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642 Rita Ct CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100 ~ BUILDING PERMIT Receipt # ~ - To be used for Est. Value ~ ~ ` ` Date ' ' ~ ,19 Site Address OFFICE USE ONLY LOt Block Sec/Sub. V t)' 1 S7 On Site Sewage _ Occupa~cy MWCC System _ 2oning ParCel No. On Site Well _ Type of Const Ciry Water _ (Actuan a Name (Allowable) W # O} $10f19S 3 Address Length ° Ciry Phone Depth S.F. Total , p Name Footprint S.F. ~ Q Address APPROVALS FEES a ~ City Phone ~ ~ ' ' Assessments _ Permit ~ ~ ¢ Water/Sewer _ Surcharge yVj W Neme Police _ Plen Review z Fire SAC, Clty x - Address - Engr. _ SAC, MWCC ~ W City Phone Planner _ water Conn. CounCil _ Water Meter I hereby acknowledge that I heve read this application end state Bldg. Off. _ Road Unit that the information is Correct and agree to comply with all appliCable APC _ Treatment P1 State of Minnesota Statutes and City of Eagan Ordinances. Variance _ Parks Copies Signature of Permittee TOTAI A Building Permit is issued to: ~ on the express condltion that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official Permit No. Permit Hold~r Dats Telaphona x Plumbing H.V.A.C. Eie~t~~~ 3 ~ . a-i p ~D Softener Inspectfon Date Insp. Commsnts Footings I Footings II Foundation Framing /J-/Lr L - G ~clou0 Roofing ~ ~ - - 7~5i'~] ' Q Rough Plbg. . Rough Htg. Isul. Fireplace Final Htg. Final Plbg. Bldg. Final Cert Occ. Temp. LP Deck Ftg. Deck Frmg. Well Pr. Disp. cirr oF ~?c~?N 379s Pilo~ Keob Road Eegas, MN S51ZZ N~ 48 Q~ PHONes 45~-8100 BUILDING PERMIT Receipt # ~Q041 Breezeway '3,OC~d. ~Y ~S~ To b~ uted for Est. Value Date _ , 19 ` 'Site /lddress E42 ::ita Ct. Erect Occupancy I Lot ' Biock Sec/Sub. K$rvey Addn Alter ? Zoning ~ l Pa~~ Repolr ? Fire Zone 3 Eninrpe ? Type of Const. ~ Name ~c'tiard SCh~ef Move ? Stories 3 Address 542 Ri ka ~t. pemolish ? Front 24 ft. ° Ci F, n Phone 454-1420 G?ade ? Depth 12 ft. Approralt Feas o Nome usr~p,~ ~~sChuar ; ,1 , o~ Addrcss 1644~ Gn^dy:in .4ve_ Assessment Permit • u~ Ci Hatinr,s~ ph~e 437-7122 Water&Sew. Surcharge ~ Police Plan check ~W Name Fire SAC Address Eng. Water Conn. <W Ci Phone Planner Water Meter CAUncil I hereby ocknowledge that I hove reod this opplication and state that Bldg. Off. the information is correct ond ogree to comply with all applicoble APC Tota? j~• 5`-' State of Minnesota Statutes and City of Eogan;Ordinonces: J Signcture of Permittee ~ ~ ~ t ; f' I A Building Permit is issued to: ~'~`}~af on the express candition that oll work shall be done in accordance with all applicable State of Minnesota Stotutes end City of Eagan Ordirances. Building Official . r.~.lt # oeM ~.w.a hr.itf« Plumbing Mechonical INSPECTI~NS DATE INSP. Raqh-In Find Footings Dota Irnp. Dots Irap. Foundotion pi urnbin9 Frome/ins. Mechonicol Final ~jfl- Remarks: INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: ~ ~ ~ ~ ~ + ~ ~ ~ ~ 3830 Pilot Knob Road Permit Number: ~ ~ Eagan, Minnesota 55122-1897 Date Issued: c~ (612) 681-4675 SITE ADDRESS: ' ' ' ` ' " ` APPUCANT: t c~ r = , ~st r . ~ i i TA ~ r i ~ t,. ~~a~ , i ~ . . • ~ . . PERMIT SUBTYPE: TYPE OF WORK: , , ; ~ , . ~ . ~ . . ; rr~r~a M~~ i~~~i~~~~ ~ r~ .,;~~,,I{ 1 r~ ~I 1~: ! i f'11l ~ ~ L~ ~ Permlt No. Pertnit Holder Date Telaphons M ELECTRIC PLUMBING HVAC Mspectlon Date Irtsp. Comments FOOTINGS FOUND FRAMING ROOFlNG ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLOG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: ~ r~' 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: 4' (612) 681-4675 SITE ADDRESS: ` ~ " ' " ~ ~ ~ ' APPUCANT: i~~E. ~ t~~~~;; . ~ r~ r r ; „ . . ~ ~ . PERMIT SUBTYPE: TYPE OF WORK: , ~ . . . . ~ ~ ~ _ ~ Permk No. Permit Holder Date Telephone # ELECTRIC PLUMBING HVAC Inapeetlon Date Insp. Commants FOQTINGS FOUND FRAMING ROOFING c~_Z~ _c~-7 ~(~T~ T~~~~ U~ ~iStuS ~ ~+~C ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPIACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.1. BSMT FINAL DECK ~G DECK FINAI CITY OF EAGAN Remarks Addition ~R~'y A~I~Q~ #1 _ Lot ~ Blk 1 Parcel~~ Owner-~ '%r Street 642 Bita C~tl2''t State '~6~s ~ 55~- Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1!