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4875 Pilot Knob Rd Use BLUE or BLACK Ink i For Office Use _ Permit City of Ea Permit Fee. / 5D I 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: ; Phone: (651) 675-5675 I I I Fax: (651) 675-5694 J U N 1 0 t;L Staff: --------TA I 2011 RESIDENTIAL BUILDING PERMIT APPLICATION i Date: Site Address: Unit M Name: ( V ebt rA /`31- uz- Phone:Z,,., y ° 5;Vr- / RESIDENT/ 7 OWNER Address /City /Zip: i Applicant is: Owner Contractor jF TYPE OF WORK Description of work: 4PI-Acr ~ t ST/AJ6 f / /O fig Construction Cost: lP 760 Multi-Family Building: (Yes No ) Company: u_Contact: CONTRACTOR Address: City: State: Zip: Phone: License Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 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: 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. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accthe approved plan in the case of work which requires a review and approval o S. 0,4 F,1 of ~ L X_ 6 L_ Q~ Q/L ~ t Applicant's Printed Name Applicant's Signature Page 1 of 3 f t I f`1 y"'UO NOT WRITE BELOW THIS LINE -7o SUB TYPES Foundation Fireplace _ Porch (3-Season) Storm Damage Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family) Multi Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) 01 of _ Plex Lower Level _ Pool Miscellaneous Accessory Building WORK TYPES _ New _ Interior Improvement Siding _ Demolish Building* Addition _ Move Building Reroof _ Demolish Interior Alteration _ Fire Repair _ Windows _ Demolish Foundation Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation Occupancy MCES System Plan Review Code Edition SAC Units (25%_ 100%-~-) Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction- Width REQUIRED INSPECTIONS Footings (New Building) l Meter Size: ootings (Deck) (~~l 1 lJ~/y(~C Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation ` HVAC _ Gas Service Test Gas Line Air Test Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In -Air Test -Final Windows Insulation Retaining Wall: _ Footings _ Backfill _ Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC u 4 Utility Connection Charge ~J J 5 y S&W Permit & Surcharge l Treatment Plant Copies TOTAL Page 2 of 3 0 yt~l • • r • , . • J z 01 3~75 lips, 03) ~ CN _~13 It'll 132-05 ~t~ 0/ i~~ -7 5 CITY OF EAGAN Remarks ? •- ? ' 1-- _- ?? -- ?`%%5 ?3 ??>>' ? S Y.,L1, _TL o .0ti5 . Addition SE TI N 3 Lot Blk Parcel 10 034(1(1 012 5f1 Owner State gZe_.--?, cv: 11e _SSR 3 7 i. -- -•^ - \ Improvement Date Amount Annual Years Payment Receipt DatB STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK a STATE OF MIN.NESOTA Departmerft of Pt7blic Safety State Fire Marshal Division EXIT INTERVIEW ? Date: Z "`l -SS Time: /U- U s30 U J ?'? '" Name: Phone: i J u? :_. ,.. f > ?< ?-._ J __ • / .. ?. ? ,- r. ? , ?. ? ??----• G ?1. ??s Y 3 G i r Address: '?Tf i•? Owner of Premises: ' In accordance with the provisions of Minnesota Statute 299F.011, Minnesota Uniform Fire Code, inspection of the above premises was completed and the following violations and/or deficiencies were noted requiring corrective action: ? Code Violation Summary Deficiency and Corrective Action - ? _?-- ? ? _ ?•?? - . ,.?? ?r? ? ? `?rre 4- i`1 - 1-'? /N/lJ i? _ '? ? 7 /'0 .r A ? ?• /? .? .. ? .? .. . y `%"- ,L f ? v , //i ? - f??LC ?' C ?=?-r %is.. J J• ? r 2/ !i? -?S J'? rp.? r G• «. i i / ? / L-9 ?1 , , " .,?.1- ?? //?--J ? L-/ uG r - / ? ?? -? • 7 j . X2?. j I17 THERE IS A VARIANCE PROCEDURE PROVIDED BY STATUTE 0 NOTE • Signatures indicate receipt of copies For further assistance please OwnerJRepresentative contact the Fire Inspector at ? the following number. 612 ???"-,?yU • ''.-? . - -? ? s, .?? Fire Chief/Representative '? ? `• Fire Inspectar, Fire Marshal Division ? .,_ ? ? ? H? ?../ -?/ i? /6 f L ?-f?'? J °'/ Distribution: White - Owner/Representative; Canary - Fire ChieflReprasentetive; PS-06057-02 Pink 7 Division Office; Gold - State Fire Inspector T a STATE OF MINNESOTA Department=offdblic Safety State Fire Marshal Division EXIT INTERVIEW N- - Date: Time: Name: Phone: ?- . . ?. .?c,<? Address: Owner of Premises: In accordance with the provisions of Minnesota Statute 299F.011, Minnesota Uniform Fire Code, inspection vf the above premises was completed and the following violations and/or deficiencies were noted requiring corrective action: Code Violation Summary Deficiency and Corrective Action --; .? : /.?:: ???r. ,.; ?? i=--?- ; j.!• 1,!?. o ? j- u ? ! er" 'r ? V U ?? iil / i? ?/ ? ? ? ?-? i"' i'? --?? ? .?-i u m ->? ?, ? //? i ? < . / ? 6 J' l r??'-'? J" ..r i ? - . l c ,% u ri < ?- l??' ! 7J K i= ? l=o ? /.W, r ??/ • . i .2 .4?41 I.? c- i ` jro??l ?/ j?- /`???/r j , i+N°? ?c /f ? i ?G?j •'r/ ?iJ?? 'oeF f' L-Z JQ . % % - . t? Ya•? ? ?', : ? ... f r C ?00/^ ;. f THERE IS A VARIANCE PROCEDURE PROVIDED BY STATUTE • NOTE *Signatures indicate receipt of copies For further assistance please Owner , JRepresentative ; contact the Fire Inspector at the following number: Fire Ghief/Representative Fire Inspector, Fire Marshal Oivision f -' , Distribution: White - OwnerlRepresentative; Canary - Fire Chief/Representative; PS-06057-02 Pink - Division Office; Gold - State Fire Inspector CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 AMOUNT $ I UOLLARS too ? CASH E]CHECK POR BY ? ? 700 NUMERICAL FILE COPY CITY OF EAGAN Remarks 0- -9"-w&A Addition SECTION 3 ?ot 013 lk 75 owner -? d 4875 Pilot 1Cnob Roa? Street i n ii --7 Improvement Date Amount Annual Years Payment Fieceipt Date STREET SURF. STREET RESTOR, GRADING SAN SEW TRUNK C003531 1-5-78 SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. - - sac 475.00 5700 4-19-77 PARK 120.00 570 4-19-77 ? CITY OF EAGAN 3795 Pilot Knob Raod Eagon, MN 58122 ' PHONE: 454-8100 BUILDING PERMIT ''' ? ?"' • Receipt # M2 4276 To be uted for S 1i1g . r`. Dote % :q, T1? Z`? • ? 19 Site Address %315 i.?-i S oC -?• Erect p Occupancy T Lot B:ock -75 Sec/Sub. Alter ? Zoning •"•-I'r' Parcel # pair ? Fire Zone _ lar E ? T of Con t ge n yps . s 0: Name IP ?• r I.*?s+^ Move ? # Stories w 3 Address 1'e - ?'. Demolish ? Front ft. ? r:?.. 454-2815 Grode p Depth 90' ft. 'Nome _ 0 Zv uoQ Address cc ri+, Nome Fees Permit - ?`? Surchorge Plan check SAC Woter Conn. Water Meter Assessment af 'L if ' Water & Sew. Police Fire Eng. Plonner Counc ?77 I hereby ocknowledge that I have read this applicotion ond state thur gldg. Off. -3/23/77 the informotion is correct and agree to comply with o!I applicobfe a State of Minnesota Stotutes and City of Eagan Ordinances. APC Total ' ? 5ignature of Permittee -- i -: j PgKi C:r?;: z A Building Permit is issued to: ' on the express condition that all work shall be donz in accordonce with oll opplicoble State of Ivlinnesoto Statutes ond City of Eocon Ordinances. Building Officinl r..mtr # oW. i..o.+ r«.?ee» Plumbin9 ??`3 ?J.s'-!S/ -'7?? ' _ _ Mechanicol j, q - ?S, zo- G -?o -77 d Jd' ? ??'