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4565 Pilot Knob RdCITY OF EAGAN Remarks ? -/? - I ` ' . _ Addition Section 28 Lot etk Parce4 10 02800 020 72 Owner i l`'_? ?,? i? Q?1__`:: st?eet 4565 Pilot Knab Rd. _ Stace Eagan,?r 5512.3. '?-7 -7 - l? Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN 5EW TRUNK 136c1 1 SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA ? STORM SEW TRK 111 1983 838.51 55 :.89 STORM SEW LAT CURB & GUTTER SfDEWALK STREET LIGHT WA7ER CONN. BUILDING PER. SAC PARK C EAGAN TOWNSHIP BUILDING PERMIT owo.: ...... ..... .....?.-?j----- -- -..._...._....... Address (Present) ....... Builder Address .............. DESCRIPTION Nlel 3044 Eagan Township Town Hell Dale __4- 73 ......................... ... 6tozies To Se Used Fos Fronf Depth Heigh2 Esl. Cos! Permi! Fee Remaska 0 j[ .? SliOel. R08d Oi OIheL DeeCL1pI1017 0I LOCSrion I LOi 7510CB AtltiiIiOn oi 'PleCI ZtfV? Q??l 1'his permit doee aot aufhorise the use of slreeffi, soads, allepa or aidewalks nor does it give the ownee or hSe sgen! the right fo ereale any sifuetion whiah is a auisauce or which presenfs a hasard !o the heailh, safetp, coaveaienae and general welfaie !o anyone in the eommuniiy. THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WOAK IS IN PROGRESS. T6is is 3o certifp. 2hai........... -.----........... haspermisaion to erec! ?.... ......... .. .. _.._upon !6e above deacribed premise subjee! !o the ptovlsiona of ffie Building Ordinaaae for Eagan Tbwnship ado !ed April 11. 1955. p ?]...?? ---..-.---°°-------...-°•+""---i-°°.---°- °......---....°°.--_.. Per ..................... `___""..._..-----°....---°---9... _.....--°°--.......-------°- Chasman of nwn Board SuSldin Inepectos _a EAGAN TOV!/N 5 H i P BUILDING PERMIT Owner ......... XI,-C,iL.....?........LE!`"fl.?f..?......'----- Address (Presenl) 1..-------- ?Iel-------- Builder ---'-"'_'?.?C'? Address ................... ...... . .. s----. N° 1186 Eagan Township Town fiall Date .d /yL...?.'../.... 5ioriea To Be Used For Fron1 Depih1 Heigh! Est. Cos! Permif Fee Remarks ?? ? / X O ^ ? I7 /+.D I7i ~ oT O / ?tl?srJ/?se . ? t• C?? ? Z I A.,a ? r• i3-•-y Ca. Aal O I LOCATION ° 1 Sfreel, Aoad or olher Descsipiion of Localion Lof Slock Addilion or Trae2 ???+- ?CJ o-+? Co s?+P 3 I ?? ,?„?;??„ ?,? ? s,? Dao y9 /•0 4asoo aaa 79 This permii does nof euihorise lhese?of slreefs, roads. alleps or sidewalks nos does it give the owner or his ageaf the right to creafe any sifuaiion which is a nvisance or whiah presenis a hasard !o the healih, safefy, convenianee and general welfare So anyone in !he communily. THIS PEAMIT MUST BE EPT /O?N pTH"E" PAEMISE WHILE THE WORK IS IN PROGRESS. ? .?.?-:a:tc?.s .......................has permission !o ereat a. . '. . ......... .... .'t?,r7q?.., ,'.?."?..upon This is fo cerlify, ihal---- .....Q . the abave described premise subjeci !o the provisions of the Building Ordinance for Ea n Townshi dopfed' April 11. 7955. y,/? - ........--`-----..........l?.Cf4..?!crR!.`.ti(........... Per .-----. enLL.....?R!e.cc1.. 5.?.'-"-"'__....... Chairman of Tnwn Board ? Building Inspecior a-,/5 - 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN \ 5 3830 PILOT KNOB RD - 55122 Q. S V 657-681-4675 ? a NewConsWetfonReauiremeMS RamodeVReoeirReaulremeMc 11 ? 3 regktered site aurvaya showing cq. R ot b; aq. R of house and all roofed areas 120°h maximum rot covemae alloxred) ? 2 aopiea ot plane (show Deam & window sizes; poured fid. design; ete.) D 7 set of energy calculatlons D 3 eopiea o(tree presenatlon plan N bt plattad after 711193 DATE: I1'I8 ` S, 2 copies of plan 1 set of onerpy ealculetlonn lor heatad additbns 1 ske survay for exterior additlons 6 decks ,g .e CONSTRUCTION COST: 3, 0 oa 4- DESCRIPTION OF WORK: lS.xW+aw . STREET ADoREss: yscs LOT: ? BLOCK: 5UBDJP.I.D. #: _ S-C <L:k? p y? PROPERTY OWNER CONTRACTOR ARCHRECT/ ENGINEER Name: fAs742 Lte,? CJ,wr?L Phone#: (Z SO YSZ • 3L $ 6 Lesl First StreetAddress: -/'LOO fi'c.nr XA1ae /sio, ChY 4&?a"' State: Nl n. . 