4244 Sequoia Dr CITY OF EAGAN Remarks
Addition Evergreen Park Lot 1 sik 1 Pefcei 10 24880 010 01
Owner ' % ' / Street ~2~ Sequoia Dr. 5tate Eagan,MN 55122
-L-
Improvement Oate Amount Annual Years Payment Receipt Date
STREET SURF. -
STREET RESTOR.
GRADING
SAN SEW TRUNK 1,21 1973 1
SEWER LATERAL
Sew cann ch 1 -74-76
WATERMAIN
WATER LATEFiAL
WATER AREA
STORM 5EW TRK L,
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET IIGHT
WATER CONN. 1 7-13-70
BUILDING PER.
SAC
PARK
SEDGWICK HEATING & AIR CONDITIONING CO. HEATING ,)OB NO. 15
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000 TEST RECORD
ADDRESS y UU \ou br- CITY E" a A'n
OCCUPANT OWNER w ee ~
SOLD BV ~ INSTALLED BY
r -
MAKE' PI~ I~ v` MODEL f"'v "l
SERIAL NO. ~ L ~/?1 ~ INPUT ~ • ~ ~ ^,rR, L` f ,
~ Q
~ c u U~i
THERMOSTAT VENT SIZE
VALVE TYPE OF LINER • -
tf
LIMIT LINER SIZE 42
T)ov
dl
LIMIT SETTING FILTERS: SIZE 1 L NUMBER
FAN SETTING WIRINC 04
PILOT TYPE ~ TEST TAG r- ~1"---
r `
IGNITION MODEL LIGHTINO INST.
PILOT TIMING 07 I-q^- 07
DATE TESTED
PFiESSURE ~ PERCENT COZ , - i
INPUT CFH PERCEh1T 02 COMPANY TESTING
STACK TEMP. f PERCENT CO NAME OF TESTER \
~r
FORM 235 (REV. 11189) FORM OISTRIBIITION: WHfI'E COPY - .IOB FILE YELLOW COPY - qTY
2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: single family dwellings & townhomes/wndos when peemits aze required for each unit Date _7_ / _L'L~_ /
Site Address oS 4 Uuit #
Property Owner ,~,1-Z' Telephaue # ((q7l
Contractor gEB6WIGK H€ATING 8 AIR rnmnRIoNING LLC
8910 Wenraortr ;iva
StreM Address MinneapG';& ,nni i~490 CitY
State (952) 881-9000 Zip Telcphone # ( )
Bond Expires:
The Applicant is _ Owner f,/ Contractor _ Other
Add-on or alteration to ezisting dweRing unit $ 30.00
furnace _Additional ~ Rep a e~`~ dl"0u11 J_ b464~ ~;6
_ air exchanger
? airconditioner _New ~Replacement0).liy'ti111~(Gi3~C~~d
other
State Surcharge $ 50
Toca? • $ ~b.SU
I hereby apply for a Residential Mechanica] Permit and aclmowledge that the informarion is complete and accurate; that the work will
be in conformance with the ordinances and codes of the City of Eagan and with [he Mechanical Codes; tliat I understand this is not a
pemut, bu[ only an application for a permi[, and work is not to start without a peanit; that thc work will be in accordance with the
approved plan in the case of work which requires a review and approval of plans. _
r }.rr . s 9.,
pp icanYs Printed ame Applicant's Signature r~
l~
I~ I JUL 2 1 2005 ~
~y
t
2005 COMMERCIAL MECHANICAL PERMIT APPLICATION
City Of Eagau
3830 Pilot Knob Road, Eagan MN 55122
Te(ephone # 651-675-5675
Please complete for: commerciaUindustnal buildings
mulli-family buildings when separate permits ure not requved for each dwelling unit
Date
Site Strcet Address Unit #
Tenant Name ('if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor
Street Address City
State Zip Tclephone # ( )
Bond Expires:
The Applicant is _ Owner _ Contractor _ Other
Work Type
_ New Construction _ Underground Tank _ Install _ Remove '"*see 6elow
_ Interior Improvement _ Install Piping _Processed _Gas
Nature of Work:
*'When installing/removing underground tank, call for inspection by Fire Marshal and Plumbing /nspecior
PC7'IIl1I F¢¢S; $70.50 Underground tank installation/removal
550.50 Minvnum (includes State Surchazge)
or
Contract Value _ x 1% Permit Fee
• If permit fee is $1,000 ar less, add $.50 $ State Surcharge
If en rmit fee is over $1,000, add $.50 for
every $1,000 gernnt fee $ Total Fee
I hereby apply For a Commercial Mechanical Permit and acknowlcdge that the information is complete and accurate; tlut tlie work
will be in conformance with the ordinances and codes of the City of Eagan and wi[h the Mechanical Codes; that I understand this is
not a pemut, but only an application for a permit, and work is not [o start without a permit; thaY the work will be in accordance with
the approved plan in the case of work which requires a review and approval oP plans.