+ ?..) ? ? - i - > ? INSPECTIONS DATE INSP. Rouph-In f1no1 Footin9s - -?7 Dote Inmp. oata Inap. Foundation Plumbing 4-1' 7 -//- Frome/ins. Mechanicol -/. Finul - -, ?? Remorks: ftirP //` .` I h0 T- eA lled k-, CITY OF EAGAN ? 3795 Pilot Knob Rortd 1 Eagan, Minnesota 55122 Phone: 454-8100 PERMIT No. ? ^ ? : Date: Jari e 20, 17)77 Receipt No.: ('643-' $ingle I Site Address: pilk)t Knu". i-Y)ad Residential X Lot Block Sub/Sec. - 34 Multi Res., Comm./Ind. I Name '7'T =s.' 1 New/After /Repoir ?'`'y: . Address 1385 I?eeLwood L?z'ive COSt of Instoilation ? Ciry ?'`nan Phone: Permit Fee 10.0? Nome Surcharge .50 ? ? ? Address ? City Phone: Total This Permit is issued on the express condition thot all work shall be done in accordance with oll applicable State of Minnesota 5tatutes and City of Eagan Ordinances. Building Official CITY Of EAGAN ? 3795 Pilot Kno6 Road • ' ? Eagan, Mineeeota 55122 Phone: 454-8100 S":P'i`IC TAN!: t JP2• ' ?: .= hERMIT Date: June 1, 1977 5ite Address: 4875 PiI.ot xnvb Ftd. Lot Block Sub/Sec. Se c . 34 No. 278 Receipt No.: r) F,Z r,_3 Single I Residentiul ti Muiti Res., Comm./Ind. I T Name New/Alter /Repair new . . . 3 Address Cost of Instoilation O City Phone: Permlt Fee 1-0• 00 Name WPierk.e TrenchinQ r Exc. Surcharge •50 ? ? Address C60 Cliff Road s City T.`aaa., Phone: Totol 1C.5!', This Permit is issued on the express condition thot oll work sholl be done in accordance with all applicoble $tate of Minnesota Stotutes and City of Eogan Ordinances. Building Official CITY OF EAGAN ' 3795 Pilot Knob Road ' t Eagon, Minnetoto 55122 Phons: 454-8100 `j'ATINr PERMIT Date: k'iay ?7 A . Site Address: Lot Blxk Sub/Sec. -i-: .. Cro:. Name o -,r. ?. ., ; Ad ss O 'caqan City _ Phone: Nome ray N. Welter Heat-^q r'o. . ? 4637 Chicago Ave. ? Address e 0 V 55107 City Phone: This Permit is issued on the express condition that oll work shall be Minnesota Statutes and City of Eagan Ordinances. No. ." Receipt No.: Single I Residential ' Multi Res., Comm./Ind. I n}tw New/Alter./Repolr Cost of Installntion 2,). r)il Permit Fee . i7 SurcFarge 7n r.? ?. Total done in accordance with oll npplicable Stote of Building Official CITY OF EAGAN 3796 Pilo! Knob Road r Eagan, Minnesota 55122 Phone: 454-8100 PERMIT Dote: t'`,av 14, 1977 Site Address: 4875 Pllot Wtob RD?d Lot Block 5ublSec. me ?--ros2 & I,ehman 0 Address ''• 'T• Fok 1211 ' ? City - ' i lle Phone: Name . ? ? Address 0 c? City Phone: This Permit is issued on the express condition thot oll work shnll be Minnesoto Stututes and City of Eogan Ordinances. No. Receipt No.: 0 E'aF.i Single Residential . Mutti Res., Comm./Ind. I New/Alter./Repair r? (-_ w Cost of Instollotion Permit Fee 20.00 Totol done in accordnnce with all upplicable Stute of Building Officiol cirr oF E?G?N 3795 PilW Knob Roaa Ea4am, MN S5122 PHOIdEs 454-8100 BUILDING PERMiT Receipt # ' ,-'' •_' ' 15 Te L. ura #ee V`':;:?:: •.,•.• . ,- Fc+ Vnlun ? f?J'? Dntn ='i Site Address ? ' . .. . • ?•• " ..••?"" ..•. "•• Lor Block t ? 3 ?G13 Porcel # w Name + +v ru vui L- 1 a ? Address 4875 Pilot .?:r?ob !io _v . fl :;2-3" .32 w 0 Z ov u? ? Ncme _ Address Name N4 4941 Erect [?} Occupancy A Alter ? Zoning Repalr ? Fire Zone 3 Enlarge ? Type of Const. Ahove ? # Stories Demolish ? Front Grode ? Depth ft. Aoarovola Fees Assessment "/ ++I ?'+ Woter & Sew. Polioe Fire Eng. Planner Council Permit 7•%;V Surcharge 1'00 Plan check SAC Water Conn. Water Meter _ I hereby acknowledge thot I hove read this application and state thot Bldg. Off. 8 11 78 the information is correcf and agree to comply with oll applicoble APC Total . Stnte of Minnesoto Stotutes ond Ciry of Eagan Ordinonces. Signoture of Permittee A Building Permit is lssued to: on the express condition that all work shall be done in accordance with oll opplicable Stote of Minnesota Stotutes ond City of Eogon Ordinances. Building Official , ranM # Dob laued /Mwlfh" Plumbing Mechaniccl INSPEGTIONS DATE INSP. Rouqh-In Finol Footings Dote Ir»p. Date Insp. Foundation Plumbing Frame/ ins. Mechanicol Firwl Remorks: (O / -/?j - ? C? o` / ?x.? This request void 18 months fromLL23 iOO ? ,' /o a3yoo o?.? ?o P 18429 bate of this Request Aug. 15, 1977 I, as iE(I,icensed Electrical Contractor O Owner, do hereby request inspection of the above electri- cal w'uing installed at: Street Address or Route No. 4$75 Pilot Knob Ro ad CityBig3i1- Section°-?-,7/Township Range County Dakat.o Co rTrs Which is occupied by Lemahan (Name oi Otcupant) Is a roughin inspection required on this job? No O Yes ? Ready NowRc Will Call ? Power Supplier Dakato Elec. Address F armi natnn ElectricalContractoi Easton El ec. Contractor'sLicenseNo.32?!a4 (Campany Name) MailingAddress Route 1 Boe lyJL Pirnr Iaka WTn 5F?71 Y (Electrlcai Contractor or Owner Making This Installat?on) Authorized Signature Phone No. 447-2490 (Elettfltal Cantractof oI Owner Making This InStallatlon) STATE BOARD COPY ' plt Type of Building New Add. Rep. p?m?C ppp?ces Wired Fw Check uipment Wired For Home ? ? ? Range ? Tempocary Wuing ? Duplex ? ? ? Water Heater ? Lighting Fixtures ? Apt. Bldg. ? ? ? Drye: ? Electric Heating ? Commercial BWg. ? ? ? Fumace ? Silo Unloadei ? Industrial Bldg. ? ? ? A'v Conditi te? Li t P? O P Bulk Milk Tank List ? Fazm ? ? ? p s ea 15j ei Ufllp p ?7sI Other ? ? ? H e He COMPUTE INSPECTION FEE BELOW Smice Entcance Size: # Fee Fcedecs&Subfeedets: # Fee C # Fee - 0 to 100 Am s. 0 to 30 Am eres eres 7-5725 lOl to 200 Amps. 3 0 ere - eres Above 200 Amps. ;1 Am a Tcensfocmers R8eC6neroFCiic; rfee Si ns Sp' In- ection Remacks ? 0? I, the Electrical Inspector, hereby certify that the above inspection has been made.5 fucic-?•?- (Rough-in) r Date 4G ''7? (Final) • Date - ?? Minnesota State Board of Electricity o 1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703 f? JSt/,? ?f ' REQUEST FOR ELECTRICAL INSPECTION CK BELOW WORK COVERED BY TH1S REQUEST ? O'I ? 13 1 This request void 18 months from CITY OP EAGAN ? 3795 Gibt Knob Raad Eagan, MN 55122 N? 4276 PHONE: 454-8100 000. . .. BUtLDING PERMIT APPLICATION $36 Receipt # S?e) _ , 7o be mua fer Sing . Fam Dwlg, d Garg, oote April 19, 1 9--ZL Site Address e87 S vi 1. .r e..nh $d. Ered [$ Occuponcy T Lot Biock Sec/Sub. SeCy33: Alter ? Zoning__-Agri Porcel # Repair ? Fire Zone E l e of Const T n arge ? yp . w Name Lehmann Move ? # Stories Z 3 1 Address _.? ToS2 E.L?