4510 Oak Pond Rd-,.? .
,
- ?
CASH RECEIPT ?
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
' DATE - • 19
?
RECEIVED
RROM
AMOUNT ? I
& OOLLARS
1 oo
F?GASH []CHECK
FUND I COOE I AMOUNT
Thank You
BY
White-Payers Copy
Yellow-Postin9 CoPY
Pink-File Copy
BLDG. P,ERMIT N0.
0I-3210 Bldg. Permi
01-3422 Plan Check
01-3445 Surch./Adm.
01-3446 SAC/Adm.
01-2155 Surcharge
17-3860 Road Unit
20-2275 SAC
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permi
20-3743 5ewer Permi
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTAL
?- - r? 3830 Pilot Knob R d! P.O. Bo 2G-A1 9, Eagan, MM 55121 N2 13164
PHONE:454-8100 l ?
BUILDING PERMIT Receipt M
To be used ror S'r' UWG/GAi2 Est value $57,000 Date Fr BRUARY 4 19 87
Site Address 4510 OAIt ;PO,I'.) !Zi) Erect Occupancy R 3
Lot 1 Block l Sec/Sub. PA1tiV F2ZAGE 2Nll Remodel ? 2oning itl
Parcel No. Repair ? Type of Const u
a
W
Z
3
0
Oemolish ? Depth
Int Impr. ? Sq. Ft
Install ?
$Ah1E
? W Name CRADIT d? ASSOC
?? Address 9TH & ?tiiISSI.SSIPPI E2IVER
<W City h1Z'LS Phone 379-4947
I hereby acknowledge that I have read this application and state thatthe
information is correct and agree to eomply vy#h all apblicabie State of
Minnesota Statutes abd CitY oi Eaoen OrdifiAn?"'`------
Signature of Permittee '? ' - ' ' '
A Building Permit is issued to: BURR OAR 8LDR5 I IVC
all work shall be done in accordance with all applicable State of Minnesc
Approvals Fesa
Assessment Permit $ 353.00
Water 8 Sew. Surcharge 28.50
Police Plan Review 176 . SU
Fire SAC 625.00
Eng. Water Conn. 525.00
Planner Water Meter 67•00
Council Road Unit 305.00
Bldg. Off. Tr. PI. 180 . 00
Var. Date I CopiPs
Total ?2 , ZtiO . OU
on the express conditlon that
Statutes and City of Eagan Ordinances.
PormR No. Pwmit Holdar Date TN?phona 8
Plumbin9
ti4.( )/;
H.V.i?.C.
elschie
v 4 /1O '7 ?i?, :J C ;,.
$OIIMM
(MPlCUOfI Da1e lf1ap. ?.'OfN11Mflft
Footinpf I
Footlnps II
FoundMion
Frsminy , !/f?? 7
RooNny
Rouph Plbp. ; ffJ ?
Rouph Htg.
linul.
Fkeplace
Finsl Htp. 3 3c x j
Fl
nal Plby.
L?- ?? 47 ? s
Bldy. Flnal ? ?•? , ? ? _ ?' .
CHt.Oec.
Deck Fty.
Deck Frmy.
Well
Pr. Dlsp.
I .'r?r.+p?t' •?Y'i"..} .. - . . , . , -t . . i:, .. "7.ury . . .. :a . . . , , . , .:;j. ? rS?'-' "°riy)• y?: .. r .
' PERMIT #
MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
?
3830 PILOT KNOB ROAD, EA(iAN, MN 55121 DATE -
CONTRACT PRICE PHONE: 454-8100
Site Address ! TYPE WORK DESCRIPTION
BLDG
.
Lot Block Sec/Sub
R
N
ew
es.
m Name lt Add
M
?
Address -on
u
C
R
i
omm.
r
epa
c City Phone ?' c r Oth
er
Name t FEES
_
c Address RES. HVAC 0-100 M 8TU -$24.00
p City - Phone ADDITiONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU
6.00
TYPE OF WORK =
GAS OUTLETS 1.50 EA.
Forced Air M BTU COMM/IND FEE - 1% OF CONTRACT FEE
Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00
Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00
Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
Vent CFM a BEYOND $1,000.00)
Gas Piping Outlets #
Other
FEE ,
S/C' SJGNATURE OF PERMITTEE
TOTAL•
FOR: CITY OF EAGAN
? .. ` . . , .,., s . ? ? . , . ,. . .. .. . . .
