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4223 Sequoia DrCity of hp 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink Permit #: / �e %� Permit Fee: Date Received: Staff: 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: '.2 7 Site Address: t/ ? ?-3 5- .[.0 r� Ge- 1 ✓ �'' Tenant: (/ Suite #: RESIDENT / OWNER Name: G r _.1.-, f v` ,; y i C2 v/t_ N�i1( Phone: 6 S —` S —5—,- 9e 7..o Address / City / Zip: 61-,2„)-3 Lt./3 r a_ P r (/ Applicant is: Owner Contractor TYPE OF WORK I C - 3 s Description of work: re -p -c--2. s r"2/`7 4-69-0--- 2 Construction Cost: , 9 (2 2 Multi -Family Building: (Yes / No— ) CONTRACTOR Name: License #: Address: City: State: Zip: Phone: Contact: Email: COMPLETE In the last 12 months, has Yes 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: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NATE' Plans and supporting documents that you submit are considered to he public information Portions the information may be classified as norl-public if you; provide specific reasons -that would permiRt #tie City to -, conclude that they are'trade: ecrets'. 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.gooherstateonecall.orq 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. x7(s- 77a,' x �p d .�G(/u� �a, tl Ap�3licant's Printed Name Applicant's Signature Page 1 of 2 CITY OF EAGAN Remarks Addition Ever reen Park Lot 4 Bik 1 Parcei. lo 24880 040 Ol Owner Street 4223 Sequoia Circle t>r`_ State E3ga~,T1,mN 55122 Improvem6rit Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN 5EW TRUNK 1973 175.00 SEWER LATERAL S6NT COT1Tl. 1 WATERMAIN WATER LATERAL 4HATER AREA STORM 5EW TRK yyl 1 363.00 C005441 6/10/80 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 280.00 ; 4745 10-18-71 BUILDING PER. sAC 2 0.00 7269 1- -73 PARK INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number. i`' w Eaqan, Minnesota 55122-1897 Date Issued: G' : ~ : ~ 's ' ~(612) 681-4675 SITE ADDRESS: n 0 It I k APPLICANT: n DR I N1. i NC PERMIT SUBTYPE: TYPE OF WORK: ~ , ~ . • ~ , INSPECTION .A . D• F L J Permit Holder Uate Telephone # PLUM8ING HVAC Inspectlon Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDRQSTATiC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL PERMIT # Af _ MECHANICAL PERMIT , RECEIPT # CITY OF EAGAN ' 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE: PHONE: 454-8100 Site Address t, BLDG. TYPE WORK DESCRIPTION Lot Block ~ Sec/Sub Res. ' New _ ~ Name Mult Add-on ~ Comm. Repair ~a Address . c Ciry Phone Other FEES Name AA t'~~~ RES. HVAC 0-100 M BTU -$24.00 (D Address ADDITIONAL 50 M BTU - 6.00 p City ~ Phone " - S2 ~fu (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION} GAS OUTLETS (MINIMUM - 1 PER PEkeAIT) - 1.50 EA. TYPE OF WORK COMM/INQ FEE - 1% OF CONTRACT FEE Forced Air M BTU APT. BLDGS. - COMM. FiATE APPLIES TOWNHOUSE & CONDQS - RES. RATE APPLIES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMODELS - 12.00 Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00 Vent CFM ~ STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets # BEYOND $1,000) Other ~FEE _ • - S/C: - SIG R ITT TOTAL• - ^ FOR: CITY OF EAGAN CITY OF EAGAN , 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100 BUILDING PERMIT Receipt# To be used for " Est. Value ;•f~ Date ,19 i Slte Address OFFICE USE ONLY 4 1 ''Yri k'A 4 K OnSiteSewage Occupancy Lot BIOCk Sec/Sub. MWCC System _ Zoning PerCel No. - On Site Well _ Type of Const City Water _ (ActuaQ ¢ Name Fk : ; I kt l r'.t' A! (Allowable) W * of Stories = Address Length ~ City Phone Depth S.F. Total . O Footprint S.F. Name Address 1o~ APPROVALS FEES ~ City Phone Assessments _ Permit Water/Sewer Surcharpe ' - yVj W Name Police _ Plan Review ~ W v o Address Fire = 5AG City Engr. SAC, MWCC cc W City Phone Planner _ Water Conn. Council _ Water Meter I hereby acknowledge that I have read this application and state Bldg. Off. _ Roed Unit thattheinformationiscoRectandagreetocomplywithallapplicable APC - TreatmentPl State of Minnesota Statutes and City o} Eagan OrdinanCea Variance _ Parka ; Copies Signature of Permittee TOTAL A Building Permit is issued ta on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and Ciry of Eagan Ordinances Building Official Permit No. Permit Holder Dste Telephone 7It Plumbing H.V.A.C. Electric Softener Inspection Date Map. CommeMs Footings I • ~ Q Footings II Foundation Framing ~Jca~ ,,gf'pd, rrdC ra.ss~s a ROOfing ~r~ ~ l~ . ~ ~ • C Rough Plbg. Rough Ntg. Isul. Fireplace Final Htg. Final Plbg. Bldg. Final Cert Occ. Temp. LP Deck Ftg. Deck Frmg. Well Pr. Disp. /`~D 75~ ~O K ~ 5853 Raqu9sl Date / L lFird o. ough-in Inspection 8-25-92 aQNfetl? oRaaayN'w 0 When Reatlg~IX G VES L NO Y Alicensed contractor O owner hereby request inspection of above electrical work at: Job Atltlress (Sireet. Boe a Route No.) Ciry 4 a~.3 5 E U b v 'J7R. F,A CrA1,I Seaion No. Townsbip Name or No. Renpe No. Courity Occupant (PRINT) Phone No. Gr-o, y,Iq zL d o Power SuOPlier PAdress Eleancal GonVactor ICampeny Namel Conhaclor5lkense No. Corrigan Electric ~ ~ - Mailirg AtlOres5(GOnvactor or Owner Making Installation) P.O. Box 475 Rosemount, MN 55068 Au ~o z a Signature ICOnV rodOwner Making Installelion) P~one NumOer b-v. , a3 - MINNESOTA STqTE BOA OF ELECTflICITY THIS INSPECTION REQUEST WILL NOT Grigg[-MiOway BIEg. - floom 5-173 BE ACCEPTED BY TME STATE BOARD iB21 UnlversNy Ave., SI. Paul. MN 55100 UNLESS PROPEF INSPECTIDN FEE IS PMne (612) 862-0800 ENCLOSED. Y1a49/9a' REQUEST FOR ELECTRICAL INSPECTION ee- oe See instmtlions im completing fiis brm on back of yelbw copy. K~; /Q Q , Below Work Covered by This Request ew Adtl Fep. TypeoiBuilding AppliancesWired EquipmentWired Home Range Temporary Service Duplex Water Heater Eledric Heating Apt. Building Dryer Other_(Specify) Comm.llndustrial Furnace Farm Air Conditioner Other(syBCity) ConVactor5 Femarks'. Compute Inspection Fee Belaw: [ 4r'~'4'L # Other Fee # ServiceEnirenceSize Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps ,5 0 to 100 Amps Transformers Above 200 _ Amps Above 700 _ Amps $ign5 Inspecmr's U. Only: TOTAL Irrigation Booms sD Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDEI7ED DISCONNECTED IF NOT Other Fee .4570 COMPLETED WITHIN 18 MONTMS7 I, the Electrical Inspector, hereby R01g"-'" certity that tRe above inspection has oa~e been made. OFFICE USE ONLY ~ This reQUest vok 1B monihs Irom _rn~~s~ ~oie 911,7c~'J / ~j'SlCv / 4 a • 44369 Aequest Dale F~rg No. Rouph-in InspacUon ~ ~ AequrteA? Reatly Ni~w~Will Notify, In Ves ?No "Z~+r When Pead5,080 ? Licensed Elecvical Contractor I hereby requast insoection ot ebove ~Owner electricel work inatalled a[: Street Address, Boz or Route No. City 0 i i dL ecuon o. Townshi0 ame or Na. RanBe No. County Ae i- Occupnnt IPfiINTI Phone No. Pawer $uppli Atldress EI¢~vical Contractor ICOmpany Namel Contrar,tor's License No. ~ MailinB AdJress (COntrector or Owner Making InstailatioN Authorized SiB^ature (C nha