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1966 Safari Tr
PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA127726 Date Issued:10/14/2014 Permit Category:ePermit Site Address: 1966 Safari Tr Lot:071 Block: 2 Addition: The Safari 3rd PID:10-75852-02-071 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Janel Behrends 122 West 3rd S Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088 Surcharge-Fixed $5.00 9001.2195 $60.00 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 - James R Dorcy 1966 Safari Tr Eagan MN 55122 Haley Comfort Systems 122 3rd St W Hastings MN 55033 (651) 437-0338 Applicant/Permitee: Signature Issued By: Signature CASH RECEIPT CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE j 19 RECEIVED FROM AMOUNT $ ? CASH & _DOLLARS too C-CH E C K Thank You BY White-Payers Copy . Yellow-Posting Co Pink-File Copy FOR BLDG. PERMIT NO. 01-3210 01-3422 01-3445 01-3446 01-2155 17-3860 20-2275 20-3865 20-3868 20-3716 20-2252 20-3713 20-3743 79-3866 11-3855 Bldg. Permit Plan Check Surch./Adm. SAC/Adm. Surcharge Road Unit SAC Water Conn. Water Trmt. Water Meter Acct. Dep. Water Permit Sewer Permit Sewer Conn. Park Ded. t i TOTAL } CASH RECEIPT CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE RECEIVED --. AMOUNT I$ 3 19 4k DOLLARS 00 E]CASH ? CHECK FOR FUND CODE AMOUNT Thank Yo u BY White-Payers Copy Yellow-Posting Copy Pink-File Copy J. INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: ! r 1 r 1 W r, 3830 Pilot Knob Road Permit Number: a ?, w Eagan, Minnesota 55122-1897 Date Issued: ++ ! (612) 681-4675 SITE ADDRESS: rli r f' APPLICANT: PERMIT SUBTYPE: TYPE OF WORK: l?l l+ I I11N i lrF Iii iillfAll 3 P } F A.MNA {t1 14AIIJ'.- ':1 I'ANAII I'{ V MI I'; AN.V Nr 0111kI 11 Ft11: ANY 1 11 C ; R I i AI 141pI t Permit No. Permit Holder Date Telephone ELECTRIC I&44? PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS 71-7lq FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL u? G Poet - ' la S? Glh! ?' 2193" CITY OF EAGAN 10 334 r 3830 7nob Road, P.O. Box 21-199, Eagan, MN 55121 ` ?br t: U BUILDI11G PERMIT PHONE: 454-8100 Receipt # To be used for DECK b Est. value Ian - Mn rlatP (V -r 9AL 1001 Site Address 2466 CJVARTTR Lot 6 Block j Sec/Sub. SAFARI 3AD Parcel No. Name TAY MAUCH' ttiR L RICHARD GRARAN W c Address 3266 SARAR11 Tit City RAGAN Phone 4Sb??SQd o Name ]!MIRlt 2 WTIVES ;k_ Address 711141 WAYUMA SLYD City UPI-- Phone 593-91 W 51 Name X Address a W City Phone Occupancy Zoning (Actual) Consl r of Stories Length Depth Diet S.F. Total S.F. Footprints On Site Sewage On Site Well MWCC System City Water PRV Required I hereby acknowlege that I have read this application and state that the Booster Pump information is correct and pgree to comply with all applicable State of Minnesota Statutes and Cil$ of Eagan Ordinances. T Signature of Permitee ,?f y f 4 4 &. APPROVALS A Building Permit is issued to: IMM RIOR WTIVES Planner on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Building Official Variance OFFIC E USE ONLY 163 FEES - Bldg. Permit Us- Surcharge iS-OO 2&a3 Plan Review 1 R1% - 30126 SAC, City SAC, MCWCC Water Conn - Wat r Mete e r Acct. Deposit S/W Permit - S/W Surcharge Treatment PI Road Unit Park Ded. - Copies 20,50 - TOTAL 505t .M Permit No_ Permit Holder Date Telephone # WATER SEWER PLUMBING H.VA.C. ELECTRIC ku pection Date Insp. Comments Footings I Foundation Framing Rooting Rough Pibg. Rough Htg. Isul. Fireplace Final Htg. Orstat Test Final Plbg. Plbg. Inspector - Notify Plumber Const. Meter Engr./Plan Bldg. Final Deck Fig. / 59/f /P 22 04P /r o6 Deck Final r G - Well Pr. Disp. BUILDING PERMIT SF DWG/GAR Est. Value $144.000 N2 12853 NOVEMBER 5 Site Address 1966 SAFARI TR Erect Cf Occupancy R3 Lot " Block 2 Sec/Sub. SAFARI 3RD Remodel ? Zoning PD Repair ? Type of Const y114 Parcel No. Addition ? No. Stories Name FORTUNE REAL'T'Y Move ? Length 16 47 z 4940 VIKING DR Addr Demolish ? Depth ess 3o EDINA 835-3363 int. Impr. ? Sq. Ft phone City Install ? o Name DESIGN-A-HONE INC Approvals 00 Address 12443 RIVER RIDGE BEVD Assessment City B' VILLEPhone 894-4100 Water 8 Sew. - Police Name Fire Address 00 Eng. W < City.. Phone Planner Council I hereby acknowledge that I have read thisapplication and statethat the Bldg. Off. 11 5 86 information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances- APC Signature of Permittee C __ _ ___ -Var. Date Permit ' -- Surcharge 77--00 Plan Review---2Tl-.-30 SAC 5 .00 Water Conn. 00.00 Water Meter'-S0 Road Unit X00 Tr. PI. 156.00 Parks Copies Total ' ' DO A Building Permit is issued to: DES IGN-A-ROME INC on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 Receipt # Building Official / ' Permit No. pam* Holder I Date I TNaphone k co 'Framiny II???7I s.J? II 160-le In L n+ , -, 0 t- 61W 7 E. 4- I Final Occ. Fig. Frmg. { PERMIT #? -? PLUMBING PERMIT RECEIPT #? CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: Site Address Lot Block m Name _ Address c City Name C Address C) City - Phone ` FEES COMM/IND FEE - 1% OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE -$10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 SIC IF PERMIT PRICE GOES BEYOND $1,000.00) BLDG. TYPE WORK DESCRIPTION Res. , New Mult Add-on Comm. Repair Other FIXTURES TOTAL Water Closet - $3.00 $ Bath Tubs - $3.00 Lavatory - $3.00 ` Shower - $3.00 Kitchen Sink - $3.00 Urinal/Bidet - $3.00 Laundry Tray - $3.00 Floor Drains - $1.50 Water Heater - $1.50 Whirlpool - $3.00 Gas Piping Outlets - $_1.50 Softener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 FOR: CITY OF EAGAN FEE: STATE S/C: GRAND TOTAL .. r PERMIT # MECHANICAL PERMIT RECEIPT # CITY OF EAGAN n 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE CONTRACT PRICE. PHONE. 454-8100 7 r c t Site Address _ t it 1 TYPE WORK DESCRIPTION BLDG . Lot Block Sec/Sub ` w R N e ea Name MuR Add-on Address Beau il Ruc° ?)r. R i C 5 omm. r epa City .ajaii Phone Oth er Name FEES c Address 124, 13 ;liver 11i6(tu '"` v`1' RES. HVAC 0-100 M BTU -$24.00 03 city 3ti:C?it; vi Phone }- ' ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 ADDITIONAL 6 M BTU - 6.00 TYPE OF WORK GAS OUTLETS - 1.50 EA. Forced Air M BTU A COMM/IND FEE - 1% OF CONTRACT FEE Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00 Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00 Air Cond M BTU STATE SURCHARGE PER PERMIT - .50 . (ADD $.50 S/C IF PERMIT PRICE GOES Vent CFM BEYOND $1,000.00) Gas Piping Outlets # Other FEE -- ' - ' SIGNATURE OF PERMITTEE S/C• TOTAL -" ' FOR: CITY OF EAGAN Terfifiratt of (Orrupaury citp of eagan 19rMtuW of NuOing JuvertWu This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following, use cusuficati M S M/-"I' Bldg, hfmit No. 12853 Occupancy Type R3 Zooing Dow Pi' Type r ?'? RE, F? -,.