+iOed DT. Demolish ? ?? f? Front ? Ci1 EegaII Phone 454-2815 Grode ? Depth 76 ft. _ Aeoeevels Fees ?p Nome_ A Address r r:«, Name I hereby acknowledge that I ha ?ead this ap' ation ond stote tl the informotion is correct o agree to wmply with all applic I State af Minnewta Statute and City of Eag rdin nces. $ignature of Permiitee -? A auiidtny Permir ?s ?ss?e ro: enneth Lehmann and all work sholl be done in ecord nce 't? h all applicable State of i Bullding Official ? Assessment j/ cj/ r Woter & Sew. Police Fire Eng. Plann 2 21 76 Council 7 BIdg.Off. 3 23 7? APC Permit SurcFwrge 1A.00_ Plan check SAC 475.00 Woter Conn. __ Water Meter Toral 598.50 GLOSZ an the express condition thot i$tatutes and City of Eagan Ordirwnces. cirir oF eaG?N 3795 Pilot Kno6.,11laad Eagaa, MN 35733 N2 4941 . PH&AFs 454-8100 BUILDING PERMIT APPLICATION Receipt # To 6e used fer woOd storage St1BdEst. Volue 2f 100 pate 8 15 , 7978 Site Addreu Lot Parcel # BI«k Sec/Sub. 10 03300 013 75 g Name F1oYd Curtis ? Address 4875 Pilot Knob Road ; Eagan m___ 452-3432 p I Name Saine ? ?? Address F r... Name _ Address 1 hereby acknowledge that 1 have read this opplication and state that the information is correct an ogrea to comply with all opplicable State of Minnesota SMt nd rty of Eagon rdinances. Signoture of Permittee utes ' µ Erect EN Occupancy i AITer ? Zoninp Repair ? Fire Zone 3 Enlorge ? Type of Const. V Move ? # Srories Demolish ? Front 22 ft, Grode ? Depth 12 ft. Approvala Fees a Asseument 01111 1 Water & Sew. Police Fire Eng. Planner Council Bldg. Off. 8 11 78 APL Permit Surcharge _ Plon check- SAC Woter Conn. Water Meter Total 10.00 A Building Permit is issued to: on the expreu conditlon that all wark shall be done in acco Ice wi oll ppli ble Stote ot Minnesoto Statutes and City of Eagan Ordinances. Buitdin9 Officini Ly??,4- f i-?c?c? f .. - 1 pn:E 8BUILDIF7G PERMIT APPLICATION include 2 sets of plans, 1 site plan w/elevations and 1 set of energy calculations. 2b be used far'3TORN? C.- 3" A? S? SivC+? 117v b ?ES e.Tc • , Site Address; Valuation 46 q (/ 3• ? Lot Block Sec, Sub. Ot,mer rI:/<, ., ,1 c 6' 1 e rt1ra l,u 12 T )' Address $'JS^4'/et Jrvch Cantract?gr, /}7t:NR2??? ? rIGS Address'"??ocbe +z a S r?les -kErt) c?ehas eiz fYtM SS90/ Arch./Eng. Address Etect Alter P.epair Erilarge Nbva T7ewlish Grade OFFICE USE Occupancy ` Zoning Fire Zone Type of Const. 8 of Stories Front Depth _ OFPICE USE Date of Approval &_Zrtitial Assessment Ldater/Se4rer Police Fire Eng. Planner Gbuncil Rldg. Off. A.P.C. PeZmit Parcel Number, /Te2ephone Te2ephone Telephone Surcharqe Plan Check SAC raater Conn. 47ater Meter FEES TOTAL ?i Name: fi Icade O` •- ( Y I rIk 1-1 ?? ? 14 ?I 0 V 3 rade Readit g Building Length ? ? Fill in 'vorth Directionc =7 ?? , E ? - ? ? ?- 3r j1?rLiTES ?K j??- ? 2c?F? R I 'QE 4 S ?'` N.VOER 1?? W ? 30 ? A. Fitl in exac} door locations. ? B. Show job site grade on floor Qlan. C. $ubmit this form with each building order. / ,,? EXACT PLAN AND DOOR LQCAT10N5 APPROVED BY: c ? ?fr?2 t? (Custom Sign) ?j Ct l--c. E M[:-PJAQRD AGRI-BUILDI14GS FLOOR PLAN FORM .4 rweNrr nQncb, , .r¦ ¦rs¦Is vm ? vm`rrEIL . . MENARD Ami • auu.aHCS -- f DIVISION MENARD, INC. . ROCHESTER SALES CENTER , 6765 0wy. 14 East. Route 3 Rahester. Minnesota 59901 't) c.• r?r?T ? j ??? im 7s ' > ? ?C r'-^?- ?I - Ln S3 1? 2 L 2• Z . r ? • ue ?wa Mo ?a.,p? n..eu r ti^ - uuc a uxruc mnW J.41 yt?? „ I ,? ? ? S?cj*K- i? P, , sa, S- r y' P, P 7- 16' r.?, ? y3 . , .n' ?? ,??,}? 3 0 0 0, a-a ? This contract is xritten uble to the approval of the Manager of ihe a6ava named CenteG UIHsioa MENaRD Inc. And shall irot be binding on r4Ewreo InC. unGl acceoted. Noh: This reasion becomes pert af, and in wnformaftce with, the existing contract YIE A6REE hereby to make changes as specified abarq at this price 0* f r'-• .i .»- oote L 1. y J? coxrun muxl I ••• " Perwn rin%rlh reAort. • 4, .f. f? ?? ??1 J .? . . G I Accepted By: Ma ger, Above Named Center DivisionMiNSRDinc. ACCEPTEO: The above prices and speCifications of Mis Change Order are satisfactory and are heroby ' accepted. RII vrork to be perfarmed under same terms and co tion?ds specified in ori6inal controct unlasa atherwise sti ulated. i; 'f ? ? ¢;gnamre ? P. Ni NaRo ? ;A I'?BUILDINGS aiviSioA r?uWwn. Inc. date r, PROPOSAL ?ROCFIES?fR Sr4f? ?CEME ? ttoute7 ? , s ?y. ra ?ster`MM. 5b96J ' , , lSO?.2S8?3275 .. FOR OFFiCE USE ONIY Oown PrymeM Chmge Order t _ _ Chmge Order auvery s - ComplNloa Z _ .... , . ,-. ? City. ! I ? Stale .'Zip CoGe A ro-,;? .N1bN,?, H?me Phone ,Phqre Oltiu Phone + . SPE(?•IFIC TION$. AND E.STIMATES rnis proposal is hasee on the sPecifications and estimates set torth belaw rMrc, M ????; - ' •. snd. b wbjecT to striNes, availability of materials, accidents, weather, and othecforces and deteys heyond ?iMn, Inc. tontrol. It is writteo r ` s?( a Ns-r n: r A c?? ` L e-1 ? i sub' M to the a oval -ot the home office of MYtAao , Inc. in Eau n ? .W. , Gaire,. Wisconsin. mMNw6 , Inc. reserves Me rigM to witMraw this praposal if noT accepted by customer within ten (10) days irom the dete R aa F nereof. owner is to prmide and carry 6uilders risM, fire, tornado, winQ . ;? . - and otAer necessary irewance. Our worNers are Tully covered by Work- . - . . . , . men's f?ompensatian Insurance. COLORS . " o 4 StRbI S TrukEover wN ItG i 1 4Rb Tki ' ' . ' ' t' ? rrim cu N Y r? M w A ? N u fd f r N e a D i u S? I,v? -?v o C:?G a Ss ' mm w 4 i ni u r eotrom rft (.0 bor orerbanr y -3 ? s t w 4 cL s k,?T?S rr! 3 &idina Ooort 0,04A Boxed 6ahls 40 A t A1 T- y 7 E . ., y llcceM Strlpes Camer Trim W u/ ' 6i6N Tdm Cr r? LD Skilffu W N 17 f Si/ b ,4vA T R1AA I cUu 1r0, ?? Ooor rrim ?1d1e ?v _ r I1? sa 07't' oNt r R 1 til :dr?dt.RSr" , . . ,, J .? .I 1. Owner ahall be resDOnsi6le for obtaining ell buNdfng end land u permka. 2. Owner shall be responsible kr removing all o6atruetionre trwn tl site including 6ut rtot Umited to snmy,' buildinge,. ibcMs aqp trees. 3. Owner shall be responsible for site predarotian ineluding 6ut not lim ed to leveling the site and grade setting. 4. Owner shall advise wamwwn, Inc. of all poteMial undergrou Aa=atda and identify their location including bu[ irot limited to und? ground utilities, drainage tile and septic tanks. Owner ahall withsta repair and or moving costs. 5. In the event tbat underground conditiom Nnawn ar uFiknawn to own such as mck ar soil-canditions, undergraund water m undergrou caverns cause Mouwo, Inc. any addkional expense tor use equipment, la6or or mahrials in yrecting .this building, tAe mn shall be responsible for all casff and expauses tor such additia work. If owner is unwilling ta pay,this addiijoaal eKpense, all mon paid by owner shall be foAeited •dnd MoWO, Inc. shall have further o6ligation ta complete the bui?ldiang. DucrlM IwNnpt ol Sfle hers ,.tio I X, .., _ '7- I We lai oanPh ---opma , it wm unpold ? W NOTE: 1 OUARAI LIABLE I BY ANY i ??.. ? $eNnd Completbn Dsta yrooas 10 lumqh hbor ond mNWrbh - ? aoesrd?ne? wIM tM ?6ev? ? : , { A mu ?nAfslbwln0oitlmNlrlerlMwm ol ?n ?- ??:? r.dotlen (t Peyments M bs meda aa follows: ' ?'?. . •I.?: r , . . DOwnWYmmt (to seM!4m),. ? S? t0 On ONiwrY (to SamFDelra) i•r, frii - OnComplNbeftoCrwrROnqmn).. 8alaeman. - - ' MAKE ALL C CKS PAYABLE TO MENARD, INC. , M no1 nrfta pfovldrd br a 8ERVICE CNAl10E H lM nb of 1% per monlh (12% mnuN rMe) wlll M Imposad on ths nalipal tidena. By Aeoipt?m 4t1hU propoW.lMYlidenlpnW proa to OII ffi prma.,candltlons, and Ilmltatbns aet lorth on md p STATED ON RFVERBE 8106 OF TN18 DOCUWIENT. Ay2 ? / '? f' ? hb?