3889 Palisade WayCITY OF EAGAN Remarks Sew & W-br COI1, pd. on 11-2$-72
Addition Cedar Grove #8 Lot 4 eik 7 Parcel 10 16707 C1L0 07
Owner?.l U -L-L LJ ,-?- `;' :111'1 Street 3889 Palisade WaY state Eagan?MN 55122
I ).,edlPilPn I a h
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1970 125-00 5,,00 25 Paid
SEWER IATERAL ZZZ 1974 1 .1O PiCl
WATERMAI N
WATER LATERAL
WATER AREA
? STORM SEW TRK 9
;?. STORM SEW LAT 197
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 00.00 6897 11 -28-72
BUILDING PER.
sac 2 0.00 6897 11-28- 2
PARK
PLUMBING PERMIT
3830 PILOT KNOB ROAD, EAGAN, MN 55122
Address
Ciry 4p,
? Name
c Address !&
O City Cc,tr E,ti,,-- Phone
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE AFPLtES
TOWNHOU$E 8 CbNDO - RES. AATE APPLIES,
MINIMUM - RESIDENTIAL FEE = $12.00
MINIMUM - COMM/IND FEE = $26:00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
. .. . ?h' , L . . . . .
PERMIT #
RECEIPT # 5?55
DATE:
BLOG. TYPE WORK DESCRIPTION
Res. New
Mult. Add-on ;.5..,
?
Comm. Repair
Other
RES. PLBG. QNLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $100
Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50„
! - I Water Heater:;$1.5b r-
- 1 PER PERMI'n
well - $10,00
Private Disp. - $10.00
Rough ppenings - $1.50
FEE:
STATE S/C:
GRAND TOTA4: - ??
INSPECTION RECORD
CITY OF EAGAN . PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota55i22-1897 Datelssued:
c! ?. ;• ? Ei /
(612) 681-4675
SITE ADDRESS: APPLICANT:
, ?? s .i ??,. ??•
? •..ti?i i???`r' , , . , ,? , ;; . , „ ?
i . ,
PERIIAIT SUBTYPE: TYPE OF WORK:
?
? ` _ ?
Permk No. Permit Holder Date Telephona !f
ELECTAIC
PLUMBING
HVAC
Inspectlon Date Inap. Comments
FOOTINGS
FOUND
FCiAMiNG
RdOFING
RpUGH
PLUMBING
PLBG
AIR TEST
RpUGH
HEATING
GAS SVC
TEST
INSUL
GYP BaARD
FIFiEPLACE
FIREPLACE
AIR TEST
FINAL PIBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
65MT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
- - ?'-----
RMA HOME SERVICES INC.
Home Depot Installed Sales
3200 Cobb Galleria Pkwy., Ste. #200
Atlanta, GA 30339
763-542-8826
BC-20268257
RESIDENT'fiAL "
LDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD • 55122
651-889-4675
New Constructian RevuiremeMs
• 3 registered site surveys shovriig sq. fL o( l04 sq, tt. of house; and all roo(ed areas
(20% maximum lot coverege allowed)
• 2 copies o( plan shaxirg beam & wifWow sizes; poured found design, etc.)
• i set of Energy Calculations
• 3 copies of Tree Preservabon Plan i( bt platted atter 7/1l93
• Rim Joist Delail Opfions selection sheet (hldgs wAh 3 or less units)
DATE
JOB SITE AD
'V 99. as
RemadellReoair Renuirements
. 2 copies of plan
• 1 set of Energy Calcula6ons fa heated addiEore
• 1 site survey for extenor addibons & decks
VALUATfON(EXCLUDIN6LAND)?J d7??
IF MULTI-FAMILY BUILDING, HOW MANY UNITS? v
PROPERTY OWNER Cp'e.'C" LlB.UC16CAU.X
TYPE OF WORK
APPLICANT
ADDRESS
PAGER #
CELL PHONE #
FAX #
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category MINNESOTA RULES 7670 CATEGORY 1 F, q
(check one) - Residential Ventilation Category 1 Worksheet Submitted I I?
- Energy Envelope Calculations Submitted U60 N ?) I II
L"
MINNESOTA RUI.ES 7672 ?
- New Energy Code Worksheet Submitted
Plumbing Contractor: _
Plumbing System Includes:
Mechanical Contractor:
Vlcchanical5ystem Includes:
Sewer/Water Contraetor:
Air Conditioning
_ Heat Recovery System
Phone #
Phone #
Fee: $70.00
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the information is correct, and agree to complywith
all opplicable State of Minnesota Statutes and City of Eagan Ordinances.
Slgnature of Applican?" Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Phone #:
Water Softener _ Lawn Sprinkler Fee: $90.00
Water Heater No. of R.I. Baths
_ No. of Baths
FIREPLACE(S) _0 _1 _2 _3
+ PHONE # gSol•345•4010
ZIPCODE SS'lW
Updated 1101
OFFICE USE ONLY
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Att - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt- SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-piex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interiar) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteretian • ? a,34 Demolish (Bldg)" O 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolition (Eatire Bldg only) - Give PCA handout to applPcant '
Valuation Occupancy , . MC/ES Systgm;; •
Census Code Zoning City Water
SAC Units - Stories Booster Pump
Nbr. of Units v, . Sq. Ft. PRV
,. , .