2ip: .$'S/ 2 Z Company: N. N?,-S 1. .. &MLJ6 2'u e Phone MCGS/ )_ (area eode) StreetAddress: C1,6/D c"GVC,O 131UD . Lieense# Exp. City ?u-ca GRer- Z6i-s, State: Y11 N. Zip: 55?7,L Company: Telephone #: ( Name: Street Address: Registration #: City ? Sawer 8 water Ilcensed plumber (new eonstrucfion onlvl: State: I PenaNy applies when address change and lot change is requested once permR is tasued. Zip: I hereby acknowledge thffi I have read this applketion, sfate that fhe infomudw is wrted, end agree to compy vA all applkable State of MfnneaWa Statutes and Cit of Eagan Ordinances. / Signature ofApplipnt:/9•?CAatiJ`da,s L±?c. OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No _ Not Required OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 4-plex ? 11 10-piex ? 16 Fireplace ? 21 Porch (3-sea.) ? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea. ? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened) ? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage ? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous woRK nrPe ? 31 New ? 35 Tenant Impr 0 39 Gas Line Only ? 43 Siding/Soffits/Fascia ? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors ? 33 Alteration ? 37 Demolish Bldg.' ? 41 Wood Stove ? 45 Fire Repair ? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof ' Give PCA handout to applicant for demolition permit GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Width APPROVALS Planning Basement sq. ft. Main level sq. ft. sq. ft. sq.ft. sq. ft. sq. ft. Footprint sq. ft. Building Engineering Census Code SAC Code No. of Units No. of Bldgs MC/ES System City Water Booster Pump PRV Fire Sprinklered Variance Permit Fee Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: Valuation: $ r' SAC Units °k SAC czrv Or CncnN . CASH:[CR: :IS TE1°tMINAl.'Nfi: 878 DA'tE: '.1.119/93 7IMC8 09:13:1Fi. Ip; NAMF: A. KpPi:i'SH G 50N8 18 9001. -1575 FIL-Ul' YNU& , 60 .00 = 2{015 3001 4575 PTL GT P:Nf1B. C?.;^;o ; iQ 30(]: 3'? 4:'?'? "TI,..07',f?i.OB , F,Q.Of! - ., 2?5 9(JDi. fiS'S F'Tl:d'i KNOB, O.SD., ;;?21f7 90C11 14'i.?'t CL.T.1=F hD E.O.q(J 2:LT.3 g['U:. 1475 CLIFC= •F:U C].,5Ll-_ 3219 9OQ4 45U5 P2c..or vac,rt 60.00 21.55 .90411. 4E;6; F?ILDT-KNdV,.` , L..;rO I 32153 '3G0 1 451 ? F'.ii.AT;KNG$ .? 6t).04 2155' ?n, Q} 451.5 PII...QT KiJdB n L1?5R CR11_`.if;r:4 • ' iJ3Eft Ifi° JAk . . i ?L.' . . -...n N' . . . ?1??7k 1k%k7k*7?Qik* **? %k1CYc.k*7K 1KWt?M7K•?{.? *??? A? crrv OF EAcaN r,ASHZER. as rERnzNAi... Nn: -re,s nnrE,g 07i23i99 l'LMLc 11:03:25 IU" PlAMC; SWSF'i HOtJSF MOVING & I-IFqVY MA 321F3 9001. 451i F'IL07 t:NOFi 75.00 2155 700:I. 4515 F'ILAT Y.NUB 0e50 321f3 9001. 1475 CI...IrF RD 75.00 21.`:i`i 9001. 1475 f.;L.IF'F FD 0.50 321E3 9001 4565 I"TL.UT KNOTS i`'5.00 21.55 ? 4Jbt1 t'I_OT t:NUE{ C1.JO / ?. '•w Tnta7. RPCei.pt Flmount,w 2.26.50 Cft:1.1.40 i G (JSEFt TI!. J(-tN 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) '; 75' -ST? ?J?g?S3 New Construction Reaulrements CITY OF EAGAN 3830 PILOT KNOB RD • 55722 651•681 •4675 ? 3 registered ske surveys showing sq. fF, 01 lo}, sq. k. of house and JI roofed areaa (20% maximum loT eoveraae allowed) D 2 coples of plans (show beam 3 window sizes; poured Ind. dealgn; etc.) ? 1 set of energy calculallons ? 3 coples of hee preservafionplan N loi plaNed alfer 7/1/93 DATE: Q 9 DESCRIPTION OF WORK: ? 1- i- a-a - 9 9 Remodel/Reoah ReaufremeMs 2 copies of plan i set of energy calculailons Iw heated addHions 7 sHe survey lor exlerior addlHons 3 decks CONSTRUCTION COST: STREET ADDRESS: L4 LOT: ?