2048 Quartz Lane. CITY OF EAGAN . -•
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHON E: 454-8100
BUILDING PERMIT
To be used for
+? ?I s1::?
Est. Value
Receipt #
Date ? ,19
Site Address
Lot Block • Sec/Sub..-,"'
Parcel No.
o? Name A 3Tf^:ANii
3 Address
° City Phone
°C
,o Name
? Q Address
? City Phone
?W
WW Name
?
? ?
Address
Q W City Phone
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.
Signature of Permittee
A Building Permit is issued ta on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
OFFI CE USE ONLY
On Site Sewage Occupancy
MWCC System Zoning
On Site Well (Actual) Const
City Water (Allowable)
PRV Required # of Stories
Booster Pump Length
Depth
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr./Assess. Permit
Planner Surcharge
Council Plan Review
Bidg. Off. SAC, City
Variance SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P1
Parks
TOTAL -
Building Official
Permit No. Permit Holder Date Telephone #
Plumbing
H.V.A.C.
E lectric
Softener
Inspection Date Insp. Comments
Footings I
Footings II
Foundation
;Z -
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Final Plbg.
Bldg. Final
Cert. Occ.
Temp. LP
Deck Ftg.
Final !
? ?
Well
Pr. Disp.
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS: 1 t, 1 :
AE;t.? t feNt
4I'f
PERMIT SUBTYPE:
Is i I I I t t ra+,
.? ?; k ??, ? , , APPLICANT:
{ F'i E. G) 4 i.1 a'? (
TYPE OF WORK:
! tt fa,{+1 F f`Iii
rq 1 I lcrtf ,
INSPECTION RECORD
PERMIT TYPE:
Permit Number:
Date tssued:
V41 I I i I : ,;,,.
ti 1,41 )1 s;;:
43 -1 1 , 41 ! s,+»- 9103-
Permit No. Permt4 Holder Date Tefephone #
S/W
PLUMBING
HVAC
ELECTRIC
ELECTRIC
inspection Date Insp. Comments
Footings I ? . 2?-d
f 3
?S
Foundation
Framing
Y
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Fltg.
Orsat Test
Fnal Pibg. Plbg. inspector - Notify Plumber
Const. Meter
Engr./Plan
Bldg. Final
Deck Ftg.
Deck Final
Well
Pr. Disp.
CITY OF EAGAN Remarks * CeCiiA. „i•_ ._.? --lquisition
,
Addition CEDAR GROVE #4 Lot 1 elk 5 Parcel lU 16703 O10 OS
Owner!h', ?;'i i i ' f' '-! i L• 'LIL;{Street 2048 Q11drtZ LaI18 State Eaqan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
ir SEWER LATERAL
WATERMAIN
* WATER LATERAL 1972
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER,
SAC
PARK
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
? 3830 PILOT KNOB RD - 55122
651-681-4675 ? ?????
New Construction Requirements RemodellReuairRequirements
• 3 registered site surveys showing sq. ft. of lot, sq, ft. of house; anc?ll roofed areas • 2 copies of plan
(20% maximum lot coverage albwed) • 1 set of Energy Caiculations for heated additions
• 2 copies of plan showing beam & window sizes; poured found design, etc.) . 1 site survey for exterior addi6ons & decks
• 1 set of Energy Calculations • Indicate if home served by septic system for additions
• 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 VALUA'ION 3O6O,?dO
JOB SITE ADDRESS cgD?J_j3__?.ko?rTZ Za.-IL'
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWNER i'Y1 ,j3ap I
TYPE OF WO
APPLICANT
REPLACE(S) e,0 _ 1 _ 2
PHONE# GS/- '1Se2 - 6a2;6
ADDRESS ;?Q E/ 6 Q.c,.a-,L, ZIP CODE .Ss? z 2
PAGER #
CELL PHONE # FAX #
NEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY
Energy Code Category
(check one)
MINNESOTA RULES 7670 CATEGORY 1
- Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
MINNESOTA RULES 7672
Plumbing Contractor:
Plumbing System Includes:
- New Energy Code Worksheet Submitted
Phone #:
Water Softener Lawn Sprinkler
Water Heater No. of R.I. Baths
No. of Baths
Mechanicai Contractor: _
Mechiuiiciil System Includes
Sewer/Water Contractor:
Air Conditioning
Heat Recovery System
Phone #
Phone #
ree: $90.00
ree: $70.00
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with alI applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant A , ?AA-4-_--- -0
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 1/01
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 07 05-plex 0 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 08-plex ? 18 Deck
? 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Y or _ N
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
? 31 New ? 35 int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition (Entire Bldg only) - Give 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 Bldgs Length Fire Sprinkiered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile
Roof Ice & Water Final Other
_ Framing _ Pool _ Ftgs _ Air/Gas Tests _ Final
Air Test
R.I.
