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3106 Pilot Knob RdCITY OF EAGAN Remarks Addition Section 10 Lot 1 sik Parcel 10 01000 010 30 Owner Street 3108 PilOt Knob Rf3. Stace E2.gan,MN 5512.1 ?7o Dah _ 31a:W -C Improvement Date Amount Annual Vears Payment Receipt Date STREET SURF, * STREET RESTOfl. 1975 GRADING SAN SEW TRUNK 1970 189.00 Paid " * SEWEfl LATERAL cXK9 19 2741.85 137,09 20 Paid WATERMAIN ? WATERLATERAL 1970 798.52 0 WATER AREA 7/9 ? STORMSEWTRK 1984 495.00 . 33.00 15 495.00 C008325 8-3-83 STORM SEW LAT gDy' 1984 495.00 33.00 15 495.00 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 230.O 2276 -9-70 BUILDING PER. sac 375.oc 8 11-15-73 PARK ? 1 This request void ? j U 3L??c .?b 18 months from Date of th s Request MaT'Ch 2?, 1Q?1 Fire No. J, 16585 l, as fl Licensed Electncal Contractor OOwner, do hereby request inspection of the above electri- cal wiring installed at Street Address or Route No. -3106 Pllot Knob Rd. City Fagan Section Towns}up Range County DpkOt& Which is occup;ea by Paul Dghler (Name ot Octupant) Is a roughin inspection required on this job? No ES Yes ? Ready Now 12 Will Call ? Power Supplier NSP Address 3000 MaXw 7 7 AvP _ Electrical Contractor Benke Electrical Cnnt ConVactor'sLicenseNo4Q3.Q'j (COmpany Name) I Mailing Address A? o ow Authorized Signature ?_? ATi/}ai Bhone No. 22?L- 59?15 (Elacf?arcont?actor o? Ownef ftfking Thls Installatlon) ? 1? /„? ?? This inspection requert will not 6e accepted by the tJ i,?j l?lltt l?, State Board unless proper inapecfion fea is enclosed. mmnesoca sqte etoara ot eiactncity Griggs Midway Bidg. - Room N191 ??' EB-00001-02 7827 University Ave., St. Paul. Minn. 55704 - Phone 297-2111 ` 4d"EQUEST FOR ELECTRICAL INSPECTION 3 CFlIEC& B'ELOW WORK COVERED BY THIS REQUEST ? T 16585 Type o[ BuAding New Add. Rep. Check Appliances Wieed Foi Check Equipment Wired For Home ? ? ? Range 11 Temporary Wiring ? Duplex ? ? ? Wate[Heater ? LightingFixtuies ? Apt. Bidg. ? ? ? Dryer ? Electric Heating ? Commercisl Bldg. ? ? ? Fumace ? Silo Unloader ? ]ndustrial Bldg. ? El ? Aiz Conditioner ? Bulk Milk Tank ? Fum 0 ? 0 List List Other ? ? ? p Heiersl p Heiers? COMPUTE INSPECTION FEE BELOW Service Entranm Size: # Fee Feeders&Subfeedeis: u Fee C¢cuita: # Fee 0 to 100 A s. 0 ro 30 Am eres 0 to 30 Am eres 101 to 20 - s. : 1 to 100 Am res 31 to 100 Am eres Above 20 t-.:?-' ? : bove 100 Amps. Above !00 Amps. Transform " RemoreControlCirc. Pa[[ialoro[herfee Signs S ecial lns ection Minimum fee S 5.0 Remazks FrOID fUSeS t0 circuit breakers TOTALFE . 0 I, the Electrical Inspector, hereby certify that ttp abo%inypeGtion has been ma e. (Final) This request void 18 months from [S?d ?x? ? .EC:• ( U ' j ?.- . ,u . : . , S ? 4 p/-ooo O/o 30 01'kD[GANcZ-.1,0. a: Pe:mi[ Yu. WELL CON-STRliCIIONAND ABANDON1fEVT / WELL PERMIT 90-9003 •"""?',z DAgOT?, COL°, iTY PUBLIC AEat.'I'H DEPAR'IrylELN'I' EWIRONhiE?`7TAL HE.fI.TIi SERVICES SECTION , ? WliTER QUALTIY MANAGEMENT UNTT 33 E Nennvorth Ave., Wcst SL Paul, MN 55118 Telephonc: (6L)450.2607 WBEREAS, the DSA: Maher Well Drillinq ADDRE88: RT. 1 Hastings, P4d 55033 has suhmitted a permit application, has paid the sum of one hundred ($100.00) dollars to the County of Dakota as required by Ordinance Number 114 and has complied with all of the requirements of said Ordinance necessary for obtaining this permit to permanently seal the well or wells described herein: An abandoned Water supply vell.with a casing diameter of 4 inches and approxi.mately 147 feet in depth. The well.shall be cTeaned of equipment