGS - R&SIDSNTIAL RENT6L 0NZTS FOR SALE iIAfIRS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIRVEY - CHBCK BITH SLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
CO.PIERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTIIRAL;PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE SOND
To Be Used For: Valuation:#/,Sw `'"' Date:
?.
Site Address /GyDdlm?wt?r? Dr,
Lot ? Block j_
?rl?G_y ?
Parcel/Sub
Owner Danot/T. J7eayrrfa,j
Address /G 640 ,(Yneuztt/,L.7r.
City/Zip Code
Phone 4,r2_p
Contraetor
Address
City/Zip Code
Phone
Arch./Engr.
Address
City/Zip Code
Phone #
OFFICE USS ONLY
On Site Sewage _ Occupancy
MWCC System Zoning
On Site Well Type of Const
City Water _ (Actual)
(Allowable)
Ok of Stories
Length
Depth
S.F. Total
' Footprint S.F.
APPROVAIS FEES
Assessments Permit
Water/Sewer Sureharge
Police Plan Review
Fire SAC, City
Engr SAC, MWCC
Planner Water Conn
Council Water Meter
Bldg Off `? 1 Road Unit
APC Treatment P1
Variance Parks
Copies
TOTAL
2q .
I,
f CITY OF FACJ+N Irticlude 2 sets of p].ans,
1 site plan w/elevations 6
BUIIDING PERdIT APPLICATION 1 Set of enexgy Ca1a118tiatis.
.} CGa Y-
Zti He Used Fbr valuation ? a ?te 41IVA40. a iCiEa
?
Site Address Il??IO (JOV?nI
Iot Ll_ Blodc 3_ Sec./Sub. 8Vi4
parcel «: in tS000 Ma
Owner:
Addness
city/Zi
Phone N
CUntractvr: I IIP1F5oIII F?I Ab
Address: 5y L6?wOTJI
city/zip axde: a
Pnor,e It: 454- 5s7??
Arch. /E:ng. .
p,ddress :
City/2ip Cade:
Phcrie # :
(" -z z -?3
CFFICE USE ONLY
Erect x Occupancy
Alter Zoning
Fepair Fire Zone i
FnLarge _ Rype of Const.
Nbve # Stories
Denolish Front ? ft.
Grade Depth 36 ft-
` ?
APPfa'NALS FEES
ASSP_SSC1eRt5 PP_ZTRlt S130
f4ater/SeMrer Surcharge 419 4?!L
Police Plan CIx?ck 2/
Fire ?- SAC 6;9c5- 912-
Eng. Water Corm. S/so ?
Plaruier Water Meter /o
Council Road Unit 250 02
Bldg. Off.
F1PC
S c?
Q -7 q k
K
7?b
?
'?/! 738
?
S5
$ ?-
°I
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JACKSON - SURVEYQRS
Ri61/T[R[D UND[R LAWt Oi ITAT[ CI YINNVOTA
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354'169 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
(651) 681-4675
New Constmc[ion Requirements Remodel/ReDair R=ouirements
? 3 registered site surveys
? 2 copies of plans (include beam & window sizes; poured fnd. design: etc.)
? 7 energy calculalions
? 3 copies of tree preservation plan if lot platted after 711l93
required: _Yes _ No
DATE: 5'd' L-\ -A I
DESCRIPTION OF WORK:
S4UC
? 2 copies of plan
? 1 site surveys (exterior additions & decks)
? 1 energy calculations for heated additions
CONSTRUCTION COST; , XTM
STREET ADDRESS: ?L0LL0 Nr61 ?c k, Dn?C5-j f)t v
LOT: ` BLOCK: J SUBD./P.I.D. #: I?dl?/U,Y/iM/tA?
v.une: Phone4: ?
_-5/ ?? _ ? ?.t.ZJ
PROPERTY `=( L Firsc
o\VvLit
SLrect Address: -------------- --------------------- ------
City
State:
"Lip:
??iT?N'--- Phonc N: ------- --
---- -- -
Cumpaiy:------- ffCUNUtr lo
CO\'1'R9CI'012 ?i??
Street Address:____ 1500 E. CLIFF RD. _____ ?cense # ZQjqz??alxp.
BURNSVTLLE, MN bb337
Citc
ARCHITECT/
ENGI\EER Coinl
Namc
Street
City.
Sewer & water licensed plumber (new construction only): _
change and lot change is requested once permit is issued.
