3859 Palisade PtCITY OF EAGAN Remarks Sew Co= pd• m 12
Addition Cedar Grove #8 Lot 5 6
Owner r?-r-t " ``??'e-? Srroor 3859 Palisade *fmr POi
X f
22
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK Z„S 1970 125.00 .QQ 2 Pa3d
SEWER LATERAL 1974 1539.10 307. 2 PaiC1
WATERMAIN
iE WATER LATERA? 197
WATER AREA
STORM SEW TRK
STORM SEW LAT 1974
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN, 300,00 7989 ----5-1 -73
BUILDING PER.
SAC 2 O.OO 7989 - -
PARK
INSPECTIaN RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
4 rtFAK G?lnvE #R (612) 460-3:326
F
L
I,It I , It I
H rr 11 .y f •,:a
PERMIT SUBTYPE: TYPE OF WORK:
Perrt?R Holder Date Telephone M
PLUMBING
HVAC
Inspection Date Inap. Comments
FOOTINGS
FOUND
FRAMING I
ROOFING
I
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG ,
FINAL HTG
ORSAT
TEST
BLOG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUC7IVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
?a S
C. (o •
VILLAUE OF' r:AGAN
3795 Pilot Knob ttoad
Eagan, Niinnesota 55122
PER14IT N0. 348
The Village of Eagan hereby grants to Cedar Grave Casatructiaa Cot
o£ 7343 Concord Blvd. Eaet, South St. Pmll
a HEATIRI(3 Permit £or; (Owner) ems
3869 xi.nertan circle 14-4-8 -1859 & 3861 Fallsade Pt. 5- - , 1727,
at 1MjSxhs.4be 2-4-8 4-4-6 ,1 44P&ant to application dated 5/11 /T3 .
Fee Paid: a120.pp dated this 1.5th day of MaV , 7973
3.00 s/c
Bui d ng Inspector
kechanical Permits:
did 'Potal:
?
,
VILLAGE OF r;AGAN
3195 Pilot Knob xoad
Eagan, Minnesota 55122
PIIZi+IIT N0. 337
The Village of Eagan hereby grants to Gadsr {?? CCngyHpt,{CA Gp.
of a343 r.?ql,,d niod_ tahat.o aorhh aii. Prt3
a _p1=hi„g Permit for: (Owner)
3869 Rivertoai Circle 14-4-8. 1859 & 3861 Palie p? r?2 n?ft
-atCoahra+_e 2 l 8)? A, 1 g? a pursuant to appc-a?e3 ????a 1727a 1718
Fee Paid: 120.00 dated this 15th day of 14fig
3.00 57a
Building Inspector
Mechanical Permits:
did Total:
EAGAN TOWNSHIP
BUILDING PERMIT
?
Owne: ........ CC?!??.-r!?.... ....... _.._.
Addtass (Preseni) ........l.?£...?.... c.
.................. _....
Builder ....... ..................._......__.---................_...----............._....._...--
Addresa ..... ._--- ............... .......................... __...................................
DESCAIPTION
N° 3008
Eagen Township
Town Hall
Defa ................
Siories To Be Used Foz Froni Deplh Heighi Esl. Cosf Permif Fee
- amarks
A
"-`- ??. ?:SG.ca
/T? ?tc S n az'
/-
G).cr
51reei. xoed or oiner Ueicrlpxton oI Loeaxlon ? Lot rilocY Addifion or Tree!
P/?/
. . $'t?
This permii doea noi aulhorfze the use oi siraela, roada, elleye or eidewalka ifox does it give the ownar oz hia agent
the righ!!o creeie eny situaiion which ie e nuisancs or which presents a ha:ard !o the heelih, sefety, conveaianee and
general welfare !o anyona in the commuaify.
THIS PERMIT MUST BE KEPT 013 THE PR£MffiE WHILE THE WORK IS IN PAOGAESS. „
This ie !o ceriify, fhaf....._.. Q..? ..... .....r:..._?+?-? has permission !o
. .............. ........... ...................c......---............................ upon
the above deseribed premise aubject fo the provitions of the Building Osdinenae Sor Eagan Township adopled April 11,
1955. ?+t
. .......................... ?_...... V. :.... . ....._
.....:_?7:.-?... ........ Pez _ ?
e _..._....._.....-?.?. ?