and debris, disi.nfected, neat cement pressure grouted and terminated at least two feet below grade. The well is located in the municipality of Eagan on the.property of: Owner: Marte Dehler Address: 3106 Pilot Rnob Rd. Eagan, MN 55121 Telephone: (612) 454-3682 NoW, THEREFORE, Maher Well Drilling is hereby permitted and authorized to permanently seal the well or wells described and located above for the period February 27, 1990 to February 27, 1991 subject to all provisions of said Ordinance, the Minnesota Water Well Construction Code and any conditions attached on the reverse side of this permit form. Given under my hand this 27th NON-TRANSFERABLE day of February, 1990. ENVIRONMENTAL FiEALTH SPECIALIST ???d'uCl??'Y1 ATTEST ?i rtt. ?i ENVIRONMENTAL HEAL SUPERVISOR PUBLIC HEAL:H DIRECTOR EAGt1N 2YIWNSHIP 3795 Pilot Knob Road St. Paul, Miaaesota 55111 Telephone 454-5242 PER141T FOR WATER SERVICE CONNECTION Date: April g, 1970 Billiag Name: G. Paul Dehler Owner; G. Paul Dehler Plumber: Weierke Trenchina & Excavating Number: 422 /p 61U0U_ d/v .3C) Site Address:3106 Pilot Knob Road Silling rkldress 3106 Pilot Knob Road of Connection Meter Size5/611 Conaection Chg. P4/9/70 Account Deposit 15.00 pd 4/9/70 Meter No,68i8471 Pexmit Fee 10.00 pd 4/15/70 Meter Reading111,00 Meter Dep. Meter Sealed: Yea Add'1 Chg. NO Total Chg. Inspected by Buildiag is a: Residence xx Multiple No, Commercial Industrial Other Date Rzosarka: Sy: Chief Inspector In coneiderat3on of the isaue and dalivery to me of the above permit, I hereby agree to do the proposed woxk ia accordance with the rules and regulations of &agan Township, Dakota County Miaaesota. By: ?,? Weierke Trenching & Fxcavating Rosemount, Minn. 55068 Please notify the abwe office when ready for inspection and connection. viuaoE oF [aoaa SEWER SERVICE PERMIT 3795 Pilot Knob Rood - ? Eug un. MN 55127 PERMIT NO.: 2112 ? - 'Loninq: A DATE: 1 111 . -- -_.._-..--_. . Owner:_?- Panl Il C lPY_._ . No. of UNte? i ? . - ? . . . Address: Site Address; -314fi3i2at_Kn,h?pg? Plumber: _ I oyree to tomplr wifh t1y Vilbg. n{ . , ' 1.9o. CoiSnectfon Charge3l5 00 Ad O rdinances. Account Ikpoelt 5.00 pd Permit Fee: 10 00 ad BY' Surchazge: $p pd ? . Date of Ins ? . p.: Ch ? . ? - .. Miec ??? Inap.: _ TOtal: . . ti?. iTate Peid: _?. , ? 1COUNT Y NORMA BBMARSH AUDI DAKOTA COUNTY GOVERNMENT CENTER 1580 HWY. 55 - HASTINGS, MINNESOTA 55033 MAR 3 0 W 138 PROJECT ORIGINAL AMOUNT S 6771.51 _ DATEi :larch 28, 1990 T0: Ronald L. & Mary J. Shaw FROM: Norma B. Marsh, County Auditor A document between i4artha A. ?ehler and Tfary J. & Ronald L. Shaw has been presented for recording on parcel LO-O1000-U10-30 This property is benefited by the following Senior Citizen Deferred special: assessment: The deferred amount must now be paid. Please contact the City Clerk's Office at Eagan , Phone # 454-8100 to obtain the amount due to be pald to the City. Norma B. Marsh Dakota County Auditor ? lia an cc: 'City of ? NOTE.: _P.lease send us a_.copy of the receipt when this is paid. / \ .--14 C° l 6 1.? % ` ? ct ?? ??.