-NA Owner of Building -" • MAT-11 Areas ? +?1 L'1.??, DR BuildingAdateas yowity If), Bt, SAFARI 3RD Data JM 6. 1987 Buddim 06icw POST IN A CONSPICUOUS PLACE CITY OF EAGAN Permit No, .-i' Date: 9-')5-.R7 3830 Pilot Knob Road Meter No: oZ Size: dk P.O. Box 21199 Reader No: 'sp a 6 7 Date 7- / Y') Eagan, MN 55121 x ner. Des ign-a-Home . Inc. -liteAddress1966 Safari Trail L6 T'.? Safari TTT number. SOuthIO-Sm Plumhing onn. Chg: 500, 00rd WA RMI%ing: pl cct Dep: 1-HHONE ?t No. of Units: 1 rmit Fee: g c? ocal utilities ucharge - ELECTR16 16tompiy with the City of Eagan Plant 156rf6rl i i n .. ?prdi nces, eter E' isc.: By WATER SERVICE PERMIT CITY OF EAGAN 3830 PIIotj,Cnolj Mad P.o. Box 2'1119 Eagan, MN 55121 nI 1 Zoning: Owner: Permit No:_ Address: Site Address: 1966 Safari Trail L6 2 Safari III Plumber. Southtotsn Plumbing 11- r ?s6 63144 100. COP(! I agree to comply with the City of Eagan Connection Charge: 47 5 - QQpd Ordinances. Account Deposit: 1 S _ oop'? Permit Fee: 1 n _ Q? R BY Date of Insp.: Insp.: OF EAGAN i Pilot I nob Road Box 21499 on, MN 55121 SEWER SERVICE PERMIT PERMIT NO.: DATE: _ _ No. of Units: Surcharge: - Misc. Charges. Total: Date Paid:.- Date, ?-75_.R7 Meter No: Size: Reader No: Date: A 1 nn. Chg: 500.00pd -t. Dep: 15. Ndle mit Fee: 10.00nd -charge: .Sand Plant 156.0apd ter. 11; 3 Snp Zoning: _ No. of Units: I agree to comply with the City of Ordinances. WATER SERVICE PERMIT L BL CITY USE ONLY RECEIPT* ^I a g y .sal/9 SUBD. RECEIPT DATE: V/ V 1997 PLUMBING 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 backtlow preventer for underground sprinkler system FIXTURES EACH N.QL TOTAL Shower 3.00 x = Water Closet 3.00 x = Bath Tub 3.00 x = Lavatory 3.00 x = Kitchen Sink 3.00 x = Laundry Tray 3.00 x = Hot Tub/Spa 3.00 x = Water Heater 3.00 x = Floor Drain 3.00 x = Gas Piping Outlet • minimum - 1 3.00 x = Rough Openings 1.50 x = Water Softener `for dwellings under construction 5.00 x = Water Snffpnor • m existing dw?9i eg 20.00 x = U.G. SpdnkLer_ ' for dwelling under const. 3.00 = nnki 'forexisting dwelling 20.00 020 era Ons • to existing residence 20.00 = Water Turn Around 20.00 = Private Disposal System ' oak cry lic. 75.00 = (new and refurbished systems) Private Disposal Systems *Abandonment 20.00 = STATE SURCHARGE .50 a TOTAL o2 ° I hereby acknowledge that I have read this application, state thabthe information Is coned; and agree to comply with all applicable City of Eagan ordinances. It is the applicant's responsibility tonotify theproperty 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: 11r66 jkAtI`-1 7®"aar OWNER NAME: go 07 kSd..RIS INSTALLER NAME: TELEPHONE STREET ADDRESS: cad-CITY: l/l 44" STATE: ZIP: 5 $ WS zr D SIGNATURE OF PERMITTEE s ?- 9,7 Aade(L) ? Pv?ae 0- # N" 4 /m 1 7 Regu ?e _ r Fire No. Roug -In Inspiclion equ' n (You mu Isall nspector ready) In pection Other Than Rough-in Ready Now E] Will Natity Inspector Ves No Data Reatl I>;<licensed contractor Downer hereby request inspection of above electrical work at: Job Address (Street, Box or Route No.) City r{., ill 0. re \ ?C \ I .? C 0.K SSIa2 Section No. Township Name or No. Range No. County Oxu ant (PRINT) Phone No. CGS 5 Y - / Power Supplier Address l EledrI Contractor (Co?JmpanyjNaa!me)e Coonrtractors License No. G. _ . L V (.. N Mailing Address (Contactor or Owner Making Instal`uion ' U;(A or3 SS SS? r Aul rizetl Sgnatua (Contractor Owner Making Installation) Phone Number MINNESOTA STATE BOARD OF ELECTRICITY Griggs-Midway Bldg. - Room 5.128 II II I I I II I I I I I I I I I THIS INSPECTION REOUEST WILL NOT BE ACCEPTED BY THE STATE BOARD 1821 University Ave., SL Paul, MN 65701 Phone (612) 642-0800 II ?J ! I + UNLESS PROPER INSPECTION FEE IS ENCLOSED. ®% - D O REQUEST FOR ELECTRICAL INSPECTION 10- 9 See instmctions for completing this form on back of yellow copy 4 ;1- V 7/7 X" Below Work Covered by This Request - New Atl Type of Building • Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial Furnace Other (Specify) Farm Air Conditioner Other (specify) Contractor's Remarks'. Compute Inspection Fee Below. # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200-Amps O -Amps Signs Inspector's Use Only: TOTAL /6 Irrigation Booms yQ .O yb 7 Special Inspection s Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONT I, the Electrical Inspector, hereby Rough-in Date/ r -! certify that the above inspection has been made. Fieal f Da OFFICE USE ONLY This request mid 1B months from 18 rom id 3475 ?. i? 7 00 Request Date ire b. Bough- in Inspection 1-19-87 Required? ?ReadyNOw Will Notify lnspec- y-y`P 'es ?No for When Ready Licensed Electrical Contractor 1 hereby request inspection of above ? Oy+ner electrical work installed at: Street Address, Bos or Route No. City 1966 SAFARI 1RAIL EAGAN Section No. Township Name or No. Range No. County DAKOTA Occupant IPRINT) Phone No. DESIGN-A-HOME 894-4100 Power Supplier Address DAKOTA ELECTRIC FARMINGTON Electrical Contractor (Company Name) C & Contractor's License No. M ELECTRIC, INC. A-042214 Mailing Ad ss (Contractor or Owner Making Installation) P.O. BOX 328; LAKEVILLE, MN 55044 Authorl d ionature (Contractpr ner ki Installation) Phone (Jper 3 2 3 3 MINNESO STATE BOARD OF E EL CTRICITY THIS INSPECTION REQUEST WILL NOT Qrigps• way Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS 7827 Un era itv Ave.. St. Peul. MN 55104 Phi....11 RAO-rtnnn ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION EB-00001-05 w ,Sea instructions for completing this farm on beak of yellow copy. Below Work Covered by This Request 79475 IN C Adtl Rep. Tvae of Buildinq? Apoliancea Wirwtl Equipment Wired awl1 Silo Unloader Bulk Milk Tank p Fee Service Entrancesize a Fee Feeders/Subfeeders k Fee Circuits 5 . 001 O to 200 qm s O to 30 Ams 14 42 . ® to 30 Amps Above 200 .1" 31 to 100 Amps 2 10 . ®1 to 100 AMps Swimming Pool Above 100_Am s Above 100_Am s Transformers Irrigation Booms Partiat-Other Fee I ISigns I I ISpecial Inspection ?s Remarks 6, -.110 TOTAL F 4i 7 aG 1. the Electrical Inspector. hereby certify that the above inspection has been made. BUILDING PERMIT To be used for SF DWG/GAR $144,000 Receipt NOVEMBER 5 12853 1966 SAFARI TR R3 Site Address Erect LJ Occupancy Lot 6 Block 2 Sec/Sub. SAFARI 3RD Remodel ? Zoning PD Parcel No. Repair ? Type of Const VN Addition ? No. Stories c Name FORTUNE REALTY Move 11 Length 76 4940 VIKING DR Demolish ? Depth G7 3 ° Address 835-3363 EDINA Ph Cit Int Impr 11 11 Sq. Ft y one Install o Name DESIGN-A-HOME INC ou 12443 RIVER RIDGE BLVD u< Address City B'VILLEPhone 894-4100 a 1 W Name F, Address <10 City Phone I hereby acknowledge: that l have information is correct and agree Minnesota Statutes and City oN Signature of CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 551121N2 PHONE: 454-8100 Assessment Water & Sew. Police Fire r:,,,, TC Planner Council