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4830 Shevlin Ct�City of➢a 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink Permit #: Permit Fee: �Sb� Date Received: Staff: INFLOWINFILTRATION PERMIT APPLICATION }\ Plumbing / Sewer &Water / J Date: Site Address: Tenant: Suite #: RESIDENT / OWNER Name: 4PA. M4 4 l" / 9 R K0 W `f .. f Phone: (o5 / - 4S2 " 710-3 (� �/ / Address / City / Zip: l /1 J CY3 0 NEW- ` N CpaA Jl ei44,/ 5312.Z. CONTRACTOR Name: License #: Address: City: State: Zip: Phone: Contact: Email: TYPE OF WORK PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope) Sump Pump Repair Repair Other: Other: DESCRIPTION Description of work: - r ' '- 74z X .',t z r�% / icf c" ---C _. If ci / / �/ 11 'c -'/s, de_ FEES $55.00 /Each (includes $5.00 State Surcharge) TOTAL FEE $ *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit Ill repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeaqan.com/inflow, or City Hall at 3838 Pilot Knob Rd. 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.00pherstateonecall.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 nd anal of plans. c Applicant's Printed Nam Applicant's Signature ' thi SEWER SERVICE PERMIT CIT1f OF EAGAN pE~{IT NO.: 37~b Pllo; Ifnob Rea~ D/1TE: Eogen, MN SS1~ ; No. of Units: Zoni~4: _ r. ; ~ r s., Qwner: _ Address: G 3 f - , ~ - Site Address: '.?P~, , Plumber. 1 e~n~ to eon~Pf! ~ the Cily of ~9~~ Connectfon Char9e: Aocourit Deposit: Ordinon~. pe~it Fee: Surcharpe: Misc. CFwr9as: By Total: Dote of Insp.: pate Pcid: I nsp.: cirr cF ~~N WATER SERVICE PERN~IT sr~s Knob Roed Eognn, MN 551~ PERMIT NO.: Zoninp: D/~TE: Owrter, .~o:t 3ecsc,rt NO' of Unlts: r; Address; Slte Address: ~ Shevl.i~ : ~ r , ' t~ ~ , . . Plumber. ~I3SC.^r`:<: ' ` i a' • , Meter No.: Size: Connection ~r9e: ~ Reader No.: Account Deposit: ~ ~ Permit Fee: • V~1 wlfi~ H~~ Ciryr of Eagos Surchnrge: Ordlnsnpa, Misc. CFanpes: ~ BY Totol: Dote of Insp.: ~e Poid: Insp.: . ` . :.l'71R~- . '~~iR,~.~ ~ . ~ CITY OF EAGAN : 18443 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # ' To be used for rIIt6PLACE Est. Value =1 oate ~T 9 , ~ g~ Site Ad ss ~3Q SHEVLItd CT Lot BIOCk Sec/Sub. A~Y ~ OFFICE USE ONLY PBfC@I NO. Occupa~cy - FEES ADAM NAPIORYQYSKI zoning - x 5. ~ ¢ Name (Actual) Const _ Bldg. Permit 0 H o Address (Allowable) - Surcharge ' ~ City Phone - ~ oi Stones _ Length Plan Review =p Name s~E Deplh - SAC, Ciry Address S.F. Total - SAC, MCWCC ~ City Phone S.F. Footprints - ~ On Sile Sewage _ Water Conn yVj'W Name On Site well - Water Me~er