4626 Ridge Cliffe DrCity of Ea�ali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Permit #:
Permit Fee: 7 LI JV
Date Received:
Staff:
2010 MECHANICAL`>PERMIT APPLICATION
P6
Date: 3 a � i 0 Site Address: ii6g62 Rs P, CII D r f V
Tenant: 77 e. l b .. ri JJJ
Suite #:
J
RESIDENT / OWNER
r3Q- r Q .PPhc.
one: p 0 '- /—'0917
Name: Z.-e..b lt/b
/� /1�
Address / City / Zip: '/1&- gays (!iTf I/Ys !--% ii � illfk! 41-2
CONTRACTOR
Name: 69 e `' fA ,:,rte - 3 ' /.l License #:
Address: /9,3W r J4 !101ij 2 City: chew/ -
7)3 f�� f
State: Zip: f r Phone: ��� "'0�'� � , -, '
Contact: d t9&r /1 Email: QGtu/Jobrien Q ''.L`4 N
TYPE OF WORK
New Replacement Additional Alteration Demolition
Description of work: _ (C(.. -PO r V —e
mounted 6
.- ase con . r I Inspector fob o
airs ` Ctt
p dim r ning tho a
PERMIT TYPE
RESIDENTIAL
X Furnace
Air Conditioner
Air Exchanger
Heat Pump
Other
COMMERCIAL
New Construction _ Interior Improvement
_
Install Piping Processed
_ _
Gas _ Exterior HVAC Unit
_
_ Under / Above ground Tank ( Install / _ Remove)
** When installing/removing tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ i SO TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x 1%
$50.50 Minimum (includes State Surcharge)
_ $ Permit Fee
- If Permit Fee is less than $1,000, surcharge is $.50.
- If Permit Fee is > $1,000, surcharge increases by $.50 for each = $ Surcharge
$1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge).
= $ TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.nooherstateonecali.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance ith the ordinances and codes of the City of
Eag at I understand this is not a permit, but only an application for a permit, and work isn/ t to starts it u a itthe work will be in accordance
wit pprovect plj it ei e of work which requires a review and approval of plans.
x
Applicant's Printed Name
x
Applicant's Signature
CITY OF EAGAN - Remarks -
Additform OEkff CAKE RTUQH 4th Lot i 8116 Pe,ce, 10 39803 010 aR
Owner Street 4626 Ridga Cliffe Drive stata Eagan, MN 55122
Improvement Date Amount Annual Years Payment Reoeipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK '
* SEWER LATERAL
WATEAMAIN
,e WATER LATERAL
STORM SEW TRK
* STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
6UILDING PEFt.
SAC
t:1TY OF EAGAN - Remarks -
AdditionJQ&= CAKE RID6E 4tb Lat 2 Rik 8 ParcelJ,O zaQnz n nQ
Owner street 4626? Ridge Cliffe Drive scate Eagan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF,
STREET RESTOR.
GRADING
SAN SEW TRUNK '
* SEWER LATERAL
ag,
981
WATERMAIN
* WATER LATERAL 1981
WATER AREA 1981 300QO 60.00 S
S7pRM SEW TFiK 1981 278.28 55.66 5
* STORM SEW LAT 1981
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
CITY OF EAGAN Remarks -
Addition?Ifl,E?_?'?IE RTD6E 4th l.ot 4 elk g Parcel 10 39803 040 08
o„„ner street 4628 Ridge Cliffe Drive State Bagan, MIlN 55122
Improvement Date Amount Annual Years Payment Receipt Dete
STREET SURF,
STREET RESTOR.
GRAOING
SAN SEW TRUNK '
,t SEWER LATERAL
WATERMAlN
* WATER LATERAL
WATER AREA Q
STORMSEWTRK 1981
278.28
55.66
5
27$.2$
C005581
IO 1S HO
* STORM SEW LAT 1981
CURB & GUTTER
SIOEWALK
STREET LIGHT
WATER CONN,
BUILDING PER.
SAC
PARK
GITY OF EAGAN Remarks
Addition.IQHI?II?IY' .AKF RTi16 . Q-F+ Lot ? Rlk R Parcelltl 99SQ7, 03g r?Q
owner streec _ 4628h IlRidAe C1iPf'e Drive State Eagan, NIN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SUAF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 5
* SEWER LATERAL 1981 2277.43 455 49
WATERMAIN
ir WATER LATERAL 1981
WATER AREA
STORM SEW TRK 623- 1981 278.28 55.66 5 278-78
* STORM SEW LAT 1981
CURB & GUTTER '
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
FdR. "i.L UNI2'S CITY OF EAGAN : Np 12581
, TUWIVHOUSE 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
L I ; 2, 3', 4 B 8 pHONE: 454-8100
BUILDING PERMIT Receipt #
To be used lor 1 OF 4 PLEX Est value $48,000 Date S EPTEMBEFt 4 1986
SiteAddress 4628 1/2 RIDGE CLIFFE DR Erect 13 Occupancy R3
Lot 3 Block a Sec/Sub. JOHNNY CAICE Remodel ? Zoning pn
Parcel No RIDGE 4TH Repair ? Type of Const.y,=
. Addition ? No.Stories
D VALUE HOINES
?
Move
?
Length 44
W Name
= 1460 93RD Lbl Demolish ? Depm 24
o Address
CiN BLAINE phone 780-5510 Int Impr.
Install ?
? Sq. Ft.
a
o
Name $AME
APProva
Z
?°, i Address Assessment _
~ City Phone Water & Sew.
? Q Police
F Name Fir
= e
? ?y Address E
z
lx ng.
s W Ciry Phone Planner
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 4t)Eagan Ordinances.
Signature o( Permittee,;.r?r.+?.?
A Buiiding Permit is issued to: GOOD VALUF HOf• S
all work shall be done in accordance with all applieable State of Minneso
Building
Bidg.
APC_
Var. [
Permit ° ' 9 • ""
Surcharge 24' Oa
Plan Review Q4
SAC
Water Conn. 500*00
Water Meter?00
Road Unit----130 0
Tr. PI. '
Parks
Copies ? ? 50
Total
on the express condition Mat
Statutes and Ciry of Eagan Ordinances.
.A- ( &J t-
S
PKmM No. Pe*mi1 Moklor Dds Tdophone N
PlumWnp '7Ct^ L/ 0 7 L
H.V.A.C.
Y?
Electric L
SoPAnw
Inspectlon Date Imp. Commenb
Footlnys I ? LIJ
Footinys 11
Foundatfon
Framinq ?p
Aoofiny
Rouyh Plbp•
Rouyn Htp•
Imul. 7
Finplaee
Final Htq. a6 ?
Final Plby.
Bldy. Final
Cwl.Occ. ?? ZA?
Dsck Ftp.
Dock Frmp.
WeN
Pr. Dbp.
'?' c . x . . ?... : . . . . . - , , . . . . n. '??• }??. .
r , .
PERMIT #
? . , PLUMBING PERMR RECEIPT # G"-- 41 ? f
CITY OF EAGAN
3830 PILOT KNOB ROAD, FJIGAN, MN 55121 DATE:
CT PRICE PHONE: 454-8100
Site Addr? y? " "
Lot Block
m Name
? Addre
c City_
04?
? Neme
; Addre
o City ?
FEES
COMM/IND FEE - 1%OF CONTRACT FEE
MINIMUM - RESiDENTIAL FEE - $10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE CaOES
BEYOND $1,000.00)
SIGNATURE OF
FOR: CITY OF EAGAN
BLqG. TYPIRE? WORK DESCRIPTION
Res. New `
Mult Add-on
Comm. Repair
Other
NO. FIXTURES TOTAL
?Water Closet - $3.00 S
Tubs - $3.00
Lavatory - $3.00
-Shower - $3.00
Kitchen Sink - $3.00
:
Urinal/Bidet - $3.00
=Laundry Tray - $3.00
? Floor Drains - $1.50
=Water Heater - $1.50 '
Whirlpool - $3.00
?
Gas Piping OuNet,a - $1.50
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
=Rough Openings - $1.50 '
FEE
STATE SlC:
•
GRAND TOTAL
PERMIT # CITY OF EAGAN
?,DMECHANICAL PERMIT
RECEIPT # 454-8100
MINIMUM RESIDENTIAL FEE - $10.00 + $.50
DATE ??? ?? MINIMUM COMMERCIAL FEE - $20.00 + $.50
1. Bldg. Type: Res `-? Comm Inst 2. New ? Add -
3. Total Bid Price "" 4. Job
Lot `--? Block g S ?/
?,_ .
6. Contractor `? `' i 0
(Neme)
7. Contractor Phone #
FEE _Z5. Sa
S/C • .5!'
TOTAL 2 ?' • U 0
Alter Repair
5. Owner ,?
?. A-1?
(City) (ZiP)
RESIDENTIAL HEATING - 01-100,000 BTU's -$24.00. Each additional 50,000 BTU's or fraction -$6.00
RESIDENTIAL COOLING - 01-24,000 BTU's -$12.00. Each additional 6,000 BTU's or fraction -$6.00
MODIFICATIONS/ALTERATIONS -$10.00 minimum fee
L.-I HEATING VENTILATING HOT WATER STEAM AIR COND.
TAIR PIPING PROCESSED PIPING AIR HAND. EQUIP. REFRIG.
RES. GAS PIPING OUTLETS - $1.50 TANKS: L.P. UNDERGROUND OTHER
COMM./IND..ftATE - 196 OF TOTAL BID P7CE PLUS $.50 STATE SURCHARGE FOR EACH $1,000 OF FEE.
Signed: ? ?"?y.•? f • ?G ?..? for ? S!? ?` ? ?-n•? -,.
Approved Inspections: Date Rough Insp. Date Final Insp.
• . ..
fttrti#ir?tit uf tOrrupanry
titp of eagan
loPwftPilf Df IOWA-tftg jwPtttDlt
Thrs Cerrificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifyrng tJrat at the lime of issuance thrs strtecnue was in com,pliance with the various
ordinances of the City regulating building constructlon or use. For the following.•
uwclas,;fimrion ? of 4 PL1PX Bwg. p.,,,;, W. 12581
o-p.-y Type R3 z., n.,,,s iti' TW cIW. `l`'•
owmoreWIai,gOOM VALL'E eWi.:? Addrm 1460 93RU I:4 Iw, 8tA1]E
H,,;kh,,g Ad&='?: ? 1/2 RIDCE C'i.,irT ui: L,,,w;ry 1-1, B8. JC$W C.1k;: itIDiZ 4L-?
Building Official
D,k: KA" 26. ?587
POST IN A CANSPICUOUS PL4CE
FOk SAI.E UN I9'S CITY OF EAGAN
TQ?WHOUSE 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454-8100
?L
I?ILb I?G RERMIT
N2 12582
Receipt # 44-?
To be used tor 1 OF 4 PLEX Est value $48,000 Date SEPTEt1IIER 4 19 86
SiteAddress 4628 RIDGE CLIFFE UIi Erect CN Occupancy R3
Lot 4 elock 8 Sec/Sub. JOHNNY C AKF Remodel ? 2onino PD
Parcel No. RZf3GF. 4TH Repair ? Type of Const ?,..«
Addition ? No. Stories
? Name GOOD VALUE HOMES Move ? Length ?a
=
1460 93RD LN Demolish ? Depth ??
3
° Addre
City ss
III.AINEPhone 780-5510 Int Impr.
Instell ?
? Sq. Ft
o Name SAME
0 a Address
City Phone
c~i °C
W W
F W
U 0
Q W
<
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?.4? ??