................................
Cheirman o Tnwn Board? Huildin Ineae}or
oe i& na -q\4 un&e 2
EAGAN TOWNSHIP
BUILDING PERMIT N?
Owner &'^-'t`^„
......'. _. _' .................... ?..... _.......... _ ... ?,............ _...........
...' .'.. _. .
Addeeu (Preseni) _.......... 44......... e-1-.1.1?.....:....?c::-.?-:5 .............
Builder ......................._.------.._-°--...................................................
Address ...........
DESCRIPTION
Lb•OP/
;.
2928
Eagan Township
Town Hall
Date
..._.......
S2orias To Be Used For Fson1 Depih Heigh! Est. Cosf Permi! Fee Remazks
l ? 9
LOCATION 17-' S'
Sireei. Road or olher DeacripSion ot Loeahon I Lo! I Bloek Addiiion or Trao!
T6is pecmif does not auihorize the use of slteefa,. zoads, a(leps or sidewelks nos doee it give the oanas or his agen!
the righlfo create anp siluafion which is a nuisanee or which presenis a hesard !o the health, safefy, eonvenienea and
genecal weliare fo anqoae in the communifp.
THIS PERMIT MUST SE KEPT ON THE PREMISE WHILE THE WORK IS IN PAOGRES3,
?--r _ .
Thts is !o cerfifY. !hel.... ....._
?.:c.J..-.z :.......:.... ...hr.................haapermusion !o ereef ?:?} ..._.F.eq^::e . upon
the above deeccibed psemise su6jeef !o the provisiona o! !he Building Ordinance for Eagan To?nship ado !ed Aprii 11.
1955.
%t-L"'?-. -J
Yk-:- Per
.? .-...._ ---° .L_...._.
...-- - -'-C .. -..._.....c=--.. :+::-:.y_. .....' ..........................
I,!j Suildinp Impeclor _,6
CSTY OF EAC,AN
CASH.T.ERa S TERMINAL NOe 773
I1FdTEe 08/12/98 TTPfE: 15:42:52
IDa
tdAME: PHIIL.IP M MrCl._ATN
3210 3001 38,°r3 F'AL..ISAIiF 1-"' 87.25
2155 9001 3853 F'ALIfaADE F' 2.00
Total. F.eceipt Amoun+,? 89.25
CFU96154
USEFi ITl; NANCY
PERMi'1'
?
CIYY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
PERMITTYPE: euiLozNG
Permit Number: 0 3 2 B 9 3
Date Issued: 0 8/ 12 / 9 8
3859 PALISADE PT
LOT: 5 BLOCK: 2
CEDAR 6ROVE #8
P.S.N.: 10-16707-050-02
DESCRIPTION:
a-? REROOF
B,juild,mPermit Type 3F (MISC.)
$uilding EJo,rk Type REPATR
?nCensuS Cotle434 AI.T. RESTDEN7IAL
REMARKS
FEE SUMMARY:
?r
a -3
<. ...._.
VALUATTON $4,000
8ase Fee $57.25
Surcharge y_ $2.00
Total Fee $89.25
CONTRACTOR: - Applicant - sT. LIC. OWNER:
ABETTER ROOFING CO 14603326 2014413 HOVIND JANE
428 CNIPPENOpLE UNIT A 3859 PALISADE PT
ARMINGTON MN 55024 EAGAN MN 55122
612) 460-3326 (651)452-2454
I hereby acknowledge that Z have read this applicatian and state that the
; infarmation is correct and agree to Cnmply with all applicable State of Mn.
StatuCes and City of Ea'gan Qrdinanees:
{?_ : APPIICANT/PERMI7EE SIGNATURE I SUED BV: SIGNA URE
• " 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PII.OT KNOB RD - 55122
681-4675
iJew Construetion Reauirements
? 3 registered site suneys
? 2 copies of plans (inGude beam & window sizes; pouretl fiG. design; etc.)