} 1~}QO~OO ],lFD~OO lO P&ld STREET RESTOR. GRADING SAN SEW TRUNK 19'TQ 1,2~j~QQ •QQ 2 Paid 'x' SEWER LATERAL ~ a,~'ll 19'72 Z ~OO 11 ~ 2O Paid WATERMAIN WATER LATERAL 1972 ZO WATER AREA STORM 5EW TRK ~ S 1 O STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 2 O.OO ?6 E)- - 1 BUILDING PER. SAC 20~ - - PARK f EAGAN TOWNSHIP No gii ' . BUILDING PERMIT Ownex .~~t~~!L~...._.._....... EaSan Township Address (presenii/~~--.'-`~....~~ Town Hall Builder l /~Cn Z_ Dale . Address DESCRIPTION SYOries To Be Used For Fronf Deplh Heigh! Esi. Cos! IPerrai2 Fee Remazks ~ tl~d " I ~ ~ [ I ~.S/ ~-v~ ~7 .S ~~~~„"a~..~~i ~j ~ ~ ~ /1 LOCATION Stseei, Road or other Descsip4ion of Locaiion Lo! 81ock Addition or TracY . ~J 6~~ G~'0~ This permit does no! aufhorise !he usa of sixeeis, roads, alleys or sidewalks nor does i! give - he owner or his agen! fhe righ! !o ereale anp siivafion which is a xuisance or whieh presenis a hazard fo She healfh, safelp, tonvenience and general welfare fo anyone in She communiip. THIS PERMIT MUST $E EP ON T E PREMISE WHILE THE WORK IS IN PROGRE . ~ This is !a cestifp, fhal--- {,-L''-("_' - - - - - --------has parmission !o ereci a--------' ' ..""'------....._..----upon !ke above described fnis9. ubjec ~ ihe p~ovisions of ihe Suilding Ordinance fos Eagan Towns ' adopied April I1, 1955. ~ ~ " .oe-f- 1~ C~'"^,~-~~__ ~J~- .............`~.r'------°°°°° Per .L~~!:'.`..'..:.....g----- P'--K't"'...-.........._..-- Chairman of nwn Board Buildin Ins ec2or ihis request voitl 18 months Irom ~ 617 6 0 ? . ~ / ~ ~~o RxQUest Date Rre o. Huoph-i Inspection ~Ct. 2.7f 198~ R~vUVis No eady Nov.~Will Nmity InsDei;- ~ ~ tnr Whnn Reatly Licensed Elec[rical Contractor I hereby request inspection ot ebove ? Owner electrical work installed aL Street AtldreSS, Box or Rou~e No. . 642 Rita Court Eagan ecuon o. Townshi0 Name or No. BenBe No. Coumy Dakota Occuunm IPRINTI Phone No. Jerry Groth 454-1920 Pownr Supplier Address N.S.P. Red Rock Electrical Contractor ~COmpany Namel Convar.lm's License No. Corrigan Electric Company 039549 8 Mailinp AdJress (Con~raclor or Owner Making Installationl P.O. Box 475, Rosemount~ MN 55068 Au o d Sipnature I 6hvac r/Owner Maklny Installationl Phnne Number 423-1131 MINNESOTA STATE 90 O OF ELECTqICITY THIS INSPECT~ON HEQUEST WILI NOT Grigge-MiAwey Bide. - Xoom N•191 BE ACCEPTED 9Y TME STATE BOAflD UN~ESS PFOPER INSPECTION FEE IS 1821 Universirv Ave.. St Peul, MN 5610G ENCLOSED. vFnno 1f.191 fi69-OA~O ~p/ REQUEST FOR ELECTRICAL INSPECTION E8-00001-06 ' See instrvctlons tor completin9 this form on bnck o} yellow copV~ ~~~8~ ~_..L 7 6 ~ ""X" Be/aw Work Covered by 7his Request Adtl Xeo. Type ol BuilE~nq Aoo~inncea WIreE En~~u~~en1 Wiretl Home Range Tempnrary Service Duplex Water Heater Lightioy Fixtures Apt. BuilAinc~ Dryer Electri~ Heatin Commercia~ Bldy. Fumace Silo Unlueider Industrial Bldg. Air Conditioner Bulk Milk Tenk Farm ~ner oeu v -~~u.r ISne~::rvl t er Sueci y Othe~ O~n~r ompule Inspection Fee Below p Fea ServicaEnlranceSixe k Fee FeeCars~Subleeders N Fee Gircuits )`.(J(1 0 to 200 Am s 0 to 30 Am s 0 tn 30 An s A6ove 200 Amps. pv 31 to 100 Amps 31 to 100 ~Am : Swimming Pool Above 100-Ain s AAOVe 100_Am~s Transiormers Irrigation Booms Partial.~Other Fee Signs Speciai Inspection ~ Xemnrks 5 a0 ~ TOTA EF~~ ~ `(/D . flou0~-in ~°1e 1, the Ele cal ~ IOSpBCtOq (18~ODy certity thet the nbove Final C~+ r ~`~~e insOection has baen (O'Z7-y made. TNe requeat voiC 18 monltu Imm CITY OF EAGAN a - 3830 Pilot Knob Road, P.O. 8ox 21-199, Ea9an, MN 55121 N_ 13 5 8 9 PHONE:454-8100 ~ -J~~3 BUILDING PERMIT Receiptit To be used for GARAGE Est. Value .000 Date MAY ~ ,19 Site Address 642 RITA CT OFFICE USE ONLY Lot 5 Block Sec/Sub. HARVEY 1ST MWCC Sy teme _ Z~oning ~CY PHrCeI No. On Site Well _ Type of Const City Water _ (ACtueq s Name DIANE GROTH (AUOwabie) w # of Stories ~ Address SAME ~ength ~ City phone 454-1920 oeotn S.F. Total , a Name GEROME GROTH Footprint S.F. ~Q Address SAME APPROVALS FEES ~ City Phone 887-7837 (W) qsseasments Permit ~72•50 FQ Weter/Sewer _ Surcherge ~0 w w Name Police _ Plan Review t i Fire SAC, City AddfBSS Engc _ SAC,MWCC City PhonB Planner WaterConn. aW _ Councll _ Water Meter I hereby aCknowledge that I have ~ead this epplication and state Bltlg. Off. _ Road