2041 Safari Heights TrAddress 2041 Safari Heights Tr Zip 5512 1
Lot 18 Blk
Sub Safari Estates 2nd
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Dat 9 Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage) v
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass l/
Trail/curb damage
Porch V_
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system.
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
City of Eapfl
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 6755694
Date:
Tenant:
------------------
For Office Usseej l
Permit #: V a 4
Permit Fee: l
Date Received: j
I l
I Staff: I
I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Site Address:
Suite #:
Ss/z7
RESIDENT IOWNER Name: ?(/e? Phone: S
A
r[
?C
SS/7 ?
/V ?
l
,
/l
lrri r
Address lCity /Zip: IG+II
1
Owner ? Contractor
Applicant is: _
TYPE OF WORK ,
Description of work: tyL' - o
Construction Cost: Multi-Family Building: (Yes_ / No
CONTRACTOR Name: y ()t/1 License #: u? y r 93 J?
Address: ? ? (1 vvl yl/ /-)/d
City: State:-///111 J Zip: S-
Phone: L S - L Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7672
_ Minnesota Rules 7670 Cateaory 1
_
Energy Code • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
(J submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No It yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public Information. Portions of
the Information may be classified as non-public If you provide specific reasons that would permit the City to
conclude that the are trade secrets.
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
x _ OF / ? 1(/J /l ( ,'if x----L ,l-
Applicant's Printed Name Appllc? s ignature
Page 1 of 3
- ------ -----
? For OfKc??USe I
Permit #.
I I
Permit Fee:
Date Received: j
I r I
I Staff: 1
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: QC / Site Address: / -3 / 5- ?? //UI?C? v> > 3jJ
Tenant:
Suite #:
RESIDENT / OWNER Name: / uEfr <- 'p- f rf ?,)o h iU?tQ Phone: X05 ? lo?--? 0?ll?
Address/ City/ Zip: /a/? ?,L
Applicantis: _Owner )Contractor
TYPE OF WORK Description of workn'- -5,
+ rlr ??
Construction Cost: Multi-Family Building: (Yes _ / No
CONTRACTOR Name: b 2o A A-9 (Lo",e a- License #: ZDS 2 3!FE?21??
Address: ??7 ?+•"• ckr dOt- -kk
City: 6_:, ? State:(C-1Zip: S?o 2 Cf
Phone: ?n !i ^ 2 7D!rr /Z 7Contact Person: h4 h •.
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7672
_ Minnesota Rules 7670 Category 1
_
Energy Code • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
(J submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans_ and supporting documents that you submit are considered to be public informatfon.;Portions of
the information ina be classified as n"' a ns that would permit, the City to
y on-public if you provide specnc6reaso
c
`
= conclude that the are trade`secrets
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
x Im? ??
ApplicAnt's Printed Name
x
Ap s Signature
Page 1 of 3
??k??%???Y:<kcY68(M>kYF?%f1X?(?kkGB<?R??Y,C?K?k?k:Yg>XNokk??k?k?;Rok
CITY OF EAGAN
CASHIER: S TERMINAL NO: 862
DATE" 0404/99 TIME: 0:5904
ID:
NAME: LEE RISIEL.. HOME'S INC
2155 9001 2041 SAFARI HTS 85.50
2252 92201 204t SAFARI H'T<3 30.00
3743 9220 2041 SAFARI HTS 50.00
3713 9220 2041 SAFARI HTS 50.00
3866 9379 2041. SAFARI HIS 100.00
3710 9220 2041 SAFARI HTS 11.4.00
3668 9220 2041 SAFARI: HTS 468.00
3805 9220 2041 SAFARI HTS 825.00
34EE 9001 200 SAFARI HTS 900.74
2215 9220 2041 SAFARI HTS 7039.50
CHO6425 CONTINUE
USER ID: NANCY CONTINUE
XC w>K;k X<Y? %%?>k ?>K ?>k YF ?>k Y/ N:Yx>k;k M?K>;c>X m?k:k at>k n ak>K yk XvX #?X ?