Fireplace _ Final _ Siding Stucco Stone
_
_
_
Insulation Windows (new/replacement)
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanicai Permit
License Search
Copies
Other
Total
Building Inspector
d 10 17
Req st Date Fire No. AInspection
Required? ???/
Ij?Ready Now f? Will Notity Inspector
R
d
?
? Wh
G Yes ? No en
ea
y
Ilicensed contractor p owner hereby request inspection of above electrical work at:
Job Address ( tree Box or Route No.)
? City
O
Section No. Township Name or No. . Range No. County
V
Occu IPRINT)
` ? ? ? ? v ? Phone No. '
? ? ? ? ? ? Y
pphe
r
Pogut
, ,
Address
3o e w e?c ( r?
Ele trica Contractor (Company Name) Contractor's License No.
,
l
Mailin Address Contract or Owner Making In pIllation) ?
1_
AMSignature (Co ctoNO er king s allation? - Pho e Numbe
MI ESOTA STATE BOARD OF EI.EeyftICITV ? THIS INSPECTION REQUEST WILL NOT ?
Griggs-Midway Bldg. - Room S-173`'' BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 fNCLOSED.
REDUEST FOR ELECTRICAL INSPECTION es-oooo,-os
? .
See instrucf ons for completing this form on back of yellow copy.
nna "X" Below Work Covered by This Request
ew rAdd Rep: TypeofBuilding AppiiancesWired EquipmentWired
- Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer - Other- (Specify)
Comm./Industrial Fumace
Farm Air Conditioner
Other (specify) Contractor's Remarks: ? :5 1,510 If ?
mn n ecu ?Q?e £ S?,?,6 {..ee?' old S?vv?
Compute Inspection Fee Below: / ? v?
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps bov 100 Amps
SignS Inspector's Use Only:
OTAL
' Irrigation Booms ?
Special Inspection
Alarm/Communication THIS INSTALLATION MAY B wl,
ED DISCONNECTED IF NOT
Other Fee , COMPLETED WITHIN 18 MONTHS.
I, the Electrical inspector, hereby Rough-in oace
certify that the above inspection has
been made. Final o a
? j
OFFICE USE 3NLY This request void 18 months from
?t
,
CITY of EAGAN
BUILDING PERMIT
Owne: .724 ------? ......... :....... ?=-...............?.................................._.. N?c Address (Prasea!) a!?? ••..`,?•• ?•-• ........................... ...A ........... fo\
c ?A
Builder ....c?`???:?...-•`•'•:: ?o?-?- :"7.••••••..•-••-............. lv ?
.................................... ............: ?:....:...............
Address .... ?r
DE3CRIPTION
YI jt/
N°_ 3770
3795 Pilot Knob Road
Eagan, Minnesota 55122
454-8100
Daie ...?a.^.?`.r..??.............
5tories To Be Used For Front Depih fieigh! Eat. Cos! Permi! Fea Remarks •
'P,
LOCATION / 7< G'-d
Slreet, Road or oiher Desc=ipiion ot Location I Lot Sloclc Additlon or TiaC2
This permit does not suthorise the use of streets, roads, alleys or sidewaIks nor does it give the owner or bis agent
the right fo create any siiuation which is a nuisance os which presenls a hazard !o the health, safety, convenieace aad
general welfare to anyone in the communily.
THIS PERMIT MUST BE KEPT ONTHE PREMISE WHILE THE WORK IS IN PROGRESS.
