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2125 Quartz LaneINSPECTION RECORD ' CIY`l( OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (612) 681-4675 4, -40 SITE ADDRESS: . , , n PERMIT SUBTYPE: APPLICANT: TYPE OF WORK: INSPECTION .. . .. ,. ? ) ? ? ? ? Permit No. Permit Holder Date Telephone # S/W PLUMBING HVAC ELECTRI Q ? ELECTRIC Inspection Date Insp. Comments Footings I Foundation Framing 21161'? 1 L</ Roofing Rough Plbg. ??. Rough Htg. isui. l.? ? ?l rrJ.? ?? /L Fireplace ! 7" Final Htg. C. Orsat Test Final Pibg. Plbg. Inspector- Notity Plumber Const. Meter Engr./Plan Bldg. Final Deck Ftg. Deck Final Well Pr. Disp. CI"I'Y OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 INSPECTION RECORD I Control No. 0723 PERMIT TYPE: "II j I k' t M' Permit Number: .?..< , . Date Issued: SITE ADDRESS: i.nY , 19 :' 1. <E, Qll feR1 f l qNk CEfiABi t40Vt= a i H PERM1T ?Y?TYP?: `? BLnc; k ; 4 APPLICANT: NEWALA I+IALOEMA!# (612) 464°-4624 TYPE OF WORK: pLTERATYt}M IYI'INARt'S: Ni1Y U1Mi)C1Hb, WXNpt161S. QOUR`i. & ?.?s.tC31NG. .. . .. . PermR No. Permk Holder Date Telephone N SNN PLUMBING HVAC ELECTRIC ELECTRIC Inspectlon Dete Insp. CommeMa Footings I Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Firepiace Final Htg. Orsat Test / Fnal Plbg. ? Pibg. Inspe Plumber Const. Meter EngrJPlan / ?- Bldg. Final . Deck Ftg. Deck Final Well Pr. Disp. , ?? ?/? Z.. CITY OF EAGAN Remarks * Cedar Grove Acquisition Addition DAR GR0 4 Lot 19 eik 4 Parcel, 0 i 6701 190 04 Ownerlell '?'• ' yS reet 2125 Quartz L3rie State Eagani I"Ild 55122 ' t Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK * SEWER LATERAL 1972 1,304.00 52.1E1 25 Paid WATERMAIN * WATERLATERAL 1972 WATER AREA STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK EACaAN TOVi/tvi SH I P BU i L.D I IoI G PE RMi'T' Ownes -•••.------ ? •-• -• ----•-- ..... . -- ---- ----•---•------ ) Address (presen!) ._..._____. ... ........ . ---- -•-•-- ---•-- ---2?/ Builder .............. ?C2!--••--•----••---•••...:•--•••-•---- ••---.._...-•-•••-----•-------- Address ------------------------------------------------------------ •---•--•-••---..._-•-------------- - DESCRIPTION N? 1_042 Eagan Township Town Hall Date ... /_i.•-'7./6"g .------••--•-----... Stories To Be Used For Front Depth Height Est. Cosi Permit Fee Remarks ? Ao ? ? - - k? S'"" ? /a-e? A'?? y - LOGATION Street, Road or olher Descripiion oi Locaiion I Loi 1 tsloclc 1 Anctision or Trac= I / 9 Zj? (V-?? _t4 ? `/ ? This permit does not authorize the use of sfreets, roads, alleys or sidewalks nor does it give the owner or his ageni the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and general welfare to anyone in the community. THIS PERMYT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. This is to certify, that__222 -_: ,El?the ??-------- has permission to erect a............ . .......... upon the above described premise subje provisions of the 8uilding Ordinance for Ea n Town ip adopted -April 11, 1955. ??. --• --••-••---- Per ..._._..--•----....--- ._..--------•-- ..... .•--••--•••--•----•• d---- ------------••---........ -?? -••- • -•-•--•--- Chairman of awn Bo? ? Bu- ildin•? g p6ctor ?. ? ,?, EAGAN TOWNSHIP N.o 805 BUILDING PERMIT ? Owne: ..?ry?%l??..??-".-"-_--• ?=--- =- ---'----------- Eagan Township' ------------------------ Address (presen!) -_•.yEF-i............. -- Town Hall Builder ..... --------- : -------------- ----••-------....