4385 Orion LaneCASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
ts
RECEIV ED
FROM
AMOUNT ? I
B DOLLARS
f 00
[]CASH FJCHECK
.
B Y
NUMERICAL FILE COPY
?
BUILDING PERMIT
5ite
Porcel #
$77,000.
ark
II
oWe Name :v4bla.i Petgrson
Z3 Address '?' O 1[J. 110 th S t.
b -„t.-,- staJ._StLi,
` Name _
0
Z
oU
Q Address
r r:...
Nome _
Address
I hereby acknowledge that 1 have rend this
the information is correct and agree to c
Stote af Minnesota Statutes and City of
that
4681
Receipt #
Erect [?9
Alter ?
Repair ?
Enlarge ?
Move ?
Demolish ?
Grade ?
Occupancy ?
Zoning ' i
Fire Zone '•
Type of Const.
# 5tories
Front ft.
Depth h.
N2
Fees
Assessment -
Water & Sew.
Police
Fire
Eng.
Planner
Council
Bldg. Off. _
APC
Permit -
Surcharge
Plan check,
SAC
Water Conn.
Water Meter
Total
Signature of Permittee -" ' - I
,. . .'F: LEi SEI'
A Building Permit is issued to: on the express condition that
oll work sholl be done in accordance with all applicable State of Minnes--ta Stotutes ond City of Eagon Ordinances.
Building Official
?
Peewuk # psfe Isned PawiffM
Plumbinp / / e f - .0 7- 7& - K .
Mechaniccl ? 04.0 7_ 7 ?c.
INSPECTIONS DATE INSP. Rouqh-In find
Footings .JF Date Insp. Dote Irap.
Foundation Plumbing "I-.vp- 7 g
Frame/lns. Mechoniwl Y-,?c, - ?
Fi?tol
?
Remorks:
..,?
6 "
HE-ATI
Date: ;>Y'll 27, 1)
Site Address:
CITY OF EAGAN
8796 Pilot Knob Reod
Eogan, Mfnnewta 53122
Phone: 464-5100
PERMIT
Lot Block • Sub/Sec. _ ?'?''Pk II
Name
.
; Address
O
City . , `•' • Phone:
Name •:1'L~cZ?ZII ? ? ?_lIt'',??:`_ -`- ..
.
g Address
c
0
v
City Phone:
This PeRnit is issued on the express condition thot all work sholl be
Minne9ota Stotutes and City of Eagan Ordinances.
V
No
Receipt No
Sinyle
Residential
Multi Res., Comm./Ind. ?
New/Alter./Repair. Cost of Installotfon
Permk Fee
Surchorpe
Total
done in eccordonoe with all applicoble State of
Building Officiol
CITY OF EAGAN
8795 Pilot Knob Rood
? Eogon, Minnesota 55122
Phone: 454-8100
S' I, W.B 1 ? : - PERMIT
Dcte:
Site Address: ' % 85 'Jr'-Ori LariE
Lot ' ' Block Sub/Sec. _ wi
Nome ?
.
3 Address
O
City Phone:
Nnme p -
.
?
? Address i 7•1 Ti Sn RC,[-iQ ` -
a
0
V
City Phone:
This Per t is issued on the express condition that all work shall be
Minneso S#otutes and City of Eogan Ordinonces.
No
?
Receipt No.: '
Single I
Residential
Multi Res., Comm,/Ind, I
Newf Alter. /Repair
C;ost of Instollation
Permit Fee • `i r,
5urcharge
Tota I
done in accordance with all applicable State of
Building Official
CITY OF EAGAN
3795 Pilot Keob Roed
Ea9an, Minnemota 55122
Phom: 454-8100
PERMIT No.
Date: Receipt No.:
5ingle I
Site Address: C'rion '..a • Residential
Lot Block Z Sub/Sec. Multi Res., Comm./Ind. I
. ? a^tes Boerner New/Alter./Repair
Nome
; Address '5 (lrion Lnne
Cost of Instollation _
O
City Eagan PMOr12' ?? ?) 2 `E+7t` ; 5
• Permit Fee
Name Lindsey 6dater bonclirion "I^;_. Surcharge '
.
? '•21? -1ar Ave.
? Address
e
0
City Phone: Total This Permit is issued on the express condition that all work sFwll be done in accordance with all opplicoble State af
Minnesota Statutes ond City of Eagan Ordinonces.