Address Mwcc Sysiem i W Clt Phone City Water _ AccL Deposit Y PRV Required _ S!W Permit I hereby acknowlege that I have read this application and state that the Booster Pump - S~W Surcharge information is correct and agree to comply with ali applicable State ol Mfnnesota Statutes and City of Eagan Ordiryances: • ~ Treatment PI SignatureofPermitee L- . ,~~,~~-i/~~L' APPROVALS RoadUnil A Building Permit is issued to: ~pIORKO~i'SK; Planner - park Ded. on the express condition thal all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. g~~. pry. _ Copies ~s. ~ Buiiding Official - ~ • - Variance - T~TAL Permit No. Permit Halder Date Telephone # WATER SEWER PLUMBING H.V.A.C. ELECTRIC lnspection Date Insp. Commenis Footings I Foundation Freming Roo(ing Rough Plbg. Rough Htg. Isul. Fireplace Z Z~ U..S Final Htg. Final Plbg. Canst. Meter Plbg. Inspecior - Notify Plumber Engr./Plan BWg. Flnal Deck Ftg. Dedc Final Well Pr. Disp. • T CITY OF EAGAN ` ' ~795 'ilot Kno~ R~ad Ee~an, MN SS122 1~ cz. : • R ° ~ • (l.~(•r ~ PHONEs ~S4-e100 BWLDING PERMIT RK~r~ # ' ' ~ Te w~d Me SF DWG/GAR Est. Vclue 57~).Q00 ~e ~+S~~ch 3A , 19~'~ Slte llddress 4830 ~~vlin Court Ercct ~ Occuponcy R-~ Lot_~_ Block~_ Sec/SubRrittan}~~~t}L_ Alter ? Zoninq Porcel #_.~f~ ~~y~~ ~~.Q~n~ Repoir p Fire Zone Na Enlor+pe ? Type of Ca~st. `1 W Name Tnl 1 afgnn Rni 1 Aorgr Tnr _ Move ? # Stories ~ ,~reg 1 fi55 Nnrr..n nr j,va Demolish ? Length_4~_ G phone 4 S4-6R7 ~ Grode Q Depth ~~Sq. Ft. °C Name ~ler APP~~ols F~e~ 0 /lddross ^ssessment Permit ~n ~ Cft ph~ Water 8~ Sew. Surchorpe G~ Police Plan check ~ ~~~~T ~yW Nome Firo SAC S? s nn H Address Enp. Water Conn4.~.~ ~ W C~ pha~ Plonner Water Meter .~..0~, Council Road Unit ~ 5n _(1f1 I hereby ackrawledge that I have reod fhis opplication nnd state ihat Bld~. Off. the info~mation is correct ond ogree to comply with all applicabls ^PC ~-~a~ R34 _ 5(] State of Minnesota Stotutes ond Gty of Eagon Ordino~ces. Sipnoturc of Permittee ^ Building Pem+it is issued ro: Tollefson Builders , Inc. or, ths express condition Ihnt oll work shall be done in occo?dante wlth all opplitoble State of Minne Stotutes ond City of Eayan Ordinonces. Buildin4 Offlciol • P ~ ,v - . PNmit No. Po?mit Holder Misc. Parmit No. Holder Plumbing ~?J. g~~ Z Q g.-g3 ~ t H. V.A.C. ~ Z- ~ ~ I ~ ~ WNI WKsr • DisP. . Sower EkMric ~/0~1~tZ ~f[1'~ "Z~-~ Ir~spection D~te Insp. Othei Footinqt ~ l~- ~ Found~tion Fnminq -9_ Rouph Plby. ~f_ZC ~ Rouph HVA y~~ ~ ~ Inwlation _ 3 Final Plb~ - l~ Final HVAC ~ ~ ~ Finsl W~r Wsuib~ Location: YVell - S~wer ' Pr. Oi~p. ' r ~ ~~-~a.