------•-•-••---------------._._...-•--------- - Date -?--- Address ---- ------------------------------- ------------ •_._..-•-------•----•--•------•--•••------ DESCRIPTION 5tories To Be Used Fo; Frani Depth Heighf Esi. Cos! PermiY Fee Remarks 4? LOCATION SlreeL Road or oiher Description of Location Loi Block Addition or Tract , -71 `?- T'his permit does not authorize the use of streets, roads, alleys or sidewalks nor does it give the owner or his agenY the righi io create any situafion which is a nuisance or which presen#s a hazard. to •ihe healYh, safety, convenience and general welfare fo anyone in !he community. ' } THIS PERMIT MUST BE KEPT O.Nj ?TH?E? ?PREMISE WHILE THE WORK IS IN PROGRESS. , This is !o cerlify,. ihat---has permission to erec3 a------ ,11.?..• -•------.?...-••-••-•--•• ----••--••---•-•-- upon !he ?above described p=e 'se subj l?c t io ?he;provisions of the Building Ordinance for Eagan Township a opfed April 11, * ? -•------•--••-•C.?-..- --•°•-•• • --•-••-•.-? • ---------•--.. Per ......... -.................... -- ---•-?"--?," ?.......... -...--•--•--- -•-•---/••-----"'-- -- - Chairman of Tnwn Board `? / Building Inspector REGIUEST FOR ELECTRICAL INSPECTION ? See instructions for completing this form on back of yellow copy. Q,? 15 " •'X" Below Work Covered by This Request EB-00007-08 ? ?. ?? ew Adft ep. __' TypeofBuilding AppliancesWired EquipmentWired Home Range Temporary Service Duplex Water Heater ElectriC Heating Apt. Building Dryer Load Management Comm./Industrial Furnace Other (Specity) Farm Air Conditioner ' Other (specify) Contractor's Remarks: _?no,,, Compute Inspection Fee Below: # ' Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to Amps Transformers Above 200 Amps Above 10 Amps SignS . Inspector's Use Only: TOTA ,Sg ' Irrigation Booms Q Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONT 1, the Electrical Inspector, hereby Rough-in Date certify that the above inspection has been made. Final Date OFFICE USE ONLY This request void 18 months from 025 5 a? ,? Request Date 3 h/ Q Fire No. Rough-In Inpsection Required (You call inspector when ready) Inspection Other Than ough-In [3 qeady NowWill Notity Inspector Yes ? Na Date Ready I Ll licensed contractor '?'owner hereby request inspection of above electrical work at: Job Address (Street. Box or Route No.) a4q iii /, N City Section yo. Township Name or No. Range No. Counry Occupant(PRINT) t'V144Dr&7#-1e Phone No. Power Supplier W ?'LD ? ?Z A? Address ? ' Cc? ?-?a.-c-•t_ Electrical Contractor (Company Name) Contractor's License No. Malling Address (Conirac or Owner-Maki g Installa ion) Oci( ? . ? n .?-?{,.? - Authorized Signature IContractoNOwner M g Installation) ?/'a.?aC&m?-? ?? Phone Numb . ?'t a. Its-t - 4 6 2-Y ? MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECI}ON REQUEST WILL NOT Griggs-Midway Bldg. - Room 5-173 BE ACCEPTED BV TNE STATE BOAFiD 1821 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. 5 4 3 3 np 70 if 41V?