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4648 Penkwe Way PERMIT City of Eagan Permit Type: Mechanical 3830 Pilot Knob Rd Permit Number: EA091810 Eagan, MN 55122 . Date Issued: 10/28/2009 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 4648 Penkwe Way Lot: 4 Block: 01 Addition: Johnny Cake Ridge 4th PID 10-39803-040-01 Use Description: Sub Type: e - Furnace & Air Conditioner Work Type: New Description: Furnace & Air Conditioner Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952) 445-2840 Fee Summary: ME - Permit Fee (Replacements) $50.00 0801.4088 Surcharge-Fixed $0.50 9001.2195 Total: $50.50 Contractor: -Applicant - Owner: Sedgwick Heating & Air Sandra K Hovland 8910 Wentworth Ave S 4648 Penkwe Way Minneapolis MN 55420 Eagan MN 55122 (952) 881-7739 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. Applicant/Permitee: Signature Issued By: Signature CASH RECEIPT • . • CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 • . ? • ^ DATE 19 RlCEI V ED FROM AMOUNT $ I 4 DULLARS e 73 ? CASH ? CHECK FOR ? ?. • . • -' l?. `i . f. . . _ J . . _ . i YI? HY White-PeYers CoPY Yellow-Posting CoPY Pink-File Copy Thank You BLDG. PERMIT NO.; ?-)( 01-321' 0 B1 01-3422 Plan Check L, 01-3445 Surch./Adm. ' 01-3446 SAC/Adm. 01-2155 Surcharge <,.<. 17-3860 Road Unit 20-2275 SAC ? 20-3865 Water Conn. 20-3868 Water Trmt. 20-3716 Water Meter 20-2252 Acct. Dep. 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewer Conn. 11-3855 Park Ded. TOTAL <<?C? ? ?J c ', 1-4, B ! CITY OF EAGAN A' p 21U?ii75? ON 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 `? - CLIFFE II? PHONE:454-8100 BUILDING P?.,?. Receipt ii 12661 To be used tor j OF 4 PLEX Est Vatue $48,000 Date SEPTEMBER 22 19 86 SiteAddress 4648 1/2 PENRWE WAY Erect 1?1 Occupancy R3 JOHNNY Lot3 Block 1 Sec/Sub CAKE Remodel O Zoning pu - . Parcel No. RIDCE 4 TIi Repair ? Type of Const vn Addition ? No. Stories ? Name G?D Vp?I+UE HOMES Move ? Length 44 3 1460 93RD LIV N A Demolish ? Depth 24 ° ddress BLAIIIE 780-5510 Cit Pho Int. Impr. I t ll ? ? Sq. Ft y ne ns a ? Approvab Fees = o Name SCAQ ? v Q Address Assessment _ `' City Phone Water 8 Sew. Q Name Address Ciry Phone Police Fire Eng. Planner I hereby acknowledge that I have read this application and state that the gldg. information is correct and agree to comply with all applicable State of Minnesota Statutes and City of. Ordinances. APC. Signature of Permittee,-?'? -f' ? ? ?/?;? • ;? Vaf. [ GOOD VALUS HOMEB Permit $ 274.00 Surcharge 24.00 Plan Review 137• 00 SAC 575.00 Water Conn. 500 . 00 Water Meter 63 . SO Road Unit 290.00 Tr. PI. P k 156.00 ar s Copies 50 . . A Building Permit is issued to: on the express condi6on that all work shall be done in accordance with all applica le State of Minnesota Statutes and Ciry of Eagan Ordinances. Building Official -- - ' PermN No. PermN Holder Date TNWphone # Plumlainy /! 09 ? H.V.A.C. • /i Elscteie 7C .?c.izc. ? C - J '$ 117 C C' SOItN1M InspecNoo Dab Insp. Commwnb FooHnys 1 FoodnyeII Foundatbn Framiny ?9 Z W Rooflny pou PI ? bg. r'/?` ? ?- Rough Nty. 9 47 ?J Insul. Flroplace FMai Htp. G /0-0 Flnai Plbp. -0 Bidg. Final Cort. Oec. r Doek Ftp. Dock Frmq. WNI Pr. Dbp. .? . . . :,. Site Address -1 Lot m Name ?v Addre .. c City 4 ? Name 3 Addre 0 C;t4 FEES COMM/IND FEE - 196 OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE - $10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) SIGNATURE OF PERMITTEE FOR CITY OF EAGAN PLUMBIHG PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 PERMIT # ? RECEIPT # ? --? ? DATE: BLDG. TYPE WORK DESCRIPTIWN hes. v New Mult Add-on Comm. Repair Other N9. FIXTURES TDTAL Water Closet - $3.00 TBath Tubs - $3.00 - TLavatory - $3.00 - t Shower - $3.00 =Kitchen Sink - $3.00 - Urinal/Bidet - $3.00 -- - T Laundry Tray - $3.00 -F- - Floor Drains - $1.50 ? Water Heater - $1.50 Whirlpool - $3.00 = Gas Piping OuUets - $1.50 So(tener - $5.00 Well - $10.00 Private Disp. - $10.00 = Rough Openings - $1.50 FEE ., _ . ' STATE S/C: GRAND TOTAL. -, r FW'.?nf` ; . , . . ... . . ? PERMIT # . , MECHANICAL PERMIT s: 7?? '? • . ' CITY OF EAGAN RECEIPT # , 3830 PILOT KNOB IiOAD, EAGAN, MN 55122 DATE: ?'?? CONTRACT PRICE: PHONE: 454-8100 Site Address ` BLDG. TYPE WORK DESCRIPTION Lot Block 1 Sec/ ? i Res. New , j MuR. ? ,.,f Add-on °-' Name . Comm. Repair ?o ? , Address ? Ciry Phone 6Z I - 1't Other FEES Name RES. HVAC 0-100 M BTU -$24.00 3 Address ADDITIONAL 50 M BTU - 6.00 O City Phone (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTIET M I U S ( IN M M - 1 PER PERMIn - 1.50 EA. TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE ForCed Air ?^= O M BTU O APT. BLDGS. - COMM. RATE APPLIES Boiler TOWNHOUSE 8 CONDOS - RES. RATE APPLIES M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMODELS - 12.00 Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00 Vent. CFM STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets # _2 • O0 BEYOND $1,000) O ther FEE S/C: 0 GNATURE OF PERMITTEE TOTAL• _V• r o FOR: CITY OF EAGAN • ? (gtr#ifiratt uf (Orrupanry Citp of eagan FP}tal'btlPtlf Of lIIdatt1 J JWPftiDtt Thrs Certificate issued pursuant ro the requirements of Section 306 of the Uniform Building Code certifying tirat at the time of issuance thu structure war in complFance with the vanous ordinances of the City reguladng building construction or use. For IJre foJlowing.• ux a.mikaoo 1 OF 4 PfEX Hldg. FLn" w. 1266 ; OMuDKnr-'Y TYP? R3 Ztroing putrip .f !r .rnx COM v'll owwr d eWmngt3 Addrm 11".' ?i?.`i. a Buil&ngAddr?a I.onlity Da9e: P, 1987 Bdding Of6cW POST IN A CONSPICUOUS PLACE ? .. .,, . . .,.. . _, r ., _. _. , _ . ._ . . . . . . . . . PERMIT N PLUMBING PERMIT RECEIPT # CITY OF EAGAN ?830 PIIOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE: PHONE: 454-9100 Site Address - BLDG. TYPE WORK DESCRIPTION Lot %Block .! SeciSuti Res. New Mult. Add-on ? ? Name Comm. Repair -?u Address Other c Ciry 4TY.f?.?._ P?one k ?- ?' PLBG ONLY - COMPLETE THE FOLLOWING: RES ? . . NO. FIXTURES TOTAL - ? Water Closet - $3.00 $ ? Name Bath Tubs - $3.00 ? 3 Address 2 ?:. -$3.00 Lavatory p City e -? Phone Shower - $3.00 Kitchen Sink - $3.00 FEES UrinaliBidet - $3.00 COMM/INO FEE - 196 OF CONTRACT FEE Laundry Tray -$3.00 APT. BLDGS - COMM RATE APPLIES Floor Drains -$1.50 TOWNHOUSE & CONDO - RES. RATE APPLIES Water Heater -$t 50 MINIMUM - RESIDENTIAL FEE -$12.00 Whiripool - 53.00 MINIMUM - COMMIIND FEE -$20.00 Gas Piping Outlets -$1.50 STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIT) . (ADD $.50 S/C IF PERMIT PRICE GOES ?1-Softener -$5 00 BEYOND $1,00C?00) j Well - $10.00 " Private Oisp. - $10.00 h R i 0 oug Open ngs - $1.5 SIGNATURE OF PERMITTEE FEE: STATE S/C: FOR: CITY OF EAGAN GRAND TOTAL: - L?. - 4, a 1 CITY OF EAGAN ? 2 DNITS .ON RIDGE 3830 Pilot Knob Road, P.O. Box 21-199, Esgan, MN 55121 ?? PHONE: 454-8100 BUILDING PERMIT Receipt # ' To be used tor 1 O.'t? 4 PLEX Est Value $48,000 oAtA SSPTFMBER 22 Site Address !I1090 IPUARWX Lot_ A! ^!ock I SeclSub. W Name t'vuu yft"uPI nVrirLa ; Address 1460 93RD LN N ° citp BLAINE phone 780-5510 = o Name Sat''tE oQ Address ~ City Phone ? F W Name ? 'Address z i W Ciry Phone 12662 is 86 Erect U' Occupancy x'3 Remodel ? Zoning pD Repair ? Type of Const. Vn Addition ? No. Stories Move ? Length 44 Demolish ? Depth 2 d Int. Impr. ? Sq. Ft Install ? Assessment Water & Sew. Police Fire Eng. Planner I hereby acknowledge that I have read this application and state that the Bld9 information is correct and agree to comply with all applicable State of Minnesota Statutes and City.qf EaAan Ordinances. APC_ 21 /'/' Var. Signature of Permit??.?,4 ?a, A euilding Permit is issued to: GOOD VALUE iiUI'9ES all work shall be done in accordance with all applicable StatE of Minnesota Stati Building Official / ( /s .- ? Permit q 4 f y • v" Surcharge .00 Plan Review00 70 SAC Water Conn. ??u . 40 Water Meter??U Road Unit__TST' 70 0 Tr. PI. Copies T_a?l I on the express condition that City of Eagan Ordinances. PKmll No. Pem+it Nold.r DaM TNophom k Plumbiny ?? 3 o9/g N.V.A.C. ? .?- /,/W 7 Electric e ?f J (p cJ a-t,/tic ' ' +T ? •? 7 SoMenar Inspectlon Date Inap. Comments P ? r L- L k/ . . 1. Fireplscs FInM Htg. y.?q, y 7 [r . fi . Final Plbp. ZA/ Bldy. Finsl y- ,x9- r7 e,.4 . cen. oa. Deck Ftq. Deck Frmy. WNI Pr. Disp. PERMIT # PLUM8ING PERMR RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE `-' / c ?'y Site Addre?s V Lot ? - Name ?o Addre c Ci1y -? L Name c Addre o citv ? FEES COMM/IND FEE - 1% OF CONTRACT FEE M1NiMUM - RESiDENT1AL FEE - $10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) PERMIT7EE FOR: CITY OF EAGAN BLDG. TYPE WORK DESCRIPTION Res. -_? New Mult Add-on Comm. Repair Other N?. FIXTURES TOTAL Water Closet - $3.00 -7-Bath Tubs - $3.00 - $ - T Lavatory - $3.00 ? 