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4070 Olivine Dr Use BLUE or BLACK Ink r For Office Use 1 Min Permit ( J(J 0 C;4 1 city of EaE(t I ~o 41 1 I Permit Fee: 1 3830 Pilot Knob Road_ Eagan MN 55122 I Date R eived: 1 Phone: (651) 675-5675 Staff: I Fax: (651) 675-5694 L __________I INFLOW & FILTRATION PERMIT APPLICATION Plumbing I Sewer & Water Date: ' ! - i J-l' Site Address: `-tom I U `y W C Tenant: Suite RESIDENT / OWNER Name, \Ck Phone: Address / City / Zip: Name: i(`S~'►~1 uvy)~Nu XNC License ~ 5~7 4 ' ! 1 Address: 0912-) l G -a 4 L_V.i (Jtt) City: CONTRACTOR State. ► w,~ Zip: Phone: K0-3 ( K Contact: Email: PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope) TYPE OF WORK Sump Pump Repair Repair Other: Other: DESCRIPTION Description of work: 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.g_opherstateonecall.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 "I~CYt ~ilUpS YI x Applicant's Printed Name Applicant's Signatur FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground -Rough-In -Final CITY OF EAGAN Np 8??9 3830 Pilot Knob Road, P.O. Box 21-199, Esgan, MN 55121 PHON E: 454-8100 I yd ' ?) C BUILD NG PERMIT Receipt # Te be wed hr ALiJM TRIM Est. Value $1860 . 00 Date ?RCli 2 3 , 19 g?' 4070 OLIVIrdE Site Address R3 Erect Occupancy Lot 8 Block 11 Sec/Sub. CED. GRV. S ? Alter Zoning Parcel No. 10-16704-080-I1 Repoir ? Fire Zone Enlorge ? Type of Corut, W Neme ??1' GAIVSFUR Move ? # Stories Z Address 4070 OT.IVINE ' ? Demolish ? Length City 1?ArAN phone 4 5 2-4 7 2 5 Grode ? Depth Sq. Ft. ? MFRLF w:> CONST. O Name Approvals Fees u? Address 860 RATxDOLPH AVF?. Assessment Permit • 0 ? City 5T _'DAiJL phone 2 s 1-116 9 Water 8 Sew. Surchorge Z' ?o #-- Polite Plon check ,W Name Fire SAC ?? Address Eng. Woter Conn. ?W City Phone picnner WoterMeter Council Rood Unit 1 hereby acknowledge thut I have read this upplicaiion ond store that gldg. Off. the inlormution is torrect and ogree to comply with oll opplicoble 33. 0 State of Minnewta Statutes and City of Eogan Ordinonces. APC Totol 5lanoturo of Permittce - ?'?''?RI,J?' S COI?TST, A Buildin Permit {s issued t. g on the e xpress conditlon thai oll work shall be done in a rda e with oll opplico¢le Stote of Minnesota 5tatutes ond City of Eagan Ordinonces. Buildirq Official i? Psrmit No. Permit Holder Miac. Permit No. Holder P p. Sewar Electric Inapection Date Insp. Other Faqtings Foundation Framiny Rough PI6g. Rough HVA Inwlation Final Plbg. Final HVAC Final Water ???ibe Loeation: Vlfell I > ( `,? i "l /?' ", j Sewer A / ? Pr. Disp. CITY OF EAGAN Remarks * Cedar Grove Acquisition Addition CEnAR C=M #5 Lot 8 Blk 11 Parcel 10 16704 080 11 OwnerLt! (h(,ty•''1_. ?t«?(L<< ?.:i .'.Street 4070 Olivlne Drive State_Edciazl. MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK -Z- 1967 100.00 5.00 20 Pai SEWERLATERAL 196 565.00 28.20 20 P WATERMAIN * WATER LATERAL ((I 1972 607.00 24.28 25 Paid WATER AREA STORM SEW TRK 1970 70.00 3.50 20 Paid STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC 200. OO PARK INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: ? „ 1 ,..,;.. -< <vrNr f,f rJIINIi tiMOVF 06 8 61 [?f t: APPLlCANT: i: 1'lii7 (Ftll P4 titl 1 I() 1 Nfi {! :' H :i }i h o7/34105 PERMIT SUBTYPE: TYPE OF WORK: rP AI I? Kof1F iNO1 Permit Ho. Permft Holder Date Tefephone M ELECTRIC PLUMBING HVAC Inspectlon Date Inap. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUM8ING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FlNAL EAGAN TOWNSHtP BUILDING PERMIT oWO.: --//Lr. . ./...J.._?............... Addsess (Preseni) --.?I•?g•Q.?7 ..... . . .. ..... . ...:F:?c..?............ Builder ...... ................ .--------------- .----------------- .------ .------------------------- ....... Address ......... N° 1868 Eagan Tawnship Town Hall Dete .....9/Z.7AZ ................ DESCRIPTION 5tories To Se Used For Fronf DepSh Heighf Est. Cos! Permit Fee Aemarks I or LOCATION or ,41° 7U g I /i I e- '42 S This permit does not auShorize the use of streeffi, roads, alleys or sidewalks nos does it give the owner os his aqenf the :igh2Yo cseafe any siYuafioa which is a nuisanee os which psesenis a hasard !o the healih, safeiy, aonvenience and general wellare !o anpone ia the eommunily. THIS PERMIT MUST BEEPT ON TtIE PREMIS£ WAILE THE WOAK IS IN PROGRESS. This is !o cerlifY. !ha!-" - -.... ._-' '-'...'_'..."---------'_"-...........has permission !o ereet a...._ --- '-°....._... .. ""-'--'-'--_...."--""-.upon the above described premise subj ei fo !ha provisions of the Building Ordinance for an To ship adopled April 11, 1955. /??? ? ? n, V 41:Gc.>.4......?^4.?..._..9u...J...................... ? ? . ' .'..,?/ .". .1..`.?.`.'`.;``:.?^- ................. Per ......._.. y. " ......................... Cheism§fi at Tnwn Soard / Building Inspecior EAGAN TOWNSHIP BUILDING PERMIT Owner ----. . ... .. _..?- --??>-?x?-'ti.--. ?.'_------- Addresa (Precent) .,...?.^'......_^-?^'?q...... >? ------..^...^..cx^! • Suildet ---"`-------- ------------------------- ..... ._. Address ---- -.___..... -....... ?-`-............... .....___............. ........ --.._'------ DESCAIPTION N° 1'790 Eaqan Township Town Hall Date ....°?9/--19?? p ... Stories -- Ta Be Used For . Fron! Depih Heighi Esi. Cost Permit Fee Aemarks ? // U 2.a1 /O /,0?- ' rnca?rnu 'r- SfI0e1, Roed Di D1hei DesCrvpiiOn oI LoCaIlon I LOI I 151acK I AddiISOn os TieCf s This permif dces not auihorize the use of sireeis, roads, alleys or sidewalks nor does it give the owner or his agen} the righi fo creafe any siiuazion which is a nuisance ar which presenls a hazard !0 the healih, safefy, convenienca and general welfare fo anyone in the communify. THIS PERMST MUST BEq KEp}? T ON TH£ PAEMISE WEiILE THE WOAK IS IN PROGAESS,. ??,,??c',,.?,??l This is So cexiity, fhaf..Le_45.r_.?.')!-5..?,..EQ? .:........... ------ ..has permission fo erecf 5-' a ...__.._. ................. .. .. ......upon the abave descri6ed premise subjeei So the provisions of the Building Ordinance for E?Townshi adopled April 31, 1955. , .... -----?-----'-'. ........ ---- ^ ----------------. Per .... ._..._.__..J!??.e.c'...?.. ..?............_.... Ch rm n of Tnwn Soard Suilding tIna... pector k ?i A i CITY OF EAGAN Np 8909 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE:454-8100 1 ? BUILDING PERMIT Receivt # v? Te be u"d for ALUM TRIM Est. Value $1860.00 Date MARCH 23 1 q 84 SiteAddress 4070 OL7VINE Erect ? Occupancy R3 Lot 8- Black 1 1 Sec/Sub. rF.n _ CRV _ 5 Alter ? Zoning Parcel No. 1 0-1 6704-OAO-11 Repoir ? Fire 2one Enlarge ? Type of Const. w Name rARV rANRFITR Move ? # Stories ; Address 4070 1]T TVTNF Demolish ? Length_ b City F.Af,AN Phone 457-4775 Grode ? Depth Sq. Ft.