rplication and state that the Bldg-Off. 11/5/86 with all applicable State of _ Fees Permit $ 543.00 Surcharge 72.00 Plan Review 271.50 SAC 575.00 Water Conn. 500.00 Water Meter 63.50 Road Unit 290.00 Tr. Pl. 156.00 ,. Date I Copies Total $2,471.00 A Building Permit is issued to: DESIGN-ALHOME INC on the express condition that all work shall be done in accord ce with all applicakllee _§4ate?of Minnesotl "Slat s and City of Eagan Ordinances. Building Official CITY OF EAGAN No - 19834 "' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 n ?yy1r/ BUILDING PERMIT Receipt # f 1. J-,`fD DECK & To be used for 4-SEASON PORCH Est. Value $30, 000 Date OCT 24 1991 Site Address 1966 SAFARI TR Lot 6 Block -2 Sec/Sub. - SAFARI 3RD OFFICE USE ONLY Parcel No. occupancy R3 FEES Zoning W Name FAY BEAUCHINE & RICHARD GRAHAM (Actual) Consl Bldg. Permit 285.00 Address 1966 SAFARI TR (Allowable) 15 00 ° Surcharge . Cit EAGAN Phone 454-4594 y r of Stories 1 5 t P 2?3 Plan Review .00 8 OTC l Length o Name INTERIOR MOTIVES Depth Deck 30x24 SAC City $a Address 7841 WAYZATA BLVD S.F. Total , City MPLS Phone 593-9860 S.F. Footprints - SAC, MCWCC Water Conn On Site Sewage rQ W Name On Site Well Water Meter W u= Address MWCC System I Acct De osit P < City Phone City Water SAN P it PRV Required erm I hereby acknowlege that I have re a d tthis application and state that the Booster Pump SM! Surcharge information i correct and ith all aPPlicable State of Zf Ei Wn OodiC w t Minnesota Statutes and C' of E n ces. a / ? Treatment PI Signature of Permitea ? 1 APPROVALS Road Unit A Building Permit is issued to: INTERIOR MOTIVES Planner Park Ded. on the express condition that all work shall be done in accordance with all Council -- 20.50 applicable State of Minnesota Sttatutes and City of Eagan Ordinances. Bldg. Off. Copies g ;, ,'NIq I LrL ? m Builtlin Official -' Variance TOTAL 505.50 TC /C7 1986 BUILDING PERMIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS MULTIPLE DWELLINGS - RESIDENTIAL RENTAL UNITS FOR SALE UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, 14?,ao $2,000 LANDSCAPE BOND o To Be Used For: Val tion: Date: - 13-p(p G Site Address ?? - Lot to Block Z Parcel/Sub $ / 7;4;?Tfeo IMO /l/ox/ Owner fti?71142` e 74/- j Address 5`9?v Kl<lelt City/Zip Code "iyA 555°35 Phone -P 3 S-3 3 G.3 Contractor ?lA?/C?N-A °e6V,"& je, Address 12 yy3 /?irO?t RiDGe STUD City/Zip Code x;?33,7 Phone d r7 Jt ag o Arch./Engr. Address OFFICE USE ONLY Erect Remodel Occupancy Zoning R-? Repair Type of Const Addition # of Stories Move Length 7C.- _ Demolish Depth 42 _ Int.Impr. Sq Ft Install _ APPROVALS FEES Assessments Permit 545, Water/Sewer Surcharge '(2. Police Plan Review 2-1 I.7-0 Fire SAC 575. Engr Water Conn Soo. Planner Water Meter Go 3. Council Road Unit 2q U• Bldg Off Treatment Pl 1 5Co. APC Parks Variance Copies TOTAL City/Zip Code Phone # NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. y?/= i77(, u 760 lUX 5 960 e ; . '% OWNER: SITE ADDRESS: EXTERIOR ENVELOPE AVERAGF "li" COMPUTATION CONTRACTOR: DATE: DETERMINE WORKING SQUARE FOOTAGE OF EACH: 1. TOTAL EXPOSED WALL AREA......,, 3 Z 5 StO O sq ft x "U" .11 2. TOTAL ROOF/CEILING AREA ........ ( 3 Z sq ft x U D,O D .026 I ...__? 3. TOTAL EXPOSED WALL AREA CALCULATIONS: m 5 e 3¢, 3 Total exposed wall area above floor Z 7 w 7. 0 0 sq ft a) Total wall window area: 1040i,y6c.&45i glazed...... 3Z(v, (os sq ft x "U" `-r- glazed.. - ••• sq ft x "U" m -- b) Total door area ,•....... 374?_ sq ft x "U" X310 R ?J??Z c) Total sliding glass door a rea: ?10 PER. INSOL,bf?iW(Sglazed...... I3 O sq ft x "U" glazed....., sq ft x "U" a - d) Total fireplace wall area 3 Oro d sq ft x "U" / ¢d D 4 (2100 e) Total wall framing area (Average lot,). ?7?0 7o f " ll nq 04 o .......... sq t x ti I , f) Total net wall area above floor (Insulated)...... I i UZ,?2;, s ft "till 6? 3 23 (? q x i q) Total rim joist area...... sq ft x "U" )a Total foundation area (Exposed).......... sq ft h) Total foundation window area............ sq ft x 1) Total net foundation ?j d area above grade....... sq ft x "U" I I m 2Qj __ 3' TOTAL a) thru i) PHONE: If item #3 is the same as, or less than item N1, you have met the Intent of S.R.r. Section 600E (c) 2. 4. TOTAL EXPOSED ROOF/CEILING CALCULATIONS: Total exposed ?2>2(?Qp roof/ceilinq area........ , sq ft )) Total skyliaht area....... 1--? sq ft x "U" ° Q Total roof/ceilinq framing 4 area (Average 109,)...... 132.00 sq ft x "U" ?• 1) Total net insulated (+ vv O p roof/ceilinq area....... !J ? sg ft x "U" 1 ° Z A 5 I 4. TOTAL f) thru 1) If total of #4 Is the same as, or less than N2, you have met the intent of S.B.C. Section 6006 (c) 1. ALTERNATE BUILDING ENVELOPE DESIGN To utilize the total envelope system method, the values established by the sum of items k3 and k4 shall not be greater than the sum of Items N1 and N2. 3. + 2. + 4. ° C E R T I F I C A T 1 0 N I hereby certify that I have calculated the "U" factors and "R" values herein and that the building here described meets or exceeds the State of Minnesota Energy Conservation Act. ? / 5 ?Ign a t uW? (Date) NSTRUCTION AMING SECTION: Interior air film 1z" 1??7(,-TILL h /2 inches so R VALUE 0.68 Exterior air tiim 0.17 -a U - 1/R v f01U WALL SECTION (INSULATED) ST SECTION: Interior air film .„_ « n. n.6R txtertor air rilm n.ii - Clti& o U - 1/R m .041 ,4 .4 I ,u4••? d °4.a ,4 4 Q'. a,`?.QO,,•aa•,? ?,'?°?? 4.41 ION SECTION: Interior air film n." Pk? r XF F,/LYS7 R€NE 1,50 I2', &"ek I,2op Exterior air film 0.17 TOTAL R a q. (o U 0 1/R a SLAR Oil GRADE 4 1 4CI 41, U - 1/R m ,043 VENTED CONSTRUCTION R VALUE CEILING SECTION (INSULATED): 1 Interior air film n.61 2 _2"uR7wAU 42 3 its" &-owe/ iNSuL o,oo 4 Fxterlor air film still n,61 TOTAL R -11.67 U - 1/R - ,Ot4 CEILING FRAMING SECTION: 1 Interior air film n,6 2 ?" iliYtrAlf ,4' 3 ?41k Fi?Okr? 33.a: 4 Interior air film still n7 S Z inches soft wood ,3; U - 1/R - ,OZ-& CEILING SECTION (INSULATED): 1 Interior air film 0.61 2 3 4 Fxterlor air film still n. ?T TOTAL R U- 1/R- CEILING FRAMING, SECTION: 1 Interior air film n.61 2 3 4 Exterior air film still O. 5 Inches soft wood TOTAL R m U - 1/R m 1 Inside air film n.61 2 3 4 5 Outside air film n.17 TOTAL R U= 1/R= PERMIT Gk CRY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: BUILDING Eagan, Minnesota 55122-1897 Permit Number: 025858 (612) 681-4675 Date Issued: 06/30/95 SITE ADDRESS: 1966 SAFARI TR LOT: 71 BLOCK: 2 THE SAFARI 3RD P.I.N.: 10-75852-071-02 DESCRIPTION: (IN-GROUND) Building'Permit Type Building Wo'r,kc Type r' i. SWIM POOL NEW REMARKS: SEPARATE PERMITS ARE REQUIRED FOR ANY ELECTRICAL WORK FEE SUMMARY: VALUATION $13,000 Base Fee $199.75 Surcharge $6.50 Total Fee $206.25 CONTRACTOR: - Applicant - ST. LIC. OWNER: CUSTOM POOLS INC 18821112 0005023 SAMS RON 601 E EXCELSIOR AVE 1966 SAFARI TR HOPKINS MN 55343 EAGAN MN (612) 933-2255 (612)452-0181 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 Mn. Statutes and City of Eagan Ordinances. r APPLICANT/PER EE SIGNATURE ISSUED BV SITU INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 BUILDING 025858 06/30/95 SITE ADDRESS:P•I•N•: 10-75852-071-02 LOT: 71 BLOCK: 1966 SAFARI TR THE SAFARI 3RD PERMIT SUBTYPE: SWIM POOL APPLICANT: 2 CUSTOM POOLS INC (612) 933-2255 TYPE OF WORK: NEW DESCRIPTION (IN-GROUND) REMARKS: SEPARATE PERMITS ARE REQUIRED FOR ANY ELECTRICAL WORK 1441 CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 co, ? 