3900 Palisade WayCITY OF EAGAN Remarks SGW & Wt,P COriri pd. on 12-18-72
Addition edar Grove #8 Lot 11 Rik 6 Parcel 10 16707 110 06
owner streec 3900 Pal3sade Way state Eagan•MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 44' 1970 125.00 .QQ 2 Paid
? SEWER LATERAL 2 Z'L 19711 1539.1 '(j,
WATERMAIN
j(- WATER LATERAL 1974
WATER AREA
jfSTORM SEW TRK
.)STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 00.00 018 12-18- 2
6UILDING PER.
SAC 260.00 -
PARK
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: ,:; ,,, ; APPLICANT:
lJAY
i ????r?i< ?,r,??•?i aclFt ??,t, , 7i9A? IaN4?
PERMIT SUBTYPE:
, , ,. ,
TYPE 4F INORK:
? .
1ct1 i I tt J wr,
N.'.; 1 :it,
04tf.'Ivq
.k . -1
-1
Permk No. Permlt Hoider Dete Telephone I!
S/VU
PLUMBING
HVAC
ELECTR J' ov
ELECTRiC
Inspectlon Dete Insp. Comments
ootin 4
Founda n
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Orsat Test
Final Plbg. Plbg. inspector - Notity Plumber
Const. Meter
Engr./Pian
Bldg. Final
Oeck Ftg.
Oedc Final
Well
Pr. Disp.
INSPECTION RECQRD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number. "•'' bt ??
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675 ?
SITE ADDRESS: APPLICAMT:
.,i,E wnv ? I A t r A t I r r;,i f ?rlix t?r•,???•i l?,c { i. f. , c3?.+};- 117A
PERMIT SUBTYPE: TYKPE OF WORK:
INSPECTION .. . ..
Permft No. Permit Holder Date Telephone #
ELECTRIC
PLUMBING
iiVAC
InspecUon Date Insp. Comments
FOOTINGS
FOUND
FFiAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
G •-
FIREPLACE
AIR TEST l( ??
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
t
VILLAGE OF' LAGAN
3795 Pilot Knob Road
Eagan, liinnesota 55122
PERP4IT IdO, : 297
The Village o£ Eagan hereby grants to Cedar Grove Con:,trtlCtim Co.
of 7343 Concord Blvd. P., South Ct:. ?%uul 55075
a PLUtSING Permit £or: (pwner) satne
1_- _'? 2 7im Q 1p ?
J?3 i
W? 9-9-?, 39 AP is?e
o?app ic4PaTie '0_ Pa3tsade
-- ,-putsu on dated 12J15/72
Fee Paid: dated this 78thday of Dp„cembgr 1 ?
3.00 s/c , 9 72
Buildin? Inspecccz? -
141.chanical Permits:
Bid Tota1•
?`f
fi-G-
c, & ,
VILLaGE 0'r' EAGAIV
379$ Pilot Knob Road
Eagan, Piinnesota 55122
PERsIT NO.: 295
The Village of Eagan hereby grants to Cgdar Grave Constructiou Co.
o£ 494; ccmaord ffivd & , 9outh 3b Pml 5$075
a gg??Jg Permit for: (Owner)
? d e L t .7 ?m 2 12- -g 1711 ae?a?i 3•9-7, 3 F
?a?i.?aale'?? ?tiflvti ?tei?.?rt?aanJQ, onSl7g .
r^ee Paid: dated this 18th day of December 19 72
3.00 s/c '
Building Inspectoi- vieohanical Permits:
aae
6id 'rotal:
? EAGAN TOWNSHIP
BUILDING PERMIT
%
Ownee
......--- .............. ..... ....l._._ ..............._.....__._..
---- -------- -..--
..
Addrass (preseni) --
Builder ._.... _...---......... ._..... _.._....... ._.......... ............_..._._._._._. ...
Address __...... ........................_--`---....-.---......_.........---.............
DESCAIPTION
?
