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3209 Random RdCITY OF EAGAN Remarks Addition AUDITORS SUB #38 Lot Blk OKwnerV I; I Aa 6OStreet 3209 RBndom Rd. R#1 I W?vI?C ?' ?1 `? f?[',Uar) , n16?/l;'1.r?1G ? X g State Parcel 10 03800 010 08 St. Paul, NIDT Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. Z? 1974 740.00 74.00 10 740.00 008357 9/28.1979 STREET RESTOR. GRADING SAN SEW TRUNK ? 1970 12$.00 5.00 25 Paid *SEWERLATERAL 1972 1411.90 70.60 20 Paid WATERMAIN ATER LATERAL 1972 20 WATER AREA STORM SEW TRK 1984 360.00 24.00 15 360.00 C008507. 9-9-83 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 300.00 6803 11- 5-72 BUILDING PER. sAC 260.00 6803 11-15-72 PAR K BUILDING PERMIT N° 89?.! ?, . Receipt # To be uw d fo? GAPac' Est. Volue $ 6, 900 Date AP.R I L 2 , 19 Site Address 3?.09 R?1idI)0; i Rr, - Erect (} Occuponcy Lot 1 Block ?01 Sec/Sub. AjiF) IxOr? 1 ? ;7LJT.; 3Lr;qlter ? Zoning Parcel No. 10'0 30 -01C-'0 i" Re oir ? Fir Z p e one E l Y 4 t n arye ? Type of Const. oc Name PAT HA7FL Move Q # Stories z 32 0 9 Address FA1,17,0; ; ?'I? . Demolish ? 2 ? Length _- - ? City T'AGAI T Phone 45 4-80 0 6 C,rode ? 271 De th F S p q. t. o Name Approvals _ Fces ?F ? Address F- City - Gity CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454•8100 Phone Name Address I hereby ocknowledge that 1 have read this applicotion ond stute that the intormotion is torrect ond ogree to comply with all applicoble Smte of Minnesoto Statutes and Cita('of IFogon OrdinoAes. Sipnature of Pertnittee A Building Permit Is issued to: '-?'AT IIA`I,1 'T oll work sholl be done ih accordqnce with Buildinp Officiol Assessment Water & Sew. Police Fire Eny. Planner Council Bldg. Off. APC - Permit v 2. 0 Surcharge % • 50 Plon check _ SAC Water Conn. Water Meter Road Unit Total $ 66.00 on the expreu condition that of Minnesota Stotutes and City of Eogan Ordinances. Permit No. Permit Holder Misc. Permit No. Holder Plumbing H.V.A.C. Well Water Disp. Sewer Electric Inspection Date Insp. Other Footings -ZfE-Le ,?. Foundation Freming • ? ? ." Rough Plby. Rouph HVAC Inwlation Final Plbg. Final HVAC Final 3 by Water Describe Location: V11ell Sevuer Pr. Disp. ? INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: ? 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 . . , ;, SITE ADDRESS: APPLICANT: . ,,;=,,tvi`•,1ON :113 PERMIT SUBTYPE: TYPE OF WORK: °4'' W <J f1 INSPECTION D. . .A ,. , , ,.. , •. ,. . ,... _ PermR No. Permit Holder Date Telephone # ELECTRIC PLUMBING HVAC Ir.spection Date Insp. Comments FOOTINGS 7 ?J FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL K V29 ?-' ? Request Date Fire N. Rou h-in Inspection Required? ? Yes No Ready Now f7 Will Notify Inspector When Ready? licensed contractor ? owner hereby request inspection of above electrical work at: Job Address (Street. Box or Ro o.) 3?()9. k&n Qc?? City - 0 Section No. Township Name or No. 11 - Range No. Cou ? 