4055 Pumice Lane-..--------
CITY OF EAGAN Remarks Sold fc,z Taxes
Addition CEDAR GROVE #7 l.ot 2 Rlk 3 Parcel 10 16706 020 03
4055 Pumice Lane Ea an, MN 55122
Street State g-
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK ? 1970 58.18 2.08 28
* SEWER LATERAL 1971 20
WATERMAIN
* WATER LATERAL I 1971, 1(].S. 00 BO. ?IS ZO - - 78
WATER AREA
* STORM SEW TRK I'M 1971 20
STOfiM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 300. 00 to 00 8368-SZZ,? 6-26-73
BUILDING PER.
sac 260 - pO 6-U-73
PARK -
CITY OF EAGAN
- 3795 Pilot Knob Rood Eagan, MN 55122 N2 4292
_ PHONE: 454-8100
BUILDING PERMIT Receipt #k
?kz
,.. . >
To be used for AC: Date ? 19
Site Address i r ?• ?_ -
Erect ?
Occuponcy
Lot B!ock Sec/Sub. -' - Alter ? Zoning
Parcel $k Repair ? Fire Zone
Enlarge ? Type of Const.
W Name Move ? #? Stories
3 Address- Demolish ? Front ft.
?
City ??.f_ '-
?- Phone . :(a Grade ? Depth •' % ft.
? N t i .t : .• r :: ': APProvals Fees
p ame _
?Q Address
z
~ City _
Uce
W W Name _
Fw
?? Address
Of Z
¢"' Citv-
Assessment _
Water & Sew
Pol ice
Fire
Eng.
Planner ?
Council _
Permit 11 8•00 _
Surcharge '5 - 50
Plan check
SAC ?'? ?• '
Water Conn.
Water Meter
I hereby acknowledge that I have read this application and state that gldg. Off.
the information is correct and agree to comply with a!I appiicable Stote of Minnesota Statutes and City of Eagan Ordinantes. APC Total
?
Signature of Permittee `
A Building Permit is issued;to: `IamGS ='ic's1 s'• _ on the express condition that
all work sholl be done in occordanc$ with all opplicable $tate of Minnescto Statutes ond City of Eagan Ordinances.
Building Official -- -- - -
Pennit # Dafe lausd PW=lffw
Plumbing ?.?.? 9 - /o - 7 -7 ?O .
Mechanical y?.S 7'- /?_ y 7
INSPECTIOMS DATE INSP.
Rough-In
Finol
Footings Date Insp. Dote Insp.
Foundation 4/ Plumbing
Frame/ins. Mechanical
Final
Remarks: 7 2 f'T
C+.,a•,taL 11, C,-I( r- °f f)na I
CITY OF EAGAN
` 3795 Pilot Knob Road
? Eagon, Minnesota 55122
Phone: 454-8100
PERMIT No
835
Dote: ?'ie 10, 1977 Receipt No.: 0631?`
Single
Site Address: `11355 rtumiCe "`f.e Residential
Lot ` Block ` Sub/Sec. Multi Res., Comm./Ind. I
Name } T`-; --- New/Alter./Repair. L
.
? ddress - - Cost of Installation -_
City Phone: Permit Fee 20'00
? Name Pxa"lo:;x Plurnk,? nq C<>>::pan y Surcharge " J
t
P Address ' ?31 - 4th Ave. `o.
e
? City -C :field 55423 Phone: Total 20. 5('
This Permit is issued on the express condition that all work shall be done in accordance with all applicoble State of
Minnesota Stotutes and City of Eagan Ordinances.
Building Officicl
?.
.
?
.'
?
HEATING
CITY OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesoto 55122
Phone: 454-8100
PERMIT
Date: ju1y 13, 1977
-.`?-? pun?ice Lanc:
Site Address:
Lot Biock Sub/Sec
IName ;j,oe Pietig,
?
w
e
?
405E: I,iamond Point
Address
u3cj ?.ri
City
Phone:
925
No.
Receipt No.:
Single I
Residentiol ?
