3972 Pumice LaneCITY OF EAGAN 9
3795 Pibf Knob Rood Eogae, MN 55122
' PHONE:4S4-8100
BUILDING PERMIT Receipt #
To be wwd for Est. Volue Dote -, 19
Site Address Erect ? Occuponcy
Lot Blotk Sec/Sub. Alter Q Zoning
Pcrcel # Repair p Fire Zone
Enlarye ? Type of Const.
oWC Nome Move p # Stories
Z Address Demolish ? Length
? Ci phone Grode p Depth Sq. Ft.-f-
°C Nome Approvals Fees
-
??o
Address
p- r:.,,
Nome
Address
Citv Phone
I hereby acknowledge that I have read this application and stote that
the informotion is correct and ogree to comply with all applicable
Stote of Minnesoto Stotutes and Ciry of Eogon Ordinonces.
Signoture of Permittee
A Building Permit is issued to: °
oll work sholl be done in accordarxe with oll opplicable State of Mir
8uildinq Offitiol
Assessment
Water & Sew.
Police
Fire
Enp.
Plonner
Council
Bldg. Off.
APC
Permit
Surcharge
Plan check
SAC
Water Conn.
Water Meter
Rood Unit
Totol
on the express condition thai
and City of Ea9on Ordinances.
Permit No. Permit Holder Misc. Permit No. Hoider
Plumbing
H.V.A.C.
Well
Water •
Disp.
Sewer
Eketric to((a S (0 S £??C -$'2-
Inspection Date Insp. Other
Footings . . , ?'
Foundation
Freminy $2
Rouyh Plbg.
Rough HVAC
Inwlation
Final Pibg.
Final HVAC
Final
Water Deacribe Location:
V11ell ? .
Sewer
Pr. D'ap. ? .
CITY OF EAGAN Remarks * Cedar Gmve AcqUisition
Addition CEDAR GROVE #5 Lot 17 Blk 7 Parcel 10 16704 170 07
Owner Street 3972 Pumice Lane State Eagan, MN 55122
vt,f'2f?
,' 2
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR,
GRADING
SAN SEW TRUNK Z 1967 100.00 5.00 20 Paid
SEWERLATERAL 1967 484.00 24.20 20 Paid
WATERMAIN
* WATERLATERAL 1972 607.00 24.28 25 437._04 2-21-78
AREA
STORM SEW TRK 1974 70.00 4.66 15 Paid
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN,
BUILDING PER.
sac 200.00 452 10-25-67
PAR K
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: `' l l I
? ' ? s ?{ ?'
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: t;, l t; F{t ut r APPLICANT:
.. t??INI Ci" t. ANF t; p1o t;Ji1'; I,jli)p l N#:i
4,0:iiAl< (,Nl1W htEf (?•:1: ) t-51-•86/#t •
L__ J
PERMIT SUBTYPE: TYPE OF WORK:
1:i !'Al3r
r1;iit) f':1Ntti1
Pertnit No. Pertnit Holder Date Telephone #
ELECTRIC
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
. ..
??,
? i
?
*?'?' IZ?IOF ?-j/L • lNGv°?S _
?• /t - / y" ?Ge? .ti.?ri'!s , i
ISIAE?g q5*?u5 Cvv 012420. LAMM- _I
C.b'797>/l-JO 7b /CWIc
CITY OF EAGAN Include 2 sets of plans,
1 site plan w/el.evations &
BUILDING PERMIT APPLICATION 1 set of energy calculations.
To Be Used For?II,U?1 T o 7-, t*mE Valuation.?? Date
Site Address: 3q `7oZ PG19V1 I Ge j-/V OFFICE USE ONLY
Lot 17 Block 7 Sec./Sub. CADA1; 6,ROVa0Erect Occupancy /C.3
Parcel #: 1 U 169 `j O ? 170 p'7 Alter Zoning
Repair Fire Zone
Owner: i/vAyNE A :F 1-/3,q AANJJ?= RS oN Enlarge Type of Const.
N1pve # Stories
Address: 32 7a Pu11iicG ?N Dermlish Front IT7 ft.
City/Zip Code: F-A(,An( Grade Depth _ ft.