} . r , AN E9UAL OGPORTUNITY EMPLOYER ; 13 J v \ :J v ? Form No.6 M-WApqqNT/ Individuel ld to Joint TenaMs ? No delinquent taxes and tranafer entered; Certificate of Real Estate Value ( ) filed ( ) not required Certiticate of Real Estate Value No. _,19 County Auditor by Deputy STATE DEED TAX DUE HEREUN: $? n Date::4lALci-+ I ,1gLv (reserved for recording data) FOR VALUABLE CONSIDERATION, Martha A. Dehler, aka Marthe Dehler and aka Martha Dahler, a sinele oerson ,Grantor(s), Mary J. Shaw and Ronald L. aw here6y convey (s).and warrant (s) to tenants, real property in , Grantees as joint County, Minnesota, described as Pollows: The North 199.63 feet of the West 228.2 feet of the Southwest Quarter of the Northwest quarter, Section 10, Township 27, Range 23, according to Che plat thereof on file and of record in the office of the County Recorder, in and for Dakota County, Minnesota ' lif more space is needed, continue on backl together with all hereditaments and xppurtenances belonging thereto, sut SuUject to restrictions, reservations and easement-§01110" IF•n? `?th3 A OF L V } ss. ? ? of _.,IU,A41 (A- 119 `i G , 7, a sing e person Grentor(s). _..._ TARIA TAMP OR 3 (O THER TITLB OR RANK) ? ,? •.- i.LR{i1 I?.•_„? yi.1s I .. . ~ ?TARY ,t1;4'r:'MTH 14 00D....?. , . j ?' ?1w ER;A': Jl4'! 7 1?11 THIS INSTRUMfiNT WAS DMFTED BY (NAME AND ADDR88S); ' UN1Vc':?SF1. Fcr^n.-.yV 51:n,/1Cri C71 L. Tax 8tabmmp fov Che :ad plopOrty dNodbed In ehls Wtn+Abt WoWd bs sant to pncluda nuno md addreu ot asmtes): Mary J. Shaw and Ronald L. Shaw 3106 Pilot Knob Road Eagan, Mn 55121 L:/ /f f?? ,, i? ??G ? ? ? C j ? or 3830 PILOT KNOB ROAD, P.O. 80X 21199 EAGAN, MINNESOTA 55121 PHONE: (612) 454-8100 October 21, 1987 MARTHA DEHLER 3106 PILOT KNOB ROAD EAGAN MINNESOTA 55121 Re: Dear Mrs. Dehler: BEA BLOM9UIST Mayor 7FiOMAS EGAN .14ME5 A. SMffH VIC ELLISON iHEODORE Wl+CHTER Coundl MembMs iHCMPS HEDGES CAy Pdminimotw EUGENE VPN OVERBEKE City Cleik In official action of the Eagan City Council at its regular meeting held Octboer 20, 1987, your application for the above- referenced deferment was approved. Please note that this deferment will be recorded against the subject property and will be collected upon a change of the status of the property. To be sure that no error has been made, examine your 1988 property tax statement to determine that no amount is listed as due for the deferred assessment. Please contact me or any other member of the City staff if you have any questions or would like any additional assistance. Sincerely, ?,,y`?,` V?,'h V?l..?{lf?_. E. Y?. VanOverbeke, CPA Finance Director/City Clerk cc: Special Assessment Clerk Kivi EJV/kf THE LONE OAK TREE. .. THE SYMBOL OF STRENGTH AND GROWfH IN OUR COMMUNIN APPLICATION AND AUTHORIZATION FOR DELAYED PAYMENT OF TAX ' ON SPECIAL ASSESSMENTS FOR SENIOR CITIZENS' HOMESTEAD LAWS 1974, CHAPTER 206 STATE OF MINNESOTA) _ COUNTY OF DAKOTA ) - DATE `S e n 1" ?? 19? T0: County Auditor, Dakota County, Minnesota I, the undersi ned, declare under penalties of perjury: That I reside at ?/U Co ?o?Kn o i? a n M n That I am not less than 65 years of age and that the date if my birth is? y,y . 1'hat I am the owner of the property legally described as: Townshin 27, Ranee 23 S tion 10 - N 199.63 ft of W 228.2 ft of SW 1!4 of NW 1!4 , Property Identification No./O-O/voo - o/o _-?o That my interest in the ownership of the above property was aquired on lo _/ yC, 3 19_L3 and is as follows: ' 1. Sole awnership (Enter Ye 2. Joint tenancy, held with 3. OTHER undivided interest That on January 2, 19_?_or June 1, 19 I owned and occupied the above property as my homestead and such occupancy began on (CJGt 19 (, 3 That the installments for improvements on the SPECIAL ASSESSMENTS duly adopted in ordin- ance by the LtL'? ?.,? ' c., OF AS OF which have heen aklocated against the subject properTy would create undue personal hard- ship on my behalf and I respectfully request that payment b.e de7ayed and that such in- stallments he so deferred for the years 19 S to"-7?.,,?, SIGNED• 0WNER SPOUSE - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - s• ? Clerk of the OFEAr qTo IN D wrk zA County, , State of Minnesota, do hereby certify'that the application of MQ,? a A. Oe%.