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4901 Safari Pass*' City of Eapll Date: Tenant: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 SEP 1 Use BLUE or BLACK Ink Permit #:C-3 Permit Fee: ` r Date Received: Staff: 2010 RESIDENTIAL BUILDING PERMIT APPLICATION — 6l) Site Address: A01 CAC—AV fl45' Suite #: RESIDENT / OWNER Name: to L)/14212G Phone: ?Sc=./— c? -O/— 47578 Address / City / Zip: '/O / S4 $ Applicant is: Owner X Contractor TYPE OF WORK Description of work: IEW ©FF /2 F Construction Cost: j01`0 Multi -Family Building: (Yes / No ) CONTRACTOR Name: 1/ S' POOP/A/6 £L License #: 0-06 3c/�� e&04//) }-/CLL '2T- City: -13.1-42-A15/1/a6- Address:/oi,, 1^ J3i State: 7C33 State: Yvt/V 5s-33- Zip: Phone: 6 1 a. - ?_29 Contact: ulP Email: COMPLETE In the last 12 months, has 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: _Yes 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. 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 I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinanc Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a p accordance with the approved plan in the case of work which requires a review and approvals plans. Wv5U71) Applicant's Printed Name s and codes of the City of it; that the work will be in Applicant's g ture Page 1 of 2 , CASH RECEIPT ~ ~ ITY OF EAGAN P. O. BOX 21-199 ~ EAGAN, MINNE50TA 55121 DATE 19 RtCE1VGD FRpM AMOUNT $ I & DOLLARS +oa ? CASH ~ CHECK FOR FUND AMOUNT Thank You SY White-Payers Copy Yellow-Posting Copy Pink-File ('nuv ' ~+-/S~dS CITY OF EAGAN Remarks ' ` Addition THE SAFARI ADDITION l.ot 2 Rik 2 Parcel 1(L75850 020 9~ Owner Street ~i~.01 S____?_~fa*'i p8.gg State Eagan, MN 55122 improvement Date Amount Annual Years Payment Receipt Date STREET SURF, 2 1 -2~- STREET RESTOR. GRADING SAN SEW TRUNK ~q 1 g2 354.20 C009983 12-27-84 SEWERLATERAL o 333.6$ " s w ss la & erv7o 82 1900.08 " " WATERMAIN WATERLATERAL trk~ 1982 381 2~9.40 C009983 12-2~-84 WATER AREA 1 8 354.20 " ater Lateral 1 85 244.42 " " STORM SEW TRK 67(j,80 " 1982 927.00 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 260.00 4~46782 10-3-84 WATER CONN, 470.~0 " " ~UILDING PER. 1 SAC ~7 ~s PARK Receipt PLUMBING PERMIT. • Permit No. , " CITY OF EAGAN - ' F~ 1%~ j% ~ Fill rn numbered spaces S/C d Type or Print legibly Tot. ~ 1. Date " ~ r~ 2. Installation Cost ~ f,. ` , 3. Job Address Lot Bik. Tract , i 4. Owner ~ r~ rQ ~ J / f~.^.-•-;•p ~ ~ ~ 5. Contractor ~,~i~ . • ~ ` ~ " Phone L ~ - r 6. Address 1 ~ lN ~ ~ 7. City "'l ~ l J='- State % Zip } 8. Building Type: Residential ? Commercial O Institutional O 9. Work Qescription: New ? Add ~ Alter I~ Repair ? 10. Describe 11. No, Fixtures No. Fixtures Water Closet Cesspool/Drainfield Bath tubs $eptic Tank Lavatory ~ Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed: for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and appro~ed. Approved CITY OF EAGAN 454-8100 , , CASH RECEIPT ~ . CITY QF EAGAN P. O. BOX 21•199 EAGAN, MINNESOTA 55121 nA~e ~9 , rescervea FiYpM ' AMOUNT $ I & DOLLARg 100 ? CASH CHECK ROR F'urvO CODE AIAOUNT / . ~ ~ . C : ~ C "-f.~ ~ . , - ~ ,:.J ';t~i{'S ~ ~i ,~S ~ _a~s = 3 Y _ - , _ Than You.",.. f . ~ ~ BY - White-Payers Copy Yellow-Posting Copy Pink-File Copy ~ , y CITY OF EAGAN 9:5 ~~1?