5hower - $3A0 - - Kitchen Sink - $3.00 f Urinal/Bidet - $3 00 . -T-Laundry Tray - $3.00 TFloor Drains - $1.50 = Water Heater - $1.50 Whirlpool - $3.00 =Gas Piping Outlets - $1.50 t ? 0 Softener - $5.00 Well - $10.00 Private Disp. - $10.00 = Rough Openings - $1.50 FEE STATE S/C: GRAND TOTAL• PERMIT # 7 ? MECHANICAL PERMIT RECEIPT # CITY QF EAGAN a? f?, 7 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: PFiONE: 454-8100 ? Namev _ ?o Address c City 4- (D c 3 0 Name _ Address Ciry - TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. Vent Gas Piping Outlets # Other '> ? 0 t:M BTU M BTU M BTU M 8TU CFM ? BLDG.TYPE Res. Muit. 11 d . ? Comm. Other WORK DESCRIPTION New Add-on Repair FEES RES. HVAC 0-100 M BTU -$24.00 ADDITIONAL 50 M BTU - 6.00 (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTIdN) GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA. COMM/INO FEE - 1% OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLIES MINIMUM FiESiDENTIAL FEE - ALL ADD-ON & REMODELS - 12.00 MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 SIC IF PERMIT PRICE GOES BEYOND $1,000) FEE: . L S/C: r ? SIGNATURE OF PERMITTEE TOTAL: n 0 FOR: CITY OF EAGAN i 4 4 t -I (Itrtifirafir v# (Orrupanrg Citp of eagan FPv8Yf1ilPriY of lwtbtno iwPtflDtl This Certificate issued pursuant to the requirnments of Section 306 of the Urriform Building Code certrfying that at Ihe time of lssuance thrs structure was in eampliance witlt the varrous ordinances of rfre City regulating building conrtruction or use. For the following.- uKa.u&=dw 1 UF 4 Pl.t;e; a?.??t ? i? ti62 R3 E' i) ? n ??, Tra ?? ? ry? c? GQOA VALL:,E HOF:i:::: 1460 93r,;: ..r; N". , BLA1.NE Owner of &Kldwg AMma euMnAddmw 4646 w.0 Wmay L l?, E:. ,. )0linNY CAKF R1DGE 4TH APk 11, 2S, 1987 &u7ding O@icial . POST IN A CONSPICUOUS PLACE CITY OF EAGAN Remarks Addition_' _+JQMM CAKE RTDGE 4t11 Lot 4 Blk 1 Parcel l(I.39o03 04Q 01 Owner Street 4648 Penkw'e lliay Scate Eaga11, IrIN 55122 Improvement Date Amount Annuel Years Payment Receipt Deta STREET SURF. STREET HESTOR. GRADING SAN SEW TRUNK * SEWER LATERAL WATERMAIN * WATER LATERAL WATER AREA STORM SEW TRK 98 278.28 * STORM SEW LA'f' 1981 CURB & GUTTER SIDEWALK STFEET LIGHT WATER CONN. BUILOING PER. SAC PARK CITY OF EAGAN Remarks 0-70 F 0 Addition aOEDfjY' C-AKE R,I= 4Lb Lot $ 81k ? Parceil(i 392SUS"'Q1U US Owner Street 64si? Penkwe WSx - Stete?gan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRAOING SAN SEVM TRUNK '? S ' • SEWER LATERAL 5 WATERMAIN * WATfR LATERAL igRi WATER AREA eflaK&RI STORM SEW TRK * STORM SEW lAT 1981 CURB & GUTTER ' SIDEWALK STREET LiGHT WATER CONN. 9UILDING PER. SAC PARK CITY OF EAGAN Remarks Zee?-? lyo/"s '???/ Addition .]'(14N11T1r' t'.AKF. RTn[tF atT, Lot 7 Bik 7 Parcell-0 _398.0.3_02.0 -0.1 Owner Street 4629 R3.d$8 Cliffe Drive Stete Eagan, MV 55122 Improvement Dafe Amounc Annual Years Payment Receipt Dete STREET SURF. STREET RESTOR, GRADING SAN SEW TRUNK 5 *SEWER LATERAI WAT£RMAIN AATER LATERAL 1981 WATER AREA ? STORM 5EW TRIC - 27$.2$ CQQ$S$Z 10 1$ 80 ,STORM SEW LAT CURB & GUTTER ' SIDEWALK STREET LIGHT WATER CONN. BUILOING PER. SAC PARK CITIf OF EAGAN 2 UNITS ON PSNRWV" Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 NA 12660 PHONE: 454-8100 BUILDING PERMIT WAY. Receipt # f To be used ior 1OF 4 PLEa Est. value $48,000 Date SEPTEMBER 22 19 86 SiteAddress 4631 RIDGE CLIE`FE DR Erect Occupancy R3 Lot 1 Block 1 Sec/Sub.7UHNNY CAICE Remodel ? Zoning PD . Parcel No. RIDGE 4TH Repair ? Type of Const Vri Addition ? No. Stories W Name GOOD VALUE HOMLS Move ? Len9th 44 Z ?.4f)0 93RD I,M AI Demolish ? Depth 24 o Address Int Impr. ? Sq. Ft City BLAINE phone 780-5510 Install ? = o Name SAM ? ¢ Address ~ City Phone cc F W Name ? ? Address ? W City Phone I hereby acknowledge that I have read this application and state that the iniormation is correct and agre? to colnply with §II applicable State of Minnesota Statutes and City e(Eaqan Ordinanaes. = 7' Signature of Permittee,-' Assessment Permit $ 274.00 Water & Sew. P li Surcharge vi Pl n R 24.00 137.00 o ce a ew e 575 00 Fire SAC . Eng. Water Conn. 500. 00 Pl W M t t 63.50 anner er er a e 290 00 Council Road Unit . Bldg. Off. 9 Z 6 Tr. PI. 156.00 APC Parks Var. Date Copie 0 ' Total ' A Building Permit is issued to: GOOD VALUE IYOMES on the express condition that all work shall be done in accordance with all applicable State of Minnasota Statutes and City of Eagan Ordinances. Buflding Oflicial =-'? ` - - - - ? o c? i° _ ? °- ?+ ? ; ? ` a n a g a ? 2 ++ ? g r a ++ s X ? ? x > 3 ? n ? h IV , o ? 3 ? I V. \ ? ? PLUM8ING PERM17 CITY flF EAGAN 3630 PILOT KNOB ROAD, EAGAN,141N 55121 Site Address -' Lot i ? Name ' w'r??r?"' - ° "' c«a Addrep c Ciry- Phone?'?? ? Name c Addre O City?U FEES COMM/IND FEE - 1% OF CONTRACT FEE MINIMiJM - RESIDENTIAL FEE - $10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADp $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) J , SIGNATURE OF PERMITTEE FOR CITY OF EAGAN PERMIT # RECEIPT # ? ' J = , ? •? DATE: /o / oy / BLDG. TYPE WORK DESCRIPTION -4;k) - Res. -- New `.- Mult Add-on Comm. Repair Other NC,. FIXTURES TOTAL Water Claset - $3.00 $ Bath Tubs - $3.00 _ ? ' ?-Lavatory - $3.00 r_ Shower - $3.00 - - - Kitchen Sink - $3.00 7 Urinal/Bidet - $3.00 1 Laundry Tray - $3.00 ` -- ? Floor Drains - $1.50 T I Water Heater - $1.50 j Whiripool - $3.00 -r-Gas Piping Outlets - $1.50 ` Softener - $5.00 Well - $10.00 Private Disp. - $10.00 = Rough Openings - $1.50 FEE STATE SJC: ? L) GRAND TOTAI: ? ?' ?? U PERMIT . , ; MECHANICAL PERMIT RE P CEI T # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: 7 CONTRACT PRICE: PHONE: 454-8100 Site Address L4, r I BLDG. TYPE WORK DESCRIPTION Lot lock I Se ub ? Res. New ?( Fn ' Mult ? Add-on m Na e f4 ' Comm. Repair ?e Address ? . ^ c City Phone i- oe•4rJ• 1-0 Other - m Name G!a .l til 4 " FEES RES. HVAC 0-100 M BTU -$24.00 c Address ADDITIONAL 50 M BTU - 6.00 p City Phone {RES. HVAC INCLUDES A/C aN NEW CONSTRUCTION} GAS OUTLETS MINIMUM PER P ( - 1 ERMIn - 1.50 EA. TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE Forced Air ; Z1 •?0 M BTU Lv APT. BLDGS. - COMM. RATE APPLIES Boiler TOWNHOUSE & CONDaS - RES. RATE APPLIES M BTU MINIMUM RESIDENTiAL FEE - ALl ADD-ON & Unit Heater M BTU $ REMODELS - 12.00 Air Cond. M BTU $ MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .gp Vent, CFM $ (ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Qutlets # s 2.00 BEYONO $1,000} Other $ FEE: : S/C: SIGNATURE OF PERMITTEE TOTAL: FOR: CITY OF EAGAN Ttr#i#irttfit of (Orrupaury Citp of (Eagan EppY'ttlipt[Y IIf s1tllmup JwPrttOtt ?'lris Certificate issued pursuanr to the requirements oJSecrion 306 of the Flniform Buildrng Cade cenifyrng that at the time of issuance thu structure was in compliance with the various ordrnances of dre Ciry regulaling building consiruction or use. For !he jollvwing.• i pF 4717' 12650 ux cwmirlmu(m BWS. rermit No. OocuWocY TYPe SV Zooing District ? ?i Tytl Type rmrt owna oc eud&R OOM VAI : r: - naa? ''f 6U 93 FD LW ";'IAT13F: stiwaing naa= 631 R_ , Lomw Y ?- n.'.? S :°87 n,? , &u7d'mg Official PO5T IN A CONSPICUOUS PLACE CITY OF EAGAN L' 1`4 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 UNITS ON PENKWE WAY PHONE:454-8100 BUILDING PERMIT Receipt # To be used tor 1 OF 9 PLEX Est. Value $4$,0 0 0 Date SEPTEMBER 22 1g 3 6 SiteAddress 4629 RIDGE CLIFFc. DR Erect C? Occupancy R3 Lot 2 Block 1 SeclSub. 30HNNY CAKE Remodel ? 2oning pp Parcel No RIDG:: 4'1'H Repair ? Type of Const vn . Addition ? No. Stories W Z ryame GOOD VAI.UE HOMES Move oemolish ? ? Length Depth 24 3 Address 1460 93RI? LN N tnt.lmpr. ? S Ft 9. ? Cih, B7,AIIIE Phone 780"5510 Install ? o Name ?AM Z ? ? Address ~ City Phone c~i a W W rZ U? Qz ` W Name _ Address Assessment _ Water & Sew. Palice Fire r Phone Planner Council Permit $ 274.00 Surcharge 24.00 Plan Review ? 40 SAC 575.00 Water Conn. 500.00 Water Meter 63.50 Road Unit 290.00 I hereby acknowledgethat I have read this application and statethatthe gldg. Off. 9 2a Tr. PI, 156.00 information is correct and agree to comply with all applicable State of Minnesota Statutes and City ot.Fsgarr?Ordinanees. APC Parks ? Var. Date Copie Signature of Permittee Total !?2 1019 . $0 'kS A Building Permit is issued to: C*OOD VAT.UE HOM on the express condition that all work shall be done in accordance with all applicable Stat of Minnesota Statutes and City of Eagan Ordinances. Building Official _? c '- s c 12659 ?