%Itr above named, has been duly reviewed and that ' in ac_ordance with the: minutes of official record in said chamhers was duly : - APPROVED "XeW=as of C)t,{-bb¢N a() . 19$L• That in accordance with approval granted, the SPECIAL ASSESSMENTS listed below on the affiants subject property levied for annual collection in the amounts and for the years shown be so deferred with interest at the annual rate shown until such time as it is deemed the applicant no longer qualifies or the property loses its eligibility. ASSESSMENT D/P N0. TOTAL AMOUNT ` YEARS INTEREST RATE Proi 469 1383 $6,771.51 10 DATED 9% ? --r-? ,•?'r , . (over) DAKOTA COUNTY AUDITORS OFFICE posting check list Record Deferred taxes/assessment book Transfer card (red dot) Local improvement assessment card Data processing notified ?ate terminated Reason (s): Posted by Date TERMINATION ORDER By: Authorized Signature MEMO TO: CITY ADMINISTRA'ZOR HEDGES FROM: FINANCE DIRECTOR/CITY CLERR DATE: OCTOBER 90 1987 SIISJECT: BENIOR CITIZEN SP$CIAL PROJBCT 469 Please find attached an application for a senior citizen deferment for Martha Dehler who lives at 3106 Pilot Knob Road. Mrs. Dehler has been assessed for the Towerview Road project at the City Council meeting of August 18, 1987. Mrs. Dehler has submitted the documentation as required by Section 2.75 of the City Code and is clearly eligible for this deferment. I am, therefore, requesting that the City Council take action to grant this deferment and that staff be directed to so notify the Dakota County Auditor. Please let me know if you would like to discuss this requested action in more detail or if you desire additional information. Finan Director/City Clerk EJV/kf Form M 1PR 1986 Minnesota Property Tax Refund 0 a Your firsl name and initial Last name Social Security numDer o ?+. .. +...w.........,.«... ?-? I GI.? T;?;. M., TM,•,T,. :..n , 551 21 Sute Electlom Gmpefpn FuM , 4 ° .c $ Z$ ? 3 4i3-38-9 uritynumber it rouaian'icnackanyot mexeo.eson n your 1988 state inwme M. lorm, and il a HARTHA Q - S H3511643 rou want $Z to go to Ihia luna b help did t ro n a 1( 3106 ? I(.17 T r10 $PD D`HL?? , - - can a es rstateo icesoaycampayn e•vense%. rou may each cnecy one cox. e $ T P A U L ly, N 55121 ` - This will npt ra0uce yaur fMUnC. ? ? ??r..? ? .....,? ? ?.r...,... ..,,.. .••, wnee.*, mn.o..a..+ o.i..r w?m...?aea woWbn C+ur+anwM Meekeech 6oa B homeowner ? age65orover ? yourentetlpart oiyournOmeloothers YO°' ? N ?? ? wMehaDWiea: ? renter ? aisa01e0 orusetlillo.business(filloutschetlule2) Spouse? ? " 0 All Applicants 1 Federal adjusted gross income (from line 32 f f d l o era e form 1040 or line 14 of form 1040A or line 3 of form 1040EZ) . . . . . . . . 1 3???. 1 2 Social security payments or railroad re[irement payments not included in line 1(include amounts deducted for Medicare) . . . . . . . 2 3 Payments to an IRA, Keogh, or Simplified Employee Pension (SEP) Plan (determine from page 3 of the instructions) . . . . . . . 3 4 Welfare payments and unemployment payments not included in line 1 . . . . . 4 5 Worker's compensation, veterans payments and all pension and annuity payments not included in line 1 or line 2 . . . . . . . 5 6 Additional items which must be included in in- come (from the list on page 3 of the insiructions) . . . . . . . . . . 