3 registered site surveys ? 2 copies of plan ? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior additions & decks) ? 1 energy calculations ? 1 energy calculations for heated additions ? 3 copies of tree preservation plan if lot platted attar 7/1/93 required: _Yes _ No DATE: n CONSTRUCTION COST: DESCRIPTION OF WORK: STREET ADDRESS: 1. "t `a so DIA LOT _LC_ BLOCK _I SUBD./P.I.D. #: Name: S ©V1 Phone #: I'C?22)-? 018 PROPERTY OWNER CONTRACTOR ARCHITECT/ ENGINEER Street City: State: Zip: Company: 1 ?uv?CC ff . Phone #: "? ???? Street Address: Ce.lSit:,c tV• License #- r City: State: - M ,,L Zip: G's Q Company: Name: Phone # Registration M Street Address, City: State: Zip: Sewer & water licensed 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 agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: ?-- ? RECEIVED OFFICE USE ONLY JUN 08 1995 Certificates of Survey Received Yes _ No --------------- Tree Preservation Plan Received Yes - No OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. -A3- 17 Swim Pool ? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility ? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous ? 05 SF Misc. ? 10 = plex ? 15 Deck WORK TYPE ,zC-a-1 New o 33 Alterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Basement sq. ft. MCNVS System Main level sq. ft. City Water sq. ft. Fire Sprinklered sq. ft. PRV sq. ft. Booster Pump sq. ft. Census Code. Footprint sq. ft. SAC Code Census Bldg Census Unit Building Engineering Variance 3z4 ai O Permit Fee Surcharge Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit SNV Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies /. 00 Total: % SAC SAC Units Valuation: $ / 3 t QO° ?i N , } °? b Z D `tr:'? / tffiq ? 9141 P l 1991 B? LDING PERMIT 7PPLICATION CITY OF EAGAN SINGLE FAMILY DWELLINGS 2 SETS OF PLANS 3 REGISTERED SITE SURVEYS 1 SET OF ENERGY CALCULATIONS MULTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL REGISTERED SITE SURVEYS - & STRUCTURAL PLANS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY GALCS _# OF RENTAL UNITS # OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED. PERMIT MUST SHOW A LICENSED PLUMBER. To Be Used For Site Address C OL 7V/?1 ) OC60) Valuation: 4 Date: 191 '-?4fw / T,e4; I Lot 1, Block 2- Parcel/Sub Owner -f-y 'g UCA1, ICfIL1/? ?52hHAP t Address ?9r0? J!}1=f?lei TQA1 City/Zip Code ??M W.?. Phone Contractor Address 7MI .W4r,44,17413KVD City/Zip Code *f)-. ////?. S5l?ZL /'?'?p laG Phone Arch./Engr. /Y/E Address City/Zip Code Phone # OFFICE USE ONLY FEES Occupancy Bldg. Permit 2? 5, c 0 Zoning Surcharge 5-, co Actual Const Plan Review Allowable SAC, City # of stories SAC, MWCC Length 4DDIWO 321/2 Water Conn. Depth DezK- 30'Y 2-4' Water Meter S.F. Total Acct. Deposit Footprint S.F. S/w Permit S/W Surcharge On site sewage_ Treatment Pl. On site well Road Unit MWCC System Park Ded. City water Trail Ded. PRV Copies Booster Pump SUBTOTAL APPROVALS Penalty Planner Lot Change Council TOTAL Bldg. Off. /,i ?39/?S Variance Sew r///Water Licensed Contr. 1/iLi-2? agrees that all work shall be done in accordance with (Signature of Contractor) all applicable State of Minnesota Statutes and City of Eagan Ordinances. /J9CZ H 1 crun Joxli/zxly - 16Ic' nro% ky `?7 I X53 ZS 3n-7 r 16 August 11, 1986 Richard M. Hefti Assistant City Engineer City of Eagan 3830 Pilot Knob Road Eagan, Minnesota 55121 RE: SAFARI THIRD ADDITION STORM SEWER, LOT 6, BLOCK 2 Dear Rich: R?CElV?D q?G y 4 1986 We have investigated the three alternatives presented to us with respect to the location of an existing storm sewer which was placed some 22 feet off the North lot line of Lot 6, Block 2, Safari 't'hird Addition. The alternatives we investigated are as follows: 1) Attempt to have the buyer of Lot 6 re-design their house to fit the lot at the 30 foot set-back. Jim Councilman, the builder, informs us that the buyer is not willing to change their house design. 2) The suggestion was made that we move the lot line of Lot 6 into Lot 7, as shown on the attached Certificate of Survey made by Probe Engineering. This is Diedrich's lot and he is opposed to this change and the buyer of Lot 6 would still be required to have a 60 foot set-back for the 76 foot wide home he is proposing to build. We have a further compli- cation with this, as they intend to build a tennis court in the back of the house. 3) The last alternative unfortunately, is to physically move the storm sewer. Under the circumstances, it appears that the storm sewer will have to be moved to the North lot line of Lot 6. Will you please advise us as to when this can be accomplished, as the buyer must start construction immediately under their loan arrangements. Sincerely, Benclosures PENTAGON PARK TOWER • 4940 VIKING DRIVE • MINNEAPOLIS, MINNESOTA 55435 • (612) 835-3363 0 "Pf M N I ?o?f? M GACALE 11N F1??fE 32.00 to ? .. I ggov 4 DRAINAGE AND UTILITY EASEMENT THIS INDENTURE, made and entered into this 216- day of n ky- q , 1987, by and between OTTO G. BONESTROO, unmarried, ROBERT W. ROSENE and JOYCE H. ROSENE, husband and wife, JOSEPH C. ANDERLIK and ELIZABETH A. ANDERLIK, husband and wife as Grantors, and the CITY OF EAGAN, Dakota County, Minnesota, as Grantee, WITNESSETH WHEREAS, said Grantors, in consideration of one Dollar ($1.00) and other good and valuable consideration, to them paid by Grantee, receipt of which is hereby acknowledged, hereby grant an easement to said Grantee, its heirs and assigns, for permanent drainage purposes, including the normal practice of filling with water from storm sewer runoff, and for utility line purposes over a tract of land 5.00 feet in width adjacent to and southeasterly of a line described as follows: Commencing at the southerly common lot corner between Lot 6 and Lot 7, Block 2, The Safari Third Addition according to the recorded plat thereof, Dakota County, Minnesota, thence South 41 degrees 17 minutes 30 seconds East (assumed bearing) along the southwesterly line of said Lot 7, a distance of 6.41 feet to the point of beginning; thence North 44 degrees 02 minutes 50 seconds East a distance of 148.12 feet; thence North 32 degrees 13 minutes 12 seconds East a distance of 31.17 feet to the