Building Official
CITY OF EAGAAI Remarks
Addition WILDERNESS PARK 2nd ADDITION ,ot 11 BIk 1 Parcel 10 84251 110 01
oWner ?1?4 1'„5;; ', I, str?t 4385 Orion Lane State Eagan, MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW 7RUNK 41 107.95 A006599 9-6-78
SEWER LATERAL
WATERMAIN
WATER LATERAL
* WATER AREA •
* STORM SEW TRK 1979
STaFiM SEW LAT
CURB & GUTTER
510EWALK
STREET LIGHT
WATER CONN. 250.00 9257 -8-78
BUILDIIVG PER. # 651
SAC _8_7$
PARK
OF EAGAN
Pilot Knob Road PERMIT NO.: -' J
MN 55122 DATE: ? ..- , .?
No. of Units:
?
Address:
to eampFy wifh fhe Citr of Eagon
of Insp.:
f
n
Connection Chorge:
Acwunt Deposit:
Permit Fee:
Surcharge: _
Misc. Charges: -
Toral: I'
Date Paid:
cirY oF EaGAN
3795 Pilot Knob Road WATER SERVICE PERMIT
PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner: '
Address:
?
Site Address:
Plumber:
Meter No.: _ Connedion Charge:
S1zQ: Account Deposit:
Reader No.: Permit Fee:
1 agroe to eomplr with the Citr af Eugow Surcharge:
Ordinanees, Misc. Chorges:
Toral:
BY - ----- Date Paid:
Dote of Insp
MECHANIrAL PERMIT DATE: 6/4/91
RECEIPT: 101653
SITE ADDRESS 4385 ORION LANE Unit # Permit # 13072
L I 1 B I Sect./Sub. WILDERNESS PARK 2ND
BURNSVILLE HTG. & A/C- 894-0005
4 INSPECTION ti INSPECTflR 1 DATE { COMMENTS I
INSPECTION INSPECTOR DATE COMMENTS
ti
BUILDING PERMIT APPLICATION
Te M usad fee $f Dw1g• d GaxQ• F
N° 4681
Recelpt # -- 9257 _
$77,000.
Site Address ?
Lo['(140 #Block/ JP Sec/Sub. Wilderness Yark
Parcel # II
c Name Cvnnd Pafarccn
w
3 Addreu 4701 W. 110th St.
° ,.,_.Bloomineton 884-5144
0
Zu
o<
z
?
ww
I-Z
u?
rcw
a
Name S8m2
Address
Nome _
Address
I hereby acknowledge that I have reod this
the information is correct and agree to c
State of Minnesoto Stututes and City_g?,
Signature ofi Permitteey?-',
A Building Permit is issued
all vrork shall be done In
Building Otficiol
CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 55124
PHONEs 444-8700
Erect [n Occupancy I
Alter ? Zoning Rl
Repulr ? Fire Zone 3
Enlorge ? Type of Const. v
Move ? # Stories ?
Demolish ? Front 46 ft.
Grade ? Depth 4R ft.
Apvrorah Fees
Assessrnent Permit 181 On
Water & Sew. Surcharge 3R 50
Police Plan check?.?
Fire SAC
Eng. Water Conn. -250 ?.40
Plnnner Water Meter 61) nn
Countil
Bldg
Off -
.
.
029
56
APG .
Tota
? on the express condition that
of Minnesota Statutes ond City of Eagon Ordirwntes.
This re'quest void 18 months from
ttc y? cS
I ' P 68027
Date of this Request - ?-
I, as %Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wir'mg installed at:
Streef Address or Route No. LT? I 60Ki Lt)i(kn,caea p" a.mc4 City?-a-?
Section Township
Range County?l???_ta?
Which is occupied by S JZ,-cQP-e?Qei?.e c*,t
(Name of OccuOant)
ls a roughin inspection required on this job? No ? Yes ? Ready Now ? Will Call ?
Power SupplierZa.?_cTcc ei e-r*l, c ASSitAddress ga 1Z.eQ • F_A? la?
6SSoky
Electrical Contractor uen . ?are*x_so,. ?{ecc.:l'w'r c Contractor's License No.3_43.&,S
(COmpany Name)
Mailing Address
Authorized
No. 9s4-4470
????(? ??? ??? /p??? This inupection requestwill not he accepted 6y the
? U ,1?, State Baard unless praper inspection fee is enclosed.