2911
Eegan Township
Town Hall
aate ..._:..._..... --- ---
Siories Ta Be Used For Front Depih Heigh! Esi. Cost Permi!
Fee
Remu?ks
3 H
J?"?
LOCATION C A((. ;t• SV/
Sireei, noaC or oines uescnpnon oi i.ocanon I L02 IBTOek I Addifion or Traef
I i ? s c_dCt. ? 7
13
This permii does not auihorize the use of sfreefs, xoads, alleps or sideivalks nor does it give the owner or his agent
the righ2io create anp situalion which is a nuisanee or which presenis a hazard fo the healih, eafelp, eonvenienee and
general welfare So anpone in She communify.
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRES$.
This is 2o cerlifY, -:.._`.°:t:'.._...... ?''.'c.`.?_..haspermission !o erect a...•?_c?:.... ,
... ........ ...?? ......""_upon
the above descrihed premise subjecf 2o the provisiona of fhe Building Ordinanee for Eagan ownship e?doplad April 11,
1955.
a?' ?G--e?? ??'?2- ? ?yk..? ? ?11..--c.< (/"i??•?i
..... ..................' -..__........................ ......... Per _....... ............................................. -- _.._...............-
C 6 ? Building Impector _?y'
s94
N 02547
REQUEST FOR ELECTRICAL INSPECTION
? See insimctions for compleling ihis form on back oi yellow copy.
"X':.Be/ow Work Covered by This Request
EB-00001-08
AF , q A1 d?ooo
e Atld TRep. TypeofBuilding AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater EleCtric Heating
Apt Building Dryer Load Menagement
Comm.llndustrial Furnace Other (Specify)
Farm Air Conditioner
Olherispeatyl Conhactor's Remarks:
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feetlers Fee
Swimming Pool 0 to 200 AmpS 0 to 100 Amps
Transiormers Above 200 _ Amps ve 100 _ Amps
SignS . Inspeciw's Use Only: TOT
Irrigation Booms ?i// / ?'?
G f
Special Inspection `
Alarm/Communication THIS INSTALLATION MAY BE O ED DISCONNECTED IF NOT
Other Fee COMPLETED WITI-Mi 18 M
I, the Electrical Inspector, hereby
certify that the above inspection has
been made. Aouqn-m ?
F;,,ai oa .7 p -
! T
oare ?
. ?
OPfICE USE ONLY
This rcqoest voiE 18 momhs imm
M?5 47 / ?
f'
'
Flepuest Oate
No. Rougn.ln Inpseetmn RapoireE Ins ectbn Othe? ihan Rough-ln
Fea
q (YOU must call inspeclor when ready) qeaEy Now ? wni NonN msoecto.
J ? Ve¢ ? NO DaleReeO
I1<licensed contractor ? owner hereby request inspection of above electrical work at
J0 6 Atldress iSireet Bo r Route No.?
?J% 1?h'r.-/?Al?x-- l1?1r Ci
!?__-"9 ?.?i n?
Section No. Township Name or Nb. Ranqe No. Gounry
:?
R
,fT
/
Oc??yyup m
a?PRINT,
???J ??
t??V1
??"
?
? / ")//?
PhorLe No.
???'-/J???/?
'
4
?J
i
Pawe, treppiier AdOress
Elecvical /Contractor /cOmpany N^me)
" ?? ???J
'?
? /?
?
?
'r/ ConVaMOrS Licensa No.
???!? I/'? j.?
7?
?
,/,
.
,_
Maiimg Adaress Xamrar or Oyp_¢r/Mak/ing Installationl
11-1?;7, /?'//? q??
/?
v?7????/L'? /?. ?7.? ?,??.?./?? /;J?:?/',/?
/?
/ /
/utnonzey Sig,.?ure/ 1y.?SZnv?a,tlor.Own?r Ma ' g Insialla Ppone um?er Jy
MINNES0T4 STATE BOAPD OF ELECTRICITY THIS INSPECTION REOUEST WILL NOT
G.igge-MlEway BIEg. - Room S113 BE ACCEPTED BV THE STATE 80nRD
1821 University Ave.. SL Peul, MN 55104 UNLESS PROPEfl INSPECTION FEE IS
Phane (813) 642-0800 ENCLOSED.