~~-~~,~~-~- ~ ~ '~,H , ~~"~?`°~`~T~~~}~.Y ~ ' '1~P' ~ew `I~F" wo? ~~f' °1~P ~ "cm°' ~ ~ ; d-~ ~ ,mt~ ~ ' ~_~,t~ _ .-.cn~c•~~i-~+R-L~~ 4••>.~ _Trc",R.`~L2:~`~~ ~~~'-v=~t1~~~~'LyT.~:.r:-c:~«~cS='~i~ " ~ d~ . _ • _ - - - - ~ ~ ' ~ ~ C~~r#tftrttf~e nf (~rru tt~r~ ~ ~ , 4~. r, ~ ~ ,r, Y~ ~ , ~ ~Cit of ~agart ~ ' I.~ 'j ~ ~ ~ t' ~p ttrtm~tt ~ ~iriid'm ,~as ertimt ~ ' . r , ~ ~ 9 ~ r~~,:, ~ ~ Buildi~ ~ i.~ ~'bfs Ccrti f t[AtC tJSTltl1 ~N>.fAltiMt 1R lIX fYqXlfCAlCttlJ Of Scctron 306 0/ thc Unrform g ~ Y~ Codc catif ying that at t/x ti~nc o f is.tt~a~rct tbi~ strurturc was in com plianu with tbt variout ,;~~y; ' ordinanat o tht Cit re ting building connrrution or rue. For thc f ollouhng; s ~ f 1 8~ _ F ' , . ' ~ SF DWG/GAR Blde.hminNo. 7852 ` ~ ~..i w. ~m ~ ~ Rl ~ ` r~; ~,w~r ~'ra ~ iYa c~u~ V u~~. NA a.~ y`,~ Tollefson Builders 1655 Norwood Dr. , Eagan ~ ~ d, 4830 Shevlin Court ~ryLot 15,Block l,Brittany 4th;r~~~ ~ ~ ~ , ~ . ~ or: R y, o~ ~u: June 10 , 19 83 ` 9~_ ~ 'WT ~N CON~M<UW~ R~CI ~ ~Y~ - - - - - - - ~ ~`'_I `~•~.yy~~ _ . .y_ : a~ •~~-i_o`i•:~..-~a~..Sa~'.i~'' y is. - ~ . ,a~ ~.L . . ~ - , . ` . r. F1~ ~ . ~ a . ~ °~:5,:~~.,~~,4~~,,~ j^~. : _,~~~~.~-~~~?~~.-~.d~~~.1~ .~'~'~d„~"~ _ , ~ _ Recelpt r MECHANICAL PERMIT Permit No. CITY OF EAGAN ' ; Fee fill in numbered spacss S/C Type ar Prin[ legib/y Tot. 1. Date 2. Installation Cost 3. JobAddress ~ Lot~Bik. ~ Tract`='~ ' ~~<<,~' ~ 1 ~ `f 4. Owner ' i ~ F- u" _ ~ . ~ . ~ _ . _ - 5. Contractor 1 Phone • ~ 6. Address ' - ~ 7. City -r-, ~ State - Zip , 8. Building Type: Residential ? Commercial O Institutional O 9. Work Description: New C3 Add O Alter ? Repair ? 10. Describe Fuel Type 11. No. F,~uioment BTU - M. Ea. ; No. Enuiament CFM Forced Air Air Handling: Mfg, Boilers Mech. Exhaust Mfg. Unit Heater Mfg. Other Air Cand. Mfg. Gas, ~ping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. , _ Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-8100 , ~ J Receipt j~ PLUMBING PERMIT Permit No. 3~ CITY OF EAGAN ~ . Fae ~ - Fil1 in numbered spaces S/C Type or Print legibly .r~ " ~ ~ - i-- ] - 1. Date , ~ ~ 2. Installation Cost ~ . `-y ` ? . ~ 1, ~ . 3. Job Address Lot Blk. Tract i 4. Owner "r'^/~- l>v . :-~i - 5. Contractar~ = t1< ' - ~ ~I ~ Phone = ~.S /~i ~j' 6. Address ' - %i~~ ~ -1 S ~•'~,'1 ~ 7. City v, ~ State t'V " Zip ~ G r' % 8. Building Type: Residential Commercial O Institutional ? 9. Work Description: New ,BL Add ? Alter ? Repair ? 