? 1 energy calculations
• 3 copies of tree preservation plan N bt platted after 7/7/93
required: _Yes No
DATE: ?? 9 0
DESCRIPT N OF V1i
STREET ADDRESS:
RemodaVReoair Reauirements
? 2 co0ies cT plan
? 2 site surveys (exterior add'Rions 8 deeks)
? 1 energy wlculations for heated addkions
q,V
LOT: S BLOCK: -Q- SUBD./P.I.D. #: G ?(O \I -C- ? 6
vvo \/1?"
Name: Phone #:
PROPERTY 1.asc Firsc
OWNER ?(1c??`7 ??,
Street Address:ti
.- •,?
City State:_
CONTRACTOR
Zip: ????Z?-,
,,? r///?p /,l 90- 113/N ?--/ -' ? ?{-(p/?
Company:,p?¢1- Phone #: 6,y 0-?:?3Q6
Ciry
'/.?NzT A License
Stare: M/I Zip:
ARCHITECT/
ENGINEER Company: Phone #: _
Name: ? Registration #:
Street Address:
City
Sewer & water licensed plumber (new constructlon only):
and lot change is requested once permit is issued.
Sffite:
I hereby acknowledge that I have read this application and sTate that the
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
Zip:
. Penaity applies when address chang
is correct and agree ta comply with all applicabi
_ . 12. 1-217- , .. 7)
-,
CONSTRUCTION COST;
K
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
? 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
? 04 SF Porch ? 09 12-piex
? 05 SF Misc. ? 10 = plex
WORK TYPE
D 31 New O 33 Alterations
? 32 Addition K34 R?pair
GENERAL INFORMATION
Const. (Actuai)
(Atlowable)
t16C Occupancy
Zoning
# of Stories
Length
Depth
OFFICE USE ONLY
? 11 Apt./Lodging
O 12 Multi RepaidRem.
? 13 Garage/Accessory
? 14 Firepiace
? 15 Deck
? 36 Move
0 37 DQmol;tlinn
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
APPROVALS
Planning
Permit Fee
Surcharge
Plan Rsview
License
MC/WS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S!W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total
% SAC
SAC Units
? 16 Basement Finish
? 17 Swim Pool
? 20 Public Facility
? 21 Miscellaneous
I
il
MGWS System
City Water
Fire Sprinkler?ed
PRV
Booster Pump
Census Code:
SAC Code I
Census Bldg '
Census Unit
Building Engineering Varia I ce
v
gT? Valuation: $ u, o O O.
a-
.
I
MASTER CARD
LOCATI
OWNER
STRUCTURE AND
LAND USED A$
Permit
No.
Issued Issued To
Contractor Owner
BUILDING
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELKTRICAL
I
HEATING ?' y
GAS INSTALLING
SANITARY SEWER /.3 q?.? i
OTHER
OTHER I I I
I}ems Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING 6--/S J SEPTIC
FOUNDATION CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL
HEATING p DEPTH
OF WELL
GAS INSTALLATION I
SEPTIC TANK .
CESSPOOL
DRAINFIELD
PLUMBING
WELL - Zj' 7
SANITARY SEWER
Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO BE USEO ONIY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO.
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
DATE OF INSPECTION
1:1 ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
? NON-COMPLIANCE. BWLDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DEIAYED BY CONDITIONS BEYOND
CONTROL.
? REINSPECTION REQUIRED DATE OF REINSPEC?ION
REINSPECTION REVEALED
CERTI FICATION -1 certify that I have carefully inspected the above in which 1 have no interest present or prospective, and that I have reported herein
all significant conditions oLserved to he at variance with ordinances of the Town of Eagan, apProved plans and specifications, and any specific require-
ments for off-site improvements relating to the propeny inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPECTOR
COMMENTS:
pATE
23
EAGFN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
nate:5/15/73 (12/29/72) Number: 1201
Billing Name:Cedar Grove Construction Co$ite Address: ,zr
3
Owner: sane Billing Addresi2859 Pa7-isade Point
Plumber: Stein's
Connection I Meter
.300.00 pd 5/15I73
Meter No. ?Permit Fee10.00 d 12429/72
. 0 pd 12 29/72
Meter Reading Meter Dep.