6 7 Total househoid income for 1986 (add lines 1 through 6) . . . . . . . 7 ,g0 I . Renten 8 Fenter's share of property tax (from line 3 of your CRP forms) . . . . . . . 8 9 Amount from the table in the instructions. 5kip lines 10 through 13 .. . . . . 9 Homeowners 70 Amount from line 1 of your Statement of Property Tax Payable in 1987 . . . . .10 1. 07I. d(a 11 Amount from the table in the instructions . . . . . . . . . . . , 71 86 Z. 00 12 Amount from line 2 of your Statement of Property Tax Payable in 1987 . . . . .12 158 .t . oz 13 Subtract line 12 from line 11 . . . . . . . . . . . . . . 13 Z 7e. 92 All Applicants 14 If you wish to donate to the Nongame Wildlife Fund fill in the , amount here. Your refund will 6e reduced by this amount . . . . ? ,14 75 If you are a renter, subtract line 14 from line 9. If you are a homeowner , subtract line 14 trom line 13. This is YOUR PROPERTY TAX REFUND . . . , p . 15 27 O. 9g Be Sure to AMach Your CRP or Properiy Tax Sfafement I tleclare Mat this application is corrBC1 and complete to tlie besl of my knowletlge and beliel. Vour signature Spouse's signature Date Day[ime phone Paitl preparer's signature MN Tax ID or Social Secunry number Date HaR BLOCK'-y (? N, 15L,) 9088382 2-25 -$7 Mdl ta Minmwh PmWrtp R: IiohuW. SC PaW, NN 55U54010 513 rF,:Aiu;:;nc;rzOm.i rD2 r:76S PROP[=R1"Y I:: I). 1i.i--1:; i f )Ci0.-010..-3!J Si.,EI.# ASSki:;i9'iiMEhdT lJli'SCtt ?:?rF:c;r.-?i_. r??_?;r:-y?,r?iEr..rrs.:s 31`LCIA_. .. ASSESi3MENl S SL=:AI1f;M SIJh'Ih4PiRY i OCifiY?.i I)(-1TE; 09J30/8I F1._HGc._._......._. ?.. ._ ??... -C,-7--t.-d_q...?t.r 1-2-'--?I-- ? ?. r _....___.__._..-_._.....__'__"_..__.........._._.._.._._......_.........."'"__-_..._.._._._.._._._ ._ YP Yc:tS 1=tri?E TI:7T/al_ AhiN.F'hTN. F';iYOFf-' CO^1MENl' 100004 SAP,i i_;Ll,.i I'Rb::: 00 ii .00:%, i439.00 189,00 ,00 {JI._O(3EL 10eh008 Uit-?1'!:F( LEi'T' i:i0 0 „ii0'% 798.52 798.52 ,t:>U CL_CtSL=11 100239 .:3 LS-I-};;g_.L.F. 74 ,`i.: 8.00"/. 2741,,E35 .iic] .c>(; CL03ED 100802 i:i-f01;:i°I SruJF=:R I_A7/TR k;-; 15 12,,50Z, 495,.00 „CrCi .00 1';I._I':lis[-D 100803 S'i'(71t1"f, SLir.lE:l=iAf-tl'c'i=3 83: 1 :5 12.50% 495.:00 si;t; .iiq t ;l_OSF'i) 101383 -T'I°ii::_E_l` ;l.)P:1= .4f,'; 5a Fi; _ lC; " t.;[;I, y„- Ga7i7..:i1 677,15 6771,,51. !;111hM:,Ft'f OF Al'_T:L'.l4' 6771.51 67::„15 671:1.51 .r..%:F.,y..q?..y. °(H.( f:i Yl'_' AF°; ' ;:i TLlT I`'9,: I ? i 1( ) ,..., * - ' ? - r.. ?-i?es;_; ?- ,--:. or 1='' i.HF?aaclcair' 1=ct-m) r_ ?r 1-7 r .I??._i3_.ta;_l-. h7687 g i ?i 3 l w m ? i b r ' ? s I t t 7 3 " - ff i H - - I ' - . 0 ?? ?l ! b _ _ , i i, I - - - - - 9? Af 1 f _ a I I I f I ? - -= ? ? , I __ _ - - , ? - ? ? ? - - - - ? 4 I Pf I 1 i . t . . I . - - _. . ( . . . _. . _. . . _ _ - .h ? ? I i ? I ? I I F I I { - I ? I I ? I I I I ? I I I i ? I ? ? I I I ; - ? - r - - i ? ? I I ? - - - I I - i I I - - ? - - C ? - ? ? h i i - i - V wiLsorv lonES coMVnnr G1507 GREEN 7507 BIIFF G7507C COVEFLE55 MPOE IN U,S.A. ' 1 _ _ 2 3 4? _ 5___' 6 ? I I I I i -- I ` ' I ? •? I i I I I -?--L i - !- --- --- }--- ? i i i?- -- - -? - -1 _? - - - - - - -- ---- ? ? I 11 I ? ? - I ? , _ i T -- ? - ; - - - ?- j ? i - ,, - - --- - ; ? i ? ? I I-i- I I ! ! ' I I _ I I I I ? --- ? --, -?' i I I i --- I I I It II I I i I I - i , - - i -- - ? - --- - --- - , - -- , , -, -- - - - -- ? - ? -- -- ? , , - i - -? ? ; - ---- ; ? ' - - - --- ? - -- - -- - - ? ? - - - - - - -; ; i I- - - ?- ? i ? ? 