?0313
o?o
2017 RESIDENTIAL BUILDING PEiiNIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX 9 651-675-5694
New Consiruqan Reauhemenls
3 rephte2d stle surveys shavnng sq. fl. of fo1, sq. R M house; and ak rcofed areas
(20 k maximum lot coverage allowed)
1 Soik Repcrt rf proposc4 buildmg is to be placed on disturbed soil
2 copies of plan shovdng beam & window, sizes poured fouM design, etc.
1 set of Energy Calculatians
3 copies N Tree Preservafion Plan if lot platletl aNer 7f153
Rin Joist Defail Options selection sheet (buildings wAh 3 or less- units)
Minnegasco mechamwl ventilation fortn
RemodelReoair Reouirements
2 cMesof plan sFowiftg footings, beams, joists
i set of Energy Calculations fur fieatedaddiWits
1 site suruep fa adtlitions & decks
Addi/nn - ind/rafe if Dn-site sephc system
Offics Use Oniv
Cert ofSurveqftPcd , _Y _N
SalsRepnt `-.. _YN
TreePresPWnftecd _YN.
TreePresRequYEtl - -- Y _N
OwsdBSepliiSysiem ?.Y-._Np'4;? .,..a"t € s t7?'3yfidC.'CV?d PCiN.@„ l.tql?ti,.dTi't?"e4jS'e leEw3#'sa j?o'w °sttfi%a°?,? sd2'e ?T--??,de seCCE:t ::9C!{? th£'. !'E.'s2«s13i.
Date j 0 / Jr / 07 Conctructiun Cost w y500
SiteAddress 39(7 o A,IrSadL waM EGSao-), SS/Z2. Unit/Ste #
lleccription uf Work ILf//ObT 4 ??-
Multi-Family Bldg _ Y ?N Fireplace(e) X_ 0 _ 1 _ 2
PropertyOwner 1 _es1iiy Soj Te]ephone#(b5`/) 'VS_P-31Zp
Contractor M14 bol LN'O44/1 IAnSTnuAo,j _
Addrrss ? 0 W MO.ZA City Ncw
las(?e.
/01-
5tate mN Zip S_(v0'7 ? Telephuee#i(,?'e? 7 Si- a3se33
COMPLETE THIS AREA ONLY IF
Energy code Getegory -Min°euota Rules 7670 4ateeon1
(J submission type) • Resideniial Ventilatlon Category i Worksheet
Submitted
• Energy Envebpe Celculations Submitted
A HEW BUILDING
Mumesota Rtiles 7672
• New Energy Code Vtbrksheet
Submitted
In ihe Iqst 12 months, has the City of Eagan issued a permit for a similar plan based on a masfer plan?
_ Y _ N If yes, dafe and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
for a
and acknowledge
Ss complete and accurat
that the work will be in conformance w7th the ordinances and codes of the Gity 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 without a
perntit; that the work will be in accordance with the approved plan in the case of wurk whrch requires a reciew and
approval of plans.
Telephone # (
Telephone # (
Telephone #(
s'
ApplicanPs P nted Name App1- itanCs iCgnature
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITEADDRESS: Lor: 11 81.OCK: 6 APPLICANT:
3900 PALISADE WAY VALLEY POOLS INC
CEDAR GRpVE 8TH (612) 894-1480
PERMIT SUBTYPE:
5WSM POOL
TYPE OF WORK:
NEW
BUILDTNG
023136
04/12J94
INSPECTION „ . D.
FOOTINGS FINAL
? _. ?
--?-CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT
PERMIT TYPE
Permit Num6er:
Date Issued:
suiLo?iviy?