Meter Sealed: Yea_ lAdd'1 Chg.
NO , Total Chg.
Building is a:
Residence xx
Multiple tio,
Commercial
Ixtdus t ria 1
Other
Inspected by
Date
Remarka:
$25.00 RE•1NISPECTION FEE FOR
IM00PERLY iiiSTALLED h9ETEi;S.
Bq:
Chief Tnspector
In conaideration of the issue and delivery to me of the above permit, I
hereby agree to do ttm proposed woxk in accordance with the rules and
regulations of Eagan Township, DakoCa County, Minaesota.
$Y:
SteinI s
Please aotify the above office when ready for inspection and connection.
tlILLAOE OF EAOAN SIE WER SERVBE PERMIT
3795 Pilat Nnob Rood PERMIT N 13
-
2-
-
?
Eagan, MN 551I2 7
?
7? 7??
?/ 1??
UATE: 1 z??9inr`T
?/? '
Zoning: No. of Uni[s:
()wner: _S.eSj2S' SiLQYg_ G.911StI'UCt,1on (.'O.
Address:
?q ??-
Site qddre?: _2?(-?S ?77 Pis3de -P_0Ut
Plumber: ?eiTL.s_
1 agrce ro comply wifh fho Villoga of Eogon Cunnectlon Chazge: 260•00 pd 51151
Ordinontes. Accbunt Depoel[:
Permtt Fee: _ 10.00 Ad 12/29/72
Surchazge: .50 Dd 12/29/72
BY: Miea Chazges:
Date of Insp.: Total:
Inep.: Date Pald:
City of Eagan
3795 Pilot Knob Road
Eagan, MN 55122
Date:
November S, 1980
St Paul Title Insurnace Q
301 W Burnsville Pkwy yP?`IAL ASSESShtENT SEARCH
Burnsville, MN 55337 RE:
ORDEF D-6985 Lot 5, Block 2 Cedar Grove #8
3859 Palisade Way, Eagan, hIN 55122
Parcel N10 16707 050 02
Enclosed herein is the search which you requested made on the a6ove described
property:
Kind of Improvement Runs Beginning Original Amount Balance Due
None
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 of Improvement Approximate date Completion Approximate Cost
None
Waiver:
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 he paid to the Couhty Auditor at Hastings, MN 55033
Very truly yours,
SPECIAL ASSESSMENT DEPARTMENT
ST `,'2,lJ l TITLE
INSUGiANCE COAPORATION- - - -- -"- --
? . '
. ........r...,...,._. ^.im!, iti
(El_'19?1 $$?"?
1235U1;1NS'.,.,<'-L5 I.:R:!a554U2
l61Z7 33c?B94
- ...6THANDW49PSNA,ST.vFUL,MINN_>5101
(6111 224 4E81
301 W. BURNSV ILLE PKN'v., BURnSV iLLE, KUNN.5533]
(612) E94 -5020
ORDER NO. D- 6985
DATE October 21, 1980
SPECIAL ASSESSMENT SEAFiCH
Legal Description: Lbt 5, Block 2, Cedar Grove #8 Addition
County of: Dakota
Property Address: 3859 Palisade Point Eagan
Plat:
Parcel
SPEGIAL ASSESSMENTS NOW PAYABLE ARE AS FOLLOWS:
Beginning No. of No. Remaining
Levy No. Type of Improvemeni Year Years Years BALANCE BALANCE
PENDING ASSESSMENTS ARE FS FOLLOWS:
Project Current Status
APPROXIMATE COMPLETION DATE FOR PENDING ASSESSMENT IS:
Estimated Cost
AUTMORIZEO SIGNqTURE
I ..._ _, $.12iJe
•?.'.? ?
