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2079 Shale LaneCITY OF EAGAN 3795 Pilet Knob Rood Eagan, MH 55122 N2 5067 PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for T-vlr7 r'10-I t Est. Value n' non. Date 19 .7'"' Site Address :?q79 17!kile T`-ir Erect ? Occupancy T ? /S b t Bl k S L Alter ? Zoning ec u . o oc Repair p Fire Zone Parcel # Enlarge] Type of Const. W To?zn J. & :Yathl??r- P1. Dtt k-!.- Nome Move ? # Stories , z ?07^ S21,11e Tan(- Addrefte Demolish ? Front It ft. Ci + am m Phone - Grade ? Depth ff. °C Name I ''.LT-Xre c^x;i 0 n F o Address T` u§ ,. r n.. o?..,.,s Name _ Address I hereby acknowledge that f have read this the information is correct and agree to c State of Minnesota Statutes and City of Signature of Permittee A Building Permit is issued to: all work shall be done in accordance with Building Official and state that oil applicable Assessment - Water & Sew. Police Fire Eng. Planner Counci I Bldg. Off. APC Fees Permit Surcharge Plan check SAC Water Conn. Water Meter Total on the express condition that State of Minnesota Statutes and City of Eagan Ordinances. Permit # Date Issued PWW&Htee Plumbing Mechanical 3$ ~ 6 - 9 A,-ee-?-(?aor? tctl 5 AI e_.- C?t_i e . 8 L l - / I - 7 YYl .?-u rat . c . INSPECTIONS DATE INSP. Rough-In Final Footings Date Irap. Date Insp. Foundation O _ Plumbing Frame/ins. Mechanical Final Remarks: CITY OF EAGAN 8795 Pilot Knob Road Eagan, Minnesota 55122 Phone: 454-8100 IMAam1; PERMIT Dote: 1-16-79 Site Address: '179 Shale Lana Q Lot Block Sub/Sec. Nome Gimmesch 00W t- . 8 Address City ? E. Stamlit Im-k-- Ville 55337 Phone: 435-6121 me cksm 4.tg. & P,1C Address 4!n 30 Beau D' -1m Drive City Phone: This Permit is issued on the express condition that all work shall be Minnesota Statutes and City of Eagan Ordinances. 00 I ISTICN AIR RROTIIM-) No. 138r Receipt No.: Z ?Gtl? Single Residential Multi Res., Comm./Ind. New/Alter./Repair. Cost of Installation Permit Fee Surcharge Total done in accordance with all applicable State of Building Official CITY OF EAGAN Remarks * Cedar Grove Acquisition Addition CEDAR GROVE #4 Lot 2 Alk 8 Parcel 10 16703 020 08 Owner Street 2079 Shale Lane State Eagan, MN 55122 -- , Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK * SEWER LATERAL 1972 1,304.00 52.16 25 886.72 A007532 3-21-79 WATERMAIN * WATER LATERAL 1972 WATER AREA STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK *e?uest void 18 months from / C99 7 R37876 Date of this Request ?.1 7?j 1, as ? Licensed Electrical Contractor ? Owner do ereby request inspection of the above electri- cal wiring installed at: L -?a, 8 8 C Street Address or Route No. zrl- 471 J93 r!#A16 Cit 'VA7 Section Township Which is occupied by Range County Do yI/J 7V Is a roughin inspection required on this job? No ? Yes jFd Ready Now ? Will Call Power Supplier DAkd A & Fi4L4r' Address A;0)ek 9 -.196-V Electrical Contractor __&4.E2fw, "r- Contractor's License No?;;' (Company Name) Mailing Address _ ?02 y? J ?p(yl??' lv4 4' S/4 1-1WC j /f ( ctrl cal nt ra or or w?ner aakin9 This tnstailation Authorized Signature _Phone No (EI cal Contractor o O e king This instailationl D v Copy This inspection request will not he accepted by the ?jo ®? State Board unless proper inspection fee is enclosed. PAM - Minnesota State Board of Electricity 954 University Ave., St. Paul, Minn. 55104-Phone 645-7703 EOUEST FOR ELECTRICAL INSPECTION CH&CK BELOW WORK COVERED BY THIS REOUEST 199 7 R 37876 Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For Home ? ? Range ? Temporary Wiring ? Duplex ? ? ? Water Heater ? Lighting Fix tares Apt. Bldg. ? ? ? Dryer _Q Electric Heating ? Commercial Bldg. ? ? ? Furnace Silo Unloader ? Industrial Bldg. ? ? ? Air Conditioner Li t %ti?1? 