4295 Sequoia Dr 'i^~•3r ~s~.C^r' . ' ~ . . . , . , _ . . _ . .
. , PERMIT
. . . PLUMBING PERMIT RECEIPT if
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 OATE: i__
CONTRACT PRICE: PHONE: 454-8100
Site Address BLDG. TYPE WORK DESCRIPTION
lot - ~ „ Block ~ -$eclS,ub Res. New
Mult. Add-on
m Name ~Comm. Repair
~u Address ~ Other
c City Phone RES. PLBG. ONLY COMPLETE THE FOLLOWiNG:
NO. FIXTURES TOTAL
Name Water Closet - $3.00 $
~ Address c Bath Tubs - $3.00
; . ; - - Lavatory
- $3.00
p City ' Phone Shower - $3.00
Ki?chen Sink - $3.00
FEES Urinal/Bidet - $3.00
COMM/INQ_FEE -I Wa_OF COMTAACT FEE Laundry Tray -$3.00
APT. BLDGS - COMM RATE APPLIES Floor Drains -$1.Sb
TOWNHOUSE & CONDO - RES. RATE APPLIES --L-Water Heater -$1.50
MINIMUM - RESIDENTIAL FEE - $12.00 Whirlpooi - $3.00
MINIMUM - COMM/IND FEE -$20.00 Gas Piping Outlets -$1.50
STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIT)
(.4DD $.50 S/G 1F PERMIT PR1CE GOES Softener -$5.00
BEYOND $1,000.00) Well - $10.00
Private Disp. - $10.00
~ Rough Openings - $1.50 r ,
SIGNATURE OF PERMITTEE FEE:
STATE SlC: '
~ :ti
FOR: CITY OF EAGAN GRAND 74TAL: ,
INSPECTION RECQRD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
PERMIT SUBTYPE: TYPE OF WORK:
~ , , • , , F
INSPECTION •
~ ~
Permit No. Permft Hoider Date Telephone #
SNV
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspection Date Insp. Camments
Footings I
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Y~
Isul.
i ~ -
Freplace
Final Htg.
Orsat Test
Final Plbg. Plbg. Inspector - Notify Plumber
Const: Meter
Engr./Plan
Bldg. Final
Dedc Ftg.
DeCk Final
Weil
Pr. Disp.
Cities Di ital Qualitv Control
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CITY OF EAGAN Remarks Wt'r COI1 pCl. Ori 10-21-70
Addition Evergreen Park Lot 1 aik 3 Parcel- 10 24880 010 03
Owner i street _ 4295 Sequoia Dr. 5tate Eagan,MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK "141 1973 1 OO 8.75 20
SEWER LATERAL
Z 1
WATERMAIN
WATER LATERAL
WATER AREA
STORM SEW TRK ~A 1981 323.00 21.53 15 323.00 C006743 5-28-80
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 26O OO 2696 - -
BUILOING PER.
SAC 2110. 00 7195 1-9-73
PAFiK
RESIDENTIAL
~T~' BUILDING PERMIT APPLICATION 1 CITY OF EAGAN f~
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Conatructbn Neaulrements ' pemodeVNeoah HeoulremeMe
• 3 repistered stte suNeys showing sq. tt. of bt, sq. fl. of house; and II rooled areas • 2 coDles of plan (20% maxMnum bt coverege albwed) . 1 set of Energy Caloulatans for heate0 adtlNbns
• 2 coples of plen showing beam & wintlax &Izes; pourad fouM Oeslgn, etc.) • 1 site suney for exlerior adtl0bns 8 Aecks
. 1 set of Energy Cakulatbns . Intlicete tt hame servetl hy septic syslem for add'Ahns .