- ?.,. ' Permft No. PermN Nolder Date TNsphone # Plummny `7 H.tA.C. 70 ? 7 Electric lP n ch:uu? ? 8oflena Inapsctlon Date Insp. Commenh Footlngs 1 FooUnqs II Foundatbn Frsming RooNny Rouph Plbq• ?' •? ? Q?p'-? pD ,. ?-? Rouyh Hiy. Insui. 3 ? Fireplace Final Htq. f?- Final Piby. Bidy. Final ?/? ?'• ?. Grt. Occ. 7 [. , /.? . Deck Fty. Deck Frmg. Well Pr. Dlsp. Y 1 • 7 \V. (Uxfi#tra#P uf OrrupaMry Citp of tagan 19Ppu-ImPt[t D# lWIbing JwPtfiDtt This Certlftcate issued parsuanllo the requirements of Sectron 306 ojthe Urufonn Building Code cerlifying tlral at the time of issuance tius slructure was in compliance with 1he various onlinaicces of 1he City regulating building consuuction or use. Far the following.• uw c,,$ffi,dm I OF 4 PLEY. BW8. pn;, No. 12659 OccuparcY TyPe R3 zaoing DieM P D 'type C.osr VII Own" of Rd"og GOOD VALtTE HQMES Addrw 1460 93RD LN N BLAINF 8udding ?? 462?' -?;.DCE CLIFFE D?ty L2, BI, JOHNNY CAKE )ate: May 18, 1987 EuBding Official POST IN A CONSPICUOUS PLACE ,... . ?_ ,,; .. , PERMIT # PLUMBINCa PERMIT RECEIPT # ClTlf OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN $5121 DATE :T PRICE PHONE: 454-8100 Site Address ? Lot BLDG.TYPE WORK DESCRIPTION m Name ? Addre? c City _ ? Name 3 Addre p CitY - FEES COMM/INO FEE - 1% OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE - $10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) SIGNATURE OF PERMITTEE Res. New Mult Add-on Comm. Repair Other NO. FU(TURES TOTAL Water Closet - $3.00 s Bath Tubs - $3.00 ? Lavatory - $3.00 ? Shower - $3.00 Kitchen Sink - $3.00 Urinal/Bidet - $3.00 Laundry Tray - $3.00 Floor Drains - $1.50 Water Heater - $1.50 Whirlpool - $3.00 Gas Piping Outiets - $1.50 SoRener - $5.00 Well - $10.00 Private Disp. - $10.00 ough Openings - $1.50 FEE STATE S/C: GRAND TOTAL• FOR CITY OF EAGAN CONTRACT Site Address PERMIT # 9,370 MECHANICAL PERMIT ?'?4Vd CITY OF EAGAN RECEIPT # 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATEE -7 PHONE: 454-8100 (D Name' •,* r ' -ia Address /i c Ciry Phone ' - 16 21 a? c 3 O Name _ Address City _ TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. Vent Gas Piping Outlets # Other M BTU M BTU M BTU M BTU CFM ? BLDG.TYPE Res. Mult Comm. Other WORK DESCRIPTION New Add-on Repair FEES RES. HVAC 0-100 M BTU -$24.00 ADDITIONAL 50 M BTU - 6.00 (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMIn - 1.50 EA. COMM/IND FEE - 1% OF CONTRACT FEE APT BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLIES MINIMUM RESIDENTIAL FEE - ALL ADD-ON & REMODELS - 12.00 MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADO $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000) ? Y. FEE ? - S/C: SIGNATURE OF PERMITTEE TOTAL: ? - FOR: CIN OF EAGAN `F . . . . . . ? .... - ?? ... i +^? ;rR.7-....!T??'1r• . ;:.t. . . . ? CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ? ?j BUILDING PERMIT ? FM? Receipt # (_- a?Zi To be used tor Est. PHONE: 454-8100 value $1, 500 Date JIJN 7 1991 Site Address 4648 AEI Lot 4 Block 1 Parcel No. W Name SILL WAY - ? Address 4648 PEHICi/E ifAY 0 City EAGAD! Phone ,o Name JEHRY SDLHEIlR ?? Address 1381 bERtY RIDCE RD ? City - F-AGAN Phone 452-5727 ?cr ?W Name _ ? ; Address a W City _ I hereby acknowlege that I have;read this application and state that the i f i ormat n on is correct and xgree; t o comply with all applicable State oi Minnesota Statutes and.City,of Ea an Ordinan s. Signature of Permitee ? \ A Building Permit is issued to: ?ERaY SOLHE IH on the express condition thaiall o rk shall be done in accordance with all applicable State of Minnesota S tu tes and City of Eagan Ordinances. Buildmg Official r ? Occupancy Zoning (Adual) Const (Allowable) * of stones Length Depth S.F. Total S.F. Footprints On Site Sewage On Site Well MWCC System Ciry Waler PRV Required Booster Pump APPROVALS Plarmer Council Bldg. Of(. Variance OFFICE USE ONLY - FEES Bidg. Permit Surcharge Plan Review SAC, Cily SAC,MCWCC Water Conn Water Meter Acct. Deposit SNJ Permil SIYJ Surcharge Treatment PI Road Unit Park Ded. Copies TOTAL 3S•00 1•00 •50 36.50 permit fdo, Permit Holder Date Telephone # WATER SEWER PLuMe1NG 14V(? ?, /? y 3? 39y /w~ H.VAC. ELEcrRIc 00 kupection Date In . Comments Footings I Foundation Framing G? Rooling Rough P{b9- (o II ? ( • Rough Htg. ? Isui. ' Fireplace Final Htg. Orstat Test Final Plbg. Plbg. lnspeCtor - Notify Plumber Gonst. Meler Engr./Plan Bldg. Final Dedc Ftg. Dedc Final we+i Pr. Disp. CITY OF EAGAN WATE! SERVICE PERMrT 3P30 Pilot K nob Road 796 6 P. O. Box 21191? PERMIT NO.: . a_ Esgan, MN 55121 DATE: Zonirq: _ No. of Units: Owner: EAddross: sia Aadrem wun-ber: _ Metar No.: .3g5 7 0 9- ? 3 500. (7!??C Siu: -rlk " X -?! C tlf B ? 1"ORn,! pl s 1?J . t?AC1 Readar No.:d 3f 355?f SOpd I ..?.e r? ?.y ,.+? ?. W?ON . . ?IM110r. REQ U'? fi y C 8 1` s:, 1?1? 6. o0AC? i?' /? ?i'3.St?nd r.?Pre, gy //-?'? Dcte Paid: Uote of Insp.: InsP•: - q- 0, - S 7 ? CITY OF rAGAN $EWER SERVICE PERMR ? 3830 Pilot Knob Rosd p??T NO.: ?' P. O. Box 21199 4 - Eagan, MN 55121 p^TE: ' - 1 ing: No. of Units: 4"" 2 PX Cood Va. _ r . J4ddress: i.?i i "£._%.17l: TwTa'f_ ite Addrcss: ?' 5 ? ??0t„11, :? 1 • `Plunber: Nm b eena* wil611M CNf of alos ConnM'lon Charpa: '. ,Ordlm?a?. /1?CCDUnf DlpOiih '-.'.••' ? Pennit Fes: t =Z 1•?.,.- SYfChGrQl: • B Misc. Clwroes: Y ; Dote of Insp.: Total: Insp.: Doh Poid: CITY OF @AGAN 3830 Pilot Knob Rosd P. O. Box 21199 Eagan, MN 55121 Zonirg: . ' Vwner: AddrQSS: Site /1ddrcu: GonP_; p2.F1iCWe c-9 - Plurnber: ; L?-•%•els??:Z P? :;4ic ::: AAettr No.. SIZO: Reader No.: I yrM fo eonv* wft !IN Ciyr of Eaygw OrdiNear. By Dote of Insp.: WATER SERVICE PERMR PERMIT NO.: DATE: No. of Untts: 0nnv Ck CO11f1ECI'tOf1 ChOfol: J'J?' • ?•t ? yii AGCOUflt DEpOSIt: : ? • v?Dd Pertnit Fee: Surcho?9e: . 50pd Mtac. CFaroes: 15 -5 . UOrd Ii ToMI: '? ^ _ SOn,-? n3et?r Dote Paid: CITY O F EAGAN 3830 Pilot Knob Road SEyyER SERVlCE PERMR P. O. Box 21798 PERMIT NO.: '- Eagan, MN 55121 pATE; ZOni^0: Na of Unita: Owrwr: = a c Address: si1'Q IWC:?QES: ?FV?iiiY• ?wI?t+.iJ','- _ C. ,? _ Plumber. NiCkelsOn ^3t+ s?? ' 1 pne ft eeM* wi16 !Iw Citi ef fyos Connsction Chorpe: r ;-; ; t?t1 n. < OrdiNSac Acooumt Qeposit: Pomdt Fes: SU1dIQrQQ: r, ?? • BY Miic. Chorgsx . Date of Irup.: Total: I"sp" Date PoW: ITY OF EAGAN a?830 Pilot Knob Road , O. Box 21199 • .?: , agan, MN 55121 Z oninp ? Addross: Slte Adf.+eas: Plumber. Meter No.: Size: Reoder No.: 1 eem !o emolp wilb ilN Citr oi Iayps aaft011Ct/. By Dote of Inap.: ITY OF FAGAN 0 PiloiiCnob Road . (!?; Box 21189 agan, MN 55121 onirg: . r, nss: ta Address: 4 64?? umber. ar No. -F ze: r! 1 u2 Iiomes Plumb WATER SERVICE PERMIT PERMIT NQ.: DIITE: No. of Units: Tol-?nny Ck Rdp, 4th Connection Chorye: -:. !0• G0pd Accowit Deposit: - `• Parmit Fee: ,. $uRhC1"Qe: - :i Mlsc. Cho?9es: Total: L?ota Poid: Inap.: WATER SERVICE PERMR PERMIT NO.: i- ^ DATE: 9 _9 . . F, ' i . :- - No. of Units: L3 B1 .To}innv Ck Rdo 47t ? am-del rvo.: L ?' tL7_t4L9ae70re a199AMaT I "No +o.owi* wa 60 citr oi UjMH0(&4,WWRjC_, o,??.?... REQUU.t? gy Dote Paid: - Date of Irxp.: Inw.: TP ? - 5 ; K7 ,CITY OF EAGAN SEWER SERVICE PERMIT +3830 Pilot Knob Rosd ;P. O. Box 21199 PERMIT NO.: Xagan, MN 55121 pA7'F: `ZoninO: - No. of Units: - --p? Ex +Owrflr: /lddress: :_' Site Address: 462 "Pfumber :jiKt.16?7x? P1?,•..??:-?. 3--86 667= . ?('I' !?'?J^Li NrM [o smrplo wilh tw d!p of fyew Connoctlon Chorpe: -1-" ??OediM?as. Acoxw* peppdt; PoRfl* FlQ: ' r Sund+orpo: . BY Miac. Chorpes: Dote of Irnp.: Totol: k=_ InsP•: Dote PaM: ? CITY OF EAGAN 3$30 Pilot Knob Road P. O. Box 27199 Eagan, MN 55121 Zonirq: _ Owner, Addre:s: Sih llddrcss: - - { ,i Pf wnber: , • s ? AAeter tdo,: Siu: -_ Readsr No.: 1off" ts eoWA wNM !lw Ciry of Esse¦ O?riwewam By Date of Insp.. ITY QF EAGAN 0 Pilot Knob Road . O. Bax 21199 aga?, MN 55121 iryp: _ r: ?: Q te AcWrcss: umber r No :?: .?ft?'t r No.: M"- te oomply wleh Mw Cih WATER SERYICF PERMIT PERMIT NO.: D/1TE: _ No. of Units: `? U- - - ?. - - ?+th 500.'Jr3T)a 1; . ?]nnd ,? V ? ? ?tIR? -ess.GC2Q1?.? in . oOrwd _ 50nr'. 9y Ca???wr`"?•- Qate of Insp.: WATER SERVICE PERMIT PERMIT NO.: DATE: No. of Units: - COM1E'CtlOfl ChOfgl: "2) • -?? !'