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
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?
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