A Building Permit is issued to: ?V&6k ?
all work shall ba done in accordance with all
Building
State of
Assessment
Water & Sew.
Police
Fire
Eng.
Planner
Council
BIdg.Off.9 4 86
Var. Date
Fees
Permit
Surcharge ' ??
Plan Review' p?
SAC 500.0(
Water Conn.
Water Meter? ' a?
Road Unit?? O?
Tr. PI. '
Parks
Copie . 5(
,
on the express condition that
City of Eagan Ordinances.
. PwmH No. Permit HoldK Daft TNephone M
Plumbiny ?- ) /
H.V.A.C_ ?-
17 1 d?7
Ekmtft
iSotten*r
Inspectlon Date Imp. Commenb
Foodnys 1
Footinys 11
Foundstbn
Fnminy
Roolfnq
Rouyh Piby.
Rouph Hfy. IG
Insul.
Fkaplace '
FMaI Ht9.
Final Plbp. '/9-f7 &dy. Flnal
Cert.Oce.
Dack Ffy.
Deck F?mp.
WNI
Pr. Disp.
9 .? . . . . . . . . ... i?: ,..:i?`?.7..?% . ..
r 1- PERMIT #
a•' PLUMBING PERMIT RECEIPT #
ClTY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN $5121 DATE:
CONTRACT PRICE
Site Address ! f. : = `
Lot Block
m Name
?o Addre
c City
? Name
3 Addre
O CttY +-.
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMJM - RESIDENTIAL FEE - $10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND a1,000.00)
SIGNATURE OF
FOR CITY OF EAGAN
BLDG. TYPE., . , WORK DESCRIPTIQN
,- ? l - _
Res. New `
Mult Add-on
Comm. Repair
Other
NO. FIXTURES TOTAL
?-Water Closet - $3.00 ?
I
Bath Tubs - $3.00
T
Lavatory - $3.00
! Shower - $3.00
=Kitchen Sink - $3.00 '
Urinal/Bidet - $3.00
=Laundry Tray - $3.00
I Floor Drains - $1.50 r
j Water Heater - $1.50
Whirlpool - $3.00
) Gas Piping Outlets - $1.50 ?
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
,73 Rough Openings - $1.50
' '•'
FEE `-?
STATE S/C:
GRAND TOTAL.
PERMIT # ?Z CITY OF EAGAN FEE ? S• ? U
?? MECHANICAL PERIIAIT ?-
RECEIPT # ?C?? ? 454-8100 S/C
MINIMUM RESIDENTIAL FEE - $10.00 +$.50 TOTAL
DATE ??49-- q L7 MINIMUM COMMERCIAL FEE - $20.00 + $.SO
1. Bldg. Type: Res ''`- Comm Inst 2. New Add Alter Repair
3. Totel Bid Price a"" 4. Job Address
Lot Block 8 S 5. Owner 6. Contractor'?? !r";r f jft-l
(Name) (Sheey (City) (Zfp)
7. Contractor Phone # -5-6 77
RESIDENTIAL HEATING - 01-100,000 BTU's -$24.00. Each additional 50,000 BTU's or fraction -$6.00
RESIDENTIAL COOLING - 01-24,000 BTU's -$12.00. Each additional 6,000 BTU's or fraction -$6.00
MODIFICATIONS/ALTERATIONS -$10.00 minimum fee
V HEATING VENTILATING HOT WATER STEAM AIR COND.
-AIR PIPING PROCESSED PIPING AIR HAND. EQUIP. RtFRIG.
'? RES. GAS PtPING OUTLETS -$1.50 TANFCS: LP. UNDERGROUND OTHER
COMM./IND. RATE - 1% OF TOTAL BID PRICE PLUS $.50 STATE SURCHARGE FOR EACH $1,000 OF FEE.
-
Signed: ??-?-.-•-?- ?? L--? for
? _ .
Approved Inspections: Date Rough Insp. Oate Final Insp.
lk 1 • I
fEtx#ifira#t of Mrrupanry
Citp of (lagan
loP,prar#mrtti of vwlding jwrr#tm
This Cerh'ficate issued pursuanl to the requiremenu of Section 306 ojthe Uniform Building
Code certifying that ar the time of issuance thrs srrucrure was in compliance with the various
ordinances of the City regulating building rnnslruction or use. For the foUowrng.•
ux ca.arwuon :CF 4 Pii0; s?. Rfmit No. 12582
Oc?rTyx R3 zoo;ng nisn;a Tya cooet. lhn
oWxrorswwwg :?", V_4IIlE W Addm lybO 93M LYi >•I.AIh'E
swia;ng Aaamn 629 RI;.tT, LmafityT H 9 AE? ,MftY C.?WE RM-L 4"iF
n.te: :?"' '1 f• "'`t?
Bw7diog Olficial
POST IN A CONSPICUOUS PLACE
Ft?R SALE [!nZTS CITY OF EAGAN
TChfl0.9 U. 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ?y 0
L1 2 3 4 B 8 PHOME:454-8100
dUILDNG PERMIT Receipt#
Ta be used ior 1 C1F 4 PLEX Est Value $48,000 Date SEpTEMBER 4
SiteAddress qp lp,& M '
Lot 2 Block e :
Parcel No.
W Name ? ?
; Address 1460 931
° HL7?1?U8
lCity Phone
d
OV
0<
?
f?R
Name SAM
Phone
Name
1 hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicabte State oi
Minnesota Statutes and City?gap?prdinanc?s. ?
, ?
Signature of Permittee ? ? `?-???-
A Building Permit is issued to: ?VAZM ?
all work shall be done in accordance with all applicable State of Minneso
Building Official ? i. ,? - -
4.
Erect L.l' Occupancy -?
Remodel
? ?
Zoning
Repair ? Type of Const.VO -
Addition ? No. Stories
-
Move ? ?
length
Demolish ? Depth 24
Int Impr. ? Sq. Ft
Install ?
12530
iy $6
Approvals Fees
Assessment _
Water & Sew.
Police
Fire
Planner
Council
BIdg.Off. 9 ` 06
Permit • a • V . vv
Surcharge 24•40
Plan Reviewo?
SAC •
Water Conn. • ??
Water Meter ? 0 0
Road Unit?o0
Tr. PI. •
Var. Date Copies r .SO
Total
on the express condition that
Statutes and City of Eagan Ordinances.
, Permil No. PormN HoWer Ode Telephone #
Plumbfny
Electric ?_-
Soitener
Inspectfan Date Insp. Commenb
Footlngs I
Footings 11
Foundation
Framinq
Roofiny
Rough Plbq. ,rpT ?- ?-
Rouyh Niq,
lesul. `
Fireplace
Final Htg• ?
Final Plpg•
81dy. Finat y- •97 L?. . f? . • c ? C?. ?? i,
Cert.Oca
Deek Ftq.
Deck Frmg.
Well
Pr. Disp.
_ , . • • . , ' '
PERMIT #
• , PLUMBING PERMIT RECEIPT #
CITIf OF EJ1(iAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
CONTRACT PRICE PHONE: 454-8100
Site Address
Lot -?^Block Sec/Sub -.?, ? BLDG. TYPE WORK DESCRIPTION
` 4?'Res. New "
Name Mult Add-on
? Address Comm. Repair
c City ?i PhOne' Other
T
TA
NQ. FIXTURES L
O
?
Name
Water Closet - $3
L
00
s - '
--
-
.
? Addreps Bath Tubs -$3.00
p3 Clty Phone ?vatOry
- $3.00
w
r
$3
Sh
00
e
-
.
o
? Kitchen Sink - $3.00
FEES Urinal/Bidet - $3.00
COMM/IND FEE - 196 OF CONTRACT FEE ?Laundry Tray -$3.00
f
MINIMtJM - RESIDENTIAL FEE -$10.00 Floor Drains -$1.50
MINIMUM - COMM/IND FEE - 20•00 =/yater Heater -$1.50
STATE SURCHARGE PER PERMIT - •50 Whirlpool -$3.00
(ADD $.50 S/C IF PERMIT PRICE GOES I_(`„as Piping OuUets -$1.50
BEYOND $1.000.00) Softener - $5.00
Well - $10.00
, Private Disp. - $10.00
Rough Openings - $1.50
?
SIGNATURE OF PERMITTEE FEE
SUTE S/C:
FOR CITY OF EAGAN TOTAL•
GRAND
'
PERMIT # C? 3 C° CITY OF EAGAN
MECHANICAL PERMIT
RECEIPT # 454-8100
MINIMUM RESIDENTIAL FEE - $10.00 + $•50
DATE MINIMUM COMMERCIAL FEE - $20.00 + S•SO
1. Btdg. Type: Res " Comm Inst 2. New ?Add _
3. Total Bid Price / r('4-' 'e'e- 4. Job
Lot -? Block ? Sec ,=L-
6. Contractor C??iC'
7. Contractor Phone
FEE _QS • S p
s/c . 5 U
TOTAL
Alter Repair
,c'''
5. Owner (/rx..c-cs' ??:3?,4.?
'
k.?? S• ??i?"1 !? 16
(Streeq (Ciry) (Zip)
RESIDENTIAL HEATING - 01-100,000 BTU's -$24.00. Each additional 50,000 BTU's or fraction -$6.00
RESIDENTIAL COOLING -- 01-24,000 BTU's -$12.00. Each additional 6,000 BTU's or iraction -$fi.00
MODIFICATIONS/ALTERATIONS -$10.00 minimum fee
? HEATING VENTILATING HOT WATER STEAM AIR COND.
AIR PIPING PROCESSED PIPING AIR HAND. EQUIP. Rt'FRIG.
?RES. GAS PIPING OUTLETS -$1.50 TANKS: L.P. UNDERGROUND OTHER
COMM.IIND. RATE - 1% QF TOTAL BID PRICE PLUS $.SO STATE SURCHARGE FOR EACH $1,000 OF FEE.
Signed: for
AppTOVed Inspections: Date Rough Insp. Date Final Insp.
(Etrfiftratt uf ()rruvanry
titp of (Eagari
arparhmrt[t u# swh)* Awieriinn
This Ceniftcate rssued pursuant to the requiremenu of Section 306 of the Uniform Building
Code certifying tlrat at the ltme of issuance this struciure was in compliance with tlre variaus
ordinances of rhe Cfty regulating building conrtruction or use. For the following:
U. chffi.,jo. I EJIF 4 PL: :?= e,ag. Petmi, no. I258C!
r
OocaD-Y T)'Pe Zoein6 DUuid ~TYPa Cooet_
Owoa d Buiibdiq com dl? .Ur
Addre?
eudacnS nearm 4,126 l /7. , - - Locwuty ?,L 0 ,,,
ax: ?
Building O[ficisl
POST IN A CONSPICUOUS PLACE
L BCITY OF EAGAN
?OR tSALF U:I I?'?11830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121N2 12579
TOWN l10USE PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used for 1 nIa 4 PLc.X Est Value $48,000 Date ?' •? '?I???'i}?j? F? 4 19 ?()
Site Address 4626 RI LKi L CL l FFr' UR Erect In Occupancy R3
Lot i Block A Sec/Sub. JOHNNY C AKE Remodel ? Zoning J?1)
ParcelNo. RIDGE 4T H Repair ? TypeofConst Vn
Addition ? No. Stories
°C Neme GOOD VALUE FfO:'ES Move ? Length 44
409RD N Demolish ? Depth 24
; Address ? t
a S ?
, ?. Impr. Sq. F
?
City I
ya
'Phone I 'Install ?
o Name SAP1E APPr?als
=
ou
-c Addreas
Assessment
~ City Phone Water 8 Sew.