- o Name MERLE' S CONST. ApProvals Fees oU Address $60 RANDOLPH AVE. " ST. PAUL phone 291-1169 r City Name _ Address City - Phone I here6y ocknowledge thot 1 have read this applicotion ond state that the information is correcf and ogree fo wmply with all opplicobla State of Minnesota Stotutes and City of Eogan Ordinonces. Signoture of Permittee - A Buildinq Permit Is issued oll work sholl be done in a Buildinp Officinl Assessment _ Water & Sew. Police - Fira Eny. Plunner _ Council _ Bldg. Off. - APC - Permit b 3L.7U Surchorge 1 -?0 Plon check SAC Water Conn. Water Meter Road Uni1 Torol 33.50 ' S CONST. on the express wndition thni ptfe.qble State of MlnnewM Statutes ond City ofi Eoyan Ordinances. CITY OF EAGAN . ' 1 16 - P? ?7 19 ? BUILDING PERMIT APPLICATION Include 2 sets of plans, 1 Certificate o£ Survey & 1 set of_ er.ercn7 cal.culations. 3-aa-A/ Y 'lb Be Used For?,?ValuationDate Site Address: OFFICE USE ONLY ? I.ot Block Sec./Sub. Erect Occupancy J Parcel #: ? Q - ? ? ?QC? . p ?Q •?? Alter Zoning Repair Fire Zone Owner: Enlarge _ Type of Const. Nbve # Stories Address: -yn /r? K? Demolish Front ft. City/Zip Coc1e: l, n a r? ,/U/n Grade Depth ft. SS/ Z Z.- Phone #: ? t%`)eg--A APPPOVAI5 FEES Contractor: 6o , Address: X?loO ?Cca?>.do-??- City/zip C«te: V, P?j?i? •,,.?,. .:? .sia:? Phone #: Arch. /FSzg. . Address: Assessments Permit 5 Water/Seurer Surcharge /. Police Plan Check Fire SAC Eng. Water Conn. Planner Water Meter Council Road Unit Bldg. Off. APC City/Zip Code: Phone #: TOTAL oz 13•5-o ? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT auzLozNG 028386 07/30/96 SITE ADDRESS: 4079 OLIVINE DR Lpr: e a4ocK: 11 CEDAR 6ROVE #5 P.I.N.: 10-16704-080-11 DESCRIPTION: sF (rszsc.) REPAIR 434 ALT. RESIDEN7IAL PERMIT TYPE Permit Number: Date Issued: °d-.s p . ?+?`S'P '?a-, a??`?' ? i€1=? gP?? a f ? ei 4 '??? ? ??? "-s?.'? i?k-?':ie ?? ?.U?is,'?,?h ??? REMARKS: FEE SUMMARY: ease Fee Surcharge 7ate1 Fee CONTRACTOR: ( ,I.her'eby ?ek in'Fo'rnlay3itn Stdttit8s (ROOFZNG) Permit Type 4ork Type VALUATION $43.60 $.65 $43.65 APPLIC?P NATUR $1,300 OWNER: - aPPlicent - HESS STEVEN 4970 OLIVINE ClR EA6AN MN 55122 (612)683-1187 I&S CITY OF EAGAN L C C?S i Nc- o+-) I 3830 PILOT KNOB RD - 55122 rt?; t--f ? ? 1 ' iL 1896 BUILDING PERMIT APPLtCATION (RESIDENTIAL) g / 881-4675 New Censwciion Reauirements RemodeVRpeir Reovirements ? 3 regislered ske surveys ? 2 coples of plan ? 2 copies of plans (Indude beam 6 window sizes; poured fid. design; etc.) ? 2 site surveya (ezterior addtfions & decks) ? 1 energy calculationa ? t energy alculations Tor healed addRions ? 3 copies W trea preservaMon plan H bt plaHed afler 7/1/93 mquired: _ Yes _ No DATE: ?/- a5 - GI(D CONSTRUCTION COST: DESCRIPTION OF WORK: lt)eu% IA?Xt STREET ADDRESS: LOT ? BLOCK ?D7(? DIi d. ? .Ur SUBD./P.I.D. #: ?G,?3r7 ?1/V -35?? PROPERTY Name: ff`cs5 ?`'?? Phone #: Z11-3" ??C-7 OWNER "'" ""`T Street Address? lo7U 7-)r. City: State: 1921(-) Zip• S? ia a r] CONTRACTOR COi12flV'?"'?''?^ Phone #: Street Address: ARCHITECTI Company: ENGINEER Name: State: /V/U License #: Phone #: Registration #• 5treet Address, City: State: Zip: Sewer & water licen5ed piumber: . Penaity appiies when address change and lot change are requested once permit is issued. I hereby acknowiedge that I have read this applfcation and state that the information is correct and agree to comply with all 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 OFFICE USE ONLY BUILDING PERMIT TYPE 0 01 Foundation o 06 Duplex 0 02 SF Dwetling ? 07 4-plex 0 03 SF Addition o 08 8-plex 0 04 SF Porch o 09 12-plex 0 05 SF Misc. 0 10 _-plex WORK TYPE 0 31 New o 33 Alterations 0 32 Addition ? 