_d?YW ,Cualomar. I ,?,?Customer. IIS 6UILDINQ 18.0EEIGNED AND 18 APPROVED, fOR AORICULTUNAL U8E ONLY. IT IS NOT DESIGNED, APPROVED, TEEO, OR IMTENDED pY US TO 8E U8ED FON ANY QTHHR USE OR PURPOSES: ANO MOrAAO, INC. BHALL NOT BE OR ANY C4AIM, WMETHER ARISINO UNDER YfB OUAIIANTEE OR bTHERWISE, W HICH FiEBULTS FROM OR IS CAUSED AODIFICATIONB OR ALTERNATIONS TO TNIB BUILDINO. AB 104 ? pVprOViA bp ' Osnonl 0ltles , (ill$?01118E ;-off , ... ... ,. . . -?„ ? _ -- _ _ --- ? ??I I ' I? I' I ?' /? ?, I '' i? , ? ' i ' i I I I i i '? .?`j c i i I ? I i ? II ? A?14? ; ? O ? i ? , i ? i.j • ? , j I I I ? ` ti , I I ? I ? i I ? I l ! ?, ? ? I I I I i ? I I , , I ? I I -l?_? ? -- ?? - - --?!('v ? - - - - -- - - -- -- -- - - - - - - - '? ? - ? - ??- -- ? - --- - - - - -? -? - - - - ?- --- - --?'?`'-c?-e- _ _ _ - -- - ? Z2- _ ? ? --?- .?- - .? - - - - - - - - ?- - - - 44 --- -- - -- ? - - - -- - -- ---- - „ - - - ? - -???- - - ?- - -- --?-? ` - - -- -- -- -- - - ---- - -- -- - - ? --- -- -- - -- - -- ?- - - --- - - - - - - -- -?? ?.?- - -- ------- _--- -- ?? ? - - - - - - - - - -- -? -- ? ??. --- - - - - --- -_ _- ?? s?%?- - ; - ---- - - - -- - -- - -- ---- !? ? -3 y?a- - - - ? MECI3ANICAL (RESIDENTIAL) r r Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 Please coniplete for: Single Famify Dwellings Tovmhomes and Condos when permits are required for each unit St3D.-'Z Date 01?D Z)3 Site Address Unit # ProperTy Owner z Telephone #(?pS1 )NA'?) S? ?`3 b 1 Contractor V -\ QD? tk --N ?4s \ r ?'(l/\??-, StreetAddress vlgLI City \J D.,L?P r State Zip Telephone # The Applicant is _ Owner _ Co n4actor _ Othei Add-on, modification or al[eration to existing dwelling unit $ 30.00 furnace replacement a xchanger air conditioner other Stake Surcharge ? " 1 ? ? ?4I ! .- $ :50 ?n? 1 Total $ n? I hereby apply for a Residenkal Mechanical Pemvt and acknowledge that the information is complete and accurate; that the tVOrk will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a pennit, but only an application for a permi[, and work is not to start without a permit; that the work will be in accoYdance witli the approved plan in the case of work which requires a review and approval of plans. ApplicanYs Printed Name Applicant's Signatwe SCREENS 26,29630 REAL E8TATE INOUIRY - NRME/ADDRE88/LEOAL XINPN003 PAtiCEL IDi 10 03400 012 SO ? PIAT NpMEt SECTION 34 TWN 27 RRNGE 23 LEBALi S 1/2 OF N 1 RC OF W 4 ACS OF NW 1/4 OF 8W 1/4 ooosoo 34 2723 AoU: ,E,? PaRcce S/ <DAAorq ci p ?+orEsTEau caen ENTEREDs oi 23 1990 A?l w /VrrP i o 0 FIRBT DIVISIONi LABT DIVISIONi FEE CURRENf OINERt WII.LIAM C 8 RMY P COULTER 4876 PILOT KNOB RD EAOfiN MN 58122 TRANBFER TO BCREEN IIMBERi PF8-SCHOI.L FORMRRD 0 33 0-o OF 3830 PILOT KNOB ROAD THOnwS EGAN EAGAN, MINNESOTA 55124-1897 M*?or PHONE: (614) 454-8100 DAVID K GUSTAFSON FAX: (614) 454-8363 nAMEln htcCRFf, TIM DAWIENTI THEODORE WACHIER Counril Memb¢rs 7}{(31h45 HEDGES J11IIe 12, 1991 cny ndmmatrat« EUGENE VAN OVERBEKE M8. AMY COIILTER Chy Clerk 4875 PILOT RNOS ROAD ' EAGANo MN. 55123 RE: City Water Availability Parcei #013-75, 8E :, Sec. 33-27-23 Dear Ms. Coulter: Recently you had contacted City staff regarding requirements for repair of an existing domestic water supply well. In areas in which City water is readily available, the City would require hook- up to the City system in the event the existing well is not functional. In your particular situation, no City water is available or planned in the immediate future and City policy allows repair of an existing domestic water supply well. Please contact the Dakota County Health Department for possible permit requirements. Even though no City water is readily available or planned in the immediate future, City water will be extended to serve your property as well as the adjacent property when the adjacent properties develop. At the time of City water extension, connection to the City system will be required in accordance with City policies in effect at that time. I trust this information satisfies your request. If you need additional information, please contact the City Engineer's office. P.E./L.S. istant Ci cc: Thomas A. Colbert, Director of Public Works Doug Reid, Chief Building Official Joe Conno2ly, Superintendent of Utilities Dakota County Health Department MPF/jf THE LONE OAK TREE...THE SYMBOL OF STRENGTH AND GROWfH IN OUR COMMUNITY Equal Opportuniry/Affirmative Actfon Employer , . SUI=,DING PF.RMIT APkiCAT#ON 04% nA2S i" i include 2 sata oE plans, 1 aite pian wJelevations and 1 set of enafgy calcu2ationg. 1b be used for /ik'tv-d Valuation .lx '°' ^`?-?7 ? 5ite Addresz; /b. 0 2oc 13 - 7-5-- Lot Block See Sub. Owner Address M.o-G• ? ? Contractor ,d-f?w -2?- Addresa Parcel Number /? " ' Telephone 'Felephone Arch./Eng. Addreffis Erect Alter Repair Enltuqe Move nemolish GYdde OFFZCE USE Occupancy ? Zoning Fire Zone Type of Const. # of Stories Front Depth OFFICE USE Date of Approval & Initial Assessment Water/Sewer PoliCe F3re Eng. Plantiex c.buncil Pl.dg. Of f . A.P.C. Telaphone E'EES Permit + -?- Surcharqe Ja"' P3an Check SAC P?ater Conn. 47ater Meter TOTAS, / ? ? 41 ' I I ! I i ?/?' I I 2 i , I , e*d I I ? ? I ? i li I I ? 1 I I ^ I I I i , I I ' . I ? I ? , ? .? I 1 I ? i i I , i /AX , ?0,m? -- - - au ------ 1,? • ,? ? ? ? c? ? ? -- - - -- -- - %L - - - - 1C/?" - - - - ?--- - --- - - - - ? -- - --- - - -r-?? r- -- - - - - _ ?J-,?'/ ?- y- - ?? MALCOLM D. REID ATTORNEY AT LAW St11TE 340 6311 WAY2ATA BOUIEVARD MINNEAPOLIS,MINNESOTA 55416 TELEPHONE (812) 544-2102 December 29, 1977 City of Eagan 3795 Pilot Knob Road Eagan, Minnesota 55122 Dear Sir: Enelosed is a check in the amount of $265.64 to cover the 1977 spee.ial assessments on 013-75 ' SeC..33 parcels number 01150,(01275 and 94-2,-6 ;---T--is property was previousowned b,y M. F. Mickel- son. I would appreciate receiving a paid re- ceipt for these special assessments as soon as possible. A S' erely yours, alcolm D. Reid mkh Enclosure: Check %-CRVOF 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 5 512 4-18 97 PHONE: (612) 454-8100 FAX: (672) 454-8363 May 15, 1990 ? 