-- BLOCK: ?"I SUBD./P.I.D. #: S`2 C-L C) Y\, Name:.aic?r ? .a f'? ?lcYSkPhone#: ?.?'I-?2-3GrY7? PROPERTY OWNER -? ? ?n-f- Sheet Address: !Z,;2Od Ket C) City Ea ??, t- State: 1/1/( ? Zip: Company:'??4 4 .E ?Rio t?6df &? ?;hone#: & t 2_ 9;7;V- 63 V3 (area code) CONTRACTOR ? Sheet Address: V 6 S L.a r 1G i v?. Q aE License #5f aZZ ? Exp City ? o ?C-+ r ai ?.. State: lNl Zip: ???! (] ARCHITECT/ ENGINEER Telephone #: area code ( Name: Streefi Address: Registration #: City State: Zip: Sewer i water Iicensed plumber (reaulred for new conshueHon onlvl: PenaNy applies when address ehange and lot change Is requesfed onee permtt is issued. > I hereby acknowiedge that 1 have read this applicaHon, state fhat the InformaHon Is conect, and agree fo eomply wffh ail applicabl State of Minnesota Sfatutes and City of Eagan Ordinances. / * Signature of Applicant ?- ? v OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No _ Not Required OFFICE USE ONLY BUILDING PERMIT TYPE / ? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) re 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea. ? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened) ? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage ? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous WORK TYPE ? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia ? 32 Addition ?r 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors ? 33 Alteration p 37 Demolish Bidg.• ? 41 Wood Stove ? 45 Fire Repair ? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof ' Give PCA handout to applicant for demolition permit GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Width APPROVALS Planning Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building V s Engineering Census Code SAC Code No. of Units No. of Bidgs MClES 5ystem City Water Booster Pump PRV Fire Sprinklered Variance ,Ew - G °J' c t Permit Fee Surcharge Plan Review License MC/ES 5AC ; City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pi. Park Ded. Trails Ded. Other Copies Total: Valuation: $ ? SAC Units % SAC o xNMESOTq 'o Minnesota Department of Transportation 9 `< - ----- ---- %Fi, Ottice of Motor Carrier Services QF TP 1110 Centre Point Curve Mail Stop 420 Mendota Heights, MN 55120 Building Mover License CERTIFICATE NO: 312227 ESSUED TO: SWIFT HOUSE MOVITIG 8x FIEa4VY MACHINERY 1NC llic abnve named license hnlder has cumplied witli ihe license rcyuiremems anJ is herehy issucd tliis Minnesota IIuilding Muver License N'l111I1 N'III expire on Ihe Jate s6nwn bclnw. IiXPIRA"IIUN 1)ATI:: PRI3RUAKY 29. 20(w llie licensc hulJer agrees iu cumply wilh nll :ipplicaMe Staie amJ Pederal Regulaiiuns. failure io comply may result in revucation of this license. lhe I.icrnse HolJer m:{y nnt perliirm huilJing nwving npcrntiuiis in Minnesuta unles< the vehicles havc heen registered And Jisplay a vnlid idcmificniiun cnb card is,ucJ M1y thc Minne.oia Ucpanman ol 'llnnspor(niiur. POR V@RIF=ICA'1'ION CALI_ (651) 405-6060 Swll°'f 11oUS1! MUViNG Xc lu'.nvY MACIIINGRY INC 20845 I.ARKIN ROAD CURCORAN MN 55340 F:PFI:CTIV[ UA'lli: 0 II25199 7-1:1-I999 1:25PM FROt4 DAKCTA ELECTRIC ENG 4636107 TH£ FOLLOVJtNG SERVICES WER$ DISCONNEC7ED 9Y OliR CREV+' ON JULY 13, ]999: 4565 PILOT KNOB R0.4D 4515 PIl.OT KNOB ROAD 4575 PILOT KNOB ROAD (2 SERVICES) 1475 CLIFF ROAD D6LORES DENTIY Dakota Electric Association 461-463-6247 P. 2 . ? U OWNER'S PERMIT APPLICATION (FOR BUILDINC MOVE) 0 Date of Application: 1-13-q9 0 Address & legal description of building being moved: 0 Address & legal description of proposed destination: - ? 0 Building owner's name: address: 01.0?45 S S phone ?: ?1,? - 4?g-?e3y 3 0 Landormer's name: address: phone u: If landowner is different from building owner, provide approval from landowner to operate on the property. 