? Police
? W Name
= Fire
E
Address
u
En
g W Ciry Phone Planner
Council
I hereby acknowledge that I have read this application and state that the Bldg. O
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of_Ea,gan Ordinances. APC
Var. Date
Signature of Permittee
GOOD VALUE EioX:
Permit "'F & ' ~ • ""
Surcharge ' A
Plan Reviewo
SAC : ?4
Water Conn. 5uo Water Meter?- a?
Road Unit?.?
Tr. PI.
Parks
Copies
. 0 019.-150
A Building Permit is issued to: on the express Condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Of(icial
PermM No. P?mdt HWdw DNe TNophons N
Ptumbiny
H.KA.C.
Elictric
SoflMer
IiupscUon DaM Insp. Communb
Footlnps I
Foorinys II
Foundst{on
Fnmfny /r
Rodfnp
Rouyh Plby f -a - -
Rouqh Ht9. . ??
IMUI.
Firoplacv
Flnal Ntq.
Flnal Plbq.
Bldy. FInN
cod. occ.
Dock Ftg.
Deck Fimp.
WNI
Pr. Dbp.
. ,., , ; . .
s ' Y • PERMIT #
PLUMBING PERMIT RECEIPT #
CITY OF EACiAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE -
Site Address ' 4=? =" `"
Lot ? Block
m Name -
9 Address.
.
c Ciiy - ' '
? Name -
3 Addregs
.
,
0 . V
Cityf
Phone
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - $10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $50 S!C IF PERMIT PRICE GOES
BEYOND $1,004.00)
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
BLDG. TYPE • WORK DESCRIPTION
Res. New -
Mult Add-on
Comm. Repair
Other
NO. FIXTURES TOTAL
I Water Closet - $3.00
= t
Bath Tubs - $3.00
I Lavatory - $3.00
-
L Shower - $3.00
/ Kftchen Sink - $3.00
Urinal/Bidet - $3.00
?Laundry Tray - $3.00 -
?Floor Drains - $1.50 `
Water Heater - $1.50
Whirlpool - $3.00
I Gas Piping Outlets - $1.50
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
=
Rough Openings - $1.50
FEE ?
-
STATE S/C: -
GRAND TOTAL: ,. _
' `"
PERMIT # ??012 CITY OF EAGAN FEE
G MECHANICAL PERMIT
RECEIPT # 454-8100 S?C " ' {1
/ MINiMUM RESIDENTIAL FEE - $70.00 + $.50 TOTAL ?? • DU
DATE MINIMUM COMMERCIAL FEE - S20.00 + $.50
1. Bldg. Type: Res Y"' Comm Inst 2. New }'- Add Alter Repair
3. Total Bid Price 4. Job Address ??? / 6' /, Di
Lot Block Sec 5. Owner <-
6. Contractor /; !n,c' C14,; ,??•- ? `?- G?g
(Name) (Streeq (City) (Zip)
7. Contractor Phone # ' "1 5 e -7 7
RESIDENTIAL HEATING - 01-100,000 BTU's -$24.00. Each additional 50,000 BTU's or naction -$6.00
RESIDENTIAL COOLING - 01-24,000 BTU's -$12.00. Each additional 6,000 BTU's or fraction -$6.00
MODIFICATIONS/ALTERATIONS -$10.00 minimum fee
i"
? HEATING VENTILATING HOT WATER STEAM AIR COND.
AIR PIPING PROCESSED PIPING AIR HAND. EQUIP. RtFRIG.
RES. GAS PIPING OUTIETS -$1.50 TANKS: LP. UNDERGROUND OTHER
COMM.IIND. RATE - 196 OF TOTAL BID PRICE PLUS $•SO STATE SURCHARGE FOR EACH $1,000 OF FEE.
, r
Signed: for ? X ?---
Approved Inspections: Date Rough Insp. Date Final Insp.
%62 ..._
2
(Itrti#trafp uf (Orrupanry
titp of (Eagan
?rVwrzmptt# of liuilbtng JMWrrtinn
This Certificale issued pursuant to the requirenrents of Secdon 306 of 1he Uniform Building
Cvde certifying thar at the time of issuance this structure Kas in cornpliance with the various
ordinances of the City regulating 6uilding construction or use. For the jollowing.u: ciassifinfim I OF 4 Pt.F:X siaa. e?t No
oocup.ncy rype I? ? 7uning pistria pTi 1m Caast. V n
Owntt of Buildi?'1!1 y? i ?? . L? t? ?; ti • . i. ?? 14 ?{ - N
gw'fdin6 pddress M; I.ocalily H2 ? J 1
?Au_r:ti 13. 1987
s?uai? o?;.l
- -
POST IN A CONSPICUOUS PLACE
f
? CITY OF EAGAN SEWER SLWICE PERMIT
, 3830 Pilot Knob Road
? P. O. Box 21199 PERMIT NO.: ,`
Eagan, MN 55M21 D^TE: - '
Zoning: ' - ? No. of Un1ts: -
?
QWMr.
AddrE55:
Site /?ddr
Plumber:
1 prN to ooR"ip wil6 60 Cky ef lpsw
OrAinsnsN.
ey
Date of Insp.:
I nap,:
?
Connsction Charpr _
Acoount DepoWt:
Permit Fw:
Surciwrps:
Mitt. Chorpas:
To*ai:
Date Pald:
CITY OF EAGAN YVATER SERVICE PERMR
3830 Pilot Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE: '
za+inD: - No. of Units: '
O+rner, i;oDC Lalne ;IomeS
Addr+ess:
Sn. I?ddrosr. 46281=, Ri„ce c;Iiff•::
Pfumber. c.ice3.sou P1 up.5 ! tt-
Nktar No.: Connactlon Chorye: - '`?? •
Siu: AoooUnt Deposit:
Reoder No.: Permit Fee: t'? n•, a
I yne ts aowpy wuh dw Qry of Ei"¦ Surcharpe: •On"
Owtmaaa Mise. Chorgss: ? ` . + `^ ^d TY
Total:
BY Date Paid:
Date of Insp.: Irnp.:
-
ITY OF EAGAN
3830 Pilot Knob Road 1IVATER SERVICE p?IT
P. O. 3ok '21199 PERMIT NO • l'.
?agan, MN 551.21
A?1TE:
i?? No. of Unlts:
1?
, sn?. ?ea.ess: ?.?.dge ctif f,_ r_r iV P ..
Plumber, fcl;elsora Pl.um1bi.ri^ .. .
?
Meter No.: _
Size: ry' ?c?ef ..?:?a ? :
Reoder No.: a O C?? vap°aw'' '. ?
e ore 1 ??
? .n?.e to eo?vh +.kw +w. c?.LE - t?CF
By - :G'aC7
Qote of Insp.:
ps*4„j8&yv F 5:, . oopa Tt
rotol:
Dete Poid:
1
CITY OF EAGAN
3830 Pilat Knob Road
P. O. Box 21199 PERMIT NO.: `
u ..: .
Eagan, MN 55121 OAT'E
Zoninp: No. of Units:
OwnaT: . <.O? VBILP ??p;t:ES
Address:
Site Add
Plumber.
I .pm co , fig? wIN eM8 ae, of [.,..
Oriweaeas.
By
Date of Inap.:
CITY OF EAGAN
3830 Pibt Knob Road
P. O. Box 21189
Eagan, MN 55121
Zoninp: -
Owner: ''"=c'. Address:
Sfte Addrcss: 46281,
Plumber.
Mster No.:
Sis¦•
Reoder No..
1 pm lo omoly wM6 t4 Ciyr of Ewa
OrAw"eM.
Bv
Date of Insp.:
Connectfon Chorps: -20.00D;!
Acc0urrt Deposlt: 002,?
Pertnit Fee: nr;p1
Surr:ftorye:
Mtsc. CMrpes: 'r
Totol:
Dote Pbid:
-
cITY OF EAGAN
3830 Pifot Knob Road WATER SERVICE PERIIAIT
P. O. 3ok 71 199 PERMIT Np.:
Eagan, MN 55121
AATE:
Zoninp: No. of Untts: ` , .
Dwner: _ ._ . :u:.:..
•L??_ •
$ib Addrm: 4 b1tS',' it j.ilg@ Cl if f e ?`r j?rr
d
Plumber ??ickelsor? Tohnrv ('k P
Plt?i. iiic.
AMter No.:
$IZQ: rr G,?'A^ a'101?; S v Ll . o?1
?de. No.: o 70 ae tC?'?I 15 .,)npd
?.o"N ee oa.Ph? •?11i tiw C?.? l??['f.ei?S_Eic
?u.--- - urchome:_ ? . . . ir)nd
By ? ? 7l Totol:
p,ata Poid:
Dote of Irisp.:
'Z ? 7 -??
Con?,.elon a,a.ge:
Account Deposft:
PlfRlit FN: - -? :';t1Y}C!
5uxhome; %JT`
Miac. Chorces:
Totol:
Date Pnid:
WATER SERYICE PERMIT
PERAAIT NO.:
DAl'E:
No, of Units: '''' ? =
CITY OF EAGAN SEWE fERVX1 PLVR
3830 Pilot Knob Rosd
P. O. Box 21109 PERMIT NO.:
Eagan, MN 55121
DATE: . ,r
Zoninp: ? No. of Units:
Owner r<)od ualu8 'lom°s
? Add?ess:
Sib Addross:
? Plumber:
100,00P<;
tapw b?ewPhr wkb !M Ci!/ ef fysw Ca+rnction C7+aMM: ?'? :;(1pj
; OftMMoM AcooLn+t Depodt:
PormR Fee:
SurC110r'pe: . .. z
.
By Misc. G+oryss:
Dote of Insp.: Totol:
Inap.: DaM Poid:
OF EAGAN
Pil
K
b R WATER SERVICE PERMIT
ot
no
oad
Box 21139 PERMIT NO.:
i, MN 55121 DATE:
o? No. of Unrrs:
CCO.1 ' . cC-
Addrcss:
No..
No.:
te aow?pli wilh s. Clty rf bve
e IA B,!
Connectian Qwrpe:
Acoount Depos(t:
Permit Fee:
Surcharge: - - i T
AMfC. C}fOrQlt: . . '}<
TOrOI: __
DoM Paid:
ITY OF EAGAN WATER SERVICE PHtMR
Piloi "nob Rosd
. O. Box 21199 PERMIT NO.:
sgan, MN 55121 DATE:
^0:
::oo
a ue No. of Units: "
.
omes
r.
ress:
Addross: ' ` ge , < , T; r:.?,
_P SOr
r.
r No.:
?
ze:
r ?No.: ???_? ??r9'??Q? ' t ? ? f
-
' ,?-
Nm to el'i W" sftRa??.
?
Husc. a,or,a..:
Total:
DaM Poid:
of insp.: Insp,;
a-1-7 -f?
CITY OF EAGAN SEVVER SIMVlCE PERMR
3830 Pilot K nob Road pERM1T NO.: :
P. O. Box 2'1199 DATE:
Eagan, MN 55121 No. of Un1is:
Zor?InO: r-- . t
pwnoor.
Address:
Sih /lddress:
Plumber. -
1 Mme fo es If Vd& 1V C*1 04 SaMo
OraN110M?
ey -
Dote of InsD.:
QnnsCNOn Qharw: ?- S ^ (?n4 -
Ncoount aPaidt:
PfRflIt FN:
SYfChO('Qe: ? ? -
Misc. Chorpm -??'-
Totol:
paft Paid:
Box 2,199 PERMIT NO.:
i, MN 55121 DATE: r ?