Applicant's Printed Name Applicant's Signature
Approved By: Inspcctor Date:
TOWN OF EAGAN
3795 Pilot Knob Road
st. Paul, Minn: 55111
PEFMIIT NO.: 51
The Board of Supervisors hereby grants to Nor16h Star Plumdinr_ B Hesting, Inc.
eP : 3427 No. DAle St., St. Paul 55112 a PLumb3,ng_`_--•--
Permit for: (Owner) Sheldon. Lee Dt (Han.ss,a HtB&@Z 4Z&4-aeqiyaitip*s St. Pau1
pursuant to applieatioh dated 8/12/70
Fee Paid: 520.00 Dated this 12th day of August , 79LO-.
~Building Inspector
TOWN OF EAGAN
3795 Pilot Knob Rcaa
st. Paui, rum. 55111
PEFQCT NO.: 88 55
The Board of Supervisora hereby grants to Mitchell HeatingLInc.
of _ 1669 Selbx-Av_enue. St. Paul 55104 a Heating____
Permit for: (Owner) Lee Sheldon nson Nomes )at 4244 Sequoia Drive_-Evergreen Park
pursuant to application dated 8425 70.________._
Fee Paid: 20 00_y__ Dated this 17th day ef Seatember , 19 70.
Building Inspector ~ ~
. ~
~ EAGAN TOWNSHIP
BUILDING PERMIT N? 2273
Owne: Eagan Township
~ Addsess (Preneni) '.'&L.......-,:e-
Town Hall
. . ~
Builder .._!s~~~!::'".-..~1 •'G~
_ °----s
Addreu
je ~ . ~ ~ Date
nk.~ .s...
..............r:
/
DESCRIPTION
8loriee To Se Uced Fos Fron! Deplh I Haigh! Eel. Cos! Permit FeeI Remarks
~ LOCATION
8lree2, Aoad or other DeseripSion of LocalSan I Lo! Block Addi!!on o: Trac!
-z-~1
Thla permit doas aot aulhozise !hs uee o! 9lreala, roade, alleye or sldewalks nos does !t give !he owner er hts sgea!
!he :igh!!o ereete sap s!!ualSoa which is e nulsanea ox which presenls e haaard !o !he heallh, safetp, coavenleacs and
general welfare !o anpone in !he eommuniip.
THIS PERMIT MUST BE{ KEPT ON THE PREMISE WHILE THE WOAK IS .N PROGR SS. ~
This is to ceslifp. lhat---..l.'~.?:?"..~6:...-:---.,T1?r......^r.... -...haspermisetoa !o ereat a..... ._...r.....`~.-.--_-........... upon
!he above described premiea subjec! !o !he provlsioas o! !he Building Ordinanee for Eaga Township adopled April 11,
1955.
~.r....._~ - Per
<
.L...............................................................
