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3896 Riverton Ave 77 y CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # ' - To be used for ADQIZ'jON Est. Value $22,000 Date A3G 1 , 1991- Site Address 38% 1tIiIE1C1"dli AVE Lat 7 Block _3 Sec/Sub, CZQAR CH~ 81tt OFFIC~ USE ONLY PafCel N0. Occupancy J1--3 FEES Zoning _ W Name 32EY8N CIND~Y CRIl~1 (Aptual) Const _ Bldg. Permit ~?S•~ o Address 3896 RIVLBTON AHt (Allowable) - Surcharge 11.00 City RAGM Phone 452•-4392 # or Scories - _ Pian Review 146*00 Length ZF Name MCM SUILDERS b RE!lODELiit$ Depth _ SAC, cicy 00 a Address 1975 SE1RCA RD S.F. Total - SAC, MCWCC ~ Clty RAW Phone _ 437-4338 S.F. Footprints - On Site Sewaga _ Water Conn ~ W Name On Site Well - Water Meter _z Address Mwcc sysiem _ a W City Phone G1y Water _ ~ct. Oeposit PRV Required _ S/W Permi! I hereby acknowlege that I have read this application and state that the Booster Pump - S!W Surcharge inlormation is correct and agree lo comply with all applicable Slate of Minnesota Stalutes and City of Eagan Ordinances. Treatment Pt Signature of Permitee ; vic. APPROVALS Road Unit A Building Permit is issued to: MM BULL= 8BOCCE= Planner - Park Ded. on the express condition that all work shall be done in accordance with all Council appiicable State of Minnesota Statutes and City of Eagan Ordinancas. gldy, pff, _ Copfes Building OffiCial c Variance _ TOTAL 3"'00 ~ Permit No. Permit Hoider Date Telephone # WATEF SEWER PLUMBING l ~ ~I l!/0 ' I H.V.A.C. ELEGTRlC Inspection Date Insp. Comments Footings I 2_ 13 _ O Foundation Framing Rooting Rough Plbg. Rough Htg. isui. , ol l Fireplace Final Htg. Y' ~ Orstat Test Final Pibg. Q_ Plbg. Inspector - Notify Plumber Const. Meter Engr./Plan Bldg. Final Q - Dedc Ftg. Dedc Final weli Pr. Disp. PERMIT # ~ CITY OF EItGAN FEE v PLUMBING PERMIT RECEIPT # 454-8100 S/C MINIMUM RESIDENTIAL FEE - $10.00 + $.50 TOTAL DATE ~ MINIMUM COMMERCIAL FEE -$20.00 + $•50 7' 1. Bldg. Type: Res Comm Inst 2. New Add Alter Repair 1L; 3. Total Bid Price 4. Job Address Lot ~ Block ~ S e c 5. Owner ~r' 6. Contractor`• (Name) !G' .3 3 ' ~o C.' d (SUeeqL (CitY) 2iP) 7. Contractor Phone # NO. FIXTURES NO. FIXTURES N0. FIxTURES -Water Closet - $3.00 -Laundry Tray - $3.00 -Well - $10.00 -Bath Tubs - $3.00 _Floor Drains - $1.50 _Private Disp Syst - $10.00 -Lavatory - $3.00 _Water Heater - $1.50 _Rough Openings w/o -Shower - $3.00 _Whirtpool - $3.00 Fixtures - $1.50 -Kitchen Sink - $3.00 Gas Piping Outlets - $1.50 -Urinal/Bidet - $3.00 :KSoftener - $5.00 COMM./IND. RAT~EI 1%,OF TOT',L BID PRICE,PLUS =.50 STATE SURCHARGE FOR EACH $1,000 OF FEE. Signed: ' L ~ for Approved Inspections: Date Rough Insp. Date Final Insp. CITYOFEAGAN Remarks S2W COri, pCl. OTl 12-29-72 W+,Y' COTlri. nd, on 6-4~7.3 Addition Cedar Grov'e #8 Lot 7 Rik 3 Parcel 10 16707 070 03 Owner _(..1) fa G i) ^ t_,~,~ t_j Street 3896 R1V2T'tOIl AY@. State - F'2,g1T1,,MN 55122 f- U - ~ Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRAOING SAN SEW TRUNK IZ 1970 125.00 OO SEWER LATERAL IZ 1974 1539.1 WATERMAIN * WATEFj LATERAL 1974 5 WATER AREA ~ STORM SEW TRK 3~. STORM SEW LAT 1974 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 300.00 8171 Ej - SUILDING PER. sAC 2 0.00 171 - -73 PARK INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: c, ~ (612) 681-4675 SITE ADDRESS:' APPLICANT: 1 t~t t~t t ~!Ii r i nrh :tvi i tir$ PERMIT SUBTYPE: TYPE OF INQRK: ~ . INSPECTION . .A . ~~~~~•il ; rl F- ~ ~ ~ Permit No. Permk Holder Date TeIephone • ELECTRIC PLUMBING HVAC Inspwdon Dab Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATINCi GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL FITf3 ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL I DECK FTG I DECK FINAL 1 I I . ~ RESIDENTIAL _ • BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD • 55122 ~ 651-881-4675 ~J airR utremenh NewConstruction Reauirements F • f registered site surveys showing sq, ft ot bt, sq. ft W house: an@~ roofed ereas f plan 20% ma)cimum bt oove~e albwed kulations for heated additlom . 2 copies of plan showing beam 8 windav s¢es; poured land de.vgq etc.) ey fw erierbr additions 8 declm ~ • 1 set ol Energy CakuWtions me served by septlc system br addNOns • 3 copies of T2e Preservafion Plan H lot p0alled after 717193 • Rim Joist Detail Optlons selection sheet (Oldgs with 3 w less unib) DATE O/ VALUNION-3 g, o C) O'C'~ JOB SITE ADDRESS 389(o /P/UaT0N AI/i' 6911JN IF MULTI-FAMILY BUILDING, HOW MANY UNITS? 