Y7? $ k kY?Y?? Y?#Y k? i k Fa W. kk X X CON'1'1NUE
CITY OF EAGAN
CASHIER: S TERMINAL NO., 862
DATE: 04/1.4/99 'T'IME" 1`i:59-. 15
ID"
NAME: LEE DISE'L_ HOMES INC
3446 9001 2041 SAFARI HTS 10.50
3WO 9001 2041 SAFARI HTS 1,305.75
Total Receipt Amount' 57058.33
CR106425
USER ID" NANCY
I ?>x>o:>x?::>zYF>xm?>K????:?>x??>x??m??k?;k>ti>n?>k???>k?k>x>x?
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
3? I I ("?
New Construction Requirements
CITY OF EAGAN
3830 PILOT KNOB RD - 55122 U 9
651-681-4675
? 3 registered site surveys showing sq. ft. of 1o4 sq. !t. of house
and 9/-I roofed areas (20% maximum lot coverage allowed)
? 2 copies of plans (show beam & window sizes; poured find. design; etc.)
? 1 set of energy calculations
? 3 copies of tree preservation plan If lot platted after 711/93
DATE: 3 ?? ?1 IJ
DESCRIPTION OF W
STREET ADDRESS:
LOT: IV_
Remodel/Reoair Requirements
? 2 copies of plan
? 1 set of energy calculations for heated additions
? 1 site survey for exterior additions & decks
CONSTRUCTION COST:
BLOCK: I SUBD./P.I.D. #:??rti I i?c Scac?+tfr
/I r
Name: _/ a _ ?i?'sc? (,V C y Phone #: 4C51"4l DS -
PROPERTY Iast gst
OWNER
Street Address: q 7 L3 47 Qt4dv hh , I I ,S
ti
City b?M Ll i State:
Company: _ Phone #:
CONTRACTOR
Street Address: License #
City
State:
ARCHITECT/ N
ENGINEER Company: t
Name: t
Street
7$p
Zip: 'Q3 l - 3?_
Zip:
Phone #: 1 J T
Registration #:
City _4, 1'e j a 0 P State: 1' J I,,/ Zip:
Sewer & water licensed plumber (required for new construction onlyJ'j M - ('
Penalty applies when address change and lot change is requested once permit is issued.
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: ?????
OFFICE USE ONLY p??'V::"g5p f!
Certificates of Survey Received ! Yes No I1
- / I ! 19
Tree Preservation Plan Received Yes No ? Not Required
!
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
X 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
31 New ? 35 Tenant Impr ? 39 Gas Line On ly ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg . ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
GENERAL INFORMATION
Const. (Actual) 5 Basement sq. ft. 12 7 Census Code co
(Allowable) S Main level sq. ft. Z_ SAC Code
UBC Occupancy
Va 2"DW sq. ft. I No. of Units
Zoning CF sq. ft. 7'5-Z-. No. of Bldgs
# of Stories ?Y sq. ft. MC/ES System
Length sq. ft. City Water
Width _
50 Footprint sq. ft. '70Z,15' Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Buil ding Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Valuation:
l2"77x t s -
1277 x5z-:7-
Z3zxls._
i
$ [ D, c+oo °`°
51 t-pr-
Total:
SAC Units
% SAC
Cities DiLyital Quality Control
The following image represents the best
available image from the original page.
Every effort was made to capture the content
from the original page.
1
-'1 ti
i.1.: .r.^0:1 SCg:', 1V .
Lt. P::ul, 144 155 i0!
(612) 246-6319
BTRMING '.i TC•F
ID? i)007CY33
i:. r1't.DER
,OF:YIO: Tt:Ota
'_.r.E R BISEL
' T.-I.^:s al- due t ::'r> ii99
I%BA: BISEL L;:,'.-IOI?ES I NC
4? 1 WES ON HI?_L L;I V .
F 4UA'v Mz _31:3-L.i
r 4
Subj: License #20007038
Date: 4/7/99 10:26:26 AM Central Daylight Time
From: Lori.Bridenstine@state.mn.us (Lori Bridenstine)
To: LBisel5947@aol.com p ?wy ?J?
