4393 Sequoia Dr CITY OF EAGAN ~,T
3830 Pilot Knob Road, P,O. Box 21-199, Eagan, MN 55121 l~l ~ 9 A 3~
BUILDING PERMIT PHONE: 454-8100 Re~'~ #-~2 '
J
Te b~ wed for Sl^lIf 1 PGOL Est. Volue r} , n~ 0 Dote Cii]:: 6 , 19 i; 9
393 SErU02A I'~R " ; :
Site Address ~ Erect d~~ Occuponcy
~ot c sio~k 6 ~/sub. ~VERGREEN PY: ~,irer 1~
10-24EF30-G4-O6 ? z~~~ iv ri
Parcel No. Repoir ~ Fire Zone
a Name CE'1VII~ SUP.'llB'i:R(_ Mov~ ~ TYPe of Const.
Z ? Stories
~ Address ~i' _ Demolish ? ~ength
City Phone Grade ? Depth Sq. Ft.
Vi~LLL'Y I~GOLS JNC Approval~ Fees
o Name
i~; . ~G
O~ Addres~s. ~ r~~ t~~ Assessment Permit
V i i~'.', ~~_,1~>~. ' ~ ='f .
1- City Phone ~ 1~"~ Water E~ Sew. Surcharge
Police Plon check
~W N~T1e Fire SAC
~
xZ Address
E~. Water Conn.
~W City Phone Plonner Water Meter
Council Rood Unit
1 hereby ocknowledge thut I hove reod this opplicotion and sto~e that g~dg. Off. -
the intormotion is torrett ond agree to comply with oll opplitoble ~
Smta of Minnesoto Statutes ond Cify of Eogan Ordiplances. ^PC Totol
; y, _ , /
Sipnaturc of Pertnittee / k,~fi~-.~`.. F.%--~ l-~~ -U`I ~
i'LI,~~~.Y i'('~ L~' ~ C~~+,
l1 Building Permit is issued to: - on the expreu condition tFun
all wo~k shall be done in accordonce th p~~ll o/ppllcoble State bf l~innesoto Stctutes and City of Eayan Ordinances.
Buildinp Officiel C./('_-~- ( ~.C-w_,--e~
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CtTY OF EAGAN
, 3795 Pilo~ Kno6 Rood En~an, MN Sb122 N~ 5 2 9 8
PHONE: 4'f4-8100
BUILDING PERMIT Receipt #
Te be uwd For Est. Value Dote , 19
Site Address Erect ? Occupancy
Lot Block Sec/Suk;.' - ~C~ Alter p Zoning
Parcel i~~~v, Repair p Fire Zone
Enlarge ? Type of Const.
W Nome Move ? Staries
; Address Demolish 0 Front ft.
b ~ ] ; ~ Grode ? Depth ft.
Ci Phone
o Name APP~~I~ Fees
Address Assessment Permit
~ Ci ph~ Water 8 Sew. Surcharge
Police Plan check
~
FW N~?^~ Fire SAC
Address Eny. Woter Conn.
a W Ci Phone Planner Woter Meter
Counci I
I hereby acknowledge thot I have read this application and state that Bldg. Off.
the informotion is correct and agree to comply with all applicable APC Total
Stote of Minnesota Statutes and City of Eagun Ordinonces.
Signature of Permittee
A Building Permit ls issued to: on the express condition that
oll work shall be done in acoordante with oll opplicable State of Minnesota Statutes and City of Eagan Ordirances.
Building Official
?MnM # paR~ Inwd ~~ewNtK
Plumbing
Mechanicol
INSPECTIpNS DATE IMSP. Rouph-In Finai
Foor~nys -9~7 note ~ro~. ~ora ~~uo.
Foundation Plumbing
Frame / i ns. Mechonicu i
Finol
Remarks:
CITY OF EAGAN Remarks wtr & s2W COY1T1 pd Ori 3-~ 2-7'I
Addition E~rerLreen Park ~ot ~ eik 6 Parcei ~ 0 2~88_ o o~~o o6
Owner - ~-~-Street ~393 Sequo3a Dr. State Eagan~Nav 55~ 22
, , , 1 ~ ~ ~ ~ ~
Improvement Date~ Amount Annual Years Payment Receipt Date
STREET SURF,
STREET RESTOR.
GRADING
SAN SEW TRUNK ~ O Z
SEWER LATERAL
~
WATERMAIN
WATER LATERAL
WATER AREA
STORM SEW TRK ::%-,':Z
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN, 26 ~ ~
BUILDING PER.