Unit thettheinfofmationiSCOrreCtendagreetoCOmptywitha118pp1iCeble APC _ TreatmentPl State of Minnesota Statutea and City of Eagan Ordinances. Variance _ Parka Copies Signature of Permittee 707n~ ~ A Building Permit is issued to: GEROME GROTH on the express condition that all work shall be done in accordance with all ap i ble State of M'_ yinesota Statutes and Ciry of Ea9an Ordinancea Bu ilding Official _ - ~r~ i c~ ~ ciTr oF ~r?c,aN ~ ' 9795 Pilw Knob Road Eugae, MN 5512Z N° 4 8 ~ 4 PHONE: 45M6100 BUILDING PERMIT APPLICATION Receipt # 10041 Breezewa $3'~~~' Ma 18 78 To be uaed for y Est. Value Date y ~ , 19 Site Addreu 642 R1t8 Ct. Erect Occupancy I lM 5 Black Sec/Sub. Harv2y AddR Alter ? Zoning Rl pa~~ # Repalr ? Fire Zone 3 Enlarge ? Type of Const. V rc Name RiChard SChaaf Move ? #~Stories ~ Address 642 Rita Ct. DemoGsh [7 Front Z~+ ft. Ct Phone 454-1920 Gmde ? Depth lZ ft. Approvals Fees p Name N,aiug3`Kis6htleF o~ Address 16440 Rnodwin Ava_ F._ ~~+ent Permit 12 00 _ V~ Cit Hatittps. Phone 437-7122 W~~r & Sew. Surcharge 1.50 Police Plan check ~w Name Fire SAC Address Eng. WMer Conn. ~ aw p~~e Planner Water Meter Councll I hereby ocknowledge thot I have [ecd this application and state thct g~dA, pf{. the Information is correct and to comply ith cU~. ~ticable SMte of Minnesotn Sta utes d ity af Eugan 5dinance~! APG Total 13. 50 (L~ ~ Signoture of Pertnittee A Building Permit is issued M• RiChBxd S h af on the expreu condition thet nll work sholl be done in ac ~ nte with a I p' ble State of innesota $tatutes and City of Eagan Ordirances. Building Official ~'t'F-~~-' -~--~~'LJ . ~ CITY USE OHLY LOT BL ~ PERMIT ~ y~ SUBD. ~C~l~'S~ RECEIPT k: RECEIPT DA1"E: ~ D ~ ~ - -O 2000 M~GHi4NIC~L ~fiMIT (~SID~NTI~4L) Cl7'Y OF EAfiAN SSSO PILOT KNOB fiD f.~1fiH1Y MA 5S 122 ~ ~ O 651-6$t-4695 Date: Complete this section onlv if you are installing HVAC in a single-family dwelling, townhome or condo under construction and not owner/occupied. • HVAC: 0-100 M B T U $ 30.00 ADDITIONAL 50 M BTU 6.00 • Gas outleu (minimum of one required @$3.00 ea.) State Surcharge .50 Total $ Complete this section anly if you are remode[inp, adding to, or renlacinQ an existing single-family dwelling, townhome, or condo. Please indicate if it is a new item, alteration, or replacement. _ New ~ Replacement _ Other ~ Furnace _ Air conditioning _ Air exchanger _ Other Fee $ 30.00 State Sutchazge .50 Total $ ~ECEI~TFI~ Reminder: Call for final inspection. • ~w~ M~ OCT ? ~:1 SITE ADDRESS: ~ OWNER NAME: ~Y'ET f`c~c~~ ~O'Y~ PHONE I_- PHONE ~A(O~S ( -~Z3~~Z~p INSTALLER NAME: P~LC.S N0.'~~•~~ ~ ~p~p CODE) STREETADDRESS: ~,.p~c~ ~ I~f-S~h S'~- ~ CITY: ~~-1'YV~~ t+.../~}-. STATE: ZIP: .3 S Q SI NATURE OF PE TTEE CITY USE ONLY L _ BL _ PERMIT#: SUBD. RECEIPT#: APPROVEO BY: , INSPECTOR RECEIPT DATE: 2000 M~CiiANICAL ~~1?iIT (COMM£RCI1kL) CITY Of £A~6AN S$SO PILOT KNOB {tD fA6AN, MN 551 YE s5i-s8i-as~5 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: WORK T'YPE: _ New construction Install U.G. Tank _ Interior Improvement _ Remove U.G. Tank _ Processed Piping lVken instalfing/removing underground tank, call 651-681-4675 for inspection by fire marsha! and plumbing inspector. Description of work: Fees: 1% of contract price OR $30.00 minimum fee, whichever is greater. Underground tank removaVinstallation = minimum fee Contract price: $ x 1%= S (Base Fee) State surchazge calculate at $.~0 for each $ I,000 Base Fee TOTAL $ SITE ADDRESS: OWNER NAME: PHONE (AREA CODE) TENANT NAME (IIvIPROVEMENTS ONLI~: WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME: INSTALLER: ADDRESS: PHONE#: - (AREA CODE) C~': STATE: ZIP: SIGNATURE OF PERMITTEE f`!..Y`~.r ~!:Y.',:.'!."' ~"'...:`c Y ~:'"Xr:r~<^!~;'Jt>g~;._ra.,..^u . ~*rv l`9- =-RC^R' ' :".F3`3-;.f:.rr S r'c:R"`IR~;._ i7~ 3e. 'AT=:~ '/'.P/3' 7'1•,'~, ~",,a~° 'Ctiv .'cµ'a. .~'J'^3::.' ~~::Trr'r._~S I*.C o`t7' ~:S.L :TY'Tfl :'r ~ ~fl. 1~'3 :~.li'" ..~-..i. ~i~.? SiY~I k.~i~ ~ ~.t~.:.~. ~ '~:n'~[r.` n ,~..~.y` ; . ~'_?.f?.r"J ~,,~~.~..~f'.~f ' ~f..-.i ' '•~~_..-~V li .,,z.1.~...,;Y .4r<~. , ,.Y'k~.