J? . ' , '" \ ^ r` ! PERMIT #
PLtI M81iYG PERMtT %?? U Ca
CITY OF EAGAN RECEIPT li xl -3 Xf
3830 PILOT KNOB ROAD, EAGAN, MN 55122 QATE: 7
Site Address
Lot . ' Block
? Name /-+r. S,
ro Address ,6W'?? !E _L- ?
c Ciry
c
3
O
Address
City -
Phone
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MiNIMUM - RESfDENTIAL FEE - $12.00
MINIMUM - COMMIIND FEE - $2pA0
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRIGE GOES
BEYOMD $1,000.00)
FOR: CIN OF EAGAN
BLDG. TYPE WORK DESCRIPTION
Res. -r? New X
Mult. Add-on
Comm. Repair
Other
RES. PLSG. OtVLY - COMPLETE THE FQLLOW!?UG:
NO. FIXTURES TQTAL
Water Closet - $3.00 "-
-L_Bath Tubs - $3.40 '
? Lavatory - $3.00 - ' '
Shower - $3.00
/ Kitchen Sink - $3.00 -'
Urinal/Bidet - $3.00
/ Laundry Tray - $3.00
_LFloor Drains - $1.50
?Water Heater - $1.50
Whirlpool - $3.00
' Gas Piping Outlcts - $1.50 ?
(MINIMUM - 1 PER PERMIT)'
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
.= Rough Openings - $1.50
FEE STATE S/C:
GRAND T07AL• -2 V
? `"
4 % e s
(ger#i#irate o# (Orru?aury
Citp of (Eagan
arparimpnt of iuYtding 3wrrii.an
Tlirs Certificate rssued pursuant to the requirenrenu ojSection 306 of the Uniform Building
Code certifying that at rhe tirne of irsuance this structure was in compliance with the various
ordinances of the City regulatfng building construcrion or use. For the following.•
u.e cxssirnooo 5A I?1Gr :- elag, Rr?c No.
Oocup-y lyPe ? Tvnin6 Dip+icl Sype C.- .
Owner of &n7ding Addrmy 1 140 ? • Z K' a`•31 1 f• +.'? ! ' ' "
Buildio6 Add?tas Loality -•! , tj2 .
D,te: !+IA.?] 3i?? i?b'
euming oaww
PO5T IN A CONSPICUOUS PLACE
cmr oF E?GAN '
3830 PNot Knob Road WATER SERVICE PERMIT
P.O. Box 21190 PERMIT NO.:
E89811, MR 55121 DATE: -?'. 3i.'. i
Zoning: No. 01 Units: '
I°nv. r' I a T.. r
Owner
.
Address:
Slt@ Add@sS: ? c> > ti:i'. nnn.i 1 1 $L I I
Plumber: ci,t'a »7urnh in
Meter No.: _
Size:
Reader No.:
I agree lo comply wlth the City of Eayan
Ordinances.
By
Dete of Insp.:
Connection Charge:
Account Deposit:
?
Permit Fee:
Surcharge: ~C, '
Misc. Charges:
-?.•;? :1:utCI
Total:
Date Paid:
' OF EAGAN SEWER SERVICE PERMIT
? Pilot Knob Road
gax 21199 PERMIT NO.:
m, MN 55121 DATE: -
ng: No. oi Unib:
Surr Ca'.: ?2.drs.
Plun
!o comply wlth the City of Eaqan
BY
Date of Insp.:
Insp.:
Connection Charge: ',25 . OOnd
Account Deposit: 15 - 0-0Rff! ?
Permit Fee: 10 -OOP' ?
Surcharge:
Misc. Charges:
Total: ?
Date Paid:
• CASH RECEIPT •
CITY OF EAGAN
3830 PILOT KN08 ROAD
EAGAN, MI NESOTA 55122
• ._...???v??/. ._ ?
oo??aws
RUNO CODE pMOVNT
?? O G
U ?
U ?
.0
Thank You ?
N_ 70860
White-Payers Copy
Vellow-POSting Copy
Pink-File Copy
?,.
CITY OF EAGAN ?
