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4661 Pello CirCITY OF EAGAN Remarks Addition RidgPCliff F1T3t Add11 Lot ` Pa,cei #lU 63980 230 02 Owner Screet 4661 Pello ('ircle State Eag3I3. MN 55122 Improvement Date Amount Annual Ysars Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK -1980 184.49 12.30 1$ 141.62 c007663 2-18-82 SEWER LATERAI WATERMAIN WATER LATERAL 98 WATER AREA 147.62 Coo 663 2-18-82 STORM SEW TRK 1982 8.24 STORM SEW LAT 1982 955.45 45 Services 2 CURB & GUTTER 51DEWALK STREET LIGHT 250.0 36899 -7- 3 WATER CONN. 450.00 n n 9UtLDING PER. 9209 SAC PARK Receipt PLUMBING PERMIT Parmit No. • CITY OF EAGAN c/ Fae Fill in numbered spaces S/C V) ° Type or Prini legib/y Tot. ? 1. Date 2. Installation Cost 3. C'' Job Address ? Lot Bik. Tract J 4. Owner /- 5. Contractor Phone 6. Address 7. City --a 5tate 8. Building Type: Residential O Commercial ? Institutional ? 9. Work Description: New ? Add 11 Alter 11 Repair ? 10. Describe 11 No, Fixtures Water Closet No. Fixtures Cess ool/Drainfield Bath tubs p Se tic Tank Lavatory ? p Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of wo k. ? Signed : for ? Rough F inal Inspections: Date Insp. Date In . This is your permit when numbered and approved. Approved CIT OF EAGAN 454-8100 CITY OF EAGAN • ° 3830 Pilot Knob Road, P.O. Box 21 -199, Eagan, MN 55121 ` PH O N E: 454-8 100 BUILDING PERMIT Receipt # To be used for -Est Value Date ,19 SiteAddress 6(1 YF[.1.0 CI°CLi. OFFtCEUSEONLY Lot '' Block Sec/Sub.'?jDCECLIFFT 151' OnSiteSewage Occupancy MWCC System _ Zoning Parcel Na On Site Well _ Type of Conat City Water (Actual) m Name _ (Allowable) W Address * of Stories ; ° Ciry Phone `22- t ) Length Depth F Totai S . . , o Name "-AL.Y?' : . '. ??i ?' CON5T Footprint S.F. o ? Address 1=s9Th ST APPROVALS FEES ?11-C Ciry Assessments _ Permit F CC Water/Sewer _ Surcharge i . _ ? W NBme Police _ Plan Review z Address Fire - SAC, City c?= Cit Ph Engr. _ SAC, MWCC ? W y one Planner Water Conn. _ Council _ Water Meter I hereby acknowledge that I have read this application and state Bidg. Off. _ Road Unit that the information is conect and agree to cOmpy with all applicable APC _ Treatment P1 State of Minnesota Statutes and City of Eagan Ordinances. Variance _ Parks Copies SignBtUf@ Of P@ffllittB@ ? t TOTAL A Building Permit is issued to: on the express condition that all work ahall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances Building Official Permit No. Permit Holder Date Telaphone it Plumbing H.V.A.C. Electric Softener inspection Oate Insp. Comments Footings I Foetinys II Foundation ? Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Final Plbg. Bldg. Final Cert. Occ. Temp. LP Deck Ftg. s ?Q ?4 g3 4p U6, -- Deck Frmg. ( ^ (' Weli Pr. Disp. CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-189 (612) 681-4675 1 w ? SITE ADDRESS: + << ? PERMIT SUBTYPE: INSPECTION RECORI) PERMIT TYPE: Permit Number: ? Date Issued: APPUCANT: TYPE OF WORK: [ir 1.1 ?: r i• ( t UN F ? Permit Holder Date Telephone # PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROdFING •??' G )? ROVGhi PLUMBING PLBG AIR TEST RQUGH HEATING GAS SVC TEST INSUL GYP BOAfiD FIREPLACE - - - - I ---- - - FIRFPLACE AIR TEST ? FINAL PLBG FINl11 HT(; ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDflOSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL ? CASH RECEIPT ? i ? . CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNE50TA 55122 DATE 19 weceiven FROM AMOUNT $ I ac ooLLwas 1 oo 0 CASH ? CHECK FUND CODE AfAOVNT ThanG You BY ,f White-Pavers Copy Yellow-Postinq Copy Pink-File Copy Receipt PLUMBING PERMIT I 1. Date 7//%?33 2. Installation Cbst 3. Job Address Lot Blk. Tract'? ? 4, owner Orrin Thor?pson ?lar^es 5. Contractor We??ze1 Mech• Phone 452-1565 6. Address 3500 Ken?rebec ur 7. City Fa9an State Zip 55122 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New 6 10. Describe 11. Add D Alter ? Repair O No, -? Fixtures Water Closet No. Fixtures Cesspool/Drainfield ` Bath tubs Septic Tank - lavatory Softner Shower Well ' Kitchen Sink - Urinal/Bidet Other SrW `_- Laundry Tray v?ater e3"- _ Floor Drains di shwasher Drinking Ftn. ;?3sh??^/dryet" Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date insp. CITY OF EAGAN Fi!l in numbered spaces Type or Prini legibly ? . Permit No. -7 Fee S/C Tot. 7his is your permit when numbered and approved. Approved C1TY OF EAGAN 464-8100 Receipt ? Y MECHANICAL PERMIT CITY OF EAGAN I:-7 ? Fi!l in numbered spaces Type or Prin[ legibly Permit No. . -' • r Fee : -`'G':0() S/C '^r Tot 1. Date 2. Installation Cost 2600.10 3. Job Address ! (E Lot Blk. - Tractl - 4. Owner 5. Contractor ii . ?'