111 i ' L _ - - --- -- i - -- --- -- REQUEST FOR UTILITY I/We hereby request of the Board of Supervisors, Eagan Township, Minnesota, utility improvements on and over property owned by me/us as follows: (Mention type of improvement e. g. water, sanitary sewer etc,) water The location of said utillty improvements shall be gnerally as follotos: eonnect to the water main on Pilot Knob Rd. I/we hereby waive notice of aay and all hearinga necessary for the installation of said improvements and further consent to any assessmeats necessarily levied by the Townahip o£ Eagan for such improvements. I/we further agree to grant to the Township of Eagan any easementa neceasary for the installatioa of such improvements. It is further understood that thfs request shall be reviewed by Che Board of Supervisors of Eagan Township or its agent and I/we will be given reaeonable notice ss to whether this request is possible under present utility planning as to timing, locatfon, etc. Dated• Nov. 1, 1968 •'/?•?- -'j--a I SNr/o? R Request accepted by Get. 29 , 1969 Date Eagan Township Request referred to Town engineer: Date Copiea; 1, lbwnship 2. Town Engineer 3. Applicant 0yf r?'?" _?2 RH(7U&4T FOR UTLLI'iY II`'nOVM`TS c.? i tD 0 . o ._3 () IJWe hereby request of the Board of Supervieore, Eegen Tovn4hlp, Mi.nneaota, utilitq lmprwemacte oa aad wer propertY ovned bY me/us as folloas: (Mentioo type of improvement e. S. rater, senitary •evez etc.) Water Lateral 1he Locatioa of eaid utillty ia4rovemeats shell be gaezs117 •s follws: 3106 Pilot Ynob Road, 55111 I/we 6ereby waive tatice of arAy and all hearinge aecaosary for the inseallation of aaid improvaments aad furthez conaeat to aDY asseseoenis nacesearily leviad by the Townehip of Segan for such imProvemeats. I/ae further agree to grant to the Toimehip of BaSan acry eesements asceseary for the iastallation of euch improvementa. It ia further tmderatood that thie requeet shell be reviewed by the goard of Supervieors of Eagan lbvnehlP or ite ageat and I/we vill be given reasonable noeice as to whether this requeet ia possible ucder preseat otility plaming as to timin8, locatioa, e[c. naced: MaTch 18, 1970 Request accepted by Hagan Towuohip Request referred to Town angineer: Date 13. Copiee: 1. lbwship 2, lbyp Engineer 3. Applicant Date ? 7`) Use BLUE or BLACK Ink --------- j For Office Use j �� Permit#: /�� Pettnit Fee: ��, vv � 3830 Pilot Knob Road AUG � $ �014 � �', �� ,� Eagan MN 55122 � Date Received: ( Phone:(651 j 675-5675 gy'___�� sta�: � Fax: (651)675-5694 -- � � 2014 RESIDENTIAL PLUMBING PERMiT APPLICATIC)N Date: a ^ � � � �� Site Address: J / �� v -�- �,�rio � / ► � Tenant: Suite#: � � ; i � a (� h �P ~� �' � aU - 23'0- -714 ��, Name: � y VJ�+ � '"1 Phone: � ( � � � ��' Address/City/Zip: �-° R'�'� rn"� � '� � � : Name:_.Nes�ic�1 ��7"�$ .p� r� ;c..�� _ License#: (o�F� � � � � - Address:�U , l�� '� o� 7�7 Z City. �`a'��"''� �� J State: ✓� Zip: S -� �� 2- Phone: (� .�l � �1- � Z�Z � �; ContaCt: �'► ' �� Email: '� �1 eJ J'�"�', )�n3'''�'• �v''"� New Replacement _Repair _Rebuild _Modify Space Work in R.O.W. �`��3��+t�.: — — ._ �: Description of work: ��:� RESIDENTtAL � � ' Water Heater ' Water Softener e ��„�� Lawn Irrigation(_RPZ 1_PVB) �` " Septic System Add Plumbing Fixtures(_Main/_�ovuer Level) _New Water Tumaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, ar Water Heater and Softener(includes$5.00 State Surcharge} C,� �, 2 Z�'� $60.00 Lawrt Irrigation(inGudes$5.00 minimum State Surcharge) � ,,..