4e~z PROPERTY OWNER STE711E'i? ~CYNTNiA G.P?m.-I, TYPE OF WORK 3ROCA.P 6ARA6E 19OV1-noN FIREPLACE(S) _ 0_ 1_ 2 APPLICANT STEfHEn/ G.PirnM PHOyNE# 4-1y.ys2- y3sa ADDRESS 3~96.Piv~~ro,v f~I/t" EA(,~J t/y/V ZPCODE SS/-Aa PAGER # 667~/0 -.~6.5'3 CELL PHONE # /Y~l1 FAX # N/f3 ~ NEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY Energy Code Cate9ory _ MINNFSOTA RULES 7670 CATEGORY 1 (check one) - Residential Ventilation Category 1 Worksheet Submitted - Energy Envelope Calculations Submitted _ MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Plumbing Contractor. Phone Plumbing System Includes: _ Water Softener _ Lawn Sprinkler Fee: $90.00 _ Water Heater _ No. of R.I. Baths _ No. of Baths Mechanical Coniractor: Phone# r--- =--n t'F. 1~ Mechanical System Includes: _ Air Conditioning ~Pee:4 ~V0,00 _ Heaz Recovery System - 3ewer/Water Conhactor. Phone # R All above information must be submitted prior to processing of applicatlon. I hereby acknowledge that I have read ihis application, siate that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Slgnature of Appllcant Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ ' . . . Updated 7/01 OFFICE USE ONLY ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Eidg O 02 SF Dwelling O 08 06-plex O 16 Fireplace O 21 Porch (3-sea.) ? 31 EM. Alt- Multi ? 03 01 of _ plex ? 09 07-plex W77 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 70 08-piex O 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex O 19 Lower Level ? 24 Stortn Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N 0 25 Miscellaneous ? 31 New 0 35 Int Improvement ? 38 Demolish (Interior) O 44 Siding f~ 32 Addition O 36 , Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair O 33 Atteration ? 37 Demolish (Bldg)' O 43 Reroof O 46 Windows/Doors ? 34 Replacement 'Demolitton (Entire Bldg anly) - Give PCA handout to applieant Valuation d dU p~ Occupancy /PL MGES System Census Code Zoning I/ r " l City Water SAC Units O/ Stories Booster Pump Nbr. of Units ~ Sq. Ft. PRV Nbr. of Bldgs l Length Fire Sprinklered Type of Const W idth REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. Footings (deck) FinaVNo C.O. ~ Footings (addirion) _ Plumbing ~ Foundation _ HVAC Drain Tile Roof Ice & Water Final Other ~ Framing _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Fireplace _ R.I. _ Air Test _ Final _ Siding Stucco Stone _ Insulation _ Windows (new/replacement) Approved By uld , Building Inspector Base Fee ~ /~.t~i ~ Surcharge Plan Review `k:" MC/ES SAC City SAC VVater Supply & Storage 58W Permit 8 Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies • Other Totai , ` ~ /007 0o G 7/od 9/9/ 0 12 9 6 7~ Reqoest Oaie Fire No- Roughin Inspection -7_ l~ _n I iretl? G Reetly Now ill Notity tnspecor Yes C N. hen Ready? Iw licensed contractor ? owner hereby request inspection of above elechical work at: ~ Job ACtlress (SVeet Box or Roule No.l Ciry 3~Q (o ~i V cri'lz~n 1611e e Y) Section No Township N.T. o, No. Aanga No. CourAy a'rC~ Ocaoam IPRMT~ Phona No. ro~rnCC~'l~ USa -9538 aower Swvifer Aatlress ~C~o~u ~.(sZt~-ri c ~'oc ~0.rmi ~orl Eleonical Gonlremor (COmpany Namej nlractor5 License No. Ma~s-A-ec- C-teL`~c-C n ~ ~`4 C>-I L4b -3 Matling Address IGontranor or Owner Mekinq Installa[ionl ~a~b-r ~on~ s sau e rnn1 553~ Amhorized 51 namrs iComraclorrOwnBrMaking Insi la~ion) Phane Number Cc 8 O' W~ MINNESOTA TE 60AH0 OF ELECTPIGITY THIS INSPECTION REOUEST WILL NOT ~p'~O(1 • Griggs-Mitlwa BIEg. - floom 54]3 BE ACGEPTE9 BY THE STATE BOARD /J. 1821 University Ave., SL Paul. MN 55100 UNLESS PPOPEF INSPECTION FEE IS ~c1 Phone (612) 642-0600 ENGLOSED. r'~ T~ep REQUEST FOR ELECTRICAL INSPECTION See insVUClions for compleling Ihs lorm on back oi yellow copy. ~ ~ Ito ~ O~ 7 '~b ~ 6 7 "X" Below Work Covered by This Request ewAtltl Rep. Type of Building AppliancesWired EquipmentWired Home Range Temporary Service Duplez 71water Heater Eleciric Heating Ap[. 