SAC
PARK
~g REQUEST POR EIECTRICAL INSPECTION ee-oooova
A. 1 e imt~uetians for completi~q this fwm on EGCk Of yallow eopy. ~1~'1
~ ~ V
"'X'" Be/ow Work Cove~ed b~;,Thrs Request
J
Adtl Nep. Typa ol Builtling Apo~~eneea Nir~E EquipTent Wlred
Home Range Tempo~ary Service
Duplex Water Heater Lightin Fixtures
Apt. Buildinp Dryer Electric Hee[in
Commercial 81dg. Furnace Silo Unloader
Industrial B~dg. Air Conditioner Bulk Milk Tank
Farm cher Dec~ y t er 15aecityl
Vo~~ Y t or Oth~3r
ompute nspection fee Below
p Fee ServicaEntrenceSiza q Fee Feadars~S~bfeatlers M Fea Circuits
0 to 200 Am s~ 0 to 30 Am s 0 to 30 Am s
Above 2_Am s 31 to 700 Amps 31 to 100 q
~ Swimmin Pool Above 100_Am s Above 700-Am •
Transforme~s Irri tion 8ooms Partial-'Other Fee
Signs Speciallnspaction S •
a~~ ~ OTA EE
• ~Q .m
Houeh-m - oac . .
F~ the EI
~ nspector, hare~y
rtify <hei the ebova
Final ~ te~j~ pactlon has Eeen
~i/(J mada.
(IW repueat vdtl 1B montM irom
this reauestvoid ~ 2`. ~(~}.(,~QrQ(w P/,~ (Q{ L •
~A 16 7_ 41 ~ a`~`~ f ! - • L ~ ~ " ~
Req~e~D te Fire No. Hou -in Inspection
G Rea ~etl~ ady Now Q W~11 Notify, Inspec-
6 es ?Na tor When Reatly
~ Licensad Elecirical Contrector I heraby reuueat inapection of ebo~e
? Owner elactrical work inatalled at:
Straet Address, Box or R ta No. .
ecti n o. wnship Nama r No. Renga o. Coun~y
OccuO'nt (PRINT) P~ona
/No.
J ~
Powa upplier Address
S
Electrical ConVactor ICOmpany N mel ConVactor'S License No.
Mailing Ad ress ~Conv tor or Owner M ne ~~steilationl
Auth' ' ed 'B~a onlracto Owner M3kinB ~nstailat ol Ph ber
r '
MINN OT A E BOARD OF ELECTRICITY ~ THIS NSPECTION REQUEST WILL NOT
Orippa-Mid y Bltlg. - Poom N-781 eE ACCEPTEO BY THE STATE BOARD
1821 University Ava., St. Paui, MN 6510< UNIESS PROPER INSPECTION FEE IS
Phona 18721 297-2111 ENCLQ4ED.
c~Tr oF eacnN
• ~ 3795 Pilot Knob Road Eagen, MN 551~2 N~ 5298
PHONEt 454-8100
BUILDING PERMIT APPLICATION Receipt # 15065 _ _
$3~000.
To 6e u~ad for Dec~L d SCreen Ad[kst. Value Date `7uly 6~ 1979
~
Site Address 4393 Se uoie Dr. Erect p~ Occupancy R3
Lot 4 Block Sec/Sub. ~ ~ Alter ? Zoning RL
Porcel # Repair ? Ffre Zone 3
Enlarge ? Type of Const. V
a Name DBVid Sundberg Move ? # Stories
; Address Demolish ? Front lZ ft.
b Grode ? Depth 14 ft.
Cit Phone 454-7Y17
' ~ Name Apo~o~ais Fees
o Address Assessment Permit 12.00 _
u~ Ci Phone Water & Sew. Surcharge 1. $0
Polite Pfan theck
~w Noma Fire SAC
Address Eng. WWer.Conn.
aW CI Phone Plonner WaterMeter
Council
I hereby ockrwwledge that a eod ~is opplicotion and state that g~dg, p~{.
the information is corre and a ree o compl w th ail applicable APC Total 13. SO
$tote of MinnetWa Stat t d i of Eo rdinantes.
Signature of Permittee
A Building Permit is iss d to: DBVi SUII on the express mndition ihat
all work shall be done in accordance wit oll ap ' of Minnesota Statutes and City of Eagon Ordinances.
Building 04fiGUl Q~(6.ps ~'r
!