0 Indicate if structure is connected to: _ City sewer City water - Septic _ Well _ Electric service _ Gas service _ Other (list) 0 Indicate party responsible for utilities disconnect: _ Ocmer Mover _ Other OFFICE IISE ONLY Real estate taxes/assessments on building Real estate taxes/asaessments on land Utility disconnectt Electric Gas I Sewer/uater Landoxner approval 2 MOOER'S PERMIT APPLICATION (FOR HOILDING MOVE) 0 Bate of 9pp11cat1on: -7, "?3 "`-V`P 0 dddress 8 legal description of building being moved: ?51.?5 _?j-L)t _I/.Xl Dl0 0 Address 6 legal description of proposed destination: 0 Qieck situation that appliess ? Suilding presently lxated ia Eagan - to be moved out of Eagan Building presently located in Eagan - to be relxated in Eagan (Requires Council approval) Huilding located outside of Eagan - to be relxated 1n Eagan (Requires Council approval) Huilding located outside of Eagan - to be moved through Eagan to aaother City. o Hover's Name: 2) ( i )I? L kD 1Sf1710U1Y\G _ 9ddress: ctoR`is lnXL/-?1? ypad' l n?COvan Pnone # (2 19 -Lt? FS'(j 34? Mn. Mover's License #?J submit a eopy of license) 0 Hig)3ligst origin, route, & destination on current City map. If County or State roads are usedp provide copy of those permits. 0 Proposed date & tlme of move (notify Eagan Police Department). aOTEt Eagan Police vill aot acoompany move unEil time ooordinatioa ha3 been aade with aeighboriag nunicipality. 0 Size & veight oP atructure: ? 44 4/(? L x /Y tt OFFICE OSS 09LY Mover's permit fee Permit # (iuarantee to repair 3 E i 6 .\ X YENO Tl! L ? ? ? ? i ! yi K L E?CNTS S'6. ? ? . "" .? ? ?_ ...__..... - f . ?'? ? E?? ..? ?..s. . ? i.d -r-, ? ; • .. ' --?? ?.??? ? ? . ? ? i ---*-- '±?? , '"?? r ? j? ,? ,- r S ?. ?,??, •,' ""? . l E , ' ,+q ? a• ?-. . ? I ,t ' a '??,` c 4n ?? /` ?11? . , ! ? . • ?.i..g4_..._?-... e . o ? , ? ! ' ' i ?- \• ' ? !. i c . _ , ?,•,'? . ?2 I \ ../.'?i:_ F: ' ' - ?,'. _'!? ?? ?,? .....a '? // ? I •;' I ? `? r ? ? ? °i ? 6'??? /? ? ?..? ! !? •? ?' % .. . e f ??,,, < r ?, ? / y , . _ v ? '` ? :f? '' •? ? .? . , , s?`'.•.. r r, r .cq? .. a. y ,' ??? ? . 1 i ; . _ '. ^ f :. ?? r .i ~ _ ` !' M1?r , . ?? ? . ?'??.? ? _ ? • 4• _ ? ,' s .? Y ? ' e ! ?' @ Z ,,• e_ ' t ?? ? ?r ,? ?!6e,,, . ; M ? ? M ? 1'e O I?? ' '? / Q r. p ? y ? • ? '• n ;? I ? ?I `?.P ...?i _ ?. ?i. ? ? I?? ?I . • ? ? 4? i 4 . ?i: ' ¢ Q +.j •? ('?q ?? ?1 r9 ti?N?° ?. ? a ^w / ?( ?t ? ? ? • ?. ? e 1 1- ? t ?I' Y ? •?? I ? ' . r z' , ??; ..?..,.. ?S } QS? ? , %f? i? Y ? ? ' /. s IPPLf YALL . EY ? ' NOSE Nf ?? I 1-74 1. ?p • D F B N 1 ¦ at: NtlUSPE/CAkAM: MtlVP, l guPehtte 1 Witl teplktt ANy gnd gll Jampge lo local rnEldways,liiilldes, gnd public riglit-o(- w#y that MAy be dameged by this moving bperaUon. bA / By: Swift Housemoving & Heavy Machinery Inc. 20845 Larkiri Rocrd, Corcorart, MN 55340 Pltone:612-478-6343 Fax:612-478-6934 Purchase Agreement This Purchase Agreement is made this 6th Day of April, 1999 by and between Eastet Lutheran Church- Mark Keel, 4200 Pilot Knob Road, Eagan, Minnesota 55122 hereinafter called the Seller and Swift Housemoving & Heavy Machinery Inc., 20845 Larkin Road, Corcoran, MN 55340 hereinafter called the Buyer. In consideration of the mutual covenants and promises contained the Buyer agrces to purchase the building described as follows:Three Bedroom Stucco Rambler., located at 4565 Pilot Knob Raod, Eagan, Minnesota. Purchase price will be $ 10,000.00 with $ 1,000.00 down and $ 9,000.00 paid prior to removal of tha building. Seller will be responsible for sewer, water ared bonding as may be required 6y the city. Seller shall be responsible for cleanup of the site and removal of the old foundation and debris. Seller further guarantees that he has the right to sell the building to be removed from the property and shall not hotd the buyer responsible for any liens or real estate obligations as may be required by the Ciry or Counry. Seller will be responsible for well abandonment and sewer diswnnection. Buyer will be atlowed to show the house fur the purposes of sale to prospective buyers. Buyer will indemnify the property owner from accident or injury related to removal of the building and provide a certificate of insurance. Buyer shall remove the building from the property on or before Tuly 15th, 1999. Buyer: Swift Housemoving & Heavy Machinery Inc. By: &J4 ?? Zz Robert A. Swift, ier Seller: SELLERS COMPANl' NAME By: SELLERS AME /??121t f_ J??? l? ?lroWtr.u?CCMMr ? 