northerly common lot corner between said Lot 6 and Lot 7 and there terminating. The Grantee shall have the right to do whatever is necessary for the enjoyment of the rights herein granted, including the right of clearing the easement area to allow for the use of the land as stated herein, and for ingress and egress to and from said tract of land and over and across said easement only for the purpose of constructing and maintaining, operating and repairing said drainage facilities and utility lines. And the said Grantors, for themselves, their heirs, executors, administrators and assigns do hereby release the said CITY OF EAGAN, its successors and assigns, from all claims for any and all damages resulting to said land by reason of the location of said drainage easement and utility lines. By acceptance of these easements, the Grantee agrees that it shall restore the property located outside the anticipated perimeter of moving water to as near the existing grade as is reasonably possible and further agrees to replace existing cultivated shrubs or sod and to seed all other areas not covered with moving water. IN WITNESS WHEREOF, the Grantors have hereunto set their hands and seals the day and year first above written. Otto G•. [B e?ssttroo? Robert W. Rosene J H. Ronsenen q Jos ph C. Anderlik E1' beth A. Anderlik on this day of -?a 19iz, before me a Notary Public within and for said 'County, personally appeared OTTO G. BONESTROO, unmarried, to me personally known to be the person described in and who executed the foregoing instrument and acknowledged that he executed the same as his free act and deed. ASUI;}>.1 M. FBEBLINU?, ???, .. Notary ublirALm?asota 16-YFa Washington Ccunry Notary Public M99 Ccrmiuion Eaprtes November 15, 1950 STATE OF MINNESOTA) ss. COUNTY OF e- 19KZ, before me a Notary said County, personally appeared ROBERT W. November 15, STATE OF MINNESOTA) ROSENE and JOYCE H. ROSENE, husband and wife, to me personally known to be the persons described -in and who executed the foregoing instrument and acknowledged that they executed the same as their free act and deed. (S E A L) Notary Public SUSAN M. EBEflLIN Notary Public-Minnesota Washington County My Ccmmusion Eapues lk01990 ss. COUNTY OF ?(l NUJ ) On this day of Public within and for STATE OF MINNESOTA) ss. COUNTY OF A14A,Wl? On this day of Ie4 , 1997, before me a Notary Public within and for said County, personally appeared JOSEPH C. ANDERLIK and ELIZABETH A. ANDERLIK, husband and wife, to me personally known to be the persons described in and who executed the foregoing instrument and acknowledged that they executed the same as their free act and deed. SUSAN- W iAI.B-nuesoew Notary Public Notary inn Nh Washington County Commission Expiroa MNovemGer 15, 1990 THIS DOCUMENT DRAFTED BY: Hauge, Eide & Keller, P.A. 1260 Yankee Doodle Road, #200 Town Centre Professional Bldg. Eagan, MN 55123 (612) 956-9000 EXEMPT FROM STATE DEED TAX STAMPS W N ? O 0 -------------------- t Q ? AloOl0 y, - 1 S9 p? n N0 n moo. 63 _ _ w N ID M b N ?' _ c £ M n / r m o n M 0 N 3 s A Z 0 h ? N n ??oPoSC7Jh h a SRjr 7 m .. / . oPq,?,gcc ?' o k W M ORLI1n//6F z3r' O 10 :$ 3 " s (D L ")?SF/4E1/T ? n F 4) Au \ ` Q N N 0 n m L ot 6, Block 2 [1 X "0 t 1\./ L THE SAFARI TRIAD ADDITION 6 / N ! 3 0 H O O I Z\ \ ? o ?0 0 O DA V z Scale: 1 inch = 30 feet JpC ?i NOTE: 6E `1i / 1) 5 foot drainage and utility A D easement on each side of y ^" ,1 E +4 the existing lot line between w z , ?yl b?y0? / rr? 1? Lots 6 and 7, Block 2 are to lj N be vacated. T N y? G -ti ?/ b? a 2) 5 foot drainage and utility S easement to br: dedicated on i M D ?Ap 1. h E tib / <? ?V) 1M" ? ??7 each side of new lot line. ? ' o r 440 ??i/y 6 / ,? m m I ?9 Lot 7, Block 2 ?U? i Ill O?J THE SAFARI THIRD ADDITION ?bY /? n Q 5w't)/ Co¢ rYC J?? A? loT ? ? \ sue' r r September 25, 1986 Honorable Mayor and City Council City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 Re: Safari 3rd Addition Project No. 85FF Our File No. 49g855FF Dear Mayor and Council: This letter is a statement of intent between the owner of Lot 6 and a potential buyer of Lot 7, both of Block 2 of Safari 3rd Addition, to modify the platted common property boundary and various easements over both of these lots. The purpose of this statement of intent is to assure the Council that the performance of the actions and agreements herein described will be subsequently executed in return for a variance to the building permit regulations that will allow the immediate issuance of a building permit for the construction of a house on Lot 6. The variance is necessary because the proposed lot 6 house location overlaps the presently platted property of lot 7. The variance is also necessary to avoid delaying the construction of the lot 6 home until such time that the performance of the tasks and agreements described herein are executed. It is believed that this variance is in the best interests of the City of Eagan because the purpose of modifying the present platting is to relieve the City from the burden of relocating an existing storm sewer pipe which is not located within its dedicated easement. An attached drawing and the following described circumstances explain the situation: During the construction of the Safari 3rd addition utility improvements it was discovered that the existing storm sewer pipe that was presumed to be located along the common lot line of lots 5 and 6 was not in its described location. Instead it was found to be located within the property of lot 6 as shown on the attached drawing. The actual location of the storm sewer pipe is beneath the planned house location. The lot owner has demanded that this location conflict be remedied so he can use the lot for its intended purpose. E-8074d Page 1. Honorable Mayor and City Council September 25, 1986 City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 Re: Safari 3rd Addition Project No. 85FF Our File No. 49g855FF One such remedy of this problem is to remove the existing pipe and reinstall it within the dedicated easement limits. This remedy however is difficult from a construction standpoint and expensive. It also causes the building structure to be constructed upon recently disturbed soil which may cause problems due to differential settlement of the structure's footing soils. The best remedy is to revise the lot layout to provide for a structure location that is not over the existing pipe. This is feasible by transferring a small portion of property from the adjacent lot no. 7 to lot no. 6. This solution however is complicated by the fact that ownership and control of lot 7 is with a different owner who will not agree to deed over the needed portion of property. The owner of lot no. 7 will however agree to sell the lot. Therefore, to facilitate