~ .k:~ ;;)f L' .:;n.y " PERMIT '-~I~Y OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: a u r ~ o~ N~ Eagan, Minnesota 55122-1897 Permit Number: 0 2 9 7 6 2 (612) 681-4675 Date Issued: 0 4/ 1 S/ 9 7 SITE ADDRESS: 6R2 RITA CT LOT; 2 B~OCKs 1 HOEFT P.I.N.: 1@-33300-020-01 DESCRIPTION: ~ ~ REPLACE WNDWS/OOORS ~,~,j„1,'.Y~~,rig'~ermit Type SF (MISC.) ~~~~[,~~„~[~,ryg Type fiLTERATZON ~ ~~€~`s~t~~ ~oi~~ A34 ALT. RESIDENTIAL m~~ < ~ ~ ` ~ k~ °~3~~A2~ ` 4~ d F°'c~~' t ~ ~,r%x`.~t~~ iu,~` °a ~ ~k ~ ~ 2 a" k we ~ ( ~ ~i:,. r~ `~"''~X9 ~~~?-~y~' ~~i s c " ~ ,~r ,b ~'*h,. ~ ~ >s 27,*"x: 8 ~ ra' ~i°.3 'y'._°S k~ ~ ti.~ 4~` ~S" ~ ~-e~' ~'''~xr;~$v~:~j ~:''r' REMARKS: FEE SUMMARY: VALURTZON $9,100 , Base Fee $99.75 . Surcharge $2.50 Total Fee $102.25 . CONTRACTOR: _ q p p 1 i c a n t- S T. l. I c. OWNER: ~GET EX7ERIQftS INC 18871613 0006564 GROTH GEROME 7 NICOLLET AVE S 642 RITA CT OOMIN6TON MN 55420 EfiGAN MN 55121 (S12) 887-1613 (512)454-1920 y i.~. . ~ ; - r . ~ , i' ~ . { r . s. v . , , ~ o ' . p .Ii . -a . t .r . t . . I hereby ~~}~4;?a4E~.~zlq~,'~ha~ Y~~i~w'a t'~a~,~~~~ ~p~+Sx~a$;ion ~~~t~! s~~~e tt~a~ ~he', %~forrt~t~o~t is co,rr~~.t ,and,,~~.r~~ "~a ~ismpS~y. sa~~k~, ~Y1 `~p~I%cab.~e ~tate a~ hln. _ ' ~ . . st~t~,~~~ ~~~t_:_e~.~~ ~r,€ ~~,~~n par~~r~~r,~~s _ . . . . n . -1 ~~L~ c APPLICANTlPERMITEE S~GNATURE SUED eY: SIGNA ~jDa. a 5 '~1. ~ CITY OF EAGAN i/~~~~~ 3830 PILOT KNOB RD - 55122 `7' 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 New Conslrudion Reouirements RemodeUReoair Reavirements ~ ? 3 registered aite surveys ? 2 eopies of plan . . . ? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior additions 6 decks) - ? 1 energy calculations ~ ~ ~ ? 1 energy calculations far healed~edditions ? 3 copies of tree preservation plan H bt platted afler 7/1/93 required: _ Ves _ No DATE: ~-I/-~I ~ CONSTRUCTION COST: DESCRIPTION OF WORK: `f ~~h~~'/~~ S g`" ~~~1~~ STREET ADDRESS: l~°y~ ~l ~ ~ n~?//r' LOT o2 BLOCK ~ SUBD./P.I.D. .I PROPERTY Name:~~Yi~th /~~.T ~;_:rrr . Phone °`~~'y-~g~C~ OWNER Street Address:ln'y~+ Cc~crr~ City: l,Zc~?zit. State: ~ Zip: conRRacTOR Company: vJi~~~P f~..k'}~rior.s ~Zhc. Phone ~~1-/l0l~ StreetAddress: h'017 ~~~'cLle~f Qvr-~. License#: ~a5~my City: ~ /h~ ft~rt . State: /~7 ~U Zip• ~"`/~n ARCHITECT/ Company: Phone ENGINEER Name: Registration Street Address: City: State: Zip; Sewer 8 water Iicensed plumber: Penalty applies when address change and lot change are requested once permit is issued. I hereby acknowledge that I have read this application and state that the information is correct and agr comply ith all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: , ~ ~ OFFICE USE ONLY Certificates of Survey Received _ Yes No Tree Preservation Plan Received Yes No OFFICE USE ONLY ~ ~ BUILDING PERMIT TYPE ? 01 Foundation o 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ~ 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool ? 03 SF Addition o 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility ? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscelfaneous ? 05 SF Misc. ? 10 = plex o 15 Deck WORK TYPE ? 31 New ? 33 Alterations ? 36 Move ? 32 Addition ~ 34 Repair ? 37 Demolition ~ENERAL INFORMATION ~onst. (Actual) Basement sq. ft. MC/WS 5ystem (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV ~ of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Depth Footprint sq. ft. SAC Code Census Bidg Census Unit APPROVALS Planning Building Engineering Variance Permit Fee Valuation: 0`_~ • b(~ Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S!W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: /0 ' . ' ~ % SAC SAC Units ~t errv~ i-1- ~C 5~~I1 b E~/~~/9~- ~'~~-~/o8ss 7 d dJ.Q.~ ~ e~-a R~~ C~~ ~Gd{~ 1~~o1~i ~r0`~~+ ~ ,~-2, Q~ ~~K `li,~ 71 c~-i~,, Eu a 15qa ~ ~dn Da.uid CaA~ts~,r~ 3~ l5'~U ~s. c~ ~d, ~5~, ~~hn m~ GYO~~ ~i5C~~ s~m Dr~ Ea~~' (11~cJi~ l~VellL 5~ 3~a ~ E~e,-.r~rPe.n ~r, ~c~r~. ct~ l.~m .~~1 \ bJ `+338 ~ndS~b~e pr, Eccc~a.~1 R~~vr~.o ~-I 39 ~ Sa.r~ds~~ D,~, Ec~ cJ a.r, ~a-~ Fece..c,, rn~ 3a ~ 3 ~ 02~. ~v- , EA5 c~.n ~S.~p lti ~ ec.l c~., - ~ ~ ~ naTe / l-G~ ~ BUILDZNG PERMIT APPLICATION Include 2 sets of plans, 1 site plan w/elevations and 1 set of enerqy calculations.. To be used for q~~ t/ .G Valuation~3~L~ site Address: ~y~ ~ ~ 1~1~~C;/~ ~~C'~~1 ~Y~~~i ~~C~/'CJ Lot Bloc See. Sa~ib. Parce2 Number ~2.000 DSD DO Owner ~P~~f' /0 ~ l`~ Telephone `t~`~` - ~9~~ Addzess _ , ` `~~.