Nbr. of Bldgs
Length
Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) FinallNo C.O.
_ Footings (addition) _ Plumbing
Foundarion HVAC
Drain Tile
Roof Ice & Water Final Other
_ Framing _ Pool _ Ftgs _ AirlGas Tesu _ Final
_ F'ueplace _ R.I. _ Au Test _ Final _ Siding Stucco Srone
_ Insulation _ Windows (newheplacement)
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanicai Permit
License Search
Copies
Other
Total
Building Inspector
/G /G;7G 7 D ?U Ci ?
VILl.AGE OF EAGAN
379$ Pilot Knob Road
Eagan, Alinnesota 55122
PERMIT N0. a 20j
?
The Village of Eagan hereby grants to „
of 73jiI Cnnr.nrr7 r+lvr7. r. __ c..,,+ti et n.,,,i .... 55075
a P:.UifiHING Permit for: (Oumer) e?P --
. - -&i 3889 Paliaade Way 4-7-
at $1 &
?' , pursuant to app ication dated
Fee Paid: t6n _m dated this 9RTh day o£ Navambep ? i9--?.?•
1.50 a/c
Building 7nspector p
itechanical Permits:
Bid Total:
?
?-7-?
? e lS •
VILLAGE OF EAGAIV
3795 Pilot Knob Road
Eagan, Minnesota 55122
PERti'tIT NO.:_ 287
The Village of iagan hereby grants to ,,. n
???r .rat*e C'enctrur}ion ^n
of 7a1?3 r. ord u?v? ,' ,90LSG Paul 55075
a _ uT
R.mTM Permit for: (Owner)_
s?ne
at 3966 Elverton 4-5-8o 3889 Pa7.isade way 4-7-8, & -.
, pursuant to application.dated 11/?5/M
Fee Paid: (Xj,Dp dated this 28th day of NOVember 19 72
1, 0 8;c ?
Building Inspecto;• --
iiechanical Permits:
bid Tota1;
? EAGAN TOWNSHIP
BUILDING PERMIT
o wne: ---- .:'!.-0. ------ &4 :°.-'-:1--
y Q` ..". _.. ....................
Addrecs (Preaeni) ------..?.....J? .........-----.--°-
Builder ......................... ...__..........._.............
Addreas
DESCRIPTION
N°
.
Eagan Townahip
Town Hatl
2898 ./
Det° ---//- ?-?- 7 Z
----.._"_---
Sfozies To Be Used For Fron! Deplh Heighl Esl. Cosf Permi! Fee Remuka
SSreel, Road or ofhes Deaesipiion of Localion Lut Block AddiiSon or Tzac!
I
I A `f 7
1'his permit doea aot auihori:e the use of afreels, roads, elleys or eidewalks nor does it give the owner or hia agant
the righ! !o creale any si2uaiion whied is s nuisanca or which presenis a hasard !o the healih, safeip, eoavenienea and
general welfare !o anpone in the eommunily.
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PAOGRES
This is !o eerlifp, fhai--?4-14'a-- l?`.c^-----_-------- haa permisaion !o eract a...:3...- ?
-- •-- . . .... ..----° - uPon
the above deseribed premise subjae! !o the provisions of the Suilding Oxdinance for Eagan wnahip adopled Apsi! 11,
1955.
.......---.._.... . I ..... ..... ......?..?...: -?-.--.. ...... ---- -?--- rBr .................. ---?---- - a? ??. n.? a?ng ?. ,.? ?
? • . . ... t . a. ...... . . . ....
.
:?
2004 RESIDENTIAL BUII,DING PERMIT APPLICATION
City Of Eagan
?O 3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
NewConstructionReoui2menp - RemodeVReoairRequlrements
3 registered site surveys showing sq. R of lot, sq. ft. of house; and all roofed areas 2 copies of plan
(200/o maximum bt coverage allowed) 1 set of Energy Calculations for heated addi0ons
2 copies of plan showing beam & window sizes; poured found desgn, etc. 1 site suney for additlons & decks
1 set of Energy CalculaUons Addif'ron - fndicate i/ai-sde septic system
3 ME
copies of Tree Preservation Plan if lol platted after 7/1193 Rlm Joist Defail Optians selection sheet (bltlgs wRh 3 or less units '
Date c?'?-_ /3uhy ! Construction Cost
Site Address ? :3 lk-$ ` -ipcd UniUSte #
Description of Work ? L1}CI1 I 0 C-a
) t r/V
O?Y
j
p
?
(
1:c
J -
1
n
y
„
-4
j?
Multi-Family Bldg ?