~O-^.. bairma - of Tnwn Board ~ BuildinQ Iaspeetor
~ On / / 4ti,r o,/,
~l
~
w ~a
~ p
iILI
~ . V
. `
~
MASTER CARD
• LOCA710N ,S'e 49 LAvA
OWNER anz~~,~T ~
STRUCTURE AND I~
LAND USED AS
Issued To
Permit No. Issued Con}ractor Owner
BUILDING
PLUMBING
CESSPOOL - SEPTIC TANK yz7N, ~le
9
WE« t oT-eY g''/<'7v ~e vKr
ELECTRICAL
HEATING 17- 7 D
GAS INSTALLING (
SANITARY SEWER 6 D 'J1..
~
OTHER I
OTHER I
• Approved
Items (Initial) Date Remarks Distance From Well
FGOTING SEPTIC
FOUNDATION CESSPOOL
FRAMING TILE PIELD FT.
F I NA L
. ELECTRICAL
DEPTH
HEATING OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WE«
SANITARY SEWER
~ r
~ 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 COMPIY.
ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS. ? COMPLETION OF CERTAIN IMPROVEMENTS
WIIL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
? REIhSPECTION REQUIRED DATE OF REINSPECTION •
REINSPECTION REVEALED
CERTI FICATION -1 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 ax 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
BUILDING INSPECTOR DATE
COMMENTS:
•
z3
PLEASE CALL NORTHWESTERN TELEPHONE C0.
SERVICE DEPT. (REPAIR) BEFORE DIGGING.
EAGFN TOWNSHIP
3795 Pilot ICnob Road
St. Paul, MinnesoCa 55111
Telephone 454-5242
PERaUT FOR WATER SERVICE CONNECTION
Date: July 13, 1970 Nymber: 458
Billing Name• Hanson Homes, Inc. Site Addresa: 4244 Sequoia Drive 1-1-Evergrea
Owaer• Lee D. Sheldon Billiag Address 4244 Sequoia Drive
Plumber: wiereke Trenching d Excavating
Location of Connection Meter Si Coanection Chg. 260.00 pd 7/13/70
Meter Na:arexmit Fee 10.00 pd 8/12/70
Meter Reading _ Meter Dep.
Meter Sealed: Yea Add'l Chg.
NO Total Chg.
1
~ Inspected by
Date
Buildiag is a: Remarka:
Residence xx
tiultiple r`o. Units
Commercial
Iaduatrial By:
Other Chief Iaspector
Ia consideration of the issue and delivery to me of the abwe permit, I
hereby agree to do tte proposed work in accordance with the rules and
regulations of Bagan Townahip, DakoCa County, Minneaota.
~
By:
Wieteke Tg nching d Excavating
Please aotify the abwe office when ready for inspection and connection.
~ a
EAGEsN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55I11
Telephone 454-5242
PERMIT FOR SEFIER SERVICE COIdNECTION
DATE: July 13, 1979 NUMBER 610
OWNER: Lee D. Sheldon Address 4244 sPwnn;n nriv,. i_i_F„o,-green Park
PLUMBER Wfereke Trenchine TYPE OF PIPE ~„cr ar,,,,
DESCRIPTION OF BUILAING
Industrial Commercial Residential Multiple Dwelling No, of units
xx
Location of Connections: Cannectlon Charge
Permit Fee 10.00 pd 8/12/70
5treet Repairs
Total
Tnspected by:
DaCe
Remarks•
By.
Chief Inspector
In consideration of Che issue axbd delivery to me of the above permiC, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Toemship, Dakota County, Minneso~a
Wierkk Trenching S Excavating
Bosemount, Minnesota 55068
Ylease notifq when ready for.inapection and coanection aad before any portion
of the work is covered.
~-Fo~- o-M~ --u~------------
i I
• ~ ~S/ ~ ;
Clty Of EapIl ~ Permit R.~-S"
I Permit Fee: 021~2i_ ~
3830 Pilot Knob Road
Eagan MN 55122 j oate Received:
Phone: (657) 675-5675 1
Fax:(651)675-5694 j S~ft' ~
2009 RESIDENTIAL BUILDING PERMIT APPLICATION l-'-" O~
oece: SiteAddress: T~ql S41(AG''a ; -5-~z~ 3
Tenant: Suite
RESIDENT / OWNER Name: iln+-i 4rtR l2nDAL ` Phone:
'I _ j ,?wN s>i
~OtY l 1UA4`Li +~O1SCti ~
Address! City I Zip: (Y
Applicant is: _ Owner 71N Contractor
~ .