No. of Uniri:
, G00.? Value 'c,; ,c
?-CITY.OF EAGAN ?U sefvtm r[mR
ribt Knob Road
? P. O. Box 21199 PERMiT NO.:
' Eagan, MN 55121 ? oATk -- 9-8-86
?ing' 3 No. of Unih: - 4 -,Lex
Ownsr: uood Vslu_ _e_Hoa•,et8
/lddress: • '-
Site Address: u r? 63 c?
PIunkbe?: L1?30rz Plumhina
J- wMl? M rC?? 1 ' ta, 100. QOpd
I
1
iWl CIpl?l: 675. L:d
$Efore digging call I?}t ?:
TEEEPKONE • ` n?Td
EIECTRIfin??DC• '
s :? ,??•wr
RED
Sa?d ,
BDoro of' 1
^*' Totol:
? ?" Dotr Poid:
CIT'" OF EAGAN
3830 Pilot Knob Road
P. O. Box 21195
Eagsn, MN 55121
Zanlnp: '3
pwner; Good VE
/lddress:
Site /lddren: } . s
Plun'fber -'^-?
AAebr No.:
Sixe; '1 oc4
Reada No.: 2; i
I Nm M eop* wo 16
rive Lz Bts Johnny ,. -,+ h
- •' P
tU • P
? p meter
' ?f/tJ u1?~ Totol: ?.....,,_•. .
By Dah Puid:
Date of Irqp.: Irup.:
WATER SERVICE PERMIT
PERMIT NO.: '
L"ATE: ' ' - -
No. of Units: -plex
CITY OF EAGAN
j 3830 Pilot Knob Road
? P. O. Box 21199
Eagan, MN 55121
Zoninp:
OwrNr. .%uoc: V
/lddress:
Site Addrosa: 4
' Plwnbsr:
No..
M 0010* allh 1M Gtp ef hgan
I Nm M 00vib Mikb IM Cky of MMo
ordlMnCe/.
! BY
? Dote of Inap.:
CITY OF EAGAN WATER SERVICE PERMIT
? 3830 {°ilot Knob Road ' -
P. O. Boz 21199 PERMIT NO.: •
Eagan, MN 55121 p^TE:
Zoninp: No. of Units:
? Owrwr,
Address:
$ih Addren:
CITY OF EAGAN
3830 Pibt Knob Road
P. O. Box 21199
Eagan, MN 541,21
Zonirg:
Owner:
/1Qdross:
51te /?ddress:
Plutnber. .• _._S
AAsftr No.: _3 7
Slze:
Reo r
1 agrN h emphr whh !1e
Total: ?°j.?IIpc'. ,''er
BY DaM Paid:
QaM of Insp.: Inap.:
SFWER SBtVlCE PERINIT
PERMIT NO.:
DATE:
No. of Unfts:
Dt
?..;t' ?17 ..4
CO/1r1eCti01 0101gfC
AOOOt111t Depodt:
Pemrit FN:
Surehor": - ':' -
11Aisc. ChonOm
Total:
Dote Paid:
Connsction Charye: 'iJ0.40r6
AcaouM Deposir:
Permit Fee:
Surchcrps:
MiiC. Ch0/gfi: 'f'i)
Totol: •? 5 ?
Date Pbid:
WATER SERVICE PERIIAIT
PERMIT NO.:
D/1TE:
_ No. of Units:
111-?1Y7 REQUEST FOR ELECTRICAL INSPECTION klft EB-00001-05
? Sea insLUelions lor completing this fwm on Eeck ot vellow co0v, ?91f7/
ir ?Z Q Qr? Q - "X" Qe/ow Work Covered by lhis Request
6JFlM.Rau.1 Tvoe of Builtlina I AGDliances Wired I EquiVment Wired I
Air
loader
p Fae icaEnbenceSize i ee Faeders/5ubieedars N Fae Ci?cuits
200 qm s 0 to 30 Am s 0 tn 30 qn?
tAb
ove
200
Amps 31 to 100 Amps 37 to 100 q y
nxning Pool Above 100-Am s Above 100_Am -
nS
rmers
fo rngation Booms art
ial.'Other Fee
I ' I $igng ' I _'Speclal InSPection }
Nemarks . t ?TOTAL
°°d••-^' //? u/R/1 A/C.LtJ - I. the ElecVi7'S1
(l / ?•?_ ? - ?•_ I, 117l insaecbr. he.eby
cerlilV thet the xbove
Fnal ^ p-y?? 1e . S insoection hes baen
I ?rr'?.?.! / / • ? meao.
repuest
This rxquasl wid (p 9 -Y`J/
18 months from
68953
G?f
,
,
Henuestbate I
!?
g ire Na. [NOUBh-in Inspec[ion "?Raatly Nuw
e mreA? lyw ?..,`?
ill Noiifv laspec•
-? q-
? Yes ?No Ttor When Peady
? Litiensed Electrical Caurxctor I herabV repuest inapaction ot ebova
? Owner elec/rical work instelled al:
Sireet Atldress, eo?ROUt No.
etuon o. Township Name o No. Nanee No. ounty
?
Oc uoant IWiINTI ? Phone No.
Powe
uppli ? ?
Atltlress
Ela ricalnConuaclar (CO?mpany Name ? ConOctor's Lice No.
Mailinp Atldress (COntraclor Owner
)
?
? ?-- 3
A orizetl Signxture IConvactor Owner Making InsW Ilationl Ph ne Number
qA
W
MINNESOTA STATE e ARD OF ELECTRICITY T„I5 INSPECTION PEQUEST WILL NOT
Grippa-Mitlwey Bldg• - Room N-781 BE ACCEPTED eY THE STATE BOAHD
UNLESS PNOPER INSPECTION FEE IS
1821 Univsreitv Ave., SL Veul. MN 66104
Phonaf6121642-0800 ENCLOSED.
7 HEQUEST FOR ELECTRICAL INSPECTION kok EB-00007-05
? See instruelians for comolelirq this lorm on back of Yellow eopy. & yn a?/ llkw Ir'r_ Q pr, 7 ,',{':.Below Work Covered by This Request IflewAAAdj Reo.1 Tyoe ol Builtling I ADVliancea Wired ? Equipmant Wirad ?
Heater
IOAdPr
Ik Tnnk
N fee ServiceEntrenceSize p Fee Feedera/Subleetlera N Fea ?Circuits
U to 200 Am s 0 to 30 Am s 0 tn 30 Am s
Above 200 qm ms 31 to 100 qmps ,110 10 122Amps
31
Swimmin Pool Above 100_Am s b
Aove 100_Amps
Transformers Irrigation Booms PartiaL'Other Fee
? I I Signs I I ISpeciallnspection 'S` -
Bamarks ?
the El?heral
? ?•// / Inspeclor, eby
e certifV ??et the ebove
Final ^ ? q Date inspection haa bean
./ .CI I.4 2 -,/; meAe.
This request void
18 months Irom
Cio8952
4,9 8>i
[]Neatly Nuw?Will Notity.InsOec-
? ? a' ?? ??es ?No 'or When NeadV
C] Licensed Elecvical Convactor 1 hareby request inapaction of ebove
? Owuer • elactrical work instelled ac
Straet Atldress, Box or Route No. CitY
ia
ectIon o. Township Name or No. Range Countv
lc? C /;t'-
Occ nl (PflINT) Phone No.
?
Powar Supplier Address
tracmr (GOmpany N el
EI hical Co
n ontt ctor'S Licen No.
/
? (?
t-c
Mailin Address (COmractor or O?w/9-?er
1 Cl Making Instailation)
3
L
J
Au riz Si9nature (ContracmdOwner Making Installaiionl Phone NumEer
SbQ-.s'
MINNESOTA STATE BOARO OF ELECTRICITY l THIS INSPECTION PEQUEST WILI NOT
Orippa-MiAway Bldp. - Room N-191 BE ACCEPTEO 8Y THE STATE BOARD
UNLESS PNOPEP INSPECTION FEE IS
1821 Univeraifv Ave.. St. Peul. MN 66104
Phone16121642-OBOO ENCLOSED.
2?$7 REQUEST FOR EIECTHICAL INSPECTION Ee-00007-05
? See instruc;ions tor compbtim this fprm on beck oi vellow copy.
? C O n C 9 -"X'-de/ow Work Covered by This Request
Mew{AAdlReo.I Type of Builtling J ApDli..cea „'ired I Equipment Wired I
CE
p Fee rviceEntmnw5ixe p Fee Fenders/Svbieedere p ff? Circuits
to 200 qm s 0 to 30 Am s ? 0 tn 30 Ani s
Above 2 0 qmps 31 to 700 Amps / 31to 700 A
Swinmin Pool Above 100_Amps . Above 100_P.m s
Transformers rngation Boorcis Partial,bther Fee
L' I$igns I I 15peciallnspeclion
- tft TOTAL •?i
Nertarks J
°Od"-'°
//sC ? ^ /^ 7 ? I Inapecb?, hereby
a.?
^ Dxte cartily that the ebove
Finel ? P . ?dection has bean
?S /?a
This ruQUest void 111,?7
78 rtwnths trom
C 68951/-i,
Cc987/
Ay7?) o
Repuest Date Fire No. !] Rough-in Insvedio
equiretl7
?Heady Nuw
ill No?ify. InsPec-
?
t ?? - ?es ?NO br When qeatly
? Licensed ElecVical Con[ractor , 1 herebV request inaDeclion of above
? Owner electrical work instelletl et:
Sueet Address, 6ox or Route No.
\
-.Wl
\
wr
ecuon o. iown5hi0 Name or o. Range o. County
Occupant(PfliNT) Phone No.
Po 5 VP??er Atldre ss
Ele ical Can[ractor (COmpanv a Con[ra?yoLicen No,
arj
/
Ma nB res5 ICon ra or r Owne Maki B
y
o?n - stailation
?J
55 4 3
Aut rizetl ignature (COntractor/Owner akinq Installation) one Number
^ (..1GOt
MINNESOTA STATE BOAflU OF EIECTRICITY ? THIS INSPECTION PEQVEST WILI NOT
6ripas•Midwev BId9. - Aoom N-197 BE ACCEPTED BY THE STATE BOAND
UNtESS PNOGEfl INSPECTION FEE IS
1821 UniversitvAve.. St. Peul. MN 65704
Phone 16121 642-0800 ENCLOSED.
i i2 b'7 REQUEST FOR ELECTRICAL INSPECTION EB-00001-05
c? 987/
See instrae[ions (or tom01¢tifq this form on back of vellow copy.
?= G O 0 C A ?X" Baiow Work Covered by This Request '
FIrA4AAI Reo.l Tvoe nf 9uileina 1 Aooliancea WireE 1 Equiument Wired 1
ex
Ce
Ik
p iee Service EnVenceSixa p Fae Faedem/5ub(eaders p Fee Circuits
to 200 qm s 0 to 30 Am s 0 to 30 Am
Above 200 qmps 31 to 100 Amps 31 to 100 AMPS
Swirmmin Pool Above 700-Am s Above 100_Am s
Transiortners Irrigation Boorris Partial.'Other Fee
SignS ISpeciailnspection ?
? OTAL FEE
_ ...
I ?..(_(7 I, the Elechica
?Q 0 InsPector, hereby
certilv [het the above
Final ^1e .y7 inspection has been
meda.
mle repuest roltl 18
This request void 114'L/a"7
18 months fmm
C'6r4l 954? 3
G 9 d'7/
9i/N r
_ ... ..____._..
retl? ? ?Ready Now Will Notify InsOec-
'e ui
1'es No. lor When ReadY
? Ucensed ElecVical Contractor ' i hereby repuasf inspection oi above
? Owner % elecirical work installed at
Stree Address, Bo or Route No.
q City
.
ec110n a. Townshio Name or No. urw o. Coun y
Occo nt (PpINTI Phone Na.