Multi Res., Comm./Ind. I
New/Alter./Repair r.ew
Cost of Installation
Permit Fee
20.00
T-??• MQta'_crart Surcharge .50
Name ? ?
`
? 2211 W. 90th Sr.
? Address
c
0
v ':a.nneapolis 55431 20.50
City Phone: Total
Thi ermit is issued on the express condition that all work shall be done in accordance with all applicable State of
nesota Statutes and City of Eogan Ordinances.
CG 7
Building Officiai
CITY OF EAGAN
3795 Pilot Knob Road
No. Eagan, Minnesota 55122
Phone: 454-8100
_-in?. '„ •
_ ?: ?1r ( i pERMIT
Dote:
Site Addreu:
Lot :2-
Name
17-E1
Block `3 Sub/Sec. e t G' 7
; Address
O
City Phone:
Nome
r
g Address
s
City Phone:
This Permit is issued on the express condition thot all work shall be
Minnesota $tatutes and City of Eogan Ordinances.
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
Receipt No.:
Single
Residential
Multi Res., Comm./Ind. I
New/Alter./Repair. Cost of Installation
Permit Fee
Surcharae
Tota I
done in accordonce with oll opplicuble State of
Building Official
CITY OF EAGAN
3795 Pilot Knob Road
Eagun, Minnesota 55122
Phone: 454-8100
WATFR ?nFTgT;g'T_ PERMIT
Date:
Site Address: - 5 •;? - T ?
Lot ?- Block ?-% Sub/Sec.
Name' i-`OL'taS Wang
.
; Address
O
City _<3q c3 ?l 5`i 12 2 Phone:
Name'??1dSiit' `:ti'c1teZ' C4`31fz1t+.o7?li1o
. "
ic Address ` 115 Cedar AV@. SO.
Receipt No.:
Single I
Residential
Multi Res., Comm./Ind. I
:::1 tera i,ion
New/Alter./Repair
Cost of Instoilation
r r?
Permit Fee
Surcharge ` S 0
`e
0
? City ?' -2 2 Phone: Totol
This Permit is issued on the express condition that all work shall be done in acwrdance with all apolitabie Stqte of
Minnesota $tatutes ond City of Eagon Ordinances.
No. --?
v Building OffitiW
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE
RECEIVED
19
AMOUNT $ I
? CASH
& DOLLARS
oo
7
? CHECK
FOR
FUND I CODE I AMOUNT
I 1&v I I I
1 2
Q?rj '
? BY
0 i779
NUMERICAL FILE COPY
CITv tbf EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMiT NO.:
Eagan, MN 55122 DATE:
.
Zoning: No. of Units:
Owner: -
Address:
Site Address: --
Plumber: -
I cgree to eomply with the City of Eagan Connedion Charge:
Ordinanees. Account Deposit:
By
Dote of Insp.:
Insp.:-_
Permit Fee:
Surcharge:
Misc. Charges:
Total:
Date Paid:
CITY OF EAGAN WATER SERVICE PERMIT
37-75 Pilof Knob Road PERMIT NO.:
MN 55122
E DATE: '
agan,
Zoning: No. of Units:
Owner
:
Address:
Site Address:
Plumber.
N
M Connection Charge:
o.: -
eter
Size: Account Deposit:
Reader No.: Permit Fee:
of Eo
an
ith the Cit
l
t
I Surcharge:
g
y
o eomp
y w
agree
Ordinances. Misc. Charges:
Total:
g Date Poid:
y
Date of I nsp.: - I nsp.:
YILLAGE OF EAGAN SEWER SERVICE PERMIT
3795 Pilot Keob Rood PERMIT NO.: 1368
Eagon, MN 55122 DATE: 12/29/72 (6/26 73)
Zoning: R-1 ]No. of Units:
owner: CedRr Grove C ons ruc ion
Address: -2-? L ,
Site Addri?s -4055 Pumice Lane
Plumber: Steln 'S
1 agroe to eomply with the Villcge of Eagon Connection Chazge?60.00 pd 6/26/3
Ordinonees. Account Deposit:
Permit Fee: 10.00 pd 127297?