1 Bulk Milk Tank Li ? Farm ? ? ? s _ - st Othe[ El El El Others ? Here Others ftHere 111111 COMPUTE INSPECTION FEE BELO Service Entrance Size: # Fee Feeder ub ers: # Fee Circuits: # Fee 0 to 100 Am s. 0 to 3 m eres 0 to 30 Amperes 101 to 200 Amps. 31 to 100 Amperes 31 to 100 Amperes Above 200 Amps. A?Amps. Above 100 Am s. Transformers Remote Control Circ. Partial or other fee Signs Special Inspection Minimum fee $5.00 Remarks TOTAL FEE S I, the Electrical Inspector, hereby certify that the above inspection has been rr(t1/J (Rough-in) Q_ _ Date (Final) This request void 18 months from EAGAN TOWNSHIP BUILD//S?ING PERMIT Owner ..._1-S::a: -6 .. ------------ Address (present) ...... Ja......... '?:.:._._;? ? . Builder ..... .........? -44^....c"L .._.........._......... Address ...... DESCRIPTION N° 1361 Eagan Township Town Hall Date GS stories To Be Used For Front Depth Height I Est. Cost. Permit Fee - Remarks TION Street, - xoaa or omer uescrtption or Location Lot Block 1 Addition or Tract 7- / C . C This permit does not authorize the use of streets, roads, alleys or si ew s nos o s.t ive the owner or his agent the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and general welfare to anyone in the community. THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. This is to certify, that.. .... ..:....e4t..-:°..:..?.'.a....................... has permission to erect a.....L.._....._ upon the above described premise subject to the provisions of the Building Ordinance for Eagan T wnship? adopted April. 11, 1955.. .............. ......---------- .. [!!.... ......-..~!......'----. Per .._`.---0-.C------ Chairman 'x-c:c4..r.......__....._.... of Tnwn Botard? / Building Inspector - CITY OF EAGAN 37" Pilot Knob Road Eagan, MN 55111 •? PHONEt 454-8100 BUILDING PERMIT APPLICATION Receipt # Site Address " r ? a Lot 2 Block $ Parcel 4 8.000. Sec/Sub. CG 4 w Name JOhn J & Kathleen M DuMaS Address 2079 Shale lane Eagan D,....e 454-6136 p Name BQ= CrQM1e2Ch oU Address 409 E. Summit lane "? ?,. B' Ville P6m . 435-7105/435-632 Name _ Address 1 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 Statuteey?¢ Kd City of E on dinances. Signature of Permittee?'LU?1?L/? N2 5067 a.S70 Erect ? Occupancy T Alter ? Zoning R1 Repair ? Fire Zone Enlarge ;] Type of Const. Move ? # Stories Demolish ? Front - I$ ft. Gmde ? Depth 14 ft. Aearovols Fees Assessment Water & Sew. Police Fire Eng. Planner Council Bldg. Off. APC Permit Li.VV Surcharge 4.00 Plan check SAC Water Conn. Water Meter Total 31.00 A Building Permit is issued to: Kathleen . Dtmlas on the express condition that all work shall be done in au once with If pplicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official ?t'f ° EAGAN TOWNSHIP BUILDING PERMIT Owner ............. - 0.1-.t . ... ... ............................. Address (present) .._?......7..2............ ;;Ie Builder .......I .......I.?`Q?? ................................................ _ Address ........ 7.9..?!.1......_.JS....u''.....a?5:°:...--a.... ........ X? 2308 Eagan Township Town Hall Date .......... . ............................. Stories To Be Used For Front Depth Height Est. Cost ' Permit Fee Remarks LOCATION Street, Road or other Description of Location Lot Block Addition or Tract 1 701> -/ This permit does not authorise the use of streets, roads, alleys or sidewalks the right to create any situation which is a nuisance or which presents a hazard general welfare to anyone in the community. THIS PERMIT MUST BE EPT ON THE PREMISE WHILE THE WORK IS IN This is to certify, that ..... ....... .........?cr................. has permission to erec the above described preen se subject to the provisions of the Building Ordinance /? 