8uilding Dryer Other (Specity) Comm.llndustrial Furnace Farm Air Conditioner OlherlsUacilyl ConUaclor's Femarks: (2eozo,ps4 Y- IDi917,70.) Compute lnspection Fee Below: ~ Other Fee # ServiceEntranceSize Fee # Circuits/Feeders Fee Swimming Poal 0 to 200 Amps 0 to 100 Amps TranSformefS P.bove 200 _ AmpS Above 100 _ Amps Signs inspecior's Use Only: TOTAL Irrigation eooms ' Special Inspection ~ Alarm/Communication THIS INSTALLATION MAV BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTy$. I, the Elsctrical Inspector, hereby Rougb-in / Date certify that the above inspection has F,,,ai 10 been made. ~ OFFICE USE ONLV ~ The raduesl voitl 18 months Irom ~ CITY OF EAGAN No . 19512 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE: 454-8100 Receipt # l~ ~J !1 ~1(' V)'- To be used ror ADDITION Est Value $22, 000 Date AUG 1 ,1991 Site Address 3896 RNERTON AVE Lot 7 Block 3 Sec/Sub. CEDAR GROVE STH OFFICE USE ONLY PefC81N0. OccuOancy B--3 FEES Zoning _ W Name STEVEN & CINDY GRII47 (ActuapConst - BIdg.Permit 225.00 o Address 3896 RIVERTON AVE (nllowable) - Surcharge 11.00 City EAGAN Phone 452-4392 xoistodes - Length _ Plan Reviaw 146.00 tF Name METRO BUILDERS 8 REMODELERS Depth - SAQCity 0a Address 1975 SENECA RD S.F.Total - SAC,MCWCC ~ City EAGAN Phone 452-9538 S.F. FootpnMS - On Sue Sawage _ Water Conn ~ W w Name On Si1e Well - Water Mefer AddfBSS MWCC Systam - qcct, De it aw City PhOn2 Cirywaier _ ~ PRV Required _ S/W Permit I hereby acknowlege ihat I have read ihis application and state that the eooster Pump - SM/ Surcharge information is correct and agree to comply with all applicable State ol Minnasota Stalutes and /City~,o-l Eagan Or~dina~nc,ews~.~ ~ Trealment PI SignaNreofPermitee/,,~~~,/~ APPROVALS RoadUnit A Building Permit is issued to: MEW $JILDW & RQM3DEIERS Planner - Park Ded. on the ezpress condition that all vrork shall be done in accordance with all Council applicable State of Minnesota StaWtes andC.ity of Eagan Ordinances. gldy, plf, _ Copies 8uilding Ofliciel ~y} J_Ly(1 Variance _ TOTAL 382.00 A. 7 CITY vr^ EACaN 3795 Pilot K;ob Road Eaga;z, Piinnesota 55122 PFEMIT NO,: 539 The City of Eagan he^eby grants to crar,dArd x-a -+_nq & A/r ro_ Of 410 West kk Mols 55408 a_p/c Permit for: (Owner) chAriae x.,anton at 3896 niverton Ave. , pursuant to application dated _ 6/36/74 Fee Paid: $5.00 dated this 28th day of June ~ 19 74 .50 s/c Building Inspectar PQechanical Permits: Bid Total: i4 70 ~ 6 ~a d 3 G,e. VILLAGE OF r~AGf1N 3195 Pilot Itnob ttoad Eagan, Iriinnesota 55122 ' PLUIIT N0. The Village of Eagan hereby grants to~Pdar Grwe ConstrLCtioa Go. o£ 7343 Concord Blod. E.. South St. Paul a ~Luenrxr_ Permit for: (Owner) Same 3896 Rinertou Ave. 7-3-8, at ~.~_s---~-..-•--~--- i~o-~ pursuant to application dated 6/1/73 Fee Paid: SGn_np dated this 4th day o£ June ~ 19 73 1.00 e/c Building Inspector Nlechanical Permits: Bid Total: l ~-3-$ VILLAGE OF EAGltN 3795 Pilot Knob Road Eagan, Iviinnesota 55722 PEMIIT N0. 357 , The Village of Eagan hereby grants to Gedar Grwe Conetruction Co. 0f7343 Coneord Bivd. E.. South SC. Pau1 a -~IEATIAIG Permit for: (Owner) Sama 3896 Riverton Ave. 7-3-8 at 2726 eoeMgge Ave 16-6-8 , pursuant to application dated 6/1/73 Fee Paid; g40.00 dated this 4th day of Juna , 19 73 1.00 s/c Building Inspector Niechanical permits: Bid Total: / 4 EAGAN TOWNSHIP BUILDING PERMIT N° 3043 Owne: Eagan Towmhip Address (Preseni) I Town Hall Builder Dele Add:ess DESCRIPTION SSOxies To Be Used For Froni Deplh FIeigh! Esi. Cos! Permif Fee Remarlcs ov ~/~Sd LOCATION ;.5<-S-v Sireel, Road or olher Deseripiion of Locafion I Lol- -Blaek_I Addilion os Trae! /L 6 T6is permit does aot authorue the vse of slreeYs, roads, alleps or sidewallcs aor does it give the owner or 6is aqen! the righ! !o creale aap situalion whic6 is a auisance or whieh presents a hasard fo the heallh, satetp, coaveaienae and general welfare !o anqone in the communi2y. THIS PEAMIT MUST BE-KEPT N THE PREMISE WHILE THE WORK IS IN PROGRESS. ~ This fs !o eertify. !hal...-----...Cd..:-. ~:.-.---4~ -r.--:-'---...._....has permission !o eree! .`..'...J...----.._upon the above deseribed premise subjec! !o the provisiom of the Building Oxdinanae fo= Eagan Township adopled April 11, 1955. Pez --'!.V""y" Chauman of Tn n Boesd Suildin Ina aefos o2i~ynal -31W un6ee 1-I CG~S' EAGAN TOWNSHIP ` BUILDING PERMIT N? 2928 Ownee Eagan Township Address (Present) '14~e 4-AC,...... Town Hall ~ Buitder 1 ~ 7 L Address Dafe - DESCRIPTION ' Siories To Se Used Fos Fron! Dapfh .Heighf Esf. Cos! ~Permif Fee Remarki Slreef, Road or oiher Deseripfion of Loealion I Lo! Block Addition os Traci O This pexmii does aot auShorise the use of slraeri, roads, alleys or.eidewalks nor doas it give the owner or his apan! !he right !o creale anp siluafion whieh is a nuisanea or whieh presenls a hazard !0 the healih, safefy, eonvenianes aad ganeral weltare !o anpona in the commvnilp. THIS PERMIT MUST BE KEPT ON THE PAEMISE WHILE THE WOAK IS IN PAOG S. This b fo certiip. !hal.....C~.x ./..:rc_._~....has Permissioa !o eree! a....