$nl ~ •S.5%zl Contractor 5 f~ f/~C ~ e~ Telephone J~~~~~ ~ Address c 7 , ~ ~s.~~ Arch./Enq. Telephone Address OFFIC~ USE. . Erect Occupancy ~ Alter Zoning iP / F,epair Fire Zone 3 ~Z~ye Type of Comst. F/ ~~e # of Stories T~emolish Front ~ ' Grade Depth ' OFFICE USE - 1?ate of Approval 6 Initial_ FEES ~ ~ ~ Assessment Perntit -.-~1~ 77atex/Sewer ~ . Surcharge ~ rlan Check Police S~ ~ ~3 ~;o Fire ~g S~ater Conn. PlanneY C7ater Meter Lbuncil Rldg. Off. A.P.C. . ~ ~ J , . l G~ 7...~,~,.,~. ~ ~l' ~ 4---,ri~ , ~ 6~ ~ ~ ~ Y ~ 1 a`i ~ a` ~ . .4__ ~ q_/ ~s~ . ~ . ' . ~ ~ 1987 BQILDING PERMI? APPLICARION - CITY OF EAGAN 5INGLE FAMILY DWELLINGS ZNCLODE 2 SETS OF PLANS~ 3 CERTIFICATES OF SIIROEY~ 1 SET OF ENERGY C9LCQLA?IONS NOTE: ADDRESSES FOR CORNEE LOTS - CONTRACTOR/HOMEOANER MDST DESIGAATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BQILDZNG PERMIT IS ISSIISD. M[TLTIPLE DWELLINGS - RFSIDENTIAL RENTAL iJRITS FOR SALE O~ITS INCLUDE 2 SETS OF PLANS~ CERTIFICATE OF SIIRVSY - CHECK iiITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COI~RCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS~ 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2:000 LANDSCAPE BOND To Se Used For: Valuation:~ d Dat~~ Site Address Y~~ !~/~~(_.p(,GL~ OFFICE USE ONLY Lot ~ Block Q~ On Site Sewage_ Occupaney MWCC System - Zoning Pareel/Sub ~ •/p/[~ On Site Well Type of Const / City Water (Actual) Owner ~//~jj7e, ~~lp ~f'( (Allowable) 6~/a ~i~ ` ~jL' ~k of Stories Address / ~ 0 L[ Length ~ d 6~~ Depth City/Zip Code rl , SS~a ~ S.F. Total Footprint S.F. Phone '~~~1 ~ 9 ~PPROVALS FS[S Contraetor ~~p~-~Wt,~ ~hO~h Assessments Permit ~2•'~ Address ~1~~ ~ Water/Sewer Surcharge ~U U Police Plan Review ~ AG~ ~ Fire SAC, City City/Zip Code ~s/o2~ Engr SAC, MWCC ~~-]~37 Planner Water Conn Phone 5y - f 9~-c~ Couneil 4 Z1•~7 Water Meter Bldg Off Road Unit Arch./Engr. C~ /yL~ ~j APC Treatment Pl Variance Parks Address ~~Q Q S C~,~U ~ Copies TOTAL ~ City/2ip Code Phone ak ~ ' L ~ ~a - ~A2V L-"~/ ~ sr ity oF eegc~n 3830 PILOT KNOB ROAD, P.O. BOX 21199 BEA BLOMQUIST EAGAN. MINNESOTA 55121 ~ . Mayar PHONE: (612) 454-8100 ~ ~ THOMqS EGpN JAMES A SMRH VIC ElLI50N ~ 7HEODORE WACHIER Cou~l Members CERTIFIED MAIL - RETURN RECEIPT REQUESTED n+ornas Heoaes crcy nam~ni:eoro, . ~Y 6' , 987 EUGENE UAN OVEReEI~ aN aenc GEROME & DIANE GROTH 642 RITA CT EAGAN, MN 55121 Dear Mr. & Mrs. Groth: The Protective Inspections Department has received plans for the garage you would like to build. The City is concerned with the use of three bar ~oists, spanning 30', supporting the second floor storage area. You advised us an architeet has stated that these bar ~oists were designed for a 30-40 lb. liveload in the building they were removed from, however he will not certify that. We will approve the use of these to support the second floor framing and roof, however if you use this area for storage of any kind, it is at your own risk. We would ask that you sign this letter below to certify that we informed you of our concerns. Thank-you. Sineerely, ~G//.._" " SCXN~!'h- Steve Hanson Construction Analyst SH/~s ~j ~ 9 ~ 7 (SIGN , RE ~ ~DATE W~ ~i THE LONE OAK TREE. ..THE SVMBOL OF STRENGTH AND GROWfH IN OUR COMMUNIiY . EAGEsN 1iDWNSHIP 3795 Pilot Rnob Rosd St. Paul, Minnesota 55111 Telephone 454-5242 PERNII T FOR WATER SL~RVICE CONNECTION ~ Date: June 7, 1971 Number: 630 +~1~1~~ Billing Name: Gerald C, Brosm Site Address: 642 Hita Court, Eagan 55121 Owaer: s~e Billing Address same P1~ber:D, Schaaf d McMillan Location af Connectioa Meter Size 5 8 Connectioa Chg. 260.00 pd 6/7/71 Read Ovt No. 21220K Meter No,2129447 Permit Fee 10.00 od 6/7/71 Meter Reading5460 Meter Dep. 15.OD pd 6/7/71 Meter Sealed: Yes Add'1 Chg. 7.50 pd 6/7/71 NO Total Chg. 292.G9 Inspected by Date Building is a: Remarks: Residence ~aac t~ultiple xo, onits ~25.~~ RE-lPv'SPtCTI?id FEE FOR Commercial IIUIPROPERLY IPdSTALLED METERS. Industrial Sy; Other Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do Cte proposed work in accordance with the rules and regulations of Fagan Township, Dakota County, A2iunesota. By: D, Schafif d McMillan a Please notify the abwe office when readq for inspection and cannection. Y EAGAN TOWNSITYP 3795 Pilot Knob Road - St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: .7une 7. 