•5
Phone # : 14S q-,5'J/ S APPROVAIS FEFS
Contractor: Cy h? D/Wh i scil e orus T &D
Address:
City/Zip Code:
Phone # : 4 35- 7/
Arch./Eng..
Address:
Assessments Permit ?,, 60%p 6-0
Water/Sewer Surcharge / ffi
Police Plan Check
Fire SAC
Eng. Water Conn.
Planner Water Meter
Council Road Unit
Bldg. Off. - ,Z4C
APC
City/Zip Code:
Phone #:
TOTAL ?? c -7- 7S
CITY OF EAGAN
,x 3795 Pilot Knob Rood Eogon, MN S5122
Np 40G
'?.4 PHONE:4S4-S100
BUILDING rERMIT ReceiPr
To be used for FAMZLY SOOM ADD. Est. Volue $22, 000 Date July 27 , 19_-Bz
Site Address 3972 pumicE Lans Erect ft Occupancy R-3
Lot 17 Block 7 Set/$ub. Cedar Grove 5 Alter 0 Zoning R`1
Porcel # 10 16704 170 07 Repoir ? Fire Zone NA
Enlarge ? Type of Const. v
W
e Wavne & I,3.sa Anderson Move ? # Stories
3 e ss
:ddr 3972 Pumfae Ldll@ Demolish ? Length_27_
0
Eag
an 5 Phone 454-5315
Grade p
Depth _].b-Sq. Ft.
°C Name
0 Groa¢ailisch Construction Cb. Approvals Pees
?F
uU Address
~ Cit _
u?
W W Nome _
?
?? Address
?Z
<"' Ciri -
1 hereby acknowledge thot I hove re this application ond stote that
the informction is correct d og e to comply with oll opplicable
State of Minnesoto Sto es nd_ i of Eagon Ordirwnces.
Signuture of Permitte
/1 Building Permif Is issued . Groimn h Const. 1
all work sholl be done in accordonce with oll ppli able State of
Buflding Offlcial
Assessment
Water & Sew.
Police
Fire
Eng.
Plonner
Council
Bidg. Off.
APC
Permit 152.50
Surchorge 11.00
Plan check 76.25
SAC
Water Conn.
Woter Meter
Rood Unit
Total $239.75.
_ on the express condition that
Ciry of Eagan Ordinances.
?.- ? ?
HOUSE HEATING TEST RECORD (?.?.t ??,
ADDRESS ?/V, APT. FLOOR CITY SUBURB
OCCUPANT OWNER
HEAT LO55 DATE HTG. N./ST.
SOLD BY I/??WZe?-- ?'(''?t !r ?a INSTALLED BY ??? 7(f ?-. 14 e *r/ ac,
Electrical Work By S i?? Gas Line By 497 hC.l J`rj/
TYPE OF HEAT GA FA X- HW STEAM SPACE HTR. UNIT HTR. OTHER _
GAS DESIGN
MAKE MAKE OF BURNER _
Model () 0 IZ? Ll ;wo- Model
Serial ? Max. BTU Rating _
I N P U T 1PJP0 MAKE OF FURNACE
THERMOSTAT
Va Ive (A)l
Limit ?
Limit Setting _
Fan Setting _
Pilot Type ?
Pilot Make -
Pilot'Model _
Pilot Timing
L.W. Cut Off
Model
CONVERSION
Vent Size q
? SIZE
KIND OF LIN'R
Draft Hood ???'f?Regularor
Fi Iters $ize ?? x??? ? _Number ?
Chimney Location Inside ? Outside
Chimney Construction ????A_ L
Smoke?Bomb Wiring ?
Draft ? Test Tao
Desr Praee..r. '"___
Lighting Inst. `
Pressure PercentCO ? Date Tested 1:2 'a'L:3 `! ?
Input CFH Percent 02 Company Testing e,
Stack Tamp. ?? Percent CO Name of Tester 'q ?`4 (
'Gt,!
CONTROLS
;Je V
-yq _ gdt PI?y9
Form 235
EAGAN TOWN S i-I I P
BUILDING PERMIT
Owne# •--•-?'C?.-•iG?--••.C:.?'-- ---------- (!!?.-'---.....---••-
Address (Presen!) -,.f?t- _-•.?._`. ,l?uti'-('t•--'?!'.c......-........
..