4 ( 0- O 3 3 00 - o13 °`7s SUSAN J BRANDERHORST 4875 PIIAT KNOB ROAD EAGAN MN 55122 Re: Proiect 590. Peadiaa Assessment Dear Mrs. Branderhorst: niavAs EGaN Mayor DAVID K. GJSTAFSON oAMELA NtOZEA TIM PAWLENTY THEODORE WACHTER Ccuncil Nembers TFIOIvWS HEDGES City Adminishator EUGENE VAN OVERBEKE Crty Clerk Please accept this letter as the City's acknowledgment of receipt of your letter dated May il, 1990, and as acceptance of the general terms contained therein. Please note that the term of the assessment will be set by the City and will be consistent with all otrier parcels being assessed for this project. The City will not list a pending assessment on parcels 10-03300- 013-75 and 10-03400-012-50 until June 19, 1990, which of course is the day after the scheduled closing. I believe that this will bring the matter to a successful conclusion and the sale of your property can proceed as you desire. Thank you for your assistance and patience with this process. I have enclosed one additional copy for the buyers since I do not have an address for them. Sincerely, E J. VanOverbeke Finance Director/City Clerk cc: City Administrator Special Assessment Amy P. Coulter and Enclosure EJV/kf Hedges Clerk Kivi william C. Coulter THE LONE OAK TREE...THE SYMBOL OF STRENGTH AND GROWfH IN OUR COMMUNIN Equal Opportunity/Affirmafive Action Employer May 11, 1990 r4r. Eugene J. Van Overbeke, CPA 3830 Pilot Knob Road P. 0. Box 21199 Eagan, Minnesota 55121 Dear Mr. Van Overbeke: We have recently placed our home on the market due to a company transfer to another state. We have received and accepted an offer on our home contingent to a pending assessment 6eing brought against the home prior to the closing scheduled for June 18th. It is the request of both the sellers and the 6uyers that the bringing of a pending assessment against the home be postponed until after the closing. This will relieve the buyer and/or the sellers the financial burden of putting 1l? times the assessment into escrow. The buyers have been infoxmed that the assessment, according to the recent feasibility study, should be $5,201.00 and they have agreed not to contest the assessment in that range or within a 50% variance with the agreement that the assessment, when levied, will be paid off with their taxes in full with payments being spread out over a number of years the duration of which to be established at a later date between the City of Eagan and the buyers. It is not our intent to try to avoid the payment of the assessment nor are we opposed to the improvements needed to be made, but to fulfill our civic responsibilities as fairly and conveniently as possible for all parties concerned. ' Susan J. randerhorst (Seller) ?n I 1. n.Q 5cott D. Branderhorst - (Seller) Sincerely, May 14, 1990 Mr, Van Overbeke, Here is the adlusted letter you requested. It has been signetl by the sellers and the buyers.. We request a letter from you (or the city-which ever is appropriate) stating that this is a"done deal". ..I.will be able to pick up this letter on Tuesday, May 15 at 12:30 p.m. Thank You, Sue Branderhorst 454=-8619 .? 4 lt$1[O TO: CITY 11TTORNSY SHSLDON FROM: pINANCB DIRSCTOR/CITY CLERR DATS: ]1PRIL 25, 1990 SIIBJECT: 4875 PILOT ZHOH ROAD q 5 I recently met with Mrs. Branderhorst regarding a problem with "e sale of their property at 4875 Pilot Knoh Road (10-03300-013-,-XS). It is expected that on May 17, 1990, the City Council will approve Project 590 which is the Pilot Knob Road improvement south of Rebecca Lane. The approval of that project will place a pending assessment on the Branderhorst parcel and require an escrow at closing. According to her, that requirement will kill the sale as the buyers cannot front the additional money. The buyers have no problem with the improvement or the assessment but want to pay it in installments when levied. In your opinion, is it possible, either informally based on this letter or more formally through a simple agreement, to delay the posting of the pending assessment until after the closing date thereby allowinq the sale transaction to take place. It seems there should be a simple way to accommodate this request. The City is interested in collecting the assessment and%'not in causing additional hardship for the residents. Please respond as soon as possible as the City's position should be known to these people in advance of the meeting on May 17. Thanks for your assistance. If more information is required, Mrs. Branderhorst can be reached at 454-8619. ?- Flnance Director/City Clerk cc: City Administrator Hedges Director of Public Works Colbert EJV/kf ? q.am P? (70 ?So ? J ? ? April 18, 1990 Mr. Eugene J. Van Overbeke, CPA 3830 Pilot Knob Rd. P.O. Box 21199 Fagan, Minnesota 55121 A'W-K-Z ???L( =? Dear Mr. Van Overbeke, We have recently placed our home on the market due to a company transfer to another state. We have received and accepted an offer on our home contingent to a pending assessment being brought against the home prior to the closing scheduled for June 18. It is the request of both the sellers and the buyers that the bringing of a pending assessment against the home be postponed until after the closing. This will relieve the buyer and/or the sellers the financial burden of putting 112 times the assessment into escrow. The buyers have been informed that the assessment could range from $3,000 to $4,000 and they have agreed not to contest the assessment in that range or within a 10% variance with the agreement that the assess- ment, when levied, will be paid off with their taxes in full with payments being spread out over a nwnber of years the duration of which to be esta- blished at a later date between the City of Fagan and the buyers. It is not our intent to try to avoid the payment of the assessment nor are we opposed to the improvements needed to be made, but to fulfill our civic responsibilities as fairly and conveniently as possible for all parties concerned. Sincerely, Susan J. randerhorst seller Amy . 7or uyer Scott D. Branderhorst (seller) William C. Coulter (buyer) Q PROPERTY DATA SYSTEM . OWNER NAME AND ADDRE55 INQUIRY :CURR 302 : . PROPERTY ID :NEXT . : 10-03300-013-75 A;;;;;;;;;2 . OWNER . . LAST NAME FIRST M CORP TAXPAY ADDR . : Owner: BRANDERHORST SCOTT N Y N . : Addri: 4875 PILOT KNOB RD Addr2: EAGAN MN 55122 . . Addr3: Addr4: . : Owner: BRANDERHORST SUSAN N Y N . : Addrl: 4875 PILOT KNOB RD Addr2: EAGAN MN 55122 . : Addr3: Addr4: . . Owner: . : Addrl: Addr2: . . Addr3: Addr4: . . Owner: . : Addri: Addr2: . : Addr3: Addr4: . Type PID: press ENTER; or F1, F2, F5, F8 PROPERTY DATA SYSTEM . LEGAL DESCRIPTIONS INQUIRY :CURR 304 : . PROPERTY ID :NEXT . : 10-03300-013-75 LOT: 13 BLOCK: 75 A;;;;;;;;;2 . SEQN D E S C R I P T I O N . . 1 S 164.94 FT OF N 329.88 FT . . 2 OF E 132.05 FT OF NE 1/4 OF . . 3 SE 1/4 . . 4 33 2723 . . 5 , . 6 , . 7 . . 8 . . 9 . . 10 , . 11 , . 12 . . 13 . . 14 . Press F1, F2, F5, FS 5?1-3 -fo ? _,)C/o .4?7 fo - 0 33Z) O- D13 - as g4W4 ? aAd-l?? -- fP?'f -- S?i?m ? .??-- -- ? --??;?- _?-? ia -?;?/? 9?0 . PROPERTY DATA SYSTEM • OWNER NAME AND ADDRESS INQUIRY :CURR 302 : . PROPERTY ID :NEXT . : 10-03300-013-75 p,;;;;;;;;;z • OWNER . . LAST NAME FIRST M CORP TAXPAY ADDR . : Owner: BRANDERHORST SCOTT N Y Y . : Addri: 4875 PZLOT KNOB RD Addr2: EAGAN MN 55122 . . Addr3: Addr4: . : Owner: BRANDERHORST SUSAN N Y Y , : Addrl: 4875 PILOT KNOB RD Addr2: EAGAN MN 55122 . . Addr3: Addr4: , . Owner: . Addri: Addr2: . . Addr3: Addr4: , . owner: . Addr1: Addr2: . . Addr3: Addr4: , Type PID: press ENTER; or F1, F2, F5, F8 PROPERTY DATA SYSTEM • OWNER NAME AND ADDRESS INQUIRY :CURR 302 : . PROPERTY ID :NEXT . : 10-03400-012-50 A;;;;;;;;;Z • OWNER . . LAST NAME FIRST M CORP TAXPAY ADDR . : Owner: BRANDERHORST SCOTT N Y N . : Addr1: 4875 PILOT KNOB RD Addr2: EAGAN MN 55122 . . Addr3: Addr4: , : Owner: BRANDERHORST SUSAN N Y N . : Addrl: 4875 PILOT KNOB RD Addr2: EAGAN MN 55122 . . Addr3: Addr4: , . Owner: . Addrl: Addr2: , . Addr3: Addr4: . . Owner: . Addrl: Addr2: , . Addr3: Addr4: , Type PID: press ENTER; or F1, F2, F5, F8 ?110 (\e aQ R J' wo , ' / ? Lo ?? y? April 20, 1978 MEMO TO: Tom Hedges FROM: Dale Peterson j0 0.3,3ao Qii 75- sc&ovL 33 --? RE: 30' X 48' Utility Building on 1 acre lot zoned agricultural 4875 Pilot Knob Road Llayd Cuxtis of 487s p;lot xnob Road has applied for a 30' X 48' Utility Building Permit on an one-acre lot for storage. Sect. 52.06 Sub D 4, B states one principal building on a lot. Mr. Curtis has a 26' X 64' house and attached 2-car garage. Mr. Curtis would meet the 208 lot coverage requirement. These lots were subject to Council action on 12/21/1976 and again on 8/2/1977 as variance building permits for Lehman & Grosz. / / ,Ct'" :. ??.Ii` L?. l•'Ea-?. Dale S. Peterson Building Inspector V- LEO MURPMV MAVOP TMOMAS EGAN MARK PI.R(iANTO JAMES A. SMITM TNEODORE WACMTER COUNCIL MEMBER9 CITY OF EAGAN . 