1971 NUMBER 789 i#r~Ey pWNER: Gerald C, Brown Address b42 Rita Court~ Eagan 55121 PLUMBER D_ Schaaf d McM Llan TYPE OF PIPE Cast Iroa AESCRIPTION OF BUILDING Industrial Commercial Reaidential Muleiple Dwelling No. of units ~ac Location of Connectiona; Conaection Charge 200,00 pd 6/7/71 Acct. Dep. 15.00 pd 6/7/71 Permit Fee 10,00 nd 6/7/71 Street Repairs Total 295_00 - ~ Inspected by: Date Remarks~ By Chief Inspector In consideration of the issue and delivery to me of the above pexmit, I hereby agree to do the proposed work in accordance with the rules and regulations of Sagan 1bFmship, Dakota County, Minneaota By D, Schaaf S McMillan Please notify when ready for inspection and connection aad before any portioa of Che work is covered. PERMIT ~ ~i?Tl~ OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 030822 (612) 681-4675 Date Issued: g 9 ~ 2 Z~ y ~ SITE ADDRESS: sa2 RITA cT LOT: 2 BIOCK: 1 HOEFT P.I.N.: 10-33300-620-01 DESCRIPTION: (ROOFING) ~EU3.'1i~2nt~'~ermit Type SF (MISC.) ~Ui~~dtlCTg~~~~~ TYPe REPATR ~Cen~u~ ~~de, A34 ALT. RESI~ENTIAL ~ ~ ` 3 i Y C ba Y ~ ' Y C ~ 9 Y p 'a ~Sfi~ $a~, *'"u:s. ' ` ~ , . zz a~. ~ ~ s, a u'tr~.~~q~ ' i2` ~,L~~ « ~ ~ ~ ~ ~ ~ ~ "`~.m~a,~ ~t REMARKS: FEE SUMMARY: VALUATION $3,000 Base Fee $74.75 Surcharge $1.50 Total Fee $76.26 r • CONTRACTOR: - Applicant - ST. ~zc OWNER: RE-CREFlTSONS ' 14783133 W008702 GROTN GERALD 4385 COUNTY ROAD 116 642 RITA CT NAMEL MN 55340 EAGAN MN 55121 (612) 478-3133 (612)454^1920 ~ ~ ~ ~ *4 e t` : rd c~ F ~ e ae 1 71 ~ C. ~ q ~~"r~ f "cf+ r.^+.u.~E~" ~ x:7 ~ iaa ~ k ~ S,. s a~a~. E Pi wwca.e ~ E~ w,,:u -k..:~ h*~..Fka.~te rzE . ao- Z h~~^e=kt~ ~~~kri9{v1~+~J~ ~h~t ~~ar~ ~~'~a~~ ; ~~t~~~ z~~i~~3~,~~G~`~~yy t~~~~ ~+~#~',t~P#~r ' ~n~~rm~~~~n ~s ~~~r~~~ a~~~~$°~~ ~t~~.~~~~~~~~~~~~~'~~~ ~ ..~~~i~a~r~~~~~~d~ ~~~`'~~"'d~~i~~~~t~. ~ . -~t~~'y z ~ ~ . ~s. s ~ ~ xa ~^~'~~~^~.e ~s nn;.-$._~ ~ r .t~ttr,~ n"~k~T ~c t ~ 3 ~`r., ~ `f I~{1/1 IC o ~~rPA I~h7~ A LICANT/PERMITEE SIGNATURE ISS 7CTED SI 7 BUILDING PERMIT APPLICATION (RESIDENTIAL) -~~G ~ ~J CITY OF EAGAN 3830 PILOT KNOB RD - 55122 681-4675 New Canstruetion Reauirements RemodeVReoair Reauirements ? 3 registered sde surveys ? 2 wpies of plan ? 2 copies of plans (incluEe beam 8 window sizes; poureE fiC. design; etc.) ? 2 site surveys (exterior add'Rions 8 tlecks) ? 1 energy wlculations ? 1 energy plculations for heated atlditions • 3 copies of tree Preservation plan if lot platteC after 7!1l93 required: _ Yes No ' DATE: ~~ZZ(~/-? CONSTRUCTIONCOST: ~ DESCRIPTION OF WORK: " STREETADDRESS: C°~Z' LOT BLOCK ~ SUBD./P.I.D. ~ M~~ PROPERTY Name: UF~a~/~-~~-~f Phone#:_~~-~yZa ~wNER usr nne+ Street Address: ~O~ Z ~ ~ City: ~iG~V~ State: Zip: =~"~~y~ %D' ° CONTRACTOR Company: ~ ` ~/I.~c~c~cS Pnone 7d-3/~a3 Street Address: ~3&~S C'~, ~ License Z City:~aa,u.e.Q State: Zip:S~-3`fa ARCHITECTf Company: Phone ENGINEER Name: Registration Street Address: City: State: Zip: Sewer 8 water iicer.~ed piumber (new construction only): . Penalty appiies when address change and lot change are ~equested once permit is issued. i hereby acknowledge that I have read this application and sfate that the infortnation is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: .~'LLf,+~ V d-~" ~ OFFICE USE. ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No _ Not Required OFFICE USE ONLY H~~ ~ ~~+r :1h1y ~ a..,s ,:~6 :4~„_+_. ~•~i:'~2e ~a? ' Cs .*~F BUILDING PERMIT TYPE ? 01 Foundation ? O6 Duplex ? 11 Apt./Lodging ? 16 Basement Finish 0 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool ? 03 SF Addition ? 08 8-plex ? 13 GaragelAccessory ? 20 Public Facility o o4 SF Porch ? 09 12-plex o 14 Firepiace ? 21 Miscellaneous ? 05 SF Misc. ? 10 _ plex ? 15 Deck WORK TYPE ? 31 New ? 33 Alterations o 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MCNVS System (Ailowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. ~ Depth Footprint sq. ft. SAC Code Census Bldg Census Unit APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: °/a SAC SAC Units ~c~a4~, ~ ~o ~ 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City OTEagan g'~~_ C~~ 3830 Pilot Knob Road, Eagan MN 55122 n, Telephone # 651-675-5675 FAX # 651-675-5694 `~pA.