. . • ~~1~
CITY OF EAGA.`I ~ 4'hc ude 2 sets of plans,
BUILDING PERMIT APPLICATION 1 site plan w/elevations S
1 set of energy calculations.~
~@cK d~-~ 1 _ G~ ~
To be used for _~,cr¢,~ r d~~ GishValuatfon ~~4~' Date l 7/ }
Site Address ~3 ~3 SeQ V V i 0. ~Y ~ OFFICE USE ONLY ~
Lot Block ~ Sec. /Su . , Erect Occupancy A 3° ~
Parcel !F _ `~Z~j SL,~'/rQ Q'qtQ ~(p Alter Zoning ~
Repair Fire Zone
Owner: ~{~"V~~ ~UA/D (3F?~C Enlarge Type of Const. ~
Move b S[ories
Address: y 3 Cj 3 S e C~iAi Demolish Front ft.
Grade Depth ft.
Phone Il: i
Approvals Fees
Contractor: ~ ~
Assessment Permit__~,
Address: Water/Sewer Surcharge~l~
Police Plan Check
Fire SAC ~
Phone ll: Eng. Water Conn. ~
Planner Water Meter :
Arch/Eng.: Council oad Unit ~
Bldg. Off.
Address: +
~
Phone ll: TOTAL I
1 .
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20
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67~ 19
This r~a~ void 18 months from~(J~~/Z~L'
~~C',~~~~ /lp~~p
j R
Date of this Request /o 5 3 21
I, as 0 Licensed Electrical Contractor'~Owner, do hereby request inspection of the above electri-
cal wiring installed at:
S2reet Address or Route No. - City~E""
Section Township Range Count~.~~-~-t~
Which is occupied by ~ ~ ~ ~-~~-~~-=-~r,y
(Name of OccuDant)
Is a roughin inspection required on this job? No ? Yes`~ Ready Now ? Will Cali` I
s.,S<"_c3si
Power Supplie~~-~-~- ~~1fldr@ss ~ s_ '
Electrical Contractor Contractor's License No. _
pany Name)
Mailing Address
Electtltal n acto~ or Ownar Makin9 Tnls Installatlon)
Authorized Signature Phone No. 7 7~~
( cal Contractof or wner Ma nq Thls Installatlon)
~`Rf This inspectian request will not be accepted 6y the
~J State Boerd unless proper inspection fee is endosed.
Minnesota State Board of Electricity /
' 1954+University Ave., St. Paul, Minn. 55104-Phone 645•7703 l~O 3~ d
'REQUEST FOR ELECTRICAL INSPECTION 'R 5321
CH~K BELOW WOIiK COVERED BY THIS REQUEST
Type o[ Budding New Add. Rep. Check Appliances Wired For Check Equipment Wirod For
Home ? ~ ? Rangc ? Temporary Wiring ?
Duplex ? ? Water Heatex ? Lighting Fixtuxes ?
Apt. Bldg. ? Dryei ? Electric Heating ?
Commercial Bldg. Fumace ? S0o Unloader ?
Industrial Bldg. Ai~ Conditionec ? Bulk Milk Tanlc ?
py~ ~ ~ ~ pList pList
Other ? ? ? Hehers~ .Heie~g~
COMPUTE INSPECTION FEE BELOW ~ ' ~ ~
Seivice Enttance Size: n Fee Feeders&Subfeeders: # Cucuits: # Fee
0 ro~100 Am s. 0 to 30 Am res to 30 Am eres
101 to 200 Amps. 31 to 100 Amperes 31 to l0U Am eres
Above 200_Amps. Above 100 Amps. Above 100 Am s.
Transformers RemoteControlCvc. Paztialoro[herfee
Signs S ecial lnspection Minimum fee 55.00 ~=-d
Remarks TOTAL FEE d
I, the Electrical Inspector, hereby certify~the ~ e~ p~ecti/o~,has been mad . l(o
(Rough-in) (/~J J~"Y"°~`Date
(Final) i~.~~4=-~~ Date ~H~
This request void 18 months from `
~ ' ' TOWN OF EAGAIQ ~~P ~ , ~
3795 Pilot :cnob Road
St, Paul~ piinn. 55111
PEPS3IT N0. 94
The Board of Supervisors hereby grants toWenzel Plumbing d Heating
of 1955 Shawnee Road St. Paul 55122 a
vt.rtt•tnrtur. Pexmit for: (Owner) W~nsmann Construction at
~~4,3~~~a ~ivP~ S_ pn , 55122 , pursuant to application dated
MA_~h 1?,~ 1971
Fee Paid: ~~n~_p~ Dated. this~~day of Ar 7, , 197 1._.