Penalty applies when address
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with ali applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
State: ---- ------- - Lip:
Phone #:
ltcgistiatiou k:
State: ------------ - Zip:
REMPVT
MAY 2 ` 19°q
BY:
OFFICE USE ONLY
BUILDING PERMIT TYPE il
? 01 Foundation
?
06
Duplex
?
11
Apt./Lodging il
? 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 _-plex ? 15 Deck ?
?
WORK TYPE I
? 31 New ? 33 Alterations ? 36 Move 1I
? 32. Addition ? 34 Repair ? 37 Demolitien
GENERAL INFORM ATION ?I
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code ';
UBC Occupancy sq. ft. Census Units
Zoning sq. ft. Census Bldg{i
# of Stories sq. ft. MC/WS System
Length sq. ft. City Water ?
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS 1?
Planning Building Engineering Varic
Permit Fee Valuation: $ ?I
Surcharge
Plan Review
License II
MC/WS SAC ?
City SAC
Water Conn. I'I
Water Meter
Acct. Deposit
S/W Permit ?I
S!W Surcharge ?
Treatment PI.
Park Ded. f'I
Trails Ded.
Other
Copies ?I
Total:
% SAC
SAC Units
ii
PERMIT # RECEIPT DATE:
MIDFNTti4I. PLUM$INF PFYJMTf Ai'i'LICATION
crrY oF EAsM
SSSO PII.OT KNOB RD
ER&AN, MN 55122
, - __ 657-6$1-4675
r'i
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit JUN P? Q 20 Q 1 I V;
? backflow preventer for irrigation system + A _i
lA„ ?
? ,-?- ----,
SITE ADDRESS: j L.PQ0 /J(')21 A ('?Cl (7 (?J2?
OWNERNAME:: _Da? TELEPHQNE#:
(AREA CODE)
INSTALLER NAME: (?n V-v.7 -
STREET ADDRESS: I U'I U? ?Q ILc) LX k? T- -r-12.
CITY: (C?SQ,VY? LL,i'll'- STATE:
TELEPHONE #: Stn ( ?-IZ?j-1 ( ?LL
(AREA COOE)
Place a cMeck mark nart tn tha narmit wnrlr }vna
_ New residential dwelling unit under construction and not owner/occupied $ 90.00
? Add-on, modification or alteration to existinq dwelling unit, including: $ 50.00
• abandonment of septic system
• new installation/repair/rebuild of RPZ
• lawn irrigation system
• water turnaround
Nature of work: lJSI 8"LC_- 6'A-
Septic System, new/refurbished - I $ 225.00
• includes County & Consulting Inspector fees
• requires MPC license
State Surcharge $ 50
Total $ GD
Reminder: Be sure to schedule inspections af alterations, i.e. water heaters, water softeners, etc.
I hereby acknowledge tnat I have read this appliraNon, stafe that Ne informatlon is correct, anq agree to comply with a!I applipble City of Eagan ordinances. It
is the applicanYs responsibility to notify the pmperty owner that Ne City of Eagan assumes n0 liability for any damages caused by the City during its normal
,erational and maintenance actlvities to the facilitles constructed under ihis pertnit within City prArtylriqht-of•wayleasement.
SIGNATURE dF PERM
Updated 1101
CITY USE ONI.Y
PERMIT#: RECEIPTDATE:
itE.SIDENTIAL bIECHANICAI. PEiMIT APPLICRTION
_ C1TY OF EAlfitkN
S$SO PII.OT KNOB 8D
E,asM axivssiQ2
- 651-681-4675
? r'Please complete for: ? single family dwellings n p 2 IC lI ? I?
townhomes and condos when pertnits are required for each unit I I JUN
I 2 0 20U1
Date: ?9' Iq ?Q ? Iu Q4(?i L
?JyJ
oy
SITE ADDRESS: ? ti-I LkC) ?2.u?C?6p ?lZ,
OWNER NAME: TELEPHONE #:
(AREA CODE)
INSTALLERNAME: Z - lL(?Y.1if? TELEPHONE#: (DSI' 14 Z'J' I
(AREA CODE)
STREET ADDRESS: I??IU? tY? ???Y1_T '(-D J..-
CI7Y: ,4lY)t^:)L1, ?Y1T STATE: 14 t?_ ZIP: =(C'l -am Place a check mark next to the nermit work tvoe
New residential dwelling unit under constructionand not owner/occupied $ 70.00
? Add-on, modification or alteration to existinq dwelling unit $ 50.00
• furnace replacement
• air exchanger
• air conditioner
• other
Nature of work: QVjD Sv,On?iPlz?,
?O M ?? ?? (?CA? ?-1L1 STl nX'? T??l?nU_1 t u? w; n-i lsu-
State Surchar e $ .50
Total $ 60 i5e
Reminder: Cal[ far inspections.