- ?o (0j?5 Request Date (`j Fire No. Rough-in Inspection Required? "IL ? Yes o Aeady Now 0 Will Notify Inspector When Ready? I licensed contractor p owner hereby request inspection of above electrical work at: Job Adyress (Street. Box or Route No.) ? City Section No. Township ame or No. Range No. Co AZ5_) Oc pan PRIN ) 4u3akr Phone No. Power Supplier • Address Ele ca Contractor ( ompany Name) C ? ?? Cont? r§OLI ?nse1Vo. Mailing Add ss IContractor o wner Making Installati r 1 i a -? ? s A??cizetl S' ?u nature (Con ractodOwnaking Install tion) T Ilo N b RICITY THIS INSPECTION REOUEST WILL NOT MINNESOTA STATE AR? O U CEPTED BY THE STATE BOARD Griggs-Midway Bidg. om BE AC 1821 University Ave., Paul. 04 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. 1oj,sjy? 9 54393 REfiUEST FOR ELECTRICAL INSPECTION ? See instructions for completing this form on back of yellow copy. "X" Below Work Covered by This Request EB•00001-08 J:- ew Acld, Rep. _ Type of Building AppliancesWired EquipmentWired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other-(Specify) Comm./Industrial Furnace Farm Air Conditioner Other (specify) Contr?act_or1s Rema ks: '? ._l?nid) on Af Compute Inspeciion Fee Below: # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Above 100 Amps SignS Inspector's Use Only: TOTAL ' Irrigation Booms /? Special Inspection ? Alarm/Communication THIS INSTAILATION MAY BE ORD ED DI NNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rough-in Date certify that the above inspection has been made. Final Date OFFICE USE ONLY This request void 18 months from REQUEST FOR ELECTRICAL INSPECTION Es-oooo1 -oa ' See instructions for completing this form on back of yellow copy. u 3o ?? " X'" BeloEa? Work Covered by This Requesi 3?$ 3Co fadd Rep. Type of Building Applinnces Wired Equipmant Wired Home Range Temporary Service Duplex Water Heater Lightin,y Fixtures Apt. Building Dryer Electric Heatin Commercial Bldg. Furnace Silo Unloader Industrial Bidg. Air Conditioner Bulk Milk Tank Farm otner pecify Other (Sper,ify) mmnute /nsnectinn # Fee Service Entrance Size # Fee Feeders/Subfeeders # Fee Circuits 0 to 200 Am s 0 to 30 Am s * 0 to 30 Am s Above 200 Amps 31 to 100 Amps 5,00 31 to 100 A s Swimming Pool Above 100_Amps Above 100_Amps Transformers Irrigation Booms e 1 -t".' Pariial%Other Fee aigns apeciai inspection ?? TOTAL `/ Remarks S I>.00 ? O / ? Rough-in Date 1, the Electrical inspector, hereby ° certify that theab v f Final ? ,?, sY1? t o e inspection has been f !'. ' ? ' ? /•` ? ? ?? made . a 4 ,f ?, ' . Tnis request voia its monms Trom 'Thisrequestvoid 33g3? ? . 18 months from VE 053021 << .??, ?o Request Date a Fire No. Rough-in Inspection Required? ?Ready Now Q Will Notify, Inspec- ?Yes ?No [or When Ready [3 Licensed Electrical Contractor I hereby request inspection of above ? Owner electrical work installed at: Street Address, Box or Route No. City 2125 Quartz Lane Ragan ection o. Township Name or No. . Range No. County Dakota Occupant (PRINT) Phone No.l!' . Wa11y Rewald Nm. 451+-4?24 Power Supplfer Address Electrical Contractor (Company Name) Conractor's License No. t ? ?+?$?7 ? Mailing Address (Contractor or Owner Making Instailation) ? ..r llaiA M • 9 installa ion) Authorized SOP ture IComrac Phone Number :aZz 774-8681 MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-MidwaY Bldg. - Room N-197 BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS 1821 University Ave., St. Paul, MN 55104 ati....e Ia171 997-50111 ENCLOSED. ^----------------- ? For:Office:Use I j Permit #: ? Permit Fee: ? Date Received: I ? I Staff: ? ? I `---------- __-___J 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Z. Site Address: Tenant: Suite #: / yi? - 'n RESIDENT / OWNER Name: Phone: Address / City / Zip: r7 Applicant is: Owner Contractor TYPE OF WORK Description of work: lq_? ? • Construction Cost: Muiti-Family Building: (Yes,,Y-/ No ) CONTRACTOR Name: License #: Address: City: State: Zip: Phone: Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7672 _ Minnesota Rules 7670 Categorv 1 _ Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Cat@gOl'y Submitted Submitted (4 submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plansand supporting documenfs thatyou..su.bmitare considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons thaf would permit the City to conclude that the are trade secrets. 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 permih that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. X x ApplicanYs Printed Name ApplicanYs Signature Page 1 of 3 J-? (?e C? ? PLUMBING (RESIDENTIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Please complete for: Single Family Dwellings Townhomes and Condos when permits are required for each unit 4-5-6 - -?Z DateJA4P, Site Address ?4,2J (:i L&' r+? Unit # 4== Property Owner 04,Pe &.v e P,C? Telephone # (E.l?/ '? ?6 -2 ? ' ^ a Contractor, C-V 77& d Pkv v6e , Address ?? ?? (,.7 L??' /' ?-? ??• ?? City ??? ?-??? r State ?? Zip S? Telephone #(?/`y Tjz - Y . ?,. The Applicant is Z? Owner Contractor Other Septic System New _ Refurbished Submit 2 sets,of plans and MPC license $ 100.00 Includes County fee. Additional consultant fees may apply. Alterations To Existing Dwelling Unit, Including $ 50.00 -jx Adding fixtures to lower levels or room additions, excluding water softener and water heater _ Abandonment of septic system _ Water turnaround (+ 5/8" meter if needed -$121.00) Other: luop-f. L&*,-Q _ RPZ _ new installation _ repair _ rebuild $ 30.00 _ Lawn irrigation system 't - Water softener _ Water heater $ 15.00 _ replacement _ additional O, 1 ? $ .50 State Surcharge ?;- Sp.Sc7 Total $ I hereby apply for a Residential Plumbing Permit and acknowledge that the mformahon is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; 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 approval of plans. lWo Ccl ecYza d ????,?'??`? Gt?,.,??-?. ?-?-?-•?,-?? Applicant's Printed Name Applicant's Signature INSPECTION RECORD Control No. 0723 CITY OF EAGAN PERMIT TYPE: BuI LpzNG., 3830 Pilot Knob Road Permit Number: 000935 Eagan, Minnesota 55123 Date Issued: 86I29I92 (612) 681-4675 SITE ADDRESS: Ln r: 19 a Lo c rc : a APPLICANT: 2125 QUARTZ LANE REWALD WAI.DEMAR CEDAR GROVE 4TH (612) 454-4624 PERMIT SUBTYPE: TYPE OF WORK: SF (MISC.) ALTERATION e _ e e . ?.. . e e e e,, e _,. e e ae _ . f „a. ,_. REMARKS: BAY WINDQWS, WINDOWS, DOORS, & SIDING t _ - , CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 tu ? PERMIT PERMIT TYPE: Permit Number: Date Issued: SITE ADDRESS: DESCRIPTION: 2125 puARTz LANE LqT: 19 BLQGK: 4 CEDAR GROVf 4TH g Permit Type SF (MISG.) ??Work Type Al7ERATION BllTLDZNG 000935 06/29/92 *' E ? ? ? ? 2,11 1??? REMARKS: C- 0 Eq'o 5-?? BAY WINqOWS, WINDOWS, DOpRS, & SIDING FEE SUMMARY: vALuATZOH $6, eee Base F'ee $81.00 Surcharge 3.00 Total Fee $84.00 CONTRACTOR: OWNER: - Rpplicanti - REWAI.D WALDEMAR 2125 QURRTZ LN EAGAN MN 55122 (612)454-4624 n.N14 61i'dl I MJ ISSUED B : S NATU E Control No. 0723 PERMIT #,- CITY OF EAGAN REACTIVATE _ 1992 BUILDING PERMIT APPLICATION 681-4675 SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies when typing of permit is requested, but not picked up by last working day of month in which re uest is made or lot chan e is re uested nce ermit is issued. Date Valuation of work ? Site Address: 2125 0-?o,?.G ?