-_- `1-.-~; -c~ . upon - . _ the aLore decaribed premisa subjecf !o the provialons of the Buildinq Oxdinanea for Eagan To~nship ado led April 11. 1955. l - ..._2. ....~-~t:.`.=.`.~...-~. ...._y. Per .........-----.....-'-~:~:-.e:'(-------O~-L'~:, ~,~-...i,--....................... ~j Buildinp Impeetor 6 1~-- I 1'~ 2- 90_ ~D 2007 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan ~ 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Conshudion Reauirtments RemodeVRmair Reouirements Otfica Uce Dniv 3 repisfead sife surveys shwxing sq. H. of IoL sq fl, oi house; and a_l roofed areae 2 copies of plan shoMng footmga beams, joisis Cert of $urvey Recti Y!_ N (20%maranumlotcoveregeatlowed) iseto(EnergyCalculatum farhaatedaddiliore Sodspzport:-~: -Y:-~N iSoikRepa[dproposedbuildngistobeplacedondslurbedsoil lsdesuraeVforadditioris&decks TreeResPMnRctd _Y:.N. 2 wpies ot plan showing beam & window sizes; poiaed found desgn, etc. AddiOOn - mdcafe ii on,0e septic sysism Trae Res Requeed _Y. _N 1setofEnergyCalculafions OnsBeSepficSyshan _Y>.-_N 3 copies d Tree Preservefion Plan 01M plaHed efler 711193 . ' Rin Joisl Detafl Options seleUion shaet (6uildings wAh 3 or less units) Minnegasco mechaniwl uantilation fmn Kam are consddes°iRd pub4iC ins-Draraation untesa yade state the are tracRe secre# antf the reason. Date 10 _ //.r /0-1, ConstruMiun Cust 414000 ssceaaaress 3M Riit&-A'u.j ALPe. Q.j Unit/Ste # DescriptionotWurk Ilt-GU6/`1 Multi-Family Bldg _ YL,/ N Fireplace(s) ? U _ 1 _ 2 Property Owner C~l n MM U~~ Telepbone ts (Io5/ 41 13 9 Z r ConYraMor P " gID$, t.v+'+f Tz&A~ Address 1~17 0 moewJ fT City /i tzk 5; KRi State M r-' Zip aIT7 I Telephuee 95aj -75';F- - 3 S3 3 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Enargy Code Gategory - M_nnesolt Rules 7670 Cateeory ] ` Mimtesota Rules 7672 (J submission rype) Residential Ventilation Categary 7 Workshaet • Naw Enerpy Code Worksheet Submitted Submitted • Errergy Emrelope Calculations Submittad In ihe lasf 12 months, has ihe CIty of Eagan issved a permit for a similar plan based on a master plan2 _ Y _ N If yes, date and address of masTer plan: Licensed Plumber Telephone ~ Mechanical Confractor Telephone # ( ) Sewer/Water Conhqctor Telephone # I hereby apply for a Residential Building Pemvt and aclmowledge ihat the informatian is complete and accurate; that the work will be in confozmance with the ordinances and codes oF the Cit} of Eagan and the State of MN Statutes; I understand this is not a permit, but onl} an applicarion for a permit, and work is not to start without a pemut; that the work will be in accordance with the approved plan in the c of wo which requires a review and approval of plans. ApplicanYs P'nted Name Appli t's Si ature r~ CITY USE ONLY L / BL 3 RECEIPT SUBD. ~ /.1~1fC. O ~ DATE: 1996 MECHANlCAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit New construction X Add-on fumace replace ` X Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc. replace Dat2: February 6, 1997 FEES ? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00 ? HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ? Gas Outlets (minimum of 1 required @$3.00 each) ? State Surcharge .50 TOTAL SITE ADDRESS: 3896 ltiverton Ave OWNER NAME: steve & Cinda Grimm PHONE 452-4392 INSTALLER NAME: F d i 7cGOn x aing & Ai ond: ioninq, ?nc_ STREET ADDRESS: 3650 Kennebec Dr.,#1 CITY: Ea9an STATE: mN ZIP: 55122-1003 PHONE ( 612 ) 452-2775 r t 3-/s ~9 7 CITY USE ONLY L BL RECEIPT SUBD. DATE: 1996 MECHANICAL PERMIT (COMMERCIAL) • CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? all commercial/industrial buildings. ? multi-family 6uildings when separate permits are Dpt required for each dwelling unit. DATE: CvN?F26`,CT PolCE: WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: FEES: - $25.00 minimum fee Q 1% of contract price, whichever is greater. 