Minnesota State Board of Electricity
7954 llniversity Ave., St. Paul, Minn. 55104-Phone 645-7703
REQUEST FOR ELECTRICAL INSPECTION
CHEZK BELOW WORK COVERED BY THIS REQUEST
P 68027
Type of Building New Add. Rep. Check Appliances W'ved For Check Equipment Wired Fm
Home ? ? ? Range ? Temporary Wiring
Duplex
ApL Bldg. ?
? ?
? ?
? Wate?-r?rt tern
c
DryB?
/ f?
'/ LightingFixtures
Electric Heating ?
?
Commoccial Bldg. ? ? ? ?
Fu ce?? ? Silo Unloader ?
Industrial Bldg. 0 ? ? Au;lndi ei Bulk Mdk Tank ?
F ? ? ? List List
arm p t
ehers p
eheTS?
OtheE ? ? ? R
> N
COMPUTE 1NSPECTION FEE BELOW -
Service Entrance Size: ? Fae Fceders&.SubPceders: # Fee
cuits: # Fce
0 to 100 Am s. 0 to 30 Am eres 0 to Am eies
31
]Ol to 2 00 Amps. 31 to 100 Am res ;
31 to 0 Am eres
Above 200Amps. Above 100 Amps. Above 0_Am s.
Transformers etControlCirc Partiaothei£ee
Si ns Special lns ction MinimCee
Remazks .^ c ' TOTAL F •(yp
t ?,kpo,?-y ?eA-r, . °?75
1, the Electrical Inspector, hereby certify that the above inspection has been madr-?
(Rough-in) Date
(Final) /r 71 ? Date
This request void 18 months fro •
This request void 18 months f'rom b?G ? ?57 7? c?
?< { W? D
!(-
Date f this i?tequest 6 U030
1, as icensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wiring installed at:
Street Address or Route No.
Section Township Range County !
Which is occupied by sileitd Az/PXScs-c C?oKS-f v-uC.?t':
?
Is a roughin inspection required on this job? No ? Yes [q Ready Now ? Will Call
Power Supplier,l.tiv.,fCn IQ UL' C'.T. lt6+i Address S--A/ J'•cl - .dfi _ T?rruc.nas?'ox
ssv$y
Electrical Contractor?n ?o reitso? ?c Contractor's License No3?43?
(Company Name)
' _. . . I_ .. . n.
Mailing Address
Authorized Signature? ?X Phone NoBS 70
JElxt?ital Contracto, or Ownar Making Thls Installstlo )
??AM ,p? ?? ?,?.? ???? This inspection reqp Pwill nPt be accepted by the
Q ? -State Board unless ra er ins ection fee is enclosed.
Minnesota State Board of Electricity
1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703
REQUEST FOR ELECTRICAL INSPECTION
fi:-IECK BELOWWORK COVERED BY THIS REQUEST
P 68030
Type ot Buyidmg New Add. Rep. Check App(iances Wired For Check Fquipment W'vcd For
Home ? E) Rnn Temporary Wiring ?
Duplex ? ? Wat er LighungFixtuies ?
Apt. Bidg. ? 11 ? Dry
0) Electric Heating ?
Commemial Bldg. ? ? ? Fur e Silo Unloader 0
Industrial Bldg. ? ? ? A'v Conditionei Bulk Mi1k Tank ?
Farm ? ?.? L
is[ ?? i 5? c.V (LSh['u List
Othec ? ? ? p
HeheTSl ? Heie?s?
COMPUTE INSPECTION FEE BELOW
Service Ent=ance Size: e Fce Feeders&Subiceders: n Fee cffcuits: # Fee
0!al 0 Am s. 30 Am eres 0 to 30 Am eies
101 t 00 mps. 100 Amperes 31 to 100 Am eies
Above 200 Amps. 4 e ]00 Amps. Above 100 Amps.
Tra iformers
oceControlCirc.
Rem
artialorotherfee
P
Si ns ial lns ection Minimum fee
Remarks
l?bruvle?e. TOTAL FE ?
linc?e, Ll??? r?Kq . ?.
o.
I, the Electrical Inspector, hereby certify tkat the o e ifspection has been ma
(Rough-in) Date 'Y aZi' 4/
(Final) Date - 3 - zx
This request void 18 months from Vu?"