Po PO??er
V `J .4ddress
Elect! I Comramor (Companv Namel ? Co,?+crz?or's Licen No.
?J?%
Mailin Ad s
90 s (CO-v r or OwVr Mang Instailationl
? ?tl
A or zd Sipnamre (COnt ctor Owner Maki e Installation) Phone Numb r ? ?
` THIS INSPECTION FEQUEST WILL NOT
MINNESOTA STATE BOAR OF ELECTRICITY
Grippe-Midwey 81dg. - Noom N•191 sE ACCEPTED BV THE STATE BOANO
UNLESS PqOPER INSPECTION FEE IS
1837 Univeraitv Ave.. SL Veul. MN 56104
Phonel8121842-OBOO ENCLOSED.
FOR SALE UNITS
TOWNHOUSE 3830 Pilot Knob Ro d'; .Q Bbx 21-199, Eagan, MN 55121N2 12581
L' 1, 2, 3, 4 B 8 PHONE: 454-8700
BUILDING PERMIT Receiptp
7obeuseator 1 OF 4 PLEX Est.vaiue $48,000 pate SEPTEMBER 4 ,1986
SiteAddress 4628 1/2 RIDGE CLIFFE DR
Lot 3 elock $ Sec/Sub. JOHNNY CAKE
Parcal No. RIDGE 4TH
$ Name GOOD VALUE HOMES
; Address 1460 93RD LN
° Ciry BLAINE phone 780-5510
= o Name SAME
? ¢ Address
Ciry Phone
a
? W Name
? p Address
a W Cily Phone
I hereby acknowiedge 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 Citya?n Ordinances.
Signature of Permittee
A Building Permit is issued to: GOOD VALUE HOM S
all work shell be done in accordance with all a icable Staie ?fJliTm?so
Building Official A.?A ??? -
Erect ? Occupancy R3
Remodel ? Zoning PD
Repair ? Type of Const yII
Addition ? No. Stories
Move 13 Length 44
Demolish ? Depth?d
Int. Impr. ? Sq. Ft
Insiall ?
Approvals Fees
Assessment _
Water & Sew.
Police _
Fire
Eng.
Planner
Council
Bldg. Off. 914186
APC
Var.
Permit $ 274.00
Surcharge 24.00
PlanReview 137.00
SAC 575.00
Water Conn. 500.00
Water Meter 63 . 50
I
, Road Unit 290.00
j Tr. PI. 156 . 00
Parks
Copies
-
Tninl $2 ,019
.50
on the express condition that
and CiTy of Eagan Ordinances.
FOR SALE UNITS CITY OF EAGAN A1p p
TOWNHOUSE 3630 Pilot Knob Road, P.O. Box 27-199, Eagan, MN 55121'Y 125o2
L 1, 2, 3, 4 B 8 PHONE: 454-8100
BUILDING PERMIT Receiptp 3?l/I
Tobeusedfor 1 OF 4 PLEX Est.vaiue $48.000 Date SEPTEMBER 4 iy $6
SiteAtldress 4628 RIDGE CLIFFE DR Erect C* Occupancy R3
Lot 4 siock $ Sec/Sub. JOHNNY CAKE
Parcel No. RIDGE 4TH
Name GOOD VALUE HOMES
nddress 1460 93RD LN
Ciry BLAINEphone 780-5510
i o I Name SAME
? a Address
? City Phone
? W
hW
?u
a
Wz
<
Aemodel ? Zoning Pn
Repair ? Type oi Const.?„??
Addition ? No. Stories
Move ? Length 44
Demolish ? Depth 24
Int. Impr. ? Sq. FL
Install ?
Approvals Feea
Assessment_
Water 8 Sew.
Police _
Name Fire
Address
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 Ci' f Ea Ordina e' s. . i?
Signature of Permitte
?
A Building Permit is issued to: GOOD VALUE HOMES
all work shall be done in accordance with all applicqyle State of Minwo
Eng.
Planner
Council
eldg. on. 9 4 86
APC
Permit ? 274.01
Swcharg?? oi
Plan Review?? 0 1
SAC 575.01
Water Conn. 500.01
WaterMeter 63.51
Road Unit 290.01
Tr.PI. 156.01
Parks
Var. Date I Copi
Tnfol $2IVL9•
on the express condition that
and Ciry of Eagan Ordinances.
Building OKcial
FOR SALE UNITS CITY OF EAGAN
TOWNHOUSE
N2
12580
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
L 1, 2, 3, 4 B 8 PHONE: 454-8100
BUILDING PERMIT 1.1 - 0 Rece iptp
7obeusedlor 1 OF 4 PLEX Est.value $48,000 Date SEPTEMBER 4 19 86
SiteAddress 4626 1/2 RIDGE CLIFFE DR Erect C? Occupancy R3
Lot 2 Block 8 Sec/Sub. JOHNNY CAKE Femodel ? 2oning D
RIDGE 4TH Repair ? Type ot Const. Vn
Parcel No. Addition ? No. Stoiies
w
Name GOOD VALUE HOMES
Move
? 44
Length
Demolish ? Depth ?a
3 Adtlress 1460 93RD LN N Int. Impr. ? Sq. Ft
° city BLAINE phone 780-5510 Install ?
o I Name SAME
Address
? Ciry Phone
F w Name
? a Address
i W Ciry Phone
I here6y 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 9 rdina?.
Signature of Permittee
GOOD VALUE HOMES
Assessment I Permit
Water R Sew.
Police _
Fire
Eng.
Planner_
Council _
Bldg. Ofl.-U
APC
Var. Date-
Surcharge 24.00
Plan Review 137 . 00
SnC 575.00
Water Conn. 5 0 0. 0 0
Water Meter 63 . 50
Road Unit 290.00
Tr. PI. 156.00
Copies
7otal $2,019.50
A Building Permit is issued to: on the express condition that
all work shall be done in accordance with all applica State of Min eso Statutes and City of Eagan Ordinances.
8uilding Official ? ? -??
L 1, 2, 3, 4 B 8 CITY OF EAGAN
FOR SALE UNIT
?830 Pilot Knob3iDad, P.O. Box 21-199, Eagan, MN 55121 2 12579
-TOWNHOUSE PHONE: 454-8100
? A?'?
BUILDING PERMIT Feceipt# (e(
Tobeusedfor 1 OF 4 PLEX Est.Value $48,000 Date SEPTEM$ER 4 19 86
SiteAddress 4626 RIDGE CLIFFE DR
Lot 1 Block 8 Sec/Sub. JOHNNY CAKE
Parcel No. RIDGE 4TH
Q Name GOOD VALUE HOMES
o Address 1460 93RD LN N
Ciry BLAINEphone 780-5510
o Name SAME
=
0 a Address
? City Phone
.?
F w
Name
? Address
0
a W Ciry 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 Ci aOrdi?
Si9nature oi Permittea
A Building Permit is issued to: GOOD VALUE HOMES
all work shall be done in accordance with all aoolicableStatdbf Minnesc
Erect n Occupancy R3
Remodel ? Zoning pn
Repair ? Type of Const VB
Addition ? No. Stories
Move El Length 44
Demolish ? Depth 24
Inl Impc ? Sq. Ft.
Install ?
Approvah Feea
Assessment Permit $ 274.00
water & Sew.
Police Surcharge
Plan Review 24.00
137.00
Fire SAC 575.00
Eng. WaterConn. 500.00
Planner Water Meter 63.50
Council Road Unit 290. 00
eid9. ott. 9/4/86 Tr. PI. 156.00
APC Parks
Var. Date Copies
rotal $2 .019.50
on the
r diti
th
tutq a?d City oi Ea9an exp
ess con
on
at
Ordinances.
Building Official
COMMERCIAL
5 p 17 3 2002 BUILDING PERMIT APPLICATION
CITY OF EAGAN
651-681-4675
1(3 7s
Foundation Onl New Construction Interior Im rovement
• Structural Plans (2) sets • Archilectural Plans (2) sets • Architectural Plans (2) sets
• Civil Plans (2) . StruGural Plans (2) • Code Analysis (1) "
• CertificateofSurvey (1) . CivilPlans (2) • Projed5pecs (1)
• CodeAnalysis (1)" . LandsqpingPlans (2) • KeyPlan (1)
• PmjectSpecs (1) . CodeAnatysis (1) • Master Exit Plan (1)
• Spec.lnsp.&TestlngSchedule" . CertifirateofSurvey (1) • EnergyCalculations (t)notalways"
• Soils Report (1) . Spec. Insp. & Testing Schedule (1) " • Elec. Power & Lighting Form (1) not always"
• Meter size must be established . Meter size must be established • Meter size must 6e established - if applirable
• ProjectSpecs (t)
1 • EnergyCalculatlons (1) ° l
1
1 •
• ElecUic Power & Lighting Form
Master Exit Plan (1)
(t)
!
•
Fire Protection Plan
(1)" F
(, ) D
2DO2
• MC/ES SAC determination letter • MC/ES SAC determination letter • MGES SA r? r??o?ellEr
call 651-602-1000 cali 651-602-1000 ra11651-60 0
" Contact Building Inspections for sample ? I
Food & beverage or lodging facilities - submit plan to MN Department of Health. Call 651-215-0700 ?etails.
DATE: ' O U WORK TYPE: NEW REMODEL CONSTRUCTION COST: ?? S U U u
SITEADDRESS:" 4&q0 1b. Qa6. UU&In1 ?kda. 1 U Q JMW? ?M IC ,
TENANT
FORMER TENANT NAME,
DESCRIPTION OF WORK
SUITE
0??Q, SC y At,
Phone #: ( Q)l d? )(?J!6 - IWYJ
PROPERTY Last J U First
OWNER iw ? _ . %.. . .__ t -
CONTRACTOR
ARCHITECT/
ENGINEER
StreetAddress:IX01(11A11, K,A Ytp
?
City: N(,?C1 State: ?}? ( ? IIV) Zip: c.?
Company: WL
Street Address:
City; &-f
Company: _
Name:
Street Address:
City:
Licensed plumber installing new sewer/water
Phone #: WaL-) b!k _QQl qo
State: _ .9 V Zip: & 11 I
Phone #: (
Regishation #: _
State: Zip:
Phone #:
I hereby acknowledge that I have read this application, state that the information is correct, a agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances. ? ,/•-
Signature of Applicant: ?l?
/ '-'o? (=-;"n arp- Updated 1102
OFFICE USE ONLY
SUBTYPE
? 01 Foundation ? 26 Public Facility ? 30 Accessory Bldg.
? 14 Apartments ? 27 Commercialllndustri al 0 32 Ext Alt - Apts.
? 15 Lodging ? 28 Greenhouse ? 34 Ext Alt - Comm.
? 25 Miscellaneous ? 29 Antennae ? 35 Ext Alt - PF
? 37 Nail Salon
WORK TYPE
? 31 New ? 35 Tenant Impr ? 42 Demolish ( Foundation) ? 46 Windows/Doars
? 32 Addi6on ? 36 Move Bldg 0 43 Reroof ? 47 Repair
? 33 Alterations ? 37 Demolish (Bldg) ? 44 Siding ? 48 Authorization
? 34 Replacement ? 38 Demolish (Int) ? 45 Fire Repair
GENERAL INFORMATION
Census Code Zoning sq. ft.
SAC Code - - ? # of Stories sq. ft.
No. of Units Length sq. ft.
No. of Bldgs. Width sq. 8. .,•.