0 Processed piping - $25.00 0 State surcharge of $.50 per $1,000 of permit fee due on all permits. CONTRACT PRICE x 1% PROCESSED PIPING STATE SURCHARGE TOTAL SITE AQDRFSS- _ OWNER NAME: TELEPHONE TENANT NAME: (iMPROVeMeNTS oNLv) INSTALLER: ADDRESS: CITY: STATE: ZIP: PHONE SIGNATURE: SIGNATURE OF PERMITTEE CITY INSPECTOR INSPECTION RECORD ~ CITY OF EAGAN PERMIT TYPE: B u z Lo z Nc 3830 Pilot Knob Road Permit Number: 025645 Eagan, MinneSOta 55122-1897 Date Issued: 0 5/ 2 2/ 9 5 (612) 681-4675 SITE ADDRESS: p•I• N.: 10-16 re7-ere-es APPLICANT: LOT: 7 BLOCK: 3 3896 RIVERTON AVE HAMLIN CQN5TRUCTION CEDAR GROVE 8TH (612) 689-5295 PERMIT SUBTYPE: TYPE OF WORK: SF (MISC.) REPAIR DESCRIPTION REROOF INSPECTION • DA FRAMTNG ROl16H TN PLBG OUGH IN H7G FINAL , . , . . . . . ~ , : _ m. _ ~ . , PERMIT -74 ~1716 CITY OF EAGAN 3830 PilotKnobRoad PERAAITTYPE: euzLozNG Eagan, Minnesota55122-1897 PermitNumber: 025645 (612) 681-4675 Date Issued: 05 J z2J y5 SITE ADDRESS: 3896 RIVERTON AVE LOTs 7 BLOCK: 3 CEDAR GROVE BTW P.I.N.; 10-16707-070-03 DESCRIPTION: RERooF B.611ding 4ermit Type SF (MISC.) Ouilding W°o~1c~TYPe REPAIR a. . . ......A - . . . . . .cA. A'a S . . . . .i9 JY ~ o t4 REMARKS: FEE SUMMARY: VALUATION $2,400 Base Fee $54.00 Surcharge $1.20 Total Fee $55,26 CONTRACTOR: - Applicant - s1'. LIC. OWNER: HAMLIN CONSTRUCTION 16895295 00003915 GRIMM STEVEN 255 460TH ST 3596 RSVERTON AVE HARRIS MN 55992 EA6AN MN (612) 689-5295 (612)452-4392 hvt^eby.ackrtnWtedge that 1- havePssd °this ap}sLicdtfort andstdte ~that th6. i:nf~rmatia+~ is aarrect onci 4gree't4 cam;ply witfr a.11 applicabla SCate af'Mn. Statutes "d City af Eagaa 4rdindnee6. ~ _ . . _ . ~ APPLICANTJPERMITEE SIGNATURE ISSU BY: SIGNATURE C I ~ CITY OF EAGAN ~ S S.ZQ o~ J`~~ S 3830 PILOT KNOB RD - 55122 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 New Construction ReauiremeMS RemodeVReoair ReauiremeMs ? 3 registered site surveys ? 2 copies of plan ? 2 copies of plans (Indude beam 8 window ahes; poured ind. deslgn; etc) ? 2 site gurveys (exterfor edditiona 8 tledcs) ? 7 energy calalatlons ? 1 eriergy plwlations for heatetl addiHons ? 3 copies of tree pieservation plan if lot platted after 7/1/93 required: _ Yes _ No ~ DATE: I o2A"S CONSTRUCTION COST: DESCRIPTION OF WORK; o~/- `t STREET ADDRESS: 3ff g 6 ,'0' 'ugg , 4,. LOT ~ BLOCK ~ SUBD./P.I.D.#: ~~~~~~~NJOIL PROPERTY Name: Sletff, Phone OWNER ~ Street Address• City: State: ~ Zip: ~S1 2 Z CONTRACTOR ComNany: /Jo'n Phone ~/a '6/lfq'S~2SS~ Street Address: ~SS `CU/d ~ sl License 39 /5 City:State: u~ Zip- ARCHfTECT1 Company: Phone ENGINEER Name: Registration Street Address, City: State: Zip: Sewer & water licensed plumber: Penalty applies when address change and lot change are requested once pertnR is issued. 1 hereby acknowiedge that 1 have read this application and state that the infortnation is correcf aod gree to wmply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. / Signature of Applicant: LOFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received Yes No OFFICE USE ONLY BUILDING PERMIT TYPE 0 01 Foundation o 06 Dupiex ? 11 Apt./Lodging o 16 Basement Finish ? 02 SF Dweliing o 07 Mplex o 12 Multi RepaidRem. ? 17 Swim Pool ? 03 SF Addition ? OS 8-plex o 13 Garage/Accessory o 20 Public Facility o 04 SF Porch o 09 12-plex ? 14 Fireplace o 21 Miscellaneous ? 05 SF Misc. ? 10 = plex o 15 Deck WORK TYPE ? 31 New o 33 Alterations ? 36 Move 0 32 Addition '~,,t 34 Repair o 37 Demolition / GENERAL INFORMATION Const. (Actuai) Basement sq. ft. MCNVS System (Allowable) Main levei sq. ft. City Water UBC Occupancy sq. ft. Fire 5prinklered 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 Pfanning Building Engineering Variance Pertnit 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: % SAC SAC Units CITY OF EAGAN FOR CITY USE ONLY ` 3830 PIIAT KNOB ROAD EAGAN MN 55122 PERMIT # PHONE: (612) 454-8100 RECEIPT # mSING DATE: --!v fF- mmNm; PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION COMPLETE THE FOLLOWING: N0. FIXTiTRES EA. TOTAL NEW CONST ADD-ON MINIMUM 15.00 ADD ON P~o SHOWER 3.00 REPAIR WATER CIASET 3.00 BATH TUB 3.00 ~r LAVATORY 3.00 OWNER NAME: KITCHEN SINK 3.00 / LAUNDRY TRAY 3.00 SITE ADDRESS: i/.xr~to~ t,ti~o _ HOT TUB/SPA 3.00 ~ ~J ~/"y~ QY~ WATER HEATER 3.00 LOT:~ BIACK dSIIBD. l~.~dir .CIICOVf, FLOOR DRAIN 3.00 / GAS PIPING OUT. INSTALLER: /Ktt.~4r ~S e~~~^-i. .=Ln c _ (MINIMUM - 1) 3.00 ' ROUGH OPENINGS 1.50 ADDRESS: ~4I7)(' C-7- _ OTHER _ WATER SOFTENER 5.00 CITY: F[s.