10. Describe 11. No. Fixtures No. Fixtures Water Closet Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner ' Shower Well , Kitchen Sink T Urinal/Bidet Other ~ ~ ~ Laundry Tray ~ a;~ % Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for ; ; . Rough F inal Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 weearveo FROIi~ AMOUNT $ I ~ DOLLARS ~oo ? CASH ? CHECK F~R FUNO GOOE AMOUNT Than You ~ ~ BY / VYhite-Payers Copy ~ Yellow-Posting Copy Pink-File Copy CI7Y OF EAGAN Remarks />ddition BRITTANY 4TH ADDN ~ot 15 e~k 1 Parcel 10-15U03-150-O1 Owne~ St~eet 4830 SHEVLIN COURT state EAGAN MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF, i9HZ 452.94 90.59 S 271.78 A012378 6-23-83 STREET RESTOR. GRADING 1981 23.82 1.59 15 19.08 AO - - SAN SEW TRUNK 1976 173. 90 11.59 15 8• AO - - * SEWERLATERAL / 19$1 246.32 16.42 15 1~ Sewer Lateral trk 1983 133.33 8.89 15 106.6 WATERMAIN 1984 629.29 62.93 10 ~F WATERLATERAL 1981 15 WATER AREA / 1981 229.95 - 23.00 10 160.98 A012378 6-23-83 STORMSEWTRK 1981 596.40 39.76 15 477.12 A012378 6-23-83 * STORM SEW LAT 1981 iS CURB & GUTTER SIDEWALK STREET LIGHT ROAD UFIT 250.00 3502~ -30- 3 WATER CONN. 50.00 ~UILDING PER. $2 SAC 2 n n PARK Tollefasn Buildera Inc. Or.113d6 183-77A . ~ / JACKSDN = SURVEYORS ~ , . ,..S~C~~e'J~- ~d~ . R~61iTtRtA WNp[R LAWf 0I iTAT[ OF MINN[fOTA ~ r t.rl . . . ~ r~. ¢ G~~ sc t~~ ~ n f ; . . 381B EAST 66tt~ STREET, MINNEAPOLiS, MN 55417 Tl7-3484 / . ooo.. _ -x/'~- ~~rl~ L'ev, ~ ` • $lttbtpOC'g dti't{fiuttt - ~''f'~ / rl ~ y ~ ~ . ~ ' ~ i~t ~ , ~ - o : ~ ~ ; . ; h ' . a ~Q~. .~~8---------~h - . . ~o. + _ ~ . - . _ ~ . . _ -c`~` ~ •o~ ti 40 ~ . / ~ ~ ~ ~ ~ ' b ~ ~ Fe~ ='r" - . . ~ ~ ~ ,r . ~1 , e r/~ 1_ Ca T I 5 j'~ '1 ~ ~ ~ v ~ fj' . ~ . ~~S G~ GE : . . . . ~ ` I , ~ . ~ 1i 6 .~Q'~ Z ~ ~ r ~ 11 , 3 y`- ` _ , ~ ~ ' _ ~40e ' Z - i•y ---"E--^ .Z_.'~__ , ~ ~ ~ r`~, i°'` ~ ~ I `~1`~ ~ : , ~ . ~_l-J I 1 v ~ 3° i ~ ~ ~ ~ ~ . - - ~ ~ - • . . . . . 1 M[R[~Y C~1ITIFY TMAT TN[ ASOVt If A TRYt AND CORRtCT rLAT OR A~UI~YlY 0/ Lot LS,Dlock 1~4ri[tar?y 4th. Additi~A, / pak~ta Caunty,Minnes~ta. ~ P~CV~r~d Oai~tg~~!'~~r'` ~ , . . Pr~p~sed First F'loor 81ev. 105.5 • ~ P~eoFoaed sase~aent Flo~= Etsv. 9~.5 A~ •URVtYED ~Y M[ TNIf---11Ctl-.-p~,Y Of-~-r~it A.D. 195~ ~f . ! ~ i SfGN[D ` ~ ` 1 F. C. J/1CK30N. MINML~17 R[o1sT~eAT~oM. No. 3d00 ; This rBpuesl wid ~ ,e~ ~s,~, I ~-~-85 A 0 1. L1 o I ~Y ~ a.0. ~il Request Oa Fira No. Hoveh-'o Insper.tion iiepwred? Heady Nuw Q W~II Nolity, InsOec- / ?Yes ?No ~or When Peatly ? ljcens d Electrica~ ConVactor ~ herebY raCuast inspection of abova ~y~ Owner elecfrical work inslalled et Sheet Ad~d/ress, Box or Floute No. ~ City . 