SIGNA PE TTEE
Updated 1101
PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA089179
Eagan, MN 55122 . Date Issued: 05/15/2009
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 1640 Norwood Dr
Lot: 9 Block: 3 Addition: Brittany 01st
PID 10-15000-090-03
Use
Description:
Sub Type: e-Reroof Construction Type:
Work Type: Replace
Description: House & Garage
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a 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 $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
Valuation: 3,000.00
Total: $90.00
Contractor: -Applicant - Owner:
Simmering Construction Dardel J Rayman
432 S Sutton Lake Blvd 1640 Norwood Dr
Jordan MN 55352 Eagan MN 55122
(952) 292-5886
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - - 1 V
I For Office Use I
41-1796
Cib Ol Ea ~11 I Permit#:
Y R ~o-~
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
- - - - - - - - - - - - - - - - -
2012 SEWER AND WATER REPAIR / DISCONNECT PERMIT
Date: Fee: $60.00
City Sewer City Water Repair Disconnect
~
w
E
E
Description Of Work:
~/~6%'`
Street Address for Proposed Work &zzl pi
Name: _ 2, Phone: Gf s~? d s rs
OWNER Address/ City /Zip:
1i/Oy?c~'f10~
Applicant is: Owner Contractor
Licensed Pipelayer Master Plumber Property Owner c~
Name: 9D TD fI Phone:
Address / City / Zip: l 9 s lyye- y w , ollre-
3
Pipelayer Training Certification Card 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 tart wit ou a permit.
Applicant (Print Name) Applicant's Signature
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
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA119387
Date Issued:11/26/2013
Permit Category:ePermit
Site Address: 1640 Norwood Dr
Lot:9 Block: 3 Addition: Brittany
PID:10-15000-03-090
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Jamie Rippel
12850 Chestnut Blvd
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
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 -
Daniel J Rayman
1640 Norwood Dr
Eagan MN 55122
Appliance Connections Inc
1313 Danita Circle
Shakopee MN 55379
(952) 445-4803
Applicant/Permitee: Signature Issued By: Signature
EAGAN
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)6in45
5-5675 I TDD: (651)4-85351 FAX. (651) 675-56194
ons C' ofe n, m
Date: 7n8/20
For Office Use — —
Permit Fee: --[mac 6 Q y C
Date Received:
I I
I Staff:
2020 SEWER AND WATER REPAIR / DISCONNECT PERMIT
city Sewer �
City Water _ Repair Disconnect
Description Of Work: Excavate small pothole in yard (no street work) and replace
8ft of 4" SCH40 where pipe is sagged per city specs and requirement
Street Address for Proposed Work 1640 Norwood Drive
Owner lnformatlon
Name: Joe Whitters
Address / City/zip: 640 Norwood Dr
Applicant is: Owner
Contractor
Licensed Pipelayer ✓
Master Plumber ✓
Name: Ouverson Sewer & Water, INC (Troy & Kelli Ouverson)
Address / City / Zip: PO BOX 247 Loretto, MN 55357
Pipelayer Training Certification Card #: 4613
I acknowledge that the information
of the City of Eagan and the State
not to start without a permit.
Kelli Ouverson
Fe_sil§§s0
Phone: 952-925-9583
Property Owner
Phone: 612-751-6888
wg
or Master Plumber License #: i%, ( / 4/ p 0
is complete and accurate and that the work will be in conformance with the ordinances and codes
of MN Statutes. I understand this is not a •emit, tonly an application for a permit, and work is
A
I�
pli•-n's Signature
Applicant (Print Name)
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.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 464-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.aooherstateonecall.orq
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA166335
Date Issued:12/31/2020
Permit Category:ePermit
Site Address: 1640 Norwood Dr
Lot:9 Block: 3 Addition: Brittany
PID:10-15000-03-090
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
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 -
Joseph & Kathleen Whitters
1640 Norwood Dr
Eagan MN 55122
(612) 695-8919
Milbert Company (culligan)
1801 50th St E
Inver Grove Heights MN 55077
(651) 451-2241
Applicant/Permitee: Signature Issued By: Signature