this preferred remedy to the pipe location problem for everyone's benefit, Bonestroo, Rosene, Anderlik & Associates, Inc., proposes to purchase lot 7, deed the appropriate property to lot 6 and to eventually resell lot 7 to recover expenses. Bonestroo and Associates makes the offer to intervene in this situation as previously described in its capacity as the City's consulting engineering firm and as its project engineer on the project which caused the installation of the storm sewer in question. This offer is not the result our belief that an error on the firm's part resulted in the pipe location problem. To the contrary, we think that the problem was caused by factors beyond our control such as land monumentation discrepancies, easement survey control errors and contractor installation error among others. We have researched the records of the storm sewer project thoroughly to attempt to determine the cause, however, nothing in the record provides an explanation to the problem. Because in situations such as these, the City is usually held responsible and because the firm believes it is in the best position to help solve the problem, we will do the following in return for the owners of lot 6 granting of a storm sewer easement over the existing pipe location to the City of Eagan. 1. Purchase lot 7 2. Deed the necessary amount of land from lot 7 to lot 6. 3. Vacate the existing utility easement along the present lot line and dedicate a utility easement along the proposed lot line. Page 2. E-8074d Honorable Mayor and City Council September 25, 1986 City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 Re: Safari 3rd Addition Project No. 85FF Our File No. 49g855FF Fortune Realty is the owner of lot 6 and they agree to do the following in exchange for the property being deeded from lot 7 and an immediate issuance of a building permit. 1. Grant to the City of Eagan an easement for drainage and utility purposes over the existing storm sewer pipe, and 2. Vacate the existing 5 ft. utility easement located along the westerly side of the currently platted common lot line of lot 6 and lot 7. This letter is offered as evidence of the parties intentions to perform as described herein. By their signatures below Bonestroo, Rosene, Anderlik & Associates, Inc., and Fortune Realty agree to perform the tasks described herein in a timely manner. Yours very truly, BONESTR00, ROSENE, ANDERLIK & ASSOCIATES, INC. Bonestroo, Rosene, Anderlik & Associates, Inc. JAB:kf Page 3. E-8074d LANG, PAULY & GREGERSON, LTD. ATTORNEYS AT LAW ROBERT I. LANG ROGER A. PAULY DAVID H. GREGERSON RICHARD F. ROSOW MARK J. JOHNSON JOSEPH A. MILAN JOHN W. LANG DIANA P. MAMIE Mr. Thomas A. Colbert Director of Public Works City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 4108 IDS CENTER 80 SOUTH EIGHTH STREET MINNEAPOLIS, MINNESOTA 55402 TELEPHONE: (612) 338-0755 September 3, 1986 Re: Safari Third Addition Storm Sewer,CLot 6, Block 2 Dear Mr. Colbert: Please be advised that I represent the Estate of Ralph J. Ditzler who is a partner in the above-referenced development. On August 11, 1986, a letter was sent to Mr. Richard M. Hefti, Assistant City Engineer, by Mr. J. Byron Watschke, President of Fortune Realty another partner in the above-referenced develop- ment. That letter was sent in an effort to resolve the situation regarding the storm sewer running through Lot 6, Block 2, of the above-referenced development. It appears that there is no way to resolve the situation involving the storm sewer short of having the City move that storm sewer. It further appears that it is the City's responsibility to move the storm sewer and place it where it should have been placed originally. Mr. Watschke has requested that the City move the sewer and place it in the correct location. I fail to see why the City has refused to move the storm sewer when it does not dispute it is responsible for the same. My client is attempting to develop property and sell the same for single family homes. Due to the fact that the City has placed the storm sewer in an incorrect location and failed to move the same, we have been unable to complete our street, curb, gutter and paving. Lot 6, Block 2, has been sold to an individual who wishes to begin building but cannot because of the storm sewer. In fact, the buyer had requested the City to provide him a building permit and the City refused. This is an unfortunate situation, but my client is sustaining substantial damages due to the fact that it is unable to complete this development and sell the lots prior to the end of the building season. Please be advised that if the Mr. Thomas A. Colbert September 3, 1986 Page Two City does not take action to move the sewer within 7 days from the date of this letter, I have the authority from my client to take whatever actions I deem necessary to protect its interest in this matter. If you have any questions or wish to discuss this matter, please do not hesitate to contact me. Very truly yours, LANG, PAULY & GREGERSON, LTD. By JWL/si CC: Mr. J. Byron Watschke Mr. Richard M. Hefti Mr. Paul Hauge Ms. Rosemary Conroy July 30, 1986 Thomas A. Colbert Director of Public Works City of Eagan 3830 Pilot Knob Rd. Eagan, Minnesota 55122 RE: SAFARI THIRD ADDITION Dear Tom: We have an engineering matter of grave concern which has come to light in our new Safari Third Addition, presently under construction for services and utilities. This work is being installed by the developer. This morning we held an emergency meeting with the following parties in attendance: Jerry Bourdon from the City's engi- neering firm; Del Schwanz, Surveyor, representing the devel- oper; as well as Ralph Wagner of Probe Engineering and Jim Councilman, a home builder. The meeting was called to discuss the location of a storm sewer installed in 1980 or there- abouts under Improvement #79-17, Project #254. The portion of the storm sewer in question is the line picking up storm water from Catch Basin 102A, 110A, and 111A, flowing northerly to Manhole #101 then westerly to a pond - approximately 330 feet. At the time this alignment was proposed for the storm sewer, we prepared a sketch plan for development of single family lots for this area North of Safari Pass, now platted and recorded as Safari Third Addition. At our meeting this morning, Del Schwanz- verified that the storm sewer basically followed the new Safari Trail to the center of the cul-de-sac and then proceeded to the ponding area, a total of 330 feet. He furthermore platted Safari Third Addition with this storm sewer alignment and provided a 10 foot easement on Lot 5 and Lot 6 in Block 2 accordingly. Now we find that through the City Contract, the pipe is approximately 20 feet southerly of the north line of Lot 6, Block 2. Lot 6 has been sold to Jim Councilman and he is ready to start construction immediately with his buyer. Unless this matter is resolved immediately, we could have legal implications by the buyer of Lot 6, plus we are holding up the street surfacing which is necessary for all prospective buyers to view the sites. PENTAGON PARK TOWER • 4940 VIKING DRIVE • MINNEAPOLIS, MINNESOTA 55435 0 (612) 835-3363 Thomas A. Colbert City of Eagan July 30, 1986 Page 2 Jerry Bourdon will be digging into the background on this; however, I understand he will be out of town next week and we would like some direction on what course of action should be taken as soon as possible. Please advise. Thank you. Sincerely, on Watschke President CC: Del Schwanz Ralph Wagner Ferdinand Volkert Rosemary Conroy John Lang, Attorney at Law zt, r ?