or/O`wner Makine Instal iun) Phona Number MINNESOTA STATE 90AflO OF ELECTRICITY TMIS INSPECTION PEQUEST WILL NOT Griggs-Mitlwey BIdB• - peom N-191 - gE ACCEPTED BY THE STATE BOARO 7027 Vniversi[y Ave., St. Peul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone I612~ 297-2117 ENCLOSED. ~ REQUEST POR ELECTRICAL INSPECTION eaoucoi-no ~/G ]/7/~~ Sae instructions br compleling this lorm on back of Vallow copy. / ~Rommercial 9 '~X~~ BeloW Work Covered by This Request AAtl ot BuilEing ApOliances Wirea Equipmenl WireA Range Temporary Service x Water Heater Lightiny Fixtures Building Dryer Electric HeaUn Bldy. Furnace Silo Unlonder Industrial BIAg. Air Conditioner Bulk Milk Tank Parm nnN, Peci v ,ne, (5nm,:;tv1 t er Suecify t er Oth.r ompute nspection Fee Below # Fee ServiroEntranceSize tl Fae Fexders/Subfeadeirs a Fee Circuits 0 ro200Am s 0 to30qm s Otn30Am s Above 200 qmpy,. 31 ta 100 Ainps 31 to 100 A s Swimming Pool Above 100_Am s Above 100_Am s Transformers Irrigation Hooms Partial-'Other e Signs Special Inspection ~ TOTAL E em9rks .11 d Rough-in Date . - P nsthaElectncal • peclaq hereby carlily that the above Final ~^1e inspection has Cean ' • tle. mie repueal voiC 18 monthe fmm ih s reauast vaie 18 months (rort1 CF V E i3957 Request Da~e " ire Rouph-in Inspection Requiretl? E]RaaAy Nuw Q Will Nutity Insoec- ?Yns ?NO [or When Peady ? Licensed Electrical ConVactor 1 hereby request inspaction ot above Owner eleclrical work installed ac Sveei AdAress, Boz or Route No. Citv ecuon o. Townsh- ame or No. RanBe No. County Occupant IPRINTI Phone No. 20 V 0. S- 4' v Power $upVli r Atldress Elecvical ConVactor ICompany Ndmel CoMrdctor's License No. Mailinp AdJress IConVac[or or Owner MakinB fristailationl uthorized Signamre IConhacm Owner Makiny Inswllalionl Phnne Numbe.r MINNESOTA STATE BOARD OF ELECTPICITV THIS INSPECTION NEQUEST WIIL NOT GrigBa-Midwev Bidg. - Noom N-191 BE qCCEPTEO BV THE STqTE 90APD UNLE55 PflOPEN INSPECTIDN FEE IS 1827 UniwrsitvAve..SL Vaul, MN 65104 Phanel6121642-0800 ENCIOSED. (y /Lp~''~ REQUEST FOR ELECTRICAL INSPECTION y ee-00001-06 See instructions lor comple~iM tbis lorm on back ot vellow copy. E 1 3 9 J 7 "X" Below Work Covered by lhis Request Adtl flep. TyOe ot Builtl urtB ~POtinntea WireE Equiumenl WireA Home Range Temporary Service Duplex Water Heater Li,yhtiny Fixtwos Apt. BuilAing Dryer Bectnc Heatin Commercial Bldy. " Fumace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm ome, o.,ri v m, 15nocIN) Ter SUCCi y Other 01hc, ompute Inspection fee Below p Fee ServiceEMrence5ize tt Fea Faxders/SUhtextlers N Pxe Circwts U to 200 qm s 0 to 30 Am s 0 tn 30 Am s Abae 200 q~nps31 to 100 qmps 31 to 100 Am s Swimvming Pool Above 100-Amps AAove 100_Amn Transiormers Irngation E3ooms Pdr[iaL'Other Fee Signs Special Inspection S 50 TO L FE Ne rk ON- Q, L~' ` r i cYI.WJ-~ Noueh-in D11e I, t Elachi Inspe erabv ce~lily 11a1 the nbove Final U7fr s// - insoection has bean «~'O~ mede. min repuasl voie le monihs irom 66241 Reques[ Date i e Roug nspection NOTICE: Vou Must Call ElecMCal Inapactor Pequir Ii A Rough-In Inspeclion ,,?Yes No IsRequiretl. I licensed contractor ? owner here6y request inspection of above elec[rical work at: Job Atldress (SVeet, Box or Route No.) City Z,iii E~4 C--,f~ Section No. Tawnship Name or No. Range No. Cqun i~ Occupan[(PftINT) , Phone Fla. . G /"t PowerSupplier Atltlress ElecVical Contraclor (COmpany Name) ConlydcNrS License No. Ca~r~.t G rJ )=-LEC77-Iff- Mailing Atldress (ConUaclor or Owner Making Inatallation) ~ ~ RJV~ vJ~~l"t~ U~1~ D Aul tri SignaWre (CoMra odOwn aking Installation) PMne Number , ~ . 