? . Phone 6. Address 3 7 C'•'• :i.C<:'-o V:?-. %. 7. City . State ?3. Zip 8. Building Type: Residential CI 9. Work Description: New 0 10. DescribelnSta-U f7rCea F,ir no, ti.ng Fuel Type cond. Commercial ? Institutional ? Add O Alter ? Repair ? 11. r.-t g:-:s No. ? Eauioment 8TU - M. Ea. Forced Air Z?"10'#0- No. Equipment CFM Ai H dli Mfg. r an ng: Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Conc2-:' . j Mfg. Gas, Piping Outleu 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for ? Rough Final Inspections: Date Insp. Date Insp. This is your permit when numhered and approved. Approved CITY OF EAGAN 464,8100 . cirr oF EAGAN • 3795 Pilet Kwob Reed Eegen, MN 55123 . ' PHONEs 454-8100 BUILDING PERMIT Receipt # ON •° 6 2 40 9 Te 6e uNd fer SF DWG/GAR Est,yalue $61,000 pate Julq 7 , 1 q83 Site Address 4661 P 1 1 n r.i rri p Eroct Occupancy R-3 Lot-?3_ BI«k2_ Sac/Sub. Kidgecliffe lst Porcel # 10 63980 230 02 oe Name Thfmpsna Lakee Diviaiori W ? Addmu 1712Hopkina Crosaroad -- "1 -1 °C Name 0 ?? Addro: r r,.., Nome /lddreu 1 hereby ocknowledge that I have read this opplicotion and state that the information is torrect end ogree to comply with oll opplicuble Stote of Minnesoto Stotutes and City of Eagan Ordinances. Alter ? Zoniny (PD) F.-1 Repofr ? Fire Zone NA Enlarpa O TYpe of Consc. V Move ? # Stories Demolish ? Length 64 Grode ? Depth 26 Sq. Ft. Aporovals fees Assessment _ Woter b 5ew. Pol ice Fire Enp. Planner ? Council Bldg. Off. _ APC Permit 316.Od Surtherye in-5n Plan check 158 _ 00 SAC 5 i _ (]n Water Conn. 450, 00 Water Meter 60.00 Rood Unit 250-00 Total S1789.50 Sipnoture of Permittee I crmpaon La es D v s on A Building Pertnit Is issued to: on ths express condition tf?ai oll work sholl be done in occordonce with oll appliwble State of Mlnnesoto Statutes ond City of Eogan Ordinnntes. Buildlny Offlcial --•L _ Permit No. Permit Holder Misc. Vxmit No. Holder nY p C. wsu rver Disp. Sswr Elect?ic u?o4S74 ? -(t'-$A Inepection Date Insp. Other Footings , Foundation Freming - Rough Plbg. Rough HVAC Insul 72.4 Plbg. Final * Final HVAC Final W? • Water Describe Location: wen Sewer Pr. D'isp. , CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: 1(11 •t? ?. ; ?•? ? i ?i ? flt I? f 111, I? I I t f i ? ? INSPECTION RECORD PERMIT TYPE: Permit Number: Date Issued: , fi, ;,, r , APPLICANT: NE Ri N- til.il F lRFI'! i1i t` (i,i.') li(lN 0a1`?N t:ll i 1 0 1 Nh N.' 1 tt.'0 N F! / .' !-• /Q' I ? J PERMIT SUBTYPE: TYPE OF WORK: I 1:,A,Nfw lit ',F; I 1 i IIM ( IiA'. ) Pertnit No. Pertnit Holder Date Telephone 8 S/1N PLUMBING HVAC ELECTRIC ELECTRIC Inspection Date Insp. Comments Footings I Foundation Frammg Roofing Rough Plbg Rough Htg. Isul. Fiieplace Final Htg. Orsat Test Final Plbg. Plbg. Inspector - Notify Plumber Cons1. Meter EngrJPlan Bldg. Final Deck Ftg. Deck Final weu Pr. Disp. OF EAGAM SEWER SERYICE PERMIT PN*t Knob Resi PERMIT NO.: , MN 55122 DA1'E: 1: N0. of Units: ' Thnnr :an-, T akpq i'iv Addi ConneGtlon Cho?pe: ^ c . Acoount Deposit: of Irup.: Permit Fee: Surcharge: Misc. Charges: Totol: Dats Poid: m 'rY OF EAGAN WATER SERVICE PCRMIT 30 Pilot Knob Road 4865 0. Box 21199 PERMIT NO.: gan, MN 55127 O11TE: ning: RIV No. of Units: 1 Thotapeon I.ake9 nev No.. te aaeOF wilr tw Gtr oF Eqyoa CORrI@CTI011 Cf1afQQ: YJ V. V V FJC. AcCOUnt Deposit: Pem,tt Fee: 10 . 00 pd SurcFwr9e: .50 pd ?? Charges, 60.00 pd meter Total: Doft Paid: Insp.: to eemoy wil6 !iw Cilr of Eayer REQUEST FOR ELECTRICAL INSPECTION ' See instructions for completing this fwm on back af Yellow coov. ? 065 ?'2 X'"?lefow Wor overed by 7his Request EB-00001-04 tj% v. 37as5 Add NeD. Type o1 Builtling ApPliances Wiretl Equipment WireA Home Range Temporary Service Duplex Water Heater Liyhtiny Fixtures Apt. Building Dryer Electric Heatin Commercial Bldg. Fumace Silo Unloader Industrial BIAg. Air Conditioner Bulk Milk Tank Feffn Other veo v rher ISUecityl [h9I $UCCIfy If1Cf OthL'I ComPtite lnspection Fee Below - k Fee ServiceEntranee5lze k Fae Feaders/5ubfeedars # Fee Circuits 0, 0 to 200 qm s 0 to 30 qm ns :33,03 0[0 30 Am os A6ove 200 qmps 31 to 100 qntps 31 to 100 A s Swimming g Pool Above 100_Am s Abave 100_/>mPs Transformers Irrigation Booms u Partial.'Other Fee Signs Speciallnspection S ? ? ? T Remarks q D? i ?Cn :!d('J \NV J Rough-in D ce r g p the ec4ical nsoecbq norehy c tif th t th b Final r DA te er y e e a ove inypectian has bee. ? maEe. ThlereauealvalGlBmanlhslrom V TniS eoes voia 37025ziI 18 months from W085792 ya,oo Request C? nte 1 Fire No. Raugh-i tln7Insuection Reqire ll ?Ready Nuw?y{? Wi NnLfy,'InSDec- ? I ' ?'3 L V es ?No r When Ready MLicensetl ElecVical CoMnCtor I heraby raquesl inspection of ebova ? Owner elactrical work installed at Street AdAress, Boz or Route No. q(de) N-W Gt.cA.e Ciry EWDAN ecsuon o. Township Name or No. anga No. Coun[y OpYM O?dnt(PRINT) ? ?