-z°_. L? STREET SUITE t Tenant Name: (commercial only) LOT I BIACK ? [SUBD.?? F? J P. I. D. o Descri tion of work: V",cBwS. - The appl i cant i s: t4 Owner ? Contractor O Other (Describe) /9?C G?QI? /j?Q?t/e?lai' Phone ?l,S?`1' ?'6 02 ef Name Pro t p@1'y L F1RST Owner L G?-K-? 25_ 0wQry a1 . ° Address STREET STE,# City ??g ett, . State Rn. Zip 5-5 127, Company Phone Contractor Address License # Exp. City State Zip Company Phone Architect/ N ? Engineer ame 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: BUILDING PERMIT TYPE ? 01 Foundation O 02 SF Dwg. ? 03 SF Addition O 04 SF Porch OR 05 SF Mi sc. WORK TYPE ? 31 New 0 32 Addition OFFICE USE ONLY 0 06 Duplex O 07 4-Plex ? 08 8-Plex O 09. 12-P1 ex 010 Multi. Add'1. Ep 33 Alterations ? 34 Repair GENERAL INFORMATION - . .,,?.. ? 11 Apt./L.odging El 12 Multi. Misc. O 13 Garage/Accessory O 14 Fireplace O 15 Deck ? 35 Tenant Finish ? 36 Move Const. (Actual) Basement sq. ft. (Allowable) lst F1. sq. ft. UBC Occupancy 2nd F1. sq. ft. Zoning Sq. Ft. total # of Stories Footprint Sq..ft. Length On-site well Depth On-site sewage APPROVALS Planning Building Engineering Variance REGIUIRED INSPECTIONS ? Site ? Footing 0 Framing ? Wallboard Ep Final O Draintile O Insulation ? Fireplace Permi t Fee v,iuat;«,: g Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter . Acct. Deposit S/W Permit S/W Surcharge Tr.eatment Pl. Road Unit Park Ded. Trails Ded. Cop ies Other Total: O 16 Basement Finish 0 17 Swim Pool 0 18 Comm./Ind. 0 19 Comm./Ind. Misc. ? 20 Public Facility O 21 Miscellaneous O 37 Demolish MWCC System City Water PRV Required . Booster PumP Fire Sprinkler Census Code ? SAC Code Assessments SAC 96 SAC Units INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (612) 681-4675 SITE ADDRESS: Lo T; 19 BLp CK : 4 APPLICANT: 2125 QUAR7Z LANE WALDEMAR REWQLD GEpAR GRQVE 4TH (612) 454-4624 PERMIT SUBTYPE: sF AoqITznN TYPE OF WORK: NEW suILoING 022195 10/11/93 INSPECTION .. . .. FoorING FaaMxNG ZNSUI.ATION FTNAL F7?, ? n 4 v -Q- 4 .? ., .? ?., .... ..o ... ? ?? m ? 'Y OF EAGAN ?ilot Knob Road , Eagan, Minnesota 55123 " (612) 681-4675 PERMIT G? , y?? PERMIT TYPE: s u x LDxNG Permit Number: 022195 Date Issued: 10/ 11/93 SITE ADDRESS: P.T.N.: 10-16703-190-04 2125 QUART2 LANE LQT: 19 BLOCK: 4 CEDAR GRQVE 4TM DESCRIPTION: 8,utldTh"q- Permit Type SF AQDITION u'11din:,??, t??rk 7ype NEW ?Bt 0ecqpaaick R-3 , ?uI.r?a.nr? L?r?23 n d gh- L ? 2 2 cl C? F ? ° f, p REMARKS: FEE SUMMARY Base Fee Plan Review Sureharge Subtatal CONTRACTOR: VAI.UATION $317.00 $206.96 $17.50 $5A@.55 lae b,?? J,,k???aw????? , ?h?tat xnar?#a ti or? is carrect ancf agree + ??az"e?- AW?f ?G?:??y f a??t? t?rd?°? ? ? ?. ezk ? > E APPLICANT/PERMITEE SIGNATURE $J:.T q C+YJBI COPIES 5.50 `fntal Fee $546.05 OWNER: - Rpplicant - WALDEMAR REWOLD 2125 QUARTZ LN EAGAN MN 55122 (612)454-4624 a4, t,?r t ??s ? ? 0 nw, a r; -c ompl;-y w4 th al 1 ?app-`I .i ip QR ?? . tN Aotin R??'rUiL SSUED BY SIG ATURE REACTIVATE .,_ CITY OF EAGAN pEAIT 9' , 1993 BUILDING PERMIT APPLICATION 681-4675 , ? 