_ Y_ N Fireplace(s) _ D _ 1 _ 2
Property Owner ck'cRl & T)-Uq,( Y-w Telephone # ((c5l) IS q' (0 Tg $
RMA HOME SERVICES, INC.
Contractor Home Deopt Installed Sales
Address 3200 Cobb Galleria Pkwy.Ste. #200 City
State Atlanta, GA 30339 Telephone #( )
763-542-8826 BC-20268257
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventllation Category 1 Worksheet . New Energy Code Worksheet
(dsubmissiontype) Submitted Su6mitted
• Energy Envetope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies. l
Licensed Plumber Telephone #(
Mechanical Contractor LTelephone #(
Sewer/WaterContractor u'u Telephone#(
I hereby apply, for a Residential Building Permit and aclrnowledge that the information is complete and accurate;
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 pernut, 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.
G.f G. ? ncr.? ? .?L ?pGy??
Applicant's Printed Name Applicant s Si?ature
OFFICE USE ONLY
Sub Types
?- 01- Foundation - ? 07 05-plez- - O, 13 -16-piex -
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace
? 03 01 of_plex ? 09 07-plex O 17 Garage
? 04. 02-plex ? 10 DS-plex ? 18 Deck
? 05 03-plex ? 11 10-piex ? 19 Lower Level
? 06 04-plex ? 12 12-plex Plbg_Y or _ N
Work Types
0- -20- Pool - -O 30 -Accessory Bldg -
? 21 Porch (3-sea.) ? 31 E#. Alt - Multi
? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 24 Storm Damage
? 25 Miscellaneous
? 31 New ? 35 Int lmprovement ? 3.8 Demolish lnterior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Founda6on ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolitian (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
_ Frarriing
_ Fireplace _ R.I. _ Air Test _ Final
_ Insulation
Approved By:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
REQUIRED INSPECTIONS
Final/C.O.
_ FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests
_ Siding _ Stucco _ Stone _ Brick
Windaws
_ Retainiiig Wall
Building Inspector
, --
Ins#alled
Siding and Windows
LIMITED POWER OF ATTORNEY
CvJNTY OF COBB
STATE OF GEOAGIA
KNOW ALL PEOPLE BY THESE PRESENTS:
THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania
("Principal"), and a licensed contractar of RMA Home Services, Inc., DBA Home
Depot Ins?alle3 Sa1_es loca±ed at 660 MendelssolLn Avenue North, Go!den Val?ey, MN
55427, having a license number of BG 20268257, do hereby appoint, name and
constitute Elder-Jones Building Permit Service, Ina ("Agent") as my true and lawful
attorney-in-fact and do authorize and grant said attarney-in-fact for me and in my
name, place and stead the power to execute, acknowledge, sign and deliver (in such
form as may he required by the municipality) a permit application, or any other
instrument(s) which may be necessary and appropriate, in arder to obtain the proper
permit(s) from the City of Eagan, Minnesota for the installation, maintenance and
repair of windows and siding (tha "Work").
The powers conveyed to the Agent by this Limited Power of AYtarney are
limited solely to the express powers delineated herein and appt_y solely to the Work.
This Limi±ed Power of Attorney shall expire and automatically be revoked on the 21st
day of lbtay, 2004, which date is one year from the execution hereof. Further, the
powe:s conveyed by this Limited Power of Attorney may be revoked by Principal at
any time by express revocation and shall also be revoked by the Principal's death,
disability, incapacity or incompetence.
IAr WT'1_'NF-SS WHEREOF this Limited Power ofA#arney is Q.xecirtcd this
21 st day of May, 2003
David N. Katz
S WORN TO AND SUB9CRIBED BEFORE ME by David N. Itatz on this
21st day of May, 2003.?
Notary PtDic in for the State of eorgia
My Commission Expires: January 21, 2006
396816.0
Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor.
3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPOT
RESI[9EMT.IAL
BUILDING PERMIT APPLICATION
U? CITY OF EAGAN
3830 PILOT KNOB RD • 55122 ?
651-681-4675
New ConsW ction Reouirements RemodeNteqalr Reouiremenb
• 3 regislered site surveys ahowing sq. R. of lot, sq. R. of house; and ?II roo(ed areas • 2 copies of plan
(20% maximum lot coverage albwed) . 1 set af Energy Cahwlations tor heated additions
• 2 copies af plan shmving beam & window sizes; paured faund design, etc.) . 1 stte survey for efterior addilions & decks
• 1 set of Enecgy CalculeGons . Indicate H home served by septic system for additions
• 3 copies W Tree Preseivation Plan'rf bt platted after 711193
• Rim Joist Detail Optiore selecfion sheet (bldgs with 3 or less unifs)
DATE Ia•'?I1s'M •Oa VALUATION TfcJ "
JOB SITE ADDRESS 691M
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWN ER GtrCkXd?-C?l-2.t
TYPE OF WORKtaq CA 1 l.A"rj[L=cjik", ?U ?S'?Sn4l FIREPLACE(S) _ 0_ 1_ 2
APPLICANT ?1fY1?•1iOn?s.?k- 5x1Sk]ACC1 SAif..SPHONE# 463• 5LG • gSo"*
ADDRESS -?Qb0 Ct:bb ?1?f?f1CA?LWK,.,fl?Io.V?? ? ZIPCODE 30334j
PAGER #
FAX #
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
energy Code Category MINNESOTA RLTLFS 7670 CA'TEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet rJUN - Energy Envelope Calculations Submitted _ MIlVNESOTARULES7672 13 2002
- New Energy Code Worksheet Submitted ,.