3796 PILOT %NOB ROAD EAGAN, MINNESOTA 53122 PMONE 964-6I00 Ym?C? April 20, 1978 Mr. Lloyd Curtis 4875 Pilot Knob Road Eagan, MN 55122 Re: Permit for 30' X 48' Utility Building Dear Mr. Curtis: I am recommending to the City Administrator that this permit application be placed on the Council Agenda to clarify Section 52.06 Su6 Div 4, B- one principal building on a lot. Very truly yours, CITY OF EAGAN ? Dal? S. Peterson Building Inspector dsp lco cc: Mr. Hedges, City Administrator iHOM45 HEDGE5 CITY aOMlrv?siNniOF AI-vCE BOLKE ._?rr c?Fax TME LONE OAK TREE ... TME SYMBOL OF STRENGTN ANO GROWTN IN OUR COMMUNI7v. i ,. . w Kenneth C. Lehman & ` NAME Pa?u,?k H. Grosz CITY OF EAGAN ADllHHEESS 1385 Deerwooc'P IDr&,M I T t1 P P L I C A 4' I 0 N TELE, N0. 454-2815 (Submit in Triplicate) FEE ? n . P?r DATE PAID 1 Y/3 7G RECETFT YSO.. STATE Or^ 1+7IVDTESOTA ) COUNq OF DAFSOTA ) $s' :..j._ T/We, the undersigned, being first duly sworn, hereby make the following application to the City Council and Planning Commission of the City of Eagan, Dakota County, Minnesota: 1. Application ia hereby made for: Trailer Building Permit Kennel Permit Rezoning Conditional Use Permit Excavatino Perr.;it Plat Approval Wainer of Platting x Other {deacribe)YSS1a (Check appropriate item(s) under Ordinance No, under Ordinance No. under Ordinance No. under Ordinanse No. cu7der Ordinance No. under Ordinanee No. under Ordinance No. 2 3 5 52 ara, sa 52 8 10 csA 8gril:ulturm mo"d prOp? ty 2. ._;ppli,car_ts haae the re3pcnsibility of checking till applieatle ordin<3noea pertaining to their applicatien and coeplyin,3 with all ordirance reqzire- r.,ente. 3. Legal description of land to be affected by application including acreage or aquare %ootage of land involved, and street address, if any: Ths AIt7i`th I A0r9 of tZie WeBt 4 Ac5e8 Df t310 I&c+riclmeat Quarter cP the Scutttarest Quarter^ of Section 34? Tomehip 27. Range 23, Cotusfy;la*n:seeota. 4. pY.Datcopose ct?sname o 5. The present zoning of the above deacribed property is: Agr¢,CU];tuyal t` / 6. 2oning classification desired: n 7. The name and address of the present owner of the above aescrit?ed Resuaettt C. L?ahmsn, 1385 Asez?od Ihr.: EagasY, PLi.nn. r}6o? i°aEe Pt. h7,ri pne year after isauanee ggqan, TAn 8. Estic:ated cost of improvements to be made w?. 6v?i 8V of permit applied for, if granted, is ? The nature of the improvement is: sinqle €8mi],y hpMF! 9. IP proposed improvements consist of buildi.ngs or atructures, specify in detail: Dimensions: Number of stOries: Type of construction: Occupancy or type of business: 10. All real estate taymya the above deseribed property kia.ve been paid through the year except: 11. The m,ethod of £i.nancing the above improvements will be: 12. Persons, firmsy eorporationa, or other than appliQant and present owner who may ar will be interested in the above described land or proposed improve- ments witnin one year after iasuance Pf permit applied for, if granted, are: 13. Attached to this application and made a part hereoP are: Plat Plans and speciPioatibns P3-,9t Plan Photographs Sketoh of improvement layout ,Other, (Describ4: ? Dated: December 13, 1976 Sub9cribed and sworn to before me / this,L day of At-L(?'-??? N tary Pablie bwner Approved Disapproved: Plannizg Commissiote DATE ? Approved Disapnroved: Cit3 Cou?c31 y! AF*?rqved; Disapp:aved: City Coumeil ?Approved Disappraved: E3asA oP Appeals -7C- ? k S?A 588??0 S-TA 5?2 ?(04 STA 5?34} lo ?' C U L. V F 1-_ D E N T- L.T. RES . E N?T'. LT. 1tvP. 24"x gz" C.MC. tNP ?5" x 2o'C.MC. 1NP. t?" K 22' X24'C.M.A.C. 1-,4 N ` M P, tx\ - i. ' ? _. h, . ,; 1(CN,V ETIf ' U ? EHMAI?J U L tt- GA?''o5Z ? ? - - onDS ( ? -L---- ---- -- --- ? --- ------ ------- ---- ? i ? I ? ? ? - - ---- --' -- _ I ?L? ---'- , ?_ - - - - - - --- - ? -- -- - - - -, -- ? Lw?=??'l-_2= - -? `- - - --------- ----- ?-?.----- ?- ?.1 .?.`_ ----- ??- -7_- _ ?- ? / PRbf'65E0.?1914D f1Gl41VMFA1T Wi Li, RG /v rT FW7/1F_!-' TAST A7 NGO? rtiD o r- P(aGcerY 4- 6 FT rvRrl?,Cg F-,q5r AT 50&7H EA)p. , "-z. iyi i+i \,,/OODS M/-\ P.V i.'? v CL Ar<? ?'- - C , ? i ; C? N M,A tl?, ; N, - ,--. _--??_ ? o - STA- 592-?-?5 F A RM E?1T . P•T• ? .. . .-. . ? ? ., ? -? •r M c? 440-C _E s / c ! ? 1 ?--? - - --- -- - I ?9F ' I I 1 ? : I I Q_ ? - -- -T - - C? 00 ? ? ?--- `----- - -?--=-_-- I --- f-?-- I v ? c? I ? i o k kZp 'r,82' C.jhC S"1"A 592 }G4 FLD ENZ'. LT. 1tVP 15" X 20' Cr i =?RANK ? LAq ERNA ? L E HM AN1?1 u 1-?) ?-4o-c ? • ??? ?? i 1?lANC`? ? J _ADAMEV? i ? • ? ??? ii ? I I I kzi i -?-------?,??----?--- . --t----? `--- - --- -- - ? ..,.t? - n r,- - -D._?- 1? ?. Q c?Nr?,e1-lr4? ? • I ? t '+I ., wootis 7) - ,r- c STA 594+ 1p S'CA 595toa RES. E NT. ?T. F L D F.N-T, L,T . M-C. INP. t\" K 2'2?" X Z4'C.M.A.C.-t-APR'S ? lNP ?S'." X 24'G.M.C.t APR'S Pl = S93 J`-.3?. S'8 Q < /°32'3D"LT dp ' 1-77, L - - .308. 33• I _ _ I i5F I I ? I ? I -- i--j- - --- a? LlI v _NI u_ L7 v- .,_ ? A?NA=c 3440:- a N , N I' ? ? :- _ ?._- - --- - - ?--?- h - ?- --- - -- ? {??'?. _------- - --- -' '--1 -Y- ?' ? ' I I ` ? J?6d f?//1/ ? = AQ. . 7 p r0 ?!O Date. March 16, 1977 ,. - BUSLDI'ciG PiRP1I^a P.rPLICr!TIOY7 LOT SLOCK IDDI:200 Nort one acre o t e West our (4) acres of the NW; of the SW „ Pait^EL & SECTIOr] PNI7T3ER IF Ui1PLnTTED Section 34, Township 27, Range 23. ?- A. w. /f d/7 / tiDDRESS OF PAItCEL Pilot Knob o d Eagan, Minn M i;0.3ry,;gAqricultura1 pCCUPANCY USE 4 TsTxI+IP,iED COST $30,000.00 Ij '`yl..Y\ dZ? ' Kennet U. e an 454-2815 Paul H. Grosz TELEPHOIQE iv0.452-3929 1385 Deerwoo rive, Eagan, Minn. ADDF,ESS4486 Woodgate Point, Eagan, Minn. CoLreiZNc'iOR Same as owner AIiDRESS same as Owner Note: Include site plan, build: anplication VAtDI^aI6??? . SAC ? STAiu2 COMNT..'CTS0A WATEK 1'g.''TEtZ BUIS,DING PER[•IIT FEE uJRCHAF.GE F'EE; Are FL'e1.3 CF:P.CiC E"£Z PARK DEDICZSTZDla P'rE OTF:ER TO`1'ALe A SPSSIM"S CLEP.iC ? •?_SUILDIIdG DEPT. TELEPFiONE TTO. same P7A'i'SR E SEF7ER DFPT. FIIL DLPT. P11,.'2K DEPT ? Dishict DAKOTA COUNTY HIGHWAY DEPARTIAENT Hwy. ?? ho. '• APPLICATION FOR ACCESS bRIVEWAY OR EN'(RANCE PERfdIT • . (n,pr,c:io< <o !.e ru.ni.i,rn witn p.oPe, s[and:trtl plate) . . , f;r .a. ._ 1 Fri.nt or t}'pe ayplication. 