~ ~ 3830 Pilot K~ob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # ~ l Te be vtid fo. SF DWG/GAR ~~a~~ $ 8~+ pate UCTOBER 3 ~ 9 S 4 4901 SAFARI pASS R3 5ite Address Erect ~ Occupancy Lot 2 Block 2 SeclSub. S~~I ~D Remodel ? Zoning Parcel No. Repair ? Type of Const. Enlarge ? No. Stories W Name GOLDEN EAGLE BUILDERS INC Move ? Length Z AddreS~, Demolish ? Oepth 32 ~ City H Phone - Grade ? Sq. Ft. SRME Aoororals Faes Name o~ Address ^ssessmenf Permif ' ~ u~ City Phone WoterBSew. Surchorge 43.50 ~W Police Plc~ check 197.00 Name Fire SAC S 2 5. ~ 0 Address Enp. Water Conn. 4_ 7~Q.~ ~W City Phone Plonner Water Meter..~QO Council Rood Unit 2~ u ~ 1 hereby acknowledge thot I have read this applicotio~ and stute tfiat g~dg. Off. 1O~3~S4 parks the intormotion is correct and ogree to comply with oll cpplicable qpC Total r State of Minnesota Stututes and City of Eagon Ordinqrces. . Var. Date SlQnoture of Permittee % ~ - , ~ Y"--~'- _ A Bullding Permit Is issued t ~LDEIV EAGLE BUIi,DERS INC on ths express condltlon thoi oft work sholl be dor?e in acco nte wlth II ogplica~ie Sfyfe of Minnesoto Statutes ond City of Eapan Ordinantes. Buildinp Officiol ~J( ~ '~'!r `"c``-'` ~ Psrmit No. Permit Holdar Oata Plumbing ~ 1 ~'~L ,~i.~: l~.¢ t t''~:~`~ ~ y'~ .,i i~ - Y~~ ~ H.v.a,.c. 4 ~,~t f r o~ ~ ( t ~ ,~c a ~ Electrit ~ Y S ,~G~l. ~ ~r~. Softener Inspection Date Insp. Other Footings p. • Foundation Framing ~ Rough Plbg. Rough HVAC • Inwlation ~ ~ j Final Plbg. O- Final HVAC _`-sij/ Final -f~ Cert/Occ. Water Describe Location: we~~ se,~~ Pr. Disp. C~ ~ ~ ~ - Receipt MECHANICAL PERMIT Permit No. / ~T l' CITY OF EAGAN pee 1,~~ ~J l Y~ . Fill In numbered spaces S/C Type or Prini /egib/y ~ "v Tot. 1. Date ~ 1 2. Installation Cost ~ - _ t... ~ . 3. Job Address``~ ~j ~ ~ ` t''~ ~ot~,_Blk.~ T ~ r ` , 4. Owner - ~ c. , 1 L_ ~ ( ~ 5. Contracto~`~ c. ~ ( r~ . ~ 1 ( Phane ~ 6. Address~~~ y\ ' 7. City State Zip - 8. Building Type: Residential ~ Commercial ? Institutional ? 9. Work Description: New ~F Add ? Alter C7 Repair ? ~ 10. Describe Fuel Type f-~` ` ~ 11. No, E,qi iRment STU - M. Ea. No. Equipment CFM i Forced Air ' , • ~ , ~ c, __J Air Handling: Mfg. , - . - Boilers Mech. Exhauyt Mfg. Unit Heater Mfg. Other Air Cond. Mtg. Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough F inal Inspections: Date Insp. Date Insp. 7his is your permit when num6ered and approved. Approved CITY OF EAGAN 4b4-8100 Receipt' ~l PLUMBING PERMIT Permit No~~ J~~_ CITY OF EAGAN _ / Fee _ i I ~ ~ ~ j Fill in numbered spaces S/C Type or Prini legibly ~ Tot. 1. Date~n .3 2. Installation Cost t . ~ ~i"t~ ~ ~ ~ ~ 3. Job Addressygo ~ ~ ~ot ~ Blk.~ Trac~ ~ i', ( ~ l_ , ~ , . ~ ~r ; ~ , ~ 4. Owner ' 5. Contractor ~ 1 ] : ? ~ ~ ~ . l.~.Ii.an o~Rlione << ~I - ~ i~ ~ ~ 6. Address 7/S 1Y ri t_'~"~ 7. City ~•~~/`.e _ State • Zip ~ S 8. Building Type: Residential~) Commercial O Institutional ? 9. Work Description: New ~ Add ? Alter O Repair ? 10. Describe 11. No. Fixtures No. Fixtures ~ Water Closet CesspooUDrainfield ~ Bath tulss Septic Tank ZL,. Lavatory Softner Shower Well / Kitchen Sink Urinal/Bidet Other LL ~ / Laundry Tray y Floor Drains ~ _ .Jl;' ~C' L Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all .o~dinan `oe~,~n~codes governing this type of work. Signed : _ . . ~ for Rough Final Inspections: Oate Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-6100 CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road PERMIT NO.: P. O. Box 21139 I Eagan, MN 551~.: ~ D/1TE: No. of Units: ~ ZO"~"~' Col~ien La~le 31drs Owner: ~ 44 Safari Pasa L2 B2 Safari Addn ; Site Address: .,~~uir.e "~cii ~ Plumber. 4 . Qa p1 ~ Conr+ection Charoe: Pt~ I Mete? No.: ~,mt DePosit: • ' ~4 i I SISE: ~ I Recdsr No.: Permit Fee: . ~ 'i 1~s~ eo oaerh? ~ M~. Cih ef E~y~~ Surd+aroe: . 