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning .. ? 11 Apt./Lodging o 16 Basement Finish ? 12 Multi Repair/Rem. ? 17 Swim Pool 0 13 GarageJAccessory o 20 Public Facility 0 14 Fireplace ? 21 Miscellaneous ? 15 Deck ? 36 Move 0 37 Demolition Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft, sq. ft. Footprint sq. ft. Building Engineering MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit Variance Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Waier Conn. Water Meter Acct. Deposit S/W Pertnit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: Valuation: $ % SAC SAC Units ? .? . .?? c,vr a ",Nw/ brormy I En9ineers Surveyons - -- MOl'tgig! LOan S'1L1'VB'31 fAY CB ?e'r', t?'PpuL ' CQ/f 5 f ?`!!e, `' ? - • I it W 11 > > C?( °r O a ? ? 4R 4j'J ;r ?.r DL > u.t .S_ ,! ?r 0 v ? ,?n _•. , t. ; v f ? IO ' ? a ! I _ 1 -se2 R VS ?n ? LnNE ' ? -- O<n.Fes U?ilify ?r? Drarnage fpsanreafLOT BLOCKCEDAR GR4VE No. 5-;? DAKOTA COUNTY ?s s a lryrevd corec/ ,spnrm+hik? ?'o wrxy e!'hk ea.de.rs #Arlw+dwAm aksu?bsdoal?!'11X4r?ia?qr?dt?i+?y:::?, :? • r`?l. 9erm. md od ,vsidrE mveor/anr+nls. j?a?')Gw a• wr rw fwd. 3m yray s eriir ewy n arrertw+ 04 a?/an+iw. d°l P?°d°0 Ak ,?r,iy o+I ov l?4ly n nxwed .arc? +? Qkrrfk,? yjc?+?h .w?? rr .? v.?r1d ?.?. rw? wrl?yr. Ma aaebsfmd ea?a9rxd m?/J Amre ?» pMxd /?r'i'r P'/"r ?aiik? ,Gldies r?rvd?j! arims. pW AVi`?SH J U 0 4"?08 S(+i1N EN61AU"16., W. --r---?------ ,'; . 1 . ?? T yFi ?? . . . . . . . .. . . +? ? efa&rftm CM.AVemy, 04 AM ??. ENCiNEERINO, IhlC. `'°w-vk . AW44V" aScple ? f"•Yu EAGl,N TOti+IASHIP 3795 Pilot Knob P,oad St. Paul, 14innesota 55211 Telephone 454-5242 PERMIT r0R SEWER SERVICE COIdDSECTI0r3 DATE: May 29, 1968 067NER: Cedar Grove Const. Co, NUMBER 180 Fddress 8-11-5 PI.UMBER Steins Inc. TYPE OF PIP3 cast iron DESCRIPTION OF BUILDING Industriali Comnerciall ResidentlAl f Multiple Dwelling No. of uniCs x Location of Connections; Connection Charge Pno„Qn rsip8/68 Permit Fee Street Repairs Total P07,,5n n Inspected by: Date Remarks• By Chief Inspector In consideration of the isscie and delivery to me of the above pexmit, I hereby agree to do the proposed worlx in accordance with the rules and regulations of Eagan Towmship, Dakota CounCy, Minnesota $y g+oina. Tnc. Please notify when ready for inspection aad connection and before any portion of the Toork is covered. p-// GG-4 ,S ("1 May 12, 1978 MEMO TO: Tom Hedges FROM: Joe Connolly RE: Water & Sewer Billing for Stenhen Bakke, 4070 Olivine Drive On March 30, 1978, the meter reading at daID Olivine showed 310,500 gallons had been used during the period from 12/27/77 thru 3/30/78. Lorna Olson caught this while bi2ling and asked me to re-read the meter as this was such a very high residential meter read. I went over to 4070 Olivine Drive and found that the reading was correct. As I knew what to check, when I took the top off the basement toilet tank, I found that the toilet had been running constantly, which according to the Bakke's, they could not hear. Althouqh the water was not running when I was there, I could see the evidence. I told Mrs. Bakke what had to be done and also explained that we would have to bill according to the reading and that any adjustment wauld have to be detormined by the Administrator and City Council. ? -ciiy of eagan MEMO TO: DIANE DOWNS, UTILITY BILLING CLERK FROM: ED KIRSCHT, SR. ENGINEERING TECHNICIAN DATE: AUGUST 23, 1993 SUBJECT: STREETLIGHT ENERGY COSTS-CEDAR