Const. (Actual) Basement sq. ft. MCIES System "
(Allowable) First F1ooYisq. ftr '_ , • ' • ' ? •! City Watef •
,
UBC Occupancy sq. ft'.- ?_ . • . ?': ? < < ; Fire Sprinklered
. . ? ! , ?'' ?''F'?-, f.' ', 'f? ;'. .. ..? ?•,r?
MISCELLANEOUS INSPECTIONS ` '? ' ' '' ' ' ' • k- ? ` ' ?' ` '" " ?
? Gas Service Test ? Heating ? Insulation 0 Plumbing ? Stucco/Stone
APPROVALS ! ,
Plannink • ? _ • ? 'Building- r . ? En,gineering' "• ? ? ? • ; • Vari ee'
• •" ' . . .. • _..l _ ?:; , a? ? _?. , .
Permit Fee
Surcharge • ' ? ? ?
Plan Review
MC/ES SA-6 ; ?' •' :,•' ' ' '
City SAC Water Supply & Storag.e,, '
S/W Permit '
S/W Surcharge
Treatment Plant
Park Dedication
Trails Dedication
Water Quality
Other
Copies
VAL6A7'IOW - *' "- I ' -,'
•?- ? : 1
%SAC
SAC Units ?. ".;. _ • . "
Meter Size
`-; . .
Total
CERTIFICA TE Of' SURVEY
fp'' GOOD VALUE HOMES
V?
\\
/ O
? 6v`Lots 1 through 4, inclusive, Block 8, JOHNNY CAKE RIDGE FOURTH ADDITION, Dakota County,
Minnesota.
?
.?
I C944•a)
C944?)
LE6E'M7 R^qowi0 /bwe £J&vstlonr Scal• 1' • AQ?
XX%.Y Mnotn Ex1st1np EUntfon
B.M. eL ,il%?
Sa('
Wf%.X) Mnotu PrODaseC Elevstion Top Of FOUndatlon /„}e,,,.*;e„ eC P?..kW. W.y
o Danotes lron Monusent Garapa F:oor 444•? If : 4aa.jf.
O Mnotes Yootlen StAke BssOwnt F1o0r - WW? hiCgVD 9,T
-4-? OoIfONs SUI'NCe Of`a1Oi0e
I HERE9Y CERTIFY THA7 T HIS SURVEY. PLAN. OR REPORT MAS PREPAREO BY ME OR UNDEii MY
DIRECT SUPERVSSION ANO THAT I AM A DULY HEGISTEFiEU LANO SURVEYOfi UNOER TME LAMS Oi
THE S?ATE OF MINNESOTA.
" Dated th1s 3td day ot SeP'? , 38 8c- C.R. MINDEN C ASSOCINTES,. INC.
dDOk_ C.R. WINDEN 6 ASSOCIATES; INC..
Land Planning, Surveya 6 Site Desiyn
1381 Eu9ti9 St., St. Peul, MN $6108
Tel. 845-3848
Mfnnesota Repietrstion No. 79 2 L
y
1986 BIIILDING PBRIiIT APPLICATION - CITY OF EAGAN
BOYB: ALL CANTRACTOES MOST BE LICfiNSBD {iITH THE CITY OF EAGAN
SIlTGLE FAlQLY DWELLIIOGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
MOLTIPLE DfiE[,LINGS - RESIDENTIAL
INCLUDE 2 SETS OF PLANS, CER
1 SET OF ENEAGY CALCULATIONS
COMMEHr-tnL
REdTAL DNITS FOR S9LE OHITS
OF SQR9EY - CHBCB WITH BLDG. DEPT.,
ZNCLIIDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Osed For: ZeValuation:
Site Address
Lot _L Block
Parcel/Sub
Owner
9dflress /?GlS 9.3..4?
City/Zip Code
Phone
Contraetor _
Address
City/Zip Code
Phone
Arch./Engr.
Address
City/Zip Code
Phone #
nate: 9-3 -??
OFFICE OSB ONLY
Ereet _ Oecupaney
Remodel Zoning
_
Repair Type of Const
Addition k oF Stories
Move _ Length
Demolish _ Depth
Int.Impr. _ Sq Ft
Install _
APPROVALS FEES
Assessments Permit
Water/Sewer Sureharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Couneil Road Unit
Bldg Off Treatment P1
APC Parks
Varianee Copies
?OTAI.
NOTE: ADDHESSSS FOR CORNEB LOTS - CONTRACTOR/HOHEOHNER MDST DESIGNATE NHICH 9DDRESS
IS DESIRED. NO CH9NGBS iIILL HE ALLOiIED ONCE BOILDING PERMIT IS ISSIIED.
. ? UlJ
. ??
1986 BOILDING PEBHIT APPLICATION - CITY OF EAG9N
NOTS: ALL COATBACTORS MOST BS LICENSBD iiTTH THB CITY OF EAGAN
SINGLE F9MIILY DiIELLINGS
INCLUDE 2 SETS OE PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
MOLTIPLS DTiiEEI.LIAGS - RESIDENTIAL
INCLUDE 2 SETS OF PLANS, CER
1 SET OF ENERGY CALCULATIONS
RENTAL DNTTS FOB SALS QNITS
OF SQRYSY - CHE($ NITH BLDG. DSPT.,
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: 40z-1Valuat ion: Date: g-?? -?G
Site Address OFFICE DSE ORLY
Lot a Block ? Erect _ Occupaney
Remodel Zoning
A
Parcel/Sub !•?448 yf' Repair _ Type of Const
/ Addition li of Stories
Owner C?po?1?y?i ? Move _ Length
/ Demolish Depth
Address Int.Impr. _ Sq Ft
Install
Phone //-7?d APPROVAI.S FBES
Contraetor Assessments Permit
Water/Sewer Surcharge
Address Police Plan Review
Fire SAC
City/Zip Code Engr Water Conn
Planner Water Meter
Phone Council Road Unit
Bldg Off Treatment P1
Areri./Engr. APC Parks
Varianee Copies
Address TOTAL
City/Zip Code
Phone #
HOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOHEONNER NQST DESIGNATE NHICH ADDRESS
IS DESIRED. NO CHANGES WILL HE ALLOi1ED ONCE BIIILDING PEAMIY IS ISSQED.
5 z
.?.
1986 BDILDING PEIaII2 APPLICATIOH - CITY OF EAGA6
HOTE: ALL CONTR6CfOH5 M[TST BE LICENSED iiITH THE CITY OF EAGAN
SIBGLE FAlIILY DAEI.LIAGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEYO 1 SET OF ENERGY CALCULATIONS
MOLTIPLfi DWELLI9CaS - RSSIDENTIAL RfiNT9L DBITS F08 SALS ONITS
INCLUDE 2 SETS OF PLANS, CER
1 SET OF SNERGY CALCULATIONS
COlMERCIAL
OF SORVSY - CHECB i1ITH BLDG. DEPT.,
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SES OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE HOND
To He Used For: /a ,- Valuation: Date:
Site Address 4e/s619' G• oFFiCE Usg oNLY
Lot ? Block g Erect _ Occupancy
Re.model Zoning
Parcel/Sub Repair Type of Const
Addition # of Stories
Owner (??0?!/??GG???h Move _ Length
Demolish Depth
Address l?G ep Int.Impr. _ Sq Ft
/ Install _
City/Zip Code
Phone ?79rz? APPROVAIS FEFS
Contraetor
Address Assessments
Water/Sewer
Police Permit
Surcharge
Plan Review
Fire SAC
City/Zip Code Engr Water Conn
Planner Water Meter
Phone Couneil Road Unit
Bldg Off Treatment P1
Areh./Engr. APC Parks
Varianee Coples
Address TOTAL
City/Zip Code
Phone 4
NOTS: ADDRESSES EOR CORNEB LOTS - CONTRACTOR/HOMEOiiNER liOST DESIGNATE iiHICH 9DDRESS
13 DFSIRED. NO CH9NGFS idII.L HE 9LLOiiED ONCE BOILDING PERMIT ZS ISSOBD.
1986 HOILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL COHTRACiOES MOSY BE LICSNSED i1ITH THE CITY OF EAGAN
SI6GL6 FAPIILY Di1ELLIAGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
M[TLTIPLS DiiE[.LIBGS - EESIDENTIAL
INCLUDE 2 SETS OF PLANS, CEA
1 SET OF ENERGY CALCULATIONS
COMRCIAL
9EBTAL UBITS FOF SALS QNTTS
OF SDRVSY - CHLC% SiITH SLDG. DEPT.,
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: Valuation:
--
Site Address
Lot _'3_ Bloek -11_
Parcel/Sub
Owner (9:/?.'; ? a. /- vdZA L? ??Z': &
Address -1??D 9 340* L.iv ?z
City/Zip Code
Phone
Contractor
Address
City/Zip Code
Phone
9rch./Engr. _
Address
City/Zip Code
Phone 4i
Erect
Remodel
Repair
Addition
Move
Demolish
Int.Impr.
Install
Date: 2-c3 -z?
Occupaney
Zoning
Type of Const
li of Stories
Length
Depth
Sq Ft
APPROVAI.S FEES
Assessments Permit
Water/Sewer Sureharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Couneil Road Unit
Bldg Off Treatment P1
APC Parks
Variance Copies
rs?F0«
NOTE: ADDRBSSSS FOR CORNEB LOTS - CONTRACTOR/HOMEOWNER lSII3T DfiSIGNATE AHICH ADDRfiSS
IS DFSIRED. NO CHilQGES WILL BE ALLOiiED OHCE HOILDING PERMIY IS ISSUED.
C1TY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
N07.w3: PAYMF'NL' OF FEE AT TIME OF
ArPr..zcUIoN noFS Nom aorszzz[rM
APPROVAL OF PERNIIT.
INsPncriotv oF sDM Arm/ox VAznt
INSTAILAzzoNs wIIa, NOr sE scHEn--
ULID UNPIL PERNIIT. HAS SEM
APPRWID.
P ease Print)
1) PROPERTY ADDRESS:
LEGAL DESCRIPTION:
L ri=F D??I L.-
V151oA or Tax PaTCe
IF EXISTING SIRCGZLME, DATE OF ORZGINAL BLILDING PERMIT ISSL'ANCE: " -
FRFSENP 7ANING/PROPOSID OSE: (hbn Year)
0 CQtiPEFtCIAL/REPAIL/OFFICE M
r7 IAIDL'STRIAL a
INSTIIL.'TIONAL/GOVERNN]ENT ?
. ?
R-1 SINGLE FAMILY
R-2 DL'PLEX (TNo [lnits)
R-3 TOWNi00SE (Three + Units) ( Units)
R-4 APARTNEN'i'/CONIDOMINILTI ( Units)
2)
NAME:_ ?1/ i C 1 Le L. S o n! P?-?- -
aDoREss: e- a, 13 o a- 1 2? .
CITY. STATE. ZIP:_S C(qnf d,' Z yyk- r,' U73
PHoNE: I/ 3 3-6-I 7/
3) • u c?• For City Ose ..
?ME• Plumbers License:
ADDRESS: Active
CITSt, STATE, ZIP:
PHONE:
MASTER LICCE[VVSE# EVirea
Not recorded
Sta £?Initial
4) •.• • • • i?-
tvnME: /
?
_ l9 C? o
I! K1l- ?f l-? o?-- -L .
_ aDDREss: 1 y 60 93 t- ek L l?- nr e 1?1 `-
CITSt, STATE, 2IP:- (j L.# In/ h2 /? -S-1(!3?!- u3 ?'i {e
PHONE: -7 F?SG - S S10 '
•5) ? v? r • ?• : a • a? - ??