1955. y.? ............_.............. ..... ... T.°-----nwn °-- B ...... d ............. Per . of Ch' / n Poe{_ nor does it give the owner or his agent to the health, safety, convenience and PROGRESS. I a ........... ............ .. .........................._upon e for Ea en Township adopted April 11. ............ c?........per ....................... Building Inspeglor 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 6755675 Fax: (651) 675-5694 ---------------- I For O?ce.l'/Se?L Permit #: L-'J ;4 j Permit Fee: 1 I Date Received: Staff: CL /2_ I ------------------ 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: -?3 " Site Address: J ?' Gee l-s? Tenant: Suite #: RESIDENT / OWNER Name: Phone:l-Q 3t z 1 W 7 r Address / City / Zip: 79 r;> k a Le Lv1 Applicant is: - Owner Contractor TYPE OF WORK Description of work: Construction Cost: Multi-Family Building: (Yes-/ No CONTRACTOR Name: e (lam ?Gxra? License #: Address: City: State: Zip: Phone: Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7672 _ Minnesota Rules 7670 Category 1 _ Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Category Submitted Submitted (J 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 submitare considered to be public information. Portions' of s non-public you provide specrbc reasons that would permit theCify to° Me information may be classified a if conclude that the '.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 % iithh,the approved plan in the case of work which requires a review and approval of plans. xA?-- Ai /uf/ad?e x Applicant's Printed Name Applicant's Si ature Page 1 of 3 PERMIT CITY OF EAGAN uAlertO 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 026211 (612) 681-4675 Date Issued: 08/14/95 SITE ADDRESS: 2079 SHALE LANE LOT: 2 BLOCK: 8 CEDAR GROVE 4TH P.I.N.: 10-16703-020-08 DESCRIPTION: .r I SIDING/DOORS/WINDOWS Building" Permit Type SF (MISC.) Building Work Type ALTERATION i r REMARKS: FEE SUMMARY: VALUATION $18,000 Base Fee $262.25 Surcharge $9.00 Total Fee $271.25 CONTRACTOR: - Applicant - ST. LIC. OWNER: MN RUSCO INC 19420641 0002173 SCHRADER MIKE 7411 WASHINGTON AVE S 2079 SHALE LN EDINA MN 55439 EAGAN MN 55122 (612) 942-0641 (612)688-7903 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 Mn. Statutes and City of Eagan Ordinances. APPLICANT/PERMff EE SIGNATURE ISSUED BY: IG RE I INSPECTION RECORD CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-189 (612) 681-4675 SITE ADDRESS: P . I • N ° LOT: 2 2079 SHALE LAN CEDAR GROVE 4TH PERMIT TYPE: BUILDING Permit Number: 026211 7 Date Issued: 08/14/95 73-BLOCKS a APPLICANT: E MN RUSCO INC (612) 942-0641 7 L- J PERMIT SUBTYPE: TYPE OF WORK: SF (MISC.) ALTERATION DESCRIPTION SIDING/DOORS/WINDOWS I ' "? CITY OF EAGAN, I ?f ' 3830 PILOT KNOB RD - 55122 ??'' 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) ??_? B81-4675 New Canshuetion Reouirements Remodel/Reoair Reouirements ? 3 registered site surveys ? 2 copies of plan ? 2 copies of plans (include beam & window sixes; poured fnd. design; etc.) ? 2 site surveys (exterior additions & decks) ? 1 energy calculations ? 1 energy calculations for heated additions ? 3 copies of tree preservation plan IF lot platted after 711/93 required: _ Yes _ No DATE: v?- 95 CONSTRUCTION COST: ?Q/U? ?a'? `/ 7r 5?d DESCRIPTION OF WORT STREET ADDRESS: LOT / BLOCK SUBD./P.I.D. M PROPERTY Name: 5cA,-gC/P r mr ko Phone #: ??P- ?9° 3 OWNER ' T Street Address• 02079 Srr a /1' MST 492 6 e.. City: ??9-t? Ss/ 2 Z State: ??? Zip: CONTRACTOR ??77 Company: /1?/Q0-PBo? &-s f d) Phone #: 9?