Plumbing Contractor: _
Plumbing System Includes:
Mechanical Contraetor.
Mechanical System Includes:
Sewer/Water Contractor:
Air Conditioning
Heat Recovery System
Fee: $90.00
Phone #
Fee: $70.00
Phone #
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the i formation is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan ?ances.
Signature of Applica A ' /\
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updatetl 2002
CELL PHONE
Water Softener _
Water Heater _
No. of Baths
Phone
Lawn Sprinkler
No. of R.I. Baths
JUN-07-2001 15:43 PROM-RMA HOME DEPOT AHS
. - 7E56428227
T-928 P.001/001 F-768
???? ???? ?? ???ORNEY
cocNrY oF Ngja,,g2?
STATE OF MINNES01'A
KNOW ALL PEOPLE BY THESE PRESENTS:
TXLAT Y, Todd Daniel Lewis, a resident of QAiriA V County,
Minnesota ("Princigal"), and a licensed contractor of RNfA Home Services, Inc.,
DBA Home Depot Instailed 5ales locazed at 646 Mendelssohn Aveane North, Gotden
Valley, M,N 55427, having a ticense mnnber of BC- 24268257, do hereby appoint,
name and conscicute Elder-Iones Building Permic Service, Ine. ("Agent") as my true
and lawfut attomey-in-fact and do authorize and grana said attomey-in-faci for me and
in my name, place and stead the power co execute, aciuiowledge, sign and deliver (in
such farm as may be rzquired by the municipality) a permit application, or any other
instrument(s) which may 6e necessary and appropriate, ia ordet to obtain the proper
permit(s) from ihe Ciry of Eagan, Minnesota for the installation, maintenance and
repair of windows and siding (the "Work").
Tha powers conveyed co che Agent by this Limited Power of Atrorney aze
limited soleIy to the express powers delineated herein and apply solely to the Work.
This Limited Power of Attomey shail expire and automaticaliy be revoked on the ?,c
day of?, 2002, which date is one yeat from the execntzon hereo£ Fwtiher,
the Qowers conveyed by this Limited Power of Attorney may be revoked by Principal
at any rime by express revocation and shail also be revoked by the Principal's death,
disability, incapaciry or incompecence.
IN WITNESS WHEREOF this Limited Pawer of Attomey is executed this
L'= day of 2001.
Todd Danie! Lewis
?,wORN TO A1VD S'U13SC,RIBE73 BEFORE ME by Todd Daniel Lewis on
this day of -?Ti hln
e ' .rrv?wlMb
?AIe ub ic ia foclt e 5tate of Nfinneso gUR70N T. BROwN ?
-9 N07AAY PUBUC-MINNES07'A
My Commission BXpires: * WAk=
A
3%816.r3
Received Time Jun. 7• 2:56PM
PERMIT# '/ "I Y1 3
RECEIPT DATE: J V
A 1?!!y I IbSg
gESIDENTIAL PLiJM$1NG i'ERMIT APPLICATION
crrYoF EasM
3$30 PILOT KAOB RD
£EkBAtA, MA 551 E8
651-8$1-4678
Please complete for:
? single family dwellings
D townhomes and condos when permits are required for each unit
? backflow preventer for irrigation system
Qn?1So de 1NUy
SITE ADDRESS:
OWNERNAME:: £ ? ),P?iPCpn??X TELEPHONE#:
(AREA CODE)
INSTALLER NAME: W01I1;jE TELEPHONE #: qha Q? q?o-I,??
STREETADDRESS: 6035 12fh AVBfIL'ESGIeiII (AREACODE)
11ypldns, m ..Y.
CITY:
Piace a check mark next to the uermit work tvne
STATE:
ZIP:
New residential dwelling unit under construction and not owner/occupied $ 90.00
? Add-on, modification or aiteration to existinq dwelling unit, including: $ 50.00
• abandonment of septic system
• new installation/repairlrebuild of RPZ
• lawn irrigation system
• waterturnaround
Nature of work: QyPeR ll.VVr te"f
Septic System, new/refurbished - $ 225.00
• includes County & Consulting Inspector fees
• requires MPC license
State Surcharge $ 50
Tota I $ !50• 5-0
Reminder: Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc.