7pa? ;?? P ? Phone No. Power Supplier Address EI tt or ompany N ? lX Ay 's License No. C U(51 Mail ing Ad ss (Contractor or ner Making Installa A) ^ O? ? Aut riz Sig ature 1 o ractoriOwner Making Instal ation) Ph N ber J -- ? S MINNESOTA STATE OF EL CTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - o S-17 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. ?j???REGlUEST FOR ELECTRICAL INSPECTION K 0 ???? ? See instructions for completing this torm on back ot yellow copy. I" ``X" Be/ow Work Covered by This Request EB-00001-08 ? ?.??. ew Add Rep. TypeofBuiiding AppliancesWired EquipmentWired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other-{Specify) Comm./Industrial Fumace Farm Air Conditioner i Other (specify) Contractor's emarks: ` s? Compute Inspection 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 INSTALLATION MAY BE ORDERED DISCONNECTED 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 ZZL-5, o t OFFtCE USE ONLY This request void 18 months from . CITY OF EAGAN ?T p e?3830 Pilot Knob Road, P.O Box 21-199, Eagan, MN 55121 lr ? 8921 PHONE: 464-870t1'' , /-4 BUILDING PERMIT ReceiPt # 7` To be uted for GARAGE Est. Value $ 6, 9 0 0 Date APRIL 2 , 19$4_ Site Address 3209 RANDOM RD. Erect Ml Occuponcy Lot 1 Biock 8 Sec/Sub. AUDITOR 'S SUB 38AIter ? Zoning Parcel No. 10-03800-0I0-08 Repoir ? Fire Zone Enlarge Q Type of Const. Vri oc Name PAT HAZEL Move Q # Stories 3 Address 3209 RANDOM RD. Demolish ? Length 24 o City EAGAN Phone 4 5 4- 8 0 0 6 Grode p Depth 24 Sq. Ft. ? o Name SAME Approvols Fees Address ? Assessment Permit $ 62.50 ? ? City Phone Water & Sew. Surcharge 3.50 r Police Plan check uW Name ?,,, Fire SAC _? Address Eng. Water Conn. m W City Phone Pionner Water Meter Council Road Unit I hereby acknowledge that I have reod this application and stote that gldg. Off. the information is torrect and ogree to comply with oll opplicoble APC Totol $ 6 6 00 State of Minnesoto $totut a d Ci of gon Ordin es. .. T Signature of Pertnittee /1 Building Permit Is issue _ PAT ZEL on the express condifion that all work sholl be done i accor e with ol opp I te of Minnesota $totutes ond City of Eagan Ordinances. Building Officiol ?? ? -p- ??z / , CITY OF`EAGAN . Zb Be Used For Site Addre Lot ? BUILDING PERMIT P.PPLICATION A. g Op_ _ Valuation Jfm. H.? 3't ad ? o -5 b Erect ? Parcel #: 1 d 038"DD o/o F? ? Owner : 1 ??? J?7G ? ?.y J Address : ? ) 9 Gi 1`i C?rs ?1 /E'l ? - ..? _ '4G" ?'` City/Zip Code: 6 Phone # : Contractor: Address: City/Zip Code: Phone #: Arch./Eng.. _ Address : City/Zip Code: Phone #: Ir_clude ?_ sets of plans, 1 Gertificate of Survey,'& 1 set c£ energy calculations. Date ' 7,4 OFFICE USE ONLY / Occupancy /i?/ Alter Zoning Repair Fire Zone Enlarqe Type of Const ?--°Nlove # Stories ft. Demolish Front ft. Grade Depth APPROVAIS FEES J-,9 Assessments , Permit Surcharge ? . rD ?aater/Sewer Police Plan Check _ Fire SAC Eng. Water Conn. Planner Water Meter _ Council Road Unit Bldg.' Off. APC -- ?----__ TOTAL GITY (7F C::(tGAN CW.-3H:C1=Ra :?5 TEfitMINAl._ NC1^ 766 DFt"C[;; 02l02/98 'T'IME"a 12u29,°,33 zD ;, NaME AMER:r.rAN BLDRta ?Nri DESIrN 2:1.r.a ??r?01. :?G oa N?:A???:???M r4?? 12„25 :s 2155 9009. 3209 RANDOM FiTi 0.50 ::32:I.0 9001. :3209 F'tANIDOM RLi :LCJtJ.t:lq 'T'o+.al. Ret^F,irit Amouni. : 112.75 CRClf.3591. c UsER .T. T? : JAN CITY OF EAGAN 3830 Pilot Knob Road Eag'an, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: P. I. N. s 10--03800-010-08 DESCRIPTION: BUIL.DTNG 031390 02/02j98 ? SF ADpITTON NEW 434 ALT. RESIDENTTAL !;; REMApt% REVTEWED BY MIKE BRRCK. CALL 445-284o REGARDING ELECTFtIGAL PERMIT & INSPECTItJNS. FEESUMMARY: VALUATIpN $6,000 Base Fee $112.25 Swrcharge $•50 7ota1 Fee $112.75 ?± -- „rN..?.wu. ,.. ,,.. .... '7i??Tn?TBLR '?9RS & DESIGNERS 18881199 2000926 W??HALq ROCER b?1 LYNDALE AVE S 11 3209 RANDOM RD BLAAMTNGTQN MN 55420 EAGAId MPi (t12) 888-1199 (612)454-1854 k PERMIT R ?