This ia to cestify, 3hat•i? ................................................... -••- has permission to erect a---..... a:..... ...........................----...,upon
the above desc;ibed premise subject to the provisions of all applicable Ordinances for the City of agE ati.
--••-•••.__........-••--•••-•• ............................•-•-....••••-••--....
_.._........••••••-••-. 7;?t ..:-•-..?°..?...,-:..-• ................ Per
Mayor BuildinQ Inspecfos
?
CITY OF EAGAN -
' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 No- 1 5 4 5 2
PH O N E: 454-8100
BUILDING PERMIT Receipt #
To be used for REPAIR WINDOWS & SIDIIst. Value Date AUGUST 16 19 88
Site Address 2048 QUARTZ LN
Lot 7- Biock 5 Sec/Sub.CEDAR GROVE 4TH
Parcel No.
x Name MICHAEL A STRAND
z Address 2048 QUARTZ LN
° City EAGAN Phone 452-6276
°C Name SAME
.o
? Q Address
? City Phone
H¢
UW Name
wW
?
_ za Address
U
cc WZ City Phone
a
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with ail applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
A euilding Permit is issued to: MICHAEL A STRAND
on the express condition that all work shall be done in accordance with ali
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official?-1,MI.A?-R-A!_i l I
- 1
OFFICE USE ONLY
On Site Sewage Occupancy
MWCC System Zoning
On Site Well (Actual) Const
City Water (Allowable)
PRV Required # of Stories
Booster Pump Length
Depth
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr./Assess. Permit NC
Planner Surcharge
Council Plan Review _
Bldg. Off. SAC, City
Variance SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P1
Parks
TOTAL NC
EAGAN T0WN S H I P
- BUILDING PERMIT
. ??
Owner ----------- ------
--
- - •- -• • -
Address (preseni) ----- _______ -- ...... - _
BuiTder . -----••----------- - - - -----
Aaaress - --- - - - -- `•-
------------------- - ---------------------- -
DESCRIPTION.
N° 850
Eagan Township
Town Hall
Da2e _._ ?7/-:#/ .E?._Z
itories To Be Used For Froni Dep3h Height EsL Cost Permi! Fee Remarks
?
LOCATION
Sfreei, Road or other Description of Location I Lo! Block Addilion or Trae1
..c'.
' ,i?F 7_ ..?-%-?1 - 3.-/- - y ? --?
Tfiis permit does not auihorize e use of streels, roads, a ys or sides nIC? does it give the. owner or his agenf
the right to create any sifuafion which is a nuisance or which presen2s a hazard to the health, safety, convenience and
general welfare to anyone in the community. '
THIS PERMIT MUST BE/,KEPT O T E PREMISE WHILE THE WORK IS IN PROGRESS.
This is io certify, thai----C?--permission !o erect a-----r? ;'-.-?f_?`tGE?c.-.'?.•-••-------------upon
!he above desc ' re ' subjecf. to fhe 70-
........ irisions of the Building Ordinance for Eagaii Township a od pYed April 11,
1955. ?..?'?-'.... ..:.....• - -•--- ------------- -•-• ....... •••-----...----------- Per ---- -- - ---- ---•---- --?-e' .------ .??._
-•- ---- ...... .
Chairman of Tnwn Board Building Inspec'?or ... ...
a ?
y
1988 BUILDING PERMIT APPLICaTION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF PLANS, 3?GERTIFI
154 5 tL
OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR RNER TS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS
IS DESIRED. NO ZCANGFS'WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS/ RENT?. QNZTS FOR SALE UNITS # OF UNITS
INC/SETS PL S, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT.,
1 SEA ULATIONS
COhIlINCL OF ARCHITECTURAL & STRUCT URAL PLANS,
1 ET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
To Be Used For: jcplac+,e W;n?ows?Sl?.y Valuation: Date:
Site Address aog 8 Q;;?6,;,.,,*fz
Lot ? Block ?
Pareel/Sub cekr
Own er ? J ?° hG? gL
Address Qoq ZiJ
City/Zip Code ga q
Phone 4s? 27 {a
Contractor 5`zf ?-
Address
City/Zip Code. '
Phone
Arch./Engr.