Surcharge: • 0 pd 12/29/7
sy:
Date of Insp.
Insp.:
Misc. Chazges:
Total:
Date Paid: _
EAGAN TOWN S H I P
BUILDING PERMIT
Ownei ._..... .........'.... •---- . . ....'"".'"f --• ..............-••---•--
Address (Preseni) ................. s..-...°°.'___..-•??.....--•--•-----•--•-•-----•
Builder ........--•••--•-•-------------•.._..-------••••------•••-••--•---•-•---•--.....----••-•-•-•----
Address ....---• .............•----•-•--••---...•----•-•--•-••--••-•--••--•--••-•••--••-••---••--•••---
DESCRIPTION
1-?
N° 292'7
Eagan Township
Towa Hall
Date ... i ;?- .....
..................................
.....
52ories To Be Used For Fron! Depth Height Est. Cos! ' Permit Fee Remarks
9e, i4li- O D
LOCATION a • dc5
Street, Road or other Descripfion of Location I Lot I Block I Addilion or Trac2
13, l f 3? ? I ? I?.Z?-tu.i
This permit does noi suthorize the use of sireets, :oads, alleps or sidewalks no: does it give the owner or hfs agen!
!he righ2 to create any situation which is a nuisance or which presents a hazard to !he heailh, safety, convenience aad
general welfare !o anpone in ihe communiiy.
THIS PERMIT MUST BE KEPT ON TpH,E? PRE`MISE WHILE THE WORK IS IN PROGAESS.
This is to certify, tha!____ _.___'?`__ permission to erect
a__?,??..._......_.._: ?.......?°.?..... .... .....upoa
the above described premise subject to the provisions of the Building Ordinance for Eagan T wnship adbpYed April 11,
1955.
....?`'.`.`.'a" Per ??--do?---?
. ............ ... ......... ...••---•-•--•••---••-•........ -• ----- -- -....-•-•--...••••-•• •-••---•••••-•••---'= ••-•-•---••g •-....-•-•---:....
?j Ch , n n oar Buildin Inspecio?,
CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 55122 N8 4292
PHONE: 454-8100
BUILDING PERMIT APPLICATION $41,000. ReceiPt # S7V?_
To be used for S1tig. Fgm Dwlg, 6. Att. GBrg, Date April 28; , 1977
Site Address -40 5 5 PUp1iCE LI1 - - Erect gg Occuponcy i
Lot 2 Block 3 Sec/Sub. CG 7 _ Alter E] Zoning Rl
Parcel #
0? Name ameS E g
Lli
3 Address 4056 Diamotld Pt
0
CitY ?s?van Phone L. RI. q]nl
?
? Name Bldr- Self
,o
?? Address
~ Cit Phone
Up?
,,, W Name
H
?? Address -
¢ z
"' Cit Phone
I hereby acknowledge that I have read this application and state that
the information is correct and ogr comply with all applicable
State of Minnesota Stotutes ond ity Eagan Or ' ncles.
/
Signature of Permittee
?
Repoir ? Fire Zone _
Enlorge ? Type of Const. V
Move ? # Stories.
Demolish ? Front 70 ft.
Grade p Depth 27 ft.
Approvols Fees
Assessment _
Water & Sew.
Police
Fire
Eng.
Planner
Councii
Bldg. Off. -
APC
Permit 1 l 8_ On _
Surcharge 20.50
Plon check
SAC 215_00
Water Conn. __LL0_Q0
Water Meter
Total 46 .
A Building Permit is issued? to: .J?eS Pietig on the express condition that
all work shall be done in/accordan with a applicable Stote of Minnesota Statutes and City of Eagan Ordinances.
Building Officiol s ?? ?'.
a-3-7
<<G.