City of Eag3n
3795 Pilot r-ic, Aoad
Eagan, KN 551-l:
Oate: September 12. 1980
St Pnul Title Insurance Co
.>J1 '! &urnsvillc Pl:wy Sr`-CI>L aSSESS"T'?i SE4F.CH
Burnsvmlic ?•.*.i 55337 fLE' Lot 5 131ock 2 Cedar Grove NE
02;)iiil # D-6745 3859 Palidacle '.t;ay; Fanan 17N 55122
Enclosed hezein is the search ::hich you reqt.jSgjda?4?46gj97t%,Oa9ae described
property:
:na: :-? r,t 3a: a?.ce ::z
Rur.s 3e :nn:^ Cr:•
None
I Euz:?er certify that according to the records of said office, the fellowing
i^p:oce^ents are con;e^placed or per.dino ai:er havir.g been a;proved, and are nov
in the ?rocess of pianning or cocp:eti-Or,.
..,?o: i".,..:e-
None
:ox:-a:e :a•e
.ca:-.ace
WAI'.TR:
tie::her the City of Eagar. nor its ecrployees guaran:ees the accurscy of 2he abeve
info:mation which was requeste?i by the person or persons indicated. !lor does
the City of its er.pleyees assume any lia6ility far the c-rrec2ness :hereof.
In consideracion for the supplying of the indicated info nac:an in the abe•+e
forr.i, and for all otner consi?leration of any nature uFatsoeve:, any claim
agains: t4e City of its employees rising there from is hereby expressly waived.
Levied assessaents to be paid to the County Auditor at Hastings, tlinr.esota 55033.
Very t:vly yours,
,e-::)
SPECIAL ASSESS;IE.YT JEPAATMENR'
&PAULTITLE
INSURANCE CORPORATIONORDER NO._
DATE $/25/80
SPECIAL ASSESSMENT SEARCH
Legal Description: Lot 5, Block 2, Cedar Grovz No. °
Dakota
County of:
3859 Palisade Point, Eagan
Property Address:
Plat:
Parcel:
SPECIAL ASSESSMENTS NOW PAYABLE ARE AS FOLLOWS:
Beginning No. of No. Remaining
Levy No. Type of Improvement Year Years Years BALANCE
PENDING ASSESSMENTS ARE AS FOLLOWS:
Project
Current Status
APPROXIMATE COMPLETION DATE FOR PENDING ASSESSMENT IS:
Anoka County 100 EAST MAIN, ANOKA, MINN. 55303
(6121 421 5882
HennepinCOUnty 12350UTH7THST.,MPLS.,MINN.55402
1612) 339-4890
Ramsey Counry 6TH ANO WABASHA, ST. PAUL, MINN. 55101
I6121 224-7681
Dakoia County 301 W. BURNSVILLE PKWV., BURNSVII.IE. MINN.5533]
16121 8945020
BALANCE
Estimated Cost
AUTMOR¢EO SIGNATURE
D-6745
.440-9'AS 32/79 Alhlialc ol Tne $I. Paul Companies Inc.
om
d?
' A'dtVmFeaqcn
3830 PIlOT KNOB ROAD, P.O. BOX 21199 eEA BLOMgUiST
EAGAN, MINNESOTA 55721 nfoyor
PHONE: (672) 454-8100
. 7HOMAS EGAN
JAMES A. SMITM
JERRV iHOMAS
DATE: TNEODORE WACHiER
MarCh 6, 1985 co?amemoers
THOMA$ HEDGES
Clfy NpIf1WVfO101
EUGENE VAN OVERBEKE
Clry Ciere
PENDING ASSESSMENT SEARCA
RE: Lot 5, Block 2
`Cedar Grove 48
3859 Palisade Point
Requested by: DAKOTA COUNTY ABSTRACT C0.
