4337 Sequoia Dr CITY OF EAGAN Remarks Sew & r pAMTLi 3 8t COIltl pCl. on 6-2-69
Addition Evergreen Park Lot LL eik 5 Parcel 14 24880 040 05
Owne} f-=~ Street 4337 Sequoia Dr. State Eagan,MN 55122
7- „
Improvement Oate Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1973 175.00 8.75 20 122.50 CQQSj$Q 9-14-78
SEWERLATERAL
0
WATERMAIN
WATER LATERAL
WATER AREA
STORM SEW TRK yL~ 32-3-00 323.00 C005393 6 6 80
STORM 5EW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 210,00 1586. 7-22-•69
BUILOING PER.
SAC 240-00 1-10-73
PARK
.
RESIDENTIAL:
~
BUILDING RERMIT AFPRICATtQN
~ uT-Y OF RAc,aN
~
383O PItOT KNOB RD..'S5't22 DL~
651-881-4675;.
Na Cons . u~reaientsRemal~UR ' l~e - ~ ~ ' ~ ~ u~:
3~agis~ered.sl~atttv$ysshay4 Bq;Voftot,SQ.,(tW,hotu@:amN'rqQfedareas • Zcapies-fif.Aw . •
- (?09y tiur6Ltn larcaon~ge`ai6?ved) . tseFaf Eiisr~y Cafiaila~',Ax hao"ZOMM
2~opieBOipJansfiowing,beam~WindaVrsi~as,pcwtedfqundd~siqn,elc~• . i~~es~er~r:~t~raae~nne~~a`
• 1 s~le[.~ttJy.Cal~xiladons ~rrbioate~Ffiane~e~:~y~e~tic.sysmRiti`bxa~lfdo~ _ -
. 3=0es.01Ti8e,P1seVaeanPkn'tf4pt*Wab9c711W.
. -
~ Rdn J9ht'i7e.ta~' QpdAtlssel~)la~~e!'{b~s witb 3 eF lesnnltsj : F -
QATE vALuRIa14
.1C)B 31TE ADL?RM
IF lVIiUlT14AMl4Y BUiLDlNG; MOW MAUY iJ.NITS~ ~
PROPERTY OWNIE - Q ' "rJ - -
Tly-PE'a:f.11U4)RK holF FIRMiACV(S), _ 4.; .t , 3'
_ . . ,
APPLfCANT . Ua S", - ; T .
~ -
IIDliE$S
A
PA?GER~# _ :C~i.l PHQNE~~:~~~~ FAX # . - :
,
NEMRES1VEN1IALBUILDING C)N1»lI- FII,l: OUT COMPLETECY '
i [Enef9y.Code~categor,y' 1~111VI~IOi~TA RULES:-7.67i~'CA`"E~~Y 1 ` -
~(efie~ck~o~e~ = ResiderTfWi VenftQan Ca*orY l; Wbr&s~?Ot $wbnnltped. - F-necgy Envelopid.CaWadorrsSubmftterl
_ MIN. NESa"[`A. I;UAIY-S 7672
' - Mernr Energy .Co0e;.Vi4riesheet S4bon(tted Plumbing Corttra+cf~o~: Phone
1'1umV~:~}stet7h Tinduclcs:- Wacer softena ~ I.,-oan SPriunkler sw 130
NWler :Heater No, of I. B-atbs: li
%
N0: vf ;Baths
- _ ,
M@Ghaflj.CE7CGOntfOC#flC: ;P~ior~~e#
iVlet-JiMe'd -Sysiew lftcwes: ~ Aie'CUZidirivnir~H I?`ee:: 176.00
Heat RccavcrvS}•steni
^
SewerJWcf?er Cvr+troctot: - - - Bhorie.~k' ~ . - -
- _ ;
. ~
it
Alf above infocmaRloni must be 46brygEfed,prior ta prv.cessirrg ,of applir.aamn. ~ J
y_~ _ .