VILLXGE 0k' EAGA1V
3795 Pilot Knob ttoad
' Eagan, iviinnesota 55122
PEIUiIT iVO. 357
The Village of Eagan hereby grants to Cedar Grove Construction Co.
of 7343 Concord Blvd. East, South St. Paul 55075
a ?I,UI'BING Permit fors (Qwner) ssae
3877 Palisade Way 11-2-8, ane -- >1953 ver on ve. --, 3840 Rive
atton Ave. 1-1-8, 1775 Taconite, TpudJu.Aily7bd application dated 6/22/73 .
Fee Paid: _$iQa.On dated this 26th day of Jurie , 19 73 .
2.50 a/c
Building Inspector
Niechanical Permitsr
t3id Total:
- 1. EAGAN TOW N 5 H I P 11 BUILDING PERMIT
.......................... ----..-............ ---------...' ...-................._._._....
owne:
, Addsess (Preseni) ..... 'B-P........ ...... (I_........................
Builder ---.--•--•-••-•-••-...-•-•----•-•...--••----•••-•-•--...---•----•-•-•---------------••-•--•- --•
Addresa ..............................•••-••-•-•--••--..._._---••--•--•---•----•--..._._._._.......•--
DESCRIPTION
N? 3060
Eagan Township
Town Hall
v - a-> - J _*?
Date .... -..........................................
53osies To Be Used For Fron! Deplh Heigh2 Est. Cos! Permit Fee Aemarks
LOCATION y`y' "
Street, Road Qr oiher Descripiion of Location I Lo! I Block I Addition or Trac!
/i
This permit does not aulhorise the use of streets, :oads, alleys or sid`ewtdks-nor does i! give the owner or his agen!
!he righ! !o create anp siiuafion which is a nuisance or which presenls a hazard !o the healfh, safely, convenience and
general welfare to anyone in the communiiy.
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS.
This is !o certify, thal---- t.e... --- has permission to esa?-a-•-?-••---•••- ...... _upon
-• • ---------------•......
the abave described premise subject to the provisions of the Building Ordinance for Eagan Township adopted April 11,
1955,
?. .
........................... 1;V•••--- ---?-°•--?-,) '-`•'--?-^-?-- • •._Y!?-?`.^..?!-? Per .................... ?.................
Chairman d'f Tnwn Boerd ? Building InspeclR
This request void 18 months from 1(.7.01. „ ? 02,01 03 p(? SS?'f
6376
??, / (, "? , P
Date of this Request ?
I, as 04 Licensed Electrical Contractor 11 Owner, do hereby request inspection of the above electri-
cal wiring installed at:
Street. Address or Route No. TD S-s- !cof k,, 7rc e Lu P) e CityegL9
Section - Tow.nship Range - County 0C ,kal
Which is occupied by
P•
?
' - (Name of OEcupant)
Is a roughin inspection required on this job? No 0 YesReady Now? Will Call ?
Power Supplier /V, JI /?t Address
Electrical Contractor 17, 81 Contractor's License No??
fCnmoanv Namel a .
Mailing Address 4004(06 .S /v`1 (_ T, LQ (? ?n • OJ ?
(Electrica on ctor o wner Ma ng This Installat ) ??
Authorized Signature ?T Phone No. "?
(Electrical Contrac r or Owner Making This Instailation)
. V B
AR OAR'u COPY
, Minnesota State Board of Electricity
1.354`University Ave., St. Paul, Minn. 55104-Phone 645-7703
-? REQUEST FOR ELECTRICAL INSPECTION
C14ECK BELOW WORK COVERED BY THIS REQUEST
6376
Type of Building New Add. Rep. Check Applian ces Wired For Check Equipment Wired For
Home ? ? Range ? Temporary Wiring ?
Duplex ? ? ? Water Heater ? Lighting Fixtures ?
Apt. Bldg. ? ? ? Dryer ? Electric Heating ?
Commerciai Bldg. ? ? ? Furnace ? Silo Unloader ?
Industrial Bldg. ? ? ? Air Conditioner ? Bulk Milk Tank ?
Fazm ? ? ? List List
Other
?
?
? p
Herers#
Rehers?