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N2 13164
, PHONE: 454-8100
BWLDING PERMIT Receipt# r ?P
7oheusedFOr SF DWG/GAR Estvalue $57,000 Date FEBRUARY 4 19 87
SiteAddress 4510 OAK POND RD Erect Occupancy R3
Lot 1 elock 2 SeciSub. FAWN RIDGE 2ND Aemodel ? zoning Rl
Parcel No. Repair ? Type of Const. V
Addition ? No. Stories
? Name BURR OAK BLDRS INC Move ? Length
z 11461 GOLDENROD ST Demolish ? Depth 44
o Address Int. Impr. ? Sq. Ft
City COON RAA;QS 452-2906 Instau ?
o SAME
Name
=
? ? Address
? City Phone
?a
Name CRADIT & ASSOC
w W
?; Address 9TH & MISSISSIPPI RIVER
gw Ciry MPhone 379-4947
I hereby acknowledge that I have read th is application and state that the
in(ormation is correct and agree to ply all ap licable State of
Minnesota Statutes dty f E r
Signature of Permitte
A Building Permit is issued to: RR OAK BLDRS INC
all work shall be done in accordance with all
of Minnesota
Assessment _
water & Sew.
Police
Fire
Eng.
Planner_
Council -
Bldg. Off.
APC
Var. Date
Fees
Permit $ 353.00
Surcharge 28.50
Plan Review 176.50
SnC 625.00
Water Conn. 525.00
Water Meter 67.00
Road Unit 305.00
Tr. PI. 180.00
Parks
Copies
T,,.,i $2,260.00
on the express condition that
and Ciry ofEagan Ordinances.
Building Official ° ° -
?'
.3101$ 7 REQUEST FOR ELECTRICAL INSPECTION Alk EB-OOOOL 5
? Sea instructiona lor completing this form on back of yellow copy.
? Qn QF, Q "R" Be/ow Wark Covered by 7his Request
IYewIFifC1 BeD.7 Tvoe of Builtlina 1 Aooliancea Wired 1 EquiVmen[ Wired I
CCtri C
ndustrial
p Fee ServicaEMrone95ixa p Fae Feeders/3ubfaeders N Fee Circuits
lD U to 200 qm s 0 to 30 qm s 0 tn 30 Am s
Above 200 qmps 31 to 100 qmps 31 to 700 Am
Swinvnin Pool Above 700_Amps A6ove T00_Am s
Transtormers rngation Booms O ?artial-'Other Fee
u I Signs iSpeciallnspection
Rem3rk5 E4TOTAL E
' ? " '
(? I, the Elecvical I
' ? n d/ ?'0? Inapector, heraby
?f cerliW lhat the xbova
Finel v 0.1e inspeelion haa been
?,?; m aa.
mis requeal v01E
This reQuesl voitl _j,?1,11•7
18 mpnths (ram
e 8 0 8 5 9?,?,
fieq4est Date
? Fire No. RouPh-in Insuec
ion
fl iretlt
Inspec-
?fleatly Now tWill Notify
?
?? aa-- r
Yes ?Nn ,
?or When Ready
? Licensed Elecvicel Contrecmr 1 hareby raquest inspeetion ot above
? Owner elecvical work installad ar.
Stree} ACdress, Box or oute No.
k ?
l
?
5/ GtY
E
D ?t,
n c
f ?t 2
ecuon o.
1
Township Name or No.
Flange o.
Cow?ko4a'
Oc pnnt IPHINT) '
?
k ?
D Phone Nn.
u rr
a
Po"? Supplier
Ua ko-4a, Atltliess
Elect ical ConVactor (COmvan Neme) "
/?I drav?d ?iec-?sc_ Contrar,mr's License No.
.?r6ro -a-
Mailine Address (ConVacmr or Owner MakinB lnstailation)
2?5-0 0 W
8u?'r?scn
0d 4
)
.
-
o1
AuMo4yed Signature ctor Owner Making Installationl
? Phone Numbe.
84'0 -96 ?l
MINNESOTA STATE BOARD OF ELECTqICITY ' . THIS INSPECTION HEQUEST WILL NOT
GriBBa-Midwey Bldp• - Room N-191 . BE ACCEPTED BY THE STqTE BOAXD
UNLESS PROPER INSPECTION FEE IS
1821 Univeraitv Ava.. St. Peul, MN 56104 .
vnnnnf5121662.0900 , ENCLOSED.
? ?? ??} KWD.?A l
t9 6 C-- R+
t /
1987 BIIII .DING PEAMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
IIiCLDDE 2 SETS OF PL6NS, 3 CERTIFICAiBS OF SORQSYt 1 SET OF ENERGY C9LCOLAYIOHS
HOTE: ADDRESSES FOE COSBER LOTS - COBTEACTOR/HOMEOiiNER lIDST DESIGHASB WHICH ADDESSS
IS DESIRED. NO CHANGES WILL.BE ALLOWED ONCS BDILDING PSRHIT IS ISSQSD.