�� $60.00 Add Plumbing Fixtures, Septic Svstem Abandonment, Water Tumaround*(includes$5.00 State Surcharge) "`Water Tumaround(add$200.00 if a 5/8"meter is required) $115.00 Se�tic Svstem New($10.00 per as built)(includes County fee and$5.00 State Surcharge) TOTAL FEES$ �' � CALL BEF4RE YOU DIG. Call Gopher Stabe One Call at{651)454-0002 for protection against underground utiliiy damage. Call 48 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 ta start without a peRnit; 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 � � , } � �� G/`► � / � X 'C�b� Applicanfs Printed Name Appli ant's Signature �/'+� r { � � �* �� .��fLR��i�.- .� JF�� r � � , . 4 �' .f x 1 �.� p'�� f �`� Y :r" �.X^ ��3MliE�ede}ik�M, N r .�� G o-� .. ,. :� �',ks �:5.�. „,.4 , } �� '{p,�^ �t �'�+� � � �ay�yy�y{�M��Rl�� . t�'r'r+^^wn^^�1�7�� '47��,�kl�� p ��Z �. 3 �. � +� �x �, ; i t� .t .. .,�"$�: �� M �:. ,��,��- j� ��+��'� � �� 4 L ;�,� I� � f s, ..�, .�. , ... .a: ,r.,,, r: ,[,.,�, , . A �'� . . ,... .. e� ..d . . ,..:� ».� .'. . ..,� . .,�. .. ., K 5116/2016 09 :19 PDT TO: 16516755694 FROM: 6123544154 Page: City of hp 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 615-5694 MAY 1 G 2016 Use BLUE or BLACK Ink For Office Use Permit tr. /ge--- 7 6 k 4 Permit Fee: _ Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: C-3 I 1(0 Site Address: k Unit #: Resident/ Owner , • • C.7 Name: l --) t ASh n Phone 0 I ,...„ i \.,„ , ....- Address / City / Zip: :31('---,k_Q_ "1- I I UT- 4____nn' Applicant is: Owner )LContractor Type of Work <,: Description of work: I ,..,_.>•--) * (ref+ Co* .,. Construction Cost: Multi -Family Building; (Yes / No Contractor Company C - 1 411 Contact: Hea+her ClreetYc__ Addresst:3') - Mit -N ' 1 .1 City, Serlit‘ I I '-e State/Oki Zip Phone0 .fff (16.144etttil C P.fA,thal , License It: Lead Certificate #. k) A-7 i 1 3. ,S - t ...._. If the project is exempt allININIIIIIMINININIMMEMINIIMMIEW from lead certification, please explain why: In the last 12 months, Yes No COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? If yes, date and address of master plan Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor Fire Sue • ression Contractor: Phone: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities, yt vAy =hp gfd gint 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 winch requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within '180 days of permit Issuance. it Applicant's Printed Name Applicant's Signature eelArg.„ Page 1 of 3 5/16/2016 09:19 PDT TO:16516755694 ROM:6123544154 c• SUB TYPES Foundation if Single Family Multi 01 of Flex WORK TYPES New Addition Alteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (26% 100%Z Census Code # of Units # of Buildings Type of Construction </C)h7 0 NOT WRITE BELOW THIS LINE Fireplace Garage Deck Lower Level Interior Improvement Move Building Fire Repair Repair Page: 4 /377 Porch (3 -Season) ....... Porch (4 -Season) Porch (Screen/GazebolPergola) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Roof: Ice 8)Nater _Final Framing t/30 Minutes 1 Hour Fireplace: Rough In _Air Test _Final Insulation Sheathing Sheetrock Fire Walls Braced Walls Shower Pan Reviewed By: Siding Reroof Windows 4, Egress Window Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Accessory Building Demolish Building" Demolish Interior Demolish Foundation Water Damage *Demolition of entire building —give PCA handout to applicant .