Address
City/Zip Code
Phone !t
Engr/Assess
Planner
Council
Bldg. Off.
Ilariance
Permit ?u _ I U J
Surcharge ?
Plan Review
SAC, City
SACy MWCC
4iater Conn
Water Meter `
Road Unit
Treatment P1
Parks
Copies
TOTAI.
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: B U I L D I N C
3830 Pilot Knob Road Permit Number: 020808
Eagan, Minnesota 55123 Date Issued: 04/ 30/ g Q
(612) 681-4675
SITE ADDRESS: APPLICANT:
LOT: 1 BLpCK: 5
2048 QUARTZ LANE STRAND MICMAEL
CEnAR GR01/E 4TM (612) 452--6276
PERMIT SUBTYPE: TYPE OF WORK:
GaRRGE/AccEssaRv NEw
REMARKSs SEPARATE ELECTRICAL PERMIT REQl1IRED
CITY OF EAGAN
3830 Pilot Knob Road
_ Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
?•d
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
2048 QUARTZ LANE
I.AT: 1 BLOCKa 5
CEDAR GF20VE 4TH
P.I.N.s 10-16703-010-05
DESCRIPTION:
GARaGE/accEssaRY
NEw
24
15
BUILQING
020808
e4 /3 0 j9?* St?
?"M ON ?p 011 W-1 '`.
REMARKS:
SEF'ARATE ELECTRIGAL PERMIT REQUIRED
FEE SUMMARY:
vALuATIorv
Base Fee
Surcharge
5ubtotal
$$1.00
3.00
$84.0Q1
$6,000
COPY .50
Total Fee $84.50
CONTRACTOR:
OWNER: - Applicant -
STRAND MICHAEL
2048 QUARTZ LANE
EAGAN MN
( 612 )452--6276
2 ?
APPLICANT/PERMITEE SIGNATURE
REACTIVATE _
PERMI7 ??
? Q'?-
CITY OF EAGAN ,....._ _ ._ .. ._. _.
1993 BUtLDtNG PERMtT APPLICAT dWCL0U4--=? 681-4675 ? s?t?? ?'u APR 2 3 1993
?
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL Z sets of architectural & structaral plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date 4y Valuation of work
Site Address:Roq5? ZA)
STREET SUITE #
Tenant Name: (commercial only)
,LOT BLOCK SUBD.W ? I P. I. D. o
Descri tion of work: (A r-)
The appl i cant i s: ? Owner ? Contractor ? Other (Describe)
Name ?5+mcAD_ ln Jy, w,f Phone
PrQperty LAST FIRST
Owner Address aoVE 0-,/-Iz l?
STREET STE #
City )5xA arJ State fl'l/1) Zip
Company ? Ck- nn -c- Phone
Co ntractor Address License # Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area has been approved.
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.
Signature of Applicant:
1?
1(
V
?
?
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
? 02 SF Dwg. 0 07 4-Plex
? 03 SF Addition ? 08 8-Plex
O 04 SF Porch 0 09 12-Plex
? 05 Sf Misc. O 10 Multi. Add'1.
? 11 Apt./Lodging
? 12 Multi. Misc.
O 13 Garage/Accessory
11 14 Fireplace
0 15 Deck ,
? 16 6asement Finish
C] 17 Swim Pool
? 18 Cortun./Ind.
O 19 Comm./Ind. Misc.
? 20 Public Facility
11 21 Miscellaneous
WORK TYPE
? 31 New ? 33 Alterations
O 32 Addition 0 34 Repair
O 35 Tenant Finish
C] 36 Move
? 37 Demalish
GENERAL INFORMATION
Const. (Actual) Y-N Basement sq. ft. MWCC System
(Allowable) lst F1. sq. ft. City Water
UBC Occupancy M_1 2nd F1. sq. ft. PRY Required
Zoning Sq. Ft. total Booster Pump
# of Staries Footprin t Sq. ft. Fire Sprinkler
Length ? On-site well Census Code
Depth ??. On-site sewage SAC Code
GW544,?6
?f ? ?