Building Inspector
~ I . ' / J\I~
. TO47PT OF EAGAIQ
3795 Pilot :Znob P.oad
St. Paul, riinn. 55111
PEE2MIT A10. $9
The Soard of Supexvisors hereby grants to Kleve Heating d Air Cond,
Co~ o~ 13075 Pioneer Trail, Eden Ptairie. 55343 a
`~EATING Permit for: (Owner) Wensmann Construction at
h993 Ser}d~oia n~a~•a pursuant to application dated
'+!9/_2].
Fee Paid: S20.00 Dated this 12th day of March , 197_ 1,
Building Inspector
' ' EAGAN TOWNSHIP
BUILDiNG PERMIT ~a 2389
Ownex .....G.V._' . ......`CL...~'°.~..:.---.-'-'-"'--'-' Eagan Township
Addsess (presen!) ....__.~~~0~'."~~.._~`.`..^..~':'~..... Town Hall ,
Builder ..........~4.:~.....-°--.........--
Date ......I..a~.L.7I
Address
DESCHIPTION
Slosiea To Be Used For Froa~ De~ Heigh! I Est. Coat iPerm!! Fael ~ Aemarki _
oZ ' _ J . 3t> yS~ a9~ .-~-o .~5/. /a~ .a~:t.c-..4-~i~-w._
~-~.g-c-~-
~~~rX.~- ~>-Xii LOCATION ~
8lrea2, Road oihe: Deecripiton oi Loca!!on I Lo! Slock Addiifon or T:ac!
~ 3 93 ,6~,~. .~f ~ ~"'''.c~
Thia pesmi2 does ao! auihoriae he vae of streefs, roads, alleys or aidewalks aor doea i! give !ha owner or his agen2
!he xighlYO ereaie any si2uation which is e nuisance or which presenls a hazard !0 1he healih, sefetp, conveaience and
general welfare !o anpone in !he eommunify.
THIS PERMIT MUST BE KEPT ON TH£ PAEMISE WHILE THE WORK IS IN PROGA SS.
T6ia is !o eerfify. !6al..~W?~'!~.^^^-t-...~.~._:""..~~..----..hes permission !o e:ec! a... . . ................._upon
!he above described premise subjec! !o !he provisions o! !he Building Ordinanee for Eag Townshi adopled Apsil 11,
1955.
]Jg~~ C
..."'....._'-'........""'...~_...'-'~...,l.."~^'_':...-"'. Per ................p.v.-~"`^- .
- "_.....""""'g......P........._'_"_..
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a4rman of nwn Board ~ Bnildin Ins eelor
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• LOCATION ~L1~ Q~ a ~~g~ C r~•
OWNER Q h
S a~ ` ~ r J~
STRUCTURE AND
LAND USED AS
~ .
.
Issued To
Permit No. Issued Coniracfor Owner
BUILDING ~ 'n i~/f M t
~v-i ~cv
PLUMBWG ~ 1~ Q i,J~h z e I
CESSPOOL - SEPTIC TANK
WE~L
ELECTRICAL
HEATING ~I ~
GAS INSTALLING
SANITARY SEWER I ~,JtNs ~
OTHER ~ I
~i--/- I ~ '
OTHER
• Approved
Items (Initial) Date Remarks Distance From Well
FOOTING ~ ~ / zv~y-~i SEPTIC
_~r,~-
FOUNDATION . ~r~'+ CESSPOOL
FRAMING ~ ~fr~ ~ TILE FIELD FT.
FINAL
ELECTRICAL
DEPTH
HEATING ~ ~~~~7 OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING ~
WELL
SANITARY SEWER~ y~ ~
~c_7- '
~ ~
_~.~~a~_ /
_ s' ? ~ ' ~'f
• Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS
. TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
~
PERMIT NO. DATE Of INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE ? NON-COMPLIANCE. BUILDER DOES NOT
OBSERVED. INTEND TO COMPLY.