GROVE NO. 5(208 LOTS) This memo is to inform your department to begin to invoice the energy costs at the single family rate effective August 1, 1993 to the property owners in Cedar Grove No. 5 Addition. Block 1, Lots 1-22 pp Block 2, Lots 1-19 19 Block 3, Lots 1-11 11 Block 4, Lots 1-16 16 Block 5, LOts 1-25 25 Block 6, Lots 1-22 22 Block 7, Lots 1-25 25 Block 8, Lots 1-5 5 Block 9, Lots 1-2 p Block 10, Lots 1-23 23 Block 11, Lot5 1-14 14 Block 12, Lots 1-9 g Block 13, Lots 1-15 15 208 The City is currently being hilled by Dakofa Electric for streetlighting in the above listed subdivision. ! ? %?-Y,?, z?' Edward J.cl?'irs'ic t Sr. Engineering Technician cc: Mike Foertsch EJK/je PERMIT# '5I f 3t RECEIPT DATE: !? 15 .?V EOOE MIDEPTIlkL PLIJM$IRfi PEiiMiT lEPPLiCATION crrY og EmAx 3930 PUM KNoa sn SA&AA, Al1Y 551EE 681-6$1-4675 Please complete for: single family dwellings, townhomes and condos when permits are required for each unit, backflow preventer for irrigation system SITE ADDRESS: _TV T V U 1 l V I C I C, d) C 1 11 e OWNERNAME:: 601VI d VeJ I 1tI rh INSTALLER NAME: TELEPHONE #: lCJS I " (1/ W " 9 ! Z6 (AREA CODE) TELEPHONE #: 95 2. - q(6q -(0999- (AREA CODE) STREETADDRESS: I ? VCd• CITY: IAVt'v( IIP. STATE: ZIP: c Vq _ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00 includes $40.00 County fee Note: Additional consultant fees may apply • MODIFICATIONIALTERATION TO EXISTING DWELLING UNIT, INCLUDING: _ Adding fiMures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00 _ Abandonment of septic system. _ Water tumaround - existing dwelling unit (+ 5/8" meter if needed -$118) Other: _ RPZ: new installation/repair/rebuild n ' ' $ 30. OD lawn irrigation system ? a? 1 s zoo3 ? ReplacemenUadditional: _ water softener ?water healgr'1=___ 1 $ 15.00 State Surcharge $ .50 $ 5 •5c) rota1 I herebyacknowledge that I have read this application, state that the information is correct, and agree to complywith II applirable City, f Eagan ordinances. It is the appliranPs responsibiliry to notiTy the property owner that the City of Eagan assumes r?p liabili for any dam used by e r g its normal operational and maintenance activities to the facilities consWcted under ihis permit i i?Cty o e y', - le ser?edt. SIGNAT E OF PERMI 1l02 , a_.^ . 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings &[ownhomes/condos when pernuts aze required for each unit Date j ? l?n l°S Site Address y07c) oIV ;"tc_ tJr'',ja' Unit # Property Owner a? f?G r?n w?? ?e S?r'e r cL? Telephone #( 6S( Contractor Street nadress 12253 NiCOllet AveqUB SOIJUI y City state TeleQhons: 952-746-5aQO ??5202 "`' Telep6one # ( ) ?95z• Bond 6-7 Ezpires: The Applicant is _ Owner ?Contractor _ Other Add-on or alteration to esisting dwelling unit $ 30.00 ? f New lacement Additi ?Re l ° urnace p ona _ ! _ air exchanger ? air conditioner I C?Jheat pump other State Surchazge $ .50 $ Total I hereby apply for a Residential Mechanical Permii and acknowledge that the information is complete and accurate; ihat the work will be in conformance with the ordinances and codes of [he City of Eagan and with the Mechanical Codes; tkiat I understand this is not a permit, but only an application for a pemtit, and work is not to start without a pemut; that [he work rvill be in accordance with the apprwed plan in the se oF work which requires a review and apprwal of plans. ?I/2?2d'' Applicant' ted Name Applica s Signature 2005 COMMERCTAL MECHANICAL