APPROVALS It ? ? ?
Planning Building Assessments
Engineering Variance
REQUIRED IN SPECTIONS
? Site '1534ooting ? Framing ? Insulation
• Wallboard Final ? Draintile ? Fireplace
Permi t Fee 81, o o vaiuac;«,: g 6000
S?archarge '9100
Plan Review
License X 360 X 5 °7G ?00 0
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge -
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Cop i es
Other
Total:
SAC 96
SAC Units
?
C I ' ?j? ?vtN-Y 1 ?
.?
CoPe o- r
?
?
6=
Page No. of Pages
INTER CITY BUILDERS
2500 Murray Ave. N. E.
MINNEAPOLtS, MtNNESOTA 55418
Phone 789-9009
PROPQSAL SU[3MII7LD TO
? G 4/
? y
CITY, STATE AND ZIP CGDE
ARCHITECT
liATE pF PIAN<
Pti(?NE DA't Ii
7 :7
7 71?)
JC'B NAME ?
?
JOB LOCFlTIUN ??
JOB PHONE.
t7 /
c.: ' !y``?D `f-'?' '~'13t'? ?.,
L L 70-:-? C.
. ?9
1b?1?h'?GL G'? ?' C
dr-11?
A1 J
_,--?
? ?
?? .
? _ .._.. ..! .
We hereby submit specific,arons s.ind r:stinnates tor.
%i' _
l
C
E
? Te f ? /? ?:s 1r _ ?,
doi) ekF';? 5 ?-el? woncg
,/-?f
r'711x!"
G?
Y
Y"
, .
??$<?r ?1?y???57E?r?i;?l;.??=3??5
?e?.C fJ??,?n
? ?/
l? h d'/?
o,<'. d?
??r--!?-= -_------- -- -- ---
IPp VCApUSP hereby to furnish material and labor - complete in accordance with above specifications, for the sum of:
,
, ..: ..,_.R
r? -- _
t ., ? ? _? ,? - ---- ? dollars
Payment to e made IIoKS. .. --
.z y ? ,,?,'.?y? ? 7-- ?it- ?'
-t:?.'?2?_ _
?
All material is guaranteed to be as specitied. All work to be completed in a workmantike
mannei according to standarct practices. Any alteration or deviation from above specifica- Authonzed
tions involving extra costs will be executed only upon written orders, and will become an SignHtUf@
eztra charge over and above the estimate. AII agreements contirgent upon strikes, accidents '?/
or delays beyond our controL Owner to carry fire, tornado and other necessery insurance NA te: This proposal may be
Our workers are tulry cuvered by Workmen's Cornpensafien insur:ince wiihdldWn bY us if not atc'cepted N'Ithtn,?-=?_-._._? C?3p5.
? O/c 14r./ i? 1-1 fi'
Arrpptttnrr vf llrapnsal - , f,e dbovP prwEs. ,perificat;ans
and conditions are satisfar.tury and are hereby accepted. You are autnorized Signature
to do the work as speciiiedJ Payrg_en1 will be mdrle js outlined above. Date of Acceptance: rl ?5 -_ SiBnature
? - ---}? ------ --- -- -- -- - -- - - -- ----- ---? /
_-------- -------------___.---- -?
`?-
FORM \ 1 8 T CJPYRIGHi 1960 -- N[W ENGlANO M/51NE84 SE1tVICE fNC„ 10WH3END MAlS
MASTER CARD
LOCATION
?
OWNER
STRUCTURE AND
LAND USED AS q ?A ot Ar'O _
Issued To
Permit No. Issued Contractor Owner
BUILDING ip,
PLUMBING
CESSPOOL - SEPTIC TANK
,._.
WELL
ELECTRICAL = ' .?
HEATING
GAS INSTALLING .,.
SANITARY SEWER
'7,`
l f l
OTHER ?
OTHER
Approved
Items (Initial) Date Remarks
FOOTING
FOUNDATION
FRAMING
FINAL j
ELECTRICAL A?P?!! JItG 1?