7~3° ~Lt¢v~~h ~0~.%7~' ~h ecUOn a. Towns~ip Name or o. angc No. Counly ~ va,~~ OccuOantIRllNTI ~ / / ~ Phone rNo. .~7 7 ~ ' q~cct-. ~ /L/Gt, / 0 /'/e~° W f K / U o~ - ! ~ ~ ( Power Suppli/er / ~ qAEress ~.~.hr`J~/i ~CuG'T l71Jh. Yw+i ~ oh ///h. Electrical Conirector ICOmpany Name) Contracmr's License No. ~~~~~a p.tldress (COntractor or Owner Maki~p Iretailationl Authorized SiB~amre (COntracmr Owner Makine ~~siallation) Phone Numbar MINNE$pTA STATE BOARD OF ELECTIIICIR' THIS INSPECTION REQUEST WI~L NOT aripgs-MidweY Bldg. - Room N-191 ~ BE ACCEPTEO BY THE STATE 80APD UNLESS PPOVEH INSPECTION FEE IS 1621 University Ave., St Peul, MN 55104 P~o~q ~61Z~ 29~-2~~~ ENCLOSED. ~ Q~ l~( R~aUEST FOR ELECTRICAL 1NSPECTION Es-ooooi-a u ' Sao i~siruetions for completlFp L~is /mm m bacl~ 07 vellow copY. 1 ~ A ~S "'X" Be/ow Wo~k Covered by This Requesf ~ Ad Rep. Type ot Builtling Applinnees VPireC Equipment Wired Home Range Temporary Service Duplex Water Heater Lightiny Fixtures ' Apt. Buildinc~ Dryer ElecVic Heatin Comnercial Bldg. Pumace Silo Unloader Industrial 81dg. Air Conditioner Bu~k Milk Tank Farm [her Pec~ OtherlSOecltyl c,. su~o~rr . o, . o~n,,. LY o J ompute lnspection f'ee Below # Fea SarviceEntranceSlze k Fee Feedars~5ubfeeders p Fn¢ Circuits Oxo200Am s Oto30Am s Otn30Am s Above 200 qm - 31 to 100 Amps 37 to 100 A s Swirmnin Pool - Above 100_Amps Above 100_Am 5 Transformers ~rrigation Booms Partial~ Other ee Signs Specia~ Inspec[ion S~ ~ SU` TOTAL F ertarks Rouph-in ( f} 4 I, the Ele trical ~~SDec[oq erB c rtity that e above Final ~~e i~spaction has been r' mede. Ttdt rapueet m1E 1B monlln irom . , CITY OF EAGAN o ,7882 9795 Plbf Knob Read Eagen~ MN SS122 • VHOHE: 4S4B100 ~ J~~ .UILDING PERMIT keceipt # Te M u~ed ior SF DWG/GAR E~,ya~~ $70~000 Date ~YCh 30 ~q 8~ S~ro Addreu 483Q Shevlin Court E.ect gy Occuponcy R-3 Lot 15 Block $et/SubBrittany 4th Alrer ? Zoning R-1 parcel # 10 15003 150 Ol Repoir ? F~re Zone NA Enlarge ? Type of Const. V w Name Tollefson Builders, Inc. Move O # S~ories Z qddrc~y 1655 Norwood Drive pe,,,o~;~ 48 ' ~ Ea an 55122 454-6873 Grode ~ Length_ Ci S ph~ ? Depth 40 Sq. Ft.- ~ Ne~ Owner Approvob Fees Addreu ' Assessment pertnit 343.00 CI php~ Water & Sew. Surcharge 35. ~0 Police Plan check 171.50 ~W Name Fire SAC 525.00 Addrese Eng. Water Conn!{$Q~.!](L iW Ci Phone Planner Water Meter 60.00 CaunNl Rood Unit 25~.