023136
04J12/94
SlTE ADDRESS:
3900 PAIISADE WAY
LOT: 11 BLOCK: 6
CEDAR GROVE 8TH
P.I.N.: 10-16707-110-06
DESCRIPTION;
Buildi?`§'„Permit 7ype SWIM POOL
Build3nq Wprk Type NEW
, Bwilding Leng'th 36
BwSld:ing 4Jidth °":" 16
?
k t /C7 ??
:' ?:L,1
/ Lt.?.? ? ? t ???
ZI
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
7ota1 Fee
VALUATTQN
$117.0@
$5.00
$122.00
$10.009
CONTRACTOR:
VALLEY POOLS INC
651 CLIFF RD
BURN9VILLE MN
(612) 894-1480
- Applicant - ST. lLC
18941489 0004421
55337
OWNER:
-IANSON LESLIE
3900 PALZSADE WAY
=AGAN MN 55122
(612)452-3120
F-
I hereby acknowledge that i have read tihis
information is correct and agree ta comply
St tu -2s and G%ty of Eagan Urdinanees.
L S=-Jj"? -j - .
APPLICANT/PERM17EE SIGNATURE
applicati,on and etate that the
with all applicable State of Mro.
rJ
?nnl '-
- I?SUE?D 8 : IG ATURE
1313C
CITY OF EAGAN
1994 BUtLQING PERMIT APPLICATION
681-4675
--- ---,
-' ;
... 2 ? ?S,:; ;
41zz.'90
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
caics.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date I /q Li Valuation of work 5vo
Site Address: O Dp,(..rZppE WA M
STREET SUI7E #
Tenant Name: (commercial only)
IAT BLOCK ? SUBD. N??????? ?}(V P. I. D. k
Descri tion of work: O
The appl i cant i s: ? Owner bf Contractor ? Other (Describe)
Name b8Sl,` Ed- R £'GKu IAAtoSorJ Phone S/SZ- 3120
Property LAST FI ,
Owner Address ?Ro-o P caC.saAAr= c.•?A!?
STREET SiE #
City 'EAc1AoU State 1'Y11J Zip 6,0IZ2
Company LJA ooLs =E c__. Phone &94-1WO
Contractor Address 6I S tLt rc QcL License # Exp.
Ci ty 2u (Z/.nsn), 11 F_ State VY1 &_? Zi p 55337
Company Phone
Architect/
Engineer Name Registration #
Address '
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that have read this application and state that the information is
correct and agree to comp y'th all applicable State of Minnesota Statutes and City of
Eagan Ordinances. ?
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE ? '? •? ,? ?
II?„? ??..,. ?._..,s?
? 01 Foundation ? 06 Duplex 13 il Apt./Lodging li? 16 Basement Finish
? 02 SF Dwg. ? 07 4-Plex O 12 Multi. Misc. "?17 Swim Poal
? 03 SF Addition ? 08 8-Plex O 13 Garage/Accessory ? 18 Comm./Ind.
? 04 3F Porch ? 09 12-Plex 0 14 Fireplace ? 19 Cormn./Ind. Misc.
? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck j? 20 Public Facility
I? 21 Miscellaneous
WORK TYPE
I? 31 New ? 33 Alterations ? 35 Tenant Finish I'CI 37 Demolish
? 32 Addition p 34 Repair O 36 Move
GENERAL INFORMATION I
Const. (Actual) Basement sq. ft. MWCC S ystem
(Allowable) lst F1. sq. ft. . City I? ater
UBC Occupancy 2nd F1. sq. ft. PRV Re 0uired
Zoning Sq. Ft. total Booste r Pump
# of Stories Footprint Sq. ft. Fire S prinkler
Length On-site well Census
l Code 3a
Depth 'ILL$ On-site sewage SAC Co de p?
Censusli ? Bldg ?
APPROVALS Census Unit
Q
B
ild l _
l
Planning ing
u Assess ents
Engineering Variance l
REQUIRED IN SPECTIONS
? .Site 0 Footing ? Framing ? Insulation
? Wallboard 0 Final ? Draintile ? Fireplace
Permit Fee veiuacfon: 000
II
Surcharge p
Plan Review • p
License
MWCC SAC
City SAC
Water Conn.