-{V ? Phone No. Pawer Suppiier Address ? fpxoA ?4(&pj Ele uical Con[rac[or ICOmVany Namel elcn4c Conuacmr's License No. f?39sZr - Z Mail i ra r Owner Mnking Inslailation) ne ?+dJress (Coni cto r o j ' ? [. ? p l1ll ?,. ?1? {Y. Au[horied S?Bn t re ICOntracmdOwner MakinB installationl Phone Number MIIVNESO A STATE BOARD OF EIECTPICITY THIS INSPECTION HEQUEST WILL NOT Griggs•Midway BIdO. - Aoom N•191 BE ACCEPTEO BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS iB21 University Ave., St. Peul. MN 56104 ENCIOSED. o.--- 1a11, ooza'll ? ??? 1,C,?v/ ao 0469 - ? Requesl Dele ire No. Ro -In Ins n NOTICE: You Must Call Electricel Inspeclor Requlr If q Rough-In Inspectlon ' No Is Require0. I ?'censed contractor ? owner hereby request inspection of above electrical work at: Job Atltlr (St ree6 Box or Route No. Ciry r Sectlon No. Towns?ip Name or No. Range No. County Occupant PRINT) Phorie No. VI ? i e s- s Power upplier -? Atldress Electri el Contraclor (COmpany Na m e ) Convactor§ Liwnse No. qy. ? ? 1??, Mailing Atltlress (CoNracror or w?r Maki InStallation) -c?c 5 AWhodieG Slg (Conlractor/Owner Making Installafion) Q,V G L Phone Numbe? ?7 Q ?/ 'LD MINNESOTA STATE BOARD OF ELECTqICITV THIS INSPECTION REQIIEST WILL NOT Grigga-Midway Bltlg. - Room 5473 , 41 C,4 U F BE ACCEPTED BY THE STATE BOARD 18R1 University Ave., St Paul, MN 5510a UNlESS PROPER INSPECTION FEE IS Phone J612) 662-0800 ?.?G?C ?QAIxo ENCLOSED. 'H C REQUEST FOR ELECTRICAL INSPECTION P. See instmctians tor completing ihls brm on beck af yallow copy. M 0146 9 'X" Below Work Covered by This Request t Vx12?04 ew A Rep. TypeofBuilding AppliancesWired EquipmentWired Home Range Temporary Service Duplex Water Healer Eledric Heating ? Apt Building Dryer Loatl Management Comm./Industrial Fumace Other (Specify) Farm Air Conditioner Other (speci(y) CoMrador5 Remarka: Campute Inspection Fee Below: 1 v ???+ ?-"? J I?? lA? # 01her Fee # ServiceEniranceSize Fee # Circuiis/Feeders Fee Svimming Pool 0 to 200 Amps o to 100 Amps Transfortners Above 200 _ Amps Above 100 _ Amps SIgnS Iwpector's Use Only: ? TOTAL Irrigation Booms L) ' G Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rouyn-m Dete ? certify that the above inspection has been made. F;,,ai ; l oace ?/_ OFFICE I1SE ONLY This requast witl 18 monihs fmm T rx#ifirtttr of (Orruvttnry C,itp ot (Cagan Drpttrimrnt nf BuilDing Jnspertimc Tbit CMi(iratc irturd purtaant to tbe seyairrnunu of Sutroa 306 0( tix Uniform Building_ Code rntifying that at dx tirru of iuuamt this ttrntture war m tompliance witb tbe varimu o.dinanrrt of thtCitr rrgulating M`ilding conmrution or utr. For tix Jollouting: ?rcmifinm SF DWG/GAR eieyr.mmt NO. 8209 ?war'hpe R3 'Arcm.w??n V eiRz.. NA z?Kw?M, PD Rl D.. a( OWd*, Thompson Lakes Div *Aaa?l 712 Hopkins Csrd., Mtka. Bmdft,wa.4661 Pello Circle ?yLot 23,Block 2,Ridgecliffe By lst -? October 21, 1983 BuiWingOlficJ ? pu: CITY OF EAGAN N2 13 617 3830 Pilot Knob Road, P.O. Box 21 •199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT : , aeceiPt# ? 33 9? To be used for DECK Est Value $3,000 Date Site Address 4661 PELLO CIRCLE OFFICE U5E ONLY Lot 23 81ock 2 Sec/Sub.RIDGECLIFFE 1ST OnSiteSewage _ Occupency MWCCSystem _ Zoning P8fC0l NO. On Site Well _ Type of ConSt Ciry Water (ACtuaq a Name FRANK KAGLER _ (AnowaEle) w 3 Address SAME # of Stories Len th ? City Phone 452-3760 g Dectn S F Total . . .0 Name RALPH HANSON CONST Foolprin[ S.F. ?a Address 3679 UPPER 149TH ST ppppOVAL3 FEES ? City ROSEMOUNT phOn6 423-2009 qssesaments _ Permit 44.50 fa Water/Sewer _ Surcharge _eSn W w Name Poiice _ Plan Review ? z x- Address Fire SAC, City - u? Engr. _ SAC,MWCC aw City PhOne planner _ WaterConn. Council _ Water Meter I hereby acknowledge that I have read thia applicetion and etate Bldg. Off. _ Raad Unlt thatlheinformationisCOrtectandagreetocomplywithallapplicable APC - TreatmentPt State of Minnesota Statut eg and City oi Ea an Ordinancea. Variance _ Parks / / ? ? Signature of Permittee f.L1E?