+ PERMIT TYPE: Permit Number: Date Issued: 3209 RANDqM RD LOT: 1 BLtIGK: S AUCIITORS SUBDIVISIpN 38 APPLICANTlPERMITEE SIGNATURE 3-sEasoN 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN ? 3830 PII.OT KNOB RD - 65122 681-4675 New Construction Reauirements RemodeVRecair Requirements ? 0 3 registered site surveys ? 2 copies cf plan ? 2 copies of plans (inGude beam & window sizes; poured fid. design; etc.) ? 2 site surveys (exterior additions 8 dedcs) ? 1 energy calculations ? 1 energy calculations for heated additions ? 3 copies of tree preservation plan if lot platted efter 711/93 required: _ Yes _ No DATE: 2r 5 CONSTRUCTION COST; 12- ?DESCRIPT{ON OF WORK: SET ADDRESS: LOT: BLOCK: ? SUBD./PJ.D. Name: s 4e? >- A u 1--(' c>2 ,,?' ?r 7 Phone #: PROPERTY I-est First OWNER Street Address: 52o`' /ec YrIe Ai d/? c p City ?? * A) State: 10Y iJ Zip: ( 105er ? ?i 1 ?' ?f102? Company: 14 m.r Phone #: ??? / 19 9 CONTRACTOR ? ,/j Street Address: n0 ? L?? K..Cd ?T /tv, S? License # 5 26r City LaD LJ°r?? L State: A'J Zip: ARCHITECT/ ENGINEER Company: Phone #: Nazne: Registration #: Street Address: City State: Zip: Sewer 8 water licensed plumber (new construction only): . Penalty appiies when address chang and lot change is requested once pennit is issued. I hereby acknowledge that I have read this application and state that the information is coRect and agree to comply with all applicabl State of Minnesota Statutes and C'ity of Eagan Ordinances. Signature of Appiicant -17 iz Z?/ OFFICE USE ONLY Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No Not OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 02 SF Dwelling ? 07 4-plex ? 03 SF Addition ? 08 8-plex 0'04 SF Porch ? 09 12-plex CI 05 SF Misc. ? 10 _ plex WORK TYPE 0 31 New ;3'32 Addition O 33 Alterations ? 34 Repair ? '11 Apt./Lodging ? ? 12 Multi Repair/Rem. ? 0 93 Garage/Accessory ? ? 14 Fireplace ? ? 15 Deck ? 36 Move ? 37 Demolition GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories . Length Depth APPROVALS Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Planning Building M'3 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscelfaneous MC/WS System ? City Water ? Fire Sprinklered PRV Booster Pump Census Code. Al 2 SAC Code C> t Census Bldg I Census Unit D Engineering Variance Permit Fee Valuation: $ C->60 Surcharge Plan Review License MC/WS SAC ? ? ? r y = c 4ca 00, ---City SAC ? Water Conn. Water Meter Acct. Deposit S/VN Permit S/W Surcharge Treatment PL Park Ded. Trails Ded. Other Copies Total .j? t °lo SAC SAC Units ? 5 .,,4 ? ? ? f • ? 3 ??,?? ? i ' ? e * ; ? - ; . , . ? . ;... -? . , .. ?.. , ,? , , , i:. . ?., ? ? , : , . .. ' ? .. ; . . ? . . ? ?..:. . . ?- _ { . . . ... . . ' . . . _ . . .. . . . . ? . . . . ._. , . . . . . . ?. . . ,.. ? '-_ ? , : , , . . . 4? . , - . . _ . . . ?. ? . ? ? . .. . . - • -. . ._ , . ,? , ? .. a . ? ? ., ?? . . . . . . + . . . . , , ' ? . ..??? . . ..?? ? ? ...?., ? , •: . . . .. .. .JS } 1?"? F «.?..<?. :,, x . ?..v. . +? ... •?.i ? ? ? . ? . ? . , . . ? . . . . ? °--- ?? ?- ? . 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" . . . .. . „ .. ._ . .. .. _ ?.. ? . ,. . . . ._ ._ . :.. :, .. . ? . w._ , „ , . ? EAGAN TOWNSHIP 3795 Pilot Knob Rosd St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR WATER SERVICE CONNECTION Date: nTovP.mb .r 15,1.