~~ 1 hereby atkrrowledge thot I hove reod this opplicotion ond state that BIdO. Off. fhe informotion is correct and ogree to wmply with oll applicable APC Totol $1834.50 Stata of Minnesoto Stotutes and Ciry of Eoqnn Ordirwnces. SiOnoture of PermiMee ! o e son ui ers', nc. A Building Permit is iaued fo: on fhe express conditlan Ihm oll work shall be done in accordanta with all opplicable ,$tu ~ ~il - a~ ond C oi Engen Ordinonces. 8u71dfn0 Offidal i'l, v 1 ~ 5 , Q~ ~ CITY OF EAGAN Include 2 sets of plans, , ~ (J 1 site plan w/elevations & UILDING PEFdNIT APPLICATION 1 set of.energy calculdtions. , ~ Zb Be Used Fbr Valuation ~,/)n 0 Date ~~~ij l C~+ IG y__.J Si~ ~SS ~3a ~v~~~ (XC(/f OFFICE USE ONLY Iot ~S 91ock J_ sec./sub. ~ Erect ~ Occupancv 3 Parcel I D I50e7 ~ 150 0 1 A7-ter Zonin4 J Repair Fire Zone Owner: Erilarge _ 'lype of Const. Address: 1`'b~ # Stories Danolish Front ft. City/Zip Code: Grade Depth ~_ft. Phone APPRL)VAIS FEFS contractor: _Lnll2~nt~ ~LU IC~21~S, `Cv~C~. assessments Pexmit ~ ~Y3 - , Address: l~~j~~~~41f~LT~ l~t~. t4ater/sewer surcharge ss~2 Police Plan Cl~eck~~~ City/2ip Oode: ~GQl~1 .~aSl~a, Fire SPr ,~--a~--°-' Phone !~5/-~ -~~~7.~J ~J. Water Conn. ySO ' Planner Water Metex ~p<~ Council Fi~ad Dnit ZSD~oO Bldg. Off - i Address: APC City/Zip Code: Phcane ZC7R'AL r~ ~ ~ ~ ~`G~N v ~ ~ ~on Qn ~ O q CITY OF EAGAN NO ~ 8443 3830 Pilot Knob Road, P.O. Box 21-799, Eagan, MN 55121 PHONE: 454-8100 ~ ~ ~ f BUILDING PERMIT Receipt # To be used for FIREPLACE Est. Value $1, 000 Date OCT 9 , ~gQ~ SiteAddress 4830 SHEVLIN CT 15 1 BRITTANY 4TH OFFICE USE ONLY Lot Block Sec/Sub. PBfC@I N0. Occupancy - FEFS Zoning - W Name ~~1M NAPIORKOWSKI (ACtuap Const - Bldg. Permil 25.00 o Address 4830 SHEVLIN CT (Allowa0le) - Surcharge .50 City EAGAN Phone 687-2698 :rots~o~ies _ Length _ Plan Review g Name SAME DeO~h - SAQ City ~a AddfBSS S.F.Total - ~ Clly Phone S.F. Footprints _ SAC, MCWCC On Site Sewage _ Water Conn ~ ~ W Name On Site Well - Wa~er Meler i~ Addf855 MWCCSyslem - ~i Acct. Deposil aW City Phone cirywater - PRV Required _ 5/~N Permit I hereby acknowlege that I have read this application and state that 1he Booster Pump - SM! Surcharga information is correct and agree to comply with all applicable ate oi Minnesota Statutes and Ciry ot~n Ordin c. / ~ Treatmenl PI i ~'4- APPROVALS SignaWre oi Permitee w"-" ~ ~ c~~ Road Uni1 A Builtling Permit is issued ro: ADAM NAPIORKOWSKT Planner - park Ded. on the express condition that all work sha11 be done in accordance with all Council applicable State o~ Min{n~esota StaWtes and Ciry~o/l Eagan Ordinances. BmgAtf Copies BuildingOtticial t`~{A ~01l~. ~ rnI1 Variance - TOTAI Z5.50 a~ This reqvesl void ~`pc ` L, 15 ~ b f+ 2~~~,~~ iy A~ LL~ 3s 3 q~ 18 months trom Q~ l~T'•• ~ ~90~6225 c~7ts6 ftequesl Date Fire No. RouHh-in Inspeclion R q rvd? ~ReaAy Nuw Will NotiiY Inspeo- - t~' ~ Yos ?No lor~hen Reedy LicenseA Electrical Convector I hereby repuest inspaction of above Owner electiical work ins~elled at Sveet Atldress, Box o~ Route No. Ciry . . ~lJ ~V W ~ ecl~on o. Township Name or No. Range No. Cowrty_ 1 -+CJLiL Occup~ nt IPAIt~TI ~ Phone Nu. ~ Power upplier Atltlress Elecvical CnnVac~or IComDany Name) Con[ractor's License No. 3- Mailing AdJresS ntractor or Owner Makin0lnstailation) ~ • Iv v'l-{ Author¢ed (COmracmr~Ow er kine Installationl P one Number ~ ~ MINNESOTA STATE BOARD OF ELECTqICITY THIS INSVECTION flEQUEST WILL NOT G.ie9s-Midwey Bldg. - Roam N-791 BE ACCEPTED BY THE STAiE BOARD UNLESS PflOPEH INSPECTION FEE IS 7821 University Ave.. St. Peul. MN 55104 ENCLOSED, . REQUEST FOR ELECTRICAL INSPECTION ~ EB-00001-U-0 , See inanuctions lor completing this form an back ot Vellaw caoV. ~X~ Be/o~ ~ ik `C~e~ d by This Request . . 3c.,?~R ~ e AAtl Nap. Type Of Building Appliunctl5 Wiretl EquiU~~Bn[ Wired Home Range Temporary Service Duplex Water Heater Lightiny fixtures Apt. Buildinc~ Dryer Electric Heatin Commercial Bldy. Fumace Silo Unloader Industrial 01dg. Air Conditioner Bulk Milk Tank Farm O ~harf5nor.it~1 t er uou(v Ot r Olher Compute lnspection Fee Below p Fee Service EnVencaSixa k Fea Faeders~Sobtaeders N Fee Circui~s U to z00 Am s 0 to 30 Am s 0 ca 30 Am s Above 200 qmps 31 to 100 Amps 31 to 100 q s Swimming Paol A6ove 100_Amps Abave 100_Amps Transtormers Irrigation Boorc~s Partial~'Other Fee Signs Speciallnspection 5 ~ TO FEE Nemarks , Roaeh~in l .Dace o `p°F:~.i',w~l_' ~ CPI nspector, ~eraby certify that the ibove Final ~ ~/r , D=,`e ~ ~ '~spection has bean ~ ~ tle. 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't ~ . , ' 'ti' , +~`~Y , i 7 : ~.~'r ~ ° ~ ~ - ; . . - ~ e • r. _ ~ i.~3 }i ~i. i.fi ".16.SIL' -~'y'...~.~-.:.1L'~' I~.7tii_`i-I I~t~.n'~~ ?.il.~.CJ~ ~:t~~siY ~ n ' '.~.I~ 7 . l' Lii ~ ~ ~ 6~_~~YJ'~ . i ~b~-~~~}'.1 L~/• ~p'l ~ l~ ~ uly~;•:.y,yi.u....al~~_~4~~..+Y.11~_'.u+~~.. ~ ~$~3 1490 BUILDING PERMIT APPLICATION CITY OF EAGAN SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS I SET OF ENERGY CALCS OF RENTAL UNITS OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PEAMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUIL?ING PERMIT IS ISSUED. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN GOMPLETED. PERMIT MUST SHOW A LICENSED PLUMBEK. To Be Used For: I~~ £ Valuation: Date: ~~/s/S C~ ~J`+Site Address ~,34 ,Srye?%i, (.or.~~ ~ OFFICE USE ONLY Lot ~ Block / FEES Occupancy Zoning o? Parcel/Sub ~jq,~,.,, /~i~ Actual Const Bldg. Permit ~J A Allowable Surcharge ~ Owner .f/DAM NAP/oRKoW.T/~/ # of stories Plan Review / Length SAC, City Address y-830 ~6uv~in G~ Depth SAC, MWCC S.F. Total Water Conn City/Zip Code ~s~v~ ry/n S t~Z-Z- Footprint S.F. Water Meter ~ ' w~•~ Acct. Deposit Phone ~J".~-79°3 ~ro~~-Z69~ On site sewage_ S/W Permit On site well _ S/W Surcharge Contractor MWCC System _ Treatment P1. City water _ Road Unit Address PRV Park Ded. Boostex Pump _ Copies City/Zip Code SUBTOTAL APPROVALS Penalty Phone Planner TOTAL i-C7 Council Arch./Engr. Bldg. Off. Variance Address City/Zip Code Phone # I 5,_ ~ i pji` ~r~~ ~+y ~ DAK 544 ZONING - NOTIFICATION OF INTENT C~/~~D~UG ~ I ~ Foster Family Homes Day.Care Homes To: - _ - (Muaicipality o Political Suh-Division) ~~95 .C/i~~ ~a! {Street Addrese) ~ `7'y)n, ss / (Cf (State) (Zip) FROM: Dekota County Social Services 357 9th Avenue North So._St. Paul, MN SSU75 APPLICANT: ~(/i~1~JQ ~ 7YCk~C2/~`7 / /q=~~Zl~`-t-uu-iC>~ (Name) . , ~ .~~-u-C.~n: ~ (screet _i `~"h~ ~ ss ~ ~ ~ (Cit (State) (Zip) N~ber of Natural Ch3idren under 18 ia home: 0 Q 2 3 4 Sf'. (circle avmbar) Numbar of Foater Children iacluded in licenae:~l 2 3 4 5 6 7 " circle number) Number of Natural Preschool dhildren in.Home: 0~ 2 3 4 5 (circle rn~mber) Number of Day Care G7iildren included in 1lcense: 0 1 2 30 5 6 7 8 9 10 (circle nmaber) DATB OF NOTZFICATION: / 9 - City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4830 Shevlin Ct Lot: 15 Block: 1 Addition: Brittany 4th PID:10- 15003- 150 -01 Use: Description: Sub Type: e- Reroof Work Type: Repair Description: House & Garage Census Code: 434 - Zoning: Square Feet: 0 Comments: If there is no ice protection inspec acceptable in lieu of inspections. Fee Summary: Valuation: 3,000.00 Contractor: Gopher Company 2701 36th Ave S Minneapolis MN 55406 (612) 331 -1555 BL - Base Fee $3K Surcharge - Based on Valuation $3K Total: Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - Construction Type: Occupancy: on prior to final, you must meet inspector with ladder and flat bar. Pictures are not Owner: Adam Napiorkowski 4830 Shevlin Ct Eagan MN 55122 Permit Type: Permit Number: Date Issued: Permit Category: $88.50 0801.4085 $1.50 9001.2195 $90.00 Issued By: Signature Building EA083927 06/30/2008 ePermit 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