• 3 copies ot Tree Preservatbn Plan tl bt platled afier 711193
. Rin Jolsl Detail Optbns seiectbn sheet (bklgs willi 3 or less untts)
DATE ^~Y1P I I ~~'Y~ VAWATION~
SITE ADDRESS (-IgQS ~:-eQUO LQ rn('. MULTI-FAMILY BLDG _ Y q,-N
TYPE OF WORK Ifnr -oecccl-F FIREPLACE(S) _ O_ 1_ 2
APPLICANT rCi )f ~)eIV~~RmFI f`c, 1011(lq
STREET ADDRESS Q2j?:a 14`ZjhPinn rt)r . CITY j1WnEkjaQ$TATEL1CL ZIP~j
TELEPHONE #tla-& CELL PHONE a Fax # Co Ia -c~a- q~°I
PROPERTYOWNER(LiJI IC?I,U (CaM..1~pP TELEPHONE#L(aA-50- qQ(Cq
COMPLETE THIS SECTION FOR uNEW- RESIDENTIAL BUILDWGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 M ~
(4 submission type) • Residential Ventilation Category 1 Worksheet Submitted • e e~LV s e mitted
. Energy Envelope Calculations Submitted 7PVUN 13 2002
Plumbing Conhactor: Phone #
Piumbing system includes: _ Water Softener _ Lawn Sprinkler Fee: $90.00
_ Water Heater _ No. of R.I. Baths
_ No. of Baths
Mechankal Conhactor. Phone U
Mechanical system includes: _ Air Conditioning Fee: $70.00
_ Heat Recovery System
Sewer/Water Contractor: Phone #
I hereby ocknowledge that I have read this appllcation, state That The information is correct, ;7dagree to comply
with all appllcable State of Minnesota StatuTes and Ci1y of Eagan Or inances
Sigrwture of Appllca ~
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Requlred _
Updated 4102
OFFICE USE ONLY
O 01 Foundation ? 07 05-plex ? 13 16plex ? 20 Pool ? 30 Accessory Bldg
O 02 SF Dwelling ? 08 06-plex O 16 Fireplace ? 21 Porch (3sea.) ? 31 Ext. Alt - Muki
? 03 01 of _ plex O 09 07-plex ? 17 Garege ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex O 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 MuHi
? OS 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
O 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof O 46 Windows/Doors
? 34 Replacement •Demolkion (Entire Bldg only) - Give PCA handout to applfcant
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 W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinallC.O.
_ Footings (deck) _ FinaUNo 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)
_ Insularion _ Retaining Wall
Approved By , Building Inspector
Base Fee
SU!Ch8rg6
Plan Review
MClES SAC
City SAC
Water Suppy & Storage
S&W Permit 8 Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
CIT`I 0:^ F,t~G"N
3795 Pi].ot KneU ?'oad
Eagan, Niinnr_sota 55122
PERMIT NO.:__3_12 .
The Cit,y o: Ea.gan hereby grants to _RaY lq. Welter Heating Co.
o;. 4637Chicago Abe.So.
a AIR COND. Permit for: (Owr.er) Wm• Lampe ---...f
`P-t 4295 Sequoia Drive p•arsuant to applicztion dabed 4/22/76
Pc:e Psi_c:: $5.00 dated this 26 day of April 19 76~
30 S/C
BUiiu.i.ng Irr.3y°r,toP
Sdec: anir,41 Permits:
sia mot;,l:
I ~ / ~
)
TOW OF EAGAN
3795 Piiot Knob Road
St. Paul, Minn. 55111
PEWIT NO.: 57
The Board of 3upervisors hereby grants toWenzel Plumbin.g d Heatine. Inc.
of 1955 Shawnee Road. St. Paul. Minn. 55111 a Plumbing
Permit for: (Owner) Waesmann Construction at 4295 Seouoia Drine_
purauant to applieation dated September_9. 1970.`___,_,___ _
Fee Paid: $;20.00 Dated this 9th day of Sectember , 197 0.
Building Inspector
/-j <5, p
TOwN OF EAGAN
3795 Pilot Ifnob Reaa
St. Paul, Atinn, 55111
PERNIIT NO.: 54
The Board o£ Supervisors hereby grants to K1eve Heatin~d Air C~onditioning
(ip 13075 Pioneer 112i1, Eden Prairie- a heatin&
Permit for: (Owner) Wensmann Construction _ at ~4295_Sequoia Drive} Evergreen Yatk .
pursuant to application dated 9/14/70 .
Fee Paid: $20.06 Dated this 17th day of September , 19 70.