Water Meter i
Acct. Deposit ?
S/W 4ermit
S/W Surcharge
Treatment P1. i
Road Unit
Park Ded.
Trails Ded.
ICopies
Other
Total:
SAC %
5AC llnits
i
i
t1?NSE. ?p a.n.n.co E ?
?
?
12
? I
1 ?VSE[i
' .S1ECr3 I I
? r
I ?
? I ? . lln?[3V u.ID'NiUG I??
J_1
- - - - -- - -
-?a.??? .
?
I
--Ls.u? -A,
3qDo ?p c?c?o? ??Ja:1_---
?c?o??
MASTER CARD
LOCATI ON
OWNER
STRUCTURE AND ?q ? 7f
LAND USEO AS c a rr
Permit
No.
Issued Issued To
Contractor Owner
BUILDING
sS 7 /?
PLUM8ING -
--
tg '?
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL ?
HEATING I 2 93
GAS WSTALLING
SANITARY SEWER
OTHER ,25-
OTHER I
Items Approved
(Initial)
Date Remarks
Distance from Well
FOOTING „ ? - SEPTIC
FOUNDATION
! CESSPOOL
FRAMING .'? TILE FIELD FT.
FINAL
ELECTRICAL
HE4TING
GAS INSTALLATION
SEPTIC TANK
5
K DEP7H
OF WELL
?
?
CESSPOOL
DRAINFIELD
PLUMBING
WEIL
SANITARY SEWER ei.
y?
?
Violations No}ed
on Back
COMMENTS:
PERMIT NO.
COMPLIANCE INSPECTION REPORTS
TO BE USED ONIY IN 6VENT OF OBSERVED VIOWTIONS
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
? ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
DATE OF INSPECTION
NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILI BE DELAYED BY CONDITIONS BEYOND
CONTROL.
ITEMIZED AND DESCRIBED AS FOLLOWS: ? REINSPECTION REQUIRED
DATE OF REINSPECTION
REINSPECTION REVEALED
CERTI FICATION - I certify that I have carefully inspected the above in which I have no interesc present or prospective, and that I harve repor[ed herein
all significant conditions observed to be at variance with ordinances of the Town of Eagan, appraved plans and specifications, and any spacific require-
ments for off-site improvements relating to the property inspected.
E] ALL IMPROVEMENTS ACCEPTABIY COMPLETED
COMMENTS:
6UILDING INSPECTOR
OATE
.. .
EAGEiN TOSdNSHIP
:795 Pilot Krtob Road
St. Paul, Minnesota 55111
Telephone 454-5242
//-64
PERMIT FOR SEWER SERVICE CONNECTiON
DATE: NOMBER 1257
OWNER? (21)?Address Q 7' M1 e
PLUMBER TYpE OF PIP? cta? -r
ro
DESCRIPTION OF BUILDING
Industriall Commerciall Residential ! Multiple Dwelling I No. of units
Location of Connections:
Connection Charge 260.00 pd 12/18/72.
Permit Fee 10.00 d 12 18 72
.50 pd s/c
Street Repairs
Total
Inspected by:
Date
Remarks•
By
Chief Inspector
In consideration of the issue and delivery to me of the above permiC, I
hereby agree to do the proposed work in accordance with the rules and
regulationa of Eagan Toc•mship, Dakota County, Minnes ta ?
By CXVfAj
Please aotify when ready for inspection and counection aad before any portioa
of the work is covered.
.? .
EAGAN 1CIWNSHIP
3795 Pilot Knob Road
St. Paui, Minnesota 55111
Telephone 454-5242
PER1'UT FOR WATER SERVICE CONNECTION
Date: (?_ Number:,
Billing Name I'?rqM3e ?SSite Addres
Owner: Billing Fdd
Plumber:
Location of Connection Meter Size
4?
2/18/72
2 18/72
Meter No, ?Permit Fee 10:O 00 d pd 1 s c
Meter Reading Meter Dep.