00 pd meteY I Misc. ~ro~ ~ ' OrJlw~n~w TotoL• ~ ~ By Dots Poid: ' I Dote of I nsp.: ` ' '?F EAGAN WATER SERVICE PEttMR .c Kno6 Road r. . dox 21199 PERMIT NO.: Eagan, MN 551i D/1TE: i ~ Zonirg: No. of Units: r: Col; ~ ~z Ea~. ' ~ rosa: 1;901 c .r ~ B~ ari _1:'.;i-~ . , Slte Addrcss: t _ , ! lumber. ~ ;t~ i ~ _ , . r No.: .3 ` Co~'nneccion r~e: 4 7 Q. 0 0 p d ~ ti " ~ ~~~t~ 15 . 0 ~c. i I 5iu: lO.Ofi r+~i ~ Reoder No.: O S~ L C~ ~l / Pertnit Fee: t ~ t~ 1~yn~ eo aae~ip wt11~ IM Ci~ ~f Es4~~ Surcharpe: E3.00 nE•~.~,.. OrdiRenoM. I/ Misc. Choryes: ~ ; l~ I~~/ Tatal: gy 1, 1 l Date Paid: i ~ Date of Insp.: I~.: - •"v'~ CITY OF EAGAN S~WER SERVICE PERMIT 3830 Pilot K~tob Road i~11; o P. O. Box 21'!a9 PERMIT NO.: ;~-29-34 Eagan, MN 551:'~ "1 ~~~p; No. of Units: Golden Fa~~i.~eBld;s /lddress: ~901 :~afari Pass L2 3~ Bafari Ad~.~ Plumber. `I~~uire 1~eclt 1 10-3-84 467~2 1 Nn~ t~ e~fP wi1~ dw Cie1r ~f ~ye~ Corv~sct~on C~wro~- 4'? S. t~U gcl OrJiMwew. Aoaount pepoalt; I 5.!}0 pd P~nnit Fee: l ~)n c n ; i SU/C~IOfqO' • BY ~fC. C~101'pl~: Dote of Irnp.: Totol: Dote Paid: ~ . RESIDENTIAL BUILDING PERMIT APPLICATION ~ y~a y y cirr oF ea~ani 3830 PILOT KNOB RD - 55122 651-681-4675 ~ ~v New ConsWCUon Reauiremantc RemodeVReuair Reauiremente • 3 registered site surveys showirg sq. ft of IoL sq. ft. of house; and all roofed ereas • 2 copies of plan (20% mazimum IW ooverage aflm+2d) . 1 set of Energy Calalatians lor heated additions • 2 copies o( plan showing beam 8 wudow s¢w; poured faW desigR ek.) • 1 sile suney for exterar additions 8 decks • 1 set o( E~qy CalcWations ~ • tndicate if Irome seived by septk syslem for addilbns • 3 copies W Tree Preservation Plan H lol platled after 711/93 • Rim Joist DelaO Options selection sheet (ddgs with 3 or less units} DATE ~ / ~ VALUATION JOB SITE ADDRESST ~ IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER ~F L~/~dL~ TYPE OF WORK /V C`r.W G~S ~PL~ C~ FIREPLACE(S) _ 0~,/_ 2 APPLICANT L~.- L nJ-Ot3~ 6-~ PHONE# ~~I `7~U~ U~FZ~ ADDRESS g D~ S,B-s~~° I T.A~S ~ ZIPCODE S~~ Z_,7 PAGER # ~ CELL PHONE # fAX # Nt7V RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY energy Code cate9ory _ MINNESOTA RULES 7670 CATEGORY 1 (check one) - Residential Ventilation Category 1 Worksheet Submitted - Energy Envelope Calculations Submitted _ MINNFSOTA RULES 7672 - New Energy Code Worksheet Submitted Plumbing Conhacior: Phone Plumbing System Includes: _ Water Softener _ lawn Sprinkler Fee: $90.00 Water Heater _ No. of R.I. Baths No. of Baths Mechanical Contractor: Phone # Mechanical System Includes: _ Air Conditioning Fee: $70.00 _ Heat Recovery System Sewer/Water Contractor: Phone # All above information must be submitted prfor to processing of application. I hereby ocknowledge ihat I have reod ihis application, state ihat the infor ation i ec n gree to compiy with all applicable State of Minnesota Statutes and City of Eagan Ordi ces. ~ Signature of Appltc Certificates of Survey Received _ Tree Preservation Plan Received _ Not Require _ ~ Updated 1I01 OFFICE USE ONLY ? 01 Foundation ? 07 OS-plex O 13 76-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 76 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 EM. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex O 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) O 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)` ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement •Demolition (Entire Bldg only) - Give PCA handout to applleant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) _ FinaUC.O. _ Footings (deck) _ FinallNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Roof Ice & Water Finel Other _ Frazning _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Fireplace _ R.I. _ Air Test _ Final _ Siding Stucco Stone _ Insulation _ Windows (new/replacement) Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total _ - , CITY OF EAGAN N~ 956i ' " ~ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55127 PHONE: 4548100 l~~S d7~~ BUILDING PERMIT Receipt # Te 6e wad /e. SF DWG/GAR Est. Value $S~ i 000 ~~e OCTOBER 3_ 19 84 4901 SAFARI PASS C~ Occupency R~ Site Addreu Ereci Lot 2 elock 2 Sec1Su6. SAFARI ADD Remodel ? Zoning Percel No. Repeir ? Type of Const. Enlarge ? No. Stories ~ Name GOLDEN EAGLE BUILDERS INC Move ? Length ~ = nddress 22040 COLLER COURT ~emoGsh ? Depth 32 ~ c~ty HAMPTON Pha~e 463-2274 Grede ? sq. Ft. Avvrovalt Feea o Nmne SAME at Address Assessment Pertnit • ~ V~ City Phone Wute~ 8 Sew. Surchorge 43 . 50 Police Plon check 197 _ 0~ ~w Name Fire SAC ~0 Address Erp. Water Conn. ~..~.0 ~W City Phone Plonner WoterMeter~QO ~ Council Road Unit 7(+0 -(1 Q I hereby ackrwwledpe that 1 hove read this aOPlication and state that Bldg. Off. 1 ~ 3 S 4 perks the intormofion is cOrrecf and ogree to comply with oll applicable APC Total ~1 • 952 . 5~ State of Minnesoto Stotutes and City of Eogun Ordinorces. Var. Dete Sipnaturc of Pertnittee 0. ~ ~ .--~J--'~"~ A Building Permit Is Issued to: GOLDEN EAGLE SUILDERS INC e~ ~ e~m~y ~o~~rya~ all work shol~ be done in atco nce ith II opplica te~of Minnewtu Stmutes and Clty o4 Eagon Ordinoncea. Bulldirg Offtdol ~~'e 7his request void l,'^'~~~l. ~ ~;I S{ 18 ~nths from 1 T A ~97732 ~a 5~~ ~ flequest Dale Fire No. ROdeh-in InsVeUion ~J Re ired~ ~Heady Nuw ~'Will NotifV. ~~speo- 3 - V ~ ~Yes ?NO [or WhenileadV Li~e~sed Elecvical Convactor I hareb r y equast insoection of abave Owne~ elechicel wmk i'otal~ad at: ~ Sveet Address, eoz or Route No. C-tY 0 ! f'AR.' /~~S.S ecLO o. Township Name o~ No. RanB¢ No. Counly Qa~e ~"~4 Occuoant Pft/INTI ~ Phone Nu. ~o~PGn. ~G ~cI~SR'J Power Supplier Address p / ~fJ. 'jdG/OZ/~C . KM1'I~J//1 f~A Ele rical Contracmr"(/CO pany N mel ~ Contractor's License No. G e.ed o.y :~cC~r.CeC GO Mailing Atldress (COnhactor or Owner Making Installatfonl /f. / 7 !/'y+ ~e C~e ~ S~1~7 Authorized SiBnatur¢ ~Conv or wner Making InsWllat o Ph ne Number z-y~2z MINNESOTA STATE B AR~ OF EIECTNICITY THIS INSPECTION REQVEST WILL NOT Griggs•Midway Bldg, - Hoom N•191 4E ACCEPTED BY TME STATE 80ARD MN 55704 UNLESS PROPER INSPECTIpN FEE IS 1821 University Ave., St. Peul, ' ENCLOSEO. PM~o 16121 29Z2171 ~,(,2~(l( REQUEST FOR ELECTRIC INSPECTION Ee"°°°°~"a ' See instructjons for comple~ihls ~orm on back of yellow copy. ~~jl ~4 ~ A o 9 7 7~~ ""X'" Below Work Covered by 7hrs Request r~ Adtl flao. Typ¢ of 8uiltling APplianeea Wired Eq~ipment Wired , Home Range Tempora~y Service Duplex Water Heater Llgh[in, Fixtures Apt. Building Dryet Electric Heafin Commercial Bldg. Fumace Silo Unloader Industrial BIAg. Air Conditioner Bulk Milk Tank Farm mer ueci y ~her Isper.ify} t er ueci y' Ot er O~her ompute lnspection Fee Belaw # Fee ServfceEntrence3iie k Fea FeeEers~S~bfaetlars N Fee Circuita 6t~ 0 to 200 ~Am s 0 to 30 Am s 0 tn 30 Am Above 200 qinps o0 37 to 100 Amps 31 to 700 q Swimmin Pool Above 100-Am Above 700_A Transformers Irrigation Boorns Panial~'Other Fee Signs Special Inspection ~ TQ ~ FEE~ emarks ~ flouph-in Di[c I rical ~ ~Yi. nspacWr, hereCY ~ certity thet Ih0 above Final ~N1e 'nspeetion hes basn • ,.e O mede. mk request voi018 manths irom , . i i 2/84 ~ : l , % CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTIODI (PLEASE PRINi) 1) PROPERTY ADDRESS: lI ~IU/ ' ~~t.