•--•----I-n----spectar
Building
PERMIT ~5y
~ CIT ~ OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55123 Permit Number: 023103
(612) 681-4675 Date Issued: 0 3/ 16 / 9 4
SITE ADDRESS:
4295 SEQUOIA pR
LOT: 1 BLOCK: 3
EVERGREEN PARK
P.I.N.: 10-24880-010-03
DESCRIPTION:
SIDING/SOFFIT/FASCIA
Building'_Permit 7ype SF (MISC.)
Building Wbrk Type ALTERATION
i
i
/
\
-r' ~ ~ , I
REMARKS:
FEE SUMMARY.
VALUATION $15,060
Base Fee $162.00
Surcharge $7.50
Total Fee $169.50
CONTRACTOR: - Applicant - sT. LIC. OWNER:
AMERICAN REMODELTNG INC 15530020 0002406 LAMPE WILLIAM
3700 ANNAPOLIS LN 4295 SEQUOIA OR
PLYMOUTH MN 55447 EAGAN MN 55122
(612) 553-0020 (612)452-4964
Z hereby acknowledge that Z have read this application and state that the
information is correct and agree to comply with a7,1 applica6le State of Mn.
L Statutes and City of Eagan Ord;inances. 00, -j
r
1 A P T/PERM EE 5 NA ISSUOjB :SIONATURL'
INSPECTION RECORD
CITY OF EAGAN PERMITTYPE: suzLoiNe
3830 Pilot Knob Road Permit Number: 023103
Eagan, Minnesota 55123 Date Issued: e 3/ 16 / 9 4
(612) 681-4675
SITE ADDRESS: Lo T: i B L 0 C K: 3 APPLICANT:
4295 SEQUOIA DR AMERICAN REMODELING INC
EUERGREEN PARK (612) 553-0020
PERMIT SUBTYPE: TYPE OF WORK:
3F (MISC.) ALTERAYION
DESCRIPTION SIDING/SOFFIT/FASCIA
INSPECTION D, . D•
FRAMING ROUGH IN PLBG
ROUGH IN HTfi FINAL
~ J
REACTIVATE _ CIIY OF EAGAN
PERMIT # 1VJ3-BUILDING PERMIT APPLICATION
- ~.3103 19q 681.4675
SINGLE 8 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications. 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month.
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date NM Qn.f In Yal uati on of work _,Ly 1/3/
Site Address: Z/a 9S J6 f~U" 6( 17f? ~ V F
STREET SUITE M
Tenant Name: (commercial only)
IAT BLOCK P.I.D. M
Descri tion of work: l ce ~
The applicant is: lW'owner ? ontractor ? Other (oes«tbee)
Name i I Phone LlS,~ - L19 64-1
Property usT FIRST
Owner Address Zl~ qS S~ ~ i~i t a 7j i i9:
SiREEi . STE / City ~ State 111-. Yu Z i p s i_Q Z
Company ' 1rn ~c. C -e ~ Phone S.s3 - oo~ o
1
Contractor Address :j760 ~VUwulv~ skPW E License #ctoo,;~44o6 Exp.
Citv State Y1'l Yt1 Zip SS"i/-7
Architect/ Company Phone
Engtneer Name Registration M
Address
City State Zip
Sewer & water licensed plumber . Processing time for
sewer & water permits .is two days once area has been approved.
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.
~~~1
Signature of Applicant: LI;Cf~l~ Iz / 4
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging 0 11Besem6nT finish
E3 02 SF Dwg. ? 07 4-Plex 0 12 Multi. Misc. ? 17 Swim Pool
? 03 SF Addition 13 08 8-Plex ? 13 Garage/Accessory O 18 Comn./Ind.
O 04 SF Porch 0 09 12-Plex O 14 Fireplace 13 19 Comm./Ind. Misc.
O OS SF Misc. ? 10 Multi. Add'1. ? 15 Oeck ? 20 Public Facility
O 21 Miscellaneous
WORK TYPE
? 31 New 33 Alterations 0 35 Tenant Finish ? 37 Demolish
? 32 Addition ? 34 Repair 0 36 Move
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. FIWCC System
(Allowable) lst F1. sq. ft. City Water
UBC bccupancy 2nd F1. sq. ft. PRY Required
Zoning Sq. Ft. total Booster Pump
N of Stories Footprint Sq. ft. Fire Sprinkler
Length On-site well Census Code
Depth On-site sewage SAC Code
APPROVALS
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS "
? Site ? Footing ? framing ? Insulation
O Wallboard ? final ? Draintile ? Fireplace
Permit Fee wiuac;«,: g
Surcharge
Plan Review
License
MWCC SAC City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total: ~ p
SAC %
SAC Units
r ,
~ EAGAN TOWNSHIP
BUILDING PERMIT N? 2299
Owne: Ea9an Township
Address (Presen!) ---...--....s-- Town Hall
Builder .......sfJ-!Cl.r.c'sC...............................................................