Builder ...............•-•----.•-••-•--•••••---•----••-•--.......-••----•---•••---••----•--•---••--- -•-
Address ............................................................
DESCRIPT2ON
N° 1532
Eagan Township
Town Hall
Dale ._f/l,?.-----•---•--------------.
52ories To Be Used For Froni Depih _Heigh! Est. Cos3 Permii Fee Remarks T
? -- ----- ------ ----
.`?Q%C.?.y? /_17/
?f U
Sireet, Aoad or
LOCATION
I -??• ?•w?+z _ naaiilotl Ol=1"rdC2
z" ?
I tL ? n
; This permit does not suthorize the use of streets, zoads, alleys or sidewalks nor does it give the owner or his agen!
the right to create any situation which is a nuisance or which presents a haaard to the healfh, safety, convenience and
i general welfare to anyone in the communiiy.
THIS PERMIT MUST BE KE,P(T ON THE PR?MISE WHILE THE WORK IS IN PROGRESS. . ?
This is !o certify, that-4 ... l?-•>---?•-----••-•-•-•:--••----•--•--
!he ab -.has permission to erect a_??..-•?:•••- ........ described remise sub'ect to the - upon
P ] provisions of the Building Ordinance for Eagan ?wnship adopied, pril 11,
' 1955.
........... -•-•-•-••-•-• -•-._._........
•---..._..1......................................
Per .................... •?•-•-•-•--?? ??---.?
Chairman of Tnwn Bo d / °••°••••••••-••--•--?
Building Inspec3or
' !
EAGAN TOWNSHIP
BUILDING PERMIT 2443
Owne: --• -••--•--••• •-••-•-• Eagan Township
v? > >
Address (preseni) .....? ?.f-a.?.____.__?u!'!!?!4?C. ? . ?? Town Hall
. ...
Builder ................... J.?e_41 .......................................................... DB:. ..... ???. ./.y:. /2??:....
Address .............. SJ??? •-••••....•••••••••••...•--........••••...................
DESCRIPTION
52ories To Be Used For
c A Froni Depih Heigh! Est. Cos! ' Permi! Fee
?
4 Remarks
l // ! v
LOCATION
S2reet, Road or other DescripYion of Location I Lo! I Block I Addition or Trac!
This permit does not authoriae ihe use of streets, roads, alleys or sidewalks nor does it give the owner or his agent
the right to create anp situation which is a nuisance or which presents a hazard !o !he health, safety, convenieace and
general welfare to anyone in the communiiy.
THIS PERMIT MUST BE KEPT T /J? RE? S WHILE THE WORK IS IN PROGRESS.
,a
This is to certify, that__r?t!b?.?"5??<1??1 .............has permission to erect a._........:..?i?,(?!L?'-_ .?..............upoa
the above described premise subject to the provisions of the Buildin Ordinance for ^ ga Towns p adopted April 11,
1955.
,
-°--. .. ............. Per .... &Z. •- ...... . .._...---?^:?:--•
-• • -- - -.._ . . ....--
----. .......... ..........°--•-•°---
'" -•--° .......
airman . .. of .Tnwn Soard Building Iaspector
.r
Eagan Township
Dakota County, Minnesota
Apg4cation Eor Building Petanit
Type of building or work contemplated.
Residentia } Commercial Industri
S?uil"d Enlargs Altes Repair
? ...... .. ............... ......
Dimensions?.."1..?
a.?
'n..a..;le .... .e...e:Le
Circle correct descriptions.
sl Other...............................
17 tall Move Wreck
`"?
Cost_ ..............................
PERMIT NO. .r?..-.???....
,
- i?
Dafe ?....? •-••---------- ??--•
Other_..--•---......-•-••-•--•---•-----••••--
Location
Nuanber I Sireet I Between what cross streets ( Size ? Est. Valuation
Loi I Block Addition Rearrangemeni or Tract
1 ? --7
Owner
?? ? 7`•' '=? ...: ?-....-•--•--• .............. Address ?f--•- ? ?••--u ---????t-?..?/ ---•- •---•-•----------••--
Contractor -----------------° .............................................................. Address •-••--------------------°-------°•--------------------°------._...------°-•--•---------•°
The undersigned hereby makes apnlication for a permit to
do work as herein specified, agreeing to do all work in strict
accordance with the building ordinance adopted April 11, 1955
Tolal fee collected. by the Eagan Township Board of Supervisors.