$72 Number:_.?._ 1049 O/U 6 ?i/ Billing Name: Judith Miller Site Address: 3209 Random Road, Eagan 55121 Owner: same Billing Address Plumber:Ron Kissling Location of Connection Builcling is a; Resi.dence xx t4ultiple K0. Units Commercial Industrial Other In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accardance with the rules aad regulations of Eagaa Township, Dakota County, Minnesota. By: Ron Kissling Meter Size 5/O Meter ReadingMeter Dep. Meter Sealed: Yes Add'1 Chg. 8•00 pd 11/15/72 coppex "'- hormm tion Chg.juu• 1 /15/72 Meter No.A06811 Persnit Fee 10.00 pd 11 /15/72 .50 p ?7S/7 2 NOiTotal Chg. Inspected by Date Remarks: $25.00 RP-INSDECTioN FEE FoR 9MPROPERLY INSTALLED METERS. By: Chief Inspector Please notify the above office when ready for inspection and connection. EAGEiN TO[JNSHTP 3795 Pilot Knob Road St. Paul, Minnesata 55111 Telephone 454•5242 PERMIT FOR SEWER SERVICE CONNECTiON DATE: November 15, 1972 , OWNER: Judith Miller PLUMBER Ron Kissling NtJMBER 1214 /U ? `Cx??' o i U c' `? Address 3299 Random Road, Eagan 55121 TYPE OF PIPE heavy cast iron A ESCRIPTION OF BUILDING Industriall Commerciall Residential { Multiple Dwelling ( No, of units Ex Location of Connections: Connection Charge 260.00 pd 11/15/72. Permit Fee 10 OQ ud,11 /15/72 .50 pd. 11 /15/72 s/c SCreet Repairs Total Inspected by: DaCe Remarks• By Chief Inspector In consideration of the issue and delivery to me of the above perm3.t, I hereby agree Co do the proposed work in accordance with the rules and regulations of Eagan Township, Dak.ota-County, Minnesota sy ; Ron Kissling Please notify when ready for.inspection and connection aad before any portion of the work is covered. ° 95 lA :16 I D:llaCOTA COUNTY p{-lyS I CAL D 1 FAX : 612-891-7431 ? ?8D0 - Ol0 - p ? Municipai Notice of We11 Permit ApPncation Dakota County Environmrntal Management Department Water and Land Nlanagernent Saction 14955 Galaxie Avenue We9t Apple Valley, (vIN 55124 7'el (6] 2) 891-7011 Fax (612) 891-7031 pATE: 8eptember I4' 1995 TO: Tom Colberr/Weyne gchwanz FROM: Water aad Land Managament Wel! Fermit #; 95_9240 Municipality: g,agan Fax#: (612) 681-46I2 WeU Typo; 15on1estic ??ijronmental Specialist: Olson PAGE The Water and Land Managemenl Seetioa of the Dalcpta Cpunty Environmental Managernent Dc r'eceived the following ??it apptication for the well described. If you require furdhar revJey? pp ?e ap lication or you hava a?t J?nenr has y questions or concern$ about it, contact the Environmenta) S P If 991-7011. lf thene is no response fi+am your office widtin 24 HOUItS (excludinglWeekedg and holidaffice al (612) essume thet you have no objectipne to the i s s ua n c e o f t h e Y$) ? W e w i l l c o n d i tio n e d on t M te perrnit applicant's otxservance af a n d c o m p l; a n e? wi t h l a l l pp? able sta e, cQUpsuad m alwa y s l a w s a n d c o c les. ty, ?un,cipal Well Contrector: Date spplication reeeived; September 12. 