••••••• MCES System SAC Units City Water Booster Pump PRV Fire Suppression Required Meter Size: Final) C.O. Required it Final / No C.O. Required HVAC Gas Service Test Gas Line Air Test Pool: Footings Air/Gas Tests Final Drain Tile Siding: _Stucco Lath Stone Lath Brick Windows Retaining Wall: Footings Backfill Final Radon Control Fire Suppression: _Rough In Final Erosion Control Other: , Building Inspector RESIDENTIAL FE Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL 21: 4/7 " Page 2 of 3 Use BLUE or BLACK Ink For Office Us� I, / ::::11,101' ty of Eaalai 2- 3830 Pilot Knob Road Eagan MN 55122 R"-CEwED Date Received: Phone:(651)675-5675 Fax:(651)675-5694 MAR 3 0 2017 Staff: iyA 2017 RESIDENTIAL BUILDING PERMIT APPLICATION � ,11 1 , Date: 302 9 h7 Site Address: 3 I D 6 RI o T Kho b (Zr�( Unit#: �1 .v441 5s p� fi - Name: Kris Pe/Ls li,1 Phone: 3ao- 333- 108 £,''3£Res dent! i .°r`i : Address/City/Zip: 3 ID 6 Pi 1.4- kwt, R. Owner,�� -e 41 P Eric m Applicant is: Owner X Contractor 7 ' Description of work: T�..r ofr moor In•us�; rcrr c�wwcy a J•r�t alx.4.3 I•. k ,� .� s a a at c, Jc fww-t a�ypeto ,Wiork �. •� L �a .,e�e^�'�'�, 4 B' �h N*k /7l:ac4 a56� ,N7�all talc Nl' aVl ‘..se •.•,•. 9a� C• RAVARBIN s € . i zi j px,x k Construction Cost: 6 1135 Multi-Family Building: (Yes /No X ) t_tfla l�a i€, tl. l� Company: Sc I r~ le (-` ; �ec rklin Contact: (3co 9 ca•61/5-" lot C WINOMERPOLVd i'°°Contr7'0,-A r l Address: 11/90 �xuisi.r 1 1J City: $f• 1.ws Srlc !rJ4 ,t � ; State: AA) Zip: c5K/G Phone: CI a- 823-8D4 Email: “:••••0 0S4 r,g .c G ao ory �ai�.4z;°;"�r��,.'`,�;�. ,� License#: � l Lead Certificate#: .NAT-dS03'/-.2 If the project is exempt from lead certification, please explain why: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: NO�TEzPs,aandspori.ngdcumnt,�.sayo - u ; itPar" nsd�ed® bepuh�ra`.yx"inform a , x o « , hen ormmat•ivii_onmbcasrfd as non blioo�deseMasosouper F ` C �tt , kx � �. o , .d 6tn E 14,— - r .. S .� 1 , A ` Fiy ,r—.0tmio ,., a �,� conclUalelthathe aerde€seo i, P . me,CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.ciopherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. X Ocvt}ctimi✓1 l.ti a X w' . � Applicdmit's Printed I ne Applic 's Sign urea Page 1 of 3 3ibCr P� t� -Y V-nob i NI DO NOT WRITE BELOW THIS LINE SUB TYPES _ Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) i' Single Family _ Garage Porch(4-Season) Exterior Alteration(Multi) Multi _ Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous 01 of_Plex Lower Level Pool Accessory Building WORK TYPES New _ Interior Improvement _ Siding Demolish Building* _ Addition _ Move Building 4 ' Reroof Demolish Interior Alteration Fire Repair _ Windows Demolish Foundation Replace Repair Egress Window Water Damage Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION Valuation 0QR7 Occupancy z G ../ MCES System Plan Review / Code Edition ,tai 7 SAC Units -- (25%_100% 4) Zoning A -/ City Water Census Code 1y,3Y Stories — Booster Pump — #of Units I Square Feet PRV #of Buildings i Length Fire Suppression Required — Type of Construction Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings (Deck) Final I C.O. Required Footings(Addition) Final I No C.O. Required Foundation Foundation Before Backfill HVAC Gas Service Test Gas Line Air Test Roof: Ice&Water Final Pool: Footings _Air/Gas Tests _Final Framing 30 Minutes 1 Hour Drain Tile Fireplace:_Rough In Air Test Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS Insulation Windows Sheathing Retaining Wall:_Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression: _Rough In Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: ''/1 , Building Inspector RESIDENTIAL FEE-, a.h1avV a Base Fee I/ Q' -"-- Surcharge00 Plan Review 3 3 ge/PoAis-4 0/dm / MCES SAC ....— \O", 0 City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant _ Copies G A it9 TOTAL Page 2 of 3