Lee, ?/l G?
1 check into the progress of your license #20007038. This has been updated. It was renewed on 04!07/99.
Look for it in the mail in about 7-10 days. If you have any questions, please do not hesitate to contact me.
Thank you, Lori B
Opt of Commerce
------- Headers ------
Retum-Path: <Lon. Bri denstine@state. mn. us>
Received: from dy-yb04.mx.aol.com (rly-yb04.mail. aol.corn [172.18.146.4]) by air-ybO4. mail. aol. com (+69.4) with SMTP;
Wed, 07 Apr 1999 11:26:25 -0500
Received: from mail. state. mn.us (mail. state. mn.us [204.73.26.11)
by fly-yb04.mx.aol.com (8.8.8/8.8.5/AOL-4.0.0)
with ESMTP id LAA03707 for <LBisel5947@aol.com>;
Wed, 7 Apr 1999 11:26:17 -0400 (EDT)
Received: from [156.99.105.3] by mail. state. mn.us. Wed, 7 Apr 1999 10:28:24 -0500
Received: from DOC-Domain-Message_Serverby commerce. state. mn.us
with Novell_GroupWise; Wed, 07 Apr 1999 10:24:56 -0500
Message-Id: <s70b3278.049@commerce.state. mn.us>
X -Mailer Novell GroupWise 5.2
Date: Wed, 07 Apr 1999 10:24:49 -0500
From: "Lori Bridenstine" <Lod.Bddenstine@state.mn.us>
To: LBisel5947@aol.com
Subject: License #20007038
MIME-Version: 1.0
Content-Type: text/plain; charset=US-ASCII
Content-Transfer-Encoding: 7bit
Content-Disposition: inline
Wedr ay, April 07, iM America OnUm: LBize169Q Page: f
EXTERIOR. ENVELOPE ENERGY CODE COMPUTATION WORKSHEET
TO Determine Compliance with the Minnesota Energy Code
(Section 502 of the State Amended 1983 Model Energy Cade)
Project Title
Site Address ?? _ k `-r
1. EXPOSED WALL CALCULATIONS
A. Cpaque Wall
1. Masonry/Concrete
a.
b.
C.
2. t rn Wa Gr
a.
b.
3. Frame Wa
a. Insulated Area
b. Framing Area (Ave. 158 at 16" oc)
c. Framing Area (Ave. 10% at 24" oo)
4. Peripheral Floor Edge/Rim Joist
a.
b.
B. Glazing
1. Windows
a.
b.
2. Doors
C. Doors
1. Wood
a. Solid
b. With storm do or
2. Metal
3. Overhead
4. Other
AREA "U" VALUE AREA x "U"
x
x =
X =
2-5_ x • o'iZL_
x
x o4 41.9
2,4C1.1 x it) Z =
220 x C4 x =
x . i = 14ti . G;8
x 47 s R..?
x =
17-n x , aCo = 1 Z
x =
x' a
x =
x =
D. TOTAL WAIL AREA, sq. ft ..................... 211 ej
E. TOTAL Of AREA x "U" ................................................... 2(02-.10
IL
ROOF/CEILING CALCULATIONS
A. Roof/Ceiling Insulated Area i[n 14. L x O Z =
B. Raof/Ceiling Framing (Ave. 158 at 16" cc) x =
C. Roof/Ceiling Framing (Ave. 108 at 24" oc) 119-4 x -o 2 =
D. Skylight x =
31 -.2-q
E. TOTAL AOCF/CEIIaM AREA sq. ft .............. I'I-9 4
F. TOTAL CF AREA x "U" .................................................. 3S.87
III. BUILDING ENVELOPE REQUIREMENTS
TOTAL AREA R90LTJM nun ALLOWABLE
(Fran I.D & II.E) (From V.) (Area x "U")
A. Exposed Wall : 27 ! Ei x
B. Roof/Ceiling: i i g 4 x O L,
C. 'DOTAL ALED ABLE BUILDING ENVELOPE (Total of A & B above)... --,?,4,S . W
IV. ACTUAL BUILDING ENVELOPE
ACTUAL
(Area x "U")
A. Exposed Wall (Fran I.E)
B. Roof/Ceiling (From II.F)
ZfoZ. ib
C. TOTAL ACTUAL BUnDING ENVELOPE (Total of A & B) ............ 29191
*(Wets cods requirsiments if less than III.Q
V. REQUIRED "U" VALUES
Detached one and two family dwellings
* Multi-Family Residential Buildings
(3 stories or less in height)
* All Other Construction Types (3 stories or less)
* All Other Construction Types (More than 3 stories)
• Based on 8007 heating degree days (lyls/St. Paul)
Adjust "U" values accordingly for other locations
CERTIFICATION
WALLS R"/CEILING
.11 .026
.238 .033
.238 .06
.28 .06
I hereby certify that r have coWleted the above information and that it oaplies with tl-.