MQLTIPLE D{iELLINGS - RBSIDENTIAL RENT9L DAITS FOR SALS IIHIYS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIRYEY - CHECB iIITH BLDG. DBPT.t
1 SET OF ENERGY CALCOLATIONS ?
COMFERCIAL I ?
??
?J
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
5"i, ?
To Be Used For: ' ? ovrr? Valuation: ? Date: a???87
4s?o
Site Address V-Rg 01¢K ftJp kD OFFICE USE ONLY
Lot j Bloek 1;?_
Parcel/Sub fjq?Jq) P 106E YZ
Owner 914 rr &k R 1 Drs -? h c^
-?
Address ?/y(/ Q0, rJ -.54.
City/Zip Code r-po,
Phone(6/,? )% :5-a -a wG
Contractor ?'?e-wE
Address
City/Zip Code
Phone
Arch./Engr. C.?d, Ly 6 SSo c
Address tSs ie[ue.r
City/Zip Code ?? n IS {14
.7?_,?.r_ -
Phone n 379-5'9y-2
On Site Sewage
MWCC System ?
On Site Well
City Water ?
6PPROVALS
Assessments
Water/Sewer
Police
Fire
Engr
Planner
Council
Bldg Off
APC
Variance
Occupancy t:?3
Zoning RI
Type of Const
(Actual)
(Allowable) ?
U of Stories
Length 38
Depth
S.F. Total
Footprint S.F.
FEES
Permit 353,
Surcharge Zb. ?
Plan Review 17(o.SO
SAC, City loa •
SAC, MWCC 525 ,
Water Conn 5zS'
Water Meter 61.
Road Unit 305.
Treatment P1 I?O•
Parks
Copies
TOTAL ? % (? ',
??.2 oA?
aosE ?`"`?'?s
ENGiNEEf?1NG ?OHSUL71H6 Eti61HEfA5
ptANHEAS aad LAHD ?URVEYOflS
COMPANY, INC.
? 1?00 GLST 1461n 57A£ET, BURNSVILLE, litNN£:OTA 5??3? pN 4:2-3000
CL•'T?Z?ZCQ?e D?' tSZ.L?"7/'e[?
Za?r,ct Lk.scrfe?io?z• Lt?7' I, ?(?Oc.K Z
???c?y `f??.0? zN+? ?Q,?-?oN
?A?o-x?. C??ra.? ? 1vl?NtilESoTP?
?Q\?'i2?
?a?? ??? -
Q??
S 89 00 40°
^ _ 11Z?1q
_ ?? iy_ ??
?
? ??
.?
? s e
-y `/ ? . ?
v ° ?
30' S6T-gA?? L?taC??
Q' ?-1 r, ,? (4'to,o? -
? ,, pAi3.i. o Zo.?
??ll'?.O) L3.yZ ?d C,
? -? LO?- I
i ?oroqe .
Pro ased , ?
?A ? 0 0 ??'
° ? ? a Hc?ee ?-Q ?o.d
? wM t
/ `n ?n'? :.d "
?(Z.PrIIJ A-?.TC l?'l ll ?O? ?+1? O$? O C
L VTiL?Ty 4'SA? ?>
? E/?Sc/?r.?T ? ??o.r
?' ?
o I?zo. ?; 9i
? ??-? N M
,? ?- '.,.
?
?? -
?4?.00 •
?s. 8 9 ° 38' o ? ` ?N
???.
=gy,
zZ.
4? 39 •, ? ?
?? ? '?',. \
4 ?
.9?° 7C (?r ?
5. ` ?o`?
-0 A ?o' 3 '
o.o °' .e ?l Q SG Q?E. I'_ 30`
D R? c s C
N
. ?) a; ?
? ?o
I?
i
? ?a ?'
?
I ? ? ?- ?
?-?? ? ?_ I.
ii
c?s.d ? ?enofes ?xis?'in9 ?/evo?'ions
?4zo,1> L7enofeS P?"oPoSed E/ev4fions
??- flenofies ?,'recf?on of Svrfqce Drcainczge.