I tien~by acknoWfedge4hetf ! havo road -#fiIs a;ppYicafion, steit. tbe irtrw~tfw is d:qgMse i0.cornpty
wi#M dll applicable S.tats o.€ Minnesota S.to#utes and .Ci3:y ofi qn rii~t~anc~.
,
.
519r~oture oE'ARPUear4t . , _
- - - -
_CerEMcate~:6tSuruey;RmFmEi _ Ttee:Pcesenvabon Ptan eiwetl ~ t4lot~°Required
4~pcfated`~ro~ .
-
,
OFFiC.E USE QNLY
a a1-. FoUpdecion :a, al 05-0ex a 18 isvrox o,20 'Poi fl 30 Acee6~W,01dg.
CI •l}2 SFIMellsng 13. ,08: 06-plex 0 ifi FirOplace' O.. 21 Porch (3rsetkw) 'O 31, Eikt: A)t- Muld
~.'Q3' Q1~of_ple~ Ct' 09 •07-plex d 1.7- Garage 13 22' ftrch/Addn.,.(+tses.y .;q 3& aL Atc-SF
. .
O 04 "02=1eya L'! 16 08-.A,1esc 0 18 .Deck [I 23 -Parch Wmerteti)r .0 16 MuIG
0 .a5• .03=p1ez ~ 11 1'0~pla~ Li 19 Lovi~er Leval 0 24 5tomn D_amag~:
C] 06, 04'rplex Q 12 12r,plax P(bg-SF or _'h! 13 25 Mtrellaneous:
b 31 New E1 ~5 Imt Improvemarit O i 3:$- Demoltsh (Intieriar) ?.44 Sidi"ng.
? 32 Ad040. 11 36 tatove8ldg. O 42- D.emokh~[~ound.atio.nJ Q 45 Rire'Repair
Oi33Atteratibrf,. 0 9T '[3,ermotish{81dg)` E3. 43' Reroof Q 46 Wlitlowsf0vars:
iCl.: 34 Replacement "00rinotittoft .JEnttre 131019,on4y) 7!.6ive PGA handout toaPPficanf
1f41patiaP pdcupe.rtcy MCIEa -Sysfem
'CenWs Code,. Zoning City'W_gter
SAC :L1nfts Staries B.aostec.Pamp
Nbr. af Units. :Sq~ Ft. ~ PRV
Nbr, afi B:Vdgs , ~.~eqg€M- Fire.SpririWererll
Type of Corast, 1N.fd#h
'REQUIRED INSPECTION-S
_ f ootiugs .(ttew bYdg) ^ Fina1ICLO-
_ '~~tin.gs;(deEk) F~i~tNo G.O:.
_ Pctoti4s.,(a3dition) ` Plnmbing
~vuAd~tr~n ~ HURC
Drain ri,!¢
Roof _ 1clt* water- ~ Fina] ' _ Oter
Ftanting: _ PQo1 Ft_gs Airr, G,asTcafis,
_ FireplaCe_ r R:I, ` A.~r T~est _ Fitat S.idung ~ :5tucco^ Stone _
Iqsularian Wincltaws ('~ewlreplaeemenx)
,Appmvocl;-By j..,840ding iinspedor
Base Fee
Surcbarpm ~ ,C)
Plan. Reyi.dv+r~
MC/ES SAC
Ciiy SAC.
Vtilate.r su1?PlY & Storage
S&.W,*Perm,it &'~-SijrcMatg.s
TreortiteRt'Mattt
P[uinbin.g permit:
Mechanic ' ai P,ermii
~t;2cense .~ear~h.
C~ipies
Qther
Totar - '
C9/6 6~3/41
Request Date ire No. gh-In Ir"ection Requiretl Mspection Olher Than Rough-In '
4~ Z 94 (vou must cen inapectar wnen ready) ~ qeatly Now ? W ill NotHy Inspeclw
? Yee El No Oate Ready
I!~ licensed coniractor ? owner hereby request inspection of above electrical work aC.