PERMIT APPLICATION City Of E$gan 3830 Pilot Knob Raad, Eagan MN 55122 Telephane # 651-675-5675 Please complete for: commerciaUindustrial buildings multi-famity buildings whrn separa[e permits are not required for each dwelling unit Date Site Street Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) Contractor ' , Street Address t;' Ctity '"' '•7'"- p . ; -a.. ., . - State Zip ? - ' Afelepgone #' (. . T ) H a Bond #: Eapires: The Applicant is Owner ` Contrac[or _ Other Work Type New Construction _ Underground Tank _ Install _Remove **see below Interiorlmprovement _ InstallPiping _ Processed ,_Gas Nature of Work: **When insfa!ling/remaving underground tank, call for inspection by Fire Marshal and Plumbing Inspecfor PEr1L11 F¢CS: $70.50 Underground tank inatallatiodremoval $50.50 Mirumum (includes State Surcharge) or Contract Value $ x 1% _ $ PermitFee $ State Surcharge If pertnit fee is less than $1.000, add $.50 If Uermit fee is more than $1,000, surcharge is $.50 for every $1,000 owed. $ Total Fee I hereby apply for a Commercial Mechanical Permit and acknowledge that the information is complete and accurate, thaz the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a permit, but only au application for a pemut, 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. ApplicanPs Printed Name Applicant's Signature Approved By: . Inspector Date: Required Inspections: - U.G. _ R.I. _ Air Test - Gas Service Test - Infloor Heat - Final Use BLUE or BLACK Ink For Office use I I Permit ~~(Cl City of Ea Ed~ ~xx Permit Fee: 50 l~ 3830 Pilot Knob Road I I Eagan MN 55122 1 Date Received: Phone: (651) 675-5675 I ; I Staff: I Fax: (651) 675-5694 2010 RESIDENTIAL PLUMBING PERMIT APPLICATION V t l V t ~e r ~qQ~ Date: (q-10 Site Address: 40-70 Tenant: T)C`✓ I 0 eS° t re i CL1 Suite RESIDENT / OWNER Name: D ow ! 0Ct;~L`r e'(C,Lq Phone: &_c5 l 4-7c 77EZ Address / City / Zip: ©'Z® 11 v t t46- r, Eaga,, 55 ! 2-Z- CONTRACTOR Name: c lrct N ~r0 ~Ur lJ t1t License b r06 ~'-y ~/0 Address: (3 t ~ 2-06.-b, erIE . City: L.Ve{/ i 1 e, State: AA 1 ~ Zip: D D 0 `r`te Phone: 95,Z- 46LI &9343 / `7 Contact , 'Deb D f( V-61 5t, t Ema TYPE OF WORK _ New Replacement _ Repair -Rebuild _ Modify Space Work in R.O.W. Description of work: PERMIT TYPE RESIDENTIAL Water Heater Water Softener Lawn Irrigation Add Plumbing Fixtures ( RPZ / _ PVB) ( Main - Lower Level) Septic System Water Turnaround _ New Abandonment RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround' (includes $.50 State Surcharge) *Water Turnaround (add $166.00 if a 5/8" meter is required) $100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ Jr' ®J (J 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.gopherstateonecaR.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,De19o frcz 4 Lai-co, Applicant's Printed Name ppli nt's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In _„_Air Test Gas Test Final PERMIT City of Eagan Permit Type:Building Permit Number:EA115573 Date Issued:09/27/2013 Permit Category:ePermit Site Address: 4070 Olivine Dr Lot:8 Block: 11 Addition: Cedar Grove 5th PID:10-16704-11-080 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: 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 . Kelly Meyer 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 - David Oestreich 4070 Olivine Dr St Paul MN 55122 Hause Construction, Jg P O Box 206 Bayport MN 55003 (651) 439-0189 Applicant/Permitee: Signature Issued By: Signature