COMPUTE INSPECTION FEE BELOW oa
Service Entrance Size: # Fee Feeders&S "
ers• "?F" Circuits:
L # Fee
0 to 100 Am s. Y
0 to 30 Ar? ?0 e , 0 to 30 Am eres / „00
101 to 200 Amps. 31 to 100 A" res ? 31 to 100 Am eres
Above 200 Amps. Above 100 Amps. Above 100 Amps.
Transformers Remote Control Circ. Partial or other fee
Signs Special Inspection Minimum fee $5.00
Remazks TOTAL F E
I, the Electrical Inspector, hereby cer;t/1 ?• at t?ins e'on has beenmade ,
(Rough-in) ? ' Date ?O ???
(Final) Date i;;- 00 y 7
This request void 18 months from '
VILLAGE 0F EkGA1V
3795 Pilot Knob hoad
Eagan, ;viinnesota 55122
PEMIT N0. 370
The Village of Eagan hereby grants to Cedar Grove Construction Co.
o£ 7343 Concord Blvd. East. South St. Yaul 55075
a HEATING Permit for: (Owner) same
3877 Palieade Waq 1-2-8, 4055 Pumine Lane --. 3953 n Riverton
at 1-1-8, 1775 Taconite Trail 1?-j?29suant to application dated 6/26/73 ,
Fee Paid: 100.00 dated this 26th day of June ? 19 73 .
2.50 e c
3-3-7
c-, C,
TOWN OF T,:Ar.,AN
3795 Pi1ot Knoi: ?:oa?
St. Paitl, Minr.. 55±1_1
PERMIT N0.78
The Board ar S?ipeivisors hereby gxants to Cedar Grove Construction Coo
of 7343 Canccrd P,lvd. E. So. ?t_ Paul 55075 a 1I7ATI`dG
3-3-7
Permit for• (Owner) Cedi* Grove Construction ar 1866 Jade Lane d. 4061 Pumice Lane
, pursuant to application dated February 172 1971
Fee Paid:' $40.00 Dated this 22nd day of February , 19, 71:
Building Inspector -
i
SS70Z
RESIDENTtAL
BUtLDING PERMIT APPLICATION
CITY OF EACAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Constructlon Reauirements
• 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas
(20% maximum lot coverage atlowed)
• 2 copies of plan showing beam & window sizes; paured found design, etc.)
. 1 set of Energy Calculations
• 3 copies of Tree Preservation Plan if lot platted after 7/1193
• Rim Joist Detail Options selection sheet (bldgs with 3 or less units)
DATE °0 ?
?
RemodellReoair Reauirements
• 2 copies of plan
• 1 set of Energy Calculations for heated additions
• 1 site survey for exterior additions & decks
• Indicate if hame served by septic system for additions
VALUATION ? ?? ? • ??
SITE ADDRESS 9 MULTI-FAMlLY BLDG _ Y ? N
TYPE OF WORK ??r ?1--1'" ??? `'?J?? FIREPLACE(S) _ 0_ 1_ 2
United Construction Inc. ?-? 4-- ?6 0 -7 l J
APPLICANT 17nc r „k,, r>rl,?.:<TOPC txTst
- --.?rAv
STREET ADDRESS ,_ CITY
e ,
TELEPHONE # CELL PHONE #
FAX #
ATE ZIP
PROPERTY OWNER I 1S?r%?? ? TELEPHONE #
-----------------------------------------------------------------------------------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category
(4 submission type)
Plumbing Contractor:
Plumbing system includes
Mechanical Contractor: _
Mechanical system includes:
Sewer/Water Contractor:
_ Water Softener ?
Water Heater ?