Minnesota State Energy Code.
BCSD 3-89
!lr•icna)ArlA
LOT SURVEY CHECKLIST FOR RESIDENTIAL
PROPERTYLEGAL: 1'f 41A J '64ad'i (d
ATE F SURVEY: ?? / 9 cl
LATEST REVISION:
N
v
m a d DOCUMENT STANDARDS
a ?
N
Q Z J
E
? Registered Land Surveyor signature and company
? Building Permit Applicant
? Legal description
? Address
? ? North arrow and scale
sa"'? ? House type (rambler, walkout, sprit w/o, sprit entry, lookout, etc.)
Fr-'13 ? Directional drainage arrows with slopelgradient %
? Proposed/existing sewer and water services & invert elevation
13 Street name
20 ? Driveway
y ? Lot Square Footage
?
?? ? Lot Coverage
ELEVATIONS
Existinc
? Sewer service (or Proposed)
? Property comers
3 ? Top of curb at the driveway
? ? Elevations of any existing adjacent homes
Proposed
?? ? Garage floor
? First floor
f ? ? Lowest exposed elevation (walkouthvindow)
a.-,? ? Property comers
?,? ? Front and rear of home at the foundation
PONDING AREA (if applicable)
? T ? Easement fine
? W'? NWL
? Z?- ? HWL
? ram/? Pond # designation
? tX ? Emergency Overflow Elevation
DIMENSIONS
of / ? ? Lot lines/Bearings & dimensions
e(' ? ? Right-of-way and street width (to back of curb)
id'? ? Proposed home dimensions including any proposed docks, overhangs greater than Z, porches, etc.
(Le. all structures requiring permanent footings)
?? ? Show all easements of record and any City utilities within those easements
er ? ? Setbacks of proposed structure and sideyard setback of adjacent existing structures
? pro Retaining wad requirements, If any g /
Reviewed: J
N,?-' / D to
March 1989
CRAr.1KJ MWrFM
* PIONEER
* eng near Rg u D
Certificate of Survey for
2422 Enterprise Drive
Mendota Heights, MN 55120
(851) 681-1914 FAX:681-9488
00NEERS
CARE AR WCrs 625 Highway 10 N.E.
Blaine. MN 55434
(612) 783-1880 FAX:783-1883
E-mail: PIONEER20PRESSENTER,COM
/BISEL HOMES, INC.
'2041 SAFARI HEIGHTS TRAIL
981.8
°ISI S
' 17
Iro (VACANT)
01
12 '0
972.0/
\ J`? 80.8 985.5 \
X X \
\ \ (981.5 \ qP0
\ 97 7 979.6 12.OQ 985.1 \\ ?Ir
--- ° BENCH MARK
\ •------r-- a6 m -?
l? 20.00 21.62 13.33 1 20.00 \ TOP OF PIPE
1 987.7 \ ELEV.=987.23
7T \ PROPOSED \
\ 1 0o HOUSE \o
1&.6 \ 980.51 ? N \
60
1 ?, \\ ,°n\ARAGE 7.b's .11`67 1987.0
o i? \\5 (48 G„
N \
,; ?F$4 ?? i r ) 986.