-~6-/Y1 ZIP: PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 PHONE > SUBTOTAL $ I.9,d O ST. SURCHARGE .50 SIGNATURE OF PE TTEE ~i TOTAL: $ "MMETA RCLM#UST8IAl` PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: FEES OWNER NAME: IS OF CONTRSCT FEE. STATE SURCHARGE e $•50 FOR SITE ADDRESS: EACH $1,000 OF PERMIT FEE. LDT: BLOCK SUBD. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 18 $ RDDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE (SIGNATURE) FOR: CITY OF EAGAN ° MASTER CARD LOCATION OWNER STRUCTURE AND LAND USED A$ JJ L/ Issued To Permii I No. Issued Contrac}or Ownar BUILDING 9zB ~ , PLUMBING ~~y 3 CESSPOOL - SEPTIC TANK VJELL / ELECTRICAL HEATING 7 GAS INSTALLING SANITARY SEWER OTHER OTHER I Approved I}ems (Initial) Date Remarks Distance From Well FOOTING SEPTIC FOUNDATION .2 CESSPOOL FRAMING TILE FIEID FT. FINAL ELECTRICAL DEPTH HEATING OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING WELL SANI7ARY SEWER Violations Noted on Back COMMENTS: COMPLIANCE INSPECTION REPORTS TO BE USED ONIY IN EVENT OF 085ERVE0 VIOLATIONS PERMIT NO. DATE OF INSPECTION CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ~ NO EVIDENCE OF NON-COMPLIANCE ? NON-COMPLIANCE. BUfLDER DOES NOT OBSERVED. INTEND TO COMPLY. ACCEPTABLE SUBSTITl1TIONS OR DEVIATIONS. ~ COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYED BY CONDITIONS BEYOND GONTROL. ? NON-COMPIIANCE. BUILDER WILL COMPLY WITHOUT DELAY. ITEMIZED AND DESCRIBED AS FOILOWS: ? REINSPECTION REQUIRED DATE OF REINSPECTION REINSPECTION REVEALED CERTI FICATI ON - I certity [hat I have carefully inspected the above in which I have no interest Dresent or prospective, and that I have reported herein all significant conditions otserved to 6e at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require- ments for off-site improvements relating to the property inspected. ? ALL IMPROVEMENTS ACCEPTABLY COMPLETED BIJILOING INSPECTOR DATE COMMENTS: EAGE3N TOWNSHIP 3795 Pilot Rnob Road St. Paui, Minnesota 55111 Telephone 454-5242 PERMIT FUR WATER SEItVICE CONNHCTION Date: 6/4/73 (12/2a/77) Number:1215 Billing Name:Cedar Grove Construction Site Addres~f~Ztiverton Ave. 7-3-8 Owaer• same Billing Addreas Plumber: Stein's Location of Connection Meter Size Connection Chg.300.00.pd 6/4/73 Meter No. Permit Fee 10.00 pd 12/29/72 -".5U p3~72729/72 Meter Resding~i Meter Dep. Meter Sealed: Yes Add'1 Chg. NO Total Chg. InspecCed by Date Suilding is a: Remarka; Residence_,Z&_ tafultiple n*o, uas.c8 $25.00 RCASPeCI!ON F!rE ;'ON Commercial IM1P`t0Ft'if..'( Industrial By; Other Chief inspector in conaideration of the isaue and delivery to me of the abave permit, I hereby agree to do ttm proposed work in accordance with the rules and regulations of Fagan Townshig, Dakota County, Minnesota. By: Ste=n' G Please aotify the above office when ready for inspection and connection. BEA BLOMpU15T MAYOp TMOMASHEDGES " - ' CiiYFUMIMiSfRntOF TMOMASEGAN CITY OF `EAGAN EUGEHEVnqOVERBEKE JAMES A. SMITM . CIiY CLEA[ JERRV THQMqS . TNEODORE WACMTER . . 3115 VILOtKHOB GOLO ' LOIINUI MEMBEPS ' I ' - P.O. BOR 2IN1 ' "EAGAN,MINNESOTA~t- DATE: y, svx: ~ PMONE 454-8100• .~qy _ . . . i^:...'.._ : G.:;.... Rf. . . . n:'.?'. ' . \~LL\ SPECIAL ASSESSA]ENT SEARCH 3 G{n• IWvE RE : Enclosed herein is the search which you requested made on the above described property. ~ Kind of Improvement Runs Beginning Original Amount Balance 5ue ~ I further certify that according to the records of said office, the following improve- ments are contemplated or pending after having been approved, and are now in the process of planning or completion. Kind of Improvement q proximate date ot Com Ietion A prosimate cost ~WN,Q ~ WAIVGR: Ncithcr the City of Eagan nor its employees guarantees the accuracy of thc above in- formaLion which was requesteJ by the person or persons indicated. Nor does tlie City or its employees assume any liability for tlxe correctness tliereof. In cansideration for the supplying of thc indicated information in the abovc form, and for all other considcration of any nature whatsoever, any claim against the City or its employees rising there fram is hereby expressly waived. Levied assessments to be paid to the County Treasurer at Hastings, M. 55033 Very tr ly Yoursy„u~ J ~ TME LON OAK TREE TNE SYMBOL OF S7RENGTw qND GROWTH IN OUR COMMUNITY. 