44, rf, u;r,l SlNGLE & MULTI-FahfILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. - COMMERCIAL 2 sets of architectural & structural 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 !d - DS- 93 /?7? / 93 Val uat i on of work & Poo Site Address: STREET fU1TE 0 Tenant Name: (commercial only) LOT ? BIACK ? SUBD. &46'- 1&1Vt^ P . I . D . 1M Descri tion of work: ? 0_ cc The appl i cant i s: Owner O Contractor O Other (Deccribe) . ?. Name ? .. (/el?Ct)??p?- Phone Property LAST F1R5T _ Owner ?/ ? ?2?? Address STREET STE 0 ? State Zip City Company Z>O nrI9 L /0 Q . d s/ ?? ?/,JaP.Cw ??hone 1/ 9, Confractor Address ??O ?4 Ae'"?ys???. license # Exp. City M" State ?I"" Zip S? Company Phone Architect/ Engineer Name Registration # Address City State Zip Sewer 8 water licensed plumber Processing time for sewer 8 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 cnrrect and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Appl icant: OFFICE USE ONLY BUILDING PERMIT TYPE O 01 Foundation O 02 SF Dwg. 03 SF Addition 04 SF Porch ? 05 SF Misc. 0 06 Duplex ? 07 4-Plex ? 08 6-Plex O 09 12-Plex ? 10 Multi. Add'1. WORK TYPE ? 31 New 932 Addition E3 33 Alterations ? 34 Repai,r GENERAL INFORMATION Const. (Actual) (Allowable) ? UBC Occupancy Zoning # of Stories length 23 Depth 22 AIPPROVALS . .? ? ? ? 11 Apt.Jlodging . 0 12 Multi. Misc. O 13 Garage/Accessory ? 14 Fireplace ? 15 Deck CJ 35 Tenant Finish p 36 Move Basement sq. ft. lst F1. sq. ft. 2nd F1. sq. ft. Sq. Ft. total Footprint Sq. ft. On-site well On-site sewage Planning Building Engineering Variance REQUIRED tNSPECTIONS ? ? Site O Footing ? Wallboard O Final ? Framing O Draintile O Insulation O Fireplace Permi t Fee 31 7 ?3?'??' Surcharge 17, s-0 -..q...la.m Plan ReviewZ0G,,,r License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. CoPies 5,50 ?• Other .?- Total : S`/6, o?; ? wtuetion: /?b+??rioYJ; ,.:. 314 9i'y .?----- . ? --. .. j . ?.. ., yT 4e? 0 16 Basement Finish 017Swim Poo1 0 18 Cortm./ I nd . C] 19 Cortxn./Ind. Misc. ? 20 Public Facility O 21 Miscellaneous O 37 Demolish MWCC System City Water PRV Required Booster Pump - --, Fire Sprinkler Census Code 3-'" SAC Code - J- Assessments ? SAC 96 SAC Units • ' Y ? ? ? L • ? • • - , • 1 ' .. ,,, ..._....------?----?-?-• """_ "_ ? ? _ . _ _ ? _ _ _ . . . . . - - s ' . • - , ? • , ut • ??d ?. ' ?' o ? . ? ? . -. _ ._ _ _ .. _ - • - - - ? .- . . • , . • ?? ? w r`-,? t-0 o ? ? .... _ . .. _ . . ., . ? ? . . ^ ? _....._ _ I r ,, 4 q ;u . ? • ` --- . .. „1 ? i --- - --- - xs . _ , . ? '• . . ? 1 ' ' , ? •' , ? : .. ? N ? ?! .. ? • . .. ' , ' ? ? ' ?---" I . ? ? l. ' ? . _ --- _-_ - ??' --- _?__..:_a _ _. . " 'C?` : ;! . . ?: . -pd --- - ,.. , ? ? .• •k ? ?.s • v ? ? ? ? ' f ? ;'? • . ? '?, ` ' ? f ? . ?ki ! •, I ^ .01, . ?.? , • •..? .7 , ? - . 6.- . .,. i„ ; •: ,, ? ^' , ? T• _..._, . ' ? . • r ? • ti ''`} ?.? • ???,,. ?? ? ? f . .. ' ' U, / ?' ?' t?? ? \ ? ••+" . . /? / ? ? ? . f ?+? ?\ ? ' ?'R . • ` . • y ?'?J . ? ? ,.*, ..,? ,, I^\ ? ? ,.r---- • ? • ?„ ? , v+ ? a \) ? 4 + AFFIDAVIT OF LREMYTION FROM BTATE CONTRAGTAR LICENSE State of Mfnnesota ) ) ss Affidavit of County of ) bein9 (Buflding Permit Applicant) oath, deposes and states the following: Building Permit Applicant first duly sraorn, upon 1. This Affidavit is submitted in connection with the Building permit application made by (g Permit Applicant) for a proposed work project located at , Eagan, Minnesota. 