1995 Anticipated DtilGng bate: 1 / Antieipsted Grouting Date: j? Time: t+++•+*,? Time: ++++**s• PtoPeKY Owner: Pat Hazal Well Owmer. - ROGBR t & ArI1TA M WESTERHpLp WELL LOCATIONC: PLS Gpordinates: 1/4 nw 1/4 sw 1/4 ne 1/4. Sec;12. Town 27, Range 23 5treet address: 3209 Random Road PIN Number: TM-P0000-015.08 WELI. INFOAMAT'ION: Di$meter: 4 Casing depth: 75 Tatal depth: g0 Siatic Water I,evel: 45 Aquifor: uneonsalidated sediments COMMENTS; R=95% . , 612 891 7031 09=14-95'02'c10PM P001 447 v, /99, WELL PERMIT DAKOTA COUNTY ? v .? . ?, WHEREAS, the PERMITTEE/DBA: ADDRESS: ENVIRONMENTAL MANAGEMENT DEPARTMENT WATER AND LAND MANAGEMENT SECTION 14955 Galaxie Avenue, Apple Vafley, MN 55124 (612) 891-7011 Roger Westerhold 3209 Random Road Eagan, MN 55121 NON-TRANSFERABLE REVIEWED BY: Farr Permit No. 94-2076 has submitted a permit application, has paid the sum of $100.00 dollars to the County of Dakota as required by Ordinance Number 114 and has complied with all of the requirements of said Ordinance necessary for obtaining a Reclaimed use Well permit described herein:. , A private water supply well is on a property served by a municipal water supply. The well is permitted for non-potable use only, such as lawn and garden watering. This well is subject to inspection by the Department of Environmental Management. THE WELL IS LOCATED IN THE MUNICTPALITY OF EAGAN AS FOLLOWS: WELL LOGATION PROPERTY OWNER & ADDRESS WELL OWNER & ADDRESS 3209 Random Roger Westerhold Roger Westerhold 3209 Random Road 3209 Random Road Eagan, MN 55121 Eagan, MN 55121 NOW THEREFORE, the property owner is hereby permitted and authorized to keep and use the well located above for the purpose described for the period of June 1994 to June 1995. This permit must be renewed at the end of this time period. Upon failure to renew the permit the well will be considered to be abandoned, and will be required to be sealed within 90 days. This permit is subject to all provisions of said ordinance. If the property is sold or otherwise transfered in this time period, the owner,must inform the buyer of permit requirements and the buyer agrees to maintain the well in accordance with ordinance requirements. Given under my hand Tuesday, June 14, 1994 A En? n ntal Supervisor Env Management Ordinnuce No. 114: WELL AND WATER SUPPLY MANAGEMENT Permit No. WELL PERMIT 9 3-2 076 DAKOTA COUNTY ENVIItONMENTAL MANAGEMENT DEPARTMENT WATER AND LAND MANAGEMENT SECTION . .?<• 14955 Galaxie Avenue, Apple Valley, MN 55124 Tdephone (612) 891-7011 WHEREAS, the NON-TRANSFERABLE PERMITTEE/DBA: Pat Hazel REVIEWED BY: Farr - ADDRESS: 3209 Random Road - Eagan, MN 55121 _, . has submitted a permit application, has paid the sum of $50.00 dollars to the County of Dakota as required by Ordinance Number 114 and has complied with all of the requirements of said Ordinance necessary for obtaining a Reclaimed Use well permit described herein: A private water supply well is on a property served by a municipal water supply. The well is permited for non-potable use oniy, such as lawn and garden•watering. This well is subject to inspection by the Department of Environmental Management. THE WELL IS LOCATED IN THE MUNICIPALITY OF EAGAN AS FOLLOWS: WELL LOCATION PROPERTY OWNER & ADDRESS WELL OWNER & ADDRESS 3209 Random Road Pat Hazel Pat Hazel 3209 Random Road 3209 Random Road Eagan, MN 55121 Eagan, MN 55121 NOW THEREFORE, the property owner is hereby permitted and authorized to keep and use the well located above for the purpose described for a period of one year from the date of this permit. This permit must be renewed at the end of this time period. Upon failure to renew the permit the well will be considered to be abandoned, and will be required to be sealed within 90 days. This permit is subject to all provisions of said ordinance. If the property is sold or otherwise transferred in this time period, the owner must inform the buyer of permit requirements and the buyer agrees to maintain the well in accordance with ordinance requirements. Given under my hand June 28, 1993 ?? ATTEST ?