Meter Sealed: Yes_ fAdd'1 Chg.
tsa i Toca1 chg.
Building is a:
Residence xx
t4ultiple No. Uni
Commercial
Industrial
Other
Inspected by
Date
Remarka:
.
_ , . : _. .
&y:
Chief Inspector
In cansideration o£ the issue and delivery to me of the above permit, I
here6y agree to do tte proposed work in accordance with the rules and
regulations of Bagan Townahip, DakoB? C?ty?es a ?
1091
//-(0 6'
Please aotify the above office when ready for inspection and connecCion.
f^T rY .-,c:
(::ns:::'7'.:Fi: Jg r.;..,,,;?7P.?A?.. 'r•:n? I.???'
.
.:? .:?r, 0i,ir-. < :.; ;:zr F::i ? n.,?_'...rE
? r, ... ..: .. F.. t..! :
,,.,? -.:. ,.,?...r?... ? 5-0
:.•:a `J?.iUt i=, ..1.!
U.?...?h
I.`iAU!'.:. N
PERMIT
CITY OF EAGAN
3t330 P-iloY Kno6 Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT TYPE
Permit Number:
Date Issued:
BUILOING
030893
10/02/97
SITE ADDRESS:
3900 PALTSADE WAY
LpT: 11 BLOCK: 6
CEDAR GROYE lP8
P.I.N.: 10-16707-110-06
DESCRIPTION:
FIREPLACE
NEW
434 A'LT. RESIDENTIAL
'? ?"" ?m ?g?5g
11M 6=
?e?4?°??'?' sT ?4? ?. ,??gn
REMARKS:
FEE SUMMARY:
Base Fee $50.00
8urcharge $.50
Total Fee $50.50
t
t
CONTRACTOR: - Applicant -
STOVE & FIREPLACE GALLERY 18981174
1278 COUNTY ROAD 42
BURNSVILLE MN 55337
(612) 899-1174 -
OWNER:
HANSOM BECKY
3900 PALISADE WAY
EAGAN MN 56122
(612)452-3120
l
T Nere?a??£v?a?k
? s3t a'ta??s ?hd
_...-
APPLICANTlPERMITEE SIGNATURE
-101 n Rj;.dI m ?
issu o siG uae
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
300945 1997 FIREPLACE PERMIT APPLICATION
681-4675
DATE: -1'"-a1- 1 1
DESCRIPTION OF WORK: ? CONSTRUCT Ma FIREPLACE
_ INSTALL GAS INSERT ONLY
_ INSTALL GAS LINE ONLY
OTfER:
PERMIT FEE: $50.50
_ ALTERATIONS TO EXISTING
STREET ADDRESS: 1 CLN
LOT ? BLOCK SUBD./P.I.D. #:
APPLICANT: (circle one only) OWNER CONTRACTOR
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.
PROPERTY Name: 4(),2L\? Phone #: u C-?a -
OWNER ?,. ??
Signature:
Street Address:
City: State: ? Zip:
FIREPLACE Company: Nkh)g q. V??lo^_a` 0 ) Phone #:
INSTALLER
Signature: ` ---?' ?
Street Address: 1'a,1 g?lu?s?, K,dL ? l,J License #:
City? State: "?M7 Zip:
GAS LINE Company: w? V Phone #: OC?Dt
INSTALLER
Name:
Signature:
Street Address:
City?? State: L Zip: `?
?\5 ?
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 14 Fireplace
WORK TYPE
? 31 New ? 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Census Code. 434
SAC Code 01
REMARKS
Chimney/flue must be inspected before concealing.
Cb
G
2007R:ESIDENTTAL BUII.DING PEsmrr ArrLicnxxox
ctty OtEagau
3834 Pilot Knob Road, Eagan MIV 55122
Telephone 4651-6755675 FAX # 651-673-5694
New Cnns0udbn Reauyemenis
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SubifYlted
kn the last 12 months, has ihe City of Eagan issued a permit ior a similar plan bosect on a masfer pEan?