04M0lVAOLm I - - O'lla e1W w?Optr 7 ANYAYTO 1 UOIIAOOqlNY 1 H OICiAWMUiv I I ucMacwMixa? ? I I ? AoWari ? I u?MEtLAtOW 0111Ct 1t1111111YMA? XW I WOOMMN//YUIILONAW ? fO?OVqIDW?YPo ? [lMCwacaoint 1100,000 g TwarRamOrar .,a 99waMIIU132596 02/13199 02/13/00! u.eAWa-rwevurT S500A00 ...rwa1?sco+iw leLaww•MriKOrn6 100,000 artr.es? 92= A *THU i Grgo Cev*rsq* 35375694 12/08/96 12/08/99', ? 000? 8500 bed. eawnft a 5w5naxnouiwWwa10L ClRT1FKA761lOlf7EN cApIMunan OrIRlLle/?Y?OVGIYM41KWiO?f/?TM t Y SIIONGMIOF'N WM?TO? OLil1MMq. ? ilWw6COWYf/?Mll FON'/? 10 ??R },Q.,,aArtwrrrw Monee To »u e"nrnaAtt NCLauwawe» rnB:vr. :o wxar sr ra.r coeresur eurrAauum?wex.on« waaMOen,e.no??w?w?n j OiMY1tlM0YrOMMfAM?Yf/. A661 011 AY , I?tEINM 7?. SaRCMn F% ACORD 254 (1190) MASTER CARD LOCATI ON OWNER -7% -?., Z / STRUCTURE AND oid 40d" oie IAND USED AS Permif No. Issued Issued To Coniracfor Owner BUILDING PLUMBING CESSPOOL - SEPTIC TANK WELL ELECTRICAL ? _ D HEATING GAS INSTALLING ' SANITARY SEWER OTHER I OTHER I Items Approved (Initial) Date Remarks Distance From Well FOOTING SEPTIC FOUNDATION CESSPOOL FRAMING 1, ???,•?il???;?? :-,? TILE FIELD FT. FINAL ELECTRICAL ? HEATING DEPTH OF WELL GAS INSTALLATION $EPTIC TANK CESSPOOL DRAINFIELD PLUMBING WELL SANITARY SEWER Violations Noted on Back COMMENTS: - oF 3830 PILOT KN08 ROAD THOMAS EGnN EAGAN, MINNESOTA 55142-1897 mva PHONE: (614) 4548100 DAVID K, GUSTAFSON FAX: (674) 4548363 DMnELA McatEq TIM PAWIENiY THEODORE WACHTER COUMII M4RIbCrS August 24, 199? 71?iOh1A5 HEDGFS CiryAtlminisnaror EUGENE VAN OVERBEKE Ciry Clerk DOROTHY A OLSEN 4565 PILOT KNOB ROAD EAGAN MN 55122 Res Bpecial Asaessment Deferment Parcel No. 10-02800-020-79 Dear Mrs. Olsen: In official action of the City Council at its regular meeting held August 21, 1990, the above referenced application was approved as presented. This information is being forwarded to the Dakota County Auditor and will be reflected on all subsequent assessment searches as senior citizen deferred assessments. Please note that under certain conditions such as the sale, transfer, or subdivision of all or any part of the property or loss of homestead status, the deferment terminates and all amounts accumulated plus applicable interest become due. Please call if you have any questions regarding this matter. ? ? Sincerely, ?"^? E. 4l+VanOverbekeA Finance Director/City Clerk cc: Linda Fink, Accountant II Deanne Kivi, Special Assessment Clerk EJV/Vmd THE LONE OAK TREE...THE SYMBOI OF STRENGTH AND GROWfH IN OUR COMMUNITY Equal Opportunfty/Affirmative Action Employer ' „APPLICATION AND AUTHORIZATION FOR DELAYED PAYMENT OF TAX ON SPECIAL ASSESSD1ENTS FOR SENIOR CITIZENS' HOMESTEAD LANS 1974, CHAPTER 206 STATE OF MINNESOTA) COUNTY OF DAKOTA C! DATE T0: County Auditor, Dakota County, Minnesota ; I, the undersigned, declare undek penalti That I reside at. c Fi/a'f H.,L 19 PU --)-.-21 my uirtn is /,?',yt ?[??) That I am the owner of the property legally described as: Section 28 'Itap'27 Range 23 PT OF $E 1/4 dF SE 1/4 COM 528 PT N OF SE COR W 435.6 FT N 300 FT E 435.6 FT S 300 FT TO BEG SUBJ TO HWY ESMNT PARCELS 9& 9-1 IN CTY R/W MAP 25 & 25A , Property Identification No.10-02800-020-79 That my interest in the ownership of the above property was aquired on January 19 64 and is as follows: • 1. Sole ownership (Enter Yes, if applicable) 2. Joint tenancy, held with 3. OTHER undivided interest (Specify) That on January2, 19 90 or June 1, 19 0 I owned and occupied t e above property as my homestead and such occupancy began on_ a ti - (. t,[ 19 --? That the installments for improvements on the SPECIAL ASSESSMENTS duly adopted in ordin- ance by the City Council OF Eagan AS OF 8-14 1990 which have been allocate against the subject property would create undue personal hard- ship on my behalf and I respectfuliy request.that payment be delayed and that such in- stallmerits be so deferred for the years 19 90 to time eligibility is lost SIGNEDd L°dt'o1S?