~ VN~~ New Consirudion Reauirements RemodeVReoair Reauiremenls tNfice Use t7nfv 3 registered site surveys showing sq. ft. oF lot, sq. fl. of house: and all roofed areas 2 copes of plan CerloF Stuvey:Recd Y_ N (20°6 mazimum lot caverage albwe~ 1 set of Energy Calculations for heated additions ~rCePres Plsn ReCtl ~~~Y _N; 2 copies of plan showinq beam & window sizes; poured found design, etc, ' 1 site survey for addilions & decks €rOeP[e5RegUirEd ,,,;:Y ,,,,M1l 1 sel of Energy Calculalions Addifion - indicate if onsife sepfic system DtMSi18 Sephc:5ystefn ...::Y _ N~ 3 copies of Tree PreseNation Plan if lot plaped afler 7l1193 Rim Joisl Detail Options seleclion sheel (buildings with 3 or less units) Date~~/ ConstructionGost ~ LFJ~~ ~ Site Address UniUSte # 6. ~I SS~z Description of Work ~~l S 1 CQ,(,'fZ ~ij ~/~~ec/ ~ C~~ Multi-Family Bldg _ Y~ N Fireplace(s) ~ 0 _ 1_ 2 Property Owner ~ Telephone # (~h ! Contractor ~ ~ ~ Address City State Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 Energy Code Category , Residential Ventilation Category 7 Worksheet . New Energy Code Wo heet (Jsubmiuiontype) Submitted Submitted • Energy Envelope Calculations Submitted ~ p05 In the last 12 months, has the Cify of Eagan issued a permit for a similar plan based on •n'ids~ter plan? _ Y _ N If yes, date and address of master plan: 1 ' . ~ ~ Licensed Plumber Telephone,#( ~ Mechanical Contractor Telephone ~ ' Sewer/WaterContractor 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 p n in the case of work which requires a review and approv 1 of plans. . ~~ti~.~ G~~~~ Applicant's Printed Name Applicant's Signature OFFICE USE ONLY Sub Types ~ ? 01 Foundation ? 07 O5-plex ? 13 16-plex O 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 OB-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garege ? 22 Porch/Addn. (4-sea.) ? 33 Eut. Alt - SF ? 04 02-plex ? 70 OS-plex ~ 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? O6 04plex ? 12 12-plex Plb~vor_N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding 32 Adddion ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement •De~nolition (Entire Bldg) -Give PCA handout to applicaM Valuation 0C917 Occupancy MCES System ~ ~ Plan Review 100°k or 25% Census Code ~1 Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bidgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) FinaUC.O. ~C Footings(deck) ~C FinaUNo C.O. _ Foopngs (addition) _ Plumbing _ Foundation HVAC _ Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final ~ Frazning _ Siding _ Stuccn _ Stone _ Brick _ Fireplace _ RI. _ Air Test _ Final _ Windows _ Insulation _ Retaining Wall Approved By: ~~o , Building Inspector Base Fee Surcharge ~ Plan Review MC/ES SAC ~ ; ~ CitySAC ~ Utility Connection Charge 5&W Permit & Surcharge Treatment Plant License Search Copies Other Total . . . . a~3, . 0 ~ ~ . ~ ~ i' ~ ~',F~~T. ~ ~OX3o' S/~~ N~ D~ /~'X r6' ~ g'ID~ I ~ ~G3~~.~ p~~ srr~ . , ~ . S~r~ ~~v ~ ~X^3f,tiG /{e~~ t~ ~ a'~e4a~- ~ /~if}~vE `+~GE2Q~- ~7~C'oTff t~a , 6'~Z. k'rr~ Gav~e..T ~ ~ 65. ~iT7f G'ov,~T' c ~ . ~ ~ P~~,~, . 1 ~j ~ ~ ; _ ' .~i~ , ; ~ - ~.3: ~ 1 ~ 1~i \ i '~~.~a ' , ; , I ~ a~~ ; _ ; i ~ r,~, ~ ~ ~ i , ~ ; . \ ; ~ ; i ; - ~ , ~ ~ ; ~ i ; . 1._~ l ~ 1~ ~ _ i ~ `S.= RESIDENT OWNER Name:G C 44) ni r a i J( A. Cfy R.v T H Phone: 4o•6J a.: Address City Zip: 619 A TA A &A 1 Applicant is: Owner Contractor TYPE OF WORK Description ofeYk: IS A Vk PvOD M A SekS EAT. INYT Construction Cost: Multi Family Building: (Yes No CONTRACTOR Name: ,S A P/1 0 S E (,.,F License Address: City: State: Zip: Phone: Contact Person: COMPLETE In the last 12 months, has Yes No If yes, THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING the City of Eagan issued a permit for a similar plan based on a master plan? 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. City of Eap 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 Date: /o^ 09 Site Address: Tenant: X ...41 o V Applicant's Printed Name Applicant's Signature Permit Permit Fee: Date Received: Staff: Use BLUE or BLACK Ink Suite €se q e 3q3 3 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.gopherstateonecall.orq 2009 RESIDENTIAL BUILDING PERMIT APPLICATION (?