No. of Baths
Air Conditioning
Heat Recovery System
Phone #
Phone #
Fee: $90.00
Fee: $70.00
--------------------------------------------------------------------------------------------------------------------------
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with ail applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant ? h
---------- --------------------------------- ------ --------------------- ------------------------------------------------- ------------------------------------------------
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
MINNESOTA RULES 7670 CATEGORY 1
• Residential Ventilation Category 1 Worksheet Submitted
• Energy Envelope Calculations Submitted
r [I
MIN E?'TA RULES 76721 ?
n? _O 7 C3 ,? ^r`•
• N Bnergy 6ad? ?orl<s?eeqSubmitted
1
'" -- --
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 of , plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 31 New
? 32 Addition
? 33 Alteration
? 34 Replacement
Valuation
Census Code
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscel(aneous
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
O 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Sldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
*Demolition (Entire Bldg only) - Give PCA handout to applicant
Occupancy
Zoning
Stories
Sq. Ft.
Length
W idth
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
REQUIRED iNSPECTIOHS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) FinallNo C.O.
_ Footings (addirion) _ Plumbing
Foundarion HVAC
_ Drain Tile Other
Roof _ Ice & Water ? Final _ Pool _ Ftgs , Air/Gas Tests _ Final
_ Framing , Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final T Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
8ase Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Suppty & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
? 07 05-plex ? 13 16-plex
? 08 06-plex 0 16 Fireplace
? 09 07-plex 0 17 Garage
? 10 08-plex ? 18 Deck
? 11 10-plex ? 19 Lower Levei
? 12 12-plex Ptbg_Y or _ N
Building Inspector
? CITY USE ONLY
I PERMIT #: 95?g? RECEIPT DATE
5--a I -01
PXSIDENTIAL blECHMICAI. PERNIIT i4PPLICATION
crrY or EALsm
sgso Paor KxoB ftn
EA6AR bdN 55188
651-6$1-4675
Please complete for: ? single family dwellings townhomes and condos when permits are required for each unit
Date: 05 1a a- iO I
siTEauoRtSs: Hc , 5 Pu.r-, i ce, L-axie.,
OWNER NAME: P I't Oe,bQ, W 0(.tnq TELEPHONE #: (n S 1 W S N' (o I?I S
(AREA CODE)
INSTALLER NAME:
,-- - -- -- -
Wohlers Southside Htg & A/C, Inc.
6950 West 146th Street, Suite 106
STREET ADDRESS: Apple Valley, MN 55124
CITY:
PlacP a rhark mark naYt tn thp narmit wnrk tvep
TELEPHONEqg?i a H3 i
(AREA CODE)
ZIP:
New residential dwelling unit under constructionand not owner/occupied $ 70.00
? Add-on, modification or alteration to existin dwelling unit $ 50.00
• fumace replacement
• air exchanger
• air conditioner ?
• other ?
Nature of work: -re_n,&. G,4?^_c!p_n i% Yle?
- - V
State Surchar e $ .50
Tota I So
$?-
Reminder: Call for inspections.
. ? tt
SIGNATURE OF PERMITTEE
Updated 1/O1
CITY USE ONLY
PERMIT #: RECEIPT DATE:
APPROVED BY: , INSPECTOR
CObIMEftCIAL MECH"CAi. PER1VIIT APPLICATION
CI1'Y oF EAE6M
3630 Pii.OT KNOB ftD
E4614N, MN 55188
651-6$1-4675
Please complete for: all commercial/industriai buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
SITE ADDRESS:
OWNER NAME: PHONE #: -
(AREA CODE)
TENANT NAME (IMPROVEMENTS ONLY):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
ADDRESS:
CITY:
WORK TYPE
New construction
Interior Improvement
Processed Piping
Install U.G. Tank
Remove U.G. Tank
Specify Nature of Work:
When installing/removing underground tank, call 65I-681-4675 for inspection by Fire Marshal and
Plumbing Iinspector.
Fees: 1% of contract price OR $50.00 minimum fee, whichever is greater.
Underground tank removaUinstallation = minimum fee
Contract price: $ x 1% _$ (Base Fee)
State surchazge calculate at $.50 for each $1,000 Base Fee
TOTAL $
PHONE #: -
(AREA CODE)
STATE:
ZIP:
SIGNATURE OF PERMITTEE
Updated 1/O1
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
Date: 6/26/73 (12/29/72,) Number: 12?36
Billing Name: Cedar Grove Con.stracti(x: Site Address :?-_ 4055 Pumice Lane
Owner: same Billing Address
Plumber; Stein's
Location of Connection Meter Size _jConaection Chg.300.00 vd 6/26/73
?