° ? O?IER SPO SE - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ?• ? I. , Clerk of the OF IN County, State of Minnesota, do hereby certify'that the application of above named, has been duly reviewed and that ' in ac=ordance wi thc? minutes of o ficial record in d ehambers was duly F?NF$p : APPAOVED ?r•9 a s of ?4 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. ASSESSMNT D/P N0. TOTAL AMOUNT YEARS INTEREST RATE Wa r 7a ra1 2066 3837:18 10 9% Street 2069 5316.00 10 9( ?Q DATED ? 19 (over) ? ?? ? ??T J(cl , .? ' ? ----- a. ?.? bu? ? 14A n, \ ? ? ? ? ? Ktt r ?.? ----- . ----- - ? . , ---- --- - --- --- ? ? --- ? .?_ - - - . ---- - ------------------ ---- ----- ----- -------- -----?--- --- T ------- --- - -------- ---- - ,\ , ?? -- -- - - ------- --- --- -- --- - - - - - ? - - '? -- --- - - - _ _ _ -- - -- - ..._-,-- --------- -- - - --?- - ------ ---- --------- ---- ----------- ----- -- - -- - _- =- - -- -- ----- ---- -------- - - - ------------ -------------- ------- r. l?t l<<.Z c - ? -- __- 4<sy E 104 label L Use IRS label. A Otherwise, B please print ? ar type. H E R E Presidential Election Can Filing 5tatus Check only one 6oz. Exemptions (See Instrudions on page 8.) If more than 6 dependents,se8 Instmctions an page S. Servlce . J?:-dec;;31";1 8,ur6thartaz er De innin :'1989,enCin ,19 1 OM8NO.1545-007a Wname0ntl'Inftial Lastname Youraalalsecurlty numEer ?j S y 1J 70 : 30 :7sa 9 ; return, spouse's first name and initial Last name SpouM's wclal secudty num6er ddress (number and street). (N a P.O. boK, see Dage 7 of Instmctions.) Apt. no. FOI PrIVeCyI ACt 8nd ' -61 P / D ` Paperwork Reductlan rm or post office, state antl ZlPcode. (N a foreign aAdress, see page 7J ACt NOtIC@, 48@ ?c/A/v 12M) -J- /a Instructions. hecking "Yes"will ?U?want$ltogotothisfund?. . . . . '. . : •t N? Note: nCotchangeyourtaxor II;VOIIlCWUIip?YVQ'V:VWia4aavaru:W+?`vwunr:.?.?....^ •--. A' 21 • . Marrfed tiling joint return (e'vBn if only one hed incom?) . 3. ..Matr?ed iilirig uyirete return. Enter apouse's social securl{y no. ebove"and full name here:' 4,.-: ;Head of fiouiehold (with qualifying pErson): (Sea pa6e 7 of In§tiuttlon's.) It the quatltying person is your chVid 6ut nat . . . -.vniuderienACirt?eriterchiltl'snamehere. . .. Yelf? Ii wmeone (sucli bs jrour parent) can clalm You as a dependent on his or her tez No. of 6oxes / ' retum, da not check box 6a. But be sure to.check the box on Ifne 33h on page checked on W., ,.. . , _ • ? . . . . .. ... ,. . ? end 6b se - C O??bddnie: (1) Chtth d under (3) N a¢e 2 a older, dependenl s ' ?(1) Relaiiunship (5) Nb, ol months ryur hame livd 11 e(6rbt?ini?i?l.?ndlastneme). age2 ?laltaurilynum6er .? 1989 , .* i.ti No. o your childten nn & MM1O: • Iired with ryu _ • didn't Ilre with ? diro?a or uperotion (see me 9) - . -No.Mother dependenbaa & - Rdd 6ers ? d.Myourffilld didn't livewith you tibt ts claimed asyaur deWent.under a Dre.1985.agreement, cBeck here ?U ' enterednumon d , oiSt number of exem tions claimed nnes above . ? ? ' ` ? -??? y r:.M'. ... .. . ... ssleries,tips.etc.faftachForm(s)W-2). ?l?ag es, ? $a' 7 • Income Ba Taxeble mterest income (alsoattach Scbedule B rlover f400) Please attach ??pt interestincame (see ?)age 10)'?ON'T include ou9ine 9E ' 1116 I I :' ' ° e 9? 6 . : CopyBofyour 9?' Hiid . 'f?come'(?I2oattachSc?ieduleBi£bver$400) t Forms W-2, W?2G, ?r?, + tru tWn§ • f l I1 ` 30 c . . ns o Bf?ds?slatJand Iaeal iricome taxesi if Bny, trom iriarkshe0t on p9ge IOi :?'