RZo.?3
_ ?inished Garcac?e Floor ?.,teva?'ioR
I hereby cartify ihat thia ia a t:ue and carrect repraaentation of ?t tract of
?and as sl?ova'and deacribed hereon.• Aa prepared by me on this •/9n/ day ot
.?.?...war?? , 19 ?7 . .
, ... ?% ? Ninn. lleE. Ho. //?rS
_ ? %?*-?' :..
. . V?sN .. . .
.q??,J;.. . . . . . .
0 I ,
579-4W7 '
?up...wm.ee?io .
? ?om a rear •... . .. , .
„
;... . . . , ,. , .. ?'
,,. .. .. . , ' +, . . ..." , - , . , :.p.
,')a. - -'arMtlmeNral dnlgnm ol outem - e _ . . : . .. .,
?1?, . . . . _ _ .. . _ , . . - , •? . ' ',r
EXTZRIOR ENVELOPE AVII?,AGE "t1" COMPDTATION OWma PLADT N0.
sxrE annx.Ess naTr MAI?h? t,(9??i ?: ,'
.. CON'P&ACTOR ?%RR OA(L P)UIl.D{:R12 ' PHODIE '
Determiae working'square Pootage oP eaoh
1. Total expoaed wall area...... sq.ft. x,?
?
'. . 2. Total rooS/ceiling area....,. ??O,O sq.ft. x?=
.. . ? . ',' T:.
3. Total floor/cant. area....... 84.ft. xALQ= "
Total ezposed wall area above Yloor (51??? ?.
8e TOf.81 WSll WiIXIOW ......??•
b• Total door 8I'68.......?.???????????.?????????• p
Qe TOt.81 5liding g1.83S door 8P88•eo?aa 0 6 0 a???e
d.' Total Pireplaoe wa11 aroa.e ................:.
e. Total wall framing area (average 10?).....oee ?
f. Tota2 h9t. W811 8T98 8bOV9 flOOrtateeeoe-o-
. 'O .
?:. . g. Total rim joiat area ....................:...e•7
Total exposed foundatlon area
ho TotRAl fOUTldati0tl WiTi[lo4i aTAao............ooe. ...... ..,' ..:.'"'
,
':- i. Total net foundation area above grade........
Determine "tJ" value of eaoh wall segmeat ,
?
a, 11910 x "U, , 35 = 5
b. ? a "U" ' .r. '.
... Qe lo x otQw
d x MUn
e. x
xNQw ? 57.7
f a ,o
g o I .?-(e,o a "U" 041 = ' ?„ ,
h x nQa a
i. ?O x "U" ?Ir? c oio
4 . ................................... TOtaai = I4S. ,
If item #4 is the same as, or less than item $19 you have met
,;. the intent oY SBC 6006(a)2.
CITY OF EAGAN
APPUCATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*R7n: PAYMFTIf OF FkE AT TIME OF
APPLIcATIoN DoFS Nar aorsrIzcrM
APPROVAL OF PII2hIIT.
INSPDCTZON OF SF.WR ADID/Cdt MTE2
IL'ST'AT.T.ATTONS WIIS, NOT BE SQ3ED-
OLID iINPILL PERNIIT fTAS BFEJ
APPF20VID.
P ease Print)
1) PROPERTY ADDRESS: •-
LEGAI. DESCRIPTION:
t
v3
IF EXISTING STR[:CIS7RE, DATE OF ORIGINAL BL'ILDING PII2MZT ISSL'ANCE: '
(Mon Yearl
PRESENT ZONING/PROPOSID (!SE:
Q COARMERCIAL/REPAIL/OFFICE _tqZ?R-1 SINGLE FAMILY
F7 IrIDL'STRIAL Q R-2 DUPLEX (1wo C?nits)
n INSTITUTIONAL/GOVII2N1ENT Q R-3 RUWNHOLSE (Three + Units) Units)
? R-4 APARTTENT/COAIDOMINZUM ( Units)
2) ?
NAME:_
ADDRES5:IQ Rt/G-,
CITY, STATE, ZIP: PHONE:_ 7 `/ ?i -7 6 n 0
, 3) • ??; ?,. For City Use .