- ? •'4? ? Copies 70TAL .00 RALPH HANSON CONST A Building Permit is i8sued toy on the express condition that all work shall 6e done in eccordance with all 9?icqble State of "nesota Statutes and City of Eagan Ordinances Building Official ,-.r CITY OF EAGAN 3795 PilaR Knab Road Ee9an, MN 35122 PVONE:. 431-8100 BUILDING PERMIT 2eceiPt # N° 8209 ?6 If 99 To bs wed fee SF DWG/GAR Eyy yalute $61,000 pafe July 7 ?y83 51te Address 4661 Pello Circle Erecr 131 Occupancy R-3 Lor 23 Block Z Sec/Sub.- RidQecliffe lst Alter p Zonina (PD) R-1 Varcet # 10 63980 230 02 Repoir p Fire Zone NA W Nama Thomnson Lakes Division 1712 Hopkins Crossroad z Aadress _ ._,_- vraeo o Name z? ?Q Addre ? r:... Name _ Address I here6y ocknowledge thaf I have read this npplication and stale ihot the inlormation is eorrect ond ngree to wmply with oll opplicable State of Minnewta $totutes and City of Eogon Ordinonces. Enlarge ? Type of Const. V Move ? # Stories Demolish ? Length 64 Grade ? Depth 26 Sq. Ft.- Aooro.als Faos Assessment - Woter & Sew. Police _ Fire Eng. Plonner - Cnumil - Bldg. Off. - APC - Signature of Pertnittee ompson a es ivision A Building Permit is iuued to: Permjt 310. V U Surctwrge 30.50 Plon check 158.00 SAC 525.00 Woter Conn. 450.00 Water Meter 60.00 Rood Unit 250.00 _ on the express conditlon thm Totol 51789.50 oll work sFall be done in acmrdonte with nll oDVliwble St of Minnemta;StHtes??and?City of Eogan Ordinances. Building Officlal {_ }Z, fi4t CPPY OF EAGAN p Include 2 sets of plans, `A-Z" jio plan w/e] evations b P 1 an : JDLV> BUILDrn'C PE_'F2MIT APP LICATION r 1 set of energy calculations. . ? G Tb Be Used For Valuation Date (o Site Pddress: +cqk -V'A\.o OFFICE USE ONLY Lot 13 Elocx Z sec./suv. i?Erect occupancy Parcel #: (D (03? TC) 7-30 C) ? Alter Zoning * /- "`'D Repair Fire Zone • /VA O,?mer: Enlarge _ 'Iype of Const. Nbve # Stories Pddress: I7PrTolish Front ft. d - Grade Depth ft. e: City/Zip Co Phone #: - - c.ontractor: - THOMPSOIV LAKES DIVI$i01V Address: 1712 MQP1ctNS CROSSF fl91N flNKA, City/Zip Code: -- Ptiane #: -'??? -`1333 Arch _ /En9 • : _ rdaress: City/Zip Code: on . APPFOVAIS " FEES Assessrents Permit 3 Water/Sewer Surcharge 3d ? Police Plan Check >Sg Fire SAC Erig. Water Conn. <,/so jw- -- Planner Water Meter fpp? cour,cil xoaa u,v t a,,5-0 ?- Bldg. Off. L-1 7- fr? APc 'IO'PAL 2006 RESIDENTIAL BUILDING PERMIT APPLICATION " City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX 4 651-675-5694 New Cohstruction Reauiremenb 3 regislered sb surveys showin9 sQ. iL of bL 59. R of house: end all raofed areas . (20%rnaximumlotcoverageaAaxed) 2 capies of plen sAOwiig beam 8 window sizes; poured tamd desgn, etc. i sd aEneryycma,iabm3 3 copies of Tree Preserva6on Plan "rf bl platted aRer 711193 Run Jds[ DOW Op6ons selectian sheet (buildings wiN 3 or less unib) Minnegasco mechenical ventilffiion form RemodellReoair ReauiremeMs 2 copies of Plen showin9 too6ngs, bemns, loists 1 set M Energy Celwlatians for heted additions 1 810E SUfVCy fOf 84dIti0fIS 8v dBd6 Adcftn -lndcafe if afsifa sep6c sysfem Olfice Use OnIV CeAOfSurveyRectl _Y _N Tree Pres Plan Recd _ Y_ N. Tree Pres Required _ Y_ N Oo-siteSepticSysOem _V _N Date 1-3- / ? / -CU `I q, (Q Oc? o? Construction Cost Site Address r,- \?-- U°it/Ste ? DescriptionotWork I2-CJ?LIf?CICA W ? r'1CIC7??j Multi-Family Bldg _ Y% N Fireplace(s) _ 0 _ 1 _ 2 PropertyOwner Sho,r?0. ??NC2 l?e{]?f>?1??1 Telephone#0'?j1 )4CY5' `- - Contractor Address City Stste V-,'1(1 Zip IZ_ Telephone#?Log) COMPLETE THIS AREA ONLY IF COHSTRUCTIN6 A NEW BUILDING - Minnesota Rules 7670 Categorv 1 _ Minnesota Rules 7672 Energy Code Category , Residential Ventilation Category 7 Wofksheet • New Energy Code Wmksheet (J suDmission type) Submitted Submitted • Energy Envelope Calculations Submitted In the last 12 monThs, has the City of Eagan issued a permit fa a similar plan based on a master plan2 _ Y N If yes, date and address of master pian: Licensed Plumber Telephone D' N11? Mechanical Contractor ?_1 V ? Telephone #( Sewer/WaterContractor UtC 0 8 2006 Telephone #( 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 pertnit, 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. -? -- ApplicanYs Printed Name AppNcant's Signature ??o'? 