Permit fees are not
refundable.
.
?1
/
?
?3'?
G
'
.
.
.
-•--------.
._-- ----
---- - -- - - -- - -
------- ?
5igned
" .?.Y. - CITY of EAGAN
BUILDING PERMIT
,. .??
o??n.: .... ................................................................
Address (Preseni) .....??.?_?'.._..........'.`."-.-•R'`:.`:............=....••--•••-
Builder .........................••---••........................•-•••._......-••._......................
Address ....................................................•--........-•••:......•-•-••._.......:._..
DESCRIPTION
.; ;.
N° _ 3241
3795 Pilot Knob Road
Eagan, Minaesota 55122
454-8100
Date ...._?:-f z:. .?x ..............
5tories To Be Used Fos Froni Depih Heigh! Est. Cos! Pe:mi! Fee Remarka
0-0
LOCATION ?-'.1 zi
Street, Road or other Descaiption of Localion I Lo! I Block I Addition or Trac!
1? 1 -7 1 6. (7 .-=M- S
This permit does not suihorize the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent
the righ2 !o creale any silusiion which is a nuisance or which presents a haaard to the health, safetp, convenieace and
general welfare to anyone in !he communiYy.
THIS PERMIT MUST BE `K?EPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. _
This is !o cer2ifp, tha!__..,N: :...._..--•-•--•-..........• -•-..................... has permission to erect a......•-'(:------------- -......-•--• .................... upoa
fhe above described premise subject to the provisions of all applicable Ordinances for the City of Eagan.
?e. (9?
............. J?`•-•-•?`?:?? .............................. Per ............... &
•---•-•--•-•-•-••-•-•--••---•--• ................•-•...... ..--•...
Mayor Is Building Inspecior
?
s°
?-? ?
Y5z
2j2 S& S 3V l ? ??
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
FOR CITY USE ONLY
PERMIT #
RECEIPT # D
DATE: /02 0? 7 /
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
......................................
.....................................
......................................
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
------------------------ -------------------------------------------------------
WORK DESCRIPTION FEES
NEW CONST
ADD ON X,_
REPAIR
OWNER NAME : /-V?v r, -f .2 S oiJ
SITE ADDRESS : 3g 7,=), `Yv/?? r`?'? ? n- -
LOT : _a_ BLOCK ? S iJBD .
INSTALLER: bf_zn- 2 k c- ADDRESS : /9 ?-S S/ Po '
C I TY :- Z I P:
?
PHONE #: y S? - ?rOCO ?
ADD-ON MINIMUM 515. ?
HVAC 0-100 M BTU 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS - MINIMUM 3.00
OF 1 PER PERMIT
?
SUBTOTAL : $
STATE SURCHARGE: .50
TlJTAL: $ J_?_-
?
SIGNATURE OF PERMITTEE
-2/?.1f 1- Ale-- ? ??
?;OMME???PLEASE COMPLETE THIS P40RTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
CONTRACT PRICE:
OWNER NAME:
S7TE ADDREGS.
LOT: BLOCK SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE #:
FOR:
CITY OF EAGAN
FEES
1% OF CONTRACT FEE.
STATE SURCHARGE a $.50 FOR
EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING = $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1$ $
STATE SURCHARGE $
TOTAL: $
(SIGNATURE)
.. ,.?
.• ? .
rs9'
1)3,
?
GAR??? ?
?
W'
N
`V7\
Cd?
?
0060
L ?gE
16--
?
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c:
3 g? 1 p u nt, I c E.
OFFICE MEMORANDUM
WHO IS
? CALLED F? By Phone
0 In Person
POLICYHOLCER: NAME
ADDRESS
??.._
?.
Q Quotation
F? Inquiry
F-] Application
0 Policy
N0.-
CLAIfN DEPARTMENT USE ONLY - This is F? First Reporting
CLAIMANT:
? ..
' ADDRESS
F-] Subsequent Inquiry
IM N0.
Street '
City State
ACCIDENT DATE_
PLACE OF ACCIDENT
?
I
• M ,
933 (12i62)
Date Hour
Rv
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: BUZLD I N G
3830 Pilot Knob Road Permit Number: 027156
Eagan, Minnesota 55122-1897 Date Issued: 03/ 15/96
(612) 681-4675
SITEADDRESS: P • T • N. ` 10-16704--170-07 APPLICANT:
LQTs 17 BLOCK: 7
3972 PUMICE LANE RIGMT WAY ROOFI(dG
GEpAR GROVE 5TN (612) 557-8678
PERMIT SUBTYPE: - TYPE OF WORK:
SF (MISC.) REPAIR
DESCRIP7ION (ROOFING)
M r . µ
.? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT PERMIT TYPE:
Permit Number:
Date Issued:
BUILqING
027156
03/15/96
SITE ADDRESS:
PeT.N. a 10-16704--170-07
DESCRIPTION:
REMARKS:
FEE SUMMARY:
5F (MTSC.)
REPAIR
434 ALr. REsroENTzaL
41
Fd
& 4
VALUATION
Base Fee $74.75
Surcharge 1.50
Tcstal Fee $76.25
?
. ? g
%l??
22 ak ??
$.J q 0YIYJ
CONTRACTOR: - Appli.cant - 5T. LIc.pWNER:
RIGM7 WAY RQOFIIVG 15578678 0003999 ANpERSQN WAYIVE
16475 45TH AVE N 3972 PUMZGE Ltd
PLYMOUTH MN 55446 EAGAN " P1N
(612) 557-8678
3972 PuMzcE L??E
Lar: a.? BLocK: 7
GEpAR CRQVE 5TH
(RqaFING)
Permit Type
41ork Type
? - --?m uoi
APPLICAN RMITEE SIGNATURE ISSUED BY: IGNA RE .
? CITY OF EAGAN
3830 PILOT KNOB RD - 55122
1996 BUILDING PEaMIT APPLICATION (RESIDENTIAL)
681-4675
New Construdion Reauirements
?
?
?
?
3 registered site sunreys
2 copies of pians (inciude beam 8 window sizes; poured fnd. design; etc.)
1 energy calculations
3 copies of tree preservation plan N lot plafled after 7/1/93
required: _ Yes _ No
DATE: ---) " 1 G"? `- 7 c
DESCRIPTION OF WORK: vvp r
STREET ADDRESS: m (G L-n _
LOT BLOCK ? SUBD./P.I.D. #: ? ?VAP't-
?i1.cQ?t?on.
PROPERTY Name: I ?? u, Phone
OWNER • * `RSt
Street Address- 3C17,,--),
Street Address. License #:
State: 1/\-_ Zip:
City:
ARCHITECT/ Company: Phone #:
ENGINEER
Name: Registration #:
Street Address*
City: State: Zip:
Sewer 8 water licensed plumber: . Penalty applies when address change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all
appiicabie State of Minnesota Statutes and City of Eagan Ordinances. 1 6?4?
Signature of Applicant: ?
OFFICE USE ONLY
Certificates of Survey Received Yes No
City: State: ? V\? Zip:
? 1G ?CC-? ?N?C-? E, C- Phone #: 5
CONTRACTOR Com ?
pany: E22
?
RemodeURecair Reauirements
? 2 copies of plan
? 2 site surveys (exterior additions 8 decks)
? 1 energy caicuiations for heated additions
)b
CONSTRUCTION COST: ?, 87c) i?° o
Tree Preservation Plan Received Yes No
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation o 06 Duplex
0 02 SF Dwelling o 07 4-plex
? 03 SF Addition o 08 8-plex
0 04 SF Porch o 09 12-plex
0 05 SF Misc. 0 10 = plex
WORK TYPE
? 31 New o 33 Alterations
0 32 Additian a 34 Repair
GENERAL INFORMATION
? 11 Apt./Lodging ? 16 Basement Finish
? 12 Mul#i Repair/Rem. ? 17 Swim Pool
0 13 Garage/Accessory ? 20 Public Facility
0 14 Fireplace o 21 Misceilaneous
a 15 Deck
? 36 Move
? 37 Demolition
Const. (Actuat) Basement sq. ft. MCIWS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code.
Depth Footprint sq. ft. SAC Code
Census Bldg
Census Unit
APPROVALS
Planning Building Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn..
Water Meter
Acct. Deposit
S/W Permit
SNV Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
% SAC
SAC Units
r
?„-?,,, ?
f ?'? ?
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? ? - , 'ii . ; . _. ?'.?.-i ?St„444,y„7 J, .
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?
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LOCATION '
OWNER ' /0
STRUCTURE AND
LAND USED AS
MASTER CARD
Permit
No.
Issued Issued To
Contractor Owner
BUILDING
.
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER
07HER L
Approved
Items (Initial) Date
FOOTING
FOUNDATION
FRAMING
FINAL
ELECTRICAL
HEATING
GAS INSTAILATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
i 3 "
COMMENTS:
Remarks Distance From Well
SEPTIC
CESSPOOL
TILE FIELD FT.
DEPTH
OF WELI
Violations Noted
on Back
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-CONIPLIANCE
OBSERVED.
F NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
a ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
? REINSPECTION REQUIRED DATE OF REINSPECTION
REINSPECTION REVEALED
CERTI FICATION - I certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein
all significant conditions ot;served to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property inspected.
F-I ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPECTOR
DATE
COMMENTS:
?J 23
-4
?/?'' 7- ? ??, ? ? ??J •???
w
? - ?-?
?
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?
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t_nr
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.?
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I
?- - - _ `
I
MASTER CARD
LOCATION
_7_
OWNER 71,o o
STRUCTURE AND
LAND USED AS
Permit
No.
Issued Issued To
Contractor Owner
BUILDING
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER
• Items
FOOTING ?
FOUNDATION
FRAMING
FINAL
ELECTRICAL
HEATING
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
b 0TV .
•
COMMENTS:
Violations Noted
on Back
Approved
(Initial) Date Remarks Distance From Well
EPTIC
CESSPOOL
TILE FIELD FT.
DEPTH
OF WELL
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTr2UCTION AT THIS INSPECTION
? NO EVIDENCE Of NON-COMPLIANCE
OBSERVED.
? ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
17 NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
? REIPtSPECTION REQUIRED
REINSPECTION REVEALED
DATE OF REINSPECTION
CERTI FICATION - I certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein
ali significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property inspected.
F-I ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPECTOR
COMMENTS:
DATE
•
•
23
-` - SPECIAL IMPROVEIVIENTS
on ?
All t7at tract or parcel of land lying and being in Cou.nty, Minnesota, described as followe,
to-w,;,
i, .
? : . .. i ' , i . . :. ..;?vcr, (?; ,' C'C,c?a:r ':7r•cave ?vo. accord.ing co the record??d ?lat
.. _ .`? --e in th:r c?.:°.f-ice of t}?e Itr.?-?ister of Deeds in and f'cr' said
? t
?
This is to certify that I have examined the records in the office of the City Clerk, City ot T%a(''an
County, Minnesota, and find that the above described tract `
cr parcel of land has the following improvements as indicated by CHECK MARKS:.
Water Mair Sidewalk Street Paving
_ Main Trunk Sewer Curb & Gutter Alley Paving
Laterial Sewer Street Grading Garbage Collect;on
Storm Sewer Alley Grading Tarring Streef
Street Sprinkling
. ?
? furt!-er ceitity that according to the records of said uffice, the followiny assessments appear unpaid: . Total Amount Unpnid
Original Subsequent to I
K:nd of Improvement. Runs Beginning Amount Current Year '
I
tti:itcr Lateral 25 years 1972 607.00 437.04 ?
j
?
?
i
!??rther certify that according to the records of said office, the following improvements are contemplated .;r. •
^ending ct'+er having been appreved, and are now in the process or planning or completion: i
?
Approximate date of " Approximate Cost of ?
Kind of Improvement Completion Improvement ' none.
i
' . f.
i
?
Da-ed rh Is_ 23 day cf January 19 78 . ?
_--
City Clerk
City of __Eagan __---- -
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN ?
--?? 3830 PILOT KNOB RD - 55122 '7J ?
