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1714 Sartell Ave41,01'' City of Eaan Date: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Tenant: Use BLUE or BLACK Ink Permit #: 966q Permit Fee: $5S• 00 Date Received: G12 Staff: INFLOW & INFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water dol( Site Address: ! / 7 /../ 5-4,/eft %,J e t-417.-9 " Suite #: RESIDENT / OWNER Name: A/ 71‘,1.., G- i A✓iel 4" Phone: 'St' g`7,l e Address / City / Zip: /7 `` ' -/// / 6L J:",.,,,,,,,,,/ s -S/ 3 CONTRACTOR Name: 'C'! et, License #: Address: City: State: Zip: Phone: Contact: Email: TYPE OF WORK PLUMBING (Within the Sump Pump Repair building envelope) SEWER & WATER (Outside the building envelope) Repair Other: Other: DESCRIPTION Description of work: FEES $55.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ * *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit I/I repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeaqan.com/inflow, or City Hall at 3830 Pilot Knob Rd. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. ;v/hew �;,d/it AP Applicant's Prin d Name FOR OFFICE USE Required Inspections: / Applicant's Si • nat CITY OF EAGAN Remarks Wtr con, pd. on 9-26-72 Addition Cedar Grove #8 Lot 22 Blk 10 Parcel 10 16707 220 10 Owner 1 Gb i- r Street 1714 rt .l l Ave. State Eagan,MN .5.5122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK Z-ar 1970 125.00 .00 2 Paid SEWER LATERAL 1974 1539-10 Paid WATERMAIN - - 1 # WATER LATERAL 19 7 1F 5 WATER AREA STORM SEW TRK # STORM SEW LAT 1974 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 200.00 6516 9-26-72 BUILDING PER. SAC 170,00 6516 9-26-72 PARK RESIDENTIAL 1 BUILDING PERMIT APPLICATION 7 CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 ?a C ? 651-681-4675 New Construction Requirements . 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas (20% maximum lot coverage allowed) . 2 copies of plan shoving beam & window sizes; poured found design, etc.) . l set of Energy Calculations . 3 copies of Tree Preservation Planf lot platted after 711193 . Rim Joist Detail Options selection sheet (bidgs with 3 or less units) DATE `6 L / -75 r fJc?_ SITE ADDRESS 17 /?/ 5.92 ell Ac/ TYPE OF WO 5111th ti/r9 °r "? W i APPLICANT ???¢Lloi? 7 65P??l ?Deg< 41 STREET ADDRESS CITY - ? STATEM^fZIP '55/a-2 TELEPHONE # /.,57/ (08(0 7p14C CELL PHONE # Co /? ? O ?g S 5 FAX # PROPERTY OWNER _ l?s?{vrvi. L i ??Pit?&l TELEPHONE# 6/6 Gt'4? 70l9' COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY I _ MINNESOTA RULES 7672 (4 submission type) . Residential Ventilation Category 1 Worksheet Submitted . New Energy Code Worksheet Submitted . Energy Envelope Calculations Submitted Plumbing Contractor: Plumbing system includes: Mechanical Contractor: _ Mechanical system includes: Sewer/Water Contractor: Air Conditioning Heat Recovery System Fee: $90.00 AUG 13 Z002 D 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 Oronopces. Signature of Applicant OFFICE USE ONLY Water Softener Water Heater No. of Baths MULTI-FAMILY BLDG _Y Y N t,,3? FIREPLACE(S) _ 0 3/1 _ 2 Phone # Iawn Sprinkler No. of R.I. Baths RemodegReoair Requirements 2 copies of plan . i set of Energy Calculations for heated additions . 1 site survey for exterior additions & decks . Indicate if home served by septic system for additions VALUATIO Z. ?2 D 0. f) C) Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _ Updated 4102 OFFICE USE ONLY ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 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 ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 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 applicant 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) _ Final/C.O. - Footings (deck) _ Final/No C.O. - Footings (addition) _ Plumbing _ Foundation _ HVAC Drain Tile Other Roof - Ice & Water _ Final - Pool _ Ftgs _ Air/Gas Tests -Final Framing Siding Stucco Stone _ Fireplace _ R.I. - Air Test - _ Final - _ _ Windows (new/replacement) Insulation - Retaining Wall Approved By 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 Building Inspector y_ EAGAN TOWNSHIP BUILDING PERMIT No 2859 Owner e ......_ * -"-?-?---............. ----- ----------- Eagan Township Address (Present) ---......-. - 'j-". ` .............:t......---``.:i.`.:`..?............... Town Hall Builder ......................... _................... ..... _.._................ .... ...._._.. '---........ Data Z- Address _...._..---........... ............ ................. .......... _.... ......... -- DESCRIPTION Stories To Be Used For Front Depth Heigh! Est. Cost Permit Fee Remarks _ LOCATION J -V ?. Street, Road or orner llescrlplron of Location I Lot Block Addition or Tract r .x y f, s 9 This permit does not authorise the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and general welfare to anyone in the community. THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. This is to certify, that ...??{: .:` ...:.:.... :.:r....:... .4.::..`............haspermission to erect a..._.td...... ?/ .' ' the above described premise subject to the provisions of the Building Ordinance for Eagan ?ownship adopted April 11, 1955. ....... ........................ Per ................... ................ ...........ildi.. . .Io . Chairman of Tnwn Bo rd Suilding Ins Ins p actor ........................ ' xf MASTER CARD LOCATION e50? y , / // I/ z X -w OWNER STRUCTURE AND LAND USED AS Permit No. Issued Issued To Contractor Owner BUILDING PLUMBING Z AA CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING 6 r GAS INSTALLING SANITARY SEWER OTHER OTHER qq? Items Approved (Initial) Date Remarks Distance From Well FOOTING SEPTIC FOUNDATION FRAMING FINAL ELECTRICAL 0. ?0 7 .j J CESSPOOL TILE FIELD FT. HEATING 4? DEPTH OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING WELL SANITARY SEWER ? Violations Noted on Back COMMENTS: COMPLIANCE INSPECTION REPORTS TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS PERMIT NO. DATE OF INSPECTION CONDITIONS OF CONSTRUCTION AT THIS INSPECTION NO EVIDENCE OF NON-COMPLIANCE OBSERVED. ? ACCEPTABLE SUBSTITUTIONS OR DEVIATIONS. ? NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. ITEMIZED AND DESCRIBED AS NON-COMPLIANCE. BUILDER DOES NOT INTEND TO COMPLY. ? COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYED BY CONDITIONS BEYOND CONTROL. ? REINSPECTION REQUIRED REINSPECTION DATE OF REINSPECTION CERTI FI CATION -I certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require- ments for off-site improvements relating to the property inspected. ? ALL IMPROVEMENTS ACCEPTABLY COMPLETED BUILOING INSPECTOR DATE .? ao ate- /?- 8" EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR WATER SERVICE CONNECTION 1 Number 998 Date: Billing Name. ?t?Site Address: 1?jw Owner: Billing Address Plumber Meter 9/26/72 Meter No, Permit Fee 10.00 pd /26/72 Meter Reading Meter Dep. .50 pd 9/26/72 s/c Meter Sealed: Yeas 'Add'1 Chg. NO Total Chg. Building is a: Residence xx Multiple No. Commercial Industrial Other inspected by Date Remarks: By: Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota unty, Minne ta. By: Q RavLe Please notify the above office when ready for inspection and connection. c9c;? -/0- K EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: q?a a NUMBER 1155 OWNER ONJ Address 17L j? ?? !`?v PLUMBER TYPE OF PIPE CI-A NA.6? DESCRIPTION OF BUILDING Industrial Commercial) Residential I Multiple Dwelling ` No. of units I Location of Connections: Connection Charge 260.00 pd 9/26/72 Permit Fee 10.00 pd y/26/72 s c Street Repairs Total Inspected by: Date Remarks: By Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesotel 0 n Please notify when ready for inspection and connection and before any portion of the work is covered. TOPN OF EAGAN 3795 Pilot Ruob Road Eagan, Minnesota 55121 /U - C?pAiC ?G1o ?? -R PERMIT NO. 2618 The Board of supervisors hereby grants to Cedar Orove Constraotian Co. of 7,343 Concord Blvd. Bast, south St. Paul. MN 55075 a PUMMI0 Permit for: (Owner) some at ITn741i 3wte t-? s pursuant to application dated 9/25/72 Fee Paid: 00900 Dated this 26th day of September 1,50 o Building Inspector m Ip . as-iv f? W"N OF EAGAN 3795 Pilot Knob road Eagan, Minnesota 55121 PEI'MIT NO. Mi The Board of Supervisors hereby grants to rmd (lrrnre Con„tr,+ntien Oa. Of 7.31' Ionrnrrj ol.a r..,gt, 0"th G;._ 25111 55075_ I AFATTyn Permit for: (Owner) game 1737 Sartell 2-9-8, 3912 Blackhawk 8-9-8, at ' 171h .nrt.ell ??_t•? R , pursuant to application dated Fee Paid: tibU.UU Dated this 26th day of ?tasgber 9?. 1.5U a/c Building Inspector Use BLUE or BLACK Ink r - - - - - - - - - - - - - - - - I For Office Use G 0 - ~ Permit Z2 City of EaEd Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I I I 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 540Z Site Address: ~5'7 e `e lz y:z Unit Name: //d✓piv~~/ G-%✓r~P/[~fl~~/L Phone: Co Resident/ i Owner Address / City / Zip: l 7 ! S-3~ PGl ~¢c/ `nz, i l j 9 Applicant is: Owner Contractor Type of Work Description of work:e p~~y C o~ ,~~c Construction Cost: 0 Multi-Family Building: (Yes / No Company: Contact: i. Contractor Address: City: r i State: Zip: Phone: Email: e i License Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to I conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x x Applicant's Pr' d Name A icant's Sign ture Page 1 of 3 ~f`