}d AOOOUIIt DEpoWt: Permit Fce: Surcho?pe: '- Misc. Clwrpes: ?? •?c': '_"p Total: .4 Date Paid: Date Pcid: CITY OF EAGAN SEWER SERVlCE PERMIT 3830 Pilot Knob Rwd P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zon1rq: Na of Units: O1Nn!?: ? Oc1 s?:, ? ,41 }Tpriq AddreSS: _ $7tO AddrOSS: =i ,,32 PEClis.j.°F? :8' TI. Bi Tiry: i1T'•i ?71= T.4 v! 4 t i) t Plumber. "Il.^kea.sor, 9_23 . r:.670; I = - 1 qme te oow* M11i fit Cily ef !aN¦ CAntrxtion Ch0/ge: . -!)?}?.,? = 473) OrdiMear. Actount Depodf: ' Penrit Fes: - , 5urchage: - ' By Misc. Chorpm Date of insp.: Tatd: Insp.: Dob Pnld: m Cf TY OF EAGAN WATER SERVICE PERMR PERMIT NO.: DATE: - No. of Units: :fcl ' -,i '!• .. Conneciion Chorpe: ` - Atcount Depqsit: ' - PeRnit Fee: _ L 4. Ofl 1 Surchorye: S )Ac' MisC. ChorpaS: • r i 003 e !-7. Total: Rv Oote of Irap.: WATER SERVICE PERMR PERMIT NO.: ' DATE: ^ ? No. of Units: _ 4-n7 ex roas: ber . roomie llddre?: f?F ; i - ^.1? ?d 4th r No.: d o?? 50t?. J??r?i :/?? ? 15 +:i,1,d ?: ' . n(Ipd ro--m* wak tm c*, of;?EPH UHM s o a ?..?... x. ? . _ ? nopa Tp REQL"€ 5 n pd-mater ? oQr. Paia: e of Insp.: Insp,; ? ?. 3830 Pilot Kno6 Road P. O. Box 21199 Eagan, MN 55121 Zonirg; _ Owner; .. Addresx -?? Sits llddreaa: Dote Paid: Render No.: 1 yn* to aoinplp wil& Nw Ciey ef Leya¦ Oerlwawem CITY OF EAGAN No 19208 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8700 2 p BUILDING PERMIT Receipt #? ? J BhSFI?If FIIdISFt To be used for - Est Value $1, 500 Date • JUN 7 ig 91 Site Address 4648 PENKWE WAY Lot 4 Block 1 SeGSub.JOHNNY CAKE RIDGE OFFICE USE ONLV Parcel No. ? 4TH occupancy - FeEs 2oning - w Name BILL WAY (ACiual) COnst BIdg.Permil 35.00 o AddresS 4648 PENKWE WAY - (pllowahla) - 1 00 Surcharge . City EAGAN Phone #otstories - Plan fleview Lerglh _ o Name .TERRY SOi.HEIM Deplh Cil SAC g? Address 1381 BERRY RIDGE RD - s.P.roul - , y SAC, MCWCC Cj F.A(:AN ty Phone 452-5727 S.F.Footprinls _ t nn W C On Site Sawaga _ er a o W w Name on sne wen W M _" Address - Mwccsystem ater eter Qu?i Qj(y e Ciry Waler _ Accl. Deposit PRV Required _ Sr4Y Permil I hereby acknowlege ad this app'cation and state that the ' Booster Pump - SNJ Surcharge inlormation is correct a t comply w h all applicable Stale oi Minnesota Statutes an it Ordinan s. Treatment PI Signalure of Pertni[ee APPAOVALS Road Unil A Building Permil is issu d 1 JERRY SOLHEIM : Planner - Park Ded. on ihe express condition ork shall ba done in accordance with all Council - 50 applicable Slate of Minnesota Statules and C ity of Eagan Ordinances. g?, pry. Copies , BuildingOflicial ttvi ? yM l ?9;d 1 111d Variance - TOTAL 36.50 L 1-4, B 1 CITY OF EAGAN 3830?1211ot I(nob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT N° 12660 Receipt N - (4'? 6? To be used tor 1 OF 4 PLEX Est Va1ue $48,000 Date SEPTEMBER 22 ? y 8 6 SiteAddress 4631 RIDGE CLIFFE DR Erect Y7 Occupancy R3 Lot 1 Block 1 Sec/SUb. JOHNNY CAKE Remodel ? Zoning PD Parcel No RIDGE 4TH Repair ? Type of ConsL V_n . Addition ? No. Stories W Name GOOD VALUE HOME$ Move ? Length 3 1460 93RD LN N Demolisn ? Depth 94 Address Int.lmpr. ? Sq.Ft ° BLAINE 780-5510 CiN Phone Install ? .o 2 °uV < ? SAME Phone U a w W Name ? ? Address i W City Phone I hereby acknowledge that I have read this application and state thatthe intormation is correct and agree to co ply with all applicable State of Minnesota Statutes and Ci r?f?a Ordina s. Signature of Permittee ????? Assessment Water 8 Sew. Police Fire Planner Council Bldg. Off. 9/2 Z/S 6 APC Var. Date Fees Permit v ' - • "" Surcharge 24.00 Plan Review 137.00 SAC 575.00 Water Conn. 500.00 Water Meter 63.50 Aoad Unit 290.00 Tr. PI. 156.00 CopiesO Total A Building Permit is issued to: GOOD VALUE HOMES on the express condition that all work shall be done in accordance with all applicq4e Sqptp of Minneso a S tes and City of Eagan Ordinances. Building FOR SALE TOWNHOUSES CITY OF EAGAN *, c L 1-4,. B 1 3830P'I tK bR d PO B 7 19 E Iv2 12v5Q `? i o no oa ,.. ox 2- 9, agan, MN 55721 PHONE:454-8100 r ? BUILDING PERMIT Receip[# D70 7o6eusedlor 1 OF 4 PLEX Est.value $48,000 Date SEPTEMBER 22 1986 SiteAddress 4629 RIDGE CLIFFE DR Erect L? Occupancy R3 Lot 2 Block 1 Secisub. JOHNNY CAKE Remodel ? Zoning pn Percel No. RIDGE 4TH Repair ? Type of Const. Vn o $< ? Addition ? No. Stories Name GOOD VALUE HOMES Move ? Length 44 1460 93RD LN N oemolish O Depth 24 Address Int. Impr. ? Sq. F? Ciry BLAINE phone 780-5510 Install ? o a uo Aoorovals Fees Address ASSessment Phone .s F w Name ? ? Address e w City _ Phone I hereby acknowledge that I have read this appl ication and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and Ciry rdina es. ? Signature o( Permittee- a ? A euilding Permit is issued to: GOOD VALUE HOMES all work shall be done in accOrdance with all applicable StatgtW Minnesc water & Sew. Police Fire Planner Council Bidg. 01 Permit $ 274.OC Surcharge 24.OL Plan Review, 137. O[ sa.c 575.0( Water Conn. 500.0( Water Meter 63.5( Road Unit 290.0C Tr. PI. 156.0( Vac Date I Copies Total $2,019.5( on the express condition that Ciry of Eagan Ordinances. Building L 1-4, B 1 CITY OF EAGAN Np 12661 , - 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT . PHONE: 454-8100 Receipt u 4/1(. ??? 7obeusedfor 1 OF 4 PLEX Est.value $48,000 oate SEPTEMBER 22 ,jg86 SiteAddress 4648 1/2 PENKWE WAY Erect L? Occupancy R3 Lot JOHNNY elock 1 Sec/Sub -3 CAKE Remodel 13 Zoning PD Parce - lNo . RIDGE 4 TH Repair ? TypeofCanst.lln - . Addition ? No. Stories c GOOD VALUE HOMES Move ? Lengm 44 W Name 1460 93RD LN N Demolish ? Depth ' ? ? o Address Intlmpr. ? Sq.Ft. cjA, BLAINE phone 780-5510 Install ? a SAME Approvals Fees o Name $a Address Assessment Permit $ 274.00 ? City Phone Water&Sew. Surcharge 24.013 00 137 Police PlanReview . ?? F W Name Fire SAC 575.010 ?? Address Eng. WaterConn. 500.00 a w ciry Phone Planner Water Meter 63.513 1 hereby acknowledge that I have ieatl this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and Ci n Ordi ces. Signature of Permine ../?s A Building Permit is issued to: GOOD VALUE HOMES all work shall be done in accordance with all applicBCle State of, M m c Council Bidg.Off. 9/22/86 APC Var. Date Road Unit 290.00 rr. PI. 156.010 CopieS r,..,, --5T-,UT9.5 C on the express condition that Statutes and City of Eagan Ordinances. Building Official L 1-4, B 1 CITYOFEAGAN NQ 1266? . 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55721 • PHONE:454-8700 r ?vl BUILDING PERMIT Receipt p ( ?2 ? Tobeusedfor 1 OF 4 PLEX Esivalue $48,000 pytB SEPTEMBER 22 8 SireAddress-_ 4648 PENKWE WAY Erect C* Occupancy R3 Lot -%'4 elock 1 Sec/Sub. JOHNNY CAICE Remodel ? Zoning PD Parcel No RIDGE 4TH Repair ? Type otConst vn . Addition ? No. Stories GOOD VALUE H OMES Move ? Length 44 W z Name 1460 93RD LN N Demolish ? Depih 2r4 p Address BLAINE 780-5510 Int. Impr. ? Sq. Ft. phone City Install ? a o Name SAME Approvals rees sa Address Assessment Permit $ 274-00 ? City Phone Water & Sew. Surcharge 24.00 Police PlanReview 137.00 F W Name Fire SAC 575.00 nddress U Eng. Water Conn. 500,00 <w ciry Pnone Planner waterroteter 63.50 Council FoadUnit 290.00 Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.Off. 9/22/8 Tr. PI. 156.00 information is correct and agree to omply with ail applicable State of Minnesota Statutes and Ci n Ordi an s. APC Parks - Signature of Permitte ? Var. Date Copies 0 Total A Building Permit is issued to: GOOD VALUE HOMES on the express condition that all work shall be done in accordance with all applicable St ?ef of Minnesofa Stat es nd City of Eagan Ordinances. , BuildingOflicial SL(1??L.- ?.?IlJ a? ? REQUESi FOR ELECTRICAL INSPECTION Ee-oooopi-o's/ See insbuetiona lor completing ihis torm on beck oT yellow copy. Ir 01C7 1 "x" Below Work Covered by 7his Hequest Equiumant Wtretl Li Silu Unlo Bulk Milk ee N Fee Servlee Entmnca5ize b Fee Feeders/5ubieeda,a b Fee Circuits 0 to200qm s 0 to30qm s Otn30Am s Above 200 qmpy 31 to 100 qmps 31 to 100 q Swinvning Pool Above 100_Am s Above 100_P.m s Transiormers rngation 80oms Partial,'QAhetj Fee This reaue3l voiC Is mnms r.om C 10-1671 -- I equiretl? ?ReaEy Now Will Noxify. Insoec- ? t ? Yes ?No tor When peadv 0 Licansed Electrical Contractor 1 hereby repuast insDaction o( ebove ? Owner electricel work insfelleA ar. Street Address, Boe or flouteMo. Cit ectwn o. ownshi0 ame or N, ng o• C ity / W O OantIPRINT) Phon¢ No. r Supplier Atldress Ele trical Contrecmr ICOrnoany 60 am ? C?tr J mr's Lice No Mai ne 'Address IConvactor or wna M ' g Instailationl Aut rizptl SiBnamre (Contrec ? Owner Ma e ?nstallalion) h n Number v? MINNESOTA gTpT5s60ppD Of ELECTRICITY I THIS INSPECTION flEQUEST WILL NOT Grigpa-Mitlwey 9lde•< Boom N-197 BE ACCEPTEO BY THE STATE BOANO 1827 Universitv Ave.. St. Peul, MN 55706 UNLESS PNOPEN INSPECTION FEE IS Phone(872)6420800 ENCLOSED. REQUEST FOH ELECTRICAL INSPECTION EB-0000/1-05 II, See instrvctions foe completim Nia torm on beck oi vellow copy. P• 'Q 1 C 7 7 "X" BeJOw Work Covered by 7his Request ol Builtline Buik Milk p Fae Servfce EnbBnce3ixe k Fee Feadars/5ubfeedarn # Fee Circutta to 200 Am s 0 to 30 qm s 0 to 30 Am A6ove 200 qmps 31 to 100 Amps 31 to 100 Amps Swinming Pool Above 100_Am s Above 700_Am s Transformers rrigation 80ort,s Partial•'Other I- L ISigns ? ? ISpecial Inspection iSiia OTA/ I „ erre.ks 4? FEE l r.?7-? c cer?ify ihet tha nbova final ?apection hes Eaen da. This reque5t 18 months lrom ( ?