1"ill our 4 copies, sign and mail to County N.ighway Depar:men[. Sketch property, present and proposed driveways and relation to County Highway en back o( allfour copies. Kenneth C. Lehman 1385 Deerwood Dr, Eagan, Mn. 454-2815 Nomeof Paul H. Grosz 4486 Woodgate Pt, Eagan, P2n. 4 .?2-3929 Applicant Address Te Name of Properiy pwner Location: 31 Co. Rd. same in Dakota Address Yel_ County. I pAiles NOE-W ol C11 f f Road (Circle One) ($pecific road, IanAmark, or roaA intersection) Legal DescripNon of Property North one (1) acre of the West four (4) acres of the NW; (as shown on your Tox S;alement) - _ of the SW4, Section 34, Township 27, Range 23, according to the govt survey there- of. Purpose of Driveway [o Residence [71 Commercial (specify type) Is a Suilding to 1Yhat - 6e Consiructed [] No [lYes Kind -?llt-entry hoUSe (check ) Vlill the Building be [] Temporary or [? Permanenl (proper ) is ihe Property in M Platted or E?] Unplatted Area (sqyares) Distance from center of highway }o front of 6uilding, or {ront of pump island is 11$ feet. Is Icnd higher? lower? or level? leVel with highway. Show feet & inchea Show (ert & ir.chen Number of Presenf Driveways to f'roperty none Date Praposed Driveway will be needed 3/16f 77 Give Exact Location o{ Proposed NE eorner Of SOUth ? Driveway }o Property Give Exact Location of Present N/A Driveway to Property _ I. N'e, the undersigned, herewith make application for pernission [e <onstrvcl the a Ces driveway at [he aSove location, said drivewny to be c nstructed lo onform with the stanAards of the Highway Departmevt anE to any special provisionssleded in tce permit. II is ag«eA tha['afl wor:c wilt be done w the satisfac[ion ot the Highway Depart-enL It is fwthar agreed that no work an conne?tionwitl' this applicstYo999 wifl be.sicrteA vntil che application ia appraved and i)i] e permit issued. --`1dL.1Sz,--1977 Date " SignotweofApplic'ant' Do \o( {V'rite I3elow This Line Not Valid UnleSs Signed and \anbea!d ACCESS DRIVEWAY OR ENTRANCE PERMIT -5? -5 c-- Permit Kum6er Permission is hereby granted 4or ihe cDnstruction of the driveway as described in ihe obove application, said driveway to 6e consiructed an occordance with t'ne Minnesofa Highwoy Departmenis Drivewuy Slandard Plate No. _ _ and subject to the requiremenls on reverse side and the following special provisions: pi? Y w-a-Y s , rcl-? / ?PI ??/ ?--h y"YGt..., c,(/i /a P -To L9 P If is exprc?ssly und?food that }his permit is conditioned replocement or restorclion of the trun'R high.oay to its original or to a satisfoctory condition. It is further understood that this permit is issued sv6ject Io the approval of local city, villoge or borough authorities hcving joint supervision over said strcet or highway. nFTea PcrzMuT ts arprzovEO; ? 11'hite lo Applicant DA.KOTA COUNTY HIGHWAY DEPARTtAENT D Bu[t to Crnlydl Of(ice I? ? Pink to Area Staint. 0[fice ' il'-U"wt/ i,mn??'[,L r/J"U4 ? WELL RECORD Well Owner and Address ro o??6 ti,j,? .7S ? VILLAGE OF EAGAN I I Location / Licenee D Size of Well_. Inches ? Water Level el Feet Well DeF,ih__ T_Feet ? Draw .Down?.? Feet at,.Q_D GPM. 1 Casi.ig Deptk.i.??' Feet Capacity Gallons Q D ,Per/F3Ft.. 2'fl].CILriPr:J ' . - _ - ? Started Ehded ? of I - :.nd of "crmation Color ? Depth Depth For;nation P.marks a ql c;o?74- q_?7- AD0/ ?oC -??e -5 6 5 411el ?An '3> 4?--%d ' L??i-<?I. Fxteria•• Space Around Casing Sealed With: pCement Grout V<?ed Clay Disinfectant Uaed 21-4 - Hours Left in Well ` AET[1RN,fiHS3 RECORD AFTER COi•PLETICGJ R ? )w Q I.i ? ?e 'l, e?0° ?O -7lvid-V 2006 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New ConshucUon Revui2rtwnts 3 registered site surveys showing sq. it of IoL sq. ft of house; and all roofed areas (20% maximum bf coverage auwr+ed) 2 copies of plan showing 6eam & window sizes; poured found design, etc. 7 set of Energy Calculations 3 copies of Tree Preservation Plan if lot platted at[er 711/93 Rim Joist Defail Op6ons seiecGon sheet (buiidings with 3 or less un'rfs) Minnegasw mechanical ventilalion form RemodeUReoair Reauiremenfs 2 copies of plan showing fco4ngs, beams, joists 1 set of Energy Calcuhfions for heated additions 1 sife survey for additions & decks Add'fion - indkafe i! on-sfie sspfic system '7D-B7 Gt;rtofS'uney?eG9 '` V HZreepresp?an?ec? treeP?sRe9?'?d Ort?Re?epLe?'%f€?6 '?T-_'?•)V Date Site Address UU ??_ Construction Cost 900 r%,oz Unit/Ste # ' Description of Work ?F 7`O ff ?/7 CTC-[ C.SS??f ??¢C9 ??x ?`? l.. h I'f I Mutti-FamilyBldg _ Y _ N Fireplare(s) _ 0 _ 1 _ 2 Proper[y Owner (? 4-,P1JL l_ AE4?? ,E11 Telephone # (? ? ) L3'sY Contractor C-J' = Address CitY State Zip Telephone # ( ) COMPLETE THIS AREA OPILY IF CONSTRUCTING A BdEW BUILDING - Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 Energy Code Category . Residential Ven6lation Category 1 Worksheel • New Energy Code Worksheet (4 submissian Type) Submitted Submitted . Energy Envelope Calculafions Svbmitted In the last 12 months, has the City of Eagan issued o permif for a similar plan based on a master plan? _ Y _ N If yes, dofe and address of masier plan: Licensed Plumber Mechanical Contractor Sewerl Water Contractor Teiephorie # ( Telephone # ( Telephone #( I hereby apply for a Residenrial Building Permit and aclaiowledge that the information is complete and accurate; that the work will be in coaformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. ? fa2M611t U L-Cy?Cdl7a-? ApplicanPs Printed Name Applicant's Sign e DO NOT WRITE BELOW THIS LINE Sub Types ? 01 Founda6on ? 02 SF Dwelling ? 03 01 of _ plex O 04 02-plex O 05 03-plex ? 06 D4-plex W rk T es 31 New ? 32 Addition ? 33 Alteration ? 34 Replacement f ? ,21-? 30 Accessory Bldg O 31 E>3. AIt - Mul6 ? 33 Ext. AI[ - SF ? 36 Multi Misc. ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 37 Demolish Building` ? 43 Reroof ? 46 Windows/Doors `DemoliBon (Entlre Bldg) - Give PCA handout to applieant D@SCfiDYiOfI: WaterDamage_YPS Valuation mv ca Occupancy Plan Review 100% or 25% Census Code Zoning SAC llnits Stories # of Units Sq. Ft. # of Bidgs Lengfh Type of Const Width _ Footings (new bldg) _ Footings(deck) _ Footings(addition) _ Foundalion _ Drain Tile Roof Ice & Water Final _ Framing - _ Fireplace _ R.I. _ Air Test _ Final Insulation t? MCES System City Water Booster Pump PRV Fire Sprinklered REQUIRED INSPECTIONS _ Sheetrock FinaUC.O. ? FinaUNo C.O. HVAC Other _ Pool Ftgs Air/Gas Tests Final _ Siding _ Stucco Lath _ Stone Lath _Brick _ Windows _ Retaining Wall Approved By. Building Inspecfor Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatrnent Plant License Search Copies Other Total ? 07 05-plex ? 13 16-plex ? 20 Pool ? OB 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 09 07-plex ? 17 Garege ? 22 PorchlAddn. (4-sea.) ? 10 OB-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 12 12-plex ? 25 Miscellaneous ? ? ???? 