651-681-4675
New Constructlon Reauirements Remodel/Reoair Reauirements
? 3 registered sNe surveys showing sq. ff. of lot, sq. ft. of house 2 coptes of plon
and cil roofed areas (20% maximum lot coveraae cllowed) 1 set of energy calculations tor heated addiHons
? 2 coptes ot plans (show becm 3 window sizes; poured fnd. design; etc.) 1 sRe suney for exterior addiHons 3 decks
D 1 set of energy colculatlons
? 3 copies of hee preservation picn U lot platted cffer 7/1/93
DATE: 4`30 -1°)
DESCRIPTION OF WORK:
CONSTRUCTION COST:
STREET ADDRESS: 39-4-2- P 1) M m Zr-
LOT: I?I BLOCK: r- SUBD./P.I.D. #:
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Name• Phone #:
?
Last First
Street Address: V M??C- "
City C?Gp+-' State• Zip:
Company: 's ?- ?- Phone #:
(area code)
Sheet Address: License # Exp.
City
Company:
Telephone #: orea code (
Name:
Street Address: Regishation #:
City
Sewer 3. water licensed plumber (reauired for new construction onlv):
State:
State:
Penalty cpplies when address change and lot change is requested once permff is issued.
ZIp:
Zip:
1 hereby acknowledge that I have read this application, state that t e information is correct, nd agree to comply wffh all applicabl
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Appltcant•
,,,e''
OFFICE UStNLY -?
Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex E3 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
O 05 3-plex 13 10 8-plex 13 15 Lodging O 20 Pool ? 25 Miscellaneous
WORK TYPE
0 31 New 0 35 Tenant Impr ? 39 Gas Line Only O 43 Siding/Soffits/Fascia
? 32 Addition 0 36 Move Bldg. ? 40 Gas Insert ? 44 WindowsJDoors
? 33 Alteration O 37 Demolish Bldg.* 0 41 Wood Stove ? 45 Fire Repair
? 34 Repair O 38 Demolish (Interior) ? 42 Reroof
' Give PCA handout to applicant for demolition
ermit
GENERAL INFORMATION p
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code
UBC Occupancy sq. ft. No. of Units
Zoning sq. ft. No. of Bldgs
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building Engineering 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:
SAC Units
Valuation: $
% SAC
Date:
City f Lagan
3830 Pilot Knob Road
Eagan MN 55122
Phone; (651) F.75-5675
Fax: (651) 675.5694
Use BLUE or BLACK Ink
For Office Use �/
Permit #: ! 5
Permit Fee: - 0 5-3.
Date Received; t:[L
Staff;
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
10/14/2013 Site Address: 3972 Pumice Lane
Regicisigt
O1stii 'at
_Unit #:
Name: Michael Doody
Phone:
Address / City /Zip: 3972 Pumice Lane , is arc an,
• Applicant is: Owner X Contractor
MN 55122
651-755-1449
Description of work: Re
lace roof on House and Garage
Construction Cost: $ 9,991 -27
Company: A2Z Construction
Multi -Family Building: (Yes / No' )
trtJr Address: 10224 5th Ave
South
Contact: J • Steve Collier
City: Bloomington
State: MN Zip: 55420 Phone: 612-363-1984
License#: BC 639780 Lead Certificate #: NAT- F 1 0 8 7 7 0 -1
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 yesdate and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
J
0,4 afiiayiil
. 1~ofrf'• •',• ti0i17drpl�t
CALL BEFORE YOU DIIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to reoaive locates of underground utilities. www. gouherstateonecall�{r
I hereby acknowledge that thi;; Information Is complete and accurate; that the work will be in conformance with the ordinances and codes of the Clty of
Eagan; that 1 understand this Is not a permit, but only an application fora 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.
Exterlorwork authorized by a building permit issued In accordance with the Minnesota State Building Code must be completed within 160
days of permit Issuance.
x Awa. 5. CCjj/re r
Applicant's Printed Name
plicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA158567
Date Issued:10/21/2019
Permit Category:ePermit
Site Address: 3972 Pumice Lane
Lot:17 Block: 7 Addition: Cedar Grove 5th
PID:10-16704-07-170
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 1,500.00
Fee Summary:BL - Base Fee $1500 $62.50 0801.4085
Surcharge - Based on Valuation $1500 $0.75 9001.2195
$63.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Ryan Lautt
3972 Pumice Lane
Eagan MN 55122
(612) 270-8654
Crew2 Inc
2650 Minnehaha Ave
Suite 100
Minneapolis MN 55406
(612) 276-1680
Applicant/Permitee: Signature Issued By: Signature