441-~ 4a. -113J MINNESOTA STATE 80A F ELECTPICRY THIS INSPECTION REQUEST Wlll NOT Griggs-Mitlway Bltlg. - HaOm 5-113 BE ACCEPTED BV THE STATE 80ARD 1821 UNVerelry Ave., St Paul, MN 55104 UNLESS PROPER INSPECTIDN FEE IS Phane (611) 642-0800 ENCLOSED. ~ 66241 REQUEST FOR ELECTRICAL INSPECTION 5 ee-oooo1-0s ? See instm ctions for comple[ing this form on back of yellow copy J ~i ~ ~~x':Ve/ow Work Covered by This Request . e dd Aep. TypeofBuilding AppliancesWired EquipmentWiretl Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial Fumace Other (Speciry) Farm Air Conditioner Otner(specity) Conlractor's Remerks: ~ A6~ ~,J YC •'v7 7'1.c_I ? Compute Inspection Fee Below: # Other Fee # ServiceEnlmnce5ize Fee # Circuits/Feedere Fee Swimming Pool 0 to 200 Amps ,j o to 10o Amps ) 2• tc Transtormers Above 200 _ Amps Ahove 100 _ Amps Signs Inspeclor's Use Only: TOTAL ,-p Irrigation Booms / ~G~ ~Jr Special Inspection ( J l Alarm/Communication THIS INSTALLATION MAY BE OR D DISCONNECTED IF NOT O[her Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rough-in oate certifythattheaboveinspectionhas Final ~ been made. -y OFFICE USE ONLV This request witl 18 months irom Tpis request voi0 C// G/~y~ 7G• 18 nwnffis fqrom Q O O D .3)8 1 ~ Re.quest Uate Fire No. j Rough-in Insver,tian ~ Renu~red? Ready Now ~W,II Notity, Inspec- [ 1~-a rf ?yes 2NO [or When Ready Licensed Electncal Contractor I heraby repuest inspaction oi above ? Owner elechical work ingtalled at Street Address, eox or Route No. City Kaa3 sk voiA pR. CAG~a ecbon o_ Townshi0 Name or No. I Renge No. County dOA Ko ; ,C OccuuantlPfllNTI Phone No. CrEo:4 GE RL+, vs4- sa170 Power suooiior Address 1 D~A C~ Q m! lJ G~,~V' Electdcal Contracror (COmVanY Name) Convnr.mr's Lici3nse No. O34S4P Mailin AtlJress (C/~onvactor (or' Owner Maki/ng~ Instailation) f QJGY. 7~ S /YOSCmO.in-~ ?I JSU~C~ Authora 5r 0na1u7onVactor Owner Making Instellationi' Phone NumExr 3-i13> MINNESOTA STATE B 4D OF ELECTRICrtY THIS INSPECTIDN REQVEST WILL NOT Griges-Midway Bldg. - Noom N•191 BE ACCEPTED BY THE STATE BOAND UNLESS PNOPER INSPECTION FEE IS 1821 Univarsitv Ave.. St. Paul, MN 55104 Phone (612) 642-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION es-oaooi-os b ~ / ~ See inslmctions for completine this form an back ol vellow cooV. y ( ~y4 +7 G' C) 8 1 "X" Be/ow Work Covered by 7his Request AAd Hap. TyOe of BuilOing Aovliances Wiretl Equiyment Wire.1 ' Home Range Teinporary Service Duplex Water Heater LightinH Fixtures Apt. BuilAing Dryer Electric Heatm Commercial 81dy. Fumace Silo Unloader Industrial BIAg. Air Conditioner Bulk Milk Tank Farm oin~, oec, v _ther (sne.;fvl t nr Sucutv xner Oihur ompute lnspection Fee Be/aw p F¢e Sarvice EnVaneaSize M Fee Fexders/5ubienders N Fee. Circuits 1 U to 200 qm s 0 to 30 Am s a to 30 Am )s Ahove 200 qmps 31 ta 7 00 qmps 31 to 100 A y Swimming Pool Above 100_Amps Ahove 100_/>m)s Transfonners Irrigation E3ooms 4ES0 Partial.'Other Fee $igns Special Inspection pemerks 5/s SO TOTAL E~ ( Mc~Jrc .SEQVICE lcN; RF1•JCrc ~tJ ~ Nough-in Daie I, tha Elec el Inspactor, hereby certily thet the abova Final inspection has been f~ 7 0 mede. mis mquest vdtl 18 montM irom . ti /o pY~'G G,lery~-~~~ TUWN OF EAGAN 3795 Pilot Knob Road Eagan, Minnesota 55122 PERMIT IdO. 1.7.0 The Board of Supervisors hereby grants to _ Jj F. Farrell d Son of 990 W. Montana Avenueg St. Paul 55117 a PLUMBING Permit for: (Owner) Tilsen Constructioa Go. at ~•T -d 4223 Sequoia , pursuant to application dated ??