/? D?5/? Street Address: 2,V11 /, ?n g/i»??P Sd License #: ? = ? City: G?Cli k State: ?"V Zip. ARCHITECT/ Company: Phone #- ENGINEER Name: Registration M Street Address* City: State: Zip: Sewer & water licensed plumber: change are requested once permit is issued. Penalty applies when address change and lot 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. Signature of Applicant:'47?'?r`?-? OFFICE USE ONLY G?+ [C C EIV r`' Certficates of Survey Received _ Yes _ No AUG 0 4 1995 Tree Preservation Plan Received Yes No -- -- OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 02 SF Dwelling ? 07 4-plex ? 03 SF Addition ? 08 8-piex ? 04 SF Porch ? 09 12-plex ew* 05 SF Misc. ? 10 = piex WORK TYPE ? 31 New A"3 Alterations ? 32 Addition ? 34 Repair GENERAL INFORMATION ? 11 Apt./Lodging ? ? 12 Multi Repair/Rem. ? ? 13 Garage/Accessory ? ? 14 Fireplace ? ? 15 Deck ? 36 Move ? 37 Demolition r r ., 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous Consi. (Actual) Besemeni sq. ii. MOANS 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 Bldg Census Unit APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ /8.000 Surcharge Plan Review License 12 r- UI=w MC/WS SAC City SAC Water Conn. Water Meter - Acct. Deposit ? S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: G/ % SAC SAC Units TIi NAI CITY OF ER^aRN1 PERMIT 383a PILOT :CNOg RD EAC-PN, KN 55122 651-681_4675 EATCII: 832 3-A-L E -S R-A+-T 035--=1 REF: C ZS CD TVr"E7 U159 TR TVPE: FI„'ya If;J: 37847 DATE: 5917, 39 A7:11:47 TOTAL x33.1@ ,OXCT: 417.;,'331478352;.; E}y 01 /09 "'1-31191 I:n:ir.:(?ti{ A'), P 5t IICES Ill TFt F. ;°;T Dr ? " iuT ?a;V '( W°EC1 A:: cT5 TO Fm.wl . 511rr1 xG 5 i }rml 1IE AS. tFZT UITH Ia4+rR A!4 FR IWI ; IV A 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) 3 CITY OF EAGAN b 3830 PILOT KNOB B RD RD - 55122 651-6814675 New Construction ReauhemeMs D 3 registered site surveys showing sq. ft. of lot, s% ft. of house and gH roofed areas (20% maximum lot coverage allowed) D 2 copies of plans (show beam i window sizes; poured fnd. design; etc.) D 1 set of energy calculations Y 3 copies of hee.,presenatkm plan I M plotted after 7/1/93 DATE: ?? I? DESCRIPTION OF 1 STREET ADDRESS: ef%AQ `F4 ?Oti ? D LOT: D- BLOCK: 26 SUBD./P.I.D. #: LQ--? r G Y O U -C -4 T" Name: I W t &b Phone #: PROPERTY Last First OWNER -, , ? , IA, ,-, , Street city Remodel/Reook Reauhemernts 33' / b 2 copies of plan 1 set of energy calculations for heated additions 1 site survey for exterior additions a decks CONSTRUCTION COST: State: al' ° Zip: 9?;l2--L- Company: tom' Phone #• -- ' (area code) CONTRACTOR Street Address: License # Exp, ' City State: ARCHITECT/ TT-? ENGINEER Company: ?t--? Name: ) Telephone #: area code It Street Address: Registration #: city State: Selmer & water licensed plumber (required for new construction only : Penalty applies when address change and lot change Is requested once permit is Issued. I hereby acknowledge that I have read this application, state that the Information Is State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received - Yes No Zip: Zip: comply with all applicabl Tree Preservation Plan Received Yes - No - Not Required OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea. ? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened) ? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage ? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous WORK TYPE ? 31 New ? 35 ? 32 Addition ? 36 ? 33 Alteration ? 37 ? 34 Repair ? 38 GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Width APPROVALS Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair Demolish (Interior) ? 