? CONNE(.`PION 1V CITY SEWII2 # CONNf)[TION M CITY WATEEt 0 O1'IIER
-
6) ? •' • r ? PLF,ASE HOLD APPROVID PERMIT FC)R PICK-OP BY ONE OF ABOVE .-' --- `_
(?fPLEASE MAIL APPROVID PERMIT TO 1.Q 3. 4. ABOVE
? (Circle one)
7) n ?. u. ?y??? ? ? ?? ?5-
6
TOR CITY USE ONLY '
PERMIT # ISSL'ED
7U- /
Pd w/Bldg. Permit FEES:
$ $ SEWER PERMIT (INCLLDE SDRCHARGE)
$ $ WATER PERMIT (INCLODE SCRCHARGE) ..
$ 6 3 SZ $ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLL'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ ACCOUNT DEPOSIT - SEWER
_
$ $ [l- a ACCOL'NT DEPOSIT - WATER
$ O ' ° D $ WAC
$ •.`J 7S^- ? $ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRL'NK SEWER ASSESSMENT
$ $ ' LATERAL BEIVEFIT/TRDNK SEWER
$ $ LATERAL BENEFIT/TRL'NK WATER
$ ?J? lo 'Q O $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ $ 5-A O--Z) TOTAL
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PPBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q
NO ROADWAY" MUST BE ISSIIED BY THE ENGINEERING
DIVISION
LIST
.
AS A CO[VDITION.
SUBJECT TO THE FOLLOWING CONDITIO[VS:
APPROVED BY:
TITLE:
DATE : %/? ?/
CITY OF EAGAiV
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
NOT;,?: PAYMFNr OF FEE AT TIME pF
APPLICAMON DOES Wr CONMMM
APPROVAL OF PIItMIT.
irrsrncriorr oF sEWM Arm/oR MM
rNerar.ramrpNS WII,i, NOT gE SQED-
ULED [7NM PERNIIT.HAS BEEN
APPR0VFD.
xx,.xx,.x-W-xW-?f,...... _.wxwx-w,.-wxxxx
P ease Print
1) PROPERTY ADDRESS :
LEGAL DESCRIPTION: a
ock/Subdivision or Tax Parce
If' EXISTING STRL'Cii'RE. DATE OF ORIGINAL BL'ILDIN^v PERMIT ISSL'ANCE:
PRESENP ZONING/PROPOSID [!SE: (Month/Year )
Q COA'AWCIAL/RETAIL/OFFICE rl R-1 SINGLE FAMILY
r7 IIdJC'STRIAL Q R-2 DL'PLEX (Twn Units)
? INSTIT[)TIONAL/GOVEk2IU?= ? R-3 TOWN-IODSE (Three + Units) ( Lhiits)
. ? R-4 APARTMEDPP/CODIDOMINIIIM ( Units)
2) R??
NAME=_hl L s p-?- ?4
aDDRESS:_ lp• c, /3 U X I 2 S- .
CITY, STATE. ZIP:_ S C}i A! A,"d NV l?1 - SU 7 3
PxoNE: 4133-SI-?!
3) u c ?•
- NAME:
ADDRESS:
CZTY, STATE, ZIP:
PHONE: MASTE[t LICENSE#
P.ctive
Expired
Not recorded
St? itial
4) •• •
ru,rE: 1- v e/?o ??-? ?
annxess: l14 ? (73 ?-? 'L aa
CiTY, SrATE. ZIP:_A LAi'/t/'e. SS4/ 113914
PxoM: 7 S ?-m- SSi ?5) :? r ? a• • ?• • a? o? u• -siu??
? CONNECTION T0 CITY SEVEI2 CONNEGTION TCl CITY WATER OTlIER •. ..
6) ? •-• r E3 PLEASE HOLD APPROVID PERMIT FDR PICK-C?P BY ONE OF ABQVE
PLEASE MAIL APPROVID PEE2MIT TO 1,?o 3. 4. ABOVE ?
(Circle one)
7) r r• u• - ?J?1,.? -? /3_ ?? K3: P ^ Z`._ o-i
FOR CITY USE Of?LY L
PERMIT # ISSUED
7&1 ??-
Pd w/Bldg. Permit
$
S
$ $
c
SEWER PERMIT (INCLODE SURCHARGE)
WATER PERMIT (INCLUDE SC'RCHARGE)
WATER METER/COPPERHORN/OCTSIDE READER
WATER TAP (INCLCDE CORPORATION STOP)
SEWER TAP
$ $ I5r . ?? ACCOLNT DEPOSIT - SEWER
$ S 1-5-• C? ACCOL'NT DEPOSIT - WATER
$ ,j L? C9 ?? D $ WAC
$ ?75-' ,-)o $ SAC
$ $ TRL'NK WATER ASSESSMENT
$ $ TRL'NK SEWER ASSESSMENT
$ $ ` LATERAL BENEFIT/TRL'NK SEWER
$ $ LATERAL BENEFIT/TRCNK WATER
$ ?S?o °O D $ WATER TREATMENT PLANT SLRCHARGE
$ $ OTHER:
$ $ 0
TOTAL
? G z,13
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQLIRE EXCA VATION IN PUBLIC RIGHT OF WAY?
O YES IF YES, THEN A" PERMIT FOR WORK WITHIN POBLIC
ROADWAY" MUST BE ISSUED BY THE ENGINEERING
Q
NO
DIVISION. LIST
AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE: ? /jo?
/
FEES:
S /n•SG
s $
$
CITY OF EAGAN
APPLICATION FOR PERMIT
5EWER AND/OR WATER CONNECTION
*TOTw,: PA7@SENT OF k'FE AT TTME OF
APPLICATION DOES NM CONSTrMVM
APPRovar, oF PEarsr.
it?sPnerioN oF sEWEt .nrro/oR WA=
RCrar.ramrONS WIIS, M1' BE SCHE>-
ULID UN7PII. PERMLT. HAS SEEN
APPRWF9.
------------------
P ease Print)
1) PROPERTY ADDRESS:
LEGAL DESCRIPTION:
IF E}ISTING STRCCIL'RE. DATE C
PF?ESENP ZONING/pROpO,SID LSE:
Q M%P+ERCIAL/REPAIL/OFFICE
Q IPIDL'STRIAI,
n INSTIZT;TIONAL/GOVII2bPg,'NT
2) ?
ADDI2ESS:
iF ORIGINAL E
?
?
d
?
C'ILDING PERMIT ISSL'ANCE: - ?
(Mon Year)
R-1 SINGLE FAMILY
R-2 DL'PLEX (7un Onits)
R-3 TUW[+?iOUSE (Three + Units) ( IInits)
R-4 APARTMENT/CODIDOMINIC'M ( ' Units )
CITY. STATE, ZIP: SC A tt/ dI` Z
k.. iV ?i'S?U 7 3
PHONE:
3) u . ?•
NAHME:
ADDRESS:
CITY. STATE, ZIP:
PHONE: MASTII2 LICENSE#
Plwnbers License:
Active
Expired
Not reaorded
Sta Initi.al
4) ??• • ? ? i?•
NAD7E: _j_O Q4
_ AUDRFSS:_ I<// o (? .j> fr c? Z?3 h? -? N l'
CITY. STATE. ZIP:-R Z-XI N f flt n!
PHONE: -2e:u
5) ? v? a• • ?• : ? • ?? ??
? CON[gGTION 1O CITY SEWIIZ ? CONMDCTION M CITY WATER ? p'PHER '.
6) " •-??- [] PI,EASE HOLD APPROVID PERI+'IIT FOR PICK-UP BY ONE OF ABOVE
? PLEASE MAIL APPROVID PII2MIT ? 1? 3, 4, p,Bp?
A (Circle one)
7) r.r_ ?u: - (.J-fi U_ f71 v, /'`
FOR CITY USE ONLI( PERMZT # ISSL'ED
Pd w/Bldg. Permit FEES:
$ $ SEWER PERMIT (INCLUDE SURCHARGE)
$ $ ?D • S G WATER PERMIT ( INCLODE SL'RCHARGE ) ..
$ $ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLIIDE CORPORATION STOP)
$ $ SEWER TAP
[i -o
$ $
ACCOUNT DEPOSIT - SEWER
$ $
ACCOL'NT DEPOSIT - WATER
$ $ wAC
$ S 7S` U v $ sAc
$ $ TRL'NK WATER ASSESSMENT
$ $ TRLiNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRONK SEWER
$ $ LATERAL BENEFIT/TRC'NK WATER
$ 6-a $ WATER TREATMENT PLANT SLRCHARGE
$ $ OTHER:
$ TOTAL
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK 6VITHIN PUBLIC
Q
NO ROADWAY" MUST BE ISSUED BY THE ENGINEERING
DIVISION
LIST AS
. A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY: ,(1/? -,9 e,1 11-LO-7-I/-r.-,
TITLE:
DATE : w fo
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*10TF: PAYMPTTl' OE FF.E AT TIMS; pF
APPLscazzoN DOES rxOm CONSMTM
APPR017AL OF PERNIIT.
-----------------
P ease Print)
1) PROPERTY ADDRESS: ?( 2 S, ,') ?i? ? ,j ?? ? LiPF ? ? OL,,t
?.L
LEGAL DESCRIPTION: 3 81 '-
Lot Block Sub ivision or Tax Parcel ID )
IF EXQSTING STRCCii'RE, DATE OF ORIGINAL HPI7,DING PERNIIT ISSL'ANCE:
PRESENf 7ANING/pRpPOSID LTSE:
(MonthfYear-j-
..
? COn-IERCIAL/RETAIL/0FFICE ? R-1 SINGLE FAMILY '
r7 IPIDL'STRIAi, ? R-2 DLPLEX (Ztoo IInits)
? INSTI'SL?TIONAL/GOVII2NMENT ? R-3 10WNfiIX!SE (Three + Units) ( Units)
. ? R-4 ApARTMED7P/COAIDDMINIUM ( Units)
2) ?
cuAnE: _ hl 7`C k e 1 s akv -k-1+ ,
ADDRESS: P. o. t30 u 7 2 fr .
CITY, STATE, ZIP: _S Ca„r d,' d i'+'? N- S U7 3
PxoNE:- / 7I
3) • u c?• ??- For City Use .
Plimhers License:
ADDRESS: Active
? Expired
CITY, STATE, ZIP: Not recorded
PHONE: MASTEEt 7,ZCENSE#
Sta Lv.tial
4) M.r U • ? n 1
NAME' ?<
_ ADDRESS: !Yt rl 4.7 ti? L/i- ..,
CITY, SfATE, ZIP: 4 I'ni -e M Ai 3 S/- 4/
PHONE: 7 fsb ^ SZSN/ U •
5) ? :? ?• . , i r• • ?: ? • ? - E.
? CONNE(.`rION 7U CITY SEWII2 ? CONNWTIOI3 1O CITY WATER El OR4IER '. .
6) Fi • • r ? PLEASE HOLD APPROVID PEf2MIT FOR PICK-UP BY ONE OF ABC7VE --'- -- -`
? PLEASE MAIL APPROVID PERMIT TO 1.V/f 3. 9, PBOVE
? (Circle one)
INSPECTION OF SETrgI2 APID/OR 47ATII2
rNernr.raTTpNS y,IL,L NYJT gE SCHD-.
[ILID [INPII, PII2MiT HAS BEEN
APPRaVF9.
7) lA .Y_ 'l1 /A. O `
FOR CITY USE aNLY-, - ?