? ? qo(-a BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EACAN MN 55122
651-681-41 f Y? , 7S
/
New Construccion Reauirements RemodeVReoair Reouirements
. 3 registered site surveys showinq 5q. ft. ol lot, sq. R. of house; and a,ll roofed a2as j• 2 copies o( pian
(20Y maximum lot coverage allowed) i;• 1 set of Energy CalcWalions for heated additlons
• 2 copies of plan showirg beam & window sizes; poured found desgn, etc.) 1 site suNey lor extenor addiUans 8 decks
. 1 set af Enecgy Calculal'wns ?. ??. Indicate if home served by Septlc system for add'Aians
• 3 capies of Tree P25ervafion Plan if lot platted aRer 7!1193
• Rim Jo'st Detail Options selection sheet (61dgs with 3 or less uniGS) Z-
0 I L L
DATE VALUATION (Or 1:1160
SITE ADDRESS q3? 0,? ?/I? 1' MUlil-FAMILY BLDG
TYPE OF WORK .1 t
APPLICANT
STREET ADDRESS
TELEPHONE #
PROPERTY OWNER ?
Energy Code Category
(J submission type)
CELL PHONE #
ill )(03z
?
_ Y vN
FIREPLACE(5) _ 0 _ 1 _ 2
FAX #
ATE -"l 5WX
TELEPHONE# 6S/-688 7/9/
COMPLETE FOR "NEW° RESIDENTIAL BUILDINGS ON4Y
?
? MINNESOTA RULES 7670 CA1'EGORYI?II _ MINNE50"1'A RULES 7672
• Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet :
• Energy Envelope Calwlations Submitted i, F?)?(?,?
I' I
Plumbing Contractor: 11 Phone #
Plurnbing system includes: Water Softener _ ?Iawn Sprinkler
Water Heater ?iNo. oFR.I. Baths
No. of Baths ?I
Mechanical Coniractor:
Mechaiical system includcs:
Sewer/Water Contractor.
Air Conditioning
Hcat Recovery Syslem II
6
Phone #
Phone #
S?P 1 3 2002 1 '_l
Fee: $90.00
Fee: $70.00
II
I hereby acknowledge thot I have read this application, state thatpthe information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan' Ordinances.
Signature of Appllcant I 5_
i
OFFIGE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Reiceived _ Not Required _
Updated 4/02
OFFICE USE ONLY
? Ot foundation ? 07 05-plex ? 13 16-plex ? 20 Poot Q 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 37 6R. Alt - Multi
? 03 01 of _ plex O 09 07-plex ? 17 Garage ? 22 Parch/Addn. (4-sea.) 0 33 ExR. Alt - SF
? 04 02-plex O 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 38 Multf
? 05 03-plex ? 11 10.plex ? 19 Lower Level ? 24 Stotm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N E3 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 Windows/Doars
? 34 Replacement •Demolitlon (EnNre Bldg anl» - Give PCA handout to applicanY
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nhr. of Units Sq. Ft, PRV `
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinallC.O.
- Footings (deck) _ FinaUNo C.O.
_ Footings (addirion) _ Plumbing
Foundation
? HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Ait/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
- Fireplace _ R.I. _ Au Test _ Final _ Windows (new/replacement)'
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Piant
Plumbing Pertnit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
CITY USE ONLY
-PERh4IT #: L 4 ? RECEIPT DATE:
11
SOOE ?SIDEPTI?cL 14IEC?4RIC?tL ?E?iM1T APf'LICATtOR
crrY (W E?sax
3630 Pnor [uoos ftn
EAc6AR 11l1V 55122
I'
651-691-4675
Please complete for: ? single family dwellings
townhomes and condos when pertnits are required for each unit
Date: 7 ? 1-7 -6 )-
SITE ADDRESS: 't'3 ff r Od' a h za"
OWNERNAM??e? ?/GLR{%I EP TELEPHONE#: C9?? CJO I!
INSTALLER NAME: G^ Nf 7' If W/L TELEPHONE #: S?d ??'! ?e 600 STREET ADDRESS:
CITY: ? ?i?(? "V-f ?E' STATE: A 4? ZIP: ?S~ 3 7 d
Place a check mark next to the permit work type
--?
r?
,1 i i
_ Add-on, modification or alteration to existinq dwelling unit JUL 1 g Z99Z $ 30.00
• furnace replacement
• air exchanger
• air conditioner gy
• other
Nature of work: ..e.a 9F ?
°f-1?r??
State Surchar e $ .50
17
rotal
?--- _
S 3D-S:t
? ? "'A '14?