20 00 11.00 0
2'1.00 - 20.00 Y /
40- 981.9 oa \ V.97 98 .9 (48-1A 75.64 0
c> ?\ 1 p3 0 1 /?JvGf 6 • 3
j? 987.4 ;P 986.2
SERV
BENCH MARK
TELE.
TOP OF PIPE ELEC. •Z,1?24n . / f
ELEV.=984.41 CATV. 3, D052 A=4 00
G
988.5 4 83 -G?
?ss?) 5 se7.?,?ti I u ;p3
987.9
LOT AREA = 22,594 sq.ft.
HOUSE AREA = 1,998 sq.ft. - '
NOTE: PROPOSED GRADES SHOWN PER GRADING PLAN BY: CCST PROPOSED HOUSE ELEVATION
NOTE: BUILDING DIMENSIONS SHOWN ARE FOR HORIZONTAL AND VERTICAL LOCATION
OF STRUCTURES ONLY. SEE ARCHITECTUAL PLANS FOR BUILDING AND LOWEST FLOOR ELEVATION: 9TO, 62,CD
FOUNDATION DIMENSIONS.
TOP OF BLOCK ELEVATION: a
NOTE: NO SPECIFIC SOILS INVESTIGATION HAS BEEN COMPLETED ON THIS LOT BY THE 09 '3
SURVEYOR. THE SUITABILITY OF SOILS TO SUPPORT THE SPECIFIC HOUSE GARAGE SLAB ELEVATION:
PROPOSED IS NOT THE RESPONSIBILITY OF THE SURVEYOR.
NOTE: THIS CERTIFICATE DOES NOT PURPORT TO SHOW EASEMENTS OTHER THAN X 000.00 DENOTES EXISTING ELEVATION
THOSE SHOWN ON THE RECORDED PLAT. ( OW.^_O ) DENOTES PROPOSED ELEVATION
NOTE: CONTRACTOR MUST VERIFY DRIVEWAY DESIGN. - - - DENOTES DRAINAGE AND UTILITY EASEMENT
DENOTES DRAINAGE FLOW DIRECTION
NOTE: BEARINGS SHOWN ARE BASED ON AN ASSUMED DATUM -0 DENOTES MONUMENT
-B DENOTES OFFSET HUB
WE HEREBY CERTIFY TO LEE BISEL HOMES, INC. THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A
SURVEY OF THE BOUNDARIES OF:
LOT 18, BLOCK 1, SAFARI ESTATES SECOND ADDITION
DAKOTA COUNTY, MINNESOTA
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCHROACHMENTS, EXCEPT AS SHOWN, AS SURVEYED BY ME OR
UNDER MY DIRECT SUPERVISION THIS 19TH DAY OF MARCH, 1999. \
SCALE : 1 INCH = 30 FEET
689
EER ENGI ERIN , P.A.
son, L.S. Rea. No. 19828
CITY USE ONLY /
LOT BL 1 RECEIPT
SUBD. h/ RECEIPT DATE: &/?///979
MECHANICAL PERMIT # 3 to qb
1999 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
5830 PILOT KNOB RD
EAHAN MN 5518E
I 1 L' /9 O (651) 681-4675
Date: 7
Complete this section only 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
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one required @ $3.00 ea.)
State Surcharge
Total
$ 30.00
6.00
.50
$3 b,Sa
Complete this section only if you are remodeling, adding to, or repairing an existing single family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or repair.
_ New _ Alteration _ Repair _ Other
Reminder: Call 681-4675 for inspections.
Furnace Air conditioning
- Airexchanger Other
SITE ADDRESS:. :).9 4 1 SA AA Iz' W' g r2
$ 30.00
State Surcharge .50
Minimum Total Due $ 30.50
OWNER NAME: L--'r, /5 )gzI tq 0r,"C5 PHONE#: /05-) - - yS2- ?g8y
` (AREA CODE)
INSTALLER NAME: G ?L d F I i N T S C r+n+L' PHONE #: (aS l 4 z 3 3 gdZ
(AREA CODE)
STREET ADDRESS: 3 e-L S SJ 13 > S `r W -
CITY: Jell j e/n 11 uN r STATE: Lt/- ZIP: _VS b 4's?
hSArRE APERM[l17EE
L BL
SUBD.