Meter No. Persnit Fee 10.0o I), i?!29/ jZ
Meter Reading Meter Dep. '50 pd 12/2j/72
Meter Sealed: Yes Add'1 Chg.
NO iTotal Chg.
Building is a:
Residence .Y
Multiple Rao. Un3ts
Commercial
Industrial
Other
Inspected by
Date
Remarks;
$25.00 RE-tmSP?CTIO??F??T? ?.
9i1flPROPERLY 0?STA
Bp:
Chief inspector
In consideration of the 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•
s.5't2.L?1 I S
Pleaje aotify the above office when ready for inspection and connection.
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STRUCTURE AND 00
LAND USED AS
Permit
No.
Issued Issued To
Contractor Owner
BUILDING
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
H EATI NG 3
2
GAS INSTALUNG _
_
-
SANITARY SEWER
OTHER
OTHER
Items Approved
(Initial)
Date
Remarks
Distance From Well
rOOTING ;K2
r?, SEPTIC
FOUNDATION _
-? CESSPOOL
FRAMING TIlE FlELD FT.
FINAL
EL.ECTRICAI
HEA7ING DEPTH
OF WELL
GAS INSTAILATION
SEPTIC TANK
CESSPOOL
t
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
,
' Violations Noted
on Back
COMMENTS:
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-COMPLIANCE
OBSERVED.
? ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
? REItVSPECTION REQUIRED
REINSPECTION REVEALED
DATE OF REINSPECTION
CERTI FICATION -1 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 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.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPECTOR
DATE
COMMENTS:
23
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2006 RESIDENTIAL PLUMBING PERnniT APPLicaTioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
AlS .So
Date
Site Street Address Unit #
Property Owner Telephone #
Contractor
'A?;-n-1'0J 11.v/1,felephone #(??'?3?-
y
Address??;??,? ity Arz"'exj!SVIZ-1?. StateAA) Zip
The Applicant is: _ Owner Contractor _Other
Se,ptic System _ New _ Refurbished Submit 2 sets of plans and MPC license includes County fee
$ 100.00
Per as-built $ 10.00
;Alterations to existing dwelling $ 50.00
Add plumbing fixtures. This fee includes installation of a water softener and/or water
'heater at the same time. If you are installing onlv a water soffener and/or water
-?. heafer, do not complete this section; move to the next section and check the
, appliance(s) you are installing.
Septic System Abandonment
l
t_Water Turnaround (add $130.00 if a 5/8" meter is required) f ?
Other:
Water Softener ? Water Heater $ 15.00
_ new 'X replacement
Lawn Irrigation _RPZ PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
J ? • ? ?
Total $
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the
work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I
understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in
accord e with the appro an in the event a plan is required.,t r viewe an ed.
D
App i ant's Printed Name A lic nt's Signature
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Cityofaali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: /b JJ,
Permit Fee: 60
Date Received: / / 30 ---/at
Staff:
I L
2012 MECHANICAL PERMIT APPLICATION
Date: 11/15/12 Site Address: 4055 Pumice Lane
Tenant: Thomas Wang
Suite #:
RESIDENT / OWNER.
Name: Thomas Wang Phone: 651-454-6175
Address/City/Zip: 4055 Pumice Lane, Eagan, MN 55122
CONTRACTOR:: `.
Name: K&S Heating, Air Conditioning & Plumbing LLC License #: 0153
Address: 4205 Hwy 14 W City: Rochester
State: MN Zip: 55901 Phone: (507) 282-4328
Contact: Heidi J Brown Email: hbrown@ksheating.com
TYPE OF;W.ORK :::
New XX Replacement Additional Alteration Demolition
Description of work:
NOTERoof.mounted and ground mounted mechanical equipment is required to be screened by City
.:Code Please contact the Mechanical inspector for information on permitted screening methods.