TURE OF PE ITTEE
voz
CITY USE ONLY
PERMIT #:
APPROVED BY:
INSPECTOR
RECEIPT DATE:
8008 COMMMCIAI. MECHAAIClkI. PEItM1T APPLICAT10A
CITY dF E4Hlk1V
3830 PILOT KAOB RD
EkHAN, Mlv 55'i 8E
651-8$1-4675
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATF.:
SITE ADDRESS:
OWNER NAME: PHONE #:
TENANT NAME (IMPROVEMENTS ONLI):
WAS TfERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
STREET ADDRESS:
CITY: STATE:
TELEPHONE#:
WORK TYPE: New construction Install U.G. Tank
_ Interior Improvement Remove U.G. Tank
_ Processed Piping
SpecifyNawre of Work
When installing/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and
Plumbing inspector.
Fees: 1% of contract price OR $50.00 minimum fee, wlilchever is greater.
Underground tank removaVinstallation = minimum fee
Con4act price: $ x 1%_$ (Base Fee)
Sbte surchazge calculate at $.50 for each $1,000 Base Fee
TOTAL $
SIGNAI'URE OF PERMITTEE
i
Updated 1/02
.. - .. .. ? 7 b
pnTE
BUILDING PERMIT APPLICATION
Include 2 sets of plans, 1 site plan w/elevations and 1 set of energy calculations.
syPv?.4?9Ar. ?77ogo ?
To be used far Valuation =117'? _
O !?
Site Address:
l?L=??/??52.rP A??l? - .. . ..
Lot lock ?- Sec, SubfParcel Nvmber /
Qhmer cg4c/l.+o
Address S7-
?tovr>iivC9rv./ 554`:7
Telephone led'y - ?z
Contracto]L?. &Te`RS'?7n/ ?JU?'? S? /
Address ?
Arch./Eng.
Address
Erect ?
Alter
Repair
IIilarge
Nbve
T>emolish
Grade
OFFICE USE
Occupancy L
zoning
Fire Zone
Type of Const. y
# of Stories y
Front 9
07-
Depth 49
OFFICE USE
Wte of Approval & Initial
Assessment
Water/Sewer
Police
Fire
Eng.
Planner
Council
Rldg. off. J,1.1ir
A.P.C.
FEES
Telephane
Telephone
Permit
Surcharge ! R ? s
P2an Check
SAC .?OO
raater Conn. rue
4later Fleter L D
TOTAL
?
. i
City of Eagan
3795 Pilot Knob Road
Eagan, A7N 55122
Date: pugust 10, 1978
Dakota County Abstract Co. SPECIAL ASSESSMENT SEARCH
1250 Highway #55 RE' 4385 Orion, Eagan
Hastings, ??il 55033 Lot 11, Block 1, Wildernoss Park 2nd Addition
Enclosed herein is the search which you requested made on the above described
property:
Kind o Improvement Runs Beginning ragina Amount Balance Due
San Sew Trunk 20 1973 154.21 107.95
Water Area 10 1979 638.85 Payable after August 15, 1978
I further certify that according to the records of said office, the following .
improvements are contemplated or pending after having been approved, and are now
in the process of planning or completion.
Kind o Improvement Approximate date o Completion Approximate Cost
iYater Area and Storm Sewes August 15, 1978 $280 mater area
0026 sq. ft.
{4AIVER:
Neither the City of Eagan nor its employees guarantees the accuracy of the above
information which was requested by the person or persons indicated. Nor does
the City of its employees assume any liability for the correctness thereof.
In consideration for the supplying of the indicated information in the above
form, and for all other consideration of any nature whatsoever, any claim
against the City of its employees rising there from is hereby expressly waived.
Levied assessments to be paid to the County Auditor at Hastings, Minnesota 55033.
Very truly yours,
SPECIAL ASSESS[dENT DEPARTMENT
/s/ Ann Goers
Assessment Clerk
.
? P. W:ZC'ELkFIONS, Prevident
DAKOTA COUNTY ABSTRACT CO.
HASTINGS PROFESSIONAL BUILDING
' 1250 Highway 55
Hastings, Minnesota 55033 Phone 437-5600
L. L. THVEN, Vice Prenldent,
Please send me a Pending Assessment Search on each of the folloMing
tracts of land: .
Lot 7, Block 4, Cedar Grove No.4
2069 Gtuartz Iane, Eagan, Minnesota
AND
Lot 11, Block 1, Wilderness Park Second Addition
4385 Orion, Eagan, Minnesota
Eaclosed please find check for $10.00 tocover costs.