PERMIT # ISSUED
716 V
Pd w/Bldg. Permit FEES:
$ $ SEWER PERMIT (INCLUDE SURCHARGE)
$ $ WATER PERMIT (INCLODE SLrRCHARGE)
$ $ WATER METER/COPPERHORN/OC'TSIDE READER
$ $ WATER TAP (INCLL'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ ACCOUNT DEPOSIT - SEWER
$ $ /5_110-0 ACCO[JNT DEPOSIT - WATER
$ $ WAC
$
$ SAC
$ $ TRONK WATER ASSESSMENT
$ $ TRLNK SEWER ASSESSMENT
$ $ ` LATERAL BENEFIT/TRDNK SEWER
$ $ LATERAL BENEFIT/TRPNR WATER
$ ??700 0 $ WATER TREATMENT PLANT SDRCHARGE
$ $ OTHER:
$ ?2'?' !t'?
TOTAL
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQLIRE EXCAVATION IN POBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PLBLIC
Q
NO ROADWAY" MUST BE ISSLED BY THE ENGI[VEERING
DIVISION
LIST A
.
S A CONDITION.
SU BJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY;
TITLE:
DATE : /? ? r?
2000 STORM DAMAGE PERMIT APPLICATION (RESIDENTIAL)
ReaWrements
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
? 2 copies ot plan pq1E: I0/7o/2 0 o a CONSTRUCTION COST: z-?o d
f?] if
DESCRIPTION OF WORK: C?CS'rvNaTla? It mulfl-family bldg., how many units? j??
INDICATE THE FOLLOWING E6IUIPMENT TO BE REPLACED AND BY WHOAA:
_ Plumbing _ Homeowner Q-r Conhactor Name
_ Mechan(cal _ Homeowner pj Conhoctor Name
"Note: If somebody other than the homeowner is performing plumbing or mechanical work they mustapply for appropriate
permit, Only Ilcensed plumbing conhactor or homeowner may complete plumbing woilc.
SfREETADDRESS: --Avg" twSIo4e L4?Ft
LOT: ? BLOCK: ? SUBD./P.I.D. #:
?
L•?ic (a
Name-'---7A"v% rOr t1 { S Phone N: 'yS 4• SL42 0
PROPERTY Last First
OWNER
Sheet Address: A62? ? tf-4cE
Clty eAE`...4 State: ???•/
Company: (AiTEc aX Phone #:
Zip: S?
Sol•2y14o
(area code)
CONiRACTOR
CQ License #COy 1177 Exp.
Sheet Address: TUA^^Gr , n
Cily ?,f?Aome?e3.?1.?? Siate: m°4 Zip;
I hereby acknowledge that I have read this application, state that ihe Infortnafan is cortect, and agree to comply wilh all applicable State
of Minnesota Statufes and City of Eagan Ordinances. n
, - j,.??.DD Signature of ApplicaM-- ?T
r) nf 7i 0 G??? J
CITY USE ONLY
LOT ? BL ? PERMIT#:
SUBD. \l0? 14 l_gn,Ihp,. EAd? RECEIPT N: . (j>15?P a
?1 q
RECEIPT DATE:
2000 MECHANICAI, PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT IRNOB RD
EAGAN MMI 55122
r?
Date: 651-681-4675
(0? ?? ` W
Complete this section onlv if you are installing HVAC in a single family dwelling, townhome or condo under
construction and not ownedoccuoied.
• HVAC: Q-100 M B T U
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one required @ $3.00 ea.)
$ 30.00
6.00
State Surchazge .50
Total $
Complete this section on[v if you are remodeline, addine to, or re airin an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or repair.
_ New X Alteration _ Repair _ Other
Furnace
_ Air exchanger
Reminder: Call for inspections
SITE ADDRESS:
OWNERNAME:
INSTALLER NAME:
STREET ADDRESS:
CITY:
x- Air conditioning
Other
Fee
State Su:chaege
Total
$ 30.00
.50
$ 30.50
PHONE #: Vl5 l - `IS `1 - Z
(AREA CODE) `?
PHONE #:
ILell STATE: 64k)_ ZIP: 55)u?
h&ylij ? ?d4B-,-
SIGNATURE OF PERMIl'TEE
CITY USE ONLY
L BL
SUBD.
APPROVED BY: • , INSPECTOR
PERMIT #:
RECEIPT#:
RECEIPT DATE:
2000 MECHANICAL PERMIT (CObMRCIAL)
CITY OF EAGAN
3830 PILOT IQd08 RD
EAGAN, MN 55122
651-681-4675
Please compiete for: all cammerciaUndustrial buildings
muld-family buildings when separate permits are not required for each dwelling unit
DATE:
WORK TYPE: New consWCtion ='Install U.G. Tank °
_ Interior Improvement _ Remove U.G. Tank
_ Processed Piping
When installing/removing underground tank, call 65I-681-4675 for rnspection by ftre marshal and
plumbing inspector.
Description of work:
Fees: i°/a of conhact price OR $30.00 minlmnm fee, whichever is greater.
Underground tank removaVinstallation = minimum fee
Contract price: $ x 1%= $ (Base Fee)
State surcharge calwlate at f.SD for each $1,000 Base Fee
TOTAL
' SITE ADDRESS:
$
OWNERNAME: PHONE#: -
(AREA CODE)
TENANT NAME (IMPROVEMENTS ONLY):
WAS TfERE A PREVIOUS TENANT IN THIS SPACE? _ Y_ N. NAME:
INSTALLER:
ADDRESS:
CIT'Y:
PHONE #: -
_ (AREA CODE)
STATE:
ZIP:
SIGNATURE OF PERMITTEE
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
V(90??u
? ?o?o(fice?l5e -------- ;
? Pertnit #: ch
I PermitFee: ?'14 - d-'b I
? Date Recelved:
I ?? I
? StaH: ?
I I
------------------
2008 RESIDENTIAL BUILDIING PERMIT APPLICATION
Date: Site Address: AM t'wV
zwe,m 111'UUbG-& 4X, 112 j q (C20 , tl 09 ?Z suite #:
RESIDENTlOWNER Name: ULLs Cc?n?Tyl1dil' (1 ?XYVl ,') Phone:
. AddresslCity/Zip:ja IW S u\m'(}1 y S"?•
Applicantis: _Owner V Contractor
TYPE OF WpRK Description of work: ?`??,_N?tu?
Construction Cost: Multi-Family Buildin
g:(Yes_/No
CONTRACTOR Name: Cjh?- ?]Ct4UOk)VJ License #: a U711)5 11
Address: Isq?OZ O?1a"OA& b,v?ao(]
City: _RY wnwwn . State: ?Zip: .?3m'-7
Phone:.(61l"'I (jb• (j',y1 Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet . New Energy Code Worksheet
Cate
Submitted
or
g
y
Su6mitted
(4 submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issueda permit for a similar plan based on a master plan7
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: P-lans andaupportrqg dacu?ents thaYyoG sub?It ate,considered
to 6e;public inforrnationr Portions of
?
the informaflon may be classAred as non pubhctif?iou
praWdepsp'eci?c reasons
thaf
wou/d permit the Cify to "
?
?
?
.„?conclude??ax;.the.ar?,trade-secrets?,"=„?y'
I hereby acknowledge that this information is complete and accurate; that the work will 6e in conformance wim the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a pefmil, and work is not to s[art without a permit; that the work will be in
acwrdance wi[h the approved plan in the case of work which requires a review and approval of plans.
?
X ?'?l'y?:.}.S, kl Mir,?(?umn X ?A rLk Q d(,'y\'
Appliclangs Printed Name Applicants Signa ure
A?.i
Page 1 of 3
o
7
100/100'd 6V:60 (0H1)0102-10-ad8
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
RECEIVED
AUG 2 4 2016
2015 RESIDENTIAL P�LUNILBING P
Date: �LS "' Site Address:44° '�Y
Tenant:
Use BLUE or BLACK Ink
For office Use
Permit*: 138 37,3
Permit Fee: 9O
Date Received: d'd Y://‘
Staff:
IT APPLICATION
Name; —b
Address / City / Zip.
Suite #:
01S
Hilbert Cornpany.Inc dba Culligan Water'
Address: '1;$01 50th St East
License #: C641376
city: Inver Grove Hgts.
State:' Mn Zip: 55077 Phone: .651-451-2241'
Contact: William R Milbert
Email:
_ New _ Replacement _ Repair _ Rebuild _ Modify Space _Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
Lawn Irrigation (RPZ / PVB)
Septic System
New
Abandonment
Water Softener
Add Plumbing Fixtures Main / _ Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surharge)
*Water Turnaround (add $200.00 if a 5/8" meter is required)
$115.00 Septic System New ($10.00 per as btiilt) (includes County fee and $5.00 State Surcharge) t0� 0 0
TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One Cali at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.00pherstateonecail,oro
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 1 understand this Is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the epproved piar1,jn.the case of wo4k which regYires a review and approval of pians.
x
Appli
nt's Signature
Oct 04 2016 03:50PM HP FaxPerfection Heating 6517773252 page 2
1111 C!tyofEaaii
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use 4
Permit #: / - /Q 1 l
Permit Fee: 00
Date Received:
Staff:
L
2016 MECHANICAL PERMIT APPLICATION
0 Please
submit two (2) sets of plans with all commercial applications.s
Date: Ap Site Address: e/ 6076, 1 ag, C<<*+t J.. LAZ
Z-.b;too.. v
Tenant:
Suite #:
y y'
r {� � ,�
> 't
� d { e' *,
4.,r t r1 °`"
Name: Phone:
Address / City /Zip:
kt
i •yyy sty `
}
?��R� ���� � ��
,. :' Y s
Name: Qr'c?r►-11D ) /./c4r a License#: kid) gi20.
Address: 1770 Coe P LA ''.. k City: l V 1oti ka.A_Dczet—C)
State: MA) i/) Zip: ,...t.0-1.01 Phone: (9.:irq• 717 • Me ,)-0
Contact Ce&'e 1J L&.Q Email: J. Pet/' 44 o.o.� civ i s� . (,0,U.` °
yy 'i��Y1.
� � 'n
,'�
` Y'g y r
i•
1i �; �SAj'l$i'#�y fit
5 ` * yy`J, t
4'k. '� A 't K Y,y
�4 z�'. 7.32h
New Replacement Additional Alteration Demolition
Description of work 1JQ/ua..1(,�lk,. UQ S,A s4 -all °t°r t It Dryer
£ ' Feil fif t4Y.4 e}'; } m ,
n¢ � y
.. 4 � � 5. °'
.XT�.°: ,?..•r.a;le�.a...:Kw.. ;Ys�• .. ?: am�.,. �:!✓...
) J. )g
II
�' �'T t
"'r 1 ° '
rf :: ..x R: , nn<•�Sw.
P '^ _d jl `� 9y. •r - ' {g•�y;,�'
`� �"7: .'
Y, . .b' C Y i
.,e$:". Ci�.� ... ,n.....v�);•qi
a,r
is
3t
kz41"
-7-.
§'`
� 4�
�
n6i�.
A;
ZI
_
"x�}ffi
' r. ��
t
`i a
, '
RESIDENTIAL
_ Fumace
- COMMERCIAL
New Construction Interior Improvement
— Air Conditioner
Air Exchanger
n9
_Install Piping Processed
Gas Exterior HVAC Unit
_Heat Pump
.1 Other VIA 1411-: At -7 -
_
Under/Above ground Tank L_ Install 1 Remove)
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit, includes State Surcharge
$100.00 Residential New, includes State Surcharge = $ TOTAL FEE
COMMERCIAL FEES Contract Value $ x .01
$60.00 Permit Fee Minimum
$75.00 Underground tank installation/removal, includes Stale Surcharge = $ Permit Fee
= $ Surcharge
Surcharge = Contract Value x $0.0005
If the project valuation is over $1 million, please call for Surcharge = $ TOTAL FEE
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 n. - 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.