1991 BUASIT41APPLICATION CITY OF EAGAN -(5'Y-~-(00 SINGLE FAMILY DWELLZNGS MIILTIPLE DWELLINGS COPRSERCIAL 2 SETS OF PLANS ' f 2 SETS OF PIANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGI5TERED SITE SURVEYS - & STRUCTURAL PIANS 1 SET OF ENERGY CALCULATIONS (CHECK WITN BLDG. DEPT.) 1 SET OF SPECIFICATIONS 'st7^ -Q 1 SET OF ENERGY CALCUTATIONS 1 SET OF ENERGY CALCS 7 aC '^w'``•, n.} OF RENTAL UNITS OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF HONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER HUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALIAWED ONCE BUILDING PERMIT IS ISSUED. PROCESSING TIME FOR SEWER 6 WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED. PERMIT MUST SHOW A LICENSED PLUMBER. 12 Xak xk To Be Used For: Valuation: 2Zi~ Date: Site Address OFFICE USE ONLY Lot ~ Block 3 FEES Occupancy ~-3 Sldg, Permit Z ZS, o 0 n ~ Zoning Surcharge I, a o Parcel/Sub Actual Const Plan Review 6.Ua Allowable 5AC, City Owner # of stories SAC, MWCC t Length Water Conn. Address Depth Water Metex S.F. Total Acct. Deposit City/Zip Code Footprint S.F. S/w Permit S/W Surcharge Phone On sita sewage_ Treatment Pl. On site well _ Road Unit Contractor t& e. MWCC System _ Pazk Ded. ~ I City water Trail Ded. Address )ti ~l$~ i/.2C0.-~-C~ ' PRV _ Copies C Booster Pump City/2ip Code G~1~r~ SIIBTOTAL 't Q APPROVALS Penalty Phone q~3(] Planner Lot Change ` Counc3l TOTAL (1O Arch./Engr. Bldg. Off. No 7 30 V,/ Variance Address City/Zip Code 4R Phone Sewer/Water Licensed Contr. 1\ )O.M-~ agrees that all wotk shall be done in accordance with (Signature of Contractor) all applicable State of Minnesota Statutes and City of Eagan Ordinances. _ . . . . . . ~ I I •o,* I I 2?5 • O0+ 11•00+ 146000+ ~ 332•00* I 225•00-F ~ ~ 11•00+ 146•00+ 38z•oo* ~ i • v ionA Plunn,nq 6875 H,Awuy 11o eS N!. lnntl Sv~•e , SO.I, Ie,lrn9~r~~' II~IIII'I'IIlI~, •~JI('• M,n,etr„~I,,, fngme.,ing r.i<Nno„~.ea-euee ~.,...,EnKineers ~ Surveyors <6 12 Mortgage Loan Survey for-Cedar G_roye C011St. I, , i ~ ;i -il-- > I 's2.g. 3 _ p ~ 1 ~ ~ /~-r- r7 • ~ I I ~ L Llj . ~ CT ~ 'tj J ~ P N . I O ~l~ t Qd . _ Q ~ ~ i G.0 12,J I ~ o I d ~ : d I ~ rv . N ~ 3r.~ t 13304 ~ h~ n M ~-C LOT 7 BLOCK 3 CEDAR GROV'E Nn. ~ COUNTY OF DAK1T Denotes drainage and Utility Easement Thi. ond <o.,ear ,np.«..,...,r.on ol a...'r ol .he eo~~,ea..e, ol rb~. IonA ~hoo n...n,b~d aoA oe me btarion,ol oll be~lAing~~ ~1 ony~ rhe.con~ nnd ull vl+ihle •ncroo~hmem~~ ~1 i..y~ I.orn o ,<I I.nA rh~~ ~ rv.y ~t mad[ enly in ~onni,<rion w1~h o mo.+gegc Ioun n b.inp plaaeJ on rbe p.operrr nd no Lub,Ley ~ n., .^ee •+,opt Ie IAe beldrr oi yuah .nor~qnqe o• anr o,hv. m~ere~~ ocqu red by the u~on ol .,b mw~guye n unde~9ood aM agreud^ n_q mwwmey~~ he.e hven Vloa~d (p, 1Fe pu~po+. of e~r.~yL.h~ng,~o~ bn~~ o. bo~nAmy eor"n. DaIed tbi, (,°qdoy ol__~U~ q, p IV 73 , . SUBURBAN ENGINEERING, INC. SCALE: 1 incho 40 feet F~9~~~~~ ":~.-•r~.' / i i • r' 1`' . , . , - - - i"e v~eer ~y ~f(///%(^//// f aers H.ye.." 1o es ~ ~o~„ r~,,,~9 • //~/!II'P%111~~ •~/l('. M..n: s5437 Munir.pal Fng~ni.e~.~~q EnKitieers Surveyors 4... c>de 612 Mortgage Loan Survey for-Ceda,r_Gxa.ve C011St I , ; ' . ,j_. w - ~ Z ' ~ i 7~ -T- ~7 ~ ~ . M ' Ot. " . W . a a ~ N I a ~ a'( r Ra ~ a c c;7 : ~ I 4 24.0 . -----------------~t-' 4 31.It 133.D4 ~ I r, ! ~ CC LOT 7 BLOCK 3 CEDAR GROYE Nn. GOUNTY OF DAK'IT Oenofes Orainage andUtiJityEasemeot . ~ iFi~ i~ o r•ue end ao.reN rrpre~.n~or.or o! o Lurv~~ ol I6e bounda,, o1 ~he lond ebe+• tle.v,Fed a.MW r6e . Isaaeion al oll budd'ny., .f uny, Ih<.eon~ wntl ell v~~ihle ~n<row~hmenr~, unr, I.em o1 an .uid lond, rF~s w.v.r n Ted< enly in tenee<lion witF a r..ertqoqc Ivon now beinp placed en rbe piopvty andm LubJ:ry o~~vmed •xc*p1 1a Ibe heldv, ol waA ne•tgnqe o. ony olhvr mH.~sr eequ,rod by ihe rrwen o/ wah mo.equ9< Ir 1t ' ondnfteedand agr.4d/~qymonvmep) Fe.