~~ rFrar DESCRI°TICN: d° a,~ a~'-~~~-,.~_~ A/ (Lot/Block/SuLxlivision o~Tax Parcel I.D_ Ntu[~r) I"r t...'`{I~'_~:G ST.4i.CP*c2E, Dr~'IF, 0_' ORIGi1AL r~,JILC~iG P~:ST ISS~?DiG: ,::oc__. , P.4E5:.`~.:' ~~:`]Ii~:/F~O.~(,'Sc.`7~ i~S~: ~ R-1 SLVGL.~ r^P`4LT.Y CJ R-2 DUPI,E:{ ('I4v0 UD7IT5) 0 R-3 ~dNE30CJSE (THRE^ + Ti?VITS) ( UNITS) ? R-4 ApAR'IT^.~'T/CODIIX`,~vINI[M ( iNITS) ? CCMMEf2CIAL/REPAI7,/OFFICE ? II~USTRIAL ? INSTITUTIONAI,/GOVII2DA'fENT 2) APPLICA~"P _.~--~~~P ~P INi~ NAh1E: ADDRESS: CITY, STATE, ZIP: ~ PHO~: .r~l,~,.~- a ~~`f 3~ p~ PLEASE PFLNi) 48ER ' n'c FOR CITY USE ONLY h~~.~.. ~ ~o_o_ _ ~ _ _ PLU,~iBERS LILENSE: ADDRESS: p p ~ Aetive ~ CITY~ STATE~ ZIP: ~ ;QQy S-~~4 Q Ezpired tcR Not o Rec - PHONE: _'~(~~j_c/ 985 PLIIMBER LICENSE N,.~'rJ,S/ /yr 1 a nitia 4) OCC[JPANT/U.~I~ NF~_ (PlE SE PNINT) ADDI2ESS: / CITY, STATE, ZIP:~ y PHONE: 5) IIVDICATE WHICH PERNIIT IS BEIhG RD~UESTID; ~ CO:v'NF.CPION TO CITY SE.S^IEEt ~ COh:'~I~X.TICV TO CITY WATEI2 ? dI'I*.ER (PLEILSE DESCRIBE) 6) ~dDIG`.~ 0:~: ? PLP<1SE HOLD APP12dVID Pg~;'~LiT EY)R PIQ:-UP BY ONE OF ABOVE Q PI.F~SSE 6g~IL APPROVID PER:~LIT 'Iq 1, 2, 3, 4 11BCA7E (Circle one) 7) SI~A7L.'RE: c.~. p.0 : yy~ D DATE: /4 S-d . . . . . _ , 4~ea+w:a+f~oi~,~rieE~ar:~ri.eLni.aa~?a.. ns.K~:..~--~-s~~.s~~~.`asa~ew _ . . . #~asw~r;s~ai~a r F 0 R C I T Y U S E O N L Y ' PER'~IIT ISSUED F~ES: $ ~ o y-a S~TriE~ n~??~IIT (I_ICL"uD: SUP,C?i'?~rZGi,) $ /a. S d WATER PERP1IT (INCLUDE SURCEARGE) S G.~_ o-d WATER METER/COPPERHORN/OUTSIDE READER $ WATER TA? (INCi.JD~ COR?ORATICN S:OP) S SEWER Tao $ i a ACCOUNT DEPOSIT - SEWER $ / 1E' ACCOUNT DEPOSIT - WATER $ ~ 7P. WAC S ~'~5---~6,- rJ SAC S TRUNK T.QATER ASSESSMENT $ TRUNK SEb~ER ASSESSMENT $ LATERAL BEN~FIT/TRUNK SEWER $ LATERAL BENEFIT/TRUNK WATER S OTHER S TOTAL $ 7/•~ ~ AMOUNT PAID/RECEIPT 7 a~~ DOES UTILITY CONLVECTION REQUIRE EXCAVATION IN PUBLIC RIGi-IT OF WAY? ~ YES IF YES, THEN A""PERMIT FOR WORK WITHIN ~ PIJBLIC ROADWAY" MUST BE ISSUED BY THE NO ENGINEERING DIVISION_ LIST AS A CONDI- TION. SUBJECT TO TEIE FOLLO?QING CONDITIONS: APPROVED IIY: ~~~~~J TITLE: .~`3_ d~ DATE : / o a ~ .a ~ w~ s~ ~a ~ w~t+~ w~ ia sw ww w.+ a~t~ w~~ ~~w w.a se ar w.a ia s~ w.~ ~ C~TY USE ONLY ia ~yas ~ ~ g~ RECEIPT#: SUBD. lATar~ RECEIPTDATE: ~I'~5-GD PERMITiF ~OJ ~O 8000 ~LiJM$INfi ~MiT (fi~S1D~IVTI~kL) crrYof ~nsnri 5930 PILOT KAOB fiD EAHAN,INN 551 fY 681~91-4675 Please complete for. D single family dwellings ? townhomes and condos when permits are required for each unit > backflow preventer for underground sprinkler system FIXTURES EACH # TOTAL ~ Alterations to existing dwelling - minimum fee Describe: $ 30.00 Bath tub $ 3.00 x = $ Floor drain 3.00 x = ~ Gas i in outlet ' minimum - ~ 3.00 x = $ Hot tub/s a 3.00 x = $ ~ Kitchen sink 3.00 x = $ Laund tra 3.00 x = $ Lavato 3.00 x = $ Se tic S stem newlrefurbishad 'requires MPC lie. 75.00 x = $ S2 tiC S stem abandonment 30.00 X = $ ~ RpZ new installatioNrepaidrebuild 30.00 x = $ ~ Rou h o enin 1.50 x = $ Shower 3.00 x = $ Under rounds rinkler irdwauin isunderconswction 3.00 x = $ Under round s rinkler if existin dwenin 30.00 x = ~ Water closet 3.00 x = $ ~ W ater heater 3.00 x = $ _ Do Watersoftener ifdweum undereonatrucSion 5.00 x = $ W ater softener ~f axiscin dwewn9 30.00 x = $ Waterturnaround 30.00 x _ $ State Surchar e .50 $ .50 $ O. D Total Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc. 1 hereby acknowledqe that I have reaE this applipdan, sta[e that Ma infortna6on is mrtect and agree to comply with all applirable Ciry of Eagan or inances. It is the applicant's respon5ibility to notlfy the property ovmer that Ne City of Eagan assumes no liability for any damages pused by ihe Cily during ifs normal operalional and mainte Jn.