TYPE OF WORK Description ofwork: '
Canstructfon Cost: MWti-Family8uilding: (YesNO~
CONTRACTOR Name: • C License#:
Address: `i"1 7tl Sf. ~lt,-
City: CA%tjYed/a011 S State: 41111 Zip:
Phone: LO 1.~--N ~ 3` ~ZT ~ Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Ef18fQy COdB . ResideMial Ventilalion Category 1 WoAcsheet • New Errergy CoCe WorCSheet
Category Submitted Submitted
submission type) • Energy Envelope Calculations Submitted
In the last 12 moMhs, has Uie City of Eagan issued a pemiit for a simllar plan based on a master plan9
_Yes _No If yes, date and address of mastar pian:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: PhoFre:
NOTE: Plans and supporting documents that you submlt are considered to be public irNormaGon. Portfons of
the information may be classified as non-public if you provide speciric reasons that would permit the City to
conclude that the are trade secreis.
I hereDy adcnowletlge that lhis iMOrmalion is complete antl accurete; that tlie work will be in cofiormance wilh the orEinances and codes of the Ciry of
Eagan; that I untlerstan0 this is not a permil, but onty an application for a pertnil, and vrork is not to starl without a permR; that the work vrill be In
accordance wifh the approved plan in the case of work which requires a 2view and approval of plans.
x X
ApplicanYa PrinOed Name APp~~~~s S~9^atWfe
Page 1 of 3
~ 1 E ~C:" I E oW F, D
MAR 1 'v 2009
' ~~~q 'SequoiA -D~2,
DO NOT WRITE BELOW THIS LINE (99-51711
SUB TYPES
Foundatlon _ Flreplace _ Porch (3Season) _ Storm Damage
~ Single Family _ Garage _ Porch (4-Season) _ ExteBor AFteration (Singls Family)
_ Multi _ Deck _ Porch (3creeNGazebo/Pergola) _ Exterior Alteration (AAuld)
_ 01 ofPlex _ Lower Level _ Pool r Mtscaflanaous
~ Accassory Building
WORK TYPES
_ New _ Interior Improvement _ Siding _ Demolish Building'
Addition _ Move Bullding _ Reroof _ Demolish Interior
~ Alberatlon _ Fire Repalr _ Wlndows _ Demollsh Foundation
_ Replace _ Repair _ Egreas Wlndow _ Water Damage
'Demolilian of entlre 6uilding - gNe PCA handout M applicant
DESCRIPTION
YaluaHon L22 Occupancy MCES System
Plan Review Code Edition SAC Units
(25%_ 100%---) Zoning City Water
Census Code Stories Booster Pump
ii of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type M Construction Width
REQUIREp INSPECTIONS
~ footings (New Building) Sheetrack
Footings (Deck) Final I C.O. Required
Footings (Addition) ~ Final / No C.O. Required
_ Foundatlon ~ HVAC
Drain Tile Other:
Roof: _Ice $ Water _Final ~ Pool: _Footings _Air/Gas Tests _Final
~ Framing Siding: _Stucco Lath -Stone Lath _Brick
Fireplace: _Rough In AirTest _Final ~ Windows
~ Insulation Retaining Wall
Meter 8ize: Erosion Control
/
Reviewed By: Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge ~ f
PlanReview
MCES SAC
•F ~
ciry snc y~1 p1'~L l
Utility Connection Charge
S8W Permit & Surcharge
Treatment PIaM
Copies
TOTAL
I ForOhjeeUse ,
I ~
Pe
~ rmit ~ I
City of Ea~~n
~ ~ 1I
3830 Pilot Knob Road I Peffnit Fee:
Eagan MN 55122 ~ Date Received: I
Phone: (651) 675-5675 i I
Fax: (651) 675-5694 i Staff:
2009 RESIDENTIAL PLUMBING PERMIT APPLICATION
~ ~
Date:~ - 2- ^ ~ Site Address: /L 'T~`t/~
"Cf a'<', r,
Tenant: Suite
1 n
RESIDENT I OWNER Name: C',\T~S`}':-.~ Phone:
Address ! City ! Zip:
CONTRACTOR Name: ~A License#:
Address: S• /3 V'I
' ~f~ 3~
City: State: ~ Zip:
Phone: G I Z- Contad Person:
TYPE OF WORK _ New kReplacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W.