132.05 ? ? ?o ? a 01 3-7? ? M03) . y N 0 132.0:5 4.T- . ' . . . ' ?.? . . ? . . . . , ?. . . . , ? • . - • ? '?• ?? . , . . ?. . . . . . ?.?. . . . , . . . . ? r N ? CVI ? ? ? ? /9V. as- F Jul 21 08 I127a Caly Condrudion Able- 'Tp" City of Eap 3830 Pilot Knob Road Eagan MN 55122 Phone: (657) 675-5675 Fax: (651) 675-5694 ?------- --i i 0 ? Permit S' I Aormil Foo: i ? ' o-atc Rocoivcd: _. i I ? siwfr: - i L ----------------' 2008 RESIDENTIAL BUILDING PERMIT APPLICA'TION oato: 0712112008 Site Address: 4875 PilOt FCnob F20ad Tcnani: Carol Cafarelli RESIDEN7/ OWNER I Name: (952}934-0099 p.2 Suite S: Carol Cafareili Pnonc: (651) 331-9480 Address ! Clry I Zip: 4875 Pilot Knob Road I EaganlMN Applicantis: _Owner EZ3COnlractor TYPE OF WOAK I Descriptwn of work: RerOOf-frpnt West Construction Cost: $8,441.76 Nutti-Famiiy oviiding: (YO; L::I No Fxl) Coty Construction and Remodeling L;ce„SQ 8C-20431519 CON7RACTOR Namc: qddfess: 5716 Glen Ave City; Minnetonka statc: MN zip: 55345 pmnc. 952-9342600 Contact Pcrson: Eric Camqbell (612) 499-1 168 COMPLE7E 1'MIS AREA ONLY IF CONSTRUCTIhIG A NEW BUILDING Minnesot Rules 7670 Cateaorv 1 MinnQsota Rules 7672 Energy Code • RosidanUal Vunlllation Gategory 1 Warksheet • Naw Enorgy Code WorkNwot Category Subminod suhmined (J submisslon tyye) - Energy Emelopc CalcWatbM Submittotl In the IaSL 12 months, h8S th0 Clty of Eagan i55UEd a parmit for a similar pian based On a master plan7 YOS _No lt yCS, dEltO ar1d address 01 M85tOr licenSEd Mechanical Contractor. Sewer & watcr Vhpne: reasons that wou/ It the C+ty to n ... ,;, 1 heroby ecluiovrludgc that [his Information Is aomplolo and aocurate; thaf the xork wifi Cagan: that I uMorsiuntl fnis 6s not a pormYt, but only an appiicelion 1a u poanl[, ar acco?danrn wilh Ihc approvcd plan in Mo case af weik which roqulros a review antl z PatriCk Ca!y Appfieant's PrlnDed Name Phone: Phone: r1o-nformanco'?cos and codoc ot tho Cily of irk is not [o sW 1 8 pOfmll; IhA( Ih8 w0rk will 6o in o1P?5. f Page t of 3 � � . i `� ��� �'�� � � � - �ti ��� ��� �u��r�� 1 r�� i� `........""`�... . � �� ���5� � � �`� ��. ���N �, ��4��-�� „� � � � . �� '�� _...�.�.�.....,......� , � _., �'.��.�. UrrivExs�TY OSTP Soil Observation Log OF MINNES�TA Client/Address: Cafarelli:4875 Pilot Knob Rd.,Eagan Legal Description/GPS: Lot: Block: Soil parent material(s):(Check all that apply) ❑artwash ❑L.acustrine ❑�cess �ru ❑Al�wium ❑sedrock ❑organic Matter Landscape Position:(check one) ❑Summit ❑Shoulder ❑1 BacWSide Slope ❑Foot Slope ❑Tce Slope Slope shape Vegetation Lawn Soil survey map units Slope% Elevation: Weather Conditions/Time of Day: 11:30am sunny Date 07/14/15 Observation#/Location: Observation Type: Course I--------Structure-----------I Depth(in) Texture Fra % Matrix Color(s) Mottle Color(s) Redox Kind(s) Indicator(s) g• Shape Grade Consistence 0-12" Loamy Sand 10YR 3/2 Granular Weak Friable 12"-36" Loamy Sand tOYR 4/3 Granular Weak Friable 36"J2" Loamy Sand 10YR 5/6 Platey Moderate Firm Comments I hereby certify that I have completed this work in accordance with all applicable ordinances,rules and laws. Gary Bohn 1043 (Designer/Ins ector) (Si nature) License# (Date r Use BLUE or BLACK Ink IC.,4/ For Office Use ;:::e: I ''' C`t O� �� �� / 6 3830 Pilot Knob Road 11. Eagan MN 55122 t�( `� S s.'. �,� Date Received: Phone: (651)675-5675 buildinginspections@cityofeagan.com Staff: 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: — 2 l -i ( Site Address: 1-/c I'1 S " /of Y`�oh (--R Unit#: t. Name: ReTYVA f C �� `'�f t vA Phone: �/�( ' id�`��� � I Resident/ �'�.� ��tl� )Z2 owner Address/City/Zip: 0 U `� 1'I j i- izyk o b ?,9 Applicant is: Owner Contractor r.„.,.„„„.---------- /' I Description of work: 11 ko &1 Type of Work g Construction Cost. 2-) 000 Multi-Family Building: (Yes /No zI Company: Contact: Contractor ; Address: City: State: Zip: Phone: Email: ' License#: Lead Certificate#: 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: 1 ISewer&Water Contractor: Phone: i Fire Suppression Contractor: Phone: NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the R information maybe classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.cityofeagan.com/subscribe. 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. 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.qopherstateonecall.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 withou a .-rmit; that the work will be in accordance with the appr ved plan in the case of work which requires a review and approval f plans. X f)C. cos.%-(_. x ApplicaanPrinte Name Ap rca s Signatu A VVV Page 1 of 3 2l R 76 4 ( )ci-- K)'o'b DO NOT WRITE BELOW THIS LINE mq4-0-cz 7 SUB TYPES Foundation Fireplace Porch (3-Season) Exterior Alteration(Single Family) ySingle 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 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 -9—POccupancy ; , MCES System Plan Review Codeupancy pIA IV 2.-a 44 SAC Units (25%_ 100% X ) Zoning /, / bo , e City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction V r1,/ Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final I C.O. Required Footings (Addition) x' Final/No C.O. Required Foundation Foundation Before Backfill x 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 y, 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 FEES Base Fee Surcharge Plan Review ll MCES SAC City SAC 0(4,034 Utility Connection Charge S&W Permit& Surcharge Treatment Plant Copies . 9 0 ° TOTAL kl �, r` Page 2 of 3 Use BLUE or BLACK Ink For Office Use Q fj�� Ci ofJ Permit#: / /�- � 1I�IlYe0- 0a Permit Fee: 3830 Pilot Knob Road Eagan MN 5512247 Date Received: Phone: (651) 675-5675 111_ 77 ni Fax: (651) 675-5694 Staff: 2017 RESIDENTIAL PLUMBING � PERMIT APPLICATION Date: Site Address. /t&Cto I\� Tenant: Suite#: Name:? kC4 �( L� ckq'�tdV'�2_. Phone: 6x47,--1 33 033c- Resident/Owner ^ A -�^ Address/City/Zip: °�7 �, C� !�b� �j < ",A) S J 1 Name: License#: Contractor Address: City: State: Zip: Phone: Contact: Email: New _Replacement Repair Rebuild Modify Space Type a Work — — — Work in R.O.W. Description of work: ccx - RESIDENTIAL Water Heater Water Softener Lawn Irrigation(_RPZ/_PVB) Permit Type Add Plumbing Fixtures(—Main/ Lower Level) Septic System —New Water Turnaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation (includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround*(includes State Surcharge) "Water Turnaround (add$280.00 if a 3/4"meter is required) $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$ 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.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without - •ermit; that the work will be in accordan•- ith the ap,roved plan in the case of work which requires a review and approval of plans. / ` x r4/ 1 _ ekC Ct'e x / Ap•V nt's tinted Name Ap ican/ Signature - FOR OFFICE USE Reviewed By: ,Date: Required Inspections: Under:Ground. Rough in Air Test: Gas Test Fina) Meter Related Items: Meter Size Radio Read Manometer.: Staff: