4019 Pumice Lanedelti.
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Permit #:
Permit Fee:
Date Received:
Staff:
CO
12011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: `� 1 ` ((1 Site Address: /401,°7 j (9tivVr% q HIQ
/
OWNER
V Phone: 3,'? 3W 1
Name:" R (
_
Address / City / Zip: Y0/ 9 Kiril 1( (clN i i\ r ' " 5-5122,
Applicant is: )( Owner Contractor
TYPE OF WORK
Description of work: lG C.A. te)i)-e (31\3 71-(C-"..---
Construction Cost: Multi -Family Building: (Yes / Nqi�)
CONTRACTOR
Company:
� Contact:
City:
Address:
State: Zip: Phone:
License #: Lead Certificate #:
If the project is exempt
from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
Yes If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit
yes, date and address of master plan:
for a similar plan based on a master plan?
_No
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:Phone:
Phone:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information Portions of
the information maybe classified as non-public if you provide specific reasons that would permit tfie C fy to
conclude that they 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.aopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approy Lof plans.
Applicant's Printed Name
x
Applicant's Signature
Page 1 of 3
CITY OF EAGAN Remarks
Addition,CEDAR GROVE #7 Lot 4 elk 1 Parcel 10 16706 040 Ol
Owner Street 4019 Pumice Lane State Eagan, MN 55122
1U'rl }j?_ j
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK Cj' 1970 5$.18 2.08 28 Paid
* SEWERLATERAL 1971 20
WATERMAIN
* WATER LATERAL 'V 1971 1,615.00 80.75 20 Paid
WATER AREA
* STORM SEW TRK 13 1971 20
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN, 300.00 6026 7-3-72
BUILDING PER.
sac 260.00 6026
PARK
CITY OF EAGAN . 10323
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ?
PHONE: 454-8100 ''? • ' `
BUILDINCs PERMIT tteceipt #
T* be wrd fer Est. Volue Dote , 19
Site Addreu ?
'.
? Erect El Occupancy
„ ;;'J C
?
Lot ? Block ?ec/Sub Remodel ?
'•' Zoning
. Repair ? Type of Const.
Parcel No. Addition ? No. Storiea
' Move ? Length
Z
HUIINF:
L
Name
Demolish ?
Depth
? Address Int Impr. ? Sq. Ft.
City Phone ? -- `? Install ?
Approvals Fees
?.. _ _
Name L _v{.•5,i, _•t
?
Zu i.,,.?,! n F',X:"T'Y.?:'i'??r7 ,?t?T
?§ Address
?- City Phone
Name
Addresa
City Phone
Assessment
Water b Sew.
Polite
Firo
Enq.
Plonner
Permit
Surcharge
Plan Review
SAC
Water Conn.
Water Meter
Countil Road Unit
I hercby acknowiedye thot 1 hew reod this opplicotion and atote that Bldg. Off. ?/29?j?y Tr. PI.
the inlormotion is torrect and ogree to comply with all applicable APC Parks
Stote of Minnewta Stotutea and City of Eoqon Ordinances.
Var. Date Copies
Sipnotum of Pertnittee
Total A 8uilding Pertnit is issued to: on fM exprost cadiNon thot
all work sholl be done in accordance with all oppliooble State of Minnesota Statutes and City o3 Eapon Ordinonces.
Buildinp Officiol
+.
Pamit No. Permk Holdsr Dat* Telephons
Plumbiop
H.VA.C.
ENctric - ,,
Soitemr
Impsetion Date Insp. Othsr
Footinga I
Footings II
Fou ndation
Framing
Roofing ; ?> >
Rough Plbg.
/
RoughHtg.
InsuL
Fireplace
Final Htg.
Final Plbg.
Finsl
CeRt/Occ.
Water Desc?ibe Loestion:
Weil A, &- #,W ?/? / (
Sewer 24
Pr. Disp.
, CITY OF EAGAN
' 3795 Pilof Knob Rood Eugoe, MN 55122
PHONE: 454-8100
BUILDING PERMIT ReceiPt #
N° 6135
To be used for ' Est. Value Date , 19
Site Address Erect p. Occupancy
Lot Block Sec/Sub. Alter ? Zoning
Parcel # Repoir ? Fire Zone
Enlarge ? Type of Const.
?
a NOme
W Move ? # Stories
3 Address Demolish ? Front ft.
0 Phone Grade ? Depth ft.
Ci
0: Name Approvals Fees
•
??o
Address
? r:..,
Name _
Address
I hereby ocknowledge that I have read this applicotion ond state that
the information is correct and ogree to comply with all applicable
State of Minnesoto Stotutes and City of Eogon Ordinances.
Assessment -
Water & Sew.
Police
Fire
Eng.
Planner
Countii
Bldg. Off. -
APC
Permit • ?JU
Surchorge
Plan check
SAC
Water Conn.
Water Meter
Road Unit
Total
Signature of Permittee I
A Building Permit is issued to: on the express condition thot
oll work shail be done in accordance with all applicable Stcte of Minnesota Statutes and City of Eagan Ordinances.
Building Official
Ponnk # DaM laued PormMh?
Plumbing
Mechanical
INSPECTIONS DATE INSP.
Rough-In
Final
Footing5 7(5 • Date Insp. Date Insp.
Foundation Plumbing
Frame/ins. ? '- Mechanicol
Final
Remarks:
CITY OF EAGAN
374o0 'ilot Knob Rood Eagan, MN 55122 L? ?2 8
PHONE: 454-8100
BUILDING PERMIT Receipt #
; . _ _.._
To ba used for jyigru ;c nr.r.x Esr. Volue tlei Date T.•i?? ?, _, 19_?t
Site Address 401,9 p11LLSfC@ T•Arp Erect Occupancy
Lot 4 BlockI_ Sec/Sub. Cpfiar Grnva 7th Alter ?Zoning
Pcrcel .# --1,0 _16706 04a 03 Repair ? Fire Zone
Enlarge ? Type of Const.
oWe Name C64arga AtmnAl Move Q # Stories
; Address 40I9 Pirrr+irP T.ane Demolish ? Length
b
City Rgigan 5r3172 phone 4 54.,,1047 Grode ? Depth Sq. Ft.
°C Ncme O*+7upr Approvols Fees
-
?O
U Address
?- r:...
Nome
Address
I hereby acknowledge that I hove read this
the informotion is correct and agree to c
$tate of Minnesota $totutes and City of
Signature of Permittee = - - --
A Buiiding Pertnit is issued to: .??-'Or?e- TT,?
oll work shull be done in occordante with oU applicat
Buildinp Officiol ?
and state that
all uppliccble
Assessment
Water & Sew.
Police
Fire
Eng.
Planner
Council
Bldg. Off.
APC
Permit -
SurchQrge --50._
Plan check
SAC
Water Conn.
Woter Meter
Road Unit
Total
on the express condition that
of Minnesota Stotutes ond City of Eagan Ordinances.
Permit No. Permit Holder Misc. Permit No. Holder
Plumbing
H.V.A.C.
Well
Water
DisP•
Sewer ?.
E lectric
Inspection Date Insp. Other
Footings
Foundation
Framing
Rough Plbg.
Rough HVAC
insulatiort
Final Plbg.
Final HVAC
Final p
p
Water Describe Location:
Well
Sewer
?.
Pr. Disp. "
ClTY OF EAGAN
. 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt #
Te bs wed For p0(JL/FENCE Est. Vo1ue $9,000 pO1e JUNE N? ? 0 3 2 3
1985
Site Address 4 019 PUMICF LN Erect ? Occupancy
Lot CED GRV # 7
4 Block 1 Sec/Sub Remodel ? 2oning
. Repair ? Type of Const.
Parcel No. Addition ? No. Stories
09 Name
GEORGE FIUNNEL
Move ?
li
h ?
D
Length
Z
?
Address
S?F emo
s
Int. Impc ? Depth
Sq. Ft.
City Phone 454-1047 Install ?
o Name
CUSTOM POOLS
Approvols
Fees
Zt~i
o
Address 601 E EXCELSIOR AVE Assessment Permit -
City HOPKIIVS phone 933-2255 Warer & Sew. Surcharge 4. 50
Police Plan Review
?
°C
Name Fire SAC
1? Address Enp. Water Conn.
? Z. City Phone Plonner Water Meter
I hereby acknowfedge that 1 have reod this appiication ond stote thct
the informotion is correct and agree to comply with oll opplicable
Stote ot Minnesota Stolute's`Nond City of^Eagon Oldinonces.
Sipnoture of Permittcq,:
h Building Permit is issued
oll work shall be done in c
Buildirp Officiol
CUSTOM POOLS
with all ouoliwble State of
Councii Road Unit
Bldg. Off. 5 2 9 $ rj Tr. PI.
APC Parks
Var. Date Copies
Total $ 7 9- 0 0
on the express conditlon thot
sotn,5t9tutes and City ot Eagon Ordinances.
i
EAGAN TOWNSHIP
I
BUILDING PERMIT
J ...........
Owner ----•---- ece-r4.-=-•-%?----• .
Addreas (Present) •-••-••-••-: < ........................
Builder .................... -,a - -4 Y..............................................
Address --•-- -•----...:...••••--•------•---•---•--••-•••--•--.....---•-•••••-••-•-••••-•---•
DESCRIPTION
N? 2768
Eagan Township
Town Hall
Date 7.?.?v -7 Z-
•-••-•--•-••-•---° ................
Stories To Be Used For Froni Depih Heigh! Esl. Cos! Permit Fee Remarks
LOCATION
Sireet, Road or other Descriplion of Location I Lot I Block I Addition or Tract
?- -y !
7
This permii does not suthorize the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent
the righi 3o create anp situation which is a nuisance or which presents a hazard to the health, safetp, convenience aad
general welfare !o anyone in the communiip.
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS.
This is !o certify, lha2...•-?---?-•?r•....... has permission !o erect a.._/.l--- ...--• . . ....---• - •• -.......-upoa
the above described premise subjec2 to the provisions of the Building Ordinance for Eaga? n Township a opted April 11.
1955.
............................ • -•
? :
-• .......................•....• •••-••--•••••---•-...--.............. --------- Per
...............
Chairman of Tnwn Board ••-...-•-•--••-..?_.._...'?.?....?..?
Building Inspector• •. .......
-•-••
?
/ D /?70<o Gs?? o/
?_ --?
TO' 'N 0 i EAGF I1
'795 I'ilot Knob ;:oad
F,agan, iiinne-sota 351;?1
PEP,NiIT N0. 234
The Board oi O'upervisors hereby gzants to Cedar Grove Construction Co. '
_ of 7343 Cc:icord Blvd. E., Sauth St. Pau1 55015
a pI'M03M Permit ior: (C?taner) same
.' 7T '' 7n, e ?? L e,74031 ce Lan , e ,a gr-se ian l?
054.Pum-
, c=e i Ja?d ?an
e, J?c3e ane, a i.mona e Lane, 2 Carne lan Lane,
a e
pursu2nt to application dated
6/2 %,/7 2
,,2e paid; v;220,00 Dated this 3rd day of . Jlh13' ? 1972
. > s c, ?
Building Inspector
sd
,
,? .
TO'.iN OF EAGFII
3795 Pilot Knob i;oad
Eagan, Minneaota 55121
PERMIT N0. 221
The Board of Supervisors hereby grants to Cedar Grove Construction Co.
of 7343 Concord Blvd. E., South St. Paul 55075
a HEATING permit ior: (Owner) same.
Id7l Carne ALar?e, 1?031 ce Lan e e ian i.n.e 4051? PUZn-
ice Lan e, ? Ja e Lan e, ? Jade ?ane, imoni e Lane, U?
Carne ian 'Lane,
at 1, 060 u@z 14?,,,?.Apursuant to application dated
6/27/72
zee Paid: $220.00 Dated this 3rd day of Jll]-y , 1972 .
s c
Building Inspector_
i0
/
BUILDING PERMIT.APPLICATION
Include 2 sets of plans,
1 site plan w/elevations &
1 set of energy calculations.
Zb Be Used For Valuation ? GOO Date
?- _2 7-eG
Site Address OFFIGE USE ONLY
Lot slock sec./sub. c,? Erect -? occupancy
Parcel #: Alter. Zoning
Owner :
Address: {'-
City/Zip Code: z-
Phane # :
Contractor:
Address:
City/Zip Code:
Phone #:
Arch./1?ng..
Address:
City/Zip Code:
Phone #:
CITY OF EAGP,N
Repair Fire Zone -3
Enlarge Zype of Const.
Nbve # Stories
Demolish Front JZa ft.
Grade Depth f:?- ft.
APPROVALS FEES
Assessments Permit 4r j
! aater/Sewer Surcharge or i AO-
--r
Police Plan Check
Fire SAC
F,hq, Water Conn.
Planner Water Meter
Council Road Unit
Bldg. Off.
APC
TOTAL
-r .. ,T
+-" • '0` ..
, ? '
1
CITY OF EAGAN
3795 Pilot Knob Rocd Eugan, MN 55122 Ng 6135
PHONE: 454-8100
BUILDING PERMIT APPLICATION Receipt #
To be used for FIREPLACE & DECK Est. Votue 3 ,000 Date 1980_
Site Address 4019 Pumice Lri. Erect oX Occuponcy R3=
Lot 4 Block 1 Sec/Sub. CG 7 Alter ? Zoning
Repair ? Fire Zone
Parcel #
Enlarge ? Type of Const.
w Name George Hunnel Move
' ?
# Stories
Z Addres ?+019 Pumice L11.
? Demolish ? Front - 22 ft.
o Ci
Eagan, 55122 phone 454-1047 Grade - '? Depth 12 ft.
?
p
Name ?n° Approvals
• Fees
_ ^ _ -
??F-
Address
t- r:+.,
Name _
Address
Assessment
Water & Sew.
Police
Fire
Eng.
Planner
Council
Permit • "v
Surcharge 1.50
Plan check
SAC
Water Conn.
Water Meter
Road Unit
I hereby acknowledge that I have read this application and state that gldg. Off.
the information is correct and gree to comply with all ap ca le APC Total 1-3.5?
State of Minnesota Statutes a City of Eagcn Ordinonces.
Signature of Permittee "
A Building Permit is issued to: G20Y'g2 Hunnel on the express condition that
oil work shali be done in accordance with oll applicak9le State of bAnnesota Statutes and Ciry of Eogan Ordinances.
Building Official
(tr )V2K7 CI'1'Y OF'' EAGAN
.. ? ? .
BUILDING PERMIT APP TI
? ___---
To Be Used For ?o Valuation i
Include 2 sets of plans,
l site plan w/el.evations &
1 set of_ ener_T.
I cal.culations.
Date -7 - ? - ??5
Site dress : OFFICE USE ONLY
Lot Block ? Sec. /Sub. ?Aac (AIbV L Erect ? Occupancy
Parcel #:
( D ? (? `7 b ?p ('? ? 6 ( .?lter zoning -
RePa ir Fire Zone
Otimer :_?.e
Address: Pu rr? r c.e Q ?
City/Zip Code:
Enlarge Type of Const.
Move # Stories
Demolish Front
Grade Depth
Phone # : </ 7 P,PPROVAI„S FEES
??k ..
Contractor: oC01'1Ef?ssessments Permit
Address• - - - Water/Sewer :Surcharge , ? -
' Police - Plan Check
City/Zip Code: ? Fire SAC
Phone #: Erig'
Planner
Arch. /Eng • : Council
Bldg. Of f .
Address: APC
City/Zip Code:
Phone #:
ft.
Water Conn.
Water Meter
Road Unit
TOTAL
- .,? -
-? cirr oF E+GaN -
`3793 Pilot Knob Rood Eogan, MN 55122 N•° 8287
PHONE: 454-8100
BUILDING PERMIT Receipt #2 rlaL ?
To bs uaed Mr PORCH & DECK Est. Volue $800.00 Dote July 25 , 19 83
Sjte Address 4019 Pumice Lane Erect
4 1 Cedar Grove 7th ??cu???
Lot Block Sec/$ub. Alter ? Zoning
Porcei # 10 16706 040 01 Repoir ? Fire Zone
oc Name George Hunnel
W
9 z Address 4019 Pumice Lane
r:... Eaaan 55122 DL„__ 454-1047
Zo Ncme Owner
8u Address
!-
Nome _
Address
Enlarge ? Type of Const.
Move ? # Stories
Demolish ? Length
Grode Q Depth Sq. Ft.
Approvals Fees
Assessment _
Woter & Sew.
POItC@
Fire
Eng.
Plonner
Council
Pertnit 14.5U
Surchorge .50
Plan check
SAC
Woter Conn.
Water Mete?
Road Unit
I hereby acknowledge that I hove read this applicotion ond stote that Bidg. Off. .?
the informotion is corre nd ogree to comply with oll oppliccble APC
Stote of Minnesoto Stotutes nd City of Eo o? Or?' .
Signafure of PermitteeJ
A Building Pertnit is iuued to: Geor e Hunnel .?-
oll work shoil be done in occordance with oaoiicoble ta of 1llinnes
Building Officiol
Totol $15 . 00
on the express condition that
ond City of Eegon Ordinances.
REQUEST FOR ELECTRICAL INSPECTION ?,. Ee-00001 :oa
,? , ? See iostructions tor completing this form on back of yellow copy. ? f ; '?' 4
A ~ G "X" Below Work Covered by This Request
ladd Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lightin,y Fixtures
Apt. Building Dryer Electric Heatin
Commerciai Bidg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm ocner peci y I-S'_ ? ? Q,,?` Other (Specify)
nn
!1 Fee Service Entrance Size t! Fee Feeders/Subfeeders # Fee Circuits
0 to200Am s 0 to30Am s 0 to30Am s
Above 200 Am ps 31 to 100 Amps 31 to 100 A s
Swimming Pool Above 100_Amps Above 100_Amps
Transformers Irrigation Booms Partial/Other Fee
aigns apeciai inspecuon
$ TOTAL FEE ?
Remarks
s
Rough-in ? ?Pg(? 1
th
Et
t
i
,
e
r
ec
cal
inspector, hereby
certif
that the ab
Final (
D le
? y
ove
inspection has been
17 I ? made.
Thh request void 18 months trom (r/ -sr °
This request void
18 months: from
A *7 98-4 8 3'1 `-e-,e .,6Yr u
Request Date
? Fire No.. Req ired?jnspection C]Ready Now Q Will Notify, Inspec-
to
Wh
R
- _ 0 Yes ? No r
en
eady
[:]Li nsed Electrical Contractor I hereby request inspection of above
?Dwner electrical work installed at:
Street Address, Bo Route No. C ity
ection o. Township Name or No. Range No. County
4d r
Oc pant (PRINT) ?J Phone No.
l? e_
wer Supplier Address
/
? e__
Electrical Contractor (Company Name) Contractor's License No.
Mailing Address (Contractor or Owner Making Instailation)
Author' Signatur (Contractor Ow Making Installation) Phone Number
MINNES A TATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs- " ay Bldg. - Room N.791 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (672) 297-2117 ENCLOSED.
MASTER CARD
LOCATION
•
OWNER
STRUCTURE AND
LAND USED AS
Permit
No.
Issued Issued To
Contractor Owner
BUiLDING .? 76 8 I
PLUMBING y
CESSPOOL - SEPTIC TANK
VdELL
ELECTRICAL
NEATING 2 },
GAS INSTALLtNG
SANITARY SEWER / ooy
?
OTHER --
? 7if
OTHER
Approved
•_ Items (Initial) Date Remarks Distance From Weli
FO0TiNG 6. 2g_7 SEPTIC _
FOUNDATION Y-3o - CESSPOOL
FRAMING ?20 '7 TILE FIELD FT.
FINAL
ELECTRfCAL DEPTH
HEATING OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING 7
WELL
SANITARY SEWER a_ ?
??
?
r3v-7
Violations Noted
• I ck
on B
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
9
PERMIT NO.
CONDITIONS OF CONST2UCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
1:1 ACCEPTABlE SUBSTITUTIONS OR
DEVIATIONS.
DATE OF INSPECTION
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
1-1 NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
F COMPLETION OF CERTAtN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
? REINSPECTION REQUIRED
REINSPECTION REVEALED
DATE OF REINSPECTION
0
CERTI FICATION - I certify that 1 have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein
all significant conditions oLserved 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.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
COMMENTS:
BUILDING INSPECTOR
DATE
i
23
/
1 ,5g RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
New Construc;tion Reauirements RemodeUReoair Reauiremenls Office Use Oniv
3 registened si0e surveys showirg sq, ft of bt sq. ft of house; and all roofed areas 1 oopies of plan _ Cert of Survey Reod
(2096 maximum lot ooverage albweO 1 set of fnergy Calculations fbr heabed additions _ Tree Pres Plan Recd
2 copies of plan shawing beam 8 window sizes: poured found design, etc. 1 siee survey for additions 8 dedcs _ Tree Pres Not Raqd
1 set of Energy Cakwlatkns AddNa? - indkate if on-site sepdc system _ On-site Septic Sy+s6em
3 copies of Tree Preservatlon Plan if bt platted after 7N/93
Rim Joist Dehail Opftns selecdon sheet (bidgs wiTh 3 or less unAs
Date 2 /
?.? f 0 ? I Q - ?t-U
Construction Cost U ? ? ? '
Site Address Pu rn? c- G l-01. Yl Unit/Ste #
DesCription oY WoriC
Multi-Family Bidg _ Y _ N Fireplace(s) _ 0 _ 1_ 2
PropertyOwner 6)eD roQ ? ?.ebv-,?? n? Telephone # ((p$ )
Contractor ?? Lakes YffittdOw 3 Sidi
Address
State ____italia. UM ?,1?A
Ph
` (? ?1'? City
.
Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Categorv 1
• Residentlal Ventllation Category 1 Worksheet
(?l submission type) Submitted
• Energy Envelope Caiculabons Submitted
Licensed Piumber
Mechanical Contractor
SewerlWater Contractor
A NEW BUILDING
Minnesota Rules 7672
• Nerv Energy Code Worksheet
Submitted
Telephone # (
Telephone # (
Telephone # (
I hereby apply for a Residential Building Pernut and acknowledge that the informatil
that the work will be in conformance with the ordinances and codes of the City of
Statutes; I understand this is not a permit, but only an application for a permit, and v
permit; that the work will be in accordance with the approved plan in the case of work
approval of plans.
r3 ? . ? ..?? K
cbin?lete an 'c te;
4
??d?t?e I?te of ?+IlV
is not to start with ?ut a
ch requires a review hn-d-
tAl-I F_ F2 ?,n2f"JS A
Applicant's Printed Name Applicant's i ature
OFFICE USE ONLY
Sub Types
? 01 Foundation 0 07 05-plex C3 13 16-plex ? 20 Pool
? 02 SF pwelling ? 08 06-plex ? 16 Firepiace ? 21 Porch (3-sea.)
? 03 01 of _ plex ? 09 07-plex ? 17 Garage 0 22 Porch/Addn. (4-sea.)
? 04 02-piex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo)
C] 05 03-plex ? 11 10-ptex ? 19 Lower tevel ? 24 Storm Damage
? 06 04-plex 13 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
O 30 Accessory Bldc
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
0 36 Multi Misc.
? 31 New 13 35 Int Improvement ? 38 Demolish (Interior) 0 44 S+ding
? 32 Addition O 36. Move Bldg. 0 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bidg)• 0 43 Reroof ? 46 Windows/Doors
? 34 ReplaCement `Demolition (Entire Bldg) - Glve PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bidgs Length Fire Sprinklered
Type of Const Width ? #.:?? ? ?•_c? ,?? v; I j
#Rris'?'?'F
,,f
lNYLfd"??",
.. ...:•{F??44'+Yi
,
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"i??? ?`°?t ?'w?,°sjc ? 'Yi 1•',? ?
F
REQUIRED INSFECTIOi'??
,_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) FinaUNo C.O.
` Footings (addition) _
_ Plumbing
_ Foundation HVAC
, Drain Tile Other
Roof _ Ice & Water ? Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Finai _ Windows (new/replacement)
_ Insulation Retaining Wall Approved By , Building Inspectar
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utitity Connection Charge
S&W Perrnit 8 Surcharge
Treatment Piant License Search
Copies
Other
Total
'O
:5,, CITY USE ONLY
? B RECEIPT #:
SUBD. e Ar rOYpJ RECEIPT DATE: IV-ao-oo
PERMIT #
2000 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT IQdOB RD
EAGAN, IrIld 55122
651-681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIXTIIRES
EACH #
TOTAL
Alterations to existing dwelling - minimum fee
Describe: $ 30.00
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
Gas piping outlet * minimum -1 3.00 x = $
Hot tub/spa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tray 3.00 x = $
Lavatory 3.00 x = $
SeptlC SySt@I1'I new/refurbished ' requires MPC lic. 75.00 X = $
Septic System abandonment 30.00 x = $
RPZ new installatioNrepaiNrebuild 30.00 x = $
Rough opening 1.50 x = $
Shower 3.00 x = $
Underground sprinkler ff dwenin9 is under construction 3.00 x = $
Underground sprinkler if existing dwelling 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
Water softener if dwelling under construction 5.00 x = $
Water softener if existing dwelling 30.00 x = $
Water tumaround 30.00 x $
State Surcharge .50 -> -> -> $ .50
Total -> _> --> --a $ 30.s'o
Reminder: Call for inspections of atterations, i.e. water heaters, water softeners, etc.
---
--------------------------------------------------------- - - - ---------------------------
I herebY adcnowledge that I have read this application, state that the information is correct, end a ree to com
g py wdh all applicable City of Eagan ordinances.
It is the applicanYs responsibiliry to notify the property owner that the Ciry of Eagan assumes no liability for any damages caused by the City during its
normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement.
SITE ADDRESS: (40[q Pl.Q,M l['g-r-- (.A1Oj-;
OWNER NAME:?? ?ILk NNLL. TELEPHONE#:???`
(AREA CODE)
INSTALLER NAME: V ? ??
STREET ADDRESS:
CITY
BY:
TELEPHONE #:-263- -'S67-OS575--
, I ,,,, (AREA CODE)
STATE: ? ZI P: ?
SIGNATURE OF PERMITTEE
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. AISO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
- ------------ - - ------- - ------------------- - -------- ---- - ---
NEW CONSTRUCTION
ADD-ON A/C
ADD-ON FURNACE
?. FIREPLACE INSERT
DATE
FEE5
HVAC: 0-100 M BTU $ 24,00
ADDTTIONAL 50 M BTU 6.00
G.4S OLTTLFTS iMl-NTMUM t @ $3.0-n EACLii ?
ADD-ON/REMODEL (ExisTTNC CorrsTtUCriorr) $ 20.00
STATE SURCHARGE .50
TOTAL G>po ?-
SITE ADDRESS: ? O ' `V ? G"_ Lri
OWNER NAME: TELEPHONE #: C'
INSTALLER: F;f'-oI a CA_
ADDRESS: /??00 9 j..? j4 ? S o
CITY: ?, SV U a"I STATE: 'd") ? ZIP CODE:
TELEPHONE #: ?? j ^ / oi o .
4?y
C.0'? ,so
1994 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR ALL COMMERCIAL/INDUSTRIAL BUII.DINGS. ALSO COMPLETE '
FOR APARTMENT BUILDIIVGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE
PERMITS ARE NOT REQUTRED FOR EACH DWELLING UNIT.
- - ----- - --------------- - - -------------------------------
DATE: CONTRACT PRICE: $
NEW BUILDING
INTERIOR IMPROVEMENT
WORK DESCRIPTION:
FEES
1 % vr FEE $
PROCESSED PIPING: $25.00
MINIMUM FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF FEE.
TOTAL $
SITE ADDRESS:
OWNER NAME: TELEPHONE #:
TENANT NAME: (IMPROVEMENTS ONLI')
INSTALLER:
ADDRESS: .
CITZ': STATE: ZIi' CODE:
TELEPHONE #:
SIGNA'I'URE OF PERMI'ITEE CITY INSPECTOR
1994 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
!
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS NUST BE LICENSED WITH THE CITY OF EAGAN
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
To Be Used For. alilm ?Lo
?? ? .? aluation:
Date:
Site Address: 14C IC1 lc,vn(c'F: OFFICE USE ONLY
Lot: ? Block I Sect/Sub Erect ? Occupancy
?tk Remodel Zoning
Parcel # Repair Type of Const
?
?
'
-? ° Enlarge 4? of Stories
Owner
?_ p? C •P
v ? ?2.
? Move Length
Demolish Depth
Address m ,c e ?. N Grade Sq Ft
c_
City/Zip Code A r-\ , m?
----------
-------------------------
Phone L4 S? - I O'4 -7
Contractor
Address (o? ( -E - ? ?(!`
City/Zip Code ?-(j P k. (V') ?--, f ? Y)
Phone q 3 -,?> ra
Arch./Engr.
Address
City/Zip Code
Phone #
APPROVALS
Assessments Permit
Water/Sewer Surcharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Council ' Raad Unit
Bldg Of ' , ' Parks
APC ? Treatment P1
Variance
TOTAL
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.
EAGAN TOtaNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454•5242
PERMIT FOR SEWER SERVICE CONNECTION ?
DATE: C? NUMBER 1047
4-1-7
OWNER. ah-,?_Address 4
?
PLUMBER TYPE OF PIPE
D ESCRIPTION OF BUILAZNG
Industriall Commerciall Residential I Multiple Dwelling I No, of units
Location of Connections:
ConnecCion Charge 260.00 pd 7/3/72
Permit Fee 10.00 pd 7/3/72
. p s/c
SCreet Repairs
Total
Inspected by:
DaCe
Remarks•
By
Chief Inspector
In consideration of the issue and delivery to me of the above perm3.t, I
heraby agree eo do the proposed worlc in accordance with the rules and
regulations of Eagan Tocroship, Dakota-CounCy, Minnesot
By
Please sxotify when ready for.iaspection and connecCion and before any portion
of the work is covered.
.?
EAGP.N TOWNSHIP
3795 Pilot Knob Rosd
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION 4'1'7
Date• W,--D?q I -7;:a Number: 87$
Billing Name: Site Address:
Owner: Billing Address
Plumber•
Connection Meter Size lConnectioa
. . O pd 7/3/72
Meter No,? PermiC Fee-- -10.00 pd 7/3/72
.]v pd 7/3/72 5lC
Mster Reading Meter Dep.
Meter Sealed: Yes Add'1 Chg.
NO iTotal Chg.
Inspected by
Building is a:
Residence xx
tRultiple 110. Units
Comanercia 1
Industrial
Other
Date
Remarks:
By:
Chief inspecCor
In consideration of tha issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Mianesota.
By. 01-1x-?O_tn
. k QbK-?-
Paotify the above office when ready for inspection and connection.
4019 pumice Lane, Eagan TCF-Burnaville
Goorge Hunnel SPECIAL IMPROVEMENTS
on
All that tract or parcel of land lying and being in Dakotg County, Mi.nnesota, described as follows,
to-w i t:
Lot 4, Block 1 Cedar Grove.#7 (Torrens)
This is to certify that I have examined the records in the office of the City Clerk, City of
, nak nYa County, Minnesota, qnd find that the above described tract
or parcel of land has the following improvements as indicated by CHECK MARKS:
Woter Main Sidewalk Street Paving
Main Trunk Sewer Curb & Gutter Alley Paving
Laterial Sewer Street Grading Garboge Collection
Storm Sewer Alley Grading Tarring Street
STreet Sprinkling
I further certify that according to the records of said office, ihe following assessments appear unpaid:
Total Amount Unpaid
Original Subsequentto
Kind of Improvement Runs Beginning Amount Current Year
none
I further certify that according to the records of said office, the following improvements are contemplated tr
pending after having been approved, and are now in the process or planning or completion:
Approximate date of Approximate Cost of
Kind of Improvement Completion Improvement
none
Dated this 7th
doy of March
, 1978 •
i
Assessment C rk --E ?
?
Ciry of Eagan
SEVERSON, SHELDON,
DOUGHERTY & MOLENDA, P.A.
SUIT'E 600
7300 WEST 147TH STREET
APPLE VALLEY, MINNESOTA 55124-7580
(952) 432-3136
TELEFAX NUMBER (952) 432-3780
E-MAIL bauerrQseversonsheldon.com
-!j
Ortec-t-1
TO: John _Q r, Assistant City Engineer
FROM: Robert B. Bauer, City Attorney 11_? '
DATE: March 16, 2004
RE: Cedar Grove - July Storm
Project 815
Our File No. 206-191 Y 7
John,
Enclosed for the City's records in connection with the above-referenced matter, please find the
followiilg original documents:
A. Drainage and Utility Easement between Lawrence Glerum and Patricia
Glerum and the City of Eagan dated June 25, 2001 and recorded with the ?
Dakota County Registrar of Titles Office on June 20, 1003 as Document
No. 503749 (Easement No. 931); B. Drainage and Utility Easement between Andrew J. Brown and Patricia
Brown and the City of Eagan dated June 20, 2001 and recorded with the
Dakota. County Registrar of Titles Office on June 20, 2003 as Document
?
??---
No. 503751 (Easemeizt No. 934); r??, o i?i
C. Drainage and Utility Easement between Charles E. Barney and Delva
Barney and the City of Eagan dated June 15, 2001 and recorded with the
Dakota County Registrar of Titles Office on June 20, 2003 as Document
No. 503742 (Easeinent No. 935); yo-?? ?'v ? - _ i`Z-t : Z-
? t
D. Drainage and Utility Easement between George L. Hunnel and Debra K.
Hunnel and the City of Eagan dated June 14, 2001 and recorded with the
Dakota County Registraz of Titles Office on June 20, 2003 as Document
No. 503748 (Easement No. 936); yd ?a &r1.,Le
E. Drainage and Utility Easement between Robert L. Saalborn and Carol
Saalborn and the City of Eagan dated June 13, 2001 and recorded with the
Dakota County Registrar of Titles Office on June 20, 2003 as Docuxnent
No. 503746 (Easement No. 938); c.{p &4 .o--. ' ? ;` ti6,l,,t.-.
F. Drainage and Utility Easement between Dennis Fischbach and Jacquelin
Fischbach and the City of Eagan dated June 13, 2001 and recorded with
the Dakota County Registrar of Titles Office on June 20, 2003 as
Document No. 503744 (Easement No. 939); ?{D Sa .?r ?.?? y S!