Jo0 Atltlress (Street. Box or Route No.) Ciry
4337 Sequoia Drive Eagan
Saction Na. Townsnio Name or No. Range No. Counry
Dakota
OccupantlPRINT) Ppone No.
Norman Peterson 454-6532
Power Su00lier AdOress
Dakota Electric Co. 4300 220th St. Farmington, MN
Eleclrical Comratlor (COmpany Name) Convector5 Licensa No.
Total Electric, Inc. CA01834
Mailing Atloress ICOnVactor pr Owner Making Installalion,
1537 92nd Lane N.E. Blaine, MN 55449
Authanze0 Sigwlyre (COnVaqonOwner Makmg Inslallanon) Phone Numb¢r
l 786-8484
MINNESOTA STATE BOARO OF ELECTPICITY THIS INSPECTION FECUEST WILL NOT
Grlggs-Mitlway BIOg. - Raom Sn73 BE ACCEPTED BV THE STATE BOAFD
1821 Universily Aw.. St. Peul. MN 55101 UNLESS PROPEF INSPECTION FEE IS
`one (612) 612-0800 ENCLOSEO. _
~ REQUEST FOR ELECTRICAL INSPECTION Ee-aoaoi-o-
S/0/ a~`~CDa g
~ See insVUCtions tor rompleting this form on back ot yellow copy ~
0
0069 3 JC" Below Wurk Covered by TM's Requesf
ew Atltl iiep. TypeofBuilding AppliancesWired EquipmeMWireU
X Home Ran9e Temporary Service
Duplex Water Heater Eleclric Heating
Apt. Building Dryer Load Management
CommJlrtdusfrial X Fumace Other (Specify)
Farm W g Air Conditioner
ONer (syecity) Conbactor's Remarks:
Compute Jnspection Fee Below:
# Other Fee # ServiceEniranceSize Fee # Circuits/Feeders Fee
Swimming Pool 0 l0 200 Amps 0 ta t00 Amps
Transformers Above 200 _ Amps Ahove 100 _ Amps
Signs lmsPec,ors use onry: rD7aL
trrigation Booms / 50
Special Inspection
Alarm/Communicatio~ THIS INSTALLATION MAY BE OR -SDI CONNECTED IF NOT
Other Fee COMPIETED WITHIN 78 MONTHS.
I, the Electrical Inspector, here6y R°°qn;m oate
certify that the above inspection has Finai ~
been made.
OFFICE IISE ONLY
This request void i6 months /rom
RECORD OF COMPLAINT
Date 1°3
Complaint taken by
Type of buBdin
Name
Address
Legal description -
Phone number --3
Complaint
a v. 04,t
Action taken
oLrJ
TZ
Commenu
,
.v... Signaturc ~
2000 STORM DAMAGE PERMIT APPLICATION (RESIDENTIAL)
. ~ CITY OF EAGAN
" 3830 PILOT KNOB RD • 55722
651-661-4675
Reauiremenfs
? 2 coples of plan 14
DATE: 9 CONSTRUCTION COST: bUO D. O O
DESCRIPTION OF WORK: B~F4YtF--nf ~ Ii mulH-Iamiy bldg., how many units?
INDICATE THE FOLLOWING EAUIPRAENi TO BE REPLACED AND BY WHOPA:
_ Plumbing _ Hameowner gt Contractor Name
_ Mechanical _ Homeowner qt Contractor Name
"Note: If somebody other than the homeowner is performing plumbing or mechanical work They must apply for appropriafe
permit. Only Iicensed plumbing contractor or homeowner may complete plumblng work.