2004 RESIDENTIAL BUII.DING PERNIIT APPLICATION City Of Eagan 3830 Yilot Knob Road, Eagan MN 55122 Telephone 4 651-675-5675 FAX # 651-675-5694 47 d New ConsWCtion Reauirements RemodeVReoair ReauiremeMs LNfice.`?Js`e?QT 3 registered sde surveys showing sq. ft o(lot, sq. ft of house; and all roofed areas 2 copies of plan (20% mazimum loi coverage albwed) 1 set of Energy Calalatlons for heated addMons Irec a??R 2 copies o( plan Showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks 7?s q 1 set of Energy Calculatans Addih'on - indicate Non-sge sepfk system 3 copies of Tree P2servation Plan'rf lot plaHed after7/1f93 , Rim Jois[ DeUil Options selection sheet (61dgs with 3 or iess units Date 12, / Z Z- /04f Construction Cost 'S 90 O Site Address 5AO 1 pGI-lo CrAc/C I UnitJSte # Description of Work / Ca/- d77 ` )E?/'au T f '?Q ?S ? Multi-Family Bldg _ Y r N Fireplace(s) _ 0 _ 1 _ 2 ProperTyOwner d?9/t"?.c CkCnJ o? N"A Telephone#(? )5cO-s' Contractor address 4100 gELWG, INC. FxrEi cIO C??, State T ST. LOUIS PARK, MN 5W6 Telephone #(O) Zq'U • 7771 lu #0001050 6,2 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 Energy Code Category . Residential VentilaGon Category 1 Worksheet • New Energy Code Worksheet (4 submission rype) Submitted Submitted . Energy Envelope Calculations Su6mitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone # ( Telephone #( Telephone #( 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 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 ofplans. ::r2 Z?4 - ApplicanYs Printed N e Applicant s igna OFFICE USE ONLY Sub Types ? 01 Foundadon ? 07 OS-ptex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-piex ? 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 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Pibg_v or _ N ? 25 Miscellaneous Work Types ? 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 8uilding' ? 43 Reroof ? 46 Windows/Doors ? 34 ReplaCement `Demolition (Entire Bldg) - G ive 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) Foundarion Drain Tile Roof Ice & Water Final _ Framing! _ 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 Treatrnent Plant License Search Copies Other Total REQUIRED INSPECTIONS FinaUC.O. FinaUNo C.O. _ Plumbing HVAC Other _ Poo] _ Ftgs _ Air/Gas Tests Final _ Siding _ Stucco _ Stone _ Brick W indows _ Retaining Wall Building Inspector 4661 C. R. W INDEN & ASSOUATES, lNC. IAND SURVEYORS faL 945•3646 1381 EUSTIS ST., ST. PAUtD MtNN. 65108 FOR: U. S. HOME CORPORATION ' Y •? ? P? 74 . , SCALE I°=40' nCb?t0 N D F"??? O fJENOTES IRON . ? Po 6-G:.. N?. ?. r43 4; ; 3o y'v -s- ? . L.A3?i H W ?i o • S?? ? 'r ?2?' ,?G ,i/??C.Ed9e °f , _ '-- :-- \ O L_ a ? -' - `- 9c) , ? ?i . Ck? p? hP? ~ w °'?' B9 • / ? . Lot 23, Block 2, Ridgecliffe First Addition, Dakota County, Minnesota. Note: Proposed qarage floor E1. 459.73 ? (900-0) Denotes proposed finished ground El. 5?' °rC, ---f-- Denotes direction of surface drainaqel?'?q `"6 Vertical Datum - N.G.V.D. 1929 F!?s s,s WE MERE6r CERTIi1' THAT TMIS IS A TRUE AND CORpECT REPiESENTATION OF A SURVEY Of TME &OUNDARIES Of THE lANO AlOVE OFSCRI6ED AND Of TNE IOCATION Of All SUIl01NG5. IF ANT, THEREON, AND All VISIlIE ENCROACkMENTS. If ANV, fROM OR ON SAID LAND. Dotad this.224 der o{. June A p I0-P3 C. t. WIMDEN 6 ASSOCIATES, INC. ir d--? &'/? Surwror. Minnewla RpiNrotion No. 7721- , ?'. INSPECTION RECORD CITYOFEAGAN PERMITTYPE: Bui1.DING 3830 Pilot Knob Road Permit Number: 021820 Eagan, Minnesota 55123 Date Issued: 0 B/ 2 5/ 9 3 (612) 681-4675 SITEADDRESS: LoT: 23 BLOCK: 2 APPLICANT: 4661 PELLO CIR HEAT-N-GLO FIREPLACES RZDGECLIFFE (612) 890-0758 PERMIT SUBTYPE: TYPE OF WORK: FIREPLACE NEW DESCRIPTION (6AS) INSPECTION D, . .. FIREPLACE ? ? ? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 PERMIT TYPE: Permit Number: Date Issued: PERMIT /)-3?- ? ? s? BUILDING 021820 08/25/93 SITE ADDRESS: P.I.N.: 10-63980-230-02 DESCRIPTION: FIREPLACE NEW ?4 .;._ =f\ L1 .. i 4661 PELLO CIR LOT: 23 BLOCK: 2 RIDGECLIFFE (GAS) Buildinip-Permit 7ype Build3ng Work Type 1 , .' REMARKS: FEE SUMMARY: Base Fee $25.00 Surcharge $.50 Total Fee $25.50 CONTRACTOR: - HEAT-N-GLO FIREPLACE3 3850 W HWY 13 BURNSVILLE MN (612) 890-0758 Applicant - ST. LIC 18900758 0002960 55337 OWNER: BRESSLER KEN 4661 PELLO CIR EAGAN MN (612)456-0557 I hereby acknowledge that I have read this information is correct and agres to comply Statutes and City of Eagan Ordinances. application and state that the with all appl3cable State oP Mn. I I APPLICANT/PERMITEE SIGNATUFE ISSUED B SI ATURE I REACJIVAT€ _ PERMIT # ' Ili 10 CITY OF EAGAN 1993 BUILDING PERMIT 681-4675 APPLICATION $1?111-`f'D ,.; a SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural 8 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. -?laluation of work ?5 ?Sr ?Od Date t? ? /?'