, L
HEATING R Qam ?r
GAS INSTALLATION SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
COMMENTS: ,V, Ar - / J ? i/ 1
Distance From Well
SEPTIC
CESSPOOL
TIIE FIELD FT.
DEPTH
OF WELL
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-COMPLIANCE
OBSERVED.
1:1 ACCEPTABIE SUBSTITUTIONS OR
DEVIATIONS.
NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
11 NON-COMPIIANCE. BUILDER DOES NOT
INTEND TO CO/NPLY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
F-I REIPlSPECTION REQUIRED
REINSPECTION REVEALED
DATE OF REINSPECTION
CERTI FICATION - I certify that I have carefuily inspected the above in which I have no interest present or prospective, and that 1 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.
? ALL IMPROVEMENTS ACCEPTABIY COMPIETED
BUILDING INSPECTOR
COMMENTS:
DATE
._. 2 3
City of Eapn
3830 Pqoi Knob Road
Eagan MN 35722
Phone: (651) 675-5675
Fax:(6S1) 675-5694
-----------------
+ FOr OHIC! Uid ?
O ?
I Permit #: . ( ? _ 5
t f? ?
? Permit Fe@: .. , ...?Y...._._._.._.....?._._ 1
j oaie Rece?ved: , ? ? i
? Staft:.._...._......... .....?...... . . ?
L___- ____________-
2008 RESIDENTIAL BUILDING PERMi'r APpLrCArioN
Site Address:
renant:
$ulis #:
RE8IDENTlOWNER . .?
.
F'hone:1?
Address City Zlp: ?7?. ?+_? t _\1 ?L,
t..
Applicant is: Owner x Cpn?ractor
TYPE OF WORK Description of work: ?, - C?' . ..... . ....... .. .._ . .......
11 ' ? ?? CC'r
Construction Cost: ??,? ? ?l .?? 1 Multl-FSmlly Bullding: (Yes I No /\ ?/')
`
CONTRACTOR Nam??C1Y1 ?nse F: _ 1?_I ? .
Address: _,_lZ 77"'..A'vE.. N.?. un 15.---..._..--------._......-•----?--------_......----.-•_---
?-• 4 - ,
City: p (' 1(\t 11v2__I' State: ?................_..
Phone: ?, •. ? )- .) Contact Person:,. ?-.S???S?_-..L?.. l?t.l
COINPLETE THIS AREA ONLY fF CONSTRUCTING A NEW BUILDING
MinnesQta Rulea_7674_CatesIOrv 1 Mlnnesata Rules 7672
Ensrgy Code ? . Residentlal Venlilatipn CatepOry 1 WOrksheet • New Energy COde Worksheet
CBtegory Submitted Submitted
(J submisslon typs) • Enerpy EnvAlOpe CdlCUlaU0n5 $ubtnitle0
In the last 12 monlhs, has the Clty of Eagart Iswed e permit for a slmllar plan based on a master ptan?
Yes No If yes, data and address ol master plan : .... ... ........ .. . . .. ...... . .. .. ............ ...... _.. . .. _ ___?
Llcensed Piumber: Phone:
Machsnlcal CpntrAClor: Phone:
Sewer 8 Wster Contractor Phone: ?
NOTE: Ptans and se?ppprfing documanta that you subm/t ero cpnsldsred to bs publlc ?nlarmatJon. Port/one ot
the informetfon R+ay bQ cluslfied aa non-pubpc lf you provlde speaKlc reesvns that would perrrilt the Clty ro
cvnclude thst the aro Hade secreta.
t nereby acknowles7ge that !hi& iruormsGon is comptele en4 accurale; that Ihe work wVli be in coMormante wiIh the ordlnsnces and codes ot the Ciry of
Eagan; thaf I understand ihis is rmt a permit, but only an application for 8 permit, flnd work is rmf to stert wiihout rmi[; i t the work will be In
the Case ol work wh?h requlres e revlew and epproval 1 plans.
8ccnrdence wilti ihe appT.?W d pl?ln x
Appllcant's PNnted Nams AppHcanYs Signatu"re
PagO I ot 3
/Z '3Jrdd L1V ££:TT 800Z'ZZ'daS