(llte?fl6v here. 2P and W- .. . r.t ` il . . . . . Al?fifony recarred .: ' . . . 11 S have If you do not . ' ' 12 ?• a W-2, see 12.11 BUSine841tfcome or (loss) (attech Schedu7e C). ': ' e6 a '?? 4 13 , p g . . . . . algain:or(loss)(attaefiScheduleD) : .' ions. 13? ?epi e 11 l ? 14 ) ..... . ine 13 (see pag AI&eih distiibutions nM repufted on lAt Ca .. . ? - •" . . ' 4 r l? ' ??' 15 s.o[(losses)(attac kgein 15 ?tE ns i b tl ?F°?? (di 1 fiFa m 16a 797) . "?ibbTaqable5mount(seep"ageil) 166 . . o IB . ii st i u ? I 1 A f"Ansibn5 and annuities 17a 3600 00 llb Tarzebla amount (See pagel2) fe E) h Sch tl t ' ' g ' 176 18 655- 20 : e u tac states trusts, etc (a roqtllbes, psrtner9hips; e L?. 18 {ter ?- .. ' . . .' ? .' ? r . e I ' ? m Oule F) ss) (attach ScN -incrne or (lo 19 4il?r r? Please s`?` Dleamount(SeeDag 21tiT 21n axa ?I '?6rIf 21? check attach , , 13 4= ' o B )..._.. .?.....--- Y-- 22i ., n rnou ?lanhctime(list t e and a or monere. gp nfs shown m the fat.rt ht c?Page olumn for lines Zthrou 2. ThiIs our total Incoi order he'".v?fAhuatn UcanieworksneetonPage14br15 YOlfl' I1;tP -24 P Rdjustments S 1cfroapplcable workstieet on page 14 oi 1 dudlon; from wmksheeT on page IS 2lti n t I om ZS 26 j ce e nsu o ne e c ed ' SEP deduction self•em lo 2 . Y? p y ,, , ..2loitdrl fsavin s 28 . . . . . . . . g o (See 89 A?1Rior?y p8id s RecIbl@nY3last naine Instructions 'sonalsecurirynum6er. . . 29 on page 14.) 3d ne3.24 thfciu i29. 7hese are our total ad uitments' - l? to Q a1 ci,tit.Aer c?,an r.no, una 23. rniz is vnur adlusteii aroas Ineome. !f this line is less than, .?-.__._ 1 . . . .. .. . . , r.?. . ? . ?, . ' . . . - . ? . ' , .. ', ..? August 4, 1975 ... ?..,. . . : . . ,?.?. - . .?.,: xan c. olsen' .. ?, . ., , 4565 Pilot Snob Road _ . . Eagan, MAt 55122 ' Dear Mr. Oleens Rea 3aa1tar7 ,Setrer Trunk Youding Eas ement . Reoent3y you aigped:_azt e6ement Por ponding xtEh •?arCit;?" cY Eetgeu .1 ' for thamae- Lake. 2 have Deen informed by oqx+, C$.ty.'Attbri?ep'+:Mr. I?Iaul Hauge_ that xs naed the Certifioate of Ti.tle in orde r t o reoord Oe eas ement. Please. ? ,..? ? .,y ?y .. ' ?701Iti8Cti? MI'w;.gBU$8 St jOl$:.@' 9 j3 ti ?wiraa?BIIOQrt'?t 45L?J;G24 tiO:ti999. 1'ihi8? . , „ mottar reeolved. ? Thanlt-you for your cooperation cancerniiig the above meiltioned•, . `. Pcndin8.eeaement. $Smere]y,. i Ann f3oera jMre. ) , _ Aeaeeament Clerk ; . ` City af Eagaa . ' . . ?. , w. ??.;' ,, . . ' . .. .. . . . . .? . .. .4'. ..f. . ... . ..'. ' . ' ' . ' . . • ? . . . ? ? . ?? ? . . . .C . . . . . . . . . . . k:!. . . .. '. . . . . . . .. . .. .. ? . . i . : . . ' wt? . . : 1 . .. . . . ? ' . . . . . . .. . . . .. ?. DELINQUENT TAX RECORD I 31 26 ?) "/)o/,Y? PT OF SE t/4 CF E 1 4 C n LASTGNANTEE 529 FT N OF SF f, RW 435.6 IS CX OCPOTNY A rLSEK F7 K 300 FT E 43 .6 T S 300 FT Tfl ?FG Dorothy A Olsen Aff of Surv 3.OU0 ACRFS 28 27 23 4f.,4? ??Lt- r4?"; s?.b? to j?wy ?.S??n1- .?areels q ? 9 f im S-- 3-?? 89-36 city of eagan 3830 PILOT KNOB ROAD. P.O. BOX 21199 VIC ELLISON EAGAN, MINNESOTA 55121 PHONE: (612) 454-8100 Special Assessment Search onvTMi? ?GusrnF?'soN PaMELA MCcaEq THEODORE WACHIER DateO January 12, 1989 CouncnMembers 7HOM0.5 HEDGES CiN ?mnisUalor Requested By; R8: Section 28 euGENEVnraovEaeEKE j ClryCleik Gonyea Land Company 10 02800 020 79 ` On the attached form is the City's response to your search request on the identified property. The information includes the original amount of the assessments and the payoff amounts of the assessments on the parcel. In addition, pendinq assessments are included for improvement projects that have been ordered to be installed by the City Council as they may affect this parcel. The levied and pending assessments may or may not reflect the complete assessment obligation based upon the parcel's current use or zoning. Certain parcels have not been assessed at the appropriate rate