-1672 nggues? ua?e rrAl rvo. npvgne -in ?nspecuon o ? \ fi¢qy?red7 ? Reatly Now ill NotityReaInspec- v' jqjYs No ror When dy ? W6nsed ElecVical ConVac[or I herebv repuast inspection of ebove ? Owner elecirical work instelled et: Strqet Address. Box or H ute No. Cit u ? eclion n. TownshiD Nama or No. n o. Couhly Oc Vant(PpINT) . 1 Phone o. Po upplier Address V `- Elec 'cel Contractor ICOmpany Name „ ConV lor's Licen No. ? 4 Mailine Address n acror or Owner akin8 tailationl N Aut ized SiBnature ICOnttacto Ownar MakinB Installationl Ithone Number 1 Sle 67-8Oco MINNESOTA STATE B RD OF ELECTNICITY THIS INSPECTION REQUEST WILL NOT GriyWtMidweY BItlQ. Room N•191 BE ACCEPTED BY THE STATE BOAflD 1921 Univereitv Avs.. 3t. Peu1, MN 55104 UNLESS PROPEP INSPECTION FEE IS Phone f6121 642-0600 ENCLOSED. PG`? ? REQUEST FOR ELECTRiCAL INSPECTION Jft ee-ooapo/i-ols/ Il, See inntruetions for comoletinq lhis lorm on back of vellow copv. c' V. 1 r, 7n "X" Below Work Covered by lhis kequest Mia4AAJl Rep.1 TVOa ot BuiltlinB I APPlionme Wirad I Equipment Wirea I ce farm oner p Fae ServiceEntrenceSiza # Fee Fexders/5ubfeetlers k fee Circuits 0 to 200 Am s 0 to 30 Am s 0 to 30 Am Above 200 qmpy 31 to 100 qmps 31 to 100 q y Swinxnin Pool Above 100_Am s Above 700_Am s Transiormers Irn tion Booms Partial.'Other Fee Signs I I ISpeciallnspection IS I,tn IacVica I Inspecbq ereby cerli/y thet [he a6ove Final ?^'e inspeetion has been /!'?, r .. A -?a ? made. mb repuest witl 18 This re9uest voitl 6fp? 18 months lrom C 81670 avf/a,?/? Oal? rZ6, ,e Request Da{? ire No. ', ouBh-in Inspection red? OAeady Nuw ill Notify Inspec- ?j Q X es ? No ?or When Reatly ? Licensed Elearical ntractor ? I hereby requast inaoe«ion ot ebove ? Owner electricel work installed et: Sireet Address, Box or Pou No. L-k ? Ci eqion o. Townshi0 N me or No. Range No• C nly Oc pant(PRINT) ? Phone Nn. P r POlier Addre55 Ele i?al Convactor ICom3any Nam e r's Licen No, M ili B AdJr ss TIContracm r Owner aking I V - ilalionl A orized Signature IConVactor Owner MakinB Installationl Pho umber MINNESOTq STATE 66ARD OF ELECTflICITY THIS INSPECTION NEQUEST WIIL NOT ?+,i99s-Midwey Bidp. - Room N•791 BE ACCEPTED BY THE STATE BOAND UNLESS PPOVEP INSPECTION FEE IS 1821 Universilv Ava.. 8t. Peul. MN 66104 Phone (612) 642-0900 ENCLOSED. u 5 ??? 23 1 fl, 3 -d , Reques? Da?e Ire No. ??n Inspeclion e iretl? Reatly Now XIhen Reed ?ector y Ves C No I-klicensed contrector J owner hereby request inspection oi above electrical work at: doo naaress Isreat. eox or Rouie No., Ciry Seceon No. _ TownsM1ip Name or No. Renge No. ? • County fy O ?T ?0 ?? __ j OccupantlPRIN TI \ Phone No. ) ? ( Power Supplier b6q??a- Aatlress ? / Eiemri omraaor ICOmpany Namel Cont tor§ License N0. o?r a y 6 z(- MaAmg AtlOress (COnhaclor or Owner Making Insiallalion, ? - Z / /C V if ( Author¢atl naWre iCOmractMOwnt Ma'e Installation) ? Phone NumOer !p ? e- 6 4 7 Zf ?_ _ -? ?. ? ?.?.y MINNESOTA dE BOl HD OF EIECTHIqtY THIS INSPEQiON FEOUEST WILL NOT Griggs-MiOway Bldg. - Poom 5473 ' BE ACGEPTED BY THE STATE BOARD 1821 llniveniry Ave.. SL Paul. MN 55100 . UNLESS PROPER INSPECTION FEE IS Phone(61Y) 642-000 ENClOSED. REQUEST FOR ELECTRICAL INSPECTION 0, See instmctions lor <ompleting this lorm on back ol yellow copy "X" Below Work Covered by This Request ? P ?'cq EB-DOOOt-OB ?.?..,- ?ew Atltl Rep. ? TypeofBuiltling AppliancesWired EquipmeniWired p Home Range Temporary Service Duplex Water Heater Elactric Heating t Apt. Building Dryer Oiher (Specify) Comm.llndusirial Furnace Farm Air Conditioner I OIDer (syeay) ConVacror's Remarks. 4 D ?YS e 14 el ? Compute Inspecfion Fee Below: p Other Fee # ServiceEniranceSize Fee # Circuits/Feeders Fee Swimminq Pool 0 to 200 Amps 0 to 100 Amps Transiormers Above 200 _ Amps ove Amps SignS Inspector's Use Onty: 1 a• p? 7OTA\ S l Irrigation Booms J ? , 3 Speciallnspeclion Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee jljr- COMPLETED WITHIN 18 MO S. I, ihe Electrical Inspectoc hereby Rougn-in certify that the above inspection has been made. ( Date •_/l ? OFFICE USE'JNLY ? This rei voitl t8 mi Imm p?$7 REQUEST FOR ELECTNICAL INSPECTION ea-00001-05 ._ ? See inatmetione lor complelin9 lhis form on baek of Yellow copy. ?QCpG _ 81SF;(a "X" Be/ow Work Covered by This Request fiew FAA Re0- 7VDe ol 9uilAine Aaolionces riired Equiymenl Wlretl Home Range Temporary Service Duplex Water Heater Lightiq Fiztures Apt. Building Dryer Electric Heatiii Commercial Bldg. Furnace Silo Unloader InMistrial Bldg. Air Conditioner Bulk Milk Tnnk Farm l e oeu v t er 15oer.;ty1 t er uccify ther Oth¢r Compute lnspection fee Belaw p Fee ServiceEnbenee5ize k Fea Feedera/Subteeders N Fee Circuita .QQ 0 to 200 Am s 0 to 30 Am s 0 tn 30 Am Above 200 qmps 31 to 100 Amps 31 to 100 Amps Swimming Pool ] Above 100_Am Above 700_Am s Transformers Irngation Booms Partiab'Other Fee , Signs Special InsUection 5 TO emerks 1 T? I ? w.. i floueh-in Date , 1, t Ele al r ?- o77} 4) InsOector, hereby certify thet the abova Final Lf?eL,q - in,,,c,;on has Oaen ' ? .ae. "le reGUeat vo1018 monlM Irom This repues[ vaid 7 78 months fmm B 1669 flequest Dat i a- - DLicensed Elechical ContraCtor ? Owner 7c 8?yi ZKI Neatly Nu ?11 Notity, InsOec-I ? r When Ready I hereby request insDaction of above elecbical work fnstailad et: St??dress, 8oz r Route No. 1 C. ecuo. o. Township Name or No. ange o. niv Occ nt (PflINT) Phone Na. Pow r Supplier Adtlress Elecvical Convacror (Ca ny Namql"^ L-.L Conv toi's Licen N=. Mai , B A ress IConvacto o wner Ma ne I? ' ationl fyl? Au orized•6ign mre IContractor Owner Maki B??stallation) ? Phon Numbe? ? MINNESOTA STATE 80AD Oi ELECTRICITV Orippe-Midwey Bltlp. - Noom N-191 1821 Univeraitv Ava.. St. Paul. MN 66104 Phene18121842-OBOO THIS INSPECTION NEQVEST WILI NOT BE ACCEPTED BY THE STAiF BOARD UNLESS PflOPER INSPECTION FEE IS ENCLOSEO. . 2000 STORM DAMAGE PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 !? ?? ? l a 651-681-4675 Reauiremenh ? 2 coples of plan DarE: s / 2-Z / U U \4 ?, -?k i1 V1w ?-_ \'v 2 DESCRIPf10N OF WORK: ex-Ap-? W c??'?k-e?ulH-family bidg., how mdny units? INDICATE THE POLLOWING EAUIPAAEM TO BE REPLACED AP1D BY WHOM: ? Plumbing _ Homeowner gs Contractor Name _ Mechanical _ Homeowner gE ConTractor Name "Note: If somebody other man me homeowner Is performing plumbing or mechanical work, fhey must apply forapproprlate permit. Only Iicensed plumbing coniraCtor or homeowner may complete plumbing work. STREET ADDRESS: LOT: 1- BLOCK: I SUBD./P.I.D. #: CONSTRUCTION COST: PROPERTY OWNER Name: R O V \c_,?? ? r'?,cPhone #: _O (c"B -73 U Lasf Fint Sheef (.04P, p CNy Stafe: MN?) Zip: Company: ? ?: c? ?ne #: G ? ? G/ :7 (area code) ? y S I o D,,.? CONTRACTOR n Sheet Address: / 3? License #a,4-p. city srate: i'?'1IJ np: .5 ?aG Co9 I hereby acknowledge iFwt I have read this opplicotion, state thatihe information is correct, and agree to compry wilh all appl"icabla State of Minnesota Stalutes and Ciiy of Eagan Ortlinances. Signature of Applicant: OFFICE USE ONLY BUILDING PERMIT SUBTYPES ? 07 Foundation ? 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.) ? 31 Ext. Att - Multi ? 02 SF Dwelling ? 08 06-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. AR - SF ? 03 01 of _ plex ? 09 07-plex ? 78 Deck ? 23 Porch (screened) ? 36. Muki ? 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage ? 05 03-plex ? 11 70-plex Plbg _YOr_N ? 25 Miscellaneous ? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bidg. WORK TYPE ? 31 New ? 36 Move Bldg. ? 43 Reroof ? 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding ? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair ? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors * Demolition permit - Give PCA handout to applicant GENERAL INFORMATION # of Stories sq. ft. No. of Units Length sq. ft. No. of Buildings Width Footprint sq. ft. Const. (Actual) Basement sq. ft. Census Code (Allowable) Main level sq. ft. MC/ES 5ystem UBC Occupancy sq. ft. City Water Zoning . sq. ft. Booster Pump PRV 2000 STORM DAMAGE PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 ? Q 651-681-4675 Reauiremanta D 2 copies of plan DATE: ?6?Z5 ?O z, CONSTRUCflON COST: ?,S a a DESCRIPTION OF WORK: If mulH-tamily bldg., how many units? INDICAiE THE POLLOWING EAUIPMEM TO BE REPLACED AND BY WHOM: _ Plumbing _ Homeowner gr Contractor Name _ Mechanical _ Homeowner gC Confractor Name "NOte: if somebody other than The homeowner is performing plumb(ng or mechanical wok fhey must apply for appropriate permit. Only ilcensed plumbing contractor or homeowner may complete plumbing work. STREETADDRESS: Yl'nkVVr Wcil/ 10 ?q a? 3 ONO O 1 LOT: -?- BLOCK: I SUBD./P.I.D. l? C'Ak I??uA ? fG? Name: 13/eg Gk Phone#: PROPERTY tast Flnt OWNER Sheet Address: ?(o K?z - Clly `-r 1 0--9A-ti? State: Zlp: Company:,?j'?8?,c2? ?-?.?Phonea: (area code) CONiRACTOR License #?i S? 7 07 E?cp Sheef Address: aty & P/s stcte.A/r/ zip: 5s`1 ? (? I hereby acknowledge fhaf I have read this applicafion, state that the informafion is correct, and agree to compry wilh all appGcable Stafe of Minnesota Stafutes and City of Eagan Ordinances. Signalure of , CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION *A1P3: PA7@SfiNP OF E'EE AT TSME OF arrr.icAMorr ooFS rOr CONSTITLTM APPROVAL OF PEL2MIT. iNSrDCriorr oF sEWM r,rro/ox vWM INLSTATJATTQjZS WjLZ IVO'p $E $CHED- CII,ID UNrII, PFRNIIT HAS BE:ErI APPROVID. ' P ease Print) 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: IE EXISTING STRLY.Z[.'12E, DATE OF ORIGINAL BIIILDING pERMIT ISSC'ANCE: (Month/Year) PRESENP ZONING/PROPOSID USE: q COM•fEE2CIAL/1ETAIL/OFFICE rl R-1 SINGLE FAMILY ? INIDCSTRIAL Q R-2 DL'PLEX (ltao Pnits) ? INSTI2L'TIOIVAL/GOVERIZ= ? R-3 10WbII-IOUSE (Three + Units) ( C?nits) R-4 APARTMMTf/CObIDOMINICTI ( Units) 2) NAME:_1ll 1'ck e L s ow h4- l? .twDMs:P.a•!t o ?C / 2 sr • cixY, srAxE, aIP: .S C? u; a n? w. S.S ? 73 PHONE:?/? ,? -S I 7I 3) ?- tuiME: ADDRFSS: CITY. STATE. 2IP: MASTIIt LICENSE# Plumbers License: Active ExPired Not recorded staff 7nit1al ? • • i?+• 4) NAME: aoDREss:_1uGG q.3F?l Ll?h?? /16?G ciTY, sraTE, zzP:_ 0LA1/n ,,.e PHONE: 2 8- 0 _ 5 •5) ? v ? r: • ?• : a • v• • a? ? CONNEC.TION M CITSC SE,'WII2 ?'?/CONNECPION ? CITY WATIIt ? OTf?R '. .. .?. 6) ? •?' C] PLEASE HOLD APPROVID PERMIT FOR PI C?P BY ONE OF ABC7VE _- ? PLEASE MAIL APPROVFU PEftMIT ZU 1,?3. 4. ABOVE ? (Circle one) PHONE: 7) r?. ui' l Y^ Y n^ // ` FOR CITY USE ONLY ? ? PERMIT # ISSL'ED L Pd w/Bldg. Permit FEES: $ $ 16 -S b SEWER PERMIT (INCLUDE SDRCHARGE) $ $ / b-S d WATER PERMIT (INCLLDE SORCHARGE) .. $ $ WATER METER/COPPERHORN/OC'TSIDE READER $ $ WATER TAP (INCLCDE CORPORATION STOP) $ $ SEWER TAP $ $ ACCOLNT DEPOSIT - SEWER $ $ ?S• C? d ACCOUNT DEPOSIT - WATER $ O • Gf ? $ WAC $ $ SAC $ $ TRLNK WATER ASSESSMENT $ $ TRCNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRL'NK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ A-12 .S /1 C/-O TOTAL . /?.7? RECEIPT RECEIPT DOES OTILITY CONNECTION REQUIRE EXCAVATION IN PCBLIC RIGHT OF WAY? Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY THE EPIGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CbNDITIONS: APPROVED BY: TITLE: DATE : /12-- 7 1.yolb . -CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION *R1P': PAYMENP OF FEE AT TIME OF r,Yrr.icATzoiu nors Nom rnNsrITUTE APPROVAL OF PFRNIIT. P ease Print 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: usr2 PeNku„? ,..A VlslOil or 'rax PdrCE IF EXISTING SIRCCiURE, DATE OF ORIGINAL BL'II,DING PIIRN1iT ISS[,'ANCE: - - (Mon Year PRESE[1f ZANING/PROPOSF9 LTSE: Q MMMERCIAL/RE,'PAIL/OFFICE n R-1 SINGLE FAMiLY r7 IbIDL?STRIAL Q R-2 DI'PLEX (Tr,o L?nits) f7 INSTIIL'TIONAL/GOVERIDENp ? R-3 10WNHOIISE (Three + Units) ( C?nits) . ? R-4 APARTMEfPP/COi,IDOMINIUM ( Units ) 2) nDDxEss:_.p• o 13ox/ ? fr -- ciTr, srazE, ziP:_ rj C Znf?.: a-fti,r/ - SS o'7 3 pxorE: t133 -S/ 7/ 3) r- NAME: ADDRESS: CITY, STATE, ZIP: PHONE: MASTER LICENSE# Active bcpired Not recorded St? tial 4) ??« • • i?• - - NAhE:- - 6-O ,O A. fi` !4 Z,V e ?-O Y.? ? _ rwDxFSS:_/V'6a 9 3 Y dL? ri?v-e 1V.E - cizY, srazE, ziP: 6 L q-1 a-e i'YL jV- PxorE: 5) ?? ?• ? w• • ?• : ? - ?• - ?. -- CONNF'.GTION Zl7 CITY SB'WER ?/ COI?pION M CITY WATII2 ? pTf?R . ? T" `- 6) 111?4'U^ ? PI.EASE HOLD APPROVID PII2MT FY)R PICIC-(JP BY ONE OF ABOVE ? PLEASE MAIL APPROVID PERMIT TC) 1S 2 3, 4. ABOVE : (Circle one) 7) ri ?SCT? ??/AO^-- ?C nvsPECTzoN oF sEWM Arro/Ct =waM rrErArramrONS WII.L NOT BE ° ED- [7LFD ONPII, PEFtMIT AAS SEQq APPROVID. TOR CITY USE ONLY' PERMIT # ISSOED ??6 • Pd w/Bldg. Permit FEES: $ $ ?D • S? SEWER PERMIT (INCLLDE SDRCHARGE) $ WATER PERMIT ( INCLL'DE SC'RCHARGE ) .. $ 63 'S-b $ WATER METER/COPPERHORN/OC'TSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ ACCOUNT DEPOSIT - SEWER $ $ ?S0Z0 ACCOONT DEPOSIT - WATER $ o. v--d $ wAc $ J 7 S l 6t--v $ SAC $ $ TRUNK WATER ASSESSMENT - $ $ TRUNK SEWER ASSESSMENT $ $ " LATERAL BEIVEFIT/TRONK SEWER $ $ LATERAL BENEFIT/TRONK WATER $ b $ - o) WATER TREATMENT PLANT SURCHARGE $ $ ' OTHER: $ $ De- TOTAL RECEIPT R ECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? ? YES IF YES, THE[V A"PERMIT FOR WORK WITHIN PUBLIC Q NO ROADWAY" MUST BE ISSL?ED BY THE ENGINEERING DIVISION IS . L T AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: CITY OF EAGAiV APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION *ATE: PAYMF'Nr OF FFE AT TIME OF APPLICAMON mES NOr CONMTM APPROVAL OF PII2NIIT. nusenMorr oF sESWEt r,rID/ox WMM TnicmAr.ramrpNS WII,L NOT SE S(7HED- ULID [R1PII, PERNIIT HAS BM APPROVID. S46 Zy (P, eate Pr nt) ) . 1) PROPERTY ADDRESS: T •- LEGAL DESCRIPTION: oZ ? 3C ?'?r Z Lot Block Subdivision or Tax Parc ID ) Zf' EXISTING STRLY.ZL'RE, DATE pF ORIGINAL BiJILDZNG PEEtP7IT ISSL'ANCE: " - PRFSENf 7ANING/PROPOSID L'SE: (Nbn Year} [] COMMERCZAL/RETAIL/OFFICE ? IbIDL?SZRIAL 0 INSTI'IL'TIONAL/GOVII2bIlNENT r7 R-1 SINGLE FAMILY (D R-2 DC'PLEX (4t,o Onits) Q R-3 70WNHOOSE (Three + Units) ( IInits) ? R-4 APARTMENT/COAIDOMINICTI ( Units) Z) ADDRMS: .o" pa x i-2? ciTY, srAZE, ziP:7? Ca.? a., a h. rv S' S ? 7? PHONE: ?13 -2 3) u ca• - NAME: ADDRFSS: CITY, STATE, ZIP: PHONE: MASTER LICINSE# Plimbers License: Active Fycpired Not recorded St?tial 4) •?« • • i?• ? N?ME: ( r d O ti (/ ,4 1, v•e ?O H?. 'e _ ADDRESS'-_I?/?U CI ? lY?[ LI?N - )1!F CITY. STATE. ZIP: ? L /F N -e /l1 /%/ 6-5'q? y - ?J f'5? PHONE: 7?'t d ? SSlU' 5) ? r• ? ? d: • ?• : ? o? • a?? CONNEC.'TION 1V CITY SEWII2 '?/CiDNNIDCTION 2U CITY WATER ? OTHER '. . 7 6) ? r• ? r ? PLF.ASE HOID APPROVFD PERNIIT FC)R PICK-L'P BY ONE OF ABOVE ? PLF.ASE MAIL APPROVID PERMIT TO 1 2, 3, 4, AHOVE : ti (Circle one) 71 FOR CITY USE ONLY PERMIT # ISSUED ' 796 cl -? Pd w/Bldg. Permit FEES: $ $ /b -5 b SEWER PERMIT (INCLDDE SURCHARGE) $ $ WATER PERMIT (INCLUDE SORCHARGE) .. $ $ WATER METER/COPPERHORN/OL'TSIDE READER $ $ WATER TAP (INCLLDE CORPORATION STOP) $ $ SEWER TAP $ $ 1,5--" ACCOUNT DEPOSIT - SEWER $ $ 7 ACCOUNT DEPOSIT - WATER $ $ wAc $ $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ ` LATERAL BENEFIT/TRL'NK SEWER $ S LATERAL BENEFIT/TRIINK WATER S WATER TREATMENT PLANT SURCHARGE $ $ OTHER: S ???> 7( S ? $ v?' ?. /1 d TOTAL RECEIPT RECEIPT DOES LTILITY CONNECTION REQUIRE EXCAVATION ZN PC'BLIC RIGHT OF WAY? F--j YES IF YES, THEN A"PERMIT FOR WORK WITAIN PUBLIC Q ROADWAY" MUST BE ISSCED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CbNDITIONS: APPROVED BY: TITLE: DATE: YlL?1Y16 ° CiTY OF EAGAiV APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION *1pTwE: PAYR*M' OF FEE AT TIME OF APPLscATIoN noES Nom oONsTTT= APPROVIII, OF PEE2MIT. INSPDCrSON OF SEWM ANID/CR WTER TISSTAi7.ATTON$ WR,j. NOj' $E $(HED- ULID UNPII, PII2MIT AAS BM APPROVID. ----------------------- P ease Print) 1) PROPERTY ADDRESS: ? LEGAL DESCRIPTION: lLOr/ttlocx/SUbaivision or Tax P IF EXISTING STRCt1L'RE, DATE OF ORIGINAL HI,'ILDING PII2MiT ZSSt'ANCE: (Nbnth/Year) PRFSENf 7ANING/PROPOSID LSE: ? Ca'?CIAL./RbTAIL/OFFICE ? R-1 SINGLE FAMILY Q IMX'STRIAL Q R-2 DL'PLEX (1WO Units) ? INSTII[,'TIONAL/GOVEF2N= ? R-3 MWNiOL?SE (Three + Units )( Units ) , Q R-4 APAR'Ima]T/COAIDOMIf7ILT1 Units) 2) ? NAM-_lu?ck?ec S?N aoDxESS: CITY, STATE, zIP: S C d n/ d I a ri\- rv 'S U7? PHONE:? 