/8/71 Fee Paid: 40.00 Dated this 8th day of Navembex , 197_A~. 1.00 s/c Building Inspector - F-G~e~~ TOWN OF EAGAN 3795 Pilot Knoh Road Eagan, Minneaota 55122 PERMIT N0, 164 The Board of Supervisora hereby grants to Neil & Aubbard 1-Ieating Ittc. of 99 North 9nelLing Ave., St. Pau7. 55104 a HEATI:VG _ Permit for; (Owner) Tilsen Canstruction Co. A322 & 4341 Lodgepole, ( 22 ,iequoia Drive, pursuant to application dated 12/2/71 , Fee Paid: 60.00 Dated this th day of DeCenber , 197 1. . ac - Building Inspector ~ 171~#C7kd:R:!S:r ~ ~C7R3Y:~YY7R~h$?hRnik71'~k71:Y~1k~#X7kAY** A;1NyN ~G! 435.1 53T -/Eri1L:! S~'8Z: :+uc~mf ;dta: ~il .~iol r r 1 ~L 0~'C b(1 VIU;'ICI35 E22> .006 9S'i2 Sd'iZ~ ?JQ tJI0Rt1.3S E22v G6 0'.26 :,Ni 03 9Ni30U ?J3H-NM .3wtlN EF.=82-iS L3kY1 86/i2/90 =314P".? E98 ZLN -,tlN_W53t S =217:h5V3 t%'tl`Jtl3 A7 A113 E~ :#X~AnkR1~.~AqoK~'M11nk.i:lnKY7k*1k*~I' ~~tgiF+kf~rlll~ , FERMIT C.IT lot~QKnoF EAGAN b Road PERMITTYPE: auzLozNs 38~0 Pi Eagan, M innesota 55122-1897 Permit Number: 0 3 2 3 5 0 (612) 681-4675 Date Issued:. 0 6/ 2 4/ 9 6 • SITE ADDRESS: 4223 SEQUOIA DR LOT: 4 BLOCKc 1 EVERGREEN PARK P.I.N.: 10-24880-040-01 DESCRIPTION: REROOP, SHINGLE B'uil.din"g. Permit Type SF (MISC.) ,Building Wqrk Type ALTERATION i'Geneu8~ Co7e 434 AL7. RESIDENTIAL i = • ~j / r t b a~ _r r~ C ?.l , ry,. i r ~ REMARKS: FEE SUMMARY: VRLUA7ION $7,000 Base Fee $124.75 Surcharge $3.50 Total Fee $128.25 I I CONTRACTOR: - Applicant - sT. LzC OWNER: WALKER ROOFING CO INC 17292325 0004229 NALI. GEORGE I"V701 36TH AVE 3 4223 SEQUOIA DR .MINNEAPOLIS MN 55406 EAGAN MN 55122 (612) 729-2325 (612)454-5290 I hereby acknawledge thaC T have raad this application and state that the informatioh is corPect and agree to comply with all a,pplicable State of Mn. 5tatutes and'City of Eagan Ordinances. ~ . _ . . . APPLICANT/PERMITEESIGNATURE aqsS :SI AUR 98 BUILDING PERMIT APPLICATION (RESIDENTIAL) 3 CITY OF EA()AN ' 3830 PII.OT KNOB RD - 56122 681-467b New Conatrudion Reavirements RemodeVReoair Reauirements . ? 3 registered ake suneys ? 2 copks oT plan - ? 2 copies at plans (indude beam 6 window sizes; poured fid. design; etc.) ? 2 stle surveys (extarfor addRions 8 decks) • 1 energy wldilations ? 1 energy calculatlons hr heated addidons ' ? 3 wpias of tree preservation plan H lot pleked after 711/93 required: _Yes No DATE: 1(/' Z 3'~ b CONSTRUCTION COST; DESCRIPTION OF WORK: STREET ADDRESS: 4223 LOT: BLOCK: SUBD./P.I.D. FV C V OY ~ Name: Iv alt aV ~ Phone 4:~T -52q 0 PROPERTY ~t F'n~ u OWNER 2 Street Address: ~22 ? y'l~tU Lo, ciri srat« WN[ z;p: 5S ( 2z Campany: Phone CONTRACTOR ' Street Address: Z7V • License # n/~ City ~D State: Urn~ li V Zip: r- ' T-VIo ARCHIT'ECT/ . ENGINEER Company: Phone Name: Registration Street Address: City State: Zip: Sewer 8 water licensed ptumber (new construction onty): . Penalty applies when address chang and lot change is 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 applicabl State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: . , . . . . • . RY..~ V.JL'..1 V. .%'rD . OFFICE USE ONLY - Certificates of Survey Received _ Yes No JUN 2 4 1993 Tree Preservation Pian Received _ Yes _ No _ Not Req , OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ? 02 SF Dwelling O 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool ? 