ACCEPTABLE SUBSTITLITIONS OR
DEVIATIONS. ? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBE~ AS FOlLOWS:
'
? REINSPECTION REQUIRED DATE OF REINSPECTION •
REINSPECTION REVEALED
CERTI FICATION -1 certify that I have carefully in~ected the above in which I have no interest preunt or prospective, and 2hat 1 have reporced herein
all significant conditions observed to 6e at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property in~ected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILOING INSPECTOR DATE
COMMENTS:
~
~ :3
CITY OF EAGAN N~ g136
3880 Pilot Knob f~oad, P.~. Box 21-199, Eagan, MN 55121
PHONE: 4548100 ~-l ~ I
BUILDING PERMIT Rece+pt # d ~
Te 6a ated hr SWIM POOL Est.Yolue ~8.000 po~e JUNE 6 ~g 84
4393 SEQUOIA DR M
Site Address Erect Occupancy
Lot 4 elock 6 sec/Sub. EVERGREEN PK Altar ? Zoninq R1
ParcelNo. 10-24880-04-06 Repuir ? FlreZone N A
~ Enlorge ? Type of Const. V
DAVID SUNDBERG
Name Move ? # Stories
Z Address S~E Demolish ? L¢ngth_
~ City Phone 454-7717 Gmda ? Depth Sq. Ft.-
s VALLEY POOLS INC Avv~ovob Faes
o Name RD Asses:ment Permit ~_50
~ A~r~ E 894-1480 Water&Sew. Surcharga 4.00
K
City Phone
Police Plon check
~W Name Fire SAC
S~ Address Erp. Water Conn.
u
<W City Phone p~o~~~ Water Meter
Countll Rood Unit
1 hereby ackrwwted9e th t hav read this applicotion and state that Bldg. Off.
the fnformotion is corr t an ee to comply with oll applicable . Q
State of Minnesma Stat s d ~ y of Ec on O di a~ces, APC Toto~
i
Signoture of PermiHee
A Building Pertnit Is issued to: ALLEY P OLS IN(.' on the express mndition thm
oll work shall 6e done in acwr once ~th ail pplicable a f nesoto Stmutes and City of Eapon O~dirwnce:.
Buildiraiq Officiul ~
_ ~
r// CITY OF EAGAN Include 2 sets of plans,
• y/~ / . , 16ertificate of Survey~&'
~ x~ BUILDING PEI~IIT APPLICATION 1 set o£ energy calculations.
4b `Be Used For ~ aluation -A ~DTta Date . ~ ~
Site Pddress ~ ~ pFFI(~ USE ONLY
~.or ~ sio~x s~. ~n P.~~~~r o~~~y.
raroel ~~~t~~ Alter Zoning
~ Repair Fire Zone
Owner: i/r9~v~D ~ts,+o~ ~~3e _ TYPe of Const.
Address• ~ ' ~i ~ ~ M°`re # Stories
. Dsnolish Front ~/o ft.
City/Zip Code: 3/ ~ Grade Depth ~o ft.
Phone / 7 ApPROVAiS ~S ,
Contractor• ~ pa ~ Assessments Pexmit
?aater/S~aer Surcharge " y ~
Address: ~ Police Plan (~eck J '
City/Zip Code: I~u2ns ? i 1 ~7n Sti~37 Fise ~
Eng. Water Conn.
Phone . ~9Y - /yd'd planner water r~eter
Council Road unit
~~~~g•~ Bldg. Off.
Address: ~
City/Zip Code: _
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EAGF.N TOWNSHIP
3795 Pilot Knob Road
SC. Paul, Minnesota 55111
Telephone 454-5242
PERNIIT FOR WATER SCRVICE CONNECTION
Date: 3/12/71 Number: 551 H rO ~+f
•
.u~ 9~
Billing Name: Wensaann Construction Co. Site Address: ~363 Sequoia Drive
Owner: Wensmann Silling Addreas
Pl~ber: Wenzel PlumbinQ d Heating Inc.
Location of Connection Meter Size-~~ Connection Chg. 260.00 nd 3/31/71
~ ~ .a/a ~0 7
,~r Meter No,aiyiS~L Permit Fee tn_nn p~/12/71
'V
Meter Reading Meter Dep.
Meter Sealed: Yes_ Add'1 Chg.
NO Total Chg.
Inspected by
Date
Building is a: Remarks:
Residence
F~~~
t4ultiple t~o. Units t't"~ :v;',`~~~ FE~.~~"~,t~-
n~
Commercial 2~.~' ,~i,~r~ t.v ~~cj",~~`~ l.r~.:-.
•.Y.'•;ii..l
Industrial By; +
Other Chief InspecYOr
In conaideration of the isaue and delivery to me of the above permit, I
hereby agree to do tYe proposed work in accordance with the rules and
regulations of Eagan Township, Dakota Count Minnesota.