42 Reroof * Give PCA handout to applicant for demolition permit Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Planning Building Permit Fee Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: Census Code SAC Code No. of Units No. of Bldgs MC/ES System City Water Booster Pump PRV Fire Sprinklered Engineering Variance Valuation: $ x SAC Units % SAC L Z g CITY USE ONLY SUBD. #4 RECEIPT#: I C7 ?S- C! ?? D C RECEIPT DATE: i:7-- I PERMIT# /172f?477 1999 PLumBiNC PERmrr (fiESIBENTIAL) CITY OF £A6AN 3630 PILOT KNOB RD KAGAN, MAI 55122 (651) 6$1-4675 Please complete for: > single family dwellings > townhomes and condos when permits are required for each unit > backflow preventer for underground sprinkler system FIXTURES EACH # TOTAL Bath tub $ 3.00 x = $ Floor drain 3.00 x = $ Gas piping outlet ` minimum - 1 3.00 x = $ Hot tub/spa 3.00 x = $ Kitchen sink 3.00 x = $ Laundry tray 3.00 x = $ Lavatory 3.00 x = $ Minimum fee alterations to existing dwelling 30.00 x = $ Private Disposal System new/refurbished ' requires MPC Iic. 75.00 x = $ Private Disposal System abandonment 30.00 x = $ RPZ new installation/repair 30.00 x = $ Rough opening 1.50 x = $ Shower 3.00 x = $ Underground srinkler if dwelling is under construction 3.00 x = $ Underground srinkler if existing dwelling 30.00 x = $ WateF-et 3.00 x = $ Water heater 3.00 x = $ Wa er ener if dwelling under construction 5.00 x = $ Water softener if existing dwelling 30.00 x = $ Water turnaround 30.00 x ---- _ $ State Surcharge .50 > > ----> $ .50 Total > > > .... > $ Ta- G Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc. --- -- ----- -- -- - -- ------------- --- --- --------------- --------"e- - - ---------------- I hereby acknowledge that I have read this application, state that the information is cortect, and agree to comply with all applicablCity of Eagan ordinances. It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement. SITE ADDRESS: oZ©?9 f?Lt ?.f/ OWNER NAME:: aL?T?G?Gc TELEPHONE #: 4rl W51 /IZ`-Z /?? (AREA CODE) INSTALLER NAME: IIW- /0a7zrw- ®6Gn?/d/lr TELEPHONE #: 4:11-1-1 (AREA CODE) STREETADDRESS: -y /60G CITY: y?y/?i®G'T? STATE: /7?,? ZIP: SSIZ2 1-51-1 F RMITTEE S? DATE //- a ff- 7p BUILDING PERMIT APPLICATION Include 2 sets of plans, 1 site plan w/elevations and 1 set of energy calcuations. To be used for I / ??yy• r? i?? Valuation DODO Site Address: Lot Block Sec./Sub. 77-7---- L/z&!'1 1we'w y Owner jJchh 1 -3 aAW?n I1'?I (kimaS Address 26.7 i S hk k k&o t? Parcel Number Telephone ?( G. clv? hN 5? i" - Contractor s/Qy??hn??_??,?/ /f Telephone Address GYy % /KLl92YlLL u?i1l /= YV12vt2Lr? Arch/Eng. Address Telephone OFFICE USE ONLY Erect Alter Repair Enlarge Move Demolish Grade Date of Approval and Initial Assessment, Water/Sewer Police Fire Engineer Planner Council Bldg. Off. Occupancy I.A ?i/35-43 Zoning 15 Fire Zone Type of Const. 4 of Stories I Front /CF w ar't Depth / y Fees D !7 Permit s2 -TA o b Surcharge/ Plan Check SAC Water Connection Water Meter A.P.C. TOTAL 3OF 0 r, 1/0 C, R?AC,E T ID,D r? - G s 5 NA?? LAIC a T 2, 131 cz.l? ?'. P 6-RcO_f- l,? MASTER CARD n U OWNER STRUCTURE AND LAND USED AS • • Permit No. Issued Issued To Contractor Owner BUILDING PLUMBING ?Sd_D Q / 8? 7? t ?8s 1??, ?, ?00? r?'? ??fl? ! 1 ?d CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING GAS INSTALLING SANITARY SEWER OTHER OTHER D 0,4 . Items Approved (Initial) Date Remarks Distance From Well FOOTING j,) 8 ?7 9? 