03 SF Addition O 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility ? 04 SF Porch ? 09 12-plex O 14 Fireplace ? 21 Miscellaneous ? 05 SF Misc. ? 10 _ plex ? 15 Deck WORK TYPE ? 31 New ? 33 Alterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENEi2.-." L ItJFCRh7ATICN Const. (Actual) Basement sq. ft. MC/WS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Depth Footprint sq. ft. SAC Code Census Bidg - ' Census Unit APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Totai: % SAC SAC Units EAGAN TOWNSHIP BUILDING PERMIT N~ 2577 Owne: J4.-x..p...... Eagan Township Address (Precent) ...---...~9~.r.......Sl....o~`.~~'-" Town Hall Buildei i x, Dale Addreu DESCRIPTION SSOries To Be Used For Fron! Deplh Haighf Eai. Coat ermi! Fee Aemarlu lP --O LOCATION Sireef, Road or olher Description of Localion I Lo! 81ock Addilioa or Tsacf ~V. Thia parmit doas ttot authorise e use oi slreets, roeds, alleys or sidewalka nor does it give the owner or h[s egen! the righ! !o create any siiuation which is a auisanae or which presents a hazard !o the healld, safely, eonveaienee and general welfare !o anyone in the eommuniYp. THIS PERMIT MUST BE K PT~ ON THE PREMISE WHILE THE WOAK IS IN PROGR SS. sa- This ia !o eertity, lha2...... _Y.1..e-.-_...C~--^~-~.......... hasperm3ssioa !o areat a upon !he above deecribed psemise subjeef io the proviaioas of the Building Ordinance for Eagan ownship dopted Apsil 31. 1955. . . . ~ . ...1.`.-.'.~!~..~ Per ~g . . . . . : . hairmen of wn Board ~ Bvildin Im ecior Cg - ~s7 71 AiQoAERTY LtlvE I I ~ I UJ_ ~ C 1 uNt~ , ( I ~ ~ NovsE I I \ ~ I ~ LiivE ( o . L or 3Lac k I i ~ rRonti'f'__~ROi?Fl~TY. .Li.NE ~ 1- LC] t 4 L AN . MASTER CARD ~ LOCATION S~l Ka,~•4L~-~/L i[ ~ ~ ,JJ-- OWNER STRUCTURE AND ~ LAND USED AS Issued To Permit No. Issued I Coniracfor - Owner i BUIIDING 2,7 7 AG' 71 ~ ..7~ _ PL11M81NG /70 / ~ ~ CESSPOOL - SEPTIC 7ANK WELI ELECTRICAL HEATING ~ GAS INSTALLING SANI7ARY SEWER ID ~7 j ~o • OTHER '~"`j ~I~~~D•~II OTHER • Approved Ifems (Initial) Date Remarks Disiance From Well ~ ?i ~ ) FOOTING SEPTIC POUNDATION 2 . 7 CESSPOOL FRAMING ~ TILE FIELD FT. FINAL I ELECTRICAL DEPTH HEATING OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBI NG WELL SANITARY SEWER 1 7/ • ~ S ~O', Violations Noted on Back COMMENTS: COMPLIANCE INSPECTION REPORTS TO BE USED ONIY IN EVENT OF OBSERVED VIOLATIONS . PERMIT NO. DATE OF INSPECTION CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ~ NO EVIDENCE OF NON-COMPLIANCE ? NON-COMPLIANCE. BUILDER DOES NOT OBSERVED. INTEND TO COMPLY. ACCEPTABLE SUBSTITUTIONS OR DEVIATIONS. ~j COMPLETION OF CERTAIN IMPROVEMENTS LJ WILL BE DELAYED BY CONDITIONS BEYOND CONTROL. ? NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. ITEMIZFD AND DESCRIBED AS FOLLOWS: ~ REINSPECTION REQUIRED OATE OF REINSPECTION • REINSPECTION REVEALED CERTI FICATION - 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 beat 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. F~ ALL IMPROVEMENTS ACCEPTABLY COMPLETED _ BUILDING INSPECTOR DATE COMMENTS: • 0 a • EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICB CONNECTION DATE: 11/8/71 NUMBER 901 OWNER:Tilsen Construction Address 4223 Sequoia Erive PLUMBER TYPE OF PIPE heavy cast iron DESCRIPTION OF BUIIA ING Industriai Commercial Residential Multiple Dwelling No. of units Location of Connectiona: Conaection Charge Permit Fee in_nn nti ~1-10-71 .50 pd 11-10-71 Street Repairs Total Inspected by: Date Remarks• $Y Chief Inspector In consideration of the issue aud delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulationa of Eagan Toc•~nship, Dakota Connty, Minnesota BY Please aotify whea ready for iaspection aad coaaeetioa and before any portion of the work is covered. 