STREET ADDRESS: / 337 01E- ~
LOT: -4- BLOCK: _S SUBD./P.I.D. lL ratFPY1 PQr N
^
Name: Phone '7' S~-~?~ 3~
PROPERIY Last flrst
OWNER
SireetAddress: q337 J~au Dl~"
City A-F~ 14 Sfate: ~ Zlp:
Company: V~r ~-~v~?~Si tr'~ YJ~SJ-phone li:
(area code)
CONTRACiOR
Sheet Addreu: u License # ~42 I// Exp. 0//
Clty wt'j STate: Zip:
~~.:E1VED
LB S EP 7 - 2000
1'':
I hereby acknowledge ihaf I have read thisapplicafion, state fhat the information is cortecf, and agres to comply wilh oll appGcable Sfate
of Minnesofa Stoiutes and City of Eagan Ordinances.
,
Signature of Applicant:
71
OFFICE USE ONLY
~ .
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.) ? 31 6ct. AR - Multi
? 02 SF Dwelling ? 08 06-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. AR - SF
? 03 01 of ` plex ? 09 07-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
D 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage
? 05 03-plex ? 11 10-plex Plbg _Y or_ N? 25 Miscellaneous
? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bldg.
WORK TYPE
? 31 New ? 36 Move Bidg. ? 43 Reroof
? 32 Addition ? 37 Demolish (Bldg)* ? 44 Siding
? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors
' Demolition permit • Give PCA handout to applicant
GENERAL INFORMATION
# of Stories ' sq. ft.
No. of Units Length sq. ft.
No. of Buildings Width Footprint sq. ft.
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. MC/ES System
UBC Occupancy sq. ft. City Water
Zoning sq. ft. Booster Pump
PRV
Orrv'1 ~ (lorO4-i~r Pe, e YSON 7 337 Se~ttO,G. Dv
~Gsr~ ~fs~- os3~= Fqq4H /n nl Ssia
1770 H:o
~7 S fq ~ r w~c l ~ I ! Heq-F2Y ~ `ai+n
~ I O I
~
r
q
~
i
_,uMp- I
-(Pri
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~ I I' i
f~
;
~
r-
i
PP,a~ _ ~ Gas ~o~~ I
,
J~LIlV!Clac"'~~ OD`3
i
orwt ~ l~oro~G,r Pe- fe rsov~ '~3J7 SgtL4o; 4 DY
I ! !Y~-0 Nso
~---Q Sfa i v wG ~ ~ He4fer ~so'4n .r
7~ i
~ ~cxr/Jac E 9
r
9
t
I ,
I °
u4
~S a
I I ~ ~r/o v
i 6 ;
,
~
~ i
,
OP~'~P~~ ~ Ja5 $±OJPi I
r~~ .
70/F
~
' . . . .
ra.•eatf
. ;~~F~'.
s... a ,~p~.<:
r d.......r?!+ . .~d::.' g~
e~.;~yGyo~:~~gw' ~ 3+~F,~ a
~
'y~'.:''~x:~Z'~:~'rw~.3~~'.r:<~. .
~k'c,
. d '
%
1994 MECHANICAL PERMIT (RESIDENI7AL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675 ~
PLEASE COMPI,ETE FOR SINGLE FAMII.Y DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WI-IEN PERMTI'S ARE REQUIItED FOR EACH UNIT.
- - - - -
NEW CONSTRUCTION
._4- ADD-ON A/C
ADD-ON FURNACE
FII2EPLACE INSERT
DATE `~fo?8~~~
FEES
HVAC: 0.100 M BTU $ 24,00
ADDITIONAL 50 M BTU 6.00
GAS OLTTLETS (MINIMUM 1 @ $3.00 EACH)
ADD-ON/REMODEL (ExisTuNG CoNSTttucrtox) $ 20.00
STATE SURCHARGE .50
TOTAL
SITE ADDRESS: 433-7 3 C-ytD! GZ •bf 1 V P ~
OWNER NAME: Ndrv~l~~.v, PP.l~ ~{P.YScn TELEPxoNE#:
nvsTAL,r.ER: kor,'s IYJPC4a~~~ca~
ADDRESS: I SQ E- SGICck01ZeP A)t17o`e
CIT'Y: S~~1CLkOa?Z.P~P / STATE: M/) ZIP CODE: 55379
TELEPHONE 5~- r~Sg 5
IGNA OF PERMITTEE
~
F~~~
t:~~ ~ ;AYIa ~~~2 gi~, ..°'~~Vi~~*~,3~.ce'`? ~yf ~~a~~.'~,g~q,'0~~x'~~;'.•"'~4~~-0c~~,'~` y~ v
ltom_
1994 MECHAHICAL PERMIT (COMMERCIAL)
C1TY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR ALL COMMERCIAI,/INDUSTRIAL BUILDINGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUII,DINGS WI-EN SEPARATE
PERMITS ARE NOT REQUIItED FOR EACH DWELLING UN1T.