? _ t L Site Address: L??/??'?' STREET SUITE i Tenant Name: (commercial only) LOT BIACR SIIBD. ?? ? _ (? • P.I.D. A? Descri tion of work: The applicant is: 0 ner Co tractor ? Other (Deacribe) ? Name Phone Property L ST nF1RSV^ Owner Address STREEi STE Y City State Zip Company - , Phone ?'I) Contractor Address ?9_?Z ?lJ ?1tib'U ??> License # Z-i'M, Exp3 City ?i o-'L.E-t-? State Zip 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 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. ?,?_.... Signature of Applicant: OFFICE USE ONLY BUIL DING PERMIT TYPE ?. I' ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. i9 ? 03 SF Addition ? OB 8-Plex ? 13 Garage/Accessoryl? ? 04 SF Porch ? 09 12-Plex ? 14 l Fireplace I ? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck I WORK TYPE ? 31 New ? 32 Addition ? 33 Alterations ? 34 Repair GENERAL INFORMATION ? 35 Tenant Finish ? 36 Move MWCC S City W PRV?IRe Booste Fire' S Census Const. (Actual) Basement sq. ft. (Allawable) lst fl. sq. ft. UBC Occupancy 2nd F1. sq. ft. Zoning Sq. Ft. total # of Stories Footprint 5q. ft. tength On-site well Depth On-site sewage APPROVALS Planning Building Engineering Variance REQUIRED INSPECTIONS ? Site ? Wallboard Permit Fee Surcharge Plan Review License MWCC SAC tity SAC Water Conn. Water Meter Acct. Deposit S/W Permit 5/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: ? Footing ? Final valuetim: $ SAC'IICo Assess i ? Framing ? Draintile . _ . . _, 1?6 &tsement Finiski 17 Swim oot 18 Comn./Ind. 19 Comm./Ind. Misc. 20 Public Facility 21 Miscellaneous 37 Demolish ired Pump inkler ? Insulation ? Fireplace SAC % SAC Units f'? 1987 BOILDING PERMIT 9PPLICATIOH - CITY OF EAGAN SINGLE FAMILY DWELLINGS INCLIIDE 2 SETS OF PLANS, 3 CERTIFICATES OF SIIRVEY, 1 SST OF ENERGY CALCULATIOAS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MQST DESIGHATE WHZCH ADDRESS IS DESIRED. NO CHANGfiS WILL BE ALLOWED ONCE SOILDING PERMIT IS ISSUrD. MOLTIPLE DWELLINGS - RFSIDENTI9L INCLUDE 2 SETS OF PLANS, CEB 1 SET OF ENERGY CALCQLATIONS CONB4ERCIAL RENTAL DAITS FOR SALE ONITS OF SQEtVEY - CHECK TiTfH BLDG. DEPT., INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND To Be Used For: IKI Valuation: ?U? ?^• c Site Address >;?re-/ 'o'"e/% ,,j. , OFF Lot C,2,3 Block aZ Parcel/Sub Owner Address City/Zip Code Phone Contractor ls,,.,.,rY- r?------ Address City/Zip Code ,(?„??ann.cac9ll?-: _?!/y_' Phone l/?-?-?O1DD Q. . Arch./Engr. Address City/Zip Code Phone ll On Site Sewage_ MWCC System _ On Site Well City Water _ 6PPROVALS Assessments Water/Sewer Police Fire Engr Planner Council Bldg Off APC Variance ` Ikzte: ';' Occupancy Zoning Type of Const (Actual) (Allowable) Jf of Stories Length Depth S.F. Total Footprint S.F. Ffi65 Permit Surcharge 1.12 Plan Review SAC, City SAC, MWCC Water Conn Water Meter Road Unit Treatment P1 Parks Copies TOTAL 7?P -V -?? I FERMIT CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 ? RERooF 8 u ? ; ° " 9 ? P e r m i t T y p e 8?Il,dLrtg tUoxk Type SITE ADDRESS: P.I.N.: 10-63980-230-02 4661 PELLO CIR LOTa 23 BLOCK: 2 RIDGECLIFFE 1ST DESCRIPTION: A PERMITTYPE: BuzLozN6 Permit Number: 0 3 3 3 4 6 Date Issued: 0 9/ 2 2/ 9 8 STORM DAMAGE REPAIR 434 ALT. RESIDENTIAL Pi- 's.4" i'0 a:a REMARKS: FEE SUMMARY: L7fQWE RL";7ATt K'U S 0 N 325 GALENA ST HASTINGS MN (612) 437-4646 mwN?af,u - ?j . L11. OWNER: 14374646 20136332 CHENOWITH CHARLOTTE 4661 PELLO CIR 55033 ERGAN MN 55122 (651)405-1389 ? I acknawledqe thaf I havo read t#ia.s applfcat3:on and 'state t#7at -Cho iafarmataan ?#s -a,arre;?-? aricp ?agree' tp tom?a?.y? aaith al1 <a{rplicobl?e, StaCo ?zfMn. statut'os and Glt?° crf aaqari vrdina:no I es. ?.? ? ?? APPLICANT/PERMITEE SIGNATURE ?TSUED BY: SIGNATURE 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PII.OT KNOB RD - 55122 "3 •3"? y ?4 681-4675 New Construction Requirements ? 3 registered site surveys • 2 copies of plans (inGude beam 8 window sizes; poured fnd. tlesign; etc.) ? 1 energy eaiculations ? 3 copies of tree preservation plan rf lot platted after 7/7193 required: _ Yes _ No DATE: C?-_ ? t r W cosT; Gfo da DESCRIFTION OF WORK: ?