( MEMO TO: Tom Colbert FROM: Jerry Bourdon DATE: July 30, 1986 t9A&cv? F"c RE: Safari 3rd Addition ?er 6„QtkZ 'Storm Sewer Easement Problem CITY PROJECT REFERENCES: Contract 79-17, Proj. 254 Private Project 85-FF File No. 49g85FF & 49120 On this date I attended a meeting to discuss a problem in the development which is the result of a storm sewer pipe being outside its easement. The meeting was requested by Byron Watseke. Participants included: Byron Watseke, Ralph Wagner, Don Dethles, Del Schwanz and Jim Councilmen. The following comments are intended to describe the situation: Probe discovered that the storm sewer was not within its easement when they excavated the pipe for the purpose of constructing a catch basin manhole. They estimated it was 22 ft. to 23 ft, from the centerline of the property line/easement. Attached sketch illustrates the exact location and circumstances. Jim Councilmen owns the lot and has a buyer. The situation jeop- ardizes the purchase. Del Schwanz is certain that City's original preplat easement as prepared by Chuck Winden & Associates is compatible to the plat's property line and easement. He does not know of a control prob- lem that would cause the situation. Problem could be the result of several things including contrac- tor installation error, construction survey error, previous ease- ment control survey error or present plat survey error. Solutions to the problem are listed below in preferred order: 1. Layout the house and tennis court on the lot to see if reorienta- tion can avoid conflict with the pipe. Probe will do this for Councilmen in the next few days. If this solution is not feas- ible, then --- 2. Examine possibility of modifying adjacent lot no. to allow dif- ferent house orientation to avoid conflict with pipe. Bill Diet- rich is the owner of lot. If this solution is not feasible, then 3. Reconstruct pipe to realign it within easement. BY ZJ ry A. Bourdon A. Bourdon cc: RWR 6839d 1 F 2/84 CITY OF EAGAN 'U4t APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION (PLEASE PRINT) 1) PROPERTY ADDRESS: LEGAL DESM-UPTT_CN: IJ Df ? ' , ? 1 i J Si ? ? (Lot/ Block/SL r>visicn or Tax s?arcei I.D. NL=--er) S-7 DAi:, OF CRT_GMAL ctiILDI?:G ZSSU \C?: R-1 SINGLE r'MILY 0 R-2 CUP={ (? UNITS) _ :. ? R-3 ZCit-L?FvISE (M--R T- T=) ( LVI S) ? R-4 APART c? T/CC SJC .t?`Ir?I ( UNITS) ? Ca INTERCLAL/RErAIL/CFFICE ? MZDUS iIRLZ L ? INSTI:LTICNAL/IG"O .E.- ; r 2) APPLIC=_NT (PLEASE PRINT) ACCR=SS: / [ ?iLrn f? J r- ?, i - C=' S=-, ZIP: " L t M 1??) PEONS. T - 3) Pam-ER `?• „ (PLEASEEPRINT) FOR CITY USE ONLY - ADCRESS: PLUM8ERS LICENSE: v 1'c- o Active CZTY, STATE, ZIP: .t_?i Expired PHONE: PLUNGER LICENSE # Not of Record A% r..w.. ------ --__-- arr lAlt13 ?• 1. W1 NAP'lE: ADDRESS: CITY. STATE, ZIP: r ctlel/Ji//a 1/I?l? S`S ?? 7 PHONE: S?`1? -?1(G?(7 5) INDICATE WHICH PER•DT IS BEINC, RDZ?UESTED: ? OC 24ECTION 10 CITY SEWER ? amNEX PICV TO CITY WATER ? 07ER (PLEASE DESCRIBE) ? PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE PLEASE :TAIL APPROVED PERMIT TO lJ%? 3, 4 ABOVE (Circle one) 7) SIG;,ATLRE: .?A? l/'/? DATE. ?wgaliRlJO ?/11?0lig?iil!'R •., . , F O R C I T Y U S E O N L Y PERMIT t ISSUED FEES: $ lo . 5-Ell $ $ , SZ $ $_?.C.'Z? =CCC'U:PT OSI_ - c_..ER ACCOUNT DEPOSIT - WATER $ 21 WAC $ 7 S r L Z? SAC $ TRUNK WATER ASSESSMENT $ TRUNK SEWER ASSESSMENT $ LATERAL BENEFIT/TRUNK SE!•7ER $ LATERAL BENEFIT/TRUNK WATER $ WATER TREATMENT PLANT SURCHARGE $ OTHER: $ TOTAL / AMOUNT PAID/RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? L YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE L_J NO ENGINEERING DIVISION. LIST AS A CONDI- TION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: ?? 1,f / ? asp ? w. s? ?? wc? ra ws? ? w ? •a +?ww.t+w?w??ws?w.at?wf?waw?wsww. SEWER PERMIT WATER PERMIT (INCLUDE SURCHARGE) (INCLUDE SURCHARGE) WATER METER/COPPERHORN/OUTSIDE READER WATER TAP (INCLUDE CORPORATION STOP) SEWER TAP HAUGE, EI,?'DE & KELLER, P.A. JAllomeys n! d,a., TO'R'N CENTRE PROFESSIONAL BLDG., SUITE 200 1260 YANKEE DOODLE ROAD EAGAN, MINNESOTA 55123 (612) 456-9000 July 8, 1987 Dakota County Abstract Company 1250 W. Highway 55 Hastings, MN 55033 RE: Lots 6 and 7, Block 2, Safari Third Addition Dear Sir: PAULH.HAUGE KEVIN W. EIDE DAVID G. KELLER LORI M. BELLIN DEBRA E. 5CHMIDT Enclosed please find a Drainage and Utility Easement for Design-A- Home, Inc. required by the City of Eagan as a condition of the Waiver of Plat which allows one part of Lot 7 to be added to Lot 6. This easement, and the easement from the owners of Lot 7, must be recorded prior to the deeds to the ultimate owner. Very truly yours, HAUGE, EIDE & KELLER, P.A. David G. Keller DGK:jjm Enclosure cc: Tom Colbert Bob Rosene 2? 6 2 23?P? •b. \ C DAIVOrA 14 \ 13 2 COZZAITY .. 37 '1 1 4?.P ?.4klC 1 1 8 2 12 a; ° G s.. 9NN q 3 4 10 \ 5 ' Eb a AR1 t hP 'M 1"s A 12 S.1 sM9110 % ?q-4TP W.1p21t0 Se4 SIIeN ?A 01 - qGP 6 a..z CO. 13 G \ 11 :\ F r ` CO, 1tA I la O / 23 C 15 10 7 26 41 a 4 9E I s t ? 50 % 6 O 27 •rn I Y ?ti• ,s.? o/TR SEE RECpRp PLAN SAFARI -RIP RAP GROUTED SHT .,1 r C I R. 22 fill STORM SEWER 990 tur: nrrr, S r nrw,E 980 990 NH-IC? .970 mm-103 MH G",h 9740 980 960 IC7A mill 970 9CO 96, H_ cpk* 961.3 21C 950 954.0 h &P j I P CL 1 _,23 4-It-RCp 2 CL 4 0,3 % CI-4 1 0.46 T P j '? --OP RING 960 11 14:1 OTP%L-11 2-111. C9, semcp 940 CL CL 41Q 0 91 -m CP CL .0 5 350 -4 DENDS 930 140 920 930 8• 1 8'm •? ? ? i u Irv ,., m_ eld • 1 1 4 1 1 .laiIv Ir?m m I°1 N m I 0 1 2 3 4 5 6 7 6 1 m m l iDlv °Im °y'Im .mole mlo •+N ?p 920 -- 9 I b K) II 12 13 •14 •15 16 • m • 1 .'c, mom f.? mm ^ia - - 17 19 m - a • Nh NrmA 1'9 20 21 22 23 24 25 26 27 26 ?? x - EAGAN MINNESOTA 521 KELLER NOV 1.1979 49120 SAFARI ESTATES 9 CITY IMPROVEMENT No. T9-I7 10 PROJECT N9. 254 12 `? Q• 3 4 - \, ?cl .?. 10 "Iftfth Pt.l ce. ,? _ a 9- 1lla t h :Pt T \ ISee ,Sheet 'Ip /1 \ See . Sheet , ;5.. s• t €: t+•%;' k,i?•. ?: .i.+..t a '?? ?.:? :y'.? P ':4: tr •3? .f.? t - y, O .t*'. .SYV r r Y :?jF G?t'4 ?.: }'.' 