I herebyacknowledge that I have read this applipfion, state that the information is correct, and agree to complywith all applicable City of Eagan ordinances. It
is the applicant's responsibility to notiTy the properry owner that the City of Eagan assumes no liability for any damages caused by the City during its normal
operational and maintenance activities to the facilities constructed under this permit within CiWl operty/right-of-way/easement.
?-
SI NA URE PERMITTEE
Updated 1101
CITY USE ONLY
LOT ? RECEIPT ?? 79(00
SUBA. RECEIPT DATE:
. ?
1997 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
Date• (612)6814675
Complete this section only if you are installin¢ HVAC in sinPle famitv, townhome, or condos that are
under construction and are not owner /occupied.
• HVAC: 0-100 M B T U $ 24.00
ADDITIONAL 50 M BTU 6.00
• Gas outlets (minimum of one required @$3.00 ea.)
• State Surcharge: .50
• TOTAL:
Complete this section onlv if vou are remodeline, adding to, or reoairing existing sinQie familv
dwellin¢s, townhomes, or condos.
!/Add-on fumace ? Add on air conditioning
_ Add-on air exchanger, i.e. Vanee system, etc. _ Other
Minimum fee applies to all remodel or add-ons of existing residences $ 20.00
State Surcharge
Total: 20.50
srrE a,DDxEss: 'Mq ?l/?sqdt5 cJa,r/
owrrER NALME: Tewaj adexedv-t PHOxE#:
INSTALLER NAME; &III/' t1Tw PHONE #: ?9r O?O 5
STREET ADDRESS: ldyyl f _L.51A11GC (/`C 1j
crr5r: s rE: wi1 zrP: J:53,&
? -
J/ y J? 1 ATURE OF PERMITTEE
??
Cf7Y USE ONLY
L _ BL _
SUBD.
RECEIPT#:
RECEiPT DATE:
1997 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 68l-W5
Please complete for.
DATE:
WORK TYPE:
? all commerciaUndustrial buildings.
• mulFi--famity buiidings when separate pertniLt are no required for each dwelling
unit
CONTRACT PRICE:
NEW CONSTRUCTION
DESCRIPTION OF WORK:
INTERIOR IMPROVEMENT
FEES: .$25.00 minimum fee 2[ 1°k of contract price, whichever is greater.
& Processed piping - $25.00
? State surcharge of $.50 per $1,000 of 22m2j= fee due on all pertnits.
CONTRACT PRICE x 1%
PROCESSED PIPING
STATE SURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME: TELEPHONE #:
TENANT NAME: (unaROVEMeta'rs oNLv)
INSTALLER:
ADDRESS:
cirY:
PHONE A`•:
STATE: Z1P:
SIGNATURE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
u INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: P.I . N. : 1e-167e7-e40-e7
LOT: 4 BLOCK:
3889 PALISADE WAY
CEpAR GRQVE 8TH
PERMIT SUBTYPE:
DECK
BUILDING
025562
05/10/95
APPLICANT:
7
VALLEY INVESTMENTS CONST
(612) 454-5191
TYPE OF WORK:
NEW
? ? ? _ ? ?
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERIVIIT CO0M
PERMIT TYPE:
Permit Number: B U I L DI N G
Date Issued: 0 2 5 5 6 2
05/10/95
SITE ADDRESS:
3889 PALISADE WAY
LQ7: Q BLOCK: 7
CEDAR GROVE 8TH
F.I.N.a 10-16707-040-07
DESCRIPTION:
Bj4a`Sd1ng ,?P?ermit Type DECK
0uiiding Work,Type NEW
?
¢ hy
ey
?£ I 4
' +3
E:£ y+ +.'3yiwe
t
? &F
s
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
Lic. Search Fee
Total Fee
?
?)-5 L7
"xi5?3.;F?
?
CONTRACTOR: - Applicant - sT. Lzc. OWNER:
VALIEY INVESTMENTS CONST 14545191 0604241 DEVEREAUX JERRY
2401 LEXINGTON AVE 5 3889 PALISADE WRY
MENDOTA HTS MN 55120 EA6AN MN
(612) 454-5191
?
I hereby acknaw.ledge t;h
3nfiormatian is ca`r.'reck'
° "Statutes enii' C3ty, a1'VE4;
$80.00
$.50
$5.00
$36.60
Li CITY OF EAGAN
3830 PILOT KNOB RD - 55722 ?•?•-•?
1985 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681 -4675
? 3 regiatered site surveys ? 2 mpies of plan
? 2 Copies of Dlana (nclude beam 8 wintlow slus; poured Tnd. design; stc.) ? 2 aite suneys (eMertor add'Rions 8 deeks)
? 1 energy wlwlations ? 1 energy calwlations for heated additbns
? 3 copks of tree prossrvation plan 'rf lot plattad after 7/1l93
iequired: _ Yee _ NO DATE: CONSTRUCTION COST: _els or
,
DESCRIPTION OF WORF
STREET ADDRESS: '
LOT ? BLOCK
PROPERTY
OWNER
Name: Phone#:
Street
City: State: Zip:
coNTRaCTOR Company: Phone #:
Street Address: nl67DK) License #•
City: r??A?00?7F'-?:IGIN-E State; ,.lr} Zip
ARCHITECTI Company: Phone #-
ENGINEER
Name: Registration #-
Street Address-
City: State: Zip:
Sewer & water licensed plumber:
change are requested once permit is issued.