---- ENVIRONMENTAL SUPE VISOR ENVIRONMEN L MANAGEMEhT DIRECTOR G 33s ? 2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos when permits are required for each unit :!) 0 Date / / 1 Site Address 3?-?Cj ?C( V1 21?n /q rf Unit # Property Owner ko--vp 'We S_e Telephone # ( 6S /) _, Carrtraet6r Street Adlltss4ARD HEATING & AIR CONDITIONINQ C0, city State MINNEARpLIs, MN &5408"2M Zip Telephone # ( ) Bond #: Egpires: The Applicant is Owner ? Contractor Other Add-on or atteration to existing dweliing unit $ 30.00 ? furnace _Additional ?Replacement air exchanger i diti N ?R l t X r con oner _ a ew ep acemen _ other State Surcharge $ .50 Total $ I hereby apply for a Residential Mechanical Pernut and acknowledge that the information is complete and acc be in conformance with the ordinances and c of the City of Ea n and with the a'cal Codes; th I pe ', ut only an application fo a pe t d rk is not to start without a pe 't; tha w k wil be appr ve lan in the case of or which re uires a view and approv of plans. Apphcant's Pnnted Name Applicant's Signature , /?!l?iR / work will s is not a ? with the 0 4 2C104 e 9 2004 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit Date Site Street Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) Contractor Street Address ' City State Zip Telephone # ( ) Bond #• Expires: The Applicant is Owner Contractor Other Work Type New Construction _ Underground Tank _ Install _Remove **see below Interior Improvement _ Install Piping _ Processed _Gas Nature of Work: **When installing/removing underground tank, call for inspection by Fire Marshal and Plumbing Inspector Permit Fees: $70.50 Underground tank installation/removal ' $50,50 Minimum (includes State Surcharge) or Contract Value $ x 1% _ $ Perxnit Fee • If nermit fee is $1,000 or less, add $.50 ? $ State Surcharge If pernut fee is over $1,000, add $.50 for every $1,000 permit fee $ Total Fee I hereby apply for a Commercial Mechanical Permit and acknowledge that the information is complete and accurate; that the wark will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I.understand this is not a pernut, but only an applicarion for a pernut, and work is not to start without a pernut; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name Applicant's Signature Approved By: , Inspector Date: ø þ ý þýý üûúû ú ùýý äûôüûúëä ää ÿ þý÷ üûúùø ñôûùø ÷ôùø ÷öõôó öõò ø û ñ ûñ ððìûø ù ï üîû ô í øôë ô îûô ô ú ô êé ôööø ý éôéô ý ø êñ éôé ø é ô ê ñ ôú è ô ô ô îûô úù ö é ù ê í æääêäêðä öù üûô ô æê ê ç û ýê õô ÷óò øø ò ö ô ò ôþ÷ ô ñûùò ñ÷ ò ò ò ë þ ãó ÝßÜßðð ô úù ö ë ô øø éô ôô ô øùö øø ú ü éã ü û ñùéþ ìô ê øø õ ô ü ûô û ùü ûô PERMIT City of Eagan Permit Type:Building Permit Number:EA143024 Date Issued:05/30/2017 Permit Category:ePermit Site Address: 3209 Random Rd Lot:001 Block: 008 Addition: Auditors Subdivision 38 PID:10-03800-08-010 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Roger E Westerhold 3209 Random Rd Eagan MN 55121 Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 Applicant/Permitee: Signature Issued By: Signature