Descriptionofwork:
PERMIT TYPE RESIDENTIAL
Water Heater _ Water Softener
Lawn Irrigation Add Plumbing Fixtures
L RPZ PVB) ~ Main _ Lower Level)
Septic System _ Water Turnaround
New
Abandonment
RESlDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn IrCigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround' (includes $.50 State Surcharge)
`Water Tumaround (add $165.00 if a 5/8" meter is required)
$700.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace 6urned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
I hereby acknowledge that this infortnation is complete and accurete; that the work will be in conformance wRh the ordes and codes of the Ciry of
Eagan; that I understand this is not a permR, but only an application for a permit, and wor ' not to s_ta1Lw permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and appro o rrs~ j
/
X
ApplicanYs Printed Name plicanYs ignature
FOR OFFICE USE Reviewed By: ` Date:
Required Inspections: "_Under Ground _Rough-In _Air Test _Gas Test _Final
For Office Use I
-7
Permit* City of EaQall I
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
2009 RESIDENTIAL BUILDING PERMIT APPLICATION C. ~C
V_ Site Address: Tf,? i c ~ ~ ' ~C4 yt , ~L'.= J t vZ - CC~`
Date:
f,
Tenant: Suite #
RESIDENT/OWNER Name: _ri 5i'R yt V Phone: 6 "fl 13~ (
Address I City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK Description of work
Construction Cost: i Multi-Family Building: (Yes I Noj
CONTRACTOR Name: License
Address:
City: ti k4;A di, State: 44K) _ Zip:
Phone: 3 0- 7 Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code • Residential Ventilation Category I Worksheet • New Energy Code Worksheet
Category Submitted Submitted
(I submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of
the information maybe classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
N _4 I x
Applicant's Printed Name Applicants Signa re
Page 1 of 3
- 'j
i, 1 w 2009`
se 9 ci
J"
DO NOT WRITE BELOW THIS LINE ! I
SUB TYPES
_ Foundation _ Fireplace Porch (3-Season) _ Storm Damage
Single Family _ Garage Porch (4-Season) _ Exterior Alteration (Single Family)
Multi _ Deck _ Porch (Screen/Gazebo/Pergola) - Exterior Alteration (Multi)
_ 01 of - Plex _ Lower Level _ Pool Miscellaneous
_ Accessory Building
WORK TYPES
_ New Interior Improvement _ Siding T Demolish Building*
Addition _ Move Building Reroof Demolish Interior
_ Alteration - Fire Repair _ Windows _ Demolish Foundation
Replace Repair Egress Window - Water Damage
*Demolition of entire building give PCA handout to applicant
DESCRIPTION
Valuations Occupancy MCES System
Plan Review Code Edition SAC Units
(25%_100°% Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Sheetrock
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC
Drain Tile Other:
Roof: _„_Ice & Water -,Final Pool: -Footings -Air/Gas Tests Final
Framing Siding: _Stucco Lath Stone Lath Brick
Fireplace: _Rough In _Air Test Final Windows
Insulation Retaining Wall
Meter Size: Erosion Control
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCESSAC O
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
~ For Office Use
City of Eap Permit#:
Permit Fee:(.'
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I
Fax: (651) 675-5694 Staff:
L - - - - - - - - - - - - - - - - - I
2009 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: _:~'r : C ( Site Address: 4,14c~
Tenant: Suite
RESIDENT / OWNER Name: C~x I-' Phone:
Address / City / Zip:
CONTRACTOR Name: . E n.Z ~A License
Address: r~ i a 5 S 5 0 w
City: n-12 State: ' I, `J Zip: 5 e4 33
Phone: G I Z- °k<b-, -rl C Contact Person:
TYPE OF WORK -New lyReplacement -Repair _Rebuild - Modify Space - Work in R.O.W.