G. Drainage and Utility Easement between Gerald Albright, Jr. and Theresa
Albright and the City of Eagan dated June 13, 2001 and recorded with the
Dakota County Registrar of Titles Office on June 20, 2003 as Document
No. 503747 (Easement No. 940); yb-,D( ?{rr7a,???,! ?/"
H. Dra.inage and Utility Easement between Brent A. Bartsch and Kristen K.
Bartsch and the City of Eagan dated June 12, 2001 and recorded with the
Dakota County Registrar of Titles Office on June 20, 2003 as Document
No. 503745 (Easement No. 941); /; n Q (?? t,;::• f.':?<- ????
Drainage and Utility Easement between Bob J. Stein and Judy A. Stein
and tlie City of Eagan dated June 13, 2001 and recorded with the Dakota
County Registrar of Titles Office on June 20, 2003 as Document No.
503743 (Easement No. 942);
J. Drainage and Utility Easement between David J. Ryan and Caryl A. Ryan
and the City of Eagan dated June 12, 2001 and recorded with the Dakota
County Registrar of Titles Office on June 20, 2003 as Document No.
503750 (EasementNo. 943); and 7r? ?e.,c?"2,. 4aw ?
K. Drainage and Utility Easement between David Efteland and Brenda
Efteland and the City of Eagan dated June 25, 2001 and recorded with the
Dakota. County Registrar of Titles Office on June 20, 2003 as Document
No. 503741 (Easement No. 945). qoya Am-,+t? s4
n •
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DRAINAGE AND UTILITY EASEMENT ' ?
THIS EASEMENT, made this ? d ?f 2001, between
GEORGE L. H:UNNEL and DEBRA K. HUNNEI?iereina er re erre to as "Landowner"), and
the CITY OF EAGAN, a municipal corporation, organized under the laws of the State of
Minnesota, (hereinafter referred to as the "City").
WITNESSETH:
That the Landowner, in consideration of the sum of One Dollar ($1.00) and other good
and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, does
hereby grant and convey unto the City, its successors and assigns, a permanent drainage and
utility easement, over, across and under the following described premises, situated within Dakota
County, Minnesota, to-wit:
A permanent drainage and utility easement over the west 10' of
Lot 4 Block 1, Cedar Grove 7. 1
The grant of the foregoing permanent easement for drainage and utility purposes includes
the right of the City, its contractors, agents and servants to enter upon the premises at all
reasonable times to construct, reconstruct, inspect, repair and maintain pipes, conduits and mains;
and the further right to remove trees, brush, undergrowth and other obstructions. After
completion of such construction, maintenance, repair or removal, the City shall restore the
premises to the condition in which it was found prior to the commencement of such actions, save
only for the necessary removal of trees, brush, undergrowth and other obstructions.
And the Landowner, its successors and assigns, does covenant with the City, its
successors and assigns, that it is the Landowner of the premises aforesaid and has good right to
grant and convey the easement herein to the City.
- . .?
IN TESTIMONY WHEREOF, the Landowner has caused this easement to be executed
as of the day and year first above written.
STATE OF MINNESOTA)
` )ss.
COUNTY OF???tC' )
The foregoing instrument was acknowledged before me this _1?\, day of
??, , 2001, by GEORGE L. H1:JN?EL and DEBRA I?FiI:JNN?I? fL?and and
wife. ?? / ? ?? APPROVED AS TO FORM: ?4?' ?'?S E.
.Q,? NJTARY PUBLIC - MWNEyOTA
AAY COMMISSION EXPIRE$
.. .___JANUARY 31, ?
City Attorne?''s Office
Dated: f0/J/()l
APPROVED AS TO CONTENT:
P lic Work e arhnent
Dated: / -.?d - U-Z
THIS INSTRUMENT WAS DRAFTED BY:
SEVERSON, SHELDON, DOUGHERTY &
MOLENDA, P.A.
7300 West 147th Street, Suite 600
Apple Valley MN 55124
(952) 432-3136
(Easement #936)
(206=19117)
2
DEBRA K. HUNNEL
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4019 Pumice Lane
Lot: 4 Block: 1 Addition: Cedar Grove 7th
PID:10- 16706 - 040 -01
Use:
Description:
Sub Type: e- Fireplace
Work Type: Gas Insert
Description:
Census Code: 434 - Occupancy:
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Hearth and Home Technologies
2700 N. Fairview Ave
Roseville MN 55113
(651) 633 -2561
PERMIT
City of Eaan
Chimney /flue must be inspected prior to concealing. Smoke detectors are required in all sleeping rooms prior to final
inspection. When wall studs or ceiling joists are exposed, hard -wired detectors are required. Battery operated types are
acceptable if the wall/ceiling finish (i.e. sheetrock) has to be removed to install a smoke detector.
SAMANTHA JAMES
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total: $90.00
Applicant/Permitee: Signature
- Applicant -
Construction Type:
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$88.50 0801.4085
$1.50 9001.2195
Owner:
% Countrywide Home L Wells Fargo Bank NA Tste
7105 Corporate Dr PTX C 35
Plano TX 75024
Issued By: Signature
Building
EA082288
03/20/2008
ePermit
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply with all applicable State