~h~ i°~~~~~~°° e n ne. rti~e ~it within Ciry propertyinghl•of-way/easement. SITE ADDRESS: ~~RG, ~EE asoi snFnRi Pnss TELEPHONE OWNER NAME: : ~ EAGAN, MN 55122 - (AREACODE) ~ . . . _ . (651) 405-0427. - . . _ . _ . _ . . ~ . TELEPHONE INSTALLER NAM : (AREA CODE) STREET ADDRESS: NORBLOM PLUM _C0~ ~ ~892 827=4Fi85 CITY: Zypg,taep4~ ' e AVE SOU1'M $TRT ~ ZIP: MINNEAPOUS, MN 55408 SIGN OF PERMITTEE CITY USE ONLY LOT o~ BL ~ PERMIT ' I U 7j suBn. ~ S~a r; ~cE~~r a: l a5 9 a g RECEIPT DATE: '7i I I' O ~J 2000 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PIIAT KNOS RD EAGAN tIId 55122 651-681-d675 Date: ~ • ~ ~ Dl7 Complete this section onlv if you are installing HVAC in a single family dwe(ling, townhome or condo under construcYior. an~± ~ot owner/xcupied. • HVAC: 0-100 M B T U $ 30.00 ADDITIONAL 50 M BTU 6.00 • Gas outlets (minimum of one required @$3.00 ea.) State Surchazge .50 ~ Total $ ~ Complete this section onlv if you aze remodeline, addine to, or re airin an existing single-Family dwelling, townhome, or condo. Please indicate if it is a new item, alteration, or repair. _ New _ Alteration ? Repair _ Other ~ Furnace _ Air conditioning _ Airexchanger _ Other Fee $ 30.00 State Surcharge .50 Total $ 30.50 Reminder.• Call for inspections S[TE ADDRESS: ~I L7~ SQTQY 1 pQ55 OWNERNAME: 1Pe LUV~~.YG PHONEN:~_- ~I~-O~a"1 (AREA CODE) [NSTALLER NAME: ~OV1 S Y~CI~IO~V1 ~ ~A~D ~ ~ Y`C . PHONE qr'fL - ~'I ~S- ~ STREE'CADDRESS: ~~Ql~ O~C~ ~j1( 1G~L `IQVC~L R,~ ~~ACODE) CITY: SY~Qk.O'~.QI) STATE: MN Z~p;~_ rk~ ~k,~ n a .~t.~-r' SIGNATCTRE OF ERMITTEE CITY USE ONLY L _ BL _ PERMIT#: SUBD. RECEIPT#: APPROVED BY: , INSPECTOR RECEIPT DATE: 2000 MECHANICAI. PERMIT (COI+A~RCIAL) CITY OF EAGAN 3830 PILOT IQIOB RD EAGAN, DIId 55122 651-681-4675 Please complete for: all commercialCndustrial buildings multi-family buildings when separate permits are not required far each dwelling unit DATE: WORK TYPE: New construction Install U.G. Tank _ Interior Improvement _ Remove U.G. Tank _ Processed Piping When installing/removing underground tank, cal! 651-681-4675 for ixspection by f:re marshal and plumbing inspector. Description of work: Fees: 1% of conuact price OR $30.00 minimum fee, rvhichever is greater. Underground tank removaVinstallation = miaimum fee Contract price: $ x 1%= $ (Base Fee) State surchazge calculate at $.50 for each $1,000 Base Fee TOTAL S SITE ADDRESS: OWNER NAME: PHONE (AREA COD~ TENANT NAME (IMPROVEMENTS ONL17: WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME: INSTALLER: ADDRESS: PHONE - (AREA CODE) CITY: STATE: ZIP: SIGNATURE OF PERMITTEE Certificate for: . ~'~`"Gtllden Eagle Builders, Inc, Bk: 82/53 = 22040 Coller Court Hampton, Mn. 55032 ~ i r< DELMA~i H. SCHWANZ ~ L/•ND SuRVE~OAS INC ~ RPO~SIPIM Vntllr L.1W< pl tM1P [IAIP ~1 MInnP4~1~ I,i 'i ^ 14750 SOUTM ROBERT TRAIL ROBEMOUNT. MINHESOTA 55068 GMONE 872 423-1789 ~ I~ \ SURVEYOR'S CERTIFICATE ~ ! SCALE: 1 incYi = 30 feet j ! ( Elevations shown are exiating i: l~ (~d~ ! \ p Denotes set wood hub 4': ~v IY o Denotea set iron pipe 'r, ~ ~ \ x , I ~ ! o s ' ~ \ a ' ' ~ Proposed gara~e floar elev. ~ 81 33_!