`e d '-0 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. Page 1 of 3 SUB TYPES Foundation Single Family Multi 01 of Plex Accessory Building WORK TYPES New Addition )L Alteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (25 100 Census Code of Units of Buildings Type of Construction Reviewed By: 3av Fireplace Garage Deck Lower Level Interior Improvement Move Building Fire Repair Repair 3Y REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: _Ice Water _Final Framing Fireplace: Rough In _Air Test Insulation Meter Size: RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S &W Permit Surcharge Treatment Plant Copies TOTAL DO NOT WRITE BELOW THIS LINE Porch (3- Season) Porch (4- Season) Porch (Screen /Gazebo /Pergola) Pool Occupancy MG- 'L Code Edition 0..,6w7 Zoning ik ~1 Stories Square Feet Length Width Final Siding Reroof Windows Egress Window Sheetrock Final C.O. Required Final No C.O. Required HVAC Other: Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Demolish Building* *Demolition of entire building give PCA handout to applicant MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Demolish Interior Demolish Foundation Water Damage i Pool: _Footings _Air /Gas Tests _Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wall: Footings Backfill Final Radon Control Erosion Control Building Inspector Page 2of3 RESIDENT OWNER Name: (')E M E I-0 I AN) C r&QT N Phone: 61/44i 4/ L/ 92, U Address City Zip: y o2 �ZiT$ A (�/�15� t CONTRACTOR Name: E L. -4' License Address: City: State: Zip: Phone: Contact Person: TYPE OF WORK X New Replacement Repair Rebuild Modify Space Work in R.O.W. Description of work: PERMIT TYPE RESIDENTIAL Water Heater Water Softener Lawn Irrigation X Add Plumbing Fixtures RPZ PVB) Main X Lower Level) Septic System Water Turnaround New Abandonment RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation $50.50 Add Plumbing *Water Turnaround $100.50 Septic System $90.50 Fire Repair (replace (includes $.50 State Surcharge) Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge) (add $165.00 if a 5/8" meter is required) New ($10.00 per as built) (includes County fee and $.50 State Surcharge) burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES City of hp 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 X Applicant's Signature Permit q 74 D Permit Fee: Date Received: Staff: 2009 RESIDENTIAL C PLUMBING PERMIT APPLICATION Date: 3 0 Site Address: l2 7- st CT k. A F1 Tenant: Suite 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 l 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 /plans. E _g /I 6 k cT App 'cant's Printed Name euie lougb�: lr Ate Te Gas T FOR OFFICE U Required 1 Under Ground ì ý ï þýüýû ÿþþ ýüû ûúù øýýþþ ú õ ð ÿ ÿþõ úù ø÷ öó é á ùø÷ öø÷ öó é ô óéï ÷ý õù á ù íù÷ýø Üü úÞùý ì ÷â Þù ý æðý üóó÷ ü ûýððýü þ ÷ æáýððý ÷ ýð ýýæ áý ä ý Þù øýó ü ðýø æ ý çååæ åæå ôø úù ýü ý çæ ãæã Ûýùýûæ óò õñð ÷÷ý ï óý ý Ý ãáùøïýáö ïýá ï þýüýòô ë è øýó ü ý ýâ ý ý÷÷ýý ý ý ðý ýýü ÷øó ýý÷÷ý úý ðò ýúýù ýáøðþýüýíý æ ÷÷ýé úüýù ù øúüýù 1_ 42 City otEapu 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: Date Received: Staff: 2013 RESIDENTIAL11BUILDING PERMIT APPLICATION Date: Site Address: (S y d hkk N CV" Unit #: Name: 0\ avS-- L, cQ)As\ Address / City / Zip: (4 CJSY T(�, • Applicant is: Owner Contractor Description of work: Plt_rnM Construction Cost: `, Company: Address: State: License #: e „. Phone: COS 55IQ \ pk&s VIme Multi -Family Building: (Yes / No ) 308 SW 15th St., Suite 100 Forest Lake, MN 55025 City: 2 Zip: Phone: Fr ) I - `'t (0y 0�c,_JL Contact: A5()Lci.9 Lead Certificate #: N A. 1- 1 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit fora 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: TE: Plans and support ng'documents that you submit are c nsidered t be pu Ie information ma r be,classified as non public rf you provide specific reasons tl conclude:that they are, trade secrets = :. CALL BEFORE YOU DIG. CallGopher 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.qopherstateonecall.orq 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. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. Applicant's Print (At ..d Name x Applicant's / col n. ure Page 1 of 3