1 4k EAGAtI TDWNSHIP 3795 Pilot Rnob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMT FOR WATER SERVICE CONNECTION Date: November 8 1971 Number: 743 y-~ P Billing Name:Tilsen Construction Co. Site Address: 4223 Sequoia Drive Owner• same Billing Address Plumber: Location of Connection Meter Size Coaaectioa Chg. 98c1_On rg Id/l $("77 S .t y~ Meter No /G Permit Fee 10.00 pd 11-10-71 Meter Readiag Meter Dep. -50 pd 11-10-71 MeCer Sealed: Yes Add'1 Chg. NO Total Chg. Inspected by Date Building is a: Remarks; Residence x Nlultiple HIo. Units Commercial Industrial By; Other Chief Inspector In consideration of Che isaue and delivery to me of the above permit, I hereby agree to do ttie proposed work in accordance with the rules and regulatioas of Eagan Township, Dakota County, Mfnnesota. sy: Please aotify the above office when ready for iaspecCion and connection. CITY OF EAGAN N! 13998 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55721 BUILDING PERMIT PHONE:4!5V-d100j ReceiPt 7cn69dZ # Tobeusedfor GARAGE Est.Value $6,000 Date JULY 31 ,1987 Site Address 4223 SEQUOIA DRIVE OFFICE USE ONLY Lot 40 Block 1 Sec/Sub. EVERGREEN PARK OnSiteSewage _ Occupancy MWCCSystem _ Zoning Parcel No. On site well _ 7ype of Const City Water _ (AduaQ a Name GEORGE & MIRIAN NALL (Allowable) W # or stories ; Addf05S SAME Length 0 City Phone 454-5290 Depth S.F. Totel .0 Name ALL-IN-ONE CONCRETE FootorintS.F. o` Address 42 Z5 LEXINGTON WAY APPROVALS FEES ~ City EAGAN Phone 454-4628 b5.80 Assessments Permit $ ~ Water/Sewer _ Surcharge W W NamB Police _ Plan Review ~ i Fire SAC, City Address - uZ Eng[ SAC,MWCC aw City Phone Plenner _ WaterConn. Council _ Water Meter I hereby aCknowledge tha[ I have read this application and state Bltlg. Off. _ Roed Unit that the information is correct and agree to comply with all applicable APC - TreatmentPl State of Minnesota Statutes and City of Eagen Ordi ces. Variance _ Parks Copies Signature of Permittee 707at A Building Permit is Issued to: ALL-IN-ONE CONCRETE on the express condition that all work shall be done in accordance wlth alt applicable St~ of MinnesqGa.Statutes and City of Eagan Ordinances. Bullding Official ~l ~ /~~Q.. ~ 137 1987 BQILDING PERMIT APPLICATION - CITY OF EAG9N SINGLE FAMILY DWELLINGS INCLIIDE 2 SEfS OF PLAAS, 3 CERTIFICATES OF SORVEY, 7 SET OF ENERGY C9LCOLATIOHS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MQST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGSS WILL BE ALLOWED ONCE BIIILDING PfiRMIT IS ISSIIED. MOLTIPLE DTiELLINGS - RFSIDENTI9L RENT9L i1NITS FOR SALE DHITS IHCLUDE 2 SETS OF PLANS, CERTIFICARE OF SDAVEY - CHECB NITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COhII9BRCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND y. To Be Used For: 611 r ,-t;uVawluation: /Date: la_~ oZ~i ~f + I Site Address 4 3L ~-3 .S~0.a ; cL Dr OFFICE USfi ONLY Lot Lt 6~ Block On Siie Sewage_ Occupancy on MWCC System Zoning F~( Parcel/Sub ~~¢,rqrD¢~ Ccrr R r&!! d/\.On Site Well Type of Const 62 City idater _ (Actual) Owner Q,orqft rhaK nd (Allowable) ~ ll of Stories Address y 1l Y Length ~ Depth ZZ= City/Zip Code GLr~~ Q'Yl vU S.F. Total Footprint S.F. Phone LA S~-f~ S~4 U APPROVAIS FEES f0 ontractor -~x.