3 3 -S/ 71 3) u i: a• NAPE: p,DDRFSS: CITY, STATE, ZIP: ?.- , PHONE: MASTER LICIIVSE# . Active ? FScpired Not recorded S a?'tial 4) ??• • • 2- rAME:_ _ AnDRESS: I V4 O Q3 L p-N ?C -Nr /:E CITY. STATE, ZIP:?jL- ltAN w- Ih/V ^ SSel 3 PHOI?: 7 ?O ^.SS/CJ • •5) ? :? vi r. • ?• : a • o? - ?? ? CON[gCTION 10 CITY SEWII2 '03/CONSIF77L`TTION ZU CITY WATER ? OTfIER '. . 6) r r u.. Q PLEASE HOLD APPROVID PEE2MIT FC)R PICK-OP BY ONE OF ABOVE ? PLEASE MA2L APPROVID PERMIT 1O 102 3, 4, ABOVE n „ ' _ (Circle one) TOR CITY USE ONLY PERMIT # ISSCED 'r Pd w/Bldg. Permit FEES: $ $ 16 -S ? SEWER PERMZT (INCLODE SURCHARGE) $ $ /b' S? WATER PERMIT (INCLUDE SL'RCHARGE) .. $- W 7J'.5? $ WATER METER/COPPERHORN/OIITSIDE READER $ $ WATER TAP (INCLODE CORPORATION STOP) $ $ SEWER TAP $ $ ?S ? ?J ACCOUNT DEPOSIT - SEWER $ $ /S <?-Z) ACCOUNT DEPOSIT - WATER $ Sa c) ° (J 6 $ WAC $ ?1 7 S• V-? S SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ " LATERAL BENEFIT/TRL[VK SEWER $ $ LATERAL BENiFIT/TRONK WATER $ $ WATER TREATMENT PLANT SLRCHARGE $ $ OTHER: $ ??/ YS'? S J7. TOTAL RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? ? YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SLBJECT TO THE FOLLOWI[VG dONDITIONS: APPROVED BY: TITLE: DATE: ??Z7` /` fO COMMERCIAL SV I?? 2002 BUILDING PERMIT APPLICATION CITY OF EAGAN 651-681-4675 113 2s- Foundation Onl New Construction Interior Im rovement • SWCtural Plans (2) sets • Mchitecturel Plans (2) sets • Nchitectu2l Plans (2) sets • Civil Plans (2) • Structurel Plans (2) • Code Analysis (1) " • CertifipteofSurvey (1) • CivilPlans (2) • PmjectSpecs (1) • CodeMalysis (1)" • LandsppingPlans (2) • KeyPlan (7) • ProjectSpecs (1) • CodeAnalysis (1)" • Master Exit Plan (7) • Spec. Insp. & Testing Schedule " • Certifipte of Survey (t) • Energy Calculations (1) not always" • Soils Report (1) . Spec. Insp. & Testing Schedule (1) " • Elec. Power & Lighting Form (1) notalways" • Meter size must be esiablished • Meter size must be established • Meter size must 6e esfablished - if applicable • Project Specs (1) 1 • Energy Calculations (1) ? 1 1 • . ElectricPower&LightingFortn Master Exit Plan (1)" (1) U 1 • Fire Proteclion Plan (1)" D { O?,?Q2 y • SoilsReport (1) ?QY d • MGES SAC detertnination letter • MC/ES SAC determination letter • MC/ES SA termination letter ca11 6 5 1-6 02-1 0 00 ca11651-602-1000 ca11651-60 0 ? Contact Building Inspections for sample Food & beverage or lodging facilities - md lan to MN DepaRment of Health. Ca11 651-21 5-0700 ?y Ra?? e,l;?. c?r S DATE: ??1 dlO? ?-ORKTYPE: _ NEW _REMODEL CONSTRUCTION COST: SITE ADDRESS.4W "4112!)I ? TENANT NAME FORMER TENANT NAME, TF APPLICABLE: DESCRIPTION OF WORK a,6 1 , ScV- 4 SUITE #: ot? PROPERTY OWNER CONTRACTOR ARCHITECT/ ENGINEER Las[ ? City: ? 1 11?M? State: 1 1 llv Zip: t?? ?(?C? ttilhJ Compan?lll??i1 ' 1vV? Phone#: (?) l?l?lJ QYJYv Street Address: City: 6t ir Company: _ Name: Street Address: City: Licensed plumber installing new sewerhvater State: bli _ Zip: &117 Phone #: ( Registrafion #: _ State: Zip: Phone #: I hereby acknowledge that I have read this application, 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: ^ ? Updated 1f02 f^. OFFICE USE ONLY SUBTYPE ? Ol Foundation ? 26 Public Facility ? 30 Accessory Bldg. ? 14 Apartments ? 27 Commercial/Ind ustri al ? 32 Ext Alt - Apts. ? IS Lodging ? 28 Greenhouse ? 34 Ext Alt - Comm. ? 25 Miscellaneous ? 29 Antennae ? 35 Ext Alt - PF ? 37 Nail Salon WORK TYPE ? 31 New ? 35 Tenant Impr 0 42 Demolish (Foundation) ? 46 Windows/Doors ? 32 Addition ? 36 Move Bldg ? 43 Reroof ? 47 Repair ? 33 Alterations ? 37 Demolish (Bldg) ? 44 Siding ? 48 Authorization ? 34 Replacement ?. 38 Demolish (Int) ? 45 Fire Repair GENERAL INFORMATION Census Code ' Zoning sq. ft. SAC Code # of Stories sq. ft. No. of Units Length sq. ft. No. ofBldgs. Width sq. ft. Const. (Actual) Basement sq. fr. MC/ES System (Allowable) FirsUFloor sq. fr. . ?? • 1 - ' ?.' 'City..Watet ' ' ?• ?' ? : ' ? UBC Occupancy ? - sq. ft. - • . ' ' ? •Fire Sprinkle,red n ? ? :" , ^R+ .'• `J?? ?,?, y? R?. ,' I'1 ?? MISCELLANEOUS INSPECTIONS ' ' ?' • ?" ? ? Gas Service Test ? Aearing ? Insulation Q Plumbing ? Stucco/Stone APPROVALS : ?,•, ., ,. . , , . . '' ' . Planning -.Buildirig' ? O ' • • ? En?I1eering (t t Vfirianc,e ..--? : ,ll • t .•.. eS. ' .? . _, i 1,? Permit Fee • ,. ? , .? .. Surcharge Plan Review MC/ES SAC •? . -' •i? City SAC Water 5upply & Storagq , S/W Permit • S/W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Other Copies V4UA71¢N$'r ? ? '? ? ? , •• „ % SAC SAC Units • , Meter Size , ....+.. ? ,..:? .?;, . , . . , . . , ? ?.' • :, ., ? .. i . . , •? .? . . ? , ?. Total I , CEHTIFICATE OF SUf7 VEY, For.• GOOD VALUE HOMES ? ? ? ? ??c\\ ? C.R. WINDEN & ASSOCIATES, INC. Land Planning, Surveys & 5ite Design f381 Eustis St., St. Paul, MN 55108 Tel. 845-3848 `q_ =_ \ ? ? ,k ? / ? Lots 1 through 4, inclusive, Block 1, JOHNNY CAKE RIDGE FOURTH ADDITION, Dakota County, Minnesota. L EGEM7 XXX.X Denotes ExlstlnB E]evatlon (X%X.X) Denotea ProposeO Elevation o Denotea iron Monument O Uenotes Mooden Stake .? Denotes Sur}ace Orainage R^oposeO hbuse Elevatlons TOp af FounUatlon - Garage F1oor 94315 8asement Flaor _ - . scale f' - B.M. Tloz_f Datum I HEREBY CERTIFY ?HAT THIS SURVEY, PLAN, OR REPORT WAS PREPARED BY ME OR UNOER MY DIRECT SUPEFVISION AND THAT I AM A DULY qEGISTERED LAND SURVEYOR UNDER 'HE LAXS OF THE STATE OF MINNESOTA. Dated this 9+h day af Seoic? fici . 19 86. C.R. MINOEN 6 ASSOCIATES, INC. BnaF-:- Page_ by MSnnesota Registration No. 77z?,. FI / C , 1986 BUILDING PEEgiIT APPLZCATIOH - CITY OF EAGAN NOTE: ALL CONTRACTORS MOST BE LICERSED WITH TSE CITY OF EAGAN SINGLE F6MIILY DiIELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SUAVEY, 1 SET OF ENERGY CALCULATIONS M[ILTIPLE DWELLINGS - RESIDENTIAL RfiNTAL OHITS FOR SAGS IINITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIR9EY - CHECg WITH BLDG. DEPT.* 1 SET OF ENERGY CALCULATIONS COAMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE HOND To Be Used For: Valuation: Site Address Lot '-/ Block Parcel/Sub Owner Address City/Zip Code Phone '27S2- Contractor Address City/Zip Code Phone Arch./Engr. _ Address City/Zip Code Phone # Erect Remodel Repair Addition Move Demolish Int.Impr. Install Date: /' ?- IF{o Occupaney Zoning Type of Const # of Stories Length Depth Sq Ft APPROVALS FEFS Assessments Permit Water/Sewer Surcharge Police Plan Review Fire SAC Engr Water Conn Planner Water Meter Council Road Unit Bldg Off Treatment P1 APC Parks Variance Copies TOTAL HOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER HQST DESIGNATE AHICH ADDRESS IS DESIRED. NO CHANGES IiILL HE 9LLOWED ONCE BIIILDING PERMI2 IS ISSQED. / 1986 BDILDING PERlSIT APPLICATION - CITY OF EAG91 NOTE: ALL COtTfRACTOHS MOST BE LICENSED HITH THE CITY OF EAGAN SIlYGLE FAPIILY DTiELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS MOLTIPLE DiIELLIAGS - RESIDENTIAL RENTAL IJNITS FOH SALE IINITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SQRVEY - CHECg iiITH HLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMAIERCI6L INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENEHGY CALCULATIONS, $2,000 LANDSCAPE BOND To Be Used For: Valuation: Date: Site Address OFFICE USS ONLY Lot 3 Block ? Erect _ Occupaney p / Remodel Zoning Parcel/Sub ?j?r?,t?,l•?,•L?_ y'ff' Repair Type of Const Addition f1 of Stories Owner Move _ Length Demolish Depth Address znt.Impr. _ Sq Ft Install City/Zip Code Phone APPR09AIS FEFS Contractor Address City/Zip Code Phone Arch./Engr. _ Address City/Zip Code Phone # Assessments Permit Water/Sewer Surcharge Police Plan Review Fire SAC Engr Water Conn Planner Water Meter Council Road Unit Bldg Off Treatment P1 APC Parks Varianee Copies TOTAL NOTE: 6DDRESSES EOR CORNER LOTS - CONTAACTOR/HOMEOANER MDST DESIGNATE WHICH ADDRESS IS DESIRED. NO CH9NGES WILL BE ALLOSiED ONCE BIIILDING PERMI? IS ISSIIED. 