'P SEPTIC FOUNDATION FRAMING JJ ? / CESSPOOL TILE FIELD FT. FINAL ELECTRICAL ---- LL.??? ---- HEATING DEPTH OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD Irv, PLUMBING WELL SANITARY SEWER Violations Noted on Back COMMENTS: COMPLIANCE INSPECTION REPORTS TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS • PERMIT NO. CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ? NO EVIDENCE OF NON-COMPLIANCE OBSERVED. ACCEPTABLE SUBSTITUTIONS OR DEVIATIONS. DATE OF INSPECTION ? NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. ITEMIZED AND DESCRIBED AS FOLLOWS: NON-COMPLIANCE. BUILDER DOES NOT INTEND TO COMPLY. ? COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYED BY CONDITIONS BEYOND CONTROL. ? REINSPECTION REQUIRED REINSPECTION REVEALED DATE OF REINSPECTION CERTI FI CATION -I certify that 1 have carefully inspected the above in which 1 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. ? ALL IMPROVEMENTS ACCEPTABLY COMPLETED BUILDING INSPECTOR COMMENTS: DATE • 1* SEDGWICK HEATING AIR CONDITIONING CO. HEATING JOB NO 046' y OS-- 8910 WENTWORTH AVENUE SOUTH MINNEAPOLIS, MN 55420 (952) 881 -9000 TEST RECORD ADDRESS a O 9 S i Le" L� ia •Q--- CITY ;4 A- N I OCCUPANT Rnf 14 °t :1 L e OWNER SA R.--- SOLD BY in me N o%^) M I INSTALLED BY MAKE Le n/ 9 n E J oD G, e/04(N3 -G' 13 0 9 4 SERIAL NO. 5 ,0C1C-e2� a p Q Nan 8<& r THERMOSTAT e-Se is4/ N VENT SIZE VALVE /Ate,/ ci TYPE OF LINER /CAC'd LIMIT f J, LINER SIZE 6 LIMIT SETTING 7 T FILTERS: SIZE /4A 0 NUMBER FAN SETTING a WIRING L ,t CI e PILOT TYPE jVe-e rm iC TEST TAG IGNITION MODEL C h1 e,AJ l G9 LIGHTING INST. PILOT TIMING f1 4 44' �j DATE TESTED PRESSURE -5 7/3' PERCENT CO INPUT CFH PERCENT 02 COMPANY TESTING STACK TEMP. 3 027 PERCENT CO NAME OF TES FORM 235 (REV. 11/89) FORM DIS IBUTION: WHITE COPY JOB FILE YELLOW COPY CITY City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 2079 Shale Lane Lot: 2 Block: 8 Addition: Cedar Grove 4th PID:10- 16703 - 020 -08 Use: Description: Sub Type: e - Furnace & Air Conditioner Work Type: New Description: Fumace & Air Conditioner Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952) 445 -2840 Fee Summary: Contractor: Sedgwick Heating & Air 8910 Wentworth Ave S Minneapolis MN 55420 (952) 881 -7739 ME - Permit Fee (Replacements) Surcharge -Fixed Total: Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - Owner: Robet W Rutledge 13016 Salem P1 Burnsville MN 55337 Permit Type: Permit Number: Date Issued: Permit Category: $50.00 0801.4088 $0.50 9001.2195 $50.50 I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Issued By: Signature Mechanical EA090406 07/30/2009 ePermit I Use BLUE or BLACK Ink I r________________� I � For Office Use I 'i � � Permit#: ���(1 7' � clty of ����� ; . �� Permit Fee: � I 3830 Pilot Knob Road � � Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I I Fax: (651)675-5694 I Staff: � � I 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: `� +Zi "�� Site Address: Z-�`�a! s"C'4'�� �"'� Unit#: Name: f�i2. �JL�� %�eL>s �oc�� Phone: ' Resident/ o-,9 ��.�- E (�,c�1� Owner Address I City/Zip: Z Applicant is: Owner �Contractor Description ofwork: l�rG.:�s� S,r�G..✓ Type of Work '�' Construction Cost: ZZ 'L� Multi-Family Building: (Yes /No� � � Company: �.��e.,.��,.V �s�c � ��� Contact: �� �S` Address: �o�/ — /2/S� �-�� ..C/.�lN. City: �w s% Contractor ` State:v'W Zip: ���� Phone: 6�L-��_l-5'�SEmail: �v�� .. ��o�� � pr�.y,( .eo�-.�� License#: L'� b3J S'�� 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: � s Mechanical Contractor: Phone: � Sewer&Water Contra � ctor: Phone: NOTE;Plans and supporting documents that you submit are considered to be;public information; Portions of � the informafion may be classified as non-public if you provide specific'reasons fhat would permit the City to conclude that the 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.aopherstateonecall.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. 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 �..�„l ` X ApplicanYs Printe Name Applicant's Signatur Page 1 of 3