1 hereby acknowledge that I have read this application and state that
applicable State of Minnesota Statutes and City of Eagan Ordinances.
OFFICE USE ONLY
Certificates of Survey Received
Tree Preservation Plan Received
5ignature of Applicant:
_ Yes _ No
_ Yes _ No
Penatty applies when address change and lot
the information is correct and agree to comply with ali
ti
/
MAY D 5 1995
OFFICE USE ONLY
I•?`"'•; i0r... ."':. ,?-„e-.
BUILDING PERMIT TYPE
0 01 Foundation o 06 Duplex ? 11 Apt./Lodging o 16
? 02 SF Dwelling ? 07 4-plex ? 12 Multi RepaiNRem. ? 17
0 03 SF Addition ? 08 8-plex ? 13 GaragelAccessory a 20
0 04 SF Porch o 09 12-plex ? 14 Firepiace a. 21
0 05 SF Misc. 0 10 _-plex c<15 Deck
WORK TYPE
,,"1 New ? 33 Alterations ? 36 Move
0 32 Addition ? 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Pfanning
Basement sq. ft.
Main level sq. ft.
sq. ft,
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building Engineering
Basement Finish
Swim Pool
Public Facility
Miscelianeous
MC/WS System
City Water "
Fire Sprinklere Id
PRV I
Booster Pump li
Census Code. I Y3,v
SAC Code
Census Bldg I i
Census Unit o
.. . ?
Permit Fee Valuation: $
Surcharge
Plan Review
License
MCNVS 5AC
City SAC
Water Conn.
Water Meter
Acct. Deposft
SNV Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
/ 2-on '
% SAC
SAC Units
.-FLo ; 7144-.,l
MASTER CAJKD
LOCATION
OWNER
STRUCTURE AND
LAND USED AS
Permit
No. '
? Issued Issued To
Contractor Owner
BWLDING r7 i
PLUMBING
1
0291
CESSPOOL - SEPTIC TANK - I
WELL
-
i
ELECTRICAL I
HEATING J QR7 I
?+
GAS INSTALLING .-?
SANITARI' SEWER
?..
OTHER
OTHER I
Items Approved
(Initial)
Date
Remarks
Distance From Well
FGOTING SEPTIC
FOUNDATION ?, - CESSPOOL
FRAMING ? TIIE FIELQ FT.
FINAL
E I_ECT R I CA L
HEATING
? DEPTH
OF WELL
GAS INSTALLATION j
SEPTIC TANK
CESSPOOL
DRAINFlELD
PLUMBING
WELL
SANITARY SEWER
Violations Noted
on Batk
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO BE USED ONIY IN EVENT OF 095ERVED VIOWTIONS
PERMIT NO.
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
OF INSPECTION
? NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
O ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
? NON-COMPUANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED 8Y CONDITIONS BEYOND
CONTROL.
ITEMIZED AND DESCRIBED AS FOLLOWS:
? REINSPECTION REQUIRED DATE OF REINSPECTION
REINSVECTION REVEALED
CERTI F ATION -1 certify that I have carefully inapected the a6ove in which I have no interest present or prospective, and that I have reported herein
all significa con itions observed <o be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-s i rovements relating to the property inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILOING INSPECTOft
DATE
,
J4-7- 8
EAGP.N TOWNSHIP
3795 Pilot Knob Rosd
SC. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SL+RVICE CONNECTION
Date:11
Billiag Name?l(??-(?i?C ?C?
Owner: 42-,
P lumber :,,?\ Y? 1 LI YYl ? ? rl 4
Number. 1056
Site Address:'In2
Billing Address / c YL \,`,T,?YIo-DA N„LA ?
1/28/72
Meter No. IPermit Fee 10.00 T)d 11 28/72
Meter Reading Meter Dep. .0 pd 11/28/72
Meter Sealed: Yes` IAdd'1 Chg.
NO ' Total Chg.
Building is a:
Residence xx
I4ultiple go.
Commercial
Industrial
Other
Inspected by
Date
Remarka:
Sy:
Chief Inspector
In consideration of the issue attd delivery to me of the abova permit, I
hereby agree to do ttE proposed work in accordance with the rules and
regulatioas of Eagan Township, Dakota County, Minaes E?a-sz B9' 1 ?L X?r Lak
Please notifq the above office when ready for inepection and connectian.
EAGAN TOWNSHIP
:795 Pilot Knob Road
St. Paul, MinneQota 55111
Telephone 454-5242
PERMIT FOR SE47ER SERVICE CONNECTION
DATE; 11151,417,3, NUMBER 1222
OWNEP.Qa???.)C? \'OY1C'? Address ? Jl??9 ?0.? ?`Y)c?EA l?.C).?