?`??"?= PLc'L.„ X'1 n? Plumbers License:
ADDRESS: 2;n?„ ., A-v'f_? ? Eycpired Active
CITY, STATE, ZIP:,S"?', /r?.?? _.S'S-?7Sl' Not recorded
PHONE: 7G o r. MASTEE2 LZCIIVSE# dCi,??i'7 h'2 D St?itial
4) @_*• • ? i3• - -
NAM:
_ ADDRESS: CITY, STATE, ZIP:?t,sr,
PHONE: 7:?'" -,)
•5) ? '? ?• ' ? a: • ?• : oi • or . a?
? CONNECI'ION TC) CITY SEWEft ?CONNECTION 'IO CITY WATER Q OTHER ' .
6) wt,1106V.14 r- • r C] PLEASE HOI7] APPROVID PERMIT FY)R PICK-L'P BY ONE OF ABOVE _`-
PLF.715E MAIL APPROVID PERh1IT 7CJ 1. 2. d? 4. ABOVE
(Circle one)
'7>
FOR CITY USE ONLY
PERMIT # ISSUED
Pd w/Sldg. Permit
c
s
C'
$
$
$
S
$
?:z5,cc
$
$
S
c
s /,317- cC'
FEES:
$ jG . 5 C'
$
c
$ SEWER TAP
ACCOUNT DEPOSIT - SEWER
U ACCOUNT DEPOSIT - WATER
$ WAC
$ SAC
$ TRONK WATER ASSESSMENT
$ TRL'NK SEWER ASSESSMENT
$ LATERAL BENEFIT/TRONK SEWER
$ LATERAL BENEFIT/TRUNK WATER
$ WATER TREATMENT PLANT SURCHARGE
$ OTAER:
$ TOTAL
11 ?c, ?aZ(c - ??, _? CP a
RECEIPT RECEIPT
DOES OTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN A"PERMIT FOR WORK SVITHIN PLBLIC
Q ROADWAY" MUST SE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
SEWER PERMIT (INCLUDE SURCHARGE)
WATER PERMIT (INCLUDE SORCHARGE)
WATER METER/COPPERHORN/OL'TSIDE READER
WATER TAP (INCLC'DE CORPORATIO[V STOP)
DATE : ??„? j / •> ?
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - -
I For Office Use
I Permit
I E
City of Era I c
1 Permit Fee:
3830 Pilot Knob Road j I
Eagan MN 55122 1 Date Received: I
Phone: (651) 675-5675
Fax: (651) 675-5694 L Staff:
INFLOW,&r INFILTRATION PERMIT APPLICATION
Plumbing / Sewer & Water
Date: Site Address:
Tenant: Suite J
Name: Phone:
RESIDENT / OWNER
Address / City / Zip:
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
Other: Other:
Description of work: 1" oce 5'/1' 41 d _
DESCRIPTION
FEES
$60.00 / 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.citvofeagan.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 x
Applicant's Printed Name Applicant's Sig ure
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground Rough-In -Final
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - - -
I For Office Use I
Permit l -7) j
City of Ea ~a~
I Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received: - jG Z
Phone: (651) 675-5675 I ,
Fax: (651) 675-5694 1 Staff: tic-) I
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ~i zo/ 2
Site Address: /?S l6~7 "t-, Unit
Name: P11 V 2 / T/Y v _s Phone: 2 5 l~ ~~SS
RESIDENT /
OWNER Address/City/Zip: 47'/"~/~"z
Applicant is: _y_ Owner Contractor
TYPE OF WORK Description of work:
Construction Cost: Z 5 Multi-Family Building: (Yes / No
Company: Contact:
CONTRACTOR 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:
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.
D
Applicant's Printed Name Applica s Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA116624
Date Issued:10/09/2013
Permit Category:ePermit
Site Address: 4510 Oak Pond Rd
Lot:1 Block: 2 Addition: Fawn Ridge 2nd
PID:10-25801-02-010
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 .
Aleksey Burlakov
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 -
Pavlo Trynos
4510 Oak Pond Rd
Eagan MN 55123
Diamond Cut Homes Inc
965 Evergreen Tr
Circle Pines MN 55014
(612) 868-9460
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA122649
Date Issued:05/15/2014
Permit Category:ePermit
Site Address: 4510 Oak Pond Rd
Lot:1 Block: 2 Addition: Fawn Ridge 2nd
PID:10-25801-02-010
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
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 by law in ALL single family homes .
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 -
Pavlo Trynos
4510 Oak Pond Rd
Eagan MN 55123
Apex Energy Solutions
1509 Southcross Drive West
Burnsville MN 55306
(651) 688-2739
Applicant/Permitee: Signature Issued By: Signature