.'.: PERMIT TYPE :• :
RESIDENTIAL
X Furnace
_Air Conditioner
_ Air Exchanger
COMMERCIAL
New Construction _ Interior Improvement
_
Install Piping Processed
— _
Gas Exterior HVAC Unit
Heat Pump
_ _
Under / Above ground Tank (_ Install / Remove)
Other
_ _
RESIDENTIAL FEES:
$60.00 Minimum Add-on or
alteration to an existing unit (includes $5.00 State
burned out appliances, ductwork, etc.) (Includes
Surcharge)
$5.00 State Surcharge) = $ 6 0 . 0 0 TOTAL FEE
$100.00 Fire repair (replace
COMMERCIAL FEES:
$75.00 Underground tank installation/removal
$60.00 Minimum (includes
- If the Permit Fee is less than
(includes $5.00 State Surcharge)
State Surcharge)
$10,010, surcharge is $ 5.00
surcharge increases by $.50 for each $1,000 Permit
Fee requires a $ 5.50 surcharge)
OR Contract Value $ x 1%
= $ Permit Fee
=s Surcharge
- If the Permit Fee Is > $10,010,
Fee
= $ TOTAL FEE
(i.e. a $10,010-$11,010 Permit
CALL BEFORE YOU DIG. CaII Gopher State One Cali at (651) 964-0002 for protection against underground utility damage. Call 98 hours before
you Intend to dig to receive locates of underground utilities. www.gopherstateonecali.orq
1 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 1 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.
Rick Keehn
Applicant's Printed Name
Applicant's Signature
FOR OFFICE USE
'Required _Inspections:
Underground
Reviewed By:.
Date:
Rough In Air Test ` Gas Service Test . In -floor Heat Final HVAC Screening
AUG/23/2013/FP,I 12:37 FM City of Eagan FAX 1•;0. 651-5? -5634 P.001/001
Use BLUE or BLACK Ink
11100, I For Office Use 1
My of Et Permit I ~ a~ I
Permit Fee: 10
15,
3830 Pilot Knob Road I 1
Eagan MN $5122 Date Received:
Phone, (651) 675-5675
I
Fax: (651) 675-5894 I Staff: I
1 t
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:
1 Site Address: ) 1 tJrtit:
101 Wit
Name. 1-1-3'=` ' l- \n ( rk ,Y 1<.M Phone:
Resident/ _
Otiytter Address I City /Zip:
Applicant is: _ Owner i Contractor
Type of Work Nscription oiwork:Q
Construction Cost:
Multi-Family Building: (Yes"/ Nom)
I
Company: 1' c(l ti r Contact: IUD ak-)
41, Atffliw Contractor Address: fL~' r City it
State:-d_Zip: Phone:
License Lead Certificate M± F- Fl o 14-
If the project is exempt from lead certificatlon, please explain why: (see Page 3 for additional information)
i
COMPLETE THIS AREA ONLY IF CONSTRUCnNG A NEW BUILDING
In the last 12 months, has the city or Eagan issued a permit fora similar plan based on a master plan?
_Yes _No if yes, date and address of master ptary
Licensed Plumber: Phone:
Mechanical Contractor. Phone.
Sewer & Water Contractor: Phone:
NOTE, Plans and supporting documen.&:fhatyou4ubmlt are corisideri d to bdpubf c intbrnlation. Portfans of
the information may be ctassifled as oun=pdVic if you provide specific reasons that would permit the'Cfty to
concludiithatthey are-trade secrets.
CALL BEFORE YOU DiG. Call Gopher State One Cali at (651) 464.0002 for proteellon against underground utility damage. COO Hours
before you intend to dig to receive locates of underground utilities. www.aooherstateonecall.ora
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; [hat f understand this is rot 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 app oved plan In the case ofworkwhich requires a review and approval of plans.
Exterior work authorized by a building permit Issued In accordance with the Inns" S , to Building Code QtbDcoeted within 1
days of permit Issuance.
Xfi
x
ApplicanNs Printed Name /t, ph s 45r6e
Page 1 of 3
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