7) 1986 BOILD2NG PERiLT 9PPLICATIOg - CITY OF EAG6N NOYE: ALL CONTRACTORS MOST BE LICENSED BITH THE CITY OF EAGAN SIAGLE FgMMY DWELLIAGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCIILATIONS MOLTIPLE DiiELLINGS - RESIDENTIAL RENT9L IILiITS FOH SALE UNITS INCLUDE 2 SETS OF PLANS, CERTIFIC9TE OF SQRVEY - CHECB iiITH BLDG. DEPT., 1 SET OF SNERGY CALCULATIONS 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: Ix Valuation: Site Address Lot o Block / Parcel/Sub Owner Address /yG6 3.r?L/ll City/Zip Code Phone Contractor S? Address City/Zip Code Phone Arch./Engr. _ Address City/Zip Code Phone # Erect Remodel Repair Addition Move Demolish Int.Impr. Install nate: 9-- 9-8G Oecupancy Zoning Type of Const If of Stories Length Depth Sq Ft APPROVAIS FEES Assessments Permit Water/Sewer Surcharge Police Plan Review Fire SAC Engr Water Conn Planner Water Meter Council Road Unit Bldg Off Treatment P1 APC Parks Variance Copies TOT9L NOTE: ADDRESSES FOR CORNER LOTS - CONTRACYOR/HOMEOWNER HIIST DESIGNATE WHICH ADDRESS ZS DFSIRED. NO CH9NGES WILL BE ALLONED ONCE BQILDING PERMIi IS ISSDED. " • , • t ? ? /`? / ( / ? L/ 1 ~ 7986 BDILDIRG PERlSIT APPLICATZOP - CITY OF EAGAH HOTE: ALL COA'fRAC'f09S MtTST BE LICENSED fiITH THE CITY OF EAGAN SIAGLE FAMILY DiiELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEYt 1 SET OF ENERGY CALCULATIONS M[1LTIPLE DWELLIAGS - RESIDENTIAL RENT9L iJNITS FOE S9L8 ONITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SQR9EY - CHECB iiITH BLDG. DfiPT., 1 SET OF ENERGY CALCULATIONS COMMERCTAT" INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 7 SE2 OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND To Be Used For: Valuation: -?? Date: Site Address Lot _I Bloek Pareel/Sub Owner Address City/Zip Code Phone Contractor -9!k- Address City/Zip Code Phone Areh./Engr. _ Address City/Zip Code Phone 11 Erect ? Oecupaney Ifs Hemodel Zoning Repair Type of Const Addition # of Stories Move Length ? Demolish _ Depth p? Int.Impr. _ Sq Ft Install _ APPROV9IS FEES Assessments Permit ? Water/Sewer Surcharge Police Plan Review "j Fire SAC 15 Engr Water Conn Planner Water Meter , b Council Road IInit Bldg Off Treatment P1 APC Parks Variance Copies TOT9L ? NOTE: 6DDRESSES FOR CORNER LOTS - CONTRAC?OR/HOMEOWNER lSIIST DESIGNATfi iIHICH ADDRESS IS DESIRED. NO CHANGES HILL BE ALLOHED ONCE BDILDING PERMIY IS ISSOED. , CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MN 55122 PHONE: (612) 454-8100 MABII±YG'az'1'1FM pm -------------- WORK DESCRIPTION NEW CONST _ ADD ON ? REPAIR _ OWNER NAME: " (? I ?-L-u Pt SITE ADDRESS;?(9 RA6+JG U)AN 1L-A(,? S??2Z LOT: l BLOCK I SUBDa4WN`( C?VcRN'kt I2u AODiTt°A) INSTALLER: S1 si «L IA& ADDRESS: 408 e-t'K"t W? ?lTY:C ZIP: 5S12Z PHONE #: AJZ T&(& _ n . ? IGNATURE OF COMPLETE THE FOLIAWING: N0. FIXTURES EA. TOTAL ADD-ON MINIMUM 15.00 S ? ? HOWER ? WATER CLOSET . 0 BATH TUB 3.00 J_ LAVATORY .?6 _ KITCHEN SINK 3.00 LAUNDRY TRAY 3.00 _ HOT TUB/SPA 3.00 WATER HEATER 3.00 _ FLOOR DRAIN 3.00 GAS PIPING OUT. _ (MINIMUM - 1) 3:00 ROUGH OPENINGS 1.50 _ OTHER WATER SOFTENER 5.00 _ PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 SUBTOTAL $ ST. SURCHARGE .50 . ?? f 5 TOTAL: $ ?bMMELtCIfsi.j3NDUST&TAI.c; PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND MSILTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: OWNER NAME: PLEHSE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS 6 TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH IINIT. ti SITE ADDRESS: LOT: BLOCK _ SUBD. INSTALLER: ADDRESS: CITY: ZIP: PHONE #: FOR: CITY OF EAGAN FOR CITY USE ONLY PERMIT # -1 RECEIPT # ' DATE: /3 FEES 18 OF CONTRACT FEE. STATE SURCHARGE a $.50 FOR EACH $1,000 OF PERMIT FEE. $25.00 MINIMUM FEE. CONTRACT PRICE x 18 $ STATE SURCHARGE TOTAL: ( S I GNAT[JRE ) 1991 B ILD NG PERMIT APPLICATION ? CITY OF EAGAN ? SINGLE FAMILY DWELLINGS MJLTIPLE DWELLINGS COMMERGIAL ? ? 2 SETS OF PLANS 2 SETS OF PIANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 S&T OF SPECTFICATI:ONS 1 SET OF ENERGY CALCUTATIONS 1 SET OE ENERGY CALGS # OF RENTAL UNITS # OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PIGKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER IATS - CONIRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS' IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED: _ PROCESSING TIME FOR SEWER & WATER FERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN-COMPLETEDs PERMIT MUST SHOW A LICENSED PLUMBER. To Be Used For: Valuation: ? Date: 6 7 ql Site Address 4(o 7Q OFFICE USE ONLY Lot 14 Block ? FEES Occupancy B1dg. Permit ??' aD Zoning Surcharge .vD Parcel/Sub Actual Const Plan Review ?A ? Owner VVIN-? Allowable # of stories SAC, City SAC, MWCC Length Water Conri. ? Address Depth Water Meter S.F. Total Acct. Deposit City/Zip Code Footprint S.F. S/w Permit SJW Surcharge Phone On site sewage^ Treatment P1. ?''(` ? ?rr E o On site well Road Unit Contractor ..1 OL cI Y+? MWCC System _ Park Ded_ ? g? err City water Trail Ded. ` b Address i 1?• PRV ` Copies ?S s ? 1'? Booster Pump _ L City/Zip Code r SUBTOTA APPROVALS Penalty Phone Planner Lot Change ?-y? Council TOTAL J ?a- ` Arch. /Engr. b^j Q- 1 Bldg. Off. L\ Variance Address City/Zip Code ? Phane # agrees that all work shall be done in accordanc`e with ture of Contractor) all applicable State of Minnesota Statutes and City of Eagan Ordinances. ?____-_--______-__i 1 ? Permit #: ? I ? ? Pertnit Fee: ? I j Date Received: ? I ? ? Staff: I 2008 MECHANICAL PERMIT APPLICATION Date: Site Address: Tenant: Sulie #: Name: .5'is t??¢i:?6G?r-???9ck' Phone: ? RESIDENT/OWNER . . Address / City / Zip: 4?6+1 4/ ?.?/<Z2 CONTRACTOR Name: license #: Address: City: State: Zip: Phone: Contact Person: TYPEOFWORK -New I?Replacement _Additional _Alteration Demolition Descriptionofwork;:. ???'UJGa'-dle`?/????7?/AL sCt/2-?.??s- NOTE• BatN roof mounted and ground mounted mechanical equlpmeni fs required ta. ? .: be screened'I?y City Code., Please contact the A9ecfianica! Inspeclar qtvne of the x. • Planners for infoririation on ermfitted screeMn -methods. " RESIDENTlAL COMMERClAL PERMIT TYPE L?'Fumace _ New Construction _ Interior Improvement Air Conditioner _ Install Piping _ Processed Air Exchanger _ Gas _ EMerior HVAC Unit ' _ HVAC units must be screened Heat Pump Under / Above ground Tank L_ Install /_ Remove) Other " When installing/removing tank(s), call for inspection by Fire Marshal and Plumbin ins ector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $50 State Surcharge) , $90.50 FIfB fBp211 (replace bumed out appliances, duciwork, etc.) (includes $.50 State Surcharg2) $ TOTALFEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ x 1°h $50.50 Minimum (includes State Surcharge) _ $ Permit Fee - If Perrnit Fee is less than $1,000, surcharge is $.50. - If Perrnit Fee is >$1,0DO, surcharge increases by $.50 for each =$ Stat2 SurCh8rg8 $1,OOD Pertnit Fee (i.e. a$1,001-$2,ODD Pertnit Fee requires a$1.00 sumharge). $ TOTALFEE I hereby ackrrowledge that ihis infortna[ion is comple[e and accurate; that the mrk will 6e in conformance with the ordinances antl codes of the City of Eagan; that I understantl this is not a permn, but only an application for a pertnd, and mrk is not to staA without a pertnit; that ihe mrk will be in accoMance with the approved plan in the case of mrk which requires a review and apprwal of plans. X ApplicanYs Printed Name Ap "licant's Sig aiT"fure `.FOR OFPICE USE ' Reviewed By:..Datet Required Inspections Under Ground Rough ln Air Test _Gas Service Tesb In-floor Heai' Final SEDGWICK HEATING & AIR CONDITIONING CO. HEATING JOB NO.A05-37 8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 • (952) 881-7739 / TEST RECORD ADDRESS CITY' " A OCCUPANT ~YJ OWNER SOLD BY INSTALLED BY all 11 u ' 3 MAKE' MODEL SERIAL NO.d INPUT U(19 THERMOSTAT VENT SIZE VALVE TYPE OF LINER. Lit LIMIT LINER SIZE U. " LIMIT SETTING I FILTERS: SIZE NUMBER/ FAN SETTING WIRING ~~X Q IC PILOT TYPE TEST TAG w IGNITION MODEL +S ► LIGHTING INST. PILOT TIMING DATE TESTED PRESSURE L PERCENT CO, TESTING INPUT CFH 1,62 PERCENT 02 COMPANY STACK TEMP. PERCENT CO del NAME OF TESTER FORM 235 (REV. 6/08) FORM DISTRIBUTION: WHITE COPY - JOB FILE YELLOW COPY - CITY PERMIT City of Eagan Permit Type: Mechanical 3830 Pilot Knob Rd Permit Number: EA091810 Eagan, MN 55122 . Date Issued: 10/28/2009 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 4648 Penkwe Way Lot: 4 Block: 01 Addition: Johnny Cake Ridge 4th PID 10-39803-040-01 Use Description: Sub Type: e - Furnace & Air Conditioner Work Type: New Description: Furnace & Air Conditioner Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952) 445-2840 Fee Summary: ME - Permit Fee (Replacements) $50.00 0801.4088 Surcharge-Fixed $0.50 9001.2195 Total: $50.50 Contractor: -Applicant - Owner: Sedgwick Heating & Air Sandra K Hovland 8910 Wentworth Ave S 4648 Penkwe Way Minneapolis MN 55420 Eagan MN 55122 (952) 881-7739 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. Applicant/Permitee: Signature Issued By: Signature