APPROVED BY:
INSPECTOR MECHANICAL PERMIT #:
1999 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAHAN
8830 PILOT KNOB RD
EAHAN, MN 55188
(651) 681-4675
Please complete for: all commerciallindustrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: 1% of contract price OR $30.00 minimum fee, whichever is greater.
Processed piping - $30.00
CONTRACT PRICE x I%
PROCESSED PIPING
PERMIT FEE
STATESURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME:
TENANT NAME (IMPROVEMENTS ONLY):
INSTALLER:
ADDRESS:
CITY:
CITY USE ONLY
RECEIPT M
RECEIPT DATE:
PHONE M
(AREA CODE)
STATE: ZIP:
($.50 per $1,000 of permit fee due on all permits.)
PHONE #:
(AREA CODE)
SIGNATURE OF PERMITTEE
L (b_ BrL- ` I (l,? CITY USE ONLY
SUBD.Y--r ya?
RECEIPT #: (o
RECEIPT DATE:
PERMIT # s3 t
1999 PLUM$INe Puma (RESIDENTIAL)
crrYoF P.ASAN
5830 PILOT KNOB RD
EAGAN, MN 5512E
(651) 681-4675
Please complete for: > single family dwellings
> townhomes and condos when permits are required for each unit
> backflow preventer for underground sprinkler system
FIXTURES
EACH #
Bath tub $ 3.00 x 2 - $ 1 "1
Floor drain 3.00 x _ $ , r 6
Gas i in outlet * minimum -1 3.00 x / _ $ . dd
Hot tub/spa 3.00 x = $
Kitchen sink 3.00 x I = $ 3- ad
Laundry tray 3.00 x $ " o d
Lavatory 3.00 x = $ /Z ad
Minimum fee alterations to existing dwelling 30.00 x = $
Private Disposal System new/refurbished * requires MPC tic. 75.00 x = $
Private Disposal System abandonment 30.00 x = $
RPZ new installation/re air 30.00 x = $
Rough opening 1.50 x = $ , Sa
Shower 3.00 x $ W
Underground srinkler if dwelling is under construction 3.00 x = $
Underground srinkler if existing dwelling 30.00 x = $
Water closet 3.00 x _ $ _-00
Water heater 3.00 x l _ $ !rRl
Water softener if dwelling under construction 5.00 x = $
Water softener if existing dwelling 30.00 x = $
Water turnaround 30.00 x ---- _ $
State Surcharge .50 > .50
$
Total > > > d > _
0 C
Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc.
- - ---- ---- - --- ------------ -------- -- - --- ---- --- ---- - -- --- --- ---- ------
I hereby acknowledge that I have read this application, state that the inforrnation is correct, and agree to comply with all applicable Cityof Eagan ordinances.
It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its
normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement.
SITE ADDRESS: 2- o t / S/?7?grr hT Tr-
OWNER NAME:: /,.E t /s/Sz-t
TELEPHONE#: 59,5/
(AREA CODE)
INSTALLER NAME: /4s, ,g1iuA / I
STREET ADDRESS:[ ZG / r
CITY: ?u_aal i>ti ??
TELEPHONE #: GS1-?3 F -OSZ90
(AREA CODE)
STATE: /P /r-ti ZIP
TOTAL
.571 Z s
SIGNA URE OF PERMITTEE
?13-1 ,r1l r # 8 0?
PRO CUSTOM
BUILDERS
3800 Minnehaha Avenue South
Minneapolis, MN 55406
License ff 20593782
11-24-2008
I, Anthony Anderson, with Pro Custom Builders didn't remove the plastic dome skylight
when re-roofing Roger Tans property. Address: 2041 Safari Heights Trail Eagan, MN
55722
Sincerely,
Anthony Anderson
L'd 6L6£ti9£Z69 sJap1!n9 wo]snO old d90Z0 90 tiZ noN
6L6SbSSZS9