- S ET ADDRESS: S?? ? CP 1 n I PP 11 o e V' _ LOT: BLOCK: ? SUBD./P.I.D. #: K,??-eA C? Q L1 x ? S? PROPERTY OWNER l , f?L /d 1 ? Phone #: Z-10 Name: ? Last First Street /(a r,J'. City ? ?? q'r-I State: /t4 el? zip: ~ Company: Phone #: (2 CONTRACTOR ?a n r? Street Address: J> / S(h".. License #??..} I?to 2- City State: Zip: ?? 3 3 ARCHITECT/ ENGINEER Street City Sewer 8 water licensed plumber (new construction only): and iot change is requested once permit is issued. Penalty applies when address chanc I hereby acknowledge that I have read this application and sfate that the infortnation is coRect and agree to comply wfth all applicat State of Minnesota Statutes and City of Eagan Ordinances. ?J•-?eJe ?vU? Signature of Applicant: ,S[ OFFICE USE ONLY D Certifcates of Survey Received _ Yes _ No Tree Preservation Pian Received _ Yes _ No _ Not Requi RemodaVReoair ReOUirements ? 2 capies of plan ? 2 sde surveys (exRerior adddions 8 decks) ? 1 energy calculations Por heated additions Phone #; Registration #: _ State: Zip: OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation 0 06 Duplex D 02 SF Dwelling ? 07 4-plex ? 03 SF Addition ? OS 8-plex ? 04 SF Porch ? 09 12-piex O 05 SF Misc. ? 10 = plex WORK TYPE ? 31 New ? 33 Alterations ? 32 Addition ? 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning ? 11 Apt./Lodging ? ? 12 Multi Repair/Rem. ? ? 13 Garage/Accessory ? ? 14 Fireplace 0 ? 15 Deck ? 36 Move ? 37 Demolition Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building Engineering 16?? Basement Finish 71 Swim Pool 201 , Public Facility 1 21 i ? Miscellaneous MC/WS Syste4n City Water I1 Fire Sprinklered PRV j II Booster P,umpi, Census Co* SAC Code Census Bldg I Census Unit I Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: i Valuation: $ ? % SAC SAC Units City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4661 Pello Cir Lot: 23 Block: 2 Addition: Ridgecliffe 1st PID:10- 63980 - 230 -02 Use: Description: Sub Type: e - Furnace & Air Conditioner Work Type: New Description: Fumace & Air Conditioner Comments: Questions regarding electrical perm 952- 445 -2840. Fee Summary: Contractor: Genz Ryan Plumbing & Heating 2200 West Highway 13 Burnsville MN 55337 (952) 767 -1000 ME - Permit Fee (Replacements) Surcharge -Fixed Total: Applicant/Bermitee: Signature PERMIT City of Eaan - Applicant - $50.50 Owner: Brace B Chenowith 4661 Pella Cir St Paul MN 55122 Permit Type: Permit Number: Date Issued: Permit Category: Mechanical EA083402 06/05/2008 ePermit equirements should be directed to Mark Anderson, State Electrical Inspector, $50.00 0801.4088 $0.50 9001.2195 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 APP.-1-2�15 14:52 FP,OM:GLWSCO 952891425� T0:6516�55694 P.1�6 � Use BLU�or BLACK Ink � Foroiflcouoew�^------� I � L I • j Permit�:�� I Y � ' It o a �� ; P0�„F�: ��. �G ; 3830 Pilot KnoD Road � -/� I Eagen MN 55122 � Uate Received: � Phone:(661)676X676 � � � Fax:+851)876-5894 I Staft: � ` �-----___......---- �V�., r _�� (`, 2014 RESIDENTIAL BUILDING PERMI? APPLICATION �,�'� �� / , Date: � � �� Site Address: "r6(a� ��n C��. Unittl� Name:�^'�• tiShAr1A G/1Encou.s�t� Phone: ,�•S1'z33"'�'t!(nd ResidenU ��j'v' �YlRlef Addres9/City/Zip:,,,�Mr►a ,Il Appli�ant is: Owner ,!Convactor Typeof Work Deacriptionofwo�Ic:�o�tw.�_��Toh_ 5�+++ro�.+�,o►Gr� arr ConSttuction Cost 84(�(,� Muiti�•Family 9uilding:(Yee r,,,_/No ) /! � �� Compeny�7�'j� L�1�t3 G.f��ucla�«� ��d�na f;ontact�'�f4r� Address_(�q0 ;raG�� City: �Fm� �Ilc-� Contractor *��"" Stete: ✓��Z�p: ss'z4- Phone:9s�'89�-3�400Emalil: �'aN4/ws d�4��'��r� LJcsnsa 3�. 1 D�D 4.Z 7 l.ead CcrHficate�C:,.Z3Z�7' � Ii the project is exempt from lead certiflcadon,please explain why: (see Page 3 for additional Information) COMP�,ETE THIS AREA ONLY IF CONSTRUCTINC�A NEW BUILOING In the last 12 months,has the City of Eegan Issued a pemtlt for a slmllar plan ba�ed on a masfer plan? _„Yes _No If yes,date and address of master D�an: LiCensed Plumbe�; _Phone: Mechanlcal Co�tracwr: _Phone: Sewer d,Water ContracMr: Phone: NOTE:Plans and supporting tlocuments tliat y�ou submit.are conslderecl to be pubflc Information. Portions of the Mformat/on may be classMed as non-publlc If you prov/de speclflc reasona that would permft fhe Gity to conclude that the are trade secrets. CALL BEFORE YOU DIG. Can Gopher 8tate One Call et(6b7)464.0002 for protecNon agal�t underground utlllty damage. Caq 48 hourg oerore you�ntend ro aig�o reoeive�oca�es