Dele
Addsens
DESCRIPTION
Slories To Be Used Fos F:on! Deplh Heigh! Esl. Coa! ~Permit Fae Ramarks
,~p-ti- 1 2-2-IaOCATI03Q ~ C!'c.-t~ •zs7S" S r w
Sireel. Roed or olher aeripilon oi Localion I Lo! Bloek Addiiion or T rae!
This pe:mil does aot aulho:ise e use of atreels, roads, alleps or sidewalke aor doas it glve the ownes or Lia agen!
the righ! !o ereale anq situation whieh ia a nuisaaee or whieh presents a hasard !o the healih, safety, eonvanienee aad
geaeral meltare to anpone in the communily.
THIS PERMIT MUST SE KEPT ON THE PAEMISE WHILE THE WOAR IS IN PROGRESB.
This ia !o cerlitp. thal---'Wo- . . has permission !o erea! a- :
. .
- ' - - - - - - _ upon
the above described pzemisa subject !o the provisions of the Su[]ding Ordinanee for Eaga Townshi adopled Apri1 11,
1955.
par
Chairma of Tnwn Boasd Buildin Ina eclos
,a.
. `Wy r .
' MASTER CARD
• LOCATION e 93
OWNER
STRUCTURE AND ~~C/~'
LAND USED AS
Issued To
Permit No. Issued Contrador Owner
BUILDING
Y
PLUM6ING
IfL
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING ~
GAS INSTALLING
SANITARY SEWER
OTHER 6A~ /
L~--
OTHER I I
• Approved
Items (Initial) Date Remarks Disiance From Well
FOOTING SEPTIC
FOUNDATION CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL
DEPTH
HE.4TING OF WELL
GAS INSTALLATION -
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER d LJ ~ D
~
. Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION BEPORTS •
TO BE I1SED ONLY 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. ? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DEIAYED BY CONDITIONS BEYOND
? NON-COMPLIANCE. BUILDER WILL COMPLY CONTROL.
WITHOUT DELAY.
ITEMIZED ANO DESCRIBED AS FOLLOWS:
? REINSPEGTION REQUIRED DATE OF REINSPECTION ~i
REINSPECTION REVEALED
CERTI FICATION - I certify that I hava carefully inspected the above in which I have no interest present or prospective, and that I have reported herein
all significant conditions obsenred to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any syecific require-
ments for Off-site improvements relating to the property inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPECTOR DATE
GOMMENTS:
•
z,
. . ;
EAGAN TOWNSffiP
3795 Pilot Knob Road
St. Paul, Minne•ota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE: October 21, 1970 NUMggg 651
OWNER:Wensmann Const. Address 4295 Sequoia Driveg Evergreen Park
PLUMBER Wenzel PlumbinQ d Heating TS[PE OF PIPE cast iron
DESCRIPTION OF BUITDING
Industrial Commercial Residential Multiple Dwelling No. of units
xxc
Location of Conaections: Connection Charge
Permit Fee 10.00 od 10/21/70
Street Repairs
Total
Inspected by: •
DaCe
Remarks•
By.
Chief Inapector
In consideration of the issue aad delivery to me of the above permit, I
hereby agree to do the proposed work ia accordance with the rules and
regulaCiona of Eagan Totmship, Dakota County, Mianeaota
By
Wenzel Plumbing b Heating, Inc.
1955 Shawnee Road, St. Paul 55111
Pleaee notifq when ready for.inspection and cownection and before any portion
of the work is covered.
Y '
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, MinaesoCa 55111
Telephone 454-5242
PERNQ T FOR WATBR SL+RVICE CONNECTION
Date: Aueust 18. 1970 Number: 491 (5p.