DAT'E: CON1'RACT PRICE: $
NEW BUILDING
TNTERIOR IMPROVEMENT
WORK DESCRIPTION:
FEES
1% OF FEE $
. :.R...:,..... Y:£aw:. •
PROCESSED PIPING: $25.00
MINIMLJM FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF FEE.
w..~.~...~.F1..a.xs..«
TOTAL $
SITE ADDRESS:
OWNER NAME: TELEPHONE
TENANT NAME: (IMPROVEMENTS ONLl)
INSTALIER:
ADDRESS:
C1TY: STATE: ZIP CODE:
TELEPHONE
SIGNATURE OF PERMITTEE CITY INSPECTOR
,
EAGAN TOWNSHIP
BUILDING PERMIT N° 2009
Owae: Eagan Townahip
Address (psesen2) ~IFae_~ ._..'!u'~:!~r.~~._..~ Town Ha)1
Builder
Dele °
Address
DESCRIPTION
5fories To Be Used For Fron! Depih Heigh2 Esf. Cos! Permif Feel Remarlcs
LOCATION
Sireei, Road or oihee Descripiion of Loea2ion I Lo! Slock Addition or Trac!
~33 7 'Je-, _ - , s' G'.-~
G
This permi2 does aoi authoris !he use of alreels, roads, alleps or sidewalke noz does it give !he owner or hia agent
the :ight to creafe any siiuation whieh is a nuisenae or which precenis a hazard !o the healYh, safelp, eonvenianee and
genesal welfare !o aayone in the communifp. ~
THIS PERMIT MUST B£ KEPT ON THE PREMISE WHILE TfiE WORK IS IN PROG SS.
ThSs is !o cezfifp, lhafl~p~`.~......^-.~^^~..~-.~~...haspermission !o erect a_ -..._upoa
-
the above described premise subjeet !o the provisions of the Building Ordinanee for Eag Townsk' adopfed April 11,
1855. ~ ~P
. : .-1`-.':............----. Per ^'.`~c~
nQ InsPectos
Chairmdfi of Tnwa Board Buildi,
91-is
' Eagan Township pERMI~NO. A.~.8._/....
Dakola Counlp, Minnesoia Date
" Application fnr Building Pexmit
Tppe of building or work coalemplated. Cirele oorreei desaripiions.
- -
~ Reside__-nfi ~ Commercial Induslrial Olher......_-----
Euil Enlarga Aller Repair Insiall Mova Wreck Oiher
Dimeasions..._--" Coai....... .
Defails ox remerks
Localion
Num6er Siree2 Beha! cross sixcels I Suo Esi. Valuahon
Lo! Bloclc Addif:on Reasrangemeal as Trac2
~
flar~~£=~~/ - . ddress ~ ~0.....0 -
`x
Coniracior Address
The undexsigned bereby makas apolicatioa !or a permit !o -
„
do mork as herein specif?ed, eing-if do all work in sfrict
acaordaace wilh !he buil g-o inanee adopled April 11, 1955
fee collecled.
bp !he / Eagan Tawaship Board o ar isors.
Permit fees ere no!
refundable.
° . ~~~~J...t~lj ~
5igned
~Na1
~
~c,~ 5 _
RE 2E Af
Yo 0
~
0
~ r
a
Cyr
i
~ .
S E4~uoi~ 02.