By• ~ Q
Wenzel P umbinR S Heatin~, Inc.
Please notify the above office when ready for inspection and connection.
j ~ \
EAGHN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE: March 12, 1971 ~ggg 710
~3 ~y
OWNER• Wensmann Construction Address Sequoia Drive~ St. Paul !.~>(g ~~F', ,
pL~ggg Wenzel Plumbing d Heating Typg OF PIPE cast iron
DESCRIPTION OF BUIIAING
Icxluatrial Cormnercial Residentiel Multiple Dwelliag No. of units
xxx
Location of Connections: Connection Charge
Yermit Fee 10.00 nd 3/12/71
Street Repairs
Total
Inepected by:
DaCe
Remarks•
By
Chief Inspector
Ia consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulationa of Eagan To~~nship, Dalcota County, Minnesota
By
Wenzel Plumbing d Heating~ Inc.
Please notify when ready for inspection and connection aad before any portion
of the work is covered. •
c~
2oos RESIDENTIAL PLUMBING PeRMiraPP~icaTioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date~ I
Site Street Address y 3 q 3 S~,~P ~f. [a~ Unit #
Property Owner A v. h i~ C b~r u Telephone # 4 bs( ) y~ri y- ~'717
-v
co~tr~~to~ P~~~ ~ c t" ~ ti~h i~~ 1 NLs Telephone L^SI ) yE°3 -7o i l
Address ~t~ 5D - a t'~r Si~. c~ty f'h~nn;~~+-c u~ 5tate Mtij z~p ~sva~r
The Appiicant is: _ Owner ~ Contractor _Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee inciudes installation of a water softener and/or water
heater at the same time. If you are installing only a water softener and/or water
heatei, do not complete this section; move to the next section and check the
appliance(s) you are instailing.
_Septic System Abandonment
_Water Turnaround (add $130.00 if a 5/8" meter is required)
Other:
Water Softener ~ Water Heater $ 15.D0
_ new ~ replacement
Lawn Irrigation _ftPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
Total $ ~5 D
I hereby apply for a Residential Plumbing Permd and acknowledge that the information is complete and accurate; that the
work wili be in conformance with the ordinances and codes of the City of Eagan and the piumbing wdes; that I
understand this is not a permit, but only an application for a permit, work is not to start without a permit and work wili be in
accordance with the approved plan in the event a plan is required to be reviewed and approved.
fti`1 k tC ; ~~s~+;. l~
ApplicanYs Printed Name ApplicanYs Signature
~
i
~ ~or Offl,e_e:Use ~ ~
Clt~ 0~ ~~~~Il ; Permit # U7j~ 02 V j
~ PermitFee: ~v" ~O I
3830 Pilot Knob Road • ~ ~
Eagan MN 55122 I Date Received: ~ j
Phone:(651)675-5675 ~ ~
Fax: (651) 675-5694 ~ Statf: ~
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: f~' 7~ G~ Site Address: ~
1' ~e U D ~ l'~
Tenant: Sulte
RESIDENT / OWNER Name: iJi?~ Q Phone: !~S I` 7-S~'~/~ ~
Address / City / Zip: ~/d ti- ~~v
Applicant is: V Owner _ Contractor
TYPE OF WORK Description of work: r
O_~
A~~ ~e-o~ ~P5
/ ~
Construction Cost: l~. O DU Mutti-Family Building: (Yes _ I No
CONTRACTOR Name: License
Address:
City: State: Zip:
Phone: Con[act Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheel
Category Suhmitted Submitled
submissio~ type) • Energy Envelope Calculations Submitted
In the last 1.2 months, has the City of Eagan issued a permit for a similar plan based on a master planT
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contrector: Phone:
NOTEi Plans and supporting documents that you submit are considered to 6e public informafion. Portions of
the information may be classlfied as non-public il you provide specific reasons that would perinit the City to ,
conclude ihat the are trade secrets. .n
I hereby acknowledge tha~ this information is complete and awurate; that ihework will,be in confo ance with ihe ordinances and codes of the City of
Eagan; that I understand lhis is not a perm0, but onty an application for permit, and ork is ol o start without a permiY that the work will be in
accordance with Ihe approved plan in the case of work which requires a revi w and approva of pla s. ~
x J,l~/~Y~. SU IUd~e V~j
Applicant's Printed Name p icant's Signature
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