orurwerorouna uti�ities. www.00nnerstateonecAn.oro 1 hereby ocknowladpa ihat thia information a complefv and aocurabe;tl�at tho woilt wfll be in conharmano@ with fhe oMinenOAe dnA COAes ol Ute Clty of Eepan;thal I under8tand lhie is not a pertnil,but only an applicetlon for a permit,and wak Is not t0 BtaA wil�out a pemtlh Ihat the wo�k wlq be In acaordance wUh 1he approved plan In the pse of wak whlch roqulres a roNew and approval of plains. EYLs�tor work suthorizod Dy a bulld(np ponnl!luuod In eccordanco wlth Uo Mln y�ull d�must bo complobA wUhln 190 qdys Of pertnit leeuence. �. x �mff�tth�E AppllcanCs PMnted Name pllcanCs:3lgnature PaQe 1 of 3 DO NOT WRITE BELOW THIS L.INE � ,� "�>'�� SUB TYPES � � �c�� C�� , Foundation Fireplace Porch(3Season) Exterior Alteration(Single Family) � Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi) _ Multi _ Deck _ Porch(Screen/Gazebo/Per�gola) _ Miscellaneous 01 of_Plex Lower Level Pool Accessory Building WORK TYPES _ New _ Interior Improvement _ Siding _ Demolish Building* Addition Move Building Reroof Demolish Interior � Alteration _ Fire Repair _ Windows _ Demolish Foundation _ Replace _ Repair _ Egress Windo��r _ Water Damage _ Retaining Wall *Demolition of entine building-give PCA handout to applicant DESCRIPTION Valuation � Occupancy Z/ G-.� MCES System --� Plan Review � Code Edition O/"'� SAC Units ''� (25%_100%{/ ) Zoning �( City Water �— Census Code �t'�y Stories �-- Booster Pump �" #of Units � Square Feet '"" PRV '' #of Buildings � Length "� Fire Suppression Required -� Type of Construction _�_ Width -- REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) Final/No C,.O. Required Foundation HVAC Gas Service Test Gas Line Air Test Roof:_Ice &Water _Final Pool:_Fc�otings _Air/Gas Tests _Final Framing Drain Tile Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath Stone Lath Brick � Insulation Windows Sheathing Retaining VVall:_Footings_Backfill Final Sheetrock Radon Control Fire Walls Fire SupprE�ssion:_Rough In_Final Braced Walls Erosion Control Other: Reviewed By: , Building Inspector RESIBENTIAL FEES '� „?� fi/J �v `�-° /�� r ase Fee "7$ �,_, `{� �' Surcharge Plan Review �{ ? 7N MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant Copies ��,'�,3'�� TOTAL Page 2 of 3 Use BLUE or BLACK Ink �-----------------, � For Office Use 1 • I Permit#: `�//L�/� � Glt of �� /y�. �� Permit Fee: lriL1 3830 Pilot Knob Road � � Eagan MN 55122 i Date Received: � Phone: (651)675-5675 i � Fax: (651)675-5694 � Staff: -----------------� 2015 RESIDENTIAL PLUMBING PERMIT APPLICATION Dates ��'�� Site Address: �� E�' ��4 C%/t?��' .C4 4�•� Tenant: Suite#: �• ` � ; �, > R�S��:�#/ t1�1 :' Name: �✓vc'� C_...�JA�oW��'Li Phone: �� . � �' Address/City/Zip: �� /�/.�✓ �.,�/Z �,,�.: �� a �� , � J�r� r; ,p �� b� " Name: 1'{f'YI./ i' �Ur�.�ji,��.. License#: `cs ��b •. T1,Ar`�y5J . . ��'��` ;�..�:�� Address:_ '�' ��LJf� ��.�� -�C City: ��S"E'rrio�n�� f,�. �� F;=,"` � State: M�/� Zip: J�L'�� Phone: �J`�/' �'/�2- /�y� rp, T,. . C � �� x;� Contact: o�� Email: � ��Ur�-i �-� ��; � �� r� ��t��'� ' } �� _New ✓�eplacement _Repair _Rebuild _Modify Space _Work in R.O.W. �`��1��?��GF1C: ,:': ��, „ � �� .o , Description of work: v ' �- � � � � rir'�. L d �cs. RESIDENTIAL ��`'v ' `�b '� ��/''- � .`� Water Heater Lawn Irrigation(�RPZ/_PVB) Water Softener � � � ��1`�11��h��F � � � � � Septic System Add Plumbing Fixtures�Main/_Lower Level) � �� New Water Turnaround . hp24 ( �y�. � r r � �� ;; ,�=�� Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge) $60.00 Lawn Irrigation (includes$5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes�5.00 State Surcharge) *Water Turnaround (add$210.00 if a 5/8"meter is required) $115.00 SeptiC System New($10.00 per as built)(includes County fee and$5.00 State Surcharge) TOTAL FEES$ CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Ca1148 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. x �P��i� C .}�G,r�SE'� x � ApplicanY rinted Name Applicant' ig re : ,�„., s t�*.0�ti ' F � w . - �� a . - r Y a�' - � x f�f�4��'� �� , ��d�: � � ` ' � �?�a� �� '� � � �r < « - a d i�� a 3� :s : : i ',��.v.+�'�rt4.�.�n..�...��.�.r 4 ' d � ` � r +� y a .� r : s • �- ryq . �y� �e� �')�'z�y��'� ��C��+w��A �l I�i#J T+�� y��+^"F�si"i TS—+37� . { {,��9��9 a 3 - - � i �� ` ,�i - `� - - .' +x i��;�a n Yr�S -a f '�"� � Met�:t�I�e�a#��lter�s�N �et�r Sia� - a 1��0 R�d::t ��a�� • ,•�ff��. ,�,��, K':;=^=== m� ;. -=.� . . r, �