2. I acknowledge and understand that Minnesota Statutes, 5326.84, requires all residential building contractors/remodelers to obtain a license from the Minnesota Department of Commerce, unless otherwise exempt under the statute. 3. I am exempt from the residential building contractor license requirement pursuant to Minnesota Statut.e §326.84, Subd. 3, ="for reason(s) indicated below (check those that apply): ? a. I am the owner of the residential real estate on which the home shall be built and I wi:11 do the work myself or jointly with my own employees or agents and I am building such home as my own personal residence and intend to permanently live therein. b. Z am an architect or engineer enqaging in professional practice as defined in Minnesota St.atutes, Chapter 326. c. My annual gross receipts are less than $15,000. d. My contracts on individual projects in agqregate do not exceed $2,500. e. I am a mechanical contractor, plumber, or an electrician. f. I am a speciality contractor, remodeler, or material supplier involved only in part of the proposed improvement to the residential real estate. 4. I acknowledge and understand that the statements in this Affidavit are made under oath and if I make any statement in this Affidavit that I know to be false or incorrect, I understand that I could be subject to criminal prosecution or denial or revocation of the building permit or both. FURTHtR YOUR AFFIANT SAYETH NOT. oated: 04 ?? - 93 Subscr bed and sworn:? o before me this day of J?T?> ? No ary Public -u- - I ? uilding Permit Applicant Print/Type Applicant's Name and Address 199,1. JILL Il APtJ84lC ? O ? A H?N MW PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. ----------------------------------------------------------------------------------------•----------------------------------------------- NEW CONSTRUCTION ADD-ON A/C AUU-ON FURNACE ? FIREPLACE INSERT DATE FEES HVAC: 0-100 M BTU ADDITIONAL 50 M BTU $ 24.00 6.00 GAS OUTLETS (MINIMUM 1 @ $3.00 EACH) ADD-ON/REMODEL (EXISTING CONS'I'RUCrION) $ 20.00 STATE SURCHARGE TOTAL .50 ? SITE ADDRESS: o2I o? c5 O WNER NAME: Lej44V 1?1_c:Gt)D1.. D TELEPHONE #: G/ c5 G/ ' y?o o`? L/ INSTALI,ER:?f?7 ADDRESS:?lD /9'.r/) C5 ? CITY: A-D I?S c14 STATE:A /tJ ZIP CODE: 6-3-0 /7 TELEPHONE . SIG ATURE O PERMITTEE 1994 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 6814675 PLEASE COMPLETE FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO COMPLETE FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. --- - ----- - ------ - ----------------------- - ------- - - - - ---------------------------------------------------------- DA TF - (:()N'T'R A r"t' PR IC'F:! !t NEW BUILDING INTERIOR IMPROVEMENT WORK DESCRIPTION: FEES 1% OF qQNT'BACT FEE $ P120CESSED PIPING: $25.00 MINIMUM FEE: $25.00 STATE SURCHARGE $.50 FOR EACH $1,000 OF PEMrI;' FEE. ... .... ............. ......................... TOTAL $ ?Cii?i L 'iLD i`LU?i. - OWNER NAME: TELEPHONE #: TENANT NAME: (IMPROVEMENTS ONLY) INSTALLER: ADDRESS: CITY: STATE: ZIP CC?DE: TELEPHONE #: SIGNATURE OF PERMITTEE CITY INSPECTOR 1994 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-4675 RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reauirements RemodeUReaair Requirements 3 registered site suroeys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site suruey for additions & decks 1 set of Energy Calculations Addition - indicate if on-site septic system 3 copies of Tree Preservation Plan if lot platted after 7/1193 Rim Joist Detail Options selection sheet (bldgs with 3 or less units Office Use Oniv MtA Cert of Suroey Recd ? _Tree Pres Plan Recd _ Tree Pres Not Reqd _ On-site Septic SystemCsx--ti`?