_.' ; ~ ~ Drainage & ~ I hereby certiPy that tihis is a~rue utility and correct representation of Lot 2, ~ easement ~ Block 2, THE SAFARI ADDITION, acoordin~l , ~ 3- to the recorded plat thereof, Dakota,'" / Q County, Minnesota. , l~ v ~ ' q6 ~ , p~ ~~j ~~aPN~ Also showing the locatian of ~ ~ ~ 7 a proposed house as staked ~ ~ ~ ~ 9~8 r~~ ~ thereon. ~P \ ~ \ s ~k v ~ ^q~ yqh~p ~ ~r~,.~ ~ ~h p~ a ~,uP°~E ~ iti•°' H cn ti I ~~oµ 98~. ~ ~ ~ % ~ tig ~~o. ?a, ~y5 2b ~ 3' / • 2 98~.z 3~ ~3 / A% v ~r~ ~ a r~ ~u,~e ~ 9 'r a ~ 5~~ ~ ~ , ,~~.n~ ~ . R '~998.d7 / ~ /7~ ' . ~ ~fM'llul3 'c a /r~t ~ ~ ~ ~5~~ C \ / ~d , 8 . M v / Yj A~ , . . I ~ 9a' ° ¢y 6ti~~ ,/P(~' + 9ssc~ ~ r 7eP uut8 ~ 3~ i / ~ MINNESOTA REGISTFATION NO. 8625 ~~~~~~~~~~~~~~~~~~~~~~~~~m~~~~~~~~~~~~~ czrv or- FFle~n r.,r~sra:r.~:r;: s rrF;t~it~ai_ Nu~ ~ rci DA'1'~~; Oi/i%!/`a9 1'LMI=; OB:?3:i.2 I0: ~~anc: rnr-~~~:r.~e:, zn~c. ,":i21.(7 `')I:)01 ~r301. ~iAFAI:::f. F'AS 12:'i.2.c~ ?~1'3.`_i ."JOU1. 49Di. 5AFf~l":I F"'AS 3.CIU ToT,a7. R~cei~crF, Am~~.xni:: 1~?F3.£'S CF:L13U87 l1SER ID. t~ANCY X~X~~F# %t~X~n ~kX~Xt~X~~'~%t~K X~ X~ ~%~X~ ~~tt # ~~t%c~k~~KX~ k:M ~k~krk~X#k~ 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD • 55122 t-a g- ar~- 3 ~S 65'I-68'I•4675 New ConshvcHen ReoulremeMs Remodel/Reoair Reavirements ~ - ~ ~ ' ~ ~ D 3 regisiered sNe surveya showfng aq. H. of 101, sq. fl. of house 2 copies of plan and all roofed areas [20% maximum lot coveraae allowed) 7 set o} energy calc~laNOns for heated addRions D 2 copies of plans (show beam 8 wintlow slzes; poured Ind. design; efc.) 7 afle survey lor exferlor addBions 8 decks D 1 sef M e~ergy calculWions D 9 copfes ol free presenat(on plan M lot plalfed after 7/1/93 DATE: 7-~~-~~ _ CONSTRUCTION COST: ,~_S,U~T,~, DESCRIPTION OF WORK: ~f ,rr~~l•~•fiCO~_~~;5'£ f-' (~-~F'- ~r~ /.vj.~ ~2.Cw , STREET ADDRESS: ~[Z~ j ~f~-,~' S 3a y E~/,2 S(i„a^,~s LOT: ~ BLOCK: SUBD./P.I.D. ~ Yv- ~c~-k~ C). n~_ Name: ~-t lnrn R4RC~r L~ ~ Phone / S a~L~ PROPERTY ~as~ Fxaf OWNER Q ~ StreetAddress: ~~D (~~_f~'S Clty ~r-y~~ State: Zip: _~~ZZ Company: Phone Sp~L~ ~~/T~~ (area codej CONTRACTOR Sfieet Address: /~O~@l'~R ~ C- . License # SZ7(~Exp. 33/-tem city l1~ S. _ State: ~iv~ z~P: _~5~f 9 i ARCHITECT/ ENGINEER Company: Name: Telephone area code ( ) Street Address: Registration City State: Zip: ° Sewer 8 water Iicensed plumber [reauired for new consiruction onN): Penaily applles when address change cnd lot change is requested once permR Is Issued. i I hereby acknowledge that I have read ihis appltcaFion, state that 1He InformaHon Is correct, and agree to comply wffh all applicabl StWe of Ml~nesota Stafutes and Clty of Engan Ordinances. ~~..C-~ S C~i11~_ - Signature of Applicanr ~ ~_T OFFICE USE ONLY P~5(D~ [ff,~tqGJr 9 " ' Certiflcates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No ~ Not Required . OFFICE U5E ONLY BUILDING PERMIT TYRE ? 01 Foundation ? 06 4-plex O 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 02 SF Dwelling ? 07 5-plex O 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea. ? 03 1 of _ plex ? 08 6-plex ~ 13 16-plex ? 18 Deck ? 23 Porch (screened) O 04 2-plex ? D9 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage ? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous woRK nrQe ? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia ? 32 Addition ? 36 Move Bldg. ? 4D Gas Insert ? 44 Windows/Doors ? 