,oo'~-- -
Gflc~~E
NoUSE
zs r z
c A n N
Fd p
H ?o
H[RTtCZG'~Y'
1$~
~
~ r
- is' o C, -1 0
' r ~
~
o N
a
~
I P~
I 1 I i
ia6~ ~
EAGAPT TOWNSHIP
:795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE• j~lv 9 NUMBER 409
OWNER• LZA=r, f/,., ,,,s / °fi,~Address~,y~-S/
PLUMBER1f~~~ TYPE OF PIPE Heavy Cast Iron
f DESCRIPTION OF BUILDING
Industrial Commercial Residential Multiple Dwelling No. of units
Location of Connectiona: Connection Charge
Pexmit Pee pd.
Street Repairs
Total
Inspected by:
DaYe
Remarks•
By
Chief Inapector
In consideration of the issue and delivery to me of the above pezmit, I
hereby agree to do the proposed work in accordance with the rules aad
regulations of Hagan Tormship, Dakota County, Minaeaota
By.
Wenzel Plumbing & Heating Co.
Please notify when ready for.iaspection and connection and before any portion
of the work is covered.
. ~
EAGf.N TOWNSHIP
3795 Pilot Knob Rosd
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
Date:~a~~~ 9 Number• 283
Billing Name: Wy~ ' Site Address: of y/,3 1J
Owaer:~3 Billing Address
Plumber: LZ_7~lg7
Location of Connection Meter Size~9f' Connection Chg. ' d
Meter N4,/ Permit Fee
Meter Reading u~-~ MeCer Dep.
Meter Sealed: Yes Add'1 Chg.
NO Total Chg.
F+Y~
Inspected by
Date
Building is a: Remarks:
Residence
Multiple No. Units
Commercial
Industrial Hq:
Chief Inspector
Other
In consideration of the iseue and delivery to me o£ the above permit, I
hereby agree to do tte proposed work in accordance with the rules and
regulations of Eagan Tocanship, Dakota Countp, Minnesota.
By:
Wenzel Plumbing & Heating Co.
Please notify the above office when ready for inspection and connection.
OUTSIDc WORK OADER
~Ei1.LL~ ~
FRO'd:
Of '.~i _',:";•~;f: ii
Chicago Title Insurance Company 11~6 1978
60 East 4th Street
St. Paul, Minnesota 55101
Teleplione: (612) 227-7226 r `
Toc
D -1 i F'
I~
uE: FILE No. Legal Aescription:
Address°: - - - ,
Please Search the records of:
( ) County ,
;
( ) City of
and furnish the ol owing in ormation in connection with the above:
(NOTE: Furnish only that information indicated by "X")
t•take new abstract covering above legal description
Make new RPC covering above legal description
Continue abstract covering above legal description (Abstract encloaed)
( ) Dtake no searches
( ) Delinquent Tax
r) Taxes for the year 19
Total Amount Homestead
Base Tax Non-Homestea
Not Paid DistriCt _
First Half Paid Plat
Paid in Full Parcel
The unpaid amount of levied assessments, including any interest due.
The amount or approximate amount of pending assessments for local
improvements.
NONE
( ) Water Tax
Easenents as si:own on the recorded plat.
( ) .7udgments ( ) Hankruptcies ( ) Federal Tax Liens
on the following:
Such search discloses the fol.lewing:
Uud9ments Bankruptcies Federal Tax Liens
( ) Check for $ is enclosed.
send statement to pay if there is a charge for the above requested
information.
NOTE: If more room is needed than provided on form, use reverse of the
this form and indicate that reverse is used. SEE REVERSE.
I hereby state that the aboye is, to my knowledge, a true and correct
stutement. {/GJ/
IIY Assessment Clerk /-~e~efr~-- _DATE=z 1,079 _
CTI T--121 (6-72)
;[l.V:X YCU.
s,
~-~-c~ ~ o s 6, 3
PERMIT; #J1 6~ 'CYCLED A/5C B& L£LECTRIC, ~`INC.