1250 Highway 55-P. 0. Box 456
Aastings, MN 55033
I CERTIFY THAT ACCORDING TO THE RECORDS OF SAID OFFICE, THE FOLLOWING P1PROVEMENTS
ARE CONTEIPLATED OR PENDING AFTER HAVING BEEN APPROVED, AND ARE NOW IN THE PROCESS
OF PLANNING OR CO:ff'LETION.
Kind of Improvement Approximate Date of Completion ApDroximate Cost
NOTHING CURRENTLY PENDING.
WAIVER:
Neither the City of Eagan nor its employees guarantees the accuracy of the above in-
formation which was requested by the person or persons indicated. Nor does the City
or 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 or its employees
rising therefrom is hereby expressly waived. Levied assessments to be paid to the
CITY OF EAGAN, 3830 Pilot Knob Road, P.O. Sox 21199, Eagan, MN 55121.
Very truly yours,
Donna Muench
SPECZAL ASSESSMENT DIVISION
THE LONE OAK TREE.. .THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNIiY
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 3859 Palisade Pt
Lot: 5 Block: 2 Addition: Cedar Grove 8th
PID:10- 16707 - 050 -02
Use:
Description:
Sub Type: e - Furnace
Work Type: New
Description: Furnace
Comments:
Fee Summary:
Contractor:
Haley Comfort Systems
122 West 3rd St
Hastings MN 55033
(651) 437 -0338
Quesetions regarding elec
952- 445 -2840
Larry Leacock
15966 Fennel Ct.
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
Permit Type:
Permit Number:
Date Issued:
Permit Category:
cal permit requirements should be directed to Mark Anderson, State Elec
ME - Permit Fee (Replacements)
Surcharge -Fixed
- Applicant -
Owner:
Jane E Hovind
3859 Palisade Pt
Eagan MN 55122
$50.00 0801.4088
$0.50 9001.2195
$50.50
Mechanical
EA089611
06/09/2009
ePermit
cal Inspector,
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
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Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - - -
For Office Use
City of EaRRo n Permit
I I
I Permit Fee: l
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff: I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 11I3 Site Address: Unit
Name: ✓ o e- hI ) yI/I o Phone: GSA" 7.52 2 Yrzf
Resident/ ✓5-~I 4~15A1A /07-
Owner Address /City /Zip: ,
Applicant is: Owner Contractor
Type of Work Description of work: /D S/- f /hSGI
Construction Cost: `o ld dot, Multi-Family Building: (Yes / No )
Company: ~zah Contact: aot ~e~ ~~c1~►
Contractor Address: /Sa City: SJw~
State: kKkl zip: M31 Phone: Go-" d t (0- , V
License G29 c3 66 ( G7 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.aopherstateonecall.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. _
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Applicant's Printed Name Applicant's Si ture
Page 1 of 3
Use BLUE or BLACK Ink
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I Permit Fee: �
3830 Pilot Knob Road � �
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I I
Fax: (651)675-5694 I Staff: �
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2015 RESIDENTIAL BUILDING PERIMIT APPLICATION
Date: �`'���r � Site Address: �v��� �Q r��S�e ��� Unit#:
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�' Name:_, �Gl � �L7 U l �I � Phone:
Address/City/Zip: ', g�� 1"��.�ciG�- r�� '�j�r-S�,-�
Applicant is: Owner /� Contractor
Description of work: Y�°� Y�U��
Construction Cost: � � ��b Multi-Family Building: (Yes /No�
Company: �`(U��vl �'�t�� �h?�` Contact: .�/`t� �SC 1 G�C f,✓�
� � Address: � ,7��S ����"D � _City: _�(�'l�dt s,%lG�
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<� E = State:�Zip; SS �3� Phone:�-��Eirail:
�. ���£ � ;�� License#:�G3�v��� Lead Certificate#:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTIING A NEW BUILDING
In the last 12 months,has the City of Eagan issued a permit for a similar plan krased on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
- �-
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.org,
I hereby acknowledge that this information is complete and accurate;that the work will be in amformance 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 S�tate Building Cod ust be completed within 180
days of permit issuance.
X�� ��y� � , X
Applicant's Printed Name Appli s Sig ure
Page 1 of 3