Thank you,
Rosie
,..
?' "v" 8 1973 ?-?
' ^ortlflcate Por:
Svand PetcrAOn
-= '. 7'ji Weat 11 Cth St.
Blc>omington, P•'inn, 55437
DELMAR H. SCHWANZ
LANDSURVEVOR
Reqi5tero0 UnOer Laws of Tpe State of M,onelota
14615 SOUTH ROBERT TRAIL P.O. BOX M ROSEMOUNT, MINNESOTA 55088
SURVEYOR'S CERTIFICATE
- 0-R+6id" - --t-&*E -/
0
M
?13k :
67.35
NO°09'S8"W
y
_? -- o
o °
, o +
PMONE 812 423-1789
0
\? s SCAI,E: 1 inch a 4? feet
r ? o Denote? iron man?unent
I \
? GAri
I r o
a s
m ?
0
0
0
M
LOT ?i
I Drainage & utility
eaaement
L -----
145.00 No0os'
\ 0N?.
?-.? •
ellw ?? ?/l.Vati.+ 4?,
I hereby certify that tYiia iD a true and ecrreet representaLion cf
Lot il, Block 1. tlILT!SRNESS PAFK SECC;?iP, ADDITTOfi, accordir.g to the
rerorded plat tnereofl, Dakota County, MSnnesota.
Alsa 3hnwing the locaY,ion of a propoaed 'riou3e aa otaked therPotl,
llated: Feb. 13, 1979
'.NESOTA REGISTRATION NO 8625
CITY OF EAGAN FOR CITY USE ONLY 3 1?02--
3830 PILOT KNOS ROAD
EACAN, MN 55122 PERMIT #
PHONE: (612) 454 8100 RECEIPT
DATE:
REpmxAT.'., PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
------------------------ -------------------------------------------------------
WORK DESCRIPTION FEES
NEW CONST _
ADD ON li?k
REPAIR
7bc3
OWNER NAME:
SITE ADDRESS:
LOT:? BIACK -j SUBD.??7/?'l244
INSTALLER:
lsurnsville Heating & A/C, Inc.
anDRess:- 12481 Rhode ici2nd Ave?e.
bavage, MN 55378•1122
CITY: 894.Of1P:
PHONE ts:
ADD-ON MINIMUM 5.00
HVAC 0-100 M BTU 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS - MINIMUM 3.00
OF 1 PER PERMIT
SUBTOTAL: $ L J `
STATE SURCHARGE: .50
r?
TOTAL: $ C 1 ?-
,vul
SIGNATURE OF PERMTYTEE
?9MM?RC1A2t??1`S$'?$?`It?A?.;!} PLEASE COMPLETE THIS PORTION FOR ALL COMMERCZAL/INDIISTRIAL SUILDINGS,
. ......:...... .......... ,.:.... .
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
CONTRACT PRICE:
OWNER NAME:
(`TTC pDDDFSS:
LOT: BIACK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE
FOR:
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
n nnn .. ..
L'.t'lVll ? Z?VV?/ Vl' lG??lll iGG.
PROCESSED PIPING = $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18
STATE SURCHARGE
TOTAL:
( S I GNATiJRE )
$
$
CITY OF EAGAN
Use BLUE or BLACK Ink
r
For Office Use
I 1
1 Permit#: ~15T57
Ila
I I
City of EaR
d
I Permit Fee:
3830 Pilot Knob Road I ( I
Eagan MN 55122 Date Received: 1 J~~
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 i Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: I Site Address: S D h f` o L a &I _4_2 Unit
Name: J0 %2- ~c ~/Q. tL "la1.QvlPhone: - ~7Dr
Resident/
Owner Address / City / Zip: 'f 3 S- Or 'e ~ Z_ PL
Applicant is: Owner ~ Contractor
Type of Work Description of work: K c-O " -
Construction Cost: ~J G Multi-Family Building: (Yes / No )
l? / 4, 0
Company: rzd lun J 84, 9yelrk Contact: of of /t c r.~
Contractor Address: -1 ~G rye-t-~ Ave-. /City:
AQ~
State: Zip: ~a Phone: - 9 - q
License S 4 3 Lead Certificate M
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 j
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 withi 180
days of permit issuance.
x 1"R g L, a,,2- J// x
Applicant's Printed Name App icant's Signatu
Page 1 of 3