BEVERLY GUSTAFSON EDWRRD LANGE
1689 COVINGTON LANE 4684 RIDGE CLIFFE DRIVE
EAGAN, 14N EAGAN, t4N
ARNOLD DUBBELDE JOFIN DETERS
4425 SLATER ROAD 4423 SLATER ROAD
EAGAN, T1N EAGAN, IdN
CHARLES SHIRRODI BRUCE CROSBY
4714 W. WIND TRAIT, 1761 WALNUT LANE
EAGAN, MN EAGAN, MN
NOAt•IAN PETERSON k0Y CREELPIAN
4337 SEQUOIA DRIVE 1883 BEAR PATH TRAIL
EAGAN, MN EAGAN, MN
JAMES DAHLBERG TERRY DAVIS
1641 MALLARD CIRCLE 4895 SAFRRI PASS
EAGAN, MN EAGAN, MN
Use BLUE or BLACK Ink
r
For Office Use
►t-f1
• , . ' Cit of Ea
Ed11 I Permit ~ I
J
I Permit Fee:
3830 Pilot Knob Road l U j
Eagan MN 55122 I Date Received:
Phone: (651) 675-5675 I
Fax: (651) 675-5694 I Staff: _ I
I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
Name: Phone("^6 5 ` -45
Residentf'
Owner. Address/ City /Zip: 43,37 ✓ ~ "
Applicant is: Owner Contractor
Description of work: 42 r ~
Type of Work / v
Construction Cost: / Multi-Family Building: (Yes / No
Company91Z l '1,-J (Al u(T col -~T Contact:
v
Contractor Address6) ~o- 3( 1 211 City: ~0~q,
State: ~f v Zip: Phone:
Lead Certificate CP'rj
~
License #:FCC,
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:
_
_ m . Pz, .m .~.e•• r . a e ~_.m. ae... w.
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.ora
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. r r
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Applicant's Printed Name App Ii s i ure
Page 1 of 3
Use BLUE or BLACK Ink
� r________________i
I For Office Use �
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� � Permit#: ��� �� � I
Cit of �ao '� � � �
Y b� I Permit Fee: �
3830 Pilot Knob Road � i
Eagan MN 55122 i Date Received: �
Phone: (651) 675-5675 � �
Fax: (651) 675-5694 L Staff: ______________�
2015 RE IDENTIAL PLUMBING PERMIT APPLICATION
�
Date: Site�ddress:
Tenant: Suite#:
�p� ��� �i�' �� ��in� � Name: U r Wl C' �''S��l Phone:�S"/ c�S�—(�5��.�'
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� �� � Name: License#:
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�° �� Descripti n of work:
��r��'��; �� '"4 � RESIDE TIAL
5��� i��� �
� �
� ,� . � �Wat r Heater �
�r��� � � �Water Softener � �
� � � a� � � � La Irrigation�RPZ/_�PVB) �
�� � ��YP���
�� �,�� ��R � ����� Se ic S stem Add Plumbing Fi�ures�Main/_Lower Level)
����u���� � '� � ����o P�� Y
���° �,��� NeW WaterTurnaround
��u w � n;,
�� "� Abandonment �
RESIDENTIAL FEES:
$60.00 Water Heater, Water So ener, or Water Heater and Softener(includes$5.00 State Surcharge)
$60.00 Lawn Irrigation (includes 5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, e tic S stem Abandonment, Water Turnaround*(includes$5.00 State Surcharge)
"Water Turnaround (add$2 0.00 if a 5/8"meter is required)
$115.00 Septic System New($1 .00 per as built)(includes County fee and$5.00 State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. C II Gopher State One Call at(651)454-0002 for protection against underground utility damage.
Call 48 hours before you intend to d g to receive locates of underground utilities. www.gopherstateonecall.orq
I hereby acknowledge that this informati n 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 ermit, 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 th case of work which requires a review and approval of plans.
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Applicant's Printed Name Appli ant's Signature
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