PLUMBER?? ?IIAYIII(??Y?? TYPE OF PZPE
-7
DESCRIPTION OF BUI?A ING
Industriall Commercfall Residential I Multiple Dwelling I No, of uafts
Location of Connections: I Connection Charge 260.00 pd 11/28/72.
Permit Pee 10.00 d 11/28/72
.50 pd 72
Street Repairs
Total
Inspected by:
Date
Remarks•
By. Chief InspecCOr
In consideratioa of the issue and delivery to me of the ahove permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagaa Toc•mship, Dakota County, Minnesota
S
Please aotify oohen ready for inapection and connection and before any portioa
of the work is coverad.
2004 RESIDENTIAL BUII:DING PERMIT APPLICATION
City Of Eagan
S `? k-f 3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construcdon Reauirements RemotleURepair Reauirements
3 registered site surveys showing sq. fl. of lot, sq, k. of house; and all roofed areas 2 copies of plan
(20% manimum lot coverage aliaxed) 1 sel of Energy Caiculations for heated addNOns
2 copies of plan showing beam & window sizes; poured found design, etc. 1 sife survey for addifbns & decks
1 set of Energy Calculations Addftion - indicete 'rf on-site septic system Wft
3 copies of Tree Preservation Plan'rf lot pletted after 711193
Rim Jois[ Oetail Options selection sheet (bklgs with 3 or less units
Date ? /(" Construction Cost
Site Address Sq ? S IIniGSte #
Description of Workq :e.C? C)7Z)C? (--+[ ` N ; 51
?ld
Malti-FamilyBldg _ Y%),j N FYreplace(s) _ 0 2 ?n}' %1"'•
V
Property Owner ?C Q?A l..CtCX? Telephone #( 651
RMA HOME SERVICES, INC.
Contractor Home Depot Installed Sales
Address 3200 Cobb Galleria Pkwy.Ste. 4200
City
Atlanta, GA 30339
State 763-542-8826 _ Telephone # ( )
BC-20268257
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Energy Code Category - M'nnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
(J su6mission type) ' Residential Venlllation Category 1 Worksheet • New Energy Code Worksheet
Submitted Submitted
• Energy Envelope Calculations Submiried
Have you previously constructed a building in Eagan with a similar plan? _ Y _
fee applies.
Licensed Plumber r,? rP- n m Telephone # (
Mechanical Contractor
Sewer/Water
Telephone #(
Telephone #(
N If so, 25% plan review
I hereby apply for a Residential Building Permit and aclmowledge that the information is complete and accurate;
that the wark 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 pernut, and work is not to start without a
permit; that the work will be in accordance with the approved plaryin the case of work which requires a review and
apgroval of plans.
. ll(X,c?a- //) X dLCri,164A 10? )
Applicant's Printed Name App icanYs Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-ptex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
O 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04. 02-plex ? 10 08-plex ? 18 Deck O 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 70-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 72 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int lmprovement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration , , ? .37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors
? 34, Replecement 'DemoliGOn (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code ? Zoning City Water
SAC Units ' Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaVC.O.
_ Footings (deck) _ Final/No C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof
Ice & W ater Final _ Pool _ Ftgs _ Air/Gas Tesu Final
_
_ Framing _ _ Siding _ Stucco _ Stone _ Br ick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
_ Insulation _ Retaining Wall
Approved By:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
Ins#alled
Siding and Windows
LIMITED POWER OF ATTORNEY
CvUNTY OF COBB
STATE OF GEORGIA
KNOW ALL PEOPLE BY THESE PRESENTS:
THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania
("Principal"), and a licensed contractor of I2MA Home Services, Inc., DBA Home
Depot Installed Sa1es loca+.ed at 660 Mendelssehn Aver_ue North, Cso'.den Va?ley, MrT
55427, having a license number of BG 20268257, do hereby appoint, name and
constitute Elder-Jones Building Permit Service, Inc. ("AgenY') as my true and lawful
attorney-in-fact and do authorize and grant said attorney-in-fact for me and in my
name, place and stead the power to execute, acknowledge, sign and deliver (in such
form as may be required by the municipality) a permit application, or any other
instrument(s) which may be necessary arid appropriate, in order to obtain the proper
permit(s) from the City of Eagan, Minnesota for the installation, maintenance and
repair of windows and siding (the "Work").
The powers conveyed to the Agent by this Limited Power of Atterney are
limited solely to the express powers.delineated herein ancl appl_y solely to the Work.
This Limited Pawer ofAttomey shall ehpire and automaticalIy be revoked on the 21st
day of May, 2004, which date is one year from the execution hereo£ Further, the
powe: s conveyed by this Limited Power of Attorney may be revoked by Principal at
any time by express revocation and shall also be revoked by the Principal's death,
disability, incapacity or incompetence.