@f2A Q, F Assessments Permit ~,,o Water/Sewer Surcharge 3_. ress t{~_a ~~(}J~.~ Police Plan Review d l Fire SAC, City i y/Zip Code rA yt-) Engr SAC, MWCC Planner Water Conn hone y Council Water Meter Bldg Off Road Unit Arch./Engr. APC Treatment P1 Variance Parks Address Copies TOTAI. City/Zip Code Phone 11 a~ howse 9a~~y~ i,~ ~ \ { S ~ ' 1w). S k CH]~CAt~O TITLE INSURANCE Edina, MN 55435 ~ 980.r est 77th Street Phone 835 3100 TO - . DATE ADORESS ! . _ . _ . FROM: FILE NO.: ! FILE NAti1E DIS: lp PLAT: 24880 - COUNTY: PLEASE CEECK TD SEE IF TFIERE ARE ANY . . LEVIED/PENDING ASSESSMENTS ABSTRACT TORRENS LEGAL DESCRIPTION: *s**r,r**a*+*~r*~,r~,~r+?*#~:*,r,r*txf~r+*++~:::r~~~x+~,e~~**a,r+r~f+~~rr~r*• PL[:ASE £URNISH THE FOLLOWING LEVIED ASSESSMENT INFORMATION ON THE ABOVE DF.SCRIBED PROPERTY: Type of Improvement Balance Due Original Amount NONE PLEASE FURNISH THE FOLLOWING PENDING ASSESSMENTS THAT ARE ESTIMATED AT THIS TIME: Storm Sewer Trunk $430.00 per lot ALSO REQUESTING ANY ASSES5MENTS CERTIFIED TO THE AUDITORS AT THIS TIME AND INTEREST: Signed t Assessment Clerk, Dat2: April 24, 1979 AMOUtdT OF UNPAID WATER HILL, IF ANY: $ City of Eapll 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r L Use BLUE or BLACK Ink For Office Use Permit#: [63 ! �� Permit Fee: w Date Received: 2 -z Staff: 2012 RESIDENTIAL PLUMBING PERMIT APPLICATION n, Dat 2� ( v " /02--- Site Address: .1.,?" 3 SZ Tenant: Name: Address / Cit / Zip* /L, Name: Suite #: Phone:e�l'' f }Z License #: f .5erb' r41--PGI-1 Address: / r SG[i '.2._ City: _ �/ �rl�Lff State: %�' Zip: .. 3"2p� Phone: 93) ••7` c2''%011 'a/'1/75) _ Contact: .071- New Email: eplacement Repair Rebuild _ Mod' Space Work in R.O.W. Description of work:LA RESIDENTIAL Water Heater Lawn Irrigation (_ RPZ / _ PVB) Septic System New Abandonment Water Softener Add Plumbing Fixtures (_ Main / _ Lower Level) Water Turnaround RESIDENTIAL FEES: $60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) *Water Turnaround (add $166.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) TOTAL FEES $ CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protectio Call 48 hours before you intend to dig to receive locates of underground utilities. www.qoph 1 hereby acknowledge that this information is complete and accurate; that the work will be in confor Eagan; that I understand this is '.t a permit, but only an application for a permit, a • ork is accordppce with the appy ed p in the case of work which requires a review an. .proval of pt Applicant's inst underground utility mage. eonecall.orq 'th the ordi tart without codes of the City of that the work will be in Use BLUE or BLACK Ink r For 11110, Office Use I City of Ea Oon j Permit b I DS3~ I 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: 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: QnS-Zg-/y Site Address: t:1 6.9~_ U 14 a4-- Unit Name: & F-® 6 46- VJ G Z Phone: Resident/ Owner Address/ City/Zip: q ZZ S Q C' ®A 5-A"PI Applicant is: Owner contractor Type of Work ` Description of work: E - 9 p o F Construction Cost: r_3 00 Multi-Family Building: (Yes / No Company: A167cI.~/y~d ' 2X eselOES 266 Contact: Contractor Address: _2,)?ZS S 7 r9rJ aT E City: /y ST 10f~(,Z State: Zip: -/O Phone: 612. 5"32- yr IiEmail: 1W 10A nQ eAfc~v c°~a76/a-c '.j License CIT 5-936-51 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 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 iPR~o v Al L)4/r x Applicant's Printed Name Applicant Page 1 of 3