`N" Dater? Site Address Construction Cost Unit/St Description of Work Multi-Family Bldg _ Y_ N p Fireplace(s) _ 0 _ 1 _ 2 Property Owner ee,& &Z+,& 0", Telephone # Contractor eeee7 eGGe.vV /7" ac.eJ e,? Address c? r a 3- C;?- ?'.,ze Crs t7 State mn., ?z °'C`ti.. ,0 , Zip Cih' ? do ey? Telephone # ( S?r COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cate,gorv 1 Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (?l submission type) Submitted Submitted • Energy Envelope Calculations Submitted Licensed Plumber ; , ?.; . Telephone # ( Mechanical Contractor Sewer/Water Contractor Telephone # ( Telephone # ( I hereby apply for a Residential Building 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 State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. ,?--? l ?9 ?????r?2 Applicant's Printed Name Applicant's Signature ' OFFICE USE ONLY Sub Types ? 01 Foundation ? 02 SF Dwelling 03 01 of _ plex U 02-plex 4tAP05 03-plex ? 06 04-plex Work Types )6 31 New ? 32 Addition ? 33 Alteration ? 34 Replacement ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous (a A,-,Tlt T2 °o/*'?- Valuation Census Code SAC Units Nbr. of Units Nbr. of Bldgs Type of Const tJ 1? ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors *Demolition (Entire Bldg) - Give PCA handout to applicant " Occupancy -3 MC/ES System Zoning City Water Stories Booster Pump Sq. Ft. PRV Length Fire Sprinklered Width _ Footings (new bldg) _ Footings (deck) _ Footings (addition) Foundation Drain Tile Roof _ Ice & Water Final ? Framing Fireplace R.I. Air Test Final ? Insulation REQUIRED INSPECTIONS FinaUC.O. ? . FinaUNo C.O. _ Plumbing HVAC Other _ Pool _ Ftgs Air/Gas Tests _ Siding Stucco Stone _ Windows (new/replacement) _ Retaining Wall Final Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total ? a w e<z 1LP V c i ,?,??ftcia t"" ,: ? - - - - - - - - - - - - - - - - - I For Office Use / Permit 1-41 1~ iii I I City of Ea I Permit Fee: I 3830 Pilot Knob Road I Eagan MN 55122 Date Received: ~ Phone: (651) 675-5675 I I Fax: (651) 675-5694 Staff: I - 2009 RESIDENTIAL BUILDING PERMIT APPLICATION IZ5 Site Address: 'C+% ~ Aw S Date: ~ Tenant: tt Suite RESIDENT / OWNER Name: q eO?'L'}/ C w~ Phone: ~~f ~``r ' _ 9 57` z L,4- Address / City / Zip: 2 . _ Lc a-r 7- Applicant is: Owner Contractor TYPE OF WORK Description of work: 4 &l t Construction Cost: Multi-Family Building: (Yes _,/P? CONTRACTOR Name: License Address: City: State: 14V Zip: S1 22 Phone: S~' T 2 Conta Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted (4 submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. 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 approval of plans. X X Applicant's Printed Name Appl ant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA149564 Date Issued:05/29/2018 Permit Category:ePermit Site Address: 2125 Quartz Lane Lot:19 Block: 4 Addition: Cedar Grove 4th PID:10-16703-04-190 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 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 - Waldemar A Rewald 2125 Quartz Lane Eagan MN 55122 Haley Comfort Systems 4320 Hwy 52 N West Frontage Rd Rochester MN 55901 (507) 281-0138 Applicant/Permitee: Signature Issued By: Signature