_ Y _ N 11 ygs, dote and address of mpsTer pibn:
licensed Pfumber
Mechqnicpl Contrqctpr
Sewer/VYafer Goniractnr
Telephone #(
T?lephone #{
7eEephone #(
I herehy appl}' for a Ttesidantzal Building Pemut and aCknowledge tlaat the information is complete and acciirate;
that the work wi1F Ue in conformance wath the ordinances and codes of the City of Eagan and the State of MN
Statutes; I uzxderstand this is noc a pernkit, but onl} an appiieazion lar a pemut, and work is not to s#art rvithout a
pezmit; that the worlc wikl be in accordance Zvitb, the approved,plaa-in 2hs°Case`6£°wol'k w i zeyuires a review and
, ?...
,
^-d
Applicd u's Printe Name Applic 's Sign4ftt
01/17/2008 23:44 6513488293
�CitJurERE'
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
2013 RESIDEN
ss J' 1'
Site Address:
TCHRLLC
PAGE 01/02
Use BLUE or BLACK Ink
For Office Use �, (Q�
Permit #: 1 S I
165:135i
Permit Fee:
Date Received:
Staff:
L BUILDING PERMIT APPLICATION
DD PA sa •,c Ld
Unit #;
.
-
• /
Name: /� Cs ASD
Phone: 6S/— O? — 3
a
Address / City / Zip: 3
ole) Ql/s ,7-.0.E 14)4
Applicant is: Own.r
Contractor
Description of work:
t go0f. 7Rn4 s (d /A/hJ itist� Flee
Construction Cost: :
• •Multi-Famil '�
Y Building: (Yes t No )
.'•.,...�,.:• �ik.,,.,a c ;1;�°t. ,••!
ti '
tot
a,,:'' ;' ••
Company: 40
/ Contact: D� NE LSC)/`J
"HE/)171)1/0111�J
Address: g'6.--c...3r.
^
A, I -C. City: / YG (J3 b/J
V
State: /�,Zip:
/1' 7t '- --3 '/a— c. '57 7
Phone:
License it: /SC IPJ .'
5'00 Lead Certificate #: NAT— F Kfl17,'1
If the project Is exempt from lead certificati •
n, please explain why: (see Page 3 for additional information)
In the last 12 months,
_Yes No If
COMPLETE THIS A
has the City of Eagan I
yes, date and address of
EA ONLY IF CONSTRUCTING A NEW BUILDING
ued a permit for a similar plan based on a master plan?
ster plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
_
Phone:
y,
:N „ '. Plans and upportiingthat
document
,.;� ,. :. .-� .r,�d
;; "% d �tfon;;may e:classified as n
,• : co
you submit are considered to be public.iufomatiotiikr��
n ublic If you provide specific reasons that wouldp irt► 'i G
elude that:they are trade secrets.
l'
;'
CALL BEFORE YOU DIG. Cell Gopher State 0
before you intend to dig to receive locates of undergrou
I hereby acknowledge that this information Is complete
Eagan; that I understand this is not a permit, but only
accordance with the approved plan in the case of work
Exterior work authorized by a building permit Issue
days of permit issuance.
x �F ELSD/•/
Applicant's Printed Name
Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
utilities. www.gophersteteonecell.orq
a accurate; that the work will be in conrormance with the ordinances and codes of the City of
n application for a permit, and work is not to start without a permit; that the work will be In
ich requires a review and approval of plans.
n accordance with the Minnesota State Building Code must be completed within 180
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA123581
Date Issued:06/11/2014
Permit Category:ePermit
Site Address: 3900 Palisade Way
Lot:11 Block: 6 Addition: Cedar Grove 8th
PID:10-16707-06-110
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Andrea Preusse
4145 Sibley Memorial Hwy
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 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 -
Leslie W Hanson
3900 Palisade Way
Eagan MN 55122
(651) 270-0005
Wenzel Heating & Air Conditioning
4145 Sibley Memorial Hwy
Eagan MN 55122
(651) 894-9898
Applicant/Permitee: Signature Issued By: Signature