Billing Name: Wensmann Constnuction Site Address: 4295 Sequoia Drive, Evergreen
Owner: Wensmann Construction Billing Addreas Burnsville. Minnesota 55378
Pltmber:ldenzel Plumbing & Heating Inc.
Location of Connection MeCer Size Connectioa Chg. 26Q.00 ud 8/18/70
Re )'Y10e- /P aQ( (!{leter No //5~ 8~b Permit Fee 10.00 pd 10/21/70
17 7460 / Meter Readiagg~2~ Meter Dep.
fio e 1{,L)e L L Meter Sea led: Yea Add l1 Chg.
NO 1bta1 Chg.
Inspected by
Date
Building is a: Remarks:
Residence XXX
Mltiple So, vni.ts $25.00 RE-INSPECSIOPd FEE FQg
IAqPROPERIY INSTAILED PAE7ERS.
Commercial
Industrial By:
Other Chief Inspector
In conaideration of the isaue and delivery to me of the above permit, I
hereby agree to do tte proposed work in accordance c+ith the rules and
regnlations of 8agan Township, Dakota County, PSianesota.
By: 2L=Z~u . I - , nJ
Wenzel PlunbinQ S HeatinQ Inc.
Please notify the above office when readq for inspectlon and connection.
I ~ s
Di~C~J~/~n
~ ~7 y I
~~t~ ~f ~~~~1~ aPR 1 2009 J i Permit#: ]S ~ / ~ ~ I
3830 PilOt Knob Road I Permit Fee:
Eagan MN 55122 I I
1 Date Received:
Phone:(651 675-5675 I ~
Fax: (651) 675-5694 ~ Stafl:
2009 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address. ' { ~7 5 ~s .LU O/ .~L, ~ •
Tenant: Suite .13
RESIDENT/OWNER Name: Phone: J v
Address / City / Zip:
CONTRACTOR Name: Chamoion License ~177 70 -PM .
651-365-1340
Address: 3670 nedd od +a100
City: E89an, MN 55123-1339 State: zip:
Phone: Contact Person:
TYPE OF WORK _ New t/ Replace ent Repair _ Rebuild Modify Space _ Work in R.O.W.
Descri tion of work; Wolabi
PERMIT TYPE RESIDENTIAL , ~
_ Water Heater l/VJater Softener
Lawn Irrigation Add Plumbing Fi#ures
L_RPZ 1_ PVB) L_ Main _ Lower Level) _
Septic System _ Water Turnaround
New
Abandonment
RESIDENTfAL 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, Waier 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 6umed out appliances,'duc[work, etc.) (includes $.50 State Surcharge) `
TOTAL FEES $
I hereby acknowledge that [his information is complete and accurate; ihat the work will be in contormance with the ordinances and codes of the City of
Eagan; that I understand this is not a pertnit, but only an application for a permit, and work is not to staA without a permit; Ihat the work will be in
accord nce with the appr~ov-e,d plan in the case of work which requires a review and approval oi plans. .
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For Office Use
City of Eapit Ly F Permit
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
Fax: (651) 675-5694 Staff: CJ
2009 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address: il
5 6/ iU
a ~2~
Tenant: Suite
RESIDENT / OWNER Name: Phone: 0 -2
Address / City / Zip: c 2-
CONTRACTOR Name: Champion License #:7170--G
651-365-1340
Address: 3670 Dodd Rd. #100
City: Eagan, MN 55123-1339 State: Zip:
Phone: Contact Person:
TYPE OF WORK New 1/ Replace ent Repair Rebuild Modify Space _ Work in R.O.W.
Description of work:
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) L-`
TOTAL FEES $ -
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.
X_ x
Applicant's Printed Name Applicant's Sgna
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA122878
Date Issued:05/21/2014
Permit Category:ePermit
Site Address: 4295 Sequoia Dr
Lot:1 Block: 3 Addition: Evergreen Park
PID:10-24880-03-010
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
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 by law in ALL single family homes .
Danielle Merritt
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 -
.
3005 Eagandale Place Apt 122
Eagan MN 55121
Merritt Restoration
2031 Basswood Ct
Rockford MN 55373
(612) 282-9979
Applicant/Permitee: Signature Issued By: Signature