< been plafed lo, the p~.pese o} e~~ebLthiny lo+ hne? or bornda~r rOrMry. Dbled Ihi1 4~~~day e/_-~uY A.0- IV~ . * ~ . SUBURBAN FNGINFFRING, 7NC. SCALE: 1 inche 40 feet E^a+~••~ er~d ~ ~r ~ ~ • . • !w'' wA 2007 RESIDENTIAL BLTILDING rERMIT arrLicnTrox City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Conslmtion Reauiremenis RemodeVReoair ReauiremenLc Office Use OnN 3 registered site surveys showing sq. ft. W lot, sq. fl. ot hause; and all roofetl arees 2 copies of plan shovnng foofings, beams, jasts Ceit af Survey:ReW _Y _ N (209% mazimumlotcoverageallowed) lsetofEmrgyCalcuWtionstorheatedaddi6ons SoilsRepat ._Y'_N 1 Sods Report if pmposed builCinq is to 6e placetl on disWrbed soH 1 site survey lor addNore 8 decks Tree Pres PWn Recd Y_ N, 2 capies of plan showing beam 8 window sizes; poured found design, etc. AtldPo'on - irMicafe'rfonsb sepNc sysfem Tree Wes Requ'ued_ Y_ N 1 set of Energy Calculamons On-site 5eptic Syslem -Y. _ N 3 capies W Tree Presevatian PWn if lot platted aRer 711193 RimJolslDefeilOp6onsselecUonsheet (bulldingswith3orlessunifs) ' Mmnegazco mechanical ventllation fortn Plans are considered ublic information unless ou state the are trade secret and the reason. Date I I /)3 / 0-7 Construction Cos ~°OG SiteAddress 39 9~p ~'LIUL-Q~fonl RJ6 Unit/Ste # Description of Work S i i76 Multi-Family Bidg _ Y_ N Fireplace(s) 0 _ 1 _ 2 Proper[y Owner ST~~C G(Z.i MM. Telephone lt( ) Contractor E`7'34{L 32 TFIE2S C ti S'! N~~^-~ ~2QGU~ Address I I o w M A i til S i City state Yh n? z;P 56G 7~ Telephone g5 a) -75~r~ 3 s 3 g COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesofa Rules 7670 Cateeorv 1 _Minnesota Rules 7672 Enefgy Code Category . Residential Ventilation Calegory 1 Worksheet • New Energy Code Worksheet (J submission lype) Submitted Submitted • Energy Envelope Calwlations Submitted In the tast 12 months, has ihe City of Eagan issued a permit for a similar plan based on a master plan2 _ Y _ N If yes, date and address of masier plan: . Licensed Plumber Telephone J Mechanical Contractor Telephone ~ Sewer/Water Contractor Telephone ) I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approvai of plans. 3X.Poi Applicant's Printed Name Applica s S' ture DO NOT WRITE BELOW THIS LINE Su6 Tvpes ? 01 Foundation ? 07 OS-plex ? 13 16-plex 0 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? OB 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt - Mufti ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ezt. Alt - SF ? 04 02-plex ? 10 OB•plex ? 18 Deck ? 23 Porch (screenlgazebolpergola) ? 36 Mutti Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage . . O 06 04-plex ? 12 12-plex ? 25 Miscellaneous Work Tvpes ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'DamoliUon (Entlre Bldg) • Gfve PCA handout to applicant D85C1'ipt1011: WaterDamage`Yes Valuation Occupancy MCES System Plan Review 100% or 25% Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIItED INSPECTIONS _ Footings (new bldg) _ Sheetrock _ Foorings(deck) _ FinaUC.O. _ Footings (addition) _ Final/No C.O. Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool Ftgs Air/Gas Tests Final _ Framing _ Siding _ Stucco Lath _ Stone Lath _Brick Fireplace _ R.I. _ Air Test _ Final _ Windows . _ Insulation _ Retaining Wall, Approved By: , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Licehse Search Copies Other ToWI TILLAGE OF EAGAN SEWER SERVICE PERMIT /1 3195 Pilot Knob Rood " PERMIT NO.: a 354 gan, MN 55122 DATE] 2129172 (6/4173) Zoning: R -1 No. of Units: owner: Cedar Grave CCEIStrIleti011 Co. Address: Site Addre,�3 +� � 7 - 3896 Riverton Avenue Plumber: S L e±n ' s I agree to comply with the Village of Eagan Connection Charge 2643.°0 pd 6/4/3 Ordinances. Account Deposit 4 12/29/72 Permit Fee: f 4 y' { Surcharge: • 50 pd 12/29/12 , By: Misc. Charges: Date of Insp.• L' 91% 7 Total: Insp.• Date Paid: Use BLUE or BLACK Ink r For Office Use I E ~ Permit#: City I I V/10/~~^S of E I Permit Fee: d I 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: / Phone: (651) 675-5675 I ~n I Fax: (651) 675-5694 I Staff: I' 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ~ 203 Site Address: 396 ~~`~«<oit Unit Name: Phone: lA~~ 33 Resident/ ,d Owner Address / City / Zip: Applicant is: Owner Contractor Type of Work Description of work: re--z Construction Cost: Multi-Family Building: (Yes / No ) Company:_:iO Contact: Address: 4-46,t- Q f' l~✓d J City: 02,41C, /t/~1Yt~ / %,Aek,r Contractor State: "I/0" Zip: b. ~ Phone: t,/.'5-/, 22e-- x"31// License Lead Certificate 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 for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. 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.org 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 Printed Name pAt6rit's Signature Page 1 of 3