IN WI'1_'NESS «THRRLQF this Lim?ted Pol.ver ofAttorney is e.xecirted this
21st day of May, 2003
David . Katz
SWORN TO AND SUBSCRIBED BEFOFtE ME by David N. Katz on this
Zlst day ofMay, 2003^
Notary P ic in for the State o eorgia
h4y Commission Expires: January 21, 2006
396816.v3 Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor.
3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79•DEPOT
20071tESIDENTIAL BiTILDING rERMiT AprLicaTiorr
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsW ction ReQUirements
9 registered site surveys showing sq. R. of lot, sq. fl. of house; and all roofed areas
(20 % maYimum tot coverage allowed)
1 Sods RepoR if pmposed 6uilding is to be placed on diswrhed sal
2 copies of plan shovring beam & window sizes; poured tound design, etc,
1 sel of Energy Calculations
3 copies of Tree Preservatlon Plan if IW plaked aker 711193
Rim Joist Detail Options selection sheet (buildngs vnN 3 or iess uni5)
Minnegasco mechanical ventilation fortn
RemodeVReoair Reouirements
2 copies of plan showing fooongs, heams,joists
1 set of Energy Calculations for heated addihons
1 site survey (w addifions 8 decks
Addifion-irMitafe ifon-sife septicsystem
? fv.o
c ?-?
Office Use Onlv
CeRofSurveyRecd- _Y _N
SoilsReport:- _Y _N
Tree Pres Plan Recd Y
.
_N
TreePresReqm{ed. _Y _N
Qn-site Septic System - _ Y' _ N
Plans are considered ublic information unless ou state Yhe are trade secret and the reason.
Date Construc[ion Cost
Site Address Unit/Ste #
Description of Work ^Z& 462_?Z
Multi-Family Bldg _ Y V_N Fireplace(s) 00 2 . .
PropertyOwner J'e rc?C? Telephoneq(Clj( )?.52 -V 7 B 8
Contractor 7-/"D x V?-`L ?`??"???C •
Address 13,50 City
State Zip Telephone #(j5 d? Y7 o' C?C? 0 3
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category • Residential Venfilation Category 1 Worksheet • New Energy Code Worksheei
(J submission type) Submitted Submitted
. Energy Envelope Calculafions Submiried
In The last 12 months, has the City of Eagan issued a permit for a similar plan based on-a master plan?
_ Y _ N It yes, date and address af master plan:
Licensed Plumber Telephone #
Mechanical Contractor Telephone #( ?
Sewer/Water Contractor Telephone # ( J
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
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 start withoue 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. ?
App icant's Printed Name Applicanf's Signature
DO NOT WRITE BELOW THIS LINE
Sub Tvpes
? 01 Foundation
?
07
05-plex
?
13
16-plex
?
20
Pool . ?
30
Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 Ot of _ plex ? 09 07-plex ? 77 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Declc ? 23 Porch (screen/gazebo/pergola) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Sform Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvpes
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building . ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building• ?i 43 Reroof ? 46 Windows/Doors
? 34 Replacement "Demolition (Entire Bldg) - Give PCA handout ta applicant
D25Cf7pt100: WaterDamage_ Yes
Valuation Occupancy MCES System
Plan Review _ 100°/a or _25%
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
. Footings (new bldg) _ Sheetrock
Footings (deck) _ FinaVC.O,
_ Footings (addition) _ Final/No C.O.
Foundation HVAC
Drain Tile Othec
Roof Ice & Water Final Pool Ftgs Air/Gas Tests Fina1
_ Framing _ Siding _ Stucco Lath _ Stone Lath _Brick
Fireplace R.I. Ai rTest Final Windows
Insulation _ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 3889 Palisade Way
Lot: 4 Block: 7 Addition: Cedar Grove 8th
PID:10- 16707 - 040 -07
Use:
Description:
Sub Type: e- Windows/Doors
Work Type: Windows/Doors - New/Replacement
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Crew2 Inc
2650 Minnehaha Ave
Minneapolis MN 55406
(612) 276 -1680
Applicant/Permitee: Signature
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Construction Type:
Occupancy:
Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes.
$88.50
$1.50
Total: $90.00
- Applicant -
Owner:
Barbara A Devereaux
3889 Palisade Way
Eagan MN 55122- -171
Permit Type:
Permit Number:
Date Issued:
Permit Category:
0801
9001
Issued By: Signature
Building
EA089603
06/09/2009
ePermit
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply
of Minnesota Statutes and City of Eagan Ordinances.
h all applicable State
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA171277
Date Issued:08/09/2021
Permit Category:ePermit
Site Address: 3889 Palisade Way
Lot:4 Block: 7 Addition: Cedar Grove 8th
PID:10-16707-07-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
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 -
Barbara Ann Devereaux
3889 Palisade Way
Saint Paul MN 55122--171
(612) 432-8969
Lofgren Heating & Air
5708 Upper 147th St W
Suite 106
Apple Valley MN 55124
(952) 431-5811
Applicant/Permitee: Signature Issued By: Signature