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair r' °~~air ? 39 Lercli~h (Ir~:. ricr) 0 42 R~roc~ * Give PCA handout to applicant for demolition permit GENERAL INFORMATION Const. (Actual) Basement sq. ft. Census Code (Allowable) Main level sq. ft. SAC Code UBC Occupancy sq. ft. No. of Units Zoning sq. ft. No. of Bldgs # of 5tories sq. ft. MC/ES System Length sq. ft. City Water Width Footprint sq. ft. Booster Pump PRV Fire Sprinklered APPROVALS Planning Building Engineering Variance Permit Fee ' ' a-'j Valuation: $ Surcharge U C.~ Plan Review Lit:ens~ MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit SMI Permit ' S/W Surcharge ' Treatment PI. , Park Ded. Trails Ded. ~ther Copies Total: SAC Units % SAC . . . ALL CONTRACTORS MUS~CENSED WITH THE CITY OF EAGAN , INCLUDE Q SETS OF PLANS, SFnw(a.~~R, ~ CERTIFICATES OF SURVEY ~ SET OF ENERGY CALCULATIONS To Be Used For: li = Valuation: , pQQ. Date: rG~ ,y7 ~ Site Address: ~~U~ ~jf~~j~,Q,~: • • Lot:~_ Block: ~ Sect/Sub:~F Erect: X Occupancy: Q-'j Parcel Remodel: Zoning: ~ ~ Repair: Type Of Const: ~ ( / Enlarge_ # Stories: Owner: \ 7` ( dC~1,/-, ~~2!i~~~~^_~ ;J,-7- Move: Length: Address: U J; Demolish: Depth: ~2 City/Zip Code: Grade: Sq. Ft.: Phone ~ ~ ~ ~ Contractor~/' tCf..Zi~ C. ~f.~~_, ,~~~r,,)~.~ ~ i7 i A~9 y ~ / Address:, J ~ , ~ Assessments: Permit: City/Zip Code: J,~,j~~~ Water/Sewer: Surcharge: 3•,~ ~ 'i ~ Police: Plan Rev. : ~ f6 Phone ~f~ ~ ~ ~ Fire: SAC: y° Engr.: Water Conn: ~~0.=° Arch./Eng: Planner- Water Meter (03.°= Council: Road Unit: ~ Address: Z-~ - Sldg. Off.: ~D.~j~ Parks: City/Zip Code: APC: 1 Phone#= Variance: ~ ~ / Sa•$O , ~ s~. , G'~ ~ ~ ~ . .-.t~E x x x x ~ fi,. Q' U~ N ~:~0,rt . ' . ' ~ ~ ~ - szs• : , « 1~ ' ie2~s*K -,._~,s,. ~ N ~ N ~ ~ o•* x x x x x 394• + V I ~ ~ ~ ^ 43•5+ ~ I l~ II 197•+ d 525 • + - ~ ~ 470 • + ~ ~ ~ ~ ~'j 63• + ^ r~ 26~• + ~Np ~ ~ N V I 1~9:,2•5* ,y ~ i V~ ~ '7~~r7 ~d 30.~~ 2006 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Plcase compiete (oc single famity dwellings & townhomes/condos when pemiits are required for each unit Date ~ / / Q p~ Site Address ~Rd f ~ q`~( r ~ ~G' ~ Unit I! Propcrty Owner ~ ( ~ Telephone # (65 , ) 'y d ~/17 Contractor STANDARDHEATINGBAIRCONDITIONING 410 Street Address ~INNEAPOLIS, MN 55408 City State Zip _ Telephone # ( ) Bond Expires: The Applican[ is _ Owner ~ Contractor _ Other Add-on or alteration to existing dwelling unit $ 3D.00 _ furnace _Additional _Replacement _ New air exchanger air conditioner ~ n(~ ~ ~ , ~_rr heat pump other State Surcharge $ .50 Total $ 3~ 's~ I hercby apply for a Residential Mechanical 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 with the Mechanical Codes understand this is not a permi but only an application for a permit, and work is not to start without ' that the r w' bc accordance with the appr d plan in the case of hich requires a review and approval of pl s. S~l-~~ ~I lM ~'J~ ApplicanYs Printed Name Applicant's Si e PERMIT City of Eagan Permit Type:Building Permit Number:EA115915 Date Issued:10/01/2013 Permit Category:ePermit Site Address: 4901 Safari Pass Lot:2 Block: 2 Addition: The Safari PID:10-75850-02-020 Use: Description: Sub Type:Siding Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes . William Krech Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Lee Lundberg 4901 Safari Pass Eagan MN 55122 (952) 201-0518 Krech Exteriors Inc 5866 Blackshire Path Inver Grove Heights MN 55076 (651) 688-6368 Applicant/Permitee: Signature Issued By: Signature