Description of work: j tea. c~ L l cap V4 r-4 *o e'~,
PERMIT TYPE RESIDENTIAL
Water Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
RPZ / _ PVB) ( Main _ Lower Level)
Septic System Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
*Water Turnaround (add $165.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ord ces and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and wor not to sta,.rLwit r' permit; that the work will be in
yr
accordance with the approved plan in the case of work which requires a review and appr~ of. ns,-'---
x -773
Applicant's Printed Name plicant s ignature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground -Rough-In Air Test Gas Test Final
Use BL E or BLACK Ink
I For Office Use 1
City OT r nn 1 maPermit
I Permit Fee: I
3830 Pilot Knob Road I I
Eagan MN 55122 ~ Date Received: -30 "l3 j
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
2013 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address:
Tenant: Suite
Resident/Owner Name: Phone:
Address / City / Zip:
Name: ~ License
Contractor Address: ~ t ss . 5 5 CIO (vj City: 6119 ~ r
State: M , ` ,~J Zip: Phone: b i 10
Contact: r z'^'~ Email: I- e r; W v--\ \ , elp
Type of Work -New Z Replacement _Repair -Rebuild - Modify Space - Work in R.O.W.
dd
Description of work:
RESIDENTIAL
Water Heater
Lawn Irrigation L- RPZ PVB) Water Softener
Permit Type
Septic System Add Plumbing Fixtures L- Main / Lower Level)
New Water Turnaround
Abandonment
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 Su charge)
'Water Turnaround (add $189.00 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 protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances a I 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 wi out a permit ,t 't the work will be in
accordance with the approved plan in the case of work which requires a review and approval of s.
x 1 tMS x
Applicant's Printed Name Appli s Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
s°
City of Eagan
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: Q(�
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Permit Fee: f lcd. 3e
Date Received: 1 '
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Site Address: rr� t' ; CO/ 4 l +', .2 Unit #:
Name: L.,Vld i 5', o •
Address / City / Zip: `'' T ( 5€7 (j a (/d
Applicant is: Owner Contractor
Phone: G 12 -fir 7 -77 �S)
Company:
Address:
t'sf r'�let
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State: /4 ,j Zip:�.S `if1
License #: ��c . 6,375'0/
Phone:
Multi -Family Building: (Yes
/ No " )
Contact:
Contact: S Lptf s►�,`714
City: ii/A /S
Lead Certificate #: , V*% // S '9 8Y "
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information;
•-10,\' �T]D
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:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
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 CaII 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 Lodes 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.
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Applicant's Printed Name
x
Applicant's Signature
Page 1 of 3
Dr --
00 NOT WRITE BOW THIS LINE
SUB TYPES
Foundation Fireplace
ylIC Single Family Garage
Multi Deck
01 of Plex Lower Level
WORK TYPES
New Interior Improvement
Addition Move Building
et Alteration Fire Repair
Replace Repair
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100% ✓ )
Census Code
# of Units
# of Buildings
Type of Construction
43�f
1
,D3
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: _Ice & Water _Final
#' Framing
Fireplace: _Rough In
Insulation
Sheathing
Sheetrock
Reviewed By:
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Siding
Reroof
Windows
Egress Window
1661(0c -h_
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building — give PCA handout to applicant
.2409
-/
Meter Size:
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Final / C.O. Required
Final / No C.O. Required
HVAC _ Gas Service Test Gas Line Air Test
Other:
Pool: Footings _Air/Gas Tests
Siding: _Stucco Lath Stone Lath
Air Test Final Windows
Retaining Wall: _ Footings _ Backfill _ Final
Radon Control
Erosion Control
, Building Inspector
TOTAL
/03
G7 "
Final
Brick
/2 lei 6oto' //
) Dt'a&
Page 2 of 3