per their zoning/use. The City's policy is to review the assessment obligation of parcels at platting, replat- ting, rezoning, waiver of platting, and prior to the issuance of conditional and special use permits and certain building permits and in other unique situations. A condition of approval requires the parcel to assume its additional assessment obligations that have not previously been levied for existing public improvements. The City's Enqineering Division can provide further clarification of this policy, if you desire. WAIVER/DISCLAiMER: Neither the City of Eagan nor its employees guarantees the accuracy or completeness of the information provided which was required by the person or persons indicated. Nor does the City or its employees assume any liability for the correctness thereof. In consideration of receiving and using information on the attached form and for all other consideration of any nature whatsoever, any claim against the City or its employees rising therefrom is hereby expressly denied. Pending assessments cannot be paid until levied. Levied assessments can be paid to the CITY OF EAGAN. Ver1• truly yours,?/ t?'?/--? ??Je?yLaCi?-7 ?^?`.'l.? SPECIAL ASSESSMENTS Attachment THE LONE OAK TREE. ..THE SYMBOL OF SiRENGiH AND GROWfH IN OUR COMMUNITY r l't.,,AI`dSFiCT:f.L.-1N :[DC F276(3 Sl'li`(.:]:rll.. AfiSk2E"i':iMEN.l_S oPlii:l;:[r')I_ AtiiSFt3Sl°IF'IVTS FiE:A1=iCFl pRi:1FER7Y I.D. TLIY)AYS L)1-;TI=:: 01/12/89 . . l. i?--0":::f.3Ci0....C):??. -'% `?' ? :3., M.. #1 ASSES?iME"I'•.I"I i:iE',3CR.. YR YfiLi Rill"I: T17TFiL 100504 BFdhJ SbJ Tf't 75 15 100151 1+lFi TFR ARL(1 76 15 100Y714 EiYd!`I'li 82 'L`; 7.;:i1=`466 1='7:i_(J`f KfqL)li Fil') 00 Q 3UI° II°IARY i=lF= i=iC i:[ VG: .yx•f..V:'?••q. 1 Y ( I'??<1 ?II'II.S. YL?YI?. ::1 ?II.?1 . ?=+ rxM ;I3UrhMi=,RY i_iP' I'6i::1,1t)TNfrn 3UI°Ih1A1=CY --- ;F•IcCI(aL. 1=L.Af'.3----- '-+ nNiv. F>F,:r.ti. PAvor=r -- c_OriMEiv 8.00% 788.50 52.62 9.00"/. 722,00 48.16 E::. pV% ,:',38. 31 I[i`:i. r19 .00i: 5316.00 5317.1)0 23=4fi. fii 156.b7 <;16.4o Ei31fa. [)I; :Ji. C:l2 96.31 447. :I. :I. `::'_:16. i 11> FF:.NI) `5YC.. O=?i 5016. 00 NOY. -30' 99 (TUE) 11: I B DAROTA CO EiNV 1UT TEL:612-891-7588 P 001 Municipal Notice of Well Permit Applica tion Dakota County Eavironmental Management Deparment Water and Land Management Section 14955 Cralaacie Avenue West Apple Valley, MN 55124 Tel (612) 891-7011 Fax (612) 891-7031 DATE: November 30, 1999 TO: Tom ColberdWayne Schwanz Fax #: (651) 681-4112 FROM: water and Lsnd Managesent RE: WellPermic#: 99-H156120-11156123 Municipality: Bagan Well Type: ?ted Environmemal Spec ialist: Luehrs The Water and Land Menagement Section of the Dakota County Environmeital Management DepartmeM has received the following permit application for t6e well described. If you i?equire futther re?'ie?' of the application or if you have any questions or concems about it, contact the Environmental Specialist listed above or our affice at (612) 891-7011. If thene is no response from your oftice ibithin 24 HO[TRS (excluding weekends and holidays), we will assume that you have no objections to the is>,uance of the permit Please note that pexmii issuance is always condifioned an the permit applicanYs observancc of and complianao with all applicable state, county, and municipal laws and wdes. We11 Contractor: Saiverda Well Company Datc applieation raceived: Novem6er 30, 1999 Anticipated Dnlling Date: Time: Anticipated Crtouting Date: Time: property Owner: Easter Lutheran Church Well Owner. Easter Lutheran Church WELL T.OCATION: PLS Coordinares: 1/4, se 1/4, se 114, se 114, Scc 28, Town 027, ltaegl 23 Street address: 4515, 4565, arsd 4575 Pilot ICnob Rd PIN Number. TM-P0000-060-26 WELL lNF4RMATION: Diameter: 4 Casing depth: 150 Total depth: 155 Staric Water Levet: Aquifer: COMNTENTS: 6128917588 => CiTY OF EAGAN ,TEL=6516814612 11/30'99 1217