3;4` y j 't.F -r ? - .1 r ,a'Saa*' a : a tP 'kN,;d• +,a r1. - ., .xF J c r n v r .. -. ... .: :,??_ _-+ .-„'.,- ;<.•c `? L2 '?y kr:. v'4' ???7Lrs'. rte' ?i 11 rr? HF [';w f? -M e ` ??r?4» c ? Fvt! I ? .?-t 7 t.: +3 , MI?• VIA 11p, _ ?? •v ?. e.,?, ^F,a' , • I?•? -?, i(` e, > ?,? ti .?. .f J u. t _ ??-. 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WINDEN i ASSOCIATES, INC. aESC,P?Pr?o?V lANO SURVEYORS / Tsi 645-3646 1361 EUS11S ST., ST. PAUL, MINN. SSIOB or. U/%/i/y eareme/7& XtOJ'S N.W;& O/" SW44f For: Ody of £0900 mr/h Ai7e o/' 11&1d' Of -f&y4 of See N1 I I ftio Scale: / 16 December 1999 `c.r \ 3e,so• 1 Ihereby certify that this eurvey.Plnn,air report 1 was prepared by me or under any dir.4 a super / vision and that I am a duly Roan:...1 Land ` 1 1 1 Surveyor under the laws of the State v Nino- \ \ 1 1 estate Date /L• i9-79 Reg. No. ro r??7 Sarvey-_.>kawn ,.? Checked--.-. Approved. $ aA) 1 ?p ell po / d' h _ _ '- -- --fN ?- - ?' 6?j5 p4??1 1 ?1 0 1 / ,., . N \ ?C ?C. ? J ` ? y fJ rT^?% / . ?)?'V' \ %i? • ?? to \ / / .0 d? / re 0 ?°j9la log '" 40 'Ln/r,/ /a f Oj' e9 W,.jfA /? h1s dole the no been recbrded? (is of t S hos? ? / SoFor' Es ?Oyl ?vuf?i //ne of \ r?rY? 34,7 hen J(Aym 0,e .9 W X of Sec 3? a?_ sy 3f 1 x O ?,. -__?`•1 ST?._S T? ?Y??aR ' 1 (D `, G f 7ArH?, f ? C I, ` 1 r _ J ,'f L t CONSULTING ENGINEERS, RORC PLANNERS and LAND SURVEYORS ENGINEERING -COMPRNY, INC. 1000 EAST 1461A STREET, BURNSVILLE, MINNESOTA 55337 1 BY CERTIFY THAT THIS VL4N WAS BRED BY ME OR UNDER MY DIRECT VERVISION AND THAT 1 AM 4 DULY REGISTERED \U NDER THE LAWS OF THE STATE OF MINNESOTA. DATE PH 432-3000 CERTIFICATE OF SURVEY DESIGNED CHLORCY DRAWN DATE Z T 7-3l-Y4 SCALE I„ JOB NO R 1 _ l r STN F4. ' PREPARED FOR JIM COUNCILMAN W N. O Q T O z .'- ?- 3o' Fg&V7- Sir .? lM,o - N 173fk`K LrnlE 3y 2,Ao. ??• - - - /? c - ?:. .LPL?.Q! PON _ IN 5 c.(z:v . ?''Yp g LOT 61 ~BL 'DAKOTA Cl w' R F , Y :la -Cb f 7Dgether with . \? r ?_ y ,? 3 ?.: ?'?ry, 4 Adf}?ion, Dakar V minutes 30 x-,N 6.41 fnet;.tho - •_ s? o\,\ /? Nw.{_Y LINO of- car? s > fec t; tne'i?ce `xa ?° s\ 5,' \. R ( g to the most' n ?\ S i L \ .02 minutes '5Q i' ?" \ t,9/ ;V ^ 17R.d7 feet t[ o? O ti \ 6.47, '- ? N ? ! ' \ ? R t) ? 7 \ r I `1 G ? ? t vvu, ; r s C 9sG •' Gi n-j 1 y I ?'+ ? ' ` 956.83 - . ?-_• ? h =, ? aY : . r s , HAT THIS PLAN WAS f3E CONSULTING ENGINEERS T Me OR UNDER MY DIRECT PLANNERS end LAND fURVEVORJ-00 NGINEERING N432-3 COMPRN4/ INC. 1000 EAST 146th STREET, BURNSVILLE, MINNESOTA 55337 PH CERTIFICATE OF .. , S1 REMARKS. REVISIONS u F v 0 0' N : ?N V, ?'V C1 Q'm 4 z u f ° LL N w? > ou $ r, r r-, 1. ?. ?. ?. _ za ?? 60 I" vo? j 5t I NORTH LINE OF NI/2 OF SW. 1/4 S, 32, T 27, R. 23 cl CL a N i v a+, 12i 752.00 1 0589 50 22 E a ; m N% W • - 22200 c' 20 200,00 o. W I? 492 00 ""? ol '0! 01 qo-}?...t.;I SURVEY LINE 20?JI» S?ff90502 •?? '"? J 4 -16 g I LINE ?yi `,/ \\ A \ ?1 , SB5'•SU 22 F Io o d «I x nl (eI 512.59 S6905O'22"E A . 1 all -L `, _ ?y21 268.21 ti I0 J 0 3 Y Q of 1 O 104 2 30 ° I tiell POND / .o J5 zo ?,nl 2 m.N •?, _ DRAINAGE AND UTILITY G- 0 & EASEMENT Z •N ^ M T29°?. "' YO v .•? d U 1 ?;° \ \J\ \? F. h 0 _ °Be ry/ 30 v?P0o6? N y? i O; o I;. SgFq`. ?N5 o m r 1 Y, J?h ?• O `?? A Rl.` ?0sa \v??•• 11?i?d/, ,f?." s ?- o ;_l 1 1 _ -W / g9, j?_ a,.o;,o ?\0 i •ap a•°w ?-?- WATER ELEVATION AS OF -FEB, O N• •. ?1 !'? w Q . /b .,n vo .A e _ e° 27, 1985 = 929, 3 FT u, i I?JJ /S I IN.G.V. D.-1929) y a L-. • r%. °.Z6 h r ?? J ASS. i i. ,; i .R0c°?'qy 1\\ ?^s 2Vcb `%\ Jr0 \?% % / +, 1? \ m ''n r•? , oo,r. N- ti / -? V, ppW oj?' VU 'gy`m 0+ ?'m J Mar ?/' p 4 SURVEY N13 chi .v 1 Q / 4, Q4 v ° LINE 1 !... ;0 y v7 . x`72 r,}.°J? 59?jy .1 a. 0• ~ z _ tg iS / dR P , 05"00 1" 1?' ?9 6 £ 101758 o 5 `oyse9 y+?Z2.- , S W? r o C?? `? xI e'? Nn3z6 .. `• 51 S ¢ = = +7 _ ,p 118 YI lpt ,. w A P?'elk 1. , p P`5 L? ml "l8 ?`6.% J! m - C'' c?F' /v ° ?'r? 1? ? ?O d: pU f ? n ml p i q 85'7 '?\ 1? 1.1 T. t. }Si: Inc l;. i" %4 f? 1 ., ' \ 5728 D:6 7 f ! -50 .70 10 -30 t v . w W- ?zoo0 a `40.81. C,a .GOB ? K C r` "r oo .r .-( .al : . j <,e-..•.,xae.c?:..:vi.`sv+w: it ` 1`f ati 1 'r-1 q+, °'eB'y°ae,r r'.`',\ p - '?. ?8'\ , ;?.,'•--1- *!? I +??w.? ti i 5 y V't,o ?? p0 iP V ?. 3• ` d ? ° 6 /%Lh/, y? p \ "'° \ a''?• !-ate ' ? L J j . ? PI +, ,(. d'3 6p`B4 "1 11 1" ,y W ?\ J' o. `b, y `b F etas 5i KIP Iv. ?• .? ]' i i s 5''ieP°y 7 7.16 t. . ?. s 60 !ice, `% ),? •, 0 100 v \ /' / ?'• / ? SCALE i, %j \ f00 41 4 SCALL•': I iurh ° IOU ft:,-'L 1.1• I LOCATION MAP SEC. 32 , T WP 27, RGE. 23 Ce4N N.) 32 (CLIFF No.I NO SCALE i NW I/4 IN E. I/4 g W u s 5W. 1/4 SE. 1/4 Y y u (I4X.v.D 1929) Az SC 04-S -t .c n.,rlb Lue ut Ih.: A..OflU IL,ti L.::uiug Of SuuCll 89 del;rv,:: 50 Ini n 6enntes 1/2 inch by 14 Inch i.r "12LS 8625", unlQbs Ol ha rwib': :. ur:NCU Nnl(h: r,.h I; luvuliun 475.46 t,.cl LOT Ise ` 5CAl W ?v ? o 4 O Z .? szy •, 1 Po Nj ??x? - T_'•..;_- ???-. ?r ?`' ?5'? In 2 7 - UTILITY' 1 - +%kYJT 0 ! , i. 1 i V I r? Y / M O \r i ?rs.>' °\ , \• ?? Nw LY 41rv& of Lor7 mosr 5 L It c o R Lo T' r. yam-6 COSULTING EFRO13C PLANNERS nd6LAND SUAVEVOAS ENGINEERING COMPRNY, INC. I HEREBY CEAl PREPARED B SUFERVISN REGISTE UNDER OF 'IF THAT THIS PLAN WAS Y Y ME OR ND R MY DIRECT U E 'N AND THAT J AM A DULY _ 'ED Sur?i yCl? - THE LAWS OF THE STATE N E SOTA. DAT eR!P EG. NQ?1000 \ ', N0. DATE BY REMARKS REVISIONS LEGAL LOT 6, BLOCK 2, T DAKOTA COUNTY, MI Together with that part o Addition, Dakota County, W Bogianiny ac the mast soutl 't'hird Addition, VY ota Cuui 17 minutes 30 seconds East 6.41 fe^t; thence North 44 feet; thence North 32 degn to the most northerly corn) 02 minutes 50 sr,conl3s West 1/8.11 feT:t to th- Ex;int o. ?vFs ?7 L47 e,/nTF_S ? C 95? • s> pEnIOTE. 1NDICATC CERTIFICATE OF SURVE ?? ?'' w? ? ?l .,?, ? ,-? ?? .. ? ? ,tee ?_? .r ??? ?`? ? `, ?,,? ?., , ?-? '1 1• ,: ?,, f? ?,. ? . 60 SC?L?,. PERMIT City of Eagan Permit Type:Building Permit Number:EA149594 Date Issued:05/30/2018 Permit Category:ePermit Site Address: 1966 Safari Tr Lot:071 Block: 2 Addition: The Safari 3rd PID:10-75852-02-071 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Valuation: 4,000.00 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 - James R Dorcy 1966 Safari Tr Eagan MN 55122 Minnesota Exteriors 8600 Jefferson Hwy Osseo MN 55369 (763) 391-5514 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA155672 Date Issued:05/29/2019 Permit Category:ePermit Site Address: 1966 Safari Tr Lot:071 Block: 2 Addition: The Safari 3rd PID:10-75852-02-071 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 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 - James R Dorcy 1966 Safari Tr Eagan MN 55122 (612) 381-7057 Scherer Brothers Lumber Company 9401 73rd Ave. N Suite 400 Brooklyn Park MN 55428 (952) 277-1600 Applicant/Permitee: Signature Issued By: Signature